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Biomedical subjects

Y Usuda

Publications and source records attributed to Y Usuda.

At least 73 records · Page 4Linked to original sources

[Periodic sublingual buprenorphine for pain relief after upper abdominal surgery].

Analgesic effects were evaluated in patients who received sublingual administration of buprenorphine (0.2mg ampule for injection) as programmed every 8 hours for 3 days following upper abdominal surgery. Patients who received periodic sublingual buprenorphine obtained satisfactory postoperative analgesia and also required less analgesics than those who never received periodic administration of analgesics. Approximately one half of patients who received periodic sublingual buprenorphine required no additional analgesics. Arterial blood-gas analysis showed a significant increase in carbon dioxide tension after sublingual buprenorphine. One patient revealed marked respiratory acidosis after sublingual buprenorphine. These results suggest that periodic sublingual buprenorphine makes up for slow onset in sublingual administration and that it is also effective, convenient, and safe for pain relief after upper abdominal surgery. We, however, should pay attention to the respiratory depression caused by sublingual buprenorphine.

Abdomen↗

[Bronchiectasis treated with negative extra-thoracic pressure ventilation].

A 25-year old man with 5-year history of bronchiectasis was admitted to the ICU complaining of severe shortness of breath. He had a respiratory rate of 40 to 50 breath/min. On 0.5 l/min of oxygen with nasal cannula, arterial blood pH was 7.39, Paco2 52.3 mmHg, Pao2 45.0 mmHg. Then, on 1 l/min of oxygen, Pao2 was unchanged, but Paco2 increased to 58 mmHg. As his consciousness was so clear, we applied to him the negative extra-thoracic pressure ventilator which was designed by the authors. Negative extra-thoracic pressure ventilation (NETPV) was maintained at a IMV rate of 30 breath/min, peak negative extra-thoracic pressure of -20 to -30 cmH2O, and an inspiratory/expiratory ratio of 1:2. During NETPV, his respiratory rate and oxygen consumption were decreased and Pao2 was increased compared with his spontaneous breathing. He made a recovery from dyspnea, especially, he was able to take a deep breath. When NETPV was applied to him, pulmonary artery and arterial catheterizations revealed that central venous pressure was slightly decreased, cardiac index unchanged or slightly decreased, heart rate, systemic blood pressure, and pulmonary arterial pressure unchanged compared with spontaneous breathing. The patient was able to read books and maintained communication in his voice with his family and the medical staff. After 3 days of the treatment with NETPV, a marked improvement was noted and the patient was discharged from the ICU. NETPV has the benefits as follows. First, it is very easy for both a patient and a doctor to assist his breathing because an endotracheal intubation is not necessary.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Low natural killer syndrome: clinical and immunologic features.

Twenty-three patients with low natural killer syndrome (LNKS), 7 males and 16 females, are reported here. These LNKS patients had an age range from 14 to 77 years, with a median of 36.5 years. LNKS is a newly proposed category of immune disorders, being characteristically diagnosed by lowered NK cell activity against K562 target cells as a definite laboratory abnormality, in association with general clinical symptoms of remittent fever and uncomfortable fatigue, persisting without explanation for more than 6 months. Other immune parameters, such as the DNA synthesis of peripheral blood mononuclear cells (PBMCs) in either the presence or absence of mitogens, the T4+/T8+ ratio and the number of Leu-11+ PBMCs, were usually within the normal range. Also, routine laboratory tests did not detect any abnormal findings. The LNKS patients responded well to the administration of an immunopotentiator called 'lentinan', a glucan extracted from the Japanese mushroom Lentinus edodes, despite no responses to conventional fever treatments such as the administration of antipyretics or antibiotics. All LNKS patients observed were universally free of antibodies in their sera to human T-lymphotropic retroviruses I and III, and lymphadenopathy was infrequent, indicating that the LNKS is a syndrome independent of acquired immunodeficiency syndrome (AIDS) or AIDS-related complex. Antibodies to other known viruses tested such as Epstein-Barr or measles virus, or cytomegalovirus were also negative or not significantly elevated in the sera before the initiation of lentinan administration. If a virus is the cause of LNKS, it may be a new, unknown virus or an unknown substrain of known viruses. None of the LNKS patients has died of this syndrome.

Adolescent↗

[Cefaclor dosage change with renal dysfunction].

Serum and/or urine levels of cefaclor (CCL) were studied in 4 patients during the therapy with CCL. In patients with severely impaired renal function, moderately higher serum and urine levels of CCL persisted, serum half-lives of CCL were moderately prolonged and urinary excretion of CCL slightly decreased. Although dosage modification of CCL is necessary in patients with renal dysfunction, multiple doses of 250 mg every 8 hours may be safe and effective even in patients with impaired renal function.

Administration, Oral↗