[A central monitoring system capturing the screen of an anesthesia monitor].

e have developed a flexible, economically efficient central monitoring system. The system converts RGB analog outputs on the screen of an anesthesia monitor display into digital video signals with TwinPact 100 (Thomson Canopus, Kobe), and depicts them on the screen of Vidi-installed (http://www.mitzpettel.com/ software/vidi.php) personal computers (iMac, Apple, Tokyo), which serve as terminal monitors. These PCs are monitored and administered through Apple Remote Desktop 3 (Apple, Tokyo) on a server computer (Mac Pro, Apple, Tokyo), connected to the LAN, in the office for anesthesiologists. As Bosco's Screen Share (http://www.componentx.com/ScreenShare/) has been installed on computers in every room, we can monitor their screens via a PC in another room using Firefox (http://mozilla.jp/firefox/) and other web browsers.The system, with a screen capturing function, was designed to comply with all monitor display of all medical equipment manufacturers, with possible expansion to the operating rooms.

A comparison of postoperative sore throat after use of laryngeal mask airway and tracheal tube.

PURPOSE: We compared the degree of postoperative sore throat (PST) after use of a laryngeal mask airway (LMA; by two insertion techniques) and a tracheal tube (TT) in adult patients. METHODS: Eighty-six adult patients undergoing surgery of an extremity were randomized into three groups. The LMAs (size 4 for men, 3 for women) and TTs were lubricated with 2% lidocaine gel. After the induction of anesthesia, an LMA with the cuff deflated was inserted and then the cuff was inflated in group A, an LMA with the cuff inflated was inserted in group B, and the trachea was intubated using vecuronium in group C; staff anesthesiologists performed all these methods. LMA cuffs were inflated with the maximum recommended volume of air. TT cuffs were inflated with the minimum volume of air without gas leakage at 20 cm H(2)O pressure. The mode of ventilation depended on the individual anesthesiologists. Blood traces on the devices were examined after their removal. PST was rated immediately after anesthesia and on the first postoperative day, using a three-point score and a 100-mm visual analog scale, respectively. RESULTS: Most of the patients receiving an LMA breathed spontaneously and those receiving a TT underwent controlled ventilation. The ratio of positive blood traces on devices, as well as the degree of PST immediately after anesthesia, was similar in the three groups; however, on the first postoperative day, the severity of PST was greater in the LMA groups than in the TT group ( P = 0.016). The severity of PST was similar with the two LMA insertion techniques. CONCLUSION: In the conditions of our study, LMAs inserted with the cuff either fully inflated or deflated worsened PST compared with TTs.

Neuroprotective effect of urinary trypsin inhibitor against focal cerebral ischemia-reperfusion injury in rats.

BACKGROUND: Acute inflammatory reactions cause neuronal damage in cerebral ischemia-reperfusion. Urinary trypsin inhibitor (UTI), a serine protease inhibitor, is cytoprotective against ischemia-reperfusion injury in the liver, intestine, kidney, heart, and lung through its antiinflammatory activity. Neuroprotective action of UTI on transient global cerebral ischemia has been documented. This is the first study to determine whether UTI is neuroprotective against transient focal cerebral ischemia. METHODS: Adult male Wistar rats were randomly assigned to the following treatment groups: 0.9% saline (control, n = 9); 100,000 U/kg UTI (n = 9); and 300,000 U/kg UTI (n = 9). Treatments were performed intravenously 10 min before right middle cerebral artery occlusion for 2 h and subsequent reperfusion. Ninety-six hours after the onset of reperfusion, the motor neurologic deficit and the cerebral infarct size were evaluated. Furthermore, immunohistochemical staining for myeloperoxidase and nitrotyrosine to count infiltrating neutrophils and nitrated cells, respectively, was performed on the brain sections. RESULTS: Infarct volume in the 300,000 U/kg UTI group was smaller than in the 100,000 U/kg UTI and saline control groups (P < 0.05). Treatment with 300,000 U/kg UTI showed a trend to improve neurologic outcome but did not reach statistical significance (P = 0.0693). The significant decrease in neutrophil infiltration was observed in the ischemic hemisphere treated with 300,000 U/kg UTI compared with saline control (P < 0.05). Nitrotyrosine deposition in the ischemic hemisphere was significantly reduced in the 300,000 U/kg UTI group compared with saline control and 100,000 U/kg UTI groups (P < 0.05). CONCLUSIONS: Intravenous pretreatment with 300,000 U/kg UTI reduces focal ischemia-reperfusion injury in the rat brain, potentially opening a novel therapeutic avenue for the treatment of cerebral ischemia.