Hospital Evacuation Assistance from Public and Private Resources: Lessons Learned from the 2018 Western Japan Floods

During major flooding in June/July 2018, the Mabi Memorial Hospital in Kurashiki, Okayama, Japan was flooded and patients were stranded in the hospital. Peace Winds Japan, a non-governmental organization, collaborated with the Japanese Disaster Medical Assistance Team and Self-Defense Force Public to transport 8 critical patients from the hospital by helicopter. Ultimately, 54 patients and hospital staff members were safely evacuated. The evacuation was accomplished without any casualties, despite the severe conditions. Public and private organizations can work together and continue to seek ways to collaborate and cooperate in disaster settings

Group IIA secreted phospholipase A2 controls skin carcinogenesis and psoriasis by shaping the gut microbiota

Besides promoting inflammation by mobilizing lipid mediators, group IIA secreted phospholipase A2 (sPLA2-IIA) prevents bacterial infection by degrading bacterial membranes. Here, we show that, despite the restricted intestinal expression of sPLA2-IIA in BALB/c mice, its genetic deletion leads to amelioration of cancer and exacerbation of psoriasis in distal skin. Intestinal expression of sPLA2-IIA is reduced after treatment with antibiotics or under germ-free conditions, suggesting its upregulation by gut microbiota. Metagenome, transcriptome, and metabolome analyses have revealed that sPLA2-IIA deficiency alters the gut microbiota, accompanied by notable changes in the intestinal expression of genes related to immunity and metabolism, as well as in the levels of various blood metabolites and fecal bacterial lipids, suggesting that sPLA2-IIA contributes to shaping of the gut microbiota. The skin phenotypes in Pla2g2a–/– mice are lost (a) when they are cohoused with littermate WT mice, resulting in the mixing of the microbiota between the genotypes, or (b) when they are housed in a more stringent pathogen-free facility, where Pla2g2a expression in WT mice is low and the gut microbial compositions in both genotypes are nearly identical. Thus, our results highlight a potentially new aspect of sPLA2-IIA as a modulator of gut microbiota, perturbation of which affects distal skin responses

Comparison of postoperative circulatory, respiratory and immunological parameters between one-stage and two-stage surgery of intrathoracic esophageal carcinoma

There are two major surgical procedures for excision of esophageal carcinoma and reconstruction of the esophagus: the one-stage procedure and the two-stage procedure. In the present study, we evaluated the two methods by comparing the cardiovascular, respiratory and immune parameters of 10 patients who underwent one-stage procedure with those of 10 other patients who underwent two-stage procedure. To estimate cardiovascular function, we measured the left ventricular stroke work index (LVSWI)-pulmonary capillary wedge pressure (PCWP). Most of the patients treated by the one-stage procedure showed a significant decrease in LVSWI-PCWP, whereas the index of patients treated by the two-stage procedure did not change much. When we assessed the respiratory system by forced vital capacity (FVC) and peak expiratory flow (PEF), the patients treated by the two-stage procedure recovered much faster and better than those receiving the one-stage procedure. Natural killer (NK) activity in lymphocytes was also measured as a marker of the immuno-reactive system. Although most patients show a drop in NK activity one week after major surgery, NK activity did not demonstrate a significant change in any of the patients who underwent the two-stage procedume. Thus, our systemic comparison of the three different parameters demonstrated better results after the two-stage procedure and we recommend it over the one-stage procedure, especially for aged and high risk patients

A case of broncholithiasis complicating hemoptysis

A 62-year-old male was admitted because of hemoptysis. The chest X-ray showed an infiltrative shadow in the right upper lung field. Tomograms and CT scans also showed an infiltrative shadow and small calcifications in the same field. Examination by bronchoscopy revealed bronchial bleeding from the depth of the right B1b. Although the detailed view was unclear due to bleeding, we did not find any growth or any mucosal abnormality. We examined only the bronchial washing cytology. The result was Papanicolaou class Ⅱ. However, we could not rule out malignancy, so we decided to perform a right upper lobectomy. A bron-cholith was seen in the B1b and a hematoma was also seen on its periphery. The stone components were calcium carbonate (74%) and calcium phosphate (26%), suggesting that the stone was caused by mucus retention