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Biomedical subjects

C Tashiro

Publications and source records attributed to C Tashiro.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Perioperative managements of the patients with cancer-pain receiving morphine].

In the patients receiving morphine preoperatively, it is preoperatively important to avoid withdrawal symptoms postoperatively and to suppress postoperative pain and to maintain an appropriate anesthetic depth during the operation. We experienced six patients who had been under preoperative pain control with oral and/or epidural morphine and undergone palliative operation for their cancer pain. Four of the patients were preoperatively administered with oral morphine ranging from 30 to 270 mg.day-1. One patient was given epidural morphine 10 mg.day-1. Another was with morphine 1800 mg.day-1 orally and 50 mg.day-1 epiduraly. In all cases, general anesthesia was maintained with inhalation anesthetics. Anesthetic supplementation and postoperative pain management were performed with continuous i.v. infusion of morphine (half dosage of daily oral dosage), or subcutaneous injection (one sixth dosage of daily oral morphine) while preoperative epidural morphine was continued throughout the perioperative period. We were able to manage these patients well and none of them developed withdrawal symptom or increased postoperative pain.

Administration, Oral↗
PubMed1997

Nitric oxide (NO) measurement accuracy.

BACKGROUND: Evaluation of the clinical utility of NO requires accurate assessment of inspired [NO]. Currently, chemiluminescence analyzers are the clinical standard for analysis; however, their performance in the clinical setting has not been systemically evaluated. METHODS: We evaluated the performance of four chemiluminescence analyzers (270B NOA, Sievers Instruments, Inc.; CLA 510S, Horiba Co., Ltd.; CLD 700 AL, Eco Physics Corp.; Model 42, Thermo Environmental Instruments Inc.) in simulated clinical settings. Transport delay and dynamic 95% response time were measured by the balloon in a glass chamber puncture technique. Fluctuating [NO] in a continuous flow of gas and [NO] during mechanical ventilation, where NO was premixed prior to entering the ventilator, were evaluated. RESULTS: Transport delay ranged from 1.02 +/- 0.02 to 24.36 +/- 2.47 s (p < 0.05) and the 95% response time ranged from 0.22 +/- 0.04 to 70.03 +/- 0.03 s (p < 0.05). Accurate analysis of [NO] in a continuous flow system was only possible with the most rapid response analyzer (270B NOA). All other analyzers under reported the maximum [NO] (p < 0.05) and over reported the minimum [NO] (p < 0.05). All analyzers accurately determined [NO] in the inspiratory limb of the ventilator circuit, but none accurately determined [NO] at the airway opening. CONCLUSIONS: Measurements of inhaled [NO] can vary greatly, dependent upon the performance characteristics of the analyzer and the location of NO analysis. All studies evaluating the clinical use of NO should fully describe the technical gas delivery methodology and the response time and transport delay of the chemiluminescence analyzer used.

Administration, Inhalation↗
PubMed1997

[Labor status of anesthesia in general hospitals in Japan Committee on Human Resources, the Japan Society of Anesthesiology].

AIMS: Investigating the labor by anesthetists in general hospitals with more than 600 beds during the month of September 1995. METHOD: Using MS/EXCEL spread sheet soft wear, we have analyzed daily OR anesthesia activities in 33 hospitals based on personal attendance of anesthesiologists. We defined anesthesia performing hours i.e. actual working hours as the time between the onset and the end of anesthesia for each anesthetist. RESULTS: An average number of monthly anesthesia cases was 961 in the first 10 hospitals we surveyed. We obtained two frequency graphs on weekly 5-day working 138 anesthetists whose anesthesia performed, and their occupied hours were as shown in fig. 1 and 2. for those who worked other less than 5 days per week, they showed the shorter hours on the frequency distribution graph as shown in fig. 3 to 7. The 5-day working anesthetists have spent more than 5 hours giving anesthesia in the 93.2% of all anesthesia times in the first 10 hospitals, while 28.1% of the times in the last 10 hospitals. There were an average of 11.6 operating tables, in the first 10 hospitals. And we have analyzed ratios of the number of 5 day working persons to the number of operating tables. The ratio was 0.86 in the first 10 hospitals, while 0.21 in the last 10 hospitals. CONCLUSIONS: There must be overwork of 5-day working anesthetists, who are working for too many hours for anesthesia. It is necessary to have better quality service in the OR.

