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Biomedical subjects

K Saitoh

Publications and source records attributed to K Saitoh.

At least 217 records · Page 12Linked to original sources
PubMed1994

[The effects of continuous interpleural vs. epidural infusion for postoperative pain relief following thoracotomy].

We studied whether continuous interpleural infusion of bupivacaine would be effective in alleviating pain after thoracotomy compared with effect of continuous epidural infusion of bupivacaine and buprenorphine. Twenty patients who had received thoracotomy and lobectomy were randomly divided into two groups to receive continuous interpleural infusion (IP group) of 0.5% bupivacaine at the rate of 5 ml.h-1 or continuous epidural infusion (E group) of 0.25% bupivacaine and 0.025 buprenorphine at the rate of 1 ml.h-1. The patients assessed their level of pain using a 100 mm visual analog scale (VAS) at rest and on coughing or changing the posture, verbal descriptor pain scale (VDPS), and times of supplemental analgesic. Assessment was performed at 7 points (mornings and evenings) for 3 postoperative days. In the evening of the day of surgery, VAS at rest in IP group was significantly higher than one in E group, but VASs at rest were similar in both groups from the first postoperative day to the third postoperative day. VAS on coughing or changing the posture in IP group was significantly higher than in E group in the evening of the day of surgery, and VASs on coughing or changing the posture in IP group were higher than in E group for 3 postoperative days. Supplemental analgesics were administered significantly more often than in E group in the evening of the first postoperative day. We conclude that continuous interpleural infusion does not give better analgesia than continuous epidural infusion after thoracotomy.

Adult↗
PubMed1994

[Changes in plasma concentrations of human hepatocyte growth factor before and after major intra-abdominal surgery under nitrous oxide-sevoflurane anesthesia].

The measurements of human hepatocyte growth factor (hHGF) in plasma and liver function tests were performed in 23 patients before and after major intra-abdominal surgery under nitrous oxide-sevoflurane anesthesia. Plasma concentrations of hHGF in 12 patients with normal liver function (Group 1) and in 11 patients with liver dysfunction (Group 2) were 0.34 +/- 0.07 and 0.44 +/- 0.12 ng.ml-1 (mean +/- SD) before the surgery, respectively. After the surgery, plasma concentration of hHGF remained unchanged in Group 1, but significantly increased to 0.61 +/- 0.32 ng.ml-1 in Group 2. Other routine laboratory data reflecting hepatic functions remained unchanged in both groups. These results suggest that liver damage during surgery and anesthesia occurs more likely in patients with liver dysfunction than in patients with normal liver function, and hHGF can be a more sensitive indicator of hepatic damage than conventional liver function tests.

Abdomen↗
PubMed1994

[Effects of repeated sevoflurane anesthesia on hepatic and renal function in a pediatric patient].

A 10-yr-old boy with an injured lower extremity received sevoflurane anesthesia 5 times within 40 days. Laboratory tests for hepatic and renal function i.e., serum transaminase (glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, gamma-glutamyl transpeptidase), serum cholinesterase, plasma protein, serum cholinesterase, serum bilirubine, serum lactic dehydrogenase, serum prothrombin time, blood urea nitrogen, serum creatinine, beta 2-microglobulin, N-acetyl-D-glucosamidase and 24 hr-creatinine clearance remained within normal ranges throughout his perioperative period. Repeated sevoflurane anesthesia did not exert any adverse effect on hepatic and renal function in this patient.

Anesthesia, Inhalation↗
PubMed1994

[Effect of indomethacin as an adjunct to postoperative pain relief by continuous epidural infusion of bupivacaine and buprenorphine].

We examined the analgesic effects of indomethacin as an adjunct to postoperative epidural analgesia in 40 patients who underwent upper abdominal surgery. Twenty patients in control group were epidurally given 0.1 mg of buprenorphine in 8 ml of 0.25% bupivacaine immediately after surgery and subsequently infused 15 micrograms buprenorphine in 1 ml of 0.25% bupivacaine at a rate of 1 ml.h-1 for 48 h. The remaining 20 patients were rectally given 50 mg of indomethacin in addition to the same epidural method described above. The patients who did not need additional narcotics in the control and indomethacin groups were 45% and 80%, respectively (P < 0.05). In upper abdominal surgery, postoperative pain relief by epidural buprenorphine and bupivacaine plus rectal indomethacin was more effective than that by epidural buprenorphine and bupivacaine.

