INTRAOPERATIVE ANGIOGRAPHIC ASSESSMENT OF RECONSTRUCTED ARTERY AND USEFULNESS OF SAPHENOUS VEIN GRAFT BRIDGING IN EARLY THROMBOSIS OCCLUSION AFTER CAROTID ENDARTERECTOMY

Early postoperative thrombosis-occlusion of the internal carotid artery after carotid endarterectomy plays a major role in postoperative neurologic morbidity and mortality. To prevent this terrible complication, many surgeons are trying various prophylactic methods such as saphenous vein patch angioplasty, prolonged use of heparin, intraoperative Doppler ultrasound assessment, and so on. However, complete protection from postoperative thrombosis-occlusion is difficult. We have performed 47 carotid endarterectomies on 43 patients in the last three years. In 28 of these endarterectomies, primary closure for arteriotomy was performed, and in 19 cases, endarterectomies were reconstructed with saphenous vein patch angioplasty. An intraoperative angiographical assessment of the reconstructed segment was done in all endarterectomies after the reversing of heparin given during the carotid arterial surgical maneuver, and restenosis, or thrombosis-occlusion, was also checked. In three arteries, restenosis was demonstrated and repair was performed with vein graft angioplasty. Three of 28 arteries recontructed with primary closure and 1 of 19 arteries with vein patch angioplasty showed thrombosis-occlusion. Although vein patch angioplasty was done immediately for the primarily closured arteries, occlusion occurred again in two arteries. One artery with patch angioplasty also reoccluded. For these arteries, saphenous vein graft bridging between common carotid artery with an intact intima and internal carotid artery with an intact intima was performed. Postoperative angiogram showed good blood flow through the vein graft bridge. These results suggest that intraoperative angiography gives important imformation about the reconstructed arterial segment and that saphenous vein bridging is very useful in arteries with thrombosis-occlusion following carotid endarterectomy

A NEW METHOD OF SURGICAL TREATMENT OF LUMBAR SPINAL STENOSIS

As the treatment of lumbar or lumbosacral stenosis, laminectomy with the preservation of tissues supporting the spine and the embracement of the exposed dura mater with thin silicone rubber to prevent the occurrence of restenosis due to exuberant fibrous tissue formation at the operative site have been performed over a period of seven years. Before the prevention of restenosis with silicone rubber, we had to reoperate in cases which developed recurrent symptoms resulting from restenosis of the lumbosacral canal. This operation that we describe is technically feasible and with practical benefit can be done routinely for spinal decompression not only in the lumbosaral, but also in cervical spinal region without requiring an extensive laminectomy

ダイズ オヨビ ソラマメ 11S グロブリン ノ ブンシ タヨウセイ ニ カンスル ケンキュウ

京都大学0048新制・論文博士農学博士乙第4568号論農博第955号新制||農||343(附属図書館)学位論文||S56||N1295(農学部図書室)UT51-57-E514(主査)教授 松下 雪郎, 教授 米澤 大造, 教授 千葉 英雄学位規則第5条第2項該当Kyoto UniversityDFA

Crystallization and preliminary X-ray analysis of the major peanut allergen Ara h 1 core region.

Peanuts contain some of the most potent food allergens known to date. Ara h 1 is one of the three major peanut allergens. As a first step towards three-dimensional structure elucidation, recombinant Ara h 1 core region was cloned, expressed in Escherichia coli and purified to homogeneity. Crystals were obtained using 0.1 M sodium citrate pH 5.6, 0.1 M NaCl, 15% PEG 400 as precipitant. The crystals diffracted to 2.25 A resolution using synchrotron radiation and belonged to the monoclinic space group C2, with unit-cell parameters a=156.521, b=88.991, c=158.971 A, beta=107.144 degrees. Data were collected at the BL-38B1 station of SPring-8 (Hyogo, Japan)