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71.
Galle C De Maertelaer V Motte S Zhou L Stordeur P Delville JP Li R Ferreira J Goldman M Capel P Wautrecht JC Pradier O Dereume JP 《Journal of vascular surgery》2000,32(2):234-246
OBJECTIVE: To determine the nature of and to compare the inflammatory responses induced by (1) endovascular and (2) conventional abdominal aortic aneurysm (AAA) repair.Material and Methods: Twelve consecutive patients undergoing elective infrarenal AAA repair were prospectively studied. Seven patients were selected for endovascular procedures (the EAAA group); five patients underwent open surgery (the OAAA group). Three control patients undergoing carotid thromboendarterectomy were also included. Serial peripheral venous blood samples were collected preoperatively, immediately after declamping or placement of the endograft, and at hours 1, 3, 6, 12, 24, 48, and 72. Acute phase response expression of peripheral T lymphocyte and monocyte activation markers and adhesion molecules (flow cytometry), soluble levels of cell adhesion molecules (enzyme-linked immunosorbent assay), cytokine (tumor necrosis factor alpha, interleukin-6, and interleukin-8) release (enzyme-linked immunosorbent assay), and liberation of complement products (nephelometry) were measured. RESULTS: Regarding acute phase response, the EAAA and OAAA groups showed significant increases in C-reactive protein (P <.001 and P =.001), body temperature (P =.035 and P =.048), and leukocyte count (P <.001 and P <.001). Similar time course patterns were observed with respect to body temperature (P =.372). Statistically significant different patterns were demonstrated for C-reactive protein (P =.032) and leukocyte count (P =.002). Regarding leukocyte activation, a significant upregulation of peripheral T lymphocyte CD38 expression was observed in the OAAA group only (P =.001). Analysis of markers such as CD69, CD40L, CD25, and CD54 revealed no perioperative fluctuations in any group. Regarding circulating cell adhesion molecules, the EAAA and OAAA groups displayed significant increases in soluble intercellular adhesion molecule-1 (P =.003 and P =.001); there was no intergroup difference (P =.193). All groups demonstrated high soluble von Willebrand factor levels (P =.018, P =. 007, and P =.027), there being no differences in the patterns (P =. 772). Otherwise, soluble vascular cell adhesion molecule-1, soluble E-selectin, and soluble P-selectin did not appear to vary in any group. Regarding cytokine release, although a tendency toward high tumor necrosis factor alpha and interleukin-8 levels was noticed in the EAAA group, global time course effects failed to reach statistical significance (P =.543 and P =.080). In contrast, interleukin-6 showed elevations in all groups (P =.058, P <.001, and P =.004). Time course patterns did not differ between the EAAA and OAAA groups (P =.840). Regarding complement activation, the C3d/C3 ratio disclosed significant postoperative elevations in the EAAA and OAAA groups (P =.013 and P =.009). This complement product release was reduced in the EAAA group (P <.001). CONCLUSIONS: The current study indicated that both endovascular and coventional AAA repair induced significant inflammatory responses. Our findings showed that there were no large differences between the procedures with respect to circulating cell adhesion molecule and cytokine release. Moreover, the endoluminal approach produced a limited response in terms of acute phase reaction, T lymphocyte activation, and complement product liberation. This might support the concept that endovascular AAA repair represents an attractive alternative to open surgery. Given the relatively small sample size, further larger studies are required for confirmation of our observations. 相似文献
72.
Bendjelid K Messner P Stordeur JM Chapuis F Kotzki PO Grolleau R 《Annales de cardiologie et d'angeiologie》1999,48(4):253-257
Plasma myosin heavy chain assay, which can be easily performed during the acute phase of myocardial infarction, is a recent method allowing quantitative assessment of the extent of infarction. However, to our knowledge, its prognostic value has not been studied in contrast with serum myosin light chain assay. We monitored the state of health of 40 patients (including 37 men with a mean age of 56 years) for two years after a first myocardial infarction, thrombolized during the acute phase. Their survival (mortality) and the development of "cardiac events" (MI, angina, sudden death, etc.) were evaluated at 2 years. The results observed at 2 years were correlated with the initial plasma myosin assay results and other direct and indirect methods of assessment of the extent of infarction, performed during the acute phase of myocardial infarction (cardiac enzymes, contrast angiography). The main result of this study is the demonstration that an unusual plasma myosin release kinetic (complex appearance) is predictive for the medium-term development of heart failure (p = 0.04) and/or destabilization of coronary insufficiency (p = 0.02). These results need to be emphasized, as with only 5 serum myosin assays performed over a 10-day period, it seems possible to identify a group of patients at high risk of medium-term complications, who possess a complex release kinetic during the acute phase of myocardial infarction and a value for area under the curve greater than 10.470 microliters U/L (cut-off value, p = 0.043). 相似文献
73.
