A recruitment maneuver followed by PEEP reduced atelectasis and improved oxygenation in morbidly obese patients, whereas PEEP or a recruitment maneuver alone did not.

We tested the hypothesis that CO 2 supersaturation along the aquatic conduit over Sweden can be explained by processes other than aquatic respiration. A first generalized-additive model (GAM) analysis evaluating the relationships between single water chemistry variables and pCO 2 in lakes and streams revealed that water chemistry variables typical for groundwater input, e.g., dissolved silicate (DSi) and Mg 2 1 had explanatory power similar to total organic carbon (TOC). Further GAM analyses on various lake size classes and stream orders corroborated the slightly higher explanatory power for DSi in lakes and Mg 2 1 for streams compared with TOC. Both DSi and TOC explained 22-46% of the pCO 2 variability in various lake classes (0.01-4100 km 2 ) and Mg 2 1 and TOC explained 11-41% of the pCO 2 variability in the various stream orders. This suggests that aquatic pCO 2 has a strong groundwater signature. Terrestrial respiration is a significant source of the observed supersaturation and we may assume that both terrestrial respiration and aquatic respiration contributed equally to pCO 2 efflux. pCO 2 and TOC concentrations decreased with lake size suggesting that the longer water residence time allow greater equilibration of CO 2 with the atmosphere and inlake mineralization of TOC. For streams, we observed a decreasing trend in pCO 2 with stream orders between 3 and 6. We calculated the total CO 2 efflux from all Swedish lakes and streams to be 2.58 Tg C yr À1 . Our analyses also demonstrated that 0.70 Tg C yr À1 are exported to the ocean by Swedish watersheds as HCO 3 À and CO 3 2À of which about 0.56 Tg C yr À1 is also a residual from terrestrial respiration and constitute a long-term sink for atmospheric CO 2 . Taking all dissolved inorganic carbon (DIC) fluxes along the aquatic conduit into account will lower the estimated net ecosystem C exchange (NEE) by 2.02 Tg C yr À1 , which corresponds to 10% of the NEE in Sweden.

Presently surgery is the most effective way to obtain a controlled weight reduction in morbidly obese patients. Roux-en-Y gastric bypass (RYGBP) surgery is effective and used worldwide, but the exact mechanism of action is unknown. The effect of RYGBP on ghrelin, insulin, adiponectin, and leptin levels was investigated in 66 obese subjects; mean weight 127 kg (range, 96-195 kg) and mean body mass index (BMI) 45 kg/m(2) (range, 33-64) before and after surgery. Ghrelin levels were also compared in 10 nonoperated and 10 operated obese, BMI-matched women. RYGBP resulted in 22% and 30% weight loss at 6 and 12 months, respectively. Ghrelin increased by 44% and 62% and adiponectin by 36% and 98%, but insulin declined by 57% and 62% and leptin by 60% and 64%. The changes were all related to the reduction in BMI. In addition, ghrelin and insulin were inversely correlated at all time points as were changes of the peptides at 12 months (F = 4.9, P = 0.031), independent of the change in BMI. No evidence for RYGBP surgery per se having an effect on ghrelin levels, independent of weight loss, was obtained. The profound changes in the regulatory peptides are likely to reflect the new state of energy balance achieved. A close inverse association between ghrelin and insulin was observed, supporting an important role for ghrelin in glucose homeostasis.

No abstract