Biomedical subjects

Y Shimodate

Publications and source records attributed to Y Shimodate.

12 recordsLinked to original sources

PubMed1996

[Intravenous infusion of prostagrandin E1 during and after gastrectomy on postoperative hepato-renal functions in senile patients].

Effect of intravenous prostagrandin E1 (PGE1) during and after surgery on postoperative hepatorenal functions in senile patients was evaluated in 36 elective surgical patients ranged in age from 60 to 85 years. The patients with carcinoma of the stomach underwent total or subtotal gastrectomy under isoflurane anesthesia. These patients were devided into two groups. Eighteen patients received intravenous PGE1 at a rate of 0.03-0.13 micrograms.kg-1.min-1 during surgery and 0.03 microgram.kg.min-1 after surgery until 9:00 am on the first operative day. The remaining 18 patients did not receive PGE1 and served as the control group. Serum GOT and GPT levels in both groups increased significantly at emergence from anesthesia compared with the preanesthetic levels and then declined to the preanesthetic levels on the 3rd postoperative day. Thereafter they increased significantly again on the 7th postoperative day. Serum GOT levels in the PGE1 administered group were significantly lower than those in the control group at the emergence from anesthesia. Serum GPT levels in the PGE1 group tended to be lower than those in the control group on awakening from anesthesia and on the first postoperative day. Serum gamma-GTP levels were stable postoperatively but they increased significantly on the 7th postoperative day in both groups. Serum bilirubin levels were within normal limits in both groups. Postoperative serum levels of urea nitrogen and creatinine were at the preanesthetic levels in both groups. Our findings suggest that continuous intravenous administration of PGE1 during and after surgery is beneficial in attenuating hepatic injury in senile patients for gastrectomy. However, protective effect of PGE1 on postoperative renal function was found to be vague in this study.

Aged↗

PubMed1995

Comparison of glucose and sucrose as an indicator for dilution volumetry in haemorrhagic shock.

A new technique for dilution volumetry using glucose as an indicator is proposed. The initial distribution volume of glucose (Vdgluc) was calculated in 11 adult mongrel dogs using a one-compartment model, and Vdgluc was then compared with the initial distribution volume of sucrose (Vdsucr), which is less metabolized. Insulin concentrations in the plasma were measured to calculate the insulinogenic index. The Vdgluc and the Vdsucr at baseline and after induced haemorrhagic shock (30 mL kg-1) were calculated. There was a significant correlation (r = 0.84, n = 22, P < 0.001) between Vdgluc and Vdsucr, but not between Vdgluc and the insulinogenic index. The limits of agreement ( +/- 2SD) between the two methods were +0.32 to -0.08L. Vdgluc indicates the volume of the central compartment, but cannot replace Vdsucr for clinical purposes. Glucose can be used repeatedly as an indicator for easy and safe dilution volumetry in vivo.

Animals↗

PubMed1994

The initial distribution volume of glucose and cardiac output after haemorrhage in dogs.

The purpose of the study was to evaluate the role of insulin in glucose kinetics after glucose administration using an insulinogenic index to indicate the magnitude of insulin response. The initial distribution volume of glucose (IDV-G) was calculated with a one-compartment model from repeated measurements of plasma glucose concentration three to seven minutes after administration of 100 mg.kg-1 glucose. The IDV-G was compared with the insulin response and the thermodilution assessments of cardiac output, measured simultaneously both before and after induced haemorrhage (30 ml.kg-1 over 30 min) in 12 adult mongrel dogs. The plasma insulin concentration was measured during the procedure and insulinogenic indices were calculated. There was no correlation between the IDV-G and insulinogenic indices, but there was a correlation between the IDV-G and thermodilution cardiac output before and after induced haemorrhage (r = 0.85, n = 24, P < 0.001). We conclude that the initial distribution volume of glucose is an indication of cardiac output in normo- and hypovolaemic dogs. Modification of glucose kinetics by the insulin response to glycaemic stimuli was negligible in that short period of time.

Animals↗

PubMed1993

The initial distribution volume of glucose and cardiac output in the critically ill.

