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Biomedical subjects

H Ishihara

Publications and source records attributed to H Ishihara.

At least 433 records · Page 24Linked to original sources
PubMed1991

[Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--5. An anesthetic experience of a pediatric patient with severe epilepsy].

A 6-year-old girl with severe epilepsy received an orthopedic surgery of the right hand under new total intravenous anesthesia with droperidol, fentanyl and ketamine. For the induction of anesthesia, droperidol 0.25 mg.kg-1, fentanyl 5.0 micrograms.kg-1 and ketamine 2.0 mg.kg-1 was administered intravenously. She was intubated and ventilated manually throughout the operative procedure to maintain the end tidal CO2 between 4.5 and 5.5%. For the maintenance of anesthesia, ketamine was given continuously at a rate of 2.0 mg.kg-1.hr-1. Intraoperative muscle relaxation was obtained with vecuronium bromide. The patient recovered from anesthesia uneventfully. The total doses of droperidol, fentanyl, ketamine and vecuronium were 8.75 mg, 1.0 mg, 210 mg and 7.5 mg, respectively. Neither epileptic seizure, nor any other adverse effects with anesthetics was observed during and after anesthesia and surgery. We conclude that this method of anesthesia for epileptic patients may deserve further detailed study.

Anesthesia, Intravenous↗
PubMed1991

[Clinical study on total intravenous anesthesia with droperidol, fentanyl, and ketamine--6. Effects on postoperative liver function].

We have developed a new method of total intravenous anesthesia with droperidol, fentanyl, and ketamine, and have administered it to more than 700 surgical patients. We studied whether this method of anesthesia would influence postoperative liver function or not. A total of sixty elective surgical patients were the subjects of this study. Thirty patients underwent total hysterectomy under either the total intravenous anesthesia (15 patients) or modified neurolept-anesthesia with pentazocine (15 patients). The remaining 30 patients underwent gastrectomy under either this total intravenous anesthesia (15 patients) or enflurane-N2O anesthesia (15 patients). The hepatic function was evaluated as judged by s-GOT, s-GPT, ALP, gamma-GPT and total bilirubin levels, before anesthesia and during the first to third postoperative day. The patients for gastrectomy under enflurane-N2O anesthesia had significantly increased postoperative gamma-GPT levels compared with the patients of total intravenous anesthesia. Any other variables showed no significant difference among groups. We consider that this method of total intravenous anesthesia has no adverse effects on postoperative liver function as compared with other usual anesthetic methods.

Anesthesia, Inhalation↗
PubMed1991

[Effect of induced hypotension with prostaglandin E1 or trimetaphan on endocrine functions in surgical patients].

Twenty patients who underwent surgery of hip joint under enflurane anesthesia were studied to evaluate the effect of induced hypotension with prostaglandin E1 or trimetaphan on endocrine functions. Ten patients were given prostaglandin E1 and the remaining ten patients were given trimetaphan intravenously to maintain systolic blood pressure at about 80 mmHg. There were no significant differences between the two groups concerning plasma level of ACTH, cortisol, TSH, T3, T4, epinephrine and dopamine. However a significant difference in plasma norepinephrine levels was observed between them. Plasma norepinephrine levels after start of hypotension increased by 50% in the prostaglandin E1 group, but decreased by 50% in the trimetaphan group, when compared with each pre-hypotensive level. The data obtained suggest that the prostaglandin E1 would not influence ACTH-cortisol and thyroid functions, but may have a tendency to increase plasma norepinephrine levels in hypertensive patients complicated with pheochromocytoma.

Endocrine Glands↗
PubMed1990

The influence of intra-arterial infusion of cisplatinum and bleomycin on the cell cycle in uterine cervical carcinoma.

