Biomedical subjects

T Murakawa

Publications and source records attributed to T Murakawa.

At least 55 records · Page 3Linked to original sources

PubMed1996

[Intravenous infusion of prostagrandin E1 during and after gastrectomy on postoperative hepato-renal functions in senile patients].

Effect of intravenous prostagrandin E1 (PGE1) during and after surgery on postoperative hepatorenal functions in senile patients was evaluated in 36 elective surgical patients ranged in age from 60 to 85 years. The patients with carcinoma of the stomach underwent total or subtotal gastrectomy under isoflurane anesthesia. These patients were devided into two groups. Eighteen patients received intravenous PGE1 at a rate of 0.03-0.13 micrograms.kg-1.min-1 during surgery and 0.03 microgram.kg.min-1 after surgery until 9:00 am on the first operative day. The remaining 18 patients did not receive PGE1 and served as the control group. Serum GOT and GPT levels in both groups increased significantly at emergence from anesthesia compared with the preanesthetic levels and then declined to the preanesthetic levels on the 3rd postoperative day. Thereafter they increased significantly again on the 7th postoperative day. Serum GOT levels in the PGE1 administered group were significantly lower than those in the control group at the emergence from anesthesia. Serum GPT levels in the PGE1 group tended to be lower than those in the control group on awakening from anesthesia and on the first postoperative day. Serum gamma-GTP levels were stable postoperatively but they increased significantly on the 7th postoperative day in both groups. Serum bilirubin levels were within normal limits in both groups. Postoperative serum levels of urea nitrogen and creatinine were at the preanesthetic levels in both groups. Our findings suggest that continuous intravenous administration of PGE1 during and after surgery is beneficial in attenuating hepatic injury in senile patients for gastrectomy. However, protective effect of PGE1 on postoperative renal function was found to be vague in this study.

Aged↗

PubMed1996

[Possibility of rice porridge for preoperative feeding in children].

To determine the effect of rice porridge feeding before elective surgery on preoperative gastric fluid pH, volume and starvation, a prospective study was undertaken in pediatric patients. Twenty healthy children ranged in age from 5 to 12 years were allocated randomly to either a fasted or rice porridge group. The children of fasted group (control group) were allowed to take solid food until midnight before the operation. The rice porridge group (study group) patients received a small amount of rice porridge 5 hours 30 minutes before the induction of anesthesia. The patients of both groups were permitted to take clear fluid until 5 hours before the induction of anesthesia. After the induction of anesthesia, gastric fluid was aspirated through an orogastric tube. The mean gastric fluid volume was 0.43 +/- 0.32 ml.kg-1 in the control group and 0.5 +/- 0.6 ml.kg-1 in the study group. The mean gastric fluid pH was 1.43 +/- 0.27 ml.kg-1 in the control group and 1.89 +/- 0.75 ml.kg-1 in the study group. There were no significant differences between the two groups concerning the gastric fluid volume and pH. The patient of the study group complained of less hunger. Preoperative rice porridge feeding is a possible preoperative feeding for pediatric patients.

Anesthesia↗

PubMed1995

[Does aging influence effect of pirenzepine alone or combination of pirenzepine and famotidine on gastric secretion during anesthesia and surgery?].

Effect of pirenzepine alone or the combination of pirenzepine and famotidine on gastric secretion during anesthesia and surgery was evaluated in 52 elective surgical patients ranged in age from 17 to 68 years. These patients of each group were divided into two subgroups according to their age either 40 years and under or over. The patients underwent orthopedic, ophthalmic, ENT, plastic or non-abdominal general surgery under neuroleptanesthesia except 5 patients who had enflurane or isoflurane anesthesia. They received either pirenzepine 10 mg or the combination of pirenzepine 10 mg and famotidine 20 mg intravenously just before the induction of anesthesia. Volume and acidity of gastric juice were measured for 3 hours after the administration of these agents. Decrease in volume and acidity of gastric juice continued for more than 3 hours after the administration of pirenzepine alone or the combination of pirenzepine and famotidine, and it was more prominent in the combination group than in the pirenzepine group. There was no statistical difference in volume of gastric juice between the patients of 40 years and under in age and those over 40 years in each group. However, the intragastric pH tended to be lower in patients of 40 years and under in age than that in those over 40 years. A percentage of patients who had intragastric pH below 2.5 was larger in the pirenzepine administered patients of 40 years and under in age than that of the remaining patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1995

[Arterial plasma keton body levels during isoflurane anesthesia and surgery].

