In a 52-year-old man with severe chest pain of 3 hours duration and ST-segment elevation in leads V1 and V2, a nondominant right coronary artery was recanalized by an intracoronary infusion of urokinase. Coronary cineangiography revealed a total occlusion of the nondominant right coronary artery and no significant narrowing of the left coronary artery. Hemodynamic studies during the acute phase of myocardial infarction demonstrated an increase of right atrial mean pressure in association with normal pulmonary capillary wedge pressure. Following the recanalization, chest pain disappeared and hemodynamic alterations were corrected. The purpose of this report is to document a case of isolated right ventricular infarction due to a nondominant right coronary artery occlusion.

Coronary Disease↗

PubMedDate not supplied

Value of virtual computed tomographic colonography for Crohn's colitis: comparison with endoscopy and barium enema.

BACKGROUND: Crohn's colitis, frequently accompanied by stenosis or narrowing, can be difficult to assess through conventional methods. We evaluated the usefulness of virtual computed tomographic colonography (CTC) for the detection of colonic lesions due to Crohn's disease. METHODS: Forty-two lesions in 33 patients with Crohn's disease were examined by CTC and barium enema (BE). Twenty-two patients also were examined by colonoscopy (CS). The visualization ability of CTC was compared with those of the other two methods. RESULTS: In the visualization of elevated lesions, there was no significant difference between CTC and BE (18 of 20, p = 0.487) or between CTC and CS (15 of 16, p = 0.99); however, ulcerative lesions were less often visualized by CTC. However, CTC enabled identification of serious lesions in the colon proximal to the stenosis in nine patients and was superior to BE and CS in terms of its ability to visualize the proximal site of the stenosis (p = 0.003). CONCLUSION: CTC is clinically useful for the evaluation of Crohn's colitis, especially those with stenotic lesions.

Adult↗

PubMedDate not supplied

Radiographic findings of intractable gastric ulcers with H2-receptor antagonists.

BACKGROUND: To clarify the radiographic characteristics of intractable gastric ulcers with H2-receptor antagonists. METHODS: The radiographic findings at the time of starting treatment were compared between 42 patients with gastric ulcers that did not heal within eight weeks of starting treatment with H2-receptor antagonists (the intractable group) and 58 patients whose ulcers healed within the eight-week period (the tractable group). RESULTS: The following radiographic findings in the intractable group were observed at a significantly higher incidence than those in the tractable group and included: an ulcer located on the angle, linear ulcers, a greater depth, an uneven mound surrounding an ulcer, prominent folds' convergence, an overhanging gastric mucosa, an irregular ulcer base, a shortening of the lesser curvature and a U-shaped deformity of the angle. A multiple logistic regression analysis showed that the following three factors had a significant and independent delaying effect on healing: a U-shaped deformity of the angle, an uneven mound surrounding an ulcer and prominent folds' convergence. The relative risk of these factors were 12.7, 14.4 and 12.5, respectively. CONCLUSIONS: Intractable gastric ulcer with H2-receptor antagonists can be predicted based on the characteristic radiographic findings at the start of treatment.

Adult↗

PubMedDate not supplied

The evolution of the lesion in the solitary rectal ulcer syndrome.

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Adult↗