著者

Yohei Tsuchikawa Yoshiyuki Tokuda Hideki Ito Miho Shimizu Shinya Tanaka Kazuki Nishida Daichi Takagi Akimasa Fukuta Natsuki Takeda Hiromasa Yamamoto Masaya Hori Yoshihiro Nishida Masato Mutsuga

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0416, (Released:2022-11-10)

参考文献数

20

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Background: The effect of delayed ambulation on the outcome of coronary artery bypass grafting (CABG) remains to be clarified.Methods and Results: The long-term and in-hospital outcomes of 887 patients who underwent isolated CABG (455 off-pump cases, 135 urgent cases) were evaluated, with a focus on the timing of first ambulation. In-hospital mortality cases were excluded. Early ambulation (first ambulation within 3 days after operation) was achieved in 339 (38%) patients. In the multivariable logistic regression analysis, longer operation time and urgent case, EuroSCORE II, re-thoracotomy, and respiratory time were associated with delayed (≥4 days) ambulation. Delayed ambulation was associated with a high incidence of postoperative complications, such as pneumonia, and stroke (P<0.01). Following discharge, 22.2% of patients experienced major cardiac events and 13.8% died during the follow-up period (median follow-up 60 months). Cox hazards analysis revealed that delayed ambulation was associated with long-term adverse events (hazard ratio 1.04 per day, P<0.001). With adjustment for preoperative factors, the estimated future risk of adverse events was found to be increased day-by-day during the delay until initial ambulation.Conclusions: In isolated CABG patients, delayed ambulation was associated with poor outcomes, even in the long-term period. The results support the current guideline recommending early ambulation protocol after cardiac surgery.

著者

Hirofumi Dohi Yoshihiro Nishida

出版者

FCCA(Forum: Carbohydrates Coming of Age)

雑誌

Trends in Glycoscience and Glycotechnology (ISSN:09157352)

巻号頁・発行日

vol.26, no.151, pp.119-130, 2014 (Released:2014-09-25)

参考文献数

60

被引用文献数

1 6

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チオグリコシドは高い化学安定性を有し、グリコシル化において化学選択的に活性化できることから糖鎖合成に幅広く用いられている。チオグリコシドはチオールから調製されるが、チオールは刺激的で不快な臭いを発するうえに、酸化によってジスルフィドを形成しやすいことから使用がはばかられる。これらの要因がチオグリコシドの化学合成への応用を事実上制限している。本稿では、チオグリコシド調製時に不快臭を伴わない手法の開発に向けた最近の取り組み、およびこれらの糖鎖合成における反応性について述べる。