Abstract:
BACKGROUND:In trauma patients a specific pattern of the hormone endocrine response to injury has been described. Conflicting data exist regarding the hormonal changes during sepsis. We studied the time course and variability of the hormonal and metabolic responses to severe sepsis in twelve medical patients. METHODS:Hormone levels were measured every 6 hours. Urinary nitrogen and 3-methylhistidine excretion were measured daily. Indirect calorimetry was used to calculate energy production rate (EPR). RESULTS:None of the hormones measured showed a time course in individual patients. Growth hormone (1.69 +/- 0.17 ng/ml) and insulin (48 +/- 5 mU/L) values were within normal range. Cortisol value (474 +/- 44 nmol/L) was in the upper normal range. Insulin-like growth factor 1 level (12.5 +/- 5.7 nmol/L) was decreased. Nitrogen balance was negative and did not change during the study period. Neither oxygen consumption (VO2) (318 +/- 20 ml/min), carbon dioxide output (283 +/- 10 ml/min), EPR (2064 +/- 435 kcal/day), nor fuel utilization showed a time course. The variability during the study period compared with values on admission ranged from 20% (insulin-like growth factor 1) to 74% (growth hormone). The variability of calculated fuel utilization ranged from 35% (protein) to 180% (fat). The variability of VO2, carbon dioxide production, and EPR was for less, 8%. CONCLUSIONS:A specific pattern in the endocrine and metabolic responses as observed in trauma patients does not occur in medical patients with severe sepsis. Hormones and calculated fuel utilization show large variations when compared with values on admission. VO2 and EPR vary for less. Nutritional needs in patients with sepsis, therefore, can be calculated on admission and need not be recalculated during the first week after admission.
journal_name
Surgeryjournal_title
Surgeryauthors
Voerman HJ,Groeneveld AB,de Boer H,Strack van Schijndel RJ,Nauta JP,van der Veen EA,Thijs LGsubject
Has Abstractpub_date
1993-11-01 00:00:00pages
951-9issue
5eissn
0039-6060issn
1532-7361pii
0039-6060(93)90235-6journal_volume
114pub_type
杂志文章相关文献
SURGERY文献大全abstract:BACKGROUND:Little is known about the clinical significance and risk factors for incomplete liver restoration after partial hepatectomy, which is defined by a liver volume restoration of less than 100% of the original volume. METHODS:We retrospectively analyzed patients who underwent hepatic resection for liver tumors ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.02.022
更新日期:2020-07-01 00:00:00
abstract::The hydrogen gas clearance technique was evaluated to estimate regional hepatic blood flow. Initially, the H2 gas method was compared to the indocyanine green clearance in mini pigs. The blood flow measured by the H2 gas method (0.49 +/- 0.03 ml/min/gm) was only 39% of the calculated blood flow by the indocyanine gree...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract::Adenosine (Ado) is a potent coronary vasodilator. Recent studies suggest that Ado may also have an important effect on myocardial carbohydrate metabolism. To determine whether Ado has a direct effect on myocardial glucose uptake, a recirculating, constant-flow, isolated rat-heart preparation was used. The hearts were ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract:BACKGROUND:The process of extrinsic reinnervation after small bowel transplantation is poorly understood. METHODS:Jejunal and ileal specimens, obtained from the dogs that underwent intestinal autotransplantation by an end-to end (E-E) or end-to-side arterial reconstruction, were analyzed at 1 (n = 7), 3 (n = 6), 6 (n ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::The acquired failure of host immunocompetence that may result from significant protein and caloric malnutrition has been associated with an increased incidence of septic complications in patients undergoing operation. Wound infection in patients undergoing vascular surgical procedures may lead to exposure or contamina...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1983-06-01 00:00:00
abstract::The standard stainless steel Greenfield filter was modified by extending the limbs at the apex to permit loading into a 12F carrier for percutaneous insertion. This model was tested for fixation and resolution of experimental embolism in dogs (six filters in four dogs) and sheep (eight suprarenal filters in eight shee...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract::Forty-five consecutive patients with 49 fractures of the first rib caused by blunt trauma underwent arteriography. The fractures were classified as posterior, lateral, or anterior and as nondisplaced, minimally displaced, or significantly displaced. Seven patients (14%) had serious vascular injuries: five had posterio...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::Approximately 1,400 nuclear pacemakers have been implanted in patients since April, 1970, without a single battery failure; 64 of these have been implanted at the Newark Beth Israel Medical Center. All except four of the 64 pulse generators were attached to transvenous electrodes, 39 to pacing wires already in place. ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1975-12-01 00:00:00
abstract::To assess the role of portal hemodynamics in the development of postshunt encephalopathy, we studied 19 patients after small-diameter portacaval H grafting (SD-PCHG). We used contrast studies as well as technetium-labeled macroaggregated albumin injected into the portal vein to assess direction of portal flow. We then...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1984-08-01 00:00:00
abstract::We retrospectively reviewed 37 patients who underwent hepatic resection between 1970 and 1989 to evaluate the role of cytoreductive hepatic surgery in patients with metastatic neuroendocrine tumors (carcinoid, 24; islet cell, 13). Seventeen resections were curative (no gross residual tumor); nine patients had symptoma...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:High-dose perioperative corticosteroids are the standard of care for steroid-treated patients undergoing surgery. There is little evidence, however, to support this practice. We investigated the safety of perioperative low-dose steroids in patients with inflammatory bowel disease (IBD) undergoing major color...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2012.02.019
更新日期:2012-08-01 00:00:00
abstract::In a 2-year period 30 patients with persistent hyperparathyroidism following 59 prior unsuccessful procedures underwent reoperation. Preoperative arteriography was useful in planning the surgical approach in 56%, and retrospectively was correct in 63%. Selective venous catheterization gave localizing information in 83...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1978-06-01 00:00:00
abstract:BACKGROUND:Detecting metastases to the cervical lymph nodes is the main problem in the management of squamous cell carcinoma of the tongue. We investigated the ability of sentinel node (SN) biopsy to predict neck status in 11 patients with lateral T1-T2, N0, and M0 squamous cell carcinoma of the tongue who underwent ip...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2000.106809
