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Y Kadoi

Publications and source records attributed to Y Kadoi.

At least 37 records · Page 2Linked to original sources

Long-term clomipramine treatment upregulates forebrain acetylcholine muscarinic receptors, and reduces behavioural sensitivity to scopolamine in mice.

We have investigated the effects of long-term treatment with clomipramine, a tricyclic antidepressant, on central muscarinic acetylcholine receptors (mAChR) in mice. Repeated clomipramine administration resulted in an increase in the forebrain receptor density value (Bmax) for [3H]quinuclidinyl benzilate, a muscarinic ligand (P < 0.05), that was dependent on dose per administration (saline or 5, 10, or 20 mg kg(-1) once a day for 7 days) and number of days treated (20 mg kg(-1) for 1, 3, 5, or 7 days). No change in apparent affinity (defined as the reciprocal of the dissociation constant) (KD) occurred. Seven daily treatments with clomipramine (saline or 5, 10, or 20 mg kg(-1)) reduced hyperlocomotion induced by scopolamine (0.5 mg kg(-1), s.c.) dose-dependently, and the effect of 20 mg kg(-1) clomipramine was significant (P < 0.05). These results suggest that an upregulation of mAChR is produced by repeated clomipramine administration, and such a change is responsible for the decreased sensitivity to the muscarinic antagonist scopolamine.

Animals↗

[Malfunctioning of cerebral function monitors in three cases of carotid endarterectomy].

In three patients, EEG, jugular venous oxygen saturation (Sjvo2) and near infrared spectroscopy (NIRS) were monitored to detect cerebral ischemia during carotid endarterectomy. In all cases, no changes in Sjvo2 and NIRS were observed during carotid artery occlusion, but in two patients EEG showed changes when carotid artery was clamped. It is important to know the precise mechanism of cerebral monitors to assess the cerebral ischemia in patients with preexisting neurological disorder during carotid endarterectomy.

Arterial Occlusive Diseases↗

Hyperventilation after tourniquet deflation prevents an increase in cerebral blood flow velocity.

PURPOSE: In this study we examined whether normocapnia maintained by hyperventilation after lower limb tourniquet deflation prevents an increase in cerebral blood flow velocity. METHODS: Thirteen patients, undergoing elective orthopedic surgery, requiring a pneumatic tourniquet around the lower extremity, were divided into two groups. In group 1, ventilation was controlled at tidal volume of 10 mL x kg(-1) and respiratory rate of eight per minute after tourniquet release. In group 2, ventilation was controlled to maintain P(ET)CO2 between 30 and 35 mmHg after tourniquet release. Arterial blood pressure, heart rate, peak and mean middle cerebral artery (MCA) flow velocity, and arterial blood gas were measured every minute for ten minutes after tourniquet release. The MCA blood flow velocity was measured using Transcranial Doppler ultrasonography (TCD). RESULTS: In group 1, the maximum peak MCA flow velocity was 53+/-6 cm x sec(-1) (50%+/-6% increase compared with pre- release value), and achieved 3+/-0.4 min after tourniquet release. In group 2, there was no increase either in mean or peak MCA velocity after tourniquet release. CONCLUSIONS: Normocapnia maintained by hyperventilation after tourniquet deflation prevents an increase in cerebral blood flow velocity.

Blood Flow Velocity↗

Effects of hypothermic and normothermic cardiopulmonary bypass on brain oxygenation.

