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Six cases of classical dissecting aneurysm of the aorta complicating aortic valvular disease in which aortic stenosis was dominant are described. In three of the cases the aortic complication occurred after the natural aortic valve had been replaced by a prosthetic valve. The longest postoperative period was four months. The factor common to all reported(More)
BACKGROUND Cerebral regional oxygen saturation (rSO2) can be measured immediately and noninvasively just after arrival at the hospital and may be useful for evaluating the futility of resuscitation for a patient with out-of-hospital cardiopulmonary arrest (OHCA). We examined the best practices involving cerebral rSO₂ as an indicator of the futility of(More)
Targeted temperature management (TTM) (primarily therapeutic hypothermia (TH)) after out-of-hospital cardiac arrest (OHCA) has been considered effective, especially for adult-witnessed OHCA with a shockable initial rhythm, based on pathophysiology and on several clinical studies (especially two randomized controlled trials (RCTs) published in 2002).(More)
Among 166 specimens with classical complete transposition, pulmonary or subpulmonary stenosis was present in 22 cases. The bases for obstruction were pulmonary valvular stenosis (one case), membranous subpulmonary stenosis (nine cases), anomalous attachment of the mitral valve to the ventricular septum (five cases) and combinations of causes (seven cases).(More)
OBJECTIVES Although cost analyses for emergency care are essential, data on costs of care for out-of-hospital cardiopulmonary arrest (OHCA) are scarce. The present study aimed to analyze health care costs related to OHCA using a nationwide administrative database in Japan. METHODS Using the Diagnosis Procedure Combination database in Japan, we identified(More)
BACKGROUND Unwitnessed OHCA patients with non-shockable initial rhythms account for nearly half of all OHCA patients, and their prognosis is extremely poor. To date, no studies have focused on these patients. This study aimed to investigating the predictors of favorable and poor prognosis in these patients. METHODS We conducted a nationwide,(More)
Population aging has rapidly advanced throughout the world and the elderly accounting for out-of-hospital cardiac arrest (OHCA) has increased yearly.We identified all adults who experienced an out-of-hospital cardiac arrest in the All-Japan Utstein Registry of the Fire and Disaster Management Agency, a prospective, population-based clinical registry,(More)
A pathologic study of the cardiac conduction system was performed in 57 patients who died within 30 days after aortic valvular replacement. Histologically, there were old and recent lesions present in 34 (60 percent) and 43 (75 percent) of the patients, respectively. Old lesions did not show meaningful correlation with preoperative electrocardiograms.(More)
BACKGROUND It is unclear whether the prehospital termination of resuscitation (TOR) rule is applicable in specific situations such as in areas extremely dense with hospitals. OBJECTIVES The objective of the study is to assess whether the prehospital TOR rule is applicable in the emergency medical services system in Japan, specifically, in an area dense(More)
Various unmeasured anions other than lactate appear in the blood of septic patients, including ketones. However, the occurrence of sepsis-induced ketoacidosis without diabetes mellitus has not been reported to date. We herein describe severe ketoacidosis in a patient with septic shock despite the absence of diabetes, alcohol and starvation. A 76-year-old(More)