Two-Stage Intracardiac Repair for Total Anomalous Pulmonary Venous Return (Ib+Ib) with a Persistent Left Superior vena cava and an Enlarged Coronary Sinus / 日本心臓血管外科学会雑誌

This study reports the case of a 0-day-old girl who was transferred to our hospital for suspected total anomalous pulmonary venous return due to her postnatal cyanosis. After she was presented at our hospital, pulmonary vein stenosis was diagnosed and emergency surgery was planned. Preoperative computed tomography showed abnormal perfusion of the pulmonary veins into the left and right superior vena cava separately on the left and right sides. Given that the persistent left superior vena cava was refluxing into the coronary sinus, the coronary sinus was enlarged greatly, and the left atrial volume was small. In the neonatal period, the right pulmonary vein was anastomosed to the right atrium, and the left pulmonary vein was anastomosed to the unroofed coronary sinus. Thereafter, at 4 months of age, the patient underwent two-stage intracardiac repair with re-routing of the right pulmonary vein and extracardiac ligation of the left vena cava. The postoperative course was good. Intracardiac repair via a two-stage surgery was effective for total anomalous pulmonary venous return (Ib+Ib) with a persistent left superior vena cava and an enlarged coronary sinus.

THE IMPACT OF GERIATRIC EXERCISE TRAINING ON ABDOMINAL FAT AND ADIPONECTIN LEVELS IN THE ELDERLY / 体力科学

We evaluated the influence of a twice-weekly group exercise program on visceral fat area (VFA) and plasma adiponectin (APN) in the elderly. Thirty-three community-dwelling elderly (age : 72.4±6.9 yrs) participated in a 12-week supervised, geriatric exercise training program (GET) followed by a 12-week unsupervised GET (u-GET), which included stretching, strengthening, and balance-training exercises. Participants were evaluated for physical fitness, blood glucose, HbA1c, triglyceride, cholesterol, insulin, and APN. VFA was measured by computed tomography. All measurements were taken before the GET (TR1), after 12-weeks of GET (TR2), and at the end of the u-GET (TR3). Twelve weeks of GET produced significant increases in physical function measures. Both walking speed and functional mobility values at TR3 were significantly higher than TR1 values. A significant reduction in VFA was seen at TR3 in men. APN progressively elevated from TR1 to TR3 in women. In the frail elderly, 12 weeks of GET effectively increased functional ability and APN. The beneficial effects on VFA and APN were sustained following the participation in the unsupervised setting, suggesting that the frail elderly should be encouraged to participate and maintain a resistance training routine to achieve preferable effects on both functional ability and cardiovascular risk factors.