We describe a ruptured internal iliac artery aneurysm associated with sigmoid colon infarction. The patient was referred to our hospital complaining of lower abdominal pain. Computed tomography scan demonstrated a massive hematoma with a ruptured left internal iliac artery aneurysm. Hypovolemic shock prompted immediate laparotomy, endoaneurysmorrhaphy of the ruptured aneurysm, and resection of the recto-sigmoidal colon. During treatment for ruptured internal iliac aneurysm, we should consider potential colon infarction.

We have developed a new gait assisting device for patients with hemiplegia, by which a single therapist alone can work with : 1) swing of the paretic limb, 2) stance of the paretic limb, and 3) alternate lateral weight-shift during gait. This device (ASSWS : Assistance of Swing, Stance and Weight Shift) imitates the kinesiological complex (patellar ligament, quadriceps, iliotibial ligament and gluteus maximus) to maintain a standing posture for the lower extremities. We compared the results of a gait analysis using a motion analyzer for gait with ASSWS and gait without ASSWS. With ASSWS, the walking speed was faster, stride length was longer, and stride duration was shorter. No differences in floor reaction force were identified. With ASSWS, the flexion peak of the hip joint became larger and the knee joint was in a more flexed position throughout the walking cycle. Also, the joint moment of hip extension, hip flexion and knee extension all increased with use of the ASSWS.

A 68-year-old man underwent percutaneous transluminal coronary angioplasty (PTCA) to left anterior descending artery (LAD) seg 7 after acute anteroseptal myocardial infarction 8 years previously. He was admitted because of syncope attack due to sustained ventricular tachycardia and subsequent fibrillation. He was treated medically in the ICU after cardiopulmonary resuscitation. Medical treatment with amiodarone and lidocaine was not successful and he was transferred to our hospital for surgical treatment of malignant ventricular tachycardia (VT) associated with left ventricular aneurysm and acute cholecystitis that occurred during admission. Left ventriculogram showed left ventricular aneurysm (ejection fraction: 35%) without any significant coronary lesions. The patient successfully underwent a Dor operation (left ventriculoplasty), double encircling endocardial cryoablation without endocardial resection, and preoperative and intraoperative endocardial mapping. Cholecystectomy was simultaneously performed after complete closure of the median chest incision. The recurrence of VT was never recognized clinically or electrophysiologically. The extended encircling endocardial cryoablation without endocardial resection and preoperative and intraoperative electrophysiological study, was a simple and effective method for ventricular tachycardia.