RESUMEN
A developing supercritical collisionless shock propagating in a homogeneously magnetized plasma of ambient gas origin having higher uniformity than the previous experiments is formed by using high-power laser experiment. The ambient plasma is not contaminated by the plasma produced in the early time after the laser shot. While the observed developing shock does not have stationary downstream structure, it possesses some characteristics of a magnetized supercritical shock, which are supported by a one-dimensional full particle-in-cell simulation taking the effect of finite time of laser-target interaction into account.
RESUMEN
We present an experimental method to generate quasiperpendicular supercritical magnetized collisionless shocks. In our experiment, ambient nitrogen (N) plasma is at rest and well magnetized, and it has uniform mass density. The plasma is pushed by laser-driven ablation aluminum (Al) plasma. Streaked optical pyrometry and spatially resolved laser collective Thomson scattering clarify structures of plasma density and temperatures, which are compared with one-dimensional particle-in-cell simulations. It is indicated that just after the laser irradiation, the Al plasma is magnetized by a self-generated Biermann battery field, and the plasma slaps the incident N plasma. The compressed external field in the N plasma reflects N ions, leading to counterstreaming magnetized N flows. Namely, we identify the edge of the reflected N ions. Such interacting plasmas form a magnetized collisionless shock.
RESUMEN
This paper describes our trial experience of the use of high radiation area for radiation education. We used environmental samples collected from the high radiation area in Fukushima prefecture and India, for the practice of radiation measurement and health risk assessment in Nagasaki University Medical School. We also carried out the field monitoring seminar for students in the existing exposure areas in Tottori prefecture and the Yamakiya observatory in Fukushima. Although the evaluation of educational effectiveness is still underway, both types of education appeared attractive for the students mostly due to the exposure from natural environment in our real life which was not achieved by using an artificial radiation source in a classroom.
Asunto(s)
Radiación de Fondo , Accidente Nuclear de Fukushima , Monitoreo de Radiación/métodos , Radiobiología/educación , Medición de Riesgo/métodos , Contaminantes Radiactivos del Suelo/análisis , Monitoreo del Ambiente , Humanos , India , Japón , Plantas de Energía NuclearRESUMEN
[This corrects the article DOI: 10.1186/s40364-017-0099-2.].
RESUMEN
Diabetes mellitus (DM) affects the male ejaculatory function. This study was designed to evaluate the role of oxidative stress in the development of diabetes-induced dysfunction of vas deferens (VD) in the rat. DM was induced by streptozotocin in 40 male Wistar rats. Subsequently, the diabetic animals were divided into three groups: DM group, DM + Eda group and DM + Tau group. These groups were administered saline, edaravone and taurine, respectively, daily for 4 weeks. Another group of ten rats served as a control group. DM was diagnosed in the 40 streptozotocin-injected rats. DM significantly reduced the VD weight. Additionally, DM induced in vitro VD hypercontractility, VD histological abnormalities and increased the serum and VD tissue concentration of malondialdehyde. VD immunohistochemistry revealed overexpression of three markers of oxidative stress. DM significantly reduced serum testosterone levels. No live birth was documented in all DM rats in mating experiments. Antioxidants significantly improved all the aforementioned parameters, except the testosterone levels. This study indicates a deleterious impact of DM-induced oxidative stress on VD histological and functional features. Antioxidant treatment may provide an adjunct tool to alleviate ejaculatory disorders for male patients with type 1 diabetes.
Asunto(s)
Antioxidantes/farmacología , Diabetes Mellitus Experimental/fisiopatología , Estrés Oxidativo/efectos de los fármacos , Conducto Deferente/efectos de los fármacos , Animales , Antipirina/análogos & derivados , Antipirina/farmacología , Diabetes Mellitus Experimental/metabolismo , Edaravona , Masculino , Malondialdehído/metabolismo , Ratas , Ratas Wistar , Taurina/farmacología , Conducto Deferente/fisiopatologíaRESUMEN
Basaloid squamous cell carcinoma (BSC) of the esophagus is classified as an epithelial malignant tumor and is a rare variant of squamous cell carcinoma (SCC). Most previous reports have suggested that advanced BSC has a poorer prognosis than typical SCC because of its high biological malignancy, but the biological activity of superficial BSC remains unclear. Twenty cases of superficial BSC, which underwent surgical resection in Tokai University Hospital between January 2004 and December 2013, were analyzed retrospectively. Among these cases, 19 cases with a T1 depth of invasion (BSC group) were compared with 180 cases of SCC that were resected during the same period and were pathologically diagnosed as T1 (SCC group). The frequency of lymph node metastasis in the T1 BSC group was significantly lower (2 patients, 11%) than that in the SCC group (84 patients, 47%) (P = 0.005). The frequency of lymphatic invasion in the BSC group was also lower (9 patients, 47%) than that in the SCC group (131 patients, 73%) (P = 0.021). The pathological type of the metastatic lymph node was BSC in all the superficial BSC cases with lymph node metastasis. This study demonstrated that lymph node metastasis was less likely to occur in cases with superficial BSC than in cases with superficial SCC.
