Search

Surgical smoke is generated during the cauterization, coagulation, and incision of biological tissues by electrocautery, ultrasonic coagulation, incising devices, and lasers. Surgical smoke comprises water, water vapor, steam, and some particulate matter, including bacteria, viruses, cell fragments, and volatile organic compounds, which can pose health risks to the operating room personnel. In this study, we measured the concentration of particulate matter 2.5 (particles with a diameter of ≤ 2.5 μm) in surgical smoke.We used digital dust counters for real-time monitoring of particulate matter 2.5 generated intraoperatively in breast and gastrointestinal surgeries performed at our hospitals between 2019 and 2020.Concentrations of particulate matter 2.5 were measured in surgical smoke generated when performing 14 different surgeries. Immediately after electrocautery, the concentration of particulate matter 2.5 increased to 2258 μg/mSurgical smoke poses potential health risks to operating room personnel by contaminating their breathing zone with high concentrations of particulate matter 2.5. A local exhaust ventilation system is needed to reduce exposure.

The 2018 Japanese Ministry of Education, Culture, Sports, Science, and Technology (MEXT) survey revealed discrimination against women in the admissions process of four Japanese medical schools, although it is not known how unusual the trend is for entire medical schools to enroll men and women. Therefore, this paper aims to examine how women are disadvantaged when they take entrance examinations for medical schools in Japan, compared to other academic disciplines. A null hypothesis that the average enrollment rates by gender in each academic discipline from 2015 to 2020 are the same was used to test the population ratio, and p-values were calculated. The results showed that no significant gender differences were found in the other disciplines, but the male enrollment rate was significantly higher only in medical schools (p

We report a case with Ebstein’s anomaly and pulmonary atresia with sustained monomorphic ventricular tachycardia in a patient without a ventriculotomy history. In the low voltage area between the atrialised right ventricle and hypoplastic right ventricle, there was a ventricular tachycardia substrate and slow conduction. The tachycardia circuit was eliminated by a point catheter ablation at the area with diastolic fractionated potentials.

Local recurrence rates of rectal cancer after anterior resection remain high, despite the continued efforts of surgeons to devise preventive measures. Anastomotic recurrence, a form of local recurrence, may be caused by the implantation of exfoliated cancer cells during resection, and rectal stump washout has been proposed as a way to reduce the risk of this occurring. In this review article, we explore the mechanism of anastomotic recurrence after low anterior resection for rectal cancer, and examine the history and effectiveness of rectal washout on reducing recurrence rates, with a focus on washout solutions, procedures, and devices. Despite the lack of evidence from randomized trials, rectal washout with normal saline or diluted iodine is performed almost routinely during low anterior resection. Clamping is usually done using cross-clamps, linear staplers, tourniquets, and other devices. Although viable cancer cells may be shed into the rectal lumen during surgical resection, their impact on anastomotic recurrence remains uncertain. However, washout poses little or no harm to patients, and appears acceptable as a routine procedure. Randomized controlled trials or large observational studies may help to clarify the best practices for rectal washout.

Quality of life (QOL) and mortality are true endpoints of epidemiological or medical research, especially for community-dwelling older adults. Nutritional status and activities of daily living (ADLs) are associated with QOL and mortality. Good oral health status supports a good nutritional status. The aim of this study was to elucidate the complex structure of these important health-related factors. We surveyed 354 healthy older adults at the age of 85. Nutritional status was evaluated by the serum level of albumin. QOL, ADLs, self-assessed chewing ability, serum albumin level, and mortality during the 15 year follow up period were analyzed. Self-assessed chewing ability was associated with QOL and ADLs. Self-assessed chewing ability for slight-hard foods was associated with mortality in men. However, it was not associated with the serum albumin level. The serum albumin level was associated with mortality in women. These results indicate that maintaining good oral function is not enough. Nutritional instruction in accordance with oral function is indispensable for health promotion in older adults. When planning health promotion strategies for older adults, different strategies are needed for men and women.

