Kokyu to junkan. Respiration & circulation
-
A case of spontaneous mediastinal emphysema in a 21-year-old female trombonist was reported. During light work, she experienced pain in her neck which later radiated into her chest. She had neither causal disease nor episode of straining at the onset of her work. ⋯ She was treated with bed rest and recovered completely within five days. Spontaneous mediastinal emphysema without causal disease or apparent precipitating episode is infrequently recognized. In our case, though the trombonist had no apparent straining episode, the causative factor can be assumed to be the tenderness of the alveoli originating from frequent over-inflations of the lungs and high intra-alveolar pressures of about 150 cmH2O during trombone performance, which may result in alveolar rupture under normal intralveolar pressures.
-
We studied the effect of the open heart surgery and the thoracic aortic aneurysm surgery on renal, liver and respiratory function and the coagulofibrinolytic system. We also investigated as to whether ulinastatin was effective or not with regard to preventing an organ system failure. The renal function, liver function and the coagulofibrinolytic system were preserved, although there was a greater number of severe cases in the group which used ulinastatin (US group) than in the group that did not use ulinastatin (non-US group). ⋯ The variables in relation to using ulinastatin, examined by a stepwise method, included kind of disease, emergency operation, PaO2, BUN and serum plasminogen. The multiple coefficient for these five variables was 0.623 (p less than 0.01) and the contribution was 38.8%. It was suggested that ulinastatin could prevent an organ system failure, especially respiratory failure, after open heart surgery and the thoracic aortic aneurysm surgery.