Outcomes of Barlow mitral valve repaired by robot-assisted keyhole surgery.

Objective: To present our strategy and the clinical outcomes of robot-assisted Barlow mitral valve keyhole surgery.

Methods: From May 2015 to March 2022, a total of 1281 patients underwent mitral valve repair at our institution, including 763 with robotics surgeries. Of these, 124 patients with Barlow mitral valve (49 ± 12 years, male/female ratio = 81:43) were treated using robotic assistance and included in this study.

Commissure leaflet prolapse closely mimics anterior mitral leaflet perforation in 2-D image of transesophageal echocardiography.

Background: Precise diagnosis of mitral valve regurgitation is challenging, particularly for distinguishing between commissure leaflet prolapse and anterior leaflet perforation, based exclusively on 2-dimensional (2-D) imaging by transesophageal echocardiography. CASE 1: Two mitral regurgitation jets suggesting anterior leaflet perforation, but no regurgitation orifices, were observed in the mid esophageal (ME) 4-chamber view. Multiple 2-D and 3-dimensional (3-D) images revealed prolapse of the anterior (A3) leaflet and posterior commissure, not anterior leaflet perforation.

Off-Pump Neochordae Implantation via Left Minithoracotomy for Recurrent Regurgitation Following Mitral Valve Repair: The First Case in Japan.

Surgical fixation after recurrent regurgitation following surgical mitral repair has been technically demanding and associated with high morbidity and mortality. Avoiding reopening the adhesive site or limiting the usage of cardiopulmonary bypass are solutions for reducing the operative risk. We report a case of recurrent mitral regurgitation treated by off-pump neochordae implantation via left minithoracotomy.

Cardiac MRI-derived Extracellular Volume Fraction versus Myocardium-to-Lumen R1 Ratio at Postcontrast T1 Mapping for Detecting Cardiac Amyloidosis.

Purpose: To evaluate the diagnostic performance of myocardium-to-lumen R1 (1/T1) ratio on postcontrast T1 maps for the detection of cardiac amyloidosis in a large patient sample.

Materials And Methods: This retrospective study included consecutive patients who underwent MRI-derived extracellular volume fraction (MRI ECV) analysis between March 2017 and July 2021 because of known or suspected heart failure or cardiomyopathy. Pre- and postcontrast T1 maps were generated using the modified Look-Locker inversion recovery sequence.

Deep learning-based reconstruction can improve the image quality of low radiation dose head CT.

Objectives: To evaluate the image quality of deep learning-based reconstruction (DLR), model-based (MBIR), and hybrid iterative reconstruction (HIR) algorithms for lower-dose (LD) unenhanced head CT and compare it with those of standard-dose (STD) HIR images.

Methods: This retrospective study included 114 patients who underwent unenhanced head CT using the STD (n = 57) or LD (n = 57) protocol on a 320-row CT. STD images were reconstructed with HIR; LD images were reconstructed with HIR (LD-HIR), MBIR (LD-MBIR), and DLR (LD-DLR).

Transesophageal echocardiography for cardiac herniation occurring during robotic-assisted mitral valve repair: a case report.

Background: Cardiac herniation has been reported in thoracic trauma and after pneumonectomy; however, it is sporadic in cardiac surgery.

Case Presentation: A 35-year-old male patient underwent an elective totally endoscopic robotic-assisted mitral valve repair (TERMVR). His hemodynamics were stable after weaning from cardiopulmonary bypass, and no residual mitral valve regurgitation was observed.

A routine de-airing method for total endoscopic robot-assisted mitral valve repair.

Intraoperative water testing is essential for assessing mitral valve morphology and degree of residual mitral regurgitation during mitral valve repair. However, in some cases, evacuating intracardiac air is challenging. Herein, we report the routine de-airing method during total endoscopic robot-assisted mitral valve repair at our institute and discuss its effectiveness.

