[Asymptomatic Congenital Left Ventricular Aneurysm Treated with Endocardial Linear Infarct Exclusion Technique( ELIET):Report of a Case].

Surgical repair of asymptomatic congenital left ventricular aneurysm is poorly reported. A 30-yearold man presented with an asymptomatic abnormal electrocardiogram. Computed tomography (CT) and angiography revealed a congenital left ventricular aneurysm, and surgical repair was conducted with endocardial linear infarct exclusion technique (ELIET). His postoperative course was uneventful. Postoperative CT showed an elliptical cardiac shape with no recurrence of aneurysm. ELIET would serve as a surgical procedure for congenital left ventricular aneurysm.

[Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy Due to Noonan Syndrome;Report of a Case].

A 15-year-old boy with Noonan syndrome, who had been diagnosed with hypertrophic cardiomyopathy (HCM) at 4 and treated by drugs, was referred to our hospital because of progression of left ventricular outflow tract obstruction (LVOTO). Transthoracic echocardiogram (TTE) revealed left ventricular hypertrophy( LVH), LVOTO( systolic gradient:102 mmHg), and systolic anterior motion of the mitral valve( SAM) with mild mitral regurgitation(MR). We performed septal myectomy by transaortic and transapical approaches. Postoperative TTE revealed significant reduction in left ventricular outflow tract (LVOT) gradient (9 mmHg), resolution of SAM, and reduction in MR grade. The postoperative course was uneventful except for transient atrial tachyarrhythmia. Myectomy for HCM in a patient with Noonan syndrome is rare. This case suggests that myectomy is useful for the patients with Noonan syndrome.

[Aorta-left Main Trunk Interposition for Adult Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Using a Prosthetic Graft;Report of a Case].

A 70-year-old woman with back pain was diagnosed with adult anomalous origin of the left coronary artery from the pulmonary artery [Bland-White-Garland (BWG) syndrome]. Preoperative transthoracic echocardiography showed diffuse hypokinesia of the left ventricle and mild mitral valve regurgitation. Coronary angiography revealed dilatation of both coronary arteries, but no aneurysms. The left coronary ostium was removed as buttons of the pulmonary arterial wall, and a prosthetic graft (8 mm ePTFE graft) was interposed between the ascending aorta and coronary button. The pulmonary arterial wall was repaired with a bovine pericardium. Postoperative angiography showed good flow of the graft. The antegrade flow provided by this simple technique will allow feasible percutaneous coronary intervention in the future.

Cardiopulmonary resuscitation at operating room entry in acute aortic dissection type A patients: is surgery contraindicated?

Background: This study aimed to compare the short-term outcomes of surgical treatment for acute type A aortic dissection between patients undergoing cardiopulmonary arrest at the time of entry into the operating room and patients who received successful preoperative cardiopulmonary resuscitation before entering the operating room or patients who had cardiopulmonary arrest on the operating room table after entering the operating room without cardiopulmonary arrest. In the present study, we focused on the circulatory status at the time of entering the operating room because it is economically and emotionally difficult to cease intervention once the patient has entered the operating room, where surgeons, anesthesiologists, nurses, and perfusionists are already present, all necessary materials are packed off and cardiopulmonary bypass have already been primed. Methods: Twenty (5.5%) of 362 patients who underwent surgical treatment for acute type A aortic dissection between January 2016 and March 2022 had preoperative cardiopulmonary arrest. To compare the early operative outcomes, the patients were divided into the spontaneous circulation group (n = 14, 70.0%) and the non-spontaneous circulation group (n = 6, 30.0%) based on the presence or absence of spontaneous circulation upon entering the operating room. The primary endpoint was postoperative 30-day mortality. The secondary endpoints included in-hospital complications and persistent neurological disorders. Results: Thirty-day mortality was 65% (n = 13/20) in the entire cohort; 50% (n = 7/14) in the spontaneous circulation group and 100% (n = 6/6) in the non-spontaneous circulation group. The major cardiopulmonary arrest causes were aortic rupture and cardiac tamponade (n = 16; 80.0%), followed by coronary malperfusion (n = 4; 20.0%). Seven patients (50.0%) survived in the spontaneous circulation group, and none survived in the non-spontaneous circulation group (P = .044). Five survivors walked unaided and were discharged home; the remaining two were comatose and paraplegic. Conclusions: The outcomes were extremely poor in patients with acute type A aortic dissection who had preoperative cardiopulmonary arrest and received ongoing cardiopulmonary resuscitation at entry into the operating room. Therefore, surgical treatment might be contraindicated in such patients.

Influence of Water Molecules on CO2 Reduction at the Pt Electrocatalyst in the Membrane Electrode Assembly System.

