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  • 1
    Electronic Resource
    Electronic Resource
    Mitral Annular Flexibility (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 12 (1997), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract An analysis of three-dimensional movement of the mitral valve annulus (MVA) may address the question of geometrical change after mitral valve repair to preserve mitral annular function. Conventionally, annular contraction has been studied for this purpose. We investigated this geometrical change occurring in the anterior half of the MVA and discuss its clinical significance. Three-dimensional images of the MVA during systole were reconstructed from magnetic resonance images of eight normal subjects. The posterior half of the MVA exhibited translational motion. We assume that this portion, exhibiting translational motion as well as contraction, purely follows the motion of the left ventricular contraction. Compensating for the discrepancy between the motion of the aortic root and that of the posterior half of the MVA, the anterior half exhibited a flexible change in shape during systole, thus maintaining a sufficient left ventricular outflow tract (LVOT). The increase in the extent of displacement of the anterior MVA from the posterior half of the MVA during systole, which was 3.6 ± 1.0 mm (mean ± SD), indicates the annular flexibility. The preservation of annular flexibility may prevent LVOT obstruction. Further geometrical analysis of patients after mitral repair will clarify annular function as presented in this article.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.1997.tb00103.x
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  • 2
    Electronic Resource
    Electronic Resource
    Effects Of Prostaglandins On Baroreflex During Reperfusion Of The Ischaemic Myocardium (2000)
    Melbourne, Australia : Blackwell Science Pty
    Clinical and experimental pharmacology and physiology 27 (2000), S. 0 
    Details
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. The present study was planned to: (i) determine whether the baroreflex control of heart rate (HR) and renal sympathetic nerve activity (RSNA) was attenuated during reperfusion of short-term ischaemic myocardium; and (ii) study whether blockade of prostaglandin synthesis with indomethacin reversed the inhibitory baroreflex.2. Arterial pressure was lowered with intravenous sodium nitroprusside before coronary occlusion and 3 min after release of a 5 min occlusion of the left circumflex coronary artery in anaesthetized rabbits. The protocol was repeated 20 min after indomethacin (5 mg/kg, i.v.) or indomethacin vehicle (50 mmol/L tris(hydroxymethyl)aminomethane buffer, pH 8.4) treatment. In addition, this study was performed in a group of vagotomized rabbits.3. Before indomethacin treatment, the slope of the mean arterial pressure (MAP)–RSNA relationship decreased from –3.3±0.77 to –2.01±0.69% change in RSNA/mmHg (P 〈 0.05) during reperfusion of ischaemic myocardium in intact rabbits. The decrease in the slope was reversed by administration of indomethacin. However, the decrease in the slope was not reversed by indomethacin vehicle. Furthermore, the reduction in the slope of the MAP–RSNA relationship during reperfusion of ischaemic myocardium was abolished in vagotomized rabbits. However, there was no inhibition of the slope of the MAP–HR relationship during reperfusion of ischaemic myocardium in either intact or vagotomized rabbits.4. In conclusion, our data suggest that prostaglandins released by ischaemic myocardium can attenuate the baroreflex-mediated response of RSNA to lowered arterial pressure via vagal afferents during reperfusion of short-term ischaemic myocardium.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1440-1681.2000.03245.x
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  • 3
    Electronic Resource
    Electronic Resource
    Effect of preoperative portal vein embolization on major hepatectomy for advanced-stage hepatocellular carcinomas in injured livers: A preliminary report (1997)
    Springer
    Surgery today 27 (1997), S. 403-410 
    Details
    ISSN: 1436-2813
    Keywords: portal vein embolization (PVE) ; hepatocellular carcinoma (HCC) ; hepatic functional capacity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract With the aim of minimizing postoperative liver dysfunction and promoting increased resectability, we employed portal vein embolization (PVE). In this study, the effect of PVE on major hepatic resection for advanced-stage hepatocellular carcinoma (HCC) in injured livers was evaluated. PVE was performed prior to hepatectomy in 13 patients with stage III and IV HCCs. Following PVE, right trisegmentectomy was performed in 3 patients, extended right lobectomy in 3 and right lobectomy in 7. To evaluate the effect of PVE, the changes in liver functional capacity and estimated remnant liver volume (ERLV), determined by computed tomography, were examined before and after PVE. The operative morbility, mortality, and survival rates after hepatectomy were also assessed. By 2 weeks after PVE, ERLV had increased in all patients, by an average of 28%, and the mean resection rates had decreased from 70.0% to 62.2%. Postoperatively, the 30-day mortality rate was 15.3%, and the 1- and 2-year survival rates were 69% and 46%, respectively. The results of this study indicate that resectability can be increased, and major hepatectomy can be made safer by employing PVE preoperatively, in view of the fact that major hepatectomy was not considered feasible without PVE in these patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02385702
