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Remaining issues of recommended management in current guidelines for asymptomatic common bile duct stones

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World Journal of Gastroenterology 2021年第18期27卷 2131-2140页

作者： Hirokazu Saito Yoshihiro Kadono Takashi Shono Kentaro Kamikawa Atsushi Urata Jiro Nasu Haruo Imamura ikuo Matsushita Shuji Tada Department of Gastroenterology Kumamoto City HospitalKumamoto City 862-8505Japan Department of Gastroenterology Tsuruta HospitalKumamoto City 862-0925Japan Department of Gastroenterology Kumamoto Chuo HospitalKumamoto City 862-0965Japan Department of Gastroenterology Saiseikai Kumamoto HospitalKumamoto City 861-4193Japan Department of Gastroenterological Surgery Kumamoto Chuo HospitalKumamoto City 862-0965Japan

Current guidelines for treating asymptomatic common bile duct stones(CBDS)recommend stone removal,with endoscopic retrograde cholangiopan-creatography(ERCP)being the first treatment *** deciding on ERCP treatment for asymptomatic CBDS,the risk of ERCP-related complications and outcome of natural history of asymptomatic CBDS should be *** incidence rate of ERCP-related complications,particularly of post-ERCP pancreatitis for asymptomatic CBDS,was reportedly higher than that of symptomatic CBDS,increasing the risk of ERCP-related complications for asymptomatic CBDS compared with that previously reported for biliopancreatic *** studies have reported short-to middle-term outcomes of natural history of asymptomatic CBDS,its long-term natural history is not well *** date,there are no prospective studies that determined whether ERCP has a better outcome than no treatment in patients with asymptomatic CBDS or *** randomized controlled trial has evaluated the risk of early and late ERCP-related complications vs the risk of biliary complications in the wait-and-see approach,suggesting that a change is needed in our perspective on endoscopic treatment for asymptomatic *** studies examining long-term complication risks of ERCP and wait-and-see groups for asymptomatic CBDS are warranted to discuss whether routine endoscopic treatment for asymptomatic CBDS is justified or not.

关键词： Asymptomatic common bile duct stone Endoscopic retrograde cholangiopancreatography Complication Natural history of asymptomatic common bile duct stone Guideline Recommendation

Reactions of Benzo[b]cyclobuta[d]pyran-3-one Derivatives with Sulfur Ylide

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复旦学报(自然科学版) 2005年第5期 285-286页

作者： Masayuki Yamashita,Yadav Navnath D.,Masaki Nagahama,Tomoki Inaba,ikuo Kawasaki,Shunsaku Ohta Kyoto Pharmaceutical University Misasagi-Nakauchicho 5 Yamashinaku Kyoto 607-8414 Japan Kyoto Pharmaceutical University Misasagi-Nakauchicho 5 Yamashinaku Kyoto 607-8414 Japan Kyoto Pharmaceutical University Misasagi-Nakauchicho 5 Yamashinaku Kyoto 607-8414 Japan Kyoto Pharmaceutical University Misasagi-Nakauchicho 5 Yamashinaku Kyoto 607-8414 Japan Kyoto Pharmaceutical University Misasagi-Nakauchicho 5 Yamashinaku Kyoto 607-8414 Japan Kyoto Pharmaceutical University Misasagi-Nakauchicho 5 Yamashinaku Kyoto 607-8414 Japan

Reactions of Benzo[b]cyclobuta[d]pyran-3-one Derivatives with Sulfur Ylide

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复旦学报（自然科学版） 2005年第5期44卷 895-896页

