KEIO JOURNAL OF MEDICINE最新文献_第10页

Midline Extraperitoneal Approach for Obturator Hernia Repair. 中线腹膜外入路修补闭孔疝。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2018-12-26 Epub Date: 2018-03-14 DOI: 10.2302/kjm.2017-0014-OA

Yuji Otsuki, Hirofumi Konn, Keisa Takeda, Masahiko Koike

{"title":"Midline Extraperitoneal Approach for Obturator Hernia Repair.","authors":"Yuji Otsuki, Hirofumi Konn, Keisa Takeda, Masahiko Koike","doi":"10.2302/kjm.2017-0014-OA","DOIUrl":"https://doi.org/10.2302/kjm.2017-0014-OA","url":null,"abstract":"Obturator hernia (OH) is a rare condition that accounts for 0.073-1% of abdominal hernias and 0.48% of bowel obstructions. OH frequently occurs in elderly women, with an incidence that increases with age. The only treatment for OH is surgical intervention, and the approaches used vary greatly. Consequently, a well-defined consensus has not yet emerged. We assessed the efficiency and safety of the midline extraperitoneal approach for OH. Six patients with OH repaired using the midline extraperitoneal approach at KKR Sapporo Medical Center between April 2011 and January 2016 were included in the study. We retrospectively evaluated the patient characteristics, intraoperative findings, and the postoperative course. All patients were elderly women [median age, 90 (range, 79-92) years], with a median body mass index of 17.0 (range, 15.6-18.3) kg/m2 at presentation. All had symptoms associated with bowel obstruction: two patients presenting with leg pain had the Howship-Romberg sign. In two patients, bowel resection was required because of irreversible ischemic changes. Five patients had coexisting femoral and inguinal hernias that were repaired by bilateral mesh repair. One patient had aspiration pneumonia as a postoperative complication. All patients were discharged alive, without infection or recurrence. OH can be efficiently and safely repaired using the midline extraperitoneal approach. This approach establishes the diagnosis of OH, avoids injuring obturator vessels, gives improved exposure of the obturator canal, enables identification and simultaneous repair of other pelvic hernias, and facilitates bowel resection. This approach reduces the risk of mesh infection in patients undergoing bowel resection.","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"67 4","pages":"67-71"},"PeriodicalIF":2.0,"publicationDate":"2018-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2302/kjm.2017-0014-OA","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35915339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Perspective of junior doctors on the cost and value in e-learning. 初级医生对电子学习成本和价值的看法。

IF 1.1

KEIO JOURNAL OF MEDICINE Pub Date : 2018-11-29 eCollection Date: 2019-01-01 DOI: 10.1136/bmjstel-2017-000262

Kieran Walsh

引用次数: 0

Depression in Cancer Care. 癌症治疗中的抑郁。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2018-09-25 Epub Date: 2017-10-14 DOI: 10.2302/kjm.2017-0010-IR

Daisuke Fujisawa

引用次数: 5

The Efficacy of Transcorneal Electrical Stimulation for the Treatment of Primary Open-angle Glaucoma: A Pilot Study. 经角膜电刺激治疗原发性开角型青光眼的疗效:一项初步研究。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2018-09-25 Epub Date: 2018-02-07 DOI: 10.2302/kjm.2017-0015-OA

Yuka Ota, Naoki Ozeki, Kenya Yuki, Daisuke Shiba, Itaru Kimura, Kazushige Tsunoda, Kei Shinoda, Hisao Ohde, Kazuo Tsubota

{"title":"The Efficacy of Transcorneal Electrical Stimulation for the Treatment of Primary Open-angle Glaucoma: A Pilot Study.","authors":"Yuka Ota, Naoki Ozeki, Kenya Yuki, Daisuke Shiba, Itaru Kimura, Kazushige Tsunoda, Kei Shinoda, Hisao Ohde, Kazuo Tsubota","doi":"10.2302/kjm.2017-0015-OA","DOIUrl":"https://doi.org/10.2302/kjm.2017-0015-OA","url":null,"abstract":"The aim of this study was to evaluate the effects of transcorneal electrical stimulation in subjects with primary open-angle glaucoma. Five eyes of four male subjects with primary open-angle glaucoma (average age: 52.25 ± 14.68 years) were enrolled. The subjects underwent transcorneal electrical stimulation every 3 months according to the following procedure. A Dawson-Trick-Litzkow electrode was placed on the cornea, and biphasic electric current pulses (10 ms, 20 Hz) were delivered using a stimulator (BPG-1,BAK Electronics) and a stimulus isolation unit (BSI-2). A current that evoked a phosphene that the subject perceived in the whole visual area was delivered continuously for 30 min. Humphrey visual field testing was performed after every third transcorneal electrical stimulation treatment. Changes in mean deviation (MD) values were evaluated with a linear regression model. Transcorneal electrical stimulation was performed 18.2 ± 9.4 times over a period of 49.8 ± 23.0 months. The average pretranscorneal electrical stimulation intraocular pressure, best corrected visual acuity, and MD values were 11.8 ± 1.79 mmHg, 0.14 ± 0.19 (logMAR) and -17.28 ± 6.24 dB, respectively. No significant differences were observed in intraocular pressure before and after transcorneal electrical stimulation. However, there was a significant positive linear relationship between changes in MD values and the number of transcorneal electrical stimulation treatments (R2 = 0.176, P = 0.005, Spearman correlation R =0.294, P = 0.008). Transcorneal electrical stimulation treatment may improve glaucomatous visual field defects in subjects with primary open-angle glaucoma. Large-scale studies are necessary to confirm these preliminary findings.","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"67 3","pages":"45-53"},"PeriodicalIF":2.0,"publicationDate":"2018-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2302/kjm.2017-0015-OA","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35806367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 20

