Makita Corporation (Japan)

Colorectal DiseaseEarly View CORRESPONDENCE Reply to comment on “Subcutaneous incision of the fistula tract and internal sphincterotomy (SIFT-IS): A novel surgical procedure for transsphincteric anal fistula” Rikisaburo Sahara, Rikisaburo Sahara Proctology Centre, Makita General Hospital, Tokyo, Japan Nishiarai Coloproctology Clinic, Tokyo, JapanSearch for more papers by this authorMichihiro Koizumi, Corresponding Author Michihiro Koizumi [email protected] orcid.org/0000-0001-5806-2982 Nishiarai Coloproctology Clinic, Tokyo, Japan Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan Correspondence Michihiro Koizumi, Nishiarai Coloproctology Clinic, 3-7-13 Shimane, Adachi-ku, Tokyo, Japan. Email: [email protected]Search for more papers by this author Rikisaburo Sahara, Rikisaburo Sahara Proctology Centre, Makita General Hospital, Tokyo, Japan Nishiarai Coloproctology Clinic, Tokyo, JapanSearch for more papers by this authorMichihiro Koizumi, Corresponding Author Michihiro Koizumi [email protected] orcid.org/0000-0001-5806-2982 Nishiarai Coloproctology Clinic, Tokyo, Japan Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan Correspondence Michihiro Koizumi, Nishiarai Coloproctology Clinic, 3-7-13 Shimane, Adachi-ku, Tokyo, Japan. Email: [email protected]Search for more papers by this author First published: 08 April 2023 https://doi.org/10.1111/codi.16564Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

Abstract Introduction: Globally, about half of all induced abortions have been estimated to be unsafe, and have resulted in maternal death. Of these, 41% unsafe abortions have been reported in young women who are dependent on their parents for livelihood. They are often left in a vulnerable position and may have difficulty in making a decision regarding abortion. This study aimed to (a) characterize and map factors that influence abortion decision-making of adolescents and young women, and (b) identify the care and support they need in their decision-making process. Methods: We conducted a scoping review following the JBI method and PRISMA-ScR checklist. We comprehensively searched MEDLINE (PubMed), EMBASE, Cochrane Library, CINAHL, and PsycINFO, and hand searched publications in Google Scholar database between November 2021 and December 2021. The search included all English language qualitative and mixed-methods research articles published from 1976 to November 2021, and included participants aged 10-24 years. The CASP checklist was used as guide for the qualitative analysis. Nvivo was used to synthesize the findings. Results: There were 14 studies from 10 countries (N = 334 young women) that met the inclusion criteria. Three domains and 11 categories were included: Personal (Desire for self-realization and Unwanted pregnancy), Interpersonal (Parental impact, Reaction of partner, Roles of peers and friends, Existence of own child, and Lack of support), and Social circumstances (Sexual crime, Financial problem, Limitation of choice, and Underutilized healthcare services). Decision-making factors regarding abortions were also found across all three domains. Conclusion: The abortion decision-making of young women is influenced by various external factors regardless of country. Parents are especially influential and tend to force their daughters to make a decision. Young women experienced suffering, frustration, and lack of autonomy in making decisions based on their preference. This emphasizes the importance of autonomous decision-making. In this regard, healthcare services should be used. However, there are barriers to access these services. To improve such access, the following are required: staff training to provide women-centered care, counseling based on women’s needs, counseling including parents or guardians that is confidential and ethical, promotion of decision aids, and affordable accessible care.

Retropharyngeal hematomas are uncommon, but they may rarely cause occlusion of the upper airway and threaten life. Retropharyngeal hematomas often occur due to head or neck injury;they rarely occur due to iatrogenic causes such as insertion of a gastric tube or anticoagulant therapy. It has been found that patients receiving anticoagulant therapy are more likely to experience potentially severe retropharyngeal hematomas. We report the case of a patient with retropharyngeal hematoma with cervical cord damage. A 75-year-old man was transferred to our hospital after he sustained a fall and damaged his face. CT showed a massive retropharyngeal hematoma, but he did not complain of any breathing issues. Therefore, we selected conservative therapy. However, after approximately 4 hours, he suddenly complained of breathing problems and suffered from loss of consciousness. We performed intubation and provided sedation. After one week, his condition clearly improved and he was extubated.

