イレウスカン ノ カンリ ニ チュウモク シタ カキイセキ ニヨル ショクジセイ イレウス ノ 1レイ

Intestinal food-induced obstruction is a rare disease. Diospyrobezoar is one of the main causes. The structure has characteristic CT findings of clear wedge and internal cavernous low density area. Diospyrobezoar sometimes exist with other stones. A 60s-year-old man with abdominal pain and vomiting was introduced to our hospital. CT scan showed the dilated small intestine and two round structures with 3.5cm and 2.5cm in minor axis in the ileum. The patient had been having dried persimmons habitually in this season without artificial teeth. Based on these findings, intestinal diospyrobezoar obstruction was diagnosed. Depressurization by a balloon-tipped long tube was performed prior to surgery. The long tube and 2 structures in the intestine were detected under the laparoscopic examination, and the small intestine at 30cm oral side from two structures was pulled-out through the umbilical incision. Another stone was led to the other one to the oral side manually and a longitudinal incision was made on the anal side of the stones. Not only 2 stones that were identified preoperatively but also 4 small stones were removed. Surgery should be needed to treat diospyrobezoar ileus with a 3.0cm stone in minor axis, and it is essential to consider multiple stones

Clinical efficacy and problems with CT lymphography in identifying the sentinel node in breast cancer

Abstract Background Combining a radioisotope with a dye-guided method is the best method for identification of the sentinel lymph nodes (SNs) in breast cancer. However, some institutions are limited to use of a dye-guided method alone. Recently, computed tomographic lymphography (CTLG) employing a nonionic contrast medium has achieved SN identification. Patients and methods 218 patients with primary breast cancer and no clinical evidence of lymph node metastasis were studied. SN identification was performed by CTLG and a dye-guided method. The SN identification rate was analyzed for correlations with the clinicopathological findings. Results The SN identification rates were 96% with CTLG, 92% with the dye-guided method and 99% with both methods combined. The identification rates with CTLG and the combined method were significantly lower in node-positive patients compared to node-negative patients, and significantly lower with the combined method in vascular invasion-positive patients compared to negative patients. In addition, the SN identification rate with the dye-guided method was significantly lower in patients with a body mass index (BMI) of ≥ 25, whereas the BMI did not affect the identification rate with CTLG or the combined method. Multiple SNs were detected in approximately 20% of the patients. Conclusion Combined performance of CTLG and a dye-guided method enables identification of SNs prior to breast cancer surgery. That SN identification is easier compared with by the dye-guided method alone, and the identification rate is improved compared with either method alone. The combination of methods was especially useful in obese patients. For patients with multiple SNs, the combination has the further advantage of enabling accurate SN biopsy. CTLG may yield false-negative findings in node-positive patients and patients with lymph vessel obstruction.</p

Elderly User Evaluation of Mobile Touchscreen Interactions

Part 2: Long and Short PapersInternational audienceSmartphones with touchscreen-based interfaces are increasingly used by non-technical groups including the elderly. However, application developers have little understanding of how senior users interact with their products and of how to design senior-friendly interfaces. As an initial study to assess standard mobile touchscreen interfaces for the elderly, we conducted performance measurements and observational evaluations of 20 elderly participants. The tasks included performing basic gestures such as taps, drags, and pinching motions and using basic interactive components such as software keyboards and photo viewers. We found that mobile touchscreens were generally easy for the elderly to use and a week’s experience generally improved their proficiency. However, careful observations identified several typical problems that should be addressed in future interfaces. We discuss the implications of our experiments, seeking to provide informal guidelines for application developers to design better interfaces for elderly people