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Nakamura K, Arai S, Kobayashi K, Nakai S, Sho R, Ishizawa A, Watanabe D, Hirooka S, Ohba E, Mizumoto M, Kuroda Y, Kim C, Uchino H, Shimanuki T, Uchida T. Safe and promising outcomes of in-hospital preoperative rehabilitation for coronary artery bypass grafting after an acute coronary syndrome. BMC Cardiovasc Disord 2024; 24:139. [PMID: 38438846 PMCID: PMC10910820 DOI: 10.1186/s12872-024-03757-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE In patients with stable hemodynamic status after an acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) after preoperative investigations can provide outcomes comparable to those of emergency surgery. However, no established guidelines exist regarding the preparation period before surgery. We report the results of the use of an inpatient cardiac rehabilitation program followed by CABG after an ACS to improve post-operative outcomes and prognosis after discharge. METHODS From 2005 to 2017, 471 patients underwent either isolated or combined CABG at our institution, and of those, the 393 who received isolated CABG were included in the analysis. Twenty-seven patients (6.9%) were admitted with ACS and underwent preoperative rehabilitation before undergoing CABG, with a subsequent review of surgical morbidity and mortality rates. Propensity score matching yielded a cohort of 26 patients who underwent preoperative rehabilitation (group A) and 26 controls (group B). Preoperative characteristics were similar between groups. RESULTS The completion rate of the rehabilitation program was 96.3%. All programs were conducted with inpatients, with an average length of stay of 23 ± 12 days. All patients completed in-bed exercises, and 85% completed out-of-bed exercises. The 30-day postoperative mortality was 0% in both groups A and B, and the rate of postoperative major adverse cardiac or cerebrovascular events at 12 months did not differ significantly between groups (7.7% vs 3.9%, respectively; p = 1.0). The duration of mechanical ventilation (1.3 ± 0.3 vs 1.5 ± 0.3 days, respectively; p = 0.633), length of intensive care unit stay (4.4 ± 2.1 vs 4.8 ± 2.3 days, respectively; p = 0.584) and length of hospital stay (25 ± 13 vs 22 ± 9 days, respectively; p = 0.378) did not differ significantly between groups. CONCLUSIONS No complications of preoperative rehabilitation were observed, suggesting that it is an acceptable option for patients who experience ACS and undergo CABG. These results are promising in offering more robust designs of future trials.
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Affiliation(s)
- Ken Nakamura
- Division of Cardiovascular Surgery, Nihonkai General Hospital, Sakata, Japan.
| | - Shusuke Arai
- Division of Cardiovascular Surgery, Nihonkai General Hospital, Sakata, Japan
| | - Kimihiro Kobayashi
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shingo Nakai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Ri Sho
- Department of Public Health, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Ai Ishizawa
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Daisuke Watanabe
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shuto Hirooka
- Division of Cardiovascular Surgery, Nihonkai General Hospital, Sakata, Japan
| | - Eiichi Ohba
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Masahiro Mizumoto
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Cholsu Kim
- Division of Cardiovascular Surgery, Nihonkai General Hospital, Sakata, Japan
| | - Hideaki Uchino
- Division of Cardiovascular Surgery, Nihonkai General Hospital, Sakata, Japan
| | - Takao Shimanuki
- Division of Cardiovascular Surgery, Nihonkai General Hospital, Sakata, Japan
| | - Tetsuro Uchida
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
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Suzuki F, Okamoto S, Nakai S, Miyagi S, Tsujiguchi H, Hara A, Nguyen TTT, Shimizu Y, Hayashi K, Suzuki K, Kasahara T, Nakamura M, Takazawa C, Ogawa A, Shibata A, Kannon T, Tajima A, Tsuboi H, Ogino N, Konoshita T, Takamura T, Sato K, Nakamura H. Association between animal protein intake, oral frailty and calf circumference in middle-aged and older adults: a cross-sectional analysis from the Shika study. BMJ Open 2024; 14:e078129. [PMID: 38365294 PMCID: PMC10875535 DOI: 10.1136/bmjopen-2023-078129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/03/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE To investigate the relationship between oral frailty (OF), nutrient intake and calf circumference (CC) in middle-aged and older adults. DESIGN Cross-sectional study. SETTING Residents of four model districts of Shika town, Ishikawa Prefecture, Japan, using data from November 2017 to February 2018. PARTICIPANTS One hundred and ninety-four residents aged ≥50 years in four model districts of Shika town. The OF total score ≥3 was defined as OF. Participants were divided into OF and non-OF groups and divided into the low-CC/kg and the high-CC/kg groups. OUTCOME MEASURES The primary outcome is to use a two-way analysis of covariance to analyse the interaction between the two CC/kg groups and the two OF groups on nutrition intake. The secondary outcome is to use multiple regression analysis to investigate the nutrients significantly related to CC/kg when stratified by OF, with age, sex, body mass index, drinking status, smoking status and regular exercise as input covariates. RESULTS A two-way analysis of covariance revealed a significant interaction between the two CC/kg groups and the two OF groups on animal protein intake (p=0.039). Multiple comparisons using the Bonferroni analysis revealed a significantly lower animal protein intake in the OF group than in the non-OF group with a low CC/kg (p=0.033) but not in the group with a high CC/kg. The multiple regression analysis stratified by OF revealed a positive correlation between animal protein intake and CC/kg (p=0.002). CONCLUSIONS The present results revealed a significantly lower animal protein intake in the OF group than in the non-OF group in the low-CC/kg group, but no such difference was observed in the high-CC/kg group. Further longitudinal studies are needed to elucidate this relationship.
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Affiliation(s)
- Fumihiko Suzuki
- Department of Geriatric Dentistry, Ohu University School of Dentistry, Koriyama, Japan
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Shigefumi Okamoto
- Laboratory of Medical Microbiology and Microbiome, Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University, Suita, Osaka, Japan
| | - Shingo Nakai
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, Kanazawa, Japan
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
| | - Akinori Hara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
| | - Thao Thi Thu Nguyen
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Viet Nam
| | - Yukari Shimizu
- Faculty of Health Sciences, Department of Nursing, Komatsu University, Komatsu, Japan
| | - Koichiro Hayashi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Keita Suzuki
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
| | - Tomoko Kasahara
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Chie Takazawa
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Aya Ogawa
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Aki Shibata
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Takayuki Kannon
- Department of Biomedical Data Science, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Atsushi Tajima
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Hirohito Tsuboi
- Graduate School of Human Nursing, The University of Shiga Prefecture, Hikone, Japan
| | - Noriyoshi Ogino
- Department of Environmental Medicine, Faculty of Medicine, Kochi University, Kochi, Japan
- Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tadashi Konoshita
- Division of Diabetes Endocrinology and Metabolism, Yachiyo Medical Center, Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - Toshinari Takamura
- Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kuniko Sato
- Laboratory of Clinical Cognitive Neuroscience, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
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Ohba E, Kuroda Y, Mizumoto M, Ishizawa A, Watanabe D, Nakai S, Kobayashi K, Uchida T. [Left Atrial Appendage Closure with Various Types of Surgical Technique and Its Results]. Kyobu Geka 2024; 77:27-33. [PMID: 38459842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Abstract
BACKGROUND Occlusion of the left atrial appendage( LAA) may prevent stroke in patients with atrial fibrillation. In this study, we reviewed various types of LAA occlusion techniques and results of patients underwent surgical LAA closure. METHODS Between 2004 and 2022, 182 patients who underwent surgical LAA closure were enrolled in this study. RESULTS The surgical LAA closure consisted of 90 cases of closure device, AtriCure, 63 cases of surgical excision, 13 cases of stapler excision, 3 cases of ligation, and 13 cases of internal suture ligation. During the follow-up period, there were no deaths owing to cardiogenic emboli and no cerebral infarctions. CONCLUSIONS Regardless of the surgical techniques, LAA closure was effective in preventing cardiogenic stroke. The AtriClip is a safe, simple, and effective and thoracoscopic LAA closure using AtriClip is expected as a less-invasive LAA management.
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Affiliation(s)
- Eiichi Ohba
- Department of Surgery Ⅱ, Yamagata University, Yamagata, Japan
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Uchida T, Kuroda Y, Mizumoto M, Ishizawa A, Watanabe D, Nakai S, Kobayashi K. [Surgical Treatment of Extensive Annular Defects by Aortic Valve Infective Endocarditis Using Stentless Bioprosthesis]. Kyobu Geka 2023; 76:289-296. [PMID: 36997177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
BACKGROUND The optimal surgical technique and valve prosthesis in patients with active aortic valve infective endocarditis with annular abscess is controversial. If extensive annular defects occur after debridement, standard techniques are difficult;more complex aortic root replacement is inevitable. The SOLO SMART stentless bioprosthesis is specially designed for supra-annular implantation without annular stitches. METHODS Since 2016, 15 patients with active aortic valve infective endocarditis underwent aortic valve surgery. Of these, we performed aortic valve replacement using the SOLO SMART valve in six patients with extensive annular destruction and complex aortic root pathologies requiring reconstruction. RESULTS Although more than two-thirds of the annular structure was missing after radical debridement of infected tissues, supra-annular aortic valve replacement with the SOLO SMART valve could be performed successfully in all six patients. All patients are doing well without prosthetic valve dysfunction and/or recurrent infection. CONCLUSIONS The supraannular aortic valve replacement using the SOLO SMART valve is considered to be a useful alternative to standard aortic valve replacement in patients complicated with extensive annular defect. It is a simple and technically less demanding alternative to aortic root replacement.
