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Biomedical subjects

K Shingu

Publications and source records attributed to K Shingu.

194 records · Page 11Linked to original sources
PubMed1981

Antianalgesic action of thiamylal sodium in cats.

The effects of thiamylal on the nociceptor-driven neural activity in the spinal cord were studied in decerebrate, non-anesthetized cats. Noxious stimulation was induced by the injection of bradykinin into the femoral artery and the neutral response in the lateral funiculus was measured by the multi-unit activity technique. The effects of thiamylal on the bradykinin-induced response were compared before and after the spinal cord transection, above the recording site. Thiamylal, 5 mg/kg i.v., potentiated the response significantly before the cord transection and depressed it after the transection. These findings indicate that the antianalgesic action of thiamylal is induced at the spinal cord level: although this anesthetic agent does have a direct intraspinal depressant action, the multisynaptic neural network of the supraspinal pain inhibition system is more susceptible to the actions of anesthetics, and the depression of this descending system by thiamylal results in a release of spinal cord nociceptive neural mechanisms from the supraspinal control.

Animals↗
PubMed1981

Naloxone does not antagonize the anesthetic-induced depression of nociceptor-driven spinal cord response in spinal cats.

The effects of several anaesthetics on spinal cord nociceptive neural mechanisms and their interactions with the opiate antagonist, naloxone, were studied in acute, spinal cord transected cats. Intra-arterial injection of bradykinin was used as the noxious test stimulus. Spontaneous activity and the neural response induced by bradykinin were recorded by the multi-unit activity technique in the lateral funiculus of the spinal cord. Naloxone, 0.1 or 2.0 mg/kg i.v. had little effect on the bradykinin-induced response, but enhanced the spontaneous firing of the lateral funiculus significantly. Fentanyl, 30 micrograms/kg i.v., depressed both the bradykinin-induced response and spontaneous firing. These effects of fentanyl were antagonized completely by naloxone, 0.1 mg/kg i.v. Nitrous oxide, thiamylal, halothane and ether depressed the bradykinin-induced response considerably, but it was not antagonized by naloxone, 0.1-2.0 mg/kg i.v. Enflurane had little effect on the bradykinin-induced response. The effects of these anesthetics on spontaneous firing were divergent: nitrous oxide enhanced it while other drugs depressed it, to various degrees. All these data suggest that the neural and/or neurochemical mechanisms of anesthetic-induced analgesia differ from mechanisms related to opioids.

Anesthetics↗
PubMed1981

Epileptic cases of late onset with the diffuse slow spike-wave.

Twenty-two cases with the diffuse slow spike-wave, whose onset of clinical symptoms was at the age of seven or later, were examined. Half of them presented symptoms pertinent to the Lennox-Gastaut syndrome. The other half were cases of absence, psychomotor seizure or grand mal. The former group was distinguished from the latter in that it had worse prognoses concerning the seizure and intelligence, and discussions were held to see if it corresponds to the "Lennox-Gastaut syndrome of late onset" (Lipinski). Atypical absence and atonic seizure were the commonest symptoms in this group, and they, preceded by other types of seizures such as grand mal, developed mostly in adolescence, and their appearance was closely followed by that of the slow spike-wave on the EEG.

Adolescent↗
PubMed1980

Uncontrollable cases of absence.

Forty-three cases of absence seizure were studied from the viewpoint of prognosis. thirty-three had been seizure-free for at least one year until the time of follow-up. The remaining 10 cases were uncontrollable and their plasma levels of the drugs were measured. The following characteristics were more significantly found in the uncontrollable group: (1) late onset (14 years old or later) (2) preceding grand mal seizures (3) accompanying automatisms. The above three factors were found to be interrelated. (4) concomitant grand mal seizures of sleep or diffuse (other than awakening) type (5) psychological disturbances (low intelligence, circuitous character) and (6) chronological shift to the Lennox-Gastaut syndrome.

Adolescent↗
PubMed1979

Three cases of unipolar delusional depression responsive to L-dopa.

We reported three cases of unipolar delusional depression which took a characteristic two-stage clinical course. Anxiety and agitation with persecutory delusions predominated the picture at first, but they were soon replaced by severe psychomotor retardation or stupor associated with delusions of poverty and guilt. The administration of L-Dopa in the latter stage brought about a rapid improvement both in mood and psychomotor activity. We considered these cases in the light of the recent biochemical studies on affective psychosis.

