The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2015
Sequential and timely transfection of hepatocyte growth factor and monocyte chemotactic protein-1 ameliorates hyperkinetic pulmonary artery hypertension in rabbits.
To investigate the effect of sequential and timely transfection of the recombinant human hepatocyte growth factor (hHGF) gene and human monocyte chemotactic protein-1 (hMCP-1) gene on hyperkinetic pulmonary artery hypertension in a rabbit model. ⋯ Expression of hHGF and hMCP-1 were found in rabbit lung after gene transfection via an airway approach. By increasing the pulmonary microvascular density and promoting arterializations, sequential and timely hHGF/hMCP-1 transfection ameliorates the shunt flow-induced pulmonary artery hypertension.
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J. Thorac. Cardiovasc. Surg. · Sep 2015
Observational StudyInsulin resistance and inflammation are a cause of hyperglycemia after pediatric cardiopulmonary bypass surgery.
Hyperglycemia is common after pediatric cardiopulmonary bypass (CPB) surgery and is attributed to a state of insulin resistance. We examined the role of CPB-induced inflammation on postoperative plasma glucose, insulin, and the glucose-to-insulin ratio, which was used as a marker of insulin resistance; a decrease in the ratio reflects increased resistance. ⋯ Hyperglycemia after pediatric CPB surgery is associated with hyperinsulinemia, which may reflect insulin resistance in some patients. Inflammation induced by CPB may play a causative role in insulin resistance.
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J. Thorac. Cardiovasc. Surg. · Sep 2015
Preoperative (3-dimensional) computed tomography lung reconstruction before anatomic segmentectomy or lobectomy for stage I non-small cell lung cancer.
Accurate cancer localization and negative resection margins are necessary for successful segmentectomy. In this study, we evaluate a newly developed software package that permits automated segmentation of the pulmonary parenchyma, allowing 3-dimensional assessment of tumor size, location, and estimates of surgical margins. ⋯ This preoperative 3-dimensional computed tomography analysis of segmental anatomy can confirm the tumor location within an anatomic segment and aid in predicting surgical margins. This 3-dimensional computed tomography information may assist in the preoperative assessment regarding the suitability of segmentectomy for peripheral lung cancers.
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J. Thorac. Cardiovasc. Surg. · Sep 2015
The effect of surgeon volume on procedure selection in non-small cell lung cancer surgeries.
Procedure selection by the surgeon can greatly affect patients' operative and long-term survival. This selection potentially reflects comfort with technically challenging surgeries. This study aims to examine surgeon choices for non-small cell lung cancer and whether surgeon volume predicts the type of procedure chosen, controlling for patient demographics, comorbidity, year of surgery, and institutional factors. ⋯ Although patient and temporal factors influence the type of resection a patient receives for non-small cell lung cancer, surgeon volume also is a strong predictor. This study may be limited by minimal stage data, but the suggestion that a surgeon's total procedural volume for non-small cell lung cancer significantly influences procedure selection has implications on how we deliver care to this patient population.
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J. Thorac. Cardiovasc. Surg. · Sep 2015
Combined hypoxia inducible factor-1α and homogeneous endothelial progenitor cell therapy attenuates shunt flow-induced pulmonary arterial hypertension in rabbits.
Hyperkinetic pulmonary arterial hypertension (PAH) is a common complication in congenital heart disease, and affects operations, indications, and prognoses for patients. Gene-based stem cell transplantation is an alternative treatment that can attenuate PAH. ⋯ Both the therapy with HIF-1α-transfected EPCs, and EPC transplantation, attenuated shunt flow-induced PAH, by means of an angiogenic effect. The former therapeutic method was more effective.