JaLCDOI 10.18926/AMO/55433
フルテキストURL 71_5_363.pdf
著者 Yumoto, Tetsuya| Kosaki, Yoshinori| Yamakawa, Yasuaki| Iida, Atsuyoshi| Yamamoto, Hirotsugu| Yamada, Taihei| Tsukahara, Kohei| Naito, Hiromichi| Osako, Takaaki| Nakao, Atsunori|
抄録 Worldwide, hemorrhagic shock in major trauma remains a major potentially preventable cause of death. Controlling bleeding and subsequent coagulopathy is a big challenge. Immediate assessment of unidentified bleeding sources is essential in blunt trauma patients with hemorrhagic shock. Chest/pelvic X-ray in conjunction with ultrasonography have been established classically as initial diagnostic imaging modalities to identify the major sources of internal bleeding including intra-thoracic, intra-abdominal, or retroperitoneal hemorrhage related to pelvic fracture. Massive soft tissue injury, regardless of whether isolated or associated with multiple injuries, occasionally causes extensive hemorrhage and acute traumatic coagulopathy. Specific types of injuries, including soft tissue injury or retroperitoneal hemorrhage unrelated to pelvic fracture, can potentially be overlooked or be considered “occult” causes of bleeding because classical diagnostic imaging often cannot exclude such injuries. The purpose of this narrative review article is to describe “occult” or unusual sources of bleeding associated with blunt trauma.
キーワード soft tissue injury subcutaneous hematoma non-cavitary hemorrhage retroperitoneal hemorrhage hemorrhagic shock
Amo Type Review
発行日 2017-10
出版物タイトル Acta Medica Okayama
71巻
5号
出版者 Okayama University Medical School
開始ページ 363
終了ページ 368
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29042693
JaLCDOI 10.18926/AMO/54590
フルテキストURL 70_5_331.pdf
著者 Iida, Atsuyoshi| Nosaka, Nobuyuki| Yumoto, Tetsuya| Knaup, Emily| Naito, Hiromichi| Nishiyama, Chihiro| Yamakawa, Yasuaki| Tsukahara, Kohei| Terado, Michihisa| Sato, Keiji| Ugawa, Toyomu| Nakao, Atsunori|
抄録 In recent years, it has become evident that molecular hydrogen is a particularyl effective treatment for various disease models such as ischemia-reperfusion injury; as a result, research on hydrogen has progressed rapidly. Hydrogen has been shown to be effective not only through intake as a gas, but also as a liquid medication taken orally, intravenously, or locally. Hydrogenʼs effectiveness is thus multifaceted. Herein we review the recent research on hydrogen-rich water, and we examine the possibilities for its clinical application. Now that hydrogen is in the limelight as a gaseous signaling molecule due to its potential ability to inhibit oxidative stress signaling, new research developments are highly anticipated.
キーワード hydrogen antioxidant effect medical gas gaseous signaling molecule clinical tests
Amo Type Review
発行日 2016-10
出版物タイトル Acta Medica Okayama
70巻
5号
出版者 Okayama University Medical School
開始ページ 331
終了ページ 337
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27777424
Web of Sience KeyUT 000388098700001
JaLCDOI 10.18926/AMO/53673
フルテキストURL 69_5_275.pdf
著者 Nosaka, Nobuyuki| Goda, Yu| Knaup, Emily| Tsukahara, Kohei| Yumoto, Tetsuya| Ugawa, Toyomu| Ujike, Yoshihito|
抄録 We sought to identify the incidence, injury patterns, and financial burden of ladder fall injuries to provide a reference for reinforcing guidelines on the prevention of such injuries. We enrolled the patients who were injured in a ladder-related fall and required intensive care between April 2012 and March 2014 at Okayama University Hospital, a tertiary care hospital in Okayama City:9 patients injured in 7 stepladder falls and 2 straight ladder falls. The median patient age was 69 years, and 8 were males. Six falls occurred in non-occupational settings. Head injuries predominated, and the injury severity score ranged from 2 to 35 (mean=21±12). At the time of discharge from the intensive care unit, one patient had died and 5 patients had some neurological disabilities. The case fatality rate was 11%. The total cost of care during the review period was ¥16,705,794, with a mean cost of ¥1,856,199 per patient. Ladder fall injuries are associated with a high rate of neurological sequelae and pose a financial burden on the health insurance system. A prevention education campaign targeting at older-aged males in non-occupational settings may be a worthwhile health service investment in this community.
