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Biomedical subjects

A Matsuki

Publications and source records attributed to A Matsuki.

At least 91 records · Page 5Linked to original sources
PubMed2000

[Abnormal Q wave in the right precordial leads unmasked during right bundle branch block in a patient with anteroseptal myocardial infarction: a case report].

Electrocardiography in a 77-year-old woman showed small R waves in leads V1-V3 3 hours after the onset of acute anteroseptal myocardial infarction. Abnormal Q waves appeared in leads V1-V3 only during intermittent right bundle branch block. The normal septal force disappeared after transmural septal infarction and a small force of right ventricle origin became apparent as a small R wave in V1. Right bundle branch block delayed activation of right ventricle, and thereby deleted the initial R wave and unmasked the Q wave of the septal infarction. Appearance of a Q wave in leads V1-V3 with right bundle branch block should not be assumed to reflect the extension of myocardial infarction.

Aged↗
PubMed2000

[New studies on the history of anesthesiology (1)--A newly discovered truth on Woolley and Roe case after an interval of 50 years].

A famous medical accident that is widely known as Woolley and Roe case occurred on Oct 13th, 1947 at the Chesterfield Royal Hospital, England. The patients Albert Woolley and Cecil Roe underwent minor operations under spinal anesthesia using cinchocaine to develop spinal cord myelopathy with paralisis of bilateral legs. Both patients sued Dr James M. Graham, the anesthetist, and the Ministry of Health. Seven years later, Dr Graham and the Ministry of Health were given a verdict of not guilty, because three judges unanimously accepted the phenol theory proposed by a witness Prof Macintosh of Oxford University. He allged that phenol entered into the ampoule of cinchocaine through invisible cracks. Thus the plaintiffs were not compensated. Recentry Dr Hutter of Nottingham University found no validity of phenol theory and also no possibility of invisible cracks. Syringes and needles for spinal anesthesia were used to be sterilised by water-boiling steriliser, and mineral acid was used for descaling the deposition of line at that time. Dr Hutter concluded that the severe spinal myelopathy occurred both in Woolley and Roe would have been caused by mineral acid which was conveyed into their subarachnoidal space by acid-contaminated syringes and needles.

Anesthesia, Spinal↗
PubMed2000

[New study on the history of anesthesiology (2)--who is the first Japanese to write a scientific paper for the journal "Anesthesiology"?].

The beginning of modern anesthesiology in Japan dates back to 1950 when Dr M. Saklad of Rhode Island Hospital came to Japan to give his lectures on endotracheal anesthesia and related procedures. Since then, many Japanese surgeons visited the United States to learn anesthesiology in depth and they began to write their papers for foreign journals. According to my survey of the journal "Anesthesiology" from Vol 1 (1940) through Vol 21 (1960), I found 12 scientific papers written by Japanese. The first paper by Japanese appeared in this journal published in 1955 entitled as "Observations on the action of thiopental (Pentothal) on the laryngeal reflex" by Akira Horita et al. He was born in the United States in 1928 as a son of Japanese immigrants. He was graduated from the University of Washington at Seattle to become professor or pharmacology. The first paper based on studies performed in Japan by Japanese authors appeared in 1956. It was entitled as "The spread of drugs used for spinal anesthesia" by Kitahara et al. This paper is the English translation of their Japanese paper which appeared in Nippon Rinsho Geka Ikai Zasshi entitled as "Basic Study on Spinal Anesthesia in 1953".

Anesthesiology↗
PubMed2000

[New studies on the history of anesthesiology--a new study on Seishu Hanaoka's "Nyugan Ckiken Roku" (a surgical experience with breast cancer)].

Among Japanese physicians before the Edo era, Seishu Hanaoka is the most well known even in foreign countries as well as in Japan. His detailed biography is described in a monograph by Shuzo Kure published in 1923 which has been the most important book for the study of Seishu Hanaoka. Hanaoka had worked very hard in various fields as surgeons, educator, poet and community developer. However, his best noted activity was his devotion to the development of oral general anesthetic "Mafutsu-San" or "Tsusen-San". He was the first to succeed in the excision of breast cancer in a 60 year old woman named Kan Aiya under general anesthesia with this agent on Oct 13th, 1804. The details of the case have been known to us, as the manuscript on the case which is believed to be by the hand of Hanaoka is extant in the Tenri Library, Tenri University and the whole manuscripts have been printed in Kure's monograph. For the past twenty years, I have studied carefully the microfilmed manuscript and the printed sentences appeared in Kure's book to find several serious bibliographical errors and dubious points between them. They are as follows. 1) There is no definite proof that the manuscript was transcribed by Seishu Hanaoka himself. This was originally proposed by Shuzo Kure without any rational reasons. 2) There are seven fundamental and unbelievable errors of incorrect use of Chinese characters in the manuscript. These basic errors can not be committed by Hanaoka considering that he was an excellent poet. For these errors Shuzo Kure falsified them to be printed in his book. He even altered Chinese characters in one of the photographs of the manuscript in his book. 3) Shuzo Kure did not exhibit this manuscript at the exhibition on the occasion of 150 anniversary of Seishu Hanaoka's death in Tokyo, supposedly to avoid careful study by other investigators. All above mentioned findings strongly suggest us that the manuscript "Nyugan Chiken Roku" could be transcribed by one of Hanaoka's disciples and not by Hanaoka himself.

