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Effets de la chirurgie bariatrique sur le métabolisme du cholestérol / Effect of bariatric surgery on cholesterol metabolismBlanchard-Louis, Claire 16 December 2016 (has links)
L’obésité représente un problème de santé publique majeur, avec une prévalence en augmentation. Celle-ci peut s’accompagner de complications métaboliques telles que le diabète de type 2, l’hypertension artérielle, et les dyslipidémies. La chirurgie bariatrique constitue l’alternative thérapeutique de choix chez les patients obèses. La cholestérolémie est clairement améliorée chez les patients opérés, mais différemment en fonction des techniques chirurgicales pratiquées suggèrant que les mécanismes cellulaires et moléculaires impliquées varient selon les méthodes chirurgicales. Notre travail réalisé chez un modèle murin, a mis en évidence une baisse de la chlolestérolémie après roux en y gastric bypass (RYGB) plus importante qu’après une sleeve gastrectomie. Le RYGB induit une augmentation de l’excrétion fécale du cholestérol via une stimulation de l’excrétion transintestinale du cholestérol (TICE) et une réduction de la capacité intestinale à absorber le cholestérol. Dans ce contexte, et en élargissant dans la prise en charge de l’hypercholestérolémie, le TICE semble être une cible thérapeutique intéressante. Parallèlement à ce travail, nous avons étudié en collaboration avec l’INSERM U913 (Dr Neunlist), l’effet précoce de la sleeve gastrectomie sur la barrière intestinale. La sleeve induit des modifications de la perméabilité et de l'expression des protéines des jonctions serrées. Ces changements accroissent la translocation du LPS dans le plasma, favorisant ainsi un état pro-inflammatoire adipocytaire. L’effet tardif de la sleeve sur la perméabilité intestinale reste à être déterminé. / Obesity is a major public health issue, with increasing prevalence. Metabolic complications such as type 2 diabetes, hypertension and dyslipidemia are frequently associated with morbid obesity. Bariatric surgery represents the therapeutic alternative of choice for these patients. Clinical studies show thatplasma cholesterol is clearly improved after surgery. Interestingly, the magnitude of reduction depends on the surgical techniques used suggesting that cellular and molecular mechanisms involved are different. Using mouse models,we demonstrated that Roux en Y Gastric Bypass (RYGB) strongly lowers plasma cholesterol compared to sleeve gastrectomy. RYGB increases fecal cholesterol excretion via the stimulation of trans intestinal cholesterol excretion (TICE) and a reduction of intestinal cholesterol absorption. In this context, and expanding in the management of hypercholesterolemia, TICE seems to be an interesting therapeutic target.In parallel with this work, we assessed, in collaboration with members of INSERM unit 913 (Dr Neunlist), the short-term effect of sleeve gastrectomy on intestinal barrier. We show that sleeve gastrectomy induces significant modifications of intestinal para and transcellular permeability by altering the expression of proteins involved in tight junctions. These changes favor plasma LPS translocation promoting a low grade pro-inflammatory state in adipose tissue. These effects of sleeve gastrectomy on intestinal permeability remain to be assessed after a longer post-surgical period.
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The Impact of Sleeve Gastrectomy as compared to Adjustable Gastric Band on Active and Total Ghrelin and other GI Hormones and their influence on Satiety and HungerAlmamar, Ahmed Unknown Date
No description available.
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Einfluss der präoperativen Konditionierung mittels Magenballon vor bariatrischer Operation auf den Therapieerfolg bei extremer Adipositas – Eine retrospektive Vergleichsstudie / Impact of preoperative weight loss achieved by gastric balloon on peri‑ and postoperative outcomes of bariatric surgery in super‑obese patients - a retrospective matched‑pair analysisDörries, Luise January 2022 (has links) (PDF)
Die Adipositaschirurgie ist die effektivste Methode in der Behandlung der Adipositas. Bei extrem adipösen Patientin ist eine primäre Operation oftmals riskant. Die Anlage eines Magenballons als erster Schritt von Mehrstufenkonzepten kann die Operabilität gewährleisten und die perioperative Sicherheit erhöhen. Durch den Magenballon wird ein signifikanter Gewichtsverlust erreicht. Der postoperative Gewichtsverlust fällt allerdings schwächer aus. Es ist wichtig, den Patienten realistische Therapieergebnisse zu vermitteln, um überhöhte Erwartungen und Unzufriedenheit zu vermeiden. Die Sleevegastrektomie eignet sich besonders für extrem adipöse Patienten, da diese eine geringere Komplikationsrate aufweist und einfach in einen Roux-en-Y Bypass umzuwandeln ist. / Bariatric surgery is currently the most effective method in the treatment of obesity. In extreme obese patients, primary surgery is often challenging and risky. A treatment with gastric balloon as first of more-stage concepts can make surgery possible and increase the perioperative safety. As a result of the gastric balloon a significant weight loss can be achieved. However, postoperative weight loss is reduced. It is important to convey patients realistic results in order to avoid excessive expectations and dissatification. Laparoscopic sleeve gastrectomy is favourable for extrem obese patient because of its lower complication rate and good technical feasibility of conversion to roux-en-y gastric bypass.
