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Katsunori Toyoda,Takeo Hata,Shigeru Yamauchi,Shinya Kinoshita,Masami Nishihara,Kazuhisa Uchiyama,Ken Inada,Tetsufumi Kanazawa 대한신경정신의학회 2021 PSYCHIATRY INVESTIGATION Vol.18 No.2
Objective The effectiveness of clozapine is clearly superior to other antipsychotics in the treatment of refractory schizophrenia. Clozapine leads to various side effects, and therefore many patients are forced to discontinue. In this study, we analyzed the registry database of all cases in Japan to identify risk factors for discontinuation of clozapine. Methods The Clozaril patient monitoring service?? (CPMS) database from July 31, 2009 to January 26, 2020 was acquired. We defined the following exclusion criteria: patients who had ever taken clozapine by a non-CPMS method, such as an individual import or clinical trial, patients who did not receive clozapine after being enrolled in CPMS, and patients with initial doses other than 12.5 mg (outside the current protocol). Therefore, all patients in this study are new users. Multivariate Cox regression analysis was used to investigate independent risk factors associated with time to discontinuation of clozapine. Results We identified 8,263 patients as the study population. Clozapine discontinuation was significantly associated with age 40 and older [hazard ratio (HR)=1.66, p<0.001], intolerance to olanzapine (HR=1.31, p=0.018), previous treatment with clozapine (HR=1.30, p=0.001), and leukocyte counts <6,000/mm3 (HR=1.24, p<0.001). The Kaplan-Meier curves for clozapine discontinuation by age group revealed that older age at the time of clozapine introduction tended to have lower continuation rates. Conclusion Careful administration is important because patients with these factors have a high risk of discontinuation. In addition, the initiation of clozapine during the younger period was more effective and more tolerated.
Drilling force and speed for mandibular trabecular bone in oral implant surgery
bin Kamisan, Mohammad Aimaduddin Atiq,Yokota, Kenichiro,Ueno, Takayuki,Kinoshita, Hideaki,Homma, Shinya,Yajima, Yasutomo,Abe, Shinichi,Takano, Naoki Techno-Press 2016 Biomaterials and biomedical engineering Vol.3 No.1
Based on a survey done recently in Japan, 30 percent of the serious accidents occurred in oral implant surgery were concerned with the mandibular canal and 3/4 of them were related to drilling. One of the reasons lies in the lack of the education system. To overcome this problem, a new educational system focusing on drilling the mandibular trabecular bone has been developed mainly for dental college students in the form of an oral implant surgery training simulator that enables student to sense the reaction force during drilling. On the other hand, the conventional system uses polymeric model. Based on these systems, two approaches were proposed; the evaluation by experienced clinicians using the simulator, and experimental works on the polymeric model. Focusing on the combination of the drilling force sensed and drilling speed obtained through both approaches, the results were compared. It was found that the polymeric models were much softer especially near the mandibular canal. In addition, the study gave us an insight of the understanding in bone quality through tactile sensation of the drilling force and speed. Furthermore, the clinicians positively reviewed the simulator as a valid tool.
Yoshitaka Nishizawa,Tetsufumi Kanazawa,Yasuo Kawabata,Toshio Matsubara,Soichiro Maruyama,Makoto Kawano,Shinya Kinoshita,Jun Koh,Koji Matsuo,Hiroshi Yoneda 대한신경정신의학회 2019 PSYCHIATRY INVESTIGATION Vol.16 No.1
Objective : Accumulated evidence collected via functional near-infrared spectroscopy (fNIRS) has been reported with regard to mental disorders. A previous finding revealed that emotional words evoke left frontal cortex activity in patients with depression. The primary aim of the current study was to replicate this finding using an independent dataset and evaluate the brain region associated with the severity of depression using an emotional Stroop task. Methods : Oxygenized and deoxygenized hemoglobin recording in the brain by fNIRS on 14 MDD patients and 20 normal controls. Results : Hyperactivated oxygenized hemoglobin was observed in the left frontal cortex on exposure to unfavorable stimuli, but no significant difference was found among patients with depression compared with healthy controls on exposure to favorable stimuli. This result is consistent with previous findings. Moreover, an evoked wave associated with the left upper frontal cortex on favorable stimuli was inversely correlated with the severity of depression. Conclusion : Our current work using fNIRS provides a potential clue regarding the location of depression symptom severity in the left upper frontal cortex. Future studies should verify our findings and expand them into a precise etiology of depression.
Drilling force and speed for mandibular trabecular bone in oral implant surgery
bin Kamisan, Mohammad Aimaduddin Atiq,Yokota, Kenichiro,Ueno, Takayuki,Kinoshita, Hideaki,Homma, Shinya,Yajima, Yasutomo,Abe, Shinichi,Takano, Naoki Techno-Press 2016 Biomaterials and Biomechanics in Bioengineering Vol.3 No.1
Based on a survey done recently in Japan, 30 percent of the serious accidents occurred in oral implant surgery were concerned with the mandibular canal and 3/4 of them were related to drilling. One of the reasons lies in the lack of the education system. To overcome this problem, a new educational system focusing on drilling the mandibular trabecular bone has been developed mainly for dental college students in the form of an oral implant surgery training simulator that enables student to sense the reaction force during drilling. On the other hand, the conventional system uses polymeric model. Based on these systems, two approaches were proposed; the evaluation by experienced clinicians using the simulator, and experimental works on the polymeric model. Focusing on the combination of the drilling force sensed and drilling speed obtained through both approaches, the results were compared. It was found that the polymeric models were much softer especially near the mandibular canal. In addition, the study gave us an insight of the understanding in bone quality through tactile sensation of the drilling force and speed. Furthermore, the clinicians positively reviewed the simulator as a valid tool.