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Biomedical subjects

S Kashimoto

Publications and source records attributed to S Kashimoto.

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

[Anesthetic management of a neonate with primary cardiac rhabdomyoma].

We have experienced anesthetic management for cardiac rhabdomyoma in a 21-day-old male, whose pulmonary trunk was obstructed by the tumor. He was anesthetized with fentanyl 70 micrograms.kg-1 and oxygen. The operative and post-operative courses were uneventful. Cardiac tumor, especially cardiac rhabdomyoma, in infant is rare. Anesthesia for the resection of the cardiac tumor must be carried out carefully, because sudden death due to arrhythmias as well as cardiac or respiratory failure is the most dangerous complication.

Anesthesia↗
PubMed1994

Effects of artificial blood (FC-43 emulsion) on myocardial energy metabolism in the rat heart-lung preparation.

We have assessed the effects of artificial blood (FC-43 emulsion) on myocardial energy metabolism in the rat heart-lung preparation. Animals were allocated to four groups (n = 8 each group) according to the ratio of perfusion blood and FC-43 as follows: group 1 = control, perfusion blood only; group 2 = 50% FC-43; group 3 = 75% FC-43; and group 4 = 100% FC-43. Hearts were perfused initially to a cardiac output of 30 ml min-1 and mean arterial pressure of 50 mm Hg. Thirty minutes after perfusion, the hearts were freeze-dried for 6 days. Myocardial high energy phosphates (ATP, ADP and AMP) were measured by high pressure liquid chromatography. Myocardial lactate and glycogen concentrations were measured by enzymatic methods. There were almost no significant differences in cardiac output, systolic pressure, right atrial pressure and heart rate among the groups. Oxygen contents of the perfusate in all FC-43 groups were significantly lower than those in the control group. Myocardial ATP concentrations in rats receiving 50%, 75% and 100% FC-43 were significantly lower than those in the control group. In addition, myocardial ADP and AMP concentrations in rats receiving 75% and 100% FC-43 were significantly higher than those in the control group. Although there is adequate oxygen-carrying capacity in FC-43 to maintain cardiac function during perfusion, the energy levels in the hearts perfused with FC-43 were lower than those in normal hearts.

Adenosine Diphosphate↗
PubMed1994

Effects of inhalation anesthetics on myocardial and hepatic energy metabolism in normotensive and spontaneously hypertensive rats subjected to hemorrhage.

Forty spontaneously hypertensive rats (SHRs) and forty normotensive Wistar-ST rats (NRs) were used to assess the influence of anesthetics on myocardial and hepatic energy metabolism after hemorrhage. They were divided into five pairs of groups: a control group (pentobarbital 6 mg.100 g BW-1 ip), and four others which received 1.2% halothane, 2.2% enflurane, 1.4% isoflurane, and 3.3% sevoflurane, respectively. Following a 10 min stabilization period, blood (2 ml.100 g BW-1) was gradually withdrawn over a 5 min period from a femoral artery. Thirty min after the induction of hemorrhage, the heart and liver were removed and myocardial and hepatic metabolites (ATP, lactate, pyruvate and glycogen) were measured by enzymatic methods. There were no significant differences in myocardial metabolites among either the anesthetic groups or between SHRs and NRs. However, hepatic ATP levels in all SHR groups were significantly lower than those in NR groups. Moreover, ATP levels in the inhalation anesthetic groups of SHRs were significantly higher than that in the control group of SHRs. All inhalation anesthetics, especially isoflurane, may reduce metabolic deterioration of the liver during hemorrhage when compared to barbiturate anesthesia.

Adenosine Triphosphate↗
PubMed1994

[Anesthetic management with continuous epidural buprenorphine of a patient with dystrophia myotonica].

We report an anesthetic management of a 45 year-old female patient with dystrophia myotonica who was scheduled for abdominal total hysterectomy. The patient was diagnosed as dystrophia myotonica 8 years ago. Epidural catheterization was performed through Th12-L1 interspace and spinal anesthesia was performed through L2-3 interspace using 3.3 ml of 0.5% bupivacaine. Adequate block below Th5 level was obtained. The intraoperative course of anesthesia was uneventful. Moreover, the continuous epidural administration of buprenorphine gave a satisfactory postoperative pain relief and no respiratory depression was observed. Spinal or epidural anesthesia seems to be effective and safe for the patient with dystrophia myotonica.

