The Journal of surgical research
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Writing and publishing are key to career development and academic success for surgeons who have less time than ever to devote to these activities. To improve the scientific writing skills of its faculty and trainees and to help them complete their manuscripts and grant proposals more quickly, the Department of Surgery at the University of California, San Francisco (UCSF) established a service dedicated to scientific writing and editing. Through coursework in scientific writing, individual writing consultations, and editorial review, the service helps academic surgeons with the difficult tasks of writing and publishing their research and seeking extramural funding. The service has rapidly become a successful adjunct to the academic mission of the UCSF Department of Surgery and could offer a model for other academic surgery departments to increase scientific productivity and advance the academic surgical mission.
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Intensive blood glucose management has been shown to decrease mortality and infections for intensive care patients. The effect of intraoperative strict glucose control on surgical outcomes, including liver transplantation, has not been well evaluated. ⋯ Intraoperative hyperglycemia during liver transplantation was associated with an increased risk of postoperative infection and mortality. Strict intraoperative glycemic control, possibly using insulin infusions, may improve outcomes following liver transplantation.
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Ischemia-reperfusion (I/R) injury, which was commonly seen in the field of hepatic surgical intervention, impaired liver regeneration and predisposed to liver failure. Previous studies have shown gender dimorphic response of the liver for various hepatic stresses including I/R injury, hemorrhagic shock-resuscitation, liver cirrhosis, endotoxemia, and chronic alcoholic consumption, and demonstrated gender dimorphism in hepatocellular dysfunction after experimental trauma and hemorrhage. The objective of this study was to examine the hypothesis that the protective effects of 17beta-estradiol (E2) in hepatic I/R injury were associated with increasing heat-shock protein 70 expression. ⋯ E2 pretreatment had protective effects on liver in hepatic I/R injury. The mechanism of this protection might be related to overexpression of Hsp70.
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Dexamethasone (DEX) is demonstrated to have anti-inflammatory properties and known to induce hemodynamic improvement in sepsis and septic shock. L-arginine (L-arg), a semi-essential amino acid, depending on its metabolic pathway, becomes very essential in stress situations such as heatstroke, burns, sepsis, trauma, and wound healing. The aim of this study was to evaluate the synergistic therapeutic effect of DEX and L-arg in rescuing the mice from experimental septic shock induced by bacterial lipopolysaccharide (LPS). The experiments were designed to delineate the molecular mechanisms responsible for the increased therapeutic benefit of the combination therapy (CT) in LPS-induced septic shock. ⋯ The therapeutic combination therapy with DEX and L-arg, at the appropriate dose, time, and sequence of administration, changed the cytokine profile, in favor of reducing the inflammatory response. The significantly enhanced survival observed in the CT group was accompanied by an increased hepatic Hsp 70, hepatic arginase, splenic arginase, and decreased organ injury. This novel concept of combined therapy could form the basis of an effective therapeutic approach in the treatment of sepsis and septic shock.
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Glutamine (GLN) has been shown to confer cytoprotection by enhancing endogenous heat shock protein (HSP) expression. We hypothesized that GLN donor pretreatment protects rat renal grafts against severe preservation reperfusion injury (PRI). ⋯ In rat renal grafts suffering severe PRI pharmacological preconditioning with GLN attenuates early structural damage, especially tubular cell apoptosis. Stimulation of renal HSP 70 expression could be an important mechanism of GLN-induced cytoprotection. Our findings may have implications for the treatment of delayed graft function in recipients of marginal donor kidneys.