Association between heated tobacco product use and airway obstruction: a single-centre observational study, Japan.

Background: While heated tobacco products (HTPs) may affect pulmonary function, the evidence supporting the utility of screening for HTP use in clinical settings is insufficient. We examined the association between HTP use and airway obstruction after switching from cigarettes.

Method: The study subjects were patients aged ≥20 years undergoing surgery from December 2021 to September 2022 who completed spirometry and reported tobacco (cigarette and HTP) use status during the preoperative assessment.

Successful weaning of a patient with severe COVID-19 pneumonia under prolonged midazolam sedation using morphine.

The coronavirus disease 2019 (COVID-19) pandemic continues to spread around the world. In April 2021, Japan experienced a fourth wave of COVID-19 infections, which led to the breakdown of the medical system. Osaka, Japan, was particularly affected, with many severe cases and the highest number of COVID-19-associated deaths in Japan.

Endocannabinoid Signaling from 2-Arachidonoylglycerol to CB Cannabinoid Receptor Facilitates Reward-based Learning of Motor Sequence.

The endocannabinoid system modulates synaptic transmission, controls neuronal excitability, and is involved in various brain functions including learning and memory. 2-arachidonoylglycerol, a major endocannabinoid produced by diacylglycerol lipase-α (DGLα), is released from postsynaptic neurons, retrogradely activates presynaptic CB cannabinoid receptors, and induces short-term or long-term synaptic plasticity. To examine whether and how the endocannabinoid system contributes to reward-based learning of a motor sequence, we subjected male CB-knockout (KO) and DGLα-KO mice to three types of operant lever-press tasks.

Theobromine up-regulates cerebral brain-derived neurotrophic factor and facilitates motor learning in mice.

Theobromine, which is a caffeine derivative, is the primary methylxanthine produced by Theobroma cacao. Theobromine works as a phosphodiesterase (PDE) inhibitor to increase intracellular cyclic adenosine monophosphate (cAMP). cAMP activates the cAMP-response element-binding protein (CREB), which is involved in a large variety of brain processes, including the induction of the brain-derived neurotrophic factor (BDNF).

New Magnetic Resonance Imaging Features Predictive for Post-Treatment Ambulatory Function: Imaging Analysis of Metastatic Spinal Cord Compression.

Study Design: This is a retrospective, single-institute, radiographical study.

Objective: The study aimed to determine the correlation of magnetic resonance imaging (MRI) findings observed in metastatic spinal cord compression (MSCC) with post-treatment ambulatory status.

Summary Of Background Data: Previous studies have reported various predictors of ambulatory outcome in patients with MSCC, but the relationship between the MRI features and post-treatment ambulatory function remains to be elucidated.

[A case of previously undiagnosed methemoglobinemia exhibiting sustained low SpO2 value at the induction of general anesthesia].

A 70-year-old woman was scheduled to undergo surgery for removal of thyroid tumor under general anesthesia. A routine preoperative evaluation confirmed that the patient was stable with no signs of cyanosis and dyspnea. However, during pre-oxygenation as well as mechanical ventilation with 100% oxygen, she showed sustained low SpO2 values (i.

Astroglial integrins in the development and regulation of neurovascular units.

In the neurovascular units of the central nervous system, astrocytes form extensive networks that physically and functionally connect the neuronal synapses and the cerebral vascular vessels. This astrocytic network is thought to be critically important for coupling neuronal signaling activity and energy demand with cerebral vascular tone and blood flow. To establish and maintain this elaborate network, astrocytes must precisely calibrate their perisynaptic and perivascular processes in order to sense and regulate neuronal and vascular activities, respectively.

Thrombomodulin: a bifunctional modulator of inflammation and coagulation in sepsis.

Deregulated interplay between inflammation and coagulation plays a pivotal role in the pathogenesis of sepsis. Therapeutic approaches that simultaneously target both inflammation and coagulation hold great promise for the treatment of sepsis. Thrombomodulin is an endogenous anticoagulant protein that, in cooperation with protein C and thrombin-activatable fibrinolysis inhibitor, serves to maintain the endothelial microenvironment in an anti-inflammatory and anticoagulant state.

Oral gastric tube-guided insertion of the ProSeal™ laryngeal mask is an easy and noninvasive method for less experienced users.

Purpose: The ProSeal™ laryngeal mask airway (PLMA) can be more difficult to insert than the classic laryngeal mask, especially in patients who have a thin palate with a steep oropharyngeal curve. Here, an oral gastric (OG) tube-guided technique is considered as a method that makes it easier to successfully insert a PLMA.

Methods: Sixty patients who were scheduled to undergo general anesthesia without neuromuscular blocking were randomly allocated into two groups: 30 patients with PLMA inserted by the standard digital technique, and 30 with the PLMA inserted by an OG tube-guided technique.

[Pre-operative smoking cessation does not always reduce the incidence of surgical site infection after gastrointestinal surgery].

Background: Centers for Disease Control (CDC) recommend pre-operative smoking cessation to reduce the risk of surgical site infection (SSI). However, whether pre-operative smoking cessation reduces the incidence of SSI for gastrointestinal surgery is unclear. We investigated whether pre-operative smoking cessation reduces the incidence of SSI among patients undergoing gastrointestinal surgery.

[Remifentanil provides fast recovery and hemodynamic stability in laryngomicrosurgery anesthesia].

Background: Stressful procedures such as intratracheal intubation and direct laryngoscopy in very short operations make anesthetic management for laryngomicrosurgery difficult. This study was conducted to evaluate which anesthetic agent, remifentanil or fentanyl, is suitable in anesthesia for laryngomicrosurgery.

