Primary chylopericardium with pulmonary shadow and large granular lymphocytosis: a case report.

A 79-year-old man with primary chylopericardium associated with large granular lymphocytosis was followed for more than 26 years. Except for development of dyspnea on exertion during the past four years and more recently cough with sputum production, he has remained largely asymptomatic over this interval. Based on detailed examinations of cellular and humoral immunity, we speculate that increased natural killer cell activity and an increased number of large granular lymphocytes circulating in his peripheral blood represent a reactive response to production of various cytokines secondary to persistent loss (? chyloptysis) and sequestration of central lymph.

Two cases of gastric antral vascular ectasia--response to medical treatment.

Two patients with severe iron deficiency anemia and gastric antral vascular ectasia (GAVE) are reported. The anemia caused by the chronic blood loss from the abnormally dilated mucosal and submucosal capillary veins in the gastric antrum was unresponsive to oral iron supplementation. However, one of the patients was successfully treated with intramuscular injection of (Asu1,7) eel calcitonin.

Arterial oxygen saturation, blood pressure, and pulse rate during upper gastrointestinal endoscopy--influence of sedation and age.

We studied the effect of sedation by I.V. meperidine on blood pressure, pulse rate, and arterial oxygen saturation during upper gastrointestinal endoscopy.

Primary amyloidosis with dry eyes and dry mouth--a case report.

We report a rare case of dry eyes and dry mouth caused by primary amyloidosis. A 66-year-old woman with keratoconjunctivitis sicca and xerostomia died of acute respiratory failure. Shirmer's test, gum test, and sialography indicated Sjögren's syndrome.

A case of gastric plasmacytoma: genetic analysis and immunofixation electrophoresis.

A case of early gastric plasmacytoma in a 66-yr-old woman is reported. The demonstration of monotypic IgM lambda immunoglobulin in plasma cells infiltrating the gastric antrum contributed the histological diagnosis. Genetic analysis of the tumor cells confirmed the presence of a monoclonal neoplastic population of plasma cells in the tumor.

Ga-67 myocardial scintigraphy in patients with acute myocarditis.

Four patients with acute myocarditis were examined by Ga-67 myocardial scintigraphy. Two cases showed positive scintigram. In one of these cases, the first scintigram showed positive one month after onset of acute myocarditis, and three and four months after its onset, Ga accumulation slightly decreased intermittently.

Hypocalcemic crisis in alcoholic fatty liver: transient hypoparathyroidism due to magnesium deficiency.

Hypocalcemic crisis developed in a patient with acute alcoholic fatty liver. In addition to jaundice and marked hepatomegaly, the patient presented with hypocalcemic crisis associated with hypomagnesemia, low plasma 1,25(OH)2-vitamin D and undetectable plasma parathyroid hormone (PTH) concentration. Subsequent computerized tomographic scan and liver biopsy showed the presence of severe fatty liver.

[Natural history of mitral valve prolapse with respect to the heart size and ventricular arrhythmias].

To evaluate the evolution of mitral valve prolapse (MVP) with increasing age, 158 patients were studied by two-dimensional echocardiography and 24-hour ambulatory electrocardiography (Holter monitoring). The patients were divided into seven age groups (25 patients ranging in age from 12 to 14 years, 21 from 15 to 17, 24 from 18 to 20, 24 from 21 to 30, 37 from 31 to 50, 8 from 51 to 60 and 19 older than 61). Each patient was echocardiographically graded as mild, moderate and severe MVP.

Twenty-four hour ambulatory ECG monitoring of junior high school students in Miki City.

To evaluate incidence of serious arrhythmias among school age youths, 24-hour ambulatory ECG monitoring was performed in 100 junior high school students, including 60 subjects with some ECG abnormalities and 40 without. With this monitoring 2 cases with multifocal VPCs and 2 cases with paired VPCs or nonsustained ventricular tachycardia were found; the case with VT died suddenly after having been lost during careful follow up. It is emphasized from these results that ambulatory ECG monitoring is quite useful in selected cases in this age group and careful follow up of students with advanced grade VPCs is very important.

[Severity and non-uniformity of regional wall motion in dilated cardiomyopathy evaluated by two-dimensional echocardiography].

A two and a half year follow-up study of segmental left ventricular wall motion was performed by two-dimensional echocardiography for 26 patients with dilated cardiomyopathy (DCM). Segmental analysis of left ventricular wall motion abnormalities (WMA) was performed using 11 segments obtained by short- and long-axis views of the left ventricle. Wall motion in each segment was classified and assigned a numerical score as normal (0), hypokinetic (1), severely hypokinetic (2), and akinetic or dyskinetic (3).

[Prognosis of mitral valve prolapse related to the changes in the grade and ventricular arrhythmias].

Eighty-four cases with idiopathic mitral valve prolapse (MVP) were followed for 3.1 years in average (1 to 6 years). Left ventricular end-diastolic and end-systolic dimensions and/or left atrial dimension increased in 72.

[Regional left ventricular function in dilated cardiomyopathy: observation of regional left ventricular wall motion before and during dobutamine administration].

