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Gallbladder stones in bariatrics and management of choledocholithiasis after gastric bypass
Mariano Palermo,Manoel Galvao Neto 소화기인터벤션의학회 2019 International journal of gastrointestinal interven Vol.8 No.1
It is known that the rapid weight loss is a predisposing factor to develop biliary lithiasis. The physiopathology is related with an oversaturation of bile with cholesterol, bile stasis, and increase in mucin concentration in bile. The incidence of cholelithiasis post gastric bypass is estimated around 37%. Almost 50% developed disease in the first year of monitoring, and 60% in the first 6 months. Meanwhile the patients undergoing sleeve gas-trectomy have an incidence of cholelithiasis of 27%. Diverse kinds of protocols exist: prophylactic surgery (simultaneous cholecystectomy and gastric bypass in every patients, whether they have or not cholelithiasis), elective (simultaneous cholecystectomy with conventional gastric bypass in the patients with asymptomatic cholelithiasis), and conventional cholecystectomy only in the presence of cholelithiasis with symptoms. Which way to go is still a topic of discussion among surgeons but the majority agree that prophylactic surgery shouldn’t be an option because the number of patients that will develop symptomatic cholelithiasis is low (around 6% to 8% of them) and this leads to an elevated number of patients exposed to an unnecessary procedure with potential complications. The presence of gallstones in the common bile duct (CBD) although is a rare complica-tion after Roux-en-Y gastric bypass (around 0.2% of the bariatric patients) represents an important challenge due to the anatomical modifications of the gastrointestinal tract. This leads to having to pursue other methods to reach the papillae for the resolution of choledocholithiasis: laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography (ERCP), balloon enteroscopy assisted ERCP, percutaneous biliary drainage with subsequent trans fistula treatment and laparoscopic exploration of CBD. Which of these methods should we choose must be based on the surgeon experience, the equipment available and the location of the stone. But whatever the method, a special training is needed on endoscopy, percutaneous surgery and laparoscopy.
Mariano Michelon,Thais de Matos de Borba,Ruan da Silva Rafael,Carlos André Veiga Burkert,Janaína Fernandes de Medeiros Burkert 한국식품과학회 2012 Food Science and Biotechnology Vol.21 No.1
The yeast Phaffia rhodozyma is known for producing carotenogenic pigments, commonly used in aquaculture feed formulation as well as in cosmetic,pharmaceutical, and food industries. Despite the high production of carotenoids from microorganisms by biotechnology, their use has limitation due to the cell wall resistance, which constitutes a barrier to the bioavailability of carotenoids. Therefore, there is a need to improve carotenoids recovering technique from microorganisms for the application of food industries. This study aimed to compare mechanical, chemical, and enzymatic techniques of cell disruption for extracting carotenoids produced by P. rhodozyma NRRL Y-17268. Among the techniques studied, the highest specific concentration of carotenoids (190.35 μg/g) resulted from the combined techniques of frozen biomass maceration using diatomaceous earth and enzymatic lysis at pH of the reaction medium of 4.5 at 55oC, with initial activity of β-1,3 glucanase of 0.6 U/mL for 30 min.
Mariano Ruiz Espejo,Housila P. Singh,Miguel Delgado Pineda,Saralees Nadarajah 한국통계학회 2008 Journal of the Korean Statistical Society Vol.37 No.4
A class of unbiased estimators of the population variance is proposed when the coefficient of variation is known for each stratum. The technique of equilibrated stratification is used. It is shown that, with optimum allocation, the variance of the suggested estimator for sufficiently large sample size is less than that of the classical minimum variance unbiased estimator under distributionfree setting. Other classes of estimators are also given with similar or better practical properties.
Forecasting Philippine Corn Trade using ARIMA Modeling
Mariano, R.A.,De Castro, M.M.E.,Nunez, C.L.R.,Depositario, D.P.T.,Panganiban, G.G.F. 한국무역학회 2019 한국무역학회 국제학술대회 Vol.2019 No.08
Corn is one of the most economically important crops in the Philippines. Data obtained from the Food and Agriculture Organization of the United Nations, the annual corn trade (imports) was predicted using the Autoregressive Integrated Moving Average (ARIMA) Model. The authors aimed to forecast the corn trade (imports) in the next five years from 2020 to 2024. Obtaining the model from the ARIMA method, the corn imports model would be ARIMA (1 1 1). Results suggest that the model satisfactorily fitted their specified series and the diagnostic checking. The forecasted values would be following a downward direction. This information may assist the policy makers in their corn trade decisions in the next five years.
Gallbladder stones in bariatrics and management of choledocholithiasis after gastric bypass
Mariano Palermo,Manoel Galvao Neto 소화기인터벤션의학회 2019 Gastrointestinal Intervention Vol.8 No.1
It is known that the rapid weight loss is a predisposing factor to develop biliary lithiasis. The physiopathology is related with an oversaturation of bile with cholesterol, bile stasis, and increase in mucin concentration in bile. The incidence of cholelithiasis post gastric bypass is estimated around 37%. Almost 50% developed disease in the first year of monitoring, and 60% in the first 6 months. Meanwhile the patients undergoing sleeve gas-trectomy have an incidence of cholelithiasis of 27%. Diverse kinds of protocols exist: prophylactic surgery (simultaneous cholecystectomy and gastric bypass in every patients, whether they have or not cholelithiasis), elective (simultaneous cholecystectomy with conventional gastric bypass in the patients with asymptomatic cholelithiasis), and conventional cholecystectomy only in the presence of cholelithiasis with symptoms. Which way to go is still a topic of discussion among surgeons but the majority agree that prophylactic surgery shouldn’t be an option because the number of patients that will develop symptomatic cholelithiasis is low (around 6% to 8% of them) and this leads to an elevated number of patients exposed to an unnecessary procedure with potential complications. The presence of gallstones in the common bile duct (CBD) although is a rare complica-tion after Roux-en-Y gastric bypass (around 0.2% of the bariatric patients) represents an important challenge due to the anatomical modifications of the gastrointestinal tract. This leads to having to pursue other methods to reach the papillae for the resolution of choledocholithiasis: laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography (ERCP), balloon enteroscopy assisted ERCP, percutaneous biliary drainage with subsequent trans fistula treatment and laparoscopic exploration of CBD. Which of these methods should we choose must be based on the surgeon experience, the equipment available and the location of the stone. But whatever the method, a special training is needed on endoscopy, percutaneous surgery and laparoscopy.