Heat Convection of Compressible Viscous Fluids. I.

The stationary problem for the heat convection of compressible fluid is considered around the equilibrium solution with the external forces in the horizontal strip domain z_0 < z < z_0 + 1 and it is proved that the solution exists uniformly with respect to z_0 larger than Z_0 . The limit system as z_0 goes to infinity is the Oberbeck-Boussinesq equation

Effect of left atrial plication for the giant left atrium on left ventricular function.

Left atrial plication (LAP) following Kawazoe's method was performed on eight patients with mitral valve stenosis associated with a giant left atrium. To investigate the effect of LAP particularly on left ventricular function, the preoperative and postoperative left ventricular function in these patients were compared. The data were also compared to that of the non-left atrial plication (non-LAP) group with left atrial dimension of 60 mm or over. In the LAP group, there were significant differences between preoperative and postoperative data in the following parameters; New York Heart Association (NYHA) class, cardiothoracic ratio, mean pulmonary arterial pressure (PAP), left ventricular end-diastolic pressure (LVEDP), left atrial dimension, stroke volume index, ejection fraction and cardiac index. On the contrary, in the non-LAP group, there were significant differences between preoperative and post-operative data in the following two factors; NYHA class and PAP. The size of the left atrium in the non-LAP group remained unchanged over the course of long-term follow-up. Despite severe clinical symptoms and severely reduced cardiac function of the patients in the LAP group, cardiac function in all patients improved satisfactorily. This suggests that left atrial plication has a considerably beneficial effect on left ventricular function, and therefore, may be recommended for patients with a giant left atrium.</p

Pharmacokinetics of Beclomethasone Dipropionate in an Hydrofluoroalkane-134a Propellant System in Japanese Children with Bronchial Asthma

ABSTRACTBackgroundHydrofluoroalkane-134a (HFA) has been shown to be a safe replacement for chlorofluorocarbons (CFCs) as a pharmaceutical propellant, with the advantage that it has no ozone-depleting potential. This is the first report of the pharmacokinetics of beclomethasone dipropionate (BDP) delivered from a pressurized solution formulation using an HFA propellant system (HFA-BDP) in Japanese children with bronchial asthma.MethodsPlasma concentrations of beclomethasone 17-monopropionate (17-BMP), a major metabolite of BDP, following an inhaled dose of HFA-BDP (200 μg as four inhalations from 50 μg/actuation) in five Japanese children with bronchial asthma were quantified and analyzed by a non-compartmental analysis to obtain pharmacokinetic parameters.ResultsThe area under the concentration-time curve from time zero to the last quantifiable time (AUC0-t) was 1659 ± 850 pg • h/mL (arithmetic mean ± standard deviation (SD)), the maximum concentration observed (Cmax) was 825 ± 453 pg/mL and the apparent elimination half-life (t1/2) was 2.1 ± 0.7 hours. The time to reach Cmax (Tmax) was 0.5 hours in all patients. No special relationship was observed between these parameters and age or body weight. These parameters were compared with the previously reported parameters of American children with bronchial asthma. The Japanese/American ratio of the geometric means of each parameter was 1.36 for AUC0-t, 1.04 for Cmax and 1.4 for t1/2. The median of Tmax was 0.5 hours in American patients as well as Japanese patients.ConclusionsThe pharmacokinetics of HFA-BDP in Japanese children with bronchial asthma are reported for the first time and a similarity to those in American children is suggested

Factors influencing the efficacy of DeVega's annuloplasty for secondary tricuspid regurgitation.

DeVega's annuloplasty was performed on 41 patients with tricuspid regurgitation (TR) associated with combined valvular disease and results were assessed based on Doppler echocardiographic findings in an attempt to examine the applicability of this surgical technique. TR was quantitatively evaluated via Doppler echocardiography before and after surgery. Clinical symptoms, cardiac function, and surgical results were assessed, and the severity of left ventricular myocardial degeneration was determined using electron microscopy. There were no differences in the following factors between the TR recurrence and TR improvement groups: previous heart surgery, number of involved valves, presence or absence of a giant left atrium, preoperative New York Heart Association (NYHA) functional class, and type of prosthetic valve (Bjork-Shiley vs. St. Jude Medical). We found no differences between these two groups in TR severity and tricuspid annulus diameter measured during surgery. Severity of myocardial degeneration was closely associated with the recurrence of TR. Clinically, most had diminished cardiac function before surgery. DeVega's technique appears to be remarkably effective in patients with well-preserved myocardium because no TR recurrence was detected even in examinations with the most accurate Doppler echocardiography. However, such long-term effectiveness of DeVega's technique cannot be expected in patients with degenerated myocardium.</p

Changes in levels of arachidonic acid metabolites in blood and bronchoalveolar lavage fluid after warm ischemia-reperfusion of lung.

