[Two cases of unexplained pupillary dysfunction after cardiac surgery in severely diabetic patients].

We experienced two cases of unexplained pupillary dysfunction in severely diabetic patients after cardiac surgery. In both patients, marked bilateral dilatation of the pupils and the absence of light reflex were recognized immediately after leaving the operating room. The pupillary dysfunction, however, was not accompanied by other neurological deficits, and the pupil sizes returned normal spontaneously by 24 hours.

Textbook of anesthesia on electronic media: trial version as a free software.

The author has compiled a textbook of anesthesia on a floppy diskette and has made it available as free software. It is called "KSAP", which stands for "Knowledge Source for Anesthesia Practice". He aims to create a new form of textbook that is appropriate for current technology.

Estimation of cerebrospinal fluid pressure via lumbar epidural space by equilibration method.

By introducing water into the lumbar epidural space from a vertically held tube under gravity, we measured lumbar epidural pressure (EDP) when the water meniscus no longer declined. In principle, the pressure of either side of dura mater had become equal at this time which is referred to as the equilibrium point. EDP measured in this way was consistently 1-3 mmHg lower than lumbar cerebrospinal fluid pressure (CSFP) not only immediately after the equilibrium point, but also for 5 min after the equilibrium point had been reached.

[The effects of incentive spirometry on pulmonary functions].

The effects of incentive spirometry on pulmonary functions were studied in 46 normal adults of advanced age ('N' group) and 42 patients with chronic pulmonary emphysema ('E' group). Subjects of the both groups carried out deep breathing exercises by using incentive spirometry, 'Souffle', for five minutes, five times daily for four weeks. Pulmonary functions and arterial blood gases were measured at the start of exercise program, and at two and four weeks after the start.

Pulmonary capillary pressure measured with a pulmonary arterial double port catheter in surgical patients.

We developed a pulmonary artery (PA) double port catheter technique for reliable clinical measurements of pulmonary capillary pressure (Ppc). In seven elective surgical patients, the PA double port catheter with the second PA port 1 cm proximal to the balloon was inserted. The two PA ports, connected to identical pressure measuring systems, provided the pulmonary arterial pressures (Ppa) distal and proximal to the balloon.

Natural frequency/damping coefficient relationship of the catheter-manometer system required for high-fidelity measurement of the pulmonary arterial pressure.

Using a digital simulation method, we analyzed the relationship between natural frequency (fn) and damping coefficient (Zeta) of the catheter-manometer system required for high-fidelity measurement of the pulmonary arterial pressure. The pulmonary artery pressure waveform was obtained with a catheter-tip transducer and it was fed into a dynamic simulator programmed on a computer. The original waveform and the output of the simulator were compared and judged visually for the fidelity.

[A graphic presentation of the anesthesiologist's action pattern].

The action patterns of anesthesiologists are different among individuals. We have developed a graphic presentation system for anesthesiologists' action patterns using computer graphics. The resulting representation is called "thought map".

Report on the computer software contest at the 39th Congress of the Lapan Society of Anesthesiology.

We held another computer software contest at the 39th Congress of the JSA. The aim and procedure were similar to those for the first contest in 1991. Twenty-four softwares entered the contest; the machines are divided approximately two to one ratio between NEC PC9801 series and Macintosh.

Cardiac autonomic dysfunction in rotogravure printers exposed to toluene in relation to peripheral nerve conduction.

The autonomic nervous effects of toluene remain less clear. To clarify this neurotoxicity, ten rotogravure printers and the same number of age-matched unexposed controls were examined, by using the coefficient of variation in electrocardiographic R-R intervals (CVRR), the distribution of nerve conduction velocities (DCV) and the maximal motor and sensory nerve conduction velocities (MCV and SCV) in the median nerve. Also, the C-CVHF and C-CVLF (two component CVs of the CVRR reflecting parasympathetic and sympathetic activities, respectively) were computed from component spectral powers using autoregressive spectral and component analyses.

[Simulation in anesthesia].

Simulation in anesthesia is reviewed. Its aim includes education/training, analysis of phenomena, explanation or interpretation of phenomena and instrument checks. It deals with pharmacokinetics/pharmacodynamics of inhalational and intravenous agents, respiration and circulation, action and behavior of anesthesiologists and income analysis.