BACKGROUND: In this study, we assessed the effects of normothermia and hypothermia during cardiopulmonary bypass (CPB) both on internal jugular venous oxygen saturation (SjvO2) and the regional cerebral oxygenation state (rSO2) estimated by near infrared spectroscopy (NIRS). METHODS: Thirty patients scheduled for elective coronary artery bypass graft surgery (CABG) were randomly divided into two groups. Group 1 (n = 15) underwent surgery for normothermic (> 35 degrees C) CPB, and group 2 (n = 15) underwent surgery for hypothermic (30 degrees C) CPB, and alpha-stat regulation was applied. A 4.0-French fiberoptic oximetry oxygen saturation catheter was inserted into the right jugular bulb to continuously monitor the SjvO2 value. To estimate the rSO2 state, a spectrophotometer probe was attached to the mid-forehead. SjvO2 and rSO2 values were then collected simultaneously using a computer. RESULTS: Neither the cerebral desaturation time (duration during SjvO2 value below 50%), nor the ratio of the cerebral desaturation time to the total CPB time significantly differed (normothermic group: 18+/-6 min, 15+/-6%; hypothermic group: 17+/-6 min, 13+/-6%, respectively). The rSO2 value in the normothermic group decreased during the CPB period compared with the pre-CPB period. The rSO2 value in the hypothermic group did not change throughout the perioperative period. CONCLUSIONS: These findings suggest that near infrared spectroscopy might be sensitive enough to detect subtle changes in regional cerebral oxygenation.

Aged↗

Balloon pump-induced pulsatile perfusion during cardiopulmonary bypass does not improve brain oxygenation.

BACKGROUND: Whether pulsatile flow offers substantial advantages for brain protection during cardiopulmonary bypass is controversial. The purpose of this study is to determine whether differences exist between pulsatile and nonpulsatile bypass concerning the effects on internal jugular venous saturation and on the state of regional cerebral oxygenation during normothermia. METHODS: Twenty-two patients undergoing elective coronary artery bypass grafting were randomly divided into 2 groups: group 1 (n = 11) received nonpulsatile perfusion during cardiopulmonary bypass and group 2 (n = 11) received pulsatile perfusion during bypass. We used an intra-aortic balloon pump to generate pulsatility. A spectrophotometric probe (INVOS 3100R, Somanetics, Troy, Mich) was used to assess the state of regional cerebral oxygenation. A 4F fiberoptic oximetry oxygen saturation catheter was inserted into the right jugular bulb to monitor jugular venous oxygen saturation. Hemodynamic variables, arterial and jugular venous blood gases, and regional cerebral oxygenation were measured at 7 times points. RESULTS: In both groups, jugular venous oxygen saturation decreased at the early stage of the cardiopulmonary bypass (P =.03). Five patients in group 1 and 6 in group 2 had a jugular venous oxygen saturation of less than 50%. In both groups, the regional cerebral oxygenation value decreased during cardiopulmonary bypass (P =.04). CONCLUSIONS: The present results showed that pulsatility generated through the use of intra-aortic balloon pumping did not produce any beneficial effects on jugular venous oxygen saturation and regional cerebral oxygenation at normothermia.

Aged↗

[The assessment of end-systolic pressure volume relationship in patients undergoing coronary artery bypass graft surgery].

Using transesophageal echocardiography (TEE) we assessed left ventricular end-systolic elastance (Ees) during the pre- and post-cardiopulmonary bypass (CPB) periods in 10 patients undergoing an elective coronary artery bypass graft surgery. The end systolic volume of the left ventricle was obtained by TEE, and the end systolic pressure was obtained by the femoral artery pressure wave form. LVSWI decreased at post-CPB compared to the value at pre-CPB. There were no significant differences in cardiac output, ejection fraction and Ees between pre-CPB and post-CPB period. Intraoperative end-systolic pressure-volume relationship may be clinically useful to assess left ventricular function and also useful to confirm anesthetic management in patients who has undergone an coronary artery bypass graft surgery.

Aged↗

Cerebral oxygenation during prostaglandin E1 induced hypotension.