Adult↗
PubMedDate not supplied

Surgical strategies for differentiated carcinoma of the thyroid isthmus.

The postoperative outcome (including clinicopathologic features) in 19 patients with differentiated thyroid cancer of the isthmus was investigated to develop more appropriate surgical strategies for these lesions. The extent of thyroidectomy, including neck dissection, tumor size, nodal involvement, and other clinical features were evaluated. The incidence of intraglandular dissemination was about 16% in all patients. Analysis of regional node metastatic distribution revealed no definite metastatic pattern. In addition, there was no apparent correlation between tumor size and nodal involvement. Two of the six patients who underwent total thyroidectomy suffered permanent postoperative hypoparathyroidism. It is thus recommended that isthmusectomy, including an adequate edge of surrounding normal thyroid tissues of each lobe and modified or limited neck dissection when cervical nodes are palpably enlarged, is sufficient as an appropriate primary surgical procedure for differentiated carcinoma of the thyroid isthmus.

Adenocarcinoma↗
PubMedDate not supplied

Management of tracheal wall resection for thyroid carcinoma by tracheocutaneous fenestration and delayed closure using auricular cartilage.

BACKGROUND: In the case of advanced thyroid carcinoma invading the trachea, surgical procedures for tracheal resection are selected in relation to the degree of invasion. We created a tracheocutaneous fenestration that was later closed with a free auricular cartilage autograft. We present a simple and effective method for permanent closure of tracheostoma. METHODS: The surgical procedure for delayed closure consists of three steps: (1) preparing the hinge flap with additional undermining of the subcutaneous layer and the strap muscles; (2) removing a portion of the conchal cartilage from the auricle, which is easily performed with a semicircular skin incision along the anthelix of the ear; and (3) placing the conchal cartilage with its convex surface upward just over the sutured hinge flap layer. RESULTS: Under local anesthesia, we successfully employed this reconstructive procedure for 5 patients. Unfortunately, however, in one patient, we had to reopen the closed tracheocutaneous fenestration on the second postoperative day because of an acute problem that was independent of the closure surgery. Four patients remain in satisfactory condition for more than 2 years since the closure of tracheostoma. CONCLUSIONS: The auricular cartilage free graft is a relatively simple procedure which supplies tracheal wall skeletal support for the permanent closure of the tracheocutaneous fenestration.

Aged↗
PubMedDate not supplied

Expression of basic fibroblast growth factor in thyroid disorders.

Morphologic and biologic studies were undertaken to clarify the biologic significance of basic fibroblast growth factor (bFGF) in human thyroid neoplasms. A total of 71 malignant tumors (50 papillary carcinomas, 14 follicular carcinomas, 7 anaplastic carcinomas), 11 follicular adenomas, 6 adenomatous goiters, and 6 Graves' disease tissues were examined employing immunohistochemical methods (avidin-biotin-peroxidase complex technique). An affinity-purified polyclonal rabbit antiserum to human bFGF was used as a primary antibody. The eluate of malignant thyroid tumor tissues from the heparin-Sepharose column was examined by Western blot analysis to elucidate the molecular weight form. With immunohistochemical staining, bFGF was frequently detected in the cytoplasm of malignant thyroid tumors compared to tissues of the benign diseases and normal controls. With anaplastic carcinoma, immunoreactivity of the tumor cells was particularly strong. In the correlative analyses between UICC TNM classification and bFGF staining in papillary carcinoma, there were significant differences when relating positive staining to the grade of nodal metastases. By Western blot analysis, the bFGF immunoreactivity was specifically detected in the two forms, with molecular weights of 18 and 33 kDa. The high-molecular-weight form was detected in only anaplastic carcinoma. The present investigations demonstrated a close correlation between the expression of bFGF and the degree of malignancy. bFGF might play an important role in promoting lymph node metastases. Moreover, the high-molecular-weight form of bFGF might have an intense influence on tumor growth.

Adenocarcinoma, Follicular↗
PubMedDate not supplied

Airway obstruction in a child with asymptomatic tracheobronchomalacia.

