Effect of blood sample storage period on d-ROMs and BAP test data.

The Diacron-reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) tests can easily and rapidly measure the state of oxidative stress in the blood; they have been used to determine the relationship between oxidative stress and various diseases. However, the extent to which the blood storage period affects the analyzed data remains unclear. In clinical practice, the storage conditions for samples after blood collection vary.

Analysis of Maternal and Fetal Oxidative Stress During Delivery with Epidural Analgesia.

Childbirth is a stressful event for mothers, and labor epidural analgesia (LEA) may reduce mental stress. Mental stressors include labor pain, fear, and anxiety, which induce oxidative stress. In this study, we focused on oxidative stress during delivery and conducted a cross-sectional analysis of maternal and fetal oxidative stress.

Outcomes of severe peripartum cardiomyopathy and mechanical circulatory support: a case series.

Background: We present three cases of severe peripartum cardiomyopathy (PPCM) that required mechanical circulatory supports.

Case Presentation: Case 1: A 33-year-old woman developed acute heart failure (AHF) after normal spontaneous delivery. Intra-aortic balloon pump (IABP) was inserted on postpartum day (PD) 10 with a peripartum cardiomyopathy (PPCM), which was withdrawn on PD 30 after medical treatment including anti-prolactin drugs.

Use of Continuous Electrical Impedance Measurement for Accurate Nerve Block in Rabbits.

Objective: To perform an effective and safe nerve block, the needle must be placed near the target nerve while avoiding nerve damage. Our objective was to conduct an animal study to determine whether changes in electrical impedance (EI) could be used to guide the needle and achieve a safe and accurate nerve block.

Methods: We measured the EI of rabbit tissues during ultrasound-guided sciatic nerve block using a bipolar needle via the in-plane needle approach.

A case of amniotic fluid embolism successfully treated by multidisciplinary treatment.

Background: Amniotic fluid embolism (AFE) is a life-threatening obstetric emergency. Because the maternal mortality associated with AFE is very high, early recognition and prompt treatment are important for improving the prognosis. We report a case of amniotic fluid embolism successfully treated by multidisciplinary treatment.

Successful pulmonary embolectomy for massive pulmonary embolism during pregnancy: a case report.

Background: Pulmonary embolism (PE) resulting from venous thromboembolism is a leading cause of maternal mortality in pregnancy. In patients with massive PE and hemodynamic instability, the treatment options often considered are thrombolytics, inferior vena caval filters, or embolectomy. We report here the case of a patient with massive PE at 28 weeks' gestation, who underwent emergency pulmonary embolectomy via cardiopulmonary bypass.

A case of laparotomic cholecystectomy in a patient with biventricular assist devices.

We describe a patient with biventricular assist devices who had systemic inflammation because of cholecystitis that required open cholecystectomy, and we discuss the anesthetics and monitors that should be used in unstable patients with ventricular assist devices (VADs) who are undergoing major surgery. The patient was a 40-year-old man in the dilated phase of hypertrophic obstructive cardiomyopathy, who was implanted with an internal left VAD and external right VAD. We anesthetized the patient with a combination of a low dose of sevoflurane and ketamine to minimize vasodilation.

Periarteritis in lung from a continuous-flow right ventricular assist device: role of the local Renin-Angiotensin system.

Background: We previously reported renal arterial periarteritis after implantation of a continuous-flow left ventricular assist device in calves. The purpose of the present study was to investigate whether the same periarteritis changes occur in the intrapulmonary arteries after implantation of a continuous-flow right ventricular assist device (CFRVAD) in calves and to determine the mechanism of those histologic changes.

Methods: Ten calves were implanted with a CFRVAD for 29 ± 7 days, and we compared pulmonary artery samples and hemodynamic data before and after CFRVAD implantation prospectively.

Does general anesthesia increase the diagnostic yield of endoscopic ultrasound-guided fine needle aspiration of pancreatic masses?

Background: : Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of the pancreas has become the preferred method for tissue diagnosis for pancreatic solid masses. The yield of EUS-FNA in this setting is influenced by multiple factors. We hypothesized that general anesthesia (GA) may improve EUS-FNA yield by improving patient cooperation and stillness during the procedure.

[A day in the busy obstetric unit from the anesthesiologist point of view, experience at the Cleveland clinic; Cleveland, Ohio].

Cleveland Clinic Labor and Delivery Unit is a syntactical delivery facility and comprised of 16 delivery rooms, 3 operating rooms, 3 triage rooms, and 1 recovery room that has a capacity of 6 beds, 43 postpartum rooms, 2 nurseries, and 1 neonatal intensive care unit (NICU). Cleveland Clinic Labor and Delivery Unit (LDU) had 3,691 delivery cases in 2007. The ratio of neuraxial analgesia (NA) during labor is 84.

[Obstetric anesthesia training in the USA, experience of the Cleveland Clinic; Cleveland, Ohio].

