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E Kitagawa

Publications and source records attributed to E Kitagawa.

5 recordsLinked to original sources

Long-term histologic results of vein grafting with the telescoping anastomotic technique.

We studied the long-term histologic results of a new method for autogenous vein grafting to examine whether stenosis at the anastomosis is maintained over time. Nineteen rat inferior epigastric veins were grafted into the femoral artery using a telescoping sleeve technique at both the proximal and the distal anastomoses. Specimens were studied macroscopically and histologically three months later. Stenosis at the anastomosis was located near the tip of the inserted vessel. The smallest inner diameters of the proximal and distal anastomoses were about 80% of the corresponding femoral artery diameter; no statistically significant difference was found between the two anastomoses. The grafts had a thickened wall due to intimal hypertrophy and fibrosis of the media. The inner diameter of the graft was, however, about twice that of the femoral artery, and these graft changes did not create any apparent constriction within the graft.

Abdominal Muscles

Responses to intravenous sedation by elderly patients at the Hokkaido University Dental Hospital.

Geriatric patients who undergo intravenous sedation require careful intraoperative management, because respiratory and circulatory depression usually accompanies the administration of recommended adult sedative doses. This study examined results when a single benzodiazepine, diazepam or flunitrazepam, was carefully titrated to a clinical endpoint of conscious sedation. A total of 335 cases was divided into seven age groups. Mean sedative doses gradually decreased with age. The 60- to 69-yr group required about 75% of the adult recommended dose, the 70- to 79-yr group required 40% to 60%, and the 80- to 89-yr group required 30% to 45%. Pulse oximetry values also declined with age; respiratory depression was observed mainly in elderly patients. Declines in blood pressure after benzodiazepine administration were not correlated with age. The rise in blood pressure normally observed intraoperatively was suppressed both in young as well as old patients. We conclude that intravenous conscious sedation in elderly patients reduces stress-induced cardiovascular stimulation and that respiratory depression may occur at even low sedative doses.

Adult

[The factors that influence intraoperative blood loss during total hip replacement].

Fifty cases of total hip replacement performed by one surgeon were reviewed to compare the effects of epidural and general anesthesia. The blood pressure in patients under epidural anesthesia was significantly lower (P less than 0.001; t-test). There was a highly significant correlation between the operation time and the intraoperative blood loss (P less than 0.005, r = 0.67). A significant correlation was noted between the blood pressure and the minute loss of blood (P less than 0.01, r = 0.43). It is concluded that epidural anesthesia is to be recommended rather than general anesthesia in patients undergoing total hip replacement.

Adult

[Parascalene brachial plexus block].

The supraclavicular brachial plexus block originated by Kulenkampff is useful but accompanies the danger of injury to the lung, i.e. pneumothorax, because the needle is directed caudad. Reviewing the anatomy of the brachial plexus in cadavers, we have found that the parascalene brachial plexus block originated by Vongvises is safer than Kulenkampff's method. We modified this block as follows: (1) An assistant pulls lightly the affected upper extremity caudad. (2) A 23-gauge 35 mm needle is inserted at right angles to the clavicle and directed cephalad at an angle of 0-30 degrees. One hundred and eighty four ASA I and II patients were operated under this block. Their ages ranged from 11 to 77, and there were 31 patients whose cervical spinal cord had been injured. Our success rate was 92%. The only complication we encountered was Horner's syndrome which occurred in 20% of our cases. None of our patients showed clinical symptoms of pneumothorax, hematoma, epidural as well as subarachnoideal block, recurrent nerve paralysis or phrenic nerve paralysis.

Brachial Plexus