JaLCDOI 10.18926/AMO/56861
FullText URL 73_3_197.pdf
Author Nishimura, Takeshi| Naito, Hiromichi| Matsuyama, Shigenari| Ishihara, Satoshi| Nakao, Atsunori| Nakayama, Shinichi|
Abstract Japan's population has been skewing toward the elderly, but the outcomes of advanced elderly trauma are not clear. Here we compared the outcomes of very elderly trauma patients (≧85 years old) with those of 65- to 84-year-old trauma patients. We retrospectively reviewed the medical records of patients treated at Hyogo Emergency Medical Center from August 2010 to August 2016; 631 patients were entered in the study. We divided them into the younger geriatrics (YG group, 65-84 years old: n=534) and older geriatrics (OG group, ≧85 years old: n=97). The group’s patient characteristics, mortality, 1-year survival rate, and Barthel index were tabulated and compared. The patients’ mean age was 75.6±7.5 years. There was no significant difference in mortality between the YG and OG groups (9.6% vs. 15.1%, odds ratio [OR] 1.73; 95% confidence interval [CI] 0.93-3.23, p=0.083). The 1-year survival rate (94.4% vs. 77.8%, OR 0.19, 95% CI 0.07-0.51; p<0.01) and Barthel index (Median score; 100 (IQR: 85-100) vs. 80 (IQR: 15-95), OR 0.98, 95% CI 0.97 to 0.99, p<0.01) differed significantly between the groups. Our study did not find a significant difference in-hospital mortality between patients in the YG group and those in the OG group.
Keywords aged injury mortality morbidity trauma
Amo Type Original Article
Published Date 2019-06
Publication Title Acta Medica Okayama
Volume volume73
Issue issue3
Publisher Okayama University Medical School
Start Page 197
End Page 203
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2019 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 31235966
JaLCDOI 10.18926/AMO/56645
FullText URL 73_2_101.pdf
Author Iida, Atsuyoshi| Naito, Hiromichi| Yorifuji, Takashi| Zamami, Yoshito| Yamada, Akane| Koga, Tadashi| Imai, Toru| Sendo, Toshiaki| Nakao, Atsunori| Ichiba, Shingo|
Abstract Sedatives are administered during extracorporeal membrane oxygenation (ECMO) therapy to ensure patient safety, reduce the metabolic rate and correct the oxygen supply-demand balance. However, the concentrations of sedatives can be decreased due to absorption into the circuit. This study examined factors affecting the absorption of a commonly used sedative, midazolam (MDZ). Using multiple ex vivo simulation models, three factors that may influence MDZ levels in the ECMO circuit were examined: polyvinyl chloride (PVC) tubing in the circuit, use of a membrane oxygenator in the circuit, and heparin coating of the circuit. We also assessed changes in drug concentration when MDZ was re-injected in a circuit. The MDZ level decreased to approximately 60% of the initial concentration in simulated circuits within the first 30 minutes. The strongest factor in this phenomenon was contact with the PVC tubing. Membrane oxygenator use tended to increase MDZ loss, whereas heparin circuit coating had no influence on MDZ absorption. Similar results were obtained when a second dose of MDZ was injected to the second-use circuits.
Keywords sedatives ECMO polyvinyl chloride pharmacokinetics pharmacodynamics
Amo Type Original Article
Published Date 2019-04
Publication Title Acta Medica Okayama
Volume volume73
Issue issue2
Publisher Okayama University Medical School
Start Page 101
End Page 107
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2019 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 31015744
JaLCDOI 10.18926/AMO/56076
FullText URL 72_3_297.pdf
Author Yamamoto, Hirotsugu| Naito, Hiromichi| Osako, Takaaki| Tsukahara, Kohei| Yamada, Taihei| Yumoto, Tetsuya| Iida, Atsuyoshi| Kosaki, Yoshinori| Oka, Makio| Endo, Fumika| Gochi, Akira| Nakao, Atsunori|
Abstract A healthy 10-year-old boy vomited during sleep and later complained of abdominal pain; he became drowsy and uncommunicative. At the nearby hospital E.R., he deteriorated rapidly, and his respiratory movements were absent with cardiac arrest. He was immediately resuscitated. Brain MRI showed no abnormalities. EEG revealed an abnormal pattern with recurrent multifocal epileptiform activity over the bilateral occipital and frontal regions during sleep. Based on the clinical/radiological findings we diagnosed Panayiotopoulos syndrome (PS), a benign form of early-onset pediatric epilepsy characterized by autonomic symptoms. Lifethreating cardiopulmonary arrest is rare in PS, but long seizure duration of PS may associate with apnea and bradycardia.
Keywords pediatric epilepsy autonomic symptom cardiac arrest afebrile seizure EEG
Amo Type Case Report
Published Date 2018-06
Publication Title Acta Medica Okayama
Volume volume72
Issue issue3
Publisher Okayama University Medical School
Start Page 297
End Page 300
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2018 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29926008
JaLCDOI 10.18926/AMO/55859
FullText URL 72_2_181.pdf
Author Tsuboi, Chika| Naito, Hiromichi| Hagioka, Shingo| Hanafusa, Hiroaki| Hirayama, Takahiro| Kosaki, Yoshinori| Iida, Atsuyoshi| Yumoto, Tetsuya| Tsukahara, Kohei| Morimoto, Naoki| Nakao, Atsunori|
Abstract The primary toxicity of hydrogen peroxide results from its interaction with catalase, which liberates water and oxygen. We report the case of a 14-year-old Japanese girl with portal venous gas that was caused by oxygen liberated from intentionally ingested hydrogen peroxide. Although she had a past history of atrial septal defect, recovery without cardiac or neurological sequelae was achieved using hyperbaric oxygen therapy. Emergency physicians must be aware of the danger of liberated oxygen due to hydrogen peroxide ingestion.
