Abstract:
BACKGROUND:The severity of ischemia and reperfusion (I/R) injury is an important determinant of patient outcome in hepatic surgery. The aim of this study was to investigate the efficacy of a protease inhibitor in alleviating I/R injury to human liver in the setting of hepatectomy under intermittent Pringle maneuver. METHODS:Sixty patients who underwent liver resection under conditions of intermittent inflow occlusion were randomly assigned to 2 groups (n = 30 each) according to the use of a synthetic protease inhibitor (gabexate mesilate or GM). GM was administered intravenously at a dosage of 2.0 mg/kg/h starting 12 hours before surgery until postoperative day 2. Preoperative and intraoperative clinical variables and postoperative outcomes were evaluated. The plasma levels of a cytokine, interleukin (IL)-6, as well as laboratory biochemical liver function parameters were analyzed to evaluate hepatic I/R injury. RESULTS:The 2 groups of patients were comparable with regard to hepatic inflow occlusion time, extent of liver resection, and background liver histology. The preoperative administration of GM (GM group) substantially alleviated hepatic I/R injury compared with the untreated control group; postoperative serum transaminase levels were significantly decreased in association with marked suppression of IL-6 levels in blood circulation during surgery. This was accompanied by a lower incidence of postoperative complications. The patients without postoperative complications had significantly lower activities of plasma IL-6 at 24 hours after surgery. CONCLUSIONS:This prospective randomized study demonstrated the hepatoprotective effect of a synthetic protease inhibitor in the setting of hepatectomy under the intermittent Pringle maneuver.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Kim YI,Chung HJ,Song KE,Hwang YJ,Lee JW,Lee YJ,Chun BYdoi
10.1016/j.amjsurg.2005.04.018subject
Has Abstractpub_date
2006-01-01 00:00:00pages
72-6issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(05)00798-1journal_volume
191pub_type
杂志文章,随机对照试验abstract:BACKGROUND:The transformation of a trainee into a surgeon is influenced strongly by communication patterns in the operating room (OR). In the current era of limited educational opportunities, elucidation of teaching and learning strategies in this environment is critical. The aim of this study was to further understand...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.01.004
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Many women with breast cancer recurrence previously treated with breast-conservation therapy desire repeat lumpectomies. We hypothesized that women undergoing mastectomy for breast cancer recurrence would show superior survival. METHODS:Patients who previously received breast-conservation therapy diagnosed ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.06.018
更新日期:2008-10-01 00:00:00
abstract::A new instrument for the placement of U tubes through malignant and benign biliary strictures consists of a 3 mm Bakes dilator modified by a circumferential groove and a small hole through its tip. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90082-5
更新日期:1979-03-01 00:00:00
abstract::Our experience from 1960 to 1976 with total infrarenal aortic thrombosis (Leriche syndrome) was reviewed. Sixteen heavy smokers (14 men and 2 women) with an average age of fifty-four years underwent thrombectomy with aortoiliac (12 patients) or aortofemoral (4) Dacron bypasses. The last ten patients were hydrated for ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90331-2
更新日期:1977-12-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to assess how the practice patterns of breast surgeons affect their income and job satisfaction. METHODS:A 19-question survey regarding practice patterns and income and job satisfaction was mailed to all active US members of the American Society of Breast Surgeons. RESULTS:The...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.09.006
更新日期:2010-03-01 00:00:00
abstract::Follicular carcinoma of the thyroid usually metastasizes through a hematogenous route to the bone, lung, and central nervous system. Metastasis to subcutaneous tissues and retro-orbital region is unusual. We report an unusual case of follicular thyroid carcinoma with metastasis to subcutaneous tissues in the right tem...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.048
更新日期:2010-06-01 00:00:00
abstract::The charts of 81 patients who underwent skull base surgery between 1982 and 1993 were reviewed retrospectively. Data relative to demographic aspects, clinical stage, previous treatment, surgical approach, type of reconstruction, histology, extent of disease, complications, and follow-up were analyzed. The craniofacial...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80106-0
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:We evaluated coronary angiography use among patients with coronary stents suffering postoperative myocardial infarction (MI) and the association with mortality. METHODS:Patients with prior coronary stenting who underwent inpatient noncardiac surgery in Veterans Affairs hospitals between 2000 and 2012 and ex...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.07.023
更新日期:2016-11-01 00:00:00
abstract::Nitric oxide (NO), a paracrine-acting gas enzymatically synthesized from L-arginine, is a unique biologic mediator that has been implicated in a myriad of physiologic and pathophysiologic states. It is an important regulator of vascular tone and may be the mediator of the hemodynamic changes involved in sepsis and cir...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80017-0
更新日期:1995-09-01 00:00:00
abstract::This study has summarized our results with popliteal-tibial in situ saphenous vein bypass in 26 patients, 25 of whom were diabetic, over a 2 year period. Both above- and below-knee popliteal inflow sites were used for bypass of limb-threatening ischemia. Distal calf or pedal outflow sites were required in all but two ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90191-7
更新日期:1987-08-01 00:00:00
abstract::Despite the advantages of aseptic nonoperative intubation of the small intestine for decompression of obstructed loops, 48% of the attempts lead to failure to pass the tube through the pylorus. The difficulty and inconvenience of passage beyond the stomach have been overcome by the development of a special tube attach...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90427-x
更新日期:1976-01-01 00:00:00
abstract:BACKGROUND:Traditional management of symptomatic paraesophageal herniation involves hernia reduction, hiatal closure, and an antireflux procedure or gastropexy. Patients with significant comorbidities may not tolerate operative repair. A new technique, laparoscopic-assisted endoscopic reduction and fixation of the stom...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00760-7
