Biomedical subjects

Y Nishijima

Publications and source records attributed to Y Nishijima.

At least 37 records · Page 2Linked to original sources

PubMed1994

Toe skin temperature as a guide to epidural anaesthesia dosing.

To determine the time for additional epidural anaesthesia, skin temperature of the big toe was evaluated in 50 patients undergoing mastectomy. Epidural catheters were placed at or near the T5-6 intervertebral space and 12 ml, lidocaine 1.5% with 1:200,000 epinephrine were injected. When the skin temperature, which had increased following epidural anaesthesia, decreased by 0.3 degrees C without an increase of systolic arterial blood pressure (ABP) of more than 20%, 8 ml lidocaine 1.5% were injected. If the skin temperature increased, the monitor was judged to have been useful. When ABP increased > 20% without a decrease of skin temperature, the monitor was judged not to have been useful. Monitoring of toe skin temperature was useful in 39 patients (78%) in estimating the time for the first additional dose of epidural anaesthetic. First, second and third intervals between injection were 96.5 +/- 21.0 (n = 39), 69.7 +/- 14.2 (n = 35) and 50.1 +/- 12.2 min (n = 7), respectively. We conclude that, when epidural puncture is performed at upper thoracic levels, toe skin temperature can be a useful monitor to judge the time for additional anaesthetic.

Anesthesia, Epidural↗

PubMed1994

Endovascular treatment of acute thrombotic occlusion of the cervical internal carotid artery associated with embolic occlusion of the middle cerebral artery: case report.

A 68-year-old man with acute, total thrombotic occlusion of the right cervical internal carotid artery, associated with embolic occlusion of the ipsilateral middle cerebral artery, was treated by the endovascular approach, i.e., intra-arterial fibrinolysis and balloon angioplasty. Endovascular treatment for a totally occluded internal carotid artery is indicated in the very early stage where there is no thrombus or a short thrombus that can be evacuated. Fibrinolysis of the associated embolus in the middle cerebral artery, if any, can be done in the same session, enabling an early restoration of the blood flow.

Aged↗

PubMed1994

[Anatomical analysis of the basilar artery and its branches with special reference to the arterial anastomosis, and its course and distribution on the pontine ventral surface].

The morphology of the basilar artery and its branches was studied in 52 human brains with special reference to arterial anastomosis, and its course and distribution on the pontine ventral surface. The results were as follows: 1. Main trunk of the basilar artery (1) The average maximum and minimum external diameter was 3.93 +/- 0.76 mm and 3.14 +/- 0.58 mm, and the average length was 35.0 +/- 5.1 mm. (2) Fenestration was observed in one case (1.9%). (3) The shape of flexion was classified into three types: S-shaped (18 cases = 34.6%), inverted S-shaped (29 cases = 55.8%) and straight (5 cases = 9.6%). (4) The average angle of flexion was 32.5 +/- 24.5 degrees. A positive correlation was observed between age and the angle of flexion; the coefficient was 0.31. 2. Branches of the basilar artery (1) The average number of branches from the main trunk of the basilar artery was 22.8 +/- 3.94. The main trunk was divided into three equal portions: the rostral, intermediate and caudal. Of all the branches, 43.9% arose from the rostral portion, 33.3% from the intermediate portion and the remaining 22.8% from the caudal portion. (2) Forty-eight percent of all the branches had an external diameter ranging from 0.35 mm to 0.55 mm, and this size was predominant in the branches from each of the three portions. (3) Of all the branches, 45.4% had a diverging angle between 45 degrees and 90 degrees. This was the predominant range of diverging angle in the intermediate and rostral portions. In the caudal portion, however, the predominant diverging angle tended to range from 0 degrees to 45 degrees. 3. Arterial anastomosis, course and distribution on the pontine ventral surface (1) Ninety-nine anastomoses were found on the pontine ventral surface in 42 cases. Fifty-seven anastomoses (57.5%) were found between pontine branches and 21 (21.3%) between a pontine branch and an anterior inferior cerebellar artery. More anastomoses were found in the median area than in the lateral area. (2) A number of arterial distributions were observed along the basilar sulcus in the middle and lower parts, around the facial and vestibulocochlear radices and around the trigeminal radix. Many branches had a downward distribution along the basilar sulcus in the middle and lower parts, an outward distribution around the facial and vestibulocochlear radices, and a downward or outward distribution around the trigeminal radix.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗

PubMed1994

[Development of spinal bone metastasis by MBT-2 tumor in mice].

