Biomedical subjects

H Yaku

Publications and source records attributed to H Yaku.

99 records · Page 6Linked to original sources

PubMedDate not supplied

Partial attenuation of the cardiovascular responses to tracheal intubation with oral nisoldipine.

STUDY OBJECTIVE: To evaluate the efficacy and safety of nisoldipine given orally in attenuating the cardiovascular responses to laryngoscopy and tracheal intubation. DESIGN: Randomized, double-blind, placebo-controlled study. SETTING: Induction of anesthesia for elective surgery at a university hospital. PATIENTS: Thirty normotensive patients (ASA physical status I) undergoing elective surgery were assigned to one of three groups; placebo, nisoldipine 5 mg, or nisoldipine 10 mg. Each group consisted of ten patients. INTERVENTIONS: Either 5 mg of nisoldipine, 10 mg of nisoldipine, or a placebo was administered orally 2 hours before induction of anesthesia. Anesthesia was induced with thiopental sodium 5 mg/kg intravenously, and tracheal intubation was facilitated with vecuronium 0.2 mg/kg. During anesthesia, ventilation was assisted or controlled with 1% enflurane and 50% nitrous oxide in oxygen. Laryngoscopy lasting 30 seconds was attempted 2 minutes after administration of thiopental sodium and vecuronium. MEASUREMENTS AND MAIN RESULTS: Patients receiving the placebo showed a significant increase in mean arterial pressure associated with tracheal intubation. These increases following tracheal intubation were significantly reduced in patients receiving nisoldipine 10 mg compared with patients receiving the placebo (p less than 0.05). CONCLUSIONS: Oral administration of nisoldipine before induction of anesthesia is a simple, practical, and safe method for attenuating pressor response to laryngoscopy and tracheal intubation.

Administration, Oral↗

PubMedDate not supplied

Attenuation of hypertensive response to tracheal intubation with nitroglycerin.

STUDY OBJECTIVE: To evaluate the efficacy and safety of intravenous (IV) nitroglycerin in attenuating the hypertensive response to laryngoscopy and intubation as a new application of the drug. DESIGN: Controlled, randomized, double-blind study. SETTING: University hospital. PATIENTS: Thirty normotensive patients (ASA physical status I) undergoing elective surgery were divided into three groups of ten patients each. INTERVENTIONS: Anesthesia was induced with thiopental sodium 5 mg/kg i.v., and tracheal intubation was facilitated with vecuronium 0.2 mg/kg i.v. During anesthesia, ventilation was assisted or controlled with 1% enflurane and 50% nitrous oxide in oxygen. Either 1.5 micrograms/kg of nitroglycerin, 2.5 micrograms/kg of nitroglycerin, or saline (control) was administered IV simultaneously with the start of laryngoscopy (lasting 30 seconds), which was attempted 2 minutes after administration of thiopental sodium and vecuronium. MEASUREMENTS AND MAIN RESULTS: Patients receiving saline showed a significant increase in mean arterial pressure and rate-pressure product associated with tracheal intubation. These increases following tracheal intubation were significantly reduced in nitroglycerin-treated patients compared with those in the control group (p < 0.05). CONCLUSION: A single, rapid IV dose of nitroglycerin is a simple, practical, effective, and safe method to attenuate the hypertensive response to laryngoscopy and tracheal intubation.

Adult↗

PubMedDate not supplied

Effects of diazoxide on the cardiovascular response to tracheal intubation.

The efficacy of 2 or 3 mg/kg diazoxide given 2.5 min before laryngoscopy in attenuating the cardiovascular responses to laryngoscopy and intubation was studied in 30 patients undergoing elective surgery. Data were compared with those from 10 control patients receiving saline. Anaesthesia was induced using 5 mg/kg thiopentone given intravenously and tracheal intubation was facilitated with 0.2 mg/kg vecuronium bromide. Patients receiving saline showed a significant increase in mean arterial pressure and rate-pressure product associated with tracheal intubation. The increases following tracheal intubation were significantly reduced (P less than 0.05) in diazoxide-treated patients compared with those in the control group, but there were no significant differences in heart rate following tracheal intubation among the three groups. Data suggest that diazoxide can be used as a supplement during induction of anaesthesia to attenuate the hypertensive response associated with laryngoscopy and tracheal intubation.

Adult↗

PubMedDate not supplied

Development of Bell's palsy despite treatment of post-traumatic headache by stellate ganglion block.

It is a controversial issue whether or not stellate ganglion block (SGB) is an effective treatment for facial palsy. A case report is presented in which a patient with traumatic cervical syndrome developed Bell's palsy after being treated by same-side SGB, suggesting that SGB was not able to prevent development of Bell's palsy. The need for further clinical investigations on efficacy of SGB against Bell's palsy seems to be justified.

Adult↗

PubMedDate not supplied

Prostaglandin E1 and tracheal intubation: relationship between the cardiovascular responses and plasma catecholamine concentrations.

