PubMed Health⌕ Search

Biomedical subjects

Y Odaka

Publications and source records attributed to Y Odaka.

17 recordsLinked to original sources
PubMed1992

[Interaction of nicardipine and inhalational anesthetics--comparison between enflurane and isoflurane].

The effects of nicardipine 1 mg bolus injection under enflurane anesthesia were compared with those under isoflurane anesthesia. Twelve neurosurgical patients were divided into 2 groups, enflurane group (n = 6) and isoflurane group (n = 6). In all patients anesthesia was induced with midazolam, thiamylal, fentanyl and vecuronium. Anesthesia was maintained with fentanyl, nitrous oxide, pancuronium plus enflurane (enflurane group) or plus isoflurane (isoflurane group). After incision of dura mater, nicardipine 1 mg was given through forearm venous line. For about 30 minutes before and after nicardipine injection, concentration of inhalational anesthetics was kept constant and no drugs were given. Blood pressure (BP), heart rate (HR), rate pressure product (RPP), and serum concentrations of catecholamine and nicardipine were monitored for 30 minutes after nicardipine injection. In isoflurane group, BP decreased more and longer, and increases of HR and serum concentration of catecholamine continued longer compared with enflurane group. Elimination half life of nicardipine was shorter, area under the curve (AUC) was smaller and clearance of nicardipine was larger in isoflurane group than in enflurane group. It was concluded that isoflurane increased the effects of nicardipine, which were BP depression and reflex sympathetic stimulation, than enflurane and that metabolism and elimination of nicardipine were accelerated more by isoflurane than by enflurane.

Anesthesia, Inhalation↗
PubMed1992

[Epidural midazolam with bupivacaine--optimal dose for postoperative pain relief].

Optimal dose of epidural midazolam with bupivacaine for postoperative pain relief was investigated. Forty seven patients for upper abdominal surgery were divided into 5 groups. Each group had either 0.25% bupivacaine 6 ml (control group), 0.25% bupivacaine 6 ml + midazolam 0.025 mg.kg-1 (0.025 group), 0.05 mg.kg-1 (0.05 group), 0.075 mg.kg-1 (0.075 group), or 0.1 mg.kg-1 (0.1 group) administered epidurally for complaint of first postoperative pain. Blood pressure (BP), heart rate (HR), respiratory rate (RR) and sedation score (SS) were monitored for 120 minutes, and the time interval for next analgesics (TNA) was checked. In each group, BP fell down 10 minutes after injection, HR was unchanged, and RR (except for 0.1 group) decreased, compared with the preinjection level. There was no difference between control group and others in BP, HR and RR. But 3 cases in 0.075 group and 4 cases in 0.1 group needed chin lift with a pillow under the shoulder for slight airway obstruction. The most optimal SS was obtained in 0.05 group. TNA was significantly longer in 0.025 and 0.05 groups than in the control group. It was concluded that the optimal dose of epidural midazolam with 0.25% bupivacaine 6 ml was 0.05 mg.kg-1 for postoperative pain relief after an upper abdominal surgery.

Abdomen↗
PubMed1992

[Epidural midazolam with saline--optimal dose for postoperative pain].

Optimal dose of epidural midazolam with saline for postoperative pain relief was investigated. Forty three patients for upper abdominal surgery were divided into 5 groups. Each group had either 10 ml saline only (saline group), 10 ml saline + midazolam 0.025 mg.kg-1 (0.025 group), 10 ml saline + midazolam 0.05 mg.kg-1 (0.05 group), 10 ml saline + midazolam 0.075 mg.kg-1 (0.075 group), or 10 ml saline + midazolam 0.1 mg.kg-1 (0.1 group) administered epidurally for complaint of postoperative pain. Blood pressure (BP), heart rate (HR), respiratory rate (RR) and sedation score (SS) were monitored for 120 minutes, and the time interval for next analgesics (TNA) was checked. In each group, BP was unchanged compared with preinjection level. HR changes were less in 0.05 and 0.1 group than in others. RR changes were less in 0.025 and 0.05 group than in others. Optimal SSs were obtained in 0.025 and 0.05 groups. In 0.075 and 0.1 groups, many patients fell into complete sleep (not responded to verbal command). TNA was about 2 hours in 0.025 and 0.05 groups, over 6 hours in 0.075 and 0.1 groups. Complete sleep was the cause of long TNA in 0.075 and 0.1 groups. It was concluded that optimal dose of epidural midazolam with saline 10 ml was 0.05 mg.kg-1 for postoperative pain relief after upper abdominal surgery.