Abdomen↗
PubMed1994

[Effects of intravenous and intramuscular atropine on bradycardia during spinal anesthesia].

The effects of intravenous and intramuscular atropine on pulse rate have been studied in 40 patients undergoing gynecological surgery. Intramuscular atropine 0.5 mg was administered 30 min before induction of spinal anesthesia in 20 patients (i.m. group). Intravenous atropine 0.5 mg was administered immediately after induction of spinal anesthesia in 20 patients (i.v. group). Decrease in heart rate after spinal block was significantly less in i.v. group than in i.m. group. Although no one in i.v. group was given an additional atropine, 10% of the patients in i.m. group was given an additional atropine for bradycardia. Authors conclude that intravenous atropine has more significant effect on prevention of bradycardia during spinal anesthesia compared with intramuscular atropine.

Anesthesia, Spinal↗
PubMed1994

[Immunohistochemical study of VLA integrins in human gastric carcinoma].

Using an immunohistochemical technique, we investigated expression of collagen receptor VLA-2 integrin and laminin receptor VLA-6 integrin in human gastric carcinoma. The expression of VLA integrins was compared in carcinoma of each histologic type and invasion/growth pattern. VLA-2 and VLA-6 were expressed more weakly in undifferentiated carcinoma than in non-cancerous epithelium. Non-localized invasion was observed in 89% of undifferentiated carcinoma. In differentiated carcinoma, expression of VLA-2 was weak in the mucosal layer. In the submucosal layer, however, VLA-2 expression was significantly different according to the invasion/growth pattern (p < 0.01); weak expression of VLA-2 in the localized invasion type and strong expression of VLA-2 in the non-localized type. VLA-6 was strongly expressed in the mucosal and submucosal layers of the differentiated carcinoma, regardless of the invasion/growth pattern. The present study suggested that VLA-6 contributed to the histologic type and VLA-2 affected the invasion/growth pattern of the gastric carcinoma in varied manners according to the histologic type.

Carcinoma↗
PubMed1994

[Failures of lumbar epidural analgesia caused by transforaminal passage of an epidural catheter in two cases].

In one case, analgesia level obtained with a 20 ml of 1.5% mepivacaine was unilateral and inadequate. In the other case, an epidural catheter was inserted after a 20 ml of 2% mepivacaine was injected through a Tuohy needle. Toxicity by local anesthetic was induced by an overdose of local anesthetic through the catheter. In both cases, transforaminal passage of a catheter was confirmed by epidurogram with iohexol. If an epidural catheter is advanced beyond 5 cm into the epidural space, it may migrate outwards through the intervertebral foramen. Therefore, the insertion of an epidural catheter should be limited to 3-4 cm.

Adult↗
PubMed1994

[Continuous epidural buprenorphine for postoperative pain relief in upper abdominal surgery].

To evaluate postoperative analgesia and side effects of epidural buprenorphine, 100 patients who underwent upper abdominal surgery were divided into 5 groups. All patients were given initially 0.1 mg of buprenorphine in 8 ml of 0.25% bupivacaine in bolus. Following an epidural bolus, 20 patients in each group were given 0.25% bupivacaine alone (group A), 5 micrograms buprenorphine in 1 ml of 0.25% bupivacaine (group B), 8 micrograms buprenorphine in 1 ml of 0.25% bupivacaine (group C), 12 micrograms buprenorphine in 1 ml of 0.25% bupivacaine (group D), or 15 micrograms buprenorphine in 1 ml of 0.25% bupivacaine (group E) with a portable disposable device at a rate of 1 ml.h-1 for 48 h. The analgesic efficacy in group E was superior to that in groups A, B, C and D. No significant difference was found in the incidence of side-effect among 5 groups. Therefore, epidural buprenorphine 15 micrograms in 1 ml of 0.25% bupivacaine given to patients at a rate of 1 ml.h-1 was thought to be optimal for postoperative pain relief in upper abdominal surgery in terms of its efficacy and side effects. However, 35% of these patients required supplementary systemic analgesics in the early postoperative period.

