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Hiromi Kojima - One of the best experts on this subject based on the ideXlab platform.
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autologous human nasal epithelial cell sheet using temperature responsive culture insert for transplantation after Middle Ear Surgery
Journal of Tissue Engineering and Regenerative Medicine, 2017Co-Authors: Takanori Hama, Kazuhisa Yamamoto, Masayuki Yamato, Yuichiro Yaguchi, Teruo Okano, Daisuke Murakami, Hiroyuki Sasaki, Hiromi KojimaAbstract:Postoperative mucosal regeneration of the Middle Ear cavity and the mastoid cavity is of great importance after Middle Ear Surgery. However, the epithelialization of the mucosa in the Middle Ear is retarded because chronic inflammation without epithelialization aggravates gas exchange and clinical function. These environmental conditions in the Middle Ear lead to postoperative retraction and adhesion of the newly-formed tympanic membrane. Therefore, if the mucosa on the exposed Middle Ear bone surface can be rapidly regenerated after Surgery, the surgical treatments for cholesteatoma and adhesive Middle Ear disease can potentially be improved. In this study, we successfully generated a cell sheet designed for the postoperative treatment of cholesteatoma. We used nasal cells to create an artificial Middle Ear mucosal cell sheet with a three-dimensional (3D) configuration similar to that of the Middle Ear mucosa. The sheets consisted of multi-layered mucosal epithelia and lower connective tissue and were similar to normal Middle Ear mucosa. This result indicates that tissue-engineered mucosal cell sheets would be useful to minimize complications after surgical operations in the Middle Ear and future clinical applications are expected. Copyright © 2015 John Wiley & Sons, Ltd.
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the effect of transplantation of nasal mucosal epithelial cell sheets after Middle Ear Surgery in a rabbit model
Biomaterials, 2015Co-Authors: Kazuhisa Yamamoto, Takanori Hama, Masayuki Yamato, Hirotaka Uchimizu, Hiroaki Sugiyama, Ryo Takagi, Yuichiro Yaguchi, Teruo Okano, Hiromi KojimaAbstract:Postoperative regeneration of the Middle Ear mucosa and pneumatization of the Middle Ear cavity are of great importance after Middle Ear Surgery. This study developed a new method to transplant autologous nasal mucosal epithelial cell sheets into the damaged Middle Ear cavity. The aim of this study was to evaluate postoperative healing after the transplantation of the cell sheets. Rabbit nasal mucosal epithelial cell sheets were fabricated on a temperature-responsive culture dish, and transplanted into the damaged Middle Ear of rabbit, which was surgically created. The healing of Middle Ears was evaluated by histology and X-ray computed tomography after transplantation. Functional evaluation was performed by measuring the maximum Middle Ear total pressure reflecting a trans-mucosal gas exchange function. Two control groups were used: the normal control group and the mucosa-eliminated control group. Transplantation of cell sheets suppressed the bone hyperplasia and the narrowing of pneumatic space in the Middle Ear cavity compared with the mucosa-eliminated control group. The mucosal gas exchange function was also better in the cell sheet-transplanted group. Nasal mucosal epithelial cell sheet was confirmed to be useful as an effective graft material after Middle Ear Surgery and hopefully become a novel therapy in the future.
Hiroyoshi Tanaka - One of the best experts on this subject based on the ideXlab platform.