Asunto(s)
Carcinoma de Células Escamosas/patología , Neoplasias Esofágicas/patología , Ganglios Linfáticos/patología , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/secundario , Carcinoma de Células Escamosas/cirugía , Neoplasias Esofágicas/cirugía , Femenino , Humanos , Metástasis Linfática , Vasos Linfáticos/patología , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
Cryptorchidism, a common anomaly of the male genitalia, affects 2-4% of male infants. The post-fertilization effects of unilateral cryptorchidism model in the rat and the effects of antioxidant treatment were investigated. Six-week-old male Wistar rats were randomly separated into four groups. Unilateral cryptorchidism was induced in the right testis of three groups. One group was treated with saline intraperitoneally (i.p.) (Crypto), one group was treated with taurine (500 mg/kg, i.p.; Tau), and another group was treated with sivelestat (15 mg/kg i.p.; Siv). The control group was treated with saline i.p. The treatment was daily for 8 weeks. Five days before sacrifice, mating studies were performed. Body, testicular, and epididymal weights were recorded. Malondialdehyde (MDA) levels in the seminal vesicular fluid (SVF) were measured. Testicular levels of MDA and 8-hydroxy-2'-deoxyguanosine (8-OHdG) were determined bilaterally. TUNEL assay was used to examine DNA fragmentation bilaterally. Histological examination and the Johnsen score were used to evaluate morphological testicular alterations. The Crypto group demonstrated significantly lower right testicular and epididymal weights, significantly increased SVF-MDA levels, testicular MDA and 8-OHdG levels, and the apoptotic score bilaterally compared to the controls. Furthermore, histological evaluation revealed significantly reduced spermatogenesis and mild injury to the cryptorchid testes compared to the control. Treatment with both taurine and sivelestat significantly reduced SVF-MDA levels, testicular MDA, 8-OHdG, and apoptosis bilaterally compared to the Crypto group. Antioxidant treatment was unable to ameliorate spermatogenesis. Newborns delivered by females that mated with Crypto-males had significantly lower body weight compared with the respective animals from the control, Tau and Siv groups. The present study demonstrated that unilateral cryptorchidism-induced testicular damage can significantly affect the contralateral testis as well having further deleterious post-fertilization effect on the development of newborns. Treatment with antioxidants can partially improve the testicular damage bilaterally with beneficial effects for the newborns.
Asunto(s)
Antioxidantes/uso terapéutico , Criptorquidismo/patología , Fertilidad , Glicina/análogos & derivados , Sulfonamidas/uso terapéutico , Taurina/uso terapéutico , Testículo/patología , Animales , Animales Recién Nacidos , Criptorquidismo/tratamiento farmacológico , Desarrollo Embrionario , Femenino , Glicina/uso terapéutico , Masculino , Ratas , Ratas Wistar , Testículo/efectos de los fármacosRESUMEN
Lactobacillus plantarum strains produce either glycerol (Gro)- or ribitol (Rbo)-backbone wall teichoic acid (WTA) (Gro-WTA and Rbo-WTA, respectively). The strain WCFS1 has been shown to be able to activate the tarIJKL locus involved in Rbo-WTA synthesis when the tagD1F1F2 locus for Gro-WTA synthesis was mutated, resulting in switching of the native Gro-WTA into Rbo-WTA. Here, we identify a regulator involved in the WTA backbone alditol switching and activation of the tarIJKL locus. Promoter reporter assays of the tarI promoter (Ptar) demonstrated its activity in the Rbo-WTA-producing mutant derivative (ΔtagF1-2) but not in the parental strain WCFS1. An electrophoresis mobility shift assay using a Ptar nucleotide fragment showed that this fragment bound to Ptar-binding protein(s) in a cell-free extract of WCFS1. Three proteins were subsequently isolated using Ptar bound to magnetic beads. These proteins were isolated efficiently from the lysate of WCFS1 but not from the lysate of its ΔtagF1-2 derivative, and were identified as redox-sensitive transcription regulator (Lp_0725), catabolite control protein A (Lp_2256) and TetR family transcriptional regulator (Lp_1153). The role of these proteins in Ptar regulation was investigated by knockout mutagenesis, showing that the Δlp_1153 mutant expressed the tarI gene at a significantly higher level, supporting its role as a repressor of the tarIJKL locus. Notably, the Δlp_1153 mutation also led to reduced expression of the tagF1 gene. These results show that Lp_1153 is a regulatory factor that plays a role in WTA alditol switching in Lb. plantarum WCFS1 and we propose to rename this gene/protein wasR/WasR, for WTA alditol switch regulator.
