Y. Oi, Shintaro Furugori, T. Sakai, J. Matsumoto, R. Yazawa, R. Furuya, S. Imaki
{"title":"Failure of airwayscope-assisted tracheal intubation in a case of drug-induced anaphylaxis","authors":"Y. Oi, Shintaro Furugori, T. Sakai, J. Matsumoto, R. Yazawa, R. Furuya, S. Imaki","doi":"10.3893/JJAAM.25.229","DOIUrl":"https://doi.org/10.3893/JJAAM.25.229","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"31 1","pages":"229-232"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77922787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nobuhiro Hayashi, M. Takemoto, Y. Sumi, Y. Inoue, S. Matsuda, Ken Okamoto, Hiroshi Tanaka
{"title":"A case of massive hemorrhage from perineal impalement injuly applying transcatheter arterial embolization","authors":"Nobuhiro Hayashi, M. Takemoto, Y. Sumi, Y. Inoue, S. Matsuda, Ken Okamoto, Hiroshi Tanaka","doi":"10.3893/JJAAM.25.69","DOIUrl":"https://doi.org/10.3893/JJAAM.25.69","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"57 1","pages":"69-74"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74187196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kiyosei Yamamoto, M. Ogawa, Y. Yoshimura, S. Ohsumi, Y. Aomatsu
{"title":"Cross-sectional and MPR CT in the diagnosis of uterine pyometra with spontaneous perforation: a case report","authors":"Kiyosei Yamamoto, M. Ogawa, Y. Yoshimura, S. Ohsumi, Y. Aomatsu","doi":"10.3893/JJAAM.25.301","DOIUrl":"https://doi.org/10.3893/JJAAM.25.301","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"62 1","pages":"301-306"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90711241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Yagi, H. Hazui, Y. Shimizu, Ryousuke Zushi, Takuya Goto, Yasuo Oishi, H. Akimoto
A report of Background : Due to its severity, thyroid crisis (TC) is occasionally treated in emergency care centers without ex-perts on endocrine disease. Objective : To clarify clinical outcomes and prognostic factors for TC treated in our hospital. Cases : Data were retrospectively collected from 8 patients (mean age, 48 years; 2 males) diagnosed with TC after 2000. All patients had Graves’ disease and were not on anti-thyroid drugs at onset. Plasma exchange (PE) was per-formed for 4 patients. Three patients who required PE and circulatory support (CS) for shock died due to non-ob-structive mesenteric infarction (n=1) or liver deficiency (n=2), although all patients were removed from CS and an-other patient died due to sepsis after surgery. In comparisons between the 4 survivors and 4 non-survivors, SOFA score (5.3 vs. 10.0; p=0.04) was significantly higher and total bilirubin value (TB) (0.9 mg/dL vs. 3.7 mg/dL; p=0.19), systolic blood pressure (SBP) (135 mmHg vs. 80.3 mmHg; p=0.25) and plasma glucose level (PG) (131.5 mg/dL vs. 66.3 mg/dL; p=0.159) tended to be higher, lower and lower in NS than S, respectively. Conclusions : TC patients with high TB and low SBP and PG in addition to high SOFA score might warrant particu-lar attention. (JJAAM.
