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Biomedical subjects

R Shimizu

Publications and source records attributed to R Shimizu.

At least 145 records · Page 8Linked to original sources
PubMed1995

[Effect of horizontal lithotomy position on spread of hyperbaric dibucaine spinal anesthesia].

We have studied the effect of horizontal lithotomy position on the spread of hyperbaric dibucaine spinal anesthesia. In three groups of 20 patients, 7.2 mg of hyperbaric dibucaine was injected intrathecally in the lateral decubitus position. In group supine, the patients were kept in supine horizontal position in which patient's legs and thighs were extended throughout the operation. In group lithotomy A, immediately after the spinal injection, the patients were placed into the lithotomy position. In group lithotomy B, after the spinal injection, the patients were placed immediately in the supine horizontal position for 15 min and then placed into the lithotomy position. There were no significant differences in height of sensory blockade among the three groups. The lithotomy position did not significantly affect the level of sensory blockade with hyperbaric dibucaine.

Adult↗
PubMed1995

[Rectal diclofenac coupled with continuous epidural infusion with buprenorphine and bupivacaine for pain relief after upper and lower abdominal surgery].

This investigation was conducted to determine the analgesic efficacy of rectal diclofenac coupled with continuous epidural infusion with buprenorphine and bupivacaine for pain relief after upper and lower abdominal surgery. Forty patients in control group received epidural buprenorphine 0.1 mg in 8 ml of 0.25% bupivacaine immediately after surgery and subsequently infusion was started with the solution of epidural buprenorphine 15 micrograms in 1 ml of 0.23% bupivacaine at a rate of 1 ml.h-1 for 48 h. Forty patients in study group received rectal diclofenac 50 mg immediately after surgery in addition to the same epidural injection method described above. Adding rectal diclofenac to continuous epidural infusion of buprenorphine and bupivacaine produced enhanced analgesia and reduced pain scores measured by VAS after upper abdominal surgery. However, after lower abdominal surgery, such effects of rectal diclofenac obtained after upper abdominal surgery were not demonstrable.

Abdomen↗
PubMed1995

An inhibitor of nitric oxide synthase, N omega-nitro-L-arginine-methyl ester, attenuates hypotension but does not improve cardiac depression in anaphylaxis in dogs.

We investigated whether a nitric oxide synthase (NOS) inhibitor improves cardiovascular depression associated with anaphylaxis. After induction of anaphylactic circulatory depression, one group received an NOS inhibitor (Group I, n = 6) and the other received saline solution (Group II, n = 5). Mean arterial pressure and right atrial pressure were significantly higher in Group I than in Group II. Hematocrit was significantly lower in Group I than in Group II. Cardiac output, stroke volume, mean pulmonary arterial pressure, the maximum rate of increase in left ventricular pressure, and the time constant of the fall in isovolumic left ventricular pressure did not differ between the groups. In conclusion, L-NAME attenuates hypotension, but does not improve cardiac depression in anaphylaxis in dogs. Our finding that NOS inhibitor did not improve cardiac function implies that the production of NO in anaphylaxis may have a protective effect with regard to cardiac performance.

Anaphylaxis↗
PubMed1995

[Severe bradycardia and hypotension during epidural anesthesia in a patient undergoing hemorrhoidectomy].

Severe bradycardia and hypotension developed suddenly in two patients undergoing hemorrhoidectomy under lumbar epidural anesthesia in the jackknife position, about 5 to 10 min after epidural administration of buprenorphine. Severe vago-vagal reflex was supposed to have been induced with buprenorphine in a situation where venous return was decreased by epidural anesthesia and the jackknife position.

Anesthesia, Epidural↗
PubMed1995

[Lumbar epidurography with iohexol: the effect of aging on the leakage of contrast media from the intervertebral foramina].

The lateral and longitudinal spread of contrast media was investigated by lumbar epidurography with 8 ml of iohexol in 47 patients aged 25 yr to 86 yr. Iohexol was injected through the epidural catheter epidurally advanced by 5 cm cephalad from the L 1-4 interspace. A significant correlation was found between the longitudinal spread of iohexol and aging. No correlation was found between the leakage of iohexol from the intervertebral foramina and aging. This finding may deny the hypothesis that in elderly patients, the more extensive longitudinal spread of local anesthetics in the epidural space may be caused by its smaller leakage from the intervertebral foramina.

