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Biomedical subjects

K Takeichi

Publications and source records attributed to K Takeichi.

8 recordsLinked to original sources

[Placental transfer of vecuronium administered with priming principle regimen in patients undergoing cesarean section].

Eight women having cesarean section under general anesthesia received vecuronium (VCB) 0.01 mg.kg-1 as a priming dose, followed 180 s later by 0.11 mg.kg-1 as an intubation dose. Subsequently, VCB concentrations of umbilical venous and maternal arterial blood at delivery were assayed. The time from the injection of intubation dose to delivery was 283 +/- 55 (mean +/- SD) s. Umbilical and maternal VCB concentrations at delivery were 79.4 +/-36.1 1ng.ml-1 (UV) and 1258.3 +/- 464.1 ng.ml-1 (MA). respectively. Thus, the umbilical venous to maternal arterial VCB concentration ratio (UV.MA-1) was 0.07 +/- 0.02. One-min and 5-min Apgar scores were 8-9 and 9-10, respectively. Judging from previous reports concerning VCB administration during cesarean section, total of VCB 0.12 mg.kg-1 may be an overdose. We concluded therefore that of total VCB 0.10 mg.kg-1 seems to be an appropriate dose for cesarean section.

Adult↗

[Short-term and long-term outcome of left heart function after cardioverter defibrillator implantation].

The usefulness and problems of implantable cardioverter defibrillators (ICD) were examined in patients with reduced heart function. Of 36 patients who received ICD for refractory ventricular tachycardia (VT) or ventricular fibrillation (VF), VT and/or VF was associated with underlying heart disease in 26 patients, and VF without underlying heart disease in 10. Of the former 26 patients, 13 with left ventricular ejection fraction (LVEF) of less than 30% were assigned to group A, 13 with LVEF of greater than 30% to group B, and the other 10 with idiopathic VF to group C. Intraoperative death, cardiac death due to heart failure, sudden death, functional status of the ICD, exacerbation of heart failure symptoms and complications were compared between the three groups. There were no intraoperative deaths in any of the groups. During the median follow-up period of 36 +/- 22 months, there was only one sudden death in group A. There were no significant differences between the three groups. There were five cardiac deaths in group A, but none in groups B or C. The cardiac death-free rates 12, 24, and 36 months after implantation in group A were 83%, 60% and 50%, respectively. These values significantly differed from those in groups B and C (p < 0.05). The number of patients who received defibrillation therapy was higher in group A (p < 0.05). Defibrillation therapy was administered earlier in group A than in groups B and C (p < 0.05). The incidence of exacerbation of heart failure after implantation was 69%, 23% and 0% in groups A, B, and C, respectively. In group A, defibrillation therapy was administered in all patients with exacerbation of heart failure. The administration of defibrillation therapy significantly differed from that in patients without exacerbation of heart failure (p < 0.05). Exacerbation of heart failure during the postoperative acute stage occurred in both patients in group A in whom an epicardial lead system was used, but not in the four patients in group B or five in group C (p < 0.05). There were no differences in the incidence of other complications between the three groups. In group A, patients with reduced heart function, ICD greatly decreased the risk of sudden death. However, heart failure mortality remained high. Therefore, ICD may have limitations for improved prognosis. In group A patients, defibrillation therapy was administered in all patients with exacerbation of heart failure or death due to heart failure. In patients with reduced heart function, treatment for heart failure and prophylaxis of VT and/or VF should be administered.

Adult↗

Coronary thrombosis induced by intracoronary acetylcholine injection in a patient with normal coronary myocardial infarction.

A 67-year-old male was admitted with acute myocardial infarction. Coronary thrombolysis was carried out because complete occlusion of the obtuse marginal branch (OM) in the circumflex artery was detected in emergent coronary angiography, and recanalization of the OM was obtained at 3 hours after the onset of chest pain. No significant stenosis of the OM was found in coronary angiography performed at the recovery stage. After intracoronary acetylcholine injection to the left coronary artery, coronary spasm was induced and coronary thrombosis was observed in the left anterior descending artery thereafter. These findings indicate the possibility that the etiology of myocardial infarction is coronary thrombosis induced by coronary spasm.

Acetylcholine↗

Spectral luminous efficiency functions in the mesopic range.

Spectral luminous efficiency functions for mesopic vision were measured extensively to establish a basic data set for the mesopic photometry system. These functions were obtained by the direct brightness matching for a 10 degrees field at nine retinal illuminance levels from 100 to 0.01 Td in 0.5-log-unit steps. Data for 12 subjects were collected. In the mesopic range, the spectral luminous efficiency function, averaged over 12 subjects, gradually changes form with retinal illuminance. This suggests that the mesopic function should be established for all the levels in that range. An attempt was made to find an empirical formula that expresses the mesopic function as a simple combination of the photopic and the scotopic brightness functions.

Humans↗