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Použití exotermických nálitků u odlitků ze slitin hliníku / Use of exothermic sleeves for aluminium alloy castingsJakubec, Petr January 2017 (has links)
This master's thesis deals with the influence of the exothermic riser sleeves on the solidification time of aluminum alloys. The thesis is divided into five parts. The first chapter describes solidification of cast alloys. The second chapter deals with the designing of risers. The third chapter is focused on the types of risers. The fourth chapter describes ways of intensification of risers and chemical composition of exothermic and insulating mixtures for production of riser sleeves. The main fifth chapter focuses on experimental measurements of temperatures and solidification time of aluminum alloy in castings, risers and exothermic and insulating riser sleeves.
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Ärmhålsstudie verifierad på grundmönster / Study of sleeves verified on basepatternsGrip Lindqvist, Rebecca January 2016 (has links)
Uppsatsen innehåller en förstudie av ärmhålskonstruktioner: isatt ärm och raglanärm, för målgrupperna herr och dam. Dessa konstruerades, analyserades och avprovades i Lectra (2013) Modaris 3D prototyping. Ärmhålskonstruktionernas passform och konstruktion jämfördes utifrån bestämda parametrar och med hjälp av ett avprovningsprotokoll med poängsystem. De ärmhålskonstruktionerna med högst poäng låg till grund vid skapandet av ett bibliotek med grundmönster anpassade för funktionsplagg. Grundmönstren kommer vara användbara för företaget i framtiden och underlätta företagets arbete vid framtagning av nya modeller. Uppsatsen omfattar även framtagningen av dessa grundmönster. Alla konstruktionerna skapades i Lectra (2015) Modaris och avprovningarna utfördes i Lectra (2013) Modaris 3D prototyping, samt i verkligheten. Resultatet redovisar avprovningarna, en rangordning av vilka ärmhålskonstruktioner som har bäst passform, samt tillvägagångsättet vid konstruktion av dem fyra grundmönstren. Slutsatsen av studien var att alla konstruktioner från befintlig litteratur kräver justeringar för att uppnå god passform. En god passform av en raglanärm uppnås när brytningspunkten på framstycket ligger vid 1/3 av ärmhålets sträcka och bakstyckets brytningspunkt ligger vid 2/5, samt när framstyckets raglansöm har en djupare kurva än bakstyckets. Bäst passform för isatt ärm uppnås när framstyckets ärmhål har en rundare, djupare form jämfört med bakstyckets. Slutsatsen visar att det finns tydliga skillnader mellan herr- och damkonstruktionerna. / The paper contains a study of sleeve constructions for set-in sleeves and raglan sleeves for the target groups, men and women. These were constructed and analyzed in Lectra (2015) Modaris 3D prototyping. The sleeves fit and construction was compared on specific parameters and using a point system with and protocol. The sleeve constructions with highest points then formed the basis for the creation of a library of basic patterns, adapted for functional garments. These will be useful for the company in the future and when developing new models. The paper also includes the development of these basic patterns. All constructions was created in Lectra (2015) Modaris and fitting was performed in Lectra (2013) Modaris 3D prototyping, and in reality. The result of this study reports a ranking of the sleeve constructions based the best fit, and the approach in the construction of these four basic patterns. The conclusion of the study was that all constructions from existing literature require adjustments to achieve good fit. The conclusion is that a good fit of a raglan sleeve is achieved when the breaking point on the front piece is places at 1/3 of the armhole line and when the breaking point on the back piece is places at 2/5. The front piece raglan seam requires a deeper curve than the back piece. Best fit for set-in sleeves is achieved when the front piece armhole has a deeper curved line, compared to the back piece. The conclusion shows that there are clear differences between men and women's sleeve constructions.
