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Volume 72, Issue 4
Displaying 1-8 of 8 articles from this issue
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ORIGINALS
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Yasuo HARADA, Maho KOBAYASHI, Chie ITO, Misaki IKAMI, Yuka MISHIMA, Ei ...2023 Volume 72 Issue 4 Pages 299-306
Published: 2023
Released on J-STAGE: December 22, 2023
JOURNAL FREE ACCESSIn this study, we investigated the effects of severe hemolysis (hemoglobin [Hb] > 500 mg/dL) in blood specimens by classifying them into non-hemolysis, hemolysis (Hb ≤ 500 mg/dL), and severe hemolysis. Investigated items were total protein (TP), albumin (ALB), total bilirubin (T-Bil), direct bilirubin (D-Bil), aspartate transaminase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LD), alkaline phosphatase (ALP), gamma-glutamyl transferase (γ-GT), creatine kinase (CK), amylase (AMY), cholinesterase (ChE), blood urea nitrogen (BUN), creatinine (Cre), sodium (Na), potassium (K), chloride (Cl), calcium (Ca), uric acid (UA), triglycerides (TG), total cholesterol (T-Cho), high-density lipoprotein cholesterol (HDL-C), lowdensity lipoprotein cholesterol (LDL-C), and C-reactive protein (CRP), and actual clinical test results were used. Based on the results, we were able to classify the error relationships into three groups according to hemolysis status. Group A shows an error between non-hemolysis and hemolysis, and an even stronger error in severe hemolysis (T-Bil, AST, LD, Na, K, Ca, and UA). Group B showed no error between non-hemolysis and hemolysis, but errors in strong hemolysis (ALB, D-Bil, ALT, γ-GT, CK, AMY, TG, T-Cho, HDL-C, and LDL-C). Group C shows no errors in either hemolysis or strong hemolysis (TP, ALP, ChE, BUN, Cre, Cl, and CRP). Among these, the Group B classification was a new finding. In situations where the measurement of hemolyzed specimens is unavoidable, it is important that clinical laboratory technologists be aware of its impact and provide the results in a way that can be used in clinical practice.View full abstractDownload PDF (946K) -
Mamiko KURIYAMA, Makoto NAKAO, Ryosuke KINOSHITA, Hiroko KIYOTOSHI, Ma ...2023 Volume 72 Issue 4 Pages 307-313
Published: 2023
Released on J-STAGE: December 22, 2023
JOURNAL FREE ACCESSBackground: Cell blocks (CBs) from pleural fluid are frequently used in the practice of respiratory medicine, but there have been few reports on the use of CBs from forceps and brush washing fluid in bronchoscopy for pathological diagnosis. We retrospectively analyzed the usefulness of CBs from forceps and brush washing fluid.
Patients and Methods: Patients who underwent bronchoscopy and had CBs made from forceps and brush washing fluid in bronchoscopy at our institution between June 2016 and May 2021 were included. Cases in which additional information was obtained from CBs were reviewed in detail.
Results: In total, 138 patients had CBs made from forceps and brush washing fluid in bronchoscopy during the study period. EBUS-GS (endobronchial ultrasound-guide sheath) was used for 102 of these patients. The final diagnosis was lung cancer in 114 cases, infection disease in 10 cases, metastatic lung tumor in 8 cases, lymphoproliferative disease in 2 cases, sarcoidosis in 1 case, and organizing pneumonia in 1 case. There were 13 cases with additional information obtained from CBs, all of which were cases of malignant tumors.
Conclusions: CBs from forceps and brush washing fluid in bronchoscopy were useful for pathological diagnosis in some cases.View full abstractDownload PDF (939K)
CASE REPORTS
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Masamitsu TAKAGI, Kanako KIRIYAMA, Masaharu MIWA, Shinsuke IMAI, Masay ...2023 Volume 72 Issue 4 Pages 314-318
Published: 2023
Released on J-STAGE: December 22, 2023
JOURNAL FREE ACCESSIn recent years, plain X-ray CT has often been the first choice for imaging examination of acute abdomen in emergency medical settings. Ultrasound examination depends on the skill of the operator and the findings are subjective. However, we often experience cases in which more information can be obtained by abdominal ultrasonography than by plain CT. In this report, we describe two cases in which ultrasonography and plain CT imaging were performed in patients with right lower abdominal pain due to suspected abscess formation around the cecum. In the future, policies to reduce medical costs such as community healthcare initiatives may progress, and the number of facilities with high-priced medical equipment such as X-ray CT may decrease. Ultrasonography provides more information than simple CT examination, so we believe that ultrasonography should be the first choice for diagnostic imaging of acute abdomen. Therefore, it is important for those involved in ultrasonography to continuously acquire knowledge and scanning techniques.View full abstractDownload PDF (1878K) -
Takayuki KUGA, Masatoshi SHIGETA, Yuka YANO, Takahiro IKESHITA2023 Volume 72 Issue 4 Pages 319-324
Published: 2023
Released on J-STAGE: December 22, 2023
