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Biomedical subjects

R Motoki

Publications and source records attributed to R Motoki.

At least 37 records · Page 2Linked to original sources
PubMed1991

Effect of neo red cells on the canine hemorrhagic shock model.

This study evaluated the newly developed artificial red blood cells named Neo Red Cells (NRC) after hemorrhagic shock in mongrel dogs. NRC is prepared as microcapsules by a method in which stroma-free hemoglobin is encapsulated using a bimolecular lipid membrane called liposome. The particle size is 0.2 micron, methemoglobin content is less than 5% and the hemoglobin concentration is 5.6 g/dl. We analyzed blood gases and hemodynamics and carried out laboratory examinations after 59-88% blood exchange using NRC. The hemodynamic parameters returned to the normal range after NRC. Inhaling normal room air, oxygen carried by NRC was 60.40% at the exchange rate of 88%. Renal and hepatic function and other laboratory findings were normal after administration of NRC. After further study and improvement NRC could be considered suitable as artificial blood for treatment of hemorrhagic shock.

Animals↗
PubMed1991

[Reevaluation of the unilateral pulmonary artery occlusion test--hemodynamics after lobectomy and pneumonectomy for lung cancer].

After lobectomy, it is recognized that functional as well as absolute reduction occurs in residual lobes of the operated side. So whether lobectomy is indicated or not is determined by the same criteria as those for pneumonectomy, namely, by the unilateral pulmonary artery occlusion (UPAO) test. However, is it really appropriate to use the same criteria for both lobectomy and pneumonectomy? To answer to this question, in patients with lung cancer we compared the hemodynamics after lobectomy (13 cases) and pneumonectomy (14 cases) with that at the UPAO test. After pneumonectomy, the mean pulmonary arterial wedge pressure (mPWP) was significantly lower than that on the preoperative day and at the test. It seemed that hypovolemic change occurred in the hemodynamics after pneumonectomy. After pneumonectomy, the pulmonary arteriolar resistance index (PARI) was significantly higher than the preoperative value. It was the same as that as at the time of the UPAO test. The total pulmonary vascular resistance index (TPVRI) at the time of the test was significantly higher than the preoperative value, but the TPVRI after pneumonectomy was not significantly higher. The TPVRI tended to decrease after pneumonectomy, compared to the value predicated by the test. These results indicated that some of the cases judged inoperable on the basis of the UPAO test might be operable. On the day of lobectomy, the PARI was significantly higher than the preoperative value, but significantly lower than that at the time of the test. The cardiac index (CI) was significantly higher and the mPWP was significantly lower than each preoperative value.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[A study of the right ventricular load at the unilateral pulmonary artery occlusion test after pneumonectomy].

After pneumonectomy, it is recognized that the absolute reduction of the pulmonary vascular bed makes the right ventricular afterload increase and can cause right heart failure in patients with low cardiopulmonary reserve. Therefore, we investigated how the right ventricular load was predicted by UPAO test, comparing hemodynamics at the time of the test with those after pneumonectomy in patients with lung cancer. At the test, the absolute reduction of the pulmonary vascular bed made the right ventricular afterload increase but the right ventricular pump function was maintained at the preoperative level by the increase of the right ventricular work load, namely, by the contraction of the right ventricle. After pneumonectomy, the absolute reduction of the vascular bed did not always make the afterload increase and in spite of the decreased preload the pump function was maintained at the preoperative level by increased heart rate. Additionally, the increase of the right ventricular work load improved during early postoperative days. It was concluded that UPAO test was apt to overestimate the right ventricular load of the postoperative day because it was done under the condition of the different compensatory function from the postoperative hypovolemic change.

Aged↗
PubMed1990

[Therapeutic evaluation of combination therapy using C-425, human native immunoglobulin liquid preparation for i.v. administration, with antibiotics in severe infections in the field of surgery].

In a nationwide study conducted in 11 surgical institutions of C-425, a newly developed human native immunoglobulin liquid preparation for intravenous injection, was combined with conventional antibiotic treatment to investigate the efficacy and safety. A total of 47 patients with severe infections which had not symptomatically responded to 3-day or longer treatment with any antibiotics was included. Doctors in charge judged the efficacy of C-425 to be "excellent" in 3 patients, "good" in 13, "fair" in 15, and "poor" in 4. Thus, a total of 16 patients (45.7%) was judged to have responded to C-425 when the "excellent" and "good" responses were combined. The number responding was 31 (88.6%) when the "fair" cases were also included. Excluding 31 patients who did not meet the Committee's criteria, the Committee judged the efficacy of C-425 in a total of 16 patients; the efficacy was "excellent" in 2 patients, "good" in 4, "fair" in 9, and "poor" in 1. The number of responding patients was 6 (37.5%) of the 16 when the "excellent" and "good" cases were combined, and 15 (93.8%) when the "fair" cases were added. Bacteriological assessment was conducted in a total of 9 patients. Causative bacteria were eradicated in 3 patients, decreased in number in 1, replaced in 2, and persisted in 3. Thus, bacteriological efficacy was observed in 6 of the 9 patients (66.7%). Neither adverse reactions nor drug-related laboratory abnormalities were observed in the 47 patients.

