bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular changes in extracellular matrix turnover after renal ischaemia–reperfusion injury
Authors: Jain S , Bicknell G R , Nicholson M L 
Published: March 2003

Abstract

Background
Renal ischaemia–reperfusion (IR) injury is an inevitable consequence of transplantation and contributes to later graft fibrosis. This study aimed to elucidate the possible mechanisms by studying the expression of genes associated with extracellular matrix (ECM) turnover.

Methods
Male Wistar rats underwent laparotomy, clamping of the right renal pedicle for 45 min, and left nephrectomy. Control animals underwent left nephrectomy only, or had no operation. Animals were killed at 8, 16 and 24 weeks and messenger RNA was extracted from renal tissue. Genes of interest were amplified and then quantified in an enzyme-linked immunosorbent assay system with levels expressed as a ratio to a known housekeeping gene (GAPDH).

Results
Experimental animals developed progressive proteinuria from 16 weeks onwards. At 8 weeks after IR injury, gene levels of matrix metalloproteinase (MMP) 2, an ECM-degrading enzyme, were significantly increased. Levels then fell progressively. This was associated with increasing expression of tissue inhibitor of metalloproteinases (TIMP) 1, an inhibitor of MMP-2, and of transforming growth factor (TGF) β, a profibrotic cytokine, by 24 weeks following injury.

Conclusion
These results suggest that, after an initial phase of increased ECM turnover following IR injury, the balance turns towards one of reduced degradation. This is likely to be an important mechanism in the subsequent development of fibrosis.
Hyaluronic acid-based agents do not affect anastomotic strength in the rat colon, in either the presence or absence of bacterial peritonitis
Authors: Reijnen M M P J , de Man B M , Hendriks Th , Postma V A , Meis J F G M , van Goor H 
Published: March 2003

Abstract

Background
Hyaluronic acid (HA) agents reduce postsurgical adhesion formation. The effect of their perioperative administration on early anastomotic healing is unknown. This study investigated the influence of two HA-containing agents on the development of strength in colonic anastomosis during the first postoperative week, both in normal rats and in rats with bacterial peritonitis.

Methods
In 90 male Wistar rats a 1-cm segment was resected from the descending colon and an end-to-end anastomosis was constructed. In 108 rats a bacterial peritonitis was induced using caecal ligation and puncture (CLP). Some 24 h after CLP the abdomen was reopened, the caecum was taken out and, after resection of a 1-cm segment, an anastomosis was made. Animals in both groups were randomized to receive either an HA–carboxymethylcellulose (CMC) bioresorbable membrane, 0·4 per cent HA solution or no treatment. One-third of each group was killed at day 1, 3 and 7 after operation. Cultures were taken from the abdominal cavity for microbiological analysis in half of the animals. Subsequently, both bursting pressure and breaking strength were determined as parameters for anastomotic strength.

Results
No differences in anastomotic bursting pressure or breaking strength were found between the experimental groups and their controls. In addition, there was no significant difference in the number of bacteria cultured from the abdominal cavity between rats treated with HA and controls.

Conclusion
Neither HA-CMC bioresorbable membrane nor 0·4 per cent HA solution interferes with the development of early anastomotic strength in the colon, and can therefore be safely used to prevent intra-abdominal adhesion formation after performing bowel anastomosis.
Prognostic significance of extensive microsatellite instability in sporadic clinicopathological stage C colorectal cancer
Authors: Wright C M , Dent O F , Barker M , Newland R C , Chapuis P H , Bokey E L , Young J P , Leggett B A , Jass J R , Macdonald G A 
Published: March 2003

Abstract

Background
Colorectal cancers exhibiting microsatellite instability (MSI) appear to have unique biological behaviour. This study analyses the association between extensive MSI (MSI-H), clinicopathological features and survival in an unselected group of patients with sporadic Australian Clinico-Pathological Stage (ACPS) C (tumour node metastasis stage III) colorectal cancer.

Methods
Some 255 patients who underwent resection for sporadic ACPS C colorectal cancer between 1986 and 1992 were studied. No patient had received chemotherapy. Minimum follow-up for all patients was 5 years. Archival normal and tumour DNA was extracted and amplified by polymerase chain reaction using a radioactive labelling technique. MSI-H was defined as instability in 40 per cent or more of seven markers.

