Is off-pump cardiac surgery better for the brain?
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Brain Ischemia↗
Biomedical subjects
S Wan
Publications and source records attributed to S Wan.
[Experimental study of preventive effect of xin-kang oral liquid on acute viral myocarditis in mice].
OBJECTIVE: To study the preventive effect of Xin-Kang oral liquid on acute Coxsackie B3 viral myocarditis in mice. METHODS: The mice were infected Coxsackie virus B3 (CVB3m) through abdominal cavity after they were fed with the Xin-Kang oral liquid for 2d, and the uses of the drug continued to the 20th day. Histopathological changes of the myocardial cells were observed under microscope and measured by morphometric quantification. RESULTS: The detection rate of pathological change of grade III of heart surface in Xin-Kang oral liquid groups were lower than in virus control group, the difference between Xin-Kang medium dose group and virus control group being specially significant (P < 0.01), and the detection rate of severe myocardial damage was much lower. The average area of myocardial damage and area of myocardial damage/area of the whole heart in Xin-Kang oral liquid groups were markedly lower than those in virus control at the 5th day and the 20th day. CONCLUSION: These results demonstrate that the preventive effect of Xin-Kang oral liquid on acute Coxsackie B3 viral myocarditis is similar to that of interferon.
Acute Disease↗
[Isozyme analysis of Gastrodia elata f. elata and G. elata f. glaucca and their hybrid].
Peroxidase(POX) isozyme analysis of Gastrodia elata f. glaucca, G. elata f. elata and its hybrid were carried out. The results indicated that shoot apex meristem was optimal material for POX analysis and the determination of the hybrid. The zymogram hands were stable and clear. POX isozyme zymogram of the hybrid F1(H x W) represented the visible supplement relation between Gastrodia elata f. elata and Gastrodia elata f. glaucca.
Gastrodia↗
Multi-organ protection during open heart surgery.
PURPOSE AND METHODS: Open-heart surgery with the use of cardiopulmonary bypass (CPB) is associated with an inflammatory cascade which contributes to the development of postoperative complications including multiple organ failure. To provide an update on the subject, we briefly review the recent English-language literature. RESULTS: During CPB, various factors have been recognized to induce a complex inflammatory response. Based on an enhanced understanding of the underlying mechanisms, therapeutic strategies have been developed to reduce this inflammatory reaction and its subsequent damaging effects. Off-pump coronary artery bypass grafting may result in less inflammatory injury as compared with the conventional maneuver, which can in turn, diminish the incidence of cardiac, renal, or neurological dysfunction. It is also clear that improving the biocompatibility of CPB materials can lead to a better patient recovery. Inasmuch as the pathophysiology involved appears to be multifactorial, it is unlikely that a single intervention could achieve the desired goal. Both pharmacologic strategies, such as steroid pretreatment, and modification of mechanical devices, such as the use of heparin-coated CPB circuits, could have important clinical implications. The balance pro- and anti-inflammatory responses may be crucial in limiting the extent of inflammatory injury. CONCLUSIONS: To date, the concept of organ protection should no longer be limited to the individual organ. Instead, investigations must be extended to focus on a systemic level.
Adrenal Cortex Hormones↗
Coordinating cell fate and morphogenesis in Drosophila renal tubules.
Using the renal tubules of Drosophila as an example, we explore how cell specification leads to the morphogenetic movements that underlie the generation of tissue architecture. Taking two stages of development, we show first that the tubule cells are allocated by signalling between the endodermal and ectodermal compartments of the posterior gut. Activation of the Wnt pathway patterns the ectodermal anlage, resulting in the expression of tubule genes in a subset of cells and their eversion from the hindgut to form the tubule primordia. We argue that early gene expression directs these morphogenetic movements but not the complete programme of tubule differentiation. In the second example we show that the allocation of the mitogenic tip cell lineage in each tubule is required not only for the normal pattern of cell division but also for the stereotyped three-dimensional arrangement of the mature tubules. Analysis of mutants in which the tip cell lineage is misspecified reveals that both daughters of the tip cell progenitor are required for the tubules to navigate through the body cavity, so that the distal tips locate in their characteristic positions. We show that the regulator of Rac, Myoblast city is essential for this second morphogenetic process.
Animals↗
Multiple signalling pathways establish cell fate and cell number in Drosophila malpighian tubules.
