Gastric Bypass - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

GASTRIC BYPASS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2003 by ICON Group International, Inc. Copyright ©2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Gastric Bypass: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83922-0 1. Gastric Bypass-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on gastric bypass. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON GASTRIC BYPASS ....................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Gastric Bypass .............................................................................. 4 The National Library of Medicine: PubMed ................................................................................ 11 CHAPTER 2. NUTRITION AND GASTRIC BYPASS ............................................................................. 59 Overview...................................................................................................................................... 59 Finding Nutrition Studies on Gastric Bypass ............................................................................. 59 Federal Resources on Nutrition ................................................................................................... 63 Additional Web Resources ........................................................................................................... 64 CHAPTER 3. ALTERNATIVE MEDICINE AND GASTRIC BYPASS ....................................................... 65 Overview...................................................................................................................................... 65 National Center for Complementary and Alternative Medicine.................................................. 65 Additional Web Resources ........................................................................................................... 68 General References ....................................................................................................................... 68 CHAPTER 4. DISSERTATIONS ON GASTRIC BYPASS ......................................................................... 69 Overview...................................................................................................................................... 69 Dissertations on Gastric Bypass .................................................................................................. 69 Keeping Current .......................................................................................................................... 69 CHAPTER 5. CLINICAL TRIALS AND GASTRIC BYPASS ................................................................... 71 Overview...................................................................................................................................... 71 Recent Trials on Gastric Bypass .................................................................................................. 71 Keeping Current on Clinical Trials ............................................................................................. 71 CHAPTER 6. PATENTS ON GASTRIC BYPASS.................................................................................... 73 Overview...................................................................................................................................... 73 Patents on Gastric Bypass ........................................................................................................... 73 Patent Applications on Gastric Bypass........................................................................................ 74 Keeping Current .......................................................................................................................... 76 CHAPTER 7. BOOKS ON GASTRIC BYPASS ....................................................................................... 77 Overview...................................................................................................................................... 77 Book Summaries: Online Booksellers........................................................................................... 77 Chapters on Gastric Bypass ......................................................................................................... 78 CHAPTER 8. MULTIMEDIA ON GASTRIC BYPASS ............................................................................ 79 Overview...................................................................................................................................... 79 Video Recordings ......................................................................................................................... 79 Bibliography: Multimedia on Gastric Bypass .............................................................................. 80 CHAPTER 9. PERIODICALS AND NEWS ON GASTRIC BYPASS ......................................................... 83 Overview...................................................................................................................................... 83 News Services and Press Releases................................................................................................ 83 Newsletter Articles ...................................................................................................................... 85 Academic Periodicals covering Gastric Bypass............................................................................ 86 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 89 Overview...................................................................................................................................... 89 NIH Guidelines............................................................................................................................ 89 NIH Databases............................................................................................................................. 91 Other Commercial Databases....................................................................................................... 93 APPENDIX B. PATIENT RESOURCES ................................................................................................. 95 Overview...................................................................................................................................... 95 Patient Guideline Sources............................................................................................................ 95 Finding Associations.................................................................................................................... 99

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APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 101 Overview.................................................................................................................................... 101 Preparation................................................................................................................................. 101 Finding a Local Medical Library................................................................................................ 101 Medical Libraries in the U.S. and Canada ................................................................................. 101 ONLINE GLOSSARIES................................................................................................................ 107 Online Dictionary Directories ................................................................................................... 107 GASTRIC BYPASS DICTIONARY ............................................................................................ 109 INDEX .............................................................................................................................................. 137

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with gastric bypass is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about gastric bypass, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to gastric bypass, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on gastric bypass. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to gastric bypass, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on gastric bypass. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON GASTRIC BYPASS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on gastric bypass.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and gastric bypass, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “gastric bypass” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Gastric bypass operation for obesity Source: World Journal of Surgery. Volume 22, p. 925-935, September 1998. Summary: Gastric bypass was a natural evolution from gastric operations that were used for the treatment of peptic ulcer disease. Gastric bypass presently exists as a hybrid operation. Comorbidities due to severe obesity are usually ameliorated or arrested after the weight loss from gastric bypass. This report with special references to the Fobi pouch operation, a modification of gastric bypass done by the author, presents the evolution, modifications, risks, outcome, and future trends for gastric bypass for treatment of obesity.

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Federally Funded Research on Gastric Bypass The U.S. Government supports a variety of research studies relating to gastric bypass. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to gastric bypass. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore gastric bypass. The following is typical of the type of information found when searching the CRISP database for gastric bypass: •

Project Title: BARIATIC PATHOPHYSIOLOGY

SURGERY:

OUTCOMES

&

IMPACT

ON

Principal Investigator & Institution: Berk, Paul D.; Chief, Division of Liver Diseases; Medicine; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): The increasing prevalence of obesity in the U.S. is well documented by a series of surveys conducted by the National Center for Health Statistics. Its 1999-2000 data revealed that a staggering 62.5 % of adult Americans aged = 20 were overweight (BMI >= 25), and 30.5 % were obese (BMI >= 30). Projections suggest that by the year 2025 45% of adult Americans will be frankly obese. The increasing prevalence of obesity has fueled an increase in obesity-associated healthcare costs that reached $100 billion annually (5.7% of our national health expenditure) by 1995, and is surely even greater today. Obesity is associated with markedly increased risks of many comorbidities, of which hypertension, non-insulin-dependent diabetes mellitus (NIDDM), dyslipidemias, and cardiovascular disease are major contributors to 300,000 obesity related deaths annually. Non-alcoholic fatty liver disease (NAFLD) has recently emerged as a serious complication of obesity, and its most severe form, nonalcoholic steatohepatitis (NASH), is now the third most common indication for liver transplantation. Medical therapies for obesity are of very limited success. The best results for long term control of weight and of the various co-morbidities of obesity derive from bariatric surgery. The Mount Sinai School of Medicine has a large and innovative bariatric surgery program, which has focused on the development of minimally invasive (laparoscopic) bariatric methods. In this application, we propose to study the efficacy and safety of a novel, two stage surgical treatment of morbid-and super-obesity (BMI = 60) that combines an initial restrictive operation (sleeve gastrectomy) with a subsequent malabsorptive procedure (biliopancreatic diversion with duodenal switch) performed after the loss of ca. 100 Ib, when the patient is a better operative risk. Preliminary data suggest the approach is both effective and safe, with an 2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

Studies

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appreciable reduction in operative morbidity and mortality compared with conventional, open abdominal surgery in this population. The nature of the protocol allows collaborating scientists to conduct virtually unique studies of changes in adipose tissue fatty acid metabolism, hepatic histology, triglyceride accumulation and fibrogenesis, patterns of adipocyte and hepatocyte gene expression, alterations in levels of circulating hormones that modulate hunger and satiety, and changes in regional brain activity in response to food stimuli, that result from extensive weight loss. In a second protocol, effects of laparoscopic Roux-en-Y gastric bypass on short and long term control of weight and NIDDM in obese patients with initial BMIs = 35 will be compared with results of ADA-recommended optimal medical care. By conducting this as a cooperative study at multiple sites within the Bariatric Surgery Clinical Research Consortium, the results will make a compelling statement about the optimal approach to control of obesity and NIDDM in this population, that represents an ever-increasing subset of adult Americans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BARIATRIC SURGERY CLINICAL RESEARCH CONSORTIUM Principal Investigator & Institution: Wolfe, Bruce M.; Surgery; University of California Davis Sponsored Programs, 118 Everson Hall Davis, Ca 95616 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): A primary objective of obesity research is to define the pathophysiology of obesity as a basis for preventing and/or effectively treating the disease. The areas for research involving bariatric surgery patients may include: 1) defining optimal surgical approaches, 2) identification of biological and genetic differences that influence development of comorbidities and outcomes of surgery, and 3) utilizing this population as a model for study of the pathogenesis and response to treatment of obesity. We propose that the Bariatric Research Clinical Research Consortium (BSCRC) employ a comprehensive relational database that includes parameters readily available to all Clinical Centers (CCs), such as basic anthropometrics, measures of body composition, clinical and surgical history, and recording of a quantitative comorbidity scale. This scale scores each of 17 comorbidities related to obesity, including diabetes, hypertension, and hyperlipidemia, and utilizes treatment as a gauge for the severity of symptoms. Further refinement to the comorbidity scale grading may be required by BSCRC participants. This scale will enable comorbidities to be correlated with mRNA expression profiles and endocrine response. UC Davis proposes two specific protocols for conduct by the BSCRC. The short term protocol will measure, using quantitative PCR, the mRNA expression level of obesity related genes in the subcutaneous and omental fat, liver, and intestine of bariatric surgery patients at the time of operation. Measures of body composition including the distribution of body fat, endocrine response to gastric bypass, and the clinical comorbidity scores will allow detailed phenotyping of the subjects from the time of operation to timepoints 2 years post-op. This will be an important initial step towards understanding the variation of comorbidity occurrence between subjects of similar adiposity. The longer term protocol will be a 3-5 year longitudinal study of the response to gastric bypass in relation to hormone activity, body composition, and physical activity. At this phase, correlation with the preoperative genetic and endocrine markers derived in the short term study, as well as history of comorbidity scores, would identify those patients who would most benefit from gastric bypass. This and other data accumulated by the BSCRC will provide a basis for establishment of further studies of obesity comorbidities and their response to surgical treatment.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BARIATRIC SURGERY RESEARCH CONSORTIUM Principal Investigator & Institution: Flum, David R.; Surgery; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): Bariatric procedures offer sustained and significant weight reduction with the potential to effect general patient health, comorbid conditions, quality of life and the healthcare system. A Bariatric Surgery Clinical Research Consortium (BSCRC) wilt provide important prospective information about the true impact of the procedure on patients and opportunities to better explore the physiologic mechanisms that result in post-surgical weight loss. The BSCRC will prospectively collect clinical, demographic, epidemiological, laboratory and histological information. In addition to this database the BSCRC will complete the following studies: 1. A cross-sectional examination of the epidemiology of non-alcoholic steatohepatitis (NASH) in patients undergoing bariatric surgery and a prospective evaluation of the effect of surgically induced weight loss on the severity NASH and cellular markers of cytotoxic activity. There is a need for epidemiologic information about the prevalence, risk factors for, and impact of fatty liver disease in patients undergoing bariatric surgery. We propose a study to evaluate liver histology in a large group of patients undergoing bariatric procedures. Patients with evidence of NASH by biopsy will undergo subsequent liver biopsy at one year to determine if NASH improves with rapid weight loss. Patients with NASH who improve after weight loss represent an important model for evaluating the cellular mechanisms that are involved in the development of NASH. This study will evaluate markers of oxidative stress and hepatic mitochondrial structure to determine their relationship to NASH during and after rapid, surgical weight loss. 2. A prospective evaluation of the relationship between ghrelin, PYY3-36, appetite and weight loss outcomes after gastric bypass. Ghrelin and PYY3-36 are gutderived peptides that are involved in energy homeostasis principally through their effect on appetite. We propose a prospective study to determine the relationship of ghrelin and weight loss after gastric bypass and to determine if the degree of ghrelin suppression is correlated to hunger suppression and/or the amount of weight lost. This study will determine if inclusion of ghrelin producing cells in the gastric pouch is correlated to worsened weight loss outcomes. Lastly the study will begin to evaluate the relationship of PYY3-36 and ghrelin and determine if it is altered by or in response to the physiologic changes associated with gastric bypass. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EACT CAROLINA UNIV. BARIATRIC SURGERY CLINICAL CENTER Principal Investigator & Institution: Pories, Walter J.; Professor; Surgery; East Carolina University 1000 E 5Th St Greenville, Nc 27858 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): Obesity, the most prevalent, fatal, chronic disease of the 21st Century, is increasing at a rate seen before only with infectious diseases. Morbid obesity, the most severe form, afflicts 23 million Americans. These individuals are not only limited by their bulk but are sharply compromised by life-endangering comorbidities. Surgery has proven to be an effective therapy. The Greenville gastric bypass operation (GGB), developed at this institution, produces not only durable weight loss greater than 100 Ibs but also induces full remission of type 2 diabetes in 83

Studies

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percent of patients, control of hypertension in over half, as well as full reversal of such co-morbidities as asthma, Pickwickian syndrome, stress incontinence, and pseudotumor cerebri. The reproducible reversal of type 2 diabetes in GGB patients is a provocative finding and requires further basic research. However, the GGB, like other bariatric procedures, is associated with serious long-term nutritional deficiencies and, in vulnerable individuals, emotional disorders. Generally, there is no consensus about which of the seven common bariatric procedures should be used. There is also considerable variation in surgical outcomes across the US for the same operation due to a lack of standardization of the surgical care. Thus, bariatric surgery is ripe for a collaborative approach to answering both clinical and basic research issues. Our current center efforts include three major areas: 1. Fostering collaboration within the bariatric surgical community to promote clinical, behavioral, and basic research in morbid obesity and its co-morbidities; 2. Clinical studies of the efficacy, efficiency, and safety of two types of gastric bypass operations with an emphasis on differences in outcomes between African-American and Caucasian women. 3. Basic science studies of insulin action and sensitivity in human subjects prior to and after bariatric surgery. In addition, this application includes three proposals for inter-institutional projects: 1. Comparison of the most commonly performed bariatric operations; 2. the mechanism for increased insulin sensitivity after gastric bypass surgery; and 3. the ethics of the informed consent in bariatric surgery. Because East Carolina University has a productive tradition of interdisciplinary clinical, basic science, and behavioral research in morbid obesity as well as a record of national leadership, we submit this application to become one of the Bariatric Surgery Clinical Centers of the NIDDK. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EATING AND QUALITY OF LIFE POST BARIATRIC SURGERY Principal Investigator & Institution: Mitchell, James E.; Professor & Chair; Neuropsychiatric Research Institute Fargo, Nd 58103 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): This grant is submitted in response to RFA:DK-03006 "Bariatric Surgery Clinical Research Consortium". We are making application to be one of the interactive Clinical Centers in this Consortium. Our research group has had a longstanding interest in eating disorders and eating problems, and has recently been interested in research in binge eating disorder, obesity and bariatric surgery. As noted in the RFA, obesity has become an alarmingly common problem in America, and baritaric surgery procedures appear to be the treatment of choice for patients with severe obesity. However, a number of important research questions have yet to be answered. In this application we review various areas of research including the relationship between psychopathology and outcome of bariatric surgery, particularly as it relates to binge eating and binge eating disorder, the development of eating disorders as a consequence of bariatric surgery, the psychosocial outcomes of individuals undergoing bariatric surgery, psychosocial interventions for patients undergoing bariatric surgery, and peptides and feeding in bariatric surgery. Preliminary data are included detailing our experiences in working with this population including an ongoing project collecting standardized databases on patients undergoing bariatric surgery at various sites, two follow-up studies that have been completed status post-gastric bypass, and our experience with various modalities which could be helpful to the consortium. These include ecological momentary assessment paradigms, the use of structured and selfreport instruments, the assessment of quality of life and studies of eating behavior and peptides in our human feeding laboratory. We propose two experiments. The first is a

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Gastric Bypass

short-term study examining eating behavior both pre- and post-bariatric surgery using 72 hour dietary recall, ecological momentary assessment and feeding laboratory assessment over a period of 9 months. A second longer-term study would involve a 24 month prospective longitudinal design with a careful assessment of psychopathology and various behavioral variables that might impact on response to surgery, on the amount of weight loss, the amount of weight regained, and on psychosocial complications post operatively, as well as quality of life. Specific hypotheses are offered regarding both of these experiments. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EATING BEHAVIOR AFTER GASTRIC BYPASS Principal Investigator & Institution: Hsu, L K.; Professor; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2001 Summary: Severe obesity causes substantially increased risk for morbidity and mortality. Bariatric surgery, in particular gastric bypass (GBP), is a useful treatment option for severe obesity because conventional weight-loss programs are usually unsuccessful for these patients. Nevertheless, wide variations occur in weight loss. Furthermore, GBP may not alter eating disturbances such as binge eating, and the initial improvement in psycosocial functioning after GBP may not be sustained. This study will examine these issues in morbidly obese subjects requiring GBP surgery. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: OBESITY

GLUCOLIPOTOXICITY

AND

CARDIAC

DYSFUNCTION

IN

Principal Investigator & Institution: Taegtmeyer, Heinrich; Professor; Internal Medicine; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): Alarming statistics on the spread of obesity include an increase in premature death from cardiovascular disease. Yet, the effects of overnutrition on the heart are not well understood. We therefore propose to examine the "molecular footprints" of obesity in the heart, and identify mechanisms leading to impaired cardiac function in animal models, as well as in clinically obese patients undergoing gastric bypass surgery. Special emphasis is placed on the myocardial consequences of deranged glucose and fatty acid metabolism leading to a cardiomyopathy of obesity that is potentially reversible. The broad objective of this proposal is to test the hypothesis that abnormal accumulation of ,qlucose and fatty acid metabolites resulting from a loss of synchronization of substrate uptake and oxidation, induces glucolipotoxicity, and leads to contractile dysfunction of the heart. The first specific aim will define the process by which excess fuel supply (beyond the storage capacity of adipocytes) results in accumulation of lipotoxic compounds in the heart and in other organs (e.g. skeletal muscle). In genetic and diet-induced rat models of obesity we shall define the time course of adaptation and maladaptation to excess substrate availability. We shall also define the time course of reversal of obesity-induced changes by food restriction or surgical intervention (gastric bypass). The second specific aim will address potential mechanisms of glucolipotoxicity in heart, as well as in skeletal muscle. We shall examine gene expression, PKC activity, protein glycosylation, protein ubiquitinization, and programmed cell death. Selective activation of these different pathways may play a significant role in glucolipotoxicity. The third specific aim will

Studies

9

apply insights gained from animal experiments to ascertain whether correlates of glucolipotoxicity exist in humans and test the hypothesis that weight loss reverses the maladaptive response in patients undergoing gastric bypass. We will define metabolic indices (BMI, insulin resistance, blood pressure, lipid profile, adipokine levels) and indices of cardiac function (by echocardiography) in tandem with skeletal muscle biopsies before, as well as three and nine months after surgery. Our Iong-term qoals are to define metabolic adaptation and maladaptation of the heart in clinically-relevant obesity, to transform the concept of glucolipotoxicity from an operational definition to a concrete physiological principle, and to establish a rationale for more effective treatment of obese patients with heart failure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MORBIDITY & MORTALITY RELATED TO GASTRIC BYPASS SURGERY Principal Investigator & Institution: Hunt, Steven C.; Professor; Internal Medicine; University of Utah 200 S University St Salt Lake City, Ut 84112 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: Three important hypotheses will be tested related to gastric bypass surgery for the treatment of severe obesity: 1) Roux-en-Y gastric bypass surgery is an effective and safe procedure to reduce weight as shown by lower long-term total and diseasespecific mortality rates compared to severely obese patients who have not had gastric surgery for treatment of obesity; 2) Roux-en-Y surgery significantly lowers long-term morbidity compared to matched severely obese patients who have not had surgery; 3) Significant weight loss after Roux-en-Y surgery will be maintained over a three year follow-up period. To test the mortality hypothesis, a consecutive series of 8,139 Roux-enY gastric bypass surgery patients who had surgery between 1980-1997 will be used. Two control series each of 1,000 unrelated severely obese controls will be selected for mortality comparisons from: 1)a database of 120,000 Utah families collected from 19831997; and 2) persons desiring surgery but refused (mostly for lack of health insurance coverage). Mean length of follow-up will be 14 years (6-24 years). Also NHANES I and II mortality data for subjects with greater than or equal to 35 BMI kg/m2 will be used as a national population-based control group. To test the morbidity and weight loss hypotheses, 400 subjects undergoing bypass surgery will be prospectively followed. Two non-surgical control groups will also be prospectively followed: 400 subjects from the Utah family database and 400 surgical refusals. These three roups will have detailed clinical visits at baseline, yearly contact with ongoing medical chart abstraction and will be re-examined after 3 years of follow-up. Because of inadequate or nonexistent control groups and limited sample size of surgical patients in nearly all studies adequate estimates of risks and benefits of gastric restrictive surgery are not available. Other than the in-progress Swedish Obesity Study, this study will be the first to include a severely obese control group for morbidity and the first to include female severely obese controls for mortality comparisons to surgical patients. Long-term follow-up of an extremely large series of surgical patients with minimal lost-to-follow-up will help define risks and benefits of this surgery. With increasing use of gastric surgery for weight control for the severely obese, it is critical to assess how effective this surgery is to reduce weight loss, improve the quality of life, and reduce morbidity and mortality. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MULTIMODAL VS UNIMODEL ANALGESIA IN MANAGEMENT OF GASTRIC BYPASS Principal Investigator & Institution: Carr, Daniel B.; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2001 Summary: This study aims to incorporate multimodal analgesia into the anesthesia regime of a subset of patients undergoing gastric bypass surgery. Comparisons will be made using several outcome criteria in an attempt to determine whether the current techniques can be improved, resulting in a simplified and cost effective anesthesia/analgesia technique for this patient population. The portion of this study which will include the GCRC is the data collection, analysis and management. We will collaborate with the GCRC systems manager and statistician to create and utilize scannable data collection tools. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: RESOLUTION FAILURE PREDICTORS IN NIDDM SEVERELY OBESE GASTRIC BYPASS PATIENTS Principal Investigator & Institution: Gonder-Frederick, Linda A.; Associate Professor; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: STRENGTH TRAINING FOLLOWING GASTRIC BYPASS FOR OBESITY Principal Investigator & Institution: Geliebter, Allan; St. Luke's-Roosevelt Inst for Hlth Scis Health Sciences New York, Ny 10019 Timing: Fiscal Year 2003; Project Start 01-MAR-2003; Project End 31-DEC-2004 Summary: (provided by applicant): As the incidence of obesity rises dramatically in the United States, more and more severely obese individuals are undergoing surgical treatment to reduce body weight and associated risk factors. Roux-en-Y gastric bypass (RYGB) is now the most common operation to treat morbid obesity in the US. However, little is known about the effects of RYGB on body composition and resting energy expenditure (REE). The main objectives of this study are to determine: 1) the composition of weight loss following surgery, 2) whether protein supplementation and strength training can limit the expected reduction of lean mass and REE. The study candidates will be morbidly obese women with a body mass index (BMI) of 40-56 kg/m2, be 18 - 49 y.o. and premenopausal. Except for severe obesity, they will be relatively healthy with a history of diet failure. They will be sedentary except for walking. There will be 36 study participants who, after stratifying by race, will be randomly assigned to three treatment groups (n = 12): 1) standard postoperative nutritional counseling only, 2) protein supplementation and standard postoperative nutritional counseling, or 3) protein supplementation plus strength training and standard postoperative nutritional counseling. The protein supplementation will begin shortly after surgery and increase from 40 g/day to 80 g/d at 4 weeks. Strength training will begin 8 weeks postoperation, to allow for adequate wound healing, and will consist of twice weekly progressive resistance training for upper and lower body for a period of 12 weeks. A battery of test measurements following a 12 h overnight fast will be

