記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Tracheal stent is a good way to maintain a patent airway in case of stenosis. Although anesthesia techniques for the placement of a stent in the trachea of patients with tracheal stenosis have been reported, the management of general anesthesia in patients with a tracheal stent is not well established. CASE PRESENTATION: We report the anesthetic management in the patient with a partly fractured tracheal stent. A 65-year-old man with colon cancer was scheduled for colectomy under general anesthesia. Eight years ago, a tracheal stent was placed because of lung cancer. Preoperative evaluation revealed that a part of the tracheal stent had penetrated the esophagus. We induced general-epidural anesthesia via spontaneous breathing through a laryngeal mask airway to avoid mediastinal emphysema caused by positive pressure ventilation. The patient has been followed up for 2 years without any respiratory complications. CONCLUSION: General anesthesia can be safely induced under spontaneous ventilation through a laryngeal mask airway in a patient with a fractured tracheal stent.

DOI： 10.1186/s40981-016-0068-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We report a case of unexpectedly difficult intubation in a patient with a huge but asymptomatic choanal polyp. A 77-year-old man with invasive bladder cancer was scheduled for total cystectomy under general anesthesia. However, tracheal intubation with a Macintosh laryngoscope proved impossible due to obstruction by a large oropharyngeal tumor. Using a video laryngoscope, intubation was successfully achieved. Choanal polyps are not uncommon, but large choanal polyps reaching the oropharynx appear relatively rare. Anesthesia and airway management for large oropharyngeal tumor has not been sufficiently discussed.

DOI： 10.1186/s40981-016-0028-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Previous reports have shown that electroconvulsive therapy (ECT) is efficacious in the treatment of neuropathic pain; however, its mechanism of action remains unclear. The present study aimed to understand these mechanisms by investigating the alterations in the expression of neuropeptide Y (NPY) and interleukin-1β (IL-1β) in the prefrontal cortex. A rat model of neuropathic pain produced by chronic constrictive injury of the sciatic nerve was used, and mechanical and thermal hyperalgesia were evaluated starting 2 days after the injury. Using a pulse generator, ECT was administered to the rodents for 6 days from days 7-12 after the injury. Thermal and mechanical stimulation were administered to assess pain thresholds. Quantitative polymerase chain reaction, used to measure gene expression levels in the prefrontal cortex, showed that NPY and IL-1β gene expression levels in the prefrontal cortex increased following the injury. The present results indicate that these gene expression level variations may be associated with the mechanisms underlying the effect of ECT in treating neuropathic pain.

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Volatile anesthetics have a lung protective effect in acute lung injury (ALI). Our previous study showed sevoflurane affects the expression of microRNA (miRNA) that control various physiological systems by regulating messenger RNA (mRNA) expression. However, the association between the anti-inflammatory effect of sevoflurane and miRNAs modulation remains unknown. The aim of the present study was to investigate the effect of sevoflurane and the expression of miRNAs in an endotoxin-induced ALI model in rats. Wistar rats were randomly assigned to three groups [lipopolysaccharide (LPS), LPS-sevoflurane and control; n=8/group]. All the rats were mechanically ventilated and intravenously-administered LPS (saline as control). Two hours post-injury, general anaesthesia was performed for 4 h with 2% sevoflurane (LPS-sevoflurane). The LPS and the control groups did not receive anaesthesia. The severity of ALI was evaluated by partial pressure of oxygen/fraction of inspired oxygen and the mRNA expression of inflammatory cytokine. The miRNA expression in lung tissue was analyzed by a reverse transcription-quantitative polymerase chain reaction. LPS caused ALI, evidenced by the impairment of pulmonary function and increased mRNA levels of tumor necrosis factor-α, interleukin-6 and nuclear factor-κB. Sevoflurane improved pulmonary function and inhibited the increased mRNAs. Of the 219 miRNAs detected, 15 and nine miRNAs were significantly changed in the LPS and LPS-sevoflurane group, respectively. In the LPS-sevoflurane group, the expression of several miRNAs that regulate inflammation was significantly changed compared to the LPS group. In conclusion, the present data showed that sevoflurane influences the expression of the miRNAs that regulate inflammation. This result suggests that the changes in miRNA expression are involved in the lung protective mechanisms of volatile anesthetics.

