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Utility of plasma D-dimer for diagnosis of venous thromboembolism after hepatectomy
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作者 Taiichiro Miyake Hiroaki Yanagimoto +16 位作者 Daisuke Tsugawa Masayuki Akita Riki Asakura Keisuke Arai toshihiko yoshida Shinichi So Jun Ishida Takeshi Urade Yoshihide Nanno Kenji Fukushima Hidetoshi Gon Shohei Komatsu Sadaki Asari Hirochika Toyama Masahiro Kido Tetsuo Ajiki Takumi Fukumoto 《World Journal of Clinical Cases》 SCIE 2024年第2期276-284,共9页
BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of hepatectomy.The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the... BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of hepatectomy.The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative bleeding.Therefore,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after hepatectomy.AIM To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after hepatectomy.METHODS The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively analyzed.Patients were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower extremities.Clinicopathological factors,including demographic data and perioperative D-dimer values,were compared between the two groups.Receiver operating characteristic curve analysis was performed to determine the D-dimer cutoff value.Univariate and multivariate analyses were performed using logistic regression analysis to identify significant predictors.RESULTS In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE group.In the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after hepatectomy.CONCLUSION Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the postoperative period. 展开更多
关键词 HEPATECTOMY Malignant tumor Postoperative complication D-DIMER Early diagnosis Venous thromboembolism
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Severe Mediastinal Emphysema and Tension Pneumothorax Caused by Cough-Induced Intercostal Lung Herniation
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作者 Shinjiro Mizuguchi Masahide Kaji +3 位作者 toshihiko yoshida Takeshi Iwasaki Takao Kamimori Hiroshi Fujiwara 《Open Journal of Thoracic Surgery》 2014年第1期1-4,共4页
We report a case of cough-induced intercostal lung herniation with severe mediastinal emphysema and pneumothorax. A 60-year-old overweight man was admitted with dyspnea, chest pain, and chest wall bulging. Imaging con... We report a case of cough-induced intercostal lung herniation with severe mediastinal emphysema and pneumothorax. A 60-year-old overweight man was admitted with dyspnea, chest pain, and chest wall bulging. Imaging confirmed left pneumothorax, fractures of the 8th to 10th ribs, and a defect in the 8th intercostal muscles. The presence of protrusion of lung parenchyma outside the intercostal space was unclear. Although the symptoms of tension pneumothorax disappeared after drainage, the subcutaneous emphysema was uncontrollable. Emergency surgery revealed lung injury near the 8th rib wedge not directly related to the rib fracture, and lung herniation was observed. We performed direct approximation of the ribs, and the lung parenchymal surface was encased by absorbable materials, avoiding infection risk. Although the lung herniation recurred 5 months later, the patient did not desire additional surgical repair. Non-absorbable materials should be considered for repair of lung herniation, excluding patients at high infection risk. 展开更多
关键词 INTERCOSTAL LUNG HERNIATION Cough/Sneeze Surgical Procedure
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Evaluation of interfacial strength by an instrumented indentation method and its application to an actual TBC vane 被引量:2
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作者 Yasuhiro YAMAZAKI Shin-ichiro KUGA toshihiko yoshida 《Acta Metallurgica Sinica(English Letters)》 SCIE EI CAS CSCD 2011年第2期109-117,共9页
The thermal fatigue behaviour of an air plasma sprayed thermal barrier coating was investigated. And also the interfacial strengths of thermal barrier coated specimens subjected to thermal fatigue, as well as a retire... The thermal fatigue behaviour of an air plasma sprayed thermal barrier coating was investigated. And also the interfacial strengths of thermal barrier coated specimens subjected to thermal fatigue, as well as a retired TBC vane were also evaluated by means of an instrumented indentation machine. The results indicated that, (1) the TGO grew at the interface during thermal fatigue cycle as a function of the exposure time at elevated temperature; (2) the microcracks were initiated in the top coating and at the interface after thermal cycle tests; (3) the interfacial strength of TBC, which was evaluated by the indentation method, increased with the thermal cycles; (4) the interfacial strength of the retired TBC vane was almost equal with that of the as-sprayed TBC specimen. 展开更多
关键词 Thermal barrier coating Interfacial fracture toughness Indentation method
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