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Antimicrobial Prophylaxis in Urological Surgery
Shingo Yamamoto,Katsumi Shigemura,Hiroshi Kiyota,Soichi Arakawa,Japanese Research Group for UTI 대한요로생식기감염학회 2016 Urogenital Tract Infection Vol.11 No.3
Surgical site infection (SSI) is defined as an infection occurring within one month from surgery or intervention. SSIs are classified into three categories: Clean, clean-contaminated, and contaminated. They are defined as procedures that avoid entering the urinary tract, involve entry of the urinary tract, and involve the bowels, respectively. The purpose of antimicrobial prophylaxis (AMP) is to protect the surgical wound from contamination by normal bacterial flora. AMP should be based on penicillin with beta-lactamase inhibitors, or first- or second-generation cephalosporins. Broad-spectrum antimicrobials, such as third- and fourth- generation cephalosporins or carbapenems, should be used to treat postoperative infections but not AMP. AMP should be started no less than 30 minutes prior to the start of the operation. AMP should be administered by a single dose or be terminated within 24 hours in cases of transurethral, clean, or clean-contaminated surgery, and within 2 days in cases of bowl (contaminated) surgery. These guidelines are applicable preoperatively only for non-infected, low-risk patients. The risk of patients for infection should be evaluated preoperatively, such as with a urine culture test. In cases with preoperative infection or bacteriuria that can cause an SSI or urinary tract infection following surgery, patients must receive adequate preoperative treatment based on their individual situation.
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山本?吾(Yamamoto Shingo) 구결학회 2009 구결연구 Vol.23 No.-
9세기의 漢字 가타카나 混用文에서, 가티카나와 오코토点의 混用을 볼 수 있다. 이 兩者의 選擇 意圖를 중심으로 고찰한 결과, 다음과 같은 결론을 얻었다. (1) 漢字 가타카나 混用文의 語順은, 日本語式과 漢文式이 때때로 混在하고 있다. 따라서, 述語 위에 主語가 오는 것이 있는가 하면 目的語가 오기도 하여 일정하지 않다. 그러한 경우에 가타카나 혹은 오코토点으로 ‘ハ’(주제 표시)나 ‘ヲ’(목적어 표시)를 나타내어, 문장의 成分을 명확하게 하고 있다. (2) 가타카나 混用에 의해서 本文의 構文의 큰 범위가 나타난 문장에 대해서, 보다 정확성을 기하기 위해서, ?句의 後句(내지는 前句)에 같은 附屬語를 보충하는 등, 오코토点을 보충 조치로서 이용하는 일이 있었다. (3) 오코토点으로도 ‘ハ’나 ‘ヲ’를 표기하는 것이 가능했지만, 複數의 附屬語를 承接시킬 때 그 接續의 순서가 문제가 된다. 이러한 부속어 상호의 접속 관계는 오코토点으로는 特定할 수 없기 때문에, 가타카나 표기가 선택되었다.
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Numerical Study of Slow-wave Instabilities in an Oversized Coaxial Slow-wave Structure
Kazuo Ogura,Shingo Abe,Hiroki Kimura,Kazumasa Yamamoto,Kiyoyuki Yambe,Ruhul Amin 한국물리학회 2011 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.59 No.61
In this paper, slow-wave instabilities in oversized coaxial SWSs are numerically analyzed. An infinitesimally thin annular beam with transverse perturbations and guided by a finite axial magnetic field is considered as the energy source for creating the instabilities. The coaxial SWSs consist of an outer oversized hollow waveguide and a central conductor and have sinusoidal corrugations. An electromagnetic slow-wave is generated by the inner corrugation and is called inner surface wave (ISW). The ISW is a cylindrical surface wave and can exist even if the outer conductor is removed. The higher-order modes are produced by the outer waveguide. The annular beam interacts with the ISW and higher-order modes. Slow cyclotron instability occurs due to the transversely modulated beam boundary, in addition to the conventional Cherenkov instability. The slow-wave instabilities are able to be controlled by the beam radius and the relative position of inner and outer corrugations.
