記述言語：英語   出版者・発行元：(一社)日本経カテーテル心臓弁治療学会  

経カテーテル大動脈弁留置術植込み術(TAVI)は、症候性重度大動脈弁狭窄症を有する高齢患者や高リスク外科患者の主要な治療法である。本研究では、当施設で広く使用されている最小サイズのバルーン拡張型経カテーテル心臓弁(THV)であるSAPIEN 3 20mmの安全性と有効性を後ろ向きに評価した。2017年6月～2022年10月に単施設でSAPIEN 3によるTAVIを受けた患者456例を、20mm THV群56例(女性98.2%、平均84.6±5.0歳)、23mm THV群254例(女性82.3%、平均85.5±4.3歳)、26/29mm THV群146例(女性25.3%、平均84.5±4.7歳)に分け、短期成績、有害事象、新規ペースメーカー植込み(PMI)、弁周囲漏出(PVL)、人工臓器患者不適合(PPM)、30日死亡率、2年死亡率を比較した。その結果、20mm THV群では新規PMIや中等度以上のPVLは観察されなかったが、中等度PPMの発生率は他群より有意に高かった。2年全死亡率には有意差が認められなかった。結論として、20mm THVの短期転帰は概ね良好であり、中等度PPMの増加は見られたものの、長期予後への影響は限定的である可能性が示唆された。

記述言語：英語   出版者・発行元：Japan Transcatheter Valve Therapies  

<p><b>Objective:</b> Transcatheter aortic valve implantation (TAVI) has become a cornerstone treatment for elderly or high-risk surgical patients with symptomatic severe aortic stenosis. The continuous evolution of TAVI techniques and technology has significantly improved its safety and efficacy. This study aims to deepen our understanding of the safety and effectiveness of the smallest size balloon-expanding transcatheter heart valve (BE-THV): SAPIEN 3 20 mm, through extensive utilization at our institution, with the goal of further refining TAVI procedures in the future.</p><p><b>Methods:</b> This retrospective single-center observational study included 456 consecutive patients who underwent TAVI with SAPIEN 3 valves between June 2017 and October 2022. The short-term outcomes, adverse events such as stroke, new pacemaker implantation (PMI), paravalvular leak (PVL), prosthesis-patient mismatch (PPM), 30-day mortality, and 2-year mortality associated with the 20-mm THV were analyzed and compared with those of the 23-mm THV or the 26-/29-mm THV.</p><p><b>Results:</b> The most commonly used THV size was 23 mm, accounting for 55.7% (254 cases), followed by the 26-/29-mm THV at 32.0% (146 cases) and the 20-mm THV at 12.3% (56 cases). There were no instances of new PMI or moderate or severe PVL observed in the 20-mm THV group. The 30-day mortality rate was 1.8% in patients who underwent the 20-mm THV, 1.6% in those with the 23-mm THV, and 0% in those with the 26-/29-mm THV, with no significant difference observed (P = 0.3012). However, the incidence of moderate PPM in patients who underwent the 20-mm THV implantation was 24.1% (13 out of 55), compared to 5.3% in those with the 23-mm THV and 4.3% in those with the 26-/29-mm THV, showing a statistically significant increase (P <0.0001), but severe PPM was not observed in any THV groups. The prevalence of a postprocedural transvalvular mean pressure gradient (MPG) ≥20 mmHg in the 20-mm THV group was higher compared to other size groups (20 mm: 14.3% vs. 23 mm: 2.0% vs 26/29 mm: 1.4%, P <0.0001). There was no significant difference in 2-year all-cause mortality rates (20 mm: 14.3% vs. 23 mm: 11.5% vs. 26/29 mm: 9.7%, P = 0.6491) among the different THV sizes.</p><p><b>Conclusion:</b> The short-term outcomes associated with the 20-mm THV were reasonably satisfactory. While the occurrence of moderate PPM was significantly higher in patients receiving the 20-mm THV compared to other THV sizes, there were no significant differences in the 2-year mortality rate.</p>

DOI： 10.33290/jtvt.oa.24-0001

CiNii Research

記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

記述言語：英語   出版者・発行元：(一社)日本心血管インターベンション治療学会  

記述言語：日本語   出版者・発行元：Asian Pacific Journal of Cancer Prevention  

Background: Delays in breast cancer diagnosis can allow the disease to progress to an incurable stage. However, factors that cause patients to delay seeking treatment are unclear. In this study, we aimed to identify behavioral economic factors and personality characteristics of patients with breast cancer who had a delayed diagnosis. Methods: We analyzed questionnaires completed by 41 patients with breast cancer. A delayed diagnosis was defined if the time between the first symptom and the medical visit was more than 6 months. Results: We found 11 patients who had a delayed diagnosis. The significant characteristics associated with patients with breast cancer who had delayed diagnosis were: (i) less experience with breast cancer screening; (ii) progressive disease stage; and (iii) low time and future time preference. We found no significant behavioral economic factors other than time preference, and personality that differed between patients with breast cancer who did and did not have a delayed diagnosis. Conclusion: Low time preference rate is a characteristic of patients with breast cancer who had a delayed diagnosis.

DOI： 10.31557/APJCP.2023.24.10.3437

Scopus

PubMed

記述言語：英語  

DOI： 10.1186/s40792-022-01364-2

PubMed

記述言語：英語  

DOI： 10.1186/s40792-021-01285-6

PubMed

記述言語：英語   出版者・発行元：(一社)日本心血管インターベンション治療学会  

記述言語：日本語   出版者・発行元：Surgery Today  

Purpose: In endoscopic surgery, surgeons occasionally encounter difficulties due to visual field obstruction by muscles or blood vessels. In these situations, specialized instruments that can effectively retract these obstructions are required. Recently, we developed a new detachable wire-rimmed retractor (KN retractor) for narrow-space surgery. Methods: We evaluated the utility of this KN retractor in 15 patients with thyroid and parathyroid disease. Of those, five patients with papillary thyroid cancer had gasless endoscopic hemithyroidectomy with central node dissection, five underwent endoscopic total thyroidectomy for Graves’ disease, and the remaining five received endoscopic parathyroidectomy with gas insufflation. Results: Surgeons were able to perform meticulous operations in a satisfactory visual field supported by the KN retractor. In all patients, the strap muscles were preserved without cutting. The average operating time was 149, 154, and 81 min in patients who underwent hemithyroidectomy with central node dissection, total thyroidectomy, and parathyroidectomy, respectively. Gas insufflation was successfully completed in all cases while maintaining sufficient airtightness. Conclusions: The KN retractor is suitable for both the gasless lifting method and gas insufflation surgery in a narrow space. We believe that the KN retractor is a new device that will greatly improve the safety and shorten the operation time in endoscopic surgery.

DOI： 10.1007/s00595-020-02124-1

Scopus

PubMed

記述言語：英語  

記述言語：日本語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：日本語