The Qualitative Analysis of Effective Work of Mourning by Victims' Family

平成13年6月8日に附属池田小学校で発生した児童殺傷事件の被害者遺族の一人である本郷由美子さんの手記『虹とひまわりの娘』を分析素材として、どんな悲嘆の対処法や社会的サポートがモーニングワークの促進に有効であるのかを探索的に探ることを研究の目的とした。加えて、「死者を殺す」というラガーシュ仮説の妥当性に関する若干の検討を行った。その結果、モーニングワークを通して親子の「絆」の結び直しがはかられ、娘に対する「愛の物語」が生成されていった過程が明らかになった。This paper is the study about victims' family of the murder case in Ikeda elementary school. The purpose of this study was to explore that what kind of coping behavior and social support. facilitate effective mourning work. In addition, Validity of Lagache hypothesis that a bereaved kills internally a deceased was discussed. It emerged that the mother has generated a love story between her and a deceased daughter through writing memoirs, and her mourning work has facilitated reunion of a bond of affection between them

Failure of Hem-o-lok clips

Hem-o-lok clips are commonly used for renal artery ligation in laparoscopic renal surgery. However, failure of the renal artery ligation clips is potentially fatal. A 61-year-old man underwent hand-assisted laparoscopic nephroureterectomy using a retroperitoneal approach for left ureteral carcinoma. One hour postoperatively, he was diagnosed with hemorrhagic shock. An immediate laparotomy revealed two closed, undamaged Hem-o-lok clips around the left renal artery. Pulsatile bleeding was observed, and the renal artery was immediately ligated with non-absorbable thread. We determined that the failure of the Hem-o-lok clips on the renal artery was caused by the lack of space between the two Hem-o-lok clips and the distal renal artery cuff beyond the distal clip. To prevent a potentially fatal failure of the renal artery ligation clips, one should maintain a sufficient space between the Hem-o-lok clips and an adequate distal renal artery cuff beyond the distal clip

Compartment Syndrome after Prostatectomy

Robot-assisted laparoscopic prostatectomy (RALP) for prostate cancer was introduced in 2000 and rapidly gained popularity. The Da Vinci Surgical System® can ensure improved local control of cancer and fewer perioperative complications. However, RALP is performed in the steep-Trendelenburg position (a combination of lithotomy and head-down tilt position / Lloyd-Davies position) to obtain a good surgical view, and as a result, well leg compartment syndrome (WLCS) can become a serious complication of RALP. Here, we report a case of WLCS after RALP. A 75-year-old man underwent surgery for prostate cancer and immediately complained of pain and numbness after surgery. The pressure of the four leg compartments increased. Ultimately, we diagnosed the patient with WLCS in his right leg, and an emergency fasciotomy was performed. He completely recovered with no permanent disability and was discharged one month after rehabilitation. Although WLCS after RALP is a rare and severe complication, the patient recovered completely with early diagnosis and intervention. Measuring the compartment pressure is useful when the patient is drowsy immediately after recovery from anesthesia. Preventing WLCS requires identifying this condition as a potential complication of RALP and all urologic surgeries performed in the lithotomy position

Rhabdomyolysis after Retroperitoneal Laparoscopic Radical Nephrectomy in the Lateral Decubitus Position

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Urothelial carcinoma in a pyelocaliceal diverticulum discovered by magnetic resonance urography

Neither computed tomography (CT) nor intravenous pyelography (IVP) alone can diagnose tumors of renal pelvic diverticula, but magnetic resonance urography (MRU) can obtain accurate preoperative information

Efficacy and Safety of Transurethral Enucleation with Bipolar Energy for Treatment of Benign Prostatic Hyperplasia: Does Prostate Volume Matter?

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Contribution of bone marrow-derived cells to reparative dentinogenesis using bone marrow transplantation model

The aim of this study was to analyze the contribution of bone marrow–derived cells (BMDCs) to reparative dentinogenesis using bone marrow transplantation (BMT) and pulp capping as an in vivo model. A chimeric mouse model was created through the injection of BMDCs expressing green fluorescent protein (GFP+ BMDCs) from C57BL/6 GFP+ transgenic donor mice into irradiated C57BL/6 wild-type recipient mice (GFP− mice). These GFP− chimeric mice (containing transplanted GFP+ BMDCs) were subjected to microscopic pulp exposure and capping with white mineral trioxide aggregate (n = 18) or Biodentine (Septodont, St Maur-des-Fossés, France) (n = 18) in the maxillary first molar. Maxillary arches from GFP− chimeric mice (with the capped tooth) were isolated and histologically processed 5 (n = 9) and 7 (n = 9) weeks after BMT. Confocal laser microscopy and immunohistochemical analysis were performed to assess the presence of GFP+ BMDCs and the expression of dentin sialoprotein, an odontoblast marker, for those cells contributing to reparative dentinogenesis in the dental pulp. Confocal laser microscopic analyses evidenced the presence of GFP+ BMDCs in close association with reparative dentin synthesized at the site of pulp exposure in GFP− mice 5 and 7 weeks after BMT. Immunohistochemical analysis revealed that GFP+ BMDCs in close association with reparative dentin expressed DSP, suggesting the contribution of nonresident GFP+ BMDCs to reparative dentinogenesis. These data suggest the presence of nonresident BMDCs in reparative dentinogenesis and its contribution to dental pulp regeneration in the pulp healing process463404412FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP2013/50251-0; 2014/18623-