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Norimasa Seo

Publications and source records attributed to Norimasa Seo.

At least 55 records · Page 3Linked to original sources
PubMed2003

Differential sublocalization of the dynamin-related protein OPA1 isoforms in mitochondria.

OPA1 is a cause gene for autosomal dominant optic atrophy and possesses eight alternative splicing variants. Here, we identified two isoforms of OPA1 proteins in HeLa cells and examined their submitochondrial localization and complex formations. RT-PCR shows that HeLa cells mainly express isoforms 7 and 1 of OPA1. Since the third cleavage site is mainly utilized in HeLa cells, the predicted molecular masses of their processed proteins are consistent with the 93- and 88-kDa proteins. Biochemical examinations indicate that both of the OPA1 isoforms are present in the intermembrane space. Submitochondrial fractionation by sucrose density-gradient centrifugation shows that the 88-kDa protein predominantly associates with the mitochondrial outer membrane, on the contrary, the 93-kDa protein associates with the inner membrane. Gel filtration analysis indicates that they compose the different molecular mass complexes in mitochondria. These differences between two isoforms of OPA1 would suggest their crucial role involved in the mitochondrial membrane formation.

Alternative Splicing↗
PubMed2003

Hypotension associated with systemic aggregated anaphylaxis is not attenuated by a selective endothelin-A receptor antagonist, BQ 610, in rabbits in vivo.

PURPOSE: The present study was done to investigate the role of endothelin-1 (ET-1) in hypotension and bronchospasm provoked by anaphylaxis in rabbits in vivo. METHODS: Forty-five rabbits sensitized to horse serum were randomly allocated to five groups: Group 1 (n = 10) received 0.5 nmol x kg(-1) of ET-1; Group 2 (n = 10) received 0.5 nmol x kg(-1) of ET-1 and 200 nmol x kg(-1) of a selective ETA receptor antagonist, BQ 610, without anaphylaxis; Group 3 (n = 5) received 200nmol x kg(-1) of BQ 610 alone without anaphylaxis, Group 4 (n = 10) received normal saline alone before being antigen challenged to induce anaphylaxis; Group 5 (n = 10) received 200 nmol x kg(-1) of BQ 610 before antigen challenge. RESULTS: Mean arterial pressure (MAP) values were significantly different between Groups 1 and 2. Heart rate (HR), central venous pressure (CVP), dynamic pulmonary compliance (C(dyn)), and pulmonary airway resistance (R(L)) did not differ significantly between Groups 1 and 2. MAP values were significantly decreased compared with baseline in both Groups 4 and 5; however, the values were not significantly different between two groups. CVP values were significantly different between Groups 4 and 5 only at the 15-min time point following antigen challenge. HR, R(L), and C(dyn) values were not significantly different between Groups 4 and 5, nor were the survival rates. CONCLUSION: BQ 610 does not improve hypotension or survival rates in systemic aggregated anaphylactic rabbits in vivo, implying that circulating ET-1 may not play an important role in anaphylaxis, although direct proof of production of circulating ET-1 or activation of ETA receptors is lacking in this study.

Anaphylaxis↗
PubMed2003

[A novel whole blood aggregometer].

We examined ADP-induced platelet aggregability in 45 patients by novel whole blood aggregometer based on the screen filtration pressure method. Platelet aggregation could be easily and immediately checked without preparing platelet rich plasma. This aggregometer was useful for determination of anesthetic methods for a patient with an anti-platelet therapy. However, PATI (platelet aggregately threshold index) demonstrated the lowest value 5 minutes after blood collection and the valve was stabilized at higher level for 30 to 120 minutes. Time-dependent change should be considered for assessment of platelet aggregability in a clinical study.

Adenosine Diphosphate↗
PubMed2003

[Life-threatening coronary ischemia in the operating room: analysis of annual survey from 1999 to 2001 conducted by Japanese Society of Anesthesiologists].

