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Ngai-Yin Chan Chi-Chung Choy Ho-Chuen Yuen Hoi-Fan Chow Ho-Fai Fong 《The Canadian journal of cardiology》2019,35(4):396-404
Background
Persistent iatrogenic atrial septal defect (iASD) is a common but poorly characterized complication after cryoballoon (CB) pulmonary vein isolation (PVI) procedures. We therefore investigate its prevalence, evolution, risk factors, and clinical outcomes in a prospective longitudinal study.Methods
A total of 108 patients (41 women, mean age 57 ± 11.3) underwent CB PVI for AF. Serial transesophageal echocardiography (TEE) was performed 9 months and then annually until 6 years after the procedure to study the characteristics of persistent iASD.Results
Persistent iASD occurred in 33 (30.6%) patients 9 months after CB PVI. Spontaneous closure of iASD was found in 6 (22.2%) and 3 (15.8%) patients 2 and 3 years after the procedures, respectively. No spontaneous closure was observed on 4, 5, and 6-year TEE follow-up. The projected long-term persistence rate of iASD after CB PVI was therefore 20% (30.6% × 0.778 × 0.842). Using multivariate logistic regression, a higher number of cryoapplications (≥ 2 minutes) was the only independent predictor of persistent iASD 9 months after CB PVI (odds ratio [OR] 1.207; 95% confidence interval [CI], 1.033-1.411, P = 0.018). Two (1.9%) patients with significantly larger iASD size than the others (long diameter 12.6 ± 0.8 vs 3.7 ± 1.5 mm, P < 0.001; short diameter 10.9 ± 0.2 vs 3 ± 1.1 mm, P < 0.001) required percutaneous closure because of exertional dyspnea and right ventricular enlargement. Over 129.7 patient-years follow-up, during which iASD persisted, there was no occurrence of neurologic events.Conclusions
Approximately one fifth of patients undergoing CB PVI will have permanently persistent iASD. Patients with defect sizes of greater than 10 mm may need percutaneous closure due to significant left-to-right shunting. 相似文献3.
报道新化合物A-失碳-17β-羟基-17α-乙炔基-Δ3(5),9(10)-雌甾二烯-2-酮2的合成。文中探讨了用炔钾粗品对A-失碳-Δ3(5),9(10)-雌甾二烯-2,17-二酮1和A-失碳-6β,19-环氧-Δ3-雄甾-2,17-二酮3的选择性炔化,分别得标题化合物2(44%)及A-失碳-17β-羟基-17α-乙炔基-6β,19-环氧-Δ3雄甾-2-酮4(65%),4经还原性破开环氧、去羟甲基和去醋酰氧基合成了标题化合物2。四步总收率为34%。 相似文献
4.
Two modified helical basket extractors are described that have increased the success rate of removing ureteral calculi using fluoroscopy from 63% to 92%. Initially a rather stiff and expandable basket with a 20-cm filiform tip is used with coaxial catheters and sheath (stage 1). If this procedure is unsuccessful, a basket with two long cable ends is passed from the nephrostomy out through the urethra (stage 2). When used with coaxial bladder catheters, this technique allows dilatation of the vesicoureteric junction and retrograde catheterization and injection of fluids or gas to dislodge the stone prior to extraction. In a series of 38 patients, stones were removed in all but three (a success rate of 92%). In five cases small stones (less than 5 mm) were not retrieved but subsequent studies were normal. Ureteral stones were found in the abdominal ureter in 28 cases, in the pelvic ureter in seven cases, and in multiple sites in three cases. Stones were larger than 1 cm in 27.7% of cases. Postextraction mucosal edema with reduced ureteral patency was common but usually cleared in 2-3 days. Occasional complications were related to the nephrostomy. 相似文献
5.
Wan-Chen Tsai Wen-Ta Chiu Hung-Yi Chiou Cheuk-Sing Choy Ching-Chang Hung Shin-Han Tsai 《Journal of clinical neuroscience》2004,11(2):126-129
Background. This study is intended to determine the causes of pediatric traumatic brain injuries (PTBI) in children aged 14 years or less, and to identify various types of craniocerebral damage resulting from different mechanisms of injury.Methods. From July 1, 1993 to June 30, 2001, a survey on PTBI was conducted in Taiwan. The data of patients used in this study were collected from 56 major hospitals among the age group of 0-14 years. The items in the traumatic brain injury survey included sex, age, causes of injuries, severity, and the eventual outcome.Results. A total of 5349 cases were identified. The male-to-female ratio was 1.69: 1. The incidence rate was higher in the age groups of 4-9 years and 10-14 years. The main cause of PTBI was traffic injury, which accounted for 2537 of the cases (47.3%), followed by falls, 2160 (40.3%). Of all traffic injuries, motorcycle-related injury had the highest incidence, followed by the pedestrian and bicycle-related injury. This study also showed that 83.2% of the patients had mild injury, 9.8% had moderate injury, and 7.0%, severe injury.Conclusions. The results of this study suggest that it is important to decrease all the risk factors in the environment of homes and public areas as much as possible. Helmet wearing and the development of public transportation are essential for the prevention of head injury. 相似文献
6.
OBJECTIVES: The purpose of this study was to report habitual physical activity levels in women and document the change in level of activity and factors affecting this change over a 5-year period. METHODS: A 5-year prospective cohort design was used. Women aged 40-80 years, living independently in the community, were recruited via the electoral role. The effects were investigated, first, of age, activity level, history of falls, number of co-morbidities and medications, body mass index and stability at baseline on change in activity level and, second, change in these demographics on activity level over the study period. RESULTS: Data from 459 women who completed our study are reported. Only activity level and body mass index at baseline significantly affected change in activity level (p<0.000). Change in activity level was not influenced by change in demographics over the study period. The forties and fifties cohorts accounted for the baseline body mass index effect on activity change (p<0.04). In the forties cohort, number of medical conditions at base line (p<0.03) and, in the sixties cohort, increase in number of medical conditions (p=0.011) affected activity level change. CONCLUSIONS: Activity level at baseline and body mass index in younger women were most likely to affect change over time. Being unsteady or having already fallen did not stimulate change. 相似文献
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In vivo production of tumor necrosis factor for the treatment of mice bearing Ehrlich ascites tumor.
Tumor necrosis factor (TNF) was produced in mice bearing Ehrlich ascites tumor (EAT) by priming with zymosan and subsequently challenging with lipopolysaccharide. The optimal conditions for the in vivo production of TNF in treating EAT bearing mice were established. The endotoxin shock induced in mice during TNF production could be minimized by the combined administration of sulindac and mannoheptulose. The endogenous TNF produced could suppress proliferation of EAT cells as well as prolong the survival time of mice bearing small tumors. 相似文献
10.
J S Sham W I Wei D Choy C M Ho P T Tai P H Choi 《The British journal of radiology》1989,62(736):355-361
The early results of brachytherapy for persistent and recurrent nasopharyngeal carcinoma in 30 patients is presented. Fifteen patients were treated by intracavitary caesium, 12 patients were treated by interstitial gold grain implant using the split-palate approach and three patients were treated by both intracavitary caesium and interstitial gold grain implant for the first and second relapse in the nasopharynx, respectively. The overall tumour control rate for intracavitary caesium was 5/18 (28%) with median follow-up of 25.2 months, and for interstitial gold grain implant it was 9/14 (64%) with median follow-up of 16.5 months. Interstitial gold grain implantation appears to be effective in the treatment of persistent and recurrent nasopharyngeal carcinoma. 相似文献