Salvage of Prosthetic Vascular Graft Infection in the Distal Thigh Using Free Latissimus Dorsi Musculocutaneous Flap: A Case Report.

Background: Prosthetic vascular graft infection (PVGI) in the distal thigh is a rare wound; thus, little is known about which muscle flaps are the most useful and cause less lower extremity morbidity in such cases. Moreover, very few reliable muscle flaps are available around the distal thigh.

Case Report: We report the case of a 72-year-old woman suffering from a distal thigh wound with PVGI.

An Evaluation of Total Reflection X-Ray Fluorescence as a Tool for Forensic Discrimination of Single Polyester Fibers.

Total reflection X-ray fluorescence (TXRF) spectrometry was applied to a forensic discrimination of single polyester fibers. In a non-destructive direct measurement of 5 mm long single fibers used for forensic references, trace metallic elements such as Ti, Sb, Ge, Mn, and Co, found in additives and catalyst residues, were detected using a benchtop TXRF spectrometer. The individual elemental compositions of the fibers were identified, and correlations between the compositions and manufacturers were established using principal component analysis (PCA).

Identification of DAB2 and Intelectin-1 as Novel Positive Immunohistochemical Markers of Epithelioid Mesothelioma by Transcriptome Microarray Analysis for Its Differentiation From Pulmonary Adenocarcinoma.

As there are currently no absolute immunohistochemical positive markers for the definite diagnosis of malignant epithelioid mesothelioma, the identification of additional "positive" markers that may facilitate this diagnosis becomes of clinical importance. Therefore, the aim of this study was to identify novel positive markers of malignant mesothelioma. Whole genome gene expression analysis was performed using RNA extracted from formalin-fixed paraffin-embedded tissue sections of epithelioid mesothelioma and pulmonary adenocarcinoma.

SPECT/CT Fusion in the Diagnosis of Hyperparathyroidism.

Objectives: In this study, we aimed to analyze the relationship between the diagnostic ability of fused single photon emission computed tomography/ computed tomography (SPECT/CT) images in localization of parathyroid lesions and the size of adenomas or hyperplastic glands.

Methods: Five patients with primary hyperparathyroidism (PHPT) and 4 patients with secondary hyperparathyroidism (SHPT) were imaged 15 and 120 minutes after the intravenous injection of technetium99m-methoxyisobutylisonitrile ((99m)Tc-MIBI). All patients underwent surgery and 5 parathyroid adenomas and 10 hyperplastic glands were detected.

The frozen elephant trunk technique for retrograde acute type A aortic dissection.

Objective: The operative strategies for retrograde acute type A aortic dissection with a primary intimal tear remain controversial because resection of an intimal tear via a median sternotomy is difficult. We evaluated the frozen elephant trunk technique for treating this type of aortic dissection.

Methods: The frozen elephant trunk technique was used for acute retrograde type A aortic dissection with a primary intimal tear in the descending aorta in 25 consecutive patients (16 men, 9 women; median age, 64 years) seen between 1997 and 2011 at the Hiroshima City Asa Hospital.

Extended aortic repair using frozen elephant trunk technique for Marfan syndrome with acute aortic dissection.

Purpose: The aim of this study was to analyze midterm results of frozen elephant trunk technique for Marfan syndrome with acute aortic dissection.

Methods: Between February 1999 and August 2011 we performed arch replacement uisng frozen elephant trunk technique for acute aortic dissection in 8 patients with Marfan syndrome containing two complicated type B dissections and six type A dissections.Five patients compromised annulo-aortic ectasia who performed Bentall operation.

New approach for extended thoracic aortic repair: anterolateral thoracotomy with partial sternotomy.

Purpose: We have introduced a new surgical approach for extended thoracic aortic repair, anterolateral thoracotomy with partial sternotomy (ALPS).

Description: The surgical approach to the chest was made via left anterolateral thoracotomy and lower median sternotomy through the third or fourth intercostal space. All cannulations (arterial, venous, venting, and cardioplegia) could be easily performed using a retractor in this approach.

In situ replacement for mycotic aneurysms on the thoracic and abdominal aorta using rifampicin-bonded grafting and omental pedicle grafting.

