Coronary snaring resulted in coronary endothelial injury, which was ameliorated by using elastic sutures instead of non-elastic sutures. Non-humidified gas insufflation made blood cells deposited and endothelial cells delaminated with time. Humidified gas insufflation attenuated these adverse effects. Heparin and dipyridamole-added humidification had potential advantage in terms of reducing deposited blood cells on the endothelium over simple humidification.

Splenic abscess is a rare complication in infective endocarditis. Here, we present two cases of splenic abscess associated with active infective endocarditis. Body computed tomography before emergency valvular surgery revealed abscess in the spleen. In case 1, the abscess was localized within the spleen; splenectomy and valve replacement were performed through the same median skin incision. In case 2, the splenic abscess was diagnosed as ruptured; valve replacement was performed, followed by splenectomy through a separate skin incision. No recurrence of infection occurred after surgery in either case. In surgical treatment for active infective endocarditis, body computed tomography is essential to diagnose splenic abscess preoperatively. If there is an abscess, then splenectomy and valvular surgery should be performed simultaneously to prevent reinfection after valvular surgery. The approach to the spleen should be individualized according to the extension of the abscess.

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Mitral annular reconstruction using a pericardial patch was performed in 3 cases of atrioventricular disruption. This technique may be useful for atrioventricular disruption in cases of active endocarditis, redo valve replacement, left ventricular rupture after mitral valve replacement, and annular calcification.

Several monoclonal antibodies specific to the human T-cell receptor (TCR) variable (V) region were used to examine whether T-cell oligoclonality plays a key role in the development of the T-cell-mediated lung disease, summer-type hypersensitivity pneumonitis (SHP). The usage of TCR V-regions was examined using bronchoalveolar lavage (BAL) and matched peripheral blood lymphocytes (PBL) in patients with SHP. In 18 SHP patients, the majority of lymphocytes in both BAL and PBL was CD3⁺ cells (94.2 vs. 63.9%, respectively), which was similar to that in normals (n = 7). Of CD3⁺ lymphocytes in a SHP patient, the percentage of CD4⁺ cells in BAL was reduced compared to those in paired PBL, whereas the percentage of CD8⁺ cells was significantly elevated. In contrast, the percentage of CD4⁺ cells was much higher than that of CD8⁺ cells in both BAL and PBL of normal subjects. While a majority of CD3⁺ T cells expressed TCR α/β⁺ in BAL and PBL from both SHP patients and normal controls, a marked increase of the expression of TCR γ/δ⁺ was observed in PBL in 4 out of 18 SHP patients. A markedly increased prevalence (> 3 SD) of specific TCR α/β⁺ V-region families in BAL was detected in 5 of 18 patients with SHP as compared to normal controls, whereas no specific increase was found in PBL. Increased Vβ8 was detected in 3 cases; Vβ6 was observed in 1 patient, and Vβ5 in another patient. These results demonstrate a compartmentalization of T cells with limited TCR V-region repertoires in subgroups of patients with SHP suggesting an accumulation of T-cell clones using a limited number of TCR V-region genes in the lung.