Megumi Kanao-Kanda
Asahikawa Medical University
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Featured researches published by Megumi Kanao-Kanda.
Journal of Cardiothoracic and Vascular Anesthesia | 2017
Hirotsugu Kanda; Fumiaki Kimura; Takafumi Iida; Megumi Kanao-Kanda; Takayuki Kunisawa; Taiji Nagaoka; Akitoshi Yoshida; Hiroyuki Kamiya
Cite this article as: Hirotsugu Kanda, Fumiaki Kimura, Takafumi Iida, Megumi Kanao-Kanda, Takayuki Kunisawa, Taiji Nagaoka, Akitoshi Yoshida and Hiroyuki Kamiya, Combined use of intra-aortic balloon pump and venoarterial extracorporeal membrane oxygenation support with femoral arterial cannulation impairs cerebral microcirculation: Evaluation with laser speckle flowgraphy, Journal of Cardiothoracic and Vascular Anesthesia, http://dx.doi.org/10.1053/j.jvca.2016.09.012
Therapeutics and Clinical Risk Management | 2015
Hirotsugu Kanda; Yuji Hirasaki; Takafumi Iida; Megumi Kanao-Kanda; Yuki Toyama; Takayuki Kunisawa; Hiroshi Iwasaki
Purpose The aim of this study was to investigate fluid loading-induced changes in left ventricular end-diastolic volume (LVEDV) and stroke volume variability (SVV) in patients with end-stage renal disease (ESRD) using real-time three-dimensional transesophageal echocardiography and the Vigileo-FloTrac system. Patients and methods After obtaining ethics committee approval and informed consent, 28 patients undergoing peripheral vascular procedures were studied. Fourteen patients with ESRD on hemodialysis (HD) were assigned to the HD group and 14 patients without ESRD were assigned to the control group. Institutional standardized general anesthesia was provided in both groups. SVV was measured using the Vigileo-FloTrac system. Simultaneously, a full-volume three-dimensional transesophageal echocardiography dataset was acquired to measure LVEDV, left ventricular end-systolic volume, and left ventricular ejection fraction. Measurements were obtained before and after loading 500 mL hydroxyethyl starch over 30 minutes in both groups. Results In the control group, intravenous colloid infusion was associated with a significant decrease in SVV (13.8%±2.6% to 6.5%±2.6%, P<0.001) and a significant increase in LVEDV (83.6±23.4 mL to 96.1±28.8 mL, P<0.001). While SVV significantly decreased after infusion in the HD group (16.2%±6.0% to 6.2%±2.8%, P<0.001), there was no significant change in LVEDV. Conclusion Our preliminary data suggest that fluid responsiveness can be assessed not by LVEDV but also by SVV due to underlying cardiovascular pathophysiology in patients with ESRD.
Journal of Pain Research | 2017
Yoshiko Onodera; Megumi Kanao-Kanda; Hirotsugu Kanda; Tomoki Sasakawa; Hiroshi Iwasaki; Takayuki Kunisawa
Purpose Pregnancy-induced analgesia develops during late pregnancy, but it is unclear whether this analgesia is effective against neuropathic pain. The detailed molecular mechanisms underlying pregnancy-induced analgesia have not been investigated. We examined the antinociceptive effect of pregnancy-induced analgesia in a neuropathic pain model and the expression of tumor necrosis factor (TNF)-α, glial fibrillary acidic protein (GFAP), Iba-1, and c-Fos in the spinal dorsal horn just before parturition. Materials and methods Female Sprague Dawley rats (200–250 g) were randomly assigned to one of four groups (pregnant + chronic constriction injury [CCI]; pregnant + sham injury; not pregnant + CCI; and not pregnant + sham injury). Separate groups were used for the behavioral and tissue analyses. CCI of the left sciatic nerve was surgically induced 3 days after confirming pregnancy in the pregnancy group or on day 3 in the not pregnant group. The spinal cord was extracted 18 days after CCI. TNF-α, GFAP, Iba-1, and c-Fos expression levels in the spinal dorsal horn were measured by Western blot analysis. Mechanical threshold was tested using von Frey filaments. Results The lowered mechanical threshold induced by CCI was significantly attenuated within 1 day before parturition and decreased after delivery. TNF-α expression in CCI rats was decreased within 1 day before parturition. Further, GFAP, Iba-1, and c-Fos expression in the spinal dorsal horn was reduced in the pregnant rats. Serum TNF-α in all groups was below measurable limits. Conclusion Our findings indicate that pregnancy-induced analgesia suppresses neuropathic pain through reducing spinal levels of TNF-α, GFAP, Iba-1, and c-Fos in a rat model of CCI.
Journal of Cardiothoracic and Vascular Anesthesia | 2017
Hirotsugu Kanda; Yuji Hirasaki; Takafumi Iida; Megumi Kanao-Kanda; Yuki Toyama; Takashi Chiba; Takayuki Kunisawa
End-stage renal disease (ESRD) is associated with significant alterations in cardiovascular function; homeostasis of body fluid, electrolytes, and acid-base equilibrium; bone metabolism, erythropoiesis; and blood coagulation. The prevalence of ESRD is increasing rapidly worldwide, as is the number of patients requiring surgery under general anesthesia. Patients with ESRD have significantly higher risks of perioperative morbidity and mortality due to multiple comorbidities. The perioperative management of patients with ESRD under general anesthesia therefore requires special considerations and a careful multidisciplinary approach. In this review, the authors summarize the available literature to address common issues related to patients with ESRD and discuss the best perioperative approach for this patient subgroup.
