A Case of Off-Pump CABG for Unstable Angina with High-Risk Complications Secondary to Aortitis
Bibliographic record
Abstract
大動脈炎とそれに起因する胸部大動脈瘤と大動脈の高度石灰化・蛇行，さらに左内胸動脈閉塞を合併したハイリスクな不安定狭心症に対し心拍動下冠動脈バイパス術を施行した．患者は66歳女性，労作時胸部不快感を訴え外来受診した．精査の結果，両冠動脈入口部の重度狭窄および左内胸動脈閉塞を有する不安定狭心症と診断され，冠動脈バイパス術が第1治療選択となった．術前検査にて両下肢のABI低下，CTにて大動脈炎による大動脈の高度石灰化，胸部下行大動脈瘤と大動脈の蛇行を合併していた．このため体外循環，補助循環サポートは使用困難であり，手術は全身麻酔下に胸骨正中切開し，右内胸動脈と大伏在静脈グラフトを使用してcomposite graftを作製し，心拍動下に4枝バイパスを施行した．術中SPY system（intraoperative ICG-based imaging system, Novaq Technologies ; Toronto, ON, Canada），術後3カ月に冠動脈Multi-Detector CT（MDCT）にてグラフトの開存を確認し，良好な結果を得た．
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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 | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.005 |
| Bibliometrics | 0.005 | 0.002 |
| Science and technology studies | 0.007 | 0.003 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.014 | 0.009 |
| 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".