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randomized double blind placebo controlled dosed finding study of the antiemetic effects and tolerability of ramosetron in adults undergoing Middle Ear Surgery
Clinical Therapeutics, 2003Co-Authors: Hiroyoshi TanakaAbstract:Background: Ramosetron is a selective serotonin receptor antagonist (SSRA) that is approved for the treatment of emetic symptoms induced by cytotoxic drugs in Japan. We have reported that ramosetron 0.3 mg had comparable efficacy to granisetron 3 mg, another SSRA, in preventing emetic symptoms in adults in the first 48 hours after the start of anesthesia for Middle Ear Surgery. Although it has been shown that a high dose of ramosetron can cause adverse effects (AEs), such as severe headache, the minimal effective dose of ramosetron is unknown. Objective: The aim of this study was to determine the minimum effective and tolerable dose of ramosetron needed to prevent postoperative emetic symptoms in adult patients undergoing Middle Ear Surgery. Methods: This randomized, double-blind, placebo-controlled, dose-finding study was conducted at the Department of Anesthesiology, Toride Kyodo General Hospital (Toride, Japan). Patients aged ≥20 yEars scheduled for Middle Ear Surgery were randomized to receive either placebo or ramosetron at 1 of 3 doses (0.15, o.3, or 0.6 mg), regardless of body weight, IV immediately before anesthesia induction. Emetic symptoms (nausea, retching, or vomiting) occurring from 0 to <24 and 24 to 48 hours after the start of anesthesia were recorded. Other AEs also were assessed. Results: A total of 100 patients (55 women, 45 men; mean [SD] age, 44 [12] yEars; mean [SD] body weight, 56 [8] kg; mean [SD] height, 159 [8] cm) were enrolled. Each treatment group comprised 25 patients. The treatment groups were comparable with regard to demographic characteristics and type of Surgery After the second 24 hour postanesthesia period, significantly more patients in the ramosetron 0.3-mg and 0.6-mg groups were emesis free than in the placebo group (both P < 0.001). The number of emesis-free patients in the ramosetron 0.15-mg group and the placebo group were similar after both study periods. No significant difference in antiemetic efficacy was found between the ramosetron 0.3-mg and 0.6-mg groups. No relationship between body weight and the efficacy of ramosetron was observed. The incidence of AEs was similar in all 4 groups. Conclusions: Ramosetron 0.3 mg, regardless of body weight, was more effective than either ramosetron 0.15 mg or placebo and as effective as ramosetron 0.6 mg for the prevention of emetic symptoms in the first 48 hours after the start of anesthesia in this selected population of adult patients who underwent Middle Ear Surgery.
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prevention of postoperative nausea and vomiting with antiemetics in patients undergoing Middle Ear Surgery comparison of a small dose of propofol with droperidol or metoclopramide
Archives of Otolaryngology-head & Neck Surgery, 2001Co-Authors: Yoshitaka Fujii, Hiroyoshi Tanaka, Noriaki KobayashiAbstract:Objective To compare the efficacy and safety of a small dose of propofol with other commonly used antiemetics, droperidol and metoclopramide, for the prevention of postoperative nausea and vomiting in patients undergoing Middle Ear Surgery. Design Prospective, randomized, double-blind study. Setting University-affiliated teaching hospital. Patients Ninety patients (48 females, 42 males) scheduled for Middle Ear Surgery. Intervention Patients received propofol, 0.5 mg/kg, droperidol, 20 µg/kg, or metoclopramide hydrochloride, 0.2 mg/kg, intravenously at the end of the surgical procedure. A standardized general anesthetic technique was employed throughout the surgical procedure. Main Outcome Measure Emetic episodes and safety assessment were performed during 2 periods—0 to 3 hours in the postanesthetic care unit and 3 to 24 hours in the ward—after receiving anesthesia. Results The incidence of patients who were emesis free during the 0- to 3-hour period after receiving anesthesia was 93% for those who received propofol, 73% for those who received droperidol, and 70% for those who received metoclopramide, respectively; the respective corresponding incidence during the 3- to 24-hour period after receiving anesthesia was 90%, 67%, and 60% ( P Conclusion A small dose of propofol is a better antiemetic than droperidol or metoclopramide for the prevention of postoperative nausea and vomiting after Middle Ear Surgery.
