Effect of cerebrospinal fluid drainage pressure in descending and thoracoabdominal aortic repair: a prospective multicenter observational study.

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.

Influence of p-glycoprotein on brain Bcl-2 family proteins and cytokines in transient cerebral ischemia.

Objectives: P-glycoprotein (P-gp), produced by the multidrug resistance (mdr1a) gene, is present in vascular endothelial cells, astrocytes, and microglia in the brain. We previously reported that P-gp aggravated cerebral infarct. Therefore, modulation of the function of P-gp is important for the treatment of brain ischemia.

Cerebrospinal fluid drainage to prevent postoperative spinal cord injury in thoracic aortic repair.

Background: Cerebrospinal fluid drainage (CSFD) is recommended as a spinal cord protective strategy in open and endovascular thoracic aortic repair. Although small studies support the use of CSFD, systematic reviews have not suggested definite conclusion and a large-scale study is needed. Therefore, we reviewed medical records of patients who had undergone descending and thoracoabdominal aortic repair (both open and endovascular repair) at multiple institutions to assess the association between CSFD and postoperative motor deficits.

Clinical Utility of Intraoperative Motor-Evoked Potential Monitoring to Prevent Postoperative Spinal Cord Injury in Thoracic and Thoracoabdominal Aneurysm Repair: An Audit of the Japanese Association of Spinal Cord Protection in Aortic Surgery Database.

Background: Spinal cord ischemic injury is the most devastating sequela of descending and thoracoabdominal aortic surgery. Motor-evoked potentials (MEPs) have been used to intraoperatively assess motor tract function, but it remains unclear whether MEP monitoring can decrease the incidence of postoperative motor deficits. Therefore, we reviewed multicenter medical records of patients who had undergone descending and thoracoabdominal aortic repair (both open surgery and endovascular repair) to assess the association of MEP monitoring with postoperative motor deficits.

Hypnotic effect of volatile anesthetics is mediated by PKC-γ dynamics.

Background: Although protein kinase C-γ (PKC-γ) is a target for the effects of volatile anesthetics, the molecular mechanisms of the kinase function remain unclear. We examined the effects of different types of anesthetics on PKC-γ knockout mice, and investigated the dynamics of the kinase in mouse brain.

Methods: We measured the required number of times for loss of righting reflex (rtfLORR) after administration of isoflurane, sevoflurane, and propofol on PKC-γ knockout mice and compared with those of wild-type mice.

[Anesthesia management during coronary artery aneurysmectomy and tricuspid valvulectomy].

A 54-year-old man with infective tricuspid endocarditis and an infective right coronary artery aneurysm was scheduled for simultaneous coronary artery aneurysmectomy and tricuspid valvulectomy. However, the tricuspid valve replacement and annuloplasty procedures could not be performed because vegetation was noted on all his tricuspid leaflets. Moreover, the infective right coronary artery aneurysm was located proximal to the annulus of the tricuspid valve.

[Molecular mechanism of ischemic brain injuries and perspectives of drug therapies for neuroprotection].

Ischemic brain injury is a critical condition in the management of patients during anesthesia and intensive care. It is not rare that pathological conditions such as cerebral ischemia, head trauma and low oxygen result in marked impairment of cerebral function, even if the patient's life is saved. We sometimes encounter sudden changes in a patient's condition not only during anesthesia, but also in intensive care unit with transient low-oxygen and ischemic conditions accompanying serious shock.

[General anesthesia for thyroplasty employing voice test].

Background: We reported an anesthetic technique for thyroplasty employing voice test. Thyroplasty is performed to improve voice quality in patients with unilateral vocal cord paralysis. Correct displacement of the vocal cord is assessed by asking the patient to phonate.

Novel radiator for carbon dioxide absorbents in low-flow anesthesia.

During long-term low-flow sevoflurane anesthesia, dew formation and the generation of compound A are increased in the anesthesia circuit because of elevated soda lime temperature. The object of this study was to develop a novel radiator for carbon dioxide absorbents used for long durations of low-flow sevoflurane anesthesia. Eleven female swine were divided into two groups comprising a "radiator" group (n = 5) that used a novel radiator for carbon dioxide absorbents and a "control" group (n = 6) that used a conventional canister.