http://hdl.handle.net/10564/1525 1998-08 2026-04-09T03:39:51Z http://hdl.handle.net/10564/463 タイトル: SIGMOID SEPTUM CAUSING AORTIC REGURGITATION 1 A CASE REPORT 著者: Mizuno, Reiko; Dohi, Kazuhiro; Fujimoto, Shinichi; Nakano, Hiroshi 抄録: An 86-year-old woman with a sigmoid septum that caused aortic regurgita- tion (AR) is described. The patient visited our hospital because of dyspnea and leg edema. On auscultation, a characteristic Levine 3/6 diastolic musical murmur was head in Erb's area. A 12-lead electrocardigram showed atrial fibrillation (heart rate=68/min) but no evidence of ischemic change. Chest radiography showed cardiomegaly but no pulmonary congestion. Two-dimensional echocardiography revealed a basal interventricular septum (IVS) markedly protruding into the left ventricular outflow tract (sigmoid septum). The angle formed by the aorta and the IVS (aorto-septal angle) was about 70 degrees. Furthermore, prolapse of the right coronary cusp toward the left ventricle accompanied by paradoxical motion of the basal IVS during diastole was also observed. Color Doppler echocardiography detected a localized and distinct regurgitant jet flow from the right coronary cusp toward the base of the anterior mitral leaflet. According to Seller's classifi- cation, the AR was grade 2. These findings suggest that AR may develop in patients with a sigmoid septum due to prolapse of the right coronary cusp leading to paradoxical motion of the basal lVS. 1998-08-30T15:00:00Z http://hdl.handle.net/10564/462 タイトル: 誘因なく発症した上腸問膜動脈症候群の1例 著者: 池中, 康英; 松下, 和広; 櫻井, 伸也; 諏訪, 好信; 佐藤, 由美子; 松本, 真; 松本, 元嗣; 栗山, 茂樹; 岸田, 秀樹; 東野, 正; 玉川, 泰浩; 岡本, 新悟; 福井, 博 抄録: Superior mesenteric artery (SMA) syndrome is a relatively rare disease, which is caused by the obstruction of the third portion of the duodenum due to extrinsic compression by the SMA and the abdominal aorta. Although anatomical characteristics, such as the acute angle of the SMA to the abdominal aorta and proximity of the SMA to the abdominal aorta, are considered as underlying factors for causing SMA syndrome, most cases occur with predisposing factors such as rapid body weight loss and rapid growth. We recently experienced a case of SMA syndrome that had occurred without any considerable predisposing factors. The patient was a 17-year-old female, who had neither lost weight nor experienced recent increase in height. ' She was also stable psychosomatically and had not been taking a slimming diet. She suddenly started vomiting shortly after meals and lost 4 kg in weight over 10 days. Although gastrointestinal fiberscopy did not show significant findings, upper gastrointestinal X-ray series revealed a sharp cut-off and obstruction to the passage of barium in the third portion of the duodenum. This obstruction was restored in a prone position. Subsequent magnetic resonance images did not show any tumorous lesions in the abdomen, resulting in the diagnosis of SMA syndrome. She recovered from the symptom by taking a prone position after meals. SMA syndrome caused without predispos- ing factors is considered to be a rare case and the related literature is reviewed. 1998-08-30T15:00:00Z http://hdl.handle.net/10564/461 タイトル: 大量の造影剤(Iomeprol)使用後に成人呼吸促迫症候群を発症した急性冠閉塞の1例 著者: 長崎, 宗嗣; 川本, 篤彦; 土肥, 直文; 上村, 史朗; 藤本, 隆; 橋本, 俊雄; 土肥, 和紘 抄録: Adult respiratory distress syndrome (ARDS) developed in a 53-year-old man with recurrent myocardial infarction who underwent percutaneous transluminal coro- nary angioplasty (PTCA) with a large quantity of a nonionic contrast medium, lomeprol. On the following day, a diffuse interstitial shadow was recognized in both lungs on chest x -ray. Investigation revealed severe hypoxemia, diffuse pulmonary infiltrates and no evidence of left ventricular failure, leading to the diagnosis of ARDS. The patient was successfully treated with corticosteroid pulse therapy. The development of ARDS in this case was believed to be due to an excess of Iomeprol. 1998-08-30T15:00:00Z http://hdl.handle.net/10564/460 タイトル: 高度の問質病変を示した糖尿病性腎症の4例 著者: 金内, 雅夫; 西野, 俊彦; 川野, 貴弘; 池田, 祐貴子; 阪口, 江津子; 尾崎, 博基; 井澤, 鉄之; 椎木, 英夫; 土肥, 和紘 抄録: Four male patients with diabetic nephropathy who had no or only mild glomerular lesions but did have severe interstitial lesions are reported. The mean duration of diabetes was 4.3 years. All patients had coronary artery disease and smoked, two had hypertension, and none had diabetic retinopathy. Microalbuminuria was detected in 2 patients, and increases in urinary excretion of β2-microglobulin and/or NAG were obser- ved in 3 patients. Renal biopsy specimens in all 4 patients revealed severe interstitial fibrosis with or without infiltration by mononuclear cells, and arteriolar hyalinosis. Drug -induced nephropathy, pyelonephritis, gouty kidney, hypokalemia and hypercalcemia were excluded. These observations suggested the hypothesis that diabetes mellitus directly affects the development of interstitial lesions associated with ischemic renal injury induced by arterio- and/or arteriolosclerosis. 1998-08-30T15:00:00Z