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Biomedical subjects

M Fujimori

Publications and source records attributed to M Fujimori.

At least 127 records · Page 7Linked to original sources
PubMed1991

Anti-triiodothyronine autoantibodies in a euthyroid woman: confirmation of immunoglobulin G antibodies employing protein A column chromatography.

The presence of thyroid hormone autoantibodies was investigated in a 48-year-old non-goitrous woman with high levels of serum total T3 and free T3. Her other thyroid function tests were normal. The presence of thyroid hormone autoantibodies were assessed in serum, acid-charcoal treated serum, IgG fractions and in a purified IgG fraction. the IgG fraction was separated from serum by a protein A-Sepharose CL-4B column chromatography and purified by gel filtration chromatography using Sephacryl S 200. Sera from normal individuals were used as controls. The results showed that the increased serum total and free T3 levels were caused by the presence of anti-T3 IgG autoantibodies. The results also indicate that protein A column chromatography is useful as a screening method for gross qualitative analyses of thyroid hormone autoantibodies.

Autoantibodies↗
PubMed1991

[The effect of intravenous injection of isosorbide dinitrate on the hypertension during general anesthesia: a multi-center controlled study].

The antihypertensive effect of intravenous injection of isosorbide dinitrate (ISDN) was evaluated in 137 patients undergoing elective surgery during general anesthesia [neuroleptanesthesia (NLA) or enflurane-nitrous oxide-oxygen-anesthesia (GOE)]. ISDN in dose of 20 micrograms.kg-1 or 40 micrograms.kg-1 was given as a bolus injection in 30 sec. ISDN produced a significant decrease in arterial pressure and central venous pressure; the maximum decrease was observed in 7 min after administration of ISDN. The antihypertensive effect of ISDN was dose-dependent, but there was no significant difference between two groups of patients given 20 or 40 micrograms.kg-1, or between those anesthetized with NLA or GOE. ISDN did not significantly alter heart rate, thereby causing a significant decrease in rate pressure product which reflects myocardial oxygen demand. The results suggest that a bolus injection of ISDN is a simple, practical and effective means of controlling hypertension during general anesthesia.

Adult↗
PubMed1991

[Hyponatremia during transurethral resection of the prostate].

In a retrospective study of 222 patients who underwent transurethral resection of the prostate under spinal anesthesia, plasma sodium levels during the operation were examined. The weight of prostate resected, the volume of irrigating fluid used and the duration of the operative procedure influenced the changes in plasma sodium levels. But, these changes were not statistically significant. The rise in central venous pressure values was associated with the absorption of irrigating fluid as evidenced by a drop in plasma sodium. The central venous pressure was monitored in 77 patients. There was a statistically significant correlation between the degree of hyponatremia and the rise in central venous pressure (P less than 0.001). The rise in central venous pressure reflected a change in the patient's cardiovascular status and it was, therefore, possible to treat the hyponatremia quickly and effectively. Central venous pressure monitoring is helpful in determining hyponatremia before it becomes clinically manifest.

Aged↗
PubMed1991

[Clinical evaluation of operative procedure for differentiated carcinoma of isthmus of the thyroid].

We studied 19 patients who had undergone operation for differentiated carcinoma of isthmus of the thyroid in Shinshu University Hospital from 1967 to 1986. Regarding the operations, total thyroidectomy was performed in 6 cases, subtotal thyroidectomy in 8 cases, lobectomy in one case and isthmectomy in 4 cases. In 12 cases, lymph node dissection was carried out. Among these 12 cases, 6 cases (50%) had evidence of metastasis. Intraglandular metastasis was found in 3 cases. There were no relationship between tumor size and nodal metastasis. From these results, we do not think that total thyroidectomy is indicated in the case of differentiated carcinoma of isthmus of the thyroid. In conclusion, subtotal thyroidectomy with bilateral modified radical neck dissection is sufficient as the operative procedure for differentiated carcinoma of isthmus of the thyroid.

Adenocarcinoma↗
PubMed1991

[General anesthesia for cesarean section in a patient with Marfan's syndrome associated with dissecting aortic aneurysm].