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Affiliation(s)
- Tetsuro Uchida
- Department of Surgery II, Yamagata University Faculty of Medicine, Yamagata, Japan
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Nakai S, Suzuki F, Okamoto S, Miyagi S, Tsujiguchi H, Hara A, Nguyen TTT, Shimizu Y, Hayashi K, Suzuki K, Kasahara T, Nakamura M, Takazawa C, Kannon T, Tajima A, Tsuboi H, Ogino N, Konoshita T, Takamura T, Nakamura H. Association between Bone Mineral Density and Oral Frailty on Renal Function: Findings from the Shika Study. Healthcare (Basel) 2023; 11:314. [PMID: 36766889 PMCID: PMC9913924 DOI: 10.3390/healthcare11030314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
The association between oral frailty (OFr) and body action has been investigated, but its association with systemic function remains unclear. Therefore, this cross-sectional study examined the association between OFr with decreased bone mineral density (BMD) and renal function in residents of Shika town, Ishikawa Prefecture, Japan aged ≥40 years. This study included 400 inhabitants. The OFr total score was assessed using three oral domains in the Kihon Checklist (a self-reported comprehensive health checklist), the number of teeth, and brushing frequency per day. Measurements were the estimated glomerular filtration rate (eGFR) and the osteo-sono assessment index (OSI). Using a two-way analysis of covariance (p = 0.002), significantly lower OSI was indicated in the eGFR < 60 and OFr group than in the eGFR of < 60 and non-OFr group after adjusting for age, body mass index, and drinking and smoking status as confounding factors. Multiple logistic regression analysis confirmed this relationship (p = 0.006). Therefore, lower BMD seems to be associated with lower renal function only when accompanied by OFr. Further longitudinal studies are needed to confirm these results.
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Affiliation(s)
- Shingo Nakai
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
| | - Fumihiko Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Community Medicine Support Dentistry, Ohu University Hospital, Koriyama 963-8611, Japan
| | - Shigefumi Okamoto
- Advanced Health Care Science Research Unit, Innovative Integrated Bio-Research Core, Institute for Frontier Science Initiative, Kanazawa University, Kanazawa 920-0942, Japan
- Department of Clinical Laboratory Sciences, Faculty of Health Sciences, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa 920-0942, Japan
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
| | - Akinori Hara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
| | - Thao Thi Thu Nguyen
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Ngo Quyen, Hai Phong 180000, Vietnam
| | - Yukari Shimizu
- Faculty of Health Sciences, Department of Nursing, Komatsu University, 14-1 Mukaimotorimachi, Komatsu 923-0961, Japan
| | - Koichiro Hayashi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
| | - Keita Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Tomoko Kasahara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Chie Takazawa
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Takayuki Kannon
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Atsushi Tajima
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Hirohito Tsuboi
- Graduate School of Human Nursing, The University of Shiga Prefecture, 2500 Hassaka-cho, Hikone 522-8533, Japan
| | - Noriyoshi Ogino
- Department of Environmental Medicine, Faculty of Medicine, Kochi University, Kohasu, Oko-cho, Nankoku 783-8505, Japan
- Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Tadashi Konoshita
- Third Department of Internal Medicine, University of Fukui Faculty of Medical Sciences, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
| | - Toshinari Takamura
- Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Sciences, Kanazawa 920-8640, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
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Kobayashi K, Kuroda Y, Nakai S, Arai S, Uchida T. Multiple Anastomotic Dehiscences After the Bentall Procedure for Aortitis Syndrome. Heart Lung Circ 2022; 31:e153-e155. [PMID: 36038468 DOI: 10.1016/j.hlc.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/14/2022] [Accepted: 07/29/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Kimihiro Kobayashi
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan.
| | - Yoshinori Kuroda
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shingo Nakai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shusuke Arai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tetsuro Uchida
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
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Asai A, Suzuki F, Tsujiguchi H, Hara A, Miyagi S, Kannon T, Suzuki K, Nakamura M, Shimizu Y, Nguyen TTT, Pham KO, Kasahara T, Nakai S, Hayashi K, Shibata A, Amatsu T, Konoshita T, Kambayashi Y, Tsuboi H, Tajima A, Nakamura H. Relationship between fatty acid intake and chronic neck/shoulder/upper limb pain without elevated CRP in a Japanese population: a cross-sectional analysis of the Shika study. J Nutr Sci 2022; 11:e38. [PMID: 35720172 PMCID: PMC9161036 DOI: 10.1017/jns.2022.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/30/2022] [Accepted: 05/05/2022] [Indexed: 01/08/2023] Open
Abstract
Although chronic pain (CP) is classified as inflammatory or non-inflammatory, the involvement of fatty acid intake in this process has not yet been examined in detail. Therefore, the present study investigated whether the relationship between CP and fatty acid intake differs between high and low C-reactive protein (CRP) levels in middle-aged and elderly individuals in the Shika study. One-thousand and seven males and 1216 females with mean ages of 68⋅78 and 69⋅65 years, respectively, participated in the present study. CRP was quantified by blood sampling from participants who responded to a CP questionnaire. The brief-type self-administered diet history questionnaire (BDHQ) was used to assess fatty acid intake. Interactions were observed between CP and CRP on monounsaturated fatty acids (MUFA) and eicosadienoic acid in a two-way analysis of covariance adjusted for sex, age, lack of exercise, lack of sleep, current smoking and drinking status, and BMI. MUFA (OR 1⋅359) and eicosadienoic acid (OR 1⋅072) were identified as significant independent variables for CP in a multiple logistic regression analysis, but only in the low CRP group. Only a high intake of MUFA and eicosadienoic acid was associated with chronic neck/shoulder/upper limb pain without elevated CRP. In psychogenic and neuropathic pain without elevated CRP, an increased intake of MUFA and eicosadienoic acid, a family member of n -6 fatty acids, appears to affect CP. Further longitudinal studies are needed to elucidate this relationship.
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Affiliation(s)
- Atsushi Asai
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Fumihiko Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
- Community Medicine Support Dentistry, Ohu University Hospital, Koriyama, Fukushima 963-8611, Japan
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Akinori Hara
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan
| | - Takayuki Kannon
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Keita Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
| | - Yukari Shimizu
- Department of Nursing, Faculty of Health Sciences, Komatsu University, 14-1 Mukaimotorimachi, Komatsu, Ishikawa 923-0961, Japan
| | - Thao Thi Thu Nguyen
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Ngo Quyen, Hai Phong 180000, Vietnam
| | - Kim Oanh Pham
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Tomoko Kasahara
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Shingo Nakai
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Koichiro Hayashi
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Aki Shibata
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
| | - Takashi Amatsu
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Tadashi Konoshita
- Third Department of Internal Medicine, University of Fukui Faculty of Medical Sciences, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
| | - Yasuhiro Kambayashi
- Department of Public Health, Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoinooka, Imabari, Ehime 794-8555, Japan
| | - Hirohito Tsuboi
- Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 1 Kakuma-machi, Kanazawa 920-1192, Japan
| | - Atsushi Tajima
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
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8
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Kobayashi K, Mizumoto M, Kuroda Y, Ishizawa A, Watanabe D, Nakai S, Arai S, Uchida T. Constrictive pericarditis caused by pericardial substitution using expanded polytetrafluoroethylene. J Card Surg 2022; 37:2429-2431. [PMID: 35526126 DOI: 10.1111/jocs.16585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/16/2022] [Accepted: 04/26/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Expanded polytetrafluoroethylene (ePTFE) is commonly used as a pericardial substitute during cardiac surgery to prevent cardiac injury during re-sternotomy. However, although rare, constrictive pericarditis associated with ePTFE has been reported. MATERIAL, METHODS AND RESULTS Here, we report a rare case of constrictive pericarditis developed due to severe restriction of cardiac motion associated with the ePTFE membrane used as a pericardial substitute. Hemodynamic improvement has been achieved by surgical removal of the ePTFE membrane and exudates within the overlapped portion of the ePTFE membranes, and dissection of the epicardial fibrous thickening. CONCLUSION Considering the risk of constrictive pericarditis, we believe that the use of ePTFE membranes as a pericardial substitute should be carefully indicated for only selected patients.
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Affiliation(s)
- Kimihiro Kobayashi
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Masahiro Mizumoto
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Ai Ishizawa
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Daisuke Watanabe
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shingo Nakai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shusuke Arai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tetsuro Uchida
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
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9
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Suzuki D, Kuroda Y, Mizumoto M, Ishizawa A, Watanabe D, Nakai S, Kobayashi K, Arai S, Uchida T. [Stanford Type B Acute Aortic Dissection Associated with Transcatheter Aortic Valve Implantation:Report of a Case]. Kyobu Geka 2022; 75:307-311. [PMID: 35342163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Transcatheter aortic valve implantation (TAVI)-related Stanford type B aortic dissection is an extremely rare but potentially fatal complication. Here, we present a case of 82-year-old man who developed acute type B aortic dissection during transfemoral TAVI. During successful TAVI procedure, dissection in the descending aorta was demonstrated by transesophageal echocardiography. Computed tomography( CT) clearly showed Stanford type B aortic dissection and an intimal tear in severely tortuous part of the descending aorta. Cause of aortic dissection was supposed to be related to the guidewire or the device that passed across affected position. The patient showed no complication associated with aortic dissection, such as rupture or malperfusion. Therefore, he was treated conservatively, and follow-up CT confirmed progressive clotting of the false lumen. Although the indication for TAVI has got broaden recently, physicians should be always aware of possible aortic dissection.
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Affiliation(s)
- Daiki Suzuki
- Second Department of Surgery, Yamagata University, Yamagata, Japan
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10
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Takahara S, Mizumoto M, Kuroda Y, Oba E, Yamashita A, Ishizawa A, Nakai S, Kobayashi K, Ochiai T, Arai S, Uchida T. [Successful Surgical Repair of Left Coronary Ostial Aneurysm after Modified Bentall Procedure Using the Carrel Patch Technique]. Kyobu Geka 2022; 75:169-174. [PMID: 35249947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A 38-year-old woman underwent aortic root surgery using the Carrel patch technique at the age of 14 years for annuloaortic ectasia of 59 mm. Although there were no clinical findings of Marfan syndrome or bicuspid aortic valve, the pathological findings of the aortic aneurysmal wall showed degeneration of the media. After 24 years, contrast-enhanced computed tomography (CT) showed an enlargement of the left coronary ostial aneurysm of 17 mm with saccular formation. Re-coronary reconstruction with the Piehler technique using an 8 mm Dacron graft was performed. The post-operative course was uneventful, and post-operative CT showed no pseudoaneurysm or stenosis at the anastomosis sites. The Carrel patch coronary ostial reconstruction has been shown to reduce coronary anastomotic pseudoaneurysms and to improve aortic root surgical outcomes. However, coronary ostial aneurysm is a true aneurysm and one of the later complications after the modified Bentall procedure using the Carrel patch technique. Although it is common in Marfan syndrome, the consensus on diagnosis, operative indication, and surgical procedure have not yet been established. Not only in Marfan syndrome, but also after coronary artery reconstruction using the Carrel patch technique, longer-term follow-up is necessary to take care for aneurysmal formation at coronary ostium.
