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[in Japanese]
1983 Volume 3 Issue 3 Pages
271-277
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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[in Japanese]
1983 Volume 3 Issue 3 Pages
278-284
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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[in Japanese]
1983 Volume 3 Issue 3 Pages
285-293
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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[in Japanese]
1983 Volume 3 Issue 3 Pages
294-297
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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[in Japanese]
1983 Volume 3 Issue 3 Pages
298-300
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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[in Japanese]
1983 Volume 3 Issue 3 Pages
301-303
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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[in Japanese]
1983 Volume 3 Issue 3 Pages
304-307
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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[in Japanese]
1983 Volume 3 Issue 3 Pages
308-310
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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Shigeo Kuwahara
1983 Volume 3 Issue 3 Pages
311-316
Published: July 15, 1983
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Ryoji HORIGUCHI, Sachiko SAKAKURA, Norimi FUJITA, Takaaki KURIOKA, Kun ...
1983 Volume 3 Issue 3 Pages
317-322
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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In fifteen patients, the effects of frames of various types on the lung-thorax compliance and central venous pressure during the prone position were investigated. Lungthorax compliance and central venous pressure were measured in the supine position, next in the prone position without any kinds of frames, successively with the Hall frame, with long pillows, with the Mackay frame and in the jack-knife position with the Mackay frame from the same patient. Lung-thorax compliance decreased significantly (about 20%) and central venous pressure increased when the patients were turned to the prone position from the supine without these frames. During the prone position, the lung-thorax compliance with the Mackay frame and in the jack-knife position with the frame decreased signficantly. Central venous pressure also decreased significantly in the prone position with the Hall frame, with the Mackay frame. From these results we conclude that usage of the Hall frame is preferable for the operation in the prone position in viewpoints of respiratory and cardiovascular effects.
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Shigeji SHIBATA, Yutaka YASUI, Shigeru TANIGUCHI, Yukio KUWATA, Koichi ...
1983 Volume 3 Issue 3 Pages
323-328
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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The 119 Patients with DOA (Dead on arrival) cases being carried to the Emergency Center of Iwate were analyzed retrospectively during 20 months from November, 1980.
The following results were obtained.
1. Among 119 patients, traumatic patients were 33, and nontraumatic were 86 patients.
2. Of the 119, 102 patients were cardiopulmonary resuscitated. Resuscitation was successful in 24 (23%) who kept alive more 5 hours after resuscitatdon, and only 3 patients were discharged.
3. Unsuccessful cases in resuscitation were 78 (76%). Of these, 8 patients survived 2 or 4 hours and remained 70 could not be resuscitated at all.
4. In successful cases in resuscitation, the interval between arrest and beginning of resuscitation was 23.7±15.3 minutes and the mean resuscitation time was 22.7±21.9 minutes.
5. In unsuccessful cases in resuscitation, the interval between arrest and beginning of resuscitation was 27.9±15.3 minutes and the mean resuscitation time was 35.5±21 minutes.
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Minoru KAWANISHI, Masaji MATSUURA, Junichi HASEGAWA, Motoshi KAINUMA, ...
1983 Volume 3 Issue 3 Pages
329-336
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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3 patients suffering from alveolar proteinosis were treated with massive pulmonary lavage. The lavage method followed the technique described by Ramirez-R, in which one lung was degassed and irrigated repeatedly by liters of a warmed saline solution. During lung lavage, percutaneous and intra-arterial PO
2 electrodes were used to monitor the blood gas changes. Swan Ganz catheter and systemic arterial pressure line were placed to monitor the hemodynamic changes. Arterial oxygen tension increased when the lung was filled with the solution, whereas PaO
2 decreased immediately when the solution was drained out of the lung. Percutaneous and intra-arterial PO
2 electrodes traced these changes very clearly. Pulmonary arterial, central venous and pulmonary capillary wedge pressures were increased at filling into the lung and were decreased at emptying, whereas cardiac output measured by thermo-dilution method was decreased at filling and was recovered at emptying. These hemodynamic and blood gas changes were mainly explained by the changes of pulmonary circulation. The application of positive end expiratory pressure (PEEP) to the ventilated lung suppressed the value of PaO
2, therefore PEEP application was considered to be contraindicated. Besides the continuous monitoring of electro-cardiogram and systemic arterial pressure, percutaneous PO
2 monitoring seems to be very valuable for the establishment of safety pulmonary lavage.
