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T Ichimiya

Publications and source records attributed to T Ichimiya.

32 records · Page 2Linked to original sources
PubMed1995

[Cardiopulmonary resuscitation with continuous veno-venous hemofiltration for intraoperative cardiac arrest owing to hypothermia--a case report].

A 77-year-old female was scheduled for an exploratory laparotomy under nitrous oxide-oxygen-neurolept anesthesia. At the time of admission to the operating room, the rectal temperature was 36.0 degrees C. From the beginning of operation, the body temperature dropped slowly despite constant efforts of warming with a blanket and warm intravenous fluids. At 5 hours and 15 minutes after the beginning of operation, she developed cardiac arrest due to hypothermia. At this time the rectal temperature was 31.8 degrees C. In spite of cardioversion and intravenous administration of epinephrine, we could not resuscitate her successfully. Immediately, rewarming was started with continuous veno-venos hemofiltration (CVVH). When the rectal temperature rose to 32.9 degrees C one hour after the rewarming, cardioversion was performed again and spontaneous heart beat was observed. As soon as the rectal temperature rose to 34.0 degrees C, CHF was stopped. Her consciousness recovered 2 hours and 10 minutes after cardiopulmonary resuscitation, we conclude that rewarming with CVVH can be an effective method of cardiopulmonary resuscitation in a patient suffering cardiac arrest due to hypothermia.

Aged↗
PubMed1994

In-vitro effects of antimicrobial agents on Pseudomonas aeruginosa biofilm formation.

The in-vitro effects of ten antimicrobial agents on the biofilm formation of Pseudomonas aeruginosa were investigated. The production of alginic acid by mucoid P. aeruginosa cells cultured in agar media with sub-MICs of antimicrobial agents was quantified by high-performance liquid chromatography. Alginic acid production was inhibited by 1/4 MIC of minocycline (P < 0.002) and tobramycin (P < 0.02), and by 1/256-1/1/64 MIC of macrolides (erythromycin, clarithromycin, roxithromycin, and rokitamycin) and clindamycin (P < 0.02), compared with drug-free controls. Piperacillin, ceftazidime, and ofloxacin did not inhibit alginic acid production. The production of exopolysaccharide by non-mucoid P. aeruginosa cells grown on silicone plates in sub-MICs of antimicrobial agents was determined by quantitative tryptophan assay. Exopolysaccharide production was inhibited by 1/16 MIC of macrolides and clindamycin, but not by other antimicrobial agents. Electron microscopy showed that biofilm formation by mucoid and non-mucoid type P. aeruginosa strains was inhibited by sub-MICs of erythromycin and correlated with the in-vitro production of alginic acid and exopolysaccharide. These results suggest that sub-MICs of macrolides and clindamycin suppress biofilm formation by P. aeruginosa and that intractable chronic respiratory tract infections due to P. aeruginosa might be prevented.

Alginates↗
PubMed1994

[Effects of ulinastatin on extravascular lung water volume in patients undergoing cardiopulmonary bypass].

Pulmonary dysfunction often follows cardiopulmonary bypass (CPB). In the present study, we examined (1) the effects of the human urinary tripsin inhibitor ulinastatin on the extravascular lung water volume (EVLW), and (2) A-aDO2 as an indicator of pulmonary function, in 30 adult patients undergoing CPB. We administered 600,000 U of ulinastatin intravenously immediately before start of CPB in 15 patients (U group). In the control group without ulinastatin, remarkable transient increases in EVLW and A-aDO2 occurred after CPB. In contrast, in the U group extravascular lung water volume level was maintained within the normal range and an inhibited transient increase in A-aDO2 after CPB was observed. We conclude that the administration of ulinastatin in patients undergoing CPB may be useful to prevent pulmonary dysfunction following CPB.

Cardiopulmonary Bypass↗
PubMed1993

[A case of cytomegalovirus pneumonia and Pneumocystis carinii pneumonia with lung cancer--diagnosis by the polymerase chain reaction].

