The traditional utilization of plants as medicine in the Mediterranean region has been investigated. Field surveys were carried out among the people who live in the Taurus Mountains. Sixty-nine ...medicinal plants have been identified, which are listed with the vernacular names, the parts used, the methods of preparing the drugs and their traditional usages.
Acute Stanford type A aortic dissection (AAD) with coronary involvement is associated with high mortality. However, coronary involvement is not always successfully visualized by computed tomography ...and two-dimensional (2D) transesophageal echocardiography (TEE). The aim of this study was to test the hypothesis that three-dimensional (3D) TEE can detect coronary involvement in patients with AAD.
Fifty-one consecutive patients with AAD who underwent intraoperative TEE using an iE33 system during emergency surgery were enrolled. Using computed tomographic images, conventional 2D transesophageal echocardiographic images, and a 3D transesophageal echocardiographic data set, the status of coronary ostia was evaluated and classified into four types-branching from true lumen, branching from false lumen, dissection, and unclear-and these results were compared with operative findings.
In six patients, coronary involvement was diagnosed operatively by surgeons. They comprised dissection at three left coronary ostia and branching from false lumen at three right coronary ostia. All six cases were successfully detected by both 2D TEE and 3D TEE before instituting cardiopulmonary bypass. However, in 45 patients (90 ostia) confirmed operatively as having no coronary involvement, 69 ostia by computed tomography (36 in the left and 33 in the right coronary artery) and 16 ostia by 2D TEE (four in the left and 12 in the right coronary artery) were evaluated as unclear coronary involvement. On the other hand, 3D TEE clearly depicted no coronary involvement in all but one (right coronary ostium) of the unclear cases.
Three-dimensional TEE reduced the number of cases evaluated as unclear coronary involvement by computed tomography and 2D TEE. In patients with AAD, 3D TEE allows evaluation of the status of coronary ostia in the operating room.
Revascularization of the diffusely diseased coronary artery is a big challenge for both cardiologists and cardiac surgeons. Long reconstruction of the diffusely diseased vessel may be a useful ...surgical option. The aim of this study is to assess clinical and angiographic outcomes of extensive reconstruction (≥4 cm) of the left anterior descending coronary artery (LAD) using an internal thoracic artery (ITA) graft with or without endarterectomy.
We retrospectively reviewed 213 patients who underwent extensive reconstruction of the LAD using an ITA graft between September 2004 and July 2009. The diffusely diseased LAD was extensively incised, additional endarterectomy was performed if necessary, and then the LAD was reconstructed with an ITA graft in a long on-lay fashion. Early and 1-year postoperative angiography was performed in 188 patients (88.3%) and 152 patients (71.4%), respectively.
The mean length of the reconstructed LAD was 5.4 ± 1.2 cm. Endarterectomy was performed in 46.0% of the patients. The operative mortality was 1.4%. Low cardiac output and perioperative myocardial infarction were observed in 3.3 and 5.2% of the patients, respectively. Freedom from death and other cardiac or cerebrovascular events was 91.5 ± 2.2% at 3 years. The early and 1-year patency rates of the ITA to LAD grafting were 95.7% and 93.4%, respectively.
Extensive reconstruction of the diffusely diseased LAD using an ITA graft could be performed safely. Early and 1-year angiographic outcome were excellent. This surgical revascularization is an useful option for revascularization of the diffuse coronary artery disease.
The treatment points and score for definition of the asthma severity were initially introduced in the guideline for pediatric asthma treatment and management on 1998. We studied the relationship ...between the severity of clinical symptoms for children with bronchial asthma and the treatment points from July 1998 to November 1999 in our hospital. One hundred twenty five patients (one to 15 years of age, 77 boys and 48 girls) were retrospectively investigated. The treatment points and scores were associated with the clinical symptom score. However, there was no relationship in some patients. In order to define the severity of bronchial asthma, we should investigate not only the severity in terms of the clinical symptoms; the number and degree of asthma attacks, but also the treatment points and score. Furthermore, we should pay attention to the seasonal variation of the treatment points.
