Fontan Physiology: Anaesthetic Implications for Non-Cardiac Surgery: A Case Report
Harikrishnan Kothandan, Lim Michelle Leanne and Shital Kumar Sharad Shah
Article Type: Case Report | First Published: February 06, 2015
Patients with congenital heart diseases are a growing population and noncardiac surgeries will become an important health care issue. Modification of surgical techniques and medical advances has improved the survival of patients with complex congenital cardiac abnormalities, resulting in more adult patients with fontan physiology presenting for non-cardiac surgery. The older fontan patient is at particular risk of thromboembolism, arrhythmias, progressive ventricular dysfunction, protein losing enteropathy and plastic bronchitis. Understanding the physiology of the fontan circulation is essent...
Phase I Clinical Study of Survivin-Derived Peptide Vaccine for Patients with Advanced Gastrointestinal Cancers
Fukino Satomi, Hiroaki Shima, Toru Mizuguchi, Toshihiko Torigoe, Goro Kutomi, Yasutoshi Kimura, Yoshihiko Hirohashi, Yasuaki Tamura, Tomohide Tsukahara, Takayuki Kanaseki, Akari Takahashi, Hiroko Asanuma, Yoichi M. Ito, Hiroshi Hayashi, Osamu Sugita, Noriyuki Sato and Koichi Hirata
Article Type: Original Article | First Published: February 04, 2015
Survivin is a member of the Inhibitor of Apoptosis Protein (IAP) family. It is expressed in fetal tissues but not in normal adult tissues. Since Survivin is over expressed in various types of tumor tissues as well as tumor cell lines, it is considered to be suitable as a target antigen for cancer vaccine therapy. We identified an HLA-A24-restricted antigenic peptide, SVN-2B (AYACNTSTL), derived from a splicing variant of Survivin-2B. In the present study, we carried out a phase I clinical study assessing the safety and efficacy of vaccination with the peptide in patients having advanced gastro...
Relationship between Insulin Levels and Coronary Atherosclerosis in Newly Diagnosed Diabetes Mellitus and Impaired Glucose Tolerance
Naohiko Nemoto, Rintarou Nakajima, Kennji Ymazaki, Makoto Utsunomiya, Masaki Hori, Shingo Ito, Itaru Yokouchi, Masamichi Wada, Masanori Shiba, Hisao Hara, Hidehiko Hara, Takuro Takagi, Kaoru Sugi and Masato Nakamura
Article Type: Review Article | First Published: February 06, 2015
Background: While some therapies implemented for newly diagnosed Diabetes Mellitus (DM) or impaired Glucose Tolerance (IGT) are effective in preventing cardiovascular events, investigations of coronary plaque in patients with newly diagnosed DM or IGT are lacking. Methods: We evaluated 96 patients with acute coronary syndrome. The External Elastic Membrane (EEM), Lumen Cross-Sectional Area (CSA), plaque CSA, and plaque burden in the Left Anterior Descending (LAD) artery proximal to the lesion, diagnosed as normal by Coronary Angiography (CAG), were measured using Intravascular Ultrasound (IVUS...
Physical Examination of the Cardiovascular System
John P. Higgins
Article Type: Review Article | First Published: January 27, 2015
The physical examination, while frequently not performed well, is critical to the diagnosis and management of cardiovascular disorders. This paper describes a basic cardiovascular physical examination and explains findings, with the goal of improving skills in this area....
Proposing a Novel Concept to Evaluate Safety of Supraglottic Devices Regarding Seal Pressure during Laparoscopic Surgery
Jose M. Belena, Monica Nunez and Alfonso Vidal
Article Type: Opinion | First Published: January 23, 2015
It is a fact that Supraglottic Airway Devices (SAD) are currently present at many clinical scenarios in anesthesia and they are also a good alternative to endotracheal intubation in some routine anesthetic procedures. Nowadays, laparoscopy is one of the most common and widely established surgical techniques. This procedures increase airway pressure due to the peritoneal insufflation and consequently the risk of regurgitation and aspiration. Over the last two decades, many studies have established the safety of SADs for this purpose, reporting a very low incidence of aspiration or more serious ...
