References 1. Centers for Disease Control and Prevention (CDC). Statespecific mortality from sudden cardiac death - United States, 1999, MMWR Morb Mortal Wkly Rep, 2002;51:123-6. 2. Myerburg RJ, Castellanos A. Cardiac arrest and sudden cardiac death. Braunwald E, ed. Heart Disease: A Textbook of Cardiovascular Medicine. 5th ed. Philadelphia, Pa: WB Saunders; 1997:742-779. 3. de Vreede-Swagemakers JJ, Gorgels AP, Dubois-Arbouw WI, et al. Out-of-hospital cardiac arrest in the 1990’s: a populationbased study in the
Monica Marton-Popovici and Dietmar Glogar
REFERENCES 1. Go AS, Mozaffarian D, Roger VL, et al. Heart Disease and Stroke Statistics—2014 Update. Circulation. 2014;129:e28-e292. https://doi.org/10.1161/01.cir.0000441139.02102.80 2. Berdowski J, Berg RA, Tijssen JG, Koster RW. Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies. Resuscitation. 2010;81:1479-1487. doi: 10.1016/j.resuscitation.2010.08.006. 3. Fukuda T, Ohashi-Fukuda N, Kondo Y, Sera T, Doi K, Yahagi N. Epidemiology, Risk Factors, and Outcomes of Out
Theodora Benedek, Monica Marton Popovici and Dietmar Glogar
, et al. Favourable survival of in-hospital compared to out-of-hospital refractory cardiac arrest patients treated with extracorporeal membrane oxygenation: an Italian tertiary care centre experience. Resuscitation. 2012;83:579-83. doi: 10.1016/j.resuscitation.2011.10.013. 6. Dworschak M. Is extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest superior compared with conventional resuscitation? Crit Care Med. 2013;41:1365-6. doi: 10.1097/CCM.0b013e31828044c0. 7. Le Guen M, Nicolas-Robin A, Carreira S, et al. Extracorporeal life
arteriovenous fistula can be attempted [ 1 ]. Adjunctive measures include placement of an inferior vena cava (IVC) filter, and fasciotomy [ 8 ]. Given the high incidence of PE with PCD, IVC filter placement is an important measure to prevent further PE that may be a complication of treatment. Case report A previously healthy 46-year-old male, on no medications, presented following a pulseless electrical activity (PEA) arrest after collapsing at home. He was resuscitated and had the return of spontaneous circulation before arriving at the nearby tertiary care hospital
R Zhivkova, S Delimitreva, D Toncheva and I Vatev
developmental arrest. Hum Reprod 1993; 8(5): 744-751. Lechniak D, Pers-Kamczyc E, Pawlak P. Timing of the first zygotic cleavage as a marker of developmental potential of mammalian embryos. Reprod Biol 2008; 8(1): 23-42. Rosenbusch B, Glaeser B, Brucker C, Schneider M. Endoreduplication of the hyperhaploid maternal complement and abnormal pronuclear formation in a human zygote obtained after intracytoplasmic sperm injection. Ann Genet 2002; 45(3): 157-159. Rosenbusch B, Schneider M, Gläser B
Andreea Bărcan, Monica Chițu, Edvin Benedek, Nora Rat, Szilamer Korodi, Mirabela Morariu and Istvan Kovacs
;8:8032-41. 10. Park JS, Cha KS, Lee DS, et al. Culprit or multivessel revascularisation in ST-elevation myocardial infarction with cardiogenic shock. Heart. 2015;101:1225-32. 11. Mylotte D, Morice MC, Eltchaninoff H, et al. Primary percutaneous coronary intervention in patients with acute myocardial infarction, resuscitated cardiac arrest, and cardiogenic shock: the role of primary multivessel revascularization. JACC Cardiovasc Interv. 2013;6:115-25. 12. Ostenfeld S, Lindholm MG, Kjaergaard J, et al. Prognostic implication of out
IA Nechifor-Boila, H Suciu, Loghin Andrada, Borda Angela, A Maier, Martha Orsolya and C Chibelean
arrest. BJU Int, 2006;98:289-297. 15. Pouliot F, Shuch B, Larochelle JC, Pantuck A, Belldegrun AS. Contemporary management of renal tumors with venous tumor thrombus. J Urol, 2010;184:833-841.
Wojciech Dyk, Piotr Wolski, Piotr Szatkowski, Eugeniusz Szpakowski and Andrzej Biederman
Deep Hypothermic Circulatory Arrest During Pulmonary Thrombendarterectomy in Patients with Chronic Thrombembolic Pulmonary Hypertension
Chronic thrombembolic pulmonary hypertension is a rare complication of acute pulmonary embolism. Narrowing or closure of pulmonary arteries is the cause of pulmonary hypertension and results in right ventricular overload and failure. The treatment of choice is pulmonary thrombendarterectomy. Deep hypothermic circulatory arrest is a very important factor required for complete removal of the thrombembolic material from the pulmonary arteries during the operation.
The aim of the study was the evaluation of the effectiveness of the use of deep hypothermic circulatory arrest during pulmonary thrombendarterectomy in patients with chronic thrombembolic pulmonary hypertension.
Material and methods. Between October 1995 and October 2006 seventy patients were operated on. All of them were operated on with the use of deep hypothermic circulatory arrest. Deep hypothermia (18-19°C), pharmacotherapy, and neuromonitoring were used as a protection of the central nervous system during circulatory arrest.
Results. In fifty-seven patients out of seventy, complete thrombendarterectomy was performed (more than 75% of branches opened). The average pulmonary artery pressure and pulmonary vascular resistance were decreased, and cardiac output and index were increased. Six patients died (8.6%).
Conclusions. Complete thrombendarterectomy gives significant hemodynamical improvement in patients undergoing the operation. Deep hypothermic circulatory arrest during the operation does not cause significant neurological complications. Incomplete thrombendarterectomy may be the cause of right ventricular failure and death after the operation.
Sebastian Adeberg, Denise Bernhardt, Semi B. Harrabi, Nils H. Nicolay, Juliane Hörner-Rieber, Laila König, Michael Repka, Angela Mohr, Amir Abdollahi, Klaus-Josef Weber, Juergen Debus and Stefan Rieken
ATP production, induction of cell cycle arrest, autophagy, and apoptotic processes through activation of adenosine-5’-monophosphate-activated protein kinase (AMPK) 5 and inhibition of the mTOR (mammalian target of rapamycin) pathway in glioblastoma cells. 6 , 7 AMPK is a serine/threonine kinase that functions as a cellular energy sensor. AMPK is an obligate heterotrimer, consisting of one catalytic subunit (α) and two regulatory subunits (β and γ). 8 Under cellular stress conditions, AMPK is activated by increased AMP-to-ATP ratios to promote catabolism and
Theodora Benedek and Mariann Gyöngyösi
References 1. Kern KB. Optimal Treatment of Patients Surviving Out-of- Hospital Cardiac Arrest. JACC Cardiovasc Interv. 2012;5:597-605. 2. Steg G, James SK, Atar D, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology. Eur Heart J. 2012;33:2569-619. 3. Bernard SA, Gray TW, Buist MD, et al. Treatment of comatose survivors of