A 32-year-old woman was referred to our hospital during the 35th week of pregnancy because of chest pain and dyspnea. The cesarean section was performed and a healthy infant was delivered. On the 16th hospital day, she developed heart failure. Echocardiograms revealed protrusion of the mitral valve into the left atrium in systole, vegetation and worsening of mitral regurgitation. CT showed splenic infarction. Mitral valve replacement was performed after inflammatory findings were improved by antibiotics. We reported here a case of infective endocarditis during the perinatal period.

We treated six patients with torsade de pointes (TdP) initiated by the prolonged QT interval in our hospital over the past five years. All the patients were on antiarrhythmic therapy ; one received procainamide, one received aprindine, one received pirmenol and the remaining three patients received disopyramide. In three of the six patients, the serum drug levels were within or below the therapeutic range. Three patients had hypokalemia as another precipitating factor. Two patients developed TdP after a long-term administration of the drugs. Great care must be exercised just in case TdP showed be developed by a conbination of precipitating factors even after the long-term administration of these antiarrhythmic drugs.

A 56- year-old woman visited our hospital complaining of right hypochondralgia. X-ray and endoscopic examinations revealed Borrmann 2 type gastric cancer in the anterior wall of an upper part of the stomach. Ultrasonography showed an echogenic mass in the suprarenal area. The mass which had septal formation within it, was about the same in density as fat on computerized tomography, and was hypovascular fed by the right inferior adrenal artery on angiography. These findings suggested that the mass might be adrenal myelolipoma. After total gastrectomy and right adrenectomy were done, histopathological study confirmed that the case is adrenal myelolipoma associated with Borrmann 2 type gastric cancer. In Japanese literature, only 54 cases of surgically resected adrenal myelolipoma have been reported, and this is the second case of adrenal myelolipoma associated with gastric cancer.