JA Clinical Reports最新文献

{"title":"Cephalad intertransverse process block for thoracic herpes zoster: a practical approach to enhance safety and effect.","authors":"Keisuke Yoshida, Yoshie Noji, Ryosuke Sasaki, Atsuyuki Hosono, Satoki Inoue","doi":"10.1186/s40981-025-00801-z","DOIUrl":"10.1186/s40981-025-00801-z","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"33"},"PeriodicalIF":0.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302084","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}

{"title":"Relationship between the updated oxygen reserve index and arterial partial pressure of oxygen: a prospective observational study.","authors":"Hidemi Ishido, Keisuke Yoshida, Tsuyoshi Isosu, Shinju Obara, Satoki Inoue","doi":"10.1186/s40981-025-00796-7","DOIUrl":"10.1186/s40981-025-00796-7","url":null,"abstract":"<p><strong>Introduction: </strong>The oxygen reserve index (ORi™), a non-invasive variable that continuously reflects oxygenation, was first reported in 2016. With the 2018 update of ORi, the scaling between 0.00 and 1.00 was modified. This article provides a follow-up report on the relationship between the updated ORi and arterial partial pressure of oxygen (PaO₂), based on our previous study using the original version of ORi.</p><p><strong>Methods: </strong>The updated ORi version analyzed in the present study used a Revision M sensor. Twenty adult patients who were scheduled for surgery under general anesthesia with arterial catheterization were enrolled. After induction of general anesthesia, arterial blood gas analysis was performed with the fraction of inspiratory oxygen (FiO₂) set at 0.33. The PaO₂ and ORi at the time of blood collection were recorded. After that, FiO₂ was changed to achieve an ORi of around 0.5, 0.2, or 0, followed by arterial blood gas analysis. The relationship between ORi and PaO₂ was then investigated using the data obtained.</p><p><strong>Results: </strong>Seventy-six datasets from the 20 patients were analyzed. When PaO₂ was < 240 mmHg (n = 73), linear regression analysis showed a relatively positive correlation (r² = 0.4683). The cut-off ORi value obtained from the receiver operating characteristic curve to detect PaO₂ ≥ 150 mmHg was 0.45 (sensitivity 0.833, specificity 0.810). Four-quadrant plot analysis demonstrated that ORi has good trending ability with respect to PaO₂ (concordance rate was 100.0%).</p><p><strong>Conclusion: </strong>Although the original and updated versions of ORi demonstrate similar properties regarding their ability to track PaO₂ changes, the updated version has a wider absolute value range. Therefore, caution is warranted when interpreting ORi values, as absolute values may vary significantly between versions, even at the same PaO₂ level.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"34"},"PeriodicalIF":0.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302094","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}

{"title":"What is safe paravertebral block and neuraxial anesthesia for patients with neurofibromatosis type 1?","authors":"Hirotaka Kinoshita, Remi Kunii, Kishiko Nakai, Masato Kitayama, Junichi Saito","doi":"10.1186/s40981-025-00798-5","DOIUrl":"10.1186/s40981-025-00798-5","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"35"},"PeriodicalIF":0.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302096","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}

{"title":"Usefulness of lower extremity pulse oximetry for detection of external iliac artery dissection during robot-assisted radical prostatectomy.","authors":"Jun Honda, Akifumi Onagi, Ruriko Honda, Seiji Hoshi, Hidenori Akaihata, Satoki Inoue","doi":"10.1186/s40981-025-00797-6","DOIUrl":"10.1186/s40981-025-00797-6","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"32"},"PeriodicalIF":0.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266237","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}

{"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":"10.1186/s40981-025-00795-8","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Case presentation: </strong>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.</p><p><strong>Conclusion: </strong>This case highlights the risk of serious complications such as compartment syndrome in patients with SCLS.</p>","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247918","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}

{"title":"Non-convulsive status epilepticus as a cause of delayed emergence after a thoracic surgery: a case report.","authors":"Yusuke Iritani, Makiko Tani, Shinji Iga, Hiroshi Morimatsu","doi":"10.1186/s40981-025-00790-z","DOIUrl":"10.1186/s40981-025-00790-z","url":null,"abstract":"<p><p>Non-convulsive status epilepticus (NCSE) is an electrical discharge which occurs without prominent motor symptoms. NCSE is one of the causes of delayed emergence from anesthesia; however, as far as we know, previous reports of postoperative NCSE were related to patients after neurological surgery. Herein, we report a case of an elderly male who developed initial NCSE after thoracic surgery. The patient remained unresponsive and developed hemiplegia after lung resection, and then the symptoms fluctuated between better and worse. Metabolic disorders and stroke were ruled out, and NCSE was diagnosed by magnetic resonance imaging (MRI) and electroencephalography (EEG). NCSE occurred in a patient who had no predisposing factors or underwent non-neurological surgery. When anesthesiologists encounter delayed emergence, NCSE should be listed as a differential diagnosis and examined by MRI and EEG.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"30"},"PeriodicalIF":0.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173791","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}

{"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":"<p><strong>Background: </strong>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.</p><p><strong>Case presentation: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","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}

{"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":"<p><strong>Background: </strong>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).</p><p><strong>Case presentation: </strong>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.</p><p><strong>Conclusion: </strong>This case highlights the importance of recognizing Hamman's syndrome in DKA and the need for culturally competent care in international residents.</p>","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}

{"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":"<p><strong>Background: </strong>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.</p><p><strong>Case presentation: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","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}

{"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":"<p><strong>Background: </strong>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.</p><p><strong>Case presentation: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","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}