175 results on '"Goran Marjanovic"'
Search Results
2. The DECON pilot project investigates predictive markers for successful bariatric surgery
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Gabriel Seifert, Luca Fagnocchi, Michael Edozie, Stephan Herrmann, Hannah Baumann, Ilaria Panzeri, Stephanie Mewes, David Aicher, Mira Runkel, Claudia Lässle, Jodok Fink, Goran Marjanovic, Stephan Fichtner-Feigl, and J. Andrew Pospisilik
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Medicine ,Science - Abstract
Abstract Obesity is a chronic, multifactorial disease which is linked to a number of adverse endocrinological and metabolic conditions. Currently, bariatric surgery is one of the most effective treatments for individuals diagnosed with severe obesity. However, the current indications for bariatric surgery are based on inadequate metrics (i.e., BMI) which do not account for the complexity of the disease, nor the heterogeneity among the patient population. Moreover, there is a lack of understanding with respect to the biological underpinnings that influence successful and sustained weight loss post-bariatric surgery. Studies have implicated age and pre-surgery body weight as two factors that are associated with favorable patient outcomes. Still, there is an urgent medical need to identify other potential factors that could improve the specificity of candidate selection and better inform the treatment plan of patients with obesity. In this report, we present and describe the cohort of the DECON pilot project, a multicenter study which aims to identify predictive biomarkers of successful weight loss after bariatric surgery.
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- 2023
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3. Immunomodulatory effects of galectin-1 in patients with chronic lymphocytic leukemia
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Milos Kostic, Tanja Dzopalic, Goran Marjanovic, Ivana Urosevic, and Ivana Milosevic
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galectin-1 ,immunodeficiency ,chronic lymphocytic leukemia ,otx008 ,dendritic cell. ,Medicine - Abstract
Galectin-1 (Gal-1) has been implicated in the progression of chronic lymphocytic leukemia (CLL) but also the development of immunodeficiency, which commonly accompany this malignancy. In this in vitro study, we investigated the effects of Gal-1 inhibition in the sera of immunocompromised CLL patients on immunomodulating properties of dendritic cells (DCs). DCs derived from peripheral blood mononuclear cells were treated with a healthy serum, CLL serum as well as the combination of CLL serum and Gal-1 inhibitor (OTX008). Following the treatment, the expression levels of DC maturation markers (CD80, CD83, CD86 and IDO-1) were determined as well as their cytokine profile and the ability to polarize the immune response in co-cultures with CD4+ T cells. After treatment with CLL serum, an increase in interleukin (IL)-10 production was observed in both DC cultures and co-cultures with CD4+ T cells. OTX008 caused a reduction in IL-10 production as well as IL-2, but no significant alteration in the expression of DC maturation markers or T regulatory cell (Treg) frequency was observed. The results of our study suggest that Gal-1 from CLL serum give rise to a specific IL-10+ CD4+ T cell phenotype, other than Treg, that could mediate immunodeficiency development in CLL patients.
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- 2021
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4. Hybrid Minimally Invasive Esophagectomy–Surgical Technique and Results
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Jasmina Kuvendjiska, Goran Marjanovic, Torben Glatz, Birte Kulemann, and Jens Hoeppner
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esophagectomy ,minimally invasive surgery ,hybrid procedures ,esophageal cancer ,surgical technique ,Medicine - Abstract
Background: Hybrid minimally invasive esophagectomy (HMIE) has been proven to be superior when compared with open esophagectomy, with a significant reduction of postoperative morbidity. In HMIE, the laparotomy is replaced by a minimally invasive laparoscopic approach. The radical mediastinal resection plus reconstruction is performed by a thoracic approach through a muscle-sparing thoracotomy. In this instructional article, we describe the surgical technique of HMIE in detail in order to facilitate possible adoption of the procedure by other surgeons. In addition, we give the monocentric results of our own practice. Methods: Between 2013 and 2018, HMIE was performed in 157 patients. The morbidity and mortality data of the procedure is shown in a retrospective monocentric analysis. Results: Overall, 54% of patients had at least one perioperative complication. Anastomotic leak was evident in 1.9%, and a single patient had focal conduit necrosis of the gastric pull-up. Postoperative pulmonary morbidity was 31%. Pneumonia was found in 17%. The 90 day mortality was 2.5%. Wound infection rate was 3%, and delayed gastric emptying occurred in 17% of patients. In follow up, 12.7% presented with diaphragmatic herniation of the bowel, requiring laparoscopic hernia reduction and hiatal reconstruction and colopexy several months after surgery. Conclusion: HMIE is a highly reliable technique, not only for the resection part but especially in terms of safety in reconstruction and anastomosis. For esophageal surgeons with experience in minimally invasive anti-reflux procedures and obesity surgery, HMIE is easy and fast to learn and adopt.
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- 2019
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5. HDACi Valproic Acid (VPA) and Suberoylanilide Hydroxamic Acid (SAHA) Delay but Fail to Protect against Warm Hepatic Ischemia-Reperfusion Injury.
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Dietrich A Ruess, Moriz Probst, Goran Marjanovic, Uwe A Wittel, Ulrich T Hopt, Tobias Keck, and Dirk Bausch
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Medicine ,Science - Abstract
Histone deacetylases (HDAC) catalyze N-terminal deacetylation of lysine-residues on histones and multiple nuclear and cytoplasmic proteins. In various animal models, such as trauma/hemorrhagic shock, ischemic stroke or myocardial infarction, HDAC inhibitor (HDACi) application is cyto- and organoprotective and promotes survival. HDACi reduce stress signaling, cell death and inflammation. Hepatic ischemia-reperfusion (I/R) injury during major liver resection or transplantation increases morbidity and mortality. Assuming protective properties, the aim of this study was to investigate the effect of the HDACi VPA and SAHA on warm hepatic I/R.Male Wistar-Kyoto rats (age: 6-8 weeks) were randomized to VPA, SAHA, vehicle control (pre-) treatment or sham-groups and underwent partial no-flow liver ischemia for 90 minutes with subsequent reperfusion for 6, 12, 24 and 60 hours. Injury and regeneration was quantified by serum AST and ALT levels, by macroscopic aspect and (immuno-) histology. HDACi treatment efficiency, impact on MAPK/SAPK-activation and Hippo-YAP signaling was determined by Western blot.Treatment with HDACi significantly enhanced hyperacetylation of Histone H3-K9 during I/R, indicative of adequate treatment efficiency. Liver injury, as measured by macroscopic aspect, serum transaminases and histology, was delayed, but not alleviated in VPA and SAHA treated animals. Importantly, tissue destruction was significantly more pronounced with VPA. SAPK-activation (p38 and JNK) was reduced by VPA and SAHA in the early (6h) reperfusion phase, but augmented later on (JNK, 24h). Regeneration appeared enhanced in SAHA and VPA treated animals and was dependent on Hippo-YAP signaling.VPA and SAHA delay warm hepatic I/R injury at least in part through modulation of SAPK-activation. However, these HDACi fail to exert organoprotective effects, in this setting. For VPA, belated damage is even aggravated.
