Publications by authors named "Kazuaki Shinohara"

Road traffic accidents are a global health concern. K-car vehicles, also known as "mini vehicles," are defined as those having an engine displacement <660 cc, vehicle length <3.4 m, width <1.

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  • - The Ohta Nishinouchi Hospital established a trauma protocol in 2013 aimed at improving outcomes for patients with severe trunk trauma, but its effectiveness had not been thoroughly evaluated until this study.
  • - The study analyzed data from 4,558 trauma patients treated between 2004 and 2019, using interrupted time-series analysis (ITSA) to assess in-hospital mortality rates before and after the protocol implementation.
  • - While ITSA showed no significant change in mortality rates, logistic regression analysis indicated that the protocol likely contributed to a reduction in in-hospital deaths, suggesting a more detailed analysis method is needed for future assessments.
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Endotracheal intubation (ETI) is a common and crucial intervention. Whether the performance of ETI differs according to the sex of the laryngoscopist remains unclear. The aim of this study was to assess sex disparities in markers of ETI performance among novices using a high-fidelity simulator.

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  • The study investigates how traumatic brain injury (TBI) impacts blood transfusion needs in patients with pelvic fractures, focusing on whether severe TBI leads to increased hemorrhage risk.
  • Conducted at a Japanese hospital, the research included patients over 16 with pelvic fractures and categorized them based on their TBI severity using the Head AIS score.
  • Results showed that while the univariable analysis indicated higher blood transfusion needs in severe TBI patients, multivariable analysis did not find a statistically significant link between severe TBI and increased transfusion volume within the first 24 hours of hospital admission.
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  • The Great East Japan Earthquake of March 11, 2011, was a major natural disaster that possibly influenced gender disparities in academic publishing among researchers in affected areas.
  • A study analyzed 5,873 biomedical articles published in the four years surrounding the earthquake and found a significant decline in female first authorship after the event, dropping from 20.5% to 14.1%.
  • The results indicate that significant natural disasters might exacerbate existing gender inequalities in scientific publishing, contrasting with reference data from minimally affected universities that showed an opposite trend.
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  • In cases where transcatheter arterial embolization (TAE) of pseudoaneurysms is challenging due to small or tortuous arteries, n-butyl-2-cyanoacrylate (NBCA) is often used, but it poses risks of uncontrolled embolization.
  • Imipenem/cilastatin sodium (IPM/CS) presents a potential alternative for TAE, especially for traumatic pseudoaneurysms, although its use had not been documented prior to this case.
  • In a reported case, a 51-year-old man who suffered traumatic injuries underwent successful TAE using IPM/CS and microspheres, which resolved his refractory pelvic pseudoaneurysm without leading to rebleeding or
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Background: Thyrocervical trunk rupture is an unusual, but critical, complication associated with central venous catheter (CVC) placement. The management of this complication has not been fully determined because it is rare.

Case Presentation: A 53-year-old Japanese woman with anorexia nervosa developed refractory ventricular fibrillation.

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Background: Nonoperative management (NOM) has become a standard strategy for hemodynamically stable patients with blunt splenic injury; however, delayed rupture of splenic pseudoaneurysm (SPA) is a serious complication of NOM. In medical literature, data regarding the long-term incidence of SPA are scarce, and the appropriate timing for performing follow-up contrast-enhanced computed tomography (CT) has not yet been reported. This study aimed to elucidate the long-term incidence and timing of SPA formation after blunt splenic injury in patients treated with NOM.

