Biomedical subjects

A Matsuki

Publications and source records attributed to A Matsuki.

At least 19 recordsLinked to original sources

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

[A relationship between plasma ANP concentration and hemodynamics during PEEP--evaluation by transesophageal ECHO cardiography].

This study was undertaken to find which cardiac function indices as judged by transesophageal ECHO cardiography (TEE) would accurately predict the plasma ANP levels during PEEP. Fourteen patients who underwent orthopedic surgery were the subjects of the study. PEEP 10 cmH2O or 15 cmH2O was added with a PEEP valve during mechanical ventilation under general anesthesia. The cardiac function indices were measured using a 5 MHz TEE probe and plasma ANP levels were evaluated by radioimmunoassay. There were significant reductions in the left atrial diameter, cardiac output and pulmonary venous flow during PEEP, while A/R and CVP were significantly increased. The plasma ANP concentration decreased significantly from 39.2 +/- 4.8 pg.ml-1 at pre PEEP period to 26.8 +/- 3.1 pg.ml-1 at PEEP 15 cmH2O (mean +/- SE, P less than 0.05). However, we could not find any significant correlation between the cardiac function indices and ANP levels. The secretion of ANP from the heart is regulated mainly by stretch tension of the atrium. PEEP increases the pericardial pressure. Therefore, it seems to be difficult to predict the stretch tension of the atrium using TEE under PEEP.

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 study on total intravenous anesthesia with droperidol, fentanyl and ketamine--15. Application for cardiac anesthesia].

Total intravenous anesthesia with droperidol, fentanyl and ketamine (DFK) was administered to 36 cardiac patients who underwent mostly coronary artery bypass graft or heart valve replacement. The induction and maintenance of anesthesia using this technique were almost satisfactory with little decrease in systolic blood pressure (SBP), although six patients among the early 21 patients developed hypotension below 90 mmHg (SBP) during the induction, and required vasopressors. Half of the patients had hypertensive episode of above 180 mmHg (SBP), from the start of operation to onset of cardiopulmonary bypass, which was safely and effectively overcome by a small dose of antihypertensive agents. Total intravenous anesthesia with DFK was accompanied with much more hypertensive episodes compared to anesthesia with moderate dose fentanyl (30 micrograms.kg-1) combined with enflurane. However, the incidence of cardiovascular complications following anesthesia was not statistically different between the two anesthesia groups. In addition, most of the patients with DFK showed a rapid awaking time with relatively good postoperative cardiovascular stability. These findings suggest that total intravenous anesthesia with DFK is accompanied with minimal hemodynamic changes during and after open heart surgery.

Aged↗

PubMed1992

[Effects of sevoflurane anesthesia on dopamine metabolism in the rat brain].

To elucidate the mechanism of general anesthesia, effects of sevoflurane anesthesia on dopamine metabolism in rat brain were studied. Sevoflurane 3% was administered for 20 minutes to Wistar male rats weighing 230-270 g under spontaneous respiration. The rats were sacrificed by decapitation and the brains were rapidly removed. They were dissected into nine discrete regions, locus coeruleus, pons plus, medulla oblongata, hypothalamus, thalamus, basal ganglia, midbrain, hippocampus, amygdala and cerebral cortex. The contents of dopamine (DA) and its major metabolites, 3, 4-dihydroxyphenyl acetic acid (DOPAC) and homovanillic acid (HVA) were measured by high performance liquid chromatography with the dual-cell coulometric detector before anesthesia, 20 minutes after the start of anesthesia and at the recovery from anesthesia. Significant increases in DA levels were observed in the pons, hypothalamus, thalamus and amygdala by sevoflurane anesthesia as compared with the control group. DOPAC levels increased significantly in the pons, hypothalamus, basal ganglia and cerebral cortex at the recovery from anesthesia. A significant increase in HVA levels was observed in amygdala by sevoflurane anesthesia, while an appreciable decrease in HVA levels was observed in hippocampus at recovery from anesthesia. It is concluded that DA metabolism is significantly suppressed in the pons, hypothalamus, thalamus, basal ganglia, midbrain and amygdala during sevoflurane anesthesia and this change in DA metabolism may be associated with the mechanism of sevoflurane anesthesia.

Anesthetics↗

PubMed1992

[Pharmacokinetics of ketamine and pentazocine during total intravenous anesthesia with droperidol, pentazocine and ketamine].

