ABSTRACT
A 68-year-old woman had unstable angina pectoris with asymptomatic right internal carotid artery and right middle cerebral artery occlusion with impaired cerebral perfusion reserve. The cardiology, cardiovascular surgery, anesthesiology, and neurosurgery departments discussed the treatment plan. We simultaneously performed superficial temporal artery-middle cerebral artery anastomosis and coronary artery bypass grafting to reduce the likelihood of perioperative ischemic stroke. Fortunately, neither cerebral ischemia nor myocardial ischemia occurred. Simultaneous superficial temporal artery-middle cerebral artery anastomosis and coronary artery bypass grafting can be a therapeutic option for patients with unstable angina and impaired cerebral perfusion reserve. However, the risk of bleeding associated with anticoagulation during coronary artery bypass grafting cannot be ignored.
ABSTRACT
A 52-year-old woman who had two episodes of cerebral hemorrhage due to cerebral arteriovenous malformation (AVM) had been treated with gamma knife radiosurgery twice. Complete obliteration of the AVM was confirmed after treatment and she was making steady progress. Twenty years after gamma knife radiosurgery, computed tomography showed cyst formation. The cyst grew larger with ensuing neurological signs and symptoms, so we performed surgery. Thereafter, it was possible to make a pathological assessment. Delayed cyst formation after gamma knife radiosurgery for AVM is known to be one of the late adverse effects of radiation but little is known beyond 10 years postoperatively. We report here on a case of cyst formation 20 years after gamma knife radiosurgery for AVM.
ABSTRACT
In order to carry out mass examination for detection of stomach ailments effectively and improve screening accuracy, the Nagano Prefectural Welfare Federation of Agricultural Cooperatives, with its mass gastric examination committee as a driving force, has made every endeavor in close collaboration with Federation-affiliated hospitals.<BR>The ratio of those receiving detailed examination to the total number of those who have undergone mass screenings, and the detection ratio of gastric cancer cases, especially those in early stages, have increased steadily over the past years.<BR>This is due in the main to untiring effort exerted by public health nurses and other persons concerned with health problems.<BR>However, the results of X-ray examination made on the basis of the diagnostic standards prepared by the Federation show that there is much need of improving examiners' ability to read mass miniature radiographs correctly.