A 64-year-old male was admitted to Oita Medical University Hospital because of primary lung cancer. After the anticancer chemotherapy, the patient developed a high fever. His chest X-ray showed diffuse reticular shadows bilaterally, which were considered to be a drug induced pneumonia, then pulse therapy with corticosteroid was performed. With this treatment, the diffuse reticular shadows disappeared. One month later, however, a severe interstitial pneumonia developed, and the patient died of respiratory failure. Autopsy findings demonstrated cytomegalovirus (CMV) and Pneumocystis carinni pneumonia. The polymerase chain reaction (PCR) for CMV in mononuclear cells in the blood was positive through out his hospitalization. In the sera, however, it was negative at the time of admission, then became positive 10 days before the onset of pneumonia. In addition, the PCR for P. carinni on the swab became positive as well. These results imply that PCR can be used for diagnosis of CMV and P. carinii infections from sera or swabs.

Cytomegalovirus Infections↗
PubMed1993

[Evaluation of low flow closed anesthesia technique for oxygen, nitrous oxide and isoflurane using Engström Elsa Anesthesia System].

We studied low flow closed anesthesia technique for oxygen, nitrous oxide and isoflurane using Engström Elsa Anesthesia System in 47 patients undergoing elective surgery. In the low flow group, anesthesia was maintained with oxygen 300 ml.min-1, nitrous oxide 300 ml.min-1 and optimal concentration of isoflurane after endotracheal intubation. The inspired oxygen concentration was kept higher than 35% through the operation. In the minimal flow group, anesthesia was maintained with nitrous oxide 4 l.min-1, oxygen 2 l.min-1 and optimal concentration of isoflurane after intubation until the inspired oxygen concentration reached approximately 35%. Then the fresh gas flow was reduced to oxygen 250 ml.min-1 and nitrous oxide 250 ml.min-1. In order to maintain the inspired oxygen concentration at 35%, the flow of nitrous oxide should have been reduced as low as to 150 ml.min-1 after 240 min. The volumes of consumption of nitrous oxide and isoflurane in the low flow and minimal flow groups were reduced to one fifth and one third respectively, compared with those of the high flow group. In conclusion, we can perform low flow closed anesthesia safely and easily with this equipment.

Adult↗
PubMed1993

[Pharmacokinetics of lidocaine used for total spinal anesthesia--a comparison between cervical and lumbar injection].

We studied the effects of site of injection on the serum concentration of lidocaine following total spinal block. Six mg.kg-1 of lidocaine was given into the cervical (n = 11) or lumbar (n = 7) subarachnoid space in 10 patients. The mean maximum serum concentration of lidocaine in the cervical group was found to be significantly greater than that in the lumbar group. Lidocaine given into the cervical subarachnoid space seems to be infiltrated easily into the intracranial space and consequently into the systemic circulation.

Adult↗
PubMed1992

[A case of idiopathic interstitial pneumonia with cytomegalovirus infection].

A 67-year-old female was admitted to our hospital because of fever, dry cough, and exertional dyspnea. The findings of chest X-ray, transbronchial lung biopsy, and bronchoalveolar lavage were compatible with the diagnosis of idiopathic interstitial pneumonia. Prednisolone was administered and she felt better for a while. However, she developed severe dyspnea, and marked diffuse infiltrative shadows were observed on chest X-ray after 3 months of steroid therapy. In spite of pulse therapy with methylprednisolone, she died of severe respiratory failure. Complement fixation test and IgG antibody enzyme immunoassay for cytomegalovirus were positive, but there was no change the titers between admission and death. IgM antibody was negative. The lung findings at autopsy compatible with usual interstitial pneumonia and diffuse alveolar damage, moreover, cytomegalovirus infection was observed. We consider that recurrent cytomegalovirus pneumonia had been present due to secondary immunodeficiency caused by administration of steroid hormones.

Aged↗
PubMed1990

Trypsin inhibitors in guinea pig plasma: isolation and characterization of contrapsin and two isoforms of alpha-1-antiproteinase and acute phase response of four major trypsin inhibitors.

Contrapsin and two isoforms, F (fast) and S (slow), of alpha-1-antiproteinase (also called alpha-1-proteinase inhibitor) were isolated in an apparently homogeneous state from plasma of inflamed guinea pigs. Contrapsin inactivated trypsin, but did not significantly affect chymotrypsin, pancreatic elastase, or pancreatic kallikrein. On the other hand, both isoforms of alpha-1-antiproteinase inhibited trypsin, chymotrypsin, and elastase, but not plasma or pancreatic kallikrein. The S isoform of alpha-1-antiproteinase was present in barely detectable amounts in healthy animals, but increased markedly when the acute-phase reaction was induced by subcutaneous injection of turpentine. On the other hand, the plasma levels of the F isoform, contrapsin, and alpha-macroglobulin showed moderate (1.5 to 2.3-fold) elevation during the acute-phase reaction. In contrast to the previous findings that rats and rabbits contain two different alpha-macroglobulins, one of which is an acute-phase reactant while the other is not, inflamed guinea pigs contained only one species of alpha-macroglobulin. Murinoglobulin, the most prominent acute-phase negative protein in both mice and rats, showed no significant change in guinea pigs. These results indicate that guinea pig plasma contains four major trypsin inhibitors, i.e., contrapsin, alpha-1-antiproteinase, alpha-macroglobulin, and murinoglobulin, the properties of which are very similar to those of the respective mouse homologues, but that the acute-phase response of these inhibitors differs greatly from that of the homologous proteins in rats or mice.