The biology of skeletal metastasis is poorly understood. In order to establish an animal model of spinal bone metastasis, we injected MBT-2 tumor cells into the tail vein of C3H/He mice while the inferior vena cava was occluded. By this technique, the tumor cells were transferred into the vertebral plexus. Spinal lesions developed in 12 of 15 (80%) experimental mice and in none of the control mice. All bone lesions resulted in local bone destruction. The predominant site of bone metastasis was lumbarvertebrae; other affected sites were thrpelvis and coccyges. This model should be of value in understanding the pathogenesis of spinal bone metastasis and in studying the effects of various agents on the prevention and control of spinal lesions.

Animals↗

PubMed1994

[Compression of medulla oblongata by the dissecting aneurysm of the vertebral artery 7 years after its rupture: case report].

A 56-year-old female, who suffered a subarachnoid hemorrhage (SAH) due to spontaneous dissection of the right vertebral artery 7 years previously, was admitted to our hospital with headache and vertigo. She hadn't had any attacks of SAH for 7 years. A magnetic resonance imaging (MRI) showed a high signal intensity mass and a low signal intensity due to calcification on the right ventrolateral surface of the medulla on both T1 and T2 weighted images. Vertebral angiography showed complete occlusion of the cervical segment of the right vertebral artery (VA). Left vertebral angiography didn't reveal any retrograde filling of the intracranial segment of the right VA through VA union. Thus, the spontaneous entrapment by dissection of the vertebral artery was demonstrated 7 years after SAH with MRI and serial angiography.

Aortic Dissection↗

PubMed1994

[Treatment of prostatic carcinoma with UFT and leucovorin--basic study using SRCA].

Combination effect of UFT and leucovorin against the rat prostatic carcinoma (R-3327) was evaluated by the subrenal capsular assay (SRCA) using nude mice. Anticancer effect of UFT was augmented by co-administration of both low and high dose leucovorin. These results suggest a clinical usefulness of UFT administration with leucovorin for the patients with hormonally refractory advanced prostatic carcinoma.

Animals↗

PubMed1993

Extravasation of contrast medium from the lenticulostriate artery following local intracarotid fibrinolysis.

Two patients with acute embolic occlusion of the intracranial internal carotid artery and the lenticulostriate arteries were treated by local intraarterial fibrinolysis using tissue plasminogen activator. Although fibrinolysis started within 2.5 hours from the ictus, extravasation of the contrast medium from the lenticulostriate arteries occurred in the region of the basal ganglia. Local intraarterial fibrinolysis for acute embolic occlusion of the internal carotid artery may be a high-risk therapeutic intervention even within the ultra-acute stage, especially when the lenticulostriate arteries are occluded by an embolus.

Aged↗

PubMed1993

Inhibition by a new bisphosphonate (YM175) of bone resorption induced by the MBT-2 tumour of mice.

A new bisphosphonate, disodium dihydrogen (cycloheptylamino) methylene bisphosphonate monohydrate (YM175), was compared with 3-amino-1-hydroxypropylidene-1, 1-bisphosphonate (AHPrBP) and 1-hydroxyethylidene-1,1-bisphosphonate (HEBP) in terms of its effect on tumour induced osteolysis using a bladder tumour in mice (MBT-2). The method consisted of inoculating tumour cells subcutaneously (SC) over the calvaria in mice, resulting in a local tumour causing fragmentation of the bone. The compounds were active not only when administered preventively before establishment of bone resorption, but also in an inhibitory fashion once the variables were already under the influence of the tumour. This osteolysis was evaluated by measuring the increased area of bone resorption in reduced opacity to radiograph and histology. The results showed the following sequence of potency: YM175 > AHPrBP = HEBP. This inhibition was obtained with no apparent effect on the growth of the MBT-2 tumour. YM175 appears to be an interesting new bisphosphonate with possible clinical application.

Animals↗

PubMed1993

Minimum effective combination dose of epidural morphine and fentanyl for posthysterectomy analgesia: a randomized, prospective, double-blind study.

Recent studies have produced conflicting results regarding whether the addition of epidural fentanyl improves postoperative analgesia from epidural morphine. Therefore, we prospectively determined the dose-response relationship and the minimum effective combination dose of epidural morphine and fentanyl (fentanyl given after morphine) for posthysterectomy analgesia. We studied 120 patients undergoing radical abdominal hysterectomy. All patients had epidural lidocaine 1.5% with epinephrine (1:200,000) for surgical anesthesia followed by light general anesthesia with endotracheal intubation. They were assigned randomly into six groups according to the combination of each narcotic dose: morphine 2 mg, morphine 2 mg/fentanyl 50 micrograms, morphine 2 mg/fentanyl 100 micrograms, morphine 4 mg, morphine 4 mg/fentanyl 50 micrograms, and morphine 4 mg/fentanyl 100 micrograms. Morphine and fentanyl were given epidurally in a double-blind manner approximately 60 and 15 min, respectively, before the completion of surgery. For 2 mg of morphine, the addition of 50 or 100 micrograms of fentanyl improved pain relief during the first 6 h postoperatively (P < 0.05), provided longer duration of analgesia (P < 0.05), and required less analgesic supplement (P < 0.05), but did not alter the incidence of side effects. For 4 mg of morphine, the same conclusion was drawn, except that vomiting occurred more frequently with addition of 100 micrograms of fentanyl (P < 0.05). Among fentanyl groups, there was no significant difference in pain scores, duration of analgesia, and analgesic requirements. Therefore, we conclude that epidural fentanyl given after morphine improves early postoperative analgesia from epidural morphine, and the minimum effective combination dose is morphine 2 mg/fentanyl 50 micrograms for posthysterectomy surgery analgesia.

