The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2012
On-pump inhibition of es-ENT1 nucleoside transporter and adenosine deaminase during aortic crossclamping entraps intracellular adenosine and protects against reperfusion injury: role of adenosine A1 receptor.
The inhibition of adenosine deaminase with erythro-9 (2-hydroxy-3-nonyl)-adenine (EHNA) and the es-ENT1 transporter with p-nitro-benzylthioinosine (NBMPR), entraps myocardial intracellular adenosine during on-pump warm aortic crossclamping, leading to a complete recovery of cardiac function and adenosine triphosphate (ATP) during reperfusion. The differential role of entrapped intracellular and circulating adenosine in EHNA/NBMPR-mediated protection is unknown. Selective (8-cyclopentyl-1,3-dipropyl-xanthine) or nonselective [8-(p-sulfophenyl)theophyline] A1 receptor antagonists were used to block adenosine A1-receptor contribution in EHNA/NBMPR-mediated cardiac recovery. ⋯ In addition to the cardioprotection mediated by activation of the adenosine receptors by extracellular adenosine, EHNA/NBMPR entrapment of intracellular adenosine provided a significant component of myocardial protection despite adenosine A1 receptor blockade.
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J. Thorac. Cardiovasc. Surg. · Jul 2012
Reversible reduction of cardiac sympathetic innervation after coronary artery bypass graft surgery: an observational study using serial iodine 123-labeled meta-iodobenzyl-guanidine (MIBG) imaging.
Various types of surgical and interventional procedures have been reported to cause cardiac sympathetic denervation. We aimed at evaluating the effects of coronary artery bypass grafting (CABG) in cardiac sympathetic innervation through meta-iodobenzyl-guanidine (MIBG) imaging. ⋯ CABG is associated with clinically important but reversible reduction in cardiac sympathetic nerve function, with periprocedural effects (cardioplegia, hypothermia, ischemia, direct nerve injury) being possible mechanisms for this finding.
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Several surgical approaches have been described to access apical thoracic malignancies extending into the thoracic inlet. However, most publications have focused on a specific approach and considered the thoracic inlet as 1 entity. In the present analysis, we divided the thoracic inlet into 5 different zones requiring specific surgical considerations to identify the best approach for each zone. ⋯ The thoracic inlet could be divided into 5 zones requiring specific surgical considerations and different approaches. Division of the thoracic inlet into these zones could provide more clarity and guidance for thoracic surgeons to select the correct surgical approach.
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J. Thorac. Cardiovasc. Surg. · Jul 2012
Segmentectomy for selected cT1N0M0 non-small cell lung cancer: a prospective study at a single institute.
To examine whether segmentectomy is radical for cT1N0M0 non-small cell lung cancer (NSCLC), a prospective single-arm study was performed at a single institution. ⋯ Segmentectomy with systematic lymph node dissection with a sufficient surgical margin could be a radical treatment for selected cT1N0M0/pN0 NSCLC while preserving pulmonary function. The surgical margin should be monitored for the development of local recurrence for a long period after segmentectomy.
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J. Thorac. Cardiovasc. Surg. · Jul 2012
Results of interventional bronchoscopy in the management of postoperative tracheobronchial stenosis.
To investigate the role of bronchoscopic intervention in the management of postoperative tracheobronchial stenosis, a retrospective study was performed at a tertiary referral hospital. ⋯ Bronchoscopic intervention could be a useful treatment modality for patients with postoperative tracheobronchial stenosis when surgery is not feasible.