Methods: After obtaining informed consent prior to the study, 18 patients undergoing elective laryngomicrosurgery were randomly allocated to one of two groups to receive remifentanil (R group) or fentanyl (F group).

[Prophylactic strategies for perioperative pulmonary thromboembolism in cancer patients].

Background: Our previous reports showed that elastic stockings (ES) combined with intermittent pneumatic compression (IPC) significantly decrease the incidence of perioperative pulmonary thromboembolism (PTE). This study was conducted to investigate whether ES with IPC is useful to prevent PTE in cancer patients.

Methods: No prophylactic strategies were employed from January 1998 to December 1999 (4511 cases).

Dopamine D2 receptor Taq IA polymorphism is associated with postoperative nausea and vomiting.

Purpose: The dopamine D2 receptor (DRD2) is considered to be involved in the development of postoperative nausea and vomiting (PONV). Our aim was to examine the relationship between DRD2 Taq IA polymorphism and the occurrence of PONV.

Methods: We enrolled 1070 patients who were scheduled to undergo elective surgery under general anesthesia.

[Wound healing in reconstructive head and neck surgery].

Background: Smoking cessation and shorter operative duration are known as factors to improve wound healing in reconstructive head and neck surgery. We investigated the other factors associated with wound healing.

Methods: Informations on age, sex, body mass index, smoking status, serum albumin level, diabetes mellitus, chronic obstructive pulmonary diseases, preoperative steroid therapy, preoperative chemotherapy, preoperative radiation therapy, preoperative starvation care, American Society of Anesthesiologists physical status (ASA-PS), intraoperative administration of prostaglandin E1, operative duration, and type of flap were obtained from the medical records of 370 patients.

[Prophylactic strategies for perioperative pulmonary embolism: the second report; reevaluation of usefulness of combination of elastic stockings and intermittent pneumatic compression].

Background: The incidence of perioperative pulmonary thromboembolism (PTE) has increased in Japan. As the mortality rate of PE is very high, its prophylaxis is important.

Methods: From January 1998 to December 1999 no prophylactic strategies were employed.

[Prophylaxis of perioperative pulmonary thromboembolism in a patient with anti-phospholipid antigen syndrome].

A 68-year-old woman with anti-phospholipid antigen syndrome (APS) was proposed to undergo partial pulmonary resection for lung cancer. She suffered from mild cerebellar ataxia. Exercised 201Tl myocardial scintigraphy was performed due to abnormal Q wave in preoperative electrocardiography and showed old myocardial infarction in inferior-to-posterior area without myocardial ischemia.

Effect of glutamine synthetase inhibition on astrocyte swelling and altered astroglial protein expression during hyperammonemia in rats.

Inhibition of glutamine synthesis reduces astrocyte swelling and associated physiological abnormalities during acute ammonium acetate infusion in anesthetized rats. We tested the hypothesis that inhibition of glutamine accumulation during more prolonged ammonium acetate infusion in unanesthetized rats reduces cortical astrocyte swelling and immunohistochemical changes in astrocytic proteins. Rats received a continuous i.

[Short-term bed rest as a cause of deep vein thrombosis in a patient with a huge abdominal tumor].

A 43-year-old female with a huge myoma uteri was scheduled for a simple total hysterectomy. However, there was massive penetration of the tumor into the retroperitoneum, and her first operation failed because we had no advance information on its posterior aspect. Angiography was done to obtain this information.

[A case of silent rupture of a cerebral arteriovenous malformation during laparotomy].

A 52-year-old female, scheduled for rectal cancer resection, had no history of central nervous system abnormality. Anesthesia was maintained with general anesthesia combined with epidural anesthesia. Her only hemodynamic change was a rise in arterial pressure to 140 mmHg just after the start of the operation.

[Prophylactic strategies for perioperative pulmonary embolism].

Background: Incidence of perioperative pulmonary embolism (PE) has increased in Japan probably due to the modernized life style. As the mortality rate of PE is very high, its prophylaxis is important. Therefore, prophylactic strategies for PE were instituted in the entire hospital.

[Occupational exposure of operating room staff to anesthetic gases during inhaled induction--a comparison with intravenous anesthesia induction].

Background: The risk of occupational exposure to waste anesthetic gases still remains during inhaled induction. In this study we investigated how much we were occupationally exposed to anesthetic gases during induction period.

Methods: Twenty-six adult patients were induced with sevoflurane 5% using a face mask for three minutes and maintained with sevoflurane 1% after end-tracheal intubations (IH-Group).

[Intensive care management of acute pulmonary thromboembolism].

Three patients with acute pulmonary thromboembolism, who had fallen into cardiopulmonary arrest or severe respiratory failure, were treated and saved in our intensive care unit. Two patients were resuscitated with percutaneous cardiopulmonary support device. Two patients underwent surgical embolectomy and we carefully applied positive pressure ventilation to prevent postoperative reperfusion pulmonary edema.

Effects of crystalloid and colloid preload on blood volume in the parturient undergoing spinal anesthesia for elective Cesarean section.

Background: The role of crystalloid preloading to prevent hypotension associated with spinal anesthesia in parturients during cesarean section has been challenged. Direct measurement of blood volume should provide insight regarding the volume-expanding effects. The aim of the current study was to clarify the effects of volume preload with either crystalloid or colloid solution on the changes in blood volume of parturients undergoing spinal anesthesia for cesarean section.