Cilostazol increases the level of intracellular cyclic adenosine monophosphate (cAMP) by inhibiting cyclic nucleotide phosphodiesterase-3. Its main role was induced by the increased cAMP, including the inhibition of platelet aggregation, anti-thrombosis, vasodilation, and anti-endothelial cell proliferation. Recent experimental studies line indicated that cilostazol is promising in the intervention of acute cerebral ischemia and chronic cerebral hypoperfusion. Clinical trials have also demonstrated its efficacy. This article summarizes the pharmacological effect and mechanism of cilostazol, as well as its protective effect during ischemic stroke.

We performed exercise intervention for 12 weeks in young females (22.3±2.5 yrs ; mean±SD) with a %fat value of 30% or more (dual energy X-ray absorptiometry : DXA) despite a body mass index (BMI) of less than 25 kg/m², which indicates hidden obesity, and the following results were obtained.The intensity of exercise was established as the double product break point calculated from heart rate and systolic blood pressure, and the subjects were instructed to exercise for 30 minutes or more for 3 or more times a week. Six weeks after exercise intervention, the BMI, body fat level, and plasma glucose level were lower than those before exercise intervention, and the %fat value was lower 12 weeks after intervention. Furthermore, cardiac autonomic function (CAF) was negatively correlated with changes in Total power and changes in fat (kg), suggesting that exercise-related improvement in CAF is involved in a decrease in %fat.

We reviewed our experience with 4 cases of chronic dissecting aortic aneurysm (DeBakey IIIb) with the false lumen extending into the abdominal aorta and major branches being perfused from the false lumen. In such cases, resection of the intrathoracic portion of the aneurysm and closing of the distral false lumen may exclude visceral perfusion from the false lumen. In order to ensure continued perfusion of true and false lumens after repair, we performed “double barrel” anastomosis for distal anastomosis in graft replacement of the descending aorta. Follow-up periods ranged from 8 to 21 months, 17 months on average. Postoperatively, neither apparent expansion of the false lumen nor compression of the true lumen was found in these cases. The advantage of this procedure is the effective restoration of visceral perfusion. We emphasize that this procedure is one of the choices of procedures, as a two-staged approach for chronic aortic dissection presenting with visceral perfusion from the false lumen and without an enlarged abdominal aorta, though more patients and longer follow-up are required to fully evaluate this procedure.