10 3 Table 1 Patient characteristics Table 2 Back ground endoleak 8 AAA EG 13 TAA EG Table 1 16 AAA OS 21 TAA OS 14
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1 10 : , 2001 EG OS EG endoleak AAA 8 TAA 13 OS AAA 16 TAA 21 EG OS TAA OS EG OS 1 EG OS TAT EG OS 30 PLG α2pi 1 FDP DD PIC EG 1 OS EG EG 10 : , 2001 endoluminal grafting: EG Parodi high risk Dake Tel: ~5 6,7 13
2 10 3 Table 1 Patient characteristics Table 2 Back ground endoleak 8 AAA EG 13 TAA EG Table 1 16 AAA OS 21 TAA OS 14
3 EG Table 3 Stent graft & Graft Table 1 Table mm 2 1 Gianturco self-expandable stainless steel Z-stent Cook UBE woven graft Table 3 covered type bare type taper type 2 Cook J 18, Fr guiding sheath pushing rod dilator 3 sheath 100 U/kg introducer sheath sheath pushing rod 4 GELSOFT GELSEAL GELWEAVE Table 3 15
4 10 3 Table 4 BT and blood levels of WBC, CRP, PT, APTT, FBG, AT-III, TAT, PLT, FDP, DD, PLG, α2pi, and PIC were analyzed preoperatively and postoperatively at 1, 3, 5, 7, 14, 30 day(s) WBC C- CRP BT BT WBC CRP PT APTTFBG III AT-III III TATPLT FDP D DD PLG α2pi PIC Table 4 AAA EG 3 mean ± SD t p < AAA EG endoleak migration AAA OS 6 1 6% TAA EG endoleak migration 1 8% TAA OS 5 24% Fig. 1 EG EG EG 16
5 EG Fig. 1 Operation time, bleeding, blood transfusion Fig. 2 Inflammation of AAA Fig. 3 Inflammation of TAA 2 1Fig. 2 BT EG OS EG % OS % EG WBC EG OS 1 OS CRP EG OS 3 3 EG OS 2Fig. 3 BT EG OS 1 1 EG % OS % 38 EG 7 OS 38 WBC EG 1 OS EG OS OS CRP EG OS EG OS OS 3 1 Fig. 4 PT EG OS APTT EG 3 OS 1 17
6 10 3 Fig. 4 Coagulation of AAA Fig. 5 Coagulation of TAA 1 EG OS FBG EG 3 14 OS 3 30 EG OS AT-III EG OS EG OS AT-III TAT EG OS 1 EG OS PLT EG OS 30 EG OS Fig. 5 PT EG OS APTT 1 EG OS 1 FBG EG OS 5 EG OS AT-III EG OS 1 TAT EG OS 1 3 EG OS PLT EG OS 3 7 EG OS 2 Fig. 6 FDP EG OS EG 1 OS 7 DD EG OS 18
7 EG Fig. 6 Fibrinolysis of AAA Fig. 7 Fibrinolysis of TAA EG 1 OS 14 PLG EG OS EG OS α2pi EG OS 1 1 PIC EG OS EG 1 OS 3 Fig. 7 FDP EG OS EG OS 1 DD EG OS EG OS EG OS 3 14 PLG EG OS 1 OS 1 3 α2pi EG OS 1 EG 5 OS 7 1 PIC EG OS EG 1 OS 14 1 EG OS high risk 19
8 BT 1 EG WBC CRP EG OS BT 1 EG BT WBC CRP OS EG 1 EG OS EG Swartbol 8 Thompson 9 reperfusion injury Syk , EG BT EG OS EG OS 7 OS TAA OS TAA OS TAT FDP DD PIC DIC 1 15~17 DIC PIC EG OS PIC EG OS AT-III EG AT-III EG tapered type F-F bypass F-F bypass graft TAT EG OS TAA OS TAT FDP DD PLG 1 EG OS OS FDP DD EG 20
9 EG 1 OS EG OS ~22 23~25 EG 1 OS 7 14 FDP DD PIC EG OS DD PIC EG 1 OS 14 FDP DD PIC EG OS TAA OS 6,7,17,26,27 28, TAA OS Parodi, J. C., Palmaz, J. C. and Barone, H. D.: Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann. Vasc. Surg., 5: , Dake, M. D., Miller, D. C., Semba, C. P. et al.: Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N. Engl. J. Med., 331: , ,, : update., 16: , ,, : DeBakey IIIb 2 21
10 ., 45: , ,, : 1., 6: , :., 4: 59-70, : Zeroporosity Dacron., 4: , Swartbol, P., Truedsson, L. and Norgren, L.: Adverse reactions during endovascular treatment of aortic aneurysms may be triggered by interleukin 6 release from the thrombotic content. J. Vasc. Surg., 28: , Thompson, M. M., Nasim, A., Sayers, R. D. et al.: Oxygen free radical and cytokine generation during endovascular and conventional aneurysm repair. Eur. J. Vasc. Endovasc. Surg.,12: 70-75, Syk, I., Brunkwall, J., Ivancev, K. et al.: Postoperative fever, bowel ischaemia and cytokine response to abdominal aortic aneurysm repair a comparison between endovascular and open surgery. Eur. J. Vasc. Endovasc. Surg., 15: , ,, : endovascular grafting., 8: 43-46, Eschen, K. B. and Rudbach, J. A.: Immunological responses of mice to native protoplasmic polysaccharide and lipopolysaccharide. J. Exp. Med., 140: , ,, :., 46: , , :,, , Gertler, J. P., Cambria, R. P., Brewster, D. C. et al.: Coagulation changes during thoracoabdominal aneurysm repair. J. Vasc. Surg., 24: , Gibbs, N. M., Crawford, P. M. and Michalopoulos, N.: Postoperative changes in coagulant and anticoagulant factors following abdominal aortic