Zensuke Yanagi

A comparative study on the patency of crimped and noncrimped vascular prostheses, with emphasis on the earliest morphological changes

In 1955 Edwards [I] announced that crimping is the best way to provide noncollapsible synthetic vascular grafts and eliminate occlusion caused by wrinkling and/or kinking. The advent of crimped tubes, coupled with the great improvement in material and elucidation of the role of porosity in the healing process, led to the worldwide use of synthetic prostheses in the field of vascular surgery. The use of crimped tubes is now taken for granted, and many surgeons tend to use them rather freely. The present authors have recently compared the early reparative process and longterm patency of the crimped and noncrimped prostheses in dogs, and found various advantages of noncrimped prostheses as far as implantation to small arteries is concerned. The authors believe that the results of this study, though they may somewhat contradict the widely held view about the superiority of crimped prostheses, will serve as a cornerstone for the discrete use of the two different types of synthetic prosthesis.

A CASE REPORT OF JUVENILE MULTIPLE COLO-RECTAL POLYPS WITH PROTEIN LOSING GASTROENTEROPATHY

A 14-year-old girl was admitted to the hospital because of watery diarrhea and edema of the lower extremities. Barium enema and endoscopy of the large intestine revealed multiple colorectal polyps with a circumferential IIa. group-like elevated lesion at the rectum. Leakage of isotopes from the rectum to the sigmoid colon was proved on 99mTc-HSA scintigram, and marked hypoproteinemia (TP 3.7g/dl), low level of IgG and increase in α1-antitrypsin clearance were recognized. From the above findings a diagnosis of multiple cold-rectal polyps with protein losing gastroenteropathy was made. Although the intestinal lesion in this patient was a tubular adenoma with slight atypia, it was a so-called IIagroup-like lesion macroscopically, assuming a form whose canceration rate is called high, and was complicated with protein losing gastroenteropathy. And hence proctosigmoidectomy was performed though the patient was young. This paper describes this case together with some literature discussion.