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Biomedical subjects

T Otagiri

Publications and source records attributed to T Otagiri.

26 records · Page 2Linked to original sources

Repair of cleft lip with nonsurgical correction of nasal deformity in the early neonatal period.

Auricular cartilage is soft and plastic at birth, so that congenital auricular deformities can easily be corrected nonsurgically in the early neonatal period. However, as the infant grows older, the flexibility of the auricle decreases. Alar cartilage exhibits the same elasticity as auricular cartilage in the early neonate. When a cleft lip is repaired, typically when the infant is about 3 months of age, it becomes difficult to correct the nasal deformity without surgical intervention. However, based on our experience, there is a fair possibility of correcting the cleft lip nasal deformity with a nonsurgical procedure in the early neonatal period. We performed cleft lip repair accompanied by nonsurgical correction of the nasal deformity in 44 neonates aged 2 to 7 days. A special retainer was placed in the affected nostril for 3 months. Following observation of 31 infants for 12 months or longer, their nasal shapes and symmetry were considered superior to those conventionally operated on at about 3 months of age. Except for one nasal infection, there were no complications.

Cartilage↗

[A case report of a patient who developed cyanosis and significant decrease in PtcO2 caused by a contraction of the ductus arteriosus].

A 2-day-old male baby with patent ductus arteriosus and pulmonary atresia had an emergency anoplasty because of anal atresia. During the operation, anesthesia was maintained satisfactorily with 1-2% halothane and 70% nitrous oxide in oxygen, accompanied with continuous infusion of prostaglandin E1 (PGE1). However, after the inspired oxygen concentration was changed to 100% from 30% at the end of the operation, transcutaneous partial pressure of oxygen (PtcO2) began to decrease progressively, developing cyanosis and sinus bradycardia. Immediately the inspiratory concentration of oxygen was returned to 30% from 100% and the infusion rate of PGE1 was increased from 2 micrograms. kg-1.min-1. Atropine 0.2mg was also administered intravenously. A few minutes after this therapy, a gradual increase in PtcO2 was observed, and he recovered from cyanosis and respiratory arrest. In this case, we suspect that the cyanosis developed because of the contraction of PDA. In summary, anesthetic management of a patient with pulmonary atresia and PDA is described. The PtcO2 should be monitored continuously and the inspiration of pure oxygen should be avoided. Continuous infusion of PGE1 may be one of the effective measures to dilate PDA.

Cyanosis↗

A microelectrode study of the effects of atracurium on neuromuscular transmission.

Using standard microelectrode recording techniques, we studied the effects of atracurium on neuromuscular transmission in a concentration range between 10(-13) and 10(-5) M in the rat diaphragm. Both intact and cut diaphragm preparations were used. Atracurium produced no significant alteration of miniature endplate potential (MEPP) frequency (P greater than 0.05). Increasing concentrations of atracurium (10(-6)-10(-5) M) caused a linear decrease in MEPP amplitude from 70.5 +/- 2.3% to 28.0 +/- 2.5% of baseline levels (P less than 0.05). In the cut diaphragm preparation, atracurium increased the degree of rundown and decreased quantum content of the endplate potential (EPP). The above observations suggest that atracurium interferes with neuromuscular transmission by, first of all, producing cholinergic receptor block and secondly, producing frequency-dependent inhibition of release of acetylcholine from the nerve terminal.

Animals↗