The main lobby of Hotel Okura Tokyo has a good reputation for its sound environment, which affects the conversations of its users. We assumed that the lobby’s reputation was related to its speech intelligibility. In this study, first, the sound during hotel operations was measured to see if there was a difference in the sound environment between the lobby and the entrance hall. As a result, we clarified that the difference in noise levels affected by the degree of crowdedness of the room was smaller in the lobby than in the other rooms. Subsequently, the indoor noise and speech intelligibility were measured to clarify the correspondence of intelligibility with the lobby’s reputation. As a result, the indoor noise was found to be at a level suitable for hotel lobbies and the intelligibility was good. A comprehensive evaluation that included the results of other acoustical surveys revealed that the lobby of Okura is a space that is suitable for conversations, corresponding to the opinions of users.
Fifteen consecutive patients with true or dissecting aneurysms of the thoracic descending aorta, and thoraco-abdominal aorta were operated upon under left thoracotomy with the support of partial cardiopulmonary bypass, equipment composed of a membrane oxygenator, centrifugal pump, and percutaneous thin wall cannulae which were all coated with covalently bonded heparin. The polyvinyl tube was coated with Biomate.The administration of systemic heparin was determined by an ACT of around 200 seconds.One perioperative death in a case treated by emergency operation for a ruptured descending aortic aneurysm occurred due to acute myocardial infarction.Other patients tolerated their operation well and are alive. No thromboembolic accident, bleeding tendency, nor organ failure were observed postoperatively in any other patients.In conclusion, the cardiopulmonary bypass using an antithrombotic circuit is safe and recommendable for thoracic descending or thoraco-abdominal aneurysm operations. Jpn. J.
, we performed open heart surgery using extracorporeal circulation in 90 patients (average age, 51.8 years old) and vascular surgery (graft replacement of abdominal aortic aneurysm and surgery for ASO) in 29 patients (average age, 58.1 years old). Among there, 8 patients with open heart surgery (EEC group) and 9 patients with vascular surgery (vascular group) had suffered from renal insufficiency preoperatively. In the two groups, we compared operative mortality, complications and postoperative severity of renal failure. Preoperative renal insufficiency was defined as a serum creatinine level of more than 1.4 mg/dl and postoperative renal failure was defined as 2.0mg/dl. There was no significant difference in operative mortality, in postoperative creatinine, Ccr, BUN and serum potassium and in effectiveness of hemodialysis in the two groups. In conclusion, it seems that we should not hesitate to perform cardiovascular surgery with extracorporeal circulation for patients with renal insufficiency or in hemodialized patients.
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