[Measurement of aortic compliance in living dogs utilizing the changes in transthoracic electrical impedance with an induced change in volume of the aorta].
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Biomedical subjects
Publications and source records attributed to J Akune.
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Three patients with recurrent uterine cancer, unresectable rectal cancer, and recurrent rectal cancer in the pelvis were treated by percutaneous superselective transarterial embolisation (TAE) of the hypogastric artery and it's branches with ethanol or gelatin sponge particles. TAE was performed for the control of life-threatening hemorrhage, severe pain and the diminishing tumor's bulk. In addition to conservative cares, this TAE needed minor surgical procedures such as urinary diversion, colostomy and drainage of abdominal abscess just when urinary bladder's necrosis, rectosigmoidal necrosis and peritonitis would be expected before and after the TAE. One local hematoma in the site inserted catheter and right ischiadic nerve paralysis occurred by TAE. Two patients died on 6 days and 2 months after TAE, respectively, however one patient is still alive one year after the TAE without the growth of tumours. As a result, this TAE with minor surgical procedures is expected as a suitable treatment for the improvement of the survival and quality of life in the patients with unresectable intrapelvic tumors.
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beta 2-microglobulin (BMG) and conventional renal function parameters (creatinine clearance (C-cr) etc.) were measured in 36 adult patients before and after open heart surgery (Group-2). Same study was performed in 14 adult patients abdominal surgery (Group-1). Urinary BMG concentration (U-BMG) increased remarkably in both groups immediately after surgery. U-BMG returned to the preoperative level on the 4th postoperative day (4-POD) in Group-1, and 7-POD in Group-2. The degree of increase in Group-2 was remarkable comparing with that in Group-1. The tubular dysfunction after surgery was believed to result in a marked rise in U-BMG, therefore, the later recovery and higher increase of U-BMG in Group-2 indicated that the tubular dysfunction after open heart surgery was severer comparing with that after abdominal surgery. On 7-POD, in Group-2, U-BMG was still abnormal in 13 cases, which suggested the prolonged tubular dysfunction after open heart surgery. A retrospective study to determine the risk factors of prolonged tubular dysfunction was performed in 34 patients in Group-2. Significant risk factors were preoperative blood urea nitrogen and urine osmolarity. Several factors were not significant including perfusion time, aortic alamp time, preoperative C-cr, U-BMG, serum creatinine concentration and free water clearance.
A 60-year-old male developed chronic respiratory failure due to central hypoventilation after cerebellar bleeding. We implanted a diaphragm pacemaker (radio-frequency type) to the patient, and his respiratory status was improved. Although this apparatus devised by Glenn has been widely used in the United States, clinical applications in Japan were rarely reported. Diaphragm pacing might be one of the effective treatments to the patient with chronic respiratory failure. We discussed the indication, mechanical subject and surgical approach concerning diaphragm pacemaker implantation in this paper.
Beta 2-microglobulin (BMG) and osmolarity (OSM) in the plasma and in the urine were measured in 23 adult female patients before and after abdominal surgery. Creatinine clearance (Ccr) and free water clearance (C-H2O) were determined simultaneously. These patients were divided into two groups, the first group receiving halothane anesthesia (n = 14) and the second group undergoing epidural anesthesia (n = 9). Results were summarised as follows. Ccr temporarily increased in both groups on the day of operation (0-POD) and on the 1st postoperative day (1-POD), suggesting a physiological compensation to the increased metabolic and circulatory needs in the post-operative state. Urinary BMG (U-BMG) concentration remarkably increased in both groups after the operation but the plasma BMG levels were unchanged. U-BMG returned to the pre-operative levels on the 4-POD in the 1st group and on the 2-POD in the 2nd group. Tubular dysfunction after anesthesia and surgery is believed to be responsible for this marked rise in U-BMG. The earlier recovery of U-BMG to the preoperative levels in the 2nd group indicates that the tubular dysfunction in epidural anesthesia is probably less in halothane anesthesia. The results of C-H2O and urine OSM studies also indicate the postoperative tubular dysfunction but these parameters may not be so sensitive as U-BMG.
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