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Biomedical subjects

A Matsuki

Publications and source records attributed to A Matsuki.

At least 289 records · Page 16Linked to original sources
PubMed1990

[Respiratory gas exchange during total body hyperthermia in man].

Respiratory gas exchange was evaluated using indirect calorimetry during total body hyperthermia (TBH) in 7 postoperative patients with disseminated gastric cancer to the peritoneal cavity. TBH was induced using veno-venous bypass and extracorporeal circuit incorporating a heat exchanger to keep pulmonary arterial temperature 42 degrees C. The high temperature was maintained for 3 hours under general anesthesia with droperidol (0.15 mg.kg-1), morphine (1 mg.kg-1) and enflurane (less than 0.5%). Oxygen consumption (VO2) was also calculated using the Fick equation and thermodilution cardiac output. Hyperthermia for three hours increased both VO2 and carbon dioxide output (VCO2) values to 1.5 times as compared to the control values before heating, respectively. VO2 values measured by indirect calorimetry correlated well with the values calculated from the Fick equation when respiratory and cardiovascular system were relatively stable during the procedure. Gradual but statistically insignificant increase in respiratory quotient was observed after recooling started. These results suggest that indirect calorimetry was valuable to measure respiratory gas exchange continuously during hyperthermic state as well as normothermic state. However, RQ value observed in the present study may be modified by several factors including lactate accumulation in the blood, and may not reflect substrate utilization during the hyperthermic state.

Adult↗
PubMed1990

[Sevoflurane anesthesia for a patient with arthrogryposis multiplex congenita].

We reported an anesthetic experience of a 6-year-old male patient with arthrogryposis multiplex congenita who underwent tonsillectomy and adenoidectomy. The induction and maintenance of anesthesia were smoothly performed with inhalation of 1-5% sevoflurane in nitrous oxide and oxygen. Emergence from anesthesia was also smooth. Halothane and succinylcholine chloride were not used to avoid possible hyperthermia. Anesthetic management of patients with arthrogryposis multiplex congenita was discussed citing literature references.

Adenoidectomy↗
PubMed1989

Cardiac distribution of alpha-hANP in an infant with total anomalous pulmonary venous return.

Atrial natriuretic polypeptide like immunoreactivity (irANP) was searched in the right and left atrial and ventricles following necropsy of a 2-month-old boy who underwent anesthesia for radical surgery to total anomalous pulmonary venous return (TAPVR), who could not be removed from a cardiopulmonary bypass. The irANP concentration was 630 micrograms.g-1 in the right atrium, 3.2 micrograms.g-1 in the right ventricule in 1 100 micrograms.g-1 in the left atrium and 1.7 micrograms.g-1 in the left ventricle, respectively in spite of numerous studies reported that ir ANP cannot be detected in adult ventricles.

Aortopulmonary Septal Defect↗
PubMed1989

[Effects of surgical intervention on plasma levels of antidiuretic hormone and alpha-human atrial natriuretic polypeptide under sevoflurane anesthesia].

Effects of surgical intervention on plasma levels of antidiuretic hormone (ADH) and alpha-human atrial natriuretic polypeptide (alpha-hANP) under sevoflurane-nitrous oxide-oxygen anesthesia were evaluated in 24 patients, ranged in ages from 15 to 65, who underwent non-abdominal surgery (orthopedic surgery) or abdominal surgery (gastrointestinal or gynecological surgery). Anesthesia was induced and maintained with sevoflurane, nitrous oxide and oxygen. Succinylcholine was administered to facilitate tracheal intubation and pancuronium was given during abdominal surgery when needed. Lactated Ringer's solution was administered intravenously throughout the procedures. Neither plasma ADH nor alpha-hANP levels changed significantly during sevoflurane anesthesia alone for 20 min. Plasma ADH levels were unchanged during surgery in patients who underwent non-abdominal surgery, but they tended to increase although insignificantly after the recovery from anesthesia. On the contrary, plasma ADH levels increased significantly during surgery and in the recovery room in patients who underwent abdominal surgery. Plasma alpha-hANP levels were unchanged during surgery and in the recovery room in patients who underwent non-abdominal or abdominal surgery. The authors' findings suggest that ADH secretion was significantly stimulated with abdominal intervention but not with orthopedic one, furthermore neither anesthesia nor surgical stress induced any influence on plasma alpha-hANP levels.

Adolescent↗
PubMed1989

[Effects of intravenous anesthetics and analgesics on plasma alpha-rat atrial natriuretic peptide (alpha-rANP) levels in rats].

