[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Feb 1990
Case Reports[Four operated cases of traumatic tricuspid regurgitation].
Four cases of tricuspid regurgitation due to nonpenetrating chest trauma are presented. From five to twenty five years after the initial blunt chest trauma, they were admitted because of dyspnea or palpitation on exertion. In all cases echocardiogram showed severe tricuspid regurgitation and enlarged right atrium and ventricle. ⋯ Five cases are treated medically. How to diagnose and how to treat them are discussed. And, in the conclusion, we consider that the surgical treatment is recommended for the case of traumatic tricuspid regurgitation with uncontrollable heart failure.
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Nihon Kyobu Geka Gakkai Zasshi · Feb 1990
[A study of spinal cord ischemia during aortic cross-clamp--evoked spinal cord potential and histological analysis of the spinal cord].
The relationship between the evoked spinal cord potential (ESP) and the histological findings of the spinal cord after thoracic aortic cross-clamp was studied. Thoracic aorta was cross-clamped in 23 dogs and ESP was monitored before, during, and after cross-clamping. Incidence of paraplegia and histological findings were studied after the dogs recovered from the procedure. ⋯ Necrotic foci were limited in the posterior horn in mild, in the anterior and posterior horn in moderate changes. And neurons were lost in entire gray matter in severe histological changes. In the spinal cords of the dogs with spastic paraplegia, severe histological changes were limited in the lower lumbar region.(ABSTRACT TRUNCATED AT 250 WORDS)
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Nihon Kyobu Geka Gakkai Zasshi · Jan 1990
Case Reports[Successful re-reconstruction for complete disruption of the right main bronchus by blunt chest trauma].
A 22 year-old man was brought to our hospital about twenty-three minutes following a high-speed motorbicycle accident in which he had blunt chest trauma. He was in severe respiratory distress with marked dyspnea and restless with extensive subcutaneous emphysema involving anterior chest wall, cervical and bilateral inguinal regions. A chest X-ray revealed bilateral pneumothorax involving mediastinal emphysema and also fracture of right submandibular and clavicula. ⋯ This complication was treated successfully. We considered that acute pneumonitis was caused by reventilation with increase of perfusion after tracheobronchial reconstruction. Consequently, we thought it important to treat such patients with long term IPPB postoperatively with adequate medication for respiratory system.
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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.