The Journal of surgical research
-
Phospholipases A(2) (PLA(2)) have been implicated in the pathogenesis of acute respiratory distress syndrome (ARDS) induced by intestinal ischemia-reperfusion (IIR). Intestinal ischemic preconditioning (IIP) has been shown to improve intestinal tolerance to subsequent sustained ischemia and limit the systemic inflammatory response. We tested the effect of IIP on the intestinal ischemia-reperfusion-induced ARDS, with particular focus on PLA(2). ⋯ Intestinal preconditioning protects IIR-induced lung injury, partly by modulating the arachidonic acid cascade.
-
Untreated hypovolemia results in impaired outcome. This study tests our hypothesis whether general hemodynamic parameters detect acute blood loss earlier than monitoring parameters of regional tissue beds. ⋯ In this hemorrhagic pig model systemic hemodynamic parameters were more sensitive to detect acute hypovolemia than tissue oxygen tension measurements or jejunal LDF measurements. Acute blood loss was detected first by dPP.
-
The identification of reliable outcome predictors after traumatic brain injury (TBI) is crucial. The objective of our study was to investigate the role of tau protein as a serum marker of TBI. ⋯ These results suggest that in addition to GCS; serum tau protein levels may serve as indicators for the prediction of outcome following severe TBI. However; it should be viewed with caution because of the small sample size and wide standard deviations.
-
Acute care surgery programs have demonstrated that trauma patient outcomes have not changed with the addition of emergency general surgery (EGS) responsibilities. EGS patient outcomes and the mentoring of fellows on EGS service have not been previously studied. We hypothesize that EGS patient outcomes would not differ by provider on a service driven by evidence-based medicine (EBM) protocols. ⋯ An EGS service with EBM protocols assures consistency in patient outcomes independent of provider level: faculty or fellows. Our model for mentoring fellows did not decrease EGS patient outcomes.
-
Mixed hematopoietic chimerism via bone marrow transplantation has been shown to induce donor specific tolerance to solid organ allografts, but graft versus host disease (GVHD) remains to be a risk. Composite tissue allografts may need a higher percentage of donor chimerism compared with less immunogenic solid organ allografts. In this study, we investigated the potential of mesenchymal stem cells (MSCs) in the induction of stable and high level chimerism and subsequent donor-specific tolerance to composite tissue allograft without the incidence of graft versus host disease (GVHD). ⋯ This study indicates a potential use of MSCs for induction of stable and high level mixed hematopoietic chimerism and subsequent donor specific tolerance in clinical composite tissue allotransplantation.