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Biomedical subjects

K Higa

Publications and source records attributed to K Higa.

At least 19 recordsLinked to original sources
PubMed2004

Use of epidural anaesthesia for surgery in a patient with Kennedy's disease.

Use of neuraxial block in a patient with motor neuron disease is controversial. We describe the anaesthetic management by epidural anaesthesia of a patient with Kennedy's disease, a rare lower motor neuron disease characterized by progressive weakness and wasting of limbs and bulbar muscles. The perioperative course was uneventful, and there was no exacerbation of neurologic signs or symptoms. We suggest that a patient with Kennedy's disease may be successfully managed by epidural anaesthesia for surgical internal urethrotomy.

Anesthesia, Epidural↗
PubMed2003

Generalized synchronization of chaos in He-Ne lasers.

We experimentally demonstrate synchronization of chaos in one-way coupled He-Ne lasers with optical feedback. We observe different types of synchronization such as identical synchronization, inverse synchronization, and random amplification. These dynamics are maintained only for a short duration of several hundred milliseconds. We also observe generalized synchronization of chaos by using one master and two slave lasers. The generalized synchronization is achieved for a long duration of tens of seconds under injection locking. The generalized synchronization is always maintained while the injection locking is achieved.

Journal Article↗
PubMed2003

Effect of continuous low-dose intravenous diltiazem on epidural fentanyl analgesia after lower abdominal surgery.

BACKGROUND: The postoperative opioid-sparing effects of systemic L-type calcium channel blockers are controversial. We investigated whether the postoperative analgesic effect of epidural fentanyl was enhanced by i.v. infusion of diltiazem at a rate that would minimize any cardiovascular depressant effect. METHODS: After elective lower abdominal gynaecological surgery, 30 patients were randomized to receive continuous i.v. diltiazem 1 micro g kg(-1) min(-1) (diltiazem group) or the same volume of saline (control group) for 24 h. Cumulative postoperative epidural fentanyl consumption, visual analogue scale (VAS) scores and verbal rating scores (VRS) at rest and during mobilization, sedation scores, incidence of side-effects and overall patient satisfaction were assessed. RESULTS: There was no significant difference in cumulative epidural fentanyl consumption between the groups at any period. Although there were no statistically significant differences in VAS scores, VRS, sedation scores, incidence of side-effects and overall patient satisfaction, there was a trend to an increased incidence of nausea in the diltiazem group. CONCLUSIONS: Continuous i.v. infusion of diltiazem did not reduce epidural fentanyl consumption when administered at dosages having minimal haemodynamic depressant effects.

Analgesia, Epidural↗
PubMed2001

Sialogogic activity in the rat of peptides analogous to [Tyr8]-substance P in which substitutions have been made in the N-terminal amino acids.

In order to elucidate the regulatory roles for salivation of amino acids in positions 1-4 of the N-terminal region of [Tyr8]-substance P (SP), the structure-sialogogic activity correlations of various synthetic octa- to undecapeptides replaced in positions 1-4 of [Tyr8]-SP with each of 19 common amino acids, one by one, and with the same sequence of the C-terminal hepatapeptide as that of [Tyr8]-SP, were studied in the submandibular glands of rats after intraperitoneal injection. Each of 19 octa-, nona-, deca- and undecapeptides with replaced amino acids and a penta- to decapeptide with the progressive elimination of the N-terminal portion were newly synthesized by the multipin peptide method. All octa- to undecapeptides replaced with each of 19 common amino acids in positions 1-4 had sialogogic activities. In 19 octa- and decapeptides in which P4 and P2 had been replaced, four and three replacements, respectively, had significantly increased secretory activities. In contrast, in 19 nonapeptides in which K3 had been replaced, none had significantly increased secretory activities. Furthermore, in 19 undecapeptides in which R1 had been replaced, most replacements had significantly increased or equipotent activities for fluid secretion. It is concluded that amino acids in the N-terminal region of various tachykinins may not need to be strictly conserved and that amino acid residues in the N-terminal portion, R1 in particular and P2, may strongly inhibit secretory activity.

Amino Acid Substitution↗
PubMed2001

GSH depletion, K-Cl cotransport, and regulatory volume decrease in high-K/high-GSH dog red blood cells.

