A Case of Ross Procedure for Aortic Regurgitation due to Prolapse of a Right Coronary Cusp Caused by Natural Closure of Ventricular Septal Defect / 日本心臓血管外科学会雑誌

A 44-year-old man had been pointed out to have a heart murmur during his elementary school days. He came to us complaining of chest pain and palpitation. He was diagnosed to have severe aortic regurgitation caused by prolapse of the right coronary cusp, and the left ventricular function was depressed. At surgery, the aortic valve was repaired with the RCC resuspension technique, but regurgitation was not controlled because the RCC annulus was retracted by natural supracristal closure of the ventricular septal defect. We proceeded to the Ross procedure. A pulmonary autograft was harvested and sewed in the aortic annulus. The right ventricular outflow tract was reconstructed using a stentless bioprosthetic valve with glutaraldehyde-treated bovine pericardium. He was discharged after a straightforward postoperative course.

Ultrasound cardiography examinations detect victims' long-term realized and potential consequences after major disasters: a case-control study

BACKGROUND@#An increase in cardiovascular diseases has been reported following major disasters. Previous work has shown that ultrasonographic findings from ultrasound cardiography examination (UCG) increased until the 44th month after the tsunami caused by the Great East Japan Earthquake. The present study conducted UCG among victims in the tsunami disaster area and investigated the frequency of disaster-related cardiovascular diseases and changes over time until the 55th month after the disaster.@*METHODS@#The subjects were residents of temporary housing complexes and neighboring housing in Watari-gun, Miyagi Prefecture, Japan. There were 207 subjects in the 18th month, 125 in the 30th month, 121 in the 44th month, and 106 in the 55th month after the disaster. Data were collected through UCG and self-report questionnaire.@*RESULTS@#Significant changes were observed among subjects with clinical findings from the UCG, which increased over the study period-from 42.0 to 60.8, 72.7, and 73.6% beginning in the 18th month after the disaster (p < 0.0001).@*CONCLUSIONS@#It is possible that the UCG can become a useful examination to visualize the potential impact of a major disaster on the cardiac function of victims. Victims with clinical findings continued increasing not only during the acute phase after a disaster but also in the long term. We therefore need to keep this in mind, and note that it is important to establish a support system to control cardiovascular diseases from the early stage of disaster.@*TRIAL REGISTRATION@#UMIN; ID000029802. R000034050 . 2 November 2017.

Implantation of Liquid Nitrogen Frozen Tumor Tissue after Posterior Decompression and Stabilization for Metastatic Spinal Tumors

STUDY DESIGN: A retrospective study. PURPOSE: To evaluate the immunity-enhancing effect of implantation of a liquid nitrogen-treated tumor. OVERVIEW OF LITERATURE: We have developed a new technique of implanting a tumor frozen in liquid nitrogen after posterior decompression and stabilization, with the aim of enhancing antitumor immunity in order to prolong the survival period of the patient. In the current study, the immunity-enhancing effect of this new technique has been evaluated. METHODS: The subjects were 19 patients in whom we had earlier performed decompression and stabilization between April 2011 and September 2013. The 19 subjects were divided into two groups, namely a frozen autologous tumor tissue implantation group (n=15; "implantation group"), which consisted of patients, who underwent implantation with autologous tumor tissue frozen in liquid nitrogen, and a control group (n=4), which consisted of patients, who did not undergo autologous cancer transplantation. To evaluate the immunity-enhancing effect of the protocol, plasma cytokines (interferon [IFN]-gamma and interleukin [IL]-12) were analyzed before surgery and a month after surgery. RESULTS: The mean rate of increase in IFN-gamma was significantly higher in the implantation group (p=0.03). Regarding IL-12, no significant difference was observed between the groups, although the implantation group exhibited increased levels of IL-12 (p=0.22). CONCLUSIONS: Decompression and stabilization combined with autologous frozen tumor cell implantation can enhance cancer immunity in metastatic spinal tumor patients. It is hypothesized that this procedure might prevent local recurrence and prolong survival period.