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- 저자 : Koji Chiba (검색결과 4 건)
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Clinical Outcomes of Varicocele Repair in Infertile Men: A Review
Koji Chiba,Masato Fujisawa 대한남성과학회 2016 The World Journal of Men's Health Vol.34 No.2
Varicoceles are a major cause of impaired spermatogenesis and the most common correctable cause of male infertility. They are found in approximately 40% of men with primary infertility and 80% of men with secondary infertility, although they also occur in 12% of men with normal semen parameters. The presence of a varicocele does not always affect spermatogenesis, as it has been reported that only 20% of men with documented varicoceles suffer fertility problems. However, varicocele repair appears to have beneficial effects in men with impaired semen parameters and palpable varicoceles. Currently, the main procedures employed for varicocele repair are microsurgical subinguinal or inguinal varicocelectomy, laparoscopic varicocelectomy, and radiological percutaneous embolization. Microsurgical varicocelectomy appears to be the optimal treatment in most cases, whereas the other procedures are useful only in specific cases. After treatment, it typically takes 3 to 6 months for patients’ semen parameters to improve; thus, other therapies, including assisted reproductive technology, should be considered if infertility persists after this interval, especially in older couples. Controversies still remain regarding how varicoceles in certain subgroups, such as adolescents or men with azoospermia, should be treated. Due to their relatively high prevalence rate among the general population, varicoceles can occur concomitantly with other conditions that cause impaired spermatogenesis. Further studies are necessary in order to identify the patients who are most likely to benefit from treatment. In this review, we sought to summarize the issues currently associated with varicocele treatment in infertile men.
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Multi-Objective Design Exploration and its Applications
Shigeru Obayashi,Shinkyu Jeong,Koji Shimoyama,Kazuhisa Chiba,Hiroyuki Morino 한국항공우주학회 2010 International Journal of Aeronautical and Space Sc Vol.11 No.4
Multi-objective design exploration (MODE) and its applications are reviewed as an attempt to utilize numerical simulation in aerospace engineering design. MODE reveals the structure of the design space based on trade-off information. A self-organizing map (SOM) is incorporated into MODE as a visual data mining tool for the design space. SOM divides the design space into clusters with specific design features. This article reviews existing visual data mining techniques applied to engineering problems. Then, we discuss three applications of MODE: multidisciplinary design optimization for a regional-jet wing, silent supersonic technology demonstrator and centrifugal diffusers.
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Multi-Objective Design Exploration and its Applications
Obayashi, Shigeru,Jeong, Shin-Kyu,Shimoyama, Koji,Chiba, Kazuhisa,Morino, Hiroyuki The Korean Society for Aeronautical and Space Scie 2010 International Journal of Aeronautical and Space Sc Vol.11 No.4
Multi-objective design exploration (MODE) and its applications are reviewed as an attempt to utilize numerical simulation in aerospace engineering design. MODE reveals the structure of the design space based on trade-off information. A self-organizing map (SOM) is incorporated into MODE as a visual data mining tool for the design space. SOM divides the design space into clusters with specific design features. This article reviews existing visual data mining techniques applied to engineering problems. Then, we discuss three applications of MODE: multidisciplinary design optimization for a regional-jet wing, silent supersonic technology demonstrator and centrifugal diffusers.
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Katsumi Shigemura,Kazushi Tanaka,Fukashi Yamamichi,Koji Chiba,Masato Fujisawa 대한배뇨장애요실금학회 2016 International Neurourology Journal Vol.20 No.1
Purpose: To detect predictive factors for postoperative incontinence following holmium laser enucleation of the prostate (Ho- LEP) according to surgeon experience (beginner or experienced) and preoperative clinical data. Methods: Of 224 patients, a total of 203 with available data on incontinence were investigated. The potential predictive factors for post-HoLEP incontinence included clinical factors, such as patient age, and preoperative urodynamic study results, including detrusor overactivity (DO). We also classified the surgeons performing the procedure according to their HoLEP experience: beginner (<21 cases) and experienced (≥21 cases). Results: Our statistical data showed DO was a significant predictive factor at the super-short period (the next day of catheter removal: odds ratio [OR], 3.375; P=0.000). Additionally, patient age, surgeon mentorship (inverse correlation), and prostate volume were significant predictive factors at the 1-month interval after HoLEP (OR, 1.072; P=0.004; OR, 0.251; P=0.002; and OR, 1.008; P=0.049, respectively). With regards to surgeon experience, DO and preoperative International Prostate Symptom Score (inverse) at the super-short period, and patient age and mentorship (inverse correlation) at the 1-month interval after HoLEP (OR, 3.952; P=0.002; OR, 1.084; P=0.015; and OR,1.084; P=0.015; OR, 0.358; P=0.003, respectively) were significant predictive factors for beginners, and first desire to void (FDV) at 1 month after HoLEP (OR, 1.009; P=0.012) was a significant predictive factor for experienced surgeons in multivariate analysis. Conclusions: Preoperative DO, IPSS, patient age, and surgeon mentorship were significant predictive factors of postoperative patient incontinence for beginner surgeons, while FDV was a significant predictive factors for experienced surgeons. These findings should be taken into account by surgeons performing HoLEP to maximize the patient’s quality of life with regards to urinary continence.
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