We designed a Japanese version of the Smartphone Dependence Scale (J-SDS) for university students, and assessed its validity and reliability. For development of this scale, we initially selected 43 preliminary items b...We designed a Japanese version of the Smartphone Dependence Scale (J-SDS) for university students, and assessed its validity and reliability. For development of this scale, we initially selected 43 preliminary items based on previous studies of Internet and mobile phone dependence. Each response was scored using a Likert scale (0, 1, 2, 3), with higher scores indicating greater dependence. After administering the preliminary scale to 149 university students, the final 29 items were selected according to exploratory factor analysis. The final scale consisted of 5 factors: 1) craving and withdrawal, 2) overuse and tolerance, 3) virtual life orientation, 4) disturbance of concentration in class, and 5) physical symptoms. Reliability coefficient (Cronbach’s alpha) values for the 5 factors and total J-SDS were 0.87, 0.87, 0.76, 0.77, 0.69, and 0.92, respectively. We then summed the Likert scores for each item to provide a quantitative overall smartphone dependence score, with higher scores indicating greater dependence. The J-SDS score became significantly higher with longer hours of smartphone use (p < 0.001). Our results suggest that the J-SDS is a reliable and valid scale for screening university students who may be at risk of developing smartphone dependence.展开更多
AIM:To evaluate a new hemostatic method using hemostatic forceps to prevent perforation and perioperative hemorrhage during colonic endoscopic submucosal dissection(ESD).METHODS:We studied 250 cases,in which ESD for c...AIM:To evaluate a new hemostatic method using hemostatic forceps to prevent perforation and perioperative hemorrhage during colonic endoscopic submucosal dissection(ESD).METHODS:We studied 250 cases,in which ESD for colorectal tumors was performed at the Kyoto Prefectural University of Medicine or Nara City Hospital between 2005 and 2010.We developed a new hemostatic method using hemostatic forceps in December 2008 for the efficient treatment of submucosal thick vessels.ESD was performed on 126 cases after adoption of the new method(the adopted group)and the new method was performed on 102 of these cases.ESD was performed on 124 cases before the adoption of the new method (the unadopted group).The details of the new method are as follows:firstly,a vessel was coagulated using the hemostatic forceps in the soft coagulation mode according to the standard procedure,and the coagulated vessel was removed using the forceps in the"endocut" mode without perioperative hemorrhage.Secondly,the partial surrounding submucosa was dissected using the forceps in the endocut mode.In the current study,we evaluated the efficacy of this method.RESULTS:Coagulated vessels were successfully removed using the hemostatic forceps in all 102 cases without severe perioperative hemorrhage.Moderate perioperative hemorrhage occurred in five cases(4.9%);however,it was stopped by immediately reuse of the hemostatic forceps.The partial surrounding submucosa was dissected using the forceps in all 102 cases.In the adopted group,the median operation time was 105 min.The proportion of endoscopic en bloc resection was 92.8%(P<0.01)compared to 80.6%in the unadopted group.The postoperative hemorrhage and perforation rates were 2.3%and 2.3%.The rate of perforation was significantly lower than that in the unadopted group (9.6%,P<0.01).We evaluated the ease of use of this method by allowing our three trainees to performed ESD on 46 cases,which were accomplished without any severe hemorrhage.CONCLUSION:The new method effectively treated submucosal thick vessels and shows promise for the prevention of perforation and perioperative hemorrhage in colonic ESD.展开更多
A 63-year-old woman was referred to our hospital for further examination because of an incidental finding of early gastric cancer.Endoscopic submucosal dissection(ESD)was successfully performed for complete resection ...A 63-year-old woman was referred to our hospital for further examination because of an incidental finding of early gastric cancer.Endoscopic submucosal dissection(ESD)was successfully performed for complete resection of the tumor.On the first post-ESD day,the patient suddenly complained of abdominal pain after an episode of vomiting.Abdominal computed tomography(CT)showed delayed perforation after ESD.The patient was conservatively treated with an intravenous proton pump inhibitor and antibiotics.On the fifth post-ESD day,CT revealed a gastric wall abscess in the gastric body.Gastroscopy revealed a gastric fistula at the edge of the post-ESD ulcer,and pus was found flowing into the stomach.An intradrainage stent and an extradrainage nasocystic catheter were successfully inserted into the abscess for endoscopic transgastric drainage.After the procedure,the clinical symptoms and laboratory test results improved quickly.Two months later,a follow-up CT scan showed no collection of pus.Consequently,the intradrainage stent was removed.Although the gastric wall abscess recurred 2 wk after stent removal,it recovered soon after endoscopic transgastric drainage.Finally,after stent removal and oral antibiotic treatment for 1 mo,no recurrence of the gastric wall abscess was found.展开更多
Primary histiocytic sarcoma of the spleen is a rare but potentially lethal condition. It can remain asymptomatic or only mildly symptomatic for a long time. An 81-year-old woman presented with an extremely enlarged sp...Primary histiocytic sarcoma of the spleen is a rare but potentially lethal condition. It can remain asymptomatic or only mildly symptomatic for a long time. An 81-year-old woman presented with an extremely enlarged spleen. She suffered from progressive anemia and required a red blood cell transfusion once a month. Although computed tomography, ultrasonography, and magnetic resonance imaging were performed for diagnosis, a confirmed diagnosis was not obtained. Her enlarged spleen compressed her stomach, and she suffered from gastritis and a sense of gastric fullness just after meals. She underwent laparoscopic splenectomy for therapeutic and diagnostic purposes. Her postoperative course was uneventful. After surgery, her red blood cell and platelet counts increased markedly. The tumor was diagnosed as splenic histiocytic sarcoma. Post-surgical chemotherapy was not performed, and the patient died of liver failure due to liver metastasis 5 mo after surgery. Laparoscopic splenectomy is minimally invasive and useful for the relief of symptoms related to hematological disorders. However, in cases of an enlarged spleen, optimal views and working space are limited. In such cases, splenic artery ligation can markedly reduce the size of the spleen, thus facilitating the procedure. The case reported herein suggests that laparoscopic splenectomy may be useful for the treatment of splenic malignancy.展开更多
文摘We designed a Japanese version of the Smartphone Dependence Scale (J-SDS) for university students, and assessed its validity and reliability. For development of this scale, we initially selected 43 preliminary items based on previous studies of Internet and mobile phone dependence. Each response was scored using a Likert scale (0, 1, 2, 3), with higher scores indicating greater dependence. After administering the preliminary scale to 149 university students, the final 29 items were selected according to exploratory factor analysis. The final scale consisted of 5 factors: 1) craving and withdrawal, 2) overuse and tolerance, 3) virtual life orientation, 4) disturbance of concentration in class, and 5) physical symptoms. Reliability coefficient (Cronbach’s alpha) values for the 5 factors and total J-SDS were 0.87, 0.87, 0.76, 0.77, 0.69, and 0.92, respectively. We then summed the Likert scores for each item to provide a quantitative overall smartphone dependence score, with higher scores indicating greater dependence. The J-SDS score became significantly higher with longer hours of smartphone use (p < 0.001). Our results suggest that the J-SDS is a reliable and valid scale for screening university students who may be at risk of developing smartphone dependence.
