The Journal of surgical research
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Growth factors affect the complex cascade of wound healing; however, interaction between different growth factors during dermal and epidermal regeneration are still not entirely defined. In the present study, we thought to determine the interaction between keratinocyte growth factor (KGF) administered as liposomal cDNA with other dermal and epidermal growth factors and collagen synthesis in an acute wound. ⋯ Exogenous administered KGF cDNA causes increases in IGF-I, IGF-BP3, FGF, and collagen IV and decreases TGF-beta concentration. KGF gene transfer accelerates wound healing without causing an increase in collagen I or III.
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Insulin-like growth factor-I (IGF-I) is accepted as a potent stimulus of wound healing when applied in combination with its binding proteins. However, there is only one study published that has investigated the effect of repeated topical application of unbound IGF-I on ischemic wound healing. The aim of this study was to show the effect of daily topical IGF-I therapy on cutaneous ulcer healing in a steroid-suppressed wound model. ⋯ Our data indicate that a repeated application of topical IGF-I enhances cutaneous ulcer healing. In addition, only the controlled release of IGF-I from the hydrogel dressing is capable of reversing the steroid-induced delay of healing, suggesting different mechanisms of action with respect to the mode of IGF-I delivery.
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Randomized Controlled Trial
The effectiveness of a human patient simulator in the ATLS shock skills station.
The use of simulation as a teaching adjunct in Advanced Trauma Life Support (ATLS) has not undergone rigorous psychometric testing. We hypothesized that an advanced, computer-controlled human patient simulator (HPS) would be a useful adjunct to the ATLS shock skills station. ⋯ Use of an advanced HPS during the ATLS shock skills station was equivalent to traditional teaching scenarios based on psychometric testing. Students subjectively preferred the simulator as a teaching tool and found it most useful in learning how to integrate data from hemodynamic monitors into clinical decision making.
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Intra-abdominal pressure (IAP) obtained by bladder pressure measurement is used to detect impending abdominal compartment syndrome (ACS), but, while it is recommended to use a supine position, the literature describes IAP measurement in varying positions. This study evaluated the impact of body position at differing head-of-bed (HOB) elevations on bladder pressure when planned to be used as a surrogate IAP measurement. ⋯ Elevating HOB significantly increases bladder pressure measurement. Bladder pressure measurements in nonsupine positions may not provide valid interpretation for IAP, and more so in cases of increased body mass index.
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Reactive oxygen radicals that cause remote organ injury are increased after the one-lung ventilation frequently used in thoracic surgery. The aim of this study was to examine the effects of one-lung ventilation on the liver and ileum. ⋯ Our findings showed that one-lung ventilation causes tissue damage in the liver and ileum and that this damage increases as occlusion duration rises.