Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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Ann Thorac Cardiovasc Surg · Oct 2003
Comparative StudyEffects of ischemic preconditioning on myocardial protective on cardiac surgery: possibility of ischemic preconditioning and adenosine administration.
We evaluated the efficacy for concomitant use of ischemic preconditioning (IPC) and cardioplegic arrest with adenosine premedication on myocardial protection. ⋯ The concomitant use of IPC enhanced the effect of a myocardial protective solution. However, the administration of adenosine during IPC did not show any further advantage than IPC along. (Ann Thorac Cardiovasc Surg 2003; 9: 307-13)
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Ann Thorac Cardiovasc Surg · Oct 2003
ReviewSurgical treatment of stage I non-small cell lung carcinoma.
In stage I non-small cell lung cancer (NSCLC), the cancer is localized to the lung. For this early stage NSCLC, therefore, surgery is considered to be the treatment of choice. In this report, we reviewed the surgical treatment approaches for stage I NSCLC, placing emphasis on limited resection and video-assisted thoracic surgery (VATS). ⋯ On the other hand, many descriptive studies have indicated that VATS may be useful for the treatment of NSCLC, although the results have not shown any statistically significant differences from those of resection by conventional open thoracotomy. In addition to the low invasiveness, the curability of NSCLC using the VATS approach has been recognized to be similar to that of the standard thoracotomic approaches in clinical practice. Well-controlled studies with strong statistical results are needed to provide strong supportive evidence for the use of VATS for NSCLC. (Ann Thorac Cardiovasc Surg 2003; 9: 283-9)
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Ann Thorac Cardiovasc Surg · Oct 2003
Comparative StudyDescending aortic pulsed wave Doppler can predict changes in cardiac output during off-pump coronary artery bypass surgery.
Retraction and stabilization of the heart can induce rapid and large changes in the hemodynamic state during off-pump coronary artery bypass graft surgery (OPCABG). We aimed to determine if Doppler measurement of flow in the descending artery with transesophageal echocardiography (TEE) can provide a beat-to-beat assessment of changes in cardiac output (CO) in 26 OPCABG patients. Simultaneous measurements were performed of CO using thermodilution, and descending aortic flow (FlowDA) with TEE, prior to grafting, and during grafting to the left anterior descending artery (LAD), circumflex (Cx) and right coronary artery (RCA) territories. ⋯ There was poor correlation between CO and FlowDA between individuals. In a subgroup of 16 patients who had grafts to all territories, the changes in Flow(DA), occurred in the same direction and magnitude as changes in CO (P = 0.062, RM-ANOVA for factor*time interaction). Doppler assessment of flow in the descending aorta is able to track changes in CO during OPCABG. (Ann Thorac Cardiovasc Surg 2003; 9: 314-8)
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Ann Thorac Cardiovasc Surg · Oct 2003
Comparative StudyA study of the myocardial protective effect of rapid cooling based on intracellular Ca, intracellular pH, and HSP70.
It has been reported that rapid cooling of the heart during normothermic coronary circulation at reperfusion after ischemia promotes early recovery of cardiac function due to the positive inotropic effects on the myocardium produced by cooling. The aim of the present study was to investigate the myocardial protective effect of rapid cooling by measuring heat shock protein (HSP) levels and examining the relationship between cardiac function, intracellular Ca concentration, and intracellular pH after rapid cooling. ⋯ Rapid cooling reduces myocardial injury by preventing intracellular Ca overload at reperfusion via inhibition of the Na(+)/Ca(2+) exchanger and also decreases the appearance of HSPs, the so-called homeostasis proteins. (Ann Thorac Cardiovasc Surg 2003; 9: 301-6)