A 42‐year‐old woman with tricuspid atresia who underwent a Fontan surgery (atrio‐pulmonary connection) was admitted to our hospital due to symptomatic ventricular tachycardia (VT). A defibrillation lead was implanted in a distal site of a coronary vein since there was no usual entry to the ventricle. Ventricular pacing was impossible due to the high threshold, however, good sensing was obtained. Three years later, she felt palpitations and a subsequent shock therapy while climbing stairs. The cardioverter data showed that an appropriate cardioversion therapy successfully converted VT to normal rhythm.

A 42-year-old woman with tricuspid atresia who underwent a Fontan surgery (atrio-pulmonary connection) was admitted to our hospital due to symptomatic ventricular tachycardia. A defibrillation lead was implanted in a distal site of a coronary vein since there was no usual entry to the ventricle. Ventricular pacing was impossible due to the high threshold, however, good sensing was obtained. Three years later, she felt palpitations and a subsequent shock therapy while climbing stairs. The cardioverter data showed that an appropriate cardioversion therapy successfully converted ventricular tachycardia to normal rhythm.

The oral microbiome of healthy older adults has valuable information about a healthy microbiome. In this study, we collected and analyzed the oral microbiome of denture plaque and tongue coating samples from four female centenarians. After DNA extraction and purification, pyrosequencing of the V3&ndash, V4 hypervariable regions of the 16S rRNA was carried out. The bacterial taxonomy for each lead was assigned based on a search of the EzBioCloud 16S database. We obtained a total of 199,723 valid, quality-controlled reads for denture plaque and 210,750 reads for tongue coating. The reads were assigned 407 operational taxonomic units with a 97% identity cutoff. Twenty-nine species were detected in both denture plaque and tongue coatings from all subjects. Firmicutes was the most abundant phylum, the Streptococcus salivarius group was the most abundant species in both the denture plaque and tongue coatings, and the Fusobacterium nucleatum group was detected in all subjects. In the bacterial profile, species formed clusters composed of bacteria with a wide range of prevalence and abundance, not dependent on phyla, each cluster may have specific species that could be candidates for a core microbiome. Firmicutes and Veillonella were abundant phyla on both plaque and tongue coatings of centenarians.

To identify the conflicts between a career as a surgeon and pregnancy and childbirth for women in Japan. The Japan Surgical Society conducted a nationwide survey on pregnancy and childbirth among its members who are women. The questionnaire included items regarding demography, working styles, and pregnancy and childbirth, including adverse events and harassment. The response rate was 29.9% (1068 responses, median age, 37 years). Among the responders, 61% were married and 47% had children (average number of children, 1.7). Half of the respondents reported having experienced sexual harassment and 62% reported having received unwelcome comments about pregnancy. About 20% had undergone fertility treatment. In total, 51% had pregnancies, with miscarriages in 33% of these. The top answer for the best timing for pregnancy and childbirth was after becoming board-certified. Nearly one-third of first-time mothers experienced adverse events during pregnancy and delivery, and 28% quit or changed their job because of their pregnancy and the birth of their first child. Japanese women who choose a career as a surgeon face obstacles during pregnancy and childbirth. It is vital to share the findings of this study and understand the issues associated with pregnancy and childbirth regardless of gender. Interventions are essential to ensure that every pregnant surgeon has a safe working environment to allow unobstructed development of her career.

The effects of hydroxyethyl starch (HES) on microcirculation, central venous oxygen saturation (ScvO2), and the central venous-to-arterial carbon dioxide gap (dCO2) are studied in a rabbit model of hemorrhagic shock for elucidating the advantages and drawbacks of resuscitation with HES compared with crystalloids. An ear chamber and sublingual mucosa were used to examine blood vessels by intravital microscopy. Hemorrhagic shock was induced by removing nearly half of the blood volume. Twenty-two rabbits received 20 mL of HES by intravenous infusion immediately after bloodletting. Additional HES was then administered intravenously to a total volume of 100 mL. The other 22 rabbits (control) were intravenously given 40 mL of normal saline solution (NSS), followed by additional NSS to a total volume of 200 mL, administered under the same conditions as HES. After the infusion, the vessel density and perfusion rate of the sublingual microcirculation recovered in the HES group. The arteriolar diameter, blood flow velocity, and blood flow rate of the ear microcirculation were maintained in this group, and microcirculatory failure did not develop. In the NSS group, however, all 5 of the aforementioned measured variables were significantly smaller than those in the HES group after the completion of infusion. The recovery of ScvO2 and dCO2 to the respective baseline values was significantly better in the HES group than in the NSS group. Intravenous infusion of HES effectively maintains adequate tissue oxygenation and perfusion in hemorrhagic shock.

