Maternal and child health in Indonesia

AIIKU-HAN activity was initiated by the Imperial Gift Foundation BOSHI-AIIKU-KAI in Japan in 1936 and has been introduced and accepted to community-based maternal and child health development in Indonesia through the international cooperation project conducted by Japan International Cooperation Agency (JICA) in order to encourage community health activities carried out by Indonesian women volunteers. As AIIKU-HAN activity in Japan and Dasa Wisma health activity in Indonesia have much in common, transferring concepts, methods and experiences met less obstacles when Indonesian community health volunteers learned AIIKU-HAN activity. Experience gained while developed countries were less developed can be transferred by shifting the time-scale of history in developed countries.     

Gastric vascular ectasia treated by endoscopic mucosal resection

An 80‐year‐old woman consulted our hospital complaining of general weakness. She had iron deficiency anemia, and upper gastrointestinal endoscopy revealed a small lesion accompanying a small amount of fresh bleeding in the stomach. Close observation of the lesion revealed that it was composed of a local assembly of dilated microvessels. The diagnosis of this patient was gastric vascular ectasia causing anemia. Endoscopic ultrasonography demonstrated that the lesion involved the mucosal and submucosal layers of the stomach, and that there were no large vessels inflowing to or outflowing from the lesion. In the present case, we attempted endoscopic mucosal resection (EMR). The lesion was completely resected by only one procedure of EMR without complications such as bleeding. After the endoscopic treatment, iron deficiency anemia improved. Follow‐up endoscopy performed 1 year later revealed that there was no residual or recurrent lesion. Although there have not been any published reports describing the use of EMR for gastric vascular ectasia, EMR may be a useful endoscopic treatment for this condition.     

Prolonged isoflurane anesthesia in a case of catastrophic asthma

A 13-year-old female patient with life-threatening asthma was treated with the inhalational anesthetic agent, 1% isoflurane, for 202 h (140 minimum alveolar concentration (MAC) hours). The patient survived and exhibited no significant side effects attributable to the medication. The present patient report provides additional clinical information supporting the utilization of long-term isoflurane general anesthesia in the management of refractory status asthmaticus that have not responded to aggressive medical management.