A Case of Localized Neuroblastoma in Caffey Disease, with Early and Uncommon Progression
Manuela Pagano, Chiara Galletto, Maurizio Bianchi and Franca Fagioli
Article Type: Case Report | First Published: January 21, 2015
Background: Caffey disease is a rare syndrome caused by mutation in the alpha-1 collagen type I gene, not described in literature as a predisposing condition to cancer development. Observation: We report a case of a 6-years-old female diagnosed with Caffey disease that developed a localized neuroblastoma. The patient had a poor clinical and radiological response with unusual disease dissemination and progression until death. Conclusion: The case is a rare example of rapid progression of localized neuroblastoma in a patient with Caffey disease. A probable predisposition to neoplasm in this synd...
Diverse Genotype Presentation of the Saudi-Type Poly A Signal Mutation (αTsaudiα) in the Population of Bahrain
Nabeel Al Moamen, Fawzia Mahdi, Ahmed Thabet, Rugaya Abbas, Ebtihal Salman and Ahmed Al Alawi
Article Type: Letter to Editor | First Published: January 15, 2015
A total of 1187 patients with α-thalassemia phenotype presentation have been recruited for this investigation. Preliminary diagnosis of α-thalassemia was based on low hematological indices (MCV and MCH) of the red blood cells and/or persistently low hemoglobin levels, along with low or normal levels of HbA2 and absence of iron deficiency. Th molecular diagnosis of α-thalassemia was established by using a commercially available α-thalassemia strip assay (α-Globin StripAssay, ViennaLab Diagnostics GmbH) and direct nucleotide sequencing for further confirmation....
Macular Multifocal Granular Hyperfluorescence on Fluorescein Angiography
Article Type: Research Article | First Published: January 30, 2015
Purpose: To investigate the causes of multifocal granular hyperfluorescence at the macula on Fluorescein Angiography (FA) in Japanese patients. Methods: I retrospectively studied 1,457 consecutive Japanese patients (1,457 eyes) who underwent digital simultaneous FA and indocyanine green angiography (ICGA). Results: One hundred forty-seven of the 1,457 eyes had multifocal granular hyperfluorescence on FA images. Of the 147 eyes, 94 (64%) eyes had polypoidal choroidal vasculopathy (PCV); 25 (17%) eyes had either recurrent or chronic central serous chorioretinopathy (CSC); 19 (13%) eyes had occul...
Optic Disk Size Assessment Techniques: Photo Essay
Sourabh Arora, Helen Chung and Karim Damji
Article Type: Case Report | First Published: January 25, 2015
Measuring optic disc size is an essential part of the optic nerve head for evaluation for glaucoma. Large discs that appearing to have large cups may in fact be physiologic because of normal neuroretinal rim area. Small discs may appear to have a normal cup to disc ratio, but have decreased neuroretinal rim area in association with glaucoma. We illustrate relevance of these points with respect to glaucoma diagnosis in two case examples. We then present clinically relevant techniques to assess disc size including direct ophthalmoscopy, slit lamp biomicroscopy, disc macula: disc diameter ratio, ...
Bnct and Nanoparticles: A Long Way to a Routine Clinical Method
Cesare Achilli, Stefania Grandi, Annarita Ciana and Giampaolo Minetti
Article Type: Commentary | First Published: January 22, 2015
We have recently had the chance to read the editorial 'Boron Neutron Capture Therapy of cancer as a part of modern nanomedicine', by Alexander V. Safronov, in which the potential of nanomaterials as boron-carriers for the treatment of many types of tumors by BNCT is discusses. The author argues that "Most of the modern papers on BNCT report 'potential' BNCT agents [...] and don't even include cell studies", and "In some cases the abbreviation BNCT may become a 'golden ticket' for authors who just want to public their current study without intent to continue". We agree with the first assertion,...