Hypothermia does not hasten death during uncontrolled hemorrhagic shock presenting as the "triad of death" in rats.

Aim: The aim of this study was to investigate the effect of hypothermia on survival and coagulopathy in hemorrhagic shock presenting as the "triad of death".

Methods: Sixteen rats were lightly anesthetized with halothane while maintaining spontaneous breathing. The triad of death was simulated by inducing hypothermia (32.

Hemodilution as a result of aggressive fluid resuscitation aggravates coagulopathy in a rat model of uncontrolled hemorrhagic shock.

Background: The relationship between dilution caused by fluid resuscitation and blood coagulability during ongoing, uncontrolled hemorrhagic shock (UHS) remains unclear. We hypothesized that dilution caused by fluid resuscitation may impair blood coagulability in UHS.

Methods: Eighteen rats underwent under halothane anesthesia.

[Investigation of the Hounsfield number of drugs in stomach using computed tomography in vitro].

Background: A high density area (HDA) that may represent ingested drugs was detected in the stomach of a patient with a drug overdose (OD) by computed tomography (CT). However, there is no prior evidence that drugs can be visualized as an HDA by abdominal CT. We investigated whether drugs can be imaged as an HDA by CT.

Hypothermia reduces resuscitation fluid volumes required to maintain blood pressure in a rat hemorrhagic shock model.

Objective: To examine the hypothesis that resuscitative hypothermia would (1) reduce fluid requirements and reactive oxygen species production during a period of resuscitation and (2) improve survival after hemorrhagic shock (HS) in rats.

Methods: Sixteen rats underwent an HS phase (phase I: 0-75 minutes), with pressure-controlled HS at a mean arterial pressure of 30 mm Hg ± 5 mm Hg; a resuscitation phase (phase II: 75-150 minutes), with fluid resuscitation to maintain mean arterial pressure ≥75 mm Hg; and an observation phase (phase III: from 150 minutes to 72 hours). During phase II, eight rats were randomized into a normothermia group (group 1: 38°C) or a hypothermia group (group 2: 34°C).

Usefulness of computed tomography in the diagnosis of an overdose.

Computed tomography (CT) is superior for the detection of substances with low radiolucency in comparison with abdominal roentgenograms. In the present study, medical chart review was retrospectively performed for patients who were admitted and underwent plain CT including the stomach on arrival to investigate whether CT is useful for diagnosing overdose (OD). The subjects were divided into patients with OD who did not undergo gastric lavage (OD group) and those without OD (Control group).

A case of successful treatment of a patient with hyperglycemia of 2700 mg/dL.

A 34-year-old man with obesity who was an avid consumer of soft drinks was found in a coma after complaining of a poor physical condition for a few days. On arrival, he had hyperglycemia of 2700 mg/dL, coma, shock, sepsis, aspiration pneumonia, acute renal failure, acute pancreatitis, liver dysfunction, and systemic mycosis. The rapid infusion of a large volume of isotonic saline, insulin, antibiotics, and ulinastatin was performed, and mechanical ventilation was applied.

Effects of arterial oxygen content on oxidative stress during resuscitation in a rat hemorrhagic shock model.

Objective: To examine whether reactive oxygen species (ROS) production is affected by arterial oxygen content (CaO(2)) in attempted resuscitation to restore blood pressure from hemorrhagic shock (HS) or not.

Methods: Under light anesthesia and spontaneous beating, 16 rats underwent HS for 80min, during which 3.0mL/100g of blood was withdrawn, followed by resuscitation attempt for 70min.

A case of thoracic degloving injury with flail chest.

A 75-year-old male patient suffered a chest degloving injury when he fell on his back and was run over by a small farm tractor he was pulling. At the time of patient admission, the paradoxical motion of the right chest wall was remarkable; and he had an open fracture of the right humerus, a dislocation of the right ankle, and a laceration of the right forearm. Chest computed tomography revealed fractures of the fifth to seventh ribs and detachment of both the right pectoralis major muscle and serratus anterior muscle from the chest wall, with a disconnected right thoracic cavity.

[Transient bilateral complete blindness and severe abdominal pain in a patient with alcoholic ketoacidosis].

A 66-year-old man presented with bilateral complete blindness and severe abdominal pain. He was diagnosed with ethanol-induced severe ketoacidosis and septic shock and dopamine and sodium bicarbonate was administered to him. This treatment rapidly ameliorated his symptoms of blindness and abdominal pain.

[Case of gluteal compartment syndrome associated with bilateral sciatic nerve palsies].

A patient presented with a rare case of bilateral gluteal compartment syndrome. A 39-year-old male, who experienced unconsciousness in a sitting position attributable to a drug overdose, suffered from right dominant bilateral gluteal compartment syndrome with bilateral leg paralysis due to sciatic nerve palsy, involving rhabdomyolysis and acute renal failure. Since the pressure in the right gluteus maximus compartment in the buttocks was recorded as 20 mmHg, he was administered conservative treatment.

Pontine infarction induced by injury of the perforating branch of the basilar artery after blunt head impact: case report.

A 77-year-old male pedestrian was hit by a car. On admission, he had disturbance of consciousness and left hemiplegia. Computed tomography (CT) indicated only left frontal subcutaneous hematoma and minor hemorrhage in the left frontal lobe, suggesting axonal injury.

Sudden asphyxial cardiac arrest due to esophageal cancer.

A 65-year-old woman with a sore throat and cough suddenly collapsed. She regained spontaneous circulation following resuscitation, but hypoxic encephalopathy was identified. Her vocal cords and the results of chest radiography were normal and no obstructive mass was identified in the neck on computed tomography (CT), but she demonstrated signs of obstructive upper airway.

Hyperammonemia is associated with generalized convulsion.

Purpose: The possibility that hyperammonemia may be associated with generalized convulsion (GC) was retrospectively investigated.

Methods: Subjects comprised 17 patients with GC who were transported to our department and underwent analysis of serum biochemistry, including ammonia, since October 2004.

Results: Causes of convulsion included intracranial lesions (n=8), endocrine diseases (n=2), epilepsy (n=2) and others (n=5).

A case of takotsubo cardiomyopathy associated with Kounis syndrome.

A sixty-five-year old female, with a past history of variant angina and asthma, collapsed after complaining of chest pain and regained spontaneous circulation by resuscitation. An electrocardiograph showed a QS pattern on the precordial leads and sonography revealed a takotsubo cardiomyopathy-like movement. During induced hypothermic therapy for protection of her brain and heart using a drug which dilated the coronary artery, she collapsed again with ventricular flatter for 40 min; however, she re-obtained return of spontaneous circulation and eventually regained consciousness.

Early diagnosis of hypovolemic shock by sonographic measurement of inferior vena cava in trauma patients.

Background: The diameter of the inferior vena cava in trauma patients may be useful for evaluating hypovolemia.

Methods: Between June 2003 and September 2003, 35 injured patients transferred to the authors' hospital were prospectively investigated. They were divided into two groups: a shock group (n = 10) and a control group (n = 25).