Biomedical subjects

K Higa

Publications and source records attributed to K Higa.

At least 37 records · Page 2Linked to original sources

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↗

PubMed1999

[Anesthetic management of a patient with hypohidrotic ectodermal dysplasia].

Hypohidrotic ectodermal dysplasia (HED) is a rare congenital anomaly complex characterized by hypodontia, hypotricosis and hypohidrosis. There have been only a few reports of anesthetic management of patients with HED. We managed a 20-year-old man with HED, who underwent debridement and skin grafting under epidural anesthesia, without untoward events. Potential problems in anesthetic management of patients with HED are also discussed.

Adult↗

PubMed1999

[Corneal abrasion after general anesthesia despite application of eye patches].

A 37-year-old man with exophthalmos underwent resection of the left apical peridontal cyst under general anesthesia. Eye patches (Opticlude) without adherence to epibulbar area were used during anesthesia and surgery. At the end of the surgery, his left eyelid was noted to be incompletely closed. His left bulbar conjunctiva showed marked conjestion with severe pain. Staining with fluorescein dye demonstrated corneal abrasion in the lower third of the left eye. The corneal abrasion healed in two days after topical treatment.

Adult↗

PubMed1998

Holt-Oram syndrome.

Holt-Oram syndrome (HOS) is a rare disorder characterized by congenital anomalies of the upper limbs and heart. Cardiac arrhythmias are common in patients with HOS. We successfully managed a 24-yr-old woman with HOS who underwent laparoscopic ovarian cystectomy. Potential problems in the anaesthetic management of patients with HOS are discussed.

Adult↗

PubMed1998

Management of a patient with familial amyloid polyneuropathy type I with lumbar epidural anaesthesia.

Familial amyloid polyneuropathy (FAP) type I is a rare disease characterized by sensorimotor polyneuropathy, and autonomic nervous system and cardiac conduction system dysfunction. Severe bradyarrhythmia and hypotension may occur during anaesthesia and surgery in patients with the FAP type I. Only one report has been published of a patient with FAP type I who was managed with epidural anaesthesia. The present authors report a 38-year-old Japanese man with a permanent pacemaker because of advanced FAP type I who underwent rotation flap of the gluteus maximus muscle to cover a trophic ulcer in the sacral region under lumbar epidural anaesthesia. Ten millilitres of adrenaline (1:200,000) was injected around the ulcer prior to surgical manipulation. Neither bradycardia nor hypotension developed during the procedures. The haemodynamic changes under lumbar epidural anaesthesia in FAP type I are discussed.

Adult↗

PubMed1997

Mexiletine-induced severe skin eruption, fever, eosinophilia, atypical lymphocytosis, and liver dysfunction.

A 64-year-old man developed a severe generalized pruritic morbilliform skin eruption, fever, eosinophilia, atypical lymphocytosis, and liver dysfunction 30 days after ingestion of mexiletine, a sodium channel blocker, prescribed to treat postherpetic neuralgia. Following intravenous dexamethasone, body temperature normalized the next day. However, the skin eruption did not disappear completely for 4 weeks. The patch test was positive for mexiletine. Clinical features and the result of patch test indicated that the patient developed hypersensitivity syndrome, a severe adverse cutaneous drug reaction, caused by mexiletine. We propose that mexiletine be added to the list of drugs that can cause severe adverse cutaneous drug reactions and that patients receiving mexiletine be warned to stop taking the drug immediately if a skin eruption occurs.

Anti-Arrhythmia Agents↗

PubMed1997

Urban teleradiology in Hong Kong.

We investigated four major teleradiology programmes in Hong Kong. We analysed the overall organizational background of each programme, the context of its implementation, the choice of technology and the decision-making process, and the subsequent dissemination of the technology. Our review suggests that the success of a telemedicine programme is contingent not only on good technology but also on effective management of issues pertaining to human and organizational factors. At the departmental level, the context of the implementation of telemedicine is crucial. At the institutional level, success depends on planning and management. At the professional level, continued education, periodic meetings and seminars are all effective means of promoting telemedicine among health-care professionals and administrators. At the national level, the Hong Kong experience suggests that telemedicine can be effectively developed by starting with urban-based programmes.

