Background: In our hospital, a mini-lecture is given before a social gathering during “Cancer Salon-”
Purpose: To examine Significance of the mini-lecture.
Method: The results of a questionnaire survey of the participants were summarized.
Results: The mini-lectures were performed by multidisciplinary persons. The survey found that a significantly large number of the participants felt the mini-lectures by persons other than medical doctors were helpful (p=0.021).
Discussion: Mini-lectures are valuable in that they provide not only information but also “create an atmosphere” of the following meeting. In addition, to receive a favorable assessment from the audience, it is important for the speakers, even the doctors, to understand the feelings of the participants, and take part in the subsequent get-together without formality.
Conclusion: The mini-lecture creates an atmosphere toward the social gatherings, and leads the speakers to adapt to the occasion with the participants.

Urgent surgical repairs were successfully performed in four patients with blunt traumatic ruptures of the thoracic aorta. All 4 patients were involved in traffic accidents and had ruptures immediately distal to the aortic isthmus. The diagnoses were achieved by IV-DSA in case 1, by IV-DSA and enhanced CT in case 2 and by enhanced helical CT in cases 3 and 4. Intraoperative transesophageal echocardiography was performed in case 4. Operations were accomplished with the aid of temporary shunt in case 1, pulmonary-femoral artery bypass in case 2 and partial left heart bypass in cases 3 and 4. Prosthetic graft interposition was performed in cases 1, 3 and 4 and end-to-end aortic anastomosis was performed in case 2. There was no postoperative paraplegia in any patient. Early diagnosis and urgent surgical repair are important in treating blunt traumatic rupture of the thoracic aorta. Enhanced helical CT and transesophageal echocardiography are useful for the diagnosis of this type of injury.

A 56-year-old man, who was admitted with cerebral infarction in our hospital, was infected with MRSA, probably through the gastrointestinal endoscopy. Taking advantage of this episode, we reevaluated the procedure of cleaning and disinfection for endoscopes by bacteriological examination. Before encountering the MRSA case, we had routinely used a simple cleaning procedure. After an examination was over, an endoscope was wiped up with ethanol-soaked gauze, sucked an enzymatic detergent, water and positive soap solution through the biopsy-suction channel, and lastly was washed by the automated reprocessor (3-5 minutes for total process), if the patient was free of infectious diseases such as hepatitis B, C and syphilis. In this symple method, bacteria were detected in 10 out of 46 samples from after-cleaning endoscopes. The results were such that we adopted the new procedure for cleaning and disinfection as follows ; after wiping the surface of an endoscope by propanol-wet gauze, an endoscope was washed by neutral detergent manually, and the biopsy-suction channel was brushed up three times. Then, the endoscope was completely immersed in a 2% glutar aldehyde solution. In this procedure, no bacterium was detected in the samples from the endoscopes. However, as the concentration of glutar aldehyde rapidly decreased, it is necessary to use a test strip specific for the minimum effective concentration of glutar aldehyde frequently to monitor the potency of such solution

A 58-year-old man was admitted for pneumonia after several business trips to Thailand, Vietnam, and Malaysia. Despite resolution of pneumonia on chest X-ray, high fever persisted. CT scan revealed a juxtarenal, atypical-shaped abdominal aortic aneurysm of 4.5cm in size, and this was thought to be the cause of persisting fever. After prolonged antibiotic treatment, surgical resection and prosthetic tube replacement of the aneurysm was performed. The aneurysm was a pseudoaneurysm, and histological examination showed chronic inflammation with no atherosclerotic change. It was thought to be of mycotic origin. On the 12th day after operation, he became febrile, and an arterial blood culture yielded Burkholderia pseudomallei. Antibiotics chosen according to sensitivity tests, were given. He was finally discharged with no exidence of persisting infection, on the 55th day after operation.

Stimulation of the trigeminal nerve can elicit various cardiovascular and autonomic responses; however, the effects of anesthesia with pentobarbital sodium on these responses are unclear. Pentobarbital sodium was infused intravenously at a nominal rate and the lingual nerve was electrically stimulated at each infusion rate. Increases in systolic blood pressure (SBP) and heart rate (HR) were evoked by lingual nerve stimulation at an infusion rate between 5 and 7 mg·kg(-1)·h(-1). This response was associated with an increase in the low-frequency band of SBP variability (SBP-LF). As the infusion rate increased to 10 mg·kg(-1)·h(-1) or more, decreases in SBP and HR were observed. This response was associated with the reduction of SBP-LF. In conclusion, lingual nerve stimulation has both sympathomimetic and sympathoinhibitory effects, depending on the depth of pentobarbital anesthesia. The reaction pattern seems to be closely related to the autonomic balance produced by pentobarbital anesthesia.
Adjuvants, Anesthesia ; administration & dosage ; pharmacology ; Adrenergic alpha-Antagonists ; pharmacology ; Animals ; Autonomic Nervous System ; drug effects ; Cats ; Dose-Response Relationship, Drug ; Electric Stimulation ; Electrocardiography ; drug effects ; Hemodynamics ; drug effects ; Hexamethonium ; pharmacology ; Hypnotics and Sedatives ; administration & dosage ; pharmacology ; Infusions, Intravenous ; Lingual Nerve ; drug effects ; physiology ; Male ; Neural Inhibition ; Phentolamine ; pharmacology ; Trigeminal Nerve ; drug effects ; physiology

Background: Choosing catecholamines, such as norepinephrine and dopamine, for perioperative blood pressure control is essential for anesthesiologists and intensivists. However, studies specific to noncardiac surgery are limited. Therefore, we aimed to evaluate the effects of postoperative norepinephrine and dopamine on clinical outcomes in adult noncardiac surgery patients by analyzing a nationwide intensive care patient database. Methods: The Japanese Intensive care PAtient Database (JIPAD) was used for this multicenter retrospective study. Adult patients in the JIPAD who received norepinephrine or dopamine within 24 h after noncardiac surgery in 2018–2020 were included. We compared the norepinephrine and dopamine groups using a one-to-one propensity score matching analysis. The primary outcome was in-hospital mortality. Secondary outcomes were intensive care unit (ICU) mortality, hospital length of stay, and ICU length of stay. Results: A total of 6,236 eligible patients from 69 ICUs were allocated to the norepinephrine (n = 4,652) or dopamine (n = 1,584) group. Propensity score matching was used to create a matched cohort of 1,230 pairs. No differences in the in-hospital mortality was found between the two propensity score matched groups (risk difference: 0.41%, 95% CI [−1.15, 1.96], P = 0.608). Among the secondary outcomes, only the ICU length of stay was significantly shorter in the norepinephrine group than in the dopamine group (median length: 3 vs. 4 days, respectively; P < 0.001). Conclusions In adult patients after noncardiac surgery, norepinephrine was not associated with decreased mortality but was associated with a shorter ICU length of stay than dopamine.