Abstract:
BACKGROUND:Hemoperfusion with PMX-F (polymyxin B covalently immobilized on fibers) has been reported to be safe and effective for patients with septic shock. However, the molecular mechanism of this usefulness is not yet clear. The purpose of this study was to evaluate whether the expression of CD14, human leukocyte antigen (HLA)-DR on monocytes, and the expression of CD16, CD11b/CD18 on neutrophils, are altered in septic patients according to the severity, and whether PMX-F treatment affects the clinical parameters and the expression of leukocyte surface antigen expression. PATIENTS AND METHODS:Thirty-four patients who were taken to the National Defense Medical College hospital at emergency, and who had an identified focus of infections, were enrolled in this study. The patients were divided into three groups: non-systemic inflammatory response syndrome [SIRS]) group, sepsis group, and septic shock group. Peripheral blood samples were collected at the time of admission to our hospital. The CD14, HLA-DR expression on monocytes and the CD11b/CD18, CD16 expression on granulocytes were evaluated using flowcytometry, and the serum interleukin (IL)-6 and IL-10 levels were measured using enzyme-linked immunosorbent assay. Treatment with a PMX-F column was performed in 10 patients with septic shock. RESULTS:The HLA-DR expression on monocytes and the CD16 intensity on granulocytes in patients with septic shock were significantly lower than those in patients with sepsis. The serum IL-6 and 10 levels in patients with septic shock were significantly higher than those in patients with sepsis. The mean systolic blood pressure in patients with septic shock was significantly increased after the PMX-F treatment; furthermore, the HLA-DR expression on monocytes and the CD16 intensity on granulocytes were significantly increased after the PMX-F treatment. The serum IL-10 levels were significantly decreased after the PMX-F treatment. CONCLUSIONS:We showed that the surface antigens, HLA-DR on monocytes and CD16 on granulocytes, are extremely decreased in patients with septic shock, and that PMX-F treatment is effective for beneficially increasing the surface antigen expression on leukocytes. This therapy might be a new strategy for helping patients recover from immunoparalysis in septic conditions.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Ono S,Tsujimoto H,Matsumoto A,Ikuta S,Kinoshita M,Mochizuki Hdoi
10.1016/j.amjsurg.2003.12.067subject
Has Abstractpub_date
2004-08-01 00:00:00pages
150-6issue
2eissn
0002-9610issn
1879-1883pii
S0002961004001369journal_volume
188pub_type
杂志文章abstract::Previous "blind" surgical intervention for recurrent, sustained ventricular tachycardia has been disappointing. Successful surgical intervention requires that a local arrhythmia circuit be interrupted, ablated, or disengaged from the adjacent healthy myocardium while incurring minimal injury to the remaining functiona...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90128-9
更新日期:1983-06-01 00:00:00
abstract:BACKGROUND:The clinical pulmonary infection score (CPIS) and bronchoalveolar lavage (BAL) are 2 tools that have been validated to diagnose pneumonia in critically ill patients. However, the role of the CPIS in diagnosing trauma-associated pneumonia (TAP) remains in question. METHODS:This prospective observational stud...
journal_title:American journal of surgery
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abstract:BACKGROUND:It was hypothesized that routine operative drainage is unnecessary for elective hepatic resection. METHODS:A review was made of the clinical records of patients undergoing liver resection at a tertiary referral hepatobiliary surgery center since the conclusion in April of 1994 of our previous randomized dra...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00998-4
更新日期:2002-11-01 00:00:00
abstract::Part II of this two-part article (See The American Journal of Surgery 1992; 164: 85-9) reviews the current definition of the role of immunosuppressive therapy in inflammatory bowel disease (IBD) and the use of antibiotics in IBD, as well as summarizes the uses of the new agents on the horizon for the treatment of IBD....
journal_title:American journal of surgery
pub_type: 杂志文章,评审
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更新日期:1992-08-01 00:00:00
abstract:BACKGROUND:Michigan repealed a 35-year mandatory helmet law on April 13, 2012. We examined the early clinical impacts at a level 1 trauma center in West Michigan. METHODS:Retrospective cohort study comparing outcomes among motorcycle crash victims in a 7-month period before and after the helmet law repeal. RESULTS:On...
journal_title:American journal of surgery
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更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Patients with spinal cord injury (SCI) frequently have pressure ulcers. Surgery is sometimes needed to close them. In rare cases, hemipelvectomy is warranted for extremely severe complications. METHODS:We conducted a retrospective study using national Department of Veterans Affairs (DVA) computer data sets ...
journal_title:American journal of surgery
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doi:10.1016/s0002-9610(02)01123-6
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abstract::Sebaceous cell carcinoma of the parotid gland is a rare lesion. A review of the English literature reveals nine previously reported cases. Two cases are presented in which the tumor was originally diagnosed as mucoepidermoid carcinoma. Aggressive treatment of the recurrence, which was subsequently recognized as sebace...
journal_title:American journal of surgery
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doi:10.1016/0002-9610(75)90494-8
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abstract::The effect of sulindac, a nonsteroid antiinflammatory drug, on colon polyposis has been evaluated in seven patients after subtotal colectomy and ileoproctostomy and in four patients with intact colons. The patients all had Gardner's syndrome or familial polyposis coli. All polyps were eliminated, except for a few that...
