1.The effect of disuse on the human femur. A study in an aged man suffered a lower leg amputation.
MASAHARU SUENAGA ; AKIRA IIBOSHI ; ICHIRO SEMBA
Japanese Journal of Physical Fitness and Sports Medicine 1989;38(4):139-150
Human femora obtained from a cadaver of a 70-year-old man were examined by means of bone histometry, image-analysis on X-ray radiographs and a mechanical strength test in order to investigate the effects of disuse on the femora. The patient had been bedfast for seven months until his death because of an amputation of the left lower leg due to a diabetic intractable ulcer on the foot caused by a burn. Other detail records of the medical and the life-style history were also examined.
A marked atrophy of the muscles of the hip and thigh was observed on the amputated side. The macroscopic shape and proportion of the femora were not significantly different between both sides. The results of bending strength test at the mid shaft, disclosed a marked mechanical fragility on the amputated side. The cortical bone area in the shaft showed no significant difference between both sides. However, the degree of bone loss was more pronounced at the anterior region of both shafts. The trabecular bone at the femoral head showed a marked atrophy on the amputated side, especially at the principal compressive group of the trabecular bone. This atrophy was thought to be due to the absence of the compressive stress because of the disuse caused by the amputation. A trabecular bone atrophy was also observed on the normal side and its degree of atrophy was greater than that of agematched values. The multiple systemic factors such as the diabetes and the bedfast condition might had influenced on the bone metabolism in this case, therefore the careful examination of the systemic conditions was required to disclose the effects of local mechanical conditions on the bone metabolism.
2.Successful Treatment of Giant Left Myxoma in an Elderly Patient with Congestive Heart Failure.
Yoshimori Araki ; Yoshito Suenaga ; Kazuyoshi Tajima ; Masaharu Yoshikawa ; Tomonobu Abe ; Akinori Io
Japanese Journal of Cardiovascular Surgery 1996;25(6):406-410
We report an 81-year-old woman with giant left atrial myxoma who had been admitted with congestive heart failure. Diagnosis was established by echocardiography and a moderate degree of tricuspid valve regurgitation was also found. The tumor was extensively attached to the atrial septum, and was excised completely including endocardium. She had concomitant tricuspid annuloplasty. Atrial fibrillation occurred on postoperative day 10, but conversion to a sinus rhythm was seen on postoperative day 19. She was discharged in good condition on postoperative day 36. Even in a patient over 80 years old with congestive heart failure, aggressive surgical treatment of left atrial myxoma should be performed.