Adult↗
PubMed1995

[A radiological analysis of the position of lumbar epidural catheters: a comparison between median and paramedian approach].

The position of lumbar epidural catheters was confirmed by radiography in 71 patients. Catheters were advanced by 5 cm cephalad in the lumbar epidural space by paramedian approach (Group P: n = 28) or median one (Group M: n = 43) and contrast media was injected through the catheters. If the contrast media was present in the paravertebral regions, the catheter was considered to be in the abnormal position. The incidence of the abnormal position of the catheters was higher in group M than in group P significantly. To advance an epidural catheter longer into the lumbar epidural space, paramedian approach may be superior to median one.

Anesthesia, Epidural↗
PubMed1995

[Diagnosis of accidental subdural block].

Accidental subdural block occurred in a 47-year-old man who underwent gastrectomy under nitrous oxide-sevoflurane anesthesia combined with continuous epidural block. The development of subdural block was suspected from unexpectedly severe hypotension with small doses of mepivacaine during operation and was confirmed by a characteristic X-ray photograph after operation. The subdural block should be suspected from abnormal changes in vital signs and by careful observation of X-ray photographs, because it is not always easy to determine the presence of contrast media either in the subdural space or in the epidural space.

Anesthesia, Epidural↗
PubMed1995

[Patient's complaints preceding severe bradycardia and hypotension during spinal anesthesia].

We reported an episode of sudden bradycardia and hypotension during spinal anesthesia, in which the patient complained of nausea before the bradycardia and hypotension were recognized by the monitors, such as, intermittent measurement of arterial pressure, electrocardiography, pulse oxymetry and continuous arterial blood gas analysis. We emphasize the importance of strict vigilance during spinal anesthesia.

Aged↗
PubMed1995

[Continuous epidural buprenorphine for postoperative pain relief after thoracotomy].

To evaluate postoperative analgesia and side effects of epidural buprenorphine, 60 patients after thoracotomy were divided into 6 groups. All patients received a bolus epidural administration of buprenorphine 0.1 mg in 8 ml of 0.25% bupivacaine. Following this epidural bolus, 10 patients in each group were given 0.25% bupivacaine alone (group A), buprenorphine 5 micrograms in 1 ml of 0.25% bupivacaine (group B), buprenorphine 8 micrograms in 1 ml of 0.25% bupivacaine (group C), buprenorphine 12 micrograms in 1 ml of 0.25% bupivacaine (group D), buprenorphine 15 micrograms in 1 ml of 0.25% bupivacaine (group E) or buprenorphine 18 micrograms in 1 ml of 0.25% bupivacaine (group F) with a portable disposable device at a rate of 1 ml.h-1 for 48 h. The percentages of patients who did not need additional narcotics for the first 24 hours postoperatively in group A, B, C, D, E, and F were 20%, 40%, 30%, 50%, 60%, and 70%, respectively. Those for the second 24 hours postoperatively in each group were 40%, 50%, 70%, 60%, 90%, and 90%, respectively. No significant difference in the incidence of side-effect was found among 6 groups. We concluded that optimal epidural doses of buprenorphine for post-thoracotomy pain relief are 15 and 18 micrograms.h-1 in the first and second 24 hours postoperatively, respectively.

Adult↗
PubMed1995

[Postoperative analgesia service by continuous epidural infusion with buprenorphine].

We examined the analgesic efficacy and side effects of continuous epidural infusion with buprenorphine in 340 surgical patients. The patients received epidural injection of 0.1 mg of buprenorphine in 8 ml of 0.25% bupivacaine immediately after surgery. The patients who underwent thoracotomy or intraabdominal surgery were subsequently infused with buprenorphine 15 micrograms in 1 ml of 0.25% buprenorphine at a rate of 1 ml.h-1 for 48 h. In the other kinds of surgery, patients were infused with buprenorphine 8 micrograms in 1 ml of 0.25% buprenorphine at a rate of 1 ml.h-1 for 48 h. The patients who did not need additional narcotics were 68% and 83% on the postoperative day 1 and 2, respectively. Visual analogue scale (VAS) was 22 +/- 2 mm at rest and 43 +/- 2 mm at movement on the postoperative day 1. Corresponding values on the postoperative day 2 were 16 +/- 2 mm and 37 +/- 2 mm, respectively. Nausea and vomiting were found in 12.4% of the patients.

