[Pyopericardium followed by acute progression of constrictive pericarditis].

A 65-year-old woman was referred to our hospital for treatment of pyopericardium and cardiac tamponade. Despite aggressive therapy that included pericardiaocentesis, drainage of pericardial effusion, and prolonged intravenous antibiotic therapy, constrictive pericarditis developed 2 weeks after an initial episode of pyopericardium. Pericardiectomy and omentopexy were performed, resulting in complete relief of the patient's symptoms and no recurrence of infection. The possibility of constrictive pericarditis should be kept in mind for the surveillance of the patients with pyopericardium and appropriate measures for pericardial drainage should be undertaken to prevent pericardial constriction.

[Left atrial sarcoma with the initial diagnosis of myxoma].

Primary tumors of the heart are rare. The majority of these tumors are benign, with myxomas located in the left atrium being the most common form. Almost all malignant tumors are sarcomas and occur preferentially in the right side of the heart. The case of a 73-year-old woman who presented with symptoms of mitral valve stenosis is reported. Echocardiography revealed a left atrial mass that was interpreted as atrial myxoma. At the operation, the tumor which was lobulated and had a smooth surface was arising from posterior wall of left atrium extending into the mitral annulus. Wide surgical excision was possible with left atrial reconstruction and mitral valve replacement. Histological and immunohistochemical studies revealed malignant undifferentiated sarcoma extending to the surface of mitral valve. Postoperative metastatic work-up showed no evidence of dissemination. The patient survived the operation without adjuvant radiation and chemotherapy and has been symptom-free over 1 year. At present, 16 months following the operation, the patient is alive with no evidence of disease.

[A case of post infarction true left ventricular aneurysm which showed pseudoaneurysm-like shape in left ventriculography].

A 69-year-old man who had a post-infarction left ventricular aneurysm underwent surgical repair. Preoperative left ventriculography showed a small aneurysm, 3.0 x 3.0 x 2.5 cm in size, with a narrow neck at the inferior wall suggesting a typical "false" aneurysm. But intraoperative and pathological examination revealed that this was a "true" aneurysm which contains coronary artery and myocardial cells in its wall. Left ventriculography is not necessarily the definite standard to differentiate between true and false left ventricular aneurysm.

[A case of subaortic stenosis due to parashute accessory mitral valve tissue].

An 11-year-old boy with subaortic stenosis due to parashute accessory mitral valve tissue was treated successfully with surgery. He had a mild left ventricular-aortic pressure gradient associated with mild aortic regurgitation. The abnormal subaortic tissue was attached to the anterior leaflet of the mitral valve and was complicated with discrete subaortic stenosis. This tissue had five chordae connecting to the anterior papillary muscle and the anterior leaflet of the mitral valve. By resection of this accessory tissue and the part of the septal discrete stenotic tissue, stenosis of the left ventricular outflow tract was relieved completely.

[Malfunction of the Omniscience valve in mitral position: a case report].

A 55-year-old woman who underwent implantation of a 27 mm Omniscience valve in mitral position 5 and a half years ago, consulted our institution complaining reappearance of signs of mitral stenosis. In preoperative examinations, the maximal opening angle of the Omniscience valve was only 32 degrees and PCWP was elevated to 20 mmHg. Her symptoms disappeared after mitral valve re-replacement with a Medtronic Hall 27 mm prosthesis. The important point is that no foreign body such as thrombus or overgrown pannus interfering motion of the Omniscience valve was observed at the time of reoperation. The cause of insufficient opening seemed to be valve mechanism itself.

[A case of bilateral atrial myxoma].

A case of 47-year-old female who underwent the surgery for the bilateral atrial myxoma two times was reported. At the first operation both tumors were attached to the same level of the atrial septum and were removed simultaneously followed by the resection of the left atrial wall. Six months later, she complained of dyspnea and easy fatigability for the recurrence of the tumor. She was operated again for the removal of the tumor. But she died of the re-recurrence of the tumor 4 months after the second operation.

Frequency-modulation spectroscopy of rubidium atoms with an AlGaAs diode laser.

Frequency-modulation (FM) spectroscopy has been performed on the D(2) transitions of rubidium atoms with an AlGaAs diode laser at 780 nm. Doppler-broadened hyperfine-structure transitions of (85)Rb and (87)Rb were resolved with no residual amplitude-modulation-induced background signal by modulating the injection current of the laser diode at a low frequency (20-50 MHz) compared with the Doppler width. To obtain Doppler-free spectra, we combined FM spectroscopy with saturation spectroscopy. The results show that the FM spectroscopy technique is sensitive and should be useful for high-resolution spectroscopy, although the resolution was instrument limited and unusual double peaks were observed.