A 58-year-old man who had inhaled acetylene while welding 2 and 4 days previously and subsequently developed cough, dyspnea, and fever was referred by his general practitioner. A computed tomography scan showed diffuse ground-glass opacities in both lungs, and bronchoalveolar lavage fluid showed an increased proportion of eosinophils (25 %). Acute eosinophilic pneumonia (AEP) was diagnosed.
View Article and Find Full Text PDF: The impacts of the coronavirus disease 2019 (COVID-19) pandemic on patients using helicopter emergency medical services (HEMS) regarding tracheal intubation and patient management remain unclear. Thus, we aimed to investigate this matter in Japan. : In this retrospective, observational study, we analyzed 2277 patients who utilized HEMS in Tochigi Prefecture during 2018-2022.
View Article and Find Full Text PDFCorynebacterium ulcerans is a closely related bacterium to the diphtheria bacterium C. diphtheriae, and some C. ulcerans strains produce toxins that are similar to diphtheria toxin.
View Article and Find Full Text PDFIn adult intensive care, brain hypothermia therapy (BHT) was reported to be effective in neuroprotection after resuscitation and cardiac arrest. By contrast, in neonatal intensive care, the pathophysiology of brain damage caused by hypoxic-ischemic encephalopathy (HIE) is attributed to circulatory disturbances resulting from ischemia/reperfusion, for which neonatal brain cryotherapy is used. The , 2010, recommends cerebral cryotherapy for HIE associated with severe neonatal pseudoparenchyma death.
View Article and Find Full Text PDFBackground: Helicopter Emergency Medical Services (HEMS) has been in operation in Japan since 2001, allowing patients almost anywhere in the nation to receive on-scene emergency treatment from physicians. However, there is insufficient literature on the characteristics of the patients who use Japanese HEMS. Thus, this study aimed to investigate the overall characteristics of patients receiving HEMS care within a single prefecture in Japan.
View Article and Find Full Text PDFManagement of abdominal compartment syndrome (ACS) due to renal injury is important. A 21-year-old man was taken to an emergent care unit with grade IV right kidney trauma and hypovolemic shock due to a road traffic injury. Despite twice targeted transcatheter arterial embolization of a renal artery, intravesical pressure increased and blood pressure was difficult to maintain.
View Article and Find Full Text PDFBackground: Infections caused by a zoonotic pathogen, have been reported worldwide. This microorganism is known to produce the diphtheria toxin and cause diphtheria-like illness.
Case Presentation: A 63-year-old woman with a history of diabetes and hypertension developed cold and flu-like symptoms, which gradually progressed into respiratory distress.
In Japan, reports on the association of individual characteristics, and geographical distance and time with clinical outcomes for neurological emergencies involving helicopter emergency medical services (HEMS) are scarce. Using Tochigi HEMS data (2010-2018), we assessed the characteristics of 1,170 emergency neurological patients (e.g.
View Article and Find Full Text PDFChildhood Guillain-Barré syndrome (GBS) occasionally leads to respiratory failure early after onset, requiring long-term ventilation management after tracheal intubation. However, patients requiring tracheostomy management are rare. In the present study, a case of a 12-year-old boy with GBS who required artificial respiration management due to rapid progression of respiratory muscle paralysis is reported.
View Article and Find Full Text PDFA 69-year-old female was introduced to our department for a retroperitoneal mass, 25 mm in diameter, in the right perirenal space indicated by computed tomography (CT). On the basis of magnetic resonance imaging (MRI), retroperitoneal soft tissue sarcoma was suspected. Because she rejected surgical treatment, we continued imaging surveillance.
View Article and Find Full Text PDFA 76-year-old man was introduced to our department with a right kidney stone. On the basis of further examination, he was diagnosed with a 23 mm right kidney stone accompanied with a horseshoe kidney. Retrograde pyelography and diuretic renogram revealed a non-obstructed right ureteropelvic junction.
View Article and Find Full Text PDFA 92-year-old man had noticed enlargement of a mass in the right scrotum and inguinal region for nine months. The patient was introduced to our department for right testicular tumor. Physical examination showed an over fist-sized, hard mass in the right scrotum.
View Article and Find Full Text PDFObjective: : The objective of this study was to identify lymphatic vessels draining from the prostate by using a fluorescence navigation (FN) system.
Methods: : Fourteen subjects were candidates for radical retropubic prostatectomy (RRP) and pelvic lymph node dissection (PLND). After an indocyanine green solution was injected into the prostate during RRP, lymphatic vessels draining from the prostate were analyzed using a FN system.
A 65-year-old man (blood type O) came to our hospital for transplant of an unrelated kidney (6/6 mismatch of HLA genotype) donated by his living 60-year-old wife (blood type B). The planned right donor nephrectomy was uneventful, with a warm ischemic time of 5 minutes, but her right renal vein was too fragile and weak to be repaired for vascular anastomosis. Therefore, we used an artificial vascular graft (polytetrafluoroethylene) interposed between the donor renal vein and the recipient's left external iliac vein.
View Article and Find Full Text PDFObjective: To investigate the longitudinal alteration of health-related quality of life (HRQL) up to 5 years after radical perineal prostatectomy (RPP) among Japanese patients with localized prostate cancer.
Patients And Methods: In all, 194 patients who had RPP were included in this longitudinal survey. The validated RAND 36-Item Health Survey (SF-36) and the University of California, Los Angeles Prostate Cancer Index (UCLA-PCI) were used to evaluate the HRQL.
Metastatic prostate cancer (PC) is incurable by androgen deprivation therapy alone, due to the presence of androgen-independent/supersensitive cells in hormone-naive PC. A 67-year-old man was diagnosed with PC (Gleason score, 5 + 4) with multiple bone metastases. He was treated by chemohormonal therapy with cisplatin and estramustine phosphate (EMP) followed by maximal androgen blockade, and showed a complete response.
View Article and Find Full Text PDFA 34-year-old man, 170 cm in height and 70 kg in weight, was scheduled for emergency operation because of gastric perforation due to gastric cancer under general anesthesia. His preoperative blood analysis showed 5.2 x 10(3) mm(-3) of red blood cell, 18 g x dl(-1) of hemoglobin and 48% of hematocrit.
View Article and Find Full Text PDFA 68-year-old male with primary aldosteronism who was scheduled for electroconvulsive therapy (ECT). We used propofol and suxamethonium to induce anesthesia, and measured plasma levels of aldosterone to evaluate the influence of ECT during anesthesia. Although plasma levels of aldosterone increased gradually after ECT, there were no complications including severe hypertension or arrhythmia perioperatively.
View Article and Find Full Text PDFPurpose: To establish the appropriate inhalation induction technique using a high concentration of sevoflurane in the elderly.
Methods: Forty-five patients, aged 70-79-yr-old, were randomly divided into three groups: 1) Group I: anesthesia was induced with propofol 2 mg x kg(-1) and sevoflurane 2% (n = 15); 2) Group II: anesthesia was induced with a three- minute inhalation of sevoflurane 8%; 3) Group III: anesthesia was induced with inhalation of sevoflurane using a gradual reduction technique (8, 6, 4% for each minute). In Groups II and III, a modified vital capacity inhalation induction was performed.