Hong Kong↗

PubMed1997

Incidence of dogs possessing red blood cells with high K in Japan and East Asia.

The phenotype of high K (HK) red blood cells, which is an autosomal recessive, was found in dog groups from 10 of 13 breeds or populations in Japan. The incidence of HK was 26 to 38% in the San'in-Shiba, Shinshu-Shiba and Akita breeds, and the gene frequencies of HK ranged from 0.513 to 0.612. The highest incidence (42%) was found in the Jindo breed from Korea, and the gene frequency was 0.652. Two other groups from Korea also possessed this HK variation. However, although HK cells were not found in dogs from Taiwan, Indonesia, Mongolia and Sakhalin, Russia, the HK phenotype is clearly distributed now throughout Japan and Korea.

Animals↗

PubMed1996

[Anesthetic management of a patient with tuberous sclerosis].

Tuberous sclerosis is characterized by facial angiofibromatosis, epilepsy, and mental retardation. There have been only a few reports of anesthetic management of patients with tuberous sclerosis. We managed a 22-year-old patient with tuberous sclerosis using nitrous oxide (67%) in oxygen supplemented with fentanyl and midazolam. There were no untoward events related to anesthesia and surgery. Problems in managing patients with tuberous sclerosis are also discussed.

Adult↗

PubMed1996

[Myoglobinuria following anesthesia with enflurane and succinylcholine in an asthmatic child on theophylline].

An 8-year-old asthmatic child on theophylline was anesthetized with enflurane in nitrous oxide and oxygen. He developed a generalized muscle rigidity after intravenous succinylcholine. Although the maximum rectal temperature was 37.9 degrees C, a marked elevation in muscle-derived enzymes and myoglobinuria were observed. The relations among theophylline which is a derivative of xanthines, inhalation anesthetics, and myoglobinuria are discussed.

Anesthesia, Inhalation↗

PubMed1995

Continuous epidural infusion of local anesthetics and shorter duration of acute zoster-associated pain.

OBJECTIVE: The purpose of this study was to investigate the effects of continuous epidural blockade on acute zoster-associated pain, compared with intermittent epidural blocks. DESIGN: The design was a retrospective, nonrandomized study. SETTING: The study was conducted at a university hospital in Japan from 1982 through 1992. PATIENTS: A total of 178 otherwise healthy patients hospitalized with moderate or severe herpes zoster lesions. INTERVENTIONS: Group A (n = 66) had intermittent epidural blocks using 1% mepivacaine, 4-6 ml, three to six time daily; group B (n = 43) were given intermittent epidural blocks and parenteral acyclovir (500 mg/day) or vidarabine (600 mg/day) for 5 days; group C (n = 69) were administered a continuous epidural 0.5% bupivacaine infusion (0.3-1.0 ml/h) for approximately 2 weeks and antiviral agents followed by intermittent blocks. MAIN OUTCOME MEASURES: The number of treatment days was used as the outcome measure. RESULTS: The length of treatment was significantly shorter in group C than in groups A or B. For moderate lesions the means (days) were 36.2 [95% confidence interval (CI), 31.4-41.7), 45.6 (95% CI, 34.0-61.4), and 26.8 (95% CI, 22.3-32.3) for groups A, B, and C, respectively (p < 0.01). For severe lesions they were 73.3 (95% CI, 55.1-97.7), 81.7 (95% CI, 59.1-113.0), and 44.9 (95% CI, 35.2-57.3) for groups A, B, and C, respectively (p < 0.01). CONCLUSIONS: Continuous epidural blockade for patients with acute zoster can shorten the duration of treatment and may reduce the incidence of postherpetic neuralgia.

Anesthesia, Epidural↗

PubMed1995

[Chronological study concerning ADL among Okinawan centenarians].

