Surgery in severe rheumatic mitral valve disease--recognition of severity and risk factors.

The postoperative course of 294 patients with rheumatic mitral valve disease, who underwent mitral valve surgery during a period from July, 1978 to June, 1981, was studied by comparing the influences of the following clinical parameters: a low left ventricular ejection fraction (LVEF), a high pulmonary arterial systolic pressure (PASP), a high pulmonary vascular resistance (PVR), tricuspid regurgitation (TR), a high right ventricular end-diastolic pressure (RVEDP) and a giant left atrium (GLA). The patients with a functional capacity of class III or IV according to the New York Heart Association were classified into 3 groups (improved, unimproved and died), and from this data we calculated the improvement ratio and the mortality rate. The improvement ratios were 73% in patients with a low LVEF, 70% with a high PASP, 78% with a high PVR, 66% with TR, 11% with a high RVEDP and 77% with a GLA; the mortality rates were 19, 14, 17, 24, 78 and 19%, respectively.

Platelet function tests in thrombotic cerebrovascular disorders.

A variety of platelet function tests were performed in patients with four forms of obstructive cerebrovascular disease (CVD); transient ischemic attacks (TIA), reversible ischemic neurological deficit (RIND), cerebral infarct, and cerebral embolism of cardiac source in rheumatic valvular heart disease (RVHD). Platelet studies included platelet aggregation induced by ADP and ristocetin, spontaneous platelet aggregation, von Willebrand factor (VIII:vWF), platelet aggregation enhancing factor (PAEF), and percentage of large platelets (megathrombocytes). Serial testing was carried out in acute stroke patients.

Some observations on the structure of Suncus liver with special reference to the vitamin A-storing cell.

The structure of the liver of the thick-tailed shrew (Suncus murinus) was studied with special reference to the vitamin A-storing cell. The macroscopic arrangement of hepatic lobes was the same as those of rodents. Connective tissues of Glisson's sheath were not prominent.

[Hepatic vein blood flow pattern measured by Doppler echocardiography as an evaluation of tricuspid valve insufficiency].

Evaluation of tricuspid regurgitation was attempted by analyzing the blood flow pattern in the hepatic vein using a combined system of a pulsed Doppler technique and two-dimensional echocardiography. The Doppler incident angle to the hepatic vein from the subcostal approach was approximately 0 degrees to 30 degrees, and the Doppler output was easily recognized as a narrow frequency-band pattern on the sound spectrogram. The study population consisted of 60 patients with valvular heart disease and 17 healthy subjects.

Clinical and echocardiographic features of pulmonary valve endocarditis.

We studied the clinical and echocardiographic features of eight patients with infective pulmonary valve endocarditis. In two patients, the vegetation was limited to the pulmonary valve; in the six other patients, infective lesions were also present on the mitral or aortic valves. None of the patients were addicted to narcotics.

Availability of electrophysiological approach to the selection and assessment of antiarrhythmic drugs for recurrent ventricular tachycardia.

We performed serial electrophysiological-pharmacological studies on 21 patients with recurrent sustained or non-sustained ventricular tachycardia (VT). In 8 of 11 patients with recurrent sustained VT, VT could be induced repeatedly by programmed electrical stimulation and terminated by ventricular burst pacing. In 13 of the 21 patients, repetitive ventricular response (RVR) was successfully induced.

Long-term follow-up of electrocardiographic findings in patients with acute myocarditis proven by endomyocardial biopsy.

Sixteen cases of acute myocarditis, proven by endomyocardial biopsy, of possible viral origin which were described in a previous paper have been followed up for up to 5 years. The cases were divided into 3 groups according to the electrocardiographic (ECG) patterns: with conduction disturbance at the early stage (Group I, 9 cases), without conduction disturbance (Group II, 4 cases); early death cases in which the follow-up could not be carried out (Group III, 3 cases). In Group I, 2 cases revealed persistent complete A-V block, 4 showed incomplete recovery of right bundle branch and/or fascicular blocks, and 3 showed complete recovery of the ECG abnormalities.

Detection of mitral ring abscess by two-dimensional echocardiography.

M-mode and two-dimensional echocardiographic features of mitral ring abscess are described. A round, dense echo mass between the posterior mitral leaflet and left ventricular posterior wall was demonstrated in long- and short-axis views of the left ventricle. The diagnosis of mitral ring abscess was confirmed at surgery.

Spectrum of the infective endocarditis in the past five years.

One hundred and thirty patients at our Heart Institute with infectious endocarditis during the past 5 years were reviewed to provide an overview of the spectrum of infective endocarditis and to assess the accuracy of echocardiography in detecting the infective valvular and endocardial lesions. Of the 130 patients, 36 (28%) had the previous cardiovascular surgery. The mean age of the patients was 34 years, and only 11% of the patients were over 50 years of age.

Early clinical profiles of cases with histopathologically proven acute idiopathic myocarditis and a proposal for diagnostic criteria.

The early clinical features, primary care, treatment and short-term prognosis in 15 cases of acute myocarditis where diagnostic confirmation was made by endomyocardial biopsy or autopsy were analyzed. Characteristically, idiopathic myocarditis of possible viral etiology revealed preceding symptoms which consisted of flu-like symptoms, i.e.

[Reliability and limitation of various diagnostic methods including nuclear medicine in myocardial disease (author's transl)].

Electrocardiography (ECG), echocardiography, nuclear method, cardiac catheterization, left ventriculography (LVG) and endomyocardial biopsy (biopsy) were performed in 40 cases of cardiomyopathy (CM), 9 of endocardial fibroelastosis (EFE) and 19 of specific heart muscle disease (SHMD), and the usefulness and limitation of each method was comparatively estimated. In CM, various methods including biopsy were performed. The 40 patients were classified into 3 groups, i.