Biomedical subjects

T Higashizawa

Publications and source records attributed to T Higashizawa.

26 records · Page 2Linked to original sources

PubMed1997

[Cervical spine movement during orotracheal intubation using the McCoy laryngoscope compared with the Macintosh and the Miller laryngoscopes].

The movement of cervical spine during orotracheal intubation was compared using the McCoy, Macintosh or Miller laryngoscope blade. Twenty ASA 1-2 patients requiring tracheal intubation were studied. Following induction of anesthesia and obtaining muscle relaxation, the cross-table lateral X-ray was taken before and during laryngoscopy using three types of laryngoscopes. Degree of cervical spine movement was evaluated by measuring the distance between the spinous processes of C1 and the occiput, and the amount of displacement of C1 and C5 against C3 by tracing on each films. The results indicated that delta C1-occiput was larger and delta C1 + C5 smaller with the McCoy laryngoscope compared with the others. The use of the McCoy laryngoscope results in less cervical spine movement during laryngoscopy and therefore should be of particular benefit in the presence of cervical spine instability as well as in the normal patients.

Adolescent↗

PubMed1997

[Assessment of the practice of endotracheal intubation by levering Laryngoscope in teaching of undergraduate medical students].

Twenty-nine inexperienced medical students tried to intubate endotracheal tubes using both levering laryngoscope (McCoy laryngoscope) and Macintosh laryngoscope in adult mannikin the Cormack and Lehane Grade 2. The number of successful intubations by McCoy type was close to those by Macintosh type. Improvement in time necessary from insertion of the laryngoscope to confirmation of placement of the endotracheal tube McCoy type was also close to that by Macintosh type. But the grade of handling difficulty of McCoy type was significantly higher than that of Macintosh type, because Macintosh type was simpler to handle than McCoy type. It was suggested that Macintosh laryngoscope was more useful than McCoy laryngoscope for teaching of inexperienced medical students.

Adult↗

PubMed1997

[Which laryngoscope is the most stressful in laryngoscopy; Macintosh, Miller, or McCoy?].

Stress responses during laryngoscopy were compared among the situations using three different laryngoscopes, Macintosh (curved standard blade), Miller (straight blade), or McCoy (levering). Blood pressure, heart rate (in 58 patients) and plasma concentration of catecholamines (in 29 patients) were measured before, during and after laryngoscopy without tracheal intubation. Systolic blood pressure after laryngoscopy was significantly higher in the Miller group than in other two groups. Plasma epinephrine concentrations after laryngoscopy in the McCoy group were lower than other two groups. Heart rate and plasma norepinephrine concentration were not different among the three groups. These results suggest that the stress response during laryngoscopy without intubation is the biggest in using the Miller laryngoscope and the smallest in using the McCoy laryngoscope.

Adolescent↗

PubMed1988

Multiple nonfunctional pancreatic islet cell tumor in multiple endocrine neoplasia type I. A case report.

A case of multiple nonfunctional pancreatic islet cell tumor in multiple endocrine neoplasia type I (MEN I) is reported. The patient was a 41-year-old woman who had a past history of thyroid cancer (papillary carcinoma) and hyperparathyroidism due to parathyroid adenoma. Later, a nonfunctional pituitary tumor and five nonfunctional pancreatic tumors were found simultaneously and the patient was finally diagnosed as having MEN I. Following surgical enucleation, the pancreatic tumors were histopathologically diagnosed as benign islet cell tumors. One of them (tumor 3) exhibited a solid nodular pattern while the others showed gyriform patterns. They were divided histochemically and immunohistochemically into three types: two (tumors 1 and 2) produced a single hormone (glucagon), one (tumor 3) produced five (insulin, glucagon, somatostatin, gastrin and pancreatic polypeptide) and the remaining two (tumors 4 and 5) produced two (glucagon and pancreatic polypeptide). Electron microscopically, three types of endosecretory granules were found in the tumor cells of tumor 3 but only one type was found in tumor 4. However, in the tumor 4 extract, glucagon, pancreatic polypeptide, C-peptide, somatostatin, vasoactive intestinal peptide and growth hormone releasing factor were detected by radioimmunoassay. These findings suggest that these pancreatic tumors were both multicellular and multihormonal.

Adenoma, Islet Cell↗

PubMed1986

Establishment and use of the M strain of stroke-prone spontaneously hypertensive rat.

An inbred strain of stroke-prone spontaneously hypertensive rat, the M-SHRSP, was established by brother-sister breeding of selected SHRSP for 24 generations while administering apresoline. Compared with SHRSP, the M-SHRSP shows an earlier rise in blood pressure, plasma renin activity (PRA) and cerebrospinal fluid (CSF) pressure, and somewhat changed cerebrovascular lesions. Crosses and back-crosses, using M-SHRSP, Wistar-Kyoto rats (WKY), spontaneously hypercholesterolaemic (SHC) rats and their hybrids produced colonies with various blood pressure levels and hypercholesterolaemia. Continued successive selective brother-sister breeding of M-SHRSP and SHC hybrids produced a colony with severe hypertension and marked hypercholesterolaemia. Streptozotocin diabetes was induced in an M-SHRSP and SHC hybrid (TC), from which diabetic TC was successively bred to the fifth generation. While each generation was hypertensive and showed a decrease in islet B-cells, symptoms of lasting glycosuria were first observed in the fourth generation among those given a high alpha-corn starch (75.7%) diet.

