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Biomedical subjects

C Tashiro

Publications and source records attributed to C Tashiro.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Anesthetic management for cesarean section in two parturients with quintuplet gestation].

Two parturients with quintuplet pregnancy underwent urgent or elective cesarean section under general anesthesia at 30 and 29 week gestational ages respectively. Since multiple gestation pregnancy requires enough medical staffs and instruments for preterm newborn resuscitation, emergency cesarean delivery was avoided. For cesarean delivery, the operation was started immediately after crash induction and intubation, and less than 1% isoflurane balanced with 60% nitrous oxide was used before birth in attempt to maintain uterine relaxation and sufficient utero-placental perfusion. After the delivery, aggressive maneuvers with PGE1 infusion, intravenous ergometrine and oxytocin, and interruption of volatile anesthetic inhalation (replaced by buprenorphine) were employed for decreasing the blood loss. The anesthesia and postoperative course of two patients and their babies were uneventful. Thus, anesthetic considerations may include; 1) high risk pregnancy related with huge pregnant uterus, 2) preterm labor, 3) preparation of sufficient man-power and instruments, 4) to avoid uterine contraction before delivery for fetal oxygenation, and 5) the puerperal promotion of uterine contraction to decrease blood loss.

Adult↗
PubMed1993

[Respiratory outcome in extremely premature infants following general anesthesia].

This study was aimed to predict the need of postoperative tracheal intubation in premature infants following anesthesia using volatile anesthetics by means of the scoring system derived from our former study of ketamine anesthesia. The subjects consisted of 14 infants (birth weight: 719 +/- 130 g and weight at operation 1882 +/- 312 g) needing cryotherapy for retinopathy and anesthetized with less than 1 MAC of volatile anesthetics. Respiratory outcome was successfully predicted in 9 patients (64%) while no infant was predicted incorrectly to be ready for tracheal extubation. The incidences of postoperative ventilatory support were 28% and 32% after anesthesia with volatile anesthetics and ketamine anesthesia, respectively. However, general anesthesia with volatile anesthetics appeared to be superior in actual outcome to ketamine anesthesia among the patients with high risk scores.

Anesthesia, General↗
PubMed1993

[The anesthetic management of cesarean section for multiple pregnant patients].

Anesthetic management of cesarean section for twenty multiple pregnant patients, who were pregnant with triplet or quadruplet, was compared with that for 325 single pregnant patients and 21 twin pregnant patients. For anesthetic methods, spinal anesthesia was chosen most frequently in the multiple pregnant patients, as in single and twin (more than 75 percent). In multiple pregnant patients, the incidence of emergency operation was less. In multiple pregnant patients who received spinal anesthesia, gestational age was lower; birth weight was lighter; length of fundus uteri was longer; and blood loss including amniotic fluid was larger. In triplets, the third infants' UID-time was prolonged and their Apgar score was lower.

Anesthesia, Epidural↗
PubMed1992

Duration of apnea in anesthetized infants and children required for desaturation of hemoglobin to 95%. The influence of upper respiratory infection.

Sixty-one patients ASA physical status 1-2 aged 1 month to 12 years undergoing elective surgery were included in the study. Anesthesia was induced via a mask with sevoflurane up to 5% and 66% nitrous oxide in oxygen. After paralysis with vecuronium (0.12 mg/kg iv), the trachea was intubated and the lungs were ventilated manually with 3% sevoflurane in oxygen until the end-tidal nitrous oxide decreased to less than 5%. Apnea was started by disconnecting the breathing circuit from the endotracheal tube. The time from the start of apnea to Spo2 of 95% was measured. Manual ventilation was reinstituted when Spo2 decreased to 95% and another set of vital signs was recorded. Twenty of 61 patients had symptoms of upper respiratory infection. The time to Spo2 of 95% correlated well with height, age, and body weight both by linear and non-linear regression analyses. The patients with symptomatic upper respiratory infection required less time for Spo2 to decrease to 95% compared to the asymptomatic children. We conclude that younger children require less time for Spo2 to decrease to 95%. The presence of upper respiratory infection is an additional factor increasing the susceptibility of small children to hypoxemia.

Anesthesia, Inhalation↗
PubMed1992

[Synthesis of metabolites of mosapramine. I. Synthesis of alcoholic metabolites].

Four alcoholic metabolites of (+-)-3-chloro-5-[3-(2-oxo-1,2,3,5,6,7,8,8a-octahydroimidazo[1,2-a] pyridine-3-spiro-4'-peperidino)propyl]-10,11-dihydro-5'-dibenz[b,f ] azepine(mosapramine), a new antipsychotic drug, were synthesized in order to determine their chemical structures. A mixture of 10-ethoxy-3-chloro-10,11-dihydro-5H-dibenz[b,f]azepine and 11-ethoxy isomer was used as a starting material. Isomeric intermediates, i.e. 10-oxo-3-chloro-5-(3-chloropropyl)-10,11-dihydro-5H-dibenz[b,f]azepine and 11-oxo isomer, were separated by chromatography with silica gel. The metabolites were obtained by NaBH4 reduction of the corresponding 10-oxo or 11-oxo compounds followed by introduction of spiro-piperidine moieties into propyl side chain.

