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Biomedical subjects

K Higa

Publications and source records attributed to K Higa.

At least 55 records · Page 3Linked to original sources
PubMed1995

Trimetaphan may cause coronary artery spasm.

We describe a patient in whom possible coronary artery spasm occurred during the infusion of trimetaphan. A 55-year-old man with a meningioma was scheduled for surgical excision of the tumour. He denied any previous history of chest pain. Anaesthesia was maintained with nitrous oxide (67%) in oxygen. The blood pressure before commencement of the surgery was 114/70 mmHg, and the pulse rate was 60 beats min-1. The blood pressure rose to 152/94 mmHg (the pulse rate to 62 beats min-1) during incision of the scalp, and intravenous infusion of trimetaphan was initiated. The blood pressure gradually decreased to 113/58 mmHg (the pulse rate 64 beats min-1) 10 min after start of this infusion, and premature ventricular contractions were evident on the electrocardiogram. Trimetaphan was withheld, and lignocaine was given intravenously. The premature ventricular contractions disappeared but ST segments were elevated. Glyceryl trinitrate was then infused intravenously. The ST segments remained elevated for 5 min, were depressed for 2 min and finally became isoelectric. There were no wide swings in blood pressure or pulse rate during the event. Post-operative laboratory examination revealed no evidence of myocardial infarction. Recovery of the patient was uneventful.

Adjuvants, Anesthesia↗
PubMed1994

Ras-dependent signal transduction is indispensable but not sufficient for the activation of AP1/Jun by PKC delta.

Modulation of gene expression by 12-O-tetradecanoylphorbol-13-acetate (TPA) is thought to be mediated by protein kinase C (PKC), a major cellular receptor for TPA. We confirm this by showing that the overexpression of PKC delta enhances the TPA induction of the TRE-tk-CAT reporter gene in NIH3T3 cells. To investigate the mutual relationship between PKC delta- and Ras-dependent signal transduction pathways to a TRE binding transcription factor, AP1/Jun, we constructed constitutively active and dominant negative mutants of PKC delta. Activated Ras induced reporter gene expression in collaboration with overexpressed c-Jun or JunD, and this induction was insensitive to the dominant negative PKC delta. On the other hand, reporter gene expression induced by the constitutively active PKC delta was severely inhibited by dominant negative Ras, as well as by the dominant negative PKC delta. Thus, Ras activation must be indispensable for PKC delta to activate AP1/Jun. In the absence of overexpressed c-Jun or JunD, activated Ras was, however, clearly less effective than constitutively active PKC delta which showed full activation of reporter gene expression by itself. This suggests the presence of an additional, Ras-independent, signaling pathway downstream of PKC delta to activate AP1/Jun. In spite of the remarkable ability of constitutively active PKC delta to activate TRE-tk-CAT expression, this mutant suppressed cell growth.

3T3 Cells↗
PubMed1994

[Anesthetic management of a patient with Kimura's disease].

Kimura's disease is a rare disease characterized by granuloma in soft tissues with formation of lymphoid follicles infiltrated with eosinophils. It is accompanied by peripheral eosinophilia and elevated IgE in some patients. Although most patients with Kimura's disease were Japanese, we are not aware of reports about anesthetic management of this disease. We managed a 38-year-old woman with Kimura's disease who underwent a removal of a right preauricular mass with general anesthesia using oxygen, nitrous oxide (50%), and isoflurane (0.5-1.5%). There were no anesthesia-related complications. Anesthetic management of patients with Kimura's disease is also discussed.

Adult↗
PubMed1994

[Anesthesia for a patient with olivopontocerebellar atrophy].

Olivopontocerebellar atrophy (OPCA) is one of the spinocerebellar degenerative diseases. Reports of patients complicated with OPCA are scarce in anesthetic literature. We managed a 79-year-old woman with sialolithiasis of the left submandibular gland complicated with OPCA. She underwent a removal of the gland under general anesthesia using oxygen, nitrous oxide, and isoflurane (0.6-2.0%). Blood pressure decreased transiently after induction of anesthesia, but, no vasopressors were needed to maintain the blood pressure during the surgery. There were no untoward cardio-respiratory events after the surgery. Perioperative anesthetic management of patients with OPCA is also discussed.

Aged↗
PubMed1994

[Tracheal rupture in a patient intubated with a double-lumen endobronchial tube].

We report a case of tracheal rupture associated with use of a double-lumen endobronchial tube. The patient was a 58-year-old woman with metastatic carcinoma of the right upper lung lobe. Her trachea was intubated easily with a left-sided double-lumen endobronchial tube (Broncho-Cath, #35Fr). She underwent right upper lobectomy under general anesthesia using isoflurane (0.4-1.0%) and nitrous oxide (50%) in oxygen. When the lungs were inflated before closure of the chest, an air leak at the membranous part of the trachea was detected. A tracheal rupture, beginning 3 cm above the carina and 7 cm long, was noted at the membranous part of the trachea, and the cuff protruded partially from the ruptured trachea. The trachea was sutured, and a tracheostomy was carried out. Mechanisms of tracheal rupture related to double-lumen endobronchial tubes are discussed.