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11
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Ochiai T, Mizumoto M, Kuroda Y, Oba E, Yamashita A, Ishizawa A, Nakai S, Kobayashi K, Matsuo S, Arai S, Uchida T. [Aortic Root Replacement with Patch Closure of Membranous Ventricular Septal Aneurysm]. Kyobu Geka 2022; 75:175-179. [PMID: 35249948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Membranous ventricular septal aneurysm (MSA) complicated with annuloaortic ectasia (AAE) is rare in adults. Herein, we reported two successful surgical cases of this setting. One case is 50-year-old man with extensive infective endocarditis with underwent aortic coarctation repair in childhood. MSA was incidentally diagnosed at preoperative examination. The other patient is 53-year-old man who had severe aortic regurgitation complicated with AAE and membranous type ventricular septal defect with MSA. Simultaneous surgery comprising patch closure of MSA and aortic root replacement was performed in both patients. As for patch closure of MSA, the technical modification should be necessitated according to the fragility of the upper margin of the MSA.
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Affiliation(s)
- Tomonori Ochiai
- Second Department of Surgery, Yamagata University, Yamagata, Japan
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12
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Kobayashi K, Yamashita A, Kuroda Y, Nakai S, Arai S, Uchida T. Unexpected Bare Metal Stent Migration Associated With Aortic Remodeling After PETTICOAT Technique for Aortic Dissection. J Endovasc Ther 2022; 30:302-306. [PMID: 35114830 DOI: 10.1177/15266028221075548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report a unique case of bare metal stent migration in the overlapping zone and subsequent distal stent graft-induced new entry (SINE) after the Provisional Extension to Induce a Complete Attachment (PETTICOAT) technique for aortic dissection. CASE REPORT A 67-year-old man underwent thoracic endovascular aortic repair (TEVAR) using the PETTICOAT technique for acute complicated type B aortic dissection. The postoperative course was uneventful, and follow-up computed tomography (CT) showed not only favorable aortic remodeling but also progressive bare metal stent migration in the overlapping zone between the stent graft and the bare metal stent. A 6-month postoperative CT revealed a distal SINE, and the patient underwent re-TEVAR to cover the new entry. Postoperative CT demonstrated successful repair of the distal SINE. The patient is currently in good health 2 years after the reintervention. CONCLUSION Surgeons should consider the potential risk of device migration due to favorable aortic remodeling after TEVAR for aortic dissection, especially with the use of additional bare metal stents.
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Affiliation(s)
- Kimihiro Kobayashi
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Atsushi Yamashita
- Department of Cardiovascular Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shingo Nakai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shusuke Arai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tetsuro Uchida
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
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13
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Nakai S, Uchida T, Kuroda Y, Yamashita A, Ohba E, Mizumoto M, Hayashi J, Kobayashi K, Ochiai T. Endovascular Repair for Abdominal Aortic Aneurysm Rupture With Neurofibromatosis Type 1. Ann Vasc Surg 2022; 79:439.e1-439.e4. [PMID: 34648864 DOI: 10.1016/j.avsg.2021.07.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/11/2021] [Accepted: 07/18/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1), also known as von Recklinghausen disease, is a rare congenital disorder with an autosomal dominant inheritance. Severe perioperative complications owing to the congenital fragility of the vascular wall in NF1 patients have been reported. The optimal vascular surgical approach remains controversial. We describe endovascular aortic repair of an abdominal aortic aneurysm rupture in a patient with NF1. CASE PRESENTATION A 78-year-old woman with NF1 was transferred to our institution with a diagnosis of ruptured abdominal aortic aneurysm. The patient showed multiple café-au-lait spots, numerous neurofibromatosis, and severe scoliosis. Emergency endovascular aortic repair was performed, without technical difficulty. Despite an uneventful postoperative course, she developed an idiopathic left cervical hematoma caused by hemorrhage, and required tracheostomy due to severe airway obstruction. In addition, postoperative CT showed a newly developed saccular aneurysm at the proximal end of the stent graft. On postoperative day 40, she was transferred to a rehabilitation hospital, without recurrent bleeding and saccular aneurysm enlargement. CONCLUSION In patients with NF1 who require a vascular surgical procedure, surgeons should consider the vascular wall fragility in selecting the optimal treatment strategy and the possible complications.
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Affiliation(s)
- Shingo Nakai
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.
| | - Tetsuro Uchida
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Atsushi Yamashita
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Eiichi Ohba
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Masahiro Mizumoto
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Jun Hayashi
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Kimihiro Kobayashi
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tomonori Ochiai
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
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14
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Mizumoto M, Uchida T, Kuroda Y, Oba E, Yamashita A, Ishizawa A, Nakai S, Kobayashi K, Ochiai T, Matsuo S, Arai S. [Successful Surgical Repair for Adult Ebstein Disease Using Cone Reconstruction Combined with One and a Half Ventricle Repair]. Kyobu Geka 2022; 75:92-97. [PMID: 35249083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A 67-year-old woman presented with dyspnea on effort and cyanosis due to massive tricuspid regurgitation and an atrial septal defect with right to left shunt. She was diagnosed with Ebstein disease at the age of 53 when she underwent surgery for varicose veins. Echocardiography showed the severe apical displacement of the septal and posterior leaflet. The anterior leaflet also partially displaced to the apex and demonstrated tethering caused by a dilated right ventricle. Cardiac magnetic resonance imaging showed a dilated right atrium and an enlarged atrialized right ventricle, in addition to marked low cardiac output in the dilated right ventricle. The surgical findings corresponded to Carpentier classification type C. Cone reconstruction was performed. Bidirectional Glenn anastomosis was reguired because of low cardiac output in the remaining functional right ventricle after Cone reconstruction. The patient's postoperative course was uneventful, and tricuspid regurgitation and stenosis remained mild. The patients had no occurrence of right heart failure or arrhythmia for two years after surgery.
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Affiliation(s)
- Masahiro Mizumoto
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
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15
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Nakai S, Uchida T, Kuroda Y, Yamashita A, Ohba E, Mizumoto M, Hayashi J, Kobayashi K, Ochiai T. Spontaneous Lumbar Artery Injury Resulting in Retroperitoneal Hematoma Mimicking Abdominal Aortic Aneurysm Rupture. Ann Vasc Dis 2021; 14:384-387. [PMID: 35082946 PMCID: PMC8752927 DOI: 10.3400/avd.cr.21-00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/26/2021] [Indexed: 11/23/2022] Open
Abstract
A 73-year-old woman, who had previously undergone endovascular aortic repair (EVAR), developed severe back pain while shoveling snow. Preoperative computed tomography (CT) revealed marked retroperitoneal hematoma around the abdominal aortic aneurysm (AAA) with extravasation of contrast media. Intraoperative angiography demonstrated spontaneous lumbar artery injury (SLI). The bleeding lumbar artery was embolized using lipiodol, and deteriorated hemodynamics were stabilized. SLI is rare and can mimic the clinical symptoms and CT findings of AAA rupture. Vascular surgeons should focus on the status of the aneurysmal sac and the possibility of another retroperitoneal disease to determine appropriate treatment options, despite successful EVAR for AAA.
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Affiliation(s)
- Shingo Nakai
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
| | - Tetsuro Uchida
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
| | - Atsushi Yamashita
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
| | - Eiichi Ohba
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
| | - Masahiro Mizumoto
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
| | - Jun Hayashi
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
| | - Kimihiro Kobayashi
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
| | - Tomonori Ochiai
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
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16
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Kobayashi K, Kuroda Y, Mizumoto M, Yamashita A, Ohba E, Nakai S, Ochiai T, Uchida T. Left coronary button aneurysm presenting with progressive enlargement after aortic root replacement. J Cardiothorac Surg 2021; 16:250. [PMID: 34488827 PMCID: PMC8422648 DOI: 10.1186/s13019-021-01645-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background Aneurysmal degeneration of the coronary button after aortic root replacement using the button technique is a rare but potentially life-threatening complication. However, the appropriate management of this complication, including the indications for conservative and surgical treatment, is still unknown. Case presentation Here we present a 38-year-old woman who successfully underwent surgical repair of a left coronary button aneurysm using the graft interposition technique 24 years after aortic root replacement. Because follow-up computed tomography after aortic root replacement showed a progressively enlarging left coronary button aneurysm, the patient was judged an acceptable candidate for surgical treatment, considering the potential risk of aneurysmal rupture and subsequent myocardial infarction. The postoperative recovery was uneventful. The patient is doing well 1 year after the surgery. Conclusions We believe that serial follow-up using computed tomography is mandatory for coronary button aneurysms, and surgical intervention may be considered if progressive enlargement of the aneurysm is observed, especially in younger patients. Supplementary Information The online version contains supplementary material available at 10.1186/s13019-021-01645-1.
