We present a 13-year-old boy who had recurrent chest pain with elevated cardiac enzymes and abnormal ST segments in electrocardiogram 36 hours after the second dose of BNT162b2 vaccination. Cardiac MRI and coronary angiography with acetylcholine provocation confirmed myocarditis and vasospastic angina, respectively. Coronary vasospasm may play a pivotal role in the chest pain in COVID-19 vaccine-related myocarditis.

Thromboembolic events increased in the

AAAD = acute type A aortic dissection GRF = gelatin-resorcin-formalin MN = microneedle MNMS = microneedle mesh sheet PLA = polylactic acid SLA = stereolithography apparatus CAD = computer-aided design PDMS = polydimethylsiloxane FDM = fused deposition modeling IntroductionAADA is defined as a tear in the intima layer from the ascending aorta, which results in blood flow into the aorta media, forming true and false lumen.AADA is caused life-threatening complications (e.g., cardiac tamponade from hemopericardium, aortic regurgitation, stroke, aortic rupture, myocardial infarction).Without treatment, mortality rates are 1 to 2 percent per hour after symptom onset. 1)A common repair for AAAD is anastomosis to replace the ascending aorta and hemi arc to artificial vessel.Prior to the replacement, applying GRF glue to obliterate the false lumen and reinforce the fragile nature.Bingley et.al. reported that the use of GRF glue develops postoperative midterm re-dissection due to the cytotoxicity of aldehyde compound. 2)As an alternative of GRF glue, fibrin glue has

Objective To investigate the incidence of coronary artery abnormalities (CAAs) by fever pattern after intravenous immunoglobulin (IVIG) therapy in patients with Kawasaki disease. Study design This retrospective cohort study included 172 patients with Kawasaki disease aged <= 12 years who underwent IVIG therapy and had no CAAs before treatment. Resistance to initial IVIG was defined as persistent fever >= 37.5 degrees C for >= 24 hours after therapy or the recurrence of Kawasaki disease after initial defervescence. The patients were divided into 3 groups: IVIG responders, nonresponders with persistent fever, and nonresponders with recurrent fever. CAAs were evaluated 2 or 4 weeks and 12 months after onset and were defined by a coronary artery z-score >= 2.5. Results The incidence of CAAs within 12 months after onset was significantly higher in nonresponders with persistent fever (27%) compared with the other 2 groups. On multivariate logistic regression analysis, being a nonresponder with persistent fever was an independent risk factor for having CAAs within 12 months after the onset of Kawasaki disease (OR, 6.48; P =.007). Conclusions In patients with Kawasaki disease resistant to IVIG therapy, persistent fever, but not recurrent fever, was found to be a risk factor for the incidence of CAAs. Aggressive additional therapy may be beneficial to prevent CAA formation in patients with Kawasaki disease with persistent

Introductions: It has been widely recognized that acute coronary syndrome develops from plaque disruption followed by obstructive thrombus formation. Sometimes, on the other hand, non-obstructive c...

Background: Previous studies have reported that left ventricular (LV) global longitudinal strain (GLS) can be used for detection of LV longitudinal dysfunction in patients with severe aortic stenosis (AS) and preserved ejection fraction (EF). Application of speckle-tracking echocardiography to the mitral annuls provides rapid assessment of mitral annular displacement (MAD). This simple method may be used as a new index for longitudinal dysfunction in patients with AS. Thus, we examined the value of MAD by speckle-tracking echocardiography for the assessment of LV longitudinal systolic dysfunction in patients with severe AS and preserved EF. Methods: We studied 50 patients with severe AS (aortic valve area ≤ 1.0 cm 2 ) and preserved EF (≥ 50%) in whom GLS was successfully obtained by speckle-tracking echocardiography (QLAB 10, Philips Medical Systems). MAD was automatically and quickly assessed with QLAB 10 as the base-to-apex displacement of mid-point of both septal and lateral annuls in 4-chamber view. The percentage of MAD to LV length from the mid-point of mitral annuls to the apex at end-diastole (% mid-MAD) was calculated (Figure). The study population was divided into two groups; 15 patients with decreased longitudinal systolic function (GLS > -16%; Group-A) and 35 patients with preserved longitudinal systolic function (GLS ≤ -16%; Group-B). Results: Both GLS and MAD were successfully assessed in 49 of 50 patients (98%). A good correlation was shown between GLS and % mid-MAD in the study patients (r=-0.80, p Conclusions: MAD which is rapidly estimated by speckle-tracking echocardiography is useful in the assessment of LV longitudinal systolic dysfunction in patients with severe AS and preserved EF.

