A5076724479- Trauma and Emergency Care Studies
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Abdominal Trauma and Injuries
- Traumatic Brain Injury and Neurovascular Disturbances
- Gastrointestinal disorders and treatments
- Blood transfusion and management
- Trauma Management and Diagnosis
- Appendicitis Diagnosis and Management
- Cardiac Arrest and Resuscitation
- Pelvic and Acetabular Injuries
- Congenital Diaphragmatic Hernia Studies
- Acute Ischemic Stroke Management
- Organ Donation and Transplantation
- Infant Development and Preterm Care
- Neurosurgical Procedures and Complications
- Electrolyte and hormonal disorders
- Aortic aneurysm repair treatments
- Gastrointestinal Tumor Research and Treatment
- Potassium and Related Disorders
- Facial Trauma and Fracture Management
- Genetic factors in colorectal cancer
- Autopsy Techniques and Outcomes
- Ureteral procedures and complications
- Intestinal and Peritoneal Adhesions
- Pancreatic and Hepatic Oncology Research
Osaka University Hospital
2024
Kitakyushu City Hospital Organization
2020-2021
Juntendo University Urayasu Hospital
2014-2020
Suwa Red Cross Hospital
2009-2020
Murata (United States)
2015
Textron Systems (United Kingdom)
2015
Japan Pediatric Society
2015
Osaka Prefectural Medical Center
2012
Yokohama City University
1979
Elevated D-dimer level in trauma patients is associated with tissue damage severity and an indicator of hyperfibrinolysis during the early phase trauma. To investigate interacting effects fibrinogen levels on arrival at emergency department for massive transfusion mortality severe a multicenter retrospective study. This study included 519 adult injury score ≥16. Patients ≥10 units red cell concentrate and/or death first 24 h were classified as having poor outcome. Receiver operating...
Abstract Background A reduction in mortality with the early use of tranexamic acid has been demonstrated severely injured patients who are bleeding. However, modest treatment effect no blood transfusion raised concerns. The aim present study was to estimate effectiveness regular patients. Methods This multicentre observational used retrospectively collected data from consecutive (Injury Severity Score at least 16) treated 15 Japanese academic institutions 2012. propensity score-matched...
Hyperfibrinolysis is a critical complication in severe trauma. traditionally diagnosed via elevated D-dimer or fibrin/fibrinogen degradation product levels, and recently, using thromboelastometry. Although hyperfibrinolysis observed patients with isolated traumatic brain injury (TBI) on arrival at the emergency department (ED), it unclear which factors induce hyperfibrinolysis. The present study aimed to investigate associated TBI. We conducted multicentre retrospective review of data for...
Objectives: To evaluate the utility of conventional lethal triad in current trauma care practice and to develop novel criteria as indicators treatment strategy. Design: Retrospective observational study. Settings: Fifteen acute critical medical centers Japan. Patients: In total, 796 consecutive patients who were admitted emergency departments with an injury severity score greater than or equal 16 from January 2012 December 2012. Interventions: None. Measurements Main Results: All data...
Low competency for determination of brain death (BD) and unfamiliarity with Japanese BD (JBD) criteria among pediatricians were highlighted in previous nationwide studies. Because the JBD amended 2010 to allow organ donation from pediatric brain-dead donors, we created a 2-day training course assess knowledge improve skill diagnosis BD.The consisted two modules: multistation round session group discussion session, was bookended by before after 20-question test. In participants rotated...
症例は55歳の女性で,検診上部消化管内視鏡検査で十二指腸に巨大腫瘍を指摘され当院を受診.腫瘍は十二指腸球部に茎を有し,十二指腸下行脚に伸びる粘膜下腫瘍様の形態であり,超音波内視鏡検査よりBrunner腺腫が疑われた.出血,嵌頓の危険性があり悪性も否定できないため切除が必要と考えられたが,内視鏡検査では全容の把握が困難であり内視鏡的切除では出血などの危険性があるため開腹手術を施行した.摘出標本は6.5×1.5 cm大で,病理組織学的にはBrunner腺過形成であった.近年,Brunner腺過形成の切除方法として内視鏡的切除の報告例が増加しているが,本例のような巨大腫瘍に対しては外科的切除の方が安全であり,また切開部位としては術後狭窄を回避するために症例によっては胃前壁切開も有効であると考えられた.
Traumatic optic neuropathy (TON) is a rare complication caused by head injury in children. TON treatment has employed conservative treatment, steroid administration, and surgical procedures; however, which preferable remains controversial. We herein present case of 10-year-old boy with TON-complicated after falling from two-meter-high slide park. Initial computed tomography (CT) revealed the right canal fracture, patient complained visual impairment. He was diagnosed TON, decompression...
Objective: Hypothermia, metabolic acidosis, and coagulopathy are the components of "lethal triad," which contributes to high mortality severe trauma. However, important factors remain unclear. This study was performed clarify whether these correlated with trauma at 24 h after therapeutic intervention.
