These results suggest that constriction of intraparenchymal arterioles occurs after SAH and may contribute to delayed cerebral ischemia.
The relatively high rate of post-operative recurrence in the treatment of chronic subdural hematoma (CSDH) is a significant problem. Goreisan is an herbal medicine that exhibits a hydragogue effect by inhibiting the expression of aquaporins, and its efficacy in preventing post-operative CSDH recurrence has been suggested by several case trials. This multi-center prospective randomized controlled trial was performed to investigate the preventative effect of goreisan on post-operative CSDH recurrence. Patients with symptomatic CSDH over 60 years old undergoing burr hole surgery were enrolled in this study. The patients were randomly allocated to the control group or the goreisan group, in which oral administration of goreisan (7.5 g daily) was continued for 12 weeks. The primary end-point was the post-operative recurrence rate at 12 weeks and the secondary end-point was hematoma volume reduction rates on computed tomography scan at 12 weeks. The analyses were performed not only on patients of all ages older than 60 years, but also on patients divided into those over or under 75 years old. One hundred and eighty patients were followed and analyzed (the control group, n = 88; the goreisan group, n = 92). The recurrence rates considering patients of all ages and patients under 75 years old were relatively low in the goreisan group but without a significant difference. The hematoma volume reduction rates showed no significant difference. Based on the results of the present study, a larger-scale study including more cases is necessary in future to confirm the efficacy of goreisan.
Summary.Human permanent teeth without caries, obtained from 10-16 year old males and females and noncarious human deciduous teeth in which roots remained intact or were only poorly resorbed, were studied histologically.The distribution of sensory nerves in deciduous teeth were compared with that in permanent teeth by means of the silver-nitrate technique. 1. In radicular pulp, the sensory nerve fiber bundles accompany blood vessels in the axial area and several nerve single-fibers occur in the peripheral area of the pulp. 2. The subodontoblastic nerve plexus is formed in or beneath the cell-rich zone of the coronal pulp, and further, the marginal nerve plexus is built up near the pulpo-predentinal border.3. The nerve fibers entering the predentin can be classified into 3 types by their courses.In the first type, nerve fibers pass directly toward the calcification front along the dentinal tubules in the predentin.In the second type, nerve fibers run obliquely or transversely in the predentin. The transversal fibers form a plexus-like structure by dividing and interlacing at various levels of predentin. The third type nerve fibers pass along the dentinal tubules in the predentin and, after reaching the predentino-dentinal border, reverse the odontoblast layer, thus forming a looped course.4. There is no essential difference between the nerve supply in the deciduous and in the permanent teeth, but the nerves in the deciduous teeth are less dense in distribution and lower in amount than in the permanent teeth.Moreover, a typical marginal nerve plexus, which occurs constantly in the permanent teeth, is only occasionally found in the deciduous teeth; and no nerve fiber was observed to penetrate into the calcified dentin in the deciduous teeth.This finding seems to account for the fact that the deciduous teeth are less sensitive than their permanent successors.
Previous studies on tooth replacement in lower vertebrates have been plagued by a lack of common integrative approaches and methods making it impossible to furnish a phylogenetic synthesis. This study is based on serial sections of the jaw of Prionurus microlepidotus. Each Toothgerm was characterized by its developmental stage and its position in the jaw. The relationship between the developmental stage of toothgerm and position in the jaw has been studied and expressed in several graphical illustrations. The following conclusions have been made: (1) The initiation of toothgerms in P. microlepidotus is governed by two Zahnreihen, which respectively initiate toothgerms on the lingual and labial side of the functioning teeth in an alternating pattern. (2) Therefore, functioning teeth in one locus are supplied by the alternate eruption of lingual and lubial toothgerms. (3) Advancing of tooth replacement in each locus is independent of functioning teeth and their successors in adjacent loci. (4) The disorders of replacement patterns are caused by an alternated rate of eruption of successive toothgerms as a response to unusual shedding of the functioning teeth.
On November 22, 2010, a simulation-based hands-on education course for medical staff in the neurosurgical fields was held in 8th Asian Congress of Neurological Surgeons (ACNS) in Kuala Lumpur, Malaysia. The present education course called Primary Neurosurgical Life Support (PNLS) course had been started by the Japan Society of Neurosurgical Emergency since 2008. This report summarizes the international version of PNLS course in 8th ACNS.
