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Aim: To evaluate the association between 11C-methionine positron-emission tomography (11C-methionine PET) findings, isocitrate dehydrogenase (IDH) gene mutation, and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation in patients with grade II and III gliomas.Materials and Methods: Data were collected from 40 patients with grade II and III gliomas who underwent both magnetic resonance imaging (MRI) and 11C-methionine PET as part of their pre-surgical examination. IDH mutation was examined via DNA sequencing, and MGMT promoter methylation via quantitative methylation-specific polymerase chain reaction (PCR).Results: A threshold of MGMT promoter methylation of 1% was significantly associated with tumour/normal tissue (T/N) ratio. The T/N ratio in samples with MGMT promoter methylation ≥1% was higher than that in samples with MGMT promoter methylation <1%, and the difference was statistically significant (p=0.011). Reliable prediction of MGMT promoter methylation (<1% versus ≥1%) was possible using the T/N ratio under the receiver operator characteristic (ROC) curve with a sensitivity and specificity of 75% each (cut-off value=1.6: p=0.0226, area under the ROC curve [AUC]=0.76172). Conversely, the T/N ratio had no association with IDH mutation (p=0.6). The ROC curve revealed no reliable prediction of IDH mutation using the T/N ratio (p=0.606, AUC=0.60577).Conclusion: 11C-methionine PET parameters can predict MGMT promoter methylation but not IDH mutation status. 11C-methionine uptake may have limited potential to reflect DNA methylation processes in grade II and III gliomas. [ABSTRACT FROM AUTHOR]

A 69-year-old hypertensive man who had 7 pseudoaneurysms caused by penetrating atherosclerotic ulcers underwent 2-staged endovascular grafting in the thoracic and thoracoabdominal aorta and a conventional graft replacement of the abdominal aorta. He had an uneventful postoperative course; follow-up computed tomography demonstrated that all aneurysmal lesions treated by endovascular grafting completely disappeared. He has been free from any aortic events 20 months after the last surgery. [ABSTRACT FROM AUTHOR]

Abstract: The 2,2,6,6-tetramethylpiperidine-1-oxy radial (TEMPO)-mediated oxidation was applied to aqueous suspensions of cotton linters, ramie and spruce holocellulose at pH 10.5, and water-insoluble fractions of the TEMPO-oxidized celluloses collected by filtration with water were analyzed by optical and transmission electron microscopy and others. The results showed that both fibrous forms and microfibrillar nature of the original native celluloses were maintained after the TEMPO-mediated oxidation, even though carboxylate and aldehyde groups of 0.67–1.16 and 0.09–0.21mmol/g, respectively, were introduced into the water-insoluble fractions. Neither crystallinity nor crystal size of cellulose I of the original native celluloses was changed under the conditions adopted in this study. Carboxylate groups in the TEMPO-oxidized ramie were mapped by labeling with lead ions as their counter ions. The transmission electron micrographs indicated that some heterogeneous distribution of carboxylate groups along each cellulose microfibril or each bundle of cellulose microfibrils seemed to be present in the TEMPO-oxidized celluloses. [Copyright &y& Elsevier]

A combined experimental and numerical study of interaction between cooling flow and mainstream gas flow in a turbine rotor-stator rim cavity is reported. Particular emphasis is put on the flow phenomena in a rim cavity downstream of rotor blades. The experiment are conducted on a rig simulating an engine HP-turbine in which cooling effectiveness distributions as well as velocities, turbulence quantities, pressure, and temperature profiles are measured. Numerical calculation, especially at a full 3D, unsteady solution level, can lead to satisfactory predictions in fluid and mass transfer inside the cavity. Both experimental and numerical results indicate that large turbulence stresses near the rotor disk intensify turbulent diffusion across the cavity and consequently axial distribution of the cooling effectiveness inside the cavity becomes uniform. In order to obtain an adequate distribution of cooling effectiveness across the rim cavity and to suppress the turbulence level near the rotor surface for more efficient cooling, a novel cooling method is developed using numerical simulation. The disk-front and -rear cavities are then redesigned according to the new cooling strategy and integrated in the test rig. Experimental results verify a significant advance in cooling performance with the new method. [ABSTRACT FROM AUTHOR]

