Cor triatriatum is an uncommon congenital malformation in which the fibromuscular abnormal septum divides the atrium into two compartments. Generally it is used to mean cor triatriatum sinister in which the left atrium is divided into two lumens. In typical cor triatriatum, an abnormal fibromuscular septum divides a proximal chamber that receives the pulmonary vein from a distal chamber that communicates with the left atrial appendage and the mitral valve. Several hypothesis were proposed concerning the mechanism of the abnormal septation of the atrium, but no single hypothesis could explain all the cases convincingly. We report the successful surgical treatment of a 6-month-old male patient with the rare variant of the cor triatriatum with pulmonary hypertension. The left pulmonary vein and superior right pulmonary vein drained into an accessory chamber which opened to the right atrium through a sinus venousus type atrial septum defect. The left inferior pulmonary vein drained into the true lumen which opened to right atrium through the patent foramen ovale.

There were 16 patients who developed acute renal failure (ARF) follwing cardiovascular operation using extracorporeal circulation. They were treated by either CPD or CAVH because their ARF were resistant to medical treatment. These patients were divided into three groups according to their treatment; 7 patients treated by CPD (Group A), 5 patients treated both CPD and CAVH (Group B), 4 patients treated by CAVH (Group C). The survival rate was 33% in Group A, 20% in Group B, and 0% in Group C. The prognosis of the each group was poor. CPD and CAVH were effective to control the concentration of serum potasium and water removing. But CPD and CAVH were not very effective to control the concentrations of serum creatinine and blood urea nitrogen. There were three patients who developed low proteinemia which was one of the side effects of CPD. Seven of nine patients treated by CAVH, developed bleeding. The side effects of CAVH were seemed to be more severe than those of CPD.

The purpose of this study was to verify the concept of Kampo medicine epidemiologically and demonstrate the objective bases of the Kampo treatment. For this purpose, a population based survey of subjective symptoms based on Kampo medicine was conducted among 1,486 residents of Hase village, Nagano prefecture, ages 20 and older. The completion rate was 80.7% and 1,199 residents provided favorable responses. An investigation of gender differences showed a higher rate of blood deficiency among female residents, while spleen and qi deficiency were more common in males. Considering age differences, symptoms related to blood deficiency and water-dampness affected younger females, symptoms related to qi deficiency primarily affected younger males, and symptoms of liver afflictions were common in younger both genders. Among the elderly residents, symptoms of kidney deficiency were overwhelmingly predominant in both genders. Though younger people with subjective sense of health had few diseases in western medicine, most of the elderly with perceived health actually had some kind of diseases for medical treatment. Physical symptoms in the chest area such as shortness of breath correlated positively with the perception not to be healthy, and these may be regarded as both the manifestation and factors contributing to ill health. Approximately 1 out of 12 residents reported currently receiving the treatment of oriental medicine or demonstrated the potential to benefit from such intervention. These results may clinically be useful as the objective bases to perform the Kampo treatment.