Pharmacokinetics was studied in ten surgical patients who underwent various operative procedures of about 4 hours under total intravenous anesthesia with droperidol, pentazocine and ketamine (DPK). Plasma levels of ketamine, its metabolites and pentazocine were determined thirteen times during and after DPK. During anesthesia, ketamine (KO) and norketamine (KMI) levels ranged from 0.7 to 1.0 micrograms.ml-1 and from 0.09 to 0.74 micrograms.ml-1, respectively. A small amount of dehydronorketamine (KM II) was detected only 90 min after the start of DPK anesthesia. Plasma half-lives of ketamine were calculated to be 33 min for distribution phase (alpha phase) and 60 min for elimination phase (beta phase), respectively. Pentazocine levels decreased 300 min after the induction of DPK to 10% of the control level measured 5 min after its injection. Plasma half-lives of pentazocine were 60 min for alpha phase and 140 min for beta phase, respectively. The data obtained in this clinical study show that pharmacokinetics of ketamine during DPK is almost similar to that of DFK.

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↗

PubMed1992

[Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine. 14. Effect on epidural pressure].

We studied effect of total intravenous anesthesia using ketamine, fentanyl and droperidol (DFK) on epidural pressure as an index for cerebrospinal fluid pressure in six surgical patients who underwent gastrectomy. The epidural catheter was inserted on the previous day. The epidural puncture was made at Th7-12 and the tip of the catheter was located 5 cm cephalad. The epidural pressure was measured before, just after and 30 minutes after the induction. The induction dose of fentanyl was 5 micrograms.kg-1 and that of ketamine was 1 mg.kg-1. The epidural pressure at the induction decreased in significantly by 19% as compared with that before the induction. The result suggested that DFK would not increase cerebrospinal fluid pressure when the doses of ketamine and fentanyl were changed.

Adult↗

PubMed1992

[Clinical study on total intravenous anesthesia with droperidol, pentazocine and ketamine].

Fifty patients underwent various surgical procedures including abdominal, orthopedic, plastic and gynecological operations under total intravenous anesthesia with ketamine, pentazocine and droperidol. Neither nitrous oxide, inhaled anesthetics nor narcotics such as fentanyl were administered to the patients. Intraoperative muscle relaxation was achieved with vecuronium and the patients were ventilated manually throughout the surgical procedures. Thirty percent of the patients developed hypertension and tachycardia, but they were easily overcome with administration of calcium ion channel blocker. Their peripheral circulation as well as urine output was well maintained. No adverse effects on the liver and kidney were observed post-operatively. Their post-operative sedation and analgesia were evaluated excellent. A few patients had strange dream as if they might have missed their way into the "pink" tunnel. The data above described suggest that this anesthetic method would deserve further detailed clinical study.

Adult↗

PubMed1991

[The effect of enflurane anesthesia on plasma superoxide dismutase (SOD)-like activity in elderly patients].

Plasma SOD-like activity during enflurane anesthesia was measured according to electron spin resonance in ten elderly patients over 66 years and in nine patients under 64 years. Anesthesia was induced with thiopental 4 mg.kg-1 and succinyl-choline 0.8-1.0 mg.kg-1 intravenously and was maintained with enflurane 1.0-2.0% in nitrous oxide and oxygen. They were ventilated manually throughout the surgery. The mean plasma SOD-like activity before anesthesia was lower in the elderly group compared with the control group. This decreased significantly in the elderly patients on the first and third day after surgery. There was no relationship between plasma SOD like activity and patient age. We conclude that increased superoxide anion production in the post-operative period may affect plasma SOD-like activity.

Aged↗

PubMed1991

[Pituitary-adrenal response to ketamine].

Fahringer and coworkers have shown the possibility that the steroid response to ketamine is not caused by a direct action on the adrenal gland and is dependent on the presence of a functioning pituitary gland. To clarify these points, we examined the effects of ketamine on ACTH production in isolated pituitary cells of rats. Corticosterone and aldosterone production was measured in isolated adrenal cells of rats to test the possibility of a direct influence of ketamine on the adrenal gland. Rat anterior pituitary and adrenal glands cells respectively were obtained by enzymatic digestion of intact glands collected from Wistar rats. This cell pellet was suspended in Hank's buffer containing 0.1% BSA and distributed to plastic tubes. The cell samples were preincubated for 90 min in a 37 degrees C waterbath under an atmosphere of 5% CO2/95% O2. Ketamine was then added to normal and to ACTH treated cells, which were incubated for 4 hr, and centrifuged. Samples of the supernatant liquid were taken, and aldosterone and ACTH were measured by radioimmunoassay. Corticosterone was determined by a fluorimetric method. Ten individual measurements were made for each sample. Results are expressed as mean +/- s.e. Statistical analysis was performed using Student's t-test. The results indicated that ketamine significantly increased ACTH secretion in the isolated pituitary cells. On the other hand, ketamine had no significant effects on adrenal corticosterone formation. There were similar effects by ketamine on ACTH-induced corticosterone production when compared with that obtained by ACTH alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Glands↗

PubMed1991

The endocrine response after burns.

