المؤلفون: Xianjie Zhang, Xiaofei Wei, Lixin Liu, Marti, Guy P., Ghanamah, Mohammed S., Arshad, Muhammad J., Strom, Lori, Spence, Robert, Jeng, James, Milner, Stephen, Harmon, John W., Semenza, Gregg L.

المصدر: Archives of Surgery; Mar2010, Vol. 145 Issue 3, p259-266, 8p

مستخلص: Objective: To perform a systematic exploration of the phenomenon of mobilization of circulating angiogenic cells (CACs) in an animal model. This phenomenon has been observed in patients with cutaneous burn wounds and may be an important mechanism for vasculogenesis in burn wound healing. Design: We used a murine model, in which burn depth can be varied precisely, and a validated culture method for quantifying circulating CACs. Setting: Michael D. Hendrix Burn Research Center, Baltimore, Maryland. Participants: Male 129S1/SvImJ mice, aged 8 weeks, and 31 patients aged 19-59 years with burn injury on 1% to 64% of the body surface area and evidence of hemodynamic stability. Main Outcome Measures: Burn wound histological features, including immunohistochemistry for blood vessels with CD31 and α-smooth muscle actin antibodies, blood flow measured with laser Doppler perfusion imaging, and mobilization of CACs into circulating blood measured with a validated culture technique. Results: Increasing burn depth resulted in a progressive delay in the time to mobilization of circulating CACs and reduced mobilization of CACs. This delay and reduction in CAC mobilization was associated with reduced perfusion and vascularization of the burn wound tissue. Analysis of CACs in the peripheral blood of the human patients, using a similar culture assay, confirmed results previously obtained by flow cytometry, that CAC levels peak early after the burn wound. Conclusion: If CAC mobilization and wound perfusion are important determinants of clinical outcome, then strategies designed to augment angiogenic responses may improve outcome in patients with severe burn wounds. [ABSTRACT FROM AUTHOR]

: Copyright of Archives of Surgery is the property of American Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Collins, Brendan J., Tomoharu Miyashita, Schweitzer, Michael, Magnuson, Thomas, Harmon, John W.

المصدر: Archives of Surgery; Oct2007, Vol. 142 Issue 10, p1000-1003, 4p

مستخلص: Objective: To highlight the clinical and experimental rationales that support why the Roux-en-Y limb is an important surgical principle for bariatric gastric bypass. Data Sources: We reviewed PubMed citations for open Roux-en-Y gastric bypass (RYGBP), laparoscopic RYGBP, loop gastric bypass, chronic alkaline reflux gastritis, and duodenoesophageal reflux. Study Selection: We reviewed clinical and experimental articles. Clinical articles included prospective, retrospective, and case series of patients undergoing RYGBP, laparoscopic RYGBP, or loop gastric bypass. Experimental articles that were reviewed included in vivo and in vitro models of chronic duodenoesophageal reflux and its effect on carcinogenesis. Data Extraction and Synthesis: No formal data extraction was performed. We reviewed published operative times, lengths of stay, and anastomotic leak rates for laparoscopic RYGBP and loop gastric bypass. For in vivo and in vitro experimental models of duodenoesophageal reflux, we reviewed the kinetics and potential molecular mechanisms of carcinogenesis. Conclusions: Recent data suggest that laparoscopic loop gastric bypass, performed without the creation of a Roux-en-Y gastroenterostomy, is a faster surgical technique that confers similarly robust weight loss compared with RYGBP or laparoscopic RYGBP. In the absence of a Roux limb, the long-term effects of chronic alkaline reflux are unknown. Animal models and in vitro analyses of chronic alkaline reflux suggest a carcinogenic effect. [ABSTRACT FROM AUTHOR]

: Copyright of Archives of Surgery is the property of American Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Zhang, Xianjie, Wei, Xiaofei, Liu, Lixin, Marti, Guy P., Ghanamah, Mohammed S., Arshad, Muhammad J., Strom, Lori, Spence, Robert, Jeng, James, Milner, Stephen, Harmon, John W., Semenza, Gregg L.