Abdomen↗
PubMed1992

[Surgical stress stimulates release of polymorphonuclear leukocyte elastase from a segmented neutrophil].

The studies were performed to find out whether increased serum levels of polymorphonuclear leukocyte elastase (PMNE) depend on increase of segmented neutrophils or increase of PMNE release from a segmented neutrophil on 17 patients for various elective surgeries. Serum levels of PMNE, leukocyte count and leukogram were determined before incision (preoperation), as well as on the 1st, 3rd and 5th day after operation. Serum levels of PMNE, segmented cell count, stab cell count, stab cell-segmented cell ratio increased most on the 1st postoperative day and decreased thereafter. Leukocyte count showed no significant changes. Serum levels of PMNE correlated well with PMNE released from a segmented neutrophil, but not with leukocyte count or segmented cell count. It was concluded that increased serum levels of PMNE by surgical stress depend on the increased PMNE release from a segmented neutrophil but not on the increased segmented cell count.

Adult↗
PubMed1991

[Epidural administration of midazolam with saline or bupivacaine for postoperative pain].

Postoperative pain relief and sedation with epidural midazolam-saline or midazolam-bupivacaine were studied in 46 patients after elective upper abdominal surgery. They were divided into 6 groups. In each group, 10 ml saline, 10 ml saline+midazolam 0.05 mg.kg-1, 10 ml saline+midazolam 0.1 mg.kg-1 (saline group), 0.25% bupivacaine 6 ml, 0.25% bupivacaine 6 ml + midazolam 0.05 mg.kg-1 or 0.25% bupivacaine 6 ml + midazolam 0.1 mg.kg-1 (bupivacaine group) was administered via epidural catheter for complaint of pain. For 120 minutes after epidural injection, blood pressure (BP), heart rate (HR), respiratory rate (RR), sedation score, and serum concentration of midazolam (conc midazolam) were evaluated. The time interval until next complaint of pain (pain relief time) was measured. In midazolam injected group, BP, HR, RR were not changed from preinjection value, but sufficient sedation was obtained and pain relief time was significantly prolonged compared with saline or bupivacaine injected group. Midazolam level was lower than that of sedation level. There were no significant differences between saline group and bupivacaine group, but the pain relief effect was slightly stronger in bupivacaine group. It is concluded that epidural saline - midazolam or 0.25% bupivacaine - midazolam is useful for postoperative pain relief after upper abdominal surgery.

Abdomen↗
PubMed1991

[Epidural midazolam for treatment of postoperative pain].

Postoperative pain relief and sedation with epidural midazolam were studied. Twenty-one patients for elective upper abdominal surgery were divided into 3 groups. Epidural catheter was inserted into thoracic epidural space before induction of general anesthesia. In each group, either 10 ml saline only, midazolam 0.05 mg.kg-1 + 10 ml saline, or midazolam 0.1 mg.kg-1 + 10 ml saline was injected into epidural catheter for complaint of pain in recovery room. For 120 minutes after epidural injection, blood pressure, heart rate, respiratory rate, serum concentration of midazolam, and sedation score were monitored. In midazolam injected groups, only slight changes were seen in blood pressure, heart rate, and respiratory rate. Sedation score was graded from 1 to 6:1 means complete sleep, and not responded to verbal command, 6 means agitated and many complaints. Midazolam 0.1 mg.kg-1 + 10 ml saline group had the lowest score, and saline 10 ml group had the highest score. Prolonged sedation and pain relief were obtained in midazolam injected group, especially 0.1 mg.kg-1 + 10 ml saline group. Serum midazolam concentrations were lower than 200 ng.ml-1. These values were considered as the lower limit for sedation by intravenous administration. In conclusion, epidural midazolam was useful for postoperative pain relief. The mechanism is considered to involve spinally mediated CNS action or direct spinal action.

Adult↗
PubMed1990

[Does midazolam release histamine?].

