1.Antagonizing with Flumazenil after Sedation with Midazolam in Upper Gastrointestinal Endoscopy
Ju MIZUNO ; Michiko MATSUKI ; Yoshinori GOUDA ; Mitsune TANIMOTO ; Kazuo HANAOKA
Journal of the Japanese Association of Rural Medicine 2003;52(5):823-830
We investigated the usefulness of the method of producing sedation with midazolam and reversing with antagonist flumazenil in upper gastrointestinal endoscopy. Twenty-five adult outpatients underwent diagnostic upper gastrointestinal endoscopy 3 min after having an intravenous injection of 5 mg of midazolam for sedation, and received 0.25 mg of flumazenil intravenously 5 min after the removal of the endoscope. Blood pressure, heart rate, and percutaneous arterial oxygen saturation (SpO2) were measured, recorded, and compared at nine points : 1 min before midazolam injection, 2 min after midazolam injection, 1, 3, and 5 min after the insertion of the endoscope, 1 and 3 min after the removal of the endoscope, 1 min after flumazenil injection, and their awakening time at which they are easily able to respond to verbal commands. Fifteen minntes after their awakening, we asked those patients about their memory during the endoscopy and evaluated their pain with the Visual Analogue Scale (VAS). A significant decrease in systolic blood pressure was noted 2 min after midazolam injection. But the systolic blood pressure measured 1 min after the insertion of the endoscope significantly increased when compared with the level 2 min after midazolam injection. Then it gradually started decreasing. Although the systolic blood pressures 1 min after flumazenil injection and at their awakening time increased slightly, the levels were significantly lower than those 1 min before midazolam injection. The heart rate increased to the maximum 1 min after the insertion of the endoscope. Then it gradually started decreasing. The heart rates 1 min after flumazenil injection and at their awakening time decreased significantly when compared with those 1 min after the insertion of the endoscope. SpO2 significantly decreased from 97.6±1.6% 1 min before midazolam injection to 95.7±2.5% 2 min after midazolam injection and remained depressing around 95% during the endoscopy. However, SpO2 recovered 96.6±2.0% at their awakening time. Two patients had a vague memory but all the rest had no memory recollection at all of what happened during the examination. VAS was 20 mm for one patient and 0 mm for another patient. We showed the clinical usefulness of the method of antagonizing with flumazenil after upper gastrointestinal endoscopy performed on patients given an i.v. injection of midazolam, because this method might provide a minimal circulatory change due to some protection against hemodynamics stress in response to manipulation of the endoscope, anterograde amnesia, and disappearance of pain. However, we should take care of respiratory depression of the patient during endoscopy.
Minute of time
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Midazolam
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Injections
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Flumazenil
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Awake
2.Validity of a Questionnaire Evaluating Physical Activity Level in Young Children
Michikazu SEKINE ; Takashi YAMAGAMI ; Xiaoli CHEN ; Yasuko HAYASHIKAWA ; Shimako HAMANISHI ; Sadanobu KAGAMIMORI
Environmental Health and Preventive Medicine 2001;6(4):264-267
Objective: To assess the validity of a questionnaire for evaluating the physical activity of young children as reported by parents. Methods: Twenty-one male 1st grade elementary school children were the study subjects. The questionnaire contained 3 questions relating to the physical activity of children and was completed by their parents. These questions were: preference for physical activity: like very much, like, don't like; physical activity compared to peers: more than, the same as, less than peers; time spent on exercise activity per day: <30 min, 30—60 min, 60 min or more. We also assessed physical activity more objectively, using a small instrument for calculating total steps, energy expenditure originating from exercise, and total energy expenditure per day. The contribution of the questionnaire items to the objective indices was evaluated by linear regression analysis. Results: Preference for physical activity was significantly associated with all the objective indices. Physical activity compared with peers had links with total energy expenditure. Time spent in activity was related to total steps and energy expenditure from exercise. Conclusion: All the questionnaire items were valid measures for evaluating the physical activity level in young children and could be applied to a large epidemiological survey.
Physical activity
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Questionnaires
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Energy Metabolism
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Child
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Minute of time
3.Clinical Evaluation of the Finger Tissue Blood Volume during Shuchi-Bushi Powder Administration
Kampo Medicine 2008;59(6):809-812
In order to evaluate the effect of shuchi-bushi, a powder form of the aconite tuber, we examined changes in finger temperature (FT) and tissue blood flow (TBF). No significant differences were observed in FT between pre-administration and 90 min post-administration, however, FT at 72 min was significantly higher than that at the pre-administration (p=0.0736and p=0.0219, respectively). The FT at 72 h was also significantly higher than that at 90 min (p=0.0253). No significant differences were observed in TBF between pre-administration and 90 min, nor between the 90 min and 72 h. However, the TBF at 72 h was significantly higher than that at pre-administration (p=0.0219). A significant correlation was observed between the FT and TBF (p=0.0052). Our results suggest that shuchi-bushi may play a role in warming and increasing tissue blood flow in human.
Minute of time
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lower case pea
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Tissues
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lower case aitch
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Powders
4.Influence of rice with different amylose contents on postprandial glycemic response
Masayuki Yamasaki ; Mamiko Watanabe ; Toshimi Yoneyama ; Akiko Nogi ; Li Wang ; Kuninori Shiwaku
Journal of Rural Medicine 2006;2(1):51-58
Objective: Clinical studies suggest that maintaining a lower postprandial glycemic response is important for improvement and prevention of metabolic syndrome and type 2 diabetes mellitus. Amylose, an ingredient in many food grains, is a major factor for the lowering of postprandial glycemic and insulinemic response. The aim of the present study was to determine the influence of rice with different level of amylose on postprandial glycemic and insulinemic response in mice and humans.Materials and Methods: The two types of rice used in the study contained 29 wt% (high amylose rice) or 17 wt% (low amylose rice) amylose. In mice and humans, postprandial glycemic and insulinemic responses were measured and then the area under the response curves of both rice groups were compared.Results: In mice, comparisons of postprandial glycemic response showed high amylose rice was lower than that for low amylose rice in all time points. Notably postprandial glycemic responses for high amylose rice at 15, 30, 45 and 60 min were significantly lower (19%, 31%, 16% and 17% respectively). The area under the glycemic response curve for high amylose rice was a remarkably 16% less than for the low amylose rice. In humans, postprandial glycemic response at 30 min and insulinemic response at 60 min for high amylose rice were significantly lower than for low amylose rice (15% and 40% lower, respectively). Furthermore, general linear measurement multivariate analysis after adjustment for eating time and hemoglobin A1c at baseline showed that postprandial glycemic response at 30 and 60 min and insulinemic response at 60 min, and the area under the glycemic response curve for high amylose rice were significantly lower than for low amylose rice in human.Conclusion: The higher amylose content of the rice lowered the postprandial glycemic and insulinemic response, demonstrating the potential to prevent or improve metabolic syndrome and type 2 diabetes mellitus.
Rice
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Minute of time
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Laboratory mice
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Syndrome
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Diabetes Mellitus, Non-Insulin-Dependent