The current study aims to evaluate the long-term outcomes of the Konno procedure.The clinical records of 63 patients who had undergone the Konno procedure between February 1984 and March 2007 were reviewed. During this period, the Ross procedure was introduced in 1996. Of the 63 patients, 38 were male and 25, female. Their ages at the time of operation ranged from 1 year 9 months to 37 years, and their body weights ranged from 8.1 to 63 kg. Valves larger than 23 mm were used in 57 patients.There was one hospital death (myocardial infarction) and six late deaths (sudden death, 2; congestive heart failure, 2; infectious endocarditis, 1; traffic accident, 1). The Kaplan-Meier survival rates including hospital mortality and late mortality were 91.9% at 10 years and 87.7% at 15 years. There were 20 significant complications in 16 patients: thromboembolism was noted in 1 patient; reoperations (Konno procedure (aortic valve replacement), 5 (thrombosed valve, 3; pannus formation, 1; IE, 1); mitral valve replacement, 3; coronary artery bypass grafting, 2; grafting of the descending aorta, 1), balloon dilatation for recoarctation, and 7 catheter interventions were required in 9, 1, and 5 patients, respectively. The event-free rates including all events were 75.2% at 10 years and 67.2% at 15 years. In the long-term period, the results of echocardiography revealed good cardiac function.The Konno procedure is effective and safe for the treatment of complex left ventricular outflow tract obstruction and for the preservation of ventricular function. Since some issues concerning anticoagulation-related complications and infectious endocarditis remain, careful observation is mandatory.
The Terumo implantable left ventricular assist system (T-ILVAS) consists of a titanium centrifugal pump with a unique magnetically suspended impeller producing continuous (non-pulsatile) flow up to 10 l/min. The interior surface is heparin-coated and there is no purge system. We implanted the device into six sheep to ascertain in-vivo haemodynamic function, mechanical reliability and biocompatibility.The T-ILVAS was implanted via left thoracotomy without cardiopulmonary bypass. The inflow cannula was placed in the left ventricular apex and a Dacron outflow graft anastomosed to the descending aorta. All animals recovered well. No anticoagulation (heparin or warfarin) was given after the surgery. Suspension position, motor current, impeller speed and pump flow were continuously monitored and stored by on-line computer. Serial blood samples were collected to determine haematological and biochemical indices of renal function, liver function and haemolysis. All animals were electively euthanized between 3 and 7 months postoperatively. The explanted pumps were examined for mechanical reliability and thrombus formation. Major organs were examined macroscopically and histologically for thromboembolism.All animals appeared completely normal for up to 210 days. At speeds between 1500 and 2000 rev./min the device pumped up to 8 l/min capturing all mitral flow. There were no major complications (pump failure, thromboembolism, haemorrhage, or driveline infection). Indices of haemolysis, liver and renal function remained within normal limits. All pumps were mechanically sound and free from thrombus. One embolus was found in a sectioned kidney.The T-ILVAS successfully supported the systemic circulation without anticoagulation for up to 210 days. Mechanical reliability and biocompatibility were demonstrated. Organ function remained within normal limits during continuous non-pulsatile flow.
The preparation of large scale monolayers of gold nanoparticles on modified silicon substrates for use in storage media is reported. Gold nanoparticles were synthesized in reverse microemulsions using the surfactant cetyltrimethylammonium bromide (CTAB). Dodecanethiol was then attached to the surface of the particles, which were subsequently purified by liquid phase extraction. The formation of nanoparticle monolayers was accomplished by vertically pulling various modified silicon substrates at controlled speeds from nanoparticle solutions. The silicon substrates used were 1 cm2 in size, had silanol and hydrogen terminated surfaces, had surfaces chemically modified by (CH3)3SiNHSi(CH3)3 and (CH3O)3Si(CH2)2(CF2)7CF3, and one was coated with amorphous carbon. All of these substrates have different surface polarities. The effects of the substrate pulling speed and solvent were also investigated. The results assessed using atomic force microscopy (AFM) indicated that the surface modification was the most significant factor. Silanol terminated silicon substrates were found to have very low coverage, and the carbon fluoride modified substrates, very high monolayer coverage. It was also found that lowering the substrate pulling speed and using higher boiling point solvents favored monolayer formation, and by optimizing these factors, a 95% monolayer coverage on the carbon fluoride modified substrate has been achieved. Conclusions from the results about the mechanism of the monolayer formation are also discussed.