Effects of induction with midazolam on serum histamine levels (Study 1) and the volume as well as pH of gastric juice (Study 2) were studied. Anesthesia was induced with midazolam 0.2 mg.kg-1 in midazolam group, thiamylal 4 mg.kg-1 in control group. In Study 1, serum histamine levels were measured with high performance liquid chromatography till 180 minutes after intubation. There were no statistical significance between the two groups in serum histamine levels at all points. But in midazolam group, at 30 minutes after intubation, the histamine level was significantly lower than the preinduction level. In control group, serum concentration of histamine increased but not significantly. In Study 2, gastric juice was sampled through naso-gastric tube inserted on the morning of operation. Gastric juice pH was measured with the use of pH Strip (E. Merck, F.R. Germany). There were no significant differences between the two groups in volume as well as pH of gastric juice at all points. It is concluded that midazolam used for induction of anesthesia might decrease histamine release, but it has no clinical effects on gastric juice secretion.

Adult↗
PubMed1990

[Does induction with midazolam decrease stress response during anesthesia?].

The effects of midazolam on stress response during surgery compared with thiamylal were studied. Twelve patients were divided into 2 groups at random; midazolam group and thiamylal group. Anesthesia was induced with midazolam 0.2 mg.kg-1 or thiamylal 4 mg.kg-1 in each group, and maintained with O2 2 l.min-1, N2O 4 l.min-1 and enflurane. The plasma concentration of catecholamine was measured at preinduction, 10, 30, 60, 120 and 180 minutes after intubation. No significant differences were seen between 2 groups in plasma concentration of catecholamine. In midazolam group, plasma concentration of epinephrine decreased significantly 10 minutes after intubation as compared with preinduction level. The plasma concentration of norepinephrine in midazolam group tended to decrease. In thiamylal group, plasma concentration of norepinephrine tended to increase and increased significantly at 120 and 180 minutes after intubation as compared with preinduction level. These results suggest that induction with midazolam suppresses stress response during anesthetic induction and surgery more intensely than induction with thiamylal.

Adult↗
PubMed1990

[Total intravenous anesthesia with continuous infusion of midazolam].

Continuous infusion of midazolam and fentanyl were used in total intravenous anesthesia. Anesthesia was induced with midazolam 0.3 mg.kg-1 in 100% O2. Tracheal intubation was facilitated with succinylcholine 1 mg.kg-1 after precurarization with pancuronium 1 mg. The infusion regimen of midazolam was as follows; an initial infusion of 0.68 mg.kg-1.hr-1 for 15 min followed by a maintenance infusion of 0.125 mg.kg-1.hr-1, and about 30 min before the end of operation infusion was stopped. Fentanyl and pancuronium were injected as required. During operation, blood pressure and heart rate were stable with a small dose of nicardipine. Total dose of fentanyl was the same as in NLA. Extubation was done as quickly as in NLA, after aminophylline infusion which was said to reverse midazolam. In the recovery room, patients were asleep and snored. But they opened eyes and responded to verbal command. Respiratory rate and PaCO2 were in normal ranges. Total intravenous anesthesia was possible with midazolam and fentanyl but a further study is necessary.

Adult↗
PubMed1990

[Total intravenous anesthesia with continuous infusion of midazolam--study on plasma levels of midazolam and catecholamines].

Total intravenous anesthesia was performed with continuous infusion of midazolam and bolus injection of fentanyl. A bolus injection of midazolam 0.3 mg.kg-1 was followed by an infusion regimen with an initial infusion rate of 0.68 mg.kg-1.hr-1 for 15 min followed by a maintenance infusion of 0.125 mg.kg-1.hr-1 and infusion was stopped at about 30 min before the end of operation. Fentanyl and pancuronium were injected as required. Nicardipine was given for intraoperative hypertension. Plasma concentrations of epinephrine and norepinephrine decreased significantly at 10 min after induction, but increased significantly during operation. Therefore, this anesthetic method was considered not to be so deep. Plasma concentrations of midazolam were higher than 200 ng.ml-1 during operation. After discontinuation of midazolam infusion, its concentration decreased quickly, and the elimination half life of midazolam was 1.675 +/- 0.2807 hr. The value was not so large as we had anticipated. Total intravenous anesthesia with continuous infusion of midazolam and bolus injection of fentanyl is thought to produce light anesthesia. Plasma concentration of midazolam decreased quickly.

