Composite Y-graft for syphilitic ostial stenosis in left main coronary artery.

Coronary ostial stenosis is one of the cardiac manifestations of tertiary syphilis and should be perceived as a disorder of the aorta. A 45-year-old man with no coronary risk factors except smoking developed severe isolated ostial stenosis in the left main coronary artery. He underwent emergency bypass surgery using the bilateral internal thoracic arteries as a composite Y-graft, and recovered uneventfully.

Changes in vertebral wedging rate between supine and standing position and its association with back pain: a prospective study in patients with osteoporotic vertebral compression fractures.

Study Design: Prospective consecutive series.

Objective: To analyze supine and standing radiographs and the association of back pain using subjective pain criteria.

Summary Of Background Data: It has been considered that there is little correlation between the degree of collapse of the vertebral body and the level of pain.

Primary closure of the common bile duct in open laparotomy for common bile duct stones.

It is common these days to treat common bile duct (CBD) stones using endoscopic techniques. However, severe complications sometimes lead to death despite the great benefit of these techniques. If the patient has many and/or large stones, it can take considerable time for duct clearance, and this is associated with high costs.

The treatment of acute thoracolumbar burst fractures with transpedicular intracorporeal hydroxyapatite grafting following indirect reduction and pedicle screw fixation: a prospective study.

Study Design: Prospective consecutive series.

Objective: To evaluate the outcomes of the treatment of acute thoracolumbar burst fractures by transpedicular hydroxyapatite grafting following indirect reduction and pedicle screw fixation.

Summary Of Background Data: In the treatment of thoracolumbar burst fractures, the major problem after posterior correction and instrumentation is failure to support the anterior spinal column, leading to the loss of correction of kyphosis and instrumentation breakage.

Pollution of the medical air at a university hospital in the metropolitan Tokyo area.

Study Objective: To investigate the quality of medical air in a hospital in the metropolitan area.

Design: Prospective study.

Setting: University hospital in the metropolitan Tokyo area.

Inhibition of growth of human breast cancer cells in culture by neutron capture using liposomes containing 10B.

Cell destruction in boron neutron capture therapy is effected by nuclear reaction between 10B and thermal neutrons with the release of alpha-particles (4He) and lithium-7 ions (7Li). 4He kills cells within 10 microm of the site of 4He generation, therefore it is theoretically possible to destroy tumour cells without affecting adjacent healthy tissue, given selective delivery of compounds containing 10B. Liposomes wore prepared by vortex dispersion of solutions containing 10B compounds with dried lipid films and the effects of those compounds on human breast cancer cells in culture were examined after thermal neutral irradiation.

Minimum alveolar concentration (MAC) of xenon with sevoflurane in humans.

Background: Although more than 30 yr ago the minimum alveolar concentration (MAC) of xenon was determined to be 71%, that previous study had technological limitations, and no other studies have confirmed the MAC value of xenon since. The current study was designed to confirm the MAC value of xenon in adult surgical patients using more modern techniques.

Methods: Sixty patients were anesthetized with sevoflurane with or without xenon.

Hearing improvement after therapy for hyperlipidemia in patients with chronic-phase sudden deafness.

Hearing in patients with chronic-phase sudden deafness and associated hyperlipidemia tends to improve with therapy for hyperlipidemia. We studied 12 patients with unilateral sudden deafness and hyperlipidemia in whom more than 1 month had elapsed since the onset of the hearing disturbance. The disturbance was considered to be irreversible without therapy.

Carotid arterial distensibility is an important determinant of improvement in autonomic balance after successful coronary angioplasty.

Objective: To determine whether arterial distensibility influences improvement of autonomic imbalance after left ventricular wall motion (LVWM) abnormality has been improved by percutaneous transluminal angioplasty (PTCA) in patients with ischemic heart disease (IHD).

Methods And Results: The following variables were assessed before and 3 months after PTCA in 63 patients with IHD who had a successful PTCA: heart rate variability (standard deviation of all normal R-R intervals [SDNN] measured from 24 h Holter electrocardiograms), baroreceptor sensitivity (determined by the phenylephrine injection method), and carotid artery distensibility (determined by ultrasonography). Abnormalities of LVWM were assessed by cineventriculography.

The effects of monotherapy or combined therapy with an angiotensin converting enzyme inhibitor following initial treatment with calcium channel blockers on residual cardiovascular abnormalities.

The effects of sequential therapy with angiotensin-converting enzyme inhibitor (cilazapril) on left ventricular (LV) mass, LV diastolic function, and carotid artery distensibility were evaluated in 90 hypertensive patients whose blood pressure controlled below 140/90 mmHg with a calcium channel blocker monotherapy. The possibility of predicting the efficacy of cilazapril based on evaluation of biochemical and genetic markers of the renin-angiotensin system was examined. Before cilazapril therapy, LV diastolic function and carotid artery distensibility were significantly impaired in 32 patients with residual LV hypertrophy compared with patients without LV hypertrophy.

Plasma concentration of fentanyl with xenon to block somatic and hemodynamic responses to surgical incision.

Background: Although anesthesia with xenon has been supplemented with fentanyl, its requirement has not been established. This study was conducted to determine the plasma concentrations of fentanyl necessary to suppress somatic and hemodynamic responses to surgical incision in 50% patients in the presence of 0.7 minimum alveolar concentration (MAC) xenon.

Effects of xenon on hemodynamic responses to skin incision in humans.

Background: The authors evaluated the hemodynamic suppressive effects of xenon in combination with sevoflurane at skin incision in patients undergoing surgery.

Methods: Forty patients were assigned randomly to receive one of the following four anesthetics: 1.3 minimum alveolar concentration (MAC) sevoflurane, 0.

The placement of the cuffed oropharyngeal airway with sevoflurane in adults: a comparison with the laryngeal mask airway.

Unlabelled: We sought to determine the anesthetic duration of sevoflurane required to achieve good conditions for placement of a cuffed oropharyngeal airway (COPA) or a laryngeal mask airway (LMA). Forty adult ASA physical status I or II patients presenting for elective surgery received single-breath vital capacity inhaled induction with 5% sevoflurane via face mask; thereafter, ventilation was manually assisted. The patients were randomized to receive either a COPA or LMA placement.

Comparison of inhalation inductions with xenon and sevoflurane.

Background: Xenon is an odorless gas with low blood-gas solubility coefficient and without occupational and environmental hazards. This investigation was performed to evaluate the speed of induction, and respiratory and cardiovascular reactions to inhalation induction with xenon compared to an equianesthetic concentration of sevoflurane.

Method: Twenty-four adult ASA 1-2 patients premedicated with 0.

[Erythropoietic protoporphyria].

Erythropoietic protoporphyria is an autosomal inherited disease characterized by decreased ferrochelatase activity. This abnormality results in excess protoporphyrin accumulation not only in red blood cells but also in other organs such as skin, and causes various degrees of skin photosensitivity according to degrees of decreased ferrochelatase activity. An excess protoporphyrin accumulation in liver results in severe liver damage which might cause juvenile death in some patients.