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K Koga

Publications and source records attributed to K Koga.

At least 109 records · Page 6Linked to original sources
PubMed1999

[Effects of various lidocaine compounds on cuff pressure of a reinforced tracheal tube].

Effects of various lidocaine compounds on cuff pressure of a tracheal tube were studied. Thirty reinforced tracheal tubes (Mallinckrodt Medical, Ireland) were divided into five groups and the cuffs were treated with normal saline, 2% lidocaine jelly, plain lubricant jelly, 4% lidocaine solution or 8% lidocaine pump spray. The cuff pressures of each tube was measured with 5, 10, 15, and 20 ml of air at the time of 0, 30, 60, 90, and 120 min after the treatment. The cuff pressures with 20 ml of air (P20) were compared among the groups. Thirty min after the treatment on the cuffs, P20 of the tubes with lidocaine spray significantly decreased than that of the control tubes with normal saline. In 2 of 10 tubes on which lidocaine had been sprayed, the cuffs were damaged 90 min after the treatment. Any jelly or solution on the cuffs did not influence the cuff pressure-volume relationship. We conclude that lidocaine pump spray should not be used as a lubricant on the cuff of a reinforced tracheal tube.

Aerosols↗
PubMed1999

Culture in vector-averaged gravity environment in a clinostat results in detachment of osteoblastic ROS 17/2.8 cells.

Studies carried out in space flights and in altered gravitational environments have shown that exposure to altered gravity conditions results in alterations in cellular structure and function. In the present study, we used a clinostat to generate a vector-averaged gravity environment, and evaluated the responses of osteoblast-like ROS 17/2.8 cells subsequent to rotation at 50 r.p.m from 24 to 72 hr. We found that the cells started to detach during the first 24 hr of culture in clinostat, but not in stationary and horizontal rotation (the latter serving as a control for turbulence, shear forces and vibrations). At 24 hr, there was a significant decrease in the number of adherent cells under clino-rotation (2.75 +/- 0.5 x 10(5) in stationary culture versus 2.02 +/- 0.27 x 10(5) under clino-rotation), and 19.8% of adherent cells were trypan-blue positive when cultured in 2% fetal bovine serum. All the detached cells were trypan-blue positive. At 72 hr, the cells became confluent in all three groups. These results suggest that vector-averaged gravity could cause the death of osteoblasts during the first 24 hr of clino-rotation. We hypothesize that this cell death might play a role in the pathogenesis of osteoporotic bone loss as observed in actual space flight.

Animals↗
PubMed1999

Effects of vector-averaged gravity on NF-kappa B activation in human osteoblast-like cells.

We have recently demonstrated that a transcription factor, nuclear factor kappa B (NF-kappa B), plays a key role in the production of cytokine and cell adhesion molecules in osteoblastic cells. In the present study, we investigated the effects of vector-averaged gravity (clinostat rotation) on tumor necrosis factor (TNF)-alpha-induced activation of NF-kappa B in human osteoblastic HOS-TE85 cells. After a 72-hr clinostat culture, the cells were treated with TNF-alpha for 30 min. Electrophoretic mobility shift assay using the nuclear extracts revealed that the DNA-binding activity of NF-kappa B was substantially reduced in clinostat-cultured cells compared with the stationary control. Concomitantly, the transactivation of NF-kappa B was examined by a transfection study. The cells were transfected with a plasmid expressing a luciferase reporter gene driven by multimerized NF-kappa B sites. They were cultured in the clinostat for 48-hr, followed by a 4-hr treatment with TNF-alpha. Clinostat culture resulted in a significant decrease in the luciferase activities, being consistent with the decreased binding of NF-kappa B. These results indicate that exposure of HOS-TE85 cells to vector-averaged gravity impairs NF-kappa B activation by TNF-alpha.

DNA↗
PubMed1998

Blockade of ATP-sensitive K+ channels attenuates preconditioning effect on myocardial metabolism in swine: myocardial metabolism and ATP-sensitive K+ channels.

