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Biomedical subjects

T Kadoya

Publications and source records attributed to T Kadoya.

At least 37 records · Page 2Linked to original sources
PubMed2000

[A case of free rupture of abdominal aortic aneurysm into the peritoneal cavity during posture change after induction of anesthesia].

We report a case in which posture change for radiography after induction of anesthesia caused free rupture of the abdominal aortic aneurysm (AAA) into the peritoneal cavity, resulting in shock, although in the patient an AAA had ruptured into only the retroperitoneal space and hemodynamics had been stable preoperatively. The massive bleeding was controlled with autotransfusion using a washing salvaging autotransfusion device and a roller pump for hemodialysis. In addition, international mild hypothermia was effective for protection of the brain from suspected ischemia during shock. Meticulous attention should be paid for anesthetic management of patients with ruptured AAA even if their hemodynamic status is stable.

Aged↗
PubMed2000

[Anesthetic management of a patient with deep venous thrombosis using temporary inferior vena cava filter].

A patient with deep venous thrombosis caused by a huge uterine leiomyoma underwent abdominal hysterectomy. To prevent pulmonary thromboembolism, the patient received anticoagulant therapy until 6 hr before surgery and temporary inferior vena cava filter was placed. A combination of preoperative anticoagulant therapy and the filter placement during perioperative period enabled this patient to be successfully-managed.

Anesthesia, General↗
PubMed2000

[Anesthetic management for an adult patient with secundum atrial septal defect associated with a large left-to-right shunt].

We describe the case of a 68-year-old woman with secundum atrial septal defect associated with a large left-to-right shunt and congestive heart failure. The patient with a pancreatic tumor was scheduled for hepatic cholangiojejunostomy and cholecystectomy. To determine the ratio of pulmonary to systemic flow (Qp/Qs) as an indicator for the magnitude of left-to-right shunt, oxymetric catheters were placed in the superior vena cava and pulmonary artery. In addition, oxygen delivery was assessed using superior vena cava oxygen saturation (SsvcO2). Although the patient was anesthetized with high-dose fentanyl to supplement nitrousoxide and sevoflurane, the Qp/Qs markedly increased after skin incision. Epidural local anesthetic was then administered. The Qp/Qs decreased to the preoperative value and the hemodynamic condition was improved thereafter. The operative course was uneventful. This case illustrates the potential usefulness of continuous measurement of the Qp/Qs and SsvcO2 for anesthetic management of adult patients with secundum atrial septal defect.

Aged↗
PubMed1999

Galectin-1 regulates initial axonal growth in peripheral nerves after axotomy.

The signals that prompt the axons to send out processes in peripheral nerves after axotomy are not well understood. Here, we report that galectin-1 can play an important role in this initial stage. We developed an in vitro nerve regeneration model that allows us to monitor the initial axon and support cell outgrowth from the proximal nerve stump, which is comparable to the initial stages of nerve repair. We isolated a factor secreted from COS1 cells that enhanced axonal regeneration, and we identified the factor as galectin-1. Recombinant human galectin-1 (rhGAL-1) showed the same activity at low concentrations (50 pg/ml) that are two orders of magnitude lower than those of lectin activity. A similarly low concentration was also effective in in vivo experiments of axonal regeneration with migrating reactive Schwann cells to a grafted silicone tube after transection of adult rat peripheral nerve. Moreover, the application of functional anti-rhGAL-1 antibody strongly inhibited the regeneration in vivo as well as in vitro. The same effect of rhGAL-1 was confirmed in crush/freeze experiments of the adult mouse sciatic nerve. Because galectin-1 is expressed in the regenerating sciatic nerves as well as in both sensory neurons and motor neurons, we suggest that galectin-1 may regulate initial repair after axotomy. This high activity of the factor applied under nonreducing conditions suggests that galectin-1 may work as a cytokine, not as a lectin.

Animals↗
PubMed1999

Fibreoptic assessment of laryngeal aperture in patients with difficult laryngoscopy.

PURPOSE: To determine the relationship between the area of the laryngeal aperture (LA) seen fibreoptically during laryngoscopy and the difficulty of tracheal intubation in patients with difficult laryngoscopy METHODS: In 587 adult patients after induction of general anesthesia and muscle relaxation, the best laryngoscopic view of the larynx using a Macintosh 3 blade was classified according to Cormack. When the LA could not be seen, with laryngoscope blade in place, the LA view provided by a fibreoptic bronchoscope (FOB)-camera passed nasally was photographed. Then, the laryngoscopist attempted to intubate the trachea using the Macintosh blade. Tracheal intubation requiring more than three attempts was defined as difficult. After the third attempt, the trachea was intubated orally aided by FOB. The LA view after jaw thrust during FOB-aided intubation was photographed. RESULTS: Laryngoscopy was difficult in 17 of 587 patients. In four, intubation was difficult. In the remaining 13 patients the trachea was easy to intubate. The LA area obtained by the FOB in the difficult group (median, 0.19; intra-quartile range, 0.14 to 0.39 cm2) was smaller than that in the easy group (2.43; 1.84 to 2.93 cm2)(P = 0.003). In contrast, the LA area provided by jaw thrust during the FOB-aided intubation in the difficult group (2.28; 1.99 to 2.73 cm2) was similar to that during laryngoscopy in the easy group. CONCLUSION: Inability of the laryngoscope to provide an adequate LA view is one cause of difficult intubation with the Macintosh laryngoscope in patients with difficult laryngoscopy.

