A strong earthquake (magnitude 6.8) off the Sea of Japan struck the Chuetsu area of Niigata Prefecture on July 16, 2007. By way of investigating the impact of the earthquake on the health of maintenance hemodialysis patients, we examined several biochemical parameters including nutritional markers and psychological stress markers and checked up on the incidence of earthquake-induced complications (heart failure and shunt obstruction). Blood samples were collected and the values of several biochemical parameters were measured. Incidences of clinical complications one, three and six months after the quake were scrutinized. Significant decreases in the nutritional markers and a significant increase in the incidence of complications were found one month after the quake. During this period, the supplies of electricity, city gas and water were completely recovered one after another. The significant changes in the nutritional levels and the incidence of complications coincided with the time of the complete recovery of these utilities. The levels of these parameters recovered and the incidence of complications reduced three months after the quake. However, the serum albumin level did not recover and remained significantly lower even six months after. The psychological stress markers increased significantly three months after. These suggested that there was the time lag between the decrease in the nutritional markers, the increase in the incidence of complications (1 month after earthquake) and the increases in the psychological stress markers (3 months after earthquake). We concluded that these findings provided important information for the total medical plan to maintain the physical and psychological states of hemodialysis patients in an earthquake- stricken district.
month ; Complications Specific to Antepartum or Postpartum ; Earthquakes ; incidence of cases ; Hemodialysis

Percutaneous endoscopic gastrostomy (PEG) is a common procedure for placing a feeding tube in the stomach to provide fluids and nutrition to patients who have difficulty in swallowing or in taking enough noutrishment through the mouth. Thought the procedure is simple and easy, PEG is not without its risks. The reported complication ratio is not low-, -between 5.7% and 33.3%. This is probably because the patients are lacking in reserves of physical faculties.The present study was conducted to work out measures to reduc the incidence of PEG complications by reviewing the complications cases treated in our hospital.From March 1997 to December 2005, we performed PEG on 110 patients, of which 11 patients (9.6%) had complications. In some cases, we inadvertently perforated the colon. From our experience, we have learned that it is not safe to perform PEG with the aid of radiography alone on cases in which the intervention of the transverse colon between stomach and abdominal wall was suspected by CT scan, and concluded PEG should be done using gastrography of the transverse colon, to guide the placement of a feeding tube in the stomach. In view of the systemic condition of the patients, we thought it necessary to take safety measures by all possible means.
Percutaneous endoscopic gastrostomy ; Complications Specific to Antepartum or Postpartum ; Stomach ; Management ; Prevention

The conventional management of scalp laceration has its drawbacks. Most patients complain of scalp itching, sticky hair and pain at the time of dressing change, because the washing of the hair is restricted and the wound is covered with gauze before the patients have their stitches removed. In this paper, we report the results of trial given to a new management method. The wound was exposed to the air two days after suturing and washing the hair was allowed at the same time. The trial involved 40 outpatients with scalp laceration. There were no complications of wound infection or delayed healing due to this method. And also most patients (90%) said they felt comfortable. Thus, as an alternative management of scalp laceration this method proved useful for comfortable wound treatment.
Scalp ; Laceration ; Injury wounds ; Hair ; Complications Specific to Antepartum or Postpartum

Objective: Recently, holmium laser enucleation of the prostate (HoLEP) has been established as one method of endoscopic surgery for the treatment of benign prostate hyperplasia (BPH). The purpose of our study was to assess initial clinical experiences with HoLEP at our hospital.;Patients and Methods: A retrospective analysis was conducted of 28 patients with obstructive symptoms due to BPH who underwent HoLEP during the 13 months between February 2004 and March 2005.;Results: The mean age of the patients was 67.4 years (range 59 to 78 years). The mean enucleation tissue weight was 24.3 g (range 2 to 95 g), and the average operation time was 94.1 minutes (range 40 to 268 minutes). The mean duration of postoperative catheterization was 3.4 days (range 1 to 6 days). The mean urine flow rate improved, and each patient's satisfaction for voiding, measured on a 5-point scale, was good. There were no major complications during the operations except one case, which was completed with TUR-P because of uncontrollable bleeding. No patients required transfusions. Long-term complications included five cases of stress incontinence (19%), four of urethral stricture (14%), and three temporary retention, two of which required re-catheterization (10%).;Conclusion: HoLEP can be performed without major intraoperative complications. It is an effective treatment for obstructive symptoms due to BPH. However, there are many postoperative problems that must be resolved, including stress incontinence and urethral stricture because of our lack of experience, with HoLEP.
Enucleation ; Prostatic Hypertrophy, Benign ; Complications Specific to Antepartum or Postpartum ; Lasers ; Holmium

