Should an emergency physician be a "surgeon" in a rural area? A case of blunt cardiac rupture successfully treated by an emergency physician.

Objective: Blunt cardiac rupture is a life-threatening injury that requires surgical repair by cardiovascular or trauma surgeons. We report a case of blunt cardiac rupture in a rural area in which emergency physicians performed emergency department thoracotomy and surgical repair to save the patient's life.

Patient And Methods: This case involved an 18-year-old female who was injured in a traffic accident and underwent emergency thoracotomy and surgical repair.

Changes in walking speed 6 months after discharge may be more sensitive to subsequent prognosis than handgrip strength in patients hospitalized for heart failure.

Background: Despite the prognostic importance of walking speed (WS) and handgrip strength (HGS) in patients with heart failure (HF), no study has reported the prognostic impact of changes in these parameters. This study aimed to examine the association between changes after discharge and the subsequent prognosis.

Methods: This study included 881 elderly patients hospitalized for HF.

[Development and Usefulness of Support Package for Learning of Image Interpretation Assistance Using CT and MRI Image in Emergency Medicine].

The Japanese Ministry of Health, Labour and Welfare announced about the expansion of duties by the radiological technologists in team medical care in April, 2010, and the importance of image interpretation assistance by the radiological technologists became higher. In that respect, for improvement in ability of image interpretation assistance by the radiological technologists in emergency medicine, we developed a support package for learning of image interpretation assistance (support package) and evaluated the usefulness for learning of image interpretation assistance by questionnaires. The support package included digital imaging and communications in medicine (DICOM) data of case, explainer video of urgent imaging findings, and DICOM viewer.

Successful Treatment of Sepsis-Induced Cardiomyopathy with Intra-Aortic Balloon Pumping: A Case Report and Literature Review.

BACKGROUND Sepsis-induced cardiomyopathy is cardiac dysfunction in sepsis that sometimes results in reduced cardiac output. Inotropic agents are recommended in patients with sepsis and cardiac dysfunction. Here, we present a case of sepsis-induced cardiomyopathy that was resistant to inotropes and was successfully treated with intra-aortic balloon pumping (IABP).

A case of welder's pneumoconiosis treated with corticosteroid followed by nintedanib.

A 32-year-old man who had worked as a welder for 13 years was hospitalized for a fever and hemosputum with dyspnea. He was diagnosed with welding fume-associated lung disease with alveolar hemorrhaging and acute respiratory failure. Despite surviving the acute phase with corticosteroid therapy, hypoxemia persisted after a month and a half, requiring home oxygen therapy.

Cardiac Strangulation Due to Partial Pericardial Defect Presenting as Acute Myocardial Infarction.

A 79-year-old man with chest pain and dyspnea underwent emergency percutaneous coronary intervention for acute myocardial infarction. However, he died 17 days later due to refractory heart failure. An autopsy revealed cardiac strangulation caused by herniation of the apical heart through a pericardial defect due to partial absence of the pericardium.

Coronary orbital atherectomy using a five-French guiding catheter.

Recently, the efficacy was demonstrated of the Diamondback 360® Coronary Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc., St. Paul, MN, USA) for treating calcified coronary lesions in percutaneous coronary intervention (PCI).

Evaluation of cervical ossification of the posterior longitudinal ligament with 3D broadband IR-prepared ultrashort echo-time imaging: a pilot study.

Purpose: We aimed to evaluate the feasibility of 3D broadband inversion-recovery-prepared ultrashort echo-time (3D IRP UTE) imaging for assessing ossification of the posterior longitudinal ligament (OPLL).

Materials And Methods: The study consisted of 25 consecutive patients with cervical OPLL [13 women, 12 men; mean age 66.3 (47-84) years] who underwent CT, 3T conventional MR, and 3D IRP UTE imaging studies.

Short-term experience with aspiration embolectomy using a ACE68 reperfusion catheter to treat embolic superior mesenteric artery occlusion.

