記述言語：英語   掲載種別：研究論文（学術雑誌）  

This case report describes a neonate with tracheal aplasia first diagnosed after birth due to the presentation of respiratory distress, absence of crying, and unsuccessful tracheal intubation. The most common finding with tracheal aplasia is polyhydramnios. However, diagnosis remains challenging in the prenatal period. In this case, maternal obesity and gestational diabetes made diagnosis more difficult. The only lifesaving treatment available is ventilation through esophageal intubation or tracheostomy. However, in some cases, tracheostomy is not an option.

DOI： 10.1213/XAA.0000000000001200

PubMed

researchmap

担当区分：筆頭著者   記述言語：英語   出版者・発行元：NATURE PUBLISHING GROUP  

DOI： 10.1038/srep46814

Web of Science

PubMed

researchmap

担当区分：筆頭著者   記述言語：英語   出版者・発行元：ELSEVIER SCIENCE INC  

We describe a very rare case of an indwelling central venous catheter (CVC) through the left internal jugular vein that perforated the superior vena cava (SVC) wall postoperatively, although the CVC was placed in the appropriate position preoperatively. Three days after CVC insertion, a chest radiograph showed that the CVC tip had moved from the lower SVC to the upper SVC. Five days after the insertion, computed tomography showed SVC perforation and the resulting hydrothorax. In cases of CVC insertion through the left side, the CVC tip should not be placed in the upper SVC (zone B). Considering individual clinical factors and the indwelling period for the CVC, the left innominate vein (zone C) may be a suitable site for the left-sided CVC tip to reduce the risk of SVC perforation. (C) 2016 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.jclinane.2016.02.002

Web of Science

PubMed

researchmap

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NATURE PUBLISHING GROUP  

Intravenous lidocaine administration produces an analgesic effect in various pain states, such as neuropathic and acute pain, although the underlying mechanisms remains unclear. Here, we hypothesized that intravenous lidocaine acts on spinal cord neurons and induces analgesia in acute pain. We therefore examined the action of intravenous lidocaine in the spinal cord using the in vivo patch-clamp technique. We first investigated the effects of intravenous lidocaine using behavioural measures in rats. We then performed in vivo patch-clamp recording from spinal substantia gelatinosa (SG) neurons. Intravenous lidocaine had a dose-dependent analgesic effect on the withdrawal response to noxious mechanical stimuli. In the electrophysiological experiments, intravenous lidocaine inhibited the excitatory postsynaptic currents (EPSCs) evoked by noxious pinch stimuli. Intravenous lidocaine also decreased the frequency, but did not change the amplitude, of both spontaneous and miniature EPSCs. However, it did not affect inhibitory postsynaptic currents. Furthermore, intravenous lidocaine induced outward currents in SG neurons. Intravenous lidocaine inhibits glutamate release from presynaptic terminals in spinal SG neurons. Concomitantly, it hyperpolarizes postsynaptic neurons by shifting the membrane potential. This decrease in the excitability of spinal dorsal horn neurons may be a possible mechanism for the analgesic action of intravenous lidocaine in acute pain.

DOI： 10.1038/srep26253

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：エーザイ(株)  

トラネキサム酸(TXA)の痛みに対する作用・機序について検討するため、まずラットを用いて行動学実験を行った。クモ膜下腔に留置したカテーテルよりTXAを投与して自発痛様行動を観察した結果、その持続時間は濃度依存性に延長した。次に電気生理学的実験として、脊髄後角膠様質細胞を用いてホールセルパッチクランプ記録を行い、TXAの灌流投与に対する自発性抑制性シナプス後電流(sIPSC)の反応を調べた。sIPSCの振幅はTXA投与により減少し、頻度は変化がなかった。またグリシン受容体拮抗薬のstrychnineまたはガンマアミノ酪酸(GABA)受容体拮抗薬のbicucullineを灌流投与したところ、strychnine存在下ではGABA作動性sIPSC、bicuculline存在下ではグリシン作動性sIPSCの振幅は減少した。TXAは脊髄後角ニューロンのGABAおよびグリシン受容体をシナプス後性に抑制し、それによって自発痛を増強させる可能性が示唆された。

researchmap