著者
Tetsuya Tamaki Muneharu Ando Yukihiro Nakagawa Hiroshi Iwasaki Shunji Tsutsui Masanari Takami Hiroshi Yamada
出版者
The Japanese Society for Spine Surgery and Related Research
雑誌
Spine Surgery and Related Research (ISSN:2432261X)
巻号頁・発行日
vol.5, no.3, pp.120-132, 2021-05-27 (Released:2021-05-27)
参考文献数
61
被引用文献数
6

An intraoperative functional spinal cord monitoring system is a technology used by spine and spinal cord surgeons to perform a safe surgery and to gain further surgical proficiency. However, no existing clinical neurophysiological method used in the operating room can monitor all complex spinal cord functions. Therefore, by observing the activities of certain neural action potentials transferred via limited neural tissues, surgeons need to deductively estimate the function of the whole spinal cord. Thus, as the number of spinal cord functions that need to be observed increases, spinal cord monitoring can be more reliable. However, in some situations, critical decision-making is affected by the limited capability of these methods. Nevertheless, good teamwork enables sharing of seamless information within the team composed of a surgeon, anesthesiologist, monitoring technician and nurses greatly contributes to making quick and accurate decisions. The surgeon, who is the person in charge of the team, should communicate with multidisciplinary team members using common technical terms. For this reason, spine and spinal cord surgeons must have appropriate knowledge of the methods currently used, especially of their utility and limitations. To date, at least six electrophysiological methods are available for clinical utilization: three are used to monitor sensory-related tracts, and three are used to monitor motor-related spinal cord functions. If surgeons perform electrode setting, utilizing their expertise, then the range of available methods is broadened, and more meticulous intraoperative functional spinal cord monitoring can be carried out. Furthermore, if the team members share information effectively by utilizing a clinically feasible judicious checklist or tools, then spinal cord monitoring will be more reliable.
著者
Hiroshi Iwasaki Masaki Wakamatsu Kazunari Sugihara Kyohei Kamio Satoshi Tsuji Junya Morita Yasuhiro Kurihara Tomoko Izumi Tomohiro Nishimoto Kohnosuke Kinoshita Yutaka Nakanishi Minoru Sasaki
出版者
The Japanese Society of Toxicology
雑誌
The Journal of Toxicological Sciences (ISSN:03881350)
巻号頁・発行日
vol.45, no.4, pp.201-218, 2020 (Released:2020-04-01)
参考文献数
32
被引用文献数
2

TP0446131, developed as an antidepressant agent, was found to cause lenticular opacity in a 13-week repeated-dose study in dogs. Histopathologically, the lenticular opacity was observed as a degeneration of the lens fibers, characterized by irregularity in the ordered arrangement of the fibers which is necessary to maintain the transparency of the lens, and was considered to manifest clinically as cataract. To evaluate the development mechanism of the lenticular opacity, the chemical constituents of the lens, which is known to be associated with the development of cataract, were examined. The results of liquid chromatography-tandem mass spectrometry analysis revealed an increase in the amplitudes of 3 unknown peaks in a dose- and time-dependent manner in the lens, with no remarkable changes in the other chemical components tested. In addition, the content of cholesterol, alterations of which have been reported to be associated with cataract, remained unchanged. The mass spectral data and chromatographic behavior of the 3 peaks indicated that these peaks corresponded to sterol-related substances, and that one of them was 7-dehydrocholesterol, a precursor of cholesterol biosynthesis. This finding suggested that TP0446131 exerts some effects on the cholesterol biosynthesis pathway, which could be involved in the development of the cataracts. Furthermore, increases in the levels of these sterol-related substances were also detected in the serum, and were, in fact, noted prior to the onset of the cataract, suggesting the possibility that these substances in the serum could be used as potential safety biomarkers for predicting the onset of cataract induced by TP0446131.