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Tanimura S.,Toyama Central Prefectural Hospital | Funamoto H.,Toyama Central Prefectural Hospital | Hosono T.,Toyama Central Prefectural Hospital | Shitano Y.,Toyama Central Prefectural Hospital | And 3 more authors.
Journal of Obstetrics and Gynaecology Research

Aim The aim of the present study was to assess the efficacy of endoscopic repair for secondary infertility caused by post-cesarean scar defect (PCSD). Our investigation focused on the validity of new diagnostic criteria and selection methods. Material and Methods The subjects were 22 women with secondary infertility due to PCSD with retention of bloody fluid in the uterine cavity. Women with a residual myometrial thickness of ≥2.5mm and an anteflexed or straight uterus underwent hysteroscopic surgery, while all others underwent laparoscopic repair. Hysteroscopic surgery involved resection and coagulation of scarred areas, whereas laparoscopic surgery involved removal of scarred areas combined with hysteroscopy, followed by resuturing. Results Fourteen of the 22 women (63.6%) who were followed up for ≥1year after surgery achieved pregnancy. Pregnancies occurred in all four women (100%) who underwent hysteroscopic surgery and in 10 of the 18 women (55.6%) who underwent laparoscopic surgery. Three out of four women who underwent hysteroscopic surgery had term deliveries. Among the women who underwent laparoscopic surgery, five had term deliveries. No cases of uterine rupture were experienced, and the delivery method was cesarean section in all cases. Conclusion We propose that infertility associated with PCSD, cesarean scar syndrome, is caused by the retention of bloody fluid in the uterine cavity and scarring. Endoscopic treatment, such as hysteroscopy or laparoscopy, was effective for cesarean scar syndrome. © 2015 Japan Society of Obstetrics and Gynecology. Source

Tanigucm H.,Toyama Central Prefectural Hospital | Hayashi T.,Toyama Central Prefectural Hospital | Uchiyama A.,Toyama Central Prefectural Hospital | Kanbara K.,Toyama Central Prefectural Hospital | And 5 more authors.
Japanese Journal of Chest Diseases

A 78-year-old woman with diabetes presented at our hospital because of high fever, cough, and dyspnea. The findings of her chest X-ray and CT scan were compatible with organizing pneumonia. But histopathological findings from transbronchial lung biopsy showed an infection with spherical fungus. She was diagnosed as having pulmonary cryptococcosis. Her infection was cured with fluconazole treatment for 1 year. We need to be careful because chest imaging findings in a patient with pulmonary cryptococcosis may be compatible with organizing pneumonia in rare cases. Source

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