Hirofumi Hino

Novel mechanism of action hypothesized for stellate ganglion block related to melatonin

The mechanism of action of stellate ganglion block has generally been explained by vasodilation within its sphere of innervation. However, the success of treatment cannot always be explained by just one mechanism of action, because its clinical indications in Japan extend to many diseases, including systemic diseases. We propose a new mechanism of action for stellate ganglion block that is based on correction of melatonin rhythm disorder resulting from increased sympathetic nerve tone and does not involve vasodilation.

Thrombomodulin improves maternal and fetal conditions in an experimental pre-eclampsia rat model

The aim of this study was to investigate whether the consecutive administration of recombinant thrombomodulin (r‐TM) for 4 days improves maternal and fetal conditions and physiological outcomes in an N′‐nitro‐L‐arginine‐methyl ester hydrochloride‐induced and low‐dose endotoxin‐induced pre‐eclampsia (PE).

1417: PREVENTION OF GLYCOCALYX DEGRADATION ON SCIATIC NERVES BY DANAPAROID SODIUM IN A SEPTIC RAT MODEL

Crit Care Med 2016 • Volume 44 • Number 12 (Suppl.) (43 vs 37%, p=0.72), or dialysis (9 vs 17%, p=0.23) between compliant and non-compliant groups. Conclusions: Clinical performance feedback improves compliance with the 3 hour sepsis bundle in critically-ill patients admitted from the ED. Improvement in bundle compliance was not associated with statistically significant improvements in measured outcomes in our small cohort.

A case of tetralogy of Fallot with no neurological deficit after prolonged hypoxia.

hospital due to increase of repeated episodes for the previous 1 month and was scheduled for surgical repair of the TOF. These attacks continued after admission, and his last attack occurred 1 week before operation. Clinical examination showed erythrocytosis (hemoglobin concentration, 17.5g·dl 1; hematocrit, 51.6%), slight coagulopathy (thrombo test, 72%), and slight hypofibrinogenemia (fibrinogen, 187mg·dl 1). Electrocardiography showed subendocardial ischemia and right ventricular hypertrophy. Angiography revealed severe infundibular stenosis and mild valvular stenosis without coronary disease. Preoperative catheterization measurements were as follows: right ventricular pressure similar to left ventricular pressure, mean pulmonary artery pressure 30mmHg, left to right shunt ratio 59%, Qp/Qs 2.3, aortic O2 saturation 88%. Chest X-ray showed right aortic arch and no increase in density in the entire lung field. The patient received routine premedication with 0.4mg scopolamine hydrobromide and 50 mg pethidine intramuscularly 30min prior to induction of anesthesia. He was sedated and hemodynamically stable; blood pressure (BP) was 120/70mmHg. Appropriate monitors were attached, and a left radial artery cannula was inserted for continuous BP monitoring. General anesthesia was induced with 0.5mg fentanyl and 0.1 mg·kg 1 midazolam intravenously. Intubation was performed after giving 0.2mg·kg 1 vecuronium intravenously with no remarkable change in vital signs or ECG. Anesthesia was maintained with 50% nitrous oxide in 50% oxygen and 40 μg·kg 1 fentanyl as required until sternotomy was performed. A pulmonary catheter was inserted via the right internal jugular vein, and the following initial mean pressures were obtained: right ventricle, 90mmHg; pulmonary artery, 15 mmHg; pulmonary capillary wedge, 9mmHg; and central venous pressure, 17mmHg. SEP (somatosensory evoked potential) was monitored continuously to evaluate cerebral oxygenation and blood perfusion. Arterial BP and heart rate