1.Ventricular Septal Perforation Repair Carried out on a Jehovah's Witness
Yuichi Morita ; Tadashi Tashiro ; Masahiro Ohsumi ; Yuta Sukehiro ; Shinji Kamiya ; Mau Amako ; Noritoshi Minematsu ; Hitoshi Matsumura ; Masaru Nishimi ; Hideichi Wada
Japanese Journal of Cardiovascular Surgery 2015;44(3):125-129
In a 63-year-old male patient Jehovah's witness, IABP was introduced due to acute myocardial infarction and cardiogenic shock, and PCI (BMS) was carried out to CAG #7 100%. Stent placement was carried out and his hemodynamics stabilized. A left-to-right shunt was observed upon carrying out LVG, so the patient was referred to our hospital for surgery purposes due to a diagnosis of ventricular septal perforation (VSP). Upon transferring the patient to hospital, his PA pressure elevated to 53 mmHg although the blood pressure was maintained, and no findings of right heart failure were observed. His respiratory condition was stable. Emergency surgery was considered, but the patient was taking Clopidogrel following PCI, and so VSP repair (extended endocardial repair) was carried out following 4 days discontinuation of Clopidogrel. Preoperative anemia was not observed ; however, postoperative hemorrhagic anemia improved due to iron preparation administration, and the patient was discharged from hospital 22 days following surgery without blood transfusion.
2.A Case of Primary Cardiac Angiosarcoma Associated with Cardiac Tamponade
Yuta Sukehiro ; Hideichi Wada ; Yuichi Morita ; Masayuki Shimizu ; Hiromitsu Teratani ; Masahiro Ohsumi ; Shinji Kamiya ; Noritoshi Minematsu ; Hitoshi Matsumura ; Tadashi Tashiro
Japanese Journal of Cardiovascular Surgery 2015;44(6):358-361
We report a rare case of primary cardiac angiosarcoma in the right atrium. A 47-year-old man was admitted to our hospital with cardiac tamponade. Echocardiography and computed tomography revealed a tumor in the right atrial cavity. We performed tumor resection to confirm the histological diagnosis, to prevent tumor embolism, and to increase the possibility of improving the prognosis. The tumor was resected with the right atrial wall and right pericardium. The right atrium was then reconstructed with a bovine pericardial patch. The pathological diagnosis was angiosarcoma. The patient survived only about 6 months after surgical resection, but there was no local recurrence. This report presents a very rare case of cardiac angiosarcoma associated with cardiac tamponade.
3.A study on the shape change of the rectus femoris muscle with knee flexion
Hiroshi SHINOHARA ; Ryouta HOSOMI ; Toshihiro HABA ; Futoshi OBATA ; Yuma TERAJIMA ; Yuichi MORITA
Japanese Journal of Physical Fitness and Sports Medicine 2022;71(2):205-212
Since the rectus femoris muscle is associated with trauma and disorders such as muscle strain, it is often a target for evaluation and treatment. However, in many studies, measurement results were obtained from only a part of the rectus femoris muscle and used as a representative value without considering the differences across the muscle. The rectus femoris muscle may change shape with knee flexion because the structure is complicated; it has an intramuscular tendon. The purpose of this study was to assess the changes in shape of the rectus femoris muscle during flexion of the knee joint in different directions. Twelve lower limbs of 12 male university students were analyzed. The rectus femoris muscle was divided into eight parts, and short-axis images were taken with an ultrasonic diagnostic imaging device at the knee joint; in extension; flexion at 30 °, 60 °, 90 °, and 120 °; muscle thickness; muscle width; and cross-sectional area. It was suggested that the thickness of the rectus femoris muscle increased from “A” to “F” due to knee flexion, and that this increase occurred because of stretching at the same site. In “G,” there was no difference between the angle conditions; conversely, in “H,” the muscle thickness decreased due to knee flexion. It should also be noted that D and E have the greatest muscle thickness when measuring in the knee flexion position.