Open Library Archives of Kagawa University (OLIVE)
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Get PDF雑報香川大学経済学会正会員・特別会員学外研究業績一覧（2023.1〜2023.12）第96巻総目次執筆者紹介香川大学経済学会正会員・特別会員奥付英語標題英語目次othe
Verification of the effectiveness of community safety map creation activities in collaboration with crime prevention volunteers
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Validating Knowledge Platform e‐Courses : Problems observed in course registration and future outlooks
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Presence of manubrium–sternum joint doesn't assure sufficient elevation of sternum in Nuss procedure for pectus excavatum patients
Get PDF香川大学Kagawa University博士（医学）Background: The manubrium and body of the sternum are connected by the manubrium-sternum joint (MSJ). In performing the Nuss procedure for pectus excavatum patients, the body of the sternum is elevated as the operator flips correction bars upside down. Theoretically, the presence of the MSJ should allow elevation of the sternum body. However, does the MSJ secure sufficient elevation of the sternum? This study aims to elucidate this clinical question.Methods: Seventy-four adult pectus excavatum patients with moderate to serious deformity (with Haller Index being equal to or greater than 5) were included in the study. The MSJ was open in all patients. For 29 patients, the sternum was elevated by only bar flipping (Non-Separation Group); for 45 patients, the sternum was horizontally separated after bar flipping (Separation Group). Whether or not additional elevation for Separation Group patients results from the division was observed, and the degree of the additional elevation was evaluated. Furthermore, 74 patients subjectively evaluated postoperative pain and gave scores with a Visual Analog Scale ranging from 0 (no pain) to 10 (intolerable pain). The VAS scores were compared between the two groups.Results: In the Separation Group, the sternums of all patients achieved additional elevation from sternum separation. The pain scores were lower for the Separation Group than for the Non-Separation Group.Conclusion: Even when the MSJ is present, horizontal separation enhances the elevation of the sternum. Furthermore, horizontal separation of the sternum reduces postoperative pain.doctoral thesi
Effective and secure closure after duodenal endoscopic submucosal dissection : Combination of endoscopic ligation with O-ring closure and over-the-scope clip
Get PDF香川大学Kagawa University博士（医学）Duodenal endoscopic submucosal dissection (ESD) is associated with high incidences of intraoperative complications and delayed adverse events (AEs). Delayed AEs can be reduced by closing the post-ESD defects. We developed a new method of closure after duodenal ESD, combining endoscopic ligation with O-ring closure (E-LOC) with an over-the-scope clip (OTSC) (Band OTSC; B-OTSC). Here, we conducted a single-center, retrospective, observational study to investigate the efficacy and safety of the B-OTSC method for preventing delayed AEs in patients undergoing duodenal ESD. The study included nine patients with superficial nonpapillary duodenal epithelial tumors who underwent ESD and were closed with B-OTSC from February 2021 to February 2023. There were no delayed AEs (0%), the mean (± standard deviation) closure time was 53 ± 21.6 min, the complete closure rate was 100%, and the mean hospital stay was 7.8 ± 1.8 days. The sustained closure rates at postoperative days 3 and 7 were 88.9% and 88.9%, respectively. The historical analysis indicated a significant difference in cost between B-OTSC and conventional OTSC (p < 0.01). In conclusion, B-OTSC was a safe, secure, and cost-effective method of closure after duodenal ESD, even in patients with post-ESD defects of more than half the circumference.doctoral thesi
Creating a Place for Children with Special Needs: A Case Study in a Kindergarten
Get PDF本研究は，特別な配慮を必要とする子どもが幼稚園で居場所を見出す過程を事例をもとに検討した。その結果，子どもが感情交流をきっかけに，自身の拠り所を物から教師，友達へと広げていく過程が明らかになった。また，そういった過程の中で，担任と加配教員の連携と職員集団の支えが影響していることも示唆された。居場所とは時間をかけて，そこにいる人たちが行きつ戻りつをしながら，涵養されていくことが明らかになった。departmental bulletin pape