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R Cichon

Publications and source records attributed to R Cichon.

31 records · Page 2Linked to original sources
PubMed1998

Minimally invasive surgical treatment of coronary artery multivessel disease.

BACKGROUND: If coronary artery multivessel disease is the target of a minimally invasive procedure, either median sternotomy or cardiopulmonary bypass can be avoided. METHODS: We used an alternate technique instead of minithoracotomy and cardiopulmonary bypass to treat 102 patients (82 men, 20 women; age range, 39 to 82 years; median, 61.0 +/- 8.9 years) for coronary artery single-vessel, double-vessel, or multivessel disease between November 1996 and January 1998. Twenty-nine patients (22 men, 7 women; age range, 46 to 78 years; median, 69.0 +/- 8.4 years), who were in a high-risk group for the development of perioperative complications because of the use of cardiopulmonary bypass, received median sternotomy and a beating heart procedure using the Octopus stabilizing technique. The left anterior descending coronary artery was the target vessel in all patients except for 1, in whom the left internal mammary artery was used. RESULTS: There was no intraoperative death in either series. In the beating heart group (Octopus) 2 patients died on postoperative day 31 and 35, respectively, of postoperative pneumonia. CONCLUSIONS: Both techniques present safe alternative procedures to conventional coronary artery bypass grafting in patients with coronary artery multivessel disease.

Adult↗
PubMed1998

Experiences with a minimally invasive surgical technique for the treatment of coronary artery multivessel disease in 100 patients.

OBJECTIVE: The treatment of coronary single vessel disease under minimally invasive surgical conditions was followed by the treatment of coronary multivessel disease using a new technique. METHODS: Using this technique 100 patients (80 male, 20 female, median age 61.0+/-8.9 years, ranged from 39 to 82 years) with coronary single vessel disease, double vessel disease or multivessel disease were treated between November 1996 and December 1997. Via a small (6-9 cm) left lateral chest incision in the second or third intercostal space, the left internal thoracic mammary artery (LIMA) was harvested and access to the central portion of the heart including the ascending aorta was obtained. In parallel, saphenous vein segments were harvested. Arterial cannulation was instituted via the ascending aorta, thus avoiding retrograde flow. In all patients except three the LIMA was used for the left anterior descending artery (LAD). In addition vein grafts were used for revascularization of the other coronary arteries. All cardiac anastomoses were performed during cardioplegic arrest after external aortic cross clamping and antegrade application of cardioplegia. RESULTS: No death or intraoperative complications were observed in this series. The median hospital stay was 6.0+/-1.4 days (median+/-SEM). Postoperative complications were reexplored for bleeding (n = 1), delayed wound healing (n = 2), wound infections (n = 4), lymphatic fistulas (n = 4), and a chest wall hernia (n = 1). CONCLUSIONS: This minimally invasive surgical technique presents a safe alternative to conventional coronary artery surgery avoiding sternotomy related complications and decreasing hospital stay and morbidity.

Adult↗
PubMed1998

[Minimal invasive surgical treatment of coronary multi-vessel disease].

To reduce surgical trauma and median sternotomy related complications in cardiac surgery, a new minimally invasive surgical technique has been developed for the treatment of coronary artery multivessel disease using a small left lateral chest incision in the 3rd intercostal space. This technique enables direct LIMA harvesting and performance of bypass surgery upon all coronary vessels with cardiopulmonary bypass and cardioplegic arrest. So far, 123 patients have been treated with this procedure and survived with fewer complications, and we believe that routine application of this procedure will lead to reduced morbidity in patients receiving coronary artery bypass surgery, short hospital stay and early convalescence, combined with good cosmetic results.

Aged↗
PubMed1992

Physical manipulation of subcutaneously implanted cardiac muscle in rat increased plasma atrial natriuretic peptide concentration.

