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Biomedical subjects

H Tsuchida

Publications and source records attributed to H Tsuchida.

At least 127 records · Page 7Linked to original sources
PubMed1990

Haemodynamic effects of famotidine and cimetidine in critically ill patients.

To compare the cardiovascular effects of the histamine H2 receptor antagonists, famotidine and cimetidine, in critically ill patients, seven ICU patients were given 20 mg of famotidine or 200 mg of cimetidine intravenously in a randomized fashion. Each patient was studied on 2 separate days. In a random fashion, they received famotidine on one of the days and cimetidine on the other. Mean systemic arterial pressure (MAP) was maximally decreased 2 min after intravenous cimetidine from 103 +/- 10 (13.7 +/- 1.3 kPa) (mean +/- s.d.) to 83 +/- 15 mmHg (11.1 +/- 2.0 kPa) (P less than 0.05). MAP returned to control values 8 min after administration of the drug. Systemic vascular resistance (SVR) was significantly decreased during the 8-min observation period (P less than 0.01). In contrast, famotidine produced little haemodynamic effect over the 8-min period. Therefore, we suggest that famotidine may be a better H2 antagonist than cimetidine in critically ill patients requiring vasoconstrictor drug support, since it avoids the significant decrease in systemic blood pressure and peripheral vasodilation seen after cimetidine.

Adult↗
PubMed1990

[Effect of cimetidine on neuromuscular blockade by succinylcholine and pancuronium].

The effect of cimetidine on neuromuscular blockade by succinylcholine and pancuronium was investigated in 54 adult patients scheduled for elective surgery. The neuromuscular blocking properties were estimated with single twitch height (T1) which was obtained by measuring the acceleration of adduction of the thumb in response to the ulnar nerve stimulation under N2O-fentanyl anesthesia. In cimetidine group, cimetidine 200 mg was administered orally on the night before surgery and 90 mins before anesthesia. Succinylcholine 1 mg.kg-1 (n = 14) or 1.5 mg.kg-1 (n = 20) was injected intravenously, and the onset time (from injection to 0% T1), the duration of maximal block (0% T1), and the recovery time from injection to 50% and 75% of control twitch height were evaluated. ED25 and ED50 of pancuronium were calculated from the dose response curve obtained by incremental administration of the drug (n = 20) whose total cumulative dose was 0.1 mg.kg-1. The recovery index of pancuronium was determined by measuring the 25%-75% recovery time. There was no significant difference between cimetidine pretreated patients and non-pretreated patients regarding these parameters of neuromuscular blockade with both succinylcholine and pancuronium. In conclusion, cimetidine has no influence on neuromuscular blockade of succinylcholine and pancuronium under N2O-fentanyl anesthesia.

Adolescent↗
PubMed1990

[A case of mitral regurgitation due to perforation of the mitral posterior leaflet].

A case of mitral regurgitation (MR) due to perforation of the mitral posterior leaflet is described. A 48-year-old male patient was admitted to the hospital because of left heart failure. A pan-systolic murmur was audible in the mitral area. Left ventriculography revealed MR. A spindle shaped perforation (about 8 X 3 mm in size) was found intraoperatively in the posterior leaflet of the mitral valve near the posterior commissure. The surface around the perforation was smooth, and the leaflet displayed good movability. No vegetation or calcification was found. Valvuloplasty was performed and the perforation was closed. The patient was regularly examined for 3 years post-surgery, and no recurrence of MR was found. The cause of this perforation was unknown but it is thought to be acquired. MR resulting only from mitral valve perforation is extremely rare. The pathogenesis and problems of diagnosis are discussed in this report.

Heart Rupture↗
PubMed1990

[Cardiac output monitoring by impedance cardiography in cardiac surgery].

The cardiac output monitoring by impedance cardiography, NCCOM3, was evaluated in adult patients (n = 12) who were subjected to coronary artery bypass grafting. Values of cardiac output measured by impedance cardiography were compared to those by the thermodilution method. Changes of base impedance level used as an index of thoracic fluid volume were also investigated before and after cardiopulmonary bypass (CPB). Correlation coefficient (r) of the values obtained by thermodilution with impedance cardiography was 0.79 and the mean difference was 1.29 +/- 16.9 (SD)% during induction of anesthesia. During the operation, r was 0.83 and the mean difference was -14.6 +/- 18.7%. The measurement by impedance cardiography could be carried out through the operation except when electro-cautery was used. Base impedance level before CPB was significantly lower as compared with that after CPB. There was a negative correlation between the base impedance level and central venous pressure (CVP). No patients showed any signs suggesting lung edema and all the values of CVP, pulmonary artery pressure and blood gas analysis were within normal ranges. From the result of this study, it was concluded that cardiac output monitoring by impedance cardiography was useful in cardiac surgery, but further detailed examinations will be necessary on the relationship between the numerical values of base impedance and the clinical state of the patients.

