著者

児玉 泰光 吉田 謙介 永井 孝宏 西川 敦 後藤 早苗 青木 美栄子 内山 正子 高木 律男

出版者

一般社団法人 日本環境感染学会

雑誌

日本環境感染学会誌 (ISSN:1882532X)

巻号頁・発行日

vol.35, no.1, pp.48-57, 2020-01-25 (Released:2020-07-22)

参考文献数

28

被引用文献数

1 2

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歯科外来における抜歯に関連した経口抗菌薬について,歯科ICTによる抗菌薬適正使用支援プロブラム(ASP)の前後で調査した.2015年1月~2018年12月において,電子カルテを用いた後ろ向き調査から抜歯当日の経口抗菌薬処方(術後投与)を抽出し,経口抗菌薬投与の有無,種類,期間を検討した.対象期間の後半(2017年1月)から,ASPとして抗菌薬適正使用に関する設問を含むe-learningを実施し,同時に関連情報を歯科系全医療スタッフで共有した.対象期間の普通抜歯は12,225件で,前半68.1%(4110/6036),後半50.4%(3120/6189)で経口抗菌薬が処方されていた.下顎埋伏智歯抜歯は4,740件で,前半90.5%(2130/2354),後半60.3%(1419/2354)で経口抗菌薬が処方されていた.ガイドラインによると普通抜歯では抗菌薬投与不要,下顎埋伏智歯抜歯では術前投与が推奨されており,適正使用化傾向が確認された.また,経口抗菌薬の種類は,第三世代セフェム系が激減し,普通抜歯では2015年上半期86.9%であったのが2018年下半期には28.3%に,下顎埋伏智歯抜歯では2015年上半期87.4%であったのが2018年下半期には8.5%となった.歯科ICTが主導するASPが歯科外来での抜歯における経口抗菌薬の適正使用に寄与したと推察された.

著者

吉元 俊輔 青山 一真 梶本 裕之 西川 敦

出版者

公益社団法人 日本生体医工学会

雑誌

生体医工学 (ISSN:1347443X)

巻号頁・発行日

vol.58, no.4-5, pp.147-159, 2020-09-10 (Released:2020-10-30)

参考文献数

46

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Studies about electrical current passing through the body such as bioelectricity measurement, electrical excitation, and electrical stimulus have contributed to the field of medical and biological engineering. To evaluate the applicability of the Clinical Trials Act, stimulus conditions are needed to be designed based on the understanding of safety criteria provided by various organizations, as well as the effects of the electricity applied to the human body. Because electrical current causes various effects such as perception, pain, injury, and fibrillation, safety design is essential. This paper summarizes the effects and safety criteria of the electricity applied to the human body based on the available guidelines. Furthermore, effects and criteria of the electricity applied to the head are discussed. Finally, we present an example of the stimulus evaluation to confirm the applicability of the Clinical Trials Act.

著者

加藤 拓哉 関野 正樹 松崎 大河 西川 敦 齋藤 洋一 大崎 博之

出版者

公益社団法人 日本生体医工学会

雑誌

生体医工学 (ISSN:1347443X)

巻号頁・発行日

vol.50, no.1, pp.180-188, 2012-02-10 (Released:2012-07-13)

参考文献数

21

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We previously proposed an eccentric figure-eight coil design which induces sufficient currents in the brain at lower output powers of stimulator. In the present study, numerical analyses were performed with various coil design parameters, such as outer and inner diameters and number of turns, to investigate the influence of these parameters on the eddy current distribution in the brain and the coil characteristics. Increases in the inner diameter, the outer diameter, and the number of turns caused increases in the induced currents. In order to downsize the stimulator system, we need to strengthen the eddy current in the brain, maintaining inductance as small as possible. Our results show that it is effective to enlarge outer diameter. In addition, there is only small difference in the eddy current distributions between the eccentric coil and the concentric coil in direction along with the coil plane and with depth of the brain.

著者

藤田 岳 上原 奈津美 山下 俊彦 西川 敦 河合 俊和 鈴木 寿 横井 純 柿木 章伸 丹生 健一

出版者

一般社団法人 日本耳鼻咽喉科頭頸部外科学会

雑誌

日本耳鼻咽喉科頭頸部外科学会会報 (ISSN:24365793)

巻号頁・発行日

vol.126, no.3, pp.181-184, 2023-03-20 (Released:2023-04-01)

参考文献数

12

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頭頸部外科領域にロボット手術が保険適応となり, 耳鼻咽喉科医にとってもロボット手術は身近な存在となってきた. しかし泌尿器・消化器領域で発展してきた手術ロボットを, そのまま耳や鼻の手術に応用することはまだ難しい. 私達は経外耳道的内視鏡下耳科手術 (Trans-canal Endoscopic Ear Surgery : TEES) を支援するロボットの研究・開発を複数の大学の工学部と共同で行っている. 手術ロボットの研究を通して, 自分たちの手術の特徴や問題点を改めて見直す機会が得られている. 本稿では, これまでの耳科手術用ロボットや内視鏡保持ロボットについて概略を述べ, 現在研究中の TEES 支援ロボットのコンセプトと試作機について述べる. また, 将来ロボット自身が自律的に手術を行うことを目標とした, ロボットの自律レベル向上に向けた研究についても紹介する.

