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Endoscopic sleeve gastroplasty in class Ⅲ obesity:Efficacy, safety, and durability outcomes in 404 consecutive patients

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World Journal of Gastrointestinal Endoscopy 2023年第6期15卷 469-479页

作者： daniel barry maselli Anna Carolina Hoff Ashley Kucera Emily Weaver Laura Sebring Lori Gooch Kathleen Walton daniel Lee Taylor Cratty Selena Beal Srikar Nanduri Kendall Rease Christina S Gainey Laura Eaton Brian Coan Christopher E McGowan Department of Endobariatrics True You Weight LossCaryNC 27513United States Bariatric Endoscopy Angioskope ClinicSão Josédos Campos 12243-680São PauloBrazil Gastroenterology and Hepatology University of North Carolina SystemChapel HillNC 27599United States UltaMed Corporation UltaMed CorporationFort LauderdaleFL 33308United States

BACKGROUND Endoscopic sleeve gastroplasty(ESG) is an effective therapy for class Ⅰ-Ⅱ obesity, but there are knowledge gaps in the published literature about its implementation in patients with class Ⅲ obesity [body mass index(BMI) ≥ 40 kg/m2].AIM To evaluate the safety, clinical efficacy, and durability of ESG in adults with class Ⅲ obesity.METHODS This was a retrospective cohort study that used prospectively collected data on adults with BMI ≥ 40 kg/m2who underwent ESG and longitudinal lifestyle counseling at two centers with expertise in endobariatric therapies from May 2018-March 2022. The primary outcome was total body weight loss(TBWL) at 12 mo. Secondary outcomes included changes in TBWL, excess weight loss(EWL) and BMI at various time points up to 36 mo, clinical responder rates at 12 and 24 mo, and comorbidity improvement. Safety outcomes were reported through the study duration. One-way ANOVA test was performed with multiple Tukey pairwise comparisons for TBWL, EWL, and BMI over the study duration.RESULTS 404 consecutive patients(78.5% female, mean age 42.9 years, mean BMI 44.8 ± 4.7 kg/m2) were enrolled. ESGs were performed using an average of 7 sutures, over 42 ± 9 min, and with 100% technical success. TBWL was 20.9 ± 6.2% at 12 mo, 20.5 ± 6.9% at 24 mo, and 20.3 ± 9.5% at 36 mo. EWL was 49.6 ± 15.1% at 12 mo, 49.4 ± 16.7% at 24 mo, and 47.1 ± 23.5% at 36 mo. There was no difference in TBWL at 12, 15, 24, and 36 mo from ESG. TBWL exceeding 10%, 15%, and 20% was achieved by 96.7%, 87.4%, and 55.6% of the cohort at 12 mo, respectively. Of the cohort with the relevant comorbidity at time of ESG, 66.1% had improvement in hypertension, 61.7% had improvement in type Ⅱ diabetes, and 45.1% had improvement in hyperlipidemia over study duration. There was one instance of dehydration requiring hospitalization(0.2% serious adverse event rate).CONCLUSION When combined with longitudinal nutritional support, ESG induces effective and durable weight loss in adults with class Ⅲ obesity, with improvement in comorbiditie

关键词： Endoscopic sleeve gastroplasty Obesity Bariatric Endobariatrics Class III obesity Comorbidities

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Congenital Cervico-Mandibular Cystic Lymphangioma in Pediatric Surgical Setting in Guinea

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Open Journal of Pediatrics 2024年第1期14卷 164-173页

作者： Thierno Saïdou barry Mohamed Lamine Sadou Sacko Balla Keita Aissatou Bailo Balde Mamadou Alpha Diallo Moussa Conde Ibrahima Kalil Dioubate Mory Sangare Salamata Sall Mariama Dalanda Diallo daniel Agbo-Panzo Pediatric Surgery Department Donka National Hospital (HND) of Conakry University Hospital (Gamal Abdel Nasser University of Conakry (UGANC) of Guinea) Conakry Guinea Hadja Bilguissou barry Medical-Surgical Clinic (HBB) Conakry Guinea Albert Royer Children’s Service Cheikh Anta DIOP University (UCAD) Dakar Senegal Surgery Department of the Regional Hospital Center of Ziguinchor (CHRZ) Ziguinchor Senegal

