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Biomedical subjects

M Yamakage

Publications and source records attributed to M Yamakage.

At least 55 records · Page 3Linked to original sources

Onset of vecuronium neuromuscular blockade at the hand with an arterio-venous shunt.

PURPOSE: To evaluate the onset of vecuronium neuromuscular blockade in the hand with an arterio-venous shunt for haemodialysis. METHODS: In 15 adult patients receiving haemodialysis for renal failure the onset of vecuronium-induced neuromuscular blockade after 0.08 mg-kg-1 vecuronium i.v. was measured. Using train-of-four mechanomyographic monitoring, the force of contraction of the adductor pollicis of both hands with and without arterio-venous shunt was measured simultaneously. RESULTS: The times from the injection to the first depression of twitch response (latent onset) and 95% twitch depression (onset) in the hand with and without arterio-venous shunt were 114.7 +/- 33.4 and 218.7 +/- 59.9 and 117.3 +/- 34.3 and 208.7 +/- 60.9 sec respectively. No difference in the onset of vecuronium neuromuscular blockade in the hand an arterio-venous shunt was demonstrated. CONCLUSION: The presence of an arteriovenous fistula does not modify the onset on neuromuscular blockade. Either arm can be used to monitor onset of neuromuscular blockade in chronic renal failure patients with an arterio-venous shunt in the hand for haemodialysis.

Adult↗

Inhibition of voltage-dependent Ca2+ channels of porcine tracheal smooth muscle by the novel Ca2+ channel antagonist RWJ-22108.

1. We compared electrophysiological effects of the bronchoselective Ca2+ channel antagonist RWJ-22108 on voltage-dependent Ca2+ channels (VDCs) of porcine tracheal smooth muscle cells to the effects of nicardipine and verapamil. 2. Each of the three Ca2+ channel antagonists tested inhibited inward Ca2+ currents (ICa) measured by whole-cell patch clamp techniques. Inhibition was dose-dependent with approximately 50% inhibition of peak ICa at +20 mV obtained with 3 x 10(-6) M RWJ-22108, 3 x 10(-7) M nicardipine, or 10(-5) M verapamil. 3. Both RWJ-22108 (3 x 10(-6) M) and nicardipine (3 x 10(-7) M) shifted the voltage dependence of steady-state inactivation to more negative potentials; however, the change in the potential of half-maximal inactivation induced by RWJ-22108 (-18 mV) was significantly greater than that induced by nicardipine (-12 mV). Verapamil did not alter the voltage dependence of inactivation. 4. We conclude that inhibition of VDCs by RWJ-22108 is qualitatively similar to that by nicardipine but with a greater stabilizing effect on the inactivated channel state.

Animals↗

Direct inhibitory mechanisms of halothane on human platelet aggregation.

BACKGROUND: Although halothane directly inhibits platelet aggregation, the mechanisms of this effect are still unknown. The current study aimed to clarify the inhibitory mechanisms of halothane on thrombin-induced human platelet aggregation by measuring (1) platelet-surface glycoprotein Ib expression, (2) the concentration of intracellular free Ca2+ ([Ca2+]i) measured simultaneously with aggregation, (3) the concentration of intracellular inositol 1,4,5-triphosphate, and (4) the concentration of intracellular cyclic 3',5'-adenosine monophosphate ([cAMP]i). METHODS: Washed platelet suspensions, obtained from healthy volunteers, were preincubated with halothane (0-2 mM) for 2 min and then exposed to 0.02 units/ml thrombin for 3 min. The glycoprotein Ib bound to fluorescein-labeled antibody was measured by fluorescence flow cytometry. [Ca2+]i was measured, simultaneously with aggregation, in Fura-2 (Ca2+ indicator)-loaded platelets by use of a fluorometer. Inositol 1,4,5-triphosphate and [cAMP]i were measured by radioimmunoassay. RESULTS: Halothane had no effect on glycoprotein Ib expression with or without thrombin. Halothane decreased the thrombin stimulated [Ca2+]i transient and inhibited platelet aggregation in a dose-dependent manner, both in the presence and in the absence of external Ca2+. Isoflurane had no apparent effect on either platelet aggregation or [Ca2+]i in the absence of external Ca2+. Halothane inhibited the increase in inositol 1,4,5-triphosphate induced by thrombin. Halothane moderately but significantly increased [cAMP]i, but the adenylate cyclase activator forskolin (which has the same inhibitory ability on aggregation as halothane) increased [cAMP]i to a much greater extent than did halothane. CONCLUSIONS: Halothane inhibits thrombin-induced human platelet aggregation by decreasing [Ca2+]i without inhibiting agonist-receptor binding; the inhibitory effect of halothane on [Ca2+]i might be mediated by a decrease in inositol 1,4,5 triphosphate and in part by an increase in [cAMP]i.

