Biomedical subjects

Y Fujii

Publications and source records attributed to Y Fujii.

At least 397 records · Page 22Linked to original sources

PubMed1998

Oral granisetron prevents postoperative vomiting in children.

We have studied the efficacy of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, administered orally for the prevention of postoperative vomiting after tonsillectomy in children. In a randomized, double-blind, placebo-controlled study, 160 paediatric patients, ASA 1, aged 4-10 yr, received placebo or granisetron (20, 40 or 80 micrograms kg-1) (n = 40 each) orally, 1 h before surgery. A standard general anaesthetic technique was used throughout. A complete response, defined as no emesis and no need for another rescue antiemetic during the first 24 h after anaesthesia, occurred in 40%, 48%, 85% and 90% of patients who had received placebo, or granisetron 20, 40 or 80 micrograms kg-1, respectively (P < 0.05; overall Fisher's exact probability test). There were no clinically important adverse events. We conclude that preoperative oral granisetron, in doses more than 40 micrograms kg-1, was effective for the prevention of postoperative vomiting in children.

Administration, Oral↗

PubMed1998

Prophylactic antiemetic therapy with granisetron in women undergoing thyroidectomy.

We have evaluated the efficacy and safety of granisetron, a selective 5-hydroxytryptamine type-3 receptor antagonist, for the prevention of postoperative nausea and vomiting (PONV) in women undergoing thyroidectomy. In a prospective, randomized, placebo-controlled, double-blind study, 100 ASA I patients, aged 30-57 yr, received placebo or granisetron at three different doses (20, 40 or 100 micrograms kg-1) (n = 25 each), i.v., immediately before induction of anaesthesia. A standard general anaesthetic technique was used. A complete response, defined as no PONV and no need for another rescue antiemetic during the first 3 h after anaesthesia, was seen in 36%, 44%, 92% and 92% of patients who received placebo, granisetron 20 micrograms kg-1, 40 micrograms kg-1 and 100 micrograms kg-1, respectively; corresponding values during the next 21 h after anaesthesia were 40%, 44%, 88%, and 88% (P < 0.05; overall Fisher's exact probability test). There were no clinically important adverse events in any group. We conclude that granisetron 40 micrograms kg-1 was an effective antiemetic for the prevention of PONV after thyroidectomy. Increasing the dose to 100 micrograms kg-1 provided no further benefit.

Adult↗

PubMed1998

Prophylactic antiemetic therapy with a combination of granisetron and dexamethasone in patients undergoing middle ear surgery.

We have compared the efficacy of granisetron in combination with dexamethasone with each drug alone in the prevention of postoperative nausea and vomiting (PONV) after middle ear surgery. In a randomized, double-blind study, 120 patients (85 females) received granisetron 3 mg, dexamethasone 8 mg or granisetron 3 mg with dexamethasone 8 mg i.v. (n = 40 in each group), immediately before induction of anaesthesia. A standardized general anaesthetic technique was used. A complete response, defined as no PONV and no need for another rescue antiemetic during the first 3 h after anaesthesia, was recorded in 83%, 50% and 98% of patients who had received granisetron, dexamethasone and granisetron-dexamethasone, respectively. The corresponding incidences during the next 21 h after anaesthesia were 80%, 55% and 98% (P < 0.05; overall Fisher's exact probability test). In summary, prophylactic use of combined granisetron and dexamethasone was more effective than each antiemetic alone for the prevention of PONV after middle ear surgery.

Adult↗

PubMed1998

Scanning electron microscopic study of erythrocyte shapes artificially jetted through tubes at different pressures by 'in vitro cryotechnique for erythrocytes'.

