A case of pediatric Perthes' disease with unexplained hyperlactatemia at the time of initial surgery and anesthetic management with remimazolam for the subsequent surgery.

Background: The causes of perioperative hyperlactatemia vary, but they are generally associated with hypoperfusion. Here, we report the case of a pediatric patient who developed unexplained hyperlactatemia during anesthesia with propofol and sevoflurane, which recurred during a second surgery under anesthesia with remimazolam.

Case Presentation: An 8-year-old boy with Perthes disease and no remarkable past or family history was scheduled for an osteotomy.

Anesthetic management of a patient with achalasia, a disease with a considerable risk for aspiration under anesthesia.

Background: Achalasia is a rare condition characterized by dysfunction of esophageal motility and impaired relaxation of the lower esophageal sphincter. Anesthetic management of these patients is challenging due to the elevated risk of regurgitation and aspiration.

Case Presentation: A 53-year-old man diagnosed with achalasia was scheduled for renal cancer surgery before esophageal myotomy.

Comparison of four documents describing adrenaline purification, and the work of three important scientists, Keizo Uenaka, Nagai Nagayoshi and Jokichi Takamine.

The name of Keizo Uenaka has not been documented in textbooks. However, Uenaka was the scientist who worked on ephedrine and played a practical role in the purification and crystallization of adrenaline. His handwritten memorandum, "On Adrenaline, Memorandum, July to December, 1900" is now stored in a Buddhist temple, Kyougyou-ji in Nashio, Japan.

Physical and psychological aspects of anorexia nervosa based on duration of illness: a cross-sectional study.

Background: We evaluated physical and psychological features of patients with anorexia nervosa (AN) who differed by duration of illness.

Methods: Data were obtained from 204 female patients with AN, divided into two groups based on illness duration: short-term illness duration (less than 5 years;  = 118); and long-term duration (5 years or more;  = 86). Physical parameters were measured using blood serum testing and psychological aspects were assessed using various instruments.