Methods: This single-center study included 130 patients with osteoporotic vertebral fractures who underwent BKP and preoperative computed tomography and magnetic resonance imaging. After propensity score matching for age; sex; body mass index; fracture level; use of steroids, teriparatide, or osteoporosis medication; and previous AVF, patients were classified into the AVF (−) and AVF (+) groups, each of which included 34 patients. Bone strength was assessed using the L1 HU, L1–4 HU (mean HU of L1–L4), L1 VBQ, and L1–4 VBQ. Group differences were analyzed, and the predictive accuracy for AVF was evaluated using area under the receiver operating characteristic curve (AUC). Results: L1 HU was significantly lower in the AVF (+) group than in the AVF (−) group (92.1±29.4 vs. 71.6±21.4, p =0.013). No significant differences between the groups were observed for L1–4 HU, L1 VBQ, and L1–4 VBQ. L1 HU had the highest AUC (0.657), compared with those for L1–4 HU (0.625), L1 VBQ (0.524), and L1–4 VBQ (0.523). The predictive accuracy of L1 was superior to that of L1–4 for both HU and VBQ scores. Conclusions HU was superior to VBQ in predicting AVF risk after BKP, with L1 HU being the most effective indicator of bone strength and AVF risk.

Staged arterial switch operation without homologous blood transfusion was successfully performed in 5 patients weighing 4.1-11.0kg (double outlet right ventricle: 2 cases, transposition of great arteries: 3 cases). The postoperative hemodynamics and respiratory status were uneventful in all patients (initial central venous pressure after ICU admission: 9.0-14.5cmH₂O, mean 12.5cmH₂O, duration of intubation: 3.5-18.0h, mean 7.8h). Autologous blood donation immediately after induction of anesthesia and minimization of bypass circuit were effective methods for open heart surgery without homologous blood transfusion, particularly in staged arterial switch operation requiring prolonged cardiopulmonary bypass.

A 58-year-old man was admitted for pneumonia after several business trips to Thailand, Vietnam, and Malaysia. Despite resolution of pneumonia on chest X-ray, high fever persisted. CT scan revealed a juxtarenal, atypical-shaped abdominal aortic aneurysm of 4.5cm in size, and this was thought to be the cause of persisting fever. After prolonged antibiotic treatment, surgical resection and prosthetic tube replacement of the aneurysm was performed. The aneurysm was a pseudoaneurysm, and histological examination showed chronic inflammation with no atherosclerotic change. It was thought to be of mycotic origin. On the 12th day after operation, he became febrile, and an arterial blood culture yielded Burkholderia pseudomallei. Antibiotics chosen according to sensitivity tests, were given. He was finally discharged with no exidence of persisting infection, on the 55th day after operation.