Abstract:
:Hypermetabolism characterizes the metabolic response to thermal injury and the extent of energy production is positively related to the rate of urinary catecholamine excretion. Alpha and beta adrenergic blockade decreased metabolism from 69.6 +/- 5.3 Kcal/m(2)/hr to 57.4 +/- 5.2 (p < 0.01), and infusion of 6 microgm epinephrine/minute in normal man significantly increased metabolic rate. Twenty noninfected burned adults with a mean burn size of 45% total body surface (range 7-84%) and four normal controls were studied in an environmental chamber at two or more temperatures between 19 and 33 C with vapor pressure constant at 11.88 mm Hg. All burn patients were hypermetabolic at all temperatures studied and their core and mean skin temperatures were significantly elevated above control values. Between 25 and 33 C ambient, metabolism was unchanged in controls and burns of less than 40% total body surface (48.9 +/- 4.6 Kcal/m(2)/hr vs. 48.9 +/- 4.5), but metabolic rate decreased in larger burns in the warmer environment (72.0 +/- 1.9 vs. 65.8 +/- 1.7, p < 0.001). At 21 C, metabolism and catecholamines increased, except in four nonsurvivors who became hypothermic with decreased catechol elaboration. Metabolic rate in ten patients with bacteremia was below predicted levels while catecholamines were markedly elevated suggesting interference with tissue uptake of the neurohormonal transmitters. Feeding burn patients or administering glucose and insulin improved nitrogen retention and altered substrate flow but did not significantly reduce urinary catecholamines or metabolic rate. Burned patients are internally warm, not externally cold, and catecholamines appear to mediate their increased heat production. Hypermetabolism may be modified by ambient temperature, infection, and pharmacologic means. Alterations in hypothalamic function due to injury, resulting in increased catecholamine elaboration, would explain the metabolic response to thermal injury.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Wilmore DW,Long JM,Mason AD Jr,Skreen RW,Pruitt BA Jrdoi
10.1097/00000658-197410000-00031subject
Has Abstractpub_date
1974-10-01 00:00:00pages
653-69issue
4eissn
0003-4932issn
1528-1140journal_volume
180pub_type
杂志文章abstract:OBJECTIVE:To compare the clinical, microbiological, and therapeutic features of nonpostoperative nosocomial intra-abdominal infections (non-PostopNAI) with community-acquired intra-abdominal infections (CAI). SUMMARY BACKGROUND DATA:Prospective (June 2000 through January 2001) consecutive case series analysis of patie...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/01.sla.0000114214.68169.e9
更新日期:2004-03-01 00:00:00
abstract::Midgestation fetal wound healing is characterized by healing without fibrosis or scar formation. The mechanisms that underlie this remarkable process are mediated in part through a fetal wound extracellular matrix rich in hyaluronic acid. In this study a newly developed assay was used to determine the hyaluronic acid ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199104000-00003
更新日期:1991-04-01 00:00:00
abstract:OBJECTIVE:Pancreatic mucinous cystic neoplasms (MCNs) provide a spectrum of neoplastic changes ranging from benign to malignant. The authors have correlated K-ras mutations and p53 overexpression with the evolution of these tumors. METHODS:Areas of mild, moderate, or severe dysplasia were microdissected from paraffin-...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199910000-00006
更新日期:1999-10-01 00:00:00
abstract::Twelve children underwent elective laparoscopic cholecystectomy for symptomatic cholelithiasis during a 10-month period in one institution. The operative technique that has been described for adults was modified because of the smaller dimensions of pediatric patients. These modifications are discussed in this report, ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199202000-00015
更新日期:1992-02-01 00:00:00
abstract::Forty-nine patients undergoing elective or emergent gastric surgery have been included in this study. Gastric needle aspiration was performed at the time of surgery in each case, followed by qualitative aerobic and anaerobic bacteriologic analysis. In 18 patients undergoing elective operation for chronic nonobstructin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197511000-00004
更新日期:1975-11-01 00:00:00
