Early and late results of total correction of congenital cardiac anomalies in infancy.

Objective: We evaluated long-term results of surgical correction of congenital cardiac anomalies in infancy.

Methods: We reviewed cases of 856 patients who underwent complete correction of major cardiac anomalies in the first year of life during last 24 years at our institution, and analyzed results. Surgery involved ventricular septal defect (n = 453), tetralogy of Fallot (n = 92), atrioventricular canal defect (n = 93), and complete transposition of the great arteries (n = 218).

Influence of glistenings on the optical quality of acrylic foldable intraocular lens.

Aims: To assess the influence of glistenings on the optical quality of acrylic foldable intraocular lens.

Methods: Several degrees of glistenings in the optic were experimentally created by immersing the lens in water at 37 degrees C for 48 hours and then at 25 degrees C for 24 hours. Optical bench tests were carried out in water including measurements of spectral transmittance with the spectrophotometer, intensity of forward scattering using the integrating sphere photometer, modulation transfer function, and resolving power at various contrasts with and without the veiling glare light source.

[Repeated vertebrobasilar ischemic stroke caused by an intracranial vertebral artery dissection not detected on the initial angiogram: a case report].

Spontaneous dissection of the intracranial vertebral artery has been increasingly recognized as a cause of vertebrobasilar ischemic stroke. However, little is known about its natural history and clinical course. The authors report a young patient with repeated cerebral infarction in the posterior cerebral circulation caused by dissection of the vertebral artery, which was not detected on the first angiogram.

Mass spectrometry for on-line monitoring of perfluoro compounds using Li+ ion attachment techniques.

Ion attachment mass spectrometry is being developed for continuous measurement of perfluoro compounds (PFCs) found in the atmosphere as a result of semiconductor manufacturing processes. Studies were made on 5 greenhouse gases, CF4, CHF3, C2F6, SF6, and c-C4F8, to develop improved methods for PFC analysis, particularly at levels found in the atmosphere (the parts-per-billion concentration range). The results demonstrate the feasibility of performing real-time measurements of the trace amounts of PFCs encountered in process facilities by generating adduct ions from Li+ ion attachment.

[Surgical management for an unruptured cerebral aneurysm accompanied by anti-phospholipid antibody syndrome: a case report].

Anti-phospholipid antibody syndrome(APS) is characterized by the presence of antibodies to phospholipids and various symptoms including those derived from thrombosis. APS has been shown to be frequently accompanied by multiple and recurrent cerebral ischemic lesions, suggesting that APS may play a critical role in developing cerebral ischemia of unknown etiology. Here, we present a case with an unruptured cerebral aneurysm accompanied by a severe stenosis of the middle cerebral artery as a manifestation of APS.

[Current status and controversies on the management of cerebral main trunk occlusion].

Management of the cerebral main trunk occlusive disease has proceeded during last decade owing to remarkable progress of diagnostic and interventional neuroradiology. Several large clinical trials have established treatment guidelines in most of stroke management. Concerning cerebral main trunk occlusion, management of acute embolic ischemia and surgical indication for chronic carotid artery occlusion has still remained unsettled.

[The surgical treatment of congenital valve disease].

The clinical results after surgical treatment of congenital valve disease have improved due to the use of several recently developed techniques. The replacement of tendinous cords using E-PTFE sutures has allowed the indications for the repair of mitral valve prolapse to be extended. The Ross procedure has made it possible to replace the aortic valve associated with small aortic annulus.

Successful staged-Fontan operation in a patient with ectopia cordis.

Ectopia cordis is a very rare and often fatal disease. We report a successful surgery case of thoracoabdominal ectopia cordis with univentricular heart. This patient underwent a three-stage Fontan procedure, a right-modified Blalock-Taussig shunt at the age of 1 month, bidirectional Glenn shunt and pulmonary arterioplasty at 2 years 8 months, and finally a total cavopulmonary connection at 4 years.

Clinicopathological study of intracranial fusiform and dolichoectatic aneurysms : insight on the mechanism of growth.

Background And Purpose: Intracranial fusiform aneurysms can be divided into 2 clinically different subtypes: acute dissecting aneurysms and chronic fusiform or dolichoectatic aneurysms. Of these 2, the natural history and growth mechanism of chronic fusiform aneurysms remains unknown.

Methods: A consecutive series of 16 patients with chronic fusiform aneurysms was studied retrospectively to clarify patient clinical and neuroradiological features.

Asymmetric synthesis and determination of the absolute configuration of FK584, an agent for the treatment of overactive detrusor.

FK584[(-)-N-tert-butyl-4,4-diphenyl-2-cyclopentenylamine hydrochloride, (-)-4-HCl], a potential candidate for the treatment of overactive detrusor, was synthesized in a 4-step approach starting with Sharpless oxidation of cyclopentenol 6 (kinetic resolution). This epoxidation is a rare case in that the empirical rule does not work. Regio- and stereoselective introduction of tert-butylamine to the obtained epoxycyclopentanol 5 and subsequent conversion of the resulting diol to an olefin completed the synthesis.

