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Get PDF上顎洞口腔瘻に対する口蓋粘膜骨膜弁法は他の術式と比較して血流を十分に確保でき, 創部を確実に閉鎖できる点で優れた方法である. しかし, 弁採取部の広範囲に骨面露出を伴うという欠点がある. 今回われわれは口蓋粘膜骨膜弁法を用いた上顎洞口腔瘻閉鎖術後に鼻口腔瘻を合併した1例を経験したので報告する. 患者は30歳代, 男性. 左側上顎6の上顎洞口腔瘻に対する精査, 加療を主訴に2020年8月中旬に当科初診となった. 2020年10月中旬, 全身麻酔下に口蓋粘膜骨膜弁法を用いた上顎洞口腔瘻閉鎖術を施行した. 術後, 瘻孔部の閉鎖を認めたが, 粘膜骨膜弁先端に位置する切歯孔からの鼻口腔瘻を合併した. 同部に対して鼻口腔瘻閉鎖術を施行することで症状は改善し, 再発なく経過している.The palatine mucoperiosteal valve technique for oral maxillary sinus fistulas is superior to other techniques in that it allows adequate blood flow and secure closure of the wound. However, it has the disadvantage of exposing a large area of bone surface at the valve extraction site. In this study, we report a case of rhino-oral fistula after closure of an oral maxillary sinus fistula using the palatine mucoperiosteal valve technique. Male, 30s. He was first seen in our department in mid-August 2020 for examination and treatment of an oral maxillary sinus fistula in the left maxillary first molar, and underwent an oral maxillary sinus fistula closure procedure in mid-October 2020. Postoperatively, the fistula was closed, but was complicated by a rhino-oral fistula from the incisal foramen located at the tip of the flap. Rhino-oral fistula closure was performed on the same area, and the patient's symptoms have improved with no recurrence.departmental bulletin pape
Effect of Emotional Information on Breast Cancer Screening Attendance among Never-Screened Female Japanese Employees: a Cluster-Randomized Controlled Trial
Get PDFThis study investigates the effectiveness of emotional information and basic information with monetary support in breast cancer screening attendance among female employees who had never had it. A total of 120 stores of a retail company in Japan were randomly classified into four groups; control, emotional information (comic book), basic information with a subsidy application form (leaflet), and combination. Among employees aged 30–49 years, the odds ratios and 95% confidence intervals for screening attendance compared with the control group were 2.50 (0.73–8.56) for the comic book group, 1.99 (0.54–7.28) for the leaflet group, and 3.41 (1.08–10.81) for the combination group. No significant effect was found for employees aged 50 years and over. A combination of basic and emotional information with a subsidy application form was found to be effective for encouraging breast cancer screening attendance among never-screened female employees in their 30s and 40s.本研究では、クラスターランダム化比較研究により、乳がん検診を受けたことのない女性従業員への乳がん検診受診啓発における情動的受診勧奨ツールの効果について年代別に検討した。小売業企業の計120事業所を30事業所ずつ無作為に非介入群、情報提供群（乳がん検診に関する基本的情報と補助金申請書のチラシ配布）、情動的介入群（読み手の感情に訴えるマンガ冊子配布による受診勧奨）、チラシとマンガの両方を配布する重点介入群の4群に割り付け、それぞれの事業所に勤務する女性従業員に媒体を配布した。その後1年間における乳がん検診受診について、30～49歳の従業員では検診受診のオッズ比と95%信頼区間は、非介入群と比較して情報提供群で1.99 （0.54-7.28）、情動的介入群で2.50 （0.73-8.56）、重点介入群で3.41 (1.08-10.81)であった。50歳以上の従業員では有意な関連は見られなかった。従来型の情報提供による受診勧奨に情動的受診勧奨ツールを組み合わせることで、乳がん検診を受けたことのない30～40代の女性従業員の検診受診促進に効果がある可能性が示された。departmental bulletin pape
Null mutation of exocyst complex component 3-like does not affect vascular development in mice
Get PDF滋賀医科大学博士（医学）Exocyst is an octameric protein complex implicated in exocytosis. The exocyst complex is highly conserved among mammalian species, but the physiological function of each subunit in exocyst remains unclear. Previously, we identified exocyst complex component 3-like (Exoc3l) as a gene abundantly expressed in embryonic endothelial cells and implicated in the process of angiogenesis in human umbilical cord endothelial cells. Here, to reveal the physiological roles of Exoc3l during development, we generated Exoc3l knockout (KO) mice by genome editing with CRISPR/Cas9. Exoc3l KO mice were viable and showed no significant phenotype in embryonic angiogenesis or postnatal retinal angiogenesis. Exoc3l KO mice also showed no significant alteration in cholesterol homeostasis or insulin secretion, although several reports suggest an association of Exoc3l with these processes. Despite the implied roles, Exoc3l KO mice exhibited no apparent phenotype in vascular development, cholesterol homeostasis, or insulin secretion.令和5年度doctoral thesi