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conducted prior to surgery and repeated postoperatively at 8 and 20 weeks. These tests will include measurement of REE and body composition using underwater weighing, air displacement (BODPOD), dual xray absorptiometry (DEXA), magnetic resonance imaging (MRI), isotope dilution (D20), sodium bromide, and regional anthropometrics. There also will be assessments of arm and leg strength. Additionally, there will be measures of fasting glucose and body weight related hormones insulin, leptin, cortisol, and the recently discovered ghrelin. The predictions are that during the dramatic weight loss after surgery, the loss of some lean tissue, which could adversely impact skeletal muscle and vital organs, will be reduced by enhanced protein intake and weight training. There also may be greater conservation of REE and bone density. Plasma glucose and hormones should all decrease, especially with exercise, except for ghrelin, which should increase. The findings should improve understanding of surgical weight loss in morbidly obese patients and have clinical applications in the postoperative care of such patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with gastric bypass, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “gastric bypass” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for gastric bypass (hyperlinks lead to article summaries): •

A biodegradeable membrane from porcine intestinal submucosa to reinforce the gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass: preliminary report. Author(s): Kini S, Gagner M, de Csepel J, Gentileschi P, Dakin G. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 August; 11(4): 469-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11501357&dopt=Abstract

3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A comparison of diet and exercise therapy versus laparoscopic Roux-en-Y gastric bypass surgery for morbid obesity: a decision analysis model. Author(s): Patterson EJ, Urbach DR, Swanstrom LL. Source: Journal of the American College of Surgeons. 2003 March; 196(3): 379-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12648689&dopt=Abstract

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A comparison of multimodal perioperative analgesia to epidural pain management after gastric bypass surgery. Author(s): Schumann R, Shikora S, Weiss JM, Wurm H, Strassels S, Carr DB. Source: Anesthesia and Analgesia. 2003 February; 96(2): 469-74, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12538198&dopt=Abstract

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A comparison of the gastric bypass and the gastric wrap for morbid obesity. Author(s): Hoekstra SM, Lucas CE, Ledgerwood AM, Lucas WF. Source: Surg Gynecol Obstet. 1993 March; 176(3): 262-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8438198&dopt=Abstract

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A comparison study of laparoscopic versus open gastric bypass for morbid obesity. Author(s): Nguyen NT, Ho HS, Palmer LS, Wolfe BM. Source: Journal of the American College of Surgeons. 2000 August; 191(2): 149-55; Discussion 155-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10945358&dopt=Abstract

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A health status assessment of the impact of weight loss following Roux-en-Y gastric bypass for clinically severe obesity. Author(s): Choban PS, Onyejekwe J, Burge JC, Flancbaum L. Source: Journal of the American College of Surgeons. 1999 May; 188(5): 491-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10235576&dopt=Abstract

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A preliminary comparison of the psychological impact of laparoscopic gastric banding and gastric bypass surgery for morbid obesity. Author(s): Delin CR, Anderson PG. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 April; 9(2): 155-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10340769&dopt=Abstract

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A prospective evaluation of intracorporeal laparoscopic small bowel anastomosis during gastric bypass. Author(s): Nguyen NT, Neuhaus AM, Ho HS, Palmer LS, Furdui GG, Wolfe BM. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 April; 11(2): 196-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11355026&dopt=Abstract

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A replicated five cluster MMPI typology of morbidly obese female candidates for gastric bypass. Author(s): Blankmeyer BL, Smylie KD, Price DC, Costello RM, McFee AS, Fuller DS. Source: International Journal of Obesity. 1990 March; 14(3): 235-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2341228&dopt=Abstract

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A technique of stapled gastrojejunostomy for open gastric bypass results in increased wound complication-rate. Author(s): Madigan JD, Morales DL, Bessler M. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 June; 10(3): 230-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10929153&dopt=Abstract

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Absence of luminal intrinsic factor after gastric bypass surgery for morbid obesity. Author(s): Marcuard SP, Sinar DR, Swanson MS, Silverman JF, Levine JS. Source: Digestive Diseases and Sciences. 1989 August; 34(8): 1238-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2666054&dopt=Abstract

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Afferent limb volvulus and perforation of the bypassed stomach as a complication of Roux-en-Y gastric bypass. Author(s): Fleser PS, Villalba M. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 453-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841911&dopt=Abstract

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Alcohol and poor compliance as factors in Wernicke's encephalopathy diagnosed 13 years after gastric bypass. Author(s): Grace DM, Alfieri MA, Leung FY. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1998 October; 41(5): 389-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9793507&dopt=Abstract

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Alternative operative techniques in laparoscopic Roux-en-Y gastric bypass for morbid obesity. Author(s): Borao FJ, Thomas TA, Steichen FM. Source: Jsls. 2001 April-June; 5(2): 123-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11394424&dopt=Abstract

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An alternative technique for creating the gastrojejunostomy in laparoscopic Roux-enY gastric bypass: experience with 28 consecutive patients. Author(s): Teixeira JA, Borao FJ, Thomas TA, Cerabona T, Artuso D. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 June; 10(3): 240-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10929155&dopt=Abstract

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Analysis of cost outliers after gastric bypass surgery: what can we learn? Author(s): Cooney RN, Haluck RS, Ku J, Bass T, MacLeod J, Brunner H, Miller CA. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 February; 13(1): 29-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630610&dopt=Abstract

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Anorexia nervosa in a 38-year-old woman 2 years after gastric bypass surgery. Author(s): Scioscia TN, Bulik CM, Levenson J, Kirby DF. Source: Psychosomatics. 1999 January-February; 40(1): 86-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9989128&dopt=Abstract

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Antiperistaltic and isoperistaltic intussusception associated with abnormal motility after Roux-en-Y gastric bypass: a case report. Author(s): Hocking MP, McCoy DM, Vogel SB, Kaude JV, Sninsky CA. Source: Surgery. 1991 July; 110(1): 109-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1866683&dopt=Abstract

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Are vitamin B12 and folate deficiency clinically important after roux-en-Y gastric bypass? Author(s): Brolin RE, Gorman JH, Gorman RC, Petschenik AJ, Bradley LJ, Kenler HA, Cody RP. Source: Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract. 1998 September-October; 2(5): 436-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9843603&dopt=Abstract

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Assessment of routine elimination of postoperative nasogastric decompression after Roux-en-Y gastric bypass. Author(s): Huerta S, Arteaga JR, Sawicki MP, Liu CD, Livingston EH. Source: Surgery. 2002 November; 132(5): 844-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12464869&dopt=Abstract

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Autopsy findings following gastric bypass surgery for morbid obesity. Author(s): Melinek J, Livingston E, Cortina G, Fishbein MC. Source: Archives of Pathology & Laboratory Medicine. 2002 September; 126(9): 1091-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12204059&dopt=Abstract

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Avoidance of weight regain after gastric bypass. Author(s): Deitel M. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 August; 11(4): 474. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11501358&dopt=Abstract

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Band erosion: incidence, etiology, management and outcome after banded vertical gastric bypass. Author(s): Fobi M, Lee H, Igwe D, Felahy B, James E, Stanczyk M, Fobi N. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 December; 11(6): 699-707. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11775567&dopt=Abstract

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Basal and exercise tests on morbidly obese patients before and after gastric bypass. Author(s): Zavala DC, Printen KJ. Source: Surgery. 1984 February; 95(2): 221-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6695339&dopt=Abstract

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Biliary and gastric bypass or stenting in nonresectable periampullary cancer: analysis on the basis of controlled trials. Author(s): Schwarz A, Beger HG. Source: International Journal of Pancreatology : Official Journal of the International Association of Pancreatology. 2000 February; 27(1): 51-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10811023&dopt=Abstract

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Binge eating among gastric bypass patients at long-term follow-up. Author(s): Kalarchian MA, Marcus MD, Wilson GT, Labouvie EW, Brolin RE, LaMarca LB. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 April; 12(2): 270-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11975227&dopt=Abstract

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Binge eating in gastric bypass patients before surgery. Author(s): Saunders R. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 February; 9(1): 72-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10065590&dopt=Abstract

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Bleeding duodenal ulcer after gastric bypass procedure for obesity. Author(s): Spires WV, Morris DM. Source: Southern Medical Journal. 1987 October; 80(10): 1325-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3660053&dopt=Abstract

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Bleeding from the bypassed stomach following gastric bypass. Author(s): Printen KJ, LeFavre J, Alden J. Source: Surg Gynecol Obstet. 1983 January; 156(1): 65-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6600204&dopt=Abstract

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Body composition assessment in extreme obesity and after massive weight loss induced by gastric bypass surgery. Author(s): Das SK, Roberts SB, Kehayias JJ, Wang J, Hsu LK, Shikora SA, Saltzman E, McCrory MA. Source: American Journal of Physiology. Endocrinology and Metabolism. 2003 June; 284(6): E1080-8. Epub 2003 February 25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12604503&dopt=Abstract

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Changes in eating behavior after horizontal gastroplasty and Roux-en-Y gastric bypass. Author(s): Kenler HA, Brolin RE, Cody RP. Source: The American Journal of Clinical Nutrition. 1990 July; 52(1): 87-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2360554&dopt=Abstract

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Changes in measured resting energy expenditure after Roux-en-Y gastric bypass for clinically severe obesity are not related to bypass limb-length. Author(s): Flancbaum L, Verducci JS, Choban PS. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1998 August; 8(4): 437-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9731680&dopt=Abstract

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Changes in patients' taste acuity after Roux-en-Y gastric bypass for clinically severe obesity. Author(s): Burge JC, Schaumburg JZ, Choban PS, DiSilvestro RA, Flancbaum L. Source: Journal of the American Dietetic Association. 1995 June; 95(6): 666-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7759742&dopt=Abstract

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Chronic parietal cell dysfunction after reversal of gastric bypass. Author(s): Crowley LV. Source: The American Journal of Gastroenterology. 1986 December; 81(12): 1188-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3788928&dopt=Abstract

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Clinical predictors of leak after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Author(s): Hamilton EC, Sims TL, Hamilton TT, Mullican MA, Jones DB, Provost DA. Source: Surgical Endoscopy. 2003 May; 17(5): 679-84. Epub 2003 March 07. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12618940&dopt=Abstract

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Comments to presidential address: gastric bypass and biliopancreatic diversion operations. Author(s): Scopinaro N. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 December; 12(6): 881-3; Author Reply 884. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568201&dopt=Abstract

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Comparing the outcomes after laparoscopic versus open gastric bypass: a matched paired analysis. Author(s): Courcoulas A, Perry Y, Buenaventura P, Luketich J. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 341-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841890&dopt=Abstract

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Comparison of 21 vs. 25 mm gastrojejunostomy in the gastric bypass procedure--early results. Author(s): Stahl RD, Sherer RA, Seevers CE, Johnston D. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 December; 10(6): 540-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11175962&dopt=Abstract

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Comparison of nutritional deficiencies after Roux-en-Y gastric bypass and after biliopancreatic diversion with Roux-en-Y gastric bypass. Author(s): Skroubis G, Sakellaropoulos G, Pouggouras K, Mead N, Nikiforidis G, Kalfarentzos F. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 August; 12(4): 551-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12194550&dopt=Abstract

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Comparison of postoperative hepatic function after laparoscopic versus open gastric bypass. Author(s): Nguyen NT, Braley S, Fleming NW, Lambourne L, Rivers R, Wolfe BM. Source: American Journal of Surgery. 2003 July; 186(1): 40-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842747&dopt=Abstract

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Comparison of pulmonary function and postoperative pain after laparoscopic versus open gastric bypass: a randomized trial. Author(s): Nguyen NT, Lee SL, Goldman C, Fleming N, Arango A, McFall R, Wolfe BM. Source: Journal of the American College of Surgeons. 2001 April; 192(4): 469-76; Discussion 476-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11294404&dopt=Abstract

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Complications after gastroplasty and gastric bypass as a primary operation and as a reoperation. Author(s): Cariani S, Nottola D, Grani S, Vittimberga G, Lucchi A, Amenta E. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 August; 11(4): 487-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11501361&dopt=Abstract

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Complications in gastric bypass. Author(s): Brannegan RT. Source: Archives of Physical Medicine and Rehabilitation. 1987 October; 68(10): 745. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2821956&dopt=Abstract

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Complications in gastric bypass. Author(s): Brannegan RT. Source: Archives of Physical Medicine and Rehabilitation. 1987 August; 68(8): 526. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3039938&dopt=Abstract

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Complications of the laparoscopic Roux-en-Y gastric bypass: 1,040 patients--what have we learned? Author(s): Higa KD, Boone KB, Ho T. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 December; 10(6): 509-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11175957&dopt=Abstract

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Compulsive eating and gastric bypass surgery: what does hunger have to do with it? Author(s): Saunders R. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 December; 11(6): 757-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11775577&dopt=Abstract

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Controlling the size of the gastrojejunostomy stoma in gastric bypass operations. Author(s): Flanagan L Jr. Source: Surg Gynecol Obstet. 1983 October; 157(4): 377. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6623331&dopt=Abstract

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Conversion of failed or complicated vertical banded gastroplasty to gastric bypass in morbid obesity. Author(s): Sugerman HJ, Kellum JM Jr, DeMaria EJ, Reines HD. Source: American Journal of Surgery. 1996 February; 171(2): 263-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8619465&dopt=Abstract

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Conversion of Lap-Band to gastric bypass for dilated gastric pouch. Author(s): Angrisani L, Borrelli V, Lorenzo M, Santoro T, Cimmino G, Ciannella M, Iovino P, Persico G, Tesauro B. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 April; 11(2): 232-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11355033&dopt=Abstract

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Cost-effectiveness of gastric bypass for severe obesity. Author(s): Craig BM, Tseng DS. Source: The American Journal of Medicine. 2002 October 15; 113(6): 491-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12427499&dopt=Abstract

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Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Author(s): Sugerman HJ, Wolfe LG, Sica DA, Clore JN. Source: Annals of Surgery. 2003 June; 237(6): 751-6; Discussion 757-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12796570&dopt=Abstract

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Dietary intake before and after gastric bypass and gastroplasty for morbid obesity in women. Author(s): Naslund I, Jarnmark I, Andersson H. Source: International Journal of Obesity. 1988; 12(6): 503-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3069767&dopt=Abstract

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Different plasma ghrelin levels after laparoscopic gastric bypass and adjustable gastric banding in morbid obese subjects. Author(s): Leonetti F, Silecchia G, Iacobellis G, Ribaudo MC, Zappaterreno A, Tiberti C, Iannucci CV, Perrotta N, Bacci V, Basso MS, Basso N, Di Mario U. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 September; 88(9): 4227-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12970291&dopt=Abstract

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Distal gastric bypass/duodenal switch procedure, Roux-en-Y gastric bypass and biliopancreatic diversion in a community practice. Author(s): Rabkin RA. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1998 February; 8(1): 53-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9562488&dopt=Abstract

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Divided gastric bypass: a fifteen-year experience. Author(s): Kirkpatrick JR, Zapas JL. Source: The American Surgeon. 1998 January; 64(1): 62-5; Discussion 65-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9457039&dopt=Abstract

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Double closed loop obstruction and perforation in a previous Roux-en-Y gastric bypass. Author(s): Keyser EJ, Ahmed NA, Mott BD, Tchervenkov J. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1998 August; 8(4): 475-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9731685&dopt=Abstract

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Duodenogastric bile reflux after gastric bypass: a cholescintigraphic study. Author(s): Sundbom M, Hedenstrom H, Gustavsson S. Source: Digestive Diseases and Sciences. 2002 August; 47(8): 1891-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12184547&dopt=Abstract

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Duplex ultrasound assessment of femoral venous flow during laparoscopic and open gastric bypass. Author(s): Nguyen NT, Cronan M, Braley S, Rivers R, Wolfe BM. Source: Surgical Endoscopy. 2003 February; 17(2): 285-90. Epub 2002 October 08. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364988&dopt=Abstract

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Dysfunctional immune-privilege in morbid obesity: implications and effect of gastric bypass surgery. Author(s): Cottam DR, Schaefer PA, Shaftan GW, Angus LD. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 February; 13(1): 49-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630613&dopt=Abstract

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Early gastrointestinal hemorrhage after laparoscopic gastric bypass. Author(s): Steffen R. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 466; Author Reply 466-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841915&dopt=Abstract

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Early gastrointestinal hemorrhage after laparoscopic gastric bypass. Author(s): Nguyen NT, Rivers R, Wolfe BM. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 February; 13(1): 62-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630615&dopt=Abstract

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Early results after laparoscopic gastric bypass: EEA vs GIA stapled gastrojejunal anastomosis. Author(s): Shope TR, Cooney RN, McLeod J, Miller CA, Haluck RS. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 355-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841893&dopt=Abstract

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Eating behavior and the experience of hunger following gastric bypass surgery for morbid obesity. Author(s): Delin CR, Watts JM, Saebel JL, Anderson PG. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 October; 7(5): 405-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730494&dopt=Abstract

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Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Author(s): Schauer PR, Burguera B, Ikramuddin S, Cottam D, Gourash W, Hamad G, Eid GM, Mattar S, Ramanathan R, Barinas-Mitchel E, Rao RH, Kuller L, Kelley D. Source: Annals of Surgery. 2003 October; 238(4): 467-84; Discussion 84-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14530719&dopt=Abstract

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Effect of prolonged pneumoperitoneum on intraoperative urine output during laparoscopic gastric bypass. Author(s): Nguyen NT, Perez RV, Fleming N, Rivers R, Wolfe BM. Source: Journal of the American College of Surgeons. 2002 October; 195(4): 476-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12375752&dopt=Abstract

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Effect of the learning curve on the early outcomes of laparoscopic Roux-en-Y gastric bypass. Author(s): Kligman MD, Thomas C, Saxe J. Source: The American Surgeon. 2003 April; 69(4): 304-9; Discussion 309-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716088&dopt=Abstract

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Effects of participation in bariatric support group after Roux-en-Y gastric bypass. Author(s): Hildebrandt SE. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1998 October; 8(5): 535-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9819086&dopt=Abstract

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Efficacy and safety of patient-controlled analgesia for morbidly obese patients following gastric bypass surgery. Author(s): Choi YK, Brolin RE, Wagner BK, Chou S, Etesham S, Pollak P. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 April; 10(2): 154-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10782177&dopt=Abstract

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Elective cholecystectomy during laparoscopic Roux-en-Y gastric bypass: is it worth the wait? Author(s): Hamad GG, Ikramuddin S, Gourash WF, Schauer PR. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 February; 13(1): 76-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630618&dopt=Abstract