キーワード accidental falls accident prevention hospital costs injuries ladder
Amo Type Original Article
発行日 2015-10
出版物タイトル Acta Medica Okayama
69巻
5号
出版者 Okayama University Medical School
開始ページ 275
終了ページ 278
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26490024
Web of Sience KeyUT 000365519600003
JaLCDOI 10.18926/AMO/53557
フルテキストURL 69_4_213.pdf
著者 Yumoto, Tetsuya| Sato, Keiji| Ugawa, Toyomu| Ichiba, Shingo| Ujike, Yoshihito|
抄録 Hyponatremia, a common electrolyte disorder associated with traumatic brain injuries (TBIs), has high mortality and morbidity rates. The aim of this study was to identify the risk factors for hyponatremia associated with TBI. We retrospectively analyzed the cases of TBI patients who were admitted to the emergency intensive care unit at Okayama University Hospital between October 2011 and September 2014. A total of 82 TBI patients were enrolled. The incidences of hyponatremia (serum sodium level of<135mEq/L) and severe hyponatremia (serum sodium level of<130mEq/L) within the first 14 days after admission were 51オ (n=42) and 20オ (n=16), respectively. After admission, hyponatremia took a median period of 7 days to develop and lasted for a median of 3 days. Multivariate analysis demonstrated that higher fluid intake from days 1 to 3 and the presence of cranial fractures were risk factors for hyponatremia. The 58 patients with hyponatremia experienced fewer ventilator-free days, longer intensive care unit stays, and less favorable outcomes compared to the 24 patients without hyponatremia;however, these differences were not significant. Further studies are needed to determine the optimal management strategy for TBI-associated hyponatremia in the intensive care unit setting.
キーワード traumatic brain injury hyponatremia cranial fracture fluid intake
Amo Type Original Article
発行日 2015-08
出版物タイトル Acta Medica Okayama
69巻
4号
出版者 Okayama University Medical School
開始ページ 213
終了ページ 218
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26289912
Web of Sience KeyUT 000365519100004
JaLCDOI 10.18926/AMO/53021
フルテキストURL 68_6_323.pdf
著者 Hirayama, Takahiro| Nagano, Osamu| Shiba, Naoki| Yumoto, Tetsuya| Sato, Keiji| Terado, Michihisa| Ugawa, Toyomu| Ichiba, Shingo| Ujike, Yoshihito|
抄録 In adult high-frequency oscillatory ventilation (HFOV), stroke volume (SV) and mean lung pressure (PLung) are important for lung protection. We measured the airway pressure at the Y-piece and the lung pressure during HFOV using a lung model and HFOV ventilators for adults (R100 and 3100B). The lung model was made of a 20-liter, airtight rigid plastic container (adiabatic compliance: 19.3ml/cmH<sub>2</sub>O) with or without a resistor (20cmH<sub>2</sub>O/l/sec). The ventilator settings were as follows: mean airway pressure (MAP), 30cmH2O;frequency, 5-15Hz (every 1Hz);airway pressure amplitude (AMP), maximum;and % of inspiratory time (IT), 50% for R100, 33% or 50% for 3100B. The measurements were also performed with an AMP of 2/3 or 1/3 maximum at 5, 10 and 15Hz. The PLung and the measured MAP were not consistently identical to the setting MAP in either ventilator, and decreasing IT decreased the PLung in 3100B. In conclusion, we must pay attention to the possible discrepancy between the PLung and the setting MAP during adult HFOV.
キーワード HFOV mean lung pressure mean airway pressure
Amo Type Original Article
発行日 2014-12
出版物タイトル Acta Medica Okayama
68巻
6号
出版者 Okayama University Medical School
開始ページ 323
終了ページ 329
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2014 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 25519026
Web of Sience KeyUT 000346882200002
関連URL http://ousar.lib.okayama-u.ac.jp/metadata/53132