Microdissection testicular sperm extraction (micro-TESE) has been performed at some experienced male infertility centers. Micro-TESE in patients with nonobstructive azoospermia (NOA) has been shown ...to be not only feasible and safe but also a technically demanding operation. To evaluate whether the improvement of surgical outcomes of micro-TESE, we hereby report the learning curves of micro-TESE for NOA patients.
Retrospective clinical analysis.
Male infertility center.
Since 2006, micro-TESE was performed in 150 patients with NOA by a single surgeon.
After the tunica albuginea was opened, direct examination of the testicular parenchyma was performed at x25 magnification.
Sperm retrieval rate and clinical factors in the first 50 patients (group A), the middle 50 patients (group B), and the last 50 patients (group C) were examined.
There were no differences in clinical factors among the three groups. Total operation times were shorter in group B and C than in group A (P<0.05). The sperm retrieval rate in group B (44%) and C (48%) was significantly higher than in group A (32%; P<0.05).
As cases increase, surgical outcomes and sperm retrieval rate have improved. We think that this report showed substantial learning curves for a microscopic surgery such as micro-TESE.
A 70-year-old male presented with intermittent macroscopic hematuria. There was no history of previous trauma or pelvic operation. At first, we were unable to clarify the origin of the hematuria, but ...3D computed tomography revealed an arteriovenous malformation (AVM) consisting of multiple feeding vessels arising from the bilateral, especially right, internal iliac artery. Treatment with transcatheter arterial embolization (TAE) with a combination of lipiodol and N-butyl-2-cyanoacrylate twice was effective. He needs to be followed up carefully for recurrence of AVM.
The purpose of this study is to understand the structure of the issues related to use of ambulance services by the elderly，and to obtain insights for strategies for solving the issues. ...Semi-structured individual or focus-group interviews were conducted on 216 healthcare professionals from 31 institutions in Kobe，including 68 physicians，59 nurses，6 policy makers. Thematic analyses were performed. The major themes identified included： 1） unclear preferences of patients about future medical care，2） barriers to ACP implementation，3） unavailability of sharing health information about ACP preference and physical conditions of patients，4） lack of cooperation among emergency department，community medical services，and long-term care facilities，and 5） insufficient local resources and public involvement． The proposals for solving these issues included; 1） clarification of the definitions，components，and evaluation methods of ACP suitable for the Japanese ，2） establishment of electronic sharing system about medical information including ACP of patients ，3） reduction of unwanted or unnecessary emergency transportation and hospitalization through cooperation of emergency department，primary care services，and long-term care facilities，and 4） fostering culture and system to think together with the residents and work toward a better society.
On the Float-area-type Flow Meter (6th Report) MORI, Yasuo; MAKI, Hiroshi; NOSE, Masami ...
Journal of the Japan Society of Precision Engineering,
1963, Letnik:
29, Številka:
338
Journal Article
Odprti dostop
The theoretical and experimental performances of float-area-type flow meters were reported in the previous reports (1st to 5th report). In this report, firstly, the integrating flow rate indicator ...with a transistor amplifier, a servo-motor, a differential gear, and a digital counter is introduced. Its performance was tested and found to be available with the accuracy of ± 2 % through 12 hours. Secondly, in order to extend the measuring range of this flow meter, a by-pass tube was installed to let the major part of the fluid flow through it. The performance of this flow meter with a by-pass tube was investigated to get design data.
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