A 6-year-old boy who had been found to have hypertrophic obstructive cardiomyopathy presented with severely limited symptoms of heart failure due to progressive left ventricular outflow obstruction. Cardiac catheterization revealed the peak systolic pressure gradient of 87mmHg at left ventricular outflow, and systolic anterior motion of the anterior mitral leaflet with concomitant mitral regurgitation was observed by echocardiography. Transaortic septal myectomy was performed using transesophageal echocardiography guidance before, during and after surgery. Although the patient needed permanent pacemaker implantation for postoperative complete heart block, the procedure reduced the left ventricular outflow obstruction and relieved his symptoms.

A study was made on and-ATLA antibody among general inhabitants, those with hematologic disease and those with hepatic disease in Nagano Prefecture.
Among 2, 299 inhabitants (990 males and 1, 309 females), anti-ATLA antibody was found to be positive in two males (0.1 %)
The number of patients with hematologic disease was 155. Of them, malignant lymphoma accounted for 50 (T: 24.3 %, B: 37.8 %), acute leukemia 32 and other hematologic malignancy 28. No ATL was found among them. It was revealed that 56 of them underwent transfusion ranging from 2 to 346 units of blood, averaging at 49.7 units. The number of person whose anti-ATLA antibody was positive was one only, who was diagnosed as AML and was transfused 170 units.
Of 42 patients with hepatic disease, HB virus-related liver disease (hepatitis, cirrhosis, hepatocellular carcinoma) accounted for 10, non-B group HBAg (-) for 18, alcoholic liver dysfunction 5 and other hepatic disorders 9. Three out of these 42 patients were found to be positive for anti-ATLA antibody, each three patients belonged to the “non-B” group (3/18, 16.6 %).
The total number of positivist was thus six. Of them, five had a history of transfusion, and all five positivists excluding the one with AML were suffering from hepatic disease with HBAg (-).
From the above, it was considered that in Nagano Prefecture, those whose anti-ATLA antibody was positive were conspicuously small in number, but main cause of the positivity was attributable to the transfusion. Most of the positivists were suffered from non-B hepatic disease with a history of transfusion, and the number of positivist was significantly greater even when compared with patients with hematologic disease with frequent transfusion. Accordingly, it is suggested that some of the hepatic diseases with HBAg (-) might be associated with HTLV.