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排序方式: 共有603条查询结果,搜索用时 15 毫秒
1.
YOSHINORI MORITA NOBUO AOYAMA DAISUKE SHIRASAKA MASATERU FUKUDA MASATO KASUGA 《Digestive endoscopy》2003,15(Z1):S12-S14
In Kobe University Hospital, a new method for endoscopic mucosal resection (EMR) using insulated‐tip electrosurgical knife (IT‐EMR) for early gastric cancer (EGC) was introduced from November 2001. To achieve an effective and safe IT‐EMR procedure, we use a high‐frequency surgical unit for cutting and coagulation (ERBOTOM ICC 200) with automatically controlled cutting mode (ENDOCUT). In this study, we show not only our results of IT‐EMR for EGC in comparison with those of the conventional strip biopsy method, but also the optimal conditions for the apparatus of a high‐frequency surgical unit to prevent complications such as bleeding and perforation. 相似文献
2.
Shinya Kodashima Mitsuhiro Fujishiro Naohisa Yahagi Naomi Kakushima Masanori Nakamura Masao Omata 《Digestive endoscopy》2006,18(2):151-153
Endoscopic resection has been accepted as the standard treatment for intramucosal gastric tumors of differentiated type. However, the indication was limited to small tumors to achieve en bloc resection and prevent local recurrence in cases of conventional endoscopic mucosal resection (EMR) such as the strip biopsy and the cap technique. To avoid multi‐fragmental resection, we have developed endoscopic submucosal dissection (ESD) as a new endoscopic resection technique. ESD is a remarkable technique, because we make it possible to remove the lesions en bloc regardless of size, shape, coexisting ulcer, and location. However, it is difficult or impossible to resect recurrent tumors en bloc in conventional EMR owing to hard fibrosis, and some patients need laparotomy. Using ESD, we can dissect the submucosal layer as we directly look at the submucosa, and remove the lesion safely and reliably even in cases of hard fibrosis. The key to treatment of recurrent tumors in ESD are as follows: (i) using enough submucosal injection solution (we use a mixture of Glyceol and 1% 1900 kDa hyaluronic acid preparation); (ii) incising the mucosa without fibrosis; (iii) understanding characteristics of various cutting devices, and changing other devices in difficult situations. In these ways we can remove the majority of the recurrent tumors en bloc. Hence, we consider that ESD is a very effective treatment which achieves excellent en bloc and complete resection rates and enables patients with intramucosal gastric tumors to a recurrent‐free survival even in recurrent tumors. 相似文献
3.
Radhouene Doggui Hanin Al-Jawaldeh Jalila El Ati Rawhieh Barham Lara Nasreddine Nawal Alqaoud Hassan Aguenaou Laila El Ammari Jana Jabbour Ayoub Al-Jawaldeh 《Nutrients》2021,13(5)
The Eastern Mediterranean Region (EMR) is experiencing a nutrition transition, characterized by the emergence of overnutrition and micro-nutrient deficiencies. No previous study has comparatively examined nutrient intake in adults across countries in the EMR. This review examined the adequacy of nutrients in adults living in the EMR. Moreover, it analyzed the food balance sheets (FBS) for 1961–2018 to identify the trajectory of energy supply from macro-nutrients in the EMR. A systematic search was conducted from January 2012 to September 2020. Only observational studies were retained with a random sampling design. An assessment of the methodological quality was conducted. Levels of nutrient daily intake and their adequacy compared to the daily reference intake of the Institute of Medicine were reported across the region. No studies were identified for half of the region’s countries. Although nutrient energy intake was satisfactory overall, fat and carbohydrate intake were high. Intake of vitamin D, calcium, potassium, zinc, and magnesium were below that recommended. The analysis of the FBS data allowed for the identification of four linear patterns of trajectories, with countries in the EMR best fitting the ‘high-energy-supply from carbohydrate’ group. This systematic review warrants multi-sectorial commitment to optimize nutrient intake. 相似文献
4.
电子病历书写的质量管理与对策 总被引:4,自引:0,他引:4
侯微 《国际医药卫生导报》2004,10(18):243-244
目的 探讨和总结电子病历(Eleetronic Medical Record,EMR)使用中医生记录的质量控制方法。方法 对EMR中医生记录进行质量分析,找出存在的常见主观性和客观性错误,采用软件设计与建立管理制度的方法提高质量。结果 通过改进软件设计和建立健全规章制度可以达到EMR质量控制。 相似文献
5.
探讨了电子病历交换的意义,指出推广医院电子病历交换、实现医疗信息共享,已成为医院信息化建设的重要任务。并分析了集团医院内电子病历交换采用ebXML的可行性及基于ebXML的电子病历交换的优势,在借鉴电子商务标准ebXML交换模式设计思想的基础上,提出医院间电子病历交换模型。 相似文献
6.
