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51.
52.
E Cosmi P Litta A Andrisani L Di Lenardo G M Fadda G Ambrosini 《Ultrasound in obstetrics & gynecology》2005,25(4):415-416
53.
Emmanuel Lansac Isabelle Di Centa Nicolas Bonnet Pascal Leprince Akthar Rama Christophe Acar Alain Pavie Iradj Gandjbakhch 《European journal of cardio-thoracic surgery》2006,29(4):537-544
OBJECTIVE: Dilation of aortic annulus, sinuses of Valsalva, and sinotubular junction (STJ) diameters are the characteristic lesions of aortic root aneurysm. The remodeling technique reduces STJ diameter and creates three neosinuses of Valsalva. Alternatively, the reimplantation technique reduces both annulus and STJ diameters to the detriment of aortic root dynamics. Although the remodeling technique is recognized as the most physiological valve-sparing procedure, aortic annulus dilation may jeopardize its results. A standardized approach that combines an external subvalvular aortic prosthetic ring annuloplasty with the remodeling technique is suggested. METHODS: Eighty-three patients underwent an elective aortic root remodeling procedure, either isolated (group 1, n=34) or combined with an external subvalvular aortic prosthetic ring annuloplasty (group 2, n=49). Preoperative aortic regurgitation was 1.59+/-1.1 (group 1) and 1.97+/-1.3 (group 2) (NS). The aortic annulus was more dilated in group 2 than in group 1 (27+/-2.77 mm vs 26.4+/-2.3 mm, p<0.01). Residual aortic regurgitation > or =grade II was the conversion criteria for aortic valve replacement. RESULTS: Operative mortality was 3.6% (n=3). Intraoperative conversion for valve replacement was 32.7% in group 1 (n=11) versus 4.2% in group 2 (n=2) (p<0.001). In group 1, preoperative annulus diameter was larger for converted than for valve-spared patients (27.6+/-1.7 mm vs 25.2+/-1.5 mm, p<0.02). In group 2, implanted aortic ring significantly reduced annulus diameter (20.6+/-1.8 mm) without significant aortic valve gradient (8.3+/-3 mmHg). Follow-up was 17.2+/-13.4 months (group 1) and 10.41+/-7.95 months (group 2). Reoperation for recurrent aortic regurgitation was 13% in group 1 (n=3) versus 4.2% in group 2 (n=2). Echocardiographic follow-up found residual aortic regurgitation < or =grade I in 17 patients in group 1 (90%) versus 43 patients in group 2 (95.5%) and of grade II in two patients in group 1 (10%) and two patients in group 2 (4.5%). CONCLUSION: The addition of external aortic prosthetic ring annuloplasty improves the remodeling technique's operative reproducibility and short-term results. Therefore, its use as a systematical adjunct to the remodeling procedure is suggested. However, further long-term evaluation comparing this valve-sparing procedure to composite graft replacement should define the best surgical strategy for aortic root aneurysm. 相似文献
54.
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56.
A Pinto A Tuttolomondo D Di Raimondo P Fernandez G Licata 《International angiology》2006,25(3):261-267
AIM: A classification of ischemic stroke subtypes tailored for individual patients is hard to achieve. In 1993, the Trial of Org 10172 in Acute Stroke Treatment (TOAST) group developed a new system to classify the subtypes of ischemic stroke. In our study we applied the TOAST classification to a group of consecutive patients affected by ischemic stroke, to evaluate outcome and factors associated to each stroke subtype. METHODS: To evaluate the prognosis and the associated factors of ischemic stroke subtypes, we classified according to the TOAST classification a cohort of 159 consecutive patients affected by an acute ischemic stroke. We evaluated neurological deficit at admission by Scandinavian Stroke Scale and scored disability at discharge and 6 months after discharge using the Rankin disability scale. We determined 30 days survival and anamnestically evaluated major vascular risk factors. RESULTS: Patients with cardioembolic stroke and stroke of undetermined etiology had a greater neurological deficit on admission and the worst prognosis either in terms of disability or mortality. Lacunar stroke had the least neurological deficit at admission and the best prognosis. Hypercholesterolemia and smoking were more frequent among patients with large artery atherosclerotic stroke. Hypertension, a history of transient ischemic attack and diabetes were more frequent among patients with lacunar stroke. A weak association with hypertension and smoking was observed for cardioembolic stroke. CONCLUSIONS: The TOAST classification is useful in the clinical setting because it identifies ischemic stroke subtypes with different prognosis and with a different profile of associated factors. 相似文献
57.