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Masuhiko TAKAORI, Yoshihito SASAKI, Takeshi OKUNOBO
1983 Volume 3 Issue 3 Pages
337-342
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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Three different fluids, were administered in over 70 years old patients operated under general anesthesia. Na concentration in the three different solution was 130mEq/l (H group), 77mEq/l (M group) and 15mEq/l (L group) and the amount of fluid infused was averaged 2500ml within 4 hours. No marked difference in water intake and output balance, was noted between the above groups. Serum Na concentration was decreased in the L and M group but not in the H. Na intake and output balance showed+170mM in the H group in this period which was mostly comparable with +100mM in the M group.
Negative balance in K intake and output was noted in the all groups. The above data indicates that elder patient may excrete water and Na sufficiently intraoperative period as well as younger suject does, and in addition suggestes that amount of K infused will be better increased to maintain serum K level normal.
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Takashi MOMOSE
1983 Volume 3 Issue 3 Pages
343-349
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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Abnormal increase of blood pressure at endotracheal intubation often results in severe worsening of the patient's condition. So it was investigated whether the hypertension could be controlled by the intravenous administration of nitroglycerin (TNG). One hundred cases aged 16-79 were put into two groups. TNG (2mcg/kg/min) was infused to one of these groups (TNG group) and the other was not treated with TNG (Control group). Blood pressure, pulse rate, plasma catecholamine (CAT) and plasma renin activity (RA) were measured four times-at rest, before intubation, at intubation and after intubation.
There was a significant difference in the rate of increase in systolic blood pressure between the TNG group and the control group. However, there was no significant difference in diastolic pressure except in the cases aged 40-60. In the TNG group and the control group, CAT increased following intubation about 3.5 times and 1.8 times, respectively. A significant difference in CAT was noticed but not in RA. But it was also shown that CAT tended to decrease at 5 minutes after the termination of TNG infusion.
The infusion of TNG was clinically effective for depressing the hypertension at endotracheal intubation although transient increases in pulse rate and CAT were caused.
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Yoki HASEGAWA, Tetsuo KOCHI, Toshiko ISHIGAMI, Tatsuo SUZUKI, Kyuta SA ...
1983 Volume 3 Issue 3 Pages
350-354
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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We studied coaxial dual flow ventilation circuit which was combined with the humidifier controlling inspired gas temperature automatically.
The variation of inspired gas temperature was controlled within ±0.3°C when tidal volume and respiratory rate were changed. Inspired gas temperature indicated stably within ±0.2°C under the change of specified temperature of inspired gas and ventilation. In addition, inspired gas temperature was little influenced by the change of room temperature.
Rainout in the circuit slightly increased with decreasing of respiratory rate, however, its value was lower than that of conventional circuit, as this circuit is dual flow system warming an inspired limb with heat of expired gas.
From the above results, we conclude that this system can control inspired gas temperature accurately and simply, and there is less rainout in the circuit.
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Takashi METOKI, Hitomi HIGUCHI, Nobuko SHINBARA, Kazuyuki SERATA, Keni ...
1983 Volume 3 Issue 3 Pages
355-360
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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One hundred and twenty-two cases (130 ears) of sudden deafness were treated with combined stellate ganglion block and steroid therapy. They were analyzed from the following factors: days after onset, mean hearing loss, major symptoms, audiogram types and prognosis.
The remarkable improvement was obserbed in 82 cases (80%) of sudden deafness of which treatment was started within the two weeks after onset. The hearing recovery was worse in the cases of severe hearing loss. In the cases that mean hearing loss of 250, 500, 1000, 2000, 4000Hz was above 80dB, prognosis was poor. The hearing recovery was poorer in the cases with vertigo than without it.
Clinical result of stellate ganglion block therapy of sudden deafness were reported. The prognosis of sudden deafness were also discussed on referring to the previous clinical reports.
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Hironori ISHIHARA, Hirofumi NAGAO, Ken-ichi ISOZAKI, Akimasa MIYATA, A ...