A 23-year-old woman with Marfan's syndrome was scheduled for Cesarean section at 31 week gestation because of progressive aortic dissection. Since she had undergone two surgical corrections for scoliosis (Harrington rod instrumentation) 5 and 12 years ago, we selected general anesthesia. She had been taking diltiazem and propranolol for hypertension and tachycardia. Anesthesia was induced with thiopental 75 mg iv followed by O2-N2O-enflurane (4%) by face mask. Following iv administration of vecuronium 4 mg and tracheal injection of 4% lidocaine 120 mg, the trachea was intubated without a significant hemodynamic change. Anesthesia was maintained with O2-N2O-enflurane (0.5-1.5%) before delivery. Following delivery, enflurane was discontinued and small doses of fentanyl iv (total 0.2 mg) were given with iv infusion of nitroglycerin (0.2-0.5 micrograms.kg-1.min-1) during surgery. Bleeding after delivery was controllable by iv infusion of oxytocin. The Apgar score was good (9 at 1 min and 10 at 5 min respectively). Post-operative course was uneventful. Therapeutic abortion or Cesarean section should be performed as soon as possible in a patient with dissecting aortic aneurysm because of increasing risk of aneurysm rupture during pregnancy. During the surgery, minimal hemodynamic changes are required to prevent the rupture.

Adult↗
PubMed1990

Clinical and immunological studies on patients with Graves' disease preoperatively treated with corticosteroids and iodides.

The purpose of this study was to evaluate the acute effects of corticosteroid and iodide preoperative therapy in patients with Graves' disease in terms of thyroid function and immunological parameters. The above combination was prescribed for 4 patients who had experienced severe side effects from antithyroid drugs (ATD) in order to reduce the possibility of post-thyroidectomy thyroid storm. Corticosteroids were employed daily for four days, and iodides were given daily for two weeks prior to thyroidectomy. The free T3 values decreased rapidly to euthyroid levels following the administration of both drugs, although the free T4 values were still much higher than normal in 3 of the 4 patients at the time of surgery. By comparison, 3 of 8 patients treated with ATD also had thyroid hormone levels above normal. Studies of lymphocyte subsets revealed that the percentage of helper T cells was significantly less in the corticosteroid-iodide treatment group than in the control and ATD groups. It is thus possible that postoperative thyroid storm might be prevented through corticosteroid-iodide therapy by virtue of the reduction of free T3 values to within the normal range by the time of surgery. The acute suppression of helper T cells was another results of this form of therapy observed.

Adult↗
PubMed1990

Sevoflurane anesthesia for elective cesarean section.

Sevoflurane anesthesia was given to sixteen women who had been scheduled for elective cesarean section. The maternal systolic blood pressure significantly decreased during the anesthesia induction. Both the anesthesia induction and emergence were smooth and rapid. These findings were supported partially by the pharmacokinetic analysis of sevoflurane concentration in the maternal artery and expired gas mixture. Spontaneous uterine contractions were good in 12 patients, fair in two and poor in two. The measured blood loss was 752 +/- 257 ml including amniotic fluid. No blood transfusion was given to any patient. The median value of the Apgar score at one minute was seven (range three to nine). No neonate was intubated for resuscitation. No abnormal maternal laboratory data were found, including liver and kidney function tests and blood cell counts one week after the operation. No adverse effect of sevoflurane on the neonate was found one week after the delivery and three months after the discharge.

Journal Article↗
PubMed1990

Effects of nitrous oxide on single breath induction with enflurane.

A single vital capacity breath method of inhalational induction using 4% enflurane in 67% nitrous oxide (group I) or 100% oxygen (group II) was studied in 30 patients. Nitrous oxide accelerated induction time (71 (22 SD) seconds in group I versus 136 (29 SD) in group II, P </= 0.01) and was associated with a decreased incidence of excitement and respiratory disturbance ( P </= 0.05). There were no significant differences between groups in systolic blood pressure, heart rate or arterial oxygen saturation. The technique was acceptable to 87% in group I and 33% in group II ( P </= 0.02).

