Hornerin expressed on endothelial cells via interacting with thrombomodulin modulates vascular inflammation and angiogenesis.

Thrombomodulin is predominantly expressed on vascular endothelial cells and modulates endothelial cell functions by interacting with multiple ligands. The specific thrombomodulin receptor or cofactor active on the endothelial cell surface remains elusive. This study aims to identify interacting partners of thrombomodulin on endothelial cells.

Successful management of temporary veno-venous extracorporeal membrane oxygenation for a pediatric lung transplant recipient with bronchiolitis obliterans syndrome awaiting lung re-transplantation: a case report.

Background: The use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation is an uncommon strategy in Japan owing to the severe donor shortage and absence of urgent allocation policy. Moreover, the use of veno-venous (VV) ECMO for immunosuppressed patients is controversial; thus, applying ECMO to patients who await lung re-transplantation is challenging.

Case Presentation: A 16-year-old lung transplant recipient with grade 3 bronchiolitis obliterans syndrome was waitlisted for lung re-transplantation.

Long-Term Exposure to Morphine Induces Cross-Tolerance to Acute Antinociceptive Effect of Remifentanil on Somatic and Visceral Stimuli in Rats.

Purpose: Remifentanil is one of the most commonly used opioids intraoperatively. Previous reports indicate that long-term use of opioids may lead to cross-tolerance to remifentanil, which poses a challenge in the control of acute pain intraoperatively. However, there is limited information regarding cross-tolerance to remifentanil, especially in visceral pain.

Recombinant Human Soluble Thrombomodulin Suppresses Monocyte Adhesion by Reducing Lipopolysaccharide-Induced Endothelial Cellular Stiffening.

Endothelial cellular stiffening has been observed not only in inflamed cultured endothelial cells but also in the endothelium of atherosclerotic regions, which is an underlying cause of monocyte adhesion and accumulation. Although recombinant soluble thrombomodulin (rsTM) has been reported to suppress the inflammatory response of endothelial cells, its role in regulating endothelial cellular stiffness remains unclear. The purpose of this study was to investigate the impact of anticoagulant rsTM on lipopolysaccharide (LPS)-induced endothelial cellular stiffening.

Positive End-expiratory Pressure and Distribution of Ventilation in Pneumoperitoneum Combined with Steep Trendelenburg Position.

Background: Pneumoperitoneum and a steep Trendelenburg position during robot-assisted laparoscopic prostatectomy have been demonstrated to promote a cranial shift of the diaphragm and the formation of atelectasis in the dorsal parts of the lungs. However, neither an impact of higher positive end-expiratory pressure (PEEP) on preserving the ventilation in the dorsal region nor its physiologic effects have been fully examined. The authors hypothesized that PEEP of 15 cm H2O during robot-assisted laparoscopic prostatectomy might maintain ventilation in the dorsal parts and thus improve lung mechanics.

Plasma proteomic changes during therapeutic hypothermia in resuscitated patients after cardiac arrest.

Hypothermia is used for several h during cardiac and aortic surgery to protect ischemic organs. Therapeutic hypothermia (TH) is used for ≤24 h as a treatment for comatose patients after the return of spontaneous circulation (ROSC) following cardiac arrest. The proteomic approach may provide unbiased data on alterations in the abundance of proteins during TH.

Biphasic Cuirass Ventilation During Anesthesia for Tracheobronchial Stent Insertion or Removal by a Rigid Bronchoscope: A Case Report.

Airway management and ventilation during a tracheobronchial stenting procedure are challenging given that mandatory positive pressure ventilation cannot be fully achieved while using a rigid bronchoscope due to leakage from the scope tip. Biphasic cuirass ventilation is a negative pressure ventilation method using an external cuirass fitted to the anterior chest, which could assist in spontaneous breathing and ventilation support. We report 3 successful anesthesia cases in which we could maintain adequate ventilation and oxygenation, supported by biphasic cuirass ventilation, in patients undergoing tracheobronchial stent placement or removal procedures using rigid bronchoscopy.

Does the Rewarmed Heart Restore the Myocardial Proteome to That of the Pre-Cooled State?--A Proteomic Analysis of Surgical Samples.

Background: Hypothermia is utilized in cardiac and aortic surgery to protect organs from ischemic reperfusion injury. Although the cooled body is invariably rewarmed after the procedure, it is still unknown whether the rewarmed body regains its former biological state. This study determined the modulatory effects of hypothermia on the human myocardial proteome and whether subsequent rewarming restores the proteome to the state prior to cooling.

[Full Recovery from Cardiopulmonary Arrest caused by Traumatic Asphyxia].

Traumatic asphyxia is a crush injury of the chest characterized by facial edema, cyanosis, conjunctival hemorrhage, and petechiae on the face and chest. The prognosis depends on the duration of chest compression and early cardiopulmonary resuscitation after cardiopulmonary arrest. Here we report a case of full recovery from cardiopulmonary arrest caused by traumatic asphyxia.

[A case report: perioperative management of adenotonsillectomy in a morbidly obese patient with severe obstructive sleep apnea syndrome].

A male patient in his thirties was scheduled to undergo adenotonsillectomy due to dyspnea from bilateral tonsillar hypertrophy. He was morbidly obese (body mass index 56 kg x m(-2)) with severe obstructive sleep apnea syndrome (OSAS), and thus was evaluated with extreme risk for difficult ventilation and intubation. We planned awake intubation via video-assisted laryngoscopy and fiberoptic bronchoscopy under dexmedetomidine sedation, and the intubation was successfully performed.

Plasma proteomic changes during hypothermic and normothermic cardiopulmonary bypass in aortic surgeries.

