[Coronary artery bypass grafting for unstable angina pectoris with aortitis syndrome; report of a case].

A 78-year-old male with aortitis syndrome was referred to our hospital for the treatment of unstable angina pectoris with ischemic mitral regurgitation, which was diagnosed by transthoracic echocardiography and coronary artery angiography. Computed tomography showed segmental wall thickness of thoracic and abdominal aorta He underwent an emergent coronary artery bypass grafting. The postoperative course was uneventful without any neurological complications. Postoperative echocardiogram and coronary artery angiography showed good mitral valve function and all patent bypass grafts. He was discharged 33 days after surgery. At 26 months after surgery, he is well without limitation of daily activities and any evidence of myocardial ischemia.

[Surgery for multiple aortic aneurysms with unstable angina pectoris; report of a case].

A 77-year-old female with unstable angina pectoris was referred to our hospital for further evaluation of multiple aortic aneurysms. Computed tomography showed descending thoracic (65 mm), thoracoabdominal (40 mm) and infra-renal abdominal aneurysm (50 mm). Initially, this patient underwent off pump coronary revascularization. On 11 days after initial surgery, descending thoracic aneurysm ruptured, followed by emergent descending thoracic and thoraco-abdominal aneurysm repair. Two months later from this aortic repair, this patient successfully underwent abdominal aortic aneurysm repair. At 3 years and 7th month after the last operation, she is well without limitation of daily activities and any evidence of myocardial ischemia.

[On pump beating heart mitral valve repair without aortic cross-clamp for low ejection fraction ischemic mitral regurgitation after coronary artery bypass grafting; report of a case].

A 59-year-old male with congestive heart failure caused by impaired left ventricular function after coronary artery bypass grafting (CABG) was referred to our hospital, and massive ischemic mitral regurgitation was detected by echocardiography. This patient underwent on-pump beating-heart mitral valve repair without aortic cross-clamp successfully through right thoracotomy. Postoperative echocardiography revealed no mitral regurgitation. The patient recovered uneventfully and was discharged on the 17th postoperative day. At 6th month after the operation, he is well without mitral regurgitation.

[Mitral valve repair with anterior leaflet augmentation for rheumatic mitral valve disease].

A 74-year-old male with congestive heart failure was referred to our hospital, and massive mitral regurgitation as well as aortic stenosis and regurgitation were detected by echocardiography. His mitral valve was successfully repaired with anterior leaflet augmentation with the equine pericardial patch followed by aortic valve replacement. Postoperative transthoracic Doppler echocardiography revealed no mitral regurgitation. The patient recovered uneventfully and was discharged on the 19th postoperative day. At 2 years and 2nd month after the operation, he is well without limitation of daily activities and any evidence of mitral regurgitation.

Effect of high-altitude exposure on myopic laser in situ keratomileusis.

PURPOSE: To study the effect of high-altitude exposure on visual acuity after myopic laser in situ keratomileusis (LASIK). SETTING: Aconcagua, Mendoza, Argentina. METHODS: In the early postoperative period after uneventful myopic LASIK, 2 physicians prospectively assessed their visual acuity during an ascent of Aconcagua (22841 feet). The distance uncorrected visual acuity (UCVA) and peripheral oxygenation were measured at approximately every 2000 feet of altitude. RESULTS: Both climbers developed a moderate loss of distance UCVA but described normal near and pinhole acuity consistent with a myopic shift. The distance UCVA diminished to 20/100 in the right eye and 20/125 in the left eye of Climber A and to 20/160 and 20/30, respectively, of Climber B. The vision loss worsened with increased altitude, duration of exposure, and decreased peripheral oxygenation. One week after the climb, the manifest refraction demonstrated a small myopic shift in both eyes of Climber A; these subsequently resolved. CONCLUSIONS: Two climbers, 8 and 14 weeks after myopic LASIK, experienced vision loss consistent with a temporary myopic shift in the refractive error with ascent to high altitude. Climbers who have LASIK, particularly those in the early postoperative period, should be prepared for visual acuity fluctuations with high-altitude exposure.

Inhaled nitric oxide improves survival in the rat model of high-altitude pulmonary edema.