A new cryotechnique for examining morphological changes of human erythrocytes at different jet pressures was developed in the present study. Human fresh or stored erythrocytes passing through a tube were jetted into precooled isopentane-propane mixture (-193 degrees C), which was named as 'in vitro cryotechnique for erythrocytes'. After the cryotechnique procedure, the routine freeze-substitution method and subsequent t-butyl alcohol freeze-drying method were used for preparing the scanning electron microscopic specimens. At 100 mmHg or higher pressures of jetting, lamellar-arranged erythrocytes were observed to have elongated shapes. The more the jetting pressure increased, the fewer discoid shapes of erythrocytes were observed. This cryofixation technique could preserve the morphology of erythrocytes jetting from tubes, and provide the three-dimensional image of erythrocyte surfaces, as followed by scanning electron microscopy.

Erythrocyte Deformability↗

PubMed1998

Prevention of postoperative nausea and vomiting with a combination of granisetron and droperidol.

UNLABELLED: In this randomized, double-blind study, we compared the efficacy and safety of granisetron plus droperidol with each antiemetic alone for preventing postoperative nausea and vomiting (PONV) in 150 female patients scheduled for elective major gynecological surgery. Patients were randomly assigned to receive i.v. either granisetron 2.5 mg (Group G), droperidol 1.25 mg (Group D), or granisetron 2.5 mg plus droperidol 1.25 mg (Group GD) immediately before the induction of anesthesia (n = 50 in each group). A standard anesthetic technique and postoperative analgesia were used. Complete response, defined as no PONV and no administration of rescue antiemetic medication during the first 24 h after anesthesia, was 84% in Group G, 54% in Group D, and 96% in Group GD (P = 0.046 versus Group G, P = 0.001 versus Group D). No clinically important adverse effects were observed in any group. In conclusion, the combination of granisetron and droperidol is more effective than each antiemetic alone for complete response in patients undergoing general anesthesia for major gynecological surgery. IMPLICATIONS: We compared the efficacy of granisetron plus droperidol with each antiemetic alone for the prevention of nausea and vomiting after gynecological surgery. The granisetron/droperidol combination was the most effective against these emetic symptoms.

Adult↗

PubMed1998

A granisetron-droperidol combination prevents postoperative vomiting in children.

UNLABELLED: This study was performed to compare the efficacy of a granisetron-droperidol combination with each antiemetic alone to prevent postoperative vomiting after tonsillectomy with or without adenoidectomy in children. One hundred eighty pediatric patients, ASA physical status I, aged 4-10 yr, were enrolled in a prospective, randomized, double-blind investigation and assigned to one of three treatment regimens: granisetron 40 microg/kg (Group G), droperidol 50 microg/kg (Group D), or granisetron 40 microg/kg plus droperidol 50 microg/kg (Group GD) (n = 60 in each group). These drugs were administered i.v. after an inhaled induction. The same standard general anesthetic technique and postoperative analgesia were used throughout. The rate of complete response, defined as no emesis and no need for rescue antiemetic, 0-3 h after anesthesia was 83% in Group G, 60% in Group D, and 97% in Group GD (P = 0.029 versus Group G, P = 0.001 versus Group D). The corresponding rates 3-24 h after anesthesia were 83%, 55%, and 97% (P = 0.029 versus Group G, P = 0.001 versus Group D). No clinically important adverse events were observed in any of the groups. In conclusion, a granisetron-droperidol combination is superior to each antiemetic alone in complete response in children undergoing general anesthesia for tonsillectomy. IMPLICATIONS: We compared the efficacy of granisetron plus droperidol with each antiemetic alone for the prevention of postoperative vomiting in children. The granisetron-droperidol combination was highly effective against postoperative emesis.

Adenoidectomy↗

PubMed1998

The effects of milrinone and its mechanism in the fatigued diaphragm in dogs.