更新日期:2001-11-01 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:Trovafloxacin, a broad-spectrum fourth-generation quinolone with gram-positive and gram-negative aerobic and anaerobic bacterial activity, is available in oral and intravenous formulations. The objective of this prospective, multicenter, double-blind, randomized study was to compare the efficacy of trovaflox...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0002-9610(98)00223-2
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:Laparoscopic rectal cancer surgery involving rectal division with intracorporeal stapling devices is technically difficult. This study aimed to identify risk factors for anastomotic leakage associated with laparoscopic anterior resection for rectal cancer. METHODS:We studied 363 patients who underwent lapar...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.11.014
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Methylene blue dye (MBD) is being used as an alternative to isosulfan blue dye in sentinel lymph node (SLN) biopsies for breast cancer patients. Complications using MBD for SLN localization have not previously been reported. METHODS:A retrospective study was conducted of 24 consecutive patients who received...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00945-5
更新日期:2002-10-01 00:00:00
abstract:PURPOSE:The goal of this study was to evaluate the efficacy, morbidity and safety of local parastomal hernia repair using biological mesh. PATIENTS AND METHODS:A retrospective analysis of a prospectively maintained database was performed for parastomal hernia repairs. All patients who underwent local parastomal hernia...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.05.005
更新日期:2018-01-01 00:00:00
abstract::The cusps of valve-bearing segments of canine cephalic, femoral, and jugular veins were completely divided and were used in interposition grafts in the femoral and carotid arteries in the nonreversed position. Three control grafts had intact valves in the reversed position, and one control graft in the reversed positi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80035-0
更新日期:1985-04-01 00:00:00
abstract::There is still considerable controversy among surgeons regarding the most opportune moment for surgical intervention in the case of acute cholecystitis. For this reason, 471 patients cholecystectomized for acute cholecystitis from 1970 through 1982 were studied. During the first period, there were two types of surgica...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90334-9
更新日期:1984-11-01 00:00:00
abstract:BACKGROUND:Studies of gender disparity in surgical training have yielded conflicting results. We hypothesize that there is no influence of gender on resident self-evaluation Milestone (SEM) scores and those assigned by the Clinical Competency Committee (CCC). METHODS:42 residents (25 male & 17 female) and faculty comp...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.12.020
更新日期:2020-12-13 00:00:00
abstract:BACKGROUND:Most thymectomies are performed via sternotomy. Minimally invasive thymectomy (MIT) has been described but its potential benefits and drawbacks remain unclear. METHODS:A retrospective chart review comparing thymectomies performed via sternotomy to MIT at a single institution between 2005 and 2009. RESULTS:...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.01.001
更新日期:2010-05-01 00:00:00
abstract::Since its inception in 1994, the National Surgical Quality Improvement Program (NSQIP) has been used to compare the performance of all Veterans Administration (VA) hospitals offering major surgical procedures. The program's outcome data are used to identify areas of both excellent and poor performance. The data can al...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.10.004
更新日期:2004-12-01 00:00:00
abstract::In his presidential address to the Southwestern Surgical Congress, he examines surgery as a profession from three different perspectives: his experience as a patient, a surgeon, and a photographer. He uses photography to illustrate the importance of perspective and illumination. He respectfully suggests that we should...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.09.002
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The changing environment in academic medical centers has had a major effect on the recruitment and the demographic characteristics of leadership positions in academic surgery. Categorization of "cultures" from the business model has been extrapolated into the academic surgical model. METHODS:The types of cu...
journal_title:American journal of surgery
pub_type: 历史文章,杂志文章
doi:10.1016/s0002-9610(02)00814-0
更新日期:2002-04-01 00:00:00
abstract::From April 1, 1990, to March 31, 1992, 8,899 patients who were 65 years of age and older underwent an anesthetic and surgical procedure in a 1,000-bed community hospital in Victoria, British Columbia, Canada. The hospital has been using a proprietary system called MedisGroups for assessing the severity of illness on a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80438-6
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Previous reports of minimally invasive antireflux surgery for gastroesophageal reflux disease (GERD) have been small, short-term series utilizing only a laparoscopic approach. We conducted a retrospective review and report our 66-month experience with more than 1,000 laparoscopic and thoracoscopic antireflux...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00034-8
更新日期:1998-04-01 00:00:00
abstract::Our thirteen year experience with villous adenomas of the colon and rectum, embracing 264 patients, is reported. The average age of patients was sixty-two years with an almost equal sex distribution. Seventy-two per cent of the lesions occurred in the rectum and rectosigmoid and the most frequent symptoms were rectal ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90430-4
更新日期:1975-12-01 00:00:00
abstract::Miliary tuberculosis is the most lethal form of tubercular disease. If dissemination of tubercle bacilli occurs without therapy, death is almost certain. The importance of establishing an etiologic diagnosis as promptly as possible in patients receiving immunosuppressive therapy is self-explanatory. The presence of a ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90402-x
更新日期:1975-09-01 00:00:00
abstract::Trovafloxacin, a new fluoronaphthyridone derivative related to fluoroquinolone antimicrobial drugs, has demonstrated the following characteristics: significant gram-positive and gram-negative activity; significant activity against anaerobes and atypical respiratory pathogens; approximately 11-hour elimination half-lif...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00213-x
更新日期:1998-12-01 00:00:00
abstract::On rare occasions, emergency tracheostomy is indicated to establish an airway. Using a large bore needle as a guide, tracheal intubation is assured with minimal damage to vital structures in the neck. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90198-7
更新日期:1976-06-01 00:00:00