Masayuki Kuroiwa

Kitasato University, Edo, Tōkyō, Japan

Are you Masayuki Kuroiwa?

Claim your profile

Publications (23)28.57 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: We described a case of 19-year-old female who developed re-expansion pulmonary edema (RPE) after removal of a huge ovarian tumor. Altered lung volume after the surgery was observed by chest X-ray. Preoperatively, the lung was highly compressed by the tumor. Patient was intubated under general anesthesia and was ventilated by pressure controlled mode with only 5 cmH2O of positive end-expiratory pressure (PEEP). P/F ratio was changed from 163 to 444 after removal of the tumor. At the end of the surgery, P/F ratio decreased to 263 with yellow frothy sputum in the endotracheal tube and we diagnosed re-expansion pulmonary edema based on appearing yellow frothy sputum and chest X-ray. No recruitment procedure was carried out through the course except positive pressure ventilation with 5 cmH2O of PEEP in the intensive care unit after surgery. Twelve hours after the surgery, we could not confirm the recovery of lung volume on chest X-ray; however the patient was extubated because of P/F ratio increasing to 507. After 8 days of the surgery, the chest X-ray showed recovery of the lung volume to almost normal size. In this case, the compressed lung needed almost 1 week to recover the lung volume. This change in chest X-ray might indicate inadequate recovery of lung volume by recruitment maneuver and this should be avoided in order not to allow development of unfavorable clinical course of RPE.
    Masui. The Japanese journal of anesthesiology 04/2014; 63(4):435-8.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Venous thromboembolism (VTE) is a well-recognized life-threatening complication in the intensive care unit (ICU). However, no data have been reported regarding the prevalence and methods of prevention of VTE in Japanese ICUs. This study aimed to document the current practice of VTE prevention across a broad sample of medical-surgical ICU patients in Japan. In November 2010, we performed a point-prevalence survey of Japanese ICUs in training facilities for intensive care specialists. We recorded data from five consecutive ICU patients in each facility at any time on the day of the survey. A total of 470 patients were registered in this study. VTE prophylaxis was received by 85.3 % of participants. Of these, 69.8 % received mechanical prophylaxis and 12.5 % received pharmacological methods, with 17.7 % receiving both methods. Analyzing a comparison of the presence or absence of a hospital prevention protocol, the protocol group had higher rates of receiving prophylaxis (88.8 % vs. 80.0 %, P < 0.01) than the no-protocol group. In conclusion, VTE prophylaxis by mechanical methods was the main method in a high number of medical-surgical ICU patients in Japan. The ICUs with a hospital VTE prevention protocol in place performed significantly higher rates of prophylaxis than those without a protocol.
    Journal of Anesthesia 05/2013; · 0.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUD: This study was designed to investigate the annual incidence and characteristics of perioperative pulmonary thromboembolism (PTE) in Japan from 2009 through 2011, and to compare the current trend with that observed in our previous studies conducted since 2002. In the 3-year study period, a questionnaire was annually mailed to all institutions certified as training hospitals for anesthesiologists by the Japanese Society of Anesthesiologists (JSA). The survey included the parameters of age, sex, type of surgery, and the risk factors in patients who were operated upon. The questionnaire was sent out to total of 3,556 institutions and obtained answers from 2,511 institutions (70.6%) in the 3-year study period. Total 4,432,538 surgeries were conducted and 1,300 cases (0.03%) of perioperative PTE were registered. The incidence of PTE in all the 3 years was significantly lower than that observed in 2002-2003 (P<0.01). In addition, the mortality in 2011 was also significantly lower than that in 2002-2003 (P<0.05). The incidence of PTE in females (0.04%) was twice of the incidence of males (0.02%). The types of surgery with higher incidence of perioperative PTE were "thoracotomy with laparotomy" (0.08%),"hip joint, limbs" (0.07%) and"craniotomy" (0.06%). Compared with the middle age group (19-65 year-old), the incidence of PTE was twice in the elderly's (66-85 year-old) and in the super-elderly (over 86 year-old) it was thrice. In this survey, most approved risk factors were obesity (44%), malignancy (35%) and long term bed-rest (26%), and the ratio of long term bed-rest was decreasing compared with 2008. In the PTE cases, the ratio of the patients who received anticoagulant drugs (29-30%) or IVC filters placement (4-5%) increased compared with the results of JSA-PTE research in 2008 (P<0.01). The incidence and mortality of perioperative PTE decreased;although the factor of decrease in an incidence was considered to be the result of preventive method, as in the decrease in the mortality, the survey should be continued.
