T. Ogino, S. Hagiwara, T. Ogawa, Yuki Ohtaka, Hiroaki Masubuchi, M. Kanbe, K. Ohshima
{"title":"Lumbar artery bleeding only with multiple transverse process fractures","authors":"T. Ogino, S. Hagiwara, T. Ogawa, Yuki Ohtaka, Hiroaki Masubuchi, M. Kanbe, K. Ohshima","doi":"10.3893/JJAAM.25.75","DOIUrl":"https://doi.org/10.3893/JJAAM.25.75","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"6 2 1","pages":"75-79"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87821795","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}
A. Onaka, Shingo Ito, H. Oka, Toru Ueyama, Teruichirou Kitaoka, Masanori Matusaka, Tatsuya Nakamura
To diagnose traumatic urinary extravasation, reexamination within 48 hours after initial excretory-phase computed tomography (CT) is recommended. We report a case of delayed traumatic urinary extravasation that was not detected on CT twice within 48 hours after injury. The patient was a 42-year-old female with blunt right renal injury. Initial CT showed a complex deep injury of the right lower kidney, no urinary extravasation, partial residual contrast medium in the injured renal parenchyma, and arterial extravasation that was not depicted on angiography. On the next day, excre-tory-phase CT images showed no urinary extravasation and partial residual contrast medium, and truncation of the right lower calyces was detected on maximum intensity projection (MIP) images. On the 8th day after injury, excreto-ry-phase CT images depicted urinary extravasation at the right lower kidney and disappearance of partial residual contrast medium. On MIP images, urinary extravasation was detected at the right lower calyces. Urinary extravasation spontaneously disappeared on the 21st day after injury. In this patient, obstruction of injured calyces was regarded as the cause of delayed excretion of contrast medium in the injured renal parenchyma and delayed urinary extravasation. MIP images were useful to detect calyceal obstruction and to diagnose delayed urinary extravasation.
{"title":"A blunt renal trauma case with delayed urinary extravasation","authors":"A. Onaka, Shingo Ito, H. Oka, Toru Ueyama, Teruichirou Kitaoka, Masanori Matusaka, Tatsuya Nakamura","doi":"10.3893/JJAAM.25.779","DOIUrl":"https://doi.org/10.3893/JJAAM.25.779","url":null,"abstract":"To diagnose traumatic urinary extravasation, reexamination within 48 hours after initial excretory-phase computed tomography (CT) is recommended. We report a case of delayed traumatic urinary extravasation that was not detected on CT twice within 48 hours after injury. The patient was a 42-year-old female with blunt right renal injury. Initial CT showed a complex deep injury of the right lower kidney, no urinary extravasation, partial residual contrast medium in the injured renal parenchyma, and arterial extravasation that was not depicted on angiography. On the next day, excre-tory-phase CT images showed no urinary extravasation and partial residual contrast medium, and truncation of the right lower calyces was detected on maximum intensity projection (MIP) images. On the 8th day after injury, excreto-ry-phase CT images depicted urinary extravasation at the right lower kidney and disappearance of partial residual contrast medium. On MIP images, urinary extravasation was detected at the right lower calyces. Urinary extravasation spontaneously disappeared on the 21st day after injury. In this patient, obstruction of injured calyces was regarded as the cause of delayed excretion of contrast medium in the injured renal parenchyma and delayed urinary extravasation. MIP images were useful to detect calyceal obstruction and to diagnose delayed urinary extravasation.","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"40 1","pages":"779-784"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79556324","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}
T. Miyauchi, Motoki Fujita, E. Suehiro, Yasutaka Oda, R. Tsuruta
Mild traumatic brain injury (mTBI) is a common reason for visiting an emergency department. In the last decade, there has been increasing interest in the delayed-onset cognitive and behavioral impairments that occur after repetitive mTBI, also known as chronic traumatic encephalopathy (CTE), in athletes and military personnel. Because many patients with mTBI are adolescents and the increasing incidence of mTBI has a significant social impact, re-searchers are exploring the mechanism underlying mTBI and its management. Cerebral concussion, a common type of mTBI, is associated with physical symptoms such as headache, dizziness, nausea, and temporary consciousness disturbance and shows no structural abnormalities on imaging studies. Because there are no diagnostic criteria for concussion, its symptoms should be carefully observed using established assessment tools. There are three sequential conditions related to mTBI with concussion: CTE, second impact syndrome, and post-concussion syndrome. Al-though repetitive mTBI is thought to increase the risk of progression of these related conditions, the mechanism is unclear. Patients with mTBI should rest from physical and cognitive activities, and avoid activities that could cause repetitive injury. For athletes, to avoid missing signs of worsening, a return-to-play protocol should be used in which the patient’s physical and cognitive conditions are evaluated at each stage of recovery. Rest and supportive care are the only ways to manage mTBI. There are currently no effective treatments to prevent worsening or prolongation of symptoms. To minimize the adverse outcomes of mTBI, especially in children whose brains are immature, it is vital to educate supervisors to prevent repetitive mTBI and to manage patients appropriately. In particular, supervisors should have a clear understanding of mTBI and its management, including strict adherence to protocols. It is also important to establish new guidelines for the management of patients with mTBI.