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- 2016
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6. The laparoscopic banded gastric bypass – operation technique
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Simon Küsters, Goran Marjanovic, Tobias Baumann, Philipp Holzner, and Wojciech K. Karcz
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bariatric surgery ,gastric bypass ,GaBp ring ,Medicine - Abstract
The banded Roux-en-Y gastric bypass can be used as a primary or revisionary bariatric procedure. This article describesthe operation technique including materials, size and placement of the banding and gives an overview con cerningevolution and indications of the operation. A video of a primary banded Roux-en-Y gastric bypass is presented.
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- 2010
7. MEDIASTINAL MASS AS A PROGNOSTIC FACTOR OF HODGKIN LYMPHOMA – CASE REVIEW
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Goran Marjanovic, Lana Macukanovic-Golubovic, Tanja Pejcic, Olivera Simonovic, and Ivana Stankovic
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mediastinal mass ,Hodgkin disease ,prognostic factor ,Medicine - Abstract
Many studies have researched the prognostic factors of Hodgkin disease. Up date, seven most important prognostic factors have been defined.Among them, as an important negative prognostic factor, the dissemination of the disease at the moment of diagnosis stands out. The aim of this study was to determine the influence of the presence of mediastinal mass greater than a third of the chest diameter in Hodgkin lymphoma on the disease outcome. In this study, an 18-year-old patient P.A. was presented. At the time of diagnosis, the patient had Bulky disease. Mediastinal mass was observed by radiography, computed tomography, ultrasound of the heart.The patient was treated with ABVD, GDP, BEACOPP, miniBEAM protocol and mediastinal radiation. In this patient, the mediastinal mass persisted in spite of the therapy.The course of disease deteriorated due to the presence of resistant pericardial effusion, and the patient died three years after.
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- 2008
8. Vector ℓ0 Sparse Conditional Independence Graphs.
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Goran Marjanovic and Victor Solo
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- 2018
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9. Parental Obesity Predisposition and Age of Onset Associate with Poor Response to Bariatric and Metabolic Surgery
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Mira Fink, Stephan Herrmann, Jodok Fink, Claudia Lässle, Goran Marjanovic, Luca Fagnocchi, J. Andrew Pospisilik, Stefan Fichtner-Feigl, and Gabriel Seifert
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Nutrition and Dietetics ,Endocrinology, Diabetes and Metabolism ,Surgery - Abstract
Introduction Parental predisposition and age of onset may be independently associated with 1-year total weight loss (TWL) failure ( Methods This cohort study includes all cases of the German StuDoQ|MBE register (2015–2019) with data on parental predisposition, obesity onset, and at least 1-year follow up after primary MBS procedures (n = 14,404). We provide descriptive statistics of the cohort in terms of the main outcome and 1-year TWL failure, and provide characteristics of surgery type subgroups. Finally, we provide a multivariate logistic regression model of 1-year TWL failure. Results 58.8% and 45.7% of patients reported maternal and paternal predisposition for obesity, respectively. Average onset of obesity was 15.5 years and duration of disease 28.3 years prior to MBS. SG is the most frequently performed procedure (47.2%) followed by RYGB (39.7%) and OAGB (13.1%). Mean 1-year TWL is 32.7 ± 9.3%, and 7.8% (n = 1,119) of patients show TWL failure (p Conclusion The proportions of MBS patients that report on paternal and maternal predisposition for obesity are 45.7% and 58.8% respectively, and average age at onset is 15.5 years. 7.8% of patients do not meet current target criteria of successful response to surgery at 1 year. Early onset, male sex, age at operation, pre-operative BMI, pre-operative weight loss, SG, and T2D are independently associated with weight loss failure. Graphical abstract
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- 2023
10. An engineer's guide to Particle Filtering on the Stiefel manifold.
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Goran Marjanovic and Victor Solo
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- 2017
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11. Numerical Methods for Stochastic Differential Equations in Matrix Lie Groups Made Simple.
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Goran Marjanovic and Victor Solo
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- 2018
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12. An engineer's guide to particle filtering on matrix Lie groups.
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Goran Marjanovic and Victor Solo
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- 2016
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13. Large-scale l0 sparse inverse covariance estimation.
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Goran Marjanovic, Magnus O. Ulfarsson, and Victor Solo
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- 2016
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14. Numerical methods for stochastic differential equations in the Stiefel manifold made simple.
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Goran Marjanovic, Marc J. Piggott, and Victor Solo
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- 2016
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15. Standardoperationen in der Adipositaschirurgie
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Goran Marjanovic, Gabriel Seifert, Claudia Läßle, and Jodok Fink
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General Medicine - Published
- 2022
16. Laparoskopische Silikonringimplantation als Therapieoption von Dumping-Symptomen und postprandialer Hypoglykämien nach Roux-en-Y-Magenbypass
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Mareike Lühn, Maximilian Meyer-Steenbruck, Goran Marjanovic, Jodok Fink, Jochen Seufert, and Katharina Laubner
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- 2023
17. Sparse and low rank decomposition using l0 penalty.
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Magnus O. Ulfarsson, Victor Solo, and Goran Marjanovic
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- 2015
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18. MIST: L0 sparse linear regression with momentum.
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Goran Marjanovic, Magnus O. Ulfarsson, and Alfred O. Hero III
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- 2015
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19. A simple approach to numerical methods for stochastic differential equations in Lie groups.
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Goran Marjanovic, Marc J. Piggott, and Victor Solo
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- 2015
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20. On lq estimation of sparse inverse covariance.
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Goran Marjanovic and Alfred O. Hero III
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- 2014
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21. Ligamentum teres augmentation (LTA) for hiatal hernia repair after minimally invasive esophageal resection: a new use for an old structure
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Mira Runkel, Goran Marjanovic, Stefan Fichtner-Feigl, Jasmina Kuvendjiska, and Markus K. Diener
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medicine.medical_specialty ,Round Ligaments ,Minimally invasive esophageal resection ,How-I-Do-It articles ,Resection ,Hiatal hernia ,Abdominal wall ,Suture (anatomy) ,Gastrectomy ,Recurrence ,Hiatoplasty ,medicine ,Humans ,Herniorrhaphy ,business.industry ,Surgical Mesh ,Vascular surgery ,medicine.disease ,digestive system diseases ,Surgery ,Cardiac surgery ,Hernia, Hiatal ,medicine.anatomical_structure ,Ligamentum teres ,Cardiothoracic surgery ,Laparoscopy ,business ,Abdominal surgery - Abstract
Purpose Hiatal hernias with intrathoracic migration of the intestines are serious complications after minimally invasive esophageal resection with gastric sleeve conduit. High recurrence rates have been reported for standard suture hiatoplasties. Additional mesh reinforcement is not generally recommended due to the serious risk of endangering the gastric sleeve. We propose a safe, simple, and effective method to close the hiatal defect with the ligamentum teres. Methods After laparoscopic repositioning the migrated intestines, the ligamentum teres is dissected from the ligamentum falciforme and the anterior abdominal wall. It is then positioned behind the left lobe of the liver and swung toward the hiatal orifice. Across the anterior aspect of the hiatal defect it is semi-circularly fixated with non-absorbable sutures. Care should be taken not to endanger the blood supply of the gastric sleeve. Results We have used this technique for a total of 6 patients with hiatal hernias after hybrid minimally invasive esophageal resection in the elective (n = 4) and emergency setting (n = 2). No intraoperative or postoperative complications have been observed. No recurrence has been reported for 3 patients after 3 months. Conclusion Primary suture hiatoplasties for hiatal hernias after minimally invasive esophageal resection can be technically challenging, and high postoperative recurrence rates are reported. An alternative, safe method is needed to close the hiatal defect. Our promising preliminary experience should stimulate further studies regarding the durability and efficacy of using the ligamentum teres hepatis to cover the hiatal defect.