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Affiliation(s)
- Kimihiro Kobayashi
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
| | - Yoshinori Kuroda
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Masahiro Mizumoto
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Atsushi Yamashita
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Eiichi Ohba
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Shingo Nakai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Tomonori Ochiai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Tetsuro Uchida
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
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17
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Kobayashi K, Uchida T, Kuroda Y, Yamashita A, Ohba E, Nakai S, Ochiai T, Sadahiro M. Double left brachiocephalic vein in an adult patient who underwent cardiac surgery: a case report. J Cardiothorac Surg 2021; 16:245. [PMID: 34454556 PMCID: PMC8403434 DOI: 10.1186/s13019-021-01630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 08/23/2021] [Indexed: 11/29/2022] Open
Abstract
Background A double left brachiocephalic vein is an extremely rare venous anomaly. Case presentation Herein, we present the case of a 79-year-old woman with a double left brachiocephalic vein who underwent cardiac surgical procedures. The normal left brachiocephalic vein was patent, and the accessory left brachiocephalic vein passed across the heart and aorta in front of the pericardium and drained into the superior vena cava. She underwent surgical ligation of the accessory left brachiocephalic vein, followed by an aortic valve replacement and coronary artery bypass grafting. Her postoperative recovery was uneventful, without any venous complications from the ligation of the accessory vein. The patient is doing well one year after the surgery. Conclusions The presence of double left brachiocephalic veins should be recognized before cardiac surgery in order for us to avoid intraoperative technical issues concerning this venous anomaly and unpredictable intraoperative bleeding due to injury of the accessory left brachiocephalic vein.
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Affiliation(s)
- Kimihiro Kobayashi
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
| | - Tetsuro Uchida
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Atushi Yamashita
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Eiichi Ohba
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Shingo Nakai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Tomonori Ochiai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Mitsuaki Sadahiro
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
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18
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Kobayashi K, Kuroda Y, Hayashi J, Mizumoto M, Yamashita A, Ohba E, Nakai S, Ochiai T, Uchida T. Step-by-step aortic clamping technique for safe retrieval of the elephant trunk. J Card Surg 2021; 36:3854-3856. [PMID: 34338372 DOI: 10.1111/jocs.15879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022]
Abstract
Staged repair of the aortic arch and downstream aorta using the elephant trunk technique is widely accepted for extensive aortic disease. However, elephant trunk retrieval is challenging in patients with unclampable descending aorta caused by extreme aneurysmal dilation or surrounding tissue adhesion. Here, we introduce a new elephant trunk retrieval technique using the step-by-step aortic clamping in descending aortic replacement of dissecting aortic aneurysm. This technique is a safe and feasible method of elephant trunk retrieval that consists of staged clamping and intraoperative ultrasound assessment of blood flow in the aorta.
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Affiliation(s)
- Kimihiro Kobayashi
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Jun Hayashi
- Department of Cardiovascular Surgery, Sendai City Hospital, Sendai, Japan
| | - Masahiro Mizumoto
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Atsushi Yamashita
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Eiichi Ohba
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shingo Nakai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tomonori Ochiai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tetsuro Uchida
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
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19
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Nakai S, Uchida T, Kuroda Y, Ohba E, Mizumoto M, Yamashita A. Surgical repair of deep femoral artery aneurysm complicated by deep vein thrombosis and pulmonary embolism. J Vasc Surg Cases Innov Tech 2021; 7:408-410. [PMID: 34278071 PMCID: PMC8261544 DOI: 10.1016/j.jvscit.2021.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/21/2021] [Indexed: 12/04/2022]
Abstract
Isolated deep femoral artery aneurysms are rare and tend to be large at the time of diagnosis owing to their deep anatomic location. Deep femoral artery aneurysms are often complicated by rupture, with subsequent lower limb amputation. However, a large aneurysm can compress the surrounding deep femoral vein, leading to thrombosis. In the present report, we have described a rare surgical case of deep femoral artery aneurysm complicated by deep femoral vein thrombosis and pulmonary embolism. Preoperative inferior vena cava filter placement was effective for preventing perioperative worsening of the pulmonary embolism in this particular circumstance.
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Affiliation(s)
- Shingo Nakai
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tetsuro Uchida
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Eiichi Ohba
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Masahiro Mizumoto
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Atsushi Yamashita
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
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20
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Mizumoto M, Uchida T, Kuroda Y, Oba E, Yamashita A, Hayashi J, Nakai S, Kobayashi K, Ochiai T, Abiko A. [Total Arch Replacement with Brain Isolation Technique for Arch Aneurysm with Shaggy Aorta]. Kyobu Geka 2021; 74:407-412. [PMID: 34059581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A shaggy aorta with a mobile atheromatous plaque in a thoracic lesion is considered a risk factor for cerebral infarction during aortic arch surgery. The brain isolation technique was introduced to prevent embolic stroke either by manipulating the severely atheromatous aorta, or by producing a sandblasting effect using the arterial jet in cardiopulmonary bypass. We performed total arch replacement with the aid of a brain isolation technique in four patients with aortic arch aneurysm complicated with a shaggy aorta between 2016 and 2020. Antegrade selective cerebral perfusion was established prior to systemic perfusion of the cardiopulmonary bypass. Total arch replacement using the frozen elephant technique was performed in all patients. There was no operative mortality, and all patients were discharged without major neurological complications. Therefore, the brain isolation technique could be a useful adjunctive method to prevent embolic stroke in patients who undergo total arch replacement for aortic arch aneurysm with a shaggy aorta.
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Affiliation(s)
- Masahiro Mizumoto
- The Second Department of Surgery, Yamagata University, Yamagata, Japan
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Kobayashi K, Uchida T, Kuroda Y, Yamashita A, Ohba E, Nakai S, Ochiai T. Large cardiac wall hematoma with rapid growth: a case report of a potentially catastrophic complication during cardiac surgery. J Cardiothorac Surg 2021; 16:88. [PMID: 33858448 PMCID: PMC8048295 DOI: 10.1186/s13019-021-01478-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 04/05/2021] [Indexed: 12/04/2022] Open
Abstract
Background Rapid growth of cardiac wall hematoma is a rare but potentially fatal complication of cardiac surgery. However, its pathophysiology and optimal management remain undefined. Case presentation Here we present a rare case of a large cardiac wall hematoma in the right ventricle during a thoracic aortic and valvular surgery. The hematoma expanded rapidly with epicardial rupture during cardiopulmonary bypass. We could establish non-surgical hemostasis and prevent further expansion of hematoma by early weaning of the cardiopulmonary bypass, followed by the administration of protamine and manual compression by hemostatic agent application. His postoperative recovery was uneventful and upon computed tomography analysis, the hematoma was observed to have absorbed completely at 1 week postoperatively. The patient is doing well 1 year after the surgery without evidence of recurrent cardiac wall hematoma on follow-up computed tomography. Conclusions Cardiovascular surgeons should bear in mind this potentially catastrophic complication during cardiac surgery. Because of the vulnerability of the cardiac wall at the area of the hematoma, we believe that a hemostatic approach without sutures may be effective for this lethal complication.
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Affiliation(s)
- Kimihiro Kobayashi
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
| | - Tetsuro Uchida
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Atsushi Yamashita
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Eiichi Ohba
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Shingo Nakai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Tomonori Ochiai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
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Nakai S, Uchida T, Hayashi J, Kuroda Y, Ohba E, Yamashita A, Kobayashi K, Ochiai T, Sadahiro M. [Surgical Strategy for Aortic Arch Aneurysms in Octogenarians]. Kyobu Geka 2021; 74:258-264. [PMID: 33831885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUNDS The purpose of this study was to evaluate the short- and mid-term outcomes of open aortic arch surgery and debranching thoracic endovascular aortic repair( TEVAR) in octogenarians. METHODS Between 2011 and 2019, 26 patients with atherosclerotic aortic arch aneurysms underwent surgery at our institution [open aortic arch surgery( group O):10 patients, debranching TEVAR(group D):16 patients]. RESULTS There was no operative death in either group. The mean length of hospitalization and intensive care unit stay were 49 and 13 days in group O and 12 and 2 days in group O, respectively. Kaplan-Meier analyses of overall survival (1/6/12/24/36/48 months) showed mortality rates of 100/100/88/88/70/70% in group O and 100/100/87/61/43/26% in group D, respectively. CONCLUSIONS The acceptable outcomes was demonstrated in octogenarians underwent both open aortic arch surgery and debranching TEVAR. Because of early postoperative recovery, debranching TEVER is considered to be a feasible alternative to conventional open aortic arch surgery in octogenarians.
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Affiliation(s)
- Shingo Nakai
- Department of the Second Surgery, Yamagata University, Yamagata, Japan
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23
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Kuroda Y, Uchida T, Ohba E, Yamashita A, Nakai S, Kobayashi K, Ochiai T, Sadahiro M. Aortic remodelling effect of the frozen elephant trunk technique on Stanford type A acute aortic dissection. Interact Cardiovasc Thorac Surg 2021; 32:789-791. [PMID: 33479773 DOI: 10.1093/icvts/ivaa339] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/26/2020] [Accepted: 12/12/2020] [Indexed: 11/14/2022] Open
Abstract
Total arch replacement using the frozen elephant trunk procedure is performed for true lumen expansion of the descending aorta in patients with type A acute aortic dissection. However, the remodelling effect of the frozen elephant trunk on the dissected descending aorta is unclear. We aimed to evaluate the effect of the frozen elephant trunk on postoperative descending aortic remodelling after surgery. Between December 2012 and January 2020, we retrospectively investigated 24 patients who underwent total arch replacement using the frozen elephant trunk for type A acute aortic dissection. Remodelling of the descending aorta was evaluated using computed tomography. The aortic remodelling effect, based on aortic true lumen ratio, was determined for (i) DeBakey type (type I versus type III retrograde); (ii) thoracic endovascular aneurysm repair reintervention status (reintervention versus no reintervention); and (iii) stent length of the frozen elephant trunk (60 vs 90 mm). Postoperative true lumen ratio significantly increased in the type I dissection group. The true lumen ratio in the no-reintervention group, which had many patients with the type I dissection, significantly increased after the frozen elephant trunk. Aortic remodelling due to the frozen elephant trunk can be expected after type I acute aortic dissections.
