Search PubMed⌕ Search

Biomedical subjects

T Asai

Publications and source records attributed to T Asai.

At least 235 records · Page 13Linked to original sources

Interactive effect of morphine and dexmedetomidine on gastric emptying and gastrointestinal transit in the rat.

We studied the interactive effect of dexmedetomidine and morphine on gastric emptying and gastrointestinal transit in the rat. In one group of rats, to examine the interactive effect on gastrointestinal transit, the two drugs were injected i.p. in a fixed ratio (30: 1)--that of their ED50 values--in six doses (0.062-1.075 mg kg-1), each to a different group of 5-8 male rats for each dose. In another group, to examine the interactive effect on gastric emptying, either dexmedetomidine or saline was injected with saline or with the ED25 or ED50 of morphine (0.22 and 2.8 mg kg-1, respectively). In both groups, at 30 min, radiolabelled saline 1 ml was infused into the stomach; at 1 h, gastric emptying or gastrointestinal transit was calculated by measuring the radioactivity in the gastrointestinal tract. Morphine and dexmedetomidine produced a supra-additive inhibitory effect on gastrointestinal transit (P = 0.02). Dexmedetomidine 0.01 mg kg-1, which itself significantly inhibited gastric emptying (P < 0.01), did not significantly alter the inhibitory effect of morphine on gastric emptying. Therefore, in rats, dexmedetomidine markedly enhanced the inhibitory effect of morphine on gastrointestinal transit, but it did not significantly alter the effect on gastric emptying.

Adrenergic alpha-Agonists↗

Appropriate size and inflation of the laryngeal mask airway.

We have compared size 3 and size 4 laryngeal masks in 30 females and size 4 and size 5 in 30 males for success rate of insertion, incidence of airleak and pressure exerted on the pharynx. First, the ex vivo volume-pressure relationship of the mask was obtained. Second, after insertion of a mask, the cuff was inflated with the recommended maximum volume of air and intracuff pressure measured. Third, the incidence of airleak during a steady airway pressure of 18 cm H2O was noted. Fourth, the cuff was deflated until it just prevented airleak, and cuff pressure was measured. The mask was removed, the other size was inserted and the same procedure repeated. At the end of operation, final in vivo and ex vivo pressures were measured. The pressure exerted on the pharynx was calculated as the difference between ex vivo and in vivo intracuff pressures. It was always possible to insert both sizes in both sexes. In females, airleak occurred in 15 patients with the size 3 and in five patients with the size 4 (difference: P = 0.005) and in males, 21 patients with the size 4 and in four patients with the size 5 (P < 0.001). Removal of air to the minimum effective volume significantly decreased intracuff pressure and pressure on the pharynx; on removal of the mask, pressures were similar to, or lower than, initial pressures. Therefore, a larger mask (size 4 in females and size 5 in males) provided a better seal than a smaller size without producing higher pressures on the pharynx.

Adolescent↗

Ease of placement of the laryngeal mask during manual in-line neck stabilization.

We studied 20 patients, in a randomized, cross-over study, to determine if manual in-line stabilization of the head and neck altered the ease of insertion of the laryngeal mask and its correct positioning. After induction of anaesthesia and neuromuscular block, the laryngeal mask was inserted and adequacy of ventilation assessed while the patient's head and neck were placed in the Magill and manual in-line positions, in turn. Ease of insertion of the mask was assessed using a 10-cm visual analogue scale (VAS) and position using a fibreoptic bronchoscope. Time for insertion of the mask was measured. The laryngeal mask was inserted and adequate ventilation obtained at the first attempt in all 20 patients in the Magill position and in 19 of 20 patients in the manual in-line position. Insertion was always more difficult (P << 0.001; 95% CI for difference in VAS 20-55 mm) and time for insertion longer (P << 0.001; 95% CI for difference 4.9-11.9 s) in the manual in-line position compared with the Magill position. The incidence of a suboptimal position was significantly higher for the manual in-line position (seven patients) than for the Magill position (15 patients) (P < 0.005). We conclude that in paralysed patients, manual in-line stabilization of the head and neck made insertion of the laryngeal mask and its correct positioning more difficult.

Anesthesia, General↗

Respiratory complications associated with tracheal intubation and extubation.

We conducted a prospective survey on the incidence of respiratory complications associated with tracheal intubation and extubation in 1005 patients who underwent elective general anaesthesia over a 4-month period. During induction of anaesthesia, respiratory complications occurred in 46 patients (4.6%; 95% confidence limits (CL): 3.3, 5.9%). The common complications were coughing (1.5%) and difficult ventilation through a facemask (1.4%). Tracheal intubation was difficult in eight patients (0.8%). Complications occurred immediately after tracheal extubation in 127 patients (12.6%; 95% CL: 10.6, 14.7) and in the recovery room in 95 patients (9.5%; 95% CL: 7.6, 11.3%). The common complications immediately after extubation were coughing (6.6%) and oxygen desaturation (SaO2 < 90%) (2.4%), and in the recovery room, airway obstruction (3.8%) and coughing (3.1%). The incidence of complications was significantly higher immediately after tracheal extubation than during induction of anaesthesia (P << 0.001). Even when all incidents of coughing that occurred after tracheal extubation were disregarded as a complication, the overall incidence was still higher immediately after extubation (7.4%) than during induction of anaesthesia (P < 0.01). We conclude that the incidence of respiratory complications associated with tracheal extubation may be higher than that during tracheal intubation.

