The reserved judgment can be broadly categorized into three types: Re-Do, Re-Set, and Natural Flowing Case (i.e. step by step in Re-Try). Hori et al. constructed the Bayes-Fuzzy Estimation and demonstrated that system...The reserved judgment can be broadly categorized into three types: Re-Do, Re-Set, and Natural Flowing Case (i.e. step by step in Re-Try). Hori et al. constructed the Bayes-Fuzzy Estimation and demonstrated that system theory can be applied to the possibility of Markov processes, and that decision-making approaches can be applied to sequential Bayes estimation. In this paper, we focus on the Natural Flowing Case within reserved judgment. Here, the possibility of oblique (or principal) factor rotation is considered as a part of the tandem fuzzy system that follows step by step for sequential Bayes estimation. Ultimately, we achieve a significant result whereby the expected utility can be calculated automatically without the need to construct a utility function for reserved judgment. There, this utility in Re-Do can be calculated by the prior utility, and that utility in Re-set does not exist by our research in this paper. Finally, we elucidate the relationship between fuzzy system theory and fuzzy decision theory through an applied example of Bayes-Fuzzy theory. Fuzzy estimation can be applied to only normal making decision, but it is impossible to apply abnormal decision problem. Our Vague, specially Type 2 Vague can be applied to abnormal case, too.展开更多
False aneurysm occurring after replacement of ascending aorta by a vascular prosthesis is a rare, but life-threatening complication. In spite of advances in endovascular techniques, surgery remains the treatment of ch...False aneurysm occurring after replacement of ascending aorta by a vascular prosthesis is a rare, but life-threatening complication. In spite of advances in endovascular techniques, surgery remains the treatment of choice in the majority of cases. We report the case of a huge pseudoaneurysm caused by late dehiscence of the right coronary ostium-aortic tubular graft anastomosis, occurred 30 years after replacement of aortic valve and ascending aorta by classical Bentall operation. A fistula originating from the aneurysmal sac extended across the sternum into the thoracic subcutaneous soft tissues and gave rise to a pulsatile mass well appreciable on the anterior chest wall. The surgical treatment, consisting of partial resection of the aortic tubular graft and sternal reconstruction was effective and uneventful.展开更多
Although liver resection(LR)is often adopted to recurrent hepatocellular carcinomas,risks of complications and conversion reportedly increase in laparoscopic repeat LR(LRLR).The indication is not agreed upon even with...Although liver resection(LR)is often adopted to recurrent hepatocellular carcinomas,risks of complications and conversion reportedly increase in laparoscopic repeat LR(LRLR).The indication is not agreed upon even with the recent advances of laparoscopic LR.We conducted an international propensity score matching study of LRLR and open repeat LR for hepatocellular carcinoma with 1,582 patients from 42 world centers.Propensity-score matched LRLR patients have smaller blood loss and longer operation time than open repeat LR patients.Median overall survival time was 8.94 years in open and 12.55 years in LRLR;although the difference was not significant,the P-value was 0.0855 and the better curve of LRLR is clearly separated from that of open.In our institution,we experienced 34 LRLR and 12 cases of three times or more repeat LR until 2019.There are no significant differences in operation time,blood loss,hospital stay,conversion,and morbidity rates among first,second,and third or higher laparoscopic LR,which is different from the open situation.However,postoperative bile leakage and intraoperative bleeding causing conversion did happen in the cases with repeat extended exposure of Glissonian pedicle.LRLR is feasible for selected patients.However,the procedure is under developing stage and further accumulation of experiences and evaluation are needed.展开更多
文摘The reserved judgment can be broadly categorized into three types: Re-Do, Re-Set, and Natural Flowing Case (i.e. step by step in Re-Try). Hori et al. constructed the Bayes-Fuzzy Estimation and demonstrated that system theory can be applied to the possibility of Markov processes, and that decision-making approaches can be applied to sequential Bayes estimation. In this paper, we focus on the Natural Flowing Case within reserved judgment. Here, the possibility of oblique (or principal) factor rotation is considered as a part of the tandem fuzzy system that follows step by step for sequential Bayes estimation. Ultimately, we achieve a significant result whereby the expected utility can be calculated automatically without the need to construct a utility function for reserved judgment. There, this utility in Re-Do can be calculated by the prior utility, and that utility in Re-set does not exist by our research in this paper. Finally, we elucidate the relationship between fuzzy system theory and fuzzy decision theory through an applied example of Bayes-Fuzzy theory. Fuzzy estimation can be applied to only normal making decision, but it is impossible to apply abnormal decision problem. Our Vague, specially Type 2 Vague can be applied to abnormal case, too.
文摘False aneurysm occurring after replacement of ascending aorta by a vascular prosthesis is a rare, but life-threatening complication. In spite of advances in endovascular techniques, surgery remains the treatment of choice in the majority of cases. We report the case of a huge pseudoaneurysm caused by late dehiscence of the right coronary ostium-aortic tubular graft anastomosis, occurred 30 years after replacement of aortic valve and ascending aorta by classical Bentall operation. A fistula originating from the aneurysmal sac extended across the sternum into the thoracic subcutaneous soft tissues and gave rise to a pulsatile mass well appreciable on the anterior chest wall. The surgical treatment, consisting of partial resection of the aortic tubular graft and sternal reconstruction was effective and uneventful.
文摘Although liver resection(LR)is often adopted to recurrent hepatocellular carcinomas,risks of complications and conversion reportedly increase in laparoscopic repeat LR(LRLR).The indication is not agreed upon even with the recent advances of laparoscopic LR.We conducted an international propensity score matching study of LRLR and open repeat LR for hepatocellular carcinoma with 1,582 patients from 42 world centers.Propensity-score matched LRLR patients have smaller blood loss and longer operation time than open repeat LR patients.Median overall survival time was 8.94 years in open and 12.55 years in LRLR;although the difference was not significant,the P-value was 0.0855 and the better curve of LRLR is clearly separated from that of open.In our institution,we experienced 34 LRLR and 12 cases of three times or more repeat LR until 2019.There are no significant differences in operation time,blood loss,hospital stay,conversion,and morbidity rates among first,second,and third or higher laparoscopic LR,which is different from the open situation.However,postoperative bile leakage and intraoperative bleeding causing conversion did happen in the cases with repeat extended exposure of Glissonian pedicle.LRLR is feasible for selected patients.However,the procedure is under developing stage and further accumulation of experiences and evaluation are needed.