背景报告:由于其严重程度，甲状腺危象(TC)偶尔在没有内分泌疾病专家的急救中心治疗。目的:了解我院治疗TC的临床结局及影响预后的因素。病例:回顾性收集8例患者的资料(平均年龄48岁;2000年后诊断为TC(2名男性)。所有患者均患有格雷夫斯病，发病时未使用抗甲状腺药物。4例患者行血浆置换(PE)。3例需要PE和循环支持(CS)治疗休克的患者死于非ob-structive肠系膜梗死(n=1)或肝功能不足(n=2)，尽管所有患者都被从CS中移除，另1例患者死于手术后败血症。在4名幸存者和4名非幸存者的比较中，SOFA评分(5.3 vs 10.0;p=0.04)和总胆红素值(TB) (0.9 mg/dL vs. 3.7 mg/dL;p=0.19)，收缩压(SBP) (135 mmHg vs. 80.3 mmHg;p=0.25)和血浆葡萄糖水平(PG) (131.5 mg/dL vs. 66.3 mg/dL;p=0.159)， NS比S高、低、低。结论:高结核、低收缩压和PG以及高SOFA评分的TC患者可能需要特别关注。(JJAAM。
{"title":"A report of 8 cases with thyroid crisis treated in an emergency and critical care center","authors":"Y. Yagi, H. Hazui, Y. Shimizu, Ryousuke Zushi, Takuya Goto, Yasuo Oishi, H. Akimoto","doi":"10.3893/JJAAM.25.879","DOIUrl":"https://doi.org/10.3893/JJAAM.25.879","url":null,"abstract":"A report of Background : Due to its severity, thyroid crisis (TC) is occasionally treated in emergency care centers without ex-perts on endocrine disease. Objective : To clarify clinical outcomes and prognostic factors for TC treated in our hospital. Cases : Data were retrospectively collected from 8 patients (mean age, 48 years; 2 males) diagnosed with TC after 2000. All patients had Graves’ disease and were not on anti-thyroid drugs at onset. Plasma exchange (PE) was per-formed for 4 patients. Three patients who required PE and circulatory support (CS) for shock died due to non-ob-structive mesenteric infarction (n=1) or liver deficiency (n=2), although all patients were removed from CS and an-other patient died due to sepsis after surgery. In comparisons between the 4 survivors and 4 non-survivors, SOFA score (5.3 vs. 10.0; p=0.04) was significantly higher and total bilirubin value (TB) (0.9 mg/dL vs. 3.7 mg/dL; p=0.19), systolic blood pressure (SBP) (135 mmHg vs. 80.3 mmHg; p=0.25) and plasma glucose level (PG) (131.5 mg/dL vs. 66.3 mg/dL; p=0.159) tended to be higher, lower and lower in NS than S, respectively. Conclusions : TC patients with high TB and low SBP and PG in addition to high SOFA score might warrant particu-lar attention. (JJAAM.","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"33 1","pages":"879-884"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89826984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hayato Taniguchi, R. Fujisaki, T. Ishida, T. Sakamoto, N. Morimura
Acute infectious purpura fulminans (AIPF) is a rare life-threatening disease that causes septic shock and disseminated intravascular coagulation, with localized purpura of the extremities. However, it has not been well documented. Herein, we describe the pathology of AIPF in relation to the presence of super-antigens. A 74-year-old woman was brought to the hospital with disturbed consciousness. Six hours after, the patient progressed into septic shock and developed localized purpura over the extremities. On the 4th day, the skin began to peel, which resulted in dry gangrene. Streptococcus pneumoniae was identified from blood cultures taken on the 5th day. Therefore, we diagnosed the patient with AIPF. However, despite providing intensive care, the patient died on the 16th day. Owing to the rapid onset of skin symptoms, we suspected the involvement of super-antigens in the pathogenesis of AIPF. On the basis of a previous report that suggested a relationship between super-antigens and AIPF, we evaluated the patient for the presence of such an association. However, we did not detect any super-antigens. There is a significant need for future studies to evaluate the association between super-antigens and AIPF, including screening for the presence of other super-antigens that were not measured in this study.