Deep hypothermic circulatory arrest (DHCA) is a protective method against brain ischemia in aortic surgery. However, the possible effects of DHCA on the plasma proteins remain to be determined. In the present study, we used novel high‑throughput technology to compare the plasma proteomes during DHCA (22˚C) with selective cerebral perfusion (SCP, n=7) to those during normothermic cardiopulmonary bypass (CPB, n=7).

[Recipient of living kidney transplantation during which heparin-induced thrombocytopenia (HIT) was suspected: a case report].

A 67-year-old woman with a diabetic renal failure was scheduled for a living kidney transplantation. Heparin was first used during hemodialysis 5 days before operation. Thrombocytopenia was found immediately after induction of general anesthesia, and the diagnosis of HIT was wade based on clinical symptom and 4 T's scoring.

Intravenous infusion of remifentanil induces transient withdrawal hyperalgesia depending on administration duration in rats.

Background: Recent studies suggest that remifentanil, similar to other μ-opioid agonists, may induce hyperalgesia. We performed animal experiments to determine whether IV remifentanil infusion, the mode of administration used in clinical practice, induces hyperalgesia and the conditions in which this phenomenon occurs. We also determined whether remifentanil-induced hyperalgesia is related to extracellular signal-regulated protein kinase 1/2 (ERK1/2) phosphorylation.

[Perioperative management of total laryngectomy for a patient with cold agglutinin disease].

Cold agglutinin disease is possible to cause thromboembolism of various organs due to changes in red blood cells by exposure to low temperature. Safety standards for perioperative management of patients with cold agglutinin have not been established. A patient with cold agglutinin disease was scheduled to undergo total laryngectomy and greater pectoral muscle flap.

[Case report of paradoxical arousal-like EEG changes during pediatric laparotomy].

An 8-year-old boy with Chiari malformation and myelomeningocele received total cystectomy and ileal neobladder surgery under general anesthesia with sevoflurane, nitrous oxide, and intravenous fentanyl. Bispectral index (BIS) suddenly decreased from 50 to 7 with large slow delta waves during ileal anastomosis, although there was no change regarding blood pressure and heart rate. This EEG change was considered first as 'paradoxical arousal', of which mechanism is commonly due to the unexpected noxious stimulation.

Profound reduction of somatic and visceral pain in mice by intrathecal administration of the anti-migraine drug, sumatriptan.

Sumatriptan and the other triptan drugs target the serotonin receptor subtypes1B, 1D, and 1F (5-HT(1B/D/F)), and are prescribed widely in the treatment of migraine. An anti-migraine action of triptans has been postulated at multiple targets, within the brain and at both the central and peripheral terminals of trigeminal "pain-sensory" fibers. However, as triptan receptors are also located on "pain-sensory" afferents throughout the body, it is surprising that triptans only reduce migraine pain in humans, and experimental cranial pain in animals.

Spider toxins activate the capsaicin receptor to produce inflammatory pain.

Bites and stings from venomous creatures can produce pain and inflammation as part of their defensive strategy to ward off predators or competitors. Molecules accounting for lethal effects of venoms have been extensively characterized, but less is known about the mechanisms by which they produce pain. Venoms from spiders, snakes, cone snails or scorpions contain a pharmacopoeia of peptide toxins that block receptor or channel activation as a means of producing shock, paralysis or death.

TRPA1 mediates the inflammatory actions of environmental irritants and proalgesic agents.

TRPA1 is an excitatory ion channel targeted by pungent irritants from mustard and garlic. TRPA1 has been proposed to function in diverse sensory processes, including thermal (cold) nociception, hearing, and inflammatory pain. Using TRPA1-deficient mice, we now show that this channel is the sole target through which mustard oil and garlic activate primary afferent nociceptors to produce inflammatory pain.

[A case of severe coronary artery spasm associated with anaphylactic reaction caused by protamine administration].

A 65-year-old man with mitral regurgitation and atrial fibrillation underwent mitral valve plasty and Maze's operation. Cardiopulmonary bypass (CPB) was finished uneventfully. But after protamine administration, severe systemic hypotension occurred suddenly with electrocardiographic ST-segment elevation and wide QRS intervals.

[Surgical stress in perioperative period of combined off-pump coronary artery bypass grafting and abdominal aortic aneurysm repair].

Objectives: It is still controversial whether we should choose simultaneous operation or two-staged operation for patients who need both coronary artery bypass grafting (CABG) and abdominal aortic aneurysm (AAA) repair. Some reports suggest that combined CABG without cardiopulmonary bypass and AAA repair is less invasive than those with cardiopulmonary bypass. We estimated surgical stress of combined off pump CABG and AAA repair (CABG + AAA) in perioperative period compared with simple AAA repair retrospectively.

[Suddenly developing low output syndrome during acute thoracic aortic dissection surgery in a patient with progressive systemic sclerosis].

A 70-year-old man with progressive systemic sclerosis (PSS) suddenly developed low output syndrome (LOS) after weaning from cardiopulmonary bypass during acute thoracic aortic dissection and died in an early postoperative stage because of multiple organ failure. PSS was kept in a relatively good condition before onset of his surgical disease, but his Raynaud's phenomenon was much worse and inflammation findings were very severe before his operation. We suspected that PSS might have been involved in LOS in this case.

Intercostal nerve block with 5% tetracaine for chronic pain syndromes.

Treating chronic pain syndromes is always challenging. We describe an effective use of an intercostal nerve block using 5% tetracaine in three patients with postherpetic intercostal neuralgia or postoperative intercostal neuralgia.