|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Training in endoscopic submucosal dissection显示文摘Endoscopic submucosal dissection (ESD) represents an important advancement in the therapy of early neoplastic gastrointestinal lesions by providing higher en-bloc curative resection rate with lower recurrence compared to endoscopic mucosal resection (EMR) and by sparing the involved organ and protecting patient' s quality of life. Despite these advantages ESD is associated with long procedure times and a higher rate of complications, making ESD a challenging procedure which requires advanced endoscopic skills. Thus, there has been a recognized need for structured training system for ESD to enhance trainee experience and, to reduce the risks of complications and inadequate treatment. ESD has a very flat learning curve. However, we do not have uniformly accepted benchmarks for competency. Nevertheless, it appears that, in Japan, more than 30 supervised gastric ESD procedures are required to achieve technical proficiency and minimize complications. A number of training algorithms have been pro-posed in Japan with the aim to standardize ESD training. These algorithms cannot be directly applied in the West due to substantial differences including the availability of highly qualified mentors, the type of pathology seen, choice of devices, and trainee's background. We propose a training algorithm for Western physicians which integrates both hands-on training courses, animal model work as well as visits to expert centers. No specific preceptor training programs have been yet developed but there is a consensus that these programs are important for permeation of ESD worldwide. | Roxana M Coman Takuji Gotoda Peter V Draganov | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，8： | 8 |
| 2 | Role of observation of live cases done by Japanese experts in the acquisition of ESD skills by a western endoscopist显示文摘AIM:To evaluate the role of observation of experts performing endoscopic submucosal dissection(ESD)in the acquisition of ESD skills.METHODS:This prospective study is documenting the learning curve of one Western endoscopist.The study consisted of three periods.In the first period(preobservation),the trainee performed ESDs in animal models in his home institution in the United States.The second period(observation)consisted of visit to Japan and observation of live ESD cases done by experts.The observation of cases occurred over a 5-wk period.During the third period(post-observation),the trainee performed ESD in animal models in a similar fashion as in the first period.Three animal models were used:live40-50 kg Yorkshire pig,explanted pig stomach model,and explanted pig rectum model.The outcomes from the ESDs done in the animal models before and after observation of live human cases(main study intervention)were compared.Statistical analysis of the data included:Fisher’s exact test to compare distributions of a categorical variable,Wilcoxon rank sum test to compare distributions of a continuous variable between the two groups(pre-observation and post-observation),and Kruskal-Wallis test to evaluate the impact of lesion location and type of model(ex-vivo vs live pig)on lesion removal time.RESULTS:The trainee performed 38 ESDs in animal model(29 pre-observation/9 post-observation).The removal times post-observation were significantly shorter than those pre-observation(32.7±15.0 min vs 63.5±9.8 min,P<0.001).To minimize the impact of improving physician skill,the 9 lesions post-observation were compared to the last 9 lesions pre-observation and the removal times remained significantly shorter(32.7±15.0 min vs 61.0±7.4 min,P=0.0011).Regression analysis showed that ESD observation significantly reduced removal time when controlling for the sequence of lesion removal(P=0.025).Furthermore,it was also noted a trend towards decrease in failure to remove lesions and decrease in complications after the period of observation.This study did not find a significant difference in the time needed to remove lesions in different animal models.This finding could have important implications in designing training programs due to the substantial difference in cost between live animal and explanted organ models.The main limitation of this study is that it reflects the experience of a single endoscopist.CONCLUSION:Observation of experts performing ESD over short period of time can significantly contribute to the acquisition of ESD skills. | Peter V Draganov Myron Chang Roxana M Coman Mihir S Wagh Qi An Takuji Gotoda | 2014 | World Journal of Gastroenterology2014，20，16： | 3 |
