[Intraoperative assessment of the ascending aorta by echogram during the CABG operation for the prevention of cerebral infarction].

While coronary artery bypass grafting operations (CABG), we started to use the echogram to evaluate the ascending aorta intraoperatively from December 1993. During a period from January, 1990, to June, 1995, 379 patients were treated with CABG. Intraoperative echogram was used in 127 cases (group I) and 252 cases unused (group II). The sites of the aorta for evaluation were following: site of cannulation, aortic clamping, and proximal anastomosis respectively. Depending on the echographical findings the operative procedures were changed as required. The incidence of postoperative cerebral embolism in group I was 0.8% (one patient) and in group II, 2.4% (6 patients). Although no significant difference was found in the cohort, rate of incidence in the group II was high. There were 4 cases who had significant atheromatous lesions clearly evaluated by echogram, which were not detected by palpation. We conclude that the intraoperative assessment of the ascending aorta by echogram is beneficial in prevention of cerebral infarction.

Sulfamethizole absorption test for the assessment of gastric emptying. Comparison with scintigraphic method.

BACKGROUND: To investigate whether the sulfamethizole absorption test can be applied for the assessment of gastric emptying, we measured comparatively plasma sulfamethizole concentration and gastric emptying as determined by scintigraphy in 15 subjects. METHODS: After the ingestion of a solid-liquid meal that contained sulfamethizole and radioisotope (technetium-99m-labeled diethylenetriaminepentaacetic acid), the plasma sulfamethizole concentrations were measured every 15 to 60 min up to 180 min. The initial emptying time (duration after ingestion until 10% reduction in radioactivity of the stomach) and the exponential curve in the cumulative reduction of radioactivity were used as indicators of gastric emptying. RESULTS: The initial emptying time was significantly correlated with the sulfamethizole concentration at 15 min after ingestion (r = -0.64, p < 0.05). A close correlation was observed between the rate of decrease in radioactivity and sulfamethizole concentration at 60 min after ingestion (r = 0.80, p < 0.001). CONCLUSIONS: The sulfamethizole absorption test can be used for the evaluation of gastric motility. Two points of measurement, 15 and 60 min after ingestion, are sufficient to demonstrate the initial and subsequent gastric emptying.

[Preoperative assessment of aortic dissection by three-dimensional CT angiography].

In 21 patients with aortic dissection including 12 patients with acute aortic dissection, aortic lesions were evaluated preoperatively by newly developed three-dimensional CT angiography (3 D-CTA) using helical scan CT. Rapid and safe three-dimensional evaluation of aortic dissection was achieved with no complications. Three-dimensional structure of aortic dissection was well reflected in the image of 3D-CTA. Preoperative three-dimensional evaluation was useful to determine and proceed the operative procedure for the repair of aortic dissection. All patients were alive and results of surgical treatments were excellent. Intimal flaps and entries were visualized by multiple threshold display (MTD) method of 3D-CTA. Multiple threshold display method is an important three-dimensional reconstructive method and 3D-CTA may be a new useful and powerful diagnostic modality for aortic dissection.