A 65-year-old man was diagnosed with angioimmunoblastic T-cell lymphoma (AITL) with bone marrow (BM) infiltration and myelofibrosis (MF). The BM infiltration and the condition of the MF improved following CHOP therapy (cyclophosphamide hydrate, doxorubicin hydrochloride, vincristine sulfate, and prednisolone). After complete remission was achieved, early central nervous system recurrence was noted, with no evidence of BM infiltration or MF. The lymph nodes and BM were examined for cytokines by immunohistochemical staining with monoclonal murine antibodies. The lymphoma cells were positive only for platelet-derived growth factor (PDGF) and negative for basic fibroblast growth factor, fibronectin, vascular endothelial growth factor, transforming growth factor-β (TGF-β), tumor necrosis factor α, interleukin-1β, and interleukin-6. It was thus inferred that the lymphoma cells producing PDGF caused the MF, and that the absence of MF at relapse may have been attributable to the absence of BM infiltration. There have been seven reported cases of AITL with intercurrent MF, although cytokine data (elevations of blood PDGF and TGFβ levels) are available for only one case. The present report is to our knowledge the only report of a case of AITL complicated by MF for which the results of immunohistostaining with anticytokine antibodies are available.

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This study aimed to evaluate the effectiveness of intrauterine gauze or balloon tamponade for the management of postpartum hemorrhage due to uterine atony during maternal transportation from private clinics to higher-level facilities. Methods: A total of 1,428 patients were transported to the Department of Obstetrics, Juntendo University Shizuoka Hospital, between January 2008 and December 2019. Among these, 42 patients had postpartum hemorrhage due to uterine atony. Of the 42 patients, 29 (69.0%) were treated with intrauterine gauze or balloon tamponade before transportation (tamponade group); no intrauterine packing was performed in the remaining 13 (31.0%) (non-tamponade group). The primary outcome was the rate of critical obstetrical hemorrhage at hospital arrival. Secondary outcomes were blood loss before and after transportation, hemoglobin, platelets, fibrinogen, amount of blood transfusion, and rate of transfusion. Results: The rate of critical obstetrical hemorrhage was significantly lower in the tamponade group (34.5% (10/29)) compared to the non-tamponade group (76.9% (10/13)). Moreover, total blood loss during transportation and after hospital arrival was significantly lower in the tamponade group (487 ± 331 g) compared to the nontamponade group (1,199 ± 1,012 g). Conclusion: Intrauterine gauze or balloon tamponade before transportation to higher-level facilities is effective for managing postpartum hemorrhage due to uterine atony.

Endometriosis is a common condition that affects women of reproductive age. It mainly occurs in the pelvis and involvesthebowelin3-37%ofcases. We report a case of intestinal endometriosis accompanied by ileocecal obstruction. The patient was a 50-year-old woman,gravida0,para0whowasadmittedforileustothelocalhospital.Acystictumorwasidentifiedinherovary. Shewastransferredtothishospitalbecauseofsuspectedileusrelatedtotheovariancyst. Although an ileus tube was inserted, ileus did not improve, and a contrast study showed ileocecal obstruction. Ileocecalresectionandsalpingo-oophorectomywereperformedlaparoscopicallyforintestinalendometriosisandovarian endometrioticcyst. Pathologicalexaminationconfirmedthepresenceofendometrialtissueinthelaminapropriamucosaeandmuscularis propriaoftheileum.Seventeenmonthsaftersurgery,therearenosignsofintestinalendometriosisrecurrence.

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