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A New Regime for Studying the High Bootstrap Current Fraction Plasma

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Chinese Physics Letters 2001年第7期18卷 931-932页

作者： X.Gao a.isayama Y.Kamada K.Ushigusa T.Fujita T.Suzuki Japan Atomic Energy Research Institute Naka Fusion Research EstablishmentNaka-machiNaka-gunIbaraki-ken 311-01Japan Institute of Plasma Physics Chinese Academy of SciencesP.O.Box 1126Hefei 230031

A new experimental regime has recently been studied for achieving high fraction of the bootstrap current in the JT-60U hydrogen *** high poloidal beta(βp~3.61)plasma was obtained by high-power neutral beam injection heating at very high edge safety factor(Ip=0.3 MA,Bt=3.65 T,qeff=25-35)region,and the bootstrap current fraction(fBS)was about 40%using the ACCOME code *** was observed that there were no magnetohydrodynamics instabilities to retard the increase ofβp and fBS parameters in the new regime.

关键词： calculation. Bootstrap neutral

Disaster Preparedness:Looking through the Lens of Hospitals in Japan

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International Journal of Disaster Risk Science 2013年第2期4卷 89-100页

作者： Farah Mulyasari Satomi Inoue Sunil Prashar Kenji isayama Mrittika Basu Nitin Srivastava Rajib Shaw Graduate School of Global Environmental Studies Kyoto University Kyoto 606-8501 Japan

Critical facilities, such as hospitals, play a crucial role in the socioeconomic and psychological recovery of the population after a disaster. Hospitals are considered important due to their roles in saving lives in the affected population and must be able to withstand hazards and remain functioning during and after a disaster. This article assesses earthquake preparedness of hospitals in eight Japanese cities using a questionnaire survey. The questionnaire consists of six parameters and 21 indicators from the “four pillars of hospital preparedness” including structural, nonstructural, functional, and human resources. The results show that the majority of the respondent hospitals fulfill the functional preparedness, which is useful during the emergency period of a disaster, while the other three pillars—structural, nonstructural, and human resources—need to be strengthened. This study helps to assess the status of disaster preparedness as well as the gaps for these hospitals in the Tohoku and Nankai Trough regions, drawing lessons from the Great East Japan Earthquake and Tsunami of the Tohoku area. This status and the gaps are used as a departure point to indicate how to enhance preparedness and resilience to future disaster risks.

关键词： disaster Japan strengthened

From cradle to grave:seamless management of chronic pancreatitis but consider the special requests for children

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Hepatobiliary Surgery and Nutrition 2023年第4期12卷 585-589页

作者： Hiroyuki isayama Shigeto Ishii Mitsuyoshi Suzuki Toshiaki Shimizu Department of Gastroenterology Graduate School of MedicineJuntendo UniversityTokyoJapan Department of Pediatrics Juntendo University Graduate School of MedicineTokyoJapan

We have read the position paper by *** Freeman and the members of the Pancreas Nutrition Committee of the North American and the European Societies for Pediatric Gastroenterology,Hepatology,and Nutrition(NASPGHAN and ESPGHAN)(1).That paper focused on chronic pancreatitis(CP)in children and endoscopic procedures about which NASPGHAN published a second position paper(2).There are clinical practice guidelines for the management of CP in adults but not for CP in children(3).

关键词： Chronic pancreatitis pediatrics endoscopic retrograde cholangiopancreatography(ERCP) endoscopic ultrasound(EUS) pancreatic enzyme replacement therapy(PERT)

Recent advances in endoscopic ultrasonography-guided biliary interventions

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World Journal of Gastroenterology 2015年第32期21卷 9494-9502页

作者： Kazumichi Kawakubo Hiroshi Kawakami Masaki Kuwatani Shin Haba Shuhei Kawahata Yoko Abe Yoshimasa Kubota Kimitoshi Kubo Hiroyuki isayama Naoya Sakamoto Department of Gastroenterology and Hepatology Hokkaido University Graduate School of Medicine Department of Gastroenterology Graduate School of Medicine The University of Tokyo

Interventional endoscopic ultrasonography(EUS) based on EUS-guided fine-needle aspiration has rapidly spread as a minimally invasive procedure. Especially in patients with failed endoscopic retrograde cholangiopancreatography, EUS-guided biliary intervention is reported to be useful as salvage therapy. EUS-guided biliary interventions are carried out using three techniques: EUS-guided bilioenteric anastomosis, EUS-guided rendezvous procedure, and EUS-guided antegrade treatment. Although interventional EUS is not yet a standardized procedure, there have been recent advances in this field that address various biliary diseases. Here, we summarize the indications, techniques, clinical results of previous studies, and future perspectives.

