In 4 children (2.4-10.9 y.o) with mitral valve regurgitation, prosthetic valve replacement was done using warm heart surgery. Three of them had previously received 1-3 times valve repair operations and the other one was accompanied by endocarditis. The condition of 3 children were in NYHA grade 4 and received dopamine preoperatively. At the esophageal temperature of 34 degree, aorta was cross clamped for 79-216min. with continuous coronary perfusion of 3ml/kg/min, however, no child showed postoperative low output syndrome, and the maximum use of dopamine was 2-6μg/kg/min and the CK-MB at 1POD was within the normal range in all cases. Warm heart surgery showed better myocardial protection for pediatric mitral valve replacement.

We report a case of vascular parkinsonism mainly treated at the patients' home with thyrotropin-releasing hormone (TRH). The patient was a 77-year-old male who had an attack of cerebral bleeding in the left posterior lobe in 1990. Thereafter, dysarthria, dysphagia and gait disturbance gradually developed. He had rigidity in the neck, and upper and lower extremities, but no tremor, and walked with short strides (marche a petit pas). We diagnosed the case as vascular parkinsonism, by his history and those symptomes.
We treated him mainly at his home since 1994. At first, we used combinations of levodopa, bromocriptine, amantadin, and anti-chorinergic drugs, but symptomes and signs of vascular parkinsonism did not disappear.
Finally, we used TRH 0.5 mg by an intravenous or intramuscular injection for 10-14 days a month. Thereafter, he became able to eat, speak and walk a little more, and we continued this therapy for about one year. He died in 1996 of asphyxia at a meal. We think TRH was effective for chronic stage of vascular parkinsonism even if treated at home.

CD57 (synonyms: Leu-7, HNK-1) is a well-known marker of nerve elements including the conductive system of the heart, as well as natural killer cells. In lung specimens from 12 human fetuses at 10–34 weeks of gestation, we have found incidentally that segmental, subsegmental, and more peripheral arteries strongly expressed CD57. Capillaries near developing alveoli were often or sometimes positive. The CD57-positive tissue elements within intrapulmonary arteries seemed to be the endothelium, internal elastic lamina, and smooth muscle layer, which corresponded to tissue positive for a DAKO antibody reactive with smooth muscle actin we used. However, the lobar artery and pulmonary arterial trunk as well as bronchial arteries were negative. Likewise, arteries in and along any abdominal viscera, as well as the heart, thymus, and thyroid, did not express CD57. Thus, the lung-specific CD57 reactivity was not connected with either of an endodermal- or a branchial arch-origin. CD57 antigen is a sugar chain characterized by a sulfated glucuronic acid residue that is likely to exist in some glycosphingolipids. Therefore, a chemical affinity or an interaction might exist between CD57-positive arterioles and glycosphingolipids originating from alveoli, resulting in acceleration of capillary budding to make contact with the alveolar wall. CD57 might therefore be a functional marker of the developing air-blood interface that characterizes the fetal lung at the canalicular stage.
Acceleration ; Actins ; Antigens, CD57 ; Arteries* ; Arterioles ; Bronchial Arteries ; Capillaries ; Endothelium ; Fetus ; Glucuronic Acid ; Glycosphingolipids ; Heart ; Humans* ; Killer Cells, Natural ; Lung* ; Muscle, Smooth ; Pregnancy ; Thymus Gland ; Thyroid Gland ; Viscera

Fatigue is a common symptom of long COVID. Fatigue can majorly disrupt daily life and be challenging to treat. Herein, we describe the effect of saikokeishito, a Kampo medicine, on fatigue in patients with long COVID.Between October 2020 and March 2023, we prescribed saikokeishito to 22 patients with long COVID in the general medicine outpatient department of our hospital. Among them, seven patients (age: 15-58 years, two females) had fatigue, a previously confirmed diagnosis of COVID-19, and no concomitant use of other Kampo formulas. We compared their condition at the start of saikokeishito administration to that 3 months later. Five patients had a slight fever, and four had inflammatory findings on blood tests. Within 3 months, all patients had a 20% or greater reduction in fatigue on a visual analogue scale. Six patients had a 20% or greater increase in health-related QOL and were able to return to society. On the other hand, one patient required a transition to an alternative medication, and one patient's follow-up was prematurely discontinued. Fatigue after COVID-19 may be improved by saikokeishito, especially for the treatment of patients with slight fever or inflammatory findings.

Sixteen cases of malignant soft tissue sarcoma (STS; 10 canines and six felines) were treated with a novel triple therapy that combined photodynamic therapy, hyperthermia using indocyanine green with a broadband light source, and local chemotherapy after surgical tumor resection. This triple therapy was called photodynamic hyperthermal chemotherapy (PHCT). In all cases, the surgical margin was insufficient. In one feline case, PHCT was performed without surgical resection. PHCT was performed over an interval of 1 to 2 weeks and was repeated three to 21 times. No severe side effects, including severe skin burns, necrosis, or skin suture rupture, were observed in any of the animals. No disease recurrence was observed in seven out of 10 (70.0%) dogs and three out of six (50.0%) cats over the follow-up periods ranging from 238 to 1901 days. These results suggest that PHCT decreases the risk of STS recurrence. PHCT should therefore be considered an adjuvant therapy for treating companion animals with STS in veterinary medicine.
Animals ; Antineoplastic Agents/*therapeutic use ; Cat Diseases/drug therapy/surgery/*therapy ; Cats ; Combined Modality Therapy/veterinary ; Dog Diseases/drug therapy/surgery/*therapy ; Dogs ; Hyperthermia, Induced/veterinary ; Indocyanine Green/*therapeutic use ; Photochemotherapy/veterinary ; Photosensitizing Agents/*therapeutic use ; Sarcoma/drug therapy/surgery/therapy/*veterinary

Introduction: To date, totally 3D-endoscopy has primarily been employed in mitral, tricuspid, and aortic valve surgeries. Herein, we describe the first case of a pulmonary valve surgery using totally 3D-endoscopy. To the best of our knowledge, this is the first case of a totally endoscopic pulmonary valve surgery. Case report: A 56-year-old woman was provisionally diagnosed with a tumor arising from the left cusp of the pulmonary valve. Totally 3D-endoscopy was planned for tumor resection. The patient was placed in a modified right lateral decubitus position and underwent mild hypothermic cardiopulmonary bypass using the left femoral artery, right jugular vein, and right femoral vein. An on-pump beating-heart technique was used during this surgery. Trocars for the 3D-endoscopic system and surgical instruments were inserted through the third and fourth intercostal spaces. Upon incision of the pulmonary artery, the suspected tumor was revealed to be a hyperplastic left pulmonary cusp; therefore surgical resection was abandoned. The patient was discharged without any complications. Conclusion: This case demonstrates that a totally 3D-endoscopic approach may provide optimal views of the pulmonary valve. Moreover, this procedure would be a novelty in MICS.