Background/Aims: Three-dimensional (3D) flexible endoscopy, a new imaging modality that provides a stereoscopic view, can facilitate endoscopic hand suturing (EHS), a novel intraluminal suturing technique. This ex-vivo pilot study evaluated the usefulness of 3D endoscopy in EHS. Methods: Four endoscopists (two certified, two non-certified) performed EHS in six sessions on a soft resin pad. Each session involved five stitches, under alternating 3D and two-dimensional (2D) conditions. Suturing time (sec/session), changes in suturing time, and accuracy of suturing were compared between 2D and 3D conditions. Results: The mean suturing time was shorter in 3D than in 2D (9.8±3.4 min/session vs. 11.2±5.1 min/session) conditions and EHS was completed faster in 3D conditions, particularly by non-certified endoscopists. The suturing speed increased as the 3D sessions progressed. Error rates (failure to grasp the needle, failure to thread the needle, and puncture retrial) in the 3D condition were lower than those in the 2D condition, whereas there was no apparent difference in deviation distance. Conclusions 3D endoscopy may contribute to increasing the speed and accuracy of EHS in a short time period. Stereoscopic viewing during 3D endoscopy may help in efficient skill acquisition for EHS, particularly among novice endoscopists.

Objective: To evaluate the efficacy of fan therapy for the relief of dyspnea in patients with chronic progressive disease. Methods: A systematic electronic database search of all available articles published before October 23, 2019 was conducted using Ichushi-Web of the Japan Medical Abstract Society databases, CENTRAL, EMBASE, and MEDLINE. In addition, a hand-search for updates was performed using PubMed on June 30, 2020 and December 7, 2021. The inclusion criteria were: 1) any RCTs comparing the effect of fan therapy with any other intervention, and 2) patients aged ≥18 years. Exclusion criteria were: 1) duplicate references, and 2) conference presentations. Results: We identified 110 studies, of which 10 met our criteria for inclusion. Finally, five studies were used in the meta-analysis. Fan therapy significantly improved dyspnea in patients with chronic progressive disease compared to control groups with a standardized mean difference of −1.43 (95% confidence interval: −2.70 to −0.17, I2=94%, p<0.0001). Conclusion: Fan therapy was found to be effective in reducing dyspnea in chronic progressive disease.

Objective: This study aimed to retrospectively investigate the clinical significance of the level of fibrin degradation products in drowning patients without cardiac arrest.Patients and Methods: All drowning patients who were transported to our department from January 2011 to December 2019 were retrospectively investigated through a medical chart review and included as subjects in the present study. The exclusion criteria were the occurrence of cardiac arrest before patient arrival to our department and lack of measurement of the fibrin degradation product level on arrival. The subjects were divided into two groups: early discharge group, which included patients who were discharged within 3 days, and late discharge group, which included patients who were discharged after 3 days.Results: The early discharge group included 10 subjects and the late discharge group included 39 subjects. No significant differences were observed in age, sex, proportion of freshwater drowning cases, proportion of alcohol drinkers, vital signs, blood gas analysis findings, proportion of lung lesions, or survival rate between the two groups. The levels of glucose and fibrin degradation products on arrival were significantly greater in the early discharge group than in the late discharge group. A multivariate analysis showed that the only significant predictor of early discharge was the fibrin degradation product level among variables identified in a univariate analysis.Conclusion: This is the first study to show that the level of fibrin degradation products on arrival can predict early or late discharge in drowning patients without cardiac arrest before arriving to the hospital.