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We report a case of angiosarcoma of the right atrium presenting superior vena cava syndrome. The patient was a 61-year-old man. Echocardiography, CT and MRI revealed a tumor arising in the anterior wall of the right atrium. The tumor was hen-egg sized and unresectable because of the invasion of the pericardium, the right ventricular wall and the superior vena cava. An open biopsy and left brachiocephalic vein-right atrium bypass grafting were performed. The pathological diagnosis was angiosarcoma. The patient agreed to chemotherapy with docetaxel, which is known to be often effective against angiosarcoma of the scalp or face. After 5 courses of docetaxel administration (30 mg/m2 on day 1, 8 and 15 followed by 14 days. rest as one course), echocardiography and CT showed a remarkable tumor reduction, which was evaluated as a partial response. The chemotherapy was suspended for 8 months because of neutropenia and general fatigue as side effects of docetaxel. The administration of docetaxel was resumed and 4 courses were performed. The tumor, however, became resistant to docetaxel and formed metastatic involvements in the liver. Following treatments with paclitaxel, IL-2 and CPT-11 were ineffective for the primary tumor and liver metastases. He died of cardiac tamponade caused by massive hemorrhage into the pericardiac space from the tumor surface. He had long-term survival 31 months after the diagnosis. An effective treatment for cardiac angiosarcoma has not yet been established. Chemotherapy with docetaxel should be considered in the treatment of patients with cardiac angiosarcoma.

The case of a 57-year-old man, who had a brother suddenly died at 62 years of age, admitted to other hospital with palpitation. Because his Holter ECG showed non-sustained ventricular tachycardia, and ultrasound cardiography showed left ventricular hypertrophy with normal cardiac function, he was introduced to our hospital for further cardiac examination of hypertrophic cardiomyopathy. Although his coronary angiography showed no organic stenosis, and his magnetic resonance imaging demonstrated asymmetrical septal hypertrophy and delayed enhancement on inferolateral wall of left ventricle compatible with hypertrophic cardiomyopathy, his biopsied tissue from cardiac muscle revealed cardiac Fabry disease. He received enzyme replacement therapy after implantation of implantable cardioverter defibrillator (ICD) for primary prevention. After 7 months from implantation, he had an appropriate ICD therapy for sustained ventricular tachycardia. Primary prevention of ICD implantation for patients with Fabry disease has not been established, while some cases of cardiac Fabry disease show fatal ventricular tachyarrhythmia in their lives. Primary prevention of ICD could be a considerable therapeutic option in some patients with cardiac Fabry disease, especially who demonstrated a family history of sudden death or ventricular tachyarrhythmias.

A 69-year-old man with effort angina was admitted to our institution. Echocardiography showed poor left ventricular systolic function with akinesis of the anterior wall and severe hypokinesis of the inferior wall. We performed coronary angiography, which revealed two diseased vessels including chronic total occlusion in the left anterior descending artery and severe stenosis in the right coronary artery (RCA). In addition, aortography revealed aortoiliac occlusive disease known as Leriche syndrome. As the patient's symptom was stable, we first planned to perform endovascular therapy (EVT) for Leriche syndrome to make a route for intra-aortic balloon pumping. We prepared a bi-directional approach from bi-femoral arteries and a left brachial artery. The guidewire was passed through the occlusive area using the retrograde approach. The self-expanding stents were deployed by a kissing technique. At one week after EVT, a 6Fr sheath was inserted from the right radial artery and an intra-aortic balloon pump was successfully inserted through the right femoral artery for percutaneous coronary intervention (PCI) to the RCA. Two drug-eluting stents were successfully deployed to RCA after using an atherectomy device (rotablator). We reported the case as a successfully performed PCI to the RCA after EVT for Leriche syndrome.

YAMBE, T., NITTA, S., CHIBA, S., SAIJOH, Y., NAGANUMA, S., AKIHO, H., KAKINUMA, Y., IZUTSU, K., KIKUCHI, Y., NAGANUMA, T., SUGAWARA, S., TANAKA, M., MEGURO, T., SASAKI, H., MITSUOKA, M., TERASAWA, Y., NITTA, K., KATAHIRA, Y., OHTOMO, T., ENDOH, N., TAKEDA, H., SONOBE, T., TAKAHASHI, K., MIURA, M., SATO, N. and MOHRI, H. Silent Obstruction of the Coronary Stenosis between Diagnostic Angiography and Later Percutaneous Transluminal Coronary Angioplasty without Myocardial Infarction. Tohoku J. Exp. Med., 1991, 163 (3), 167-174 - Among 204 patients with severe coronary artery senosis amenable to percutaneous transluminal coronary angioplasty (PTCA), 5 (2.5%) developed new silent total coronary occlusion of the vessel to be dilated without any chest symptom during the period between diagnostic coronary angiography and repeat coronary angiography at the time of the operation. We evaluated the clinical and angiographical characteristics of the patients with silent obstruction of the coronary artery in a short time, compared with the patients with unstable angina pectoris, who is considered to be suffering from acute myocardial infarction with severe chest symptom. None of the clinical variables studied showed a significant difference between the two groups. Among the angiographic variables, the degree of collateral was higher and impaired coronary perfusion distal to the lesion was more frequently found in unstable angina group. These results suggest that unstable angina is in a later stage of the ischemic heart disease compared with the time of the diagnostic angiography in patients with silent obstruction. Silent obstruction of high degree coronary stenosis is presumably due to the development of collateral circulation.