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  • 4
    Electronic Resource
    Electronic Resource
    Development of a fistula between an internal mammary artery graft and the pulmonary vasculature following coronary artery bypass grafting: Report of a case (1995)
    Springer
    Surgery today 25 (1995), S. 461-464 
    Details
    ISSN: 1436-2813
    Keywords: fistula ; internal mammary artery ; coronary artery bypass grafting
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report herein the rare case of a 56-year-old man who gradually developed congestive cardiac failure 6 months after undergoing coronary artery bypass grafting and was found to have a fistula between the internal mammary artery and the pulmonary artery of the upper lobe diagnosed by selective left internal mammary arteriogram. A second sternotomy was performed and demonstrated dense adhesion between the fissure surrounding the internal mammary artery and the upper lobe, and the fistula was resected. We believe that the patient's increasing cardiac failure was almost certainly caused by coronary steal.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00311829
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  • 5
    Electronic Resource
    Electronic Resource
    Increase in portal blood interleukin-6 soon after the commencement of digestive surgery (1996)
    Springer
    Surgery today 26 (1996), S. 890-894 
    Details
    ISSN: 1436-2813
    Keywords: interleukin-6 ; digestive surgical trauma ; portal blood ; liver function tests ; C-reactive protein
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To determine whether cytokines produced in the operative field during digestive surgery selectively spill over into the portal blood, the changes in interleukin-6 (IL-6) levels in portal and peripheral venous blood were assayed at several points in time from the commencement of surgery until 14 days later, in 11 patients. Similar changes in the IL-6 levels were observed in the portal and peripheral blood samples; however, the IL-6 levels in the portal blood reached a maximum 6–12 h after the commencement of surgery, being earlier than in the peripheral venous blood. In fact, between 3 and 12 h after the commencement of surgery, the IL-6 levels were higher in the portal blood by 33–81 pg/ml. By 24 h or more after the commencement of surgery, the IL-6 levels did not differ significantly in the two types of blood samples. Moreover, the C-reactive protein levels 2 days after surgery were even more closely correlated to the maximum IL-6 levels in the portal blood than to those in the peripheral venous blood. These results suggest that IL-6 produced during intraabdominal digestive surgery initially enters the portal blood, being trapped by IL-6 receptors in the liver, where it may regulate the synthesis of acute-phase proteins as a hepatocyte-stimulating factor.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00311790
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  • 6
    Electronic Resource
    Electronic Resource
    Treatment of Recurrent Hepatocellular Carcinoma by Hepatectomy with Right and Middle Hepatic Vein Reconstruction Using Total Vascular Exclusion with Extracorporeal Bypass and Hypothermic Hepatic Perfusion: Report of a Case (1998)
    Springer
    Surgery today 28 (1998), S. 547-550 
    Details
    ISSN: 1436-2813
    Keywords: Key Words: hepatocellular carcinoma ; hepatic vein reconstruction ; total vascular exclusion ; extracorporeal bypass ; hypothermic hepatic perfusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005950050181
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  • 7
    Electronic Resource
    Electronic Resource
    The effects of intraportal administration of prostaglandin E1 on liver ischemia and hepatectomy in rats (1998)
    Springer
    Journal of hepato-biliary-pancreatic surgery 5 (1998), S. 437-444 
    Details
    ISSN: 1436-0691
    Keywords: Key words: liver hemodynamics ; liver ischemia ; partial hepatectomy ; prostaglandin E1 ; reperfusion injury ; systemic arterial pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The effects of intraportal administration of prostaglandin E1 (PGE1) on portal venous flow, hepatic arterial flow, peripheral tissue blood flow, and systemic arterial flow before and after 60 min total liver ischemia followed by 70% partial hepatectomy in rats were investigated. Total liver ischemia was induced by occluding the hepatoduodenal ligament for 60 min. PGE1 at a dose of 0.5 μg/kg/min was infused intraportally for 15 min before inducing hepatic ischemia (preischemic period) and for 60 min after ischemia (postischemic reperfusion period) in the treatment group. Normal saline was infused in the control group. Seventy percent partial hepatectomy was performed