Although direct oral anticoagulants (DOACs) are widely used in Japanese patients with atrial fibrillation (AF), large-scale investigations into their use, with suitable follow-up times and rates, are lacking. The SAKURA AF Registry is a prospective multicenter registry created to investigate therapeutic outcomes of oral anticoagulant (OAC) use in Japanese AF patients. We conducted a study involving 3,237 enrollees from 63 institutions in the Tokyo area being treated with any of 4 DOACs (n=1,676) or warfarin (n=1,561) and followed-up for a median of 39.3 months (range 28.5-43.6 months). Analyses of 1- and 2-year follow-up data available for 3,157 (97.5%) and 2,952 (91.2%) patients, respectively, showed no significant differences in rates of stroke or systemic embolism (SE), major bleeding, and all-cause mortality for DOAC vs. warfarin users (1.2 vs. 1.8%/year, 0.5 vs. 1.2%/year, and 2.1 vs. 1.7%/year, respectively). Under propensity score matching, the incidence of stroke or SE (P=0.679) and all-cause death (P=0.864) remained equivalent, but the incidence of major bleeding was significantly lower (P=0.014) among DOAC than warfarin users. A high follow-up rate allowed us to obtain reliable data on the status of OAC use and therapeutic outcomes among AF patients in Japan. Warfarin and DOACs appear to yield equivalent 3-year stroke and all-cause mortality rates, but DOACs appear to reduce the risk of major bleeding.

We describe a patient with posterior spinal artery (PSA) syndrome due to vertebral artery (VA) dissection. A 63-year-old woman developed neck pain, bilateral shoulder and arm numbness, and paraparesis after prolonged neck extension during a dental procedure. Neurological examination revealed sensory deficits in the legs, paraparesis, cerebellar ataxia, urinary retention and constipation. Magnetic resonance imaging disclosed T2-hyperintense lesions in the posterolateral C4-C7 cord with partial enhancement. T1-hyperintensity and stenosis were found in the right VA at C3-C5. These clinicoradiological findings suggested bilateral PSA syndrome and unilateral VA dissection. This is the fourth report of VA dissection-induced PSA syndrome.

The EU Directives implementing the climate and energy package will result in the increased demand for natural gas in all EU countries, especially in Poland, whose energy management is coal-based. In the following decades we will observe the substantial increase in demand for natural gas as an energy carrier in power and heating sectors. Another factor, which will contribute to the increase in gas consumption, is the expansion of gas transmission and distribution network. In order to secure natural gas supply for the customers in is necessary to ensure the proper gas storage capacity, expand the existing underground gas storage facilities (UGS) and build new ones. Currently used Polish underground natural gas storage facilities allow storing 1.6 billion m3. Taking into consideration the expansion of investments in underground natural gas storage facilities and the projected increase in demand for natural gas, it is justified to build the new large salt cavern underground gas storage facility in Poland.

This study develops a hybrid damper for multi-modal vibration by combining an elastomer and a piezo ceramic element. The basic idea is to obtain satisfactory damping in the low frequency range, where elastomer does not work well, by introducing a piezoelectric element. In this hybrid damper, the elastomer comprises a dynamic absorber with a metal plate of small mass that deals with higher-frequency vibration, while piezo ceramic comprises a shunt damper with an electric shunt circuit that works for lower-frequency vibration. The effectiveness of this approach is examined through vibration control of a cantilever beam. The aim is to suppress the 1st mode vibration with the shunt damper and the 2nd mode with the dynamic absorber. With appropriate tuning procedures for the control parameters, vibration suppression of more than 10dB is attained in each mode.

Effects of asymmetric and radial multi jets on the combustion and heat transfer characteristics in a divided chamber combustor are examined by measuring pressure histories and visualizing flow patterns in the main chamber. Diameter and arrangement of 40 nozzles, uniformly equipped on a hemi-circular sub-chamber, are varied in the manner that multiple radial jets produce various types of flow patterns in the main chamber before the main chamber mixture ignites. To examine the combustion characteristics pressure histories in the combustor are measured, whereas visualization of model water flows induced by the asymmetric multi jets is made to obtain flow characteristics before ignition. Based on the results obtained, the interrelation between the flow pattern and the combustion and heat transfer properties are considered and some key factors will be examined to introduce intense asymmetric flow fields in the divided chamber combustor.