A 2-month-old female Holstein calf and a 5-month-old female Japanese black calf presented with gingival vascular hamartoma located in the interdental space between the second and third mandibular incisors in the right and left mandibles, respectively. On radiographic or computed tomographic images, osteolytic changes appeared within the mandibular bones adjacent to the masses. The masses were removed along with affected mandibular bone by using unilateral rostral mandibulectomy. After surgery, both cases exhibited a normal appetite and grew normally, with no cosmetic changes or recurrences. Unilateral rostral mandibulectomy can be applied for invasive gingival vascular hamartomas associated with osteolytic changes.
Animals ; Appetite ; Asian Continental Ancestry Group ; Cattle ; Female ; Hamartoma ; Humans ; Incisor ; Infant ; Mandible ; Mandibular Osteotomy ; Radiography ; Recurrence

A 62-year old man was referred to our hospital with endocarditis. Although the infection was improved by antibiotic therapy, he underwent surgery because of severe aortic and mitral valve regurgitation. Preoperative computed tomography revealed a pseudoaneurysm of 20 mm in diameter at the posterior wall of the ascending aorta. The non-coronary cusp was infected and there was a punched-out pseudoaneurysm at the ascending aorta adjacent to the sino-tubular junction. After resection of the aortic wall and the aortic valve, a modified Bentall operation with a composite graft and mitral valve plasty was performed. Postoperative whole body computed tomography revealed no other pseudoaneurysms. In case of endocarditis, we have to consider the possibility of aneurysm formation throughout the body.

A 71-year-old man had sudden onset of left lower limb swelling and consulted an orthopedic surgeon 14 days later. Venous echography demonstrated compression of the left iliac vein and the thrombus of the common iliac vein. After emergency admission, conservative therapy was given for 7 days, but the symptoms did not sufficiently diminish and a thrombus was also present. We therefore performed femoro-iliac cross-over vein bypass using a 10mm ringed ePTFE graft. Symptoms were completely improved and the graft was shown to be patent by echography after 3 months.

A 16-year-old high school boy experienced intermittent claudication of his left lower limb during boxing training. Physical examination revealed a cold left foot and diminished pulse. A 64-row multi-slice CT (MSCT) demonstrated lateral shift and severe stenosis of the left popliteal artery due to malposition of the medial head of the gastrocnemius muscle. A diagnosis of popliteal artery entrapment syndrome (Delaney type II) was established and a surgical correction was planned. During surgery, since the artery was found to be compressed but not occluded, we simply released the popliteal artery by division of the medial head of the gastrocnemius and abnormal flips of muscle. The postoperative ankle brachial pressure index rose from “not measurable” to 1.22. MSCT was useful to characterize this anomaly by expressing the precise anatomical relation of muscle, bone and artery, which was a good guide for an appropriate surgical intervention.

Pulse wave velocity is widely used as an index of arterial stiffness. The aim of this study is to assess the usefulness of pulse wave velocity as a risk factor in patients who underwent coronary artery bypass grafting. Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV) and the ratio of the patient's baPWV to the age-matched normal value was calculated in 42 CABG patients. Age and male/female ratios were 66.7 years and 33/9, respectively. baPWV (1, 820.7±459.8cm/s) was higher in CABG patients than that in age-matched normal value. Preoperatively, the baPWV ratio in the group with the history of cerebrovascular disease was significantly higher than that in the group who had no cerebrovascular disease (p<0.05). In contrast, the baPWV ratio did not correlate to the severity of other cardiovascular diseases. There was one (2.4%) in-hospital death and 23 incidences of postoperative complication in 16 patients. The baPWV ratio in the group with postoperative complications was significantly higher than that in the group with no complications (1.38±0.33 vs. 1.16±0.22; p<0.05). In this study, baPWV in CABG patients was higher compared with that in the age-matched general population, indicating the existence of atherosclerotic vascular changes. The elevated bePWV is also a risk factor of postoperative complications in patients who have undergone CABG.