Abdominal reapproximation anchor system (ABRA) を使用したOpen abdominal managementの1例(A case of open abdominal management with abdominal reapproximation anchor system (ABRA))
Bibliographic record
Abstract
はじめに：重症腹部外傷や重症腹腔内感染症に対するopen abdominal management（以下OAM）の概念は近年急速に広まりつつある。多くは根治的閉腹が可能であるが，不可能な症例もある。根治的閉腹が不可能な症例に対する閉腹方法に関するデバイス選択は明確でなく，様々な報告がみられる。今回我々は，abdominal reapproximation anchor system（以下ABRA）を用いた閉腹を行い良好な転帰を得た。症例：30歳代，体重125kg，body mass index 41.7の男性である。急性心筋梗塞による院外心停止で救急搬送されたが，蘇生され神経学的予後は良好（Glasgow Outcome Scale：good recovery）となった。その後，原因不明の重症急性膵炎を発症し，経過中に感染性膵壊死に伴う下行結腸穿孔を来し，左半結腸切除術・盲腸人工肛門造設術を施行した。術後，横行結腸断端漏や出血等を合併し，OAMとなった。閉腹に向けWittmann patchを装着したが，腹壁創縁の壊死を認め中止とした。腹膜の浮腫や腹壁の退縮が著明のため，ABRA＋V.A.C.systemを用いた閉腹術を行い，ABRA装着後21日目に根治的閉腹術を施行した。重篤な合併症はなく，第233病日転院となった。結語：Wittmann patchを用いた根治的閉腹が困難な長期OAM症例に対しABRAを用い閉腹に成功した1例を経験した。
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".