Optical properties of poly[(disilanylene)oligophenylenes]

Optical Science, Engineering and Instrumentation '97, 1997, San Diego, CA, United StatesKatsumi Yoshino, Masaharu Hirohata, Kazuya Tada, Akihiko Fujii, Masanori Ozaki, Akinobu Naka, and Mitsuo Ishikawa "Optical properties of poly(disilanylene oligophenylenes)", Proc. SPIE 3145, Optical Probes of Conjugated Polymers, (1 December 1997). DOI: https://doi.org/10.1117/12.28414

Increase in the resistance of stenotic coronary segment by intravenous infusion of isoproterenol.

The effects of intravenous infusion of isoproterenol on stenosis resistance were studied in the anesthetized open-chest dog. The circumflex coronary artery (LCx) was isolated near its origin and an electromagnetic flow transducer was placed around the vessel for measuring coronary flow. A polyethylene catheter was inserted into the small branch of LCx for monitoring distal coronary pressure. LCx was constricted with a thick cotton string to a degree of obstruction that eliminated reactive hyperemia following a 20-second coronary occlusion. The coronary resistance across the stenotic segment (RL) was calculated as the pressure gradient across the stenosis divided by coronary flow. Isoproterenol was infused intravenously in a dose to keep the heart rate at a level 25-30% above the control with and without coronary constriction. For maintaining the ascending aortic pressure at the pre-isoproterenol level, the descending thoracic aorta was constricted with a tape. In the absence of coronary constriction, the vascular resistance of large coronary arteries was not affected by isoproterenol with a significant increase in coronary flow. In the presence of coronary stenosis, isoproterenol markedly increased RI regardless of additional aortic constriction. The magnitude of the increase in RL during aortic constriction varied directly with the percent increase in the pressure gradient across the coronary stenosis. Pacing-tachycardia essentially did not affect RL. These results suggest that isoproterenol increased the vascular resistance of the stenotic segment with fixed caliber.</p

Complications Associated With Spine Surgery in Patients Aged 80 Years or Older: Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study

Study Design:Retrospective study of registry data.Objectives:Aging of society and recent advances in surgical techniques and general anesthesia have increased the demand for spinal surgery in elderly patients. Many complications have been described in elderly patients, but a multicenter study of perioperative complications in spinal surgery in patients aged 80 years or older has not been reported. Therefore, the goal of the study was to analyze complications associated with spine surgery in patients aged 80 years or older with cervical, thoracic, or lumbar lesions.Methods:A multicenter study was performed in patients aged 80 years or older who underwent 262 spinal surgeries at 35 facilities. The frequency and severity of complications were examined for perioperative complications, including intraoperative and postoperative complications, and for major postoperative complications that were potentially life threatening, required reoperation in the perioperative period, or left a permanent injury.Results:Perioperative complications occurred in 75 of the 262 surgeries (29%) and 33 were major complications (13%). In multivariate logistic regression, age over 85 years (hazard ratio [HR] = 1.007, P = 0.025) and estimated blood loss ≥500 g (HR = 3.076, P = .004) were significantly associated with perioperative complications, and an operative time ≥180 min (HR = 2.78, P = .007) was significantly associated with major complications.Conclusions:Elderly patients aged 80 years or older with comorbidities are at higher risk for complications. Increased surgical invasion, and particularly a long operative time, can cause serious complications that may be life threatening. Therefore, careful decisions are required with regard to the surgical indication and procedure in elderly patients

Risk Factors for Delirium After Spine Surgery in Extremely Elderly Patients Aged 80 Years or Older and Review of the Literature: Japan Association of Spine Surgeons with Ambition Multicenter Study

Study Design:Retrospective database analysis.Objective:Spine surgeries in elderly patients have increased in recent years due to aging of society and recent advances in surgical techniques, and postoperative complications have become more of a concern. Postoperative delirium is a common complication in elderly patients that impairs recovery and increases morbidity and mortality. The objective of the study was to analyze postoperative delirium associated with spine surgery in patients aged 80 years or older with cervical, thoracic, and lumbar lesions.Methods:A retrospective multicenter study was performed in 262 patients 80 years of age or older who underwent spine surgeries at 35 facilities. Postoperative complications, incidence of postoperative delirium, and hazard ratios of patient-specific and surgical risk factors were examined.Results:Postoperative complications occurred in 59 of the 262 spine surgeries (23%). Postoperative delirium was the most frequent complication, occurring in 15 of 262 patients (5.7%), and was significantly associated with hypertension, cerebrovascular disease, cervical lesion surgery, and greater estimated blood loss (P < .05). In multivariate logistic regression using perioperative factors, cervical lesion surgery (odds ratio = 4.27, P < .05) and estimated blood loss ≥300 mL (odds ratio = 4.52, P < .05) were significantly associated with postoperative delirium.Conclusions:Cervical lesion surgery and greater blood loss were perioperative risk factors for delirium in extremely elderly patients after spine surgery. Hypertension and cerebrovascular disease were significant risk factors for postoperative delirium, and careful management is required for patients with such risk factors