Results
Twenty-one patients showed MSI-H. No association was found between MSI and age or sex. Tumours exhibiting MSI-H were more commonly right sided (P &lt; 0·00001), larger (P = 0·002) and more likely to be high grade (P = 0·049). After adjustment for age, sex and other pathological variables, patients whose cancers exhibited MSI-H had improved survival (P = 0·015).

Conclusion
Recognition of MSI-H in sporadic ACPS C tumours identifies a subset of cancers with improved prognosis. Such stratification should be considered in trials of adjuvant therapy and may be relevant to therapeutic decision making.
Pharmacological hepatic preconditioning: involvement of 70-kDa heat shock proteins (HSP72 and HSP73) in ischaemic tolerance after intravenous administration of doxorubicin
Authors: Kume M , Yamamoto Y , Yamagami K , Ishikawa Y , Uchinami H , Yamaoka Y 
Published: March 2003

Abstract

Background
Pharmacological preconditioning may induce a stress response which protects liver against ischaemia–reperfusion injury (IRI). The aim of this study was to determine, in an animal model, whether intravenous administration of doxorubicin induces heat shock proteins (HSPs) in liver tissue and facilitates liver tolerance to subsequent warm IRI.

Methods
Male Wistar rats were used. Production of HSPs was determined in liver tissue sequentially after the injection of doxorubicin 1 mg/kg body-weight. Acquisition of tolerance for 30 min warm ischaemia and reperfusion of the liver was determined in animals pretreated (48 h beforehand) with doxorubicin, and in controls. Biochemical liver function and liver adenine nucleotide concentration 40 min after reperfusion and survival rate at 7 days after the ischaemic insult were recorded.

Results
Expression of HSP72 and HSP73 in the liver was confirmed 48 h after doxorubicin administration. Biochemical parameters and survival rates were significantly better in pretreated animals than in controls.

Conclusion
These results indicate that doxorubicin has the potential to provide the liver with tolerance against IRI. A simultaneous increase of both HSP72 and HSP73 in liver tissue may explain the acquisition of tolerance following the administration of doxorubicin.
Natural history of patients with adhesive small bowel obstruction
Authors: Miller G , Boman J , Shrier I , Gordon P H 
Published: March 2003

Abstract

Background
Small bowel obstruction (SBO) is a major cause of morbidity and financial expenditure. The goals of this study were to determine factors predisposing to adhesive SBO, to note the long-term prognosis and recurrence rates for operative and non-operative treatment, to elicit the complication rate of operations and to highlight factors predictive of recurrence.

Methods
The medical records of all patients admitted to one hospital between 1986 and 1996 with the diagnosis of SBO were reviewed retrospectively. This included 410 patients accounting for 675 admissions.

Results
The frequency of previous operation by procedure type was colorectal surgery (24 per cent), followed by gynaecological surgery (22 per cent), herniorrhaphy (15 per cent) and appendicectomy (14 per cent). A history of colorectal surgery (odds 2·7) and vertical incisions (odds 2·5) tended to predispose to multiple matted adhesions rather than an obstructive band. At initial admission 36 per cent of patients were treated by means of operation. As the number of admissions increased, the recurrence rate increased while the time interval between admissions decreased. Patients with an adhesive band had a 25 per cent readmission rate, compared with a 49 per cent rate for patients with matted adhesions (P &lt; 0·004). At the initial admission 36 per cent of patients were treated surgically. Patients treated without operation had a 34 per cent readmission rate, compared with 32 per cent for those treated surgically (P not significant), a shorter time to readmission (median 0·7 versus 2·0 years; P &lt; 0·05), no difference in reoperation rate (14 versus 11 per cent; P not significant) and fewer inpatient days over all admissions (4 versus 12 days; P &lt; 0·0001).

Conclusion
The likelihood of reobstruction increases and the time to reobstruction decreases with increasing number of previous episodes of obstruction. Patients with matted adhesions have a greater recurrence rate than those with band adhesions. Non-operative treatment for adhesions in stable patients results in a shorter hospital stay and similar recurrence and reoperation rates, but a reduced interval to reobstruction when compared with operative treatment.
Retrospective analysis of prognostic factors after liver resection and transplantation for cholangiocellular carcinoma
Authors: Weimann A , Varnholt H , Schlitt H J , Lang H , Flemming P , Hustedt C , Tusch G , Raab R 
Published: March 2003

Abstract

Background
Cholangiocellular carcinoma is an uncommon primary liver cancer, which may be mixed with hepatocellular carcinoma. A retrospective analysis was undertaken to evaluate the results of surgical treatment and to identify prognostic factors.