Background: Pediatric trauma patients present unique clinical challenges such as different mechanisms of injury, physiological responses, and indications for operative versus nonoperative management compared to adults.Nonoperative blunt abdominal is generally preferred in hemodynamically stable children its outcomes are excellent.However, therapeutic strategy pseudoaneurysms (PA) after solid organ injury (SOI) controversial.Methods: Patients aged ≤ 15 years admitted our hospital from April...
症例は58歳，女性．自殺目的にアルカリ性漂白剤であるマイキッチンブリーチ500mlを服用し，当センター搬送となった．CTにて食道周囲の縦隔に広範な液体貯留と上部内視鏡検査で穿孔を疑う深い潰瘍性病変を認め，腐食性食道炎と診断した．これらの所見から食道穿孔の危険性が高いと考え，急性期における食道切除術を施行した．術中所見では上部から中部食道周囲の縦隔に炎症性の変化を認めたが，肉眼的に明らかな穿孔は認めなかった．病理組織学的検査で粘膜全体の壊死性変化を認め，粘膜下層から固有筋層にかけての炎症の波及を認めた．アルカリ製剤による腐食性食道炎は遅発性の穿孔を起こす場合があるが急性期の手術適応に関してのコンセンサスは得られていない．一度，穿孔を起こした場合は致命的な合併症となる為，手術時期を逸することのないように判断を行う必要がある．
A 4-year-old girl with no medical history ran into the road and collided a car. She was knocked over injured back of her head. Her consciousness clear but she vomited twice. CT scan head revealed linear fracture occipital bone across sinus intracranial
Abstract Vaginal foreign bodies usually present with bleeding and foul‐smelling discharge. It is often difficult to detect identify vaginal in pediatric cases without any symptoms. Therefore, detection of using noninvasive methods, like transabdominal ultrasonography, important patients.
• NOM using ductal stenting and endoscopic drainage for pancreatic injury is efficacy. We can wait pseudocyst formation. Ductal safer than OM.
Background and aims: Pseudoaneurysm (PA) is sometimes complicated with abdominal solid organ injury (SOI). It reported the account for SOI around 5%. Therapeutic strategy PA after controversial, because dangerousness of rupture would induce lethal damage, 1% total cases. Aims: The object this study to clarify clinical characteristic SOI, including trauma backgrounds, treatments complications establish safety non-operative management (NOM) SOI. Methods: 15 patients who were admitted our...
症例は23歳の男性。既往歴に特記すべきことなし。作業中に約1トンの鉄鋼が胸腹部に落下して受傷し、当センターに救急搬送された。呼吸促迫と下顎呼吸のため気管挿管を行った。右上腕開放骨折からの外出血を圧迫止血し，急速輸液を行った。右気胸と左血気胸に対して胸腔ドレナージを行った。CTで脾損傷，腹腔内出血，両側肺挫傷，左鎖骨下動脈損傷（椎骨動脈分岐後閉塞）等を認めた。緊急開腹で脾摘を行った後，肺挫傷に対する人工呼吸管理を行った。左胸腔ドレーン排液は翌日漿液性となったが，第3病日に経腸栄養開始とともに白濁し，第4病日に胸水中の脂肪滴陽性，リンパ球優位の細胞数増加より乳糜胸と診断した。完全静脈栄養法としたが，第5病日の排液は4.4リットルで，第3病日（乳糜胸発症）2.4リットル，第4病日1.8リットルに比べてむしろ増加し，蛋白喪失による全身浮腫，肺酸素化能の悪化傾向を生じたため，保存的治療の限界と判断し，第6病日（乳糜胸発症後4日目）に右側臥位，分離換気の全身麻酔下，小開胸併用で胸腔鏡補助下に手術を行った。乳糜の漏出は左鎖骨下動脈損傷部に近接した胸管および分枝からで，同部と横隔膜上での胸管結紮...
症例は32歳女性で，自ら心窩部を刺して受傷し当センターへ搬送された．来院時全身状態は安定していたが，腹部CTにて肝損傷，膵損傷が疑われたため緊急開腹術を施行し，肝貫通創と膵体部に切創を認めた．開腹時に主膵管損傷は明らかではなく，術後，内視鏡的に精査および必要に応じてステントを留置する方針として膵縫合術とドレナージ術のみ施行した．内視鏡的逆行性膵管造影を施行したところ主膵管損傷を認めたため，内視鏡的にステントを留置した．第10病日にステントは自然落下したが，術後経過は良好で，膵液瘻は認めず第44日目に転院となった．主膵管損傷を伴う鋭的膵損傷に対して，膵縫合術と内視鏡的ステント留置術の併用による治療戦略が奏効した．
On this report, the effect of Sc 295 on internal hemorrhoids was studied with inactive placebo by double blind group comparative trial.The subjects were 144 cases administrated and 141 placebo, totaling 285 cases.1) The global utility rating showed more significant than that in one week 2 weeks.2) effects pain, bleeding swelling especially significant.3) incidence side 9.7% when compared 5.5% placebo. However, there no significance between them.4) Laboratory examinations during trial...