[Mitral valve repair for infectious endocarditis].

Fourteen patients with mitral regurgitation resulting from infectious endocarditis underwent mitral valve repair between December 1988 and July 1994. There were nine males and five females aged from 14 to 70 years (mean 40.2 +/- 19.

[Cardiac emergencies after the Hanshin (Kobe-Osaka) earthquake].

The Hanshin earthquake occurred on January 17, 1995, causing considerable disruption at our hospital due to lack of water and gas supplies for about 5-6 weeks after the earthquake. We admitted 63 cardiac patients as emergencies during first 3 weeks, including 32 with congestive heart failure, 6 with unstable angina, 8 with acute myocardial infarction and 17 with other diseases. Congestive heart failure occurred mainly in aged patients who suffered from upper respiratory infection or bronchitis.

[Detection of hibernating myocardium in patients with myocardial infarction by low-dose dobutamine echocardiography: comparison with thallium-201 scintigraphy with reinjection].

The identification of hibernating myocardium is important for selecting patients who will benefit from coronary revascularization. The relationship between echocardiographic and radioisotopic markers of hibernating myocardium and postrevascularization recovery of myocardial function was investigated in 21 patients who underwent successful revascularization. Each patient underwent low-dose dobutamine stress echocardiography and thallium-201 (201Tl) scintigraphy with reinjection before revascularization.

Comparison of the Carpentier and Duran prosthetic rings used in mitral reconstruction.

This clinical study was undertaken to evaluate the Duran flexible ring and the Carpentier rigid ring in terms of mitral annulus motion, transmitral flow and left ventricular function. Twenty-six patients (11 receiving rigid rings and 15, flexible rings) with normal sinus rhythm and with no or only trivial mitral valve regurgitation after surgical repair were selected. Angiograms demonstrated no significant differences in left ventricular systolic function between the two groups of patients.

Flow capacity of internal mammary artery grafts: early restriction and later improvement assessed by Doppler guide wire. Comparison with saphenous vein grafts.

Objectives: The purpose of this study was to assess flow dynamics and flow capacities of internal mammary artery and saphenous vein grafts to the left anterior descending coronary artery.

Background: The postoperative flow capacity of internal mammary artery grafts to the left anterior descending coronary artery has been reported to be restricted compared with that of saphenous vein grafts in studies using radionuclide angiography. A recently developed Doppler guide wire has been used to analyze the flow dynamics of bypass grafts and to clarify the mechanism of this limited flow capacity.

[Relationship between regional flow reserve supplied by the great saphenous vein graft and regional left ventricular wall motion: a Doppler guide wire study].

The relationship between regional flow reserve supplied by a great saphenous vein graft and myocardial infarction and anterior wall motion assessed by left ventriculography was studied in 28 patients with no stenosis in the great saphenous vein graft and the peripheral site of the recipient left anterior descending coronary arteries. The proximal segment to the anastomosis was totally or subtotally occluded. The resting graft blood flow velocity was measured using a Doppler guide wire, then 0.

[Adenosine triphosphate loading thallium-201 myocardial scintigraphy: optimal dose and diagnostic accuracy].

Adenosine triphosphate (ATP) is an alternative to dipyridamole or adenosine in thallium-201 myocardial scintigraphy. However, the optimal dose of ATP has not been determined. A Doppler guide wire study showed the coronary flow velocity at a dose of 0.

[Assessment of coronary stenosis severity using a Doppler guide wire in vivo: is the continuity equation applicable to moderate to severe coronary artery stenosis?].

The usefulness of a Doppler guide wire was evaluated in the estimation of coronary stenosis severity in patients with moderate to severe coronary stenosis using the continuity equation. The maximal coronary flow velocities (V) proximal to the stenosis (p), at the stenosis (s), and distal to the stenosis (d) were measured using a Doppler guide wire (12-MHz, 0.018-in) in 12 patients with mild coronary stenosis (less than 50% diameter stenosis: group A) and 12 patients with moderate to severe coronary stenosis (more than 50% diameter stenosis: group B).

[Studies on the efficacy and safety of biapenem (L-627) against infections in pediatrics].

The efficacy and the safety of biapenem (L-627), a new carbapenem antibiotic, against infections in pediatrics were studied. The obtained results are summarized as follows. 1.

Clinical spectrum and genetic studies of Fukuyama congenital muscular dystrophy.

The association of congenital muscular dystrophy (CMD) with type II lissencephaly and ocular anomalies is found in Fukuyama CMD (FCMD), the Walker-Warburg syndrome (WWS), and muscle-eye-brain disease (MEBD). The classification of these disorders remains controversial. Between 1972 and 1992, we performed clinical and genetic studies in 41 families of FCMD, which is particularly frequent in Japan.

