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Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct procedure designed to sustain the circulation until definitive hemostasis is obtained. The device is indicated in trauma patients with abdominal trauma and/or pelvic fractures, but there is limited evidence for its use in gastrointestinal bleeding. A 76-year-old woman was admitted to the emergency department of our hospital because of shock, manifesting as hematemesis. We performed emergency endoscopy and detected active bleeding from a gastric ulcer. Achieving hemostasis was difficult, and she experienced shock again during the procedure, leading to cardiopulmonary arrest. REBOA was performed after the return of spontaneous circulation because she continued to be in a state of shock. Her blood pressure rose, and endoscopic hemostasis was continued with balloon inflation, but it didn't stop the bleeding completely, so we shifted to emergency laparotomy and performed suture hemostasis. The patient developed no postoperative complications and was transferred to another hospital. REBOA can be effective at improving the hemodynamic status in patients with uncontrollable gastrointestinal bleeding.

Management of early nutrition plays an important role in the treatment of acute pancreatitis patients, but the sample sizes of randomized control trials that have compared enteral and parental nutrition were small. From the data of Diagnostic Procedure Combination, we identified patients who had been diagnosed with acute pancreatitis and discharged from the hospital between 2014 and 2015. We compared the length of hospital stay and hospital mortality among patients with acute pancreatitis that was managed with and without enteral nutrition within 7 days from hospitalization. The results showed a significant decrease in the in-hospital mortality rate of 56% (odds ratio 0.444, 95% confidence interval [CI] 0.358 - 0.551, P

In the process of closing three-phase vacuum circuit breakers (VCBs), the collisions between the contacts in the vacuum interrupters cause the contacts to bounce. Consequently, repetition of make-and-break of the electrical circuit happens. If the duration of this phenomenon exceeds a certain time length, the surfaces of the contacts are damaged by the heat of the arcs between the contacts. This causes deterioration of the intrinsic functions of the VCB.