To assess the true conditions and perceptions of the personal lives of men and women working as surgeons in Japan.In 2014, all e-mail subscribed members of the Japan Surgical Society (JSS, n = 29,861) were invited to complete a web-based survey. The questions covered demographic information, work environment, and personal life (including marital status, childcare, and nursing care for adult family members).In total, 6211 surgeons (5586 men and 625 women) returned the questionnaires, representing a response rate of 20.8%. Based on the questionnaire responses, surgeons generally prioritize work and spend most of their time at work, although women with children prioritize their family over work; men spend significantly fewer hours on domestic work/childcare than do their female counterparts (men 0.76 h/day vs. women 2.93 h/day, p 0.01); and both men and women surgeons, regardless of their age or whether they have children, place more importance on the role of women in the family.The personal lives of Japanese surgeons differed significantly according to gender and whether they have children. The conservative idea that women should bear primary responsibility for the family still pertains for both men and women working as surgeons in Japan.

To assess the true conditions and perceptions of the personal lives of men and women working as surgeons in Japan. In 2014, all e-mail subscribed members of the Japan Surgical Society (JSS, n = 29,861) were invited to complete a web-based survey. The questions covered demographic information, work environment, and personal life (including marital status, childcare, and nursing care for adult family members). In total, 6211 surgeons (5586 men and 625 women) returned the questionnaires, representing a response rate of 20.8%. Based on the questionnaire responses, surgeons generally prioritize work and spend most of their time at work, although women with children prioritize their family over work; men spend significantly fewer hours on domestic work/childcare than do their female counterparts (men 0.76 h/day vs. women 2.93 h/day, p

Japan is still a patriarchal society. There is an increasing number of female doctors who wish to follow a career path in surgery. This new generation of female surgeons need support not only in their career but also in work-life balance, especially after they have a family. We founded the Japan Association of Women Surgeons (JAWS) with the aims to advance females in surgery by providing networking and to develop leadership, mentorship, education, expertise and advocacy. This article describes our philosophy and activities, and our concept of role modeling. To find a single perfect role model is impossible in Japan, because lifestyle and family situations are quite different among individuals. Many young doctors in Japan find difficulties in identifying role models appropriate to their own situations. Our concept of remote role modeling is to identify multiple outstanding persons with excellent roles that one wishes to emulate; classify them by field of work, lifestyle, family situations, and others; then select the parts that one needs and assemble them to customize one's own ideal role model. This type of role modeling is probably the most practical approach. While modern technology is good for communication, meeting role models in person at meetings and social occasions is important in building an ideal role model.

Playing musical instruments can bring joy to people, but can also cause a wide variety of health issues that range from mild disorders to potentially fatal conditions. Although sports medicine is an established medical subspecialty, relatively few studies have investigated the health issues associated with musical instruments. Here we present an overview of these health issues. These include infections due to microorganisms, allergic reactions, as well as mechanical injuries from sustained high pressures within the oral, mediastinal, thoracic, and abdominal cavities. For example, wind instruments can potentially harbor thousands of pathogenic organisms. If several players share the same instrument, these instruments present potential hazards in the spread of infections. A fatal case of hypersensitivity pneumonitis in a bagpiper is particularly noteworthy. Similarly, a case of gastrointestinal anthrax in an animal-hide drummer is a reminder of this rare but highly fatal disease. Although not fatal, hearing-related disorders, neuromuscular issues, musculoskeletal problems, and contact dermatitis are also very common among instrumentalists. This review aims to illuminate these under-recognized health issues by highlighting both the common conditions and the rare but fatal cases.

