巻号一覧
62 巻, 2 号
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REVIEW
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Jean-Francois Rey2013 年 62 巻 2 号 p. 41-46
発行日: 2013年
公開日: 2013/06/25
[早期公開] 公開日: 2013/05/27ジャーナル フリーSmall-bowel capsule endoscopy (SBCE) was introduced 11 years ago by Given Imaging and is becoming the gold standard for small-bowel examination. This major step in the field of digestive medicine has opened the possibility of promising non-invasive explorations of the esophagus, stomach, and colon. SBCE can be used to overcome the inherent limitations of enteroscopy, especially in the West, where the capsule has been available since 2001. Obscure gastrointestinal (GI) bleeding with normal findings on upper and lower endoscopy remains the most important indication, and suspected Crohn’s disease is also a well-accepted indication. Findings from a capsule investigation may warrant therapeutic endoscopy, but in many cases, SBCE avoids this useful but time-consuming endoscopic procedure. The use of a colon capsule for colorectal cancer screening when traditional colonoscopy is contraindicated or impossible is undergoing clinical trials. Early results seem promising, but control of colonic motility is still cumbersome, and patient preparation remains the most important drawback. We performed the first clinical trial in humans of a magnetically guided gastric capsule that offers the possibility of investigation with a capsule that can be controlled spatially. To date, we have carried out procedures in more than 400 patients and volunteers, with impressive results compared with high-definition gastroscopy. Even though endoscopy remains the most important tool in the GI field, capsules offer promising new possibilities.抄録全体を表示PDF形式でダウンロード (716K) -
Chang Hyun Oh, Seung Hwan Yoon2013 年 62 巻 2 号 p. 47-52
発行日: 2013年
公開日: 2013/06/25
ジャーナル フリーCervical arthroplasty was developed in an attempt to maintain cervical motion and potentially to avoid or minimize adjacent-segment degeneration. If cervical arthroplasty is successful, the long-term results of surgery for cervical disc disease should improve. However, problems associated with cervical arthroplasty have been reported: these include kyphosis, heterotopic ossification-induced motion limitation, no motion preservation even at the index level, and a higher revision rate in a limited number of cases compared with anterior cervical discectomy and fusion (ACDF). In addition, for degenerative cervical disc disorders, the risk of developing adjacent segment degeneration more than 2 years after surgery is reportedly similar for ACDF and cervical arthroplasty. Cervical disc arthroplasty is an emerging motion-sparing technology and is currently undergoing evaluation in many countries as an alternative to arthrodesis for the treatment of cervical radiculopathy and myelopathy. The decision whether to use arthrodesis or arthroplasty is a difficult one. The achievement of good prosthetic performance demands exacting implantation techniques to ensure correct placement. This fact underlines the increasing importance of special instrumentation and surgical skills that involve an understanding of prosthetic lubrication, wear, and biologic effects and familiarity with currently available information regarding kinematics, basic science, testing, and early clinical results. Fortunately, a number of devices are at the late preclinical study stage or at the early clinical trial stage, and results in many cases are promising. In the near future, it is likely that new designs will be produced to replace spinal discs totally or partially in a pathologic entity-specific manner.抄録全体を表示PDF形式でダウンロード (827K)
CASE REPORT
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Engin Deniz Arslan, Ali Demir, Fevzi Yilmaz, Cemil Kavalci, Evvah Kara ...2013 年 62 巻 2 号 p. 53-57
発行日: 2013年
公開日: 2013/06/25
[早期公開] 公開日: 2013/05/27ジャーナル フリーWe report the case of a 29-year-old woman who attempted suicide by oral ingestion of potentially fatal doses of multiple drugs including quetiapine. Intravenous lipid emulsion (ILE) was administered at a dose higher than that used in the standard management of toxicity. Rapid improvement was observed in the patient’s status, and no additional treatment was required during the period of observation. No adverse effect of lipid administration was observed. ILE treatment seems to have great potential in the management of lipophilic drug toxicity in the future.抄録全体を表示PDF形式でダウンロード (2421K)
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