{"title":"Evaluating the association between super-antigens and acute infectious purpura fulminans: a case report","authors":"Hayato Taniguchi, R. Fujisaki, T. Ishida, T. Sakamoto, N. Morimura","doi":"10.3893/JJAAM.25.152","DOIUrl":"https://doi.org/10.3893/JJAAM.25.152","url":null,"abstract":"Acute infectious purpura fulminans (AIPF) is a rare life-threatening disease that causes septic shock and disseminated intravascular coagulation, with localized purpura of the extremities. However, it has not been well documented. Herein, we describe the pathology of AIPF in relation to the presence of super-antigens. A 74-year-old woman was brought to the hospital with disturbed consciousness. Six hours after, the patient progressed into septic shock and developed localized purpura over the extremities. On the 4th day, the skin began to peel, which resulted in dry gangrene. Streptococcus pneumoniae was identified from blood cultures taken on the 5th day. Therefore, we diagnosed the patient with AIPF. However, despite providing intensive care, the patient died on the 16th day. Owing to the rapid onset of skin symptoms, we suspected the involvement of super-antigens in the pathogenesis of AIPF. On the basis of a previous report that suggested a relationship between super-antigens and AIPF, we evaluated the patient for the presence of such an association. However, we did not detect any super-antigens. There is a significant need for future studies to evaluate the association between super-antigens and AIPF, including screening for the presence of other super-antigens that were not measured in this study.","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"25 1","pages":"152-158"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81200450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Ueyama, Sanae Hosomi, Machiko Kanzaki, Y. Sakata, Y. Ogura, I. Komuro, T. Shimazu
Takotsubo cardiomyopathy triggered by hypoglycemic A 61-year-old woman with a history of diabetes mellitus arrived at our hospital’s emergency department in hypoglycemic coma following loss of appetite for 3 weeks. Initial blood glucose level was 24 mg/dL. Although she respond-ed to intravenous glucose administration and recovered from the coma, electrocardiography demonstrated ST elevation in leads II, III and aVF, and echocardiography revealed asynergy at the cardiac apex. This episode was followed by slightly increased serum levels of creatine kinase MB and troponin I. ST elevation had almost returned to baseline at 1 hour after admission, but 2 hours later, negative T waves were observed in leads II, aVF and V6. Coronary angi-ography revealed no critical coronary artery disease, and left ventriculography showed apical and inferior wall hypo-kinesis. Takotsubo cardiomyopathy was diagnosed. Her clinical course was uneventful. Although the electrocardiogram (ECG) showed deep T-wave inversion in leads II, III and aVF, echocardiographic evaluation on hospital day 7 showed resolution of the left ventricular dysfunction. Only a few cases of takotsubo cardiomyopathy after hypoglycemic coma have been reported. When prolonged anorexia causes hypoglycemia in a patient and an abnormal ECG is observed, the possibility of takotsubo cardiomyopathy should not be overlooked.
{"title":"Takotsubo cardiomyopathy triggered by hypoglycemic coma after anorexia: a case report","authors":"K. Ueyama, Sanae Hosomi, Machiko Kanzaki, Y. Sakata, Y. Ogura, I. Komuro, T. Shimazu","doi":"10.3893/JJAAM.25.159","DOIUrl":"https://doi.org/10.3893/JJAAM.25.159","url":null,"abstract":"Takotsubo cardiomyopathy triggered by hypoglycemic A 61-year-old woman with a history of diabetes mellitus arrived at our hospital’s emergency department in hypoglycemic coma following loss of appetite for 3 weeks. Initial blood glucose level was 24 mg/dL. Although she respond-ed to intravenous glucose administration and recovered from the coma, electrocardiography demonstrated ST elevation in leads II, III and aVF, and echocardiography revealed asynergy at the cardiac apex. This episode was followed by slightly increased serum levels of creatine kinase MB and troponin I. ST elevation had almost returned to baseline at 1 hour after admission, but 2 hours later, negative T waves were observed in leads II, aVF and V6. Coronary angi-ography revealed no critical coronary artery disease, and left ventriculography showed apical and inferior wall hypo-kinesis. Takotsubo cardiomyopathy was diagnosed. Her clinical course was uneventful. Although the electrocardiogram (ECG) showed deep T-wave inversion in leads II, III and aVF, echocardiographic evaluation on hospital day 7 showed resolution of the left ventricular dysfunction. Only a few cases of takotsubo cardiomyopathy after hypoglycemic coma have been reported. When prolonged anorexia causes hypoglycemia in a patient and an abnormal ECG is observed, the possibility of takotsubo cardiomyopathy should not be overlooked.","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"11 1","pages":"159-164"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74507449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Onodera, N. Koizumi, Y. Fujino, S. Kikuchi, Y. Inoue, A. Sakai, S. Endo