Anesthesia, General↗
PubMed2000

Haemodynamic comparison of propofol-fentanyl anaesthesia with midazolam-fentanyl anaesthesia in CABG patients without preoperative heart failure.

This study was designed to compare prebypass haemodynamics under total intravenous anaesthesia (TIVA) using midazolam-fentanyl (group M) and propofol-fentanyl (group P) combinations. Sixteen adult patients undergoing CABG were studied with patients in group M and P (n = 8 each) given intravenous midazolam 0.1 mg.kg-1.h-1 and propofol 4 mg.kg-1.h-1 with fentanyl 25 micrograms.kg-1 until sternotomy, respectively. Following induction of anaesthesia, cardiac index and heart rate decreased significantly (30% and 20% in both groups, p < 0.05) these variables returned to baseline on completion of sternotomy. In addition, in group P mean arterial pressure decreased significantly (about 15%) following induction and there were no ischaemic signs. Overall for MAP there was no significant difference between the two groups. LVSWI and RVSWI were reduced by around 25% in both groups. Only the change in LVSWI reached statistical significance (p < 0.05). This reduction may have exert a caridioprotectant action by decreasing myocardial oxygen consumption. We conclude that both TIVA techniques represent an acceptable anaesthetic regimen for use in cardiac anaesthesia.

Aged↗
PubMed2000

[New study on the history of anesthesiology--(5) and (6). Reevaluation of surgical achievements by Tokumei Takamine].

A half century has passed since K. Higaon-na, a historian from Okinawa, first reported that in 1689 Tokumei Takamine (1653-1738) had performed successfully a hare-lip operation under general anesthesia with mafutsu-san for a royal grandchild Sho-eki of the Ryukyu Dynasty in the Ruykuys, now known as Okinawa. As Higaon-na obtruded his opinion above mentioned without any substantial proof on the public, and many medical historians as well as historians have followed him thereafter. No historical documents are available concerning surgical achievements by Tokumei Takamine to clarify them in detail but it clearly says in the genealogy of the Takamines that Kou Kaiyu ([symbol: see text]) taught his ancestral prescription and surgical technique of hare-lip operation to Tokumei Takamine on his repeated solicitation when they stayed in Fu-chou. Takamine made two scrolls describing the secret prescription and surgical method of hare-lip, and presented them to a magistrate Genzaimon Murao and his physician Doh-yo Isashiki in 1690. In 1986, a scroll has been found in Sendai city of Kagoshima prefecture, which was transcribed by two physicians named Antei Kore-eda and Encho Nagai at Kagoshima in 1754. No information is available about biographies of these two physicians. A careful study of this scroll has revealed that it bears the prescription of an ointment including ten remedies to dress the incision and surgical method of hare-lip. Accordingly it is clearly proven by this newly discovered scroll that Tokumei Takamine did not administer any general anesthetics when he performed surgical operations for hare-lip on several occasions.

Anesthesiology↗
PubMed1999

Physostigmine antagonizes ketamine-induced noradrenaline release from the medial prefrontal cortex in rats.

Physostigmine is known to antagonize ketamine anesthesia. In this study, effects of physostigmine (0.1 mg kg(-1) i.p.) on ketamine (100 mg kg(-1) i.p.)-induced anesthesia time and noradrenaline release from the medial prefrontal cortex in rats were examined. Ketamine produced anesthesia for 27+/-1 min and increased noradrenaline release to 405% of the basal. Physostigmine significantly reduced anesthesia time to 23+/-1 min (p<0.05), and noradrenaline to 248% (p<0.05). Therefore, noradrenaline release may play an important role in ketamine anesthesia.

