Nonreentrant supraventricular tachycardia due to double ventricular response via dual atrioventricular nodal pathways

In twenty eight patients with iron deficiency the efficacy of iron-acetil-transferrin treatment (2-3 mg/kg/die) has been evaluated from the changes of the following variables: RBC and reticulocyte count, Hb concentration, MCV, MCH, serum ferritin, serum iron, TIBC, and ZnPP. These variables were assessed before and after three months of treatment in all patients, and after three months from the end of the treatment in thirteen patients. At the end of the treatment there was a significant increase of RBC count, Hb concentration, MCV, MCH, serum ferritin, serum iron, and TIBC, a significant decrease of ZnPP, while reticulocyte count remained essentially unchanged. After three months from the end of the treatment only serum ferritin and ZnPP underwent an additional significant increase and decrease, respectively. In twenty-six patients serum ferritin values returned to normal. The changes of RBC and reticulocyte count, Hb concentration, MCV, serum iron, and TIBC were larger the lower the initial values, suggesting that the efficacy of the treatment is greater the more serious the iron deficiency.     

Cardiac surgery in Jehovah's Witness

Clinical experiences of 35 cardiothoracic operations in Jehovah's Witness patients were presented with special reference to a method of taking informed consent for surgery. At first the surgeon explained the details of the proposed surgery including its risks and benefits. He should also express his confidence in accomplishing the operation without blood transfusion. Otherwise he should not dare to perform the operation. The surgeon asked the patient to talk about his or her religious belief in transfusion denial. Then the surgeon was allowed to talk about his professional duty and ethical belief in saving the patient at all costs. Finally, both the patient and the surgeon would sign the document of informed consent without fully determining whether or not the patient would undergo transfusion at an unexpected situation since the possibility of such unexpected necessity of blood transfusion was believed extremely low by both the surgeon and the patient. The trust of the patient in the technique of the surgeon was the key to this agreement.     

Mitral valve repair through combined left atrial and ventricular approach for congenital mitral stenosis

A 3-year-old boy underwent mitral valve repair for congenital mitral stenosis through combined superior-septal atriotomy and apical left ventriculotomy. The operation was performed safely with excellent exposure of the subvalvular apparatus by the ventricular approach, while sufficient visualization of the valvular lesion was obtained by the atrial approach. Postoperative echocardiography demonstrated normal left-ventricular motion and no residual mitral stenosis.     

Method of improving EM field distribution in a small room with anRF radiator

A method of controlling the field distribution in a room is proposed to improve the electromagnetic (EM) environment in a relatively small room compared to the wavelength of an RF radiator such as a medical treatment device. For this purpose, this paper investigates a method of realizing both a region of weak and strong electric fields in the room by adjusting the material constant of the room or by changing the shape and arrangement of ceiling, walls, etc. This idea is based upon the principle that an electric field concentrates on materials with a large permittivity. The electric field distribution is analyzed using the finite-element method to understand the effects of concentrating the electric field by taking into account many factors as parameters. To examine these in a qualitative investigation, electric field distribution is verified using a reduced-scale model. Further, on the basis of these concepts, a shielded room is constructed. It is clarified that the electric field distribution in the room is effectively controlled using the method proposed     

Pulsatile total cavopulmonary shunt for hypoplastic right heart syndrome with abnormal systemic venous return--a case report

A pulsatile total cavopulmonary shunt was successfully performed on a 5-year-old girl with hypoplastic right heart syndrome associated with abnormal systemic venous return; at the same time, modified mitral valve replacement was performed for mitral regurgitation. The right atrium, tricuspid valve and right ventricle were all extremely dimunitive. The diameter of the tricuspid valve was 50% of normal and the volume of the right ventricle was 8.6% of normal. In addition, there were severe subpumonary stenosis, a restrictive ventricular septal defect (VSD) and an atrial septal defect (ASD). The bilateral superior venae cavae (SVCs) and the hepatic vein drained to the left atrium, and the inferior vena cava was infrahepatically interrupted with a hemiazygos connection to the left superior vena cava. At the operation, each SVC was anastomosed end-to-side to each branch of the pulmonary artery (PA). The restrictive ventricular septal defect and stenotic subpulmonary lesion were left. The diameter of the ASD was reduced from 12 mm to 7 mm. The main PA was neither divided nor banded. The pulsatile blood flow from the left heart to the PA was regurated by a native restrictive VSD and stenotic subpulmonary lesion, and that from the right heart via the ASD was limited by reducing the size of the ASD. These described anatomic arrangements produced adequate antegrade pulsatile flow in the PA, which might prevent the development of pulmonary arteriovenous fistulae and, besides permit transfer of drainage of the hepatic vein from the left to the right atrium via the ASD in future.     

Fundamental investigation on a weakly magnetized ferrite absorber

Investigated are the matching characteristics of a magnetized ferrite absorber, which applies a weakly static magnetic field H_dc perpendicular to the sintered ferrite surface. Applying a static magnetic field to the ferrite enables the matching thickness of the absorber to be reduced from 8 mm in the absence of H_dc to 3 mm under 750 gauss. The matching frequency can also be changed broadly from 0.1 to 0.9 GHz by controlling ferrite thickness and H_dc, simultaneously. These are well explained in terns of an nonsaturated permeability rather than tensor permeability. A thin magnetized ferrite absorber is realized using a ferrite with a large value of imaginary part of permeability when real part takes the value near 1.0. Matching frequency characteristics, whether broad or narrow, correlates closely with the slant of the curve for real part of permeability taking the value near 1.0 in the present frequency