Background: The objective of this report is to discuss the efficacy of in situ replacement for treating mycotic aneurysm, particularly using rifampicin-bonded grafts and omental pedicle grafts, on the basis of our 7 years of experience.

Methods: Between December 2003 and December 2010, we performed surgical treatments in 23 patients (for the thoracic aorta in 6 patients, for the thoracoabdominal aorta in 8 patients, and for the abdominal aorta in 9 patients; 7 emergency, 10 urgent, and 6 elective operations) with mycotic aneurysm by using rifampicin-bonded grafting and omental pedicle grafting.

Results: One patient died in hospital because of local recurrent infection.

One-stage total thoracic aortic repair for mega-aorta using frozen elephant trunk technique.

We report the case of a 71-year-old female with mega-aorta extending from the ascending aorta to the descending aorta, who was successfully treated with a one-stage total thoracic aortic repair by the frozen elephant trunk technique using a stent-graft. We used a home-made frozen elephant trunk with four giant-turco Z-stents on the distal side that was inserted into the downstream descending aorta via an aortic arch guiding pull-through wire. The stent-graft was distally positioned at the level of the 12th thoracic vertebra after total arch replacement had been performed using a four-branch graft.

Early entry closure for acute type B aortic dissection by open stent grafting.

Purpose: We describe the long-term efficacy of early entry closure for acute type B aortic dissection by open stent grafting based on long-term results and changes in the false lumen on enhanced computed tomography (CT).

Methods: We performed open stent grafting for acute type B aortic dissection in 28 28 patients between 1998 a 2008. They included 14 patients with complicated type B aortic dissection (11 patients with limb and/or visceral ischemia and 4 patients with impending rupture).

Frozen elephant trunk technique and partial remodeling for acute type A aortic dissection.

Objective: The aimed to describe the frozen elephant trunk (FET) technique and partial remodeling (PR) for acute type A aortic dissection (ATAAD), considering the long-term prognosis on the basis of our 13 years of experience.

Methods: There were 80 consecutive patients (mean age: 66.4 years) with an FET and PR technique for ATAAD between September 1997 and February 2010.

Long-term results of the frozen elephant trunk technique for extended aortic arch disease.

Objectives: This study describes the long-term safety and effectiveness of extended aortic arch replacement with the frozen elephant trunk technique from our 12 years of experience.

Methods: Between September 1997 and September 2008, 156 patients (mean age 67.9 years) with different pathologies from the aortic arch to the extended descending aorta in 100 dissections (acute A/acute B/chronic B=66/26/8) and 56 thoracic arteriosclerotic aneurysms (TAAs) had the frozen elephant technique performed upon them.

Long-term results of the frozen elephant trunk technique for the extensive arteriosclerotic aneurysm.

Objectives: The objective of this report is to elucidate the feasibility of the frozen elephant trunk technique as a one-stage operation for extensive arteriosclerotic aneurysms and to investigate the long-term durability and efficacy of this procedure from our 11 years of experience.

Methods: The subjects were 58 consecutive patients who electively received the frozen elephant trunk technique for arteriosclerotic aneurysms involving the aortic arch and the descending aorta between September 1997 and September 2008. Concomitant procedures included 15 coronary artery bypass grafts, 2 aortic valve replacements, 1 aortic root replacement, and 3 maze procedures.

Surgical strategies for organ malperfusions in acute type B aortic dissection.

This study is retrospectively to evaluate strategies for organ malperfusion on the view point of two mechanisms (true lumen collapse in the aorta=Ao type, or branch dissection=Br type) in acute type B aortic dissection. There were 16 of Ao type and 4 of Br type in 20 patients with organ malperfusion. In Ao type, we performed entry closure in 12 patients, surgical bypass grafting in two to superior mesenteric artery (SMA) in one and femoral artery in two, and surgical fenestration in two.

A patient with simplified gyral pattern followed by progressive brain atrophy.

We present the case of a three-year-old boy who suffered from intractable epilepsy from birth, and who displayed microcephaly and severe developmental delay. Neuroradiological examination revealed the presence of simplified gyri of the cerebral cortex, and increased signal intensity changes in the cerebral white matter on T2-weighted magnetic resonance imaging. A tentative diagnosis of congenital cortical malformation was made, but unexpectedly, the cerebrum, cerebellum, and pons showed a progressive atrophy during the follow-up period.