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prevention of nausea and vomiting after Middle Ear Surgery granisetron versus ramosetron
Laryngoscope, 1999Co-Authors: Hiroyoshi Tanaka, Noriaki KobayashiAbstract:Objective/Hypothesis: Middle Ear Surgery is associated with a relatively high incidence of postoperative nausea and vomiting. This study was undertaken to compare the efficacy of ramosetron with granisetron for preventing nausea and vomiting after Middle Ear Surgery. Study Design: Prospective, randomized, double-blind study. Methods: In a randomized, double-blind manner, 100 ASA I patients (69 women), aged 23 to 65 yEars, received either ramosetron 0.3 mg or granisetron 3 mg intravenously (n = 50 of each) immediately before the induction of anesthesia. A standard general anesthetic technique and postoperative analgesia were used. Postoperative nausea and vomiting and safety assessments were performed continuously during the first 24 hours (0-24 h) and the next 24 hours (24-48 h) after anesthesia. Results: A complete response, defined as no nausea and vomiting and no need for another rescue medication, during the first 24 hours after anesthesia (0-24 h) occurred in 90% of patients receiving ramosetron and in 86% of patients receiving granisetron, respectively (P = .379); the corresponding incidence rates in the second 24 hours after anesthesia (24-48 h) were 90% and 66% (P = .003). No clinically important adverse events were observed in either group. Conclusion: Prophylactic use of ramosetron is more effective than granisetron for long-term prevention of nausea and vomiting after Middle Ear Surgery.
Younghoon Jeon - One of the best experts on this subject based on the ideXlab platform.
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comparison of the cuff pressure of a taperguard endotracheal tube and a cylindrical endotracheal tube after lateral rotation of head during Middle Ear Surgery a single blind randomized clinical consort study
Medicine, 2017Co-Authors: Eunkyung Choi, Yongmin Park, Younghoon JeonAbstract:BACKGROUND Positional change affects the cuff pressure of an endotracheal tube (ETT) in treacheally intubated patients. We compared the cuff pressure of a TaperGuard ETT and a cylindrical ETT after lateral rotation of head during Middle Ear Surgery. METHODS Fifty-two patients aged 18-70 yEars underwent a tympanomastoidectomy under general anesthesia were randomly allocated to receive endotracheal intubation with cylindrical (group C, n = 26) or TaperGuard ETTs (group T, n = 26). After endotracheal intubation, the ETT cuff pressure was set at 22 cmH2O in the neutral position of head. After lateral rotation of head, the cuff pressure was measured again and readjusted to 22 cmH2O. In addition, the change of distance from the carina to the tip of the ETT was measured before and after the positional change. The incidence of cough, sore throat, and hoarseness was assessed at 30 minutes, 6 hours, and 24 hours after Surgery. RESULTS There was no difference in demographic data between groups. After lateral rotation of head, the cuff pressure significantly increased in group T (11.9 ± 2.3 cmH2O) compared with group C (6.0 ± 1.9 cmH2O) (P 30 cmH2O was higher in group T (96.2%) than in group C (30.8%) (P < 0.001). In addition, the degree of displacement of an ETT was greater in group T (11.0 ± 1.7 mm) than in group C (7.2 ± 2.6 mm) (P < 0.001). The overall incidences of postoperative sore throat, hoarseness, and cough at 30 minutes, 6 hours, and 24 hours after Surgery were comparable between two groups. CONCLUSION The cuff pressure was higher in the TaperGuard ETT than in the cylindrical ETT after positional change of head from neutral to lateral rotation. In addition, after a positional change, the extent of displacement of ETT was greater in the TaperGuard ETT than in the cylindrical ETT.
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antiemetic efficacy of dexamethasone combined with midazolam after Middle Ear Surgery
Otolaryngology-Head and Neck Surgery, 2009Co-Authors: Jinseok Yeo, Jaesik Jung, Taeha Ryu, Younghoon Jeon, Sioh Kim, Woonyi BaekAbstract:Abstract Objectives To evaluate the antiemetic efficacy of dexamethasone combined with midazolam after Middle Ear Surgery. Study Design A prospective, randomized, double-blind, placebo-controlled study. Setting University hospital. Subjects and Methods The study population consisted of 120 American Society of Anesthesiologists physical status I or II, adult female patients undergoing Middle Ear Surgery under general anesthesia. Patients were randomized into three groups of 40 each who received a dexamethasone dose of 10 mg/kg (group D), a combination of dexamethasone 10 mg and midazolam 0.075 mg/kg (group DM), and normal saline (group C) immediately after the induction of anesthesia. The incidence of nausea and vomiting, usage of rescue antiemetics, pain intensity, and side effects, such as headache and dizziness, were assessed during the first 24 hours after Surgery. Results The overall incidence of nausea and vomiting was significantly lower in group D (35%, P Conclusions The combination of dexamethasone and midazolam was better than dexamethasone alone in reducing the incidence of vomiting and the rescue antiemetic requirements in women patients undergoing Middle Ear Surgery. However, this combination treatment did not significantly decrease the overall incidence of nausea and vomiting compared with the use of dexamethasone alone.