Asunto(s)
Regulación Bacteriana de la Expresión Génica , Lactobacillus plantarum/genética , Nucleotidiltransferasas/genética , Fosfotransferasas/genética , Deshidrogenasas del Alcohol de Azúcar/genética , Ácidos Teicoicos/biosíntesis , Pared Celular/química , Lactobacillus plantarum/metabolismo , Nucleotidiltransferasas/biosíntesis , Fosfotransferasas/biosíntesis , Deshidrogenasas del Alcohol de Azúcar/biosíntesisRESUMEN
BACKGROUND AND PURPOSE: T2 relaxation time is a quantitative MR imaging parameter used to detect degenerated cartilage in the knee and lumbar intervertebral disks. We measured the T2 relaxation time of the articular disk of the temporomandibular joint in patients with temporomandibular disorders and asymptomatic volunteers to demonstrate an association between T2 relaxation time and temporomandibular disorder MR imaging findings. MATERIALS AND METHODS: One hundred forty-four patients with temporomandibular disorders and 17 volunteers were enrolled in this study. An 8-echo spin-echo sequence for measuring the T2 relaxation times was performed in the closed mouth position, and the T2 relaxation time of the entire articular disk was measured. Patients were classified according to the articular disk location and function, articular disk configuration, presence of joint effusion, osteoarthritis, and bone marrow abnormalities. RESULTS: The T2 relaxation time of the entire articular disk was 29.3 ± 3.8 ms in the volunteer group and 30.7 ± 5.1 ms in the patient group (P = .177). When subgroups were analyzed, however, the T2 relaxation times of the entire articular disk in the anterior disk displacement without reduction group, the marked or extensive joint effusion group, the osteoarthritis-positive group, and the bone marrow abnormality-positive group were significantly longer than those in the volunteer group (P < .05). CONCLUSIONS: The T2 relaxation times of the articular disk of the temporomandibular joint in patients with progressive temporomandibular disorders were longer than those of healthy volunteers.
Asunto(s)
Algoritmos , Interpretación de Imagen Asistida por Computador/métodos , Imagen por Resonancia Magnética/métodos , Disco de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Adulto JovenRESUMEN
Most patients diagnosed with tongue carcinoma undergo surgical resection and reconstructive surgery to preserve tongue mobility and swallowing functions. Twenty-four patients who underwent a total or subtotal glossectomy and surgical reconstruction were evaluated for residual taste sensation. The graded filter paper test for all four tastes (sweet, salt, sour, and bitter) was performed on the posterior wall of the oropharynx and on tongue remnants if they were visible from the mouth. Eleven of the 24 patients were aware of their taste disorder after surgery. Four patients with more than 1/2 residual tongue base had no taste complaints, whereas seven of 14 patients with less than 1/3 residual tongue base reported taste abnormalities. Patients who could only tolerate a poor diet or tube feeding tended to have taste complaints (P=0.017). The taste test showed that the taste threshold of the residual tongue was significantly lower compared to controls. The taste threshold was significantly correlated with the remaining volume of tongue base. Patients with >1/2 the tongue base remaining had good taste sensation, whereas those with <1/3 residual tissue had impaired taste. This study suggests that glossectomy strategies aimed at preserving at least half the tongue base may substantially reduce dysgeusia in the patients.
