Tsutomu Inoh

Arterial oxygen saturation, blood pressure, and pulse rate during upper gastrointestinal endoscopy — Influence of sedation and age

We studied the effect of sedation by I.V. meperidine on blood pressure, pulse rate, and arterial oxygen saturation during upper gastrointestinal endoscopy. Meperidine increased the tolerance of the patients and attenuated the endoscopy-induced rise in blood pressure and pulse rate. Arterial oxygen saturation was transiently depressed in the first few minutes of the endoscopic procedure even without sedation, and meperidine administration did not aggravate this oxygen desaturation. Therefore, meperidine may be a favorable sedative for upper gastrointestinal endoscopy because its treatment increases the tolerance of patients and decreases cardiac oxygen demand without decreasing arterial oxygen saturation.

Two cases of gastric antral vascular ectasia-Response to medical treatment

SummaryTwo patients with severe iron deficiency anemia and gastric antral vascular ectasia (GAVE) are reported. The anemia caused by the chronic blood loss from the abnormally dilated mucosal and submucosal capillary veins in the gastric antrum was unresponsive to oral iron supplementation. However, one of the patients was successfully treated with intramuscular injection of (Asu17) eel calcitonin. The other one was treated by oral prednisolone with resulting improvement iron deficiency anemia. The possible mechanisms of successful calcitonin and prednisolone treatments on chronic blood loss from GAVE is discussed.

Clinical evaluation of observations in poorly contracting and nondilated left ventricles (nondilated cardiomyopathy)

Abstract Idiopathic cardiomyopathy is defined as a heart muscle disease of unknown etiology and classified in 3 categories: dilated, hypertrophic and restrictive cardiomyopathy. 1 We occasionally encounter cases not classifiable in any of these 3 categories. 2–4 Cases with poorly contracting left ventricles without dilatation and hypertrophy are difficult to classify if intracardiac pressure does not have any restrictive feature. This study examines the pathophysiology of patients with poorly contracting and nondilated left ventricle (nondilated cardiomyopathy).