    Masui. The Japanese journal of anesthesiology 05/2013; 62(5):629-38.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In mouse hippocampal CA1 pyramidal neurons, the activity of synaptic small-conductance Ca(2+)-activated K(+) channels type 2 (SK2 channels) provides a negative feedback on N-methyl-D-aspartate receptors (NMDARs), reestablishing Mg(2+) block that reduces Ca(2+) influx. The well-established role of NMDARs in ischemia-induced excitotoxicity led us to test the neuroprotective effect of modulating SK2 channel activity following cerebral ischemia induced by cardiac arrest and cardiopulmonary resuscitation (CA/CPR). Administration of the SK channel positive modulator, 1-ethyl-benzimidazolinone (1-EBIO), significantly reduced CA1 neuron cell death and improved CA/CPR-induced cognitive outcome. Electrophysiological recordings showed that CA/CPR-induced ischemia caused delayed and sustained reduction of synaptic SK channel activity, and immunoelectron microscopy showed that this is associated with internalization of synaptic SK2 channels, which was prevented by 1-EBIO treatment. These results suggest that increasing SK2 channel activity, or preventing ischemia-induced loss of synaptic SK2 channels, are promising and novel approaches to neuroprotection following cerebral ischemia.
    Journal of cerebral blood flow and metabolism: official journal of the International Society of Cerebral Blood Flow and Metabolism 06/2011; 31(12):2302-12. · 5.46 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Allopregnanolone (ALLO) is a neurosteroid that has many functions in the brain, most notably neuroprotection and modulation of gamma-amino butyric acid (GABA) neurotransmission. Using a mouse model of cardiac arrest and cardiopulmonary resuscitation, we have previously demonstrated that ALLO protects cerebellar Purkinje cells (PCs) from ischemia in a GABA(A) receptor-dependent manner. In this study we examined the effect of sex on ALLO neuroprotection, observing that low dose ALLO (2 mg/kg) provided greater neuroprotection in females compared to males. At a higher dose of ALLO (8 mg/kg), both sexes were significantly protected from ischemic damage. Using an acute cerebellar slice preparation, whole cell voltage clamp recordings were made from PCs. Spontaneous inhibitory post synaptic currents (IPSCs) were analyzed and the response to physiological ALLO (10 nM) was significantly greater in female PCs compared to male. In contrast, recordings of miniature IPSCs, did not exhibit a sex difference in response to ALLO, suggesting that ALLO affects males and females differentially through a mechanism other than binding postsynaptic GABA(A) receptors. We conclude that the female brain has greater sensitivity to ALLO mediated potentiation of GABAergic neurotransmission, contributing to increased neuroprotection.