Asunto(s)
Glosectomía/métodos , Procedimientos de Cirugía Plástica/métodos , Trastornos del Gusto/diagnóstico , Trastornos del Gusto/prevención & control , Neoplasias de la Lengua/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Umbral Gustativo , Lengua/cirugía , Resultado del TratamientoRESUMEN
There is increasing evidence that the effects of administered ATP sensitive potassium (KATP ) channel openers or blockers during ischaemia are still controversial in many organs/tissues. Testicular torsion detorsion which causes ischaemia-reperfusion (IR) injury, cannot be predicted, thus an effective drug should be administered during or after the ischaemia. The aim of this study was to examine whether the administration of KATP channel openers or blockers during ischaemia ameliorates IR injury in the testis. Eight-week-old male Sprague-Dawley rats were subjected to 2 h right testicular ischaemia followed by 24 h reperfusion. The selective mitochondrial (mito) KATP channel blocker, 5-hydroxydecanoate (5-HD) (40 mg/kg), the non-selective KATP channel blocker glibenclamide (5 mg/kg), the selective mito KATP channel opener diazoxide (10 mg/kg) and the non-selective KATP channel opener cromakalim (300 µg/kg) were administered intraperitoneally 15 min prior to the ischaemia or 75 min after the induction of ischaemia. Tissue damage was evaluated by malondialdehyde concentration, myeloperoxidase activity, histological evaluation and TdT-mediated dUTP nick end labelling assay in the testis. There was a significant increase in oxidative stress, neutrophil infiltration, histological damage and apoptosis in the testicular IR model. A significant reduction in the testicular IR injury was observed with the administration of glibenclamide, but not 5-HD, diazoxide or cromakalim during ischaemia. The administration of non-selective KATP channel blocker glibenclamide ameliorated the testicular IR injury. On the other hand, the selective mito KATP channel blocker, 5-HD and KATP channel openers did not reduce the testicular IR injury. These data suggest that blocking of the membrane KATP channel may have a protective effect during the testicular ischaemia. Glibenclamide could be an effective drug to manage the post-ischaemic injury caused by the testicular torsion-detorsion.
Asunto(s)
Canales KATP/agonistas , Canales KATP/antagonistas & inhibidores , Bloqueadores de los Canales de Potasio/uso terapéutico , Daño por Reperfusión/tratamiento farmacológico , Torsión del Cordón Espermático/patología , Testículo/patología , Animales , Apoptosis , Cromakalim/uso terapéutico , Ácidos Decanoicos/uso terapéutico , Diazóxido/uso terapéutico , Gliburida/uso terapéutico , Hidroxiácidos/uso terapéutico , Masculino , Malondialdehído/antagonistas & inhibidores , Infiltración Neutrófila , Estrés Oxidativo , Peroxidasa/análisis , Distribución Aleatoria , Ratas , Ratas Sprague-DawleyAsunto(s)
Pólipos Adenomatosos/patología , Neoplasias Colorrectales/patología , Adenoma , Pólipos Adenomatosos/cirugía , Anciano de 80 o más Años , Infecciones por Campylobacter , Colonoscopía , Neoplasias Colorrectales/cirugía , Enterocolitis/microbiología , Enterocolitis/patología , Femenino , HumanosRESUMEN
INTRODUCTION: The 35delG mutation in the connexin 26 gene is the most common mutation that generates deafness, but its frequency in different countries is strongly based on its ethnicity. Brazilians belong to different ethnic groups. OBJECTIVES: To report the frequency of homo and heterozygosis 35delG mutation in a population with severe to profound bilateral sensorineural deafness, and separate them by ethnicity. METHODS: 100 individuals were studied with severe to profound hearing loss, with no other etiology found, and tested for 35delG mutation. The group presented the following ethnicity distribution: 25% Blacks; 30% Latin Europeans; 26.2% Blacks/Latin Europeans and 2.3% native. RESULTS: The 35delG mutation was found in 20% of patients: 15% were heterozygous and 5% homozygous. All homozygous were of Latin European origin. CONCLUSION: Ethnicity shows marked determination of the presence of the 35delG mutation, and it was only found in homozygosis in the group of Latin Europeans.
