1.Effect of knee flexion angles during maximum isometric hip extension
Yuki Yamamoto ; Hajime Kato ; Takashi Fukuda ; Yuki Tsuga ; Shumpei Miyakawa
Japanese Journal of Physical Fitness and Sports Medicine 2015;64(3):289-294
The purpose of this study was to examine the effects of knee flexion angles during maximum isometric hip extension. Ten healthy men performed maximum isometric hip extension in prone position at 15° and 90° knee flexion. Then, the hip extension torque was measured, and electromyographic (EMG) data were obtained from the biceps femoris long head, semitendinosus, semimembranosus, adductor magnus, and gluteus maximus muscles. The EMG data were full-wave rectified and integrated (IEMG). The IEMG values obtained during the measurement of isometric hip extension were normalized with the values collected at 90° knee flexion (normalized IEMG [NIEMG]). The hip extension torque at 15° knee flexion was significantly greater than that at 90° knee flexion. The NIEMG values from the hamstrings at 15° knee flexion significantly increased compared with those at 90° knee flexion. Meanwhile, the NIEMG values from the gluteus maximus at 90° knee flexion were significantly greater than those at 15° knee flexion. However, the NIEMG values from the adductor magnus did not significantly differ between 15° and 90° knee flexion. These results indicate that the hamstrings effectively generate contracting force during isometric hip extension and at knee extended position because its fiber length was close to the optimal length.
2.A Case of Acute Aortic Regurgitation due to Leaflet Dehiscence of the Carpentier-Edwards Pericardial Bioprosthesis 18 Years after Implantation
Satoru Otani ; Tsuyoshi Yamamoto ; Yuki Yamada ; Taiichiro Matsumoto
Japanese Journal of Cardiovascular Surgery 2014;43(6):344-346
A 65-year-old man, who had undergone the aortic valve replacement with a Carpentier-Edwards pericardial bioprosthesis (CEP 25 mm) 18 years previously (at age 48), was admitted to our hospital with a diagnosis of acute heart failure due to acute aortic regurgitation. Redo surgery was performed. The ascending aorta was cross clamped, and cardiac arrest was induced, and aortotomy was done. One of the leaflets of the CEP was entirely collapsed and dislocated to the LV side, which caused acute aortic regurgitation. Although there was no evidence of endocarditis, the other two leaflets of CEP were severely calcified. Aortic valve replacement was performed with a CEP 23 mm. He was discharged in good condition on the 16th post-operative day.
3.Huge Solitary Fibrous Tumor of the Left Ventricular Epicardium
Satoru Otani ; Tsuyoshi Yamamoto ; Yuki Yamada ; Taiichirou Matsumoto
Japanese Journal of Cardiovascular Surgery 2016;45(4):192-195
An 89-year-old woman had undergone a medical examination and treatment due to exertional dyspnea symptom and cardiac enlargement, but her symptoms had not improved. According to images from a computed tomography scan, a huge intrapercardial mass excluding the heart was detected, and the patient was referred to our department for surgical treatment. Because of cardiac failure due to the mass excluding the heart, we planned to excise the tumor for cure and also for diagnosis. We did not distinguish the tumor before operation as is often the case with cardiac tumor. The tumor arose from the epicardium of the left ventricular (LV) anterior wall, and was attached to the LV wall with a broad stalk (approximately 3×10 cm) along the left anterior descending coronary artery (LAD). We had to operate under cardiopulmonary bypass and cardiac arrest, since the tumor involved the LAD, so we underwent resection of a part of the LAD. The patient was discharged uneventfully on postoperative day 37. On histopathology, the tumor was diagnosed as a solitary fibrous tumor (SFT) of the epicardium. Cardiac SFTs are rare. Above all, SFTs arising from LV epicardium are very rare. We report this case with some literature review.
