1.A Case of Primary Cardiac Lymphoma Diagnosed by Open Biopsy with Median Sternotomy.
Kazunori Uemura ; Junichi Utoh ; Ryuji Kunitomo ; Hisashi Sakaguchi ; Nobuo Kitamura
Japanese Journal of Cardiovascular Surgery 1999;28(2):136-139
An 60-year-old man who initially presented with ventricular tachycardia was suspected of cardiac tumor because of localised hypertrophy of the right ventricle. Although the localized region detected by an echocardiography suggested malignancy, percutaneous transcatheter myocardial biopsy failed to obtain a histological diagnosis. Six months later, a permanent pace maker was implanted due to complete AV block. Two years after the first admission, echocardiogram and computed tomography demonstrated a cardiac tumor in the right ventricle. To obtain a histological diagnosis, open biopsy was performed under median sternotomy and showed malignant lymphoma. Antemortem diagnosis of cardiac malignancy is usually very difficult. Median sternotomy is an established procedure for cardiovascular surgeons. Open biopsy can be an acceptable technique to obtain histological diagnosis of the neoplastic region in terms of safety and simplicity, and has good sampling accuracy compared with other diagnostic modalities. We recommend early stage surgical exploration when cardiac malignancy is a diagnostic possibility.
2."Diabetes Education Class IPE" -Challenge to promote new IPE (interprofessional education) with real patients-
Mina Suematsu ; Keiko Abe ; Hiroki Yasui ; Nobuko Aida ; Manako Hanya ; Hiroyuki Kamei ; Keiko Yamauchi ; Hiraku Komori ; Hisashi Wakita ; Kazumasa Uemura
Medical Education 2015;46(1):79-82
The WHO reported the importance of IPE (Interprofessional Education) in order to implement team-based medicine smoothly. Some Japanese medical educational institutes presented their IPE programs, which involved real patients, but most IPE programs used scenario-based or standardized patients. Moreover, few reports showed IPE programs for diabetic patient education. We created a new program, called the "Diabetes education class IPE" . Participants were 2 medical, 4 nursing, 4 pharmacy, and 3 dietician students. The students experienced the planning and management of and reflection on diabetes education classes. As a result of reflection, the "Diabetes education class IPE" was viewed as a useful IPE program.
3.Debranching Thoracic Endovascular Aortic Repair for Kommerell's Diverticulum with Right-Sided Aortic Arch
Takaya NAKAGAWA ; Hajime MATSUE ; Yasuo SUEHIRO ; Hisashi UEMURA ; Ayaka SATOH ; Hisashi SATOH
Japanese Journal of Cardiovascular Surgery 2023;52(3):181-184
We report a case of debranching thoracic endovascular aortic repair for Kommerell's diverticulum with right-sided aortic arch in 78-year-old women. The computed tomography (CT) demonstrated Kommerell's diverticulum with a right-sided aortic arch and the trachea and esophagus were compressed by the diverticulum. The diverticulum had a maximum diameter of 32 mm, and surgical intervention was chosen because of the aneurysmal change and the possibility of rupture. We performed endovascular aortic repair for Kommerell's diverticulum with a right-sided aortic arch because of low lung function and low frailty. The patient was discharged on the 21st postoperative day. There was no evidence of aortic event during 2 years follow up.