[Mitral Valve Replacement Under Cardiac Arrest Using Systemic Hyperkalemia in a Patient with Atheromatous Aorta].

We report a successful case of mitral valve replacement and coronary artery bypass grafting under mild hypothermia and systemic hyperkalemia in a patient with severely atheromatous ascending aorta on which placing a clamp seemed contraindicated. A 78-year-old man was referred to our hospital with the diagnosis of heart failure associated with severe mitral regurgitation and coronary artery disease. Echocardiography showed severe mitral regurgitation due to A3, P3 and posterior commissure (PC) prolapse and coronary angiography showed three vessel disease. Computed tomography( CT) revealed a severely atheromatous ascending aorta. Surgery was performed under cardiac arrest using systemic hyperkalemia and superior transseptal approach. Although cardiopulmonary bypass (CPB) time was a little prolonged in order to wash out potassium with dilutional ultrafiltration, the patient was uneventfully separated from CPB. The patient had no neurological complications and was discharged from the hospital 15 days after surgery. Mitral valve replacement under cardiac arrest using systemic hyperkalemia without cross clamping the aorta is useful to avoid neurological complications.

[Surgical Treatment for Primary Pulmonary Artery Sarcoma;Report of a Case].

Primary pulmonary artery sarcoma is a very rare tumor. The prognosis of primary pulmonary artery sarcoma is extremely poor and it is reported as 1.5 months without treatment. Here we report our experience of surgical treatment of primary pulmonary artery sarcoma. A 66-year-old woman with a diagnosis of pulmonary sarcoma by chest computed tomography( CT) scan was referred to our hospital because of a loss of consciousness. An emergecy surgery was planned to eliminate the risk of sudden death. To avoid circulatory collapse, we placed her on extracorporeal bypass before anesthesia induction. The tumor extending from right ventricle outflow tract to bilateral pulmonary artery was removed and resected without leaving residual mass, but the surgical margin was positive, and adjuvant chemoradiotherapy was performed after discharge. In conclusion, surgical resection was succesfully conducted to avoid sudden death.

[Simultaneous Transapical Transcatheter Aortic Valve Implantation and Coronary Artery Bypass Grafting;Report of a Case].

Coronary artery disease(CAD) is often found concurrently in patients presenting with severe aortic stenosis(AS). Surgical aortic valve replacement(SAVR) and coronary artery bypass grafting(CABG) were usually selected with such patients. Recently, transcatheter aortic valve implantation (TAVI) is considered as a less invasive and more feasible treatment option in high-risk AS patients. A 74-year-old woman admitted due to acute myocardial infarction and treated with percutaneous coronary intervention revealed severe AS. Because of her comorbidities, concomitant transapical TAVI and CABG were performed with an excellent clinical course.

Complete genome sequence of pigeon circovirus detected in racing pigeons in western Japan.

We report the genetic analysis of a pigeon circovirus (PiCV/Japan/2/2010) detected in a racing pigeon with diarrheal symptoms in western Japan. Sequencing revealed a genome size of 2,041 bp that contained 3 open reading frames (ORFs), designated V1, C1, and C2, a structure consistent with to those of other pigeon circoviruses. Phylogenetic analyses of the ORF C1 revealed that PiCV/Japan/2/2010 diverges from other Asian pigeon circoviruses, suggesting genetic diversity of pigeon circoviruses in Asia.

Effect of D23N mutation on the dimer conformation of amyloid ß-proteins: ab initio molecular simulations in water.

The molecular pathogenesis of Alzheimer's disease (AD) is deeply involved in aggregations of amyloid ß-proteins (Aß) in a diseased brain. The recent experimental studies indicated that the mutation of Asp23 by Asn (D23N) within the coding sequence of Aß increases the risk for the pathogeny of cerebral amyloid angiopathy and early-onset familial ADs. Fibrils of the D23N mutated Aßs can form both parallel and antiparallel structures, and the parallel one is considered to be associated with the pathogeny. However, the structure and the aggregation mechanism of the mutated Aß fibrils are not elucidated at atomic and electronic levels. We here investigated solvated structures of the two types of Aß dimers, each of which is composed of the wild-type or the D23N mutated Aß, using classical molecular mechanics and ab initio fragment molecular orbital (FMO) methods, in order to reveal the effect of the D23N mutation on the structure of Aß dimer as well as the specific interactions between the Aß monomers. The results elucidate that the effect of the D23N mutation is significant for the parallel structure of Aß dimer and that the solvating water molecules around the Aß dimer have significant contribution to the stability of Aß dimer.