    Neuropharmacology 05/2011; 61(4):724-9. · 4.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Japanese Society of Anesthesiologists (JSA) has maintained records of the annual incidence and characteristics of perioperative pulmonary thromboembolism (perioperative PTE) since 2002. The aim of this paper was to provide recent results of the JSA annual study conducted in 2008, and to determine the current factors that tend to prevent perioperative venous thromboembolism (VTE) in Japan. A comprehensive questionnaire designed by the JSA PTE working group was mailed to all institutions certified as teaching hospitals by JSA. The data tics of patients with perioperative PTE, such as types of diseases and surgeries, age, sex, methods used for the prevention of VTE (in some cases), and prognosis of perioperative PTE. The rate of effective responses was 56.1% (634/1116), and 1,177,626 surgeries were registered during the study period. There were 324 patients who were reported to have had PTE, and the incidence was 2.75 per 10,000 surgeries. The incidence of perioperative PTE in 2008 did not change significantly from that in 2005-07. The surgeries that most commonly resulted in perioperative PTE were limb and/or hip joint surgery (5.71 per 10,000 surgeries), craniotomy (4.64 per 10,000), and thoracotomy with laparotomy (3.46 per 10,000 surgeries). The mortality rate of perioperative PTE in 2008 was found to have significantly decreased from that in 2005-07 (15.6% vs. 22.4%; P = 0.01). Further, the rate of patients who received anticoagulant drugs in 2008 was significantly higher than that in 2005-07 (17.6% vs. 10.8%; P = 0.0018). Individual guidelines for the prevention of perioperative VTE were adopted in 55.4% of the training institutions. The increase in the percentage of patients who received anticoagulant drugs around the time of the operation, and the decreased mortality of patients with perioperative PTE suggested that the prophylaxis for perioperative VTE with anticoagulant drugs reduces perioperative mortality.
    Masui. The Japanese journal of anesthesiology 05/2010; 59(5):667-73.
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study aimed to investigate the annual incidence and characteristics of perioperative pulmonary thromboembolism (PTE) in Japan from 2005 through 2007, and to compare the current trend with that observed in our previous studies conducted since 2002. In the 3-year study period, a questionnaire was annually mailed to every institution certified as a training hospital for anesthesiologists by the Japanese Society of Anesthesiologists (JSA). The survey included the parameters of age, sex, type of surgery, and the risk factors in patients who were operated upon. The average rate of effective responses was 55.1%, and a total of 825 cases of perioperative PTE were registered in the 3-year study period. The incidence of perioperative PTE was 2.79 per 10,000 cases in 2005, 2.25 per 10,000 cases in 2006, and 2.57 per 10,000 cases in 2007. The incidence of PTE in all the 3 years was significantly lower than that observed in 2002-03 (P < 0.01). In addition, the incidence of fetal PTE in 2006 and 2007 was also significantly lower than that in 2002-03. The incidence of PTE in older persons (66-85 years) was approximately twice (4.70 per 10,000 cases) and that in the oldest persons (> 86 years) was approximately thrice (6.28 per 10,000 cases) the incidence in middle-aged individuals (2.17 per 10,000 cases). PTE was found to be more frequent in females than in males (males, 1.89 per 10,000 cases; females, 3.75 per 10,000 cases). The types of surgery that most commonly resulted in perioperative PTE were limb and/or hip joint surgery (5.57 per 10,000 cases), thoracotomy with laparotomy (5.19 per 10,000 cases), and spinal surgery (4.49 per 10,000 cases). Perioperative PTE was fatal in 185 patients (22.4%), and the mortality rate of patients who had not received prophylaxis was significantly higher (37.8%) than that of patients who received anticoagulant drugs (20.8%). Guidelines for prevention of perioperative PTE were accepted by 58% of all training institutions. The incidence of perioperative PTE and fetal PTE has currently decreased; however, prophylaxis with anticoagulant drugs may have reduced the mortality in some cases.
