Osteochondromas, or exostoses, are the most frequent benign bone tumors. Although many osteochondromas are asymptomatic, they are sometimes responsible for vascular complications, most often associated with the popliteal artery. Here, we present a rare case of pseudo-aneurysm of the popliteal artery secondary to an osteochondroma of the femur in a 48-year-old woman. During surgery, a pseudo-aneurysm developed from a 1-mm hole in the anterior aspect of the popliteal artery, which was closely related to the protrusion of the femoral osteochondroma. The surface of the osteochondroma was quite sharp, rigid and firm. It was removed completely through the lumen of the aneurysm. A short segment of the popliteal artery, including the hole, was resected with an end-to-end anastomosis. The postoperative course was uneventful, and the patient recovered completely. The precise pathogenesis of pseudo-aneurysmal formation is still unknown. We speculate that local compression of the popliteal artery by a spiky osteochondroma can stretch the vessel and lead to rupture of the artery by continuous friction. Considering the potential risk of this vascular complication, shonld be closely monitered patients with osteochondroma of the femur.

The objective of this study was to examine whether the combination of n-3 polyunsaturated fatty acids PUFA) supplementation and physical exercise training would decrease oxidative stress in comparison with n-3 PUFA supplementation only in humans. Eighteen women college students were divided into a perilla oil supplemented control group or a perilla oil supplemented physical exercise trained group throughout the experimental period of 4 weeks. After the intervention in both groups, plasma triglyceride levels were decreased. Serum thiobarbituric acid reactive substances (TBARS) level in the control group was increased by n-3 PUFA supplementation. In the trained group, however, TBARS level was unchanged. Plasma vitamin C level in the trained group was significantly decreased by n-3 PUFA supplementation. These results suggest that the combination of n-3 PUFA supplementation and physical exercise training might result in attenuated tissue damage induced by reactive oxygen species, if appropriate daily antioxidants, especially vitamin C, were provided.

N-3 polyunsaturated fatty acid supplementation has been recognized to affect the peripheral oxygen delivery system with increasing blood rheology. The purpose of the present study was to investigate whether n-3 polyunsaturated fatty acid supplementation, using purified perilla oil rich in α-linoleic acid, improves aerobic capacity in young women. Eighteen young, sedentary female college students were divided into an n-3 polyunsaturated fatty acid supplemented control group (PUFA-C, n=10) and an n-3 polyunsaturated fatty acid supplemented trained group (PUFA-T, n=8). All subjects took 20g of perilla oil (11g of n-3 polyunsaturated fatty acid) in addition to the usual diet throughout the experimental period of 4 weeks. PUFA-T subjects exercised for 30 min on a bicycle ergometer (intensity, 60% of VO₂max) 4 times a week for 4 weeks. Maximal oxygen uptake (VO₂max) and oxygen uptake at the ventilatory anaerobic threshold level (VT) significantly (p<0.05) increased after treatment in both groups. However, the endurance time in the exhaustive exercise test significantly (p<0.05) increased in the PUFA-T group only. Increasing rates of VO₂max and VT with treatment for the PUFA-C group were lower than those for the PUFA-T group (VO₂max, 12.6% vs 14.4%, VT, 9.7% vs 16.9%). After treatment, these values returned to baseline levels within 2 months of the recovery period without n-3 polyunsaturated fatty acid supplementation in both groups. Only for the PUFA-T group, VO₂max and VT at 2 months after the treatment period were significantly (p<0.05) higher compared with baseline levels. These results suggest that n-3 polyunsaturated fatty acid supplementation might have a beneficial effect on improving aerobic capacity with increasing peripheral oxygen delivery. However, n-3 polyunsaturated fatty acid supplementation was less effective than aerobic training.

A 68-year-old woman with a sudden onset of back pain was brought to our hospital by ambulance. Computed tomography (CT) showed Stanford type A (DeBakey type II) acute aortic dissection, left hemothorax, and hematoma extending along the pulmonary artery ; therefore, the patient underwent emergency operation. We performed a median sternotomy. Pericardial effusion was not observed ; however, a hematoma was found around the ascending aorta. Preoperative CT showed left hemothorax, but pleural effusion was not observed in the left pleural cavity. The left hemothorax, which was detected on preoperative CT, was diagnosed as an extrapleural hematoma. The dissection entry site was located at the proximal aortic arch ; therefore, ascending aorta-hemiarch replacement was performed. After weaning from cardiopulmonary bypass, the patient experienced sudden airway bleeding. The bleeding was attributed to the hematoma extending along the pulmonary artery. Here, we have reported a rare case of Stanford type A acute aortic dissection with the left extrapleural hematoma and lung hemorrhage.

The treatment tactics for subclavian artery occlusion include the more commonly used endovascular therapy rather than surgical intervention. We present a case of a 61-year-old woman with dialysis-dependent chronic renal failure who experienced left finger necrosis in the left upper extremity. To salvage the limb, we performed femoro-axillary (fem-ax) artery bypass using an autologous saphenous vein graft. However, 10 months later, she experienced coldness in the left forearm. Angiography revealed chronic total occlusion of the venous bypass. Despite emergent thrombectomy, redo fem-ax artery bypass operation was performed using a prosthetic graft. Upper limb salvage can be achieved by fem-ax artery retrograde bypass.
Angiography ; Arteries* ; Extremities ; Female ; Fingers ; Forearm ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Necrosis ; Saphenous Vein ; Subclavian Artery* ; Thrombectomy ; Transplants ; Upper Extremity