Mitral valve replacement using bileaflet mechanical prosthetic valve in the first year of life.

Objective: The operative management and long term outcome of mitral valve replacement in infancy remain a therapeutic challenge. The selection of a prosthetic valve for this particular age group might affect the clinical outcome. Here we present our experience of mitral valve replacement in 6 infants using small bileaflet mechanical prosthetic valves.

[Patching of the raw surface of the posterior right ventricular wall in Ross procedure to prevent bleeding and to confirm anastomosis of the conduit].

An 8-year-old boy underwent Ross procedure to repair aortic regurgitation and subaortic stenosis. In reconstruction of the right ventricular outflow tract, the raw surface of the right ventricular posterior wall was covered with autologous pericardial patch to prevent bleeding and to confirm the anastomosis of the pulmonary tract conduit made of expanded polytetrafluoroethylene. Bleeding from the posterior wall was absent and he led uneventful postoperative course.

Chronic encapsulated intracerebral haematoma in a patient with medically intractable epilepsy.

A patient with a chronic encapsulated intracerebral haematoma presenting with medically intractable epilepsy is described. A tough capsule containing an old haematoma was confirmed surgically, and consisted of dense collagenous tissue with rich neovascularization. The radiological features, aetiology and treatment of this rare occurrence are discussed.

Cloning and characterization of a human brain Na(+)-independent transporter for small neutral amino acids that transports D-serine with high affinity.

We isolated a cDNA for the human homologue of system asc transporter Asc-1 from human brain. The encoded protein designated as hAsc-1 (human Asc-1) exhibited 91 % sequence identity to mouse Asc-1. Consistent with mouse Asc-1, hAsc-1 required 4F2 heavy chain for its functional expression in Xenopus oocytes.

[Efficacy of intravenous administration of atrial natriuretic peptide after cardiac surgery in neonates and infants].

Intravenous infusion of alpha-human atrial natriuretic polypeptide (hANP) and furosemide was performed in 12 patients (4: TGA, 3: univentricular heart, 3: HLHS, 2: VSD) after cardiopulmonary bypass. Their mean age at the operation was 68 days (6 patients in neonate), the mean body weight was 3.3 kg.

Norwood procedure without circulatory arrest.

In the Norwood procedure for hypoplastic left heart yndrome, the distal descending thoracic aorta was cannulated just superior to the diaphragm through median sternotomy. In combination with cerebral perfusion through the graft anastomosed to the innominate artery, which was used as a systemic-to-pulmonary shunt later, this technique enabled us to completely avoid circulatory arrest and deep hypothermia throughout the operation.

Clinical results of mitral valve repair by reconstructing artificial chordae tendineae in children.

Objective: There are an increasing number of reports concerning mitral valve repair by reconstructing the chordae tendineae with the use of expanded polytetrafluoroethylene sutures in adults. However, little information is available about application or results of this technique in children.

Methods: Between January 1995 and December 1997, 16 children who had from moderate to severe mitral regurgitation mainly as the result of a prolapse of the anterior leaflet (age range, 5 months-12.

Clinical results of arterial switch operation for double-outlet right ventricle with subpulmonary VSD.

Objective: An arterial switch operation is considered a good alternative for the repair of double-outlet right ventricle (DORV) with atrioventricular concordance connection and subpulmonary ventricular septal defect (VSD) when intraventricular rerouting is not feasible. The clinical results of an arterial switch operation with ventricular septal defect closure for this anomaly were studied.

Methods: Between 1986 and 1997, 27 patients ranging from 10 days to 5 years of age (mean 0.

[Descending aorta perfusion through median sternotomy in primary repair of aortic interruption complex].

Circulatory arrest is frequently used in aortic arch reconstruction in pediatric cardiac surgery. However, risks of postoperative acute renal failure and neurological deficit can not be ignored. We performed primary repair of aortic interruption in one-month old girl.

[Clinical results of mitral valve surgery in children].

The clinical results of mitral valve surgery in children were evaluated. Fifty children (age ranged between 1 month and 12 years) with mitral valve regurgitation have undergone valve surgery with low operative mortality (2%). Valve plasty using several techniques including annuloplasty have been performed with quite high success rate (92%), while valve replacement was required in four patients who had the prolapse of the anterior mitral leaflet (8%).

A new technique of surface anatomy MR scanning of the brain: its application to scalp incision planning.

Background And Purpose: Surface anatomy scanning (SAS) is an established technique for demonstrating the brain's surface. We describe our experience in applying SAS with superposition of MR venograms to preoperative scalp incision planning.

Methods: In 16 patients, scalp incision planning was done by placing a water-filled plastic tube at the intended incision site when we performed SAS using half-Fourier single-shot fast spin-echo sequences.