Anesthesia, Epidural↗
PubMed1994

[Anesthetic management of laparoscopic ovarian cystectomy in a 2-year-old child].

We have experienced the anesthetic management of laparoscopic ovarian cystectomy in a 2-year-old child. The patient was anesthetized with isoflurane and manually ventilated to keep PaCO2 at 30 mmHg prior to the carbon dioxide insufflation of the peritoneal cavity. Two minutes after the abdomen was distended, end-tidal CO2 began to increase and after 10 minutes PaCO2 was 50 mmHg. We had to increase tidal volume and respiratory rate, although airway pressure was 30 cmH2O. We should be careful because children who undergo pneumoperitoneum become hypercapnic easily during general anesthesia.

Anesthesia, General↗
PubMed1994

Effects of intravenous anaesthetics on function and metabolism in the isolated rat heart-lung preparation.

The influence of several intravenous anaesthetics on the heart was assessed using the isolated rat heart-lung preparation. Each group received 10(-3)mol litre-1 and 10(-4)mol liter-1 of ketamine, 6 micrograms ml-1 and 60 micrograms ml-1 of midazolam, 6 micrograms ml-1 and 60 micrograms ml-1 of diazepam or 0.6 micrograms ml-1 and 6 micrograms ml-1 of flunitrazepam. Systolic blood pressure in rats receiving high doses of midazolam, diazepam and ketamine were higher than that in the control group. Heart rate in rats receiving high doses of ketamine and diazepam were lower than that in the control group. However, there were no significant changes in cardiac output among the groups. Maximum rate of left ventricular tension development in rats receiving high doses of midazolam and diazepam increased significantly in comparison with that in the control group. There were no significant changes in myocardial high energy phosphates among the groups. None of the intravenous anaesthetics, even in doses which were 100 times greater than therapeutic doses, showed any depressant effects in this preparation. Moreover, it is surprising that midazolam and diazepam produced direct increases in myocardial contractility. These results suggest that the cardiodepressant effects of intravenous anaesthetics may be due to their effects on the central nervous system.

Adenosine Diphosphate↗
PubMed1993

A new infrared tympanic thermometer in surgery and anesthesia.

We have evaluated a new infrared tympanic thermometer, IT-10, as an intraoperative temperature monitor in patients with or without open abdominal surgery. It determines temperature by measuring infrared radiation given off by a warm object. Temperatures measured with this device were closely correlated with those measured with rectal and bladder thermometries. We conclude that this new tympanic thermometer is safe, convenient, accurate, and easily usable in the clinical situation.

Journal Article↗
PubMed1993

Is pentobarbital appropriate for basal anesthesia in the working rat heart model?

In the present study we have examined the effects of the general anesthetic agents for the excision of the heart on the hemodynamic function of the ischemic perfused heart. Animals were divided into three groups. In one group rats were anesthetized with sodium pentobarbital intraperitoneally. Animals of the second and third groups were anesthetized with inhalation anesthetics, sevoflurane and isoflurane, respectively. The hearts were then rapidly excised and perfused by a working heart model. After control perfusion, whole-heart ischemia was induced by one-way aortic valve for 15 min followed by reperfusion for 30 min. During preischemic control period, cardiac output (CO) and left ventricular dP/dT maximum (LV dP/dT max) in the isoflurane group were significantly higher than those in the pentobarbital group. During reperfusion, CO and LV dP/dT max in the isoflurane and sevoflurane groups recovered more rapidly than those in the pentobarbital group. Although there were no significant differences in myocardial ATP and glycogen levels among the groups, myocardial lactate in the pentobarbital group was significantly higher than those in the sevoflurane and isoflurane groups. These results suggest that intraperitoneal pentobarbital anesthesia, administered prior to heart excision, may affect the performance of the ischemic perfused heart thereafter. Therefore, we would suggest that isolation of hearts by means of inhalation anesthesia is better than by means of pentobarbital in the working rat heart.