4.A Case of Redo Aortic Valve Replacement by Right Minithoracotomy Approach with Port Access for Aortic Valve Stenosis after Coronary Artery Bypass Grafting
Takanori Tokuda ; Takashi Murakami ; Yuki Yamada ; Takashi Yamamoto ; Satoru Oya
Japanese Journal of Cardiovascular Surgery 2012;41(6):320-322
We report a case of redo aortic valve replacement by right minithoracotomy approach for aortic stenosis after coronary artery bypass grafting (CABG). An 81-year-old man was followed-up once a year for 9 years after CABG. He complained of increasing respiratory distress, showed narrowing of the aortic valve area, elevation of the aortic valve pressure gradient, and tricuspid valve regurgitation by echocardiography. He was admitted for surgery. We considered minimally invasive operation would be better for him and performed aortic valve replacement (Carpentier-Edwards Perimaunt valve 19 mm) by a right minithoracotomy approach because graft injury could occur by median sternotomy after CABG, and he had the risks of advanced age, low activities of daily living, and mild dementia. His postoperative course was uneventful. On echocardiography performed at postoperative days 9, the ejection fraction recovered to 75% from 53% before surgery and the mean aortic valve pressure gradient was 8 mmHg. He was discharged on postoperative day 12. Right minithoracotomy approach with port access is a good option for redo operation for aortic valve stenosis after CABG.
5.EFFECT OF HEAT STRESS ON DESMIN EXPRESSION IN ATROPHIED SOLEUS MUSCLE
TAKAO SUGIURA ; TSUBASA SHIBAGUCHI ; TOSHINORI YOSHIHARA ; YUKI YAMAMOTO ; KATSUMASA GOTO ; HISASHI NAITO ; TOSHITADA YOSHIOKA
Japanese Journal of Physical Fitness and Sports Medicine 2010;59(1):167-174
In the present study, we investigated the effect of heat stress on disuse atrophy from changes in the muscle protein levels of desmin and calpain. Wistar strain female rats (6-8 months old) were randomly assigned to two experimental groups: control (C) and heat stress (H). One hindlimb of all animals was immobilized in plantar flexion with plaster. Before immobilization, animals in H group were placed in a heat chamber (42°C for 60 min). Following 6 days of immobilization, the soleus muscles were removed and analyzed. Although immobilization resulted in significant muscle atrophy in all experimental animals, the soleus weight-to-body weight ratio in immobilized limbs of H group was significantly higher compared to that of C group. Expression of desmin and HSP72 in the atrophied soleus muscle from C group was significantly lower compared with the contralateral muscle; but this was not the case in H group. Further, in C group, the ratio of autolyzed calpains I increased significantly in the atrophied muscle compared to the contralateral muscle. These results show that the effect of heat stress on disuse skeletal muscle atrophy is attributed to the decreasing degradation of desmin by suppressing the activation of calpain.
6.Gelastic seizures in a child with frontal lobe epilepsy controlled by topiramate monotherapy
Hideo Enoki ; Takuya Yokota ; Mitsuyo Nishimura ; Yuki Sasaki ; Ayataka Fujimoto ; Takamichi Yamamoto
Neurology Asia 2014;19(1):89-92
We report a childhood case of localization-related epilepsy manifesting frequent gelastic seizures,
which were successfully treated with topiramate (TPM) monotherapy. The seizures were not associated
with feelings of mirth. High-resolution three-tesla magnetic resonance imaging revealed no structural
abnormality. Interictal 18F-fluorodeoxyglucose positron emission tomography showed hypometabolism
over the entire right hemisphere. Single-photon emission computed tomography imaging, both ictal
and interictal, demonstrated no significant findings. Interictal electroencephalography (EEG) showed
paroxysms in the right frontal region. Ictal video EEG demonstrated diffuse attenuation, followed by
fast activities and spike-wave complexes predominantly over the right hemisphere. At the ictal EEG
onset, low amplitude paroxysmal fast activity was recorded over the F8-T4 region. The seizures were
considered to have originated from the right frontal lobe. TPM monotherapy resulted in complete
cessation of the seizure. We suggest that TPM should be considered as a valuable tool for treating
childhood intractable gelastic seizures, which are not due to hypothalamic hamartoma.