1983 Volume 3 Issue 3 Pages
361-366
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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An improved anesthetic information by micro-computer system is described. Input data such as anesthesiologists, operative procedure, anesthetic techinque or agents, muscle relaxants and complications are coded and entered in a microcomputer system using "NEC PC8800". Output data from the system are expressed in English or Japanese without using coded number. Thus, errors in the data-entering process can be found easily and simply. The system allows us to detect anesthesia cases which will fulfill three conditions in any items of the coded data in time saving way. This also provides us precise information of anesthetic number, date, name of the patient, age, sex, duration of anesthesia and operation, special remarks and coded data listed above.
The system developed by us will contribute greatly to make statistical evaluation of anesthesia data by obtaining necessary information rapidly and effectively.
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Shinichi KANEKO, Junichi NOGUCHI, Masahiro HIGA, Shingo ASANO, Taro KA ...
1983 Volume 3 Issue 3 Pages
367-371
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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The effects of preanesthetic cimetidine on the pH and volume of gastric contents were studied in 65 patients scheduled for elective operation.
Oral cimetidine was given to 51 patients: 200mg to 20 patients (Group 1), and 400mg to 17 (Group 2), both 2 hours hours before induction of anesthesia, and 800mg every 6 hours on the day before operation and 200mg 2 hours before induction to 14 (Group 3). The remaining 14 patients served as controls.
Immediately after induction, gastric contents were aspirated via a double-lumen gastric tube and their pH and volume were measured and compared with the controls.
The gastric pH was significantly higher (p<0.01) in all treatment groups. The gastric volume was significantly lower in Group 2 (p<0.05) and Group 3 (p<0.01), but not in Group 1.
The percentages of those patients at high risk of pulmonary reaction following aspiration of gastric contents (i. e., with pH_??_2.5 and volume_??_25ml) were 50% for the controls, 20% for Group 1, 18% for Group 2, and 0% for Group 3.
These results demonstrate that premedication with oral cimetidine markedly increases gastric pH and decreases gastric volume, thereby reducing the incidence of pulmonary reaction in high risk surgical patients.
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Ikuko OTANI, Tetsuo TAKAYA, Yonosuke YAMAZAKI, Mamoru TAKIGUCHI, [in J ...
1983 Volume 3 Issue 3 Pages
372-376
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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We give high concentration of oxygen during Cesarean section in the hope of giving the fetus more oxygen.
In order to assess the validity of the practice, we measured the umbilical arterial and venous blood O
2 tention.
The study was performed in 32 healthy pregnant women undergoing Cesarean section with spinal anesthesia by making them inhale 21%, 50%, or 90% O
2. The maternal PaO
2 (MAPO
2) was compared with the umbilical artery PO
2 (UAPO
2) and umbilical vein PO
2 (UVPO
2) obtained immediately after delivery.
The results showed that UVPO
2 change little with MAPO
2 up to 250mmHg, while UVPO
2 increased linearly with MAPO
2 between 250 and 400mmHg, but some cases showed declining UVPO
2 with MAPO
2 above 400mmHg.
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Takesuke MUTEKI, [in Japanese], [in Japanese], [in Japanese], [in Japa ...
1983 Volume 3 Issue 3 Pages
377-387
Published: July 15, 1983
Released on J-STAGE: December 11, 2008
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In order to obtain much higher quantitative and reliable data of dynamic performances of cardiovascular system during anesthesia and surgery, clinical application of the computer, ATAC-450 (Nihon-Koden) was performed for real time processing the data related to pressure and flow of circulatory system as an aid to clinical decisionmaking in critical care medicine.
Stroke volume was obtained from waveform of aortic pressure (Warner's pulse contour method), and systemic vascular resistance, venous return resistance, TTI (MAPXHR×TS) mean systolic ejection rate (SI×TS), LVWI, RVWI, right atrial electromechanical index RaEMI (contractile work index of right atrial systole performance), O
2 delivery (CaO
2×CI×10) and O
2 extraction (CaO
2-CvO
2)⁄(CaO
2) were all measured and calculated in 0.005sec of sampling time with 1024 points. And beside, these numerous data were displayed on nine different diagrams on real time processing system.
Clinical value of CVP monitoring has been extended and confirmed with possibility of clinical measurement of mean circulatory filling pressure, and right atrial function.
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