Abstract:
BACKGROUND:Despite successful revascularization of ischemic extremities, multiorgan dysfunction syndrome develops in some patients. Mechanisms responsible for this are not known; however, the gastrointestinal tract has been implicated as a possible mediator. Our objective was to demonstrate increased intestinal mucosal permeability after bilateral hindlimb ischemia-reperfusion (I-R) in a rodent model. METHODS:Sixteen male Wistar rats were randomized either to 4 hours of bilateral hindlimb tourniquet ischemia and 24 hours of reperfusion (n = 8) or control groups (n = 8). The animals received 10 MuCi 51Cr-ethylenediaminetetraacetic acid (EDTA) by gavage, and excretion was measured in urine collected every 8 hours in 16 animals and every 4 hours in 8 animals. Arterial blood pressure was monitored continuously. Intravenous normal saline solution (3 ml/hr) with fentanyl (2 microgram/100 gm/hr) was continuously administered. Immediately before death complete blood count and levels of arterial lactate, creatinine, and urea were obtained. Mesenteric lymph nodes were harvested from the ileocecal region and cultured. Distal small bowel and proximal colon were preserved for histologic analysis. An additional 11 rats, six experimental and five control, were evaluated for mesenteric lymph node cultures only. RESULTS:Urinary excretion of 51Cr-EDTA was significantly greater in the I-R group between 0 and 8 hours (p < 0.02) and 8 to 16 hours (p < 0.0002) of reperfusion. This increase occurred as early as 4 to 8 hours of reperfusion (p < 0.0001). Urine volume in the I-R group was significantly reduced during 0 to 4 hours of reperfusion (p < 0.002). Hemoglobin and lactate level were significantly different in the I-R group. Leukocyte and platelet counts, levels of creatinine and urea, and colony counts from mesenteric lymph nodes were similar in I-R and control groups. Blinded histologic analysis of bowel segments did not reveal morphologic differences. CONCLUSIONS:Bilateral hindlimb I-R produces remote intestinal mucosal injury shown by significantly increased permeability to 51Cr-EDTA. Such increased mucosal permeability may be important in the development of multiorgan dysfunction syndrome in patients who sustain lower extremity I-R injury.
journal_name
Surgeryjournal_title
Surgeryauthors
Willoughby RP,Harris KA,Carson MW,Martin CM,Troster M,DeRose G,Jamieson WG,Potter RFdoi
10.1016/s0039-6060(96)80076-6subject
Has Abstractpub_date
1996-09-01 00:00:00pages
547-53issue
3eissn
0039-6060issn
1532-7361pii
S0039-6060(96)80076-6journal_volume
120pub_type
杂志文章相关文献
SURGERY文献大全abstract:BACKGROUND:Bacterial translocation has been implicated in the alteration of the immune response after shock and trauma. This study examined the effect of bacterial translocation on myelopoiesis after hemorrhagic shock in germ-free and conventional rats. METHODS:Awake, unrestrained germ-free and conventional rats were ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
abstract::The diagnosis of multiple endocrine neoplasia (MEN) in patients with presumed hyperparathyroidism has important ramifications for patient management especially since as many as 20% of patients with hyperparathyroidism may have associated MEN. Gut hormone levels were measured before and after surgery in 28 patients who...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract:BACKGROUND:Obesity is known as a risk factor for intra- and postoperative complications in pancreatic operation. However, the operative outcomes in obese patients undergoing laparoscopic distal pancreatectomy remain unclear. METHODS:A total number of 423 patients underwent laparoscopic distal pancreatectomy at Oslo Un...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2016.05.046
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:In the evaluation of patients with primary hyperparathyroidism (PHP), specific query for a personal or family history of MEN1 (Hx) is recommended widely, but responses are rarely positiv. We instituted a 6-question panel (6Q) to routinely screen for MEN1 preoperatively. METHODS:The clinical database entries...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2008.07.030
更新日期:2008-12-01 00:00:00
abstract::We found mentions of 581 resections of hilar bile duct cancer in the literature to January 1989. Resection in 499 patients, reported or updated since 1980, resulted in an operative mortality of 12% and a 5-year survival rate of 13%. Resections confined to the hepatic duct confluence or extended to the quadrate lobe le...
