[Left Ventricular Plasty for Left Ventricular Aneurysm Following Takotsubo Cardiomyopathy].

An 82-years-old woman was admitted with sudden chest pain. Coronary angiography did not reveal any significant stenosis, but left ventriculography showed akinesis and ballooning of the apex with a hyperkinetic basal segment, suggestive of takotsubo cardiomyopathy. She suffered intractable heart failure, and laboratory data, electrocardiogram signs of ST-segment elevation and left ventricular( LV) apical dysfunction failed to show improvement. LV plasty was performed on 106th day after the onset because of aneurysmal change of the left ventricular apex myocardium, unremitting sanguineous pericardial effusion, and anemia. She had a good postoperative course and end-diastolic ventricular volume index was remarkably reduced from 144 to 55 ml/m2. She discharged home on the 38th postoperative day.

MOF-Polymer Hybrid Materials: From Simple Composites to Tailored Architectures.

Metal-organic frameworks (MOFs) are inherently crystalline, brittle porous solids. Conversely, polymers are flexible, malleable, and processable solids that are used for a broad range of commonly used technologies. The stark differences between the nature of MOFs and polymers has motivated efforts to hybridize crystalline MOFs and flexible polymers to produce composites that retain the desired properties of these disparate materials. Importantly, studies have shown that MOFs can be used to influence polymer structure, and polymers can be used to modulate MOF growth and characteristics. In this Review, we highlight the development and recent advances in the synthesis of MOF-polymer mixed-matrix membranes (MMMs) and applications of these MMMs in gas and liquid separations and purifications, including aqueous applications such as dye removal, toxic heavy metal sequestration, and desalination. Other elegant ways of synthesizing MOF-polymer hybrid materials, such as grafting polymers to and from MOFs, polymerization of polymers within MOFs, using polymers to template MOFs, and the bottom-up synthesis of polyMOFs and polyMOPs are also discussed. This review highlights recent papers in the advancement of MOF-polymer hybrid materials, as well as seminal reports that significantly advanced the field.

Self-Assembly of Metal-Organic Framework (MOF) Nanoparticle Monolayers and Free-Standing Multilayers.

We report the first self-assembled porous monolayer and free-standing multilayer films composed of metal-organic framework (MOF) nanoparticles. Self-assembled MOF monolayers (SAMMs) were assembled at a liquid-air interface to produce films that are 87 wt % (89 vol %) MOF. Monolayer self-assembly was aided by growing a layer of poly(methyl methacrylate) (PMMA) on the particle surface using a histamine anchor. SAMMs could be stacked to obtain MOF multilayers, including alternating MOF/polymer heterostructures. SAMMs were coated on silicon microparticles, and a MOF film constructed of only five stacked layers could be manipulated as a free-standing, opalescent film. These monolayers are a significant advancement for obtaining highly functional porous membranes and coatings.

[Coronary Artery to Pulmonary Artery Fistula with a Large Coronary Artery Aneurysm Detected by Multi-detector Row Computed Tomography;Report of a Case].

We report a case of coronary artery to pulmonary artery fistula with a large coronary artery aneurysm (80 mm). A 62-year-old man was referred to our hospital because of syncope without heart failure. Electrocardiogram abnormality and asynergy in the anteroseptal wall were detected on echocardiography. Coronary angiography and multi-detector row computed tomography( MDCT) showed a large coronary artery aneurysm and coronary artery to pulmonary artery fistula originating from the right coronary artery( RCA), left main trunk( LMT) and left anterior descending artery( LAD). The fistula was treated using ligation and endocardial closure, and the aneurysm was resected without coronary artery bypass grafting. Postoperatively, MDCT showed that the fistula and aneurysm had disappeared. MDCT was useful for understanding the spatial relation of the coronary artery to pulmonary artery fistula.

[Mitral Valve and Tricuspid Valve Regurgitation in a Patient with Dextrocardia and Absence of the Inferior Vena Cava].

Dextrocardia is a rare condition frequently associated with multiple and complex cardiovascular abnormalities. A 66-year-old woman, who had been diagnosed with dextrocardia at young age, was referred to our hospital with complaint of increasing dyspnea. Severe mitral regurgitation, moderate tricuspid regurgitation, and atrial fibrillation were detected. The multi detector-row computed tomography(MDCT) revealed absence of the inferior vena cava, and the hepatic vein connected directly with the right atrium. The venous cannulae were inserted into the superior vena cava directly and into the hepatic vein from the right atrium. Mitral valve repair, tricuspid valve repair, and maze procedure were successfully performed. MDCT is useful for detecting abnormality of vena cava in a cases of dextrocardia.

