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51.
Sung-Jin Hong Myeong-Ki Hong Young-Guk Ko Donghoon Choi Geu-Ru Hong Jae-Kwang Shim Young-Lan Kwak Sak Lee Byung-Chul Chang Yangsoo Jang 《Yonsei medical journal》2014,55(5):1246-1252
Purpose
We sought to evaluate the clinical usefulness of decision making by a multidisciplinary heart team for identifying potential candidates for transcatheter aortic valve implantation (TAVI) in patients with symptomatic severe aortic stenosis.Materials and Methods
The multidisciplinary team consisted of two interventional cardiologists, two cardiovascular surgeons, one cardiac imaging specialist, and two cardiac anesthesiologists.Results
Out of 60 patients who were screened as potential TAVI candidates, 31 patients were initially recommended as appropriate for TAVI, and 20 of these 31 eventually underwent TAVI. Twenty-two patients underwent surgical aortic valve replacement (AVR), and 17 patients received only medical treatment. Patients who underwent TAVI and medical therapy were older than those who underwent surgical AVR (p<0.001). The logistic Euroscore was significantly highest in the TAVI group and lowest in the surgical AVR group (p=0.012). Most patients in the TAVI group (90%) and the surgical AVR group (91%) had severe cardiac symptoms, but only 47% in the medical therapy group had severe symptoms. The cumulative percentages of survival without re-hospitalization or all-cause death at 6 months for the surgical AVR, TAVI, and medical therapy groups were 84%, 75%, and 28%, respectively (p=0.007, by log-rank).Conclusion
TAVI was recommended in half of the potential candidates following a multidisciplinary team approach and was eventually performed in one-third of these patients. One-third of the patients who were initially considered potential candidates received surgical AVR with favorable clinical outcomes. 相似文献52.
Hyung Soon Lee Hongjin Shim Ji Young Jang Hosun Lee Jae Gil Lee 《Yonsei medical journal》2014,55(2):395-400
Purpose
This study was undertaken to assess the feasibility of early feeding in patients that have undergone emergency gastrointestinal (GI) surgery.Materials and Methods
The authors retrospectively reviewed 84 patients that underwent emergency bowel resection and/or anastomosis from March 2008 to December 2011. Patients with severe shock, intestinal ischemia, sustained bowel perforation, or short bowel syndrome were excluded. Patients were divided into the early (group E; n=44) or late (group L; n=40) group according to the time of feeding commencement. Early feeding was defined as enteral feeding that started within 48 hours after surgery. Early and late feeding groups were compared with respect to clinical data and surgical outcomes.Results
The most common cause of operation was bowel perforation, and the small bowel was the most commonly involved site. No significant intergroup differences were found for causes, sites, or types of operation. However, length of stay (LOS) in the intensive care unit (1 day vs. 2 days, p=0.038) and LOS in the hospital after surgery were significantly greater (9 days vs. 12 days, p=0.012) in group L than group E; pulmonary complications were also significantly more common (13.6% vs. 47.5%, p=0.001) in group L than group E.Conclusion
After emergency GI surgery, early feeding may be feasible in patients without severe shock or bowel anastomosis instability. 相似文献53.
Background
Small bowel volvulus caused by a jejunal trichobezoar is an extremely rare and life-threatening emergency in children.Case characteristics
An 8-year-old girl with abdominal pain and persistent bilious vomiting.Observation
The abdominal computed tomography scan showed a solitary intraluminal mass and a whirl sign, suggesting the small bowel volvulus. Emergency laparoscopic exploration revealed the rotated segment of small bowel loops by a jejunal trichobezoar.Outcome
Satisfactory recovery after surgery.Message
Trichobezoars should be considered in the differential diagnosis of abdominal pain and projectile vomiting in children. 相似文献54.
55.
This article describes a digital technique that combines intraoral digital scans with a 3-dimensional facial scan to predict the outcome of prosthodontic treatment of anterior teeth at the treatment planning phase. This approach may increase patient acceptance of the definitive treatment, as the altered facial appearance is visualized with definitive prosthodontic restorations, thereby improving communication before treatment begins. 相似文献
56.
57.
Shim J Perdigou C Chen ER Bertoldi K Reis PM 《Proceedings of the National Academy of Sciences of the United States of America》2012,109(16):5978-5983
We introduce a class of continuum shell structures, the Buckliball, which undergoes a structural transformation induced by buckling under pressure loading. The geometry of the Buckliball comprises a spherical shell patterned with a regular array of circular voids. In order for the pattern transformation to be induced by buckling, the possible number and arrangement of these voids are found to be restricted to five specific configurations. Below a critical internal pressure, the narrow ligaments between the voids buckle, leading to a cooperative buckling cascade of the skeleton of the ball. This ligament buckling leads to closure of the voids and a reduction of the total volume of the shell by up to 54%, while remaining spherical, thereby opening the possibility of encapsulation. We use a combination of precision desktop-scale experiments, finite element simulations, and scaling analyses to explore the underlying mechanics of these foldable structures, finding excellent qualitative and quantitative agreement. Given that this folding mechanism is induced by a mechanical instability, our Buckliball opens the possibility for reversible encapsulation, over a wide range of length scales. 相似文献
58.