A unique cell, the tip mother cell, arises in the primordium of each Drosophila Malpighian tubule by lateral inhibition within a cluster of achaete-expressing cells. This cell maintains achaete expression and divides to produce daughters of equivalent potential, of which only one, the tip cell, adopts the primary fate and continues to express achaete, while in the other, the sibling cell, achaete expression is lost (M. Hoch et al., 1994, Development 120, 3439-3450). In this paper we chart the mechanisms by which achaete expression is differentially maintained in the tip cell lineage to stabilise cell fate. First, wingless is required to maintain the expression of achaete in the tubule primordium so that wingless mutants lack tip cells. Conversely, increasing wingless expression results in the persistence of achaete expression in the cell cluster. Second, Notch signalling is restricted by the asymmetric segregation of Numb, as the tip mother cell divides, so that achaete expression is maintained only in the tip cell. In embryos mutant for Notch tip cells segregate at the expense of sibling cells, whereas in numb neither daughter cell adopts the tip cell fate resulting in tubules with two sibling cells. Conversely, when numb is overexpressed two tip cells segregate and tubules have no sibling cells. Analysis of cell proliferation in the developing tubules of embryos lacking Wingless after the critical period for tip cell allocation reveals an additional requirement for wingless for the promotion of cell division. In contrast, alteration in the expression of numb has no effect on the final tubule cell number.
Animals↗
VATS lobectomy reduces cytokine responses compared with conventional surgery.
BACKGROUND: Video-assisted thoracic surgery (VATS) lobectomy for early lung cancer has been shown to be technically feasible. Comparative studies on laparoscopic versus open procedures indicate that laparoscopy may reduce inflammatory reactions as reflected by the lesser release of cytokines. We investigated the cytokine responses following VATS and conventional lobectomy for clinical stage I lung cancer. METHODS: Thirty-six patients with clinical stage I nonsmall cell lung cancer were studied. 18 patients underwent VATS lobectomy and the other 18 by conventional thoracotomy. There were no differences between the two groups with respect to age, gender, pulmonary function, smoking history, comorbidity, tumor size, and pathology. Plasma levels of tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1beta, IL-6, IL-8, and an antiinflammatory cytokine IL-10 were measured before surgery, at the end of the procedure, and 4, 8, 24, and 48 hours thereafter in all patients. RESULTS: There was no mortality or major complication in either group. Analgesic requirement was significantly less in the VATS group. Although the release of TNF-alpha and IL-1beta were minimal after surgery in both groups, the levels of IL-6, IL-8, and IL-10 were elevated. IL-6 and IL-8 levels were significantly lower in the VATS group at the end of surgery than in the open group. In addition, reduced release of IL-10 was also observed in the VATS group shortly after surgery. CONCLUSIONS: VATS lobectomy is associated with reduced postoperative release of both proinflammatory and antiinflammatory cytokines compared with the open approach. The clinical significance of these findings remains to be fully elucidated.
Aged↗
'Needlescopic' video-assisted thoracic surgery for palmar hyperhidrosis.
OBJECTIVE: The video-assisted thoracic surgery (VATS) approach for thoracodorsal sympathectomy has been well accepted. We report the use of ultra-fine thoracoscopic equipment for this procedure, based on the experience from two centers in Asia. MATERIALS AND METHODS: Thirty-eight patients with palmar hyperhidrosis underwent bilateral VATS thoracodorsal sympathectomy using 2-mm instruments exclusively. General anesthesia with selective one lung ventilation was used. Carbon dioxide insufflation was used when lung collapse was found to be inadequate. In 11 patients, the sympathetic chain was excised (T2-T3 for palmar hyperhidrosis alone, extending to T4 for axillary hyperhidrosis), and in 27 patients, the chain was cauterized. The choice of procedure reflects the surgeon's preference. No chest drains were left after the procedure and no stitching of the wound was necessary. RESULTS: There was no mortality or major complications. A small pneumothorax was found in the postoperative chest X-ray in three patients. They all resolved without further intervention. Twenty-seven patients were discharged on the same day of admission, and 11 patients were discharged on postoperative day one. After an average follow-up of 16 months (range 5-28), there has been no recurrence of symptoms. Compensatory truncal hyperhidrosis was encountered in two patients, but the symptoms were not severe enough to interfere with lifestyle, and this required no further treatment. CONCLUSION: Thoracodorsal sympathectomy using 2-mm instruments is technically feasible and is associated with an excellent clinical outcome. Limitations of the equipment, however, exist (narrow field of vision, lower resolution and difficulty in maintaining fine control), and we are currently restricting its use to relatively simple procedures.