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- 2021
22. l0 Sparse Inverse Covariance Estimation.
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Goran Marjanovic and Alfred O. Hero III
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- 2015
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23. On exact lq denoising.
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Goran Marjanovic and Victor Solo
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- 2013
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24. lq matrix completion.
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Goran Marjanovic and Victor Solo
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- 2012
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25. L0 sparse graphical modeling.
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Goran Marjanovic and Victor Solo
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- 2011
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26. Sparse signal estimation with nonlinear conjugate gradients.
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Goran Marjanovic and Victor Solo
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- 2010
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27. lq Sparsity Penalized Linear Regression With Cyclic Descent.
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Goran Marjanovic and Victor Solo
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- 2014
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28. On lq Optimization and Sparse Inverse Covariance Selection.
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Goran Marjanovic and Victor Solo
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- 2014
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29. Effects of galectin-1 on immunomodulatory properties of human monocyte-derived dendritic cells
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Vladimir Jurisic, Goran Marjanovic, Jelena Guzina, Milena Kostic, Biljana Božić Nedeljković, Miloš Kostić, and Tanja Džopalić
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Galectin 1 ,Cytokine profile ,Clinical Biochemistry ,Monocytes ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Immune system ,Humans ,Cells, Cultured ,030304 developmental biology ,CD86 ,0303 health sciences ,Immune Stimulation ,Monocyte derived ,Chemistry ,Immunity ,Cell Differentiation ,Dendritic Cells ,Cell Biology ,Phenotype ,Galectin-1 ,Immunology ,Cytokines ,CD80 ,030215 immunology - Abstract
Our study aimed to evaluate the effects of Gal-1 in dose depending manner on maturation and immunomodulatory properties of monocyte-derived (Mo) DCs in-vitro. The effects were analyzed by monitoring their phenotypic characteristics, cytokine profile, and the ability to direct the immune response in the co-culture with allogeneic CD4+T cells. Gal-1 reduced the expression of CD80 and CD86 molecules on MoDCs compared to untreated MoDCs. Gal-1 at concentrations of 1 and 6 μg/mL significantly reduced IL-12 production, while the concentration of 3 μg/mL led to its significant increase. Gal-1 in all concentrations induced a significant increase in the production of IL-10. Treatment of MoDCs with 3 and 6 μg/mL of Gal-1 stimulated the production of IL-2 and IFN-γ in the co-culture with CD4+T lymphocytes. This study demonstrated a dual immunomodulatory effect of Gal-1 on MoDCs in terms of immune stimulation and immune suppression, depending on the applied concentration.
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- 2020
30. Obesity Surgery: Weight Loss, Metabolic Changes, Oncological Effects, and Follow-Up
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Matthias Blüher, Goran Marjanovic, Gabriel Seifert, Jodok Fink, and Stefan Fichtner-Feigl
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Sleeve gastrectomy ,Pediatrics ,medicine.medical_specialty ,Continuing Medical Education ,business.industry ,medicine.medical_treatment ,Incidence (epidemiology) ,MEDLINE ,General Medicine ,Type 2 diabetes ,medicine.disease ,Obesity ,Bile Acids and Salts ,Weight loss ,Diabetes mellitus ,Medicine ,Humans ,Dumping syndrome ,medicine.symptom ,business - Abstract
Background In 2017, the prevalence of obesity (BMI ≥ 30 kg/m2) in Germany was approximately 16%. Obesity increases an individual's risk of developing type 2 diabetes (T2DM) and arterial hypertension; it also increases overall mortality. Consequently, effective treatment is a necessity. Approximately 20 000 bariatric operations are performed in Germany each year. Methods This review is based on pertinent publications retrieved by a selective search in the PubMed and Cochrane databases and on current German clinical practice guidelines. Results The types of obesity surgery most commonly performed in Germany, Roux-en-Y gastric bypass and sleeve gastrectomy, lead to an excess weight loss of 27-69% ≥ 10 years after the procedure. In obese patients with T2DM, the diabetes remission rate ≥ 10 years after these procedures ranges from 25% to 62%. Adjusted regression analyses of data from large registries have shown that the incidence of malignancies is 33% lower in persons who have undergone obesity surgery compared to control subjects with obesity (unadjusted incidence 5.6 versus 9.0 cases per 1000 person-years). The operation can cause vitamin deficiency, surgical complications, gastroesophageal reflux, and dumping syndrome. Therefore, lifelong follow-up is necessary. Conclusion In view of an increasing number of patients undergoing bariatric surgery, it will probably not be feasible in the future for lifelong follow-up to be provided exclusively in specialized centers.
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- 2022
31. Influence of slip velocity in a two-phase bubbly jet
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Hyunduk Seo, Goran Marjanovic, S. Balachandar, and Kyung Chun Kim
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Mechanics of Materials ,Mechanical Engineering ,Condensed Matter Physics - Abstract
The effect of the slip velocity in a bubbly jet ( $Re = 3000$ , initial void $\textrm {fraction} = 1.1\,\%$ ) is studied with various bubble slip ratios (0.07–2.1 times the inlet velocity, 0.01–0.31 m s $^{-1}$ in dimension). The governing equations, which are the conservation of mass, momentum and volume fraction, are solved by direct numerical simulations. A set of ordinary differential equations was derived by using a conventional one-dimensional integral framework on jets and by expressing the slip velocity using an exponential function. The one-dimensional analysis of bubbly jets successfully predicted the jet velocity radius, centreline velocity and the gas spread rate downstream of the bubbly jet. Second- and third-order statistics were also analysed to better understand the turbulent characteristics of the bubbly jet. A high slip ratio results in a rigid, narrower bubbly jet core region, where the turbulent kinetic energy is conserved along the centreline but does not diffuse towards the ambient region. The narrow, circular region around the core at high slip ratios decreased the turbulent kinetic energy. In the rigid bubbly jet core, turbulent diffusion of the gas phase is suppressed and has low correlations with the velocity fluctuations. Turbulence characteristics such as turbulence stress were compared with single-phase jet and plume results from existing literature. The magnitude of the turbulence characteristics at the lowest slip ratio is comparable with what is found in the literature, but there is a rapid transition from slip ratios of $0.14$ to $0.7$ . Furthermore, the turbulent kinetic energy budget was analysed for each case. The production term had the largest contribution, and its magnitude was almost five times the buoyancy production downstream. High slip ratio cases show a positive peak of pressure strain and turbulent diffusion along the centreline.
