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1.
Folia Morphol (Warsz) ; 82(2): 300-306, 2023.
Article in English | MEDLINE | ID: mdl-35411547

ABSTRACT

BACKGROUND: Retrocaval ureter is a rare congenital anomaly resulting from anomalous development of inferior vena cava (IVC) and not from anomalous of the ureter. The anomaly always occurs on the right side due to regression of right supracardinal vein and persistence of right posterior cardinal vein. Retrocaval ureter tends to be associated with various vena cava anomalies because of the embryogenesis. We aimed to identify the prevalence of associated congenital venous anomalies (CVA) resulting from cardinal vein development in adults with retrocaval ureter using computed tomography (CT) images. MATERIALS AND METHODS: The study included 22 adults with retrocaval ureter. We evaluated CT findings and determined the incidence of associated CVA using thin slice data sets from CT scanner with 64 or more detectors. We compared the prevalence of CVA in the retrocaval ureter group (mean age: 57 ± 19 years) and in the control group of 6189 adults with normal ureter (mean age: 66 ± 14 years). RESULTS: In the retrocaval ureter group, 4 (18.2%) adults had CVA including double IVC, right double IVC, preisthmic IVC with horseshoe kidney, and preaortic iliac confluence. One of 2 adults with preaortic iliac confluence had right double right IVC. In the control group, 49 (0.79%) adults had CVA including 37 double IVC, 11 left IVC, and 1 IVC interruption azygos continuation. Fifteen horseshow kidneys were found. The prevalence of associated CVA in the retrocaval ureter group was higher than that in the control group (p < 0.001). CONCLUSIONS: Retrocaval ureter is frequently associated with CVA. Various CVA with retrocaval ureter could happen because of abnormal development of not only the right posterior or supra cardinal vein but also other cardinal veins.


Subject(s)
Retrocaval Ureter , Ureter , Adult , Humans , Middle Aged , Aged , Aged, 80 and over , Retrocaval Ureter/diagnostic imaging , Vena Cava, Inferior/diagnostic imaging , Vena Cava, Inferior/abnormalities , Tomography, X-Ray Computed/methods , Ureter/diagnostic imaging , Ureter/abnormalities , Kidney/abnormalities
3.
J Cardiovasc Surg (Torino) ; 50(4): 493-9, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19734834

ABSTRACT

AIM: The authors described their three-year experience with hybrid surgical and endovascular therapy for multifocal peripheral TASC D lesions, involving both the aortoiliac and/or superficial femoral and common femoral arteries. METHODS: From February 2005 to March 2008, 21 lower limbs in 20 patients with multifocal peripheral artery disease, involving the aortoiliac and/or superficial femoral as well as common femoral arteries, were treated by hybrid surgical and endovascular therapy, such as aortoiliac and/or superficial femoral artery stenting as an adjunct to common femoral artery endarterectomy. Technical and hemodynamic success as well as primary and primary assisted patency and limb salvage rates were determined in concordance with the Society for Vascular Surgery guidelines. RESULTS: All lower limbs successfully underwent successful hybrid surgical and endovascular therapy. The average ABPI before and after hybrid therapy significantly increased from 0.50 +/- 0.32 to 0.79 +/- 0.24 (P = 0.0022). The mean duration of follow-up was 357 days (range, 4 to 1400 days). Over all, the primary patency rates were 94%, 70% and 70% at 6, 12, and 24 months, respectively, and the primary assisted patency rates were 94% at 24 months. The limb salvage rate was 100% at 24 months. The survival rates were 95%, 88%, and 88% at 6, 12, and 24 months, respectively. The primary patency rate for intermittent claudication was significantly higher that that for critical limb ischemia, while no significant difference was found in the assisted primary patency and survival rates between intermittent claudication and critical limb ischemia. CONCLUSION: Hybrid surgical and endovascular therapy, such as aortoiliac and/or superficial femoral artery stenting as an adjunct to common femoral artery endarterectomy, can provide a less invasive yet effective and durable option to patients with multifocal peripheral artery disease.


