Publications by authors named "Obata N"

Background: Spinal cord stimulation (SCS) is widely accepted as a useful treatment for patients with intractable chronic pain. However, its effectiveness varies between individuals. Therefore, a tool for evaluating its effectiveness in advance is eagerly awaited.

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Aim: When elderly people return to their daily lives after inpatient treatment, they may be offered a chance to change the residence to which they are accustomed. The present study clarified the changes in the residence of elderly patients through an Integrated Community Care Ward (ICCW).

Subjects And Methods: Patients were admitted to and discharged from the ICCW (53 beds) of Hospital A, located in a city with a population of 30,000 and an aging rate of 37%, for 2 years from April 1, 2018, to March 31, 2020.

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Article Synopsis
  • * A 68-year-old woman with this condition, linked to Takayasu arteritis, underwent a bypass surgery with extracorporeal membrane oxygenation (ECMO) due to severe cardiac dysfunction and recurrent heart failure.
  • * The patient's care involved careful preparation for potential circulatory collapse during anesthesia induction, ensuring a quick response with ECMO if complications arose.
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  • * A 71-year-old man with a history of heart issues experienced cardiac arrest due to an AAA rupture into the inferior vena cava, requiring emergency surgery.
  • * Successful management involved early recognition of an intraoperative right-to-left shunt via transesophageal echocardiography and the use of intra-aortic balloon occlusion to control severe bleeding.
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Background: Although 5-aminolevulinic acid is useful for the photodynamic diagnosis of bladder tumors, it often causes severe intraoperative hypotension. We report a case of postoperative cardiac arrest in addition to severe intraoperative hypotension, probably owing to the use of 5-aminolevulinic acid.

Case Presentation: An 81-year-old Japanese man was scheduled to undergo transurethral resection of bladder tumor.

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Article Synopsis
  • - The case discusses the perioperative approach for a pregnant woman with a severe fear of needles who required a cesarean section.
  • - Unique anesthesia was used, involving slow induction with an inhalant due to her reluctance to have needles or indwelling objects.
  • - Post-surgery, the patient was in the ICU on mechanical ventilation under deep sedation, but both she and her baby recovered without complications.
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Background: Various factors can cause vascular endothelial damage during cardiovascular surgery (CVS) with cardiopulmonary bypass (CPB), which has been suggested to be associated with postoperative complications. However, few studies have specifically investigated the relationship between the degree of vascular endothelial damage and postoperative acute kidney injury (pAKI). The objectives of this study were to measure perioperative serum syndecan-1 concentrations in patients who underwent CVS with CPB, evaluate their trends, and determine their association with pAKI.

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Purpose: Elderly patients with proximal femoral fractures are known to be a high-risk group for postoperative delirium (POD). The aim of this study was to determine the association of the benzodiazepine drug remimazolam with POD in elderly patients with proximal femoral fractures.

Methods: In this single-center retrospective observational study, we included patients aged 65 years or older who underwent general anesthesia for proximal femoral fractures.

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We report a case involving anesthetic management of Stanford type B acute aortic dissection occurred during transcatheter aortic valve implantation (TAVI) under monitored anesthesia care (MAC) in a patient with aortic stenosis (AS). An 87-year-old woman was undergoing TAVI under MAC for severe AS. During the surgery, the patient suddenly moved possibly because of pain.

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Objective: Patients with chronic pain often have sleep disturbances, and many patients receive sleep medications in addition to analgesics. Although there have been scattered reports of negative pain-sleep interactions, only a few reports have investigated the efficacy of sleep medication interventions in patients with chronic pain for improving sleep disturbances and reducing pain. We retrospectively examined whether lemborexant, an orexin receptor antagonist, is effective in improving sleep disturbances and reducing pain in patients with chronic pain.

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We conducted the treatment of a highly obese patient with severe Covid-19 pneumonia who had a history of asthma. When she arrived at the hospital, she was already intubated and had mediastinal emphysema and severe hypoxemia. Because the patient's condition did not improve with mechanical ventilation, we introduced extracorporeal membrane oxygenation (ECMO) immediately after admission.

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The neuromuscular blocking potency of rocuronium varies with respiratory pH changes, increasing at lower pH and decreasing at higher pH; thus, hyperventilation-induced respiratory alkalosis is expected to decrease the potency of rocuronium. We report a case of anesthetic management of modified electroconvulsive therapy (m-ECT) for a patient monitored with electromyography-based neuromuscular monitoring during two patterns of ventilation to elucidate their relationship and propose the possible mechanisms underlying the effects by computational simulations. Case presentation: The patient was a 25-year-old man with schizophrenia.

