[Recurrent right atrium thrombus in long term follow-up after repair of atrial septal defect; report of a case].

A 76-year-old woman with recurrent ball-like thrombus in right atrium after primary repair of atrial septal defect (ASD) and tricuspid annuloplasty was successfully treated by surgical resection and strict management of anticoagulation and antiarrhythmics. A routine follow-up echocardiography, 27 months after initial operation, showed a swinging ball mass looks like a myxoma in the right atrium. Intra-operative findings showed the mass attached the free wall of right atrium with a 5 mm stalk, which was far from the ASD patch, initial suture lines, and the tricuspid annulus. Histological examination revealed the round and smooth mass was thrombus. She was successfully discharged 13 days after the 2nd operation without any complaint. A postoperative laboratory check demonstrated normal coagulability. Despite the patient was prescribed warfarin potassium and aspirin, the follow-up echocardiography at 3 months showed a recurrent thrombus in the right atrium. However the strict anticoagulation therapy with warfarin potassium and aspirin induced thrombolysis and prevent any embolic event, 1 month later. It is important to continue a strict anticoagulant therapy and prevent arrhythmia to avoid recurrence thrombus.

[Pulmonary venous obstruction after the Williams procedure for partial anomalous pulmonary venous connection].

A 54-year-old man was admitted to our hospital because of chest discomfort. Cardiac catheterization revealed partial anomalous pulmonary venous connection with an intact atrial septum. The right upper pulmonary vein (RUPV) drained into the upper segment of the superior vena cava (SVC). Using the Williams procedure, an atrial septal defect (ASD) was created and a fresh autologous pericardial patch was used to fashion a new pulmonary vein return route from SVC to the ASD. Although the patient was stable after the procedure, he was admitted again 6 months later because of obstruction of RUPV. At reoperation, it was found that the previous pulmonary vein route was obstructed and that the pericardial baffle had adhered to the atrial septum above the ASD. The shrunken and thickened pericardial baffle was removed and the orifice of the ASD was extensively enlarged, after which an expanded polytetrafluoroethylene (ePTFE) patch was used as a new baffle. After the reoperation, the patient's condition improved.

Choroid plexus arteriovenous malformation in a full-term neonate. Case report.

A full-term newborn infant with intracranial hemorrhage secondary to an arteriovenous malformation (AVM) of the choroid plexus is presented. Although angiography was not undertaken before surgery, a vascular nodule containing an AVM nidus was found in the hematoma wall. The authors stress that an AVM should be considered as a cause of intracranial hemorrhage and that the hematoma wall be searched thoroughly in neonates without predisposing factors.

[Fundamental and clinical studies on cefotaxime in the field of obstetrics and gynecology (author's transl)].

UNLABELLED: Fundamental and clinical studies were made on cefotaxime (CTX), a new cephalosporin antibiotic. The following results were obtained: 1. Antibacterial activity: At a concentration of 3.13 mcg/ml, CTX inhibited the growth of 90.2% of 92 strains of Gram-negative rods and 80.0% of 15 strains of Gram-positive cocci. 2. Concentrations of CTX in body fluids and genital organs after 2 g i.v.: (1) CTX level in pus reached the peak (5.6mcg/ml) at 2 hours after administration. (2) Mean CTX levels in the pelvic space exudate reached the peak (28.0 mcg/ml) at 2 hours after administration. (3) CTX levels in the uterine appendages and uterus reached the peak (8.9 and 4.5 mcg/g, respectively) at 100 to 280 minutes after administration. 3. CLINICAL RESULTS: CTX was excellent in 7 of 13 cases and good in the remaining 6 cases. The response rate to CTX was 100%. 4. The bacteriological effect: The bacteriological effect of CTX was also 100%. Bacteria were eradicated in 7 of the 10 cases where organisms were demonstrated before CTX treatment. Partial reduction bacteria was observed in the remaining 3 cases. 5. No side effect attributable to CTX was observed.

[Laboratory and clinical studies on latamoxef in the field of obstetrics and gynecology].

Latamoxef (LMOX) is a new antibiotic synthesized by Shionogi Research Laboratory. Chemically LMOX is especially unique with a sulfur atom replacing the oxygen atom in the 1 position of the conventional cephalosporin nucleus, and in addition, this antibiotic has a cephamycin-like structure. The antibacterial activity of LMOX shows high potency against Gram-negative bacteria, but tends to be weak against Gram-positive bacteria. The tissue levels of LMOX in humans after intravenous injection of 1 g were examined. The levels in uterine and adnexa uteri tissue at 1 hour after administration were 25.4 and 27.4 micrograms/g respectively. LMOX was administered to 147 cases in infections of obstetric and gynecological field. The clinical effect according to disease was 94.6% for intrauterine infections, 95.0% for adnexitis, 87.0% intrapelvic infections, and 100% for external genital organ infections, making a total of 92.5%. The rate of occurrence of side effects or abnormal laboratory findings was similar to or slightly less than that seen with other beta-lactam antibiotics.

Fetal polycystic kidney disease in oro-facio-digital syndrome type I.

We report a girl with oro-facio-digital syndrome type I (OFD I) associated with polycystic kidney disease (PKD), which was identified on fetal US and fetal MRI. After birth, the diagnosis of this X-linked dominant disorder, which is lethal in males, was achieved by recognition of facial dysmorphism, lingual hamartomas, postaxial polydactyly, brain malformations, and the existence of her deceased male sibling with similar malformations. Adult PKD is a common feature in heterozygous females with OFD I. However, fetal PKD has been reported only in a lethal homozygous male. Our observation expands our knowledge about the phenotypic variations of PKD in OFD I.