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Analysis of the flow field between two eccentric rotating cylinders in the presence of a slotted sleeve.Hird, Lee D. January 1997 (has links)
Overend et al [68] designed a viscometer to measure the viscosity of slurries that have a tendency to settle. This viscometer consists of a rotating ribbed rotor surrounded by a stationary slotted sleeve; this system is then placed eccentrically within an inclined rotating bowl. It, is claimed that this overcomes most of the difficulties encountered when attempting to obtain accurate measurements for these types of mixtures. If the mixture being sheared within the annulus does not represent the true composition of the slurry being, tested then the results are expected to be inaccurate. The presence of sediment at the bottom of the rotor or the formation of large masses of particles within the flow domain will affect the accuracy of the measurements obtained. This dissertation studies the amount of flow through the slotted sleeve and the region, or regions, of low shear rate within the flow domain. Assuming that end-effects are unimportant and that the slurries can be replaced by a single-phase fluid, three two-dimensional models are proposed. These models are designed to capture the large-slot construction of the sleeve and the, approximate, non-Newtonian behaviour of the slurries. The first two models solve analytically (using a regular perturbation scheme) and numerically (using a finite volume method) the moderate-and large-Reynolds-number flow, and the third model uses a finite volume method to study the flow patterns developed by pseudoplastic fluids. The results show that the mixing of the slurry is expected to be enhanced by moving the concentric system (i.e., the rotor and the slotted sleeve) close to the rotating bowl and using low to moderate speeds for the rotor and bowl. In addition, when the cylinders rotate in the same directions, two (counter-rotating) eddies are present within the flow domain; whereas, only one eddy (rotating counter-clockwise) is ++ / present when the cylinders rotate in opposite directions. The presence of eddies in the former situation inhibits the flow through the sleeve; while, for moderate rotorspeeds, the flow through the sleeve is enhanced in the latter. When the slurry assumed pseudoplastic, we observe a region of low shear rate located near the dividing streamline present within the flow field. The distribution of shear rate within the flow field is shown to be affected by factors such as the rate of diffusion of the apparent viscosity and the value of the power law index. Therefore, this study suggests that for certain types of slurries, concentrations of particles exist within the domain and that the mixing of slurries can be impeded by the presence of eddies within the main flow field.
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Elastomeric Sleeve Bearing DesignFafarman, Lawrence Milton 03 1900 (has links)
<p> It is shown that the experimentally determined deflectional behavior of certain elastomer-lined sleeve bearings under static radial loads can be modeled to some extent by the compressive behavior of flat elastomeric slabs.</p> <p> An equation for the thermal bearing-bore change is developed using the conventional theory for the thermoelasticity of homogeneous cylinders. Some experimental results agree fairly well with this equation. An equation for the bore contraction due to liquid swell is developed in terms of thermoelasticity.</p> <p> Minimizing the lining thickness is recommended for minimizing both the radial deflections and the bore changes.</p> <p> An analysis is made of the frictional forces involved with the interference fit between the lining and its housing.</p> <p> Areas for further investigation are suggested.</p> / Thesis / Master of Engineering (MEngr)
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Effets de la chirurgie bariatrique sur les complications hépatiques de l’obésité / The effects of bariatric surgery on hepatic complications of obesitySchneck, Anne-Sophie 19 December 2014 (has links)
La sleeve gastrectomie (SG) est une opération qui consiste à réduire le volume de l’estomac. L’hypothèse que d’autres mécanismes indépendants de la perte de poids sont impliqués dans l’amélioration des complications métaboliques de l’obésité après SG a été émise. L’effet de la SG chez des souris soumis à un régime High Fat Diet a été étudié chez trois groupes d’animaux : SG, sham pair fed (SPF) et sham. Le test de tolérance au glucose montrait une amélioration de l’insulinorésistance des animaux SG à J23. Au niveau hépatique les animaux SG montraient une diminution significative de la stéatose. Il existe donc des mécanismes améliorant les complications hépatiques et métaboliques de l’obésité qui sont en partie indépendants de la réduction de l’apport calorique. Dans le second volet nous avons étudié l’évolution à long terme des lésions hépatiques liées à la NASH chez des patients obèses morbides avec une NASH lors de la chirurgie bariatrique. Dix patients d’une cohorte prospective ont été inclus. La deuxième biopsie a été réalisée à une médiane de 57 