A case of placenta percreta with massive hemorrhage during cesarean section

We describe a case of a 39-year-old woman diagnosed with placenta percreta complicated by massive hemorrhage during a cesarean section. At 27 weeks of gestation, she underwent an emergency cesarean section under general anesthesia for vaginal bleeding and an intrauterine infection. Soon after delivery, a massive hemorrhage was encountered while attempting to separate the placenta percreta from the bladder wall. Although total abdominal hysterectomy and partial cystectomy were performed, massive hemorrhaging persisted. Bleeding was finally controlled following bilateral internal iliac artery embolization. We used a cell salvage device and a rapid infuser for hemodynamics stabilization. Total blood loss was 47,000 mL, and anesthesia time was 12 h and 47 min. The patient was discharged on the 32nd postoperative day without major complications. Placenta accreta can be associated with life-threatening hemorrhage and it is vital to plan accordingly preoperatively

Modelling of wave propagation and attenuation in the Osaka sedimentary basin, western Japan, during the 2013 Awaji Island earthquake

On 2013 April 13, an inland earthquake of Mw 5.8 occurred in Awaji Island, which forms the western boundary of the Osaka sedimentary basin in western Japan. The strong ground motion data were collected from more than 100 stations within the basin and it was found that in the Osaka Plain, the pseudo velocity response spectra at a period of around 6.5 s were significantly larger than at other stations of similar epicentral distance outside the basin. The ground motion lasted longer than 3 min in the Osaka Plain where its bedrock depth spatially varies from approximately 1 to 2 km. We modelled long-period (higher than 2 s) ground motions excited by this earthquake, using the finite difference method assuming a point source, to validate the present velocity structure model and to obtain better constraint of the attenuation factor of the sedimentary part of the basin. The effect of attenuation in the simulation was included in the form of Q(f) = Q0(f/f0), where Q0 at a reference frequency f0 was given by a function of the S-wave velocity, Q0 = αVS. We searched for appropriate Q0 values by changing α for a fixed value of f0 = 0.2 Hz. It was found that values of α from 0.2 to 0.5 fitted the observations reasonably well, but that the value of α = 0.3 performed best. Good agreement between the observed and simulated velocity waveforms was obtained for most stations within the Osaka Basin in terms of both amplitude and ground motion duration. However, underestimation of the pseudo velocity response spectra in the period range of 5–7 s was recognized in the central part of the Osaka Plain, which was caused by the inadequate modelling of later phases or wave packets in this period range observed approximately 2 min after the direct S-wave arrival. We analysed this observed later phase and concluded that it was a Love wave originating from the direction of the east coast of Awaji Island

Carrot Consumption Frequency Associated with Reduced BMI and Obesity through the SNP Intermediary rs4445711

It is unclear whether genetic interactions are involved in the association between vegetable intake and reduced body mass index (BMI) or obesity. We conducted a comprehensive search for single nucleotide polymorphisms (SNPs) which are associated with the interaction between vegetable intake frequency and BMI or obesity. We performed a genome-wide association analysis to evaluate the genetic interactions between self-reported intake of vegetables such as carrot, broccoli, spinach, other green vegetables (green pepper and green beans), pumpkin, and cabbage with BMI and obesity, which is defined as a BMI ≥ 25.0 kg/m2 in the Japanese population (n = 12,225). The mean BMI and prevalence of obesity was 23.9 ± 3.4 kg/m2 and 32.3% in men and 22.1 ± 3.8 kg/m2 and 17.3% in in women, respectively. A significant interaction was observed between rs4445711 and frequency of carrot intake on BMI (p = 4.5 × 10−8). This interaction was slightly attenuated after adjustment for age, sex, alcohol intake, smoking, physical activity and the frequency of total vegetable intake (p = 2.1 × 10−7). A significant interaction was also observed between rs4445711 and frequency of carrot intake on obesity (p = 2.5 × 10−8). No significant interactions that were the same as the interaction between frequency of carrot intake and rs4445711 were observed between the intake frequency of broccoli, spinach, other green vegetables, pumpkin or cabbage and BMI or obesity. The frequency of carrot consumption is implicated in reducing BMI by the intermediary of rs4445711. This novel genetic association may provide new clues to clarify the association between vegetable intake and BMI or obesity