Subject(s)
Angioplasty, Balloon/instrumentation , Arterial Occlusive Diseases/therapy , Endarterectomy , Femoral Artery/surgery , Iliac Artery/surgery , Lower Extremity/blood supply , Peripheral Vascular Diseases/therapy , Stents , Aged , Aged, 80 and over , Arterial Occlusive Diseases/complications , Arterial Occlusive Diseases/diagnostic imaging , Arterial Occlusive Diseases/physiopathology , Arterial Occlusive Diseases/surgery , Combined Modality Therapy , Constriction, Pathologic , Female , Femoral Artery/diagnostic imaging , Femoral Artery/physiopathology , Hemodynamics , Humans , Iliac Artery/diagnostic imaging , Iliac Artery/physiopathology , Ischemia/etiology , Ischemia/therapy , Kaplan-Meier Estimate , Limb Salvage , Male , Middle Aged , Peripheral Vascular Diseases/complications , Peripheral Vascular Diseases/diagnostic imaging , Peripheral Vascular Diseases/physiopathology , Peripheral Vascular Diseases/surgery , Radiography , Reoperation , Time Factors , Treatment Outcome , Vascular Patency
4.
Int Angiol ; 28(6): 484-9, 2009 Dec.
Article in English | MEDLINE | ID: mdl-20087287

ABSTRACT

AIM: Chronic hemodialysis is associated with a high prevalence of peripheral artery disease (PAD), and patients on chronic hemodialysis with PAD have an increased risk of critical limb ischemia. The present study assessed the hemodynamic and clinical outcomes of stent placement in the superficial femoral artery (SFA) for patients on chronic hemodialysis. METHODS: Between February 2005 to August 2008, 43 consecutive lower limbs in 42 patients with SFA lesions that were successfully treated by primary stent placement were included in this study. Those were divided into a dialysis group (18 limbs) and a nondialysis group (25 limbs). Outcome measures included primary patency, assisted primary patency, limb salvage, and survival. RESULTS: Patients were significantly younger and presented with significantly more symptomatic limb ischemia in the dialysis group compared to the nondialysis group, despite comparable TransAtlantic Inter-Society Consensus (TASC) classification scores of SFA lesions between the two groups. The primary patency, primary assisted patency, limb salvage, and survival rates of the dialysis group were similar to those of the nondialysis group. CONCLUSIONS: Stent placement in the SFA is a feasible, safe, and effective procedure in patients on chronic hemodialysis with PAD, and may be offered as a first-choice therapeutic option for these patients.


Subject(s)
Angioplasty, Balloon/instrumentation , Femoral Artery , Ischemia/therapy , Kidney Diseases/therapy , Peripheral Vascular Diseases/therapy , Renal Dialysis , Stents , Aged , Angiography, Digital Subtraction , Angioplasty, Balloon/adverse effects , Angioplasty, Balloon/mortality , Ankle Brachial Index , Case-Control Studies , Chronic Disease , Female , Femoral Artery/diagnostic imaging , Femoral Artery/physiopathology , Hemodynamics , Humans , Ischemia/diagnosis , Ischemia/etiology , Ischemia/mortality , Ischemia/physiopathology , Kaplan-Meier Estimate , Kidney Diseases/complications , Kidney Diseases/mortality , Limb Salvage , Male , Middle Aged , Peripheral Vascular Diseases/complications , Peripheral Vascular Diseases/diagnosis , Peripheral Vascular Diseases/mortality , Peripheral Vascular Diseases/physiopathology , Risk Assessment , Risk Factors , Time Factors , Treatment Outcome , Ultrasonography, Doppler, Duplex , Vascular Patency
5.
Clin Pharmacol Ther ; 83(5): 731-9, 2008 May.
Article in English | MEDLINE | ID: mdl-17957184

ABSTRACT

An open, randomized, four-phased crossover study using 4 mg of pitavastatin or 20 mg of atorvastatin was performed to compare their efficacy and safety, especially regarding plasma levels of coenzyme Q10 (CoQ10) in 19 Japanese patients with heterozygous familial hypercholesterolemia. Pitavastatin and atorvastatin caused significant and almost comparable reductions in serum levels of total cholesterol (-35.4 vs. -33.8%), low-density lipoprotein cholesterol (-42.8 vs. -40.7%), and triglyceride (-26.1 vs. -29.4%), and significantly increased serum levels of high-density lipoprotein cholesterol (12.1 vs. 11.4%). Under these conditions, plasma levels of CoQ10 were reduced by atorvastatin (-26.1%, P=0.0007) but not by pitavastatin (-7.7%, P=0.39), although no adverse events or abnormalities of liver and muscle enzyme were observed after either statin treatment. It remains to be seen whether the observed changes in CoQ10 levels are related to the long-term safety of this drug.


