Nihon Geka Gakkai zasshi
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Nihon Geka Gakkai zasshi · Oct 1990
Comparative Study[Clinical results of selective treatment for flail chest].
A better understanding in pathophysiology of flail chest has brought an evolution to the principles of it's management. The methods of stabilization changed from surgical to pneumatic measures and now, a concept of conservative treatment is recognized. Adhering to our protocol for flail chest, which essentially limits mechanical ventilation, we have prospectively treated 36 patients since 1981. ⋯ Group B patients required respiratory support for 14 days average, which was not reduced by surgical stabilization. Restrictive pulmonary disturbance in group A was milder than that of group B, and this again was not affected by surgical stabilization. We conclude that 40% of flail chest are controllable without mechanical ventilation and that the result of this conservative therapy is superior to any other treatments.
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Nihon Geka Gakkai zasshi · May 1990
[Hepatic hemodynamics after hepatectomy and the effect of administration of glucagon].
The effect of hepatectomy and administration of glucagon on hepatic hemodynamics were studied using mongrel dogs. The results were as follows: 1) Hepatic blood flow in the 70% hepatectomized dogs was significantly less than that in dogs subjected to sham operation or 40% hepatectomy. 2) Bolus injection of glucagon (10 micrograms/kg) increased blood flow in the hepatectomized dogs as well as that in the control dogs. The percentage increment, however, was significantly smaller in the 70% hepatectomized dogs, possibly due to little increase of portal vein blood flow. 3) Portal vein pressure and its resistance were significantly higher in the 70% hepatectomized dogs than in both the 40% hepatectomized dogs and the control dogs. 4) Although pre-sinusoidal resistance showed no significant difference among these three groups, post-sinusoidal resistance increased stepwise in the order of extent of hepatectomy. These results suggest that administration of glucagon after extended major hepatectomy is not so particularly effective in generating adequate hepatic tissue blood flow.
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Nihon Geka Gakkai zasshi · Nov 1989
Review Case Reports[Surgical treatment in dissecting aneurysm of the infrarenal abdominal aorta--report of two cases].
In this paper, we present two cases of dissecting aneurysm in the infrarenal abdominal aorta and a review of this type of lesion. DeBakey's classification has found wide acceptance since it combines both anatomical description and a basis for management. However, there is another type of the aneurysm, omitted in this classification, which involves the infrarenal segment of the abdominal aorta, the intimal tear being distal to the renal arteries. ⋯ However, precise visualization of the intimal defect together with the site of entry is a prerequisite of operation. Angiography remains the most suitable method of achieving this end. Although both abdominal and thoracic aortic dissection share a common management in respect to hypotensive therapy, we believe that surgical intervention is required, especially in dissection of the abdominal aorta, with prosthetic replacement of the infrarenal segment and obliteration of any proximal or distal false lumen.
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Nihon Geka Gakkai zasshi · Oct 1989
Case Reports[A case of hemosuccus pancreaticus associated with chronic pancreatitis].
The term "hemosuccus pancreaticus" was coined by Sandblom in 1970, to describe a syndrome manifested by massive gastrointestinal hemorrhage through the pancreatic duct and the ampulla of water. A case of hemosuccus pancreaticus which had no hematemesis and melena is reported in comparison with two previously experienced cases. A 68-year-old alcoholic man was referred to Eiju General Hospital for poor appetite and occasional colicky pain in left epigastrium. ⋯ Resection of pancreatic tail and splenectomy was performed without complication. Histopathological diagnosis of the resected pancreas was chronic pancreatitis. He has complained no abdominal pain and melena for 6 months after operation.
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Nihon Geka Gakkai zasshi · Sep 1989
[The role of oxygen free radical and free radical scavenger in septic and hemorrhagic shock].
The roles of oxygen free radical (O2-), lipoperoxide (LPO) and free radical scavenger were clinically and experimentally studied in septic and hemorrhagic shock. The reduction of hepatic tissue blood flow (TBF) were equalized in two groups (40-55% of normal level) and rats were subdivided into 3 groups: untreated, normal saline (NS) continuous IV and superoxide dismutase: SOD + catalase (S/c) continuous IV as free radical scavenger. ⋯ The neutrophil derived O2- was markedly elevated in Et shock animals as well as septic shock patients but no significant change was noted in hemorrhagic shock animals or non septic shock patient. SOD and catalase were effective for neutrophil derived O2- in septic shock whereas little beneficial effect was noted in hemorrhagic or non septic shock.