The number of physicians is related to the number of nighttime emergency surgeries in Japan: An ecological study.

Purpose: Increasing the number of physicians per population may improve the quality of medical services, but there are few reports on this aspect in the field of surgery. This study aimed to examine whether the number of physicians is associated with the number of nighttime emergency surgeries, which may be one of the indicators of the quality of medical services in the field of surgery.

Methods: This was a prefecture-based ecological study utilizing open data from Japanese government surveys conducted between 2015 and 2019.

The Association between Preoperative Blood Pressure Elevations and Postoperative Adverse Outcomes after Non-cardiac Surgery: A Single-center Retrospective Observational Study.

Blood pressure (BP) often rises before surgery. This study investigated whether BP elevation immediately before surgery was associated with adverse outcomes. Medical records of 11,732 patients (average age: 61 years; male: 47.

General anesthesia with remimazolam for a pediatric patient with MELAS and recurrent epilepsy: a case report.

Background: Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) is a mitochondrial disease. We report here the safe use of remimazolam in a pediatric MELAS patient.

Case Presentation: A 10-year-old girl (118 cm, 16 kg) was scheduled for an open gastrostomy to improve nutrition and epileptic seizure control.

Physiological Modeling of Concentration-Effect Relationship for Nondepolarizing Neuromuscular Blocking Drugs.

This paper reports modeling of physiological processes of neuromuscular transmission considering effects of nondepolarizing neuromuscualr blocking drugs (NDNBs) used during general anesthesia. NDNBs are considered to act by interacting with acetylcohine receptors located at pre- and post-junctional sites. This paper proposes an extension of the standard model of synaptic depression used in the field of neuroscience to describe the pre-junctional effect of NDNBs.

Immunoreactivities for hepcidin, ferroportin, and hephaestin in astrocytes and choroid plexus epithelium of human brains.

Iron plays essential roles in the central nervous system. However, how the iron level is regulated in brain cells including glia and neurons remains to be fully clarified. In this study, the localizations of hepcidin, ferroportin, and hephaestin, which are known to be involved in iron efflux, were immunohistochemically examined in autopsied human brains.

Lung-thorax compliance measured during a spontaneous breathing trial is a good index of extubation failure in the surgical intensive care unit: a retrospective cohort study.

Background: Extubation failure is associated with mortality and morbidity in the intensive care unit. Ventilator weaning protocols have been introduced, and extubation is conducted based on the results of a spontaneous breathing trial. Room for improvement still exists in extubation management, and additional objective indices may improve the safety of the weaning and extubation process.

Effect of the volatile anesthetic agent isoflurane on lateral diffusion of cell membrane proteins.

The volatile anesthetic isoflurane (ISO) has previously been shown to increase the fluidity of artificial lipid membranes, but very few studies have used biological cell membranes. Therefore, to investigate whether ISO affects the mobility of membrane proteins, fluorescence-labeled transferrin receptor (TfR) and glycosylphosphatidylinositol (GPI)-anchored protein were expressed in human embryonic kidney 293T cells and neural cells and lateral diffusion was examined using fluorescence recovery after photobleaching. Lateral diffusion of the TfR increased with ISO treatment.

Guanylyl Cyclase A in Both Renal Proximal Tubular and Vascular Endothelial Cells Protects the Kidney against Acute Injury in Rodent Experimental Endotoxemia Models.

What We Already Know About This Topic: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Natriuretic peptides are used, based on empirical observations, in intensive care units as antioliguric treatments. We hypothesized that natriuretic peptides prevent lipopolysaccharide-induced oliguria by activating guanylyl cyclase A, a receptor for natriuretic peptides, in proximal tubules and endothelial cells.

Methods: Normal Sprague-Dawley rats and mice lacking guanylyl cyclase A in either endothelial cells or proximal tubular cells were challenged with lipopolysaccharide and assessed for oliguria and intratubular flow rate by intravital imaging with multiphoton microscopy.

Immunoreactivity of urate transporters, GLUT9 and URAT1, is located in epithelial cells of the choroid plexus of human brains.

It has been suggested that urate plays a protective role in neurons, while hyperuricemia is correlated with atherosclerosis and cardiovascular disease. However, whether there is a system that directly transports urate into the brain remains to be clarified. In this study, the localization of glucose transporter 9 (GLUT9) and urate transporter 1 (URAT1), which are known to be representative reabsorptive urate transporters, was immunohistochemically examined in autopsied human brains.

Sex differences in attachment to spouses among older Japanese couples.

Aim: Attachment among older adults can partially explain sex differences in bereavement outcomes, but there is currently little evidence regarding this. The aim was to quantify sex differences in the proportion of spouses as attachment figures among older couples.

Methods: We carried out a secondary analysis of cross-sectional questionnaire survey data.

Comparison of general anesthesia and monitored anesthesia care in patients undergoing breast cancer surgery using a combination of ultrasound-guided thoracic paravertebral block and local infiltration anesthesia: a retrospective study.

Purpose: The aim of this study was to compare post-anesthesia recovery time and the incidence of hypotension episodes during anesthesia in breast cancer surgery between general anesthesia (GA) and monitored anesthesia care (MAC) retrospectively. Both techniques were combined with ultrasound-guided paravertebral block (US-PVB) and local infiltration anesthesia (LIA).

Methods: We reviewed the medical records of patients who received US-PVB for breast cancer surgery retrospectively and divided them into two groups based on the method of anesthetic management.

