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Biomedical subjects

M Fujimori

Publications and source records attributed to M Fujimori.

At least 91 records · Page 5Linked to original sources
PubMed1995

Development of Babesia gibsoni in the salivary glands of the larval tick, Rhipicephalus sanguineus.

The development of Babesia gibsoni in the salivary glands of larval Rhipicephalus sanguineus ticks was morphologically studied for 4 days of feeding of tick on rabbits. Babesia gibsoni showed two forms (sporont and sporozoite) in the budding process. Sporozoites were formed in the acinar cells of salivary glands and released from the hollow cytoplasmic area of these cells by day 4 of feeding. The morphology of B. gibsoni in the salivary glands of R. sanguineus shows a close similarity to those of B. gibsoni in Haemaphysalis longicornis.

Animals↗
PubMed1995

[Tele-ECG transmission for patients with out-of-hospital cardiac arrest in Osaka City].

The efficacy of a tele-ECG transmission system for transmission of electrocardiograms from ambulance to Osaka City University Hospital for 59 patients with out-of-hospital cardiac arrest was evaluated from December 1992 to November 1993. Authorized emergency life saving technicians (ELSTs) transmitted electrocardiograms by automobilephone connected with electrocardiogram from the location of out-of-hospital cardiac arrest recognized by them to the ICU. Successful tele-ECG transfer was achieved in 34 cases (57.6%). The most common reason for failure of transmission was interference by large buildings located in our urban location, which occurred in 12 of the 25 cases. Defibrillary shock was applied in 9 of 10 cases of ventricular fibrillation, and one patient among them could return to work. In most cases, laryngeal mask airway insertion was performed. The group with tele-ECG transmission required longer time for transfer to the hospital. The time required for insertion of the laryngeal mask airway and tele-ECG transmission appeared to be the main reason for the delay in transport. Although use of tele-ECG transmission can be useful for patients with out-of-hospital cardiac arrest, further improvement on the transmission system will be needed.

Adult↗
PubMed1995

[Chest pain in a patient after median sternotomy].

A 62-year-old woman presented with a 1-year history of painful operative scar following median sternotomy performed for coronary artery bypass grafting at another hospital shortly after myocardial infarction. She had a 5-year history of diabetes mellitus, which had been controlled with diet therapy. There were no abnormalities in electrocardiographic or cardiac function. She complained of burning pain and marked tenderness bilaterally in the parasternal region. There were no abnormal laboratory findings. No fractures were detected in the ribs or sternum radiographically. Her chest pain was not alleviated by analgesics including nonsteroidal anti-inflammatory agents or tricyclic antidepressants. Neither local anesthesia nor thoracic epidural anesthesia was effective in eliminating her pain. Slight relief was obtained by heating with infrared radiation, but the duration of pain relief was very short. This patient's findings indicate that painful operative scar should be considered as a potentially serious complication of surgery requiring median sternotomy.

Chest Pain↗
PubMed1995

[A case of graft-versus-host disease following red cell concentrate (MAP-CRC) transfusion].

We report a case of transfusion-associated graft-versus-host disease (GVHD). A 79-year-old woman with Hodgkin's disease, respiratory failure and severe anemia who had been treated with two courses of chemotherapy was transfused with red cell concentrate (MAP-CRC) and fresh frozen plasma (FFP) in the ICU. On the 7-9th days after transfusion, she developed a diffuse erythematous rash mainly on the chest, high fever, liver dysfunction and thrombocytopenia. Despite treatment with immunoglobulin products and methylprednisolone, her condition deteriorated rapidly, and she died of multiple organ failure on the 7th day after appearance of rash. Skin biopsy demonstrated typical features of acute GVHD, suggesting that MAP-CRC-associated GVHD had occurred.

Aged↗
PubMed1994

Metabolism of lidocaine by rat pulmonary cytochrome P450.