Antipsychotic Agents↗
PubMed1992

[Synthesis of metabolites of mosapramine. II. Synthesis of phenolic metabolites of mosapramine and their pharmacological activities].

Four phenolic metabolites 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), a new antipsychotic drug, were synthesized in order to determine their chemical structures. Pharmacological activities of the three main metabolites were compared with those of mosapramine. The activities of the metabolites were far less potent than those of mosapramine.

Animals↗
PubMed1992

Capnometry during high-frequency oscillatory ventilation.

We used capnometry during high-frequency oscillatory ventilation (HFOV), and compared CO2 measurements at the distal and proximal ends of an endotracheal tube with arterial CO2 values. Ten white rabbits (mean weight, 2.00 +/- 0.2 [SD] kg) underwent tracheostomy under anesthesia with pentobarbital. The trachea was intubated with an endotracheal tube with a second lumen for sampling respiratory gas at the distal tip. Capnometry was performed through the lumen (CO2d) and the proximal end of the endotracheal tube (CO2p). The internal carotid artery was cannulated to sample blood for measuring arterial blood gases. The differences between CO2d, CO2p, and PaCO2 were measured. Only the relation between CO2d and PaCO2 was good (r = 0.915). We concluded that capnometry can be used during HFOV to estimate PaCO2 provided that respiratory gas is sampled from the distal tip of the endotracheal tube.

Animals↗
PubMed1991

Respiratory outcome in extremely premature infants following ketamine anaesthesia.

Premature infants are prone to develop postoperative apnoea. The purpose of the present study was to determine if risk factors could be identified to predict which patients would require postoperative tracheal intubation and lung ventilation. Twenty-five extremely premature infants (birth weight: 811 +/- 242 g (mean +/- SD) and operation weight: 1585 +/- 394 g) needing cryotherapy for retinopathy were studied. After surgery the tracheas were extubated if there was no prolonged apnoea, SaO2 greater than 85%, and heart rate greater than 120 bpm. In eight, tracheal extubation in the operating room was unsuccessful. Using multivariate discriminant analysis, four risk factors correlated with the need for pulmonary ventilation-gestational duration, birth weight, postconceptional age, and preoperative aminophylline treatment for seven days. A scoring system using these factors successfully predicted the need for a tracheal tube after surgery in 92% of patients. It is concluded that the system may be clinically useful in the perioperative care of low-birth-weight infants as it identifies important variables for evaluating postoperative prolonged apnoea.

Age Factors↗
PubMed1991

Roles of beta 1- and beta 2-adrenoceptors in the mechanism of halothane myocardial sensitization in dogs.

The authors investigated the comparative roles of beta 1- and beta 2-adrenoceptors in myocardial sensitization by halothane in dogs. The arrhythmogenic dose (AD) of isoproterenol was determined in the presence of various doses of phenylephrine during halothane anesthesia in dogs, and the influences of 1-metoprolol (beta 1-antagonist) and ICI-118,551 (beta 2-antagonist) on the AD were examined. In the presence of 1-metoprolol, the AD of isoproterenol was significantly greater than the control, but in the presence of ICI-118,551, the AD of isoproterenol was lower. Blood pressure during the arrhythmias was higher in the presence of ICI-118,551 than that in controls. In addition, the AD of ritodrine (beta 2-agonist) was also determined at various doses of phenylephrine. The interaction between phenylephrine and ritodrine in inducing arrhythmias showed hyperbolic isoboles. However, 1-metoprolol completely inhibited the occurrence of arrhythmias induced by ritodrine and phenylephrine. The results suggest that myocardial beta 1-adrenoceptors play an essential role in the genesis of arrhythmias during halothane anesthesia in dogs, whereas beta 2-adrenoceptors do not.

Adrenergic beta-Agonists↗
PubMed1991

[Anesthesia for cesarean section in patients with fetal anomaly].

Twenty-two cases of Cesarean section due to fetal anomaly diagnosed prenatally were reviewed in terms of the anesthetic managements. In 6 cases, diazepam 0.3 mg.kg-1, which provides fetal anesthesia for surgery scheduled immediately after birth, was administered intravenously to the mothers with/without fentanyl (2 general anesthesia and 4 regional anesthesia). The diagnosis of their fetuses was congenital diaphragmatic hernia, congenital cystic adenomatoid malformation of the lung, gastroschisis or omphalocele. No fetal anesthesia was performed in the other 16 cases (15 spinal anesthesia and 1 general anesthesia). Seven of their fetuses were diagnosed as hydrops. Since the general condition of the diseased newborn is known to be deteriorated after receiving various stress and aerophagia, fetal anesthesia in Cesarean delivery has the advantage of stress reduction and prevention of aerophagia. When the newborn is considered to need immediate neonatal resuscitation or intensive care including surgery, fetal anesthesia may be a choice of anesthetic technique.

