We report an extremely rare case of renal cell carcinoma (RCC) extending into the left atrium through the pulmonary vein next to lung metastasis. The patient was a 76-year-old man. Extirpation of the RCC in the right kidney was carried out. Metastasis to the lungs, mediastinal lymph nodes and the pubis were diagnosed and 4 years later, a myxoma-like tumor was formed in the left atrium by echocardiography. We extirpated of the tumor. During surgery, continuity with the metastatic lesion in the right lung, right inferior pulmonary vein and the left atrium was suggested. Histopathologic examination showed the same histopathology as seen in the RCC.

No abstract available.
Rupture ; Transcatheter Aortic Valve Replacement

No abstract available.
Transcatheter Aortic Valve Replacement

As well as active smoking, passive smoking is associated with a high risk of developing cardiovascular disease. The antioxidant vitamin C may inhibit the unfavorable effects of passive smoking. In this study, we investigated the effects of vitamin C ingestion on changes in the flow-mediated dilatation (FMD) at the brachial artery in patients exposed to transient passive smoking. The study participants included seven healthy adult males who were examined by high-resolution ultrasonography of the brachial artery before and after 15-minute of passive smoking. FMD was used to examine the endothelial function. Randomized crossover controlled trial, measurements were performed on two different days 120-minute after the oral administration of 1000mg of ascorbic acid (VC trial) or a placebo (P trial). Although the FMD values decreased after passive smoking in both trials, the FMD values of the VC trial were higher than those of the P trial, with significant differences between the trials observed immediately and 30-minute after passive smoking. The results of this study suggested that the ingestion of vitamin C may suppress the decrease in the vascular endothelial function caused by transient passive smoking.

Heat-not-burn (HNB) tobacco smoking has spread throughout the market. While it is suggested that HNB tobacco smoking reduces the vascular endothelial function and is associated with a high risk of developing cardiovascular disease. The antioxidant of vitamin C may attenuate the unfavorable effects of HNB tobacco smoking. In the present study, we examined the effect of oral vitamin C ingestion on the flow-mediated dilation (FMD) at the brachial artery and oxidative stress markers in patients before and after transient HNB tobacco smoking. Twelve healthy adult males underwent high-resolution ultrasonography of the brachial artery and evaluations of reactive oxygen metabolites (d-ROMs) and the biological antioxidant potential (BAP) before and after a single session of HNB smoking. FMD was used to examine the endothelial function and the oxidative stress and antioxidant status were determined by using a FRES4 analyzer. In this randomized, crossover, controlled trial, measurements were performed on 2 different days 20 min after the oral administration of 1000 mg of ascorbic acid (VC trial) or a placebo (P trial). Although the FMD values decreased after a single HNB smoking session in both trials, the VC trial showed significantly higher values than the P trial at 60 and 120 min after smoking. Whereas the FMD values 120 min after smoking in the P trial were lower compared to the Pre values, there was no difference in the VC trial. These results suggested that the ingestion of vitamin C might suppress the decrease in the endothelial function caused by a single HNB smoking.

BACKGROUND: We hypothesized that ketamine, when administered as the anesthetic induction agent, may prevent cardiovascular depression during high-dose remifentanil administration, unlike propofol. To test our hypothesis, we retrospectively compared the hemodynamic effects of ketamine, during high-dose remifentanil administration, with those of propofol. METHODS: Thirty-eight patients who underwent oral surgery at the Nagasaki University Hospital between April 2014 and June 2015 were included in this study. Anesthesia was induced by the following procedure: First, high-dose remifentanil (0.3-0.5 µg/kg/min) was administered 2-3 min before anesthesia induction; next, the anesthetic induction agent, either propofol (Group P) or ketamine (Group K), was administered. Mean arterial pressure (MAP) and the heart rate were recorded by the automated anesthesia recording system at four time points: immediately before the administration of high-dose remifentanil (T1); immediately before the administration of propofol or ketamine (T2); 2.5 min (T3), and 5 min (T4) after the administration of the anesthetic induction agent. RESULTS: In Group P, the MAP at T3 (75.7 ± 15.5 mmHg, P = 0.0015) and T4 (68.3 ± 12.5 mmHg, P < 0.001) were significantly lower than those at T1 (94.0 ± 12.4 mmHg). However, the MAP values in the K group were very similar (P = 0.133) at all time points. The heart rates in both Groups P (P = 0.254) and K (P = 0.859) remained unchanged over time. CONCLUSIONS: We showed that ketamine, when administered as the anesthetic induction agent during high-dose remifentanil administration, prevents cardiovascular depression.
Anesthesia ; Arterial Pressure ; Depression ; Heart Rate ; Hemodynamics* ; Humans ; Ketamine* ; Propofol* ; Retrospective Studies* ; Surgery, Oral

