[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Recently, classification and nomenclature of lung sounds has been changed from assessment based on subjective interpretation to assessment based on objective, measureable criteria related to mechanisms of sound generation. The adventitious sounds was classified to four kinds of principal terms, continuous adventitious sounds (wheezes, rhonchi) and discontinuous adventitious sounds (coarse crackles, fine crackle) at the 1985 International Symposium on Lung Auscultation. ⋯ Rhonchi, fine crackle and tracheal stenotic sounds were characterized by the analysis of the frequency domain. Lung sound analysis is promising because it is safe, non invasive and may be used for clinical studies in the surgical patients.
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Nihon Kyobu Geka Gakkai Zasshi · Dec 1989
[Surgical treatment of interrupted aortic arch in infants under three months of age].
From March, 1982, through March, 1988, 8 infants less than 3 months of age underwent surgical treatment of interrupted aortic arch. Five patients had IAA type A and 3 patients had type B. Seven patients with associated VSD underwent staged operations and 1 infant with aortopulmonary window underwent primary repair off cardiopulmonary bypass. ⋯ The operative death occurred in an infant in whom modified Damus-Kaye-Stansel operation was carried out for severe subaortic stenosis, which rerouting all left ventricular blood through VSD and the main pulmonary artery into the ascending aorta and reconstructing right ventricular-distal pulmonary artery connection by a valved external conduit. All six surviving patients are doing well at present (mean follow up of 3 years) without any significant pressure gradient between the ascending and thoracic aorta. Based on these data we conclude: (1) Aortic arch reconstruction and pulmonary artery banding can be reliably performed even in critically ill infants with IAA and isolated VSD. (2) The primary repair will provide better chance of survival in infants with IAA associated with significant LVOTO, truncus arteriosus or aortopulmonary window that do not readily lend themselves to pulmonary artery banding.
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Nihon Kyobu Geka Gakkai Zasshi · Dec 1989
Comparative Study[Pulsatile assistance for profoundly hypothermic circulatory arrest, low-flow perfusion, and moderate-flow perfusion: comparative study of brain tissue pH, PO2, and PCO2].
The pH, oxygen tension, and carbon dioxide tension of canine brain tissue were experimentally examined during profoundly hypothermic cardiopulmonary bypass with and without pulsatile assistance. After core cooling, a 60-minute of circulatory arrest was performed in group 1 (n = 16), a 120-minute of low-flow perfusion (25 ml/kg/min) in group 2 (n = 16), and 120 minute of moderate-flow perfusion (50 ml/kg/min) in group 3 (n = 16). The core rewarming was done to the temperature above 32 degrees C. ⋯ In group 3, mild acidosis and hypercapnea were eliminated with pulsatile assistance. Brain tissue hypoxia was severe in group 1, slight in group 2, but not found in group 3. We conclude that a pulsatile assistance provides brain protection at any flow-ratio, and that the less flow-ratio and the longer perfusion period will make the pulsatile assistance the more necessary.