Anesthesia↗
PubMed1999

Allelic loss mapping and physical delineation of a region harboring a putative thymic lymphoma suppressor gene on mouse chromosome 12.

Our previous allelic loss analysis of gamma-ray induced thymic lymphomas in F1 hybrid and backcross mice between BALB/c and MSM strains mapped the Tlsr4 region exhibiting a high frequency of allelic loss (62%) to a 2.9 cM interval between the markers D12Mit53 and D12Mit279 on mouse chromosome 12. To narrow further the interval harboring a putative tumor suppressor gene, a high-density scan has been carried out for informative 361 thymic lymphomas. Construction of a physical map of Tlsr4 with 3 YAC and 15 BAC clones and isolation of YAC- and BAC-derived polymorphic probes lead to fine allelic loss mapping. Three successive polymorphic sites within one BAC exhibit the retention of both alleles in seven, one and four lymphomas, suggesting that a common region of allelic loss for Tlsr4 exists within the BAC region. Pulsed-field gel electrophoresis of NotI digests of this and other clones determines that the commonly lost region is a 35 kb interval with a NotI site. NotI sites are frequently associated with coding regions, and our preliminary sequencing has identified ESTs in the region. Thus, the present study facilitates the identification of genes in the Tlsr4 region that would lead to isolation of a novel tumor suppressor gene.

Alleles↗
PubMed1999

Mutations in the p53 and scid genes do not cooperate in lymphomagenesis in doubly heterozygous mice.

Analysis of double mutant mice of the p53 and scid genes, which have a combination of cell cycle checkpoint/apoptosis and DNA repair defects, shows that the latter defect synergistically enhances lymphoma development with loss of the former function. These mice lack the ability to eliminate lymphocytes predisposed to neoplastic transformation resulting from faulty antigen receptor gene rearrangement. Here we examine the cooperativity in double heterozygotes of p53 and scid in which normal development of lymphocytes is not impaired. MSM mice carrying a p53-knockout allele were crossed with BALB/c mice heterozygous for the scid locus and 129 offspring were obtained. They were subjected to gamma-ray irradiation, 84 thymic lymphomas being generated. The tumors and host mice were genotyped of p53 and scid. Among 42 mice developing p53-deficient lymphomas, scid/+ and +/+ genotypes did not provide difference in onset and latency. Besides, allelic loss of the Scid gene occurred at a high frequency in those lymphomas but the loss exhibited no allelic bias. The results suggest that the scid/+ genotype is not a modifier of loss of p53 function in the double heterozygotes.

Alleles↗
PubMed1999

Esophageal mucoepidermoid carcinoma containing signet-ring cells: three case reports and a literature review.

We report 3 cases of esophageal signet-ring cell carcinoma which were found in a set of 505 resected esophageal tumors. The incidence of esophageal signet-ring cell carcinoma was 0.6%. All of the signet-ring cell carcinomas were histologically mixed with squamous cell carcinoma (mucoepidermoid carcinoma). The signet-ring cells had intracellular mucin, which was positive for both periodic acid-Schiff (PAS) and alcian blue at pH 2.5. At the time of presentation, extensive extraesophageal tumor spread and local extension were found in all cases. All of the patients died within 2 years after the esophagectomy irrespective of whether they received chemotherapy or radiotherapy. Our results, and those previously reported, suggest that most esophageal carcinomas containing signet-ring cell carcinoma are aggressive neoplasms associated with a poor prognosis after esophagectomy.

Aged↗
PubMed1999

Response to surgical stress in elderly patients and Alzheimer's disease.

PURPOSE: To determine the effect of surgical stress on plasma epinephrine, norepinephrine, ACTH and cortisol concentrations in patients aged 80-99 yr and in patients complicated with Alzheimer's disease. METHODS: A prospective controlled study was undertaken in 55 undergoing surgical reduction of femur neck fracture in Hirosaki University hospital and Hakodate Watanabe hospital; 18 patients in 80-99 yr (Group 1) and 18 patients in 40-59 yr (Group 2) and 7 patients (Group A) with and 12 patients (Group B) without Alzheimer's dementia (AD) aged 60-79 yr. RESULTS: The increase in plasma norepinephrine level (274%) of group 1 patients, 15 min after skin incision was higher than that in group 2 (191%) (P < 0.01). Mean plasma cortisol levels (40.4+/-4.7 and 44.1+/-5.2 microg x dl(-1)) of group 1, 15 min after skin incision and 60 min after the end of surgery were significantly higher than the 29.8+/-3.5 and 22.3+/-3.0 microg x dl(-1) of group 2 (P < 0.05). Plasma norepinephrine (1092.9+/-112.0 pg x ml(-1)) and cortisol concentrations (53.4+/-5.8 microg x dl(-1)) in group A were higher than in group B (772.6+/-82.4 pg x ml(-1) and 41.7+/-4.3 microg x dl(-1)) 15 min after skin incision (P < 0.05). CONCLUSIONS: Plasma norepinephrine and cortisol responses to surgical stress are activated in elderly patients and in patients with Alzheimer's disease.