Adult↗
PubMed1990

[Effects of the synthetic proteinase inhibitor, FOY, on hypercoagulability after surgery for esophageal carcinoma].

Hypercoagulability develops after surgery for esophageal carcinoma, and it related closely to postoperative complications. This study evaluated the effects of the synthetic proteinase inhibitor, Cabexate Mesilate (FOY), on this hypercoagulability. The subjects used were 25 patients with a mean age of 63 who had undergone surgery for esophageal carcinoma. Of these, eight patients (test group) received FOY (2,000 mg/day) for three to 23 days after surgery, but 17 (control group) did not. In the test group, FOY controlled aggregation and release of the platelets and minimized their exhaustion. FOY almost completely checked the abnormal increase in thrombin activity which might trigger the hypercoagulability. Also, FOY suppressed the fibrinolytic activity slightly. These results indicate that FOY is effective in controlling hypercoagulability after surgery for esophageal carcinoma and in suppressing activity of the proteinases that cause both blood coagulation and fibrinolysis.

Adult↗
PubMed1990

[Hypercoagulability after surgery of esophageal carcinoma].

The purpose of this study was to determine hypercoagulability in patients surgically treated for thoracic esophageal cancer. Twenty-four patients were evaluated; 19 subjected to open chest esophagectomy and 5 closed chest blunt dissection. Six patients subjected to gastrectomy served as controls. In all test patients, preoperative coagulability was within the normal range. Immediately after surgery, however, they were in a hypercoagulable state, showing a marked decrease in platelet count, prothrombin time, antithrombin III level and plasminogen level and an increase in activated partial thromboplastin time and fibrinopeptide B beta 15-42. The controls showed almost no change. There was a close correlation between hypercoagulability on one hand and the time needed for surgery and hemorrhage during 3rd to 7th postoperative day except those with multiple organ failure whose recovery was delayed and those with leakage of anastomosis whose condition did not improve even on the 10th postoperative day.

Adult↗
PubMed1989

[The effect of protease inhibitors in shock].

UNLABELLED: Protease inhibitors, such as ulinastatin and gabexate mesilate, are widely used for the patients in shock state. The purpose of this study was to evaluate the effects of these protease inhibitors on renal protection and coagulofibrinolytic disorders. The obtained results were as follows: 1. Ulinastatin studies. 1) Beta 2-microglobulin (BMG) excretion and N-acetyl-beta-D-glucosaminidase (NAG) activity in urine were increased in cases of emergency operation (10 patients) compared with elective operation (38 patients). 2) In canine experimental model of renal ischemia, ulinastatin significantly improved urine volume and urine NAG levels. 3) Administration of ulinastatin suppressed urine NAG level in 12 patients, but BMG level did not significantly change. 2. Gabexate mesilate (FOY) studies. 1) All patients in shock state showed coagulofibrinolytic disorders. Especially remarkable hypercoagulability was observed in 21 patients. 2) FOY suppressed platelet aggregation and the release of beta-thromboglobulin and platelet factor 4. 3) In 24 patients, administration of FOY markedly increased the antithrombin III levels in early postoperative period. 4) Fibrinolytic system was not affected any significant changes with administration of FOY. CONCLUSION: Our results suggested that protease inhibitors are useful for management of the patients in shock state.

Animals↗
PubMed1989

[A case report of mycotic false aortic aneurysm associated with aortic regurgitation].

The patient was 63-year-old man, who underwent patch closure of VSP 37 days after onset. LVAD was required for weaning from CPB. Mediastinitis occurred after LVAD was removed. The mediastinum was irrigated using diluted antibiotics through the retrosternal drain. He discharged on 79th day postoperatively. False aortic aneurysm and marked AR was pointed out by cineangiography and enhanced CT scan two years after operation. AVR was performed through right thoracotomy, because false aortic aneurysm invaded the sternum. The aneurysmal wall was repaired with patch. Postoperatively, peritoneal dialysis was performed for two days. Flail chest made difficult weaning from the respirator. He died 11 days postoperatively due to respiratory failure. There remains the possibility that mediastinitis resulted in false aortic aneurysm and AR. It was esseutial to remove the foreign materials placed on the aorta for eradication of infection.