Subject(s)
Heptanoic Acids/therapeutic use , Hyperlipoproteinemia Type II/drug therapy , Hyperlipoproteinemia Type II/enzymology , Pyrroles/therapeutic use , Quinolines/therapeutic use , Ubiquinone/analogs & derivatives , Anticholesteremic Agents/adverse effects , Anticholesteremic Agents/therapeutic use , Atorvastatin , Cholesterol/blood , Cholesterol, LDL/blood , Coenzymes/blood , Cross-Over Studies , Female , Heptanoic Acids/adverse effects , Humans , Hyperlipoproteinemia Type II/blood , Male , Middle Aged , Pyrroles/adverse effects , Quinolines/adverse effects , Triglycerides/blood , Ubiquinone/blood
6.
Horm Metab Res ; 39(8): 612-6, 2007 Aug.
Article in English | MEDLINE | ID: mdl-17712727

ABSTRACT

BACKGROUND: There have been no previous reports showing specifically the relation between lipoprotein lipase (LPL) and apolipoprotein (apo) B-48 or remnant metabolism. In this study, we have clarified the relationships of LPL mass in pre-heparin with serum apo B-48 measured by enzyme-linked immunosorbent assay, triglycerides (TG), and remnant-like particle triglycerides (RLP-TG). MATERIAL AND METHODS: Seventy-nine type 2 diabetic subjects [age, 55+/-13; body mass index (BMI), 25+/-5.0 kg/m2; fasting plasma glucose (FPG), 7.39+/-2.22 mmol/l, HbA1c, 6.5+/-1.3%, total cholesterol (TC), 5.36+/-1.09 mmol/l, TG, 2.32+/-2.53 mmol/l; HDL-C, 1.22+/-0.44 mmol/l; serum LPL mass, 45+/-22 ng/ml; apo B-48, 6.6+/-6.3 microg/ml] were recruited in this study. Fasting serum apo B-48 were measured by ELISA using anti-human apo B-48 monoclonal antibodies (MoAb) and LPL mass by ELISA using anti-bovine milk LPL MoAb. RLP-TG levels were measured using monoclonal antibodies to apo B-100 and apo A-1. RESULTS: There was no relationship of LPL mass to age, BMI, FPG, and HbA1c. Serum LPL mass was correlated inversely with TG (r=-0.529 p<0.0001) and positively with HDL-C (r=0.576, p<0.0001). Also, LPL mass showed inverse correlations with apo B-48 (r=-0.383 p<0.0001) and RLP-TG (r=-0.422 p<0.0001, n=51). Multiple regression analysis with TG, apo B-48, or RLP-TG as dependent variables, and age, gender, BMI, plasma glucose, and LPL mass as independent variables showed that LPL mass was associated independently with TG, apo B-48, or RLP-TG. CONCLUSION: The decrease in LPL protein mass could cause an increase in serum apo B-48 and RLP-TG levels, which is related to the retardation of remnant metabolism.


Subject(s)
Apolipoprotein B-48/blood , Cholesterol/blood , Diabetes Mellitus, Type 2/blood , Fasting/blood , Lipoprotein Lipase/blood , Lipoproteins/blood , Triglycerides/blood , Adult , Aged , Blood Glucose/analysis , Female , Humans , Male , Middle Aged , Molecular Weight , Regression Analysis , Sex Characteristics , Triglycerides/chemistry
7.
Int Angiol ; 26(2): 171-82, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17489082