Effects of various intravenous anesthetics and analgesics on alpha-rat atrial natriuretic peptide (alpha-rANP) concentrations in the plasma were studied in unrestrained rats. Morphine (30 mg.kg-1), fentanyl (0.2mg.kg-1) and buprenorphine (1mg.kg-1) produced 10-, 10- and 3.3-fold significant increases in plasma alpha-rANP over control group at 20min after intraperitoneal injections of each drug, respectively. A marked increase in plasma alpha-rANP after morphine administration was still observed at 60min, but those after fentanyl and buprenorphine were reduced to 4.7-from 10.0-fold and 1.6-from 3.3-fold increase at 60min, respectively. Pentazocine (40mg.kg-1) significantly increased plasma alpha-rANP to 1.3 times higher than that of control group only at 60 min, while ketamine (40mg.kg-1) caused an insignificant increase in plasma alpha-rANP to 1.4 and 1.3 times at 40 and 60 min. Droperidol (10mg.kg-1) tended to decrease plasma alpha-rANP and a significant reduction was observed at 60 min. Propofol (40mg.kg-1) did not affect on plasma alpha-rANP. Pentobarbital (50mg.kg-1) produced an insignificant fall in plasma alpha-rANP. Plasma levels of ACTH, compB and aldosterone increased after injections of morphine and fentanyl. These results indicate that mu-type opiate receptor plays an important role in secreting alpha-rANP and activating pituitary-adrenal axis in the rats.

Analgesics↗
PubMed1989

[Effect of dexamethasone and ACTH on plasma atrial natriuretic polypeptide levels during hemorrhage in rats].

Anti-shock effect of dexamethasone (Dexa) and ACTH on atrial natriuretic polypeptide (ir-ANP) secretion was studied during hemorrhage in rats as reflected in the plasma ir-ANP, corticosterone (Comp B) and ACTH levels. We also observed the number of survived rats and plasma ir-ANP levels stimulated by volume loading of the shed blood or fluid. The rats were divided into non-treated group (saline), Dexa group (Dexa 5mg.kg-1) and ACTH group (ACTH 200 micrograms.kg-1). They were anesthetized by intravenous injection of pentobarbital sodium 30 mg.kg-1. Atrial blood sample for control value was collected before hemorrhage. Approximately 20% and then 30% of the estimated blood volume was taken for hemorrhage. Hemorrhage induced significant reductions in plasma ir-ANP levels. They decreased from a control value of 133.8 +/- 6.1 pg.ml-1 to 76.6 +/- 4.2 pg.ml-1 (P less than 0.005), but plasma levels of Comp B and ACTH increased markedly. The ir-ANP secretion increased in response to the elevation of atrial pressures after volume loading. The administration of Dexa and ACTH to the rats tended to inhibit the reduction of plasma ir-ANP levels during hemorrhage and improved the survival rate 24hr after bleeding 30% of the estimated blood volume.

Adrenocorticotropic Hormone↗
PubMed1989

[Effects of sevoflurane anesthesia and surgery on plasma catecholamine levels].

Effects of sevoflurane-nitrous oxide-oxygen anesthesia and surgery on plasma levels of epinephrine, norepinephrine and dopamine were evaluated in twenty four patients who ranged in ages from 15 to 65 years. They underwent non-abdominal surgery (orthopedic surgery) or abdominal surgery (gastrointestinal or gynecological surgery). Anesthesia was induced and maintained with sevoflurane in 50% nitrous oxide and 50% oxygen. Succinylcholine was administered intravenously to facilitate tracheal intubation and pancuronium was given intravenously during surgery. Lactated Ringer's solution at a speed of 5-15 ml.kg-1.h-1 was also administered intravenously throughout the procedures. Neither plasma epinephrine, norepinephrine nor dopamine levels changed significantly during the anesthetic induction with sevoflurane anesthesia. Plasma catecholamines were unchanged during and after surgery in patients who underwent non-abdominal surgery, while plasma epinephrine and norepinephrine levels increased significantly during and after abdominal surgery. Plasma dopamine levels, however, were unchanged during and after surgery in these patients. The findings suggest that epinephrine and norepinephrine secretion was significantly stimulated with abdominal intervention but not with orthopedic one under sevoflurane anesthesia.

Adolescent↗
PubMed1989

The effect of pentobarbital and ether anesthesia on rat brain PGD2 content.