To identify the dynamic response of hormones after burns with special reference to ANP during shock and the subsequent period, plasma concentrations of atrial natriuretic peptide (ANP), aldosterone, cortisol, arginine vasopressin (AVP), corticotropin, (ACTH), plasma renin activities (PRA), norepinephrine (NE) and epinephrine (E) were measured from the day of ICU admission and for 7 days following burn injury. Plasma AVP levels were highest on ICU admission and correlated with size of the burn injury ranged from 20-60 percent of the total body surface area. Between the 5th and 6th postburn day plasma ANP levels elevated while plasma AVP levels returned to normal. Urine sodium concentrations decreased from the 3rd day. Plasma aldosterone levels declined after the 2nd day. Mean epinephrine (E) and norepinephrine (NE) levels elevated on admission and remained elevated throughout the study. These results suggest that ANP plays important role for restoring fluid homeostasis by improving edema in burned tissues during refilling periods in burns.

Adrenocorticotropic Hormone↗

PubMed1991

[Role of prostaglandin E1 in steroidogenesis by isolated rat adrenal cells].

In order to investigate the effects of prostaglandin E1 (PGE1) used in hypotensive anesthesia on the adrenal endocrine function, aldosterone, corticosterone (Comp B) and cAMP production were measured in isolated glomerulosa (G-c) and fasciculata cells (F-c) of the rats. Rat glomerulosa and fasciculata cells were obtained by enzymatic digestion of the adrenals of male wistar rats. The cell pellet was suspended in Hank's balanced salt solution containing 0.1% BSA and distributed in 900 microliters aliquots to polyethylene tubes. The samples were preincubated for 90 min in a 37 degrees C water bath aerated with 5% CO2/95% O2. PGE1 or ACTH 50 microliters was added and incubated for 4 hr. Total volume of the incubation medium is 1.0 ml. Aldosterone and cAMP were measured by radioimmunoassay and Comp B was determined by fluorimetric method. PGE1 increased significantly the basal secretion of aldosterone and Comp B in G-c and F-c, respectively. The steroidogenic effect of PGE1 was dose dependent in aldosterone production. This aldosterone production was also accompanied with cAMP production. On the other hand, significant increase of cAMP was not observed in comp B production. These results suggest that cAMP may be the second messenger in PGE1-induced aldosterone production in G-c. But PGE1 receptors in F-c seem not to be coupled to the adenylate cyclase system. The addition of ACTH and PGE1 resulted in inhibition of aldosterone secretion when compared with that obtained by ACTH alone. Several researchers have shown that low doses of PGE1 depressed the basal aldosterone secretion. These findings may be contributing to Na-uresis effect during PGE1-induced hypotension.

Adrenal Cortex↗

PubMed1991

[Survey of cardiac arrests during and following anesthesia and surgery for the past seven years].

Cardiac arrests, excluding those associated with cardiac surgery, occurred in eleven out of 13,278 patients who had general anesthesia in our hospital for seven years from 1983 to 1989. Four of them were successfully resuscitated, while the remaining seven patients were lost. The causes of these cardiac arrests were as follows: massive bleeding in four; cardiac compression by surgeons in two; possible coronary artery spasm in one; hyperpotassemia in one; severe metabolic acidosis in one; myocardial ischemia in one; and unknown cardiogenic origin in one. There is no case in which anesthesia was the primary cause of cardiac arrest. Although we can not be absolutely free from cardiac arrest during anesthesia and surgery, we should do our best to detect and correct any factors leading to perioperative cardiac arrests.

Anesthesia, General↗

PubMed1991

[Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--10. Effects of prostaglandin E1 on the hepatic and renal functions following prolonged surgery under total intravenous anesthesia].

Twenty one patients who underwent prolonged surgical procedures over 10 hours under total intravenous anesthesia with droperidol, fentanyl and ketamine were studied to evaluate post-operative hepatic and renal functions as judged by serum levels of GOT, GPT, BUN and creatinine. They were divided into two groups. Ten patients of the PGE1 group were given PGE1 at a rate of 0.035 micrograms.kg-1.min-1 during anesthesia, and the remaining eleven of the control group were not given PGE1. The two groups were comparable concerning, age, body weight, height, operation time and anesthesia time. In the PGE1 group, significantly more intraoperative fluid was given than in the control group. The blood loss was more but insignificantly in the PGE1 group than in the control group. There was no significant difference in urine output and the amount of blood transfused between the two groups. In both groups, post-operative s-GOT and s-GPT levels were increased significantly compared with pre-operative values, but there was no significant difference between the two groups. Serum BUN levels of the 7-10 the post-operative days were increased significantly in the PGE1 group, but those of the control group were not. These data suggest that our method of total intravenous anesthesia with droperidol, fentanyl and ketamine, when applied even for prolonged surgical procedure over 10 hours, would have beneficial effects on the post-operative hepatic and renal functions.

