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Biomedical subjects

S Miyagi

Publications and source records attributed to S Miyagi.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Pulmonary emergency medicine at Okinawa Chubu Hospital, including care of patients with primary, secondary, and tertiary emergency problems].

In the emergency department of Okinawa Chubu Hospital, 32,088 patients were seen between November 1992 and October 1993. Of these patients, 19,306 were over 16 years old. About 20% of the patients seen in the emergency department had pulmonary diseases. In decreasing order of frequency, the five most commonly seen conditions were: upper respiratory tract infections (19%), bacterial pneumonia (12%), acute bronchitis, acute exacerbation of chronic obstructive pulmonary disease, and chest trauma. Medical (i.e. nonsurgical) treatment was required by 10,034 patients. Thirty five percent of those had pulmonary disorders, and the mortality rate was 0.9%. A total of 747 patients were hospitalized, and 65 were admitted to the intensive care unit. Of those admitted to the intensive care unit, 9% died of respiratory problems. Surgical treatment was required by 5587 patients. Only 5.1% of them had pulmonary problems, and the mortality rate was 3.5%. However, the mortality rate among the 25 patients admitted to the intensive care unit for surgical pulmonary problems was 8%. Among patients with medical problems who were hospitalized via the emergency department, 36% had pulmonary disorders (mainly pneumonias, asthmatic attacks, acute bacterial bronchitis, and acute exacerbation of chronic obstructive pulmonary disease), but only 7% of patients with surgical problems had chest trauma (mainly due to traffic accidents of falls).

Adolescent↗
PubMed1993

Alpha replacement method for the displaced Swan neck catheter.

We have developed a new method for the displacement of the Swan neck straight (SNS) catheter and have named it the "alpha replacement method." The procedure is to insert a 1.5 mm flexible metal guide wire into the transfer tube, passing it through the catheter tip until it touches the mesenterium. Continued gentle pressure will cause the guide wire to make a big loop in the abdomen, and as the loop increases in size, the catheter will move into the minor pelvic space. The guide wire is pulled out by pressing down on the lower abdomen, and the catheter remains in the minor pelvic space. The procedure is then complete. The alpha replacement method was successful in all 8 patients, with the manipulation time being about 15 minutes. No complications have occurred.

Catheterization↗
PubMed1991

[Diagnosis and significance of ARDS].

Adult respiratory distress syndrome (ARDS) is defined as a syndrome of acute respiratory failure following generalized or localized catastrophic events, without a past history of underlying pulmonary diseases, which is manifested by acute onset of dyspnea, laboured breathing and non-cardiogenic lung edema. This syndrome is also characterized by preceding pulmonary or extrapulmonary insults, an almost normal lung function immediately after the catastrophic events, and acute and progressive hypoxemia, decreased pulmonary compliance with chest radiographs showing bilateral diffuse pulmonary infiltrates, associated with very poor outcome. The diagnostic modalities for obtaining pathognomonic findings indicative of ARDS are not established as yet, hence the only way to diagnose ARDS is to evaluate the pathophysiological status, as mentioned in the definition above, by various laboratory examinations. Although there are many reported modifications, the diagnostic criteria suggested by Petty, et al are still widely used in practice. However, it is unknown whether they are strictly followed or not. Nowadays, the significance of making a diagnosis of ARDS on the basis of the above criteria is questioned by some physicians. To address these questions, the authors reported on an overview of ARDS cases seen at ICU of our institute which is providing acute and emergency care services in Okinawa. In the past 10 years (1979-1988), 4500 patients were admitted to our ICU and 170 of them were diagnosed as either having ARDS or their course in ICU were complicated by ARDS. These cases were retrospectively studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Physical signs and lung function tests in patients with chronic obstructive pulmonary disease (COPD)].

We examined 40 consecutive patients with chronic obstructive pulmonary disease (COPD) admitted to our institute between April and September 1985 for acute exacerbation, when they recovered from acute exacerbation and became cooperative to undergo lung function tests. Additionally, a follow up study was also done 4 years later, for assessing whether the physical signs were indicative of poor prognosis or not, correlated with survival rate, frequency of acute exacerbations and mechanical ventilation required and application of home oxygen therapy (HOT). Four physical signs, including increased activity of strap muscle, recession of supraclavicular fossae in inspiration, loss of pump-handle movement and loss of bucket-handle movement were associated with significantly low values in all lung function parameters tested but other signs were correlated with only in 2 or 3 parameters. The long-term prognosis was poor in the patients with more physical signs (abnormality score), namely the patients, who were on HOT because of development of chronic respiratory failure had significantly more frequent episodes of acute exacerbation and mechanical ventilation, had definitely higher scores than others who did not need HOT.

Aged↗
PubMed1989

[New trends in home oxygen therapy (HOT) after the introduction of health insurance coverage in Okinawa and factors contributing to long-term survival].

A total of 179 cases given HOT after introduction of health insurance coverage in 1985 were reported from 12 medical institutes in Okinawa and were compared with 110 cases followed at Okinawa Chubu Hospital during 1976-1985, prior to insurance coverage. The number of patients on HOT have rapidly increased after insurance coverage not only in our institute but also in other institutes in Okinawa and the patients with emphysema formed the largest group. The oxygen enricher is now utilized more than the compressed gas system, accounting for about 70% of all patients compared with the previous figure of 7.3%. Average PaO2 on room air was higher (from 42 Torr to 49 Torr) and the levels of PaO2 maintained by HOT had 2 peaks, one in the 60-65 Torr range and the other in the 75-80 Torr range in patients newly given HOT. The patients with emphysema, who had the worst prognosis in the past, remarkably improved and showed no statistical difference from patients with chronic bronchitis or bronchiectasis in terms of long-term survival. The female patients had better prognosis than males, but the reason is still unclear to us. The absolute volume of FEV1.0 and the presence or absence of cor pulmonale have not affected the long-term survival. A group of the patients with CO2 retention (bronchitic in type) did not benefit from HOT in terms of long-term survival unless their PaO2 levels on room air were below 50 Torr and it was felt that PaO2 levels of 50-59 were too mild in severity for application of HOT.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Cor pulmonale due to tumor cell microemboli. Report of a case with occult gastric carcinoma.

Progressive dyspnea developed in a 36-year-old woman. Physical examination and chest roentgenogram showed the signs of pulmonary hypertension. She died of respiratory failure in spite of treatment. Autopsy disclosed gastric carcinoma in the pylorus with metastases to the regional lymph nodes, left adrenal gland, and ovaries. There were no gross pulmonary emboli, but more than 50% of pulmonary microvasculature was occluded by tumor cell microemboli. No parenchymal metastases were found in the lung. This case was remarkable because cor pulmonale due to tumor cell microemboli to the lung was the initial and terminal manifestation of clinically occult, but pathologically advanced, gastric carcinoma.

Adenocarcinoma, Mucinous↗
PubMed1987

Interruption of inferior vena cava with anomalous continuations.

A case of interruption of the inferior vena cava which has two continuational pathways is reported. One is the hemiazygos and azygos continuation and the other is an unusual intrathoracic continuation, phrenic and pericardial vein draining through the highest intercostal vein into the left brachiocephalic vein.

Aged↗