[Coronary sinus type atrial septal defect diagnosed by two-dimensional color Doppler echocardiography: a case report]

This is a case report of coronary sinus type atrial septal defect (ASD) diagnosed preoperatively by two-dimensional color Doppler echocardiography. A 22-year-old asymptomatic woman was admitted for preoperative cardiac evaluation. A cardiac murmur and cardiomegaly had been noted at a routine examination which included electrocardiography and chest radiography, and M-mode echocardiography suggested the presence of a secundum type ASD. Color Doppler echocardiography revealed a left to right atrial shunt flow through the coronary sinus ostium into the right atrium. By peripheral contrast echocardiography, a negative contrast echo from the coronary sinus ostium was observed within the right atrium and persistent left superior vena cava was excluded. At operation, a 2 X 3 cm defect was demonstrated at the interatrial septum in the vicinity of the coronary sinus ostium. This is the first reported case of a coronary sinus type ASD diagnosed preoperatively by color Doppler echocardiography.

[The role of lymphadenectomy in the treatment of renal cell carcinoma]

The usefulness of radical nephrectomy combined with lymphadenectomy for improving the prognosis of renal cell carcinoma was evaluated in 146 patients with this disease during the 21-year period from 1963 to 1983. Eighty-six out of the 146 underwent radical nephrectomy alone, while the remaining 60 patients received radical nephrectomy combined with lymphadenectomy. In cases of stage I and stage IV B, lymphadenectomy produced no improvement in the survival rate. On the other hand, of the 58 patients who had stage II and stage III disease, in the 23 who underwent lymphadenectomy, the survival rate improved significantly as compared to the 35 who did not.

[Fever in renal cell carcinoma]

Fever developed in 65 (37.8%) out of 172 patients with renal cell carcinoma, being the third most frequent symptom following hematuria and renal mass. Patients who developed fever were associated with symptoms such as palpable renal mass, general malaise anorexia, weight loss, acceleration in ESR, liver dysfunctions and an increase in alpha 2-globulin significantly more frequently than those who did not. Histologically also, high graded cases were more common with a significant. Moreover, the prognosis was significantly more poor.

Clinical experience with atrial inversion using a Gore-Tex baffle in 52 cases of transposition of the great arteries

Atrial inversion was achieved by a modified Mustard operation in 334 patients with various types of transposition of the great arteries (TGA) between January, 1974, and January, 1983, in Hannover, West Germany. The overall mortality was 4.2% (N = 14). Between March, 1978, and January, 1983, 197 of the patients were operated on using a new design of a Gore-Tex prosthetic baffle. In February, 1982, a new step was integrated into our modification of the Mustard operation. It consisted of creating a pericardial flap that serves to enlarge the pulmonary venous atrium. This article describes the modified Mustard operations with Gore-Tex baffle used in 52 children with TGA between October, 1981, and January, 1983. Special attention is focused on operative techniques and on postoperative dysrhythmias and hemodynamics.

Abnormal accessory mitral leaflet simulating left ventricular outflow tract tumor

This is a case report of an uncommon form of subaortic stenosis caused by an abnormal accessory mitral leaflet simulating a left ventricular outflow tract tumor. A 5-year-old boy with a systolic heart murmur underwent cardiac catheterization which demonstrated a subaortic stenosis with a 90 mmHg peak systolic pressure gradient. Angiography showed a tumor-like structure in the left ventricular outflow tract. At operation this mass was found to be an abnormal bulky accessory mitral leaflet. Resection of this deformed leaflet was carried out successfully.

