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Surgeon-Operated In-Office Ultrasonography for the Diagnosis of Rotator Cuff Tears: A Comparison with Magnetic Resonance Imaging

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Surgical Science 2013年第9期4卷 6-14页

作者： Tsutomu Kobayashi Atsushi Yamamoto Hitoshi Shitara Tsuyoshi Ichinose Eiji Takasawa daisuke shimoyama Toshihisa Osawa Kenji Takagishi Department of Orthopaedic Surgery Graduate School of Medicine Gunma University Maebashi Japan Department of Orthopaedic Surgery Takasaki General Medical Center Takasaki Japan

Objective: Few investigators have evaluated whether ultrasonography operated by a surgeon during a patient’s clinic visit is capable of obtaining a similar degree of accuracy as magnetic resonance imaging in regard to the diagnosis of rotator cuff tears and lesions of the biceps tendon. The purpose of this study was to clarify the accuracy of in-office ultrasonography for the diagnosis of rotator cuff tears in comparison to magnetic resonance imaging. Methods: One hundred and three patients (105 shoulders) with a clinical diagnosis of impingement and suspected rotator cuff tear, who subsequently underwent arthroscopic surgery were retrospectively enrolled in this study, including 7 males with 89 shoulders, and 33 females with 33 shoulders, and their mean age was 60.9 years (range, 30 to 83 years). The subjects were examined using ultrasonography and magnetic resonance imaging within three months pre-operatively per normal practice of the outpatient clinic. The two modalities were then compared to the reference standard, arthroscopic findings. Results: Intra-operatively, 79 full-thickness and 15 partial-thickness rotator cuff tears were found. The agreement between ultrasonography and magnetic resonance imaging for diagnosis of rotator cuff tears was statistically good;observed degree of agreement was 87% with Kappa coefficient of 0.73. Ultrasonography showed a sensitivity of 94% and a specificity of 100% for full-thickness tears, and a sensitivity of 80% and a specificity of 91% for partial-thickness tears. The agreement of the two modalities for diagnosis of lesions of the biceps tendon was also good;observed degree of agreement was 93% with Kappa coefficient of 0.76. In addition, ultrasonography showed comparable accuracy for classifying the size of rotator cuff tears to that of magnetic resonance imaging. Conclusion: Surgeon-operated in-office ultrasonography is an appropriate technique for the assessment of rotator cuff tears with a comparable sensitivity and sp

关键词： Diagnostic Accuracy Magnetic Resonance Imaging Rotator Cuff Tear Ultrasonography Arthroscopic Surgery

Assessment of physical stress during the perioperative period of endoscopic submucosal dissection

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World Journal of Gastroenterology 2022年第32期28卷 4508-4515页

作者： daisuke Chinda Tadashi shimoyama Department of Gastroenterology Hirosaki University Graduate School of MedicineHirosaki 036-8562Japan Division of Endoscopy Hirosaki University HospitalHirosaki 036-8563Japan Department of Internal Medicine Aomori General Health Examination CenterAomori 030-0962Japan

The advantage of endoscopic submucosal dissection(ESD)is that it is less invasive than *** is one of the best treatments for older patients as surgery in this age group of patients is ***,it is unclear how much lower the physical stress of ESD is compared with that of ***,objective methods are required to assess physical stress in patients who have undergone *** current review of ESD aimed to summarize the recent advancements in the assessment of physical stress during the perioperative period,focusing on changes in energy metabolism and serum opsonic activity(SOA).Based on metabolic changes,resting energy expenditure(REE)was measured using an indirect *** stress factor calculated from the REE and the basal energy expenditure computed using the Harris-Benedict equation can be used to assess physical *** was assessed using the chemiluminescence method,wherein the use of chemiluminescent probes(i.e.,lucigenin and luminol)allowed quantification of reactive oxygen species generated by *** an auto luminescence analyzer,the results were evaluated based on the maximum light emission and area under the emission *** quantifiable results revealed the minimal invasiveness of ESD.

关键词： Physical stress Endoscopic submucosal dissection Indirect calorimeter Resting energy expenditure Chemiluminescence Serum opsonic activity

Effectiveness of a Telenursing System on Side Effects of Chemotherapy by a Crossover Trial

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Open Journal of Nursing 2022年第12期12卷 817-830页

作者： daisuke Sato Makoto shimoyama Faculty of Medical Sciences Division of Nursing University of Fukui Fukui Japan School of Nursing Miyagi University Miyagi Japan

