Extraction of Disease Area from Retinal Optical Coherence Tomography Images Using Three Dimensional Regional Statistics

AbstractWe propose a new extraction method of the macular disease area in the human retinal layer from OCT images using three dimensional regional statistics. In previous researches, we extracted disease area by using the mean and standard deviation of the two dimensional disease part pointed out by a clinical doctor. However, the previous method cannot extract disease area for some disease OCT images precisely. In this paper, we propose a new extraction method of the disease area using three dimensional regional statistics. We use a set of 128 images (3D-OCT image) consisted of 2 dimensional OCT retinal image about one retina of a patient. The regional mean and regional standard deviation of gray level are calculated in the three dimensional region of interest (ROI, 125 (=5 × 5 × 5) pixels) in the abnormal area pointed by a clinical doctor. These values are compared with every ROI in the abnormal area to extract the disease area, and the proposal system measures the volume of the disease area. We apply the proposed method to OCT images of 5 patients with retinal diseases. As a result, we can measure the volume of the abnormal area with 80.7% average accuracy

New Surgical Procedure for Pancreas Head

In this study, we demonstrate two new methods for pancreaticoduodenectomy (PD). One method is the mini‐laparotomic PD by Shuriken‐shaped umbilicoplasty with the real‐time moving window‘s method. The other method is the new pancreaticojejunostomy (PJ) by punctured stent slide guiding method (PSSGM). This procedure could be performed by complete mini‐laparotomy under direct vision, and the final major wound is only 2 cm of round navel. PSSGM prevents the difference of caliber between pancreatic anastomosis and the inside out of jejunal mucosa in theory. Ten cases of mini‐lap PD were successfully performed under new PJ anastomosis. The pancreatic leakage (PL) was only one case of ISGPF grade A, and its frequency was 9% (1/11). Our mini‐lap PD by Shuriken‐shaped umbilicoplasty might be a useful way for overcoming the obstacles about safety, complication risk, cosmetic demand, and medical cost compared to laparoscopic PD. Also, our new device of PJ reconstruction by PSSGM might be an easy and useful device for the prevention of PL

Removal of accidentally ingested large foreign object via the anus after watchful waiting

One of the commonest complaints, for which a patient arrives in hospitals, is the presence of foreign body. It could be due to accidental ingestion or any other cause which leads to presences of a foreign body in the gastrointestinal tract. It is believed that foreign objects larger than 5–6 cm in size are unlikely to pass through the duodenum. Here, we describe a case wherein the patient accidentally swallowed a 7-cm-sized mouthguard that could not be removed by emergency upper gastrointestinal endoscopy but was subsequently removed via the anus after a period of watchful waiting

Development of the Japanese version of state self-esteem scale

publisher奈良状態自尊（state self-esteem）は、その理論的重要性にもかかわらず測定指標が充実しているとは言い難い。本研究の目的は、国際比較研究に用いることのできる日本語版状態自尊心尺度の作成である。状態自尊心の尺度として国際的に最もよく用いられているHeatherton & Polivy（1991）を、言語の等価性を確保した翻訳を行うことで日本語版項目を作成した。研究1では、尺度の総合得点について高い内的一貫性を有することが確認された。その一方で、下位尺度については先行研究と一貫した構造が示されなった。また、研究1、2を通じて尺度が十分な併存的妥当性を有していることが確認された

A novel locally operated master-slave robot system for single-incision laparoscopic surgery

Purpose: Single-incision laparoscopic surgery (SILS) provides more cosmetic benefits than conventional laparoscopic surgery but presents operational difficulties. To overcome this technical problem, we have developed a locally operated master-slave robot system that provides operability and a visual field similar to conventional laparoscopic surgery. Material and methods: A surgeon grasps the master device with the left hand, which is placed above the abdominal wall, and holds a normal instrument with the right hand. A laparoscope, a slave robot, and the right-sided instrument are inserted through one incision. The slave robot is bent in the body cavity and its length, pose, and tip angle are changed by manipulating the master device; thus the surgeon has almost the same operability as with normal laparoscopic surgery. To evaluate our proposed system, we conducted a basic task and an ex vivo experiment. Results: In basic task experiments, the average object-passing task time was 9.50 sec (SILS cross), 22.25 sec (SILS parallel), and 7.23 sec (proposed SILS). The average number of instrument collisions was 3.67 (SILS cross), 14 (SILS parallel), and 0.33 (proposed SILS). In the ex vivo experiment, we confirmed the applicability of our system for single-port laparoscopic cholecystectomy. Conclusion: We demonstrated that our proposed robot system is useful for single-incision laparoscopic surgery.ArticleMINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES. 23(6):326-332 (2014)journal articl

Comparison of Surgeon Stress and Workload between Reduced-port and Laparoscopic Cholecystectomy : A Prospective Study

Single-port laparoscopic surgery（SPLS）has attracted attention in the field of minimally invasive surgery; however, the associated technical difficulty has delayed its adoption by all surgeons. Reduced-port laparoscopic surgery might be easier to perform than SPLS, and in this prospective study, we compared surgeon stress and workload between reduced-port laparoscopic cholecystectomy（RPLC）and conventional laparoscopic cholecystectomy（CLC）. Twenty consecutive patients were assigned to undergo either RPLC or CLC between July 2016 and April 2017. Two surgeons performed the operations. The differences in surgeon workload and stress between RPLC and CLC were evaluated. Patient factors and operative outcomes were not significantly different between RPLC and CLC. In the surgeon-reported Surgery Task Load Index, the task demand subscale was significantly higher for RPLC than for CLC（P＝0.005）, although the salivary amylase levels were not significantly different between RPLC and CLC. RPLC was similar to CLC with respect to surgeon stress. Considering workload, the task demand was higher in CLC than in RPLC, which therefore might be an acceptable alternative to CLC for treating benign gallbladder disease