journal_title:Surgery
pub_type: 杂志文章,评审
doi:
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:The management of low-risk micropapillary thyroid cancer <1 cm in size has come into question, because recent data have shown that nonoperative active surveillance of micropapillary thyroid cancer is a viable alternative to hemithyroidectomy. We conducted a cost-effectiveness analysis to help decide between ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2016.06.076
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:We previously demonstrated that therapy with a new endothelin A receptor antagonist (ET-RA) significantly reduced mortality rates in severe acute pancreatitis (AP) in the rat without attenuating local signs of disease severity (intrapancreatic protease activation, acinar cell necrosis). This raised the quest...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2000.107104
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:Cathepsin D is a widely distributed lysosomal acidic endopeptidase. It is an estrogen-regulated protein that is a prognostic factor in breast cancer. The aim of this study was to measure cathepsin D concentrations in thyroid tissues and to correlate these concentrations with clinical and pathologic parameter...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(05)80111-4
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:The "July phenomenon," a common belief in medical academia, refers to purported errors, inefficiency, and negative outcomes during the summertime transition of the house staff. We hypothesized that care in a trauma service is consistent throughout the year and that the July phenomenon therefore is a myth. M...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2001.116670
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:With the large amounts of data on patient, tumor, and treatment factors available to clinicians, it has become critically important to harness this information to guide clinicians in discussing a patient's prognosis. However, no widely accepted survival calculator is available that uses national data and inc...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2015.08.006
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Small bowel neuroendocrine tumors (SBNETs) present frequently with metastases, yet little is known about the molecular basis of this progression. This study sought to identify the serial differential expression of genes between normal small bowel, primary small bowel neuroendocrine tumors, and liver metastas...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2017.07.031
更新日期:2018-01-01 00:00:00
abstract::Twenty dogs underwent 15 minutes of normothermic ischemic arrest and 30 minutes of reperfusion while on cardiopulmonary bypass. In 10 control dogs, the reperfusate blood was not modified. In 10 other dogs, the aorta was reclamped and the heart reperfused for 5 minutes with blood containing L-glutamate (0.026M). We mea...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1980-11-01 00:00:00
abstract::Nelson's syndrome--progressive cutaneous hyperpigmentation with x-ray film evidence of an expanding pituitary tumor--is now a well-recognized sequela of bilateral adrenalectomy for Cushing's disease. It is estimated to occur in 8% to 38% of adults. Because Cushing's disease is rare in children, a higher incidence of N...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:To help control the coronavirus disease 2019 pandemic, elective procedures have been cancelled in most US hospitals by government order. The purpose of this study is to estimate national hospital reimbursement and net income losses owing to elective surgical procedure cancellation during the coronavirus dise...
journal_title:Surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.surg.2020.07.014
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Long-term outcomes after face transplantation are rarely reported in the scientific literature. Here we present outcome data of a partial face allograft recipient 10 years after transplantation. METHODS:Medical records were reviewed for functional and psychosocial outcomes as well as complications. Histopat...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.01.010
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Adequate surgical care is lacking in many low- and middle-income countries because of diverse barriers preventing patients from reaching providers. We sought to assess perceived difficulties to accessing surgical care in Nepal using the Surgeons OverSeas Assessment of Surgical Need tool. METHODS:Fifteen of ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2016.03.012
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:High rates of extrapancreatic malignancies (EPM) have been observed in patients with intraductal papillary mucinous neoplasm (IPMN). IPMN in patients with familial pancreatic cancer have also been reported. Our purpose was to evaluate the association of IPMN with EPM, malignancies in family members, and germ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2011.06.036
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Benign thyroid cysts have been successfully treated with nonoperative sclerotherapy. Although OK-432 is a safe and effective sclerosing agent used to treat benign cystic lesions, little is known about its effectiveness in thyroid cysts. This study tested the efficacy of OK-432 sclerotherapy for thyroid cysts...