The purpose of this study was to evaluate the role of arachidonic acid metabolites in the reimplantation response after lung transplantation in mongrel dogs. The left lung was used and two groups were studied. Group I underwent hilar stripping, while Group II underwent hilar stripping plus warm ischemia for 60 min., achieved by clamping the left pulmonary artery and veins. We measured the lung wet to dry weight ratio (W/D ratio), total pulmonary vascular resistance (TPVR), and blood and bronchoalveolar lavage fluid (BALF) levels of leukotriene B4 and C4 (LTB4,C4) and thromboxane B2 (TXB2). These parameters were measured periodically for 7 days after reperfusion. In group II, the W/D ratio and TPVR were significantly increased in comparison with Group I. The blood LTC4 level was elevated immediately after reperfusion, and BALF level of LTC4 also rose subsequently. These levels changed concomitantly with the W/D ratio. The above results suggest that arachidonic acid metabolism plays an important role in the reimplantation response, especially in pulmonary edema.</p

Continuous in-vIvo measurement of the brain tissue and the ischemic muscle gas tension using MEDSPECT, MS-8

I MEDSPECT is a medical mass spectrometer for continuous in-vivo measurement of tissue, blood and respiratory gases. Interfacing catheter for tissue in measurement has Teflon membrane. The permeability and perfusion rate for various gases through its membrane varied with temperature. The temperature coefficient of Teflon catheter in the range of 15℃-40℃ is approximately constant with -2% of correction per degree for oxygen and carbon dioxide. Linear correlation was confirmed experimentally. II The brain tissue gas tensions were measured in ten dogs with intra-venous anesthesia at normothermia and deep hypothermia using perfusion cooling, including circulatory arrest for 30 minutes at 20°C of cerebral temperature. On average, the brain tissue P(O2) was 15mmHg in normothermia when the arterial P(O2) showed 95mmHg and the brain tissue P(CO2) was 49mmHg when the arterial PC02 showed 30mmHg. The brain tissue carbon dioxide tension gradually decreased by cooling and increased during circulatory arrest for 30 minutes; from 45mmHg to 72mmHg. The brain tissue oxygen tension increased during cooling from 15mmHg to 41mmHg and decreased in the circulatory arrest; from 41mmHg to 36mmHg. III The ischemic muscle gas tension was measured in a 22-year-old man, who was suffered from thromboangiitis obliterans bilaterally, and had the popliteal autovein bypass surgery 3 months ago. Control oxygen tensions in the both anterior tibial muscles showed about the same; 35mmHg and 36mmHg respectivelly, and the P(O2) of the non-operated side showed remarkable low level of 18mmHg as compared with the side of arterial reconstruction surgery after 5-minutes ankle exercise

Absolute ethanol injection for non-parasitic hepatic cyst.

非寄生虫性肝嚢胞の3例に，超音波ガイド下にドレナージ及び純エタノール注入を行い，全例に嚢胞の著明な縮小効果を認めた。本法は手技も容易で，副作用も軽微であり，エタノール注入と嚢胞縮小効果の間には1カ月以上の時間的な経過を要するが，肝嚢胞に対して，外科的療法に代わる有用な治療法であると思われる。Three patients suffering from nonparasitic hepatic cysts were successfully treated with absolute ethanol injection under ultrasonic guided puncture. As the procedure was simple and less invasive, it was considered that this treatment for hepatic cysts was an alternative to surgery.　However, more than one month was needed, untill remqrkable shrinkage of cysts was expected in all three patients

Antithrombogenic therapy after heart valve replacement - Effect of anti-platelet drug on aggregation-

人工弁置換患者の血栓塞栓症（TE）は，長期予後の成績を左右する。　TEを減少させるために凝固因子を抑制するwarfarinと抗血小板剤による抗血栓療法が行われている。人工弁置換患者103例を対象に，抗血小板剤であるtrapidil（TP）とdipyridamole（DP）の血小板凝集能に与える効果を検討した。36ヵ月間検討したが，warfarin単独群は血小板凝集能に変化がなく，TP，DP共にADP凝集能を抑制した。しかし有意差の見られたのは全経過ではなく，凝集能抑制は強力かつ持続的ではなかった。またコラーゲン誘導凝集能は変化を認めなかった。TPとDPの抗血小板効果は同等と思われる。期間中の血栓塞栓発生は，warfarin単独群9.5％，TP群4.3％，DP群7.7％であった。臨床的に抗血小板剤の併用は有効と思われるが，血小板凝集抑制には投与量の増量，あるいは他の薬剤の検討が必要であろう。To evaluate the effect of anti-thrombotic thrapy after valve replacement, serial platelet aggregation measurememnts were carried out in 103 patients. Patients were divided into three groups. e. i. warfarin alone (control), warfarin with trapidil (TP) of 300mg/day and dipyridamole (DP) of 300mg/day. The aggregation of platelet of the control group did not change through 36 months. TP group showed a decrease in platelet aggregation at 24 and 30 months from the pretreatment value. The aggregation of 24 month in TP was significantly lower than that of control. There was no difference of platelet aggregation between TP and DP group. The incidence of thromboembolism of control, TP and DP group were 9.5%, 4.3% and 7.7%, respectively. These data suggest that the supression of platelet aggregation .by TP and DP is not adequate to continue for long time and TP has similar anti-thrombotic effect to DP