Ambient Temperature Is Correlated With the Severity of Neonatal Hypoxic-Ischemic Brain Injury via Microglial Accumulation in Mice
Get PDF滋賀医科大学博士（医学）Frontiers in pediatrics. 2022 May 6:10:883556.令和5年度thesi
Sublingual immunotherapy decreases the avidity of antigen-specific IgE in patients with Japanese cedar pollinosis
Get PDF滋賀医科大学博士（医学）Allergy. 2023 Dec;78(12):3268-3271.令和5年度thesi
Factors associated with self-perceived treatment-resistance in bipolar disorder
Get PDF滋賀医科大学博士（医学）Patients with bipolar disorder often report self-perceived treatment resistance. However, it is not known to what extent it is due to actual treatment resistance. The Juntendo University provides "Bipolar Disorder Treatment Rebuilding Program," in which patients with self-reported treatment resistant bipolar disorder are hospitalized for 2 weeks and undergo detailed examinations. In this study, we report our experience with the initial 43 patients hospitalized during the one and half years after the launch of the program. Among the patients who underwent full assessment, only one was regarded as having genuine treatment-resistant bipolar disorder without comorbidity. In other cases, ten were not diagnosed with bipolar disorder, 3 had organic brain diseases, 12 had comorbid mental disorders and its symptoms were regarded as treatment-resistant bipolar symptoms by the patients, and 18 did not receive adequate treatment because attendant physicians did not adhere to the treatment guidelines or patients did not adhere to the treatment because of lack of insight. The number of participants was not large, and selection bias hampered the generalization of the findings. Insight and adherence were assessed without the use of validated tools. We could not verify recovery after adequate treatment because of the limited hospitalization period. The findings suggest that most patients with self-perceived treatment-resistant bipolar disorder may not have genuine treatment-resistant bipolar disorder. These results shed light on the difficulties of public education of bipolar disorder and importance of providing appropriate services for diagnosis and treatment of bipolar disorder in the community.令和5年度doctoral thesi
Knee joint synovial hemangioma treated with arthroscopic resection without hemarthrosis: A case report
Get PDFIntroduction:
Intra-articular synovial hemangioma of the knee is a relatively rare benign tumor that if left undiagnosed and treated may be followed by degenerative cartilaginous changes and osteoarthritis. However, the non-specific symptoms of synovial hemangiomas limit its early diagnosis. We report our encounter with synovial hemangioma of the knee in which the diagnosis was based on a > 20-year history of chronic pain without joint swelling or hematoma.
Presentation of case:
A 34-year-old man with a localized vascular malformation on the upper edge of the left patella presented with pain and a restricted range of motion. CT and MRI revealed a tumorous lesion at this location. Upon excision of the lesion, the patient's symptoms disappeared, with no recurrence at the 1-year follow-up.
Discussion:
Accurate diagnosis and appropriate early treatment are necessary for synovial hemangiomas to forestall articular cartilage degeneration due to recurrent intra-articular hemorrhages.
Conclusion:
Synovial hemangioma should be considered when a patient presents with recurrent knee pain, even in the absence of swelling or episodes of joint effusion.journal articl