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Elevated liver enzymes as an operative complication of gastric bypass surgery. Author(s): Saranita J, Soto RG, Paoli D. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 April; 13(2): 314-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12740146&dopt=Abstract

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Endoscopic dilation of gastroesophageal anastomosis stricture after gastric bypass. Author(s): Barba CA, Butensky MS, Lorenzo M, Newman R. Source: Surgical Endoscopy. 2003 March; 17(3): 416-20. Epub 2002 December 04. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457221&dopt=Abstract

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Energy economy hampers body weight loss after gastric bypass. Author(s): Bobbioni-Harsch E, Morel P, Huber O, Assimacopoulos-Jeannet F, Chassot G, Lehmann T, Volery M, Golay A. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 December; 85(12): 4695-700. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11134130&dopt=Abstract

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Establishing a laparoscopic gastric bypass program. Author(s): Dresel A, Kuhn JA, Westmoreland MV, Talaasen LJ, McCarty TM. Source: American Journal of Surgery. 2002 December; 184(6): 617-20; Discussion 620. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488190&dopt=Abstract

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Evaluation of core temperature during laparoscopic and open gastric bypass. Author(s): Nguyen NT, Fleming NW, Singh A, Lee SJ, Goldman CD, Wolfe BM. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 October; 11(5): 570-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11594097&dopt=Abstract

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Evaluation of health status and quality of life after bariatric surgery: comparison of standard Roux-en-Y gastric bypass, vertical banded gastroplasty and laparoscopic adjustable silicone gastric banding. Author(s): Hell E, Miller KA, Moorehead MK, Norman S. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 June; 10(3): 214-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10929151&dopt=Abstract

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Evaluation of intra-abdominal pressure after laparoscopic and open gastric bypass. Author(s): Nguyen NT, Lee SL, Anderson JT, Palmer LS, Canet F, Wolfe BM. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 February; 11(1): 40-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11361167&dopt=Abstract

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Evidence for diminished B12 absorption after gastric bypass: oral supplementation does not prevent low plasma B12 levels in bypass patients. Author(s): Provenzale D, Reinhold RB, Golner B, Irwin V, Dallal GE, Papathanasopoulos N, Sahyoun N, Samloff IM, Russell RM. Source: Journal of the American College of Nutrition. 1992 February; 11(1): 29-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1541791&dopt=Abstract

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Excellent weight result after Roux-en-Y gastric bypass in spite of gastro-gastric fistula. Author(s): Gustavsson S, Sundbom M. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 457-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841912&dopt=Abstract

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Experience with the Roux-en-Y gastric bypass, and commentary on current trends. Author(s): Jones KB Jr. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 April; 10(2): 183-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10782184&dopt=Abstract

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Facilitated vertical gastric pouch construction for gastric bypass. Author(s): Gleysteen JJ. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 April; 10(2): 174-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10782181&dopt=Abstract

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Facilitating retrocolic-retrogastric gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass for morbid obesity. Author(s): Clements RH, Harper HC 3rd, Laws HL. Source: Journal of the American College of Surgeons. 2001 September; 193(3): 331-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11548806&dopt=Abstract

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Factors associated with operative outcomes in laparoscopic gastric bypass. Author(s): Nguyen NT, Rivers R, Wolfe BM. Source: Journal of the American College of Surgeons. 2003 October; 197(4): 548-55; Discussion 555-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14522321&dopt=Abstract

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Factors influencing energy intake and body weight loss after gastric bypass. Author(s): Bobbioni-Harsch E, Huber O, Morel P, Chassot G, Lehmann T, Volery M, Chliamovitch E, Muggler C, Golay A. Source: European Journal of Clinical Nutrition. 2002 June; 56(6): 551-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12032656&dopt=Abstract

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Failed gastroplasty for morbid obesity. Revised gastroplasty versus Roux-Y gastric bypass. Author(s): Sugerman HJ, Wolper JL. Source: American Journal of Surgery. 1984 September; 148(3): 331-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6383098&dopt=Abstract

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Failure of a nursing infant to thrive after the mother's gastric bypass for morbid obesity. Author(s): Martens WS 2nd, Martin LF, Berlin CM Jr. Source: Pediatrics. 1990 November; 86(5): 777-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2235232&dopt=Abstract

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Faster absorption of ethanol and higher peak concentration in women after gastric bypass surgery. Author(s): Klockhoff H, Naslund I, Jones AW. Source: British Journal of Clinical Pharmacology. 2002 December; 54(6): 587-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492605&dopt=Abstract

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Flexible endoscopy in the management of patients undergoing Roux-en-Y gastric bypass. Author(s): Schirmer B, Erenoglu C, Miller A. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 October; 12(5): 634-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12448383&dopt=Abstract

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Food intake patterns of gastric bypass patients. Author(s): Brown EK, Settle EA, Van Rij AM. Source: Journal of the American Dietetic Association. 1982 May; 80(5): 437-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7077000&dopt=Abstract

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Four-year weight loss Roux-Y gastric bypass: anastomotic reinforcement not additive. Author(s): Gleysteen JJ. Source: Gastroenterology Clinics of North America. 1987 September; 16(3): 525-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3325428&dopt=Abstract

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Fully stapled gastric bypass with isolated pouch and terminal anastomosis: 1-3 year results. Author(s): Hedenbro JL, Frederiksen SG. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 August; 12(4): 546-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12194549&dopt=Abstract

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Functional gastric bypass with an adjustable gastric band. Author(s): Furbetta F, Gambinotti G. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 December; 12(6): 876-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568200&dopt=Abstract

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Gastric acid secretion and vitamin B12 absorption after vertical Roux-en-Y gastric bypass for morbid obesity. Author(s): Smith CD, Herkes SB, Behrns KE, Fairbanks VF, Kelly KA, Sarr MG. Source: Annals of Surgery. 1993 July; 218(1): 91-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8328834&dopt=Abstract

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Gastric bypass for morbid obesity in patients 50 years or older: is laparoscopic technique safer? Author(s): Gonzalez R, Lin E, Mattar SG, Venkatesh KR, Smith CD. Source: The American Surgeon. 2003 July; 69(7): 547-53; Discussion 553-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12889614&dopt=Abstract

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Gastric bypass for morbid obesity: a standard surgical technique by consensus. Author(s): Talieh J, Kirgan D, Fisher BL. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 June; 7(3): 198-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730548&dopt=Abstract

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Gastric bypass is an effective treatment for obstructive sleep apnea in patients with clinically significant obesity. Author(s): Rasheid S, Banasiak M, Gallagher SF, Lipska A, Kaba S, Ventimiglia D, Anderson WM, Murr MM. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 February; 13(1): 58-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630614&dopt=Abstract

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Gastric bypass procedures. Author(s): Fisher BL, Barber AE. Source: European Journal of Gastroenterology & Hepatology. 1999 February; 11(2): 93-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10102217&dopt=Abstract

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Gastric bypass surgery for obesity. Author(s): Buechner JS. Source: Medicine and Health, Rhode Island. 2003 March; 86(3): 81-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12703143&dopt=Abstract

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Gastric bypass surgery for severe obesity. Author(s): Sugerman HJ. Source: Semin Laparosc Surg. 2002 June; 9(2): 79-85. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12152150&dopt=Abstract

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Gastric bypass surgery in adolescents with morbid obesity. Author(s): Strauss RS, Bradley LJ, Brolin RE. Source: The Journal of Pediatrics. 2001 April; 138(4): 499-504. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11295712&dopt=Abstract

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Gastric bypass. Author(s): Brolin RE. Source: The Surgical Clinics of North America. 2001 October; 81(5): 1077-95. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11589246&dopt=Abstract

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Gastric bypass: it pays to keep military hospitals busy. Author(s): Chang CG, Helling TS, Dezutti B, Koenig C, Cruz S. Source: Military Medicine. 2003 September; 168(9): 725-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14529247&dopt=Abstract

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Gastric bypass: standard surgical technique. Author(s): Fobi MA. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 December; 7(6): 518-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730512&dopt=Abstract

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Gastroesophageal reflux after intact vertical banded gastroplasty: correction by conversion to Roux-en-Y gastric bypass. Author(s): Balsiger BM, Murr MM, Mai J, Sarr MG. Source: Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract. 2000 May-June; 4(3): 276-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10769090&dopt=Abstract

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Gastro-gastric fistulas and marginal ulcers in gastric bypass procedures for weight reduction. Author(s): Capella JF, Capella RF. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 February; 9(1): 22-7; Discussion 28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10065576&dopt=Abstract

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Gastrogastric fistulas. A complication of divided gastric bypass surgery. Author(s): Cucchi SG, Pories WJ, MacDonald KG, Morgan EJ. Source: Annals of Surgery. 1995 April; 221(4): 387-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7726674&dopt=Abstract

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Gastrointestinal complications of laparoscopic roux-en-Y gastric bypass surgery in patients who are morbidly obese: findings on radiography and CT. Author(s): Blachar A, Federle MP. Source: Ajr. American Journal of Roentgenology. 2002 December; 179(6): 1437-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12438032&dopt=Abstract

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Gastrojejunostomy during laparoscopic gastric bypass: analysis of 3 techniques. Author(s): Gonzalez R, Lin E, Venkatesh KR, Bowers SP, Smith CD. Source: Archives of Surgery (Chicago, Ill. : 1960). 2003 February; 138(2): 181-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12578417&dopt=Abstract

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Ghrelin and adipose tissue regulatory peptides: effect of gastric bypass surgery in obese humans. Author(s): Holdstock C, Engstrom BE, Ohrvall M, Lind L, Sundbom M, Karlsson FA. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 July; 88(7): 3177-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12843162&dopt=Abstract

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Ghrelin and gastric bypass: is there a hormonal contribution to surgical weight loss? Author(s): Cummings DE, Shannon MH. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 July; 88(7): 29993002. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12843132&dopt=Abstract

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Ghrelin: a gut-brain hormone: effect of gastric bypass surgery. Author(s): Geloneze B, Tambascia MA, Pilla VF, Geloneze SR, Repetto EM, Pareja JC. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 February; 13(1): 17-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630608&dopt=Abstract

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Glucose utilization in morbidly obese subjects before and after weight loss by gastric bypass operation. Author(s): Burstein R, Epstein Y, Charuzi I, Suessholz A, Karnieli E, Shapiro Y. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1995 August; 19(8): 558-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7489026&dopt=Abstract

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Haloperidol pharmacokinetics following gastric bypass surgery. Author(s): Fuller AK, Tingle D, DeVane CL, Scott JA, Stewart RB. Source: Journal of Clinical Psychopharmacology. 1986 December; 6(6): 376-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3805335&dopt=Abstract

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Hand-assisted laparoscopic gastric bypass does not improve outcome and increases costs when compared to open gastric bypass for the surgical treatment of obesity. Author(s): DeMaria EJ, Schweitzer MA, Kellum JM, Meador J, Wolfe L, Sugerman HJ. Source: Surgical Endoscopy. 2002 October; 16(10): 1452-5. Epub 2002 June 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12063573&dopt=Abstract

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Hand-assisted laparoscopic Roux-en-y gastric bypass: aspects of surgical technique and early results. Author(s): Sundbom M, Gustavsson S. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 October; 10(5): 420-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11054246&dopt=Abstract

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Health-related quality of life in morbidly obese patients: effect of gastric bypass surgery. Author(s): de Zwaan M, Lancaster KL, Mitchell JE, Howell LM, Monson N, Roerig JL, Crosby RD. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 December; 12(6): 773-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568181&dopt=Abstract

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Health-related quality of life in patients seeking gastric bypass surgery vs nontreatment-seeking controls. Author(s): Kolotkin RL, Crosby RD, Pendleton R, Strong M, Gress RE, Adams T. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 371-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841896&dopt=Abstract

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Helicobacter pylori infection in patients undergoing gastric bypass surgery for morbid obesity. Author(s): Renshaw AA, Rabaza JR, Gonzalez AM, Verdeja JC. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 June; 11(3): 281-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11433901&dopt=Abstract

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Hematologic complications of gastric bypass for morbid obesity. Author(s): Simon SR, Zemel R, Betancourt S, Zidar BL. Source: Southern Medical Journal. 1989 September; 82(9): 1108-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2772679&dopt=Abstract

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Heparin thromboprophylaxis in gastric bypass surgery. Author(s): Shepherd MF, Rosborough TK, Schwartz ML. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 April; 13(2): 249-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12740133&dopt=Abstract

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Histologic and endoscopic studies before and after gastric bypass surgery. Author(s): Park HK, Sinar DR, Sloss RR, Whitley TW, Silverman JF. Source: Archives of Pathology & Laboratory Medicine. 1986 December; 110(12): 1164-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3778145&dopt=Abstract

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Horizontal gastroplasty. A safe, effective alternative to gastric bypass in the surgical management of morbid obesity. Author(s): Jones KB Jr. Source: The American Surgeon. 1984 March; 50(3): 128-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6703523&dopt=Abstract

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Hyperinsulinism, glucose-dependent insulinotropic polypeptide, and the enteroinsular axis in morbidly obese patients before and after gastric bypass. Author(s): Sirinek KR, O'Dorisio TM, Hill D, McFee AS. Source: Surgery. 1986 October; 100(4): 781-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3532392&dopt=Abstract

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Hypopharyngeal perforation during laparoscopic Roux-en-Y gastric bypass. Author(s): Nguyen NT, Wolfe BM. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 February; 10(1): 64-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10715649&dopt=Abstract

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Hypoxemia after gastric bypass surgery for morbid obesity. Author(s): Taylor RR, Kelly TM, Elliott CG, Jensen RL, Jones SB. Source: Archives of Surgery (Chicago, Ill. : 1960). 1985 November; 120(11): 1298-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4051734&dopt=Abstract

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Immune response after gastric bypass and weight loss. Author(s): Grace DM, Harle IA, Rycroft KM, Sinclair NR. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1986 July; 29(4): 284-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3730974&dopt=Abstract

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Improvement in co-morbidities following weight loss from gastric bypass surgery. Author(s): Dhabuwala A, Cannan RJ, Stubbs RS. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 October; 10(5): 428-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11054247&dopt=Abstract

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Improvement in heart disease risk factors after gastric bypass. Author(s): Gleysteen JJ, Barboriak JJ. Source: Archives of Surgery (Chicago, Ill. : 1960). 1983 June; 118(6): 681-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6847361&dopt=Abstract

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Increased binding of insulin to mononuclear blood cells following gastric bypass for morbid obesity. Author(s): Kramer JL, Halverson JD, Thomas L, Santiago JV. Source: The Journal of Surgical Research. 1982 April; 32(4): 343-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7040809&dopt=Abstract

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Indications for gastric bypass in palliative operations for pancreatic carcinoma. Author(s): Potts JR 3rd, Vogt DP, Broughan T, Hermann RE. Source: The American Surgeon. 1991 January; 57(1): 24-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1724593&dopt=Abstract

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Influence of a forced air warming system on morbidly obese patients undergoing Roux-en-Y gastric bypass. Author(s): Mason DS, Sapala JA, Wood MH, Sapala MA. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1998 August; 8(4): 453-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9731682&dopt=Abstract

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Initial (1-year) weight loss after gastric banding, gastroplasty or gastric bypass. Author(s): Backman L, Granstrom L. Source: Acta Chir Scand. 1984; 150(1): 63-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6702395&dopt=Abstract

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Initial results with a stapled gastrojejunostomy for the laparoscopic isolated roux-enY gastric bypass. Author(s): Matthews BD, Sing RF, DeLegge MH, Ponsky JL, Heniford BT. Source: American Journal of Surgery. 2000 June; 179(6): 476-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11004334&dopt=Abstract

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Internal hernia formation after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Author(s): Filip JE, Mattar SG, Bowers SP, Smith CD. Source: The American Surgeon. 2002 July; 68(7): 640-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132750&dopt=Abstract

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Internal hernias after laparoscopic Roux-en-Y gastric bypass: incidence, treatment and prevention. Author(s): Higa KD, Ho T, Boone KB. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 350-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841892&dopt=Abstract

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Internal hernias and gastric perforation after a laparoscopic gastric bypass. Author(s): Serra C, Baltasar A, Bou R, Miro J, Cipagauta LA. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 December; 9(6): 546-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10638480&dopt=Abstract

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Interval jejunoileal bypass reduces the morbidity and mortality of Roux-en-Y gastric bypass in the super-obese. Author(s): Arteaga JR, Huerta S, Basa NR, Livingston EH. Source: The American Surgeon. 2003 October; 69(10): 873-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14570366&dopt=Abstract

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Interventional radiologic treatment of complications following gastric bypass surgery for morbid obesity. Author(s): Mishkin JD, Meranze SG, Burke DR, Stein EJ, McLean GK. Source: Gastrointest Radiol. 1988; 13(1): 9-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3350275&dopt=Abstract

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Intestinal and gastric bypass. Changes in intestinal microecology after surgical treatment of morbid obesity in man. Author(s): Bjorneklett A, Viddal KO, Midtvedt T, Nygaard K. Source: Scandinavian Journal of Gastroenterology. 1981; 16(5): 681-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7323701&dopt=Abstract

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Intrathoracic gastric bypass for carcinoma of oesophagus found unresectable at exploration. Author(s): Lam KH, Wong J, Lim ST, Ong GB. Source: The British Journal of Surgery. 1982 February; 69(2): 71-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6174170&dopt=Abstract

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Intravenous valproate treatment of severe manic symptoms after gastric bypass surgery: a case report. Author(s): Kaltsounis J, De Leon OA. Source: Psychosomatics. 2000 September-October; 41(5): 454-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11015641&dopt=Abstract

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Intussusception after Roux-en-Y gastric bypass. Author(s): Duane TM, Wohlgemuth S, Ruffin K. Source: The American Surgeon. 2000 January; 66(1): 82-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10651354&dopt=Abstract

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Investigation of the excluded stomach after Roux-en-Y gastric bypass. Author(s): Sundbom M, Nyman R, Hedenstrom H, Gustavsson S. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 February; 11(1): 25-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11361163&dopt=Abstract

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Iron absorption and therapy after gastric bypass. Author(s): Rhode BM, Shustik C, Christou NV, MacLean LD. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 February; 9(1): 17-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10065575&dopt=Abstract

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Jejunoileal bypass versus gastric bypass or gastroplasty in the operative treatment of obesity. Author(s): Scott HW Jr. Source: Langenbecks Arch Chir. 1982; 356(1): 25-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7054630&dopt=Abstract

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Laparoscopic approach to open gastric bypass. Author(s): Harold KL, Heniford BT, Matthews BD, Sing RF. Source: American Journal of Surgery. 2002 July; 184(1): 61-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12135723&dopt=Abstract

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Laparoscopic gastric bypass for morbid obesity with linear gastroenterostomy. Author(s): Korenkov M, Goh P, Yucel N, Troidl H. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 360-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841894&dopt=Abstract

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Laparoscopic gastric bypass in the treatment of morbid obesity. Preliminary results of a new technique. Author(s): Lujan JA, Hernandez Q, Frutos MD, Valero G, Cuenca JR, Parrilla P. Source: Surgical Endoscopy. 2002 December; 16(12): 1658-62. Epub 2002 July 29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12140634&dopt=Abstract

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Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1,200 cases. Author(s): Biertho L, Steffen R, Ricklin T, Horber FF, Pomp A, Inabnet WB, Herron D, Gagner M. Source: Journal of the American College of Surgeons. 2003 October; 197(4): 536-44; Discussion 544-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14522318&dopt=Abstract

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Laparoscopic gastric bypass with BMI > or = 60. Author(s): Kamelgard JI. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 February; 13(1): 140; Author Reply 140. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630631&dopt=Abstract

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Laparoscopic gastric bypass: development of technique, respiratory function, and long-term outcome. Author(s): Olbers T, Lonroth H, Fagevik-Olsen M, Lundell L. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 364-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841895&dopt=Abstract

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Laparoscopic inflatable band with Roux-en-Y gastric bypass. Author(s): Himpens JM, Rogge F, Leman G, Sonneville T. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 August; 11(4): 528-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11501369&dopt=Abstract

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Laparoscopic management of complications following laparoscopic Roux-en-Y gastric bypass for morbid obesity. Author(s): Papasavas PK, Caushaj PF, McCormick JT, Quinlin RF, Hayetian FD, Maurer J, Kelly JJ, Gagne DJ. Source: Surgical Endoscopy. 2003 April; 17(4): 610-4. Epub 2003 February 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12582772&dopt=Abstract

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Laparoscopic reoperation for early complications of laparoscopic gastric bypass. Author(s): Papasavas PK, O'Mara MS, Quinlin RF, Maurer J, Caushaj PF, Gagne DJ. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 August; 12(4): 559-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12194551&dopt=Abstract