Introduction: Cystic lymphangiomas are rare benign malformative tumors of the lymphatic system of obscure etiopathogenesis. The cervico-facial location remains the most common (75%). Although benign, these tumors remain potentially fatal, due to possible compression of the upper aero-digestive tract. The aim of this work is to study the epidemiological, diagnostic and therapeutic characteristics of cervico-mandibular congenital cystic lymphangiomas in the pediatric surgery department of the Donka National Hospital (HND) Conakry. Patients and methods: This is a retrospective and descriptive study of 13 files lasting 7 years from January 2015 to December 31, 2021. The files of children whose age is less than or equal to 15 years operated on cervical tumor with histological evidence of cystic lymphangioma were retained. The data were analyzed using SPSS statistical software 21 and anonymously. Results: The incidence of this study was 1.86 cases per year and a sex ratio of 0.62 in favor of girls. The average age was 8 months 19 days. In the antecedents, we only find poorly monitored pregnancies. The average size of the tumors was 11.85 cm. Cervical ultrasound and standard x-ray of the cervical mass were the only examinations performed. Total surgical excision of the cervical tumor was performed in all patients. The mass was polycystic on exploration. The histological examination of the surgical specimens was in favor of a cystic lymphangioma. The surgical consequences were simple in 11 patients (84.62%) and complicated by parietal suppuration in 2 cases (15.38%). There were no cases of recurrence after one year of follow-up. Conclusion: Cervico-mandibular cystic lymphangiomas are the most frequent locations of congenital lymphangiomas in children. Their severity is linked to the risk of compression of the aero-digestive tracts. Their diagnosis must be confirmed by the histology of the surgical specimen. Despite the therapeutic arsenal, excision of the cystic mass remains the only effective alternative in our socio-ec

关键词： Congenital Cystic Lymphangioma (LKC) Child Pediatric Surgery Guinea

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The collagen receptor,discoidin domain receptor 2,functions in Gli1-positive skeletal progenitors and chondrocytes to control bone development

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Bone Research 2022年第1期10卷 178-194页

作者： Fatma F.Mohamed Chunxi Ge Randy T.Cowling daniel Lucas Shawn A.Hallett Noriaki Ono Abdul-Aziz Binrayes barry Greenberg Renny T.Franceschi Department of Periodontics&Oral Medicine University of MichiganAnn ArborMIUSA Division of Cardiovascular Medicine University of California at San DiegoSan DiegoCAUSA Division of Experimental Hematology and Cancer Biology Cincinnati Children’s Medical CenterCincinnatiOHUSA Department of Pediatrics Cincinnati Children’s HospitalCincinnatiOHUSA Department of Orthodontics&Pediatric Dentistry University of MichiganAnn ArborMIUSA Department of Prosthetic Dental Sciences College of DentistryKing Saud UniversityRiyadhSaudi Arabia Department of Biological Chemistry School of MedicineUniversity of MichiganAnn ArborMIUSA Department of Biomedical Engineering University of MichiganAnn ArborMIUSA

Discoidin Domain Receptor 2(DDR2)is a collagen-activated receptor kinase that,together with integrins,is required for cells to respond to the extracellular matrix.Ddr2 loss-of-function mutations in humans and mice cause severe defects in skeletal growth and development.However,the cellular functions of Ddr2 in bone are not understood.Expression and lineage analysis showed selective expression of Ddr2 at early stages of bone formation in the resting zone and proliferating chondrocytes and periosteum.Consistent with these findings,Ddr2^(+)cells could differentiate into hypertrophic chondrocytes,osteoblasts,and osteocytes and showed a high degree of colocalization with the skeletal progenitor marker,Gli1.A conditional deletion approach showed a requirement for Ddr2 in Gli1-positive skeletal progenitors and chondrocytes but not mature osteoblasts.Furthermore,Ddr2 knockout in limb bud chondroprogenitors or purified marrow-derived skeletal progenitors inhibited chondrogenic or osteogenic differentiation,respectively.This work establishes a cell-autonomous function for Ddr2 in skeletal progenitors and cartilage and emphasizes the critical role of this collagen receptor in bone development.