文摘AIM:To evaluate a new hemostatic method using hemostatic forceps to prevent perforation and perioperative hemorrhage during colonic endoscopic submucosal dissection(ESD).METHODS:We studied 250 cases,in which ESD for colorectal tumors was performed at the Kyoto Prefectural University of Medicine or Nara City Hospital between 2005 and 2010.We developed a new hemostatic method using hemostatic forceps in December 2008 for the efficient treatment of submucosal thick vessels.ESD was performed on 126 cases after adoption of the new method(the adopted group)and the new method was performed on 102 of these cases.ESD was performed on 124 cases before the adoption of the new method (the unadopted group).The details of the new method are as follows:firstly,a vessel was coagulated using the hemostatic forceps in the soft coagulation mode according to the standard procedure,and the coagulated vessel was removed using the forceps in the"endocut" mode without perioperative hemorrhage.Secondly,the partial surrounding submucosa was dissected using the forceps in the endocut mode.In the current study,we evaluated the efficacy of this method.RESULTS:Coagulated vessels were successfully removed using the hemostatic forceps in all 102 cases without severe perioperative hemorrhage.Moderate perioperative hemorrhage occurred in five cases(4.9%);however,it was stopped by immediately reuse of the hemostatic forceps.The partial surrounding submucosa was dissected using the forceps in all 102 cases.In the adopted group,the median operation time was 105 min.The proportion of endoscopic en bloc resection was 92.8%(P<0.01)compared to 80.6%in the unadopted group.The postoperative hemorrhage and perforation rates were 2.3%and 2.3%.The rate of perforation was significantly lower than that in the unadopted group (9.6%,P<0.01).We evaluated the ease of use of this method by allowing our three trainees to performed ESD on 46 cases,which were accomplished without any severe hemorrhage.CONCLUSION:The new method effectively treated submucosal thick vessels and shows promise for the prevention of perforation and perioperative hemorrhage in colonic ESD.
文摘A 63-year-old woman was referred to our hospital for further examination because of an incidental finding of early gastric cancer.Endoscopic submucosal dissection(ESD)was successfully performed for complete resection of the tumor.On the first post-ESD day,the patient suddenly complained of abdominal pain after an episode of vomiting.Abdominal computed tomography(CT)showed delayed perforation after ESD.The patient was conservatively treated with an intravenous proton pump inhibitor and antibiotics.On the fifth post-ESD day,CT revealed a gastric wall abscess in the gastric body.Gastroscopy revealed a gastric fistula at the edge of the post-ESD ulcer,and pus was found flowing into the stomach.An intradrainage stent and an extradrainage nasocystic catheter were successfully inserted into the abscess for endoscopic transgastric drainage.After the procedure,the clinical symptoms and laboratory test results improved quickly.Two months later,a follow-up CT scan showed no collection of pus.Consequently,the intradrainage stent was removed.Although the gastric wall abscess recurred 2 wk after stent removal,it recovered soon after endoscopic transgastric drainage.Finally,after stent removal and oral antibiotic treatment for 1 mo,no recurrence of the gastric wall abscess was found.
文摘Primary histiocytic sarcoma of the spleen is a rare but potentially lethal condition. It can remain asymptomatic or only mildly symptomatic for a long time. An 81-year-old woman presented with an extremely enlarged spleen. She suffered from progressive anemia and required a red blood cell transfusion once a month. Although computed tomography, ultrasonography, and magnetic resonance imaging were performed for diagnosis, a confirmed diagnosis was not obtained. Her enlarged spleen compressed her stomach, and she suffered from gastritis and a sense of gastric fullness just after meals. She underwent laparoscopic splenectomy for therapeutic and diagnostic purposes. Her postoperative course was uneventful. After surgery, her red blood cell and platelet counts increased markedly. The tumor was diagnosed as splenic histiocytic sarcoma. Post-surgical chemotherapy was not performed, and the patient died of liver failure due to liver metastasis 5 mo after surgery. Laparoscopic splenectomy is minimally invasive and useful for the relief of symptoms related to hematological disorders. However, in cases of an enlarged spleen, optimal views and working space are limited. In such cases, splenic artery ligation can markedly reduce the size of the spleen, thus facilitating the procedure. The case reported herein suggests that laparoscopic splenectomy may be useful for the treatment of splenic malignancy.
