Influence of the characteristics of Japanese patients on the long-term outcomes after aortic valve replacement: results of a microsimulation.

Objectives: The aim of this study was to explore the influence of the characteristics of Japanese patients on the long-term outcomes after aortic valve replacement with either mechanical or biological prostheses by means of a microsimulation.

Methods: A microsimulation model was used to simulate the lives of patients living in Japan and in the United States after aortic valve replacement. The background mortality data taken from the 21st complete life table of Japan and the bleeding hazard determined from a meta-analysis of long-term results in Japanese institutions were used to simulate Japanese patients.

High-Resolution Imaging of Patients with Bietti Crystalline Dystrophy with CYP4V2 Mutation.

The purpose of this study was to determine the retinal morphology of eyes with Bietti crystalline dystrophy (BCD) associated with a CYP4V2 mutation using high-resolution imaging techniques. Three subjects with BCD underwent detailed ophthalmic examinations. High-resolution fundus images were obtained with an adaptive optics (AO) fundus camera.

The melatonin receptor agonist is effective for free-running type circadian rhythm sleep disorder: case report on two sighted patients.

Along with urbanization of the living environment, the number of patients with circadian rhythm sleep disorder (CRSD) has been increasing. There are several treatment candidates for CRSD, such as light therapy, drugs (melatonin and vitamin B12), and sleep hygiene education. However, successful treatment method has not been established.

Feasibility of neuromuscular electrical stimulation immediately after cardiovascular surgery.

Objective: To determine the safety and feasibility of neuromuscular electrical stimulation (NMES) from postoperative days (PODs) 1 to 5 after cardiovascular surgery.

Design: Pre-post interventional study.

Setting: Surgical intensive care unit and thoracic surgical ward of a university hospital.

Brain protection during ascending aortic repair for Stanford type A acute aortic dissection surgery. Nationwide analysis in Japan.

Background: The optimal brain protection strategy for use during acute type A aortic dissection surgery is controversial.

Methods And Results: We reviewed the results for 2 different methods: antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion (RCP), during ascending aortic repair for acute type A aortic dissection for the period between 2008 and 2012 nationwide. Cases involving root repair, arch vessel reconstruction and/or concomitant procedures were excluded.

Metal-free C-H bond activation of branched aldehydes with a hypervalent iodine(III) catalyst under visible-light photolysis: successful trapping with electron-deficient olefins.

Direct acyl radical formation of linear aldehydes (RCH2-CHO) and subsequent hydroacylation with electron-deficient olefins can be effected with various types of metal and nonmetal catalysts/reagents. In marked contrast, however, no successful reports on the use of branched aldehydes have been made thus far because of their strong tendency of generating alkyl radicals through the facile decarbonylation of acyl radicals. Here, use of a hypervalent iodine(III) catalyst under visible light photolysis allows a mild way of generating acyl radicals from various branched aldehydes, thereby giving the corresponding hydroacylated products almost exclusively.

[Cerebral blood flow monitoring].

Cerebral ischemic events remain a major problem in patients undergoing cardiac and thoracic aortic surgery. Efforts to improve outcomes have been made in many aspects which include cerebral monitoring. New technology is making it possible to shed a light to the brain, which historically used to be a black box during general anesthesia in the operating room.

Cervical aortic arch with multiple aortic aneurysms that required two aortic replacements with a 34-year interval.

A 57-year old female was referred to our hospital after symptoms of hoarseness and dysphagia for a few years. She was diagnosed with a cervical vessel anomaly during childhood and had undergone surgery for a right-sided thoracic descending aortic aneurysm through a right thoracotomy at the age of 23 years. Now, enhanced computed tomography revealed newly developed multiple aneurysms in the aorta between the left carotid artery and the proximal descending aorta in the left hemithorax.

Mesenchymal stem cells for treatment of aortic aneurysms.

An aortic aneurysm (AA) is a silent but life-threatening disease that involves rupture. It occurs mainly in aging and severe atherosclerotic damage of the aortic wall. Even though surgical intervention is effective to prevent rupture, surgery for the thoracic and thoraco-abdominal aorta is an invasive procedure with high mortality and morbidity.

Chondroma of the diaphragm mimicking a giant liver tumor with calcification: report of a case.

Extraskeletal chondroma is an unusual benign tumor, which rarely arises in the diaphragm. We report a case of chondroma of the diaphragm in a 31-year-old woman. Initially, a benign liver tumor with calcification was suspected, based on pre and intraoperative examination findings.

Fibrinogen concentrate administration attributes to significant reductions of blood loss and transfusion requirements in thoracic aneurysm repair.

Background: Repair of thoracic aortic aneurysm (TAA) is often associated with massive hemorrhage aggravated by dilutional coagulopathy with severe hypofibrinogenemia. Although only fresh frozen plasma (FFP) is available for acquired hypofibrinogenemia in Japan, the hemostatic effect of FFP has not been enough for dilutional coagulopathy in TAA surgery. There are increasing reports suggesting that fibrinogen concentrate may be effective in controlling perioperative bleeding and reducing transfusion requirements.

Postmortem lung features in drowning cases on computed tomography.

Purpose: We sought to compare postmortem chest computed tomography (CT) features of drowning cases with autopsy findings, and to classify these features.