Exercise vectorcardiographic study in essential hypertension

Tha cause of ST-T changes with QRS high voltage in essential hypertension was investigated using Frank lead vectorcardiograms. Submaximal treadmill exercise was performed according to the modified Bruce protocol. The patients were divided into three groups. Group N consisted of 29 normal subjects; Group I (ischemic heart disease) consisted of 10 patients with angina pectoris and 16 patients with angiographically documented narrowing of one or more coronary arteries and Group H (essential hypertension) was subdivided into four groups according to ECG findings: Group H-1 of 30 subjects with normal ECG, Group H-2 of 20 subjects with QRS high voltage (Sv(1)+Rv(6)≧35mm) with normal ST-T pattern, Group H-3 of 20 subjects with QRS high voltage with ST-T changes but no "strain pattern" and Group 4 of 20 subjects with QRS high voltage and "strain pattern". After exercise, the maximum spatial QRS vectors shifted posteriorly and to the left in all groups. In Group N, the maximum spatial T vector was reduced in magnitude, and directed anteriorly, superiorly and to the left after exercise. The T loop configuration showed no significant changes, though slightly rounded and inscribed uniformly. In Group I, the maximum spatial T vector decreased in magnitude as in Group N, but was directed in significantly more ways than in Group N. In a few cases, the vectors were extremely dislocated upward. The T loop configurations had wide variation. This variation of the T loop after exercise was characteristic of Group I. In group H, the maximum spatial T vector was also reduced in size, while the azimuth, elevation and spatial QRS-T angle moved in the opposite direction of Group N, as cardiac hypertrophy beveloped. Analysis of T loop configuration changes induced by exercise strongly suggested that the ST-T changes in Group H-3 were related to primary changes due to myocardial ishemia. Effects of exercise on spatial T vectors and T loop configurations in Group H-4 were quite different from those in Group I, so that the ST-T changes in this group seemed to be secondary changes in association with QRS high voltage

ベリニ管由来が示唆された乳頭状腺癌の1例

76歳男, 健康診断のため施行された腹部CTで左腎腫瘍が疑われ根治的左腎摘出術が施行された。摘除腎の髄質に割面黄褐色で直径約2cmの腫瘍を認め病理組織学的に円柱状で好酸性胞体を有する悪性細胞が乳頭状に増殖していた。レクチンおよび2種のモノクローナル抗体を用いた検討では, Soybean agglutinin, Peanut agglutinin, Dolichos biflorus agglutinin, Lotus tetragonolobus agglutininおよびCytokeratinは弱陽性でTamm-Horsfall proteinが陰性であった。腫瘍の肉眼的および組織学的所見は, 本腫瘍がベリニ管上皮由来であることを強く示唆した。患者は手術後1年を経たが腫瘍の再発を認めず健在であるA case of Bellini duct carcinoma is reported. A left renal tumor was detected by abdominal computerized tomography in a 76-year-old male, although he had no symptoms, such as hematuria, weight loss or flank pain. Radical nephrectomy was performed under the diagnosis of renal cell carcinoma in the left kidney. Macroscopic examination of the resected kidney revealed a tumor 2.0 cm in diameter, with a yellow-brown cut surface, located in the renal medulla. Histological examinations showed malignant tumor cells with eosinophilic cytoplasm with a papillary growth pattern. Immunohistostaining examinations using Lectin and two kinds of monoclonal antibodies demonstrated no significant staining with soybean agglutinin, peanut agglutinin, Dolichos biflorus agglutinin, Lotus tetragonolobus agglutinin or cytokeratin, and negative staining with Tamm-Horsfall protein. Although the results of immunohistostaining did not provide support, both macroscopic and microscopic findings strongly suggested that this tumor originated from Bellini duct epithelium (Bellini duct carcinoma). The patient is alive with no evidence of disease 1 year after surgery. Bellini duct carcinoma is a rare malignant condition and the prognosis is usually poor. Differential diagnosis from other renal or pelvic tumors is difficult and long-term careful follow-up is necessary