JA Clinical Reports最新文献

Systemic capillary leak syndrome complicated by lower extremity compartment syndrome: a case report. 全身毛细血管渗漏综合征合并下肢筋膜室综合征1例。

IF 0.8

JA Clinical Reports Pub Date : 2025-06-09 DOI: 10.1186/s40981-025-00795-8

Asahi Ishihara, Katsuyuki Sagishima, Tadashi Ejima, Manami Kuwahara, Naoyuki Hirata

{"title":"Systemic capillary leak syndrome complicated by lower extremity compartment syndrome: a case report.","authors":"Asahi Ishihara, Katsuyuki Sagishima, Tadashi Ejima, Manami Kuwahara, Naoyuki Hirata","doi":"10.1186/s40981-025-00795-8","DOIUrl":"https://doi.org/10.1186/s40981-025-00795-8","url":null,"abstract":"Background: Systemic capillary leak syndrome (SCLS) is a rare disorder characterized by hypotension, hypoalbuminemia, and hemoconcentration, typically caused by increased vascular permeability due to endothelial dysfunction. We report a case of SCLS complicated by bilateral lower extremity compartment syndrome.Case presentation: A 29-year-old man developed fever, cough, and rhinorrhea. He was restless, hypotensive, and had generalized edema with tense extremities. Laboratory findings included a hemoglobin level of 24.9 g/dL, hematocrit of 69.3%, albumin of 1.8 g/dL, and creatinine of 3.27 mg/dL. SCLS-induced shock was diagnosed with detection of monoclonal gammopathy of the IgG-λ type. Treatment consisted of fluid resuscitation, vasopressors, high-dose corticosteroids, and intravenous immunoglobulin. Although hemodynamic status improved, he developed bilateral lower-limb compartment syndrome, necessitating fasciotomy. Although the patient exhibited sensory deficits and impaired dorsiflexion and plantarflexion in both ankles, he was able to ambulate with a cane and was discharged on hospital day 50.Conclusion: This case highlights the risk of serious complications such as compartment syndrome in patients with SCLS.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"31"},"PeriodicalIF":0.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Non-convulsive status epilepticus as a cause of delayed emergence after a thoracic surgery: a case report. 非惊厥性癫痫持续状态作为胸外科手术后迟发性发作的原因：1例报告。

IF 0.8

JA Clinical Reports Pub Date : 2025-05-29 DOI: 10.1186/s40981-025-00790-z

Yusuke Iritani, Makiko Tani, Shinji Iga, Hiroshi Morimatsu

引用次数: 0

Cerebral gas embolism in a patient without right-to-left shunt after robotic partial nephrectomy. 机械人肾部分切除术后无左-右分流术患者的脑气栓塞。

IF 0.8

JA Clinical Reports Pub Date : 2025-05-24 DOI: 10.1186/s40981-025-00793-w

Mori Satori, Mitsuhiro Matsuo, Yoshinori Ikehata, Hiroshi Kitamura, Tomonori Takazawa

{"title":"Cerebral gas embolism in a patient without right-to-left shunt after robotic partial nephrectomy.","authors":"Mori Satori, Mitsuhiro Matsuo, Yoshinori Ikehata, Hiroshi Kitamura, Tomonori Takazawa","doi":"10.1186/s40981-025-00793-w","DOIUrl":"10.1186/s40981-025-00793-w","url":null,"abstract":"Background: Cerebral gas embolism is a rare but serious complication of laparoscopic surgeries, the risk of which is increased by the presence of right-to-left shunt. A case of cerebral gas embolism after robotic partial nephrectomy is presented.Case presentation: A 71-year-old man underwent robotic partial nephrectomy. During tumor resection, end-tidal CO₂ (ETCO₂) decreased from 42 to 34 mmHg, followed by a decrease in mean arterial pressure (MAP) to < 65 mmHg and oxygen saturation (SpO₂) to 95%. Postoperatively, he exhibited delayed emergence from anesthesia and left conjugate gaze deviation. Neuroimaging revealed cerebral gas embolism. A bubble test performed by a cardiologist under positive pressure ventilation ruled out right-to-left shunt. Despite postoperative treatment, the patient became bedridden with severe neurological sequelae.Conclusions: Cerebral gas embolism can occur during robotic procedures even without right-to-left shunt. Anesthesiologists must promptly recognize intraoperative signs of this complication and initiate timely interventions to prevent severe complications.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"29"},"PeriodicalIF":0.8,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hamman's syndrome in a patient with uncontrolled type 1 diabetes mellitus: a case report. 1型糖尿病未控制患者的哈曼综合征1例报告。