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Affiliation(s)
- Yoshinori Kuroda
- Division of Cardiovascular Surgery, Department of Surgery II, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tetsuro Uchida
- Division of Cardiovascular Surgery, Department of Surgery II, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Eiichi Ohba
- Division of Cardiovascular Surgery, Department of Surgery II, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Atsushi Yamashita
- Division of Cardiovascular Surgery, Department of Surgery II, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Shingo Nakai
- Division of Cardiovascular Surgery, Department of Surgery II, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Kimihiro Kobayashi
- Division of Cardiovascular Surgery, Department of Surgery II, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tomonori Ochiai
- Division of Cardiovascular Surgery, Department of Surgery II, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Mitsuaki Sadahiro
- Division of Cardiovascular Surgery, Department of Surgery II, Yamagata University Faculty of Medicine, Yamagata, Japan
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Nakai S, Uchida T, Kuroda Y, Yamashita A, Oba E, Kobayashi K, Ochiai T, Sadahiro M. Spinal Cord Ischemia Following Endovascular Repair of Infrarenal Abdominal Aortic Aneurysm. Ann Vasc Dis 2020; 13:335-338. [PMID: 33384742 PMCID: PMC7751069 DOI: 10.3400/avd.cr.20-00061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Spinal cord injury (SCI) following endovascular aortic repair (EVAR) for an abdominal aortic aneurysm (AAA) is a rare but serious complication. Case 1 presented with ruptured AAA and shock and underwent emergency EVAR. The patient developed incomplete paraplegia 2 days following EVAR. Case 2, diagnosed with impending rupture of AAA with extremely shaggy aorta, was treated with emergency EVAR. The patient was diagnosed with complete paraplegia soon after EVAR. Case 3 underwent elective EVAR and developed delayed paraplegia 2 weeks later. In EVAR, the etiology of SCI leading to paraplegia is often multifactorial. Surgeons must consider the possibility of SCI-induced paraplegia.
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Affiliation(s)
- Shingo Nakai
- Second Department of Surgery, Yamagata University Faculty of Medicine
| | - Tetsuro Uchida
- Second Department of Surgery, Yamagata University Faculty of Medicine
| | - Yoshinori Kuroda
- Second Department of Surgery, Yamagata University Faculty of Medicine
| | - Atsushi Yamashita
- Second Department of Surgery, Yamagata University Faculty of Medicine
| | - Eiichi Oba
- Second Department of Surgery, Yamagata University Faculty of Medicine
| | | | - Tomonori Ochiai
- Second Department of Surgery, Yamagata University Faculty of Medicine
| | - Mitsuaki Sadahiro
- Second Department of Surgery, Yamagata University Faculty of Medicine
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Uchida T, Kobayashi K, Nakai S, Sadahiro M. Bare stent removal in open thoraco-abdominal aortic repair after endovascular treatment with the PETTICOAT technique. Interact Cardiovasc Thorac Surg 2020; 31:271-273. [PMID: 32594117 DOI: 10.1093/icvts/ivaa073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/19/2020] [Accepted: 03/24/2020] [Indexed: 11/13/2022] Open
Abstract
The Provisional Extension to Induce Complete Attachment (PETTICOAT) technique using distal bare stents can enhance the effect of proximal thoracic endovascular aortic repair. Here, we present the case of a patient who underwent open surgical conversion and bare stent removal due to progressive thoraco-abdominal aortic enlargement. Previously placed bare-metal stents were embedded deeply in the aortic wall. After explantation of the bare stents, reno-visceral arterial orifices became fragile due to considerable intimal defects, and special care was necessary to make buttons and subsequent separate branch graft anastomoses. As bare stent removal makes open surgical conversion technically difficult, the indication for the PETTICOAT technique should be considered.
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Affiliation(s)
- Tetsuro Uchida
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Kimihiro Kobayashi
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shingo Nakai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Mitsuaki Sadahiro
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
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Kobayashi K, Uchida T, Kuroda Y, Yamashita A, Ohba E, Nakai S, Ochiai T, Sadahiro M. Right-sided double valve replacement in an adult patient who underwent surgery for pulmonary stenosis in childhood: a case report. J Cardiothorac Surg 2020; 15:170. [PMID: 32664912 PMCID: PMC7362504 DOI: 10.1186/s13019-020-01207-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pulmonary regurgitation and the subsequent functional tricuspid regurgitation are frequently observed in adult patients who previously underwent pulmonary valvular operations. Pulmonary valve replacement, in combination with tricuspid annuloplasty, is frequently performed in adult patients. However, postoperative worsening or recurrence of tricuspid regurgitation is a major concern after pulmonary valve replacement with tricuspid annuloplasty. CASE PRESENTATION Herein, we describe the case of a 56-year-old woman with severe pulmonary regurgitation and functional tricuspid regurgitation after congenital pulmonary stenosis surgery in childhood. Functional tricuspid regurgitation was due to tricuspid annular dilatation, marked right ventricle enlargement, and significant tethering. We performed a bioprosthetic double valve replacement, and the postoperative course was uneventful. The patient is doing well one year after the surgery without prosthetic valve dysfunction. CONCLUSIONS When functional tricuspid regurgitation is severe and is associated with right ventricular dilatation and subsequent tethering, tricuspid valve replacement rather than annuloplasty should be considered.
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Affiliation(s)
- Kimihiro Kobayashi
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
| | - Tetsuro Uchida
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Atsushi Yamashita
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Eiichi Ohba
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Shingo Nakai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Tomonori Ochiai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Mitsuaki Sadahiro
- Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
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Uchida T, Kuroda Y, Ohba E, Yamashita A, Nakai S, Kobayashi K, Ochiai T, Sadahiro M. Ruptured aneurysm of coronary arteriovenous fistula without aneurysmal coronary artery. J Card Surg 2020; 35:2403-2406. [PMID: 32652717 DOI: 10.1111/jocs.14793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Approximately 25% of coronary arteriovenous fistulas present aneurysmal dilatation; however, spontaneous rupture of the aneurysm is rare. Most coronary arteries branching the feeding arteries demonstrate aneurysmal formation, possibly because of shunt flow. CASE REPORT A 48-year-old woman was referred to our institution for surgical management of ruptured aneurysm of coronary arteriovenous fistula. The aneurysm was located on the left-anterior aspect of the pulmonary artery trunk, communicating with both left and right coronary arteries through two small feeding arteries draining into the pulmonary artery trunk. Both left and right coronary arteries showed normal diameter. The feeding arteries were ligated externally, and fistulous openings were closed within the aneurysm. Postoperative course was uneventful. CONCLUSION Aneurysm of coronary arteriovenous fistula can occur in patients without aneurysmal coronary artery. Although the association of ruptured aneurysm with coronary fistulas is relatively rare, it should be considered a potential cause of acute cardiac tamponade.
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Affiliation(s)
- Tetsuro Uchida
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Eiichi Ohba
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Atsushi Yamashita
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shingo Nakai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Kimihiro Kobayashi
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tomonori Ochiai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Mitsuaki Sadahiro
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
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Nakai S, Hamasaki A, Uchida T, Sadahiro M. Arterioplasty using gastroepiploic artery patch for common femoral artery occlusive disease. Interact Cardiovasc Thorac Surg 2020; 31:138-139. [PMID: 32415768 DOI: 10.1093/icvts/ivaa058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/04/2020] [Accepted: 03/11/2020] [Indexed: 11/13/2022] Open
Abstract
We present the first case of arterioplasty of the common femoral artery performed using a gastroepiploic artery (GEA) patch for a 59-year-old man on haemodialysis. He was incidentally diagnosed with coronary artery disease with left main trunk stenosis and double-vessel disease upon screening examination for peripheral artery disease. Preoperative computed tomography revealed a severely narrowed right common femoral artery. We planned a simultaneous off-pump coronary artery bypass grafting (CABG) involving the bilateral internal thoracic arteries and GEA, and endarterectomy of the right common femoral artery. Because the remnant GEA was sufficiently long and its diameter was sufficiently large, we used a GEA patch during arterioplasty to preserve the saphenous vein. This method is limited to simultaneous surgery with CABG using GEA but is a useful alternative for preserving the saphenous vein.
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Affiliation(s)
- Shingo Nakai
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Azumi Hamasaki
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tetsuro Uchida
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Mitsuaki Sadahiro
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
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Uchida T, Kuroda Y, Yamashita A, Nakai S, Kobayashi K, Sadahiro M. Solo Smart stentless bioprosthesis for extensive aortic annular defects caused by infective endocarditis. J Card Surg 2020; 35:897-900. [PMID: 32092179 DOI: 10.1111/jocs.14473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS The optimal valve and prosthesis in patients with aortic valve infective endocarditis with annular abscess is controversial. If extensive annular defects occur after debridement, standard techniques are difficult; more complex aortic root replacement (ARR) or aortic valve translocation technique are inevitable. The Solo Smart stentless bioprosthesis is specially designed for supra-annular implantation without annular stitches. METHODS Nineteen patients with active aortic valve infective endocarditis underwent aortic valve replacement in the past 3 years. Of these, we performed aortic valve replacement using the Solo Smart valve in four patients with extensive annular destruction and complex aortic root pathologies requiring reconstruction. RESULTS Although more than two-thirds of the annular structure was missing after radical debridement of infected tissues, supra-annular aortic valve replacement with the Solo Smart valve could be performed successfully in all four patients. All patients are doing well without prosthetic valve dysfunction and/or recurrent infection. CONCLUSION The supra-annular aortic valve replacement using the Solo Smart valve is considered to be a useful alternative to standard aortic valve replacement in patients complicated with extensive annular defect. It is a simple and technically less demanding alternative to ARR or aortic valve translocation technique.
