Jichi Medical University Institutional Repository
Not a member yet
1006 research outputs found
Sort by
Ingenuity and issues related to emergency blood transfusion on a small and extremely remote island (Hahajima, Ogasawara Islands)
Get PDF小笠原村母島は小規模な超遠隔離島である。当診療所は母島で唯一の医療機関で全科対応を行っているが，医療スタッフは医師１名看護職員３名と少ない。おもに急性出血性病態への対応を目的としBlood Rotation System（BRS）が2018年９月から導入された。当院での緊急輸血対応を行う上で課題点は臨床検査技師の不在，輸血前検査は医師監督下で看護職員が実施することだった。今回，急性貧血および循環血液量減少性ショックを呈した59歳男性に対し，母島でBRSが導入されてから備蓄血を初めて使用した。備蓄血使用１週間前にHb11.8g/dlだったが，Hb5.8g/dlまで低下しており急性貧血を考慮し備蓄血の輸血をおこなった。全身状態を維持することが可能になり高次医療機関への緊急搬送をおこなうことができた。本症例を通し，小規模離島診療所での緊急輸血対応において，事前訓練実施という工夫点の有用性と，原因検索の検査実施の困難さ，症例による輸血単位数不足の可能性といった課題点が分かった。departmental bulletin pape
Current status of sperm cryopreservation for fertility preservation prior to cancer treatment at Jichi Medical University Hospital
Get PDFObjective: The objective of this study was to clarify the current status of sperm cryopreservation for fertility preservation prior to cancer treatment at Jichi Medical University Hospital.
Target population and methods: Retrospective analysis of the medical records of patients who underwent sperm cryopreservation at our Center for Reproductive Medicine prior to cancer treatment was done.
Results: Thirty-two patients who underwent sperm cryopreservation between May 1997 and January 2019 were included. The median age at the time of storage was 32 years old (15–52 years). Twenty patients were married and twelve were not married. The primary underlying diseases were hematologic malignancies in 13, gastrointestinal malignancies in 5, germ cell tumors in 4, respiratory malignancies in 4, brain tumors in 2, rhabdomyosarcoma in 2, and urological malignancies in 2 patients. There were 9 patients (28.1%) whose sperm were utilized in intracytoplasmic sperm injection (ICSI), but all did not result in live birth.
Discussion: During a period of about 22 years, sperm cryopreservation for fertility preservation was performed in 32 patients at our institution. This number is comparatively less than those mentioned in previous reports. The reasons for this were as follows: there was a lack of a consultation system, there was an assisted reproductive technology clinic close to our institution, and there was a lack of consideration for fertility preservation by physicians treating cancer. However, the storage number increased after the establishment of a regular consultation system, and this suggested the importance of establishing a system in medical institutions.departmental bulletin pape
A CASE OF IDIOPATHIC INTUSSUSCEPTION COMPLICATING ULCERATIVE COLITIS TREATED WITH LAPAROSCOPIC RESECTION
Get PDF症例は30歳代女性。潰瘍性大腸炎に対し内服治療中であった。間欠的な腹痛を主訴に救急外来を受診した。腹部造影CT検査で盲腸，上行結腸が横行結腸に重積する像を認め，腸重積症と診断し同日緊急手術を施行した。腹腔鏡で観察したところ，盲腸の後腹膜への固定が弱く，盲腸が上行結腸内に重積していることを確認した。小開腹し腹腔外で重積を解除すると盲腸に弾性軟な腫瘤を触知し，同部位を先進部とする腸重積症と判断した。悪性腫瘍の可能性も考慮しリンパ節郭清を伴う腹腔鏡補助下回盲部切除術を施行した。病理所見では盲腸の粘膜下層に鬱血を認めたが，悪性所見，潰瘍性大腸炎に伴う炎症の所見はなく特発性腸重積症と診断した。departmental bulletin pape