[Cardiac Amyloidosis Diagnosed Following Mitral Valve Repair; Report of a Case].

We present a case of a 60-year-old female who underwent elective mitral valve repair for mitral valve regurgitation. Intra-aortic balloon pumping was necessary to wean her from cardiopulmonary bypass, and a sudden cardiac arrest happened on postoperative day 17. Due to such unexpected postoperative course, a right ventricular biopsy was done, and she was diagnosed with light chain amyloidosis (AL) type cardiac amyloidosis. Despite long percutaneous cardiopulmonary bypass support, she never recovered from severe heart failure. Cardiac surgeons should be aware of this fatal disease, and preoperative screening with various tests is required.

Myrmecophilous rove beetles (Coleoptera: Staphylinidae) associated with Aenictus hodgsoni (Hymenoptera: Formicidae) from Thailand, with description of two new genera and three new species.

Three species of rove beetles (subfamily Aleocharinae) were collected from colonies of Aenictus hodgsoni Forel, 1901 in Khao Yai National Park, Thailand. They are classified into three genera, including two new genera, and described herein as: Aenictobia siamensis Maruyama, sp. n. (tribe Aenictoteratini), Aenictosymbia cornuta Maruyama, gen. & sp. n. (tribe Lomechusini) and Aenictoxenides mirabilis Maruyama, gen. & sp. n. (tribe Pygostenini). The systematic positions of the new genera are discussed.

Endoscopic Pedicle Saphenous Vein Graft Harvesting.

The excellent long-term patency of no-touch (NT) saphenous vein grafts (SVGs) makes the grafts very attractive for coronary artery bypass grafting; however, NT-SVG harvesting has a greater incidence of wound complications than conventional methods. Since 2009, we have performed endoscopic vein harvesting (EVH) in our department with very few major wound complications. Because NT-SVG harvesting is expected to provide long-term patency, if performed with EVH, the incidence of wound complications will be reduced. Thus, we began performing endoscopic pedicle SVG harvesting (Pedicle-EVH) in March 2019. Herein, we report the early results obtained using our current Pedicle-EVH procedure. No major wound complications were reported, and the early results, including patency, were satisfactory. To harvest the pedicle SVG, however, we used a different method than the NT-SVG procedure, so careful monitoring will be needed to assess long-term outcomes.

Risk factors for early-onset high myopia after treatment for retinopathy of prematurity.

PURPOSE: To investigate the prevalence of myopia and high myopia and the risk factors for high myopia in infants at 3 years of age with retinopathy of prematurity (ROP). STUDY DESIGN: Retrospective, observational. METHODS: We retrospectively analyzed all 89 preterm infants (178 eyes) with medical records of ROP between October 2008 and March 2018 at Toho University Medical Center Omori Hospital; these infants had a birth weight of less than 1,500 g and were followed up at least until 3 years of age. Cycloplegic autorefraction was performed to measure refractive outcomes. Multivariate analysis was performed to determine the risk factors for early-onset high myopia at 3 years of age. RESULTS: The prevalence of myopia and high myopia was significantly higher in the treated group (59.7% and 17.9%, respectively) than in the untreated group (19.7% and 0%, respectively) (p<0.001). Spherical equivalent (SE) at age 3 was more myopic in the treatment group (-1.72 ± 3.53 D) than in the untreated group (0.54 ± 1.08 D) (p<0.001). In the sub-analysis of the treatment group, there was a significant correlation between SE at age 3 and the number of laser shots (R2 = 0.36, p<0.001). Multivariate logistic analysis showed that the number of laser shots was an independent risk factor for early onset high myopia (p<0.05). CONCLUSION: The number of laser shots is an independent risk factor for early onset high myopia, and preterm infants who have undergone laser treatment for severe ROP should be considered for early optical correction with cycloplegic refractive examination.

New general method for regio- and stereoselective allylic substitution with aryl and alkenyl coppers derived from Grignard reagents.

