1.A Case of Acute Descending Aortic Rupture Associated with Splenic Rupture and Pelvic Fracture.
Yuji Hanafusa ; Noboru Murata ; Atsushi Ozawa ; Hirosi Ohta ; Makoto Funami ; Kouichi Inoue ; Toshihiro Takaba
Japanese Journal of Cardiovascular Surgery 1997;26(6):388-391
A 24-year-old woman had been injured in an automobile accident. The chest X-ray showed widening of the mediastinum and computed tomography showed mediastinal hematoma around the aortic arch. Aortic rupture was suspected, so we performed aortography, which revealed pseudoaneurysm of the descending aorta. Moreover, she also had splenic rupture and pelvic fracture. She underwent an emergency operation 4 hours after the accident. Medial tear of the descending aorta was replaced with a graft under temporary bypass without heparin. Simultaneously, splenectomy was performed. Her postoperative course was uneventful. We consider that temporary bypass without heparin is a useful method during repair of the descending aortic rupture due to trauma.
2.The Myocardial Protection of Immersion Hearts in Perfluorochemicals during Ischemia.
Koichi Inoue ; Osamu Honda ; Yuji Hanabusa ; Susumu Ando ; Atsushi Ozawa ; Shigeaki Sekiguchi ; Seiro Nomoto ; Mitsutaka Kadokura ; Makoto Yamada ; Toshihiro Takaba
Japanese Journal of Cardiovascular Surgery 1995;24(5):305-310
Topical cardiac hypothermia has unequivocal preservation effects during ischemia, but it has some disadvantages. Topical cooling, especially with ice slush, can injure the phrenic nerve, disturb the equal distribution of the cardioplegic solution due to coronary artery spasm and damage the epicardium. It is easy to prevent cooling injury without topical hypothermia, but the myocardial oxygen demands are increased. In order to supply the myocardium with oxygen for the increased oxygen demands during ischemia, isolated rat hearts were immersed in perfluorochemicals (PFC) which have excellent transportation of oxygen. The effects of immersion in PFC during mild hypothermic ischemia (at 20°C without cardioplegia and at 30°C cardioplegic arrest) on the cardiac function on reperfusion were evaluated. Under 20°C hypothermic ischemia without cardioplegia, cardiac beating was maintained for 20±4 minutes in the hearts were immersed in PFC, and for 10±2 minutes in the hearts that were not immersed in any solution. In the recovery of cardiac function (LVDP and LVmax dp/dt) after mild hypothermic (30°C) cardioplegic arrest, the hearts immersed in PFC showed better results than hearts that were not immersed.
3.Influence of the stage of emergency declaration due to the coronavirus disease 2019 outbreak on plasma glucose control of patients with diabetes mellitus in the Saku region of Japan
Takuya WATANABE ; Yuichi TEMMA ; Junichi OKADA ; Eijiro YAMADA ; Tsugumichi SAITO ; Kazuya OKADA ; Yasuyo NAKAJIMA ; Atsushi OZAWA ; Tetsuya TAKAMIZAWA ; Mitsuaki HORIGOME ; Shuichi OKADA ; Masanobu YAMADA
Journal of Rural Medicine 2021;16(2):98-101
Objective: Because patients with diabetes mellitus (DM) were forced to stay indoors during the state of emergency, resulting in stress and a lack of physical activity, concerns about their glycemic control were raised.Patients and Methods: The 165 patients’ glycated hemoglobin (HbA1c) levels were compared during the following periods: the 4 months that were selected as a representative condition 1 year before the COVID-19 pandemic (May 2018, March 2019, June 2019, and July 2019) and the latter 3 months as a 1-year follow-up during the COVID-19 pandemic (May 2019, March 2020, June 2020, and July 2020).Results: The patients’ HbA1c levels were 7.32 ± 1.23, 7.44 ± 1.20, 7.16 ± 1.06, 7.01 ± 1.05, 7.23 ± 1.06, 7.45 ± 1.18, 7.15 ± 10.7, and 7.11 ± 1.17 in May 2018, March 2019, June 2019, July 2019, May 2019, March 2020, June 2020, and July 2020, respectively (expressed as mean ± standard deviation).Conclusion: The analysis showed that HbA1c levels did not worsen during the self-restraint period.