Adult↗

Sodium nitroprusside stimulates Ca2+ -activated K+ channels in porcine tracheal smooth muscle cells.

To directly investigate the possible role of large-conductance Ca2+ -activated K+ (KCa) channels in nitro-vasodilator-induced relaxation of airway smooth muscle, we used cell-attached patch-clamp techniques to test the effects of sodium nitroprusside (SNP) on KCa channels in freshly dispersed porcine tracheal smooth muscle cells. Channel open-state probability (nPo) increased approximately 13-fold with exposure to 10(-5) M SNP, and this was partially reversed by addition of the guanylate cyclase inhibitors methylene blue (3 X 10(-4) M) or LY-83583 (5 X 10(-5) M). Pretreatment with the guanosine 3',5' -cyclic monophosphate (cGMP)-dependent protein kinase (G kinase) inhibitor Rp-8-(p-chlorophenylthio) cGMP-phosphorothioate (2 X 10(-5) M) prevented activation of KCa channels by SNP. We also tested the ability of G kinase to directly activate KCa channels in inside-out patches. G kinase (2.5 U/microliter) with ATP (0.5 mM) and cGMP (0.1 mM), but not ATP and cGMP alone, increased nPo approximately 23-fold. We conclude that SNP activates KCa channels in airway smooth muscle via guanylate cyclase and G kinase. Phosphorylation of the channel protein by G kinase may account for this response. Consequent membrane hyperpolarization and inhibition of Ca2+ entry through voltage-dependent channels may contribute to SNP-induced relaxation of airway smooth muscle.

Adenosine Triphosphate↗

The effects of extracellular pH on intracellular pH, Ca2+ and tension of canine tracheal smooth muscle strips.

The effects of changes in extracellular pH (pHo) on intracellular Ca2+ concentration ([Ca2+]i) or intracellular pH (pHi) were measured simultaneously with muscle tension in canine tracheal smooth muscle strips. [Ca2+]i and pHi were measured using the fluorescent dyes fura-2 and BCECF, respectively. During high K(+)-induced contractions (24.2, 36.4 or 72.7 mM) at pH 7.4, pHo was changed to 7.8 or 7.0 with NaOH or HCl, respectively. Induced changes in pHi were equal to approximately 50% of the changes in pHo. Alkalinization significantly increased [Ca2+]i and enhanced muscle contraction at all concentrations of K+ but did not alter the relationship between muscle tension and [Ca2+]i. Acidification significantly decreased [Ca2+]i without changing muscle tone; hence, the muscle tension-[Ca2+]i relationship was shifted to the left. These results suggest that changes in pHo can alter airway smooth muscle tone by changing [Ca2+]i and pHi.

Animals↗

Inhibitory effects of thiopental, ketamine, and propofol on voltage-dependent Ca2+ channels in porcine tracheal smooth muscle cells.

