The neutrophil to lymphocyte ratio (NLR) is gaining interest as an independent predictor of survival in patients with various clinical conditions. No study to date has reported an association between inflammat...
The number of morbidly obese patients who have undergone bariatric surgery has been gradually increasing in Japan. These obese patients are often complicated with metabolic, cardiac, respiratory, and other dis...
Authors: Takashi Kobayashi, Yoko Watanabe, Jun Aizawa and Kenji S. Suzuki
Patients with congenital central hypoventilation syndrome (CCHS) develop alveolar hypoventilation resulting from a failure of central ventilatory control. Late-onset CCHS (LO-CCHS), which may be precipitated b...
Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. For this, good coverage analgesia is essential. Epidural anesthesia, a st...
Pulmonary embolism (PE) resulting from venous thromboembolism is a leading cause of maternal mortality in pregnancy. In patients with massive PE and hemodynamic instability, the treatment options often conside...
Authors: Hiroki Taenaka, Chiyo Ootaki, Chie Matsuda and Yuji Fujino
The tongue flap is an accepted treatment method for cleft palate repair. Orotracheal or nasotracheal intubation using a fiberoptic scope is preferred for the division of the tongue flap. We report two cases of...
Authors: Kaori K. Kuroiwa, Masaaki Nishizawa, Nami Kondo, Haruka Nakazawa and Takanobu Hirabayashi
Epidural anesthesia is widely used for postoperative analgesia and rarely causes permanent neurological complications. We report a case of paraplegia following abdominal surgery under combined epidural/general...
Right ventricular assist device (RVAD) implantation is one type of surgical treatment used for right heart failure. It is important to assess right ventricular (RV) function precisely when RVAD withdrawal is c...
Sugammadex has been reported to cause upper-airway obstruction, such as laryngospasm or bronchospasm. These two conditions are treated using different approaches, but the differential diagnosis is difficult.
Authors: Keito Kou, Takeshi Omae, Saiko Wakabayashi and Sonoko Sakuraba
Postoperative pain management after upper limb surgery is important for preventing adverse events that can prolong hospital stay and cause readmission. This study aimed to identify the risk factors associated ...
Authors: Tatsunori Watanabe, Koji Moriya, Takuya Yoda, Naoto Tsubokawa, Andrey B. Petrenko and Hiroshi Baba
In pediatric general anesthesia, our goal should be quicker extubation to facilitate rapid turnover in the operating room without compromising on safety and quality of anesthesia. Although many studies have fo...
Authors: Akihiro Kanaya, Norifumi Kuratani, Yoshinori Nakata and Masanori Yamauchi
Narcolepsy is a neurological disease characterized by excessive daytime sleepiness, cataplexy, and/or a sudden loss of muscle tone due to malfunction of the orexinergic system, which may cause delayed emergenc...
Authors: Daiki Takekawa, Tetsuya Kushikata, Masato Kitayama and Kazuyoshi Hirota
The effect of volatile anesthetics on emergence agitation in adults remains unclear. We compared the degree of emergence agitation between desflurane and sevoflurane anesthesia in adults undergoing thyroid sur...
Authors: Takeshi Suzuki, Takuya Kurazumi, Tomomi Ueda, Hiromasa Nagata, Takashige Yamada, Shizuko Kosugi, Saori Hashiguchi, Koichi Ito and Hiroshi Morisaki
Warfarin, a widely used anticoagulant, interacts with various agents used in palliative care, such as oxycodone, morphine, acetaminophen, and non-steroidal anti-inflammatory drugs (NSAIDs); however, there are ...
Aortobronchial fistula (ABF) is a rare and potentially lethal complication of thoracic aortic replacement surgery. Currently, thoracic endovascular aortic repair (TEVAR) has emerged as a less invasive alternat...
Rectus sheath block is a common peripheral nerve block for patients undergoing umbilical hernia repair surgery. However, rectus sheath block alone can affect only anterior branches of intercostal nerves and, t...
Authors: Masayuki Akatsuka, Takeshi Murouchi, Johji Arakawa and Michiaki Yamakage
Schwartz–Jampel syndrome (SJS) is a rare syndrome that is clinically characterized by myotonia and skeletal abnormalities. Most reports regarding SJS have stated that patients with SJS are susceptible to malig...
Respiratory management in patients with esophagobronchial fistulae is challenging since positive pressure ventilation (PPV) may not be feasible due to air leaks and possible risks for regurgitation and aspirat...
Authors: Seiji Ishikawa, Tsubasa Akune, Tomoko Ishibashi and Koshi Makita
The accuracy of simulation-predicted fentanyl concentration in different types of surgical procedure is not fully understood. We wished to estimate the effect of different types of surgical procedure on the ac...