Adolescent↗

Effects of nalbuphine, pentazocine and U50488H on gastric emptying and gastrointestinal transit in the rat.

We studied the effect of mixed agonist-antagonist opioids (nalbuphine and pentazocine) and a kappa opioid agonist (U50488H) on gastric emptying and gastrointestinal transit, and their interactions with morphine in rats. In each group, nalbuphine (0.01-30 mg kg-1), pentazocine (1-30 mg kg-1), U50488H (1-100 mg kg(-1)1) or saline was injected i.p. at 0 min. Another four groups of rats received morphine 13.4 mg kg-1 (ED75) and one of the following substances: saline, nalbuphine, pentazocine or U50488H. In both groups, at 30 min, radiolabelled saline 1 ml was infused into the stomach; at 1 h, gastric emptying and gastrointestinal transit were calculated by measuring the radioactivity in the gastrointestinal tract. Slopes for dose-response curves were determined. Nalbuphine significantly, but only weakly, delayed gastric emptying (P < 0.0005) and gastrointestinal transit (P < 0.01). Pentazocine markedly inhibited both, whereas U50488H did not significantly inhibit either. The slopes of the dose-response curves for nalbuphine, but not for pentazocine, on both gastric emptying and gastrointestinal transit were significantly less steep than those for morphine. Nalbuphine significantly antagonized the inhibitory effect of morphine on gastric emptying (P = 0.005) and gastrointestinal transit (P = 0.02), whereas pentazocine and U50488H did not. Nalbuphine and pentazocine delay gastric emptying and gastrointestinal transit, possibly by different mechanisms.

3,4-Dichloro-N-methyl-N-(2-(1-pyrrolidinyl)-cycloh↗

Affinity purification of recombinant cholera toxin B subunit oligomer expressed in Bacillus brevis for potential human use as a mucosal adjuvant.

For use as a mucosal adjuvant for human vaccines, a simple method has been developed for the affinity purification of recombinant cholera toxin B subunit which had been expressed in a safe host, Bacillus brevis. Recombinant cholera toxin B subunit, adsorbed quantitatively to a D-galactose-agarose column, was eluted with an 0.1-0.4 M D-galactose gradient with a yield of > 90%. The cholera toxin B subunit preparation was similar to the native cholera toxin B subunit with respect to GM1 binding ability, remarkable stability of the pentamer, and the dissociation-reassociation property by shifting pHs. Cross-linking experiments with glutaraldehyde demonstrated that the pentameric form was predominant; tetrameric, trimeric, dimeric and monomeric forms were detected to a lesser extent, and additionally 10- and 15-mers were observed depending on the concentration of the cholera toxin B subunit.

Adjuvants, Immunologic↗

Induction of macrophage VEGF in response to oxidized LDL and VEGF accumulation in human atherosclerotic lesions.

The interaction between macrophages and oxidatively modified low density lipoprotein (Ox-LDL) appears to play a central role in the development of atherosclerosis, not only through foam cell formation but also via the induction of numerous cytokines and growth factors. The current study demonstrated that Ox-LDL upregulated vascular endothelial growth factor (VEGF) mRNA expression in RAW 264 cells, a monocytic cell line, in a time- and concentration-dependent manner and that Ox-LDL stimulated VEGF protein secretion from the cells. Lysophosphatidylcholine, a component of Ox-LDL, also enhanced VEGF mRNA expression in RAW 264 cells and VEGF secretion from RAW 264 cells, with a maximal effect at a concentration of 10 micromol/L lysophosphatidylcholine. Immunohistochemical studies showed that human early atherosclerotic lesions exhibited intense VEGF immunoreactivity in subendothelial macrophage-rich regions of the thickened intima. In atherosclerotic plaques, VEGF staining was also observed in foam cell-rich regions adjacent to the lipid core or the neovascularized basal regions of plaque consisting predominantly of smooth muscle cells. High-power-field observation revealed that VEGF was localized in the extracellular space as well as at the macrophage cell surface. These observations suggest the possible involvement of Ox-LDL in the development of human atherosclerosis through VEGF induction in macrophages.

3T3 Cells↗

Antitumor activity of 5'-O-dipalmitoylphosphatidyl 2'-C-cyano-2'-deoxy-1-beta-D-arabino-pentofuranosylcytosine is enhanced by long-circulating liposomalization.

