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Background According to the etiological classification, anal fistulas in Crohn’s disease (CD) which derived from CD lesions are secondary lesions (s.l.). We classified s.l. as follows: In case of presence of clear CD lesion at the primary orifice (p.o.), it was classified as s.l.CD lesion (+), whereas in the absence of CD lesion, it was classified as a s.l.CD lesion (-). To examine the prognosis of patients that primary orifice (p.o.) is not on the dentate line and no clear CD lesion. Methods 17 patients who have been followed up for >5 years post-the first examination under anesthesia (EUA) were included in the study. To determine the therapeutic effect, we defined cases with closed fistula as cured, those in whom drain can be removed, but symptoms may exist as improved, those in whom drains cannot be removed as unchanged, and those in whom rectal amputation was required as worsened. The target cases were divided into s.l.CD lesion (+), and s.l.CD lesion (-), and the prognosis was examined. Results Nine and eight patients showed s.l.CD lesion (+), and s.l.CD lesion (-), respectively. The results are shown in the table 1. Among s.l. cases, more patients with CD lesion (-) underwent biotreatment before EUA than those with s.l.CD lesion (+); furthermore, biotreatment was started earlier after EUA in the former than in the latter. Nevertheless, the prognosis of CD lesion (-) cases tended to be poor. Conclusions Based on the findings, the prognosis of patients that p.o. is not on the dentate line and no clear CD lesion is poor. more...

Background Previous studies have shown proximal extension (PE) rate of ulcerative proctitis (UP) is approximately 50%. This rate teach us the importance of treating UP adequately. Basically, we have to treat them with topical 5-ASA. But in clinical practice, we sometimes experience the case whose inflammation remain endoscopically, even though the symptoms have been relieved. Should we strengthen our treatment at this situation, especially inflammation at lower rectum? We aimed to know PE rate of lower rectal UP and optimize the treatment. Methods We retrospectively investigated the medical charts of patients with UP from 2010 to 2020 at Kenseikai Nara Coloproctology Center. We excluded the patients with UP shrinking from left-sided or pancolitis as a result of the treatment. The cases with missing value were excluded too. Variables of interest included gender, onset age, disease location, initial mayo endoscopic subscore (MES) and treatment, and the time to PE. To compare the cohorts we used Fisher’s exact test and Mann-Whitney test. Proximal extension free survival (PEFS) was calculated using the Kaplan-Meier method. Results Sixty-five patients were recruited. Mean age was 42 years old, the ratio of males to females was 1.17. The number of lower rectal UP patients at first examination was 24. We observed MES 1 inflammation for 30 patients, and MES 2 for 35. Median follow-up duration was 73.5 months. PE occurred in 34 patients: 28 patients had left-sided colitis and 6 had pancolitis. Fifty-four patients were medicated and other 11 patients were just observed. Among the patients medicated, 23 patients were took only topical drugs, 18 were took only oral drugs and other 13 were took both. We couldn’t find any relationships between initial medication and PE rate. The multivariate analysis revealed that having peri-appendiceal red patch and lower rectal UP were reduce the risk of PE. MES was not related to PE (table 1). PEFS at 1 year, 2 year are 81%, 81% for lower rectal UP (Rb group), and 66%, 61% for the patients having the disease beyond middle Houston’s valve (Not-Rb group), though we couldn’t find significant difference (Fig.1). Among 34 patients having PE, we used biologics for only five patients and got their inflammation under control. Conclusion Patients with lower rectal UP is less likely to extent their disease location. There’s no difference between the route of treatment and PE rate, but it’s important to carefully check PE within first one year. more...

