The survival rate of commotio cordis is low, and there is often associated neurological disability if return of spontaneous circulation (ROSC) can be achieved. We report a case of commotio cordis treated with therapeutic hypothermia (TH) that demonstrated a favorable outcome. A 16-year-old female was transferred to our emergency department (ED) for collapse after being struck in the chest with a dodgeball. She has no history of heart problems. She was brought to our ED with pulseless ventricular tachycardia (VT), and ROSC was achieved with defibrillation. She was comatose at our ED and was treated with TH at a target temperature of 33degrees C for 24 hours. After transfer to the intensive care unit, pulseless VT occurred, and defibrillation was performed twice. She recovered to baseline neurologic status with the exception of some memory difficulties.
Adolescent ; Coma ; Commotio Cordis* ; Emergency Service, Hospital ; Female ; Heart ; Humans ; Hypothermia* ; Intensive Care Units ; Memory ; Survival Rate ; Tachycardia ; Tachycardia, Ventricular* ; Thoracic Injuries ; Thorax

Endovascular aneurysm repair (EVAR) is now considered the first choice treatment modality for abdominal aortic aneurysm (AAA) treatment. Advocates for endovascular strategies will try to treat all AAA by EVAR, regardless if the anatomy is conducive for treatment or not. However, the long-term outcomes of EVAR outside the instructions for use (IFU) due to a hostile aneurysmal neck or iliac artery anatomy are known to be poor. The EVAR procedures can be classified according to the technical difficulty, IFU, and need for visceral revascularization: standard, adjunctive, and complex EVAR. The situation required for adjunctive procedures can be classified as the following four steps: a hostile neck (i.e., short or severely angled); large inferior mesenteric or lumbar artery; tough iliac artery anatomy, such as a short common iliac artery and stenotic external iliac artery; and limitations in vascular access. This article will discuss the adjunctive procedures to overcome hostile aneurysm neck and unsuitable iliac artery anatomy.

The purpose of this study was to investigate consumer awareness and demand related to country-of-origin labeling at restaurants, and to provide basic data to reexamine the need for current policies and to determine problems. The study found that 70% of the respondents thought that the implemented representation policy had improved food quality, and 81.3% of the respondents checked country-of-origin labeling at restaurants. In addition, 74.7% of the respondents answered that "reward for accusation" was appropriate policy. Regarding the degree of recognition of the meat importers, the respondents were well aware of the importing countries, but did not recognize the importing country of chicken. In terms of preference for meat importers, Australian beef was rated highest, but beef from the U.S. was ranked seventh. However, in preferences for pork and chicken, U.S. products were rated highest. According to the survey, in a question regarding the perception toward country-of-origin labeling, the respondents recognized that rice, beef, pork, and chicken were the targeted items. In addition, the respondents suggested that other food ingredients at restaurants should be designated as target items for country-of-origin labeling.
Adult ; Chickens ; Surveys and Questionnaires ; Food Quality ; Humans ; Meat ; Restaurants

For the modern practice of cancer surgery, the concept of oncovascular surgery (OVS), defined as cancer resection with concurrent ligation or reconstruction of a major vascular structure, can be very important. OVS for advanced cancers requires specialized procedures performed by a specialized multidisciplinary team. Roles of oncovascular surgeons are summarized as: a primary surgeon in vessel-origin tumors, a rescue surgeon treating complications during cancer surgery, and a consultant surgeon as a multidisciplinary team for cancer surgery. Vascular surgeons must show leadership in cancer surgery in cases of complex advanced diseases, such as angiosarcoma, leiomyosarcoma, intravenous leiomyomatosis, retroperitoneal soft tissue sarcoma, iatrogenic injury of the major vessels during cancer surgery, pancreatic cancer with vascular invasion, extremity soft tissue sarcoma, melanoma and others.
Consultants ; Extremities ; Hemangiosarcoma ; Humans ; Leadership ; Leiomyomatosis ; Leiomyosarcoma ; Ligation ; Melanoma ; Pancreatic Neoplasms ; Sarcoma ; Surgeons

Major vessel invasion, particularly involving the portal and superior mesenteric veins, poses significant challenges during the radical resection of hepatobiliary and pancreatic cancers. Oncovascular surgery is essential for curative outcomes, and often requires portomesenteric vein reconstruction. Techniques, such as lateral venorrhaphy, patch repair, end-to-end anastomosis, and interposition grafting, have been employed. Autogenous veins such as the internal jugular, left renal, external iliac, or femoral veins are options, although not always available. Alternatives include great saphenous vein grafts, other autogenous materials, including the parietal peritoneum, bovine patches and allografts. Despite the higher risks of infection and thrombosis, prosthetic grafts are also considered. Ensuring long-term patency through meticulous surgical techniques is crucial for preventing complications, such as thrombosis and variceal bleeding.