The authors measured arterial plasma levels of acetoacetate, 3-hydroxybutyrate, free fatty acid and the blood levels of lactate and glucose to evaluate fat metabolism during isoflurane anesthesia and surgery in twenty patients who ranged in age from 17 to 67 years. They underwent non-abdominal surgery (orthopedic surgery) or abdominal surgery (gastrointestinal or gynecological surgery). The operation started at 9 AM following starvation after 9 PM of the day before surgery. Anesthesia was induced with intravenous thiopental followed by intravenous succinylcholine to facilitate tracheal intubation, and maintained with isoflurane in 50 % nitrous oxide and 50 % oxygen. Vecuronium was given intravenously during surgery. Lactated Ringer's solution at a speed of 5-15 ml.kg-1.h-1 was also administered intravenously throughout the procedures. Patients who had received glucose solution or blood transfusion were excluded. Plasma acetoacetate and 3-hydroxybutyrate levels increased significantly with surgical stimulation in both groups and they were slightly higher in the abdominal group than those in the non-abdominal group. However there was no statistical difference in plasma keton body levels between the groups. Mild increases in plasma free fatty acid and blood lactate levels were detected during surgery in both groups to the same extent. Blood glucose increased significantly during surgery in both groups and the increase was statistically higher in the abdominal group than that in the non-abdominal group. The findings suggest that there is no difference in fat metabolism between non-abdominal and abdominal groups during surgical intervention lasting as long as 3 hours when patients are starved and do not receive any glucose during surgery.

Adolescent↗

PubMed1994

[Hormonal changes during removal of aldosterone-producing adrenal tumor under sevoflurane anesthesia].

We measured plasma aldosterone, cortisol, ACTH and catecholamine concentrations during removal of aldosterone-producing adrenal tumor under sevoflurane anesthesia in four adult patients. Sevoflurane anesthesia alone did not affect the plasma levels of aldosterone, cortisol, ACTH and catecholamine. Plasma aldosterone levels increased significantly with surgical stimulation and reached the peak value before surgical manipulation. Thereafter they declined in magnitude and reached the value below the peanesthetic levels at recovery from anesthesia. Plasma cortisol and ACTH levels increased significantly with surgical stimulation, and plasma ACTH levels reached the peak values after the emergence from anesthesia in the recovery room. Plasma catecholamine levels increased with surgical stimulation, but the increase in plasma epinephrine levels was more striking than that in plasma norepinephrine levels during surgical manipulation of the tumor. Hypertension during manipulation of the tumor was demonstrated to correlate with increase in plasma epinephrine levels but not with plasma aldosterone levels. Sevoflurane gave us no trouble during anesthetic management for removal of aldosterone-producing adrenal tumor. We conclude that sevoflurane anesthesia is a better choice for surgery for primary aldosteronism.

Adrenal Gland Neoplasms↗

PubMed1994

[Plasma catecholamine levels in patients during surgical removal of pheochromocytoma under sevoflurane anesthesia].

We measured plasma catecholamine levels and hemodynamics in 5 patients during surgical removal of pheochromocytoma under sevoflurane anesthesia. Plasma catecholamine levels were unchanged with sevoflurane anesthesia. Plasma epinephrine, norepinephrine and dopamine levels increased 149 folds, 7.8 folds and 2.9 folds respectively as compared with preanesthetic values during surgical manipulation of the tumor, and then declined in magnitude but still remained 15 folds, 2.7 folds and 1.8 folds higher respectively as compared with the preanesthetic levels after removal of the tumor. These catecholamine levels finally reached 180%, 20% and 60% of the preanesthetic values respectively after the emergence from anesthesia in the recovery room. Mean systolic and diastolic arterial blood pressures were 127/82 mmHg before anesthetic induction and increased to 211/71 mmHg during manipulation of the tumor. Then they decreased to 75/52 mmHg immediately after removal of the tumor but recovered up to 126/71 mmHg on recovery from anesthesia. Alpha and beta adrenal blockers were administered if necessary to control hypertension and tachycardia during manipulation of the tumor. Hypotension after removal of the tumor was treated with volume replacement, vasopressor and/or catecholamines. No correlation was found between plasma catecholamine levels and arterial blood pressure in our study except during manipulation of the tumor. No arrhythmias were observed during anesthesia and surgery in our cases even though plasma catecholamines increased extremely with surgical intervention. We conclude that sevoflurane anesthesia is a better choice for surgery for pheochromocytoma.