We examine the influence of CDDP and BLM on the cell cycle in the patients with uterine cervical cancer. Specimens were obtained from 8 cases of local recurrent uterine cervical cancer which were treated with CDDP and BLM bolus infusions into bilateral internal iliac arteries. Except for two patients who showed no response according to the criteria of the National Cancer Institute (NCI), the other patients exhibited partial response (PR). The concentrations of BLM and CDDP were 0.83 +/- 0.05 microgram/g and 2.9 +/- 0.54 microgram/g in the tumor tissues 24 hours after treatment. The peak values of the drug concentrations in serum, which were observed at 30 min for both drugs, were 0.92 +/- 0.12 microgram/ml BLM and 1.02 +/- 0.65 microgram/ml CDDP and the concentrations of the drugs decreased rapidly in the serum. The higher levels of CDDP and BLM were retained in the tumor tissue 24 hours after treatment, than in serum. Changes in DNA content determined by flow cytometry, revealed that proliferation indices (PI) increased after treatment only in PR cases. The mean increase in the ratio was 0.10 +/- 0.015. The BrdU staining showed that cells in S phase increased in tumor tissues. Labeling indices increased from 0.10 +/- 0.04 to 0.18 +/- 0.05. These results suggested that cell synchronization was induced by CDDP and BLM in vivo. PI seemed a useful parameter for measuring drug sensitivity.

Aged↗
PubMed1990

[A long survived case of malignant pheochromocytoma treated with alpha-methyl-p-tyrosine and midaglizol (DG-5128)].

Survival period of malignant pheochromocytoma treated only conservatively is reported to be less than one year by T. Sato. A patient of malignant pheochromocytoma with liver metastasis has been treated with alpha-methyl-p-tyrosine (alpha MPT), tyrosine hydroxylase inhibitor, in the last 5 years. Catecholamine levels markedly decreased and he has a long survival time. He lives over 17 years from the detection of malignant pheochromocytoma. alpha MPT was considered to have a role to protect a patient from cardiomyopathy induced by hyper-catecholaminemia and to have the action of inhibiting the growth of this tumor. The growth of this tumor was very slow. Since this case had insulin independent diabetes mellitus, insulin therapy was applied, however, blood glucose level was not controlled well. Then we tried midaglizol (DG-5128), alpha 2-adrenoceptor antagonist, to control diabetes mellitus and a sufficient control was obtained. C-peptide level in urine was increased concomitant with decrease of blood glucose. This fact suggested that insulin secretion was improved. It is well known that catecholamine, especially noradrenaline has an inhibiting action on insulin secretion from beta cell. This action was appeared through alpha 2-adrenergic receptor. DG-5128 has an action as alpha 2-adrenoceptor antagonist. We think an inhibiting action on insulin secretion of catecholamine was diminished through its action as adrenoceptor antagonist. Kawazu et al. reported that catecholamine levels, heart rate and blood pressure did not change by DG-5128 administration in healthy subjects. In this patient, no change was appeared either. No major complication was observed during this treatment.

Adrenal Gland Neoplasms↗
PubMed1990

Electroblotting of double-stranded DNA for hybridization experiments: DNA transfer is complete within 10 minutes after pulsed-field gel electrophoresis.

A rapid, simple, and efficient method for DNA blotting is presented. This method is characteristic in that DNA is transferred without denaturation from an electrophoretic gel to a membrane in low-salt concentrations and denatured on the membrane after blotting. More than 89% of double-stranded DNAs ranging in size from 75 to 1.9 million bp can simultaneously be transferred from the gel to a positively charged nylon membrane within 10 min. The present "low-salt electroblotting" method is superior to other blotting methods in that it saves time and labor and its high and even transfer efficiency makes it useful for hybridization analysis.

Blotting, Southern↗
PubMed1990

A centrifugal pump for graft replacement of the descending thoracic or thoraco-abdominal aorta.

Between January 1987, and December 1988, 14 cases of descending thoracic or thoraco-abdominal aortic aneurysm underwent operation using a prosthetic graft replacement. In order to avoid hypoperfusion to distal organs and proximal hypertension during aortic cross-clamping, two different adjuncts were used and the effectiveness of those methods were compared according to the results of surgery. Seven patients were treated with a temporary shunt of heparin-bonded tube from the left axillary artery to left femoral artery, or else Dacron vascular prosthesis from right axillary artery to right femoral artery (Group I). In Group II (seven patients), left heart bypass was performed, using a centrifugal pump from the left atrium to the left femoral artery with minimal heparinization. In Group I, there were two hospital deaths, due to respiratory and hepatic failure respectively, and paraplegia has occurred in one case. In Group II, there was no death during a post-operative observation period of 5-15 months, and there was no case of paraplegia. We think that temporary left heart bypass with a centrifugal pump seems to be the most useful method today for graft replacement of the descending thoracic or thoraco-abdominal aorta.

