Nihon Geka Gakkai zasshi
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Nihon Geka Gakkai zasshi · Nov 1985
[Chloride and lactate composition of hypertonic sodium solution for fluid resuscitation of burn injury].
This study was performed to determine the appropriate anion composition of hypertonic sodium solution for fluid therapy of severely burned patients. Two different solutions with equal sodium concentration (Na 300 mEq/1) were prepared. The first one, low chloride solution (C1 88 mEq/1), was used for ten patients (group I); the second, high chloride solution (C1 244 mEq/1), for other ten patients (group II). ⋯ Although both had same urine output, CH2O of group I increased. Water and sodium intake of group I were lower than those of group II. Water diuresis was related with limited chloride intake in group I and this suggested the relation between urine concentration and chloride loading in kidney. conclusively, hypertonic sodium solution with low chloride concentration requires less volume for resuscitation and may be preferred to high chloride solution in the initial therapy of burn injury.
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Nihon Geka Gakkai zasshi · Oct 1985
Case Reports[Aortocaval fistula secondary to rupture of abdominal aortic aneurysm; report of two cases].
Two cases of aortocaval fistula secondary to rupture of abdominal aortic aneurysm were presented. First case was 70 year old man who was admitted with pulsating abdominal mass. Prior to admission, he had been suffering from congestive heart failure. ⋯ Large fistula (2 cm X 1cm) was noted. This patient died of renal failure and cerebral damage on 30th post operative day. Problems of pre- and post-operative patient management and surgical therapy for aortocaval fistula secondary to rupture of abdominal aortic aneurysm were discussed.
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Nihon Geka Gakkai zasshi · Jun 1985
[Influence of post-vagotomy duodenogastric reflux on gastric mucosal structure].
There has not come to any definite conclusion on morphological changes in post-vagotomy gastric mucosa. And, it was reported that duodenogastric reflux in consequence of pyloroplasty or gastroenterostomy could aggravate these gastric mucosal changes. To elucidate this problem, 34 Wistar male rats were subjected to either truncal vagotomy, duodenogastric reflux procedure (transection of the lower part of the duodenum and gastrojejunostomy), or truncal vagotomy with duodenogastric reflux procedure. ⋯ Rats subjected to duodenogastric reflux also showed chronic ulceration in the prepyloric region on the lesser curvature and hyperplasia of gastric glands. However, no remarkable changes were observed in the stomach of rats with vagotomy. These results indicate that chronic influence of postvagotomy duodenogastric reflux can lead to severe gastritis as well as altered structure of gastric mucosa.
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Nihon Geka Gakkai zasshi · May 1985
[Prevention of spinal cord ischemia after thoracic aortic occlusion].
Paraplegia has been a devastating and unpredictable complication following surgical procedures necessitating temporary occlusion of the thoracic aorta. This study was undertaken to investigate the effect of the pressure gradient between the aortic pressure distal to the occlusion and cerebrospinal fluid pressure (CSFP), defined as "Relative spinal cord perfusion pressure" (RSPP) on the development of ischemia to the spinal cord by using somatosensory evoked potentials (SEP). In 30 mongrel dogs, the thoracic aorta just distal to the left subclavian artery was occluded for either 30 or 120 minutes until SEP disappeared. ⋯ SEP were recorded as a cortical response to the electrical stimulation of bilateral peroneal nerves. SEP did not disappear for 30 or 120 minutes when RSPP was 40 mmHg. It would be concluded that 40 mmHg or higher of RSPP is necessary in order to prevent the spinal cord ischemia due to the temporary occlusion of the thoracic aorta.
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Nihon Geka Gakkai zasshi · Feb 1985
[Systemic hemodynamics and oxygen metabolism after hepatectomy--effect of hyperdynamic systemic circulatory support on postoperative prognosis].
This study was undertaken to evaluate inotropic effect of dobutamine (DOB) on systemic and hepatic hemodynamics after hepatectomy. Systemic hemodynamics after 70% hepatectomy using mongrel dogs was depressed and oxygen metabolism was disturbed. Whereas in the dogs administrated DOB after hepatectomy, systemic circulation was improved and oxygen metabolism was maintained in a favorable state. ⋯ Whereas in DOB group, oxygen delivery increased according to hyperdynamic systemic circulation and was followed by increase of oxygen consumption. These favorable hemodynamic results in DOB group reflected on the postoperative prognosis of these patients; 5 of 22 in control group, whereas only 1 of 15 in DOB group died of hepatic failure postoperatively. It is concluded administration of DOB in cirrhotic hepatectomized patients maintained systemic circulation in a hyperdynamic state and this resulted in improvement of postoperative prognosis.