Osaka Kaisei Hospital

Summary: Peace Winds (PW) is an international NGO that provides humanitarian aid to people facing crises worldwide. ARROWS (Airborne Rescue and Relief Operations With Search), a part of PW’s project, supports victims of man made and natural disasters. On January 1, 2024, the Noto Peninsula in Japan suffered a magnitude 7.6 earthquake. During that time, the PW staff and rosters (registered members) were dispatched to the affected area to provide disaster relief. This study aims to discuss the importance of a standardized handover process during humanitarian aid and identify the potential improvements to enhance effective disaster relief activities from the rosters’ perspective for future catastrophes. During the initial relief efforts, the PW staff and the rosters started gathering accurate information, evaluating the victims’ needs, and planning the next steps. However, due to the ever-changing nature of the situation, they needed to adapt to different tasks, which changed day by day. The rosters working on the next phase recognized the need to establish a standardized handover procedure to delegate responsibilities to later-joining rosters effectively. This structured handover process provided a clear overview of the relief efforts to the rosters involved at different times and for different durations. While the handover procedure was successfully created during this response, it could have been further optimized if it had been introduced from the onset of the activities. Thus, the handover process should be discussed in advance between the PW staff and the rosters during preparatory training. This approach may also apply to other organizations with similar personnel structures. An efficient handover process is crucial for disaster management. By discussing responsibility delegation and simulating the handover procedure during preparatory training, cooperation in the actual humanitarian activities could be optimized.

IntroductionPost-operative remodeling of the femoral neck after cam osteoplasty treatment has previously been reported, but remodeling of the acetabular rim in the borderline dysplastic patient has not been studied. The purpose of this study is to evaluate whether post-operative remodeling of the acetabular rim in the bordering dysplastic FAI patients can be seen and if there are any contributing factors related to the FAI treatment.MethodsRetrospectively, Patients treated for FAI with borderline dysplasia (CE angle<25°) at our institute from 2011 to 2019, with a minimal follow-up of 2 years, were reviewed. Pre- and post-operative final follow-up radiographs and clinical outcome scores using the m-HHS were evaluated.ResultsTwenty-eight hips in 27 cases were reviewed and the 20 hips in 19 patients with comparable pre- and post-operative AP view roentgenograms were included in the study. Six were male and 13 female; the mean age was 24.8 years. Mean follow-up was 41 months. In 16 hips a combination of Cam plasty and or labral repair was done. In 4 hips only labral repair was done.In 14 out of the 20 hips, a prominent increase in bony configuration was found. All 14 cases were in the camplasty-treated group. Of these 14 cases, the mean CE angle increased and the mean Tonnis angle decreased from a mean of 20.7(18-24)°and 14.4(8-22)°pre-operatively to a mean of 26.6(23-32)°and 10.2(18-24)°post-operatively. For all cases, the mean m-HHS improved from a mean of 65 to 94.ConclusionWe observed a consistent increase in the bony configuration of the acetabular rim after cam plasty treatment in the borderline dysplastic FAI hip. The camplasty and treatment of FAI may have allowed for the advantageous remodeling of the dysplastic acetabulum.

Abstract Streptococcus intermedius, a commensal bacterium in the human oral cavity, can occasionally cause severe infections in deep tissues. Here, we report the first known case of infectious blepharoconjunctivitis associated with S. intermedius sinusitis mimicking a conjunctival tumor. Smear microscopy of the eye and nasal discharge was useful for the differential diagnosis. Metagenomic analysis using MinION as adjunctive diagnostic tool has contributed to rigorous species identification of the pathogenic strain.

It remains unclear whether patients with metastatic castration-sensitive prostate cancer (mCSPC) are suitable for upfront docetaxel therapy. Therefore, we retrospectively evaluated patients with metastatic castration-resistant prostate cancer (mCRPC) who could not receive ≥6 cycles of docetaxel for mCRPC. This study enrolled 274 patients diagnosed with mCSPC who later developed mCRPC, with data at diagnosis, including blood test results, available from 17 hospitals between 2008 and 2022. Failure to receive ≥6 cycles of docetaxel was defined as receiving ≤5 cycles of docetaxel for mCRPC or dying due to prostate cancer without docetaxel therapy. Factors at mCSPC diagnosis associated with failure to receive ≥6 cycles of docetaxel were evaluated using logistic regression analysis. Ninety-three patients were not able to receive ≥6 cycles of docetaxel for mCRPC. Multivariate analysis revealed that high lactate dehydrogenase levels and Gleason grade group 5 were significantly associated with failure receive ≥6 cycles of docetaxel for mCRPC. Furthermore, in patients with these factors at mCSPC diagnosis, receiving ≥6 cycles of docetaxel was significantly associated with better overall survival. Patients with mCSPC who have high lactate dehydrogenase levels and a Gleason grade 5 may be candidates for upfront docetaxel therapy, as they may otherwise miss the chance to receive adequate doses for prostate cancer.

Gastropleural fistula (GPF) is a rare and life-threatening condition, often associated with peptic ulcer disease, trauma, abscess, malignancies, prior surgeries, or chemoradiation therapy. Its rarity, diverse clinical presentations, and the general condition of affected patients make GPF challenging to diagnose and treat. We present a case of GPF occurring during chemotherapy with anti-vascular endothelial growth factor (anti-VEGF) therapy for stage IV colon cancer with multiple peritoneal metastases. The patient underwent surgical repair of the fistula four weeks after the last administration of anti-VEGF therapy. Postoperative recovery was uneventful, and the patient successfully resumed oral intake. To the best of our knowledge, this is the first reported case of GPF in the context of stage IV colon cancer. This case highlights the importance of selecting an appropriate timing for surgical intervention, taking into account the patient's overall condition and treatment history.

Clinical findings and postoperative follow-up data on remnant gastric cancer (RGC) are limited due to its rarity. Additionally, the preoperative staging, radical surgery, and managing recurrence in RGC present significant clinical challenges. We analyzed the clinicopathological findings, adjuvant chemotherapy, and patterns of postoperative recurrence of 313 consecutive patients who underwent curative surgery for RGC at 17 Japanese institutions. This study investigated the optimal management of RGC and the impact of adjuvant chemotherapy (AC) on recurrence-free survival (RFS). Pathological stages I, II, and III were observed in 55.9% (N = 175), 24.9% (N = 78), and 19.2% (N = 60) of the patients, respectively. The overall concordance rate between clinical and pathological T staging was 58.3%, with a clinical T4 sensitivity of 41.4% for diagnosing pathological T4. During the median follow-up period of 4.6years, disease recurrence occurred in 24.3% of patients. Most recurrences (over 80%) occurred within 2.5years, and 96.1% within 5years after RGC surgery. Peritoneal recurrence was the most common in patients with advanced RGC, accounting for 14.1% in stage II and 28.3% in stage III. Multivariable regression analysis showed that AC was significantly associated with a longer RFS, with a hazard ratio of 0.45 (95% confidence interval: 0.26-0.76). Our study underscores the importance of early detection, accurate preoperative staging, and postoperative surveillance in managing advanced RGC cases. Despite some limitations, our findings indicate that AC may provide survival benefits comparable to those seen in primary gastric cancer.