In Japan, the incidence of cardiac morbidity among patients with ischemic heart diseases has been reported to be 13.2-16.4%, and that of perioperative myocardial infarction in these patients about 1%. We investigated the perioperative morbidity and mortality due to coronary ischemia by using data from an annual survey concerning anesthesia-related critical incidents, conducted by the Committee on Operating Room Safety, Japanese Society of Anesthesiologists. In this survey, coronary ischemia was divided into intraoperative pathological events (coronary ischemia as intraoperative event) and preoperative complication (coronary ischemia as preoperative complication). The former consists of coronary ischemia which developed in patients without preoperative diagnosis of ischemic heart diseases or which was induced by surgical and/or anesthetic procedures. The latter was coronary ischemia developed in patients with preoperative diagnosis of ischemic heart diseases. From January 1, 1999, to December 31, 2001, 3,020,021 patients were registered from certified training hospitals of Japanese Society of the Anesthesiologists in the survey. Among them 1,918 episodes of intraoperative cardiac arrest and 2,054 deaths (within 7th postoperative days) were reported. Of these 7.5% and 6.3% of cardiac arrests were due to coronary ischemia as intraoperative event and as preoperative complication, respectively. Death was due to coronary ischemia as intraoperative event in 4.0% and as preoperative complication in 5.1%. The occurrence of critical incidents (cardiac arrest and the other life-threatening events) due to both types of coronary ischemia depended on ASA-PS. The percentage of coronary ischemia as preoperative complication was higher in emergency patients than in elective patients. The percentage of coronary ischemia as intraoperative event was almost the same between emergency and elective patients. Both types of coronary ischemia developed most frequently in cardiac/aortic surgeries, followed by thoracotomy with or without laparotomy. The number of critical incidents due to coronary ischemia as preoperative complication was the largest in emergency cardiac/aortic surgeries, followed by elective non-cardiac surgeries. The number of critical incidents due to coronary ischemia as intraoperative event was the largest in elective non-cardiac, especially open abdominal, surgeries in patients with ASA-PS 1(E) + 2(E). Among the patients with ASA-PS 1(E) + 2(E) who underwent non-cardiac surgeries 13.9% of deaths were due to coronary ischemia as preoperative complication and 12.5% as intraoperative event. It should be noted that many critical incidents due to coronary ischemia as intraoperative event during laparotomy developed in patients anesthetized by inhalation anesthesia combined with epidural, spinal or conduction block. Prognosis of cardiac arrest due to coronary ischemia as preoperative complication was the worst: 47.1% of these patients died. The best prognosis was found in critical incidents other than cardiac arrest due to coronary ischemia as intraoperative event with mortality of 12.3%. The results show that quality improvement from the standpoint of intraoperative coronary ischemia is required.

Anesthesia↗
PubMed2003

[Anesthetic management for infected abdominal aneurysm].

A 48-year-old man was scheduled for repair of mycotic abdominal aortic aneurysm. Extraanatomic bypass was performed due to infection of the aneurysm. General anesthesia combined with continuous epidural anesthesia was performed. In spite of severe blood loss, hemodynamic state was stable during anesthesia and postoperative period. He was managed in the intensive care unit without any complication. In this anesthetic management, it is very important to maintain adequate cardiac output and circulating blood volume to prevent visceral ischemia.

Anesthesia, Epidural↗
PubMed2003

[Successful control of rapid heart rate in a patient with atrial fibrillation by continuous intravenous administration of landiolol hydrochloride].

A 79-year-old man with atrial fibrillation underwent total pharyngolaryngectomy and free flap reconstruction for hypolaryngeal cancer under general anesthesia. He developed tachyarrhythmia with ST depression and inverted T wave. The treatment including sufficient fluid therapy, continuous administration of vasodilator and intravenous digoxin failed to control the abnormalities. Then landiolol hydrochloride, a new cardioselective ultra-short acting beta-blocker, was continuously administered. Despite the relatively low doses with 1 min loading infusion at 0.04 mg.kg-1.min-1 and continuous infusion at 0.016 mg.kg1.min-1, rapid control of heart rate occurred in a few minutes and inverted T waves were normalized in fifteen minutes. There was no significant change of peripheral blood pressure. The present case suggests that landiolol hydrochloride is effective in controlling heart rate in a patient with atrial fibrillation and that the optimal dose should be carefully evaluated for each case.

Aged↗
PubMed2003

[Annual study of anesthesia-related mortality and morbidity in the year 2001 in Japan: the outlines--report of Japanese Society of Anesthesiologists Committee on Operating Room Safety].