Background Recently, the importance of top-down therapy is emphasised for early Crohn’s Disease (CD). Especially early use of biologics after onset may prevent rectal amputation or permanent stoma concrete of CD with perianal lesion (CDp). The aim of this study was to evaluate the risk factors of permanent stoma concrete for CDp, and especially we had an interest for the relationship between permanent stoma concrete and length of time it takes for infliximab (IFX) was started to use after onset. Methods This is a comparative retrospective study of CDp patients who received IFX therapy at Kenseikai Nara Coloproctology Center between 2002 and 2018. We analysed risk factors of their rectal amputation using logistic regression analysis. Patients were included if they had perianal lesions and received IFX. The cases who received IFX after rectal amputation and who have missing values were excluded. Variables of interest included gender, age at onset and diagnosis, disease duration and location, disease behaviour, smoking, perianal surgical history, timing of IFX use after anoperineal lesion’s onset. Late IFX use was defined as we started to use IFX 2 years after perianal lesion’s onset. Results Fifty-four patients were recruited. Mean age was 37 years old, the ratio of males to females was 3.5. Forty-one patients’ disease was located in the small and large intestine, and thirteen patients’ were located in the large intestine. Median follow-up duration was 149 months. Among 54 patients, 10 patients were received rectal amputation or permanent stoma concrete. The univariate analysis revealed that the risk factors for rectal amputation were smoking habit (OR 7.56, 95% CI 1.41–53.88, p-value = 0.007), penetrating type (OR 6.44, 95% CI 1.21–39.22, p-value = 0.013) and Late IFX use (OR 12.47, 95% CI 1.50–589.26, p = 0.011). A multivariate analysis revealed that smoking habit (OR 21.5, 95% CI 1.92–239, p = 0.013) smoking behaviour (OR 21.5, 95% CI 1.92–239.00, p = 0.013) and Late IFX use (OR 16.0, 95% CI 1.01–254, p = 0.049) were independent risk factor for rectal amputation (Table 1). Conclusion Smoking and late IFX use may be a significant risk factor of rectal amputation for CDp. Early use of biologics may prevent permanent stoma concrete for CDp. more...

目的：腹腔鏡下手術時に腸管拡張を抑え，良好な術野展開を可能にするための最適な前処置法の確立．方法：腹腔鏡下手術を行った67例をmagnesium citrate（MGC，マグコロールP®高張液）またはpolyethylene glycol electrolyte solution（PEG，ニフレック®等張液）を前処置として使用した2群に割り付け，手術時の小腸および大腸の拡張をスコア化し比較検討する．結果：全症例および大腸癌症例において，MGCがPEGと比較し小腸（上部，中部，下部）および上行結腸，横行結腸の拡張を有意に抑制した．結語：MGC高張液を用いた前処置法は腹腔鏡下手術時の腸管拡張を抑制し，術野の展開を容易にすることで安全な手術を行うことに寄与すると考えられた． more...

症例は60歳代，男性で，下血を主訴に近医受診した．大腸内視鏡検査で，S状結腸に亜全周2型の腫瘍を認め，手術目的にて当院紹介受診となった．上腹部造影CT検査にてinteraorticからretrocavalに及ぶ多発性傍大動脈周囲リンパ節転移を認めた．S状結腸切除術を施行した．また，傍大動脈周囲リンパ節転移巣の一部を切除した．病理組織学的検査では，粘膜内から奬膜下層へかけて一部に腺腔形成をともないまたシート状に増生する腫瘍が混在し，一部には角化像もともなっていた．以上より腺扁平上皮癌と診断．病理組織学的進行度は，pSS，N1，P0，H0，M1（No. 216）， stage IVであった．退院後，m-FOLFOX6療法を6クール施行した．術後14カ月の，平成22年2月に施行した腹部CT造影検査にても傍大動脈周囲リンパ節転移に対してCRを維持しており，他に再発を認めておらず経過良好である． more...

後腹膜に発生した脂肪肉腫は稀ではないが,傍直腸脂肪組織内に発生した脂肪肉腫の報告例は無い.また脂肪肉腫に対する治療後長期にわたり予後を観察した症例の報告例は少ない.今回術後8年間無再発生存している傍直腸脂肪組織内に発生した脂肪肉腫の一例を経験したので報告する.症例は34歳女性で,第2子出産の際,産婦入科医に直腸腫瘤を指摘されて来院.腫瘍は腹膜翻転部直下の直腸左側のいわゆる"pararectal space"に存在.術前に経皮針生検検査施行し,脂肪肉腫の診断を得た後に手術を施行した.周囲組織への浸潤を認めなかったので,腹会陰式直腸切断術は施行せず,摘出術のみとした.術後の化学療法,放射線療法は施行していない.文献的考察を加えて報告する. more...

患者は34歳の男性. 2年前発症の潰瘍性大腸炎(UC)患者.重症の全大腸炎型の診断にて近医入院し中心静脈栄養,プレドニゾロン,メサラジン,顆粒球除去療法(GCAP)が施行された. 2カ月にわたって治療されるも症状改善せず当院紹介入院となった.転院時,呼吸困難,発熱,低酸素血症,胸部X線像にて両肺にびまん性の淡いスリガラス状の陰影を認めた.カリニ肺炎による間質性肺炎と診断し, ST合剤を投与した.これにより呼吸状態が改善し,結腸亜全摘,一時的回腸瘻, S状結腸粘液瘻造設術を行った. UCの治療経過中にステロイド剤や免疫抑制剤, GCAPなどが併用される.これによって免疫不全をきたし日和見感染症を合併することもある.内科的治療の限界を見極め,感染合併症を引き起こす前に手術に踏み切ることが重要と考える. more...

