Abstract:
:Delivery of cardioplegic (CP) solutions to all regions of the myocardium is critical for optimal myocardial protection during cardiac surgery. However, there are little data regarding the effects of CP agents upon coronary vascular resistance (CVR) and CP delivery. Accordingly, we evaluated blood CP (Hct 30) delivery and CVR during 75 minutes of multi-dose hypothermic blood CP arrest in an in vivo isolated dog heart preparation. Three groups of dogs were studied: K(K+ = 30 mEq/L; n = 6), L (Lidocaine = 400 mg/L; K+ = 4 mEq/L; n = 6), and KL (K+ = 30 mEq/L, Lidocaine 400 mg/L; n = 6) during total cardiopulmonary bypass and moderate systemic hypothermia (28 C). Basal CVR was calculated by measuring total coronary flow (HR 120/min; mean aortic pressure = 80 mmHg) in the empty beating heart. After aortic cross-clamping, the blood CP solution was infused into the aortic root at a constant pressure (80 mmHg) and constant temperature (16 +/- 2 C) for 60 seconds at 15 minute intervals for a total arrest time of 75 min. Total CP flow, CVR, O2 consumption, lactate extraction/production, and K+ balance during 75 minutes of arrest and 30 minutes of reperfusion were determined. The distribution of the CP solution in the left ventricle was measured with radioactive microspheres (9 +/- 1 mu). Biopsy specimens were taken to measure wet to dry ratios. Values are mean +/- SEM. Data were analyzed by BMDP-P2V. During the first CP infusion, after aortic cross-clamping, no differences in CVR or CP distribution were found among the three groups. However, CVR was increased significantly in the K group during the second CP infusion (O': 0.98 +/- 0.20 mmHg/ml/min/100 g; 15': 2.66 +/- 0.82; p less than 0.001). The CVR remained high for the remainder of the arrest period. Moreover, total, epi- and endocardial flow decreased significantly (54%, p less than 0.001). In groups L and KL, no significant changes in CVR were seen. Groups K and KL showed a significant K+ extraction during the first CP infusion. During the early reperfusion period, K+ washout occurred in these two groups, which was not seen in the L group. There was no significant difference between the three groups in myocardial O2 consumption, lactate metabolism, and water content during the arrest and the reperfusion period. In conclusion, high concentrations of K+ (30 mEq/L) can markedly increase CVR and impair blood CP delivery and distribution. These effects can be prevented by lidocaine. These findings warrant reassessment of the various additives to CP solutions and their effects on CVR and CP distribution during multi-dose hypothermic CP arrest.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Leicher FG,Magrassi P,LaRaia PJ,Derkac WM,Buckley MJ,Austen WGdoi
10.1097/00000658-198309000-00003subject
Has Abstractpub_date
1983-09-01 00:00:00pages
266-72issue
3eissn
0003-4932issn
1528-1140journal_volume
198pub_type
杂志文章abstract:OBJECTIVE:To evaluate the influence of the response to preoperative chemotherapy, especially tumor progression, on the outcome following resection of multiple colorectal liver metastases (CRM). SUMMARY BACKGROUND DATA:Hepatic resection is the only treatment that currently offers a chance of long-term survival, althoug...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000145964.08365.01
更新日期:2004-12-01 00:00:00
abstract::We have demonstrated previously that oxygen-derived free radicals are important mediators of tissue injury following ischemia (total venous occlusion) and reperfusion in small (3 cm X 6 cm) island skin flaps in rats. In this study, we evaluated extension of this concept to regional ischemia in large (8 cm X 8 cm) acut...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198503000-00018
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVE:To investigate the incidence of nodal metastasis in a consecutive series of patients treated at the authors' institution with highly selective criteria, and to determine the impact that lymphatic mapping and sentinel node biopsy have on the detection of nodal metastases in this carefully selected patient popu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000071564.27229.A9
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND AND AIMS:The lower esophageal sphincter (LES) in patients with gastroesophageal reflux disease often has a low resting pressure and a short abdominal length. The mechanism by which this occurs is unknown. We hypothesize that gastric distension causes progressive effacement of the abdominal portion of the LES...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181e3e411
更新日期:2010-07-01 00:00:00
abstract::Twenty patients with metastatic renal cell carcinoma and nine patients with minimal residual disease (MRD) but at high risk for recurrence following nephrectomy received weekly four milligram intradermal injections of purified RNA extracted from lymphoid organs of sheep immunized with human renal cell carcinoma. Eight...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197710000-00007
更新日期:1977-10-01 00:00:00
