Nihon Geka Gakkai zasshi
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Nihon Geka Gakkai zasshi · Nov 1984
[Measurement of extravascular lung water by double-indicator dilution method amd its clinical assessment].
In this study, thermal-dye double-indicator dilution method using Lung water computer (Edwards Laboratories) was used to detect the changes of extravascular lung water (EVLW) in 14 patients, including 8 head injuries, one multiple injury, and 5 burns. The coefficient of variation of multiple readings at the same time was 5.04 +/- 3.64% (M +/- SD, n = 180), so reproducibility was excellent. EVLW showed no correlation with cardiac index, Qs/Qt ratio, PAO2/PaO2 ratio, and PaO2/FiO2 ratio, but did show significant correlation with pulmonary capillary wedge pressure (PCWP) (r = 0.50, n = 54, p less than 0.01). ⋯ Although it is very difficult to determine the threshold of EVLW to diagnose pulmonary edema, the elevation of EVLW appeared earlier than the changes of X-ray films. In estimate of EVLW, we must always take into consideration changes in effective vascular bed and pulmonary capillary permeability. The measurement of EVLW was also of much help in the differential diagnosis of pulmonary edema and other lung diseases.
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Nihon Geka Gakkai zasshi · Sep 1984
[Progress and problems in pediatric surgery--the Association of Pediatric Anesthesiologists].
From the first meeting of the Japanese Society of Pediatric Surgeons in 1964 a small group discussion on anesthetic problems and patient care was held by some anesthesiologists at night. The Association of Pediatric Anesthesiologists (started in 1971) has undertaken the night meeting ever since the twelfth Annual Meeting of the Society of Pediatric Surgeons in 1975. The problems about pediatric respiratory management, neonatal emergency surgery and pediatric anesthesia were discussed frequently by doctors in different specialties. ⋯ This night meeting of anesthesiologists has had a major role in the resolution of problems in pediatric respiratory impairment. The problems to be resolved in an emergency--persistent fetal circulation, barotrauma, nutritional problems in long term ventilatory support and so on--, will be discussed in the future. The purpose of this association is to elevate the quality of pediatric anesthesiologists by discussion with the other specialists of medicine and to make clear their responsibility in Children's Hospitals or Centers.
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Nihon Geka Gakkai zasshi · Feb 1984
Case Reports[Right-sided traumatic diaphragmatic hernia following blunt trauma].
The mechanism of right-sided traumatic diaphragmatic hernia following blunt trauma was examined. In 13 cases of Traumatic diaphragmatic hernia admitted to the Department of Traumatology Osaka University Hospital, 3 cases were on the right. All cases were associated with severe injuries in the chest, abdomen and pelvis. ⋯ Main force which caused right-sided diaphragmatic rupture was the blunt impact to the right thoracic wall. In the right-sided diaphragmatic hernia, the most frequently herniated organ was the right lobe of the liver and there was high-frequency of G-I tract herniation in delayed types. Herniation of the abdominal organs seemed to be varied as the time passed.
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Nihon Geka Gakkai zasshi · Feb 1984
[Extravascular lung water content following thoracic vagotomy. Experimental investigations in relation to the cause of pulmonary complications after surgery for esophageal cancer].
In order to investigate the relationship between postoperative pulmonary complications after surgery for esophageal cancer and surgical injury to the thoracic vagus nerves, changes of the extravascular lung water volume (EVLW) were studied in 26 mongrel dogs. Two protocols of experiment were designed as follows. In Experiment I (18 dogs), EVLW was measured before and on successive three days after thoracic vagotomy or sham operation. ⋯ These observations suggested that the increase of EVLW was due to enhanced permeability of the pulmonary capillary wall. The volume load of saline resulted in increase of EVLW in vagotomized dogs, while no changes were observed in sham-operated dogs. The results of the current investigations indicate that the injury to the vagus nerves during surgery for esophageal cancer may induce water retention in the lung, which may be one of the underlying mechanisms of postoperative pulmonary complications.
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Nihon Geka Gakkai zasshi · Nov 1983
[Problem in myocardial protection in coronary artery bypass surgery; regional difference of myocardial tolerance to global ischemia].
This study was aimed to evaluate the hypothesis that the left ventricular myocardium has different resistance to ischemic stress, thus, perioperative myocardial infarction occurs in the myocardium with poor resistance to ischemia. Patients who died of acute low output syndrome after coronary artery bypass graft under potassium induced cardioplegia associated with topical and systemic hypothermia were studied by histopathology of the left ventricular muscle taken at the time of autopsy. ⋯ Ischemic myocardial damage that appears most likely the events in the perioperative period was observed sporadically in the normal myocardial architecture independent of the degree of stenosis of the coronary arteries. Thus, this result suggests that the regional myocardium has different resistance to global ischemia, and it may be responsible to perioperative myocardial infarction.