Design of a high-temperature and high-pressure liquid flow cell for x-ray absorption fine structure measurements under catalytic reaction conditions.

The design and performance of a new high-pressure and high-temperature cell for measurement of x-ray absorption fine structure (XAFS) spectra of solid catalysts working in a flowing liquid are presented. The cell has flat, high-purity sintered cubic boron nitride (c-BN) windows which can tolerate high temperature (900 K) and high pressure (10 MPa). The c-BN is a new material which has the highest tensile strength, second only to diamond, and is also chemically and thermally stable.

Successful percutaneous ultrasound-guided drainage for treatment of a splenic abscess.

We report a case of splenic abscess that was successfully treated with percutaneous ultrasound-guided drainage and without splenectomy. A 40-year-old woman was admitted to Nippon Medical School Hospital because of pyrexia and left upper quadrant pain, which had persisted despite antibiotic treatment. On admission, computed tomography demonstrated a low-density area in the spleen, which had been been seen on computed tomography 3 months earlier.

Is extracorporeal life support contraindicated in elderly patients?

Background: Extracorporeal life support (ECLS) using percutaneous extracorporeal membrane oxygenation (ECMO) is now considered an important means of resuscitation for patients suffering from refractory cardiogenic shock. The indications for the use of ECLS have yet to be established, however, and its use for elderly patients is still controversial. We retrospectively evaluated the impact of ECLS on the survival of patients with cardiogenic shock to determine the validity of using ECLS in elderly patients (> or = 75 years of age).

Redo off-pump coronary bypass grafting with arterial grafts for Kawasaki disease.

Surgical revascularization for coronary artery lesions secondary to Kawasaki disease is relatively uncommon. The late stenosis of the saphenous vein graft is the problem to be solved. We report a case of redo off-pump coronary bypass grafting in a 35-year-old man, 20 years after bypass grafting using a saphenous vein graft.

In situ UV-vis and EPR study on the formation of hydroperoxide species during direct gas phase propylene epoxidation over Au/Ti-SiO(2) catalyst.

In recent years, there have been great experimental and theoretical advances in the understanding of the epoxidation of propylene by O(2) and H(2) over Au supported on titanium-containing oxidic supports; however, thus far spectroscopic evidence of reacting species for proposed mechanisms has been lacking. Hydroperoxide species have been postulated as an intermediate responsible for the epoxidation of propylene with O(2) and H(2). In order to obtain direct evidence for the different type of active oxygen species, in situ UV-vis and EPR measurements were carried out during the epoxidation of propylene with O(2) and H(2) over a Au/Ti-SiO(2) (Ti/Si = 3:100) catalyst.

Crystallization and preliminary X-ray analysis of the catalytic domain of chitinase D from Bacillus circulans WL-12.

We report here on crystallization and preliminary X-ray analysis of the catalytic domain of chitinase D from Bacillus circulans WL-12. The native crystals of this domain were found to belong to the orthorhombic space group P2(1)2(1)2(1). To elucidate the structure of the catalytic domain by the multiple isomorphous replacement method, 30 kinds of derivatized crystals were prepared by soaking the native crystals into a mother liquor containing salts of heavy metal atoms.

[A case of idiopathic thoracic spinal cord herniation].

We report a case of idiopathic thoracic spinal cord herniation. A 63-year-old female came to our hospital complaining of a slowly progressive gait disturbance that began 5 years ago. She showed signs of a left dominant spastic paraparesis and sensory disturbance.

Off-pump coronary artery bypass grafting for acute myocardial infarction.

Background: The aim of this study was to evaluate the surgical results of off-pump coronary artery bypass grafting (OPCAB) for patients with acute myocardial infarction (AMI) within 14 days of the infarction.

Methods And Results: From April 2000 to January 2005 among 841 patients who underwent OPCAB, 43 consecutive patients (5.1%) were examined.

Prognosis of proximal femoral fracture in patients aged 90 years and older.

Purpose: To examine the walking ability and survival outcome of patients aged 90 years and older who sustained proximal femoral fractures, and to compare the findings with those of younger patients reported in previous studies.

Methods: Between January 1997 and June 2004 inclusive, 56 patients (11 men and 45 women) aged 90 years and older (range, 90-103 years; mean, 93 years) with hip fracture were reviewed. Their walking ability and survival outcome at discharge was investigated.

[A patient with hepatic, pulmonary, and nodal metastases of colon cancer responding to CPT-11/TS-1 therapy].

In December 2002, a 67-year-old man underwent right colectomy (stage IIIa, cur B) for cancer of the ascending colon. Chemotherapy with 5'-DFUR and PSK was performed after surgery, but was discontinued due to grade 3 diarrhea. The patient refused treatment with other drugs.

The impact of mitral valve surgery combined with maze procedure.

Objective: Recent studies indicated that successful maze procedure for atrial fibrillation (AF) adjunct to mitral valve surgery provided a lower incidence of stroke and recurrence of AF. The purpose of this study is to review the 13-year experience of these combined procedures and to identify the risk factors and late outcomes of successful maze procedures compared to failed maze procedures.

Methods: At a single institution, 521 consecutive patients underwent combined maze procedures with mitral valve replacements or valvuloplasties.

Infective endocarditis and pseudoaneurysm: fatal complications of mitral annular calcification.

We present a case of successful surgical repair for infected mitral valve and left ventricular pseudoaneurysm, which can be fatal complications of mitral annular calcification.