Methods
Between 1978 and 1996, 162 patients underwent surgery for cholangiocellular carcinoma: liver resection (n = 95), liver transplantation (n = 24) and exploratory laparotomy with and without drainage (n = 43). Univariate and multivariate analyses of prognostic factors were performed.

Results
Overall survival was 47 per cent at 1 year, 28 per cent at 2 years and 13 per cent at 5 years. Survival rates for patients with resectable tumours were 64, 43 and 21 per cent respectively, and for those who underwent liver transplantation 21, 8 per cent and zero respectively. Univariate analysis showed that the following variables had an effect on survival: age, jaundice, liver resection, T, N and M stage in the tumour node metastasis classification, Union Internacional Contra la Cancrum (UICC) tumour stage, tumour-free margins, vascular infiltration, tumour number, tumour size and serum level of carcinoembryonic antigen. Multivariate analysis identified jaundice, N and M category, and UICC tumour stage as independent prognostic factors.

Conclusion
The data underscore the importance and prognostic value of the UICC tumour classification for cholangiocellular carcinoma. The prognosis of mixed tumours is no different. Liver resection remains the treatment of choice; transplantation offers no solution for otherwise unresectable tumours.
Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials
Authors:   EU Hernia Trialists Collaboration, Grant A 
Published: March 2003

Abstract

Background
Open tension-free methods of groin hernia repair have been widely adopted despite little rigorous evaluation.

Methods
Information was assimilated from all randomized or quasi-randomized trials comparing open mesh with open non-mesh methods to assess benefits and safety. Electronic databases were searched and members of the EU Hernia Trialists Collaboration consulted to identify trials. Prespecified data items were extracted from reports, and quantitative or, if not possible, qualitative meta-analysis was performed.

Results
Fifteen eligible trials, which included 4005 participants, were identified. There were similar numbers of complications in each group, with few data to address short-term pain and length of stay in hospital. Return to usual activities was quicker in the mesh group for seven of ten trials (P not significant). There were fewer reported recurrences in the mesh groups: overall 21 (1·4 per cent) of 1513 versus 72 (4·4 per cent) of 1634 (odds ratio 0·39 (95 per cent confidence interval 0·25–0·59); P &lt; 0·001).

Conclusion
Although the rigorous search maximized trial identification, formal meta-analysis was limited by the variation in trial reporting. Within the data available, mesh repair was associated with fewer recurrences.
Influence of antiseptic agents on interleukin 8 release and transmigration of polymorphonuclear granulocytes in an in vitro model of peritonitis
Authors: Sendt W , Mansouri E , Schmitt-Graeff A , Wollenberg K , Schöffel U 
Published: March 2003

Abstract

Background
The effect of antiseptic agents on peritoneal cells is ill defined. The influence of taurolidine (TAU) and polyhexamide (HEX) was investigated in an in vitro model.

Methods
Human umbilical vein endothelial cells (HUVECs) and human peritoneal mesothelial cells (HPMCs) were laid on collagen-coated filter inserts (HUVECs on the bottom, HPMCs on the top), thus representing a two-chamber peritoneal model. When confluence was reached, HPMCs were stimulated with 0·5 ml tumour necrosis factor (TNF) α 10 μg ml−1 for 4 h. Afterwards 0·5 ml TAU (1 and 2 per cent) or 0·5 ml HEX (0·1 and 0·2 per cent) solutions were added to the upper compartment. After 1 h polymorphonuclear granulocytes (PMNs) (105 ml−1) were added to the lower compartment. After 2 and 6 h aliquots were taken from both compartments, transmigrated PMNs were counted and interleukin (IL) 8 concentrations were measured. Controls were either TNF-α-stimulated HPMCs or stimulated HPMCs where culture medium had been substituted for TNF-α. Significance of differences was assessed by analysis of variance with Bonferroni corrections. Correlations were calculated by linear regression analysis.

Results
Stimulation with TNF-α led to a time-dependent increase in PMN transmigration. IL-8 secretion into the apical compartment increased time dependently, resulting in a gradient between the two chambers. After substitution of the stimulus by culture medium, significantly less IL-8 was measured in both compartments. PMN transmigration was almost absent. Addition of HEX resulted in an initial increase in IL-8 levels comparable to TNF controls without further changes. A concentration-dependent decrease in IL-8 gradient was associated with reduced transmigration. The IL-8 gradient between the upper and lower chambers correlated significantly with PMN transmigration (r = 0·8205, P &lt; 0·0001).

