The Journal of surgical research
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It is well known that hemorrhagic shock induces inflammatory changes. Our objective was to study the histologic and biochemical changes in the lung and evaluate alterations in respiratory function after hemorrhage and resuscitation (H/R) in mice. ⋯ Hemorrhage and resuscitation cause delayed biochemical, histologic, and physiologic changes in the lung. These were marked by increased lung MPO, increased neutrophils, and decreased alveolar function. The alterations of pulmonary function and structure were most severe 5 days after H/R.
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The kidney has an important function in the exchange of nitrogenous metabolites. Glutamine is the most important substrate for renal ammoniagenesis and thus plays a crucial role in acid-base homeostasis. Furthermore, the kidney is the main endogenous source for de novo arginine production from citrulline, which in turn is derived from intestinal glutamine metabolism. Sepsis is a condition in which glutamine availability is reduced, whereas the need for arginine biosynthesis may be increased. Limited bioavailability of glutamine may affect arginine synthesis, which may have consequences for nitric oxide (NO) synthesis. Therefore, we studied renal glutamine and arginine metabolism in a rat model of endotoxemia and related this to NO metabolism. ⋯ Although the kidney has very important functions in the excretion of waste products and in interorgan metabolism, this study suggests that the kidney has a limited role in glutamine, arginine, and NO metabolism during late endotoxemia in rats.
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Octreotide (OCT) is used for the protection of pancreato-intestinal anastomoses and for treatment of acute pancreatitis. Its effect on jejunal microcirculation after ischemia-reperfusion has not been investigated. ⋯ OCT impairs microvascular perfusion of the jejunum both under physiological conditions and after ischemia-reperfusion.
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Clinical Trial Controlled Clinical Trial
Peer teaching and computer-assisted learning: An effective combination for surgical skill training?
The surgical literature suggests that collaborative learning using peers may be a valid way to teach surgical skills and there is a growing interest in the use of computer-assisted learning for this purpose. Combining this evolving technology with this type of teaching would theoretically offer a number of advantages including a reduction in the amount of faculty time devoted to this task. In this study, we evaluate the efficacy of a type of collaborative learning in a computer-assisted learning environment. ⋯ Collaborative learning in a computer-assisted learning environment is not an effective combination for teaching surgical skills to novices.
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The measurement of burn surface area is important during the initial management of burn patients for estimating fluid requirements and determining hospital admission criteria. The "rule of nines" is commonly used for this purpose. However, the proportional contribution of various major body segments to the total body surface area changes with obesity. Similarly infants have very large heads, altering the overall contribution of other body segments to the total body surface area. ⋯ Various body parts differentially contribute to the total body surface area. Because these relationships remain relatively constant throughout growth, the rule of nines provides reasonable estimates for the determination of burned body surface area for most children and adults. These relationships break down for infants and obese adults and the proposed modifications to the rule of nines provide better estimates of surface area for these groups.