ABSTRACT
<p>A 75-year-old man who presented with fever and cough was given a diagnosis with active pulmonary valve endocarditis and transferred to our institution. Blood cultures were positive for <i>Enterococcus faecalis</i>, and transthoracic echocardiography showed a mobile vegetation attached to the pulmonary valve. Despite an 8-week treatment with antibiotics, a relapse of the infection required surgery. During the surgical procedure, we found that the vegetation had destroyed all of the pulmonary valve leaflets. After excising the pulmonary valve leaflets, we implanted a bioprosthetic valve and closed the pulmonary artery with autologous pericardium. The patient completed a 6-week course of intravenous antibiotics and was discharged on postoperative day 68. Postoperative transthoracic echocardiography demonstrated an adequate effective orifice area index. Our case report of isolated pulmonary valve endocarditis without predisposing factors is rare. The implantation of a bioprosthetic valve and enlargement with an autologous pericardial patch is an effective option for achieving a satisfactory hemodynamic profile.</p>
ABSTRACT
A brachiocepharic artery aneurysm is relatively rare in comparison with other peripheral artery aneurysms. A 62-year-old woman who had had a sudden chest pain 1 year previously was referred to our hospital because of a right upper mediastinal mass on a chest roentgenogram. Computed tomography demonstrated the dissection and dilatation of the innominate artery. The dissection extended to the right carotid artery and right subclavian artery. Furthermore, the ascending aorta was dilated. We performed reconstruction of the innominate artery with a Y-shaped composite graft and replacement of the ascending aorta and total aortic arch. Her postoperative course was uneventful with no neurological event. We describe our surgical strategy in this report with a review of the literature because operative methods and plans are various according to the shape and extent of the aneurysm of the brachiocepharic artery.
ABSTRACT
We began gastric mass survey at our hospital in May, 1980. During 3 years and 8 months since then, (May, 1980-December, 1983) we performed screening examinations to 16, 341 people by indirect radiography, and checked 2, 824 cases (17.3%) for thorough examination. Among these cases, 2, 083 (73.8%) received endoscopic examination actually, and 55 cases of gastric cancer were discovered. The discovery rate of gastric cancer was 0.336 per cent.<BR>35 cases of these 55 gastric cancer were operated in the surgical department of our hospital. 34 cases were resected (rate of resection was 97.1%) and 33 cases were resected curatively (rate of curative resection was 94.3%). These results were better than that of gastric cancer cases from out-patient clinic of the same period. The results of cases from out-patient clinic of our hospital were: total number of cases 321, resected cases 254 (79.1%), curative resection 189 cases (58.9%), respectively.