Conclusion
The decrease in IL-8 gradients by HEX and the diminished IL-8 response after addition of TAU may reflect either anti-inflammatory effects or cellular damage. Both antiseptic solutions reduced PMN migration, irrespective of continuous stimulation in this model.
Rebound phenomenon in tissue plasminogen activator activity of parietal peritoneum after anastomosing colon in rats with bacterial peritonitis
Authors: Reijnen M M P J , Holmdahl L , Falk P , van Goor H 
Published: March 2003

Abstract

Background
This study aimed to measure the fibrinolytic response, which plays a role in adhesion and abscess formation, of the parietal peritoneum to surgery in the presence and absence of bacterial peritonitis.

Methods
In 48 male Wistar rats bacterial peritonitis was induced using caecal ligation and puncture (CLP). Some 24 h after CLP (day 0), 12 rats were killed and biopsies were taken from the parietal peritoneum. The remaining 36 rats were reoperated whereby the ligated caecum was resected followed by resection of a 1-cm segment of the descending colon and end-to-end anastomosis. Thirty additional rats underwent resection of a 1-cm segment and anastomosis of the descending colon without any previous procedure. One-third of the rats were killed on days 1, 3 and 7 after anastomosing the colon, and biopsies were taken from the parietal peritoneum. From ten untreated rats, biopsies were taken for measurement of baseline levels. All biopsies were homogenized and tissue plasminogen activator (tPA) activity was measured using an enzyme-linked immunosorbent assay.

Results
Some 24 h after inducing peritonitis (day 0), tPA activity was significantly (P &lt; 0·0001) decreased compared with baseline levels. One day after anastomosis in rats with peritonitis, tPA activity was in the same range as baseline values, while tPA activity was significantly increased on days 3 and 7 after anastomosis, in comparison to baseline levels (P = 0·0002). There was no significant difference in tPA activity compared with baseline levels 1, 3 and 7 days after anastomosing colon in normal rats.

Conclusion
In rats with bacterial peritonitis, tPA activity in the parietal peritoneum was depressed after 24 h; 24–48 h after inducing peritonitis, tPA activity increased, reaching supranormal levels at days 3–7. Surgery alone does not influence tPA activity of the parietal peritoneum.
Investigation of a potential effect of exogenous interleukin 10 on lipopolysaccharide mediated tolerance to lipopolysaccharide in rabbits
Authors: Riese J , Cavaillon J M , Hohenberger W , Haupt W 
Published: March 2003

Abstract

Background
Postoperative immunosuppression is a risk factor for postoperative infection and sepsis. The lipopolysaccharide (LPS) sensitivity of circulating leucocytes is diminished in the postoperative course. A similar state of LPS tolerance can be induced in the experimental setting by injection of low doses of LPS. This tolerance may be mediated by cytokines which are released following LPS injection. In the presence of interleukin (IL) 10 the LPS-induced production of numerous cytokines is diminished in leucocytes. The aim of the study was to investigate the effect of exogenous IL-10 on LPS-induced tolerance to LPS in rabbits.

Methods
Rabbits were injected intravenously with LPS 5 μg kg−1 or human recombinant IL-10 (hrIL-10) 5 μg kg−1 or with sodium chloride or hrIL-10 1 h before LPS. Blood was drawn thereafter repeatedly up to the fifth day and incubated without or with LPS (10 ng ml−1, 1000 ng ml−1) for 20 h. Tumour necrosis factor (TNF) α was assayed in plasma supernatants using the L929 bioassay and hrIL-10 was detected in serum samples by enzyme-linked immunosorbent assay. Rectal temperature was measured at the indicated time points.

Results
Injection of LPS transiently (3 days) caused a biphasic fever and a LPS-tolerant state. IL-10, like LPS, transiently diminished the capacity for TNF-α production. The administration of IL-10 1 h before the injection of LPS neither affected the LPS-induced suppression of TNF-α production, nor modified the duration of tolerance. Likewise, fever curves were no different.