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Laparoscopic Roux-en-Y gastric bypass in morbidly obese adolescents. Author(s): Stanford A, Glascock JM, Eid GM, Kane T, Ford HR, Ikramuddin S, Schauer P. Source: Journal of Pediatric Surgery. 2003 March; 38(3): 430-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12632362&dopt=Abstract

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Laparoscopic Roux-en-Y gastric bypass in the “megaobese”. Author(s): Kreitz K, Rovito PF. Source: Archives of Surgery (Chicago, Ill. : 1960). 2003 July; 138(7): 707-9; Discussion 710. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12860749&dopt=Abstract

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Laparoscopic Roux-en-Y gastric bypass with remnant gastrectomy for focal intestinal metaplasia of the gastric antrum. Author(s): Voellinger DC, Inabnet WB. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 October; 12(5): 695-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12448395&dopt=Abstract

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Laparoscopic Roux-en-Y gastric bypass: defining the learning curve. Author(s): Oliak D, Ballantyne GH, Weber P, Wasielewski A, Davies RJ, Schmidt HJ. Source: Surgical Endoscopy. 2003 March; 17(3): 405-8. Epub 2002 October 29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399853&dopt=Abstract

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Laparoscopic Roux-en-Y gastric bypass: initial 2-year experience. Author(s): Suter M, Giusti V, Heraief E, Zysset F, Calmes JM. Source: Surgical Endoscopy. 2003 April; 17(4): 603-9. Epub 2003 February 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12582767&dopt=Abstract

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Laparoscopic Roux-en-Y gastric bypass--evaluation of three different techniques. Author(s): Abdel-Galil E, Sabry AA. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 October; 12(5): 639-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12448384&dopt=Abstract

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Laparoscopic versus open gastric bypass. Author(s): Nguyen NT, Wolfe BM. Source: Semin Laparosc Surg. 2002 June; 9(2): 86-93. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12152151&dopt=Abstract

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Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Author(s): Nguyen NT, Goldman C, Rosenquist CJ, Arango A, Cole CJ, Lee SJ, Wolfe BM. Source: Annals of Surgery. 2001 September; 234(3): 279-89; Discussion 289-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11524581&dopt=Abstract

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Lesser curvature Roux-en-Y gastric bypass as an alternative procedure to failed vertical banded gastroplasty: surgical technique and short-term results. Author(s): Denoel C, Denoel A, Coimbra C, Heymans O. Source: Acta Chir Belg. 2001 July-August; 101(4): 179-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11680061&dopt=Abstract

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Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery. Author(s): Das SK, Roberts SB, McCrory MA, Hsu LK, Shikora SA, Kehayias JJ, Dallal GE, Saltzman E. Source: The American Journal of Clinical Nutrition. 2003 July; 78(1): 22-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12816767&dopt=Abstract

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Lumbar muscle rhabdomyolysis as a cause of acute renal failure after Roux-en-Y gastric bypass. Author(s): Wiltshire JP, Custer T. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 April; 13(2): 306-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12740145&dopt=Abstract

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Malabsorptive procedures for severe obesity: comparison of pancreaticobiliary bypass and very very long limb Roux-en-Y gastric bypass. Author(s): Murr MM, Balsiger BM, Kennedy FP, Mai JL, Sarr MG. Source: Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract. 1999 November-December; 3(6): 607-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10554367&dopt=Abstract

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Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Author(s): Livingston EH, Huerta S, Arthur D, Lee S, De Shields S, Heber D. Source: Annals of Surgery. 2002 November; 236(5): 576-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409663&dopt=Abstract

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Malnutrition-induced myopathy following Roux-en-Y gastric bypass. Author(s): Hsia AW, Hattab EM, Katz JS. Source: Muscle & Nerve. 2001 December; 24(12): 1692-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11745979&dopt=Abstract

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Management of gastrojejunal anastomotic leaks after Roux-en-Y gastric bypass. Author(s): Arteaga JR, Huerta S, Livingston EH. Source: The American Surgeon. 2002 December; 68(12): 1061-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12516809&dopt=Abstract

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Marginal ulcer after gastric bypass: a prospective 3-year study of 173 patients. Author(s): Sapala JA, Wood MH, Sapala MA, Flake TM Jr. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1998 October; 8(5): 505-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9819081&dopt=Abstract

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Marginal ulcer following gastric bypass for morbid obesity. Author(s): Jordan JH, Hocking MP, Rout WR, Woodward ER. Source: The American Surgeon. 1991 May; 57(5): 286-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2039124&dopt=Abstract

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Mason gastric bypass. Long-term follow-up and comparison with other gastric procedures. Author(s): Knecht BH. Source: American Journal of Surgery. 1983 May; 145(5): 604-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6846697&dopt=Abstract

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Measurement of gastric emptying after gastric bypass surgery using radionuclides. Author(s): Horowitz M, Cook DJ, Collins PJ, Harding PE, Hooper MJ, Walsh JF, Shearman DJ. Source: The British Journal of Surgery. 1982 November; 69(11): 655-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7127049&dopt=Abstract

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Mechanisms of satiety after gastric stapling and gastric bypass. Author(s): Villar HV, Burks TF, Wangensteen SL. Source: Surg Forum. 1979; 30: 353-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=538632&dopt=Abstract

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Medical care and pregnancy outcome after gastric bypass surgery for obesity. Author(s): Rand CS, Macgregor AM. Source: Southern Medical Journal. 1989 October; 82(10): 1319-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2799456&dopt=Abstract

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Megaloblastic anemia after gastric bypass for obesity. Author(s): Crowley LV, Olson RW. Source: The American Journal of Gastroenterology. 1983 July; 78(7): 406-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6869350&dopt=Abstract

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Metabolic consequences from conversion of jejunoileal bypass to gastric bypass. Author(s): Ackerman NB. Source: Annals of Surgery. 1982 November; 196(5): 553-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7125740&dopt=Abstract

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Micronutrient deficiencies after gastric bypass for morbid obesity. Author(s): Halverson JD. Source: The American Surgeon. 1986 November; 52(11): 594-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3777703&dopt=Abstract

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Micropouch gastric bypass: indications for gastrostomy tube placement in the bypassed stomach. Author(s): Wood MF, Sapala JA, Sapala MA, Schuhknecht MP, Flake TM. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 October; 10(5): 413-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11054245&dopt=Abstract

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Mini-gastric bypass controversy. Author(s): Fisher BL, Buchwald H, Clark W, Champion JK, Fox SR, MacDonald KG, Mason EE, Terry BE, Schauer PR, Sugerman HJ. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 December; 11(6): 773-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11775581&dopt=Abstract

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Modified VBG vs gastric bypass. Author(s): Mason EE. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 February; 10(1): 68-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10715650&dopt=Abstract

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Morbid obesity: gastric bypass. Author(s): VanHouden CE, deBakker J. Source: J Kans Med Soc. 1979 May; 80(5): 269-71. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=448231&dopt=Abstract

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Morbid obesity: good and poor results of jejunoileal and gastric bypass. Author(s): Buckwalter JA. Source: The American Journal of Clinical Nutrition. 1980 February; 33(2 Suppl): 476-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7355822&dopt=Abstract

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More on mini-gastric bypass. Author(s): Olchowski S, Timms MR, O'Brien P, Bauman R, Quattlebaum JK. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 August; 11(4): 532. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11501371&dopt=Abstract

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Multivitamin prophylaxis in prevention of post-gastric bypass vitamin and mineral deficiencies. Author(s): Brolin RE, Gorman RC, Milgrim LM, Kenler HA. Source: International Journal of Obesity. 1991 October; 15(10): 661-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1752727&dopt=Abstract

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Narcotic withdrawal syndrome following gastric bypass--a difficult diagnosis. Author(s): Higa KD, Ho T, Boone KB, Roubicek MC. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 October; 11(5): 631-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11594109&dopt=Abstract

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Near-total gastric bypass for morbid obesity. Author(s): Hartford CE. Source: Archives of Surgery (Chicago, Ill. : 1960). 1984 March; 119(3): 282-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6696621&dopt=Abstract

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Neural tube defects after gastric bypass. Author(s): Haddow JE, Hill LE, Kloza EM, Thanhauser D. Source: Lancet. 1986 June 7; 1(8493): 1330. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2872457&dopt=Abstract

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Nutritional status after Roux-en-Y gastric bypass surgery. Author(s): Sugerman HJ. Source: Surgery. 1993 June; 113(6): 720. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8506535&dopt=Abstract

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Nutritional status seven years after Roux-en-Y gastric bypass surgery. Author(s): Avinoah E, Ovnat A, Charuzi I. Source: Surgery. 1992 February; 111(2): 137-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1736382&dopt=Abstract

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Nutritional vitamin B12 deficiency in a breastfed infant following maternal gastric bypass. Author(s): Grange DK, Finlay JL. Source: Pediatric Hematology and Oncology. 1994 May-June; 11(3): 311-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8060815&dopt=Abstract

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Obese patients have inadequate protein intake related to protein intolerance up to 1 year following Roux-en-Y gastric bypass. Author(s): Moize V, Geliebter A, Gluck ME, Yahav E, Lorence M, Colarusso T, Drake V, Flancbaum L. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 February; 13(1): 23-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630609&dopt=Abstract

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Obstructive sleep apnea in the morbidly obese. An indication for gastric bypass. Author(s): Victor DW Jr, Sarmiento CF, Yanta M, Halverson JD. Source: Archives of Surgery (Chicago, Ill. : 1960). 1984 August; 119(8): 970-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6743016&dopt=Abstract

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Open Roux-en-Y gastric bypass for the morbidly obese in the era of laparoscopy. Author(s): Reddy RM, Riker A, Marra D, Thomas R, Brems JJ. Source: American Journal of Surgery. 2002 December; 184(6): 611-5; Discussion 615-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488188&dopt=Abstract

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Optimizing results of gastric bypass. Author(s): Mason EE, Printen KJ, Hartford CE, Boyd WC. Source: Annals of Surgery. 1975 October; 182(4): 405-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1180579&dopt=Abstract

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Outcome analysis of laparoscopic Roux-en-Y gastric bypass for morbid obesity. The first 116 cases. Author(s): Papasavas PK, Hayetian FD, Caushaj PF, Landreneau RJ, Maurer J, Keenan RJ, Quinlin RF, Gagne DJ. Source: Surgical Endoscopy. 2002 December; 16(12): 1653-7. Epub 2002 September 23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12239643&dopt=Abstract

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Outcome of gastric bypass patients. Author(s): Holzwarth R, Huber D, Majkrzak A, Tareen B. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 April; 12(2): 261-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11975225&dopt=Abstract

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Outcome of palliative and gastric bypass surgery for pancreatic head carcinoma in 126 patients. Author(s): Parks RW, Diamond T. Source: The British Journal of Surgery. 1998 February; 85(2): 280. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9501838&dopt=Abstract

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Outcome of palliative biliary and gastric bypass surgery for pancreatic head carcinoma in 126 patients. Author(s): van Wagensveld BA, Coene PP, van Gulik TM, Rauws EA, Obertop H, Gouma DJ. Source: The British Journal of Surgery. 1997 October; 84(10): 1402-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9361599&dopt=Abstract

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Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Author(s): Schauer PR, Ikramuddin S, Gourash W, Ramanathan R, Luketich J. Source: Annals of Surgery. 2000 October; 232(4): 515-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10998650&dopt=Abstract

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Patient satisfaction and results of vertical banded gastroplasty and gastric bypass. Author(s): Choi Y, Frizzi J, Foley A, Harkabus M. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 February; 9(1): 33-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10065578&dopt=Abstract

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Patient well-being after gastric bypass surgery for morbid obesity. Author(s): Hall JC, Horne K, O'Brien PE, Watts JM. Source: The Australian and New Zealand Journal of Surgery. 1983 August; 53(4): 321-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6577847&dopt=Abstract

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Patients with laparoscopically staged unresectable pancreatic adenocarcinoma do not require subsequent surgical biliary or gastric bypass. Author(s): Espat NJ, Brennan MF, Conlon KC. Source: Journal of the American College of Surgeons. 1999 June; 188(6): 649-55; Discussion 655-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10359358&dopt=Abstract

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Perceived psychosocial outcomes of gastric bypass surgery: a qualitative study. Author(s): Bocchieri LE, Meana M, Fisher BL. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 December; 12(6): 781-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568182&dopt=Abstract

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Percutaneous contrast examination of the stomach after gastric bypass. Author(s): McNeely GF, Kinard RE, Macgregor AM, Kniffen JC. Source: Ajr. American Journal of Roentgenology. 1987 November; 149(5): 928-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3499796&dopt=Abstract

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Perforated duodenal ulcer after gastric bypass surgery. Author(s): Bjorkman DJ, Alexander JR, Simons MA. Source: The American Journal of Gastroenterology. 1989 February; 84(2): 170-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2916529&dopt=Abstract

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Perforated peptic ulcer following gastric bypass for obesity. Author(s): Macgregor AM, Pickens NE, Thoburn EK. Source: The American Surgeon. 1999 March; 65(3): 222-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10075296&dopt=Abstract

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Plasma acylation-stimulating protein, adiponectin, leptin, and ghrelin before and after weight loss induced by gastric bypass surgery in morbidly obese subjects. Author(s): Faraj M, Havel PJ, Phelis S, Blank D, Sniderman AD, Cianflone K. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 April; 88(4): 1594602. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679444&dopt=Abstract

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Predictors of complication and suboptimal weight loss after laparoscopic Roux-en-Y gastric bypass: a series of 188 patients. Author(s): Perugini RA, Mason R, Czerniach DR, Novitsky YW, Baker S, Litwin DE, Kelly JJ. Source: Archives of Surgery (Chicago, Ill. : 1960). 2003 May; 138(5): 541-5; Discussion 545-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742960&dopt=Abstract

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Pregnancy after gastric bypass for morbid obesity. Author(s): Richards DS, Miller DK, Goodman GN. Source: J Reprod Med. 1987 March; 32(3): 172-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3572896&dopt=Abstract

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Pregnancy following gastric bypass for morbid obesity. Author(s): Wittgrove AC, Jester L, Wittgrove P, Clark GW. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1998 August; 8(4): 461-4; Discussion 465-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9731683&dopt=Abstract

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Preoperative insurance status influences postoperative complication rates for gastric bypass. Author(s): Martin LF, Tan TL, Holmes PA, Becker DA, Horn J, Mann LD, Bixler EO. Source: American Journal of Surgery. 1991 June; 161(6): 625-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1830719&dopt=Abstract

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Preperitoneal Richter hernia after a laparoscopic gastric bypass. Author(s): Matthews BD, Heniford BT, Sing RF. Source: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2001 February; 11(1): 47-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11269556&dopt=Abstract

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Prevalence of non-alcoholic steatohepatitis in morbidly obese subjects undergoing gastric bypass. Author(s): Spaulding L, Trainer T, Janiec D. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 347-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841891&dopt=Abstract

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Prophylactic gastric bypass for unresectable periampullary cancer. Author(s): Tandon V. Source: Trop Gastroenterol. 1999 October-December; 20(4): 185-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10769610&dopt=Abstract

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Prospective comparative evaluation of stapled versus transected silastic ring gastric bypass: 6-year follow-up. Author(s): Fobi MA, Lee H, Igwe D Jr, Stanczyk M, Tambi JN. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 February; 11(1): 18-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11361162&dopt=Abstract

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Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity. Author(s): Behrns KE, Smith CD, Sarr MG. Source: Digestive Diseases and Sciences. 1994 February; 39(2): 315-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8313814&dopt=Abstract

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Prospective evaluation of Roux-en-Y gastric bypass as primary operation for medically complicated obesity. Author(s): Balsiger BM, Kennedy FP, Abu-Lebdeh HS, Collazo-Clavell M, Jensen MD, O'Brien T, Hensrud DD, Dinneen SF, Thompson GB, Que FG, Williams DE, Clark MM, Grant JE, Frick MS, Mueller RA, Mai JL, Sarr MG. Source: Mayo Clinic Proceedings. 2000 July; 75(7): 673-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10907381&dopt=Abstract

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Psychologic assessment of morbidly obese patients undergoing gastric bypass: a comparison of preoperative and postoperative adjustment. Author(s): Gentry K, Halverson JD, Heisler S. Source: Surgery. 1984 February; 95(2): 215-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6695338&dopt=Abstract

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Pulmonary vascular resistance and right ventricular function in morbid obesity in relation to gastric bypass surgery. Author(s): Nakatsuka M. Source: Journal of Clinical Anesthesia. 1996 May; 8(3): 205-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8703455&dopt=Abstract

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Quality of life after gastric bypass for morbid obesity. Author(s): Hafner RJ, Watts JM, Rogers J. Source: International Journal of Obesity. 1991 August; 15(8): 555-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1938099&dopt=Abstract

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Quality of life after gastric bypass surgery: a cross-sectional study. Author(s): Dymek MP, Le Grange D, Neven K, Alverdy J. Source: Obesity Research. 2002 November; 10(11): 1135-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12429877&dopt=Abstract

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Quality of life and psychosocial adjustment in patients after Roux-en-Y gastric bypass: a brief report. Author(s): Dymek MP, le Grange D, Neven K, Alverdy J. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 February; 11(1): 32-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11361166&dopt=Abstract

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Radiologic assessment of the distal stomach and duodenum after gastric bypass: percutaneous CT-guided transcatheter technique. Author(s): Barmeir EP, Solomon H, Charuzi I, Hirsch M. Source: Gastrointest Radiol. 1984; 9(3): 203-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6468852&dopt=Abstract

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Radiologic evaluation before gastric bypass for morbid obesity. Author(s): Bova JG, Robinson JR, McFee AS. Source: American Journal of Surgery. 1984 March; 147(3): 372-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6703209&dopt=Abstract

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Reasonable solutions to weight regain after gastric bypass. Author(s): Owens M. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 April; 13(2): 317. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12740147&dopt=Abstract

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Reducing early technical complications in gastric bypass surgery. Author(s): Capella RF, Capella JF. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 April; 7(2): 149-56; Discussion 157. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730543&dopt=Abstract

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Reduction in serum pepsinogen I after Roux-en-Y gastric bypass. Author(s): Sundbom M, Mardh E, Mardh S, Ohrvall M, Gustavsson S. Source: Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract. 2003 May-June; 7(4): 529-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12763411&dopt=Abstract

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Regression of hepatic steatosis in morbidly obese persons after gastric bypass. Author(s): Silverman EM, Sapala JA, Appelman HD. Source: American Journal of Clinical Pathology. 1995 July; 104(1): 23-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7611176&dopt=Abstract

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Regression of liver steatosis following gastroplasty or gastric bypass for morbid obesity. Author(s): Ranlov I, Hardt F. Source: Digestion. 1990; 47(4): 208-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2100271&dopt=Abstract

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Reinforcing gastric staple-lines with bovine pericardial strips may decrease the likelihood of gastric leak after laparoscopic Roux-en-Y gastric bypass. Author(s): Shikora SA, Kim JJ, Tarnoff ME. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 February; 13(1): 37-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630611&dopt=Abstract

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Reoperation for failed gastric bypass procedures for obesity. Author(s): Mason EE, Scott DH. Source: The Surgical Clinics of North America. 1991 February; 71(1): 45-56. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1989109&dopt=Abstract

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Results of esophagectomy and gastric bypass for cancer of the esophagus. Author(s): Muller JM, Zieren U, Wolters U, Pichlmaier H. Source: Hepatogastroenterology. 1989 December; 36(6): 522-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2613175&dopt=Abstract

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Retrosternal gastric bypass for inoperable esophageal cancer: a report of 71 patients. Author(s): Conlan AA, Nicolaou N, Hammond CA, Pool R, de Nobrega C, Mistry BD. Source: The Annals of Thoracic Surgery. 1983 October; 36(4): 396-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6194765&dopt=Abstract

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Retrosternal gastric bypass for the palliative treatment of unresectable oesophageal carcinoma. A simple technique. Author(s): Angorn IB, Haffejee AA. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1983 November 26; 64(23): 901-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6195742&dopt=Abstract

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Revision of failed gastric bypass to distal Roux-en-Y gastric bypass: a review of 65 cases. Author(s): Fobi MA, Lee H, Igwe D Jr, Felahy B, James E, Stanczyk M, Tambi J, Eyong P. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 April; 11(2): 190-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11355025&dopt=Abstract

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Risks and benefits of gastric bypass in morbidly obese patients with severe venous stasis disease. Author(s): Sugerman HJ, Sugerman EL, Wolfe L, Kellum JM Jr, Schweitzer MA, DeMaria EJ. Source: Annals of Surgery. 2001 July; 234(1): 41-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11460821&dopt=Abstract

