Increased infiltration of CD4 T cell in the complement deficient lymphedema model.

Background: Lymphedema is an intractable disease that can be caused by injury to lymphatic vessels, such as by surgical treatments for cancer. It can lead to impaired joint mobility in the extremities and reduced quality of life. Chronic inflammation due to infiltration of various immune cells in an area of lymphedema is thought to lead to local fibrosis, but the molecular pathogenesis of lymphedema remains unclear.

Predictors of In-Hospital Death in Patients With Acute Myocardial Infarction.

Objective: Factors such as age, vital signs, renal function, Killip class, cardiac arrest, elevated cardiac biomarker levels, and ST deviation predict survival in patients with acute myocardial infarction (AMI). However, the existing risk assessment tools lack comprehensive consideration of catheter-related factors, and short-term prognostic predictors are unknown. This study aimed to clarify in-hospital prognostic predictors in hospitalized patients with AMI.

Heat Stroke-Induced Takotsubo Cardiomyopathy With a Concomitant Transient Brugada-Like Electrocardiogram.

A 79-year-old man presented with impaired consciousness, fever with a body temperature of 41.1°C, and an electrocardiogram showing significant ST segment elevation in leads V1-6, coved-type ST elevation in leads V1-3, and partial right bundle branch block. Echocardiography revealed notable left ventricle dysfunction with apex-based akinesis.

Earlobe Creases as a Marker of the Risk for Coronary Atherosclerosis Before Angiography in Elderly and Non-elderly Patients.

Background The close relationship between earlobe creases (ELC) and the presence of coronary artery disease (CAD) has been reported. In addition, this study aimed to determine associations between ELC and the presence, extent, and severity of coronary atherosclerosis assessed by coronary angiography in non-elderly and elderly patients. Methods We assessed 1,086 consecutive patients with suspected CAD by coronary angiography.

Loss of Lower Eyelid Bulge after the Reconstruction of Zygomatic Complex Fractures.

Background: Surgery for zygomatic complex fractures primarily aims to obtain facial symmetry. We investigated facial symmetry specific to lower eyelid bulges following zygomatic complex fractures approached through the lower eyelid.

Methods: Forty-one consecutive patients underwent treatment of zygomatic complex fractures by swinging eyelid approach or subciliary approach.

Application of Free Iliac Bone Flap Based on Superficial Circumflex Iliac Perforators in Mandibular Reconstruction.

We introduce the application of mandibular reconstruction with the superficial circumflex iliac artery (SCIA)-based iliac bone flap. Until now, iliac bone flaps based on the SCIA have been used in relatively small bony and plane defects, such as in the orbital floor, maxilla, distal phalanx, and calcaneus. This flap has minimal donor-site morbidity compared with the conventional deep circumflex iliac artery flap, and it can be harvested simultaneously with tumor resection in most reconstructions, including those in the head and neck.

A case of surgically treated traumatic ptosis caused by scratching by human hand.

The patient was a 49-year-old woman. She had worked at a child welfare facility where she sustained a wound to the left side of her upper eyelid after it was scratched by a child facility resident's finger. One month had passed since the injury when she visited our hospital.

Iatrogenic Atrial Septal Defect After Percutaneous Mitral Valve Repair With the MitraClip System.

This study examines the incidence of iatrogenic atrial septal defect (iASD) after the MitraClip procedure and its influence on echocardiographic and clinical outcomes. We examined 96 patients who underwent a successful MitraClip procedure and who also had baseline and 1-year postprocedure transthoracic echocardiograms. At 1-year follow-up, iASD were observed in 24% of cases.

The impact of left ventricular deformation and dyssynchrony on improvement of left ventricular ejection fraction following radiofrequency catheter ablation in Wolff-Parkinson-White syndrome: A comprehensive study by speckle tracking echocardiography.

Purpose: The purpose of this study was to evaluate left ventricular (LV) deformation and LV dyssynchrony in patients with Wolff-Parkinson-White (WPW) syndrome and to identify the factors that affect the efficacy of radiofrequency catheter ablation (RFCA).

Methods: Thirty patients (26 men, mean age 40 ± 12 years) with WPW syndrome were prospectively recruited for this study. They underwent 2-dimensional transthoracic echocardiography with speckle tracking analysis before RFCA and again within 48 hours after RFCA.

Prognostic importance of sodium level trajectory in acute heart failure.

Low sodium levels are strongly associated with poor prognosis in acute heart failure (AHF); however, the prognostic impact of the sodium level trajectory overtime has not been determined. A secondary analysis of the AQUAMARINE study in which patients with AHF and renal impairment were randomized to receive either tolvaptan or conventional treatment was performed. Sodium levels were evaluated at the baseline and at 6, 12, 24, and 48 h.

Postprocedural Changes of Tricuspid Regurgitation After MitraClip Therapy for Mitral Regurgitation.

The effect of percutaneous mitral valve repair using the MitraClip system on tricuspid regurgitation (TR) has not been well investigated. We retrospectively analyzed 102 consecutive patients who underwent the successful MitraClip procedure, and who also had a preprocedural and 1-year follow-up transthoracic echocardiography. TR severity was graded by standard guideline-recommended criteria.

Early treatment with tolvaptan improves diuretic response in acute heart failure with renal dysfunction.

Background: Poor response to diuretics is associated with worse prognosis in patients with acute heart failure (AHF). We hypothesized that treatment with tolvaptan improves diuretic response in patients with AHF.