Anesthesia↗
PubMed1997

[Antinociceptive activity of intracisternal clonidine in the mouse].

The antinociceptive activities of clonidine have been determined against three qualitatively different noxious stimuli in the mouse. The methods used to evaluate this activity were selected to include tests which employ different types of noxious stimuli, i.e. heat (hot plate), chemical (acetic acid-induced writhing) and mechanical (tail pinch). Test drug and control treatments were given by cisternal injection in a dose volume of 10 microliters.mouse-1. The results presented here show that clonidine has potent antinociceptive properties against several types of noxious stimuli. Clonidine produced steep dose-response lines in all tests. The response to the writhing assays were completely inhibited by 1.0 microgram.mouse-1 of clonidine. In contrast in both the hot plate and tail pinch assay, however, clonidine did not produce a consistent antinociceptive effect at a dose of 200 micrograms.mouse-1. Utilizing these three different types of assays, the rank order of antinociceptive potency for clonidine in different noxia was the writhing >> hot plate > tail pinch. It was concluded from these results that clonidine has potent antinociceptive properties against chemical visceral stimuli.

Adrenergic alpha-Agonists↗
PubMed1996

[Dextran-induced anaphylactoid reactions in two patients with gastrointestinal cancer].

We report dextran-induced anaphylactoid reactions (DIAR) subsequent to rapid infusion of Rheomacrodex (dextran 40) in two patients, a 67 year old man with gastric cancer undergoing distal gastrectomy and a 47 year old man with transverse colon cancer undergoing colectomy. Both showed sudden tachycardia, hypotension and skin flush, which were treated with epinephrine or etilephrine administration. Most cases of severe DIAR are immune complex anaphylaxis mediated by dextran-reactive antibodies (DRA) of the IgG class, which are considered to arise mainly in response to immunization with dextran-cross-reactive bacterial polysaccharides in the gastrointestinal tract. High titers of DRA have previously been reported in gastric ulcer patients with pyloric stenosis, suggesting bacterial polysaccharides permeation through the luminal wall which may easily occur in the presence of local inflammation or ulcer. Although serum DRA titers in our patients have not been examined, inflammation or ulcer around the tumor might have played a role in producing high titers of DRA. In patients suspected of gastrointestinal ulcer or inflammation, including cancer, dextran administration is not preferable or should be avoided, unless hapten-dextran preparation is used for the prophylaxis of severe DIAR.

Aged↗
PubMed1996

[Differentiation of antinociceptive effects of mu, delta and kappa agonists using heat, chemical and mechanical nociception].

The antinociceptive properties of mu (D-Ala2, N-Me-Phe4, Gly5-ol, enkephalin, DAGO), delta (D-Ala2, D-leu5, enkephalin, DADL) and kappa (dynorphin, DYN) were assessed using hot plate (heat), acetic acid-induced writhing (chemical) and tail pinch (mechanical) assays in mice. Test drug and control treatments were given by cisternal injection in a dose volume of 10 microliters.mouse-1. DAGO and DADL produced steep dose-response lines in all the tests. DYN did not produce a consistent antinociceptive effect on the tail pinch test. Utilizing these three different types of assays, the rank order of antinociceptive potency for these three opioids was DAGO > DADL > DYN. The responses to the hot plate and writhing assays were completely inhibited by the same dose of DAGO. DADL displayed equal antinociceptive effects in the hot plate and writhing tests. In the tail pinch assay, however, antinociceptive potency of DAGO was 1/3 less than in other two assays, and DADL was also 1/10 less than in the others. The rank order of antinociceptive potency for DYN in different noxia was the writhing > hot plate >> tail pinch. It was concluded that there are differences in the potency of mu-, delta- and kappa-agonists even when the intensities of chemical and heat noxia are equal. It was also proposed that antinociceptive potencies against mechanical noxia is greatly different among mu-, delta- and kappa-agonists.

Acetic Acid↗
PubMed1996

[The dual effect of ketamine on dopamine release from rat pheochromocytoma (PC-12) cells].