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Routine upper gastrointestinal Gastrografin swallow after laparoscopic Roux-en-Y gastric bypass. Author(s): Sims TL, Mullican MA, Hamilton EC, Provost DA, Jones DB. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 February; 13(1): 66-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630616&dopt=Abstract

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Roux en Y gastric bypass. Surgical treatment of morbid obesity. Author(s): Mason DS, Sapala MA, Sapala JE, Sapala JA. Source: Aorn Journal. 1993 December; 58(6): 1113-7, 1120-1, 1124-35; Quiz 1136-. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8279833&dopt=Abstract

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Roux-en-Y gastric bypass after previous unsuccessful gastric restrictive surgery. Author(s): Gagner M. Source: Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract. 2003 March-April; 7(3): 429; Author Reply 429-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654570&dopt=Abstract

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Roux-en-Y gastric bypass for morbid obesity. Author(s): Barrow CJ. Source: Aorn Journal. 2002 October; 76(4): 590, 593-604; Quiz 606-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12382465&dopt=Abstract

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Roux-en-Y gastric bypass for recurrent nonalcoholic steatohepatitis in liver transplant recipients with morbid obesity. Author(s): Duchini A, Brunson ME. Source: Transplantation. 2001 July 15; 72(1): 156-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11468551&dopt=Abstract

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Roux-en-Y gastric bypass leak complications. Author(s): Marshall JS, Srivastava A, Gupta SK, Rossi TR, DeBord JR. Source: Archives of Surgery (Chicago, Ill. : 1960). 2003 May; 138(5): 520-3; Discussion 523-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742956&dopt=Abstract

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Sensitivity and specificity of postoperative upper GI series following gastric bypass. Author(s): Singh R, Fisher BL. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 February; 13(1): 73-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630617&dopt=Abstract

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Serum lipids after gastric bypass surgery for morbid obesity. Author(s): Brolin RE, Kenler HA, Wilson AC, Kuo PT, Cody RP. Source: International Journal of Obesity. 1990 November; 14(11): 939-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2276855&dopt=Abstract

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Short-term results of laparoscopic gastric bypass in patients with BMI > or = 60. Author(s): Oliak D, Ballantyne GH, Davies RJ, Wasielewski A, Schmidt HJ. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 October; 12(5): 643-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12448385&dopt=Abstract

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Significant improvement in HbA1c in a morbidly obese type 2 diabetic patient after gastric bypass surgery despite relatively small weight loss. Author(s): Khateeb NI, Roslin MS, Chin D, Khan N, Anhalt H. Source: Diabetes Care. 1999 April; 22(4): 651. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10189552&dopt=Abstract

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Silastic ring gastric bypass: a comparison of two ring sizes: a preliminary report. Author(s): Crampton NA, Izvornikov V, Stubbs RS. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 December; 7(6): 495-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730507&dopt=Abstract

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Silastic ring gastric bypass: results in 64 patients. Author(s): Crampton NA, Izvornikov V, Stubbs RS. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 December; 7(6): 489-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730506&dopt=Abstract

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Similarity of Magenstrasse-and-Mill and Mini-Gastric bypass. Author(s): Rutledge R. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 April; 13(2): 318. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12740148&dopt=Abstract

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Simultaneous laparoscopic biliary and retrocolic gastric bypass in patients with unresectable carcinoma of the pancreas. Author(s): Kuriansky J, Saenz A, Astudillo E, Cardona V, Fernandez-Cruz L. Source: Surgical Endoscopy. 2000 February; 14(2): 179-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10656956&dopt=Abstract

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Single-loop biliary and gastric bypass for irresectable pancreatic carcinoma. Author(s): Lindemann F, Hehl JA, Witte J. Source: The British Journal of Surgery. 1993 October; 80(10): 1350-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8242325&dopt=Abstract

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Single-loop biliary and gastric bypass for irresectable pancreatic carcinoma. Author(s): Watanapa P, Williamson RC. Source: The British Journal of Surgery. 1993 February; 80(2): 237-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7680270&dopt=Abstract

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Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Author(s): Felsher J, Brodsky J, Brody F. Source: Surgery. 2003 September; 134(3): 501-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14555940&dopt=Abstract

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Stapler division of the omentum and small bowel mesentery in morbidly obese patients undergoing gastric bypass surgery. Author(s): Sapala JA, Wood MH, Sapala MA, Mason DS. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 June; 7(3): 207-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730550&dopt=Abstract

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Stomal complications of gastric bypass: incidence and outcome of therapy. Author(s): Sanyal AJ, Sugerman HJ, Kellum JM, Engle KM, Wolfe L. Source: The American Journal of Gastroenterology. 1992 September; 87(9): 1165-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1519574&dopt=Abstract

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Success habits of long-term gastric bypass patients. Author(s): Cook CM, Edwards C. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 February; 9(1): 80-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10065592&dopt=Abstract

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Surgery for morbid obesity: comparison of gastric bypass with vertically stapled gastroplasty. Author(s): Eckhout GV, Prinzing JF. Source: Colo Med. 1981 April; 78(4): 117-22. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7285513&dopt=Abstract

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Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. Author(s): Brolin RE, Leung M. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 April; 9(2): 150-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10340768&dopt=Abstract

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Sustained coronary-risk-factor reduction after gastric bypass for morbid obesity. Author(s): Gleysteen JJ, Barboriak JJ, Sasse EA. Source: The American Journal of Clinical Nutrition. 1990 May; 51(5): 774-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2333834&dopt=Abstract

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Swedish adjustable gastric band (SAGB)-distal gastric bypass: a new variant of an old technique in the treatment of superobesity and failed band restriction. Author(s): Steffen R, Horber F, Hauri P. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 April; 9(2): 171-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10340772&dopt=Abstract

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Symptomatic and clinical improvement in morbidly obese patients with gastroesophageal reflux disease following Roux-en-Y gastric bypass. Author(s): Smith SC, Edwards CB, Goodman GN. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 December; 7(6): 479-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730504&dopt=Abstract

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Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass. Author(s): Nguyen NT, Owings JT, Gosselin R, Pevec WC, Lee SJ, Goldman C, Wolfe BM. Source: Archives of Surgery (Chicago, Ill. : 1960). 2001 August; 136(8): 909-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11485526&dopt=Abstract

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Technical considerations for transabdominal loading of the circular stapler in laparoscopic Roux-en-Y gastric bypass. Author(s): Murr MM, Gallagher SF. Source: American Journal of Surgery. 2003 June; 185(6): 585-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12781891&dopt=Abstract

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Techniques of laparoscopic Roux-en-Y gastric bypass. Author(s): Ali MR, Sugerman HJ, DeMaria EJ. Source: Semin Laparosc Surg. 2002 June; 9(2): 94-104. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12152152&dopt=Abstract

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The control of diabetes mellitus (NIDDM) in the morbidly obese with the Greenville Gastric Bypass. Author(s): Pories WJ, Caro JF, Flickinger EG, Meelheim HD, Swanson MS. Source: Annals of Surgery. 1987 September; 206(3): 316-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3632094&dopt=Abstract

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The effect of dextrose and amino acids on respiratory function and energy expenditure in morbidly obese patients following gastric bypass surgery. Author(s): Abbott WC, Bistrian BR, Blackburn GL. Source: The Journal of Surgical Research. 1986 September; 41(3): 225-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3093773&dopt=Abstract

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The effect of erythromycin on bile excretion and proximal small bowel motility following divided gastric bypass surgery: a prospective randomized placebocontrolled trial. Author(s): Wilkinson NW, Gustafson RJ, Frizzi JD. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 December; 12(6): 765-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568180&dopt=Abstract

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The effect of gastric bypass surgery on hypertension in morbidly obese patients. Author(s): Carson JL, Ruddy ME, Duff AE, Holmes NJ, Cody RP, Brolin RE. Source: Archives of Internal Medicine. 1994 January 24; 154(2): 193-200. Erratum In: Arch Intern Med 1994 August 8; 154(15): 1770. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8285814&dopt=Abstract

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The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial. Author(s): Choban PS, Flancbaum L. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 August; 12(4): 540-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12194548&dopt=Abstract

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The effectiveness of gastric bypass over gastric partition in morbid obesity: consequence of distal gastric and duodenal exclusion. Author(s): Pories WJ, Flickinger EG, Meelheim D, Van Rij AM, Thomas FT. Source: Annals of Surgery. 1982 October; 196(4): 389-99. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7125726&dopt=Abstract

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The frequency of respiratory failure in patients with morbid obesity undergoing gastric bypass. Author(s): Blouw EL, Rudolph AD, Narr BJ, Sarr MG. Source: Aana Journal. 2003 February; 71(1): 45-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12776650&dopt=Abstract

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The gastric bypass procedure in the treatment of morbid obesity. Author(s): Husemann B. Source: Int Surg. 1980 March-April; 65(2): 107-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7216654&dopt=Abstract

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The impact of a clinical pathway for gastric bypass surgery on resource utilization. Author(s): Cooney RN, Bryant P, Haluck R, Rodgers M, Lowery M. Source: The Journal of Surgical Research. 2001 June 15; 98(2): 97-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11397125&dopt=Abstract

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The impact of small bowel resection on the incidence of stomal stenosis and marginal ulcer after gastric bypass. Author(s): Spaulding L. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 December; 7(6): 485-7; Discussion 488. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730505&dopt=Abstract

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The learning curve for laparoscopic Roux-en-Y gastric bypass is 100 cases. Author(s): Schauer P, Ikramuddin S, Hamad G, Gourash W. Source: Surgical Endoscopy. 2003 February; 17(2): 212-5. Epub 2002 December 04. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457218&dopt=Abstract

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The micropouch gastric bypass: technical considerations in primary and revisionary operations. Author(s): Sapala JA, Wood MH, Sapala MA, Schuhknecht MP, Flake TM Jr. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 February; 11(1): 3-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11361165&dopt=Abstract

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The mini-gastric bypass: experience with the first 1,274 cases. Author(s): Rutledge R. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 June; 11(3): 276-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11433900&dopt=Abstract

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The nutritional knowledge scores of morbidly obese patients selected for gastric bypass surgery. Author(s): Hall JC, Veale B, Horne K, Watts JM. Source: International Journal of Obesity. 1984; 8(2): 123-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6724793&dopt=Abstract

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The psychology of gastric bypass surgery. Author(s): Glinski J, Wetzler S, Goodman E. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 October; 11(5): 581-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11594099&dopt=Abstract

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The use of methylene blue solution to test for leaks in gastric bypass operations for morbid obesity. Author(s): Sensenig DM, Jurgeleit HC. Source: J Maine Med Assoc. 1980 August; 71(8): 234. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7240947&dopt=Abstract

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The weight reduction operation of choice: vertical banded gastroplasty or gastric bypass? Author(s): Capella JF, Capella RF. Source: American Journal of Surgery. 1996 January; 171(1): 74-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8554155&dopt=Abstract

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True informed consent in surgical treatment of morbid obesity: the current case for both jejunoileal and gastric bypass. Author(s): Buchwald H. Source: The American Journal of Clinical Nutrition. 1980 February; 33(2 Suppl): 482-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7355824&dopt=Abstract

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Vagal innervation of the bypassed stomach following gastric bypass. Author(s): Printen KJ, Owensby M. Source: Surgery. 1978 October; 84(4): 455-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=694734&dopt=Abstract

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Variation in postoperative analgesic requirements in the morbidly obese following gastric bypass surgery. Author(s): Bennett R, Batenhorst R, Graves DA, Foster TS, Griffen WO, Wright BD. Source: Pharmacotherapy. 1982 January-February; 2(1): 50-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6927210&dopt=Abstract

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Vertical banded gastroplasty versus standard or distal Roux-en-Y gastric bypass based on specific selection criteria in the morbidly obese: preliminary results. Author(s): Kalfarentzos F, Dimakopoulos A, Kehagias I, Loukidi A, Mead N. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 October; 9(5): 433-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10605899&dopt=Abstract

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Vertical banded gastroplasty vs gastric bypass in the treatment of obesity. Author(s): Fobi MA, Fleming AW. Source: Journal of the National Medical Association. 1986 November; 78(11): 1091-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3795288&dopt=Abstract

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Vertical banded gastroplasty-gastric bypass in Mexican patients with severe obesity: 1 year experience. Author(s): Zorrilla PG, Salinas RJ, Salinas-Martinez AM. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 August; 7(4): 322-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730518&dopt=Abstract

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Vertical banded gastroplasty-gastric bypass with and without the interposition of jejunum: preliminary report. Author(s): Zorrilla PG, Salinas RJ, Salinas-Martinez AM. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 February; 9(1): 29-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10065577&dopt=Abstract

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Virtual gastroduodenoscopy: a new look at the bypassed stomach and duodenum after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Author(s): Silecchia G, Catalano C, Gentileschi P, Elmore U, Restuccia A, Gagner M, Basso N. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 February; 12(1): 39-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11868296&dopt=Abstract

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Vitamin B12 deficiency after gastric bypass surgery for obesity. Author(s): Schilling RF, Gohdes PN, Hardie GH. Source: Annals of Internal Medicine. 1984 October; 101(4): 501-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6476636&dopt=Abstract

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Vitamin B12 deficiency associated with low breast-milk vitamin B12 concentration in an infant following maternal gastric bypass surgery. Author(s): Wardinsky TD, Montes RG, Friederich RL, Broadhurst RB, Sinnhuber V, Bartholomew D. Source: Archives of Pediatrics & Adolescent Medicine. 1995 November; 149(11): 1281-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7581767&dopt=Abstract

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Vitamin E, vitamin B-6, vitamin B-12, and folate status of gastric bypass surgery patients. Author(s): Boylan LM, Sugerman HJ, Driskell JA. Source: Journal of the American Dietetic Association. 1988 May; 88(5): 579-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3367015&dopt=Abstract

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Waking up the gastric bypass patient. Author(s): Walter DA. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 August; 7(4): 374-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730528&dopt=Abstract

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Weakness after gastric bypass. Author(s): Chang CG, Helling TS, Black WE, Rymer MM. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 August; 12(4): 592-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12194558&dopt=Abstract

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Weight loss after extended gastric bypass. Author(s): Freeman JB, Kotlarewsky M, Phoenix C. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 August; 7(4): 337-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730521&dopt=Abstract

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Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Author(s): Brolin RL, Robertson LB, Kenler HA, Cody RP. Source: Annals of Surgery. 1994 December; 220(6): 782-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7986146&dopt=Abstract

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Weight loss following transected gastric bypass with proximal Roux-en-Y. Author(s): Oh CH, Kim HJ, Oh S. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 April; 7(2): 142-7; Discussion 148. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730542&dopt=Abstract

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Weight loss with vertical banded gastroplasty and Roux-Y gastric bypass for morbid obesity with selective versus random assignment. Author(s): Sugerman HJ, Londrey GL, Kellum JM, Wolf L, Liszka T, Engle KM, Birkenhauer R, Starkey JV. Source: American Journal of Surgery. 1989 January; 157(1): 93-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2910132&dopt=Abstract

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Weight reduction after gastric bypass and horizontal gastroplasty for morbid obesity. Author(s): Sugerman HJ. Source: The European Journal of Surgery = Acta Chirurgica. 1996 February; 162(2): 1578. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8639733&dopt=Abstract

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Weight reduction after gastric bypass and horizontal gastroplasty for morbid obesity. Results after 10 years. Author(s): Wolfel R, Gunther K, Rumenapf G, Koerfgen P, Husemann B. Source: The European Journal of Surgery = Acta Chirurgica. 1994 April; 160(4): 219-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8049312&dopt=Abstract

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CHAPTER 2. NUTRITION AND GASTRIC BYPASS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and gastric bypass.

Finding Nutrition Studies on Gastric Bypass The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “gastric bypass” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “gastric bypass” (or a synonym): •

A prospective evaluation of intracorporeal laparoscopic small bowel anastomosis during gastric bypass. Author(s): Department of Surgery, University of California, Davis, Medical Center, Sacramento 95817-1418, USA. [email protected] Source: Nguyen, N T Neuhaus, A M Ho, H S Palmer, L S Furdui, G G Wolfe, B M ObesSurg. 2001 April; 11(2): 196-9 0960-8923

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A randomized prospective trial of gastric bypass versus vertical banded gastroplasty for morbid obesity and their effects on sweets versus non-sweets eaters. Source: Sugerman, H J Starkey, J V Birkenhauer, R Ann-Surg. 1987 June; 205(6): 613-24 0003-4932

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Alcohol and poor compliance as factors in Wernicke's encephalopathy diagnosed 13 years after gastric bypass. Author(s): Department of Surgery, University of Western Ontario, London. Source: Grace, D M Alfieri, M A Leung, F Y Can-J-Surg. 1998 October; 41(5): 389-92 0008428X

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Are vitamin B12 and folate deficiency clinically important after roux-en-Y gastric bypass? Author(s): Department of Surgery, University of Medicine and Dentistry of New JerseyRobert Wood Johnson Medical School, New Brunswick, NJ, USA. Source: Brolin, R E Gorman, J H Gorman, R C Petschenik, A J Bradley, L J Kenler, H A Cody, R P J-Gastrointest-Surg. 1998 Sep-October; 2(5): 436-42 1091-255X

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Changes in eating behavior after horizontal gastroplasty and Roux-en-Y gastric bypass. Author(s): Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903. Source: Kenler, H A Brolin, R E Cody, R P Am-J-Clin-Nutr. 1990 July; 52(1): 87-92 00029165

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Changes in measured resting energy expenditure after Roux-en-Y gastric bypass for clinically severe obesity. Author(s): Department of Surgery, College of Medicine, Ohio State University, Columbus 43210, USA. Source: Flancbaum, L Choban, P S Bradley, L R Burge, J C Surgery. 1997 November; 122(5): 943-9 0039-6060

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Changes in serum lipids after gastric bypass surgery. Lack of a relationship to weight loss. Source: Kelly, T.M. Jones, S.B. Int-J-Obesity. London : John Libbey & Company. 1986. volume 10 (6) page 443-452. ill., charts. 0307-0565

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Comparison of nutritional deficiencies after Roux-en-Y gastric bypass and after biliopancreatic diversion with Roux-en-Y gastric bypass. Author(s): Nutrition Support and Morbid Obesity Clinic, Department of Surgery, School of Medicine, University of Patras, Greece. Source: Skroubis, G Sakellaropoulos, G Pouggouras, K Mead, N Nikiforidis, G Kalfarentzos, F Obes-Surg. 2002 August; 12(4): 551-8 0960-8923

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Dietary intake before and after gastric bypass and gastroplasty for morbid obesity in women. Author(s): Department of Surgery and Medicine, Orebro Medical Center Hospital, Sweden. Source: Naslund, I Jarnmark, I Andersson, H Int-J-Obes. 1988; 12(6): 503-13 0307-0565

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Effects of participation in bariatric support group after Roux-en-Y gastric bypass. Author(s): Pacific Bariatric Surgical Medical Group, Inc., San Diego, California, USA. Source: Hildebrandt, S E Obes-Surg. 1998 October; 8(5): 535-42 0960-8923

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Efficacy and safety of patient-controlled analgesia for morbidly obese patients following gastric bypass surgery. Author(s): New Jersey Pain Institute, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08901 USA. Source: Choi, Y K Brolin, R E Wagner, B K Chou, S Etesham, S Pollak, P Obes-Surg. 2000 April; 10(2): 154-9 0960-8923

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Establishing a laparoscopic gastric bypass program. Author(s): Department of Surgery, Baylor University Medical Center, Dallas, TX, USA. Source: Dresel, A Kuhn, J A Westmoreland, M V Talaasen, L J McCarty, T M Am-J-Surg. 2002 December; 184(6): 617-20; discussion 620 0002-9610

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Evaluation of magnesium before and after jejuno-ileal versus gastric bypass surgery for morbid obesity. Source: Gaal, L.van Delvigne, C. Vandewoude, M. Cogge, E. Vaneerdeweg, W. Schoofs, E. Leeuw, I. de J-Am-Coll-Nutr. New York, N.Y. : John Wiley & Sons. October 1987. volume 6 (5) page 397-400. 0731-5724

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Evidence for diminished B12 absorption after gastric bypass: oral supplementation does not prevent low plasma B12 levels in bypass patients. Author(s): US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111. Source: Provenzale, D Reinhold, R B Golner, B Irwin, V Dallal, G E Papathanasopoulos, N Sahyoun, N Samloff, I M Russell, R M J-Am-Coll-Nutr. 1992 February; 11(1): 29-35 0731-5724

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Factors influencing energy intake and body weight loss after gastric bypass. Author(s): Division of Therapeutic Education for Chronic Diseases, Geneva University Hospital, Geneva, Switzerland. Source: Bobbioni Harsch, E Huber, O Morel, P Chassot, G Lehmann, T Volery, M Chliamovitch, E Muggler, C Golay, A Eur-J-Clin-Nutr. 2002 June; 56(6): 551-6 0954-3007

