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Biomedical subjects

M Kawamata

Publications and source records attributed to M Kawamata.

At least 55 records · Page 3Linked to original sources
PubMed1995

[A case of spasticity following spinal cord injury improved by epidural spinal cord stimulation].

Epidural spinal cord stimulation was performed in a patient complaining of spasticity with intractable pain after operation of metastatic spinal tumor. The end of the electrode was positioned along a line extending down the 11th vertebral body. Following confirmation of satisfactory effects during 10 days of trial stimulation, the electrode was permanently implanted. Excellent pain relief (80%) and significant relaxation of spasticity resulted in a medication free period with improved daily activities. Although the treatment of this case resulted in clinical success, the problem concerning the payment of the transmitter remained. We hope that the health insurance system will extend its indications to cover medical fees for the transmitter.

Carcinoma, Renal Cell↗
PubMed1995

[Hemodynamic and blood gas changes during femoral neck prosthetic replacement using a cement gun].

We investigated hemodynamic and blood gas changes in eight patients undergoing femoral neck prosthetic replacement. We measured blood pressure, heart rate, pulmonary artery pressure, cardiac output and blood gas before packing bone cement with a cement gun and 5, 10, and 15 min after the insertion of the prosthesis. Significant increases in mean pulmonary artery pressure, and arterial PCO2 were observed, but there were no significant changes in mean arterial pressure, cardiac output, or arterial PaO2. These pulmonary circulatory and blood gas alterations suggested that pulmonary embolism or pulmonary vasospasm had been brought about by the insertion of the prosthesis, but this did not result in systemic changes in the patients in this study. In conclusion, it is recommended to monitor circulatory and respiratory changes closely to detect pulmonary embolism during femoral neck prosthetic replacement using a cement gun.

Aged↗
PubMed1995

[Effect of preoperative treatment with recombinant human erythropoietin in patients undergoing hemodilutional autologous transfusion].

This study evaluated whether a combination of recombinant human erythropoietin (rHuEPO) and hemodilutional autologous transfusion could reduce homologous blood transfusion in 37 patients who underwent elective urological surgery. A single dose of 6000 IU rHuEPO was administered 2 weeks before operation to patients whose preoperative hemoglobin was less than 12.0 g.dl-1 (8.5-12.0 g.dl-1) (EPO group, n = 15) and compared these with control subjects whose preoperative hemoglobin was more than 12.0 g.dl-1 (non-EPO group, n = 22). Both hemoglobin and hematocrit levels after administration of rHuEPO in the EPO group increased significantly to the same levels as in those in the non-EPO group and remained at these levels. The mean volume of donated autologous blood was 980 g in the EPO group and 110 g in the non-EPO group. The mean surgical blood loss was 1330 g in the EPO group and 1120 g in the non-EPO group. No homologous blood transfusion was required in 80 percent of the cases in both groups: however, homologous transfusions were added to 3 cases in the EPO group and 4 cases in the non-EPO group whose surgical blood loss was over 2500 g. We conclude that the combination of preoperative rHuEPO treatment and hemodilutional autologous transfusion can reduce homologous transfusion during surgery in anemic patients.

Aged↗
PubMed1994

Temperature-dependent change of serological specificity of Candida albicans NIH A-207 cells cultured in yeast extract-added Sabouraud liquid medium: disappearance of surface antigenic factors 4, 5, and 6 at high temperature.

The cells of Candida albicans NIH A-207 strain (A-strain) cultivated in YSLM at high temperatures (37 and 40 degrees C) did not undergo agglutination with the factor sera 4, 5, and 6 in a commercially available factor serum kit, 'Candida Check', and formed a grape-like shape. The mannans isolated from the cells had lost their reactivity against the factor sera in ELISA. It was also revealed by 1H NMR analysis that the mannans contained neither a phosphate group nor a beta-1,2-linked mannopyranose unit, although these mannans increased the non-reducing terminal alpha-1,3-linked mannopyranose unit. The cells and the mannans prepared by cultivation at such high temperatures followed by 27 degrees C in the same medium entirely recovered the reactivity with the factor sera.

Agglutination Tests↗
PubMed1994

Measurement of intercostal and pleural pressures by epidural catheter.

