Further Hospital Art Development of Masking Tape Using Thin Film Sheet

The authors and collaborators have continued practice of hospital art in the university and community hospitals and various research with experts. The material for hospital art is masking tape which is easily made and attached for everyone. Formerly, we have conducted artwork in front of the wall, which took a long time. Currently, we have tried to take the most advantage of the thin-film sheet. Our staff can prepare artwork with a size of 20 cm square in advance. Many square parts with double-sided attachment tape can be gathered together, which is completed and useful in a short time.

Several Effective Measures for Minus Excess Mortality of COVID-19 in Japan Including Mutual Interrelationships and Long-Term Care Facilities (LTCF)

The impact of COVID-19 can be shown by life expectancy, excess death and total years of life lost (YLL). United States showed life expectancy minus 1.67 years, excess deaths 375,235 and total YLL 7,362,555. The excess death of Japan has remained minus value for long, in which long-term care facilities (LTCF) may contribute. LTCF has characteristic points as i) mutual interrelationships between hospitals, medical societies and prefectural offices, ii) rapid communication channels for regulatory official authorities, iii) high degree of citizenship and cooperation of all Japanese people for daily life and iv) mild lockdown without any punishment with declaration.

A Case Report of Delayed Hemothorax Complicated by Fibrothorax

Delayed hemothorax is a potentially life-threatening complication of thoracic trauma that should be carefully considered in all patients presenting with thoracic injury. We report a case of delayed hemothorax in a 77-year-old male presenting eleven days’ status post multiple right mid- to high-rib fractures. His case was complicated by retained hemothorax after CT-guided chest-tube with subsequent video-assisted tube thoracostomy (VATS) revealing fibrothorax necessitating conversion to open thoracotomy. Known risk factors for development of delayed hemothorax include older patient age, three or more rib fractures, and presence of mid- to high-rib fractures, and should be used in risk stratification of thoracic trauma. Tube thoracostomy is often sufficient in management of delayed hemothorax. In rare cases, hemothoraces can be complicated by retained hemothorax or fibrothorax, which require more invasive therapy and carry greater morbidity and mortality.

Case Report and Highlight Clues on the Diagnosis of Pilomatrical Carcinoma

Pilomatrical Carcinoma (PC) is a rare malignant adnexal tumor with matrical differentiation. Its benign counterpart (Pilomatrixoma) is diagnosed much more frequently in daily pathological practice. Both entities share genetic alterations but the malignant counterpart acquires mutations that make it develop an aggressive behavior [1]. We describe a 33-year-old man who presented with a 7 x 6 cm nodular ulcerated lesion in the left ear with markedly accelerated growth in the last month. Incisional biopsy was referred to us with suspicion of squamous cell carcinoma versus pyogenic granuloma. Histologic sections showed ulcerated fragments infiltrated by a basaloid cell proliferation interspersed with groups of “ghost cells”. The neoplastic cells were arranged in irregular sheets with infiltrative borders. Groups of Squamous cells with trichilemmal keratinization and foci of necrosis were also identified. The biopsy was diagnosed as an adnexal neoplasm with pilomatrical differentiation, suggesting its complete resection with safety margins due to the presence of aggressive characteristics. The subsequent study of the excisional biopsy showed similar characteristics to those previously described. Notoriously, focal infiltration of the auricular cartilage was identified, leading us to the undoubted diagnosis of pilomatrical carcinoma.

Congenital Constriction Band Syndrome: Clinical Study of Three Cases in Togo

Introduction: Congenital constriction band syndrome (CCBS) or amniotic band syndrome is a complex set of congenital malformations, mainly affecting the limbs, but also the craniofacial and thoraco-abdominal region. The Patients: The purpose of this work is to describe the clinical and diagnostic aspects of CCBS in Togo in relation to 03 clinical cases. The Primary Diagnoses, Interventions, and Outcomes: The first case is characterized by an asymmetric bilateral superficial constriction groove of the lower limbs, pseudosyndactylias and synostosis of the tibia and fibula on X-ray. The second has a deep strangulation in the left arm with an amputation of the fingers associated with hypochromic skin lesions, poorly hemmed polylobal ear and skin growths. The latter characterized by persistent bridle, strangulation and ischemia downstream of that of the left wrist with postnatal amputation of the left hand. Conclusion: The strengthening of antenatal diagnosis, the introduction of genetic counselling and the establishment of a national malformations register should make it possible to improve the management of cases of amniotic flange disease.