Alprostadil↗

PubMed1991

[Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--11. Effect on epidural pressure].

We have developed a new method of total intravenous anesthesia using ketamine, fentanyl and droperidol (NLA-FK). There are many reports describing a significant increase in cerebrospinal fluid pressure (CSFP) during ketamine administration, but little is known about changes in CSFP during NLA-FK. As epidural pressure (EP) is considered as a good index for CSFP, we measured it in 12 patients under either NLA-FK or isoflurane anesthesia, who underwent gastrectomy. In the NLA-FK group the EP increased significantly by 26% at the induction of anesthesia as compared with the preinduction level, and it decreased to the preinduction level 30 minutes after the induction. Thereafter the pressure was not appreciably changed. In the isoflurane group EP significantly decreased by 16% at induction, but the pressure significantly increased by 29% 30 minutes after the induction as compared with the preinduction level. The change was similar to that of the NLA-FK group. Although the increase in the EP during the induction of NLA-FK is significant, it is considered to be within normal ranges. However, further detailed clinical study is needed to attenuate the significant increase in the EP during the induction of NLA-FK.

Anesthesia, Intravenous↗

PubMed1991

[Cerebral infarction during operation on the neck of the femur under epidural anesthesia: a report of two cases].

Cerebral infarction occurred during operation in two cases. An 83-year-old senile demented female underwent osteosynthesis with Ender pins under epidural anesthesia. Soon after Ender pins were inserted, her systolic blood pressure fell from 180 mmHg to 140 mmHg. The patient complained of chest pain and developed disturbed consciousness and right hemiparesis. On the second postoperative day, CT scanning showed the infarction of a left middle cerebral artery region. A 93-year-old female was another patient. She underwent a cup arthroplasty of the right hip bone fracture. Soon after bone cement was applied, she developed a mental confusion and her blood pressure increased from 120/60 mmHg to 160/80 mmHg. CT scanning on the first postoperative day showed the infarction of a left middle cerebral artery region. Sudden changes in systolic blood pressure and changes of mental status are possible signs of cerebral infarction not to be neglected. If elderly patients with any episodes of cerebral function troubles would undergo operation of the hip fracture, it is necessary to pay a particular attention to possible cerebral infarction.

Aged↗

PubMed1991

[Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--12. Effects on plasma complement and immunoglobulin concentrations].

Complements and immunoglobulins in the plasma are the important humoral factors to maintain immunity. As there is no study on immune response to total intravenous anesthesia with droperidol, fentanyl and ketamine (DFK), twelve patients who underwent abdominal, neck dissection, or plastic surgery were studied to determine plasma concentrations of complements and immunoglobulins. In five patients of isoflurane group, anesthesia was induced with intravenous thiopental 5 mg.kg-1 and succinylcholine 0.8-1 mg.kg-1 and maintained with 1-2% isoflurane in nitrous oxide (50%) and oxygen (50%). The remaining seven patients of the DFK group received intravenous droperidol 0.25 mg.kg-1, fentanyl 1-2 micrograms.kg-1, ketamine 1-1.5 mg.kg-1 and succinylcholine 0.8-1 mg.kg-1 for the induction of anesthesia, and then they were given a total dose of fentanyl 5-15 micrograms.kg-1, ketamine 2 mg.kg-1.hr-1 and oxygen (30%) for the maintenance of anesthesia. Vecuronium was given intravenously as needed. Lactated Ringer's solution was used for intraoperative fluid replacement. A total of 40 ml of arterial blood was drawn on four occasions, just before the induction of anesthesia, at the recovery from anesthesia, on the third and tenth post-operative days. Plasma concentrations of complements (C3.C4) and immunoglobulins (IgG.IgA.IgM.IgD) were measured by immuno-turbidimetry. C3 concentrations in the plasma decreased significantly when the patients recovered from anesthesia, but they increased significantly on the third and tenth post-operative days in the isoflurane group. In the DFK group, they increased significantly on the tenth post-operative day only. No significant difference in the C3 concentrations was detected between two groups at any time of measurement.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