Ketamine is known to increase arterial pressure and heart rate with its sympathomimetic action. However, it also relaxes vascular smooth muscle and causes hypotension. We studied such a bipartite effect in terms of ketamine induced changes of dopamine (DA) release from rat pheochromocytoma (PC-12) cells as a model of sympathetic nervous system. Without KCl stimulation, ketamine increased the DA release from PC-12 cells in a dose-related fashion (10(-4)M: 2.6 +/- 0.4, 10(-3)M : 7.5 +/- 0.3, 10(-2)M: 27.1 +/- 3.2%). The similar increase of DA release was observed with absence of extracellular Ca2+. Exposure of KCl (50 mM) to PC-12 cells increased the DA efflux from 1.7 +/- 0.4 to 14.2 +/- 0.8% (P < 0.001). The release of DA stimulated by KCl (50 mM) was reduced to 9.0 +/- 1.0% and 11.4 +/- 0.3% in the presence of ketamine 5 x 10(-4)M and 10(-3)M respectively, and increased with the ketamine concentration of 10(-3)M. These findings indicate that ketamine depresses DA efflux related to membrane depolarization (K+) but it promotes a number of spontaneous DA efflux.

Adrenal Gland Neoplasms↗
PubMed1995

Anesthetic management of a 656-g neonate undergoing pulmonary valvotomy.

We describe the successful management of a 656-g preterm infant of 29 weeks' postconceptional age undergoing closed transventricular pulmonary valvotomy. The patient had a critical pulmonary stenosis and was treated with an infusion of prostaglandin E1, which resulted in excessive pulmonary blood flow through the ductus arteriosus. The key points in anaesthetic management were maintaining an optimum balance between the systemic and pulmonary circulation and preparing for the abrupt haemodynamic change caused by valvotomy.

Anesthesia↗
PubMed1995

Duration of apnoea in anaesthetized children required for desaturation of haemoglobin to 95%: comparison of three different breathing gases.

In this study, we compared three gas compositions to determine if the duration of apnoea for SpO2 to decrease is proportionate to the oxygen fraction of the gas prior to apnoea. Twenty-five patients ASA physical status 1-2 aged two months to 12 years were included in the study. Anaesthesia was induced via a mask with 5% sevoflurane and 66% N2O in oxygen. After paralysis with vecuronium (0.12 mg.kg-1, i.v.) the trachea was intubated and anaesthesia was maintained with sevoflurane and N2O in oxygen. When cardiovascular stability was obtained, the patient was randomly set to breathe one of three gas compositions: 1. oxygen (FiO2 1.0), 2. N2O/O2 (FiO2 0.4), and 3. air/O2 (FiO2 0.4). All three gas compositions included 2-4% of sevoflurane to maintain anaesthesia. After more than eight min of each gas breathing, apnoea was begun by disconnecting the breathing circuit from the tracheal tube. The time from the start of apnoea (SpO2 100%) to SpO2 of 95% (T95) was measured. T95 measured after breathing N2O/O2 and air/O2 were 34.6 +/- 5.7 and 28.8 +/- 4.7% of that measured after oxygen breathing (P < 0.001 vs oxygen breathing, P < 0.001 vs oxygen and N2O/O2 breathing), respectively. Preoxygenation before intubation was validated to delay the haemoglobin desaturation brought about by apnoea. An induction technique using a low FiO2 will allow rapid haemoglobin desaturation.

Age Factors↗
PubMed1995

Effects of electrical stimulation of cervical sympathetic trunks on microcirculation in the facial nerve.

This study evaluates the circulatory effects of electrical stimulation of the cervical sympathetic trunks on blood flow in the common carotid artery and facial nerve tissue in dogs. Marked increases in arterial pressure and heart rate were observed due to electrical stimulation of the cervical sympathetic trunks, while blood flow volume in the common carotid artery and in the facial nerve tissue decreased markedly. It was assumed that microcirculation of the facial nerve is definitely impaired by electrical stimulation of the cervical sympathetic trunks, and the tonicity of the sympathetic nervous system appears to be a major factor in changes in the microcirculation of the facial nerve. It is well known that impaired circulation in the nutrient vessels of the facial nerve has an important effect on the pathogenesis of facial palsy. The hypertonicity of the sympathetic nervous system is closely involved in the onset of facial palsy.

Animals↗
PubMed1995

[Changes of tympanic temperature by stellate ganglion block].

