〈Case Reports〉HELLP syndrome at 22 weeks of gestation with resulting stillbirth and a favorable outcome in a subsequent pregnancy: A case report

[Abstract]HELLP syndrome, characterized by hemolysis,elevated liver enzymes, and low platelets,is one of the diseases related to hypertension in pregnancy. If the pregnancy is not terminated soon after HELLP is diagnosed, liver failure or disseminated intravascular coagulopathy (DIC)may occur. HELLP syndrome occurs in 0.2%–0.9% of all pregnancies; Onset before 24 weeks of gestation is extremely rare but is more likely to result in stillbirth. Women who have had a stillbirth often hope for another pregnancy soon after,but there is little information about the risks and outcomes for subsequent pregnancy in women who developed HELLP syndrome in early pregnancy.Thus, it is important to accumulate data on these outcomes in this population. Here, we report a case in which severe HELLP syndrome developed at 22 weeks of gestation, resulting in stillbirth, and was followed six months later by a pregnancy that with early intervention, produced a live birth

Risk factors for future osteoporosis in perimenopausal Japanese women

近畿大学Kindai University博士（医学）主査：今野弘規 教授　　学内授与番号：医第1404号 Akiko Kanto, Yasushi Kotani, Kosuke Murakami, Junko Tamaki, Yuho Sato, Sadanobu Kagamimori, Noriomi Matsumura, Masayuki Iki”Risk factors for future osteoporosis in perimenopausal Japanese women" Menopause, Vol.29, No 10, p.1176-1183. doi: 10.1097/GME.0000000000002034 掲載doctoral thesi

Risk factors for future osteoporosis in perimenopausal Japanese women

主査：今野弘規 教授　　学内授与番号：医第1404号 Akiko Kanto, Yasushi Kotani, Kosuke Murakami, Junko Tamaki, Yuho Sato, Sadanobu Kagamimori, Noriomi Matsumura, Masayuki Iki”Risk factors for future osteoporosis in perimenopausal Japanese women" Menopause, Vol.29, No 10, p.1176-1183. doi: 10.1097/GME.0000000000002034 掲

Correction to: Quality of life after laparoscopic hysterectomy versus abdominal hysterectomy

An amendment to this paper has been published and can be accessed via the original article

〈Original〉Conservative treatment of retained placenta in six patients: a retrospective case series Analysis of conservative medical treatment against retained placenta was possible in six cases

[Abstract] Retained placenta is associated with postpartum hemorrhage and intrauterine infection and can be comorbid with placenta accreta. Although critical obstetric hemorrhages necessitating massive blood transfusion, intensive care, or total hysterectomy occur in some cases of retained placenta, conservative treatment was possible in many recently reported cases. This retrospective study investigated six cases of retained placenta treated conservatively at our hospital. We report a comparative evaluation of the clinical course and serum levels of human chorionic gonadotropin in each case. The retained placenta was expelled spontaneously in three of the six cases, while rebleeding occurred in the other three cases, necessitating hemostatic treatment. Finally, the uterus was successfully preserved in all six cases

Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study

[Background]The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. [Methods] Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan. A total of 3, 353 patients with out-of-hospital cardiac arrest (age ≥18 years) who underwent CPR by emergency medical service personnel and achieved the return of spontaneous circulation in a pre- or in-hospital setting were analyzed. The primary outcome was a 1-month favorable neurological outcome. Logistic regression analysis was performed to estimate the influence of cardiopulmonary resuscitation duration. The CPR duration that achieved a cumulative proportion >99% of cases with a 1-month neurologically favorable outcome was determined. [Results] Of the 3, 353 eligible cases, pre-hospital return of spontaneous circulation was obtained in 1, 692 cases (50.5%). A total of 279 (8.3%) cases had a 1-month neurologically favorable outcome. The CPR duration was significantly and inversely associated with 1-month neurologically favorable outcomes with adjustment for pre- and in-hospital confounders (adjusted odds ratio: 0.911, per minute, 95% CI: 0.892–0.929, p 99%. [Conclusions] The CPR duration was independently and inversely associated with 1-month neurologically favorable outcomes after out-of-hospital cardiac arrest. The CPR duration required to achieve return of spontaneous circulation in >99% of out-of-hospital cardiac arrest patients with a 1-month favorable neurological outcome was 45 min, considering both pre- and in-hospital settings