Surgery for Cystadenoma of the Retromolar Pad Area With Reconstruction Using a Buccal Fat Pad Flap: A Case Report.

Salivary gland tumors can also occur rarely in the retromolar area, though common near the junction of hard and soft palate, labial mucosa, and buccal mucosa. Most salivary gland tumors in the retromolar pad area are malignant and should be excised. The cystadenoma is a rare, benign, salivary gland tumor.

Impact of childhood growth and obesity curves in school health examinations.

Background: With the revision of the Japanese School Health and Safety Law in 2016, the use of growth and obesity curves has been recommended. This study aimed to determine the prevalence of growth and obesity curve creation in elementary and junior high schools using government-issued software in Japan between 2016 and 2019.

Methods: A questionnaire survey was conducted with school nursing teachers in elementary and junior high schools in Osaka, Japan.

Robotic mitral valve plasty for isolated clefts of mitral valve leaflets.

A 21-year-old female patient referred to our institute had been suffering from severe mitral valve regurgitation due to a rare anomaly: a typical cleft at the posterior mitral leaflet and the other partial one at the anterior leaflet. We successfully fixed the mitral valve using the robot-assisted totally endoscopic technique which could perform suture closure of both leaflets and annuloplasty. This communication is the first report of the robotic and totally endoscopic procedure which could treat this rare mitral anomaly.

Radiation dose optimization potential of deep learning-based reconstruction for multiphase hepatic CT: A clinical and phantom study.

Purpose: This clinical and phantom study aimed to evaluate the impact of deep learning-based reconstruction (DLR) on image quality and its radiation dose optimization capability for multiphase hepatic CT relative to hybrid iterative reconstruction (HIR).

Methods: Task-based image quality was assessed with a physical evaluation phantom; the high- and low-contrast detectability of HIR and DLR images were computed from the noise power spectrum and task-based transfer function at five different size-specific dose estimate (SSDE) values in the range 5.3 to 18.

Practical Preventive Strategies for Extravasation of Contrast Media During CT: What the Radiology Team Should Do.

Rationale And Objectives: This study aimed to assess the effectiveness of practical preventive strategies (i.e., venous vulnerability assessment and prevention scan protocol rules) taken by our radiology team (radiology nurses, radiology technicians, radiologists) on reducing extravasation of contrast media (ECM) during CT.

Radiation Dose Reduction for 80-kVp Pediatric CT Using Deep Learning-Based Reconstruction: A Clinical and Phantom Study.

Deep learning-based reconstruction (DLR) may facilitate CT radiation dose reduction, but a paucity of literature has compared lower-dose DLR images with standard-dose iterative reconstruction (IR) images or explored application of DLR to low-tube-voltage scanning in children. The purpose of this study was to assess whether DLR can be used to reduce radiation dose while maintaining diagnostic image quality in comparison with hybrid IR (HIR) and model-based IR (MBIR) for low-tube-voltage pediatric CT. This retrospective study included children 6 years old or younger who underwent contrast-enhanced 80-kVp CT with a standard-dose or lower-dose protocol.

Degradation and inactivation efficacy of ozone water for antineoplastic drugs in hospital settings.

Purpose: Occupational exposure to antineoplastic drugs in hospital settings is recognized to be hazardous, and as such environmental decontamination including degradation and inactivation of such drugs is recommended. To data, although various agents such as oxidants have been reported to be useful for decontamination, simpler, safer, and more convenient methods are required. In this study, the degradation and inactivation efficacy of ozone water, which has newly been introduced for decontamination of antineoplastic drugs in spills, was investigated for formulations of gemcitabine, irinotecan, and paclitaxel.

Pre-hospital portable monitoring of cerebral regional oxygen saturation (rSO) by ambulance personnel during cardiopulmonary resuscitation: A prospective observational analysis of 87 cases in Osaka city, Japan.

