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Biomedical subjects

M Endo

Publications and source records attributed to M Endo.

At least 523 records · Page 29Linked to original sources
PubMed1994

[Effects of solvent, baricity and dextrose concentration of 0.5% tetracaine solution on the efficacy of spinal anesthesia].

In 108 spinal anesthetic cases, 2.36 ml of each of five 0.5% tetracaine solutions, either with distilled water (DW), normal saline (NS) or different concentrations of dextrose (2.5%-2.5 G, 5%-5 G, 10%-10 G) was injected intrathecally at the L2/3 or L3/4 interspace. The specific gravity and osmotic pressure of these solutions and cerebrospinal fluid were measured. The cephalad spread of analgesia was greater with higher concentration of dextrose (5 G-Th7.4, 10 G-Th6.0), compared with DW, NS and 2.5 G (Th9.5-9.8). The variation of the maximum level of analgesia was large with DW and NS. The time to complete motor block of both legs were longer with DW and NS than with dextrose containing solutions. The hemodynamic changes after intrathecal injection were small with 2.5 G, DW and NS. Arterial hypotension requiring treatment occurred with 5 G and 10 G. The baricity of spinal anesthetic solution had an important effect on characteristics of the blockade.

Adult↗
PubMed1994

[Clinical experience of autotransfusion of shed mediastinal blood using a new device].

Autotransfusion of shed mediastinal blood is expected to be adopted as a technique to reduce transfusion thus preventing various complications such as hepatitis, AIDS, and GVHD. We report the usefulness and problems of a new device-Solcotrans Plus, which only requires connection to wall suction. This device consists of three parts: suction, reservoir bag, and filter for autoinfusion. After setting the suction and reservoir bag primed with anticoagulant, ACD or heparin, and connecting the unit to a wall suction, we performed autotransfusion of shed blood through the filtration component in ICU after operation. Postoperative hematological and biochemical examinations revealed no complications or adverse effects of autotransfusion. This device is available, simple to handle, and is useful for returning shed blood. We believe that this device will be effective for non-blood open heart surgery or reduction of transfusion.

Aged↗
PubMed1994

[Combined operations of coronary artery bypass grafting using the right gastro-epiploic artery and other abdominal operation].

We carried out combined operation of coronary artery bypass grafting using the right gastro-epiploic artery (GEA) and other abdominal operation in four patients. The abdominal operation were one total gastrectomy for double early gastric cancer, one bypass with Y-shaped graft for arteriosclerosis obliterans in iliac region and two peritoneal dialysis for chronic renal failure. There were no early death. The postoperative course was uneventful without any mediastinitis or other infectious events. Doing careful maneuver, we can use the GEA for grafts in such cases.

Aged↗
PubMed1994

Pathophysiologic role of endothelin-1 in renal function in rats with endotoxin shock.

BACKGROUND: We hypothesized that endothelin-1 (ET-1) is an important mediator in renal dysfunction under septic conditions. This study clarified the pathophysiologic role of ET-1 in renal function under conditions of surgical stress, especially sepsis. METHODS: We investigated the correlation between ET-1 levels and renal function and the effect of anti-ET-1 antibody (AwET-1N40) on renal function in a septic shock rat model. RESULTS: The plasma ET-1 level increased significantly at 30 minutes and remained significantly elevated for 24 hours, reaching a peak (195 +/- 24.4 pg/ml) 3 hours after the endotoxin (lipopolysaccharide derived from Escherichia coli) injection. Increases in plasma creatinine concentration and blood urea nitrogen (BUN) level and decreases in urine volume and urinary sodium excretion were also observed in the early phase after endotoxin injection. The plasma creatinine concentration and the plasma ET-1 level increased significantly at 30 minutes, reached a peak at 3 hours, and then decreased. Anti-ET-1 antibody administration (5 nmol/kg body, four times intravenously) decreased plasma creatinine concentration and BUN level and increased urine volume and urinary sodium excretion 3 hours after endotoxin injection (creatinine, p = 0.07; BUN, p < 0.05; urine volume, p < 0.01; urinary sodium excretion, p < 0.01; anti-ET-1 vs shams). CONCLUSIONS: These results suggest that the increase in endogenous ET-1 induced by sepsis plays an important role in renal dysfunction in the septic state.

