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Biomedical subjects

H Fukuda

Publications and source records attributed to H Fukuda.

At least 667 records · Page 37Linked to original sources
PubMed1993

[The evaluation of interval period to prepare the left ventricle for Jatene operation for simple transposition of the great arteries].

Laboratory studies indicate that it can be as short as one week after a first-stage operation to prepare the left ventricle for a subsequent second-stage arterial switch (Jatene operation) for simple transposition of the great arteries (TGA). In order to ascertain it, we evaluated the left ventricular (LV) function immediately after the first-stage procedure and late postoperatively by echocardiography and catheterization. There were 6 cases with simple TGA. The age at palliation was 6.6 +/- 4.5 (mean +/- SD) months, and the interval between the first-stage and Jatene operation was 16 days-16 months (6.7 +/- 6.4 months). All patients survived after arterial switch. In 2 early infant cases, arterial switch operation was performed with ventilatory support due to cardiac and respiratory failures 16 and 21 days after the first-stage operation respectively. LV end-diastolic dimension increased by 1 week and showed no change after 1 week (n = 4). LV ejection fraction was depressed from 0.84 +/- 0.03 preoperatively to 0.61 +/- 0.08 at 1-4 days after the first-stage operation but improved to 0.83 +/- 0.06 by 7-9 days after that (n = 4). LV end-diastolic posterior wall thickness increased to more than 4 mm in 3 infant cases, more than 3 mm in 2 early infant cases by 7 days. The results of catheterization after the first-stage operation were as follows (n = 5); left ventricular right ventricular peak systolic pressure ratio increased from 0.53 +/- 0.16 to 0.94 +/- 0.04 (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMed1993

[Acute respiratory arrest associated with medullary lesion in a case of multiple sclerosis].

We present a case history of a patient with multiple sclerosis who developed an abrupt onset of respiratory arrest associated with medullary lesion. A 27-year-old man developed shallow, totally irregular, ataxic respirations with aggravation of bulbar palsy and quadriplegia in the course of multiple sclerosis. As respiration was almost arrested, artificial respiration was started and continued for five days. Respiration was almost normal after 16 days from the onset of respiratory arrest. MRI showed bilateral, medullary lesions without upper cervical lesions. Pyramidal tracts, medial lemnisci, and paramedian reticular formations in medulla were damaged bilaterally. We supposed that the medullary lesions involved dual respiratory systems: a voluntary system and an automatic system, and caused acute respiratory arrest.

Acute Disease↗
PubMed1993

[Continuous epidural buprenorphine for postoperative pain relief in patients after lower abdominal surgery].

Postoperative analgesia with epidurally injected buprenorphine and its side effects were investigated in 100 patients who had received lower abdominal surgery. All patients received initially 8 ml of bupivacaine and 0.1 mg of buprenorphine. Following bolus epidural injection, five different groups of 20 patients each received either bupivacaine alone (group A), 5 micrograms.ml-1 buprenorphine.bupivacaine mixture (group B), 8 micrograms.ml-1 buprenorphine.bupivacaine mixture (group C), 12 micrograms.ml-1 buprenorphine.bupivacaine mixture (group D), or 15 micrograms.ml-1 buprenorphine.bupivacaine mixture (group E) by a portable disposable device at a rate of 1 ml.h-1 for 48 h. The analgesic efficacy in group E was superior to those in groups A, B, C or D. No significant difference in the incidence of side-effect was found among groups C, D, E. We conclude that a dose of a approximately 15 micrograms.h-1 might be optimal for postoperative pain relief after lower abdominal surgery.

Abdomen↗
PubMed1993

[Spread of spinal anesthesia with 0.5% isobaric bupivacaine].

The effects of age, weight, height, weight.height ratio, and body mass index on the spread of spinal anesthesia with 3.0 ml of 0.5% isobaric bupivacaine was examined in 185 patients. No significant correlation was found between the spread of analgesia and the age, weight, height, weight.height ratio, or body mass index. A significant correlation was found between the decrease in mean arterial pressure and the height of sensory analgesia (rho = -0.21, P < 0.05) as well as the aging (rho = -0.35, P < 0.001).

Adolescent↗
PubMed1993

[A new headholder for positron emission tomography].

We developed a new headholder for the fixation and repositioning of patient head in PET study. The device consists of acryl frame and headrest of thermoplastic resin. Special gel is placed on the headrest to adapt different shape of occipit a in each patient. Individual face mask was made with thermoplastic resin just before the PET study and was fixed with the holder using plastic taper. It took about 2-3 min to fix the patient head using these system. Immobilization of the patient's head during PET study was good. Accuracy of repositioning in the same patient was relatively good between separate PET studies.

