Risk Communication and Japan’s Fukushima Daiichi Nuclear Power Plant Meltdown: Ethical Implications for Government-Citizen Divides

The response of Tokyo Electric Power Company (TEPCO), which has been hobbled by a natural disaster, provides startling lessons in how organizations that disregard public outcry, even in a high-context culture that embraces pauses, silences, and understatements in communication exchanges, can be vulnerable to stakeholder backlash. The risk communication used by TEPCO in the wake of the meltdown at the Fukushima Daiichi Nuclear Power Plant in March 2011 continues to raise major ethical questions among families with children at risk for illnesses from radiation leaks—and from contamination. TEPCO’s actions exacerbated tensions in government-citizen divides. This article analyzes the implications of such divides for the ethics of TEPCO’s risk communication—that is, communication between those facing a health or an environmental risk and an organization with the wherewithal to reduce or control significantly that risk or its impact

ヒゾウ ゲンパツ Inflammatory pseudotumor ノ 1レイ

A case of inflammatory pseudotumor of the spleen is reported. This benign tumor in the spleen is rare. To our knowledge, 68 cases had been reported in the literature and 26 cases in the japanese literature. A splenic mass was incidentally detected by abdominal CT scan during the examination of the preoperative course of cholecystectomy for cholecystlithiasis. An abdominal CT scan revealed an slightly low density mass in the spleen, and MRI showed a low intensity mass. Cholecystectomy and extirpation of spelenic tumor was performed and the tumor measured 45×35×25mm in size. The tumor was diagnosed histologically as a inflammatory pseudotumor of the spleen

ジュウニシチョウ gastrointestinal stromal tumor ノ 1レイ

77 year-old male presented with prolonged melena and anemia. There was a well-defined enhancing mass in the descending portion of the duodenum that was approximately 6 cm in diameter on contrast-enhanced computed tomography (CT). Large ulcerated mass was seen in the duodenum on endoscopy. Preoperative biopsy was diagnostic for gastrointestinal stromal tumor (GIST) and partial resection of the duodenum was performed. Postoperative diagnosis was malignant GIST. Immunohistochemistry demonstrated negative S-100, negative actin, positive C-kit and partially positive CD34

フククウキョウカ タンノウ テキシュツジュツ ジュツゴ メイニュウ シタ クリップ オ カク トシテ ソウタンカンケッセキ オ ケイセイ シタ 1レイ

The patient was a 71-year-old who had received laparoscopic cholecystectomy for cholecystitis due to cholecystolithiasis on November, 1993. He had spent with no complaint after operation. But he consulted our department with epigastralgia and jaundice on February 1997. Abdominal CT and DIC revealed one calculus-like shadowy defect in the common bile duct and demonstrated metallic density at the defect in the lower part of the common bile duct. We diagnosed postoperative bile duct stone by aberrant surgical clip after laparoscopic cholecystectomy. We performed endoscopic balloon dilation of duodenal papilla and removed the common bile duct stone using basket forceps. In Japan, eight cases of migration of clip after laparoscopic cholecystectomy into bile duct have been reported, including our case. In accordance with the prevalence of laparoscopic cholecystectomy, such cases will increase and it was suggested that we must observe the course over a long period of time

変わりゆく肺癌診療 ｰShared Decision Making とNudge‐

令和3 年の国内における死亡原因の第一位は悪性腫瘍で第二位は心疾患，第三位は老衰である．第一位の悪性腫瘍を部位別に見ると肺癌が最も多く，その死亡者数は約7.6 万人となっている．罹患者数は胃癌や大腸癌の方が多いのに対し，死亡者数は肺癌が最も多いというのは肺癌の予後の悪さを反映している．しかし近年，肺癌の治療方法は多種多様となり，その効果もかなり期待できるようになってきた．一方で，多くの治療方法に対して医療者と患者が協働し，患者にとって最善で適切な治療を見出すShared Decision Making（SDM）という概念は非常に重要となりつつある．医師と患者の双方が情報を共有しながら治療方針を決定するSDM の視点から肺癌診療を考察する．departmental bulletin pape

Spontaneous rupture of a dissection of the left ovarian artery

A 53-year-old female was suddenly hospitalized with acute left lateral abdominal pain. There was no history of trauma to the abdomen. She had received no abdominal operation. X-ray showed a soft tissue shadow in the left flank which displaced the bowel shadows medially. Plain abdominal CT showed a left retroperitoneal hematoma. Dynamic abdominal CT showed an outflow of medium from a blood vessel in the hematoma. At laparotomy, the source of bleeding was found to be the left ovarian artery. The ovarian artery was dilated and meandered remarkably. The ovarian artery and vein were ligated proximally and left adenectomy was performed. The patient made an uneventful recovery. Histological examination suggested a spontaneous rupture of a dissection of the left ovarian artery

タンノウ ネンテンショウ ノ 2レイ

Torsion of the gallbladder is a rare entity and pre-operative diagnosis of the disease is uncommon. Since it was first described by A.V. Wendel in 1898, about 400 cases have been reported in the literature. Two cases of torsion of the gallbladder were presented. First case was 82 year old male who was admitted with 48 hour history of right upper quadrant abdominal pain, fever, and vomiting. On physical examination there was right upper quadrant tenderness with muscle guarding and rebound tenderness. An abdominal ultrasonogram and CT showed a distended gallbladder with thickness of the wall and a stone. A diagnosis of cholecystitis due to the stone was made and conservative therapy was tried. But the condition didn’t become better and a cholecystectomy was performed 2days later. The gallbladder was found to be necrotic with a 360 degree in an anticlock wise direction. Post operative recovery was unremarkable and the patient discharged at 12 days. Second case was 80 year old female who was admitted with 11 hour history of right upper quadrant abdominal pain and vomiting. A physical examination was similar to the first case. An abdominal ultrasonogram showed a distended and floating gallbladder. A diagnosis of torsion of the gallbladder was made without CT and a cholecystectomy was performed immediately. The gallbladder was found to be necrotic with a 360 degree in an anticlock wise direction. Post operative recovery was unremarkable and the patient discharged at 16 days