Sex differences in the human group mean SEP

The following results were obtained with SEPs recorded from strictly age-matched normal human subjects, 100 males and 100 females, 22.29 +/- 1.90 years. (1) The sex factor on the wave form of SEP was confirmed highly significant by MANOVA. (2) It was confirmed that the group mean SEP of each sex each converges to a given wave form which significantly differed from each other. (3) The differences in the wave form of the group mean SEP between sexes were established. The group mean SEP for females consisted of the 12 components, N1, P1, N2, P2, N3, P3, N4, P4, N5, P5, N6 and P6, and was approximately tetraphasic within 500 msec in latency, while that for males consisted of the same components except for N4 and P4. The baseline amplitude of the wave form of the group mean SEP, smaller in males than in females, differed significantly between sexes, corresponding to the most remarkable difference in its wave form, in the descending slope from the highest positive peak P2 to the deep negative trough N6, where there was a high convex arch with P4 (80 msec) in females, a low hollow slope without the peak in males. The latencies of the components tended to be longer in males than in females. (4) With scaled SEPs, which were converted from SEPs by amplitude scaling, results were similar to those with SEPs, and the sex difference in the scaled group mean SEP was also verified to be significant. These results indicate the further possibility of data reduction by amplitude scaling.

Sex differences in the human group mean SEP

With 200 SEPs of normal human subjects, the sex differences in the waveform of the Group Mean SEP were established eliminating those attributable to the peripheral factors, the statures and the nutritional conditions represented by Rohrer's index. The differences in baseline amplitude of the Group Mean SEP between sexes, in the sections between 25--110 msec and behind 400 msec in latency, were verified removing those between the tallers and the shorters and those between with high and with low values of Rohrer's index, not attributable to these peripheral factors and might be the central origin. The differences in the Scaled Group Mean SEP were also verified similarly, being more a significant indication of the sex difference itself than those in the Group Mean SEP.

[Clinical evaluation of pivmecillinam in the maintenance therapy of chronic urinary tract infection (author's transl)]

In order to evaluate the efficacy and safety of pivmecillinam (melysin tablet, PMPC), PMPC was administered to 78 chronic UTI cases in the field of obstetrics and gynecology (posthysterectomy infection, chronic cystitis, chronic pyelonephritis and etc.). In principle, daily 400 mg of PMPC was administered for 2 weeks. (1) Overall clinical efficacy judged by doctor was evaluated in 78 cases and the result was; excellent in 17, good in 37, fair in 10, poor in 13 and unknown in 1 case with the effectiveness rate of 69.2%. (2) Overall clinical efficacy judged by 'criteria for clinical evaluation in complicated UTI' recommended by UTI study member was evaluated in 54 cases and the result was; excellent in 15, good in 20 and poor in 19 cases with the overall efficacy rate of 64.8%, the result of which was similar to that of doctor's judgement. (3) Efficacy on pyuria was evaluated in 72 cases and it was cleared in 27, decreased in 25, unchanged in 20 and unknown in 6 cases. Efficacy on bacteriuria was evaluated in 72 cases and it was eliminated in 44, decreased in 9, replaced in 8, unchanged in 8 and unknown in 9 cases. (4) Side effect, considered by doctors to be caused by PMPC administration, was noticed in 3 out of 78 cases (3.8%), all of which was mild gastrointestinal disturbance and the administration of PMPC was continued. Abnormal change of laboratory finding considered by doctors to be caused by PMPC administration was noticed in 1 out of 78 cases, which was slight elevation of GOT and GPT values. It is therefore considered that PMPC appear to be useful drug for the maintenance therapy of chronic UTI in the field of obstetrics and gynecology.

Differences in human group mean SEP between sexes: with reference to the Rohrer's index

With 200 SEPs of normal subjects, the differences in the Group Mean SEP between sexes were defined eliminating the differences attributable to another peripheral factor relating to the nutritional condition represented by the Rohrer's index. The differences in the baseline amplitude of the Group Mean SEP between males vs. females in the section between roughly 23-111 msec, around 330 msec, and behind 389 msec in latency were verified, subtracting the differences between the groups with a high vs. low value of the Rohrer's index, not attributable to the different nutritional condition, and might be the central origin. Applying the Amplitude Scaling, the differences in the section 23-104 msec in latency were verified similarly, being more a significant indication of the sex difference per se.

