Publications by authors named "Yudai Yamamoto"

17 Publications

  • Page 1 of 1

TEG6s Platelet Mapping assay for the estimation of plasma fibrinogen concentration during cardiovascular surgery: a single-center prospective observational study.

J Anesth 2021 Oct 13. Epub 2021 Oct 13.

Department of Anesthesiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.

Purpose: The Activator F (ActF) test on the TEG6s Platelet Mapping assay system is a means of quantifying blood viscoelasticity caused by fibrin network formation, triggered by reptilase and factor XIII, while platelets are inhibited. This unique methodology enables the measurement of blood viscoelasticity, even in highly heparinized blood. Here, we investigated whether fibrinogen concentration could be estimated using the ActF test in blood samples obtained during cardiopulmonary bypass (CPB) and after CPB in patients undergoing cardiovascular surgery.

Methods: We performed a single-center prospective observational study at a university hospital. Forty patients aged ≥ 18 years who underwent elective cardiovascular surgery with CPB were enrolled. Blood samples were drawn after the induction of anesthesia, after declamping of the aorta during CPB, and after the reversal of heparinization using protamine (after CPB). Coagulation profiles were evaluated using the Platelet Mapping assay and standard laboratory tests.

Results: There were strong correlations between the maximal amplitude of clot strength (MA) in the ActF test and fibrinogen concentration in samples drawn during CPB (R = 0.84, 95% confidence interval [CI] 0.72-0.91; P < 0.001) and after CPB (R = 0.83, 95% CI 0.70-0.91; P < 0.001). The areas under the receiver-operating characteristic curve for the ActF MA for fibrinogen concentrations < 150 mg/dL were 0.86 (95% CI 0.73-1.0) during CPB and 0.98 (95% CI 0.94-1.0) after CPB.

Conclusion: TEG6s Platelet Mapping ActF MA values strongly correlated with plasma fibrinogen concentration in highly heparinized blood during CPB and yielded highly accurate measurements of low fibrinogen concentrations.
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http://dx.doi.org/10.1007/s00540-021-03009-4DOI Listing
October 2021

Epidemiological trends of imported infectious diseases in Japan: Analysis of imported 2-year infectious disease registry data.

J Infect Chemother 2021 Apr 10;27(4):632-638. Epub 2020 Dec 10.

Nagoya City East Medical Center, 1-2-23 Wakamizu, Chikusa-ku, Nagoya-city, Aichi, 464-8547, Japan.

Introduction: The epidemiology of infectious diseases in Japan remains undefined despite the increasing tourism. GeoSentinel, an epidemiological surveillance system for reporting imported infectious diseases, has only two participating facilities in Japan. Although the number of infectious diseases is reported by the National Institute of Infectious Diseases, there is no detailed clinical information about these cases. Therefore, we established J-RIDA (Japan Registry for Infectious Diseases from Abroad) to clarify the status of imported infectious diseases in Japan and provide detailed information.

Methods: J-RIDA was started as a registry of imported infectious diseases. Case registration began in October 2017. Between October 2017 and September 2019, 15 medical institutions participated in this clinical study. The registry collected information about the patient's age, sex, nationality, chief complaint, consultation date, date of onset, whether visit was made to a travel clinic before travel, blood test results (if samples were collected), travel history, and final diagnosis.

Results: Of the 3046 cases included in this study, 46.7% to Southeast Asia, 13.0% to Africa, 13.7% to East Asia, 11.5% to South Asia, 7.5% to Europe, 3.8% to Central and South America, 4.6% to North America, 3.9% to Oceania, and 2.8% to Central and west Asia. More than 85% of chief complaints were fever and general symptoms, gastrointestinal symptoms, respiratory symptoms, or dermatologic problems. The most common diseases were travelers' diarrhea, animal bite, upper respiratory infection, influenza, and dengue fever.

Conclusions: We summarized two-year cases registered in Japan's imported infectious disease registry. These results will significantly contribute to the epidemiology in Japan.
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http://dx.doi.org/10.1016/j.jiac.2020.11.028DOI Listing
April 2021

Dielectric blood coagulometry as a means of evaluating the change in thrombin generation induced by direct oral anticoagulants.

