[Factors that affect the mortality in patients receiving emergency surgery for ruptured abdominal aortic aneurysms].

This retrospective study was performed to identify the perioperative factors affecting the mortality rate in 28 patients, who had received emergency surgery for ruptured abdominal aortic aneurysms from January, 2005 to June, 2008. Five (17.9%) of these 28 patients died of massive bleeding, sepsis, or multiple organ failure during or within 11 days after surgery.

[Retrospective investigation and analysis of dental injuries during endotracheal intubation].

Background: The objective of this study is to clarify the causes of dental injuries (DIs) developed during the direct laryngoscopy for the endotracheal intubation (EI) in our hospital.

Methods: Subjects are 4173 patients who had the EI from April 1, 2006 to March 31, 2007. Mallampati's classification and Miller's classification were used for the evaluation of difficult airway and the dental unsteadiness, respectively.

[Anesthetic management for gastrectomy in two gastric cancer patients after coronary artery bypass grafting using right gastroepiploic artery].

We report two cases for anesthetic management of gastrectomy for gastric cancer which took place after receiving coronary artery bypass grafting (CABG) using the right gastroepiploic artery (RGEA). The first patient was a 75-year-old man after CABG using the RGEA 14 years before. He was diagnosed with gastric cancer and was scheduled for total gastrectomy.

Role of adrenoceptors in the regulation of dopamine/DARPP-32 signaling in neostriatal neurons.

Studies in animal models of Parkinson's disease have revealed that degeneration of noradrenaline neurons is involved in the motor deficits. Several types of adrenoceptors are highly expressed in neostriatal neurons. However, the selective actions of these receptors on striatal signaling pathways have not been characterized.

Gradient of bronchial end-tidal CO2 during two-lung ventilation in lateral decubitus position is predictive of oxygenation disorder during subsequent one-lung ventilation.

Purpose: Hypoxemia is one of the major problems during one-lung ventilation (OLV). During two-lung ventilation (TLV) using a double-lumen bronchial tube, bronchial endtidal carbon dioxide partial pressure (ETbr(CO2)) can be determined on both sides, independently. The ETbr(CO2) is mainly dependent on the pulmonary perfusion to each lung.

Thiamylal antagonizes the inhibitory effects of dorsal column stimulation on dorsal horn activities in humans.

In humans, peripheral somatosensory information converges upon dorsal horn neurons in the spinal cord, which can be recorded from the dorsal epidural space as spinal cord potentials (SCPs) following segmental dorsal root stimulation (SS) employing epidural catheter electrodes. Antidromic action potentials and descending inhibition from the dorsolateral funiculus may contribute to SCPs following dorsal column stimulation (DCS). Effects of thiamylal (2.

Cuff occlusion on the left upper arm increases flow of the left internal mammary artery and bypass flow to the left anterior descending artery.

Purpose: Changes in vascular resistance in the left forearm may affect the flow of left internal mammary artery (LIMA)- to left anterior descending artery (LADA) bypass, because the LIMA is a major branch of the subclavian artery. We studied the effects of occlusion of the left upper arm on blood flow of LIMA-to-LADA bypass in patients undergoing coronary artery bypass grafting (CABG).

Methods: In ten patients, the blood volume shed from LIMA with the distal end open (LIMA free flow) was stored for 1 min before and during cuff inflation in CABG surgery.

Effects of nasal application of an epinephrine and lidocaine mixture on the hemodynamics and nasal mucosa in oral and maxillofacial surgery.

Purpose: Our purpose was to investigate the influences of nasal pretreatment with a mixed solution of epinephrine and lidocaine (E-L pretreatment) on the systemic hemodynamics and the mucosa of the inferior nasal concha, which is carried out for expansion of the nasal cavity and the prevention of mucosal injury before nasotracheal intubation.

Patients And Methods: Subjects included 29 adult patients undergoing oral and maxillofacial surgery. This study consisted of 2 parts.

[Cesarean section for case with preoperatively-suspected placenta accrete followed by hysterectomy due to uncontrollable massive bleeding].

A 42-yr-old pregnant woman highly suspicious of the placenta accreta was scheduled for cesarean section (c-section) under general anesthesia. She had received emergency c-section for the placenta previa at 36 years of age and three episodes of intrauterine curettage for spontaneous abortion. While the possibility of placenta accreta was pointed out and the risks accompanying with it were explained at the 7th week of pregnancy, she insisted on having a baby.

[Combination of spinal and inhalation anesthesia for nephrectomy in a cirrhotic patient].

We report a 75-year-old man with the liver cirrhosis of Child-Pugh B who underwent nephrectomy. Preoperative serum examination revealed increases in GOT, GPT, LDH and total bilirubin, decreases in cholinesterase and albumin, and prolongation of prothrombin time. We selected spinal anesthesia using bupivacaine and fentanyl rather than epidural anesthesia in combination with isoflurane inhalation anesthesia to supplement intra-operative anesthesia and post-operative pain relief.

Moderate cerebral venous congestion induces rapid cerebral protection via adenosine A1 receptor activation.

Stroke is a devastating complication in cardiovascular surgery, and neuronal damage is worsened by intracranial pressure elevation caused by cerebral venous circulatory disturbances (CVCD). However, we have previously reported that CVCD before cerebral ischemia decreases the infarct area. In the present study, focal cerebral ischemia was induced in spontaneously hypertensive rats by filament insertion through the carotid artery.

Effects of systemic deep hypothermia and subarachnoid block on the longitudinally conducting evoked spinal cord potentials in man.

