Showa University Academic Resource Repository / 昭和大学学術業績リポジトリ
Not a member yet
3721 research outputs found
Sort by
Analysis of the causes of 9 sudden deaths and 24 deaths after short-term hospitalization using 112 consecutive autopsy cases
Get PDFDespite occasional observations of sudden or unexpected deaths and deaths occurring shortly after hospitalization, studies on sudden in-hospital deaths in adults, particularly those that have been autopsied, are scarce. This study investigated 112 consecutive autopsy cases to determine the cause of death at our hospital. The cases were divided into three groups: sudden death （death within 24h of symptom onset, regardless of the duration of hospitalization; n＝9）, short-term death （death within 2-5 days after admission, excluding sudden death; n＝24）, and others （n＝79）. No differences were observed in age, sex, season, or time of death between the groups. The sudden-death group included the following cases: aortic dissection （n＝3）, acute pneumonia （n＝2）, asphyxia （n＝2）, other cause （n＝1）, and unknown cause （n＝1）. The short-term death group, on the other hand, consisted of brain disease （n＝8）, digestive disease （n＝7）, cardiovascular disease （n＝6）, respiratory disease （n＝1）, and other causes （n＝2）. The discordance rates between the clinical and pathological diagnoses were 22.2％, 29.2％, and 44.3％ for sudden death, short-term death, and others, respectively. We found that the causes of sudden and short-term deaths were not only cardiogenic but also involved other diseases. The discordant diagnoses were aortic dissection and acute pneumonia in sudden death. Myocardial infarction was the most common cause of short-term death. To prevent sudden in-hospital deaths, not only cardiovascular diseases, such as aortic dissection and acute myocardial infarction, but also noncardiovascular ones, such as acute pneumonia, should be considered as differential diagnoses.departmental bulletin pape
Novel ultrasound-guided lateral approach for modified thoracoabdominal nerve block through the perichondrial approach provides effective analgesia in gynecological lower abdominal surgery
Get PDFA modified thoracoabdominal nerve block through the perichondrial approach （M-TAPA） effectively blocks the anterior and lateral cutaneous branches of the Th5-12 thoracoabdominal nerves. A new method was devised for puncturing parallel to the costal cartilage by rotating the echo probe by 90°. This study presents two patients who underwent M-TAPA for surgical intervention: laparoscopic vaginal total hysterectomy and open adnexal resection. Case 1 involved a 49-year-old woman who underwent laparoscopic surgery and was bilaterally injected with 0.25％ levobupivacaine, which successfully relieved pain and minimal postoperative complaints. Case 2 was a 38-year-old woman who underwent open adnexal resection, was bilaterally administered 0.2％ levobupivacaine, and experienced effective pain management for laparotomy. Postoperative analgesia was managed with intravenous acetaminophen and fentanyl in both patients. Our approach is useful because the block was performed with a view similar to that of the existing transversus abdominis plane block under the costal arch and needle visibility was improved by placing the probe parallel to the costal cartilage. Our approach is as effective as the conventional block for lower abdominal surgery.departmental bulletin pape
鼓室に進展した頭蓋底腫瘍の稀な2症例
Get PDF原発性頭蓋底腫瘍が鼓室内に進展した稀な2症例を経験したので若干の文献的考察を加えて報告する．症例1は55歳女性．約30年前より左難聴を自覚していたが放置していた．左癒着性中耳炎を近医で指摘されて受診した．左鼓室内に腫瘤が透見され，生検を目的に試験的鼓室開放術を施行した．切除腫瘍の病理診断は髄膜腫であった．左難聴以外の症状，所見がなく脳神経外科で経過観察としている．症例2は46歳女性．左難聴を自覚し，近医で滲出性中耳炎の診断のもとで加療したが改善せず，当科を受診した．左鼓膜換気チューブ留置術を施行したが，左伝音難聴は改善しなかった．画像検査で，左頭蓋底腫瘤を認めた．脳神経外科で腫瘍塞栓術及び，開頭による腫瘍摘出術を施行した．摘出腫瘍の病理診断は骨巨細胞腫であった．術後の左聴力は術前と著変なく，難聴は残存した．明らかな合併症はなく，経過観察中である．2例とも難聴を主訴とし，診断には画像検査が有用であり，脳神経外科医との連携が大切であった．departmental bulletin pape
インプラント治療における歯槽骨再生
