Self-imagery and advertising effectiveness: the role of sense of presence.

The purpose of this study was to assess whether self-imagery is more effective than other-imagery, and if so, to investigate the mechanism of how self-imagery generates more increased positive responses from consumers. Furthermore, we explored the boundary conditions associated with reduced positive effects of self-imagery on consumer responses. The results of Experiment 1 suggest that self-imagery was more effective than other-imagery in generating a favorable attitude toward an advertisement and purchase intention, since it enhanced a sense of presence, and consequently, imagery engagement. However, based on the results of Experiment 2, when an advertisement evoked a sense of high-risk, self-imagery generated a less favorable attitude toward the advertisement than other-imagery due to the emotion of fear evoked by the advertisement.

Seafloor geodetic constraints on interplate coupling of the Nankai Trough megathrust zone.

Interplate megathrust earthquakes have inflicted catastrophic damage on human society. Such an earthquake is predicted to occur in the near future along the Nankai Trough off southwestern Japan--an economically active and densely populated area in which megathrust earthquakes have already occurred. Megathrust earthquakes are the result of a plate-subduction mechanism and occur at slip-deficit regions (also known as 'coupling' regions), where friction prevents plates from slipping against each other and the accumulated energy is eventually released forcefully. Many studies have attempted to capture distributions of slip-deficit rates (SDRs) in order to predict earthquakes. However, these studies could not obtain a complete view of the earthquake source region, because they had no seafloor geodetic data. The Hydrographic and Oceanographic Department of the Japan Coast Guard (JHOD) has been developing a precise and sustainable seafloor geodetic observation network in this subduction zone to obtain information related to offshore SDRs. Here, we present seafloor geodetic observation data and an offshore interplate SDR-distribution model. Our data suggest that most offshore regions in this subduction zone have positive SDRs. Specifically, our observations indicate previously unknown regions of high SDR that will be important for tsunami disaster mitigation, and regions of low SDR that are consistent with distributions of shallow slow earthquakes and subducting seamounts. This is the first direct evidence that coupling conditions might be related to these seismological and geological phenomena. Our findings provide information for inferring megathrust earthquake scenarios and interpreting research on the Nankai Trough subduction zone.

Systemic dexmedetomidine augments inhibitory synaptic transmission in the superficial dorsal horn through activation of descending noradrenergic control: an in vivo patch-clamp analysis of analgesic mechanisms.

α2-Adrenoceptors are widely distributed throughout the central nervous system (CNS) and the systemic administration of α2-agonists such as dexmedetomidine produces clinically useful, centrally mediated sedation and analgesia; however, these same actions also limit the utility of these agents (ie, unwanted sedative actions). Despite a wealth of data on cellular and synaptic actions of α2-agonists in vitro, it is not known which neuronal circuits are modulated in vivo to produce the analgesic effect. To address this issue, we made in vivo recordings of membrane currents and synaptic activities in superficial spinal dorsal horn neurons and examined their responses to systemic dexmedetomidine. We found that dexmedetomidine at doses that produce analgesia (<10 µg/kg) enhanced inhibitory postsynaptic transmission within the superficial dorsal horn without altering excitatory synaptic transmission or evoking direct postsynaptic membrane currents. In contrast, higher doses of dexmedetomidine (>10 µg/kg) induced outward currents by a direct postsynaptic action. The dexmedetomidine-mediated inhibitory postsynaptic current facilitation was not mimicked by spinal application of dexmedetomidine and was absent in spinalized rats, suggesting that it acts at a supraspinal site. Furthermore, it was inhibited by spinal application of the α1-antagonist prazosin. In the brainstem, low doses of systemic dexmedetomidine produced an excitation of locus coeruleus neurons. These results suggest that systemic α2-adrenoceptor stimulation may facilitate inhibitory synaptic responses in the superficial dorsal horn to produce analgesia mediated by activation of the pontospinal noradrenergic inhibitory system. This novel mechanism may provide new targets for intervention, perhaps allowing analgesic actions to be dissociated from excessive sedation.

