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Biomedical subjects

M Kume

Publications and source records attributed to M Kume.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Epidural anesthesia with high dose fentanyl for thoracic surgeries].

Twenty-two elective thoracic surgeries were performed under epidural high dose fentanyl anesthesia. These included 11 mastectomies, 3 lung lobectomies, and 8 operations for esophageal carcinoma. Through an epidural catheter, 10 micrograms.kg-1 fentanyl with [E (+)] or without [E (-)] epinephrine (1: 100,000) was given. N2O (66%) and enflurane (0.2-0.8%) were also administered, and muscle relaxants were given as needed. The onset and duration of the action were approximately 20 minutes and 3 hours, respectively. Anesthesia was maintained with enflurane (up to 0.4%) in 17 patients (77.3%). There were no differences between the E (+) group and the E (-) group. Systolic pressure, diastolic pressure and heart rate during operations were about 30% lower than those observed before the operations. Patients recovered from anesthesia rapidly. Naloxone was administered intravenously in 6 patients after mastectomies or lung lobectomies (42.9%), whose respiratory rate was below 10.min-1. The patients with short operating time (shorter than 2 hours) needed more naloxone. Troubles did not occur either in the recovery room or in the ward with both naloxone and non-naloxone groups.

Adult↗
PubMed1991

[Evaluation of treatment of lung cancer combined with the disease which has needed a semi-emergency operation].

Six cases of lung cancer combined with the disease which has needed semi-emergency operation, two cases of unstable angina, two of ileus due to colon cancer, one of impending rupture of abdominal aortic aneurysm and one of purulent cholecystitis with cholelithiasis, were discussed. Mean age was 62.0 years (range, 36 to 73); four were male and two were female. Case 1 and 2 were admitted with anterior chest pain, Case 3 with lumbago and abdominal pain, Case 4 and 5 with an abnormal shadow on chest x-ray film and Case 6 with abdominal pain. Of the two with unstable angina, one was operated on with right upper lobectomy during the first months after aorto-coronary bypass. Of the two with colon cancer, one was operated on with right upper lobectomy during about 5 weeks after right hemi-colectomy. Case 3 with abdominal aortic aneurysm operated on with left upper lobectomy during 4 weeks after replacement of abdominal aorta. Case 4 with cholecystitis was operated on with left pneumonectomy during about 3 weeks after cholecystectomy. The postoperative course of 4 cases and the post-chemotherapy condition of 2 cases were uneventful.

Adenocarcinoma↗
PubMed1990

Interaction between calcium channel blockers and volatile anaesthetics in the rat heart-lung preparation.

We have studied the effects of the calcium channel blockers verapamil, diltiazem and nifedipine and the volatile anaesthetics halothane, enflurane and isoflurane on myocardial metabolism after postischaemic reperfusion in the rat isolated heart-lung preparation. In the presence of the volatile anaesthetics, the preparations were perfused for 10 min, made globally ischaemic for 8 min, and then reperfused for 10 min. Each of the calcium blockers was administered 5 min before ischaemia. Three hearts in the halothane-verapamil group (n = 10) failed to recover from the ischaemia and the recovery time in the same group was significantly longer than in the enflurane-verapamil or isoflurane-verapamil groups. Although there was no significant difference in myocardial lactate concentrations among the groups, ATP and glycogen contents in the halothane-verapamil group were significantly less than those in the other groups. The results suggest that the combination of halothane and verapamil causes significant myocardial depression during recovery from ischaemia and subsequent metabolic deterioration.

Anesthetics↗
PubMed1990

Functional and metabolic effects of bupivacaine and lignocaine in the rat heart-lung preparation.

We have examined the effects of bupivacaine and lignocaine on myocardial metabolism in the rat isolated heart-lung preparation. Bupivacaine 1, 5 or 25 micrograms ml-1 or lignocaine 4, 20 or 100 micrograms ml-1 was administered 5 min after the start of perfusion. Both bupivacaine 25 micrograms ml-1 and lignocaine 100 micrograms ml-1 reduced heart rate significantly. Bupivacaine 25 micrograms ml-1 was associated with a higher incidence of arrhythmias than the other groups. Three hearts in the bupivacaine 25 micrograms ml-1 group (n = 8) and two hearts in the lignocaine 100 micrograms ml-1 group (n = 8) failed (zero cardiac output) at the end of the experiment. Although there were no significant differences in myocardial lactate and glycogen concentrations between groups, ATP content in the bupivacaine 25 micrograms ml-1 and lignocaine 100 micrograms ml-1 groups was significantly less than that in the control group. The results suggest that myocardial depression and subsequent metabolic deterioration occurred with both the high doses of local anaesthetics; these findings do not account for the apparent increased cardiotoxicity of bupivacaine.

