Background and Aims : With the childbirth age becoming high in addition to the low birth rate in recent years, there is a growing perception that a child itself is a variable baby. With this, coupled with the increased safety of cesarean section, indications for cesarean section have been expanded. Previously we closely examined and studied the cases in which vaginal birth after cesarean section (VBAC) resulted in uterine rupture. Methods : Using 226 cases subjected to VBAC as the subjects, a retrospective analysis was made. Results : Uterine rupture (threatening uterine rupture, incomplete uterine rupture) occurred in 20 cases (8.9%) of the 226 cases of VBAC. Conclusion : Considering that medical suits for obstetric accidents are assuming a serious proportion, it is necessary to judge the situation properly and take steps suited to the occasion. In trying VBAC, utmost care is required, and it would be worthwhile to recommend elective cesarean section for the pregnant women who have the history of cesarean section.
We describe a 15-year-old Japanese boy with porokeratosis Mibelli with a unique clinical appearance. Two typical lesions were symmetrically distributed in the preauricular area bilaterally. An immunohistochemical study demonstrated CD1a+ /HLA-DR-cells in the lesion epidermis ; these were considered Langerhans cells with an abnormal phenotype. Since porokeratosis is believed to represent a clonal expansion of mutated epidermal cells, cutaneous mosaicism of keratinocytes may be involved in the development of this disease, in which the loss of HLA-DR antigen in Langerhans cells in the lesion allows the clonal expansion of abnormal keratinocytes. The symmetric distribution of the lesions in our case supports this hypothesis.
The major postoperative complications in rectal surgery are urinary retention and urinary tract infection. Although the pelvic autonomic nerve preserving procedure is performed, urinary dysfunction may still occur. In this article, we report a patient with rectal cancer who developed a postoperative urinary tract infection (UTI). An insufficient estimation of bladder function and frequent periodical bladder catheterizations were considered to be the cause of the UTI. In conclusion, the careful management of urinary tract complications is required in patients undergoing surgery for rectal cancer.