Journal of the American College of Surgeons
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Review Comparative Study Historical Article
"Modern" military surgery: 19th century compared with 20th century.
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Comparative Study
Increased expression of Cyr61 (CCN1) identified in peritoneal metastases from human pancreatic cancer.
Identification of extracellular matrix proteins (ECM) associated with tumor cell metastasis may generate targets for future therapy against pancreatic cancer metastases. We hypothesized that comparison of ECM-associated gene expression in primary and metastatic pancreatic tumors would identify ECM proteins associated with pancreatic metastasis. ⋯ The ECM protein Cyr61 shows increased expression in metastatic lesions in a clinically relevant model of pancreatic adenocarcinoma. Protein analysis confirms the microarray results and collocalization of Cyr61, and alpha(v) suggests that interaction between Cyr61 and alpha(v)beta(3) promotes formation of peritoneal metastases.
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Biography Historical Article
Days 2 and 3 of the dawn of modern military surgery: the sequel to Senn.
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Randomized Controlled Trial Clinical Trial
Evaluation of continuous infusion of 0.5% bupivacaine by elastomeric pump for postoperative pain management after open inguinal hernia repair.
Postoperative pain management and narcotic usage after inguinal hernia repair is an important concern for anesthesiologists and surgeons. Regional anesthesia incisional infiltration techniques may reduce the need for systemic medications. ⋯ Demonstrable benefits include reduction of narcotic usage and pain with no apparent increase in the risk of infection or complication. Continuous infusion of 0.5% bupivacaine at 2 mL/h through the ONQ pump is a safe and effective adjunct in postoperative pain management for open inguinal hernia repair. This represents a viable and possibly superior option for prolonged pain management, minimizing use of narcotics in patients undergoing this procedure.