المصدر: Archives of Surgery; March 2010, Vol. 145 Issue: 3 p259-266, 8p

مستخلص: OBJECTIVE To perform a systematic exploration of the phenomenon of mobilization of circulating angiogenic cells (CACs) in an animal model. This phenomenon has been observed in patients with cutaneous burn wounds and may be an important mechanism for vasculogenesis in burn wound healing. DESIGN We used a murine model, in which burn depth can be varied precisely, and a validated culture method for quantifying circulating CACs. SETTING Michael D. Hendrix Burn Research Center, Baltimore, Maryland. PARTICIPANTS Male 129S1/SvImJ mice, aged 8 weeks, and 31 patients aged 19-59 years with burn injury on 1% to 64% of the body surface area and evidence of hemodynamic stability. MAIN OUTCOME MEASURES Burn wound histological features, including immunohistochemistry for blood vessels with CD31 and α-smooth muscle actin antibodies, blood flow measured with laser Doppler perfusion imaging, and mobilization of CACs into circulating blood measured with a validated culture technique. RESULTS Increasing burn depth resulted in a progressive delay in the time to mobilization of circulating CACs and reduced mobilization of CACs. This delay and reduction in CAC mobilization was associated with reduced perfusion and vascularization of the burn wound tissue. Analysis of CACs in the peripheral blood of the human patients, using a similar culture assay, confirmed results previously obtained by flow cytometry, that CAC levels peak early after the burn wound. CONCLUSION If CAC mobilization and wound perfusion are important determinants of clinical outcome, then strategies designed to augment angiogenic responses may improve outcome in patients with severe burn wounds. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00796627Arch Surg. 2010;145(3):259-266--

المؤلفون: Collins, Brendan J., Miyashita, Tomoharu, Schweitzer, Michael, Magnuson, Thomas, Harmon, John W.

المصدر: Archives of Surgery; October 2007, Vol. 142 Issue: 10 p1000-1003, 4p

مستخلص: OBJECTIVE To highlight the clinical and experimental rationales that support why the Roux-en-Y limb is an important surgical principle for bariatric gastric bypass. DATA SOURCES We reviewed PubMed citations for open Roux-en-Y gastric bypass (RYGBP), laparoscopic RYGBP, loop gastric bypass, chronic alkaline reflux gastritis, and duodenoesophageal reflux. STUDY SELECTION We reviewed clinical and experimental articles. Clinical articles included prospective, retrospective, and case series of patients undergoing RYGBP, laparoscopic RYGBP, or loop gastric bypass. Experimental articles that were reviewed included in vivo and in vitro models of chronic duodenoesophageal reflux and its effect on carcinogenesis. DATA EXTRACTION AND SYNTHESIS No formal data extraction was performed. We reviewed published operative times, lengths of stay, and anastomotic leak rates for laparoscopic RYGBP and loop gastric bypass. For in vivo and in vitro experimental models of duodenoesophageal reflux, we reviewed the kinetics and potential molecular mechanisms of carcinogenesis. CONCLUSIONS Recent data suggest that laparoscopic loop gastric bypass, performed without the creation of a Roux-en-Y gastroenterostomy, is a faster surgical technique that confers similarly robust weight loss compared with RYGBP or laparoscopic RYGBP. In the absence of a Roux limb, the long-term effects of chronic alkaline reflux are unknown. Animal models and in vitro analyses of chronic alkaline reflux suggest a carcinogenic effect.Arch Surg. 2007;142(10):1000-1003--

المؤلفون: Graeber, Geoffrey M., O'Neill, John F., Wolf, Robert E., Wukich, Dane K., Cafferty, Patrick J., Harmon, John W.

