Histopathology of Giant Coronary Artery Aneurysm Associated with Coronary Artery Fistula.

Giant coronary artery aneurysms related to coronary fistula are rare, and the precise mechanisms by which they occur are unknown. We present a case of giant coronary artery aneurysm of the left coronary artery to the pulmonary artery fistula with a lack of internal and (or) external elastic lamina and medial degeneration.

High dose immune globulin therapy ameliorates peripartum cardiomyopathy with elevated serum antibody titer to influenza virus: case report of two patients.

Background: Peripartum cardiomyopathy (PPCM) is a rare complication characterized by heart failure that arises between the last month of pregnancy and the first 5 months after delivery. The etiology of this disorder has not been clarified due to its low incidence. We describe two patients with PPCM and elevated antibody titers to influenza virus in paired sera that were recovered by high doses of intravenous immune globulin.

Endoscopic submucosal dissection of a minute intramucosal adenocarcinoma in Barrett's esophagus.

A 73-year-old man with short segmental Barrett's esophagus underwent esophagoscopy, and a slightly depressed, discolored lesion was found on the anterior wall of the lower esophagus. Under a provisional diagnosis of differentiated adenocarcinoma without local lymph node metastasis, endoscopic submucosal dissection (ESD) was carried out. En bloc resection with tumor-free lateral/basal margins was accomplished without complication.

[Evaluation of metabolic syndrome in elderly age patients of coronary heart disease].

Background: Recently, metabolic syndrome is increasing in Japan and it is thought to be the cause of coronary heart disease. In this study, we evaluated the metabolic syndrome and insulin resistance that is thought to be located in the upstream of metabolic syndrome in high age patients of coronary heart disease.

Patients And Methods: Coronary risk factors were examined and OGTT with measurement of plasma glucose and serum insulin was done to evaluate metabolic syndrome and insulin resistance in 214 patients who underwent coronary angiography; 102 patients were over 65 years old (high age group) and another 112 were young age group.

Evaluation of glucose tolerance, post-prandial hyperglycemia and hyperinsulinemia influencing the incidence of coronary heart disease.

Background: Recently, the frequency of patients who have glucose intolerance has been increasing in Japan. Glucose intolerance and insulin resistance/hyperinsulinemia are thought to influence the progression of atherosclerosis. The present study examined glucose tolerance, insulin resistance, post-prandial hyperglycemia/hyperinsulinemia and coronary risk factors by using 75 g oral glucose tolerance test (OGTT).

Relationship between ECG findings and pulmonary artery pressure in patients with acute massive pulmonary thromboembolism.

Pulmonary thromboembolism (PTE) is associated with various electrocardiogram (ECG) abnormalities, but the utility of evaluating the severity of PTE based on ECG abnormalities alone has not been investigated in Japanese patients previously. The purpose of this study was to examine the relationship between ECG abnormalities and the mean pulmonary artery pressure (MPAP) in patients with acute massive PTE (AMPTE). ECG examination of 21 patients, who were diagnosed with AMPTE by pulmonary arteriography, found that S(1)Q(3)T (3) was the most frequently observed abnormality (in 67% of the patients), followed by negative T (62%), clockwise rotation (57%), and ST elevation (48%).

Characteristic clinical findings of reversible left ventricular dysfunction.

Objective: In this study, clinical findings were evaluated in 16 patients with reversible left ventricular dysfunction (RLVD) who showed a clinical picture similar to that of acute myocardial infarction, in addition to akinesis or dyskinesis of the left ventricular apex without showing any abnormalities in the coronary artery.

Results: The frequency of RLVD was markedly higher in women than in men in these 16 patients (men:women = 1:7). In addition, these patients showed ECG changes similar to those observed in ischemic heart diseases, such as ST elevation or depression, negative T waves and QT prolongation.

Present status of hepatitis virus-associated hepatocellular carcinoma in Nagasaki Prefecture, Japan: a cross-sectional study of 1019 patients.

The present study was designed to determine the frequency of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in patients with hepatocellular carcinoma (HCC) in Nagasaki Prefecture, Japan. We examined the clinical features of 1019 patients with HCC who visited our hospitals between January and December 1999. The ratio of men to women was 709 : 310, and the peak incidence of HCC was in the seventh decade of life in both men and women.

Successful removal of a left main coronary artery thrombus induced by vasospasm to the aorta [correction of vasospasm of the aorta] after the injection of contrast medium.

A 51-year-old woman with acute myocardial infarction underwent emergency coronary angiography. The patient had an episode of idiopathic thrombocytopenic purpura, and underwent splenectomy at the age of 36. On admission, platelet count in the peripheral blood was 43.

[A study of infusional port re-insertion in patients with liver metastasis].

We evaluated the importance and usefulness of re-insertion of the intra-arterial infusion catheter in 10 patients with liver metastasis who showed problems in the catheter or system during intra-arterial infusion chemotherapy. The route of re-insertion was laparotomy-->left subclavian method in 3 patients, left subclavian-->left subclavian method in 5, and left subclavian-->femoral method in 2. The cause of re-insertion was dislocation in 5 patients, obstruction of the system in 4, and obstruction of CHA in 1.