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Continuous cardiac output measured with a Swan-Ganz catheter reacts too slowly in animal experiments with sudden circulatory failure

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Animal Models and Experimental Medicine 2022年第3期5卷 258-265页

作者： Sigríður Olga Magnúsdóttir Carsten Simonsen Bodil Steen Rasmussen Peter Enemark Lund Benedict Kjærgaard Biomedical Research Laboratory Aalborg University HospitalAalborgDenmark Department of Clinical Medicine Aalborg UniversityAalborgDenmark Department of Cardiothoracic surgery Aalborg University HospitalAalborgDenmark Department of Anesthesia and Intensive Care Aalborg University HospitalAalborgDenmark Unit of Clinical biostatistics Aalborg University HospitalAalborgDenmark

Background : In many animal experiments, it is vital to detect sudden changes in cardiac output(CO). This porcine study compared CO that was measured with a SwanGanz pulmonary catheter with the gold standard(which was a transit-time flow probe around the pulmonary artery) during interventions that caused hemodynamic *** : In one series, 7 pigs were exposed to sudden changes in CO. In another series, 9 pigs experienced more prolonged changes in CO. All the pigs had a Swan-Ganz catheter placed into the pulmonary artery and a flow probe around the pulmonary artery. Adrenaline infusion and controlled hemorrhage were used to increase and decrease CO, respectively. The measurements of CO before and after each intervention were compared for correlation, agreement, and the time delay that it took each method to detect at least a 30% change in CO. A Bland– Altman test was used to identify correlations and agreements between the *** : In the first series, there was a delay of 5– 7 min for the Swan Ganz catheter to register a 30% change in cardiac output, compared with the flow probe. However,during prolonged changes in CO in the second series, there was a good correlation between the 2 methods. Mixed venous oxygen saturation reacted faster to changes than did CO;both were measured via the Swan-Ganz *** : In many animal studies, the use of Swan-Ganz catheters is suitable;however, in experiments with sudden hemodynamic instability, the flow probe is the most advantageous method for measuring CO.

关键词： cardiac output flow probe hemodynamics pigs Swan-Ganz catheter

Cystic duct cancer: Should it be deemed as a type of gallbladder cancer?

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World Journal of Gastroenterology 2019年第44期25卷 6541-6550页

作者： Tu-Nan Yu Ying-Ying Mao Fang-Qiang Wei Hui Liu Department of General surgery Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhou 310016Zhejiang ProvinceChina Department of Epidemiology and biostatistics Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Hepatobiliary and Pancreatic surgery Zhejiang Provincial People’s HospitalHangzhou Medical CollegeHangzhou 310014Zhejiang ProvinceChina Zhejiang Provincial Key Laboratory of Laparoscopic Technology Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhou 310016Zhejiang ProvinceChina

BACKGROUND According to the latest American Joint Committee on Cancer and Union for International Cancer Control manuals,cystic duct cancer(CC)is categorized as a type of gallbladder cancer(GC),which has the worst prognosis among all types of biliary *** hypothesized that this categorization could be verified by using taxonomic *** To investigate the categorization of CC based on population-level *** Cases of biliary cancers were identified from the Surveillance,Epidemiology,and End Results 18 registries *** with routinely used statistical methods,three taxonomic methods,including Fisher’s discriminant,binary logistics and artificial neuron network(ANN)models,were used to clarify the categorizing problem of *** The T staging system of perihilar cholangiocarcinoma[a type of extrahepatic cholangiocarcinoma(EC)]better discriminated CC prognosis than that of *** adjusting other covariates,the hazard ratio of CC tended to be closer to that of EC,although not reaching statistical *** differentiate EC from GC,three taxonomic models were built and all showed good *** ANN model had an area under the receiver operating characteristic curve of *** the three models,the majority(75.0%-77.8%)of CC cases were categorized as *** Our study suggested that CC should be categorized as a type of EC,not *** surgical attitude might be considered in CC cases,to see whether long-term prognosis could be immensely improved like the situation in EC.