Abdomen↗
PubMed1994

[Comparison of intraoperative complications between laparoscopic cholecystectomy by intraperitoneal insufflation and abdominal wall lifting].

We compared intraoperative circulatory and respiratory complications and changes in body temperature during laparoscopic cholecystectomy by intraperitoneal insufflation of carbon dioxide gas (24 cases) with those by abdominal wall lifting (16 cases). The abdominal wall lifting method tended to produce fewer complications than the intraperitoneal insufflation method, but not significantly. In conclusion, the former was thought to be safer than the latter.

Abdominal Muscles↗
PubMed1994

Effects of recombinant human soluble thrombomodulin (rhs-TM) on a rat model of disseminated intravascular coagulation with decreased levels of plasma antithrombin III.

We reported that recombinant human soluble thrombomodulin (rhs-TM) is effective for disseminated intravascular coagulation (DIC) in vivo, in mice and rats. In the present work, we investigated the effects of decreased plasma antithrombin III (ATIII) levels on anticoagulant effects of rhs-TM, as compared to findings with heparin, of which effect is lowered by the decreased plasma ATIII levels in patients with DIC. Rat plasma ATIII levels decreased when we mixed plasma with anti-rat ATIII antibody and the potential of heparin to prolong APTT or PT was markedly diminished. The potential of rhs-TM to prolong APTT and PT was not affected. In rats injected with anti-rat ATIII antibody, plasma ATIII levels decreased immediately. When the rats were infused with tissue factor (TF), DIC was induced. At doses of rhs-TM and heparin which were equally effective at inhibiting the decrease in platelet count and fibrinogen level in control rats treated with TF, only rhs-TM remained effective in preventing DIC in rats with reduced ATIII levels. Heparin was not effective when administered to these rats with reduced ATIII levels. Therefore, rhs-TM effectively inhibits coagulation independent of ATIII levels, in contrast to heparin, which depends on the ATIII level.

Animals↗
PubMed1994

[Spinal anesthesia for open reduction of tibial fracture in a patient with late cerebellar cortical atrophy].

We could successfully perform spinal anesthesia with bupivacaine for open reduction of tibial fracture in a patient with late cerebellar cortical atrophy (LCCA). LCCA is a very rare neurologic degenerative disorder localized chiefly in the cerebellum, and it may be followed by various complications. His postoperative course was uneventful, followed by no neurological complication. Regional anesthesia including spinal anesthesia seems to be safe for operations in patients with LCCA.

Anesthesia, Spinal↗
PubMed1994

[Effects of nephrectomy and interferon administration on immunological parameters in patients with renal cell carcinoma].

To study the changes in the subsets of peripheral blood lymphocytes before and after nephrectomy and interferon (IFN) therapy, 57 patients with renal cell carcinoma were divided into three groups; one group consisted of 16 patients with metastasis who had been administered IFN-alpha, one group consisted of 16 patients without metastasis who had been administered IFN-alpha, and the other consisted of 25 patients without metastasis who had not been administered IFN-alpha. Immunological parameters such as percentages of NK (Leu-11+ [Leu-7-) cells, percentages of activated CD4 (Leu-3a+ HLA-DR+) positive cells and percentages of activated CD8 (Leu-2a+ HLA-DR+) positive cells were examined by two color flow cytometry and the percentages of CD4 (Leu-3a+) positive cells, percentages of CD8 (Leu-2a+) positive cells values and the ratio of percentages of CD4 positive cells/percentages of CD8 positive cells were evaluated. The percentages of NK cells showed a tendency to decrease after nephrectomy and the administration of IFN-alpha. The percentage of CD4 positive cells showed a significant increase after the administration of IFN-alpha. The percentage of activated CD4 positive cells and the ratio of percentage of CD4 positive cells/percentage of CD8 positive cells showed a tendency to increase slightly. The percentage of CD8 positive cells and percentage of activated CD8 positive cells showed no particular changes. There was a specific correlation between the administration of IFN-alpha and the changes of percentage of CD4-positive cells and this suggests that the administration of IFN-alpha led to the increase of helper T cells.