Administration, Inhalation↗
PubMed1993

Effects of thiopental and ketamine on cardiac function during moderate hemorrhage in chronically instrumented rats.

This study was designed to assess the effects of thiopental and ketamine on cardiac function after a blood loss of 2 ml/100 g of body weight. In nine Sprague-Dawley rats, a catheter was placed in the abdominal aorta, a pulsed Doppler probe was positioned around the thoracic aorta, and a wall-thickness probe was sutured onto the left ventricle. On three occasions, all rats were studied awake, during thiopental anesthesia, and during ketamine anesthesia. In awake rats, a 30% blood loss resulted in an immediate, transient hypotension (49%) and a prolonged decrease in cardiac output (39%) and stroke volume (28%). No significant changes were observed in the wall-thickening fraction, which is an index of cardiac contractility, and in the heart rate. The effect of thiopental on cardiovascular responses to moderate hemorrhage was minimal. Although ketamine did not affect the hypotensive response to moderate hemorrhage, it did accentuate systemic vasoconstriction and cardiac depression as indicated by a decrease in cardiac output (57%), stroke volume (49%), and wall thickness (47%).

Animals↗
PubMed1993

[Anesthetic management of a patient with hypertrophic obstructive cardiomyopathy under epidural anesthesia with high dose fentanyl].

Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by asymmetric hypertrophy of the intraventricular septum, causing intermittent obstruction of the left ventricular outflow tract. General principles of management for HOCM include maintenance of adequate preload and afterload, and avoidance of tachycardia and increased myocardial contractility. A 57 year old male for subtotal gastrectomy and gastrojejunostomy received epidural anesthesia with epidural high dose fentanyl (0.5 mg) and 0.5% isoflurane with N2O and oxygen. Blood pressure and heart rate decreased mildly but were stable during the operation and during the recovery period from anesthesia without any complaints of pain. The results suggest that epidural high dose fentanyl anesthesia is a good method for patients with HOCM.

Anesthesia, Epidural↗
PubMed1992

Effects of propafenone on function and metabolism in the ischemic working rat heart.

We examined the effects of propafenone, a new anti-dysrhythmic agent, on myocardial function and metabolism in ischemic working rat heart preparations. In the treated hearts, propafenone, 0.3 micrograms/ml and 3 micrograms/ml, were added to Krebs-Henseleit bicarbonate buffer perfusate throughout the experiments. Whole heart ischemia was induced through a one-way aortic valve for 15 min followed by 'reperfusion for 30 min. After induction of ischemia, the cardiac output, peak aortic systolic pressure, left ventricular dP/dtmax, and myocardial ATP concentration were greater in the treated hearts than in the untreated ones. All hearts in the untreated group developed ventricular fibrillation (Vf) at the beginning of the reperfusion period. On the other hand, no treated hearts had Vf at any time during the experiment. However, propafenone, 3 micrograms/ml, evoked a negative inotropic effect before and after ischemia. These results indicate that propafenone may contribute to early recovery from ischemia in myocardial function and metabolism, although it has a negative inotropic action.

Adenosine Triphosphate↗
PubMed1992

Cardiac and hepatic metabolism in spontaneously hypertensive rats following acute blood loss.

Seven spontaneously hypertensive rats (SHRs) and eight Wistar-St rats were used to assess the influence of hemorrhage on myocardial and hepatic energy metabolism. They received 2% halothane and pancuronium, 0.3 mg.kg(-1), during preparation. After discontinuation of halothane, blood (2 ml.100 g body weight(-1)) was gradually withdrawn over a 5 min period from a femoral artery. Thirty min after induction of hemorrhage, the heart and liver were removed and myocardial and hepatic metabolites (ATP, lactate, pyruvate and glycogen) were measured by the enzymatic methods. Acidosis and decreased hematocrit were noted in the both groups after hemorrhage. Mean arterial pressure (MAP) in SHR was significantly higher than that in Wistar rat before hemorrhage. However, there were no significant differences in MAP and heart rate between the two groups after hemorrhage. Although there were no significant differences in cardiac metabolites, a significant decrease of hepatic ATP and an increase of hepatic lactate/pyruvate ratio were found in SHR when compared with Wistar rat. These results suggest that human hypertensive disease may run a high risk in connection with acute hemorrhage.