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Affiliation(s)
- Tetsuro Uchida
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Atsushi Yamashita
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shingo Nakai
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Kimihiro Kobayashi
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Mitsuaki Sadahiro
- Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
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Nakai S, Uchida T, Kuroda Y, Yamashita A, Hirooka S, Kobayashi K, Hamasaki A, Sadahiro M. [Pleuro-peritoneal Shunt for Intractable Pleural Effusion Complicated with Unresectable Cardiac Tumor]. Kyobu Geka 2020; 73:108-112. [PMID: 32393716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We present a case of palliative pleuro-peritoneal shunt for refractory hydrothorax complicated with unresectable cardiac tumor. The patient was a 77-year-old woman, who was admitted to our hospital for evaluation of intractable pleural effusion. It was attributed to severe diastolic dysfunction associated with cardiac tumor. The cardiac tumor occupied a large area of the anterior surface of the right atrium, and curative surgical resection was difficult. Therefore, we planned multidisciplinary staged treatment with chemotherapy followed by tumor excision. Persistent intractable bilateral pleural effusion necessitated repeat chest drainage. To maintain the patient's quality of daily life, bilateral pleuro-peritoneal shunts were inserted. Then, the problem of pleural effusion was resolved and her symptoms were improved. However, she expired 3 months later, due to deterioration of general condition. Pleuro-peritoneal shunting is a useful palliative approach to improve quality of life in patients with refractory hydrothorax.
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Affiliation(s)
- Shingo Nakai
- Department of the Second Surgery, Yamagata University, Yamagata, Japan
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Nakai S, Hamasaki A, Uchida T, Sadahiro M. Redo aortic root replacement for postoperative left ventricular outflow tract pseudoaneurysm after valve-sparing aortic root replacement in a patient with Marfan syndrome. Multimed Man Cardiothorac Surg 2019; 2019. [PMID: 31869008 DOI: 10.1510/mmcts.2019.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Postoperative pseudoaneurysm of the left ventricular outflow tract after valve-sparing root replacement is a rare but critical complication. We present a case of postoperative left ventricular outflow tract pseudoaneurysm that occurred in a 49-year-old woman with Marfan syndrome after valve-sparing aortic root replacement. Four months postoperatively, severe dehiscence of the aortic root graft resulted in a retrosternal giant pseudoaneurysm, which was diagnosed incidentally at her routine postoperative follow-up computed tomography. We performed an emergency redo aortic root replacement. In this video tutorial, we present tips that might be useful for other surgeons as they approach this procedure.
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Affiliation(s)
- Shingo Nakai
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Azumi Hamasaki
- Second Department of Surgery Yamagata University Faculty of Medicine Yamagata, Japan
| | - Tetsuro Uchida
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Mitsuaki Sadahiro
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
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32
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Uchida T, Kuroda Y, Yamashita A, Hamasaki A, Hirooka S, Nakai S, Kobayashi K, Sadahiro M. [Successful Pregnancy Outcome in a Woman Undergoing Aortic Valve Replacement Using a Mechanical Valve which Allows Reduced Anticoagulation]. Kyobu Geka 2019; 72:1057-1060. [PMID: 31879379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Pregnant women undergoing mechanical valve replacement are at a considerable risk of thromboembolic events, bleeding, and fetotoxicity associated with the administration of vitamin K antagonists and some other anticoagulants. We present our clinical experience of pregnancy and childbirth in a young woman who underwent aortic valve replacement (AVR) with a mechanical valve. A young woman underwent AVR with a bioprosthetic valve for a diagnosis of aortic regurgitation and bicuspid aortic valve at age 23. Four years later, structural valve deterioration(SVD) of the prosthetic valve necessitated redo AVR with bioprosthesis. Three years after the redo AVR, she developed recurrent SVD of the bioprosthesis, and the 3rd AVR operation was performed using an On-X mechanical valve, which allows reduced anticoagulation. She conceived 5 months after AVR using the On-X valve. Anticoagulation therapy was administered with a low-dose vitamin K antagonist combined with heparin infusion during pregnancy. No anticoagulation-induced maternal and fetal complications occurred throughout the pregnancy. The On-X valve, which allows lower levels of anticoagulation is useful in women wishing to get pregnant.
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Affiliation(s)
- Tetsuro Uchida
- Second Department of Surgery, Yamagata University, Yamagata, Japan
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Uchida T, Kuroda Y, Yamashita A, Hamasaki A, Hirooka S, Nakai S, Kobayashi K, Sadahiro M. [Clinical Experience of Endovascular Stent-graft Treatment for Stanford Type A Acute Aortic Dissection]. Kyobu Geka 2019; 72:976-983. [PMID: 31701906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUNDS Recently, thoracic endovascular aortic repair (TEVAR) is widely accepted and performed in patients with complicated and uncomplicated Stanford type B aortic dissection. However, TEVAR for Stanford type A aortic dissection is not commonly performed even in the endovascular era. This report describes patients who underwent TEVAR for Stanford type A dissection. PATIENTS Since 2016, 5 patients underwent TEVAR for retrograde acute Stanford type A dissection. A covered stent-graft was placed in the descending aorta for primary entry coverage. An additional bare-stent was placed in the narrowed true lumen of the downstream aorta. A thrombosed false lumen was observed in 4 and a partially thrombosed lumen in 1 patient. No patient showed pericardial effusion, aortic insufficiency, or persistent back pain. Four of 5 patients were asymptomatic, and only 1 patient developed multiorgan malperfusion. Repetitive computed tomography (CT) was performed postoperatively. RESULTS All patients underwent successful TEVAR without the need for additional intervention, and no operative mortality and morbidity were observed. The patient with multiorgan malperfusion recovered uneventfully without any complication. Follow-up CT revealed complete disappearance of the false lumen in the ascending aorta in all patients. CONCLUSIONS Although TEVAR of the descending aorta was performed with acceptable mortality and morbidity rates in strictly selected patients with retrograde Stanford type A dissection, conceptual and technical issues remain unresolved in patients with ascending aortic stent-graft placement. Technological advances would lead to the development of innovative disease-specific endovascular devices and solutions in the future for TEVAR in patients with Stanford type A dissection.
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Affiliation(s)
- Tetsuro Uchida
- Second Department of Surgery, Yamagata University, Yamagata, Japan
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Nakai S, Uchida T, Kuroda Y, Hamasaki A, Yamashita A, Nakamura K, Hayashi J, Watanabe D, Sadahiro M. [Excision of a Left Ventricular Papillary Fibroelastoma via Right Thoracotomy with a Small Skin Incision]. Kyobu Geka 2018; 71:937-941. [PMID: 30310006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 75-year-old woman was referred to our hospital for surgical treatment of a left ventricular mass. Echocardiography demonstrated a mobile left ventricular mass originating from the apex of the anteroseptal wall. Cardiac magnetic resonance imaging showed low signal intensity on T1 images and high signal intensity on T2 images. A right 4th intercostal thoracotomy with a small skin incision was performed, and cardiopulmonary bypass was established via the right femoral artery and vein and the right jugular vein. After cardiac arrest, we approached the tumor through the mitral valve via a left atrial incision. Resection of the tumor was difficult owing to its deep location;however, we could successfully resect it using an endoscope. Histopathological diagnosis confirmed a papillary fibroelastoma. Postoperative course was uneventful. A papillary fibroelastoma originating from the left ventricular wall is rare. Although a right thoracotomy is a useful approach for the management of a cardiac mass, careful planning is needed to obtain access to a mass in deep location.
