[Prevention of catheter and endoscope related infection].

Catheters such as venous catheters (e. g., peripheral venous catheters and central venous catheters), epidural catheters and the urethral catheters, as well as endoscopes such as bronchoscopes and transesophageal echo probes are the medical equipments indispensable in medical practice for the anesthesiologists. Although such equipments are necessary for patients, these use may cause infectious complications. Even infectious complication associated with these equipments is rare, it may put patients at risk of death or increased medical costs. It is necessary to use these devices with enough knowledge of the infectious complication that is critical in their use. Several guidelines for prevention of catheter and endoscope related infection from Ministry of Health, Labour and Welfare and each academic society are published and opened to the public on the WEB. To prevent infectious complication due to these equipments, it is most important to make the manual in each institution referring to these guidelines according to the characteristic of each institution, and to execute it diligently.

[Epidemiological study of hepatitis B and C in 34,336 patients operated at Hiroshima Prefectural Hospital during the period from 1993 to 2000].

BACKGROUND: We have many chances to deal with blood transfusion in the operation room, and it is important for us to pay more attention to prevent hospital infection. METHODS: We surveyed epidemiologically the prevalence of hepatitis B virus surface antigen (HBV) and hepatitis C virus antibody (HCV) in 34,336 patients operated at Hiroshima Prefectural Hospital from April 1993 through March 2001. RESULTS: The prevalence of HBV seropositivity was 1.8% in total, 1.6% in scheduled, and 2.5% in emergent cases. The prevalence of HCV seropositivity was 7.1% in total, 6.8% in scheduled, and 8.0% in emergent cases. Prevalences of both of them in emergent cases were higher than scheduled. The prevalence of HBV was highest (3.4%) in patients with age of 40's, and the prevalence of HCV increased with age. The prevalences of HBV and HCV were highest (4.5% and 19.0%) in the division of surgery and dialysis-kidney disease center. CONCLUSIONS: It is important to carry out standard precautions for all patients to prevent hospital infection. Furthermore, we should pay attention to emergent operative cases and operative cases in dialyzed patients.

Effects of morphine on visceral nociception evoked by colorectal distension in rats: comparative examinations of electrophysiological and behavioral responses.

The purpose of this study was to compare the effects of intravenously administered morphine on electrophysiological and behavioral responses to colorectal distension (CRD) and to examine the influence of noxious stimuli applied to another part of the body (a laminectomy) on the visceromotor response to CRD. The effects of morphine (0.1-6.4 mg·kg-1) were examined in rate anesthetized with pentobarbital. Electrophysiological (n=16) and behavioral experiments (n=47) were done. Electrophysiological experiments were conducted to examine the effects of morphine on the responses of visceral dorsal horn neurons to CRD; behavioral studies were conducted to compare the effects of morphine with and without a laminectomy (intact group:n=24; laminectomy group:n=23). Morphine suppressed the evoked activities of the visceral dorsal horn neurons in a dose-dependent manner. Similar suppression of the behavioral visceromotor response was observed. Visceromotor thresholds were significantly lower in the intact group than in the laminectomy group during the control study. When morphine was administered, the visceromotor thresholds in both groups increased to a similar level. Behavioral and neurophysiological responses to CRD were suppressed in a similar fashion by morphine. Although laminectomy affected the threshold values of CRD for visceromotor responses, the laminectomy per se plays an insignificant role when adequate morphine is administered.