Blood or plasma glucose concentration can be measured accurately and rapidly. However, after a glucose challenge metabolism may modify glucose kinetics, so that glucose has not been used as an indicator for dilution volumetry. To test the hypothesis that the initial distribution volume of glucose (IDVG) reflects cardiac output rather than glucose metabolism in the critically ill, the relationship between IDVG and thermodilution cardiac output was evaluated at 27 points in 13 non-surgical, critically ill patients without congestive heart failure. The IDVG was calculated from incremental plasma glucose concentrations using a one compartment model. Correlations were obtained between the IDVG and cardiac output (r = 0.89, n = 27, P < 0.001), and between the incremental plasma glucose concentrations three minutes after the injection and the IDVG (r = 0.94, n = 27, P < 0.001). No difference was found between the IDVG with or without continuous insulin infusions. The results indicate that the IDVG reflects cardiac output rather than glucose metabolism in patients without congestive heart failure.

Adult↗

PubMed1992

[Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine. 14. Effect on epidural pressure].

We studied effect of total intravenous anesthesia using ketamine, fentanyl and droperidol (DFK) on epidural pressure as an index for cerebrospinal fluid pressure in six surgical patients who underwent gastrectomy. The epidural catheter was inserted on the previous day. The epidural puncture was made at Th7-12 and the tip of the catheter was located 5 cm cephalad. The epidural pressure was measured before, just after and 30 minutes after the induction. The induction dose of fentanyl was 5 micrograms.kg-1 and that of ketamine was 1 mg.kg-1. The epidural pressure at the induction decreased in significantly by 19% as compared with that before the induction. The result suggested that DFK would not increase cerebrospinal fluid pressure when the doses of ketamine and fentanyl were changed.

Adult↗

PubMed1991

[Cerebral infarction during operation on the neck of the femur under epidural anesthesia: a report of two cases].

Cerebral infarction occurred during operation in two cases. An 83-year-old senile demented female underwent osteosynthesis with Ender pins under epidural anesthesia. Soon after Ender pins were inserted, her systolic blood pressure fell from 180 mmHg to 140 mmHg. The patient complained of chest pain and developed disturbed consciousness and right hemiparesis. On the second postoperative day, CT scanning showed the infarction of a left middle cerebral artery region. A 93-year-old female was another patient. She underwent a cup arthroplasty of the right hip bone fracture. Soon after bone cement was applied, she developed a mental confusion and her blood pressure increased from 120/60 mmHg to 160/80 mmHg. CT scanning on the first postoperative day showed the infarction of a left middle cerebral artery region. Sudden changes in systolic blood pressure and changes of mental status are possible signs of cerebral infarction not to be neglected. If elderly patients with any episodes of cerebral function troubles would undergo operation of the hip fracture, it is necessary to pay a particular attention to possible cerebral infarction.

Aged↗

PubMed1991

[Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--8. Hepatic and renal functions following prolonged surgical operation of over 10 hours].

Forty-four patients were studied to evaluate their postoperative hepatic and renal functions on 2nd to 4th and 7th to 10th postoperative days as judged by serum GOT, GPT, BUN and creatinine levels. The patients were divided into two groups. Twenty two patients received total intravenous anesthesia with droperidol, fentanyl and ketamine (FK group). The remaining 22 patients were given conventional enflurane-nitrous oxide anesthesia. The two groups were comparable concerning age, body weight, sex distribution, performed operation, operation time and anesthesia time. In the total intravenous group, fluid given and urine output were significantly larger than those of the enflurane group, and the amounts of blood loss and blood given tended to be greater but insignificantly in the total intravenous group than in the enflurane group. In both groups, postoperative S-GOT levels increased significantly and those of the enflurane group were significantly higher than those of the FK group on 2nd to 4th postoperative days. In the enflurane group, postoperative S-GPT levels were significantly higher, but those of the FK group were not. S-GPT on 2nd to 4th postoperative days of the enflurane group were significantly higher than those of the FK group. As to serum BUN and creatinine, no significant differences were observed between the two groups. These data suggest that FK is much more beneficial than enflurane anesthesia to protect hepatic functions, particularly when it is applied for prolonged surgical procedures.