BACKGROUND: Intravenously administered anesthetics directly inhibit airway smooth muscle contraction. Because many anesthetic agents affect membrane ion channel function and sustained contraction of airway smooth muscle requires the influx of Ca2+ through voltage-dependent Ca2+ channels, it was hypothesized that intravenous anesthetics inhibit airway smooth muscle voltage-dependent Ca2+ channels. METHODS: Porcine tracheal smooth muscle cells were enzymatically dispersed and studied using whole-cell, patch-clamp techniques. The cells were exposed to thiopental (10(-7)-3 x 10(-4) M), ketamine (10(-6)-10(-3) M), or propofol (10(-7)-3 x 10(-4) M) while recording macroscopic voltage-activated Ca2+ currents (ICa). RESULTS: Each intravenous anesthetic tested significantly inhibited ICa in a dose-dependent manner with 3 x 10(-4) M thiopental, 10(-3) M ketamine, and 3 x 10(-4) M propofol each causing approximately 50% depression of peak ICa, but with no apparent shift in the voltage dependence of induced ICa. After pretreatment with the Ca2+ channel agonist Bay K 8644, thiopental, but not ketamine or propofol, shifted the maximum ICa to more positive potentials. All three anesthetics promoted the inactivated state of the channel at more negative potentials, but propofol was less effective than thiopental or ketamine in this regard. CONCLUSIONS: Three intravenous anesthetics evaluated in this study decreased the ICa of porcine tracheal smooth muscle cells but with subtle electrophysiologic differences. Hence, thiopental, ketamine, and propofol each inhibit L-type voltage-dependent Ca2+ channels of porcine tracheal smooth muscle cells but the molecular mechanisms involved may be agent specific. This inhibition may contribute to the airway smooth muscle relaxant effects of these agents observed in vitro at concentrations greater than those encountered clinically.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗

Volatile anesthetics inhibit voltage-dependent Ca2+ channels in porcine tracheal smooth muscle cells.

The relaxation of airway smooth muscle by volatile anesthetics is associated with a decreased concentration of intracellular free Ca2+. We hypothesized that inhibition of the entry of extracellular Ca2+ contributes to the relaxation. We therefore examined the effects of halothane, isoflurane, and sevoflurane on macroscopic voltage-activated Ca2+ currents (ICa) in porcine tracheal smooth muscle cells, using the whole cell patch-clamp technique. All three volatile anesthetics significantly inhibited ICa in a dose-dependent manner with no apparent shift in the voltage dependence of induced ICa. The order of inhibitory potencies for ICa was halothane > isoflurane > sevoflurane. When data were plotted as a function of the estimated anesthetic concentrations in the lipid phase, the potencies for inhibition of ICa by the three anesthetics were indistinguishable. We conclude that volatile anesthetics have an inhibitory effect on ICa of porcine tracheal smooth muscle cells at clinically relevant concentrations and that the inhibitory potencies of volatile anesthetics on ICa are closely related to their lipid-phase solubilities.

Anesthetics↗

Intracellular pH regulates voltage-dependent Ca2+ channels in porcine tracheal smooth muscle cells.

Changes in CO2 or in pH modify airway smooth muscle contractility. To investigate the mechanisms involved, we compared K(+)-induced contractions in porcine bronchial rings exposed to different CO2 concentrations and directly measured the effects of changes in intracellular (pHi) or extracellular pH (pHo) on Ca2+ currents (ICa) through voltage-dependent Ca2+ channels (VDC) in porcine tracheal smooth muscle cells. Hypocapnia and hypercapnia caused leftward and rightward shifts, respectively, in the dose-response to K+ (P < 0.05) but did not change the maximum force obtained. Peak ICa (10 mM external Ca2+) elicited by depolarizing pulses from -80 mV was maximal [-265 +/- 12 pA (mean +/- SE), n = 19] at +10 mV. Intracellular acidification decreased the peak ICa at +10 mV from -261 +/- 20 pA to -177 +/- 12 pA (P < 0.05, n = 4), while intracellular alkalinization increased the peak ICa at +10 mV from -302 +/- 27 pA to -368 +/- 26 pA (P < 0.05, n = 4). Changes in pHo had little effect on ICa. There was no shift in the voltage-dependence of induced ICa with any change. We conclude that pHi, but not pHo, directly modulates the entry of Ca2+ into airway smooth muscle cells through VDC. This mechanism may contribute to regulation of airway tone by CO2.

Animals↗

Cholinergic regulation of voltage-dependent Ca2+ channels in porcine tracheal smooth muscle cells.