Sung YK Cho SK Choi CB Park SY Shim J Ahn JK Bang SY Cha HS Choe JY Chung WT Her M Hong SJ Hong YK Joung CI Jun JB Jung YO Kang YM Kim DY Kim HR Kim HA Kim J Kim SK Kim SI Kim TH Kim TJ Koh E Lee CK Lee HS Lee J Lee SH Lee SH Lee SS Lee SW Lee YA Nah SS Park SH Sheen DH Shim SC Gyu Song G Suh CH Uhm WS Yoo DH Yoo WH Yoon BY Bae SC 《Seminars in arthritis and rheumatism》2012,41(6):745-751
59.
Hwang HJ Youn HJ Lee MY Park CS Choi YS Chung WB Lee JB Shim B 《Clinical cardiology》2012,35(2):119-124
Background:
Several studies demonstrated that endothelial or atherosclerotic biomarkers, including plasma free insulin‐like growth factor‐I(IGF‐I), soluble CD40 ligand (sCD40L), adiponectin, and leptin have an influence on coronary endothelial function.Hypothesis:
The aim of the present study was to investigate whether change of coronary flow velocity of the distal left anterior descending artery (LAD) during the cold pressor test (CPT) with transthoracic Doppler echocardiography (TTE) was associated with these biomarkers in subjects with chest pain and a normal coronary angiogram.Methods:
In 190 subjects (mean age, 54±11 years; male:female, 113:77) with chest pain and a normal coronary angiogram, peak diastolic velocity (PDV) of the distal LAD during the CPT with TTE was assessed. Acetylcholine provocation test was performed in 58 subjects (mean age, 51±10 years) who were clinically suspected of vasospasm. CPT%PDV was defined as the percent change in PDV during the CPT. Associations between CPT%PDV and clinical parameters were analyzed.Results:
According to multiple regression analysis, CPT%PDV was associated with plasma free IGF‐I in the entire study population (β=0.295, P<0.001 in all subjects; β=0.341, P=0.001 in males; β=0.243, P=0.037 in females; β=0.303, P=0.002 in nonsmokers; and β=0.256, P=0.047 in smokers), and sCD40L in males (β=?0.269, P=0.008)and smokers (β=?0.261, P=0.046). Subjects with vasospasm to intracoronary acetylcholine had lower plasma free IGF‐I(6.9±3.3 vs 8.9±3.4, P=0.026) and CPT%PDV (8.8±24.9 vs 52.7±26.0, P<0.001) than the others. Plasma adiponectin and leptin were not associated with CPT%PDV.Conclusions:
Change of coronary flow velocity assessed using the CPT with TTE may be related to endothelial markers, especially plasma free IGF‐I. © 2011 Wiley Periodicals, Inc. Additional Supporting Information may be found in the online version of this article. The authors have no funding, financial relationships, or conflicts of interest to disclose.60.
Yoon B Shim YS Hong YJ Kim YD Lee KO Na SJ Yang DW 《Archives of gerontology and geriatrics》2012,54(2):325-329
The SCI, the MCI, and the Alzheimer's disease (AD) are on a spectrum of disease progression; therefore, identification of the earliest signs of cognitive deterioration is becoming a crucial issue. The goal of this study was to examine symptom characteristics and distinguish predictive symptoms in patients with MCI compared with SCI, using caregiver questionnaires. We assessed the Korean Dementia Screening Questionnaire (KDSQ) and Seoul Instrumental activities of Daily Living (S-IADL) of 344 subjects with SCI and 697 with MCI. Multivariate logistic regression analyses were conducted after adjusting for age, sex, and educational status. Common and rare symptoms were similar between the SCI and MCI groups. The most distinguishing features of KDSQ were 'Finds it hard to go somewhere on his/her own using public transportation' (odds ratio=OR=4.56, p<0.0001), 'Has difficulty in operating appliances' (OR=2.47, p=0.001), and 'Keeps repeating the same question' (OR=2.03, p<0.0001). In S-IADL, the most outstanding features were 'using household appliances' (OR=3.99, p<0.0001), 'taking medication' (OR=2.38, p=0.01), and 'using public transportation' (OR=1.94, p=0.04). The dysfunction in 'using household appliance' and 'using public transportation' reflect the possibility of MCI rather than SCI. Therefore, it is suggested that these symptoms also have a discriminative and predictive power in identifying SCI. 相似文献