Forty-year durability of a Smeloff-Cutter ball valve prosthesis in the mitral position.

A rare case requiring replacement of an intact Smeloff-Cutter ball prosthesis in the mitral position 40 years after implantation is presented. The Smeloff-Cutter ball valve prosthesis was designed to have two open cages. It has two potential advantages: a relatively large, effective orifice area and its self-washing effect that prevents thrombus formation. There have been only a few reports of survivors with ball valve prostheses in place for more than three decades especially in the mitral position. This is a valuable report describing the long-term durability of a Smeloff-Cutter ball valve prosthesis in the mitral position.

Hydrogen therapy attenuates irradiation-induced lung damage by reducing oxidative stress.

Molecular hydrogen (H(2)) is an efficient antioxidant that diffuses rapidly across cell membranes, reduces reactive oxygen species (ROS), such as hydroxyl radicals and peroxynitrite, and suppresses oxidative stress-induced injury in several organs. ROS have been implicated in radiation-induced damage to lungs. Because prompt elimination of irradiation-induced ROS should protect lung tissue from damaging effects of irradiation, we investigated the possibility that H(2) could serve as a radioprotector in the lung. Cells of the human lung epithelial cell line A549 received 10 Gy irradiation with or without H(2) treatment via H(2)-rich PBS or medium. We studied the possible radioprotective effects of H(2) by analyzing ROS and cell damage. Also, C57BL/6J female mice received 15 Gy irradiation to the thorax. Treatment groups inhaled 3% H(2) gas and drank H(2)-enriched water. We evaluated acute and late-irradiation lung damage after H(2) treatment. H(2) reduced the amount of irradiation-induced ROS in A549 cells, as shown by electron spin resonance and fluorescent indicator signals. H(2) also reduced cell damage, measured as levels of oxidative stress and apoptotic markers, and improved cell viability. Within 1 wk after whole thorax irradiation, immunohistochemistry and immunoblotting showed that H(2) treatment reduced oxidative stress and apoptosis, measures of acute damage, in the lungs of mice. At 5 mo after irradiation, chest computed tomography, Ashcroft scores, and type III collagen deposition demonstrated that H(2) treatment reduced lung fibrosis (late damage). This study thus demonstrated that H(2) treatment is valuable for protection against irradiation lung damage with no known toxicity.

[Aortic regurgitation due to quadricuspid aortic valve; report of a case].

A 66-year-old man was referred to our hospital for surgical treatment for aortic regurgitation. Transthoracic echocardiography revealed the diagnosis of aortic regurgitation due to quadricuspid aortic valve. During operation, we confirmed that the aortic valve consisted of 4 leaflets with almost same size (Hurwitz and Roberts classification type A). We performed valve replacement because each leaflet has degenerative change. The patient's postoperative course was uneventful and discharged the hospital without complications. Congenital quadricuspid aortic valves are rare, and patients with this disease are frequently operated because of aortic regurgitation. Presently, common operative procedure is aortic valve replacement, although in the future valvuloplasty should be investigated.

Use of a bioabasorbable bone pin fixation for nasal fractures.

After repairing a nasal fracture, it is customary to provide postoperative support for the nasal bone with intranasal, antibiotic-soaked gauze packing and an external splint. However, in cases of a skull base fracture with liquorrhea, this procedure is generally contraindicated because of the risk of infection. To lessen this risk, the authors used a bioabsorbable pin which is ultimately absorbed by the body through the natural process of hydrolysis. An intranasal support was inserted from outside the skin down to the maxilla. The operative results were satisfactory with no postoperative complications such as an inflammatory reaction or an infection.