Evaluation Studies as Topic↗
PubMed1993

[Helicobacter pylori infection in gastric cancer].

The relationship between Helicobacter pylori (H. pylori) infection and gastric cancer becomes the topics in the world, since some reports thereon in 1991. The purpose of this study was to know the prevalence of H. pylori infection in many patients with gastric cancer. We examined the H. pylori IgG antibody in 507 patients with gastric cancer resected surgically in our hospital from 1989 to 1991, retrospectively. For the test of H. pylori IgG antibody, HM-CAP EIA kit (Italy, ENTERIC PRODUCTS Co.) was used. The overall detection rate of H. pylori IgG antibody was 75% (378/507). H. pylori infection was significant significantly frequent in early cancer (80%, 231/288) than advanced cancer (67%, 147/219). But, the other clinicopathological features such as sex, age, histological type, location and the degree of intestinal metaplasia were not significantly correlated with H. pylori infection. To evaluate the risk of H. pylori infection for gastric cancer, we are going to plan a matched-pair case-control study.

Aged↗
PubMed1993

[Rapid induction of anesthesia with inhalation of sevoflurane].

Induction of anesthesia with inhalation of sevoflurane was evaluated in 45 patients. Inhalation anesthesia was induced by a single vital capacity breath followed by spontaneous breathing. The compositions of anesthetic gases were as follows: 5% sevoflurane in oxygen, 5% sevoflurane in 67% nitrous oxide and oxygen, and 7% sevoflurane in 67% nitrous oxide and oxygen. The time (mean +/- SEM) necessary for the loss of consciousness was 85 +/- 6, 56 +/- 4, and 42 +/- 3 seconds, and breathing frequency was 8 +/- 1, 5 +/- 0.6, 1.4 +/- 0.2, in each composition of anesthetic gasses, respectively. Changes in blood pressure and heart rate were relatively small. The technique was found to be acceptable to all of the patients studied. We conclude that the technique of single breath induction with sevoflurane is a safe and acceptable alternative to intravenous induction in cooperative adult patients.

Adult↗
PubMed1993

[Serum nitroglycerin concentrations during extracorporeal circulation with a membrane oxygenator incorporated with a cardiopulmonary bypass circuit].

The effect of a cardiopulmonary bypass circuit (CPB) on serum nitroglycerin (TNG) concentrations was studied in eight patients scheduled for cardiac surgery. The CPB consisted of polyvinyl chloride tubes and polypropyrene membrane oxygenator. TNG was administered intravenously at a rate of 1 microgram.kg-1.min-1 after induction of anesthesia. Blood samples were obtained from the radial artery, central vein, venous inlet of the CPB, and arterial outlet of the CPB. No significant difference in serum TNG concentration was found between the venous inlet of the CPB and arterial outlet of the CPB. Serum TNG concentration tended to increase during complete extracorporeal circulation. This suggests that the hypothermic inhibition of TNG metabolism may be greater than the adsorption of TNG by the CPB.

Adolescent↗
PubMed1993

[A case of hereditary motor and sensory neuropathy with vocal cords palsy and diaphragmatic weakness].

A case of hereditary motor and sensory neuropathy (HMSN) type 1 (Charcot-Marie-Tooth disease (CMT)) is reported with vocal cords palsy, deafness, diaphragmatic weakness, and cerebellopontine atrophy. A 42-year-old man was admitted to our hospital in April, 1991 with marked respiratory distress. He had been diagnosed as having CMT 14 years previously. On admission to our hospital, he revealed dyspnea with marked stridor during inspiration. Physical examination showed marked use of respiratory accessory muscles with thoracoabdominal paradox in the supine position. Neurologic examination revealed tonic pupils, mild bilateral weakness of facial muscles, deafness, mild bulbar palsy, severe wasting and weakness in both proximal and distal muscles of the arms and legs, areflexia, distal loss of all sensory modalities. Pes cavus and hammer toe were present. Movement of upper extremities was ataxic. No hypertrophic changes were noted in his peripheral nerves. Peripheral nerve conduction study showed undetectable both sensory and motor action potentials. Electromyography showed evidence of denervation, more marked in distal muscles. Auditory brain stem response was undetectable. Chest radiographic film showed a normal-sized heart with marked elevation of both hemidiaphragm. Laryngofiberscopy confirmed the presence of bilateral vocal cord paralysis without tumor formation, inflammation or anomaly. The vocal cords lay near the midline and did not show any movement during respiration. Moderate cerebellopontine atrophy was confirmed on MRI scan. A sural nerve section showed severe decrease of myelinated fibers, and onion bulbs. Diagnosis of HMSN type 1 was made by clinical, electrodiagnostic, and sural nerve sections study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Effect of age on dose requirement for lumbar epidural anesthesia].