Correlation of the Blood Test Results Obtained between Assays Using Microliter-scale Fingertip Blood Samples Collected with a Novel Blood Collection Device and Conventional Venous Blood Assays: a Secondary Publication in English. 一种新型采血装置采集的指尖微量血样与传统静脉血测定的血液检测结果的相关性:一篇英文二级出版物。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2018-06-25 Epub Date: 2017-11-21 DOI: 10.2302/kjm.2017-0009-OA

Hajime Iwasawa, Tomoaki Nishimura, Shota Nemoto, Naoki Aikawa, Kiyoaki Watanabe

{"title":"Correlation of the Blood Test Results Obtained between Assays Using Microliter-scale Fingertip Blood Samples Collected with a Novel Blood Collection Device and Conventional Venous Blood Assays: a Secondary Publication in English.","authors":"Hajime Iwasawa, Tomoaki Nishimura, Shota Nemoto, Naoki Aikawa, Kiyoaki Watanabe","doi":"10.2302/kjm.2017-0009-OA","DOIUrl":"https://doi.org/10.2302/kjm.2017-0009-OA","url":null,"abstract":"In this study, we investigated the correlations between biochemical and hematological test results obtained using microliter-scale fingertip blood samples collected with a newly developed blood collection device and those obtained using conventional venous blood. Eighty volunteer subjects were enrolled in this study. Blood samples were drawn from the fingertip of the ring finger by a single puncture, and 60-µL samples were promptly and accurately aspirated into a blood collection chip. Then the chip was tightly sealed in a chip container and was shaken to mix the contents without dispersion. For biochemical tests other than that for HbA1c, blood was collected without anticoagulant and centrifuged to obtain 15 µL of serum which was then diluted with 190 µL of physiological saline for the assay. For hematological tests and the test for HbA1c, the sample was assayed with blood collected using EDTA-2 K. Good correlations were obtained between the test results of the assay using fingertip blood and that using venous blood. The correlation coefficients were ≥0.97 for TG, T-CHO, HDL-C, LDL-C, GLU, ALT, γ-GTP, UA, BUN, and HbA1c and ≥0.95 for WBC, RBC, Hgb, and Hct. These results suggest that our microliter-scale blood testing system is comparable to assays using venous blood and may be useful as a rapid and simple test to determine basic clinical parameters that are close to the reference intervals.","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"67 2","pages":"26-34"},"PeriodicalIF":2.0,"publicationDate":"2018-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2302/kjm.2017-0009-OA","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35574167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The History and Future of Unlinked Total Elbow Arthroplasty. 非连锁全肘关节置换术的历史和未来。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2018-06-25 Epub Date: 2017-08-24 DOI: 10.2302/kjm.2017-0007-IR

Takuji Iwamoto, Hiroyasu Ikegami, Taku Suzuki, Satoshi Oki, Noboru Matsumura, Masaya Nakamura, Morio Matsumoto, Kazuki Sato

{"title":"The History and Future of Unlinked Total Elbow Arthroplasty.","authors":"Takuji Iwamoto, Hiroyasu Ikegami, Taku Suzuki, Satoshi Oki, Noboru Matsumura, Masaya Nakamura, Morio Matsumoto, Kazuki Sato","doi":"10.2302/kjm.2017-0007-IR","DOIUrl":"https://doi.org/10.2302/kjm.2017-0007-IR","url":null,"abstract":"Unlinked total elbow arthroplasty (TEA), which has no mechanical connection between the humeral and ulnar components, has theoretical advantages based on its near-normal elbow kinematics and the preservation of bone stock. Unlinked TEA is appropriate only for patients who have limited bone loss or limited deformity and good ligamentous function. This is because postoperative instability has been a major complication of unlinked prostheses. The concept and goal of unlinked TEA is to share the loading stress on the bone implant interface with the surrounding tissues. Although the loosening rate of unlinked prostheses theoretically should be lower than that of linked prostheses (which have a mechanical connection between the humeral and ulnar components), there is no clear evidence that unlinked TEAs are superior to linked TEAs in this respect. However, we believe that primary TEA should be performed using an unlinked TEA, especially for younger patients, because revision surgery for unlinked TEA results in longer prosthesis survival than revision surgery for linked TEA. Improvement of the design of unlinked prostheses and the introduction of less invasive surgical techniques are required to reduce postoperative instability.","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"67 2","pages":"19-25"},"PeriodicalIF":2.0,"publicationDate":"2018-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2302/kjm.2017-0007-IR","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35294208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