Anesthesia, Intravenous↗

PubMed1990

[Treatment of priapism with intracavernous injection of etilefrine hydrochloride].

A case of priapism following epidural anesthesia was reported. A 67 year old man received epidural anesthesia for the transurethral resection of a malignant bladder tumor. Epidural anesthesia which he had wanted to receive was given through the L3 to L4 intervertebral space with 18 ml of 2% lidocaine. The penile erection occurred while he was prepared and draped. Additional 8 ml of 1% lidocaine failed to overcome it and the operation cancelled. After this episode, he had anesthesia on 5 occasions in 2 years. General anesthesia was given 3 times without penile erection, but epidural block was tried on 2 occasions, which was followed by penile erection. For the penile erection, intracavernous injection of etilefrine hydrochloride was effective and surgical procedure could be done smoothly. The mechanism of priapism remained unclear but imbalance of the autonomic nervous system may be a involved. This case suggests that intracavernous injection of etilefrine hydrochloride is effective for treatment of penile erection during transurethral surgery.

Aged↗

PubMed1990

[Marked changes in the core temperature during anaphylactic shock].

Three cases of anaphylactic shock were reported in which the core temperature was measured continuously. Two core temperature thermister probes were fixed on the forehead and the sole. Temperature dissociation between the core and the periphery disappeared in a few minutes after the administration of the causative agents. The clinical signs of the anaphylactic shock such as erythema, wheal and marked hypotension also developed in a few minutes after the disappearance of temperature dissociation. Thus treatment of anaphylactic shock could be started even before the patients develop severe hypotension. This clinical study suggests that a sudden disappearance of the temperature dissociation is a incipient sign of anaphylactic shock and to monitor the core as well as the peripheral temperature is a useful method for early diagnosis and treatment of anaphylactic shock.

Aged↗

PubMed1990

[Sevoflurane anesthesia for a patient with cerebral palsy].

We report anesthetic management of a 20-year-old male patient with cerebral palsy who underwent an operation for retinal detachment of the left eye. Induction and maintenance of anesthesia were smoothly done with inhalation of 1-5% sevoflurane with nitrous oxide and oxygen. Emergence of anesthesia was also smooth except for slight and transient excitement. Anesthetic management of a patient with cerebral palsy was also discussed.

Adult↗

PubMed1990

[Respiratory gas exchange during total body hyperthermia in man].

Respiratory gas exchange was evaluated using indirect calorimetry during total body hyperthermia (TBH) in 7 postoperative patients with disseminated gastric cancer to the peritoneal cavity. TBH was induced using veno-venous bypass and extracorporeal circuit incorporating a heat exchanger to keep pulmonary arterial temperature 42 degrees C. The high temperature was maintained for 3 hours under general anesthesia with droperidol (0.15 mg.kg-1), morphine (1 mg.kg-1) and enflurane (less than 0.5%). Oxygen consumption (VO2) was also calculated using the Fick equation and thermodilution cardiac output. Hyperthermia for three hours increased both VO2 and carbon dioxide output (VCO2) values to 1.5 times as compared to the control values before heating, respectively. VO2 values measured by indirect calorimetry correlated well with the values calculated from the Fick equation when respiratory and cardiovascular system were relatively stable during the procedure. Gradual but statistically insignificant increase in respiratory quotient was observed after recooling started. These results suggest that indirect calorimetry was valuable to measure respiratory gas exchange continuously during hyperthermic state as well as normothermic state. However, RQ value observed in the present study may be modified by several factors including lactate accumulation in the blood, and may not reflect substrate utilization during the hyperthermic state.

Adult↗

PubMed1990

[Sevoflurane anesthesia for a patient with arthrogryposis multiplex congenita].

We reported an anesthetic experience of a 6-year-old male patient with arthrogryposis multiplex congenita who underwent tonsillectomy and adenoidectomy. The induction and maintenance of anesthesia were smoothly performed with inhalation of 1-5% sevoflurane in nitrous oxide and oxygen. Emergence from anesthesia was also smooth. Halothane and succinylcholine chloride were not used to avoid possible hyperthermia. Anesthetic management of patients with arthrogryposis multiplex congenita was discussed citing literature references.

Adenoidectomy↗