Animals↗
PubMed1994

[Reoperations on valvular disease: an analysis of outcome].

To evaluate risks and complications of reoperation on valvular disease, we reviewed data on 186 patients who underwent reoperations because of prosthetic valve malfunctions, pregression of valvular disease after open mitral commissulotomy and previous valvular replacement. Overall hospital mortality was 4.8% (9/186 patients). The common causes of death was low cardiac output syndrome (3 pts.) and respiratory failure (3 pts.) and others (3 pts). Hospital mortality was different according to the risk factors. There was no significant difference between the operative procedures; AVR (6.2%), MVR (3.2%), DVR (8%), TVR (0%) and MVR + TVR (9%). Furthermore, advanced age, valve position, renal failure, preoperative %FS, LVDd and diagnosis of prosthetic valve malfunction did not appear to be significant risk factor. However, preoperative respiratory failure and emergency operation showed significant increase of hospital mortality in comparison with other factors. On the basis of this reports, hospital mortality and late survival indicated that reoperation should be performed early as the potentially safe condition.

Disease Progression↗
PubMed1994

[Seventy-seven coronary reoperations: incidence, indication and results].

As the number of patients who have undergone primary myocardial revascularization continues to burgeon, the number of potential candidates for a secondary myocardial revascularization has increased gradually. The number of secondary CABG at the Cleveland Clinic were performed, which represents 18% of the total CABG. However, the number of secondary CABG at The Heart Institute of Japan were performed, which represents of 5-10% of the annual CABG. There was one operative death (1.3%). The graft patency rate was 92.8%. Including non-cardiac death, the actuarial survival rate at 10 years was 88.2%, and events free rate including all deaths, the third time CABG, PTCA and myocardial infarction was 78.4% at 10 years.

Adult↗
PubMed1994

[Phrenic nerve injury following coronary artery bypass surgery: its clinical implication and management].

The hospital records of 80 patients undergoing coronary artery bypass surgery, including 19 patients using the "isolation pad", were reviewed to examine the prevalence of the phrenic nerve injury (PNI). All patients received ice slush for topical cooling during operation. The degree of the elevated diaphragm was evaluated objectively by "Diaphragmatic Elevation Index, DEI" calculated from the plain chest roentgenogram taken before and after the operation. Sixty-one patients without using the isolation pad were subdivided into 3 groups, mild (35), moderate (15), and severe (11) according to the degree of the elevated diaphragm, and compared along with those using the isolation pad. All groups could not be distinguished by clinical course. The degree of left diaphragmatic elevation was significantly high compared with that of right, but recovered significantly at discharge except 2 patients. Pulmonary complication was highly associated with the "severe" groups. Because PNI is often transient and of little clinical significance, it is sometimes neglected. But considering the high frequency of the development of pulmonary complication, proper protective measure should be undertaken. Utilization of the isolation pad was effective means in terms of protection of phrenic nerve.

Coronary Artery Bypass↗
PubMed1994

[Two cases of tuberculous constrictive pericarditis].

Case 1 was a 79-year-old male suspected of tuberculous constrictive pericarditis. He was admitted to our hospital because of surgical treatment. His heart failure was NYHA IV. Culture of pleural effusion and pericardial effusion was negative. But ADA level in pericardial effusion was found to be increased. So tuberculosis was suspected. Cardiac catheterization date was compatible with constrictive pericarditis. Case 2 was a 73-year-old female. She was admitted because of heart failure (NYHA IV). As RVP wave indicated dip & platou at cardiac catheterization, she was diagnosed as constrictive pericarditis. ADA level in pleural effusion increased. So tuberculosis was suspected as etiology of constrictive pericarditis. In both cases, after pericardiectomy, heart failure improved to NYHA I. Results of pathological examination were tuberculous inflammation.

Aged↗
PubMed1993

Critical intracellular Ca2+ concentration for all-or-none Ca2+ spiking in single smooth muscle cells.

