Total correction for a chronic aortic dissection, producing progressive enlargement of the false lumen of the aorta involving wide range of aorta and aortic manifestation of Marfan's syndrome is a very difficult procedure. However, with the recent development in surgical techniques and management, it became possible to replace total or subtotal aorta with the prosthetic graft. Recently, we treated a 24 y/o male patient with annuloaortic ectasia, DeBakey type II+IIIb aortic dissection, and obstruction of right common iliac artery, associated with Marfan's syndrome with a two-staged operation. For the first stage, we performed Cabrol's procedure on his lesions in ascending aorta. About 2 years after that, for the second stage, replacement of total descending and abdominal aorta was pertformed.

We present one case of true aneurysm of the branchial artery which is very rare among peripheral aneurysms. A 52-year-old woman developed a bruise on the right upper arm around June 1993, but did nothing about it because she felt no symptoms. A pulsating mass became palpable at this site around the following month. Digital subtraction angiography revealed an aneurysm formation of 1.5×1.5cm in size in the right brachial artery. Operative findings showed that the wall of the aneurysm joined the normal region and all the vascular layers in the aneurysm were maintained. After resection of the aneurysm, end-to-end anastomosis was carried out. A diagnosis of true aneurysm was confirmed by the pathohistological findings that the vascular three-layer structure was maintained, with few arteriosclerotic changes.

A 74-year-old man had an inflammatory pseudoaneurysm of the ascending aorta. He was admitted to a local hospital because of loss of appetite. Following intravenous hyperalimentation, he was placed under ventilatory support because of acute respiratory failure. Since his high fever and respiratory failure continued, he was transferred to our hospital. Computed tomography revealed a sealed rupture of an aneurysm in the ascending aorta. During the operation, we identified the ascending aortic aneurysm but it was very tightly attached to the surrounding wall in the perianeurysmal space. To avoid excessive hemorrhage, we closed the communication between the aneurysm and the aorta with a Dacron graft patch under deep hypothermia with circulatory arrest. He was discharged 42 days after operation without any complications. A pathological evaluation of the aneurysmal wall revealed an inflammatory pseudoaneurysm with a thick and inflammatory infiltration in the adventitia.

The objective of this study was to assess the possibility of developing a clinical minimally invasive and standardized method to evaluate the relationship between the microstructure of the jaw bone and systemic bone turnover. For this purpose, we performed standardized bone biopsy of the alveolar bone, and compared the 3D bone microstructure using micro-computed tomography (micro-CT) with bone mineral density (BMD) of the lumbar spine and biochemical markers of bone turnover. We evaluated a total of 9 samples taken from 6 patients by standardized biopsy using a trephine bur. BMD was evaluated using dual energy X-ray absorptiometry (DXA). Regarding the biochemical markers of bone turnover, serum bone-specific alkaline phosphatase (BAP) and serum osteocalcin (OC) were used as bone formation markers, and urinary cross-linked N-telopeptides of type I collagen (NTx) and urinary deoxypyridinoline (DPD) were selected as bone resorption markers. We scanned micro-CT images of these samples. Bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular spacing (Tb.Spac), fractal dimension, trabecular bone pattern factor (TBPf) and node-strut (Nd.Nd/TV, TSL/TV) were measured. Regarding the correlations between the parameters of bone microstructures, TB/TV, Tb.N, fractal dimension, and node-strut seemed to be positively correlated and Tb.Spac and TBPf seemed to be negatively correlated with each other, but Tb.Th seemed to have a low correlation with other parameters. OC and/or BAP showed a significantly high correlation with many structural parameters (p<0.05%). In conclusion, some microstructural parameters may change according to the systemic bone turnover.

Since distal femoral varus osteotomy (DFO)
Asian Continental Ancestry Group ; Humans ; Japan ; Knee ; Osteoarthritis ; Osteotomy ; Tibia ; Weight-Bearing