Patients with ulcerative colitis (UC) have elevated/activated myeloid lineage leucocytes and may respond favorably to adsorptive granulocyte/monocyte apheresis (GMA). However, there are patients who respond well to GMA, and patients who do not benefit. Therefore, predictive factors of GMA efficacy need to be defined.In a prospective multicenter setting, 200 UC patients at 32 institutes received one GMA session per week over 10 weeks. Patients who achieved remission were followed for 12 months. The Clinical Activity Index (CAI) ≤3 meant remission, and response meant CAI decreased by ≥3. Quality of life was evaluated by the Inflammatory Bowel Disease Questionnaire (IBDQ).After final GMA, remission, response and no response rates were 67.0%, 15.0% and 18%, respectively. The remission group had a significant decrease in myeloid leucocytes and platelets. Corticosteroid dose decreased (P0.001); 49 of 97 patients on corticosteroids became steroid-free. Baseline CAI was lower in the remission group versus non-remission (P0.01), whereas IBDQ was higher in the remission group versus non-remission (P0.05). After 12 months, 52 of 134 patients had maintained remission. Disease duration was longer in the relapsed group versus maintained remission group (P = 0.041). Male gender, first UC episode and corticosteroid responder were significant factors for maintaining remission, whereas corticosteroid dependent UC was associating with relapse.Selective myeloid leucocyte depletion was effective for remission induction and improving patients' quality of life. Baseline demographics such as disease activity level, duration and corticosteroid dependency appear to predict response to GMA. Additionally, patients with a first UC episode who were drug naive responded well to GMA and achieved a favorable long-term disease course by avoiding pharmacologics from an early stage of their inflammatory bowel disease. These findings should help to end unnecessary use of medical resources by targeting GMA to patients who may respond well. more...

われわれは子宮内避妊リング (intrauterine device: IUD)による骨盤腹膜炎に起因する直腸S状結腸狭窄を呈した症例を経験した.患者は46歳,女性.主訴は下腹部痛,排便困難.血液検査所見で著明な炎症反応を認めた.注腸X線検査,内視鏡検査で直腸S状結腸に狭窄所見を認めた.下腹部CTでは子宮筋腫,右卵巣嚢腫が疑われ, S状結腸の腸管壁肥厚が疑われた.大腸癌あるいは炎症による直腸S状結腸狭窄,腸閉塞と診断し,手術を施行した.開腹所見では回腸末端,右卵巣が子宮後方に癒着しており,直腸S状結腸は漿膜面の炎症性変化があり,腸管は非常に硬くなっていた.付属器炎などからの骨盤腹膜炎による直腸S状結腸狭窄と診断し直腸切除術を行った.術後5カ月で腹腔内膿瘍が再燃し,保存的治療で軽快しないため開腹ドレナージ術を行った.術後IUDを抜去された後,現在まで良好に経過している. more...

肛門周囲膿瘍を契機に重症化した非定型的潰瘍性大腸炎(以下UC) の症例を経験したので文献的考察を加え報告する.症例は24歳,男性.平成6年 (22歳)発症時より全大腸炎型のUCと診断され,治療により緩解していた.平成8年12月下旬に肛門周囲膿瘍を契機に炎症が再燃した.9時から3時方向にかけて坐骨直腸窩膿瘍を認め, seton法で膿瘍ドレナージを行った.ステロイド大量投与に反応せず下血が持続した.大量下血を認めたため,平成9年1月8日緊急手術(大腸亜全摘,一時的回腸瘻, S状結腸粘液瘻造設術)を行った.切除標本では上行結腸,下行結腸,S状結腸に区域性に縦走潰瘍を認めたが,病変間の粘膜は肉眼上健常にみえた.術後合併症を生じることなく経過したが,難治性痔瘻となった.痔瘻が治癒するまでまち,初回手術より8カ月後回腸嚢下部直腸吻合術を行った.以後痔瘻の再発はなく経過良好である. more...