Adolescent↗
PubMed1995

[Spinal anesthesia for oophorectomy in a patient with pulmonary lymphangiomyomatosis accompanied by hypochondriasis].

A 41-year-old woman with pulmonary lymphangiomyomatosis had been scheduled for bilateral oophorectomy which led to amelioration of the pulmonary pathology. The discrepancy between her dyspnea on exertion and lung function tests suggested that she had a marked tendency toward hypochondria. Therefore, we chose spinal anesthesia because of its technical simplicity, rapid onset, and effectiveness of some sedatives used perioperatively. Surgery was performed uneventfully. The anesthetic method mentioned above did not worsen respiratory function perioperatively. Spinal anesthesia is thought to be appropriate anesthesia for patients with pulmonary lymphangiomyomatosis, if feasible.

Adult↗
PubMed1995

[Usefulness of measurement of mast cell tryptase for differential diagnosis of anaphylaxis and anaphylactoid reaction].

We described a case of anaphylaxis diagnosed by the evaluation of plasma mast cell tryptase and a case of anaphylactoid reaction. In a patient undergoing pulmonary lobectomy, anaphylaxis, showing the elevation of plasma tryptase, was provoked by physiological glue for hemostasis during the operation. During the operation, cardiovascular collapse occurred suddenly, at which time the cause was not diagnosed. After completion of the operation and removal of drapes, diffuse urticaria with wide erythema on the torso and the upper extremity was noticed. Suspecting allergic adverse reaction, plasma tryptase was measured 2h and 5h after the start of the episode, showing 34.6 ng.ml-1 at 2h and 15.3 at 5h. Because these elevations of plasma tryptase indicated degranulation of mast cells, evaluation of the causative drugs was performed 7 weeks after the episode. Physiological glue was confirmed to be causative drug. In another patient for total hysterectomy and bilateral oophorectomy, adverse reaction occurred after completion of the operation and extubation. Increase in plasma histamine concentration to 4.94 ng.ml-1 that could induce systemic reaction was noticed; however, concentrations of plasma tryptase 25 min, 3h and 7h after the episode were not elevated. This finding indicated that the adverse reaction was not based on degranulation of mast cell, and was anaphylactoid reaction provoked by nonspecific histamine-release. In conclusion, measurement of plasma tryptase is a useful method for differential diagnosis of anaphylaxis and anaphylactoid reaction.

Aged↗
PubMed1995

[Reevaluation of protective effect of mild hypothermia on brain ischemia following massive bleeding].

Mild hypothermia was speculated to have protected the brain from ischemic damage attributed to hypotension in two patients who had suffered massive bleeding. One patient developed hypotension below 40 mmHg of systolic pressure for 2 hr 30 min during hemi-hepatectomy. The patient's body temperature fell spontaneously to 31 degrees C and was maintained at about 31 degrees C during hypotension because a large amount of cold blood and fluid were given. Another patient injured by traffic accident developed hypotension below 40 mmHg of systolic pressure for 30 min. The patient was placed in hypothermic state of 33 degrees C by surface cooling immediately after induction of anesthesia. After the completion of surgery, no neurological deficit was found in either patient. Mild hypothermia is a useful and valuable method for protecting the brain during accidental profound hypotension.

Adult↗
PubMed1995

[mRNA expression and protein localization of placental tissue protein 11, 12, 19 in gynecologic malignant tumors].

In recent years, the localization and function of placental tissue proteins (PPs), extracted by Bohn et al., have been extensively studied, the genetic code has been identified for each of the PPs. The present study was carried out to clarify the mRNA expression and protein localization of PP11, PP12, PP19 at the cell level and also to define PP19 the nature of which has remained obscure. PP19 was said to be placenta-derived S-100P. PP11 mRNA was not expressed in cytotrophoblast-derived normal placental tissue or endometrium-derived normal cells, but was expressed in syncytiotrophoblast-derived normal placental tissue, and in choriocarcinoma and endometrial adenocarcinoma, suggesting its involvement in carcinogenesis. PP12 mRNA was expressed in cytotrophoblast-derived normal placental tissue or endometrium-derived normal cells, but was not expressed in syncytiotrophoblast-derived normal placental tissue, choriocarcinoma or endometrial adenocarcinoma, suggesting that this protein serves in the function of normal cells. PP19 mRNA was expressed in the squamous epithelial cells of the uterine cervix and the villous cells, PP19 was localized in more differentiated regions, where cells tended toward keratinization, in both normal and dysplastic uterine cervices. In squamous cell carcinoma, PP19 was localized in more differentiated cells with a large cytoplasm. PP19 mRNA was not expressed in normal endometrial glands, but was detected in endometrial adenocarcinoma, suggesting its involvement in cell differentiation in cervical epitherial cells.