{"title":"Pathophysiology and management of mild traumatic brain injury","authors":"T. Miyauchi, Motoki Fujita, E. Suehiro, Yasutaka Oda, R. Tsuruta","doi":"10.3893/JJAAM.25.191","DOIUrl":"https://doi.org/10.3893/JJAAM.25.191","url":null,"abstract":"Mild traumatic brain injury (mTBI) is a common reason for visiting an emergency department. In the last decade, there has been increasing interest in the delayed-onset cognitive and behavioral impairments that occur after repetitive mTBI, also known as chronic traumatic encephalopathy (CTE), in athletes and military personnel. Because many patients with mTBI are adolescents and the increasing incidence of mTBI has a significant social impact, re-searchers are exploring the mechanism underlying mTBI and its management. Cerebral concussion, a common type of mTBI, is associated with physical symptoms such as headache, dizziness, nausea, and temporary consciousness disturbance and shows no structural abnormalities on imaging studies. Because there are no diagnostic criteria for concussion, its symptoms should be carefully observed using established assessment tools. There are three sequential conditions related to mTBI with concussion: CTE, second impact syndrome, and post-concussion syndrome. Al-though repetitive mTBI is thought to increase the risk of progression of these related conditions, the mechanism is unclear. Patients with mTBI should rest from physical and cognitive activities, and avoid activities that could cause repetitive injury. For athletes, to avoid missing signs of worsening, a return-to-play protocol should be used in which the patient’s physical and cognitive conditions are evaluated at each stage of recovery. Rest and supportive care are the only ways to manage mTBI. There are currently no effective treatments to prevent worsening or prolongation of symptoms. To minimize the adverse outcomes of mTBI, especially in children whose brains are immature, it is vital to educate supervisors to prevent repetitive mTBI and to manage patients appropriately. In particular, supervisors should have a clear understanding of mTBI and its management, including strict adherence to protocols. It is also important to establish new guidelines for the management of patients with mTBI.","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"25 1","pages":"191-200"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87160164","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}
Noritaka Yada, T. Hirota, S. Kikuta, T. Usami, Katsuyuki Yamada
{"title":"Successful treatment of subscapular arterial injury following anterior shoulder dislocation by using a covered stent","authors":"Noritaka Yada, T. Hirota, S. Kikuta, T. Usami, Katsuyuki Yamada","doi":"10.3893/JJAAM.25.179","DOIUrl":"https://doi.org/10.3893/JJAAM.25.179","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"9 1","pages":"179-185"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87165406","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}
S. Niiyama, O. Takasu, A. Nakamura, M. Takamatsu, N. Yamashita, K. Ushijima, Teruo Sakamoto
We report a patient who took a strongly toxic organic phosphorus preparation, ethylthiometon granules, to commit suicide, leading to protracted central respiratory depression, in which the dosage form may have been etiologically involved. The patient was a 56-year-old female. She took approximately 75 g of 5% ethylthiometon granules at home, and was admitted to our hospital. As respiratory depression was observed, endotracheal intubation was per-formed. Subsequently, gastric lavage was conducted. In addition, activated carbon was used for decontamination. As an antagonist, atropine was used. Stable spontaneous respiration could not be achieved for 1 month. Ventilator-de-pendent central respiratory depression was protracted. The ventilator was weaned off 34 days after admission. Based on previous case reports on ethylthiometon poisoning, the protracted respiratory depression in the present case was possibly associated with granules strongly adhering to the stomach. For organic phosphorus poisoning, treatment and management must be performed, considering the dosage form. In particular, granules may strongly adhere to the gastric wall. It may be necessary to perform upper digestive tract endoscopy in the early stage and decontamination of the digestive tract under direct vision. Furthermore, it may be necessary to perform repetitive gastric and intestinal lavage with charcoal.
