Masui. The Japanese journal of anesthesiology
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According to Wikipedia, translational research is scientific research that facilitates the translation of findings from basic science to practical applications that enhance human health and well-being. In this special issue, the topic of translational research in anesthesiology was featured. Six subtopics including 1) adaptation of induced pluripotent stem (iPS) cells to central nerve injury, 2) signaling of granulocyte macrophage colony stimulating factor and its clinical application: host-defense and organ protection, 3) molecular mechanisms of chronic pain and its therapeutic strategy, 4) endoplasmic reticulum stress and opioid tolerance, 5) relationships of damage-associated molecular patterns and organ injury, and 6) translational research in omics science to clinical anesthesia, are presented and discussed in detail. Anesthesiologists always keep in mind that the goal of translational research is to improve our health through research and that there would be no bright future in anesthesiology without the fruits of translational research.
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Every airway maneuver will cause some degree of neck movement. Ventilation via face-mask technique requires lifting the mandible (jaw thrust) to the facemask. A significant degree of cervical spine motion induced by bag-mask ventilation has been reported on human cadavers with destabilized cervical vertebrae. However, to our knowledge, no quantitative data have reported evaluating the effects of bag-mask ventilation on cervical spine motion in living humans. We measured the cervical spine movement during bag-mask ventilation. ⋯ The lifting the mandible causes both extension and anterior disposition in the cervical vertebrae.
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Randomized Controlled Trial
[The preventive effect of flurbiprofen on preventing mesenteric traction syndrome].
Mesenteric traction syndrome (MTS) is associated with facial flushing, hypotension and tachycardia. The ways to treat MTS are fluid replacement, administration of vasopressors and nonsteroidal anti-inflammatory drugs (NSAIDs) such as flurbiprofen. In order to stabilize the hemodynamics during operation, preventing MTS is more reasonable. Thus, we investigated the preventive effect of flurbiprofen on MTS, the only injectable formulation which can be used in Japan. ⋯ Our results indicate that pretreatment with flurbiprofen might prevent MTS.
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An 83-year-old woman was scheduled for surgery of the left upper and lower extremity fracture. She had past history of lung partial resection for lung cancer and rheumatoid arthritis, and recent history of pneumonia. She also had fluid retention in the thoracic cavity. ⋯ A few hours later, she became conscious and mask CPAP was used after extubation for one day. Pa(CO2) was 90-100 mmHg for 3 days and decreased to 56.9 mmHg on the 6th day, but her consciousness had been clear. Phrenic nerve palsy and sedation in the patient with decreased lung function might have induced prolonged hypercapnea.
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Case Reports
[A case of respiratory distress due to massive pleural effusion after surgery for ovarian tumor].
A 59-year-old woman with ovarian tumor was scheduled for radical hysterectomy under general anesthesia. Preoperative examination showed massive ascites and slight pleural effusion. Since respiratory status had improved by oxgen therapy, she underwent a surgery as scheduled, although she complained of slight dyspnea and low Sp(O2). ⋯ Oxygenation improved, and the endotracheal tube was removed. Patients with ovarian tumor with pleural effusion and ascites may have desaturation due to increased pleural effusion during the operation, or pleural effusion might increase preoperatively. Therefore, we need to be cautious about anesthetic management of them and examine chest X-ray and arterial blood gas frequently.