Journal Article↗
PubMed1992

Prostaglandin E1 reduces blood loss during and after resection of lumbar herniated disc.

Controlled hypotension was employed during resection of lumbar herniated disc on 10 patients. Prostaglandin E(1) (PG) was used as a hypotensive agent. The systolic blood pressure was lowered less than 100 mmHg in the hypotensive group. The average blood loss during surgery was 95 +/- 41 ml for the hypotensive group compared with 154 +/- 81 ml for the normotensive group ( P < 0.05). The blood loss after surgery was also significantly less in the hypotensive group than in the normotensive group ( P < 0.05). We conclude that PG is an effective hypotensive agent on blood loss during and after surgery.

Journal Article↗
PubMed1992

Effects of prostacyclin analogue, OP-2507, on function and metabolism in the ischemic working rat heart.

We examined the effects of a new stable prostacyclin analogue, OP-2507, on myocardial function and metabolism in the ischemic working rat heart preparation. The hearts were perfused with Krebs-Henseleit bicarbonate (KHB) buffer, and whole heart ischemia was induced by one-way aortic valve for 15 min follows by reperfusion for 30 min. In the treated hearts, OP-2507, 20 ng.ml(-1), was administered to KHB buffer from the beginning to the end of experiment. During ischemia, coronary flow in the OP-2507 group increased significantly more than that in the control group. The mechanical performance of both groups was impaired after ischemia. However, the recovery of coronary flow, cardiac output, peak systolic pressure and LV dP/dT(max) was significantly higher in the treated group than in the control group. The incidence of ventricular fibrillation during reperfusion was 100% and 25% in the control and the OP-2507 groups, respectively. Myocardial ATP content was significantly higher in the treated hearts than that in the control hearts. These results indicate that this stable prostacyclin analogue is beneficial in myocardial ischemia, even without its well known action of preventing platelet aggregation.

Journal Article↗
PubMed1992

Anesthetic influences on myocardial and hepatic energy metabolism in hemorrhaged spontaneous hypertensive rats.

Twenty four spontaneously hypertensive rats (SHRs) were used to assess the influence of anesthetics on myocardial and hepatic energy metabolism after hemorrhage. They were divided into four groups: a control group and three others which received pentobarbital (60 mg.kg-1 ip), 2.2% enflurane, or 1.4% isoflurane. Following a 10-min stabilisation period, blood (2 ml.100 g body weight-1) was gradually withdrawn over a 5-min period from a femoral artery. Thirty minutes after the induction of hemorrhage, the heart and liver were removed, and myocardial and hepatic metabolites (ATP, lactate, pyruvate, and glycogen) were measured by the enzymatic methods. Metabolic acidosis and decreased hematocrit were noted in all groups after hemorrhage. The mean arterial pressure in rats receiving anesthetics decreased significantly in comparison with the control group. There were significant increases of myocardial and hepatic lactate/pyruvate ratios in rats receiving enflurane when compared with controls. These results suggest that enflurane may be more detrimental than other anesthetics to the maintenance of anesthesia in hypovolemic SHRs.

Acidosis↗
PubMed1992

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

The effects of mexiletine on cardiac function and myocardial metabolism were assessed in the isolated rat heart-lung preparation. Mexiletine 1, 2, 4 or 8 micrograms ml-1 was administered 5 min after the start of perfusion. Heart rate decreased in the 2, 4 and 8 micrograms ml-1 groups significantly following the drug administration. The highest dose of mexiletine reduced cardiac output significantly, and this dose was associated with a higher incidence of dysrhythmias than the other groups. Although there was no significant difference in myocardial glycogen concentration among groups, ATP contents in the 4 micrograms ml-1 and 8 micrograms ml-1 groups were significantly less than in the control group. Lactate contents in the 4 micrograms ml-1 and 8 micrograms ml-1 groups were significantly higher than in the control group. Generally, the therapeutic plasma concentration of mexiletine is 0.5-2.0 micrograms ml-1. These results suggest that mexiletine may have a lesser margin of safety than lignocaine.

Adenosine Triphosphate↗