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- 2022
32. Long-Term Diabetes Improvement After Duodenal Exclusion in Zucker Diabetic Fatty Rats Is Associated with Prevention of Strain-Specific Pancreatic Remodeling and Increased Beta Cell Proliferation
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Gabriel Seifert, Ambrus Malyi, Peter Bronsert, Sven Plohmann, Rebeccca Kesselring, Stefan Fichtner-Feigl, Goran Marjanovic, Jodok Matthias Fink, and Claudia Laessle
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Blood Glucose ,Male ,Nutrition and Dietetics ,Endocrinology, Diabetes and Metabolism ,Obesity, Morbid ,Rats ,Rats, Zucker ,Jejunum ,Diabetes Mellitus, Type 2 ,Artificial Intelligence ,Proliferating Cell Nuclear Antigen ,Animals ,Humans ,Insulin ,Surgery ,Pancreas ,Cell Proliferation - Abstract
Background Response to metabolic surgery is heterogeneous and the metabolic states that underpin weight loss and metabolic improvement are still unclear. In this study, we investigate parameters of post-bariatric fasting glucoregulation and leverage artificial intelligence-assisted whole-slide image analyses to characterize associated immunohistologic features of the pancreas. Materials and Methods We performed either loop duodeno-jejunostomy (DJOS) with exclusion of 1/3 of total intestinal length, loop duodeno-ileostomy with exclusion of 2/3 of total intestinal length (DiOS), or a sham operation on 8-week-old male obese ZDF rats. Six months post-operative, we measured blood metabolites and hormones. Subsequently, pancreatic and intestinal tissue was removed, formalin fixed, and paraffin embedded. Immunohistologic (IHC) analyses included proliferating cell nuclear antigen (PCNA) to visualize the proliferation fraction and pancreatic and duodenal homeobox 1 (PDX 1) as a measure of pancreatic cell differentiation. For IHC quantification, all slides were digitalized and analyzed using QuPath. All analyzed slides were reviewed by two independent pathologists for correctness. Results DJOS and DiOS were associated with preserved fasting insulin production compared to sham. Histopathologic evaluation showed significantly higher numbers of beta cells and specifically of clustered cell organization in DJOS and DiOS compared to sham. Cell proliferation (PCNA) was significantly elevated in DJOS and DiOS compared to sham. Conclusion In this interventional model of bariatric surgery in severe genetic diabetes, we demonstrate post-operative histologic and immunohistologic features of the pancreas associated with improved fasting glucose homeostasis. Graphical abstract
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- 2022
33. On lq Optimization and Matrix Completion.
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Goran Marjanovic and Victor Solo
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- 2012
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34. Banded Versus Nonbanded Sleeve Gastrectomy
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Andrea Hetzenecker, Mira Runkel, Jodok Fink, Claudia Laessle, Stefan Fichtner-Feigl, Goran Marjanovic, and Gabriel Seifert
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Adult ,Male ,Sleeve gastrectomy ,medicine.medical_specialty ,medicine.medical_treatment ,Silicones ,Comorbidity ,Type 2 diabetes ,law.invention ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Randomized controlled trial ,Gastrectomy ,law ,Weight loss ,Germany ,medicine ,Clinical endpoint ,Humans ,business.industry ,Reflux ,Middle Aged ,medicine.disease ,Confidence interval ,Obesity, Morbid ,Surgery ,030220 oncology & carcinogenesis ,Quality of Life ,Female ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Body mass index ,Follow-Up Studies - Abstract
Objective The aim of this study was to compare silicone-banded sleeve gastrectomy (BSG) to nonbanded sleeve gastrectomy (SG) regarding weight loss, obesity-related comorbidities, and complications. Summary background data As a primary bariatric procedure, SG leads to excellent weight loss, yet weight regain is a relevant issue in mid- to long-term follow-up. Retrospective analyses suggest that banding a sleeve using a silicone ring may decrease weight regain and improve weight loss. Methods The banded versus nonbanded sleeve gastrectomy single-center, randomized controlled trial was conducted from January 2015 to August 2019. The primary endpoint was defined as excess weight loss 3 years after surgery. Secondary endpoints included the surgery's impact on obesity-related comorbidities, quality of life, and complications. The study was registered under DRKS00007729. Results Among 94 patients randomized, 97% completed 3-year follow-up. Mean initial body mass index was 50.9 kg/m [95% confidence interval (CI), 49.6-52.2]. Mean adjusted excess weight loss 3 years after SG amounted to 62.3% (95% CI, 56.2-68.5) and 73.9% ( 95% CI, 67.8-80.0) after BSG (difference 11.6%, P = 0.0073). Remission of type 2 diabetes occurred in 66.7% (4/6) after SG and in 91.0% (10/11) following BSG (P = 0.21). Three years after surgery, ring implantation correlated with decreased frequency of symptomatic reflux episodes (P = 0.01) but increased frequency of regurgitation (P = 0.03). The rate of major complications was not different between the study groups (BSG, n = 3; SG, n = 2; P = 0.63). Quality of life was better following BSG (P = 0.001). Conclusions BSG provided better weight loss than nonbanded SG 3 years after surgery. Regurgitation was the main clinically relevant negative effect after BSG.
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- 2020
35. The New Interest of Bariatric Surgeons in the Old Ligamentum Teres Hepatis
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Norbert Runkel, Goran Marjanovic, Oliver Scheffel, and Alexander Runkel
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Sleeve gastrectomy ,medicine.medical_specialty ,Round Ligaments ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Round Ligament of Liver ,English language ,Hiatal hernia ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Distal esophagus ,Surgeons ,Nutrition and Dietetics ,Round Ligament ,business.industry ,medicine.disease ,Obesity, Morbid ,Surgery ,medicine.anatomical_structure ,Gastroesophageal Reflux ,Ligament ,GERD ,030211 gastroenterology & hepatology ,business ,Systematic search - Abstract
The search for an operation that effectively prevents and treats intrathoracic gastric migration (ITGM) after bariatric surgery has revived a long-forgotten technique: ligamentum teres cardiopexy (LTC) by which a vascularized flap of the teres ligament is wrapped around the distal esophagus. The systematic search of publications in the English language revealed 4 studies (total number of patients 53) in the non-bariatric literature with an unsatisfactory resolution of GERD. There were 5 reports from the bariatric literature with small patient numbers (total 64) and a short follow-up (6-36 months). There were no objective signs of gastric remigration in 93% of investigated patients. Acknowledging the limitations of these preliminary reports, bariatric surgeons are encouraged to further investigate the potentials of LTC in their patients.