OBJECTIVE: We investigated if blockade of ATP-sensitive K+ channels (KATP) abolishes the protective effect of ischemic preconditioning (IP) on myocardial metabolism and ischemia-induced reactive hyperemia (RH) in pigs. METHODS: IP was elicited by a single cycle of 5 min occlusion and 5 min reperfusion of coronary artery, followed by 15 min of test ischemia and 120 min of reperfusion. Vehicle or the ATP-sensitive K+ channels (KATP) blocker, glibenclamide (3 or 6 mg/kg; G3 or G6) was administered before IP (groups; IP, G3+IP, G6+IP). As respective controls, the same treatment was performed in groups without IP (groups; C, G3, G6). Tissue levels of ATP, creatine phosphate (CP) and intracellular pH (pHi) in the area at risk were measured by 31P-nuclear magnetic resonance spectroscopy. RH after 5 min of preconditioning ischemia was assessed by regional myocardial blood flow. RESULTS: ATP and pHi were preserved after 15 min of ischemia in the IP group [C/IP; ATP=57+/-4/76+/-10% of baseline, pHi=6.18+/-0.08/6.66+/-0.03, P<0.05, C vs. IP]. Both doses of glibenclamide completely abolished the ATP sparing effect of IP. The high dose completely abolished pHi preservation (G6+IP=6.33+/-0.06), while the low dose showed only a partial effect (G3+IP=6.48+/-0.03). Glibenclamide did not adversely affect myocardial metabolism in groups without IP. Glibenclamide attenuated RH after 5 min of ischemia by 30% in both subendocardium and subepicardium. CONCLUSIONS: Blockade of KATP abolished the preconditioning effect on myocardial metabolism, and partially attenuated post-ischemic reactive hyperemia in pigs. These results indicate that KATP activation might be involved in the mechanisms of these phenomena, reactive hyperemia is not sufficient to induce IP protection.

Adenosine Triphosphate↗
PubMed1998

Difference in the mechanisms for compensating ischemic acidosis in diabetic rat hearts.

To elucidate the difference in the mechanisms for alkalization during ischemic acidosis between diabetic and non-diabetic hearts, intracellular pH (pHi) was measured by phosphorus-31 magnetic resonance spectroscopy. Diabetes was induced by the injection of streptozotocin. The accumulation of proton ion (DeltaH+) during 15 min global ischemia at 37 degreesC was calculated from pH i. There were no significant differences in DeltaH+ between diabetic (DM: 0. 54+/-0.03 micromol/l,n=6; mean+/-s.e.m.) and non-DM hearts (0.57+/-0.04, n=6), when perfused with bicarbonate buffer. However, perfusion with HEPES buffer revealed a significant increase of DeltaH+ in DM (0.85+/-0.07, n=5) compared with non-DM (0.61+/-0.06, n=5P<0.05). On the contrary, the addition of a Na+/H+ exchange inhibitor (EIPA; 1 micromol/l) to bicarbonate buffer significantly increased DeltaH+ in non-DM (1.09+/-0.10, n=4) compared with DM (0.71+/-0.03, n=5P<0.01). Perfusion with HEPES buffer and EIPA equally increased DeltaH+ in both groups (DM 1.13+/-0.13, n=4; non-DM 1.15+/-0.14, n=4). Thus, the activity of Na+/H+ exchanger during ischemic acidosis, assessed as the increase of DeltaH+ induced by addition of EIPA to bicarbonate buffer, was higher in non-DM (0.52) than DM (0.17). In contrast, the contribution of bicarbonate-dependent systems evaluated by the deference of DeltaH+ between the bicarbonate buffer and the HEPES buffer was markedly bigger in DM (0.31) than non-DM (0.04). These results indicate that Na+/H+ exchange is a major mechanism to compensate ischemic acidosis in non-DM hearts, whereas bicarbonate-dependent systems compensate the depressed activity of Na+/H+ exchange in DM.

Acidosis↗
PubMed1998

Measurement of abdominal fat by magnetic resonance imaging of OLETF rats, an animal model of NIDDM.

We measured abdominal fat masses (intra-abdominal visceral fat summing retroperitoneal, mesenteric, and epididymal fat and subcutaneous fat) and analyzed abdominal fat distribution of Otsuka Long-Evans Tokushima Fatty (OLETF) rats with non-insulin-dependent diabetes mellitus and control strain Long-Evans Tokushima Otsuka (LETO) rats using magnetic resonance imaging. Intra-abdominal visceral and subcutaneous fat were highly correlated with body weight both in OLETF and in LETO rats. Both intra-abdominal visceral and subcutaneous fat of OLETF rats significantly accumulated compared with those of LETO rats. Intra-abdominal visceral fat mass correlated positively with subcutaneous fat mass, and the accumulation of intra-abdominal visceral fat mass was about 3.5 times that of subcutaneous fat. Thus, obesity of OLETF rats was characterized by marked accumulation of intra-abdominal visceral fat compared with that of subcutaneous fat. Body weight and abdominal fat of OLETF rats were closely correlated with the level of total plasma glucose measured by oral glucose tolerance test. However the ratio of intra-abdominal visceral to subcutaneous fat of OLETF rats was not correlated with the level of total plasma glucose.