A study was carried out on 30 normotensive patients (American Society of Anesthesiologists physical status 1) to investigate whether or not a suppressive effect of 0.3 or 0.6 microgram/kg prostaglandin E1 on the hypertensive response to tracheal intubation was due to inhibition of the increase in plasma catecholamine concentrations following the stressful stimulation. A total of 30 patients in three groups underwent elective surgery. Anaesthesia was induced with 5 mg/kg sodium thiopentone given intravenously and tracheal intubation was facilitated by 0.2 mg/kg vecuronium. Either saline (group A) or 0.3 (group B) or 0.6 micrograms/kg (group C) prostaglandin E1 was administered intravenously 15 s before direct laryngoscopy (lasting 30 s) which was attempted 2 min after administering thiopentone and vecuronium. All groups exhibited significant (P less than 0.05) increases in mean arterial pressure, heart rate, rate-pressure product and plasma noradrenaline concentrations following tracheal intubation, but the increases in mean arterial blood pressure and rate - pressure product were significantly (P less than 0.05) less in groups B and C than in group A. Prostaglandin E1, however, enhanced the increase in plasma noradrenaline concentrations following intubation. Data suggest that attenuation of the pressor response to intubation by prostaglandin E1 may not be due to inhibition of the noradrenaline release stimulated by intubation but to inhibition of noradrenaline-induced vasoconstriction.

Adult↗

PubMedDate not supplied

Use of prostaglandin E1 to treat peri-anaesthetic pulmonary hypertension associated with mitral valve disease.

Severe pulmonary hypertension (PH) can be a critical problem during and after cardiac surgery, since it increases right ventricular afterload resulting in decreased cardiac output. A case of pulmonary hypertension associated with mitral valve disease and resistant to glyceryl trinitrate therapy during surgery is reported. The case was treated successfully with prostaglandin E1 (PGE1), indicating that PGE1 can be used peri-operatively in a patient with refractory PH resistant to glyceryl trinitrate treatment.

Alprostadil↗

PubMedDate not supplied

Effect of superoxide dismutase on endothelium-dependent relaxation of aorta from endotoxin-treated rabbits.

To assess the protective effect of superoxide dismutase (SOD) on the endothelium of aorta in endotoxaemia, we investigated the production of endothelium-derived relaxing factor in aorta obtained from endotoxin-treated rabbits concomitantly receiving SOD or not. Thirty-two male Japanese white rabbits were randomly divided into four groups (n = 8 for each group): one group receiving saline as a placebo, a second receiving 5 mg/kg endotoxin intravenously, a third receiving 5 mg/kg endotoxin intravenously plus SOD, and a fourth receiving SOD alone. SOD was injected intravenously at a dose of 10,000 U/kg before the endotoxin and was infused continuously at a rate of 15,000 units/kg/h throughout the experiment. The tension of the aorta was recorded in vitro 6 h after the start of in vivo treatment with endotoxin or saline. In the aorta of rabbits receiving endotoxin alone, acetylcholine-induced relaxation was reduced by 50%. The SOD fully restored the reduction of acetylcholine-induced relaxation by endotoxin. Histological studies using photomicroscopy revealed endothelial damage in the endotoxin-treated aorta, which was attenuated in the SOD-treated group. These data suggest that intravenous SOD may be an effective treatment for unstable haemodynamics in endotoxaemia.

Acetylcholine↗

PubMedDate not supplied

Limited proteolysis of protein kinase C subspecies by calpain: stimulation by basic polypeptides.

Limited proteolysis of Protein Kinase C (PKC) subspecies by Ca(2+)-dependent neutral protease II (calpain II) was remarkably stimulated by the presence of basic polypeptides, such as H1 histone, protamine, poly-L-arginine, and poly-L-lysine. The stimulatory effect of basic polypeptides was observed for proteolysis of the active form of PKC which was associated with diacylglycerol and phospholipid. The inactive form of PKC was far less susceptible to proteolysis, either in the presence or absence of the basic polypeptides. The basic polypeptides did not appear to interact with calpain II, but caused a conformational change in PKC to make the kinase molecule more susceptible to proteolysis. The relative rates of cleavage of the active form of types I (gamma), II (beta), and III (alpha) PKC by calpain II in the absence and presence of basic polypeptides were 100:48:23 and 100:100:50, respectively. Available evidence suggests that, like calpain I, calpain II may also contribute to the down-regulation or depletion of PKC.

Animals↗

PubMedDate not supplied

New assist method for orthotopic heart transplantation in the dog.

We used cross circulation as an assist method for orthotopic heart transplantation in eight dogs. Seven of the eight dogs could be extubated on the first to third postoperative day and were able to eat and walk several hours after extubation. The survival times and the causes of death in these eight dogs were as follows: 436 days (alive), 5 days (sudden death), 17 days (rejection), 17 days (pyothorax), 3 days (accidental death), 59 days (rejection), 19 days (pneumothorax), and 188 days (alive). None of the dogs died of any problems related to the use of cross circulation. Hematologic and biochemical studies revealed that the CK, CK-MB, LDH, GOT, GPT, and lactate levels increased shortly after the operation and returned to the preoperative values within 14 days. The blood urea nitrogen, creatinine, amylase, hematocrit, and total protein levels remained almost unchanged. No free hemoglobin was detected. These findings indicated that no severe damage occurred to the recipient's organs. The key factors for performing successful cross circulation are as follows: (1) The body weight of the support dog should be at least three times that of the recipient. (2) The systolic pressure of the support dog and the pressure gradient between the support and the recipient should be kept above 150 mm Hg and 50 mm Hg, respectively. (3) The flow rate in the arterial tube should be maintained at between 30% and 50% of the basal cardiac output of the recipient. In conclusion, cross circulation is a suitable assist method for orthotopic heart transplantation in the dog.

Animals↗