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Biomedical subjects

Y Masaki

Publications and source records attributed to Y Masaki.

At least 127 records · Page 7Linked to original sources
PubMed1991

[Effect of endotoxin on plasma angiotensin-converting enzyme in dogs].

We calculated angiotensin converting enzyme (ACE) index (ACE/CO) to exclude the influence of pulmonary perfusion and investigated the relationship among ACE, ACE index, hemodynamic changes in 6 endotoxin dogs. Systemic arterial pressure and cardiac output (CO) decreased significantly after 3 mg.kg-1 of endotoxin administration, but neither pulmonary arterial pressure nor pulmonary arterial wedge pressure changed. Lung wet/dry ratio was higher. Although endotoxin administration caused the pulmonary capillary endothelial damage in this experiment, plasma ACE showed a nonsignificant increase. The main reason may be related to the reduction of surface area of pulmonary capillary endothelial cells caused by the decrease in cardiac output. The increased ACE index lasted for 15 to 90 min and began to return to baseline at 120 min after endotoxin administration. We conclude that ACE index is more useful than plasma ACE as an early marker of the pulmonary capillary endothelial damage induced by endotoxin.

Animals↗
PubMed1991

[A prospective study of lung cancer in cases of idiopathic interstitial pneumonia (IIP)].

The incidence of lung cancer in 45 patients (37 males and 8 females), who were originally diagnosed as having idiopathic interstitial pneumonia (IIP), was studied prospectively by following them 4 to 10 years. As controls, sex-, age-, and smoking history matched patients with chronic obstructive lung disease (COLD) were also surveyed for the same follow up period. In addition, the differences in clinical findings between those with and without lung cancer were examined. Eight out of 45 patients with IIP (18%) developed lung cancer (adenocarcinoma; 4, small cell carcinoma; 3, squamous cell carcinoma; 2, including one double cancer). All lung cancer patients were male smokers. Looking only at males, 8 out of 37 patients with IIP (21.6%) developed lung cancer. This incidence was significantly higher than that of the male COLD group (2.2%, less than 0.01). In clinical findings, IIP patients with lung cancer had the characteristics of the chronic type of IIP (lack of volume loss on chest radiographic milder dyspnea, not on steroid treatment) when compared with those who did not develop lung cancer.

Adenocarcinoma↗
PubMed1991

[General anesthesia and surgery inhibited natural killer cell cytotoxicity in patients with cancer or benign disease undergoing upper abdominal surgery].

In this study, effect of enflurane anesthesia combined with epidural analgesia on natural killer cell cytotoxicity (NKCC) was investigated in 20 patients. Patients were divided into two groups: the first group with adenocarcinoma of stomach (Group 1); the second with cholecystolithiasis (Group 2). Four samples were taken; 1) on arrival at operating room; 2) during anesthesia and 1 hour after skin incision; 3) on 1st postoperative day; and 4) on 4th or 5th postoperative day. NKCC was determined with a chromium release assay against K 562 cell. NKCC was already significantly higher before induction in Group 1 compared with Group 2 and normal value. In Group 1, NKCC decreased significantly compared with baseline during operation, but in group 2 NKCC was unchanged during operation. NKCC in group 2 was inhibited significantly less than Group 1 during 5 postoperative days, while NKCC was significantly inhibited postoperatively in both groups compared with the baseline. We conclude that enflurane anesthesia combined with epidural analgesia and surgery did not decrease NKCC below normal value during operation, but it was significantly inhibited during 5 postoperative days in both groups. There were differences in responses to stress of anesthesia and surgery between patients with and without cancer.

Adenocarcinoma↗
PubMed1991

[Effects of ulinastatin on granulocyte elastase and fibronectin in patients undergoing cardiopulmonary bypass].

We investigated the effects of ulinastatin on the increase of granulocyte elastase (GEL) and the decrease of fibronectin (FN) after cardiopulmonary bypass (CPB) in 30 patients undergoing cardiopulmonary bypass. Ulinastatin 300,000 units were given immediately after the induction of anesthesia (U1) or during CPB (U2). GEL increased by 20 times after CPB. GEL was lower in U2 than those in other groups. FN increased by 7-13% after CPB in U1 but decreased in other groups. FN decreased by 21-13% on the first postoperative day in three groups. There was a close relationship between CPB time and increase of GEL in the control group (no ulinastatin given) (y = 18.5 x -833, r = 0.751), between CPB time and increase of FN in U1 (y = 1.4 x -163.4, r = 0.683) or increases of GEL and FN in the control group (y = 0.068 x -202.6, r = 0.812). From these results, we recommend that ulinastatin should be given after the induction of anesthesia and during CPB, to keep a favorable host defense function after CPB.

