Masato Machii

Protection of the spinal cord with pentobarbital and hypothermia

BACKGROUND Ischemic spinal cord damage during thoracic aortic operations has not been eliminated despite application of various adjuncts. We experimentally investigated the protective effects of pentobarbital and hypothermia on the spinal cord subjected to ischemia. METHODS Among nine groups of 6 rabbits each, groups AI to AIII underwent 20-minute infrarenal aortic occlusion, and groups BI to BVI underwent 40-minute occlusion. Five milligrams per kilogram of pentobarbital was administered to groups AII and BII; 10 mg/kg in groups AIII, BIII, and BVI; 20 mg/kg in group BIV; and none in groups AI, BI, and BV. In groups BV and BVI, hypothermia was induced. Forty-eight hours postoperatively, the motor function of the lower limbs was evaluated. RESULTS Statistically significant recovery of motor function was observed in animals in groups AII, AIII, BIII, BIV, BV, and BVI. CONCLUSIONS Pentobarbital showed dose-dependent protective effects of the spinal cord. Moderate hypothermia alone also showed protective effects. Combined use of pentobarbital and hypothermia resulted in highly significant recovery of spinal cord function.

Aortic stump tailoring with GRF glue and a felt strip

We describe herein a new technique of aortic stump tailoring for aortic dissection. This method involves the application of gelatine-resorcin-formalin (GRF) glue and a felt strip, with manipulation using the balloon of an endotracheal tube. The conjoined wall consists of three layers, but it is completed like a single layer. This procedure facilitates anastomosis to the graft in the next step.

Simplified physiological pacing after cardiac surgery.

Temporary pacing wires are routinely placed at the end of cardiac surgery. These pacing wires are helpful in maintaining patients with postoperative bradycardias, and physiological pacing is also more desirable in critically ill patients. We herein report our simplified procedure for atrial pacing. This technique uses commercially available intravenous pacing catheters. The catheter is passed through the skin, and its tip is placed at the pericardial oblique sinus just between the right and left pulmonary veins. Atrial pacing is then initiated with a temporary pulse generator. This procedure is simple and effective for patients undergoing cardiac surgery. We also report two clinical cases that satisfactorily underwent atrial pacing using this procedure.

A Case Report of Purulent Pericarditis with Cardiac Tamponade: Echocardiographic Findings

A five year old girl with cardiac tamponade due to purulent pericarditis caused by Staphylococcus aureus was treated successfully with a combination therapy of appropriate antibiotics and surgical open drainage. Right atrial collapse was observed during early systole using two‐dimensional echocardiography. This case illustrated the usefulness of echocardiography for early detection and treatment of cardiac tamponade in pediatric patients.