Thiol reagents activate K-Cl cotransport (K-Cl COT), the Cl-dependent and Na-independent ouabain-resistant K flux, in red blood cells (RBCs) of several species, upon depletion of cellular glutathione (GSH). K-Cl COT is physiologically active in high potassium (HK), high GSH (HG) dog RBCs. In this unique model, we studied whether the same inverse relationship exists between GSH levels and K-Cl COT activity found in other species. The effects of GSH depletion by three different chemical reactions [nitrite (NO(2))-mediated oxidation, diazene dicarboxylic acid bis-N,N-dimethylamide (diamide)-induced dithiol formation, and glutathione S-transferase (GST)-catalyzed conjugation of GSH with 1-chloro-2,4-dinitrobenzene (CDNB)] were tested on K-Cl COT and regulatory volume decrease (RVD). After 85% GSH depletion, all three interventions stimulated K-Cl COT half-maximally with the following order of potency: diamide > NO(2) > CDNB. Repletion of GSH reversed K-Cl COT stimulation by 50%. Cl-dependent RVD accompanied K-Cl COT activation by NO(2) and diamide. K-Cl COT activation at concentration ratios of oxidant/GSH greater than unity was irreversible, suggesting either nitrosothiolation, heterodithiol formation, or GST-mediated dinitrophenylation of protein thiols. The data support the hypothesis that an intact redox system, rather than the absolute GSH levels, protects K-Cl COT activity and cell volume regulation from thiol modification.

Animals↗
PubMed2001

[Pseudohypoxemia in a patient with chronic myeloid leukemia and splenomegaly].

A 35-year-old man with chronic myeloid leukemia whose peripheral leukocyte count was 18.6 x 10(4).mm-3 underwent splenectomy. Perioperative arterial blood gas analysis showed lower oxygen saturations than those measured with pulse oximetry. The findings suggested pseudohypoxemia because of marked leukocytosis.

Adult↗
PubMed2001

[Recurrence of bullous pemphigoid after surgery: report of a case].

We report a 38-year-old woman with myoma uteri and bullous pemphigoid controlled by oral prednisolone (7.5 mg.day-1). She underwent transabdominal hysterectomy under epidural anesthesia using mepivacaine supplemented with intravenous midazolam and butorphanol, without untoward event. On the postoperative day 2, recurrence of bullous pemphigoid was noted. The skin lesion of pemphigoid was improved after increasing the prednisolone dose up to 60 mg a day.

Adult↗
PubMed2001

[Anesthetic management of a patient with tetanus using epidural anesthesia].

A 75-year-old woman with breast cancer complicated with tetanus was scheduled for mastectomy. Since severe bradycardia (17 beats.min-1) was detected by preoperative Holter monitoring, a temporary pacing catheter was inserted. She underwent mastectomy under general anesthesia using propofol combined with thoracic epidural anesthesia. She also received postoperative thoracic epidural block. Her perioperative heart rate was 80-105 beats.min-1 and the rhythm was sinus. There was no marked perioperative cardiovascular derangement.

Aged↗
PubMed2001

The roles of the N-terminal portions of various tachykinins in promoting salivation.

OBJECTIVES: In order to determine the active sites for salivation of various tachykinins, the regulatory roles of the N-terminal portion of various newly-synthesized tachykinins were studied after i.p. injection of rats using the submandibular glands as model organs. METHODS: N-shortened oligopeptides from kassinin, eledoisin, neurokinins A (NKA) and NKB were synthesized by the multipin peptide synthesis method. Amino acids were eliminated one by one to form octa- to undeca-peptides adjoining the inactive or less active heptapeptides and various heptapeptides, in which an amino acid in position 8 (Xaa8), numbering as in an undecapeptide, was replaced with Tyr, Phe, Ile or Val. RESULTS: The N-terminal amino acids in positions 1 to 4 could be activators or inhibitors, depending on whether the C-terminal heptapeptide was inactive or less active. The Xaa8 residue, in combination with amino acids in positions 5 and 6, seemed to be very important in determining the sialogogic activity of a heptapeptide. The discrimination between NKA and NKB appeared due to the N-terminal amino acid sequence in positions I to 4 including Phe or Ser in position 6. CONCLUSIONS: It is concluded that the N-terminal amino acids in positions I to 4 serve as either activators or inhibitors depending upon the sialogogic activity of the C-terminal heptapeptide, in which particular amino acids in positions 5, 6 and 8 regulate its activity.

Analysis of Variance↗
PubMed2000

Molecular cloning and expression of aquaporin 1 [correction of aquapolin 1] (AQP1) in dog kidney and erythroblasts.

