Masaaki Takemoto

Recombinant thrombomodulin improves the visceral microcirculation by attenuating the leukocyte-endothelial interaction in a rat LPS model.

INTRODUCTION Abnormalities in vascular endothelial function play an important role in the development of septic organ dysfunction. The aim of this study was to examine the effect of recombinant thrombomodulin (rTM) on leukocyte-endothelial interaction and subsequent malcirculation in endotoxemia. MATERIALS AND METHODS Wistar rats were administered with either low, medium or high dose of rTM (n=7 each) 2hours after lipopolysaccharide (LPS) infusion. Mesenteric microcirculation after the treatment was observed under the intravital microscopy. In another series (n=5 each), plasma levels of high-mobility group box 1 (HMGB1) levels were measured at 5hours after LPS infusion. RESULTS Microscopic findings revealed suppression in leukocyte adhesion, thrombus formation and endothelial damage with the treatment by rTM. However, high-dose rTM tended to increase the bleeding events. Thus, blood flow was better maintained with medium-dose rTM (P<0.05). The increase in HMGB1 level was significantly suppressed by medium and high-dose rTM (P<0.05, respectively). CONCLUSIONS rTM demonstrated a protective effect on microcirculation through the inhibition of leukocyte-endothelial interaction and suppression of HMGB1.

Analysis of non-traumatic truncal back pain in patients who visited an emergency room

To investigate epidemiology of acute non‐traumatic back pain using modern diagnostic methods in patients who visited an emergency room.

A vascular anomaly of the iliac artery in a patient with VATER association

In patients with VATER association, some have vascular anomaly that makes procedure difficult. Pretreatment CT angiography should be necessary for the patients with VATER associations feature.

Pulmonary edema caused by inhalation of vapors from water-soluble paint

To report the effects of inhaling vapor from water‐soluble paint after a recent encounter with 16 patients treated in our emergency department.

Accuracy of the smaller superior mesenteric vein sign for the detection of acute superior mesenteric artery occlusion

The smaller superior mesenteric vein (SMV) sign is a well‐known computed tomography (CT) parameter for acute superior mesenteric artery (SMA) occlusion. This CT sign is potentially beneficial for the early diagnosis of acute SMA occlusion; however, few reports have documented this sign. The present study aimed to determine the accuracy of the smaller SMV sign for the detection of acute SMA occlusion.

A Case of Lung Lesions Induced by a Soccer Ball

An 18-year-old youth soccer forward received a direct hit from a kicked soccer ball on the anterior right chest when the goal keeper kicked the ball from a distance of 1 meter. Immediately following the hit, the subject experienced dypnea, chest pain and had a cough, with several milliliters of hemoptysis. His symptoms subsided after 20 minutes of rest. However, he still felt mild discomfort and was taken to our department for evaluation. On examination, all vital signs were normal. A computed tomography scan of the chest was obtained, and revealed a small area of opacification in the right lung field suggesting a pulmonary contusion or traumatic lung edema. Ten days after the initial injury, he was cleared for full participation. We herein reported the first case of a lung lesion induced by a soccer ball. Conservative treatment resulted in a favorable outcome.