Abstract:
:Despite intensive investigation, the pathogenesis of postinjury multiple organ failure (MOF) remains elusive. Laboratory and clinical research strongly implicate that the gastrointestinal tract plays a pivotal role. Shock with resulting gut hypoperfusion appears to be one important inciting event. While early studies persuasively focused attention on bacterial translocation as a unifying mechanism to explain early and late sepsis syndromes that characterize postinjury MOF, subsequent studies suggest that other gut-specific mechanisms are operational. Based on our Trauma Research Center observations and those of others, we conclude that: 1) bacterial translocation may contribute to early refractory shock; 2) for patients who survive shock, the reperfused gut appears to be a source of proinflammatory mediators that may amplify the early systemic inflammatory response syndrome; and 3) early gut hypoperfusion sets the stage for progressive gut dysfunction such that the gut becomes a reservoir for pathogens and toxins that contribute to late MOF.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Moore FAdoi
10.1016/s0002-9610(99)00231-7subject
Has Abstractpub_date
1999-12-01 00:00:00pages
449-53issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(99)00231-7journal_volume
178pub_type
杂志文章,评审abstract::Seventeen cases of carcinoma of the stomach occurring late after previous gastric operation are presented. In all instances, patients had undergone gastroenterostomy, with or without gastric resection. Most patients had undergone the initial operation for peptic ulcer disease an average of 18 years before presenting w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90145-8
更新日期:1981-04-01 00:00:00
abstract:BACKGROUND:The optimal number of sentinel lymph nodes (SLN) that need to be harvested to achieve favorable survival outcome during a SLN biopsy (SLNB) has not yet been established. METHODS:Six hundred and thirteen patients with clinically node-negative breast cancer who underwent SLNB were reviewed. Survival outcomes ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.10.019
更新日期:2017-10-01 00:00:00
abstract::By means of intragastric instillation of meat extract, two groups of duodenal ulcer patients were identified--antral responders and antral nonresponders. Antral response was abolished ater vagotomy and drainage or vagotomy-antrectomy. The differentiation would allow for selective surgery for duodenal ulcer patients. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90355-5
更新日期:1977-08-01 00:00:00
abstract:BACKGROUND:Patients with cancer who undergo pancreaticoduodenectomy (PD) followed by radiation and 5-fluorouracil (5-FU) therapy have experienced median overall survival from 18 to 24 months and an actuarial 2-year overall survival from 34% to 48%. We previously reported an 84% 2-year survival using a novel adjuvant ch...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(03)00051-5
更新日期:2003-05-01 00:00:00
abstract::Angioaccess procedures at one institution over a 4-year period were retrospectively reviewed to ascertain the frequency of major limb- or life-threatening complications. A total of 435 angioaccess procedures were performed, including 81 Cimino-Brescia fistulas, 166 polytetrafluoroethylene grafts, and 111 thrombectomy/...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81076-1
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:Recent cognitive research in medicine has demonstrated that expert diagnosticians solve many clinical problems through "pattern recognition" rather than deductive reasoning strategies. Development of the ability to recognize and diagnose common surgical problems is a critical objective of undergraduate surgi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(99)80172-X
更新日期:1995-03-01 00:00:00
abstract::Tube pancreatostomy for complete external drainage of pancreatic juice following pancreatoduodenectomy and a subsequent second-stage pancreatojejunostomy were carried out in four high-risk patients without morbidity. This procedure avoids the fatal outcome associated with pancreatojejunal anastomotic leakage following...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80073-x
更新日期:1994-07-01 00:00:00
abstract::Over a 5-year period, iliopsoas abscesses were found in 11 patients. Although the most common underlying condition was Crohn's disease (3 of 11 patients), 5 abscesses resulted from hematogenous spread from a distant site. Each of these five patients was elderly, severely malnourished, or had an underlying chronic dise...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90043-q
更新日期:1992-04-01 00:00:00
abstract::Aortoesophageal fistula secondary to a thoracic aortic aneurysm is usually a fatal disease with few survivors reported previously. We encountered 2 consecutive patients who were treated successfully with esophagectomy and in situ aorta reconstruction using cryopreserved homograft that was wrapped completely with oment...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.09.011
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to identify patients with rib injuries who were at risk for solid organ injury. METHODS:A retrospective chart review was performed of all blunt trauma patients with rib fractures during the period from July 2007 to July 2012. Data were analyzed for association of rib fractures ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.08.002
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Rurality adversely impacts the continuum of cancer care. However, investigations of rural cancer surgery are notably absent. We examined patterns and outcomes of oncologic resections at rural US hospitals. METHODS:We identified 928,370 hospital admissions in which 1 of 20 oncologic resections was performed ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.07.012
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Traumatic injuries during pregnancy are the leading cause of nonobstetric maternal mortality. We aimed to determine hospital charges for trauma activations during pregnancy. METHODS:We used the Illinois State Trauma Registry data from 1999 to 2003. Using STATA for bivariate and regression analyses, we compa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.10.018
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Whether or not tumor response to chemotherapy-sensitized radiation therapy (CTRT) for head and neck cancer leads to an improved outcome is unknown. METHODS:Forty patients who received preoperative cisplatin plus simultaneous radiotherapy for operable stage III and IV head and neck cancer were reviewed retro...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00151-7
更新日期:1997-11-01 00:00:00