{"title":"A case of pentazocine addiction in a physician imposter at hospitals in three prefectures within the Tohoku region of Japan","authors":"M. Onodera, N. Koizumi, Y. Fujino, S. Kikuchi, Y. Inoue, A. Sakai, S. Endo","doi":"10.3893/JJAAM.25.307","DOIUrl":"https://doi.org/10.3893/JJAAM.25.307","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"42 1","pages":"307-312"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73889690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report a case of fulminant-type pneumococcal infection in a 48-year-old man who was a heavy drinker, present-ing disseminated intravascular coagulation (DIC) and multiple organ failure (MOF). His limbs and trunk showed rapidly progressive purpura. He died only 13 hours after admission despite of intensive therapy. Autopsy revealed presence of petechiae and small thrombi in many organs, bilateral adorenocortical hemorrhage, pulmonary conges-tion, and a small spleen, but no focal signs of the original infection. The etiologic agent was Streptococcus pneumo-nia identified by blood culture. Fulminant-type pneumococcal infection can cause sudden onset of sepsis, DIC, and MOF, leading to death within a few days. There have been few reports on the general pathologic examination of fulminant pneumococcal infection in Japan. Based on the accumulation of case reports of fulminant pneumococcal infection including post-mortem examinations, it is important to elucidate the molecular mechanisms of fulminant infection and to clarify whether alcohol abuse is a risk factor or not. (JJAAM. 2014; 25:
{"title":"Fulminant-type pneumococcal infection in a heavy drinker: a case report","authors":"Hiroki Kamei, Y. Imai, H. Nishioka","doi":"10.3893/JJAAM.25.273","DOIUrl":"https://doi.org/10.3893/JJAAM.25.273","url":null,"abstract":"We report a case of fulminant-type pneumococcal infection in a 48-year-old man who was a heavy drinker, present-ing disseminated intravascular coagulation (DIC) and multiple organ failure (MOF). His limbs and trunk showed rapidly progressive purpura. He died only 13 hours after admission despite of intensive therapy. Autopsy revealed presence of petechiae and small thrombi in many organs, bilateral adorenocortical hemorrhage, pulmonary conges-tion, and a small spleen, but no focal signs of the original infection. The etiologic agent was Streptococcus pneumo-nia identified by blood culture. Fulminant-type pneumococcal infection can cause sudden onset of sepsis, DIC, and MOF, leading to death within a few days. There have been few reports on the general pathologic examination of fulminant pneumococcal infection in Japan. Based on the accumulation of case reports of fulminant pneumococcal infection including post-mortem examinations, it is important to elucidate the molecular mechanisms of fulminant infection and to clarify whether alcohol abuse is a risk factor or not. (JJAAM. 2014; 25:","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"38 1","pages":"273-278"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82565983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Okada, Y. Arai, R. Iiduka, K. Sakakibara, W. Ishii, S. Higaki, M. Kitamura
{"title":"A case of delayed rupture of an intrasplenic pseudoaneurysm after blunt abdominal trauma","authors":"Y. Okada, Y. Arai, R. Iiduka, K. Sakakibara, W. Ishii, S. Higaki, M. Kitamura","doi":"10.3893/JJAAM.25.295","DOIUrl":"https://doi.org/10.3893/JJAAM.25.295","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"6 2 1","pages":"295-300"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78398270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuriko Tomioka, H. Yoshimura, M. Fukuoka, Y. Tatsumi
{"title":"Delayed cardiac rupture after blunt chest trauma associated with multiple rib fractures","authors":"Yuriko Tomioka, H. Yoshimura, M. Fukuoka, Y. Tatsumi","doi":"10.3893/JJAAM.25.827","DOIUrl":"https://doi.org/10.3893/JJAAM.25.827","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"1 1","pages":"827-832"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81814254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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