关键词： Gli1 progenitor skeletal

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Multi-Institutional US Experience of the Occlutech AFR Device in Congenital and Acquired Heart Disease

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Congenital Heart Disease 2022年第1期17卷 107-116页

作者： barry O’Callaghan Jenny Zablah Joseph Vettukattil daniel Levi Morris Salem Allison Cabalka Jason Anderson Makram Ebeid Ryan Alexy Gareth J.Morgan The Heart Institute Children’s Hospital ColoradoAuroraUSA Pediatric Cardiology Helen DeVos Children’s HospitalGrand RapidsUSA Pediatric Cardiology UCLA HealthMattel Children’s HospitalLos AngelesUSA Pediatric Cardiology UCLA Medical CentreLos AngelesUSA Pediatric Cardiology Mayo ClinicRochesterUSA Pediatric Cardiology University of Mississippi Medical CenterJacksonUSA Pediatric Cardiology Riley Hospital for Children at Indiana University HealthIndianapolisUSA

Objectives:To detail the US multi-institutional experience with the Occlutech©(Occlutech International AB,Helsingborg,Sweden)atrial flow regulator(AFR)in children and adults with acquired or congenital heart disease.Background:The creation of a long-term atrial communication is desirable in several cardiovascular disease phenotypes,most notably pulmonary arterial hypertension,disorders of increased left ventricular filling and increased cavopulmonary pressures in patients with a Fontan type circulation.Methods:Patients were identified for inclusion from the AFR device manufacturer database.Data was collected using a RedCap database following IRB approval.8 weeks of follow up data was sought for each patient based on available data.Data was analyzed and summarized using SPSS.Results:We report the experience of 6 US centers in the implantation of AFR devices in 15 patients,across a wide age range,with different disease phenotypes and a variety of indications.Implantation was technically successful in all patients and improvement was noted in both clinical and hemodynamic parameters.There were no immediate or intermediate term complications reported.3 patients died remote from implantation.Their deaths were not felt to be related to the AFR device or related procedural complications.Conclusion:Compassionate use of the AFR device in children and adults with congenital&acquired heart disease is technically feasible and produces beneficial short term hemodynamic and symptomatic improvement.Widespread uptake of this technique and treatment at specialist centers has the potential to provide significant benefits to a variety of complex patients with currently limited treatment options and indeterminate prognosis.

关键词： Congenital heart disease pulmonary hypertension left atrial hypertension single ventricle palliation diastolic heart failure

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A preliminary study of sperm identification in microdissection testicular sperm extraction samples with deep convolutional neural networks

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Asian Journal of Andrology 2021年第2期23卷 135-139页

作者： daniel J Wu Odgerel Badamjav Vikrant V Reddy Michael Eisenberg barry Behr Department of Computer Science Stanford UniversityStanfordCA 94305USA Department of Urology University of Utah HealthSalt Lake CityUT 84108USA Department of Obstetrics and Gynecology Stanford Children’s HealthStanfordCA 94305USA Department of Urology Stanford University School of MedicineStanfordCA 94305USA

Sperm identification and selection is an essential task when processing human testicular samples for in vitro fertilization.Locating and identifying sperm cell(s)in human testicular biopsy samples is labor intensive and time consuming.We developed a new computer-aided sperm analysis(CASA)system,which utilizes deep learning for near human-level performance on testicular sperm extraction(TESE),trained on a custom dataset.The system automates the identification of sperm in testicular biopsy samples.A dataset of 702 de-identified images from testicular biopsy samples of 30 patients was collected.Each image was normalized and passed through glare filters and diffraction correction.The data were split 80%,10%,and 10%into training,validation,and test sets,respectively.Then,a deep object detection network,composed of a feature extraction network and object detection network,was trained on this dataset.The model was benchmarked against embryologists’performance on the detection task.Our deep learning CASA system achieved a mean average precision(mAP)of 0.741,with an average recall(AR)of 0.376 on our dataset.Our proposed method can work in real time;its speed is effectively limited only by the imaging speed of the microscope.Our results indicate that deep learning-based technologies can improve the efficiency of finding sperm in testicular biopsy samples.

关键词： artificial intelligence computer vision male infertility microdissection testicular sperm extraction sperm

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Influence of age in estimating maximal oxygen uptake

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Journal of Geriatric Cardiology 2016年第2期13卷 126-131页

作者： Christina G de Souza Silva barry A Franklin daniel E Forman Claudio Gil S Araujo Heart Institute Edson Saad and Medical School Federal University of Rio de Janeiro Rio de Janeiro R J Brazil Exercise Medicine Clinic CLINIMEX Rio de Janeiro R J Brazil Preventive Cardiology and Cardiac Rehabilitation William Beaumont Hospital Royal Oak MI United States Section of Geriatric Cardiology University of Pittsburgh Medical Center Geriatrics Research Education and Clinical Center System University of Pittsburgh Pittsburgh PA USA

ObjectiveTo 在最大的氧举起的估计( EE )的错误上估计年龄的影响( VO 2最大)用性别和在自从估计，测试的周期测力计锻练特定方程的人口， VO 2最大与实质的 EE 被联系，经常超过20%， 18～91 年，可能，由于机械 efficiency.Methods18... 详细信息

