[Airway management in a patient with Williams syndrome].

Williams syndrome is characterized by the triad of supravalvular aortic stenosis (SAS), mental retardation and elfin facies. Generally, difficult airway is expected in patients with Williams syndrome by characteristic face. A 26-year-old female with Williams syndrome was scheduled for abdominal myomectomy under general anesthesia.

[Case of severe hypokalemia during emergency surgery caused by long-term administration of Shakuyaku-kanzo-to].

An 82-year-old female underwent emergency surgery for right femoral incarcerated hernia under general anesthesia. Anesthesia was induced and maintained with remifentanil and propofol. Her laboratory data showed severe hypokalemia (1.

[Sleep and anesthesia--part 2, on the relationship between sleep and general anesthesia].

We reviewed historical and current trends on study regarding the relationship between sleep and general anesthesia. Historically, sleep has been recognized as a completely different physiological phenomenon from general anesthesia. Therefore, sleep study has been thought that it has no merit in anesthesia study.

[Severe hypoxia during right lateral position induced by mediastinal shift].

An 87-year-old woman with osteoarthrosis of her left hip joint was scheduled for total hip arthroplasty. After induction of anesthesia the patient was put into the right lateral position for surgery. Oxygen saturation had decreased gradually and the respiratory sound of the right lung was not auscultated.

[Sleep and anesthesia--Part 1, Recent findings in research].

We described how modern neuroscience has elucidated what is sleep and its implication, and also reviewed histological and current trends in search of sleep mechanism from view of neurocirculatory or hormonary basis studies. We conclude that anesthesia and sleep share some neuronal structure in their action and mechanism of anesthesia could be elucidated through sleep study. In addition, anesthesia-related sleep disturbance must be settled to serve satisfied quality of life of patients and to save economic and medical resources.

[Case of hemoglobinuria following glycerin enema].

A 57-year-old man with lung tumor was scheduled for right middle lobectomy under general anesthesia. The patient received glycerin enema 2 hours before anesthesia. Anesthesia was induced with propofol, fentanyl, ketamine and vecuronium.

Growth hormone-releasing hormone: cerebral cortical sleep-related EEG actions and expression.

Growth hormone-releasing hormone (GHRH), its receptor (GHRHR), and other members of the somatotropic axis are involved in non-rapid eye movement sleep (NREMS) regulation. Previously, studies established the involvement of hypothalamic GHRHergic mechanisms in NREMS regulation, but cerebral cortical GHRH mechanisms in sleep regulation remained uninvestigated. Here, we show that unilateral application of low doses of GHRH to the surface of the rat somatosensory cortex ipsilaterally decreased EEG delta wave power, while higher doses enhanced delta power.

TNFalpha siRNA reduces brain TNF and EEG delta wave activity in rats.

Tumor necrosis factor alpha (TNFalpha) is a pleiotropic cytokine with several CNS physiological and pathophysiological actions including sleep, memory, thermal and appetite regulation. Short interfering RNAs (siRNA) targeting TNFalpha were incubated with cortical cell cultures and microinjected into the primary somatosensory cortex (SSctx) of rats. The TNFalpha siRNA treatment specifically reduced TNFalpha mRNA by 45% in vitro without affecting interleukin-6 or gluR1-4 mRNA levels.

Unilateral cortical application of interleukin-1beta (IL1beta) induces asymmetry in fos, IL1beta and nerve growth factor immunoreactivity: implications for sleep regulation.

Unilateral injection of interleukin-1 beta (IL1beta) into the somatosensory cortex enhances EEG slow wave activity ipsilaterally during non-rapid eye movement sleep [Yasuda, T., Yoshida, H., Garcia-Garcia, F.

State-dependent effects of light-dark cycle on somatosensory and visual cortex EEG in rats.

Somatosensory (SSctx) and visual cortex (Vctx) EEG were evaluated in rats under a 12:12-h light-dark (LD) cycle and under constant light (LL) or constant dark (DD) in each sleep or wake state. Under LD conditions during light period, relative Vctx EEG slow-wave activity (SWA) was higher than that of the SSctx, whereas during dark period, relative Vctx EEG SWA was lower than in the SSctx. These effects were state specific, occurring only during non-rapid eye movement sleep (NREMS).

Interleukin-1beta has a role in cerebral cortical state-dependent electroencephalographic slow-wave activity.

Study Objectives: To investigate the hypothesis that interleukin (IL)-1beta is involved in mediating localized electroencephalogram synchronization.

Design: We evaluated bilateral cortical electroencephalograms after unilateral local application of IL-1beta onto the somatosensory cortex of rats. Furthermore, we investigated the effects of unilateral application of an IL-1beta inhibitor, the IL-1 soluble receptor, on spontaneous sleep and sleep rebound after sleep deprivation.

Unilateral cortical application of tumor necrosis factor alpha induces asymmetry in Fos- and interleukin-1beta-immunoreactive cells within the corticothalamic projection.

A unilateral microinjection of tumor necrosis factor alpha (TNFalpha) (150 ng) onto the primary somatosensory cortex induces state-dependent asymmetries in electroencephalographic (EEG) slow wave activity during non-rapid eye movement sleep in rats [H. Yoshida, Z. Peterfi, F.

State-specific asymmetries in EEG slow wave activity induced by local application of TNFalpha.

Sleep is posited to be a fundamental property of groups of highly interconnected neurons and regulated in part by activity-dependent sleep regulatory substances such as tumor necrosis factor alpha (TNFalpha). We show that the unilateral local application of TNFalpha onto the somatosensory cortex of rats induced state- and frequency-dependent EEG asymmetries. In contrast, the unilateral injection of a TNFalpha inhibitor, a TNFalpha soluble receptor, attenuated sleep deprivation-enhanced EEG slow wave power ipsilaterally during non-rapid eye movement sleep (NREMS) but not during REMS or waking.

Tumor necrosis factor-alpha reduces ketamine- and propofol-induced anesthesia time in rats.

Unlabelled: Tumor necrosis factor-alpha (TNFalpha) is a crucial neuromodulator in the brain. TNFalpha is involved in many physiological events including pain response and sleep. However, the interactions between TNFalpha and anesthetics have not been elucidated yet.

Middle-ear pressure variations during total intravenous anesthesia with propofol, fentanyl, and ketamine.

Purpose: As the middle-ear cavity is one of the noncompliant gas-filled cavities, an increase in middle-ear pressure (MEP) instead of volume expansion is observed with inhalation of nitrous oxide (NO). Changes in MEP cause many complications, such as ear pain, temporary hearing impairment, and postoperative emesis. Therefore, we investigated changes in MEP during total intravenous anesthesia (TIVA) with propofol, fentanyl, and ketamine (PFK) and inhalation of NO.