Adolescent↗

PubMed1993

[Phenotypic difference of lymphocytes circulating in tumorous renal artery and renal vein in patients with renal cell carcinoma].

Phenotypic difference of lymphocytes circulating in tumorous renal artery and renal vein in patients with renal cell carcinoma was studied. Fifteen patients with no prior treatment were studied, from whom blood samples were taken at the time of radical nephrectomy. Mononuclear cells separated from tumorous renal arterial and venous blood were analyzed for cell surface markers. CD3, CD4, CD8, CD11b, CD16, CD25, CD57, Leu8 HLA-DR were compared. CD25 positive cells were significantly increased in venous blood than in arterial blood in the kidneys with tumor. No significant difference was found regarding the other surface markers.

Carcinoma, Renal Cell↗

PubMed1993

[Hemorrhagic vascular lesions in facial injuries treated by intravascular embolization: report of two cases].

We have encountered 2 cases of hemorrhagic vascular lesion in the external carotid artery system caused by facial injury. In case 1, treatment of epistaxis by nasal packing was unsuccessful. Good result was obtained by intravascular embolization in the internal maxillary artery using polyvinyl alcohol particles and gelatin sponge pieces. In case 2, massive subgaleal hemorrhage due to tearing of the middle meningeal artery caused by a skull base fracture appeared following surgery for open skull fracture. Hemostasis was performed successfully by intravascular embolization in the middle meningeal artery using microcoils and gelatin sponge pieces. In cases of facial injuries with hemorrhagic lesions in the external carotid artery system, hemostasis is generally difficult. Referring to these two cases, we think that the treatment of choice is angiography followed by intravascular embolization.

Adult↗

PubMed1993

[Subrenal capsule assay of nude mice for testing the effectiveness of UFT for rat prostatic carcinoma (R3327)].

Combination effect of UFT and CDDP against the rat prostatic carcinoma (R3327) was evaluated by the subrenal capsule assay in nude mice. The tumor growth of R3327 was inhibited in proportion to the UFT concentration. Anticancer effect of UFT was elevated by co-administration of CDDP. These data suggest a clinical usefulness of UFT administration with CDDP for hormonally refractory advanced prostatic carcinoma.

Animals↗

PubMed1993

[A newly devised endotracheal tube for patients with narrowed trachea].

A 27 year old female patient with pulmonary adenoid cystic cancer was planned for emergency tracheotomy for hemoptysis and severe dyspnea. Six month previously she had a silicon tube (5.5 mm-ID, 40 mm in length) placed in her trachea, because of severe tracheal stenosis. Airway management by endotracheal intubation was deemed necessary during the tracheotomy. However, because of her tracheal narrowing, it was not possible to insert a usual endotracheal tube for adult. First, we made a 4.0 mm-ID endotracheal tube without cuff 12 cm in length (TUBE 1), and a 5.5 mm-ID tube 18 cm in length (TUBE 2). We inserted the TUBE 1 into the TUBE 2, and glued them with Aron-Alpha, making it 25 cm long. We could perform tracheotomy by intubating and wedging this tube into silicon tube.

Adult↗

PubMed1993

[The usefulness of a pulse oximeter on the postanesthesia round].

In our hospital, a patient must be transported to one of several types of wards according to the degree of severity of illness (PPC-system). Severely ill patients are surveyed in ICU and HCU with various kinds of monitors. On the contrary, for the patients outside the ICU and HCU wards, the number of monitors is not enough even during postoperative periods. Therefore, we studied the occurrence of hypoxic state of patients with a portable pulse oximeter on postanesthesia round. We surveyed 843 patients during 4 months, and found 79 hypoxemic patients. The number of hypoxemic patients was greater not only after longer operations and anesthesia, but also in obese patients (P < 0.05) as reported previously. Interestingly, we also found more hypoxemic patients in common wards than in ICU and HCU wards. In conclusion, a portable pulse oximeter is a useful equipment in ordinary wards during postanesthesia round.

