Among the TORCH agents, the occurrence of rubella and human T-lymphotropic virus type 1 (HTLV-1) in Japan were studied. Rubella epidemics occurred throughout Japan from 1964 to 1969 and from 1975 to 1979. Low prevalences of CRS were observed in northeastern Japan, and high prevalences in southwestern Japan, with the highest in Okinawa. These conditions could be explained by the lower rate of rubella H1 antibody in the female population of southwestern Japan. Time of maternal rubella was in the gestational age interval from 26 to 57 days for cataract, from 25 to 62 days for heart disease and from 16 to 131 days for deafness. HTLV-1 is the causative agent of adult T-cell leukemia. Main route of transmission of this virus is mother-to-child transmission, through breast milk. Among the 311 mother-child pairs in Okinawa, 65 mothers (20.9%) and 10 children (3.2%) were seropositive for HTLV-1. Ten (15.4%) of the 65 seropositive mothers had seropositive children. These children had acquired their HTLV-1 antibodies by the age of 3 years. A significant difference existed between the prevalence rate of HTLV-1 antibodies in mothers and children.

Female↗

PubMedDate not supplied

Surgical treatment of aneurysm or dissection involving the ascending aorta and aortic arch, utilizing circulatory arrest and retrograde cerebral perfusion.

Recently we replaced the ascending aorta and aortic arch in 8 patients with aneurysm or dissection, using profound hypothermic circulatory arrest with retrograde cerebral perfusion. There were no operative deaths. Open aortic anastomosis facilitated repair of the aortic arch without clamping the arch tributaries, and embolism due to particulate debris from clamping of the arch vessels was eliminated. Retrograde cerebral perfusion during profound hypothermic circulatory arrest is a simplified technique that may protect the brain. This method offers advantages over previously described methods, particularly in obviating dissection of the arch tributaries and the clamping thereof, and in protecting the central nervous system.

Aged↗

PubMedDate not supplied

Repair of intracardiac defects associated with congenitally corrected transposition of the great arteries.

From October 1976 to June 1986, 12 patients with corrected transposition of the great arteries (c-TGA) underwent repair of associated intracardiac defects. Ventricular septal defect (VSD) was closed by the method of de Leval in 7 patients, pulmonary outflow tract obstruction was relieved by valvotomy in 2, and bypassed by an external valved conduit in 6. The systemic atrioventricular (A-V) valve was replaced in 2. There was one operative death, giving a mortality rate of 8%. None of the patients developed complete heart block. The ejection fraction of the systemic ventricle was impaired (29-38%), particularly after ventriculotomy of this chamber. Surgical repair of intracardiac defects associated with c-TGA currently can be performed with acceptable risk, and de Leval's method for VSD closure is recommended; but the possibility of the postoperative development of systemic ventricular dysfunction and A-V valve regurgitation necessitates careful follow-up.

Adolescent↗