A 65-year-old man was diagnosed with hypertrophic cardiomyopathy 11 years previously. Five years previously, he was hospitalized for pneumonia and heart failure and mitral regurgitation (MR) occurred due to systolic anterior motion (SAM) of the mitral valve. Two months previously, he was admitted for cardioembolic stroke, and echocardiography showed that SAM had disappeared. However, severe MR owing to posterior leaflet prolapse was observed. Mitral valvuloplasty, ventricular septal myectomy, pulmonary vein isolation, and left atrial appendage closure were performed. Postoperative echocardiography revealed no SAM and the patient was doing well. Here, we report a rare case of MR due to chordae rupture during follow-up of hypertrophic obstructive cardiomyopathy.

A 50-year-old man was referred to our hospital due to chest pain and loss of consciousness. Diagnosed with cardiac tamponade, he underwent emergency percutaneous pericardial drainage and endotracheal intubation. AAD was not found, although aortic root dissection was suspected from the CT scan and CAG. The MDCT revealed a 16 mm ruptured coronary artery aneurysm connected to the LMT with a CA-PA fistula. Urgently, coronary artery aneurysmectomy, CA-PA fistula repair, and CABG were performed, and the postoperative course was smooth. Surgery reports for ruptured coronary artery aneurysm are rare, so we report the successful surgical case.

To our knowledge, there are no previous reports of bilateral internal iliac artery aneurysms with bilateral hydronephrosis. We herein report the successful surgical treatment of bilateral hydronephrosis in a 65-year-old woman. The patient was referred to the urology department of our medical center. CT showed bilateral internal iliac artery aneurysms （right: 30 mm, left: 26 mm） and hydronephrosis,which was caused by ureteral compression by the aneurysms. First, bilateral ureteral stents were placed to improve hydronephrosis. Then we performed open abdominal aortic graft replacement with bilateral internal iliac aneurysmectomy. The patient had no perioperative complications, and the ureteral stents were removed after the patient was discharged from the hospital.

Clarifying the current state of ophthalmic solutions and the handling of eye drops is important for the proper use of ophthalmic solutions. In this study, a questionnaire survey was conducted from May 2018 to February 2019 on 200 ophthalmic inpatients who provided consent. In total, 36.5% of the patients were dissatisfied with the usability of ophthalmic containers due to their hard material andthe difficulty of releasing the ophthalmic solution. In addition, 43.0% of the patients repliedthat they hadlearnedfrom medical professionals, such as doctors and pharmacists, about the handling of eye drops, whereas 45.0% reported failing to apply ophthalmic solutions onto their eyes correctly. Only 2.0% of the respondents answeredthat they hadconsulteddoctors or pharmacists about the use of ophthalmic solutions. These findings underscore the current problems about patients’ satisfaction with ophthalmic solutions andhandling of eye drops. Therefore, pharmacists may needto be actively involvedin patients’ selection of ophthalmic solutions andinstruct them regarding usage.