消痔霊は,中華人民共和国にて開発された硬化剤で,水溶性局所用注射剤である.明礬およびタンニン酸を主成分とし,内痔核・直腸脱等に適応がある.これまではGoligher III・IV度の内痔核に対しては手術療法が優先されたが,それらの内痔核に対しても十分な効果が認められた.注射方法は,四歩注射法といい,痔核本体の最も上端・痔核の底面・表面そして下端の4箇所に適切な量を注射する.注射量は痔核の大きさによるが,全体で30～60ml程度を使用する.注射部位が不適切であったり,注射量の過不足があると痔核の残存・合併症を引き起こす可能性があり,注射手技の充分な習得を要する.1991年7月より2001年6月までに,計483回施行したが,重大な合併症もなく,痔核の残存・再発に対しては,追加投与を行い有効であった.進行した内痔核に対する非手術的治療法として,第一選択としてよい治療法である. more...

TOKAI PULP has 600 tpd kraft pulp mill with 2 digester. The measurment of Kappa number is very important parameter of pulping process. In TOKAI PULP mill, we have installed BTG automatic Kappa number measurement system in 1996 instead of the previous semiautomatic measurement system.This time we report the performance of the past 3 years of this BTG automatic Kappa numbermeasurement system. more...

Fournier's gangrene is a specific type of necrotic fascitis. It is a fulminating infection characterized by a rapid progress of necrosis of subcutaneous tissue covering from the lower abdomen to the scrotum. It is necessary to detect the disease as early as possible and to perform incision, drainage snd debridement completely and without hesitation. A 51-year-old man who had a past history of diabetes mellitus was seen at our hospital because of pain, swelling, and redness of the perianal area and perineum to the right upper leg. Computed tomography revealed a widespread low-density area, from the perianal lesion to the right thigh. Colonoscopic examination showed type 2 advanced cancer in the lower portion of the rectun. Debridement of necrosed tissue was performed. Leakage of contrast material from the rectum into the pelvic cavity was detected on fluoroscopic study after surgery, suggesting that penetration of the rectal cancer might have caused the disease in this patient. more...

Among malignant lymphomas of the intestine, those arising in the rectum are rare, especially Burkitt lymphoma. A 54-year-old woman visited another clinic because her stool was positive for occult blood. A breast-like submucosal tumor at Rb region of the rectum was revealed by colonoscopy and barium enema study. Carcinoid tumor was suspected and an endoscopic polypectomy was performed. Histological diagnosis was malignant lymphoma with positive cut end. Then she was referred to the hospital. After admission, a low anterior resection with D3 lymph nodes dissection was performed. Histological grading was sm3, n0, H0, P0, M (-), and stage I. Histological and imunohistological diagnosis of the resected specimen was Burkitt lymphoma B-cell type. She has been doing well without any evidence of recurrence for six months after surgery. In this paper, we clinico-pathologically reviewed 85 cases of malignant lymphoma of the rectum reported in Japan from 1981 to 1996. And 30 cases of rectal malignant lymphoma in which lymph node metastases were noted were reviewed with regard to the relationship between macroscopic findings, max size of the tumor and the grade of invasion. more...

The lactate (LAC), creatine (CRN), taurine (TAU), anserine (ANS) and carnosine (CAR) content of the masseter muscles (MM), long extensor muscles of digits (EDL) and soleus muscles (SOL) of young rats were determined using in vitro 1H-NMR spectroscopy to assess the significance of CRN, TAU, ANS and CAR in these muscles. The muscles of Wistar rats at the ages of 6, 12 and 18 weeks were dissected after decapitation and used for the metabolite analyses. The LAC and CAR content of all muscle groups showed no age dependence. The CRN content was increased age-dependently in MM but not in EDL or SOL. The LAC and CRN content was higher in MM and EDL (fast-twitch) than in SOL (slow-twitch) (P0.01-0.001 at 18 weeks). A significant positive correlation existed between the LAC and CRN content (P0.00001, r=0.80), suggesting that the CRN content reflects the capacity of the anaerobic glycolysis of the individual muscles. The TAU content was higher in SOL and MM than in EDL (P0.05) and showed an approximately 1.5-fold increase with age in all three muscle groups. The ANS content was higher in EDL than in SOL and MM (P0.001), and showed an approximately threefold increase with age in all three muscle groups. The ANS content positively correlated with the LAC content (P0.001, r=0.41), and the chemical shift of the imidazole proton in ANS showed a correlation with the LAC content (P0.0001, r0.76), indicating that ANS would buffer the pH change produced by LAC. These results suggest that 1H-NMR spectroscopy would provide an adjunct method of assessing the muscle types and their development. more...