Adult↗
PubMed1990

Direct inhibition of chicken gizzard smooth muscle contractile apparatus by caffeine.

The mechanism of the inhibitory effect of caffeine on smooth muscle contraction was examined using chicken gizzard. Caffeine (0.1-5 mmol/l) inhibited the KCl-induced contraction of the muscle with an IC50 of 1.1 mmol/l. Forskolin (0.01-10 mumol/l) also inhibited KCl-induced contraction. The inhibitory effect of caffeine was potentiated by a low concentration of forskolin (0.3 mumol/l) and the inhibitory effect of forskolin was potentiated by a low concentration of caffeine (0.1 mmol/l). Although caffeine and forskolin increased tissue cyclic AMP levels, caffeine inhibited the KCl-induced contraction more strongly than forskolin at a given cyclic AMP level. Caffeine (1-40 mmol/l) inhibited the contractions induced by 3 mumol/l Ca2+ in Triton X-100-permeabilized muscle. Caffeine (1-40 mmol/l) inhibited the phosphorylation of 20 kDa myosin light chain (MLC) in native actomyosin preparation and the inhibition was enhanced by decreasing the ATP concentration in the reaction medium. Calmodulin (CaM) activity, as monitored by Ca2+/CaM-dependent erythrocyte membrane (Ca2+ + Mg2+)-ATPase, was not affected by 20 mmol/l caffeine. Time-dependent dephosphorylation of MLC upon removal of Ca2+, an indicator of phosphate activity, was not affected by caffeine. Caffeine also inhibited the Ca2(+)-independent contraction in thiophosphorylated permeabilized muscle. These results indicate that caffeine inhibits smooth muscle contraction by a direct inhibition of MLC kinase and actin-myosin interaction. A part of the inhibitory effect may be mediated by cyclic AMP-dependent mechanism(s).

Actomyosin↗
PubMed1990

Effect of surfactant on bioelectric properties of canine tracheal epithelium.

The functional significance of pulmonary surfactant in the airways is not well known and the effects of surfactant on bioelectrical properties of airway epithelium have not been investigated. In the present study, we examined the effect of synthetic surfactant (TR-14) or calf lung surfactant extract (surfactant TA) on transepithelial potential difference (PD) and short circuit current (SCC) in canine trachea. The conductance (G) was calculated as the ratio of SCC per open-circuited PD. The posterior membrane without muscular layer from canine trachea was mounted in an Ussing-type chamber, bathed with Krebs-Ringer buffer solution at 37 degrees C and gassed with 95% O2-5% CO2, pH 7.4. Treatment with mucosal surfactant produced an increase in both PD and SCC in a dose-dependent fashion. PD and SCC reached 132% and 124% of before control at 0.25 mg/ml after the addition of each surfactant respectively, whereas G remained unchanged. Both ouabain and furosemide abolished surfactant-evoked increases in PD and SCC, whereas amiloride did not alter the surfactant-evoked increases. No significant differences in the effect on bioelectric parameters were observed between TR-14 and surfactant TA. These findings suggest that lung surfactant affects bioelectrical properties and changes ion transport (Cl- secretion) across airway epithelium, probably through the activity of ion pumps in the cellular membrane.

Animals↗
PubMed1990

CT simulator: a new 3-D planning and simulating system for radiotherapy: Part 1. Description of system.

A real time CT-linked 3-D treatment planning system, called a CT simulator, has been developed. The basic system consists of a CT scanner, a multi-image display component, a treatment planning device with real time visual optimization, and a laser beam projecting component. All the components are connected on line. The system can be conveniently used for 3-D planning and simulation for radiation therapy within a reasonably short period of time.

Computer Simulation↗
PubMed1990

CT simulator: a new 3-D planning and simulating system for radiotherapy: Part 2. Clinical application.