UNLABELLED: To examine the effects of physical stretch on cardiac muscle endocrine activity, the authors transplanted whole neonatal hearts subcutaneously into the back and the ears of the correspondent mother (n = 9). Seven days later, physical manipulation was applied on the implanted heart by stretching the skin and the subcutaneous tissue encasing the implanted cardiac muscle, for a period of five to ten minutes. Such manipulation was repeated approximately every seven days postoperatively for a total of two to four times for each rat. The plasma atrial natriuretic peptide (ANP) levels were measured by radioimmunoassay prior to and immediately following manipulation. Postmanipulation plasma ANP levels were found to increase from the premanipulation levels. At two weeks postimplant, the average increase was 290% with the highest single-specimen increase being nearly twelvefold. The increases observed at two and three weeks following implantation had Signed Rank Test p values of 0.015 and 0.042 respectively. The viability of the implanted hearts was confirmed by cell culture. Light microscopic immunocytochemistry detected ANP immunoreactivity in the implanted cardiocytes. The elevated plasma ANP concentration induced by the manipulation appeared to be correlated with the functional status of the implanted cardiocytes. IN CONCLUSION: (1) Subcutaneously transplanted neonatal myocardiocytes survived for at least three to four weeks while retaining the ability to produce ANP. (2) Physical manipulation of implanted heart induced ANP release. Therefore, cardiac ANP production and release is indeed stimulated by physical stretching.

Animals↗
PubMed1991

A new biological membrane for pericardial closure.

In an attempt to develop a new and better biological membrane for the pericardium, we evaluated the use of glutaraldehyde treated human amniotic membrane (AM) and compared it to polytetraflouroethylene (PTFE) membrane as a pericardial substitute. Four dogs underwent a right thoracotomy. Two 4 x 3-cm portions of pericardium, 3-4 cm apart, were excised in each animal and both sites replaced with a similar sized patch of 0.8% glutaraldehyde-treated AM and 0.2-mm PTFE membrane respectively. The AM was sutured to the pericardial defect with its smooth surface facing the epicardium. After 18 weeks, the materials were evaluated. The AM patches revealed minimal extrapericardial and no epicardial adhesion. The PTFE patches had moderate to severe epicardial adhesions and severe extrapericardial adhesions. Histopathological examination of AM patches revealed that the integrity of the AM was preserved, however, neovascularization and slight lymphocytic infiltration were observed. In the PTFE patches, there were severe inflammatory infiltration and fibroblast proliferation into both surfaces. AM patches by virtue of their low immunogenicity evoke very minimal host to graft reaction. These AM grafts, however, tear easily unless carefully sutured. Improved methods of treatment may improve suturing strength. We conclude that AM performs satisfactorily and is superior to PTFE as a pericardial substitute.

Amnion↗
PubMed1991

The cryopreserved stented pulmonary homograft valve in the tricuspid position.

This study was designed to evaluate the early phase events occurring in a stented pulmonary homograft valve implanted in the tricuspid position. A human pulmonary homograft was sterilized in antibiotic solution for 48 hours and cryopreserved in liquid nitrogen (-176 degrees C). Following thawing and trimming, the pulmonary valve was mounted on a Dacron cloth-covered Delrin stent and implanted into the tricuspid position in 3-month-old sheep, for a mean of 95 +/- 5 days. Seven animals were studied. Morphological assessment indicated good structural tissue preservation despite a decrease in viable fibroblasts noted in the distal part of the leaflets. The collagen fibers remained unchanged, and no tissue calcification was found. Viability of the mounted homograft was evaluated using an in vitro tissue culture method, and the viable cells underwent chromosomal analysis to identify whether they originated from the donor or host. Cells with 56 chromosomes, a number intrinsic to sheep cells, were cultured from the donor recipient junctional area. Hemodynamic and angiographic data, which were collected at the time of both implantation and explantation, revealed no functional deterioration of the implanted valve over 3 months. At the time of explantation, six of the seven valves were competent and no cusp retraction or thickening was noted. The seventh valve had deteriorated due to endocarditis. We conclude that stented cryopreserved pulmonary homografts may be useful as bioprostheses in the tricuspid position.

Animals↗
PubMed1991

Physical overdistension converts ventricular cardiomyocytes to acquire endocrine property and regulate ventricular atrial natriuretic peptide production.

Atrial natriuretic peptide (ANP) is present in adult atria but at very low concentrations in normal adult mammalian ventricles. In the atria, the production of ANP is regulated by physical distension of the atrial wall. The same phenomenon was investigated in the ventricles of rats and men. Cardiac tissues from human ventricular aneurysm (n = 5), spontaneously hypertensive rats (n = 30), and rats that had overloaded left ventricles induced by surgery (n = 84) were studied with the methods of light microscopic immunocytochemistry, electron microscopic immunogold staining, and RNA-RNA tissue in situ hybridization. It was found that the levels of ANP gene expression, ANP immunoreactivity, and ANP-containing specific granules in the overburdened ventricles were elevated and their degrees of fluctuation were directly proportional to the force of physical distension applied to the ventricular cardiomyocytes. In rats, ANP mRNA and ANP immunoreactivity returned to the control level seven days after the ventricular overload was surgically released. The changes of ANP and its mRNA in the ventricles were related more closely to the changes of intraventricular pressure than to cardiocytic hypertrophy. In addition, ANP immunoreactivity was demonstrated in Purkinje cells and periarteriolar cardiomyocytes in the ventricles of normotensive rats. In conclusion, physical overstretch of the ventricle wall is likely to be the triggering factor affecting ventricular cardiomyocytes to acquire endocrine property, and also to regulate the production of ventricular ANP, thereby contributing to the control of the blood volume and the blood pressure.