Functional angiographic evaluation of individual, sequential, and composite arterial grafts.

Background: To help optimize graft arrangement, we examined the effects of target vessel characteristics, conduit type, and interactions between the target vessels on the occurrence of flow reversal or occlusion.

Methods: The postoperative angiograms of 458 patients after total arterial revascularization with an off-pump, no aortic manipulation technique beginning in December 2000 were reviewed. Reverse flow was defined as the lack of opacification of a distal anastomotic site during graft angiography, but clear retrograde graft opacification during native coronary angiography.

Surgical treatment of aortic regurgitation due to Takayasu arteritis: long-term morbidity and mortality.

Background: The goal of this retrospective study was to determine the late outcome of surgical treatment for aortic valve regurgitation due to Takayasu arteritis and correlate it with evidence of inflammation on pathological examination.

Methods And Results: Ninety consecutive patients who underwent surgery for aortic valve regurgitation due to Takayasu arteritis between 1979 and 2003 were studied. Intraoperative pathological specimens of the aortic wall from 69 patients were retrospectively examined for inflammation.

Coronary embolism and subsequent myocardial abscess complicating ventricular aneurysm and tachycardia.

A 62-year-old female experienced a ventricular aneurysm and tachycardia caused by coronary embolism from mitral valve endocarditis. The patient underwent endoventricular patch plasty and cryoablation concomitant with valve replacement and survived without any operative complications. Pathological examination suggested that abscess formation played an important role regarding the disruption of the ventricular wall and development of the ventricular aneurysm and tachycardia.

Successful excision of a cystic tumor of the atrioventricular nodal region.

Cystic tumor of the atrioventricular nodal region is a rare cardiac primary tumor that can cause heart blockage and sudden death. Antemortem diagnosis and successful excision of the atrioventricular nodal region are extremely rare. A 45-year-old woman who presented with palpitations is reported.

Late outcomes after isolated coronary artery bypass grafting for ischemic mitral regurgitation.

Objectives: Although ischemic mitral regurgitation (IMR) is one of the most important issues to determine therapeutic strategy for ischemic heart disease, long-term outcome after coronary artery bypass grafting (CABG) for IMR is still unclear. It is also controversial how patients who would benefit from mitral valve (MV) surgery in combination with CABG should be identified. The purpose of this study is to elucidate late outcomes after isolated CABG for moderate IMR and to assess the indication of combined MV surgery.

Off-pump coronary artery bypass grafting using only arterial grafts in elderly patients.

Background: This study aimed to elucidate the safety and feasibility of off-pump coronary artery bypass grafting with only arterial grafts for elderly patients.

Methods: Of 653 patients who underwent off-pump coronary artery bypass grafting from April 2000 to December 2003, 581 patients did so with only arterial grafts. The average age was 66.

Early results of off-pump coronary artery bypass grafting for patients on chronic renal dialysis.

Objective: Renal dialysis is one of the independent risk factors for coronary artery bypass graft surgery. Off-pump coronary artery bypass grafting (OPCAB) may become a good option for these patients. In this study, early results as well as surgical techniques of OPCAB in dialysis patients were analyzed compared with non-dialysis patients.

Impact of preoperative and postoperative atrial fibrillation on outcome after mitral valvuloplasty for nonischemic mitral regurgitation.

Objective: We sought to determine the impact of preoperative or postoperative atrial fibrillation on survival, stroke, and cardiac function after mitral valvuloplasty for mitral regurgitation.

Methods: Between 1991 and 2003, 1026 patients with nonischemic/noncardiomyopathy mitral valve regurgitation underwent mitral valve plasty in 3 centers; 663 patients remained in sinus rhythm (group A), and 363 patients had atrial fibrillation or flutter preoperatively (group B) with concomitant maze procedures (group BM, n = 163) or without maze procedures (group BN, n = 200).

Results: Eight-year freedom from cardiovascular-related death was better in group A (99.

The Ross procedure performed in the setting of congenitally bifoliate aortic valve with anomalous right coronary artery.

We treated successfully using the Ross procedure a 14-year old with a congenitally stenotic bifoliate aortic valve associated with anomalous origin of the right coronary artery. The anomalous artery arose from the same aortic sinus that gave rise to the main stem of the left coronary artery, and reached the right atrioventricular groove by traversing the tissue plane between the aortic root and the subpulmonary infundibulum. Both coronary arteries were reimplanted using a single arterial button.

Rationale of off-pump coronary artery bypass grafting for left main trunk disease.

Objective: Off-pump coronary artery bypass grafting (OPCAB) remains controversial in patients with left main trunk (LMT) disease because of a concern about the ability to tolerate hemodynamic instability. This study examined the safety of OPCAB for LMT disease compared with conventional coronary artery bypass grafting (CABG).

Methods: Between April 1997 and December 2002, 257 consecutive patients with LMT stenosis who underwent CABG were enrolled.

Total arterial off-pump coronary artery bypass grafting for revascularization of the total coronary system: clinical outcome and angiographic evaluation.

Background: We assessed the clinical outcome and conducted an angiographic study of total arterial off-pump coronary artery bypass grafting for revascularization of the total coronary system.

Methods: Of 382 consecutive patients who underwent off-pump coronary artery bypass between April 2000 and December 2002, 235 patients (193 men and 42 women, mean age 66 +/- 9 years) with three-vessel disease underwent off-pump coronary artery bypass with all arterial grafts. A total of 872 vessels were bypassed (average number of grafts 3.