In 161 patients, aged 19-75 yr and subjected to epidural anesthesia for extracorporeal shock wave lithotripsy, the relationships between the spread of lumbar epidural analgesia with 10 ml of 2% mepivacaine and age, height, weight, weight/height ratio, and body mass index were studied. The highest correlation was found between the age and the spread (r = 0.67, P < 0.001). The next higher correlation was found between the height and the spread (r = -0.32, P < 0.001). The lowest but a statistically significant correlation was found between the body mass index and the spread (r = 0.16, P < 0.05). A strong inverse linear relationship was found between the age and the epidural dose requirement (r = -0.59, P < 0.001).

Adult↗
PubMed1993

[Epileptogenicity and neurotoxicity induced by intra-amygdaloid injection of various excitatory amino acids in rats].

The electroencephalographic and histopathological changes following intra-amygdaloid injection of excitatory amino acids were examined in rats. Limbic seizure status was induced after injection of kainic acid (KA), domoic acid (DA), quisqualic acid (QA), alpha-allo-kainic acid (ALLO-KA) and D-glutamic acid (D-GA). The excitatory effect was found to be in the following order: KA > DA >> QA > ALLO-KA >> D-GA. D-GA caused only a transient paroxysmal discharge on EEG. However, seizure was not induced by an injection of L-glutamic acid (L-GA), D-aspartic acid (D-AA) and L-aspartic acid (L-AA). The minimum epileptogenic doses of these amino acids were defined and intra-amygdaloid injection of these doses were performed. Seven days following the injections, histopathological study was performed. These injection resulted in various degree of degeneration and neuronal cell loss of the pyramidal cells in the ipsilateral hippocampus in the following order of severity: DA > or = KA > D-GA > ALLO-KA > QA. These results indicate absence of correlation between epileptogenicity and histopathological changes. Non epileptogenic amino acids induced no pathological changes of hippocampus or the injected site. These results suggest that the severity of hippocampal damage induced by intra-amygdaloid injection of amino acids depends not only on the magnitude of the induced limbic seizure status but also on the difference of neuropharmacological properties of those amino acids in terms of the interaction with their receptors. Further studies are necessary to elucidate the mechanism of actions of these excitatory amino acids in relation to their receptor subtypes.

Amino Acids↗
PubMed1993

Free anterolateral thigh flaps for reconstruction of head and neck defects.

The anterolateral thigh flap is a septocutaneous artery flap based on the septocutaneous or muscle perforators of the lateral circumflex femoral system. Little has been reported about the variations in its vascular anatomy and its application for head and neck reconstruction. We report 22 cases in which this flap was used for the reconstruction of head and neck defects. Based on our clinical and cadevaric experiences, the derivation of the vascular pedicle of this flap has four variations by which the septocutaneous perforators are derived from the descending branch of the lateral circumflex femoral system and/or from the transverse branch of that system, or for which there are no septocutaneous perforators but there are muscle perforators originating from the lateral circumflex femoral system. Clinically, the vascular variations and the locations of perforators of this system can be determined preoperatively with stereoangiograms or simple angiograms and Doppler audiometry. The anterolateral thigh fasciocutaneous flap is suitable for reconstruction of defects in an oral floor with tongue and esophageal deficits, scalp defects with dural defects, and for large full thickness defects of the lip. The advantages of this flap are safe elevation, a long and wide vascular pedicle, skin that is generally thin, and good pliability. Even if the skin is thick, a thinner flap can be created by sacrificing a large amount of fatty tissue. Furthermore, the skin territory is very wide and long. The donor defect can often be closed directly with its scar being less noticeable. The disadvantage of this flap is that the anatomy of the pedicle vessels has irregular derivation from the main vessels. This can be overcome, however, by employing preoperative stereoangiograms.

Adult↗
PubMed1993

[Evaluation of the efficacy of a leukocyte depletion filter].

We evaluated the efficacy of a leukocyte depletion filter (Pall RC 100) during operation. Clinically necessary blood was transfused to replace blood loss during the operation. Kinds of transfused blood and speed of transfusion were selected by clinical need. One leukocyte depletion filter was used at most for 4 units of transfused pack (200 ml). Blood samples were taken before and after the filtration to measure white blood cell (WBC), red blood cell (RBC), platelet and hematocrit. Blood samples before filtration and after filtration with white blood cell excluded, were examined by automated hematology analyzer (Coulter counter). White blood cell after filtration was counted by the hemacytometer method using Hauser chamber. The method of multiple linear regression was applied in order to estimate the removal rate of WBC and recovery rate of RBC. The independent variables were categorized in the following 3 sets: the age of transfused blood (day), duration of transfusion (min) and transfused volume (ml). Removal rates of WBC when 1, 2, 3 or 4 units were passed per filter, were 99.99% +/- 0.028%, 99.89% +/- 0.224%, 99.12% +/- 1.519% and 97.81% +/- 2. 866%, respectively. Removal rate of WBC when 4 units were passed per filter, was significantly lower compared with the rate when fewer units were passed. Recovery rates of RBC when 1, 2, 3, or 4 units were passed per filter, were over 99.5%, and there were no significant differences among 4 examined points. Only three variables, the age of transfused blood, duration of transfusion and transfused volume, showed a significant correlation with the removal rate of WBC.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation Studies as Topic↗
PubMed1993