IF 0.8

JA Clinical Reports Pub Date : 2025-05-17 DOI: 10.1186/s40981-025-00792-x

Asahi Ishihara, Katsuyuki Sagishima, Tadashi Ejima, Manami Kuwahara, Naoyuki Hirata

{"title":"Hamman's syndrome in a patient with uncontrolled type 1 diabetes mellitus: a case report.","authors":"Asahi Ishihara, Katsuyuki Sagishima, Tadashi Ejima, Manami Kuwahara, Naoyuki Hirata","doi":"10.1186/s40981-025-00792-x","DOIUrl":"10.1186/s40981-025-00792-x","url":null,"abstract":"Background: Hamman's syndrome is a clinical entity characterized by the spontaneous leakage of air into the mediastinum. We report a patient with Hamman's syndrome associated with diabetes ketoacidosis (DKA).Case presentation: A 20-year-old foreign technical intern visited to a hospital because of nausea and shortness of breath. He had been diagnosed with diabetes in his home country and had initiated insulin therapy; however, since arriving in Japan, he had not accessed any medical services. Computed tomography revealed pneumomediastinum, while laboratory tests showed marked hyperglycemia, metabolic acidosis, and a significantly elevated blood ketone level (15,044 µmol/L). The patient was diagnosed with Hamman's syndrome associated with DKA. Upper gastrointestinal endoscopy showed no evidence of gastrointestinal perforation. Conservative intensive care, including insulin therapy and fluid resuscitation, resulted in clinical improvement.Conclusion: This case highlights the importance of recognizing Hamman's syndrome in DKA and the need for culturally competent care in international residents.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"28"},"PeriodicalIF":0.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comprehensive evaluation of coagulability using thromboelastography in four patients with essential thrombocythemia. 应用血小板弹性成像综合评价4例原发性血小板增多症患者的凝血能力。

IF 0.8

JA Clinical Reports Pub Date : 2025-05-17 DOI: 10.1186/s40981-025-00789-6

Shuji Kawamoto, Tsuguhiro Matsumoto, Yohei Chiwata, Chikashi Takeda, Eriko Kusudo, Moritoki Egi

{"title":"Comprehensive evaluation of coagulability using thromboelastography in four patients with essential thrombocythemia.","authors":"Shuji Kawamoto, Tsuguhiro Matsumoto, Yohei Chiwata, Chikashi Takeda, Eriko Kusudo, Moritoki Egi","doi":"10.1186/s40981-025-00789-6","DOIUrl":"10.1186/s40981-025-00789-6","url":null,"abstract":"Background: Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by increased platelet count and risk of thrombosis and bleeding, which necessitates careful perioperative management. However, there are no standardized guidelines for perioperative antithrombotic therapy, and optimal preoperative evaluation remains unclear. In this report, we evaluate the utility of thromboelastography (TEG®6 s) for assessing coagulation and platelet function in ET patients undergoing surgery.Case presentation: Four ET patients (platelet counts: 289,000-833,000/µL) underwent thromboelastography at anesthesia induction. Two had normal coagulation, while two had a hypercoagulable state undetected by conventional tests. Hypercoagulability was observed in patients who discontinued anticoagulants or antiplatelets preoperatively.Conclusions: Thromboelastography identified thrombotic tendencies not evident with conventional coagulation tests, suggesting its potential for perioperative risk assessment in ET patients. This approach may improve individualized coagulation management beyond use of platelet counts and standard tests. Further studies are needed to establish the role of thromboelastography in optimizing perioperative antithrombotic strategies.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"27"},"PeriodicalIF":0.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of abnormal hypertension and Takotsubo syndrome caused by adrenal hemostasis using an electric scalpel: a case report. 用电刀肾上腺止血致异常高血压及Takotsubo综合征1例。