Thromb Res 2021 01 10;197:141-143. Epub 2020 Nov 10.

Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan.

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http://dx.doi.org/10.1016/j.thromres.2020.11.007DOI Listing
January 2021

[A Case of Pelvic Desmoid-Type Fibromatosis Treated by Radiation and Medication Therapies].

Gan To Kagaku Ryoho 2020 Feb;47(2):337-339

Dept. of Gastrointestinal Surgery, Tokyo Medical and Dental University.

The treatment for desmoid-type fibromatosis involves surgical resection and medication therapy, but the standard treatment has not yet been established. In the West, the usefulness of radiation therapy has been reported. We encountered a patient with desmoid-type fibromatosis in the pelvis who was treated by radiation and medication therapies and achieved a good tumor reduction effect. The patient was a 70-year-old man. He had a 6-year history of pain in the right leg and had a palpable mass on the right side of the anus; he was admitted to our department. CT showed a 12×7×12 cm mass in the pelvis, and CT-guided needle biopsy revealed a desmoid-type fibromatosis. Because tumor exclusion resulted in obstruction of the rectum, radiation therapy(60 Gy in 30 Fr)was started after performing transverse colon colostomy; simultaneous medication therapy with a COX-2 inhibitor and the anti-allergic agent tranilast was administered. Cystic degeneration was observed 5 months after the end of radiation therapy, and after 12 months, the tumor volume had halved. Around 28 months after the end of radiation therapy, medication treatment has been continued with slow contraction.
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February 2020

Cytotoxicity of propofol in human induced pluripotent stem cell-derived cardiomyocytes.

J Anesth 2018 02 29;32(1):120-131. Epub 2017 Dec 29.

Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.

Purpose: Propofol infusion syndrome (PRIS) is a lethal condition caused by propofol overdose. Previous studies suggest that pathophysiological mechanisms underlying PRIS involve mitochondrial dysfunction; however, these mechanisms have not been fully elucidated. This study aimed to establish an experimental model of propofol-induced cytotoxicity using cultured human induced pluripotent stem cell (iPSC)-derived cardiomyocytes to determine the mechanisms behind propofol-induced mitochondrial dysfunction, and to evaluate the protective effects of coenzyme Q10 (CoQ10).

Methods: Human iPSC-derived cardiomyocytes were exposed to propofol (0, 2, 10, or 50 µg/ml) with or without 5 µM CoQ10. Mitochondrial function was assessed by measuring intracellular ATP, lactate concentrations in culture media, NAD/NADH ratio, and the mitochondrial membrane potential. Propofol-induced cytotoxicity was evaluated by analysis of cell viability. Expression levels of genes associated with mitochondrial energy metabolism were determined by PCR. Intracellular morphological changes were analyzed by confocal microscopy.

Results: Treatment with 50 µg/ml propofol for 48 h reduced cell viability. High concentrations of propofol (≥ 10 µg/ml) induced mitochondrial dysfunction accompanied by downregulation of gene expression of PGC-1alpha and its downstream targets (NDUFS8 and SDHB, which are involved in the respiratory chain reaction; and CPT1B, which regulates beta-oxidation). Cardiomyocytes co-treated with 5 µM CoQ10 exhibited resistance to propofol-induced toxicity through recovery of gene expression.

Conclusions: Propofol-induced cytotoxicity in human iPSC-derived cardiomyocytes may be associated with mitochondrial dysfunction via downregulation of PGC-1alpha-regulated genes associated with mitochondrial energy metabolism. Co-treatment with CoQ10 protected cardiomyocytes from propofol-induced cytotoxicity.
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http://dx.doi.org/10.1007/s00540-017-2441-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797219PMC
February 2018

[A Case of Retroperitoneal Recurrence and Left Kidney Metastasis Occurring Four Years after Laparoscopy-Assisted Surgery for Sigmoid Colon Cancer].