journal_title:American journal of surgery
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更新日期:1989-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.07.023
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更新日期:2006-11-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.11.005
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the impact of computed tomographic (CT) scans of the abdomen on clinical outcomes and costs in young male patients presenting with suspected appendicitis. METHODS:Discharge data from the University HealthSystem Consortium was accessed for all male patients between 1...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.05.024
更新日期:2012-12-01 00:00:00
abstract::A significant amount of red blood cells were conserved with use of the Cell Saver in cardiac surgery patients and in some orthopedic and vascular surgery patients. No major complications have been associated with its use in our cases. Our results are similar to those of others who have reported on the use of this devi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90600-6
更新日期:1982-07-01 00:00:00
abstract::Early postoperative small bowel obstruction (ESBO) is a challenging problem. Although it is usually amenable to non-operative management, a significant proportion of patients will require re-operation. Certain causes of ESBO and types of index procedures should prompt consideration for early re-operation. A laparoscop...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2019.11.008
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Axillary lymph node dissection (ALND) is performed less commonly for the axillary staging of elderly patients because it is felt to uncommonly alter therapy. Sentinel lymph node (SLN) dissection can accomplish axillary staging with less morbidity, but it is unclear if it alters subsequent therapy. METHODS:R...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.03.028
更新日期:2005-09-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.08.031
更新日期:2006-12-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.025
更新日期:2009-11-01 00:00:00
abstract::The care of patients with rhabdomyosarcoma has undergone significant change in the past decade. Careful staging and multidisciplinary treatment have improved the prognosis for patients with this neoplasm. A review of the medical literature of the past decade documents these changes in staging, therapy and prognosis. ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/0002-9610(80)90059-8
更新日期:1980-11-01 00:00:00
abstract::The correlation between serum amylase and pancreatic amylase secretion was studied in two patients. Both patients underwent sphincterotomy, and the pancreatic duct was cannulated with a polyethylene tube. The tube was left in place for 15 to 21 days. The rate of amylase secretion over 7 days was studied in response to...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90178-7
更新日期:1982-05-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90431-1
更新日期:1976-01-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.10.050
更新日期:2006-03-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.01.007
更新日期:2013-04-01 00:00:00
abstract::During the past 5 years, extended cholecystectomy and/or more radical procedures, including pancreatoduodenectomy and extended hepatic lobectomy, were performed on 48 patients with carcinoma of the gallbladder in an attempt to cure the disease. It was retrospectively proven from microscopic analysis of the surgical sp...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90109-5
更新日期:1992-02-01 00:00:00
abstract:BACKGROUND:We hypothesized that medical experts would concur the American College of Surgeons/Association for Surgical Education Medical Student Simulation-based Surgical Skills Curriculum ("ACS/ASE Curriculum") could be used to teach and assess Entrustable Professional Activities (EPAs). METHODS:A "crosswalk" was cre...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.10.012
更新日期:2019-02-01 00:00:00
abstract::The value of barium enema examination in diagnosing acute appendicitis in patients with equivocal findings has been confirmed by our experience with five patients. Cecal spasm, extrinsic compression of the cecum, nonvisualization of the appendix, and partial visualization of the appendix appear to be useful roentgenog...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90306-4
更新日期:1979-12-01 00:00:00
abstract:BACKGROUND:Little is known regarding medical school curricular variability regarding safe prescribing of post-operative opioids for students entering surgical residency. METHODS:Surveys were administered to general surgery residency interviewees at an accredited academic institution for 2018-2019 application season. R...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.10.024
更新日期:2020-03-01 00:00:00
abstract::1. A well defined group of patients have been studied. 2. Composite operation resulted in a 56 per cent five year disease-free survival rate. 3. Treatment of recurrent disease with irradiation increased the five year survival to 61 per cent. 4. Preoperative irradiation for squamous cell carcinoma of the intraoral cavi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90490-0
更新日期:1975-10-01 00:00:00
abstract:INTRODUCTION:Medical students applying for general surgery residencies often require a letter of recommendation (LOR) from the Surgical Chair. However, LORs may reveal gender and ethnic bias. This study examines the presence of implicit bias in general surgery resident selection by evaluating chair LORs. METHODS:A ret...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.08.010
更新日期:2020-08-15 00:00:00
abstract::Technetium 99m-pyridoxylideneglutamate (99mTc-PG) administered intravenously is excreted by hepatocytes into the bile canaliculi and enters the gallbladder through the cystic duct and consequently, can be used for scanning the hepatobiliary ductal system. A total of 166 patients representing 27 normal subjects, 84 pat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90204-5
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:The treatment of idiopathic anal ulcerations in AIDS patients is still evolving. These patients suffer with severe incapacitating anal pain. PATIENTS AND METHODS:Relief of pain was achieved with the use of intralesional steroid injections. Twenty-one patients from 1990 to 1993 presented with severe anal pai...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00117-7
更新日期:1997-10-01 00:00:00