Journal Article↗
PubMed1990

Comparison of conventional and rapid inhalational induction of anaesthesia with enflurane.

Inhalational induction of anaesthesia using either a conventional method or a vital capacity breath of 4% enflurane in 67% nitrous oxide was compared in 30 adult surgical patients. Induction time was significantly faster in patients who took a vital capacity breath (71, SD 22 versus 132, SD 18 seconds, p less than 0.01). There were no significant differences between groups in respect of systolic blood pressure, heart rate, arterial oxygen saturation or incidences of excitement or coughing. The vital capacity breath method was acceptable to 87% of patients.

Adult↗
PubMed1990

Recovery of bowel motility after high dose fentanyl or morphine anaesthesia for cardiac surgery.

Recovery of bowel function was investigated after cardiac surgery. The time to first passage of flatus was measured using a carbon dioxide analyser as an indication of the return of coordinated bowel motility in 22 adult patients who received high-dose fentanyl (56.3, SD 20.9 micrograms/kg) or morphine (1.3, SD 0.7 mg/kg) anaesthesia. The time from the patient's arrival in the intensive care unit to passage of the first flatus in patients who received fentanyl anaesthesia was significantly longer than in those who received morphine (p less than 0.05). There was a significant relationship between the time to first flatus and the total dose of fentanyl, but no such relationship could be demonstrated for morphine. It is concluded that high-dose fentanyl anaesthesia delays recovery of bowel motility in a dose-dependent manner.

Adult↗
PubMed1990

Effects of intravenous administration of local anesthetics on the renal sympathetic nerve activity during nitrous oxide and nitrous oxide-halothane anesthesia in the cat.

The effects of subseizure doses of lidocaine and bupivacaine administered intravenously (i.v.) on mean arterial pressure (MAP), heart rate (HR) and renal sympathetic nerve activity (RSNA) were studied in cats anesthetized with nitrous oxide (N2O)-O2 and N2O-O2-halothane (1%). In cats anesthetized with N2O-O2, MAP decreased briefly (P less than 0.01) and then returned to the initial level within a minute after the i.v. injection of lidocaine (5 mg/kg, 10 mg/kg). RSNA increased at first and then decreased slightly. In cats with denervated baroreceptors, the change in RSNA after lidocaine 5 mg/kg i.v. was similar to that in cats with intact baroreceptors. In contrast, MAP, HR and RSNA decreased significantly (P less than 0.01) after i.v. injection of lidocaine during N2O-O2-halothane anesthesia. The effects of bupivacaine on RSNA were similar to those of lidocaine. It is concluded that cardiovascular depression following intravenous local anesthetics during N2O-O2-halothane anesthesia may be caused by both a decreased sympathetic activity and a direct depressant effect on the myocardium.

Anesthesia, Inhalation↗
PubMed1990

[Comparison of effects of intravenous versus intramuscular famotidine on pH and volume of gastric juice].

Famotidine, an H2-antagonist, is frequently used for prevention of acid aspiration in surgical patients. Intravenous as well as intramuscular administration of famotidine has proved effective to reduce gastric acid secretion during anesthesia. However, the onset and duration of action of famotidine following intravenous administration has not been extensively investigated. In the present study on 89 patients undergoing elective surgery, the effects of famotidine 20 mg administered intravenously 5-30 min before endotracheal intubation on pH and volume of gastric contents aspirated 0, 1, 2, and 4 hrs after tracheal intubation and immediately after extubation through nasogastric tube were compared with the effects of the drug administered intramuscularly one hour before endotracheal intubation. Famotidine administered intramuscularly 5-14 min before endotracheal intubation produced inadequate suppression of gastric secretion after tracheal intubation. In contrast, intravenous famotidine given 15-30 min before tracheal intubation, as well as the intramuscular administration of famotidine as premedication, effectively decreased gastric fluid volume and increased gastric pH. Suppression of gastric secretion by intravenous and intramuscular famotidine continued for over 4 hours. Intravenous famotidine has a rapid onset and a long duration of depressant action on gastric secretion, thus reducing the risk of aspiration pneumonitis during and after general anesthesia.

Adult↗