Objective Minimizing surgical access in reoperative cardiac surgery allows limitation of dissection, trauma, and manipulation of patent bypass grafts. We report an 11-year experience with reoperative ...minimal access aortic valve surgery through an upper hemisternotomy. Methods From July 1996 to June 2007 at our institution, 146 patients underwent reoperative minimal access aortic valve surgery, 109 of whom had undergone previous coronary artery bypass grafting and 93 of whom had a patent left internal thoracic artery graft. In patients with a patent left internal thoracic artery graft, the graft remained undissected. Myocardial protection was achieved with hypothermia, cold cardioplegia, and systemic hyperkalemia. Early and late outcomes were analyzed. Results Median age was 76 years, and 43 patients (29%) were 80 years or older. Nineteen patients(13%) underwent concomitant procedures, such as coronary artery bypass grafting, mitral valve repair, and ascending aortic replacement. Median cardiopulmonary bypass and aortic crossclamp times were 150 and 80 minutes, respectively. Four patients (2.8%) had conversion to full sternotomy. Operative mortality was 4.1% (6/146). The incidences of reoperation for bleeding and blood transfusion were 0.7% (1/146) and 83.6% (122/146), respectively. No patient had left internal thoracic artery or aortocoronary graft injury. Median stay was 8 days, and 56% (79/140) were discharged home. Five-year actuarial survival was 85%. Conclusion An upper hemisternotomy approach for reoperative aortic valve surgery is safe and feasible. This approach minimizes tissue dissection and trauma, thereby reducing the risk of injury to patent grafts and mediastinal organs.
An experiment was conducted to examine whether circadian self‐feeding rhythms exist in groups of rainbow trout Oncorhynchus mykiss (Walbaum) and to investigate individual variability of self‐ feeding ...and its influence on growth. Ten trout of 144.9 ± 12.0 g (mean ± SD) were transferred to each of eight 290‐L tanks and given free access to feed via a self‐feeder. Fish in four of the eight groups were individually tagged, and the individual activating the trigger was identified using video observations. The self‐feeding activity of each group was recorded under a light:dark cycle of 16.5:7.5 h and under continuous light (LL) conditions. Although diel self‐feeding rhythms in the groups of trout were, in general, diurnal, night‐feeding activity was observed in the initial LD phase, but there was a progressive reduction and eventual cessation in most groups. Endogenous circadian self‐feeding rhythms were detected in the groups of trout under LL conditions. The trout formed dominance hierarchies of self‐feeding activity, with one or two individuals accounting for the majority of trigger actuations. However, the dominants did not occupy the area surrounding the trigger. Growth rates did not differ significantly between the dominants and the subordinates within the groups.
To examine the direct effects of tributyltin acetate (TBTA) on osteoclasts and osteoblasts, teleost scale, which has both osteoclasts and osteoblasts and is similar to mammalian membrane bone, was ...used in the present study. The activities of tartrate-resistant acid phosphatase and alkaline-phosphatase, as respective indicators of activity in both cells, were used. In freshwater teleost (goldfish) and marine teleosts (nibbler and wrasse), the osteoclastic activity in the scales did not change as a result of TBTA treatment (10
−
9
to 10
−
5
M). However, the osteoblastic activity decreased in the goldfish, nibbler, and wrasse after 6 h of incubation. In goldfish, even 10
−
10
M of TBTA significantly inhibited the osteoblastic activity. The inhibitory activity in goldfish was stronger than that in nibbler and wrasse. Therefore, details of the mechanism were examined using goldfish. The mRNA expressions of the estrogen receptor and insulin-like growth factor-I, which participate in osteoblastic growth and differentiation, decreased in the TBTA-treated scales. However, the mRNA expression of metallothionein (MT), a metal-binding protein that protects the organism from heavy metal, increased much less than those of cadmium and methyl-mercury. Furthermore, we showed that the plasma calcium and hypocalcemic hormone (calcitonin) level increased in goldfish kept in water containing TBTA (10
−
10
and 10
−
8
M). The current data are the first to demonstrate that, in teleosts, TBTA inhibits osteoblastic activity without affecting osteoclastic activity and disrupts the calcium metabolism, including the calcemic hormone, in goldfish.
Resistance to conventional chemotherapy including CDDP is the most important therapeutic problem in ovarian cancer. The combination chemotherapy of 5-FU (civ) and low-dose CDDP (i.v.) was applied to ...a patient with recurrent ovarian clear cell adenocarcinoma (stage IIa), which is often more resistant to systemic chemotherapy than other ovarian adenocarcinomas and is a poor prognostic factor. The patient underwent cytoreductive surgery. Then, 5-FU 375 mg/m2/day civ (days 1-5, 8-12, 15-19, 22-26) and CDDP 3.75 mg/m2/day i.v. (days 1-5, 8-12, 15-19, 22-26) were administered. After four courses of this treatment, there is no sign of recurrence. This result indicates that the combination of 5-FU and CDDP is useful in the treatment of recurrent ovarian cancers.
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