[Pretreatment dose of vecuronium and its effect on succinylcholine-induced fasciculations and neuromuscular blockade].
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Biomedical subjects
Publications and source records attributed to M Nishimura.
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A 30-year-old man with peripheral neuroepithelioma which was present in the retroperitoneum underwent surgical treatment under the diagnosis of germ cell tumor. Subsequently he died of local recurrence and multiple metastases to the liver seven months after surgery. To our knowledge, this is the second case of peripheral neuroepithelioma which was observed in the retroperitoneal space in the literature of the world. We also reviewed 20 cases of peripheral neuroepithelioma reported in Japan.
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Studies were conducted to evaluate the role of water-sodium balance and renal dopaminergic activity in the hypertensive mechanisms of overweight patients with essential hypertension (EHT). The body mass index (BMI) was correlated positively with arterial pressure, plasma volume, extracellular fluid volume, or total exchangeable sodium and negatively with plasma noradrenaline concentration or plasma renin activity in patients with EHT. Fractional excretion of sodium (FENa) was significantly lower in overweight patients with EHT than that in normal-weight patients with EHT. Hypotensive effects of sodium restriction or the natriuretic response to infused dopamine was more remarkable in overweight than in normal-weight patients with EHT. Urinary excretion of free dopamine (UDA) was correlated positively with simultaneously measured urinary excretion of sodium or FENa and negatively with the natriuretic response to dopamine infusion. In addition, UDA was positively correlated with the BMI in normal-weight patients with EHT, whereas the relation between UDA and BMI was significantly negative in overweight patients with EHT. These findings suggest that the expansion of body fluid volume and sodium might result from the blunted natriuretic ability due to an attenuation of the renal dopaminergic activity in overweight patients with EHT. The expansion of body fluid volume and sodium may play an important role in the hypertensive mechanisms of overweight patients with EHT.
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Effects of various factors before and during operation on postoperative renal hypofunction were studied in 34 preoperatively evaluated surgical cases of non-ruptured abdominal aneurysm. The cases were divided into two groups, with and without postoperative renal hypofunction. The two groups showed no differences with respect to age, sex, preoperative serum Crn or Ccr level, presence or absence of treatment with antihypertensives or diabetes mellitus, duration of intraoperative aortic clamping, or the volume of blood loss or transfusion. However, the group with postoperative renal hypofunction included many cases of preoperative hypertension. The incidence of postoperative renal hypofunction was high among cases which exhibited preoperative hypertension, but was low among those with preoperative normal blood pressure. Further, renal hypofunction occurred in few of the patients whose blood pressure had been controlled by the use of antihypertensives. The possibility was suggested that in palliative operations, preoperative blood pressure control, was useful for the prevention of postoperative renal hypofunction.