The metabolism of lidocaine was studied using microsomes from extrahepatic tissues of rats, including lung, kidney and brain, or using a reconstituted system with purified CYP2B1 and CYP4B. Rat pulmonary microsomes metabolized lidocaine to an N-deethylated metabolite, monoethylglycinexylidide (MEGX). Renal microsomes produced MEGX and 3-hydroxylidocaine (3-OH LID), although the rate of MEGX formation was much lower in renal than in pulmonary microsomes. Other metabolites were not detected. Lidocaine was not metabolized by brain microsomes. In extrahepatic tissues, pulmonary microsomes had the highest activity. Hence, two major forms of cytochrome P450 isozymes, CYP2B1 and CYP4B1, in rat pulmonary microsomes were used for further study. The study with a reconstituted system using purified cytochrome P450 isozymes revealed that only CYP2B1 showed lidocaine deethylation activity; the other form of cytochrome P450 in the lung, CYP4B1, did not. The Michaelis-Menten constant for lidocaine N-deethylation by rat pulmonary microsomes was 0.27 mM. Antibody against CYP2B1 completely inhibited the formation of MEGX by pulmonary microsomes. These results suggest that lidocaine is metabolized by rat lung, including CYP2B1.

Animals↗
PubMed1994

Effects of intravenous lidocaine on cardiac sympathetic nerve activity and A-V conduction in halothane-anesthetized cats.

To study neural contributions to the alterations in intracardiac conduction induced by i.v. lidocaine, we measured cardiac sympathetic nerve activity (CSNA) simultaneously with sinus cycle length (SCL) and A-V cats. Sixteen cats were anesthetized with halothane in oxygen and mid-sternotomized. The His-bundle electrogram and CSNA were recorded from an electrode placed in the interatrial septum and from the left ventrolateral or ventromedial nerve, respectively. Atrium-His (A-H), His-Purkinje (H-V), and total intraventricular (H-S) conduction times were measured during atrial pacing conducted at a cycle length of 300 ms. In eight cats, 1 MAC, 2 MAC, and 3 MAC halothane were given during i.v. lidocaine (Groups H-1, H-2 and H-3). In the other eight cats, anesthesia was switched from halothane to i.v. alpha-chloralose (30-50 mg.kg BW-1; Group C). A significant decrease in CSNA with i.v. lidocaine, 2 mg.kg BW-1 was recognized in Groups C and H-1, but not in Groups H-2 and H-3. Prolongations of SCL during the spontaneous cycle, A-H and H-V in the paced mode following i.v. lidocaine were significant in Groups C, H-1 and H-2, but not significant in Group H-3. We conclude that i.v. lidocaine induces a significant decrease in CSNA during alpha-chloralose or 1 MAC halothane anesthesia which partly contributes to the control of intracardiac conduction.

Anesthesia, Inhalation↗
PubMed1994

[Clinical study of postoperative sedation in pediatric patients--effects of inhalation anesthetics and postoperative analgesics].

The effects of three different inhalation anesthetics (sevoflurane, isoflurane and halothane) delivered with oxygen and nitrous oxide during surgery and of postoperative analgesics on degree %% postoperative sedation immediately following removal of the tracheal tube, in the recovery room and thereafter in the surgical ward, were studied in 74 pediatric patients under 12 years of age. They underwent elective surgical procedures including repair of inguinal hernia, orchidopexy, tonsillectomy, repair of cleft lip and certain orthopedic procedures. The degree of postoperative sedation was assessed using a nine-point behavioral scale (sedation score) designed for the rating of postoperative pain in children. There were no significant differences in sedation score or frequency of use of postoperative analgesics at any time of assessment among the three inhalation anesthetics. Thirty-eight percent of the patients received analgesics such as diclofenac and acetaminophen suppositories, and intravenous pentazocine. There were no significant differences in sedation score between the group of patients who received analgesics and the group of those who did not, and many patients had satisfactory sedation scores in the surgical ward, suggesting that appropriate administration of postoperative analgesics is possible.

