CONCLUSION: Intravascular temperature management stabilizes both brain and body core temperature; prophylactic normothermia reduces the otherwise extreme increase of intracerebral temperature in patients with severe TBI. The intravascular cooling management proved to be an efficacious and feasible method to control brain temperature and to avoid hyperthermia in the injured brain. We could not find a statistically significant correlation between brain temperature and ICP.”
“Objective: Because the left atrial appendage is thought to be a major source of stroke in patients with atrial fibrillation, a new device and technique were developed
for thoracoscopic isolation of the left atrial appendage.
Methods: The left and right atrial appendages were approached from an 11.5-mm port in the left thorax in 15 canines. With an atraumatic MK-0518 datasheet grasper for appendage positioning, expandable silicone bands covered with polyester fabric were placed at the base of the left and right atrial appendages. The location of the bands was marked
with radiopaque clips to assess migration, and radiopaque dye was injected to confirm occlusion. The animals were killed at 1 JQ1 in vitro week (n = 3), 2 weeks (n = 6), or 12 weeks (n = 6).
Results: The bands were deployed on 30 appendages without complications. The appendages were 100% occluded, and there was no migration of any bands at death. There was no indication of bleeding, rupture, or systemic emboli in any of the 15 animals. Following complete occlusion, the appendages became necrotic and were replaced by scar tissue. The healed atrial surface was consistently smooth and devoid of thrombus. There was evidence of mild-to-moderate inflammation associated with a foreign body-type reaction to the fabric material but no pericarditis.
Conclusions: Permanent
occlusion of the left atrial appendage is feasible via a thoracoscopic epicardial approach with this novel silicone band. As the atrial tissue becomes necrotic, the silicone band continues to constrict, ensuring that the appendage remains isolated. Band occlusion of the left atrial appendage could potentially improve overall treatment outcome in patients at high risk of atrial thrombus formation. (J Eltanexor purchase Thorac Cardiovasc Surg 2010;140:885-9)”
“BACKGROUND: Cystic vestibular schwannomas (VSs) are described as being more aggressive than solid tumors.
OBJECTIVE: We examined 468 VS patients to evaluate whether the presence of cystic components in VSs may be an important feature for predicting postoperative outcome.
METHODS: We selected all VS patients from a prospectively collected database (1984-2009) who underwent microsurgical resection for VS. Hearing data were analyzed using American Association of Otolaryngology-Head and Neck Surgery. Facial nerve dysfunction was analyzed using the House-Brackmann scale. We used univariate comparisons to determine the clinical impact of cystic changes on preoperative and postsurgical hearing and facial nerve preservation.