7.Tricuspid Valve Replacement in an Adult Patient with Congenitally Corrected Transposition of the Great Arteries and Situs Inversus
Takashi Wakabayashi ; Kazuo Yamamoto ; Tsutomu Sugimoto ; Yuki Okamoto ; Kaori Kato ; Shinya Mimura ; Shinpei Yoshii
Japanese Journal of Cardiovascular Surgery 2014;43(2):80-83
A 62-year-old woman was admitted to our hospital because of dextrocardia on her chest X-ray film. She had been in good health though the X-ray abnormality had been pointed out from her childhood. Echocardiogram, magnetic resonance imaging, and cardiac catheterization revealed situs inversus, congenitally corrected transposition of the great arteries, and severe tricuspid valve (systemic atrioventricular valve) regurgitation with mild systemic ventricular dysfunction. The surgeon stood on the patient's left side during the operation. On cardiopulmonary bypass, the tricuspid valve, facing almost dorsally, was exposed through a superior transseptal approach. Tricuspid valve replacement with a mechanical valve was performed with leaflet preservation. Systemic ventricular function is preserved at one year after operation.
8.EFFECTS OF COMBINATION OF HEAT STRESS AND ASTAXANTHIN SUPPLEMENTATION ON DISUSE MUSCLE ATROPHY
TOSHINORI YOSHIHARA ; TAKAO SUGIURA ; TSUBASA SIBAGUCHI ; YUKI YAMAMOTO ; KATSUMASA GOTO ; TOMOMI ISOYAMA ; HISASHI NAITO ; DAIJIRO OHMORI ; TOSHITADA YOSHIOKA
Japanese Journal of Physical Fitness and Sports Medicine 2010;59(3):303-312
The purpose of this study was to examine the effects of combination of a heat stress and astaxanthin supplementation, known as a potent anti-oxidative nutrient, on muscle protein degradation and disuse muscle atrophy. Fifty-two male Wistar rats (261.7±1.17 g) were divided into five groups: control (Cont, n=10), suspension (Sus, n=11), heat stress and suspension (Heat, n=10), astaxanthin and suspension (Ax, n=10), and heat stress, astaxanthin and suspension (H+A, n=11). There were no significant differences in Cu,Zn-SOD, cathepsin L and caspase-3 levels among the Heat, Ax and H+A groups in the soleus and plantaris muscles. Although levels of calpain 2 and ubiquitinated protein in the myofibrillar fraction in the soleus muscle were not significantly different among the Heat, Ax and H+A groups, levels in the H+A group were significantly (p<0.05) lower than Sus. Concerning atrophied plantaris muscles, the H+A group significantly (p<0.05) suppressed the expression of calpain 1 in the myofibrillar fraction, but there were no marked changes of proteolytic indexes. These data indicate that the combination of the heat stress and astaxanthin supplementation could be effective in inhibiting muscle protein degradation in disuse atrophy of the soleus.
10.Preceding Re-entry Closure for Chronic Thoracic Aortic Dissection in a Patient with Marfan Syndrome
Akihiro Yamamoto ; Hirono Satokawa ; Shinya Takase ; Hiroki Wakamatsu ; Yoshiyuki Sato ; Yuki Seto ; Akihito Kagoshima ; Tomohiro Takano ; Tsuyoshi Fujimiya ; Hitoshi Yokoyama
Japanese Journal of Cardiovascular Surgery 2017;46(1):25-28
A 42 year-old woman with Marfan syndrome, who had replacement of the ascending aorta for acute aortic dissection several years ago, was found to have distal aortic arch aneurysm. The aneurysm had small entries at cervical arterial branches and large re-entry at the left external iliac artery. It was necessary to perform two-staged operation Bentall procedure with total arch replacement and abdominal aortic replacement with re-entry closure. It was usually performed with a primary entry closure for chronic aortic dissection, but massive invasion was expected. We performed catheter angiography for entry and re-entry, and decided to perform preceding re-entry closure. First, we underwent replacement of the abdominal aorta, and then successfully performed the Bentall procedure with total aortic arch replacement. The catheter angiography was useful for decision-making for medical treatment.