Carcinoma, Renal Cell↗
PubMed1994

[Atropine has little significance as a premedication for spinal anesthesia].

Intramuscular atropine 0.5 mg as an anticholinergic premedicant for spinal anesthesia was studied in 14 patients. Twelve patients of a control group did not receive atropine. No significant difference was found between the groups with regard to changes in blood pressure during spinal anesthesia whose analgesic level reached T4. A significant difference was found between the groups with regard to changes in heart rate during spinal anesthesia, but the incidence of bradycardia below 60 beats.min-1 was similar between the groups. Intramuscular atropine 0.5 mg as a premedicant offered little vagal blockade of the heart during spinal anesthesia.

Adult↗
PubMed1994

[Responses of arterial pressure and heart rate to epidural anesthesia in controlled hypertensive patients].

We have compared the responses to thoracic epidural anesthesia in 14 controlled hypertensive patients with those in 36 normotensive patients. Arterial pressure and heart rate were measured on the day before surgery, before and after the establishment of the epidural anesthesia, during light general anesthesia combined with epidural anesthesia, and after extubation. No significant difference in systolic, diastolic and mean arterial pressures were found between hypertensive and normotensive patients on the day before surgery. Changes in systolic and mean arterial pressures were greater in hypertensive patients than in normotensive ones, but absolute values of systolic, diastolic and mean arterial pressures after the establishment of the epidural anesthesia were similar between hypertensive patients and normotensive ones. Although no significant difference was found between the groups with respect to the highest and lowest systolic arterial pressure during operation, systolic arterial pressure after extubation was significantly higher in hypertensive patients than in normotensive ones. These suggest that the combination of epidural and general anesthesia is a safe technique for patients with medically controlled hypertension.

Aged↗
PubMed1994

[Cardiac arrests probably induced by hypermagnesemia during anesthesia for caesarean section].

A 24-year-old pregnant woman was scheduled for Caesarean section during the 31st week of pregnancy. The patient had been treated with MgSO4 for premature labor and toxemia. During anesthesia, cardiac arrest occurred twice. The first cardiac arrest occurred immediately after induction of anesthesia and seemed to be due to combined effects of hypermagnesemia, thiopental and supine hypotensive syndrome. Three babies were delivered during cardiac massage. The second one occurred immediately after administration of methyl-ergometrine malate and seemed to be due to combined effects of hypermagnesemia and methyl-ergometrine malate. The patient and three babies did not develop any complication. In giving anesthesia for patients with hypermagnesemia, anesthetists should take account of interactions between magnesium, anesthetics and other drugs.

Adult↗
PubMed1993

5-Fluorouracil increases susceptibility of renal cell cancer cell lines to lymphokine-activated killer cells: evidence for alteration not at the level of recognition but at a post-binding stage of the lytic cycle.

To investigate the usefulness of 5-Fluorouracil (5FU) for combination with immunotherapy, we examined the effect of preincubation with 5FU on the susceptibility of a renal cell cancer (RCC) cell line, ACHN, to lymphokine-activated killer (LAK) cells. A 4-h 51Cr release assay showed a remarkable increase in the susceptibility of ACHN cells to LAK cells. Dose response experiments demonstrated that 5FU at concentrations as low as 0.002 microgram/ml increased susceptibility to LAK cells. Presence of 5FU at 2 micrograms/ml but not at 0.2 microgram/ml in media blocked LAK activity induction by IL-2. Furthermore, an adhesion assay showed that preincubation with 5FU did not alter the adhesion of LAK cells to tumor cells nor the expression of intercellular adhesion molecule-1 (ICAM-1), lymphocyte function-associated antigen-3 (LFA-3) or major histocompatibility complex (MHC) class I molecules on tumor cells. Cold target competition did not show any difference between 5FU-treated and untreated competitors. These results suggest that increased susceptibility of RCC cells to LAK cells due to preincubation with 5FU might depend on changes in intrinsic lysability involving a post-binding stage of the lytic cycle.

Antigens, Differentiation, T-Lymphocyte↗