M. L. Garrè V. Capra E. Di Battista L. Giampietri P. Nozza A. Raso A. Pezzolo A. Rossi C. Milanaccio M. Pavanello A. Naselli 《Child's nervous system》2007,23(2):219-223
Objects Genetic syndromes associated with ependymoma are uncommon, with the exception of NF2. We describe two cases of ependymoma
presenting with Klinefelter’s Syndrome (KS) as co-morbid condition.
Materials and methods The first patient was diagnosed for KS during pregnancy; he also presented a thyroid agenesis and a deficit of methyltetrahydrofolate
reductase (MTHFR); at 30 months of age he was operated on for a grade II ependymoma of IV ventricle; after a multiple-stage
surgery, he underwent oral chemotherapy and stereotactic radiotherapy, but after 15 months he presented a local recurrence
and died. The second patient was diagnosed for KS at the age of 16 months; at 10 years of age, due to back pain, he underwent
an MRI, which showed a cauda equine tumor. He underwent surgery and radiotherapy. Histology was of mixopapillary ependymoma.
Conclusion In a review of literature, various neoplasms have been described in association with KS. To our knowledge, these are the first
two cases reported of ependymoma associated to KS. A retrospective study of 44 monoinstitutional ependymoma cases demonstrated
association with genetic syndromes in 22%. 相似文献
58.
Neurological Sciences - Bladder and urethra are innervated peripherally by pelvic parasympathetic, lumbar sympathetic and pudendal nerves; but a complex of brain networks is involved in the... 相似文献
59.
Correlation of serum metalloproteinase levels with lung cancer metastasis and response to therapy. 总被引:14,自引:0,他引:14
S Garbisa G Scagliotti L Masiero C Di Francesco C Caenazzo M Onisto M Micela W G Stetler-Stevenson L A Liotta 《Cancer research》1992,52(16):4548-4549
Cancer cells elaborate metalloproteinases which may play a role in invasion and metastasis. The serum level of the M(r) 72,000 type IV collagenase (MMP-2) was measured in 87 lung cancer patients. Stage IV cancer levels were significantly elevated (P less than 0.0001) compared to normal sera. A significant difference (P less than 0.01) was found between enzyme levels in the presence versus the absence of distant metastasis. For 29 patients treated with combination chemotherapy, a positive relationship was noted between response failure and elevated enzyme levels. Serum metalloproteinase levels may provide information relevant to prognosis as well as treatment decisions. 相似文献
60.
Sylvie Di Filippo Bertrand Semiond Ricardo Roriz Francois Sassolas Marie José Raboisson André Bozio 《The Journal of heart and lung transplantation》2003,22(8):876-882
BACKGROUND: Coronary vasculopathy is the main cause of cardiac graft failure. Because yearly coronary angiography is invasive in children, a non-invasive method for detecting graft vasculopathy is needed. The aim of this study was to test dobutamine-stress echocardiography in a pediatric population to determine its feasibility, safety and reliability in the detection of graft coronary artery disease. METHODS: Eighteen patients, aged 2 days to 16.8 years at transplantation (mean 8.4 years), underwent 44 dobutamine-stress echocardiography (DSE) exams, at a follow-up of 1.1 to 11.8 years (mean 5.1 years). Selective coronary angiography was performed for comparison. Echocardiographic recordings were obtained in 4 standard views of the left ventricle and measurements carried out within the frames of a 16-segment model. Segmental scores of contractility were obtained for each segment and a total segmental contractility index was calculated at each stage. RESULTS: All patients reached the maximum dose stage. Maximum heart rate was 57% to 90% of predicted maximum. Maximum systolic blood pressure reached 190 mmHg. Segmental scores were normal in 37 and abnormal in 7 cases. Echographic results were concordant with angiography in 82% and discordant in 18% of the cases (4 negative DSEs with minor angiographic lesions, 2 positive DSEs with normal angiography), but there was no significant angiographic lesion with normal DSE. CONCLUSIONS: DSE is a safe and highly feasible non-invasive technique in transplanted children. A normal DSE study successfully predicts the absence of significant coronary artery disease in the post-transplant population. 相似文献