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Purpose: Cerebrospinal fluid drainage (CSFD) is recommended during open or endovascular thoracic aortic repair. However, the incidence of CSFD complications is still high. Recently, CSF pressure has been kept high to avoid complications, but the efficacy of CSFD at higher pressures has not been confirmed.

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Objectives: To study the timing, threshold, and duration of intraoperative hypotension (IOH) associated with the risk of postoperative delirium (POD).

Design: A single-center retrospective observational study.

Setting: University teaching hospital.

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The southern root-knot nematode (SRKN; ) is a typical parasitic nematode that affects sweetpotato [ (L.) Lam.], causing a significant decrease in crop yield and commercial value.

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Sustained neuropathic pain from injury or inflammation remains a major burden for society. Rodent pain models have informed some cellular mechanisms increasing neuronal excitability within the spinal cord and primary somatosensory cortex (S1), but how activity patterns within these circuits change during pain remains unclear. We have applied multiphoton in vivo imaging and holographic stimulation to examine single S1 neuron activity patterns and connectivity during sustained pain.

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Antiresorptive agent-related osteonecrosis of the jaw (ARONJ) causes severe pain that cannot be controlled well by common analgesic drugs. This is a first case report of intractable mandibular pain due to ARONJ that was eliminated by a continuous mandibular nerve block. A 72-year-old woman with osteoporosis had been administered bisphosphonate.

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Article Synopsis
  • - This study focuses on a male patient with schizophrenia who has a de-novo balanced translocation involving chromosomes 4 and 13.
  • - Researchers identified the specific breakpoints in these chromosomes, discovering that the one on chromosome 4 is located 32.6 kbp upstream of the LDB2 gene, which is associated with brain function.
  • - The investigation also found a rare, novel missense variant in patients with psychiatric disorders, suggesting a potential link between genetic variations and psychiatric conditions.
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Background: The risk of surgical site infection has been reported to be higher in patients with poorly controlled diabetes. Since chronic hyperglycemia impairs neutrophil functions, preoperative glycemic control may restore neutrophil function. However, long-term insulin therapy may lead to a delay in surgery, which may be a problem, especially in cancer surgery.

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  • The study aimed to measure glycemic fluctuations (MAGE) in septic patients using continuous glucose monitoring (CGM) and examine its links to patient outcomes and oxidative stress indicators.
  • Data was collected from 40 adult septic patients in the ICU over a 48-hour period, focusing on their blood glucose levels and the effects on 90-day mortality and ICU-free days.
  • Results showed that higher MAGE was linked to increased mortality rates, fewer ICU-free days, and higher levels of oxidative stress marker (urinary 8-isoprostaglandinF2α) in non-survivors compared to survivors.
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We report a successful case of fluoroscopic percutaneous retrocrural coeliac plexus neurolysis (PRCPN) for pancreatic cancer pain refractory to endoscopic ultrasound-guided coeliac plexus neurolysis (EUS-CPN). A 55-year-old man with upper abdominal pain due to end-stage pancreatic cancer underwent EUS-CPN. Although CT revealed distribution of the contrast medium with neurolytic agent around the left and cephalic sides of the coeliac artery, the pain did not improve and became even more severe.

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Background: There has been much discussion recently about the occurrence of neuropsychological complications during the perioperative period. Diabetes is known to be one of the metabolic risk factors. Although the number of patients with diabetes mellitus (DM) has been increasing, the pathophysiology of postoperative neuropsychological dysfunction in DM patients is still unclear.

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We managed general anesthesia for transcatheter aortic valve replacement (TAVR) under elective extracorporeal membrane oxygenation (ECMO) in a patient with aortic valve stenosis (AS) complicated with acute decompensated heart failure. The patient was an 87-year-old woman with acute heart failure due to severe AS who had been hospitalized. However, her low cardiac output did not improve, and weaned her off catecholamines was difficult, so semi-urgent TAVR was performed.

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Background: Modified electroconvulsive therapy (m-ECT) is utilized worldwide as an effective treatment for drug-resistant psychiatric disorders. However, during m-ECT, treatment of hypotension and hypertension in response to rapid hemodynamic changes is required. We used noninvasive continuous blood pressure monitoring system for continuous hemodynamic measurement during m-ECT.

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