Neurotransmitters induce contractions of smooth muscle cells initially by mobilizing Ca2+ from intracellular Ca2+ stores through inositol 1,4,5-trisphosphate (InsP3) receptors. Here we studied roles of the molecules involved in Ca2+ mobilization in single smooth muscle cells. A slow rise in cytoplasmic Ca2+ ([Ca2+]i) in agonist-stimulated smooth muscle cells was followed by a wave of rapid regenerative Ca2+ release as the local [Ca2+]i reached a critical concentration of approximately 160 nM. Neither feedback regulation of phospholipase C nor caffeine-sensitive Ca(2+)-induced Ca2+ release was found to be required in the regenerative Ca2+ release. These results indicate that Ca(2+)-dependent feedback control of InsP3-induced Ca2+ release plays a dominant role in the generation of the regenerative Ca2+ release. The resulting Ca2+ release in a whole cell was an all-or-none event, i.e. constant peak [Ca2+]i was attained with agonist concentrations above the threshold value. This finding suggests a possible digital mode involved in the neural control of smooth muscle contraction.

Animals↗
PubMed1993

Purification of a human cytochrome P-450 isozyme catalyzing lanosterol 14 alpha-demethylation.

An isozyme of cytochrome P-450 catalyzing lanosterol 14 alpha-demethylation was purified from human liver using column chromatography, including immunoaffinity chromatography. The purified protein exhibited a single protein band (53 kDa) on sodium dodecylsulfate-polyacrylamide gel electrophoresis. When reconstituted with NADPH-cytochrome P-450 reductase, the purified protein showed an activity of 14 alpha-demethylation of 24,25-dihydrolanosterol (3.20 nmol/min per mg protein). The apparent Km value for 24,25-dihydrolanosterol was found to be 27 microM. This enzyme converted in the reconstituted system, the oxygenated intermediates of 24,25-dihydrolanosterol 14 alpha-demethylation, 32-hydroxy-24,25-dihydrolanosterol and 32-oxo-24,25-dihydrolanosterol, to the 32-nor compound, 4,4-dimethylcholesta-8,14-dien-3 beta-ol.

Animals↗
PubMed1993

Caffeine inhibits Ca(2+)-mediated potentiation of inositol 1,4,5-trisphosphate-induced Ca2+ release in permeabilized vascular smooth muscle cells.

We studied the effects of caffeine on inositol 1,4,5-trisphosphate (IP3)-induced Ca2+ release in saponin-permeabilized smooth muscle cells. The Ca2+ concentration in the vicinity of the Ca2+ store was strongly buffered to exclude the secondary effect of Ca2+ on the Ca2+ release. 2 mM caffeine shifted the IP3 concentration-Ca2+ release relation at 100 nM Ca2+ to the higher IP3 concentration without decreasing the steepness of the relation. The ascending limb of the biphasic Ca2+ dependence of IP3-induced Ca2+ release was shifted to the higher Ca2+ concentration by 2 mM caffeine. However, caffeine showed little inhibitory effect in the absence of Ca2+. These results indicate that caffeine inhibits IP3-induced Ca2+ release only when the Ca2+ release is potentiated by Ca2+.

Animals↗
PubMed1993

[Clinical utility of computed radiography (CR) for the diagnosis of lung cancer].

To clarify the clinical utility of computed radiography (CR) for the diagnosis of lung cancer, several kinds of image-processed CR images were compared with conventional radiographs (CXR). The images in the three patients with peripheral lung cancer were processed by the following six types: 1) processing close to CXR (plain CR), 2) wide latitude and high frequency emphasis (wide CR), 3) advanced high frequency emphasis (HE-CR), 4) lower frequency emphasis (LE-CR), 5) single exposure dual energy subtraction (ES) and 6) ES with lower frequency emphasis (LE-ES). In the two cases of hilar lung cancer, 1) plain CR, 2) wide CR, 3) CR tomographs similar to CXR tomographs (plain CR-TOMO) and 4) high frequency emphasized CR tomographs (HE-CR-TOMO) were processed. Twenty-six radiologists rated the image-processed CR images using a 5 point rating scale method. The following results were found for the evaluation of lung anatomy: almost all image-processed CR images were equal or superior to CXR; especially scores for plain CR were better than those for CXR in all anatomical structures studied; scores for ES were superior to those for plain CR in the bilateral main bronchi, left upper lobe bronchus and right paratracheal stripe; and scores for CR tomographs were better than those for CXR tomographs. In peripheral lung cancer, plain CR and ES were superior to CXR. Especially ES had the best scores. In hilar lung cancer, plain CR and CR tomographs were judged better than CXR and CXR tomographs. These findings indicate the usefulness of CR images for the diagnosis of lung cancer.

Aged↗