[Tracheal Resection and Primary Anastomosis for Adenoid Cystic Carcinoma Using an Extracorporeal Membrane Oxygenation].

We report a case of tracheal resection and primary anastomosis for adenoid cystic carcinoma using an extracorporeal membrane oxygenation (ECMO). A 45-year-old female was referred to our hospital because of a tracheal tumor that occupied most of the tracheal lumen. In case of airway obstruction by the tracheal tumor during anesthesia and operation, we decided to use ECMO before induction of general anesthesia. Under secure respiratory control using ECMO, tracheal resection and primary anastomosis was performed. Since histopathological examination revealed microscopically positive results at the surgical margin, postoperative adjuvant radiation therapy( 60 Gy/30 Fr) was conducted. Although a tracheal tumor is a relatively rare neoplasm, careful planning and a treatment strategy are necessary with special emphasis on the location and size of tumor. In this case, ECMO made a substantial contribution to secure respiratory control during surgery.

Effect of blood sample storage period on d-ROMs and BAP test data.

The Diacron-reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) tests can easily and rapidly measure the state of oxidative stress in the blood; they have been used to determine the relationship between oxidative stress and various diseases. However, the extent to which the blood storage period affects the analyzed data remains unclear. In clinical practice, the storage conditions for samples after blood collection vary. Therefore, the influence of blood storage conditions, particularly the reversible redox state, on biochemical tests has been thoroughly investigated. The storage conditions of the sample may affect its state; however, its effect on oxidative stress has not been investigated yet. In this study, considering that the time from blood collection to blood cell separation differs depending on the clinical setting, we analyzed the effect of storage period on the redox analysis data of blood samples stored for a certain period in a 4 °C refrigerator without centrifugation. Heparinized plasma samples from three healthy adult men in their 30s were subjected to the d-ROMs and BAP tests. The analysis was performed at the following 12 time points: immediately after blood collection; 1, 3, 6, 12, and 24 h later; and 2, 3, 4, 5, 6, and 7 days later. The d-ROMs and BAP values varied and were unstable after 1 h of blood collection. These findings suggest that centrifugation should be performed within 1 h after blood collection, at the latest. In a clinical setting, data should be interpreted with caution if centrifugation is performed more than 1 h after blood collection, even if heparin is added and the samples are stored at 4 °C.

Fever in childbirth: a mini-review of epidural-related maternal fever.

Fever during childbirth, which is often observed in clinical settings, is characterized by a temperature of 38°C or higher, and can occur due to infectious and non-infectious causes. A significant proportion of non-infectious causes are associated with epidural-related maternal fever during vaginal delivery. Therapeutic interventions are required because fever has adverse effects on both mother and newborn. Effective treatment options for ERMF are lacking. As it is difficult to distinguish it from intrauterine infections such as chorioamnionitis, antibiotic administration remains the only viable option. We mentioned the importance of interleukin-1 receptor antagonist in the sterile inflammatory fever pathway and the hormonal influence on temperature regulation during childbirth, an important factor in elucidating the pathophysiology of ERMF. This review spotlighted the etiology and management of ERMF, underscoring recent advancements in our understanding of hypothalamic involvement in thermoregulation and its link to sterile inflammation. We propose to deepen the understanding of ERMF within the broader context of autonomic neuroscience, aiming to foster the development of targeted therapies.

Analysis of Maternal and Fetal Oxidative Stress During Delivery with Epidural Analgesia.

Childbirth is a stressful event for mothers, and labor epidural analgesia (LEA) may reduce mental stress. Mental stressors include labor pain, fear, and anxiety, which induce oxidative stress. In this study, we focused on oxidative stress during delivery and conducted a cross-sectional analysis of maternal and fetal oxidative stress. The participants included 15 women who received LEA (LEA group) and 15 who did not (No LEA group). Participants with a gestational age of < 37 weeks, BMI of ≥ 35 kg/m2, cerebrovascular or cardiovascular complications, multiple pregnancies, gestational hypertension, gestational diabetes, chronic hypertension, thyroid disease, birth weight of < 2,500 g, emergency cesarean section, or cases in which epidural anesthesia was re-administered during delivery were excluded from the study. Maternal blood was collected on admission, and immediately after delivery, and umbilical artery blood was collected from the fetus. The oxidative stress status was assessed by measuring diacron-reactive oxygen metabolite (an index of the degree of lipid peroxide oxidation), biological antioxidant potential (an index of antioxidant capacity) and calculating the ratio of BAP/d-ROMs (an index of the oxidative stress). The results showed that maternal oxidative stress immediately after delivery was lower in the LEA group than in the No LEA group. Moreover, the fetuses experienced less oxidative stress in the LEA group than in the No LEA group. Taken together, these results suggest that LEA may reduce maternal and fetal oxidative stress associated with childbirth.