The Keio journal of medicine
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We report the case of a 29-year-old woman who attempted suicide by oral ingestion of potentially fatal doses of multiple drugs including quetiapine. Intravenous lipid emulsion (ILE) was administered at a dose higher than that used in the standard management of toxicity. ⋯ No adverse effect of lipid administration was observed. ILE treatment seems to have great potential in the management of lipophilic drug toxicity in the future.
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Comparative Study
Comparison of two large earthquakes: the 2008 Sichuan Earthquake and the 2011 East Japan Earthquake.
Between August 15th and 19th, 2011, eight 5th-year medical students from the Keio University School of Medicine had the opportunity to visit the Peking University School of Medicine and hold a discussion session titled "What is the most effective way to educate people for survival in an acute disaster situation (before the mental health care stage)?" During the session, we discussed the following six points: basic information regarding the Sichuan Earthquake and the East Japan Earthquake, differences in preparedness for earthquakes, government actions, acceptance of medical rescue teams, earthquake-induced secondary effects, and media restrictions. Although comparison of the two earthquakes was not simple, we concluded that three major points should be emphasized to facilitate the most effective course of disaster planning and action. ⋯ Finally, the central government should establish a single headquarters responsible for command, control, and coordination during a natural disaster emergency and should centralize all powers in this single authority. We hope this discussion may be of some use in future natural disasters in China, Japan, and worldwide.
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There have been few reports published in English on emergency medicine (EM) in Japan; the main reason for this is that the concept of EM was different in Japan from that in western countries. In the 1960s, legislation was passed in Japan that implemented emergency medical services, and emergency hospitals were designated by the government. There were no emergency medicine specialists, and so surgeons/physicians without specialist training in emergency medicine provided care to emergency patients (the multispecialist-type model). ⋯ The JAAM established a committee to promote the ER-type model of EM in 2003. By 2007, more than 150 JAAM-affiliated hospitals had implemented this type of EM. In conclusion, emergency medicine in Japan is currently based on a mixture of three models: the multispecialist-type, the ICU-type and the ER-type models.
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Adult neural stem cells (NSCs) are a potential endogenous source for neuronal cell replacement in the diseased adult central nervous system (CNS). However, the recruitment of adult NSCs for repair is hampered by the current lack of knowledge about the cellular and molecular mechanisms that control their behavior in vivo. ⋯ In this review I will examine in vitro and in vivo the molecular mechanisms underlying the neuronal fate instruction of adult NSCs by the local astrocyte population in the adult hippocampus. In particular, I will focus on the Wnt family of proteins, which we have found to be expressed in adult hippocampal astrocytes; our preliminary studies have also shown that these proteins enhance the generation of neurons from adult NSCs in vitro.