ABSTRACT
A 63-year old man was referred to our hospital with dyspnea on exertion and palpitation. An echocardiogram disclosed aortic stenosis and regurgitation, mitral regurgitation and tricuspid regurgitation. During cardiac catheterization, the right coronary ostium could not be cannulated, by coincidence, showed ventricular outpouching. Preoperative contrast-enhanced CT showed the partition wall isolating the right coronary ostium and the left ventricular outpouching in the subaortic valve area. The patient underwent aortic valve replacement after resection of the rudimentary right coronary cusp, and we resected the outpouching and closed the orifice with mattress sutures from the inside of the LV and the outside. Histopathology demonstrated that the resected outpouching was congenital fibrous left ventricular diverticulum.
ABSTRACT
<b>Objective: </b>In drug treatment for pregnant and lactating women, pharmacists need to contribute to adequate drug treatment by collecting much information from various sources. However, it takes much time to collect information using plural sources. In this study, we tried to develop a database system which enables expeditiously collecting the domestic and foreign drug use criteria information in order to streamline collecting information for pregnant and lactating women. In addition, we assessed the utility of the database by comparing the time to collect information using the database to that using each information source and the usability by questionnaires.<br><b>Methods: </b>We developed a database system that integrates drug information from the FDA Pregnancy Category, Australian categories for prescribing medicines in pregnancy, “Drugs in Pregnancy & Lactation,” and Japanese package inserts. For assessment of the usability of the database, we assessed the time required to collect information and subjective evaluation using the five-method questionnaires.<br><b>Results: </b>The database significantly reduced the time needed for collecting criteria information and made it possible to compile the information simultaneously from various sources. The questionnaire survey showed that over 80% of pharmacists and students were satisfied with the database.<br><b>Conclusion: </b>It is suggested that our database system is useful to efficiently collect drug use criteria information for pregnant and lactating women.
ABSTRACT
A 53-year-old woman underwent mitral valve replacement for congestive heart failure due to mitral stenosis and regurgitation. She had been receiving hemodialysis because of diabetic nephropathy since 1993, and had had congestive heart failure since 1999. Echocardiography demonstrated mitral stenosis (MVA; 1.10cm<sup>2</sup>) and regurgitation with a severely calcified mitral annulus. Annular calcification extended to the posterior wall of the left ventricle and the base of bilateral papillary muscles. After removing all calcium from the mitral annulus to the base of the papillary muscle, the left ventricular posterior wall and mitral annulus were reconstructed by glutaraldehyde-preserved autologous pericardium. Then, a Carbo-Medics mechanical valve was placed at the mitral annulus using everting mattress sutures. Although her hemodynamics were stable, bacteremia and multi-organ failure developed 3 months after surgery and she died. Autopsy showed that the reconstructed left ventricular posterior wall and mitral annulus using glutaraldehyde preserved autologous pericardium were in excellent condition without any thrombus. No dehiscence was found at the suture line of the mechanical valve. Mitral annulus reconstruction with glutaraldehyde preserved autologous pericardium is thought to be effective for patients with calcified mitral annulus who require mitral valve surgery.
ABSTRACT
Extracorporeal shock wave lithotripsy (ESWL) represents the preferred treatment for most upper ureteric and renal calculi. Complication rates associated with ESWL are low, justifying the enthusiasm and acceptance of this treatment modality. We report a case of abdominal aortic pseudoaneurysm due to ESWL. A 47-year-old man had undergone ESWL treatment for ureteric calculi since 1990. He was admitted to our hospital because of lumbar pain. Physical examination revealed a pulsatile mass in his abdomen. Abdominal CT scan showed an abdominal aortic aneurysm (5.3cm in diameter). Angiography showed a fusiform aneurysm of the infrarenal abdominal aorta. Y-graft replacement was performed after aneurysm resection. Histological examination revealed that it was a pseudoaneurysm. The patient had no history of trauma, inflammation or operation except ESWL. This is the first report of abdominal aortic pseudoaneurysm due to ESWL.
