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Introduction: We sought to examine midterm results and remodeling effect of false-lumen occlusion treatment using AFX VELA in case of chronic dissection repair. Material and Methods: From June 2019 to May 2022, we performed false lumen occlusion treatment using a modified Candy-Plug technique with AFX VELA on 8 chronic aortic dissection patients with a patent false lumen. We collected operative data, short-term clinical outcomes, mid-term clinical outcomes and imaging test results. We conducted follow-up examinations at postoperative, 6-month and 1-, 2- and 3-year intervals, including contrast-enhanced computed tomography to evaluate the diameter, false lumen thrombosis and any events. Results: The average time from the symptom onset to the thoracic endovascular repair was 81.5 (35-155) months. The aorta showed aneurysmal dilation with an average maximum short-axis diameter of 58.9 (41-91) mm. Two cases needed emergency surgery due to rupture and impending rupture. There were no postoperative deaths. Complete thrombosis within the false lumen was achieved in 6 cases (75%), but 2 cases had incomplete thrombosis, requiring additional treatment. The mean maximum diameter showed a significant decrease at 6 months, 1 year and 2 years postoperatively compared to preoperative measurements (P <.05). Conclusion: We showed the results of false lumen occlusion treatment using the AFX VELA cuff. We observed favorable clinical outcomes and remodeling effects. While the long-term durability and efficacy of this technique in aortic remodeling will need to be monitored with further observation, the use of this cuff is considered a reliable approach to false lumen occlusion treatment. [ABSTRACT FROM AUTHOR]

Myxomas are the most common type of benign cardiac tumors, and the right atrium is the second most common location among them, with an incidence ranging from 8.6% to 20% of all cardiac myxomas. Herein, we described a rare case of right atrial myxoma originating from the inferior vena cava orifice. In this case, main pulmonary artery cannulation and moderate hypothermic circulatory arrest were helpful to obtain a clear and simple view of the operative field without blood, which led to complete resection of the tumor with safety and better outcomes with no future recurrence. [ABSTRACT FROM AUTHOR]

p53 is a tumor suppressor gene contributing for genomic stability. p53 is involved in a broad range of cellular responses including cellular senescence, thereby mediates undesirable responses in some settings in age-related disorders. Recently it was shown that p53 promotes pathologies in age-related diseases including diabetes and heart failure. Here we show that endothelial p53 induces vascular dysfunction in hyperglycemia and ischemic conditions. First, we generated streptozotocin (STZ) -induced murine type I diabetic model. In these mice, endothelial p53 expression was increased and acetylcholine-induced vasodilatation was significantly impaired. Endothelial cell specific p53 depletion significantly improved endothelial dysfunction in hyperglycemic condition. Furthermore, p53 negatively regulated the phosphorylation of eNOS (p-eNOS) by up-regulating PTEN expression. We also found that p53 expression was increased in ischemic arteries. Endothelial cell specific p53 knockdown significantly augmented ischemia-induced angiogenesis. Next, we generated endothelial cell specific MDM4 knockout (EC-MDM4 KO) mice. EC-MDM4 KO mice increased p53 expression and decreased phospho-eNOS level in endothelial cells. Up-regulating endothelial p53 resulted in endothelial dysfunction together with reduced angiogenesis in ischemic arteries. These results suggest that endothelial p53 is critically involved in regulating vascular function under hyperglycemic and hypoxic conditions. Suppression of endothelial p53 would become a novel therapeutic target for metabolic diseases. [ABSTRACT FROM AUTHOR]

A 78-year-old Japanese male with previous gastric cancer and untreated diabetes mellitus was admitted to hospital for persistent fever and leg edema. Blood culture was positive for Streptococcus angino'sus, and echocardiography showed isolated tricuspid valve infective endocarditis. Infection was controlled with intravenous antibiotics, but surgery was indicated because of persistent severe regurgitation and large vegetation of 15 mm in size. As the tricuspid valve anterior leaflet was extensively damaged, he underwent valve replacement using a bioprosthetic valve. The patient was discharged 25 days postoperatively with additional antibiotics, and he has been free from recurrent endocarditis for 6 months.

We carried out a retrospective evaluation of the early and late outcomes of valve surgery for acute endocarditis patients with cerebrovascular disease. Between January 2002 and August 2014, a total of 17 patients (early group, n=10;delayed group, n=7) underwent valve surgery with or without an additional procedure. Craniotomy was performed in 1 patient in the early group and 2 patients in the delayed group before valve surgery. There was 1 in-hospital death due to acute respiratory distress syndrome in the early group and 1 death due to intestinal bleeding in the delayed group. Postoperative deterioration was observed in 1 in the delayed group. Overall survival in the early group was 90% and was not significantly different from survival in the delayed group (86%). In conclusion, our study demonstrated good early and mid-term outcomes for valve surgery in active endocarditis patients with cerebrovascular disease. There was no postoperative deterioration in the early group. Thus, an early operation for these patients may be acceptable.

Purpose: This study was conducted to examine the effect of increased physical and/or intellectual activities on changes in cognitive function in elderly dwellers., Methods: The subjects comprised 61 residents aged 65 or over living in Suginami Ward, Tokyo, who took part in a community-based dementia prevention class aimed at increasing both physical and intellectual activities. Physical activity was evaluated by the number of daily steps using a pedometer. Intellectual activity was evaluated by the number of pictures taken by a cellular phone and/or submitted through an internet "Dress" system by cellular phone. These activities were classified into two groups (higher and lower activity groups) according to whether above or below the respective median value. For assessment, the subjects underwent tests of physical and cognitive functions before and after the 7-weeks intervention., Results: Subjects with a greater increment in physical activity during the intervention period showed a greater improvement in usual and maximal walking speed than did those with a lesser increment in physical activity. Analysis using the general linear model demonstrated that increase in physical activity independently correlated with improvement in physical function, but did not correlate with cognitive function. Subjects with a greater increment in intellectual activity showed a greater improvement in weight, BMI and trail making test-task B. This association was independent of potential confounders. Further, those who used the "Dress" system more often showed a greater improvement in stress coping tests. Analysis using a general linear model indicated that increased intellectual activity was independently associated with changes in cognitive and mental function., Conclusion: The present findings suggest that community-based dementia prevention classes should be stressed not only for increasing physical activity but also in order to stimulate intellectual activity.