[Extrapyramidal reactions in three patients due to droperidol infusion for intravenous patient-controlled analgesia].

Intravenous patient-controlled analgesia (iv-PCA) has a great advantage for pain control in the postoperative period with occasional disadvantages of postoperative nausea and vomiting, which should be treated appropriately. Droperidol is commonly used as anti-emetic drug, but it also has a potential risk to induce extrapyramidal reactions. We report three patients who showed extrapyramidal reactions among 589 patients after droperidol administration. Although this complication is rare, we should be aware of the possible extrapyramidal reactions due to droperidol.

Effects of general anesthetics on P2X4 receptors in a mouse microglial cell line.

The purinergic P2X4 receptors (P2X4Rs) of spinal microglia are upregulated after a peripheral nerve injury and play important roles in the pathogenesis of chronic pain. The effects of general anesthetics on chronic pain and the mechanisms are still unclear. The aim of this study is to examine the effects of general anesthetics on microglial P2X4Rs. Currents induced by ATP were recorded by the whole-cell clamp technique using a mouse microglial cell line (MG5). Isoflurane and sevoflurane, ketamine, thiopental, midazolam, and propofol were coapplied with ATP using the U-tube system or added to the external perfusate. ATP-induced two distinct types of current: P2X4R-mediated and P2X7R-mediated currents. P2X4R-mediated currents were identified pharmacologically and isolated. Volatile anesthetics including sevoflurane and isoflurane and intravenous anesthetics including thiopental, ketamine, and midazolam had no effect at clinically relevant concentrations (n=5-8). Propofol showed a dual effect, potentiating at lower concentrations (0.3-3 µM) and inhibiting at higher concentrations (IC50 57 µM). The maximum enhancement was observed at 1 µM propofol (143±5% of control, n=5). Propofol (1 µM) shifted the dose-response curve for the P2X4R currents to lower concentrations of ATP and increased the maximum amplitude. Propofol exerted dual actions on P2X4R-mediated currents at clinically relevant concentrations. This may suggest that the administration of propofol could affect the development of chronic pain through the modulation of microglial P2X4R responses.

Discovery of new hydrothermal activity and chemosynthetic fauna on the Central Indian Ridge at 18°-20° S.

Indian Ocean hydrothermal vents are believed to represent a novel biogeographic province, and are host to many novel genera and families of animals, potentially indigenous to Indian Ocean hydrothermal systems. In particular, since its discovery in 2001, much attention has been paid to a so-called 'scaly-foot' gastropod because of its unique iron-sulfide-coated dermal sclerites and the chemosynthetic symbioses in its various tissues. Despite increasing interest in the faunal assemblages at Indian Ocean hydrothermal vents, only two hydrothermal vent fields have been investigated in the Indian Ocean. Here we report two newly discovered hydrothermal vent fields, the Dodo and Solitaire fields, which are located in the Central Indian Ridge (CIR) segments 16 and 15, respectively. Chemosynthetic faunal communities at the Dodo field are emaciated in size and composition. In contrast, at the Solitaire field, we observed faunal communities that potentially contained almost all genera found at CIR hydrothermal environments to date, and even identified previously unreported taxa. Moreover, a new morphotype of 'scaly-foot' gastropod has been found at the Solitaire field. The newly discovered 'scaly-foot' gastropod has similar morphological and anatomical features to the previously reported type that inhabits the Kairei field, and both types of 'scaly-foot' gastropods genetically belong to the same species according to analyses of their COI gene and nuclear SSU rRNA gene sequences. However, the new morphotype completely lacks an iron-sulfide coating on the sclerites, which had been believed to be a novel feature restricted to 'scaly-foot' gastropods. Our new findings at the two newly discovered hydrothermal vent sites provide important insights into the biodiversity and biogeography of vent-endemic ecosystems in the Indian Ocean.