Adult↗
PubMed1999

Screening for gastroenterological malignancies in new and maintenance dialysis patients.

To screen for gastroenterological malignancies in dialysis patients, we used the fecal occult blood test, examined the upper and lower gastrointestinal tract, and used abdominal ultrasonography in 178 patients starting dialysis (171 on hemodialysis and 7 on continuous ambulatory peritoneal dialysis (CAPD)) and 34 patients on maintenance dialysis (27 on hemodialysis and 7 on CAPD). Screening disclosed ten cancers (one esophageal cancer, three gastric cancers, four colorectal cancers, and two hepatocellular carcinomas) in 9 of the patients starting dialysis. Six cancers (one esophageal, three gastric, one colorectal, and one renal) were detected in 5 of the patients on maintenance dialysis. Since an increased incidence of malignancy has been reported in dialysis patients, gastroenterological screening appears to be worthwhile.

Abdomen↗
PubMed1999

Development of rapid atrial fibrillation with a wide QRS complex after neostigmine in a patient with intermittent Wolff-Parkinson-White syndrome.

We report the case of a 67-yr-old man with intermittent Wolff-Parkinson-White (WPW) syndrome in whom neostigmine produced life-threatening tachyarrhythmias. The patient was scheduled for microsurgery for a laryngeal tumour. When he arrived in the operating room, the electrocardiogram showed normal sinus rhythm with a rate of 82 beat min-1 and a narrow QRS complex which remained normal throughout the operative period. On emergence from anaesthesia, the sinus rhythm (87 beat min-1) changed to atrial fibrillation with a rate of 80-120 beat min-1 and a normal QRS complex. We did not treat the atrial fibrillation because the patient was haemodynamically stable. Neostigmine 1 mg without atropine was then administered to antagonize residual neuromuscular block produced by vecuronium. Two minutes later, the narrow QRS complexes changed to a wide QRS complex tachycardia with a rate of 110-180 beat min-1, which was diagnosed as rapid atrial fibrillation. As the patient was hypotensive, two synchronized DC cardioversions of 100 J and 200 J were given, which restored sinus rhythm. No electrophysiological studies of anticholinesterase drugs have been performed in patients with WPW syndrome. We discuss the use of these drugs in this condition.

Aged↗
PubMed1999

Malposition of the epiglottis after tracheal intubation via the intubating laryngeal mask.

The intubating laryngeal mask has been reported to be a successful method of tracheal intubation although advancement of the tracheal tube via the laryngeal inlet into the trachea cannot be seen. Damage to the larynx or other tissues may occur during blind passage of a tracheal tube. We report a case in which the tracheal tube, advanced blindly, tucked the epiglottis into the laryngeal inlet, resulting in oedema of the epiglottis. This case illustrates the potential for airway obstruction after extubation when using the intubating laryngeal mask as a blind intubation guide.

Epiglottis↗
PubMed1999

Effects of methanol and temperature on enzyme immunoassay with monoclonal antibodies specific to the insecticide etofenprox.

We examined the effects of methanol and temperature on the reactivity of monoclonal antibodies specific to the insecticide etofenprox. When the antigen-antibody reaction was done at 4 degrees C in 10% methanol, the sensitivity in the enzyme immunoassay with each antibody was more than 10-fold higher than that measured at 37 degrees C. Although in 10% methanol one of the antibodies reacted equally with both etofenprox and the carbonate-derivative of etofenprox, in 50% methanol the antibody reacted with etofenprox, but not with the derivative.

Antibodies, Monoclonal↗
PubMed1999

A factor that prevents EDTA-induced cell-growth inhibition: purification of transthyretin from chick embryo brain.

We previously reported the inhibition of cell-growth in Neuro-2A cells, mouse neuroblastoma, by Zn2+ chelation with EDTA. This paper describes the purification of a factor that prevents EDTA-induced cell-growth inhibition from chick embryo brain. The purified factor has a molecular mass of 16 kDa on SDS-polyacrylamide gel electrophoresis under reducing conditions. This factor prevents the cell-growth inhibition in a dose-dependent manner and also binds thyroxine. Analysis of the N-terminal amino acid sequence revealed that 40 residues coincide with the sequence of chicken liver transthyretin.

Amino Acid Sequence↗