A case series of favorable vessel dilatation using a nitinol scoring element-equipped helical balloon catheter (AngioSculpt®).

Objective: Although percutaneous transluminal angioplasty is an effective therapy against vascular access failure in hemodialysis patients, recurrent stenosis imposes enormous burden for hemodialysis patients. A nitinol scoring element-equipped helical balloon catheter (AngioSculpt) has been altered the landscape for treating several vascular diseases. It is not, however, fully elucidated whether AngioSculpt for advanced vascular access stenosis, difficult to expand by conventional balloons, successfully provides bailout angioplasty.

New steps of robot-assisted radical prostatectomy using the extraperitoneal approach: a propensity-score matched comparison between extraperitoneal and transperitoneal approach in Japanese patients.

Background: Robot-assisted radical prostatectomy (RARP) is commonly performed using the transperitoneal (TP) approach with six trocars over an 8-cm distance in the steep Trendelenburg position. In this study, we investigated the feasibility and the benefit of using the extraperitoneal (EP) approach with six trocars over a 4-cm distance in a flat or 5° Trendelenburg position. We also introduced four new steps to the surgical procedure and compared the surgical results and complications between the EP and TP approach using propensity score matching.

Ethanol injection into the Marshall vein provoking a pericardial effusion resulting in a fatal complication in a patient with persistent atrial fibrillation.

An EIM (ethanol infusion into the vein of Marshall [VOM]) provoked a fatal complication in a chronic hemodialysis patient. Autopsy revealed a lacerated VOM covered with thrombi as the only potential cause. The EIM caused vascular damage and clots resulting in myocardial necrosis and interstitial bleeding around the lacerated VOM.

Beneficial effects of a gait used while wearing a kimono to decrease the knee adduction moment in healthy adults.

The knee adduction moment (KAM) relates to medial knee osteoarthritis (OA). Several gait modifications to reduce the KAM for the prevention of knee OA have been studied. Most of the modifications, however, involve voluntary changes in leg alignment.

Successful Treatment of Carcinomatous Central Airway Obstruction with Bronchoscopic Electrocautery Using Hot Biopsy Forceps during Mechanical Ventilation.

We report the case of a 72-year-old man with occlusion of the left main bronchus due to squamous cell carcinoma of the lung. He required tracheal intubation and mechanical ventilation because of the aggravation of atelectasis and obstructive pneumonia. Electrocautery using hot biopsy forceps was performed during mechanical ventilation with a 40% fraction of inspired oxygen.

Adrenal Neuroblastoma in an Adult: Effect of Radiotherapy on Local Progression after Surgical Removal.

Here, we report the case of a 62-year-old man with neuroblastoma, which is extremely rare in adults. His tumor was resected, but it recurred four months later. Radiotherapy reduced tumor size, and the patient remained in good health three years after surgical tumor removal.

Predictors of patent false lumen of the aortic arch after hemiarch replacement.

Background: Hemiarch replacement for acute type A aortic dissection is less invasive than total arch replacement but involves increased risk of late aortic arch dilation because of patent false lumen of the aortic arch. If we can predict this risk, it may be a valuable prognostic indicator for selecting surgical procedures for acute type A aortic dissection.

Methods: We reviewed our surgical experience to predict patent false lumen.

Atrophy of submandibular gland by the duct ligation and a blockade of SP receptor in rats.

To clarify the mechanisms underlying the submandibular gland atrophies associated with ptyalolithiasis, morphological changes were examined in the rat submandibular gland following either surgical intervention of the duct or functional blockade at substance P receptors (SPRs). Progressive acinar atrophy was observed after duct ligation or avulsion of periductal tissues. This suggested that damage to periductal tissue involving nerve fibers might contribute to ligation-associated acinar atrophy.

Emergency Pulmonary Embolectomy Using Minimally Invasive Cardiac Surgery.

A 78-year-old man who had undergone operation for acute type A aortic dissection presented with dyspnea and shock. Chest computed tomography revealed pulmonary embolism. Minimally invasive cardiac surgery was performed through a right fourth intercostal skin incision using cardiopulmonary bypass through the right femoral artery and vein.

[Post Fenestrated Thoracic Empyema with Broncopleural Fistula, Healed Successfully without Plombage].

A 60-year-old man was performed right middle and lower bilobectomy. High fever was observed on the 17th postoperative day and the patient was diagnosed as having empyema with bronchopleural fistula(BPF). Chest tube drainage and antibiotics were started followed by open window thoracotomy on the 61st postoperative day.

Oblique venotomy with parallelogram anastomosis in sequential bypass grafting.

The proximal vein graft is incised obliquely and anastomosed to the coronary artery to ensure that the proximal rim of the vein incision is adjusted to the lateral side of the coronary artery incision adjacent to the proximal rim. So the vein graft can be placed perpendicular to the coronary artery without kinking, and the anastomosis orifice can be made wider than those made with diamond anastomosis. Oblique venotomy with parallelogram anastomosis provides sufficient anastomotic flow, allows long incisions, and prevents kinking.

A comprehensive expression analysis of mucins in appendiceal carcinoma in a multicenter study: MUC3 is a novel prognostic factor.