Adenosine Triphosphate↗
PubMed1990

[Epidural anesthesia with high dose fentanyl for abdominal surgery].

An epidural catheter was inserted at T9-L2 interspace and 10 micrograms.kg-1 fentanyl with (E+) or without (E-) epinephrine 1:100,000 was given for 82 elective abdominal surgeries. N2O 66%, enflurane and muscle relaxant were used as needed. The onset and the duration of the action were estimated to be approximately 15 minutes and 4 hours, respectively. Anesthesia was maintained with enflurane below 0.4% (0.22 +/- 0.09%) in 70 patients (85.4%). E+ group needed significantly lower concentration of enflurane than E- group. There was no severe hemodynamic change during the operation. Systolic pressure, diastolic pressure and heart rate during the operation were 115.2 +/- 16.0 mmHg, 69.4 +/- 10.8 mmHg and 74.2 +/- 11.4 min-1, respectively, each of which was about 18% less than the values on arrival in the operating room. Sixty-one patients (82.5%) woke rapidly. Almost all patients felt well and had no pain during the recovery period. Naloxone 0.05-4 mg was administered intravenously in 21 patients (31.7%) whose respiratory rate was below 10 min-1. The patients with shorter operation time (shorter than 2.5 hours) needed more naloxone. Troubles of respiratory depression did not occur in the recovery room and in the ward in both naloxone and non-naloxone groups. This anesthesia method which induces mild depression of blood pressure and heart rate may be indicated for patients with ischemic heart disease or with poor cardiac function, but has no advantages in patients with poor respiratory function who need early extubation after a short operation.

Abdomen↗
PubMed1989

Effects of sevoflurane on myocardial metabolism during postischemic reperfusion in the rat.

In experiments on isolated rat heart lung preparation, the effects of sevoflurane on myocardial metabolism during postischemic reperfusion were evaluated with intramyocardial high energy phosphates, lactate and glycogen. Hearts were perfused for 10 min initially and made globally ischemic for 8 min. Afterwards, they were reperfused for 12 min. Sevoflurane was administered from 5 min after the start of perfusion to the end of reperfusion. There was no significant difference in myocardial lactate levels between the sevoflurane (S) and control groups. However, the myocardial ATP level in Group S was significantly higher than that in control (17.45 +/- 1.51 vs 15.50 +/- 0.87 : P < 0.01). The administration of sevoflurane to the isolated rat heart during pre- and post-ischemia enhanced metabolic recovery in the postischemic state.

Journal Article↗
PubMed1989

Erythroderma with generalized lymphadenopathy induced by phenytoin.

A 40-year-old man developed a generalized erythematous rash, fever, and systemic lymphadenopathy after treatment for two months with anticonvulsants including phenytoin. Laboratory examinations revealed increased white blood cell counts with eosinophilia, abnormal liver function, and increased gammaglobulin levels. A lymphocyte stimulation test showed a significant stimulation index for phenytoin. Skin biopsy findings were nonspecific cellular infiltrates in the upper dermis whereas in lymph nodes the normal architecture was replaced by massive cellular infiltrates consisting largely of lymphocytes, immunoblasts, and eosinophils suggesting a pattern of phenytoin lymphadenopathy. No malignant changes were noted. Phenytoin was discontinued and after a two-month treatment with oral corticosteroids, all manifestations had nearly subsided. However, the patient should be carefully followed up since phenytoin occasionally induces lymphoproliferative states including malignant lymphoma even after cessation of the medication.

Adult↗
PubMed1989

[Effects of inhalation anesthetics on hepatic ATP and L/P ratio in the rat subjected to hemorrhagic shock].

Both anesthetics and hemorrhage may affect the hepatic energy metabolism. The effects of inhalation anesthetics (halothane, enflurane and isoflurane) on hepatic ATP level and L/P ratio were evaluated in rat under hemorrhagic shock. There was no significant difference in the hepatic ATP levels among 4 groups. However the L/P ratio in 3 inhalation anesthetic groups was significantly lower than that in control group. These results suggest that inhalation anesthetics may improve the hepatic energy metabolism during hemorrhagic shock.

Animals↗
PubMed1989

[Retroperitoneal lymph node metastasis in patients with ovarian cancer].

