Abstract:
OBJECTIVE:To determine whether ischemic preconditioning protects the human liver against a subsequent period of ischemia in patients undergoing hemihepatectomy, and to identify possible underlying protective mechanisms of ischemic preconditioning, such as inhibition of hepatocellular apoptosis. SUMMARY BACKGROUND DATA:Ischemic preconditioning is a short period of ischemia followed by a brief period of reperfusion before a sustained ischemic insult. Recent studies in rodents suggest that ischemic preconditioning is a simple and powerful protective modality against ischemic injury of the liver. The underlying mechanisms are thought to be related to downregulation of the apoptotic pathway. METHODS:Twenty-four patients undergoing hemihepatectomy for various reasons alternatively received ischemic preconditioning (10 minutes of ischemia and 10 minutes of reperfusion) before transection of the liver performed under inflow occlusion for exactly 30 minutes. Liver wedge and Tru-cut biopsy samples were obtained at the opening of the abdomen and 30 minutes after the end of the hepatectomy. Serum levels of aspartate transferase, alanine transferase, bilirubin and prothrombin time were determined daily until discharge. Hepatocellular apoptosis was evaluated by in situ terminal deoxynucleotidyl transferase mediated d-UTP nick end-labeling (TUNEL) assay and electron microscopy. Caspase 3 and 8 activities were measured in tissue using specific fluorometric assays. RESULTS:Serum levels of aspartate transferase and alanine transferase were reduced by more than twofold in patients subjected to ischemic preconditioning versus controls. The analysis of a subgroup of patients with mild to moderate steatosis indicated possible increased protective effects of ischemic preconditioning. In situ TUNEL staining demonstrated a dramatic reduction in the number of apoptotic sinusoidal lining cells in the ischemic preconditioning group. Electron microscopy confirmed features of apoptosis present in control but not in ischemic preconditioning patients. There was no significant difference in caspase 3 and 8 activity when patients with ischemic preconditioning were compared with controls. CONCLUSIONS:Ischemic preconditioning is a simple and effective modality protecting the liver against subsequent prolonged periods of ischemia. This strategy may be a more attractive technique than intermittent inflow occlusion, which is associated with increased blood loss during each period of reperfusion.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Clavien PA,Yadav S,Sindram D,Bentley RCdoi
10.1097/00000658-200008000-00001subject
Has Abstractpub_date
2000-08-01 00:00:00pages
155-62issue
2eissn
0003-4932issn
1528-1140journal_volume
232pub_type
杂志文章abstract:OBJECTIVE:To assess the impact of the 80-hour resident workweek restrictions on surgical residents and attending surgeons. SUMMARY BACKGROUND DATA:The ACGME mandated resident duty hour restrictions have required a major workforce restructuring. The impact of these changes needs to be critically evaluated for both the ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000220042.48310.66
更新日期:2006-06-01 00:00:00
abstract::To determine if visceral blood flow was altered by thermal injury, effective renal blood flow (ERBF) was measured by para-aminohippurate clearance in five control subjects and 13 nonbacteremic burn patients (mean burn size: 50% total body surface, range: 24.5-83.5) 6-25 days after burn injury. Splanchnic blood flow (S...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198101000-00018
更新日期:1981-01-01 00:00:00
abstract:OBJECTIVE:The effects of interleukin (IL)-6 in the injured patient are examined in an attempt to clarify the potential pathophysiologic role of IL-6 in the response to injury. SUMMARY BACKGROUND DATA:Interleukin-6 is an integral cytokine mediator of the acute phase response to injury and infection. However, prolonged ...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199611000-00009
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the preoperative relationships of hypertension and diabetes mellitus in severe obesity and the effects of gastric bypass (GBP)-induced weight loss. SUMMARY BACKGROUND DATA:Severe obesity is associated with multiple comorbidities, particularly hypertension and type 2 diabetes mellitus, that may af...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000071560.76194.11
更新日期:2003-06-01 00:00:00
abstract::A prospective (Part I) and a retrospective (Part II) study were used to determine the safety and efficacy of corticosteroids in the treatment of septic shock. In Part I, 172 consecutive patients in septic shock admitted over an 8-year period were treated with either steroid or saline: 43 received dexamethasone (DMP), ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-197609000-00011
更新日期:1976-09-01 00:00:00
abstract::A review of the experience with 66 patients on chronic hemodialysis who underwent 67 major surgical procedures is presented. There were 58 general surgical procedures, and nine major cardiovascular procedures including four emergency cardiac valve replacements. The preoperative, intraoperative and postoperative manage...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197406000-00008