We previously synthesized the 5'-O-diacylphosphatidyl derivative of 2'-C-cyano-2'-deoxy-1-beta-D-arabino-pentofuranosylcytosine (CNDAC), a novel antitumor nucleoside, and observed it to have a high antitumor activity. Since this compound is readily incorporated into liposomal membranes, we liposomalized the compound using a formulation for conventional and long-circulating liposomes, and investigated the antitumor activity of liposomal 5'-O-dipalmitoylphosphatidyl CNDAC (DPP-CNDAC). Long-circulating liposomes composed of DPP-CNDAC, dipalmitoylphosphatidylcholine, cholesterol and palmityl-D-glucuronide (PGlcUA) (2:2:2:1 as a molar ratio), as well as liposomes containing dipalmitoylphosphatidylglycerol (DPPG) instead of palmityl-D-glucuronide and those composed of only DPP-CNDAC, were injected intravenously into Meth A sarcoma-bearing mice. DPP-CNDAC showed suppression of tumor growth, whereas CNDAC did not at the same concentration, suggesting that 5'-phosphatidylation is useful to enhance therapeutic efficacy. Furthermore, liposomal DPP-CNDAC reduced the acute toxicity, and liposomes containing PGlcUA showed more enhanced activities of reducing tumor growth and increasing the lifetime of the mice than liposomes containing DPPG. To obtain a higher therapeutic efficacy, we injected long-circulating liposomal DPP-CNDAC 5 times. The tumor growth was suppressed to 13.2% (86.8% inhibition), and the survival time of the tumor-bearing mice increased to 128.5% with one completely cured mouse out of five. Next, the effect of DPP-CNDAC incorporation on the in vivo behavior of PGlcUA and DPPG liposomes was examined by a non-invasive method using positron emission tomography (PET). Liposomes were labeled with [2-(18)F]-2-fluoro-2-deoxy-D-glucose, and administered to tumor-bearing mice. PET images and time-activity curves indicated that DPP-CNDAC/PGlcUA-liposomes tended to accumulate in tumor tissues a little bit more than DPP-CNDAC/DPPG-liposomes, although the difference between the two kinds of liposomal distribution was not as marked as between PGlcUA and DPPG liposomes, suggesting that DPP-CNDAC incorporation partly affected the liposomal behavior in vivo but that the long-circulating character of PGlcUA-liposomes might not be fully abolished. Thus, the enhanced therapeutic efficacy of long circulating liposomalized DPP-CNDAC observed here may be due to passive targeting of DPP-CNDAC to the tumor tissue, making this formulation of DPP-CNDAC useful for cancer chemotherapy.

Animals↗

Prevalence of antibodies of field pseudorabies virus in pigs of herd vaccinated with live vaccine.

This trial was performed in a 350-sow farrow-to-finish pig farm in which animals had been vaccinated against Aujeszky's disease with glycoprotein gC deletion (gC(-)) vaccine. The prevalence of antibodies against field pseudorabies virus (PRV) in serum samples collected from sows and fattening pigs during the period March 1995 to May 1997 was determined by using a commercial assay kit. The frequencies with which PRV-positive sows were found were 28.9% and 25.0% in March and October of 1995, 12.5% and 2.5% in April and October of 1996, and 0% in May of 1997. The fattening pigs tested at these times had no antibody to field PRV. These results thus indicate the probability that the PRV infection at the farm was eliminated by the gC(-) vaccine.

Animals↗

Tracheal intubation through the intubating laryngeal mask in a patient with a fixed flexed neck and deviated larynx.

Insertion of the conventional laryngeal mask is more difficult or impossible when the patient's head and neck are in either the neutral or flexed position. The intubating laryngeal mask is best inserted when the patient's head is supported by a pillow, without placing the head and neck into the Magill position; therefore, insertion of this modified mask may be less difficult than the conventional mask in the patient with a flexed neck. We report a case of successful insertion of the intubating laryngeal mask and subsequent tracheal intubation through the mask using a fibre-optic bronchoscope, in a patient with a flexed neck in whom tracheal intubation using several methods had been difficult previously.

Adult↗

[A case of so-called carcinosarcoma of peripheral lung].

A 67-year-old man was admitted to our hospital with blood sputum. Adenocarcinoma was diagnosed by sputum cytological examination. A chest X-ray film showed a tumor shadow in the lower field of the right lung. The middle and lower lobes were resected and lymph node dissection was performed. Tumor was composed of well differentiated adenocarcinoma and spindle cell sarcomatous element, and diagnosed as so-called carcinosarcoma. Pathological staging was IIIA by pT1N2M0. Postoperative chemotherapy was not performed for side effect, so radiotherapy only was done. He died of recurrence and metastasis after about 1 postoperative year.

Aged↗