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- 2020
36. Hiatoplasty for Intrathoracic Gastric Migration Associated with One Anastomosis Gastric Bypass (OAGB)
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Oliver Scheffel, Norbert Runkel, Sonja Chiappetta, Goran Marjanovic, and Alexander Runkel
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medicine.medical_specialty ,Sleeve gastrectomy ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Gastric Bypass ,030209 endocrinology & metabolism ,Anastomosis ,Hiatal hernia ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,Weight Loss ,Humans ,Medicine ,Retrospective Studies ,Nutrition and Dietetics ,business.industry ,Proportional hazards model ,Hazard ratio ,Retrospective cohort study ,medicine.disease ,digestive system diseases ,Obesity, Morbid ,Surgery ,Concomitant ,030211 gastroenterology & hepatology ,Pouch ,business - Abstract
The standard of surgical correction of post-bariatric intrathoracic gastric migration (ITGM) is hiatal hernia repair, but little is known about its efficacy in patients with one anastomosis gastric bypass (OAGB). We present our experience. This retrospective cohort study includes all patients with OAGB who had undergone hiatal hernia repair from 2014 to 2019. The primary outcome was recurrence of ITGM as diagnosed by computed tomography and gastroscopy. A total of 63 patients underwent hiatal hernia repair 2–54 months (median 13) after primary OAGB (40 patients) or concurrent with revisional OAGB after prior sleeve gastrectomy (23 patients). ITGM recurred in 48% of patients with hiatal repair after primary OAGB and in 91% of patients with concomitant hiatal repair. Recurrences were diagnosed after a median interval of 9 and 8.5 months, respectively. Thirty-six patients (57% of total number) required a revision, and a re-recurrence of ITGM was detected in 15 patients. The Cox regression analysis of all hiatal repairs showed that two variables significantly influenced the likelihood of ITGM recurrence: the length of the migrated pouch (hazard ratio 1.32; p = 0.016) and the type of repair. Combining hiatoplasty with ligamentum teres augmentation (LTA) and conversion to Roux-en-Y gastric bypass (RYGB) lowered the probability of ITGM recurrence (compared with stand-alone hiatoplasty; hazard ratio 0.21, p = 0.029). The outcome of hiatal repair in patients with OAGB is unsatisfactory. Stand-alone hiatoplasty is particularly ineffective. The combination of hiatoplasty with LTA and conversion to RYGB improves the early results, but the long-term durability needs to be tested.
- Published
- 2020
37. CD161 expressing CD4+ CD25hi T cells accumulate in the liver of obese patients with NASH
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Rafael Kaeser, Emilia Schlaak, Franziska Engels, Saskia Killmer, Katharina Zoldan, Lukas Sturm, Lena Mayer, Gabriel Seifert, Jodok Matthias Fink, Goran Marjanovic, Thomas Longerich, Agnieszka Kabat, Edward Pearce, Dominik Bettinger, Maike Hofmann, Robert Thimme, Bertram Bengsch, and Tobias Böttler
- Subjects
Hepatology - Published
- 2022
38. Banded versus nonbanded sleeve gastrectomy: 5-year results of a matched-pair analysis
- Author
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Stefan Fichtner-Feigl, Anais von Pigenot, Goran Marjanovic, Gabriel Seifert, Claudia Laessle, and Jodok Fink
- Subjects
Adult ,Male ,medicine.medical_specialty ,Matched Pair Analysis ,Sleeve gastrectomy ,medicine.medical_treatment ,030209 endocrinology & metabolism ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Gastrectomy ,Weight loss ,Weight Loss ,medicine ,Humans ,Retrospective Studies ,Laparoscopic sleeve gastrectomy ,business.industry ,Reflux ,Odds ratio ,Middle Aged ,University hospital ,Obesity, Morbid ,Surgery ,Exact test ,Treatment Outcome ,Female ,030211 gastroenterology & hepatology ,medicine.symptom ,business - Abstract
Background Laparoscopic sleeve gastrectomy (SG) achieves excellent weight loss, yet recent reports indicate weight regain in a substantial number of patients. Objectives Inserting a nonadjustable gastric band may improve weight loss after SG. Setting University Hospital, Germany. Methods In a retrospective matched-pair analysis 51 patients who underwent banded SG (BSG) using a silicone ring between November 2010 and May 2017 were compared with patients who underwent conventional SG regarding weight loss, complications, and co-morbidity. Median follow-up was 5 years. Results Total weight loss was equal in the early follow-up (P = .118 and P = .111) but significantly better in BSG 3 and 5 years after surgery (BSG versus SG at 3 yr 38.7% ± 7.8, n = 33 versus 31.9 ± 10.7, n = 33, P = .002; BSG versus SG at 5 yr 37.6% ± 8.5, n = 27 versus 29.5 ± 12.9, n = 23, P = .008). Ring placement had no significant impact on clinical reflux signs (Fisher's exact test P > .999), yet 37 % of BSG patients reported ≥1 regurgitation per week (Fisher's exact test P = .013, odds ratio 12.4). Conclusion BSG leads to better weight loss than nonbanded SG 5 years after surgery. This comes at the expense of a higher rate of regurgitation. At a time in which weight loss limitations of a stand-alone SG are becoming a clinical problem, banding the sleeve may be a strategy to improve weight loss with this procedure.
- Published
- 2019
39. Putting the Hindgut Hypothesis to the Test in a Diabetic Zucker Rat Model
- Author
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Jodok Fink, Sylvia Timme-Bronsert, Stefan Fichtner-Feigl, Ke Jin, Goran Marjanovic, Claudia Laessle, and Gabriel Seifert
- Subjects
Blood Glucose ,Male ,medicine.medical_specialty ,Duodenum ,medicine.drug_class ,Endocrinology, Diabetes and Metabolism ,Rat model ,030209 endocrinology & metabolism ,Ileum ,Stimulation ,Diabetes Mellitus, Experimental ,Bile Acids and Salts ,Random Allocation ,03 medical and health sciences ,0302 clinical medicine ,Glucagon-Like Peptide 1 ,Internal medicine ,Diabetes mellitus ,Glucose Intolerance ,Intestine, Small ,medicine ,Animals ,Insulin ,Nutrition and Dietetics ,Bile acid ,business.industry ,Hindgut ,Glucose Tolerance Test ,medicine.disease ,Rats ,Rats, Zucker ,Jejunum ,medicine.anatomical_structure ,Endocrinology ,030211 gastroenterology & hepatology ,Surgery ,Analysis of variance ,business ,Biomarkers ,Hormone - Abstract
The hindgut theory hypothesizes a key role of differential hindgut stimulation following metabolic procedures in ameliorating diabetes mellitus. We used two strategies to remove the hindgut from intestinal continuity in order to analyze its impact on diabetes mellitus. Loop duodeno-jejunostomy (DJOS) with exclusion of one-third of total intestinal length was performed in 3 groups of 9-week-old Zucker diabetic fatty rats. In group 1, no further alteration of the intestinal tract was made. Group 2 received additional ileal exclusion (IE). Group 3 underwent additional resection of 50% of the ileum with side-to-side ileocecal anastomosis (IR). One, 2, and 4 months after surgery, fasting blood glucose levels, oral glucose tolerance tests (OGTT), and glucose-stimulated hormone analyses were conducted, and bile acid blood levels were compared. Body weight was documented weekly. In relation to DJOS, glucose control was not impaired in IR or IE. On the contrary, only IR could maintain preOP glucose values until 4 months. There were no significant weight differences between the groups. Confirming effective ileal diversion, bile acid blood levels were significantly higher in the DJOS group compared with both IR and IE (p = 0.0025 and p = 0.0047). Operative interventions had no impact on GLP-1 levels at any time point (ANOVA p > 0.05 for all). Insulin secretion was preserved in all groups. This data supports the hypothesis that the mechanisms driving amelioration of diabetes mellitus are complex and cannot be reduced to the ileum.