Aneurysm, Infected↗
PubMed1989

[Pulmonary artery aneurysm-like associated with pulmonary stenosis].

A 55-year old man had complained shortness of breathing and an abnormal shadow at left hilus region had been pointed out on the chest X-ray film. Right heart catheterization and right ventriculography revealed pulmonary valve stenosis with pulmonary artery aneurysm-like. Utilizing cardiopulmonary bypass, aneurysmorrhaphy and valvotomy was performed. Postoperative course was good and he was discharged on the 29th postoperative day. It is considered that mild post-stenotic dilatation of pulmonary trunk due to pulmonary valvular stenosis might develop into the aneurysmal change because of some congenital structural deficiency in the pulmonary arterial wall.

Aneurysm↗
PubMed1988

[Cooperative research on post-operative adjuvant therapy of breast cancer. Tohoku Society of Adjuvant Chemo-endocrine Therapy of Breast Cancer].

A randomized trial was carried out in 55 institutes in the Tohoku district to examine the significance of breast cancer post-operative adjuvant chemo-endocrine therapy in stage II and IIIa patients for possible radical mastectomy. A total of 619 patients were entered from November 1982 to November 1984, of whom 554 were eligible. Patients were administered MMC 13 mg/m2 after surgery, and randomized using the envelope method into either group A, treated with Tegafur 400 mg/m2 alone (275 patients), or group B, treated with Tegafur 400 mg/m2 and Tamoxifen 20 mg/daily (279 patients), for a year from the 7th day after operation. There was no significant difference between the two groups in the background factors of age, menopausal status, operation methods, stage or number of positive lymph nodes, but there were more patients of ER(+) in group B. A Kaplan-Meier method comparison showed no significant difference between the two groups in 3-year disease-free survival rates. There was no significant difference between the two groups compared by ER or menopausal status. However, patients with 4 or more positive lymph nodes showed a significant benefit in group B. Group B also marked a higher disease-free survival rate for ER(+) patients with 4 or more positive lymph nodes.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

[Blood volume measurement of newborn using stable isotope 50Cr].

A technique for the blood volume measurement of newborns was established in which nonradioactive 50Cr was used in patients for whom radioactive labels were not advisable. The red blood cells (RBC) in the newborn's blood withdrawn from umbilical cord after birth were tagged with enriched stable isotope 50Cr (96%, normal abundance 4.3%) and reinjected into the newborn. Blood samples (0.5 ml) were withdrawn at 30 min and thereafter at 6, 12, 24, 48, 72 and 120 hours old. Samples were centrifugalized and portion of RBC was then freeze-dried, weighed and sealed into polyethylene sheet bag together with 50Cr standard. Neutron irradiation was performed in the reactors of the JAERI with thermal neutron flux 5 X 10(13), 2 X 10(13), 8 X 10(13) cm-2s-1 at JRR-2, -3 and -4 respectively for 20 min and samples were left for about two weeks after irradiation. Induced radioactivity (51Cr, 59Fe) of the sample was measured with a Ge(Li) gamma-ray detector system and 4096 channels pulse height analyzer. Analysis of activity data was carried out by BOB-76 code. The RBC and total blood volume of the newborn was calculated using an isotopic dilution technique. We have investigated on tagging efficiency of 50Cr to RBC, washing effect and dilution rate by 50Cr content or 51Cr/59Fe ratio. Significant difference was observed in the total blood volume of newborns depending on the delivery style and in addition, it changed dynamically along the time elapsed after birth.

Blood Volume Determination↗
PubMed1985

[Recent advances in artificial blood].

Naito, et al. has succeeded in the development of perfluorochemical emulsion which is capable of plasma volume expansion and oxygen transport. The perfluorochemical-based substitute named Fluosol-DA (FDA) has been proven to be effective for treatment of patients with hemorrhagic shock. FDA was administrated effectively when blood transfusion was refused for religious reason or delivery of compatible blood was delayed due to transportation or other factors. There is a wide range of other potential application of FDA. Organ perfusion with FDA has been a major concern. The usage of FDA as a priming solution for extracorporeal circulation has been studied. Its protective effect on cerebral ischemia and therapeutic effect on myocardial ischemic damage were reported. Current FDA, however, has some limitation. Relative short intravascular persistence, toxicity and instability of emulsion particles have been pointed out. Development of a new perfluorochemicals and a potent surfactant will solve the problems, and perfluorochemical emulsions will become much more practical and common.

Animals↗