Major vessel invasion, particularly involving the portal and superior mesenteric veins, poses significant challenges during the radical resection of hepatobiliary and pancreatic cancers. Oncovascular surgery is essential for curative outcomes, and often requires portomesenteric vein reconstruction. Techniques, such as lateral venorrhaphy, patch repair, end-to-end anastomosis, and interposition grafting, have been employed. Autogenous veins such as the internal jugular, left renal, external iliac, or femoral veins are options, although not always available. Alternatives include great saphenous vein grafts, other autogenous materials, including the parietal peritoneum, bovine patches and allografts. Despite the higher risks of infection and thrombosis, prosthetic grafts are also considered. Ensuring long-term patency through meticulous surgical techniques is crucial for preventing complications, such as thrombosis and variceal bleeding.

Major vessel invasion, particularly involving the portal and superior mesenteric veins, poses significant challenges during the radical resection of hepatobiliary and pancreatic cancers. Oncovascular surgery is essential for curative outcomes, and often requires portomesenteric vein reconstruction. Techniques, such as lateral venorrhaphy, patch repair, end-to-end anastomosis, and interposition grafting, have been employed. Autogenous veins such as the internal jugular, left renal, external iliac, or femoral veins are options, although not always available. Alternatives include great saphenous vein grafts, other autogenous materials, including the parietal peritoneum, bovine patches and allografts. Despite the higher risks of infection and thrombosis, prosthetic grafts are also considered. Ensuring long-term patency through meticulous surgical techniques is crucial for preventing complications, such as thrombosis and variceal bleeding.

Major vessel invasion, particularly involving the portal and superior mesenteric veins, poses significant challenges during the radical resection of hepatobiliary and pancreatic cancers. Oncovascular surgery is essential for curative outcomes, and often requires portomesenteric vein reconstruction. Techniques, such as lateral venorrhaphy, patch repair, end-to-end anastomosis, and interposition grafting, have been employed. Autogenous veins such as the internal jugular, left renal, external iliac, or femoral veins are options, although not always available. Alternatives include great saphenous vein grafts, other autogenous materials, including the parietal peritoneum, bovine patches and allografts. Despite the higher risks of infection and thrombosis, prosthetic grafts are also considered. Ensuring long-term patency through meticulous surgical techniques is crucial for preventing complications, such as thrombosis and variceal bleeding.

Major vessel invasion, particularly involving the portal and superior mesenteric veins, poses significant challenges during the radical resection of hepatobiliary and pancreatic cancers. Oncovascular surgery is essential for curative outcomes, and often requires portomesenteric vein reconstruction. Techniques, such as lateral venorrhaphy, patch repair, end-to-end anastomosis, and interposition grafting, have been employed. Autogenous veins such as the internal jugular, left renal, external iliac, or femoral veins are options, although not always available. Alternatives include great saphenous vein grafts, other autogenous materials, including the parietal peritoneum, bovine patches and allografts. Despite the higher risks of infection and thrombosis, prosthetic grafts are also considered. Ensuring long-term patency through meticulous surgical techniques is crucial for preventing complications, such as thrombosis and variceal bleeding.

Sulfoxaflor is the first insecticide belonging to the sulfoximine class and is efficient against sap-feeding insects that are resistant to other insecticides. Sulfoxaflor acts as a neurotoxin to the central nervous system of insects compared with very low toxicity to mammalian. We report on a case of a 67-year-old male who ingested insecticide and received conservative treatment for mild metabolic acidosis and gastrointestinal symptoms.
Acidosis ; Aged ; Central Nervous System ; Humans ; Insecticides ; Insects ; Male ; Poisoning*