Base Sequence↗
PubMed1995

[Efficacy of the artificial ventilation for the treatment of IgE-mediated anaphylactic shock in dog].

To evaluate efficacy of artificial ventilation with 100 % oxygen for treatment of IgE-mediated anaphylaxis, we compared survival of control ventilated dogs with one of dogs with spontaneous ventilation. Fourteen dogs sensitized to Toxica canis were randomly assigned to two groups: spontaneous respiration group (Group S, n = 8) and artificial ventilation group (Group A, n = 6). All dogs were anesthetized with pentobarbital. In Group S, all dogs breathed spontaneously with constant flow of 4 l.min-1 of oxygen. Spontaneous respiration maintained an end-tidal CO2 level between 40 and 50 mmHg. In Group A, the dogs, paralyzed with pancuronium, were ventilated mechanically with 100 % oxygen, and the tidal volume was adjusted to maintain an end-tidal CO2 level between 35 and 40 mmHg. After measurements of pulmonary resistance (RL), dynamic compliance (Cdyn), and circulatory parameters at baseline, Ascaris suum antigen was administered intravenously into the systemic circulation to induce IgE-mediated anaphylaxis. RL, Cdyn and circulatory parameters were recorded continuously for 120 min after antigen challenge. Analysis of arterial blood gases was done throughout the study. Survival rates were 100 % and 50 % in Group A and Group S, respectively. In 7 of 8 dogs in Group S, apnea was observed during the period of 1 min to 5 min after antigen challenge, and the apnea continued during the period of 30s to 22 min. Four dogs died during the period of 20 min to 30 min after antigen challenge. In both groups, RL increased significantly and Cdyn decreased significantly after antigen challenge.(ABSTRACT TRUNCATED AT 250 WORDS)

Anaphylaxis↗
PubMed1995

[Anesthesia in a patient with history of multiple drug allergies].

A 38-year-old woman was admitted for intranasal ethmoidectomy. She had a history of serious anaphylactic reactions, including respiratory distress, hypotension and unconsciousness, to nonsteroidal anti-inflammatory drugs (Loxonin, Niflan) and antibiotics (Kefral, Minomycin). Preoperative intradermal skin tests against anesthesia-related drugs showed positive reactions to succinylcholine and vecuronium. After bilateral maxillary nerve block with 0.5 % bupivacaine (negative intradermal test) 3 ml, anesthesia was induced with diazepam, nitrous oxide, oxygen and sevoflurane. Trachea was intubated smoothly without muscle relaxants. Anesthesia was maintained with nitrous oxide, oxygen and sevoflurane 0.5-1 %. The anesthesia and postoperative course of this patient were uneventful. To confirm the initiation of allergic reaction to anesthetics used in the patient, serum histamine, tryptase, and complement 1, 3 and 4 factors were measured at 3 points: preoperatively, immediately after the induction, and after extubation. They showed normal levels. These results showed that no allergic reaction occurred perioperatively. In conclusion, the valuable information was provided for the choice of anesthetics by thorough evaluation of the past history and intradermal testing.

Adult↗
PubMed1994

Changes in blood lactate and heart rate in thoroughbred horses during swimming and running according to their stage of training.

The purpose of this study was to investigate whether the change in the performance capacity of horses trained by running could be evaluated with a standardised swimming exercise test as well as by a standardised running exercise test. Seven two-year-old thoroughbred horses were trained by running for four months and were subjected to a standardised swimming exercise tolerance test before the training began and after two and four months of training in addition to the standardised running tolerance test after two and four months of training. The running training brought about a significant change in the correlation between the swimming speed of the horses and their blood lactate concentration, and the correlation between the blood lactate concentration and maximum heart rate and running speed also changed significantly after two months of training.

Animals↗