2012年9月28日 星期五
這次到日本的St. Marianna University School of Medicine (聖マリアンナ医科大学病院) 與 Kurimoto 教授學習
搜尋 pubmed :
http://www.ncbi.nlm.nih.gov/pubmed?term=Kurimoto%20N[Author]
共有40篇文章"而已" (有些還可能只是同名..)
但 Kurimoto 教授或其他日本地區的bronchoscope確實領先台灣甚多(如下描述)。
Chest. 2002 Dec;122(6):1887-94.
Analysis of the internal structure of peripheral pulmonary lesions using endobronchial ultrasonography
Dr. Kurimoto 在2002年發表的文章，他從1996年就開始做EBUS，使用Olympus的 miniature probe (external diameter 2.5 or 2.0mm)
台灣在4-5年後也有幾篇文章
Chest. 2006 Oct;130(4):1191-7.
Differentiating peripheral pulmonary lesions based on images of endobronchial ultrasonography.
Chest. 2007 Sep;132(3):922-9. Epub 2007 Jul 23.
Diagnosis of peripheral lung cancer with three echoic features via endobronchial ultrasound.
Respirology. 2009 Aug;14(6):859-64.
Factors influencing visibility and diagnostic yield of transbronchial biopsy using endobronchial ultrasound in peripheral pulmonary lesions.
如台灣2009這一篇的結論是：越大的tumor越容易biopsy(以20mm來分大或小)，越peripheral 的tumor越不容易biopsy
Chest. 2004 Sep;126(3):959-65.
Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically.
但 Dr. Kurimoto 在2004年發表的，使用1.7mm EBUS + guide sheath 就已經可以取到小於10mm lesion by bronchoscopy。
TBLB failure or too small ---- CT guided or surgical intervention TBLB failure原因 ---- small size? ---- 發展更小的 EBUS + guide sheath ---- adjacent to lesion? ---- 使用器械變成within
Chest. 2009 Jul;136(1):229-36. Epub 2008 Sep 23. Endobronchial ultrasonography-guided transbronchial needle aspiration increases the diagnostic yield of peripheral pulmonary lesions: a randomized trial.
高雄長庚所發表，用TBNA在adjacent lesion. 所以就診斷性氣管鏡來說，台灣落後日本至少5年?
這剛好就是「亡台從五年五百億開始」一文提到的：「五年五百億卻用SCI 和 SSCI 綁架了所有優秀的學者，不許他們研究真正台灣需要的技術。」的反面例子。
日本學者研究的東西和產業相輔相成，緊密結合。所以隨著氣管鏡的進步，提供技術的Olympus獲利也越大。
網路時代，學習沒有秘密
Bronchoscopy International
2015-8-27 update:
This time, we visited Japan hospital for learning bronchoscopy again. Their technology advanced than 3 years ago. EBUS-TBNA is a easy method and is routinely practiced. Pathologic tissue could always be obtained. Besides, GGO is also routinely be obtained by TBLB.
Radial endobronchial ultrasound images for ground-glass opacity pulmonary lesions.
The diagnostic value of histology and cytology samples during endobronchial ultrasound with a guide sheath
Endobronchial ultrasound elastography in the diagnosis of mediastinal and hilar lymph nodes.
Analysis of the internal structure of peripheral pulmonary lesions using endobronchial ultrasonography
Dr. Kurimoto 在2002年發表的文章，他從1996年就開始做EBUS，使用Olympus的 miniature probe (external diameter 2.5 or 2.0mm)
台灣在4-5年後也有幾篇文章
Chest. 2006 Oct;130(4):1191-7.
Differentiating peripheral pulmonary lesions based on images of endobronchial ultrasonography.
Chest. 2007 Sep;132(3):922-9. Epub 2007 Jul 23.
Diagnosis of peripheral lung cancer with three echoic features via endobronchial ultrasound.
Respirology. 2009 Aug;14(6):859-64.
Factors influencing visibility and diagnostic yield of transbronchial biopsy using endobronchial ultrasound in peripheral pulmonary lesions.
如台灣2009這一篇的結論是：越大的tumor越容易biopsy(以20mm來分大或小)，越peripheral 的tumor越不容易biopsy
Chest. 2004 Sep;126(3):959-65.
Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically.
但 Dr. Kurimoto 在2004年發表的，使用1.7mm EBUS + guide sheath 就已經可以取到小於10mm lesion by bronchoscopy。
TBLB failure or too small ---- CT guided or surgical intervention TBLB failure原因 ---- small size? ---- 發展更小的 EBUS + guide sheath ---- adjacent to lesion? ---- 使用器械變成within
Chest. 2009 Jul;136(1):229-36. Epub 2008 Sep 23. Endobronchial ultrasonography-guided transbronchial needle aspiration increases the diagnostic yield of peripheral pulmonary lesions: a randomized trial.
高雄長庚所發表，用TBNA在adjacent lesion. 所以就診斷性氣管鏡來說，台灣落後日本至少5年?
這剛好就是「亡台從五年五百億開始」一文提到的：「五年五百億卻用SCI 和 SSCI 綁架了所有優秀的學者，不許他們研究真正台灣需要的技術。」的反面例子。
日本學者研究的東西和產業相輔相成，緊密結合。所以隨著氣管鏡的進步，提供技術的Olympus獲利也越大。
網路時代，學習沒有秘密
Bronchoscopy International
2015-8-27 update:
This time, we visited Japan hospital for learning bronchoscopy again. Their technology advanced than 3 years ago. EBUS-TBNA is a easy method and is routinely practiced. Pathologic tissue could always be obtained. Besides, GGO is also routinely be obtained by TBLB.
Radial endobronchial ultrasound images for ground-glass opacity pulmonary lesions.
The diagnostic value of histology and cytology samples during endobronchial ultrasound with a guide sheath
Endobronchial ultrasound elastography in the diagnosis of mediastinal and hilar lymph nodes.
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