Transcatheter Arterial Embolization of a Gluteal Pseudoaneurysm Due to Ground-Level Fall in an Elderly Woman Taking Apixaban.

A 90-year-old woman prescribed with apixaban was admitted to a hospital after a ground-level fall. She was transferred to our hospital for advanced evaluation and treatment. Contrast-enhanced computed tomography showed a pseudoaneurysm inside the right gluteus maximus muscle.

A novel scale for predicting delayed intubation in patients with inhalation injury.

Background: Strategies to predict delayed airway obstruction in patients with inhalation injury have not been extensively studied. This study aimed to develop a novel scale, predicting the need for Delayed Intubation after inhalation injury (PDI) score.

Methods: We retrospectively identified patients with inhalation injury at four tertiary care centers in Japan between 2012 and 2018.

Transcatheter arterial embolization for initial hemostasis in a hemodynamically unstable patient with mesenteric hemorrhage: A case report.

Surgical treatment of mesenteric injuries is necessary to control hemorrhage, manage bowel injuries, and evaluate bowel perfusion. It has recently been suggested that some patients can be managed with transcatheter arterial embolization (TAE) for initial hemostasis. We present a hemodynamically unstable patient who was initially managed by TAE for traumatic mesenteric hemorrhage.

Difference in severity and distribution of bodily injuries following collision between drivers of K-cars and standard vehicles.

Background: Although K-cars, small four-wheeled vehicles with an engine capacity of <660 cc, have been used almost exclusively in Japan, they have recently become increasingly popular in other countries. Therefore, reporting the characteristics of bodily injuries sustained by K-car drivers after road traffic accidents (RTAs) may be important not only for health professionals but also for car manufacturers.

Methods: A single-center, retrospective observational study was conducted using prospectively acquired data.

Impact of cardiopulmonary resuscitation time on the effectiveness of emergency department thoracotomy after blunt trauma.

Purpose: Debate remains about the threshold cardiopulmonary resuscitation (CPR) duration associated with futile emergency department thoracotomy (EDT). To validate the CPR duration associated with favorable outcomes, we investigated the relationship between CPR duration and return of spontaneous circulation (ROSC) after EDT in blunt trauma.

Methods: A retrospective observational study was conducted at three tertiary centers over the last 7 years.

Necrotizing enterocolitis associated with in a Japanese man.

Case: Necrotizing enterocolitis (NEC) caused by is common in neonates; however, a case of NEC in adults has not been previously reported. An 84-year-old Japanese man developed -related NEC during hospitalization for treatment of stab wounds to the left side of the neck and lower abdomen, without organ damage, and concomitant pneumonia.

Outcome: The patient developed acute onset of emesis accompanied by shock during his admission; partial resection of the small intestine was carried out due to necrosis.

Successful treatment for descending necrotizing mediastinitis with severe thoracic emphysema using video-assisted thoracoscopic surgery.

Descending necrotizing mediastinitis (DNM) is a rare, highly fatal disease that occurs as a complication of a cervical or odontogenic infection spreading into the mediastinum. We herein report of a 50-year-old man with DNM and severe thoracic emphysema who was successfully treated using surgical drainage by video-assisted thoracoscopic surgery (VATS) and a transcervical approach. Chest enhanced computed tomography on admission revealed massive left pleural effusion, pneumothorax, absolute collapse of the left lung, and a mediastinal shift to the right side with emphysema.

Cardiac arrest due to food asphyxiation in adults: resuscitation profiles and outcomes.

Aim: Food asphyxiation is uncommon but unignorable cause of sudden death in the elderly. Several autopsy studies, which identified those at particular risk, have been conducted on the subject. Resuscitation profiles and outcomes of food asphyxiation victims presenting with out-of-hospital cardiac arrest (OHCA) to the emergency department, however, have rarely been reported.

Prognostic significance of acute pain preceding out-of-hospital cardiac arrest.

Background: Sudden loss of consciousness (LOC) and chest pain are common manifestations of out-of-hospital cardiac arrest (OHCA). History of acute pain may be helpful in estimating aetiology and prognosis of OHCA victims. The objective of this study was to evaluate the relationship between acute pain at various locations preceding collapse and outcome.

Early CT signs in out-of-hospital cardiac arrest survivors: Temporal profile and prognostic significance.

Aim: Although computed tomography (CT) signs of ischaemia, including loss of boundary (LOB) between grey matter and white matter and cortical sulcal effacement, in cardiac arrest (CA) survivors are known, their temporal profile and prognostic significance remains unclear; their clarification is necessary.

Methods: Brain CT scans were obtained immediately after resuscitation in 75 non-traumatic CA survivors in a prospective fashion. They were divided into two groups according to the CA-return of spontaneous circulation (ROSC) interval: < or =20 min vs.

Headache, cardiac arrest, and intracranial hemorrhage.

Headache is one of the most common manifestations of non-traumatic intracranial hemorrhage, which is an uncommon, but not rare, cause of cardiac arrest in adults. History of a sudden headache preceding collapse may be a helpful clue to estimate the cause of out-of-hospital cardiac arrest (OHCA). Medical records of witnessed OHCA patients were reviewed to identify those who complained of a sudden headache preceding collapse, and the incidence of intracranial hemorrhage among them as well as their clinical characteristics was investigated retrospectively.

Subarachnoid haemorrhage as a cause of out-of-hospital cardiac arrest: a prospective computed tomography study.

Aim: Aneurysmal subarachnoid haemorrhage (SAH) is a relatively common cause of out-of-hospital cardiac arrest (OHCA). Early identification of SAH-induced OHCA with the use of brain computed tomography (CT) scan obtained immediately after resuscitation may help emergency physicians make therapeutic decision as quickly as they can.

Methods: During the 4-year observation period, brain CT scan was obtained prospectively in 142 witnessed non-traumatic OHCA survivors who remained haemodynamically stable after resuscitation.

Granular cell tumor of the breast preoperatively diagnosed by fine-needle aspiration cytology: report of a case.

Granular cell tumors (GCTs) have a characteristic cytological appearance, and fine-needle aspiration cytology (FNAC) has been suggested to be the diagnostic modality of choice. However, the differential diagnosis has not yet been well described. We herein describe a rare case of GCT of the breast and discuss the differential diagnosis.