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  • 1
    Electronic Resource
    Electronic Resource
    350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England . : Blackwell Science Inc
    Journal of cardiac surgery 20 (2005), S. 0 
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Coronary artery bypass grafting (CABG) in patients with severely diseased ascending aorta has been associated with high risk for cerebral vascular accidents due to atheromatous embolism. In this situation, aortic no-touch techniques are widely employed as most important surgical strategy to prevent these complications. A case of 75-year-old man with effort angina associated with porcelain ascending aorta was reported here. He successfully underwent off-pump axillo-coronary bypass grafting with saphenous vein graft and has remained uneventful during his follow-up period. The off-pump axillo-coronary artery bypass grafting seemed to be an appropriate procedure for coronary revascularization with severely diseased ascending aorta.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1523-5378
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background. The ammonia-monochloramine system plays an important role in Helicobacter pylori-associated gastric mucosal injury. Polaprezinc, a new antiulcer agent, has a scavenging action against monochloramine. The aim of the experiment was to investigate the inhibitory effects of polaprezinc on the H. pylori-induced gastritis in Mongolian gerbils.Materials and Methods. Mongolian gerbils fasting for 24 hours were orally given culture broth containing 2–4 × 108 colony-forming units of H. pylori ATCC 43054 per milliliter. From 4 hours after inoculation until the end of the experiment, gerbils were given chow pellets with or without 0.02% polaprezinc. All gerbils were killed 12 weeks later. The grades of H. pylori density and histologic features of gastritis were evaluated in accordance with the Updated Sydney System. The scavenging effect of polaprezinc on monochloramine was investigated spectrophotometrically.Results. Polaprezinc had little or no influence on the H. pylori density in both pyloric and fundic mucosae. However, it significantly attenuated the development of polymorphonuclear neutrophil activity, mononuclear infiltration, and surface epithelial erosion in both pyloric and fundic mucosae compared with those of the control group. H. pylori inoculation significantly increased the heights of both pyloric and fundic mucosae (mainly due to the increased height of foveolar hyperplasia), but polaprezinc inhibited the increase of mucosal thickness in both pyloric and fundic mucasae. No intestinal metaplasia was detected in this study. Spectrophotometric examination revealed that polaprezinc scavenged monochloramine.Conclusions. Polaprezinc inhibited the development of H. pylori-induced gastritis through its scavenging action against monochloramine.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 21 (1998), S. 0 
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A 74-year-old woman with a unilateral left superior vena cava required dual chamber permanent pacing after a radical cardiac operation for an incomplete form of endocardial cushion defect. An active fixation ventricular lead was used to prevent the instability induced by the strange course of the electrode. For atrial pacing, a ventricular passive fixation lead was used. A transvenous dual chamber pacemaker was successfully inserted via a unilateral left superior vena cava.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1530-0358
    Keywords: Carcinoid tumor ; Rectum ; Two-channel colonoscope ; Colonoscopic resection ; Surgical technique
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Complete resection of small carcinoid tumors of the rectum is difficult with conventional polypectomy, because these tumors are most often located in the submucosal layer of the rectal wall. To completely remove these tumors, we used a two-channel videocolonoscope with which both a grasping forceps and a polypectomy snare could be used simultaneously. We evaluated its clinical usefulness in comparison with one-channel colonoscopic polypectomy. METHODS: At Osaka Medical Center for Cancer and Cardiovascular Diseases, seven carcinoid tumors in seven patients were removed with a one-channel videocolonoscope from 1985 to 1992. In 1993 and 1994, ten tumors in nine patients were removed with a two-channel colonoscope. RESULTS: The rate of complete removal of carcinoid tumors with a two-channel videocolonoscope (9 of 10 tumors, 90 percent) was significantly higher (P〈0.05) than with a one-channel videocolonoscope (2 of 7 tumors, 29 percent). No complications occurred during or after endoscopic resection with a two-channel colonoscope. CONCLUSIONS: Endoscopic resection with a two-channel colonoscope is a useful and safe method for resection of small carcinoid tumors of the rectum.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1436-2813