Methods: A first-person case study analysis of a 2005, Greyhound bus accident, which occurred near Edmonton, Alberta, Canada, was analyzed. Results: Achieving success and organization of a catastrophic event or natural disaster requires the recognition of the importance of scene control and command, accurate triage and the assurance of destination resource capacity. Multi casualty events are rare, and due to sparse exposure, first responders have limited experience to manage these events effectively. Mass casualty exercises are generally used, although no standardized method exists to evaluate their function and effectiveness. Accurate and timely information are essential in successful multi-casualty events; however, inexperience and limitations often lead to ineffective and inaccurate triage, treatment and transportation of patients. Conclusion: To ensure efficient and effective mass casualty response, future research should focus on adequate professional development programs for first responders. In addition, tools and instruments to aid in successful multi-casualty events would be an asset in achieving success. Study/Objective: To evaluate the predictive value of Modified Burn Score (MBS), Abbreviated Burn Severity Index (ABSI), Belgian Outcome in Burn Injury (BOBI), and Injury Severity Score (ISS) for death risk in adult patients with severe thermal burns. Background: Severe burn patients have high mortality. Accurate prediction of the risk of death in patients with severe burn, contributed to objectively assess the disease, to help clinicians with better clinical decision-making and rational allocation of medical resources. At present, there is a variety of scores on the risk of mortality in burn patients. However there are still, few studies on the prediction of the risk of death in adults with severe thermal burns. Methods: Retrospectively analyzed data of patients in West China Hospital from 2012 to 2014. The patient's name, gender, age, burn area, and whether complicated with inhalation injury were recorded; and the ISS, MBS, ABSI and BOBI score were calculated. Through drawing Receiver Operating Characteristic curve (ROC curve), the area under the curve of the four scores Area Under Curve (AUC), and the sensitivity and specificity for death prediction were obtained. Based on the sensitivity and specificity for death risk prediction, the Youden index was calculated, the best cutoff value was found, and the best score of death risk prediction for adult patients with severe thermal burn was selected. Results: There were 85 adult patients with severe thermal burn that were included, with 49 males and 36 females. The AUC of ABSI, MBS, BOBI and ISS were 0.925, 0.825, 0.813, 0.715. Conclusion: ABSI has the best value for the death risk in severe thermal burns adult patients. Study/Objective: We examined the capability of this new triage system, using digitized information entered via a digital pen, as an information tool in times of disaster. Background: Triage is important in deciding the priority of treatme...
various nuclear disaster, new concept and new comprehensive disaster medical system is necessary as well as effective utilization of pre-existing resources.Prehosp Disaster Med 2017;32(Suppl. 1):s3-s4 doi:10.1017/S1049023X17000371The New Radiation Emergency Medical System in Japan: Lessons from the Fukushima Nuclear Plant Accident Hitoshi Yamamura, Shinya Yaguchi, Katsuhiro Itoh Dept Of Disaster And Critical Care Medicine, Hirosaki University, Graduate School of Medicine, Hirosaki Aomori/Japan Study/Objective: Our aim was to clarify the new radiation emergency medical system in Japan, and the related activities at our hospital after the Fukushima No. 1 Nuclear Power Plant accident. Background: The radiation accident at Fukushima No. 1 Nuclear Power Plant occurred on March 11, 2011. After this accident, the Japanese radiation medical system was in a state of confusion because health care workers had no knowledge about radiation emergencies and there was no appropriate organization to handle the control of a radiation disaster. Methods: The Japanese government created two special radiation medical centers after the accident. First was a Radiation Disaster Medical Care and general Support Center comprised of four hospitals, with the role of coordinating the radiation emergency medical assistant teams, treatment of radiation exposure patients, and training of the hospital staff in Radiation Emergency Medicine (REM). Second was an Advanced Radiation Emergency Medical Support Center comprised of five hospitals with an advisory role in dispensing advice about professional REM dissymmetry for internal exposure, special training for professional research, and knowledge about REM. Our hospital was designated as a member of the above two centers, and we investigated our related activities. Results: Since our designation, we have rebuilt the REM system in our hospital. Our achievements mainly include education, the development of training contents for activities in our hospital, and lectures on REM for the hospital staff including the doctors, nurses, radiologists, laboratory technicians, and office employees. Hands-on training and lectures were given on REM for medical students. We have also participated in REM training on the national and prefatory levels. Conclusion: It is important for us to educate all of the health care workers in our hospital about radiation emergencies, and to train professional staff who are familiar with both general disaster medical care and radiation emergency medical treatment. Many hospitals train for protective equipment through large group lectures. Some institutions conduct handson training, but the educational contents and assessment tools are not standardized. PPE training is needed for all hospital personnel that has the potential to be in contact with patients. The number of hospital personnel mounts to more than 1,000, and it is very difficult to train everyone in a single place by few trained instructors. Therefore, it is important to train trainers to be competent in training PPE. Me...
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