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71.
Ryo Aeba Toshiyuki Katogi Kenichi Hashizume Yoshimi Iino Kiyoshi Koizumi Kentaro Hotoda Shinya Inoue Hideki Matayoshi Akihiro Yoshitake Ryohei Yozu 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2003,51(7):302-307
OBJECTIVE: Severe aortic arch obstruction including an interrupted aortic arch in congenital complex heart anomalies remains a challenge in surgical management. METHODS: Treatment and outcomes in 75 consecutive patients who underwent an aortic arch repair as the first step of the staged repair protocol between 1975 and 2000 were reviewed. Their ages at repair ranged from 1 day to 8.5 months. RESULTS: Cross-sectional postoperative follow-up data were available in all the patients. The follow-up period ranged from 0 to 27.6 years (mean: 7.3 +/- 7.3 years). There were 20 postoperative hospital deaths (27%) and 7 late deaths. The Kaplan-Meier estimate of survival was 81.3% +/- 4.5% at 1 month, 68.0% +/- 5.4% at 1 year, 65.0% +/- 5.5% at 5 years, 63.1% +/- 5.7% at 10 years, 63.1% +/- 5.7% at 20 years. By Cox regression analysis, body weight of 2.5 kg or less is the only independent determinant of postoperative mortality (p = 0.04, multivariable odds ratio: 2.50, [95% confidence interval: 1.02-6.1]). The aortic arch morphology, the primary cardiac lesion, or date of operation did not reach a statistically significant level to show correlation with mortality. Reintervention to reconstruct the aortic arch was performed at 9 occasions in 8 of the 55 patients who survived the primary operation (14.5%). The Kaplan-Meier estimate of the reintervention-free rate was 91.3% +/- 4.2% at 5 years, 85.5% +/- 5.6% at 10 years, 75.6% +/- 8.2% at 20 years. Using multivariable Cox regression analysis, interrupted aortic arch (versus aortic coarctation) was the only independent predictor of a shorter time to reintervention (p = 0.001, multivariable odds ratio: 16.1, [95% confidence interval: 3.2-80.2]). CONCLUSIONS: The staged repair protocol was associated with significant limitations in patient survival and with the development of recurrent aortic arch obstruction. Thus, a primary repair protocol may serve as an alternate approach, especially in patients with low weight or with an interrupted aortic arch. 相似文献
72.
73.
Isao Iwamoto Hisamichi Baba Yasunori Koga Noriyuki Uchida Kazuhiko Matsuo Kiyoshi Ishii Toshio Onitsuka Kouichirou Shibata 《Surgery today》1990,20(2):158-162
In order to assess the accuracy of electroencephalography (EEG), in children who have undergone cardiac surgery under simple
deep hypothermia, the relation between IQ or schoolwork achievement and the duration of circulatory arrest was investigated
in 75 such children. Abnormal preoperative EEG's were found in 16 per cent of the children while abnormal postoperative EEG's
were found in 17 per cent. The children were divided into 4 groups, according to pre- and postoperative EEG results. Schoolwork
achievement scores ranged between 3.0 and 3.2, the difference among the groups being insignificant. Moreover, no significant
shift in IQ was found among the groups. Finally, regarding the number of children who were able to go on to a higher level
of education, including high school the college or university, again no significant differences were found among the 4 groups.
In a comparison with the number of such children in neighboring Nagasaki prefecture able to continue on to a higher level
of education, no significant differences were seen either. The findings and statistics of this investigation therefore indicate
that pre- and postoperative EEG's are not always a reliable reference for assessing the prognosis of cerebral activity. 相似文献
74.
75.