UNLABELLED: We studied the effects of milrinone and its mechanism in nonfatigued and fatigued diaphragms in dogs. In Group Ia (n = 5), animals without fatigue, defined as the inability to sustain muscle force, received only maintenance fluids. In Group Ib (n = 5), dogs without fatigue were given a bolus injection (50 microg/kg) followed by continuous infusion (0.5 microg x kg(-1) x min(-1)) of milrinone. In Groups IIa, IIb, and IIc (n = 8 in each), diaphragmatic fatigue was induced by intermittent supramaximal bilateral electrophrenic stimulation at a frequency of 20 Hz applied for 30 min. After producing fatigue, only maintenance fluids were administered (Group IIa); milrinone (50 microg/kg loading dose plus 0.5 microg x kg(-1) x min(-1) maintenance dose) was administered (Group IIb); or nicardipine 5 microg x kg(-1) x min(-1) was infused simultaneously with milrinone (Group IIc). Diaphragmatic contractility was assessed with transdiaphragmatic pressure (Pdi). No differences in Pdi were observed in Groups Ia and Ib. After the fatigue-producing period, Pdi at low-frequency (20-Hz) stimulation decreased from the prefatigued values in Groups IIa, IIb, and IIc (P < 0.05), whereas the decrease was minimal at high-frequency (100-Hz) stimulation. Compared with Group IIa, Pdi to each stimulus increased during milrinone infusion in Group IIb (P < 0.05). In Group IIc, the augmentation of Pdi in the fatigued diaphragm by milrinone was not abolished with an administration of nicardipine. In conclusion, milrinone improves contractility in the fatigued canine diaphragm but not via its effect on transmembrane calcium movement. IMPLICATIONS: Diaphragmatic fatigue may contribute to the development of respiratory failure. Milrinone increases contractility in the fatigued diaphragm and thereby may have an inotropic action on the improvement of diaphragmatic fatigue.

Animals↗

PubMed1998

Prophylactic oral antiemetics for preventing postoperative nausea and vomiting: granisetron versus domperidone.

UNLABELLED: In this prospective, randomized, double-blinded study, we evaluated the efficacy of the oral antiemetics, granisetron and domperidone, for the prevention of postoperative nausea and vomiting (PONV) in 100 women undergoing major gynecologic surgery. Patients received either granisetron 2 mg or domperidone 20 mg (n = 50 in each group) orally 1 h before surgery. Standardized anesthetic techniques and postoperative analgesia regimens were used. Complete response (defined as no PONV and no administration of rescue antiemetic medication) for 0-3 h after anesthesia was 88% with granisetron and 52% with domperidone; the corresponding incidence for 3-24 h after anesthesia was 86% and 48% (P < 0.05). No clinically important adverse events due to the drugs were observed in any of the groups. In conclusion, the efficacy of preoperative oral granisetron is superior to that of domperidone for the prevention of PONV after major gynecologic surgery. IMPLICATIONS: We compared the efficacy of granisetron and domperidone administered orally for the prevention of postoperative nausea and vomiting in women undergoing gynecologic surgery. Preoperative oral granisetron was more effective than domperidone.

Administration, Oral↗

PubMed1998

Accelographic and mechanical post-tetanic count and train-of-four ratio assessed at the great toe.

We examined post-tetanic count (PTC) and train-of-four (TOF) ratios at the great toe assessed accelographically or mechanically and compared these with post-tetanic count and train-of-four ratios evaluated mechanically at the thumb in 24 patients who were given vecuronium. An acceleration transducer was attached to the right great toe, a force transducer to the left great toe and another force transducer to the thumb of the left hand. In the PTC group (n = 12) and TOF group (n = 12), post-tetanic count and train-of-four ratios were simultaneously recorded using the two great toes and the thumb of the left hand respectively. Accelographic post-tetanic count at the great toe was greater than the post-tetanic count at the thumb; however, mechanical post-tetanic count at the great toe was lower than the mechanical post-tetanic count at the thumb. Accelographic and mechanical train-of-four ratios at the great toe were greater than the mechanical train-of-four ratios at the thumb. But mechanical train-of-four ratios at the great toe became similar to mechanical train-of-four ratios at the thumb as the degree of neuromuscular block lessened. In conclusion, the mechanical post-tetanic count at the great toe is lower than the mechanical post-tetanic count at the thumb. In contrast, mechanical train-of-four ratios at the great toe are greater than the mechanical train-of-four at the thumb. Nevertheless, as the mechanical train-of-four ratios at the great toe became comparable with the mechanical train-of-four ratios at the thumb, mechanical assessment of the train-of-four ratio at the great toe may be useful for the evaluation of residual neuromuscular block.