OBJECTIVES: High-altitude pulmonary edema (HAPE) afflicts certain individuals after a rapid gain in elevation. Those susceptible demonstrate an exaggerated hypoxic pulmonary vasoconstrictive response. This causes pulmonary hypertension, which may disrupt vascular integrity. This experiment was designed to test whether inhaled nitric oxide would affect development of HAPE in a rat model. METHODS: Subjects were exposed in a hypobaric chamber to a simulated altitude of 6200 m (barometric pressure = 380 mm Hg, fraction of inspired oxygen = 0.19) for 24 hours. Control animals (n = 48) spontaneously breathed a mixture of 90% room air and 10% nitrogen, whereas the nitric oxide group (n = 48) received a similar mixture containing 83 ppm nitric oxide. Postmortem examination of lungs was performed for light microscopy, total hemoglobin, and gravimetric estimates of water content. RESULTS: Mortality was 39.5% (n = 19) in control animals and 6.2% (n = 3) in the nitric oxide group (P < .001). Both groups significantly increased their lung weight-body weight ratio. Percentage of lung water was similar in both groups despite increases in lung weight, which is consistent with the protein-rich edema characteristic of HAPE. Light microscopic examination of survivors' lungs in both groups revealed scattered alveolar hemorrhage. No significant cellular inflammatory response was present. CONCLUSIONS: We conclude that inhaled nitric oxide improves survival in the rat model of HAPE.

Rapid fluctuations in sea level recorded at huon peninsula during the penultimate deglaciation

About 140,000 years ago, the breakup of large continental ice sheets initiated the Last Interglacial period. Sea level rose and peaked around 135,000 years ago about 14 meters below present levels. A record of Last Interglacial sea levels between 116,000 years to 136, 000 years ago is preserved at reef VII of the uplifted coral terraces of Huon Peninsula in Papua New Guinea. However, corals from a cave situated about 90 meters below the crest of reef VII are 130, 000 +/- 2000 years old and appear to have grown in conditions that were 6 degreesC cooler than those at present. These observations imply a drop in sea level of 60 to 80 meters. After 130,000 years, sea level began rising again in response to the major insolation maximum at 126,000 to 128,000 years ago. The early (about 140,000 years ago) start of the penultimate deglaciation, well before the peak in insolation, is consistent with the Devils Hole chronology.

Coral record of equatorial sea-surface temperatures during the penultimate deglaciation at huon peninsula

Uplifted coral terraces at Huon Peninsula, Papua New Guinea, preserve a record of sea level, sea-surface temperature, and salinity from the penultimate deglaciation. Remnants have been found of a shallow-water reef that formed during a pause, similar to the Younger Dryas, in the penultimate deglaciation at 130,000 +/- 2000 years ago, when sea level was 60 to 80 meters lower than it is today. Porites coral, which grew during this period, has oxygen isotopic values and strontium/calcium ratios that indicate that sea-surface temperatures were much cooler (22 degrees +/- 2 degreesC) than either Last Interglacial or present-day tropical temperatures (29 degrees +/- 1 degreesC). These observations provide further evidence for a major cooling of the equatorial western Pacific followed by an extremely rapid rise in sea level during the latter stages of Termination II.

Clinical manifestations of Japanese cedar pollinosis: an epidemiological study.

In an investigation of the clinical features of Japanese cedar pollinosis in Toyama Prefecture, Central Japan, an epidemiological study was carried out in 1991 by means of questionnaires. There were 1,720 female and 1,163 male patients, a total of 2,883 patients. In both female and male patients, the highest incidence was found in those in their thirties. The most frequent onset was 19th March 1991, when the maximum number of air-borne pollen was detected and also the highest temperature in March was recorded. The 236 patients in the children's group ranged in age from 5 to 15 years, and the number of male children was greater than that of female. The number of patients tended to increase only gradually up to the age of 11 years, and then rapidly from 12 to 15 years of age. The greatest number of patients developed symptoms at the age of 10 years. HD-RAST positivity was definitely higher in the children group than in the adult group. No significant association was found between the age of development of symptoms and HD-RAST positivity.

Squamous cell carcinoma of the oral cavity consisting of band-like nests.

Four squamous cell carcinomas of the oral cavity shared common histological and clinical characteristics. The primary lesion was situated at the floor of the mouth or the tongue. The cancer cell nests were band-like. The border between nests and stroma was smooth and distinct, with the continuity of the basement membrane being well maintained. The response to preoperative chemoradiotherapy was relatively poor. Although the lesion was locally advanced, no cervical metastasis was detected. No recurrence has occurred after the operation.

