[Usefulness of epidural anesthesia for percutaneous endoscopic lumbar discectomy (PELD)].

Background And Methods: To study feasibility of epidural anesthesia for percutaneous endoscopic lumbar discectomy (PELD), we made a retrospective comparison of three anesthetic groups (28 cases with epidural anesthesia, 19 cases with local anesthesia, and 28 cases with general anesthesia) undergoing PELD.

Results: Three groups matched each other in age, the surgical site, and the duration of surgery; however, the frequency of male patients was significantly greater in the local anesthesia (LA) group. In the epidural anesthesia (EA) group, there was no patient who required a change of the anesthetic technique or analgesics administration during surgery.

Effects of erythropoietin on intracellular calcium concentration of rat primary cortical neurons.

Erythropoietin (Epo) has been shown to afford neuroprotection in many experimental models. Although the cytosolic Ca(2+) concentration ([Ca(2+)](i)) is an important factor regulating cell survival, the effects of Epo on [Ca(2+)](i) in neurons are not fully elucidated. We studied the effects of human recombinant Epo on [Ca(2+)](i) of rat primary cortical neurons in normal and excitotoxic conditions.

[Facial edema and pruritus after intravenous injection of midazolam].

Midazolam is a short-acting benzodiazepine commonly used for conscious sedation for a variety of procedures. Severe adverse reactions, including respiratory depression, respiratory arrest, and anaphylactoid reaction, have been described by manufacturers. We report a patient who developed facial edema after iv injection of midazolam during caesarian section.

[Anesthesia management may alter long-term outcome-review of recent reports].

Perioperative management including anesthesia may alter long-term outcome of surgical patients. We have reviewed abstracts for meeting and articles published recently concerning effects of anesthetic depth, volatile anesthetic preconditioning, beta-blockers, alpha-agonists, statins, and glucose control on long-term outcome. Although research in this area has just been started, we, anesthesiologists should recognize its importance.

[The effects of inhaled carbon monoxide on lung injury in rats caused by lipopolysaccharide].

Background: Carbon monoxide (CO) has long been considered a toxic substance. Recent studies have revealed that CO may play an important role in intercellular signaling. We hypothesized that CO modulates the inflammatory mechanisms.

[Prostanoids and acute lung injury].

Prostanoids with various physiological effects in the lung, have been shown to be one of the important factors in acute lung injury. However, in large scale clinical studies, beneficial effects of NSAIDs or PGE1 have not been demonstrated. On the other hand, with progress of basic research in prostaglandin metabolic pathway, receptor and synthase of each prostanoid have been clarified, and selective COX-2 blockers have been developed and are now available in Japan.

[Effects of fentanyl on acetylcholine release from hippocampus and righting reflex in rat: an in vivo brain microdialysis study].

Fentanyl, a synthetic mu-opioid agonist, is one of the most popular opioids in clinical anesthesia. It is well-known that memory is affected by opioids and opioid antagonists in animals. Cholinergic neurones releasing acetylcholine (ACh) particularly in the hippocampus have been shown to be related to memory.

Activation of alveolar macrophages in acid-injured lung in rats: different effects of pentoxifylline on tumor necrosis factor-alpha and nitric oxide production.

Objective: To determine whether acid instillation augments tumor necrosis factor-alpha and nitric oxide production by alveolar macrophages in rats, and to study the effects of treatment with pentoxifylline before acid instillation on the production of these inflammatory mediators.

Design: Controlled laboratory investigation on tumor necrosis factor-alpha and nitric oxide production by alveolar macrophages of rats that had acid-induced lung injury.

Setting: University research laboratory.

Acid instillation enhances the inflammatory response to subsequent lipopolysaccharide challenge in rats.

Aspiration of gastric contents is one of leading causes of the acute respiratory distress syndrome (ARDS). The pathogenesis of acid aspiration-induced acute lung injury is well understood. Less clear is why patients who have suffered acid aspiration are susceptible to ARDS.

[Pretreatment of acid-induced lung injury with specific neutrophil elastase inhibitor ONO-5046 did not exasperate the subsequent bacterial lung infection by Pseudomonas aeruginosa].

Patients with acid lung injuries are at high risk for bacterial pulmonary infections which commonly occur several days after the acid aspiration. We reported that a specific neutrophil elastase inhibitor ONO-5046 inhibited the multi-organ injury caused by acid-instillation into the lung. In this study, we evaluated the effect of ONO-5046 on lung infection by Pseudomonas aeruginosa (PAO-1:Ps.

8 Br-cAMP enhances both humoral and cell-mediated immune responses induced by an HIV-1 DNA vaccine.

From a series of preclinical studies and animal experiments, we have been able to demonstrate that DNA vaccines are a promising tool in strategies for protecting hosts from a variety of infectious diseases. Since the promoter activity of the human cytomegalovirus immediate-early promoter/ enhancer (CMV promoter) is known to be responsive to an elevation in the level of intracellular cAMP, we hypothesized that use of cAMP analogue (8-Bromo adenosine 3'5'-cyclic monophosphate, 8 Br-cAMP) would increase the level of transgene expression supported by the CMV, and enhance the ability of DNA vaccines to evoke an immune response against the transgene product in vivo. To evaluate this hypothesis, immune responses against HIV-1 envelope protein, gp160, an immunogenic HIV-1 component expressed under the control of the CMV promoter, were evaluated in BALB/c mice with or without stimulation by 8 Br-cAMP.

In vivo gene gun-mediated DNA delivery into rodent brain tissue.