Adrenal Gland Neoplasms↗

PubMed1994

[A gastric proton pump inhibitor as preanesthetic medication].

Effect of omeprazole, a gastric proton pump inhibitor, on gastric secretion during anesthesia and surgery was evaluated in 39 elective surgical patients ranged in age from 18 to 69 years. These patients were divided into two groups according to their age either of 40 years and under or over. The patients of both groups underwent orthopedic, ophthalmic, ENT, plastic, oral or non-abdominal surgery under neuroleptanesthesia, enflurane anesthesia or total intravenous anesthesia with droperidol, fentanyl and ketamine. They all were administered omeprazole 20 mg orally at 21:00 the night before surgery and again at 7:00 on the morning of surgery. The volume and acidity of gastric juice were measured at anesthetic induction and emergence from anesthesia. The volume and pH of the gastric juice in patients of 40 years and under in age averaged to 9.8 +/- 3.2 (mean +/- SE) ml, 2.45 +/- 0.56 at the anesthetic induction and 9.3 +/- 4.1 ml, 4.66 +/- 0.60 at the emergence from anesthesia respectively. The mean volume and pH of the gastric juice in patients over 40 years of age were 5.0 +/- 1.7 ml, 4.68 +/- 0.56 at the anesthetic induction and 9.9 +/- 2.4 ml, 5.76 +/- 0.36 at the emergence from anesthesia respectively. Significant decrease in the volume and acidity of gastric juice was observed in the patients of both groups except that the average of intragastric pH of the patients under 40 years of age was below 2.50 at the induction of anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

PubMed1994

[Effect of pirenzepine on gastric secretion during anesthesia and surgery].

Effect of pirenzepine on gastric secretion during anesthesia and surgery was evaluated in 46 surgical patients ranged in age from 18 to 68 years. The patients underwent orthopedic, ophthalmic, ENT, plastic or non-abdominal general surgery under neuroleptanesthesia except two patients who had enflurane or isoflurane anesthesia. They received either pirenzepine 10 mg, 20 mg or the combination of pirenzepine 10 mg and famotidine 20 mg intravenously just before the induction of anesthesia. Volume and acidity of gastric juice were measured for 3 hours after the administration of these agents. Decrease in volume and acidity of gastric juice after pirenzepine 10 mg as well as after pirenzepine 20 mg continued for more than 3 hrs after the administration of the agents. Efficacy of the combination of pirenzepine and famotidine on gastric secretion was more prominent than that of pirenzepine alone in a double dose.

Adolescent↗

PubMed1993

Effect of interferon-gamma on ACNU-induced DNA damage and cytotoxicity in human glioblastoma cells.

Interferons (IFNs) are a natural body defense with powerful effects on tumor growth, including gliomas. The direct effects of IFN-gamma on (1-4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride (ACNU)-induced deoxyribonucleic acid (DNA) damage and cytotoxicity were investigated in two human glioblastoma cell lines, A-172 and T98G, using a single cell microgel electrophoresis technique and a microculture tetrazolium assay. The results demonstrated a synergistic effect of IFN-gamma with ACNU on intracellular damage in both cell lines. 10 micrograms/ml ACNU induced a cell inhibition rate of 23.9% in A-172 cells, and almost no effect on T98G cells. 1000 U/ml IFN-gamma and 10 micrograms/ml ACNU caused a significant increase in cell inhibition, 51.2% for A-172 and 72.3% for T98G cells. DNA damage in individual A-172 and T98G cells exposed to ACNU was enhanced significantly by IFN-gamma (p < 0.001). The findings suggest a direct effect of IFN-gamma on ACNU-induced cell damage in human glioma, in addition to its effect on immunomodulation.

Brain Neoplasms↗

PubMed1993

Recurrence of choroid plexus papilloma with malignant transformation--case report and lectin histochemistry study.

A very rare primary choroid plexus carcinoma occurred in a 44-year-old male presenting with occipitalgia, nausea, and blurred vision. The tumor had progressed from a choroid plexus papilloma in the fourth ventricle which was totally removed 6 years previously. Lectin histochemistry might be useful for the differential diagnosis of primary choroid plexus neoplasms and other brain tumors such as secondary carcinoma.

Adult↗

PubMed1993

[Assessment of left ventricular contractility (Emax) and arterial load (Ea) in humans by transesophageal echocardiography and radial artery pressure tracing].

