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Investigation and prediction of enteral nutrition problems after percutaneous endoscopic gastrostomy

World Journal of Gastroenterology 2009年第11期15卷 1367-1372页

作者： Shiro Yokohama Masaru Aoshima Yukiomi Nakade Junya Shindo junichi maruyama Masashi Yoneda Department of Gastroenterology Asahikawa Rehabilitation HospitalAsahikawa078-8801Japan Division of Gastro-enterology Department of Internal MedicineAichi Medical University School of MedicineAichi 480-1195Japan Department of Rehabilitation Asahikawa Rehabilitation HospitalAsahikawa 078-8801Japan Department of Internal Medicine Asahikawa Rehabilitation HospitalAsahikawa 078-8801Japan

AIM： To investigate and predict enteral nutrition problems after percutaneous endoscopic gastrostomy （PEG）. METHODS： We retrospectively analyzed data for 252 out of 285 patients who underwent PEG at our hospital from 1999 to 2008 after PEG were defined as： Enteral nutrition problems （1） patients who required ≥ 1 mo after surgery to switch to complete enteral nutrition, or who required additional parenteral alimentation continuously; or （2） patients who abandoned switching to enteral nutrition using the gastrostoma and employed other nutritional methods. We attempted to identify the predictors of problem cases by using a logistic regression analysis that examined the patients＇ backgrounds and the specific causes that led to their problems. RESULTS： Mean age of the patients was 75 years, and in general, their body weight was low and their overall condition was markedly poor. Blood testing revealed that patients tended to be anemic and malnourished. A total of 44 patients （17.5%） were diagnosed as having enteral nutrition problems after PEG. Major causes of the problems included pneumonia, acute enterocolitis （often Clostridium difficile-related）, paralytic ileus and biliary tract infection. A multivariate analysis identified the following independent predictors for problem cases：（1） enteral nutrition before gastrectomy （a risk reduction factor）; （2） presence of esophageal hiatal hernia; （3） past history of paralytic ileus; and （4） presence of chronic renal dysfunction. CONCLUSION： Enteral nutrition problems after PEG occurred at a comparatively high rate. Patient background analysis elucidated four predictive factors for the problem cases.

关键词： Percutaneous endoscopic gastrostomy Enteral nutrition Complication, Risk factor Predictor

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iShim and Water Excitation Improves the Signal-to-Noise Ratio on q-Space Imaging: A Single-Center Clinical Study

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Open Journal of Radiology 2018年第4期8卷 244-259页

作者： Yoshifumi Sone junichi Hata Yasushi Sera Katsuya maruyama Thomas Benkert Zhouchen Lu Jun Kasahara Hideyuki Okano Morio Matsumoto Masaya Nakamura Daisuke Nakashima Takeo Nagura Medical Scanning Tokyo Tokyo Japan Central Institute for Experimental Animals Kanagawa Japan Department of Physiology Keio University School of Medicine Tokyo Japan Riken Brain Science Institute Saitama Japan Institute for Integrated Sports Medicine Keio University School of Medicine Tokyo Japan MR Research & Collaboration Department Diagnostic Imaging Business Area Siemens Healthcare K.K. Tokyo Japan Siemens Healthcare GmbH Erlangen Germany Department of Orthopaedic Surgery Keio University School of Medicine Tokyo Japan

Purpose: This study aimed to examine whether the signal-to-noise ratio (SNR) could be increased by combining integrated slice-by-slice shimming (iShim) with a fat suppression (FS) method other than short-tau inversion recovery (STIR) in diffusion-weighted imaging (DWI) and q-space imaging (qsi). Methods: We acquired DWI images (b-values: 0 and nine steps from 400 to 10,000 s/mm2 for six axes) using a prototypical single-shot echo planar imaging sequence by combining two types of shimming (3D Shim and iShim) and two types of FS (STIR and water excitation [WE]) in 10 volunteers. In the DWI study, the SNR for each b-value, FS effect in the b0 image, and distortion in the added image (b0 - b10,000) were evaluated for the above-mentioned four imaging methods. qsi involved original DWI images. In the qsi study, the SNR was evaluated. Results: With regard to both 3D Shim and iShim, the SNRs were significantly higher when using WE than when using STIR in b0 - b900 images (p Conclusion: The combination of iShim and WE has a high SNR on qsi.

关键词： iShim Fat Suppression Water Excitation Diffusion-Weighted Imaging q-Space Imaging (qsi)

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