Background: Regional cerebral oxygen saturation (rSO) is a non-invasive method of measuring cerebral perfusion; However, serial changes in cerebral rSO values among out-of-hospital cardiac arrest (OHCA) patients in pre-hospital settings have not been sufficiently investigated. We aimed to investigate the association between the serial change in rSO pattern and patient outcome.

Methods: We evaluated rSO in OHCA patients using portable monitoring by emergency life-saving technicians (ELTs) from June 2013 to December 2019 in Osaka City, Japan.

Safety of perioperative period in robot-assisted atrial septal defect repair under hyperkalemic arrest.

Background: Various attempts have been made to meet patient desires, especially among younger and otherwise healthy individuals, for cosmetically satisfying incision with atrial septal defect (ASD) repair. One of procedures was a robotic-assisted totally endoscopic ASD repair via only two ports under hyperkalemic arrest without aortic cross-clamping. This study investigated perioperative management and safety for robotic-assisted total endoscopic ASD repair surgery under hyperkalemic arrest.

A preoperative prognostic nutritional index is a prognostic indicator in oral squamous cell carcinoma patients undergoing radical surgery.

The purpose of this study was to investigate the prognostic value of prognostic nutritional index (PNI) in oral squamous cell carcinoma (OSCC) patients and to undertake a comparative evaluation of the prognostic value of comparing PNI, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in terms of prognostic utility. A retrospective study was conducted involving 203 consecutive patients with OSCC who were treated with radical surgery with curative intent. The PNI and systemic inflammatory response were developed, and their prognostic utility was evaluated.

Two patterns of the "crossed swords sign" for the accurate diagnosis of diverse mitral valve regurgitations.

The "crossed swords sign," demonstrating the divergent jet, is visualized on 2-dimensional color Doppler imaging and indicates complicated mitral regurgitation (MR). We describe the cases of two patients with varying patterns of the crossed swords sign. In the first patient, the crossed swords sign was detected during the holosystolic phase.

Actinin-4 Expression Predicts Poor Disease-free Survival and Correlates with Delayed Lymph Node Metastasis in Patients with Completely Resected Oral Squamous Cell Carcinoma.

Oral squamous cell carcinoma is generally characterized by poor prognosis, and biomarkers are needed for development and selection of therapy. The purpose of this study was to assess expression of actinin-4, which has been implicated in cancer invasion and metastasis, to determine its viability as a prognostic indicator in oral squamous cell carcinoma. Clinical factors and tumor samples immunohistochemically stained for actinin-4 were retrospectively investigated in 55 patients who underwent curative surgery for oral squamous cell carcinoma.

Additional cleft mitral valve diagnosed by a combination of 2-D and 3-D echocardiography using transesophageal echocardiography during mitral valve prolapse: a case report.

Background: A mitral cleft may be an important etiological factor for significant mitral regurgitation. We diagnose an additional cleft mitral valve by a combination of 2-dimensional (2-D) and 3-dimensional (3-D) echocardiography.

Case Presentation: We describe the case of a severe mitral regurgitation due to posterior leaflet prolapse (P2).

Pneumonia prevention effects of perioperative oral management in approximately 25,000 patients following cancer surgery.

Aim: We conducted a multicenter study to explore the risk factors of developing pneumonia and the effectiveness of perioperative oral management (POM) for the prevention of pneumonia in postsurgical patients.

Methods And Results: A survey covering eight regional hospitals was conducted over 4 years, from April 2010 to March 2014. Using the Diagnosis Procedure Combination database, a target group of 25,554 patients with cancer who underwent surgery was selected and assessed from a population of 346,563 patients without pneumonia on admission (sample population).

Intraoperative detection of stuck leaflet after implantation of a mechanical aortic valve: a case report.

Background: Mechanical aortic valve dysfunction is a rare but potentially fatal complication. It is usually caused by thrombosis, vegetation, and pannus overgrowth. However, it very rarely occurs immediately after the cardiopulmonary bypass weaning period.