Coplanar discharge is a new type of barrier discharge, and has some advantages for high-concentration ozone generation. In this article, basic parameters of coplanar discharge are clarified by experimental and theoretical approaches. Coplanar electrodes consist of many pairs of line electrodes printed on a glass plane, and are covered with dielectric layer. The discharge properties, ozone diffusion process, and surface reaction are discussed. Finally, the scaling rule of a coplanar discharge ozone generator is demonstrated by fabrication of a 3 kg/h ozone generator. [ABSTRACT FROM AUTHOR]

ABSTRACT--The authors propose a simulation method for analyzing the distributions of blood flow velocity and shear stress in a cross-sectional plane of the intramyocardial coronary vessel. They compute a fully developed viscous fluid flow in a helical coiled pipe conformed in a cubic space for simulating the blood flow in an intramyocardial coronary vessel. The fluid and continuity equations are solved by the series expansion method under the small Dean number. The authors compute the axial, radial, and vertical blood flow velocities and their rates of spatial changes along the circumferential direction that are parallel to the shear stresses acting on the helical tube wall under the variable geometric changes in the helical coiling tube. The velocities and their rates of spatial changes accelerate as the number of helical coiling increases. The authors discuss the rational conformation of the helically coiled intramyocardial coronary vessel system and its relation to the effective blood perfusion. An extended version of the present method will be available for evaluating the intramyocardial coronary perfusion in relation to the coronary arterial sclerosis and surgical operation. [ABSTRACT FROM AUTHOR]

Abstract: We have performed the neutron diffraction experiments of the Kondo-lattice compound Ce(Ru0.9Rh0.1)2 to study the response of the magnetic order to hydrostatic and chemical pressure. The magnetic wave vector, , hardly depends on the pressure for and 0.25, where and 0.35, respectively. On the other hand, q shows strong pressure dependence in the intermediate Ge-concentration region, which is interpreted as a manifestation of the continuous change of the Fermi surface due to the evolution of the cf-coherence caused by applying pressure. From these results, we regard to have observed a pressure-induced alternation of scheme of the magnetic order between RKKY-regime of the localized electrons and the quasi-particle band regime. [Copyright &y& Elsevier]

Fast walking is considered as a factor that causes pain in patients suffering from knee disorders. This study examined the effect of walking speed on the medial knee contact force and identified contributions to the muscle tension on the medial knee contact force during fast walking using musculoskeletal simulation analysis. The muscle contribution to the medial knee contact force was calculated based on the joint angles and ground reaction force for the normal and fast walking experiments of seven subjects. The muscle force and joint reaction force were used to estimate the medial knee contact force. Results showed, in average, 70% increase in medial knee contact force at the first peak and 34% increase at the second peak with a fast walking speed, compared to when they walked at a normal walking speed. The remarkable increase in the first peak was mainly contributed by the increase in the quadriceps force resisting the external knee flexion moment. In contrast, the moderate increase of second peak was contributed by the increase in the gastrocnemius muscle force. These results suggest that the increase in medial knee contact force at fast walking speeds is caused by the increased muscle force. [ABSTRACT FROM AUTHOR]