Inhibition of voltage-gated proton channels by local anaesthetics in GMI-R1 rat microglia.

Voltage-gated proton channels play crucial roles during the respiratory burst in phagocytes, such as microglia. As local anaesthetics have a variety of anti-inflammatory properties, including inhibition of phagocytosis, they may act on the proton channels. Most local anaesthetics are tertiary amines and may affect proton channels through modification of pH(i) as weak bases. To test these hypotheses, the effects of lidocaine and bupivacaine on proton channels were examined in a rat microglial cell line (GMI-R1) as a function of pH(o) and pH(i). Both lidocaine and bupivacaine reversibly decreased the current, with IC(50) values of ∼1.2 and ∼0.5 mM, respectively, at pH(o)/pH(i) 7.3/5.5. The inhibition was enhanced with either pH(o) increase or pH(i) decrease, suggesting that the protonation of the base forms inside the cell contributed to the inhibitory effects. Both local anaesthetics shifted the reversal potentials to more positive voltages, indicating increases in pH(i). The potencies of inhibition were correlated well with the degree of increase in pH(i). The lidocaine-induced inhibition was eliminated when the pH(i) increases were cancelled by co-application of a weak acid, butyrate. The cytosolic alkalizations by lidocaine and bupivacaine were confirmed using a pH-sensitive fluorescent dye, BCECF, in non-voltage-clamped cells. Furthermore, chemiluminescence measurement proved that both anaesthetics inhibited production of reactive oxygen species by the cells. In conclusion, lidocaine and bupivacaine inhibit proton channels primarily by the weak base mechanism via an increase in pH(i). This is a novel mechanism underlying actions of local anaesthtics.

[Anesthesia for three patients with Hunter syndrome].

Airway compromise is one of the greatest concerns in the anesthetic management in Hunter syndrome. We report anesthetic management of three cases of Hunter syndrome. The first was a 3-year-old boy scheduled for laparoscopic inguinal hernia repair. A laryngeal mask airway (LMA) was inserted and fiberoptic intubation through the LMA was successfully performed. The second was a 23-year-old man with a past history of difficult intubation, scheduled for repair of femur neck fracture. He received lateral cutaneous nerve block and monitored anesthesia care using remifentanil. The third was a 53-year-old man scheduled for repair of giant inguinal hernia. Having failed regional (combined spinal and epidural) anesthesia, we administered general anesthesia with placement of a LMA. Manual assisted ventilation was needed during operation due to unideal fit. The difficulty of airway management in Hunter syndrome is thought to increase with age. The airway obstruction is one of the most essential problems for anesthesia in these patients. It is important to assess the airway carefully, and to make plans for the anesthesia.

[Introduction of hospital information system and anesthesia information management system into the perianesthetic practice at Osaka City University Hospital].

BACKGROUND: Recently, the hospital information systems (HIS) and anesthesia information management systems (AIMS) have been rapidly improved and have been introduced into the clinical practice in Japan drastically; however, few reports have detailed their influences on clinical practice. We here report our experience. METHODS: We introduced HIS (EGMAIN-EX, Fujitsu Co., Ltd.) in our preoperative evaluation clinic and in the postoperative care unit. AIMS (ORSYS, Philips Electronics Japan) was introduced almost only to the intraoperative management. RESULTS: It became easy for us to acquire patient's information and to share it with the medical staffs in the other departments. However, we had to invest large human resources for the introduction and maintenance of the HIS and the AIMS. CONCLUSIONS: Though AIMS is more useful in anesthetic management than HIS, it seems to be more suitable for coordination with the medical staffs in the other departments to use HIS for perioperative management than to use AIMS.

Displacement above the hypocenter of the 2011 Tohoku-Oki earthquake.

