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sympathectomy and sepsis

Joseph C Gigliotti, Liping Huang, Amandeep Bajwa, Hong Ye, Eric H Mace, John A Hossack, Kambiz Kalantari, Tsuyoshi Inoue, Diane L Rosin, Mark D Okusa
We showed previously that prior exposure to a modified ultrasound regimen prevents kidney ischemia-reperfusion injury (IRI) likely via the splenic cholinergic anti-inflammatory pathway (CAP) and α7 nicotinic acetylcholine receptors (α7nAChR). However, it is unclear how ultrasound stimulates the splenic CAP. Further investigating the role of the spleen in ischemic injury, we found that prior splenectomy (-7d) or chemical sympathectomy of the spleen with 6-hydroxydopamine (6OHDA; -14d) exacerbated injury after subthreshold (24-minute ischemia) IRI...
October 2015: Journal of the American Society of Nephrology: JASN
Michelle C Roughton, Shailesh Agarwal, Lawrence J Gottlieb
Purpura fulminans is a syndrome characterized by hemorrhagic infarction of the skin and underlying soft tissue as a result of disseminated intravascular coagulation and intravascular thrombosis. In this study, the authors report their experience with surgical intervention for acute infectious purpura fulminans (AIPF). A retrospective chart review was performed including all patients diagnosed with AIPF from January 1, 2006, to December 31, 2008, and treated at an academic medical center. Primary endpoints of interest were overall survival rate and the need for and level of eventual amputation...
March 2011: Journal of Burn Care & Research: Official Publication of the American Burn Association
Rainer H Straub, Georg Pongratz, Claudia Weidler, Hans-Jörg Linde, Carsten J Kirschning, Thomas Glück, Jürgen Schölmerich, Werner Falk
The sympathetic nervous system is intensely activated during bacteremia, but its immediate influence on the bacterial tissue burden remains unclear. We demonstrate that prior ablation of the sympathetic nervous system decreases this dissemination of Pseudomonas aeruginosa or Escherichia coli through a mechanism of increased secretion of peritoneal tumor necrosis factor, improved phagocytic response of peritoneal cells, and increased influx of monocytes into the peritoneal cavity. When gram-positive Staphylococcus aureus strains were used, sympathectomy increased the bacterial tissue burden, which was caused by a reduction in corticosterone tonus, and decreased both interleukin-4 secretion from peritoneal cells and the influx of lymphocytes into the peritoneal cavity...
August 15, 2005: Journal of Infectious Diseases
D J Adam, S Raptis, R A Fitridge
BACKGROUND: This study examines trends in the presentation and surgical management of acute diabetic foot problems in a single institution. METHOD: Prospective audit of all diabetic patients who had a primary procedure for critical lower limb ischaemia (CLI) and/or foot sepsis between 1st January 1990 and 31st December 2002. Primary and secondary intervention, mortality and limb salvage rate within 6 weeks of the index procedure were recorded. RESULTS: There were 661 patients (417 men and 244 women of median age 69, range 31-99, years) with 799 affected limbs...
February 2006: European Journal of Vascular and Endovascular Surgery
Mitchell J Cohen, Ravi Shankar, Julia Stevenson, Rosaura Fernandez, Richard L Gamelli, Stephen B Jones
OBJECTIVE: We sought to determine the influence of thermal (burn) injury with sepsis and norepinephrine on the clonogenic potential and functional cytokine response to lipopolysaccharide (LPS) stimulation in nonmyeloid committed (CD117) and myeloid committed (ER-MP12) bone marrow progenitor cells. SUMMARY AND BACKGROUND DATA: We have previously demonstrated that norepinephrine stimulated myelopoiesis after burn injury and sepsis, but the site of this stimulation in monocyte development is unknown...
July 2004: Annals of Surgery
Jürgen Birnbaum, Christian Lehmann, Harald M Stauss, Mathias Weber, Alexander Georgiew, Björn Lorenz, Sven Pulletz, Matthias Gründling, Dragan Pavlovic, Michael Wendt, Wolfgang J Kox
Impairment of the intestinal microcirculation has been recognized as an important factor in the pathogenesis of endotoxin related sepsis syndrome. We investigated the effects of endotoxemia on the variability of intestinal microvascular blood flow (IMBF) and arterial blood pressure (BP) in a prospective, randomized, controlled animal study. Recordings of IMBF (laser Doppler fluxmetry) and BP were performed before, two and four hours after i.v. injection of either placebo or endotoxin (5 mg/kg b.w. lipopolysaccharide from E...
2003: Clinical Hemorheology and Microcirculation
T M Willis, R J Hopp, J R Romero, P D Larsen
Acute infectious purpura fulminans is reported in a 16-month-old male with a history of posttraumatic asplenia and complete left brachial plexus palsy. This patient developed peripheral necrosis of both lower extremities and the right upper extremity, whereas the left upper extremity was completely spared from ischemia and tissue damage. Amputation of four digits on the right hand and debridement of both lower extremities were required. This patient demonstrated the protective effect of a traumatic sympathectomy, which suggests the requirement of an intact sympathetic reflex in the development of purpura fulminans...
May 2001: Pediatric Neurology
Y Tang, R Shankar, M Gamboa, S Desai, R L Gamelli, S B Jones
OBJECTIVE: To determine whether thermal injury and sepsis cause an increase in bone marrow norepinephrine release and whether such a release influences bone marrow monocytopoiesis. SUMMARY BACKGROUND DATA: The authors previously demonstrated enhanced bone marrow monocytopoiesis after burn with sepsis. They also showed that physiologic stress and bacterial challenge without injury could lead to a dynamic release of norepinephrine from the bone marrow compartment...
February 2001: Annals of Surgery
J Bríza, Z Krska
The authors describe group of 60 patients with diabetic gangrena of lower extremity. In 24 cases was performed primary amputation (14 acral and 10 in thigh for sepsis). In 14 patients was carried out balloon angioplasty, in 6 bypass and in 16 a lumbal sympathectomy. The big amputation was necessary after the revascularization in 9 cases. A treatment of the diabetic foot have to be complex. Before amputation is the angiography necessary. It is enabled also by the balloon angioplasty. Microangiopathy with the good arteriography finding in main limb arteries make acral amputation possible...
1996: Sborník Lékar̆ský
B J Pardy, M C Hoare, H H Eastcott, C C Miles, T N Needham, T Harbourne, B W Ellis
Twenty-one patients with severe Raynaud's phenomenon were treated on 29 occasions with prostaglandin E1 (PGE1), a potent vasodilator and pyrogen. A history of finger sepsis or necrosis was absent in 8 (group I) and present in 13 (group II). Three group I and eight group II patients had an associated connective tissue disease, and previously eight upper limbs had been sympathectomized in six group I patients and 14 upper limbs in eight group II patients. A total of 12 fingers had been amputated in six group II patients...
December 1982: Surgery
N A Matheson, P Diomi
No abstract text is available yet for this article.
October 1970: Surgery, Gynecology & Obstetrics
P L Harris, F Read, A Eardley, D Charlesworth, J Wakefield, R A Sellwood
No abstract text is available yet for this article.
August 1974: British Journal of Surgery
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