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- 저자 : Alfonsi, Jeffrey E. (검색결과 5 건)
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Transcatheter Mitral Valve Implantation in Open Heart Surgery: An Off-Label Technique
Jacopo Alfonsi,Giacomo Murana,Anna Corsini,Carlo Savini,Roberto Di Bartolomeo,Davide Pacini 대한흉부외과학회 2017 Journal of Chest Surgery (J Chest Surg) Vol.50 No.6
Extensive mitral annulus calcifications are considered a contraindication for valve surgery. We describe the case of a 76-year-old female with severe mitral and aortic stenosis associated with extensive calcifications of the heart. The patient underwent an open mitroaortic valve replacement using transcatheter aortic valve implantation with an Edwards SAPIEN XT valve (Edwards Lifesciences Corp., Irvine, CA, USA) in the mitral position. T he a ortic valve was replaced u sing a s tentless v alve p rosthesis (LivaNova S OLO; L ivaNova PLC, London, UK). Postoperative echocardiography showed that the prosthetic valve was in the correct position and there were no paravalvular leaks. A bailout open transcatheter valve implantation can be considered a safe and effective option in selected cases with an extensively calcified mitral valve.
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Radial forearm free flap in a patient with an unusual radial artery variation: a case report
Giulio Menichini,Sara Calabrese,Nicola Alfonsi,Marco Innocenti 대한성형외과학회 2021 Archives of Plastic Surgery Vol.48 No.6
Head and neck reconstruction poses unique challenges in rehabilitating surgical defects in terms of integrity, function, and form. The radial forearm free flap (RFFF) has been widely used for defect coverage, especially in the head and neck area, but its versatility allows it to be used for soft-tissue reconstruction in various parts of the body. The vascular features of the flap are quite constant and reliable. Nevertheless, abnormalities of the forearm vascular tree have been described over the decades. We report a case of intraoral reconstruction after verrucous carcinoma recurrence in a 74-year-old woman with an unusual forearm flap, which we called the median forearm free flap, based on a median branch of the radial artery that was preoperatively detected using handheld Doppler ultrasonography. The distally located skin paddle was predominantly supplied by the aberrant median vessel with its perforators. The flap was thus safely harvested with this atypical pedicle. Successful reconstruction of the intraoral defect was achieved, with an uneventful postoperative course.
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The association between insulin resistance and depression in the Korean general population
Lee, Jae-Hon,Park, Sung Keun,Ryoo, Jae-Hong,Oh, Chang-Mo,Mansur, Rodrigo B.,Alfonsi, Jeffrey E.,Cha, Danielle S.,Lee, Yena,McIntyre, Roger S.,Jung, Ju Young Elsevier 2017 Journal of affective disorders Vol.208 No.-
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Previous studies showed that the insulin resistance (IR) could be related to depression. However, this association is still equivocal in the general population. Herein, we aimed to investigate the association between IR and depressive symptoms in a large sample in South Korea.</P> <P><B>Methods</B></P> <P>A cross-sectional study was carried out for 165,443 Korean men and women who received a health checkup including various clinical parameters and the Center for Epidemiologic Studies Depression scales (CES-D). Subjects were stratified into subgroups by CES-D score, sex, age, and presence of diabetes. The odd ratios (ORs) for homeostasis model assessment of insulin resistance (HOMA-IR) were compared between groups using multivariable logistic regression analyses.</P> <P><B>Results</B></P> <P>After adjusting covariates (e.g. smoking, family income, marriage state, unemployment status, average alcohol use, BMI, physical activity, systolic blood pressure, diabetes), increased IR was weakly associated with greater depressive symptoms (adjusted OR=1.01 [95% CI 1.0001–1.03]). Subgroup analysis revealed this association was statistically significant in females (adjusted OR=1.03, [95% CI 1.001–1.06]), non-diabetic group (adjusted OR=1.04, [95% CI 1.02–1.06]), and young participants under the age of thirty (adjusted OR=1.17, [95% CI 1.07–1.27]). But we couldn’t find significant association in diabetic and middle to elderly participants.</P> <P><B>Conclusions</B></P> <P>This study demonstrates that there is a relationship between IR and depressive symptoms in the Korean general population. Results from this epidemiological study revealed that young adults and non-diabetic individuals with increased IR may be related with depressive symptoms.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Increased insulin resistance was associated with depressive symptoms in the Korean general population (N=165,443). </LI> <LI> The subgroup analysis revealed the association was statistically significant in female, non-diabetic and young groups. </LI> <LI> Increased insulin resistance in non-diabetic participants was more strongly associated with depressive symptoms. </LI> <LI> These findings suggest that early management of insulin resistance may prevent progression toward depressive symptoms. </LI> </UL> </P>
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Karamian Brian,Kothari Parth,Toci Gregory,Lambrechts Mark James,Canseco Jose,Mao Jennifer,Narayan Raj,Alfonsi Samuel,Sirch Francis,Kheir Nadim,Semenza Nicholas,Woods Barrett,Rihn Jeffrey,Kurd Mark,Rad 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.2
Study Design: Single-center retrospective cohort.Purpose: To compare surgical outcomes of patients based on lumbar drain variables relating to output and duration. Overview of Literature: The use of drains following lumbar spine surgery, specifically with respect to hospital readmission, postoperative hematoma, postoperative anemia, and surgical site infections, has been controversial.Methods: Patients aged ≥18 years who underwent lumbar fusion with a postoperative drain between 2017 and 2020 were included and grouped based on hospital readmission status, last 8-hour drain output (<40 mL cutoff), or drain duration (2 days cutoff). Total output of all drains, total output of the primary drain, drain duration in days, drain output per day, last 8-hour output, penultimate 8-hour output, and last 8-hour delta (last 8-hour output subtracted by penultimate 8-hour output) were collected. Continuous and categorical data were compared between groups. Multivariate logistic regression analysis and receiver operating characteristic (ROC) analysis were performed to determine whether drain variables can predict hospital readmission, postoperative blood transfusions, and postoperative anemia. Alpha was 0.05.Results: Our cohort consisted of 1,166 patients with 111 (9.5%) hospital readmissions. Results of regression analysis did not identify any of the drain variables as independent predictors of hospital readmission, postoperative blood transfusion, or postoperative anemia. ROC analysis demonstrated the drain variables to be poor predictors of hospital readmission, with the highest area under curve of 0.524 (drain duration), corresponding to a sensitivity of 61.3% and specificity of 49.9%.Conclusions: Drain output or duration did not affect readmission rates following lumbar spine surgery.
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