8.Coronary Artery Revascularization in Chronic Hemodialysis Patients.
Shin Yamamoto ; Shirou Sasaguri ; Yasumasa Hirooka ; Minoru Tahara ; Norio Kikuti ; Shiori Kawasaki ; Mikio Watanabe ; Atsushi Tanaka ; Yasuyuki Hosoda
Japanese Journal of Cardiovascular Surgery 1994;23(1):1-5
We controlled the hemodilution and electrolyte levels during coronary artery revascularization in chronic hemodialysis patients by hemofiltration during the period of extracorporeal circulation. Subjects comprised 7 chronic hemodialysis patients (males, average age 53) undergoing coronary artery revascularization in our department from January 1988 to December 1989. All patients had been undergoing hemodialysis for chronic renal failure and in one patient, after admission, continuous ambulatory peritoneal dialysis (CAPD) was additionally performed. During surgery, the dialyzer was equipped with an extracorporeal circulation circuit and the electrolyte level and hemodilution were adjusted using transfusion (1, 270±372ml). A large infusion volume (12, 657± 3, 966ml) was maintained and removal of water was carried out by ultrafiltration. After surgery, all patients underwent hemodialysis twice or more by the 3rd day of recovery. Concentrations of electrolytes were maintained at appropriate levels throughout the day of surgery except for one case of postoperative hypokalemia, but no marked changes in hemodynamics were observed during and after surgery. Hemofiltration during extracorporeal circulation is safe and useful in coronary surgery because it is simpler and requires less time than hemodialysis.
9.A Personal View on “Self-Assessment of Medical Education”
Keiro ONO ; Shiko CHICHIBU ; Kiichiro NODA ; Nariyoshi YAMAGUCHI ; Tohru UOZUMI ; Ryukoh SIRASAKA ; Keiichi MATSUURA ; Mikio KANDA ; Shozo YAMAMOTO ; Yoichi SUGIOKA ; Toshitaka MATSUYAMA ; Kohei HARA ; Hiroshi SAITO ; Kazuro TAKAHASHI
Medical Education 1994;25(1):3-20,25
10.Clinical study on the prevention of recurrent tonshillitis by acupuncture (III)
Keishi YOSHIKAWA ; Kazushi NISHIJO ; Kazuhiro YAZAWA ; Hidetoshi MORI ; Tomomi SAKAI ; Akihiro OGATA ; Kazuo SASAKI ; Toshikazu SHIMA ; Hiroki SUGA ; Mikio NAKAMURA ; Shuichi KATAI ; Katsumi KURIHARA ; Takeshi TOMIYASU ; Masahiro KIMURA ; Takanori KAWANO ; Koki KOBAYASHI ; Koichi WADA ; Harumi TAKETANI ; Akemi YAMAMOTO
Journal of the Japan Society of Acupuncture and Moxibustion 1984;34(1):15-22
We have conducted acupuncture treatment for prevening the relapse of recurrent tonsillitis. We previously noted the effectiveness of this treatment in 121 of 239 patients treated in 1980, especially in elementary school children. In the present study, we compared the annual days of absence from school and the body dimensions of children with tonsillitis given acupuncture treatment with those having tonsillar hypertrophy chosen by a school study, although there is a question on the latter's propriety as a control group in a strict sense, in order to investigate the degree of spontaneous healing included in the preventive effects of acupuncture treatment on the relapse of recurrent tonsillitis.
By May 1983, our reseach was completed in 22 children with tonsillitis given acupuncture treatment and 19 with tonsillar hypertrophy not given such therapy. In children with tonsillitis given acupuncture treatment, the average annual days of absence from school before treatment was 14.0, which was more than that for all children in the S elementary school, and that in the year after treatment was 6.5, approximating that for all children in the school. In children with tonsillar hypertrophy not given acupuncture treatment, the average number of days of absence was close to that for all children in the S elementary school in both years.
Among 14 children with tonsillitis given acupuncture treatment, lower values of height and weight were noted in eight and 12 children, respectively, at the beginning of treatment, as compared with the national averages. The body dimensions of children with tonsillar hypertrophy not given acupuncture treatment were similar to the national averages. Of 14 children with tonsillitis given acupuncture treatment, an increase to a value exceeding the national average was observed with both the height and weight in six children, the height in two and the weight in one within the year after treatment.
The above results show that children with tonsillitis have a problem from the educational and developmental standpoint, even if they do not have a focal tonsil. We think that acupuncture treatment is worth attempting prior to tonsillectomy, although it is not so surely effective as tonsillectomy, when the severity of operative stress on the living body due to tonsillectomy and the burden of medical expenses and the load on the patient's family caused by hospitalization are taken into consideration.