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Biomedical subjects

H Iwasaka

Publications and source records attributed to H Iwasaka.

9 recordsLinked to original sources

Bulimia nervosa in a pair of male monozygotic twins.

This is a report of a pair of male monozygotic twins meeting the DSM-III-R criteria for bulimia nervosa. At the age of 15, both brothers began to diet and suffered from bulimia. They were admitted to psychiatric hospitals and separated. After admission, their clinical course dramatically changed. The differences in their clinical courses and endocrinological data are suggestive as to the roles of environmental and hereditary factors in the etiology of bulimia nervosa.

Adolescent

[A comparison of the effects of omeprazole with those of ranitidine on intragastric pH and volume in patients for elective surgeries].

This study compared the effect of omeprazole with those of ranitidine on intragastric secretion during perioperative period. Thirty-one patients were randomly allocated to three groups. Each group received either omeprazole, ranitidine orally or one on the night before surgery. Intragastric pH and volume were measured after induction of anesthesia. Omeprazole group and ranitidine group had a higher mean pH than control group (P less than 0.01). None of the omeprazole group had an aspirate of pH lower than 2.5. One patient (10%) in the ranitidine group and five patients (50%) in the control group and five patients (50%) in the control group had aspirates of pH lower than 2.5. Mean gastric volume was not significantly different among these groups. A single dose of omeprazole 20 mg significantly decreased the number of patients at risk of aspiration pneumonitis.

Gastric Acid

[Coagulation changes during liver resection].

Thrombin-antithrombin III complex (TAT) and plasminogen activator inhibitor (PAI) were measured during liver resection surgery in 8 patients. TAT and PAI activities of patients under liver resection were compared with those of 11 patients under resection of esophageal carcinoma. TAT activity increased during liver resection (P < 0.001) and reached 14 times (P < 0.001) of its control value in the recovery room. PAI activity was very stable during operation, but increased to twice (P < 0.01) of its control value in the recovery room. TAT activity of patients after liver surgery in the recovery room was (P < 0.05) more than twice of that of patients after esophageal surgery. We conclude that hypercoagulable state occurred during liver resection to a greater degree compared with that observed with esophageal surgery, and that its cause might be liver resection itself.

Antithrombin III

[Hemodynamic management of LOS using prolonged VA bypass circulatory assist].

The authors managed five LOS patients using prolonged V-A bypass circulatory assist. Maximum CVP values were under 12 mmHg in three survivors, and 17 mmHg and 20 mmHg in two nonsurvivors. Maximum PCWP values were under 14 mmHg in survivors, and 19 mmHg and 20 mmHg in nonsurvivors. Dopamine was administrated in all cases and norepinephrine was administrated at a rate of less than 0.3 microgram.kg-1.min-1 in survivors, and in two nonsurvivors, norepinephrine was used at a rate of 0.36 and 1.2 micrograms.kg-1.min-1. Before and after disconnection of V-A bypass, the bypass flow of the three survivors were under 1.0 l.min-1 just before disconnection, and immediately after it, the preload did not increase, and the dose of administrated catecholamine increased. V-A bypass time intervals of the three survivors were 71, 42 and 87 hours, and those of the two nonsurvivors were 71 and 43 hours. Maximum bypass flow rate was above 40ml.kg-1.min-1 in four of five patients. The authors discussed the management of the patients' heart and of the V-A bypass machine during the prolonged V-A bypass circulatory assist.

Aged

[Heat conservation during abdominal surgery].

Intraoperative hypothermia is a major problem in anesthetic management. We compared the heat conserving effect of a forced air warming system (Bair Hugger, Augustine Medical Inc.) with that of a warming blanket. Sixteen patients undergoing abdominal surgery were studied. Patients were anesthetized with nitrous oxide and oxygen combined with epidural anesthesia. Patients received tympanic, rectal, bladder and core temperature monitorings. Patients were divided randomly to Bair Hugger group (BH, n = 8) or warming blanket group (WB, n = 8). Temperature were measured every one hour over three hours. The BH group showed significantly higher temperatures than WB group. Bair Hugger system is an efficient way to maintain intraoperative body temperature.

Abdomen

[Diuretic effects of aminophylline in patients after cardiac surgery].

Diuretic effects of aminophylline in patients after cardiac surgery were studied by using the local renal thermodilution catheter (Goodman Co. Ltd.). The subjects were 11 patients who underwent cardiac surgery in our hospital. All patients had shown almost normal renal and endocrine function. On the day of operation, we indwelld renal thermodilution catheter into the left renal vein under fluoroscopy. After operation, when the urinary volume decreased below 1 ml.kg-1.hr-1, we administered aminophylline at a rate of 2 ml.kg-1.hr-1. We measured HR, BP, CO, PAP, CVP, renal blood flow, urinary volume, urinary electrolytes, plasma renin activity, angiotensin II, aldosteron, ADH and alpha hANP just before and after infusion of aminophylline. The urine volume, renal blood flow and renal blood flow distribution rate showed significant increases of about 70%, 40% and 35% respectively. But hemodynamic parameters including HR, mean BP and CO increased for 5%, 10% and 8% respectively after administration of aminophylline. In the endocrine system, only angiotensin II increased significantly but aminophylline did not cause any change in endocrine system. The results suggest that diuretic effect of aminophylline is mainly achieved by increasing renal blood flow.

Adult

[Intraoperative cardiac output monitoring by the transtracheal Doppler method].

We investigated the cardiac output measured with a transtracheal doppler (TTD) tube in surgical patients and evaluated its usefulness during operations. This tube was located at the point where maximum velocity of blood flow was obtained in the ascending aorta. At this point the cross-sectional area of the ascending aorta was calculated and the cardiac output was obtained by multiplying this area with average blood flow velocity which had been ultrasonically determined. The cardiac output by the TTD method was compared with that of the thermodilution method in 10 patients. The results with both groups showed a direct linear correlation. We obtained the following linear equation: TTD C.O. = 0.61 Thermo C.O. + 1.3 C.O.: cardiac output. The direct correlation coefficient proved to be 0.85 at a risk factor of 0.01. The result suggests that this non-invasive TTD method is easily available and useful in monitoring the intraoperative cardiac output.

Aged