One way of preventing the spread of COVID-19 infection during sports activities is to disinfect equipments and goods. The purpose of this study was to evaluate the difference in finger tactile sensation and the ultrastructural change of the surface of baseballs after applying various antiseptic solutions to them. The objects of this study were baseballs made from natural leather and natural rubber. Disinfection methods were A: water, B: sodium hypochlorite, C: surfactant, and D: ethanol. After repeating the application and wiping of each liquid on each baseball's surface 200 times, sensory testing was conducted. Eleven healthy adults evaluated three sensations, smooth, sticky, and bulky, by Visual Analogue Scale (VAS). The Mann-Whitney U test was used for statistical analysis with no disinfection as the control (P < 0.05). Further, we observed structural changes on the ball surface before and after disinfection using an electron microscope. The tactile sensation was evaluated by VAS (range, 0-10)with the control value being 5. For leather baseballs, C resulted in significantly lower values than the control group for “smooth” (2.7) and “sticky” (3.4) sensations. For rubber baseballs, B showed a significantly lower value (4.3) only for “dryness.” A, C, and D showed significant changes in each of the three tactile sensations. Observation with an electron microscope revealed that baseballs showed changes in the depth and number of irregularities on the surface before and after disinfection. These results suggested that the antiseptic solution for baseballs is recommended to be C for leather baseballs and B for rubber baseballs.

In this case of traumatic liver injury, the form of injury changed from type Ib to type IIIb within a short time.

Case: A man in his twenties was hit on the front right side of his trunk by material at a construction site and was transported to our emergency department. Upon arrival, his consciousness was clear and vital signs were stable. CT revealed intraparenchymal injury near the middle hepatic vein, but as the hepatic capsule was not ruptured, we determined the presence of type Ib traumatic liver injury and initiated non-operative management (NOM). Follow-up CT scan 46 hours after injury revealed that the hematoma had increased in size but remained under the capsule. The patient's subjective symptoms had subsided and his vital signs remained stable, so we decided to continue NOM. At 77 hours after injury, his abdominal pain began to worsen, and CT revealed type IIIb liver injury. His vital signs indicated shock, so we performed an emergency laparotomy. Hemostasis of the injured liver was obtained by suturing the torn middle hepatic vein. Gauze packing was used to wrap the surface of the right lobe and the medial area, and he was returned to the ICU. We removed the gauze packing on postoperative day (POD) 2. The patient's postoperative progress was good, and he was discharged from hospital on POD 22 and returned to normal life two months later.

Conclusion: When determining whether to continue NOM, it is important to assess both anatomic damage and physiologic circulatory kinetics.

There have been numerous reports of pseudo-hypoaldosteronism type III (PHA III) associated with upper urinary tract infections (uUTIs) and/or urinary tract abnormalities occurring in infants younger than 90 days of age. This transient distal tubular dysfunction is not usually missed because it mostly presents as life-threatening events including severe hyponatremia and hyperkalemia. In this case, we experienced a simple upper urinary tract infection complicated by transient Fanconi syndrome (FS), without PHA III or other distal tubular lesions. A 28-day-old baby girl with 21 trisomy had her first upper urinary tract infection without urinary tract abnormalities, as determined by imaging studies. Despite rapid resolution of fever with appropriate antimicrobial therapy, the baby continued to be limp and weak. Further examination confirmed a diagnosis of FS with no evidence of distal tubular dysfunction. Short-term alkaline and potassium infusion promptly improved her general condition, but it took two months to achieve complete biochemical resolution. uUTIs in young infants may be complicated by transient renal tubular dysfunction limited to proximal site and may last for weeks after control of the underlying infection has been achieved. Secondary transient FS should be considered when poor general activities persist following uUTIs in young infants even if their fever subsides promptly after use of appropriate antibiotic agents. Careful follow-up of patient recovery is crucial.

Background: Blunt trauma to the chest may cause respiratory-related severe disease because of the presence of vital organs such as the heart and lungs.

Case: A man in his 20s jumped from the roof of a five-story building and was transported to the hospital by ambulance. On arrival, he was in shock, with pulmonary contusion; left pulmonary artery injury and hemorrhage; left iliopsoas hematoma; burst fracture of the thoracolumbar spine; fractures of the right scapula, left clavicle, and first rib; and open fractures of the left tibia and fibula. Because of significant left pulmonary contusion and airway hemorrhage, isolated pulmonary ventilation was necessary, and selective embolization of the left upper lobe and lingular pulmonary artery was performed. Respiratory failure progressed after admission to the ICU. As there was possibility of injury to the inferior vena cava, a 27F double lumen catheter (DLC) was inserted from the right internal jugular vein and veno-venous extracorporeal membrane oxygenation (V-V ECMO) was performed without anticoagulant therapy. However, right severe pneumothorax appeared immediately after, which temporarily led to complete dependence on ECMO. On the 5th hospital day, the patient showed gradual improvement in oxygenation and was weaned from ECMO. The patient was discharged on the 31st hospital day.

Discussion and conclusion: The present patient was initially treated with isolated pulmonary ventilation and vascular embolization for traumatic respiratory failure; however, due to manifestation of contralateral lung injury, oxygenation ability decreased markedly, so we performed V-V ECMO with DLC. To the best of our knowledge, this is the first case in Japan in which separate lung ventilation and ECMO using DLC have been used in combination for the treatment of respiratory failure due to chest trauma. Our findings suggest that intensive care that includes ECMO should be considered for severe respiratory failure due to chest trauma.