A case of a right coronary artery to left ventricle fistula observed over twenty years.

Since the natural history of a coronary artery to left ventricle fistula is not well known, a case of such a fistula in 36-year-old female patient, followed for 20 years is presented. Two-dimensional echocardiography performed as a follow-up examination revealed enlargement of the right coronary artery and the right Valsalva sinus. Two-dimensional color flow mapping showed the jet flow to the apex from the base of the left ventricle only during the diastolic phase.

Scintigraphic imaging of a case of congenitally corrected transposition of the great vessels and an adult case of single atrium and single ventricle.

We report on the clinical utility of radionuclide angiography and gated blood pool single emission computed tomography (gated blood pool SPECT) in two patients having congenital heart disease. Both conventional equilibrium radionuclide angiography and gated blood pool SPECT demonstrated the connection of the great vessels with both ventricles in a 15-year-old male patient with a congenitally corrected transposition of the great vessels. In particular, the latter procedure could provide very useful information about the ventricular morphology and inversion which is important for diagnosing this disorder.

A clinical study of patients with idiopathic thrombocytopenic purpura.

Fifty patients with chronic idiopathic thrombocytopenic purpura (ITP) were initially treated with corticosteroids. Seven patients had an excellent response (normal platelet count after therapy), 17, 18, and 8 had a good response (normal platelet count during therapy), fair response (improved platelet count during therapy) and poor response (no improvement), respectively. Nine patients, who had a fair or poor response to the corticosteroids, were splenectomized.

[A case of intra-ventricular dissociation with dual ventricular tachycardia].

A 63 year old woman with chronic heart failure was admitted to our hospital for palpitation attack on 26th Apr 1988. The patient was died by cardiogenic shock and recurrent ventricular fibrillation 12-hours after admission. The autopsy revealed diffuse myocardial fibrosis and disarray which was compatible with dilated cardiomyopathy.

[A case of WPW syndrome with slow Kent documented by ATP injection].

A 46-year-old woman with chest tightness and palpitation at exercise was admitted to Sapporo Medical College Hospital for the evaluation of the ST-T changes on stress electrocardiogram. In this patient, PQ time was 0.14 second and pre-exitation was not clearly documented on electrocardiogram at rest.

Regression and recovery of well-developed coronary collateral function in canine hearts after aorta-coronary bypass.

After restoration of antegrade blood flow by coronary artery bypass grafting to a region of myocardium supplied by well-developed collateral vessels, there is regression of collateral supply to that region. There is controversy as to how rapidly this regression occurs, how soon collateral flow might return after an acute occlusion of the bypass graft, and how effective pharmacologic agents such as nitroglycerin might be in accelerating this return. To investigate this problem, 14 canine hearts were collateralized by Ameroid occlusion of the left anterior descending coronary artery.

Effects of norepinephrine and angiotensin II on plasma atrial natriuretic peptide concentration in humans.

To clarify the effects of norepinephrine and angiotension II (Ang II) on plasma atrial natriuretic peptide (ANP), both pressor substances were infused into normal volunteers, and plasma ANP levels and venous return were determined. When norepinephrine infusion elevated mean arterial pressure by 15 mm Hg, a transient increase of plasma ANP was observed. However, Ang II infusion showed no effect on plasma ANP levels, even though it also elevated arterial pressure.

Inspiratory right ventricular outflow obstruction in a patient with hypertrophic cardiomyopathy.

A patient with familial hypertrophic cardiomyopathy with exertional near syncope is reported. Intra-right ventricular obstruction was demonstrated by hemodynamic studies during inspiration and the Valsalva maneuver with systemic hypotension. Improvement occurred following the administration of propranolol.

Siblings with left ventricular diverticulum and hypertrophic cardiomyopathy.

This report describes very rare siblings who had a left ventricular muscular diverticulum and hypertrophic cardiomyopathy. The first case is a 16-year-old male. On two-dimensional echocardiography, a left ventricular muscular diverticulum in the posterior wall and mitral valve prolapse were detected.

Peripheral embolization provides evidence for microvascular collaterals in hearts with chronic coronary artery occlusion.

