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Biomedical subjects

F Uesugi

Publications and source records attributed to F Uesugi.

11 recordsLinked to original sources
PubMed2001

[The effects of intravenous nicardipine on jugular venous oxygen saturation].

We investigated the effects of intravenous nicardipine on jugular venous oxygen saturation (SjO2) in patients undergoing superficial temporal artery-middle cerebral artery anastomosis. Anesthesia was induced with intravenous thiamylal and fentanyl, and maintained by isoflurane and nitrous oxide in oxygen. In the presence of stable condition after the induction, nicardipine 0.5 microgram.kg-1.min-1 was administered intravenously for 180 minutes. Mean arterial pressure, heart rate, SjO2 and bladder temperature were recorded. Three hours after continuous infusion of nicardipine, plasma levels of nicardipine in artery and jugular vein were measured by liquid chromatography. The arterial concentration of nicardipine reached 23.9 +/- 8.06 ng.ml-1. The area under the curve between the arterial and jugular venous nicardipine during infusion was significantly different. Mean arterial pressure was reduced in response to administration of nicardipine. There were no significant changes in heart rate, bladder temperature and SjO2. We concluded that the current dose of nicardipine reached effective concentration for systemic hypotension without influencing SjO2.

Adult↗
PubMed2001

[Blood concentration of propofol during cardiopulmonary bypass--comparison between arterial and internal jugular venous blood].

Twelve adult patients for cardiac surgery were divided into 2 groups, normothermia (6 patients) and mild hypothermia (6 patients), based on their body temperature during cardiopulmonary bypass (CPB). Propofol was continuously administered throughout each operation at a dose of 2 mg.kg-1.h-1. Arterial and internal jugular venous bulb blood samples were drawn simultaneously before CPB, at 5, 30, 60, and 90 minutes after the start of CPB, 30 minutes after the end of CPB, and at the conclusion of the operation, to measure propofol concentrations. In the normothermia group, propofol concentration in the arterial blood decreased significantly 5 minutes after the start of CPB, and then recovered immediately to the pre-CPB value. In the mild hypothermia group, however, no significant change in propofol concentration was observed. In both groups, there was no significant difference in propofol concentration between arterial and internal jugular venous bulb blood throughout the study period. Our results suggest that there are no significant differences between the effect of normothermic and that of mild hypothermic CPB on the pharmacokinetics of propofol in the brain.

Adult↗
PubMed2001

[Evaluation of peripheral facial nerve palsy with R 2 wave latency in blink reflex].

Electrically elicited blink reflexes were investigated in 60 patients with peripheral facial nerve palsy. The purpose of this study was to evaluate the utility of analysis of R 2 wave in blink reflex as a prognostic indicator for the patients with facial palsy. The patients treated by stellate ganglion block were classified into three groups: Group I scored more than 90 points (full score is 100 points) within 2 weeks, Group II scored more than 90 points over 2 weeks, and Group III scored less than 90 points. The examinations were performed at the first visit, and 2, 4, 6 weeks after the onset of facial palsy. Latencies of ipsilateral and contralateral R 2 wave were measured by electrical stimulation on both side. There were significant differences of R 2 latency between ipsilateral and contralateral side in each of the three groups at the first visit. In Group II, contralateral R 2 latency obtained by stimulation of the paralytic side was prolonged significantly. In Group III, the ipsilateral R 2 wave was not observed. The results of this study indicate that measurement of the R 2 latency of blink reflex is useful in judging the severity of the peripheral facial nerve palsy. The R 2 latencies obtained by stimulation of ipsilateral and contralateral side should be used as one of the parameters for evaluation of the prognosis of patients with peripheral facial nerve palsy.

Adult↗
PubMed2000

A new method for dynamical HOLZ calculations

An exact scheme for dynamical HOLZ calculations has been developed with a matrix formula based on the modified Bethe's theory and current flow without the small angle approximation. The HOLZ intensity must be calculated with the current flow for electron beams. For a quantitative intensity calculation at large illumination, not only the current flow in diffracted beams from an exit surface but also the current flow in a primary beam plays an important role.

Journal Article↗
PubMed2000

[Pain management for patients with cancer--current problems in a pain clinic].

One hundred and twenty-three patients with early or advanced cancer who had been referred to our pain clinic were studied retrospectively to investigate current problems with pain management for cancer patients. Pain due to advanced cancer and prolonged post-thoracotomy pain were two major reasons for referral. It was found that 51.7% of the patients with advanced cancer had not been treated appropriately with the WHO protocol for cancer pain relief before referral; however, increased administration of morphine did not necessarily relieve cancer pain, and in fact decreased the QOL of some patients; and 47.7% of patients with cancer pain were effectively treated with nerve block therapy. The present investigation also indicates that many patients who had undergone thoracotomy suffered prolonged post thoracotomy pain. Although post-thoracotomy pain was refractory to NSAIDs, trigger point injections with or without intercostal nerve block were effective in 65.4% of such patients. We conclude that further propagation of the WHO protocol for cancer pain relief, appropriate use of nerve block and establishment of practical guidelines for multidisciplinary management of pain are mandatory for improving the QOL of patients with cancer.

