Leukemia autopsies in Japan

For the purpose to know whether the annual increase of leukemia incidence in Japan is due to some leukemogenic factors or due to the increased detection rate, the authors made some statistical survey of autopsy cases in which the diagnosis is reliable and not any type of leukemias escape the detection. The results showed that acute leukemias, which are found mostly in younger age, is actually increasing. In addition, it has been deduced that among the suspected factors the increase in ionizing radiation will be one of the most probable factors for the increase in leukemia incidence</p

Analysis of Acute Transfusion Reactions and Their Occurrence Times

Acute transfusion reactions (ATRs) are significantly relevant to the morbidity and mortality of patients. ATRs are mostly not severe and rarely cause severe conditions, including anaphylactic shock. The aim of this study was to clarify the frequency of ATRs and the time of event occurrence. A total of 18,745 transfusions were administered to 11,718 patients during a 3-year period. Adverse reactions including at least one sign or symptom were collected through a report system in 143 of 2,478 (5.7%) platelet concentrate transfusions, 105 of 6,629 (1.6%) red blood cell component transfusions and 51 of 2,307 (2.2%) fresh frozen plasma transfusions. Allergic signs and symptoms accounted for 70% of all adverse events. Severe signs and symptoms were observed in 7.1% of patients. These events appeared significantly earlier than those of non-severe signs and symptoms (median time 20 min vs 100 min, P < 0.05). For patients who have had repetitive transfusion-associated adverse events, preventive treatments for adverse events should be proactively promoted

A case with difficulty in airway management nevertheless switching from emergency tracheostomy to cricothyrotomy

深頸部膿瘍は時に急速な喉頭浮腫を来たし窒息に至ることもある救急疾患である．深夜に救急外来を受診し手術室にて気道確保中に窒息をきたし，院内コードブルー発動を経て救命し得た深頸部膿瘍の1例を経験したので報告する．症例は60代男性．増悪する咽頭痛，軽度の呼吸苦を主訴に当院へ救急搬送された来院後より次第に呼吸苦が増悪し，甲状軟骨内側の膿瘍および高度の喉頭浮腫を認め，気管切開による気道確保を計画した．術中，窒息が切迫した状態となり迅速に気道を確保するために輪状甲状膜切開に術式を切り替えた．しかし，呼吸苦から体動が多く不穏となりまた体動・出血に伴い窒息に至り，徐々に血中酸素飽和度が低下していった通常の手術続行が不可能となった段階で院内コードブルーを要請し，人員を集め，輪状甲状間膜切開・気道確保に成功した最終的には後遺症なく救命が可能であった

A Japanese retrospective study of non-tuberculous mycobacterial infection in children, adolescents, and young adult patients with hematologic-oncologic diseases

Non-tuberculous mycobacterial infection (NTM) is rare in healthy children, with lymphadenitis being the most common presentation. Immunocompromised populations are known to be at high risk, but the clinical picture of NTM infection in pediatric hematology/oncology patients is unclear. In this nationwide retrospective analysis of patients under the age of 40 treated in Japanese pediatric hematology/oncology departments who developed NTM infection between January 2010 and December 2020, 36 patients (21 patients with hematopoietic stem cell transplantation (HSCT) and 15 nontransplant patients) were identified. Post-transplant patients were infected with NTM at 24 sites, including the lungs (n = 12), skin and soft tissues (n = 6), bloodstream (n = 4), and others (n = 2). Nine of twelve patients with pulmonary NTM infection had a history of pulmonary graft-versus-host disease (GVHD), and rapid-growing mycobacteria (RGM) were isolated from five of them. In nontransplant patients, the primary diseases were acute lymphoblastic leukemia (ALL; n = 5), inborn errors of immunity (IEI; n = 6), and others (n = 4). All cases of ALL had bloodstream infections with RGM, whereas all cases of IEI were infected with slow-growing mycobacteria (SGM). In summary, three typical clinical scenarios for pediatric hematology/oncology patients have been established: RGM-induced pulmonary disease in patients with pulmonary GVHD, RGM bloodstream infection in patients with ALL, and SGM infection in patients with IEI. Our findings suggest that NTM must be regarded as a pathogen for infections in these high-risk patients, especially those with pulmonary GVHD, who may require active screening for NTM

社会体育実習授業に関する調査

The purpose of the this paper is to clarify our students needs to course of internship in sports buiseness. Students responded to questionnaire, which has 20 items. We examined the results. 1 Many studenst want to get information of their enterprises which accept them before their pracuticum. 2 Many students are satisfied with their internship and they recommnded this course for their juniors

社会体育実習授業に関する調査第2報

The purpose of the this paper is to clarify our students needs to internship course in sports buiseness. Students responded to a questionnaire which has 20 items.The following results were obtained. 1Many students want to get information of their enterprises which accept them before their pracuticum. 2 Many students are satisfied with their internship and they recommnded this course for their juniors