Abstract: Fusion zone of three TRIP steels, categorized as AT: C–Mn–Al, AST: C–Mn–Al–Si and ST: C–Mn–Si, in resistance spot welding was characterized with respect to microstructure, phase analysis, and hardness. The fusion zone microstructure was found to depend on chemistry: (i) AT steel contained ferrite phase surrounded by bainite and martensite regions, (ii) AST steel showed a bainite structures along with martensite laths and interlath retained austenite, whereas (iii) ST steel constituted single phase martensite laths with interlath austenite. X-ray diffraction study indicated that retained austenite fraction in the fusion zone increases with increase in Si content in it. The AST fusion zone hardness lies between those of the AT and ST steels; the ST fusion zone hardness was higher than that of AT steel because of the single phase martensite microstructure. Comparison of fusion zone microstructure and hardness to earlier study on laser welding of the TRIP steels with similar chemistries revealed that higher cooling rate in resistance spot welding led to higher fusion zone hardness compared to laser welding; which was attributed either to decrease in softer ferrite phase (AT steel) in the microstructure or refinement of martensite laths (ST steel). [Copyright &y& Elsevier]

The inflammatory reaction is known to be controlled in neonates. We clarified the characteristics of cytokine profile in neonatal patients and assess its clinical significance. Serum levels of interleukin (IL)-6 and IL-1 receptor antagonist (ra) were determined in 152 pediatric patients and 33 each of maternal and cord bloods. Supernatant IL-1ra levels of cultured monocytes and granulocytes stimulated with IL-1beta or LPS, and IL-1ra mRNA expression of granulocytes were assayed in 15 each of cord and healthy adult bloods. Although surgical stress in neonates was heavier than that in infants, there was no difference in the occurrence of postoperative morbidity and mortality. In neonates, the perioperative serum level of IL-1ra was significantly raised, and the postoperative IL-6 response was well controlled. The serum concentration of IL-1ra in cord blood was not different from that in maternal blood, whereas, the serum concentration of IL-6 in cord blood was significantly reduced than that in maternal blood. In granulocytes, significantly more IL-1ra was produced from cord than from adult blood. An IL-1ra predominant immune status in neonates may be a naturally acquired adaptation system and play a crucial role in attenuating acute inflammatory reaction in a vulnerable host defense. [ABSTRACT FROM AUTHOR]

The development of a quality of life (QL) instrument for evaluating quality of services requires extensive validation. This study examines the impact of subject/respondent characteristics on a newly developed quality of life instrument for the Japanese elderly with dementia (QLDJ) as a part of the validity examination. In the QLDJ, QL is defined as a three-dimensional construct: 'interacting with surroundings', expressing self', and 'experiencing minimum negative behaviors'. Thus the QLDJ is a multi-dimensional, 24-item instrument, and it is answered by a proxy, the formal caregiver (respondent) because the elderly with severe dementia cannot be directly interviewed. Altogether 623 elderly persons experiencing dementia from 37 institutions (e.g., nursing homes, day care centers) in Japan were assessed using the QLDJ by their formal caregivers. In addition to the levels of dementia and independence in activities of daily living, factors such as gender of the elderly person and respondent, elderly person's age, participation in recreational activities, qualification of the respondent were significantly associated with 'interacting with surroundings' and 'expressing self'. The levels of dementia and independence as well as qualification of the respondent were associated with 'experiencing minimum negative behaviors'. Possible reasons for these associations and how to deal with them are discussed. Careful control for those factors is needed when the QLDJ is used in future research. [ABSTRACT FROM AUTHOR]

This study develops a quality of life instrument for older Japanese people experiencing dementia (QLDJ). Quality of life (QL) for these older adults is defined as a three dimensional construct including 1) interacting with surroundings, 2) expressing self, and 3) experiencing minimum negative behaviors. From 53 items in the initial item pool, 24 were selected based on item reliability and validity using data from 3 studies that involve ten dementia-care experts (Study A) and 36 and 623 older persons and their formal caregivers in various care settings (Study B & C). Factor analysis of these items identified three domains that correspond to the conceptual definition of QL for older adults with dementia. The domain and total QL scores were calculated considering the relative weights of each item. Resultant domain and total scores of the QLDJ showed satisfactory reliability and evidence of validity. [ABSTRACT FROM AUTHOR]

