A Successfully Operated Case of Traumatic Aortic Disruption with Multisystem Trauma / 日本心臓血管外科学会雑誌

A 63-year-old man suffered from multisystem trauma including pelvic bone fracture and lung contusion caused by a traffic accident. Chest CT revealed mediastinum and periaortic hematoma. Because of hemorrhagic complications, a emergency operation was avoided, and conservative therapy was decided on. Though his blood pressure was controlled strictly, re-bleeding appeared. An urgent operation was performed 4 days after the injury. Under partial cardiopulmonary bypass, the aortic isthmus disruption was resected and replaced with an artificial graft. The postoperative course was uneventful. In cases of traumatic aortic disruption with multisystem trauma, the delayed operation is more common than urgent operation. However, there is always the possibility of rupture. It is extremely important to appropriately judge the timing of the operation.

Staged Arterial Switch Operation without Homologous Blood Transfusion / 日本心臓血管外科学会雑誌

Staged arterial switch operation without homologous blood transfusion was successfully performed in 5 patients weighing 4.1-11.0kg (double outlet right ventricle: 2 cases, transposition of great arteries: 3 cases). The postoperative hemodynamics and respiratory status were uneventful in all patients (initial central venous pressure after ICU admission: 9.0-14.5cmH₂O, mean 12.5cmH₂O, duration of intubation: 3.5-18.0h, mean 7.8h). Autologous blood donation immediately after induction of anesthesia and minimization of bypass circuit were effective methods for open heart surgery without homologous blood transfusion, particularly in staged arterial switch operation requiring prolonged cardiopulmonary bypass.

Strategies to Improve Attendance Ratio of People Requiring Colon Cancer Workup: Effects of Educational Meetings for Residents / 日本農村医学会雑誌

The number of people who participate in our mass screening program for the detection of colorectal neoplasms has been increasing year by year. Regrettably, though, only 60% to 70% of those screened with positive tests have complied with doctors' exhortations about receiving workup.<BR>To improve the low attendance ratio of colon cancer candidates, the first thing we did was to hold classes for public health nurses at city, town and village levels to update their knowledge as professional health supervisors and to perceive the need to enlighten the public.<BR>Following these classes, we sponsored educational lectures directed to the inhabitants in various districts with the cooperation of public health nurses there. Emphasis was placed on the importance of regular physicals and the need of workup in the case of positive screenings. Using slides, lecturers presented eveyday health-related data and explained the procedures and the medical equipment used in the screening and testing processes, using plain language.<BR>As a result of these efforts, the workup attendance ratio is on the rise in every district, with the average ratio now reaching 80%.