    Keywords: Key Words: brain natriuretic peptide ; cardiopulmonary bypass ; cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: P 〈 0.0001 versus baseline). They had returned to the baseline values when measured 3 weeks postoperatively. The preoperative plasma BNP concentration correlated significantly with the left ventricular ejection fraction (r = −0.895). The peak plasma BNP concentration 24 h after bypass correlated with the cardiac index (r = −0.64), stroke volume index (r = −0.62), injection rate of dopamine hydrochloride (r = 0.65), and aortic crossclamp time (r = 0.57). There was also a significant correlation between the preoperative BNP concentration and the plasma BNP concentration 24 h post-CPB. These findings led us to conclude that the plasma concentrations of BNP become markedly and acutely elevated after cardiac surgery with CPB, and reflect the state of left ventricular function. Moreover, the severity of acute heart failure after cardiac surgery can be predicted by the preoperative plasma BNP concentration.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1436-2813
    Keywords: brain natriuretic peptide ; cardiopulmonary bypass ; cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The plasma concentrations of brain natriuretic peptide (BNP), a cardiac hormone, were measured in 30 consecutive adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) during the perioperative period. BNP concentrations remained unchanged until 6 h after the cessation of bypass, and were elevated 12, 24, and 48 h post-bypass (P〈0.0001 versus baseline). They had returned to the baseline values when measured 3 weeks postoperatively. The preoperative plasma BNP concentration correlated significantly with the left ventricular ejection fraction (r=−0.895). The peak plasma BNP concentration 24 h after bypass correlated with the cardiac index (r=−0.64), stroke volume index (r=−0.62), injection rate of dopamine hydrochloride (r=0.65), and aortic crossclamp time (r=0.57). There was also a significant correlation between the preoperative BNP concentration and the plasma BNP concentration 24 h post-CPB. These findings led us to conclude that the plasma concentrations of BNP become markedly and acutely elevated after cardiac surgery with CPB, and reflect the state of left ventricular function. Moreover, the severity of acute heart failure after cardiac surgery can be predicted by the preoperative plasma BNP concentration.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1436-3305
    Keywords: Key words Small gastric cancer ; Time trends ; Mucin phenotype
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Background. Gastric cancer rates in Japan have been declining since the 1970s. The rate of differentiated carcinomas has decreased and that of undifferentiated carcinomas has increased. However, little is known about the time trends of small gastric cancer. The aim of this study was to investigate the trends of small gastric cancer over time in Japan. Methods. We reviewed cases of small gastric cancer (less than 20 mm in diameter) in two groups of patients who entered the age range of 55-to-67 years 14 years apart: patients in cohort 1 (n = 66) were born between 1899 and 1912, and those in cohort 2 (n = 66) were born between 1926 and 1936. Between-group comparisons were made for macroscopic, microscopic, and histochemical findings. Mucin histochemical analysis was used to investigate gastric and nongastric phenotypes. Helicobacter pylori was also investigated by immunohistochemistry. Results. There were significant decreases in the incidence of elevated carcinoma (20% in cohort 1 vs 6% in cohort 2; P 〈 0.05) and papillary adenocarcinoma (11% vs 2%; P 〈 0.05). The incidence of flat carcinomas was significantly increased (3% vs 15%; P 〈 0.05). The incidence of tumors surrounded by fundic gland mucosa increased (20% vs 29%), whereas that of tumors surrounded by intestinal metaplastic mucosa decreased (52% vs 41%). The rate of H. pylori infection in mucosa surrounding tumors was the same in both groups (35%). The incidence of tubular adenocarcinoma with gastric-type mucin was higher in cohort 2 (64%) than in cohort 1 (51%). Conclusion. The rate of tubular adenocarcinomas containing gastric type mucin has increased over time. These tumors had a tendency to develop in the fundic gland mucosa and to show less intestinal metaplasia. The H. pylori infection rate was unrelated to this time trend. In advanced gastric cancer, the differentiated carcinoma rate has decreased; however, in small gastric cancer, the rate of tubular adenocarcinoma containing gastric type mucin has increased. This suggests that tubular adenocarcinoma with gastric type mucin changes into poorly differentiated adenocarcinoma as tumors grow to advanced stages.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1436-2813