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

General anesthesia is commonly used in the surgical arena, but little is known regarding its influence at the genomic and molecular levels. MicroRNAs (miRNAs) belong to a new class of non-coding RNA molecules which influence cell biology. In the present study, it was hypothesized that miRNAs alter gene expression levels under general anesthesia. The aim was to compare the miRNA expression profiles in the rat hippocampus in response to anesthesia with representative volatile (sevoflurane) and intravenous (propofol) anesthetics. Wistar Rats were randomly assigned to either a 2.4% sevoflurane, 600 µg/kg/min propofol or control (without anesthetics) group. Total RNA from hippocampal samples which contained miRNA was subjected to quantitative reverse transcription-polymerase chain reaction and Taqman Low-Density Arrays (TLDA). A total of 373 miRNAs are associated with rats and the TLDA analysis revealed that 279 expressed miRNAs (74.8%) were expressed in all three groups. Significant differences in the levels of 33 of the 279 expressed miRNAs (11.8%) were observed among the three groups in response to the anesthetic agents, and when compared with the control group, significant differences were found in 26 of the 279 expressed miRNAs (9.3%). Following sevoflurane anesthesia, the levels of four miRNAs were significantly increased and those of 12 were significantly reduced. By contrast, following propofol anesthesia, the levels of 11 miRNAs were significantly reduced but no miRNAs exhibited significantly elevated levels. One miRNA was common between the two anesthesia groups, whereas 14 miRNAs were significantly differentially expressed. In conclusion, sevoflurane and propofol exerted different effects on miRNA expression in the rat hippocampus.

DOI： 10.3892/mmr.2014.2038

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The frequency of malpositioning of gastric tubes in the trachea has been reported to be 0.3-15%, which may cause severe complications, such as pneumonia, if not detected promptly. If a gastric tube can be guided into the esophagus under direct vision with a video laryngoscope, misplacement of the gastric tube into the trachea can be avoided. We compared gastric tube insertion under direct vision using a video laryngoscope with the conventional method of blind insertion. METHODS: We enrolled 60 patients who required a transnasal gastric tube to facilitate elective abdominal surgery under general anesthesia. The participants were recruited consecutively into one of two groups, a group of 30 patients in whom a gastric tube was inserted using a King Vision™ video laryngoscope (KV group), and a group of 30 patients who underwent conventional blind insertion of the gastric tube (Blind group). The success rate, the time taken to insert the gastric tube, and the incidence of complications were compared. RESULTS: In the KV group, the time required for gastric tube placement was 52.5 ± 17.1 seconds, with a success rate of 100%. Slight oral hemorrhage occurred in two participants and slight epistaxis in one participant. In the Blind group, the time required for gastric tube placement was 65.9 ± 39.9 seconds, with a success rate of 90% (27 out of 30 patients). Slight oral hemorrhage occurred in two participants, slight epistaxis occurred in two participants, and tracheal malposition occurred in one participant but was detected promptly and corrected using the video laryngoscope. There were no significant differences in the time required for placing the gastric tube, the success rate, or the incidence of complications between the groups. CONCLUSIONS: Gastric tube insertion using a King Vision video laryngoscope was straightforward, and was particularly useful for detecting and correcting tracheal malpositioning. TRIAL REGISTRY NUMBER: UMIN000011014.

DOI： 10.1186/1471-2253-14-82

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The two most common forms of chronic pain are inflammatory pain and neuropathic pain. Nevertheless, the underlying mechanisms of these pain conditions and their therapeutic responses are poorly understood. MicroRNAs (miRNAs) negatively regulate cell genes, and thus control cell proliferation, inflammation and metabolism. In the present study, we examined gene expression in the hippocampus of rats in two models of chronic pain. In addition, we used the left hindpaw procedure to identify differences in the bilateral hippocampus. We divided the rats into the 4 following groups: the group with chronic constriction injury (CCI), the sham-operated group, the group injected with complete Freund's adjuvant (CFA) and the group injected with normal saline. miRNA expression profiles were analyzed using TaqMan low-density array (TLDA). We observed 54 miRNAs (22.7%) in the rats with CCI rats that were differentially expressed, including 7 miRNAs that were downregulated compared with the sham-operated rats. In the CFA-injected rats, 40 miRNAs (16.8%) were differentially expressed, including 8 miRNAs that were downregulated compared with the normal saline-injected rats. Pearson's correlation co-efficient for all detected miRNAs in the rat hippocampus failed to identify differences between the hippocampi bilaterally. An unsupervised cluster analysis produced separate clusters between the control and experimental groups. In this study, we demonstrate the differential expression of hippocampal miRNAs in two rat models of chronic pain; however, no significant differences were observed bilaterally in hippocampal miRNA expression. Further research is required to determine the correlation among miRNAs, messenger RNAs (mRNAs) and proteins.

DOI： 10.3892/ijmm.2013.1504

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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記述言語：日本語   出版者・発行元：日本手術医学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓血管麻酔学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓血管麻酔学会  

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