更新日期:1974-06-01 00:00:00
abstract::The effectiveness of enteral and parenteral feeding in supporting a satisfactory nutritional status and/or reversing protein-energy malnutrition was evaluated in 28 children, ages 1-19 (14 female) with advanced malignant disease (21 solid tumors, 7 leukemia-lymphoma). At the onset of treatment, 21 patients received in...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-197912000-00018
更新日期:1979-12-01 00:00:00
abstract:OBJECTIVE:The authors' aim was to determine the requirement for an active interleukin (IL)-1 receptor during the development and progression of acute pancreatitis. SUMMARY OF BACKGROUND DATA:Interleukin-1 is a pro- inflammatory cytokine that has been shown to be produced during acute pancreatitis. Earlier animal studi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199602000-00008
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:To analyze the impact of a conservative strategy of management in patients with necrotizing pancreatitis, reserving intervention for patients with documented infection or the late complications of organized necrosis. SUMMARY BACKGROUND DATA:The role of surgery in patients with sterile pancreatic necrosis rem...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200110000-00016
更新日期:2001-10-01 00:00:00
abstract::Three patients with Menetrier's disease and protein-losing gastropathy who were studied during a 12 year period have been presented. The characteristic findings which differentiate them from patients with hypertrophic hypersecretory gastropathy, including the Zollinger-Ellison syndrome, are: 1) hypertrophy of gastric ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197505000-00036
更新日期:1975-05-01 00:00:00
abstract:OBJECTIVE:We sought to test whether postconditioning, a series of brief mechanical interruptions of reperfusion applied during the onset of reperfusion, can prevent neurologic injury of the spinal cord after transient ischemia. SUMMARY BACKGROUND DATA:Ischemia-reperfusion injury of the spinal cord is the principal mec...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000217608.08582.35
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:To determine whether the immune system limits or improves the therapeutic efficacy of an adenovirus vector expressing the herpes simplex thymidine kinase (HSVtk) gene in a subcutaneous tumor model. BACKGROUND DATA:Enhanced immune reactions against tumors may be therapeutically useful. However, recent studies...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199509000-00008
更新日期:1995-09-01 00:00:00
abstract::Sixty patients with chronic alcohol-induced pancreatitis with endoscopic retrograde cholangiopancreatography evidence of common bile duct stenosis were studied to determine the clinical spectrum and natural history of this complication, as well as the indications for biliary bypass. In 17% of patients, common bile duc...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198911000-00007
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVE:We aimed to determine whether the severity of inhalation injury evokes an immune response measurable at the systemic level and to further characterize the balance of systemic pro- and anti-inflammation early after burn and inhalation injury. BACKGROUND:Previously, we reported that the pulmonary inflammatory ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318275f424
更新日期:2013-06-01 00:00:00
abstract::Twenty-two patients undergoing elective abdominal surgery were given total parenteral nutrition (TPN) after the operation. The TPN contained either a conventional amino acid solution supplemented with glutamine or a conventional amino acid solution without supplementation. To study amino acid and protein metabolism, m...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198904000-00011
更新日期:1989-04-01 00:00:00
abstract::Percutaneous transluminal angioplasty (PTA) was performed as an adjunct to an operation in 43 patients with peripheral arterial insufficiency. This represents 26% of patients undergoing PTA over the past 44 months. In 23 patients PTA was done in conjunction with planned vascular reconstruction. It was successful in al...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198206000-00016
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVE:The outcome of pelvic exenteration was compared in patients with locally advanced primary (LAP) cancer and recurrent rectal cancer (RRC). BACKGROUND:There are few reports comparing the results of pelvic exenteration for primary advanced rectal cancer and RRC. METHODS:Consecutive patients undergoing pelvic e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31828a0d22
更新日期:2014-02-01 00:00:00
abstract:PURPOSE:Surgical resection provides the only possibility of cure for pancreas cancer. A standard adjuvant approach has not been established. We tested the safety and efficacy of a granulocyte-macrophage colony-stimulating factor (GM-CSF)-based immunotherapy administered in patients with resected pancreatic adenocarcino...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181fd271c
