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Risk factors for severity of colonic diverticular hemorrhage
Ken Kinjo,Toshiyuki Matsui,Takashi Hisabe,Hiroshi Ishihara,Toshiki Kojima,Kenta Chuman,Shigeyoshi Yasukawa,Tsuyoshi Beppu,Akihiro Koga,Satoshi Ishikawa,Masahiro Kishi,Noritaka Takatsu,Fumihito Hirai,K 대한장연구학회 2018 Intestinal Research Vol.16 No.3
Background/Aims: Colonic diverticular hemorrhage (DH) was a rare disease until the 1990s, and its incidence has increased rapidly since 2000 in Japan. In recent years, colonic DH has been the most frequent cause of lower gastrointestinal bleeding (LGIB). Nearly all cases of DH are mild, with the bleeding often stopping spontaneously. Some cases, however, require surgery or arterial embolization. In this study, using a cohort at Fukuoka University Chikushi Hospital, we investigated factors associated with severe colonic DH. Methods: Among patients with LGIB who underwent colonoscopy at our hospital between 1995 and 2013, DH was identified in 273 patients. Among them, 62 patients (22.7%) were defined as having severe colonic DH according to recurrence of bleeding in a short period, and/or the necessity of transfusion, arterial embolization, or surgery. We then evaluated risk factors for severe DH among DH patients in this retrospective cohort. Results: Among the 273 patients with DH, use of non-steroidal anti-inflammatory drugs (NSAIDs) (odds ratio [OR], 2.801; 95% confidence interval [CI], 1.164–6.742), Charlson Risk Index (CRI) ≥2 (OR, 3.336; 95% CI, 1.154–7.353), right-sided colonic DH (OR, 3.873; 95% CI, 1.554–9.653), and symptoms of cerebral hypoperfusion (such as light-headedness, dizziness, or syncope) (OR, 2.926; 95% CI, 1.310–6.535) showed an increased risk of severe DH even after controlling for other factors. Conclusions: Severe DH occurred in 23% of DH patients, and NSAID use, CRI ≥2, right-sided colonic DH, and symptoms of cerebral hypoperfusion are suggested to be predictors of severe DH.
Yoo, Chul-Moon,Ishihara, Hideki,Nakao, Ken-ichi,Tagoshi, Hideyuki Yukawa Institute for Theoretical Physics and the P 2008 Progress of theoretical physics Vol.120 No.5
Lensing effects on light rays from point light sources, such like Type Ia supernovae, are simulated in a clumpy universe model. In our universe model, it is assumed that all matter in the universe takes the form of randomly distributed objects each of which has finite size and is transparent for light rays. Monte-Carlo simulations are performed for several lens models, and we compute probability distribution functions of magnification. In the case of the lens models that have a smooth density profile or the same degree of density concentration as the spherical NFW (Navarro-Frenk-White) lens model at the center, the so-called gamma distributions fit well the magnification probability distribution functions if the size of lenses is sufficiently larger than the Einstein radius. In contrast, the gamma distributions do not fit the magnification probability distribution functions in the case of the SIS (Singular Isothermal Sphere) lens model. We find, by using the power law cusp model, that the magnification probability distribution function is fitted well using the gamma distribution only when the slope of the central density profile is not very steep. These results suggest that we may obtain information about the slope of the central density profiles of dark matter halo from the lensing effect of Type Ia supernovae.
Archetype Model-Driven Development Framework for EHR Web System
Shinji Kobayashi,Eizen Kimura,Ken Ishihara 대한의료정보학회 2013 Healthcare Informatics Research Vol.19 No.4
Objectives: This article describes the Web application framework for Electronic Health Records (EHRs) we have developed to reduce construction costs for EHR sytems. Methods: The openEHR project has developed clinical model driven architecture for future-proof interoperable EHR systems. This project provides the specifications to standardize clinical domain model implementations, upon which the ISO/CEN 13606 standards are based. The reference implementation has been formally described in Eiffel. Moreover C# and Java implementations have been developed as reference. While scripting languages had been more popular because of their higher efficiency and faster development in recent years, they had not been involved in the openEHR implementations. From 2007, we have used the Ruby language and Ruby on Rails (RoR) as an agile development platform to implement EHR systems, which is in conformity with the openEHR specifications. Results: We implemented almost all of the specifications, the Archetype Definition Language parser, and RoR scaffold generator from archetype. Although some problems have emerged, most of them have been resolved. Conclusions: We have provided an agile EHR Web framework, which can build up Web systems from archetype models using RoR. The feasibility of the archetype model to provide semantic interoperability of EHRs has been demonstrated and we have verified that that it is suitable for the construction of EHR systems.