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Transbronchial Lung Cryobiopsy : single institutional report in Japan
( Takashi Niwa ),( Tomohisa Baba ),( Tamiko Takemura ),( Kenta Murotani ),( Takashi Ogura ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-
Background: In out institution Transbronchial lung cryobiopsy (TBLC) was introduced at May, 2017. Now we experienced TBLC for 500 and more patients. We summarize here our experience.Method: All patients who performed TBLC from May 2017 to December 2018 at Kanagawa cardiovascular and respiratory center were enrolled in this study. We assessed safety profiles and diagnostic yield for all patients and calculated CUSUM score to analyze the learning curve of TBLC for patients in first half year. For the patients with peripheral lesion TBLC was performed under fluoroscopy with Fogarty® occlusion catheter to manage pneumothorax and bleeding. Results: Of 512 cases, diffuse parenchymal lung disease was 492 and lung cancer was 20 cases. Incidence of pneumothorax was 3.9% (20 cases) and there were no patient of pneumothorax to need surgical operation. All bleeding was managed by occlusion catheter. Acute exacerbation was observed in one case. During a half year in 174 cases incidence of pneumothorax changed at 79th experience and bleeding incidence changed at 69th experience. For patients with peripheral small lesion we use extra-large size (2.7mm) guide sheath (Machida® SG-27092) to do Endobronchial ultrasound guided cryobiopsy (EBUS-Cryo). EBUS-Cryo with extra-large GS were performed for 13 patients. Median target size in computed tomography was 25mm (12-43mm) and diagnostic yield was 84.6%. In case with positive echo result by radial echo (within or adjacent to) diagnostic yield was 100% and invisible cases could not diagnose. Discussion: In our study incidence of TBLC was low compared to previous report. This results revealed fluoroscopy guided TBLC with balloon occlusion method is well tolerable. And Extra-large size GS enable us EBUS-Cryo conveniently even if using 1.9 mm cryoprobe. Using larger probe in EBUS-Cryo seems to be better diagnostic yield and 2.7mm GS is promising. Conclusion: TBLC and EBUS-Cryo using extra-large size GS is useful. Further investigation is warranted.
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일본의 유치원 보육소의 전통놀이 실시현황 및 유아교사의 인식 조사연구
丹羽 孝,勅使千鶴,穐丸武臣 이화여자대학교 교육과학연구소 2007 교육과학연구 Vol.38 No.2
본 연구는 일본의 유치원과 보육소(한국의 보육시설 해당)에서 운영되는?u전통놀이?v 실시현황과 전통놀이에 대한 교사의 인식을 설문지를 통해 조사하였다. 조사 대상은 단계별 무작위 표집에 의해 일본 전국 도도부현의 도시부와 시정촌 지역의 유치원 568개원, 보육소 590개소, 합계1,158개소를 선정하였다. 설문지 회수율은 약 56%였다. 연구결과에 의하면, 대부분 유치원과 보육소(99%)에서 전통놀이가 실시되고 있었고, 전통놀이는 교육내용 및 자료로서 가치를 인정받고 있었다. 유아교육기관의 교육내용에 전통놀이를 도입한 이유로는 첫째, 어린이들의 성장과 발달에 유익하기 때문에, 둘째, 일본의 놀이문화를 계승하기 위하여로 나타났다. 전통놀이를 교육현장에 보급하며 충실하게 운영하는데 나타나는 가장 큰 어려움은 유아 교사의 역량부족으로 드러났다. 이를 위해 전통놀이에 대한 교사 연수가 필요하다고 인식하였다 This is a nation-wide survey, conducted by mailing of questionnaires, aboutthe knowledge and use of ?gtraditional games?h by teachers as part of thecurriculum and teaching materials in the pre-school and day care facilities inJapan. The results of the survey showed that most of the kindergarten and day-carecenters (99%) used traditional games and its value as part of nursery curriculumand teaching material is widely recognized. The reasons for introducing ?gtraditional games?h in the curriculum are asfollows:1. It is effective in child growth and development. 2. In order to continue the play culture of Japan. However, the survey also revealed that the lack of knowledge about traditionalgames among teachers (a general term for pre-school teachers and child careteachers) was an obstacle in introducing these games to the children. Theresults of this study emphasized the need for teachers?f training.
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Kadowaki, Shigenori,Komori, Azusa,Takahari, Daisuke,Ura, Takashi,Ito, Seiji,Tajika, Masahiro,Niwa, Yasumasa,Oze, Isao,Muro, Kei Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.13
Background: Systemic chemotherapy for patients with metastatic gastric cancer (MGC) is generally palliative, although some patients experience long-term survival after treatment. Thus, we identified clinical characteristics that are associated with long-term survival of patients with MGC after palliative chemotherapy. Materials and Methods: We retrospectively reviewed 514 MGC patients who received systemic chemotherapy at our institution from 2001 to 2008. To identify clinical predictors of survival beyond 2 years, multivariate logistic regression analyses were performed, and 5-year survival rates were estimated among MGC patients following chemotherapy. Results: Among 514 patients, 96 (19%) and 16 (3%) survived beyond 2 and 5 years, respectively, and performance status of 0 or 1 (odds ratio [OR]=3.39; p=0.01), previous gastrectomy (OR=1.86; p=0.01), single metastatic site (OR=1.80; p=0.03), and normal alkaline phosphatase levels (OR=2.81; p<0.01) were identified as independent predictors of long-term survival. Of the 16 5-year survivors, six were alive at the end of the study and showed no evidence of disease despite cessation of chemotherapy. Conclusions: The present data demonstrate distinct clinical characteristics that are associated with long-term survival of MGC patients, and indicated that palliative chemotherapy can be curative in highly selected patients.
KCI
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