Adult↗
PubMed1991

[Effects of local anesthetics upon human natural killer cytotoxicity in vitro].

Effects of 3 local anesthetics, bupivacaine, mepivacaine and lidocaine, upon natural killer cytotoxicity were studied in vitro. Mononuclear cell layer was recovered by Ficoll-Paque sedimentation from heparinized venous blood obtained prior to the induction of anesthesia. The mononuclear cells were divided into three groups: control group was incubated in medium only: low concentration group incubated in medium with 2.0 micrograms.ml-1 of mepivacaine (n = 20) or lidocaine (n = 20), or 0.5 micrograms.ml-1 of bupivacaine (n = 21); high concentration group in medium with 20 micrograms.ml-1 of mepivacaine or lidocaine, or 5 micrograms.ml-1 of bupivacaine. These three groups were incubated simultaneously in humidified atmosphere with 5% CO2 in incubator for 2 hours. NK cell cytotoxicity was determined in a chromium release assay against K 562 cell as a target cell. An effector to target cell ratio of 40:1 was used. Comparison among 3 local anesthetics showed no significant difference at high concentration, but a significant difference at low concentration. This was due to the differences between bupivacaine and lidocaine. Neither bupivacaine nor mepivacaine inhibited % NK cytotoxicity at both low and high concentrations compared with control. Lidocaine significantly inhibited % NK cytotoxicity at low concentration, but did not inhibit at high concentration compared with control. We concluded that neither bupivacaine nor mepivacaine inhibited % NK cytotoxicity at concentration of clinical dose compared with control in vitro, but lidocaine inhibited % NK cytotoxicity at a concentration of 2.0 micrograms.ml-1 compared with control.

Bupivacaine↗
PubMed1991

[Effect of almitrine in acute canine lung injury induced by paraquat].

The effects of intravenously administered almitrine (0.3 or 1.0 micrograms/kg/min, for 30 min) on hemodynamics and pulmonary gas exchange were assessed in eight dogs with acute lung injury induced by paraquat under controlled ventilation. Arterial blood gases, pulmonary and systemic hemodynamics, and ventilation-perfusion distribution (VA/Q) using the multiple inert gas elimination technique were examined before (control) and during infusion of almitrine. Almitrine produced significant increases in mean pulmonary arterial pressure from 17.4 +/- 3.3 (control, mean +/- SD) to 20.4 +/- 1.5 mmHg (1.0 micrograms/kg/min), and in total pulmonary vascular resistance. There was no change in other hemodynamic parameters, arterial gas tensions, or VA/Q distribution. These results indicate that almitrine causes pulmonary vasoconstriction without changing ventilation-perfusion distribution in dogs with paraquat-induced lung injury.

Acute Disease↗
PubMed1991

Host immunosuppression following orthotopic bowel allotransplantation in rats using low-dose cyclosporine.

This study shows that Le rats bearing total bowel allografts treated with CyA (5 mg/kg for 14 days) demonstrated within one month immunological unresponsiveness to donor and third-party alloantigens as determined by MLR responses. Assays performed in long-term survivors (greater than 100 days) showed a continued depressed MLR response to antigen-specific (BN) alloantigens. The response to third-party (ACI) alloantigens was not significantly depressed. After the long-term bowel recipients rejected donor skin grafts, the MLR responses were increased over control, but the transplanted bowel remained intact.

Animals↗
PubMed1991

[Prediction of postoperative exercise capacity in lung resection candidates].