    Masui. The Japanese journal of anesthesiology 12/2009; 58(12):1567-73.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cerebellar Purkinje cells (PC) are particularly vulnerable to ischemic injury and excitotoxicity, although the molecular basis of this sensitivity remains unclear. We tested the hypothesis that ischemia causes rapid down-regulation of GABA(A) receptors in cerebellar PC, thereby increasing susceptibility to excitotoxicity. Oxygen-glucose deprivation (OGD) caused a decline in functional GABA(A) receptors, within the first hour of re-oxygenation. Decreased amplitude of miniature inhibitory post-synaptic potentials confirmed that OGD caused a significant decrease in functional synaptic GABA(A) receptors and quantitative Western blot analysis demonstrated the loss of GABA(A) receptor current was associated with a decline in total receptor protein. Interestingly, the potent neuroprotectant allopregnanolone (ALLO) prevented the decline in GABA(A) receptor current and protein. Consistent with our in vitro data, global ischemia in mice caused a significant decline in total cerebellar GABA(A) receptor protein and PC specific immunoreactivity. Moreover, ALLO provided strong protection of PC and prevented ischemia-induced decline in GABA(A) receptor protein. Our findings indicate that ischemia causes a rapid and sustained loss of GABA(A) receptors in PC, whereas ALLO prevents the decline in GABA(A) receptors and protects against ischemia-induced damage. Thus, interventions which prevent ischemia-induced decline in GABA(A) receptors may represent a novel neuroprotective strategy.
    Journal of Neurochemistry 09/2008; 107(3):668-78. · 3.97 Impact Factor
  • Masayuki Kuroiwa, Sumio Hoka
    Journal of Anesthesia 04/2007; 21(2):289-289. · 0.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: There have been no reports on acute pulmonary embolism (APE) after earthquakes. Our aim was to clarify the actual the occurrence of APE following the 2004 Mid Niigata Prefecture earthquake in Japan, and to assess the risk factors for APE after the event. We sent questionnaires to 122 hospitals in the Niigata Prefecture after the earthquake. Cities, towns, and villages in the prefecture were classified into two areas (high evacuee rate area, and low evacuee rate area) due to the mean ratio of evacuees to the overall population during 1 week immediately after the earthquake. A rate of 5% and higher was encountered for the high evacuee rate area and a rate of < 5% was encountered for the low evacuee rate area. Ten out-of-hospital cases of APE (seven in the high evacuee rate area and three in the low evacuee rate area) were diagnosed within the first month after the earthquake. The relative risk of APE was high in the high evacuee rate area (13.09; P = 0.0002) and also higher in women (8.55; P = 0.04). All patients in the high evacuee rate area had stayed in their automobiles for long periods of time, but none had done so in the low evacuee rate area ( P = 0.008).
    Seminars in Thrombosis and Hemostasis 12/2006; 32(8):856-60. · 4.22 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The incidence of perioperative pulmonary thromboembolism (PTE) is reported not to be low in Japan. The aim of this study is to investigate the incidence and characteristics of perioperative PTE in Japan in 2004. A questionnaire was mailed to 960 institutions registered as the teaching hospitals of the Japanese Society of Anesthesiologists (JSA). The survey details included age, sex, type of surgery, and risk factors of patients operated in 2004. Effective responses were received from 642 institutions (66.9%) of 960 institutions. A total of 409 cases of perioperative PTE were reported from 245 institutions (25.5% of the institutions responded). The incidence of perioperative PTE was 3.62 per 10,000 cases. Cardiac arrest occurred at the onset in 65 cases (15.9%). Of the patients, 150 (36.7%) had malignancy; 142 (34.7%) were obese; and 121 (29.6%) were bed-ridden (> 4 days). In 273 cases (66.7%), the patients were over 60 years of age. PTE was found to be more frequent in females than in males (males, 147 cases; females, 259 cases). The types of surgery resulted in perioperative PTE with high frequency were "spinal surgery" (6.95 per 10,000 cases) and "limbs and/or hip joint surgery" (9.79 per 10,000 cases). Eighty-nine patients (21.8%) died from perioperative PTE. The incidence of perioperative PTE was not low and its mortality was high in Japan in 2004. In particular, the incidence of perioperative PTE was found to be high in females, the elderly, patients with malignancy, and patients who had undergone orthopedic surgery.
    Masui. The Japanese journal of anesthesiology 09/2006; 55(8):1031-8.