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prophylactic antiemetic effect of midazolam after Middle Ear Surgery
Otolaryngology-Head and Neck Surgery, 2007Co-Authors: Jaesik Jung, Sioh Kim, Jun Sik Park, Dong Gun Lim, Sung Sik Park, Kyung Hwa Kwak, Jin Duck Cho, Younghoon JeonAbstract:ObjectiveTo investigate the prophylactic antiemetic effect of midazolam after Middle Ear Surgery.Study DesignA prospective, randomized, double-blind, placebo-controlled study.Subjects and MethodsNinety women patients undergoing Middle Ear Surgery with general anesthesia received intravenously either midazolam 0.075 mg/kg or normal saline (n = 45 each) after induction of anesthesia. The incidence and severity of postoperative nausea and vomiting, rescue antiemetics, pain intensity, and side effects such as headache, dizziness, and drowsiness were assessed during the first 24 hours after anesthesia.ResultsMidazolam groups showed total incidence and severity of nausea and vomiting. Patients who required rescue antiemetics were significantly lower than in saline group (P < 0.05), but there were no significant differences in pain intensity and side effects such as headache, dizziness, and drowsiness between groups.ConclusionsMidazolam 0.075 mg/kg is effective for reducing nausea and vomiting after Middle Ear s...
Noriaki Kobayashi - One of the best experts on this subject based on the ideXlab platform.
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prevention of postoperative nausea and vomiting with antiemetics in patients undergoing Middle Ear Surgery comparison of a small dose of propofol with droperidol or metoclopramide
Archives of Otolaryngology-head & Neck Surgery, 2001Co-Authors: Yoshitaka Fujii, Hiroyoshi Tanaka, Noriaki KobayashiAbstract:Objective To compare the efficacy and safety of a small dose of propofol with other commonly used antiemetics, droperidol and metoclopramide, for the prevention of postoperative nausea and vomiting in patients undergoing Middle Ear Surgery. Design Prospective, randomized, double-blind study. Setting University-affiliated teaching hospital. Patients Ninety patients (48 females, 42 males) scheduled for Middle Ear Surgery. Intervention Patients received propofol, 0.5 mg/kg, droperidol, 20 µg/kg, or metoclopramide hydrochloride, 0.2 mg/kg, intravenously at the end of the surgical procedure. A standardized general anesthetic technique was employed throughout the surgical procedure. Main Outcome Measure Emetic episodes and safety assessment were performed during 2 periods—0 to 3 hours in the postanesthetic care unit and 3 to 24 hours in the ward—after receiving anesthesia. Results The incidence of patients who were emesis free during the 0- to 3-hour period after receiving anesthesia was 93% for those who received propofol, 73% for those who received droperidol, and 70% for those who received metoclopramide, respectively; the respective corresponding incidence during the 3- to 24-hour period after receiving anesthesia was 90%, 67%, and 60% ( P Conclusion A small dose of propofol is a better antiemetic than droperidol or metoclopramide for the prevention of postoperative nausea and vomiting after Middle Ear Surgery.
