The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2001
Is hyperglycemia seen in children during cardiopulmonary bypass a result of hyperoxia?
We sought to identify whether elevated PaO (2) itself can directly cause hyperglycemia in newborns and to document any additional effects of cardiopulmonary bypass on this response. ⋯ Hyperoxia triggers a hyperglycemic response in both ventilatory and bypass models. Cardiopulmonary bypass does not exacerbate this response, as shown by the similar levels of hyperglycemia sustained for the duration of the hyperoxic exposure in both experimental models. Therefore, not only may hyperoxia play a crucial role in the hyperglycemic response seen during neonatal cardiopulmonary bypass, but its effect on glucose homeostasis should be considered whenever children are exposed to hyperoxia.
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J. Thorac. Cardiovasc. Surg. · Oct 2001
Comparative StudyCompletely resected stage IIIA non-small cell lung cancer: the significance of primary tumor location and N2 station.
The number of N2 stations (single vs multiple N2 stations) is an important prognostic factor in patients with completely resected stage IIIA-N2 non-small cell lung cancer. However, the significance of both the N2 station(s) actually involved and the primary tumor location remains unclear. ⋯ The primary tumors in each lobe showed a prevalence of N2 station(s). The number of N2 stations is a good prognosticator except in patients with a primary tumor in the left lower lobe. In addition, the site of a primary tumor itself is also considered to influence the survival of the patients.
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J. Thorac. Cardiovasc. Surg. · Oct 2001
Clinical TrialA phase II trial of surgical resection and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma.
Surgical resection of malignant pleural mesothelioma is reported to have up to an 80% rate of local recurrence. We performed a phase II trial of high-dose hemithoracic radiation after complete resection to determine feasibility and to estimate rates of local recurrence and survival. ⋯ Hemithoracic radiation after complete surgical resection at a dose not previously reported is feasible. This approach dramatically reduces local recurrence and is associated with prolonged survival for early-stage tumors. Stage III disease has a high risk of early distant relapse and should be considered for trials of systemic therapy added to this regimen of resection and radiation.
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J. Thorac. Cardiovasc. Surg. · Oct 2001
Comparative StudyA morphologic study of Carpentier-Edwards pericardial xenografts in the mitral position exhibiting primary tissue failure in adults in comparison with Ionescu-Shiley pericardial xenografts.
We sought to investigate the durability and mechanism of the Carpentier-Edwards pericardial xenograft in the mitral position in comparison with that of the Ionescu-Shiley pericardial xenograft. ⋯ Tissue overgrowth on the atrial surface, ventricular surface, or both was the cause of structural valve deterioration, nonstructural valve deterioration, or both of Carpentier-Edwards pericardial xenografts in adults. This was different from Ionescu-Shiley pericardial xenograft failure, which resulted from severe calcification and leaflet tears. Organized thrombi on cusps, in addition to valve design, may have contributed to such tissue overgrowth on Carpentier-Edwards pericardial xenografts.