ABSTRACT

Prior to surgery or endovascular therapy for the lower extremity varicose veins or deep venous thrombosis (DVT), ultrasonography provides useful information. But it depends on the operator's technique, each image is limited to a small field of view and interpretation may be subjective. On the other hand, magnetic resonance (MR) imaging is now available with several postprocessing techniques using workstations to demonstrate the gross and objective morphology of these lesions less invasively than the conventional ascending venography. As non-contrast MR venography, fat suppressed three-dimensional (3D) coronal balanced turbo field echo (bTFE) is mainly applied in the semisupine position. The varicose veins on the muscle fascia are easily recognized on volume rendering and the perforating veins can be identified on maximum intensity projection (MIP) and axial multiplanar reconstructions. Gadolinium-enhanced fluid attenuated inversion recovery-bTFE is added when coexisting joint effusion or edema masks the veins. For DVT, direct thrombus imaging (DTI) using fat suppressed 3D coronal inversion recovery-prepared blood suppressed gradient echo sequence is applied. However, the signal intensity of DVT depends on the clot's age on DTI and is sometimes confusing on bTFE. After gadolinium administration, blood shows higher signal intensity than clots regardless of the age and DVT can be easily depicted as filling defects on the axial reformations and summarized on the soap bubble-MIP.


Subject(s)
Lower Extremity/blood supply , Magnetic Resonance Imaging/methods , Veins/pathology , Contrast Media , Gadolinium DTPA , Humans , Lower Extremity/pathology , Varicose Veins/pathology , Venous Thrombosis/pathology
8.
J Cardiovasc Surg (Torino) ; 48(1): 21-5, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17308518

ABSTRACT

AIM: The intermediate-term efficacy of angioscopy-assisted anterior valve sinus plication for primary deep venous insufficiency was evaluated. METHODS: Twelve limbs in 11 patients had class 4 or higher disease on the SVS/ISCVS classification. Descending venography revealed grade-3 or 4-reflux in all limbs. The limbs were treated with angioscopy-assisted anterior valve sinus plication of the highest valve of the superficial femoral vein. Clinical evaluation and air plethysmography were performed at the final follow-up. RESULTS: The mean follow-up was 38.4 months with a range of 24 to 48 months. Postoperative descending venography revealed significant improvement of the reflux of the superficial femoral vein. At the final follow-up, all patients reported relief of subjective symptoms. The ulcers healed and did not recur in the single limb with class-6 disease, the ulcers did not recur in four class-5 limbs, and there was a distinct clinical improvement with resolution of skin changes in the seven class-4 limbs. The venous filling index measured by air plethysmography was in a normal range in 8 of the 12 limbs. CONCLUSIONS: Angioscopy-assisted anterior valve sinus plication may be a surgical technique that results in intermediate-term clinical and hemodynamic improvement in patients with primary deep venous insufficiency.


Subject(s)
Angioplasty, Balloon/methods , Angioscopy/methods , Femoral Vein/surgery , Venous Insufficiency/therapy , Adult , Female , Femoral Vein/diagnostic imaging , Follow-Up Studies , Humans , Male , Middle Aged , Phlebography , Plethysmography , Time Factors , Treatment Outcome , Venous Insufficiency/diagnostic imaging , Venous Insufficiency/pathology
9.
J Lipid Res ; 48(2): 453-7, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17090661

ABSTRACT

The objective of this study was to establish a hepatic lipase (HL) assay method that can be applied to automatic clinical analyzers. Seventy-four hyperlipidemic subjects (men/women 45/29) were recruited. Lipase activity was assayed measuring the increase in absorbance at 546 nm due to quinonediimine dye production. Reaction mixture R-1 contained 50 mM Tris-HCl (pH 9.5), 0.5 mM glycerol-1,2-dioleate, 0.4% (unless otherwise noted) polyoxyethylene-nonylphenylether, 3 mM ATP, 3 mM MgCl(2), 1.5 mM CaCl(2), monoacylglycerol-specific lipase, glycerol kinase, glycerol-3-phosphate oxidase, 0.075% N,N-bis-(4-sulfobutyl)-3-methylaniline-2 Na, peroxidase, ascorbic acid oxidase. Reaction mixture R-2 contained 50 mM Tris-HCl (pH9.5), 0.15% 4-aminoantypirine. Automated assay for activity was performed with a Model 7080 Hitachi analyzer. In the lipase assay, 160 microl of R-1 was incubated at 37 degrees C with 3 microl of samples for 5 min, and 80 microl of R-2 was added. Within-run coefficient of variations was 0.9-1.0%. Calibration curve of lipase activity was linear (r = 0.999) between 0 and 320 U/l. Analytical recoveries of purified HL added to plasma were 96.6-99.8%. HL activity in postheparin plasma measured in this method had a closer correlation with HL mass by a sandwich ELISA (r = 0.888, P < 0.0001) than those in the conventional method using [(14)C-]triolein (r = 0.730, P < 0.0001). This assay method for HL activity can be applied to an automatic clinical analyzer.