Abdomen↗
PubMed1998

Dynamics of the carbohydrate chains attached to the Fc portion of immunoglobulin G as studied by NMR spectroscopy assisted by selective 13C labeling of the glycans.

A systematic method for 13C labeling of the glycan of immunoglobulin G for NMR study has been developed. A mouse immunoglobulin of subclass IgG2b has been used for the experiment. On the basis of chemical shift and linewidth data, it has been concluded that (1) the mobility of the carbohydrate chain in IgG2b is comparable to that of the backbone polypeptide chain with the exception of the galactose residue at the nonreducing end of the Man alpha 1-3 branch, which is extremely mobile and (2) agalactosylation does not induce any significant change in the mobility. The results obtained indicate that even in the agalactosyl from the glycans are buried in the protein. Biological significance of the NMR results obtained is also briefly discussed.

Animals↗
PubMed1998

Respiratory complications associated with tracheal extubation. Timing of tracheal extubation and use of the laryngeal mask during emergence from anaesthesia.

Sixty patients were randomly allocated to one of three groups and the incidences of respiratory complications which occurred during emergence from anaesthesia were compared under the following three circumstances: tracheal extubation after the patient had regained consciousness (awake group); tracheal extubation while the patient was still anaesthetised (anaesthetised group); and the use of the laryngeal mask during emergence from anaesthesia (mask group). In the mask group, the laryngeal mask was inserted under deep anaesthesia before tracheal extubation and the lungs were ventilated through the laryngeal mask after tracheal extubation. In the awake group, straining (bucking) occurred in 18 patients and desaturation (arterial oxygen haemoglobin saturation < 95%) in two patients. In the anaesthetised group, airway obstruction occurred in 17 patients and desaturation in one of these patients. In the mask group, ventilation through the laryngeal mask was temporarily difficult immediately after tracheal extubation in one patient and coughing occurred before removal of the mask in three patients. No respiratory complications occurred in two patients in the awake group, three patients in the anaesthetised group and 16 patients in the mask group. The incidence of respiratory complications during recovery from anaesthesia was significantly lower in the mask group than in the other two groups (pooled) (p << 0.001). Therefore, the use of the laryngeal mask after tracheal extubation decreases the incidence of respiratory complications during recovery from anaesthesia.

Adolescent↗
PubMed1998

The cuffed oropharyngeal airway. Its clinical use in 100 patients.

We studied the efficacy of the cuffed oropharyngeal airway in 100 patients. Insertion of the airway after induction of anaesthesia with propofol was easy in 95 of 100 patients, moderately difficult in four patients and failed in one patient. Complications, such as coughing, gagging or body movement, occurred during induction and insertion in 15 patients. Insertion of the airway was not associated with tachycardia or hypertension. Manual ventilation through the airway was easy in less than 30% of patients immediately after insertion. Manual ventilation became easier after adjusting the position of the patient's head, neck or jaw. During spontaneous breathing, adjustment of the head, neck or jaw was required in 30% of patients. Complete airway obstruction occurred in one patient after insertion of the device and in two patients during maintenance of anaesthesia. The airway was left in place during emergence from anaesthesia in the remaining 97 patients. No complications occurred in 91 patients and coughing occurred in the remaining six patients before or during removal of the airway. No regurgitation, vomiting or laryngospasm occurred in any patient at any time. Therefore, the cuffed oropharyngeal airway has a potential use in anaesthetised patients who are breathing spontaneously.

Adolescent↗
PubMed1998

Evaluation of Mini Mental State Examination and Brief Psychiatric Rating Scale on aged schizophrenic patients.

Mini Mental State Examination (MMSE), Brief Psychiatric Rating Scale (BPRS) and subscales of the BPRS were performed on 73 elderly inpatients (mean age: 67.9 years; standard deviation: 7.2; range: 60-89) diagnosed with DSM-III-R chronic schizophrenia. Forty of the subjects were men and 33 were women. A significant negative correlation was observed between MMSE and the age, factor negative, factor depressive, and total score of BPRS. We believe, however, that it is relatively sufficient to screen for demented illness of schizophrenics using MMSE when considering the age and the psychiatric symptoms (especially negative or depressive symptoms ). Forty-eight (66%) of the 73 patients were categorized as 'demented' by MMSE. These results suggest that the aged inpatients with schizophrenia in a hospital showed certain kinds of cognitive deficits (including senile dementia) more frequently than the general population.