Adrenocorticotropic Hormone↗
PubMed1999

Effects of ketamine and pentobarbital on noradrenaline release from the medial prefrontal cortex in rats.

PURPOSE: To determine the effects of ketamine and pentobarbital on noradrenaline release from the medial prefrontal cortex. METHODS: In 14 male Wistar rats, a microdialysis probe with a 2 mm long semipermeable membrane was implanted in the medial prefrontal cortex. The dialysis probe was perfused at a rate of 1 microl x min(-1) with an artificial cerebrospinal fluid solution. The rats were randomly allocated to two groups: ketamine (group K, n=7) and pentobarbital (group P, n=7). Each rat was subsequently given 0 (saline), 1, 10 and 100 mg x kg(-1) ketamine i.p. in group K, and 0 (saline), 0.5, 5 and 50 mg x kg(-1) pentobarbital i.p. in group P. Sixty minutes elapsed between administration. Noradrenaline concentration was measured by HPLC with an electrochemical detector at 20 min intervals. (detection limit: 250 fg x 20 microl(-1), coefficient variation of the assay: 4.9%). The data in the 20-40 min after each dose of ketamine or pentobarbital i.p. were used for the statistical analysis. RESULTS: Noradrenaline release after 100 mg x kg(-1) ketamine increased by 7.7 +/- 2.0 (SEM) pg x collection(-1) compared with 2.7 +/- 0.7, 3.3 +/- 1.0 and 4.2 +/- 0.8 pg x collection(-1) after saline, 1 and 10 mg x kg(-1) ketamine, respectively (P < 0.05). Noradrenaline release did not change after pentobarbital. CONCLUSION: This study suggests the ketamine and pentobarbital have different effects on noradrenergic neurons in the medial prefrontal cortex. The stimulating effect of ketamine on noradrenaline release from the cortex might contribute to unique clinical features of ketamine anesthesia.

Adjuvants, Anesthesia↗
PubMed1999

Detection of histamine-induced capillary protein leakage and hypovolaemia by determination of indocyanine green and glucose dilution method in dogs.

OBJECTIVE: The plasma volume of histamine-induced protein capillary leakage may be overestimated when this is determined using the indocyanine green (ICG) dilution method (Vd-ICG), since this dye binds to plasma proteins. The initial distribution volume of glucose (IDVG) has been shown to indicate the central extracellular fluid volume including plasma. Accordingly, the overestimation would be detected by a higher Vd-ICG/IDVG ratio. Our study was intended to examine whether the simultaneous measurement of these two variables can evaluate histamine-induced protein leakage and associated hypovolaemia. DESIGN: Prospective animal study. SETTING: Institutional animal research laboratory. SUBJECTS: Twenty-four anaesthetized and ventilated mongrel dogs. INTERVENTIONS: Anaesthetized animals were mechanically ventilated and received infusions of normal saline (n = 8), histamine 50 microg/kg per h (n = 8), or histamine 100 microg/kg per h. The Vd-ICG and IDVG were calculated using a one-compartment model by simultaneous administration of ICG 0.5 mg/kg, and glucose 100 mg/kg followed by serial arterial blood sampling. MEASUREMENTS AND RESULTS: In both histamine groups, a significant elevation of haematocrit and a decrease of plasma albumin concentration were found (p<0.05). Although the IDVG decreased following histamine administration (p<0.05), the Vd-ICG remained unchanged. The Vd-ICG/IDVG ratio increased in a dose-dependent manner after histamine administration (p<0.05), but remained unchanged following normal saline administration. CONCLUSION: The results suggest that the Vd-ICG/IDVG ratio and the IDVG are useful in evaluating the magnitude of the leakage and hypovolaemia.

Animals↗
PubMed1999

Does indocyanine green accurately measure plasma volume independently of its disappearance rate from plasma in critically ill patients?