Background: Mucins are implicated in survival in various cancers, but there have been no report addressed on survival in appendiceal carcinoma, an uncommon disease with different clinical and pathological features from those of other colon cancers. We aimed to investigate the clinical implications of expression of mucins in appendiceal carcinoma.

Methods: Expression profiles of MUC1, MUC2, MUC3, MUC4, MUC5AC, MUC6, MUC16 and MUC17 in cancer tissue were examined by immunohistochemistry in 108 cases of surgically resected appendiceal carcinoma.

Outcomes of Robot-Assisted Laparoscopic Prostatectomy with a Posterior Approach to the Seminal Vesicle in 300 Patients.

Background. The goal of this study was to analyze the perioperative outcomes of robot-assisted laparoscopic radical prostatectomies (RALPs) performed at our center. Methodology.

Congenital pericardial defect with ruptured acute type A aortic dissection.

We report 2 cases of congenital pericardial defect with ruptured acute type A aortic dissection. Case 1: An 83-year old man presented with sudden chest and back pain, and computed tomography (CT) showed acute aortic dissection with left pleural massive effusion. Because of his unstable haemodynamic condition with low blood pressure, an emergency operation was performed.

Fundamental wire technique and current standard strategy of percutaneous intervention for chronic total occlusion with histopathological insights.

Currently, successful treatment of chronic total occlusion (CTO) seems markedly improved, due to several new techniques and dedicated device developments. However, this improved success rate is often limited to procedures performed by skilled, highly experienced operators. To improve the overall success rate of percutaneous coronary intervention of CTO from a worldwide perspective, a deeper understanding of CTO histopathology might offer insights into the development of new techniques and procedural strategies.

[Ruptured thoracic aortic aneurysm complicated by acute aortic dissection and aortic valve regurgitation; report of a case].

An 87-year-old man was found loss of consciousness after falling. He was found in a state of shock. Computed tomography showed rupture of aneurysm of the ascending aorta and aortic arch with acute aortic dissection.

[Mobile mass in the descending aorta with multiple embolism].

A 46-year-old man was referred to our hospital for abdominal pain. Computed tomography (CT) revealed mobile mass in the descending aorta and multiple systemic embolism. Emergent operation was indicated.

[Cylindrical patch repair for circumferential subvalvular abscess due to prosthetic valve endocarditis].

A 51-year-old male underwent aortic valve replacement and vascular prosthesis implantation due to an aneurysm of the ascending aorta combined with aortic regurgitation caused by the bicuspid aortic valve. Semi-emergency surgery was performed due to severe paravalvular leakage with prosthetic valve endocarditis 16 months after the 1st operation. The circumferential annular abscess cavities were closed with a cylindrical patch, and a mechanical valve was installed on the upper edge of the sutured cylindrical patch.

Giant cardiac fibroma.

A 29-year-old woman who presented with persistent ventricular premature beat during her delivery was referred to us. Her cardiac echocardiography showed a giant tumor located in the posterior wall of the left ventricle. She had no symptoms of heart failure.

Usefulness of unipolar epicardial ventricular electrogram for triggering of intraaortic balloon counterpulsation during off-pump coronary artery bypass surgery in patients with hemodynamic instability complicating acute coronary syndromes.

During off-pump coronary artery bypass graft (CABG) surgery for patients requiring preoperative intraaortic balloon counterpulsation (IABP) support, errors in timing of IABP during mobilization of the heart can induce unstable hemodynamic conditions. We applied a simple technique for triggering IABP accurately during off-pump CABG: one end of an epicardial pacemaker wire is placed on the surface of the left ventricle, and the other end is linked to one of the precordial V leads. This technique provided an exact detection of R-wave potentials in any position of the heart during the off-pump CABG procedure.

A simple method of triggering balloon counterpulsation accurately during off-pump coronary artery bypass surgery.

With increasing experience, off-pump coronary artery bypass grafting for high-risk patients can be performed safely. However, in patients who need intraaortic balloon counterpulsation support, mistriggering of intraaortic balloon counterpulsation during mobilization of the heart can induce unstable hemodynamic conditions. My colleagues and I have developed a simple method of detecting the trigger signal accurately: an epicardial pacemaker wire is placed close to the apex of the left ventricle, and 1 precordial V lead is disconnected and then linked to the epicardial pacemaker wire.

[A technique for off-pump ablation of atrial fibrillation on beating heart using the epicardial radiofrequency approach].

Recently ablation surgery for atrial fibrillation, so-called maze procedure, has become popular. However, this procedure usually needs cardiopulmonary bypass. Here we describe 3 patients for whom the simple, new procedure in which epicardial radiofrequency ablation is sucessfully done without cardiopulmonary bypass prior to concomitant cardiac operation.

Case of hemorrhagic pancreatic pseudocyst in which ultrasound imaging was useful.

A 50-year-old man was admitted to our institution for upper abdominal pain. The diagnosis was chronic pancreatitis. A pseudocyst 3 cm in diameter had been detected in the head of the pancreas by ultrasonography a year and a half earlier.