Prostacyclin (PGI2) is well known to play crucial roles in induction of edema and pain behavior in the periphery. In the present study, we investigated the central role of PGI2 in inflammatory pain. Intraplantar injection of carrageenan markedly induced the expression of prostacyclin receptor (IP receptor) mRNA with the maximum at 6 h, coincidently induction of the inducible form of cyclooxygenase (COX-2), although IP receptor mRNA was weakly expressed in the spinal cord of naive mice. Intrathecal administration of the IP agonist cicaprost induced mechanical hyperalgesia 6 h after carrageenan injection. These results suggest that PGI2 is involved in pain transmission at the spinal cord following expression of IP receptor mRNA induced by peripheral inflammation.
Central venous catheter (CVC) insertion is an essential procedure in various clinical practices. However, the method of training trainees differs according to each supervising doctor. A medical safety committee for the safe insertion of CVC (CVC committee) was established in order to create an original protocol for CVC insertion at the Osaka Medical College Hospital. The committee established a registration system for CVC-certified doctors, and also created an educational program mainly targeted towards first-or second-year residents at the simulation training center. Under this system, the CVC committee requires all CVC-certified doctors to submit a CVC safety checklist to the medical safety committee in order to analyze major or minor complications, the number of punctures and utilization of ultrasound technique. Currently, 241 doctors are registered in the system while 100 residents are participating in the training sessions. Up until now, submission of the CVC safety checklist from out-of-operating-room and from the operating room was approximately 75% and nearly 100%, respectively. The ultrasound utilization rate was 25%. Our educational system for non-experts provides an excellent training opportunity. However, the checklists and registration system still have room for improvement, and such efforts will ultimately lead to enhanced patient safety.
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