  • Masayuki Kuroiwa, Sumio Hoka
    Journal of Anesthesia 02/2006; 20(1):71-2. · 0.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: Venous thromboembolism (VTE), which had been considered a relatively rare disease in Japan, has been on the increase in recent years as eating habits have become more similar to those of the West. The Ministry of Health, Labor and Welfare in Japan reported in a patient survey that there were 4,000 patients with pulmonary thromboembolism (PTE) and 1,738 deaths from PTE in 1999 increasing in about 3 times for a decade. We investigated the clinical efficacy of thromboprophylaxis for perioperative PTE after drafting Japanese guidelines. Methods: The Japanese Society of Pulmonary Embolism Research analyzed 309 cases of acute PTE among a total of 533 registry patients. Main risk factors were recent major surgery, cancer, prolonged immobilization, and obesity; only a few patients had coagulopathy. Among 110 cases of recent major surgery, PTE occurred associated with orthopedic surgery (29.1%), general surgery (21.8%), gynecological surgery (18.2%), neurosurgery (8.2%), urological surgery (5.5%), and others (17.3%). In-hospital mortality rate was 14%. In patients with cardiogenic shock, the mortality rate was reduced by thrombolysis. Based on these investigations we drafted Japanese guidelines for perioperative PTE prophylaxis in 2004. And, perioperative PTE was investigated by Editorial Committee on Guideline for Prevention of Venous Thromboembolism by Japanese Society of Anesthesiologists from 2002 to 2004. Results: The incidence of PTE in Japan is considered to be one level lower compared with Western populations according to ACCP (American College of Chest Physicians) guidelines. Furthermore, low molecular weight heparin (LMWH) is not covered by health insurance and is contraindicated for pregnant women still now in Japan. We classified four risk groups according to ACCP guidelines. Recommended thromboprophylaxis is early mobilization for low risk group, elastic stocking (ES) or intermittent pneumatic compression (IPC) for moderate risk group, IPC or low dose unfractionated heparin (LDUH) for high risk group, and LDUH + IPC or LDUH + ES for highest risk group. And, risk group should be raised one rank in cases with any additional risks, such as obesity, advanced age, pregnancy, operation time, and other complications. 369 cases of PTE were registered to Editorial Committee by Japanese Society of Anesthesiologists in 2002. The rate of perioperative PTE is estimated to be 0.044% (369/837,540), and the fatal rate among clinical PTE was 17.9%. 36% of the cases occurred in orthopedics, 22% in general surgery and 10% in obstetrics and gynecology. 59% of the cases did not received prophylaxis, and 52% of the cases were restricted mobility. The rate of perioperative PTE has increased to be 0.048% (440/925,260) in 2003, however, its rate has decreased to be 0.036% (409/1,131,154) in 2004. Fortunately, the management fee for PTE prophylaxis was established and covered by health insurance in April 2004. Surprisingly, the incidence of perioperative PTE decreased just after this guideline was issued. Conclusion: Japanese guideline for PTE prophylaxis is effective for a decrease in the occurrence of PTE. After accumulation of further clinical evidences and application of pharmacological agents, such as LMWH and fondaparinux, we will establish the advanced guidelines in the future.