We investigated the in vivo selective anti-inflammatory effect of L-156,602, which was first identified as a preferential delayed-type hypersensitivity-suppressant in our screening program and first reported to be a C5a antagonist. The agent most profoundly suppressed footpad edema 4 h after elicitation by concanavalin A (con A) and also caused a significantly impaired response after a further 20 h. Footpad edema induced by either serotonin, carrageenan or zymosan was not much influenced by the agent. Although the dominant cell population that migrated in response to con A and zymosan 4 h after elicitation was neutrophils, L-156,602 specifically prevented the con-A-induced migration of neutrophils, suggesting a distinct mechanism of neutrophil recruitment between con A and zymosan-induced inflammation. The agent also reduced the contact-sensitivity response, especially in host mice sensitized with a moderate dose of picryl chloride and almost completely suppressed the infiltration of mononuclear leukocytes and neutrophils into the site of inflammation. These selective effects of L-156,602 on inflammatory reactions appeared to be not merely via C5a antagonism. more...

In computed tomography (CT)-controlled stereotactic surgery, the coordinate system of the CT scanner is applied to determine the target depth and direction as well as for readjustment of final probe direction. This method can be used for all types of stereotactic surgery for the brain. more...

従来より高血圧性脳内出血で血腫の脳室内穿破をみる例は一般的に予後不良であると考えられがちであった.しかし, なかにはこの考えと矛盾する非常に良好な経過をとる脳室穿破例のあることも経験される.そこで我々は脳室内穿破例でその予後を左右する因子につき, 主としてCT所見を中心として, 自験例をもとに検討した.対象はCTの精度の向上した最近3年間 (昭和53年1月～55年12月) に経験したテント上出血219例中脳室内に血腫の穿破をみた104例 (47%) である.これらについて検討したところでは, 血腫が脳室内穿破をし, 第III, 第IV脳室内に及ぶものでも, それが直接的に予後不良となる原因とはならないようであった.むしろCT上予後不良を示唆する因子は, 1) 血腫径が3×3cm以上の場合, 2) 急性脳室拡大, 迂廻槽の消失, 血腫の視床下部進展などが重複してみられた場合, 3) 第III, 第IV脳室内に鋳型血腫がみられた場合, と考えられた.もし, これらの所見がみられない場合は, たとえ脳室内に血腫の一部の流入をみてもそれが予後を直接左右する因子とはならないわけで, したがって, 脳室内の血腫をみることのみでは血腫除去を目的とした脳室ドレナージの適応とはならないと思われた.むしろ脳圧亢進なく, その他一般的臨床症状もよければ, 脳室内に血腫があっても経時的CTにより厳重な観察を行いつつ手術侵襲を避けるべきであろうとの結論をみた.高血圧性脳出血による脳室内穿破例の予後について検討を加え以下の結論を得た. more...

A consecutive series of 112 cases of hypertensive intracerebral hematoma from June 1976 to April 1978 were studied with repeated scanning by CT of EMI model 1010 and ACTA model 0100. Ninety-four cases were diagnosed as basal ganglionic bleeding and 9 were subcortical bleeding in this series. Fifty-four of basal ganglionic bleeding were operated and 50 were not operated. These 103 cases of supratentorial hematomas were analyzed by CT based on density of hematoma and perifocal low density area surrounding hematoma chronologically. It was suggested that indication and timing for surgery of hypertensive intracerebral hemorrhage should be decided on hematoma factors (namely, hematoma size, midline shift and ventricular rupture) and chronological change of perifocal area surrounding hematoma on CT. 1. A progressive and concentric diminution in density of hematoma always occurred from the periphery. The high density in the center of hematoma did not change for a certain period until the area of the density decreased to 1-1.5 cm in size. Then, the high density area of 1-1.5 cm in size started to decrease its density and reached isodensity with the surrounding brain parenchyma during 18-20 days. As could be predicted, the larger the hematoma the longer the resolution time, but the general pattern of resolution as described above can be identified. 2. The rim of lucency surrounding hematoma probably represented secondary changes of edema, degeneration and necrosis of the adjacent parenchyma. So, the perilucent area varied according to the age of intracerebral hematoma. The area surrounding hematoma was small within 6 hours from onset and then increased greatly until the 4th day. The peak of perilucent area ranged between the 4th and the 15th day. The area was noted to decrease after the 15th day and to disappear within a month after. 3. Mortality of patients with basal ganglionic hematoma correlated with hematoma size, midline shift and ventricular rupture. Thirteen of our 33 non-operative cases with hematoma of less than 2.5 cm in diameter and midline shift of less than 5 mm were all alive. Fourteen cases fell between 2.5 and 4.5 cm in diameter and within 10 mm in shift. In 3 of these 14 cases, rupture of the intracerebral hematoma into the ventricular system was observed. One of them died and the others survived. The other 6 cases showed hematoma of more than 4.5 cm in diameter and/or shift of more than 10 mm and rupture of the hematoma into the ventricular system. All of these cases died. 4. Positive contrast enhancement in non-operative cases was observed first on the 14th day from the onset and frequently had a ring formed configuration contrast enhancement after the 20th day. Ratio of positive contrast enhancement changed according to hematoma size. Large hematoma was accompanied by contrast enhancement of longer duration. Four types of configurations of contrast enhancement; namely, ring, ring with inside high density, incomplete ring, and spot form, were observed in these cases. more...