abstract::The morphologic characteristics of a scar may render it an "immunologically privileged site" providing fertile ground for tumor occurrence and growth. We sought to extend this concept and to determine the effect of different stages of wound healing on tumor occurrence. Syngeneic strain-2 guinea pigs and a methylcholan...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197902000-00009
更新日期:1979-02-01 00:00:00
abstract::We analyzed the course of 186 patients with external gastrointestinal fistulas treated at the University of California Medical Center, San Francisco from 1968 to 1977. There were 82 patients in the earlier group (1968-1971) and 104 patients in the later group (1972-1977). The groups differed in that 35% of patients in...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197810000-00003
更新日期:1978-10-01 00:00:00
abstract::After attaching appropriate monitoring devices enabling the measurement of the slope of the left ventricular function curve, left atrial pressure, mean aortic pressure, peak left ventricular pressure, and tension time index, three groups of ten dogs were subjected to varying periods of hemorrhagic shock until a slope ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197501000-00025
更新日期:1975-01-01 00:00:00
abstract::Verapamil administered before treatment, but not after treatment, had a beneficial effect on a 90-minute warm ischemia-reperfusion rat liver injury model. The possible activation of proteases converting the xanthine dehydrogenase to xanthine oxidase, the significant mitochondrial calcium loading during the ischemic pe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199102000-00008
更新日期:1991-02-01 00:00:00
abstract::Nineteen patients with vascular deformities of the lower extremity were studied and were classified into three groups based on their clinical and angiographic findings. 1) The Klippel or Venous Dysplasia Group (n = 8) demonstrated: cutaneous nevi of metameric distribution, congenital varices (many of which were anomal...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197702000-00005
更新日期:1977-02-01 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::The development of effective, non-toxic (local and systemic) methods for the rapid chemical (enzymatic and non-enzymatic) debridement of third degree burns would dramatically reduce the morbidity and mortality of severely burned patients. Sepsis is still the major cause of death of patients with extensive deep burns. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00032
更新日期:1974-10-01 00:00:00
abstract::Occurence of gastroenteric fistulae in non-surgically treated peptic ulcer disease is rare as suggested by only 26 cases published in the literature so far. We had the opportunity to care for 3 patients with this problem in a period of one year. At our institution, a search of the medical records dating back to 1955 y...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197608000-00017
更新日期:1976-08-01 00:00:00
abstract::The pattern of failure was studied in 1012 patients with resected Stage I or II non-small-cell carcinoma of the lung. Initial intrathoracic failure (41%) was more common than initial extrathoracic failure (34%) even though a complete resection was the intent in all patients. The most frequent sites of initial failure ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198701000-00012
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Experience with minimal access, transoral/transmural endoscopic drainage/debridement of walled-off pancreatic necrosis (WOPN) after necrotizing pancreatitis is limited. We sought to determine outcome using this technique. METHODS:Retrospective analysis. RESULTS:From 1998 to 2006, 53 patients underwent tran...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000254366.19366.69
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:The aim of the present study was to determine whether trainee involvement in esophageal cancer resection is associated with adverse patient outcomes. BACKGROUND:Operative experience for surgical trainees is under threat. A number of factors have been implicated in this leading to fewer hours for training. Es...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002047
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:We have previously demonstrated that P. aeruginosa can have profound effects on the intestinal epithelial barrier via one of its virulence factors, the PA-I lectin/adhesin. The aims of the present study were to further characterize the interaction of P. aeruginosa and the intestinal epithelium using both in v...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000094551.88143.f8
更新日期:2003-11-01 00:00:00
abstract::In a prospective, block-randomized, multicenter study, the safety and efficacy of cefoxitin in preoperative prophylaxis were studied. 1735 patients undergoing appendectomy were evaluable, and half of these patients received 2 g of cefoxitin before undergoing operation. The patients were divided into three groups: pati...