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Affiliation(s)
- Shingo Nakai
- Department of Surgery II, Yamagata University, Yamagata, Japan
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Affiliation(s)
- T. Shinzato
- Nagoya University Daiko Medical Center, Nagoya - Japan
| | - S. Nakai
- Nagoya University Daiko Medical Center, Nagoya - Japan
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Nakai S, Nakatsuka M, Fujita H, Miyanaga N, Jitsuno T, Kanabe T, Izawa Y, Norimatsu T, Takagi M, Yamanaka T, Kato Y, Azechi H, Nishimura H, Shiraga H, Nakai M, Tanaka K, Kodama R, Takabe H, Nishihara K, Mima K, Kitagawa Y, Sakabe S, Yamanaka M, Kosaki Y, Yamanaka C, Sasaki T, Mori Y, Miyazaki K, Nishikawa M, Kan H, Hiruma T, Soman Y, Ito H, Perlado J, Alonso E, Munoz E, Sanz J. Laser Fusion Research at Ile Osaka University. ACTA ACUST UNITED AC 2018. [DOI: 10.13182/fst96-a11963008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. Nakai
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - M. Nakatsuka
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - H. Fujita
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - N. Miyanaga
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - T. Jitsuno
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - T. Kanabe
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - Y. Izawa
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - T. Norimatsu
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - M. Takagi
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - T. Yamanaka
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - Y. Kato
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - H. Azechi
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - H. Nishimura
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - H. Shiraga
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - M. Nakai
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - K.A. Tanaka
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - R. Kodama
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - H. Takabe
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - K. Nishihara
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - K. Mima
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - Y. Kitagawa
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - S. Sakabe
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - M. Yamanaka
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - Y. Kosaki
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - C. Yamanaka
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - T. Sasaki
- Faculy of Engineering, Osaka University 2-1 Yamada-oka, Suita, Osaka 565 Japan
| | - Y. Mori
- Faculy of Engineering, Osaka University 2-1 Yamada-oka, Suita, Osaka 565 Japan
| | - K. Miyazaki
- Faculy of Engineering, Osaka University 2-1 Yamada-oka, Suita, Osaka 565 Japan
| | - M. Nishikawa
- Faculy of Engineering, Osaka University 2-1 Yamada-oka, Suita, Osaka 565 Japan
| | - H. Kan
- Hamamatsu Photonics K.K. 5000 Hirakuchi, Hamakita, Shizuoka 434 Japan
| | - T. Hiruma
- Hamamatsu Photonics K.K. 5000 Hirakuchi, Hamakita, Shizuoka 434 Japan
| | - Y. Soman
- Mitsubishi Heavy Industries. Ltd. 1-1-1 Wadasaki-cho, Hyogo-ku, Kobe 562 Japan
| | - H. Ito
- Kawasaki Heavy Industries. Ltd. 2-4-25 Minamisuna, Koto-ku, Tokyo 136 Japan
- Members of Laser Fusion Reactor Committee of Laser Society of Japan
| | - J.M. Perlado
- Instituto de Fusion Nuclear, Universidad Politecnica de Madrid 28006 Madrid Spain
| | - E. Alonso
- Instituto de Fusion Nuclear, Universidad Politecnica de Madrid 28006 Madrid Spain
| | - E. Munoz
- Instituto de Fusion Nuclear, Universidad Politecnica de Madrid 28006 Madrid Spain
| | - J. Sanz
- Instituto de Fusion Nuclear, Universidad Politecnica de Madrid 28006 Madrid Spain
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Nakatuska M, Azechi H, Jitsuno T, Kanabe T, Matsuoka S, Miyanaga M, Tada M, Nakai S. Glass Laser System, Gekko XII Upgrade for ICF Ignition. ACTA ACUST UNITED AC 2017. [DOI: 10.13182/fst94-a40244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Nakatuska
- Institute of Laser Engineering, Osaka University, Suita, Osaka, 565, Japan (06)879-8726
| | - H. Azechi
- Institute of Laser Engineering, Osaka University, Suita, Osaka, 565, Japan (06)879-8726
| | - T. Jitsuno
- Institute of Laser Engineering, Osaka University, Suita, Osaka, 565, Japan (06)879-8726
| | - T. Kanabe
- Institute of Laser Engineering, Osaka University, Suita, Osaka, 565, Japan (06)879-8726
| | - S. Matsuoka
- Institute of Laser Engineering, Osaka University, Suita, Osaka, 565, Japan (06)879-8726
| | - M. Miyanaga
- Institute of Laser Engineering, Osaka University, Suita, Osaka, 565, Japan (06)879-8726
| | - M. Tada
- Institute of Laser Engineering, Osaka University, Suita, Osaka, 565, Japan (06)879-8726
| | - S. Nakai
- Institute of Laser Engineering, Osaka University, Suita, Osaka, 565, Japan (06)879-8726
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Kuroda Y, Uchida T, Togashi H, Haga K, Takahashi A, Kobayashi K, Nakai S, Sadahiro M. PC214 In Vivo Evaluation of Ischemia-Reperfusion Injury of Skeletal Muscle, Using 3-Carbamoyl-PROXYL-Enhanced MRI. J Vasc Surg 2017. [DOI: 10.1016/j.jvs.2017.03.372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kikuyama K, Uchida T, Hamasaki A, Kuroda Y, Yamashita A, Hayashi J, Nakamura K, Nakai S, Watanabe D, Kobayashi K, Sadahiro M. [Surgical Experience of Infective Aneurysm of Brachial Artery Complicated with Infective Mitral Valve Endocarditis]. Kyobu Geka 2017; 70:348-351. [PMID: 28496080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We report a rare case of aneurysmal formation of the left brachial artery complicated with infective endocarditis of the mitral valve. A 67-year-old man was referred to our institution for further examination of pulsatile mass at the left upper extremity. Computed tomography showed a left brachial arterial aneurysm with a diameter of 4 cm and gradual expansion of the aneurysm was also recognized. Furthermore, echocardiography revealed severe mitral valve regurgitation with a vegetation. There was no feature of congestive heart failure. He was diagnosed with subacute infective endocarditis and infective left brachial arterial aneurysm. Considering these clinical findings, staged surgical treatment was planned. He underwent resection of the brachial arterial aneurysm and bypass grafting with an autologous saphenous vein on an urgent basis. One month after the initial operation, elective mitral valve plasty was successfully performed. Although aneurysmal formation of the brachial artery subsequent to infective endocarditis is rare, we should keep this potentially serious complication in mind.
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Affiliation(s)
- Kaoru Kikuyama
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
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Takahashi A, Uchida T, Hamasaki A, Kuroda Y, Eiichi O, Yamashita A, Hayashi J, Watanabe D, Nakai S, Gomi S, Sadahiro M. Popliteal Artery Pseudoaneurysm Associated with Osteochondroma. Ann Vasc Dis 2017; 10. [PMID: 29147156 PMCID: PMC5684155 DOI: 10.3400/avd.cr.17-00026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Osteochondroma is the most common benign bone tumor, which can sometimes cause vascular complications. Here we report two rare cases (a 48-year-old woman and a 28-year-old woman) presenting with pain and a pulsatile mass in the popliteal region. Computed tomography revealed pseudoaneurysm in the popliteal artery, which was closely associated with a protrusion of a femoral osteochondroma. Surgical repairs were performed, and the patients remained asymptomatic during follow-up. Therefore, considering the potential risk of vascular complications, close observation is mandatory in patients with femoral osteochondroma.
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Affiliation(s)
- Ai Takahashi
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tetsuro Uchida
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Azumi Hamasaki
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Yoshinori Kuroda
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Ohba Eiichi
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Atsushi Yamashita
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Jun Hayashi
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Daisuke Watanabe
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Shingo Nakai
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Seigo Gomi
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Mitsuaki Sadahiro
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
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Tada M, Hasegawa M, Sasaki H, Kusaka M, Shiroki R, Hoshinaga K, Ito T, Kenmochi T, Nakai S, Takahashi K, Hayashi H, Koide S, Yuzawa Y. Kidney Transplantation, Cardiovascular Risk, and Long-Term Dialysis in Japan. Transplant Proc 2016; 48:26-30. [PMID: 26915838 DOI: 10.1016/j.transproceed.2015.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 11/11/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND The waiting time for deceased-donor kidney-only transplantations in Japan is long. Herein, we assessed the effect of length of dialysis on the outcomes of these patients. METHODS We divided patients into 2 groups based on length of dialysis (Group A, <15 years, and Group B, ≥15 years), and compared the background and outcomes after kidney transplantation. RESULTS Group A included 210 patients and Group B included 35 patients. In Group B, 20% of transplants were from living donors. Patient age (P = .017) and the hepatitis C infection rate (P = .018) were significantly higher in Group B, whereas hypertension (P = .011), diabetes (P = .041), and ABO-incompatibility rates (P = .015) were significantly higher in Group A. The 5- and 10-year survival rates were 97.0% and 95.4%, respectively, in Group A and 97.1% and 97.1%, respectively, in Group B. The 5- and 10-year graft survival rates were 95.4% and 84.8%, respectively, in Group A and 97.1% and 73.1%, respectively, in Group B. There were no significant differences between the groups in patient survival (P = .74) and graft survival (P = .72). The 5- and 10-year cardiovascular event-free survival rates were 95.9% and 92.4%, respectively, in Group A and 88.6% and 76.8%, respectively, in Group B. Cardiovascular event-free survival was significantly higher in Group A (P = .038). Cox stepwise multivariate analysis indicated that length of dialysis was a significant predictor of cardiovascular events (hazard risk, 1.007; range, 1.001-1.012; P = .012). CONCLUSION The prognosis after kidney transplantation is promising even after a long length of dialysis, although evaluation of the cardiovascular risk is needed in these cases.
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Affiliation(s)
- M Tada
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan
| | - M Hasegawa
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan.