关键词： Endosonography-guided biliary intervention Choledo

Clinical benefit of radiation therapy and metallic stenting for unresectable hilar cholangiocarcinoma

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World Journal of Gastroenterology 2012年第19期18卷 2364-2370页

作者： Hiroyuki isayama Takeshi Tsujino Yousuke Nakai Takashi Sasaki Keiichi Nakagawa Hideomi Yamashita Taku Aoki Kazuhiko Koike Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Radiology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Division of Hepato-Biliary-Pancreatic and Transplantation Surgery Department of SurgeryGraduate School of MedicineUniversity of TokyoTokyo 113-8655Japan

AIM： To determine the efficacy of external beam radiotherapy （EBRT）, with or without intraluminal brachytherapy （ILBT）, in patients with non-resected locally advanced hilar cholangiocarcinoma.METHODS： We analyzed 64 patients with locally advanced hilar cholangiocarcinoma, including 25 who underwent resection （17 curative and 8 non-curative）, 28 treated with radiotherapy, and 11 who received best supportive care （BSC）. The radiotherapy group received EBRT （50 Gy, 30 fractions）, with 11 receiving an ad- ditional 24 Gy （4 fractions） ILBT by iridium-192 with remote after loading. ILBT was performed using percu-taneous transhepatic biliary drainage （PTBD） route. Uncovered metallic stents （UMS） were inserted into nonresected patients with obstructive jaundice, with the exception of four patients who received percutaneous transhepatic biliary drainage only. UMS were placed endoscopically or percutaneously, depending on the initial drainage procedure. The primary endpoints were patient death or stent occlusion. Survival time of patients in the radiotherapy group was compared with that of patients in the resection and BSC groups. Stent patency was compared in the radiotherapy and BSC groups.RESULTS： No statistically significant differences in patient characteristics were found among the resection, radiotherapy, and BSC groups. Three patients in the radiotherapy group and one in the BSC group did not receive UMS insertion but received PTBD alone; cholangitis occurred after endoscopic stenting, and patients were treated with PTBD. A total of 16 patients were administered additional systemic chemotherapy （5-fluorouracil-based regimen in 9, S-1 in 6, and gemcitabine in 1）. Overall survival varied significantly among groups, with median survival times of 48.7 mo in the surgery group, 22.1 mo in the radiotherapy group, and 5.7 mo in the BSC group. Patients who underwent curative resection survived significantly longer than those who were not candidates for surgery （P = 0.0076）

关键词： Hilar cholangiocarcinoma Radiotherapy Intra-luminal brachytherapy Biliary metallic stent Ob-structive jaundice

Improvement of prognosis for unresectable biliary tract cancer

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World Journal of Gastroenterology 2013年第1期19卷 72-77页

作者： Takashi Sasaki Hiroyuki isayama Yousuke Nakai Naminatsu Takahara Naoki Sasahira Hirofumi Kogure Suguru Mizuno Hiroshi Yagioka Yukiko Ito Natsuyo Yamamoto Kenji Hirano Nobuo Toda Minoru Tada Masao Omata Kazuhiko Koike Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Gastroenterology Kanto Central HospitalTokyo 158-8531Japan Department of Gastroenterology JR Tokyo General HospitalTokyo 151-8528Japan Department of Gastroenterology Japanese Red Cross Medical CenterTokyo 150-8935Japan Department of Gastroenterology Mitsui Memorial HospitalTokyo 101-8643Japan Yamanashi Prefectural Hospital Organization Yamanashi 400-8506Japan

AIM:To evaluate the chemotherapeutic outcomes and confirm the recent improvement of prognosis for unresectable biliary tract ***:A total of 186 consecutive patients with unresectable biliary tract cancer,who had been treated with chemotherapy between 2000 and 2009 at five institutions in Japan,were retrospectively *** patients were divided into three groups based on the year beginning chemotherapy:Group A(2000-2003),Group B(2004-2006),and Group C(2007-2009).The data were fixed at the end of December *** survival and time-to-progression were analyzed and compared ***:No patient characteristics were significantly different among the three *** gallbladder was involved in about half of the patients in each group,and metastatic biliary tract cancer was present in three quarters of the *** Group A,5-fluorouracilbased chemotherapies were primarily selected as firstline chemotherapy,and only 24% were treated with second-line *** Group B,gemcitabine or S-1 monotherapy was mainly introduced as firstline chemotherapy,and 51% of the patients who were refractory to first-line chemotherapy were treated with second-line chemotherapy mainly with *** Group C,the combination therapy with gemcitabine and S-1 was mainly chosen as first-line chemotherapy,and 53% of the patients refractory to first-line chemotherapy were treated with second-line chemotherapy mainly with combination *** median timeto-progressions were 4.4 mo,3.5 mo and 5.9 mo in Groups A,B and C,respectively(4.4 mo vs 3.5 mo vs 5.9 mo,P < 0.01).The median overall survivals were 7.1,7.3,and 11.7 mo in Groups A,B and C(7.1 mo vs 7.3 mo vs 11.7 mo,P = 0.03).Induction rates of all three drugs(gemcitabine,platinum analogs,and fluoropyrimidine) in Groups A,B and C were 4%,2% and 27%(4% vs 2% vs 27%,P < 0.01).CONCLUSION:The prognosis of unresectable biliary tract cancer has improved *** three effective drugs(gemcitabine,p