CO2 electroreduction using a Pt catalyst in an aqueous solution system is known to produce only H2. Recently, a remarkable result has been reported that CH4 can be obtained by reducing CO2 using a membrane electrode assembly (MEA) containing a Pt catalyst. A big difference that exists between the two systems is the number of water molecules. Therefore, this study investigated the influence of water molecules on the CO2-reduction process at the Pt electrocatalyst in the MEA system. As a result, cyclic voltammetry indicated that adsorbed CO (COads) was formed by CO2 reduction in the MEA system more preferably than the aqueous solution system. In detail, the ratio of COads at the atop sites (linear CO, COL) on Pt, which participates in the CH4 generation reaction, to the total COads formed by the CO2 reduction became higher as the lower relative humidity (RH) at 50 °C in the MEA system. Cyclic voltammetry combined with in-line mass spectrometry revealed that the amount of COL and CH4 generated by the CO2 reduction reached their maximums at 63.1% RH. CH4 production by the extremely low-overpotential CO2 reduction was significantly achieved under all the RH conditions. Consequently, the Faradaic efficiency of the CH4 production at 63.1% RH was improved by 1.35 times compared to that at 100% RH. These results would be mainly obtained based on the H2O-involved chemical equilibrium of the reactions for the COads and CH4 formation. Overall, the present study experimentally clarified that the formation of COads (particularly COL) and the following CH4 from the CO2 reduction at the Pt electrocatalyst in the MEA system was facilitated by appropriately controlling the water-molecule content.

Utility of Crowdsourced User Experiments for Measuring the Central Tendency of User Performance: A Case of Error-Rate Model Evaluation in a Pointing Task.

The usage of crowdsourcing to recruit numerous participants has been recognized as beneficial in the human-computer interaction (HCI) field, such as for designing user interfaces and validating user performance models. In this work, we investigate its effectiveness for evaluating an error-rate prediction model in target pointing tasks. In contrast to models for operational times, a clicking error (i.e., missing a target) occurs by chance at a certain probability, e.g., 5%. Therefore, in traditional laboratory-based experiments, a lot of repetitions are needed to measure the central tendency of error rates. We hypothesize that recruiting many workers would enable us to keep the number of repetitions per worker much smaller. We collected data from 384 workers and found that existing models on operational time and error rate showed good fits (both R 2 > 0.95). A simulation where we changed the number of participants N P and the number of repetitions N repeat showed that the time prediction model was robust against small N P and N repeat, although the error-rate model fitness was considerably degraded. These findings empirically demonstrate a new utility of crowdsourced user experiments for collecting numerous participants, which should be of great use to HCI researchers for their evaluation studies.

Early Structural Valve Deterioration of Tricuspid Pericardial Valve Caused by Native Valve Adhesion.

Although preservation of the subvalvular apparatus affects left ventricular function and late outcome in mitral valve replacement, there are some reports of early structural valve deterioration caused by the adhesion of native valves. We report the case of a 41-year-old woman who developed early structural valve deterioration after tricuspid valve replacement caused by the adhesion of native valves. It is a rare complication, but one to consider upon observing early rising of the pressure gradient or symptoms after tricuspid valve replacement like mitral valve replacement.

Paper-cutting operations using scissors in Drury's law tasks.

Human performance modeling is a core topic in ergonomics. In addition to deriving models, it is important to verify the kinds of tasks that can be modeled. Drury's law is promising for path tracking tasks such as navigating a path with pens or driving a car. We conducted an experiment based on the observation that paper-cutting tasks using scissors resemble such tasks. The results showed that cutting arc-like paths (1/4 of a circle) showed an excellent fit with Drury's law (R2 > 0.98), whereas cutting linear paths showed a worse fit (R2 > 0.87). Since linear paths yielded better fits when path amplitudes were divided (R2 > 0.99 for all amplitudes), we discuss the characteristics of paper-cutting operations using scissors.

Efficacy of the Stonehenge Technique for Minimally Invasive Aortic Valve Replacement via Right Infraaxillary Thoracotomy.

Minimally invasive cardiac surgeries for aortic valve replacement (AVR) are still a technical challenge for surgeons because these procedures are undertaken through small incisions and deep surgical fields. Although AVR via vertical infraaxillary thoracotomy can be a cosmetically superior option, a disadvantage of this approach is the distance between the thoracotomy incision and the ascending aorta. Therefore, we devised a technique to perform all manipulations using the fingertips without the aid of a knot pusher or long-shafted surgical instruments. This was achieved by particular placement of several retracted sutures to the right chest wall. We named placement of these sutures the "Stonehenge technique." In conclusion, AVR via vertical infraaxillary thoracotomy with our Stonehenge technique can be safely and simply performed with superior cosmetic advantages.

Cep169, a Novel Microtubule Plus-End-Tracking Centrosomal Protein, Binds to CDK5RAP2 and Regulates Microtubule Stability.

The centrosomal protein, CDK5RAP2, is a microcephaly protein that regulates centrosomal maturation by recruitment of a γ-tubulin ring complex (γ-TuRC) onto centrosomes. In this report, we identified a novel human centrosomal protein, Cep169, as a binding partner of CDK5RAP2, a member of microtubule plus-end-tracking proteins (+TIPs). Cep169 interacts directly with CDK5RAP2 through CM1, an evolutionarily conserved domain, and colocalizes at the pericentriolar matrix (PCM) around centrioles with CDK5RAP2. In addition, Cep169 interacts with EB1 through SxIP-motif responsible for EB1 binding, and colocalizes with CDK5RAP2 at the microtubule plus-end. EB1-binding-deficient Cep169 abolishes EB1 interaction and microtubule plus-end attachment, indicating Cep169 as a novel member of +TIPs. We further show that ectopic expression of either Cep169 or CDK5RAP2 induces microtubule bundling and acetylation in U2OS cells, and depletion of Cep169 induces microtubule depolymerization in HeLa cells, although Cep169 is not required for assembly of γ-tubulin onto centrosome by CDK5RAP2. These results show that Cep169 targets microtubule tips and regulates stability of microtubules with CDK5RAP2.