Marine Envenomation in Okinawa: Overview and Treatment Concept.

Okinawa prefecture is a popular tourist destination due to its beaches and reefs. The reefs host a large variety of animals, including a number of venomous species. Because of the popularity of the reefs and marine activities, people are frequently in close contact with dangerous venomous species and, thus, are exposed to potential envenomation. Commonly encountered venomous animals throughout Okinawa include the invertebrate cone snail, sea urchin, crown-of-thorns starfish, blue-ringed octopus, box jellyfish, and fire coral. The vertebrates include the stonefish, lionfish, sea snake, and moray eel. Treatment for marine envenomation can involve first aid, hot water immersion, antivenom, supportive care, regional anesthesia, and pharmaceutical administration. Information on venomous animals, their toxins, and treatment should be well understood by prehospital care providers and physicians practicing in the prefecture.

Sudden Cardiac Arrest as the First Manifestation in a Patient with Catastrophic Antiphospholipid Syndrome.

We herein report a 26-year-old woman with sudden cardiac arrest who had no remarkable medical history. While resuscitation was successfully performed with adrenalin administration and extracorporeal membrane oxygenation, the cause of cardiac arrest could not be determined for over two weeks. Given the presence of autoimmune disease along with the findings of refractory renal insufficiency and thrombocytopenia, a kidney biopsy and blood examinations, including lupus anticoagulant testing, were performed, which proved the presence of antiphospholipid syndrome. The patient was successfully treated with steroid pulse therapy. This drastic case scenario highlighted the fact that autoimmune disease can be the cause of sudden cardiac arrest.

Anterior early repolarization pattern and T-wave inversion in a healthy African-Japanese athlete.

Precordial lead T-wave inversion subsequent to early repolarization is thought to be a normal variant in African athletes and that additional testing is unnecessary. With the increasing number of foreign people living in and traveling to Asian countries, it is becoming crucial for Asian physicians to comprehend the abnormal ECG change in African athletes.

Arteriovenous femoral fistula after insertion of leadless pacemaker-A case with an anomaly of the deep femoral artery.

With the increasing number of implanted leadless pacemakers, complications related to the implantation procedure are being reported. We herein report a case of an 87-year-old male with an arteriovenous fistula after leadless pacemaker implantation due to an anomaly of the right deep femoral artery (DFA). In this present case, a right DFA arising from the antero-medial side of the main femoral artery was attributed to this complication.