The effects of stellate ganglion block (SGB) on the temperature of tympanic membrane were determined clinically. Thirty patients received SGB with 8 ml of 1 % mepivacaine. The tympanic temperature was measured using radiation non-contact tympanic membrane thermometer before and after administration of SGB for 30 min on the side where SGB was given. Before SGB the tympanic temperature was 37.29 +/- 0.08 degrees C, and there was no difference in the readings between the two sides. The tympanic temperature dropped significantly 5 min after SGB and reached its lowest value of 36.90 +/- 0.08 degrees C 15 min later. This drop persisted for more than 30 min after SGB. The fact that therapeutic effect of SGB is partly due to vasodilation and improvement in blood flow to the affected region was demonstrated, but these effects in internal carotid arterial system have not yet been studied in detail. Tympanic temperature has been proposed as a valid index of brain temperature in man. The mechanism of brain cooling has been suggested that countercurrent heat exchange takes place between carotid and jugular blood flow. Therefore the result of the study suggests that SGB could enhance an increase in the brain blood flow.

Adolescent↗
PubMed1994

Low dose intrathecal morphine and pain relief following caesarean section.

Healthy women who underwent caesarean section under spinal anaesthesia were studied to determine the extent of postoperative analgesia and side-effects produced by low doses of intrathecal morphine. Patients were randomly allocated to receive, in double-blind fashion, 0 mg (group 1: control group), 0.05 mg (group 2), 0.1 mg (group 3), or 0.2 mg (group 4) of morphine, with 10 mg tetracaine in 10% dextrose 2.5 ml. (n = 20 x 4 groups). The effect of intrathecal morphine was examined in terms of the duration until the first supplemental analgesic was needed and the numbers of the doses within the first postoperative 48 h. Pain relief was significantly greater in groups 3 and 4 than in group 1. The incidence of nausea, vomiting and pruritus increased in a dose-dependent manner. No patient developed respiratory depression. Our results suggest that postoperative analgesia lasts more than 24 h with 0.1 mg or 0.2 mg of intrathecal morphine. Since the incidence of side-effects was higher at 0.2 mg, 0.1 mg may be the optimum dose for caesarean section.

Journal Article↗
PubMed1994

[FIO2 and SpO2 during cardiac surgery in neonates and infants].

Fractional inspired oxygen (FIO2) applied before and after a repair or palliative procedure for cardiac defects along with SpO2 measured by pulse oximeter were reviewed from anesthetic records of 62 neonates and infants. Fentanyl was used for anesthesia, except in cases without i.v. route in which sevoflurane with nitrous oxide in oxygen was used for induction of anesthesia. FIO2 was adjusted using air and oxygen. The lower FIO2 was applied to the patients for a closure of ventricular septal defect, a reconstruction of coarctation or interrupted aortic arch, and pulmonary artery banding, while the higher FIO2 was used for systemic-to-pulmonary artery shunts and the repair of tetralogy of Fallot. In the congenital heart disease with the intracardiac shunt, the magnitude of the shunt flow and hemodynamics can be altered by changing systemic and pulmonary vascular resistance which could be induced by various ways. Since alveolar oxygen tension is a known determinant of pulmonary vascular resistance, an appropriate FIO2 should be applied to each patient with different pathophysiology. A low FIO2 should be set for the cases with nonrestrictive left-to-right shunting, since a high FIO2 may cause a torrential pulmonary blood flow. A high FIO2 is preferable for the cases with right-to-left shunting and a concomitant decreased pulmonary blood flow.

Anesthesia↗
PubMed1993

Crystallization and preliminary X-ray studies on the trypsin inhibitor I-2 from wheat germ and its complex with trypsin.