Macroscopic collateral vessels are widely regarded as the primary source of blood flow to collateral-dependent myocardium. Microscopic coronary collateral vessels have also been described, but their functional significance is controversial. Experiments were conducted in 18 anesthetized dogs with chronic coronary artery occlusions.

Dominant role of circulating catecholamines in the myocardial contractile response to intravenous nicotine.

Experiments were conducted in anesthetized dogs to determine the mechanism primarily responsible for the increase in myocardial contractile function during intravenous infusion of nicotine. Myocardial function was assessed regionally by measuring segment shortening using ultrasonic dimension gauges. The role of cardiac neural stimulation in the absence of direct effects of nicotine and other circulating factors was evaluated by perfusing a region of left ventricular myocardium with blood from a reservoir during systemic nicotine infusion.

Adenosine deaminase attenuates canine coronary vasodilatation during regional non-ischaemic myocardial hypoxia.

To test the hypothesis that adenosine contributes to the coronary hyperaemia produced by regional non-ischaemic myocardial hypoxia coronary blood flow and myocardial oxygen extraction and consumption were continuously monitored in 21 anaesthetised open chest dogs under the following conditions: control 1--postinstrumentation, steady state control; hypoxia 1--3-5 min of regional (LAD) hypoxaemia (partial pressure of oxygen, PO2, 21.4(2.0) mmHg (3.

Transmural variation in autoregulation of right ventricular blood flow.

We examined transmurally the right coronary autoregulatory flow response to varied perfusion pressures in 11 anesthetized, open-chest dogs. Right coronary artery flow was measured electromagnetically, and its transmural distribution was defined with 15-micron radioactive microspheres. Heart rate, mean aortic blood pressure, right ventricular systolic pressure, end-diastolic pressure, and dP/dtmax were constant.

Adenosine deaminase attenuates norepinephrine-induced coronary functional hyperemia.

Responses to norepinephrine (NE) before and after treatment with adenosine deaminase (ADA) were examined in anesthetized dogs. In four dogs repeatable changes in coronary blood flow, myocardial oxygen extraction and consumption, left ventricular +dP/dtmax, and heart rate (HR) were demonstrated during two successive intracoronary infusions of 0.13 micrograms.

Adult T-cell leukemia following long-term remission from non-Hodgkin's lymphoma.

A female patient who had been initially diagnosed with non-Hodgkin's lymphoma (NHL) and achieved complete clinical remission with combined chemotherapy, developed overt adult T-cell leukemia (ATL) after 9 yr of disease-free survival. This is the first case of the development of ATL following the complete remission of NHL. Secondary malignant neoplasms are not well-documented in patients previously diagnosed with Hodgkin's disease.

Regional myocardial blood flow during cardiac tamponade in hearts with chronic coronary artery occlusion.

The effects of increased pericardial pressure on blood flow to collateral dependent and normal myocardium were investigated and the mechanisms responsible for these effects evaluated in 10 anaesthetised dogs after collateral inducement by gradual occlusion of a coronary artery. Regional myocardial blood flows were measured with radioactive microspheres during control conditions, mild tamponade, severe tamponade, and severe tamponade with aortic blood pressure held at the control value by blood volume expansion. Mild tamponade increased heart rate by 10% and decreased aortic blood pressure by 15%.

Mechanism of attenuated pressure-flow autoregulation in right coronary circulation of dogs.

Right coronary autoregulation was assessed in 14 open-chest, anesthetized dogs. In Group 1 (n = 5), the left common and right coronary arteries were cannulated and perfused independently. As coronary perfusion pressures varied simultaneously between 70 and 120 mm Hg, right coronary blood flow changed by 48%, whereas left coronary flow changed by 13%.

Small-dose cytosine arabinoside in the treatment of elderly patients with acute leukemia and refractory anemia with excess of blast.

Five elderly patients with acute nonlymphocytic leukemia (ANLL) and four patients with refractory anemia with excess of blast (RAEB) were treated with small doses of Ara-C (5-30 mg/day, subcutaneous injection) for 10-28 days. Three patients achieved complete remission and four patients partial remission. Side effects were severe bone marrow suppression in eight patients and gastrointestinal symptoms in three patients.