Aim: Precise biomarkers for predicting prognosis could help to identify high‐risk Crohn's disease (CD) patients to facilitate better follow‐up during the postoperative course. In this study, the primary aim is the identification of the most reliable nutrition marker that predicts surgical relapse in CD patients. Method: We first evaluated the predictive value of various nutrition markers for postoperative surgical relapse in CD patients and identified the advanced lung cancer inflammation index (ALI) as a promising biomarker. Then, we assessed the clinical significance of preoperative ALI in CD patients using two cohorts. Results: Preoperative ALI showed the highest correlation with reoperation rate compared with other nutritional parameters in CD patients receiving surgical resection (sensitivity 53%, specificity 86%, area under the curve 0.71). Lower levels of preoperative ALI were significantly correlated with the presence of perianal disease. A lower level of preoperative ALI was an independent prognostic factor for reoperation rate after an intestinal resection (hazard ratio 3.37, 95% CI 1.38–10.12, P = 0.006), and the prognostic impact of preoperative ALI was successfully validated in an independent cohort using the same cut‐off value. Conclusion: Preoperative ALI might be useful for postoperative management of CD patients. [ABSTRACT FROM AUTHOR]

Background Brain metastases (BM) from esophageal cancer (EC) are rare. Despite of an advance of treatments for the patients with BM from EC, life expectancy and quality of life of these patients are still poor. We present an overview of the patients with BM from EC at a single institute. Methods We retrospectively identified 10 patients with BM from EC treated with surgery, radiation, or a combination of multidisciplinary therapies at Osaka National Hospital between 2003 and 2017 for stages IIb through IV of primary EC (follow-up, > 157 days). Medical records were reviewed to collect demographic and clinical information. Results Median age at diagnosis of BM was 63.5 years (range, 53–79 years). 9 patients were male, and 7 patients had squamous cell carcinoma of EC at the primary esophageal resection. Median overall survival from the commencements of therapy for BM was 156 days (range, 17–5404 days). The interval between the primary esophagectomy and the start of therapy for BM from EC was 298 days (range, 64–860 days). The average score of Karnofsky performance status (KPS) just before a diagnosis of BM was 75 (range, 50–90). On univariate analysis, the patients with the lower score of KPS (P  = 0.01) or the shorter interval between the primary esophageal surgery and the start of therapy for BM (P  = 0.06) were found to have worsened survival after the therapy for BM from EC. Conclusion The patients who had a poor KPS just before a diagnosis of BM, or the shorter interval between the esophagectomy for the primary EC and the start of therapy for BM, had poor prognosis. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Biological disease-modifying anti-rheumatic drugs (bDMARDs) against pathogenic proinflammatory cytokines and lymphocytes, such as tumour necrosis factor- (TNF- ), interleukin-6, T cells and B cells, have been developed and have become leading drugs in the treatment of rheumatoid arthritis (RA). Here, we focused on I TNFAIP3 i as a possible genetic marker for TNFi therapeutic response and examined the association of one of the representative disease-susceptible SNPs of I TNFAIP3 i , rs2230926, with therapeutic failure of TNFi. [Extracted from the article]

Aortoesophageal fistula is a critical and life-threatening disease. The cardiovascular strategy for graft replacement has been widely discussed. However, the surgical strategy of esophageal resection and reconstruction for aortoesophageal fistula has rarely been discussed. The objective of this study is to establish a surgical strategy and procedure of esophageal resection and reconstruction for aortoesophageal fistula. Eleven patients with aortoesophageal fistula who underwent aortic graft replacement and esophagectomy between 2008 and 2015 at Kobe University Hospital were enrolled in this study. Patient characteristics, operative methods, and clinical outcomes were obtained by retrospective chart review. All 11 patients underwent graft replacement, esophagectomy, and omental wrapping. Ten esophagectomies were simultaneously accomplished in the same operative field as aortic graft replacement. Seven patients underwent subtotal esophagectomy from a left thoracotomy, and three patients underwent upper hemiesophagectomy from a median sternotomy. The other patient underwent staged esophagectomy from a right thoracotomy. Seven of 11 patients (63.6%) successfully underwent staged esophageal reconstruction. Pedicled jejunal transfer with supercharge and superdrainage were performed in six patients, and ileocecal reconstruction was performed in one patient. Median survival time in the patients with esophageal reconstruction was 21 months while that in the patients without esophageal reconstruction was 10 months. Six of 7 patients (85.7%) who underwent esophageal reconstructions were alive. Our surgical strategy for aortoesophageal fistula, which includes simultaneous graft replacement and esophagectomy in the same operative field and staged reconstruction by pedicled jejunal transfer to ensure omental wrapping, is feasible and promising. [ABSTRACT FROM AUTHOR]

