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Background: Retrospective analyses have shown that long-term recurrence rates after Lichtenstein mesh and Shouldice herniorrhaphies are low. Therefore differences in short-term outcome may be important determinants of one's choice of repair. Although proponents of the mesh repair claim that their method is less morbid, to our knowledge no prospective comparative studies of short-term morbidity have...
Background: Apart from rejection-related events, the manifestation of ischemia/reperfusion (I/R) injury remains a major problem, hampering success in human small bowel transplantation (SBTx). Therefore the aim of this study was to determine the potential of Carolina rinse (CR) to attenuate microvascular reperfusion injury in rat intestinal isografts. Methods: After 18 hours of cold preservation in...
Background: With tighter constraints on health care spending, many recognize the need to identify and restrict clinical interventions that are not cost-effective. As a result, cost-effectiveness analysis is being used increasingly to assess the relative value of surgical interventions. Methods and Results: We first present the general concept of cost-effectiveness analysis and review a recent study...
Background: Immunosuppressive strategies have largely ignored donor-derived stimulatory cells as a target. This study examined whether lipopolysaccharide (LPS) or 16,16 dimethyl prostaglandin E 2 (dmPGE 2 ) pretreatment of stimulator cells from B10.BR mice influences effector function of responder T lymphocytes from C3H/HeJ mice in vitro or in vivo. Methods: B10.BR spleen cells were...
Background: We examined the recent experience of a large urban trauma center to identify overall morbidity and factors predictive of outcome in patients undergoing colostomy closure after trauma. Methods: We did a retrospective analysis of 40 patients who underwent colostomy closure after trauma at our institution between January 1992 and August 1996. Results: The mechanism of injury was a gunshot...
Background: We performed bilateral laparoscopic adrenalectomies on four patients (three women and one man) with Cushing's disease (pituitary-dependent Cushing's syndrome) showing persistent hypercortisolism after transsphenoidal surgery. Methods: The technique for bilateral transperitoneal laparoscopic adrenalectomy was derived from the one previously adopted by our group for unilateral adrenalectomy...
Background: This study examines the effect of the angiotensin II receptor (type 1) antagonist (L158,809) on the formation of vein graft intimal hyperplasia in vivo, by both localized and systemic administration. Methods: Forty New Zealand White rabbits underwent right carotid interposition bypass grafting with the external jugular vein and were killed on postoperative day 28. To determine the effect...
Background: It has been reported that surgical excision of hilar cholangiocarcinoma rather than palliative surgical therapy, chemotherapy, or radiotherapy caused prolonged survival in some patients. However, excision is associated with high operative morbidity and mortality rates, particularly when hepatic resection is also performed. The aim of this study was to evaluate the clinical implications...
Background: Tumor necrosis factor–α (TNF-α) and interleukin-6 (IL-6) increase the synthesis of hepatic acute-phase proteins; these effects appear mediated by activation of transcription factors. The purpose of this study was to determine the effects of TNF-α and IL-6 on expression of the jun family of activator protein-1 (AP-1) transcription factors with the human hepatoma cell line HepG2, a well-characterized...
Background: Although there is an increasing incidence of proximal gastric cancers in the United States, the appropriate extent of resection for proximal gastric cancer is not known. This study addresses whether the type of operation (total gastrectomy [TG] vs proximal gastrectomy [PG]) affects outcome for proximal gastric adenocarcinoma. Methods: Review of the prospective gastric database at Memorial...
Background: This study was performed to determine whether there is a significant association between abdominal aortic aneurysms (AAAs) and malignancy and to determine the impact of malignancy on late survival in patients with AAA. Methods: We studied 126 men undergoing AAA repair and compared them with 99 men undergoing aortofemoral bypass (AFB) for occlusive disease and with 100 men undergoing herniorrhaphy...
Background: Alcohol abuse is a risk factor for hepatocellular carcinoma (HCC) and the recurrence of HCC after resection. We therefore investigated polyamine metabolism, which is important in cell proliferation, HCC tissue, and noncancerous hepatic tissue. Methods: In 30 patients who underwent liver resection for HCC, 13 patients had drunk 86 gm or more ethanol per day for at least 10 years (group...
Background: Although the individual actions of neutrophils and serum proteins such as complement in acute inflammation are well characterized, less is known about their effects in combination. We investigated the combined effects of neutrophil contact and active serum proteins on the expression of endothelial leukocyte adhesion molecule 1 (ELAM-1). Methods: Confluent monolayers of human umbilical...
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