Various types of gene transfer into live tissues have been tried. However, in vivo gene transfer into brain tissue or neuronal cells without virus vector has required a great effort. Particle-mediated gene transfer into live brain tissue was thought to be impossible because of its fragility and the mechanical problem of a previous type of gene gun.

The effects of two antiinflammatory pretreatments on bacterial-induced lung injury.

Background: Two antiinflammatory therapies that have been effective in preventing acid-induced lung injury were evaluated. Specifically, their effects on a subsequent bacterial-airspace challenge were compared. Bacteria were instilled 24 h after acid-induced lung injury.

Intranasal administration of HIV-DNA vaccine formulated with a polymer, carboxymethylcellulose, augments mucosal antibody production and cell-mediated immune response.

We previously reported that intramuscular (i.m.) immunization of DNA vaccine encoding human immunodeficiency virus type 1 (HIV-1)IIIB env and rev genes alone or in combination with appropriate adjuvant induces substantial and enhanced immune response against HIV-1.

Role of alveolar macrophages in initiation and regulation of inflammation in Pseudomonas aeruginosa pneumonia.

To evaluate the role of alveolar macrophages (AMs) in acute Pseudomonas aeruginosa pneumonia in mice, AMs were depleted by aerosol inhalation of liposomes containing clodronate disodium. AM-depleted mice were then intratracheally infected with 5 x 10(5) CFU of P. aeruginosa.

Induction of cyclooxygenase-2 in alveolar macrophages after acid aspiration: selective cyclooxygenase-2 blockade reduces interleukin-6 production.

Background: Gastric acid aspiration can result in acute lung injury. In this study, the authors determined whether alveolar macrophages express cyclooxygenase-2 as a source of inflammatory mediators after acid aspiration.

Methods: Seventy-five microliters of hydrochloric acid solution, pH 1.

Endothelial exposure to Pseudomonas aeruginosa proteases increases the vulnerability of the alveolar epithelium to a second injury.

The alveolar epithelium is not injured by the apical application of moderate doses of Pseudomonas aeruginosa strains that produce protease. To determine the effect of Pseudomonas proteases on the basolateral surface of the alveolar epithelium, a series of experiments were done, in which P. aeruginosa strains that produce and do not produce proteases were administered intravenously.

[Aspiration pneumonitis; progress in understanding its acute pathophysiology and its therapy].

Aspiration of gastric contents has been a major cause of acute respiratory failure in adult patients, and its mortality has been very high. Current method of treatment is limited, but the pathogenesis of acid aspiration lung injury has been well studied. The lung injury can be divided into direct and secondary injury.

Neutrophil elastase inhibitor, ONO-5046, modulates acid-induced lung and systemic injury in rabbits.

Background: Acid instillation leads to direct lung and to secondary systemic organ injury, probably via activated macrophages and neutrophils. This study investigated the effects of neutrophil elastase on organ injury after unilateral lung acid instillation by administrating a specific neutrophil elastase inhibitor, ONO-5046, before acid instillation.

Methods: Three groups of anesthetized rabbits (n = 12 in each group) underwent tracheostomies, and instillations were made into their right lower lobe airspaces with either phosphate buffered saline (pH, 7.

Complement partially mediates acid aspiration-induced remote organ injury in the rat.

Background: Acid aspiration into one lung is known to cause both a local as well as remote organ injury characterized by neutrophil sequestration and subsequent edema. This study investigated investigated the role of the complement cascade in the development of acid aspiration-induced local lung and remote organ injuries using K-76 COONa (K76), an anticomplement agent that inhibits the complement pathway at the C5 step, and its usefulness as a treatment drug.

Methods: Anesthetized rats underwent tracheostomy and insertion of a cannula.

[Activation of endothelium in cardiac surgery: the circulating levels of soluble E-selectin as a marker of the activation of endothelium].

Cardiopulmonary bypass (CPB) is associated with a whole body inflammatory response which may have detrimental consequence resulting in post perfusion syndrome. Adhesion molecule E-selectin plays a pivotal role in the inflammatory response, especially in the interaction of endothelium and neutrophils. Soluble form of E-selectin (sE-selectin) is thought to be a marker of endothelial activation.

Hepatitis B virus carriers in the treatment of malignant lymphoma: an epidemiological study in Japan.

Background: Hepatitis B after the withdrawal of cytotoxic chemotherapy in hepatitis B virus (HBV) carriers is well known and may lead to fatal hepatic failure. We retrospectively analyzed the prevalence of HBV carriers, the incidence, and the risk factors of hepatitis B in the treatment of malignant lymphoma.

Patients And Methods: HBV carriers were defined as patients with positive HBs-antigen, either with normal or abnormal serum aminotransferase level at patient presentation.

Soluble complement receptor type 1 inhibited the systemic organ injury caused by acid instillation into a lung.

Background: Acid aspiration into one lung causes contralateral lung injury and systemic organ injury; this injury is thought to be mediated by the sequestration of activated neutrophils. Recombinant human soluble complement receptor 1 (sCR1) inhibits both the classical and alternative complement pathways; this study investigated the role of the complement system in unilateral acid lung injury by measuring the effects of administering sCR1 before or immediately after acid instillation.

Methods: Anesthetized rats (n = 18 in each group) underwent tracheostomy and insertion of a cannula into the anterior segment of the left lung.

Cerebral autoregulation is impaired in patients resuscitated after cardiac arrest.

Background: Cerebral autoregulation is important to maintain a constant perfusion in the face of changes in blood pressure. It is reported to be impaired in pathologic states, including hypertension, cerebral infarction, and head injury. However, it is not clear whether cerebral autoregulation is impaired in resuscitated patients after cardiac arrest.