Get PDFインプラント治療における歯槽骨再生は，インプラントのチタン表面と骨がオッセオインテグレーションしなければならない点や，オッセオインテグレーションしたインプラントと骨の複合体が咬合力やブラキシズム等の荷重に耐えられる必要性があることが，歯根膜支持である歯周組織における歯槽骨再生とは様相が異なる．そして，歯を喪失した欠損部の歯槽骨再生は，インプラント治療の予後を担う重要な要件であると考えられている．インプラント治療における骨造成にはさまざまな術式が開発されており，良好な結果を示している．しかし，骨再生の足場としてのスペースメイキングが必要であることから生体骨もしくは人工骨等の骨移植材料が必須であることが現状である．今後，幹細胞等による細胞治療により，人工足場としての骨移植材が不要になることで真の再生医療がインプラント治療に応用されることを期待する．departmental bulletin pape
Ars longa, vita brevis に関する, polyphony的示唆と超克の視座
Get PDF2023年度昭和大学医学部教授会主催 医学部教授最終講義departmental bulletin pape
Orthodontic force distribution when retracting anterior teeth during aligner treatment
Get PDFClinical outcomes may differ from the simulation when the anterior teeth are retracted during aligner treatment. For example, the tooth axis of the anterior teeth may not be maintained, thereby resulting in excessive tipping on the lingual side and severe overbite and tooth root exposure. This study aimed to quantitatively evaluate the effects on orthodontic force magnitude and distribution of different movement methods when retracting anterior teeth during aligner treatment by performing two-dimensional birefringence evaluation （measurement using near-infrared birefringence and retardation）. Two types of aligners were prepared: one that tipped the anterior maxillary teeth by 0.63° to the lingual side and one that produced 0.25mm bodily movement of the tooth. Orthodontic forces exerted on a model by the aligners were compared, and the mechanical energy was calculated from the generated optical retardation using a two-dimensional birefringence measurement system （WPA-200-NIR）. Despite the insignificant difference observed in the amount of movement, significant differences were observed in orthodontic force magnitude and distribution when tipping and/or bodily movement occurred while retracting anterior teeth. Furthermore, loads were exerted in the other loci in addition to those in the anterior teeth. When retracting anterior teeth, orthodontic force magnitude and distribution varied on the basis of differences in the tooth axis tipping angle.departmental bulletin pape
Investigating the online influence and psychological characteristics of patients with gambling disorder: A review of 41 patients who visited Sanyo Hospital in Yamagata, Japan
Get PDFThe present study analyzed the effects of online gambling on patients with gambling disorder, with special focus on their financial status and psychological characteristics, and investigated the mechanisms that changed the type of gambling. Overall, 41 patients were divided into three groups by online experience （no online, partially online, and mostly online）, and were analyzed retrospectively. In addition, results of Wechsler Adult Intelligence Scale （WAIS）, Wender Utah rating scale （WURS）, Autism-Spectrum Quotient （AQ test）, and South Oaks Gambling Screen （SOGS）, were assessed to elucidate their psychological characteristics. The main gambling gateways were pachinko （41.5％）, pachislot （29.3％）, and horse racing （12.2％）. Moreover, 29.2％ patients participated in online gambling. The total SOGS score was 11.4 （SD＝3.1）, exceeding the cutoff value of 5/6 with no observed difference among the three groups. The total amount of money invested was highest in the “mostly online” group, followed by the “no online” and “partially online” groups （P＜0.05 between “mostly online” and “partially online” groups）. Number of gambles was highest in the “partially online” group, followed by the “mostly online” and “no online” groups （P＜0.01 between “partially online” and “no online” groups）. In WURS, 30.0％ of the respondents exceeded the attention-deficit/hyperactivity disorder （ADHD） trend cutoff. The highest working memory （WM） of 103.5 （SD＝15.0） was observed in WAIS-IV （P＜0.001 between WM and processing speed）. WAIS WM scores revealed that the “mostly online” group had the highest WM of 106.1 （SD＝11.3）, followed by the “partially online” group with 101.2 （SD＝13.3） and the “no online” group with 99.5 （SD＝18.6）. Pachinko and pachislot were the gambling gateways, and online gambling increased total debt. ADHD screening is crucial in treatment of patients with gambling disorders, and higher WM may be associated with a greater tendency of online gambling.departmental bulletin pape