Background: This crossover trial aimed to examine the efficacy of the Tele-nursing Symptom Management System for Chemotherapy in Outpatient Treatment (T-SCOT) in reducing the side effects in patients undergoing out-patient chemotherapy. Methods: Using a tablet computer, participants were asked to provide information on various items, including fever, nausea, hair loss, fatigue, and vital signs. Both the participants and researchers automati-cally monitored time-dependent changes in symptoms, and the researchers proposed concrete measures to reduce patients’ complications. The primary endpoint was the M. D. Anderson Symptom Inventory (MDASI-J) score. The secondary endpoint, Quality of Life (QOL) was evaluated using the Quality of Life Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL- ACD). Results: This study included 20 patients who met all the inclusion cri-teria, 14 of whom agreed to participate in the study. There was no significant difference between the MDASI-J and QOL-ACD pre- and post-comparison of the primary and secondary evaluations in the intervention group. The control group had significantly higher scores 3 months after the intervention for symptom intensity (p = 0.04) and symptom-induced disruption to life (p = 0.03), and the symptoms worsened. The QOL-ACD had significantly lower scores for activity (p = 0.03), overall QOL (p = 0.04), and total QOL score (p = 0.02), resulting in a lower quality of life. Conclusions: Participants used the Internet to obtain information on treatments and side effects and changed their behavior in daily life. It is speculated that the Information and Commu-nications Technology (ICT) literacy in older adults has improved, and they are benefiting from digital utilization.

关键词： Telenursing Outpatient Chemotherapy Symptoms Complications Prevention

Effectiveness of a Telenursing System to Prevent the Exacerbation of Symptoms in Patients with Cancer Undergoing Outpatient Chemotherapy

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Open Journal of Nursing 2021年第6期11卷 466-476页

作者： daisuke Sato Makoto shimoyama Faculty of Health Sciences Komatsu University Ishikawa Japan Faculty of Nursing Miyagi University Miyagi Japan

During outpatient chemotherapy, adverse events occurring at home must be carefully monitored. We have developed a tele-nursing system that can store physical information such as blood pressure and pulse measured by cancer patients in the cloud by using Bluetooth, which is wireless communication technology, and collect information from remote locations. The tele-nursing system name is T-SCOT. The purpose of this study is to conduct a randomized controlled trial to investigate the efficacy of T-SCOT intervention. Participants are those who receive T-SCOT intervention plus Care as usual as the intervention group, and those who receive only Care as usual as the control group. T-SCOT includes the following five steps: 1) Answer questions related to side effects of chemotherapy [10 items];2) Measure blood pressure, pulse, body temperature, and SPO2. The measured data is automatically saved in the cloud via Bluetooth;3) Watch a video of coping behavior for side effects;4) The data entered by the patient is visualized as a line graph;5) Utilize the videophone function with researchers if you have any problems or troubles. Utilization of ICT in telenursing makes it possible to visualize patient’s physical information and contributes to the reduction of medical expenses.

关键词： Telenursing Outpatient Chemotherapy Symptoms Complications Prevention

Correlation of prefrontal activity measured by near-infrared spectroscopy (NIRS) with mood, BDNF genotype and serum BDNF level in healthy individuals

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Open Journal of Psychiatry 2012年第3期2卷 194-203页

作者： daisuke Matsuzawa Kotaro Takeda Hiroyuki Ohtsuka Jun Takasugi Takashi Watanabe Junko Maeda Saeka Nagakubo Chihiro Sutoh Ichiro shimoyama Ken Nakazawa Eiji Shimizu Clinical Research Center National Hospital Organization Murayama Medical Center Tokyo Japan Department of Cognitive Behavior Physiology Graduate School of Medicine Chiba University Chiba Japan Section for Human Neurophysiology Frontier Medical Engineering Chiba University Chiba Japan

Depression has been known to reduce the prefrontal activity associated with the execution of certain cognitive tasks, although whether a temporarily depressed or anxious mood in healthy individuals affects the prefrontal blood oxygen level during cognitive tasks is unknown. Combining the measurement of prefrontal activity with near-infrared spectroscopy (NIRS) and the two cognitive tasks, namely the letter version of the verbal fluency test (VFT-l) and the Stroop test, we measured the effect of a depressed or anxious mood and gender on the changes in the prefrontal oxygenated hemoglobin (Oxy-Hb) levels during those cognitive tests in healthy individuals. Depressed mood or anxious mood was assessed by the Hospital Anxiety and Depression Scale (HADS). Thereby we aimed to explore the possibility of NIRS measurement for detecting the early subclinical manifestation of major depression. Moreover, we examined the possible relationships between prefrontal activation and the functional Val66Met polymorphisms of the brain derived neurotropic factor (BDNF) gene and serum BDNF level. As a result, the increased prefrontal Oxy-Hb levels during cognitive tasks were significantly correlated with the severity of depressed mood in males. The course of the prefrontal Oxy-Hb increase was different depending on the cognitive tasks, i.e., the VFT-l or the Stroop test, in both genders. Correlations of BDNF genotype and serum BDNF level with the prefrontal Oxy-Hb levels during those cognitive tasks were negative. Our results suggest that the early subclinical manifestation of depressed mood in males might be detected by the NIRS measurement, which is not correlated with the individual properties of BDNF.

关键词： Near-Infrared Spectroscopy (NIRS) Depression Anxiety Brain Derived Neurotropic Factor (BDNF)