The pressures in the intercostal and interpleural spaces were measured in 20 patients using an 18 gauge epidural catheter to confirm accurate catheter positioning for continuous intercostal and interpleural local anaesthetic blockade. In the intercostal space the mean (SD) pressure was negative (-1.8 (0.3)) mmHg and positive (+2.1 (0.3)) mmHg at the end of inspiration and expiration respectively. In contrast, in the interpleural space although the pressure varied with the respiratory cycle it remained negative both at the end of inspiration (-8.3 (1.0)) mmHg and expiration (-2.1 (0.8)) mmHg. We conclude that measurement of intercostal and interpleural pressures with an epidural catheter is a straightforward procedure which may be helpful in confirming accurate catheter placement for continuous intercostal or interpleural local anaesthetic blockade.

Adult↗
PubMed1994

Effects of morphine on neuronal and behavioural responses to visceral and somatic nociception at the level of spinal cord.

This study was undertaken to examine the role of morphine in modulation of nociception in visceral and somatic pain tests at the level of the spinal cord, using neurophysiological and behavioural reflex assays. In the neurophysiological study, we recorded extracellularly the activity of the single viscero-somatic convergent neurons of the spinal dorsal horn, which was evoked by the colorectal distention (80 mmHg) of noxious visceral stimulation and the radiant heat (51 degrees C) of noxious somatic stimulation, in decerebrated, spinally transected cats. Spinally administered morphine (200 micrograms) produced significant suppression of noxiously evoked activity by both stimuli in a time-dependent manner. In addition, intravenously administered naloxone reversed the suppressive effects of morphine. In the behavioral reflex study, colorectal distension threshold and tail-flick latency were measured in rats chronically implanted with lumbar intrathecal catheter. Intrathecally administered morphine significantly elevated the colorectal distension threshold and prolonged the tail-flick latency in a time- and dose-dependent manner. The results of the present study demonstrated that spinal morphine was capable of suppressing the evoked activity of the viscero-somatic convergent neurons, resulting in suppression visceral and somatic pain behavioral reflexes.

Afferent Pathways↗
PubMed1994

Relationships between the number of small follicles prior to superovulatory treatment and superovulatory response in Holstein cows.

In order to determine relationships between the number of small follicles prior to superovulatory treatment and superovulatory response, a total of 55 superovulations were induced in Holstein cows. The ovaries were examined ultrasonographically once 0-1.5 days before the initiation of superovulatory treatment. The number of small follicles 3-6 mm in diameter on both ovaries before superovulatory treatment was found to be significantly correlated with the numbers of corpora lutea after superovulation (r = 0.440, P < 0.001), total ova recovered (r = 0.503, P < 0.001) and transferable embryos recovered (r = 0.482, P < 0.001). These results indicate that a single ultrasonographic examination of follicles 3-6 mm in diameter prior to superovulatory treatment can be utilized to predict superovulatory response.

Animals↗
PubMed1994

Acetic acid intoxication by rectal administration.

The enhanced toxicity of acid instilled directly into the rectum, without benefit of dilution and neutralization in the upper intestine, is evident in a case of acetic acid intoxication by accidental rectal administration of 50 mL of 9% acetic acid to a 5-year-old boy. The complications included necrosis of the colon, acute renal failure, acute liver dysfunction, disseminated intravascular coagulopathy (DIC) and sepsis.

Acetates↗
PubMed1994

[Clinical evaluation of controlled hypotensive anesthesia with MR7S1].

Efficacy, safety and the optimal dose of MR7S1, an injectable preparation of sodium nitroprusside, were studied in 37 patients (ASA class I and II) under nitrous oxide-oxygen-enflurane anesthesia. MR7S1 was administered by intravenous infusion. The dose of MR7S1 was increased gradually starting from 0.25 micrograms.kg-1.min-1 to the dose which could achieve the target value of systolic blood pressure (80-100 mmHg). Thereafter this dose level was maintained. During the period in which the dose was increased, the blood pressure was reduced in proportion to the rate of administration. With the rate of administration of 1.0 to 3.0 micrograms.kg-1.min-1, a significant decrease in systolic blood pressure (SBP) was observed compared with the pretreatment level of SBP. During the maintenance period, the SBP was maintained around 80 to 100 mmHg at a rate of administration of 0.25 to 3.5 micrograms.kg-1.min-1. Two out of 37 patients showed a slight decrease in PaO2, but these values returned to normal without any treatment. These findings suggest that MR7S1 is a useful agent to control blood pressure for the hypotensive anesthesia.

Adult↗
PubMed1994

[Evaluation of analgesic effects of morphine, buprenorphine and pentazocine in rats receiving somatic and visceral stimulation].