abstract::An adaptable on-line computer system for entry, retrieval, and analysis of medical discharge summaries has been developed and applied in the Trauma Service of a busy city hospital. Each summary occupied 5 to 10 minutes of the physician's time and compared favorably in cost to the standard dictated summary. While the a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90049-0
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND:The unpredictability of prosthetic vascular access thrombosis precludes the scheduling of elective graft thrombectomy. This results in inconsistent dialysis for patients, as well as logistical challenges for dialysis clinics and surgeons, and increased cost. In an effort to solve this problem a community-wid...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00133-6
更新日期:1999-08-01 00:00:00
abstract::One hundred patients with advanced, recurrent, or metastatic squamous cell carcinoma of the head and neck were treated with chemotherapy and BCG as adjuvant immunotherapy. The overall response rate was 35 per cent, and the median duration of response was seventeen weeks. BCG does not prolong duration of remission or s...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9610(77)90381-6
更新日期:1977-10-01 00:00:00
abstract:BACKGROUND:Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada. METHODS:The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 1...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.12.011
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:The current opinion is that the reflux of jejunal juice over the whole length of a long Roux-en-Y jejunal loop is very uncommon. We aimed to challenge this concept by monitoring the presence of bile in the organ proximal to a 60-cm loop during a 24-hour period with use of the Bilitec device, an optoelectroni...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00326-3
更新日期:2000-04-01 00:00:00
abstract::Sixty-seven cases of neck exploration for suspected hyperparathyroidism were reviewed. Thirty-nine patients underwent removal of an adenoma with biopsy of one or more other parathyroid glands. In another group, nine patients underwent removal of the adenoma only. Both groups have had no recurrences of hyperparathyroid...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90389-5
更新日期:1976-09-01 00:00:00
abstract::These experimental studies provide an explanation for the therapeutic value of proteolytic enzymes as adjuncts to antibiotic treatment of contaminated wounds. After wounding, a fibrinous coagulum develops on the wound surface. This coagulum surrounds the bacteria and protects them from contact with sustemically or top...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90299-4
更新日期:1978-09-01 00:00:00
abstract:BACKGROUND:The objective of this study was to compare middle authorships between male and female general surgeons in the United States. METHODS:A stratified random sample of American College of Surgeons general surgery fellows was identified. Relevant author demographic, affiliation, and publication metrics were colle...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.04.025
更新日期:2020-12-01 00:00:00
abstract::This study is a retrospective review of 18 patients treated from 1964 to 1990 with inguinal lymph node metastases from rectal adenocarcinoma. Statistical analyses were performed to determine the effects of sex, disease-free interval, extent of inguinal lymph node metastases, and the presence of extranodal disease upon...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80204-1
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:This study analyzed presentation and management of hemorrhage after pancreaticoduodenectomy (PD) to determine the respective role of surgery and embolization. METHODS:From January 1992 to March 2005, 411 patients underwent PD and were analyzed with regard to postoperative hemorrhage. RESULTS:Hemorrhage occ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.08.088
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Extended release LCP-tacrolimus (LCPT) allows once-daily dosing in transplant recipients. The improved bioavailability may be beneficial for simultaneous pancreas-kidney recipients (SPK). METHODS:This is a study of 39 SPK recipients on standard immediate-release tacrolimus (IR-TAC, n = 21) or LCPT (n = 18)....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.02.027
更新日期:2020-04-01 00:00:00
abstract::The effects of ranitidine, a new H2-receptor antagonist, on liver regeneration were investigated using a protocol described previously. The animals in Group I had standard two-thirds hepatectomy. In Group II, the rats received an 8 mg/kg intramuscular dose of ranitidine immediately and 24 and 48 hours after two-thirds...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80074-x
更新日期:1985-02-01 00:00:00
abstract:BACKGROUND:The use of neoadjuvant chemotherapy (NAC) for pancreatic ductal adenocarcinoma (PDAC) has increased in recent years. Limited data exists on the impact of NAC on biliary microbiome. METHODS:Patients who underwent pancreaticoduodenectomy (PD) for PDAC between 2014 and 2017 were reviewed. Patients were stratif...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.09.042
更新日期:2020-10-05 00:00:00
abstract:BACKGROUND:Hypercapnia and local pressure effects unique to CO(2) base minimally invasive surgery alter renal blood flow. We have demonstrated laparoscopic antireflux surgery to have an additional impact upon hemodynamics (decreased cardiac output), potentially extending known effects upon renal blood flow. METHODS:We...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00824-3
更新日期:2002-04-01 00:00:00
abstract::Despite immediate operation, patients with abdominal aortic injuries and profound hypovolemic shock do not respond to the usual methods of resuscitation and die soon after celiotomy, prior to control and repair of the aortic injury. The rate of aortic hemorrhage exceeds the ability to restore blood volume. Shock becom...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90385-4
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:Thirty-five percent of hemodialysis patients with polytetrafluoroethylene grafts lose their access secondary to infection. We hypothesized that partial graft excision (PGE) for infection increases the incidence of vascular anastomotic complications when compared with total graft excision (TGE). METHODS:The ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.09.028
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:The Michigan Appropriate Perioperative (MAP) criteria provide guidance regarding urinary catheter use. For Category A (e.g., laparoscopic cholecystectomy), B (e.g., hemicolectomy), and C (e.g., abdominoperineal resection) procedures, recommendations are to avoid catheter, remove POD 0 or 1, and remove POD 1-...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2020.01.008
更新日期:2020-09-01 00:00:00