The moment magnitude (M(w)) = 9.0 2011 Tohoku-Oki mega-thrust earthquake occurred off the coast of northeastern Japan. Combining Global Positioning System (GPS) and acoustic data, we detected very large sea-floor movements associated with this event directly above the focal region. An area with more than 20 meters of horizontal displacement, that is, four times larger than those detected on land, stretches several tens of kilometers long along the trench; the largest amount reaches about 24 meters toward east-southeast just above the hypocenter. Furthermore, nearly 3 meters of vertical uplift occurred, contrary to observed terrestrial subsidence.

[Anesthetic management for mitral valve replacement in a patient with mitral stenosis and dilated cardiomyopathy].

A 69-year-old man who has mitral stenosis concomitantly with dilated cardiomyopathy underwent mitral valve replacement. The preoperative left ventricular ejection fraction was 23%. Preoperative dobutamine stress echocardiography showed poor response. High dose fentanyl was administered for induction and maintenance of general anesthesia, and blood pressure was kept with vasoconstrictors. Circulatory assist with milrinone and intraaortic balloon pumping after the cardiopulmonary bypass enabled us to obtain stable hemodynamics.

[A case of anaphylactic shock induced by latex during cesarean section].

We report a 39-year-old woman who showed intraoperative anaphylactic shock during elective cesarean section in the 38th week of pregnancy. She underwent cesarean sections under general anesthesia at 33 years of age, and under spinal anesthesia at 37 years without any complication; other past history was unremarkable. Spinal anesthesia was performed with 0.5% hyperbaric bupivacaine 2.5 ml and analgesia level up to T2 was obtained 12 minutes later. The operation was uneventful at the birth of a neonate weighing 2700 g delivered with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. Drip infusion of oxytocin was started after the delivery and uterine contraction was good. Five minutes later, blood pressure decreased abruptly to 70/40 mmHg, heart rate increased to 130 beats min(-1) and the patient complained of chest discomfort. Bolus injections of ephedrine and phenylephrine were ineffective, and continuous infusion of adrenaline was started to maintain blood pressure. The operation was finished and the patient was intubated for artificial ventilation to prevent airway obstruction. The tracheal tube was removed the following day and the postoperative course was uneventful thereafter. Plasma tryptase levels at 1 and 6 hours after the episode of hypotension were 9.0 and 1.3 ng x ml(-1). Postoperative blood tests revealed an increase in latex-specific immunoglobulin E, suggesting that anaphylactic shock was induced by latex.

Intrathecal gabapentin and clonidine synergistically inhibit allodynia in spinal nerve-ligated rats.

AIMS: The objective of this study was to elucidate the interaction between intrathecally administered gabapentin and clonidine on neuropathic pain associated with allodynia in the spinal nerve ligation model in the rat. MAIN METHODS: Thresholds for hind paw responses to mechanical stimuli were determined by delivering von Frey filaments to the plantar surface. The left L5 spinal nerve was ligated and a fine catheter was intrathecally implanted at the L3-4 interspace under sevoflurane anesthesia. After confirmation of the established allodynia, gabapentin at 10, 30, 60 and 100µg or clonidine at 5, 15, 30 and 50µg was injected as a monotherapy in conscious rats through the intrathecal catheter to obtain the dose-response curve of %MPE (maximum possible effect) of the antiallodynic effect and its ED(50). Gabapentin and clonidine were concomitantly administered in a fixed-dose ratio proportional to the predetermined ED(50) of these drugs, thereby obtaining a dose-response curve for the drug combination and its ED(50). The profile of the interaction between these drugs was analyzed using an isobolographic analysis. KEY FINDINGS: The ED(50) for gabapentin and clonidine were 57.3±4.0 and 20.2±1.0µg, respectively (mean±SEM). However, the co-administration of gabapentin and clonidine at a ratio of 20:7 contributed to a much smaller experimental ED(50) values (gabapentin 10.1±1.1µg, and clonidine 3.6±0.3µg) compared with their theoretical ED(50)s on the additive line in the isobologram. SIGNIFICANCE: In the L5 spinal nerve-ligated rats, the intrathecal co-administration of gabapentin and clonidine exerted a synergistic action on the mechanical antiallodynic effect.