We report the short-term results with aspiration embolectomy using an ACE68 reperfusion catheter to treat patients with acute embolic superior mesenteric artery (SMA) occlusion. Our study included 4 consecutive male patients ranging in age from 72 to 86 years (mean age 79 years). In all patients, the main trunk of the SMA was occluded.

A Rare Case of Prolapsed Sigmoid End Colostomy Complicated by Small Bowel Incarceration Treated with Manual Reduction and Emergency Surgery.

BACKGROUND Stoma prolapse is the full-thickness protrusion of bowel through a stoma, which occurs in 2% to 26% of colostomies. However, stoma prolapse complicated by small bowel incarceration is very rare, reported in only 3 cases thus far. To our knowledge, the present case is the first reported case of surgical treatment after preoperative manual reduction for small bowel incarceration.

A rare case of simultaneous rectal and gastric carcinomas accompanied with inferior mesenteric arterioportal fistula: case report.

Background: Inferior mesenteric arterioportal fistula (APF) is rare as only 35 case reports in the literature. We herein presented a case of simultaneously double cancer in the rectum and stomach with inferior mesenteric APF, which is the first case report by searching using PubMed. Combination of interventional embolization and surgical operation seemed to be optimal treatment for avoiding postoperative complications and the curability.

Determining if Cerebrospinal Fluid Prevents Recurrence of Chronic Subdural Hematoma: A Multi-Center Prospective Randomized Clinical Trial.

Over the decades, the problem of postoperative recurrence of chronic subdural hematoma (CSDH) has not been resolved. The objective of our study was to investigate whether the recurrence rate of CSDH is decreased when artificial cerebrospinal fluid (ACF) is used as irrigation solution for CSDH surgery. The present study was a multi-center, prospective, randomized, open parallel group comparison test of patients enrolled from 10 hospitals in Japan.

Association Between Liver Function and Peak Oxygen Uptake in Heart Failure Patients: A Retrospective Observational Study.

Objective: With respect to liver function and heart failure, 46% of acute decompensated heart failure patients exhibit abnormal liver function. However, there have been no reports of the association between liver function and functional capacity in these patients. Our aim was to clarify the relationship between liver function and functional capacity using the peak oxygen uptake (VO).

Prediction of Blood-Brain Barrier Disruption and Intracerebral Hemorrhagic Infarction Using Arterial Spin-Labeling Magnetic Resonance Imaging.

Background And Purpose: Arterial spin-labeling magnetic resonance imaging is sensitive for detecting hyperemic lesions (HLs) in patients with acute ischemic stroke. We evaluated whether HLs could predict blood-brain barrier (BBB) disruption and hemorrhagic transformation (HT) in acute ischemic stroke patients.

Methods: In a retrospective study, arterial spin-labeling was performed within 6 hours of symptom onset before revascularization treatment in 25 patients with anterior circulation large vessel occlusion on baseline magnetic resonance angiography.

Percutaneous aspiration embolectomy of superior mesenteric artery using a 5MAX ACE reperfusion catheter.

Acute mesenteric ischaemia is a rare abdominal emergency that commonly results in bowel infarction and has a very high mortality rate. Therefore, prompt recognition and treatment are crucial for a successful outcome. A thrombectomy for embolism in the mid portion of the main trunk of the superior mesenteric artery (SMA) is proposed.

Agenesis of the Left Internal Carotid Artery in the Right Aortic Arch with Isolation of the Left Innominate Artery Associated with Ruptured Cerebral Aneurysm: Case Report.

As we occasionally encounter congenital blood vessel abnormalities, their variety, embryology, and associated clinical problems must be understood. We report a case of a 50-year-old man with subarachnoid hemorrhage due to a ruptured cerebral aneurysm at the internal carotid-anterior choroidal artery bifurcation who manifested extremely rare congenital anomalies, i.e.

