Two experiments, using color images of Japanese lacquer objects, investigated the relation between the strength of blackness and the visual and artistic impression of digital color images presented on a display. The first experiment determined the mean RGB values of black surface areas in the test stimuli where observers began to perceive the areas as “black”, and the mean RGB values where observers perceived the areas “really black”. Results indicate that to perceive a “really black” surface, RGB values should be lower than those of the original image in some pictures. The second experiment investigated, how, and to what degree the RGB values of black areas affect the visual impression of an artistic picture. Three factors, “high-quality axis”, “mysterious axis”, and “feeling of material axis”, were extracted by factor analysis. Results indicate that the Art students seem to be more sensitive in the evaluations along the “high-quality axis” and “mysterious axis” than the Engineering students are, while the opposite tendency is observed in the evaluation along the “feeling of material axis”.
Background/Aims The aim of this study was to evaluate the safety of sedation with propofol as an alternative to benzodiazepine drugs in outpatient endoscopy. Methods In this prospective study, examinees who underwent outpatient endoscopy under propofol sedation and submitted a nextday questionnaire with providing informed consent were evaluated. Periprocedural acute responses, late adverse events within 24 hours, and examinee satisfaction were evaluated. Results Among the 4,122 patients who received propofol in the 17,978 outpatient-based endoscopic examinations performed between November 2016 and March 2018, 2,305 eligible examinees (esophagogastroduodenoscopy for 1,340, endoscopic ultrasonography for 945, and total colonoscopy for 20) were enrolled, and their responses to a questionnaire were analyzed. The mean propofol dose was 69.6±24.4 mg (range, 20–200 mg). Diazepam, midazolam, and/or pentazocine in combination with propofol was administered to 146 examinees. Mild oxygen desaturation was observed in 59 examinees (2.6%); and mild bradycardia, in 2 (0.09%). Other severe reactions or late events did not occur. After eliminating 181 invalid responses, 97.7% (2,065/2,124) of the patients desired propofol sedation in future examinations. Conclusions Propofol sedation was found to be safe-without severe adverse events or accidents-for outpatient endoscopy on the basis of the patients' next-day self-evaluation. Given the high satisfaction level, propofol sedation might be an ideal tool for painless endoscopic screening. Keywords: Cancer screening; Endoscopic ultrasonography; Esophagogastroduodenoscopy; Propofol; Sedation
A 30-year-old woman with chest discomfort at swallowing and occasional vomiting was referred to our department with a diagnosis of esophageal submucosal tumor. CT visualized a mass 70 mm in diameter in the middle esophagus. Esophagogastroduodenoscopy revealed a pedunculated submucosal tumor, and endoscopic resection was considered. As the size of the tumor was so large, retrieval of the resected specimen via the stomach following incision, laparotomy was planned. En bloc resection by endoscopic submucosal dissection with a Hook-knife was performed. Retrieval of the resected specimen was carried out as planned. The specimen, which was 53×48×43mm in size with a distinct margin, was diagnosed as leiomyoma derived from the muscularis mucosae histologically. Her postprocedural course was uneventful. Endoscopic resection can be chosen when an esophageal submucosal tumor is pedunculated with abundant mobility, making it possible to avoid invasive surgery.
Background/Aims: For early gastric cancer (EGC) treated using endoscopic submucosal dissection (ESD) with poor curability defined by the Japanese Guidelines (non-curative EGC, N-EGC), additional gastrectomy has been recommended. However, N-EGC patients without additional gastrectomy often die of other diseases within a relatively short interval after ESD. It has been unclear whether additional gastrectomy is beneficial or not for such patients. The aim of this study was to clarify predictors for short-term survival of N-EGC patients without additional gastrectomy after ESD. Methods: One hundred six N-EGC patients without additional gastrectomy were included in this study. Factors related to short-term survival, defined as death within 3 years after ESD, were evaluated using uni- and multivariate analyses by comparing patients with and without short-term survival (Groups S and C, respectively). Results: During the mean follow-up period of 89 months, 39 patients died (14 patients died within 3 years, being Group S). The cause of death was gastric cancer for only 1 patient in the Group C. The 3- and 5-year overall survival rates were 86.8 and 81.8%, respectively, and the 3- and 5-years disease-specific survival rates were 100 and 98.9%, respectively. Univariate analyses showed that short-term survival was statistically associated with elevated morphology, high-risk status for lymph node metastases as defined by the eCura system, severe comorbidity (Charlson Comorbidity Index [CCI] ≥3), low level of activity in daily living (being unable to go out by oneself), habitation (a nursing home), and several poor nutritional prognostic indices (neutrophil to lymphocyte ratio ≥2.5, geriatric nutritional risk index <92, C-reactive protein ≥1.0). In the multivariate analysis, a high CCI (≥3) was the independent predictor for short-term survival after ESD (odds ratio, 8.1; 95% confidence interval, 1.53–43.0; p = 0.014). Conclusions: Severe comorbidity indicated by a high CCI score (≥3) was the independent predictor for short-term survival for EGC patients without additional gastrectomy after non-curative ESD. Since the cause of death for most patients was not gastric cancer, observational follow-ups without additional gastrectomy might be a reasonable option for patients with a poor general status indicated by a CCI ≥3.
In order to evaluate the left ventricular function in patients with myocardial infarction, echocardiographic analysis of the left ventricular function was made during ergometer exercise with monitoring heart rate, blood pressue, ECG and Symptom.The materials consisted of 23 patients with myocardial infarction and 20 normal subjects as a control. The graded exercise was performed in supine position on the bed. Echocardiographic parameters, such as % change in diameter (%ΔD), maximal posterior wall velocity in systole (Max PWV), maximal posterior velocity in diasole (-Max PWV), % change in thickness of the septum (%ΔThs) and that of the posterior wall (%ΔThp), were measured at rest, during and after exercise. In the patients with myocardial infarction, echocardiographic indicies revealed abnormal motions of the wall including infarcted area and impaired left ventricular function after exercise. This tendency was not found out in the control group. Exercise echocardiography appears to be useful to detect wall motion abnormalities and to evaluate cardiac function of the patients with myocardial infarction.