Anesthesia, General↗
PubMed1990

[Skin disinfectants for nerve blocks and their long-lasting antimicrobial effects].

Although epidural catheterization has many advantages in anesthesia and in the treatment of acute pain, spinal epidural abscess is a serious complication after the procedure. Since it is presumed that the epidural space is contaminated by bacteria on the skin via the space around the catheter, it seems important to clarify bacterial re-growth after application of skin disinfectant. Therefore, bacterial growths on human back 1, 2 days, and 1 week after application of disinfectants were studied in summer and winter to elucidate whether there are differences between the two seasons. Four disinfectants, 0.5% chlorhexidine in 80% ethyl alcohol (CA), 0.2% benzalkonium in 80% ethyl alcohol (BA), 10% povidone iodine (PI), and 80% ethyl alcohol (EA) were applied on the back of 76 adult healthy volunteers, and the specimens were taken by agar-contact method. The frequencies of positive cultures for bacteria were higher in summer than in winter. The frequencies of positive culture in summer after the applications of CA, BA, PI, and EA were as follows, respectively: 50%, 20%, 5%, and 40% after 1 day; 47%, 50%, 60%, and 50% after 2 days; and 82%, 82%, 70%, and 64% after 1 week. In winter, these frequencies after the application of CA, BA, PI, and EA were as follows, respectively: 0%, 0%, 18%, and 18% after 1 day; 5%, 26%, 32%, and 58% after 2 days; and 21%, 21%, 32%, and 42% after 1 week. We conclude that when an epidural catheter is in situ, more frequent skin disinfection has to be carried out, preferably by CA, in summer than in winter, since the presence of sweat on the back seems to hasten the re-growth of bacteria.

Abscess↗
PubMed1987

Varicella-zoster virus infections during pregnancy: hypothesis concerning the mechanisms of congenital malformations.

An analysis of the data on 52 infants whose mothers had contracted varicella during pregnancy revealed that 27 had congenital malformations ascribed to the maternal varicella infections, while another 25 developed herpes zoster in the early postnatal period. Most of the mothers whose infants had congenital malformations had contracted varicella within the first 20 weeks of gestation, whereas most of the mothers whose infants developed herpes zoster had varicella after 21 weeks of gestation. The clinical features of the various congenital malformations and dysfunctions after maternal varicella were diverse; however, there were peculiar segmental manifestations of anomalies of the skin, the peripheral nervous, the autonomic nervous, and the musculoskeletal systems, all of which receive common innervations from the same levels of the spinal cord. Most other dysfunctions may be ascribed to an encephalitis. Therefore, the mechanism of congenital malformations caused by varicella-zoster virus seems to be due not to fetal varicella but to the development of herpes zoster in utero and to an encephalitis associated with herpes zoster. At least one infant had congenital malformations that were due to maternal herpes zoster infection.

Congenital Abnormalities↗
PubMed1985

A Japanese survey on first attempts of percutaneous transluminal coronary angioplasty.

Experiences of the initial application of percutaneous transluminal coronary angioplasty (PTCA) in Japan performed during 1980-1981 at the multicenter level were analyzed. A survey in 72 cases which were collected from 12 centers showed an overall success rate of 64.7%, unimproved stenotic lesions in 8.1% and unpassable lesions in 24.3% of the cases. Complications were death of the patient in 2(2.8%), acute myocardial infarction in 6(8.3%) and dissection of the coronary artery in 3 cases (4.2%). Aortocoronary bypass graft surgery was performed in 8 cases (11.1%).

Adult↗
PubMed1983

A comparison between the sciences of epidemiology and statistics based on an examination of epidemiological or statistical studies on diabetes in Japan.

The authors selected 24 original papers which were regarded them as the epidemiological study and the statistical study from their titles, from the end of World War II to 1981. And these papers were selected from 3 medical journals of internal medicine, other medical journals and proceedings of 2 International Conferences (see Table 1), and also were the object of study, namely, theoretical considerations. Besides we classified these 24 papers into 2 sorts; papers for an epidemiological study and a statistical study, and made a comparative study of details of these papers theoretically. As the result we were able to clarify what the authors of 24 papers had considered about the natures of epidemiology and statistics as the science. It was clarified that two sciences, epidemiology and statistics, had been in the general trend without any recognition of the differences between two. And as the conclusion we pointed out that the field of activity of statistics was broader than that of epidemiology, and the nature of statistics as the science might be changeable according to the object, moreover, statistical theory might be a branch of mathematics and so on.

Diabetes Mellitus↗