High fat diet consumption induces fat accumulation in the liver. An understanding of when liver fat accumulation begins is important for exploring the mechanisms underlying fatty liver. The aim of this study was to investigate the processes of fat accumulation in the liver during high fat diet consumption with or without exercise using computed tomography (CT). Male 6 week old C57BL/6J mice were randomly assigned to the normal diet or high fat diet group. After 6 weeks, mice in the high-fat diet group were further divided into voluntary wheel exercise (HFD+Ex) and no exercise (HFD) groups. We measured body weight, food intake and locomotor activity in all mice. Liver fat accumulation was measured by CT scan weekly. Blood and tissue sampling was performed at the end of the experimental period. Following the 6 week exercise period, total body, mesenteric fat and liver weight in the HFD+Ex group were significantly lower than those in the HFD group. Alanine aminotransferase levels improved in HFD+Ex mice compared with those of HFD mice. The hounsfield unit value in HFD mice decreased between 3 and 8 weeks, suggesting that liver fat accumulation accelerated during this period. In contrast this decrease was not observed one week after exercise in HFD+Ex mice. These results suggest that liver fat accumulation estimated by CT was not observed until the 3rd week of high fat feeding while the effects of voluntary wheel exercise appeared immediately.

Aortic stenosis (AS) is one of the most common valvular heart diseases and the number of patients with AS is expected to increase globally as the older population is growing fast.Since the majority of patients are elderly, AS is no longer a simple valvular heart disease of left ventricular outflow obstruction but is accompanied by other cardiac and comorbid conditions. Because of the significant variations of the disease, identifying patients at high risk and even earlier detection of patients with AS before developing symptomatic severe AS is becoming increasingly important. With the proven of efficacy and safety of transcatheter aortic valve replacement (TAVR) in the severe AS population, there is a growing interest in applying TAVR in those with less than severe AS. A medical therapy to reduce or prevent the progression in AS is actively investigated by several randomized control trials. In this review, we will summarize the most recent findings in AS and discuss potential future management strategies of patients with AS.

A 73-year-old woman was diagnosed with coronary artery aneurysms associated with coronary-pulmonary arterial fistula in a preoperative examination for transverse colon cancer. One of the aneurysms (28 mm) originated from a branch of the right coronary artery and the other two (16 and 12 mm) originated from a branch of the left coronary artery. We performed surgery to prevent their rupture because the right coronary artery aneurysm showed a tendency to enlarge. Surgery was performed through a median sternotomy under cardiopulmonary bypass. Suture closure of the inflow and outflow of the aneurysm was performed. The coronary-pulmonary arterial fistula was ligated. In addition, suture closure of the outflow of the coronary-pulmonary artery fistula into the pulmonary artery was performed, under direct view after incision of the pulmonary trunk. No residual shunt blood flow in the coronary-pulmonary arterial fistula was observed on postoperative echocardiography. Furthermore, no coronary aneurysm and coronary-pulmonary arterial fistula was recognized on postoperative coronary computed tomography. The patient made an uneventful recovery and was discharged from the hospital on postoperative day 12.