OBJECTIVE: To determine whether plasma volume determined by the indocyanine green (ICG) dilution method (PV-ICG) is equally accurate independently of its disappearance rate from plasma in the critically ill. DESIGN: Retrospective clinical investigation. SETTING: Intensive care unit of a university teaching hospital. PATIENTS AND METHODS: 192 adult patients were initially enrolled. The PV-ICG and the initial distribution volume of glucose (IDVG) were calculated utilizing a one-compartment model by simultaneous administration of ICG 25 mg and glucose 5 g on the first day of measurement in each patient. Twenty-one patients were excluded from the study because of a higher PV-ICG/IDVG ratio (> 0.45) indicating apparent overestimation of the PV-ICG associated with the generalized protein capillary leakage. The remaining 171 patients were divided into four groups according to the magnitude of their disappearance rate of ICG from plasma (Ke-ICG). RESULTS: Convergence was assumed consistently in each ICG or glucose decay curve, even in the lower Ke-ICG less than 0.10/min. The relationship between the two volumes was not statistically different among groups. CONCLUSIONS: The results suggest that the measurement of the PV-ICG can be equally accurate independently of its disappearance rate from plasma unless there is generalized protein capillary leakage.

APACHE↗
PubMed1999

Effects of sedatives on noradrenaline release from the medial prefrontal cortex in rats.

RATIONALE: N-Methyl-d-aspartate (NMDA) receptor antagonism and GABA(A) receptor activation are believed to be critical targets for general anesthetic action. However, as NMDA antagonism of intravenous anesthetic agents causes post-anesthetic emergence reactions such as hallucination and agitation, while the GABA(A)-mimetic intravenous anesthetic agents do not, these two classes of intravenous anesthetic agents produce differential clinical profiles. OBJECTIVE: We have investigated the differential effects of the GABA(A) agonists propofol and midazolam and the NMDA antagonist ketamine on noradrenaline release from the medial prefrontal cortex of the rat using microdialysis, as noradrenergic neurons have a role to play in anesthesia and are known to be important in the control of sleep, attention and learning. METHODS: Twenty-one male Wistar rats (200-270 g) were randomly allocated into three groups: ketamine 100 mg x kg(-1) (n = 6), propofol 60 mg x kg(-1) (n = 8) and midazolam 5 mg x kg(-1) (n = 7) IP. A unilateral guide cannula was implanted stereotaxically into the medial prefrontal cortex under pentobarbital anesthesia (50 mg x kg(-1) IP). Forty-eight hours later, a dialysis probe was inserted through the guide cannula, and perfused with an artificial cerebrospinal fluid solution containing 1 mM pargyline. Following an equilibration period, samples of dialysate were collected every 10 min. Noradrenaline content was measured by high-performance liquid chromatography using an electrochemical detector. RESULTS: Anesthesia times, defined as the duration between the loss of righting reflex and recovery, were 24.7+/-5.6 (SEM), 20.5+/-1.9 and 25.2+/-1.5 min for propofol, midazolam and ketamine, respectively (no significant between-group differences). Both GABA(A )agonists, propofol and midazolam, significantly decreased noradrenaline release (75% and 71% of basal release, respectively). The NMDA antagonist ketamine markedly increased noradrenaline release (413% of basal). CONCLUSION: These data suggest that different clinical profiles observed with these two classes of sedatives may result from changes in noradrenaline release from the medial prefrontal cortex.

Animals↗
PubMed1999

No psychological emergence reactions in schizophrenic surgical patients immediately after propofol, fentanyl, and ketamine intravenous anesthesia.

PURPOSE: We attempted to determine the frequency of adverse psychological events after total intravenous anesthesia with propofol-fentanyl-ketamine (PFK) in surgical schizophrenic patients. METHODS: PFK was used in 25 schizophrenic patients undergoing various surgical procedures from 1995 to 1997. Adverse events occurring during and after anesthesia were recorded. Psychiatric follow-up was also done during the first 3 postoperative weeks at least. RESULTS: One patient died postoperatively of airway obstruction from concomitant severe malignant thyroid disease, but in the remaining patients neither respiratory nor cardiovascular states during or after anesthesia became unstable. None of the patients developed adverse psychological emergence reactions immediately after anesthesia. Two patients undergoing major surgical procedures exhibited delirium in the early postoperative days despite taking their routine antipsychotic drugs postoperatively. CONCLUSIONS: We suggest that PFK maintains stable respiratory and cardiovascular states, and causes no psychological emergence reactions in schizophrenic surgical patients. However, adverse psychological events may occur postoperatively, probably due to continued psychic stress. We therefore recommend appropriate perioperative management and further psychological studies for such patients.

Journal Article↗