The relation between submaximal oxygen consumption (MVO2) before and after lung resection was studied, and the possibility to predict postoperative MVO2 was investigated. Thirty four patients (19 lobectomies, 9 bi-lobectomies, 6 pneumonectomies) performed exercise tests one week before operation and at the time when they were able to resume work daily after operation (in two to eleven months). Predicted postoperative MVO2 was calculated from preoperative MVO2 as follows: 0.8 x resection rate x age index x preoperative MVO2 + 183. In this formula the resection rate means [the number of total lung segments--the number of non-working segments]. The age index is 1.5 for patients under 50 years, 1.0 for those between 50 to 69, and 0.8 for those over 70. This predicted MVO2 had strong correlation with actual postoperative MVO2 (r = 0.94, t = 13.4, y = 1.08x - 83) in twenty five patients. Correlation was low in the remaining nine patients, however. The nine had old myocard infarction, postoperative cerebral infarction, marked wet lung, anticancerous chemotherapy within ten days or marked reduced exercise capacity (below 3 METS at maximal exercise). From these results, we concluded it is possible to predict the postoperative MVO2 using preoperative MVO2 except in cases which have some exercise limiting factors or whose exercise capacity is very small.

Adult↗
PubMed1991

[Studies on right ventricular performance in surgical treatment for primary lung cancer--especially in changes of right ventricular ejection fraction in acute phase].

In surgical treatment for lung cancer, increase of right ventricular afterload associated with decrease of pulmonary vascular bed after lung resection is serious problem in acute phase. Intensive care is necessary for the patients having major surgery, especially in aged. Until now, we have studied on pre and post operative extravascular lung water (EVLW) in addition to measurement of conventional hemodynamic changes on right ventricular afterload. And then, we have discussed when we should start to care intensively for degradation of compensatory hyperdynamic change. According to percent exchanges (delta %) between pre and post operative measurement, we established following criterion 1) delta %HR greater than 150% 2) delta SVI less than 60% 3) delta % PARI greater than 200% 4) observed postoperative EVLW greater than predicted postoperative EVLW. Furthermore, we investigated the correlation with these criterion and RVEF in 14 patients using a rapid computerized thermodilution method on right cardiac function in acute phase. We found that 1) changes of RVEF seem to depend on endsystolic volume 2) RVEF decreased just after operation and then slowly increased until 48 hours 3) PARI elevated to 194 +/- 117% in average at 6 to 24 hours showing significant inversed linear correlation to changes of RVEF (R = -0.54). The patients having prolonged elevation of PARI showed degradation of cardiac output and RVEF. RVSWI showed compensative acceleration gradually with increased right ventricular afterload.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Simplified prediction of postoperative lung function by plain chest roentgenogram in patients with primary lung cancer--in correlation to postoperative respiratory complications].

For the purpose of simplification of prediction of postoperative lung function, we studied to predict lung function by analizing the frontal and lateral view of chest plain roentgenogram and investigate the correlation to respiratory complication on 111 patients with lung cancer. According to TNM classification of lung cancer, prediction was performed as follows. Predicted postoperative lung function = [(42-number of resected subsegments)/(42-number of occupied subsegments)] x preoperative VC or FEV1.0. In this formula, 42 was the number of functioning subsegments of whole lung (right: 22, left: 20), and then preoperative occupied subsegments was ordered by T factor, where T1 lesion in lung field was prescribed as 1 subsegment and T2 was more than 2 subsegments respectively in plain chest roentgenogram. And also, on the patients having hilar lesions, it was required to calculate the number of subsegments in atelectasis, peripheral obstructive pneumonia and/or partial emphysematous change due to intrabronchial lesions. There was uniformly positive correlations in VC (R = 0.7949) and FEV1.0 (R = 0.8235) of the patients studied respectively. The patients having pneumonectomy showed tendency of over estimation, on the other hand, the patients having resection of a few segments showed under estimation. To predict the postoperative respiratory condition, we calculated the predicted post-operative %VC and %FEV1.0 for predicted preoperative normal VC and FEV1.0. Above the al, we tried to investigate the correlation with predicted postoperative %VC, %FEV1.0 and postoperative respiratory complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Management of pain after thoracotomy: experience of intercostal nerve block with alcohol during operation].