Subject(s)
Heparin/blood , Lipase/blood , Adult , Asian People , Female , Humans , Hyperlipidemias/blood , Male , Middle Aged , Polyethylene Glycols/pharmacology
11.
J Phys Condens Matter ; 18(17): L209-16, 2006 May 03.
Article in English | MEDLINE | ID: mdl-21690763

ABSTRACT

Initial oxidation processes on Si(001) have been studied by means of surface differential reflectance (SDR). The time courses of the SDR spectra measured during thermal oxidation at 820 and 920 K allowed two different growth modes, Langmuir-type adsorption and two-dimensional island growth, to be distinguished. No photon energy dependence was observed in the time course of the SDR intensity at either temperature. On the other hand, different uptake curves were observed at different photon energies for oxidation at 300 K. The difference between the oxidation mechanisms at 300 K and at high temperatures was qualitatively apparent from SDR results, because significant photon energy dependence was observed only at 300 K. Possible assignments of the spectral components in the SDR spectra are discussed.

12.
Kyobu Geka ; 55(12): 1011-3, 2002 Nov.
Article in Japanese | MEDLINE | ID: mdl-12428333

ABSTRACT

Osteogenesis imperfecta is a disease in which fragile bones readily cause fracture. Valvular disease concurrently develops. However, the surgery-related mortality rate is approximately 30%. In this study, we report 2 patients with osteogenesis imperfecta who underwent valvular heart surgery. Patient 1 was a 31-year-old male. He had previously been diagnosed as having osteogenesis imperfecta. Echocardiography suggested aortic valve insufficiency, and aortic valve replacement was performed. Patient 2 was a 59-year-old male. During admission, osteogenesis imperfecta was diagnosed. Echocardiography suggested mitral valve insufficiency, and mitral valve plasty was performed. In the 2 patients, intraoperative hemorrhage was marked. However, there were no fatal complications. We also reviewed the literature.


Subject(s)
Aortic Valve Insufficiency/surgery , Heart Valve Prosthesis Implantation , Mitral Valve Insufficiency/surgery , Osteogenesis Imperfecta/complications , Adult , Aortic Valve/surgery , Cardiac Surgical Procedures , Humans , Male , Middle Aged , Mitral Valve/surgery , Osteogenesis Imperfecta/classification
13.
Kyobu Geka ; 55(10): 891-4, 2002 Sep.
Article in Japanese | MEDLINE | ID: mdl-12233111

ABSTRACT

In redo coronary artery bypass grafting (CABG), graft selection and revascularization methods are major problems. We experienced a redo-CABG with occluded previous vein grafts. These grafts were to the circumflex artery and right coronary artery. We conducted operation using cardiopulmonary bypass. We at this operation, chose right internal thoracic artery (RITA) as a conduit and anastomosed it to the side of functioning left internal thoracic artery (LITA) graft, and then diogonal branch, posterolateral branch, and atrioventricular branch were revascularized with the RITA. Post operative course was uneventful. Internal thoracic artery (ITA) is superior to vein graft and other arterial graft as to long term patency. We believe composite Y graft with the use of bilateral ITA can be one of the revascularization strategy in redo CABG.