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Failure of a nursing infant to thrive after the mother's gastric bypass for morbid obesity. Author(s): Lancaster Pediatric Associates, Ltd., PA. Source: Martens, W S 2nd Martin, L F Berlin, C M Pediatrics. 1990 November; 86(5): 7778 0031-4005

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Gastric bypass surgery for severe obesity. Author(s): Virginia Commonwealth University, Richmond, VA, USA. Source: Sugerman, H J Semin-Laparosc-Surg. 2002 June; 9(2): 79-85 1071-5517

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Gastric bypass versus gastroplasty. A prospective study of differences in two surgical procedures for morbid obesity. Source: Naslund, I Acta-Chir-Scand-Suppl. 1987; 5361-60 0301-1860

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Gastrointestinal hormone responses to meals before and after gastric bypass and vertical banded gastroplasty. Author(s): Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond. Source: Kellum, J M Kuemmerle, J F O'Dorisio, T M Rayford, P Martin, D Engle, K Wolf, L Sugerman, H J Ann-Surg. 1990 June; 211(6): 763-70; discussion 770-1 0003-4932

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Improvement of metabolic problems after gastric bypass for morbid obesity. Source: Ackerman, N.B. J-Obesity-Weight-Regul. New York : Human Sciences Press. Fall 1984. volume 3 (3) page 184-189. 0731-4361

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Iron absorption and therapy after gastric bypass. Author(s): Department of Surgery, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada. Source: Rhode, B M Shustik, C Christou, N V MacLean, L D Obes-Surg. 1999 February; 9(1): 17-21 0960-8923

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Malnutrition-induced myopathy following Roux-en-Y gastric bypass. Author(s): Department of Neurology, Stanford University, Room A343, Stanford, California 94305-5235, USA. Source: Hsia, A W Hattab, E M Katz, J S Muscle-Nerve. 2001 December; 24(12): 1692-4 0148-639X

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Multivitamin prophylaxis in prevention of post-gastric bypass vitamin and mineral deficiencies. Author(s): Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903. Source: Brolin, R E Gorman, R C Milgrim, L M Kenler, H A Int-J-Obes. 1991 October; 15(10): 661-7 0307-0565

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Nutritional management after gastric bypass surgery. Source: Crapo, P.A. Nutr-M.D. Van Nuys, Calif. : Nutrition & the M.D. May 1985. volume 11 (5) page 4-5. 0732-0167

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Nutritional status seven years after Roux-en-Y gastric bypass surgery. Author(s): Department of Surgery C, Soroka Medical Center, Beer-Sheva, Israel. Source: Avinoah, E Ovnat, A Charuzi, I Surgery. 1992 February; 111(2): 137-42 0039-6060

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Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. Author(s): Department of Medicine, University of Washington; the Veterans Affairs Puget Sound Health Care System, Seattle 98108, USA. [email protected] Source: Cummings, David E Weigle, David S Frayo, R Scott Breen, Patricia A Ma, Marina K Dellinger, E Patchen Purnell, Jonathan Q N-Engl-J-Med. 2002 May 23; 346(21): 1623-30 1533-4406

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Prophylactic iron supplementation after Roux-en-Y gastric bypass: a prospective, double-blind, randomized study. Author(s): Department of Surgery, University of Medicine and Dentistry, of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08903, USA. Source: Brolin, R E Gorman, J H Gorman, R C Petschenik, A J Bradley, L B Kenler, H A Cody, R P Arch-Surg. 1998 July; 133(7): 740-4 0004-0010

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Serum lipids after gastric bypass surgery for morbid obesity. Source: Brolin, R.E. Kenler, H.A. Wilson, A.C. Kuo, P.T. Cody, R.P. Int-J-Obesity. Basingstoke, Hampshire : The Macmillan Press Ltd. November 1990. volume 14 (11) page 939-950. charts. 0307-0565

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Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. Author(s): Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903, USA. Source: Brolin, R E Leung, M Obes-Surg. 1999 April; 9(2): 150-4 0960-8923

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Swedish adjustable gastric band (SAGB)-distal gastric bypass: a new variant of an old technique in the treatment of superobesity and failed band restriction. Author(s): [email protected] Source: Steffen, R Horber, F Hauri, P Obes-Surg. 1999 April; 9(2): 171-6 0960-8923

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The control of diabetes mellitus (NIDDM) in the morbidly obese with the Greenville Gastric Bypass. Source: Pories, W J Caro, J F Flickinger, E G Meelheim, H D Swanson, M S Ann-Surg. 1987 September; 206(3): 316-23 0003-4932

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Vertical banded gastroplasty versus standard or distal Roux-en-Y gastric bypass based on specific selection criteria in the morbidly obese: preliminary results. Author(s): Nutrition Support and Morbid Obesity Clinic, University Hospital of Patras, Rio, Greece. Source: Kalfarentzos, F Dimakopoulos, A Kehagias, I Loukidi, A Mead, N Obes-Surg. 1999 October; 9(5): 433-42 0960-8923

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Vitamin E, vitamin B-6, vitamin B-12, and folate status of gastric bypass surgery patients. Author(s): Department of Human Nutrition and Foods, Virginia Polytechnic Institute and State University, Blacksburg. Source: Boylan, L M Sugerman, H J Driskell, J A J-Am-Diet-Assoc. 1988 May; 88(5): 57985 0002-8223

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Weight loss after extended gastric bypass. Author(s): Division of General Surgery, Ottawa General Hospital, University of Ottawa, ON, Canada. [email protected] Source: Freeman, J B Kotlarewsky, M Phoenix, C Obes-Surg. 1997 August; 7(4): 337-44 0960-8923

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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•

The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMD®Health: http://my.webmd.com/nutrition

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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CHAPTER 3. ALTERNATIVE MEDICINE AND GASTRIC BYPASS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to gastric bypass. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to gastric bypass and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “gastric bypass” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to gastric bypass: •

Current status of medical and surgical therapy for obesity. Author(s): Mun EC, Blackburn GL, Matthews JB. Source: Gastroenterology. 2001 February; 120(3): 669-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11179243&dopt=Abstract

•

Differences between treatment seekers in an obese population: medical intervention vs. dietary restriction. Author(s): Higgs ML, Wade T, Cescato M, Atchison M, Slavotinek A, Higgins B. Source: Journal of Behavioral Medicine. 1997 August; 20(4): 391-405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9298437&dopt=Abstract

•

Elevated homocysteine with weight loss. Author(s): Dixon JB.

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Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 October; 11(5): 537-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11594089&dopt=Abstract •

Enhanced dietary fat clearance in postobese women. Author(s): Faraj M, Jones P, Sniderman AD, Cianflone K. Source: Journal of Lipid Research. 2001 April; 42(4): 571-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11290829&dopt=Abstract

•

Evidence for diminished B12 absorption after gastric bypass: oral supplementation does not prevent low plasma B12 levels in bypass patients. Author(s): Provenzale D, Reinhold RB, Golner B, Irwin V, Dallal GE, Papathanasopoulos N, Sahyoun N, Samloff IM, Russell RM. Source: Journal of the American College of Nutrition. 1992 February; 11(1): 29-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1541791&dopt=Abstract

•

Gastric bypass surgery for obesity: weight loss, psychosocial outcome, and morbidity one and three years later. Author(s): Rand CS, Macgregor A, Hankins G. Source: Southern Medical Journal. 1986 December; 79(12): 1511-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3787289&dopt=Abstract

•

Gastric decontamination in patient with gastric stapling. Author(s): Buchwald H. Source: Jama : the Journal of the American Medical Association. 1991 December 4; 266(21): 3040. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1687926&dopt=Abstract

•

Obesity article ignores surgery as possible option. Author(s): Sing RF, Backus CL, Heniford BT. Source: J Am Osteopath Assoc. 1999 November; 99(11): 557-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10612949&dopt=Abstract

•

Pregnancy following gastric bypass for morbid obesity. Author(s): Wittgrove AC, Jester L, Wittgrove P, Clark GW. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1998 August; 8(4): 461-4; Discussion 465-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9731683&dopt=Abstract

•

Prophylactic iron supplementation after Roux-en-Y gastric bypass: a prospective, double-blind, randomized study.

Alternative Medicine 67

Author(s): Brolin RE, Gorman JH, Gorman RC, Petschenik AJ, Bradley LB, Kenler HA, Cody RP. Source: Archives of Surgery (Chicago, Ill. : 1960). 1998 July; 133(7): 740-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9688002&dopt=Abstract •

Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. Author(s): Brolin RE, Leung M. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 April; 9(2): 150-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10340768&dopt=Abstract

•

The surgical treatment of obesity. Author(s): Wastell C. Source: Postgraduate Medical Journal. 1984; 60 Suppl 3: 27-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6514651&dopt=Abstract

•

The treatment of obesity. Author(s): Mina WC, Burns RW, Terry BE. Source: Mo Med. 2003 May-June; 100(3): 248-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847866&dopt=Abstract

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The validation of the Moorehead-Ardelt Quality of Life Questionnaire II. Author(s): Moorehead MK, Ardelt-Gattinger E, Lechner H, Oria HE. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 October; 13(5): 684-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14627461&dopt=Abstract

•

Waking up the gastric bypass patient. Author(s): Walter DA. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 August; 7(4): 374-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730528&dopt=Abstract

•

Wernicke's syndrome after bariatric surgery. Author(s): Salas-Salvado J, Garcia-Lorda P, Cuatrecasas G, Bonada A, Formiguera X, Del Castillo D, Hernandez M, Olive JM. Source: Clinical Nutrition (Edinburgh, Lothian). 2000 October; 19(5): 371-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11031078&dopt=Abstract

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Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

•

Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMD®Health: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

•

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. DISSERTATIONS ON GASTRIC BYPASS Overview In this chapter, we will give you a bibliography on recent dissertations relating to gastric bypass. We will also provide you with information on how to use the Internet to stay current on dissertations.

Dissertations on Gastric Bypass ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to gastric bypass. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

Roux-en-y Gastric Bypass: Hand-assisted Laparoscopy and Investigation of the Excluded Stomach by Sundbom, Magnus; PhDDr from Uppsala Universitet (Sweden), 2003, 62 pages http://wwwlib.umi.com/dissertations/fullcit/f192961

•

Shedding the Obese Role: a Three-year Study of Twenty Obese Females, Ages 13-53, Who Had Surgery for Weight Loss (gastric Bypass, Intestinal Bypass) by Wrobel, Sylvia Burroughs, PhD from University of Kentucky, 1989, 221 pages http://wwwlib.umi.com/dissertations/fullcit/9014238

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. CLINICAL TRIALS AND GASTRIC BYPASS Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning gastric bypass.

Recent Trials on Gastric Bypass The following is a list of recent trials dedicated to gastric bypass.5 Further information on a trial is available at the Web site indicated. •

Strength Training Following Gastric Bypass for Obesity Condition(s): Obesity Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Purpose - Excerpt: We will assess whether undesirable loss of lean tissue following gastric bypass surgery for obesity can be minimized by protein supplementation and exercise training. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00065013

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions.

5

These are listed at www.ClinicalTrials.gov.

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The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “gastric bypass” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

•

For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 6. PATENTS ON GASTRIC BYPASS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.6 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “gastric bypass” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on gastric bypass, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Gastric Bypass By performing a patent search focusing on gastric bypass, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 6Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on gastric bypass: •

Method for minimally invasive surgery in the digestive system Inventor(s): Freeman; Lynetta J. (West Chester, OH) Assignee(s): Ethicon Endo-Surgery, Inc. (Cincinnati, OH) Patent Number: 6,543,456 Date filed: May 31, 2002 Abstract: A method for intraluminally performing a gastric bypass surgery is provided. Two anastomosis members are inserted transorally and located in a proximal position and a distal position within the digestive system. The stomach and the small intestine are transected to create a gastric pouch, a drainage loop, and a Roux limb. The distal anastomosis member joins the drainage loop to a distal portion of the intestine, and the proximal anastomosis member joins the Roux limb to the gastric pouch. Excerpt(s): The present invention relates, in general, to surgery and, more particularly, to a method of performing a surgical procedure on the digestive system. The percentage of the world population suffering from morbid obesity is steadily increasing. Severely obese persons are susceptible to increased risk of heart disease, stroke, diabetes, pulmonary disease, and accidents. Because of the effect of morbid obesity to the life of the patient, methods of treating morbid obesity are being researched. Numerous nonoperative therapies for morbid obesity have been tried with virtually no permanent success. Dietary counseling, behavior modification, wiring a patient's jaws shut, and pharmacologic methods have all been tried, and, though temporarily effective, failed to correct the condition. Nonsurgical approaches using mechanical devices, such as esophago-gastric balloons to fill the stomach have also been used to treat the condition. Such devices cannot be employed over a long term, however, as they often cause severe irritation, necessitating their periodic removal and hence interruption of treatment. Thus, the medical community has evolved surgical approaches to treatment of morbid obesity. Many surgical procedures for treatment of morbid obesity may generally be classified as being directed toward creation of a smaller stomach, also known as gastrorestrictive surgery, or toward the prevention of absorption of food, the most common of which is the gastric bypass. In variations of the gastric bypass, the stomach is divided into two pouches, with the upper pouch connected to the esophagus and having a small food capacity. The lower pouch remains in situ connected to the duodenum. The upper pouch is then surgically attached to a portion of the small intestine, called the jejunum, through a small opening. The opening restricts the passage of food by the greatly reduced useable stomach. The smaller stomach causes a feeling of fullness, or early satiety, with less food consumption, causing the patient to eat less food overall. Web site: http://www.delphion.com/details?pn=US06543456__

Patent Applications on Gastric Bypass As of December 2000, U.S. patent applications are open to public viewing.7 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take 7

This has been a common practice outside the United States prior to December 2000.

Patents 75

several years.) The following patent applications have been filed since December 2000 relating to gastric bypass: •

Obesity treatment tools and methods Inventor(s): Andreas, Bernard H.; (Redwood City, CA), Deem, Mark E.; (Mountain View, CA), French, Ronald G.; (Santa Clara, CA), Gifford, Hanson S.; (Woodside, CA), Sutton, Douglas S.; (Pacifica, CA) Correspondence: Morrison & Foerster Llp; 755 Page Mill RD; Palo Alto; CA; 94304-1018; US Patent Application Number: 20020183768 Date filed: May 30, 2001 Abstract: Various obesity treatment tools and methods are described herein, as well as treatments for other gastric-related diseases, e.g., GERD. Treatment includes reducing the size of the stomach pouch to limit the caloric intake as well as to provide an earlier feeling of satiety. This may be done by creating a smaller gastric pouch within the stomach directly from the interior of the stomach itself. The smaller pouches may be made through the use of individual anchoring devices, rotating probes, or volume reduction devices. A pyloroplasty procedure may also be performed to render the pyloric sphincter incompetent. A gastric bypass procedure may additionally be performed using atraumatic magnetic anastomoses devices so that sugars and fats are passed directly to the bowel while bypassing the stomach. Many of these procedures may be done in a variety of combinations. Treatment may create enforced behavioral modifications by discouraging the ingestion of high-caloric foods. Excerpt(s): The present invention relates generally to tools and methods for the treatment of obesity. More particularly, the present invention relates to tools and methods for performing less traumatic gastroplasty procedures. Obesity is considered a major health problem with annual associated costs reaching $100 billion in the U.S. alone. Morbid obesity is a condition of obesity with the presence of a secondary debilitating progressive disease and is generally associated with a body mass index (BMI).gtoreq.40 kg/m.sup.2. While the basic mechanism of obesity is simply an imbalance between caloric intake and burn rate, the underlying factors are varied and complex and conservative attempts at sustained weight loss with this population are almost always unsuccessful. Often, there are genetic and other biological influences that may override environmental causes. Consequently, obesity is a disease that eludes a simple treatment, with a recurrence rate above 90% for those who attempt to lose weight. Moreover, long-term results using conservative treatments for morbid obesity are generally unsuccessful and are typically associated with further loss of self-esteem with the regaining of weight. Hypertension, cardiovascular disease, diabetes, along with a host of other comorbidities all make morbid obesity second only to smoking as a preventable cause of death. Surgical procedures for obesity date back to 1889 (Billroth) with the earliest peer reviewed procedure being the jejuno-ileal bypass in 1954 (Kreman). A successful procedure is commonly defined as one that results in at least 50% excess weight loss at 2 years. Today, the most commonly done operation is the Roux-en-Y gastric bypass (RYGB), with around 35,000 performed annually in the U.S. Other forms of bariatric surgery include Fobi pouch, bilio-pancreatic diversion, and gastroplasty or "stomach stapling". The single existing procedure that involves an implanted device is the Lap-Band, which is a laparoscopically installed inflatable cuff that is placed around the top of the stomach just below the lower esophageal sphincter (LES). This device affects satiety only (no reduced caloric absorption). Because there is

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more to obesity than simple overeating, it is unlikely that Lap-Band by itself will ever be as effective as a surgery that includes other physiologic feedback mechanisms. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with gastric bypass, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “gastric bypass” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on gastric bypass. You can also use this procedure to view pending patent applications concerning gastric bypass. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 7. BOOKS ON GASTRIC BYPASS Overview This chapter provides bibliographic book references relating to gastric bypass. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on gastric bypass include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “gastric bypass” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “gastric bypass” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “gastric bypass” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Culinary Classics: Essentials of Cooking for the Gastric Bypass Patient by David Fouts; ISBN: 0971260192; http://www.amazon.com/exec/obidos/ASIN/0971260192/icongroupinterna

•

Gastric Bypass Surgery: Everything You Need to Know to Make an Informed Decision by Mary P. McGowan, Jo McGowan Chopra; ISBN: 0071431926; http://www.amazon.com/exec/obidos/ASIN/0071431926/icongroupinterna

•

I Want To Live: Gastric Bypass Reversal by Dani Hart; ISBN: 0972655409; http://www.amazon.com/exec/obidos/ASIN/0972655409/icongroupinterna

•

The Magic Pill: A Mental Health Companion for the Gastric Bypass Patient by Teri Kai Holtzclaw; ISBN: 0971260117; http://www.amazon.com/exec/obidos/ASIN/0971260117/icongroupinterna

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•

The Patient's Guide to Weight Loss Surgery: Everything You Need To Know About Gastric Bypass and Bariatric Surgery by April Hochstrasser, S. Ross Fox (2004); ISBN: 1578261651; http://www.amazon.com/exec/obidos/ASIN/1578261651/icongroupinterna

•

This is NOT Brain Surgery! A Mental Health Companion for the Gastric Bypass Patient by Teri Kai Holtzclaw (2001); ISBN: 0971260109; http://www.amazon.com/exec/obidos/ASIN/0971260109/icongroupinterna

Chapters on Gastric Bypass In order to find chapters that specifically relate to gastric bypass, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and gastric bypass using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “gastric bypass” (or synonyms) into the “For these words:” box.

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CHAPTER 8. MULTIMEDIA ON GASTRIC BYPASS Overview In this chapter, we show you how to keep current on multimedia sources of information on gastric bypass. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on gastric bypass is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “gastric bypass” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “gastric bypass” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on gastric bypass: •

Severe Obesity, the New Epidemic: Surgical Update Source: Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 1992, 60 minutes. Contact: WIN, 1 WIN WAY, Bethesda, MD 20892-3665. Summary: In this lecture, Dr. Pories discusses how morbid obesity can be controlled through improved gastric bypass surgical procedures and how morbidly obese patients who also had insulin-treated noninsulin-dependent diabetes mellitus (NIDDM) were able to stop or greatly reduce their daily insulin dosage as a co-result of the surgery. More than 2 percent (5 million) of the U.S. population is morbidly obese, which Dr. Pories defines as being more than 100 pounds over ideal body weight, or a body mass index (BMI) of greater than 40. Dr. Pories notes that morbid obesity is a major cause of illnesses such as hypertension, diabetes, and arthritis and often is a cause of premature death. Dr. Pories recommends that morbidly obese patients with diabetes should be recommended for surgery.