关键词： Cystic duct cancer Gallbladder cancer Extrahepatic cholangiocarcinoma Surgical management Taxonomy Categorization

Significance of postoperative follow-up of patients with metastatic colorectal cancer using circulating tumor DNA

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World Journal of Gastroenterology 2019年第48期25卷 6939-6948页

作者： Lucie Benešová Tereza Hálková Renata Ptáčková Anastasiya Semyakina Kateřina Menclová JiříPudil Miroslav Ryska Miroslav Levý JaromírŠimša Filip Pazdírek JiříHoch Milan Blaha Marek Minárik Centre for Applied Genomics of Solid Tumors Genomac Research InstitutePrague CZ 16100Czech Republic surgery Department 2nd Faculty of Medicine of Charles University Prague and Military University HospitalPrague CZ 16902Czech Republic surgery Department 1st Faculty of MedicineCharles University Prague and Thomayer HospitalPrague CZ 14059Czech Republic surgery Department 2nd Faculty of Medicine of Charles University Prague and Motol University HospitalPrague CZ 15006Czech Republic Institute of biostatistics and Analyses of the Masaryk University Brno CZ 62500Czech Republic Elphogene Prague CZ 16100Czech Republic

BACKGROUND One of the most notable applications for circulating tumor DNA(ctDNA)detection in peripheral blood of patients with metastatic colorectal cancer(mCRC)is a long-term postoperative *** referred to as a“liquid(re)biopsy”it is a minimally invasive procedure and can be performed repeatedly at relatively short intervals(months or even weeks).The presence of the disease and the actual extent of the tumor burden(tumor mass)within the patient’s body can be *** is of particular importance,especially when evaluating radicality of surgical treatment as well as for early detection of disease progression or *** To confirm the radicality of surgery using ctDNA and compare available methods for detection of recurrence in metastatic colorectal *** total of 47 patients with detected ctDNA and indications for resection of mCRC were enrolled in the multicenter study involving three surgical *** postoperative follow-ups using imaging techniques and the determination of tumor markers were supplemented by ctDNA *** addition to the baseline ctDNA testing prior to surgery,a postoperative observation was conducted by evaluating ctDNA presence up to a week after surgery and subsequently at approximately three-month *** presence of ctDNA was correlated with radicality of surgical treatment and the actual clinical status of the *** Among the monitored patients,the R0(curative)resection correlated with postoperative ctDNA negativity in 26 out of 28 cases of surgical procedures(26/28,93%).In the remaining cases of R0 surgeries that displayed ctDNA,both patients were diagnosed with a recurrence of the disease after 6 *** 7 patients who underwent an R1 resection,4 ctDNA positivities(4/7,57%)were detected after surgery and associated with the confirmation of early disease recurrence(after 3 to 7 months).All 15 patients(15/15,100%)undergoing R2 resection remained constantly ctDNA positive dur

关键词： Circulating tumor DNA Metastatic colorectal cancer Postoperative Radicality of resection Follow-up Recurrence

Clinical validation of scoring systems of postoperative pancreatic fistula after pancreatoduodenectomy: applicability to Eastern cohorts?

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Hepatobiliary surgery and Nutrition 2019年第3期8卷 211-218页

作者： Jae Seung Kang Taesung Park Youngmin Han Seungyeon Lee Jae Ri Kim Hongbeom Kim Wooil Kwon Sun-Whe Kim Jin Seok Heo Seong Ho Choi Dong Wook Choi Song Cheol Kim Tae Ho Hong Dong Sup Yoon Joon Seong Park Sang Jae Park Sung-Sik Han Sae-Byeol Choi Joo Seop Kim Chang-Sup Lim Jin-Young Jang Department of surgery and Cancer Research Institute Seoul National University College of MedicineSeoulRepublic of Korea Department of Statistics and Interdisciplinary Program in biostatistics Seoul National UniversitySeoulRepublic of Korea Department of Mathematics and Statistics Sejung UniversitySeoulRepublic of Korea Department of surgery Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea Division of Hepatobiliary and Pancreatic surgery Department of SurgeryUlsan University College of Medicine and Asan Medical CenterSeoulRepublic of Korea Department of surgery Seoul St.Mary’s HospitalThe Catholic University of KoreaCollege of MedicineSeoulRepublic of Korea Pancreatobiliary Cancer Clinic Department of SurgeryGangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea Center for Liver Cancer National Cancer CenterGyeonggidoRepublic of Korea Department of surgery Korea University Guro HospitalKorea University College of MedicineSeoulRepublic of Korea Department of surgery Kangdong Sacred Heart HospitalHallym University College of MedicineSeoulRepublic of Korea Department of surgery Seoul Metropolitan Government-Seoul National University Boramae Medical CenterSeoul National University College of MedicineSeoulRepublic of Korea

