Choonpa Igaku
Online ISSN : 1881-9311
Print ISSN : 1346-1176
ISSN-L : 1346-1176
Advance online publication
Displaying 1-4 of 4 articles from this issue
  • Atsushi TAMURA, Miyu SUGIMOTO, Keikoku KASHO, Yusuke OKUYAMA, Shunzo M ...
    Article ID: JJMU.A.250
    Published: 2024
    Advance online publication: March 29, 2024
    JOURNAL RESTRICTED ACCESS ADVANCE PUBLICATION

    Cor triatriatum (CT) is a rare congenital heart disease (CHD) that accounts for about 0.1-0.4% of CHD cases. It causes various clinical symptoms due to an abnormal septum in the right or left atrium. Atrial fibrillation occurs in about 30% of all CT patients. We describe a case of an adult male who presented with symptomatic CT sinister. He had paroxysmal atrial fibrillation, and he was incidentally diagnosed with CT sinister based on transesophageal echocardiography performed for preoperative workup for catheter ablation. In patients with CT, other CHDs such as partial anomalous pulmonary venous connection or atrial septal defect often coexist. In addition, the abnormal septum may cause obstruction of catheter passage. We carefully considered whether extensive encircling pulmonary vein isolation (EEPVI) could be safely performed. He had no other CHDs, and his abnormal septum was located in the lower atrial septum. Thus, we performed EEPVI without complication using intracardiac echocardiography for transseptal puncture. It is important to consider whether catheter ablation can be safely performed using various modalities. We described a case of CT with paroxysmal atrial fibrillation.

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  • Tadashi YAMAGUCHI
    Article ID: JJMU.R.245
    Published: 2024
    Advance online publication: March 12, 2024
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    Although ultrasound has long been applied in a wide range of clinical fields, there are hardware limitations in acquiring physical information from actual wave propagation in the human body, and the complexity of biological tissues also affects the echo image rendered, which can cause a discrepancy between theoretical ideas and diagnostic indicators. To overcome this problem, much research on quantitative ultrasound and tissue characterization has been pursued, and several technologies have been put into practical use in recent years. In addition, fusion technologies of ultrasound and other medical imaging modalities are also in practical use, and it is expected that use of multimodality diagnostic and therapeutic aid technologies will become more widespread in the future.

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  • Tomoyuki SATO
    Article ID: JJMU.R.247
    Published: 2024
    Advance online publication: March 11, 2024
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    Echocardiography is often used to assess congenital heart diseases in children. Specific knowledge of pediatric echocardiography is essential to avoid pitfalls because the points of assessment differ from those in adult echocardiography. This review focuses on 1) indications for pediatric echocardiography, 2) assessment of pediatric echocardiography, and 3) echocardiographic findings that can lead to pitfalls. Cardiac murmur is a major indication for pediatric echocardiography. First, it is important to approach the examination assuming cardiac disease as the possible cause based on the nature and location of the murmur. Second, it is necessary to confirm the structure of the heart via sequential segmental analysis, especially in the initial echocardiography, because congenital heart disease is often assessed in children. The subcostal cross-sectional sweep view with an upside-down image is useful for assessing the structures of the heart and the connections between the cardiac segments in children. Third, this review provides typical examples of echocardiographic findings that are likely to be pitfalls in pediatric echocardiography. However, this review alone does not provide sufficient knowledge to avoid all pitfalls because there are many variations in pediatric echocardiography. Thus, the confirmation of each undefined echocardiographic finding by a pediatric cardiologist or experienced sonographer is critical for avoiding pitfalls in pediatric echocardiography.

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  • Hiroaki SHIMA, Yuta KONDO, Fukino SATOMI, Goro KUTOMI, Ichiro TAKEMASA
    Article ID: JJMU.R.246
    Published: 2024
    Advance online publication: March 08, 2024
    JOURNAL RESTRICTED ACCESS ADVANCE PUBLICATION

    In this section, we describe the flow of examinations for diagnosis of breast cancer, including close examination leading to surgery, and evaluation of the extent of the breast cancer immediately before surgery. Also discussed is the methodology of ultrasonography tools, especially in contrast-enhanced ultrasound. It is well known that Sonazoid, a second-generation ultrasound contrast agent used in contrast-enhanced ultrasound, is a pure intravascular contrast agent that does not leak out of blood vessels, unlike the water-soluble contrast agents used in CT and breast MRI examinations. Therefore, it can be expected to provide detailed blood flow information and has in recent years been commonly applied in modern clinical practice. In general, after a definitive histological breast cancer is diagnosed, its extent is comprehensively assessed based on the results of mammography, ultrasonography (including elastography and color Doppler imaging), and breast MRI. Second-look US is performed for lesions found during this process, and a qualitative diagnosis is made on an individual basis. Based on these factors, a comprehensive evaluation is made to determine the surgical options. If a partial resection is selected along with the surgical technique, the evaluation of extent is important to determine the extent of resection. We describe the significance of each modality, as well as the role of contrast-enhanced ultrasound and what determines its significance. Finally, we will discuss actual cases and the specific processes leading up to surgery.

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