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Biomedical subjects

H Kaneda

Publications and source records attributed to H Kaneda.

At least 127 records · Page 7Linked to original sources

Elevated plasma renin activity in patients with acute pyelonephritis.

Thirty-three patients with acute pyelonephritis were studied with regard to the changes in plasma renin activity (PRA) along the clinical course of the disease. 1) Abnormally high PRA was found in 64% of patients in the active stage of acute pyelonephritis; they showed a decrease in urinary output of sodium, a reduction in creatinine clearance, and high indices of inflammatory activity. 2) The changes of PRA in the course of acute pyelonephritis were negatively correlated to the urinary sodium excretion and creatinine clearance, but positively to the activity of inflammation, serum sodium concentration and the number of E. coli in the urine. PRA returned to normal with the improvement of pyelonephritis. 3) Concerning the mechanism of hyperreninemia in the active stage of the disease, the following three factors may be considered; renal ischemia, negative sodium balance in the body, and inflammation. Of these, the negative sodium balance seems to be the most important. The patients could not take enough foods to maintain their energy and sodium balance because of fever and pain. 4) The significance of resting PRA in acute pyelonephritis might be to reflect the sodium status in the body, but not to be related to hypertension.

Acute Disease↗

Effect of dialysis treatment on glucose metabolism in uremic patients.

To study the carbohydrate metabolism in uremic patients, the intravenous glucose tolerance test (iv GTT) and insulin sensitivity test were investigated on 69 patients with chronic renal failure, 27 of whom were under the dialysis treatment. 1) Abnormal K-values averaging 1.05 were obtained in uremic patients (creatinine clearance less than 20 ml/min). 2) Carbohydrate intolerance in uremic patients was corrected with regular dialysis and the improvement was correlated with the duration of dialyses. 3) The mechanisms of improvement in carbohydrate metabolism were different between the short-term dialysis group (less than 12 months of dialysis) and the long-term group (more than 12 months). Enhanced secretion of insulin seemed to be the main cause of this improvement in the former, while the correction of impaired sensitivity to insulin in peripheral tissues in the latter.

Adolescent↗

A patient with recurrent hepatic encephalopathy and chronic renal failure treated successfully with long-term hemodialysis.

A 38-year-old man suffering from chronic recurrent hepatic enchephalopathy due to liver cirrhosis complicated with chronic renal failure had been maintained well by regular hemodialysis treatment for 14 months. Only four episodes of hepatic encephalopathy occurred in that period. Each of four episodes of disturbed consciousness was accompanied by slightly elevated blood ammonia levels. Energetic serial dialysis for 5-7 days was necessary for its recovery. The factors causing hepatic encephalopathy did not appear to be easily dialysable as compared with those of uremic coma. It is concluded that the hemodialysis is quite an effective treatment for the recurrent type of hepatic encephalopathy.

Adult↗

Hemodynamic effects of locally applied epinephrine used with various general anesthetic techniques.

Halothane-nitrous oxide-oxygen (GOF), nitrous oxide-oxygen with diallyl-nor-toxiferine (Jackson-Rees method), or nitrous oxide-oxygen with droperidol-pentazocine (modified NLA) were administered in 190 instances of repair of cleft lips and cleft palates. Epinephrine, 1:30,000, 1:100,000, or 1:300,000, was injected as the vasoconstrictor around the operative field. Epinephrine concentration of 1:100,000 provided sufficient hemostasis, whereas 1:300,000 was insufficient. With the same concentration of epinephrine, GOF and modified NLA seemed to be better than the Jackson-Rees method, since the GOF and modified NLA groups showed less increase of pulse rate, blood pressure, and plethysmographic changes. A 1:30,000 concentration of epinephrine could be used safely with the Jackson-Rees method and the hemostasis with this concentration was superior to 1:100,000. However, it is recommended only for the cleft lip operation, since these patients are younger and need better hemostasis, and hypersalivation after reversal does not disturb the postoperative course. So-called epinephrine-induced arrhythmia with halothane anesthesia occurred in 1 of 34 instances with 1:300,000 solution and in 5 of 48 instances with 1:100,000 solution. Propranolol was given in only one instance. All others returned to normal rhythm with hyperventilation with pure oxygen. The use of 1:100,000 solution of epinephrine as an adjunct with modified NLA is the most satisfactory and safe method for cleft palate operations, and 1:30,000 with the Jackson-Rees is the better method for cleft lip repairs.

Alcuronium↗