Background:Although several prediction models for the occurrence of postoperative pancreatic fistula(POPF)after pancreatoduodenectomy(PD)exist,all were established using Western ***-scale external validation studies in Eastern cohorts that consider demographic variables including lower body mass index(BMI)are *** purpose of this study was to externally validate POPF prediction models using nationwide large-scale Korean ***:Nine tertiary university hospitals in the Republic of Korea ***'preoperative characteristics,intraoperative factors,and pathologic findings were *** grades were determined according to the 2016 International Study Group on Pancreatic surgery *** POPF risk models(Callery,Roberts,and Mungroop)were selected for external ***:A total of 1,898 PD patients were enrolled.A non-pancreatic disease diagnosis[hazard ratio(HR),1.856;95%confidence interval(CI),1.223–2.817;P=0.004),higher preoperative BMI(HR,1.069;95%CI,1.019–1.121;P=0.006),and soft pancreatic texture(HR,1.859;95%CI,1.264–2.735;P=0.002)were independent risk factors for clinically relevant POPF(CR-POPF).The area under the receiver operating characteristic curve(AUC)values were 0.61,0.64,and 0.63 on the Callery,Roberts,and Mungroop models,respectively;all were lower than those published in each external validation ***:Western POPF prediction models performed less well when applied to Korean ***,a large-scale Eastern-specific and externally validated POPF prediction model is needed.

关键词： Pancreatic fistula pancreatoduodenectomy(PD) predictive score

A Spectrophotometric Analysis of Human Osteoarthritic Cartilage Explants Subjected to Specific Capacitively Coupled Electric Fields

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Open Journal of Biophysics 2013年第2期3卷 158-164页

作者： Carl T. Brighton Wei Wang Charles C. Clark Amy Praestgaard Department of Epidemiology and biostatistics Perelman School of Medicine at the University of Pennsylvania Philadelphia USA Department of Orthopaedic surgery Perelman School of Medicine at the University of Pennsylvania Philadelphia USA

We have previously shown that capacitively coupled electrical stimulation of either normal bovine articular chondrocytes or osteoarthritic human articular cartilage explants resulted in up-regulation of cartilage matrix gene expression and down-regulation of metalloproteinase gene expression. In addition, collagen and proteoglycan protein levels were also elevated. To determine visually the effect of specific electric fields on modifying cartilage structure, freshly harvested human full-thickness osteoarthritic cartilage explants were stimulated in the absence or presence of interleukin-1β, an inflammatory cytokine, and were examined photographically and spectrophotometrically. Hexosamine and hydroxyproline contents were also determined. Spectrophotometric analysis was used to quantify any changes in the depth of defects in the cartilage ranging from surface level (red-colored) to the deepest affected layer (blue-colored). Interleukin-1β treatment alone caused significant additional cartilage erosion. Electrical stimulation alone resulted in significant decreases in the cartilage defects. Electrical stimulation in the presence of interleukin-1β resulted in a small, but significant, surface improvement. Meta-analysis also confirmed a significant increase in the hexosamine and hydroxyproline contents (indicating matrix deposition). It was concluded that an appropriate electric field could modify osteoarthritic lesions in full-thickness cartilage plugs by increasing matrix production and/or by decreasing matrix destruction. Furthermore, it appears that spectrophotometric analysis is a relatively easy method for quantifying the “filling in” or healing of articular cartilage defects.

关键词： Osteoarthritis Cartilage Explants Capacitive Coupling Spectrophotometry Disease Modification

An epidemiological report on the burden and trend of injuries in the Philippines from 2011 to 2018

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Journal of Acute Disease 2020年第5期9卷 200-205页

作者： Imee T.Macaranas Kin Israel R.Notarte Abbygail Therese M.Ver Adriel M.Pastrana Franchesca J.Chua Derick Erl P.Sumalapao Faculty of Medicine and surgery University of Santo TomasEspañaManilaPhilippines Department of Epidemiology and biostatistics College of Public HealthUniversity of the Philippines ManilaManilaPhilippines