We treated a case with bilateral pneumothorax. A 58-year-old woman was treated with acupuncture on the back, neck and chest for poor general condition, and later complained chest discomfort and respiratory difficulty. She was transferred to our center. Her consciousness was clear, blood pressure was 200/110mmHg, pulse rate was 151/minute, respiration rate was 36/minute, and she presented with a cold sweat with no cyanosis, as well as respiratory sounds in both sides of her chest. Cardioechography and electrocardiogram showed no abnormality, and blood examination showed few abnormalities except leukocytosis. Arterial blood gas analysis showed pH 7.215, PaO2 118.7mmHg, and PCO2 63.9mmHg. We made a diagnosis of bilateral pneumothorax upon chest x-ray examination with information from her previous clinic, and performed bilateral thoracic drainage. Arterial blood gas then improved to pH 7.326, PaO2 181.6mmHg, and PCO2 42.8mmHg. She became asymptomatic, recovered, and was discharged on the 13th hospital day. Commonly a patient, who has complications such as pneumothorax after acupuncture therapy, is managed by doctors other than acupuncture therapists. The management of complications after acupuncture therapy is thought insufficient, and under-developed. It is necessary to qualify informed consent, and to better establish cooperation between acupuncture therapists and doctors who managing such complications.
Acupuncture ; Right and left ; Thorax ; Complications Specific to Antepartum or Postpartum ; Pneumothorax

Indication for pediatric tracheostomy has changed. Upper airway obstruction secondary to infectious disorders is no longer the commonest indication. The aim of this study was to establish data on indications, outcome and complications of pediatric tracheostomy. A retrospective analysis of pediatric tracheostomies carried out between March 2002 to March 2004 was done. Eighteen patients were identified. The commonest indication was prolonged ventilation (94.5%) followed by pulmonary toilet (5.5%). None was performed for upper airway obstruction. Postoperative complications were encountered in six patients (33.3%), the commonest being accidental decannulation notably in children less than six years of age. Twelve patients (66.6%) were successfully decannulated. The mortality rate was 16.6%. All death were non tracheostomy related. The commonest indication for tracheostomy was prolonged ventilation and tracheostomy in children is relatively safe despite complications.
Tracheostomy procedure ; Complications Specific to Antepartum or Postpartum ; Universities ; trends ; Obstruction

A retrospective analysis of 15 cases intracanalicular acoustic neuroma that undergone tumour excision by translabyrinthine approach spanning from August 1996 until December 2002 is presented. The main presenting complaints are unilateral hearing loss (100%) and tinnitus (86.7%). The mean age of presentation was 48.5 years old. Magnetic resonance imaging is the most important investigation tool to diagnose acoustic neuroma. At six months post operatively, the facial nerve was normal or near normal (grade I and II) in 46.6%, grade III to IV in 46.6% and grade V to VI in 6.7% of the cases respectively. There were also four cases of post operative cerebrospinal fluid leak, which was successfully managed with conservative measures. The translabyrinthine approach is the most familiar surgical technique employed by otologist. It is the most direct route to the cerebellopontine angle and internal auditory canal. It requires minimum cerebellar retraction. However, it sacrifices any residual hearing in the operated ear.
Neuroma, Acoustic ; Grade ; seconds ; Complications Specific to Antepartum or Postpartum ; sacrifice