BACKGROUND: We hypothesized that ketamine, when administered as the anesthetic induction agent, may prevent cardiovascular depression during high-dose remifentanil administration, unlike propofol. To test our hypothesis, we retrospectively compared the hemodynamic effects of ketamine, during high-dose remifentanil administration, with those of propofol. METHODS: Thirty-eight patients who underwent oral surgery at the Nagasaki University Hospital between April 2014 and June 2015 were included in this study. Anesthesia was induced by the following procedure: First, high-dose remifentanil (0.3-0.5 µg/kg/min) was administered 2-3 min before anesthesia induction; next, the anesthetic induction agent, either propofol (Group P) or ketamine (Group K), was administered. Mean arterial pressure (MAP) and the heart rate were recorded by the automated anesthesia recording system at four time points: immediately before the administration of high-dose remifentanil (T1); immediately before the administration of propofol or ketamine (T2); 2.5 min (T3), and 5 min (T4) after the administration of the anesthetic induction agent. RESULTS: In Group P, the MAP at T3 (75.7 ± 15.5 mmHg, P = 0.0015) and T4 (68.3 ± 12.5 mmHg, P < 0.001) were significantly lower than those at T1 (94.0 ± 12.4 mmHg). However, the MAP values in the K group were very similar (P = 0.133) at all time points. The heart rates in both Groups P (P = 0.254) and K (P = 0.859) remained unchanged over time. CONCLUSIONS: We showed that ketamine, when administered as the anesthetic induction agent during high-dose remifentanil administration, prevents cardiovascular depression.
Anesthesia ; Arterial Pressure ; Depression ; Heart Rate ; Hemodynamics* ; Humans ; Ketamine* ; Propofol* ; Retrospective Studies* ; Surgery, Oral

Endurance exercises such as cycling and running are useful for improving the arterial function and preventing cardiovascular disease (CVD). However, subjects suffering from spinal cord injury (SCI) or lower limb osteoarthritis (OA) cannot perform these kinds of lower limb exercises. Recently, electrical muscle stimulation (EMS) has been shown to be able to increase the muscle strength and blood flow and improve the peripheral circulation. Arm-cranking exercises with EMS may therefore be able to reduce the risk of CVD for patients with SCI and lower OA. However, this point has not been fully clarified. The purpose of this study was to assess the effect of submaximal arm-cranking exercise with EMS on arterial stiffness. Ten healthy young subjects performed submaximal arm-cranking exercise alone (A) and submaximal arm-cranking exercise with EMS (A+E). In the A+E trial, the submaximal arm-cranking exercise was performed at 30%VO2 max for 20 min while EMS was applied to their thigh and calf muscles during the exercise. The brachial-ankle pulse wave velocity (ba-PWV), systolic and diastolic blood pressure (SBP/DBP) and heart rate (HR) were measured before and after each exercise. Immediately after the exercise session, the HR of the subjects in the A+E trial was significantly elevated in comparison to those in the A trial. The SBP and DBP did not differ between the two trials to a statistically significant extent. In the A+E trial, the ba-PWV was significantly reduced immediately after exercise in comparison to the A trial (1082.6 ± 105.9 cm·sec-1 vs. 1191.7 ± 86.7 cm·sec-1, p < 0.05). These findings suggest that arm-cranking exercise with EMS reduces arterial stiffness and might be useful for reducing the risk of CVD.