The influence of hyperbaric bupivacaine temperature on the spread of spinal anesthesia.

The distribution of spinal anesthesia is affected by the density and viscosity of the local anesthetic solution that, in turn, may be influenced by the temperature of the injectate. Our hypothesis in the present study was that the temperature of the injectate influences its distribution into the subarachnoid space. We measured the density and viscosity of hyperbaric 0.

[A case of pulmonary parenchymal endometriosis].

In 1982, a 45-year-old woman was hospitalized because of an abnormal lung shadow. The chest film provided evidence of pulmonary nodules. She was asymptomatic and had no labolatory abnormalities.

The effects of chin lift and jaw thrust while in the lateral position on stridor score in anesthetized children with adenotonsillar hypertrophy.

Obstruction of the upper airway is a major challenge for anesthesiologists administering general anesthesia in spontaneously breathing patients, especially in pediatric anesthesia with adenotonsillar hypertrophy. Lateral positioning is a simple treatment for obstructive sleep apnea and also decreases collapsibility of the pharynx in anesthetized adults with obstructive sleep apnea. In this study, we examined the effects of body position shifting and common airway maneuvers, such as chin lift and jaw thrust, on airway patency (stridor score) in anesthetized children scheduled for adenotonsillectomy.

New intraluminal coronary shunt tube for off-pump coronary artery bypass grafting.

Purpose: In cooperation with JMS Co., Ltd. (Hiroshima, Japan), we have developed a new intraluminal coronary shunt tube to allow easier, safer, and more accurate off-pump coronary artery bypass grafting (OPCABG).

[The effect and role of the intraaortic balloon pumping in off-pump coronary artery bypass].

Eighty consecutive patients who underwent off-pump coronary artery bypass (OPCAB) were studied. They were divided into group I (n = 10) which received preoperative intraaortic balloon pumping (IABP), and group II (n = 70) which did not receive IABP. The indications for preoperative IABP were severe left main coronary artery disease in 7 patients, severe 3 vessel disease in 3 patients, unstable angina in 5 patients, acute myocardial infarction in 3 patients.

Usefulness of preoperative intraaortic balloon pump therapy during off-pump coronary artery bypass grafting in high-risk patients.

Background: In off-pump coronary artery bypass grafting (OPCABG) surgery, the most critical complication is hemodynamic deterioration, which can occur during displacement of the heart to expose the target vessels. Preoperative intraaortic balloon pump (IABP) therapy improves cardiac performance and facilitates access to the target coronary artery while maintaining hemodynamic stability, especially in high-risk patients.

Methods: One hundred thirty-three consecutive patients who underwent OPCABG through sternotomy between April 2000 and July 2003 were studied.

Warm steaming enhances the topical anesthetic effect of lidocaine.

Unlabelled: Warm steaming has been used for hydrating the skin, thereby increasing its permeability. We studied whether skin pretreatment with a steamed towel (at 45 degrees C) for 5 min could enhance the anesthetic effect of a topical lidocaine tape in 14 female volunteers. After each volunteer received the skin pretreatment on one of the forearms, lidocaine tape was applied for 30 min on both the treated and the untreated forearms.

Video-assisted thoracic surgery for lung cancer: is it a feasible operation for stage I lung cancer?

Objective: The objective of this study was to confirm the safety and feasibility of video-assisted thoracic surgery (VATS) for primary lung cancer and to compare prognoses with that of conventional procedures, and then to examine whether VATS would supplant a conventional thoracotomy for stage I lung cancer.

Methods: From September 1995 through March 2002, 144 patients with primary lung cancer, included 118 patients with postoperative stage I, underwent VATS lobectomy. We reviewed the previous cases whether they could be candidates for VATS lobectomy according to present indications.

Our experiences for off-pump coronary artery bypass grafting to the circumflex system.

Background: Complete revascularization has been difficult in off-pump coronary artery bypass grafting (OPCAB). Hemodynamic deterioration often prevents access to the circumflex territory. This study presents instrumentation for accessing the circumflex territory, and our clinical experience.

[Routine application of trans-sternal off-pump coronary artery bypass grafting using innovative technique].

Objective: With specific apparatus and surgical techniques, we have extended the use of off-pump coronary artery bypass grafting (CABG) [OPCAB] through sternotomy approach to all of the patients with multiple coronary vessel lesions necessitating CABG. The objective of this study is to assess the safety and efficacy of our technique.

Methods: All of the consecutive 100 patients with multiple coronary vessel lesions necessitating CABG underwent trans-sternal OPCAB using our innovative technique between September 2000 and December 2002.

[A case of multicentric Castleman's disease with multiple pulmonary nodules].

A 55-year-old woman visited our hospital for further examination of abnormal shadows on chest radiographs. Her routine chest radiograph showed two nodular shadows in the right lower lung field. A chest CT scan revealed other nodules, small patchy shadows in both lung fields, and enlargement of the mediastinal lymphnodes (#2, 3).