Subject(s)
Coronary Artery Bypass/methods , Humans , Male , Mammary Arteries/surgery , Middle Aged , Myocardial Infarction/surgery , Reoperation
14.
Kyobu Geka ; 55(9): 793-5, 2002 Aug.
Article in Japanese | MEDLINE | ID: mdl-12174625

ABSTRACT

We report a giant coronary artery aneurysm occurred in the diagonal artery. A 44-year-old woman was referred to our institution for further examination of chest X-ray abnormality. Computed tomography revealed a 6 cm intracardiac mass adjacent to pulmonary artery. Cardiac catheterization revealed a giant coronary artery aneurysm with the large thrombus in the diagonal artery. A giant aneurysm 6 cm in diameter was exposed through a median sternotomy. Under beating heart with cardiopulmonary bypass, the aneurysm was opened and organized thrombus was removed. The influx and efflux of the aneurysm were identified and ligated. Under arrested heart with cardioplegia, the diagonal artery was bypassed with the left internal thoracic artery. Finally the aneurysm was obliterated with the running suture. The patient discharged at the 17th postoperative day without any complications. Histologic evaluation of the resected aneurysm revealed atherosclerotic change, destruction of vascular layers and infiltration of inflammatory cells. These findings suggested previous history of coronary arteritis. The coronary aneurysm in this case might be resulted from Kawasaki disease.


Subject(s)
Coronary Aneurysm/surgery , Adult , Coronary Aneurysm/diagnosis , Coronary Aneurysm/etiology , Coronary Aneurysm/pathology , Coronary Artery Bypass/methods , Female , Humans , Mucocutaneous Lymph Node Syndrome/complications , Treatment Outcome
15.
J Cancer Res Clin Oncol ; 128(7): 363-8, 2002 Jul.
Article in English | MEDLINE | ID: mdl-12136250

ABSTRACT

PURPOSE: We studied the antitumor activity of 2-amino-4,4alpha-dihydro-4alpha,7-dimethyl-3H-phenoxazine-3-one (Phx), which was synthesized by the reactions of 2-amino-5-methylphenol with bovine hemoglobin, on human B cell lymphoblastoid cell lines, P3HR-1 and Raji derived from African Burkitt's lymphoma, and the human T cell lymphoblastoid cell line Molt-4. We also studied whether Phx might cause apoptosis and necrosis in these cells. METHODS: We evaluated cell viability and apoptosis and necrosis of the cells in the presence of Phx, by using agarose gel electrophoresis, flow cytometry, and fluorescence microscopy. RESULTS: Phx suppressed the viability of P3HR-1, Raji, and Molt-4 cells, though the suppression patterns were different, i.e., Phx suppressed the viability of P3HR-1, Raji, and Molt-4 cells at higher concentrations, while the drug enhanced the viability of Raji cells, but not those of P3HR-1 and Molt-4 cells at lower concentrations. To investigate which type of cell death - apoptosis or necrosis - is induced by Phx, induction of DNA ladder, phosphatidylserine externalization, and propidium iodide-permeable cells were examined in Phx-treated cells. Although Phx did not induce DNA ladder formation, it induced the phosphatidylserine externalization and propidium iodide-permeable cells, suggesting that Phx caused a mixed type of cell death, both apoptosis and necrosis. The population of early stage apoptotic cells was dominant in Raji cells, and that of the late stage apoptotic/necrotic cells was dominant in Molt-4 cells after 72-h treatment with Phx. The population of the early stage apoptotic cells and the late stage apoptotic/necrotic cells was almost equal in P3HR-1 cells in the presence of Phx, though the population of both types of cells increased with time. The nuclear morphological analysis of Phx-treated Raji, P3HR-1, and Molt-4 cells also showed that Phx induces apoptosis. CONCLUSIONS: The present results suggest that Phx shows antitumor activity against human B cell-derived and T cell-derived lymphoblastoid cell lines, in vitro, causing apoptosis and necrosis.


Subject(s)
Antineoplastic Agents/toxicity , Apoptosis/drug effects , Cell Death/drug effects , Cell Survival/drug effects , Oxazines/toxicity , Annexin A5/analysis , B-Lymphocytes , Cell Line , Humans , Molecular Structure , Necrosis , T-Lymphocytes , Tumor Cells, Cultured
16.
Kyobu Geka ; 55(2): 178-80, 2002 Feb.
Article in Japanese | MEDLINE | ID: mdl-11842559

ABSTRACT

A 55-year-old woman was presented with large left-sided chest wall mass and spinal paralysis. She had undergone pleural plombage using paraffin for pulmonary tuberculosis at age 40 years. Thoracotomy was performed and all paraffin was removed. Paraffin provoked granulomatous change (paraffinoma) and invaded to vertebral canal. She remains well at 16 months postoperatively without spinal paralysis.