[Prolonged apnea from rocuronium in a patient with hypermagnesemia after cesarean section: a case report].

A patient developed prolonged apnea after emergency cesarean section. The patient was a 38-year-old primiparous woman with myoma uteri and her body weight was 44.8 kg. She received intravenous magnesium sulfate 1 g x hr(-1) as tocolytic agent for threatened premature delivery. We performed rapid sequence induction of anesthesia with thiopental 250 mg and rocuronium 50 mg because she was suspected of full stomach. After the intubation, we did not administer any muscle relaxants during the operation. After the operation which was finished in 65 minutes, the effect of rocuronium remained for more than 100 minutes after its administration probably due to hypermagnesemia. Rocuronium shows rapid onset, and several studies indicate that it can be used for rapid sequence induction instead of suxamethonium. But rocuronium should be used carefully and its effect should be monitored in a patient with hypermagnesemia.

Pharmacokinetics of lidocaine, bupivacaine, and levobupivacaine in plasma and brain in awake rats.

BACKGROUND: We have compared the pharmacokinetics and brain distribution of lidocaine, racemic bupivacaine (bupivacaine), and levobupivacaine in awake, spontaneously breathing rats. METHODS: Lidocaine (0.5 mg x kg x min), bupivacaine (0.1 mg x kg x min), or levobupivacaine (0.1 mg x kg x min) was continuously administered to rats for 2 h (n = 12, each anesthetic). Blood samples and cerebral dialysate were collected during infusion and for 2 h after termination of infusion. Concentrations of anesthetics in the cerebral extracellular fluid were measured by microdialysis using the retrodialysis calibration method. Tissue-to-plasma partition coefficients calculated from the total (protein-bound and unbound) and unbound concentrations in plasma and brain as well as pharmacokinetic parameters in plasma and cerebral extracellular fluid were compared among the three anesthetics. RESULTS: There were no differences in plasma total or unbound concentrations between bupivacaine and levobupivacaine. Concentrations of bupivacaine in the cerebral extracellular fluid were significantly higher than levobupivacaine (P < 0.001). Despite no differences in the ratio of total brain concentration to total plasma concentration among the three anesthetics, the ratio of cerebral extracellular fluid concentration to plasma unbound fraction of bupivacaine was significantly higher than lidocaine and levobupivacaine (0.58 +/- 0.09, 0.47 +/- 0.18, and 0.40 +/- 0.09, respectively; P = 0.03 and 0.003, respectively). CONCLUSIONS: Although the ratio of total brain concentration to total plasma concentrations of lidocaine, bupivacaine, and levobupivacaine was similar, concentration ratio of bupivacaine in the cerebral extracellular fluid to plasma unbound fraction was significantly higher than lidocaine and levobupivacaine.

Electroencephalographic response following midazolam-induced general anesthesia: relationship to plasma and effect-site midazolam concentrations.

PURPOSE: To examine the relationships between effect-site concentrations and electroencephalographic parameters after the induction of general anesthesia with midazolam. METHODS: Twenty-four patients with American Society of Anesthesiologists status I or II were randomly allocated to receive either an intravenous (i.v.) bolus of midazolam 0.2 mg kg(-1) (small-dose group, n = 12) or 0.3 mg kg(-1) (large-dose group, n = 12) for induction of general anesthesia in a double-blind experimental design. The bispectral index (BIS), 95% spectral edge frequency (SEF95), spectral power density, and plasma concentrations of midazolam were measured for 60 min following the induction of general anesthesia. RESULTS: Plasma and simulated effect-site concentrations of midazolam were significantly higher in the large-dose group than in the small-dose group (P = 0.005 and <0.001, respectively). There was a correlation between the relative beta ratio and BIS (r (2) = 0.30, P < 0.001; n = 168); however, effect-site concentrations of midazolam showed no association with BIS, relative beta ratio, or SEF95 (r (2) = 0.07, 0.11 and 0.01, respectively; n = 168). The electroencephalographic spectral power density in the beta-band (>/=13 and <30 Hz) was significantly increased after induction and was significantly larger in the large-dose group than in the small-dose group (P = 0.009). CONCLUSION: Following the induction of general anesthesia with i.v. midazolam 0.2 or 0.3 mg kg(-1), the BIS was positively correlated with the relative beta ratio. Despite a rapid decrease in the plasma and effect-site concentrations of midazolam, the average BIS remained >60 for 60 min after induction, reflecting an increased power of the electroencephalographic high-frequency band.