Allylic substitution with sp(2)-carbon reagents (aryl and alkenyl anions) was realized by using allylic picolinates and copper reagents derived from RMgBr and CuBr x Me(2)S to afford anti S(N)2' products regio- and stereoselectively. Steric and electronic factors in the reagents and the size of the methylene substituents around the allylic moiety marginally affected the selectivity. The reaction system was compatible with alkyl reagents as well. Furthermore, the substitution was applied to construction of a quaternary center and synthesis of (-)-sesquichamaenol. Electron-withdrawing nature of the pyridyl group and chelation of the C(=O)-C(5)H(4)N to MgBr(2) generated in situ were found to be responsible for the high efficiency of the substitution.

Mitral valve stenosis caused by abnormal pannus extension over the prosthetic ring and leaflets after Duran ring mitral annuloplasty.

We treated a 61-year-old woman with mitral stenosis caused by pannus formation after Duran ring annuloplasty. Pannus overgrowth on the ring with extension onto both leaflets narrowed the mitral orifice and severely restricted the mobility of the valve leaflets. Mitral valve replacement with a St. Jude Medical mechanical heart valve prosthesis was successfully performed, and the postoperative course was uneventful. Patients undergoing Duran ring annuloplasty should be followed up with the consideration of possible mitral stenosis caused by pannus extension, as the cause for pannus formation remains unclear.

[Aortitis syndrome with repeated restenoses of a drug eluting stent].

The patient was a 49-year-old female who developed acute myocardial infarction of the right coronary artery in August 2005. In a short period of time, the patient had restenosis repeatedly after percutaneous coronary intervention (PCI). Restenosis could not be prevented even with a drug eluting stent (DES), and thus, off-pump coronary artery bypass grafting (OPCAB) was performed. The diagnosis of aortitis syndrome was made due to protracted postoperative inflammation. Aortitis syndrome was determined to be the main cause of repeated restenosis. This case was a middle-aged female who had restenosis in a short period of time, and aortitis syndrome should have been included in the differential diagnosis. Although some positive results have been reported on DES placement for coronary lesions of aortitis syndrome, DES was completely ineffective in our patient. Further studies with more patients are necessary to examine the effectiveness of DES.

Defect-Free MOF-Based Mixed-Matrix Membranes Obtained by Corona Cross-Linking.

Functionalized UiO-66 metal-organic frameworks (MOF) particles were covalently grafted with hydride-terminated poly(dimethylsiloxane) (PDMS) via postsynthetic modification. These PDMS-coated MOF particles (termed here "corona-MOF") were used in the preparation of mixed-matrix membranes (MMMs). Defect-free MMMs with weight loadings of 50% were achieved with corona-MOF particles, attributed to the improved dispersibility of the corona-MOF particles and covalent linkages between the corona-MOF particles and the polymer matrix. The PDMS MMMs showed distinct separation features in single gas permeation tests, displaying much higher CO2 gas permeation with no decrease in selectivity when compared to MMMs prepared with unmodified UiO-66 particles. Single gas separation tests with CO2, N2, and propane were performed to probe the separation mechanism of the corona-MOF MMMs, demonstrating that these MMMs avoid nonideal "sieve-in-a-cage" and "plugged sieves" scenarios. Additionally, due to covalent bond formation between both the MOF and the polymer matrix in corona-MOF MMMs, particle aggregation is negligible during film curing, allowing for the formation of flexible, self-standing MMMs of <1 µm in thickness. Low quantities of polymer covalently attached to the MOF surface (<5 wt %) are sufficient to fabricate thin, defect-free, high MOF-loading MMMs.

Picolinoxy group, a new leaving group for anti SN2' selective allylic substitution with aryl anions based on Grignard reagents.

The picolinoxy group was found to be an extremely powerful leaving group for allylic substitution with aryl nucleophiles derived from ArMgBr and CuBr*Me2S. The substitution proceeds with anti SN2' pathway and with high chirality transfer. The electron-withdrawing effect of the pyridyl group and chelation to MgBr2 are likely the origin of success. Results suggesting these effects were obtained.

Cardiac angiosarcoma with right atrial perforation and cardiac tamponade.

Primary cardiac angiosarcoma is a rare tumor associated with a poor prognosis. We report a case of a 59-year-old woman with right atrial angiosarcoma presenting with cardiac tamponade due to right atrial perforation. She underwent urgent surgical resection of the tumor. However, the patient died 68 days after surgery due to local recurrence. An effective treatment for cardiac angiosarcoma has not yet been established. However, more aggressive treatment with a combination of surgery, radiation, chemotherapy and IL-2 should be considered.

Perioperative coronary artery spasm in off-pump coronary artery bypass grafting and its possible relation with perioperative hypomagnesemia.

