Aesthetic pectoral muscle flap repair for refractory enterocutaneous fistula after salvage esophagectomy in a female patient

Anastomotic leakage is a severe complication of esophagectomy. Development of an enterocutaneous fistula after anastomotic leakage often occurs after subcutaneous-route reconstruction at esophagectomy. Pectoralis myocutaneous flap (PMCF) repair has recently been performed when an enterocutaneous fistula was refractory to conservative treatment. However, this procedure requires a conspicuous incision and results in deformity of the breast especially in female patient. We performed pectoralis muscle flap (PMF) repair for a 50-year-old woman with a refractory enterocutaneous fistula after salvage esophagectomy. We made an oblique incision along the inframammary crease in order to avoid a conspicuous scar and moved the PMF under the mammary gland to the site of anastomosis. This method was effective for repairing a refractory enterocutaneous fistula, with especially good aesthetic results in a female patient

Development of a screening system for central visual field using the eye-tracking device\n

　Background: Visual field test with gaze movements do not require a subjective response because they are based on reflexive movements. In this study, we developed a visual field test system with gaze movements to perform a central visual field screening, and then examined the reproducibility of the measurements in healthy adult volunteers.　Methods: We examined 30 right eyes of 30 healthy volunteers (mean age, 22.7 ± 5.2 years) with a best-corrected visual acuity of at least 20/20. Gazefinder, an eye-tracking device, was used to measure gaze movements. Subjects with refractive correction were asked to follow a white target presented on a monitor. If a subject can accurately perform eye tracking with respect to the visual target, visual field with gaze movements measurements are theoretically possible in eight directions (horizontal/vertical to 15.3° and oblique to 21.5° ). After a total of three measurements, the data were quantified using analysis software (CreateChart). Finally, the intraclass correlation coefficients of the measurement values were obtained.　Results: The difference between theoretical and actual measurement values, which is thought to reflect gaze accuracy, were –0.1° ± 0.9° for upper, –0.6° ± 1.0° for upper right, –0.2° ± 1.0° for right, –0.8° ± 0.9° for lower right, –0.5° ± 0.7° for lower, –0.5° ± 0.9° for lower left, –0.6 ° ± 0.5 ° for left, and –0.6 ° ± 0.5 ° for upper left. No significant differences were found among the eight directions, and gaze accuracy was high, at within 1°. The intraclass correlation coefficients were 0.6 or higher in each direction (P < 0.01), indicating high repeatability.　Conclusions: In the traditional method for measuring visual field with gaze movements, the fixation point of view needs to be reset for each gaze movement. On the other hand, the system developed in this study has the advantage of not requiring eye movements to return to the fixation point. The present findings indicate that our newly developed system is a useful device when standard perimetry is difficult to measure

High serum alpha-fetoprotein and positive immunohistochemistry of alpha-fetoprotein are related to poor prognosis of gastric cancer with liver metastasis

Abstract Liver metastasis in gastric cancer is incurable. Alpha-fetoprotein-producing gastric cancer has a poor prognosis and is prone to liver metastasis. We investigated the association between preoperative serum alpha-fetoprotein levels, liver metastasis, and expression of primitive enterocyte phenotype markers. We reviewed the medical records of 401 patients with gastric cancer who underwent curative surgical resection and immunohistochemically evaluated the primitive phenotype markers. The preoperative serum alpha-fetoprotein levels were elevated and normal in 8 and 393 patients, respectively. Liver metastasis was more frequent in patients with higher preoperative alpha-fetoprotein levels. The 5-year postoperative recurrence-free survival and overall survival rates were significantly worse in patients with higher preoperative serum alpha-fetoprotein levels. Although alpha-fetoprotein and Glypican3 and Spalt-like transcription factor 4 tended to be stained with high preoperative serum alpha-fetoprotein levels, these markers were also positive in some patients with normal alpha-fetoprotein levels. In summary, patients with gastric cancer and high preoperative serum alpha-fetoprotein levels have a poor prognosis and high incidence of liver metastasis. Alpha-fetoprotein can help detect liver metastasis relating to the primitive enterocyte phenotype

Aesthetic pectoral muscle flap repair for refractory enterocutaneous fistula after salvage esophagectomy in a female patient

