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Ju Mizuno

Publications and source records attributed to Ju Mizuno.

21 records · Page 2Linked to original sources

Temperature-dependent postextrasystolic potentiation and Ca(2+) recirculation fraction in canine hearts.

We have found that cardiac temperature proportionally changes O(2) cost of contractility, defined as O(2) consumption for myocardial total Ca(2+) handling normalized to contractility in terms of the end-systolic pressure-volume ratio (maximal elastance, E(max)), in the canine left ventricle (temperature sensitivity, Q(10) = 2). We have separately found that a decrease in the recirculation fraction (RF) of Ca(2+) within myocardial cells underlies an increased O(2) cost of E(max) in stunned hearts. We therefore hypothesized that a similar change in RF would underlie the Q(10) of O(2) cost of E(max). We tested this hypothesis by analyzing RF calculated from an exponential decay component of the transiently alternating postextrasystolic potentiation in the canine left ventricle. RF decreased from 0.7 to 0.5 as cardiac temperature increased from 33 to 38 degrees C with Q(10) of 0.5, reciprocal to that of O(2) cost of E(max). We conclude that Q(10) of ATP-consuming reactions involved in Ca(2+) handling and E(max) response to it could reasonably account for the reciprocal Q(10) of RF and O(2) cost of E(max).

Adenosine Triphosphate↗

[Efficacy of propofol in controlling myoclonus during rewarming in a brain hypothermia patient].

Propofol is an intravenous anaesthetic agent having anticonvulsant property. We report here a case in which propofol was effective in controlling myoclonus during rewarming in brain hypothermia patient. A 35-year-old male patient was admitted in a comatose state with right-sided hemiparesis, anisocoria and absence of bilateral light reflex. On admission, a head CT showed traumatic subarachnoid hemorrhage, left subdural hematoma, 10 mm midline shift and tentorial herniation with massive brain swelling together with extensive hypodensity in the frontal, temporal and occipital lobes bilaterally. Left decompressive hemicraniectomy, removal of hematoma and brain hypothermia therapy were started immediately. Postoperative head CT showed 15 mm midline shift. The temperature of the jugular bulb was maintained at 34 degrees C for 2 days together with sedation using midazolam under artificial ventilation. The patient was gradually rewarmed at a rate of 0.5 degree C per day from the third hospital day. Myoclonus of sudden onset developed on the patient's head and upper extremities on the third hospital day. An intravenous bolus injection of 10 mg midazolam and continued intravenous infusion of midazolam were given but they did not completely stop myoclonus. A bolus of propofol 60 mg was given intravenously and continuous intravenous infusion of propofol 2 mg.kg-1.hr-1 was started after which the progression of myoclonus disappeared. Myoclonus was kept controlled until the continuous intravenous infusion of midazolam and propofol was discontinued on the sixth hospital day, after which myoclonus occurred again after extubation on the seventh hospital day. The clinical course of this case suggests that propofol might be an alternative effective agent to suppress refractory myoclonus.

Adult↗

[A case of multiple organ dysfunction following postoperative epididymitis].

We report a case of multiple organ dysfunction following epididymitis. A 53-year-old male patient was admitted to our emergency room with bilateral clavicular fractures, multiple costal fractures and left hemopneumothorax due to a traffic accident. Open reduction of the right clavicular fracture was performed under general anesthesia on the sixth hospital day. A bladder balloon catheter was inserted after induction of anesthesia. The clinical course in the perioperative period was satisfactory and the bladder balloon catheter was removed on the seventh hospital day. However, spontaneous left scrotal pain with tenderness, intense heat with swelling developing on the tenth hospital day, and hypotension, dyspnea and oliguria were noted on the eleventh hospital day. Blood chemistry data showed severe inflammatory findings. Chest X-ray showed acute respiratory distress syndrome. Blood coagulation data showed pre-disseminated intravascular coagulation. The patient's condition continued to deteriorate and we suspected septic shock due to left epididymitis. Emergent left orchiectomy was performed under local anesthesia on the twelfth hospital day. Postoperatively he recovered rapidly. We consider that multiple organ dysfunction following postoperative epididymitis was caused by cytokines released due to systemic inflammatory response syndrome (SIRS) after the trauma, operation, and placement of the bladder catheter. In conclusion, it is important to note that patients with SIRS should undergo further examinations of septic shock immediately and resection of the causative tissue should be performed as soon as possible.

Accidents, Traffic↗