Surgery
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Comparative Study
Morphologic changes and prognosis of the respiratory tract epithelium in inhalation injury and their relationship with clinical manifestations.
We set out to observe the morphologic changes and determine prognosis based on airway epithelial injury after inhalation injury of varying severity using a fiberbronchoscope and to explore the relationship between the severity of epithelial injury and its clinical manifestation. ⋯ Fiberoptic bronchoscopy contributes to the accurate evaluation of tracheal epithelial injury severity. As the severity of inhalation injury increased, the clinical symptoms also increased. Severe complications (eg, bleeding and asphyxia caused by epithelial slough) may occur in patients with third-degree injury and should be closely observed by clinicians. The airway epithelium has a substantial potential for repair. Even if the airway epithelial injury is severe, the damaged epithelium will recover.
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In a population-based study, we examined recurrence rates of acute pancreatitis (AP) after cholecystectomy performed to prevent recurrences of AP. ⋯ When AP is associated with significantly elevated liver enzymes on day 1, recurrence rates after cholecystectomy are low (9%). However, postcholecystectomy recurrence rates of AP are high in those without such laboratory abnormalities (34%), especially in those without gall bladder stones/sludge (61%) on abdominal ultrasonography. Our results raise doubts about the efficacy of cholecystectomy to prevent recurrent AP in patients with the absence of either a significant elevation of liver tests on day 1 of AP or gallstones and/or sludge in the gall bladder on initial ultrasound examination.
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To investigate the role of CD4+ CD25+ Foxp3+ regulatory T cells (Tregs) in septic conditions, and to examine the potential of targeting them for the treatment of sepsis. ⋯ We found an increase in the percentages of Tregs in peripheral blood circulating CD4+ T cells from patients with sepsis, and in splenic MNCs from septic mice, and observed that regulation of Tregs by neutralizing IL-10 or TGF-β might represent a novel strategy for treating the immunosuppressive conditions in sepsis.
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The present study was designed to evaluate the results of phenolization for pilonidal sinus disease and the risk factors for treatment failure. ⋯ With an early return to work and low rates of complications and recurrence, phenolization is a simple outpatient procedure for the treatment of pilonidal sinus disease in selected patients.
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The clinical impact of the distal pancreatectomy with en-bloc celiac axis resection for locally advanced pancreatic body cancer remains unclear. ⋯ Aggressive resection for T4 pancreatic body cancer by distal pancreatectomy-celiac axis resection can be justified for otherwise unresectable tumors. The surgical indication should be evaluated carefully because of the higher incidence of morbidity and lower incidence of curability compared with distal pancreatectomy, as well as because there have been no long-term survivors so far.