关键词： Unresectable Biliary tract cancer Gemcitabine Platinum analogs Fluoropyrimidine

Treatment outcomes of chemotherapy between unresectable and recurrent biliary tract cancer

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World Journal of Gastroenterology 2014年第48期20卷 18452-18457页

作者： Takashi Sasaki Hiroyuki isayama Yousuke Nakai Yukiko Ito Ichiro Yasuda Nobuo Toda Hiroshi Yagioka Saburo Matsubara Keiji Hanada Hiroyuki Maguchi Hideki Kamada Osamu Hasebe Tsuyoshi Mukai Yoshihiro Okabe Iruru Maetani Kazuhiko Koike Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo 113-8655 Japan Department of Gastroenterology Japanese Red Cross Medical Center Tokyo 150-8935 Japan First Department of Internal Medicine Gifu University Hospital Gifu 501-1194 Japan Department of Gastroenterology Mitsui MemorialHospital Tokyo 101-8643 Japan Department of Gastroenterology JR Tokyo General Hospital Tokyo 151-8528 Japan Department of Gastroenterology Kanto Central Hospital Tokyo 158-8531 Japan Center for Gastroendoscopy Onomichi General Hospital Hiroshima 722-8508 Japan Center for Gastroenterology Teine-Keijinkai Hospital Hokkaido 006-8555 Japan Department of Gastroenterology and Neurology Faculty of Medicine Kagawa University Kagawa 761-0793 Japan Department of Gastroenterology Nagano Municipal Hospital Nagano 381-8551 Japan Department of Gastroenterology Gifu Municipal Hospital Gifu 500-8513 Japan Department of Gastroenterology Osaka Red Cross Hospital Osaka 543-8555 Japan Division of Gastroenterology Department ofInternal Medicine Toho University Ohashi Medical CenterTokyo 153-8515 Japan

AIM: To evaluate the differences in the treatment outcomes between the unresectable and recurrent biliary tract cancer patients who received chemotherapy.

关键词： Biliary tract cancer Unresectable Recurrent Pooled analysis Chemotherapy

Anchor-wire technique for multiple plastic biliary stents to prevent stent dislocation

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World Journal of Gastroenterology 2011年第28期17卷 3366-3368页

作者： Tsuyoshi Hamada Yousuke Nakai Saburo Matsubara Hiroyuki isayama Akiko Narita Kazuhiro Watanabe Yukihiro Koike Shigeo Matsukawa Tateo Kawase Kazuhiko Koike Department of Gastroenterology Kanto Central Hospital Department of Gastroenterology Graduate School of MedicineThe University of Tokyo

In endoscopic placement of multiple plastic biliary stents (PBSs),we sometimes experience proximal dislocation of the first PBS at the time of subsequent PBS *** describe the case of a 79-year-old male with obstructive jaundice caused by cholangiocarcinoma who needed to receive multiple PBS placements for management of *** proximal dislocation of the first PBS was observed,we prevented the dislocation via our technique of using guidewire inserted from the distal end of the first PBS to the side hole as the *** could complete this technique only by inserting guidewire through the side hole of the first PBS during the process of releasing the first PBS and pulling out the guidewire and the inner *** did not matter whether the anchor-wire went towards the third portion of the duodenum or the duodenal *** we introduce this "anchor-wire technique",which is useful for the prevention of PBS proximal dislocation in placing multiple PBSs.

关键词： Plastic biliary stent Anchor-wire technique Proximal dislocation Prevention Endoscopic retrograde cholangiography

Mucosal hyperplasia in an uncovered portion of partially covered metal stent

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World Journal of Gastrointestinal Endoscopy 2012年第9期4卷 432-433页

作者： Kazumichi Kawakubo Hiroyuki isayama Naoki Sasahira Hirofumi Kogure Koji Miyabayashi Kenji Hirano Minoru Tada Kazuhiko Koike Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan

Covered self-expandable metal stents were developed to overcome tumor in-growth through the metal *** migration is one of their ***,the partially covered wallflex stent(PCWS) was developed with flared ends to prevent migration However,difficulty has been reported in its *** describe the removal of a PCWS embedded in mucosal hyperplasia at the uncovered proximal flared end,visualized by using SpyGlass cholangioscopy.

关键词： Self-expandable metal stent Complication Mucosal hyperplasia Stent removal