Effects of pentobarbital and ether anesthesia on PGD2 contents in brain and plasma levels of compound beta, A.C.TH. epinephrine (E) norepinephrine (NE) and dopamine were investigated in 39 male Wistar strain rats weighing 280-300 g. They were divided into 3 groups: pentobarbital anesthesia group (P.A.), ether anesthesia group (E.A.) and control. Anesthesia or not the rats were decapitated the heads were frozen with liquid nitrogen and PGD2 were extracted and assayed by radioimmunoassay. In the group of P.A. and E.A., PGD2 contents of the brain were decreased by 69.6% and 77.8% of the control group respectively. In the group PA, plasma levels of Comp-beta, ACTH, E and NE were significantly decreased. In the EA group, plasma levels of Comp-beta was not changed but that of ACTH, E and NE were significantly increased. In the EA and PA groups, plasma levels of dopamine were not significantly changed. Intraventricularly injected PGD2 has been reported to induce the natural sleep in rat, increase or decrease the pain threshold and lower the body temperature in rat. On the other hand, intravenous injection of PGD2 has been reported to prolong the duration of pentobarbital anesthesia in rat or changed the EEG pattern to slow wave in cat. Stresses including restrain and foot shock have been reported to increase the PGE2 and PGF2a in the brain of rat. The present findings demonstrate that pentobarbital and ether anesthesia decreased the PGD2 contents in the brain of rat.

Anesthesia, General↗
PubMed1989

[An anesthetic experience with a patient with ornithine transcarbamylase deficiency].

We report an anesthetic experience with ornithine transcarbamylase deficiency. The patient was 26 years of age who underwent open biopsy of the liver for a definitive diagnosis. OTC deficiency is an X-linked disorder of urea cycle. One of the anesthetic problems is how to control the blood ammonia level resulting in neurological damage which occurs following anesthesia and surgery. Recently it has been advocated that benzoate is effective to prevent hyperammonemia in patients with OTC deficiency. As patients with this disease are frequently complicated with hepatic dysfunction, anesthetics which may cause hepatic damage such as halothane should be avoided.

Adult↗
PubMed1989

[Effects of modified NLA with droperidol and eptazocine and surgery on pituitary-adrenocortical function in man].

Effects of modified NLA with droperidol + eptazocine on pituitary-adrenocortical function were evaluated in ten patients who received abdominal hysterectomy. They were premedicated adequately. The induction of anesthesia was started with eptazocine 30 mg iv and thiopental 3-4 mg.kg-1 iv and the trachea was intubated smoothly following succinylcholine 40 mg iv. Then, they were given intravenous droperidol 0.15 mg.kg-1 with inhalation of 70% N2O and 30% O2. Good intraoperative muscle relaxation was obtained by dialferine or pancuronium. Five ml of the venous blood was taken on six occasions as follows; before the anesthetic induction, 5 and 30 minutes after the induction, 30 and 60 minutes after the start of surgery and finally at full recovery from anesthesia in the recovery room. The blood samples were immediately centrifuged and the plasma was separated and stored at -20 degrees C until measurement. Plasma cortisol, ACTH, human growth hormone (HGH) and prolactin (PRL) were measured for evaluation of the anterior pituitary-adrenocortical function. No significant increase in plasma levels of cortisol, ACTH and HGH were observed during anesthesia alone, but they increased significantly during surgery. Plasma levels of PRL increased significantly soon after the induction. These results were similar to those of other neuroleptic anesthesia. The systemic blood pressure and the heart rate were stable during anesthesia and surgery, and plasma eptazocine concentration determined by GC-MS showed that effective concentrations of eptazocine were maintained during surgery. These data suggest that modified NLA with droperidol and eptazocine would deserve a further detailed clinical study.

Adult↗
PubMed1989

[Prolonged respiratory depression following general anesthesia in a patient with dystrophia myotonica].

A case of general anesthesia for a 52 year old female with previously undiagnosed dystrophia myotonica was reported. The patient was diagnosed as flaccid paralysis of the bilateral lower extremities but myotonic symptoms were not found preoperatively. The patient underwent duodenal resection to have a benign tumor removed. Anesthesia was induced with thiamylal 250 mg and pancuronium bromide 4 mg intravenously to facilitate tracheal intubation. Anesthesia was maintained with enflurane (0.6-1.0%) in nitrous oxide (50%) and oxygen (50%). The course of anesthesia was uneventful except for a transient hypotension of 80 mmHg systolic for about 10 minutes. The patient did not recover smoothly from anesthesia and prolonged apnea was observed. 90 minutes after the end of surgical procedure, spontaneous ventilation appeared. Then the tidal volume increased gradually but it still remained around 100-150 ml even 3 hours after the end of the operation. She was on ventilator and observed carefully. The endotracheal tube was removed four days after the operation. The patient was examined again by a neurologist and a final diagnosis of dystrophia myotonica was made. Prolonged recovery from anesthesia and postoperative respiratory depression observed in this patient was due to preoperatively undiagnosed dystrophia myotonica. A careful preoperative examination should be made to minimize possible complication related to anesthesia in the disease.

