Colonic ischemia possibly due to resuscitative endovascular balloon occlusion of the aorta (REBOA) used to manage amniotic fluid embolism: a case report.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) can control massive postpartum hemorrhage.

Case Presentation: A 41-year-old woman transferred to hospital following cesarean section presented in refractory hemorrhagic shock. REBOA was blindly performed in the emergency department.

A review of the history of the origin of triage from a disaster medicine perspective.

We usually associate triage with the Simple Triage and Rapid Treatment method, but much of its origin is still unknown. Therefore, French studies and the origin of triage shown in domestic and foreign published works have been investigated and its significance reaffirmed. The etymology of the word "triage" means "to break into three pieces.

Reduction of thoracic aorta motion artifact with high-pitch 128-slice dual-source computed tomographic angiography: a historical control study.

Objectives: Electrocardiogram-gated imaging combined with multi-detector row computed tomography (MDCT) has reduced cardiac motion artifacts, but it was not practical in the emergency setting. The purpose of this study was to evaluate the ability of a high-pitch, 128-slice dual-source CT (DSCT) scanner to reduce motion artifacts in patients admitted to the emergency room.

Methods: This study comprised 100 patients suspected of having thoracic aorta lesions.

[The potential of dual-energy virtual monochromatic imaging in reducing renal cyst pseudoenhancement: a phantom study].

Renal cyst pseudoenhancement, an artifactual increase of computed tomography (CT) attenuation for cysts with increased iodine concentrations in the renal parenchyma, complicates the classification of cysts and may thus lead to the mischaracterization of a benign non-enhancing lesion as an enhancing mass. The purpose of this study was to use a phantom model to assess the ability of dual-energy virtual monochromatic imaging to reduce renal pseudoenhancement. A water-filled cylindrical cyst model suspended in varying concentrations of iodine solution, to simulate varying levels of parenchymal enhancement, was scanned with a dual-energy CT scanner using the following three scanning protocols with different combinations of tube voltage: 80 and 140 kV; 80 and 140 kV with tin filter; and 100 and 140 kV with tin filter.

Report from J-PULSE multicenter registry of patients with shock-resistant out-of-hospital cardiac arrest treated with nifekalant hydrochloride.

Background: Nifekalant hydrochloride (NIF) is an intravenous class-III antiarrhythmic agent that purely blocks the K(+)-channel without inhibiting β-adrenergic receptors. The present study was designed to investigate the feasibility of NIF as a life-saving therapy for out-of-hospital ventricular fibrillation (VF).

Methods And Results: The Japanese Population-based Utstein-style study with basic and advanced Life Support Education study was a multi-center registry study with 4 participating institutes located at the northern urban area of Osaka, Japan.

Spontaneous splenic rupture due to extensive venous malformation with consumptive coagulopathy: treatment with splenic artery embolization.

Extensive venous malformation (VM) is often associated with chronic consumptive coagulopathy, which may result in bleeding complications. We report herein the case of a 25-year-old man with extensive VM involving the left lower extremity who presented with hypovolemic shock and abdominal distension without abdominal trauma. Abdomen computed tomography revealed splenic rupture with massive hemoperitoneum.

Nonoperative catheter management for cervical necrotizing fasciitis with and without descending necrotizing mediastinitis.

Objective: To evaluate the clinical utility of catheter drainage for cervical necrotizing fasciitis (CNF) with and without descending necrotizing mediastinitis (DNM).

Design: Retrospective analysis.

Setting: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine.

Spontaneous occlusion of splenic and renal pseudoaneurysm after blunt abdominal trauma: a case report and literature review.

Pseudoaneurysms caused by blunt abdominal trauma are rarely observed in solid organs. The preferred therapy for pseudoaneurysm after blunt abdominal trauma is often angiography and embolization. Here, we report a case of a spontaneous occlusion of splenic pseudoaneurysm and renal pseudoaneurysm after blunt abdominal trauma.

Classification of acute pancreatitis based on retroperitoneal extension: application of the concept of interfascial planes.

Objective: This study aimed to provide a classification system for acute pancreatitis by applying the principle that the disease spreads along the retroperitoneal interfascial planes.

Materials And Methods: Medical records and computed tomography (CT) images of 58 patients with acute pancreatitis treated between 2000 and 2005 were reviewed. The retroperitoneum was subdivided into 10 components according to the concept of interfascial planes.

A neutrophil elastase inhibitor, sivelestat, improves leukocyte deformability in patients with acute lung injury.

Background: The objective of this study was to evaluate whether the neutrophil elastase (NE) inhibitor, sivelestat, improves leukocyte deformability and pulmonary function in patients with acute lung injury (ALI).

Patients And Methods: Twenty-four patients with systemic inflammatory response syndrome (SIRS) were divided into two groups: those with ALI (ALI group, n = 14), and those without ALI (non-ALI group, n = 10). Within 72 hours after the diagnosis, we measured the total leukocyte count (TLC), C-reactive protein (CRP) level, NE concentration, APACHE II score, Goris multiple organ failure (MOF) index, respiratory index (RI), lung injury score (LIS), and oxygenation index (P/F ratio).

Protective effects of a selective neutrophil elastase inhibitor (sivelestat) on lipopolysaccharide-induced acute dysfunction of the pulmonary microcirculation.

Objective: The purpose of this study was to evaluate the effect of a neutrophil elastase inhibitor, sivelestat, on lipopolysaccharide-induced acute lung injury through analysis of hemodynamic changes in the pulmonary microcirculation.

Design: Randomized animal study.

Setting: Medical school laboratory.