[Usefulness and limitations of dobutamine stress echocardiography for detection of coronary artery disease].

The value of dobutamine stress echocardiography for detecting coronary artery disease was evaluated in 67 patients with normal left ventricular wall motion at rest who also underwent quantitative angiography. The overall sensitivity and specificity of dobutamine stress echocardiography for detecting coronary artery disease were 83% and 70%, respectively. The sensitivities for detecting multivessel disease and single vessel disease were 92% and 76%, respectively.

[Effects of infarcted myocardium on coronary flow reserve: a study by transesophageal Doppler echocardiography].

Myocardial disorder or microvascular disorder can cause impairment of coronary flow reserve in patients without epicardial coronary artery stenosis. This study investigated whether infarcted myocardium influences the coronary flow reserve using transesophageal echocardiography. The coronary flow reserve was examined in 15 patients with anterior myocardial infarction without residual coronary artery stenosis in the chronic phase.

[Residual, recurrent mitral regurgitation after mitral valve reconstruction: differences in lesion and operation method].

Patients developing residual or recurrent mitral regurgitation (MR) increased to moderate or severe grade after mitral valve reconstruction for MR were investigated by correlating the lesion and operation method with the echocardiographic course of postoperative MR. Postoperative moderate or severe grade MR [more than 4.0 cm2 color Doppler flow area on postoperative transesophageal echocardiography (TEE)] occurred in 21 of 80 mitral valve reconstruction patients.

[A case of infrarenal left inferior vena cava with macrohematuria after contusion in the lumber region].

A 33-year-old woman was admitted with macrohematuria after contusion in the left lumber region. The excretory urogram showed no abnormal findings, but color doppler and RI-angiography revealed infrarenal left-sided inferior vena cava (left IVC). The pressure in the dilated left renal vein was higher than that in the right one.

[Diagnosis of sinus venosus atrial septal defect by transesophageal color Doppler and two-dimensional echocardiography].

Diagnosis of sinus venosus atrial septal defect based on transthoracic color Doppler and two-dimensional echocardiography is often difficult. We recently experienced two cases of sinus venosus atrial septal defect which were correctly diagnosed using transesophageal color Doppler and two-dimensional echocardiography. Transthoracic color Doppler flow imaging did not demonstrate the atrial septal defect or the shunt flow across the defect in either case.

[Change in mitral valve area after percutaneous transvenous mitral commissurotomy: prediction of mitral valve restenosis].

Factors indicating changes in mitral valve area after single-balloon percutaneous transvenous mitral commissurotomy (PTMC) were evaluated in 53 patients receiving PTMC by follow up for 3-48 months (mean 18 +/- 12 months) using serial transthoracic echocardiography to measure mitral valve area by planimetry. The echocardiographic scores of the mitral commissures and mitral valve, and other clinical variables were assessed. Mitral valve area showed an immediate increase from 1.

[Relationship between early peaking of serum myosin light chain 1 level and washout phenomenon of creatine kinase in acute myocardial infarction].

To investigate the serum levels of myosin light chain 1 (MLC1) during the acute phase of myocardial infarction, the MLC1 and creatine kinase (CK) levels were measured in samples from 59 consecutive patients with acute myocardial infarction. The serum concentration of MLC1 increased rapidly, reaching an early peak in 22 of the 59 patients (the MLP + group). Fifteen patients showed rapid increases in MLC1 levels without an early peak (the MLP - group).

[Improvement of transthoracic pulsed Doppler imaging of pulmonary venous flow by intravenous injection of sonicated albumin].

Enhancement of pulmonary venous Doppler flow signals by intravenous injection of sonicated albumin was evaluated in 200 patients. Baseline pulsed Doppler signals were strong in 153 (77%) patients and weak in 47 patients. After injection of sonicated albumin, adequate pulsed Doppler flow signals were recorded in 44 (94%) of the 47 patients.

Phasic coronary flow characteristics in patients with hypertrophic cardiomyopathy: a study by coronary Doppler catheter.

Abnormal patterns of coronary flow velocity have been observed in patients with symmetric left ventricular hypertrophy in conditions such as aortic stenosis and systemic hypertension. However, phasic coronary flow characteristics have not been investigated in patients with asymmetric left ventricular hypertrophy in hypertrophic cardiomyopathy. The purpose of this study was to assess phasic coronary flow characteristics and their relation to echocardiographic and hemodynamic parameters in patients with hypertrophic cardiomyopathy.