abstract::Fetus-in-fetu is an unusual cause of retroperitoneal abdominal mass in infants, which most likely arises from inclusion of a monozygotic, diamniotic twin. This entity is distinguished from teratoma by its embryological origin, its unusual location in the retroperitoneal space, its invariable benignity, and by the pres...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197407000-00011
更新日期:1974-07-01 00:00:00
abstract::The proportion of the population of the U.S. 65 years of age and over is increasing. Biliary tract disease is estimated to involve 15% of the adult population. A review of 12,200 patients treated surgically at one medical center reveals that 2401 (20%) had acute cholecystitis. There were 93 deaths, for a mortality rat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198101000-00009
更新日期:1981-01-01 00:00:00
abstract::Is colon cancer surgery justified in the very elderly from the standpoint of cost and 3-year survival rates? Two hundred eighty patients undergoing major surgery for colon cancer during 1981-1983 were divided into a group of 61 with ages greater than or equal to 80 (GE80) and 219 less than 80 (LT80). Although those GE...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198602000-00003
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVE:This study was designed to determine if resection of positive regional nodes in patients with breast cancer provided a group of cured patients. SUMMARY BACKGROUND DATA:Previous studies of long-term follow-up of patients with breast cancer have demonstrated that 30% of patients with positive nodes may be aliv...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199309000-00006
更新日期:1993-09-01 00:00:00
abstract:OBJECTIVE:To investigate the association of the genetic variants in excision repair cross-complementation group 2 (ERCC2) R156R and ERCC4 rs3136038 with survival duration for patients with esophageal cancer. BACKGROUND:ERCC2 and ERCC4 are important molecules participating nucleotide excision repair system. The clinica...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318216f374
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of a novel 2-stage treatment with reductive surgery plus percutaneous isolated hepatic perfusion (PIHP) for multiple hepatocellular carcinoma (HCC), which was previously unresectable. SUMMARY BACKGROUND DATA:Surgical resection is the treatment of choice for HCC, but the majority of p...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/01.sla.0000103133.03688.3d
更新日期:2004-01-01 00:00:00
abstract::Sixty patients with chronic alcohol-induced pancreatitis with endoscopic retrograde cholangiopancreatography evidence of common bile duct stenosis were studied to determine the clinical spectrum and natural history of this complication, as well as the indications for biliary bypass. In 17% of patients, common bile duc...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198911000-00007
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVE:Arginine transport was characterized and studied in human liver. SUMMARY BACKGROUND DATA:Plasma arginine uptake may regulate hepatocyte intracellular availability and the subsequent biosynthesis of nitric oxide (NO), but little is known about arginine transport across the human hepatocyte plasma membrane. M...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199309000-00014
更新日期:1993-09-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate tumor recurrence after liver transplantation for hepatocellular carcinoma (HCC), with and without hypothermic oxygenated liver perfusion (HOPE) before transplantation. PATIENTS AND METHODS:We analyzed all liver recipients with HCC, transplanted between January 2012 an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004258
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:To directly compare the oncologic outcomes of TLPD and OPD in the setting of pancreatic ductal adenocarcinoma. BACKGROUND:Total laparoscopic pancreaticoduodenectomy (TLPD) has been demonstrated to be feasible and may have several potential advantages over open pancreaticoduodenectomy (OPD), including lower b...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000937
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:To determine whether an intervention with smoking cessation starting 4 weeks before general and orthopedic surgery would reduce the frequency of postoperative complications. SUMMARY BACKGROUND DATA:Complications are a major concern after elective surgery and smokers have an increased risk. There is insuffici...