IF 0.8

JA Clinical Reports Pub Date : 2025-05-16 DOI: 10.1186/s40981-025-00791-y

Tsutomu Suzuki, Naoko Kubo, Kei Kamiutsuri

{"title":"A case of abnormal hypertension and Takotsubo syndrome caused by adrenal hemostasis using an electric scalpel: a case report.","authors":"Tsutomu Suzuki, Naoko Kubo, Kei Kamiutsuri","doi":"10.1186/s40981-025-00791-y","DOIUrl":"10.1186/s40981-025-00791-y","url":null,"abstract":"Background: Although intraoperative adrenal hemostasis by cauterization can cause abnormal hypertension, hemodynamic condition is usually normalized in a few minutes without any postoperative complications. We present a rare case of abnormal hypertension caused by adrenal hemostasis using an electric scalpel, which resulted in cardiac dysfunction: Takotsubo syndrome.Case presentation: A 74-year-old woman received open hepatectomy for a hepatic tumor. During adrenal electrocauterization, abnormal hypertension and tachycardia suddenly occurred. Although the blood pressure returned to the baseline in a few minutes by nicardipine and landiolol, postoperative echocardiography revealed apical hypokinesis and basal hyperkinesis of the left ventricular wall with a decreased ejection fraction of 50%. Along with no coronary artery stenosis by CT angiography, a diagnosis of Takotsubo syndrome was made. Postoperative course was uneventful; ejection fraction increased to 69% with no obvious left ventricular wall asynergy at 1-month postoperative follow-up.Conclusions: Adrenal cauterization during surgery may cause abnormal hypertension by release of excessive catecholamines, and potentially lead to Takotsubo syndrome. Anesthesiologists should be prepared to respond quickly to any unexpected changes in hemodynamics.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"26"},"PeriodicalIF":0.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effective management of acute hemorrhage using an SL One^® rapid infusion device in a pediatric patient undergoing nephrectomy for Wilms tumor with inferior vena cava extension: a case report. SL One®快速输液器对儿童肾切除术伴下腔静脉扩张肾母细胞瘤患者急性出血的有效治疗：1例报告。

IF 0.8

JA Clinical Reports Pub Date : 2025-05-04 DOI: 10.1186/s40981-025-00788-7

Shoko Fujioka, Yusuke Miyazaki, Hinako Furuya, Chika Miyazaki, Nobuyuki Katori, Yoshie Taniguchi

{"title":"Effective management of acute hemorrhage using an SL One® rapid infusion device in a pediatric patient undergoing nephrectomy for Wilms tumor with inferior vena cava extension: a case report.","authors":"Shoko Fujioka, Yusuke Miyazaki, Hinako Furuya, Chika Miyazaki, Nobuyuki Katori, Yoshie Taniguchi","doi":"10.1186/s40981-025-00788-7","DOIUrl":"https://doi.org/10.1186/s40981-025-00788-7","url":null,"abstract":"Background: Wilms tumor is the most common pediatric renal tumor. Tumor extension into the inferior vena cava (IVC) can increase hemorrhage risk during surgical resection, necessitating rapid transfusion. Pediatric patients have lower circulating blood volume, heightening their susceptibility to hemodynamic instability.Case presentation: A 2-year-old boy with an IVC-extending Wilms tumor underwent nephrectomy. Anticipating hemorrhage, we employed an SL One® rapid infusion device via a Broviac™ central venous catheter. During a sudden, high-volume bleeding, transfusion was initiated at 23 mL/min and intermittently increased to 150 mL/min while preload was evaluated using transesophageal echocardiography, rapidly stabilizing hemodynamics. No rapid-transfusion-related complications, such as hyperkalemia or hypothermia, were observed, and the postoperative course was uneventful.Conclusions: In this pediatric case at high risk for acute blood loss, the SL One® provided effective circulatory stabilization without adverse events. Further studies are needed to validate the safety of the SL One® in pediatric patients.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"25"},"PeriodicalIF":0.8,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of intermittent and continuous renal replacement therapy for sepsis-associated AKI: a retrospective analysis of the Japanese ICU database. 间歇和连续肾替代治疗脓毒症相关AKI的比较：日本ICU数据库的回顾性分析