We determined both the slope of the left ventricular end-systolic pressure-volume relation (Emax), which is a measure of contractility independent of loading conditions, and the slope of the arterial end-systolic pressure-stroke volume relation (Ea), which is a measure of arterial load independent of ventricular function, in 10 patients undergoing elective noncardiac surgery. Left ventricular end-systolic volume (Ves) was measured by transesophageal echocardiography and instantaneous left ventricular end-systolic pressure (Pes) was estimated from the dicrotic notch pressure in the radial artery. Emax was calculated during afterload reduction (nicardipine 30 micrograms.kg-1 iv), and the correlation of Emax to either Pes/Ves ratio or MAP (mean arterial blood pressure)/Ves ratio was accomplished in order to investigate whether these indices were clinically useful measurements of ventricular function or not. Ea was also calculated from the data obtained before and 2-3 min after nicardipine iv. The averaged Emax and x-axis intercept (Vo) were 3.11 mmHg.ml-1 and -3.8 ml, respectively. The correlation coefficient obtained between Emax and Pes/Ves was 0.96, and that obtained between Emax and MAP/Ves was 0.97. Ea decreased significantly (P < 0.05) following intravenous nicardipine, demonstrating a decreased arterial load. The direction of changes in Ea was similar to that reported previously in systemic vascular resistance. From these results, we conclude that measurement of Emax (or Pes/Ves, MAP/Ves) and Ea using transesophageal echocardiography and radial artery pressure tracing is feasible and these are a useful tool to estimate left ventricular performance and arterial load during surgery.

Blood Pressure↗

PubMed1993

[Perioperative management of patients on long-term administration of psychotropic drugs].

We experienced perioperative management of thirty two surgical patients complicated with either schizophrenia or depression on long-term administration of psychotropic drugs during a period of three years from 1989 through 1991. They underwent various operative procedures under either general anesthesia or epidural anesthesia. Mental confusion was most frequently encountered in immediate postoperative period. The longer the patients had been treated with psychotropic drugs, the more postoperative complications were observed. We lost four patients within two weeks postoperatively. They all underwent laparotomy and had been treated with psychotropic drugs for a prolonged period. No significant association between the types of anesthesia and postoperative complications was observed. Surgical patients on long-term administration of psychotropic drugs should be managed carefully particularly during postoperative period.

Adult↗

PubMed1993

[Effects of intravenous infusion of isosorbide dinitrate on hemodynamics during anesthesia and surgery].

Ninety nine patients with ischemic changes of the heart on preoperative and intraoperative ECG tracings were studied to evaluate effects of intravenous infusion of isosorbide dinitrate on hemodynamics during anesthesia and surgery. These patients ranging in ages from 24 to 80 years were administered intravenous isosorbide dinitrate at a rate of either 0.5 or 1 microgram.kg-1 x min-1 during anesthesia and surgery. Arterial blood pressure was not influenced with intravenous isosorbide dinitrate at the speed of 0.5 microgram.kg-1 x min-1 during anesthesia and surgery. The arterial pressure of the patients decreased slightly but significantly 30 min after the start of 1 microgram.kg-1 x min-1 of isosorbide dinitrate infusion, but it recovered to the control level at the end of administration of isosorbide dinitrate. Heart rate was unchanged with intravenous isosorbide dinitrate during anesthesia and surgery in both groups, except a mild increase at the end of isosorbide dinitrate infusion of 1 microgram.kg-1 x min-1. Arterial blood oxygen tension showed no decrease during the administration of isosorbide dinitrate and no adverse reactions associated with administration of the drug was detected in this study. Significant improvement of ischemic changes on ECG tracings were observed in about 25% of the patients who received 1 micrograms.kg-1 x min-1 of intravenous isosorbide dinitrate.

Adult↗

PubMed1993

[Application of the concept of fuzzy logistic controller for treatment of hypertension during anesthesia].

The concept of Zadeh's fuzzy logistic controller was applied to control hypertension during anesthesia, and its clinical usefulness was examined in patients undergoing elective surgery. Arterial blood pressure was determined by use of an automatic blood pressure device. Nicardipine was used as hypotensive drug. Based on the fuzzy control rules, we developed state-action diagram so as to maintain systolic blood pressure at around 130 mmHg. Nicardipine was infused by using a digitally controlled infusion pump, and its infusion rate was changed according to this diagram. Although acute hypertension associated with endotracheal intubation was not significantly attenuated, hypertension associated with either skin incision or endotracheal extubation, where blood pressure increased slowly, was successfully controlled with our system. These results suggest that the application of the concept of fuzzy logistic controller is useful for treatment of hypertension during anesthesia, especially when blood pressure increases slowly.