Keywords air embolism ASD breaching agent HBO intoxication
Amo Type Case Report
Published Date 2018-04
Publication Title Acta Medica Okayama
Volume volume72
Issue issue2
Publisher Okayama University Medical School
Start Page 181
End Page 183
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2018 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29674767
JaLCDOI 10.18926/AMO/55669
FullText URL 72_1_85.pdf
Author Kosaki, Yoshinori| Yumoto, Tetsuya| Naito, Hiromichi| Tsuboi, Nobushige| Kameda, Masahiro| Hirano, Masayuki| Morizane, Yuki| Senoo, Takaya| Tokuyama, Eijirou| Nakao, Atsunori|
Abstract Traumatic eyeball luxation is a rare clinical condition with a dramatic presentation. Here, we describe a unique case of traumatic globe luxation and complete optic nerve transection caused by heavy object compression. A 45-year-old male automobile mechanic was injured when a truck slipped from its supports, crushing his head and face. On arrival, his right eyeball was obviously displaced anteriorly and he had no light perception. Computed tomography revealed complex frontal bone and facial fractures with underlying brain contusion in addition to complete transection of the right optic nerve. The patient was successfully treated using a multidisciplinary approach.
Keywords globe luxation optic nerve avulsion traumatic brain injury facial trauma
Amo Type Case Report
Published Date 2018-02
Publication Title Acta Medica Okayama
Volume volume72
Issue issue1
Publisher Okayama University Medical School
Start Page 85
End Page 88
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2018 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29463945
JaLCDOI 10.18926/AMO/55583
FullText URL 71_6_467.pdf
Author Obata, Kengo| Yumoto, Tetsuya| Fuke, Soichiro| Tsukahara, Kohei| Naito, Hiromichi| Iida, Atsuyoshi| Takahashi, Tetsuya| Ujike, Yoshihito| Nakao, Atsunori|
Abstract Early mobilization is advocated to prevent intensive care unit-acquired physical weakness, but the patient's workload and its changes in response to body position changes have not been established. We used indirect calorimetry to determine the energy expenditure (EE) in response to body position changes, and we assessed EE's correlation with respiratory parameters in healthy volunteers: 8 males and 8 females, mean age 23.4±1.3 years. The subjects started in the resting supine position followed by a 30° head-up position, a 60° head-up position, an upright sitting position, a standing position, and the resting supine position. EE was determined in real time by indirect calorimetry monitoring the subject’s respiratory rate, tidal volume (VT), and minute volume (MV). The highest values were observed immediately after the subjects transitioned from standing to supine, and this was significantly higher compared to the original supine position (1,450±285 vs. 2,004±519 kcal/day, p<0.01). Moderate correlations were observed between VT and EE (r=0.609, p<0.001) and between MV and EE (r=0.576, p<0.001). Increasing VT or MV indicates an increasing patient workload during mobilization. Monitoring these parameters may contribute to safe rehabilitation. Further studies should assess EE in critically ill patients.
Keywords early mobilization energy expenditure indirect calorimetry rehabilitation body position
Amo Type Original Article
Published Date 2017-12
Publication Title Acta Medica Okayama
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 467
End Page 473
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276219
JaLCDOI 10.18926/AMO/52402
FullText URL 68_2_57.pdf
Author Hagiya, Hideharu| Naito, Hiromichi| Hagioka, Shingo| Okahara, Shuji| Morimoto, Naoki| Kusano, Nobuchika| Otsuka, Fumio|
Abstract The effect of antibiotics during the perioperative period of percutaneous dilatational tracheostomy (PDT) is still controversial. A total of 297 patients who underwent the PDT procedure were divided into 2 groups:those administered antibiotics perioperatively and those not administered antibiotics. Wound infections were noted in 7 cases (incidence rate, 2.36%) and no death was recorded. Of the 69 patients without antibiotics, 5 developed wound infections (incidence rate, 7.25%), while only 2 of the 228 patients with antibiotics developed wound infections (incidence rate, 0.88%) (p=0.002;risk ratio, 8.82;95% confidence interval, 1.67-46.6). Of the 7 cases of wound infection, 5 cases occurred during the early period after PDT (within 7 days). Collectively, the present results suggest that prophylactic administration of antibiotics may prevent the incidence of PDT-induced wound infection, especially in the early phase after the PDT procedures. The need for antibiotics in PDT should be reconsidered.
Keywords airway management critically ill patient percutaneous dilatational tracheostomy surgical site infection
Amo Type Original Article
Published Date 2014-04
Publication Title Acta Medica Okayama
Volume volume68
Issue issue2
Publisher Okayama University Medical School
Start Page 57
End Page 62
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24743781
Web of Sience KeyUT 000334652700001
Author Danura, Tetsuya| Takeda, Yoshimasa| Shiraishi, Kensuke| Naito, Hiromichi| Mizoue, Ryoichi| Sato, Sachiko| Morita, Kiyoshi|
Published Date 2013-07
Publication Title Journal of Neurosurgical Anesthesiology
Volume volume25
Issue issue3
Content Type Journal Article