Open stent grafting with a trifurcated graft for an infected aortic arch aneurysm concomitant with severe calcified aorta.

An infected aortic arch aneurysm is a rare but life-threatening condition. Moreover, surgical treatment for patients with severe calcified aorta is challenging and needs a well-planned strategy. We report a patient with an infected aortic arch aneurysm concomitant with severe calcification of the aorta in whom good results were obtained with open stent grafting in combination with a trifurcated graft.

Determining if the relative shear modulus or the inverse of the relative shear modulus should be imaged using axial strain ratios on agar phantoms.

An axial strain image is considered to be an image of a relative shear modulus. However, through simulations of focal lesions, it was previously confirmed that reconstruction imaging of the 1-D relative shear modulus or its inverse obtained from the ratio of the axial strain in the axial direction (i.e., the axial strain ratio), with respect to a reference strain, produces larger contrast-to-noise ratios (CNRs) than that of the axial strain, although both of the reconstructions have smaller relative contrasts than that of the original shear modulus. The reference strain is appropriately chosen in the area of a homogeneous neighborhood in front of or behind the target by viewing in the B-mode and strain images. It has also been confirmed that the evaluations of CNRs of reconstructions immediately after strain measurement permit a prediction of which reconstructions should be imaged, i.e., a decision can be made without obtaining the reconstruction images, but by using the statistical evaluations of the measured strains in the focal lesion and in the surrounding region. In this study, the feasibility of using this prediction is verified through agar phantom experiments using actual measured axial strains obtained with the 2-D cross-spectrum phase-gradient method. The resulting successful prediction revealed that the assumptions of independent stationary and random axial-strain measurement errors in the focal lesion and in the surrounding region are appropriate.

Quantitative evaluation for anastomotic technique of coronary artery bypass grafting by using in-vitro mock circulatory system.

This study focuses on the development of self-training system for surgical operation and quantitative evaluation of the surgical skills. Our group has developed a self-training system for anastomotic technique in Coronary Artery Bypass Grafting (CABG) to contribute the education of cardiovascular surgery without a risk to patients. The self-training system consists of following portions, 1) "YOUCAN", coronary and graft vascular silicone model, 2) "BEAT", a device, simulating stabilized myocardial surface, and 3) Quantitative evaluation system based on in vitro mock circulatory system. The coronary and graft model has been anastomosed by expert and trainee cardiac surgeon. The anastomosed model was mounted onto test section of the in vitro mock circulatory system then identical waveforms of coronary artery was applied into the inlet of an anastomosis. The energy loss was quantified as a pressure difference between proximal and distal ends of anastomosis. The energy loss was obtained as 67.3+/-1.75 mJ (trainee) and 41.3+/-3.08 mJ (registered surgeon). It was founded that average energy loss by expert surgeon was lower by 38.6% than that by trainee surgeon. The major difference among the models of expert and trainee was the Effective Orifice Area (EOA) of the anastomosis. Through the experiment, EOA was confirmed by image analysis as 2.73 mm2 for an expert against 0.534 mm2 for a trainee. In conclusion, it was suggested that the anastomotic skill among expert and trainee surgeons could be hydrodynamically differentiated by using in vitro mock circulatory system.

Cloning and characterization of the novel isoforms for PGF2 alpha receptor in the bovine corpus luteum.

The cDNA clones for five novel isoforms of prostaglandin (PG) F2 alpha receptor (FP) were isolated from the bovine corpus luteal cDNA library. The sequence analysis revealed that each FP isoform, respectively, encodes 325 (alpha), 326 (beta), 339 (gamma), 293 (delta), and 298 (epsilon) amino acid proteins, carrying the specific carboxyl tails (C-tails) caused by alternative mRNA splicing. Depending on the splicing sites, FP isoforms can be classified into two types. The FP-alpha, FP-beta, and FP-gamma belong to the same group (Type I), which has common amino acid sequences with the exception of each specific 4th intracellular C-tail, while FP-delta and FP-epsilon are classified into the second group (Type II), which has a truncated structure lacking transmembrane domain VII and an intracellular C-tail. The RT-PCR analysis indicated that the mRNAs for these isoforms are expressed at the same time with that of FP in the bovine corpus luteum during the estrous cycle and pregnancy.