[Right ventricular perforation and cardiac tamponade caused by a central venous catheter].

A 5 year old girl with ASD was scheduled for open heart surgery. A central venous catheter was placed via the right infraclavicular vein after induction of anesthesia. Thirty minutes after insertion of the catheter, a decrease in arterial pressure and pulse pressure, an increase in heart rate and central venous pressure were observed. Cardiac tamponade was revealed by rapid opening of the chest. Gushing blood out of a hole in the right ventricular free wall was confirmed by pericardiotomy. The hemodynamics were stabilized by blood transfusion and surgical closure of the hole on the ventricle. This perforation was thought to be caused by careless insertion of a relatively stiff central venous catheter.

Cardiac Surgical Procedures↗
PubMed1993

High accumulation of 2-deoxy-2-fluorine-18-fluoro-D-galactose by well-differentiated hepatomas of mice and rats.

The potential application of 2-deoxy-2-[18F]fluoro-D-galactose for the detection and evaluation of hepatomas with PET was examined in mouse and rat liver tumor models. Biodistribution studies showed that uptake of this marker was high in well-differentiated, spontaneous hepatoma of C3H mice at almost 92% of the normal liver level. The uptake by well-differentiated Morris rat hepatoma (5123D) was relatively high and second to that of the C3H hepatoma. On the other hand, uptake values for poorly differentiated mouse hepatoma (MH129P), rat hepatomas (AH109A, AH272), mouse melanoma (B-16) and mammary carcinoma (FM3A) were very low and only 14%-18% of that in the normal liver. The results suggest that while well-differentiated hepatomas maintain a high galactose metabolic activity, poorly differentiated hepatomas or other tumors lose this to a large extent. Consequently, this radiopharmaceutical can be used with PET for biochemical characterization of hepatomas and the differential diagnosis between hepatomas and other cancers.

Animals↗
PubMed1993

[Sevoflurane anesthesia in a patient following renal transplantation].

A 29-year-old male after renal transplantation with aseptic necrosis of the head of the left femur was anesthetized with sevoflurane-nitrous oxide-oxygen for replacement surgery. Anesthesia was induced with N2O 4 l.min-1, O2 2 l.min-1, plus sevoflurane and maintained with N2O4 l.min-1, O2 2 l.min-1 and sevoflurane. Sevoflurane concentrations ranged from 1% to 4%. The serum inorganic fluoride showed the peak level of 38.4 microM.l-1 about 60 minutes after discontinuation of sevoflurane a decrease in serum inorganic fluoride was delayed. Urinary N-acetyl-beta-D-glucosaminidase (NAG), gamma-glutamyl transpeptidase (gamma-GTP) and beta 2-microglobulin (beta 2-m) increased over five postoperative days. NAG and gamma-GTP returned to the preanesthetic level on the 6th postoperative day, but beta 2-m higher than the preanesthetic level lasted for 14 postoperative days. In conclusion, sevoflurane brought about little effect on the transplanted kidney in this patient.

Adult↗
PubMed1992

Two reactions are simultaneously catalyzed by a single enzyme: the arginine-dependent simultaneous formation of two products, ethylene and succinate, from 2-oxoglutarate by an enzyme from Pseudomonas syringae.

A single enzyme isolated from Pseudomonas syringae pv. phaseolicola PK2 simultaneously catalyzed two reactions, namely, the formation of ethylene and succinate from 2-oxoglutarate, at a molar ratio of 2:1. In the main reaction, 2-oxoglutarate was dioxygenated to produce one molecule of ethylene and three molecules of carbon dioxide. In the sub-reaction, both 2-oxoglutarate and L-arginine were mono-oxygenated to yield succinate plus carbon dioxide and L-hydroxyarginine, respectively, the latter being further transformed to guanidine and L-delta 1-pyrroline-5-carboxylate. We propose a dual-circuit mechanism for the entire reaction, in which the binding of L-arginine and 2-oxoglutarate in a Schiff-base structure generates a common intermediate for two reactions.

Arginine↗