Anterior spinal artery syndrome after minimally invasive direct coronary artery bypass grafting under general combined epidural anesthesia.

A 65-year-old patient with ischemic heart disease and severe diabetes mellitus underwent minimally invasive direct coronary artery bypass grafting under general combined with epidural anesthesia. Paraplegia developed after surgery and the diagnosis of anterior spinal artery syndrome was made based on the patient's neurological condition and magnetic resonance imaging findings. Paraplegia following epidural anesthesia is a rare but recognized complication and this complication should be taken into account, especially in patients at risk, when considering epidural analgesia techniques in the minimally invasive cardiac surgery.

[A successful management of acute myocardial infarction with severe left main trunk lesion using beating heart coronary artery bypass grafting: report of a case].

A 56-year-old male was admitted for sudden onset of severe chest pain and diagnosed as acute myocardial infarction (AMI). Emergency coronary angiography revealed complete obstruction of the left anterior descending artery (LAD) and 99% stenosis of left circumflex coronary artery (LCX), which was almost same with obstruction of the left main trunk coronary artery. Emergency coronary artery bypass grafting (CABG) to LAD and LCX was performed under a beating-heart.

[Coronary vasospasm during off-pump coronary artery bypass grafting; report of two cases].

Coronary vasospasm is one of the most dangerous and fatal complications of coronary artery bypass grafting (CABG) operation. Our experiences in recent 2 cases happened during off-pump CABG (OPCAB) are presented. Case 1: A 63-year-old male who had 3 vessels disease underwent OPCAB using left internal thoracic artery (LITA) and the radial artery.

Acute mitral regurgitation due to total rupture in the anterior papillary muscle after acute myocardial infarction successfully treated by emergency surgery.

A 68-year-old female was admitted for sudden onset of chest pain. She received a successful percutaneus coronary intervension for total occlusion in the diagonal artery, but continued to develop progressive heart failure. A chest X-ray showed right pulmonary edema without cardiomegaly, and an echocardiogram revealed massive mitral regurgitation with prolapse in the anterior mitral leaflet due to a rupture in the papillary muscle.

Cardiac displacement after lobectomy in a patient with a congenital complete left-sided pericardial defect.

A 74-year-old man underwent left upper lobectomy for a suspected lung cancer. At thoracotomy, the pericardium was found to be completely absent. The heart was fixed in a central position with an artificial patch to prevent displacement.

Rudimentary meningocele presenting with an annular alopecia.

Rudimentary meningocele (RM) is a relatively rare developmental anomaly in which meningotherial elements are found in the skin. We present a case presenting with an annular alopecia over a rudimentary meningocele. Due to the occasional presence of connection or relationship to the central nervous system in RM, knowledge of the various clinical appearances including annular alopecia is clinically important.

Long lasting spasticity in controlled vasospastic angina.

Objective: To evaluate changes in coronary artery spasticity in patients with vasospastic angina who had been stable for years under continuous drug treatment.

Methods: Follow up coronary angiography was performed under intracoronary ergonovine provocation in 27 well controlled patients with vasospastic angina and no organic stenosis; the tests were done > 24 months after the initial coronary angiography, in which occlusive spasm had been induced by the same regimen of ergonovine provocation.

Results: The mean (SD) follow up period was 47.

Gliosarcoma of the posterior cranial fossa: MRI findings.

We report the MR findings of a biopsy-proven gliosarcoma of the posterior cranial fossa. Multiple homogeneously enhancing lesions had shaggy margins and broad-based dural attachments, which may reflect the gliomatous and sarcomatous element of this tumour.

[Intracoronary administration of ergonovine maleate for detecting vasospastic angina; one dose method].

Coronary spasm is an important etiologic mechanism in the pathogenesis of myocardial ischemia. Provocative test of coronary spasm during coronary arteriography is clinically useful. The ergonovine test has gained widespread use, and we have examined the efficacy and safety of intracoronary ergonovine application with a fixed dose of 16 micrograms.