An important role of voltage-gated sodium channels (VGSCs) in many different pain states has been established in animal models and humans wherein sodium channel blockers partially ameliorate pain. However, behavioral tests for screening analgesics that exhibit pharmacologic action by acting on VGSCs are rarely reported, and there are no studies on antinociception using veratrine as a nociceptive agent. The aim of the present study was to examine the amount of nociceptive behavior evoked by subcutaneous administration of veratrine into the hind paw and investigate whether veratrine can be used as a VGSC agonist to test the pharmacological properties of candidate analgesics via sodium channel blockade. We report for the first time that intraplantar injection of veratrine produced a reproducible nociceptive response in mice. Furthermore, several sodium channel blockers, namely carbamazepine, valproate, mexiletine, and the selective Nav1.7 inhibitor PF-04856264, but not flecainide or pilsicainide, reduced veratrine-induced nociception. In contrast, calcium channel blockers gabapentin and ethosuximide did not change veratrine-induced nociception. The veratrine test in mice might be a useful tool, at least in part, to evaluate the potential analgesic effect of sodium channel blockers.

The efficacy of landiolol hydrochloride, an ultrashort-acting β-blocker with high β1 selectivity, has been confirmed in patients undergoing cardiac surgery in Japan, but there have been few reports about its use for patients having lung resection. We investigated the safety of continuous infusion of landiolol in patients undergoing lung resection. Between May 2008 and May 2011, 200 patients scheduled for lung resection were enrolled. Patients who underwent surgery before the introduction of landiolol in February 2010 were studied retrospectively (Group C) and were compared with those who received landiolol along with surgery (Group L). During the 48-hour study period, the incidence of arrhythmias, changes in heart rate and blood pressure, and occurrence of adverse reactions were examined. The white blood cell count and C-reactive protein level were measured before and after surgery to assess the anti-inflammatory effect. The heart rate was significantly lower in Group L throughout the study period. No patient in Group L developed hypotension requiring discontinuation of landiolol therapy, and no respiratory symptoms (including asthma or hypoxemia) were observed. White blood cell and C-reactive protein were significantly increased after surgery in both groups, and there were no between-group differences. Arrhythmic events occurred in 1.1% (1/99) and 9.2% (7/76) of Group L and Group C, respectively. One patient in Group C developed ventricular tachycardia. Landiolol can be administered safely during the perioperative period in patients undergoing lung resection.

Four anatomical variants of the cephalic vein around the clavicle were identified. Clinicians' knowledge of these variants is expected to decrease possible complications if venous access via the cephalic vein is needed.

Dorsal scapular nerve (DSN) block is often performed in Japanese pain clinics to treat neck pain and katakori (a unique symptom in Japanese population characterized by myofascial pain syndromes such as shoulder girdle pain). However, to the best of our knowledge, there are only a few studies regarding anatomical variations in DSN paths around the middle scalene muscle (MSM) in Japanese population. Thus, we conducted a cadaveric study to examine anatomical variations in DSN paths around the MSM in Japanese population. DSN anatomies of 70 adult Japanese cadavers used for research and gross anatomy practice at the Tokai University School of Medicine between 2015 and 2016 were examined. In all cadavers, DSNs originated from the brachial plexus (BP) and innervated the rhomboid major, rhomboid minor, and levator scapulae muscles via the MSM. Two types of DSN paths were observed: piercing-type (piercing the MSM) and anterior-type (running in front of the MSM). We surveyed all 140 sides in 70 Japanese cadavers; of these, 95 sides had piercing-type and 45 had anterior-type paths. Of the 70 cadavers, 42 had piercing-type and 17 had anterior-type paths on both the sides. In 9 cadavers, the left and right sides had piercing-type and anterior-type paths, respectively. In the other 2 cadavers, the right and left sides had piercing-type and anterior-type paths, respectively. We found 2 distinct anatomical variants for DSN paths around the MSM in this Japanese cohort. Our results suggest that the rate of anterior-type DSN path is higher in Japanese population. Therefore, it is necessary to maintain caution while injecting anesthetic agents during a DSN block and the type of DSN should be considered.

In a 94-year-old male cadaver, upon which routine dissection was being conducted, a rare variation was found in the gastrophrenic trunk (GPT) (Folia Morphol 2017; 76, 3: 408-413)