Patients undergoing LILT in short bowel syndrome have a high survival rate, weight gain, and a high quality of life. Autologous gastrointestinal reconstruction remains therefore the first choice in the treatment of patients with short bowel syndrome.

Background Decisions between medical and surgical management of Crohn’s disease (CD) incorporate risk assessments for potential complications of each therapy. Analytic morphomics is a novel method of image analysis providing quantifiable measurements of body tissue composition, characterizing body fat more comprehensively than body mass index (BMI) alone. The aim of this study was to determine risk factors associated with post-operative complications in CD, incorporating fat composition analysis using analytic morphomics. Methods We performed a retrospective review of adults undergoing bowel resection for CD between 2004–2011 at a single center. CT scans within 30 days prior to surgery underwent morphomic analysis of body geometry and fat characterization. Post-operative infectious complications were defined as the need for a post-operative abdominal drain, intravenous antibiotics, or re-operation within 30 days. Bivariate and multivariate analysis using logistic regression were used to generate a prediction model of infectious complications. Results A total of 269 subjects met selection criteria; 27% incurred post-operative infectious complications. Bivariate analysis showed hemoglobin, albumin, surgical urgency, high-dose prednisone use, and subcutaneous-to-visceral fat volume distribution as predictors of complications. BMI, anti-TNF-alpha-therapies, and immunomodulator use were not predictors of complication. Multivariate modeling demonstrated a c-statistic of 0.77 and a NPV of 81.1% with surgical urgency (OR 2.78, 95% CI 1.46–6.02, P=.004), subcutaneous-to-visceral fat distribution (OR 2.01, 95% CI 1.20–3.19, P=.006), and hemoglobin (OR 0.69, 95% CI 0.55–0.85, P =.001) as predictors of infectious complication. Conclusions Fat subtype and distribution are predictive of post-operative infectious complications following bowel resection for Crohn’s disease. Analytic morphomics provides additional body composition detail not captured by BMI.

After LILT, all patients with liver fibrosis who could be weaned from parenteral nutrition showed a normalization of liver enzymes. Preoperative liver biopsy is mandatory in order to differentiate reversible liver fibrosis from end-stage liver disease. A higher grade of liver fibrosis and elevated INR has been shown to be a sensitive parameter for peri- and postoperative complications.

Obscurin is a giant structural and signaling protein that participates in the assembly and structural integrity of striated myofibrils. Previous work has examined the physical interactions between obscurin and other cytoskeletal elements but its in vivo role in cell signaling, including the functions of its RhoGTPase Exchange Factor (RhoGEF) domain have not been characterized. In this study, morpholino antisense oligonucleotides were used to create an in-frame deletion of the active site of the obscurin A RhoGEF domain in order to examine its functions in zebrafish development. Cardiac myocytes in the morphant embryos lacked the intercalated disks that were present in controls by 72 hpf and, in the more severely affected embryos, the contractile filaments were not organized into mature sarcomeres. Neural abnormalities included delay or loss of retinal lamination. Rescue of the phenotype with co-injection of mini-obscurin A expression constructs demonstrated that the observed effects were due to the loss of small GTPase activation by obscurin A. The immature phenotype of the cardiac myocytes and the retinal neuroblasts observed in the morphant embryos suggests that obscurin A-mediated small GTPase signaling promotes tissue-specific cellular differentiation. This is the first demonstration of the importance of the obscurin A-mediated RhoGEF signaling in vertebrate organogenesis and highlights the central role of obscurin A in striated muscle and neural development.