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.0b013e3181889d0d
更新日期:2008-11-01 00:00:00
abstract::In a prospective study of 112 patients suspected of periampullary cancer endoscopic retrograde cholangiopancreatography (ERCP) was successfully performed in 87 patients (78%). Technical failures were due to gastric outlet obstruction in four patients and inability to cannulate the ampulla of Vater in 21 patients. Succ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197803000-00018
更新日期:1978-03-01 00:00:00
abstract::The etiology and mechanisms by which severe trauma or sepsis induce hepatic failure are unknown. Previously we showed that Kupffer cells (KC), the fixed macrophages of the liver, induce a profound decrease in hepatocyte (HC) total-protein synthesis when exposed to endotoxin. Furthermore we demonstrated that endotoxin-...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199010000-00009
更新日期:1990-10-01 00:00:00
abstract::In a five-year study of massive upper gastrointestinal hemorrhage, 143 patients had esophageal varices diagnosed on emergency endoscopic examination. Seventy-one patients had active bleeding from varices and required Sengstaken tube tamponade during at least one hospital admission. The remaining patients included 33 w...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198110000-00015
更新日期:1981-10-01 00:00:00
abstract:OBJECTIVES:Immediate breast reconstruction (IBR) after mastectomy for cancer has increased in recent years, yet long-term, modality-specific comparative data are lacking. We performed this study to compare short- and long-term outcomes after expander, autologous (AT), and direct-to-implant (DI) breast reconstruction. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001457
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To determine whether resting energy expenditure (REE) is increased in cachectic patients with pancreatic cancer and to define the relation of tumor necrosis factor (TNF) and interleukin-6 (IL-6) production to the acute-phase response and to REE. METHODS:Measurement of REE (indirect calorimetry) and assessmen...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199404000-00001
更新日期:1994-04-01 00:00:00
abstract::Records of 32 patients with 34 villous and tubulovillous adenomas of the duodenum, treated at the Cleveland Clinic over the past 21 years, were reviewed. Twenty-two patients (69%) had complete resection of the adenoma; the incidence of malignancy was 47%. Five patients underwent a Whipple procedure; 4 patients had seg...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198803000-00002
更新日期:1988-03-01 00:00:00
abstract:OBJECTIVE:To validate the global features of postoperative adverse outcomes for surgical patients with schizophrenia. BACKGROUND:Patients with schizophrenia were known to have a higher risk of complications during hospitalization. Quality of care has become the key factor in reducing their potential mortality afterwar...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e31827b9b25
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:To examine the financial impact of quality improvement using Medicare payment data. BACKGROUND:Demonstrating a business case for quality improvement--that is, that fewer complications translates into lower costs--is essential to justify investment in quality improvement. Prior research is limited to cross-se...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001069
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To investigate the expression of interferon regulatory factors 1 and 2 (IRF-1 and IRF-2) in human breast cancer. SUMMARY BACKGROUND DATA:Interferon regulatory factors 1 and 2 are transcription factors in the interferon gamma signal transduction pathway. IRF-1 acts as the effector arm of the interferon gamma ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200105000-00005
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:Impact of inguinal hernia defect size as stratified by the European Hernia Society (EHS) classification I to III on the rate of chronic postoperative inguinal pain (CPIP). BACKGROUND:CPIP is the most important complication after inguinal hernia repair. The impact of hernia defect size according to the EHS cl...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000003065
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To determine if addition of the S-nitrosylating agent ethyl nitrite (ENO) to the preservation solution can improve perfusion parameters in pumped human kidneys. BACKGROUND:A significant percentage of actively stored kidneys experience elevations in resistance and decreases in flow rate during the ex vivo sto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003702
更新日期:2019-12-05 00:00:00
abstract:OBJECTIVE:To assess whether perioperative variables or deviation from enhanced recovery after surgery (ERAS) items could be associated with delayed discharge after esophagectomy, and to convert them into a scoring system to predict it. SUMMARY BACKGROUND DATA:ERAS perioperative pathways have been recently applied to e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002775
更新日期:2019-07-01 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::One hundred forty-eight patients were treated with preoperative radiation therapy and surgery for resectable rectal adenocarcinoma at the University of Florida between 1975 and 1986. All patients had at least 5 years' follow-up; no patient was lost to follow-up. Three treatment protocols were used over the study perio...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199206000-00017
更新日期:1992-06-01 00:00:00