When performing aortic valve replacement (AVR) in patients with a past history of coronary artery bypass grafting (CABG) using the internal thoracic artery (ITA), the patent ITA graft needs to be detached from the surrounding tissue and occluded to properly protect the myocardium. However, detaching the ITA graft from the surrounding tissue takes time, and caution must be exercised to avoid damaging the graft. Two patients with a past history of CABG using the ITA were scheduled to undergo AVR. To simplify AVR, a balloon was placed preoperatively, and was inflated during aortic occlusion to occlude the ITA graft. The myocardium was adequately protected in this manner. Furthermore, since adhesion detachment was limited to around the ascending aorta, operative duration was short and bleeding volume was low. Balloon occlusion of the ITA graft appears to be useful in reducing the invasiveness of AVR in patients with a past history of CABG.

The mediobasal segment (S7) of the right lung has been considered to correspond to the cardiac lobe generally seen in mammals. To investigate fetal development of the right mediobasal segmental bronchus (B7), we examined paraffin-embedded serial sections of 15 embrynic and fetal lungs at 7-8 weeks (serial sections) as well as semiserial sections of 8 fetuses at 15-18 weeks (semiserial sections). All of the smaller specimens did not contain B7, but 2 of the 8 larger specimens carried B7: one was found in the immediately anterior side of the inferior pulmonary vein, while in the other, the subdivisions (B7a, B7b) were overriding the vein. Although the incidence might be underestimated because of observations using semiserial sections, the B7 was most likely to develop secondarily during a period from 8 to 15 weeks. Fetal topographical changes (mainly, the descent) of the middle lobe and the inferior pulmonary vein might relate with the secondarily budding of B7. The present result does not reduce a clinical relevance of B7 as a segmental bronchus of the lung segment system.
Bronchi ; Fetal Development* ; Fetus ; Incidence ; Lung* ; Mammals ; Pulmonary Veins ; Veins

STUDY DESIGN: Prospective study. PURPOSE: To assess the prevalence of periodontoid calcification and its associations with acute cervical pain. OVERVIEW OF LITERATURE: Calcium pyrophosphate dihydrate (CPPD) deposition disease is a common rheumatological disorder that occurs especially in elderly patients. Although CPPD crystals induce acute arthritis, these crystals are not usually symptomatic. Calcification surrounding the odontoid process (periodontoid calcification) has been reported to induce inflammation, resulting in acute neck pain. This disease is called crowned dens syndrome. Whether calcification induces inflammation or whether the crystals are symptomatic remains unclear. METHODS: The prevalence of periodontoid calcification at the atlas transverse ligament was examined by computed tomography of the upper cervical spine in patients suspected of brain disease but no cervical pain (control group, n=296), patients with pseudogout of the peripheral joints but no cervical pain (arthritis group, n=41), and patients with acute neck pain (neck pain group, n=22). Next, the correlation between the prevalence of periodontoid calcification and symptoms was analyzed. RESULTS: In the control group, 40 patients (13.5%) showed periodontoid calcification with no significant difference in the prevalence with gender. The prevalence of calcification increased significantly with age (p=0.002). In the arthritis group, 26 patients (63.4%) reported periodontoid calcification. In the neck pain group, 14 patients (63.6%) reported periodontoid calcification. Multiple logistic regression analysis by age and group revealed that higher age, inclusion in the arthritis group, and inclusion in the neck pain group significantly affected the prevalence of calcification. CONCLUSIONS: Our results cumulatively suggest that periodontoid calcification is an aging-related reaction and that calcification per se does not always cause neck pain. Periodontoid calcification was observed more frequently in patients with pseudogout of the peripheral joints and in those with acute neck pain than in asymptomatic control patients.
Aged ; Arthritis ; Brain Diseases ; Calcium Pyrophosphate ; Chondrocalcinosis ; Crowns ; Humans ; Inflammation ; Joints ; Ligaments ; Logistic Models ; Neck Pain ; Odontoid Process ; Prevalence ; Prospective Studies ; Spine