mois après le RYGB. La perte de poids moyenne était de –13,3 points de l’IMC lors du suivi. La rémission du syndrome métabolique et du diabète a été observée chez 71,6 % et 100 % des patients respectivement. Le NAS score a été amélioré chez tous les patients. Le taux sérique moyen du fragment clivé de la cytokératine 18 (M30), marqueur de l’apoptose hépatocytaire, était significativement abaissé. Le RYGB a permis une amélioration à long terme des lésions hépatocytaires liées à la NASH chez les patients obèses morbides. L’amélioration post-opératoire de la souffrance hépatocytaire corrèle avec la baisse du taux sérique du M30. / The mechanisms responsible for weight loss and improvement of metabolic disturbances have not been completely elucidated. We investigated the effect of sleeve gastrectomy (SG) on body weight, adipose tissue depots, glucose tolerance, and liver steatosis independent of reduced caloric intake in high-fat-diet-induced obese mice. Mice fed a high fat diet were divided into 3 groups: SG, sham-operated ad libitum fed and sham-operated pair fed. SG mice showed improved glucose tolerance and lower levels of liver steatosis. This was associated with a decrease in the ratios of the weight of pancreas, epididymal and inguinal adipose tissues to body weight. Reduced white adipose tissue inflammation, modification of adipose tissue development, and ectopic fat are potential mechanisms that may account for the reduced caloric intake independent effects of SG. We also investigated long-term impact of RYGB surgery on liver complications in morbidly obese patients with NASH. Ten morbidly obese patients with biopsy-proven NASH were followed after RYGB and underwent a second liver biopsy. The median interval between the RYGB and second liver biopsy was 57 months. Clinical and biological data were obtained at baseline and ≥40 months after RYGB. RYGB was associated with significant weight loss, improved hepatic steatosis, resolution of hepatic inflammation and hepatocyte ballooning. Hepatocyte apoptosis, as evaluated by serum K18 fragment improved within the first year and at 57 months. Hepatic fibrosis resolved in 90% of cases. RYGB in morbidly obese patients with NASH is associated with a long-term beneficial impact on hepatic steatosis, inflammation, injury and, possibly, fibrosis.
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Estudo da estabilidade de nectar de manga (Mangifera indica L.) envasado em garrafas pet, comparados com envasados em embalagem cartonada e lata de aluminio / Study of the stability of nectar of sleeve (Mangifera indicates L.) planted in bottles pet, compared with planted in cartonada packing and can of aluminioArruda, Ana Flavia Pedroso de 16 December 2003 (has links)
Orientador: Roberto Herminio Moretti / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia de Alimentos / Made available in DSpace on 2018-08-03T18:03:59Z (GMT). No. of bitstreams: 1
Arruda_AnaFlaviaPedrosode_M.pdf: 5724087 bytes, checksum: 5f150b453b4e7cefbf71614d42b7f60e (MD5)
Previous issue date: 2003 / Resumo: No presente trabalho, foi estudada a viabilidade do uso da garrafa PET termorresistente como embalagem para néctar de manga, através de ensaios de vida de prateleira comparativos com embalagem cartonada Tetra Brik Aseptic e lata de alumínio comercializadas atualmente, durante um período de 180 dias, com armazenamento sob temperatura ambiente. Néctar de manga comercializado em embalagem cartonada Tetra Brik Aseptic foi adicionado de ácido ascórbico e goma xantana e processado em um sistema composto por um tanque de alimentação com capacidade de 8l, dotado de pressurizador manual para transporte do fluido, e serpentina imersa em banho de água quente, para envase manual realizado à quente (75 OC) em garrafas PET termorresistentes, que foram fechadas e invertidas, e assim mantidas por 2 minutos, antes do resfriamento em água fria. Foi adotado o Planejamento Experimental Completo tipo 22 cujas variáveis independentes foram a concentração do ácido ascórbico (com adições de 14,75 à 85,25 mg/100ml) e goma xantana (com adições de 0,012 à 0,068%), com a finalidade de retardar a oxidação e obter uma viscosidade aceitável pelo consumidor. As análises foram efetuadas com uma freqüência de 45 dias (1 Q, 45Q, 90Q, 135Q e 180Q dia após o processamento). As respostas analisadas foram: ºBrix, acidez titulável, pH, viscosidade, b-carotenos, análises microbiológicas (contagem de bolores/leveduras, contagem total, termófilos e coliformes fecais), determinações do teor de Vitamina C e de Cor e avaliação sensorial. As análises de variância dos resultados indicaram que as condições de processo reais estudadas não influenciaram as características físico-químicas do néctar (ºBrix, acidez titulável, pH e viscosidade). Sob o aspecto microbiológico, foi verificada a eficiência do processo de pasteurização. Durante o período de armazenamento avaliado (180 dias), foi verificado que o produto com teores maiores que 50,0 mg/100mL de ácido ascórbico e teores intermediários de goma xantana (0,04%) resultou em maior aceitabilidade. Sensorialmente, os produtos apresentaram médias de aceitação próximas ou superiores a 7,0, para o atributo