[Acid-base disorders in anesthesiology and in related fields].

Acid-Base disorders in anesthesia and in related fields were discussed. Four topics were chosen because they are relatively new and attracting attentions. They are 1) Monitoring Petco2 in anesthesia and in Intensive Care, 2) Relationships between newly established laparoscopic surgery and ventilatory impairment/elevation of Paco2, 3) Surgery in which large amount of chloride ion is absorbed, and 4) High venous Pco2 in resuscitation.

MPO activity and generation of active O2 species in leukocytes from poorly controlled diabetic patients.

Objective: This study was undertaken to determine which part of ROI generation is reduced in the neutrophils from patients with NIDDM.

Research Design And Methods: Superoxide anion (O2-) production, LDCL activity in response to opsonized zymosan, and MPO activity were measured in leukocytes of poorly controlled NIDDM patients (FBG greater than 8.89 mM, HbA1 greater than 10%).

Analysis of oxygen transport to the brain when two or more parameters are affected simultaneously.

We composed a model, combining oxygen transport system from blood to tissue with the oxygen consumption system at the tissue. The aim of this study is to apply it to the brain tissue under conditions when two or more oxygen transport parameters are affected simultaneously. The following values were assumed.

Programming a predictive formula for angina and other risk factors in patients with cardiac diseases undergoing noncardiac operations.

We programmed a formula which predicts the incidence of either myocardial infarction or cardiac death during the postoperative period. The original formula was proposed by Shah et al, based on their own data and analysis. The program is simple and is written in a language called Quick Basic.

Analysis of oxygen transport and oxygen utilization combined.

We propose a model which combines oxygen transport system from blood to tissue with oxygen utilization system at the tissue. The model consists of 3 equations; the relationship between tissue P(O)(2) (Pts(O)(2)) and O(2) utilization (Vrc(O)(2)), diffusion from vessel to tissue, and Fick equation. This model has two advantages.

Mechanism of inhibitory action of ketone bodies on the production of reactive oxygen intermediates (ROIS) by polymorphonuclear leukocytes.

We determined an effect of acetoacetic acid (AcAc) and 3-hydroxybutyrate (3-OHB) on the production of reactive oxygen intermediates (ROIs) in polymorphonuclear leukocytes from healthy volunteers. Both AcAc and 3-OHB inhibited the luminol-dependent chemiluminescence (LDCL) activities assessed with initial slope and the inhibition rates were about 42%, 44% respectively by AcAc and 3-OHB when the leukocytes were preincubated with 10 mM AcAc or 3-OHB for 60 minutes. The LDCL activity was reduced by 16% and 42% following the addition of 1mM and 10 mM AcAc.

Report on the computer software contest at 38th Congress of the Japan Society of Anesthesiology.

We held a computer software contest at 38th Congress of the JSA, held in March, 1991. The aim is to encourage the members of the Society to write softwares and to help distribute them, especially as Freewares. We received 25 entries for the contest; two-thirds of these are for computers of NEC PC9801 series and a third are for Macintosh.

[Experience in using personal computers in writing and publishing books].

Experiences in using personal computers in writing and publishing books are presented. Since 1984, I have written 8 books, translated 4, and edited two books, in all of which personal computers/wordprocessors have been somehow involved. Their relationships to computers were; writing using a wordprocessor, drawing graphs and figures by computers, writing books about computers and doing analysis using them, such as acid-base and uptake of inhalational anesthetics.

[Weaning and chest wall mechanics].

I discussed following four points. 1. Weaning means an increase in energy demand.

Phasic capillary pressure determined by arterial occlusion in intact dog lung lobes.

In six open-chest dogs, electrocardiogram- (ECG) controlled pulmonary arterial occlusion was performed during the control period and during the infusions of serotonin and histamine. A temporal series of instantaneous pulmonary capillary pressure and the longitudinal distributions of vascular resistance and compliance were evaluated in the intact left lower lung lobe. In the control period, we found a significant phasic variation of pulmonary capillary pressure (Pc) with the cardiac cycle.