Metastasis to the heart is not so rare, but it is not diagnosed easily during patient's lifetime because clinical symptoms are not related to the nature of the tumor. We present a rare case of resection of cardiac metastasis of liposarcoma. A 37-year-old man suffered from dyspnea on effort was given a diagnosis of heart failure. He had already suffered from primary liposarcomas of the right heel which had been resected at age 28 and 32. Echocardiography revealed pericardial effusion and a tumor exiting from the apex. The mass grew rapidly and was excised using a cardiopulmonary bypass. The pathophysiological diagnosis was metastatic liposarcoma to the heart. The surgical margins of tumor were positive and cancer cells were exposed on the epicardial surfaces on some places. Adjuvant chemotherapy was therefore performed for 6 months. The patient was discharged after a good post-operative course and has been in good health for 40 months since the operation. Despite the generally poor prognosis of metastatic liposarcoma to the heart, combination of surgical treatment and chemotherapy yield a long period of survival in this case. It is important not only to establish the therapeutic strategy for metastatic tumor to the heart but also to detect it at an early stage.

Fourteen patients with 22 solitary aneurysms of the iliac artery were operated in a 16-year period (1983 to 1999). Patients were divided into two groups. The non-ruptured group consisted of 6 patients who underwent surgical intervention before aneurysm rupture, and their mean age was 78.5 years. The ruptured group consisted of 8 patients who underwent surgical intervention for aneurysm rupture, with a mean age of 68.5 years. Although seven patients underwent emergency surgery for aneurysm rupture, less than half of them were operated upon within 24hr after the onset of aneurysm rupture. The average size of aneurysms was similar in the two groups (common iliac artery aneurysms: non-ruptured 47mm vs. ruptured 44mm in diameter, internal iliac artery aneurysms: non-ruptured 55mm vs. ruptured 55mm). Two patients died in the ruptured group, in which the operative mortality rate was 25%. Six patients (75%) of the ruptured group had hypovolemic shock, and two of them died during surgical repair. Of the patients with shock, two patients had intestinal ischemia after operation. Intestinal ischemia was one of the serious complications of ruptured iliac aneurysms. These results suggest that in patients with shock from ruptured iliac artery aneurysms, strategy for treatment is an important determinant of the outcome.

We reported four cases of agricultural chemicals poisoning treated in our hospital during the past two years. These comprised two Paraquat poisoning and two Sumition poisoning cases. One Paraquat poisoned patient and one Sumition poisoned patient died of respiratory failure. The survivor of Paraquat poisoning had drank more Paraquat solutions than the dead case. However, the patient vomitted many times, and received medical treatment promptly, including gastric lavage, hemodialysis, and hemoperfusion.
While on the other hand, it took a long time before starting of hemodialysis and hemoper-fusion on the dead case of Sumition poisoning. Because the poison was unknown when the patient was sent to our hospital. Our experience suggesuted that every time we examine a case of agricultural chemical poisoning, we have to treat a patient intensively from the beginning.