Animals↗
PubMed1991

Effect of polyoxyethylene glycols (PEG) on properties of the matrix model of transdermal therapeutic system (TTS) with testosterone.

Polyoxyethylene glycols (PEG) are nontoxic substances, which ones do not irritate the skin, therefore can be used as pharmaceutical excipients to differentiate the properties of various matrices. The effect of variable content and molecular mass of PEG in cellulose acetate matrices on the testosterone solubility, the rate of water sorption and the release rate of testosterone from the matrix model of TTS was studied. It may be concluded that the testosterone solubility in matrices, the rate of water sorption by systems and the pharmaceutical availability of drug can be regulated on a relatively wide scale independently of molecular mass by the amounts of PEGs incorporated into matrices. It was found that in all cases of triphase matrices the liberation process of terosterone was well correlated with Higuchi's equation. The rate of water sorption by PEG and matrices may be described by the equation Q = k square root of t.

Administration, Cutaneous↗
PubMed1983

Effect of prostaglandins on chloropromazine induced catalepsy in mice.

The effect of prostaglandins (PGs) F1 alpha, F2 alpha, E2, D2, A1, B1 and I2 administered intracerebroventricularly (i.c.v.) in mice in a dose of 1 microgram on catalepsy induced by chloropromazine (2.5 mg/kg i.p.) was examined. It was demonstrated that only PGF2 alpha reduced significantly the chloropromazine induced catalepsy, while PGI2 intensified it. The other examined PGs were without any effect on chlorpromazine catalepsy. The results show the modifying role of some PGs on chloropromazine effects on central dopaminergic receptors in mice.

Animals↗
PubMed1978

On rapeseed meals. Part XXVI. Some remarks on the biological value of rapeseed meal proteins after silage.

The influence of propionic bacteria on the biological value of potato-rapeseed meal protein ensilage was investigated. The inoculation of the ensilage with Propionibacterium Petersoni T 112 led to the reduction of the content of goitrogenous compounds (isothiocyanates and oxazolidinethiones) and to an increase of the nutritive value (NPU, PER) of the rapeseed protein. The increase of the protein value is greater by the application of propionic bacteria than by toasting of rapeseed meal.

Animal Feed↗
PubMedDate not supplied

Three-year follow-up after port-access mitral valve surgery.

INTRODUCTION: After the promising early results with Port-Access mitral valve (MV) surgery, the mid-term results were evaluated. METHODS: Among 31 patients receiving this surgery, there were two subgroups (A and B). The 14 patients in group A (7 men, 7 women, 64.0 +/- 12.8 years, LVEF 0.62 +/- 0.118) received the procedure exactly as proposed by Heartport. The 17 patients in group B (6 men, 11 women, 63.0 +/- 11.48 years, LVEF 0.61 +/- 0.117) received a modified technique for a less complex procedure. The underlying diseases were MV insufficiency (n = 14), MV stenosis (n = 9), and combined MV disease (n = 8). One female patient had a partial atrial ventricular canal. RESULTS: Perioperative mortality was 3.2%. Survival at 39.0 +/- 6.3 months (median +/- SEM) was 93.5%. Two patients required intraoperative inotropic and mechanical support (intra-aortic balloon pump [IABP]). One of these two patients died on postoperative day 3 due to low cardiac output syndrome. All ther patients survived the procedure. Twenty-four patients underwent MV replacement, 7 patients received MV repair, and 1 patient received, in addition, ASD repair. In group B, operative time, ICU stay, and hospitalization was shorter. CONCLUSIONS: Good early results after Port-Access MV surgery were confirmed by equal mid-term results. The patients are satisfied with the surgical and the cosmetic results, however, Port-Access MV surgery still has to prove superior outcome compared to conventional MV surgery. In selected cases a true reduction of the surgical trauma is possible.

Adult↗