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조규영,Nakamura Akinobu,Oba-Yamamoto Chiho,Tsuchida Kazuhisa,Yanagiya Shingo,Manda Naoki,Kurihara Yoshio,Aoki Shin,Atsumi Tatsuya,Miyoshi Hideaki 대한당뇨병학회 2020 Diabetes and Metabolism Journal Vol.44 No.4
Background: To explore the efficacy and safety of switching from once-daily basal insulin therapy to once-daily pre-meal injection insulin degludec/insulin aspart (IDegAsp) with respect to the glycemic control of participants with type 2 diabetes mellitus (T2DM). Methods: In this multicenter, open-label, prospective, randomized, parallel-group comparison trial, participants on basal insulin therapy were switched to IDegAsp (IDegAsp group; n=30) or continued basal insulin (Basal group; n=29). The primary endpoint was the superiority of IDegAsp in causing changes in the daily blood glucose profile, especially post-prandial blood glucose concentration after 12 weeks. Results: Blood glucose concentrations after dinner and before bedtime were lower in the IDegAsp group, and the improvement in blood glucose before bedtime was significantly greater in the IDegAsp group than in the Basal group at 12 weeks (−1.7±3.0 mmol/L vs. 0.3±2.1 mmol/L, P<0.05). Intriguingly, glycemic control after breakfast was not improved by IDegAsp injection before breakfast, in contrast to the favorable effect of injection before dinner on blood glucose after dinner. Glycosylated hemoglobin significantly decreased only in the IDegAsp group (58 to 55 mmol/mol, P<0.05). Changes in daily insulin dose, body mass, and recorded adverse effects, including hypoglycemia, were comparable between groups. Conclusion: IDegAsp was more effective than basal insulin at reducing blood glucose after dinner and before bedtime, but did not increase the incidence of hypoglycemia. Switching from basal insulin to IDegAsp does not increase the burden on the patient and positively impacts glycemic control in patients with T2DM.
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Natural History of Chronic Intestinal Pseudo-obstruction and Need for Palliative Care
Kosuke Tanaka,Hidenori Ohkubo,Atsushi Yamamoto,Kota Takahashi,Yuki Kasai,Anna Ozaki,Michihiro Iwaki,Takashi Kobayashi,Tsutomu Yoshihara,Noboru Misawa,Akiko Fuyuki,Shingo Kato,Takuma Higurashi,Kunihiro 대한소화기 기능성질환∙운동학회 2023 Journal of Neurogastroenterology and Motility (JNM Vol.29 No.3
Background/AimsNatural history of chronic intestinal pseudo-obstruction (CIPO), a rare disease characterized by episodes of non-mechanical obstruction, is unclear in adults. This study evaluates the clinical course of CIPO and palliative care needs of patients. MethodsFrom October 2010 to September 2021, 74 patients who underwent cine MRI and had a definitive diagnosis of CIPO were prospectively included. We investigated disease etiology and outcomes, age at onset, nutritional status at consultation (body mass index and serum albumin), hydrogen breath test results, and total parenteral nutrition (TPN) during the disease course. ResultsForty-seven patients (64%) were women, with a mean age of 44 years at onset and 49 years at diagnosis. Primary CIPO was observed in 48 patients (65%). Secondary CIPO was observed in 26 cases (35%), of whom 18 (69%) had scleroderma. The mean body mass index, serum albumin level, and hydrogen breath test positivity rate were 17 kg/m2, 3.8 mg/dL, and 60%, respectively. TPN and invasive decompression therapy were required by 23 (31%) and 18 (24%) patients, respectively. Intestinal sterilization was performed in 51 (69%) patients and was effective in 33 (65%); of these, 28 (85%) were taking metronidazole. Seven (9%) patients used opioids. There were 9 deaths (12%), including 5 (56%) from infection and 2 (22%) from suicide. Of the deaths, 6 (67%) and 4 (44%) underwent TPN management and decompression therapy, respectively. Fifty-one patients (69%) wanted palliative care. ConclusionCIPO is a rare, severe, and under-recognized disease. Standardization of treatment strategies, including palliative care and psychiatric interventions, is desired.
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