de aceitação global, situado na escala hedônica não estruturada, equivalente a "gostei muito" e "gostei moderadamente". Em relação à resposta de cor, até 90 dias, houve redução da Luminosidade (L) para todas as amostras e todos os tratamentos dos produtos em PET ficaram com valores de L próximos aos dos produtos em Tetra Brik Aseptic e lata, e depois deste período a L aumentou para estes produtos e manteve-se relativamente estável nos experimentos com garrafas de PET. Para a cromaticidade (a e b) o produto na lata de alumínio apresentou-se mais escuro, quando comparado com os demais, enquanto as amostras em PET contendo maiores teores de ácido ascórbico adicionados apresentaram menor escurecimento no decorrer do período analisado / Abstract: In this work the viability of using thermoresistant PET bottles as package for mango nectar was studied. Three types of packages were studied: aluminum cans, multifoil package (Tetra Brik Aseptic) and PET bottles, by following the shelf-life of the mango nectar, for 180 days shelf-life period, under room temperature. Commercial mango nectar in multifoil package was used for the experiment. There was added ascorbic acid and xantham gum according to the Experimental Design (Surface Response). Product was thermal treated by heating at 75OC and filled at this temperature in PET bottles, closed and kept for two minutes, before cooling at room temperature. It was used the Complete Experimental Design 22, varying the ascorbic acid (14,75 mg/100mL up to 85,25 mg/100mL) and xantham gum (0,012% up to 0,068%), with the objective of reduce oxidation and get a better viscosity. Determination of: ºBrix, pH, titrable acidity, viscosity, b-carotenes, ascorbic acid, color, sensory evaluation and microbial analysis (molds and yeasts, total count, themophylos and coliforms) were done with a frequency of 45 days (1 Q, 45Q, 90Q, 135Q e 180Q day after bottling). Analysis of Variance showed that the process condition did not influence significantly the nectar physico-chemical characteristics (ºBrix, pH, titrable acidity and viscosity). Under the microbiological aspect, it was concluded the efficiency of the pasteurization process. Under the studied shelf-life period of 180 days, it was observed that mango nectar with higher concentrations of ascorbic acid (over 50mg/1OOmL) and intermediary concentrations (0,04%) of xantham gum, resulted in better acceptability. Organoleptically the products were accepted with scores of 7 or higher, for the attribute "global acceptance", in the non-structured hedonic scale, equivalent to "accept very much". In relation to the color attribute up to 90 days, Luminosity (L) for all samples in all experiments of PET packaged nectar, the L values were very close to the products in multifoil package and Aluminum can, after 90 days L increased for all products and was kept stable when packed in PET. For the chromaticity a and b the canned product in aluminum can presented darker products, when compared to the other experiments. Experiments in PET bottled nectar with higher ascorbic acid content resulted clearer products than the ones with lower addition of ascorbic acid, during the shelf-life period / Mestrado / Tecnologia de Alimentos / Mestre em Tecnologia de Alimentos
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Determination of effective riser sleeve thermophysical properties for simulation and analysis of riser sleeve performanceWilliams, Thomas John 01 May 2016 (has links)
Riser sleeve thermophysical properties for simulation are developed using an inverse modeling technique. Casting experiments using riser sleeves are performed in order to measure temperatures in the liquid steel, the riser sleeve, and the sand mold. Simulations are created and designed to replicate the casting experiments. Riser sleeve material thermophysical properties are iteratively modified until agreement is achieved between the simulation and the measured data. Analyses of sleeve material performance are carried out using the developed thermophysical properties. The modulus extension factor (MEF) is used to quantify sleeve performance and is determined for all riser sleeve materials studied here. Values are found to range from 1.07 to 1.27. A sleeve material's effects on casting yield are shown to depend only on the MEF and therefore a sleeve's exothermic or insulating properties serve only to increase the overall quality of the sleeve, expressed by the MEF, and do not independently affect the casting yield at any casting size studied here. The use of riser sleeves is shown to increase the maximum yield up to 40% for chunky castings, however increases of only 8% are observed for very rangy castings. Riser sleeve thickness is shown to be extremely influential on casting yield. Scaling the sleeve thickness by the riser diameter shows that, for a typical sleeve, an optimum riser sleeve thickness is 0.2 times the riser diameter for chunky castings. A scaled sleeve thickness of 0.1 is found to be an optimum sleeve thickness for very rangy castings. Below a scaled sleeve thickness of 0.1 sleeve performance is found to be highly sub-optimal.
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