| | - H Sasaki
- Department of Urology, Fujita Health University School of Medicine, Aichi, Japan
| | - M Kusaka
- Department of Urology, Fujita Health University School of Medicine, Aichi, Japan
| | - R Shiroki
- Department of Urology, Fujita Health University School of Medicine, Aichi, Japan
| | - K Hoshinaga
- Department of Urology, Fujita Health University School of Medicine, Aichi, Japan
| | - T Ito
- Department of Organ Transplantation, Fujita Health University School of Medicine, Aichi, Japan
| | - T Kenmochi
- Department of Organ Transplantation, Fujita Health University School of Medicine, Aichi, Japan
| | - S Nakai
- Fujita Health University School of Health Science, Aichi, Japan
| | - K Takahashi
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan
| | - H Hayashi
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan
| | - S Koide
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan
| | - Y Yuzawa
- Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan
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Shinzato T, Fujisawa K, Nakai S, Miwa M, Kobayakawa H, Takai I, Morita H, Maeda K. Newly developed economical and efficient push/pull hemodiafiltration. Contrib Nephrol 2015; 108:79-86. [PMID: 8039400 DOI: 10.1159/000423360] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- T Shinzato
- Department of Internal Medicine, Nagoya University School of Medicine, Japan
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Shinzato T, Miwa M, Kobayakawa H, Morita H, Nakai S, Miyata T, Maeda K. Effectiveness of new push/pull hemodiafiltration for arthralgia in long-term hemodialysis patients. Contrib Nephrol 2015; 112:111-8. [PMID: 7554982 DOI: 10.1159/000424099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- T Shinzato
- Department of Internal Medicine, Branch Hospital, Nagoya University School of Medicine, Japan
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Alvarez J, Fernández-Tobias J, Mima K, Nakai S, Kar S, Kato Y, Perlado J. Laser Driven Neutron Sources: Characteristics, Applications and Prospects. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.phpro.2014.11.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Steckiph D, Calabrese G, Bertucci A, Mazzotta A, Vagelli G, Gonella M, Stamopoulos D, Manios E, Papachristos N, Grapsa E, Papageorgiou G, Gogola V, So B, Dey V, Spalding EM, Libetta C, Esposito P, Margiotta E, Maffioli P, Bonaventura A, Bianchi L, Romano D, Rampino T, De Rosa G, Mauric A, Haug U, Enzinger G, Kern-Derstvenscheg E, Sluga A, Ausserwinkler C, Beck W, Rosenkranz AR, Maheshwari V, Haroon S, Loy Y, Samavedham L, Rangaiah GP, Lau T, Stamopoulos D, Mpakirtzi N, Panagiotou M, Barbarousi D, Matsouka C, Grapsa E, Bunani AD, Kowalczyk M, Bartnicki P, Banach M, Rysz J, Lentini P, Zanoli L, Granata A, Contestabile A, Basso A, Berlingo G, Pellanda V, de Cal M, Grazia V, Clementi A, Insalaco M, Dell'Aquila R, Karkar A, Abdelrahman M, Martins AR, Parreira L, Duque AS, Rodrigues I, Baffoun AB, Youssfi MA, Sayeh A, Beji M, Ben Khadra R, Hmida J, Akazawa M, Horiuchi H, Hori Y, Yamada A, Satou H, Odamaki S, Nakai S, Satou K, Aoki K, Saito I, Kamijo Y, Ogata S, Ishibashi Y, Basso F, Wojewodzka-Zelezniakowicz M, Cruz D, Giuliani A, Blanca Martos L, Piccinni P, Ronco C, Potier J, Queffeulou G, Bouet J, Nilsson A, Sternby J, Grundstrom G, Alquist M, Ferraresi M, Di Vico MC, Vigotti FN, Deagostini M, Scognamiglio S, Consiglio V, Clari R, Moro I, Mongilardi E, Piccoli GB, Hancock V, Huang S, Nilsson A, Grundstrom G, Nilsson Ekdahl K, Calabrese G, Steckiph D, Bertucci A, Baldin C, Petrarulo M, Mancuso D, Vagelli G, Gonella M, Inguaggiato P, Canepari G, Gigliola G, Ferrando C, Meinero S, Sicuso C, Pacitti A, Stamopoulos D, Mpakirtzi N, Manios E, Afentakis N, Grapsa E, Tomo T, Matsuyama K, Nakata T, Ishida K, Takeno T, Kadota JI, Minakuchi J, Kastl J, Merello M, Boccato C, Giordana G, Mazzone S, Moscardo V, Kastl J, Giordana G, Reinhardt B, Knaup R, Kruger W, Tovbin D, Kim S, Avnon L, Zlotnik M, Storch S, Umimoto K, Shimamoto Y, Suyama M, Miyata M, Bosch Benitez-Parodi E, Baamonde Laborda EE, Perez G, Ramirez JI, Ramirez Puga A, Guerra R, Garcia Canton C, Lago Alonso MM, Toledo A, Checa Andres MD, Latif FE, Mochida Y, Matsumoto K, Morita K, Tsutsumi D, Ishioka K, Maesato K, Oka M, Moriya H, Hidaka S, Ohtake T, Kobayashi S, Ficheux A, Gayrard N, Duranton F, Guzman C, Szwarc I, Bismuth-Mondolfo J, Brunet P, Servel MF, Argiles A, Tsikliras N, Mademtzoglou S, Balaskas E, Zeid M, Mostafa A, Mowafy MN, Abdo EI, Al Amin OM, Ksiazek A, Zaluska W, Waniewski J, Debowska M, Wojcik-Zaluska A, Elias M, Francois H, Obada E, Lorenzo HK, Charpentier B, Durrbach A, Beaudreuil S, Imamovic G, Marcelli D, Bayh I, Hrvacevic R, Kapun S, Grassmann A, Scatizzi L, Maslovaric J, Daelemans R, Mesens S, Mohamed EA, Wafae A, Kawtar H, Mohamed Amine H, Driss K, Mohammed B. Extracorporeal dialysis: techniques and adequacy - A. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fujii T, Suzuki S, Shinozaki M, Tanaka H, Bell S, Cooper S, Lomonte C, Libutti P, Chimienti D, Casucci F, Bruno A, Antonelli M, Lisi P, Cocola L, Basile C, Negri A, Del Valle E, Zanchetta M, Zanchetta J, Di Vico MC, Ferraresi M, Pia A, Aroasio E, Gonella S, Mongilardi E, Clari R, Moro I, Piccoli GB, Gonzalez-Parra E, Rodriguez-Osorio L, Ortiz-Arduan A, de la Piedra C, Egido J, Perez Gomez MV, Tabikh AA, Afsar B, Kirkpantur A, Imanishi Y, Yamagata M, Nagata Y, Ohara M, Michigami T, Yukimura T, Inaba M, Bieber B, Robinson B, Mariani L, Jacobson S, Frimat L, Bommer J, Pisoni R, Tentori F, Ciceri P, Elli F, Brancaccio D, Cozzolino M, Adamczak M, Wiecek A, Kuczera P, Sezer S, Bal Z, Tutal E, Kal O, Yavuz D, Y ld r m I, Sayin B, Ozelsancak R, Ozkurt S, Turk S, Ozdemir N, Lehmann R, Roesel M, Fritz P, Braun N, Ulmer C, Steurer W, Dagmar B, Ott G, Dippon J, Alscher D, Kimmel M, Latus J, Turkvatan A, Balci M, Mandiroglu S, Seloglu B, Alkis M, Serin M, Calik Y, Erkula S, Gorboz H, Afsar B, Mandiroglu F, Kirkpantur A, Lindley E, Cruz Casal M, Rogers S, Pancirova J, Kernc J, Copley JB, Fouque D, Kiss I, Kiss Z, Szabo A, Szegedi J, Balla J, Ladanyi E, Csiky B, orkossy O, Torok M, Turi S, Ambrus C, Deak G, Tisler A, Kulcsar I, K d r V, Altuntas A, Akp nar A, Orhan H, Sezer M, Filiopoulos V, Manolios N, Arvanitis D, Pani I, Panagiotopoulos K, Vlassopoulos D, Rodriguez-Ortiz ME, Canalejo A, Herencia C, Martinez-Moreno JM, Peralta-Ramirez A, Perez-Martinez P, Navarro-Gonzalez JF, Rodriguez M, Peter M, Gundlach K, Steppan S, Passlick-Deetjen J, Munoz-Castaneda JR, Almaden Y, Munoz-Castaneda JR, Peralta-Ramirez A, Rodriguez-Ortiz M, Herencia C, Martinez-Moreno J, Lopez I, Aguilera-Tejero E, Peter M, Gundlach K, Steppan S, Passlick-Deetjen J, Rodriguez M, Almaden Y, Hanafusa N, Masakane I, Ito S, Nakai S, Maeda K, Suzuki H, Tsunoda M, Ikee R, Sasaki N, Sato M, Hashimoto N, Wang MH, Hung KY, Chiang CK, Huang JW, Lu KC, Lang CL, Okano K, Yamashita T, Tsuruta Y, Hibi A, Miwa N, Kimata N, Tsuchiya K, Nitta K, Akiba T, Sasaki N, Tsunoda M, Ikee R, Sato M, Hashimoto N, Harb L, Komaba H, Kakuta T, Suzuki H, Suga T, Fukagawa M, Kikuchi H, Shimada H, Karasawa R, Suzuki M, Zhelyazkova-Savova M, Gerova D, Paskalev D, Ikonomov V, Zortcheva R, Galunska B, Jean G, Deleaval P, Hurot JM, Lorriaux C, Mayor B, Chazot C, Vannucchi H, Vannucchi MT, Martins JC, Merino JL, Teruel JL, Fernandez-Lucas M, Villafruela JJ, Bueno B, Gomis A, Paraiso V, Quereda C, Ibrahim FH, Fadhlina NZ, Ng EK, Thong KM, Goh BL, Sulaiman DM, Fatimah DAN, Evi DO, Siti SR, Wilson RJ, Keith M, Copley JB, Gros B, Galan A, Gonzalez-Parra E, Herrero JA, Oyaguez I, Keith M, Casado MA, Lucisano S, Coppolino G, Villari A, Cernaro V, Lupica R, Trimboli D, Aloisi C, Buemi M. CKD-MBD II. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mima K, Fujita K, Azuma H, Yamazaki A, Kato Y, Okuda C, Ukyo Y, Sawada H, Gonzalez-Arrabal R, Perlado J, Nishimura H, Nakai S. Application of laser produced ion beams to nuclear analysis of materials. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20135919001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nakai S, Zou G, Okuda T, Nishijima W, Hosomi M, Okada M. Polyphenols and fatty acids responsible for anti-cyanobacterial allelopathic effects of submerged macrophyte Myriophyllum spicatum. Water Sci Technol 2012; 66:993-999. [PMID: 22797226 DOI: 10.2166/wst.2012.272] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Myriophyllum spicatum is known to inhibit the growth of cyanobacteria such as Microcystis aeruginosa by releasing anti-cyanobacterial allelochemicals. The allelochemicals possibly responsible for the inhibition include five polyphenols and three fatty acids, but the extent to which these are indeed responsible for the anti-cyanobacterial effects is unclear. The goal of this research was to determine the contribution of these compounds to the allelopathic effect of M. spicatum on M. aeruginosa. We first collected information on the release rates of these compounds and then added the compounds to a cyanobacterial medium on the basis of their release rates so as to simulate their excretion by M. spicatum. Addition of the polyphenols and fatty acids inhibited the growth of M. aeruginosa, and the interaction of the polyphenols and fatty acids was additive. The EC50 of a polyphenol and fatty acid mixture was compared with that of M. spicatum itself as previously determined in a mixed culture system in which M. spicatum and M. aeruginosa were incubated. The former was about 1.9 times higher than that of the latter, the implication being that the inhibitory effect of the polyphenols and fatty acids contributed about 53% of the allelopathic effect of M. spicatum. This paper is the first to describe allelochemicals that account for a half of the anti-cyanobacterial allelopathic effect of a macrophyte.
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Affiliation(s)
- S Nakai
- Graduate School of Engineering, Hiroshima University, Higashi-hiroshima 739-8527, Japan.
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Liu F, Marzell B, Arkossy O, Gurevich K, Kaufmann P, Schoder V, Arens HJ, Passlick-Deetjen J, Bosticardo G, Malberti F, Basile C, Libutti P, Filiberti O, Cozzolino M, Brancaccio D, Cannella G, Messa P, Mazzaferro S, Fujii N, Hamano T, Taniguchi M, Shoji T, Shigematsu T, Nakai S, Iseki K, Tsubakihara Y. Dialysis / Mineral bone disease 2. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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