Anesthesia Recovery Period↗
PubMed1989

[Effect of continuous epidural infusion of morphine for postoperative analgesia on pituitary-adrenocortical function].

Plasma levels of cortisol, ACTH and beta-endorphin like immunoreactivity (beta-ELI) were measured to evaluate postoperative pain relief with epidural morphine and systemic analgesics in conjunction with endocrine functions in 16 patients who underwent gastrectomy. Eight of these patients (epidural morphine group) obtained postoperative analgesia with continuous epidural infusion of morphine with a pump as in our previous report. A bolus of epidural morphine was administered through an indwelling thoracic (Th8,9) catheter at 3 hrs prior to the proposed end of the surgery, which was followed with continuous epidural infusion of morphine at a rate of 0.167-0.042 mg.hr-1 with a pump (CADD-PCA, Model 5200P, Pharmacia) during and after anesthesia and surgery with gradual decrease in dose until the third postoperative day. The remaining eight patients (systemic analgesics group) repeatedly received systemic pentazocine and buprenorphine when needed. Plasma cortisol levels increased significantly at the end of surgery and after in both groups. However plasma concentrations of cortisol in the epidural morphine group were significantly lower than those in the systemic analgesics group on the first and second postoperative days. Plasma levels of ACTH and beta-ELI increased significantly at the end of surgery but returned to levels of the previous day in both groups postoperatively. Our study suggests that continuous epidural infusion of morphine is adequate for postoperative pain relief and has suppressing effect on plasma cortisol levels as compared with systemic analgesics regimen.

Adult↗
PubMed1989

[Plasma morphine levels during its continuous epidural infusion].

We evaluated plasma levels of morphine during its continuous epidural infusion for postoperative analgesia in nine adult patients. A bolus injection of 3 mg of morphine was administered epidurally 3 hours prior to the proposed end of the surgery, and thereafter continuous epidural infusion of morphine was continued at a rate of 0.167-0.042 mg.hr-1 with a pump (CADD-PCA, 5200P, Pharmacia) during and after the surgery until the 3rd postoperative day. The dose of morphine was gradually decreased to 0.021-0.042 mg.hr-1 without reducing the quality of postoperative analgesia. Plasma morphine levels were measured by gas chromatography-mass spectrometry method. Plasma concentrations of morphine were 4.6 +/- 0.7 (Mean +/- SE) ng.ml-1 at the end of surgery and they decreased thereafter to 0.7 +/- 0.1 ng.ml-1, 0.3 +/- 0.1 ng.ml-1 and 0.1 +/- 0.1 ng.ml-1 on the 1st, 2nd and 3rd postoperative days, respectively. Plasma levels of morphine decreased gradually correlating with reduction of infused morphine. Adequate postoperative pain relief was obtained throughout the procedure without any severe complications such as respiratory depression. The analgesic effect of epidural morphine did not parallel with that of plasma concentration. Plasma concentrations of morphine administered by continuous epidural infusion with a pump were estimated to be lower than the minimum analgesic plasma concentration (10-40 ng.ml-1), and the toxic levels of morphine during continuous epidural infusion were not detected by our method.

Aged↗
PubMed1989

[An anesthetic experience of a patient with congestive cardiomyopathy].

A 54 year-old man with congestive cardiomyopathy underwent total cystectomy with formation of ileal conduit under fentanyl anesthesia. Preoperative status was evaluated to be very risky with ASA 3, Goldman cardiac risk index 28 and NYHA 3. Cardiac function was evaluated with Swan-Ganz catheter during anesthesia with fentanyl (30 mcg.kg-1) and 60% nitrous oxide. Dopamine, dobutamine and vasodilators (prostaglandin E1, trinitroglycerin) were continuously infused intravenously to decrease high afterload and enhance diminished cardiac contractility. On the 7th post-operative day, massive atelectasis in the right lung was observed, which was improved by positive pressure ventilation and vigorous bronchial lavage. A careful management with meticulous anesthetic care is emphasized for patients with congestive cardiomyopathy.

Anesthesia↗