We report on an 88-year-old woman who underwent successful repair of ventricular septal perforation (VSP) following acute myocardial infarction. She was admitted as an emergency case to our hospital with acute myocardial infarction. Color Doppler echocardiogram revealed anterior VSP. Right heart catheterization was conducted under intraaortic balloon pumping and showed a Q_P/Q_S of 3.0. She also had acute renal failure for which continuous hemodialysis and filtration was started. In spite of intensive medical therapy, her hemodynamic condition was gradually worsened. An emergency operation was performed on the 6th day after the onset. A single porcine pericardial patch was sutured on the left side of the septum around the perforation and the left ventricular free wall was closed including the patch with two felt strips. She suffered from various complications through the postoperative course. However, she recovered and was discharged on the 77th postoperative day. She was, to the best of our knowledge, the oldest among the reported cases of successful surgical repair of VSP in Japan.

We report a case of angiosarcoma of the right atrium, which manifested as cardiac tamponade. A 50-year-old man was admitted to our hospital complaining of dyspnea on effort. Echocardiography and chest CT revealed massive pericardial effusion and a right atrial tumor mass. An emergency pericardiocentesis was performed to remove massive hemorrhagic fluids. Further examinations revealed primary cardiac neoplasm. Because there was no distant metastasis, the tumor in the right atrium was resected with the right atrial free wall under cardiopulmonary bypass support. The sinus node involved in the tumor was resected, necessitating pacemaker implantation. Microscopic examination of the resected tumor revealed angiosarcoma. As the resection border showed tumor tissue, postoperative radiotherapy was added. There was no evidence of recurrence or metastasis 14 months after surgery. The prognosis for angiosarcoma is very poor, and mean survival is less than 6 months. In cases with no metastases, early resection is the treatment of choice. In spite of incomplete resection, long-term survival may be possible with postoperative radiotherapy.

A questionnairing was conducted on those who had graduated from acupuncture schools for last three years. 288 questionnaires, that is, 28.8% of the total were answerd.
As the result, 41% of the graduates are practicing, 27% are working for institutions connected with acupuncture, and 28% are working in hospitals.
Combining present practitioners and those who are to start practice, it seems 76% of the graduates enter practice; most of the graduates aim at setting up practice. Which course to be taken makes the difference in medical charge, the number of patients, and their annual income.

Changes of hemodynamics and chemical mediators before and after aortic clamping were investigated in 12 patients who underwent infrarenal abdominal aortic aneurysmectomy. Patients were divided into two groups; one with an aortic clamping time greater than 1 hour (the long group) and the other with aortic clamping time less than 1 hour (the short group). Cardiac output, mean pulmonary arterial pressure (MPAP), extravascular thermal volume (ETV), polymorphonuclear elastase (PMN-E), α₁ trypsin inhibitor (α₁-TI) superoxide dismutase (SOD), urine N-acetyl-β-D-glucosaminidase (NAG), were measured before and immediately after aortic clamping, immediately after, 1 and 4 hours after aortic declamping. In addition, serum GOT, GPT, creatinine and BUN were measured before and 1, 3 and 7 day after operation. These levels were expressed as ratios of the level before aortic clamping and operation. The MPAP ratio immediately after aortic clamping was 0.83±0.06 in the long group and 0.99±0.08 in the short group. There was statistical significant difference in the MPAP between both groups (p<0.01). In contrast, there was no significant difference in the cardiac output or ETV between the two groups. The PMN-E ratio immediately after aortic declamping was 2.24±0.81 in the long group and 1.19±0.45 in the short group. These ratios increased at 1 and 4 hours after aortic declamping. The PMN-E ratio following aortic clamping in the long group was greater than those in the short group (p<0.05). The SOD at 1 hour after aortic declamping was 0.78±0.13 in the long group and 1.01±0.11 in the short group (p<0.05). The NAG ratio immediately and at 1 hour after aortic declamping was significantly higher in the long group when compared with the short group (p<0.01, 0.1). Serum GOT, GPT, creatinine and BUN ratios showed no change through out this study. There was an increase in protease and a decrease of free radical scavengers in the long group. These findings are commonly known to be linked with organ damage. Through the findings of this study, we suggest that clamping time should be minimized; thus reducing the possible chance of postoperative organ damage.