作者： Masayuki Yamashita Yadav Navnath D. Masaki Nagahama Tomoki Inaba ikuo Kawasaki Shunsaku Ohta Kyoto Pharmaceutical University Misasagi-Nakauchicho 5 Yamashinaku Kyoto 607-8414 JapanKyoto Pharmaceutical University Misasagi-Nakauchicho 5 Yamashinaku Kyoto 607-8414 JapanKyoto Pharmaceutical University Misasagi-Nakauchicho 5 Yamashinaku Kyoto 607-8414 JapanKyoto Pharmaceutical University Misasagi-Nakauchicho 5 Yamashinaku Kyoto 607-8414 JapanKyoto Pharmaceutical University Misasagi-Nakauchicho 5 Yamashinaku Kyoto 607-8414 JapanKyoto Pharmaceutical University Misasagi-Nakauchicho 5 Yamashinaku Kyoto 607-8414 Japan

Small ring size cycloalkanes such as cyclopropanes and cyclobutanes have been found as a basic structuralconstituent in a wide rang of natural products[1]. In organic synthesis, their cycloalkanes also play an impor-t... 详细信息

关键词：立体收敛反应光化学叶立德加氢催化吡喃

MAGNETIC BEHAVIORS OF AMORPHOUS Gd2T (T=Co,Ni and Cu)

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MAGNETIC BEHAVIORS OF AMORPHOUS Gd2T (T=Co,Ni and Cu)

Association of polymorphic alleles of CTLA4 with inflammatory bowel disease in the Japanese

The 2nd International Symposium on Physics of Magnetic Materials

作者： ikuo Nakai Department of Physics Faculty of General EducationTottori UniversityTottori 680JAPAN

We report studies of precise magnetization measurements on amorphous GdT(T=Co,Ni and Cu) alloys between 4.2 K and 300 K under a magnetic field of 5.0 T.A form for temperature changes in magnetization is proposed from the viewpoint of fluctuations of the local magnetic *** magnetization of the amorphous GdNi and GdCu ferromagnets obeys the simple spin wave T *** the amorphous QdCo alloy,on the other hand,we have found the Stoner-type T contribution to the magnetization as well as the spin wave T term.

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World Journal of Gastroenterology 2005年第27期11卷 4188-4193页

作者： Haruhisa Machida Kazuhiro Tsukamoto Chun-Yang Wen Yukiko Narumi Saburou Shikuwa Hajime Isomoto Fuminao Takeshima Yohei Mizuta Norio Niikawa ikuo Murata Shigeru Kohno Second Department of Internal Medicine Nagasaki University School of Medicine 1-7-1 SakamotoNagasaki 852-8501 Japan Department of Pharmacotherapeutics Nagasaki University Graduate School of Biomedical Sciences 1-14 Bunkyo-machi Nagasaki 852-8521Japan Department of Molecular Pathology Atomic Bomb Disease Institute Nagasaki University Graduate School of Biomedical Sciences 1-12-4 Sakamoto Nagasaki 852-8523Japan Department of Human Genetics Nagasaki University Graduate School of Biomedical Sciences 1-12-4 Sakamoto Nagasaki 852-8523 Japan

AIM： To examine an association between the cytotoxic Tlymphocyte antigen 4 （CTLA4） gene that plays a role in downregulation of T-cell activation and inflammatory bowel disease consisting of ulcerative colitis （UC） and Crohn＇s disease （CD） in the ***： We studied 108 patients with UC, 79 patients with CD, and 200 sex-matched healthy controls, with respect to three single nucleotide polymorphisms （SNPs） in CTLA4, such as C-318T in the promoter region, A＋49 Gin exon 1 and G＋6230A in the 3＇ untranslated region （3＇-UTR） by a PCR-restriction fragment length polymorphism method, and to an （AT）, repeat polymorphism in 3＇-UTR by fragment analysis with fluorescence-labeling on denaturing sequence gels. Frequency of alleles and genotypes and their distribution were compared statistically between patients and controls and among subgroups of patients, using X^2 and Fisher exact ***： The frequency of ＂A/A＂ genotype at the G＋6230A SNP site was statistically lower in UC patients than in controls （3.7% vs 11.0%, P = 0.047, odds ratio （OR） = 0.311）. Moreover, the frequency of ＂G/G＂ genotype at the A＋49G SNP site was significantly higher in CD patients with fistula （48.6%） than those without it （26.2%）（P = 0.0388, OR=2.67）.CONCLUSION： The results suggest that CTLA4 located at 2q33 is a determinant of UC and responsible for fistula formation in CD in the Japanese.