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•

Obesity Source: Los Angeles, CA: National Health Video, Inc. 1999. (videocassette). Contact: Available from National Health Video, Inc. 12021 Wilshire Boulevard, Suite 550, Los Angeles, CA 90025. (800) 543-6803. Fax (310) 477-8198. E-mail: [email protected]. PRICE: $89.00 plus shipping and handling. Summary: Obesity is a word that means one thing to the public and another to the health professional. To most people, to be obese is to be very overweight. To health professionals, however, a person can be considered obese even if the degree of overweight is not very great. This health education videotape program focuses on obesity, the impact of obesity on health, and strategies to fight obesity. The program describes methods to measure obesity, including percentage of body fat, and the Body Mass Index (BMI). A worksheet to figure one's own BMI is included in the teacher's guide. The program emphasizes that the causes of obesity are probably some combination of heredity and environment (including food and exercise habits), and notes that physical activity is a key factor in weight management. The program also describes the surgical techniques that can be used to treat obesity; these procedures are often effective but carry their own risks. Procedures covered include the stomach restriction or pouch procedure and the Roux en Y gastric bypass, in which the small intestine is surgically bypassed. The program also discusses miracle diets and diet pills, health problems associated with obesity, childhood obesity and its causes, and how to evaluate a commercial weight loss program. The teacher's guide includes a transcript of the video narration, a worksheet to determine BMI, a list of learning activities and teaching objectives, and a quiz for pre and posttesting. The video features many different people of different ethnic groups, ages, and body sizes; a variety of interactions with health care providers are also depicted. Simple graphics are used to explore some of the scientific concepts covered.

Bibliography: Multimedia on Gastric Bypass The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in gastric bypass (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on gastric bypass: •

Gastric bypass [videorecording] Source: from the Motion Picture Library of the American College of Surgeons; Year: 1983; Format: Videorecording; Danbury, Conn.: American College of Surgeons/Davis & Geck Surgical Film-Video Library, [1983]

•

Gastric bypass for morbid obesity [motion picture] Source: Committee on Medical Motion Pictures, American College of Surgeons; produced by Davis+Geck, American Cyanamid Company; Year: 1977; Format: Motion picture; Danbury, Conn.: Davis+Geck, [1977]

•

Gastric bypass for morbid obesity and conversion of dilated vertical banded gastroplasty to gastric bypass [videorecording] Source: American College of Surgeons; produced by Ciné-Med; Year: 1995; Format: Videorecording; Woodbury, Conn.: CinéMed, c1995

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•

Hand-assisted laparoscopic gastric bypass for morbid obesity [videorecording] Source: American College of Surgeons; produced by Ciné-Med; Year: 1999; Format: Videorecording; [Woodbury, Conn.]: Ciné-Med, c1999

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Laparoscopic gastric bypass for morbid obesity [electronic resource] Source: M. Vix; Year: 2003; Format: Electronic resource; France: WebSurg, [2003?]

•

Laparoscopic isolated gastric bypass after failed bariatric surgery [videorecording] Source: from the Film Library and the Clinical Congress of ACS, Mount Sinai; Year: 1997; Format: Videorecording; [Woodbury, Conn.: Ciné-Med, 1997]

•

Laparoscopic Janeway gastrostomy [videorecording]; Laparoscopic Roux-en-Y gastric bypass for morbid obesity; Laparoscopic isolated gastric bypass with Roux-en-Y gastroenterostomy for morbid obesity; Laparoscopic gastrectomy Source: Society of American Gastro; Year: 1998; Format: Videorecording; Woodbury, CT: Ciné-Med, [1998]

•

Laparoscopic Roux-en-Y gastric bypass [videorecording] Source: from the Film Library and the Clinical Congress of ACS, Southwestern Center for Minimally Invasive Surgery at the University of Texas Southwestern Medical Center at Dallas; Year: 2001; Format: Videorecording; Woodbury, CT: Ciné-Med, [2001]

•

Laparoscopic Roux-en-Y gastric bypass for morbid obesity [videorecording]: the University of Pittsburgh approach Source: American College of Surgeons; produced by Ciné-Med; Year: 1999; Format: Videorecording; [Woodbury, Conn.]: Ciné-Med, c1999

•

Minimally invasive surgery for benign gastric tumors [videorecording]; Transgastric access for a stapled endoscopic pancreatic cystagastrostomy [sic]; Hand-assisted laparoscopic isolated gastric bypass for morbid obesity Source: Society American Gastrointesti; Year: 1997; Format: Videorecording; Woodbury, Conn.: Ciné-Med, [1997]

•

Roux-en-Y gastric bypass with triple stapled gastric pouch [videorecording] Source: from the Film Library and the Clinical Congress of ACS; produced by Ciné-Med; Year: 1995; Format: Videorecording; Woodbury, Conn.: Ciné-Med, [1995]

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CHAPTER 9. PERIODICALS AND NEWS ON GASTRIC BYPASS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover gastric bypass.

News Services and Press Releases One of the simplest ways of tracking press releases on gastric bypass is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “gastric bypass” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to gastric bypass. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “gastric bypass” (or synonyms). The following was recently listed in this archive for gastric bypass: •

Gastric bypass urged for very obese diabetics Source: Reuters Health eLine Date: October 22, 2003

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Gastric bypass recommended for very obese diabetics Source: Reuters Medical News Date: October 22, 2003

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Postprandial surge in gut hormone aids weight loss after gastric bypass Source: Reuters Medical News Date: June 23, 2003

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Gastric bypass for obesity often leads to resolution of type 2 diabetes Source: Reuters Medical News Date: April 25, 2003

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Gastric bypass surgery increases survival of obese patients Source: Reuters Medical News Date: October 09, 2002

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Laparoscopic gastric bypass is an acceptable alternative to open surgery Source: Reuters Medical News Date: October 25, 2000

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Laparoscopic Roux-en-Y gastric bypass reduces weight with fewer complications Source: Reuters Medical News Date: October 20, 2000

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Roux-en-Y gastric bypass safe and effective for morbid obesity Source: Reuters Medical News Date: August 01, 2000

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Gastric bypass reduces diabetic symptoms in morbidly obese Source: Reuters Medical News Date: June 27, 2000

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Gastric bypass an option for some heart/lung recipients with severe gastroparesis Source: Reuters Medical News Date: April 07, 2000

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Laparoscopic gastric bypass shortens recovery tiMen Source: Reuters Medical News Date: December 29, 1999 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name.

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Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “gastric bypass” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “gastric bypass” (or synonyms). If you know the name of a company that is relevant to gastric bypass, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “gastric bypass” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “gastric bypass” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on gastric bypass: •

FDA Approves Adjustable Stomach Band to Treat Severe Obesity Source: WIN Notes. p. 7. Winter 2001/2002. Contact: Weight-control Information Network, 1 WIN Way, Bethesda, MD 20992-3665. (202) 828-1025. [email protected]. Summary: In June 2001, the United States Food and Drug Administration (FDA) approved a new surgical device for the treatment of severe obesity. The device, called the Lap-Band Adjustable Gastric Banding System, provides some advantages over traditional gastric bypass surgery, but may not be as effective. The Lap-Band is inserted via laparoscopy, a procedure less invasive than some types of obesity surgeries.

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Researchers at the Medical College of Virginia of the Virginia Commonwealth University (VCU) in Richmond, one of eight centers performing the procedure during FDA's clinical trial, did not find the Lap-Band to be effective for the surgical treatment of morbid obesity and recommended further studies to determine its long-term efficacy. VCU patients lost an average of 38 percent of their excess weight over 3 years, which is about half the amount of weight usually lost after more traditional gastric bypass surgery.

Academic Periodicals covering Gastric Bypass Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to gastric bypass. In addition to these sources, you can search for articles covering gastric bypass that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute8: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

8

These publications are typically written by one or more of the various NIH Institutes.

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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.9 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:10 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

9

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 10 See http://www.nlm.nih.gov/databases/databases.html.

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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway11 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.12 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “gastric bypass” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 1338 22 975 4 0 2339

HSTAT13 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.14 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.15 Simply search by “gastric bypass” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

11

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

12

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 13 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 14 15

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists16 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.17 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.18 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

16 Adapted 17

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 18 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on gastric bypass can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to gastric bypass. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to gastric bypass. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “gastric bypass”:

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Other guides Arthritis http://www.nlm.nih.gov/medlineplus/arthritis.html Breast Implants/Breast Reconstruction http://www.nlm.nih.gov/medlineplus/breastimplantsbreastreconstruction.html Weight Loss Surgery http://www.nlm.nih.gov/medlineplus/weightlosssurgery.html

Within the health topic page dedicated to gastric bypass, the following was listed: •

General/Overviews Bariatric Surgery Source: American Medical Association http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZCVJLXI9D&s ub_cat=382 Surgery for Obesity: What Is It and When Is It Appropriate? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01465

•

Specific Conditions/Aspects Gastric Bypass Procedure: Questions and Answers Source: Cleveland Clinic Foundation http://www.clevelandclinic.org/health/healthinfo/docs/2500/2534.asp?index=9671 Implanted Stomach Band to Treat Severe Obesity Approved Source: Food and Drug Administration http://www.fda.gov/bbs/topics/ANSWERS/2001/ANS01087.html Laparoscopic Gastric Bypass Procedure Source: Cleveland Clinic Foundation http://www.clevelandclinic.org/health/healthinfo/docs/1900/1993.asp?index=4355 Lap-Band Adjustable Gastric Banding (LAGB) System Source: Center for Devices and Radiological Health http://www.fda.gov/cdrh/mda/docs/p000008.html Obesity Surgery Source: American Obesity Association http://www.obesity.org/education/advisor.shtml Several Factors Contribute to Complications Following Weight Loss Surgery Source: American Medical Association http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZD2N03RFD& sub_cat=651

Patient Resources

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From the National Institutes of Health Gastric Surgery for Severe Obesity Source: Weight-control Information Network http://www.niddk.nih.gov/health/nutrit/pubs/gastric/gastricsurgery.htm

•

Organizations American Obesity Association http://www.obesity.org/ National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/

•

Research Innovative Approach to Body Contouring after Massive Weight Loss Gives Patients New Body Image Source: American Society of Plastic Surgeons http://www.plasticsurgery.org/news_room/press_releases/Innovative-Approachto-Body-Contouring-After-Massive-Weight-Loss-Gives-Patients-New-Body-ImageASPS-Study-Reveals.cfm Mayo Clinic Study Finds Gastric Bypass Surgery Effective Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.org/news2000-rst/705.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on gastric bypass. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Surgery for Severe Obesity: What Patients Should Know Source: San Francisco, CA: American Society for Bariatric Surgery, 28 p., 1994. Contact: American Society for Bariatric Surgery, 140 NW 75th Drive, Suite C., Gainesville, FL. 32607 (U.S.A.). (352) 331-4900. FAX (352) 331-4975. Website: http://www.asbs.org.

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Summary: This booklet provides patients and their families with basic information on the surgical treatment of severe obesity. A patient should be at least 100 pounds overweight or have sufficient medical need for weight reduction to qualify for surgical treatment. The ways in which the surgery will control obesity are described; these are restriction of food intake and malabsorption of ingested foods. The anatomy and functions involved with the process are also outlined. The risks and benefits of gastric banding, vertical banded gastroplasty, gastric bypass, and biliopancreatic diversion are considered. The booklet also discusses the risks and benefits over the patient's lifetime. •

Dieting and Gallstones Source: Bethesda, MD: Weight-Control Information Network. 1993. 4 p. Contact: Available from Weight-Control Information Network. 1 Win Way, Bethesda, MD 20892-3665. (301) 984-7378. Fax (301) 984-7196. E-mail: [email protected]. PRICE: Free. NIH Publication No. 94-3677. Summary: This fact sheet provides information on weight loss programs and the risk of developing gallstones. Written in a question and answer format, the fact sheet covers the physiology and causes of gallstones; risk factors for gallstones, including obesity; gallstone risk factors associated with very low calorie diets; why weight loss can cause gallstones; gallstone risk factors associated with surgery performed to lose weight (gastric bypass surgery); weight loss considerations for people who already have gallstones; gallstone treatments; and weighing the benefits of weight loss versus the risks of getting gallstones. The fact sheet concludes with an annotated list of five resources for additional reading. 1 table. The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to gastric bypass. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

Patient Resources

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMD®Health: http://my.webmd.com/health_topics

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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to gastric bypass. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with gastric bypass. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about gastric bypass. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “gastric bypass” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “gastric bypass”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “gastric bypass” (or synonyms) into the “For

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these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “gastric bypass” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.19

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

19

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)20: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

20

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

107

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

109

GASTRIC BYPASS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abscess: A localized, circumscribed collection of pus. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Acylation: The addition of an organic acid radical into a molecule. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the

110 Gastric Bypass

complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Ameliorated: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on

Dictionary 111

the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antrectomy: An operation to remove the upper portion of the stomach, called the antrum. This operation helps reduce the amount of stomach acid. It is used when a person has complications from ulcers. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Reflux: Reflux of bile mainly into the upper digestive tract, but also into the pancreas. [NIH]

Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliopancreatic Diversion: A surgical procedure which diverts pancreatobiliary secretions

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via the duodenum and the jejunum into the colon, the remaining small intestine being anastomosed to the stomach after antrectomy. The procedure produces less diarrhea than does jejunoileal bypass. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [NIH]

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Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Chemical Warfare: Tactical warfare using incendiary mixtures, smokes, or irritant, burning, or asphyxiating gases. [NIH] Chemical Warfare Agents: Chemicals that are used to cause the disturbance, disease, or death of humans during war. [NIH] Cholecystectomy: Surgical removal of the gallbladder. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU]

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Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the

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formation of a viable zygote. [EU] Consciousness: Sense of awareness of self and of the environment. [NIH] Constriction: The act of constricting. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyanide: An extremely toxic class of compounds that can be lethal on inhaling of ingesting in minute quantities. [NIH] Cytotoxic: Cell-killing. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Decontamination: The removal of contaminating material, such as radioactive materials, biological materials, or chemical warfare agents, from a person or object. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH]

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Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]

Duodenum: The first part of the small intestine. [NIH] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in

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all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [NIH] Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Energy Intake: Total number of calories taken in daily whether ingested or by parenteral routes. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagectomy: An operation to remove a portion of the esophagus. [NIH]

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Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Evacuation: An emptying, as of the bowels. [EU] Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by determining a person's exercise capacity. [NIH] Exercise Therapy: Motion of the body or its parts to relieve symptoms or to improve function, leading to physical fitness, but not physical education and training. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extreme obesity: A body mass index [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty Liver: The buildup of fat in liver cells. The most common cause is alcoholism. Other causes include obesity, diabetes, and pregnancy. Also called steatosis. [NIH] Femoral: Pertaining to the femur, or to the thigh. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fertilization in Vitro: Fertilization of an egg outside the body when the egg is normally fertilized in the body. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinolysis: The natural enzymatic dissolution of fibrin. [NIH] Fistulas: An abnormal passage from one hollow structure of the body to another, or from a hollow structure to the surface, formed by an abscess, disease process, incomplete closure of a wound, or by a congenital anomaly. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called

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folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. [NIH]

Forearm: The part between the elbow and the wrist. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastrectomy: An operation to remove all or part of the stomach. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric banding: Surgery to limit the amount of food the stomach can hold by closing part of it off. A band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach. The small outlet delays the emptying of food from the pouch and causes a feeling of fullness. [NIH]

Gastric Bypass: Surgical procedure in which the stomach is transected high on the body. The resulting proximal remnant is joined to a loop of the jejunum in an end-to-side anastomosis. This procedure is used frequently in the treatment of morbid obesity. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Fistula: Abnormal passage communicating with the stomach. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastroenterostomy: Surgical construction of a channel between the stomach and intestines. [NIH]

Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH]

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Gastroesophageal Reflux Disease: Flow of the stomach's contents back up into the esophagus. Happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal Hemorrhage: Bleeding in the gastrointestinal tract. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gastroparesis: Nerve or muscle damage in the stomach. Causes slow digestion and emptying, vomiting, nausea, or bloating. Also called delayed gastric emptying. [NIH] Gastroplasty: Surgical treatment of the stomach or lower esophagus used to decrease the size of the stomach. The procedure is used mainly in the treatment of morbid obesity and to correct defects in the lower esophagus or the stomach. Different procedures employed include vertical (mesh) banded gastroplasty, silicone elastomer ring vertical gastroplasty and horizontal banded gastroplasty. [NIH] Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosylation: The chemical or biochemical addition of carbohydrate or glycosyl groups to other chemicals, especially peptides or proteins. Glycosyl transferases are used in this biochemical reaction. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions. [NIH]

Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH]

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Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hepatocyte: A liver cell. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]

Histology: The study of tissues and cells under a microscope. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels

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are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Ileal: Related to the ileum, the lowest end of the small intestine. [NIH] Ileum: The lower end of the small intestine. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH] Ingestion: Taking into the body by mouth [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inoperable: Not suitable to be operated upon. [EU] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Pressure: Pressure within the cranial cavity. It is influenced by brain mass, the

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circulatory system, CSF dynamics, and skull rigidity. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intrinsic Factor: A glycoprotein secreted by the cells of the gastric glands that is required for the absorption of vitamin B 12. Deficiency of intrinsic factor results in pernicious anemia. [NIH]

Intussusception: A rare disorder. A part of the intestines folds into another part of the intestines, causing blockage. Most common in infants. Can be treated with an operation. [NIH]

Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Jejunoileal Bypass: A surgical procedure consisting of the anastomosis of the proximal part of the jejunum to the distal portion of the ileum, so as to bypass the nutrient-absorptive segment of the small intestine, to treat morbid obesity. [NIH] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kinetic: Pertaining to or producing motion. [EU] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a

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given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] Metaplasia: A condition in which there is a change of one adult cell type to another similar adult cell type. [NIH] Methylene Blue: A compound consisting of dark green crystals or crystalline powder, having a bronze-like luster. Solutions in water or alcohol have a deep blue color. Methylene blue is used as a bacteriologic stain and as an indicator. It inhibits Guanylate cyclase, and has been used to treat cyanide poisoning and to lower levels of methemoglobin. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH]

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Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Mononuclear: A cell with one nucleus. [NIH] Motility: The ability to move spontaneously. [EU] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopathy: Any disease of a muscle. [EU] Nasogastric: The process of passing a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Omentum: A fold of the peritoneum (the thin tissue that lines the abdomen) that surrounds the stomach and other organs in the abdomen. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Optic Nerve Diseases: Conditions which produce injury or dysfunction of the second

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cranial or optic nerve, which is generally considered a component of the central nervous system. Damage to optic nerve fibers may occur at or near their origin in the retina, at the optic disk, or in the nerve, optic chiasm, optic tract, or lateral geniculate nuclei. Clinical manifestations may include decreased visual acuity and contrast sensitivity, impaired color vision, and an afferent pupillary defect. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Papilledema: Swelling around the optic disk. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parietal Lobe: Upper central part of the cerebral hemisphere. [NIH] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Peer Review: An organized procedure carried out by a select committee of professionals in evaluating the performance of other professionals in meeting the standards of their

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specialty. Review by peers is used by editors in the evaluation of articles and other papers submitted for publication. Peer review is used also in the evaluation of grant applications. It is applied also in evaluating the quality of health care provided to patients. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Pernicious: Tending to a fatal issue. [EU] Pernicious anemia: A type of anemia (low red blood cell count) caused by the body's inability to absorb vitamin B12. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have

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grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physical Fitness: A state of well-being in which performance is optimal, often as a result of physical conditioning which may be prescribed for disease therapy. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postoperative: After surgery. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Pregnancy Outcome: Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo transfer or fertilization in vitro. [NIH] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Progressive disease: Cancer that is increasing in scope or severity. [NIH]

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Prophylaxis: An attempt to prevent disease. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pseudotumor Cerebri: A condition marked by raised intracranial pressure and characterized clinically by headaches; nausea; papilledema, peripheral constriction of the visual fields, transient visual obscurations, and pulsatile tinnitus. Obesity is frequently associated with this condition, which primarily affects women between 20 and 44 years of age. Chronic papilledema may lead to optic nerve injury (optic nerve diseases) and visual loss (blindness). [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pupil: The aperture in the iris through which light passes. [NIH] Pyloric Sphincter: The muscle between the stomach and the small intestine. [NIH] Pyloroplasty: An operation to widen the opening between the stomach and the small intestine. This allows stomach contents to pass more freely from the stomach. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH]

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Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Reoperation: A repeat operation for the same condition in the same patient. It includes reoperation for reexamination, reoperation for disease progression or recurrence, or reoperation following operative failure. [NIH] Reproduction Techniques: Methods pertaining to the generation of new individuals. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Rhabdomyolysis: Necrosis or disintegration of skeletal muscle often followed by myoglobinuria. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH]

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Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sedentary: 1. Sitting habitually; of inactive habits. 2. Pertaining to a sitting posture. [EU] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH]

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Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Steatosis: Fatty degeneration. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stoma: A surgically created opening from an area inside the body to the outside. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress incontinence: An involuntary loss of urine that occurs at the same time that internal abdominal pressure is increased, such as with laughing, sneezing, coughing, or physical activity. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH]

Dictionary 133

Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transferases: Transferases are enzymes transferring a group, for example, the methyl group or a glycosyl group, from one compound (generally regarded as donor) to another compound (generally regarded as acceptor). The classification is based on the scheme "donor:acceptor group transferase". (Enzyme Nomenclature, 1992) EC 2. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of

134 Gastric Bypass

metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Unresectable: Unable to be surgically removed. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Veins: The vessels carrying blood toward the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]