Asunto(s)
Población Negra/estadística & datos numéricos , Conexinas/genética , Eliminación de Gen , Pérdida Auditiva Sensorineural/etnología , Pérdida Auditiva Sensorineural/genética , Hispánicos o Latinos/estadística & datos numéricos , Población Blanca/estadística & datos numéricos , Adolescente , Biomarcadores/metabolismo , Brasil/etnología , Conexina 26 , Consanguinidad , Estudios Transversales , Femenino , Pérdida Auditiva Sensorineural/diagnóstico , Heterocigoto , Homocigoto , Humanos , Masculino , Grupos de Población/estadística & datos numéricos , Valor Predictivo de las Pruebas , Medición de Riesgo , Factores de Riesgo , Sensibilidad y Especificidad , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: Oestrogens usually stimulate the progression of oestrogen receptor (ER)-positive breast cancer. Paradoxically, high-dose oestrogens suppress the growth of these tumours in certain circumstances. METHODS: We prospectively examined the efficacy and safety of ethinylestradiol treatment (3 mg per day oral) in postmenopausal patients with advanced or recurrent ER-positive breast cancer who had previously received endocrine therapies, especially those with resistance to aromatase inhibitors. RESULTS: Eighteen patients were enrolled with the median age of 63 years and the mean observation time of 9.2 months. Three cases withdrew within 1 week due to oestrogen flare reactions with nausea, fatigue and muscle-skeletal pain. The response rate was 50% (9 out of 18), and the clinical benefit rate was 56% (10 out of 18). The stable disease (<6 months) was 17% (3 out of 18) and another 2 cases were judged as progressive disease. Time-to-treatment failure including 2 on treatment was a median of 5.6 months (range 0.1 to 14.5(+)). Although vaginal bleeding or endometrial thickening was observed in patients receiving long-term treatment, there were no severe adverse events, such as deep venous thrombosis or other malignancies. CONCLUSION: Although the mechanism of this treatment has not been fully understood, our data may contribute to change the common view of late-stage endocrine therapy.
Asunto(s)
Antineoplásicos Hormonales/uso terapéutico , Inhibidores de la Aromatasa/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Estrógenos/uso terapéutico , Etinilestradiol/uso terapéutico , Anciano , Anciano de 80 o más Años , Antineoplásicos Hormonales/administración & dosificación , Antineoplásicos Hormonales/efectos adversos , Inhibidores de la Aromatasa/administración & dosificación , Neoplasias de la Mama/patología , Estrógenos/efectos adversos , Etinilestradiol/efectos adversos , Femenino , Humanos , Estimación de Kaplan-Meier , Persona de Mediana Edad , Metástasis de la Neoplasia , Proyectos Piloto , Posmenopausia , Estudios ProspectivosRESUMEN
We performed a randomised, crossover study to investigate the effects of intravenous sedation on grip strength and bite force. Twenty male volunteers received a bolus intravenous injection of midazolam (0.02 mg.kg(-1)) together with a 30-min propofol infusion designed to achieve an effect-site concentration of 1.0 µg.ml(-1). Observed variables included bispectral index, observer's assessment of alertness/sedation, correct answer rate of Stroop colour-word test, grip strength and bite force. Grip strength decreased from a median (IQR [range]) of 483 (443-517 [380-586]) N to 358 (280-405 [108-580]) N (p < 0.001) during sedation and recovered following flumazenil administration, while bite force increased from 818 (593-1026 [405-1406]) N to 1377 (1243-1585 [836-2357]) N (p < 0.001) during sedation. Although bite force gradually returned to baseline following flumazenil administration, it remained increased throughout the experimental period. We conclude that bite force increased during intravenous sedation and that this may have clinical implications.
Asunto(s)
Fuerza de la Mordida , Fuerza de la Mano/fisiología , Hipnóticos y Sedantes/farmacología , Midazolam/farmacología , Fuerza Muscular/efectos de los fármacos , Músculo Esquelético/efectos de los fármacos , Propofol/farmacología , Adulto , Sedación Consciente , Monitores de Conciencia , Estudios Cruzados , Flumazenil/farmacología , Humanos , Hipnóticos y Sedantes/administración & dosificación , Inyecciones Intravenosas , Masculino , Midazolam/administración & dosificación , Dinamómetro de Fuerza Muscular , Pruebas Neuropsicológicas , Propofol/administración & dosificación , Tamaño de la Muestra , Test de StroopAsunto(s)
Niños con Discapacidad , Adolescente , Niño , Preescolar , Redes Comunitarias , Femenino , Humanos , Lactante , Masculino , Cuidados Intermitentes , Tokio , Adulto JovenRESUMEN
The purpose of this work was to associate the modified swim-up method with centrifugation in density gradient for the separation of X-bearing spermatozoa. Sperm viability and integrity were evaluated through the Trypan Blue/Giemsa staining method. Quality control of centrifuged spermatozoa was performed in in vitro produced embryos. The results were validated by the sex ratio of in vitro produced embryos using PCR by Y- specific sequences present in bovine male genomic DNA. After determining genetic sex of in vitro produced embryos, the results showed difference (P<0.05) in deviation of sex ratio when comparing the control group (45.2% females) with the other spermatozoa selection procedures (60.6% females) (P<0.05). The sperm selection methods are capable of selecting X-bearing spermatozoa without compromising the spermatozoa fertility (cleavage and blastocyst rates, 70% and 26%, respectively) and were considered relevant methods to be introduced in bovine in vitro produced embryo programs.