This study aimed to determine the effect of muscle co-contraction on balance recovery by using a simulation model. The muscle-driven forward simulation model included an inverted pendulum with two ankle muscles, a plantar flexor muscle (PF), and a dorsal flexor muscle (DF). The model was created based on experimental data obtained from balance recovery after applying backward platform translation to a standing elderly woman. Baseline simulation was performed using this model. Additionally, we performed two simulations with increased DF excitation at the same level of simulation and at the same pattern of simulation. The same level of simulation had the same PF excitation level as the baseline simulation with increased DF excitation. The same pattern simulation had the same increased or decreased PF excitation pattern but with a constant increase in PF excitation level to offset the increased DF excitation. Our results revealed that the same pattern simulation decreased the maximum dorsal flexion angle after platform translation. During the same level of simulation, the insufficient PF force used to recover balance resulted in a forward fall. These results imply that co-contraction is an effective strategy for recovering balance at the expense of additional muscle excitation in the elderly. [ABSTRACT FROM AUTHOR]

Background: Single-dose human fibrinogen concentrate (FCH) might have haemostatic benefits in complex cardiovascular surgery.Methods: Patients undergoing elective aortic surgery requiring cardiopulmonary bypass were randomly assigned to receive FCH or placebo. Study medication was administered to patients with a 5 min bleeding mass of 60-250 g after separation from bypass and surgical haemostasis. A standardized algorithm for allogeneic blood product transfusion was followed if bleeding continued after study medication.Results: 519 patients from 34 centres were randomized, of whom 152 (29%) met inclusion criteria for study medication. Median (IQR) pretreatment 5 min bleeding mass was 107 (76-138) and 91 (71-112) g in the FCH and placebo groups, respectively (P=0.13). More allogeneic blood product units were administered during the first 24 h after FCH, 5.0 (2.0-11.0), when compared with placebo, 3.0 (0.0-7.0), P=0.026. Fewer patients avoided transfusion in the FCH group (15.4%) compared with placebo (28.4%), P=0.047. The FCH immediately increased plasma fibrinogen concentration and fibrin-based clot strength. Adverse event rates were comparable in each group.Conclusions: Human fibrinogen concentrate was associated with increased allogeneic blood product transfusion, an unexpected finding contrary to previous studies. Human fibrinogen concentrate may not be effective in this setting when administered according to 5-minute bleeding mass. Low bleeding rates and normal-range plasma fibrinogen concentrations before study medication, and variability in adherence to the complex transfusion algorithm, may have contributed to these results.Clinical Trial Registration: ClinicalTrials.gov identifier no. NCT01475669; EudraCT trial no. 2011-002685-20. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to elucidate the association between plasma intestinal fatty acid-binding protein (I-FABP) level and actual pathological damage of intestinal mucosa and its reversibility. Methods: An intestinal ischemia-reperfusion model was created by temporary occlusion of the descending aorta in 9 pigs which were divided into 3 groups according to the duration of visceral ischemic insult: 15-minute ischemia (n=3), 30-minute ischemia (n=3) and 60-minute ischemia (n=3). Blood samples and short segments of the jejunum for pathological examinations, including immunohistochemical staining of I-FABP, Ki-67 and E-cadherin, were taken at the beginning of the operation (T1) and 15 minutes (T2), 30 minutes (T3), 45 minutes (T4) and 60 minutes (T5) after reperfusion. Results: Plasma I-FABP after 15 minutes of ischemia reached a peak of 1859±1089 pg/ml at T3, while the level after 30 minutes of ischemia achieved a peak level of 5053±1717 pg/ml at T5. The level after 60 minutes of ischemia demonstrated a rapid increment up to 10734±93 pg/ml at T3. There was a significant difference in the trend of plasma I-FABP levels between 30 minutes and 60 minutes of ischemia (p=0.01). The strongest immunohistochemical staining of the intestinal epithelium for I-FABP was observed at T4 after 30 minutes of ischemia, with the shedding of injured epithelium followed by re-epithelialisation, with sequential up-regulation of Ki67 and E-cadherin. However, the intestinal epithelium after 60 minutes of ischemia demonstrated the lack of I-FABP expression with irreversible damage. Conclusion: Plasma I-FABP levels may be a crucial marker to recognize the reversibility of damage of the intestinal epithelium after an ischemic insult and the level of 5000 pg/ml is considered to be the critical borderline for irreversibility, which might prevent diagnostic delay in the clinical setting. [ABSTRACT FROM AUTHOR]