著者

西川 敦子 西野 一三

出版者

日本神経治療学会

雑誌

神経治療学 (ISSN:09168443)

巻号頁・発行日

vol.33, no.6, pp.622-626, 2017 (Released:2017-04-30)

参考文献数

41

被引用文献数

2

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Immune–mediated necrotizing myopathy (IMNM) is a subgroup of idiopathic inflammatory myopathies, characterized by usually subacutely progressive course, symmetrical and proximal muscle weakness and atrophy, highly elevated serum creatine kinase levels, and muscle fiber necrosis and regeneration with little or no lymphocytic inflammatory infiltration on muscle pathology. Two major autoantibodies, anti–signal recognition particle (SRP) and anti–3–hydroxy–3–methylglutaryl–coenzyme A reductase (HMGCR) antibodies, are known to be associated with IMNM. IMNM with those antibodies were initially reported in adults but are now known to be seen also in children. Anti–SRP antibodies seem to be more frequently seen in IMNM pateints than anti–HMGCR antibodies. Although anti–HMGCR necrotizing myopathy was first found in patients who were taking statins, majority of patients do not have history of statin use. Myositis associated with anti–aminoacyl tRNA synthetases (ARS) is pathologically characterized by perifascicular necrotizing myopathy with perimysial alkaline phosphatase activity. Clinically, patients typically develop triad of interstitial lung disease, mechanic's hands, and myositis, which is sometimes called anti–synthetase syndrome or anti–ARS syndrome. Of note, necrotizing muscle pathology can also be observed in a variety of other conditions, including myositis associated with anti–mitochondria M2 autoantibodies, malignancy, viral infections (HIV and hepatitis C), and connective tissue diseases. In addition, muscular dystrophy, such as dysferlinopathy or facioscapulohumeral muscular dystrophy, may also display similar muscle pathology. Not surprisingly, it can be clinically difficult to distinguish IMNM from muscular dystrophy especially in children. As IMNM is treatable by immunosuppressive therapy, it should not be misdiagnosed. Immunohistochemical analysis including MHC class I and C5b–9 may be useful as cytoplsmic upregulation of MHC class I in non–necrotic fibers and sarcolemmal deposition of membrane attack complex (C5b–9) are often observed in IMNM but not in muscular dystrophy. This review focuses on muscle pathological features of IMNM.

著者

福島 大志 西川 敦 宮崎 文夫 関野 正樹 安室 喜弘 松崎 大河 細見 晃一 齋藤 洋一

出版者

公益社団法人 日本生体医工学会

雑誌

生体医工学 (ISSN:1347443X)

巻号頁・発行日

vol.49, no.1, pp.122-131, 2011-02-10 (Released:2011-12-13)

参考文献数

16

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Repetitive Transcranial Magnetic Stimulation (rTMS) is effective for intractable diseases of the nervous system. As the effects of rTMS last only several hours, rTMS therapies need to be continued daily. Under present circumstances, it is difficult to use rTMS in patients' home, because only experienced physicians in limited hospitals can use the expensive and complicated rTMS system. Therefore, we developed a magnetic navigation system for home use of rTMS. The proposed system uses inexpensive and small magnetic sensors; hence it is suitable for home use. By using the proposed method, even people who have no medical knowledge and technique can easily navigate the coil to the optimal position preliminarily specified by expert physicians. Our system needs to collect some dataset which consists of magnetic field and the corresponding position of the coil at the patients' initial visit. Since it is bothersome to collect a large number of dataset, we reduced the dataset by approximation using multi-regression analysis.

著者

西川 敦子 森 まどか 岡本 智子 大矢 寧 中田 智彦 大野 欽司 村田 美穂

出版者

日本神経学会

雑誌

臨床神経学 (ISSN:0009918X)

巻号頁・発行日

vol.54, no.7, pp.561-564, 2014-07-01 (Released:2014-08-02)

参考文献数

19

被引用文献数

6

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症例は26歳の女性である.出生時に呼吸不全,筋力低下があり,5歳時,顔面肩甲上腕型筋ジストロフィーと臨床診断されていた.歩行の可否などが週単位で変動した.12歳時,プロテカロール塩酸塩で変動が改善,内服を継続した.26歳時,当院受診.眼瞼下垂,顔面・体幹・四肢近位筋の筋力低下,易疲労性があり,血清CK正常,抗アセチルコリン受容体抗体と抗筋特異的チロシンキナーゼ抗体は陰性,僧帽筋の反復刺激試験でwaning現象をみとめた.DOK7遺伝子に新規変異をみとめ,先天性筋無力症候群と確定診断した.症状はアンベノニウム塩酸塩で悪化し,3,4-ジアミノピリジンで改善した.筋力低下の週から月単位の変動は診断に重要である.

著者

福島 大志 西川 敦 宮崎 文夫 関野 正樹 安室 喜弘 松崎 大河 細見 晃一 齋藤 洋一

出版者

Japanese Society for Medical and Biological Engineering

雑誌

生体医工学 (ISSN:1347443X)

巻号頁・発行日

vol.49, no.1, pp.122-131, 2011

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Repetitive Transcranial Magnetic Stimulation (rTMS) is effective for intractable diseases of the nervous system. As the effects of rTMS last only several hours, rTMS therapies need to be continued daily. Under present circumstances, it is difficult to use rTMS in patients' home, because only experienced physicians in limited hospitals can use the expensive and complicated rTMS system. Therefore, we developed a magnetic navigation system for home use of rTMS. The proposed system uses inexpensive and small magnetic sensors; hence it is suitable for home use. By using the proposed method, even people who have no medical knowledge and technique can easily navigate the coil to the optimal position preliminarily specified by expert physicians. Our system needs to collect some dataset which consists of magnetic field and the corresponding position of the coil at the patients' initial visit. Since it is bothersome to collect a large number of dataset, we reduced the dataset by approximation using multi-regression analysis.

著者

西川 敦 西村 正典 平野 敦士 小荒 健吾 宮崎 文夫

出版者

一般社団法人電子情報通信学会

雑誌

電子情報通信学会総合大会講演論文集

巻号頁・発行日

vol.1999, no.2, 1999-03-08

被引用文献数

1