Subject(s)
Granuloma, Foreign-Body/complications , Paraffin/adverse effects , Paraplegia/etiology , Female , Humans , Middle Aged , Paraffin/therapeutic use , Tuberculosis, Pulmonary/surgery
17.
Kyobu Geka ; 55(1): 89-92, 2002 Jan.
Article in Japanese | MEDLINE | ID: mdl-11797414

ABSTRACT

Our case is a 50-year-old man with angina and chronic renal failure. He underwent double vessel MIDCAB (LITA-LAD and GEA-SVG-RCA). Postoperative course was uneventful and postoperative angiography revealed patent grafts. MIDCAB is thought to be effective for patients who have chronic renal failure, because they are able to resume hemodialysis in early postoperative period for controlling water and electolyte.


Subject(s)
Coronary Artery Bypass/methods , Kidney Failure, Chronic/complications , Minimally Invasive Surgical Procedures , Myocardial Ischemia/surgery , Epigastric Arteries/transplantation , Humans , Male , Middle Aged , Myocardial Ischemia/complications , Myocardial Revascularization
18.
Abdom Imaging ; 27(1): 77-81, 2002.
Article in English | MEDLINE | ID: mdl-11740614

ABSTRACT

We report the case of a 56-year-old woman with a presyncopal episode followed by melena. A sentinel clot sign in the pancreatic duct on precontrast computed tomography and the presence of a splenic artery aneurysm on postcontrast computed tomography strongly suggested a fistula between the aneurysm and the duct, as visualized by magnetic resonance imaging. The patient was treated successfully by complete embolization of the splenic artery aneurysm.


Subject(s)
Aneurysm/diagnosis , Magnetic Resonance Imaging , Pancreatic Fistula/diagnosis , Splenic Artery/diagnostic imaging , Tomography, X-Ray Computed , Aneurysm/complications , Aneurysm/therapy , Embolization, Therapeutic , Female , Gastrointestinal Hemorrhage/etiology , Humans , Image Enhancement , Middle Aged , Pancreatic Ducts/diagnostic imaging , Pancreatic Fistula/complications , Pancreatic Fistula/therapy
20.
Surg Neurol ; 55(6): 359-64, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11483196

ABSTRACT

BACKGROUND: We have used magnetic resonance angiography (MRA) in screening for unruptured cerebral aneurysms since 1993. The development of high-resolution magnetic resonance (MR) imaging has led to a remarkable improvement in image quality. Three-dimensional (3D) MRA can be used for surgical simulation. Here, we report on the usefulness of and problems associated with 3D MRA for the surgery of ruptured cerebral aneurysms. METHODS: Between June 1998 and June 2000, 106 patients with SAH diagnosed by 3D MRA underwent surgery. We compared 3D MRA images with operative findings and investigated the usefulness of this assessment tool. RESULTS: In 48 of 106 cases (45.3%), we were able to perform surgery based on 3D MRA alone. By using the 3D images, we could easily detect the relative location of the aneurysm, its neck and the surrounding arteries. The remaining cases required further examinations because of uncertainty of diagnosis or insufficient information. CONCLUSION: 3D MRA is a safe and useful procedure for the diagnosis and surgery of ruptured cerebral aneurysms. However, in approximately half of all cases, 3D computed tomographic angiography (CTA) or digital subtraction angiography (DSA) is required in addition for the planning of surgery. It is important to use 3D MRA for surgery only after taking sufficient consideration of certain limitations peculiar to MRA.


Subject(s)
Intracranial Aneurysm/diagnostic imaging , Intracranial Aneurysm/surgery , Magnetic Resonance Angiography , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Rupture, Spontaneous , Tomography, X-Ray Computed , Treatment Outcome
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