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Biomedical subjects

Y Kosaka

Publications and source records attributed to Y Kosaka.

240 records · Page 14Linked to original sources
PubMedDate not supplied

The effects of epidural anesthesia on ventilatory response to hypoxia.

STUDY OBJECTIVE: To evaluate the effects of epidural morphine on the ventilatory response to hypoxia in patients having abdominal surgery and to compare the effects of epidural lidocaine. DESIGN: Open-label, randomized study. SETTING: Shimane Medical University Hospital, Shimane, Japan. PATIENTS: Sixteen consenting, unpremedicated ASA physical status I and II patients undergoing abdominal surgery. INTERVENTIONS: Patients were administered 2 mg of morphine diluted in 10 ml of saline or 10 ml of 2% lidocaine from an epidural catheter that was inserted the day before surgery. MEASUREMENTS AND MAIN RESULTS: On the day before surgery, ventilatory parameters consisting of minute expiratory volume (VE), tidal volume (VT), respiratory frequency (f), and oxygen saturation by pulse oximeter (SpO2) were measured during resting state and hypoxic challenge. The same measurements were repeated 30 minutes after the epidural injection before surgery. The slope of VE/SpO2 decreased significantly from 1.6 +/- 0.3 to 1.2 +/- 0.2 after epidural morphine, although ventilatory values such as f, VT, VE, and PaCO2 were unchanged. Epidural lidocaine produced no significant changes in ventilatory response. CONCLUSION: Epidural anesthesia with morphine, but not lidocaine, reduced the ventilatory response to hypoxia indicated by VE/SpO2.

Abdomen↗
PubMedDate not supplied

Effect of lumbar epidural anesthesia on ventilatory response to hypercapnia in young and elderly patients.

STUDY OBJECTIVE: To examine the influence of age on resting ventilation, arterial blood gas tensions, and the ventilatory response to hypercapnia in lumbar epidural anesthesia. DESIGN: Clinical study using groups of young and elderly patients. SETTING: Surgical operation center of a university hospital. PATIENTS: Seven young (average age 39 years) and seven elderly (average age, 69 years) unpremedicated patients undergoing lower abdominal surgery. INTERVENTIONS: Patients were administered lumbar epidural anesthesia with 10 ml of 2% lidocaine. MEASUREMENTS AND MAIN RESULTS: Resting ventilation, arterial blood gas tensions, and ventilatory response to hypercapnia were measured before and 20 minutes after the block. Regarding the ventilatory response to hypercapnia, the mean slope of the hypercapnic response curve [change in minute ventilation (VE) divided by change in end-tidal partial pressure of carbon dioxide (PETCO2)] increased significantly following the epidural block, by 16% in the young patients and by 23% in the elderly patients, and the mean VE at a PETCO2 of 55 mmHg (VE55) also increased significantly, by 16% in the young subjects and by 26% in the older subjects. These changes in delta VE/delta PETCO2 and VE55 were statistically equivalent between the two age-groups. CONCLUSIONS: The effects of lumbar epidural anesthesia on resting ventilation, arterial blood gas tensions, and ventilatory response to hypercapnia were not affected by age.

Adult↗
PubMedDate not supplied

Prognostic value of peritoneoscopic findings in cirrhosis of the liver.

The prognostic value of peritoneoscopy was examined in 372 patients with liver cirrhosis according to the degree of development and size of regenerating nodules, the development of reddish markings, the development of small lymphatic vesicles, the presence or absence of patchy markings, the size of the right and left hepatic lobes, and the degree of splenomegaly. The cumulative survival rate was compared with these peritoneoscopic parameters. The usefulness of peritoneoscopic and histological findings in the prognosis of liver cirrhosis was evaluated using the proportional hazard model of Cox. Significant differences were observed in the cumulative survival rate with respect to the degree of development of regenerating nodules, the size of the right hepatic lobe, the formation of small lymphatic vesicles, and the degree of splenomegaly. Analysis using Cox's proportional hazard model indicated that peritoneoscopic findings are of greater clinical use than histological findings in determining the prognosis of liver cirrhosis.

Adult↗
PubMedDate not supplied

Absorption of topical disodium cromoglycate and its preservatives by soft contact lenses.

Disodium cromoglycate (2%) (DSCG) was administered four times daily for one month to 10 patients using extended wear contact lenses. The same regimen was also followed for five days by 25 patients using daily wear soft contact lenses. The contact lenses and their soaking solutions were collected at the end of the wearing period and analyzed for DSCG, benzalkonium chloride (BAK), 2-phenylethanol, and EDTA. The lens soaking solutions and eluates prepared from the lenses were tested. In the extended wear group, small amounts of DSCG were detected in both the eluates and the soaking solutions. In the daily wear group DSCG was detected in small amounts in the soaking solutions but not in the eluates. BAK, EDTA, and 2-phenylethanol were not detected in any of the eluates or soaking solutions. During the study, no side effects of DSCG were observed in any of the patients. In animal experiments, radioactive DSCG was applied once to a series of rabbit eyes. Four hours after administration of the labelled DSCG, the animals' tears, cornea, and aqueous humor were examined for DSCG. Of the instilled dose, approximately 0.2% was found in the cornea, and less than 0.04% was found in the aqueous humor. We conclude that commercial DSCG applied topically to contact lenses does not result in the accumulation of either the drug or its preservatives in lenses and that DSCG can be safely applied directly onto a worn contact lens.

Animals↗