Complementary DNA of the water channel aquaporin 1 (AQP1) was cloned from dog kidney and erythroblasts. The cDNA amplified from mRNA in dog kidney was 816 bp, the same as that in bovines, but longer by 6 bp than that in humans, mice and rats. The 235-bp fragment cDNA amplified from the mRNA in dog erythroblasts, which was differentiated from peripheral blood, was completely identical to the corresponding sequence of cDNA from the dog kidney. Thus, mature red blood cells from dog may have AQP1 in their cell membranes. The amino acid sequence in dog AQP1 was 91-94% identical to that in the other species mentioned above. Dog AQP1 has six predicted transmembrane domains, two NPA motifs, one mercury-sensitive site and four consensus phosphorylation sites, the same as the other species. However, dog and bovine AQP1 have only one N-glycosylation site, while two glycosylation sites were found in human and rodent AQP1. Xenopus oocytes injected with the mRNA of the dog AQP1 exhibited high water permeability in a hyposmotic medium. Thus, dog AQP1 performs water transport the same as in the other species.

Amino Acid Sequence↗
PubMed2000

[Pain treatment of herpes zoster].

Reactivation of varicella-zoster virus causes herpes zoster, which accompanies severe pain in most patients. Treatment of pain is mandatory in herpes zoster. Pain caused by herpes zoster is classified as acute herpetic pain and postherpetic neuralgia. The mechanisms and treatments for the two pains are different. Acute herpetic pain is inflammatory and nociceptive one. Treatment for acute herpetic pain includes antiviral drugs, non-steroidal anti-inflammatory drugs, opioids, and sympathetic nerve blockade. Postherpetic neuralgia is a neuropathic pain and requires antidepressants, anticonvulsants, and anti-arrhythmic drugs to relieve the pain. Topical application of capsaicin and local anesthetics may benefit some patients with postherpetic neuralgia.

Aged↗
PubMed2000

[Anesthetic management of a patient with a huge ovarian tumor].

We managed a patient with a huge ovarian tumor (15 kg). The patient was a 50-year-old woman and could not take the supine position because of the tumor causing respiratory embarrassment. An epidural catheter was inserted 3 cm cephalad via the Th 11-12 interspace in the right lateral position. Three milliliters of 1% mepivacaine was injected epidurally for test dose and produced hypesthesia of Th 9-12 five min after the injection. Additional 3 ml of 1% mepivacaine was injected epidurally, which widened the hypesthesia to Th 5-L 2. Intra-arterial pressure was monitored continuously. Under epidural anesthesia without sedation, 11,000 ml of fluid was suctioned slowly from the cyst in 20 min, during which time remarkable hemodynamic derangement did not occur. The patient was turned into the supine position and the trachea was intubated. Laparotomy was performed under general anesthesia. During the surgery, respiratory and hemodynamic conditions were stable. On the following day, chest radiography demonstrated an abnormal shadow in the lower lobe of the right lung. It disappeared the next day without any treatment. Anesthetic management of patients with huge abdominal tumor is also discussed.

Adenocarcinoma, Clear Cell↗
PubMed2000

[Extrapyramidal reactions after epidural droperidol].

We report two patients who developed extrapyramidal reactions after epidural droperidol given to prevent postoperative nausea and vomiting. The reactions may have been related to interactions of drugs given perioperatively. One patient had been taking amlodipine and amitriptyline preoperatively, capable of causing extrapyramidal reactions, and developed akathisia after 2.5 mg of droperidol given epidurally. The other patient had received 1.5 mg of prophylactic epidural droperidol and 10 mg of metoclopramide for postoperative nausea and vomiting, and developed acute dystonia shortly after 0.5 mg of intravenous droperidol.

Adult↗
PubMed2000

[Anesthetic management of tracheal stent insertion under total intravenous anesthesia--a report of two cases].

Tracheal stent insertion is a useful method for patients with malignant tracheal stenosis. Expandable metal stents were inserted in two patients with severe dyspnea due to tracheal stenosis caused by lung cancer and esophageal cancer. The tracheas were intubated after spraying the pharynx with 4% lidocaine solution. The respiration was assisted. Anesthesia was maintained by intravenous propofol. There were no episodes of coughing during and after the procedure.

Aged↗
PubMed1999

[Efficacy of the cuffed oropharyngeal airway in spontaneously breathing patients].

A cuffed oropharyngeal airway (COPA) was used in 20 adult patients for airway management under epidural and brachial plexus block supplemented with light general anesthesia. Insertion of a COPA was successful at first attempt in 17 of 20 patients (85%). Sore throat developed in one patient (5%). Aspiration regurgitation, or laryngospasm was not observed. We conclude that a COPA can be an efficient airway device is spontaneously breathing patients under anesthesia.

Adult↗