We reported anesthesia-related mortality and morbidity in Japanese Society of Anesthesiologists Certified Training Hospitals (JSACTH) in the year 2001, as a part of the second series of annual studies in the identical questionnaires form started in 1999. JSA Committee on Operating Room Safety sent confidential questionnaires to 813 JSACTH and received effective answers from 87.9% of the hospitals. A total number of 1,284,957 anesthetics were documented. The respondents were asked to report all cases of cardiac arrests and other critical incidents (serious hypotension, serious hypoxemia and others) during anesthesia and surgery, and their outcomes (death in operating room, death within 7 days, transfer to vegetative state and rescue without sequelae) as well as one principal cause for each incident from the list of 52 items. Definition of serious hypotension, serious hypoxemia and others was those events suggesting the possibility of impending cardiac arrest or permanent disability of the central nervous system or myocardium. The respondents were also requested to submit the tabulation of patients by ASA physical status, age distribution, surgery sites and anesthetic methods. Analysis was made by total incidents under anesthesia/surgery, and also by incidents totally attributable to anesthetic management (AM), due to preoperative complications (PC), due to intraoperative pathological events (IP) and due to surgery (SG). This paper focused on analysis of entire patients, as other later papers will report analyses with special reference to ASA physical status, age distribution, surgery sites and anesthetic methods. Total incidence of cardiac arrest under anesthesia/surgery was 6.12 per 10,000 anesthetics. PC, IP and SG occupied 47.2%, 21.1% and 24.2% of principal causes of total cardiac arrest, respectively. AM occupied only 6.4% of the principal causes and the incidence was 0.39 per 10,000. The most frequent cause of cardiac arrest in 52 more detailed classifications of principal causes was preoperative hemorrhagic shock that occupied 19.2% of all cardiac arrests. The second was massive hemorrhage due to surgical procedures (12.3%), and the third was surgery itself (9.7%). Prognosis of the cardiac arrest was worst in that due to PC, i.e. 86.1% of cardiac arrests died in the operating room or within 7 days after surgery and only 5.3% survived without sequelae. Very low survival rate of preoperative hemorrhagic shock (5.3%) and preoperative multiple organ failure/sepsis (7.1%) aggravated the prognosis. Pulmonary embolism was the worst single cause in prognosis of cardiac arrest due to IP. The best prognosis was found in cardiac arrest due to AM, 82.0% survived without sequelae and 10.0% died. The mortality rate after cardiac arrest was 3.04 per 10,000 anesthetics, of them 0.04 was due to AM, 0.43 due to IP, 1.89 due to PC and 0.67 due to SG. The mortality rate after critical incidents other than cardiac arrest such as severe hypotension and severe hypoxemia was 3.37, and of them 0.06 was due to AM, 0.23 due to IP, 2.25 due to PC and 0.82 due to SG. The final mortality rate attributable to anesthesia/surgery including deaths after cardiac arrest and after other critical incidents was 6.41 per 10,000 anesthetics. The final mortality rate totally attributable to AM was 0.10 per 10,000 anesthetics, which was significantly improved from 0.21 [0.15, 0.27], that of mean [95%C.I.] in 1994-1998. IP, PC and SG showed the final mortality rate of 0.65, 4.14 and 1.49, respectively. Three major causes of all critical incidents in 52 detailed classification of principal causes were preoperative hemorrhagic shock (31.4%), massive hemorrhage due to surgical procedures (16.9%), and preoperative multiple organ failure/sepsis (9.0%). In conclusion, the obtained incidences as to cardiac arrest and death, either in total number during anesthesia/surgery or in that due to anesthetic management, kept decreasing lineally through 8 years study in 1994-2001. We expect that this second series of annual studies for five-years should reveal precise and definite direction for us to reduce anesthesia-related mortality and morbidity by analyzing further detail with special reference to ASA physical status, age distribution, surgery sites and anesthetic methods.

Anesthesia↗
PubMed2003

[Anesthetic management for cerebral aneurysm surgery in a patient with aortitis syndrome accompanied by lung edema].

A 48-year-old woman with aortitis syndrome underwent clipping of dissecting aneurysm of the left posterior inferior cerebellar artery following subarachnoid hemorrhage. Preoperative echocardiography demonstrated moderate aortic regurgitation and pulmonary hypertension. Intravenous infusion (1900 ml.day-1) was performed to avoid cerebral vasospasm, but the patient developed lung edema. She received delayed surgical treatment after the improvement of lung symptoms. Anesthesia was induced with fentanyl (0.1 mg), propofol (90 mg) and vecuronium (6 mg). Radial arterial flow was judged to be insufficient for cannulation, and a cannulation was therefore performed on the dorsal pedis artery. During induction of anesthesia, there was a significant decrease in the arterial pressure, that required a total of 32 mg of intravenous ephedrine. Following tracheal intubation, a central venous catheter was inserted and dopamine was continuously administered. The patient was positioned in the park bench position. We thought that the placement of the introducer for Swan-Ganz catheter was difficult under the position and Swan-Ganz catheter was not inserted. Anesthesia was maintained with sevoflurane, air, and oxygen. We continuously monitored the central venous pressure as an indicator of fluid balance. In this case, we monitored dorsal pedis arterial pressure directly, which might not be sufficiently reliable to predict the decrease in cerebral blood flow.

Anesthesia↗
PubMed2003

[Heparin resistance during cardiopulmonary bypass].