O objetivo do presente trabalho foi associar o método de swim-up modificado à centrifugação em gradiente de densidade para a separação de espermatozoides portadores do cromossomo X. A viabilidade e a integridade espermática foram avaliadas pelo método de coloração Azul de Tripan e Giemsa. O controle de qualidade dos espermatozoides centrifugados foi realizado por meio da produção in vitro de embriões bovinos. Os resultados foram validados pela técnica de PCR para verificar a proporção sexual dos embriões produzidos in vitro, com o uso de sequências Y especificas presente no DNA genômico de machos bovinos. Após determinar o sexo genético dos embriões produzidos in vitro, os resultados não mostraram diferença (P<0,05) no desvio da proporção do sexo quando comparou o grupo controle (45,2% de fêmeas) com os outros processos de seleção de espermatozoides (60,6% de fêmeas) (P<0,05). Os métodos de seleção de espermatozoides são capazes de selecionar espermatozoides portadores do cromossomo X sem comprometer a fertilidade, medida pelas taxas de clivagem e blastocisto de 70% e 26%, respectivamente, e foram considerados métodos de relevância para serem introduzidos nos programas de produção in vitro de embriões bovinos.
RESUMEN
Neoplasm and cardiac diseases are rarely found at the same time. If the standard treatment for both of these diseases is operation, several problems arise;1 stage or 2 stage operation, which operation should be done 1st etc. Especially, if cardiac operation needs cardiopulmonary bypass, neoplasm may grow faster. In such cases, we must decide operative procedure carefully.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Neoplasias/complicaciones , Anciano , Femenino , Neoplasias Cardíacas/cirugía , Defectos del Tabique Interatrial/cirugía , Máquina Corazón-Pulmón , Humanos , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/cirugía , Masculino , Persona de Mediana Edad , Neoplasias del Recto/complicaciones , Neoplasias del Recto/cirugíaRESUMEN
With the overall increase in ischemic heart disease (IHD), cases combining arteriosclerosis obliterans (ASO) of the lower extremities and IHD are on the rise. Therefore, it is necessary to consider methods and timing of operation. These cases have occasionally large collateral pathways from the internal thoracic artery (ITA) to the femoral artery via the epigastric artery. To prevent irreversible ischemia of the lower limbs after harvesting of ITA, we planned to perform a one-stage operation for ASO-combined IHD. Revascularization of the lower extremities was performed 1st. Subsequently coronary artery bypass grafting with ITA was completed. The operative courses were uneventful.
Asunto(s)
Arteriosclerosis Obliterante/cirugía , Puente de Arteria Coronaria/métodos , Pierna/irrigación sanguínea , Isquemia Miocárdica/cirugía , Procedimientos Quirúrgicos Vasculares/métodos , Anciano , Arteriosclerosis Obliterante/complicaciones , Humanos , Masculino , Isquemia Miocárdica/complicacionesRESUMEN
We examined a total of 12 cases; 8 cases were identified by searching the literature on Pubmed (excluding case reports published prior to 2000) and 4 cases were ones we personally encountered. We examined age, sex, history of smoking, and preoperative risk factors as preoperative factors, the access route and coverage of the descending aorta as perioperative factors, and complications and survival time as postoperative factors. Mean coverage of the thoracic aorta was 90.8 mm. In terms of perioperative deaths, 8.3% (1 patient) were due to coagulopathy. Perioperative complications occurred in 16.7% of cases (coagulopathy in 1 patient and paralysis in another). No patients experienced complications or underwent additional treatment during a mean follow-up of 22.9 months. This study suggested that simultaneous open abdominal aortic repair and thoracic aortic endovascular therapy is feasible and also involves few postoperative complications. Paraplegia and paralysis tended to occur less frequently than with two-stage surgery, but further study is needed to explain why this is true.