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Volume 17, Issue 7
Displaying 1-13 of 13 articles from this issue
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[in Japanese]1997 Volume 17 Issue 7 Pages 407-408
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (262K) -
[in Japanese]1997 Volume 17 Issue 7 Pages 409-412
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (555K) -
[in Japanese], [in Japanese]1997 Volume 17 Issue 7 Pages 413-417
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (2523K) -
[in Japanese]1997 Volume 17 Issue 7 Pages 418-419
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (250K) -
[in Japanese]1997 Volume 17 Issue 7 Pages 420-423
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (461K) -
Takafumi KOBAYASHI, Kunihiko HOSHI, Hitoshi SUZUKI, Izumi HONDA, Hiroa ...1997 Volume 17 Issue 7 Pages 424-428
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSForty patients were studied to determine temperature changes before and after induction of spinal anesthesia during transurethral resection of the prostate. Using a core thermometer (Coretemp®; Terumo CTM-205), "deep" forehead temperature was measured as the core temperature, and "deep" palm and "deep" foot temperature as the peripheral temperatures. Shivering occurred during anesthesia in 7 patients. Mean body weight was significantly smaller in the shivering group, but there was no correlation between the presence or absence of shivering with age, anesthesia time, operation time, fluid volume, irrigating fluid volume, blood loss or resected tissue weight. After spinal anesthesia, forehead temperature in the shivering group was significantly less than that in the non-shivering group. Postanesthetic forehead temperature was correlated with preanesthetic forehead temperature, decreases in forehead temperature during anesthesia, postanesthetic palm temperature and postanesthetic foot temperature. We conclude that the perioperative hypothermia during spinal anesthesia in patients undergoing transurethral resection of the prostate correlates to body mass, preanesthetic core temperature and preanesthetic ambient temperature.View full abstractDownload PDF (631K) -
Shunichi KODAMA, Iwao KOBAYASHI, Hiromi TAKAHASHI, Masato KURIHARA, Sh ...1997 Volume 17 Issue 7 Pages 429-432
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe report a case of pulmonary thromboembolism (PTE) in an 81-year-old male who was successfully treated by anticoagulation therapy and circulation support. The patient was transferred to the ICU due to acute respiratory and cardiac failure. PTE was diagnosed after finding thrombi in the right atrium and the deep veins of the legs by echo examination. PTE was treated with a small molecular weight heparin, and urokinase administration and Kimary-Greenfield filter placement performed by monitoring the size of the thrombus in the right atrium. Correction of dehydration and tachyarrhythmia without a pulmonary artery catheter was difficult. He developed pulmonary edema, which was treated successfully by artificial ventilation, inotropics and diuretics. He was discharged from the ICU 19 days after the episode. Prevention of recurrence.
PTE aswellas circulatory support are essential in the treatment of PTE in elderly patients.View full abstractDownload PDF (913K) -
Ryoko NOGUCHI1997 Volume 17 Issue 7 Pages 433-438
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe used propofol in sedation and wake up tests in 13 Parkinson's disease patients who were scheduled for stereotactic surgery.
Propofol infusion was initially administered at 6 to 10mg•kg-1•hr-1 and later maintained at 2 to 10mg•kg-1•hr-1. The general condition of the patients under propofol sedation was carefully managed. Only the nasal airway was used to maintain breathing. There was no severe respiratory or cardiovascular depression during sedation. During the wake up test, all patients except case no. 2 emerged rapidly and clearly, and neurophysiologic recording was satisfactory in all patients. Furthermore, propofol had an unexpected amnesic effect on all patients.
We conclude that propofol sedation reduces the discomfort of stereotactic surgery patients.View full abstractDownload PDF (625K) -
Tomoko BABA, Yoshihiro SHIBATA, Fumiyo KUBOTA, Tomoko GOTO, Atsushi YO ...1997 Volume 17 Issue 7 Pages 439-443
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSNeuropsychological dysfunction after cardiac surgery may contribute to postoperative morbidity. We usually evaluate neuropsychological function using a revised version of Hasegawa's dementia scale (HDS-R) before and after cardiac surgery. HDS-R is a brief, easily-scored (maximum score 30 points) test of several cognitive functions.
A 67-year-old man underwent coronary artery bypass grafting. His preoperative HDS-R score was 29. Surgery was completed uneventfully. Although he had no neurological abnormality postoperatively, HDS-R scores 1 day and 7 days after surgery were 17 and 19, respectively. His main intellectual impairment was acalculia. In addition to this, a left parietal infarction was newly detected in postoperative MRI. He was diagnosed as having Gerstmann-like syndrome (three other major symptoms, finger agnosia, right-left disorientation and agraphia were not found). Acalculia remained in an 8-month follow-up.
