The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Mortality after coronary artery revascularization of patients with rheumatoid arthritis.
Patients with rheumatoid arthritis have an increased risk for accelerated atherosclerosis. It is not known, however, whether this disorder is associated with a higher risk of complications after coronary artery revascularization. ⋯ Among patients undergoing coronary artery revascularization, patients with rheumatoid arthritis have an in-hospital survival advantage along with reduced days of hospitalization compared with patients without rheumatoid arthritis.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Risk factor analysis for postoperative acute respiratory distress syndrome and early mortality after pneumonectomy: the predictive value of preoperative lung perfusion distribution.
This study aims to establish the preoperative risk factors in the development of acute respiratory distress syndrome (ARDS) and early mortality after pneumonectomy for lung cancer and to examine the influence of reduced pulmonary perfusion on outcomes. ⋯ Patients with a low ppo-FEV(1), a high perfusion fraction of resected lung, or both had a higher incidence of ARDS and early mortality after pneumonectomy. Therefore, although the ppo-FEV(1) appears to be within an acceptable limit for pneumonectomy, much attention should be given to patients with a high perfusion fraction of resected lung.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Loss of p53, rather than beta-catenin overexpression, induces survivin-mediated resistance to apoptosis in an esophageal cancer cell line.
Survivin, an important inhibitor of apoptosis, is overexpressed in esophageal cancer and negatively affects survival. The complex regulation of survivin transcription involves enhancement by beta-catenin and repression by p53. The purpose of this study is to test whether inhibition of beta-catenin or overexpression of p53 can decrease survivin expression and render esophageal cancer cells more susceptible to apoptosis. ⋯ Survivin plays a critical role in TE7 cell resistance to camptothecin-induced apoptosis. This effect is not dependent on beta-catenin expression. Overexpression of p53 decreases survivin transcription but does not decrease levels of survivin protein, suggesting posttranscriptional control of survivin expression.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Chronologic changes in P-wave characteristics after the Fontan procedure: the effect of surgical modification.
The Fontan-type procedure has undergone 2 major modifications, including intra-atrial baffling and extracardiac conduit. To clarify the effect of these modifications on arrhythmia propensity, we analyzed chronologic changes in P-wave characteristics after atriopulmonary connection, intra-atrial baffling, or extracardiac conduit. ⋯ After intra-atrial baffling, patients increasingly had prolonged P-wave duration and larger dispersion associated with sinus node dysfunction, suggesting a propensity to arrhythmia, although less progressive than seen in those undergoing atriopulmonary connection. In contrast, despite an equal prevalence of sinus node dysfunction after extracardiac conduit, the lack of important changes in P-wave characteristics over time suggests that the extracardiac conduit procedure is the preferred option for optimal rhythm prognosis.