Perioperative changes in platelet count in patients with atrial septal defect.

Background: Platelet count and function change following atrial septal defect (ASD) closure with the Amplatzer septal occluder (ASO). However, the clinical significance of these changes remains unclear. We examined changes in platelet count and mean platelet volume (MPV) before and after ASO placement, and the association between platelet count, MPV and various factors.

A case of circumferential type A aortic dissection with intimal intussusception diagnosed using repeat transthoracic echocardiography examination.

Case: Sometimes it is difficult to diagnose circumferential aortic dissection with enhanced computed tomography alone. A 58-year-old woman presented with sudden-onset chest discomfort and loss of consciousness. Transthoracic echocardiogram showed mild aortic regurgitation.

Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study.

Background: The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest.

Association between delay to coronary reperfusion and outcome in patients with acute coronary syndrome undergoing extracorporeal cardiopulmonary resuscitation.

Aim: The prognostic effect of early coronary reperfusion therapy with extracorporeal cardiopulmonary resuscitation (ECPR) in patients with cardiac arrest due to acute coronary syndrome (ACS) has yet to be clarified. We investigated the relationship between time interval from collapse to start of ECPR (CtoE) and coronary reperfusion (CtoR) time and neurological outcome in patients with cardiac arrest due to ACS.

Methods: A cohort of 119 consecutive patients (63±12 years old) with ACS who underwent ECPR and percutaneous coronary intervention(PCI) at our hospital was registered from January 2005 to June 2016.

Effect of ultrasonography and fluoroscopic guidance on the incidence of complications of cannulation in extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a retrospective observational study.

Background: It remains unclear which cannulation method is best in cases of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest. We assessed the effect of ultrasound- and fluoroscopy-guided percutaneous cannulation on complication incidence, compared with that using only ultrasound guidance.

Methods: This single-center retrospective observational study was conducted between February 2011 and December 2015.

Prognostic effect of estimated glomerular filtration rate in patients with cardiogenic shock or cardiac arrest undergoing percutaneous veno-arterial extracorporeal membrane oxygenation.

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can improve survival in patients with cardiogenic shock or cardiac arrest. We investigated the association between initial renal function and clinical outcome in patients undergoing VA-ECMO for cardiogenic shock and cardiac arrest.

Methods: This was a single-center, retrospective cohort study of 287 patients who underwent ECMO at our hospital from January 2005 to December 2014.

Unilateral cardiogenic pulmonary edema associated with acute mitral regurgitation.

Case: Two cases of cardiogenic unilateral pulmonary edema are reported. Both patients presented to the emergency department with dyspnea, and chest radiography revealed unilateral infiltration, which mimics pulmonary disease. However, the patients were diagnosed with cardiogenic pulmonary edema, because echocardiography showed severe mitral regurgitation with an eccentric jet.

[The current situation of aggravated intoxication with "kiken" drugs (law-evading drugs)].

The intoxication caused by "kiken" drugs (law-evading drugs), such as synthetic cannabinoids, cathinones, and methoxetamine, has recently increased in Japan. We retrospectively examined the characteristics of patients poisoned with the "kiken" drugs. We included patients who presented at the emergency department at the Tokyo Metropolitan Bokutoh Hospital from January 2011 to December 2014.

Diverticulitis-induced pylephlebitis possibly misdiagnosed as biliary duct obstruction.

Case: A 59-year-old Asian man presented to our emergency department with hypogastrium pain, loss of appetite, and diarrhea. On admission, he was hypotensive and jaundiced. Laboratory test results revealed thrombocytopenia, hypercreatininemia, and hyperbilirubinemia.

Prognostic value of the recovery time of continuous normal voltage in amplitude-integrated electroencephalography in out-of-hospital cardiac arrest patients treated with therapeutic hypothermia: a retrospective study.

Background: The early prediction of neurological outcomes in postcardiac arrest patients treated with therapeutic hypothermia (TH) remains challenging. Amplitude-integrated electroencephalography (aEEG) is a type of quantitative EEG. A particular cutoff time from the return of spontaneous circulation (ROSC) to the recovery of a normal aEEG trace for predicting a good neurological outcome has not yet been established.

Applying the termination of resuscitation rules to out-of-hospital cardiac arrests of both cardiac and non-cardiac etiologies: a prospective cohort study.

Background: The 2015 American Heart Association Guidelines for Cardiopulmonary Resuscitation recommend Basic Life Support (BLS) and Advanced Life Support (ALS) rules for termination of resuscitation (TOR). However, it is unclear whether the TOR rules are valid for out-of-hospital cardiac arrests (OHCAs) of both cardiac and non-cardiac etiologies. In this study, we validated the TOR rules for OHCA resulting from both etiologies.

Hemodialysis for removal of dabigatran in a patient with gastric hemorrhage.

Case: An 82-year-old man taking dabigatran was admitted with syncope. Computed tomography showed extravasation from the stomach. Laboratory data revealed renal insufficiency and prolonged activated partial thromboplastin time.

An infant case of dilated cardiomyopathy associated with congenital cytomegalovirus infection.

A 2-month-old infant with congestive heart failure was referred to the authors' hospital. Echocardiography exhibited a dilated left ventricle (LV), poor LV systolic function, and intraventricular thrombus. Laboratory data showed a normal creatinine phosphokinase level and negative troponin T test results.

CLINICAL case report: falciparum malaria with hemophagocytic syndrome.

A 30-year-old Japanese woman with falciparum malaria was hospitalized because of fever and renal failure, and prolonged anemia was identified despite the eradication of malaria parasites through anti-malaria therapy. Bone marrow aspiration revealed the presence of macrophages with hemophagocytosis, and serum interleukin (IL)-18 and tumor necrosis factor (TNF)-alpha levels were high in the anemic phase. Hemophagocytosis was confirmed for at least 3 weeks, and prolonged hemophagocytic syndrome is thought to be one of the causes of prolonged anemia in patients with falciparum malaria.

West syndrome associated with mosaic Down syndrome.

We report a girl with West syndrome associated with mosaic Down syndrome. She had repetitive tonic spasms at 6 months and an electroencephalography (EEG) showed hypsarrhythmia. Her facial appearance was normal and she had no minor anomalies.