PURPOSE: To evaluate the cerebral oxygenation effects of hypotension induced by prostaglandin E1 (PGE1) during fentanyl-oxygen anaesthesia. METHODS: Ten patients who underwent elective cardiac surgery received infusion of PGE1. After measuring the baseline arterial, mixed venous and internal jugular vein blood gases, systemic haemodynamics, and regional cerebral oxygen saturation (rSO2) estimated by INVOS 3100R, PGE1 was continuously infused at 0.25-0.65 microgram.kg-1.min-1 (mean dosage: 410 +/- 41.4 mg.kg-1.min-1) intravenously. Ten, 20 and 30 minutes after the start of drug infusions, blood gases described above were obtained simultaneously with the measurement of systemic haemodynamics and rSO2. Thirty minutes from the start of drug infusions, administration of PGE1 was stopped. The same parameters were measured again 10, 30 minutes after the stop of drug infusion. RESULTS: PGE1 decreased mean arterial pressure (MAP) to approximately 70% of the baseline value (P < 0.05). PGE1 increased mixed venous saturation, but in contrast did not affect internal jugular pressure, internal jugular oxygen saturation and rSO2. CONCLUSIONS: These results suggest that PGE1 is a suitable drug for induced hypotension because flow/metabolism coupling of brain and regional cerebral oxygenation were well maintained during hypotension.

Alprostadil↗

The end-systolic pressure-volume relationship and ventriculoarterial coupling in patients undergoing coronary artery bypass graft surgery.

BACKGROUND: The end-systolic pressure-volume relationship and analysis of ventriculoarterial coupling have been established as a useful tool to determine the left ventricular performance and arterial loading conditions. The purpose of this study was to evaluate the end-systolic pressure-volume relationship and ventriculoarterial coupling in anesthetized patients with either a normal heart or coronary artery disease (CAD) using a transesophageal echocardiography (TEE) monitor. METHODS: Sixteen patients with CAD and 4 patients without ischemic disease were studied. The end-systolic volume of the left ventricle was obtained by TEE, and the end-systolic pressure was obtained from the brachial arterial dicrotic pressure. In order to obtain the end-systolic pressure-volume relationship, we plotted 7 different left ventricular end-systolic pressures against the corresponding left ventricular end-systolic volumes during the pressure manipulation. The linear regression obtained by this method was designated as the end-systolic elastance (Ees). Furthermore, we calculated the effective arterial elastance (Ea) using the pressure-volume framework. RESULTS: We divided the patients with CAD into 3 groups: Group A: left ventricular ejection fraction (LVEF) > 50%, Group B: LVEF 35-50%, Group C: LVEF < 35%. We also studied a control group (Group D) who did not suffer from an ischemic heart condition. Ees in group C (1.4 +/- 0.2) was lower than in the other 3 groups (P < 0.05). Ea/Ees in group C (1.9 +/- 0.1) was greater than in group A (0.7 +/- 0.1), group B (1.0 +/- 0.06) and group D (0.6 +/- 0.1)(P < 0.05). There were no significant differences in Ees and Ea/Ees between group A and group D. CONCLUSIONS: We found that patients with CAD and a normal LVEF had a physiological Ea/Ees identical to the control subjects. We also demonstrated that patients with CAD and a reduced LVEF showed a deterioration in Ea/Ees.

Aged↗

A comparative study of the vasodilator effects of prostaglandin E1 in patients with pulmonary hypertension after mitral valve replacement and with adult respiratory distress syndrome.

