Short-term outcomes of laparoscopic gastric plication in morbidly obese patients: Importance of postoperative follow-up

Demand for feasible, safe, and preferably low-cost methods of weight reduction is rising every day. The present study reports findings from laparoscopic gastric plication (LGP), which is a new restrictive bariatric technique, combined with a postoperative follow-up program. A 2-year prospective study was performed following LGP in 53 female morbidly obese patients from Gorgan, Iran, with a mean age of 36.3 years and mean body mass index (BMI) of 42.6 kg/m2 (35.3-62.4). Through a four-port approach, the greater omentum and short gastric vessels were transected and the greater curvature was imbricated into the body of the stomach with two rows of nonabsorbable sutures. After surgery, all patients were scheduled to attend a weekly group meeting for behavioral modification and psychotherapy. The mean operative time and hospital stay was 95 min and 72 h, respectively. No intraoperative complications occurred. Mean percentages of excess weight loss (%EWL) were 25.6 %, 54.2 %, 70.2 %, and 74.4 % after 1, 6, 12, and 24 months, respectively. Six patients lost >84 % of their excess weight after 24 months. Patients who did not participate in the group meetings had a lower %EWL after 12 (79.5 % vs. 55.6 %) and 24 months (90 % vs. 43.4 %) compared with the patients who regularly participated in the group meetings (P < 0.005). LGP is a feasible, safe, and effective surgical method for weight loss for at least 24 months when performed on morbidly obese patients. Postoperative group meetings (POGM) for psychotherapy and behavioral modification helped patients to achieve better results. © 2012 Springer Science + Business Media, LLC

The effect of gag reflex on cardiac sympatovagal tone

Objectives: Heart velocity may be influenced by gagging. The medulla oblongata receives the afferents of gag reflex. Neuronal pools of vomiting, salivation and cardiac parasympathetic fibers are very close in this area. So, their activities may be changed by spillover from each other. Using the heart rate variability (HRV) analysis, the effect of gagging on cardiac sympatovagal balance was studied. Methods: ECG was recorded from 9 healthy nonsmoker volunteer students for 10 minutes in the sitting position between 10 and 11 AM. Gagging was elicited by tactile stimulation of the posterior pharyngeal wall. At 1 kHz sampling rate, HRV was calculated. The mean of heart rate at low and high frequencies (LF: 0.04-0.15; HF: 0.15-0.4 Hz) were compared before and after the stimulus. Results: The mean of average heart rate, LF and HF in normalized units (nu) and the ratio of them (LF/HF) before and after the gagging were 89.9 ± 3 and 95.2 ± 3 bpm; 44.2 ± 5.8 and 21.2 ± 4; 31.1 ± 5.3 and 39.4 ± 3.8; and 1.7 ± 0.3 and 0.6 ± 0.2 respectively. Conclusion: Gagging increased heart velocity and had differential effect on two branches of cardiac autonomic nerves. The paradoxical relation between average heart rate and HRV indexes of sympatovagal tone may be due to unequal rate of change in autonomic fiber activities which is masked by 5 minutes interval averaging. © OMSB, 2012

Study of embryotoxicity of mentha piperita l. during organogenesis in balb/c mice

Mentha piperita (Labiatae), commonly known as peppermint is a native Iranian herb which is used in folk medicine for various purposes. This study was carried out to reveal the teratogenic effect of Mentha piperita on mice fetuses. In this experimental study, pregnant Balb/c mice divided to four groups. Case group received 600 (treatment I) and 1200 (treatment II) mg/kg/day the hydroalcoholic extract of Mentha piperita during 6-15 of gestational days and one control group received normal saline during GD6-GD15 by gavages and other control group did not receive any matter during 6-15 of gestational days. Mice sacrificed at GD18 and embryos were collected. Macroscopic observation was done by stereomicroscope. 20 fetuses of each group were stained by Alizarin red-S and Alcian blue staining method. The Mean weight of fetuses decreased in treatment groups rather than control (P<0.05) but CRL there was no significant difference between treatments and controls groups. In the treatment I (600 mg/kg/day) and treatment II (1200 mg/kg/day), normal saline and control group, no gross congenital malformations were observed in fetuses. Treated fetuses also had no delayed bone ossification as determined by Alizarin red-S and Alcian blue staining method. This study showed that the hydroalcoholic extract of Mentha piperita (600 and 1200 mg/ kg/day) has no teratogenic effect in mice fetuses if used continuously during embryonic period

Janssen effect and the stability of quasi 2-D sandpiles

We present the results of three dimensional molecular dynamics study of global normal stresses in quasi two dimensional sandpiles formed by pouring mono dispersed cohesionless spherical grains into a vertical granular Hele-Shaw cell. We observe Janssen effect which is the phenomenon of pressure saturation at the bottom of the container. Simulation of cells with different thicknesses shows that the Janssen coefficient $\kappa$ is a function of the cell thickness. Dependence of global normal stresses as well as $\kappa$ on the friction coefficients between the grains ($\mu_p$) and with walls ($\mu_w$) are also studied. The results show that in the range of our simulations $\kappa$ usually increases with wall-grain friction coefficient. Meanwhile by increasing $\mu_p$ while the other system parameters are fixed, we witness a gradual increase in $\kappa$ to a parameter dependent maximal value

Differentiation in logical form

We introduce a logical theory of differentiation for a real-valued function on a finite dimensional real Euclidean space. A real-valued continuous function is represented by a localic approximable mapping between two semi-strong proximity lattices, representing the two stably locally compact Euclidean spaces for the domain and the range of the function. Similarly, the Clarke subgradient, equivalently the L-derivative, of a locally Lipschitz map, which is non-empty, compact and convex valued, is represented by an approximable mapping. Approximable mappings of the latter type form a bounded complete domain isomorphic with the function space of Scott continuous functions of a real variable into the domain of non-empty compact and convex subsets of the finite dimensional Euclidean space partially ordered with reverse inclusion. Corresponding to the notion of a single-tie of a locally Lipschitz function, used to derive the domain-theoretic L-derivative of the function, we introduce the dual notion of a single-knot of approximable mappings which gives rise to Lipschitzian approximable mappings. We then develop the notion of a strong single-tie and that of a strong knot leading to a Stone duality result for locally Lipschitz maps and Lipschitzian approximable mappings. The strong single-knots, in which a Lipschitzian approximable mapping belongs, are employed to define the Lipschitzian derivative of the approximable mapping. The latter is dual to the Clarke subgradient of the corresponding locally Lipschitz map defined domain-theoretically using strong single-ties. A stricter notion of strong single-knots is subsequently developed which captures approximable mappings of continuously differentiable maps providing a gradient Stone duality for these maps. Finally, we derive a calculus for Lipschitzian derivative of approximable mapping for some basic constructors and show that it is dual to the calculus satisfied by the Clarke subgradient