We have performed radiotherapy treatment planning (RTP) with a new system called CT simulator in 72 patients. With the system, RTP is performed with the patient lying on the CT couch within a short period of time. All the CT images scanned were immediately transported to the multi-image monitors and to the treatment planning device. Radiotherapy treatment planning could be performed not only at the beam center but also at any CT slice. Using a laser-beam field projector, field outlines were drawn over the patient's skin. In clinical use, the system was useful for cases in which a target lies adjacent to dose limiting organs, cases with a complicated target shape, cases with complicated dose distribution curves, and cases treated with tangential fields. This system enables us to make optimum use of CT information and to make accurate 3-dimensional treatment planning programs.

Computer Simulation↗
PubMed1990

Preparation of asialofetuin-labeled liposomes with encapsulated human interferon-gamma and their uptake by isolated rat hepatocytes.

The selective delivery of human recombinant interferon (IFN)-gamma to isolated rat hepatocytes was studied with asialofetuin (AF)-labeled liposomes. AF-liposomes containing buffer solution were initially prepared by the detergent removal method, and IFN-gamma was subsequently encapsulated by the freeze-thawing method without loss of activity. Virtually no free [32P]IFN-gamma was internalized into isolated rat hepatocytes, whereas AF-liposomes containing [32P]IFN-gamma were taken up to a significant degree. Liposomal binding to the hepatocytes (estimated at 4 degrees C) was one-fifth of the uptake (estimated at 37 degrees C). Since the uptake was inhibited by the addition of free AF, AF-liposomes may be taken up by the action of galactose-binding protein on the hepatocytic cell surface. The liposome preparation method reported in this paper provides a useful means for the encapsulation of unstable macromolecules into AF-liposomes. AF-liposomes were found effectively to carry IFN-gamma into hepatocytes in vitro.

Animals↗
PubMed1990

Massive fetomaternal hemorrhage: case report.

Massive fetomaternal hemorrhage (FMH) is rare. Early diagnosis is important because FMH has a poor prognosis in the antepartum or early postpartum period. A case of massive FMH in which 400 ml blood was lost is presented here. Fetal anemia was suspected from the sinusoidal fetal heart rate pattern. The hemorrhage in the maternal circulation was diagnosed before delivery by using the Kleihauer-Betke test. An emergency cesarean section was performed. The cord hemoglobin level was 3.7 g/dl. The baby's severe anemia was treated with a neonatal blood transfusion. In this case, the baby had a good clinical course. Early diagnosis and treatment of massive FMH are necessary for a good prognosis.

Adult↗
PubMed1990

Intracellular calcium concentration of acinar cells in feline tracheal submucosal glands.

We measured the intracellular free calcium ion concentration [( Ca2+]i) of acinar cells in isolated feline tracheal submucosal glands in response to secretagogues using the Ca2(+)-sensitive fluorescent dye fura-2. The secretagogues included cholinergic, adrenergic agonists, substance P (SP), and vasoactive intestinal polypeptide (VIP) which induce mucus glycoprotein secretion from feline tracheal submucosal glands. Methacholine (MCh) produced a significant increase in [Ca2+]i of up to 9.8 times that of control in a dose-dependent fashion at concentrations of 10(-8) to 10(-3) M. [Ca2+]i increase by MCh reached a peak within 30 s after stimulation and thereafter showed a sustained rise. In Ca2(+)-free medium, MCh produced an initial transient rise, which was less than 30% of that in a Ca2(+)-containing solution, and which lasted for 60 s with no prolonged sustained rise in [Ca2+]i. Atropine abolished MCh-evoked [Ca2+]i increase. Phenylephrine and SP produced a prolonged increase in [Ca2+]i without an initial transient increase. Phenylephrine (up to 10(-4) M) evoked an increase in [Ca2+]i by up to 240% that of control, which was abolished by prazosin. SP (up to 10(-4) M) also evoked an increase in [Ca2+]i by 155% that of control, which was abolished by atropine. By contrast, both isoproterenol (up to 10(-5) M) and VIP (up to 10(-5) M) failed to alter [Ca2+]i. These findings indicate that the mucus glycoprotein secretion evoked by muscarinic cholinergic, alpha-adrenergic agonist or SP can be mediated by intracellular Ca2+, whereas that by beta-adrenergic agonists or VIP cannot.

Animals↗