Adult↗

PubMed1992

Clinical significance of the vertebral vein in prostate cancer metastasis.

A total of 75 prostate cancer and 67 lung cancer patients with positive bone scintigrams were studied. The patterns of spread in the axial skeleton and pelvis were different between the groups. The differences in the distribution of bony metastases between prostate and lung are explained by the role of Batson's vertebral venous plexus. We developed an animal model of spinal bone metastasis to prove this route. As suspension of tumor cells was injected into the tail vein of mice with vena caval occlusion. This procedure reproducibly resulted in metastatic tumor growth in the lumbar region of the vertebral column. The prevalence of spinal bone metastasis is attributed to passage of tumor cells via the vertebral venous plexus.

Adenocarcinoma↗

PubMed1992

2-Guanidinoethanol increased dopamine release and 3,4-dihydroxyphenylacetic acid content, but not homovanillic acid content in the rat brain: electroneurochemical and enzymological studies.

The effects of 2-guanidinoethanol (GEt) on the release of monoamines and on the activity of their degrading enzymes were studied in order to investigate why 3,4-dihydroxyphenylacetic acid (DO-PAC) increased to a much greater extent than homovanillic acid (HVA) after GEt injection into rat brain. In differential pulse voltammograms recorded using an electrochemically treated carbon fiber electrode, two distinct oxidation peaks, one at 130mV (DOPAC peak) and the other at 300 mV (5-hydroxyindoleacetic acid (5-HIAA) peak), were observed. In the hippocampus, the DOPAC peak increased markedly compared to the peak height recorded prior to the intracerebroventricular injection of GEt (6 mumol). Although the DOPAC peak height increased to 350% 4 hours after GEt injection, the 5-HIAA peak showed no change. In the striatum, the DOPAC peak increased to 150% 3 hours after GEt injection. Serial changes in the extracellular levels of DOPAC, HVA, and 5-HIAA were monitored in the striatum after GEt injection, using an in vivo brain micro-dialysis technique. Although the DOPAC levels strated to increase 80 minutes after GEt injection, HVA and 5-HIAA levels showed no change. On the other hand, monoamineoxidase, which metabolizes dopamine to DOPAC, was not activated and catechol-O-methyltransferase, which metabolizes DOPAC to HVA, were not inhibited by 5 mM of GEt in vitro. These data suggested that GEt increased the release of dopamine, but not of serotonin, and that GEt might restrict the DOPAC transport system.

3,4-Dihydroxyphenylacetic Acid↗

PubMed1992

Peripheral acting muscle relaxants alter the effects of baclofen on the electrocorticograms in the rat.

The effects of intraperitoneally administered baclofen on behavior and electrocorticograms (ECoG) were studied in freely moving and paralyzed rats. In the freely moving rats, 10 mg/kg of baclofen suppressed ECoGs with behavioral sedation, and 20 mg/kg caused whole body twitching accompanied with spike discharges in low voltage slow waves background. In the freely moving rats, baclofen acted as depressant in low dose and convulsant in high dose. In the paralyzed rat, 10 mg/kg of baclofen first suppressed ECoGs. Though fast waves components recovered with slow waves background in the ECoGs of rats paralyzed with gallamine (50 mg/kg) 3 hours after the baclofen injection, fast waves activities were not observed in the ECoG of rats paralyzed with succinylcholine (50 mg/kg), d-tubocurarine (3 mg/kg) or pancuronium (1 mg/kg). Under paralysis with d-tubocurarine, baclofen suppressed ECoG first, and then spike discharges started 90 min after the injection. These results suggest that the effects of baclofen on ECoG were different depending on the muscle relaxant used.

Animals↗

PubMed1992

Intraoperative monitoring for thoracolumbar or lumbar surgery with somatosensory evoked potentials after double stimuli.

Somatosensory evoked potentials were after double stimuli on the posterior tibial nerve for the intraoperative monitoring in 58 thoracolumbar or lumbar surgeries. The first cortical positive potential P38 and P'38 after the second stimulus was recorded after double stimuli. Transient decreased amplitude more than 50% or missing potential of P'38 was found in 11 cases. These P'38 changes occurred in five procedures of retracting the nerve roots or dural sacs, three cases of reducing of thoracolumbar fractures, and two procedures of transpedicular screwing. No causative procedure was found in one case. In those 11 cases, 5 showed no abnormality in P38 potentials and 6 cases showed less decreased amplitude in P38 than in P'38. Consequently, P'38, which was evoked by the second stimulus, can be used for the intraoperative monitoring in the thoracolumbar and lower lumbar surgery.

Adolescent↗