- Published
- 2019
40. On the effects of buoyancy on higher order moments in lazy plumes
- Author
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S. Balachandar, Gordon Taub, and Goran Marjanovic
- Subjects
Physics ,Momentum (technical analysis) ,Buoyancy ,Turbulence ,Computational Mechanics ,Direct numerical simulation ,General Physics and Astronomy ,Mechanics ,engineering.material ,Condensed Matter Physics ,Shear (sheet metal) ,Mechanics of Materials ,engineering ,Higher order moments - Abstract
Jets and plumes are shear flows created by momentum and buoyant sources. They can be classified as either pure jets, forced plumes, pure plumes, or lazy plumes. Lazy plumes are characterised as hav...
- Published
- 2019
41. FOLLICULAR LYMPHOMA INCIDENCE AND MORTALITY IN RELATION TO OVERWEIGHT, OBESI TY AND PHYSICAL ACTIVITY: A META - ANALYSIS
- Author
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Goran Marjanovic, Hemathology, Milan Radojkovic, Milorad Pavlovic, Dušan Sokolović, Danijela Radojkovic, Aleksandar Karanikolic, and Ilija Golubović
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,Meta-analysis ,Incidence (epidemiology) ,medicine ,Physical activity ,Follicular lymphoma ,Overweight ,medicine.symptom ,business ,medicine.disease ,Industrial and Manufacturing Engineering - Published
- 2018
42. The effect of pasireotide on intestinal anastomotic healing with and without whole-body irradiation in a rat model
- Author
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Birte Kulemann, P Holzner, Simon Kirste, Goran Marjanovic, Gunnar Leithold, Jens Hoeppner, Claudia Laessle, Torben Glatz, and Gabriel Seifert
- Subjects
Blood Glucose ,Male ,medicine.medical_specialty ,Anastomosis ,Rat model ,Urology ,Whole body irradiation ,Tissue Adhesions ,030230 surgery ,Injections ,03 medical and health sciences ,chemistry.chemical_compound ,Postoperative Complications ,0302 clinical medicine ,Cause of Death ,Internal medicine ,Pressure ,medicine ,Animals ,Insulin-Like Growth Factor I ,Rats, Wistar ,Fibroblast ,Wound Healing ,business.industry ,Anastomosis, Surgical ,Body Weight ,Gastroenterology ,Histology ,Intestinal healing ,Hepatology ,Pasireotide ,Intestines ,SOM230 ,Disease Models, Animal ,medicine.anatomical_structure ,chemistry ,030220 oncology & carcinogenesis ,Original Article ,Irradiation ,Somatostatin ,Wound healing ,business ,Whole-Body Irradiation ,Granulocytes - Abstract
Objective To examine pasireotide’s effect on intestinal anastomotic healing under physiological conditions and following preoperative whole-body irradiation. Material and methods Forty-five male Wistar rats received an ileoileal end-to-end anastomosis. Group 1 (Co, n = 9) served as control. Group 2 (SOM, n = 10) received pasireotide (60 mg/kg) 6 days preoperatively. Group 3 (R-Co, n = 13) was subjected to 8 Gy whole-body irradiation 4 days preoperatively. Finally, group 4 (R-SOM, n = 13) received pasireotide 6 days preoperatively and whole-body irradiation 4 days preoperatively. On postoperative day 4, anastomotic bursting pressure, histology, IGF-1 staining, and collagen density were examined. Results Mortality was higher in irradiated animals (30.8% vs. 5.3%, p = 0.021), and anastomotic bursting pressure was significantly lower (median, R-Co = 83 mmHg; R-SOM = 101 mmHg; Co = 149.5 mmHg; SOM = 169 mmHg). Inflammation measured by leukocyte infiltration following irradiation was reduced (p = 0.023), and less collagen was observed, though this was not statistically significant. Bursting pressure did not significantly differ between Co and SOM and between R-Co and R-SOM animals respectively. Semi-quantitative scoring of IGF-1, fibroblast bridging, or collagen density did not reveal significant differences among the groups. Conclusion Whole-body irradiation decreases the quality of intestinal anastomotic wound healing and increases mortality. Pasireotide does not significantly lessen this detrimental effect.
- Published
- 2018
43. Leg Volume in Patients with Lipoedema following Bariatric Surgery
- Author
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Tobias Bertsch, Jodok Fink, Martha Foeldi, Gabriel Seifert, Lisa Schreiner, Goran Marjanovic, and Gabriele Erbacher
- Subjects
medicine.medical_specialty ,Sleeve gastrectomy ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Lipoedema ,Lipohypertrophy ,Retrospective cohort study ,Thigh ,medicine.disease ,Confidence interval ,Surgery ,body regions ,medicine.anatomical_structure ,Weight loss ,Edema ,medicine ,medicine.symptom ,business ,Research Article - Abstract
Introduction: Lipoedema is characterized as subcutaneous lipohypertrophy in association with soft-tissue pain affecting female patients. Recently, the disease has undergone a paradigm shift departing from historic reiterations of defining lipoedema in terms of classic edema paired with the notion of weight loss-resistant leg volume towards an evidence-based, patient-centered approach. Although lipoedema is strongly associated with obesity, the effect of bariatric surgery on thigh volume and weight loss has not been explored. Material and Methods: In a retrospective cohort study, thigh volume and weight loss of 31 patients with lipoedema were analyzed before and 10–18 and ≥19 months after sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). Fourteen patients, with distal leg lymphoedema (i.e., with healthy thighs), who had undergone bariatric surgery served as controls. Statistical analysis was performed using a linear mixed-effects model adjusted for patient age and initial BMI. Results: Adjusted initial thigh volume in patients with lipoedema was 23,785.4 mL (95% confidence interval [CI] 22,316.6–25,254.1). Thigh volumes decreased significantly in lipoedema and control patients (baseline vs. 1st follow-up, p < 0.0001 and p = 0.0001; baseline vs. 2nd follow-up, p < 0.0001 and p = 0.0013). Adjusted thigh volume reduction amounted to 33.4 and 37.0% in the lipoedema and control groups at the 1st follow-up, and 30.4 and 34.7% at the 2nd follow-up, respectively (lipoedema vs. control p > 0.999 for both). SG and RYGB led to an equal reduction in leg volume (operation type × time, p = 0.83). Volume reduction was equally effective in obese and superobese patients (weight category × time, p = 0.43). Conclusion: SG and RYGB lead to a significant thigh volume reduction in patients with lipoedema.
