The Journal of surgical research
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Pancreatic stone protein (PSP/reg) is a constitutively secreted protein in pancreatic juice. Pancreatitis-associated protein (PAP) belongs to the same family of proteins. PAP is highly increased during acute pancreatitis, while no exact data exist regarding PSP/reg protein synthesis and secretion. Recently, an attempt to determine PSP/reg and PAP levels in sera of rats with acute pancreatitis showed a significant increase in PAP but failed to demonstrate changes in PSP/reg. Others reported that surgical manipulation of the pancreas, including sham controls, affected mRNA levels of PSP/reg. Neither report determined protein levels of PSP/reg. ⋯ PSP/reg and PAP levels are increased through similar mechanisms by physiological and supramaximal doses of caerulein. However, PSP/reg regulation appears to sustain high levels while PAP levels are more transient. Since the regulation of this protein family is affected even under mild stress, we define them as secretory stress proteins.
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It is not clear that hepatic venous backflow actually contributes to hepatic tissue oxygenation under inflow occlusion of the liver. In order to prove that substances delivered via the hepatic vein can be utilized and/or metabolized in hepatocytes during inflow occlusion, hepatic uptake in bile and excretion of indocyanine green (ICG) were investigated in pigs. ⋯ These results indicate that ICG can be extracted in hepatocytes and excreted in bile under IO of the liver. Consequently, substances such as oxygen and drugs, which are delivered via the hepatic vein, can be utilized and/or metabolized in hepatocytes under IO.
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Treatment of the cancer patient is multifaceted. In addition to treating the cancer itself, there are additional important, "noncancer" issues to consider concomitantly, such as the patient's coexistent diseases, their health behaviors, and preventive care measures. While the need for coordination among surgeons, oncologists, and radiation oncologists has been well documented for treatment of the cancer, little attention has been paid to the importance of "noncancer" issues. In an attempt to characterize such issues, we performed a study to describe the prevalence of comorbid diseases as well as other "noncancer" issues (i.e., presence of poor health habits and use of preventive care measures) for four common, surgically related cancers. Finally, we describe the use of provider resources for these cancer patients. ⋯ To optimize cancer outcomes, successful treatment of both the cancer and the "noncancer" issues is required. This study demonstrates that the burden of coexistent diseases is considerable. We also found the prevalence of continued poor health behaviors (i.e., use of tobacco) as well as suboptimal performance of preventive care measures to be notable. Since cancer patients see specialists twice as often as controls, it appears paramount that specialists (surgeons included) maintain diligence in addressing patient comorbidities, health habits, and other "noncancer" measures. If the substantial rates of smoking and suboptimal performance of preventive care measures are an indication of the "noncancer" quality of care that is being provided to the typical cancer patient, then a more concerted effort by all providers needs to be made regarding these and other "noncancer" issues.