关键词： Ulcerative colitis CTLA4 gene Diseasesusceptible gene Crohn's disease Fistula formation

Skeletal muscle and whole body insulin resistance but not cardiac muscle insulin resistance could be improved by troglitazone therapy within 12 weeks in type-2 diabetes

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Journal of Biomedical Science and Engineering 2012年第12期5卷 829-835页

作者： ikuo Yokoyama Toshiyuki Moritan Yusuke Inoue Department of Cardiovascular Medicine Clinical Research Center Sanno Hospital of International University of Health and Welfare Tokyo Japan Department of Clinical Engineering Faculty of Medical Engineering Suzuka University of Medical Science Suzuka Japan JapanDepartment of Radiology Institute of Medical Science Graduate School of Medicine University of Tokyo Tokyo Japan

Background: Existence of myocardial insulin resistance (IR) has been reported in type II diabetics (T2- DM) and coronary artery disease (CAD). Improvement in heart and skeletal muscle IR after thiazolidinedione’s therapy was reported in T2DM and CAD. However effects of troglitazone therapy (TRO) on myocardial IR remain uncertain. To clarify heart and skeletal muscle and whole body IR in T2DM without CAD by TRO to clarify whether TRO would provide different results. Methods: We analyzed data on 15 T2DM patients who underwent dynamic PET with 18F-FDG under insulin clamping before and during TRO (200 mg/day) and 17 controls. Results: Whole body glucose disposal rate (WBGR mg/min/kg) in T2DM before TRO (3.41 ± 1.72) was significantly lower than in controls (9.76 ± 2.97, p < 0.01) as was the skeletal muscle glucose utilization rate (SMGU mg/min/kg);T2DM (0.367 ± 0.217) vs. controls (1.34 ± 0.613, p < 0.01) and myocardial glucose utilization rate (MGU mg/min/kg;T2DM 5.86 ± 2.03 vs. controls 7.34 ± 1.80, p < 0.05). WBGR in T2DM during TRO (5.17 ± 2.75, p < 0.05) was significantly higher than that before TRO, as was the SMGU (0.782 ± 0.20, p < 0.05). The MGU in T2DM during TRO (6.59 ± 0.72) was comparable with that before TRO. Conclusion: Myocardial IR response to TRO differed from that in skeletal muscle and the whole body in T2DM without CAD.

关键词： Insulin Resistance Myocardial Insulin Resistance Glucose Metabolism Skeletal Muscle Type II Diabetes Mellitus 18F-FDG PET

Solving the Balance Problem of On-Line Role-Playing Games Using Evolutionary Algorithms

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Journal of Software Engineering and Applications 2012年第8期5卷 574-582页

作者： Haoyang Chen Yasukuni Mori ikuo Matsuba Advanced Integration Science Graduate School of Chiba University Chiba Japan

In on-line role-playing games (RPG), each race holds some attributes and skills. Each skill contains several abilities such as physical damage, hit rate, etc. Parts of the attributes and all the abilities are a function of the character’s level, which are called Ability-Increasing Functions (AIFs). A well-balanced on-line RPG is characterized by having a set of well-balanced AIFs. In this paper, we propose an evolutionary design method, including integration with an improved Probabilistic Incremental Program Evolution (PIPE) and a Cooperative Coevolutionary Algorithm (CCEA), for on-line RPGs to maintain the game balance. Moreover, we construct a simplest turn-based game model and perform a series of experiments based on it. The results indicate that the proposed method is able to obtain a set of well-balanced AIFs efficiently. They also show that in this case the CCEA outperforms the simple genetic algorithm, and that the capability of PIPE has been significantly improved through the improvement work.

