Surgical treatment of abdominal aortic aneurysms in elderly patients aged over 90 is rare, and the surgical indications in such patients is controversial. Two cases of abdominal aortic aneurysm successfully treated surgically are reported. The first case was a 92-year-old woman, who manifested a severe abdominal pain without hypotension. An impending rupture of an abdominal aortic aneurysm was suggested on enhanced CT scan, and emergency surgery was indicated. The aneurysm was replaced with a woven Dacron Y-graft. Postoperatively, the patient's social activity returned to the preoperative level. The second case was a 91-year-old man, in whom an increasing abdominal aortic aneurysm had been pointed out on UCG and enhanced CT scan. Because he was socially very active for his age, elective surgery was indicated. The aneurysm was resected and replaced with a woven Dacron I-graft. Postoperatively, the patient overcame a respiratory complication and was eventually discharged without any physical complication. Although he was able to climb mountains before the surgery, he lost some physical activity after the surgery. Because of the potential decrease in physical strength especially in very elderly patients, the general risk evaluation did not always correspond to a precise evaluation and prediction of postoperative activity. It is therefore necessary to be flexible in deciding on the surgical indications in each case.

Introduction
Floods are the most common natural disaster. Although infectious diseases are paid attention in flood settings, public health impact from other diseases has been rarely discussed. In Thailand, a large-scale flood disaster severely affected local people and the societies mainly in the North and Central regions due to unusual heavy rain in 2011. To provide information on health issues from a prolonged flood, we reported the health issues among the patients in several areas of Thailand where a flood lasted more than 1 month.
Methods
Data on the patients were extracted from records of the collaborated activities between two NGOs in Thailand and Japan in three areas of two provinces in the Central region at the end of November, 2011. The data on the venues were also abstracted: main stations for medical care in three areas and mobile clinics at evacuation centers (tent, temple, and school) in two areas. We evaluated distributions of health issues, and examined the characteristics of the distributions stratifying by place and patients' age.
Results
High prevalence was observed for muscle and joint pain, chronic diseases, and acute respiratory infections. Among patients with the infections, 96 % or more was those with upper respiratory infections. In the evacuation centers, the prevalence of acute respiratory infections was high (39 %) at school compared to that at other places. The prevalence of muscle and joint pain sharply increased among patients in their 30's, which was highest among those in their 40's and 50's.
Conclusions
Muscle and joint pain, chronic diseases, and acute respiratory infections were main issues in this flood setting. This study would provide information on potential health issues in the coming floods. Future research is needed to examine whether an occurrence of flood disaster could be associated with increased risk of muscle and joint pain.

Anthropometry measurements, such as height and weight, have recently been used to predict poorer birth outcomes. However, the relationship between maternal height and birth outcomes remains unclear. We examined the effect of shorter maternal height on low birth weight (LBW) among 17,150 pairs of Japanese mothers and newborns. Data for this analysis were collected from newborns who were delivered at a large hospital in Japan. Maternal height was the exposure variable, and LBW and admission to the neonatal intensive care unit were the outcome variables. Logistic regression models were used to estimate the associations. The shortest maternal height quartile (131.0-151.9 cm) was related to LBW (OR 1.91 [95% CI 1.64, 2.22]). The groups with the second (152.0-157.9 cm) and the third shortest maternal height quartiles (158.0-160.9 cm) were also related to LBW. A P trend with one quartile change also showed a significant relationship. The relationship between maternal height and NICU admission disappeared when the statistical model was adjusted for LBW. A newborn's small size was one factor in the relationship between shorter maternal height and NICU admission. In developed countries, shorter mothers provide a useful prenatal target to anticipate and plan for LBW newborns and NICU admission.
Adult ; *Body Height ; Body Mass Index ; Female ; Hospitals ; Humans ; *Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; Japan ; Logistic Models ; Male ; Mothers/*statistics & numerical data ; Odds Ratio ; Risk Factors ; Weight Gain

The breakage of an epidural catheter is an extremely rare complication. We describe a unique case where a retained epidural catheter fragment after epidural anesthesia was treated by surgery. The epidural catheter broke during its removal, requiring surgery to remove the retained catheter. Intraoperatively, the removal of the catheter was attempted by simple traction, but was impossible because of the adhesion. The adhesion of the dura mater surface was carefully exfoliated and the successful removal of the catheter was accomplished. Conventionally, it was said that this follow-up was enough for the retained catheter. However, if a catheter is retained within the spinal canal, surgical removal should thus be considered before the adhesion advances.
Anesthesia, Epidural ; Catheters* ; Dura Mater ; Follow-Up Studies ; Spinal Canal ; Traction

　　Since February, 2012, Anjo Kosei Hospital has embarked upon a new scheme for efficiently handling narcotics during surgical operations. For the purpose pharmacists are allowed to enter the operating room for a while. At the same time, the implementation of digital record keeping for narcotics management tasks has started, making it possible to simplify the handling of a great number of patients. By reviewing the effects on narcotics handling and hours billed, we could determine the effectiveness of operating room pharmacist-led narcotics management at Anjo Kosei. Out of narcotics prescriptions (n＝647) handled in the operating room for one month, 84.7% (548/647) was accounted for by prepared narcotics and 99.8% (646/647) by post-operation management. The introduction of the digital record system resulted in a reduction from 53.3±9.6 minutes to 39.6±6.3 minutes for narcotics preparation, and a reduction from 66.8±16.1 minutes to 41.1±13.5 minutes for post-operation management (p<0.01). It has added to the work efficiency and simplification of operations. Moreover, due to the intervention of pharmacists in the operating room, 92.3% of narcotics prescriptions was performed using the new management system within a relatively short time (80.8±18.4minutes). These data show that the introduction of the new scheme has resulted in more efficient management of narcotics at Anjo Kosei.