Regional cerebral tissue blood flow measured by the colored microsphere method during retrograde cerebral perfusion

AbstractBrain tissue blood flow was measured precisely by the colored microsphere method during retrograde cerebral perfusion in 10 normothermic mongrel dogs. The average tissue blood flow rates to the cerebral cortex, cerebral medulla, brain stem, cerebellum, and spinal cord during retrograde cerebral perfusion at 25 mm Hg of external jugular venous pressure were 10.5 ± 10.3, 4.2 ± 4.6, 11.1 ± 9.8, 12.3 ± 8.6, and 9.1 ± 5.8 ml/min per 100 gm, respectively. The brain was perfused wholly by retrograde cerebral perfusion without lateralization. Total cerebral blood flow was calculated as the sum total rates of blood flow to each area. Total cerebral blood flow during retrograde cerebral perfusion at 25 mm Hg was 7.8 ± 4.4 ml/min, which represented 3.5% ± 1.9% of whole body blood flow and one third of the total cerebral blood flow (28.0 ± 4.2 ml/min) during cardiopulmonary bypass at a flow rate of 1000 ml/min. Oxygen consumption and carbon dioxide elimination by the total cerebrum during retrograde cerebral perfusion at 25 mm Hg were 0.54 ± 0.23 ml/min and 34 ± 15 μmol/min, respectively, or 8.6% ± 3.6% and 7.0% ± 3.1% of the corresponding whole body value and represented about one third of that measured during cardiopulmonary bypass (1.21 ± 0.39 ml/min and 96 ± 15 μmol/min). Total cerebral blood flow, total cerebral oxygen consumption, and carbon dioxide elimination increased as the external jugular venous pressure increased from 15 to 25 mm Hg; however, no further increase occurred once the external jugular venous pressure exceeded 25 mm Hg. (J THORAC CARDIOVASC SURG 1995;109:772-9

膀胱内Inverted Papillomaの2例

膀胱内に発生したInvertedPapiliomaの2例を報告し, 若干の文献的考察を加えた.患者はそれぞれ肉眼的血尿と尿線途絶を主訴とする39歳の男性と36歳の女性であった.両症例とも膀胱内腫瘍は経尿道的に切除され, 組織学的ecPt型的なInvertedPapillomaの所見を示した.Two cases of inverted papilloma of the urinary bladder are reported. The patients were a 39-year-old male with macrohematuria and a 36-year-old female with interrupted urination. In both of the patients, tumors were resected transurethrally, and histologic examination revealed them to be typical inverted papilloma

Percutaneous Cardiopulmonary Support System for the Treatment of Fulminant Myocarditis

We have developed a simple percutaneous cardiopulmonary support (PCPS) system. The circuit of the system is set up and sterilized beforehand and can be used promptly in an emergency situation. We used the PCPS on three patients with fulminant myocarditis and treated them successfully. Case 1 was a 53-yr-old man and Case 2 was a 12-yr-old girl. They had failed to respond to treatment of their circulatory states with conventional therapy. Their circulatory states improved dramatically after application of PCPS with 2 L/min blood flow. They were weaned from PCPS after 107 and 227 hours use, respectively. Case 3 was a 37-yr-old woman who developed ventricular fibrillation which was resistant to drug therapy and cardioversion. After starting PCPSwith4 L/min blood flow, arrhythmia disappeared and her circulatory state improved. She was successfully weaned after 39-hour of PCPS. Patients with fulminant myocarditis fall into circulatory collapse which is resistant to conventional therapy, but there is a possibility that cardiac function will recover after the acute phase of myocarditis. Therefore, PCPS can be the only treatment of the circulatory collapse of fulminant myocarditis, which is refractory to conventional therapy