UNLABELLED: To determine whether the vasodilator effects of prostaglandin E1 (PGE1) differ according to the etiology and pathophysiology of pulmonary hypertension, we studied 30 patients with pulmonary hypertension after mitral valve replacement (MVR) (n = 16) or with the adult respiratory distress syndrome (ARDS) (n = 14). PGE1 was administered to decrease the mean pulmonary artery pressure to below 30 mm Hg in both groups. Cardiac index and oxygen delivery tended to increase, whereas mean systemic artery pressure, mean pulmonary artery pressure, systemic vascular resistance index (SVRI), and pulmonary vascular resistance index (PVRI) significantly decreased in both groups. A vasodilatory index was defined in this study to allow evaluation of vasodilation relative to PGE1 dose: systemic vasodilatory index (VIs) = SVRI change/PGE1 dose; and pulmonary vasodilatory index (VIp) = PVRI change/PGE1 dose. The VIp was similar in both groups, but the VIs was significantly greater in the ARDS group compared with the MVR group (13.3 +/- 7.8 vs 4.8 +/- 5.1, P < 0.01). A good correlation was found between the pretreatment intrapulmonary shunt fraction (Qs/Qt [%]) value and PGE1 extraction rate in the lung (r = 0.60), and between the pretreatment Qs/Qt value and PGE1 concentration in the radial artery (r = 0.65) in an additional 15 patients. We conclude that the vasodilator effects of PGE1 on the pulmonary circulation are similar in the two groups, whereas the vasodilator effects on the systemic circulation are significantly greater in the ARDS group and that significant reduction in VIs in the ARDS group was associated with decreased PGE1 extraction in the lung. IMPLICATIONS: Pulmonary hypertension after mitral valve replacement, or with adult respiratory distress syndrome, is a major medical problem. The authors found that administration of prostaglandin E1 significantly dilated the pulmonary circulation with a concomitant decrease in pulmonary artery pressure. Because the systemic vasodilatory effect was greater in the adult respiratory distress syndrome group, the authors concluded that prostaglandin E1 concentrations in the systemic circulation depend on the severity of lung injury.

Adult↗

The differential effects of prostaglandin E1 and nitroglycerin on regional cerebral oxygenation in anesthetized patients.

UNLABELLED: We evaluated the effects of prostaglandin E1 (PGE1) and nitroglycerin (NTG) on regional tissue oxygenation and use in the brain using near infrared spectroscopy (NIRS). Twenty-four patients who underwent elective cardiac surgery were randomly divided into two groups. The study was performed after the induction of anesthesia and before the start of the surgical procedure. After measuring arterial and jugular venous blood gases, cardiovascular hemodynamics, and relative cerebral oxyhemoglobin (HbO2), deoxyhemoglobin, and cytochrome aa3 at the baseline, PGE1 (n = 12) or NTG (n = 12) was infused intravenously at a rate of 0.3 g/kg or 5 g/kg, respectively. Thirty minutes after the start of drug infusion, administration of the drugs was stopped. Both PGE1 and NTG reduced mean arterial pressure to approximately 70% of the baseline value 10, 20, and 30 min after start of drug infusion (P < 0.05). Internal jugular venous pressure increased significantly during NTG but not during PGE1 infusion (P < 0.05). PGE1 increased HbO2 concentration, which was sustained for 30 min after discontinuing the drug. NTG increased HbO2 concentration, but this gradually returned to the baseline level after discontinuation of the drug. Baseline value of jugular oxygen saturation was 64.5% +/- 2.1%, and there was no significant changes during the infusion of PGE1 or NTG. These results demonstrate that both NTG and PGE1 increased cerebral oxygen saturation as measured by NIRS. This may be explained by local cerebral hyperemia without major alteration in flow/metabolism coupling of brain. The onset of this increase was slower and the duration of this effect after discontinuation of the drug was more prolonged with PGE1. These phenomena occurred despite the relatively similar time course of the effect of these two drugs on systemic hemodynamic values. IMPLICATIONS: The cerebrovascular effects of vasodilators used for induced hypotension are not fully understood. In this study, we used near infrared spectrometry and jugular oxygen saturation measurement to assess the effects of prostaglandin E1 and nitroglycerin on cerebral perfusion. We found that nitroglycerin and prostaglandin E1 increase cerebral oxygen saturation as measured by near infrared spectrometry, but with different time courses. This information will hopefully help anesthesiologists to better maintain adequate regional cerebral oxygenation.

Aged↗

[The change of oxygen consumption and oxygen delivery in patients undergoing heart surgery during perioperative period].

