ABSTRACT
<p>We report a case of reoperation for proximal pseudoaneurysmal formation of the ascending aorta and distal enlargement of the dissecting arch and descending aorta after ascending aorta replacement for acute type A aortic dissection. The patient was a 47-year-old man who had undergone ascending aorta replacement and aortic valve replacement for acute type A aortic dissection three months previously. Pseudoaneurysm of the ascending aorta and enlargement of the dissecting arch and descending aorta were revealed by computed tomography. Therefore, we performed extensive replacement of the aortic root, arch and descending aorta. Median re-sternotomy with left anterolateral thoracotomy the (“Door open method”) was applied as the surgical approach. After reconstructing the aortic root using the modified Bentall procedure, we replaced the arch and descending aorta using antegrade continuous coronary perfusion with systemic blood through the composite graft of the aortic root under non-cardioplegic arrest. Despite the long duration of extracorporeal circulation, the duration of cardioplegic arrest was relatively short, and the postoperative cardiac function was not deteriorated at all. The patient is currently doing well with no problems at 1.5 years after the surgery. The Door open method was a useful approach providing good operative exposure in this case requiring extensive replacement of the thoracic aorta. Antegrade continuous blood coronary perfusion was useful for performing the arch and descending aortic replacement under non-cardioplegic arrest, and it was a reliable strategy for ensuring myocardial protection and avoiding prolonged duration of cardiac ischemia.</p>
ABSTRACT
OBJECTIVE: To compare the mouse oocyte vitrification outcomes of the CryoLogic vitrification method (CVM) and the conventional open method using a Cryotop. Two CVM methods (original CVM and modified CVM) were tested. METHODS: Mature oocytes obtained from female BDF-1 mice were vitrified by two-step exposure to equilibrium and vitrification solutions. Three vitrification protocols were tested on three groups: the CVM-kit, modified CVM, and Cryotop groups. After exposure to the two solutions, the oocytes were vitrified. After warming, the oocytes were fertilized in vitro, and the embryo development was assessed. Blastomeres positive for caspase were counted using an in situ assay kit. The spindle morphology and chromosome configurations of warmed vitrified oocytes were also assessed. RESULTS: The modified CVM and Cryotop groups showed similar developmental capacities, and similar proportions of cells with intact spindles and chromosome configurations. The modified CVM protocol was superior to the original CVM protocol for developmental competence and intact spindle preservation. However, the CVM group showed a relatively higher number of apoptotic cells in blastocysts. CONCLUSION: Closed vitrification using the modified CVM protocol may be used as an alternative to the conventional open method, but strategies to decrease apoptosis in the blastomere need to be investigated.
Subject(s)
Animals , Female , Humans , Mice , Pregnancy , Apoptosis , Blastocyst , Blastomeres , Embryonic Development , Mental Competency , Methods , Oocytes , VitrificationABSTRACT
PURPOSE: To compare the results of posterior cruciate ligament reconstruction by open and arthroscopic method. MATERIALS AND METHODS: From 1995 to 1997, 18 reconstructions of posterior cruciate ligament were performed. Group 1 (open method) was composed of 9 cases and group 2 (arthroscopic method) was consisted of 9 cases. After 21-month follow-up, The two groups were compared by clinical and radiologic methods. RESULTS: Clinically, Lysholm knee score was 80 points in group 1 and 83 points in group 2 after operation. Post operative results by Hughston's criteria were good in 5, fair in 2 and poor in 2 cases (group 1) and good in 6, fair in 2 and poor in 1 cases (group 2). Radiologically, post operative average of posterior drawer stress view was 5.2 mm (group 1) and 5.0 mm (group 2). Almost double the operation time was taken to reconstruct posterior cruciate ligament by arthroscopic method than open method. There were technical errors in 2 cases performed by arthroscopic method. CONCLUSIONS: The results of both methods had no significant difference. We think that the reconstruction of PCL using patellar tendon by open method is a recommendable treatment method together with arthroscopic method, if the merits or demerits of both methods are considered carefully. But more long-term follow-up is necessary to compare the results of PCL reconstruction by open and arthroscopic methods.