Objective:To describe the epidemiological distribution of injury cases in the Philippines from 2011 to ***:A retrospective review of records from the Online National Electronic Injury Surveillance System involving trauma cases was done,and data were collated,tabulated,and statistically ***:A total of 668?179 injury cases were recorded,and 68.99%of these cases involved *** individuals belonged to the group aged 15-29 years(34.01%).The most populated regions in the country,the National Capital Region(14.90%)and RegionⅣA(13.96%),incurred the highest number of recorded *** crash(32.67%)was reported to be the major cause of injury;and open wounds(37.56%)and abrasion(26.23%)were found to be the most common types of ***:The burden of injury remains high in the Philippines due to the lack of resources and inadequate *** findings of the present study on the distribution of injury cases provide useful information for taking appropriate preventive measures,developing effective safety guidelines,allocating limited resources in an appropriate manner,and implementing necessary public health programs.

关键词： Traffic crash Trauma Surveillance system

Preoperative Feeding in Single Ventricle Neonates is Predictive of Shorter Time to Goal Feed

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Congenital Heart Disease 2022年第5期17卷 505-518页

作者： Alyssia Venna Kathleen Reid Sarah Davis Jiaxiang Gai Yves d’Udekem Sarah Clauss Department of Cardiovascular surgery Children’s National Heart InstituteThe George Washington University School of MedicineWashington DCUSA Department of Cardiology Children’s National Heart InstituteThe George Washington University School of MedicineWashington DCUSA Department of biostatistics Children’s National Heart InstituteThe George Washington University School of MedicineWashington DCUSA

Background:Patients with single ventricle anatomy are at increased risk of growth failure and *** cardiac centers,there is little standardization of feeding practices in this complex *** hypothesized that initiation of our center’s preoperative feeding protocol would result in decreased gastrostomy tube(G-tube)use,decreased length of stay and would not result in increased Necrotizing Enterocolitis(NEC)***:A single institution review of 52 patients who had undergone stage I single ventricle palliative repair was *** diagnoses were hypoplastic left heart syndrome(39%),atrioventricular canal(15%),and other(46%).Postoperative parameters such as time to goal feed and need for gastrostomy tube(G-tube)were compared among preoperatively fed and non-preoperatively fed *** to goal feed was calculated as time from first postoperative enteral feed to goal volume of 100 mL/***:Of the 26 patients who met inclusion criteria for preoperative feeding,22 patients(85%)were fed prior to *** proportional hazard ratio revealed that age at surgery(p=0.047)and being preoperatively fed(p=0.001)were associated with reaching goal feed *** analysis revealed that being preoperatively fed made a patient twice as likely to reach goal feed sooner(p=0.047).Univariable logistic regression revealed that days on total parenteral nutrition(p=0.018),length of hospitalization(p=0.008),and time to 1st postoperative feed(p=0.020)were significantly associated with higher odds of needing a G-tube *** logistic regression did not show any predictors of postoperative G-tube ***,there was a trend towards lower G-tube usage in the preoperatively fed ***:Implementing a standardized preoperative feeding protocol in single ventricle neonates can result in significantly shorter time to goal feed in preoperatively fed *** is beneficial for institutions to begin implementi

关键词： Single ventricle feeding guidelines enteral nutrition hypoplastic left heart syndrome necrotizing enterocolitis preoperative

Incidence of sports-related sternoclavicular joint dislocations in the United States over the last two decades

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World Journal of Orthopedics 2023年第6期14卷 427-435页

作者： Alexis B Sandler Michael D Baird John P Scanaliato Ayden LW Harris Sorana Raiciulescu Clare K Green John C Dunn Nata Parnes Department of Orthopaedic surgery Texas Tech University Health Sciences Center El PasoEl PasoTX 79905United States Department of Orthopaedic surgery Walter Reed National Military Medical CenterBethesdaMD 20307United States Department of Preventive Medicine and biostatistics Uniformed Services UniversityBethesdaMD 20307United States School of Medicine and Health Sciences The George Washington UniversityWashingtonDC 20001United States Department of Orthopaedic surgery Carthage Area HospitalCarthageNY 13619United States Department of Orthopaedic surgery Claxton-Hepburn Medical CenterOgdensburgNY 13669United States