Since 1976 medicobiological and sociological surveys have been carried out upon centenarians in Okinawa. Recently dementia and disability have increased among centenarians. In order to determine the statistical significance, ADL (Activities of Daily Living) scores among Okinawan centenarians were compared; 43 subjects were studied from the 1970's (1976-1980), 99 subjects from the 1980's (1986-1988), and 109 subjects from the 1990's (1992-1994). ADL scores of each centenarian were recorded by the same researchers at the University of the Ryukyus Hospital, based on observation and examination of the centenarians where they lived. Five categories of self sufficiency were defined; completely independent, independent but slow, independent with difficulty, partially dependent, and completely dependent. There were seven physical tasks scored; taking meals, bowel and bladder continence, ability to rise from a toilet, ability to stand, extent of general activities, ability to bathe, and ability to dress oneself. Their sensory functions (auditory acuity and eyesight) and cognitive abilities (comprehension and self-expression) were also scored. Declining rates of total ADL scores were more marked between the 1970's and the 1980's than between the 1980's and the early 1990's. It was also more remarkable in institutionalized centenarians than in centenarians living at home. Decline in physical activities was more distinct in institutionalized than in home-living centenarians. On the other hand, cognitive abilities declined more among centenarian living at home than among institutionalized centenarians. The population of centenarians has increased 23 times over the past 22 years in Okinawa. Human life span has been remarkably extended by advanced medical technology, physically easier life style, and improvement in overall social welfare.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗

PubMed1995

[Red blood cell parameters of healthy centenarians].

Since the number of centenarians is increasing rapidly in recent years, the establishment of normal ranges in red blood cell (RBC) parameters for healthy centenarians is necessary for diagnostic criteria of anemia. The subjects were 129 centenarians consisting of 27 men (17; healthy, 69; low ADL) and 102 women (33; healthy, 69; low ADL) after excluding centenarians with diseases affecting RBC parameters. The t test was used for statistical evaluation. The mean RBC count for healthy centenarian men was 403 +/- 54.7 x 10(4)/microliters; hemoglobin (Hb) level, 12.4 +/- 1.3 g/dl; hematocrit (Hct), 38.2 +/- 3.9%; MVC, 95.3 +/- 5.3 fl; MCH, 31.4 +/- 2.2 pg; and MCHC, 32.1 +/- 1.1%. Comparable results for healthy centenarian women were as follows: 375 +/- 43.9 x 10(4)/microliters, 11.6 +/- 1.2 g/dl, 36.3 +/- 3.6%, 97.1 +/- 5.3 fl, 31.0 +/- 2.3 pg, and 32.0 +/- 1.3%, respectively. The mean Hb for healthy centenarian women was significantly lower than that for healthy centenarian men. The mean RBC, Hb and hematocrit values for low ADL-centenarian men were lower than the comparable values for healthy centenarian men. Conversely, the mean MCV value for low ADL-centenarian men was higher than that for healthy centenarian men. There was no difference in any RBC parameter between healthy centenarian women and low ADL-centenarian women. In addition, there was no difference in any RBC parameter between centenarian women living in their own homes and those living in old-aged homes. This study demonstrated the normal ranges of RBC parameters for healthy centenarians, and lower RBC, Hb, and Hct values for low ADL-centenarian men.

Activities of Daily Living↗

PubMed1995

[Rehabilitation in rheumatoid arthritis (RA) patients--assessment of effects of rehabilitation based on activities of daily living (ADL)].

The 37 hospitalized RA patients undergoing rehabilitation (for 4 weeks) were evaluated on effects of rehabilitation by comparing scores of ADL at the time of admission and discharge. Items of ADL were composed of 32. Items of ADL which were likely to be disabled were related to those of ADL which were influenced by rehabilitation (r = 0.7412, p < 0.01). From this result, 11 items of ADL which were likely to be disabled and influenced by rehabilitation could be selected in order. Usefulness of these selected items of ADL on evaluation of rehabilitation was admitted.

Activities of Daily Living↗