Adult↗

PubMed1998

Purification and characterization of enterotoxin produced by Aeromonas sobria.

We purified the toxin of Aeromonas sobria capable of inducing a positive response in the mouse intestinal loop assay. The purified toxin showed a positive response not only in the loop assay but also in a hemolytic assay. Subsequently, we cloned the toxin gene and demonstrated that the product of this gene possessed both hemolytic and enterotoxic activities. These results showed that the enterotoxin of A. sobria possesses hemolytic activity. Nucleotide sequence determination of the toxin gene and amino acid sequence analysis of the purified toxin revealed that it is synthesized as a precursor composed of 488 amino acid residues, and that the 24 amino-terminal amino acid residues of the precursor is removed in the mature toxin. As antiserum against the purified toxin neutralized the fluid accumulation induced by living cells not only of A. sobria but also of A. hydrophila, this and antigenically related toxin(s) are thought to play an essential role in the induction of diarrhea by these organisms. The toxin-injured Chinese hamster ovary (CHO) cells induced the release of intracellular lactose dehydrogenase (LDH). The release of LDH from CHO cells and the lysis of erythrocytes by the toxin were repressed by the addition of dextran to the reaction solution, indicating that the toxin forms pores in the membranes and that the cells were injured by the osmotic gradient developed due to pore formation. However, the histopathological examination of intestinal cells exposed to the toxin showed that it caused fluid accumulation in the mouse intestinal loop without causing cellular damage.

Aeromonas↗

PubMed1998

Granisetron prevents nausea and vomiting during spinal anaesthesia for caesarean section.

BACKGROUND: Nausea and vomiting during spinal anaesthesia for caesarean section are common and unpleasant complications. This study was undertaken to evaluate the efficacy of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, for prophylactic treatment of nausea and vomiting in parturients undergoing nonemergent caesarean section under spinal anaesthesia. METHODS: In a randomized, double-blind, placebo-controlled trial, 100 patients, 21-38 years, received either placebo (saline) or granisetron at 3 different doses (20 micrograms.kg-1, 40 micrograms.kg-1 or 80 micrograms.kg-1) (n = 25 for each) intravenously immediately after clamping of the foetal umbilical cord. Nausea, vomiting and safety assessments were performed during spinal anaesthesia for caesarean section. RESULTS: The treatment groups were similar with regard to maternal characteristics and operative management. The incidence of nausea and vomiting was 64%, 52%, 14% and 12% after administration of placebo and granisetron in a dose of 20 micrograms.kg-1, 40 micrograms.kg-1 and 80 micrograms.kg-1, respectively (P < 0.05; overall Fisher's exact probability test). No clinically important adverse effects were observed in any group. CONCLUSION: Prophylactic use of granisetron in a minimum dose of 40 micrograms.kg-1 is effective for preventing nausea and vomiting during spinal anaesthesia for caesarean section.

Adult↗

PubMed1998

Prevention of nausea and vomiting in female patients undergoing breast surgery: a comparison with granisetron, droperidol, metoclopramide and placebo.

BACKGROUND: Breast surgery is associated with a relatively high incidence of postoperative nausea and vomiting (PONV). This study was undertaken to evaluate the efficacy of granisetron, droperidol and metoclopramide for preventing PONV after breast surgery. METHODS: In a randomized, double-blind, placebo-controlled trial, 120 female patients received granisetron 40 micrograms.kg-1, droperidol 1.25 mg, metoclopramide 10 mg or placebo (saline) (n = 30 for each) intravenously immediately before the induction of anaesthesia. A standard general anaesthetic technique was employed throughout. Postoperatively, during the first 24 h after anaesthesia, the incidence of PONV and adverse events was recorded. RESULTS: The incidence of PONV was 17% with granisetron, 37% with droperidol, 43% with metoclopramide and 50% with placebo (P < 0.05; overall Fisher's exact probability test). The incidence of adverse events was not different among the groups. CONCLUSION: Granisetron is highly effective for reducing the incidence of PONV in female patients undergoing breast surgery. Droperidol and metoclopramide are ineffective in this population.