Post-thoracotomy wound pain in 11 patients who underwent thoracic operation was controlled by intercostal nerve block with alcohol and thoracic epidural anesthesia. The intercostal nerve block was performed just before the closure of the thoracotomy wound. Epidural anesthesia was employed from the 1st to 5th post operative day. This method alleviated post-thoracotomy pain and obviated postoperative pulmonary complication in all patients in early post operative periods. In late post operative periods after discharge, intercostal nerve block could maintain excellent analgesia in 9 of 11 patients, only 2 patients required analgesic drugs or re-block of the intercostal nerve. Thus, intercostal nerve block with alcohol is an effective and simple option to control recalcitrant post-thoracotomy wound pain in thoracic surgery.

Adult↗
PubMed1991

[Studies on increased sputum after bronchoplastic surgery for lung cancer in correlation with hemodynamics and extravascular lung water].

In surgical treatment for lung cancer, large amount of intrabronchial sputum and secretion was occasionally encountered in patients, especially underwent bronchoplastic surgery. It has been discussed as causes which was affected from transection of pulmonary branches of vagal nerve and bronchial arteries. So we have measured pre- and postoperative hemodynamics and extravascular lung water (EVLW) at the bedside, as to investigate the correlation with formyl sputum and increase of right ventricular afterload which was presumed by lung resection and bronchoplasty. Respiratory complication was classified by the incidence of forced bronchial toilet in acute phase. Seven patients were investigated. Three of seven showed white sputum which was difficult to excrete. EVLW was 9.91 +/- 2.12 ml/kg in average before operation and then showed a tendency to increase within 102 +/- 29% of percent exchange (delta %) between pre- and postoperation. As to comparison of delta % of EVLW in acute period, the patients underwent bronchoplastic surgery showed a tendency to increase rather than the patients underwent lobectomy. According to former studies, we found the uniform correlation R = 0.7075 between observed EVLW and predicted postoperative EVLW estimated by prediction of residual functioning lung volume before operation. And also, the patients showing postoperative EVLW more than predicted EVLW before operation had a tendency to increase amount of sputum. Furthermore, concerning hemodynamic changes, pulmonary arterial resistance index (PARI) elevated to 196 +/- 165% (83-515%) in average associated with increased right ventricular stroke work index (RVSWI) as a result of compensatory changes for increased right cardiac afterload.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Importance of attitude evaluation in diabetes patient education.

Attitudes were evaluated according to the 'Personal Responsibility Attitude Assessment System' (PRAS), which allows grading of patients' attitudes into five levels of perception of responsibility toward their disease. In 59 diabetics evaluated in this study, no sex difference was observed in attitude level, but more of those aged less than 40 years showed lower attitude levels (levels 1-4) than those aged 40 years or over (P less than 0.01). Of those aged 40 or over, more patients with a high attitude level (level 5) had had diabetes for 10 years or longer than those with low attitude levels (levels 1-4) (P less than 0.05). Among those not treated with insulin, patients with a low attitude level showed higher hemoglobin A1 (HbA1) levels (P less than 0.01) and more frequently had retinopathy (P less than 0.05) than patients with high attitude levels. As for women, low attitude level patients consumed less fruit, meat or fish, and vegetables (P less than 0.05) but more fat and sweetening agents (P less than 0.05) than high attitude level patients. These results suggest an association between the attitude level of diabetic patients evaluated by PRAS and the degree of their self-care. Evaluation of patients' attitudes is important in predicting the response to educational intervention in diabetes.

Adult↗
PubMed1990

The role of the left ventricle in atrial natriuretic peptide secretion in acute mitral regurgitation.

To examine the role of the ventricle in ANP secretion, the atrial natriuretic peptide (ANP) concentration in the plasma, left atrial tissue and left ventricular tissue were observed in a canine during the course of experimental reversible mitral regurgitation (MR). For reversible MR, a basket catheter was inserted into the left atrium via the pulmonary vein and fixed at the mitral valve. The regurgitation arose when the tip basket wire was extended and disappeared immediately when it was closed. Left atrial pressure (LAP), right atrial pressure (RAP) and pulmonary artery pressure (PAP) increased significantly during MR, and decreased to the normal level after recovery from MR. Plasma ANP concentration showed a reversible change in correlation with LAP and RAP in each canine studied. The ANP level in the atrial and ventricular tissue decreased during MR, and the low levels were maintained after recovery from MR. Both the left arterial and left ventricular tissue ANP levels showed the same changes in acute MR. Therefore, it was suggested that normal ventricles might play a role in ANP secretion in acute MR.

Animals↗