To determine the anomeric preference of uptake of D-glucose and of D-galactose by rat lenses, we crystallized alpha-, beta-D-[U-14C]glucose (720 microCi/mmol) and alpha-, beta-D-[U-14C]galactose (180 microCi/mmol) by our method and incubated them separately with rat lenses for 1 min, because of the short half-life of mutarotation of alpha-D-glucose (9.6 min) and of alpha-D-galactose (4.6 min) in HEPES medium at 30 degrees C. During aerobic incubation of rat lenses in HEPES medium containing radioactive alpha or beta anomer of D-glucose, there was no significant difference in the rate of uptake between alpha and beta anomers of D-glucose by rat lenses. However, 1.59 times greater incorporation of alpha-D-galactose was observed over that of beta-D-galactose under the same conditions. 相似文献
76.
Fourteen strains of Eikenella corrodens isolated from human oral cavity were studied to determine corroding characteristics. Nine out of the 14 strains produced corroding colonies under anaerobic culture condition. One of them produced corrosion even in an aerobic culture. No morphological differences in surface structures were observed between corroding and non-corroding strains of E. corrodens by transmission electron microscopy. The morphology of corroding colonies of E. corrodens was then examined by scanning electron microscopy. The surface of the corroding-colony center was smoothly convex. A boundary line was clear between the smooth center and the surrounding corrosion region. Double or triple frill-like structures surrounded the center portion with small convexities. Spreading bacterial masses were observed in the outer portion of the colony. Morphological observations of the corroding colony edge indicated that a surface translocation termed "twitching motility" or "gliding motility" occurs in the outer portion and plays a role in its colonization of periodontal regions. 相似文献
77.
Key words intractable pain - celiac plexus neurolysis - ultrasonography 相似文献
78.
79.
In vitro tuberculin reactivity of lymphocytes from patients with tuberculous pleurisy. 总被引:5,自引:0,他引:5
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Mononuclear cells in pleural fluid from patients with tuberculous pleurisy were predominantly T cells. Responsiveness of pleural fluid T cells to purified protein derivative of tuberculin were studied by the assay of cell proliferation and production of lymphocyte mitogenic factor by the stimulation with purified protein derivative. Peripheral blood lymphocytes were also studied from patients and tuberculin-positive healthy controls. The order of responsiveness was as follows: pleural fluid lymphocytes greater than peripheral blood lymphocytes of patients without effusion = peripheral blood lymphocytes of healthy controls greater than peripheral blood lymphocytes of patients with effusion. The poor response of peripheral blood lymphocytes from pleurisy patients were recovered by the elimination of adherent cells in peripheral blood lymphocytes to the level of the response of peripheral blood lymphocytes from healthy controls. T cells purified from pleural fluid mononuclear cells responded more than those from peripheral blood. These results suggested that in the pleurisy patients purified protein derivative-reactive T cells in peripheral blood did not decrease in activity, but were depressed by suppressor cells, and further suggested that highly purified protein derivative-reactive T cells were accumulated in the pleural fluid. 相似文献
80.
Hayashi S Ichihara K Kanakura Y Iwatani Y 《Rinsho byori. The Japanese journal of clinical pathology》2004,52(3):204-211
The average of normals(AON) method is a quality control(QC) method that uses measured values of patients' samples instead of QC samples. Because this method is easily affected by fluctuations in the patient population and is insensitive to short-term changes in test values, we developed an alternative method based on the moving average(MA) of latent reference values(LRVs) which are the test results of patients whose other related test results are all within reference intervals. We evaluate the new methodology(MALRV) using seven commonly measured biochemical tests. The LRV of each test were selected with reference to four other items that had the highest coincidences of abnormality. The optimum amount of data needed to compute the MA is determined as that making the coefficient of variation(CV) of the consecutive MA over a study period less than 5.0%. The MALRV is computed each time a new LRV is encountered to monitor quality status continuously. The MALRV CV was within 5.0% when sample sizes were between 20 and 110. When shift and trend simulations were performed with the patient data, the corresponding alterations were detected. MALRV is a useful measure for detecting short-term alterations in patient test results, supplementing the conventional QC chart method. 相似文献