Adult↗

PubMed1998

Preoperative oral granisetron prevents postoperative nausea and vomiting.

BACKGROUND: Postoperative nausea and vomiting (PONV) is a commonly observed adverse effect of anaesthesia. This study was designed to evaluate the efficacy of granisetron administered orally for preventing PONV in female patients undergoing major gynaecological surgery. METHODS: In a prospective, randomized, placebo-controlled, double-blind study, 120 patients received orally either placebo or granisetron (1 mg, 2 mg or 4 mg) (n = 30 for each) 1 h before surgery. The same standard general plus regional anaesthetic technique was employed throughout. Postoperatively, during the first 24 h after anaesthesia, the incidence of PONV and adverse events was recorded by nursing staff. RESULTS: The incidence of PONV was 47% with placebo, 37% with granisetron 1 mg, 10% with granisetron 2 mg and 10% with granisetron 4 mg (P < 0.05; overall Fisher's exact probability test). No difference in the incidence of adverse events was observed among the groups. CONCLUSION: Preoperative oral granisetron in a minimum dose of 2 mg is effective for preventing PONV after major gynaecological surgery.

Administration, Oral↗

PubMed1998

Modified double burst stimulation of varying stimulating currents.

BACKGROUND: Using modified double burst stimulation (modified DBS), sufficient level of recovery from neuromuscular blockade (train-of-four (TOF) ratio > 0.7) can properly be diagnosed. Modified DBS may often be applied in awake patients in the postanesthetic care unit. As the stimulating current decreases, the neurostimulation-induced discomfort becomes less for awake subjects. It is relevant to investigate the usefulness of the modified DBS delivered at low currents. METHODS: One hundred and twenty-one adult patients undergoing nitrous oxide-oxygen-isoflurane anesthesia were randomly divided into one of four groups: group 50 (n = 40), group 30 (n = 40), group 20 (n = 40), and supramaximality group (n = 1). After administration of vecuronium, in one hand and forearm (fixed arm), the degree of neuromuscular blockade was quantified mechanically. In the contralateral arm (free arm), modified DBS stimuli were delivered at 50, 30, and 20 mA in groups 50, 30, and 20, respectively. An observer determined tactilely on the free arm the presence or absence of fade in response to the modified DBS applied at 50, 30, and 20 mA. In one patient (the supramaximality group), modified DBS ratios (D2/D1) were examined at 50, 40, 30, 20, and 10 mA before administration of vecuronium. Moreover, discomfort associated with modified DBS applied at 50, 30, and 20 mA was evaluated using a 10-cm visual analog scale (VAS) in 15 awake volunteers. RESULTS: Probabilities of detection of fade in response to modified DBS in groups 50, 30, and 20 were 90, 86, and 96% (TOF ratios of 0.61-0.70), 62, 73, 94*#% (0.71-0.80), 26, 39, and 79*#% (0.81-0.90), and 4, 33*, and 51*#% (0.91-1.00), respectively. *P < 0.05 as compared to group 50. #P < 0.05 as compared to group 30. Supramaximal responses to D1 and D2 could be elicited at a current > or = 30 mA. The mean VAS scores were 8.7, 6.5*, and 4.1* when stimulated at 50, 30, and 20 mA, respectively. *P < 0.05 as compared to 50 mA. #P < 0.05 as compared to 30 mA. CONCLUSION: Modified DBS-induced discomfort becomes less as the stimulating current decreases. However, when stimulated at 30 or 20 mA, fade in response to modified DBS is felt in too many cases, even after neuromuscular blockage subsides to an adequate level.

Adult↗

PubMed1998

Prevention of nausea and vomiting with granisetron, droperidol and metoclopramide during and after spinal anaesthesia for caesarean section: a randomized, double-blind, placebo-controlled trial.