We examined the changes of oxygen consumption (Vo2), oxygen delivery (Do2) and Vo2/Do2 in 38 patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) during perioperative period. There were no significant correlations between Svo2 and cardiac index. The Vo2/Do2 showed a good level at pre-CPB and 1 hour after CPB, but the value became deteriorated 4 and 12 hours after CPB. These data suggest that we should be careful about the oxygen debt in tissue 4 and 12 hours after CPB.

Adult↗

[A case of prosthetic valve malfunction found by transesophageal echocardiography soon after the termination of cardiopulmonary bypass].

We present a case of mitral prosthetic valve malfunction soon after the termination of cardiopulmonary bypass. One leaflet of the St. Jude prosthetic mitral valve was found immobilized in the closed position during diastole by transesophageal echocardiography, with no abnormal hemodynamic changes. We started cardiopulmonary bypass again, and removed residual chordae. TEE is an essential tool for evaluating prosthetic valve function after the valve replacement.

Aged↗

[Diastolic function in patients with coronary artery disease before and after CABG].

We evaluated diastolic cardiac function in 16 patients with coronary artery disease before and after coronary angioplasty using transesophageal echocardiography. Peak early diastolic and late diastolic filling velocities (E wave and A wave) and velocity time integrals of early and late diastolic filling (VTI-E and VTI-A) were measured by pulsed doppler echocardiography. The patients were divided into two groups: Group A; E/A > or = 1. Group B; E/A < 1. There were statistical differences between the two groups in E-acceleration time and VTI 0-33%/ total VTI at pre-coronary angioplasty period (P < 0.05). There were statistical differences in E-decelaration time and E-decelaration slope of group B before and after coronary angioplasty (p < 0.05). These results suggest that the left ventricular diastolic function in group B has recovered partly at one hour after coronary angioplasty.

Adult↗

[A case of aortic dissection after the termination of cardiopulmonary bypass].

We report, a case of aortic dissection after the termination of cardiopulmonary bypass (CPB), which was diagnosed by transesophageal echocardiography (TEE). A 70-year old male with aortic regurgitation received aortic valve replacement. After the termination of CPB, the aortic dissection was diagnosed by TEE. Furthermore wall motion abnormality was found by TEE, and aorto-coronary bypass was performed after observation by TEE. This case report suggests that TEE is useful not only for diagnosis but also for therapeutic orientation of aortic dissection.

Aged↗

Impairment of the brain beta-adrenergic system during experimental endotoxemia.

Brain dysfunction is observed clinically in patients suffering from prolonged endotoxic shock. However, the etiology of brain dysfunction during sepsis is not clear. Certain researchers have reported that the decrease in brain catecholamines concentration during septic shock might be etiologically important in brain dysfunction. Therefore, we hypothesized that the beta-adrenergic receptor system undergoes a change during septic shock, and plays a role in the pathogenesis of septic encephalopathy. In this study, we examined two models of septic shock in rats, each of which has a different time course for the shock state. Male Wistar rats were divided into four groups: (1) Control--0.9% saline vehicle, (2) Lipopolysaccharide (LPS) i.v.-- Escherichia coli endotoxin 1.0 mg/ml i.v. bolus, (3) Sham-operated, and (4) Cecal ligation and puncture (CLP) model. The rats were killed by decapitation at 3, 12, or 24 hr after the treatments, and the brains were removed and subdivided into three areas: the forebrain, cerebellum, and brain stem. In the LPS i.v. group, the brain tissue norepinephrine (NE) concentration had decreased in the forebrain and brain stem and the tissue epinephrine (E) concentration had decreased in the brain stem by 3 hr after treatment. In the CLP group, the brain tissue NE concentration had decreased in the forebrain, cerebellum, and brain stem (P < 0.05), and the tissue E concentration had decreased in the forebrain and brain stem by 24 hr after treatment (P < 0.05). An alteration in beta-adrenergic receptor density in the forebrain was observed at 24 hr in the CLP group (control, 237.0 +/- 14.0 fmole/mg protein; LPS i.v., 233.2 +/- 3.0 fmole/mg protein; sham-operated, 236.0 +/- 3.0 fmole/mg protein; CLP, 177.0 +/- 4.2 fmole/mg protein). These alterations in transmitter concentrations and beta-adrenergic density in the forebrain may be an important factor in septic encephalopathy.