Materials And Method: We performed a retrospective analysis of high-resolution and multi-planar reconstruction chest CT images of drowning in 92 adults (54 men, 38 women; mean age 65.4 years) scanned before forensic autopsy.

Surgical management of infected thoracic aneurysms.

Infected thoracic aortic aneurysm (ITAA) is a relatively rare disease. The diagnosis of ITAA is generally made comprehensively based on symptoms, laboratory data and CT findings. Several series of blood cultures are mandatory to first detect the infecting organism.

Long-term outcome of the carpentier-edwards pericardial valve in the aortic position in Japanese patients.

Background:  According to the Japanese Circulation Society guidelines, a bioprosthesis is recommended for aortic valve replacement (AVR) in patients aged ≥65 years who have no risk factors for thromboembolism. There are few data, however, regarding the actual durability of bioprosthetic valves in Japanese patients. The purpose of this study was to assess the long-term durability of Carpentier-Edwards pericardial (CEP) valves in Japanese AVR patients, and to assess the risk factors for reoperation due to structural valve deterioration (SVD).

Therapeutic potential of bone marrow-derived mesenchymal stem cells in formed aortic aneurysms of a mouse model.

Objectives: An aortic aneurysm (AA) is caused by atherosclerosis with chronic inflammation. Mesenchymal stem cells (MSCs) have potential anti-inflammatory properties. In this study, we examined whether an already-formed AA can be treated by intravenous injection of bone marrow-derived (BM)-MSCs in a mouse model.

P-cadherin promotes ovarian cancer dissemination through tumor cell aggregation and tumor-peritoneum interactions.

Unlabelled: More than 60% of patients who are diagnosed with epithelial ovarian cancer (EOC) present with extensive peritoneal carcinomatosis. EOC cells typically disseminate by shedding into the peritoneal fluid in which they survive as multicellular aggregates and then implant onto peritoneal surfaces. However, the mechanism that facilitates aggregation and implantation of EOC cells is poorly understood.

Effects of tricuspid valve surgery on tricuspid regurgitation in patients with hypoplastic left heart syndrome: a non-randomized series comparing surgical and non-surgical cases.

Objectives: Tricuspid regurgitation (TR) remains a significant risk factor affecting the survival of patients with hypoplastic left heart syndrome (HLHS). We performed this study to investigate differences in the clinical course based on the timing of the development of TR and the effects of tricuspid valve surgery (TVS).

Methods: One hundred and five patients of classic HLHS underwent staged operations from May 1991 to July 2010.

[A study of laparoscopic stoma creation for patients with malignant bowel obstruction].

Unlabelled: We evaluated the efficacy of laparoscopic palliative stoma creation for patients with malignant bowel obstruction (MBO).

Patients And Methods: Twenty-four patients with MBO who underwent laparoscopic stoma creation between January 2009 and December 2012 were studied and their clinical outcome was evaluated retrospectively.

Results: Compared to the open approach, the laparoscopic approach led to significantly shorter operation times and a significantly lower incidence of surgical site infection( SSI).

TEVAR for type B aortic dissection in Japan.

TEVAR is a new strategy for treating both acute and chronic type B aortic dissection. The JSC guidelines classify TEVAR as a Class I recommendation for cases of complicated acute type B dissection and a Class IIa recommendation for cases of chronic type B aortic dissection. While TEVAR has been primarily applied to treat complicated acute type B aortic dissection in Europe and the USA, the procedure remains an off-label treatment strategy for aortic dissection in Japan.

Sudden, unexpected infant death due to pulmonary arterial hypertension.

A 3-year-old girl with no particular medical history complained of a stomachache and died on the way to the hospital. The autopsy revealed marked right ventricular hypertrophy and dilation with no other cardiac abnormalities. Microscopically, the pulmonary small arteries showed marked medial hypertrophy and varying degrees of intimal and adventitial thickening.

The validity of the PAM-RL device for evaluating periodic limb movements in sleep and an investigation on night-to-night variability of periodic limb movements during sleep in patients with restless legs syndrome or periodic limb movement disorder using this system.

Background: The status of night-to-night variability for periodic limb movements in sleep (PLMS) has not been clarified. With this in mind, we investigated the validity of PLMS measurement by actigraphy with the PAM-RL device in Japanese patients with suspected restless legs syndrome (RLS) or periodic limb movement disorder (PLMD) and the night-to-night variability of PLMS among the subjects.

Methods: Forty-one subjects (mean age, 52.

[Surgical strategy for extended aortic arch aneurysm].

The management of an extended aortic arch aneurysm still remains a clinical challenge. Open surgery can be invasive for the patients with comorbidities. Since thoracic endovascular aneurysm repair (TEVAR) was introduced, hybrid therapy has been applied for the extended arch aneurysm.

Sympathetic innervation induced in engrafted engineered cardiomyocyte sheets by glial cell line derived neurotrophic factor in vivo.

The aim of myocardial tissue engineering is to repair or regenerate damaged myocardium with engineered cardiac tissue. However, this strategy has been hampered by lack of functional integration of grafts with native myocardium. Autonomic innervation may be crucial for grafts to function properly with host myocardium.