[Case of chronic trifascicular block resulting in cardiac arrest during operation].

An 82-year-old man underwent thoracoscopic upper lobectomy of the left lung for the treatment of the lung cancer. The major complication was asymptomatic chronic trifascicular block. During the surgery, after the upper lobe had been resected, second degree atrioventricular block (Morbitz type II) occurred unexpectedly, soon evolving in complete AV block, with pulse wave disappearing, indicating pulseless electrical activity. Immediately, we used an epicardial pacing wire, and spontaneous circulation returned. Postoperatively, a permanent pacemaker was implanted. Asymptomatic chronic bifascicular block and trifascicular block rarely progress into complete AV block during operation, which we should be prepared in advance. Accordingly in some cases, preoperative insertion of a temporary pacemaker should be considered as a preventive measure.

Effect of remifentanil on cardiovascular and bispectral index responses following the induction of anesthesia with midazolam and subsequent tracheal intubation.

PURPOSE: We examined the hypothesis that remifentanil decreases the bispectral index (BIS) as well as blunts cardiovascular responses to tracheal intubation during anesthesia with midazolam. METHODS: Sixty patients were randomly allocated to three groups according to the dose of remifentanil-0.1 (S), 0.2 (M), or 0.5 (L) microg kg(-1) min(-1), respectively. Infusion of remifentanil was started 5 min before the induction of general anesthesia with midazolam 0.2 mg/kg in all groups. Following the administration of vecuronium 0.1 mg/kg, the trachea was intubated 5 min after induction, and the infusion rate of remifentanil was then reduced to 0.05 microg kg(-1) min(-1) in all groups. Mean arterial blood pressure (MAP), heart rate (HR), BIS, and 95% spectral edge frequency (SEF95) were measured until 10 min after tracheal intubation. RESULTS: Infusion of remifentanil alone before the induction of anesthesia did not affect the hemodynamic or electroencephalographic parameters. MAP was significantly decreased after induction in all groups of patients (P < 0.01), with no differences among the three groups, while it was significantly increased after tracheal intubation in the patients of groups S and M, but not in those of group L. The HR did not change after induction in any of the groups, but it was also significantly increased after tracheal intubation of group S and M patients, although not in those of group L. The BIS decreased after induction, and both the BIS and SEF95 were significantly lower in group L patients than in those of group S (P < 0.01). All patients were unconscious after induction, and none complained of intraoperative awareness. CONCLUSION: In our patient cohort, remifentanil 0.5 microg kg(-1) min(-1) effectively decreased the BIS after the induction of general anesthesia with midazolam 0.2 mg/kg and suppressed the increase of MAP and HR in response to subsequent laryngoscopy and tracheal intubation.

[Use of remifentanil in a patient with renal failure and liver dysfunction undergoing hepatectomy].

A 74-year-old woman was scheduled for a hepatectomy. Delayed emergence from anesthesia was anticipated because she had renal failure and liver dysfunction. We induced and maintained anesthesia for 478 minutes with propofol and remifentanil. The intraoperative course was uneventful and emergence from anesthesia was not delayed. Spontaneous respiration returned and her trachea was extubated 15 minutes after the surgery. Postoperative analgesia was established by epidural ropivacaine. This case shows that remifentanil is effective in anesthetic management for a patient with renal failure and liver dysfunction undergoing hepatectomy due to its unique mode of metabolism.