| 3 | Selective inhibittion of inducible nitric oxide synthase in experimental osteoarthritis is associated with reduction in tissue levels of catabolic factors 显示文摘 | Pelletier JP Lascau- Coman V Jovanovic D | 1999 | J Rheumatol1999，26，： | 1 |
| 4 | Selective inhibi- tion of inducible nitric oxide synthase in experimental oateoarthritis is associated with reduction intissue levels of catabolic factors显示文摘 | Pelletier JP Lascau - Coman V J Jovanovic D | 1999 | Rheu- matot1999，26，： | 1 |
| 5 | Selective inhibition of inducible nitric oxide synthase reduces progression of experimental osteoarthritis in vivo:possible link with the reduction in chondrocyte apoptosis and caspase 3 level1显示文摘 | Jovanovic DV Lascau Coman V | 2000 | Arthritis Rheum2000，43，6： | 1 |
| 6 | Collagenase-1 and collagenase-3 synthesis in normal and early experimental osteoarthritic canine cartilage:an immunohistochemical study显示文摘 | FERNANDES J C MARTEL PELLETIER J LASCAU COMAN V | 1998 | J Rheumatol1998，25，8： | 1 |
| 7 | Measuring the specific caesium sorption capacity of soils, sediments and clay minerals 显示文摘 | Koning A D Konoplev A V Comans RNJ | 2007 | Appl Geochem2007，22，： | 1 |
| 8 | Selective inhibition of inducible nitric oxide synthase in experimental osteoarthritis is associated with reduction in tissue levels of catabolic factors 显示文摘 | Pelletier JP Lascau - Coman V Jovanovic D | 1999 | J Rheumatol1999，26，： | 1 |
| 9 | Selective inhibition of inducible nitric oxide synthase in experimental osteoarthritis is associated with reduction in tissue levels of catabolic factors显示文摘 | Pelletier JP Lascau - Coman V Jovanovic D | 1999 | J Rheumatol1999，26，9： | 1 |
| 10 | Transformation of C6 hydrocarbons of sulfated zirconia catalysts显示文摘 | COMAN S PARVULESCU V GRANEE P | 1998 | J Catal1998，176，： | 1 |
| 11 | Simultaneous determination of glucose, fructose, sucrose and sorbitol in the leaf and fruit peel of dif- ferent apple cultivars by the HPLC-RI optimized method显示文摘 | FILIP M VLASSA M COMAN V | 2016 | Food Chem2016，199，： | 1 |
| 12 | Preparation and characterization of sulfated zirconia catalysts obtained via various procedures显示文摘 | Coman S Grange P | 1999 | Appl Catal1999，176，： | 1 |
| 13 | Improving the uncommon (110) growing orientation of Al-doped ZnO thin films through sequential pulsed laser deposition 显示文摘 | COMAN T URSU E L NICA V | 2014 | Thin Solid Films2014，571，： | 1 |
| 14 | Reducibility of ruthenium in relation with zeolite structure显示文摘 | Parvulescu V I Coman S Palade P | 1999 | Applied Surface Science1999，141，12： | 1 |
| 15 | Comparative behavior of various lipases in benign water显示文摘 | Mantarosie L Coman S Parvulescu V I | 2008 | J Mol Catal A:Chem2008，279，2： | 1 |
| 16 | 显示文摘 | Iosif F Coman S Parvulescu V | 2004 | Chemical Communications2004，11，： | 1 |
| 17 | Selective inhibi- tion of inducible nitricoxi desynthase in experimental oateoarthritis is associated with reduction in tissue levels of catabolic factors 显示文摘 | Pelletier JP Lascau- Coman V Jovanovic D | 1999 | J Rheumatol1999，9，： | 1 |
| 18 | Contribution of Natural Organic Matter to Copper Leaching from Municipal Solid Waste Incinerator Bottom Ash 显示文摘 | Zomeren A V Comans Rob N J | 2004 | Environ Sci Teehnol2004，38，： | 1 |
| 19 | selective inhibition of inducible nitric oxide synthase in experimental osteoarthritis is associated with reduction in tissue levels of catabolic factors显示文摘 | Pelletier JP Lascau - Coman V Jovanovic D | 1999 | J Rheumatol1999，26，： | 1 |
| 20 | Supratentorial epidural hematoma of traumatic etiology in infants显示文摘 | Ciurea A V Kapsalaki E Z Coman T C | 2007 | Childs Nerv Syst2007，23，3： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员