Background: A tortuous lesion with hinge motion was reported one of the risk factors of in-stent restenosis (ISR) after BMS implantation. Sirolimus-eluting stents (SESs) have dramatically reduced the rate of ISR, however, this problem was not completely resolved. Especially, stent platform of SES is made of closed cell design stainless steel stent, which has less conformability and flexibility. The aim of this study was to investigate the relationship between a tortuous lesion with hinge motion and ISR after SES implantation.

The origin of the pronucleus (PN) in a single PN zygote (1PN), and whether its genome is normal still remains controversial. We recently established a novel method of discriminating between maternally- and paternally-derived PN using immunofluorescence staining and demonstrated the possibility that both the male and female genome could be packed in 1PN in some cases. However, currently analyzing karyotypes is an invasive technique, limiting its clinical application. Therefore, we tried to distinguish between normally-fertilized zygotes and 1PN zygotes by their morphology or developmental behavior. In this study, we used a microscope with time-lapse system to analyze the developmental time course and morphology of human 1PN zygotes, especially parthenogenetic zygotes induced by artificial oocyte activation. Research study. This study used 32 MII oocytes donated between October 2014 and August 2015 by patients who gave informed consent for this study. Fresh or freeze-thawed MII oocytes were activated electronically and the oocytes were observed by EmbryoScope®. We compared the developmental time course and morphology between parthenogenetic zygotes and normal 2PN zygotes fertilized by assisted reproductive technology. There was no difference in the diameter of the PN in parthenogenetic zygotes compared to the female PN in normal fertilized zygotes (28.9 ± 2.2 vs 26.4 ± 2.0 μ m, respectively). There were significant differences between normal 2PN and parthenogenetic zygotes for the time from intracytoplasmic sperm injection or electronic activation to the 2nd polar body (PB) extrusion (3.0 ± 1.7 vs 2.3 ± 0.5 h, respectively), from 2nd PB extrusion to syngamy (20.8 ± 4.1 vs 18.7 ± 2.9 h, respectively), from syngamy to 1st cleavage (3.0 ± 2.3 vs 3.9 ± 1.1 h, respectively), and from 1st cleavage to 2nd cleavage (9.8 ± 4.8 vs 13.6 ± 5.2 h, respectively). In addition, some parthenogenetic zygotes (6 of 21) developed to blastocysts. The time required from electronic activation to 2nd PB extrusion and from 2nd PB extrusion to syngamy in parthenogenetic zygotes was significantly shorter than in normal zygotes. This may be because oocyte activation or decondensation of the sperm nucleus is not required in parthenogenetic zygotes. In addition, the time required from syngamy to 1st cleavage, and from 1st cleavage to 2nd cleavage in parthenogenetic zygotes was significantly longer than in normal embryos. Thus, differences in the time course of embryonic development in activated zygotes could be used to identify the characteristics of parthenogenetic zygotes, even though further studies are needed. Furthermore, although some parthenogenetic zygotes develop to blastocysts, the clinical use of zygotes with 1PN should be questioned.

Introduction: Visit-to-visit variability in systolic blood pressure (SBP) has been reported as a risk of long-term cardiovascular events in hypertensive patients. However, a little has been known t...

Previous studies have demonstrated the higher accuracy of frequency-domain optical coherence tomography (FD-OCT) for quantitative measurements in comparison with intravascular ultrasound (IVUS). However, those analyses were based on the cross-sectional images. The aim of this study was to assess the accuracy of FD-OCT for longitudinal geometric measurements of coronary arteries in comparison with IVUS. Between October 2011 and March 2012, we performed prospective FD-OCT and IVUS examinations in consecutive 77 patients who underwent percutaneous coronary intervention with single stent. Regression analysis and Bland–Altman analysis revealed an excellent correlation between the FD-OCT-measured stent lengths and IVUS-measured stent lengths (r = 0.986, p < 0.001; mean difference = −0.51 mm). There was an excellent agreement between the actual stent lengths and the FD-OCT-measured stent lengths (r = 0.993, p < 0.001) as well as between the actual stent lengths and the IVUS-measured stent lengths (r = 0.981, p < 0.001). The difference between the actual stent lengths and the FD-OCT-measured stent lengths was significantly smaller than that between the actual stent lengths and the IVUS-measured stent lengths (0.15 ± 0.68 vs. 0.70 ± 1.15 mm, p < 0.001). Both FD-OCT (mean difference = −0.04 and −0.04 mm, respectively) and IVUS (mean difference = −0.06 and −0.06 mm, respectively) showed an excellent intra-observer and inter-observer reproducibility for the stent length measurements. In conclusion, FD-OCT provides accurate longitudinal measurement with excellent intra-observer and inter-observer reproducibility. FD-OCT might be a reliable technique for longitudinal geometric measurement in human coronary arteries.