Anesthesia↗

PubMed1993

[Plasma levels of isosorbide dinitrate and its metabolites during intravenous infusion in surgical patients--effect of preoperative administration of isosorbide dinitrate].

Nineteen patients with ischemic heart disease were studied to determine plasma levels of isosorbide dinitrate (ISDN) and its metabolites, isosorbide-2-mononitrate (2-ISMN) and isosorbide-5-mononitrate (5-ISMN) for 6 hrs during intravenous administration of ISDN, using gas chromatography. Differences in plasma levels of these substances were also evaluated in patients with or without preanesthetic medication of ISDN. These patients ranging in ages from 42 to 80 years were administered ISDN intravenously at a rate of 1 micrograms.kg-1 x min-1 during anesthesia and surgery. Preanesthetic administration of ISDN consisted of transdermal application of 40 mg dose. Surgery included gastrectomy, pneumonectomy, extended cholecystectomy, radical mastectomy and so on under either enflurane anesthesia or neuroleptanesthesia. Plasma ISDN levels increased and reached a plateau 3 hrs after the start of intravenous infusion of ISDN in patients of both groups. Plasma 2-ISMN levels increased gradually and reached a plateau 5 hrs after the commencement of intravenous administration of ISDN in patients of both groups. Plasma 5-ISMN levels increased gradually reaching the peak 6 hrs after the start of intravenous infusion of ISDN in both groups. Plasma ISDN, 2-ISMN and 5-ISMN levels were slightly higher in patients who received preanesthetic ISDN than in those who did not receive preanesthetic ISDN. However, there were no statistical differences in plasma ISDN or 2-ISMN levels between the groups except prior to the infusion. On the contrary, plasma 5-ISMN levels were significantly higher in patients who received preanesthetic ISDN than in those who did not receive preanesthetic ISDN for 3 hrs after the start of the infusion.

Adult↗

PubMed1992

[Autonomic nervous function and plasma catecholamine levels of perioperative patients treated with antipsychotic drugs].

The RR intervals on ECG and the coefficient of variation of R-R interval (CV) and perioperative plasma catecholamine levels were measured in patients receiving long-term administration of antipsychotic drugs. CV was significantly reduced (P less than 0.05) in patients on antipsychotic drugs. Preoperative plasma catecholamine levels increased significantly and elevation of plasma catecholamine levels on the first postoperative day was less than that of the control group. These findings suggest that the patients on antipsychotic drugs have disturbed autonomic nervous function. Therefore, a careful perioperative care is mandatory.

Adult↗

PubMed1992

[Effect of M1 blocker or H2 blocker on gastric secretion during anesthesia and surgery].

Effect of pirenzepine, famotidine or a combination of both agents on gastric secretion during anesthesia and surgery was evaluated in 42 surgical patients ranged in age from 17 y to 70 y. They underwent orthopedic, ophthalmic, ENT, plastic, oral or non-abdominal surgery under either neuroleptanesthesia or enflurane anesthesia. They received either pirenzepine 10 mg, famotidine 20 mg or the combination of both agents intravenously just before the induction of anesthesia. Volume and acidity of gastric juice were measured during 3 hours after the administration of these agents. A continued decrease in volume and acidity of gastric juice was observed 3 hrs after the administration of the agents both in the pirenzepine group and in the famotidine group. Efficacy of the combination of pirenzepine and famotidine on gastric secretion tended to be more prominent than that of either pirenzepine or famotidine alone.

Adolescent↗

PubMed1992

[Clinical evaluation of prostaglandin E1 during anesthesia in non-elderly and elderly patients].

The effects of prostaglandin E1 (PGE1) on blood pressure during anesthesia and the postoperative changes in organ functions were examined and compared in 358 cases. Two hundred and eighty patients were under 64 years of age and 128 patients were over 65 years. It was possible to control blood pressure satisfactorily with PGE1 in both non-elderly and elderly groups. However in the elderly group, it was more difficult to control blood pressure with PGE1 under NLA as compared with enflurane anesthesia. In both groups, urinary flow increased during and after the administration of PGE1, and the livers and kidneys showed neither dysfunction nor deterioration after operation. We had very few incidences of side effects with this drug. PGE1 is also considered safe and useful for elderly people during and after surgery.

Adolescent↗