Search

We report a case of vascular injury caused by a multi‐lumen catheter for CRRT inserted through left jugular vein. Diagnosis was delayed because CRRT could be continued. Clinicians should be aware of potential vascular complications associated with the wrong placement of multi‐lumen catheters even if blood flow continues without difficulty. [ABSTRACT FROM AUTHOR]

Introduction: Japan Disaster Medical Assistance Team (JDMAT) consists of four personnel. They are selected in 47 local governments in Japan, and after the completion of a four day boot camp, they are registered in the list of JDMAT. Hyogo Emergency Medical Center (HEMC) has been playing an important role as one of the oldest boot camps with Disaster Medical Center in Tachikawa. The boot camp's significance is obvious, but the JDMAT system requires a trainer for the course. Many courses were discontinued and affected by the COVID-19 Pandemic. Method: Retrospective, single institute data, observed in the number of participants for instruction. The periods are from March 2019 to September 2022. Instructing members of this boot camp consist of three categories of Drs, Nurses, and logisticians. Results: In FY2019, from April to March during the pre-pandemic year, a boot camp was held nine times. During those days, the total number of instructors, including potential ones, was 659 persons, and fortunately 75 people participated for the very first time. However, during the Corona era, in FY2020, the boot camp was held only four times. The total number of instructors was 161 persons, and 14 people participated for the first time. In FY2021, the boot camp was held only three times. The total number of instructors was 141 persons, and 11 people participated for the first time. In FY2022, after two quarters passed, the boot camp was held five times according to the schedule. The total number of instructors was 256 persons, and 18 people participated for the very first time. Conclusion: Officers were not trained for future disaster response for two years because of the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Both prevention and preparedness are essential to avoid casualties and deaths in mass gathering disasters (MGDs). What countermeasures should be taken? Method: Retrospective analysis of a MGD at Akashi City Fireworks Festival in 2001; discussion of countermeasures at Kobe Luminarie, an annual light festival to commemorate the Great Hanshin Earthquake. Retrospective analysis of mass casualty incidents (MCIs) between 2003 and 2022 in which the alert function of EMISHP (Emergency Medical Information System in Hyogo Prefecture) was activated. Duration from emergency call to activation of alert function (activation time), number of casualties, and number of destination hospitals were evaluated. Results: More than 200 persons were injured and eleven people died in the Akashi Fireworks crowd crush. The main cause of this MGD was lack of gateway control and one-way flow control of visitors. With such measures in place, no MGD has occurred at Kobe Luminarie. In the past nineteen years in Hyogo, the alert function has been activated for 288 MCIs, such as vehicle accidents and fires. Activation time ranged from 1 to 73 minutes (median value=12). The casualty count ranged from 0 to 662 (median value=5). The number of destination hospitals ranged from 0 to 54 (median value=2). In all cases, emergency medical coordinators at Hyogo Emergency Medical Center, a principal hub hospital for disasters, directly or indirectly contributed to the medical response, e.g. securing hospital capacity, dispatching doctor-attending cars/helicopters and other medical teams to the scene, sharing information on the MCI between fire departments and hospitals. Conclusion: Prevention of MGDs requires taking proactive measures, such as gateway restriction and one-way flow control without bottlenecks. Preparedness is made possible by the alert function of EMISHP; it enables smoother patient transport to hospitals and contributes much in securing sufficient time and resources for medical response in MCIs, including MDGs. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma is fatal and has a marked propensity for vascular invasion. However, tumor thrombi rarely occur in the right atrium. A 72-year-old man was admitted with dyspnea and disturbed consciousness. Abdominal computed tomography and echocardiography showed a huge tumor thrombus in the inferior vena cava and the right atrium. The tumor thrombus was surgically removed to treat the hemodynamic compromise. The patient underwent transcatheter arterial chemoembolization postoperatively and survived for 6 months. [ABSTRACT FROM PUBLISHER]

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has caused great disruptions in education and healthcare systems. However, before the COVID-19 pandemic, Hyogo Prefecture did not have a centralized system for sharing information among hospitals, public healthcare centers, the government, fire departments, and medical associations. In March 2021, we used Slack,® an enterprise social network, to invite people from hospitals, healthcare centers, the government, fire departments, and medical associations to join our workspace. This study was undertaken to verify whether the use of Slack can improve information sharing during a disaster., Methods: A questionnaire on whether information-sharing tools such as Slack are useful for disaster response in Hyogo Prefecture, including for COVID-19, was administered using a Google Form., Results: Of the 19 people who responded to the questionnaire, 15 (78.9 percent) were first-time users of Slack and 18 (94.7 percent) found it easy to use. All 19 participants stated that Slack proved useful in providing pertinent information regarding preventive measures for the control of COVID-19, and they believed that it would be a helpful tool if such disasters were to occur in the future. Regarding the launch time of Slack, 11 respondents (57.9 percent) answered that it was launched at the appropriate time, while five respondents (26.3 percent) answered that it was launched too late., Conclusions: The participants thought that Slack was effective for accelerating their communication. The use of Slack could also improve future disaster response communications.

Background and Aim of the Study: Surgical results after aortic valve repair in patients with aortic regurgitation (AR) of tricuspid valve morphology and with no evidence of aortic root disease have not yet been clarified., Methods: Between January 1994 and June 2001, aortic valve repair was performed in 40 patients (eight females, 32 males; mean age 61.0 +/- 10.5 years) of this type. Surgical results and follow up data were summarized after aortic valve repair (for AR) in these patients., Results: One patient died in hospital (mortality 2.5%). The mean cardiopulmonary bypass time was 143.5 +/- 47.4 min, and mean aortic cross-clamp time 99.8 +/- 34.3 min. At follow up, the mean AR grade was 1.5 +/- 0.8 and mean NYHA class 1.0 +/- 0; both parameters showed significant improvement compared to preoperative status (p < 0.0001). Survival was 94.9% at one year and 82.6% at five years. The five-year reoperation-free rate was 87%., Conclusion: Aortic valve repair for AR in patients with tricuspid valve morphology is a safe procedure that provides good intermediate-term results.

Background and Aim of the Study: A recently developed technique of aortic annuloplasty, together with immediate postoperative results, are described., Methods: Between June 1998 and October 2000, 26 patients (22 men, four women; mean age 59 years) with chronic dominant aortic regurgitation (AR) underwent aortic valve repair in which subvalvular circular annuloplasty was used. A concomitant repair technique was performed in all patients. Operative results are summarized, along with perioperative changes in NYHA status and echocardiographic findings., Results: There were no hospital deaths. Mean cardiopulmonary bypass time was 139.0+/-32.8 min, and mean aortic cross-clamp time 106.0+/-33.2 min. Mean postoperative NYHA class at one month postoperatively was 1.0. Mean postoperative AR grade at hospital discharge was 0.9+/-0.7, which represented an improvement over preoperative grade (p <0.0001). LVEDD was reduced from 6.3+/-0.9 cm to 5.1+/-1.1 cm (n = 25; p <0.001), and LVEF from 64.3+/-9.2% to 51.9+/-11.0% (n = 26; p <0.0001). Annulus size was reduced from 2.6+/-0.3 cm to 2.2+/-0.2 cm (n = 18; p <0.0001)., Conclusion: A new technique of aortic annuloplasty as a component of aortic valve repair was developed and used successfully in 26 consecutive patients. The short-term postoperative outcome was satisfactory.