Journal of Cardiothoracic and Vascular Anesthesia | 2017
Yuki Toyama; Hirotsugu Kanda; Kotaro Igarashi; Hajime Iwasaki; Megumi Kanao-Kanda; Takafumi Iida; Takayuki Kunisawa
OBJECTIVE To evaluate the morphologic changes of the mitral annulus using 3-dimensional transesophageal echocardiography during heart displacement to expose the anastomosis site in off-pump coronary artery bypass surgery (OPCAB). DESIGN Prospective case series. SETTING Single center, university hospital. PARTICIPANTS The study comprised 34 consecutive patients who underwent OPCAB of the left circumflex artery (LCX) and the right coronary artery (RCA). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Mitral annulus parameters were measured using the Mitral Valve Quantification program after sternotomy (physiologic position) and during displacement of the heart to expose the LCX (LCX position) and the RCA (RCA position). The height of the mitral annulus was significantly lower in the LCX (5.76 ± 0.90 mm) and RCA (5.92 ± 0.97 mm) positions than in the physiologic position (6.96 ± 0.99 mm; both p < 0.0001). The percent change in the height of the mitral annulus was significantly greater in the mitral regurgitation group than in the mitral regurgitation nondeterioration group when in the LCX (-16.3% ± 6.0% v -11.9% ± 3.3%, p = 0.0203) and RCA (-16.9% ± 6.3% v -12.1% ± 3.8%, p = 0.0207) positions. The anteroposterior and intercommissural diameters, annulus perimeter, and surface area of the mitral annulus did not differ significantly among all heart positions. CONCLUSIONS The mitral annulus flattened and lost its saddle shape without expanding while in the LCX and RCA positions. The greater percent change in the height of the mitral annulus may aggravate mitral regurgitation.
Journal of Cardiothoracic and Vascular Anesthesia | 2017
Hirotsugu Kanda; Hiroto Kitahara; Yuki Toyama; Megumi Kanao-Kanda; Takayuki Kunisawa; Hiroyuki Kamiya
NOTE. There was no significant difference in MBR between IABP with central ECMO and only central ECMO. IABP did not impede cerebral blood flow in combination with central ECMO. Abbreviations: AU, arbitrary units; BIS, bispectral index; CVP, central vein pressure; ECMO, extracorporeal membrane oxygenation support; IABP, intraaortic balloon pump; MBR, mean blur rate; rSO2, regional oxygen saturation; SpO2, peripheral capillary oxygen saturation. To the Editor:
Therapeutics and Clinical Risk Management | 2017
Izumi Sato; Hirotsugu Kanda; Megumi Kanao-Kanda; Atsushi Kurosawa; Takayuki Kunisawa
We report a case of iatrogenic pneumothorax in which chest tube placement was avoided by continuous intraoperative evaluation with transthoracic ultrasonography. A 53-year-old man had undergone a subsegmentectomy. While attempting to place a central venous catheter in the right internal jugular vein after the induction of anesthesia, we identified gas absorption during the puncture and suspected a pneumothorax. Chest X-ray revealed an ~5-mm collapse of the right lung apex. Tension pneumothorax was a concern during surgery because of the long-term positive pressure ventilation, but we decided to start the operation without preventative chest tube placement. During the operation, we regularly observed the midclavicular line of the second intercostal space using ultrasound. The operation was completed uneventfully. In this case, we effectively utilized ultrasound and avoided preventive chest tube placement and the associated complications. Transthoracic ultrasonography could be performed easily and continuously during surgery and was effective for evaluating the progression of an intraoperative pneumothorax.
Therapeutics and Clinical Risk Management | 2016
Megumi Kanao-Kanda; Hirotsugu Kanda; Osamu Takahata; Takayuki Kunisawa
Gabapentin, an anticonvulsant agent, is now often used for the treatment of neuropathic pain all over the world. It is unclear whether the combined use of gabapentin, sodium valproate, and flunitrazepam results in enhancement of the side effect, a gait disturbance. A 60-year-old man was taking oral sodium valproate for symptomatic epilepsy after a brain contusion and flunitrazepam to relieve insomnia. Oral gabapentin therapy was started for suspected neuropathic pain. Although the initial dose of oral gabapentin (200 mg) relieved the pain, the lower extremities became weak, resulting in a gait disturbance. The therapy was restarted with a halved dose, and this resolved the gait disturbance and relieved the pain.
Therapeutics and Clinical Risk Management | 2015
Megumi Kanao-Kanda; Takayuki Kunisawa; Kunihiko Yamamoto; Hirotsugu Kanda; Hiroshi Iwasaki
Dear editor Insufficient pulmonary blood flow through a right ventricle-to-pulmonary artery conduit following the Norwood procedure is remediable by adding a modified Blalock–Taussig shunt (MBTS).1 First, however, perioperative hypoxemia must be managed. Venovenous extracorporeal membrane oxygenation (VV-ECMO) is likely to be a useful method for respiratory support in such cases.2,3 We present the case of a 2-month-old patient with graft dysfunction after the Norwood procedure who underwent MBTS with VV-ECMO support.
Journal of Cardiothoracic and Vascular Anesthesia | 2018
Hirotsugu Kanda; Yuki Toyama; Akane Oshiro; Yoshiko Onodera; Megumi Kanao-Kanda; Hiroyuki Kamiya; Takayuki Kunisawa