[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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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.
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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.
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Nihon Kyobu Geka Gakkai Zasshi · Oct 1989
Case Reports[A case report of ventricular septal defect accompanied by winded and elongated malformation of the aortic arch].
A three-year-old boy, surgically treated for a ventricular septal defect, had a winded and elongated aortic arch between the left common carotid artery and the left subclavian artery. Angiography revealed that the arch was positioned more caudalward than normally, and that it was in contact with the left pulmonary artery at a point near the central portion of the arch (i.e., near the position of the ductus arteriosus). The embryological cause of this malformation was speculated. ⋯ Pressure monitoring during the operation revealed no pressure loss in the winded and elongated portion of the artery; hence, the malformation seemed to cause no hemodynamic problems at present. Considering that the patient is only three years old and that the aorta will continue to grow, we have decided to refrain from any surgical treatment of the winded and alongated part of the aorta for the time being. However, the patient might develop aortic aneurysm in the future because of the relative coactation of the aorta and the insufficient mechanical strength of the winded and elongated area.(ABSTRACT TRUNCATED AT 250 WORDS)