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Biomedical subjects

K Shibutani

Publications and source records attributed to K Shibutani.

At least 19 recordsLinked to original sources
PubMed1992

Effects of fentanyl-diazepam-pancuronium anesthesia on heart rate variability: a spectral analysis.

The effects of induction of anesthesia with fentanyl, 62.1 +/- 7.9 micrograms/kg, diazepam, 0.21 +/- 0.08 mg/kg, and pancuronium on beat-to-beat heart rate variations were studied in seven patients undergoing cardiac surgery. Spectral analysis was used to determine the intensity of the variations in each of the two main frequency bands in which variations are known to occur: (1) high-frequency band, mediated by the parasympathetic nervous system, at the frequency band of respiration, and (2) the low-frequency band, mediated by both sympathetic and parasympathetic nervous systems, at 0.04-0.12 Hz. Both the mean low- and high-frequency band areas were significantly decreased after induction of anesthesia. The ratio of high-to-low frequency band areas increased significantly after induction of anesthesia, from 45% to 62% (P less than 0.05). These results suggest that fentanyl-diazepam-pancuronium anesthesia decreases total autonomic nervous system activity and alters the balance between parasympathetic and sympathetic activities. Thus, spectral analysis of heart rate variations during anesthesia may provide a quantitative measure of assessing the activity of the autonomic nervous system.

Adult↗
PubMed1992

[A case with hepatocellular carcinoma effectively treated by continuous hepatic arterial infusion of etoposide, epirubicin and CDDP].

A 53-year-old man who suffered from advanced hepatocellular carcinoma (HCC) was treated with hepatic arterial infusion (HAI) of Etoposide, Epirubicin and CDDP. Treatment consisted of a continuous HAI of Epirubicin (50 mg/body, day 1.7), CDDP (75 mg/body, day 2.8) and Etoposide (80 mg/body, day 4-6). He had two series of infusions and was treated by transarterial embolization using CDDP powder (100 mg) added to lipiodol and aluminum stearate as suspension following HAI. The tumor regression rate was about 60% after HAI, but the remaining tumor seemed to be almost necrotic. AFP and PIVKA-II reached the normal range after TAE. We could not find lipiodol accumulated in tumor on CT carried out eight weeks after TAE. No recurrence has been noticed in the following 8 months. Toxicity was not so severe and was well tolerated.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Chondrosarcoma of the parapharyngeal space.

Chondrosarcoma is rarely found arising in the head and neck region. An unusual case arising in the parapharyngeal space in a male is reported and the differential diagnosis, pathology and treatment are discussed.

Adult↗
PubMed1990

[Dentist's understanding on dental anesthesiology--on the basis of a questionnaire on post-graduation study].

We set out a questionnaire for 400 participants of the seminar, to investigate the thoughts of dental practitioners and dentists on duty with regard to the post-graduation study and training in particular, to dental anesthesiology. The results obtained were as follows. 1. Almost all of the dental practitioners felt necessary to receive the post-graduation study and training to brush up their techniques. 2. The dental practitioners felt defective in actual techniques prepared by post-graduation trainings now under way, and they desired a particular training in an actual technique specific to an emergency therapy. 3. Seminars for re-education they desired to attend were those related to anesthesia in majority, followed by prosthetics, maintenance and periodontosis, orthodontics, and surgery, implantodontics, and pedodontics. 4. Major curriculums of anesthesiology they desired to receive were systemic management, resuscitation, how to apply the first-aid medicine, and treatment for shock states. The number of those participants who desired to receive these curriculums was help or above of all members, followed by those in dental psychosomatic disease, treatment for senile patients and acupuncture anesthesia. 5. It was unexpected that those who had been aware of the concept of authorized dental anesthesiologist were confined to 54% of the participants. This led us to consider that clinical dentist should be re-educated regarding the system for authorized anesthesiologist. 6. Major participants answered nothing with regard to the advocated curriculums we questioned, so that it was postulated that none felt unsatisfactory of the advocated curriculums at present.

Anesthesia, Dental↗
PubMed1990

[Judgement on students' exercise for resuscitation using a manikin for CPCR exercise (1st report)].

We performed the training for resuscitation using dental students and used a manikin for CPCR Exercise before and after the training to investigate the result obtained. The results were as follows. 1. Although cases in which too much or too little ventilation in amount was judged showed no significant changes before and after the training, those judged too much in ventilation amounted to approx. 1/5 and those judged too little were approx. 1/2 of the total subjects. This suggests that it is preferable to instruct the students to maintain sufficient ventilation when allowing them to exercise artificial breathing of CPCR. But the instruction is somewhat difficult to take because inhibition of gastric distention should be taken into account. 2. Although no changes were shown before and after the training by cases judged too deep in the depth of thoracic oppression, the number of those cases amounted to approx. 4/5 of the total subjects. Cases judged too shallow in depth of thoracic oppression, on the other hand, were significantly decreased from approx. 4/5 before training to approx. 2/3 after training, suggesting that improvement of the shallow oppression initially made is easy rather than to improve the oppression unduly deepened. Accordingly, it appears effective for students to avoid undue oppression when they are trained. 3. Thoracic oppression at a correct position was increased significantly to approx. 1/5 of the total cases, although most of the subjects were in error to choose a correct position for thoracic oppression before training.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiopulmonary Resuscitation↗
PubMed1987

Critical level of oxygen delivery after cardiopulmonary bypass.

The relationship between oxygen uptake (Vo2) and delivery (Do2) was examined in 64 patients immediately after cardiopulmonary bypass. In 44 patients with lactate levels below 2.5 mmol/L, Vo2 decreased proportionally when Do2 decreased below 300 ml/min X m2. At a Do2 over this level, Vo2 plateaued at 105 +/- 13 (SD) ml/min X m2. In a contrasting group of 22 patients with blood lactate levels above 2.5 mmol/L, Vo2 changes depended on changes in Do2 both alone and below 300 ml/min X m2.

Cardiopulmonary Bypass↗
PubMed1986

Effects of intermittent positive-pressure ventilation on cardiac output measurements by thermodilution.

Sequential thermodilution measurements of cardiac output in mechanically ventilated patients undergoing cardiac surgery demonstrated a cyclic modulation which correlated with changes in airway pressure, and was not affected by opening the pericardium. There was no satisfactory point for single measurements, which suggests that random thermodilution measurements of cardiac output during intermittent positive-pressure ventilation should be avoided, even when triplicate measurements are performed. To estimate the mean cardiac output, at least two measurements should be made at predetermined points of the ventilatory cycle. We recommend paired measurements at midinspiration and end-expiration.

Adult↗