Aged↗
PubMed1989

N-acetylation in chitosan and the rate of its enzymic hydrolysis.

Partially N-acetylated derivatives (degree of substitution (d.s.) 0.2, 0.4, 0.6 and 0.8 for N-acetyl) of chitosan were prepared from prawn shell chitosan, and their susceptibility towards a lysozyme from hen egg-white, three microbial chitinases and a chitinase from potato skins was examined. The partially N-acetylated derivatives (d.s. 0.4-0.8 for N-acetyl) were 1.5-4.0 times more digestible than N-acetylchitosan (d.s. 1.0 for N-acetyl), and their enzymic hydrolysis rate is controlled by the d.s. for N-acetyl group. These data suggest that chitosan is usable as a digestible material in the biomedical and biotechnological fields.

Acetylation↗
PubMed1989

[Anesthetic management of caesarean section in a patient with idiopathic thrombocytopenic purpura and placenta praevia].

A 24-year-old female with idiopathic thrombocytopenic purpura (ITP) and total placenta praevia was scheduled for caesarean section. Anesthetic management during caesarean section with ITP and placenta praevia is critical because of possibility of massive intra- and postpartal bleeding. The patient received prednisolone 30 mg per day for 10 days before surgery. Bleeding time and value of platelet count returned to normal range on the operative day. Hydrocortisone 100 mg and atropine sulfate 0.3 mg were given intravenously just before the start of anesthesia. Anesthesia was induced with thiamylal 4 mg.kg-1 and SCC 1 mg.kg-1 and maintained with N2O-O2-enflurane. A baby girl was delivered after 7 min, and the Apgar score was 9 at 1 min after delivery. Intraoperative bleeding totaled 1,314 ml, but we could avoid total hysterectomy.

Adult↗
PubMed1989

[Local changes in prostanoids in arteriosclerosis obliterans].

In order to identify local changes in prostanoids in arteriosclerosis obliterans (ASO), plasma levels of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1 alpha(6-Keto-PGF1 alpha) in cubital venous blood (CV blood), in femoral arterial blood (FA blood) and in femoral venous blood (FV blood) of 27 patients with ASO of lower limbs and of 10 healthy controls were measured by RIA technique. The following results were obtained. 1) In the ASO patients, levels of TXB2 and the ratio between TXB2 and 6-Keto-PGF1 alpha (TXB2/6-Keto-PGF1 alpha) in FV blood of ischemic legs were elevated in comparison to those in CV blood or FA blood of the same group or those in FV blood of the controls. 2) This change was more clearly observed in the femoro-popliteal group, but in the aorto-iliac+ combined group, they were elevated not only in FV blood but also in FA blood. 3) No significant difference was observed between the Fontaine I + II group and the Fontaine III + IV group in these local changes in prostanoids. 4) The severer the angiographic manifestation between the abdominal aorta and the common femoral artery, the higher the plasma TXB2 levels in FA blood. Also, the poorer the peripheral run-off, the higher the plasma TXB2 production in the legs. These results suggest that the imbalance between TXA2 and PGI2 is obvious in ischemic legs of ASO patients, TXA2 is elevated downstream from damaged vessels, and the local plasma TXB2 levels reflect the severity of the vascular damage in ASO patients.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

[An aged case of peripheral arterial obstructive disease with progressive limb necrosis].

An aged case of peripheral arterial obstructive disease with progressive limb necrosis is reported. A 70-year old man was admitted to our hospital with the complaint of numbness and rest pain on left lower limb. Thereafter, necrosis of the digital region of the upper limbs and the toe region of the lower limbs became progressively worse 3 weeks after onset. Bilateral lower limb amputations after lumbar sympathectomy and digital amputation of upper limbs after thoracic sympathectomy were performed. The histological findings of artery and vein in amputated limbs showed thromboangiitis obliterans. We conclude that Buerger's disease in the aged is rare, but does really exist.

Aged↗
PubMed1989

[Two cases of ruptured aneurysm of sinus of Valsalva into right atrium (Konno's type IV)].