To investigate cholinergic regulation of voltage-dependent Ca2+ channels (VDCs) in airway smooth muscle, we measured inward currents through VDCs in enzymatically dispersed porcine tracheal smooth muscle cells using conventional (10 mM Ca2+ as charge carrier) and nystatin-perforated (5 mM Ba2+ as charge carrier) whole cell patch clamp techniques. Carbachol (CCh) had significant and dose-dependent inhibitory effects on inward currents (12% with 10(-7) M and 42% with 10(-6) M) in perforated whole cell clamp experiments, but had no effect on currents in conventional whole cell experiments. CCh also shifted the steady-state inactivation curve to more negative potentials. Further experiments tested the hypothesis that CCh inhibits VDCs in part by the activation of protein kinase C (PKC). Phorbol 12,13-diacetate, an exogenous PKC activator, inhibited currents through VDCs. and calphostin C, a specific PKC inhibitor, antagonized the inhibitory effect of CCh. Furthermore, intracellular exposure to the activating PKC fragment 530-558, using a pipette perfusion technique, also inhibited currents through VDCs. We conclude that cholinergic receptor stimulation can inhibit inward Ca2+ currents through VDCs of porcine tracheal smooth muscle and that this effect may be mediated in part by activation of PKC.

Animals↗

[The utility of thermistor attached tracheal tube for pediatric patients in cardiac surgery].

During cardiac surgery, esophageal, rectal, or bladder temperature is usually monitored as an index of core temperature; however, these methods are invasive, and often inconsistently reflect the central body temperature, especially in pediatric patients. The purpose of this study was to evaluate the utility of tracheal temperature monitoring during cardiac surgery in pediatric patients. Fifteen children (ages; 8 m.-7 yr.) undergoing cardiac surgery with cardio-pulmonary bypass (CPB) were studied. Anesthesia was induced and maintained with high doses of fentanyl and intermittent doses of midazolam. After anesthetic induction, esophageal, rectal, bladder, tympanic, and forehead deep temperatures were monitored with a Core Temp Monitor (CTM-205, Terumo Co.). Simultaneously, the tracheal temperature was monitored with a specially made tracheal tube. A thermistor was attached by medical glue (Loctite Prism, Loctite Co.) at the anterior surface of a tracheal tube (Trachelon, Terumo Co.) without cuff (inside diameter 4.0-6.0 mm) where the tracheal tube tightly fits against the trachea. The inspired gas was warmed to 35 degrees C and humidified. During CPB, the blood temperature at the inlet to the patients was also recorded simultaneously. All indicated temperatures (Y) during CPB were analyzed for correlation with the blood temperature to the patients (X). The tracheal temperature had the highest correlation with the blood temperature from the patients (Y = 0.68X + 10.60, r = 0.89). There were also good correlations of the esophageal as well as bladder temperatures with blood temperature. There were no patients who suffered tracheal inflammation or laryngeal edema from the thermistor. Monitoring tracheal temperature is not only valuable for monitoring the core temperature, but also is convenient for pediatric patients in cardiac surgery.

Anesthesia, General↗

Effects of induced hypotension on arterial blood-gases under spontaneous breathing.

The effects of deliberate hypotension on both PaO2 and PaCO2 were investigated under isoflurane anaesthesia with spontaneous breathing from a laryngeal mask. Lumbar epidural block was introduced; anaesthesia was induced with thiamylal (4 mg.kg-1) and maintained with 0.5% isoflurane in nitrous oxide (4 l.min-1) and oxygen (2 l.min-1) under spontaneous breathing. After that nitroglycerin, trimetaphan or prostaglandin E1 were used to induce a hypotension of 70% of control. All three drugs significantly decreased PaO2, from 19.9 +/- 3.3, 19.2 +/- 2.7, and 19.6 +/- 3.1 kPa to 14.6 +/- 1.9, 16.6 +/- 2.2, and 16.2 +/- 2.4 kPa (mean +/- s.d.), respectively; none of them increased PaCO2. In spite of the sparing of functional residual capacity under spontaneous breathing, the levels of reduction of PaO2 were the same as levels reported in paralyzed and mechanically ventilated subjects. In conclusion, under deliberate hypotension PaO2 decreases to a considerable degree, even under spontaneous breathing, presumably not because of alveolar hypoventilation, but because of the suppression of hypoxic pulmonary vasoconstriction by the drugs used in this study.

Adult↗

Inhibitory effects of halothane on high(K+)-induced canine tracheal smooth muscle contraction and intracellular Ca2+ increment.