المصدر: Archives of Surgery; July 1983, Vol. 118 Issue: 7 p837-840, 4p

مستخلص: • Experimental arterial bowel infarction can cause elevetions in levels of peripheral serum creatine phosphokinase (CPK), lactic dehydrogenase (LDH), and their isoenzymes. To test whether these changes would occur in strangulated small bowel infarctions, 18 dogs were placed under general anesthesia and randomized to one of three categories: laparotomy alone, simple mechanical small bowel obstruction, or strangulated small bowel infarction induced by incarcerating bowel in a surgically created ventral hernia. Serum samples were drawn for 48 hours postoperatively. Total CPK and LDH activity were determined by automated spectrophotometry; isoenzyme levels were determined by agarose gel electrophoresis. Levels of peripheral serum CPK and each of its isoenzymes became significantly elevated in the dogs with strangulated infarction. Such elevations did not occur with LDH. The findings suggest that changes in peripheral serum CPK could prove helpful in evaluating bowel viability in cases of intestinal obstruction.(Arch Surg 1983;118:837-840)

المؤلفون: Temeck, Barbara K., Schafer, Paul W., Park, Woo Y., Harmon, John W

المصدر: Archives of Surgery; April 1989, Vol. 124 Issue: 4 p415-418, 4p

مستخلص: • Epidural anesthesia has been reported to exert beneficial effects in surgical procedures. Over the past 3 years at the Veterans Administration Medical Center in Washington, DC, thoracic surgical procedures have been done using a combined technique of epidural anesthesia with light general anesthesia. A retrospective review of this experience from January 1984 to November 1987 was done in 90 consecutive patients. Postoperative extubation of patients was accomplished immediately in 32%, within 1 hour in 34%, within 3 hours in 28%, within 18 hours in 4%, and was prolonged in only 1% of patients. Mortality was 2% and morbidity was 3%. This analysis indicates that the technique of epidural anesthesia with light general anesthesia provided satisfactory anesthesia with low mortality and morbidity in a high-risk group of patients undergoing surgery.(Arch Surg. 1989;124:415-418)

المؤلفون: Harmon, John W., Hoar, Carl S.

المصدر: Archives of Surgery; March 1973, Vol. 106 Issue: 3 p282-285, 4p

مستخلص: Cloth femoral-popliteal bypass grafts were inserted in 29 diabetic patients, in 28 of whom the saphenous vein was unavailable. Fourteen of 29 grafts were open longer than one year, and only two of the 14 subsequently closed. Four grafts were open more than four years. However, seven patients had spontaneous graft closure during the first year. The accumulated five-year patency rate was 59%. A walking foot was preserved for a significant period for 19 of the patients. All but one of the nine patients whose graft closed required a major amputation, while one of the sixteen patients with open grafts came to a major amputation. The relationship of the popliteal anastomosis to the knee joint did not affect late closure rate.

المؤلفون: Lillemoe, Keith D., Brigham, Robert A., Harmon, John W., Feaster, Marshall M., Saunders, John R., d'Avis, Juan A.

المصدر: Archives of Surgery; August 1983, Vol. 118 Issue: 8 p905-907, 3p

مستخلص: • We treated 17 patients with severe small-bowel radiation enteritis surgically. Fourteen patients were female. Gynecologic malignant lesions (cervical, ovarian, and endometrial) were the most frequent sites of the primary tumors for which radiation was given. Thirteen patients had bowel obstruction, and the remainder had enterovaginal fistulae. Intestinal bypass, rather than resection, was the preferred approach in the treatment of these patients, and was used in 11 cases. Successful palliation was provided in nine patients, with minimal morbidity and no operative deaths. Follow-up at eight to 60 months has shown no further sequelae of radiation injury or of blind loop syndrome. This supports the relative safety of intestinal bypass for the surgical management of small-bowel radiation enteritis.(Arch Surg 1983;118:905-907)

المؤلفون: Harmon, John W.

المصدر: Archives of Surgery; Aug2008, Vol. 143 Issue 8, p808-808, 1/4p

المؤلفون: Harmon, John W.

المصدر: Archives of Surgery; May2008, Vol. 143 Issue 5, p470-470, 1/2p