Aged↗
PubMed1998

Appropriate size and inflation of the laryngeal mask airway.

We have compared size 3 and size 4 laryngeal masks in 30 females and size 4 and size 5 in 30 males for success rate of insertion, incidence of airleak and pressure exerted on the pharynx. First, the ex vivo volume-pressure relationship of the mask was obtained. Second, after insertion of a mask, the cuff was inflated with the recommended maximum volume of air and intracuff pressure measured. Third, the incidence of airleak during a steady airway pressure of 18 cm H2O was noted. Fourth, the cuff was deflated until it just prevented airleak, and cuff pressure was measured. The mask was removed, the other size was inserted and the same procedure repeated. At the end of operation, final in vivo and ex vivo pressures were measured. The pressure exerted on the pharynx was calculated as the difference between ex vivo and in vivo intracuff pressures. It was always possible to insert both sizes in both sexes. In females, airleak occurred in 15 patients with the size 3 and in five patients with the size 4 (difference: P = 0.005) and in males, 21 patients with the size 4 and in four patients with the size 5 (P < 0.001). Removal of air to the minimum effective volume significantly decreased intracuff pressure and pressure on the pharynx; on removal of the mask, pressures were similar to, or lower than, initial pressures. Therefore, a larger mask (size 4 in females and size 5 in males) provided a better seal than a smaller size without producing higher pressures on the pharynx.

Adolescent↗
PubMed1998

Respiratory complications associated with tracheal intubation and extubation.

We conducted a prospective survey on the incidence of respiratory complications associated with tracheal intubation and extubation in 1005 patients who underwent elective general anaesthesia over a 4-month period. During induction of anaesthesia, respiratory complications occurred in 46 patients (4.6%; 95% confidence limits (CL): 3.3, 5.9%). The common complications were coughing (1.5%) and difficult ventilation through a facemask (1.4%). Tracheal intubation was difficult in eight patients (0.8%). Complications occurred immediately after tracheal extubation in 127 patients (12.6%; 95% CL: 10.6, 14.7) and in the recovery room in 95 patients (9.5%; 95% CL: 7.6, 11.3%). The common complications immediately after extubation were coughing (6.6%) and oxygen desaturation (SaO2 < 90%) (2.4%), and in the recovery room, airway obstruction (3.8%) and coughing (3.1%). The incidence of complications was significantly higher immediately after tracheal extubation than during induction of anaesthesia (P << 0.001). Even when all incidents of coughing that occurred after tracheal extubation were disregarded as a complication, the overall incidence was still higher immediately after extubation (7.4%) than during induction of anaesthesia (P < 0.01). We conclude that the incidence of respiratory complications associated with tracheal extubation may be higher than that during tracheal intubation.

Adolescent↗
PubMed1998

Effects of fatty acid sucrose esters on ceftibuten transport by rat intestinal brush-border membrane vesicles.

The effects of fatty acid sucrose esters on membrane lipid dynamics and ceftibuten transport by rat intestinal brush-border membrane vesicles (BBMV) were examined to clarify the differences in the action of mono- and poly-acyl sucrose esters on the drug transport. Fatty acid sucrose mono-acyl ester (SS) inhibited ceftibuten transport by BBMV similar to the action of polyoxyethylene sorbitans (Tweens), while fatty acid sucrose polyacyl ester mixtures (F-160 and F-140) did not affect the drug transport by BBMV. SS but not F-160 and F-140 caused an increase in the anisotropy of 1,6-diphenyl-1,3,5-hexatriene (DPH)- and 1-(4-trimethylammoniumphenyl)-6-phenyl-1,3,5-hexatriene iodide (TMA-DPH)-labeled BBMV in a concentration-dependent manner. Thus, the uptake of ceftibuten by BBMV was strongly correlated with the lipid fluidity of BBMV, in the outer layer and in the inner hydrophobic regions; however, there was no strong correlation between the membrane lipid fluidity and the drug uptake by BBMV. The micelle size and the size distribution of F-160 and F-140 were larger and more widely dispersed, respectively, compared to those of SS and Tweens. These results suggest that the effects of fatty acid sucrose esters on ceftibuten transport by BBMV are related to the dispersion parameter of these pharmaceutical adjuvants.

Animals↗
PubMed1998

Clinical aspects of cryptogenic hepatocellular carcinoma.