Adult↗
Steroids in cardiopulmonary bypass.
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Adrenal Cortex Hormones↗
Coronary artery bypass grafting in the elderly: the challenge and the opportunity.
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Aged↗
Can CT scanning be used to select patients with unilateral primary spontaneous pneumothorax for bilateral surgery?
STUDY OBJECTIVES: Despite advances in the surgical treatment of spontaneous pneumothorax, the timing of surgical intervention continues to be a subject of controversy. We test the hypothesis that CT scanning can help to predict the probability of the occurrence of primary spontaneous pneumothorax (PSP) by detecting lung bullae. DESIGN: Prospective, longitudinal cohort study. PATIENTS AND METHODS: Between May 1994 to March 1995, 28 consecutive patients (23 men; age range, 18 to 47 years; mean, 29 years) with unilateral PSP who were to undergo video-assisted thoracic surgery (VATS) received preoperative CT of the thorax. CT scans were interpreted by one radiologist blinded to the clinical data for the presence of bullae in both lungs. All patients were followed-up in our outpatient clinic for an average of 59.0 months (range, 54 to 64 months). RESULTS: Eighty-eight percent of the blebs or bullae identified intraoperatively were demonstrated on preoperative CT scans. CT scans also showed the presence of lung blebs or bullae in the contralateral lung in 15 patients (53.6%). During the follow-up period, 4 of these 15 patients (26.7%) with contralateral blebs developed PSP in the untreated lung; none of the patients who did not have contralateral blebs (n = 13) developed PSP (p = 0.04 [chi(2) analysis]). CONCLUSIONS: The detection of lung bullae by CT scanning in the contralateral lung following unilateral PSP is associated with a higher rate of subsequent occurrence of pneumothorax in that lung. Thus, CT scanning can be used to predict the risk of occurrence of this condition, allowing preemptive surgical intervention in selected patients.
Adolescent↗
Management of massive hemoptysis: a single institution experience.
BACKGROUND: Massive hemoptysis is a life threatening condition. Several therapeutic strategies have been applied in the clinical setting, with variable results. We reviewed our recent experience on this subject. MATERIAL AND METHODS: In a 5-year period, fifty-four patients (41 males, mean age 57.9 years) were treated for massive hemoptysis in our unit. The underlying pathology included bronchiectasis (n=31), active tuberculosis (n=9), pneumoconiosis (n=3), lung cancer (n=2) and pulmonary angiodysplasia (n=1). These patients often present with continuous bleeding with large volume of hemoptysis, or with recurrent episodes of bleeding. Bronchoscopic assessment and interventions were performed upon admission in all patients. Surgery was considered if the patient had acceptable pulmonary reserve and a bleeding source was clearly identified. If the patient was not considered fit for surgery, bronchial artery embolization was attempted. RESULTS: Hemoptysis ceased with conservative management in 7 patients (13%) only. Twenty seven (50%) patients received surgical resection. The procedures included lobectomy (n=21), bilobectomy (n=4) and pneumonectomy (n=2). The in-hospital mortality after surgery was 15%. Postoperative morbidity occurred in 8 patients, including prolonged ventilatory support, bronchopleural fistulae, empyema and myocardial infarction. Twenty-one patients not suitable for surgery were treated with bronchial artery embolisation, which was successful in 17 patients without any complications. CONCLUSION: The clinical outcome for massive hemoptysis reflects the generalized nature of a destructive disease process involving both lungs and a limited respiratory reserve. Surgery is associated with high risk of morbidity and mortality, and should be performed only in selected patients. Meanwhile, aggressive conservative therapy including bronchial artery embolization should be pursued.
Adolescent↗
[Study on the quality standard of changan oral solution].
OBJECTIVE: To study the quality standard of Changan oral solution. METHOD: Thin layer chromatography was used for identification pig's bile plaster. TLC scanning was used for the determination of hyodeoxycholic acid. RESULTS: The TLC identification was highly specific and the spots was clear and concentrated. Linear regression for hyodeoxycholic acid was over the range of 3.50-12.25 micrograms. The average recovery of hyodeoxycholic acid was 100.5%, RSD was 3.2%. CONCLUSION: This standard was capable to effectively control the quality of Changan oral solution.