A Bowman-Birk type trypsin inhibitor I-2, M(r) = 14 000, 123 amino-acid residues, isolated from wheat germ, and its complex with trypsin have been crystallized. For I-2 two morphologically different crystal forms were obtained. Crystal form 1 is tetragonal, P4(1)22 or P4(3)22, with a = 55.45 (2), c = 129.1 (2) A and V = 3.97 (2) x 10(5) A(3). The crystals diffract X-rays very anisotropically, to less than 6 A resolution normal to the c* direction, but up to 3 A resolution in the other directions. Crystal form 2 is monoclinic, space group C2. The cell parameters show significant variation even for crystals in the same batch. The median parameters are: a = 83.9, b = 41.5, c = 45.7 A, beta = 95.9 degrees and V = 1.58 x 10(5) A(3). The diffraction pattern is isotropic and reflections up to 2.2 A resolution were observed. The crystals of the complex between bovine trypsin and I-2 (2:1) belong to the orthorhombic space group P2(1)2(1)2(1) with a = 73.49 (2), b = 120.56 (3), c = 70.04 (2) A and V = 6.206 (5) x 10(5) A(3). The crystals diffract up to 2.3 A resolution, and contain one complex of 60 100 Da in an asymmetric unit.

Journal Article↗
PubMed1993

Postoperative recovery of arterial oxygen saturation determined by pulse oximetry in pediatric patients.

Small children are physiologically subject to arterial oxygen desaturation. However, few reports have referred to the risk factors related to postanesthetic hypoxemia and the duration of hypoxemia. The purpose of this study was to clarify these two aspects. Eighty-five ASA physical status I infants and children were included in the study. They were scheduled for minor surgery. Fifty-six underwent oral endotracheal intubation, and 29 patients breathed from a mask. Anesthesia was maintained with Enflurane or Halothane and nitrous oxide. Arterial oxygen saturation was measured with a pulse oximeter. The measurements were started shortly after patients' arrival in the recovery room, and conducted every 5 min at least for 1 hour. Ten patients had SpO2 values of less than 95%. In all except one, SpO2 decreased within 10 min after arrival in the recovery room. Age, height, and weight of these 10 children were significantly different from the remaining 75, but there were no significant differences in anesthetic duration and postanesthetic awakefulness between the group with postanesthetic hypoxemia and the one without. The importance of monitoring the clinical condition of pediatric patients after general anesthesia is universally acknowledged. Monitoring with the pulse oximeter has proven very useful and shows that, unless oxygen saturation is monitored, all children should receive supplemental oxygen.

Journal Article↗
PubMed1993

Alterations in pain threshold and psychomotor response associated with subanaesthetic concentrations of inhalation anaesthetics in humans.

We studied the effects of six inhalation anaesthetics at subanaesthetic concentrations of 0.2 MAC on pain threshold and psychomotor function in six healthy volunteers. When compared with 100% oxygen inhalation, nitrous oxide and methyoxyflurane significantly increased pain threshold as measured by a radiant heat algometer, and prolonged the response time to auditory stimuli. In contrast, halothane, enflurane, isoflurane and sevoflurane produced prolongation of the response time to auditory stimuli but did not influence pain perception. The pain threshold with nitrous oxide remained significantly increased 30 min after its discontinuation, while the response time returned to the preinhalation value. We conclude that nitrous oxide and methoxyflurane possess both analgesic and hypnotic actions but halothane, enflurane, isoflurane and sevoflurane do not have an analgesic action at subanaesthetic concentrations, and the analgesic action of nitrous oxide persists after its elimination.

Adult↗
PubMed1993

Syntheses and biological activities of optical isomers of 3-chloro-5-[3-(2-oxo-1,2,3,5,6,7,8,8a-octahydroimidazo[1,2-a]pyridine- 3-spiro-4'-piperidino)propyl]-10,11-dihydro-5H-dibenz[b,f]azepine (mosapramine) dihydrochloride.

Mosapramine (1) is a new neuroleptic drug with an asymmetric carbon atom (8a) in its imidazopyridine ring. The enantiomers of this agent were synthesized to compare their biological activities, such as antiapomorphine activity, affinity for dopamine D2 receptor and acute toxicity. The key intermediates, (R)-(-)- and (S)-(+)-2-oxo-1,2,3,5,6,7,8,8a-octahydroimidazo[1,2-a]pyridine- 3-spiro-4'-piperidines, were prepared by optical resolution of the corresponding (+/-)-compound and were treated with 3-chloro-5-(3-methanesulfonyloxypropyl)-10,11-dihydro-5H-dibenz[b, f]azepine to afford (R)-(-)-1 and (S)-(+)-1, respectively. There were few differences in the examined biological activities of the two enantiomers as their dihydrochlorides.

Animals↗