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Biomedical subjects

K Kumon

Publications and source records attributed to K Kumon.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Effect of immune response during cardiopulmonary bypass on post-operative infections].

To study the effects of extracorporeal circulation on the post operative infections, the relationship between the influences of the immunologic change during cardiopulmonary bypass (CPB) and post operative change of neutrophilia was evaluated in 52 patients. These patients were divided into two groups: group A (non-infected), 19 patients whose neutrophil count increased within 15,000/microliters in peripheral blood after operation. Group B (infected), 33 patients whose neutrophil count increased 15,000/microliters or more within one week after operation. Immunoglobulins (IgG, IgA, IgM) and complement fraction (C3, C4, CH50) levels decreased significantly during CPB, but there was no significant difference between the two groups. The amount of lymphocyte subsets of helper/inducer T cell and suppressor/cytotoxic T cell showed similar change in both groups. On the contrary the amount of lymphocyte subset of Natural Killer cell showed significant increase in A group during CPB when compared with B group, suggesting immunological activation, however, in the group which showed less than 40% increase of NK cell during CPB, there was significant increase of neutrophils after operation compared with the other group which showed high increase of NK cell. These findings suggested the increased activation of the Natural Killer cell during CPB is a favorable response, especially for preventing infections after operation.

Adult↗
PubMed1988

Evaluation of rapid drying hand disinfectant preparations in the intensive care unit.

MK412A (0.2% chlorhexidine in 70% ethanol) and MK412B (0.2% benzalkonium chloride in 70% ethanol), which are rapid drying and rubbing antiseptic preparations, have been evaluated for hand sterilization over a month by ICU nurses. They have been shown to have effective skin decontaminant efficacy under practical conditions in a busy ICU. There were no adverse reactions except for two cases of mild erythema in the MK412A treatment group. In a comparative in vitro study with Pseudomonas cepacia, 0.2% chlorhexidine solution alone and 0.2% benzalkonium chloride solution alone were less bactericidal than MK412A and MK412B.

Benzalkonium Compounds↗
PubMed1987

Continuous measurement of coronary sinus oxygen saturation after cardiac surgery.

To estimate the balance of myocardial oxygen supply and demand after cardiac surgery, we used fiberoptic reflection oximetry to measure continuously the coronary sinus oxygen saturation (ScsO2) in six patients. ScsO2 decreased with massive bleeding, atrial fibrillation, after DC countershock, and continuous iv infusion of hydralazine, phentolamine, and dibutyryl cyclic-AMP. ScsO2 increased with iv infusion of nicardipine or nitroglycerin, suggesting an improved oxygen metabolism in the myocardium. Continuous ScsO2 measurement provides such on-line information on myocardial oxygenation in postoperative patients.

Adult↗
PubMed1986

Respiratory care of pediatric patients requiring prolonged intubation after cardiac surgery.

Pediatric patients requiring intubation more than 4 days after cardiac surgery can experience many respiratory and other problems. We found that 48 of 264 pediatric patients could not be extubated within 4 days after open-heart surgery because PaO2 was less than 75 torr and PaCO2 was over 45 torr on an inspired oxygen fraction of 0.4. Most of the 48 patients were under 12 months old, had pulmonary hypertension and/or complex cardiac anomalies, and were not hemodynamically stable and/or fully conscious. The intensity of long-term intubation was attributed to cardiovascular or respiratory complications and multiple organ failure. At the time of extubation, water infusion was maintained below 80 ml/kg X day and positive water balance below 15 ml/kg X day. Calories and amino acid were maintained over 70 kcal/kg X day and 1.5 g/kg X day, respectively.

Body Water↗
PubMed1986

Organ failures due to low cardiac output syndrome following open heart surgery.

During the period from August, 1977 to December, 1984, a total of 3003 patients who received open heart surgery were treated postoperatively at the ICU of National Cardiovascular Center. Low cardiac output syndrome (LOS) developed in 669 (22.3%) patients. Organ failures due to LOS were studied in these patients. Although the overall mortality of postoperative patients was 5.6% and improved to around 4% in the later years, death rate of patients with LOS was persistently high (22.8%) and showed no tendency to improve even in the latest years. Moreover, the clinical results of those LOS patients who developed organ failure were extremely poor; the mortality of patients with respiratory failure (RF) accounted for 36.8% and that of patients with other organ failure exceeded 50%. The incidence of impaired organs in LOS patients was 49.9% in RF, 29.9% in acute renal failure (ARF), 18.4% in hepatic failure (HF), 16.4% in disseminated intravascular coagulation (DIC), 15.5% in central nervous system failure (CNSF), and 11.1% in gastrointestinal bleeding (GIB). Pathophysiological mechanisms as well as the management of these major complications caused by LOS are also discussed. Some patients developed multiple organ failure (MOF). Plasma exchange (PE) was performed on 16 patients who developed MOF. Improvement of various organ functions was obtained and consequently three patients were successfully treated by means of PE. Removal of various substances toxic to organs, supplement of deficient substances and cessation of the vicious cycle produced by the interaction of impaired organs in patients with MOF are major roles of PE in the treatment of MOF.

Acute Kidney Injury↗
PubMed1985

Pulmonary circulation in low cardiac output syndrome following open heart surgery.

The pulmonary circulation of 41 patients with low cardiac output syndrome (LOS) in the recovery period following open heart surgery was studied. Cardiac indices (CI) of these patients in LOS was 1.64 +/- 0.28 (Mean +/- SD) L/min X m2 and increased to 2.60 +/- 0.50 L/min X m2 after the stabilization of hemodynamic conditions. Mean pulmonary arterial pressure, pulmonary arteriolar resistance index (PARI) and total pulmonary resistance index (TPRI) in the condition of LOS were very high and significantly decreased after recovery from LOS, although the mean left atrial pressure showed no significant change. The correlation coefficient (r) between CI and PARI was found to be -0.574. High Pao2 with reductions of alveolar-arterial oxygen tension difference (A-aDo2) and physiological pulmonary shunt ratio (Qs/Qt) in LOS significantly decreased concomitant with significant increases in both A-aDo2 and Qs/Qt after the stabilization of the hemodynamic condition. Moderate correlations were obtained between CI and Pao2 (r = -0.478), and high correlations were established between CI and physiological pulmonary shunt flow (Qps) (r = 0.747). These studies showed that pulmonary vasoconstriction was playing a major role in the elevation of pulmonary vascular resistance in LOS, which eventually leads to the reduction of intrapulmonary shunting.

Aortic Valve↗