The Journal of surgical research
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Sweat glands play some key roles in homeostasis maintenance and body temperature regulation. In full-thickness burn wounds, sweat glands cannot regenerate to form their three-dimensional organization via the division and terminal differentiation of sweat gland cells. However, the plasticity of mesenchymal stem cells (MSCs) may offer the hope and potentiality to regenerate sweat glands after severe burn injury.
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A decreased synthesis of interferon gamma (IFN-gamma) by TH 1 lymphocytes after cardiac operations with cardiopulmonary bypass (CPB) is part of the inflammatory response to local operative and systemic traumas. The consequences of this mechanism on the release of pro- and anti-inflammatory cytokines remain unclear. To evaluate the role of IFN-gamma, we added recombinant IFN-gamma to peripheral blood mononuclear cells (PBMCs) on the first post-operative day in an attempt to restore pre-operative values and then measured the release of pro- and anti-inflammatory cytokines in vitro. ⋯ Contrary to our expectations, the in vitro release of IL-6 and IL-8 as well as IL-10 and IL-4 was not influenced by the addition of IFN-gamma. However, TNF-alpha production in isolated PBMC cultures increased significantly on the first post-operative day. This may indicate a hyper-reactivity of PBMCs to IFN-gamma and suggests that the decrease in IFN-gamma synthesis might prevent an excessive stimulation of the non-specific immune system by high TNF-alpha levels after cardiac surgery.
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We studied the effects of early versus delayed fluid resuscitation on hemodynamic response and short-term survival in a porcine model of severe hepatic injury associated with hemorrhagic shock. ⋯ Early versus delayed fluid infusion with HSD resulted in a comparable hemodynamic response and survival 100 min after injury. No rebleeding was observed.
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Our goal was to create surgical resident centered, interactive teaching modules rich in basic science and clinical content directly pertinent to patient care and surgical techniques that would facilitate education in the 80-h work week environment. ⋯ Teaching modules enable maximal trainee and instructor flexibility, which translates into optimal adult learning and teaching. Lecture packets can be conveyed to all residents with unlimited availability in the virtual domain. Further refinement and continued implementation will help fill the void in direct didactic teaching left by mandated work hour restrictions, allowing for more efficient learning and teaching. There is great potential for broad application of the concept and technology to other training programs.
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Considering the renal effects of fluid resuscitation in hemorrhaged patients, the choice of fluid has been a source of controversy. In a model of hemorrhagic shock, we studied the early hemodynamic and renal effects of fluid resuscitation with lactated Ringer's (LR), 6% hydroxyethyl starch (HES), and 7.5% hypertonic saline (HS) with or without 6% dextran-70 (HSD). ⋯ Despite the immediate differences in hemodynamic responses, the low-volume resuscitation fluids, HS and HSD, are equally effective to LR and HES in restoring renal performance 120 min after hemorrhagic shock treatment.