Sentinel lymph node biopsy in patients with papillary thyroid carcinoma.

Background: It remains controversial whether modified radical neck dissection (MRND) for patients with papillary thyroid carcinoma improves prognosis. However, it is highly probable that the incidence of local recurrence is reduced by lymph node dissection. Sentinel lymph node (SLN) biopsy (SLNB) for patients with melanoma and breast carcinoma has been validated as an accurate method for assessing lymph node status.

Giant coronary artery aneurysm arising from sinus node artery.

A giant coronary aneurysm arising from the sinus node artery is reported. Diagnosis of this lesion by computed tomography and angiography is illustrated. The operative management is described.

Metastatic thyroid cancer manifesting as a mediastinal mass in a man with an aberrant right subclavian artery.

We treated a case of thyroid cancer manifesting as a mediastinal mass, completely resecting it without difficulty despite a vascular anomaly. An asymptomatic 42-year-old woman was admitted with a mediastinal mass. Ten years earlier, she had undergone surgery for a thyroid tumor diagnosed as follicular adenoma.

[Drug-induced interstitial pneumonia associated with inhalation of fibrinolysin-deoxyribonuclease (ElaseR)].

A 73-year-old man was referred to our department because of sputum production and fever. He had under-gone a total laryngectomy for laryngeal cancer. His chest radiograph showed patchy ground-glass shadows in both lung fields.

Successful treatment of mucoepidermoid carcinoma of the carina.

We successfully treated a 33-year-old man with mucoepidermoid carcinoma at the carina. Through preoperative spiral computed tomography with multiplanar and three-dimensional reconstructions, the lesion extended along the right main bronchus across the orifice of the right upper lobe. He underwent a carinal resection plus right upper lobectomy and reconstruction of the carina.

Combined choriocarcinoma and adenocarcinoma of the lung occurring in a man: case report and review of the literature.

Background: Human chorionic gonadotropin (hCG)-producing large or giant cell carcinoma of the lung is not uncommon, but primary pulmonary choriocarcinoma is an extremely rare entity. Even rarer are cases occurring in males; to date the authors have found only 12 reported cases in the English literature.

Methods: The clinical record of a 61-year-old man who presented with hemoptysis is described.

Combined superior-transseptal approach versus conventional approach for mitral valve surgery.

Objective: This study was designed to evaluate the safety and effectiveness of the combined superior-transseptal approach for mitral valve surgery.

Methods: We compared the preoperative status, operative factors, and postoperative outcomes among patients having mitral valve operations with three atrial incisions. The incisions were transseptal (n = 40), combined superior-transseptal (n = 33), and left atrial (n = 22).

Inverted left atrial appendage.

An unexpected left atrial mass was found during postoperative echocardiography in a 17-years old man following aortic valve replacement, suggesting thrombus, vegetation and neoplasm. Reoperation showed that the mass to be an inverted left atrial appendage. Left ventricular venting may cause such inversion.

[Aortic valve replacement for aortic valve stenosis due to congenital bicuspid aortic valve with abnormal positioning of coronary orifice, pseudotendon, and persistent left superior vena cava, report of a case].

A patient was a 65-year-old female who had a complaint of palpitation was diagnosed aortic valve stenosis due to congenital bicuspid aortic valve with pseudotendon by the echocardiographic examination. We suspected left single coronary artery by the aortography and the coronary artery angiography. Aortic valve replacement and resection of pseudotendon was performed with Carbomedics supra-annular aortic valve (21 A).

[A case of successful reoperation for distal aortic arch pseudoaneurysm after replacement of descending aorta].

The patient was a 69-year-old man who had undergone replacement of descending aorta under close clump technique. Hoarseness occurred 8 years after the operation. Computed tomography and aortography revealed a saccular aneurysm of the distal aortic arch.

[Four cases of cancer of unknown primary site that manifested as mediastinal metastatic lesions].

We encountered 4 patients with cancers of unknown primary sites that were manifested by mediastinal lesions. Patient 1 was a 58-year-old man with enlarged superior mediastinal lymph nodes. An exploratory thoracotomy yielded a diagnosis of lymph node metastasis of poorly differentiated adenocarcinoma.

[Pulmonary infarction diagnosed by transbronchial lung biopsy].

A 43-year-old man complained of chest pain, fever, and hemosputum in February 1997. Chest X-ray films revealed small opacity in the right lower lung field. The patient received therapy for pneumonia and his condition gradually improved.

Carcinosarcoma of the lung mis-diagnosed preoperatively as a mediastinal tumor.

Carcinosarcoma of the lung is an uncommon tumor and is rarely preoperatively correctly diagnosed. The prognosis of patients with carcinosarcoma is extremely poor, despite treatment. A 79-year-old man was mis-diagnosed preoperatively as having a malignant mediastinal tumor.