Search

The excess heat due to the global warming has already penetrated and stored to the mid- and deep ocean, based on a huge amount of recent Argo and other observational data (IPCC, 2021). An upward trend of ocean heat content (OHC) has also been shown from various data sets with error bars. However, the mechanisms of the warming slowdown called the hiatus period have not yet been fully understood, although oceanic influences are presumably considered to be a strong factor, based on studies using climate models and observational data. In order to elucidate the theme, capturing actual state of oceanic variability is crucial. In this study, we utilized Argo temperature data which has been accumulated for more than 20 years to make gridded data and attempted to statistically describe the characteristics of OHC variability during and after the hiatus period. The slowdown and subsequent increase in temperature rise noted in previous studies is also evident in the observed OHC variability, which is particularly similar in the tropics, North Pacific, and North Atlantic regions. In the Southern Hemisphere, on the other hand, the hiatus period seems to stop earlier, and warming begins.A similar trend is hardly seen at depths below 300 m. These characteristics indicate that the events occur mainly above the main thermocline and follows the temperature fluctuations more closely in the Northern Hemisphere. The detailed spatial distribution of OHC variability and seasonal variability will be presented in the session., The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Original Article, Introduction: Anesthetic depth monitors, such as the bispectral index (BIS) monitor, are based on the analyses of electroencephalogram. SmartPilot View, another type of anesthetic depth monitor, calculates the effect-site concentration of anesthetics based on pharmacokinetic/pharmacodynamic simulations, computes the pharmacodynamic interaction between hypnotics and opioids, and displays the noxious stimulation response index (NSRI). NSRI is, thus, completely different from BIS as an anesthetic depth index. This study aimed to elucidate the predictability of BIS from NSRI. Methods: We recorded the BIS values when the NSRI values ranged from 0 to 20, 21 to 50, 50 to 70, 71 to 90, and 91 to 100 in patients under desflurane/opioid anesthesia (group D, n = 20) and those under propofol/opioid anesthesia (group P, n = 20). We examined the predictability of BIS from NSRI using linear regression analysis. Results: In both groups, linear regression analysis demonstrated the difficulty in the prediction of BIS from NSRI. Many patients in both groups showed a BIS value of 60 or less when the NSRI values ranged from 71 to 100 and a BIS value of less than 40 when the NSRI values ranged from 0 to 20. Conclusions: It is difficult to predict BIS from NSRI, and the observed discrepancies between NSRI and BIS suggest that simultaneous monitoring of NSRI and BIS might have clinical utility in guiding appropriate anesthetic depth.

Case Report, A 32-year-old woman complained of fever, hallucinations, and seizures. Based on her symptoms and the presence of an ovarian tumor, anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis was suspected. Without waiting for specific antibody test results, she underwent emergency laparoscopic salpingo-oophorectomy. The patient received general anesthesia, which was maintained with midazolam, propofol, opioids, and rocuronium. Her anesthesia recovery was uneventful, and she had tracheal extubation after surgery. Postoperatively, her symptoms deteriorated, despite first-line immunotherapy using immunoglobulin, steroids, and plasmapheresis. She required respiratory support for central hypoventilation. As second-line immunotherapy, rituximab and cyclophosphamide were administered, resulting in gradual symptom improvement. Approximately five months after onset, she was discharged in an ambulatory condition. Early tumor resection, combined with immunotherapy, is recommended for anti-NMDAR encephalitis secondary to tumors. Since there are individual differences in the clinical courses of patients with this disease, careful perioperative management is essential.

Background : Auscultation training using a simulator before professors' rounds has been performed in fifth-year medical students since 2012. The objective of the present study was to assess whether students could differentiate abnormal lung sounds in patients and whether their performance improved during professors' rounds after simulation-based training. / Methods : Fifth-year medical students were divided into a simulation-based training group (Group S) and a non-simulation training group (Group N). In Group S, auscultation training using a simulator was performed just before professors' rounds....

Original Article, Introduction: Glucose metabolism is modified perioperatively, resulting in hyperglycemia. While surgical stress is the predominant factor for hyperglycemic responses, anesthesia also modifies glucose metabolism. We examined the effects of anesthetics on intraoperative insulin sensitivity in fasted rats. Methods: Two experiments were carried out in this study. In experiment 1, fasted rats underwent descending colostomy under sevoflurane (n = 8) and propofol (n = 8) anesthesia without exogenous glucose administration. The surgery took approximately 30 min. Blood glucose, plasma insulin, tumor necrosis factor-α, and high-molecular-weight adiponectin levels were measured. Before and after surgery, insulin sensitivity was evaluated using the quantitative insulin sensitivity check index (QUICKI) in each rat. In experiment 2, fasted rats underwent descending colostomy under sevoflurane (n = 8) and propofol (n = 8) anesthesia with exogenous glucose administration. Subsequently, these rats underwent the insulin tolerance test (ITT); we measured blood glucose levels 30 min after insulin administration. Results: In experiment 1, rats under propofol anesthesia showed significantly lower blood glucose levels and significantly higher plasma insulin levels than rats under sevoflurane anesthesia before and after surgery. Rats under propofol anesthesia had a significantly lower QUICKI than rats under sevoflurane anesthesia. In experiment 2, rats under propofol anesthesia had less decreases in blood glucose levels during ITT than rats under sevoflurane anesthesia. Additionally, plasma tumor necrosis factor-α (TNF-α) levels under propofol anesthesia were significantly higher than those under sevoflurane anesthesia. Conclusions: Propofol anesthesia impairs insulin sensitivity during surgery in fasted rats, compared with sevoflurane anesthesia; TNF-α might be involved in insulin resistance.