Laparoscopic-assisted colonic resection gives significant improvements in return of gastrointestinal function and length of stay, with an increased operative time and no difference in the postoperative complication rate.
Helicobacter pylon infection of the stomach is accompanied by a persistent polymorphonuclear leukocyte (PMNL) infiltrate of the mucosa. The aim of this work was to study the activation of human PMNL by substances produced by H pylon. Filtered H pyloon con-
The temporal relationship of changes in atrial natriuretic peptide (ANP) secretion to other pathophysiological changes in heart failure has not been investigated. We studied the hemodynamic, hormonal, and metabolic changes before, during, and after the induction of heart failure in eight sheep using a 14-day period of rapid left ventricular pacing (LVP). Arterial pressure declined 21% on the first day, while cardiac output fell progressively to 48% of base line, and atrial pressures rose to a plateau over the first week. Plasma ANP levels increased 10-fold with a close correlation to left atrial pressure in all sheep. Furthermore, ANP secretion appeared to be sustained throughout the LVP period but did not prevent avid sodium retention. Marked and early activation of the renin-angiotensin system was observed, whereas the major increase in plasma aldosterone commenced 4 days later. On termination of LVP, a prompt natriuresis and diuresis occurred with return of all parameters toward base line. Thus this ovine model is useful for studying pathophysiological changes during the onset and offset of heart failure.
Helicobacter pylori infection in humans is associated with diverse of clinical outcomes which are partly attributed to bacterial strain differences. Secreted bacterial products are thought to be involved in the pathogenesis caused by this non-invasive bacterium. Electron microscopy of gastric biopsies from infected individuals revealed blebbing of the H. pylori outer membrane, similar to the process of outer membrane vesicle shedding which occurs when the bacterium is grown in broth. Porins, a class of proinflammatory proteins, were observed in the outer membrane vesicles. The VacA cytotoxin, which is produced by 50-60% of H. pylori strains and associated with increased pathogenesis of infection, was also found to be vesicle-associated and biologically active. This supports the hypothesis that these vesicles represent a vehicle for the delivery of damaging bacterial products to the gastric mucosa.
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