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVES:To develop a risk prediction model for serious complications after bariatric surgery. BACKGROUND:Despite evidence for improved safety with bariatric surgery, serious complications remain a concern for patients, providers and payers. There is little population-level data on which risk factors can be used to ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318230058c
更新日期:2011-10-01 00:00:00
abstract::Of 915 resections for bronchogenic carcinoma over a 25-year period (1945-1969), 249 patients survived over 5 years; 127 of the patients eligible survived over 10 years, 61 over 15 years, and 22 over 20 years. The case material was divided into three time periods: 1945-49, 1950-59 and 1960-69, as well as by extent of r...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197609000-00010
更新日期:1976-09-01 00:00:00
abstract::Nine patients with arteriographic right colon arteriovenous malformations (AVM's) are reviewed. Even though five of the eight surviving patients had diverticulosis in remaining colon, right colectomy with removal of the AVM effectively controlled bleeding in seven of the eight patients in follow-up intervals of 14-66 ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197908000-00013
更新日期:1979-08-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility and safety of laparoscopic liver resections. SUMMARY BACKGROUND DATA:The use of the laparoscopic approach for liver resections has remained limited for technical reasons. Progress in laparoscopic procedures and the development of dedicated technology have made it possible to conside...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200012000-00004
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:Demonstrate intratumoral genetic heterogeneity in rectal cancer. BACKGROUND:Several clinical management decisions in rectal cancer may be influenced by pretreatment biopsy information. However, in the setting of significant intratumoral heterogeneity, biopsies may not be representative of the entirety of the...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001937
更新日期:2017-01-01 00:00:00
abstract::This report defines the incidence of variations in the renal vascular pedicle in a group of patients with normal renal function as determined by standard laboratory criteria. The study group consisted of 166 patients undergoing renal arteriography as potential renal allograft donors. Ninety-seven patients were male an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197807000-00014
更新日期:1978-07-01 00:00:00
abstract::The role of surgery in the treatment of gastrinoma is unclear. The purpose of this study was to determine prospectively the surgical cure rate using a controlled clinical trial. Eleven patients who fit the entry criteria underwent abdominal exploration and attempted tumor resection for cure. A historical control group...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199001000-00002
更新日期:1990-01-01 00:00:00
abstract::Arterial blood flow was measured in dogs simultaneously with electromagnetic flow probes and with ultrasonic "flow probes." The ultrasonic probes were used to determine transcutaneously the mean velocity of arterial flow and the cross-sectional area of the blood vessel. A 10 MHz probe was used for blood vessels 1 cm d...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198204000-00013
更新日期:1982-04-01 00:00:00
abstract:OBJECTIVE:Length of stay (LOS) is an important outcome as a marker of resource consumption. Determining which factors increase LOS may provide information on reducing costs and improving the delivery of care. The purpose of this study was to determine the independent association of intraoperative process of care and po...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199908000-00016
更新日期:1999-08-01 00:00:00
abstract::Thirty-two conditioned 15-18 kg dogs underwent laparotomy, heparinization, left lateral hepatic lobe injury and subsequent partial left lateral hepatic lobectomy. The hemostatic capabilities of the surgical scalpel combined with suture ligatures and stay sutures, the Bovie, and the CO2 laser were compared. The CO2 las...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197501000-00016
更新日期:1975-01-01 00:00:00
abstract::Population based surgical rates for various common surgical procedures were analyzed on a regional basis by examining select uniform hospital discharge abstract data from Wisconsin hospitals. The surgical asbracts of nearly 64,000 procedures were compared to the supply of physicians and showed a significant variation ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197802000-00012
更新日期:1978-02-01 00:00:00
abstract:OBJECTIVE:This multicenter study sought to evaluate the accuracy of the American College of Surgeons National Surgical Quality Improvement Program's (ACS-NSQIP) surgical risk calculator for predicting outcomes after pancreatoduodenectomy (PD) and to determine whether incorporating other factors improves its predictive ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001796
更新日期:2017-05-01 00:00:00