Fukuoka igaku zasshi = Hukuoka acta medica
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Fukuoka Igaku Zasshi · May 2008
Case ReportsDegenerative change in the adjacent segments to the fusion site after posterolateral lumbar fusion with pedicle screw instrumentation--a minimum 4-year follow-up.
Controversy remains regarding the subsequent degeneration of adjacent segments, and little reliable information could be found in the literature regarding long-term clinical results and adjacent segment degeneration. The objective of this study is to investigate the degenerative change of adjacent segments to the fusion site and clinical outcome after posterolateral lumbar fusion with pedicle screw instrumentation and identify the risk factors in degenerative change at adjacent segments. ⋯ The rate of radiographic degeneration at the adjacent segments was 46.8%. No significant correlation was found between degenerative change in the adjacent segments and the clinical results. We could not identify any preoperative radiographic factors which might have influenced the segments adjacent to the fusion.
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Fukuoka Igaku Zasshi · Mar 2008
Incidence of anesthesia-related medication errors over a 15-year period in a university hospital.
To clarify the incidence of anesthesia-related medication errors in Kyushu University Hospital, a retrospective analysis of anesthesia-related incidents from 1993 to 2007 was conducted based on the "Investigation of anesthesia-related medication incidents" by the Japanese Society of Anesthesiologists. Out of a total of 64,285 anesthesia cases, drug errors occurred in 50 cases (0.078%), but none of the incidents led to serious sequelae. Wrong medication was the most common type of drug error (48%), followed by overdose (38%), underdose (4%), omission (2%), and incorrect administration route (8%). ⋯ The error frequency did not decrease over the 15-year period. The responsible anesthesiologists were most likely to be doctors with a little experience. To reduce anesthesia-related medication errors, improvements of protocols for handling medication and instruction, and an improved education system for the anesthesia trainees are essential.
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Fukuoka Igaku Zasshi · Mar 2007
Prognosis of patient with cardiopulmonary arrest transported to Kyushu University Hospital.
Three hundreds and sixty six patients with out-of-hospital cardiopulmonary arrest, transported to the Kyushu University Hospital from 2000 to 2006, were examined using the Utstein style in witnessed cardiogenic cardiopulmonary arrest patients. Also, we examined the influence on prognosis due to the difference in the treatment of airway control in out-of-hospital settings. Nineteen patients out of 78 witnessed cardiogenic out-of-hospital cardiopulmonary arrest patients were discharged alive and 11 were with a good prognosis. ⋯ By the time course, collapse to cardiopulmonary resuscitation interval, collapse to initial defibrillation interval and collapse to the return of spontaneous circulation interval were shorter in the group discharged with a good prognosis, especially in the witnessed ventricular fibrillation or pulseless ventricular tachycardia patients corresponding to former reports. Most patients with a good prognosis resuscitated before arrival at the hospital. These results suggest the prehospital treatment is the critical point other than in-hospital treatment.