结直肠癌大多起源于结直肠早癌及腺瘤等癌前病变,若在发展到浸润癌之前发现并予以切除,即可取得预防或根治效果。随着内镜技术的发展,尤其是EMR/ESD技术的不断成熟,从早期诊断到治疗及预后,与传统开腹手术相比优点突出,但要严格把握其适应症,由于技术难度大,出血、穿孔等是常见并发症。EMR/ESD是经济、安全、可靠的治疗结直肠早癌及癌前病变的方法,同时中药治疗疗效肯定。 相似文献
7.
Daniel J. Stein Christian Salinas Saher Sabri Rose Onyeali Stephen Caldwell Zachary Henry 《Journal of vascular and interventional radiology : JVIR》2019,30(2):187-194
Purpose
To assess short- and long-term mortality and rebleeding with endoscopic cyanoacrylate (EC) versus balloon-occluded retrograde transvenous obliteration (BRTO).Materials and Methods
A retrospective cohort comparison was conducted of 90 EC patients and 71 BRTO patients from 1997 through 2015 with portal hypertension who presented due to endoscopically confirmed bleeding cardiofundal gastric varices. Patients underwent either endoscopic intra-varix injection of 4-carbon-n-butyl-2-cyanoacrylate or sclerosis with sodium tetradecyl sulfate with balloon occlusion for primary variceal treatment.Results
Seventy-one BRTO patients and 90 EC patients, of whom 89% had cirrhosis and 35% were women, were included, with a respective average Model for End-Stage Liver Disease (MELD) score of 13.4 and 14.4, respectively. Mortality at 6 weeks was 14.4% for EC patients and 13.1% for BRTO patients (Kaplan-Meier/Wilcoxon, P = .85). No long-term mortality difference was observed (Cox hazard ratio [HR] = 0.89, P = .64). Also, 5.1% of EC patients and 3.5% of BRTO patients (Kaplan-Meier/Wilcoxon, P = .62) rebled at 6 weeks, but at 1 year, 22.0% of EC patients and 3.5% of BRTO patients had rebled (Kaplan-Meier/Wilcoxon, P < .01). Lower rates of long-term rebleeding were found with BRTO (Cox HR = 0.25, P = .03). No difference was seen in the rate of new portal hypertensive complications (Cox HR = 1.21, P = .464). However, 16/71 patients who underwent BRTO had simultaneous transjugular intrahepatic portosystemic shunt. Age, sex, MELD score, and presence of cirrhosis were the primary predictors of mortality. One death in the EC group and 5 deaths in the BRTO group were deemed to be procedurally related (chi-square, P = .088).Conclusions
BRTO is associated with a lower rate of rebleeding but no change in mortality. 相似文献8.
在借鉴美国电子病历标准基础上,对中美电子病历标准化的发展历史、现状和内容等进行分析比较,找出我国电子病历标准化存在的问题和解决方案,使我国的电子病历标准建设更加健康和规范。 相似文献
9.
本文介绍了将电子生命体征检测仪和无线网络技术用于记录病人体温、脉搏、呼吸及血压的三测单数据并传入电子病历数据库的设计思路和实现步骤。 相似文献
10.
Harunobu Sato Tetsuya Tsukamoto Yoshihisa Mizuno Tomoaki Ichikawa Yoshihito Kotani Katsuyuki Honda Kouhei Hatta Makoto Kuroda 《Digestive endoscopy》2014,26(6):749-751
Malakoplakia in the gastrointestinal tract is rare in healthy young people without underlying disease. Sufficient tissue is required for accurate diagnosis. We describe a malakoplakia that developed in a healthy young woman and was treated by endoscopic mucosal resection (EMR). A 40‐year‐old woman with a history of taking oral contraceptives until one year earlier was referred to our hospital with anal bleeding and constipation. A colonoscopy carried out at our another hospital 18 months earlier disclosed no abnormal findings. Colonoscopy at presentation revealed a yellowish‐white tumor, 5 mm in diameter, in the rectum. The lesion was slightly protruded and had a smooth flat surface, without erosion or ulceration. EMR was carried out for a definitive diagnosis. Histopathological examination showed that the tumor contained granular histiocytes, positive for CD68 and negative forcytokeratin (AE1/AE3). Several histiocytes contained intracytoplasmic round bodies (Michaelis–Gutmann bodies), which reacted positively with periodic acid‐Schiff and calcium (Von Kossa) stains. Intracytoplasmic Escherichia coli (von Hansemann bodies) were identified by Giemsa staining. Based on these results, the tumor in the rectum was diagnosed as a malakoplakia. Following EMR, the patient did not receive further treatment for malakoplakia because she had no symptoms associated with malakoplakia. She has been well for more than 9 months, with no symptoms of disease. Awareness of colorectal malakoplakia is important in patients taking steroids, including oral contraceptives. 相似文献