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Ichiro Ohashi

Publications and source records attributed to Ichiro Ohashi.

6 recordsLinked to original sources

Alcohols increase calmodulin affinity for Ca2+ and decrease target affinity for calmodulin.

It has been proposed that alcohols and anesthetics selectively inhibit proteins containing easily disrupted motifs, e.g., alpha-helices. In this study, the calcineurin/calmodulin/Ca(2+) enzyme system was used to examine the effects of alcohols on calmodulin, a protein with a predominantly alpha-helical structure. Calcineurin phosphatase activity and Ca(2+) binding were monitored as indicators of calmodulin function. Alcohols inhibited enzyme activity in a concentration-dependent manner, with two-, four- and five-carbon n-alcohols exhibiting similar leftward shifts in the inhibition curves for calmodulin-dependent and -independent activities; the former was slightly more sensitive than the latter. Ca(2+) binding was measured by flow dialysis as a direct measure of calmodulin function, whereas, with the addition of a binding domain peptide, measured calmodulin-target interactions. Ethanol increased the affinity of calmodulin for Ca(2+) in the presence and absence of the peptide, indicating that ethanol stabilizes the Ca(2+) bound form of calmodulin. An increase in Ca(2+) affinity was detected in a calmodulin binding assay, but the affinity of calmodulin for calcineurin decreased at saturating Ca(2+). These data demonstrate that although specific regions within proteins may be more sensitive to alcohols and anesthetics, the presence of alpha-helices is unlikely to be a reliable indicator of alcohol or anesthetic potency.

Alcohols↗

[Living-related liver transplantation in a patient with hepatopulmonary syndrome].

We experienced the perioperative management of the living related liver transplantation (LRLT) in a patient with hepatopulmonary syndrome (HPS). HPS is seen in 15% of patients of the endstage liver failure, and it accompanies the various types of hypoxia. The diagnostic standards of HPS are chronic liver disease usually complicated by portal hypertension with or without cirrhosis, arterial hypoxemia (PaO2 < 70 mmHg or A-aDO2 gradient > 20 mmHg), and intrapulmonary vascular dilation. The present case conformed to the diagnostic standard. But this case was of a mild type of HPS, because PaO2 was elevated after O2 inhalation and extrapulmonary uptake of 99mTcMAA after lung perfusion was lower than 40%. During perioperative period of LRLT, there were no complications such as hypoxia, acute rejection, bleeding and infection. Therefore HPS would be improved after LRLT. In the management of perioperative period it is important to be aware of hypoxia and to evaluate preoperatively the condition of the patient properly.

Adult↗

[Severe acute pulmonary edema during living related liver transplantation surgery].

We report a case of severe intraoperative pulmonary edema during living related liver transplantation (LRLT) surgery. A 60-year-old woman with end-stage primary biliary cirrhosis underwent LRLT. After administration of several units of packed red blood cells and fresh frozen plasma, a gradual decline in oxygen saturation was observed. After an unexpectedly prolonged ahepatic phase, she developed severe pulmonary edema and critical hypoxemia. Further deterioration of hypoxemia was observed after reperfuion of the portal vein. We conclude that this severe pulmonary edema was caused by transfusion related acute lung injury, and prolonged ahepatic phase with reperfusion injury deteriorated the lung condition.

Acute Disease↗

[Changes of urinary tripsin inhibitor in blood and urine, as well as serum cytokines in living related liver transplantation].

BACKGROUND: Living related liver transplantation induces the production of many inflammatory and anti-inflammatory cytokines. Urinary tripsin inhibitor (UTI) is produced in the liver and wellknown as one of the markers of surgical stress. METHODS: To clarify the significance of UTI in blood and urine and serum cytokines in living related liver transplantation, we examined the changes of UTI, polymorphonuclear elastase (PMNE), interleukin (IL)-6, IL-1 ra and IL-10 perioperatively. RESULTS: UTI in blood increased gradually after operation. It increased from 5.2 +/- 2.2 U.ml-1 at the end of operation to 19.4 +/- 7.5 U.ml-1 on the 10 th postoperative day (POD). Similarly, UTI in urine increased after operation and the peak was on the 7th POD. Cytokines including IL-6, IL-1 ra and IL-10 showed similar changes in general gastrointestinal surgery, but the peak values in liver transplantation were lower. CONCLUSION: These results demonstrate that the recovery of the transplanted liver function require certain time after operation and UTI in urine could be an important marker whether the liver is working or not. The immunosuppressive drugs, like steroid, administered during and after operation would suppress the production of cytokines.

Adult↗

[Two cases of non-MICS surgery successfully managed with Port-Access EndoCPB system].

We report two cases of non-MICS surgery successfully managed with Port-Access EndoCPB system. The first patient is a case of non-ruptured giant aneurysm of middle cerebral artery proposed for clipping procedure under hypothermic cardiopulmonary arrest. The second patient is a case of infectious pseudoaneurysm of the ascending aorta. We conclude that this system can be a powerful option of anesthetic strategy for the patients in need of cardiac arrest without having severe physical stress like sternotomy.

Anesthesiology↗

[A case of severe acute hyperkalemia during pre-anhepatic stage in living-related liver transplantation].

We reported a case of severe acute hyperkalemia during pre-anhepatic stage in living-related liver transplantation. The serum potassium concentration was elevated from 5.1 mmol.l-1 to 7.3 mmol.l-1 after hepatic artery ligation. Inspite of administration of diuretics, calcium and glucose-insulin, T wave on ECG was elevated and premature ventricular contractions occurred frequently. Finally, ventricular tachycardia occurred three times. After hepatic vein ligation, in anhepatic stage, serum potassium decreased gradually to 3.7 mmol.l-1 and arrhythmia disappeared. We consider that the main cause of hyperkalemia in this case is flowing out of potassium from the ischemic liver by surgical manipulation. It is necessary to take care of the change of serum potassium concentration not only in postreperfusion but also pre-anhepatic stage in living-related liver transplantation.

Acute Disease↗