Laser thermal angioplasty with a metal hot tip probe for atherosclerosis obliterans of iliac, femoral and popliteal artery lesions was used instead of conventional balloon angioplasty. Initial angiographic and clinical success was achieved in 24 of 28 (85.7%) vessels. The 1-year cumulative patency rate was 82.6 % of 19 vessels with clinical success in 23 vessels (one of 24 clinical success cases died due AMI at 14 days after operation). In the 8 iliac and 15 femoro-popliteal arteries, the cumulative success rates were 100% and 73.3%, respectively. Complications were observed in 25% of vessels (7 of 28 vessels). One of them necessitated emergency bypass surgery but not the others. In the 24 laser thermal angioplasty, other revascularization methods were performed on 12 cases (50%) at the same time. Although many problems remain to be solved laser thermal angioplasty can be effective for atherosclerotic disease.

We perfomed an aortic valve replacement and intraoperative plasma exchange with Cell Saver 4^® made by Haemonetics for removal of bilirubin. Diluted blood after cardiopulmonary bypass and suctioned blood (total volume 11, 300ml) was washed, concentrated and transfused. Plasma bilirubin level was decreased to 5.4mg/dl from 9.9mg/dl during operation. It was concluded that intraoperative plasma excange with Cell Saver 4^® was safe and effective technique for removal of bilirubin during open heart surgery.

An internal felt-reinforced patch-plasty was performed in 11 patients with dissecting aortic aneurysm (DeBakey type I: 4 cases, type II: 1 case, type III: 5 cases, aortic arch dissection: 1 case). The aortic cross-clamp time was 84±19 min on the average. The initial tear of the aortic intima was closed on 10 patients. Minor leakage through a felt inserted in the false lumen was observed in one patient of type I. There was no operation-related death except one patient of type III who died from arrythmia encountered following termination of centrifugal pump bypass. Thrombotic occlusion of the false lumen developed in the ascending aorta in type I and II cases, and in the desceding aorta in type III one month after operation. The false lumen localized in the aortic arch was completely occluded by thromi. Postoperative course was excellent in all patients after 16 months on the average. Internal felt-reinforced patch-plasty is a simple and reliable procedure for closing the intial tear of dissecting aortic aneurysms.

The early and mid-term survival after thoracic aortic surgery and the influence of age on operative mortality were examined in 93 consecutive patients from August 1994 to June 1999, together with assessment of postoperative quality of life (QOL). The mean age was 63.8±11.6 years old (range 26 to 84 years) and 65 patients were male. Aneurysms were atherosclerotic in 43 patients and aortic dissection was present in 50. Forty-eight (52%) required emergency operation. Operative procedures consisted of ascending aorta or hemiarch replacement in 23 patients, Bentall's operation was performed in 4, total arch replacement in 31, distal arch replacement in 9, descending aorta replacement in 13, replacement of the thoracoabdominal aorta in 6, and patch repair in 7. These patients were divided into two groups: the under 70 group (Y group, n=61) and the 70 or older group (O group, n=32). Current QOL of the survivors was assessed using the Asanoi method with a mailed questionnaire. There were 13 early deaths (14%). There were 10 late deaths (5.6%/P-Y (Patients-Years)). The actuarial survival rate of the Y group was significantly higher than that of the O group (p=0.0412). Perioperative stroke was seen in 11% of the Y group and 16% of the O group. These patients had a high mortality rate (Y group 43%, O group 100%) during early and long term follow-up periods. The postoperative NYHA category and exercise ability of the O group were better than those of the Y group. We obtained satisfactory answers concerning the results of operation in the majority of current survivors. Patients aged 70 years and older could undergo thoracic aortic surgery with reasonable risk. QOL following operation was satisfactory except in patients with merged perioperative stroke.

In China, for years they have been studying the PSC to investigate scientifically the substance of traditional meridians. As we had been to there, we learned how to investigate it. According to their method we did it in Japan.
Objects were 340 healthy youths. The stimulated points were the well points in each meridian. The low frequency electroacupuncture (5-20Hz) was given to these points 30 minutes. Objects showed us their sensation or orally or by gesture.
We divided the result into 4 stages according to the chinese method;
salient…5 (1.5%)
comparatively salient…3 (0.9%)
slightly salient…7 (2.0%)
Non-salient…325 (95.6%)
In China, by the way, objects were 1, 000 people and it was 1.3%, 1.8%, 15.2% and 81.7%.
In this study, though it showed a low incidence of about 4.4% (about 18% in China), it was found that there was a phenomenon of the PSC.