    Journal of Thrombosis and Haemostasis 01/2006; 4:84-84. · 6.08 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Pulmonary thromboembolism (PTE) is increasingly recognized as a significant perioperative complication in Japan. A recent study reported that the incidence was 0.32 patients per 10,000 people per year in Japan. The aim of this investigation is to elucidate the incidence and characteristics of perioperative pulmonary thromboembolism in Japan. A questionnaire was mailed to 844 institutions registered under the Japanese Society of Anesthesiologists (JSA). The survey details included age, sex, type of surgery, and risk factors of the cases operated in 2003. Among the 844 institutions, 504 (59.7%) responded effectively. There were 440 cases of perioperative PTE in 230 institutions (45.6% of the institutions responded). The incidence of perioperative PTE was 4.76 per 10,000 cases. Massive PTE or cardiac arrest at the onset occurred in 60 cases (13.7%). Among these patients, 178 (40.5%) were obese, 162 (36.8%) had malignant diseases, and 111 (25.2%) were bed-ridden (> 4 days). The types of surgery that resulted in PTE with high frequency were "limbs and/or hip joint surgery" (9.0 per cases), "thoracic surgery with laparotomy" (7.6 per 10,000 cases), and "abdominal surgery" (6.6 per 10,000 cases). Eighty-three patients died from perioperative PTE; out of these, 9 (10.8%) died during operation, 23 (27.7%) died within 3 days after the operation, and 51 (61.4%) died 4 days after the operation. Despite having risk factors, 80 patients (33. 9%) either received unrecommended measures or did not receive any preventive measures for PTE. The incidence of perioperative PTE is not low in Japan and is 13 times higher than the rate observed in the general population. The use of thromboprophylaxis should be considered in patients with risk factors.
    Masui. The Japanese journal of anesthesiology 07/2005; 54(7):822-8.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To review six cases of Brugada syndrome presenting for insertion of a cardioverter-defibrillator under general anesthesia. All patients had a history of syncope, ST segment elevation in the right precordial lead of the electrocardiogram (ECG) which became prominent after a pilsicainide challenge test. Routine monitors, right precordial lead of the ECG and an external defibrillator were installed prior to anesthesia. We administered propofol/midazolam for induction, and propofol/sevoflurane combined with fentanyl for maintenance of anesthesia. Atropine and ephedrine were administered to decrease vagal tone. No ECG change or arrhythmia was observed perioperatively. After the successful implantation of the defibrillator, all patients were discharged without any adverse event. By avoiding agents or conditions that may exacerbate Brugada syndrome during anesthesia, we were able to manage the patients uneventfully for implantation of a cardioverter-defibrillator.
    Canadian Journal of Anaesthesia 05/2005; 52(4):409-12. · 2.13 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The management of patient with interstitial cystitis (IC) remains a challenge because no single agent has proven effective. IC is a chronic sterile inflammatory disease of the bladder of unknown etiology characterized by urinary frequency, urgenecy, nocturia and lower abdominal pain. We experienced anesthetic management of five patients with IC during intravesical resiniferatoxin (RTX) therapy. RTX is associated with irritative urinary symptom during bladder instillation. The patients with IC had bladder instillation with 100 ml of 10(-8) M RTX solution for 30 min. The first patient received combined spinal-epidural anesthesia (CSEA), and the others general anesthesia. The patient with regional anesthesia had no critical troubles related to circulatory status during the procedure, but increases of blood pressure after instillation of RTX were observed in two patients receiving general anesthesia. In spite of the increase in blood pressure during general anesthesia, regional anesthesia should not be used, because the effect of RTX on the spinal cord has to be maintained.
    Masui. The Japanese journal of anesthesiology 03/2005; 54(2):149-52.
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 38-year-old man diagnosed as esophageal achalasia developed masseter muscle rigidity after intravenous suxamethonium during anesthetic induction. Anesthesia was maintained with intravenous agents and epidural blockade, while the masseter muscle rigidity continued. After the surgery, his body temperature increased to 38.8 degrees C concomitantly with the appearance of myoglobinuria suggesting the occurrence of abortive malignant hyperthermia. These symptoms were dissolved by dantrolene administration. He was later proved to be negative with CICR test.