Anastomotic leakage is a severe complication of esophagectomy. Development of an enterocutaneous fistula after anastomotic leakage often occurs after subcutaneous-route reconstruction at esophagectomy. Pectoralis myocutaneous flap (PMCF) repair has recently been performed when an enterocutaneous fistula was refractory to conservative treatment. However, this procedure requires a conspicuous incision and results in deformity of the breast especially in female patient. We performed pectoralis muscle flap (PMF) repair for a 50-year-old woman with a refractory enterocutaneous fistula after salvage esophagectomy. We made an oblique incision along the inframammary crease in order to avoid a conspicuous scar and moved the PMF under the mammary gland to the site of anastomosis. This method was effective for repairing a refractory enterocutaneous fistula, with especially good aesthetic results in a female patient

Development of a screening system for central visual field using the eye-tracking device\n

Regular Articlejournal articl

ニホンゴ センモン ブンショ サクセイ シエン ノ ホウコウ : リケイ センモン ニホンゴ キョウイク ノ カンテン カラ

　理系の大学院に在籍する留学生が論文など学術的専門文書の作成の際に起こす問題は、その基本的在り方についての知識、即ち「論文構造スキーマ」(以下、「スキーマ」)を有するか否かによって異なる。文書作成支援においてはスキーマの有無に留意し、これを持たない者にはその形成に特化した指導を行う必要がある。スキーマは諸分野に当てはまる抽象的実体であるが、実際の論文の談話展開構造や表現は専門分野によって異なり、各分野共通の「理系テンプレート」として実体化することは難しい。文系理系の学習者が共に利用することを想定した一般モデルでの学習方法が提案されているが、時間的制約などのためその利用が困難な者や、そうした学習がスキーマ形成に結びつきにくい者があり、迅速なスキーマ形成を促す方法を開発することが必要である。一つの可能性として、本人の専門分野かそれに近い分野の論文を用いて、論述のムーブ分析・適切性判断・訂正などの「テクスト分析タスク」を行うことが考えられる。今後はリソースやその作成主体についての概念を拡大し、学習者自身の貢献も利用しつつ従来の教材の概念に該当しない素材やその利用法をもリソースとして集積し、データベース化を進めることが課題である。This article discusses the problems in the graduate international student\u27s academic writing and possible solutions to them. We claim that an urgent task for us is to develop the means to assist learners in forming the schema of academic argumentation, i.e. the knowledge of what should be written in a piece of academic writing and how it is organized. Learners who lack this knowledge fail to construct a proper discourse in spite of explicit instruction on vocabulary and discourse structure. We suggest that use of `direct models\u27 and performing text analyzing tasks would help

ノウガクケイ コウガクケイ ニホンゴ ロンブン ノ ショゲン ノ ロンリ テンカイ ブンセキ : ケイシキ ダンラク ト コウセイ ヨウソ ノ カンテン カラ

　本研究は、農学系と工学系の代表的な学術雑誌6種に発表された1,194本の論文の緒言について、分野ごとに1)内容とその論理展開の様相、2)用いられる表現とを分析した。こうした研究を行うのは、理系研究留学生に対し、論文作成に必要な論理展開と言語についての知識を迅速に獲得させるために、当該留学生の最も関心の深い分野の典型的な論文を集約的に直接的モデルとして提示したいと考えたことによる。本研究の調査の結果、緒言は典型的には3段落か4段落によって構成され、それらの各段落は「領域提示」「課題設定」「研究動向提示」「研究概要紹介」に対応していることが明らかとなった。この結果を用いて、今後、論文作成方法についての一般的知識を具現化した分野別のモデル集をリソースとして編纂していきたいと考える。This paper analyzest he logicals tructure and expressionsu sed in the introductions ectionso f 1194p aperst hat appearedi n representatives electiono f recenta cademicj ournalso n agriculturea nd engineeringin ordert o gain data-basede videncea s to 1) what logicalc ontenti s typicallyc hosena nd arrangedi n the introductionf or each specializedf ield, and 2) what expressionsa nd structure are used to represent these contents.O ur aim is to provide international students with a substantial number of direct models selected from papers in their own fieldsb ecaused irectm odelsw hichd iscussi deas most familiara nd at most concernf or learners will assist them in understandingt he logicalf rame and relevant linguistick nowledgen eeded to write their own papers. The results showt hat the introductionsty picallyc onsisto f three or four paragraphs that correspondr espectivelyto four specificc ontents:1 ) a definitiono f the territory,2 ) a reviewo f previousr esearch,3 ) the "puzzle"th e author intends to solvea nd 4) a comprehensivien troductorys ummaryo f the author\u27sr esearch. Wee xpectt he results willh elp us to prepare resourcesf or each specializedfi eldc ontainings electedr eadingst hat substantiateg eneral informationa bouth ow a paper shouldb e structureda nd written