Fifteen patients were operated on infective endocarditis (IE). We studied indication for operation, operative methods and results. There were 13 male and 2 female patients and the mean age of these patients was 48.5 years. 8 cases were inactive IE and 3 of them were prosthetic valve endocarditis (PVE). The patients consisted of 4 cases of aortic valve regurgetation, 2 cases of mitral valve regurgetation, 3 cases of PVE and 3 cases of VSD. Casual bacteria were positive for blood culture in 5 cases. The following bacteria findings were found: Streptcoccus viridans in 3 patients, gram-negative bacteria and Staphylococcus each in one case. Valve cultures were positive in 3 cases: There were gram-positive bacteria in 2 patients and Enterococcus in one case. Vegetations were present in all native valves and the echocardiogram was useful for these findings. There were 3 perioperative deaths (20%) and 2 of those patients were active PVE. All patients with IE who develop progressive congestive heart failure and cerebral emboli should have prompt valve relacement. In paticular active PVE still has high mortality rate.

The patient was a 43-year-old male who presented with heart murmur. Echocardiography, chest CT, and cardiac catheterization data showed extracardiac extension of an aneurysm of the noncoronary sinus, compressing the right atrium, right ventricular outflow tract, and superior vena cava. Severe aortic regurgitation was also recognized. The aneurysm was incised under extracorporeal circulation. The orifice of the aneurysm was closed, and the elongated annulus of the noncoronary sinus was corrected with woven Dacron patch. Mild aortic regurgitation was shown on postoperative aortogram, and the case is being carefully followed up.

Two cases that were surgically treated with atherosclerotic aortic aneurysm, followed by innominate artery aneurysm are reported. The causes of these aneurysms were determined to be arteriosclerosis and idiopathic inflammation. Blood flow reconstruction surgery using grafts was performed on these two patients. In one case, we also employed an internal shunt technique to prevent brain ischemia. It was speculated that this type of aneurysm develops not only in cases of inflammation, but also in multifocal arteriosclerotic vascular diseases. This type of aneurysm will probably increase in the future.

Metastasis to the heart is not so rare, but it is not diagnosed easily during patient's lifetime because clinical symptoms are not related to the nature of the tumor. We present a rare case of resection of cardiac metastasis of liposarcoma. A 37-year-old man suffered from dyspnea on effort was given a diagnosis of heart failure. He had already suffered from primary liposarcomas of the right heel which had been resected at age 28 and 32. Echocardiography revealed pericardial effusion and a tumor exiting from the apex. The mass grew rapidly and was excised using a cardiopulmonary bypass. The pathophysiological diagnosis was metastatic liposarcoma to the heart. The surgical margins of tumor were positive and cancer cells were exposed on the epicardial surfaces on some places. Adjuvant chemotherapy was therefore performed for 6 months. The patient was discharged after a good post-operative course and has been in good health for 40 months since the operation. Despite the generally poor prognosis of metastatic liposarcoma to the heart, combination of surgical treatment and chemotherapy yield a long period of survival in this case. It is important not only to establish the therapeutic strategy for metastatic tumor to the heart but also to detect it at an early stage.

1. 5-HT inhibits spontaneous fluid secretion as well as stimulated secretion with secretin (cAMP mediated) or ACh (Ca2+ mediated) in the isolated guinea pig pancreatic ducts. 2. The inhibitory effect of 5-HT is reversible and is dependent on the concentration in the range 0.01-0.1 microM, which is much lower than those that affect intestinal motility and secretion. 3. The 5-HT3 receptor in duct cells appears to mediate the inhibitory effect of 5-HT. 4. [Ca2+]i is unlikely to mediate the inhibitory effect of 5-HT.
5-Methoxytryptamine/pharmacology ; Acetylcholine/pharmacology ; Animal ; Calcium/metabolism ; Guinea Pigs ; Pancreatic Ducts/metabolism* ; Pancreatic Ducts/drug effects ; Secretin/pharmacology ; Serotonin/pharmacology ; Serotonin/metabolism* ; Serotonin/analogs & derivatives* ; Vasodilator Agents/pharmacology