In Japan, the re-organization of obstetrical medical system is needed and this project is ongoing under Japanese government initiative. However the ratio of using neuraxial analgesia (NA) during labor in Japan has been low and, increased demand for NA during labor is anticipated in near future. To prepare for these demands, the adequate number of obstetrical (OB) anesthesia specialists in the advanced OB hospital is necessary.

Human clinical fitting study of the DexAide right ventricular assist device.

The DexAide right ventricular assist device (RVAD) has been developed as an implantable RVAD. The purpose of this study was to determine the final design and optimal anatomical placement of the DexAide RVAD when implanted simultaneously with either of two commercially available left ventricular assist devices (LVADs) in patients. A mock-up DexAide RVAD was used to assess configuration with each of two types of commercially available LVADs at the time of LVAD implantation in three human clinical cases.

Comparative study of heart rate variability between healthy human subjects and healthy dogs, rabbits and calves.

Several studies have been performed to assess heart rate variability (HRV) in several species such as humans, dogs, pigs, calves, rabbits and rats. However, haemodynamic parameters are totally different in each animal, and optimal animal models for studying HRV corresponding to human HRV are still unclear. The purpose of this study was to assess HRV in human subjects and to compare those HRV data with canine, bovine and rabbit HRV data.

Heart rate variability in a progressive heart failure model with rapid ventricular pacing.

Background: Heart rate variability (HRV) is an indicator of autonomic nervous system functionality and a recognized predictor of cardiac death; however, the changes in HRV occurring in progressive heart failure are not fully understood. The purpose of this study was to evaluate the progressive changes of autonomic system activity in progressive heart failure by rapid ventricular pacing in an animal model.

Methods: Heart failure was induced in 13 mongrel dogs (27.

Phasic coronary blood flow patterns in dogs vs. pigs: an acute ischemic heart study.

Background: Canine and porcine hearts have been widely used to investigate diagnoses, interventions, and surgical therapies for ischemic heart disease. Dogs and pigs are known to vary with regard to the anatomic distribution of their coronary arteries. However, the mechanisms of these differences and the differing phasic coronary blood flow patterns between the two species are not well characterized.

Reduced pulsatility induces periarteritis in kidney: role of the local renin-angiotensin system.

Objective: The need for pulsatility in the circulation during long-term mechanical support has been a subject of debate. We compared histologic changes in calf renal arteries subjected to various degrees of pulsatile circulation in vivo. We addressed the hypothesis that the local renin-angiotensin system may be implicated in these histologic changes.

Acute reduction of functional mitral regurgitation in canine model using an epicardial device.

Purpose: This study evaluated the short-term feasibility of a novel epicardial device that treats functional mitral regurgitation by simultaneously changing the mitral and the left ventricular geometry.

Description: We implanted a prototype device that consists of 2 tissue anchors, a deflector, and a flexible tightening chord in 7 mongrel dogs with heart failure and functional mitral regurgitation induced by rapid ventricular pacing. Hemodynamic and echocardiographic data were obtained before and after device implantation.

Beating heart cardioscopy: a platform for real-time, intracardiac imaging.

Purpose: The purpose of this study was to develop a method for real-time, fiberoptic, intracardiac imaging to serve as a platform for closed-chest, intracardiac surgery on the beating heart.

Description: Fiberoptic cardioscopy of the left and right heart was conducted in a porcine model. A cardiopulmonary bypass circuit maintained systemic organ perfusion and a separate circuit replaced intracardiac blood with oxygenated, modified Krebs-Henseleit perfusate.

Development of the DexAide right ventricular assist device inflow cannula.

Cannula design and cannulation site can pose major limitations to chronic pump implantations in animal studies. The aim of this study was to evaluate the biocompatibility of various inflow cannula designs for the DexAide right ventricular assist device (RVAD). The DexAide RVAD was implanted for intended durations of 14, 30, or 90 days in 19 animals (mean 20 +/- 11 days).

Acute in vivo evaluation of an implantable continuous flow biventricular assist system.

An implantable biventricular assist device offers a considerable opportunity to save the lives of patients with combined irreversible right and left ventricular failure. The purpose of this study was to evaluate the hemodynamic and physiologic performance of the combined implantation of the CorAide left ventricular assist device (LVAD) and the DexAide right ventricular assist device (RVAD). Acute hemodynamic responses were evaluated after simulating seven different physiological conditions in two calves.

Innovative, replaceable heart valve: concept, in vitro study, and acute in vivo study.

The purpose of this study was to evaluate the feasibility of our innovative, replaceable heart valves that can be easily detached from the sewing ring at the time of repeat replacement. The prototype devices consist of the base magnet ring assembly and the valve magnet ring assembly that utilize magnetic coupling force for the locking mechanism. Magnetic coupling strength was evaluated in vitro.