[An Anastomotic Aneurysm Thirty Years After Open Surgery of the Descending Thoracic Aorta:Report of a Case].

An 86-year-old man was hospitalized urgently to our department because of his worsening hemoptysis. He had undergone open thoracic aortic grafting for the Stanford type B chronic aortic dissecting aneurysm 30 years earlier. Contrast enhanced computed tomography (CT) revealed the distal anastomotic aneurysm, leakage of the contrast medium around the distal anastomotic site.

Correlation between immune-related adverse events and prognosis in patients with various cancers treated with anti PD-1 antibody.

Background: Immune checkpoint inhibitors (ICIs) targeting programmed cell death protein 1 (PD-1) are used for the treatment of various cancer types. However, immune-related adverse events (irAEs) occur in patients treated with ICIs. Several small-scale studies have reported the onset of irAEs and therapeutic effects of ICIs.

[Infected Thoracic Aortic Aneurysm Secondary to the Purulent Pericarditis;Report of a Case].

A 69-year-old man was hospitalized urgently to the department of cardiology, with the progressive general malaise. On admission, his blood pressure was 80/42 mmHg, his white cell count 13,700/µl, and C-reactive protein 25.55 mg/dl suggesting existence of aggressive infection with impaired circulation.

Deep vein thrombosis in orthopedic surgery of the lower extremities.

To prevent pulmonary embolism due to deep venous thrombosis (DVT), we have treated 611 patients undergoing orthopedic surgery of the lower extremities with our protocol including pre- and postoperative ultrasonic venous screening and anticoagulant therapy if necessary. A total of 118 patients (19.3%) developed DVT.

[Preservation of arch branch patency during the placement of Gore-TAG; protection sheath insertion method].

Purpose: We report a technique to place Gore-TAG (TAG) precisely just below the origin of the neck vessel without overstenting.

Technique: Before deploying TAG, retrograde insertion of the protection sheath through the left subclavian artery (LSCA), or the left common carotid artery (LCCA), into the aortic arch was accomplished. The proximal flare portion of TAG catheter was positioned to touch or partially cross the protection sheath.

Histopathological study of specimens obtained by left ventricular biopsy during ventriculoplasty for idiopathic dilated cardiomyopathy.

Objective: Pathological changes in the myocardium in idiopathic dilated cardiomyopathy (DCM) are usually studied using endomyocardial biopsy specimens, but the relationship between pathological changes in the myocardium and clinical findings is unclear. The goal of the study was to examine correlations between clinical findings and histopathological findings in specimens of the left ventricular myocardium collected during left ventriculoplasty in DCM patients.

Methods: The subjects were 20 DCM patients (17 males and 3 females; mean age: 59 ± 14 years old) who underwent left ventriculoplasty, including 16 cases of overlapping ventriculoplasty (OLVP) and 4 of papillary muscle approximation (PMA) with left ventricular incision.

A surgical case for hemolytic anemia after ascending and total arch replacement.

A 61-year-old man presented with consistent hemolytic anemia 15 months after ascending and total arch replacement for DeBakey I type acute aortic dissection. The cause of hemolysis turned out to be mechanical damage of red blood cells at the inverted felt of the proximal anastomosis. Reoperation of resection of the felt and repair of the proximal anastomosis successfully resolved this problem.

Late rupture of knitted Dacron graft.

An 87-year-old man underwent aorto-bifemoral bypass using a bifurcated Bionit II knitted Dacron graft for high aortic occlusion in 1987 at another hospital. In November, 2004, he was admitted to our institution because of difficulty in walking due to swelling and tenderness in the right groin. Computed tomography (CT) scan indicated bilateral aneurysms of the grafts in the groins.

[Atrial fibrillation after isolated coronary bypass surgery].

Postoperative atrial fibrillation (Af) remains a significant source of morbidity after coronary artery bypass grafting (CABG). Prophylactic therapy with beta-adrenergic blockers or amiodarone hydrochloride is reported to reduce the incidence of Af. We studied the incidence of Af retrospectively and considered the risk factors for it.

A surgical case for severe hemolytic anemia after mitral valve repair.

We report a rare case of severe hemolytic anemia accompanied by moderate renal insufficiency after mitral valve repair. Although the degree of the residual mitral regurgitation was less than 1+ during the first three weeks after the operation, the maximum lactate dehydrogenase (LDH) was up to 7,430 U/l and the minimum hemoglobin was 4.9 g/dl.

[Operative decision for acute type A aortic dissection; ascending aorta or arch replacement].

Operative technique of acute type A aortic dissection remains controversial. We adopted the strategy to replace the aortic arch only when the entry of the dissection was found in the aortic arch, or atherosclerotic arch aneurysm existed. The purpose of the current study was to elucidate the feasibility of the ascending aorta and hemiarch replacement and to follow the fate of the patent false lumen distal to the anastomosis after surgery.

[Surgical treatment of ventricular and pericardial perforation by a permanent pacing lead: a case report].

An 83-year-old woman was transferred to our hospital because of pacing failure and suspected ventricular perforation by a permanent pacing lead. She had undergone permanent pacemaker implantation 5 months previously. Chest radiography showed the pacing lead running out of the cardiac shadow.

[A case of large carcinoma of the tongue and mouth floor, in which chemotherapy using a combination of nedaplatin and 5-FU was effective].