BACKGROUND Epidemiological understanding of acute sternoclavicular(SC)dislocations secondary to sports across the United States is poorly *** To identify and assess epidemiological trends of SC dislocations occurring secondary to sports-related mechanisms across United States over the past two *** This cross-sectional,descriptive epidemiological study evaluates epidemiological trends of SC dislocations from sports that present to emergency departments(EDs)across the United *** were obtained from the National Electronic Injury Surveillance System database spanning two *** on incidence,patient demographics,mechanisms of injury,dislocation types,incident locales,and patient dispositions were *** 1622 SC dislocations occurred nationwide from 2001 to 2020[incidence=0.262/1000000 people,confidence interval(CI)=0.250-0.275],comprising 0.1%of shoulder/upper trunk *** patients were male(91%,n=1480)and aged 5-17(61%,n=982).Football,wrestling,and biking were the most frequently implicated sports,with contact sports responsible for 59%of athletic injuries(n=961).Recreational vehicle-related sports injuries,such as all-terrain vehicles,dirt bikes,and mopeds accounted for 7.8%of all injuries(n=126),with dirt bikes specifically comprising 3.7%(n=61).Ultimately,82%were discharged from the ED(n=1337),12%were admitted(n=194),and 6%were transferred(n=90).All recorded posterior dislocations were admitted or transferred from the *** sustaining SC dislocations from contact sports had a significantly increased risk of hospital admission or transfer rather than discharge from the ED as compared to patients whose injuries were from non-contact sports(incidence rate ratio=1.46,CI:=1.32-1.61,P<0.001).CONCLUSION SC dislocations from sports continue to be rare with a stably low incidence over the past two decades,likely comprising a smaller proportion of shoulder dislocations than previously *** sports are a fr

关键词： Sternoclavicular dislocation Sternoclavicular joint Epidemiology Football Contact sports

Frontal lobe position after single-layer cadaveric dermal matrix repair of large anterior skull base defects

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World Journal of Otorhinolaryngology-Head and Neck surgery 2022年第1期8卷 36-41页

作者： Corinna G.Levine Abdullah N.Al-Rasheedi Alejandro Mantero Mohammad Al-Bar Roy R.Casiano Rhinology&Skull Base surgery Department of OtolaryngologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA Otolaryngology Head&Neck surgery Jouf University-Medical CollegeSkakaSaudi Arabia Department of Public Health Sciences Biostatistics Collaboration and Consulting Core.MiamiFlorida.USA Otolaryngology King Fahad Hospital of the UniversityImam Abdulrahman Bin Faisal UniversityKhobarSaudi Arabia

Objective:Endoscopic repair of large anterior skull base(ASB)defects has excellent results when using multilayered repairs with a nasoseptal ***,in extensive intranasal tumors,a nasoseptal flap may not always be *** alternative option is a flexible single-layer ASB *** studies indicate low cerebrospinal fluid leak rates with a single-layer ***,the level of frontal lobe support,particularly the propensity for a significant inferior displacement of the frontal lobe,is not *** goal of this study is to determine the frontal lobe position after single-layer acellular dermal allograft repair in large ASB *** Design:Retrospective cohort ***:Tertiary care medical *** and Methods:This cohort study compares the frontal lobe position in adults who underwent endoscopic endonasal ASB tumor resection and single-layer cadaveric dermal matrix repair(ASB cohort)with control subjects without intracranial abnormalities(control cohort).The ASB cohort includes subjects with an ASB defect of≥5 cm anterior/posterior and≥1.5 cm wide and who had imaging at least 2 months after *** frontal lobe position is measured on sagittal CT/MRI using a reference line from the base of the sella to the nasion.A value of zero indicates that the inferior-most aspect of the frontal lobe is at the level of the nasion-sellar line.A positive value indicates that the frontal lobe is inferior to the nasion-sellar *** ASB cohort frontal lobe position is compared with the control cohort using the Mann-WhitneyU test.A priori we set an absolute difference of 5 mm as a clinically significant ***:The ASB cohort includes 47 subjects who are 57%male with an average age of 60 years(range:31-89 years).The most common ASB pathology is esthesioneuroblastoma(n=21)and 81%of the ASB cohort had postoperative *** control cohort includes 20 subjects who are 60%male,with a mean age of 45 years(range:19-74 years).The

关键词： anterior skull base cohort study frontal lobe skull base repair skull base tumor