Evaluation of contrast-enhanced MR angiography in the follow-up of visceral arterial aneurysms after coil embolization.

Background: The placement of detachable coil has become the alternative method of treating visceral arterial aneurysms (VAAs). Imaging follow-up is necessary after coil embolization because of frequent incomplete occlusion.

Purpose: To compare contrast-enhanced magnetic resonance angiography (CE-MRA) at 3T with a reference standard of digital subtraction angiography (DSA) for the evaluation of VAAs after coil embolization.

Ultraselective transcatheter infusion of epirubicin in water-in-oil-in-water emulsion for small hepatocellular carcinoma.

Objective: We have previously reported the clinical efficacy of water-in-oil-in-water (W/O/W) emulsions, particularly for non-selective transcatheter arterial infusion (TAI) therapy. W/O/W emulsions limit damage to normal hepatic parenchyma, because of their minimal embolic effect on peripheral arteries and slow release of anticancer agent. The purpose of this study was to evaluate the safety and effectiveness of ultraselective TAI (UTI) of a W/O/W emulsion for hepatocellular carcinoma (HCC).

Confluent two-balloon technique: an alternative method for subintimal recanalization of peripheral arterial occlusion.

The present report describes a technique of simultaneous confluent balloon inflation in cases in which conventional subintimal angioplasty failed. Eight patients with peripheral vascular occlusive disease (n = 4 each with iliac arterial lesions and superficial femoral arterial lesions) of clinical category 3-5 received treatment with the confluent two-balloon technique. Recanalization was successfully completed with this technique in all eight patients, without any major complications.

Empiric transcatheter arterial embolization for massive bleeding from duodenal ulcers: efficacy and complications.

Purpose: To evaluate the efficacy and safety of empiric transcatheter arterial embolization (TAE) for patients with massive bleeding from duodenal ulcers.

Materials And Methods: During January 2000 and December 2009, 59 patients with duodenal ulcer bleeding in whom TAE was attempted after endoscopic therapy failed were retrospectively analyzed. The patients were divided into empiric TAE (n = 36) and identifiable TAE (n = 23) groups according to angiographic findings with or without identification of the bleeding sites.

A better effect of cilostazol for reducing in-stent restenosis after femoropopliteal artery stent placement in comparison with ticlopidine.

Purpose: The purpose of this study was to assess the preventive effect of cilostazol on in-stent restenosis in patients after superficial femoral artery (SFA) stent placement.

Materials And Methods: Of 28 patients with peripheral arterial disease, who had successfully undergone stent implantation, 15 received cilostazol and 13 received ticlopidine. Primary patency rates were retrospectively analyzed by means of Kaplan-Meier survival curves, with differences between the two medication groups compared by log-rank test.

Transcatheter infusion of epirubicin in water-in-oil-in-water emulsion via a cystic artery for the treatment of hepatocellular carcinoma.

Purpose: We have previously reported the clinical efficacy of water-in-oil-in-water (W/O/W) emulsion containing anticancer agent. The purpose of this study was to evaluate the safety and effectiveness of transcatheter arterial infusion (TAI) of W/O/W emulsion via a cystic artery for hepatocellular carcinoma (HCC).

Methods: TAI of a W/O/W emulsion was performed at our institute in five patients with Stage III or IV HCC with blood supply from the cystic artery.

Transarterial infusion chemotherapy with epirubicin in water-in-oil-in-water emulsion for recurrent hepatocellular carcinoma in the residual liver after hepatectomy.

Purpose: To evaluate the midterm results of transarterial infusion (TAI) with water-in-oil-in-water (W/O/W) emulsion containing an anticancer agent for patients with recurrent hepatocellular carcinoma (HCC) after surgical resection.

Materials And Methods: We retrospectively analyzed the results of TAI of W/O/W emulsion containing epirubicin for 18 consecutive patients with recurrent HCC after surgical resection. Fourteen patients were males and four were females; their ages ranged from 51 to 86 years (mean 69.