A 71-year-old woman was admitted with general fatigue and appetite loss. Computed tomography showed hypertrophy of the pericardium surrounding the anterior of the right ventricule (RV). Cardiac catheterization demonstrated a rise of RV end-diastolic pressure and a dip-and-plateau pattern of the pressure curve of RV without any coronary disease. Therefore, we diagnosed heart failure due to constrictive pericarditis and performed pericardectomy using an Ultrasonic Scalpel through a median sternotomy without cardiopulmonary bypass. No improvement of the hemodynamics during the operation was found despite subtotal pericardectomy. Then, we performed the waffle shape cutting of the residual epicardium using an Ultrasonic Scalpel and obtained improvement of the hemodynamics on the operation. We then obtained increased cardiac output and the improved hemodynamics without a dip-and-plateau of the pressure curve of RV. No recurrence of the constrictive pericarditis has been found for two years. Hence, we consider that the waffle shape cutting of the epicardium using an Ultrasonic Scalpel is one of the most useful surgical repairs.

Mortarity due to pesticide poisoning for prefectures in Japan is examined according to the vital statistics in 1979-1981. The atlases of pesticide poisoning mortality for prefectures in Japan are presented.
There is a wide range in mortality among prefectures and the highest mortality is 17.8 times as high as that observed in the prefecture which showed the lowest mortality. Regional characteristic is observed in the mortality. Northern part of Kanto Area and the southern part of Kyusyu Island show high mortality and low mortality is observed in Hokuriku Area.
The ratio of the deaths due to pesticide poisoning to those due to automobile accident also show wide range among prefectures. The highest ratio is 38.3% and the lowest is 2.4%. The ratio shows similar regional characteristic to that observed in mortality.