We synthesized the sterically hindered amine A by an appropriate placement of alkyl groups. Quantitative 13C NMR spectroscopy was performed on 30 wt% aqueous solution of the amine A with different amount of CO2 at 40 °C. The results suggested that the amine A only formed the carbonate anion in this system. Performance evaluations of the absorbent-A containing the amine A were carried out based on their CO2 absorption rate, absorption capacity and heat of reaction measurements. The absorbent-A containing the amine A showed high absorption capacity and high absorption rate and relative low heat of reaction compared to 30 wt% MEA solution. The absorbent-A has been selected for further tests in the bench- scale apparatus. We will evaluate the absorbent-A at Mikawa pilot plant (10 ton/day) owned by TOSHIBA, using the actual flue gas from Mikawa coal fired power plant in Fukuoka prefecture, Japan.
Background: It has been suggested that intensive lipid-lowering therapy using statins significantly decreases atheromatous plaque volume. The effect of rosuvastatin on plaque volume in patients with stable coronary artery disease (CAD), including those receiving prior lipid-lowering therapy, was examined in the present study. Methods and Results: A 76-week open-label trial was performed at 37 centers in Japan. Eligible patients began treatment with rosuvastatin 2.5 mg/day, which could be increased at 4-week intervals to ≤20 mg/day. A total of 214 patients underwent intravascular ultrasound (IVUS) at baseline; 126 patients had analyzable IVUS images at the end of the study. The change in the serum low-density lipoprotein-cholesterol level from baseline to end of follow-up was -38.6 ±16.9%, whereas that of high-density lipoprotein-cholesterol was +19.8 ±22.9% (both P<0.0001). Percent change of plaque volume, the primary endpoint, was -5.1 ±14.1% (P<0.0001). Conclusions: Rosuvastatin exerted significant regression of coronary plaque volume in Japanese patients with stable CAD, including those who had previously used other lipid-lowering drugs. Rosuvastatin might be useful in the setting of secondary prevention in patients with stable CAD. (Circ J 2009; 73: 2110-2117)
Cerium (Ce) in silicate melt is considered to provide important information about the nature of silicate magmas in the Earth's and planetary interiors, especially about their oxidation state. However, the behavior of Ce in a silicate melt may not be simple, particularly in hydrous silicate melt, where a strong depression of the Ce4+/Ce3+ ratio occurs. Here we investigate the interaction between cerium and H2O in the structure of hydrous rhyolitic melts. Hydrous rhyolitic glasses quenched from melts at 1 GPa and 1300 °C show a significant decrease of H2O solubility by the incorporation of Ce. Pair distribution function analyses show no distinct change in the local structures of hydrous rhyolitic glasses with the incorporation of Ce, while we found a distinct change in the intensity of the T–OH (where T is Si or Al) Raman peak. The incorporation of Ce decreases the proportion of T–OH species and increases those of Q4 and Q3 species. These results suggest the occurrence of a direct charge transfer reaction between OH− in the melt and incorporated Ce as Cemelt4+ + 2(OH)melt– → Cemelt3+ + H2O + Omelt. This reaction causes a charge transfer from Ce4+ to Ce3+ in the hydrous rhyolitic melt, and it inevitably produces Ce3+. X-ray absorption near-edge structure (XANES) measurements show almost completely trivalent Ce (Ce3+) in the Ce-incorporated hydrous rhyolitic glasses, which supports the production of Ce3+ through the charge transfer reaction between Ce and OH−. The decrease of Ce4+/Ce3+ ratio reported in hydrous silicate melts would be due to the charge transfer reaction between Ce and H, which implies that the Ce4+/Ce3+ ratio in hydrous silicate melts may bear a complex relationship to the oxidation state of magmas.