Japan ranks low in the global gender gap index. Academic promotion is difficult for women doctors, and the leaky pipeline of women doctors is evident in academic medicine. The Japan Surgical Society (JSS) has 2,874 (7.2% of total membership) female members as of April 2014. The total number of councilors in JSS has increased, but there is still only one female member on the Council. The fact that there are so few women in decision-making positions makes it challenging to fight for equality. The Japanese Association of Medical Science (JAMS) is an association with exclusive institutional membership comprising the major medical societies in Japan, and currently has a membership of 122 specialist medical societies. It is essential to have at least one female committee member in each committee of the JAMS, which would provide opportunities to establish career paths for women doctors, to make rules that suit the lifestyle of women doctors, and to improve work-life balance.

Purpose The satisfaction rating of currently available mechanical staplers for Japanese surgeons with small hands is low. To identify the issue, we examined the relationship of hand dimensions and grip force with the operation force of a mechanical circular stapler. Methods Hand dimensions and grip force were measured in 113 Japanese surgeons (52 men and 61 women). We then evaluated the relationship between grip width and the operation force required to push the lever of the stapler, at three points on the lever, using a digital force gauge. Results The optimal grip width of the dominant hand was 62.5 ± 8.5 mm for men and 55.5 ± 5.9 mm for women (p

The objective of the present study was to explore how women surgeons manage their work-life balance in three environmental and cultural settings.Members of the Japan Association of Women Surgeons (JAWS), the United States of America (US) based Association of Women Surgeons (AWS), and the Women's Chapter of the College of Surgeons of Hong Kong (WCHK) were surveyed.Among 822 women surgeons contacted, 252 responded (response rate 31.8 %; 55.5 % JAWS, 28.2 % AWS, and 25.3 % WCHK). Japanese women surgeons think that work is the number one priority, whereas US and Hong Kong China (HK) respondents think the number one priority is home life. Work satisfaction level was generally high among women surgeons in all countries; however, 19 % of US surgeons are somewhat dissatisfied with their work and 76.1 % think that men are treated more favorably than women at work. Whereas 51.6 % of Japanese women surgeons think that men are treated more favorably than women at home, at the same time they placed more importance on the role of women in the family. More than half of Japanese women surgeons are "uncertain" about their career path in the future, whereas 55.2/87.1 % of US/HK respondents are optimistic. All surgeons recommended expanding support for child rearing or nursing care during work hours, promoting a flexible work schedule and changing some of the older conventional ideas about gender role.It is essential to address women surgeons' concerns to enable them to have a clearer vision and a challenging career, and to be more certain about their personal and professional goals.

Commercially available mechanical devices for gastrointestinal anastomosis are mostly made in overseas. Japanese female surgeons have described these devices as being too large and difficult to handle. This study investigated the degree of satisfaction and problems experienced by Japanese surgeons in using various staplers for mechanical anastomosis. A questionnaire was prepared and sent via email to 5,537 members of the Japanese Society of Gastroenterological Surgery. The questionnaire included sex, age, surgical glove size, degree of satisfaction with various mechanical staplers, stress felt when using the staplers in anastomosis, and problems regarding the devices. Valid responses were received from 241 respondents (167 males, 74 females, response rate 4.9 %). The satisfaction rate ranged from 0 to 100 %. The average glove size in males was significantly larger than that in females (median: 7.0 versus 6.0; P

The use of an expanded polytetrafluoroethylene (ePTFE) sheet wrapping device for patients with pacemaker contact dermatitis is still controversial. This study aimed to retrospectively investigate the occurrence rate of allergies and other complications after implantation of a cardiovascular implantable electronic device (CIED) wrapped with an ePTFE sheet. A total of 4,497 procedures of CIED implantation were performed at our institution between January 1993 and April 2010. Among 19 patients who underwent implantation of an electronic cardiac device wrapped with an ePTFE sheet, device implantation was performed in 11 patients for secondary prevention of device contact sensitivity, in 7 patients for primary prevention of device contact sensitivity, and in 1 patient for avoiding over-sensing of myopotentials. During follow-up periods (mean 46 ± 34 months), there were no allergic or inflammatory reactions to components of the device or ePTFE itself. Among 11 patients with a device wrapped with an ePTFE sheet for secondary prevention, 5 patients completed device replacement due to battery depletion and 3 patients had infections from the device. Wrapping implantable devices with an ePTFE sheet is an effective way of preventing device sensitivity in patients who require CIED therapy. However, the risk of infection from the device should be taken into consideration.