PURPOSE: We experienced 3 cases of serious perioperative coronary artery spasm in off-pump coronary artery bypass grafting (OPCAB). In consideration of the causes, we directed our attention to hypomagnesemia, one of the triggers of coronary artery spasm. This study was performed to confirm the tendency to hypomagnesemia in OPCAB. METHODS: First, we report 3 patients having severe coronary artery spasm immediately after OPCAB with consideration of the causes. Second, serial magnesium (Mg) value (xylidyl blue method, normal 1.9-3.1 mg/dl) was measured in 45 consecutive patients with OPCAB between April and October 2002, 1) before starting the operation, and 2) after the patient's entrance into the intensive care unit. RESULTS: Preoperative and postoperative values of Mg (mg/dl) were 2.1+/-0.3, 1.7+/-0.3, respectively (p < 0.01). Postoperative incidence of hypomagnesemia was as high as 89% of the patients (40 out of 45 patients). In this study and thereafter, we corrected hypomagnesemia with magnesium sulfate during and after OPCAB, and no perioperative coronary artery spasm occurred. CONCLUSION: Hypomagnesemia, one of the triggers of coronary artery spasm, is very common in OPCAB. We strongly recommend the correction of hypomagnesemia during and after OPCAB for the prevention of perioperative coronary artery spasm.

Surgical treatment of pseudoaneurysm of the sinus of valsalva after aortic valve replacement for active infective endocarditis.

Pseudoaneurysm is an uncommon and serious complication of infective endocarditis (IE). It is often fatal because of its rapid progress, high rates of rupture and recurrence, and worsening effects on the systemic condition. We report the rare case of a patient who developed a pseudoaneurysm of the sinus of Valsalva two months after emergency aortic valve replacement for active IE. At the previous operation, we had directly closed a small fistulous hole in the non-coronary sinus of Valsalva using two mattress sutures with autologous pericardial pledgets, because the tissue surrounding the hole did not appear to be infected on visual inspection. A pseudoaneurysm developed from this portion due to detachment of sutures. If the fistula had been completely resected during the first surgery instead of performing a simple closure, the pseudoaneurysm of the sinus of Valsalva would not have formed. However, the primary aim of the first emergency surgery was to spare the life of a critically ill patient. In the second surgery, the pseudoaneurysm was completely resected with the aortic wall--including the non-coronary sinus of Valsalva and the communicating hole. Then, patch plasty of the non-Valsalva sinus was successfully performed.

Surgical treatment for coronary artery aneurysm.

Two successful cases of the surgical treatment for coronary artery aneurysm (non-Kawasaki disease) were reported. The first case had a saccular aneurysm on the left circumflex coronary artery (LCx) #14. Resection of the LCx aneurysm was performed subsequent to single vessel coronary artery bypass grafting (CABG) to the distal portion of LCx#14 under the cardioplegic cardiac arrest. The second case had aneurysms on both the left anterior descending artery (LAD) #7 (fusiform) and the LCx#11 (saccular). After double vessel CABG to LAD#7 and LCx#11, ligation or resection of two aneurysms was performed successfully. Postoperative courses have been uneventful with good angiographic results achieved. Since these surgical procedures demonstrated safety, the patients are expected to achieve a good long-term prognosis.

Reproducibility of Neonate Ocular Circulation Measurements Using Laser Speckle Flowgraphy.

Measuring the ocular blood flow in neonates may clarify the relationships between eye diseases and ocular circulation abnormalities. However, no method for noninvasively measuring ocular circulation in neonates is established. We used laser speckle flowgraphy (LSFG) modified for neonates to measure their ocular circulation and investigated whether this method is reproducible. During their normal sleep, we studied 16 subjects (adjusted age of 34-48 weeks) whose blood flow could be measured three consecutive times. While the subjects slept in the supine position, three mean blur rate (MBR) values of the optic nerve head (ONH) were obtained: the MBR-A (mean of all values), MBR-V (vessel mean), and MBR-T (tissue mean), and nine blood flow pulse waveform parameters in the ONH were examined. We analyzed the coefficient of variation (COV) and the intraclass correlation coefficient (ICC) for each parameter. The COVs of the MBR values were all ≤ 10%. The ICCs of the MBR values were all >0.8. Good COVs were observed for the blowout score, blowout time, rising rate, falling rate, and acceleration time index. Although the measurement of ocular circulation in the neonates was difficult, our results exhibited reproducibility, suggesting that this method could be used in clinical research.