Carlos Haruo Arasaki

Response to Dietary Oxalate after Bariatric Surgery

BACKGROUND AND OBJECTIVES Bariatric surgery (BS) may be associated with increased oxalate excretion and a higher risk of nephrolithiasis. This study aimed to investigate urinary abnormalities and responses to an acute oxalate load as an indirect assessment of the intestinal absorption of oxalate in this population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Twenty-four-hour urine specimens were collected from 61 patients a median of 48 months after BS (post-BS) as well as from 30 morbidly obese (MO) participants; dietary information was obtained through 24-hour food recalls. An oral oxalate load test (OLT), consisting of 2-hour urine samples after overnight fasting and 2, 4, and 6 hours after consuming 375 mg of oxalate (spinach juice), was performed on 21 MO and 22 post-BS patients 12 months after BS. Ten post-BS patients also underwent OLT before surgery (pre-BS). RESULTS There was a higher percentage of low urinary volume (<1.5 L/d) in post-BS versus MO (P<0.001). Hypocitraturia and hyperoxaluria (P=0.13 and P=0.36, respectively) were more frequent in BS versus MO patients. The OLT showed intragroup (P<0.001 for all periods versus baseline) and intergroup differences (P<0.001 for post-BS versus MO; P=0.03 for post-BS versus pre-BS). The total mean increment in oxaluria after 6 hours of load, expressed as area under the curve, was higher in both post-BS versus MO and in post-BS versus pre-BS participants (P<0.001 for both). CONCLUSIONS The mean oxaluric response to an oxalate load is markedly elevated in post-bariatric surgery patients, suggesting that increased intestinal absorption of dietary oxalate is a predisposing mechanism for enteric hyperoxaluria.

Lean and Fat Mass Loss in Obese Patients Before and After Roux-en-Y Gastric Bypass: A New Application for Ultrasound Technique

ObjectiveThis study aims to evaluate the thickness of the femoral quadriceps and biceps brachii and brachialis muscles bilaterally and the adjacent subcutaneous fat in patients undergoing gastric bypass Roux-en-Y before and after surgery, using ultrasound as the diagnostic method of choice.MethodsWe studied 12 patients undergoing this surgical method preoperatively and during the first, third, and sixth postoperative months. During these periods, patients were evaluated by ultrasound to determine the thickness of subcutaneous adipose tissue and muscle of the upper and lower limbs.ResultsPostoperatively, these patients showed a reduction in the thickness of the upper and lower extremities muscle and adipose tissue as compared to their preoperative values. There was a significant difference in the loss of muscle thickness in all postoperative months and in the thickness of fatty tissue in the sixth month after surgery, compared to the preoperative muscle and fatty tissue thickness.ConclusionsUltrasound can be considered as the diagnostic method of choice when assessment of the fat and lean body mass is required in morbidly obese patients before and after bariatric surgery.

Postprandial Adiponectin Levels Are Associated with Improvements in Postprandial Triglycerides After Roux-en-Y Gastric Bypass in Type 2 Diabetic Patients

BACKGROUND Postprandial hypertrygliceridemia is a known factor for cardiovascular disease and is often observed in patients with type 2 diabetes mellitus (T2DM) and visceral adiposity. Adiponectin is a hormone with antiatherogenic and anti-inflammatory effects, which decreases in obesity and T2DM subjects. The weight loss induced by diet or bariatric surgery could be restoring adiponectin levels. OBJECTIVE The aim of the study was to evaluate the impact of weight loss induced by bariatric surgery, which could restore adiponectin and triglycerides (TG) levels in obese and diabetic patients. METHODS Ten patients with T2DM (BMI 39.3+2.44) were evaluated before and at 7 and 90 days after Roux-en-Y gastric bypass (RYGB). A meal test was performed and plasma insulin, glucagon-like peptide-1 (GLP-1), glucose, TG, and adiponectin levels were measured at fasting and at 30, 60, 90, and 120 min postprandial. RESULTS Seven days after surgery, significant reductions in the insulin resistance were observed, while TG and adiponectin levels remained unchanged during the meal test. Ninety days after surgery, TG and glucose levels decreased significantly at fasting, and postprandial, adiponectin, GLP-1, and insulin curves increased significantly after meal ingestion. Both changes in the area under the curve (AUC) of adiponectin correlated with changes in the AUC of TG (R=-0.64, P=0.003) and changes in AUC of adiponectin correlated with changes in total fat mass. No correlation was found between changes in insulin, GLP-1, and TG levels. CONCLUSIONS The adiponectin levels may be involved in the mechanism responsible for high TG levels in obese and diabetic patients. These abnormalities can be reversed by RYGB.

Oximetria do estômago: estudo comparativo entre vagotomia gástrica proximal e seromiotomia da curvatura gástrica menor anterior com vagotomia troncular posterior na úlcera duodenal crônica

Retardo do esvaziamento gastrico de alimentos solidos ocorre mais intensamente depois de vagotomia gastrica proximal (VGP) que apos seromiotomia da curvatura gastrica menor anterior com vagotomia troncular posterior (SMAVTP), podendo estar relacionado a hipoxia da parede gastrica e, principalmente, do marcapasso gastrico. OBJETIVO: Determinar a repercussao da desvascularizacao cirurgica da curvatura menor e do fundo gastrico no estomago como um todo e, particularmente, na regiao do marcapasso. METODOS: Mediu-se a saturacao de oxigenio da hemoglobina (SpO2) intra-operatoria, por oximetria de pulso, da parede gastrica anterior em 20 portadores de ulcera duodenal cronica, alocados casualmente em dois grupos de 10 pacientes para tratamento cirurgico por VGP ou SMAVTP. RESULTADOS: As medicoes, obtidas antes de fundoplicatura parcial, mostraram que o fundo gastrico e a curvatura menor proximal tiveram reducao significante da SpO2 quando comparados ao corpo gastrico (p < 0,05); que a SpO2, na regiao do marcapasso gastrico, nao sofreu alteracao estatisticamente significante; que a associacao entre ligadura dos vasos gastricos curtos e VGP ou SMAVTP reduziu significantemente a SpO2 (p < 0,05); e que a tecnica da VGP resultou em SpO2 significantemente menor que a SMAVTP (p < 0,05). CONCLUSAO: A VGP, quando associada a ligadura dos vasos gastricos curtos, produz alteracoes isquemicas agudas da parede gastrica, na regiao da curvatura menor proximal e do fundo gastrico, mais intensas que a SMAVTP. A regiao do marcapasso gastrico nao sofre hipoxia imediatamente apos os procedimentos operatorios.

Identification of suitable reference genes for miRNA expression normalization in gastric cancer

Please cite this article as: Ana Carolina Anauate, Mariana Ferreira Leal, Fernanda Wisnieski, Leonardo Caires Santos, Carolina Oliveira Gigek, Elizabeth Suchi Chen, Jaqueline Cruz Geraldis, Danielle Queiroz Calcagno, Paulo Pimentel Assumpção, Samia Demachki, Carlos Haruo Arasaki, Laércio Gomes Lourenço, Ricardo Artigiani, Rommel Rodríguez Burbano, Marília Arruda Cardoso Smith , Identification of suitable reference genes for miRNA expression normalization in gastric cancer. The address for the corresponding author was captured as affiliation for all authors. Please check if appropriate. Gene(2017), doi: 10.1016/j.gene.2017.04.016