[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Nov 1989
Case Reports[Surgical repair of scimitar syndrome by direct anastomosis between right pulmonary vein and left atrium].
A surgical case of 8-year-old boy with scimitar syndrome is presented. The patient was admitted to the hospital because of exertional dyspnea and underdevelopment. Cardiac catheterization revealed a large amount of left to right shunt and O2 step up at the level of the inferior vena cava below the diaphragm. ⋯ To avoid kinking or stenosis of this vein, the parenchyma of the right lung (S7) was divided to create a passway of the vein. Anastomosis was performed without excessive tension or kinking on it. We conclude that the method applied in this case might be a procedure of choice for the repair of scimitar syndrome especially when there is no associating atrial septal defect or scimitar vein drains into IVC at the level lower than hepatic vein.
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Nihon Kyobu Geka Gakkai Zasshi · Nov 1989
[The effect of epidural injection with morphine on the post-thoracotomy respiratory function].
Patients undergoing thoracotomy experience severe post-operative pain and marked respiratory impairment, which causes pulmonary atelectasis and pneumonia. The effects of epidural injection on postoperative pain and respiratory function were examined in this study. The group undergoing epidural injection of 3 mg morphine (at the end of operation, 09oo and 21oo for the next 3 days) included 37 patients, while the control group involved 16. ⋯ These effects help the expectoration of sputum especially in senile patients. As the side-effects of epidural morphine, urinary retention, nausea, vomiting and itching were seen in few patients. No serious side effect such as hypotension or ventilatory depression were seen.
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Nihon Kyobu Geka Gakkai Zasshi · Nov 1989
[Assessment of cardiac rejection following heart and lung transplantation (I)].
To diagnose the cardiac rejection after the heart and lung transplantation, the histopathological assessment is the most reliable method at the present time. In this study, the heterotopic heart and lung transplantation was performed using rat model and the rejection process of heart allograft was sequentially examined at 1 day, 4 days, 7 days, and 12 days after the transplantation. The gross finding of both ventricles were observed to investigate the development process of the rejection. ⋯ Myocyte degeneration. This study demonstrates that allograft rejection after heart and lung transplantation initiates from right ventricular free wall and spreads into outer layer of left ventricle as same fashion as orthotopic cardiac transplantation. The assessment of these 3 components using the indicators shown in this study might be very useful method to objectively determine the grades of rejection after the heart and lung transplantation.