Animals↗

An alteration in the gamma-aminobutyric acid receptor system in experimentally induced septic shock in rats.

OBJECTIVE: To investigate the role of the brain gamma-aminobutyric acid receptor system in septic shock. DESIGN: Prospective, controlled study. SETTING: Animal laboratory. SUBJECTS: Twenty-one male Wistar rats (7 wks old) were randomized to three groups: group 1 (n = 7, control); group 2 (n = 7, sham-operated); group 3 (n = 7, cecal ligation and puncture group). INTERVENTIONS: Under light ether anesthesia, the rats were treated as described above. Twenty-four hours after treatment, the rats were killed by decapitation. Plasma amino acid concentrations were measured using the collected blood. The brain was excised as rapidly as possible, and separated into forebrain, cerebellum, and brain stem. The brain gamma-aminobutyric acid concentration was measured at each of the three regions. Using 3H-musimol, which is a gamma-aminobutyric acid receptor agonist, as a radioligand, the gamma-aminobutyric receptor densities were measured in these three regions by a radio-receptor assay. MEASUREMENTS AND MAIN RESULTS: The concentrations of the branch-chain amino acids (leucine, isoleucine, valine) were lower in the cecal ligation and puncture group than in the control and sham operated groups. The concentrations of the sulfur-containing amino acids (cysteine and taurine) were increased in the cecal ligation and puncture group compared with the other two groups, but the methionine concentration was increased in the sham-operated and the cecal ligation and puncture groups compared with the control group (p < .05). The plasma gamma-aminobutyric acid concentration was not detectable in any of the three groups. The ammonia concentration was greater in the cecal ligation and puncture group than in the other two groups. There was no significant difference in the brain gamma-aminobutyric acid concentration among the three groups. The maximum number of binding sites in the forebrain of the cecal ligation and puncture group was higher than in the other two groups at both high- and low-affinity sites (control group: high-affinity sites 0.34 +/- 0.03, low-affinity sites 2.93 +/- 0.28; sham-operated group: high-affinity sites 0.35 +/- 0.03, low-affinity sites 2.73 +/- 0.18; cecal ligation and puncture group: high-affinity sites 0.59 +/- 0.13, low-affinity sites 3.53 +/- 0.21; mean +/- SEM pmol/mg protein) (p < .05). There were no significant differences observed in other regions of the brain (cerebellum and brain stem) in the three groups. The dissociation constants for 3H-musimol were almost unchanged in the three groups. CONCLUSIONS: An increase in the gamma-aminobutyric acid-A receptor density was observed in the forebrain of the cecal ligation and puncture model rats. This alteration may be closely related to the pathogenesis of brain dysfunction during septic shock.

Amino Acids↗

[Assessment of cardiac functions in patients for coronary artery bypass graft using transesophageal echocardiography before and after cardiopulmonary bypass].

We evaluated cardiac functions in 7 patients for elective coronary artery bypass graft surgery before and after cardiopulmonary bypass (CPB) using transesophageal echocardiography (TEE). There was no significant difference in the ratio of end-systolic meridional wall stress (ESS) and end-systolic area (ESA), which is a good indicator of cardiac contractility, before and after CPB period. However, left ventricular stroke work index (LVSWI) decreased after CPB compared to that before CPB. There was a positive correlation between the ESS/ESA ratio after induction of anesthesia and left ventricular ejection fraction at the pre-operative study. As the ESS/ESA ratio represents cardiac contractility and the ESS is a reliable indicator of afterload, we thought it possible to assess cardiac contractility and precise afterload by using TEE during perioperative period.

Aged↗