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Traumatic wound dehiscence after penetrating keratoplasty: a retrospective analysis
Get PDFTraumatic wound dehiscence is one of the most serious postoperative complications that can be seen after penetrating keratoplasty (PK). Depending on the damage caused by the trauma to the anterior and posterior segments of the eye, the level of vision can be most severely affected. Data from 17 eyes of 17 patients treated for traumatic wound dehiscence after PK between 2013 and 2024 were retrospectively reviewed. Patient records were reviewed for type and time of injury, corrected distance visual acuity (CDVA), surgical method, and final results. The incidence of graft dehiscence was 2.46% (17 eyes) in 690 PK eyes. The interval between PK and trauma ranged from 2 months to 60 months, with a median of 10 months. The median age at trauma was 36.7 years (range, 12–78 years). Wound dehiscence occurred at the donor-recipient interface in all patients, and 75.2% of graft dehiscence occurred at 16 months postoperatively. In all patients, the wound was closed by primary repair under general anesthesia. The mean follow-up period was 16.4±12.3 months (4–66 months). Median CDVA was 4 mps (range, 2 mps– 0.2, Snellen chart) at final visit. Graft failure was the most common complication after wound repair (29.42%). This study aimed to demonstrate the postoperative outcomes due to traumatic wound dehiscence after PK.departmental bulletin pape
Potency of real-time virtual sonography for the preoperative evaluation of invasion in nephroblastoma
Get PDFFusion with a real-time virtual sonography system is an ultrasonography fusion technology with magnetic position navigation. We present a case of a left nephroblastoma successfully resected using real-time virtual sonography for tumor margin assessment and excision boundary determination. A 2-year-old girl presented with fever and abdominal distension. Contrast-enhanced computed tomography revealed a large heterogeneous mass (90 × 75 × 125 mm^3) in the left kidney. Needle biopsy confirmed nephroblastoma. Chemotherapy with vincristine and actinomycin was initiated according to the International Society of Pediatric Oncology Wilms Tumor 2001 guidelines. Subsequent computed tomography revealed that the tumor size decreased to 45 × 25 × 63 mm^3 ; however, margins with adjacent muscles remained unclear, indicating potential invasion beyond Gerota's fascia. Real-time virtual sonography evaluation revealed a single fat layer separating the tumor from the muscle groups, showing tumor regression to the medial side of Gerota’s fascia, with visible respiratory movements on ultrasonography. Left nephrectomy, including Gerota’s fascia, was performed, preserving the abdominal wall muscles. Pathology confirmed that the tumor had penetrated the renal capsule but was completely resected with clear margins. The postoperative diagnosis was high-risk stage II blastemal type nephroblastoma, prompting chemotherapy on postoperative day 12. During the 5-year follow-up, no recurrence was observed. Real-time virtual sonography is a valuable adjunct for detailed preoperative evaluation when computed tomography alone is inadequate, facilitating precise tumor margin assessment and successful surgical outcomes.departmental bulletin pape
Reconsidering psychological safety from the perspective of personality organization levels
Get PDFIn medical education, psychological safety in teams and organizations facilitates problem solving in healthcare teams and learning opportunities for learners. Based on four types of organizational climate, this study examines the interventions needed for each type of team and organization to increase psychological safety and create an environment in which learners can learn independently and effectively. In considering interventions, the concept of three levels of personality organization, a framework for psychological assessment, seems to be valuable. Based on the overlap between the four types of organizational climate and the three levels of personality organization, the “Apathy Zone” requires educators and learners to reestablish autonomy rooted in reality. In the “Anxiety Zone,” the challenge is for educators to recognize their own limitations and be willing to understand learners. In the “Comfort Zone,” educators must respect learners’ autonomy while observing norms. Both educators and learners must distinguish between the realms of self and others, focusing on essential goals. The “Learning Zone” requires educators and learners to move without overthinking to achieve essential goals. The psychological perspective provides guidance for understanding the formation of organizational climate and considering specific interventions.departmental bulletin pape
Individual- and Facility-Level Factors Related to Quality-of-Life Transitions in Older Adults in Residential Facilities: A Systematic Review