Authors: Yoshihito Fujita, Saya Yoshizawa, Maiko Hoshika, Koichi Inoue, Shoko Matsushita, Hisao Oka and Kazuya Sobue
We report that sevoflurane not only caused marked QTc interval prolongation but also increased transmural dispersion of repolarization in a patient with long QT syndrome 3 (LQT3). A 16-year-old male with LQT3 ...
The major perioperative concern in patients with second-degree atrioventricular (AV) block is the progression to complete AV block. Therefore, the prophylactic implantation of a temporary pacemaker prior to su...
Authors: Marie Shigematsu-Locatelli, Takashi Kawano, Atsushi Nishigaki, Daiki Yamanaka, Bun Aoyama, Hiroki Tateiwa, Noriko Kitaoka and Masataka Yokoyama
Bacillus cereus (B. cereus) rarely causes lower respiratory tract infections, although most reported cases of B. cereus pneumonia are fatal despite intensive antibiotic therapy. We pre...
We encountered a case of abdominal compartment syndrome during hip arthroscopic surgery, caused by the irrigation fluid flowing into the peritoneal cavity.
Authors: Tomoharu Shakuo, Kiyoko Bito, Seiichi Yasuda and Chie Asagi
Central venous catheters (CVCs) are commonly used in the management of critically ill patients. This study aimed to determine whether an educational program could reduce the rate of catheter-related bloodstrea...
Hyperventilation syndrome (HVS) sometimes occurs in patients under stressful conditions and may provoke severe complications such as myocardial infarction and death. The authors report a case of HVS following ...
Authors: Junichi Saito, Erika Amanai and Kazuyoshi Hirota
Patients with vascular Ehlers-Danlos syndrome (EDS) are susceptible to significant vascular complications, such as aortic and visceral arterial ruptures, aneurysms, and dissection. We describe a case of repeat...
Extubation is a more challenging medical practice than intubation, and countermeasures against it are similar to those described in the Difficult Intubation Guidelines, but problems cannot be overcome by compl...
Patients with complex congenital heart disease increasingly undergo noncardiac surgeries because of advancements in surgical techniques and medical management. In Fontan circulation, maintaining an adequate tr...
Authors: Toshiyuki Nakanishi, Kazuyoshi Ishida, Kiyotaka Shiramoto and Mishiya Matsumoto
As pregnancy accelerates glioma growth, therapeutic abortion has been recommended prior to tumor resection. Additionally, it has also been suggested that the extent of glioma resection is closely correlated wi...
Authors: Kotoe Kamata, Risa Fukushima, Minoru Nomura and Makoto Ozaki
Since acute respiratory failure (ARF) is a life-threatening complication, particularly in the gestational period, differential diagnosis and rapid treatment are required. Among the various causes of sudden ons...
Authors: Yuki Sugiyama, Ryusuke Tanaka, Yuki Yoshiyama, Takashi Ichino, Norimasa Hishinuma, Sari Shimizu, Noriko Imai, Kunihiro Mitsuzawa and Mikito Kawamata
Following cerebral arteriovenous malformation (AVM) surgery, severe brain edema and hemorrhage may be caused by postoperative normal perfusion pressure breakthrough (NPPB). Sedation is necessary for this popul...
Authors: Chanatthee Kitsiripant, Kotoe Kamata, Rie Kanamori, Koji Yamaguchi, Makoto Ozaki and Minoru Nomura
Acute bioprosthetic valve thrombosis can occur after surgery and sometimes cause hemodynamic instability and cardiogenic shock. Risk factors for bioprosthetic valve thrombosis are hypercoagulability, atrial fi...
Authors: Tatsuyuki Imada, Sho Carl Shibata, Kenta Okitsu and Yuji Fujino
Easier to perform than the conventional procedure, mini-tracheostomy (MT) is widely used in the operating room or intensive care unit to remove sputum or other obstructions of the upper airway. This option, ho...
Authors: Hiroshi Inoue, Jun Ito, Hiroaki Uchida, Mariko Morita, Takahiko Masuda, Kazuhiro Yamaya, Masaki Hata and Shigeaki Kato
Coronary ostial stenosis is a life-threatening complication of aortic valve replacement (AVR). Clinical symptoms usually appear within the first 6 months after AVR (Funada and Mizuno et al., Circ J 70:1312–7, ...
Authors: Naomi Ono, Toshiyuki Sawai and Hisanari Ishii
Regional cerebral oxygen saturation (rSO2) monitoring by near-infrared spectroscopy provides valuable information regarding cerebral oxygen delivery, and it has been increasingly used in cardiovascular surgery. A...
