1.Effects of Bulb Type Palatal Lift Prosthesis Therapy on Nasality and Velopharyngeal Function of Patients Following Palatoplasty
Yuko Ogata ; Sachiyo Matsuzaki ; Masaaki Sasaguri ; Yasutaka Kubota ; Akira Suzuki ; Seiji Nakamura ; Kanemitsu Shirasuna ; Norifumi Nakamura
Oral Science International 2009;6(2):73-84
In the present study, the effects of bulb type palatal lift prosthesis (bulb-PLP) therapy on nasality and velopharyngeal function (VPF) of patients with velopharyngeal incompetence (VPI) following palatoplasty were longitudinally assessed.The subjects included 18 patients (3 to 52 years of age) who had shown persistent VPI following palatoplasty and who had received bulb-PLP therapy. Nasality and VPF were assessed by perceptual voice analysis, nasometer test, blowing test, and cephalometric radiographic examination. Based on the outcomes of bulb-PLP therapy, the subjects were classified into two groups: the effective group and the ineffective group. Furthermore, the obturating and VPF-activating effects by bulb-PLP therapy were analyzed, and factors relating to different VPF activities were determined.All subjects achieved adequate VPF by wearing a bulb-PLP. After treatment, 10 patients (55.6%) achieved successful activation of VPF without bulb-PLP (the effective group), while persistent VPI remained in 8 patients (the ineffective group). The beginning-blowing ratio of the effective group was significantly greater than that of the ineffective group (P < 0.05) and the velopharyngeal distance (V-P distance) of the effective group tended to be smaller (P = 0.07). Regarding the shape of the bulb head, the angular type was dominant in the ineffective group, while the round type was dominant in the effective group.Bulb-PLP therapy was useful for providing adequate VPF activation. Possible signs of the subsequent effective activation of VPF are considered to be: 1) preexisting adequate VPF on blowing, 2) smaller V-P distance, and 3) synchronized palatopharyngeal movement.
2.The Role of Nurses in International Disaster Relief Operations:
Yumi FUKUYAMA ; Koichi SHINCHI ; Toyoka SHINCHI ; Yumi MATSUZAKI ; Mamiko FURUKAWA ; Masashi TAKAMURA ; Kouki KAKU ; Kenichiro ONO ; Yuko YAMAKAWA ; Hiromi KIMURA
Journal of International Health 2006;21(3):169-175
When participating in international disaster relief operations (IDR), medical staff must work under limited human resources and medical equipment. The actual role of a nurse in IDR has not yet been clarified, while the role of a doctor is relatively clear.
In this study, we have examined the actual role of nurses in IDR through a survey by questionnaire to 61 medical staff who have worked in past IDR. Full usable responses were received from 50 (82%) of them. These 50 were consisted of 24 doctors, 17 nurses, and 9 medical coordinators. The questionnaire was distributed from September 1 to December 31 in 2005. We investigated 17 activities reported variously in the literature;-setting up temporary medical facilities, inside arrangements, health care of the medical staff, coordination within the team, keeping medical records, performing triage, wound irrigation, debridement, performing incisions, removing stitches, suturing, reception of patients, medical interview of patients, assisting a doctor performing medical examination and treatment, management of commodities, management of medical waste, management of medical records, and conventional nursing care. The questionnaire asked the respondent to indicate a level of appropriate for a nurse to perform each of the activities in IDR.
Provided that the nurse had a basic national licence in nursing and IDR education and training, then triage and wound irrigation were each considered appropriate during IDR with a doctor supervising, beyond the conventional nursing role. But suturing, performing incisions, removing stitches, and debridement were each considered to be problematic for nurses.
3.Treatment Using the SpyGlass Digital System in a Patient with Hepatolithiasis after a Whipple Procedure.
Hirofumi HARIMA ; Kouichi HAMABE ; Fusako HISANO ; Yuko MATSUZAKI ; Tadahiko ITOH ; Kazutoshi SANUKI ; Isao SAKAIDA
Clinical Endoscopy 2018;51(6):596-599
An 89-year-old man was referred to our hospital for treatment of hepatolithiasis causing recurrent cholangitis. He had undergone a prior Whipple procedure. Computed tomography demonstrated left-sided hepatolithiasis. First, we conducted peroral direct cholangioscopy (PDCS) using an ultraslim endoscope. Although PDCS was successfully conducted, it was unsuccessful in removing all the stones. The stones located in the B2 segment were difficult to remove because the endoscope could not be inserted deeply into this segment due to the small size of the intrahepatic bile duct. Next, we substituted the endoscope with an upper gastrointestinal endoscope. After positioning the endoscope, the SpyGlass digital system (SPY-DS) was successfully inserted deep into the B2 segment. Upon visualizing the residual stones, we conducted SPY-DS-guided electrohydraulic lithotripsy. The stones were disintegrated and completely removed. In cases of PDCS failure, a treatment strategy using the SPY-DS can be considered for patients with hepatolithiasis after a Whipple procedure.
Aged, 80 and over
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Bile Ducts, Intrahepatic
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Cholangitis
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Endoscopes
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Endoscopes, Gastrointestinal
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Humans
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Lithotripsy