journal_title:Surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.surg.2008.06.014
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:We have demonstrated that gastrin-releasing peptide (GRP) binds specifically to its cell surface receptor, GRP-R, to act as an autocrine/paracrine growth factor for neuroblastomas (NBs); an increased expression of GRP-R was found in more advanced-stage NBs. Ets family proteins are nuclear targets for intrace...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2004.05.030
更新日期:2004-08-01 00:00:00
abstract::Computed tomography was used to evaluate 25 hemodynamically stable patients with suspected leaking abdominal aortic aneurysms. Of 10 patients found to have the presence of free retroperitoneal blood, six underwent immediate operation and five survived (83%). Delay in operation uniformly resulted in death. There was on...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:The nonparenchymal cells (NPC) of the liver have strong cytotoxic activity. Our hypothesis is that their activity may be imparted by obstructive jaundice and show recovery after biliary drainage. METHODS:In Donryu rats, we performed either a sham operation (group C; n = 5), production of irreversible obstru...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Certain behavioral traits and inadequate social support are known risk factors for complications after cancer surgery. Despite their importance, it is unclear whether conventional patient preoperative evaluation captures them. This study was conducted to assess concordance between documentation and patient s...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2019.04.015
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Surgical wrapping (SW) of the pancreas causes islet neogenesis in rodents. Pancreatic duodenal hoemobox-1 (PDX-1) is one of the transcriptional factors needed by pancreatic stem cells to develop a mature pancreas. The purpose of this study was to determine whether islet neogenesis arises from ductal cells an...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(03)00394-5
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:For the normal resolution of an acute inflammatory response, neutrophil (PMN) apoptosis is essential to maintain immune homeostasis and to limit inappropriate host tissue damage. A delay in PMN apoptosis has been implicated in the pathogenesis of the systemic inflammatory response syndrome (SIRS). Dopamine, ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Cigarette smoke and nicotine are among the leading environmental risk factors for developing pancreatic ductal adenocarcinoma (PDA). We showed recently that nicotine induces osteopontin (OPN), a protein that plays critical roles in inflammation and tumor metastasis. We identified an OPN isoform, OPNc, that i...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2010.05.002
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Recent evidence suggests that gadolinium ethoxybenzyl diethylenetriamine penta acetic acid-enhanced (Gd-EOB-DTPA) magnetic resonance imaging may be used to evaluate liver function. The aim of this study was to assess whether the signal intensity of Gd-EOB-DTPA magnetic resonance imaging may be used to predic...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.04.041
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:In an attempt to prevent overly aggressive treatment of low-risk thyroid cancers, the American Thyroid Association changed guideline recommendations in late 2015 to state that either hemithyroidectomy or total thyroidectomy are acceptable operations for these patients. We hypothesized that surgeons would inc...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2019.03.002
更新日期:2019-09-01 00:00:00
abstract::Bile peritonitis after injury to the biliary tree is a serious complication that requires exploratory laparotomy. Our patient had an obstructing ampullary carcinoma, and generalized bile peritonitis developed from attempted percutaneous transhepatic cholangiography. The patient's condition was managed by peritoneal la...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:We wished to determine the role and significance of preoperative chemotherapy and radiotherapy in management of operable cancer of the esophagus. METHODS:Twenty-two patients with clinical stage I-II cancer of the esophagus were entered in a prospective study of preoperative chemotherapy (5-fluorouracil/cisp...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:Vascular endothelial growth factor (VEGF) promotes tumor angioinvasion while VEGF-C is a potent lymphangiogenic factor. This study aims at evaluating serum VEGF (sVEGF) and sVEGF-C levels in recurrent papillary thyroid carcinoma (PTC) patients. METHODS:Serum samples were collected preoperatively from 85 pat...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2008.07.027
更新日期:2008-12-01 00:00:00