关键词： Game Design Game Balance Cooperative Coevolutionary Algorithm Probabilistic Incremental Program Evolution

A Competitive Markov Approach to the Optimal Combat Strategies of On-Line Action Role-Playing Game Using Evolutionary Algorithms

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Journal of Intelligent Learning Systems and Applications 2012年第3期4卷 176-187页

作者： Haoyang Chen Yasukuni Mori ikuo Matsuba Graduate School of Advanced Integration Science Chiba University Chiba Japan.

In the case of on-line action role-playing game, the combat strategies can be divided into three distinct classes, Strategy of Motion(SM), Strategy of Attacking Occasion (SAO) and Strategy of Using Skill (SUS). In this paper, we analyze such strategies of a basic game model in which the combat is modeled by the discrete competitive Markov decision process. By introducing the chase model and the combat assistant technology, we identify the optimal SM and the optimal SAO, successfully. Also, we propose an evolutionary framework, including integration with competitive coevolution and cooperative coevolution, to search the optimal SUS pair which is regarded as the Nash equilibrium point of the strategy space. Moreover, some experiments are made to demonstrate that the proposed framework has the ability to find the optimal SUS pair. Furthermore, from the results, it is shown that using cooperative coevolutionary algorithm is much more efficient than using simple evolutionary algorithm.

关键词： Game Design Game Balance Competitive Markov Decision Process Cooperative Coevolutionary Algorithm Competitive Coevolution

Functional imaging of skeletal muscle glucose metabolism by <sup>18</sup>FDG PET to characterize insulin resistance in patients at high risk for coronary artery disease

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Journal of Biomedical Science and Engineering 2012年第12期5卷 819-825页

作者： ikuo Yokoyama Toshiyuki Moritan Yusuke Inoue Department of Cardiovascular Medicine Clinical Research Center Sanno Hospital of International University of Health and Welfare Tokyo Japan Department of Clinical Engineering Faculty of Medical Engineering Suzuka University of Medical Science Suzuka Japan Department of Radiology Kitasato University Graduate School of Medicine Sagamihara Japan

Insulin resistance is associated with several coronary risk factors and is thought to play a critical role for the development of coronary artery disease. Insulin resistance has several causes, including an impaired skeletal muscle glucose utilization rate (SMGU), reduced peripheral blood flow, and altered fatty tissue metabolism, with SMGU being considered the most important. Nonetheless, insulin resistance has only been estimated by the glucose disposal rate (GDR) in previous studies. Methods: Skeletal muscle metabolic imaging with 18FDG and positron emission tomography (PET) was undertaken to measure SMGU during hyperinsulinemiceuglycemic clamping in 22 normotensive type-2 diabetics under no medications (T2- DM), 17 normotensive non-diabetic hypertriglyceridemics, 22 patients with hypertension, and 12 agematched controls. Whole body insulin resistance was assessed by the GDR during hyperinsulinemiceuglycemic insulin clamping. Results: The SMGU and GDR were significantly reduced in T2DM (32.1 ± 16.6 μmol/min/kg and 24.3 ± 13.0 μmol/min/kg, respectively), hypertriglyceridemics (36.5 ± 13.5 μmol/min/ kg and 22.7 ± 8.07 μmol/min/kg respectively) and patients with hypertension (35.4 ± 26.6 μmol/min/kg and 29.0 ± 9.90 μmol/min/kg, respectively) compared with controls (72.2 ± 44.1 μmol/min/kg and 43.0 ± 22.9 μmol/min/kg, p < 0.01, respectively). In all groups studied, SMGU was significantly correlated with GDR (r = 0.76, p < 0.01) and GDR (F = 13.9) was independently related to SMGU (r = 0.81, p < 0.01). Conclusion: Insulin resistance is significantly associated with SMGU to a similar degree among patients with T2DM, essential hypertension and hypertriglyceridemia. 18FDG PET functional imaging allows insulin resistance to be assessed.

关键词： Insulin Resistance Glucose Metabolism Skeletal Muscle Coronary Risk Factor Type II Diabetes Mellitus Hypertension Hyperlipidemia 18F-FDG PET