Abstract Current diagnostic testing for coronavirus disease 2019 (COVID-19) is based on detection of severe acute respiratory syndrome 2 (SARS-CoV-2) in nasopharyngeal swab samples by reverse transcription polymerase chain reaction (RT-PCR). However, this test associated with increased risks viral dissemination and environmental contamination shows relatively low sensitivity, attributable to technical deficiencies the sampling method. Given that COVID-19 transmitted via exhaled aerosols...

Patients with severe trauma often present critical coagulopathy, resulting in impaired hemostasis, massive hemorrhage, and a poor survival prognosis. The efficacy of hemostatic resuscitation correcting coagulopathy restoring tissue perfusion has not been studied. We assessed novel approach pre-emptive administration fibrinogen concentrate to improve patients trauma.We retrospectively compared blood transfusion volumes prognosis between three groups trauma, an Injury Severity Score (ISS) ≥26...

Background Hypocalcemia has been reported as an independent predictor of trauma mortality. We investigated the relationship between temporal variations in blood ionized calcium concentration (iCa) and prognosis severe patients who underwent massive transfusion protocol (MTP). Methods This single-center, retrospective, observational study 117 treated with MTP Department Emergency Medicine Critical Care, Saitama Medical Center, University, March 2013 2019. Multivariate logistic regression...

Hemorrhage from pelvic fracture is a major cause of mortality after blunt trauma. Several studies have suggested that early fibrinogen supplementation improves outcomes traumatic hemorrhage. Thus, we revised our massive transfusion protocol (MTP) in April 2013 to include off-label administration concentrate. The objective this study was evaluate the impact revision on short-term patients.This single-center, retrospective, cohort study. A total 224 consecutive patients hospitalized Saitama...

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant is considered responsible for worldwide surges in disease 2019 (COVID-19) cases 2021, with increased infectivity compared to the wild type (Wuhan-1). In a previous study, we identified temporal changes wild-type SARS-CoV-2 RNA load and detection rate EBC collected from COVID-19 patients. primary objective of this study was clarify Delta-variant rates patients, validate feasibility diagnosing COVID-19. secondary...

Diagnosis of SARS-COV-2 infection (COVID-19) is currently based on detection the viral RNA in nasopharyngeal swab samples by reverse transcription polymerase chain reaction (RT-PCR). However, sampling via swabs frequently provokes sneezing or coughing, which results increased risk dissemination and environmental contamination. Furthermore, sensitivity associated with PCR tests s limited to 60%-70%, mainly attributable technical deficiency sampling. Given that disease transmitted exhaled...

Study Design: Retrospective study.Purpose: This research aimed to assess the clinical outcomes of patients with traumatic cervical spine dislocation who underwent closed reduction employing our approach.Overview Literature: Bedside is quickest procedure for repairing dislocations; nevertheless, it also possesses risk neurological deterioration.Methods: For reduction, patient’s head was elevated on a motorized bed, placed at midline, traction 10 kg applied, bed gradually returned flat...

Numerous studies have confirmed the role of endogenous carbon monoxide (CO) gas as a signal transmitter. However, CO is considered an intracellular transmitter, no demonstrated redistribution from blood to tissue cells. Tracer analyses 13CO2 production following 13CO inhalation that oxidized dioxide (CO2) in body and oxidation does not occur circulation. these results could clearly demonstrate CO, because may occurred airway epithelium. The objective this study, therefore, was definitively...

We developed a non-invasive, continuous, high-resolution method of measuring carboxyhaemoglobin fraction (COHb%) using expiratory gas analysis (EGA). assessed whether application EGA to dilution provides red cell volume (RCV) measurement with accuracy equivalent that CO-haemoximetry, smaller infusion carbon-monoxide-saturated autologous blood (COB). Method. the agreement between repeated COHb% measurements by and simultaneous Bland Altman plot, in healthy subjects patients artificially...

The coronavirus disease 2019 (COVID-19) pandemic has imposed a considerable burden on hospitals and healthcare workers (HCWs) worldwide, increasing the risk of outbreaks nosocomial transmission to 'non-COVID-19' patients, who represent highest-risk population in terms mortality, HCWs. Since HCWs are at interface between one hand community other, they potential reservoirs, carriers, or victims severe acute respiratory syndrome 2 cross-transmission. In addition, there been paradigm shift...

