1.Graft Replacement of an Abdominal Aortic Aneurysm Previously Treated by Endovascular Stent Grafting in Two Cases
Toshiro Ito ; Nobuyoshi Kawaharada ; Yoshihiko Kurimoto ; Kenji Kuwaki ; Ryou Harada ; Yousuke Kuroda ; Kiyohumi Morishita ; Tetsuya Higami
Japanese Journal of Cardiovascular Surgery 2007;36(3):141-144
Ninety patients with abdominal aortic aneurysm underwent endovascular stent grafting in our hospital between 2001 and 2006 and two patients required graft replacement of abdominal aortic aneurysms during the late postoperative phase. Case 1 was a 77-year-old man for whom endovascular stent grafting for an abdominal aortic aneurysm and thoracic aortic aneurysm had been performed concomitantly. Six months later, because the abdominal aortic aneurysm had expanded from 68mm to 75mm in diameter, due to a type I endoleak which was detected postoperatively, he underwent open surgery. An occlusion balloon was inflated at the proximal site of the celiac artery until the stent graft was extracted. After positioning the aortic clamp below the origin of the renal arteries, a bifurcated graft was implanted. The postoperative course was uneventful. Case 2 was an 86-year-old woman who had undergone endovascular stent grafting for an abdominal aortic aneurysm. The endovascular procedure was successful and no endoleak was detected postoperatively. However, 13 months later, a community hospital admitted her in a state of shock due to ruptured abdominal aortic aneurysm. She was transferred to our hospital and underwent an emergency operation. Because insertion of an occlusion balloon into the brachial artery failed, we primarily performed supravisceral aortic cross clamping. After opening the aneurysm sac, the stent graft was removed and a bifurcated graft was implanted. After declamping, we found that the right common iliac artery was occluded, and therefore aorto-right external iliac bypass grafting was then also performed. The postoperative course was uneventful.
2.Acupuncture for sports disorders in track and field events.
Toshikazu MIYAMOTO ; Hideo KOBAYASI ; Hidetoshi MORI ; Keishi YOSHIKAWA ; Kazushi NISHIJO ; Tetsuya KURODA ; Tetsuo HOSOKAWA ; Takeshi TOMIYASU
Journal of the Japan Society of Acupuncture and Moxibustion 1987;37(2):111-119
We investigated sports disorders in 112 (82 men, 30 women) members of Field and Track Club, University of Tsukuba.
Before acupuncture treatment, they entered their painful and fatigued areas in our chart and were tested by Cornel Medical Index.
After six months, we questioned 51 (38 men, 13 women) members treated by acupuncture on effects.
The following results were obtained.
1. The painful areas varied with athletic events, that were muscles and joints they moved frequently.
The painful areas were mostly low backs and thighs in a short distance and hurdle race, hips and legs in a middle and long distance, low backs and legs in a jumping event, elbows and low backs in a throwing event.
2. As a result of Cornel Medical Index, it was proved that many members had more mental than physical symptoms.
3. Most of members treated by acupuncture could still go on with training in spite of pains.
4. The effects of treatment continued for 2-3 days.
5. The effects were rated as follows: better 78.4%, no change 14%, worse 6%.
3.A Surgical Case of Acute Aortic Dissection with Antiphospholipid Syndrome.
Tsuneo Nakajima ; Hiroto Kitahara ; Tetsuya Kono ; Keizo Ohta ; Tamaki Takano ; Ryo Hasegasa ; Hirohisa Goto ; Hirofumi Nakano ; Hideo Kuroda ; Jun Amano
Japanese Journal of Cardiovascular Surgery 2001;30(6):311-313
The patient was a 52-year-old man with a history of antiphospholipid syndrome (APS), renal dysfunction and myasthenia gravis (MG). On May 2, 1998, he had sudden chest pain while sleeping. Enhanced computed tomography revealed acute aortic dissection (DeBakey type I). We performed emergency graft replacement of the ascending aorta and the aortic arch under extracorporeal circulation. Because of perioperative anuria, we used peritoneal dialysis (PD) just after the operation. Two days after the operation, we performed re-intubation nine hours after the extubation of the tracheal tube, and performed re-extubation three days later. For a while, his postoperative course was uneventful, but because of gradual worsening of APS, we administered more prednisolone, but 74 days after the operation, he died of multiple organ failure caused by an opportunistic infection, sepsis, and disseminated intravascular coagulation. This was very rare case of acute aortic dissection with MG and APS. After administration of more glucocorticoids, it is important to be wary of opportunistic infections.