The manipulation of extracorporeal circulation (ECC), which is performed by perfusionists during cardiovascular surgery, is a highly sophisticated cognitive process based on visual information obtained from information sources such as ECC indicators, surgeons, an operating field, a scrub nurse, surgical instruments, displays, patients, among others. An eye-tracking approach is expected to be a powerful means of automatic and rapid analysis. This paper presents the results of a pilot study in which an eye-tracking approach was applied to the analysis of ECC operation tasks conducted during real clinical cardiovascular surgery in the operating room. Eye-tracking data on four perfusionists were recorded while they were manipulating the ECC during a series of cardiovascular surgeries. The experience of the perfusionists ranged from 2 to 26+ years. Based on the data obtained, fixation-by-fixation cataloging of eye-tracking data in which each fixation was transcribed in timeline style was performed for each perfusionist. Gaze allocation tendencies during the surgeries for all four perfusionists were determined through a comparative analysis. It was noted that an expert engineer dispersed his attention more widely than did intermediate and novice perfusionists. Taking the results of the data analysis into consideration, we discuss the implications of well-skilled perfusionists' performance during the manipulation of ECC, as well as the principles that guide how eye-tracking data obtained in real surgery should be processed. This is the first study on the application of an eye-tracking approach to the analysis of ECC operation tasks to be reported in the Japanese literature.

As olfactory perceptions vary from person to person, it is difficult to describe smells objectively. In contrast, electronic noses also detect smells with their sensors, but in addition describe those using electronic signals. Here we showed a virtual connection method between a human nose perceptions and electronic nose responses with the smell of standard gases. In this method, Amorphophallus titanum flowers, which emit a strong carrion smell, could objectively be described using an electronic nose, in a way resembling the skill of sommeliers. We could describe the flower smell to be close to that of a mixture of methyl mercaptan and propionic acid, by calculation of the dilution index from electronic resistances. In other words, the smell resembled that of “decayed cabbage, garlic and pungent sour” with possible descriptors. Additionally, we compared the smells of flowers which bloomed on different dates and at different locations and showed the similarity of odor intensities visually, in standard gas categories. We anticipate our assay to be a starting point for a perceptive connection between our noses and electronic noses.

最近，外科を選択する女性医師数は増加しているが，日本において女性医師のおかれている状況は厳しい．日本では夫が家事と育児に参加することが少なく，女性医師の家事と育児の負担が重い．2008年に，日本外科学会女性外科医支援委員会は医学会分科会105学会にアンケート調査を行った（回答率96.2%）．外科系11学会のうち4学会には合計16名の女性評議員が，また1学会には女性理事1名が就任していた．創設から100年以上の歴史ある日本外科学会と日本内科学会には，女性理事は未だに就任しておらず，日本心臓血管外科学会では評議員にも女性が就任していなかった．また，2008年の第38回日本心臓血管外科学会学術総会の座長を，女性は1名も担当していなかった．また医学会分科会では専門医更新時の留保条件に妊娠，出産，育児が含まれていることは少ない．日本では処遇改善，外科を専門として選択する場合の継続就労支援，男女共同参画，および育児支援が必要である．

Spontaneous nonanastomotic transgraft hemorrhage occurring several years after grafting may be a new late complication of biological material-impregnated fabric vascular grafts (BMIFVs). Autologous connective tissue detachment may be caused by high porosity of the fabric graft and high blood pressure. Bleeding around the fiber is the first sign of development. Fabric grafts with optimal porosity and biocompatibility should be used for manufacturing BMIFVs.