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prevention of nausea and vomiting after Middle Ear Surgery granisetron versus ramosetron
Laryngoscope, 1999Co-Authors: Hiroyoshi Tanaka, Noriaki KobayashiAbstract:Objective/Hypothesis: Middle Ear Surgery is associated with a relatively high incidence of postoperative nausea and vomiting. This study was undertaken to compare the efficacy of ramosetron with granisetron for preventing nausea and vomiting after Middle Ear Surgery. Study Design: Prospective, randomized, double-blind study. Methods: In a randomized, double-blind manner, 100 ASA I patients (69 women), aged 23 to 65 yEars, received either ramosetron 0.3 mg or granisetron 3 mg intravenously (n = 50 of each) immediately before the induction of anesthesia. A standard general anesthetic technique and postoperative analgesia were used. Postoperative nausea and vomiting and safety assessments were performed continuously during the first 24 hours (0-24 h) and the next 24 hours (24-48 h) after anesthesia. Results: A complete response, defined as no nausea and vomiting and no need for another rescue medication, during the first 24 hours after anesthesia (0-24 h) occurred in 90% of patients receiving ramosetron and in 86% of patients receiving granisetron, respectively (P = .379); the corresponding incidence rates in the second 24 hours after anesthesia (24-48 h) were 90% and 66% (P = .003). No clinically important adverse events were observed in either group. Conclusion: Prophylactic use of ramosetron is more effective than granisetron for long-term prevention of nausea and vomiting after Middle Ear Surgery.
Kazuhisa Yamamoto - One of the best experts on this subject based on the ideXlab platform.
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autologous human nasal epithelial cell sheet using temperature responsive culture insert for transplantation after Middle Ear Surgery
Journal of Tissue Engineering and Regenerative Medicine, 2017Co-Authors: Takanori Hama, Kazuhisa Yamamoto, Masayuki Yamato, Yuichiro Yaguchi, Teruo Okano, Daisuke Murakami, Hiroyuki Sasaki, Hiromi KojimaAbstract:Postoperative mucosal regeneration of the Middle Ear cavity and the mastoid cavity is of great importance after Middle Ear Surgery. However, the epithelialization of the mucosa in the Middle Ear is retarded because chronic inflammation without epithelialization aggravates gas exchange and clinical function. These environmental conditions in the Middle Ear lead to postoperative retraction and adhesion of the newly-formed tympanic membrane. Therefore, if the mucosa on the exposed Middle Ear bone surface can be rapidly regenerated after Surgery, the surgical treatments for cholesteatoma and adhesive Middle Ear disease can potentially be improved. In this study, we successfully generated a cell sheet designed for the postoperative treatment of cholesteatoma. We used nasal cells to create an artificial Middle Ear mucosal cell sheet with a three-dimensional (3D) configuration similar to that of the Middle Ear mucosa. The sheets consisted of multi-layered mucosal epithelia and lower connective tissue and were similar to normal Middle Ear mucosa. This result indicates that tissue-engineered mucosal cell sheets would be useful to minimize complications after surgical operations in the Middle Ear and future clinical applications are expected. Copyright © 2015 John Wiley & Sons, Ltd.
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the effect of transplantation of nasal mucosal epithelial cell sheets after Middle Ear Surgery in a rabbit model
Biomaterials, 2015Co-Authors: Kazuhisa Yamamoto, Takanori Hama, Masayuki Yamato, Hirotaka Uchimizu, Hiroaki Sugiyama, Ryo Takagi, Yuichiro Yaguchi, Teruo Okano, Hiromi KojimaAbstract:Postoperative regeneration of the Middle Ear mucosa and pneumatization of the Middle Ear cavity are of great importance after Middle Ear Surgery. This study developed a new method to transplant autologous nasal mucosal epithelial cell sheets into the damaged Middle Ear cavity. The aim of this study was to evaluate postoperative healing after the transplantation of the cell sheets. Rabbit nasal mucosal epithelial cell sheets were fabricated on a temperature-responsive culture dish, and transplanted into the damaged Middle Ear of rabbit, which was surgically created. The healing of Middle Ears was evaluated by histology and X-ray computed tomography after transplantation. Functional evaluation was performed by measuring the maximum Middle Ear total pressure reflecting a trans-mucosal gas exchange function. Two control groups were used: the normal control group and the mucosa-eliminated control group. Transplantation of cell sheets suppressed the bone hyperplasia and the narrowing of pneumatic space in the Middle Ear cavity compared with the mucosa-eliminated control group. The mucosal gas exchange function was also better in the cell sheet-transplanted group. Nasal mucosal epithelial cell sheet was confirmed to be useful as an effective graft material after Middle Ear Surgery and hopefully become a novel therapy in the future.