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:10.1097/00000658-198903000-00010
更新日期:1989-03-01 00:00:00
abstract::Pancreas divisum is an anatomic duct variant, which may predispose to pancreatitis. Most patients are managed conservatively, but some patients justify attempts to improve drainage. The correct surgical approach is not yet established, and there has been no series published concerning pancreatic resection in this cont...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198411000-00006
更新日期:1984-11-01 00:00:00
abstract:OBJECTIVE:The authors investigate the recovery of gastrointestinal motility in the fed and fasted state after laparoscopic and open cholecystectomy. SUMMARY BACKGROUND DATA:Clinical recovery after laparoscopic cholecystectomy is known to be more rapid than after conventional open cholecystectomy. However, the actual e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199604000-00010
更新日期:1996-04-01 00:00:00
abstract::Extracorporeal Membrane Oxygenation (ECMO) has been available to neonates with respiratory failure at the University of Michigan School of Medicine since June 1981. In order to evaluate the impact of this type of pulmonary support, a retrospective analysis of 50 neonates with posterolateral congenital diaphragmatic he...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-198902000-00014
更新日期:1989-02-01 00:00:00
abstract:OBJECTIVE:To compare safety and healthcare utilization after sleeve gastrectomy versus Roux-en-Y gastric bypass in a national Medicare cohort. SUMMARY BACKGROUND DATA:Though bariatric surgery is increasing among Medicare beneficiaries, no long-term, national studies examining comparative effectiveness between procedur...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004526
更新日期:2020-11-17 00:00:00
abstract:OBJECTIVE:Few studies have evaluated long-term outcomes after orthotopic liver transplantation (OLT). This work analyzes the experience of nearly 2 decades by the same team in a single center. Outcomes of OLT and factors affecting survival were analyzed. METHODS:Retrospective analysis of 3200 consecutive OLTs that wer...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000164077.77912.98
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:To determine the association between race/ethnicity and perioperative outcomes in individuals undergoing major oncologic and nononcologic surgical procedures in the United States. BACKGROUND:Prior work has shown that there are significant racial/ethnic disparities in perioperative outcomes after several type...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001078
更新日期:2015-12-01 00:00:00
abstract::From 1966 to 1975, 38 patients underwent 42 procedures for renovascular hypertension; 35 operations were aortorenal bypasses and 7 were nephrectomies. Forty-five per cent of the patients were cured, 43% were improved and 12% were unimproved. There were no operative deaths and only three late deaths. Two grafts occlude...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197512000-00019
更新日期:1975-12-01 00:00:00
abstract::The induction of donor-specific tolerance could prevent the side effects of immunosuppression while improving allograft survival. Male adult Buffalo (RT1b) rats underwent an intrathymic (IT), portal venous (PV), intrasplenic (IS), or subcutaneous (SQ) injection of 25 x 10(6) major histocompatibility complex (MHC) mism...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199210000-00003
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the perioperative morbidity and mortality of patients with COVID-19 who undergo urgent and emergent surgery. SUMMARY BACKGROUND DATA:Although COVID-19 infection is usually associated with mild disease, it can lead to severe respiratory complications. Little is known about the perioperative outcom...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000004420
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the current knowledge on the risk factors for recurrence, efficacy of adjuvant therapy in preventing recurrence, and the optimal management of recurrence after resection of hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:The long-term prognosis after resection of HCC remains unsatisfactor...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-200007000-00003
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:To explore the events and people that shaped Harvey Cushing, one of the nation's leading surgeons, into a political actor as he rallied support for the issue of military medical preparedness for World War One. SUMMARY BACKGROUND DATA:In a little remembered episode of American medical history, for 2 years bef...
journal_title:Annals of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1097/SLA.0b013e3181e77bdc
更新日期:2010-07-01 00:00:00
abstract::Secretin was injected into a feeding or nonfeeding artery of a gastrinoma and blood samples were taken from the hepatic vein (HV) or a peripheral artery (PA) to measure the changes of serum immunoreactive gastrin concentration (IRG). The IRG in the HV rose within 40 seconds and in the PA rose within 60 seconds after t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198703000-00003
更新日期:1987-03-01 00:00:00