during ischemia. Serum biochemical analysis and liver tissue histology were carried out 1, 3, and 24 h, and 1 and 24 h after reperfusion respectively. One-week survival of the PGE1 group was improved to 70% compared to that of the control group of 30%. Postischemia reperfusion values of portal and peripheral tissue blood flows in the PGE1 group were 6.33 ± 0.600 ml/min and 27.2 ± 23.5 (arbitrary), and were significantly different from those of the control group of 4.34 ± 0.400 ml/min and 23.5 ± 5.54 (arbitrary), respectively. There was no significant difference in hepatic arterial flow between the two groups. Serum alkaline phosphatase decreased significantly in the prostaglandin group. Histological examination revealed a significant portal venous congestion in the control group 1 and 24 h after reperfusion. The extent of the sinusoidal congestion was also severe in the control group 24 h after reperfusion. It was concluded that PGE1 has a protective effect against liver damage when the liver was injured by warm ischemia and reperfusion followed by partial resection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005340050069
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  • 8
    Electronic Resource
    Electronic Resource
    Extent of pathologic invasion of the inferior vena cava in resected liver cancer compared with possible caval invasion diagnosed by preoperative images (2000)
    Springer
    Journal of hepato-biliary-pancreatic surgery 7 (2000), S. 299-305 
    Details
    ISSN: 1436-0691
    Keywords: Key words: liver cancer ; IVC invasion ; imaging findings
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The extent of cancerous invasion of the inferior vena cava (IVC) determined from resected liver cancer was examined pathologically. Ten patients presenting with liver cancer (metastatic liver cancer, five patients; hepatocellular carcinoma, three; and cholangiocellular carcinoma, two) were diagnosed with positive IVC invasion using preoperative imaging techniques of extracorporeal ultrasonography, computed tomography, magnetic resonance imaging, and vena cavography. The diagnostic criterion for positive IVC invasion by preoperative imaging was longitudinal IVC compression measuring over 50 mm, or transverse IVC compression extending to more than half the circumference of the IVC, or the presence of lesions protruding into the IVC lumen, or the presence of developed collateral veins. All patients underwent combined resection of the IVC. However, pathology results revealed that four of the ten patients had no cancerous invasion of the IVC, and that the extent of invasion along both the longitudinal and transverse axes of the IVC was much smaller than the compression shown by imaging results. We believe that detailed preoperative assessment, using a more precise imaging technique, as well as further intraoperative examination, is required to predict the full pathological extent of cancerous invasion of the IVC.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005340070052
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  • 9
    Electronic Resource
    Electronic Resource
    Decrease in aortic distensibility after an extended aortic reconstruction for Marfan's syndrome as a cause of postoperative acute aortic dissection DeBakey type I: A report of two cases (1993)
    Springer
    Surgery today 23 (1993), S. 1010-1013 
    Details
    ISSN: 1436-2813
    Keywords: Marfan's syndrome ; acute aortic dissection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two cases of Marfan's syndrome underwent a reconstruction of the abdominal aorta and descending thoracic aorta. A replacement of the abdominal aorta with visceral arteries as well as a wrapping of the descending thoracic aorta was performed in case 1 while a reconstruction of the descending thoracic aorta and infra-renal abdominal aorta was done in case 2. After the reconstruction, both cases developed acute aortic dissection DeBakey type I. Another reconstruction of the ascending aorta was then urgently performed. Cardiac catheterization after the second operation in case 1 revealed that the distensibility of the aorta had disappeared at the location of the vascular prosthesis while it had also decreased at the wrapped portion, and the maximum dp/dt of the ascending aorta also increased. Increases in the pulse pressure and pulse rate after the first operation were observed in both cases. These hemodynamic changes, which were produced by a decreased distensibility of the reconstructed aorta, increased the mechanical stress to the native aortic wall, and may have been one of the causes of acute aortic dissection DeBakey type I occurring after reconstruction with a prosthesis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00308980
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  • 10
    Electronic Resource
    Electronic Resource
    Castleman Disease of the Pararenal Retroperitoneum: Report of a Case (1999)
    Springer
    Surgery today 29 (1999), S. 178-181 
    Details
    ISSN: 1436-2813
    Keywords: Key Words: Castleman disease ; retroperitoneum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005950050382
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