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Volume 72, Issue 1
Displaying 1-6 of 6 articles from this issue
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ORIGINAL
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Natsuki YATABE, Rie KITANO, Fumiko TSUBATA, Shiho KANEKO, Shiho TAKEUC ...2023 Volume 72 Issue 1 Pages 1-10
Published: 2023
Released on J-STAGE: July 08, 2023
JOURNAL FREE ACCESSPlacenta accreta spectrum (PAS) disorders may lead to massive postpartum hemorrhage but optimal treatment strategies have yet to be determined. This retrospective analysis involved 35 cases of PAS that occurred at our hospital between January 2014 and November 2021. Mean maternal age was 37 (21-43) years and 8 pregnancies were the result of assisted reproductive therapy. Fifteen patients had placenta previa, 12 had a history of cesarean delivery, and one had a history of PAS. Mean gestational age was 36 (26-41) weeks. Twenty deliveries were by cesarean section and 15 were vaginal deliveries. Mean blood loss was 2,970 (300-14,727) mL. Nine patients were treated by manual placenta removal, one of whom had a delayed hysterectomy because of bleeding. Eleven patients were treated by cesarean hysterectomy and 2 were treated by curettage. Thirteen patients were treated by conservative management, and in 3 of them, treatment was changed to curettage, abdominal placenta resection, or hysterectomy because of vaginal bleeding or intrauterine infection. Four patients thought to have PAS before delivery were treated by cesarean hysterectomy and the amount of bleeding was not severe. Conservative treatment for placenta accreta was successful in 10 patients (77%), and the uterus could be preserved in 12 women (92%). In cases thought to be PAS before delivery, if the placenta is not removed, cesarean hysterectomy should be selected. Conservative management tends to be selected in cases of PAS when the main part of the placenta can be removed. However, in cases of life-threatening hemorrhage or infection, clinicians might need to perform peripartum hysterectomy or uterine artery embolization when bleeding or infection occurs. Therefore, clinicians should obtain informed consent for such treatment in advance.View full abstractDownload PDF (944K)
RESEARCH REPORTS
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Manabu MAEDA2023 Volume 72 Issue 1 Pages 11-17
Published: 2023
Released on J-STAGE: July 08, 2023
JOURNAL FREE ACCESSStatistical analysis of bee stings was carried out for patients who visited Hachiman Hospital during the 7-year period from April, 2015 to October, 2021. Of 234 total cases, 223 were analyzed (105 men, 118 women;age 44.6±21.8 years; range 7-97 years). The mean number of cases per year was 30, although there were twice as many in 2016 when the rainfall was low. August was the month with the most cases, and most bee stings occurred in the morning. Most patients were stung only once, and the most common sites were the hands, followed by the upper extremities, head, face, lower extremities, trunk, feet, and neck. Erythema and swelling were the most common clinical manifestations, followed by petechiae, purpura, and vesicles (erosion). Systemic symptoms were observed in 19 cases (8.1%), including pharyngeal swelling, pruritis, urticaria, and fatigue. Swelling was the most common clinical manifestation in patients stung by paper wasps, but a wide range of symptoms were observed in patients stung by hornets. Effective treatment were corticosteroids (p.o. and ointment), anti-allergic medicines (p.o), biscoclaulin alkaloid (cepharanthine;20-30 mg injection), and kampo medicine (Saireito 7.5 g/day).View full abstractDownload PDF (1141K) -
Shimon NASU, Makoto MOTOMIYA, Naoya WATANABE, Kazuhiro YAMAMOTO, Hayat ...2023 Volume 72 Issue 1 Pages 18-25
Published: 2023
Released on J-STAGE: July 08, 2023
JOURNAL FREE ACCESSWhen treating finger, hand, and elbow trauma (hereinafter, surgically treated hand trauma) in self-employed farmers, it is also necessary to consider how the patient will be able to continue working in the family business. This study investigated return-to-work outcomes of self-employed farmers in the Tokachi area in Hokkaido, Japan after surgically treated hand trauma. A survey was conducted with 56 self-employed farmers (39 men and 17 women, median age 55 years). More than 80% of the farmers (n = 49) returned to their previous work, and most returned to work during the farming season while still experiencing functional impairment. Self-employed farmers with surgically treated hand trauma tend to return to work in time for the farming season regardless of the severity of functional impairment they are experiencing, and it is important for health care providers to recognize this fact and consider return-to-work support as part of the treatment plan in addition to treatment itself. Therefore, providers must understand the processes and details of tasks performed during each farming season and devise individualized measures to accommodate patients returning to work while still experiencing impairment. In cases where multiple treatments are required, such as two-stage functional reconstruction, it is also important that the treatment plan consider the farming season, for example, by having the patient temporarily return to work and then undergo surgery during the off season.View full abstractDownload PDF (1321K)
CASE REPORTS
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Wakana NAKATSU, Shigeki NISHIHIRA2023 Volume 72 Issue 1 Pages 26-29
Published: 2023
Released on J-STAGE: July 08, 2023
JOURNAL FREE ACCESSMyxoma is a benign soft-tissue tumor that rarely occurs in the head and neck region. Here we report a case of laryngeal myxoma in a 60-year-old man who presented with the chief complaint of progressive hoarseness beginning 5 years earlier. Fiberscopic examination of the larynx revealed a solid mass involving the left vocal cord or left laryngeal ventricle.
During laryngomicrosurgery, the mass was located in the left vocal cord. The elastic mass was diagnosed as a myxoma. His postoperative course was uneventful and he is currently free from disease at 1 month after surgery, but careful follow-up is necessary.View full abstractDownload PDF (1363K) -
Hiroshi NAKANO, Ryo KANOUDA, Masashi KANAZAWA2023 Volume 72 Issue 1 Pages 30-36
Published: 2023
Released on J-STAGE: July 08, 2023
JOURNAL FREE ACCESSThe patient was a 75-year-old man with advanced rectal cancer underwent abdominoperineal resection and lymph node dissection as conversion surgery after chemotherapy. Intraoperatively, lateral lymph node metastasis was evident in internal iliac vasculature and was deemed unresectable, so chemotherapy was continued after the operation. Due to an elevation in tumor markers and the appearance of lung metastasis, S-1 + irinotecan + bevacizumab therapy was performed as third-line therapy. On day 22 of the third course, he was transported to our hospital with abdominal pain and nausea. Contrast-enhanced computed tomography revealed adhesive bowel obstruction, and chemotherapy was discontinued. Restlessness and diplopia appeared after admission, and magnetic resonance imaging showed a high-intensity area on T2-fluid attenuated inversion recovery images, mainly in the occipital lobe. Because neurological symptoms and imaging findings improved with symptomatic treatment, we diagnosed him with posterior reversible encephalopathy syndrome. Although this disease can develop in association with chemotherapy and, for example, eclampsia, sepsis, renal failure, and autoimmune disease, it is rare and we report this case together with a review of the literature.View full abstractDownload PDF (1605K)
REGIONAL MEETING
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2023 Volume 72 Issue 1 Pages 37-43
Published: 2023
Released on J-STAGE: July 08, 2023
JOURNAL FREE ACCESSDownload PDF (830K)
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