The H2SO4–H2O2–H2O system, typically a solution with five parts H2SO4, one part H2O2 and one part H2O in volume ratio, is currently used for chemical polishing of a GaAs crystal to obtain microscopically smooth surfaces. However, the etching of the (111)Ga surface in this etchant leads to the formation of etch pits. In this study, the etching behavior of the (111)Ga surface in various compositions of the H2SO4–H2O2–H2O system at temperatures of 0–70°C is mainly re-examined. It is found that a microscopically smooth {111} surface can be obtained by etching in the solutions with 78+x parts H2SO4, two parts H2O2 and 20-x parts H2O (x=0–4) at 70°C. In contrast, dark and light pits are formed on the (111)Ga surface etched in a solution with two parts H2SO4, one part H2O2 and seven parts H2O at 0°C. Their origin is predicted on the basis of double-etching test results.

A thin-film sample of Al–Pd–Mn ternary alloy has been produced by a vacuum deposition technique using dual evaporation sources, followed by thermal annealing. The microstructure of the film has been examined by transmission electron microscopy (TEM) and by atomic force microscopy (AFM). The TEM observations reveal that the film has a granular texture of highly ordered icosahedral phase islands embedded in the matrix consisting mainly of multiple-twinned crystals exhibiting a pseudo-tenfold symmetry. It is shown by AFM that the icosahedral islands form protuberant structures with the average height of approximately 50 nm.

For visualizing blood flow in the human heart noninvasively, the stream‐function method based on the ultrasonic Doppler technique was introduced. In this method intracardiac blood flow is displayed as a two‐dimensional streamline distribution pattern. In normal hearts, blood flow in the left ventricle during systole is displayed as a fan‐shaped streamline pattern converging from the whole ventricular wall toward the outflow tract, and in diastole the streamline distribution shows fan‐shaped divergence from the left atrium toward the whole ventricular wall. The fan‐shaped streamline distribution is considered to reflect the uniform contractability and extensibility in the whole ventricular wall. On the other hand, in infarcted hearts with regional asynergy in the left ventricle, the streamline pattern is remarkably different. In systole, the streamline pattern at the normokinetic portion is the same as that in normals, but in the infarcted portion, the streamlines show a crooked pattern caused by the inflo...

In-situ electron microscopy of the melt growth of Bi (111) films of purity 99.9 and 99.9999% was performed. The film was partially melted and regrown in the presence and in the absence of a small temperature oscillation at a cooling rate of 8.3×10 -3 to 2.7×10 -1 K/s, and the dynamic behavior of growing interface and crystal defect was observed. The growing interface was smoothly curved more frequently than faceted in any growth condition. When a small temperature oscillation was imposed on cooling, the curved interface showed a back-and-forth advancement, while the faceted interface moved stepwise or steadily without back-melting. When the oscillation was absent, both the interfaces moved nearly steadily

La dissolution des sites en bords de dislocations sur la surface (111) de monocristaux de cuivre a ete etudiee en fonction de la concentration de l'inhibiteur NH 4 Br dans le reactif de Young. L'epaisseur dissoute de la surface a ete mesuree par interferometrie et la largeur et la profondeur des piqures d'attaque formees ont ete mesurees par microscopie electronique

SummaryUsing echo-dynamography, systolic blood flow structure in the ascending aorta and aortic arch was investigated in 10 healthy volunteers. The blood flow structure was analyzed based on the two-dimensional (2D) and 1D velocity vector distributions, changing acceleration of flow direction (CAFD), vorticity distribution, and Doppler pressure distribution. To justify the results obtained in humans, in vitro experiments were done using straight and curved tube models of 20mm diameter.The distribution of the CAFD showed a spiral staircase pattern along the flow axis line. In addition, the changes in the velocity profile in the short-axis direction, 2D distribution of the vorticity, and velocity vector distribution on the aortic cross-section plane, all confirmed the presence of systolic twisted spiral flow rotating clockwise toward the peripheral part of the ascending aorta.The rotation cycle of this spiral flow correlated inversely with the maximum velocity of the aortic flow, so that this cycle was shorter in early systole and longer in late systole. The model experiments showed similar results.The spiral flow seemed to be produced by several factors: (i) anterior shift of the direction of ejected blood flow due to the anterior displacement of the projection of the aorta; (ii) accelerated high pressure flow ejected antero-upward; (iii) inertia resistance at the peripheral boundary of the sinus of Valsalva; and (iv) reflection caused by the concave spherical structure of the inner surface of the basal part of the aorta.Because the main spiral flow axis line nearly coincided with the center line of the aorta, it is concluded that the occurrence of the spiral flow plays an important role in maintaining the blood flow direction passing through the cylindrical curved aortic arch and thus in keeping the most effective ejection as well as in dispersing the shear stress in the aortic wall.