BACKGROUND: Nausea and vomiting during and after spinal anaesthesia for caesarean section are distressing to the patient. This study was undertaken to evaluate the efficacy and safety of granisetron, droperidol and metoclopramide for the prevention of nausea and vomiting in parturients undergoing caesarean section under spinal anaesthesia. METHODS: In a randomized, double-blind, placebo-controlled trial, 120 patients received granisetron 3 mg, droperidol 1.25 mg, metoclopramide 10 mg or placebo (saline) (n = 30 of each) i.v. immediately after clamping of the foetal umbilical cord. Nausea, vomiting and safety assessments were performed during and after spinal anaesthesia for caesarean section. RESULTS: The incidence of intraoperative, post-delivery nausea and vomiting was 13%, 17%, 20% and 63% after administration of granisetron, droperidol, metoclopramide and placebo, respectively; the corresponding incidence during 0-3 h after surgery was 7%, 27%, 27% and 43%; the corresponding incidence during 3-24 h after surgery was 7%, 20%, 23% and 37% (P < 0.05; overall Fisher's exact probability test). No clinically important adverse events were observed in any of the groups. CONCLUSION: Granisetron is highly effective for preventing nausea and vomiting during and after spinal anaesthesia for caesarean section. Droperidol and metoclopramide are effective for the prevention of intraoperative, post-delivery emesis, but are ineffective for the reduction of the incidence of postoperative emesis.

Adult↗

PubMed1998

Prophylactic antiemetic therapy with granisetron-dexamethasone combination in women undergoing breast surgery.

BACKGROUND: Dexamethasone decreases chemotherapy-induced emesis when added to an antiemetic regimen. This study was undertaken to evaluate the efficacy of granisetron-dexamethasone combination for the prevention of postoperative nausea and vomiting (PONV) in female patients undergoing general anaesthesia for breast surgery. METHODS: In a randomized, double-blind manner, 135 ASA I patients, aged 40-65 years, were assigned to receive placebo (saline), granisetron 40 micrograms.kg-1 or granisetron 40 micrograms.kg-1 plus dexamethasone 8 mg i.v. (n = 45 of each) immediately before the induction of anaesthesia. A standard general anaesthetic technique and postoperative analgesia were used. The PONV and safety assessments were performed continuously during the first 3 h (0-3 h) and the next 21 h (3-24 h) after anaesthesia. RESULTS: A complete response, defined as no PONV and no administration of rescue antiemetic medication, during 0-3 h after anaesthesia was 51%, 82% and 96% in patients who had received placebo, granisetron and granisetron-dexamethasone combination, respectively; the corresponding incidence during 3-24 h after anaesthesia was 56%, 84% and 98% (P < 0.05; overall Fisher's exact probability test). No clinically important adverse events were observed in any of the groups. CONCLUSION: Prophylactic use of granisetron-dexamethasone combination is more effective than granisetron alone for the prevention of PONV after breast surgery.

Adult↗

PubMed1998

Pseudosarcomatous myofibroblastic tumor of the urinary bladder with massive intraperitoneal hemorrhage in a child.

A 3-year-old boy presented with persistent abdominal pain, hematuria and facial pallor with progressive anemia. A computed tomography scan showed a massive intraperitoneal hemorrhage and tumor mass in the bladder. Histological examinations of the resected tumor revealed findings of pseudosarcomatous myofibroblastic tumor (PMT). The clinico-pathological features of this case warn us that PMT can cause acute abdomen syndrome with massive intraperitoneal hemorrhage.

Abdomen, Acute↗

PubMed1998

Chromophobe cell renal carcinoma in childhood.

We report the first case of chromophobe cell renal carcinoma in childhood. A 12-year-old boy presented gross hematuria following minor trauma. He was diagnosed as having a left renal tumor 45-mm in diameter. Radical nephrectomy was performed. One year later the boy was well.

Carcinoma, Renal Cell↗