Administration, Oral↗
[Study on the IR and UV dual-spectrum radiation].
The article gives a method to produce dual spectrum radiation in IR and UV. Relying on theoretical analysis, the relative data are computed, some atomic materials are selected and added to a double-base propellants. When the UV pyrotechnics is ignited together with traditional IR pyrotechnics, the spectrum of IR and UV is emitted at the same time. The final measuring curves show that all results are satisfying.
English Abstract↗
The topoisomerase I poison camptothecin generates a Chk1-dependent DNA damage checkpoint signal in fission yeast.
The protein kinase Chk1 is essential for the DNA damage checkpoint. Cells lacking Chk1 are hypersensitive to DNA-damaging agents such as UV light and gamma-irradiation because they fail to arrest the cell cycle when DNA damage is generated. Phosphorylation of Chk1 occurs after DNA damage and is dependent on the integrity of the DNA damage checkpoint pathway. We have tested whether a topoisomerase I inhibitor, camptothecin (CPT), generates DNA damage in the fission yeast Schizosaccharomyces pombe that results in Chk1 phosphorylation. We demonstrate that Chk1 is phosphorylated in response to CPT treatment in a time- and dose-dependent manner and that phosphorylation is dependent on an intact DNA damage checkpoint pathway. Furthermore, we show that cells must be actively dividing in order for CPT to generate a Chk1-responsive DNA damage signal. This observation is consistent with a model whereby the cytotoxic event caused by CPT treatment is the production of a DNA double-strand break resulting from the collision of a DNA replication fork with a trapped CPT-topoisomerase I cleavable complex. Cells lacking Chk1 are hypersensitive to CPT treatment, suggesting that the DNA damage checkpoint pathway can be an important determinant for CPT sensitivity or resistance. Finally, as a well-characterized, soluble agent that specifically causes DNA damage, CPT will allow a biochemical analysis of the checkpoint pathway that responds to DNA damage.
Camptothecin↗
A survey on partial left ventriculectomy in the Asia-Pacific region.
BACKGROUND: There has been increasing interest in partial left ventriculectomy as a new therapy for end-stage heart failure. Because the most significant impact of this development is likely to be in regions where heart transplantation is largely unavailable, we conducted a survey among a group of cardiac surgeons based in the Asia-Pacific region to evaluate their overall views on partial left ventriculectomy procedures. METHODS: A questionnaire was sent to surgeons from 65 major institutions in 17 countries and regions in the Asia-Pacific. Questions examined current demographics and opinions regarding potential application and future prospects of this operation. RESULTS: Surveyed surgeons were based in equal proportions in academic, government, and private practice institutions. One third of respondents have already performed partial left ventriculectomy operations, largely in small numbers. In total, 86 procedures were performed with 75% hospital survival rate. Failures were thought to be caused by limited knowledge about patient selection criteria and lack of experience with operative technique and perioperative care. The majority of respondents believe that partial left ventriculectomy is potentially a valuable intervention and intend to perform more cases. Nevertheless, most surgeons identified the need to have larger clinical experience, to perform randomized trials against other therapeutic modalities, and to improve perioperative care. CONCLUSIONS: Although all surgeons recognize that more knowledge is needed before partial left ventriculectomy becomes a standard procedure, it is clear from this survey that the procedure has rapidly gained interest, with more surgeons seeking to learn it.
Cardiac Volume↗
A Chinese thoracic surgeon and his two decisions.
Doctor Wu Ying-Kai is known to many in the thoracic surgical academia worldwide. This article focuses on the two decisions he made at the ages of 33 and 70 that profoundly influenced the development of thoracic and cardiovascular medicine in a country with one quarter of the world population. His successful career was gauged not so much by the position he achieved, but by the obstacles he had to overcome to achieve it.
China↗
Ministernotomy for aortic valve replacement in a patient with osteogenesis imperfecta.
Open heart operations in patients with osteogenesis imperfecta are associated with increased morbidity and mortality resulting from tissue friability and bone brittleness. We used a ministernotomy approach for aortic valve replacement in a patient with osteogenesis imperfecta, with clear benefits and a satisfactory outcome.
Adult↗