The number of surgeons is decreasing in Japan. We investigated the trend and factors influencing surgeons' selection of and retention in surgical specialty. In 2016, we obtained data of biennial surveys conducted by the government, and analyzed the annual data of doctors up to the latest available survey at that time (survey, 1994-2014; medical license acquisition, 1993-2014). The rate of selecting surgery by male and female doctors during early career (first three surveys after acquiring medical license) decreased from 28.1% in 1994 to 21.3% in 2010 (first to nineth survey). Female surgeons increased from 7.8% in 1993 to 12.4% in 2003, but decreased from 12.5% in 2006 to 10.7% in 2010. Total number of surgeons declined throughout the period. In females, the rate of selecting surgery tended to increase at the beginning of the new training system in 2004, but declined slightly thereafter. The retention rate in those who selected surgery at least once by the third survey (1998) after acquiring medical license in 1993 showed a downward trend. The retention rate in females declined continuously to 48.4% in 2002, stabilized thereafter, and then increased from 47.6% in 2006 to 50.8% in 2014. The retention rate after 10 years (1993-2003) was almost stable (72.4%) in males, but increased to 57.5% in females, and the gender difference tended to decrease. Younger doctors tend to value their private life, and may not choose or continue to practice surgery unless working conditions in surgery improve and income is commensurate with their work.

Fires, explosions and electrical accidents in the operating theater are rare events, but are devastating in terms of structural damage to the equipment in theaters and to human lives. While various circumstances lead to these troubles, we can avoid and manage them by learning from the instructive cases accumulated so far. We describe operating room crises such as fires, explosions and electrical breakdowns, and discuss causes and countermeasures.

We developed a simple device that stabilizes the blood level in the reservoir of the extracorporeal circulation open circuit system by measuring the hydrostatic pressure of the reservoir to control the flow rate of the arterial pump. When the flow rate of the venous return decreases, the rotation speed of the arterial pump is automatically slowed down. Consequently, the blood level in the reservoir is stabilized quickly between two arbitrarily set levels and never falls below the pre-set low level. We conducted a basic experiment to verify the operation of the device, using a mock circuit with water. Commercially available pumps and reservoir were used without modification. The results confirmed that the control method effectively regulates the reservoir liquid level and is highly reliable. The device possibly also functions as a safety device.

A warning on the danger of unretrieved device fragments and recommendations to mitigate the danger were issued by the Food and Drug Administration in January 2008. The causes of intravascular foreign bodies are classified into three main categories: improper manipulation and usage, device defects, and others, such as patient and anatomical factors. Device failure after long-term use is rarely predicted at the time of approval, since device abnormality is rarely experienced in animal studies and clinical trials conducted during development of the device. Stent fracture due to metal fatigue is one example. Complex complications could occur from simultaneous use of two or more devices with diverse characteristics. The success rate of percutaneous retrieval of intravascular foreign bodies has improved with the advances in commercially available devices. However, the procedure is not always successful and sometimes surgical removal becomes necessary. Appropriate device selection and acquisition of experience in using the device are important. When an intravascular foreign body cannot be retrieved, the risk of complication could be high. Magnetic resonance imaging examination sometimes causes adverse events, including burns due to the heat generated by metal movement. Such information should be correctly recorded. Furthermore, it is necessary to provide patients with adequate information about the characteristics of implanted devices and unretrieved fragments. We reviewed the literature on unretrieved medical device fragments and include articles that describe the Japanese experience.