A Heart-shaped Sleeve Simplifies Intramedullary Tibial Nail Insertion when Using the Suprapatellar Approach. 心形套管简化髌上入路胫骨髓内钉入路。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2018-03-23 Epub Date: 2017-07-15 DOI: 10.2302/kjm.2017-0001-OA

Kosuke Tajima, Chikako Shimizu, Soichiro Ohno, Yusho Nishida, Kazuhiko Udagawa, Junichi Sasaki

{"title":"A Heart-shaped Sleeve Simplifies Intramedullary Tibial Nail Insertion when Using the Suprapatellar Approach.","authors":"Kosuke Tajima, Chikako Shimizu, Soichiro Ohno, Yusho Nishida, Kazuhiko Udagawa, Junichi Sasaki","doi":"10.2302/kjm.2017-0001-OA","DOIUrl":"https://doi.org/10.2302/kjm.2017-0001-OA","url":null,"abstract":"The suprapatellar approach for intramedullary tibial nailing has become widely accepted over the past decade. A round sleeve is passed beneath the patella to protect the surface of the patellofemoral joint (PFJ). However, the round sleeve cannot be easily stabilized in the PFJ because it does not conform to the shape of the patellar apex. Consequently, we produced a heart-shaped sleeve to simplify the insertion of the entry sleeve during the suprapatellar approach. Using the new sleeve, the following procedure is used: (1) make a longitudinal 4 cm skin incision proximal to the patella to reach the PFJ, (2) insert the guide pin manually to the ventral edge of the tibial plateau, (3) insert the cannulated trocar along the guide pin, (4) insert the heart-shaped sleeve along the cannulated trocar, (5) remove the cannulated trocar, (6) ream the entry point through the heart-shaped sleeve. Then, continue insertion of the nail in the standard manner. Among 44 patients (29 men, mean age 45.6 years, range 26-87 years) with tibial fractures treated between 2010 and 2015, the first 18 consecutive cases were performed using a round sleeve and the rest were performed using the heart-shaped sleeve. The surgery time until entry reaming commenced was 8.9 min (range 6-12 min) using the round sleeve and 6.2 min (range 3-12 min) using the heart-shaped sleeve (P < 0.05). The heart-shaped sleeve is easily stabilized in the PFJ and greatly simplifies the intramedullary nailing of tibial shaft fractures using the suprapatellar approach.","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"67 1","pages":"10-16"},"PeriodicalIF":2.0,"publicationDate":"2018-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2302/kjm.2017-0001-OA","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35176971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Roles of Hypoxia Response in Retinal Development and Pathophysiology. 缺氧反应在视网膜发育和病理生理中的作用。

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2018-03-23 Epub Date: 2017-06-06 DOI: 10.2302/kjm.2017-0002-IR

Toshihide Kurihara

{"title":"Roles of Hypoxia Response in Retinal Development and Pathophysiology.","authors":"Toshihide Kurihara","doi":"10.2302/kjm.2017-0002-IR","DOIUrl":"https://doi.org/10.2302/kjm.2017-0002-IR","url":null,"abstract":"The hypoxia response is a fundamental phenomenon mainly regulated by hypoxia-inducible factors (HIFs). For more than a decade, we have investigated and revealed the roles of the hypoxia response in the development, physiology, and pathophysiology of the retina by generating and utilizing cell-type-specific conditional knockout mice. To investigate the functions of genes related to the hypoxia response in cells composing the retina, we generated various mouse lines that lack HIFs and/or related genes specifically in retinal neurons, astrocytes, myeloid cells, or retinal pigment epithelium cells. We found that these genes in the different types of retinal cells contribute in various ways to the homeostasis of ocular vascular and visual function. We hypothesized that the activation of HIFs is likely involved in the development and progress of retinal diseases, and we subsequently confirmed the pathological roles of HIFs in animal models of neovascular and atrophic ocular diseases. Currently, anti-vascular endothelial growth factor (anti-VEGF) therapy is a first-line treatment widely used for neovascular retinal diseases. However, alternative or additional targets are now required because several recent large-scale clinical trials and animal studies, including our own research, have indicated that VEGF antagonism may induce retinal vascular and neuronal degeneration. We have identified and confirmed a microRNA as a candidate for an alternative target against neovascular retinal diseases, and we are now working to establish a novel HIF inhibitor for clinical use based on the disease mechanism that we identified.","PeriodicalId":46245,"journal":{"name":"KEIO JOURNAL OF MEDICINE","volume":"67 1","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2018-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2302/kjm.2017-0002-IR","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35070328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

GVHD Prevention in 2018: Tried and True or Something New? 2018年的GVHD预防:尝试过的还是新的?

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2018-01-01 DOI: 10.2302/kjm.67-001-ABST

Masumi Ueda

引用次数: 0

Protein Ubiquitination; A molecular switch for helper T cell differentiation 蛋白质泛素化;辅助性T细胞分化的分子开关

IF 2

KEIO JOURNAL OF MEDICINE Pub Date : 2018-01-01 DOI: 10.2302/KJM.67-002-ABST

Daisuke Aki

引用次数: 0