The Tokai journal of experimental and clinical medicine
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Tokai J. Exp. Clin. Med. · Dec 2006
Video-assisted thoracoscopic surgery in treatment of stabbing chest injuries.
Since 1994, we have performed video-assisted thoracoscopic surgery in order to treat thoracic trauma. In general, emergency surgery is performed for trauma injuries incurred by knives. ⋯ Among these eighteen cases, two were characterized by wounds to the internal thoracic artery, and they had to be switched over to open thoracotomy due to excessive bleeding. In conclusion, open thoracotomy should be performed in cases in which the patient is in a state of shock due to severe intrathoracic bleeding; however, in cases in which the vital signs are stable, thoracoscopic surgery may be carried out to stop intrathoracic bleeding, to repair the lung injury by suturing, as well as by performing a partial resection of the lung.
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Tokai J. Exp. Clin. Med. · Jul 2006
Case ReportsLife-saving treatment by fluid resuscitation and a thoracotomy in a case of deep pulmonary laceration.
A 41-year-old man survived deep pulmonary and hepatic lacerations by treatment with fluid resuscitation, blood transfusion, thoracotomy, and transcatheter hepatic artery embolization. The patient was transferred to our hospital 46 minutes after his motorbike struck a station wagon from behind. Hemorrhagic shock with systolic blood pressure of 68 mmHg was observed. He showed nonresponse to 20-minute intravenous infusion of 1,500 mL of lactated Ringer's solution. The initial plain chest radiograph showed mediastinal deviation to the left, radio-opacity of the right lower lobe, and decreased radiolucency of the right thorax. Rapid drainage of 800 mL of blood through a right chest tube led to a diagnosis of a deep pulmonary laceration of the right lower lobe. Abdominal computed tomography revealed another deep laceration affecting 40% of the liver. A right lower lobectomy of the lung was performed at 169 minutes after arrival. After the thoracotomy,transcatheter arterial embolization of the right hepatic artery was performed. The patient was discharged on hospital day 57. ⋯ Prompt diagnosis and appropriate treatment are necessary to save patients with multiple, severe blunt injuries. Advanced Trauma Life Support (ATLS) guidelines should be adhered to for appropriate early treatment of patients with severe trauma.
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Tokai J. Exp. Clin. Med. · Apr 2006
Increased dosage of propofol in anesthesia induction cannot control the patient's responses to insertion of a laryngeal mask airway.
An increased dosage of propofol is frequently administered to reduce responses to insertion of the laryngeal mask airway (LMA). However, its clinical effect remains unknown. We investigated whether an increased dosage of propofol reduces responses to LMA insertion. ⋯ These results suggest that propofol alone at clinical dosage levels does not completely control responses to LMA insertion. It is also suggested that the monitoring of BIS score is not effective in predicting responses to LMA insertion. Combination of propofol and analgesics such as fentanyl may be useful in reducing responses to LMA insertion.
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Tokai J. Exp. Clin. Med. · Apr 2005
Evaluation of applied cases of thrombolytic therapy against ultra-acute ischemic stroke. Using the Japanese Standard Stroke Registry Database.
A retrospective evaluation was made concerning thrombolytic therapy for ultra-acute ischemic stroke patients, using a recombinant tissue plasminogen activator (rt-PA), which is not yet approved as a drug for brain infarction in Japan. The evaluation was implemented using the database of patients that suffered acute strokes as collected by the Japanese Standard Stroke Registry Study (JSSRS). ⋯ From the present analysis, in spite of being a retrospective analysis based on comparatively small number of patient cases from the stroke database, it is concluded that the clinical application of thrombolytic therapy for ultra-acute ischemic strokes was effective. Moreover, it was demonstrated that, if it is possible to start rehabilitation early, a dramatic improvement of the effects might be expected.
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Tokai J. Exp. Clin. Med. · Dec 2004
Comparative StudyDifferences in penetration force of intravenous catheters: effect of grinding methods on inner needles of intravenous catheters.
To compare penetration forces of intravenous catheters based on two grinding methods used for the inner needle tip. ⋯ Backcut shows less penetration force of inner needles of peripheral intravenous catheters than lancet.