IF 0.8

JA Clinical Reports Pub Date : 2025-04-28 DOI: 10.1186/s40981-025-00787-8

Hiromu Okano, Hiroshi Okamoto, Haruna Tanaka, Ryota Sakurai, Tsutomu Yamazaki

{"title":"Comparison of intermittent and continuous renal replacement therapy for sepsis-associated AKI: a retrospective analysis of the Japanese ICU database.","authors":"Hiromu Okano, Hiroshi Okamoto, Haruna Tanaka, Ryota Sakurai, Tsutomu Yamazaki","doi":"10.1186/s40981-025-00787-8","DOIUrl":"https://doi.org/10.1186/s40981-025-00787-8","url":null,"abstract":"Introduction: While both intermittent renal replacement therapy (IRRT) and continuous renal replacement therapy (CRRT) are used to treat sepsis-associated acute kidney injury (S-AKI), their comparative effectiveness remains unclear. We compared the outcomes between these modalities in patients with S-AKI.Methods: Data from the Japanese Intensive Care Patient Database (JIPAD) was used for this multi-center retrospective cohort study. Adult patients with S-AKI who received either IRRT or CRRT between 2015 and 2021 were included. The primary outcome was in-hospital mortality. We compared IRRT and CRRT using one-to-three propensity score matching analysis. A subgroup analysis was performed in patients with septic shock.Results: Of the 756 patients analyzed, 79 received IRRT, and 677 received CRRT. After propensity score matching, baseline characteristics were well-balanced between groups. In-hospital mortality showed no significant difference between IRRT and CRRT (48.6% vs. 38.0%; risk difference - 10.6%; 95% CI - 23.0 to 2.9; P = 0.11). In patients with septic shock, in-hospital mortality was also not different between groups (52.6% vs. 40.4%; risk difference - 12.2%; 95% CI - 28.8 to 3.7; P = 0.10).Conclusion: IRRT and CRRT may be similar in-hospital mortality in patients with S-AKI. Further studies are warranted to determine the most effective renal replacement modality for this patient population.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"24"},"PeriodicalIF":0.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Severe pulmonary hypertension in weaning from cardiopulmonary bypass following double Ozaki procedure: a case report. 双尾崎手术后体外循环脱机后严重肺动脉高压1例报告。

IF 0.8

JA Clinical Reports Pub Date : 2025-04-21 DOI: 10.1186/s40981-025-00785-w

Jin Sato, Hideki Hino, Ryota Watanabe, Takashi Mori

{"title":"Severe pulmonary hypertension in weaning from cardiopulmonary bypass following double Ozaki procedure: a case report.","authors":"Jin Sato, Hideki Hino, Ryota Watanabe, Takashi Mori","doi":"10.1186/s40981-025-00785-w","DOIUrl":"https://doi.org/10.1186/s40981-025-00785-w","url":null,"abstract":"Background: Ozaki surgery, which reconstructs cardiac valves using autologous pericardium, is commonly performed for aortic valve replacement and offers benefits such as avoiding anticoagulation and reducing valve degeneration. However, its application to pulmonary valve replacement remains rare, and anesthetic management for such cases is not well documented.Case presentation: A 71-year-old woman with severe aortic and pulmonary valve stenosis underwent double valve replacement using the Ozaki procedure and coronary artery bypass grafting. Post-cardiopulmonary bypass, she developed severe pulmonary hypertension and systemic hypotension. Norepinephrine exacerbated pulmonary hypertension, while arginine vasopressin effectively stabilized systemic pressure without worsening pulmonary pressure.Conclusions: This is the first reported case of anesthetic management for double valve replacement using the Ozaki procedure. Adequate use of vasopressin led to ameliorating pulmonary hypertension after cardiopulmonary bypass. Assessing preoperative right ventricular pressure and selecting appropriate vasopressors are crucial in mitigating perioperative pulmonary hypertension.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"23"},"PeriodicalIF":0.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High-flow oxygenation therapy for a sedated elderly frail patient with hiccups undergoing transcatheter aortic valve implantation. 高流量氧合治疗经导管主动脉瓣植入术中镇静的老年虚弱打嗝患者。

IF 0.8

JA Clinical Reports Pub Date : 2025-04-21 DOI: 10.1186/s40981-025-00784-x

Ryosuke Osawa, Takero Arai, Takashi Asai

{"title":"High-flow oxygenation therapy for a sedated elderly frail patient with hiccups undergoing transcatheter aortic valve implantation.","authors":"Ryosuke Osawa, Takero Arai, Takashi Asai","doi":"10.1186/s40981-025-00784-x","DOIUrl":"https://doi.org/10.1186/s40981-025-00784-x","url":null,"abstract":"Background: Transcatheter aortic valve implantation (TAVI) can be performed under sedation, but body movements may lower the efficacy of the procedure and may increase the risk of complications, such as cardiac tamponade. Additional sedatives and analgesics may be required to prevent body movements; this would increase the risk of upper airway obstruction and of respiratory depression. We report a frail patient with hypoxemia and hiccups, in whom high-flow nasal oxygenation facilitated TAVI by effectively inhibiting body movements and respiratory complications.Case presentation: In an 82-year-old patient with severe aortic stenosis, heart failure, hypoxemia, and hiccups, TAVI was planned under sedation with dexmedetomidine, fentanyl, and ketamine. High-flow nasal oxygenation effectively prevented hiccups and associated body movements, and prevented upper airway obstruction and respiratory depression, during TAVI.Conclusions: High-flow nasal oxygenation therapy is potentially useful during cardiac catheterization procedure under monitored anesthesia care, in elderly frail patients with reduced cardiopulmonary function.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"22"},"PeriodicalIF":0.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0