Authors: Shino Matsukawa, Miho Hamada and Toshiyuki Mizota
A 13-month-old infant weighing 8.3 kg with a height of 72.3 cm visited our hospital for surgical resection of facial vascular malformation detected at birth. Because we anticipated the patient would have diffi...
Authors: Kumi Moriyama, Masanori Mitsuda, Masakazu Kurita, Mine Ozaki, Kiyoshi Moriyama and Tomoko Yorozu
Chronic subdural hematoma (CSDH) after spinal anesthesia is a rare complication. We experienced a patient who developed CSDH after postdural puncture headache (PDPH) following combined spinal and epidural anes...
Authors: Yuri Iwase, Manzo Suzuki and Hiroyasu Bito
Subglottic stenosis can lead to life-threatening difficult tracheal intubation during general anesthesia. We report a case of difficult tracheal intubation in an 11-month-old female who had unrecognized subglo...
Authors: Natsuko Ohsima, Fumimasa Amaya, Shunsuke Yamakita, Yoshinobu Nakayama, Hideya Kato, Yumi Muranishi, Toshiaki Numajiri and Teiji Sawa
A scalp block or wound infiltration of local anesthetic is thought to effectively control post-craniotomy pain. However, it can result in local anesthetic toxicity (LAST), which is difficult to distinguish fro...
Authors: Rintaro Hoshino, Yoshinori Kamiya, Yuka Fujii and Tsunehisa Tsubokawa
Glycosylation is one of the major posttranslational modifications of proteins and it is essential for proteins to obtain normal biological functions. Congenital disorders of glycosylation (CDGs) are very rare ...
Authors: Wataru Sakai, Yusuke Yoshikawa, Yasuyuki Tokinaga and Michiaki Yamakage
We describe a patient with biventricular assist devices who had systemic inflammation because of cholecystitis that required open cholecystectomy, and we discuss the anesthetics and monitors that should be use...
Authors: Kenta Okitsu, Takeshi Iritakenishi, Chiyo Ootaki and Yuji Fujino
A pulse oximeter is one of the most important monitors to save patients undergoing anesthesia and monitored sedation. The authors report a case of orthopedic surgery, in which interference of pulse oximetry oc...
Authors: Junichi Saito, Masato Kitayama, Ryutaro Kato and Kazuyoshi Hirota
Patient satisfaction with postoperative pain management is an important quality indicator in patient health care, but its determinants are poorly understood. Here, we examined the contribution of the discrepan...
Authors: Marie Shigematsu-Locatelli, Takashi Kawano, Sonoe Kitamura, Atsushi Nishigaki, Daiki Yamanaka, Bun Aoyama, Hiroki Tateiwa and Masataka Yokoyama
Epidural blood patch (EBP) is a recognized treatment for spontaneous cerebrospinal fluid leak (SCFL) and is typically administered by the interlaminar approach. Here, we report a case of a patient in whom SCFL...
Authors: Aki Fujiwara, Keisuke Watanabe, Keiji Hashizume, Kozue Shinohara, Michiko Fukumoto, Katsuhiro Kimoto and Masahiko Kawaguchi
Paravertebral catheters are generally inserted and removed without complications. However, catheter breakage occurs rarely. This is the first report describing breakage of a thoracic paravertebral catheter and...
Authors: Tasuku Fujii, Yasuyuki Shibata and Kimitoshi Nishiwaki
A 36-year-old parturient with a suspicion of placenta accreta under tocolytic therapy with ritodrine infusion underwent emergency cesarean section under general anesthesia with propofol, ketamine, and remifent...
Authors: Daiki Takekawa, Kei Jinushi, Masato Kitayama and Kazuyoshi Hirota
Although data from several studies support the use of arginine vasopressin (AVP) for the treatment of hypotension concomitant with pulmonary hypertension (PH) in the cardiac surgery setting, to our knowledge, ...
In 1976, Gonzales-Crussi et al. (Am. J. Dis. Child. 130:1015–18, 1976) introduced the first case of bridging bronchus as a rare bronchial branching anomaly; since then, only 14 worldwide cases was described. W...
Post-herpetic itch (PHI) is a neuropathic itch syndrome following herpes zoster. It has been reported that PHI is occasionally sufficiently severe to compromise patients’ quality of life and frequently refract...
Authors: Daiki Yamanaka, Takashi Kawano, Marie Shigematsu-Locatelli, Atsushi Nishigaki, Sonoe Kitamura, Bun Aoyama, Hiroki Tateiwa, Noriko Kitaoka and Masataka Yokoyama