Acute-Phase Reaction↗
PubMed1990

[Anesthetic management of a patient with osteogenesis imperfecta congenita].

We experienced anesthetic management of three cases of osteogenesis imperfecta. Case 1: A 2-year-old boy weighing 8.6 kg was premedicated with chloral hydrate 250 mg intrarectally, but he was very excited on arrival at the operating room. Induction of anesthesia was performed by intramuscular injection of ketamine 40 mg. Case 2: A 4-year-old girl underwent three surgeries (2 osteomies and 1 intramedullary nailing of the tibias) during the past two years. On the second and third procedures, marked hyperthermia (over 39.2 degrees C as rectal temperature) developed during halothane (1-2%) and enflurane (1.5-2.5%) anesthesia. However, on the first surgery, hyperthermia did not occur under combined light halothane (0.3-0.5%) anesthesia with caudal epidural block. Case 3: A 14-year-old female underwent osteotomy of the radius under brachial plexus block without any anesthetic complications. In conclusion, anesthetic considerations for children with this disease are as follows; 1) It is necessary to premedicate to provide good preoperative sedation. 2) Care should be taken to use inhaled anesthetic agents (halothane and enflurane) because of tendency to develop abnormal hyperthermia. 3) It is desirable to use regional anesthesia.

Adolescent↗
PubMedDate not supplied

The in vitro effect of macrolides on the interaction of human polymorphonuclear leukocytes with Pseudomonas aeruginosa in biofilm.

The in vitro effect of macrolides at concentrations below the minimum inhibitory concentration (sub-MIC) on the interaction between Pseudomonas aeruginosa biofilm and human polymorphonuclear leukocytes (PMNs) was investigated by using a chemiluminescence assay. The PMN response to either mucoid or nonmucoid P. aeruginosa biofilm was strongly reduced compared with the response to planktonic bacteria (p < 0.01, p < 0.001, respectively). When biofilms were treated with erythromycin, clarithromycin, roxithromycin and azithromycin prior to incubation with PMNs, the chemiluminescence response was markedly enhanced as compared to untreated controls, and a dose-dependent effect was noted over the range of sub-MIC concentrations studied. In general, macrolides appeared to be slightly more active against mucoid biofilm. Azithromycin was shown to be the most active macrolide against P. aeruginosa biofilms. However, the treatment with sub-MICs of rokitamycin did not have any effect. On the other hand, treatment of planktonic bacteria with macrolides before being exposed to the PMNs did not affect the chemiluminescence response as compared to untreated controls. These findings suggest that macrolides inhibiting the biofilm formation of P. aeruginosa may facilitate the phagocytosis of bacteria by PMNs.

Anti-Bacterial Agents↗
PubMedDate not supplied

The influence of azithromycin on the biofilm formation of Pseudomonas aeruginosa in vitro.

The influence of azithromycin on biofilm formation by Pseudomonas aeruginosa, a cause of refractory chronic respiratory tract infection, was investigated. Alginic acid produced by a mucoid strain of P. aeruginosa was quantified by high-performance liquid chromatography from colonies growing on an agar medium. Polysaccharides in the biofilm formed on silicon chips by a nonmucoid strain were determined by a tryptophan reaction. The effect of azithromycin was examined at concentrations below the minimum inhibitory concentration (sub-MIC) for each strain. Azithromycin significantly inhibited the production of alginic acid from the mucoid strain at > or = 1/256 MIC, and the production of exopolysaccharides from the nonmucoid strain at > or = 1/16 MIC. The inhibition of biofilm formation by azithromycin was also observed by scanning electron microscopy. These findings suggest that azithromycin inhibits biofilm formation by P. aeruginosa at concentrations well below the MIC.

Alginates↗