Yukifumi Nakata

Vascular lesions due to obstruction of the vasa vasorum.

DISTURBANCE of the vasa vasorum is probably a major factor in the aetiology of various vascular lesions such as cervical rib syndrome, medionecrosis, arteriosclerosis, and pulseless disease1. Various experimental methods of destroying the vasa vasorum have been reported2,3. These involve crushing or dissecting the adventitia, or applying acids and thermocautery to the outside of the vascular wall. We have found no references to any method involving disturbance of the vasa vasorum alone, however. This communication describes an experimental procedure designed to obstruct the vasa vasorum alone.

Pathogenesis of mycotic aneurysm.

Aneurysms are more frequently attributable to arteriosclerosis than to syphilis, trauma and bacterial Although mycotic aneurysms are relatively uncommon,2 it seems necessary to take more notice of mycotic aneurysms because, in contrast with arteriosclerotic aneurysms, most mycotic aneurysms occur in patients under 40 years old and have a tendency to rapid growth and rupture.2-5 The surgical procedure is difficult and the prognosis is poor for the inflammation in the involved vessel.2, 5, 6 Since the middle of the last century mycotic aneurysms have been the subject of increasing clinical investigation, and many investigators have discussed whether mycotic aneurysms are formed by the direct infection on the inner surface of the artery or by the infection through the vasa vasorum from the outer side of the arteries.3, 5, 7, 8 The purpose of this report is to describe vascular lesions caused by infection through the vasa vasorum by the new injecting method, and to discuss

False aneurysm of the superficial temporal artery

Abstract A case of false aneurysm with fistula of the superficial temporal artery is reported, and the English literature is reviewed.

Onset and Clinicopathological Course in Buerger's Disease:

From clinicopathological study, vasculitis of Buergers disease seemed to start at small branch arteries and veins and progress to the trunk artery with thrombus. Progress of vascular lesions in trunk artery was gradual in general; the pathogenesis was briefly discussed.

Influences of bradykinin on the microcirculation.

Department of Surgery, Nagoya University Branch Hospital, Nagoya and the First Department of Surgery, Nagoya Universitv, School of Medicine, Nagoya, Japan. * Nagoya University Branch Hospital, Nagoya, Japan. Bradykinin is the prototype of a group of related vasoactive polypeptides termed &dquo;kinines&dquo;, and the pathophysiological significance of the peptide is recently discussed as a chemical mediator of the inflammatory response. Elliott et al (1) reported that pure bradykinin produces vasodilation, increased capillary permeability and pain. However, the effects of bradykinin on the postcapillary vascular bed are complex. As vasodilation and exudation are the most characteristic phenomena in the inflammatory response, it is important for the pathogenesis of the various vascular diseases to observe the influences of bradykinin on the microcirculation in the vessel wall. The following experiments were therefore undertaken in an effort to resolve some of these

Late changes in a bovine graft: A case report

We treated a Japanese man with aneurysmal dilatation of the bovine graft transplanted for femorofemoral bypass. The reconstruction was performed successfully by the replacement with a Dacron graft 29 months after the first operation. Aneurysmal dilatation was observed over the entire length of the graft, and the wall of the graft was fragile. Disruption of collagen fibers and bleeding into the graft wall from the arteries which had been newly formed in abundance were extensive. The histological findings suggested that bovine grafts should be used for only a short period or for the replacement of small arteries.

Reconstructive Surgery for Combined Aortofemoral and Infrafemoral Occlusion

In reconstructive surgery for combined aortoiliac and infrafemoral occlu sion, there are many reports that only proximal repair with profunda plasty has resulted in a symptomatic improvement.1-5 However, the 5-year patency and the limb salvage rate were low, and some surgeons have reported that many patients had remained without symptomatic improvement. 6-11 This study was made to assess the indication for subsequent repair in peripheral combined lesions and report the prognosis in the reconstructive surgery for tandem lesions.

Surgical Treatment of Peripheral Congenital Vascular Dysplasia

From the Department of Surgery, Nagoya University Branch Hospital, Nagoya, Japan. Hemangioma (HS), arteriovenous fistula (AVF), and Klippel-Trenaunay syndrome (KTS) originate in the anomalous development of the primitive vascular system.l°2 Differences in the stage of abnormal development of the vascular system cause a variety of clinical manifestations.3°4 These diseases therefore fall within the same category and call for the same treatment. Surgical treatment for widespread lesions is technically difficult, and poor results have been reported.2, 3, 5

Lont-term prognosis for reconstruction of arterial lesions due to arteriosclerosis

Out of 769 patients with arterial diseases, reconstructive surgery was performed on 100 limbs of 79 patients for arteriosclerosis. The overall patency rate was 59 per cent over a period of 3 to 8 years. Longterm patency was influenced by the condition of the run-off arteries, the site of the operation, and the method of surgery. No relation was found between patency rate and hypertension, cardiac insufficiency, total serum cholesterol, diabetes mellitus, or age. The survival rate was 62 per cent at 5 years and 48 per cent at 7 years. These rates were significantly poor (p<0.001), compared with those in the normal population. Mortality was related to the degree of hypertension, with cardiac and renal failure being responsible for 72 per cent of deaths. Aggressive reconstruction may be indicated in cases with hypertension of stage 2 or below based on the WHO classification. However, especially in patients with associated diabetes mellitus close long-term observation of the cardiovascular system is necessary.

Recurrence of the Nephrotic Syndrome in the Renal Isograft: A Preliminary Report

The fifth case of kidney transplantation between monozygotic twins in Japan is presented. Immediately after the transplanation the original disease, nephrotic syndrome, recurred but it was treated with steroids successfully. There have been few cases reported in which recurrence of the original disease in the isograft was treated successfully.