Psychological Application for New Version of Tokyo University Egogram Battery

Transactional Analysis (TA) has been a personality theory beneficial to mutual communication associated with the research of egogram. Tokyo University Egogram (TEG) has been a reliable psychological battery. TEG ver3 was recently introduced, which was applied to 98 university students. The results for 5 egogram factors were compared to previous standard values. Similar data were observed in Critical Parent(CP), Nurturing Parent(NP), and Adult(A). Higher tendency values (vs standard value) were found in male Free Child (FC) 12.3 vs 10.6, male Adapted Child (AC) 13.6 vs 10.0, and female AC 14.8 vs 10.8. Further study for TEG will be expected in the future.

Infectious Endocarditis with Major Cutaneous Expression: About A Case

Introduction: Infectious endocarditis is a transplant of microorganisms in healthy endocardium, in injured endocardium or intracardiac material. The modes of revelation can be multiple and varied, the skin manifestations of an infectious although classical endocarditis, are rare. Observation: This was a young 20-year-old patient, admitted in our cardiac unit for the exploration of a cardiac murmur in a context of long-term fever evolving for nearly 3 weeks associated with a skin rash. The examination found fever at 39°C and tachycardia at 115 beats/min. The cardiac auscultation revealed tachycardia with a systolic breath apexian mitral insufficiency. The skin examination revealed Osler’s nodules, an erythema of Janeway on the soles of the feet and on the palms of the hands. In biology, there was a non-specific biological inflammatory syndrome. Blood cultures from three series of samples did not isolate a germ. The transthoracic echography showed large vegetations in the anterior and posterior leaflets of mitral valve associated with severe mitral regurgitation. In this context, the diagnosis of mitral endocarditis is retained according to the Duke criteria. A double intravenous antibiotic therapy based on ceftriaxone and gentamycin was administrated. The evolution was favorable with stable apyrexia, disappearance of skin signs, regression of non-specific biological inflammatory syndrome. A replacement surgery of mitral valve was proposed. Conclusion: Infectious endocarditis is a disease with multiple and varied modes of revelation. Although skin manifestations are rare, they are still a determining factor in the diagnosis of infectious endocarditis.

Current Data on Lower Prevalence and Age-Related Aggravation of COVID-19 in Japan

Pandemic COVID-19 has been crucial problem worldwide, and authors have reported less prevalence and excess death in Japan. The Ministry of Health, Labour and Welfare of Japan presented COVID-report of July 2021 Edition. Among them, the number of people diagnosed with COVID-19 in Japan was 796,835 until July 1, 2021, which is equivalent to 0.6% of the total population. Aggravation rate of COVID-19 increases remarkably with aging. The result shows 1, 4, 10, 25, 47, 70< in 30s, 40s, 50s, 60, 70s, 80s< years old, respectively. In contrast, it shows 0.5, 0.2, 0.3 in <9, 10-19, 20-29 years, respectively.

Emergency Transcatheter Aortic Valve Implantation in A Patient with The Assistance of Intra-Aortic Balloon Pump

Surgical aortic valve replacement (SAVR) is considered the gold-standard treatment for patients with severe aortic valve stenosis (AS), yet 30% are considered inappropriate for SAVR on account of the advanced age and multiple comorbidities. Transcatheter aortic valve implantation (TAVI) provides an option for high-risk patients with severe AS, especially for those accompanied with acute cardiogenic shock and multiple organ dysfunction. Herein, we presented a case of a patient resuscitated successfully with TAVI in combination with intra-aortic balloon pump.

Satisfactory Rapid Response to Xultophy Associated with Meal Tolerance Test (MTT) by Carbohydrate Loading

The case is a 69-year-old male patient with Type 2 Diabetes Mellitus (T2DM) for 21 years. His diabetic control was not so satisfactory, and his HbA1c value increased in spring 2021. Then, he started Xultophy (IDegLira), which includes a fixed ratio of two agents of basal degludec and liraglutide. Just after providing Xultophy, the daily profile of blood glucose decreased from 179-400 mg/dL to 112-171 mg/dL, with remarkable clinical efficacy. He usually takes 80g of carbohydrates in breakfast, and the meal tolerance test (MTT) was challenged. As carbohydrate loading was given 100-75-50-0%, postprandial hyperglycemia at 60-min showed 277-219-159-133 mg/dL, respectively.