The waveforms of the group mean SEP of each sex

With SEPs recorded from age-matched normal human subjects, 100 males and 100 females 22.34 + 1.69 years, it was confirmed that the Group Mean SEP of each sex each converges to a given waveform which significantly differed from each other. The waveform of the Group Mean SEP for females consisted of the 12 components, and was approximately tetraphasic within 500 msec in latency, while that for males consisted of the same components except for N4 and P4. There was a high convex arch with P4 (82 msec) between P2 and N6 for females, but a low hollow slope without the peak for males. With Scaled SEPs, which were converted from SEPs by Amplitude Scaling, the results similar to those with SEPs were obtained.

Differences in human group Mean SEP between sexes: with reference to statures

With 200 SEPs of normal human subjects, the differences in the Group Mean SEP between sexes were defined, removing those attributable to the peripheral factor, the statures. The differences in baseline amplitude in the sections roughly 1) between 29-110 msec, where there were the most remarkable differences in the waveform of the Group Mean SEP, between P2 and N6, with a high convex arch peaking at P4 (80 msec) for females but not for males, 2) around 320 msec, and 3) behind 400 msec in latency, were verified, not attributable to the different statures, and might be the central origin. With Scaled SEPs, which were converted from SEPs by the Amplitude Scaling, results similar to those with the unscaled SEPs were obtained.

[Clinical studies on cefoperazone in gynecological and obstetrical field (author's transl)]

Fourteen patients suffering from female genital organ infections including mastitis and urinary tract infections were treated with cefoperazone (CPZ). CPZ was administered intravenously or by drip infusion at a dose of 2.0-4.0 g/day for 3-7 days. Clinical results obtained were as follows: Of 8 patients with genital organ infections, excellent responses were seen in 2 patients, good responses in 5 patients. Of 3 patients with mastitis, good responses were seen in all the patients. Of 3 patients with pyelonephritis, excellent and good responses were seen in all the patients. No adverse effects and abnormal laboratory findings were observed. From the above results, we concluded that CPZ was an effective and safe antibiotic against infections in the field of obstetrics and gynecology.

The group mean SEP of normal human subjects

The following conclusions were deduced from the SEPs of 100 normal human subjects, whose mean age was 21.80+/-1.62. It was confirmed that the waveform of a Group Mean SEP and of a Group SD each converges to a waveform different from a flat horizontal line. The waveform of the Group Mean SEP consisted of 12 components, and was roughly tetraphasic within 500 msec in latency. Large discrepancies were found in the later components between the Group Mean SEP and the Group Schematic SEPs reported by others, although some coincidences were shown in the early components within 100 msec in latency. The results derived from the Scaled SEPs, which were converted from the (unscaled) SEPs, indicated the possibility of a reduction of the data by the Amplitude Scaling.

The waveform of the group mean SEP of normal human subjects

The following conclusions were deduced from 200 SEPs recorded from 100 male and 100 female controls, of average age 22.34 +/- 1.70 years. (1) It was confirmed that the waveforms of a group mean SEP and of a group SD converge to a waveform which is not a flat horizontal line. (2) The waveform of the group mean SEP for the 200 normal subjects consisted of 12 components and was tetraphasic within 500 msec latency. The waveform of the group SD for the 200 normal subjects was also shown. (3) Some coincidences were established in early components within 50 msec latency, between the group mean SEP obtained in the present study and the group schematic SEPs reported by others, but large discrepancies were noted in later components. (4) With scaled SEPs, which were converted from unscaled SEPs by amplitude scaling in order to eliminate individual variation in absolute amplitude, similar results were obtained to those with unscaled SEPs. These results indicate the possibility of data reduction by amplitude scaling.

Chromatin transcription by progesterone-receptor complex in rabbit uterus

This study was designed to investigate the chromatin transcription in vitro by progesterone-receptor complex in the estrogen-primed rabbit uterus. RNA synthesis by the uterine chromatin was stimulated when progesterone-uterine cytosol complex was bound to the chromatin and the stimulation was dependent upon the dose of the bound progesterone-cytosol 8S complex and upon the incubation time of the complex in the presence of the chromatin. Either norethindrone- or dydrogesterone-uterine cytosol complex also stimulated the uterine chromatin transcription but the extent was less than that of progesterone complex. These results indicate that progesterone as well as synthetic progestogens can directly regulate chromatin transcription via progesterone receptor in the rabbit uterine cells.