We encountered a case of extensive squamous cell carcinoma ranging from the tongue to the mouth floor, in which chemotherapy using a combination of nedaplatin and 5-FU was effective. The patient was a 46-year-old male, who noticed a small mass in the mouth floor in September 2000, and visited the department of oral and maxillofacial surgery at a hospital on October 12, 2000. A 27 x 15 mm tumor with erosion was noted on the mouth floor, which was diagnosed as squamous cell carcinoma by biopsy, and the patient was referred to our department for treatment on November 16, 2000.

[Evaluation of a combination chemotherapy with nedaplatin and 5-FU for oral cancers].

Nedaplatin (cis-diammine-glycolato platinum: CDGP) is a platinum compound with a molecular weight of 303.18 that was recently developed in Japan. There have been reports of the antineoplastic effects of Nedaplatin on cancers in the cranio-cervical region, lung, esophagus, urinary bladder, testis, ovary, and uterus.

Recombinant adenoviral mediated CD39 gene transfer prolongs cardiac xenograft survival.

Background: Extracellular ATP and ADP may be important mediators of vascular inflammation and thrombosis. Nucleoside triphosphate diphosphohydrolase (NTPDase or CD39) is a vascular ectoenzyme that hydrolyses ATP and ADP; however, this activity is lost during reperfusion injury. We show that the supplementation of NTPDase activity within xenograft vasculature using CD39 recombinant adenoviruses (AdCD39) has protective effects in vivo.

Modulation of nucleoside [correction of nucleotide] triphosphate diphosphohydrolase-1 (NTPDase-1)cd39 in xenograft rejection.

Background: There is increasing evidence showing that extracellular nucleosides [corrected] may be important mediators of vascular inflammation. Nucleoside [corrected] triphosphate diphosphohydrolase-1 (NTPDase-1, identical to CD39), the major vascular endothelial ectonucleotidase, is responsible for the hydrolysis of both extracellular ATP and ADP in the blood plasma to AMP. Studies were therefore conducted to evaluate the role of vascular NTPDase-1/cd39 in modulating platelet activation and vascular injury in cardiac xenografts.

Suppression of delayed xenograft rejection by specific depletion of elicited antibodies of the IgM isotype.

Background: Hamster hearts transplanted into untreated rats undergo delayed xenograft rejection (DXR). This acute inflammatory response is associated with the deposition of anti-graft antibodies of the immunoglobulin (Ig)M isotype in the vasculature. We have previously shown that these antibodies are generated in a T cell-independent manner.

Accommodated xenografts survive in the presence of anti-donor antibodies and complement that precipitate rejection of naive xenografts.

Hamster hearts transplanted into transiently complement-depleted and continuously cyclosporin A (CyA)-immunosuppressed rats survive long-term despite deposition of anti-donor IgM Abs and complement on the graft vascular endothelium. This phenomenon is referred to as "accommodation." The hypothesis tested here is that accommodated xenografts are resistant to IgM Abs and complement that could result in rejection of naive xenografts.

Abdominal aortic aneurysms in aged patients: analysis of risk factors in non-ruptured cases.

Background And Methods: A retrospective analysis of 304 patients (274 males and 30 females) surgically treated for non-ruptured, infrarenal abdominal aortic aneurysm (AAA) to determine the relative contribution of preoperative, operative, and postoperative factors to mortality and to the development of postoperative complications. 1) Risk factors, hospital mortality and long-term survival rate were compared between patients aged 75 or older (- group I; n=79) and those under 75 years of age (group II; n=225). 2) These risk factors were subjected to univariate and multivariate analysis to determine their relative contribution to patient hospital mortality and to the development of major postoperative complications in aged patients.

Rejection of cardiac xenografts by CD4+ or CD8+ T cells.

We recently showed that brief complement inhibition induces accommodation of hamster cardiac transplants in nude rats. We have reconstituted nude rats carrying an accommodated xenograft with syngeneic CD4+ or CD8+ T cells to investigate the cellular mechanism of xenograft rejection. We show that CD4+ T cells can initiate xenograft rejection (10 +/- 1.

Application of the reversed elephant trunk technique during total thoracoabdominal replacement in patients with Marfan's syndrome.

The reversed elephant trunk operation has been applied in patients with extensive aortic involvement as a scheduled staged operation. We report application of the same technique in two patients with Marfan's syndrome. The two patients underwent total replacement of the thoracoabdominal aorta for a DeBakey IIIb aortic dissection.

[Surgical treatment for perforated aorta caused by mediastinitis after bidirectional Glenn shunt and closure of atrial septal defect--a case report].

A 24-year-old man with Ebstein anomaly underwent a bidirectional Glenn shunt and closure of an atrial septal defect. Postsurgical prulent mediastinitis was treated by irrigation and drainage, but was followed by rupture of the ascending aorta. During emergency surgery, hypothermic circulatory arrest became necessary due to massive bleeding.

Expression of heme oxygenase-1 can determine cardiac xenograft survival.

The rejection of concordant xenografts, such as mouse-to-rat cardiac xenografts, is very similar to the delayed rejection of porcine-to-primate discordant xenografts. In concordant models, this type of rejection is prevented by brief complement inhibition by cobra venom factor (CVF) and sustained T-cell immunosuppression by cyclosporin A (CyA). Mouse hearts that survive indefinitely in rats treated with CVF plus CyA express the anti-inflammatory gene heme oxygenase-1 (HO-1) in their endothelial cells and smooth muscle cells.