A Simple and Reliable Method of Endotracheal Intubation in Mice: Advantages of Exposing the Trachea

Mice are popular models in experimental studies because they can be genetically modified and have a short  gestation period. In long-term studies requiring recovery from anesthesia or repeated measurements of pulmonary  function, endotracheal intubation is advantageous. However, this is difficult because of the small  anatomic structures involved. Various methods have been previously reported, the majority of them calling  for expensive devices or techniques which require special training. Therefore, we have created a simple  method of endotracheal intubation in mice using a light-emitting diode (LED) light, a metal laryngoscope,  a 22-gauge plastic cannula and a stylet made of a 0.3mm piano wire, which can all be easily prepared.  Transillumination after exposure of the trachea makes it possible to illuminate the oropharynx with a lowpriced  LED light and a metal laryngoscope provides good visualization of the tracheal opening. With direct  vision, a 22-gauge plastic cannula can easily be inserted into the trachea. The custom-made stylet is suitably  flexible for performing tracheal intubation without tissue injury. In a series of 42 mice, the success rate with  the procedure was 97.6% (n=41). Only in one case was it necessary for the procedure to be repeated. There  were no airway complications. Though exposure of the trachea is invasive, it does have advantages. We  conclude that this method is simple, safe and inexpensive, and could be used by any researchers interested  in it, no matter how small their budget.

Congenital-idiopathic superficial femoral artery aneurysm in a 7-year-old child

Superficial femoral artery aneurysm in children is distinctly uncommon, and usually results from infection, vasculitis, connective tissue disorder, or trauma. We report a 7-year-old girl who had multiple fusiform aneurysms of the right superficial femoral artery, with no evidence of related disorders. The patient successfully underwent aneurysm resection and femoral artery reconstruction with autogenous saphenous vein. Histologic examination revealed intimal thickening with fibroplasia without severe inflammatory infiltrates or cystic medial necrosis, suggesting a congenital-idiopathic arterial aneurysm. Three years after the procedure, the saphenous vein graft is fully patent and the patient is in good condition

Effects of Initial Graft Tension during Anterior Talofibular Ligament Reconstruction on Ankle Kinematics, Laxity, and In-situ Forces of the Reconstructed Graft

前距腓靭帯は，足関節の安定性に関わる重要な靱帯である．前距腓靱帯の損傷後に慢性的な足関節の不安定性が残存した場合，前距腓靱帯再建手術が必要となるが，その際に再建靭帯にかける適切な張力について研究した報告はなかった．本論文では，再建靭帯にかける張力の違いが，足関節のキネマティクス，制動性，術後の靱帯張力に及ぼす影響と適切な再建靭帯初期固定張力を明らかにした

Early surgical management of traumatic dislocation of the tibialis posterior tendon: a case report and review of the literature

Abstract Background Traumatic dislocation of the tibialis posterior tendon at the ankle is a rare injury. Some of these cases are misdiagnosed as ankle sprains and are not treated properly. In addition, because the conservative treatment is not as effective as the surgical treatment, it is essential that patients be diagnosed early so that proper surgical treatment can be performed. We report the early surgical management of traumatic dislocation of the tibialis posterior tendon. Case presentation A 44-year-old Japanese man, who was a karate coach, was injured while acting as an umpire in a karate competition. On the same day of his injury, he came to our hospital. He complained of swelling and pain in the medial malleolus. Anterior dislocation of the tibialis posterior tendon was detected upon palpation. Magnetic resonance imaging showed the presence of anterior dislocation of the tibialis posterior tendon with retinaculum injury. Four days after the injury, we performed the Das De procedure as the surgical treatment. Three months after the surgery, the patient was able to participate in karate again. Conclusions Dislocation of the tibialis posterior tendon is likely to be misdiagnosed, thus delaying the start of proper treatment. It is essential to diagnose the patient accurately by carefully assessing the physical symptoms manifested. Moreover, magnetic resonance imaging can also be used for better diagnosis, thereby leading to an early and proper surgical treatment

Phosphodiesterase type 4 inhibition of activated polymorphonuclear leukocytes in a simulated extracorporeal circulation model

AbstractObjectives: Cardiopulmonary bypass is associated with a systemic inflammatory response syndrome and the risk of multiorgan injuries mediated by activated polymorphonuclear leukocytes. Phosphodiesterase type 4 is the predominant phosphodiesterase isozyme in polymorphonuclear leukocytes and plays a key role in the regulation of polymorphonuclear leukocyte activation. The aim of this study was to examine the effect of rolipram, a selective phosphodiesterase type 4 inhibitor, on the functional changes of polymorphonuclear leukocytes by using simulated extracorporeal circulation. Methods: Simulated extracorporeal circulation was established by recirculating heparinized human blood for 120 minutes on a membrane oxygenator with and without 10 μmol/L rolipram. F-actin content and L-selectin and CD11b expression of polymorphonuclear leukocytes were measured by means of flow cytometry. Polymorphonuclear leukocyte deformability was evaluated with a microchannel array flow analyzer that had a similar diameter as the capillaries. Polymorphonuclear leukocyte elastase was measured with an enzyme immunoassay. Results: Rolipram reduced the increase of F-actin content of polymorphonuclear leukocytes and the increase of transit time of 100 μL of blood sample through a microchannel. Rolipram reduced the increase of CD11b expression and the decrease of L-selectin expression of polymorphonuclear leukocytes. Rolipram reduced the release of elastase from polymorphonuclear leukocytes. Conclusion: Rolipram inhibited the deformability change mediated by F-actin assembly, the changes in adhesion molecules, and the release of elastase from activated polymorphonuclear leukocytes in simulated extracorporeal circulation. This study suggests that phosphodiesterase type 4 inhibition could be a feasible therapeutic strategy to prevent the exaggerated inflammatory response related to cardiopulmonary bypass.J Thorac Cardiovasc Surg 2003;125:172-