Aged↗
PubMed2000

[Left lung lavage affected the cardiac autonomic nervous activity more than right lung lavage during one lung ventilation in a patient with pulmonary alveolar proteinosis].

A 31-year-old man with pulmonary alveolar proteinosis underwent whole lung lavage using differential lung ventilation under general anesthesia with propofol and fentanyl. Left lung lavage was performed under the differential lung ventilation using extracorporeal lung assist. A month later, right lung lavage was performed under the differential lung ventilation alone. We compared left lung lavage with right one in the effects on heart rate variability and relationships between heart rate and arterial pressure. In the left lung lavage compared with the right one, arterial pressure was maintained higher; sympathetic nervous activity was kept tonic as shown in the power spectral analysis of heart rate variability; coherency showed lower; and a phase relationship analysis indicated a delay of almost 180 degrees. Therefore, we conclude that left lung lavage affected the cardiac autonomic nervous activity more than right one in differential lung ventilation.

Adult↗
PubMed1998

The tracheal tube with a high-volume, low-pressure cuff at various airway inflation pressures.

When the tracheal tube with a high-volume, low-pressure cuff is used, the pressure exerted by the cuff on the tracheal wall is similar to the intracuff pressure, and the pressure is claimed to be lower than the capillary perfusion pressure; however, it is not known if this is the case when a high airway pressure is required. In a randomized, cross-over design, we studied 61 patients (31 men) and measured the intracuff pressures of the tracheal tube at various airway pressures. While the lungs were inflated at five different airway pressures in turn (10, 15, 20, 25 and 30 cm H2O), the cuff of the tracheal tube was inflated with air until it prevented an airleak ('just-seal' pressure). Intracuff pressures [median (range)] at airway pressures of 10, 15, 20, 25 and 30 cm H2O were 8 (0-20), 15 (4-20), 22 (6-32), 26 (11-52) and 31 (16-54) cm H2O, respectively, for men and 6 (0-20), 11 (0-20), 15 (0-24), 21 (0-32) and 25 (1-41) cm H2O, respectively, for women. Therefore, we conclude that the pressure exerted by the cuff of the tracheal tube on the tracheal wall is unlikely to exceed the capillary perfusion pressure (arbitrarily defined as 25 mmHg or 34 cm H2O) when the airway pressure is 25 cm H2O or less, but it may exceed the capillary perfusion pressure when the airway pressure is greater than 25 cm H2O.

Anesthesiology↗
PubMed1997

Lidocaine tape relieves pain due to needle insertion during stellate ganglion block.

PURPOSE: To investigate the efficacy of lidocaine tape, a new preparation of lidocaine for cutaneous topical anaesthesia in the form of a self-adhesive tape, in alleviating the pain of needle insertion during stellate ganglion block. METHODS: In a double-blind, placebo controlled study, 30 adult outpatients undergoing stellate ganglion block were allocated to receive all of the following five treatments in random order: placebo tape applied to the intended site of the block (control), or lidocaine tape applied for 7, 15, 30, and 60 min. After the block was performed using a 24-gauge needle, the pain associated with needle insertion was assessed using a visual analogue scale (10 cm VAS) and the four-point verbal rating score (VRS 0-3). RESULTS: With placebo tape, the VAS and VRS scores were 2.4 +/- 1.27 (0.5-4.8) (mean +/- SD (range)) and 1.5 (1-2) (mean (range)), respectively. The pain scores were reduced (P < 0.01) by lidocaine tape after application for 7 min (1.6 +/- 1.06 and 1.0 (0-2) for VAS (mean +/- SD) and VRS (mean (range)), respectively), 15 min (1.5 +/- 1.00 and 1.0 (1-2)), 30 min (1.5 +/- 1.08 and 1.0 (1)), and 60 min (0.6 +/- 0.70 and 0.6 (0-1)). Skin erythema was more frequent with lidocaine tape than with placebo tape (seven minutes of lidocaine tape vs placebo tape, P < 0.05; 15, 30, and 60 min of lidocaine tape vs placebo, P < 0.0005). CONCLUSION: Stellate ganglion block without analgesia is fairly painful in some patients, even when using a 24-gauge needle, and needle pain is reduced by lidocaine tape after an application time of seven minutes or more.

Adult↗
PubMed1996

Changes in tracheal tube position during laparoscopic cholecystectomy.

The distance from the carina to the tip of the tracheal tube was measured with a fibreoptic bronchoscope in 21 consecutive patients undergoing elective laparoscopic cholecystectomy. After placement of an Eschmann tracheal tube with a printed intubation guide mark at the vocal cords, the distance was 28 (15) [5-54] mm (mean (SD) [range]). The tube was then repositioned so that the distance was 34 (3) [30-40] mm from tip of the tube to the carina. After creation of pneumoperitoneum, the distance was significantly decreased to 26 (5) [17-35] mm (p < 0.005), which was not significantly altered by subsequent moving of the patient to the reverse Trendelenburg and left lateral tilt position. The maximum distance of tube migration was 8 (4) [0-15] mm. Four out of 21 patients would have been at risk of bronchial intubation after pneumoperitoneum if the tube had not been repositioned. Placement of the tube according to the guide mark is not recommended for laparoscopic cholecystectomy.

Adult↗