No full textObjectives: To elucidate factors related to the transitions of quality of life (QoL) and well-being in older adults living in residential facilities. Design: We undertook a systematic review and narrative synthesis. Setting and Participants The participants were individuals aged ≥60 years living in various types of residential facilities. Methods: We conducted a search in PubMed and Embase (Ovid) using free-text words and Medical Subject Heading terms on December 1, 2024. We included longitudinal studies published after 2000 that quantitatively assessed QoL and/or well-being at ≥2 time points. Studies published before 2000, non–English-language papers, and interventional or qualitative studies were excluded. The title, abstract, and full-text assessments were performed by multiple independent reviewers based on eligibility criteria. The Study Quality Assessment Tool for observational cohort and cross-sectional studies was used to assess methodologic quality. Results: Of the 7705 papers initially identified, 18 studies involving 122,057 participants were included. These studies, predominantly multicenter studies and studies conducted in the United States, revealed that QoL and well-being tended to decline gradually after admission. Key factors associated with maintaining and enhancing QoL and well-being included facility-level factors (eg, age-friendly architectural environments, social support and activities) and individual aspects (eg, cognitive function, activities of daily living, urinary continence). The variation in outcome measures precluded a meta-analysis. Conclusions and Implications: We identified both facility- and individual-level factors associated with changes related to QoL and well-being in older adults living in residential facilities. The importance of modifiable facility-level factors should be reconsidered in ensuring quality care for older residents.journal articl
A simple method to discriminate non-seismic pulses and long-period noise in broadband seismic records and its application to centroid moment tensor inversion of earthquakes in Colombia
No full textNon-seismic pulses and long-period noise are artifacts produced by broadband seismometers and degrade centroid moment tensor (CMT) solutions of earthquakes estimated from waveform inversion. In addition to the source amplitude ratio proposed by a previous study, we found that kurtosis is useful for discriminating artifacts from seismic signals. For 157 tectonic earthquakes with moment magnitudes of 4.6–7.5 in and around Colombia in 2014–2022, we manually selected waveforms from the Colombian broadband seismic network and estimated CMT solutions by waveform inversion in a long-period (50−200 s) band. We found that 98% of the selected waveforms had kurtosis values and signal-to-noise ratios larger than 2.5 and 3, respectively, and 92% had source amplitude ratios smaller than 11. We used these values as thresholds and automatically selected waveforms using the three parameters for the 157 earthquakes. Their CMT solutions showed a clear improvement compared to those estimated without any selection. They were better than those estimated with the previous method using only the source amplitude and the signal-to-noise ratios. The proposed parameters were implemented to obtain real-time automatic solutions that were similar to corresponding manual CMT solutions, and 87% of them were estimated within 20 min. Our simple method based on the statistical parameters applied to automatic CMT inversion contributes to improved earthquake monitoring and tsunami warnings in Colombina.journal articl
A gradient-based shape optimisation for time-domain acoustic problems regarding the 3D dissipative wave equation with using the boundary element method
No full textThis paper presents a shape optimisation (SO) method for the three-dimensional dissipative wave equation in the time domain. Building upon existing work on the standard wave equation, we derive a novel shape derivative using the adjoint variable method. This derivative, expressed solely in terms of boundary integrals, is then discretised within a NURBS-based framework for representing the surface of acoustic scatterers. The resulting sensitivities with respect to the NURBS control points are employed as the gradient of the objective functional in a quasi-Newton optimisation algorithm. Both the primary and adjoint wave equations are solved using the time-domain boundary element method recently developed by the first author, with enhancements to address instability issues encountered in homogeneous Dirichlet problems. The effectiveness of the proposed SO system is demonstrated through sensitivity analyses and two validation problems, comparing the results for dissipative and non-dissipative cases.journal articl
大学博物館の学生の「保健室」化機能の実現を目指して
Get PDF名古屋大学博物館は，学生運営団体「MusaForum」とともに活動を展開するが，その一環で学生の心身の健康支援は必須であるとして，大学博物館の「保健室」的機能の実現に取り組み始めた．九州産業大学の緒方泉特任教授との「博物館浴」の実証実験では，博物館見学が若者のメンタルヘルスに与える効果を調査し，ストレス軽減や気分の改善が確認された．これを受け，館内にセルフ式の血圧・脈拍測定器を設置し，「博物館浴」に関する情報を発信したところ，アンケート結果より，多くの来館者の関心を集めたことが示された．さらに，入館後に「暑い」「眠い」「疲れた」という声が聞かれた来館者が，退館前には「楽しい」「リラックス」というポジティブな感想を述べるようになり，心理的なリフレッシュ効果が具体的に示された．すべての来館者が強い学習意欲を持って博物館を訪れているわけではない．しかし，これらの結果は，博物館が知識や文化を提供する場であるだけでなく，「心の保健室」として，多様な来館者に対して活力や心の支えを提供できる可能性を示唆している．Nagoya University Museum, in collaboration with the student organization MusaForum, has been exploring the concept of a university museum as a “health room” to support students’ mental and physical well-being. As part of this initiative, the museum conducted a “Museum Bathing” study in partnership with Prof. Izumi Ogata of Kyushu Sangyo University. This study examined the impact of museum visits on young people's mental health and found significant benefits, including stress reduction and improved mood. Building on these findings, the museum installed a self-service blood pressure and pulse monitor and began promoting the concept of “Museum Bathing.” Visitor surveys revealed strong interest, with many participants noting a shift in their emotional state. For instance, visitors who initially reported feeling “hot,” “sleepy,” or “tired” frequently described feeling “relaxed” and “enjoyable” by the end of their visit. This suggests that the museum fosters psychological refreshment and serves as a source of comfort. Not all visitors come to the museum with a strong motivation to learn. However, these findings suggest that museums are not only spaces for the dissemination of knowledge and culture but also have the potential to serve as “health rooms for the mind,” offering revitalization and emotional support to a diverse range of visitors.departmental bulletin pape