Gan To Kagaku Ryoho 2016 Nov;43(12):1827-1829

Dept. of Surgery, Niigata Prefectural Tokamachi Hospital.

A 67-year old woman underwent laparoscopy-assisted high anterior resection for sigmoid colon cancer. A histopathological examination revealed no lymph node metastasis, but extramural cancer deposits were present. Four years later, enhanced computed tomography revealed recurrence in the retroperitoneum and metastasis to the left kidney. A left nephrectomy and left hemicolectomy were performed. A year after the second operation, computed tomography revealed metastasis to the lung. Histopathological reexamination for extra-lymph nodal spread after the first operation revealed venous involvement. Generally, colon cancer with extra-lymph nodal spread has a higher risk of retroperitoneal recurrence, and venous involvement leads to a poor prognosis. We describe our case with the known report.
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November 2016

[Four Cases of Colorectal Cancer with Para-Aortic Lymph Node Metastases Successfully Resected Resulting in Long-Term Survival].

Gan To Kagaku Ryoho 2016 Nov;43(12):1718-1720

Dept. of Surgery, Niigata Prefectural Tokamachi Hospital.

We encountered 4 cases of colorectal cancer with para-aortic lymph node(LN)metastases.Para -aortic LN dissection was performed after the diagnosis of solitary LN metastases.Case 1: A 69-year-old woman was diagnosed with ascending colon cancer.She underwent right hemicolectomy with D3 LN dissection.After 1 year and 3 months, tumor marker levels(CEA) were elevated, and para-aortic LN metastases were detected on CT.She was administered FOLFOX.After 1 year, para-aortic LN dissection was performed.She is doing well without any recurrence for 8 years and 9 months.Case 2: A 52-year-old man was diagnosed with rectal cancer.He underwent abdominoperineal resection with lateral pelvic LN dissection.After 5 months, his tumor marker levels(CEA)were elevated, and para-aortic LN metastases were detected on CT.He was administered various chemotherapies, but the LN were swollen.After 6 years and 2 months, para-aortic LN dissection was performed.He received systematic chemotherapy, and is alive with recurrent disease.Case 3: A 67-year-old man was diagnosed with obstructive sigmoid colon cancer.He underwent high-anterior resection with D3 LN and para-aortic LN dissection.He received systematic chemotherapy and is alive with recurrent disease.Case 4: A 61-year-old man was diagnosed with obstructive rectal cancer.He underwent low-anterior resection with D3 LN and para-aortic LN dissection.He is doing well without recurrences for 2 years and 1 month.Our results suggest that patients with localized para-aortic metastases of colorectal cancer may achieve good long-term survival after dissection of para-aortic LN.and surgical treatment is indicated in selected cases.
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November 2016

[Three Cases of Long-Term Survival in Colon Cancer with Postoperative Peritoneal Recurrence].

Gan To Kagaku Ryoho 2016 Nov;43(12):1626-1628

Dept. of Surgery, Niigata Prefectural Tokamachi Hospital.

Case 1 is a 57-year-old man with pelvic recurrence 1 year 8 months after surgery for ascending colon cancer.We performed a Hartmann's operation.He has been relapse-free for 11 years.Case 2 is a 67-year-old man with intraperitoneal small intestinal relapse 4 years after surgery for cecum cancer.We performed resection.He has brain metastases recurrence in 2 years 6 months after surgery, died after 2 years 9 months.Case 3 is a 53-year-old man with recurrence in the bladder rectal fossa 5 years after sigmoidectomy.We performed resection.He has been relapse-free survival at 1 year 2 months.
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November 2016

Cross-sectional and longitudinal investigation of human herpesvirus 8 seroprevalence in HIV-1-infected individuals in Osaka, Japan.

J Infect Chemother 2017 Apr 26;23(4):201-205. Epub 2017 Jan 26.

AIDS Medical Center, National Hospital Organization Osaka National Hospital, Japan; Department of Advanced Medicine for HIV Infection, Osaka University Graduate School of Medicine, Japan.