Halothane is a potent bronchodilator. The effects of halothane on isolated canine tracheal smooth muscle contraction and intracellular Ca(2+) increment induced by a high concentration of K+ were investigated to clarify how this anaesthetic decreases intracellular Ca2+ concentration ([Ca2+]i), an important second messenger. The tension of the muscle strips was measured using an isometric transducer, and [Ca2+]i was measured using a surface fluorescence spectroscopy. Exposure to a 72.7 mM K+ solution increased muscle tension and [Ca2+]i. Halothane (1,2,3 and 4% at the vaporiser) was introduced by bubbling in the presence of the 72.7 mM K+, and significantly decreased both this elevated muscle tension and the [Ca2+]i in a concentration-dependent manner. Similarly, slowly decreasing concentrations of K+ (48.5, 36.4, 24.2 and 18.2 mM) significantly decreased both of these variables. There was no significant difference between the slopes of the two regression lines of changes in muscle tension and changes in [Ca2+]i. From the evidence that tonic increase in [Ca2+]i by high concentrations of K+ is due to the influx of Ca2+ via L-type voltage channels, halothane may modify the L-type channels to decrease Ca2+ influx. In conclusion, halothane inhibits the high K(+)-induced canine airway smooth muscle contraction by decreasing [Ca2+]i. The decrease in [Ca2+]i by halothane might be due to inhibition of voltage-operated channels, especially the L-type channels.

Animals↗

Changes in work of breathing during continuous positive airway pressure with increased airway resistance.

STUDY OBJECTIVES: To describe the importance of measuring work of breathing (WOB) in patients with high airway resistance (Raw) during continuous positive airway pressure (CPAP) support. DESIGN: Fundamental study using an advanced model lung and a pulmonary function monitor. SETTING: A research laboratory at the ICU of a university hospital. INTERVENTIONS: Spontaneous breathing (tidal volume x respiratory rate: 400 ml x 15 min-1) was simulated with a time-cycled jet-flow generator. The CPAP and Raw were adjusted to 0, 5, and 10 cm H2O and to 5, 10, and 20 cm H2O.L-1.s-1, respectively. MEASUREMENTS AND RESULTS: Using four advanced demand-flow system type ventilators (Evita, 7200a, Servo 900C, and Servo 300), a two-bellows-in-a-box type model lung, and a pulmonary function monitor with an esophageal catheter (CP-100), we measured WOB during CPAP with increased Raw. The WOB of the model lung increased significantly with increase in CPAP. The WOB of the model lung also increased significantly with increase in Raw for all ventilators tested in this study; some values showed over 1 J.L-1. The WOB under the Servo 300 exhibited the lowest values in all situations of all the ventilators tested in this study. CONCLUSIONS: Patients with high Raw may suffer excessive WOB even during CPAP with advanced demand-flow system type ventilators. It is vital to monitor WOB continuously using an adequate pulmonary function monitor such as that used in this study.

Airway Resistance↗

[Complications of pediatric spinal anesthesia].

We evaluated retrospectively the complications of pediatric spinal anesthesia in our center based on the histories of 50 spinal anesthesia cases (5-15 years of age, 0.56%) over the last 15 years. Five cases (10%) showed transient hypotension. In the prospective study of those under 5 years of age (35 children), there were no hypotensive cases, and the only critical complication was high spinal anesthesia; this case was complicated by giant hepatoblastoma. There was no obvious neurological damage in any of the patients who underwent spinal anesthesia. Because of low incidence of complications, pediatric spinal anesthesia is a useful method especially for patients with respiratory insufficiency. It is advisable to watch carefully for changes in blood pressure in senior infants, and to avoid spinal anesthesia in patients with giant abdominal tumors.

Adolescent↗

Effects of halothane and isoflurane on cytosolic calcium ion concentrations and contraction in the vascular smooth muscle of the rat aorta.