- Published
- 2020
44. Augmentation of Hiatal Repair with the Ligamentum Teres Hepatis for Intrathoracic Gastric Migration After Bariatric Surgery
- Author
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Alexander Runkel, Oliver Scheffel, Norbert Runkel, Sonja Chiappetta, and Goran Marjanovic
- Subjects
medicine.medical_specialty ,Sleeve gastrectomy ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Gastric Bypass ,030209 endocrinology & metabolism ,Round Ligament of Liver ,Anastomosis ,Single Center ,Hiatal hernia ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,medicine ,Humans ,Retrospective Studies ,Surgical repair ,Nutrition and Dietetics ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Surgery ,Endoscopy ,Obesity, Morbid ,stomatognathic diseases ,GERD ,030211 gastroenterology & hepatology ,Pouch ,business - Abstract
The augmentation of hiatoplasty (HP) with the ligamentum teres hepatis (LTA) is a new concept for intrathoracic migration of a gastric sleeve or pouch (ITGM). We retrospectively analyzed all cases of hiatal hernia repair in a single center between 2015 and 2019. A total of 171 patients underwent 307 hiatal hernia repairs after sleeve gastrectomy (SG) (n = 79), Roux-en-Y gastric bypass (RYGB) (n = 129), and one anastomosis gastric bypass (OAGB) (n = 99). Each hiatal hernia repair was defined as a “case” and assigned to the LTA group or the non-LTA group. The primary outcome was the recurrence of ITGM as detected by endoscopy or CT. The basic characteristics in the LTA group (78 cases) and the non-LTA group (229 cases) were comparable with the exception of the rate of revisional HP (72% vs. 21%), the rate of prior conversion to RYGB (33% vs. 17%), the initial BMI (45.9 ± 8.2 kg/m2 vs. 49.0 ± 8.8 kg/m2), and the follow-up (7 months (1–16) vs. 8 months (1–54)). The ITGM recurrence rate was 15% in the LTA group and 72% in non-LTA group (p
- Published
- 2020
45. Immunomodulatory effects of galectin-1 in patients with chronic lymphocytic leukemia
- Author
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Goran Marjanovic, Ivana Milosevic, Tanja Dzopalic, Ivana Urosevic, and Miloš Kostić
- Subjects
dendritic cell ,T cell ,Chronic lymphocytic leukemia ,Immunology ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,hemic and lymphatic diseases ,medicine ,Immunology and Allergy ,galectin-1 ,Immunodeficiency ,CD86 ,OTX008 ,business.industry ,Interleukin ,Dendritic cell ,medicine.disease ,medicine.anatomical_structure ,Medicine ,chronic lymphocytic leukemia ,Clinical Immunology ,business ,immunodeficiency ,CD80 ,030215 immunology - Abstract
Galectin-1 (Gal-1) has been implicated in the progression of chronic lymphocytic leukemia (CLL) but also the development of immunodeficiency, which commonly accompany this malignancy. In this in vitro study, we investigated the effects of Gal-1 inhibition in the sera of immunocompromised CLL patients on immunomodulating properties of dendritic cells (DCs). DCs derived from peripheral blood mononuclear cells were treated with a healthy serum, CLL serum as well as the combination of CLL serum and Gal-1 inhibitor (OTX008). Following the treatment, the expression levels of DC maturation markers (CD80, CD83, CD86 and IDO-1) were determined as well as their cytokine profile and the ability to polarize the immune response in co-cultures with CD4+ T cells. After treatment with CLL serum, an increase in interleukin (IL)-10 production was observed in both DC cultures and co-cultures with CD4+ T cells. OTX008 caused a reduction in IL-10 production as well as IL-2, but no significant alteration in the expression of DC maturation markers or T regulatory cell (Treg) frequency was observed. The results of our study suggest that Gal-1 from CLL serum give rise to a specific IL-10+ CD4+ T cell phenotype, other than Treg, that could mediate immunodeficiency development in CLL patients.
- Published
- 2020
46. Der deutsche Schneeball-Effekt
- Author
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Goran Marjanovic, J Höppner, Claudia Läßle, Gergana Nenova, Stefan Fichtner-Feigl, Gabriel Seifert, and Jodok Fink
- Subjects
Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Transplant surgery ,business.industry ,030220 oncology & carcinogenesis ,Medicine ,030211 gastroenterology & hepatology ,Surgery ,business - Abstract
Die chirurgische Therapie der Adipositas in Deutschland ist ein sich rasch entwickelndes Gebiet, welches streng an die Nationalen Leitlinien gebunden ist. Darstellung der Belastung der Adipositaszentren durch den exponentiellen Anstieg postbariatrischer Patienten In einer retrospektiven Studie haben wir deskriptiv die Entwicklung der ambulanten Patientenzahlen an unserem universitaren Adipositaszentrum (gegrundet 2007) untersucht. Die Patientenbesuche wurden jahrlich ausgewertet und in zwei Gruppen eingeteilt: Erstvorstellung und Wiedervorstellung. Die Anzahl der durchgefuhrten bariatrischen Operationen sowie deren Akzeptanz/Kostenubernahme durch die Krankenkassen wurden ebenfalls evaluiert. Im Jahr 2007 wurden insgesamt 318 Patienten gesehen: 156 waren Erstvorstellungen, 162 Wiedervorstellungen. Die Ablehnungsrate der Kostenubernahme durch die Krankenkassen betrug 16,8 %. 2016 gab es 1691 Patientenvorstellungen (2016 vs. 2007 + 532 %), hiervon 487 Erstvorstellungen (+312 %) und 1204 Wiedervorstellungen (+743 %). Die Ablehnungsrate seitens der Krankenkassen fiel auf 1,8 %, wahrend sich die Anzahl der Operationen nahezu verzehnfachte. Mit der steigenden Akzeptanz der bariatrischen Therapie muss sich eine vergleichsweise kleine Zahl an spezialisierten Zentren mit der exponentiell steigenden Nachsorgefrequenz auseinandersetzen. In Anbetracht des Ausmases der Adipositasepidemie stellt insbesondere eine adaquate Nachsorge ein soziookonomisches Problem dar, welches nur im interdisziplinaren Setting unter struktureller Integration in das komplexe Gesundheitssystem gelost werden kann.
