Chylothorax is a serious complication that can jeopardize the outcome of thoracic surgery and prolong hospitalization. We report a 66-year-old man who underwent graft replacement for a distal arch aneurysm, in whom a persistent postoperative chylothorax developed. It was necessary to perform continuous drainage and conservative management. Administration of octreotide sharply decreased the drainage volume and the chylothorax disappeared within 2 weeks. Early administration of octreotide for postoperative chylothorax may shorten the therapeutic period.

A 60-year-old man with constrictive tuberculous pericarditis rapidly progressing after his hospitalization underwent partial pericardiectomy, anterior to the bilateral phrenic nerves through a midline sternotomy without a cardiopulmonary bypass. The results of right cardiac examination a month postoperatively showed the cardiac diastolic dysfunction remained unchanged. However, the results after 6 months and also 3 years postoperatively showed the cardiac function recovered from the constrictive pericarditis. He is free from tuberculosis and heart failure. We should be aware of a sign of heart failure due to constrictive tuberculous pericarditis and take the surgical treatment into consideration. We regard the partial pericardiectomy without cardiopulmonary bypass as one of the effective treatments for constrictive tuberculous pericarditis.

This study is to examine whether health food containing α-lipoic acid, Ginkgo biloba extract, and L-carnitine can improve cognitive function of human subjects complaining amnesia. A before-after study was done on 31 adult subjects comprising of 14 males and 17 females with an average age of 57.3±5.8 years who had symptoms of memory impairment. The Japanese version of ‘Repeatable Battery for the Assessment of the Neuropsychological Status (RBANS)’ was utilized to evaluate cognitive functions of these subjects before and after the supplementation for 12 weeks. As a result, the placebo group showed no improvement of cognitive functions. In contrast, in the supplementation group, immediate memory (story), language (picture naming and semantic fluency), attention (digit span), and short-term memory (list, story and figure recall) were significantly improved. In conclusion, the present health food is useful for improving cognitive functions such as memory and attention.

A 66-year-old man had presented with nausea and vomiting at a neighboring hospital. Abdominal CT scan revealed a giant aortic abdominal aneurysm accompanied by duodenal obstruction. Y-graft replacement operation was performed in our hospital. Although aortic abdominal aneurysm is often unexpectedly diagnosed by abdominal CT scan, very few cases of aortic abdominal aneurysm have been diagnosed in association with ileac abdominal symptoms; for example vomiting and abdominal pain. We report a case of giant aortic abdominal aneurysm with symptoms of duodenal obstruction, describing pathophysiologic aspects.

Mycobacterial infection after open-heart surgery is a rare complication. We report 2 cases of cutaneous infection caused by Mycobacterium fortuitum (M. fortuitum). Case 1: A 56-year-old man had wound infection from the 10th postoperative day (POD). The growth of M. fortuitum was detected on the 38th POD. Combination of multiple antibiotic therapy was performed. He was cured after several recurrences of cutaneous ulcer and abscess following 15 months. Case 2: A 26-year-old man had wound infection from the 28th POD. Deep sternal infection with mediastinitis developed. Bacteriological examination revealed the growth of M. fortuitum on the 61st POD. Omentopexy was performed on the 67th POD. Wound infection completely healed, and the patient was discharged from our hospital on the 137th POD. Mycobacterial infection should be considered when the wound infection is resistant to ordina antibiotics.

Persistent sciatic artery (PSA) is a rare congenital peripheral artery disorder that is usually detected incidentally on computed tomographic examination. PSA can also cause iliac aneurysm and acute thromboembolism, which are potentially associated with rest pain, claudication, and limb-threatening ischemia. Patients with PSA and leg ischemia should be treated with revascularization and appropriate management of PSA aneurysm. The authors often choose emergent bypass surgery or endovascular intervention for aneurysmal rupture and acute lower-extremity arterial occlusion. This report describes an emergency procedure using catheter-based thrombolysis for acute limb ischemia in a patient with PSA.

Popliteal artery aneurysm (PAA) is a rare vascular disease, especially in women, and presents with various symptoms, ranging from being asymptomatic to rupture or acute life-threatening ischemia. We have presented a case of PAA in an 81-yearold woman complaining of tingling sensations in her leg. Computed tomography revealed a large 10-cm sized PAA. Because of the compression related symptoms, an open repair approach was selected and performed successfully via a posterior approach, including partial aneurysm resection and interposition graft with a reversed saphenous vein.

Popliteal artery aneurysm (PAA) is a rare vascular disease, especially in women, and presents with various symptoms, ranging from being asymptomatic to rupture or acute life-threatening ischemia. We have presented a case of PAA in an 81-yearold woman complaining of tingling sensations in her leg. Computed tomography revealed a large 10-cm sized PAA. Because of the compression related symptoms, an open repair approach was selected and performed successfully via a posterior approach, including partial aneurysm resection and interposition graft with a reversed saphenous vein.

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