Methods: We performed a secondary analysis of the AQUAMARINE open-label randomized study in which a total of 217 AHF patients with renal impairment (eGFR < 60 mL/min/1.

Mitral annular motion in patients after transcatheter MitraClip and mitral valve surgery.

Background: Longitudinal motion of the mitral annulus is an index that reflects left ventricular (LV) function. The aim of this study was to evaluate and compare the effects of transcatheter mitral valve (MV) repair and open heart surgery for mitral regurgitation (MR) on mitral annular motion (MAM).

Methods: We retrospectively analyzed in total 115 patients who underwent isolated transcatheter MV repair using MitraClip (n=50) or surgical MV interventions (n=65, 50 repairs and 15 replacements) for MR.

Echocardiographic Changes in Eosinophilic Endocarditis Induced by Churg-Strauss Syndrome.

Eosinophilic myocarditis may be accompanied by Churg-Strauss syndrome (CSS). We report a case of CSS that was accompanied by myocardial changes in the early stage. A 71-year-old woman complained of mild chest pain at rest, but routine echocardiography did not reveal any endocardial abnormalities.

Prognostic impact of early treatment with tolvaptan in patients with acute heart failure and renal dysfunction.

Background: Renal dysfunction is a common comorbidity in acute heart failure (AHF) patients. The prognostic significance of early treatment with tolvaptan in AHF patients complicated with renal dysfunction has not been elucidated.

Methods: Post hoc analysis was performed on a randomized clinical study for prespecified prognostic endpoints and prespecified subgroups.

Clinical Effectiveness of Tolvaptan in Patients With Acute Heart Failure and Renal Dysfunction.

Background: More efficacious and/or safer decongestive therapy is clearly needed in acute heart failure (AHF) patients complicated by renal dysfunction. We tested the hypothesis that adding tolvaptan, an oral vasopressin-2 receptor antagonist, to conventional therapy with loop diuretics would be more effective treatment in this population.

Methods And Results: A multicenter, open-label, randomized control trial was performed, and 217 AHF patients with renal dysfunction (estimated glomerular filtration rate 15-60 mL • min(-1) • 1.

Momentary and wide aortic regurgitation as an indicator of aortic dissection.

A 55-year-old female with a history of hypertension was admitted for dyspnea, epigastralgia and nausea. A chest X-ray showed pulmonary congestion. Transthoracic echocardiography (TTE) revealed severe left ventricular dysfunction with akinesis of the infero-posterior wall and Doppler color-flow mode showed mild aortic regurgitation (AR).

Eicosapentaenoic Acid combined with optimal statin therapy improves endothelial dysfunction in patients with coronary artery disease.

Purpose: Eicosapentaenoic acid (EPA) has been reported to augment endothelial function and improve clinical outcomes in patients with coronary artery disease (CAD). The purpose of this study was to determine whether EPA could improve residual endothelial dysfunction despite adequate lipid-lowering with statin in CAD patients.

Methods: Eighty patients with established CAD, who had been on statin treatment and had serum low-density lipoprotein cholesterol (LDL-C) levels <100 mg/dl, were randomly assigned to receive either 1,800 mg of EPA daily plus statin (EPA group, n = 40) or statin alone (Control group, n = 40).

Clinical effectiveness of tolvaptan in patients with acute decompensated heart failure and renal failure: design and rationale of the AQUAMARINE study.

Purpose: Over half of all admitted acute decompensated heart failure (ADHF) patients have renal failure. Although diuretics represent the mainstay of treatment strategy even in this population, there are unmet needs for safer and more effective treatment. Tolvaptan is a vasopressin-2 receptor antagonist, and we hypothesized that adding tolvaptan to standard diuretic therapy would be more effective in ADHF patients with renal function impairment.

Aortopulmonary artery fistula: ruptured aneurysm of the distal aortic arch into the pulmonary artery.

Aortopulmonary artery fistula is uncommon, but the clinical outcome is often lethal. A 76-year-old man with a history of acute thoracic aortic dissection 6 years previously was admitted with dyspnea. A chest x-ray showed pleural effusion and pulmonary congestion.

Longitudinal heterogeneity of coronary artery distensibility in plaques related to acute coronary syndrome.

Background: How coronary distensibility contributes to stable or unstable clinical manifestations remains obscure. We postulated that the heterogeneous plaque distensibility is associated with unstable clinical presentations in patients with acute coronary syndrome (ACS).

Methods And Results: Seventeen and 19 ACS-related and -unrelated lesions, respectively, were visualized using intravascular ultrasound imaging with simultaneous intracoronary pressure recording.

Enhancement of ultrasonic thrombus imaging using novel liposomal bubbles targeting activated platelet glycoprotein IIb/IIIa complex--in vitro and in vivo study.

Background: We developed perfluorocarbon gas-containing bubble liposomes (BL) with Arg-Gly-Asp (RGD) sequence-containing peptides, which bind to activated platelet glycoprotein IIb/IIIa complexes. The aim of this study was to examine the enhancing effects in ultrasonic thrombus imaging using these targeted BL in vitro and in vivo.

Methods: Liposomes composed of phosphatidylcholine and cholesterol were manufactured, and RGD peptide was attached by a covalent coupling reaction.

Impact of nitroglycerin and verapamil on coronary arterial distensibility as assessed by intravascular ultrasound.

Objectives: To examine the effects of coronary artery vasodilators on coronary arterial distensibility using intravascular coronary ultrasound (IVUS).

Background: There is limited information on the effect of coronary artery vasodilators on coronary arterial distensibility.

Methods: We studied 20 patients using IVUS.