Vertical banded gastroplasty: A surgical treatment for extreme obesity; an operation on the stomach that involves constructing a small pouch in the stomach that empties through a narrow opening into the distal stomach and duodenum. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visual field: The entire area that can be seen when the eye is forward, including peripheral vision. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Volvulus: A twisting of the stomach or large intestine. May be caused by the stomach being in the wrong position, a foreign substance, or abnormal joining of one part of the stomach or intestine to another. Volvulus can lead to blockage, perforation, peritonitis, and poor blood flow. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Wound Healing: Restoration of integrity to traumatized tissue. [NIH]

Dictionary 135

Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

137

INDEX A Abdominal, 5, 24, 109, 124, 126, 127, 132 Abscess, 109, 118 Acceptor, 109, 123, 126, 133 Acuity, 17, 109, 126 Acute renal, 37, 109 Acylation, 43, 109 Adaptability, 109, 113 Adaptation, 8, 109 Adenocarcinoma, 43, 109 Adipocytes, 8, 109, 123 Adipose Tissue, 5, 28, 109 Adjustment, 45, 46, 109 Adrenal Cortex, 109, 115 Adverse Effect, 109, 131 Aerobic, 109, 118 Afferent, 13, 109, 123, 126 Affinity, 109, 131 Age of Onset, 110, 134 Airway, 110, 131 Algorithms, 110, 112 Alimentary, 14, 28, 37, 46, 48, 110, 126, 127 Alternative medicine, 85, 110 Ameliorated, 3, 110 Amino Acids, 52, 110, 117, 127, 128, 129, 133 Ampulla, 110, 117 Anal, 110, 123 Analgesic, 55, 110 Anastomosis, 12, 21, 23, 26, 60, 74, 110, 119, 123 Anemia, 39, 110, 119, 127 Anesthesia, 10, 12, 45, 110 Animal model, 8, 110 Antibiotic, 110, 117 Antibody, 110, 111, 114, 122, 131 Antigen, 110, 111, 114, 122 Antioxidant, 111, 126 Antrectomy, 111, 112 Apnea, 111 Arterial, 111, 121, 129, 132 Arteries, 111, 112, 115, 124 Arterioles, 111, 112, 134 Attenuated, 111, 116 B Bacterial Physiology, 109, 111 Bactericidal, 111, 118 Bacteriostatic, 111, 117

Base, 111, 115, 123 Benign, 81, 111 Bile, 21, 52, 111, 112, 119, 123, 132 Bile Acids, 111, 119, 132 Bile Acids and Salts, 111 Bile Ducts, 111, 119 Bile Reflux, 21, 111 Biliary, 15, 42, 43, 50, 111 Biliopancreatic Diversion, 4, 17, 18, 20, 51, 60, 63, 67, 98, 111 Bilirubin, 112, 119 Biochemical, 112, 120 Biopsy, 6, 112, 127 Biotechnology, 11, 85, 91, 112 Biotransformation, 112 Bladder, 112, 122, 134 Bloating, 112, 120 Blood Glucose, 112, 121, 122 Blood pressure, 9, 112, 113, 121, 131 Blood vessel, 112, 113, 124, 127, 132, 133, 134 Body Composition, 5, 10, 37, 112 Body Fluids, 112, 125, 131 Body Mass Index, 10, 75, 79, 80, 112, 118, 126 Bone Density, 11, 112 Bowel, 12, 50, 52, 53, 60, 75, 110, 112, 116, 122, 127 Bowel Movement, 112, 116 Branch, 105, 112, 117, 126, 131, 132 C Caloric intake, 75, 112 Carbohydrate, 113, 120 Carcinoma, 32, 33, 42, 47, 50, 113 Cardiac, 8, 113, 119, 125, 132 Cardiomyopathy, 8, 113 Cardiovascular, 4, 8, 75, 113, 118 Cardiovascular disease, 4, 8, 75, 113 Case report, 14, 33, 113 Cause of Death, 75, 113 Cell, 8, 17, 112, 113, 114, 115, 117, 118, 121, 122, 124, 125, 127, 128, 130 Cell Death, 8, 113, 125 Cerebrovascular, 113 Chemical Warfare, 113, 115 Chemical Warfare Agents, 113, 115 Cholecystectomy, 23, 113 Cholesterol, 111, 113, 115, 119, 132

138 Gastric Bypass

Chronic, 6, 17, 61, 113, 116, 118, 122, 129, 132 Chronic Disease, 6, 61, 113 Clinical trial, 4, 71, 72, 86, 91, 113, 115, 129 Cloning, 112, 113 Coagulation, 52, 113 Cofactor, 114, 129 Collapse, 114, 131 Comorbidity, 5, 114 Complement, 114 Complementary and alternative medicine, 65, 68, 114 Complementary medicine, 65, 114 Complete remission, 114, 130 Computational Biology, 91, 114 Conception, 114, 128 Consciousness, 110, 115 Constriction, 115, 129 Consumption, 74, 115, 126 Contraindications, ii, 115 Control group, 9, 115 Coronary, 51, 113, 115, 124 Coronary heart disease, 113, 115 Coronary Thrombosis, 115, 124 Cortisol, 11, 115 Curative, 115, 132 Cyanide, 115, 124 Cytotoxic, 6, 115 D Data Collection, 10, 115 Databases, Bibliographic, 91, 115 Decompression, 14, 115 Decompression Sickness, 115 Decontamination, 66, 115 Density, 112, 115 Diabetes Mellitus, 52, 63, 79, 116, 120, 121 Diagnostic procedure, 73, 85, 116 Diarrhea, 112, 116 Diastolic, 116, 122 Diffusion, 116 Digestion, 47, 110, 111, 112, 116, 120, 122, 123, 127, 132 Digestive system, 72, 74, 116 Digestive tract, 111, 116, 131 Dilation, 23, 116 Dilution, 11, 116 Direct, iii, 116, 130 Disease Progression, 116, 130 Disinfectant, 116, 118 Distal, 20, 46, 47, 51, 53, 55, 63, 74, 116, 119, 123, 129, 134 Drug Interactions, 116

Duodenal Ulcer, 16, 43, 116 Duodenum, 46, 56, 74, 111, 112, 116, 117, 119, 123, 126, 132, 134 E Eating Disorders, 7, 116 Echocardiography, 9, 116 Efficacy, 4, 7, 22, 61, 86, 116 Electrocoagulation, 113, 116 Electrolyte, 116, 125, 131 Electrons, 111, 116, 126 Electrophysiological, 117, 134 Embryo, 117, 128, 131 Embryo Transfer, 117, 128 Encephalopathy, 13, 60, 117 Endoscope, 117 Endoscopic, 23, 30, 81, 117 Endoscopy, 17, 21, 23, 25, 29, 34, 35, 36, 42, 44, 50, 53, 117 Energy balance, 117, 123 Energy Intake, 25, 61, 117 Environmental Health, 90, 92, 117 Enzymatic, 114, 117, 118 Enzyme, 117, 127, 132, 133 Epidemiological, 6, 117 Epidural, 12, 117 Epigastric, 117, 126 Epithelial, 109, 117 Erythrocytes, 110, 117 Erythromycin, 52, 117 Esophageal, 47, 117, 120 Esophagectomy, 47, 117 Esophagitis, 118, 120 Esophagus, 47, 74, 116, 117, 118, 119, 120, 124, 127, 130, 132 Ethanol, 25, 118 Ethnic Groups, 80, 118 Evacuation, 118, 119 Exercise Test, 15, 118 Exercise Therapy, 12, 118 Exocrine, 118, 126 Exogenous, 112, 118, 134 Extracellular, 118, 131 Extreme obesity, 16, 118, 134 F Family Planning, 91, 118 Fat, 5, 66, 80, 109, 111, 112, 115, 118, 123, 126, 133 Fatigue, 118, 121 Fatty Liver, 4, 6, 118 Femoral, 21, 118 Femur, 118 Fertilization in Vitro, 118, 128

Index 139

Fibrin, 118, 127 Fibrinolysis, 52, 118 Fistulas, 28, 118 Folate, 14, 56, 60, 63, 118, 119 Fold, 119, 125 Folic Acid, 119 Follow-Up Studies, 7, 119 Forearm, 112, 119 G Gallbladder, 109, 111, 113, 116, 119 Gallstones, 98, 111, 119 Gas, 115, 116, 119, 121, 130 Gas exchange, 119, 130 Gastrectomy, 4, 36, 81, 119 Gastric Acid, 45, 119 Gastric banding, 12, 20, 24, 32, 35, 98, 119 Gastric Emptying, 38, 119, 120 Gastric Fistula, 24, 28, 119 Gastric Juices, 119, 127 Gastric Mucosa, 119, 127 Gastrin, 119, 121 Gastroenterostomy, 34, 81, 119 Gastroesophageal Reflux, 51, 119, 120 Gastroesophageal Reflux Disease, 51, 120 Gastrointestinal, 14, 21, 28, 37, 46, 48, 62, 118, 120, 132 Gastrointestinal Hemorrhage, 21, 120 Gastrointestinal tract, 118, 120 Gastroparesis, 84, 120 Gastrostomy, 39, 81, 120 Gene, 5, 8, 112, 120 Gene Expression, 5, 8, 120 Gland, 109, 120, 126, 131, 132 Glucose, 8, 11, 29, 31, 112, 116, 120, 121, 122 Glucose Intolerance, 116, 120 Glycoprotein, 120, 123 Glycosylation, 8, 120 Governing Board, 120, 128 Grade, 120 Grading, 5, 120 Graft, 120, 121 Growth, 111, 113, 120, 121, 124, 128 H Health Education, 80, 121 Health Status, 12, 24, 121 Heart attack, 113, 121 Heart failure, 9, 121 Hemoglobin, 110, 117, 121 Hemorrhage, 116, 121, 132 Hepatic, 5, 6, 18, 46, 121 Hepatocyte, 5, 121

Heredity, 80, 120, 121 Hernia, 32, 44, 121 Histology, 5, 6, 121 Homeostasis, 6, 121 Hormonal, 29, 121 Hormone, 5, 29, 62, 84, 115, 119, 121, 122, 123 Host, 75, 121 Hybrid, 3, 121 Hydrogen, 109, 111, 113, 121, 123, 125, 126, 127 Hydrolysis, 112, 121, 128 Hyperlipidemia, 5, 121 Hypertension, 4, 5, 7, 20, 52, 75, 79, 113, 121, 133 I Id, 64, 68, 86, 96, 98, 104, 106, 122 Ileal, 61, 75, 122 Ileum, 122, 123 Impairment, 122, 124 In situ, 74, 122 Incision, 122, 123 Incompetence, 119, 122 Incontinence, 122 Indicative, 77, 122, 126, 134 Infarction, 115, 122, 124 Infection, 30, 122, 124, 132 Informed Consent, 7, 55, 122 Ingestion, 75, 122, 128 Innervation, 55, 122 Inoperable, 47, 122 Insulin, 4, 7, 9, 11, 32, 79, 122, 134 Insulin-dependent diabetes mellitus, 4, 122 Intestinal, 11, 33, 36, 69, 122, 124 Intestine, 5, 74, 111, 112, 122, 123, 134 Intoxication, 122, 134 Intracellular, 122 Intracranial Pressure, 122, 129 Intrinsic, 13, 110, 123 Intrinsic Factor, 13, 123 Intussusception, 14, 33, 123 Invasive, 4, 74, 81, 85, 123, 124 Involuntary, 123, 125, 131, 132 J Jejunoileal Bypass, 33, 39, 112, 123 Jejunum, 56, 74, 112, 119, 123 K Kb, 90, 123 Kinetic, 123 L Laparoscopy, 41, 44, 69, 85, 123

140 Gastric Bypass

Large Intestine, 116, 122, 123, 130, 131, 134 Leptin, 11, 43, 123 Lesion, 123, 134 Library Services, 104, 123 Ligaments, 115, 123 Lipid, 9, 66, 122, 123, 126, 133 Lipid Peroxidation, 123, 126 Liver, 4, 5, 6, 23, 47, 48, 109, 111, 116, 118, 119, 121, 123 Liver Transplantation, 4, 123 Localized, 109, 122, 123, 128, 134 Longitudinal study, 5, 123 Loop, 20, 50, 74, 119, 121, 124 Lower Esophageal Sphincter, 75, 119, 120, 124 Lymphatic, 122, 124 M Magnetic Resonance Imaging, 11, 124 Malabsorption, 98, 124 Malignant, 109, 124 Mania, 124 Manic, 33, 124 MEDLINE, 91, 124 Membrane, 11, 114, 124, 127 Menopause, 124, 128 Mental Disorders, 72, 124 Mental Processes, 124, 129 Mesentery, 50, 124, 127 Metaplasia, 36, 124 Methylene Blue, 54, 124 MI, 10, 75, 79, 80, 107, 124 Microbiology, 109, 124 Milliliter, 112, 124 Modification, 3, 74, 125, 129 Molecular, 8, 91, 93, 112, 114, 125 Molecule, 109, 111, 114, 121, 125, 126, 130 Mononuclear, 32, 125 Motility, 14, 52, 125 Mydriatic, 116, 125 Myocardium, 124, 125 Myopathy, 38, 62, 125 N Nasogastric, 14, 125 Nausea, 120, 125, 129 NCI, 1, 72, 89, 125 Necrosis, 122, 124, 125, 130 Need, 3, 6, 77, 78, 79, 85, 98, 99, 109, 125 Nerve, 38, 62, 110, 120, 122, 125, 126, 132, 133 Nuclei, 117, 124, 125, 126 Nucleus, 125 Nutritional Support, 120, 125

O Omentum, 50, 125 Optic Nerve, 125, 129 Optic Nerve Diseases, 125, 129 Overweight, 4, 63, 80, 98, 126 Oxidation, 8, 109, 111, 112, 123, 126 Oxidative Stress, 6, 126 Oxygen Consumption, 118, 126 P Palliative, 32, 42, 47, 126, 132 Pancreas, 50, 109, 111, 116, 122, 126 Pancreatic, 32, 42, 43, 50, 75, 81, 119, 126 Pancreatic Juice, 119, 126 Papilledema, 126, 129 Parenteral, 117, 126 Parietal, 17, 126, 127 Parietal Lobe, 126 Partial remission, 126, 130 Pathogenesis, 5, 126 Pathologic, 112, 115, 126 Pathophysiology, 5, 126 Patient Education, 97, 102, 104, 107, 126 Peer Review, 59, 75, 126 Pepsin, 127 Pepsin A, 127 Peptic, 3, 43, 127 Peptic Ulcer, 3, 43, 127 Peptide, 123, 127, 128, 129 Percutaneous, 43, 44, 46, 127 Perforation, 13, 20, 31, 33, 127, 134 Perioperative, 12, 127 Peritoneum, 124, 125, 127 Peritonitis, 127, 134 Pernicious, 123, 127 Pernicious anemia, 123, 127 PH, 112, 127 Pharmacokinetic, 127 Pharmacologic, 74, 110, 127, 133 Pharynx, 119, 127 Phospholipids, 118, 127 Photocoagulation, 113, 127 Physical Fitness, 118, 128 Physiologic, 6, 76, 128, 130 Physiology, 16, 98, 117, 128 Plants, 120, 128, 133 Plasma, 11, 20, 24, 43, 61, 62, 66, 120, 121, 128 Platinum, 124, 128 Poisoning, 122, 124, 125, 128 Polypeptide, 31, 127, 128 Posterior, 110, 126, 128 Postoperative, 10, 14, 18, 44, 45, 49, 55, 128

Index 141

Practice Guidelines, 92, 128 Pregnancy Outcome, 39, 128 Premenopausal, 10, 128 Prevalence, 4, 6, 44, 128 Progression, 110, 128 Progressive, 10, 75, 121, 125, 128 Progressive disease, 75, 128 Prophylaxis, 40, 62, 129, 130 Prospective study, 6, 61, 123, 129 Protein S, 10, 71, 112, 117, 129 Proteins, 110, 111, 114, 117, 120, 125, 127, 128, 129, 131, 133 Protocol, 5, 129 Proximal, 52, 57, 74, 116, 119, 123, 129 Pseudotumor Cerebri, 7, 129 Psychology, 54, 129 Psychopathology, 7, 129 Public Policy, 91, 129 Pulmonary, 18, 45, 74, 112, 115, 118, 129, 134 Pulmonary Artery, 112, 129, 134 Pupil, 116, 125, 129 Pyloric Sphincter, 75, 129 Pyloroplasty, 75, 129 Q Quality of Life, 6, 7, 9, 24, 30, 37, 67, 129 R Race, 10, 129 Radioactive, 115, 121, 129 Radiography, 28, 129 Radiological, 96, 127, 129 Randomized, 18, 37, 52, 53, 60, 62, 66, 116, 129, 130 Randomized clinical trial, 53, 130 Receptor, 109, 111, 130 Rectum, 112, 116, 119, 122, 123, 130 Recurrence, 75, 130 Refer, 1, 114, 130 Reflux, 28, 111, 119, 120, 130 Regimen, 116, 130 Regurgitation, 119, 130 Remission, 6, 130 Reoperation, 18, 35, 47, 130 Reproduction Techniques, 128, 130 Resection, 53, 130 Respiratory failure, 53, 130 Retinoids, 130, 134 Rhabdomyolysis, 37, 130 Risk factor, 6, 10, 31, 98, 129, 130 S Salivary, 116, 130 Salivary glands, 116, 130

Schizoid, 130, 134 Schizophrenia, 130, 134 Schizotypal Personality Disorder, 130, 134 Screening, 113, 131 Secretion, 26, 45, 122, 131 Sedentary, 10, 131 Serum, 46, 49, 60, 62, 114, 127, 131 Side effect, 109, 131, 133 Signs and Symptoms, 130, 131 Skeletal, 8, 11, 130, 131 Skeleton, 118, 131 Sleep apnea, 27, 41, 131 Small intestine, 74, 80, 111, 112, 116, 121, 122, 123, 125, 129, 131 Sneezing, 131, 132 Social Environment, 129, 131 Sodium, 11, 131 Solvent, 118, 131 Specialist, 99, 116, 131 Species, 121, 129, 131, 133, 135 Specificity, 49, 110, 131 Spinal cord, 113, 117, 131 Spontaneous Abortion, 128, 131 Stasis, 48, 132 Steatosis, 46, 47, 118, 132 Steroid, 111, 115, 132 Stillbirth, 128, 132 Stimulus, 122, 132, 133 Stoma, 19, 132 Stress, 7, 115, 125, 126, 132 Stress incontinence, 7, 132 Stricture, 23, 132 Stroke, 72, 74, 90, 113, 132 Subacute, 122, 132 Subclinical, 122, 132 Subcutaneous, 5, 109, 126, 132 Substance P, 117, 131, 132 Substrate, 8, 132 Supplementation, 10, 24, 51, 61, 62, 63, 66, 67, 132 Support group, 22, 61, 132 Suppression, 6, 132 Systemic, 52, 112, 122, 132, 134 Systolic, 122, 132 T Therapeutics, 132 Thigh, 118, 132 Threshold, 121, 133 Thrombosis, 129, 132, 133 Tinnitus, 129, 133

142 Gastric Bypass

Tissue, 11, 71, 109, 111, 112, 113, 115, 117, 120, 121, 123, 124, 125, 127, 130, 131, 133, 134 Tomography, 112, 133 Tooth Preparation, 109, 133 Topical, 118, 133 Toxic, iv, 115, 133 Toxicity, 116, 133 Toxicokinetics, 133 Toxicology, 92, 133 Toxins, 111, 122, 133 Transfection, 112, 133 Transferases, 120, 133 Translation, 117, 133 Translocation, 117, 133 Triglyceride, 5, 133 Tuberculosis, 115, 133 Type 2 diabetes, 6, 22, 84, 133 U Ulcer, 38, 53, 116, 127, 134 Unconscious, 122, 134 Unresectable, 33, 43, 44, 47, 50, 134 Urethra, 134 Urine, 22, 112, 122, 132, 134

V Vaccine, 129, 134 Vascular, 45, 122, 134 Vascular Resistance, 45, 134 Veins, 112, 134 Venous, 21, 48, 129, 134 Ventricle, 129, 132, 134 Ventricular, 45, 134 Ventricular Function, 45, 134 Vertical banded gastroplasty, 19, 24, 28, 37, 42, 54, 55, 56, 57, 60, 62, 63, 80, 98, 134 Veterinary Medicine, 91, 134 Viscera, 124, 134 Visual field, 129, 134 Vitamin A, 40, 51, 62, 63, 67, 134 Volvulus, 13, 134 W Withdrawal, 40, 134 Wound Healing, 10, 134 X Xenograft, 110, 135 X-ray, 112, 135

Index 143

144 Gastric Bypass