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 · Feb 2003
Comparative StudyComparison of m-RNA expression for inflammatory mediators in leukocytes between on-pump and off-pump coronary artery bypass grafting.
Coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) is associated with a systemic inflammatory response. This is mainly attributed to cytokine release caused by CPB and global myocardial ischemia. Coronary artery bypass grafting without cardiopulmonary bypass (off-pump CABG, OPCAB) is now accepted as a less invasive technique than conventional CABG. This study was designed to compare the inflammatory response at the m-RNA level of proinflammatory cytokines and adhesion molecules before and after operation in patients undergoing CABG with and without CPB. ⋯ In view of the m-RNA level of proinflammatory cytokines and adhesion molecules, it can be concluded that OPCAB is a less invasive technique than on-pump CABG. Direct contact of circulating blood with the synthetic surfaces of the CPB system may be the main cause of the systemic inflammation.
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Ann Thorac Cardiovasc Surg · Feb 2003
Case ReportsLeft upper division sleeve segmentectomy for early stage squamous cell carcinoma of the segmental bronchus: report of two cases.
Early hilar lung cancer is rare. It is usually curable if properly diagnosed and treated. We recently encountered two cases of early stage squamous cell carcinoma of the left upper division bronchus, which responded well to left upper division sleeve segmentectomy. ⋯ His postoperative course was uneventful, and he shows good respiratory condition, without any evidence of recurrence five months after surgery. The pathological stage was TisN0M0 (stage 0) in both patients, and their tumors were confirmed as early hilar lung cancer. Sleeve segmentectomy, aimed at radical resection of cancer while preserving lung function, can serve as a standard procedure for surgical treatment of cases of early hilar lung cancer confined to the segmental bronchi.
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Ann Thorac Cardiovasc Surg · Dec 2002
Case Reports Comparative StudySurgical treatment of Budd-Chiari syndrome induced by Behcet's disease.
Although Budd-Chiari syndrome in Japanese is usually chronic, and of unknown etiology and idiopathic, Behcet's disease is rare as an underlying disorder of Budd-Chiari syndrome in Japanese. To clarify the Behcet-induced Budd-Chiari syndrome, the clinical course and pathologic findings of patients with Behcet-induced Budd-Chiari syndrome were compared with those of patients with idiopathic Budd-Chiari syndrome. ⋯ In Budd-Chiari syndrome in Japanese, the Behcet-induced Budd-Chiari syndrome had an acute clinical course, and its postoperative prognosis depends on the prognosis of the Behcet's disease.
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Ann Thorac Cardiovasc Surg · Dec 2002
Case ReportsTreatment of refractory coronary vasospasm during cardiopulmonary bypass with compulsory coronary perfusion.
Coronary vasospasm is still a devastating complication during cardiac surgery. We report on a case of intractable coronary vasospasm in a 45-year-old male during coronary bypass surgery refractory to drugs and intra-aortic balloon pumping (IABP). ⋯ Coronary vasospasm was dramatically resolved. He was then successfully weaned from CPB and recovered without further incidents.