Successful Endoscopic Removal of an Ingested Thumbtack Stuck in the Ileocecal Valve in a Patient With a Psychiatric Disorder.

Foreign body ingestion is sometimes missed during the initial evaluation of a patient with a psychiatric disorder in the emergency department. This is often due to a lack of awareness regarding the need for thorough physical and diagnostic imaging examinations. Additionally, the management of ingested foreign bodies is often controversial.

Clinical outcomes of endovascular interventions for cerebral venous thrombosis in Japan: a nationwide retrospective study.

Introduction: Cerebral venous thrombosis (CVT) is a rare but serious disease. Despite anticoagulation being the cornerstone therapy, some patients experience worsening disease, necessitating alternative treatment. Endovascular treatment is an anticipated option with an uncertain clinical relevance.

Rupture of a Splenic Artery Aneurysm With Gastric Perforation After Pancreaticoduodenectomy: A Case Report.

Splenic artery aneurysm (SAA) is the most common visceral artery aneurysm and can lead to severe outcomes if ruptured. This report presents the case of a 71-year-old female who experienced a sudden and severe gastrointestinal hemorrhage 19 years after undergoing pancreaticoduodenectomy for pancreatic head cancer. The patient arrived at the hospital with signs of shock, and imaging revealed an SAA rupture with associated gastric perforation.

Differences in outcomes of patients with out-of-hospital cardiac arrest treated with extracorporeal cardiopulmonary resuscitation between day-time and night-time.

Although patients who underwent night-time resuscitation for out-of-hospital cardiac arrest (OHCA) had worse clinical outcomes than those who underwent day-time resuscitation, the differences between the outcomes of patients with OHCA who underwent extracorporeal cardiopulmonary resuscitation (ECPR) in the day-time and night-time remain unclear. We analyzed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan. Patients were categorized according to whether they received treatment during the day-time or night-time.

Gastric rupture caused by intragastric perforation of splenic artery aneurysm: a case report and literature review.

Background: The rupture of splenic artery pseudoaneurysm (SAP) is life-threatening disease, often caused by trauma and pancreatitis. SAPs often rupture into the abdominal cavity and rarely into the stomach.

Case Presentation: A 70-year-old male with no previous medical history was transported to our emergency center with transient loss of consciousness and tarry stools.

A well-managed case of discontinuous anorectal injury caused by a personal watercraft treated by combining surgery and colonoscopy.

Background: Anorectal injury caused by personal watercraft (PWC)-related trauma is rare. However, PWC accidents have increased recently, and since patients tend to be younger, treatment strategies should consider anal function preservation in addition to saving lives.

Case Presentation: A 30-year-old female patient who fell into the water when a PWC suddenly accelerated and injured her perineum with a forceful water jet was transported to our hospital.

Effect of Early Cyclosporine Treatment on Survival in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.

Introduction: Early cyclosporine administration is a potentially useful treatment in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN). However, previous studies have reported conflicting results regarding the survival benefits. Therefore, in this study, we evaluated the survival of patients with SJS/TEN according to whether they received early cyclosporine administration.

Successful Management With Continuous Negative Abdominal Pressure Therapy in a Severely Obese Patient With Inhalation Burn-Induced Severe Respiratory Failure Requiring Veno-Venous Extracorporeal Membrane Oxygenation: A Case Report.

Continuous negative abdominal pressure (CNAP) therapy effectively provides respiratory support in patients with respiratory failure and severe obesity; however, its use in clinical practice remains limited. In this case, we report a significant improvement in the respiratory condition of a patient with severe obesity and inhalation burns following the application of CNAP in addition to venovenous extracorporeal membrane oxygenation (V-V ECMO) and mechanical ventilation. The patient was able to wean off these devices successfully.

Prostaglandin E-major urinary metabolites as a new biomarker for acute mesenteric ischemia.

Background: Acute mesenteric ischemia (AMI) is an emergent vascular disease caused by cessation of the blood supply to the small intestine. Despite advances in the diagnosis, intervention, and surgical procedures, AMI remains a life-threatening condition. Prostaglandin E2 major urinary metabolite (PGE-MUM), the urinary metabolite of prostaglandin E2, is known to be stable in urine and has been suggested to be a valuable biomarker for intestinal mucosal inflammation, such as ulcerative colitis.

Does frailty impact failure-to-rescue in geriatric trauma patients?

Background: Failure-to-rescue (FTR), defined as death following a major complication, is a metric of trauma quality. The impact of patient frailty on FTR has not been fully investigated, especially in geriatric trauma patients. This study hypothesized that frailty increased the risk of FTR in geriatric patients with severe injury.

Analysis of lipid metabolites derived from gut microbiota in ischemia-reperfusion model.

