Kiyoshi Matsuda

Validation of extravascular lung water measurement by single transpulmonary thermodilution: human autopsy study

IntroductionGravimetric validation of single-indicator extravascular lung water (EVLW) and normal EVLW values has not been well studied in humans thus far. The aims of this study were (1) to validate the accuracy of EVLW measurement by single transpulmonary thermodilution with postmortem lung weight measurement in humans and (2) to define the statistically normal EVLW values.MethodsWe evaluated the correlation between pre-mortem EVLW value by single transpulmonary thermodilution and post-mortem lung weight from 30 consecutive autopsies completed within 48 hours following the final thermodilution measurement. A linear regression equation for the correlation was calculated. In order to clarify the normal lung weight value by statistical analysis, we conducted a literature search and obtained the normal reference ranges for post-mortem lung weight. These values were substituted into the equation for the correlation between EVLW and lung weight to estimate the normal EVLW values.ResultsEVLW determined using transpulmonary single thermodilution correlated closely with post-mortem lung weight (r = 0.904, P < 0.001). A linear regression equation was calculated: EVLW (mL) = 0.56 × lung weight (g) - 58.0. The normal EVLW values indexed by predicted body weight were approximately 7.4 ± 3.3 mL/kg (7.5 ± 3.3 mL/kg for males and 7.3 ± 3.3 mL/kg for females).ConclusionsA definite correlation exists between EVLW measured by the single-indicator transpulmonary thermodilution technique and post-mortem lung weight in humans. The normal EVLW value is approximately 7.4 ± 3.3 mL/kg.Trial registrationUMIN000002780.

Electrode reaction mechanisms of platinum isocyanide complexes in acetonitrile solutions

Abstract Electrochemical reaction properties of platinum(II) aryl isocyanide complexes were investigated to determine preparative conditions of electroreduction and to analyse formation mechanisms of low-valent di- and tri-platinum complexes. Polarographic and chronoamperometric measurements were carried out for the analysis of reaction properties of Pt-complexes, PtCl 2 L 2 and Pt 2 Cl 2 L 4 (L means 2,4- t -Bu 2 -6-MeC 6 H 2 NC, 2,6-Me 2 C 6 H 3 NC and 2,4,6- t -Bu 3 C 6 H 2 NC). The main reduction wave of Pt(II)-complexes on dc polarograms was related to the electrode reaction of 3PtCl 2 L 2 + 6e − → Pt 3 L 6 + Cl − and formation of Pt 2 Cl 2 L 4 was due to a disproportionation reaction between the Pt 3 Cl 6 and PtCl 2 L 2 . A strong adsorption of Pt(0) on a mercury electrode was suggested from the polarograms and chronoamperograms, which was correlated to the formation of Hgue5f8Pt mixed cluster, Hg[Pt 3 Lb 6 ] 2 .

Recent trends in 30-day mortality in patients with blunt splenic injury: A nationwide trauma database study in Japan

Background Splenic injury frequently occurs after blunt abdominal trauma; however, limited epidemiological data regarding mortality are available. We aimed to investigate mortality rate trends after blunt splenic injury in Japan. Methods We retrospectively identified 1,721 adults with blunt splenic injury (American Association for the Surgery of Trauma splenic injury scale grades III–V) from the 2004–2014 Japan Trauma Data Bank. We grouped the records of these patients into 3 time phases: phase I (2004–2008), phase II (2009–2012), and phase III (2013–2014). Over the 3 phases, we analysed 30-day mortality rates and investigated their association with the prevalence of certain initial interventions (Mantel-Haenszel trend test). We further performed multiple imputation and multivariable analyses for comparing the characteristics and outcomes of patients who underwent TAE or splenectomy/splenorrhaphy, adjusting for known potential confounders and for within-hospital clustering using generalised estimating equation. Results Over time, there was a significant decrease in 30-day mortality after splenic injury (p < 0.01). Logistic regression analysis revealed that mortality significantly decreased over time (from phase I to phase II, odds ratio: 0.39, 95% confidence interval: 0.22–0.67; from phase I to phase III, odds ratio: 0.34, 95% confidence interval: 0.19–0.62) for the overall cohort. While the 30-day mortality for splenectomy/splenorrhaphy diminished significantly over time (p = 0.01), there were no significant differences regarding mortality for non-operative management, with or without transcatheter arterial embolisation (p = 0.43, p = 0.29, respectively). Conclusions In Japan, in-hospital 30-day mortality rates decreased significantly after splenic injury between 2004 and 2014, even after adjustment for within-hospital clustering and other factors independently associated with mortality. Over time, mortality rates decreased significantly after splenectomy/splenorrhaphy, but not after non-operative management. This information is useful for clinicians when making decisions about treatments for patients with blunt splenic injury.

Electrochemical reactions of dichlorobis(aryl isocyanide)platinum(II) complexes

Electrochemical reduction of cis-[PtCl2(RNC)2][(1a), R = 2,4-But2-6-Me6H2; (1c), R = 2,4,6-But3C6H2] produced [Pt2Cl2(RNC)4](2) or [Pt3(RNC)6](4), depending on the charge consumed and reduction potential. Potentiostatic reduction of [PtCl2(2,6-Me2C6H3NC)2](1b) gave [Hg{Pt3(2,6-Me2C6H3NC)6}2](3b)via a two-electron transfer process. [Pt2Cl2(RNC)4](2) was formed by the chemical reaction of cis-[Pt2Cl2(RNC)2] with zero-valent complexes (3) or (4) which were obtained by the above electrochemical process. The structure of compound (2) consists of two perpendicular PtCl(RNC)2 planes joined by a Pt–Pt bond; extended Huckel molecular orbital calculations on [Pt2Cl2(HNC)4] indicate that the perpendicular geometry is more stable than the planar one. Reaction of binuclear complexes (2) with isocyanide in the presence of [NH4][PF6] or NaClO4 gave [Pt2(RNC)6][X]2(8)(X = PF6 or ClO4). In the electronic spectra of the binuclear complexes (2) and (8) the absorption near 320 nm is assigned to a σ–σ* excitation.