Analgesics↗
PubMed1994

[Combination neoadjuvant therapy with continuous intra-arterial CDDP infusion and radiotherapy for locally advanced breast cancer].

Neoadjuvant therapy combined with intra-arterial continuous infusion of CDDP and external radiation was evaluated in a patient with locally advanced breast cancer. Although only MR was observed on the primary tumor, PR was found in several metastatic lymph nodes and daughter nodules. All tumor markers elevated before treatment decreased to normal ranges only by this therapy, and histological damage was also recognized remarkably with a high concentration of free Pt (8.89 micrograms/g) in cancer tissues. Since no severe side effects appeared during the present therapy, extended radical mastectomy with wide skin resection could be performed following additional intra-arterial chemotherapy using 5-FU, epi-ADM and MMC. From this experience, it was suggested that CDDP was an useful drug in the chemotherapy for breast cancer.

Adult↗
PubMed1993

Phaeochromocytoma crisis in Sipple's syndrome with intrauterine death and disseminated intravascular coagulation.

Unrecognized phaeochromocytoma during pregnancy is dangerous for both fetus and mother. We report here a case of phaeochromocytoma crisis in Sipple's syndrome associated with disseminated intravascular coagulation that developed following intrauterine death. Early evacuation of the uterus seems advisable, to rid the patient with phaeochromocytoma of further complications associated with fetal death.

Journal Article↗
PubMed1993

Effect of barbiturate therapy on phenytoin pharmacokinetics.

OBJECTIVE: To evaluate the effect of high-dose pentobarbital therapy on phenytoin pharmacokinetics. DESIGN: A prospective, clinical study. SETTING: The intensive care unit of a university hospital. PATIENTS: Ten adult patients with cerebral lesions requiring anticonvulsants and control of intracranial pressure. INTERVENTIONS: Each patient received phenytoin sufficient to maintain a plasma concentration at 15 micrograms/mL (60 mumol/L) both before and after barbiturate therapy. Plasma concentrations of total phenytoin, unbound phenytoin, and the major metabolite of phenytoin, 5-(p-hydroxyphenyl)-5-phenylhydantoin, were measured, and pharmacokinetic variables obtained before and after barbiturate therapy were compared. MEASUREMENTS AND MAIN RESULTS: Plasma concentrations of total phenytoin remained within the therapeutic range during the 12-hr period preceding barbiturate therapy. After barbiturate therapy, plasma concentrations of both total and unbound phenytoin were significantly less than those concentrations before barbiturate therapy. For total phenytoin, maximum metabolic velocity was increased by 62% (1.09 +/- 0.62 to 1.77 +/- 0.52 mg/L/hr, 1.20 +/- 0.68 to 1.95 +/- 0.57 nmol/L/sec, p < .05), and area under the plasma concentration-time curve (0 to infinity) and mean residence time were each decreased by 73% (32.5 +/- 20.0 to 8.7 +/- 3.1 min.mg/mL, 2.14 +/- 1.25 to 0.57 +/- 0.19 sec.mmol/L, p < .01, and 135,000 +/- 69,000 to 37,000 +/- 11,000 secs, p < .005, respectively) after barbiturate therapy. The plasma concentration of the principal metabolite of phenytoin, 5-(p-hydroxyphenyl)-5-phenylhydantoin, was significantly increased after barbiturate therapy. CONCLUSIONS: Phenytoin metabolism is increased by barbiturate therapy, and supplemental doses of phenytoin and frequent drug monitoring may be required after barbiturate therapy.

Adult↗
PubMed1993

Concealed Wolff-Parkinson-White syndrome detected during spinal anaesthesia.