To investigate left ventricular function and the prognosis of patients with dilated cardiomyopathy (DCM), regional wall motion of the left ventricle of 38 patients with DCM was observed before and during dobutamine infusion (8 micrograms/kg X min) by two-dimensional echocardiography (2DE). The left ventricle was divided into 11 segments and the severity of wall motion abnormality (WMA) was classified into 4 grades, i.e.

[Three-dimensional evaluation of mitral regurgitation by pulsed Doppler echocardiography: analysis of the amount and direction of regurgitant flow].

Pulsed doppler echocardiography (PDE) was used to evaluate mitral regurgitation (MR) non-invasively and quantitatively in 156 patients including 51 of rheumatic valvular disease, 57 of mitral valve prolapse (MVP) or chordal rupture of the mitral valve (RCT), and 48 of ischemic heart disease (IHD) or dilated cardiomyopathy (DCM). The severity of MR was estimated three-dimensionally by a MR scoring system as follows: As an index of direction and extent of regurgitation, nine sampling sites were selected in the left atrium at the level of the mitral annulus. These include the anterior, mid, and posterior parts of each portion of the postero-medial, middle, and antero-lateral sides.

A long-term follow-up study of acute myocarditis an electrocardiographic and echocardiographic study.

In an attempt to prove that myocarditis may be a cause of idiopathic cardiomyopathy, 10 cases with acute myocarditis were involved in a long-term follow-up study. There were 9 males and 1 female patient, ranging in age from 22 to 63 years. The etiology of myocarditis was idiopathic in 9 cases and rubella virus in 1 case.

Arrhythmia in young patients with mitral valve prolapse.

Twenty four-hour ambulatory ECG monitoring were examined in 68 patients (33 patients in a young group and 35 patients in an adult group) with mitral valve prolapse (MVP) in order to characterize the features of arrhythmias in young patients with MVP in comparison with those in adult patients. Diagnosis of MVP was made by two-dimensional echocardiography. On 24-hour ambulatory ECG monitoring 29 patients (88%) in a young group had arrhythmias which was as frequent as those in adult group, but serious ventricular arrhythmias were more often detected in the young group (7 patients) than in the adult group (2 patients).

Dilated cardiomyopathy. An echocardiographic follow-up of 50 patients.

To evaluate the significance of left ventricular (LV) hypertrophy in dilated cardiomyopathy (DCM), 50 patients seen between 1976 and 1983 were studied echocardiographically. Patients were classified into 4 groups according to the degree of LV dilatation and LV hypertrophy. Group I consisted of 17 patients who had mild to moderate LV dilatation without LV hypertrophy (LV end-systolic dimension: Ds less than 60 mm, LV wall thickness at end-systole: WTs less than 15 mm).

[The heart in acromegaly: an echocardiographic study].

Clinical examinations including echocardiography were performed for 14 acromegalic patients (five men and nine women, whose mean age was 48.6 years). Three of these had hypertension (HT) above 160/95 mmHg, three had diabetes mellitus (DM).

Clinical significance of left ventricular hypertrophy in dilated cardiomyopathy: an echocardiographic follow-up of 50 patients.

To evaluate the significance of left ventricular (LV) hypertrophy in patients with dilated cardiomyopathy (DCM), 50 patients seen between 1976 and 1983 were studied echocardiographically. We categorized the patients as four groups according to the degree of LV dilatation or hypertrophy. Group consisted of 17 patients with mild to moderate LV dilatation without hypertrophy (LV end-systolic I dimension: Ds less than 60 mm, LV wall thickness at end-systole: WTs less than 15 mm).

A long-term follow-up study of acute viral and idiopathic myocarditis.

In order to clarify the prognosis of myocarditis and the relationship between myocarditis and idiopathic cardiomyopathy, 20 patients with myocarditis (one with Coxsackie B; one with rubella and 18 with idiopathic myocarditis) were followed up for a long period using echocardiography and Holter electrocardiographic monitoring. The follow-up period was 49.1 +/- 39.

[Hypertrophic cardiomyopathy with dilatation of the left ventricle and congestive heart failure: comparison with postmyocarditis cardiomegaly and hypertensive heart failure].

In a total of 114 cases of hypertrophic cardiomyopathy (HCM), four cases were regarded to have dilated left ventricle and congestive heart failure. History of myocardial infarction was not present, and significant narrowing of coronary arteries was not detected in each case. The clinical manifestations were analyzed in the light of the differentiation from postmyocarditis cardiomyopathy (PMC: three cases) and hypertensive heart disease ( HHD : five cases).

Unresponsiveness of GH and cortisol to insulin-hypoglycemia in a patient with sub-total pancreatectomy.

Responses of plasma growth hormone (GH) and cortisol to insulin-induced hypoglycemia were repeatedly examined during a therapy of diabetes mellitus in a sub-totally pancreatectomized patient. During a mild control period of diabetes mellitus without any hypoglycemic attacks, insulin-induced hypoglycemia evoked a remarkable increase in plasma GH as well as cortisol while neither GH nor cortisol responded to insulin hypoglycemia during the strict control period with frequent episodes of hypoglycemia. On the other hand, plasma GH and cortisol responses to all other endocrinological stimuli were normal.