Tetsuo Anzai

Sudden Hemorrhage of the Breast Caused by Breast Cancer Without Skin Invasion: Report of a Case

A rare case of sudden hemorrhage caused by breast cancer is herein presented. A 65-year-old woman was admitted to our hospital because of bleeding from her left breast. On physical examination, a continuous hemorrhage accompanied by an open cavity formation was observed in her left breast. She had no history of breast trauma. Her bleeding profile studies and liver function were both normal. In addition, no anticoagulation medication had been administered. The histological findings of the cavity wall indicated invasive ductal carcinoma without skin invasion. After carrying out chemotherapy, a standard radical mastectomy was performed.

Persistent fifth aortic arch left subclavian aneurysm in an adult

Persistent fifth aortic arch is so rare an anomaly that only seven cases have been reported. We treated an adult with this anomaly in which there was a single lumen aortic arch, single arterial trunk and left subclavian aneurysm. The patient underwent corrective surgery. From an analysis of the eight cases, this anomaly can be divided into two groups, depending on the aortic arch. The first group of six had double lumen aortic arch. All in this group had intra and/or extra cardiac anomalies, and only two with only PDA underwent ligation. The second group of two had a single lumen aortic arch and corrective surgery was done. Thus, those patients with a persistent fifth aortic arch should be classed into the first or second group, according to the angiographical findings.

Surgical Management of Perimembranous or Infundibular-isolated Ventricular Septal Defect Associated with Prolapse of Aortic Cusp or Aortic Regurgitation.

膜様部および漏斗部孤立型心室中隔欠損症 (VSD) 104例中, 大動脈弁逸脱17例, 大動脈弁逆流 (AR) 10例を認めた. 症例の病態および手術成績から逸脱およびARの発生機序と手術適応について検討した. 術前では逸脱・AR群では大動脈弁正常群に比して, 左-右短絡率, 肺体血流比は小で, 術中計測によるVSD径も大動脈弁正常群よりも小であり, 大動脈弁逸脱, ARの発生における血流作用の関与が示唆された. 手術は27例中4例に弁形成術, 1例に弁置換術, 22例にVSD閉鎖のみを行った. ARは10例中3例で術後残存した. 術前AR I度の7例中6例は術後にARが消失したが, AR II度の2例では共にI度のAR残存がみられた. それ故, 術前の注意深い経過観察とAR発症前の早期手術が重要と考えられた.