BACKGROUND: Halothane and isoflurane have been reported to suppress the contraction of vascular smooth muscle, although the exact mechanism has not been explained fully. This study examined the effect of halothane and isoflurane on cytosolic calcium ion (Ca2+) concentrations ([Ca2+]cyt), which was measured simultaneously with muscle tension in the vascular smooth muscle of the rat aorta to improve the understanding of the anesthetic's effect on vascular smooth muscle. METHODS: Isolated spiral strips of rat thoracic aorta were suspended for isometric tension recordings in physiologic salt solution. The [Ca2+]cyt was measured concomitantly by using fura-2-Ca2+ fluorescence. During exposure to 0%, 1%, 2%, or 3% halothane or 0%, 2%, or 4% isoflurane, increases in muscle tension and [Ca2+]cyt induced by 32.8 mM K+ or 30 nM norepinephrine were measured and compared with the reference values. In the other series, the 3% halothane-induced increase in [Ca2+]cyt was measured in Ca2+)-free solution without and with a pretreatment of ryanodine, caffeine, or norepinephrine. RESULTS: Halothane and isoflurane increased resting-state [Ca2+]cyt, although only 3% halothane elicited a transient increase in muscle tension during the resting state. By contrast, both anesthetic agents attenuated the high K(+)- and norepinephrine-induced increases in [Ca2+]cyt and muscle tension in a concentration-dependent manner. During 3% halothane or 4% isoflurane exposure, the pretreatment of the muscle strip with a 10(-6)-M dose of Bay K 8644 augmented the high K(+)-induced increase in [Ca2+]cyt to the level observed in the control (0% anesthetic exposure) state. However, the increase in muscle tension in the presence of Bay K 8644 was low; it was still attenuated from the control level during 3% halothane or 4% isoflurane administration. These results indicate that, not only [Ca2+]cyt-dependent, but also [Ca2+]cyt-independent, mechanisms are involved in the anesthetic-induced suppression of smooth muscle contraction. A 3% halothane-induced increase in [Ca2+]cyt was observed in the Ca(2+)-free solution even when the muscle strip was pretreated with a 10(-6)-M dose of ryanodine and a 20-mM dose of caffeine, whereas it was abolished completely after the muscle strip was pretreated with ryanodine, caffeine, and 100 nM norepinephrine. These results indicate that halothane can release Ca2+ from an intracellular Ca2+ store other than the caffeine-releasable site. CONCLUSIONS: Halothane and isoflurane have multiple effects on the [Ca2+]cyt and induce [Ca2+]cyt-dependent and [Ca2+]cyt-independent suppression of the contraction in the vascular smooth muscle.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗

The inhibitory effects of positive end-expiratory pressure (PEEP) on phrenic motoneuronal activity in cats.

We examined the effects of positive end-expiratory pressure (PEEP) on phrenic single motoneuronal activity (SMA) in anesthetized, paralyzed, and mechanically ventilated cats. SMA was isolated and recorded from the right C-5 phrenic root. Phrenic nerve compound activity was also recorded simultaneously from the contralateral C-5 phrenic root in each preparation. With the vagus nerve intact, phrenic SMA significantly decreased to 91.5, 76.2, 45.3, and 21.6% of control when PEEP was loaded to levels of 2.5, 5, 7.5, and 10 cm H2O, respectively. Compound activity also decreased. Moreover, not only phrenic single postinspiratory inspiratory activity (PIIA) but also the ratio of PIIA to the inspiratory SMA significantly decreased with increments of PEEP. In contrast, with the vagus nerve sectioned, phrenic nerve activity, including PIIA, remained unchanged when loading PEEP. These results suggest that 1) SMA might be inhibited in lung volume-dependent manner by PEEP, and that 2) the vagal nerve afferents are essential for the inhibition of SMA by PEEP.

Action Potentials↗

The utility of tracheal temperature monitoring.

Tracheal temperature--the temperature of the tracheal wall--is believed to reflect the core temperature. The trachea reacts quickly to temperature changes because it is surrounded by various large arteries and veins. Using the blood temperature from the cardiopulmonary bypass (CPB) and the jugular vein temperature as standards for core temperature, we evaluated the utility of monitoring the tracheal temperature during cardiac surgery. The tracheal temperature was measured by a thermistor which was attached to the anterior inner surface of the cuff of a tracheal tube. The tracheal temperature had correlation coefficients more than 0.99 with both blood temperature from the CPB (r = 0.993, P < 0.001) and jugular vein temperature (r = 0.993, P < 0.001) during CPB. Because the blood from the CPB draining into the ascending aorta and the jugular vein temperature might reflect the hypothalamic temperature directly, the tracheal temperature, which correlates with both of these quite closely, may reflect the core value directly. The monitoring of the tracheal temperature is not only valuable in monitoring the core value, but is also convenient during general anesthesia.

Aged↗