A 74-year-old man was scheduled for coronary artery bypass graft surgery with cardiopulmonary bypass. After intravenous heparin (200 U.kg-1), the activated clotting time (ACT) increased from 124 to 436 sec. However, it decreased to 128 sec immediately after cardiopulmonary bypass. The bypass was discontinued because the addition of heparin (200 U.kg-1) proved heparin resistance. The coronary artery bypass procedure was completed uneventfully without cardiopulmonary bypass. Several recent articles have reported that heparin resistance was corrected with antithrombin III concentrates, fresh frozen plasma, or argatroban. In this case, these drugs could not be used because the mechanism of heparin resistance remains uncertain. Thus, the off-pump technique is useful for unknown heparin resistance.

Aged↗
PubMed2003

[Postoperative pulmonary thromboembolism].

Since 1986, American College of Chest Physicians (ACCP) has been regularly releasing guidelines for antithrombotic therapy for prevention and treatment of thrombosis. The sixth ACCP consensus 2001 conference has recommended successful prevention strategies in surgical patients. A few Japanese prospective studies disclosed that the incidence of deep vein thrombosis(DVT) after general surgery in Japan is about half in western countries. On the other hand, it is reported that the incidence of DVT after total hip replacement and total knee replacement in Japan is almost as same as in western countries. Since there is still little data available for the incidence of postoperative DVT and pulmonary thromboembolism in Japan, it is necessary to organize some prospective multicenter surveys for them.

Female↗
PubMed2003

[The relationship between the yearly number of operations and mortality due to intraoperative critical incidents in patients for cardiac surgery: an analysis of annual survey 2001 conducted by the Japanese Society of Anesthesiologists].

BACKGROUND: The number of surgical operations performed has been reported to have a relation with surgical morbidity and mortality. In Japan, however, the relationship between surgical load and outcome has not been elucidated. METHODS: We investigated this relationship in patients for cardiac surgery using data from the 2001 annual survey concerning anesthesia-related critical incidents, conducted by the Committee on Operating Room Safety, Japanese Society of Anesthesiologists. Between January 1, 2001 and December 31, 2001, 43,411 patients for cardiac surgery patients were registered from 486 training hospitals certified by the Japanese Society of Anesthesiologists. Intraoperative critical incidents occurred in 632 of the patients. Of these, 289 patients died within 7 postoperative days. The overall mortality was 66.57 per 10,000 anesthetics. Hospitals were divided into 4 groups according to their annual numbers of cardiac operations: Group A, fewer than 50; Group B, 50-99; Group C, 100-199; Group D, more than 200. Mortality rate was expressed as a mean +/- SD (95% confidence interval). RESULTS: The mortality rates in Group A-D were 107.64 +/- 327.33 (63.47-151.81), 114.42 +/- 168.76 (83.02-145.87), 63.53 +/- 84.35 (48.04-79.01), and 36.97 +/- 52.83 (22.32-51.61) per 10,000 anesthetics, respectively. CONCLUSIONS: The yearly number of operations has been shown to affect mortality rate due to intraoperative critical incidents among patients for cardiac surgery in Japan. Hospitals with a small number operations should pay significant attention to improving surgical outcome. These results also suggest that centralization or regionalization of cardiac surgery should be discussed from the socio-economical points as well as patient safety.

Anesthesia↗
PubMed2003

[Successful airway management using a Cook airway exchange catheter as an emergent dilator for life-threatening neoplastic stenosis of the trachea: a case report].

A 68-year-old male patient was referred to our hospital for his intractable and progressive dyspnea. Chest roentgenography and computerized tomography revealed severe lower tracheal stenosis due to neoplastic invasion. The tumor completely surrounded his trachea for 5 cm length and the remaining internal diameter of the trachea was less than 5 mm. To avoid fatal asphyxia, emergency airway security was required. After placing both femoral arterial and venous cannulae for percutaneous cardiopulmonary support system, we dilated the stenotic trachea using a Cook airway exchange catheter (CAEC), and then an armored tube of 7 mm inner diameter was introduced through the CAEC. The maneuver was smoothly completed within one minute without any complications. His dyspnea was completely relieved. Following chemotherapy and radiotherapy were so effective that the endotracheal tube was extubated two weeks later uneventfully. After several series of chemotherapy and 50 Gy irradiation, the patient was discharged three months later without symptoms. We concluded that CAEC could be one of the life-saving instruments for emergent airway management in case of severe organic tracheal stenosis.

Aged↗
PubMed2003

[Anesthetic management with ATP for endovascular thoracic aortic repair].