Introduction: High human herpesvirus 8 (HHV-8) seroprevalence has been reported in men who have sex with men (MSM) and are infected with HIV-1. However, it is unclear when they become infected with HHV-8. Thus, we conducted cross-sectional and longitudinal investigations of HHV-8 seroprevalence in HIV-1-infected individuals in Osaka, Japan.

Patients And Methods: Plasma was collected from 121 individuals infected with HIV-1 and the anti-HHV-8 antibody titer was measured using an enzyme-linked immunosorbent assay with whole virus lysate. Subjects were classified into those with and without a past medical history of HHV-8-associated disease; the latter group was then classified into 3 subgroups based on the assumed route of HIV-1 infection: blood products, homosexual contact, and other routes. HHV-8 seroprevalence was compared among the groups and measured again approximately 3 years after the baseline measurement. The relationship between HHV-8 seropositivity and possible associated factors was also investigated.

Results: All 15 subjects with HHV-8-associated disease were seropositive, and all 11 subjects in the blood product group were seronegative. In the MSM group, 25 (30%) of 79 subjects were HHV-8 seropositive and, in the non-MSM group, 1 (6%) of 16 subjects was (p < 0.0001). In the longitudinal investigation, seroconversion was observed in 10 (19%) of 52 subjects in the MSM group who were seronegative at baseline. A correlation was observed between seroconversion and symptomatic syphilis (p = 0.0432).

Conclusions: HHV-8 seropositivity and seroconversion rates were high in HIV-1-infected MSM, suggesting that, currently, HHV-8 is an epidemic pathogen in this population.
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http://dx.doi.org/10.1016/j.jiac.2016.12.007DOI Listing
April 2017

Perioperative Elevation in Cell-Free DNA Levels in Patients Undergoing Cardiac Surgery: Possible Contribution of Neutrophil Extracellular Traps to Perioperative Renal Dysfunction.

Anesthesiol Res Pract 2016 2;2016:2794364. Epub 2016 Nov 2.

Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.

. This study aimed to determine the perioperative change in serum double-strand DNA (dsDNA) as a marker potentially reflecting neutrophil extracellular trap concentration in samples from patients undergoing cardiac surgery and to analyze a relationship between serum dsDNA concentrations and perioperative renal dysfunction. . Serum dsDNA concentrations in samples that were collected during a previously conducted, prospective, multicenter, observational study were measured. Eighty patients undergoing elective cardiac surgery were studied. Serum samples were collected at baseline, immediately after surgery, and the day after surgery (POD-1). . Serum dsDNA concentration was significantly increased from baseline (median, 398 ng/mL [interquartile range, 372-475 ng/mL]) to immediately after surgery (median, 540 ng/mL [437-682 ng/mL], < 0.001), and they were reduced by POD-1 (median, 323 ng/mL [256-436 ng/mL]). The difference in serum creatinine concentration between baseline and POD-1 was correlated with dsDNA concentration on POD-1 ( = 0.61, < 0.001). . In patients undergoing cardiac surgery, serum dsDNA concentration is elevated postoperatively. Prolonged elevation in dsDNA concentration is correlated with perioperative renal dysfunction. Further large-scale studies are needed to determine the relationship between serum concentration of circulating dsDNA and perioperative renal dysfunction.
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http://dx.doi.org/10.1155/2016/2794364DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110877PMC
November 2016

[A Case of Long-Term Survival after Resection of Liver and Adrenal Metastases from Rectal Cancer].

Gan To Kagaku Ryoho 2015 Nov;42(12):2340-2

Dept. of Surgery, Niigata Prefectural Tokamachi Hospital.