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Hilar resection, especially in combination with liver resection, results in substantial morbidity and mortality, which clearly influences the overall outcome. In the present study, patients who underwent resection of a proximal bile duct tumor were analyzed with the aim of identifying risk factors for morbid...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2000.104250
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Apoptosis-suppressing gene, bcl-2, and apoptosis-inducing gene, bax, are expressed in various tumors. Human telomerase reverse transcriptase (hTERT) expression is increased in many cancers. The purpose of this investigation was to determine whether bcl-2 or bax gene expression differs between benign and mali...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2002.128616
更新日期:2002-12-01 00:00:00
abstract::Thirty-ones limbs of 29 consecutive patients undergoing bypass grafts to the tibial or peroneal arteries were studied. Twenty-five limbs had ischemic rest pain with or without localized gangrene, and six had incapacitating claudication. The mean segmental pressure indices were upper thigh, 1.16 +/- 0.36; above knee, 0...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract::The esophageal mucosa is exposed to damaging agents both by ingestion and reflux. Using our in vivo rabbit model of esophagitis, we have observed that acute luminal exposure (within 1 to 5 minutes) to potentially harmful agents, such as acid, bile, or ethanol, induces a rapid increase in mucosal blood flow; whereas pr...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:Although most pancreatic neuroendocrine tumors are solid, approximately 10% are cystic. Some studies have suggested that cystic pancreatic neuroendocrine tumors are associated with a more favorable prognosis. METHODS:A retrospective review of all patients with pancreatic neuroendocrine tumors who underwent ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2016.04.005
更新日期:2016-09-01 00:00:00
abstract::Previous studies performed in our laboratory with a constant-pressure model of hemorrhagic shock in the anesthetized rat have failed to find any significant effect of shock on the glycogen or high-energy phosphate content of the soleus muscle that would be consistent with inadequate oxygen supply. The present study ex...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract:BACKGROUND:The prevalence of insomnia in patients with symptomatic secondary hyperparathyroidism and the improvements of sleep disturbances after parathyroidectomy have not been previously reported. METHODS:Thirty-one patients who had undergone successful total parathyroidectomy and autotransplantation for symptomatic...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2004.12.010
更新日期:2005-04-01 00:00:00
abstract::This study examines the appropriateness of incidental appendectomy in the elderly. By examining the incidences of appendicitis and incidental appendectomy in 1977 in Wisconsin's elderly, this study calculated the chances that a citizen undergoing incidental appendectomy would have required otherwise an operation for a...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1980-08-01 00:00:00
abstract:BACKGROUND:Many breast cancer patients and survivors experience clinically significant distress, which poses a danger to both their psychologic and clinical well-being. Improved understanding of the types of distress that patients experience at the time of breast cancer diagnosis may reveal areas for intervention to im...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.04.051
更新日期:2020-11-01 00:00:00
abstract::This study evaluates the effect of reverse electrical pacing on intestinal absorption and transit time in an enterostomy model. Twenty-five male Sprague-Dawley rats (148 to 208 gm) underwent division and anastomosis of the proximal jejunum to eliminate the proximal gastroduodenal pacemaker. A 30.0 cm loop ileostomy wa...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-08-01 00:00:00
abstract:BACKGROUND:Ischemia-reperfusion injury of skeletal muscle is a common clinical and experimental problem. To date, there has been no uniform and reproducible method to assess the extent of histologic injury. In this study, we developed a novel statistical methodology for evaluating injury in individual myocytes and 3 di...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2007.06.005
更新日期:2008-01-01 00:00:00
abstract::Anomalies of the appendix are extremely rare. The case presented here has not been previously described and is that of a "horseshoe" appendix in a 33-year-old man with sigmoid diverticulitis. This appendiceal variant cannot be classified into any of the existing categories of appendiceal anomalies. ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00
abstract::An increase in the left ventricular end-diastolic pressure (LVEDP), resulting from the intravenous administration of blood, a colloid solution, or a crystalloid solution, was accompanied by an increase in both the inner:outer left ventricular wall flow ratio and the diastolic myocardial tissue pressure gradient. With ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1976-06-01 00:00:00
abstract:BACKGROUND:Resection for hepatocellular carcinoma in patients with cirrhosis and impaired liver function is usually unjustified because of higher surgical risks and poorer long-term prognosis. METHODS:A retrospective comparison of the background and resectional results of patients with cirrhosis and hepatocellular car...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(96)80238-8
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:Peptide receptor radionuclide therapy is a valid therapeutic option for pancreatic neuroendocrine neoplasms. The aim of this study was to describe an initial experience with the use of peptide receptor radionuclide therapy as a neoadjuvant agent for resectable or potentially resectable pancreatic neuroendocr...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2017.11.007
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Secondary peritonitis continues to carry a high mortality rate despite the aggressive use of imaging, drainage, and antibiotics. Although host factors and microbial burden contribute to the outcome of peritonitis, we propose a role for bacterial virulence as a determinant of outcome from peritonitis. Bacteri...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2012.06.022
更新日期:2013-01-01 00:00:00
abstract::Twenty-six cases of carcinoid-related mesenteric angiopathy and intestinal infarction (three from our institution and 23 previously reported cases) were reviewed. Twenty patients presented with acute abdominal findings, including peritonitis (13 cases), intestinal obstruction (five cases), and bleeding per rectum (two...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1981-10-01 00:00:00