Abstract:
:Although previous studies have suggested that bacteria may contribute to pigment gallstone formation, the current experiments provide evidence that bacteria have a central role in this process. The studies included scanning electron microscopy (SEM) of gallstones, measurements of bacterial adherence to gallstones in vitro, and determination of glycocalyx elaboration by biliary bacteria. Gallstones from 85 patients were studied under SEM. Twenty-five (78%) of 32 pigment stones had evidence of bacterial microcolonies throughout the interior of the stones. Bacteria were absent from the interior of all 35 cholesterol stones studied. Composite stones (stones with separate pigment and cholesterol portions) showed evidence of bacteria within the pigment portions in 14 (78%) of 18 cases. Biliary bacteria adhered to the surface of pigment gallstones in vitro in 35 (90%) of 39 cases, compared with three (8%) of 39 cholesterol stones. Glycocalyx was elaborated by bacteria isolated from nine (82%) of 11 patients with either pigment or composite gallstones. One (33%) of three bacterial species from patients with cholesterol gallstone disease produced glycocalyx. These studies indicate that most pigment gallstones obtained from patients in Western cultures form as a composite of bacteria, bacterial glycocalyx, and pigment solids. Bacteria were found in the majority of black as well as brown pigment stones. These findings serve as the basis of a new theory of pigment stone formation in which bacteria and glycocalyx are postulated to be responsible for the precipitation and subsequent agglomeration of bilirubin pigment. These results also suggest that sepsis is more common in pigment gallstone disease because the stones can serve as a sanctuary for bacteria.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Stewart L,Smith AL,Pellegrini CA,Motson RW,Way LWdoi
10.1097/00000658-198709000-00002subject
Has Abstractpub_date
1987-09-01 00:00:00pages
242-50issue
3eissn
0003-4932issn
1528-1140journal_volume
206pub_type
杂志文章abstract:OBJECTIVE:The HepatAssist liver support system is an extracorporeal porcine hepatocyte-based bioartificial liver (BAL). The safety and efficacy of the BAL were evaluated in a prospective, randomized, controlled, multicenter trial in patients with severe acute liver failure. SUMMARY BACKGROUND DATA:In experimental anim...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/01.sla.0000124298.74199.e5
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:To evaluate angiographic and clinical outcomes associated with open and closed dissection tunnel endoscopic vein harvesting (EVH) devices. BACKGROUND:A previous PREVENT-IV (PRoject of Ex-vivo Vein graft ENgineering via Transfection IV) analysis reported that EVH for coronary artery bypass graft surgery was a...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000000377
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Clinical coding is the translation of clinical activity into a coded language. Coded data drive hospital reimbursement and are used for audit and research, and benchmarking and outcomes management purposes. METHODS:We undertook a 2-center audit of coding accuracy across surgery. Clinician-auditor multidisci...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000851
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:To compare three options for the elective treatment of portal hypertension during a 10-year period. METHODS:Patients included in the trial were 18 to 76 years old, had a history of bleeding portal hypertension, and had undergone no prior treatment. Treatment options were beta-blockers (propranolol), scleroth...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200008000-00011
更新日期:2000-08-01 00:00:00
abstract::This report describes 140 cases in which Linton splenorenal shunts were performed for the management of the complications of portal hypertension by a large number of surgeons in a single hospital. There was a history of variceal bleeding in 130. Using the Childs designation to reflect hepatic functional reserve, the o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198212001-00008
更新日期:1982-12-01 00:00:00
abstract:OBJECTIVE:To determine overall survival and disease-free survival in selected patients with nonresectable liver-only colorectal cancer receiving liver transplantation. BACKGROUND:Patients with nonresectable colorectal cancer receiving palliative chemotherapy has a 5-year overall survival of about 10%. Liver transplant...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0000000000003404
更新日期:2020-02-01 00:00:00
abstract::Middle aortic syndrome typically occurs as severe hypertension in young patients who have weak or absent femoral pulses and an abdominal bruit. It results from a diffuse narrowing of the distal thoracic and abdominal aorta, commonly involving the visceral and renal arteries. The clinical presentation, angiographic ass...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198609000-00012
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVE:This single-institution review examined the incidence of biliary stricture formation after pancreaticoduodenectomy (PD) for benign and malignant periampullary disease. BACKGROUND:The incidence and course of stricture of the hepaticojejunostomy have not been documented after PD. METHODS:Between January 1995 ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000216285.07069.fc
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:To describe causes of death in the first year after esophagectomy and determine the time frame that should be used for measurement of quality of surgery. A case-mix adjustment model was developed for the comparison between hospitals. BACKGROUND:The time period in which postoperative mortality should be measu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000482
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:This study hypothesized that tumor size, number of tumors, surgical approach, and tumor histology significantly affected microwave ablation (MWA) success and recurrence-free survival. BACKGROUND:Although many hepatobiliary centers have adopted MWA, the factors that influence local control are not well descri...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000234
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this retrospective cohort study was to investigate whether current practice where residents perform appendectomies affects quality of care. Therefore, we investigated whether there was a difference in incidence of complications and mortality in appendectomies performed by surgeons (S), supervis...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318248bdb5
更新日期:2012-04-01 00:00:00
abstract::Pressures in the Oddi sphincter and common bile duct were determined before, immediately after and several weeks after endoscopic papillotomy. Fifteen patients were included in the study. Significant decreases in Oddi sphincter and common bile duct pressures were found and the decrease in Oddi sphincter pressure was t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197908000-00009
更新日期:1979-08-01 00:00:00
