DSpace コレクション: 2014-12

腹腔鏡下に整復したS状結腸間膜窩ヘルニアによる絞扼性イレウスの一例

Tue, 30 Dec 2014 15:00:00 GMT

タイトル: 腹腔鏡下に整復したS状結腸間膜窩ヘルニアによる絞扼性イレウスの一例著者: 三宅, 佳乃子; 青松, 幸雄; 中尾, 武; 平尾, 具子; 福本, 晃久; 辻, 泰子; 杉原, 誠一; 細井, 孝純; 今川, 敦史抄録: A 50-year-old woman visited our hospital in emergency because of sudden lower abdominal pain. There was tenderness in the left lower abdomen. An abdominal computed tomography scan showed a loop-shaped small bowel in the left lower abdomen. A strangulated ileus due to an internal hernia was diagnosed and emergency laparoscopic surgery was performed 21 hours after the onset of symptoms. The laparoscopic findings showed that the small bowe1 had herniated into the intersigmoid fossa. We diagnosed intersigmoid hernia. The incarceration was reduced by laparoscopic maneuver. Since the incarcerated portion of the small bowel was viable, we did not remove it. The postoperative course was uneventful. The patient was discharged from our hospital on the fifth day after surgery and we followed the patient 47 days after surgery. Intersigmoid hernia is very rare. We report our experience of successful laparoscopic diagnosis and treatment for intersigmoid hernia along with a literature revlew.

鼠径ヘルニア嵌頓整復後の小腸狭窄に対し腹腔鏡補助下に手術を行った1例

Tue, 30 Dec 2014 15:00:00 GMT

タイトル: 鼠径ヘルニア嵌頓整復後の小腸狭窄に対し腹腔鏡補助下に手術を行った1例著者: 蜂須, 賀崇; 森田, 敏裕; 鶴井, 裕和抄録: We report a case of a small intestinal obstruction after reduction of an incarcerated inguinal hernia, which was treated by laparoscopy-assisted surgery. A 64-year old man with incarceration of a right inguinal hernia underwent repair by direct Kugel patch method on February 19,2014. From around the 13th day after surgery, he had intermittent abdominal pain and appetite loss. It was thought that the symptoms were caused by an infiammatory change in the small intestine after reduction, but the symptoms were not improved by conservative therapy. On the 28th day after surgery, abdominal CT revealed a narrow segment of small intestine in the right lower abdomen. This segment was resected by laparoscopy-assisted surgery, and pathological examination of the specimen revealed fibrosis of the subserosal layer in the stenosis. We reviewed 7 other cases of small intestinal obstruction after reduction of incarcerated inguinal hernia in Japan. Because bowel obstruction has occurred within one month in such cases, we should follow the patient carefully in this period.

Impact of A Transparent Hood on The Performance and Therapeutic Result of Endoscopic Injection Sclerotherapy.

Tue, 30 Dec 2014 15:00:00 GMT

タイトル: Impact of A Transparent Hood on The Performance and Therapeutic Result of Endoscopic Injection Sclerotherapy. 著者: Uejima, Masakazu; Matsumura, Masahiko; Umemoto, Norie; Yoshida, Motoyuki; Sawai, Masayoshi; Namisaki, Tadashi; Kitade, Mitsuteru; Kawaratani, Hideto; Takaya, Hiroaki; Aihara, Yosuke; Mitoro, Akira; Yoshiji, Hitoshi; Yamao, Junichi; Fukui, Hiroshi 抄録: Objective: Although the effectiveness of a transparent hood has been reported in various endoscopic procedures, there are only a few reports regarding the benefit of a transparent hood in endoscopic injection sclerotherapy(EIS). In the current study, we conducted a retrospective evaluation of the efficacy and long-term benefit of an oblique transparent hood on EIS. Methods: The transparent hood, manufactured by Olympus (MAJ295 or MAJ296), consisted of a reusable wide oblique distal attachment with rim. This hood was attached when the varix was fine (F0 or F1). In this retrospective study, a total of 201 patients were recruited, and 99 patients (designated as the "Hood Group") received this hood while 102 patients (designated as the "Conventional Group") did not. We compared the rate of intravariceal injection, enhanced supply vessels, variceal eradication, and recurrence between these two groups. Results: This transparent hood provided a better visual field, and there was no serious complication in any of the patients. Intravariceal injection rates in the Hood Group and Conventional Group were 73.9% (190/257) and 57.7% (146/253) respectively (p<0.01). The rates of enhanced supply vessels in the Hood Group and Conventional Group were 89.8% (89/99) and 72.5% (74/102) respectively (p<0.01). The rates of variceal eradication did not differ significantly. We also assessed the cumulative non-recurrence probability for up to 3000 days between the two groups. The Hood Group was statistically superior to the Conventional Group (p<0.01) Conclusion: The application of an oblique transparent hood method is safe and effective for intravariceal EIS. This hood contributes especially to reduction of the long-term recurrence probability. 内容記述: 博士（医学）・乙第1365号・平成27年11月27日

A Study of Factors Associated with Dietary Supplement Consumption in Menopausal Women.

Tue, 30 Dec 2014 15:00:00 GMT

タイトル: A Study of Factors Associated with Dietary Supplement Consumption in Menopausal Women. 著者: Nakanishi, Nobuko 抄録: The purpose of the present study was to find factors associated with dietary supplement consumption in menopausal women, and to examine nursing support for maintaining and improving their health. We surveyed menopausal women (aged 40-60 years) using an anonymous self-administered questionnaire. The relationship between dietary supplement consumption status and individual characteristics, menopausal symptoms, the perception regarding menopause, sense of selfefficacy, and health promotion behaviors (HPB) were examined. HPB were measured using the Japanese version of the Health-Promoting Lifestyle Profile (HPLP). Responses were obtained from 256 women (response rate: 67.9%). Of these, 187 responses were valid and were included in our data analyses. Among the factors associated with dietary supplement consumption, we found significant correlations between the severity of menopausal symptoms, age, change in menstruation, surgical history, and the HPB items "participation in seminars" and "finding someone who can give advice." Of these, the most significant independent variable was the severity of menopausal symptoms. These results suggest that menopausal women became concerned about their health when their menstruation status changed and started taking dietary supplements according to these symptoms. To support health maintenance and improvement in menopausal women, nurses should provide information regarding menopause before its onset, hold health classes, and establish a consultation office for menopausal women.