The effects of dimples, protrusions, and ribs on turbulent heat transfer were numerically investigated by using the large eddy simulation with a Lagrangian dynamic subgrid-scale model. The dimpled case gave the high heat transfer area in downstream half of the dimple and also in the downstream region behind the dimple. By adding the ribs on the dimpled walls, the heat transfer was further enhanced. On the other hand, the protrusions deteriorated the heat transfer due to the severe contraction caused by their height. [ABSTRACT FROM AUTHOR]

A 44-year-old man with abdominal pain was diagnosed as having a spontaneous isolated dissection of the superior mesenteric artery. The patient was successfully treated with endoaneurysmorrhaphy 5 months after the onset and has been symptom free 15 months after surgery. In view of the excellent surgical outcome in the literatures, surgical intervention for this rare pathology should be considered. [ABSTRACT FROM AUTHOR]

Purpose: Mutation of the p53 gene and deregulation of telomerase may be essential for canceration in some malignant diseases. However, relationships between these occurrences have not yet been clarified. We examined the roles of p53 gene mutation and telomerase activity relative to the clinical and pathologic features of non-small cell lung carcinoma (NSCLC).Methods: Frozen sections of 40 surgically resected NSCLC specimens were used. DNA extracted from fresh tumor specimens was analyzed with polymerase chain reaction (PCR), single-strand conformation polymorphism (SSCP) method, to screen alterations in the p53 gene. Exons showing aberrant band shifts on SSCP were reamplified, and the PCR products were directly sequenced. In addition, the telomerase activity of the same specimens was analyzed quantitatively with the fluorescence-based telomeric repeat amplification protocol assay, and the total product generated (TPG) method. Clinical and pathologic parameters were evaluated using a statistical analysis system.Results: Mutations of the p53 gene relevant to an altered protein were confirmed in 19 of 40 specimens (47.5%). The TPG of 40 specimens was 75.24 +/- 15.55 (mean +/- SE). The TPG of the 19 specimens positive for p53 gene mutation was significantly higher than that of the 21 specimens negative for p53 gene mutation. Furthermore, the degree of cell differentiation was significantly correlated with both p53 gene mutation and high telomerase activity.Conclusions: p53 gene mutation and high telomerase activity cooperate to induce tumorigenesis and low-grade differentiation in NSCLC. Simultaneous occurrence of p53 gene mutation and high telomerase activity may be relevant to the grade of malignancy in NSCLC. [ABSTRACT FROM AUTHOR]