A 72-year-old man underwent Miles' operation for rectal cancer. Histological findings showed moderately differentiated adenocarcinoma, a, ly0, v1, n0, stage Ⅱ(ly0, v1). Five months later, left lateral segmentectomy and left adrenalectomy were performed owing to the metastasis of the rectal cancer to the liver and adrenal glands. Two years after these operations, left nephrectomy was performed for retroperitoneal recurrence around the left kidney. All resected specimens showed metastatic adenocarcinoma derived from the rectal cancer. No recurrence has been detected in the 4 years since the left nephrectomy. Aggressive resection of well-controlled metastatic lesions including those in the adrenal glands is recommended.
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November 2015

[Colorectal Cancer with Macroscopic Invasion to Adjacent Organs--A Case Report].

Gan To Kagaku Ryoho 2015 Nov;42(12):2193-5

Dept. of Surgery, Niigata Prefectural Tokamachi Hospital.

We encountered a case of colorectal cancer with macroscopic invasion to the adjacent organs. A 61-year-old man with abdominal pain and nausea was diagnosed as having sigmoid colon cancer invading the ileum, ureter, internal iliac artery, and external iliac vein. A lower anterior resection and resection of the small bowel, ureter, external iliac vein, and internal iliac artery was performed and succeeded in an R0 resection. The patient was discharged from the hospital in 29 POD. Pathology results revealed an adenocarcinoma, pT4b, pSI, INF b, int, ly0, v, pPM0, pDM0, pN0, Type 2, Stage Ⅱ. Four courses of XELOX plus bevacizumab were administered. The patient underwent ileostomy closure, and is currently free of relapse 3 years 2 months after resection. The survival rate of patients with combined resection of the invaded organs is significantly higher than that of patients with a non-combined resection. The survival rate after curative resection is also significantly higher compared with non-curative resection. Aggressive resection of invaded organs seems to be important for a good outcome.
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November 2015

[A Case of Long-Term Survival of a Patient with Gastric Cancer with Peritoneal Dissemination].

Gan To Kagaku Ryoho 2015 Nov;42(12):2000-2

Dept. of Surgery, Niigata Prefectural Tokamachi Hospital.

The patient was a 75-year-old man with a history of gastrectomy with combined resection of the transverse colon ligament for gastric cancer in July 2011. He was diagnosed with adenocarcinoma (tub2, tub1), L, Ant-Gre, type 2, pT4b (SI: transverse colon ligament) and pN3b, H0, M0, P0, CY0, Stage ⅢC. On abdominal computed tomography 7 months after surgery a peritoneal metastasis was seen near the transverse colon. The patient was treated with resection for peritoneal dissemination with part of the transverse colon. Three years after the last surgery, the patient is still alive without relapse.
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November 2015

[A Case of Para-Aortic Lymph Node Metastases of Sigmoid Colon Cancer Treated with Complete Resection].

Gan To Kagaku Ryoho 2015 Nov;42(12):1656-8

Dept. of Surgery, Niigata Prefectural Tokamachi Hospital.

We present a case of sigmoid colon cancer with isolated para-aortic lymph node metastasis in a 67-year-old male patient. We treated this patient using simultaneous curative lymph node dissection with primary tumor resection. After inserting a transanal tube and decompressing the proximal colon for obstructive colitis, we performed high anterior resection with paraaortic lymph node dissection without neoadjuvant chemotherapy. The pathology results were as follows: tub2, SE, N3, H0, P0, M1(No. 216, 280), stage Ⅳ, curability B. Adjuvant chemotherapy with the XELOX regimen was administered, and the patient remains alive with no signs of recurrence 24 months after surgery. Although simultaneous dissection of para-aortic lymph node metastasis is controversial, curative dissection is advisable for localized cases.
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November 2015

[Two cases showing the absence of motor evoked potentials without developing postoperative paraplegia following thoracoabdominal aortic repair--role of epidural cooling, spinal drainage and aorto-iliac side-arm conduit distal perfusion].

Masui 2012 Aug;61(8):847-51

Department of Anesthesiology, Critical Care Medicine, Tokyo Medical and Dental University, Tokyo 113-8519.