[Transient Femoral Nerve Palsy after Ilioinguinal-Iliohypogastric Nerve Block: Comparison of Ultrasound-guided and Landmark-based Techniques in Adult Inguinal Hernia Surgery].

Background: Transient femoral nerve palsy (TFNP) is a well-known complication associated with ilioinguinal-iliohypogastric nerve block (IINB). We compared the incidence of TFNP after ultrasound-guided IINB and that after anatomical landmark-based IINB.

Methods: We reviewed medical records of adult patients (ASA-PS 1-3, Age 21-87) who had received inguinal hernia surgery under general anesthesia and LINB retrospectively.

[Monitored Anesthesia Care for Respiratory Endoscopy].

Sedation and/or analgesia are required during respiratory endoscopy procedure to reduce the patient's anxiety, unpleasantness and pain. At present most of diagnostic respiratory endoscopy cases are carried out outside the operating room without the involvement of anesthesiologists in Japan. Inadequate anesthesia/sedation may cause patient's discomfort and/or serious injury.

Aldehyde dehydrogenase 2 deficiency increases resting-state glutamate and expression of the GluN1 subunit of N-methyl-D-aspartate receptor in the frontal cortex of mice.

Our previous study showed that Aldh2-knockout (Aldh2-KO) mice, an animal model of inactive aldehyde dehydrogenase 2 (ALDH2), have better spatial memory when compared with wild-type (WT) mice. Given that the neurotransmitter glutamate has been associated with learning and memory, the goal of the present study was to investigate whether the strain-dependent difference in spatial memory was associated with changes in glutamate transmitter levels or receptor function in the frontal cortex of Aldh2-KO and WT mice. Thus, we first measured extracellular glutamate levels in free-moving mice using microdialysis.

Case of vascular air embolism during holmium laser enucleation of the prostate.

Vascular air embolism is a rare complication during transurethral surgery. A case of air embolism during holmium laser enucleation of the prostate in a 76-year-old man is presented. During the step of morcellation, the patient's blood pressure suddenly oscillated up and down, and end-tidal CO2 and arterial saturation decreased.

Effort-reward imbalance and low back pain among eldercare workers in nursing homes: a cross-sectional study in Kagawa Prefecture, Japan.

Objectives: To clarify effort-reward imbalance among eldercare workers in nursing homes and to examine the association between the effort-reward imbalance (ERI) and low back pain (LBP) among them.

Methods: A total of 549 questionnaires were distributed to a random sample comprising 23% of the 79 special elderly nursing homes in Kagawa in 2013. A total of 467 eldercare workers (response rate 85%) participated in this study.

Hypnosis control based on the minimum concentration of anesthetic drug for maintaining appropriate hypnosis.

This paper proposes a novel hypnosis control method using Auditory Evoked Potential Index (aepEX) as a hypnosis index. In order to avoid side effects of an anesthetic drug, it is desirable to reduce the amount of an anesthetic drug during surgery. For this purpose many studies of hypnosis control systems have been done.

[Safety in general anesthesia for ambulatory electroconvulsive therapy].

Background: Ambulatory electroconvulsive therapy (ECT) is prevailing nowadays because of its lower cost and less disruption of the patient's social activity. We evaluated the safety and recovery profiles of general anesthesia for acute-phase or continuation/maintenance ambulatory ECT.

Methods: Forty outpatients with a mean age of 56 years for the management of mental disorders were reviewed.

D-allose ameliorates cisplatin-induced nephrotoxicity in mice.

Cisplatin (cis-diamminedichloroplatinum II) is a potent antineoplastic agent widely used to treat various forms of cancer. However, its therapeutic use is limited because of dose-dependent nephrotoxicity. Inflammatory mechanisms may play an important role in the pathogenesis of cisplatin nephrotoxicity.

High ethanol and acetaldehyde impair spatial memory in mouse models: opposite effects of aldehyde dehydrogenase 2 and apolipoprotein E on memory.

Aldehyde dehydrogenase 2 deficiency may directly contribute to excess acetaldehyde (AcH) accumulation after ethanol (EtOH) drinking and AcH mediates some of the behavioral effects of EtOH. Apolipoprotein E has been suggested to be involved in the alteration of attention and memory. We have chosen Aldh2-knockout (Aldh2-KO), ApoE-KO, and their wild-type (WT) control mice to examine the effects of EtOH and AcH on spatial memory and to compare the possible relationship between genetic deficiency and memory using two behavioral assessments.

[Remifentanil is useful for cardiovascular stability during cesarean delivery in a parturient with Marfan's syndrome].

A 25-year-old parturient with Marfan's syndrome was scheduled for cesarean delivery. She suffered with severe scoliosis and asymptomatic aortic root dilatation. To establish a cardiovascular stability and prevent aortic dissection perioperatively, we selected the use of remifentanil, an ultra-short acting opioid analgesic with general anesthesia.

Effect of single-dose dexmedetomidine on emergence agitation and recovery profiles after sevoflurane anesthesia in pediatric ambulatory surgery.

Purpose: To study the effects of dexmedetomidine (DEX), a selective α(2)-adrenoreceptor agonist, on emergence agitation (EA), recovery profiles, and parents' satisfaction after sevoflurane anesthesia in pediatric ambulatory surgery.

Methods: In a double-blind trial, 81 children (ASA PS 1 or 2, 1-9 years) undergoing same-day or overnight-stay surgery were randomly assigned to receive intravenous DEX 0.3 μg kg⁻¹ (n = 39) or saline (n = 42) over 10 min after induction of anesthesia.