1.A case of diffuse alveolar hemorrhage following synthetic cathinone inhalation
World Journal of Emergency Medicine 2020;11(3):182-183
Dear editor,
Diffuse alveolar hemorrhage (DAH) sometimes
causes a life-threatening condition; thus, prompt
diagnosis and treatment for DAH is crucial. However,
a variety of diseases (e.g., systemic autoimmune
diseases, infectious diseases, drugs) are associated with
the development of DAH, which occasionally causes
diffi culty with identifying the specifi c etiology.[1
2.Effects of 38.DEG.C. Bathing for 30 min on Hemostatic Function and Autonomic Nervous Function in Patients with Cerebral Infarction.
Yumi KATOH ; Toshiaki YOSHIDA ; Mariko AIHARA ; Masakazu NITTA ; Hiroyuki SHIONO ; Junichi SAKAI ; Tadashi OKADA ; Isamu SUGIE ; Nariaki IIJIMA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2001;64(2):93-102
Effects of 38°C 30-minute bathing on hemostatic function and autonomic nervous function were studied in 15 48-to-72-year-old patients with cerebral infarction. Blood samples were collected three times: immediately before the bathing, at the end of 30 minutes of bathing, and 30 minutes after the bathing. Hematocrit values and fibrinogen concentrations decreased during bathing and returned to the pre-bathing levels 30 minutes after bathing. This indicates that bathing caused hemodilution due to the fluid shift. During bathing, noradrenaline decreased at a rate significantly higher than that of hemodilution while the sympathetic nervous function, which was evaluated by spectral analysis of sequential variation in arterial blood pressure, was not suppressed. The autonomic nervous system seemed to be inactive in these patients. Coagulation time (PT and APTT) and platelet factor (β-TG and PF4) showed few changes. In the fibrinolytic system, however, tissue plasminogen activator (t-PA) antigen levels increased and plasminogen activator inhibitor type-1 (PAI-1) levels decreased after 30 minutes of bathing. This suggests that fibrinolytic activity was enhanced by 38°C bathing for 30 minutes. Thus, subthermal bathing with comfort may be useful in preventing cerebral infarction.
3.Aortoesophageal Fistula after Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury
Masakazu NITTA ; Taro TAMAKAWA ; Natsuo KAMIMURA ; Tadayuki HONDA ; Hiroshi ENDOH
Journal of the Korean Society of Traumatology 2019;32(3):172-175
Although thoracic endovascular aortic repair (TEVAR) has grown to become the standard of care to treat blunt thoracic aortic injury (BTAI), the long-term effects of TEVAR are still unclear. We here present a 72-year-old man with BTAI due to a traffic accident. He successfully underwent TEVAR and was transferred to another rehabilitation hospital 2 months after the accident. However, 1 month later, he underwent gastroscopy with fever and hematemesis and was diagnosed with aorto-esophageal fistula (AEF). After being re-transferred to Niigata University Medical and Dental Hospital, we tried to convince him to undergo surgical treatment, but he strongly refused. He received palliative care and died due to rupture of the aortic pseudoaneurysm 3 days after the hospital transfer. Fatal complications like AEF may occur after TEVAR, so clinicians need to carefully follow patients who underwent TEVAR.