Past studies have suggested that some carbon monoxide (CO) moves from blood haemoglobin to tissue cells and mitochondrial cytochrome c oxidase oxidizes CO dioxide (CO(2)). However, no study has demonstrated this redistribution oxidization of under physiological conditions. The objective was trace the in human body by detecting (13)CO(2) production after inhalation (13)CO. In Experiment 1, we asked a healthy subject inhale 50 ppm (13)CO gas. 2, circulated heparinized cardio-pulmonary bypass...

As previously reported, the cerebral arterioles are surrounded by unique perivascular Mato cells. They contain many inclusion bodies rich in hydrolytic enzymes, and have strong uptake capacity. thus considered scavenger cells of vascular neural tissues steady-state. In this study, employing hypertensive SHR-SP (Izm) rats, viability was investigated. capacity for horse radish peroxidase (HRP) activity acid phosphatase (ACPase) were markedly reduced, on electron-microscopic examination found...

Blunt vertebral artery injuries (BVAI) associated with cervical spine fractures are often problematic due to symptoms of occlusion. Denver grade V cases, in which the is transected, rare but fatal, and treatment has rarely been reported. We encountered a case hemorrhagic shock an injury branch upper fracture. Transcatheter arterial embolization was performed successfully achieve hemostasis, requiring superselective preserve main trunk artery. It important be aware that vascular vessels as...

Previous studies have reported various predictive indicators of diffuse axonal injury (DAI), but no consensus has not been reached. Although the efficiency automated pupillometry in patients with consciousness disorder widely reported, there are few reports its use DAI. This study aimed to investigate significance pupillary findings predicting prognosis We included admitted our center a diagnosis DAI from June 1, 2021 30, 2022. Pupillary both eyes were quantitatively measured by every 2...

Transcatheter arterial embolization (TAE) has increasingly replaced surgery for treating solid organ injuries, including the spleen, due to its minimally invasive approach. Studies show only a 3% splenectomy rate after TAE, despite 10% incidence of missed vascular injuries in American Association Surgery Trauma (AAST) grade III splenic on initial computed tomography (CT) scans. However, there's lack high-quality studies recommending specific CT follow-up intervals non-operative management...

We present a rare case of clival fracture in which the patient presented with multiple lower cranial nerve palsy (similar to Vernet syndrome or Collet-Sicard syndrome). Multiple from skull base lesions includes and syndrome. Clival is condition, optimal treatment method has yet be established. A 73-year-old man fell down flight stairs was diagnosed injuries such as traumatic intracranial hemorrhage, fracture, facial bone fracture. The bilateral VI, IX, X, XI, right XII palsies caused by but...

We report a rare case of acquired membranous tracheal stenosis in patient with anorexia nervosa and history self-induced vomiting, but without intubation or tracheostomy. A 50-year-old woman presented difficulty breathing swallowing, self-expectoration, impaired consciousness due to acute benzodiazepine intoxication. Bronchoscopic examination was performed after tracheotomy placement tracheostomy tube failed secure her respiratory tract ventilation continued deteriorate. flap-like structure...

Patients with heel pad degloving injury frequently develop ischemic necrosis of the area, necessitating soft-tissue reconstruction surgery. We have developed a technique for arterialization plantar venous system via vein graft (APV) as primary revascularization treatment. The objective this study was to clarify both utility APV preservation degloved pads and impact on clinical outcomes.Ten consecutive cases devascularized were treated at single trauma center from 2008 2018. Five underwent...

N/A (editorial).

症例は69歳の女性，既往にうつ病。自殺目的にて購入した観賞用トリカブトの根を煎じて服用したところ胸部苦悶が出現し救急隊を要請，服用から30分後に摂取したトリカブトを持参し当院へ搬送された。来院時，頻発する心室性期外収縮と血圧低下を認め，人工呼吸治療，胃洗浄，活性炭及び塩酸リドカイン投与を行った。一時的に循環動態は改善したが，その後房室伝導解離や脚ブロックなどの多彩な不整脈が出現したことから，原因物質である体内のアコニチン系アルカロイド（aconitine alkaloids; AA）の除去を目的として血液吸着法（direct hemo-perfusion; DHP）を合計2クール施行した。DHPの開始後まもなく，不整脈は消失し循環動態は改善した。経過中に血中及び尿中AA濃度を入院時， 2 度のDHPの後，入院翌日の計 4 回，アコニチン（AC），ヒパコニチン（HC），メサコニチン（MC）の 3...