Laparoscopic cholecystectomy has represented a potentially more morbid procedure than open cholecystectomy. Some of this morbidity has been due to complications associated with pneumoperitoneum. We have developed a technique that employs abdominal wall retraction during laparoscopic cholecystectomy and allows access to the right upper part of the abdomen without maintenance of pneumoperitoneum. Among 151 patients who underwent laparoscopic cholecystectomy using abdominal wall retraction there were no recognized adverse effects. Abdominal wall retraction enables the surgeon to minimize the risk of serious complications associated with pneumoperitoneum during laparoscopic cholecystectomy.

Abdominal Muscles↗

PubMedDate not supplied

Subclavian vein puncture under ultrasonic guidance.

Ultrasonically guided subclavian venipuncture is described. Since this method permits direct tapping of the subclavian vein and control of the insertion to the innominate vein under ultrasonic guidance, complications such as pneumothorax, accidental subclavian artery puncture, and malposition of the catheter, which often accompany the conventional method, can be avoided. As a result, this technique produces no radiation damage.

Aged↗

PubMedDate not supplied

[Studies on early changes in myocardial electrolytes and histological reaction in isoproterenol-induced myocardial injury].

To determine morphological changes in the very early stage of damage and recovery of myocardial fibers in relation to electrolytes and water content in the myocardium, experimental myocardial infarcts were produced after injection of 75 mg/kg isoproterenol (Isp) to rats weighing 270 +/- 10 g. Electrolytes were examined by an atomic absorption spectrophotometer, and histologic examination was performed by light and electron microscopy. At 30 min after Isp injection, Ca and water contents of myocardium increased, but Mg decreased. These myocardial damages showed a maximum level from 6 to 12 h after injection of Isp. It consisted of reversible injury of muscle fibers represented by eosinophilic and fatty degeneration, intermingled with coagulation necrosis of fibers which was irreversible. Most of these eosinophilic degeneration fibers recovered to normal fibers between 12 h and 3 d after the injection. The chronological changes of Ca, Mg, and water contents were well correlated to the morphological early changes of myocardial fibers, and this experimental model by using Isp may be useful for examining the recovery of damaged myocardial tissue and estimating the effects of therapeutics.

Animals↗

PubMedDate not supplied

Magnetic resonance imaging as an effective tool for successful localization of superior mediastinal parathyroid adenoma.

Noninvasive diagnostic procedures for the preoperative localization of parathyroid tumors were performed on a 59-year-old woman with hypercalcemia. In this case, sonography and computed tomographic scanning could not pinpoint the location of the tumor. Thallium-201 and technetium-99m subtraction scintigraphy was also inconclusive in the precise localization of the tumor, but it did define the location retrospectively. However, magnetic resonance imaging (MRI) clearly demonstrated the parathyroid tumor as a high signal on T2-weighted image in the left upper part of the superior mediastinum. The intrathymic parathyroid oxyphil adenoma was resected. Therefore, MRI was considered an effective tool for the localization of parathyroid adenoma, particularly mediastinal parathyroid adenoma.

Adenoma↗

PubMedDate not supplied

[Basic study on blood pressure measurements with a digital sphygmomanometers].

In the present study, digital sphygmomanometer (SMmeter)(Omuron Digital 709 Fuzzy and Digital 806F)for family use and 24 hour ambulatory SMmeter were checked in terms of reproducibility (CV%) of blood pressure(BP) measured and comparison of measured BP with Digital SMmeter with those measured with mercury SMmeter, the golden standard. Reproducibility of BP measured with Hg-SMmeter was less than 4%, with each Digital SMmeter less than 9%. Inter-unit reproducibility was less than 5% in each SMmeter. Systolic BP measured with 24 hour ambulatory SMmeter were higher by 2-4% than BP measured with Hg-SMmeter, diastolic BP higher by 4-9%. Systolic BP measured with Digital 709 Fuzzy were higher by 5-10% than Hg-SMmeter in lower range of systolic BP to be actually measured, in 130-170 mmHg both values almost coincident, in more than 170 mmHg Digital 709 Fuzzy lower by 2-7%. Diastolic BP measured with Digital 709 Fuzzy were higher by 10-15% than Hg-SMmeter in lower range of diastolic BP to be actually measured. In more than 80 mmHg both values were almost coincident. Systolic BP with Digital 806F were higher by 1.5-7%, diastolic BP higher by about 10% than the value with Hg-SMmeter. In conclusion, by taking account of different reproducibilities and characteristics of SMmeter, home BP monitoring can be performed by patient or/and his family.

Blood Pressure Monitoring, Ambulatory↗