A case of Bickerstaff's encephalitis. With special reference to neurotological findings.

The case of a 60-year old male with prodromal common cold symptoms and progression of brain stem involvement with no cardiac or respiratory complications is described. This conformed to the criteria of Bickerstaff's encephalitis. Neurotological examinations, including the OKN test, the caloric test, and the GBST were performed from onset to recovery of the disease. The results of these tests closely reflected the central nervous system disorders each time, but there was a discrepancy in the results of the two test batteries of equilibrium function, the caloric test and the GBST. The caloric test showed bilateral canal paresis while the GBST showed normal responses. These results suggested that the involved area of the vestibular nucleus was localized to the superior portions. Form our clinical observations, we can conclude that neurotological examinations provide more vital information for localized diagnosis and follow-up of the brain stem lesion in Bickerstaff's encephalitis.

Bi-directional transmission of molecular information by photon or electron beams passing in the close vicinity of specific molecules, and its clinical and basic research applications: 1) Diagnosis of humans or animal patients without any direct contact; 2) Light microscopic and electron microscopic localization of neuro-transmitters, heavy metals, Oncogen C-fos (AB2), etc. of intracellular fine structures of normal and abnormal single cells using light or electro-microscopic indirect Bi-Digital O-Ring Test.

In 1985, Omura, Y. discovered that, when specific molecules were placed anywhere in the close vicinity of the path of a light beam (laser), their molecular information, as well as information on electrical & magnetic fields, is transmitted bi-directionally along the path of this light beam. Namely, this information is transmitted in the direction the light beam is projected and towards the direction from which the light beam is coming. This finding was applied to the following clinical and basic research: 1) In the past, using indirect Bi-Digital O-Ring Test, human or animal patients were diagnosed through an intermediate third person holding a good electrical conducting probe, the tip of which was touching the part of the patient to be examined. However, in order to diagnose the patient in isolation from a distance, or a dangerous or unmanagable unanesthesized animal, such as a lion or tiger, the author succeeded in making a diagnosis by replacing the metal conducting probe with a soft laser beam which is held by the one hand of the third person whose index finger is placed in close vicinity of the laser beam generated by a battery-powered penlight-type solid state laser generator. Thus, diagnosis within visible distance, without direct patient contact, became a reality. 2) Using a projection light microscope, by giving indirect Bi-Digital O-Ring Test while contacting with a fine electro-conductive probe on the magnified fine structure of normal and abnormal cells, various normal and abnormal intracellular substances were localized through a third person holding a pure reference control substance with the same hand that is holding the probe as an intermediary for the indirect Bi-Digital O-Ring Test. Instead of the photon beam in a light microscope, the author found that, using an electron beam passing through the close vicinity of specific molecules of specimens in an electron microscope, the molecular information is transmitted to the magnified fluorescent screen, and an indirect Bi-Digital O-Ring Test could be performed through a projected penlight-type solid state soft laser beam on the magnified intracellular structure through an observation glass window. Using the magnified fine structure of the cells, by either a light projection microscopic field or electron microscope, in various cancer cells of both humans and animals, Oncogen C-fos (AB2) and mercury were found inside of the nucleus. Integrin alpha 5 beta 1 was found on cell membranes and nuclear cell membranes of cancer cells. Acetylcholine was not found anywhere within cancer cells.(ABSTRACT TRUNCATED AT 400 WORDS)

Common factors contributing to intractable pain and medical problems with insufficient drug uptake in areas to be treated, and their pathogenesis and treatment: Part I. Combined use of medication with acupuncture, (+) Qi gong energy-stored material, soft laser or electrical stimulation.

