Cluster analysis showed 4 patterns of aortic dilatation: cluster I, aortic root alone (n = 8, 13%); cluster II, tubular ascending aorta alone (n = 9, 14%); cluster III, tubular portion and transverse arch (n = 18, 28%); and, cluster IV, aortic root and tubular portion with tapering across the transverse arch (n = 29, 45%).
Conclusion: Distinct patterns of aortic dilatation in patients with bicuspid aortic valves call for an individualized
degree of aortic replacement to minimize late aortic complications and reoperation. Patients in clusters III and IV should have transverse arch replacement (plus concomitant root replacement in cluster IV). Patients in cluster I should undergo complete aortic root replacement, whereas in patients in cluster II supracommissural ascending aortic grafting is adequate.”
“Literature highlights that serotonergic descending pathways are implicated in somatosensory functions
in the spinal cord and Vorinostat datasheet that serotonin (5-HT) in the dorsal horn might play a role in motor function through proprioceptive feedback. We hypothesized that 5-HT release in dorsal horn might represent an important factor in the completion of locomotion THZ1 mw by facilitation of the spinocerebellar tract and/or by modulation of spinal reflex pathways. The present study demonstrates that during locomotor activity, 5-HT is released in layers II, III, IV, V of Rexed. Microdialysis in combination with HPLC was used to measure concentrations of neurotransmitters in the lumbar dorsal horn before, during, and after a treadmill running exercise. Our results show a significant 41% increase of 5-HT release within the dorsal horn during the exercise. 5-HT release is temporally related to exercise. The present study demonstrates that dorsal horn 5-HT release might modulate locomotion. (C) 2008 Elsevier Ireland Ltd. All rights reserved.”
“Objective: This study was undertaken to identify preoperative and intraoperative risk factors influencing outcome selleckchem after operations requiring hypothermic circulatory arrest with selective antegrade cerebral perfusion in a single
center.
Methods: Between November 1999 and March 2006, a total of 501 consecutive patients (median age 64 years, range 20 – 86 years, 320 male) underwent aortic arch surgery with moderate hypothermic circulatory arrest (25 degrees C +/- 2 degrees C) and additional selective antegrade cerebral perfusion (14 degrees C) at our institution for various indications (256 aneurysms, 153 acute and 23 chronic type A aortic dissections, 66 other). Of these, 181 were emergency operations. Statistical analysis was carried out to determine risk factors for 30-day mortality as well as for temporary and permanent neurologic dysfunction.
Results: Overall mortality was 11.6%. Permanent neurologic dysfunction occurred in 48 patients (9.6%); temporary neurologic dysfunction was detected in 67 patients (13.4%). Multivariate analysis revealed age (P = .001, odds ratio 1.08), reoperation (P = .006, odds ratio 3.