| Japanese |
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| Title | 褐色細胞腫の麻酔管理と皮膚末梢血流量測定 |
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| Subtitle | 症例 |
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| Authors | 玉木章雅*, 野中明彦*, 小口健史*, 熊澤光生* |
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| Authors(kana) | |
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| Organization | *山梨医科大学医学部麻酔科 |
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| Journal | 循環制御 |
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| Volume | 20 |
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| Number | 1 |
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| Page | 102-105 |
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| Year/Month | 1999/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「緒言」褐色細胞腫の麻酔管理に関しては多くの報告1〜5)があるが, 手術操作が腫瘍に及んだときや腫瘍静脈結紮後の著明な血行動態変動を予見する良い指標は未だ無い. 最近末梢皮膚血流量は褐色細胞腫手術中の血中カテコラミン濃度と良く相関するという報告6)がある. 今回著者らはノルエピネフリン優位とエピネフリン優位の褐色細胞腫の麻酔管理に際し, 末梢皮膚血流量を測定し, 褐色細胞腫の分泌カテコラミンの違いにより, その有用性に差があるか否か検討したので報告する. 「症例」症例1:50歳, 女性, 身長154cm, 体重33kg. 家族歴, 既往歴に特記すべきことなし. 体重減少と四肢冷感を主訴として当院受診, 精査の結果, ノルエピネフリン優位の右副腎の褐色細胞腫と診断された. 術前検査では, 末梢血漿エピネフリン濃度0.94ng・ml-1(正常値<0.12ng・ml-1), ノルエピネフリン濃度11.0ng・ml-1(0.1〜0.45ng・ml-1), 尿中VMA16.5mg・day-1(1.1〜7.2mg・day-1), メタネフリン2.2mg・day-1(0.05〜0.23mg・day-1), ノルメタネフリン5.28mg・day-1(0.07〜0.26mg・day-1), レニン活性5.8ng・ml-1・h-1(<2.0ng・ml-1・h-1)であった. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | |
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| English |
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| Title | Skin Blood Flow Measurement during Removal of Pheochromocytoma |
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| Authors | Fumimasa Tamaki*, Akihiko Nonaka*, Takeshi Oguchi*, Teruo Kumazawa* |
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| Authors(kana) | |
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| Organization | *Department of Anesthesiology , Yamanashi Medical University |
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| Journal | Circulation Control |
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| Volume | 20 |
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| Number | 1 |
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| Page | 102-105 |
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| Year/Month | 1999/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We measured skin blood flow in two patients undergoing removal of pheochromocytoma. The skin blood flow was measured in the first finger by a laser Doppler flowmeter. Anesthesia was maintained with propofol-ketamine combination with continuous epidural block in both cases. In the patient with norepinephrine dominant type of pheochromocytoma, the skin blood flow decreased during tumor manipulations and increased 10 min after ligation of veins drainage the adrenal gland. The skin blood flow continued to increase during the rest of surgery. On the contrary, the skin blood flow did not change during operation in the patient with epinephrine dominant type of pheochromocytoma. Skin blood flow measurement may be a useful marker for the changes of the concentration of plasma cathecholamines during removal of pheochromocytoma, especially in patients with norepinephrine dominant pheochromocytoma. The changes in skin blood flow may be helpful to conjecture the complete removal of the tumor. |
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| Practice | Basic medicine |
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| Keywords | Pheochromocytoma, Skin blood flow, Epinephrine, Norepinephrine |
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