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Biomedical subjects

K Higa

Publications and source records attributed to K Higa.

77 records · Page 5Linked to original sources
PubMed1975

[RI-cisternography of traumatic pneumocephalus (author's transl)].

A radionuclide, when injected intrathecally, normally does not enter into the ventricle system. In our three cases of intra cerebral-ventricular pneumocephalus the radionuclide entered into the ventricle and concentrated in the cyst. Such an abnormal movement of the radionuclide was generally caused by the obstruction of subarachnoid space and the increased C.S.F. absorption in the enlarged ventricle. Under consideration of the pre-and post-operative cisternograms of our three cases we examined the principal factor which brought on the abnormal movement of a radionuclide. Each principal factor was the excessive C.S.F. rhinorrohea in the first case, the increased C.S.F. absorption in the enlarged ventricle and the cyst in the third case. An analysis of our three cases shows that the accumulation of radionuclide into the ventricle system is not necessarily due to the obstruction of subarachnoid space, but also due to more C.S.F. absorption in the ventricle system than that in the subarachnoid space.

Adolescent↗
PubMedDate not supplied

Anesthetic management of a patient with Bartter's syndrome.

Bartter's syndrome is a rare disorder characterized by normal or low arterial blood pressure (BP), despite marked elevation in plasma renin activity, angiotensin II (Ang-II), and aldosterone, along with hypokalemic metabolic alkalosis. Perioperative changes in the cardiovascular and renin-angiotensin-aldosterone (RAA) systems in Bartter's syndrome patients are not well understood. We managed a 44-year-old Japanese man with rectal cancer and Bartter's syndrome complicated by renal dysfunction. He underwent anterior resection of the rectum with general anesthesia (50% nitrous oxide-oxygen with 0.5% to 0.8% isoflurane, supplemented with intravenous midazolam and butorphanol). Epidural morphine was given postoperatively. Although BP tended to be lower (75/35 to 110/60 mmHg) during surgery, there were no profound perioperative hemodynamic derangements. Plasma renin activity. Ang-II, and aldosterone values were highest during surgery. These responses of the RAA system to anesthesia and surgery were the same as previously noted in otherwise healthy surgical patients.

Adult↗
PubMedDate not supplied

High thoracic epidural block relieves acute herpetic pain involving the trigeminal and cervical regions: comparison with effects of stellate ganglion block.

BACKGROUND AND OBJECTIVES: Stellate ganglion block can promptly relieve acute herpetic pain (AHP) involving the trigeminal and cervical regions. However, repeated blocks are needed to maintain pain relief in most patients with severe AHP. Because continuous epidural block is easily performed using an indwelling catheter, we compared the effect of high thoracic epidural block with that of stellate ganglion block to relieve moderate-to-severe AHP involving these regions. METHODS: Six patients received stellate ganglion blocks and seven patients received high thoracic epidural blocks. Six milliliters 1% of mepivacaine was given to each patient. Acute herpetic pain was evaluated before and up to 60 minutes after the blocks, using a visual analog scale (VAS) of pain. RESULTS: There was no significant difference in VAS pain scores before the blocks between the groups, but there were significant (P < .05) decreases in VAS pain scores for both groups between 10 and 60 minutes after the blocks. There were no significant differences in VAS pain scores between the groups after the blocks. CONCLUSIONS: High thoracic epidural block was as effective as stellate ganglion block in relieving moderate-to-severe AHP involving the trigeminal and cervical regions.

Acute Disease↗
PubMedDate not supplied

Disappearance of wheezing during epidural lidocaine anesthesia in a patient with bronchial asthma.

BACKGROUND AND OBJECTIVES: Local anesthetics in blood absorbed from the epidural space attenuate bronchial hyperreactivity to chemical stimuli. However, it is not documented whether local anesthetics at clinically relevant concentrations improve active wheezing in patients with bronchial asthma. CASE REPORT: We managed a 60-year-old man with bronchial asthma and active wheezing under continuous epidural anesthesia using plain lidocaine. The wheezing gradually diminished 20 minutes after the epidural injection of 13 mL 2% lidocaine and completely disappeared over 155 minutes during continuous epidural injection of 2% lidocaine (6 mL/h). The plasma concentrations of lidocaine in arterial blood during the epidural anesthesia ranged from 2.5 to 3.9 microg/mL. Wheezing reappeared 55 minutes after termination of the continuous epidural injection of lidocaine. The plasma concentration of lidocaine at this time was 1.9 microg/mL. CONCLUSIONS: At clinically relevant concentrations, lidocaine in the blood absorbed from the epidural space may improve bronchospasm in patients with bronchial asthma.

Anesthesia, Epidural↗