Dokkyo Medical University Repository / 獨協医科大学リポジトリ
Not a member yet
2844 research outputs found
Sort by
The combination of MMSE with VSRAD and eZIS has greater accuracy for discriminating mild cognitive impairment from early Alzheimer’s disease than MMSE alone
Get PDF獨協医科大学博士（医学）令和4年度doctoral thesi
Diagnostic error rates and associated factors for lower gastrointestinal perforation
Get PDF獨協医科大学博士（医学）令和4年度doctoral thesi
Two Cases of Intrathoracic Subclavian Artery Aneurysm Treated with Endovascular Treatment Combinations
Get PDFThe surgical procedure for intrathoracic subclavian artery aneurysm requires thoracotomy and is therefore highly invasive. We experienced two cases of intrathoracic subclavian artery aneurysm, one of which underwent endovascular treatment and one hybrid treatment. In the first case, an 80-year-old woman had a covered stent placed in a left intrathoracic subclavian artery aneurysm (30 mm diameter) through the left brachial artery. The second case involved a 79-year-old man who had previously undergone thoracic endovascular aortic repair of an aortic arch aneurysm that covered the origin of the left subclavian artery with a stent graft. He had a 32-mm-diameter aneurysm on the proximal side of the right subclavian artery. The right vertebral artery branched from the aneurysm, and the right common carotid artery branched near the aneurysm. A bypass with an expanded polytetrafluoroethylene graft was placed from the extrathoracic right subclavian artery to the right common carotid artery and extrathoracic left subclavian artery. A covered stent was then inserted from the brachiocephalic artery to the right subclavian artery to completely exclude the subclavian artery aneurysm. Both patients were discharged 7 days postoperatively without endoleak or complications.journal articl
A Case of Successful Electroconvulsive Therapy on the Use of Sansoninto as Substitute for Benzodiazepine Hypnotics
Get PDFThere is no information on the use of herbal medicines as substitute for benzodiazepine hypnotics in electroconvulsive therapy. A 50-year-old woman was admitted to our department due to worsening depressive symptoms. To perform electroconvulsive therapy, we reduced the dose of the benzodiazepine hypnotic flunitrazepam and initiated 7.5 g of sansoninto, followed by the discontinuation of flunitrazepam. A remission of symptoms was observed after 5 sessions of electroconvulsive therapy, which yielded effective convulsions. Since it is often difficult to reduce or discontinue benzodiazepine hypnotics, sansoninto can be considered an alternative insomnia treatment when electroconvulsive therapy is performed.journal articl
Medicine and AI - Learning about AI Through Own Research
Get PDF医療分野での人工知能（AI；artificial intelligence）は開発から利用のフェーズに移りつつある．最近のAIの発展の中心の技術となるのがディープラーニング（deep learning）という，複雑化させたニューラルネットワークを用いた機械学習である．結果が得られている画像をトレーニング・データとして多数用意しておけば，それをもとにコンピュータが自動で学習し，その後に与えた画像に対して判別を行えるようになる．医療分野では画像領域のAIを中心に製品が登場しており，病変検出を補助するCADe（computer aided detection）や，欧米では診断を補助するCADx （computer aided diagnosis）も導入されつつある．画像診断へのAIの活用においては，画像分類，物体検出，画像生成といったものがあり，我々は自験例をもとにこれらのAIの研究を行ってきた．ディープラーニングではトレーニング・データの質や内容によってAIの精度が決まり，単施設でも日常診療での精度の高い画像を用いれば診断能の高いAIを作ることが可能である．AIに触れることで理解し，今後の課題として医療にどのように実装していくかということを考えたい．Artificial intelligence（ AI） in the medical field is moving from the development phase to the utilization phase. The central technology in the recent development of AI is deep learning, which is machine learning using complex neural networks. By preparing a large number of images that have already yielded results as training data, a computer can automatically learn from them and then discriminate the images that are given to it. In the medical field, AI products have emerged mainly in the imaging area. In Japan, CADe（computer aided detection）has been introduced, and CADx（computer aided diagnosis）is being introduced in other countries. AI applications in diagnostic imaging include image classification, object detection, and image generation. We have been studying these AI applications based on cases at our institution. In deep learning, the accuracy of AI is determined by the quality and content of training data, and it is possible to create AI with high diagnostic capability even at a single institution by using highly accurate images from daily practice. We would like to understand AI by conducting some AI research independently and consider how to implement AI in medical care as a future challenge.journal articl
An Approach to Confronting the Disease in Patients with Progressive Pancreatic Cancer Undergoing Chemotherapy
Get PDF【目的】 化学療法を受ける進行膵がん患者の病いとの向き合い方を明らかにする．
【方法】 化学療法を受ける進行膵がん患者9 名を対象に，半構造化面接を用いてデータ収集を行い，質的・帰納的に分析した．
【結果】 分析の結果，化学療法を受ける進行膵がん患者の病いとの向き合い方として367 のコードが抽出され，それらは32 サブカテゴリ，11 カテゴリにまとめられ，最終的に【化学療法は受け続ける】【副作用症状にうまくつき合う】【生活の質を保つ努力をする】【大切な人が生きていけるように備える】【自分の信念を貫く】【周囲の支えに生きる力をもらう】の6 つのコアカテゴリが抽出された．
【結論】 化学療法を受ける進行膵がん患者は，根治できなくても【化学療法は受け続ける】ことで，一日でも長く生き延びる希望を見出し，【副作用症状にうまくつき合う】ことや【生活の質を保つ努力をする】ことで，今受けている治療を一日でも長く続けることができるように取り組んでいた．その一方で自分の限られた生の時間を意識し，自分がいなくなっても【大切な人が生きていけるように備える】ことに取り組んでいた．これらの取り組みは，【周囲の支えに生きる力をもらう】ことを原動力にして，膵がんになっても変わらず【自分の信念を貫く】という価値観を支えに病いと向き合っていた．看護者は，化学療法を受ける進行膵がん患者が，根治できなくても化学療法を受け続ける一方で，自分がいなくなっても大切な人が生きていけるように備えをしながら病いと向き合っていることを理解し，支援する必要性が示唆された．departmental bulletin pape
