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論文(リポジトリ)

論文(リポジトリ)
大谷, 哲也 ; 齋藤, 英樹 ; 片柳, 憲雄 ; 藍沢, 喜久雄 ; 山本, 睦生 ; 藍沢, 修
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  113  pp.404-410,  1999-09.  新潟医学会
本文リンク: http://hdl.handle.net/10191/46836
概要: This study was conducted to clarify the safety and efficacy of laparoscopic cholecystectomy. A total of 443 consecutive laparoscopic cholecystectomies were performed between March, 1992 and October, 1998 at Niigata City General Hospital. The overall conversion rate from laparoscopic to open cholecystectomy was 7.9% (35). Without these 35, two patients group were compared: the initial 200 cases and the late 208 cases. The average postoperative length of hospital stay was 4.9 days for the initial 200 cases and 4.6 days for the late 208 cases. The average operative time for the late 208 cases was 74 min., which was significantly shorter (p<0.001) than the time of 87 min. for the initial 200 cases. Significant morbidity occurred in 3.6% of the 443 patients, including bile duct injuries (6), bile leak (4), vascular injury (1), small bowel injury (1), and the others (5). The conversion to laparotomy for the treatment of a complication was 1.8% (8). The re-laparotomy was required for a complication in 3, one of who died of pulmonary infarction. We analyzed quality-of-life indicators for 37 unselected patients to clarify the feasibility of laparoscopic cholecystectomy. Postoperative pain was well controlled in 97% of the patients. Eighty five % of the patients returned to their jobs within 20 days after operation. Although some specific complications are associated with laparoscopic approach, laparoscopic cholecystectomy shows its overall safety and efficacy. Adequate training and experience of laparoscopic cholecystectomy is required for prevention of these complications. 続きを見る
2.

論文(リポジトリ)

論文(リポジトリ)
小池, 正
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  111  pp.133-136,  1997-03.  新潟医学会
本文リンク: http://hdl.handle.net/10191/44490
概要: Although the majority of adults with acute leukemia obtain a complete remission with current induction therapies, most of them relapse within 1-2 years. In an attempt to improve on these discouraging results, we have begun to offer bone marrow transplanataion to patients with HLA-identical siblings. BMT long-term survivors appear to demonstrate a quality of life that is slightly lower than that of chemotherpy long-term survivors. 続きを見る
3.

論文(リポジトリ)

論文(リポジトリ)
島村, 公年 ; 畠山, 勝義 ; 須田, 武保 ; 酒井, 靖夫
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  111  pp.142-146,  1997-03.  新潟医学会
本文リンク: http://hdl.handle.net/10191/44492
概要: Recently, function-preserving surgery has become more widely applied to patients with rectal cancer. Compared with abdom ioperineal resection, sphincter-saving procedure generally leads to an improved quality of life(QOL). However, straight colo-anal anastomsis(St type)for extremely low rectal carcinoma often causes a deterioration. Therefore, we have performed colonic J pouch-anal anastomosis(J type)since 1988. Forty patients who received the J type and 14 who received the St type are discussed. Mean daily stool frequency was 2.4 at 12 months after surgery in the J group, significantly lower than 5.0 in the St group. Frequent bowel movements and urgency placed restrictions on daily life in 29% of the St group, while there were no severe restrictions in the J group. An increased number of patients are undergoing autonomic nerve-preserving procedures, and good functional results have been obtained. The incidence of urinary dysfunction requiring consultation with a urologist was lower in the autonomic nerve-preserving group(3.4%)than in the non-preserving group(34.8%). Some sexual dysfunction was found in 14.3% of the autonomic nerve-preserving group, and in 92.3% of the non-preserving group. These results that the sphincter and autonomic nerve-preserving procedures produce good postoperative QOL. 続きを見る
4.

論文(リポジトリ)

論文(リポジトリ)
畑山, 潤治
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  102  pp.402-404,  1988-07.  新潟医学会
本文リンク: http://hdl.handle.net/10191/40854
概要: In Japan a welfare for the aged has been developed by Low for the welfare of the aged which enacted in 1963. This low provided three kinds of institution for the elderly i.e. Home with moderate fee, Nursing home and Special nursing home. These institutions have been increased by construction year after year. Today in Nagaoka, a plan of new institution for the patient who needs terminal nursing and care is being embodied by medical care staffs, social welfare institutional care staffs, Buddhist priests and other persons. This institution was named Vihara. It means a place of rest or a temple for Buddhist in Sanskrit. We hope to establish a manner of desirable terminal nursing and care for Japanese supported by Buddhistical standpoints. 続きを見る
5.

論文(リポジトリ)

論文(リポジトリ)
佐藤, 豊
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  103  pp.893-900,  1989-11.  新潟医学会
本文リンク: http://hdl.handle.net/10191/41454
概要: In the field of rehabilitation medicine, during the past two decades rehabilitation goal has changed from getting independency in activities of daily living (ADL) to getting higher quality of life (QOL). On the evaluation of the disabled people, impairment, disability and handicaps must be always considered, in order to getting higher quality of life the most important things are to make much improvement in the handicap level, not in the impairment nor disability level. In the patient with spinal cord injury the most paraplegics and quadriplegics whose injury level are lower than C-6 can be independent in ADL and are able to drive a car and go back to jobs and enjoy their lives with some recreational activities and sports with wheelchair. But the quadriplegics whose injury level are higher than C-5 will be mostly dependent in ADL and will become partially independent in ADL by using environmental control system (ECS) and micro-computer, so we must encourage the patients to use the ECS and micro-computer that they will be able to participate in creative activities like to write something, to call somebody, to put on TV or radio etc. In the patient with cerebral vascular accident, the elderly patients with CVA can be independent in ADL and go back to their home and take some role at home, the younger patients with CVA can be independent in ADL and must be able to go back to jobs and to enjoy sports and recreation activities or leisures. 続きを見る
6.

論文(リポジトリ)

論文(リポジトリ)
森田, 昌宏 ; 須賀, 良一 ; 滝沢, 謙二
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  103  pp.901-910,  1989-11.  新潟医学会
本文リンク: http://hdl.handle.net/10191/41457
概要: Psychiatrists have been confronted with a difficult task to help psychiatric patients adequately adapt to their social environments. Thus, it is necessary for psychiatrists to make efforts persistently to improve Quality of Life in psychiatric patient. The present paper describes two types of problems concerning QOL from the viewpoint of Consultation-Liaison Psychiatry. The first problem frequently occurs in the case of chronic schizophrenia associated with severe physical illness. There are some obstacles resulted in settings of medical and surgical treatements for their physical illness, since schizophrenic symptoms (loss of spontaneity, disturbance of reality-testing and so on) injure their ability of cooperating with medical staffs. For a successful treatment on their physical complications, physicians should ask psychiatrist for collaboration and set up an adequate goal of treatment and rehabilitation inconsideration of their mental and physical aspects of disabilities. The second is psychosocial problems, including a refusal to medical treatments, an interpersonal trouble with the medical staffs, a suicidal act and so on, that sometimes occur in the patients suffering from chronic and severe physical illness. It is useful to apply psychiatric approach to a solution of these problems. In this approach each patient is appreciated comprehensively as an unique existence who has his own personality and life, and treated with focusing on the therapeutic relation between patient and therapist. 続きを見る