Leonie Schumm Coline L Lemale Sebastian Major Nils Hecht Melina Nieminen-Kelh Anna Zdunczyk Christina M Kowoll Peter Martus Christiane M Thiel Jens P Dreier Johannes Woitzik 《Journal of cerebral blood flow and metabolism》2022,42(1):121
Physiological effects of spreading depolarizations (SD) are only well studied in the first hours after experimental stroke. In patients with malignant hemispheric stroke (MHS), monitoring of SDs is restricted to the postoperative ICU stay, typically day 2-7 post-ictus. Therefore, we investigated the role of physiological variables (temperature, intracranial pressure, mean arterial pressure and cerebral perfusion pressure) in relationship to SD during the late phase after MHS in humans. Additionally, an experimental stroke model was used to investigate hemodynamic consequences of SD during this time window. In 60 patients with MHS, the occurrence of 1692 SDs was preceded by a decrease in mean arterial pressure (−1.04 mmHg; p = .02) and cerebral perfusion pressure (−1.04 mmHg; p = .03). Twenty-four hours after middle cerebral artery occlusion in 50 C57Bl6/J mice, hypothermia led to prolonged SD-induced hyperperfusion (+2.8 min; p < .05) whereas hypertension mitigated initial hypoperfusion (−1.4 min and +18.5%Δ rCBF; p < .01). MRI revealed that SDs elicited 24 hours after experimental stroke were associated with lesion progression (15.9 vs. 14.8 mm³; p < .01). These findings of small but significant effects of physiological variables on SDs in the late phase after ischemia support the hypothesis that the impact of SDs may be modified by adjusting physiological variables. 相似文献
74.
Bret Puvilland Coline Boisson Bertrand Fusaro Mathieu Bustamante Jacinta Bertrand Yves Ceraulo Antony Ouachée-Chardin Marie 《Journal of clinical immunology》2021,41(5):1099-1102
Journal of Clinical Immunology - 相似文献
75.
Coline Covington 《British Journal of Psychotherapy》2016,32(1):3-20
Psychoanalytic theory attributes the development of morality largely to the role of the superego, as the internalization of authority that helps the ego live within the constraints of reality. Conscience is born when the infant is able to imagine the feelings of another, to see that his actions have an impact on others, and to experience concern. This is the attainment of the depressive position in which good and bad are no longer split and kept separate from one another but coexist within the same object, just as the child can experience both love and hate towards his object. While having a conscience and doing the ‘right’ thing reflect larger group norms that develop from childhood, is there nevertheless an idea of ‘right’ and ‘wrong’ that precedes the tenets of the group? This paper proposes that our sense of morality is based on our initial perception of ourselves, as mirrored by the observing ego, and the degree to which our experience of reality is validated internally. The idea of ‘being true to oneself’ is the fundamental cornerstone of moral sensibility. 相似文献
76.
Eric Ducasse Caroline Caradu Coline Brochier Dominique Midy Xavier Bérard Mathieu Poirier Nicolas Ottaviani 《Journal of vascular and interventional radiology : JVIR》2019,30(4):511-520.e1
Purpose
To report the midterm experience with chimney-endovascular aneurysm repair (Ch-EVAR) with the use of open self-expending stents for branch vessel preservation.Materials and Methods
From July 2010 to May 2017, 67 patients underwent open Ch-EVAR because their proximal landing zones were adjacent to, or covered, the renal or mesenteric arteries (Zones 7–9), and they were not suitable for standard or fenestrated endovascular aneurysm repair. The proximal landing zone was relocated below the highest renal artery in 46 cases, the superior mesenteric artery in 17 cases, and the celiac artery in 4 cases, using 84 open chimneys (131 stents). A subgroup analysis was performed between an early (2010–2014) and a later (2015–2017) time period. Thirty-two patients were treated during the early period, and 35 were treated during the later period. In the later period, open chimneys were strengthened by a second self-expanding stent.Results
The primary technical success rate was 89.6%; the early mortality rate was 9.0%; and the median follow-up duration was 13 months (range, 1–76 months). The estimated actuarial survival rate was 85.7% in year 1 and 79.2% in year 2, and the estimated patency rate of open chimneys reached 95.2% at 2 years. Aneurysm sac regression >5 mm and sac stability rates were 39.0% and 57.6%, respectively. Freedom from aneurysm-related reintervention was lower in the later period (log-rank P = .04), while type Ia endoleaks tended to be twice as likely.Conclusions
Midterm results of open Ch-EVAR show high technical success with acceptable midterm patency and lack of endoleak in appropriately selected patients. The advantages over covered stents are lower-profile delivery systems and maintenance of branch vessel patency in early bifurcations and overlying visceral vessels. 相似文献77.
Arnaud Blanchard Agathe Roubertie Marion Simonetta‐Moreau Vuthy Ea Coline Coquart Melissa Y. Frederic Gael Gallouedec Jean‐Paul Adenis Isabelle Benatru Michel Borg Pierre Burbaud Patrick Calvas Laura Cif Philippe Damier Alain Destee Laurence Faivre Lucie Guyant‐Marechal Piotr Janik Samer Janoura Alexandre Kreisler Anna Lusakowska Sylvie Odent Anna Potulska‐Chromik Monika Rudziska Stephane Thobois Isabelle Vuillaume Christine Tranchant Sylvie Tuffery‐Giraud Philippe Coubes Bernard Sablonnire Mireille Claustres Gwenaelle Collod‐Broud 《Movement disorders》2011,26(9):1775-1776
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