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Volume 23, Issue 7
Displaying 1-6 of 6 articles from this issue
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[in Japanese]2003 Volume 23 Issue 7 Pages 173-174
Published: September 15, 2003
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (177K) -
Kaori YOSHITOMI, Yasutoshi MATAYOSHI, Hisashi TAMURA, Masato UCHIDA, Y ...2003 Volume 23 Issue 7 Pages 175-178
Published: September 15, 2003
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe encountered trouble in the perioperative management of a patient who had not been preoperatively diagnosed as having Ehlers-Danlos Syndrome (EDS) type IV. A 20-year-old woman presenting for resection of the colon to repair a fistula following the surgical closure of colostomy, which had been performed with the diagnosis of idiopathic perforation of the descending colon in another hospital 3 months ago. Because she had a life-long history of easy bleeding, she had been considered as having von Willebrand disease. After anesthesia induction, the first attempt at placing the central venous catheter resulted in subclavian arterial puncture, and she developed hemorrhagic shock and hemothorax. The operation was discontinued and she was admitted to our intensive care unit. Thereafter the patient was diagnosed as having EDS type IV by clinical signs and histopathological findings of the skin. Few days later, she underwent colectomy without a hemorrhagic episode, but she required 2 weeks of ventilatory support postoperatively.
In patients severely affected by EDS, tissue fragility and the potential for respiratory complications can present management problems during anesthesia.View full abstractDownload PDF (530K) -
Naoyuki HIRATA, Naohiro KOKITA, Masanobu NAMIKI, Asuka KITA, Takahiro ...2003 Volume 23 Issue 7 Pages 179-182
Published: September 15, 2003
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe experienced two cases of abortive malignant hyperthermia (a-MH) that occurred during tympanoplasty.
The two patients were young, muscular men, and they had no abnormal family history or past history of MH.
During the operation, a rise in body temperature was noted in the patients. After the operation, they complained of severe myalgia in their legs, and the creative kinase (CK) level on the day after the operation was abnormally elevated. Both patients were diagnosed as having a-MH.
Three weeks later, thigh muscle biopsy under local anesthesia was performed in both patients to examine the Ca2+ release function of the sarcoplasmic reticulum using skinned muscle fibers.
The findings of potentiated Ca2+-induced Ca2+ release from the sarcoplasmic reticulum when Ca2+ concentrations were 0 and 0.3μM suggested MH susceptibility.View full abstractDownload PDF (477K) -
Shinji MITSUMIZO, Mikio NAKASHIMA, Yoshinori MAEDA, Yuuhei UEMURA, Nao ...2003 Volume 23 Issue 7 Pages 183-186
Published: September 15, 2003
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe report a case of a 62-year-old woman undergoing pancreatoduodenectomy who developed a stunned myocardium following tracheal suctioning after surgery. She had no history of ischemic heart disease and was free from any risk of heart disease. After an uneventful surgery, atropine and neostigmine were administered intravenously and intratracheal suctioning was performed. Immediately we found inverted T waves in leads I, II, III, aVF and V2-V6 and hypokinesis at the apex of the left ventricle. Treatment included intravenous administeration of nitroglycerin and nicorandil. The wall motion of the left ventricle was restored the day after the operation and the inverted T wave was disappeared. There was no significant elevation of CPK-MB. In this case chathecholamine release and sympathetic excitation following intratracheal suctioning may cause myocardial stunning.View full abstractDownload PDF (1097K) -
Yuki ROKKAKU, Masahiro MURAKAWA, Manabu OTSUKI, Hiroaki MARU, Hiroshi ...2003 Volume 23 Issue 7 Pages 187-190
Published: September 15, 2003
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSA 52-year-old man underwent laparoscopic cholecystectomy. Preoperative electrocardiogram (ECG) showed flat T at I and aVL leads but his echocardiogram showed no abnormalities. Epidural catherization was performed at the Th8-9 interspace. Anesthesia was induced with propofol, fentanyl and vecuronium. His blood pressure suddenly decreased from 100/45 mmHg to 78/40 mmHg after pneumoperitoneum. Ephedrine was given and the blood pressure increased to 90/45 mmHg and the ECG showed a marked elevation of the ST-segment. Isosorbide dinitrate was given intravenously and ST-segment elevation gradually normalized within 5 minutes.
The transient elevation of ST-segment might be due to coronary artery spasm induced by ephedrine.View full abstractDownload PDF (506K) -
[in Japanese], [in Japanese]2003 Volume 23 Issue 7 Pages 191-194
Published: September 15, 2003
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (1231K)
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