The heart-lung machines for open-heart surgery have improved over the past 50 years; they rarely break down and are almost always equipped with backup batteries. The hand-cranking procedure only becomes necessary when a pump breaks down during perfusion or after the batteries have run out. In this study, the performance of hand cranking a roller pump was quantitatively assessed by an objective method using the ECCSIM-Lite educational simulator system. A roller pump connected to an extracorporeal circuit with an oxygenator and with gravity venous drainage was used. A flow sensor unit consisting of electromagnetic sensors was used to measure arterial and venous flow rates, and a built-in pressure sensor was used to measure the water level in the reservoir. A preliminary study of continuous cranking by a team of six people was conducted as a surprise drill. This system was then used at a perfusion seminar. At the seminar, 1-min hand-cranking drills were conducted by volunteers according to a prepared scenario. The data were calculated on site and trend graphs of individual performances were given to the participants as a handout. Preliminary studies showed that each person's performance was different. Results from 1-min drills showed that good performance was not related to the number of clinical cases experienced, years of practice, or experience in hand cranking. Hand cranking to maintain the target flow rate could be achieved without practice; however, manipulating the venous return clamp requires practice. While the necessity of performing hand cranking during perfusion due to pump failure is rare, we believe that it is beneficial for perfusionists and patients to include hand-cranking practice in periodic extracorporeal circulation crisis management drills because a drill allows perfusionists to mentally rehearse the procedures should such a crisis occur.

Permissive hypercapnia improves outcomes in patients with respiratory failure, most likely because of a reduction in ventilator-induced lung injury. Because hypercapnia is a potent vasoactive stimulus, adequate tissue perfusion and oxygen delivery to dilated microvessels may be restored. We examined how Paco2 affects microvascular changes, hemodynamics, and cardiac output in rabbits. We evaluated the permissive range of Paco2 required for maintenance of the peripheral circulation.Prospective experimental animal study.Animal research laboratory.A total of 31 Japanese domestic white rabbits.The animals were anesthetized with pentobarbital. An ear chamber was prepared to examine blood vessels by intravital microscopy. The rabbits were mechanically ventilated with air, oxygen, and CO2. The values of Paco2 were adjusted to about 20 (hypocapnia), 40 (normocapnia), 60, 80, 100, 125, 150, and250 mm Hg (hypercapnia). After stabilization at each Paco2 level, microvascular changes were recorded with a microscope-closed video camera to permit analysis of arteriolar diameter and blood flow.The pH and heart rate decreased and mean blood pressure increased progressively as the Paco2 was increased. When Paco2 was increased from 20 to 80 mm Hg, vessel diameter, blood-flow velocity, and blood-flow rate increased markedly. Cardiac output increased slightly. When Paco2 exceeded 100 mm Hg, all of these variables decreased. When Paco2 exceeded 150 mm Hg, all variables were significantly lower than the control values (p.01).Intravital microscopic visualization of the rabbit ear microcirculation showed that 150 mm Hg is the permissive upper limit of acute hypercapnia with respect to maintenance of the peripheral microcirculation.

Objectives: The effect of direct local injection of dehydrated ethanol on hormone-independent prostatic carcinoma cells (PC3 cells) implanted in nude mice was investigated. Methods: PC3 tumors were implanted subcutaneously into 30 nude mice. Three weeks later, dehydrated ethanol was injected directly into the tumors. Twenty-three animals received an injection of ethanol at a volume of 40 μL, 80 μL, or 160 μL, and were divided into a low-dose group (n = 11) and a high-dose group (n = 12) on the basis of the ethanol/tumor volume ratio (

Women have accounted for over 30 % of new medical students since 1995 in Japan. Establishing support systems for women surgeons to continue their work is a major issue in Japan. Mentorship can be one of the most effective means to help women surgeons to continue their work. The purpose of this study was to clarify the current status of mentorship among Japanese women surgeons and to discuss the role of mentors for women surgeons. Invitation letters were sent to all female members of the Japan Association of Women Surgeons in April 2011. An 84-item questionnaire survey was sent to those who agreed to participate in this study via the internet. Fifty-five surgeons participated in this study, a response rate of 48.7 %. Sixty-seven percent of respondents found it difficult to continue in their job; 85 % thought mentorship was necessary for women surgeons to progress in their careers; and 84 % reported that they already had a mentor. Respondents thought that a mentor helped them to advance their clinical career, to stay in their job, and to provide moral support. However, mentors appeared to be less useful in helping them to advance their research career, to network, to increase their status, and to achieve a work–life balance. This study revealed areas where mentors appeared to be less helpful to women surgeons. The survey gave an indication of how to help improve and develop the career and personal life of women surgeons in Japan.