ABSTRACT
A 58-year-old woman visited our hospital with the chief complaint of an abnormal chest shadow. Chest CT showed an 18-mm ground-glass opacity in the right upper lobe, which became enlarged over time, and lung cancer was suspected. At the same time, a tracheal bronchus originating directly from the trachea was observed. She underwent thoracoscopic right upper lobectomy and mediastinal lymph node dissection. During surgery, in addition to the tracheal bronchus, a pulmonary vein variation was seen running dorsal to the pulmonary artery. Her postoperative course was uneventful. Tracheal bronchus is a rare anomaly, with an incidence of 0.1%-5%. Since tracheal bronchus is often accompanied by pulmonary vessel variations and may be associated with repeated previous infections, care should be taken when performing thoracoscopic lung resection.
Subject(s)
Adenocarcinoma, Bronchiolo-Alveolar/surgery , Bronchi/abnormalities , Lung Neoplasms/surgery , Pneumonectomy , Pulmonary Veins/abnormalities , Thoracoscopy , Adenocarcinoma, Bronchiolo-Alveolar/complications , Adenocarcinoma, Bronchiolo-Alveolar/diagnosis , Female , Humans , Lung Neoplasms/complications , Lung Neoplasms/diagnosis , Middle Aged , Pneumonectomy/methodsABSTRACT
We present a case treated with aprindine and metoprolol combined with a DDD type pacemaker for repetitive monomorphic ventricular tachycardia. A 50-year-old man was admitted because of palpitation and near syncope attack. Electrocardiogram showed repetitive monomorphic ventricular tachycardias (RBBB LAD type) and R-R interval of about 440 msec and I degree A-V block in sinus rhythm. Electrophysiologic study disclosed that overdrive pacing in HRA suppressed ventricular tachycardias. Left ventriculography revealed a dilated left ventricular and decreased contractility. Antiarrhythmic agents such as quinidine sulfate, procainamide, disopyramide, mexiletine, lidocaine and propranolol were not effective. But, the combination of propranolol and aprindine decreased the rate of the ventricular tachycardia. With aprindine 60 mg/day and metoprolol 60 mg/day combined with the atrioventricular sequential pacing at 85/min, ventricular tachycardia completely disappeared.
Subject(s)
Aprindine/administration & dosage , Metoprolol/administration & dosage , Tachycardia/therapy , Cardiac Pacing, Artificial , Cardiomyopathy, Hypertrophic/complications , Drug Therapy, Combination , Electrocardiography , Humans , Male , Middle Aged , Recurrence , Tachycardia/diagnosis , Tachycardia/etiologyABSTRACT
We produced experimental isolated right ventricular infarction (RVI) with closed chest method, and examined ECG changes of right precordial leads and changes of cardiac output (C. O) in 19 dogs. As a result, ECG showed ST depressions in leads, II, III, aVF and V2-V6 and ST elevations in a VR lead in all 15 cases of the proximal occlusion of right coronary artery (RCA). In 10 of 15 dogs ST elevations in some right precordial leads occurred, and the sensitivity of ST elevation in single right precordial lead was 60% (V5R), 53% (V4R) and 47% (V3R and V1), respectively for the detection of RVI. When left circumflex artery (LCX) was occluded, ST elevation in V4R lead after RCA occlusion was blocked. Therefore, it is thought that the sensitivity of ST elevation in right precordial lead may be lower than expectation in identifying RVI. Concerning anterior chest leads, none of 15 dogs with RVI showed ST elevations in leads V2-V6 in this study. If ST elevations in right precordial leads did not appear, variation of C.O was small and C.O reduced in proportion to the extension of ST elevations in right precordial leads.
Subject(s)
Electrocardiography , Myocardial Infarction/physiopathology , Animals , Dogs , Heart Ventricles/pathology , Myocardial Infarction/pathologySubject(s)
Atrial Fibrillation/diagnosis , Electrocardiography , Heart Auscultation , Heart Sounds , Heart/diagnostic imaging , Adult , Aged , Echocardiography , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Models, Structural , Radionuclide Imaging , Scintillation Counting/instrumentation , Scintillation Counting/methods , Stroke VolumeABSTRACT
The regurgitant fraction (RF) of aortic regurgitation (AR) was calculated using pulsed Doppler echocardiography (PDE), and the results were compared with those of aortography. Two-dimensional echocardiography (2DE), PDE and cine angiography were performed for 33 patients, including nine in whom aortic regurgitation (AR) was ruled out by contrast 2DE and 24 in whom AR was confirmed by aortography (AOG). The latter were subdivided into six of Sellers' degree I, seven of degree II, eight of degree III and three of degree IV. Sampling was obtained from the main pulmonary artery, the left ventricular outflow tract, and the mean circulation velocity (f1) was calculated from the power spectrum wave pattern obtained from each source. With the following formula, Qp (pulmonary arterial blood flow), Qs (left ventricular ejection blood flow) and RF [= (Qs--Qp)/Qs] were calculated, and compared with the findings obtained from invasive methods: (formula; see text) (L = vascular diameter; theta = angle of incidence; C = velocity of sound; fo = oscillating frequency; ET = ejection time; HR = heart rate) A correlation of r = 0.81 was found between Qp calculated with PDE and right cardiac output (CO) by the thermodilution method. A correlation of r = 0.66 was observed between Qs and left ventricular ejection volume obtained from left ventriculography using Dodge's method. Comparison of RF using Sellers' classification with AOG revealed that the RF in the group uncomplicated with AR was 0.14 +/- 0.10, and Sellers' degrees I, 0.27 +/- 0.08; II, 0.36 +/- 0.04; III, 0.53 +/- 0.05; and IV, 0.64 +/- 0.06, indicating consistency with severity and RF.(ABSTRACT TRUNCATED AT 250 WORDS)