The analgesic effects of morphine, buprenorphine and pentazocine examined by behavioral responses to tail-flick (TF) and colorectal distension (CD) were studied in rats. Animals were randomly divided into three groups; morphine (M) groups of 4 mg.kg-1 (n = 7), buprenorphine (B) groups of 0.03 mg.kg-1 (n = 8), pentazocine (P) groups of 3 mg.kg-1 (n = 8). After determinations of TF and CD values, animals were administered each analgesic intraperitoneally, and both procedures were repeated every 5 minutes until 40 minutes. Three drugs produced an almost same degree of increase in pain threshold for TF; % maximum possible effects (%MPEs) were approximately 30%. Similar patterns of increase in pain thresholds for CD were observed in M and B groups; %MPEs were approximately 20%. In contrast, P groups showed a significant increase in thresholds for CD compared to M and B groups; 20 minutes after intraperitoneal administration of P, %MPE was approximately 50%. These results indicate that there are different antinociceptive effects to somatic and visceral stimuli between M, B and P, and suggest that selective opioid agonists modulate responses to different kinds of noxious stimuli.

Abdominal Pain↗
PubMed1994

Suppression of the thyrotropin response to thyrotropin-releasing hormone and its association with severity of critical illness.

OBJECTIVE: To study whether the suppression of the thyrotropin (thyroid-stimulating hormone, TSH) response to thyrotropin-releasing hormone (TRH) correlates with severity of illness and death in patients with nonthyroidal critical illness. DESIGN: Prospective study. SETTING: Intensive care unit (ICU) of a university hospital. PATIENTS: Forty-one critically ill patients without thyroid disease with multiple organ failure who were admitted to the ICU. MEASUREMENTS AND MAIN RESULTS: The TSH response to TRH was tested within 24 hrs of ICU admission. Blood samples were obtained just before, and at 15, 30, 60, 90, and 120 mins after 500-micrograms injection of synthetic TRH. Triiodothyronine, free-triiodothyronine, thyroxine, free-thyroxine and TSH concentrations were measured in the samples obtained just before TRH injection. Acute Physiology and Chronic Health Evaluation (APACHE II) scores and Sepsis scores were calculated based on the data obtained within 24 hrs of ICU admission. Individual variables were compared between survivors and nonsurvivors. The APACHE II scores and Sepsis scores of nonsurvivors were significantly higher than those scores of survivors. The overall occurrence of suppressed TSH response to TRH was 88%. Peak TSH concentration of the TSH response was significantly lower in nonsurvivors than in survivors. Serial measurement of the TSH response showed that nonsurvivors experienced a decrease in peak TSH concentration from 1.55 +/- 0.78 to 0.55 +/- 0.30 microIU/mL; in survivors, it increased from 2.10 +/- 0.26 to 7.38 +/- 1.83 microIU/mL. Conversely, the basal TSH concentration did not change in either survivors or nonsurvivors. The "severity" of illness of nonsurvivors remained high; their mean APACHE II score varied from 20.0 +/- 1.9 to 22.1 +/- 1.3 and the mean Sepsis score varied from 20.0 +/- 4.3 to 25.4 +/- 4.0, while the same scores for survivors decreased significantly (p < .05): their APACHE II score decreased from 16.2 +/- 0.7 to 7.6 +/- 2.0 and the Sepsis score went from 14.0 +/- 1.9 to 6.0 +/- 1.6. CONCLUSIONS: In critically ill patients with multiple organ failure, suppression of the TSH response to TRH frequently occurs and correlates with severity of illness and outcome. Our data indicate that measurement of the TSH response is helpful in evaluating the severity of illness and prognosis for critically ill patients.

APACHE↗
PubMed1994

[Study of administration of buprenorphine suppository for postoperative pain relief following transvaginal hysterectomy].

Buprenorphine suppository (BSP) has been available as an analgesic agent in Japan since 1990. It has gained considerable popularity in various clinical situations; however, its usefulness for postoperative pain relief has been controversial. The present study is addressed to postoperative pain in fifty-seven women who underwent transvaginal hysterectomy under spinal anesthesia with tetracaine and phenylephrine. We examined the analgesic effects of buprenorphine (0.4 mg) suppository. Patients were divided into four groups according to the timing of buprenorphine suppository administration: group A1, preoperative administration of BSP, n = 12; group A2, postoperative administration of BSP, n = 17; group A3, intravenous injection of 0.1 mg of buprenorphine during surgery and postoperative administration of BSP, n = 14; group C, control group, n = 14. All the patients in group C complained of pain within 24 hr. The onset time of pain after surgery was significantly longer in patients in group A1 (372 +/- 220 min) and A3 (481 +/- 161 min) than in control group C (282 +/- 97 min). The percentage of patients who did not complain of pain within 24 hr was the largest in group A3 (36%). However there were no significant differences in age, body weight, effective analgesic time, analgesic level or operation time among the four groups. Nausea and vomiting were observed in all groups: C (36%), A1 (41%), A2 (18%), and A3 (29%). From these results, we conclude that preoperative or intraoperative administration of buprenorphine is useful for control of postoperative pain; the method of administration of buprenorphine suppository needs further study.