Animals↗

PubMedDate not supplied

Catheter dislodgement of percutaneous transhepatic biliary drainage: identification of role of puncture sites and catheter sheath.

BACKGROUND: To identify the appropriate puncture points in the bile duct to avoid catheter dislodgement. METHODS: Percutaneous transhepatic biliary drainage catheters (n = 300) were placed in 242 patients. The frequency of dislodgement (complete dislodgement or bending of the catheter) was prospectively investigated. The puncture site of the bile duct was classified on the ultrasonographic findings as follows: Main-B3, main branch of the lateral inferior segment; peripheral-B3, peripheral branch of the lateral inferior segment; B2, lateral superior segment; left hepatic duct, proximal portion of the left hepatic duct; B8, anterior superior segment; B5, anterior inferior segment; B5 + 8, main bile duct of the anterior segment; B6, bile duct of posterior inferior segment; and right hepatic duct, proximal portion of the right hepatic duct. RESULTS: When a catheter without an outer sheath was used, catheter dislodgement in peripheral-B3 (2/11, 18%) was more common than in main-B3 (0/32, 0%; p < 0.05). In B5, catheter dislodgement (6/12, 50%) was more frequent than in B8 (3/20, 15%; p < 0.05) and in B6 (0/14, 0%; p < 0.005). When a catheter with an outer sheath was used, catheter dislodgement (2/207, 1%) was rare. CONCLUSION: Drainage from B5 and peripheral-B3 is associated with a high risk of dislodgement of the catheter. A catheter with an outer sheath was useful to prevent catheter dislodgement.

Adult↗

PubMedDate not supplied

Hyperechoic lines as a sonographic confirmatory sign during percutaneous transhepatic biliary drainage.

BACKGROUND: In ultrasonically guided percutaneous transhepatic biliary drainage, we often can recognize hyperechoic lines at the tip of the needle when the duct is penetrated successfully. We evaluated the frequency of this phenomenon and analyzed whether it was a useful sign for confirming successful bile duct puncture. METHODS: In 65 patients with biliary tract diseases, 84 catheters were placed in the course of 108 attempts at puncture. Results of puncture and the presence of hyperechoic lines were investigated prospectively. RESULTS: When the ultrasonographic findings showed hyperechoic lines, successful puncture was significantly more frequent than when the findings did not show hyperechoic lines (53/55, 96%, vs. 31/59, 53%; p < 0.0001). When we judged the hyperechoic lines as the sign of successful puncture, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 63%, 93%, 96%, 48%, and 71%, respectively. CONCLUSION: Hyperechoic lines are a useful confirmatory sign of successful puncture. However, absence of these lines was not invariably associated with unsuccessful puncture.

Aged↗

PubMedDate not supplied

Intraductal ultrasonography for evaluating the patency of biliary metallic stents: correlation with cholangioscopic findings.

BACKGROUND: This is the first study to correlate intraductal ultrasonography (IDUS) with cholangioscopy in evaluating the patency of biliary metallic stents. METHODS: The findings of IDUS (probe 2.0 mm in diameter and 20-MHz frequency) through a percutaneous transhepatic (n = 24) or transpapillary (n = 2) approach were retrospectively reviewed without other information. Criteria for IDUS are as follows: type 1, the inside of the stent is free; type 2, the inner edge is smooth; type 3, the inner edge is irregular; type 4, the inside of the stent is totally occupied; type 5, the solid echo is connected to the outside mass; type 2+D, a hypoechoic line is seen between the bile duct wall and the inside solid component and the inner edge of the bile duct wall is smooth; type 3+D, an irregular hypoechoic line is seen between the bile duct wall and the inside solid component. RESULTS: In the control group (n = 11), IDUS showed type 1 (n = 9) or type 2 (n = 2). In the occluded group (n = 15), when IDUS showed type 3 or 5, the patients (n = 5) required additional stents (n = 3), microwave coagulation of the tumor (n = 1), or transient external drainage (n = 1). When IDUS showed type 4 (n = 5), after washing, the findings changed to type 2+D (n = 4). When IDUS after washing showed a smooth inner edge (type 2+D), the patients were treated without additional stents more frequently than the other groups (eight of nine vs. two of six), a significant distinction (p < 0.05). CONCLUSION: IDUS is useful in assessing the patency of metallic stents. When the inside of the stent is totally occupied, however, examination after washing is necessary.

Aged↗