Background: Cardiomyoplasty utilizes the latissimus dorsi muscle to boost the failing ventricle. However, the mechanism for clinical improvement still remains controversial. We have previously shown that left ventricular contraction was improved in the long-term periods after cardiomyoplasty in the normal canine heart model and in the dilated failing heart model. On the other hand, right ventricular filling was impaired if a rapid volume loading test was employed in the long-term period after cardiomyoplasty. The purpose of the present study was to determine whether cardiomyoplasty impairs the left atrial function and affects ventricular filling.Method: Eleven mongrel dogs that had undergone cardiomyoplasty (study group, n = 5) or a sham operation (control group, n = 6) were studied for 12 weeks postoperatively. An IV 4.5% albumin solution (10 mL/kg) was infused into the right atrium, and hemodynamic changes in right cardiac catheterization and left atrial volume (LAV) were obtained by two-dimensional echocardiography. Atrial function was assessed by hemodynamic changes in Doppler echocardiography and hormonal changes.Results: Stroke volume was significantly increased, from 17.0 +/- 4.4 to 21.1 +/- 7.0 mL, respectively, before and 15 min after albumin infusion in the control group (p < 0.05). Heart rate and cardiac output were significantly increased, from 131.2 +/- 18.1 to 152.0 +/- 9.8 beats/min and 2.72 +/- 1.29 to 4.03 +/- 1.67 L/min, respectively, before and 15 min after albumin infusion in the study group (p < 0.05). No changes were observed in mean right atrial pressure and pulmonary capillary wedge pressure. LAV and atrial natriuretic peptide (ANP) levels increased significantly, from 5.8 +/- 2.1 to 8.5 +/- 3.8 mL and 22.5 +/- 7.5 to 44.5 +/- 31.7 pg/mL, respectively, before and 15 min after albumin infusion in the control group (p < 0.05). In the study group, LAV and ANP levels were also increased, from 10.1 +/- 2.4 to 12.7 +/- 2.8 mL and 64.2 +/- 60.6 to 232.6 +/- 272.2 pg/mL, respectively, before and 15 min after albumin infusion (p < 0.05). The peak velocities and the time-velocity integrals in the pulmonary venous flow of the systolic and diastolic waves, as well as their ratios (systolic to diastolic peak velocity ratio and systolic to diastolic time-velocity integral ratio) showed no significant differences between the two groups.Conclusions: Cardiomyoplasty preserves left atrial filling and transport function; therefore, cardiomyoplasty may also activate ANP production by stimulating the atrium in the long-term period after cardiomyoplasty. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cardiac tamponade is associated with fatal outcomes for patients with acute type A aortic dissection, and the presence of cardiac tamponade should prompt urgent aortic repair. However, treatment of the patient with critical cardiac tamponade who cannot survive until surgery remains unclear. We analyzed our experience of controlled pericardial drainage (CPD) managing critical cardiac tamponade. METHODS AND RESULTS: Between September 2003 and May 2011, 175 patients with acute type A aortic dissection were treated surgically, including 43 (24.6%) who presented with cardiac tamponade on arrival. Eighteen patients, who did not respond to intravenous volume resuscitation, underwent CPD in the emergency department. An 8F pigtail drainage catheter was inserted percutaneously, and drainage volume was controlled by means of several cycles of intermittent drainage to maintain blood pressure at ~=90 mm Hg. After CPD, all of the patients were transferred to the operating room, and immediate aortic repair was performed. Systolic blood pressure before CPD was 64.3±8.2 mm Hg and elevated significantly in all of the cases after CPD. Systolic blood pressure after CPD was 94.8±10.5 mm Hg, and increase in systolic pressure was 30.5±11.7 mm Hg. Total volume of aspirated pericardial effusion was 40.1±30.6 mL, and 10 patients required only <=30-mL aspiration volume. All of the patients underwent aortic repair successfully. In-hospital mortality was 16.7%; however, there was no complications or mortality related to CPD. CONCLUSIONS: Preoperative pericardial drainage with control of volume is a safe and effective procedure for acute type A aortic dissection complicated by critical cardiac tamponade. In our patient population, timely controlled pericardial drainage is warranted. [ABSTRACT FROM AUTHOR]