Neuropsychological deficit is not a trivial affliction and may exert an adverse effect on the quality of life. The evaluation of neuropsychological function following cardiac surgery is important.View full abstractDownload PDF (1227K) -
Kimiyoshi SATOH1997 Volume 17 Issue 7 Pages 444-448
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSThe author encountered a case of postoperative pneumonia caused by an antibiotic.
Case: a 56-year-old man. Esophagojejunostomy was performed 1 month after total gastrectomy for gastric cancer because of postoperative stenosis of the anastomosed site. Cefmetazole was administered as postoperative antibiotic therapy, but he developed pneumonia on the 3rd postoperative day (POD). Enterobacter cloacae was isolated as a causal organism on sputum culture, and the susceptibility of this strain to PIPC administered from the 3rd POD was determined to be as high as +++. However, blood gas analysis suggested aggravation. On the 8th POD, Ent. cloacae was no longer present in sputum culture, but his respiratory condition worsened and liver function was also aggravated. With suspicion of drug-induced pneumonia, administration of methylprednisolone at lg/day was initiated on the 10th POD. His X-ray findings and blood gas values gradually improved. The lymphocyte stimulation test showed cefmetazole to be positive (208%).View full abstractDownload PDF (1459K) -
Shigeki YAMAGUCHI, Toshio TAKANISHI, Tsutomu MATSUMOTO, Yukio MIDORIKA ...1997 Volume 17 Issue 7 Pages 449-452
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSBeckwith-Wiedemann syndrome consists of three major symptoms, exomphalos, macroglossia and giantism. A 20-month-old infant with Beckwith-Wiedemann syndrome underwent palatoplasty. Her sister with Beckwith-Wiedemann syndrome had died suddenly after palatoplasty. Anesthesia was induced with nitrous oxide and sevoflurane. When the depth of anesthesia was adequate, tracheal intubation was attempted using RAE tube® (I.D.4.5mm). However, it was impossible to insert it into the trachea because the larynx and vocal cords were swollen. Therefore, we intubatod with a smaller diameter RAE tube®(I.D. 4.0mm). However, it was pulled out.
Accidentally when the neck was extended backward for the placement of a mouth gag. A Sweigh-type tracheal tube® (I.D. 4.0mm) was inserted at an adequate depth into the trachea. Anesthesia was maintained with nitrous oxide and sevoflurane. After surgery, the tongue was thrust f oward and fixed with a thread to prevent airway obstruction. The tracheal tube was extubated after the patient had fully recovered from anesthesia. We administered methylprednisolone 125mg intravenously to prevent edema in the mouth. The postoperative course was uneventful, and the thread was removed 2 days after operation.View full abstractDownload PDF (496K) -
Noriomi INOUE, Minoru KAWANISHI1997 Volume 17 Issue 7 Pages 453-456
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSInjury to elongated, upper convex, isolated, mobile, and prosthetic (crown & bridge) teeth may occur during oro-tracheal intubation under general anesthesia.
Three types of protectors were studied in 32 of the 192 patients given general anesthesia from June to October 1993 at our hospital.
The first type, "Modeling Compound", proved to be useful, but some problems were noted. The second type, "premade protector", was not always suitable for elongated, upper convex, or isolated teeth or individual irregularities.
The third type, "Pressed custom-made protector", can be adapted for all patients, but it is costly and time consuming prior to the operation.
In conclusion, in addition to "Modeling Compound" which is currently being used at our hospital, we are adopting the "Pressed custom-made" type as an additional protector.View full abstractDownload PDF (1012K) -
Kazutoshi OKADA, Naoko ASANO, Oka KIMURA, Hiroshi OKADA, Takae KAWAMUR ...1997 Volume 17 Issue 7 Pages 457-463
Published: September 15, 1997
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSLow flow, closed system and functional closed system anesthesia can be performed using a regular anesthesia machine attached with an anesthesia gas monitor. However, thecareful and continuous monitoring of anesthetic concentration and intracircuit pressure necessary to this method are very mentally taking to the anesthetist. We modified and manufactured a regular anesthefic machine to perform many functions utilized in low flow and closed system anesthesia. We were able to administer closed system anesthesia, functional closed system anesthesia and low flow anesthesia with this machine for 5 to 6 hours without any problems such as hypoxia or undesirably high pressure in the breathing tube.View full abstractDownload PDF (821K)
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