abstract:OBJECTIVE:To compare outcomes of fenestrated (FEVAR) and open repairs of complex abdominal aortic aneurysms (cAAA). BACKGROUND:FEVAR has emerged as an alternative to open surgery for treating cAAA, but direct comparisons are limited. METHODS:We studied all repairs of intact or symptomatic cAAA in the Vascular Quality...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000003094
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES:Early hospital readmission is a common and costly problem in the Medicare population. In 2009, the Centers for Medicaid and Medicare Services began mandating hospital reporting of disease-specific readmission rates. We sought to determine the rate and predictors of readmission after colectomy for cancer, as ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181d3d27c
更新日期:2010-04-01 00:00:00
abstract::In an attempt to determine the best provocative test for the diagnosis of gastrinoma, ten normal subjects, 13 patients with known gastrinoma, and one patient with presumed gastrinoma were administered four regimens: (1) rapid calcium infusion (2 mg Ca++/kg/min), (2) secretin (2 clinical units (CU)/kg/bolus), (3) long ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198305000-00015
更新日期:1983-05-01 00:00:00
abstract:OBJECTIVE:Using a prospective randomized study to assess postoperative morbidity and pancreatic function after pancreaticoduodenectomy with pancreaticojejunostomy and duct occlusion without pancreaticojejunostomy. SUMMARY BACKGROUND DATA:Postoperative complications after pancreaticoduodenectomy are largely due to leak...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200210000-00004
更新日期:2002-10-01 00:00:00
abstract::Prior experience with the rare combination of horseshoe kidney and significant atherosclerotic vascular disease suggests difficulty in intraoperative management, often requiring division of the renal isthmus or sacrifice of some renal tissue. Seven patients have been managed successfully over the past ten years at The...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197807000-00012
更新日期:1978-07-01 00:00:00
abstract::A total of 360 patients underwent preoperative cardiac risk assessment using 23 clinical parameters, seven multivariate clinical scoring systems, and quantitative dipyridamole-thallium imaging to predict postoperative and long-term myocardial infarction and cardiac death after noncardiac surgery. There were 30 postope...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199208000-00010
更新日期:1992-08-01 00:00:00
abstract::Gastric carcinoma following operation for benign peptic ulcer disease has been considered rare but nine patients have been seen during the past five years. All were male patients, the average time interval from prior ulcer operation to development of cancer was 17 years, but was a short as ten years. The symptoms of c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197803000-00007
更新日期:1978-03-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to identify the utility of "keyhole" thoracotomy approaches to single vessel coronary artery bypass surgery. SUMMARY BACKGROUND DATA:Although minimally invasive surgery is efficacious in a wide variety of surgical disciplines, it has been slow to emerge in cardiac surgery. Amo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199610000-00004
更新日期:1996-10-01 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:OBJECTIVE:To describe the outcomes of elderly patients with do-not-resuscitate (DNR) status who undergo emergency general surgery and to improve understanding of the relationship between preoperative DNR status and postoperative mortality. BACKGROUND:Preoperative DNR status has previously been shown to predict increas...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31826578fb
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to compare the hand-sewn and stapled methods in esophagogastric anastomosis. SUMMARY BACKGROUND DATA:After esophageal resection for cancer, the relative merits of the hand-sewn and the stapled methods of esophagogastric anastomosis, especially regarding leakage and stricture r...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199708000-00008
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To analyze the association between pre- and perioperative factors and pouch-related septic complications (PRSC) in ulcerative colitis (UC) and in familial adenomatous polyposis (FAP) after ileal pouch-anal anastomosis (IPAA). SUMMARY BACKGROUND DATA:For patients with UC and FAP, IPAA is the surgical therapy ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200202000-00008
更新日期:2002-02-01 00:00:00
abstract::Adenocarcinoma involving the distal esophagus usually is far advanced when the patient is first seen. Adenocarcinoma differs from squamous carcinoma of the esophagus since it is relatively unresponsive to radiation therapy or chemotherapy. Adenocarcinoma of the esophagus resembles gastric cancer in its tendency to for...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198705000-00015
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:To compare the accuracy of the modified Fried Index (mFI) and the Clinical Frailty Scale (CFS) to predict death or patient-reported new disability 90 days after major elective surgery. BACKGROUND:The association of frailty with patient-reported outcomes, and comparisons between preoperative frailty instrumen...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002967
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate the psychosocial outcomes and body image of patients 2 years postmastectomy reconstruction using a multicenter, multisurgeon approach. BACKGROUND:Although breast reconstruction has been shown to confer significant psychosocial benefits in breast cancer patients at year 1 postreconst...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e3181728a5c
更新日期:2008-06-01 00:00:00
abstract::The object of this study was to compare the ultrastructure pulmonary effects of the infusion of homologous and heterologous serum albumin solution in the treatment of hemorrhagic shock in baboons. Adult baboons subjected to hemorrhagic shock were resuscitated with either baboon serum albumin, human serum albumin, or R...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197902000-00016
更新日期:1979-02-01 00:00:00
abstract::A historical review of work bearing on the rationale for hepatic artery ligation in the treatment of malignant disease in the liver is presented, particularly the early work showing that malignant disease of the liver is supplied primarily by the arterial circulation and not by the portal. A review is presented of som...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197409000-00008
更新日期:1974-09-01 00:00:00
abstract::Medullary thyroid carcinoma (MTC) develops in virtually all patients affected with multiple endocrine neoplasia type II (MEN II), a disease inherited as an autosomal dominant trait. The thyroid tumor cells secrete calcitonin (CT) and the detection of elevated plasma levels (>300 pg/ml) of this hormone in MEN II kindre...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197809000-00013
更新日期:1978-09-01 00:00:00