- Published
- 2018
47. Serum biomarkers and clinical characteristics of patients with Hodgkin lymphoma
- Author
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Goran Marjanovic, Lana Macukanovic-Golubovic, Biljana Mihaljevic, Ivan Petković, Tatjana Stoimenov-Jevtovic, Olivera Simonovic, and Milena Todorovic
- Subjects
Oncology ,lcsh:R5-920 ,medicine.medical_specialty ,business.industry ,hodgkin disease ,03 medical and health sciences ,0302 clinical medicine ,biomarkers, tumor ,Serum biomarkers ,030220 oncology & carcinogenesis ,Internal medicine ,treatment outcome ,medicine ,Hodgkin lymphoma ,Pharmacology (medical) ,enzyme-linked immunosorbent assay ,prognosis ,lcsh:Medicine (General) ,business ,030215 immunology - Abstract
Background/Aim. In classical Hodgkin?s lymphoma (cHL) the existing prognostic scoring systems do not include markers that adequately reflect the interaction of malignant Hodgkin and Reed-Sternberg (HRS) cells and tumor environment. The aim of this study was to determine the relationship between serum Galectin-1 (Gal-1) and soluble CD163 (sCD163) and the clinical status of patients with cHL, with special emphasis on the presence of relapse, progression, or resistance to the therapy applied. Methods. The research included 79 patients of whom 63 were patients with cHL, and the control group of 16 healthy volunteers. The study group of 63 patients with cHL included a subgroup of newly diagnosed patients without therapy, newly diagnosed patients with therapy, patients with relapse and progression of the disease and primary refractory patients during 2014 and 2015. Results. Analysis of the levels of sCD163 and Gal-1 within a group of patients suffering from cHL showed that the values of both molecules were higher in relapsed patients and the subgroup with progressive disease comparing to the subgroup of newly diagnosed patients without therapy or patients with therapy onset. Conclusion. Determination of Gal-1 and sCD163 levels is simple and reliable analysis that can contribute to the identification of high-risk patients with cHL and deserves inclusion in current prognostic scoring systems.
- Published
- 2018
48. Duodenal Exclusion but Not Sleeve Gastrectomy Preserves Insulin Secretion, Making It the More Effective Metabolic Procedure
- Author
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Goran Marjanovic, Jodok Fink, Stefan Fichtner-Feigl, Gergana Nenova, Gabriel Seifert, Claudia Laessle, Bernd Jaenigen, and Lampros Kousoulas
- Subjects
Blood Glucose ,Male ,medicine.medical_specialty ,Sleeve gastrectomy ,Glucose control ,Duodenum ,medicine.drug_class ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Bariatric Surgery ,030209 endocrinology & metabolism ,Type 2 diabetes ,Diabetes Mellitus, Experimental ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,Glucagon-Like Peptide 1 ,Insulin-Secreting Cells ,Internal medicine ,Diabetes mellitus ,Insulin Secretion ,Animals ,Insulin ,Medicine ,Insulin secretion ,Nutrition and Dietetics ,Bile acid ,business.industry ,Anastomosis, Surgical ,Body Weight ,Glucose Tolerance Test ,medicine.disease ,Zdf rats ,Obesity, Morbid ,Rats ,Rats, Zucker ,Jejunum ,Endocrinology ,Diabetes Mellitus, Type 2 ,030211 gastroenterology & hepatology ,Surgery ,Insulin Resistance ,business - Abstract
There is an ongoing debate on which procedure provides the best treatment for type 2 diabetes. Furthermore, the pathomechanisms of diabetes improvement of partly anatomically differing operations is not fully understood. A loop duodenojejunostomy (DJOS) with exclusion of one third of intestinal length, a sleeve gastrectomy (SG), or a combination of DJOS + SG was performed in 8-week-old male ZDF rats. One, three, and six months after surgery, an oral glucose tolerance test and measurements of GLP-1, GIP, insulin, and bile acids were conducted. After an initial (4 weeks) equal glucose control, DJOS and DJOS + SG showed significantly lower glucose levels than SG 3 and 6 months after surgery. There was sharp decline of insulin levels in SG animals over time, whereas insulin levels in DJOS and DJOS + SG were preserved. GIP levels were significantly larger in both groups containing a sleeve at all three time points, whereas GLP-1 was equal in all groups at all time. Bile acid levels were significantly higher in the DJOS compared to the SG group at all time points. Interestingly, the additional SG in the DJOS + SG group led to lower bile acid levels 1 and 6 months postoperatively. The effect of SG on glucose control was transient, whereas a duodenal exclusion was the more effective procedure in this model due to a sustained pancreatic function with a preserved insulin secretion.
- Published
- 2017
49. Prediction of acute pancreatitis severity via the combined analysis of inflammatory biomarkers and coagulation parameters
- Author
-
Sasa Grgov, Snezana Tesic Rajkovic, Goran Marjanovic, Miodrag Djordjevic, and Biljana Radovanović Dinić
- Subjects
acute pancreatitis ,business.industry ,macromolecular substances ,medicine.disease ,Bioinformatics ,Inflammatory biomarkers ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,Medicine ,Coagulation (water treatment) ,Acute pancreatitis ,030211 gastroenterology & hepatology ,business ,procalcitonin ,c reactive protein ,d dimer - Abstract
Introduction. Timely assessment of severity of acute pancreatitis is needed to avoid severe systemic complications by making optimal therapeutic approach and correct prognosis of the disease. The aim of the study was to establish the role of several inflammatory biomarkers and coagulation parameters in prediction of AP severity, and also to propose a mathematical formula which allows their combined use for the same purpose. Material and Methods. The prospective study included 70 patients with AP. The patients were divided into groups: mild (group I), moderate (group II) and severe AP (group III). All patients were further classified into two groups: group A (mild AP) and group B (moderate and severe AP). Biochemical markers, inflammatory biomarkers and coagulation factors were tested in all patients. Results. Based on the results of Mann-Whitney,s test, it can be concluded that groups A and B are significant different from each other for CRP (p
- Published
- 2017
50. Current Issues in Histology, Biology and Prognosis of Hodgkin Lymphoma
- Author
-
Goran Marjanovic and Olivera Simonovic
- Subjects
Pathology ,medicine.medical_specialty ,Hodgkin Lymphoma ,business.industry ,lcsh:R ,lcsh:Medicine ,Histology ,General Medicine ,check point inhibition ,microenvironment ,03 medical and health sciences ,0302 clinical medicine ,hemic and lymphatic diseases ,030220 oncology & carcinogenesis ,interim PET ,Medicine ,Hodgkin lymphoma ,prognosis ,business ,030215 immunology - Abstract
Summary High risk Hodgkin lymphoma patients may occasionally have borderline characteristics similar to gray zone lymphomas and T-cell/histiocyte rich B cell lymphomas. These entities require different and more aggressive treatment modalities. Aggressive behavior is often associated with disturbances caused by Epstein Barr virus, or immune evasion caused by overexpression of check point inhibitors PDL-1 and PDL-2 coupled with the lack of expression of Class I and II MHC molecules. Galectin-1, TARC, sCD163 and other surrogate markers of immunosuppression in Hodgkin lymphoma may be useful for the assessment of treatment response. The improvements in lymphoma management diminished the importance of prognostic factors unified in the International Prognostic Scoring system, reducing them from 7 to 3 factors that remained relevant. Interim PET analysis is the only method able to identify resistant patients while chemotherapy is ongoing, thus enabling adjustment of treatment according to the treatment response. Efforts for stratification of patients according to disease histology, biology, microenvironment, clinical scoring systems and PET scan are ongoing. Current breakthroughs have set strong background for novel therapies with monoclonal antibodies and check point inhibitors that will result in improvement of management of high risk patients.
- Published
- 2017
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