Anesthesia, Obstetrical↗
PubMed1991

[Chemical burn caused by povidone-iodine].

Povidone-iodine (PVP-I) is a widely used antiseptic because of its low toxicity and high germicidal effect. A one-year-old boy who had undergone Nissen's fundoplication developed a chemical burn on his back postoperatively. The lesion was exposed to the surgical sheet immersed with a large amount of 10% PVP-I solution for 4 hours. Patch test with PVP-I (small aluminum chamber keeps a wet paper with PVP-I) revealed positive response in the patient. The same patch tests were performed in 17 volunteers. Sixteen subjects showed positive and one negative, while direct painting of a small quantity of PVP-I on skin without the chamber produced negative responses. This may indicate that prolonged exposure to wet PVP-I is harmful. It is important to use PVP-I carefully for the prevention of contact dermatitis.

Burns, Chemical↗
PubMed1989

Myocardial sensitization by thiopental to arrhythmogenic action of epinephrine in dogs.

This study examined the interaction between thiopental and epinephrine in inducing ventricular arrhythmias in dogs. The arrhythmogenic threshold of epinephrine was determined during anesthesia with either halothane alone, thiopental alone, etomidate plus different doses of thiopental, or halothane plus different doses of thiopental. The arrhythmogenic dose and the corresponding plasma concentration of epinephrine during thiopental anesthesia (plasma thiopental concentration: 46-57 micrograms/ml) were 0.77 +/- 0.04 micrograms.kg-1.min-1 and 10.7 +/- 1.5 ng/ml, respectively. During halothane anesthesia (end-tidal: 1.3 MAC) they were 2.59 +/- 0.49 micrograms.kg-1.min-1 and 45.3 +/- 9.2 ng/ml, respectively. The dose-effect relationship for the thiopental action was examined during etomidate plus thiopental and halothane plus thiopental anesthesia. The arrhythmogenic plasma concentration of epinephrine was inversely proportional to the plasma thiopental concentration during both anesthetics. During etomidate plus thiopental anesthesia, at plasma thiopental concentrations of 0, 11.2 +/- 0.83, 20.1 +/- 1.34, and 33.2 +/- 1.95 micrograms/ml, the corresponding epinephrine concentrations were 201.3 +/- 34.3, 142 +/- 19.5, 69.1 +/- 21.2, and 22.7 +/- 4.5 ng/ml. During halothane plus thiopental anesthesia, at plasma thiopental concentrations of 0, 10 +/- 0.86, 18.3 +/- 0.87, and 31.8 +/- 1.05 micrograms/ml, the corresponding epinephrine concentrations were 45.3 +/- 9.2, 34.6 +/- 8.9, 16.2 +/- 1.74, and 15.1 +/- 1.32 micrograms/ml, respectively. These results suggest that thiopental sensitizes the heart to epinephrine in a dose-dependent manner. This sensitizing action of thiopental would in part explain the thiopental potentiation of hydrocarbon anesthetic-epinephrine arrhythmias.

Anesthetics↗
PubMed1989

Comparison of recorded values from six pulse oximeters.

Recorded values (SpO2) of oxygen saturation from six noninvasive pulse oximeters were compared to each other and to the value from a cooximeter. Simultaneous measurements were obtained from each instrument in eight healthy nonsmoking volunteers rendered hypoxic greater than 70% SpO2. Functional arterial oxygen saturation (SaO2), fractional SaO2 (%HbO2), and percent fraction of carboxyhemoglobin (HbCO) and methemoglobin (MetHb) were determined by a cooximeter. The difference between SaO2 and %HbO2 was 2.3 +/- 0.3 (SD) % (p less than .001) with 1.4 +/- 0.1% HbCO and 0.9 +/- 0.1% MetHb. The SpO2 values in two instruments were close to %HbO2, while the other instruments correlated approximately with SaO2. The greatest SpO2 difference among the instruments was 2.7 +/- 1.9% (p less than .001). These results may indicate that, under normal dyshemoglobin levels, some pulse oximeters are calibrated to estimate SaO2 and others to estimate %HbO2. Since the pulse oximeter using two wavelengths cannot measure accurately %HbO2 or SaO2 in the presence of dyshemoglobin, SpO2 values would be independent from %HbO2 and SaO2. A standard calibration method for pulse oximeters should be established by the manufacturers.

Adult↗