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Emma J. Birks MRCP Magdi H. Yacoub DSc FRS Ani Anyanwu FRCS Rosemary Radley Smith FRCP Nicholas R. Banner FRCP Asghar Khaghani FRCS 《The Journal of heart and lung transplantation》2004,23(12):3688-1344
BACKGROUND: Transplantation for patients with a high pulmonary vascular resistance (PVR) carries an increased risk of mortality and right heart failure following heart transplantation and continues to be a major problem. We evaluated the use of hearts from patients who underwent heart and lung transplantation for primary pulmonary hypertension (PPH) as part of a domino procedure because these hearts have hypertrophied right ventricles used to increased pulmonary pressures, but could have a compromised left ventricle or irreversible damage of the right ventricle. METHODS: We reviewed 12 patients with PVR >4 Wood units who underwent orthotopic heart transplantation between 1989 and 1998 using hearts from donors with PPH as part of a domino procedure. RESULTS: We studied 10 men and 2 women, mean age 42.9 years. Mean PVR was 5.3 (range, 4-9) Wood units. Mean ischemia time was 85.3 minutes, and mean donor age was 32 years. Actuarial survival was 75% at 1 year and 75% at 5 years. In the early post-operative period, 3 patients had temporary arrhythmias, 2 required permanent pacemaker implantation, 1 had atrial fibrillation, and 1 had ventricular tachycardia that required defibrillator implantation. At a mean follow-up of 7.8 years, 2 patients had developed asymptomatic transplant coronary disease (both at 8.5 years after transplantation), 1 moderate and 1 very mild; the rest had none. Mean left ventricular ejection fraction at latest follow-up was 70.1% (range, 63%-78%). Right ventricular function assessed clinically and by echocardiography was adequate in the short and long term. CONCLUSIONS: Our results suggest that heart and lung recipients with PPH can provide useful donor hearts to patients with increased PVR and that these hearts function well in the intermediate and long term. 相似文献
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A novel method to measure mitral valve area in patients with rheumatic mitral stenosis using three‐dimensional transesophageal echocardiography: Feasibility and validation 下载免费PDF全文
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Mutations in mammalian target of rapamycin regulator DEPDC5 cause focal epilepsy with brain malformations 下载免费PDF全文
Ingrid E. Scheffer MB BS PhD Sarah E. Heron BSc PhD Brigid M. Regan BSc Simone Mandelstam MB ChB Douglas E. Crompton MBBS PhD Bree L. Hodgson Dip Biomed Sci Laura Licchetta MD Federica Provini MD PhD Francesca Bisulli MD PhD Lata Vadlamudi MB BS PhD Jozef Gecz PhD Alan Connelly PhD Paolo Tinuper MD Michael G. Ricos BSc PhD Samuel F. Berkovic MD FRS Leanne M. Dibbens BSc PhD 《Annals of neurology》2014,75(5):782-787
We recently identified DEPDC5 as the gene for familial focal epilepsy with variable foci and found mutations in >10% of small families with nonlesional focal epilepsy. Here we show that DEPDC5 mutations are associated with both lesional and nonlesional epilepsies, even within the same family. DEPDC5‐associated malformations include bottom‐of‐the‐sulcus dysplasia (3 members from 2 families), and focal band heterotopia (1 individual). DEPDC5 negatively regulates the mammalian target of rapamycin (mTOR) pathway, which plays a key role in cell growth. The clinicoradiological phenotypes associated with DEPDC5 mutations share features with the archetypal mTORopathy, tuberous sclerosis, raising the possibility of therapies targeted to this pathway. Ann Neurol 2014;75:782–787 相似文献
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Professor John Humphrey BE MD FRCP FRS 《Medicine, conflict, and survival》2013,29(3):165-166
The Medical Association for Prevention of War (UK) submitted the following written statement to the Third Special Session on Disarmament of the United Nations General Assembly, which was held at UN headquarters in New York on 31 May‐25 June 1988. 相似文献
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