We report a case of concealed Wolff-Parkinson-White syndrome detected for the first time during spinal anaesthesia in an adult male. Episodes of tachyarrhythmia with a heart rate of approximately 115 beat.min-1, wide QRS complexes and negative T waves which lasted 30-60 s, but were unassociated with hypotension, occurred three times after spinal anaesthesia. Postoperative Holter ECG monitoring showed the frequent occurrence of supraventricular premature contractions and paroxysmal supraventricular tachycardias with the same electrophysiological characteristics as those noted during spinal anaesthesia. The patient was diagnosed as having concealed Wolff-Parkinson-White syndrome. Since this condition is asymptomatic and undetectable by routine pre-operative screening it is likely that other unsuspected cases will arise. When episodes of tachyarrhythmia occur unexpectedly during anaesthesia, as was the case in this patient, postoperative examination including Holter ECG monitoring will be necessary to determine the nature and severity of the tachyarrhythmia.

Anesthesia, Spinal↗
PubMed1993

A double-blind comparison of lidocaine and mepivacaine during epidural anaesthesia.

The effects of epidural anaesthesia with plain 2% lidocaine or mepivacaine were compared in 200 patients undergoing extracorporeal shock wave lithotripsy in a double-blind manner. The onset, spread, duration and quality of analgesia were similar in both groups. The numbers of patients who needed vasoconstrictor or atropine were almost equal in both the lidocaine and the mepivacaine groups. Mild but significant hypotension continued for a longer period in the mepivacaine group than in the lidocaine group. A transient decrease in arterial oxygen saturation was seen in two patients receiving lidocaine and in three patients receiving mepivacaine. Mild systemic toxicity was observed in eight patients in both groups, although serious complications such as convulsions did not occur. It is concluded that both drugs can be used equally safely for epidural anaesthesia, although the maximum recommended doses differ.

Adolescent↗
PubMed1993

Intravenous lidocaine as a suppressant of coughing during tracheal intubation in elderly patients.

The effects of intravenously administered lidocaine on cough suppression in elderly patients over the age of 60 yr during tracheal intubation under general anesthesia were evaluated in two studies. In the first study, 100 patients received a placebo of either 0.5, 1.0, 1.5, or 2.0 mg/kg lidocaine intravenously 1 min before tracheal intubation. All visible coughs were classified as coughing. The incidence of coughing decreased as the dose of lidocaine increased. A dose of 1.5 mg/kg or more of intravenous lidocaine suppressed the cough reflex significantly (P < 0.01). In the second study, 108 patients received 2 mg/kg lidocaine intravenously or a placebo 1, 3, 5, 7, 10, or 15 min before intubation. The same criteria for determining whether a patient did or did not cough during tracheal intubation were used as in Study 1. The incidence of coughing decreased significantly (P < 0.01) when 2 mg/kg lidocaine was injected intravenously between 1 min and 3 min before attempting intubation. The cough reflex was almost entirely suppressed by plasma concentrations of lidocaine in excess of 4 micrograms/mL. The results suggest that intravenous administration of lidocaine is effective in suppressing the cough reflex during tracheal intubation in elderly patients under general anesthesia, but that relatively high plasma concentrations of lidocaine may be required for suppression of coughing.

Aged↗
PubMed1993

Relation between preoperative CT findings in rectal cancer and local recurrence rate. A pilot study.

To identify predictive factors of local recurrence possible to use as criteria for preoperative radiotherapy, we reviewed the CT scans of 51 patients undergoing curative resection for rectal cancer. Seven patients developed local recurrence. The presence of the CT images of spicular structures or a fibrous soft tissue layer around the rectum was related to extrarectal spread with a positive predictive value of 88% (30/34) when compared with the pathology. Six out of 34 cases with these CT findings developed recurrence, compared to only one out of 17 cases without such findings. The recurrence rate was especially high, (4/14), in patients where the abnormal tissue as judged by CT was attached to the perirectal fascia or extended beyond it. CT may be a useful tool for predicting local recurrence by using the perirectal fascia as a diagnostic marker.

Adult↗