No abstract

BackgroundThe continuous suture (CS) technique has several advantages as a method for simple, fast, and secure aortic valve replacement (AVR). We used a simple CS technique without the use of a pledget for AVR and evaluated the surgical outcomes.Materials and MethodsBetween October 2007 and 2012, 123 patients with aortic valve disease underwent AVR alone (n=28) or with other concomitant cardiac procedures (n=95), such as mitral, tricuspid, or aortic surgery. The patients were divided into two groups: the interrupted suture (IS) group (n=47), in which the conventional IS technique was used, and the CS group (n=76), in which the simple CS technique was used.ResultsThere were two hospital deaths (1.6%), which were not related to the suture technique. There were no significant differences in cardiopulmonary bypass time or aortic cross-clamp time between the two groups for AVR alone or AVR with concomitant cardiac procedures. In the IS group, two patients had prosthetic endocarditis and one patient experienced significant perivalvular leak. These patients underwent reoperations. In the CS group, there were no complications related to the surgery. Postoperatively, the two groups had similar aortic valve gradients.ConclusionThe simple CS method is useful and secure for AVR in patients with aortic valve disease, and it may minimize surgical complications, as neither pledgets nor braided sutures are used.

Coarctation of the aorta is frequently associated with intracardiac disease. It is very difficult to decide on the best method for surgically treating adult patients with these combined heart diseases. We performed single-stage repair via a modified Bentall operation and by creating an intrapericardial ascending-descending aortic bypass through a median sternotomy in a patient with coarctation of the aorta and annuloaortic ectasia, and the latter was associated with aortic valve regurgitation.

To evaluate a new reliable sclerosant of the gallbladder. we attempted gallbladder ablation with 10% phenol. and the resu 1ts compared with those from using 95% ethanol which had been used previousy as gallbladder sclerosing agent in laboratory animals in other re ports. After lapa rotomy , ligation of the cystic ducts with silk and cannulation of gallbladder with 18 gauge angiocath eter were done. Then , transcatheter administration of two differe nt scleroing agents w as performed in 8 rabbits resp ectively and norma l saline in four rabbits as a control. Additionally, preliminary washing with each agent were implemented to prevent the dilutional effect of residual bile and bleeding All animals survived without complication. Eight a nimals were used for each agent, four each being sacrified two wee ks a nd six weeks after adminstration of sclerosing agents respectively. In our results , 10 % phenol was more effective than 95 % ethanol in denuding the gallbladder epithelium and promoting fibrosis of gallbladder wall. And it was relatively safe in regard to the dilutional effect of residual fluid and bleeding during procedure. Toxic effects on the liver evaluated by examination of histologic specimen were non-specific except for e dematous swelling on some cases, which had a lso been observe d on others including control group .10% phenol can be considered to be a promosing sc1erosant for gallbladder a blation, but furth e r study of its toxicity is needed before its application on human gallbladder.

BackgroundGenetic variation which related with progression to castration-resistant prostate cancer (CRPC) during androgen-deprivation therapy (ADT) has not been elucidated in patients with metastatic prostate cancer (mPCa). Therefore, we assessed the association between genetic variats in mPCa and progession to CRPC.ResultsAnalysis of exome genotypes revealed that 42 SNPs were significantly associated with mPCa. The top five polymorphisms were statistically significantly associated with metastatic disease. In addition, one of these SNPs, rs56350726, was significantly associated with time to CRPC in Kaplan-Meier analysis (Log-rank test, p = 0.011). In multivariable Cox regression, rs56350726 was strongly associated with progression to CRPC (HR = 4.172 95% CI = 1.223-14.239, p = 0.023).Materials and MethodsWe assessed genetic variation among 1000 patients with PCa with or without metastasis, using 242,221 single nucleotide polymorphisms (SNPs) on the custom HumanExome BeadChip v1.0 (Illuminam Inc.). We analyzed the time to CRPC in 110 of the 1000 patients who were treated with ADT. Genetic data were analyzed using unconditional logistic regression and odds ratios calculated as estimates of relative risk of metastasis. We identified SNPs associated with metastasis and analyzed the relationship between these SNPs and time to CRPC in mPCa.ConclusionsBased on a genetic variation, the five top SNPs were observed to associate with mPCa. And one (SLC28A3, rs56350726) of five SNP was found the association with the progression to CRPC in patients with mPCa.