Experience with surgery for ruptured aneurysm of sinus of Valsalva into right atrium (Konno's type IV) in two cases was reported. The first case is a 39-year-old male developing into congestive heart failure for 5 days after the onset that was suspected of "rupture's attack". In the second case of 33-year-old male the course was slow progressing and the onset could not be identified. Mitral valve prolapse was suspected previously because of his syncope attack and infectious endocarditis. Closure of the ruptured noncoronary sinus of Valsalva with mattress suture was undertaken on both cases through the right atrium. Cardiac murmur was disappeared postoperatively on the both cases, and MR was denied in the later case. Postoperative courses were uneventful.

Adult↗
PubMed1988

Immunohistochemical identification of infiltrating mononuclear cells in tubulointerstitial nephritis associated with Sjögren's syndrome.

Using monoclonal antibodies, immunoperoxidase analysis was performed on eight renal biopsy samples obtained from patients with Sjögren's syndrome-associated tubulointerstitial nephritis. In all cases the interstitial infiltrates were predominantly CD5-positive T-cells (mean 66%), whereas both B-cell (CD19-positive) and monocyte (CD15-positive) populations participated to a lesser degree. CD16-positive NK/K cells were rarely encountered. The CD4/CD8 ratio was consistently higher than 1.0 (mean 2.08). The lymphocytes which invaded the tubular epithelial cells to present a feature of tubulitis were CD8-positive, suggesting that they were cytotoxic T-cells. These results were in general accord with those obtained in the salivary glands of patients with Sjögren's syndrome. It was thus concluded that the same immunological process was probably operative in the renal tubulointerstitial tissue as in the salivary glands to induce the characteristic tissue changes of Sjögren's syndrome.

Adolescent↗
PubMed1988

[Emergency embolectomy in embolic occlusion of the middle cerebral artery].

UNLABELLED: The natural course of embolic occlusion of the middle cerebral artery (MCA) has many variations, which include the frequent appearance of hemorrhagic infarction. There are also fatal cases among which severe ischemic edema is found. There haven's been many cases reported of MCA embolectomy in the acute stage, and findings concerning them have been very complicated and hard to analyze. Nevertheless there certainly exist cases where remarkable improvement of neurological signs is shown soon after the procedure. Five cases of emergency embolectomy have been undergone in our hospital in the past 2 years. The results were better than results obtained in cases where embolectomy was not performed. Three male and two female cases are the objectives, whose average age was 61 +/- 6 years (ranging from 54 to 67 years). The left side of the MC was involved in three cases and the right in two, and all cases had past history of heart diseases which may have been the embolic source. Each case had undergone CT scan soon after admission to make sure not to be the other type of intracranial lesion. Cerebral angiography was performed next, to discover the site of the occlusion and the degree of collateral circulation. Emergency embolectomy was performed as soon as possible in every case. The functional outcome was estimated from the ADL three months later using the international fifth degree grading. RESULTS: The period from onset to recanalization ranges between 4.5 to 11 hours (average 6.9 +/- 2.5 hours). Good MC recanalization was demonstrated in each case angiographically within a week after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

[The influence and outcome of acute infantile intracranial hematoma with hypoxemia].

Unusually broad areas of cerebral infarction were demonstrated by CT scan in three head injured infants with acute intracranial hematoma. They revealed very characteristic CT findings including contralateral hemispheric ischemic zone. Case 1 is a 5-month-old boy who had hit his head 4 days before. On admission he was semicomatose and his respiration had suffered from generalized seizures with arterial PO2 value of 43 mmHg. CT scan revealed right subdural hematoma, and bihemispheric ischemic low density was also demonstrable. Hematoma clot weighing 10 grams was removed through emergency craniotomy, followed by external decompression. There was a marked atrophic change in the right cerebral hemisphere and contralateral frontal base during the following few months, but the basal ganglionic region, brainstem and cerebellum were hardly affected. The patient developed comparatively well mentally for the next one and a half years. Case 2 was a 2-year-old boy who had a previous history of moderate head trauma 8 hours before admission. After a lucid interval, sudden epileptic attacks hospitalized him in a condition of cardiopulmonary arrest. CT scan revealed severe epidural hematoma on the patient's right cerebrum. Emergency craniotomy was performed and hematoma 95 g in weight was removed followed by decompression. Postoperative CT showed broad ipsilateral ischemic edema including the contralateral cerebral hemisphere and brainstem. One and a half years later, the patient shows decorticated posture with ataxic respiration and negative light reflexes. Case 3 was an 8-month-old boy who had fallen down and hit his head on the floor. Status epilepticus had attacked him, causing him to be admitted in a dyspneic state.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