We surgically treated coronary artery fistula with 2 aneurysmal formations without cardiopulmonary bypass. Preoperative epicardial imaging suggested that ligation of both inflow and outflow of the coronary artery fistula was feasible. Preoperative understanding of anatomical relationships by 3D-CT imaging can be very useful in selection of surgical procedures.

  In Kochi prefecture, the mortality rate of males in their 40s and 50s exceeds the mean death rate of Japanese men by more than 10%. The causes of death in general in Kochi are cancer (27.1%), cardiac disease (16.8%), cerebrovascular disease (11.9%) and pneumonia (11.2%) in that order. We analysed the data of a total of 1,826 males in the 40-50 age band who had panticipated in the one-day health screening course provided by our hospital. Our findings showed that many of these middle-aged males, were heavy drinkers and obese people with BMI of 25 or more. The amount of alcohol consumption in Kochi is the second largest in Japan, which may impact on the incidence of alcohol-related diseases and death. As for blood pressure, the ratio of those people in their 50s and 60s with hypertension in Kochi was higher than the mean of this country. To prevent the development of the metabolic syndrome, we must keep on making efforts and encourage them to adopt a healthy life style.