A 78-year-old man with thoracic aortic aneurysm was scheduled for endovascular stent-graft surgery without cardiopulmonary bypass. He had a history of myocardial infarction five months before and echocardiography revealed ejection fraction of 37%. Deployment of the stent-graft was performed during third degree atrioventricular (A-V) block of 32 seconds produced by adenosine 5'-triphosphate (ATP) 30 mg. There were no complications during this procedure. ATP is a convenient and suitable agent to produce transient A-V block for the precise deployment of the stent-graft in these patients with severe cardiopulmonary complications.

Adenosine Triphosphate↗
PubMed2003

[Retroperitoneal emphysema during total hip replacement].

A 55-year-old woman with rheumatic arthritis was scheduled for total hip replacement. The procedure was performed under combined spinal and epidural anesthesia. Intraoperatively, the part of acetabular roof was cracked by reaming the region but she did not complain of any symptom. However, during pulse irrigation she complained of abdominal pain. After the operation, abdominal distension was noticed and retroperitoneal emphysema was disclosed. She was managed in a ward without problems postoperatively.

Anesthesia, Epidural↗
PubMed2002

[Perioperative mortality and morbidity in the year 2000 in 502 Japanese certified anesthesia-training hospitals: with a special reference to ASA-physical status--report of the Japan Society of Anesthesiologists Committee on Operating Room Safety].

Perioperative mortality and morbidity in Japan from Jan. 1 to Dec. 31, 2000 were studied retrospectively. Committee on Operating Room Safety in Japanese Society of Anesthesiologists (JSA) sent confidential questionnaires to 794 certified training hospitals of JSA and received answers from 67.6% of the hospitals. We analyzed their answers with a special reference to ASA physical status (ASA-PS). The total number of anesthesia available for this analysis was 897,733. The percentages of patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E are 38.0, 40.3, 8.5, 0.4, 4.3, 5.3, 2.5, and 0.7%, respectively. Mortality and morbidity from all kinds of causes including anesthetic management, intraoperative events, co-existing diseases, and surgical problems were as follows. The incidences of cardiac arrest (per 10,000 cases of anesthesia) were 1.11, 3.26, 12.25, 54.60, 0.77, 4.46, 21.08 and 217.75 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The incidences of critical events including cardiac arrest, severe hypotension, and severe hypoxemia were 6.89, 20.22, 62.18, 148.21, 6.71, 20.38, 106.72 and 592.21 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The mortality rates (death during anesthesia and within 7 postoperative days) after cardiac arrest were 0.26, 0.77, 3.69, 41.60, 0.00, 1.06, 9.42 and 163.31 per 10,000 cases of anesthesia in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The overall mortality rates were 0.32, 1.38, 9.75, 70.20, 0.26, 2.12, 29.15 and 353.02 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. Overall mortality and morbidity were higher in emergency anesthesia than in elective anesthesia. ASA-PS correlated well with overall mortality and morbidity, regardless of etiology. The incidences of cardiac arrest totally attributable to anesthesia were 0.23, 0.50, 1.32, 0.00, 0.00, 0.85, 2.69 and 4.95 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The incidences of all critical events totally attributable to anesthesia were 3.13, 5.56, 11.46, 5.20, 3.87, 5.94, 13.90 and 14.85 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The mortality rates after cardiac arrest totally attributable to anesthesia were 0.03, 0.03, 0.00, 0.00, 0.00, 0.21, 0.45 and 3.30 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The overall mortality rates totally attributable to anesthesia were 0.03, 0.06, 0.00, 0.00, 0.00, 0.21, 0.45 and 6.60 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The overall mortality rate totally attributable to anesthesia among patients with good physical status (ASA-PS of I, II, I E, II E) was 0.05. Anesthetic management was mainly responsible for critical events in patients with good physical status, while coexisting diseases were in those with poor physical status. Surgical problems including procedures and massive hemorrhage were the leading causes of mortality in patients with good physical status. We reconfirmed that ASA-PS is useful to predict perioperative mortality and morbidity. It also seems likely that we should make much more efforts to reduce anesthetic morbidity in patients with good physical status, and to improve preanesthetic assessment and preparation in those with poor physical status. Reducing mortality and morbidity from surgical problems is also required for improving perioperative mortality.

Anesthesia↗
PubMed2002

[Drug-induced side effects in a patient with status asthmaticus treated with long-term isoflurane inhalation].

We describe a 23 year-old woman with status asthmaticus who was treated with long-term isoflurane inhalation. In this case, we experienced severe drug-induced side effects. We conclude that isoflurane has low metabolic rate and may be the best alternative in the treatment of status asthmaticus. In long-term treatment, we have to take care of drug overdosing to avoid side effects.

Adult↗