A CASE OF ATRIAL SEPTAL DEFECT WITH PULMONARY HYPERTENSION COMPLICATED WITH ACUTE MYOCARDIAL INFARCTION

We describe a patient with pulmonary hypertension associated with an atrial septal defect (ASD) who suffered an acute myocardial infarction. The patient, 70-year-old man, was admitted to our hospital after developing chest pain. He had een diagnosed as having an ASD at the age of 69. From the electrocardiogram obtainedon admission, acute myocardial infarction was suspected. Coronary anglography revealed total obstruction of the left anterior descending coronary artery, which was successfully treated by percutaneous transluminal coronary angioplasty(PTCA). Because of repeated heart failure, ASD closure and coronary artery bypass grafting (CABG) were performed in a one-stage operation. After surgery, cardiac function improved. Direct PTCA in the acute phase and ASD closure and CABG in the chronic phase were effective for heart failure in this patient

AN ACCIDENT OF INTERNAL CONTAMINATION WITH PLUTONIUM AND AMERICIUM AT A NUCLEAR FACILITY IN JAPAN: A PRELIMINARY REPORT AND THE POSSIBILITY OF DTPA ADMINISTRATION ADDING TO THE DIAGNOSIS

This article introduces the first accident of internal contamination with plutonium (Pu) or americium (Am) in Japan for which treatment was carried out. An accident of internal contamination with Pu and Am occurred at a Pu research facility at Oarai-town of Ibaraki prefecture in Japan. A plastic bag containing these radionuclides ruptured when five workers were inspecting a storage container in a hood. As a consequence, these workers were internally contaminated with Pu and Am. Although contamination on the body surface was observed in all five workers, a positive nasal swab was detected in only three of them. A chelating agent, calcium diethylenetriaminepenta-acetate (CaDTPA), was administered to all of them including the two workers without a positive nasal swab. However, bioassay detected a significant amount of Pu and Am in urine after administration of DTPA in these two workers, whereas the levels of these nuclides were below minimum detectable levels in urine before the administration. Since the prevalence of adverse reactions in DTPAs is low, the present results suggest that administration of DTPA can be used for the diagnosis of internal contamination even when a nasal swab is negative or contamination around body orifices is not detected