Conclusion
This pilot study shows that, despite IL-10-induced reduction of the capacity for (proinflammatory) cytokine production, LPS tolerance following LPS injection was not altered. Thus systemic cytokine production seems not to be responsible for the induction of fever and LPS tolerance.
Kinetics of tumour necrosis factor α and interleukin 10 in rats with endotoxaemia and obstructive jaundice-induced anergy
Authors: Yorganci K , Baykal A , Kologlu M , Saribas Z , Hascelik G , Sayek I 
Published: March 2003

Abstract

Background
Obstructive jaundice leads to a significant increase in septic complications. In addition, endotoxaemia may cause a secondary insult. The effects of endotoxaemia and obstructive jaundice-induced anergy on the kinetics of two early mediators of the response to sepsis, tumour necrosis factor (TNF) α and interleukin (IL) 10, were investigated.

Methods
Wistar rats had either bile duct ligation (BDL) or sham operation. After 2 weeks, anergy was confirmed by a delayed-type hypersensitivity response in rats that had undergone BDL. All rats were challenged with Escherichia coli lipopolysaccharide (LPS) 20 mg kg−1 or saline. After 90 and 180 min, rats were killed and blood samples were obtained for TNF-α and IL-10 measurement.

Results
There was no intragroup difference after saline challenge. LPS injection significantly increased both TNF-α and IL-10 levels in all groups compared with all saline injection groups. LPS injection following BDL led to significantly higher TNF-α levels and lower IL-10 levels at 90 min compared with those after sham operation (P &lt; 0·05). There were no differences between TNF-α and IL-10 levels at 180 min following LPS challenge in rats that had undergone BDL.

Conclusion
BDL primes for an increase in TNF-α levels to a subsequent LPS challenge. However, the IL-10 increase following an LPS challenge is suppressed by BDL. These results suggest that BDL primes for a more vigorous inflammatory response to LPS challenge.
Hyperglycaemia is associated with fungaemia and an increased mortality rate in severely burned children
Authors: Gore D , Chinkes D , Herndon D N , Heggers J , Desai M , Wolf S 
Published: March 2003

Abstract

Background
Hyperglycaemia may have detrimental effects on immunity. The purpose of this study was to assess any relationship between hyperglycaemia and clinical outcome following injury.

Methods
The records of children with burns covering 60 per cent or more of the body surface admitted after 1996 were reviewed. Patients were categorized as having poor glucose control if 40 per cent or more of all plasma glucose determinations were 7·8 mmol l−1 or greater and were compared with patients with adequate glucose control (less than 40 per cent of glucose values 7·8 mmol l−1 or greater).

Results
Despite similar age, burn size and caloric intake, the extent and severity of hyperglycaemia was significantly greater in the 33 patients categorized as having poor glucose control than in the 25 patients with adequate glucose control. Patients with hyperglycaemia had a significantly higher proportion of blood cultures positive for yeast (mean(s.d.) 3·7(10·0) versus 0·1(0·7) per cent; P &lt; 0·05, Student's t test). Nine of 33 patients with persistent hyperglycaemia died, compared with only one of 25 with adequate glucose control (P ≤ 0·05, Fisher's exact test).

Conclusion
This association between hyperglycaemia, fungaemia and subsequent death in severely burned children may be related to a hyperglycaemia-induced deterioration in immune function. This suggests that aggressive manoeuvres to normalize plasma glucose may be warranted.
Treatment of Candida infection in patients with infected pancreatic necrosis
Authors: Farkas G , Márton J , Leindler L , Nagy E 
Published: March 2003

Abstract

Background
The purpose of this review was to determine the incidence of Candida infection in patients with infected pancreatic necrosis, to determine the most frequent risk factors and to assess the best treatment approach for disseminated candidal infections.

Methods
Of 145 patients with infected pancreatic necrosis identified, 30 (21 per cent) were infected with C. albicans. Risk factors identified in patients with Candida infection included the presence of necrotic tissue, and the use of broad-spectrum antibiotics, intravascular catheters and parenteral nutrition.

Results
With one exception, all cases involved mixed bacterial and fungal infections. The positive fungal result was obtained either during or after operation. Sixteen of the 30 patients displayed fungal colonization, while the other 14 had disseminated fungal infection. There were two deaths in the disseminated group, but none in the colonization group. In both fatal cases, flucytosine was applied. When fluconazole was used against disseminated fungal infection, no death was noted. Recently, prophylactic fluconazole has also been used in 20 patients with infected pancreatic necrosis, with no evidence of fungal infection after operation.

Conclusion
The combination of adequate surgical treatment with effective antibiotics and early antifungal therapy is the ideal management approach for infected pancreatic necrosis with Candida infection. Fluconazole may be regarded as an efficient drug for the prophylaxis of candidiasis.