On the basis of the acetylcholine inhalation test performed in 45 patients who had atopic dermatitis, it appears that patients with a history of bronchial asthma (Group I), patients with a suggestive history of bronchial asthma (Group II), and nearly half of nonasthmatic patients with a family history of bronchial asthma (Group III) show respiratory thresholds to acetylcholine, ranging from 98 to 1,563 μg, as low as those of asthmatic patients. On the other hand, the rest of Group III and all of the patients with neither personal nor family history of bronchial asthma (Group IV) show values, from 1,563 to 25,000 μg, as high as those of healthy subjects. The patients in Group III with a lower value may be regarded as latent asthmatics. Thus, the patients with atopic dermatitis can clearly be divided into two groups, namely, (1) those with and (2) those without a predisposition to bronchial asthma. Consequently, it is reasonable to consider that atopic dermatitis and bronchial asthma are not based on a single predisposition controlled by the same gene, but rather on different predispositions controlled by separate genes. Their close genetic relationship might be more complicated than it was previously reported to be. more...

(1982). Construction of “Sleeper” Cloning Vehicles for Enzyme Overproduction. Agricultural and Biological Chemistry: Vol. 46, No. 1, pp. 313-315.

The effects of the calcium entry blocker nicardipine on CBF, CMRO2, and neurologic outcome following 10 min of complete cerebral ischemia were examined in dogs. In CBF and CMRO2 studies, the CBF in the untreated group (seven dogs) and the nicardipine group (seven dogs; 20 μg kg−1 at 30 min postischemia and a subsequent infusion of 2 μg kg−1 min−1 for 90 min) initially increased to 300–400% and then returned to preischemic values at 30 min postischemia. Thereafter the CBF in the untreated group significantly decreased to 50% of preischemic values for the following 90-min period (hypoperfusion), while the CBF in the nicardipine group did not differ from preischemic values. The CMRO2 in both groups decreased to ∼50–80% of preischemic values after 15 min postischemia and did not differ between the groups throughout the study. In neurologic outcome studies, 18 dogs were divided into three groups (of six dogs each): untreated; saline infusion only, posttreated; nicardipine as in CBF and CMRO2 studies, pretreated; nicardipine 20 μg kg−1 at 2 min preischemia and a subsequent infusion of 2 μg kg−1 min−1 from immediately postischemia to 120 min postischemia. Nicardipine treatment initiated either before or after ischemia failed to improve neurologic outcome at 48 h postischemia. Thus, the increase of postischemic global CBF by nicardipine is not accompanied by neurologic recovery in a canine model of complete cerebral ischemia. more...

The effect of alcuronium given before succinylcholine (SCh) on plasma catecholamine concentrations, systolic blood pressure and heart rate was studied in patients anesthetized with enflurane. Twenty-one patients were divided into three groups; six control patients without SCh, eight SCh (1 mg/kg) patients, and seven pretreated patients given alcuronium, 0.04 mg/kg, 5 min before SCh, 1 mg/kg. In the SCh group, mean plasma norepinephrine concentrations, systolic blood pressure, and heart rate significantly increased with onset of fasciculations, whereas in the pretreated patients these variables did not change significantly and no fasciculation was observed. These results indicate that alcuronium pretreatment significantly attenuates the SCh-induced increases in plasma norepinephrine concentrations, systolic blood pressure and heart rate. more...