Background: Disruption of intestinal barrier caused by intestinal ischemia due to hemorrhagic shock is associated with the pathogenesis of multiple organ dysfunction (MOD) after severe trauma. Mesenteric lymph (ML) plays an important role as a route for transporting inflammatory mediators, including lipids. Postbiotics, such as 10-hydroxy-cis-12-octadecenoic acid (HYA), have received much attention as a treatment option.

Extremity Tourniquet Self-Application by Antarctica Zodiac Crew Members.

Search and rescue teams and Antarctic research groups use protective cold-water anti-exposure suits (AES) when cruising on Zodiacs. Extremity tourniquet (ET) self-application (SA) donned with AESs has not been previously studied. Our study therefore assessed the SA of 5 commercial ETs (CAT, OMNA, RATS, RMT, and SWAT-T) among 15 volunteers who donned these suits.

Tourniquet self-application assessment in cold weather conditions.

Background: Our study aimed to assess the ability of nonmedical civilians to self-apply extremity tourniquets in cold weather conditions while wearing insulating technical clothing after receiving basic training.

Methods: A field study was conducted among 37 voluntary participants of an expedition party to the Spanish Antarctic base. The researchers assessed the participant's ability to self-apply five commercial extremity tourniquets (CAT, OMNA, RMT, SWAT-T, and RATS) over cold-weather clothing and their achieved effectiveness for vascular occlusion.

Manual Chest Compression versus Automated Chest Compression Device during Day-Time and Night-Time Resuscitation Following Out-of-Hospital Cardiac Arrest: A Retrospective Historical Control Study.

Objective: We assessed the effectiveness of automated chest compression devices depending on the time of admission based on the frequency of iatrogenic chest injuries, the duration of in-hospital resuscitation efforts, and clinical outcomes among out-of-hospital cardiac arrest (OHCA) patients.

Methods: We conducted a retrospective historical control study of OHCA patients in Japan between 2015-2022. The patients were divided according to time of admission, where day-time was considered 07:00-22:59 and night-time 23:00-06:59.

Time-saving effect of real-time ultrasound-guided cannulation for extracorporeal cardiopulmonary resuscitation: A multicenter retrospective cohort study.

Background: Extracorporeal cardiopulmonary resuscitation (ECPR), a bridge to treatments for cardiac arrest patients, can be technically challenging and requires expertise. While ultrasound guidance is frequently used for vascular access, its effects on cannulation time in patients treated with ECPR are poorly defined. We hypothesized that real-time ultrasound guidance would contribute to faster and safer cannulation for ECPR.

The American Association for the Surgery of Trauma-European Society of Trauma and Emergency Surgery Emergency Surgery Course: Initial experience in Japan.

Background: Acute care surgery has recently been recognized as a field of surgery in Japan, but no well-organized nontrauma emergency surgery education system exists. The American Association for the Surgery of Trauma-European Society of Trauma and Emergency Surgery Emergency Surgery Course (AAST-ESTES ESC) course gives surgeons the knowledge and skills to make daily decisions about nontrauma emergency surgery. We held an AAST-ESTES ESC course in Japan from October 2 to 3, 2022.

Profiles of lipid, protein and microRNA expression in exosomes derived from intestinal epithelial cells after ischemia-reperfusion injury in a cellular hypoxia model.

Intestinal ischemia-reperfusion injury leads to proinflammatory responses via gut-derived mediators, and accumulating evidence suggests that exosomes secreted by intestinal epithelial cells are involved in the development of systemic inflammation. Studies have reported changes in protein, lipid, and microRNA (miRNA) expression; however, considering the different experimental conditions, information on the relationships among these biomolecules remains insufficient. The aim of this study was to elucidate the multiple changes that simultaneously occur in exosomes after ischemic stimulation.

Motivating factors for frontline healthcare workers during the COVID-19 pandemic: A survey in Japan.

Unlabelled: Healthcare workers (HCWs), who are at the frontline of the COVID-19 pandemic, treated COVID-19 patients under many types of stress for over a year. As an external motivating factor, incentives could be important for HCWs dealing with COVID-19. However, there has been no research regarding the change in the consciousness of HCWs during the unrelenting waves of COVID-19.

Subchronic tolerance trials of graded oral supplementation with ornithine hydrochloride or citrulline in healthy adults.

Ornithine and citrulline are amino acids used in dietary supplements and nutritional products consumed by healthy consumers, but the safe supplementation levels of these compounds are unknown. The objective of this study was to conduct two 4-week clinical trials to evaluate the safety and tolerability of graded dosages of oral ornithine (as hydrochloride) and citrulline. Healthy male adults (n = 60, age 41.

Life-saving case of cardiopulmonary arrest by secondary aortoenteric fistula formed in the anastomotic site between the inferior mesenteric artery and aortic graft.

Background: Secondary aortoenteric fistula is a fatal cause of gastrointestinal bleeding after aortic reconstructive surgery with a prosthesis. In most cases, the proximal suture line is involved. We herein report a rare case in which the fistula formed between the suture line of inferior mesenteric artery reimplantation and the jejunum.