Adult↗
PubMed1990

[Midazolam for rapid sequence induction].

We compared midazolam 0.2 mg.kg-1 and fentanyl 50 micrograms with thiamylal 4 mg.kg-1 for rapid sequence induction. We could use midazolam safely in patients with bronchial asthma or drug allergy. There was no difference in time from the beginning of induction to intubation between midazolam treated group and thiamylal treated group. Changes in systolic as well as diastolic blood pressure and heart rate during 2 hours from intubation were smaller in midazolam treated group than in thiamylal treated group. In midazolam treated group, no arrhythmias were observed at the time of intubation. We could reduce the amount of anesthetics in midazolam treated group during 2 hours from intubation. From the results mentioned above, we conclude that midazolam is a useful agent for rapid sequence induction.

Adult↗
PubMed1989

[Clinical effectiveness of arterial infusion chemotherapy in advanced and recurrent gastric cancer].

Arterial infusion therapy was applied to 77 patients with 18 unresectable, 29 non-curatively resected and 20 recurrent gastric cancers. 5-fluorouracil (5-FU) was administered by arterial continuous infusion, and adriamycin (ADM) and mitomycin C (MMC) by bolus infusion. The clinical effectiveness of each was evaluated. One-year cumulative survival rate of primary case by Kaplan-Meier method was 19.2%, and that of recurrent gastric cancer was 5.3%. Median survival time of primary case was 6.5 months, showing prolongation compared with recurrent ones. Also, in primary cases, the arterial infusion therapy was more effective in non-curatively resected cases than in unresectable ones. Two of the patients are now alive and another is apparently free of tumor and the remaining one had a recurrence. Continuous arterial 5-FU infusion and ADM low-dose intermittent bolus infusion chemotherapy (AF therapy) were considered an effective supportive treatment without any serious side effects for unresectable, noncuratively resected and recurrent gastric cancer.

Adult↗
PubMed1988

[Hyperfunctioning follicular carcinoma of the thyroid. A case report].

A 76-year-old female patient with a large neck lump of 15-year duration, was accompanied by palpitation and tremor. The lump was 9 x 5cm in size and the lower half of it was not palpable because the lower pole was located in the mediastinum. Physical examination revealed two enlarged lymph nodes in the right supraclavicular area. Chest X-ray film showed a coin lesion in the right lung that seemed to be a metastasis. The patient was apparently thyrotoxic with elevated serum concentrations of 15.7 micrograms/dl thyroxin and 359 ng/dl triiodothyronine. A neck scintigraphy using 123Iodine showed a thyroid hot nodule in accordance with this lesion. A total thyroidectomy with a modified neck dissection was carried out. This was followed by 131Iodine therapy. Specimen of the primary lesion weighed 147 g. Pathology of this tumor was follicular carcinoma of the thyroid. The patient was doing well 14 months after surgery. In the literature, three cases of similar hyperfunctioning thyroid carcinoma have been reported, all of which had a large primary lesion. The histological features proved to be of follicular or papillofollicular type. The treatment in these cases was administration of an antithyroid drug followed by surgical removal.

Adenocarcinoma↗
PubMed1975

Studies on the biochemical action of ginseng saponin. I. Purification from ginseng extract of the active component stimulating serum protein biosynthesis.

Systematic isolation and purification of the biologically active component of ginseng extract were followed by observing the incorporation of labeled leucine into serum protein at 6 hr after a single intraperitoneal injection in a mouse. Ginseng saponin mixture (fraction 5) exhibited high activity for such incorporation. Seven saponins were isolated from fraction 5 by means of preparative TLC, and assayed. Administration of all these saponins (ginsenoside-Rb2, Rc, Rc2, Rd, Re, and Rg1)except for ginsenoside-Rb1, caused an increase of leucine incorporation over that in control animals. The incorporation rate was directly proportional to the dose in the case of ginsenoside-Rd, which had the highest activity. The increase specific radio-activity of serum protein was not due to a decrease in the pool size of free amino acids in the liver. It was conclusively shown that the active component stimulating serum protein biosynthesis is saponin.

Animals↗