Publications (2)2 Total impact
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ABSTRACT: The role of crystalloid or colloid preloading to prevent hypotension associated with spinal anesthesia in parturients during cesarean section has recently been questioned. The aim of the current study was to investigate the effects of volume preload with either crystalloid or colloid, or with no preload on changes of maternal hemodynamics and neonatal outcomes. After written informed consent had been obtained from each patient, thirty-two healthy parturients undergoing cesarean section were randomized to receive either acetated Ringer's solution (1,000 ml, n=8, AR group), 6% hydroxyethylstarch (1,000 ml, n=9, HES group), or no preload (n=10) before spinal anesthesia. In addition, emergency cases (n=5) such as prolonged labor without any maternal complication were also included for analysis. The incidence of hypotension, systolic blood pressure <80% of baseline or <100 mmHg, and the amount of ephedrine used to treat hypotension were compared. Neonatal outcome was also assessed measuring pH and lactate concentration in umbilical arterial blood samples. Apgar score was also measured at 1 and 5 min after delivery. There was no difference in demographic characteristics among the four groups. Minimal systolic arterial pressure (SAP) after spinal anesthesia did not differ among AR, HES, and no preload groups. However, a significant decline in SAP was observed in emergency group (82.2 +/- 14.3 mmHg, P<0.05). Although there was no difference in umbilical arterial blood pH, lactate concentration was significantly higher in emergency group (3.7 +/- 1.0 mmol x l(-1), P<0.01) than those of other groups. Apgar score at 1 min after delivery was significantly lower in emergency group. In healthy patients with full-term pregnancy, volume preloading has little effect on maternal hemodynamics and neonatal outcomes, suggesting that stable perioperative management is possible with or without volume preload before spinal anesthesia. However, preloading may be needed for prevention of hypotension in emergency cases.Masui. The Japanese journal of anesthesiology 10/2004; 53(9):1019-24.
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ABSTRACT: The pheochromocytoma cell line (PC12) has been used as a model system for the study of regulation of expression of NMDA receptors. PC12 cells express a substantial amount of NMDAR1 subunit (NR1) mRNA, whereas they express only a small amount of NR1 protein. The level of functional NMDA receptor expression is almost negligible. To test the possibility that NMDAR2 subunits (NR2) control expression of functional NMDA receptors as well as NR1 protein, we transferred NR2A-D cDNAs into PC12 cells using adenovirus vectors. Prominent NMDA receptor-mediated currents were recorded in PC12 cells to which NR2A or NR2B cDNA was delivered without NR1 cDNA. The amplitudes of these responses were similar to those in PC12 cells to which NR1 cDNA was delivered together with NR2A or NR2B cDNA. In cells to which either NR2C or NR2D cDNA alone was delivered, NMDA receptor-mediated currents were also detected, although to a much lesser extent. These results showed that NR2 proteins produced by gene transfer are co-assembled with the endogenous NR1 protein to form functional heteromeric receptors. The delivery of NR2A-D cDNAs also increased the amount of NR1 protein but not that of NR1 mRNA, suggesting that this protein increase is due to post-transcriptional mechanisms. The effects of NR2A-B gene transfer on expression of NR1 protein were much more efficient than those of NR2C-D gene transfer.Molecular Brain Research 03/2003; 110(2):159-68. · 2.00 Impact Factor