    Keywords: calcium ; continuous cardioplegia ; cardiac arrest ; myocardial protection ; calcium paradox
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects of calcium (Ca) on a hyperkalemic cardioplegic solution for continuous cardioplegia were examined in an isolated perfused working rat heart model. The coronary arteries were perfused with a modified Krebs-Henseleit bicarbonate buffer (K-H) solution, containing various concentrations of Ca(0.1, 0.6, 1.2, and 2.5 mmol/l) and a high concentration of potassium (20 mmol/l), for 180 min, after which cardiac arrest was induced at 37°C for 180 min. Cardiac function and creatine kinase (CK) were measured. In the control group, K-H solution was infused in place of the cardioplegic solution, and cardiac arrest was not induced. No significant differences were observed between the groups infused with the K-H solution containing Ca concentrations of 0.6, 1.2, and 2.5 mmol/l in the percent recovery of aortic flow (82.1±2.9%, 80.6±2.0%, and 71.5±3.7% (mean±SEM) respectively) or in the recovery of other indices of cardiac function, or in CK leakage. There were also no significant differences in the recovery of cardiac function and CK leakage between these groups and the control group. In the Ca 0.1 mmol/l group, however, the characteristic Ca paradox was observed. These findings suggest that if the Ca concentration in a cardioplegic solution is higher than 0.6 mmol/l during continuous cardioplegia, excellent cardioprotective effects will be achieved.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1420-908X
    Keywords: Key words: Ulcerative colitis – Inflammatory bowel disease – Hepatocyte growth factor – c-met – Colorectal cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Objective and Design: This study was designed to determine if the hepatocyte growth factor (HGF)-Met system is involved in the repair process of inflamed mucosa of ulcerative colitis (UC) and in the development of UC-associated colorectal cancer.¶Materials and Methods: HGF and c-met gene expressions were quantified in colonic mucosal specimens from healthy control subjects, patients with UC and patients with UC-associated colorectal cancer, using the competitive reverse transcription-polymerase chain reaction. Expression of HGF protein was determined by immunoblot analysis. Expression of c-Met protein was analyzed immunohistochemically.¶Results: HGF and c-met gene expressions were increased in inflamed mucosa of UC, compared with control subjects. Gene expression of HGF was also increased in the surrounding inflamed mucosa of UC-associated cancers. In cases in which the HGF gene expression was increased, an apparent increase in protein levels of HGF in inflamed mucosa of UC were observed by immunoblot analysis. The c-met gene was overexpressed in UC-associated cancers and a high level of immunoreactivity of the c-Met protein was immunohistochemically detected within the cancer cells.¶Conclusion: We showed that HGF and c-met expression is increased in the inflamed mucosa of UC and that c-met is overexpressed in UC-associated colorectal cancers. These observations suggest HGF-Met system is involved in the repair process of the inflamed mucosa of UC and provide further support for the view that the inappropriate expressions of both HGF and c-met genes predispose to the development of colorectal cancer in patients with UC.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-0509
    Keywords: Esophagus, neoplasm ; Esophagus, radiography ; Early carcinoma ; Mucosal carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To clarify the exact radiologic features of mucosal carcinoma of the esophagus with a favorable prognosis, contact radiography was performed on 8 surgical specimens diagnosed preoperatively as showing early or superficial carcinoma. Mucosal carcinoma appeared as a well-defined smooth or nodular protrusion or as a feathered flat mucosa with tiny nodulations and barium poolings. Submucosal carcinoma showed a mound-like defect. The size of tumor was not a good index for estimating the depth of invasion. Protruded lesions were easily demonstrated on clinical radiographs and their profile was useful in determining the depth of invasion. Flat lesions were not easy to recognize; attention must therefore be paid not only to mucosal patterns but also to the contour of the esophageal wall.
    Type of Medium: Electronic Resource
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