Most frequently encountered causes of intractable pain and intractable medical problems, including headache, post-herpetic neuralgia, tinnitus with hearing difficulty, brachial essential hypertension, cephalic hypertension and hypotension, arrhythmia, stroke, osteo-arthritis, Minamata disease, Alzheimer's disease and neuromuscular problems, such as Amyotrophic Lateral Sclerosis, and cancer are often found to be due to co-existence of 1) viral or bacterial infection, 2) localized microcirculatory disturbances, 3) localized deposits of heavy metals, such as lead or mercury, in affected areas of the body, 4) with or without additional harmful environmental electro-magnetic or electric fields from household electrical devices in close vicinity, which create microcirculatory disturbances and reduced acetylcholine. The main reason why medications known to be effective prove ineffective with intractable medical problems, the authors found, is that even effective medications often cannot reach these affected areas in sufficient therapeutic doses, even though the medications can reach the normal parts of the body and result in side effects when doses are excessive. These conditions are often difficult to treat or may be considered incurable in both Western and Oriental medicine. As solutions to these problems, the authors found some of the following methods can improve circulation and selectively enhance drug uptake: 1) Acupuncture, 2) Low pulse repetition rate electrical stimulation (1-2 pulses/second), 3) (+) Qi Gong energy, 4) Soft lasers using Ga-As diode laser or He-Ne gas laser, 5) Certain electro-magnetic fields or rapidly changing or moving electric or magnetic fields, 6) Heat or moxibustion, 7) Individually selected Calcium Channel Blockers, 8) Individually selected Oriental herb medicines known to reduce or eliminate circulatory disturbances. Each method has advantages and limitations and therefore the individually optimal method has to be selected. Applications of (+) Qi Gong energy stored paper or cloth every 4 hours, along with effective medications, were often found to be effective, as Qigongnized materials can often be used repeatedly, as long as they are not exposed to rapidly changing electric, magnetic or electro-magnetic fields. Application of (+) Qi Gong energy-stored paper or cloth, soft laser or changing electric field for 30-60 seconds on the area above the medulla oblongata, vertebral arteries or endocrine representation area at the tail of pancreas reduced or eliminated microcirculatory disturbances and enhanced drug uptake.(ABSTRACT TRUNCATED AT 400 WORDS)

Chronic or intractable medical problems associated with prolonged exposure to unsuspected harmful environmental electric, magnetic or electro-magnetic fields radiating in the bedroom or workplace and their exacerbation by intake of harmful light and heavy metals from common sources.

Unsuspected prolonged exposure to abnormal environmental (very high frequency) electro-magnetic fields (EMF), electric fields (EF) or magnetic fields (MF) at 60 Hz or 16K Hz in the bedroom or workplace may contribute to the development of various intractable medical problems. Most of the clinical symptoms appear when the individuals are exposed to EMF for many hours a day for at least several months to 1-year for relatively benign diseases or symptoms (such as intractable pain or medical problems), or several to over 10 years for more serious diseases (such as cancers of the digestive system or other organs), all of which seem to appear with the additional co-existence of micro-circulatory disturbances with Thromboxane B2 (TXB2), bacterial or viral infections and decrease or absence of acetylcholine, and lead, mercury, or aluminum deposits, with or without asbestos. These abnormal environmental EMF's or EF's can be detected by the Bi-Digital O-Ring Test, which has good correlation with standard laboratory measurement, especially with EF measurement, and the distribution of EMF often includes a linear band-like appearance on the abnormal part of the patient's body, as well as on the patient's corresponding area of the bed, or at the workplace. These EMF's can be eliminated either by a metal sheet, acting as a reflector, which redirects the harmful EMF or eliminates it completely by grounding the metal sheet at high frequency range, while extremely low frequency (ELF) magnetic fields at the near field are more difficult to eliminate. Several examples of medical problems that appear to be associated with repeated and prolonged exposure to abnormal environmental EMF, EF or MF are summarized in this article. EF or MF-induced abnormalities were artificially and reversibly created in humans by exposing the extremities or head to a 10Volt/Meter (V/M) EF at 60 Hz about 33 (evening) to 50 cm (daytime or after midnight) from a pair of rubber insulated wires connected to an AC source, but where no current is passed, so that no extra MF exists. After exposing normal parts of the extremities and head to a 10 V/M EF for 5 minutes, abnormal increase of TXB2 and disappearance or significant reduction of acetylcholine was observed for 5 minutes, and slightly longer abnormal time duration was observed in those who have aluminum, lead, or mercury deposits. This indicates that the upper limit of relatively safe EF should be around 10V/M at 60 Hz rather than 25V/M at ELF by Swedish Government recommendation, which is now widely accepted.(ABSTRACT TRUNCATED AT 400 WORDS)