PubMed Health⌕ Search

Biomedical subjects

H Kohase

Publications and source records attributed to H Kohase.

9 recordsLinked to original sources
PubMed2006

Delirium during intravenous sedation with midazolam alone and with propofol in dental treatment.

A 62-year-old man visited our clinic for dental implantation under intravenous sedation. He demonstrated increased psychomotor activity and incomprehensible verbal contact during intravenous sedation. Although delirium caused by midazolam or propofol in different patients has been reported, the present case represents a delirium that developed from both drugs in the same patient, possibly because of the patient's smaller tolerance to midazolam and propofol.

Alveolar Ridge Augmentation↗
PubMed2004

Application of a mandibular nerve block using an indwelling catheter for intractable cancer pain.

We report a case in which a mandibular nerve block using an indwelling catheter was employed for pain management in a terminal case of orofacial cancer. The patient was a 74-year-old female weighing 27 kg. She had a 27-month history of mouth floor and tongue cancer. The cancer recurred and spread to bilateral face and neck. The severest pain mainly originated from the right mandibular region. Two steps of pain relief were performed for the patient. First, pain control using 1% lidocaine or 0.25% bupivacaine administered intermittently or continuously through an indwelling catheter in the mandibular nerve was performed for 1 week to estimate the amount of pain relief thereby obtained. Second, a neurolytic block was applied to the mandibular nerve through the catheter. After the neurolytic block, the total dosage of morphine and diclofenac remained unchanged for 2 months. We conclude from the present case that this technique is an excellent means of obtaining long-term pain control in patients with intractable orofacial cancer pain.

Aged↗
PubMed2003

Decreased bispectral index as an indicator of syncope before hypotension and bradycardia in two patients with needle phobia.

We report two cases who exhibited a decrease in their bispectral index (BIS) score, associated with syncope during venipuncture in patients with suspected needle phobia. In case 1, the reduction in BIS score occurred during the development of hypotension and bradycardia and may well have been caused by cerebral hypoperfusion. In case 2, the patient lost consciousness with decreasing BIS score before hypotension and bradycardia; this patient's condition could not be completely explained by cerebral hypoperfusion as a result of a vasovagal reflex because the patient's blood pressure and heart rate remained normal during the syncopal episode.

Adult↗
PubMed2000

Benign hyperthermia following prolonged TIVA with propofol.

PURPOSE: Propofol is widely used for general anesthesia because of its rapid onset and recovery. We had four cases that had higher body temperatures toward the end of anesthesia. The etiology of the hyperthermia is discussed. CLINICAL FEATURES: Four patients (three male, one female, 22-26 yr of age, weighing 53-57 kg) with facial deformities were anesthetized with propofol infusion (3-10 mg x kg(-1) x hr(-1)) and fentanyl (400-1,300 microg) without nitrous oxide, immobilized with vecuronium bromide (18-37 mg) or pancuronium bromide (31 mg). In order to reduce blood loss and improve the surgical view, tri-nitro-glycerin (TNG) was used in all cases. Osteotomy of maxilla and mandible or sagittal split ramus osteotomy of mandible was successfully performed. Although their body temperatures were normal preoperatively and stable during the operation, toward the end of anesthesia (one hour), they increased to over 38 degrees C. The room temperature was decreased and the water blanket on the operating table was also decreased. In addition, cool crystalloid solution was infused. Body temperature returned to normal in the ward and no complications due to the high temperature were seen postoperatively. It is thought that lighter anesthesia was masked by continuous infusion of propofol and TNG-induced hypotension and that benign hyperthermia occurred toward the end of anesthesia. CONCLUSION: Propofol reduces blood pressure, which suggests deep anesthesia. However, care must be taken to maintain the optimum depth of anesthesia during propofol anesthesia, especially when deliberate hypotensive anesthesia is induced.

Adult↗
PubMed2000

[Dental treatment for the handicapped by a combination of public community, dental association and university hospital--a system of Suginoki Dental Clinic].

Suginoki Dental Clinic, which is managed by Suginami Dental Association, financially supported by Suginami City, and technically assisted by the University Hospital, Tokyo Medical and Dental University, was established for dental treatment of handicapped persons living in Suginami City, Tokyo who are difficult to be treated by private practitioners. It has one full-time dentist, 12 part-time dentists, two dental hygienists, one nurse, and one clerk; one of the part-time dentists practices twice a week there. Since December 1994, 406 patients visited the clinic and the total cases was 9,273 in December 1999; 99 cases were mentally retarded, 36 autism, and 30 epileptic patients in the younger group; and 65 cases were cerebrovascular disease and 27 cardiac malfunction patients in the older group. Almost all the patients needed special care such as monitoring, intravenous sedation, nitrous oxide sedation, and general anesthesia. Four cases underwent general anesthesia, and no complication was seen among the cases. It was concluded that the clinic has been successful due to a good relationship among the Dental Association, Suginami City, and the dental hospital.

Community Dentistry↗
PubMed1998

[Transient global amnesia after general anesthesia].

A 61 year old male patient with left mandibular cyst, received marsupialization of the left mandible under general anesthesia. Four hours after the end of anesthesia, his memory for the past 4 months and short term memory plastisity were impaired. No neurological abnormalies were found at that time. On the 2nd postoperative day, he recovered his lost memory for the past 4 months. The memory of events between 6 hours before operation and next morning, however, remained lost. It is suggested that the memory disorder is the TGA due to various causes including transient hypertension, operative stress, postoperative pain and diazepam.

Adjuvants, Anesthesia↗
PubMed1995

Dual brain stem projection from the cortical masticatory area in guinea-pig.

The cortical masticatory area (CMA) in the guinea pig is subdivided into the anterior and posterior parts (A-CMA and P-CMA), based on the pattern of the CMA-induced rhythmical digastric EMG burst and the cytoarchitecture. The anterograde tracing of horseradish peroxidase from the A-CMA and P-CMA revealed, in addition to a common projection to the region around the trigeminal motor nucleus and the parvicellular reticular formation bilaterally, a massive projection to the ipsilateral superior colliculus (SC) from the A-CMA but not from the P-CMA. The results suggest a dual brain stem projection system from the CMA: the direct pyramidal route from the P-CMA and the SC-mediated indirect route from the A-CMA.

Animals↗
PubMed1993

Resetting of cortically induced rhythmical jaw movements by stimulation of the cerebellar interpositus nucleus in the guinea pig.

Effects of stimulation of the cerebellar interpositus nucleus on fictive rhythmical jaw movements induced by stimulation of the cortical masticatory area were studied in ketamine-anesthetized, paralyzed guinea pigs. A short pulse-train applied to the interpositus nucleus caused a phase shift in cortically induced rhythmical jaw movements. A phase transition curve indicated that interpositus stimulation can reset the cortically induced rhythmical jaw movements.

Animals↗