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  • Postpartum hemorrhage is a significant risk during delivery, being the leading cause of maternal deaths worldwide, especially in high-risk patients.
  • The text discusses two specific cases of high-risk patients who underwent successful cesarean sections with a technique called resuscitative endovascular balloon occlusion of the aorta to manage potential massive bleeding.
  • In both cases, the patients had issues related to the placenta and were monitored closely; they both experienced natural placental resorption and were discharged without major complications five days after delivery.*
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  • Injured patients needing surgery or transarterial embolization are highly time-sensitive, and this study examined the impact of emergency physician (EP)-staffed ambulances versus emergency life-saving technician (ELST)-staffed ambulances on preoperative times and mortality rates.
  • Conducted in Japan over 17 years, the study involved 1,020 injured patients, comparing prehospital and emergency department (ED) lengths of stay and in-hospital mortality between the two ambulance types.
  • Results indicated that EP-staffed ambulances had longer prehospital and total times to definitive intervention compared to ELSTs, while ED stay was shorter; however, there was no significant difference in mortality rates between the two groups.
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Trial Design: This investigator-initiated, single-center, open-label, parallel-group, randomized-controlled pilot study was designed to compare the intraoperative fluid balance and perioperative complications in patients undergoing hepato-biliary-pancreatic surgery with or without stroke volume variation (SVV)-guided fluid management.

Methods: Patients who were aged >18 years and underwent elective major hepato-biliary-pancreatic surgery between June 30, 2015, and August 31, 2016 at our center were randomly assigned to receive SVV-guided or conventional fluid therapy. The intervention group used SVV to determine the patients' volume status.

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A 76-year-old man who had been bathing in a hot spring was taken to the hospital in a coma. PCR assay performed on the eschar revealed a serotype Hirano/Kuroki of . Coexisted heatstroke superimposed on multiple underlying risk factors likely led to a fatal clinical course.

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Background: Published reports regarding the use of veno-venous extracorporeal membrane oxygenation (V-V ECMO) for massive hemoptysis following a thoracic injury are still scarce.

Case Presentation: A 34-year-old man developed massive hemoptysis from the right lung after a 2 m fall and being compressed with an iron pipe weighing 500 kg. He was immediately intubated using a double-lumen tube, and one-lung ventilation was started.

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  • - This study investigated the impact of using a gum-elastic bougie (GEB) compared to an endotracheal tube with a stylet during endotracheal intubation (ETI) on the force applied to oral structures by medical students with no prior ETI experience.
  • - Conducted in Japan with 209 medical students, the research measured the maximum forces on the maxillary incisors and tongue while using both the Macintosh direct laryngoscope and C-MAC video laryngoscope, finding significantly lower forces when using the GEB.
  • - The results suggested that using a GEB during ETI may reduce the risk of complications, such as dental trauma, as it applies less force compared to traditional methods.*
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Vehicles can be classified by configuration as either bonnet-type or cab-over type according to engine location. Compared to bonnet-type, the front compartment of cab-over type vehicles is considerably shorter; thus, it may be less likely to absorb the energy generated in a collision, and in turn be unable to prevent deformation of the occupant space and protect occupants from injury. This study was a cohort study involving 943 occupants of mini-vehicles who were injured in frontal collision accidents between 2001 and 2015 and transferred to Ohta Nishinouchi Hospital.

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Background: Commencement of a new academic cycle is presumed to be associated with poor patient outcomes. However, supportive evidence is limited for trauma patients treated in under-resourced hospitals, especially those who require specialized interventions and with little physiological reserve. We examined whether a new academic cycle affects the survival outcomes of injured patients in a typical Japanese teaching hospital.

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Objective: Clinical procedural experience and confidence are both important when performing complex medical procedures. Since out-of-hospital endotracheal intubation (ETI) is a complex intervention, we sought to clarify clinical ETI experience among prehospital rescuers as well as their confidence in performing ETI and confidence-associated factors.

Design: Population-based cross-sectional study conducted from January to September 2017.

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The aim of this study was to determine complication rates and possible risk factors of expert-performed endotracheal intubation (ETI) in patients with trauma, in both the prehospital setting and the emergency department. We also investigated how the occurrence of ETI-related complications affected the survival of trauma patients. This single-center retrospective observational study included all injured patients who underwent anesthesiologist-performed ETI from 2007 to 2017.

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Wild boar attacks have rarely been reported in the medical literature. This is the case of an 83-year-old male farmer who was assaulted from behind by an injured adult wild boar. He presented with hemorrhagic shock after sustaining injuries to the right profunda femoris artery and right sciatic nerve as well as significant soft-tissue injuries, bilateral iliac wing fractures, an open pneumothorax, and an anorectal injury.

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