The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2017
Using the National Cancer Database to create a scoring system that identifies patients with early-stage esophageal cancer at risk for nodal metastases.
Endoscopic resection is gaining popularity as a treatment for early-stage esophageal adenocarcinoma, particularly for T1a tumors. The goal of this study was to create a scoring system to reflect the risk of nodal metastases in early-stage esophageal adenocarcinoma to be used after endoscopic resection to better individualize treatment. ⋯ The proposed scoring system seems to be useful in discriminating risk of nodal metastases in patients with T1a or T1b esophageal adenocarcinoma and may be useful in directing patients who received endoscopic resection to esophagectomy or careful follow-up.
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J. Thorac. Cardiovasc. Surg. · Nov 2017
Elevated oxidative stress in the aortic media of patients with bicuspid aortic valve.
Congenital bicuspid aortic valve (BAV) is distinctly associated with the development of ascending aortopathy in adulthood, portending risk of both ascending aortic aneurysm and dissection. Our previous work implicated deficiency in oxidative stress response as a mediator of the BAV-associated aortopathy. We hypothesize that reactive oxygen species generation invokes elevated local oxidative tissue damage in ascending aorta of patients with BAV. ⋯ Superoxide anion accumulation and increased lipid peroxidation demonstrate that, despite increased peroxidase activity, the ascending aortopathy of patients with BAV involves oxidative stress. In addition, the absence of increased superoxide dismutase activity in BAV specimens indicates a deficiency in antioxidant defense. This suggests that the characteristic smooth muscle cell loss observed in BAV aortopathy may be a consequence of superoxide-mediated cell damage.
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J. Thorac. Cardiovasc. Surg. · Nov 2017
Predictors of operating room extubation in adult cardiac surgery.
The primary objective of the study was to identify perioperative factors associated with successful immediate extubation in the operating room after adult cardiac surgery. The secondary objective was to derive a simplified predictive scoring system to guide clinicians in operating room extubation. ⋯ Perioperative factors that are independently associated with successful operating room extubation after adult cardiac operations were identified, and an operating room extubation prediction scoring system was validated. This scoring system may be used to guide safe operating room extubation after cardiac operations.
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J. Thorac. Cardiovasc. Surg. · Nov 2017
Prognostic impacts of EGFR mutation status and subtype in patients with surgically resected lung adenocarcinoma.
Epidermal growth factor receptor (EGFR) gene mutation status is a well-established predictor of the efficacy of EGFR tyrosine-kinase inhibitor (TKI) therapy in patients with non-small cell lung cancer. Recently, differences in EGFR mutation subtypes have been reported to be associated with the efficacy of EGFR-TKI therapy. The prognostic impact of EGFR mutation status and subtypes remains controversial, however. ⋯ Positive EGFR mutation status is a favorable prognostic factor in patients with surgically resected lung adenocarcinomas; however, EGFR mutation subtype (exon 21 L858R mutation or exon 19 deletion) exhibits no prognostic impact.
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J. Thorac. Cardiovasc. Surg. · Nov 2017
CommentA neonatal rat model of increased right ventricular afterload by pulmonary artery banding.
To construct a neonatal rat model of increased right ventricular (RV) afterload for studying the pathophysiological remodeling of the right ventricle in patients with congenital heart disease with increased RV afterload. ⋯ We successfully established a neonatal RV afterload increase model through PAB within 6 hours after birth, which can be used to study the pathophysiological changes in congenital heart diseases with increased RV afterload.