ABSTRACT
Since arteriosclerosis is a general progressive disease, an aneurysm of the thoracic aorta is not infrequently complicated by ischemic heart disease. Therefore, assessment of indications of surgical treatment and selection of the surgical procedure and auxiliary procedures on the basis of accurate preoperative evaluation of ischemic heart disease are considered to be very important for improving the results of operations for thoracic aortic aneurysm. Recently. we successfully operated on a 64-year-old patient with a left ventricular aneurysm and a descending aortic aneurysm. One-stage operation was performed by a left thoracotomy approach and partial left heart bypass by draining the pulmonary artery into the femoral artery with mild hypothermia. The approach and the auxiliary procedures employed in this patient are considered to be a useful combination applicable also to one-stage operation for descending aortic aneurysm and coronary artery bypass grafting.
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Effects of treadmill running and restricted food intake on the metabolism of protein in several tissues were studied in male Wistar rats, aged 5 weeks and weighing about 100 g. Rats were divided into control group under free food intake (C), sedentary group under restricted food intake (Sr), exercise group under restricted food intake (Er), Food intake was restricted approximately to 66% of fed ad libitum for control group. Exercise program consisted of treadmill running for 60 minutes a day at 30 m/min on 6 days a week for 12 weeks.<BR>A. The effects of sedentary under restricted food intake.<BR>When compared with C<BR>1) Lowering of body weight and increment in mg tissue/g body weight ratios. (M. Gastrocnemius, Liver, Brain, Testis, M. Soleus, M. Plantaris)<BR>2) Significantly low level of protein content in gastrocnemius muscles, liver and kidney.<BR>3) Inhibition in incorporation of <SUP>14</SUP>C-amino acid mixture into brain and kidney protein in vivo.<BR>B. The effects of exercise under restricted food intake.<BR>i) compared with C<BR>The effects were the same as those of Sr.<BR>ii) compared with Sr<BR>1) Lowering of body weight and increment in mg tissue/g body weight ratios. (Liver, Heart, Kidney, Testis)<BR>2) Significantly low level of protein content in gastrocnemius muscles.<BR>From this study it was suggested that, under the food restriction of long duration, the maintenance of protein content in brain in spite of the decrease of protein content in the other tissues indicated the existence of internal mechanism for life conservation in severe environment. And loaded with exercise under food restriction, protein content in gastra cnemius muscles decreased. Therefore, it was conceivable that skeletal muscles protein was consumed as energy for exercise.
ABSTRACT
The purpose of this study was to observe the effect of training on morphological properties in the collagen fibers of tendons. Wistar strain rats at 7 weeks old were assigned to high speed endurance (H), moderate speed endurance (M), jump training (J) and control (C) groups. The amount of exercise for H group (speed at 30m/min for 60 minutes) and M group (speed at 17m/min for 75 minutes) was equalized according to the amount of oxygen consumed during training. As for the anaerobic training (J group), rats made high jumping form the standing position, wearing jacket with 50% of body weight, 50 times/day, which lasted for 4-5 minutes. The training period was designed for 5 days per week for 16 weeks.<BR>The follwing is a summary of the results obtained:<BR>1) Increases in fiber areas of both Slow-Twitch (ST) and Fast-Twitch (FT) fibers were observed in the H, M and J groups. The ST fiber area of H group was significantly larger than that of C group. Significant increase in FT fiber area was observed in both M and J groups.<BR>2) Hypertrophy of collagen fiber in gastrocnemius muscle tendon was observed in Hand M groups; especially, M group showed much larger increase than H group. It tended to be greater for J group as compared with C group.<BR>3) Collagen fiber area and diameter of tendon in plantar muscle were slightly larger for H and M groups relative to C group, but these differences were not significant.<BR>These results suggested that both types of aerobic training induced hypertrophy in the collagen fibers of the tendons and increased the tensile strength; especially, the group which trained longer hours induced the higher effect.