Adult↗
PubMed1994

[Open heart surgery in patient with hyperthyroidism].

A 57-yr-old male with atrial septal defect (ASD) was scheduled for the patch closure operation. The patient had a history of hyperthyroidism due to giant adenoma of the thyroid gland. The patient was controlled under euthyroid state by thiamazole for four years. With this treatment, his thyroid function became normal and he was doing well for over the last seven years. On the morning of the day of operation, thiamazole was given orally to this patient. When the ASD patch closure was performed, the examination of his thyroid gland revealed hypothyroidism, but the operation could be performed without any thyroidal trouble. After the operation thiamazole was given intramuscularly to this patient and from the next day it was continued orally. Thyroid storm did not occur after the operation until discharge. We conclude that in a case of heart disease with hyperthyroidism, it is important to keep the patient's thyroid function under normal for a long time before surgery.

Administration, Oral↗
PubMed1993

Potentiation of antinociceptive effects of morphine by calcium-channel blockers at the level of the spinal cord.

BACKGROUND: Opioids inhibit voltage-dependent calcium-channel conductance, which is essential for the nervous system to be able to signal a painful event. Accordingly, interference with calcium-channel conductance may enhance opioid analgesia. The current study was designed to investigate the effects of calcium-channel blocking drugs on the antinociception of morphine at the level of the spinal cord. METHODS: Rats were chronically implanted with catheters in the lumbar intrathecal space. Tail-flick test was used to assess thermal nociception. Intrathecally administered drugs were morphine, calcium-channel blockers (verapamil, diltiazem, and nicardipine), or a combination of morphine and calcium-channel blocker. RESULTS: Intrathecal administration of morphine produced a significant dose-dependent antinociception in the tail-flick test. In contrast, intrathecal administration of calcium-channel blockers, verapamil, diltiazem, and nicardipine, did not show any antinociception at the employed doses. However, when intrathecally administered calcium-channel blockers, verapamil (50 micrograms), diltiazem (100 micrograms), or nicardipine (20 micrograms), were combined with ineffective (0.25, 0.5, 1, or 2 micrograms) or moderately effective (5 micrograms) doses of intrathecally administered morphine, significant antinociception was produced. These interactions were synergistic. There were no significant changes in MAP or HR after the intrathecal administration of 200 micrograms verapamil or 2 micrograms morphine combined with 50 micrograms verapamil. CONCLUSIONS: The authors interpreted these results to indicate that calcium-channel blocking drugs synergistically potentiate the analgesic effects of morphine at the level of the spinal cord. Before these results can be translated into clinical use, however, adequate toxicity studies must be conducted to examine the effect of the perispinal administration of calcium-channel blocking drugs on spinal cord function.

Animals↗
PubMed1993

Central venous catheter migration to the popliteal artery during total cavopulmonary shunt.

Central venous catheter migration to the arterial system occurred due to the surgical procedure during total cavopulmonary shunt. The catheter seems to have crept into the portion of the vena cava that had been designated for clamping, because of the position for the surgery and the anatomic characteristics of the patient. The catheter migrated in the right popliteal artery and was removed immediately; however, it could enter the pulmonary arterial system and the other systemic arterial branches.

Adolescent↗
PubMed1993

[Continuous thoracic epidural blockade in combination with general anesthesia with nitrous oxide, oxygen, and sevoflurane in two patients with myasthenia gravis].

Continuous thoracic epidural anesthesia (T4/5) using 4-5 ml.h-1 of 1.5% lidocaine with 1:200,000 epinephrine and inhaled anesthesia using nitrous oxide, oxygen and sevoflurane were performed in two patients, (40 and 22 yr-old females) with myasthenia gravis. This combined anesthetic technique provided muscle relaxation for endotracheal intubation and optimal operating conditions, including muscle relaxation and stability of hemodynamics during transsternal thymectomy. Further, continuous epidural anesthesia using 4 ml.h-1 of 0.25% bupivacaine provided postoperative pain relief without other analgesics and stable postoperative respiratory conditions. In conclusion, we confirm the benefits of this technique which provides not only safe and stable conditions during the surgery, but also an improved comfort for patients in the postoperative period following transsternal thymectomy for myasthenia gravis.

Adult↗