PURPOSE: To report a case of airway obstruction with hypoxia during emergence from anesthesia due to unexpected tracheobronchomalacia in a child. CLINICAL FEATURES: In a previously healthy 22-month-old boy with no symptoms or signs of respiratory disease, general anesthesia was induced by inhalation of increasing concentrations of sevoflurane (up to 5%) in oxygen and a laryngeal mask was inserted. Partial airway obstruction persisted during surgery, but obstruction was relieved by positive-pressure ventilation. During emergence from anesthesia, airway obstruction with hypoxia occurred, necessitating tracheal intubation. Emission of carbon dioxide as well as of sevoflurane was reduced and emergence from anesthesia markedly delayed. Fibreoptic tracheoscopy showed marked collapse of the tracheobronchi during expiration, and a diagnosis of tracheobronchomalacia was made. No respiratory complications occurred postoperatively. CONCLUSION: Asymptomatic tracheomalacia should also be suspected in case of airway obstruction during anesthesia in young children.

Airway Obstruction↗
PubMedDate not supplied

Secondary malignant lymphoma which simulated primary thyroid cancer.

A patient with secondary thyroid lymphoma who complained of a neck mass was presented. Multiple nodules were detected in both lobes of the thyroid gland, which appeared as homogeneous hypoechoic masses on ultrasonogarphy (US), low-density masses on computed tomography (CT), and areas of increased uptake on gallium-67 scintigraphy. The residual thyroid gland was normal. Surgery established a diagnosis of secondary thyroid lymphoma with no coexistent Hashimoto's thyroiditis but with cervical node involvement by lymphoma. Radiologic evidence of normal residual thyroid gland in a patient with thyroid lymphoma may be a sign of secondary thyroid lymphoma.

Adult↗
PubMedDate not supplied

Tetraphasic actions of local anesthetics on central nervous system electrical activities in cats.

BACKGROUND AND OBJECTIVES: The effects of seven local anesthetics, mepivacaine, bupivacaine, etidocaine, dibucaine, prilocaine, procaine, and tetracaine, on the central nervous system (CNS) electrical activities were studied in five cats with each agent. METHODS: Brain electrodes were implanted chronically in the cortex, amygdala, hippocampus, and midbrain reticular formation. The cortical, amygdala, and hippocampus electroencephalograms (EEGs), reticular multiunit activity (R-MUA), and heart rate were recorded. Drugs were administered intravenously with constant rates of equipotent doses until EEG seizures appeared. Effects of lidocaine, 1 mg.kg-1.min-1, were studied for comparison. The rates of infusion were: mepivacaine, 1 mg.kg-1.min-1; procaine, 4 mg.kg-1.min-1; bupivacaine and tetracaine, 0.25 mg.kg-1.min-1; etidocaine, 0.5 mg.kg-1.min-1; dibucaine, 0.15 mg.kg-1.min-1; and prilocaine, 3 mg.kg-1.min-1. The effects of 10-15 times higher rates of infusion were also studied in two cats with each drug. RESULTS: During the slow rates of infusion, a tetraphasic sequence of changes, common to all agents, was observed: the initial stage represented by diffuse EEG slowing and a suppression of the R-MUA; the second stage by low voltage fast wave EEG and an activation of the R-MUA; the third stage by reappearance of slow wave EEG and a suppression of the R-MUA; and the fourth stage by an epileptiform EEG and an activation of the R-MUA. These changes in EEG were not typical in some cats administered procaine, bupivacaine, prilocaine, and dibucaine. During the high rates of infusion, suppressive stages in the R-MUA were less dominant and activations dominated. High rates of infusion of mepivacaine produced sudden epileptic activities in EEG. Tetracaine, procaine, etidocaine, and bupivacaine in the high rates of infusion produced slow waves for a short period, prior to seizure activities in the EEG. Dibucaine or prilocaine in high rates of infusion could not produce seizure activities in the EEG, but slow waves and isoelectrical EEG, which were accompanied with idioventricular rhythm followed by ventricular fibrillation. CONCLUSIONS: All local anesthetics have similar tetraphasic CNS actions and whether the expression of CNS intoxication with subconvulsive doses is excitation or suppression may possibly be dependent on the brain drug level and its rate of increase.

Anesthetics, Local↗