Bergershea5831

We previously reported that high-resolution computed tomography (HRCT) patterns and certain serum marker levels can predict survival in patients with acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) and in those with idiopathic interstitial pneumonias (IIPs). The utility of serum marker changes before and during AE has not been previously evaluated. This study aimed to clarify whether changes in serum marker levels could improve the prognostic significance of HRCT patterns in patients with AE-IIPs.

Seventy-seven patients (60 males, 17 females) with AE-IIP diagnosed between 2004 and 2016 and whose serum Krebs von den Lungen (KL)-6 and surfactant protein (SP)-D levels were measured before and at the onset of AE were enrolled in this study. The HRCT pattern of each patient was classified as diffuse, multifocal, or peripheral. PF-03084014 in vivo We examined the prognostic significance of the HRCT pattern, increased serum marker levels, and a combination of these parameters using Cox proportional hazard regression ity to predict the survival of AE-IIP patients.

Surgical strategy for treating chronic type A dissection with small true lumen at the descending aorta has not been reported. In this retrospective study, we reviewed our experience of applying a two-stage procedure for treating chronic type A dissection with small true lumen at the descending aorta.

Between February 2016 and December 2019, seven patients suffering from chronic type A dissection with small true lumen at the descending aorta underwent this procedure. Preoperative computed tomographic angiography (CTA) was performed to carefully assess the diameter of the descending aorta, tear site, and visceral arteries. The interval between the two procedures is determined by the condition of the patients' recovery and illustration of postoperative CTA after the first stage procedure.

All patients underwent first- and second-stage procedures. No mortality was observed among the seven patients. One patient who had a transient neurological deficit after the first stage recovered completely before hospital discharge. In two patients, the diameter of the descending aorta was enlarged postoperatively after the first-stage procedure. The interval between the two procedures was 2-3 months. However, no adverse events, such as stroke, paraparesis, visceral malperfusion, and lower extremity malfunction, were observed.

The two-staged procedure for the repair of chronic type A dissection with small true lumen at the descending aorta is adaptable with low prevalence of mortality and complication.

The two-staged procedure for the repair of chronic type A dissection with small true lumen at the descending aorta is adaptable with low prevalence of mortality and complication.

Paravertebral block (PVB) conducted by epidural catheter is a prevalent pain management for patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy. The aim of this study was to assess the efficacy and safety of paravertebral block with a modified PVB (MPVB) catheter under surgeon's direct vision after video-assisted thoracoscopic lobectomy.

Three hundred fifty-six patients undergoing VATS lobectomy were retrospectively reviewed and divided into two groups consecutively according to the catheter applied in PVB procedure (PVB group and MPVB group). In the MPVB group, a modified catheter with a flexible forepart and more apertures distributing along the forepart than the conventional epidural catheter was introduced. An infusion pump containing of 150 mL mixture was connected to the catheter to provide sustained regional analgesia. Intramuscular dezocine 10 mg was administered as a rescue medication when necessary. Postoperative pain management effect was assessed by visual analog scale (Vysis showed a normal range of pH and PaCO2 in both groups. There was no significant difference of analgesia-related adverse events as well as major complications between the two groups.

PVB with modified catheter under surgeon's direct vision was effective and safe after video-assisted thoracoscopic lobectomy.

PVB with modified catheter under surgeon's direct vision was effective and safe after video-assisted thoracoscopic lobectomy.

To determine the safely and effectively of del Nido cardioplegia (DNC) in surgery for aortic root disease, with mild hypothermic cardiopulmonary bypass (CPB).

From July to December 2017, all patients undergoing the surgery for aortic root disease (total aortic root replacement, valve-sparing aortic root replacement and replacement of aortic valve plus ascending aorta), with mild hypothermic CPB, were retrospectively reviewed at our institution. Patients were divided into two groups based on the type of cardioplegia the classical blood cardioplegia (CBC group) and del Nido cardioplegia (DNC group). Demographics, operative details, perioperative data and postoperative complications were recorded and compared. A propensity score matching was performed in this study.

The preoperative data in DNC group were similar to CBC group. The volume of ultrafiltration was lower in DNC than CBC group (2,053.49±806.62 DNC

. 2,666.00±967.14 CBC, P=0.001), when matched. The use of temporary pacemaker was more in DNC group (n=20, 46.5%, P=0.023), and the rate of automatic heart resuscitating was higher in the CBC group (92.0%

. 72.1% DNC group, P=0.024, unmatched).There were no differences in in-hospital mortality, troponin T (mean 0.66 ng/mL for CBC group

. 0.49 ng/mL for DNC group, P=0.152), left ventricular ejection fraction (mean 58.37% for CBC group

. 60.07% for DNC group, P=0.395) or other postoperative complications between two groups, after matching. In subgroup analysis, the ultrafiltration volume was lower in DNC than CBC group (1,932.26±749.39 DNC

. 2,640.00±996.24 CBC, P=0.004), when ACC time less than or equal to 90 minutes. The apache score was better in DNC group (4.75±3.41, P=0.041), when ACC time greater than 90 min. There were no statistical significances in other characteristics between groups.

DNC is safe and effective for surgery for aortic root disease, not inferior to the CBC.

DNC is safe and effective for surgery for aortic root disease, not inferior to the CBC.