JOURNAL FREE ACCESSPregnancy and childbearing are important issues for female survivors of childhood, adolescent, and young adult (CAYA) cancer. Here, we report the case of a 38-year-old primiparous woman who had been treated with multimodal therapy for ovarian dysgerminoma in childhood. During junior high school, she had been admitted to our hospital complaining of abdominal distension, fever, and dyspnea. A massive abdominal tumor was found, and she was referred to a university hospital for treatment. Ovarian tumors suspected to be ovarian dysgerminoma were diagnosed, and right oophorectomy with lymph node dissection was performed. The left ovary was preserved. Postoperative histologic examination revealed ovarian dysgerminoma with class V ascites cytology, indicating Stage IIIc disease. The postoperative course was uneventful. Following surgery, she received bleomycin, etoposide phosphate, and cisplatin chemotherapy. Menarche occurred 12 years after surgery. She visited a gynecology clinic 24 years and 9 months after surgery because of suspected pregnancy. Pregnancy was confirmed, and she gave birth by vaginal delivery at a gestational age of 35 weeks + 1 day. Both the patient and child are now in good health. Fertility is an important consideration for CAYA cancer survivors. In cases of CAYA cancer, it is important to make treatment decisions together with patients with due consideration given to survival and fertility.View full abstractDownload PDF (1947K) -
Naoyuki KUROIWA, Koji TAKAHASHI, Kentarou SHIRAI, Shota TAKAHASHI, Shi ...2023 Volume 72 Issue 4 Pages 325-331
Published: 2023
Released on J-STAGE: December 22, 2023
JOURNAL FREE ACCESSLow-grade epilepsy-associated tumors (LEAT) are brain tumors that should be differentiated as a cause of symptomatic epilepsy in children. The most common initial symptom is epileptic seizure, particularly focal seizures. We present a case of LEAT in which an infant presented to our department with convulsive-like seizures that were observed from approximately 3 months of age. At the first visit, growth and development, including head circumference, were appropriate for age. The seizures were atypical, but ictal video electroencephalography showed abnormal waves indicative of left hemispheric epilepsy. The patient subsequently presented with somnolence and poor feeding, and a sudden increase in head circumference and hydrocephalus were observed. Thus, the patient was urgently admitted to the neurosurgery department of our hospital. Brain MRI showed a suspected brain tumor and elective craniotomy was performed. No epileptic seizures were observed postoperatively. When focal epileptic seizures are observed in infancy, a brain tumor should also be considered as a differential diagnosis, and further examination may be warranted.View full abstractDownload PDF (3446K) -
A Case of Successful Pleurodesis for Bilateral Pneumothorax and Pneumoperitoneum After EsophagectomyYayoi SAKATOKU2023 Volume 72 Issue 4 Pages 332-338
Published: 2023
Released on J-STAGE: December 22, 2023
JOURNAL FREE ACCESSThe patient was an 83-year-old man who had undergone thoracoscopic subtotal esophagectomy 1 year and 6 months earlier with no evidence of recurrence. He was hospitalized for heart failure. On day 6 of hospitalization, a plain chest X-ray revealed bilateral pneumothorax and bilateral subdiaphragmatic free air, and CT showed a large amount of free air in the abdominal cavity. Gastrointestinal perforation was ruled out because of the absence of both abdominal findings and an elevated inflammatory response. Because the patient had a history of surgery for esophageal cancer, we assumed that air from the right spontaneous pneumothorax had disseminated into the contralateral thoracic and abdominal cavities. Therefore, a right chest drain was inserted. Air leakage persisted despite improvements in both collapsed lungs and the disappearance of intraperitoneal free air. No improvement was observed even after performing pleurodesis with autologous blood and glucose solution. Surgery was deemed challenging due to the patient’s low heart function; thus, pleurodesis was performed again using OK-432, which ameliorated the pneumothorax. To our knowledge, there have been no Japanese reports of pleurodesis using OK-432 for pneumothorax after esophagectomy.View full abstractDownload PDF (1659K) -
Kazushi OTA, Takatomo TESAKI, Noriaki SEKIYA, Rie KINUGASA, Makoto OYA ...2023 Volume 72 Issue 4 Pages 339-344
Published: 2023
Released on J-STAGE: December 22, 2023
JOURNAL FREE ACCESSWe encountered a case in which decreased cardiac afterload due to intra-aortic balloon pumping (IABP) caused left ventricular outflow tract obstruction (LVOTO), resulting in cardiogenic shock in a patient with hypertrophic obstructive cardiomyopathy (HOCM). The patient was a woman in her 60 with HOCM and angina, which were had been diagnosed before endometrial cancer surgery. An intra-aortic balloon pump was placed before surgery to maintain coronary artery blood flow, and increases in diastolic blood pressure were observed. However, she went into shock upon induction of anesthesia and required a large dose of vasopressor. The patient remained in shock after surgery and was admitted to the ICU while unresponsive and intubated. Transthoracic echocardiography showed LVOTO and mitral regurgitation, indicating the possibility that lowered cardiac afterload by IABP caused LVOTO. Discontinuation of IABP resulted in striking recovery from shock such that no vasopressor was required, and echocardiography findings improved. Although IABP offers a variety of benefits such as maintenance of coronary artery blood flow, we should keep in mind that decreased cardiac afterload due to IABP may cause LVOTO in patients with HOCM.View full abstractDownload PDF (1394K)
REGIONAL MEETING
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2023 Volume 72 Issue 4 Pages 345-354
Published: 2023
Released on J-STAGE: December 22, 2023
JOURNAL FREE ACCESSDownload PDF (945K)
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