我们报告了一位服用剧毒有机磷制剂乙基硫米顿颗粒自杀的患者，导致持续性中枢性呼吸抑制，其中剂型可能与病因有关。患者为56岁女性。她在家中服用了约75 g 5%乙基硫脲颗粒，并住进了我们医院。观察到呼吸抑制后，行气管插管。随后进行洗胃。此外，还采用活性炭进行净化。使用阿托品作为拮抗剂。1个月不能实现稳定的自主呼吸。呼吸机依赖型中枢呼吸抑制延长。入院后34天停用呼吸机。根据以往乙基硫脲中毒的病例报告，本病例的持续呼吸抑制可能与颗粒强烈粘附胃有关。有机磷中毒必须根据剂型进行处理和管理。特别是，颗粒可能强烈粘附在胃壁上。早期可能需要进行上消化道内窥镜检查，并在直视下对消化道进行净化。此外，可能需要用木炭进行反复的胃和肠洗胃。
{"title":"A patient with ethylthiometon poisoning in whom the dosage form possibly contributed to protracted central respiratory depression","authors":"S. Niiyama, O. Takasu, A. Nakamura, M. Takamatsu, N. Yamashita, K. Ushijima, Teruo Sakamoto","doi":"10.3893/JJAAM.25.16","DOIUrl":"https://doi.org/10.3893/JJAAM.25.16","url":null,"abstract":"We report a patient who took a strongly toxic organic phosphorus preparation, ethylthiometon granules, to commit suicide, leading to protracted central respiratory depression, in which the dosage form may have been etiologically involved. The patient was a 56-year-old female. She took approximately 75 g of 5% ethylthiometon granules at home, and was admitted to our hospital. As respiratory depression was observed, endotracheal intubation was per-formed. Subsequently, gastric lavage was conducted. In addition, activated carbon was used for decontamination. As an antagonist, atropine was used. Stable spontaneous respiration could not be achieved for 1 month. Ventilator-de-pendent central respiratory depression was protracted. The ventilator was weaned off 34 days after admission. Based on previous case reports on ethylthiometon poisoning, the protracted respiratory depression in the present case was possibly associated with granules strongly adhering to the stomach. For organic phosphorus poisoning, treatment and management must be performed, considering the dosage form. In particular, granules may strongly adhere to the gastric wall. It may be necessary to perform upper digestive tract endoscopy in the early stage and decontamination of the digestive tract under direct vision. Furthermore, it may be necessary to perform repetitive gastric and intestinal lavage with charcoal.","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"296 1","pages":"16-22"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76486645","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}
J. Maehara, Yuichiro Kawano, Yujiro Nakayama, Y. Gushima, K. Takaji, K. Nishigami, T. Sakamoto
{"title":"A successfully treated case of blunt multiple trauma with cardiac tamponade from intrapericardial inferior vena cava injury, resulting in subsequent paradoxical cerebral embolism","authors":"J. Maehara, Yuichiro Kawano, Yujiro Nakayama, Y. Gushima, K. Takaji, K. Nishigami, T. Sakamoto","doi":"10.3893/JJAAM.25.254","DOIUrl":"https://doi.org/10.3893/JJAAM.25.254","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"55 3","pages":"254-260"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72633371","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}
W. Ishii, N. Sato, R. Iiduka, T. Ichikawa, Kazumasa Oda, S. Higaki, M. Kitamura
{"title":"A case of volvulus of the intestine with chylous ascites","authors":"W. Ishii, N. Sato, R. Iiduka, T. Ichikawa, Kazumasa Oda, S. Higaki, M. Kitamura","doi":"10.3893/JJAAM.25.233","DOIUrl":"https://doi.org/10.3893/JJAAM.25.233","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"21 1","pages":"233-237"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72660004","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. Ichimura, Haruki Takada, T. Masuno, Mio Yoshino, Eri Inamoto, Y. Matsui, Hiroyuki Yokota
{"title":"The relation between psychological conditions and mental health on the physicians working in prehospital care","authors":"M. Ichimura, Haruki Takada, T. Masuno, Mio Yoshino, Eri Inamoto, Y. Matsui, Hiroyuki Yokota","doi":"10.3893/JJAAM.25.141","DOIUrl":"https://doi.org/10.3893/JJAAM.25.141","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"208 1","pages":"141-151"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88056760","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. Okamoto, H. Ohtsuka, M. Nishimoto, N. Amano, Katsunori Mori, Sachio Hayama
{"title":"Nonoperative management for blunt intimal injury of a major artery in lower extremities: a report of two cases","authors":"M. Okamoto, H. Ohtsuka, M. Nishimoto, N. Amano, Katsunori Mori, Sachio Hayama","doi":"10.3893/JJAAM.25.107","DOIUrl":"https://doi.org/10.3893/JJAAM.25.107","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"89 1","pages":"107-112"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82684936","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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