ObjectiveTo 在最大的氧举起的估计( EE )的错误上估计年龄的影响( VO 2最大)用性别和在自从估计，测试的周期测力计锻练特定方程的人口， VO 2最大与实质的 EE 被联系，经常超过20%， 18～91 年，可能，由于机械 efficiency.Methods1850 的内在的可变性，成年人(68%人)经历了最大的周期测力计测试的心肺的锻练。心和肺的健康(CRF ) 相对性别和年龄被估计[更年轻(18 ～ 35 年) ，中年(36 ～ 60 年) 并且更旧(>；60 年)] 。VO 2 最大[mL·；(kg·； min )−1] 被对煤气的交换的评价直接测量并且估计了使用性别和人口特定方程。VO 2 最大和相关 EE 在三年龄特定、性特定的 groups.ResultsDirectly 测量的 VO 2 男人和女人的最大是 29.5 ±；10.5 mL·；(kg·； min )−1 和 24.2 ±；9.0 mL·；(kg·； min )−1(P <；0.01 ) 。EE [mL·；(kg·； min ) 为男人和女人的 −1] 和百分比错误(% E ) 有类似的价值， 0.5 ±；3.2 和 0.4 ±；2.9 mL·；(kg·； min )−1, 和 −； 0.8 ±；13.1% 并且 −； 1.7 ±；15.4%(P >；0.05 ) 分别地。分别地，为每个年龄组的 EE 和 % E 为男人：更年轻的 = 1.9 ±；4.1 mL·；(kg·； min )−1 和 3.8 ±；10.5% ，中年的 = 0.6 ±；3.1 mL·；(kg·； min )−1 和 0.4 ±；10.3% ，更旧的 =−； 0.2 ±；2.7 mL·；(kg·； min )−1 和 −； 4.2 ±；16.6%(P <；0.01 ) ；并且为女人：更年轻的 = 1.2 ±；3.1 mL·；(kg·； min )−1 和 2.7 ±；10.0% ，中年的 = 0.7 ±；2.8 mL·；(kg·； min )−1 和 0.5 ±；11.1% ，更旧的 =-0.8 ±；2.3 mL·；(kg·； min )−1 和 −； 9.5 ±；22.4%(P <；0.01 ).ConclusionVO 2 最大在更年轻的年龄组被低估并且在老年组被过高估计。年龄显著地影响 VO 2 在男人和女人的最大并且当 CRF 用人口被估计时，应该被认为特定方程，而非直接测量了。

关键词：最大摄氧量年龄组估计误差直接测量估算自行车运动运动试验机械效率

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Pubo-Penile Testicular Ectopia (ETPP) of the Infant of 4 Months about a Case

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Open Journal of Urology 2023年第4期13卷 108-113页

作者： Mohamed Lamine Sadou Sacko Balla Keita Thierno Saidou barry Mory Sangare Mamadou Madiou barry Moussa Conde daniel Agbo-Panzo Pediatric Surgery Department of The University Hospital of Donka Donka Guinea University Gamal Abdel Nasser of Conakry Conakry Guinea

Pubo-penile testicular ectopia is a rare congenital malformation whose etiopathogenesis remains poorly understood. It represents other testicular ectopias less than 1% of all testicular migration disorders. We report a clinical observation of a 4-month-old infant who consulted for swelling at the root of the penis associated with vacuity of the right hemi scrotum. An inguinal ultrasound was performed which confirmed the presence of the right testicle. An orchidopexy was performed at 4 months of life by an inguinal approach, the postoperative course was simple with a follow-up of 6 months.

关键词： Pubo-Penile Testicular Ectopia Infant Early Orchidopexy

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Abdominal Mass Revealing a Right Ovarian Cyst in a 2-Year-Old Infant: A Case Report

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Open Journal of Pediatrics 2023年第2期13卷 276-283页

