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E Mikus

Publications and source records attributed to E Mikus.

At least 19 recordsLinked to original sources

Nine years experience of aortic arch repair with the aid of antegrade selective cerebral perfusion.

AIM: Antegrade selective cerebral perfusion (ASCP) is gaining widespread popularity in aortic arch surgery because it has been demonstrated to be an optimal technique of cerebral protection. This study demonstrates the clinical results of aortic arch repair with ASCP. METHODS: Between November 1996 and September 2004, 250 patients underwent thoracic aorta replacement using ASCP under moderate hypothermia. Mean patients age was 63+/-11.5 years. Presenting pathologies were chronic aneurysm in 136 patient (54.4%), type A acute aortic dissection in 80 patients (32%), post-dissection aneurysm in 30 patients (12%). Ascending aorta and hemiarch replacement was performed in 63 patients (25.2%), ascending aorta and total arch replacement in 131 patients (52.4%), total arch replacement in 33 patients (13.2%), total arch and descending aorta replacement in 10 patients (4%) and complete replacement of the thoracic aorta in 13 patients (5.2%). RESULTS: Hospital mortality was 11.6%. Multivariate analysis showed preoperative renal failure (P=0.050), cerebral perfusion time (P<0.001), pulmonary complications (P=0.009) and postoperative dialysis (P=0.030) as risk factors for hospital mortality. Permanent neurologic deficits occurred in 4 patients (1.6%) and coronary artery disease (P=0.029) was found to be the only independent risk factor. Transient neurologic deficits were noted in 18 patients (7.2%). Multivariate analysis revealed age (P=0.043), coronary artery disease (P=0.036), urgent/emergency status of the operation (P=0.016) and concomitant aortic valve replacement (P=0.001) to be independent predictors of transient neurologic dysfunction. The actuarial survival rate at 7 years was 61.7%. CONCLUSIONS: | Our results confirmed that ASCP is a safe method of brain protection allowing complex aortic repairs to be performed with good results in terms of hospital mortality and neurologic outcome. Cerebral perfusion time did not influence postoperative outcome. The use of moderate hypothermia avoided all undesirable effects of deep hypothermia.

Adolescent↗

[Animal experiment study of performance ultrasound in the welding of liver wounds].

Liver cuts were performed on 21 Mini-Leewe-pigs and than closed with suture and by ultrasonic welding with Ligament-FIMOMED and Gelaspon. The sound pressure leads to the forced penetration of the monomere into performed gaps. The application of the ultrasound is sensible in order to force the polymerisation. The experiments resulted in the succesful closure of the liver wounds in all cases where ultrasonic welding of Fimomed-Gelaspon compound was used. Application to human medicine is, however, not yet justified.

Animals↗

Cardioprotective effect of prostacyclin and 7-oxo-PGI2 in rats against chronic isoproterenol damage.

Isoproterenol (ISO) was injected in 5 mg/kg i.p. doses to rats, daily for two weeks. We evaluated the developed myocardial hypoxia and necrosis quantitatively by histological methods. To follow the time course of cardioprotection prostacyclin or 7-oxo-PGI2 were injected daily, i.p. 5, 30 min and 1, 2, 3, 4 hours before or after the ISO to groups of ten rats, respectively. Cardioprotection was defined as the reduction of necrotized areas and was expressed as percentage change compared to the control (saline treated) group. 1 microgram/kg PGI2 and 50 micrograms/kg 7-oxo-PGI2+ showed nearly equipotent cardioprotection (37.3-7.9% and 38.3-6.8%, respectively). The peak effect of both compounds appeared when injected prior to ISO in the 120. min but the action of 7-oxo-PGI2 was more prolonged. The different doses of prostacyclin analogs given after the ISO injection were ineffective with the exception of 50 micrograms/kg 7-oxo-PGI2 (29.75 +/- 5.2%).

Animals↗

[Basic research on ultrasound surgery. VI: Comparative histological liver findings following treatment of the wound with ultrasound welding and suturing].

Liver cuts were performed on 21 Mini- Lewe pigs and then closed with suture in one case, and by ultrasonic welding of Fimomed - Gelaspon conglomerate in the other. Macroscopic assessment in situ and the histological examination of cut out liver areas regularly showed perifocal inflammatory peritoneal reactions and abscess formation for the sutured regions. From a histological point of view the liver tissue in the regions subjected to ultrasonic treatment reacted more strongly than after suture, particularly in the form of lobule structure disturbances, focal hepatitis, hepatic duct proliferation and destruction, and cholangitis. All of these were limited to the immediate vicinity of the conglomerate with its fibrous demarcation, which remained identifiable until the end of the experiment after a year and a half. The experiments resulted in the sucessful closure of the liver wounds in all cases where ultrasonic welding of Fimomed - Gelaspon compound was used. Application to human medicine is, however, not yet justified.

Animals↗