The present study reports the effects of systemic deep hypothermia (SDH) and subarachnoid block (SAB) on the longitudinally conducting evoked spinal cord potential (conducting ESCP) in man. Before induction of anesthesia, a pair of bipolar catheter electrodes was introduced to the epidural space: one at the level of the cervical enlargement and the other at the lumbosacral enlargement. The conducting ESCP was produced by electrical stimulation through the upper electrode and recorded through the lower electrode, and vice versa.

[Labor management using epidural anesthesia in a gravida patient with high spinal injury].

Since autonomic hyperreflexia (AH) is a serious complication during labor in a gravida with spinal cord injury, anesthetic measures should be taken for the suppression of AH even in a sensory-loss condition. Several reports have described various methods for the suppression of AH, in which epidural anesthesia has been advocated as a useful means for the prevention or amelioration of AH. However, it is difficult to evaluate the efficacy of epidural anesthesia due to the lack of sensory and motor functions.

Induction of neuronal tolerance by electroconvulsive shock in rats subjected to forebrain ischemia.

We have examined ischemic tolerance induced by electroconvulsive shock before exposure to forebrain ischemia. Subjects were 40 rats, which were randomly allocated to control, single ECS (sECS), repeated ECS (rECS) or sham group. sECS group and rECS group received ECS only once 2 days before the subsequent 8-min forebrain ischemia and once a day for 9 consecutive days until 2 days before the exposure to ischemia, respectively.

[Intra-operative monitoring of EEG].

The fundamentals and clinical applications of intra-operative EEG monitoring are described. EEG monitored on line at bedside is useful for the evaluation of the depth of anesthesia and sedation, and also for the early detection of cerebral ischemia and seizure. However, EEG monitoring is not easy in the operating room, where a number of electrical machines and medical personnel are working.

The neuropeptide neuromedin U promotes IL-6 production from macrophages and endotoxin shock.

Neuromedin U (NMU) is a neuropeptide involved in appetite, circadian rhythm, and pronociception. However, the NMU receptor NMU-R1 has been shown to be expressed in immune cells and NMU promotes mast cell-dependent inflammation. In this study, we demonstrated that NMU plays an important role in IL-6 production in macrophages.

The neuropeptide neuromedin U activates eosinophils and is involved in allergen-induced eosinophilia.

Neuromedin U (NMU) is a neuropeptide expressed not only in the central nervous system but also in various organs, including the gastrointestinal tract and lungs. NMU interacts with two G protein-coupled receptors, NMU-R1 and NMU-R2. Although NMU-R2 is expressed in a specific region of the brain, NMU-R1 is expressed in various peripheral tissues, including immune and hematopoietic cells.

[Anesthetic management for a patient with multiple sclerosis].

A 49-year-old woman with multiple sclerosis (MS) received emergency laparotomy for panperitonitis. She had been suffering from MS for 13 years, and her main clinical symptoms were disorders in sight, walking and touch sensation below T 7. We used propofol and fentanyl for induction and maintained anesthesia with nitrous oxide, sevoflurane and additional fentanyl.

The neuropeptide neuromedin U promotes inflammation by direct activation of mast cells.

Neuromedin U (NMU) is a neuropeptide that is expressed in the gastrointestinal tract and central nervous system. NMU interacts with two G protein-coupled receptors, NMU-R1 and NMU-R2. Whereas NMU-R2 localizes predominantly to nerve cells, NMU-R1 is expressed in peripheral tissues including lymphocytes and monocytes, suggesting a role of NMU in immunoregulation.

Neuroprotective effect of epidural electrical stimulation against ischemic spinal cord injury in rats: electrical preconditioning.

Background: Electroconvulsion therapy is likely to serve as an effective preconditioning stimulus for inducing tolerance to ischemic brain injury. The current study examines whether electrical stimuli on the spinal cord is also capable of inducing tolerance to ischemic spinal cord injury by transient aortic occlusion.

Methods: Spinal cord ischemia was induced by occlusion of the descending thoracic aorta in combination with maintaining systemic hypotension (40 mmHg) during the procedure.

A novel method of detecting rCBF with laser-Doppler flowmetry without cranial window through the skull for a MCAO rat model.

Background And Purpose: In a rat model of middle cerebral artery occlusion (MCAO) with intraluminal technique, lesion volume and its reproducibility vary among laboratories. Although laser-Doppler flowmetry (LDF) is useful to optimize the reliability, conventional methods require a craniotomy and special apparatus. The purpose of this study was to evaluate a novel approach for LDF monitoring of rCBF through lateral aspect of the skull without a craniotomy.

[Two cases of gravity dependent atelectasis after laparoscopic nephrectomy].

Two patients developed postoperative pulmonary atelectasis after receving laparoscopic nephrectomy in the lateral kidney position. In both patients, the trachea was intubated with a single lumen tube and the lateral kidney position was kept over 9 hours. Because the pulmonary atelectasis had developed on the lower side of the lungs, we considered it as the gravity dependent atelectasis (GDA).

Presynaptic modulation by neuromedin U of sensory synaptic transmission in rat spinal dorsal horn neurones.

Neuromedin U (NMU) is a brain-gut peptide first isolated from the spinal cord. Recent studies on NMU and its receptors have suggested a role of NMU in sensory transmission. Here we report on the localization of NMU in sensory neurones, and the actions of NMU in the substantia gelatinosa (SG) and the deep layer of the dorsal horn (laminae III-V) in adult rat spinal cord slices using the patch-clamp technique.

[Iliopsoas abscess accompanied by epidural abscess--a case report].

A 55-year-old man was admitted to a hospital with pain of the low back as well as the left leg, and fever. He was suspected of suffering from the lumbar disc herniation because of the presence of Lasegue's sign on the first physical examination. Abdominal computed tomography, however, revealed the swelling of the left iliopsoas muscle.