Clinical features of hepatocellular carcinoma in 22 patients without serum HBsAg, HBV DNA, anti-HCV antibody and HCV RNA were characterized and possible pathogenic factors for this cryptogenic hepatocellular carcinoma were prospectively assessed. Twenty-two patients were selected from 434 patients with hepatocellular carcinoma (HCC) who were treated at the Second Department of Internal Medicine, Kurume University Hospital between January 1994 and December 1996. Serum samples collected from these patients were all negative for HBsAg, HBV DNA, anti-HCV antibody, and HCV RNA. Patients were evaluated based on past history, present illness, history of habitual alcohol consumption, results of the serological and biochemical laboratory tests at diagnosis of HCC, Anti-HBc antibody, autoantibodies, GBV-C/HGV RNA, and histopathologic findings of non-cancerous portion of the liver were also evaluated. Among 22 patients with non-B non-C HCC, 16 patients (72.7%) had a history of alcoholic liver disease, 6 patients had an infection of schistosomiasis Japonica, and 1 patient had Budd-Chiari syndrome. Nine patients (40.9%) were positive for anti-HBc antibody, but their titers were low in all cases. Among 22 patients, positive for auto antibody, 7 patients (31.8%) were positive for anti-nuclear antibody, and 17 patients (77.3%) were positive for anti-smooth muscle antibody. Only 1 patient was positive for GBV-C/HGV RNA. Histopathologic examination was performed in 3 cases for non-cancerous portions of the liver. Liver cirrhosis and liver with passive congestive fibrosis were diagnosed in 2 cases each. The remaining one case showed normal feature of the liver. In conclusion, the majority of the 22 patients with non-B non-C HCC had a history of alcoholic liver disease. Many were also positive for auto antibodies. These results suggest that patients with alcoholic liver disease or hepatic disease with autoantibodies may be defined as the high-risk group of developing non-B non-C HCC and should be periodically underwent a complete medical examination.

Aged↗
PubMed1998

A patient with Paget's disease of bone treated with etidronate disodium.

A 69-year-old Japanese woman was referred to our hospital because of abnormal skull X-ray findings. Serum total alkaline phosphatase, bone-specific alkaline phosphatase 3, osteocalcin and propeptide carboxyterminal of type I procollagen (PICP) levels were markedly elevated. Urinary excretion of hydroxyproline was also increased, suggesting that both bone formation and resorption were accelerated. Radiography of the skull showed "cotton wool" appearance. T1-enhanced MRI revealed that the skull-cap and diploe were swelled up. In 99mTc-MDP bone scintigraphy, all areas of the skull and a part of the right hemipelvis showed high uptake of the radioisotope. Based on the findings we made diagnosis of Paget's disease of bone which is a rare bone disorder in Japanese. Three-month oral administration of etidronate disodium resulted in normalization of serum PICP levels and urinary hydroxyproline excretion, whereas alkaline phosphatase levels were only partially lowered. Levels of the markers of bone turnover remained normal during a follow-up period of 3 months after the discontinuation of the treatment.

Aged↗
PubMed1998

Apparent body tilt and postural aftereffect.

Apparent orientation of the body tilted laterally in the frontal plane was studied with the methods of absolute judgments in four experiments. In Experiment 1, 17 subjects, who maintained the normal adaptation of body to gravity, estimated their body tilts under the condition of seeing the gravitational vertical and under the condition of eliminating it. The results showed that (1) there was not a significant difference between the two conditions and (2) the small tilts of less than 45 degrees were exactly estimated, whereas the large tilts of 45 degrees-108 degrees were overestimated. In Experiment 2, 10 subjects estimated their body tilts under three velocities of a rotating chair on which each subject was placed. Although both body tilt and chair velocity were found to influence tilt estimation, the effect of body tilt was overwhelmingly greater than that of chair velocity. In Experiment 3, 11 subjects adapted their bodies to a 72 degrees left tilt for 10 min and then estimated various body tilts around the adapting tilt. The estimations obtained under the 72 degrees adaptation were lower than those obtained under the 0 degree adaptation, and this reduction was greater for the test tilt that was farther away from the adapting tilt. In Experiment 4, 11 subjects adjusted their own body tilts to designated angles. The results confirmed the outcomes of absolute estimation in Experiments 1-3. From these findings and past literature, the judgments of body tilt were considered to be subserved by a single sensory process that was based on the cutaneous and muscular proprioceptors, rather than the vestibular and joint proprioceptors.

Adult↗