作者： Mohamed Lamine Sadou Sacko Balla Keita Thierno Saidou barry Mory Sangare Mamadou Madiou barry Moussa Conde daniel Agbo-Panzo Department of Pediatric Surgery Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: Ovarian cysts are rare pathologies in infants. They represent 1% to 2% of all abdominal tumors in children. Abdominal pain is the most frequent initial sign. Sometimes the discovery is fortuitous, revealed by an abdominal ultrasound. We report here the case of an ovarian cyst in an infant in order to clarify the diagnostic and therapeutic particularities. Patient and observation: 2-year-old infant, female, weighing 12 kg and with no particular pathological history, was admitted to our department for pain plus abdominal mass evolving for 2 months. The clinical examination had noted: a mass ranging from FID to hypogastrium, painless, of firm consistency, with regular contour, with a smooth and mobile surface in relation to the deep plane. The abdominal ultrasound performed had concluded to a mesenteric cyst. The treatment consisted of a monobloc total cystectomy with preservation of the healthy ovarian tissue by a transverse laparotomy under the umbilical. The postoperative course was simple;the histological study of the surgical specimen had concluded to a serous cystadenoma. Conclusion: Ovarian cysts are benign tumors in most cases. Abdominal pain is the most common initial symptom at any age. Sometimes they can be incidentally discovered by ultrasound. The preservation of healthy ovarian tissue in the rules of oncological surgery allows the preservation of subsequent fertility.

关键词： Right Ovarian Cyst in Infants Conservative Treatment

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Restricted nutrient intake does not alter serum-mediated measures of implant response in cell culture

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Journal of Animal Science and Biotechnology 2014年第1期5卷 80-87页

作者： Christopher D Reinhardt Tiffany L Lee daniel U Thomson Laman K Mamedova barry J Bradford Department of Animal Sciences and Industry 232 Weber Hall Kansas State University Department of Clinical Sciences A-111 Mosier Hall Kansas State University

Background： During nutritional stress, reduced intake may reduce the efficacy of anabolic implants. This study was conducted to evaluate basic cellular responses to a growth promotant implant at two intake levels. Methods： Sixteen crossbred steers （293 ± 19.3 kg） were used to evaluate the impact of anabolic implants in either an adequate or a restricted nutritional state. Steers were trained to individual Calan gates, and then randomly assigned to 1 of 4 treatments in a 2 × 2 factorial arrangement. Treatments consisted off presence or absence of an anabolic growth implant （Revalor-XS, 200 mg TBA and 40 mg estradiol; IMPLANT or CONTROL） and a moderate energy, pelleted, starting cattle diet fed at either 2.0 × or 1.0 × maintenance energy （NEM） requirements （HIGH or LOW）. Serum （d O, 14, and 28） was used for application to bovine muscle satellite cells. After treatment with the serum （20% of total media） from the trial cattle, the satellite cells were incubated for 72 h. Protein abundance of myosin heavy chain （MHC）, phosphorylated extracellular signal-related kinase （phospho-ERK）, and phosphorylated mammalian target of rapamycin （phospho-mTOR） were analyzed to determine the effects of implant, intake, and their interaction （applied via the serum）. Results： Intake had no effect on MHC （P = 0.85） but IMPLANT increased （P 〈 0.01） MHC abundance vs. CONTROL. Implant status, intake status, and the interaction had no effect on the abundance of phospho-ERK （P〉0.23）. Implanting increased phospho-mTOR （P 〈 0.01） but there was no effect （P 〉 0.51） of intake or intake x implant. Conclusions： The nearly complete lack of interaction between implant and nutritional status indicates that the signaling molecules measured herein respond to implants and nutritional status independently. Furthermore, results suggest that the muscle hypertrophic effects of anabolic implants may not be mediated by circulating IGF-1.

关键词： Beef cattle Implant Muscle Myosin heavy chain Nutrient restriction Satellite cells

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Urinary Lithiasis Secondary to Urethral Duplication: A Case Report

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泌尿学期刊(英文) 2023年第10期13卷 453-458页

作者： Mohamed Lamine Sadou Sacko Balla Keita Thierno Saidou barry Mory Sangare Mamadou Madiou barry Moussa Conde Seydou Keita daniel Agbo-Panzo Department of Pediatric Surgery CHU de Donka Conakry Guinea Gamal Abdel Nasser University Conakry Guinea General Surgery Department Ignace Deen University Hospital Conakry Guinea

Urethral duplication is a rare congenital anomaly, mainly involving boys, although cases in girls have been reported. The majority of duplications of the urethra are asymptomatic and the discovery of this malformation can be done at any age. Diagnosis and determination of its type are based on urethrocystography with mid-void images, which helps to guide the surgical approach. The treatment is not yet well codified and the therapeutic attitude varies from one author to another. We report a clinical observation of a urethral duplication with a calculus in a six-year-old boy who underwent a partial urethrectomy of the supernumerary urethra in whom a lithotomy and a urethrectomy were performed via a suspension approach. This observation illustrates the possibility of urinary stone formation after partial urethrectomy of the supernumerary urethra.

关键词： Urethra Duplication Calculus Child

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