Makiko Uji

Tenri Yorozu Hospital, Тэнри, Nara, Japan

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Publications (6)3.08 Total impact

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    ABSTRACT: Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) need many blood products due to deficiency of coagulation factors. Blood transfusion therapy in patients with excessive bleeding after CPB is generally empiric. We checked and studied the fibrinogen concentration and transfusion, as well as bleeding amount in the perioperative period. The study was approved by our institutional ethics committee. Thirty patients were studied. Blood samples were obtained at the induction of anesthesia (before CPB), at the end of CPB, at the end of operation, and on the next morning, or before the patient was given fresh frozen plasma in the intensive care unit. For all cases, fibrinogen concentration and platelet concentration were lowest at the end of CPB. Fibrinogen concentration rose up to before CPB level on the next morning. The group in which fibrinogen concentration was less than 150 mg x dl(-1) at the end of CPB consumed more blood products than the group with fibrinogen concentration of over 150 mg x dl(-1). Blood transfusion therapy based on fibrinogen concentration is needed to maintain adequacy of the perioperative blood transfusion and blood conservation in cardiac surgery.
    Masui. The Japanese journal of anesthesiology 08/2012; 61(8):814-9.
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    ABSTRACT: We examined the effect of landiolol hydrochloride, a selective beta1-adrenoreceptor antagonist, on the incidence of atrial fibrillation(AF). The incidence of AF after lung resection was evaluated retrospectively in patients with intraoperative treatment with landiolol hydrochloride or those without it. Landiolol hydrochloride (5 microg x kg(-1) x min(-1)) was administered intravenously from the beginning of anesthesia induction to the end of operation. In non-treatment group with landiolol hydrochloride (224 patients), the incidence of AF after surgery was 14.2%, peaking on postoperative day 2, and the average peak day was day 3.5. Older age, removal of the lymph nodes, lengthy surgery, and ischemic heart failure were risk factors. In treatment group with landiolol hydrochloride (77 patients), the incidence of AF after surgery was 5.2%, which was significantly lower than that in non-treatment group. Increased numbers of risk factors led to the high incidence of AF. But the administration of landiolol hydrochloride suppressed the incidence of AF. Landiolol hydrochloride is effective for the preventionof AF and it is safe without causing a severe decrease in blood pressure and bradycardia in high risk patients.
    Masui. The Japanese journal of anesthesiology 09/2008; 57(8):953-8.
  • Source
    Anesthesia and analgesia 04/2006; 102(3):976. · 3.08 Impact Factor
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    ABSTRACT: A 69-year-old male patient underwent subtotal esophagectomy for esophageal cancer under sevoflurane anesthesia combined with epidural analgesia. According to the protocol for the prevention of deep vein thrombosis (DVT) in our hospital, only an intermittent pneumatic compression device (IPC) and elastic stockings were perioperatively used for prophylaxis of DVT although D-dimer level was slightly increased to 1.2 microg x ml(-1). On the 2nd post-operative day, a venous ultrasound examination was performed, because D-dimer level was suddenly increased up to 41.5 microg x ml(-1) without any signs of thrombus in the atrium and pleural cavity. Since DVT was detected with the right lower limb, the use of an IPC was stopped and an inferior vena cava filter was inserted through the right jugular vein with a continuous administration of heparin. An aggressive search should be performed if DVT is suspected by any clinical signs including an increase in D-dimer level. We should also keep in mind the possibility of DVT even if an IPC and elastic stockings are perioperatively used.
    Masui. The Japanese journal of anesthesiology 08/2005; 54(7):805-8.
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    ABSTRACT: We evaluated retrospectively the effectiveness of low dose colforsin daropate hydrochloride (CDH) in 12 patients undergoing off-pump coronary artery bypass grafting (CABG). Low dose CDH was administered intravenously at a rate of 0.05-0.1 microg x kg(-1) x min(-1) from sternotomy to the end of coronary artery anastomosis. Hemodynamic measurements were made before infusion of CDH, and before, during, and after coronary artery anastomosis. Heart rate was significantly higher before, during and after the anastomosis compared with the value before the infusion of CDH. Heart rate was also significantly higher after the anastomosis compared with the value before the anastomosis. Systolic blood pressure, mean pulmonary pressure, right atrial pressure and pulmonary artery wedge pressure showed no significant changes after the start of infusion of CDH. Cardiac output was significantly higher before, during and after the anastomosis compared with the value before the infusion of CDH. Systemic vascular resistance was significantly lower before and during anastomosis compared with the value before the infusion of CDH. Infusion of low dose CDH prevents the elevations of mean pulmonary artery pressure, right atrial pressure and pulmonary artery wedge pressure without reducing systolic bood pressure during coronary artery anastomosis. Cardiac output was significantly increased, and SVR as well as PVR were significantly decreased after the infusion of CDH. In patients undergoing off-pump CABG, we recommend infusion of low dose colforsin daropate hydrochloride from sternotomy to the end of coronary artery anastomosis.
    Masui. The Japanese journal of anesthesiology 01/2005; 53(12):1386-90.
  • The Journal of Japan Society for Clinical Anesthesia. 01/2005; 25(5):543-548.