Kyobu Geka
Department of Cardiovascular Surgery, Kobe University School of Medicine, Kobe, Japan.
Published: October 2013
Objective: We report our current surgical management and early and late outcomes of total arch replacement.
Method: From October 1999 to December 2012, 372 consecutive patients (mean age 71.8±12.0) underwent total arch replacement through a median sternotomy at our institute. Mean Japan score (predicted 30 day mortality) was 8.0±9.2( median 4.4). Our current surgical approach included the following:(1) meticulous selection of arterial cannulation site and type of arterial cannula;(2) circulatory arrest at tympanic temperature (below 23 °C) and rectal temperature (below 30 °C);(3) antegrade selective cerebral perfusion and cerebral monitoring of regional cerebral saturation;(4) early rewarming just after distal anastomosis;(5)maintaining fluid balance below 1,000 ml during cardiopulmonary bypass.
Results: Overall 30 day and in-hospital mortality was 1.6%( 6/372) and 3.8%( 14/372), and was 1.0%(3/308)and 2.6% (8/308) in elective cases. Permanent neurologic deficit occurred in 2.2%(8/372) of patients. The mean follow up period were46±39months(range2~165 months). Survival at 5 and 10 years after surgery was 75.8±2.8% and 66.0±3.8%, respectively. During follow up period, there was only one total arch replacement related problem (proximal anastomosis aneurysm). Freedom from additional aortic surgery and aortic related event at 5 and 10 years was 90.8 ±2.2% and 86.1±3.4%,respectively.
Conclusion: Our current approach for total aortic arch replacement was associated with low hospital mortality and morbidities and with favorable long-term outcome.
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PLoS One
January 2025
School of Human Nutrition, McGill University, Montreal, Québec, Canada.
Objective: Managing blood glucose levels is challenging for elite athletes with type 1 diabetes (T1D) as competition can cause unpredictable fluctuations. While fear of hypoglycemia during physical activity is well documented, research on hyperglycemia-related anxiety (HRA) is limited. HRA refers to the heightened fear that hyperglycemia-related symptoms will impair functioning.
View Article and Find Full Text PDFAnal Chem
January 2025
Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei 230032, China.
The absence of an effective imaging tool for diagnosing renal ischemia-reperfusion injury (RIRI) severely delays its treatment, and currently, no definitive clinical interventions are available. Pyroglutamate aminopeptidase-1 (PGP-1), a potential inflammatory cytokine, has shown considerable potential as a biomarker for tracing the inflammatory process in vivo. However, its exact role in the enhanced visualization of RIRI in complex biological systems has yet to be fully established.
View Article and Find Full Text PDFJ Bone Joint Surg Am
January 2025
Department of Orthopaedic Surgery, Children Hospital, National Taiwan University Hospital, Taipei, Taiwan.
Background: Reoperation is a major adverse event following surgical treatment but has yet to be used as a primary outcome measure in population studies to assess current treatments for developmental dysplasia of the hip (DDH). The purpose of the present study was to explore the risk factors associated with reoperations following procedures under anesthesia ("operations") for DDH in patients between the ages of 1 and 3.00 years, with the goal of deriving treatment recommendations.
View Article and Find Full Text PDFUrogynecology (Phila)
January 2025
From the Department of Obstetrics and Gynecology, Oregon Health Science University.
Importance: Evaluation of racial and ethnic differences in apical suspension during prolapse repair is crucial for equitable gynecological care.
Objective: The objective was to assess racial and ethnic disparities in apical suspension during native tissue prolapse repair.
Study Design: We analyzed data from the 2019 Healthcare Cost and Utilization Project National Inpatient Sample and Nationwide Ambulatory Surgery Sample, using Current Procedural Terminology and International Classification of Diseases, Tenth Revision, codes.
World J Clin Cases
January 2025
Department of Surgery, National and Kapodistrian University of Athens, Athens 11527, Greece.
Carcinosarcoma (CS), also known as metaplastic breast carcinoma with mesenchymal differentiation, is one of the five distinct subtypes of metaplastic breast cancer. It is considered as a mixed, biphasic neoplasm consisting of a carcinomatous component combined with a malignant nonepithelial element of mesenchymal origin without an intermediate transition zone. Although cellular origin of this neoplasm remains controversial, most researchers declare that neoplastic cells derive from a cellular structure with potential biphasic differentiation.
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