基本情報
研究分野
1主要な論文
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Journal of anatomy 2022年12月18日The functional association between hip joint motion and defaecation/urinary function has attracted considerable research and clinical attention owing to the potential novel approaches for pelvic floor rehabilitation; however, the anatomical basis remains unclear. This study, therefore, aimed to analyse the anatomical basis of force transmission between the obturator internus, a muscle of the hip joint, and the levator ani, a muscle of the pelvic floor. Twenty-three cadavers were used for macroscopic and histological analyses. The three-dimensional structures of the muscles and fascia were recorded using a high-definition camera and a 3D scanner. The arrangement and attachment of the muscle fibres, tendons and fascia were visualised using histological sections stained with Masson's trichrome. The obturator internus and levator ani were in broad contact through the obturator fascia. The height of their contact area was 24.6 ± 9.1 mm. Histologically, the obturator internus and levator ani shared a large area of the obturator fascia, and the obturator fascia provided the attachment of several muscle layers of the levator ani. The contribution of hip joint motion to defaecation/urinary function can be explained by the broad 'planar' contact between the obturator internus and levator ani. This anatomical feature suggests that movement of the obturator internus creates the foundation for the function of the levator ani and contributes to pelvic floor support through the obturator fascia. This study provides an anatomical basis for the effectiveness of the hip muscles in improving defaecation/urinary function by enabling balanced and proper movements.
MISC
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日本産科婦人科内視鏡学会雑誌 34(2) 152-158 2018年12月本県で行った内視鏡研修会について、参加者に対しアンケート調査を行った。研修会は、内視鏡技術認定未取得者を対象に2016年から開始し全3回行った。県内の婦人科手術を行う大学病院2施設、二次病院8施設から参加者が集まり、参加人数は第1回39人、第2回32人、第3回19人であった。腹腔鏡執刀経験については、第1回は執刀経験がない者が多く、第3回は執刀経験者数、更に執刀数ともに多くなった。参加動機については、第1回および2回はともに「同僚からの誘い」が最多であったが、第3回では「技術向上目的」が最多であった。研修効果の評価として、第1回の研修会前後で結紮縫合時間を比較したところ短縮を認めた。手術トレーニングの必要性については、第1回、第3回で「絶対必要」と答えた者が増加した。技術認定医取得への興味については、全3回とも研修後に増加したものの有意差はなかった。次回研修会への参加は、ほぼ全員が「是非参加したい」または「時間が合えば参加したい」と答えた。
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関東連合産科婦人科学会誌 51(2) 307 2014年5月1日
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日本産科婦人科内視鏡学会雑誌 27(1) 251-254 2011年<B>[Objective] </B>An air-fluid level (niveau) on abdominal X-ray is usually an important sign of ileus. We experienced two cases of ileus without air-fluid level following gynecologic surgery. Both patients underwent double-balloon enteroscopy for diagnosis, followed by laparoscopic adhesiolysis.<BR><B>[Case 1] </B>The patient underwent total abdominal hysterectomy and right salpingo-oophrectomy for myoma uteri and right ovarian tumor. Five months later, she was readmitted with abdominal pain and constipation, but there was no air-fluid level on abdominal x-ray. Adhesion of the small bowel was diagnosed by enteroscopy. Laparoscopic adhesiolysis was performed. There was a 20 cm adhesion of the small bowel to the scar from the previous operation, but there was no stenosis or obstruction. Usually, a post-operative ileus is a mechanical ileus, but this case it was not only a mechanical ileus, but also a functional ileus because there was peristalsis abnormality.<BR><B>[Case 2] </B>A patient who was being treated for depression underwent right adnexectomy for torsion of a right ovarian tumor. 16 months later, she was readmitted with lower abdominal pain and constipation without air-fluid levels. We initially suspected functional ileus because the patient was on antidepressants, but conservative therapy was not effective. Diagnostic enteroscopy revealed adhesion of the small bowel. Because of the enteroscopy results, laparoscopic surgery was selected and laparoscopic adhesiolysis between the ileum and retroperitoneum was performed.<BR><B>[Conclusion] </B>When abdominal pain and constipation without air-fluid level are persistent, we must consider the possibility of ileus. Enteroscopy and laparoscopic adhesiolysis may be options in these cases.
共同研究・競争的資金等の研究課題
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日本学術振興会 科学研究費助成事業 若手研究 2021年4月 - 2026年3月