    Masui. The Japanese journal of anesthesiology 04/2004; 53(3):287-90.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Perioperative pulmonary thromboembolism (preoperative PTE) is widely recognized as one of the life-threatening perioperative complications in Japan. However, incidence of perioperative PTE is not well surveyed. The Japanese Society of Anesthesiologist (JSA) mailed the questionnaire about incidence of perioperative PTE and its characteristics to the institutions registered in JSA. The questionnaire was mailed to 844 institutions. The items of the survey included age, sex, type of surgery and risk factors of the cases performed in 2002. Data were analyzed using chi-square test and Fisher's test, and P < 0.05 was taken as significant. Four-hundred sixty-seven out of 844 institutions responded (55.3%) effectively. There were 369 cases of perioperative PTE in 208 institutions (44.5% of the institutions responded). The incidence of perioperative PTE was 4.4 per ten thousand cases. Massive PTE or cardiac arrest at the onset occurred in 57 cases (15.4%). Out of these patients, 117 patients (31.7%) had obesity, and bed-ridden rest (> 4 days) patients and cancer patients were each 105 (28.5%). Sixty-six patients died from perioperative PTE, out of which 5 patients (7.5%) died during operation, 31 patients (47.0%) died within 7 days after the operation, and 30 patients (45.5%) died 8 days after the operation. The commonest type of surgery among mortality cases was abdominal surgery (20 cases: 30.3%), and the commonest risk factor was being bedridden (34.5 cases: 51.5%). The patients who had developed PTE during surgery counted 64, among whom the major type of operation was lower limb/pelvic surgery (36 cases: 56.3%). Major risk factors were being bed-ridden in 25 cases (39.1%) and lower limb/pelvic fracture in 25 cases (39.1%). Despite having dangerous risk factors, 128 patients (57.7%) received the measures not recommended or did not receive any preventive measure for PTE. This survey revealed that the incidence of perioperative PTE in Japan is considerable. On the ground that most PTE could be prevented, it is suggested that by employing preventive measures for PTE, the incidence of perioperative PTE will decrease.
    Masui. The Japanese journal of anesthesiology 04/2004; 53(4):454-63.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cesarean section was performed under general anesthesia in a 38-year-old patient with congestive heart failure due to severe mitral stenosis. During surgery, pulmonary hypertension, right ventricular distension and the dissociation of PETCO2 and PaCO2 were observed. However, pulmonary thromboembolism (PTE) was proved after the operation when she developed severe hypotension in the intensive care unit. Although she recovered once from circulatory unstability with the use of percutaneous cardiopulmonary support (PCPS) and she could be weaned from PCPS at the 4th postoperative day, she died from tracheal bleeding and recurrent cardiopulmonary collapse 22nd day after the surgery. It should be noted that the increasing dissociation of PETCO2 and PaCO2 may be an early sign of PTE even in a patient with severe mitral stenosis and pulmonary hypertension.
    Masui. The Japanese journal of anesthesiology 11/2003; 52(10):1100-3.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to examine the incidence of cardiac complications in patients with hypertrophic cardiomyopathy (HCM) during noncardiac surgery. A retrospective study was made for surgical patients in the period of 1989-2000 at Kitasato University Hospital. Thirty out of 66000 patients were preoperatively diagnosed as HCM. Sixty percent of the HCM patients had one or more perioperative cardiovascular complications. There were perioperative congestive heart failure in 3 patients (10%), and myocardial ischemia in 4 patients (13%). However, there were no myocardial infarction, no life-threatening dysarrthythmia and no cardiac death. Factors which appeared to be associated with the perioperative cardiovascular complications were the type of HCM (HOCM), major surgery, general anesthesia and preoperative medication with a beta-blocker or a calcium channel blocker. It is suggested that patients with HCM undergoing noncardiac surgery have a high incidence of cardiac complications such as congestive heart failure and myocardial ischemia.
    Masui. The Japanese journal of anesthesiology 08/2003; 52(7):733-9.

Publication Stats

90 Citations
28.57 Total Impact Points

Institutions

  • 2002–2013
    • Kitasato University
      • • Medical Department
      • • Department of Anesthesiology
      Edo, Tōkyō, Japan
  • 2008–2011
    • Oregon Health and Science University
      • Department of Anesthesiology & Perioperative Medicine
      Portland, OR, United States
  • 2004–2006
    • Sagamihara National Hospital
      Йокосука, Kanagawa, Japan