二重房室伝導経路と潜在性WPW症候群を合併した僧帽弁逸脱の1例

聴診および心エコー図上,僧帽弁逸脱を認め頻拍発作を繰り返す37歳男性例に対して電気生理学的検査が行われた.その結果,二重房室伝導経路と潜在性WPW症候群をあわせもつことが判明した.90～220/分の心室ペーシングにて室房(V-A)伝導時間は一定であった.さらにアトロピン投与後120～240/分の心室ペーシングにても室房伝導時間は一定で,逆行性最早期心房興奮部位は左房(室-左房伝導時間は140msec)であった.多部位心房ペーシングにても顕性pre-excitationはみられなかった.これらの所見から左側副伝導路を逆行性に伝導する経路(concealed WPW)の存在が示唆された.本例における発作性上室性頻拍は,slow AV nodal pathwayを順行性に,左側副伝導路を逆行性に伝導する回帰性頻拍と考えられた.僧帽弁逸脱と2種の異常房室伝導路合併との関係は不明であるが,僧帽弁逸脱例に二重房室伝導経路と潜在性WPW症候群を合わせもつことはまれと思われた.An electrophysiologic study was performed on a 37-year-old male with auscultatory and echocardiographic findings of mitral valve prolapsed (MVP), because of frequent episodes of palpitation with tachycardia. It was found to have dual atrioventricular (AV) nodal pathways as well as the concealed Wolff-Parkinson-White (WPW) syndrome. As a result of atrial extrastimulus testing, a discontinuous AV nodal conduction curve, suggesting dual AV nodal pathways, was obtained. The ventriculoatrial (V-A) interval was constant at ventricular paced rates of 90 to 220 beats/min. In addition, ventricular pacing at a rate of 120 to 240/min after atropine revealed a V-A conduction time identical to that in the control period, and the earliest retrograde atrial activation occurred on left atrial site (LA) with a V-LA interval of 140 msec. Manifest pre-excitation was not demonstrated by means of pacing at multiple atrial sites. These findings suggested the presence of retrograde conduction via only the left-sided accessory pathway (concealed WPW syndrome). In this patient, paroxysmal supraventricular tachycardia was re-entrant arrhythmia utilizing the slow AV nodal pathway for antegrade conduction and the left-sided accessory pathway for retrograde conduction. Although the relationships of MVP and the combination of these two abnormal AV conduction pathways are unknown, this appears to be a rare case of coexistence of the dual AV nodal pathways and the concealed WPW syndrome in a patient with MVP

Contrast-enhanced Computed Tomography-Guided Percutaneous Cryoablation of Renal Cell Carcinoma in a Renal Allograft: First Case in Asia

Nephron-sparing treatment should be offered whenever possible to avoid dialysis in allograph cases. Cryoablation is a new treatment option for treating small-sized renal cell cancer (RCCs). We report a case of RCC arising in a kidney allograft treated by cryoablation. To our knowledge, this is the first case in Asia of RCC in a renal allograft treated using cryoablation. Contrast-enhanced CT-guided percutaneous renal needle biopsy and cryoablation were used to identify the RCC, which could not be identified by other techniques. The postoperative course was uneventful. Contrast-enhanced CT also showed no recurrence or metastases at the 6-month follow-up

レーザーレーダーニヨルセイソウケンエアロゾルノケンキュウ

京都大学0048新制・論文博士理学博士乙第3144号論理博第545号新制||理||237(附属図書館)5144UT51-52-C135(主査)教授 山元 龍三郎, 教授 前田 坦, 教授 中島 暢太郎学位規則第5条第2項該当Kyoto UniversityDA

Laser Radar Monitoring of the Polar Middle Atmosphere

The laser radar system used for the monitoring of the polar middle atmosphere (10km-120km) is discussed. This system can emit laser pulses at three different wavelengths : 694nm, 589nm and 347nm. The laser radar measurements make an important contribution to clarify the behavior of stratospheric aerosols, the formation of stratospheric "Cist", and the interaction between noctilucent cloud particles and charged particles in the lower ionosphere of the polar region

hemispherical emissivity of a fine fibre

Short-hot-wire method for the measurement of tota

DOI:10.1068/htjr069 Accurate measurements of thermal conductivity and thermal diffusivity of molten carbonates

Abstract. Thermal conductivity and thermal diffusivity of molten carbonates (Li 2 CO 3 =K 2 CO 3

Magnetotransport of carbon nanotubes: magnetic-field-induced metal-insulator transition

We have measured magnetotransport of an individual multi-walled carbon nanotube. Though the resistance without magnetic field increases with decreasing temperature (non-metallic) from room temperature down to 2 K, it becomes metallic below 30 K by applying a magnetic field (H ≒ 4 T) perpendicular to the nanotube axis. The transverse magnetoresistance (TMR) below 30 K decreases with increasing magnetic field, and after reaching minimum value around 4 T, it increases. On the other hand, under the intense magnetic field above 6 T the TMR does not show continuous increase but tends to be saturated. The results can be explained by the theoretical prediction of the magnetic-field-induced metal-insulator transition of semiconducting carbon nanotubes