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Hiroaki Urayama

Publications and source records attributed to Hiroaki Urayama.

3 recordsLinked to original sources

Use of near-infrared spectroscopic measurement at the buttocks during abdominal aortic surgery.

During abdominal aortic surgery, dynamic changes occur in the pelvic circulation. Near-infrared spectroscopy (NIRS) was used in this study to evaluate arterial flow in the buttocks as a monitor of arterial flow in the pelvic area during abdominal aortic surgery. Twenty-two patients who underwent abdominal aortic aneurysmectomy comprised the study group. The NIRS probe was mounted on the left buttock during surgery, and the changes in oxy- and deoxy-hemoglobin (Hb) concentration were measured. In all cases Hb values reflected decreased arterial flow caused by aortic clamping and increased arterial flow after reconstruction of the distal arteries. The recovery pattern of the Hb values varied, but all recovered to the baseline value recorded before aortic clamping. None of the patients exhibited postoperative claudication of vessels supplying the gluteal muscles or colonic ischemia, and recovery time varied in accordance with the patient's arterial condition. This method is simple and enables individual evaluation of blood flow recovery from reconstructed arteries. This method allows approximate evaluation of the pelvic arterial flow of individual arteries, helps to predict postoperative claudication of the gluteal muscles, and offers additional information for evaluating colonic ischemia.

Aged↗

Increasing circulation in the lower limb under general anesthesia using the A-V impulse system.

The action of foot impulse technology (FIT) in reducing the risk of deep vein thrombosis (DVT) is well established. We hypothesized that intraoperative use of FIT devices will be effective in the prophylaxis of DVT. The aim of this study was to investigate the effect of a FIT device (A-V impulse system) on the venous flow of the lower extremity using duplex ultrasound scanning while the patient was under general anesthesia. Thirteen surgical patients who had no lower limb vessel lesions were selected for the study. Duplex scanning was used to measure blood velocity in the right common femoral vein, with and without the foot pump, before and during general anesthesia. The mean resting velocity was 33.2 +/- 5.5 cm/sec in the pre-anesthetic state, 32.1 +/- 4.2 cm/sec under anesthetic, and 30.4 +/- 5.0 cm/sec postoperatively. The peak velocities with the pump active were 38.6 +/- 5.0 cm/sec before anesthetic, 54.6 +/- 5.9 cm/sec while anesthetized, and 52.7 +/- 7.8 cm/sec postoperatively. The measured increases while under anesthesia and postoperatively both reached statistical significance (p<0.05). Our study demonstrated that use of the A-V impulse system causes a statistically significant increase in venous velocity of the lower extremity while the patient is under general anesthesia.

Adult↗

Incomplete ventricular septal rupture following blunt chest trauma--a case report.

This report describes a case of traumatic incomplete rupture of the ventricular septum, a rare complication caused by blunt chest trauma. Although a serial ECG progressed its course similar to acute anteroseptal myocardial infarction in this case, there was little clinical clue of septal tear. The diagnosis was established by transthoracic echocardiography. The authors chose a conservative line of management rather than surgical repair for incomplete septal rupture because of the patent's stable clinical course and hemodynamic status. A sequence of echocardiography during a 32-day stay in the hospital showed no change in the extent of incomplete septal rupture, septal structure, systolic function, and shape of left ventricle and also obtained no evidence of shunting through the rupture. In conclusion, echocardiography is a useful investigation to make a diagnosis as well as for follow-up in case of incomplete ventricular septal rupture. A close follow-up of incomplete septal rupture with serial echocardiography should be performed, because several cases of delayed ventricular septal rupture following blunt chest trauma have been reported.

Accidents, Traffic↗