The New England journal of medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized comparison of off-pump and on-pump multivessel coronary-artery bypass surgery.
The effect of the use of coronary-artery bypass surgery without cardiopulmonary bypass and cardiac arrest ("off pump") on graft patency remains uncertain. We undertook a prospective, randomized, controlled study to compare graft-patency rates and clinical outcomes in off-pump surgery with conventional, "on-pump" surgery. ⋯ In this randomized study, off-pump coronary surgery was as safe as on-pump surgery and caused less myocardial damage. However, the graft-patency rate was lower at three months in the off-pump group than in the on-pump group, and this difference has implications with respect to the long-term outcome.
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Myeloma cells may secrete factors that affect the function of osteoblasts, osteoclasts, or both. ⋯ The production of DKK1, an inhibitor of osteoblast differentiation, by myeloma cells is associated with the presence of lytic bone lesions in patients with multiple myeloma.