We describe two cases which developed loss of motor evoked potentials from bilateral lower limbs following thoracoabdominal aortic repair. Paraplegia was suspected in both cases; however, one case of Crawford type 2 aneurysm showed transient left leg monoplegia with a sensory deficit and the other case of aortic pseudoaneurysm showed no neurologic dysfunction postoperatively. We employed epidural cooling and spinal drainage for spinal protection and distal perfusion was provided through aorto-iliac side-arm conduit. Despite the prolonged spinal ischemia during thoracoabdominal aortic repair, spinal drainage and epidural cooling were very helpful for protecting the spinal cord from ischemia. The interpretation of MEPs seems very difficult especially when the potentials remain absent even after reconstruction or reperfusion of segmental arteries, because variety of intraoperative factors may affect them.
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August 2012

Retrospective analysis of spontaneous recovery from neuromuscular blockade produced by empirical use of rocuronium.

J Anesth 2011 Dec 21;25(6):845-9. Epub 2011 Sep 21.

Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.

Purpose: A train-of-four ratio (TOF ratio) of >0.9 should be the clinical cut-off to avoid residual paralysis. However, it is not rare to extubate patients without measurement of the TOF ratio, although the safe interval from the last administration of rocuronium assuring a TOF ratio of >0.9 has not been established in the daily clinical setting. In this study, to estimate the safe interval to avoid residual paralysis, we retrospectively selected patients in whom the TOF ratio was measured during remifentanil administration before extubation, and we studied the characteristics of recovery from the neuromuscular blockade produced by the empirical use of rocuronium.

Methods: Patients undergoing surgery under general anesthesia with sevoflurane and remifentanil were studied (n = 134). Rocuronium was administered at 0.7-1.0 mg/kg for tracheal intubation, and repeated bolus administration (10 mg) or continuous infusion (15-25 mg/h) was performed by the anesthesiologists in charge of the patient to maintain intraoperative paralysis. At the end of the surgery, the TOF ratio was measured, during remifentanil infusion and the contribution of clinical parameters to spontaneous recovery from the rocuronium-induced paralysis was studied by multivariate logistic regression analyses.

Results: Spontaneous recovery from rocuronium-induced paralysis within 2 h after the last administration of rocuronium varied among the patients. Multivariate logistic regression analyses showed that age (P = 0.002) and time elapsed from the last administration of rocuronium (P < 0.0001) significantly contributed to TOF recovery, and elderly patients demonstrated significantly slower recovery.

Conclusion: Because of the large variation in the recovery from rocuronium-induced paralysis, TOF-based evaluation of residual paralysis is essential to determine the appropriate indication for reversal, especially for elderly patients.
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http://dx.doi.org/10.1007/s00540-011-1229-xDOI Listing
December 2011

[Case of cardiac arrest due to coronary spasm during laparoscopic distal gastrectomy].

Masui 2011 Jan;60(1):75-9

Department of Anesthesiology & Critical Care Medicine, Tokyo Medical & Dental University, School of Medicine, Tokyo 113-8519.

We describe a 50-year-old man who developed ventricular arrhythmia followed by cardiac arrest during laparoscopic distal gastrectomy. Preoperatively, there were no findings suggesting an ischemic heart disease. Anesthesia was maintained using sevoflurane combined with epidural anesthesia. His blood pressure, heart rate, and ECG waves were stable during the initial stage of laparoscopic procedure. After establishment of small laparotomy for stomach resection, the blood pressure decreased to before 60 mmHg without remarkable ST change on lead II. Administration of intravenous ephedrine was not effective and a short run appeared. Then persistent ventricular tachycardia followed by ventricular standstill developed. Chest compression and intravenous adrenalin restored sinus rhythm, and thereafter the patient remained hemodynamically stable with intravenous nitroglycerine and nicorandil. The operation was completed and the patient awoke without neurological deficits. Postoperatively the coronary angiography showed no stenosis of coronary arteries; however, when acetylcholine test was attempted on right coronary artery, paroxysmal ventricular fibrillation in accordance with spasm of #1 segmental coronary artery developed. In the case of abrupt onset of lethal arrhythmia, coronary vasospasm should be suspected even when ST changes are not recognized with routine ECG monitor.
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January 2011
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