surgery. J. Cardiothorac. Vasc. Anesth., 16: , Schwartz, R. A., Nichols, W. K. and Silver, D.: Is thrombosis of the infrarenal abdominal aortic 10 3 aneurysm an acceptable alternative?. J. Vasc. Surg., 3: , Reid, D. B. and Pollock, J. G.: A prospective study of 100 gelatinsealed aortic grafts. Ann. Vasc. Surg., 5: , Drury, J. K., Ashton, T. R., Cunningham, J. D. et al.: Experimental and clinical experience with a gelatin impregnated dacron prosthesis. Ann. Vasc. Surg., 1: , ,, :., 23: , ,, :., 22: , Jonas, R. A., Ziemer, G., Schoen, F. J. et al.: A new sealant for knitted Dacron prostheses: Minimally cross-linked gelatin. J. Vasc. Surg., 7: , Pasquinelli, G., Preda, P., Curti, T. et al.: Endothelialization of a new Dacron graft In an experimental model:light microscopy,electron microscopy and immunocytochemistry. Scanning Microsc., 1: , Pasquinelli, G., Freyrie, A., Preda, P., et al.: Healing of prosthetic arterial grafts. Scanning Microsc., 4: , Guidoin, R., Marceau, D., Rao, T. et al.: In vitro and in vivo characterization of an impervious polyester arterial prosthesis: the Gelseal Triaxial (R) graft. Biomaterials, 8: , ,, :., 4: , ,, :., 4: , ,, :., 8: , ,, : endovascular grafting., 8: ,
11 EG Inflammation and Blood Coagulation and Fibrinolytic System in Endoluminal Grafting for Aortic Aneurysms Kazuya Sato Department of Cardiovascular Surgery, Fukushima Medical University Key words: Endoluminal grafting, Aortic aneurysm, Inflammation, Blood coagulation and fibrinolytic system Inflammation and coagulation and fibrinolytic changes during endoluminal grafting (EG) have not been well defined in clinical studies. Moreover, EG also possibly causes consumption coagulopathy. We investigated perioperative changes in inflammation and coagulation and fibrinolytic system associated with EG versus conventional open surgery (OS) for aortic aneurysms in order to determine if any significant differences exist. Eight cases of EG and 16 cases of OS for infrarenal abdominal aortic aneurysm (AAA) repair were studied; and 13 cases of EG and 21 cases of OS for thoracic aortic aneurysm (TAA) repair. There was no difference in inflammation immediately after operation; however, inflammation did not occur in the TAA OS group due to a lot of bleeding and cardio pulmonary bypass. Postoperative course was similar in both EG and OS. In all cases we found: hypercoagulability on either post operative day (POD) 1 or POD 3; the level of TAT increased on POD 30; the level of PLG and α2pi decreased on POD 1. In EG, levels of FDP, DD, and PIC increased on POD 1 then decreased, but the level do not return to normal on POD 30. In OS, levels of FDP, DD, and PIC increased on either POD 7 or POD 14 then decreased, and similarly the level do not return to normal on POD 30. EG for aortic aneurysms is minimally invasive in comparison with OS. Inflammation and blood coagulation and the fibrinolytic system in EG did not differ significantly from the OS in our study. Therefore, it can be concluded that EG for aortic aneurysms is safe and do not cause consumption coagulopathy. (Jpn. J. Vasc. Surg., 10 : , 2001) 23
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九州大学学術情報リポジトリ Kyushu University Institutional Repository 看護師の勤務体制による睡眠実態についての調査 岩下, 智香九州大学医学部保健学科看護学専攻 出版情報 : 九州大学医学部保健学
九州大学学術情報リポジトリ Kyushu University Institutional Repository 看護師の勤務体制による睡眠実態についての調査 岩下, 智香九州大学医学部保健学科看護学専攻 https://doi.org/10.15017/4055 出版情報 : 九州大学医学部保健学科紀要. 8, pp.59-68, 2007-03-12. 九州大学医学部保健学科バージョン : 権利関係
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VOL. 36 S-3 CHEMOTHERAPY 437 438 CHEMOTHERAPY JULY 1988 Fig. 1 Contractile response of gastrointestinal tract to intravenous administration of saline and EM in interdigestive state in dogs (a) : Saline,
日本消化器外科学会雑誌第30巻第3号
Key words : gastric cancer, progltostic factor. multivariate analysis Factors selected after Coffelation- after Stepwise rnitrally check check H o s t l A g e C O 2 S e x C O 3 Pre-op. compliation O Treatment