From 1979 to 1987 retroperitoneal lymph node dissection was performed at the Tokyo University Hospital in 41 cases (pelvic lymph node biopsy was done in 4 cases, pelvic lymphadenectomy in 23 cases, pelvic and paraaortic lymphadenectomy up to the renal vessels in 14 cases) of Stage Ia to IV ovarian cancer following cytoreductive surgery. The incidence of retroperitoneal positive nodes was 11.1% (2/18) in Stage I, 50.0% (5/10) in Stage II, 50.0% (5/10) in Stage III and 0% (0/3) in Stage IV (FIGO criteria without considering the pathologic findings of retroperitoneal lymph nodes). The positive rate of lymph node involvement in Stage II and Stage III was significantly higher than that in Stage I. The tumors involving both ovaries were more likely to metastasize to retroperitoneal lymph nodes. Enlargement of tumors and increased ascites were not the risk factors of retroperitoneal lymph node metastasis. These data suggest that the occurrence of retroperitoneal lymphatic spread in ovarian cancer is comparable to that in uterine cancer and increased by involvement of both ovaries and extension to other pelvic tissues.

Adult↗
PubMed1982

Identification of motoneurons supplying the tensor veli palatini muscle in the guinea pig and cat: an horseradish peroxidase study.

Identification of motoneurons supplying the tensor veli palatini muscle was attempted by the horseradish peroxidase (HRP) method in the guinea pig and cat. After HRP injection into the tensor veli palatini muscle, HRP-labeled neurons were seen in the regions closely medial to the cluster of the lateral pterygoid motoneurons in the dorsolateral division of the trigeminal motor nucleus. In the guinea pig the tensor veli palatini motoneurons were observed at the level of the whole rostrocaudal extent of the trigeminal motor nucleus, while in the cat they were seen at the level of the rostral two-thirds of the nucleus.

Animals↗
PubMed1981

Representation of the masticatory muscles in the motor trigeminal nucleus of the macaque monkey.

The pattern of representation of the masticatory muscles in the motor trigeminal nucleus was examined in macaque monkeys by the horseradish peroxidase method. The motor trigeminal nucleus was divided cytoarchitectonically into the dorsolateral and ventromedial divisions. The temporalis, masseter and pterygoid muscles were represented in the dorsomedial, central and ventrolateral parts of the dorsolateral division, respectively. In the ventromedial division, which was located at the level of the caudal half of the nucleus. The anterior digastric or mylohyoid muscle was represented in the dorsomedial or ventrolateral part of the division, respectively.

Animals↗
PubMed1980

Non-selective distribution of hypoglossal nerve fibers after section and resuture: a horseradish peroxidase study in the cat.

The retrograde tracing method of horseradish peroxidase (HRP) was applied to examine the process of regeneration of severed hypoglossal nerve in the cat. After section and resuture of the hypoglossal nerve, the cats were allowed to survive for 4-6 months. In these cats, distribution of neurons labeled with HRP injected into the genioglossus muscle was examined and compared with that in the normal cat. In the operated cats, labeled genioglossus motoneurons were scattered within all subdivisions of the hypoglossal nucleus, indicating non-selective distribution of regenerating hypoglossal nerve fibers to the lingual muscles.

Animals↗
PubMed1979

Topographical arrangement of hypoglossal motoneurons: an HRP study in the cat.

Myotopical localization of hypoglossal motoneurons and representation of the main branches of the hypoglossal nerve within the hypoglossal nucleus were examined in the cat by the HRP method. The hypoglossal nucleus is divided cytoarchitectonically into the ventromedial and dorsolateral divisions; the medial and lateral branches of the hypoglossal nerve are represented respectively in the ventromedial and dorsolateral divisions. The genioglossus motoneurons are located in the ventrolateral part of the ventromedial division, and the geniohyoid motoneurons are in the most ventral part of the ventromedial division. The hypoglossus and styloglossus motoneurons are located in the lateral and dorsolateral parts of the dorsolateral division.

Animals↗
PubMed1979

Localization of motoneurons innervating the posterior belly of the digastric muscle: a comparative anatomical study by the HRP method.

Motoneurons innervating the posterior belly of the digastric muscle were identified in the monkey, cat, dog, guinea pig and rat by the HRP method. After injections of horseradish peroxidase (HRP) into the posterior belly of the digastric muscle, two groups of HRP-labeled motoneurons were observed; the rostral group was seen as a small cluster of neurons in the lateral reticular area along the medial border of the descending root of the facial nerve, and the neurons of the caudal group were distributed among the ascending root fibers of the facial nerve. The distribution pattern of these neurons corresponded to that of the accessory facial nucleus neurons. The accessory facial nucleus was lacking in the rabbit in which the posterior digastric (PD) muscle is nonexistent.

Animals↗