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Medical malpractice litigation related to gastrointestinal endoscopy in Japan:A two-decade review of civil court cases

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World Journal of Gastroenterology 2006年第42期12卷 6857-6860页

作者： Toru Hiyama shinji Tanaka Masaharu Yoshihara Tatsuma Fukuhara Shinichi Mukai Kazuaki Chayama Health Service Center Hiroshima University Higashihiroshima Department of Endoscopy Hiroshima University Hospital Hiroshima Department of Medicine and Molecular Science Division of Frontier Medical Science Programs for Biomedical Research Graduate School of Biomedical Sciences Hiroshima University Hiroshima Japan

AIM: To examine the allegations in malpractice litigations related to gastrointestinal endoscopy in Japan. METHODS: A retrospective review of cases tried in the civil court system during the 21-year period from 1985 to 2005, identified in a computerized legal database, was undertaken. RESULTS: Eighteen malpractice litigations and a total of 30 allegations were identified. Of the 18 (44%) malpractice litigations, 8 (44%) were related to eso- phagogastroduodenoscopy, 4 (22%) to colonoscopy, 4 (22%) to endoscopic sphincterotomy, and 2 (11%) to endoscopic retrograde cholangiopancreatography. Seventeen (94%) cases pertained to complications, and the remaining (6%) case pertained to misdiagnosis. In 10 cases, the patient died of the complications. Allegations were categorized as: (1) performance error during the endoscopic procedure (n = 12, 40%); (2) lack of informed consent (n = 9, 30%); (3) performance error during the treatment after the endoscopic procedure (n = 4, 13%); (4) premedication error (n = 3, 10%); (5) diagnostic error (n = 1, 3%); and (6) indication error for the endoscopic procedure (n = 1, 3%). CONCLUSION: These data may aid in the design of risk prevention strategies to be used by gastrointestinal endoscopists.

关键词： Gastrointestinal endoscopy Malpractice Litigation Risk management

Outcome of patients who have undergone total enteroscopy for obscure gastrointestinal bleeding

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World Journal of Gastroenterology 2012年第7期18卷 666-672页

作者： Takayoshi Shishido Shiro Oka shinji Tanaka Hiroki Imagawa Yoshito Takemura Shigeto Yoshida Kazuaki Chayama Department of Gastroenterology Hiroshima UniversityHiroshima 734-8551Japan Department of Endoscopy Hiroshima University HospitalHiroshima 734-8551Japan

AIM： To assess the diagnostic success and outcome among patients with obscure gastrointestinal bleeding who underwent total enteroscopy with double-balloon endoscopy.

关键词： Double-balloon endoscopy Small bowel Obscure gastrointestinal bleeding Total enteroscopy Outcome

Treatment of bleaching wastewater from pulp paper plants in China using enzymes and coagulants

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Journal of Environmental Sciences 1999年第4期11卷 480-484页

作者： ZHANG Tong shinji Wada Takao Yamagishi Ichikawa Hiroyasu Kenji Tatsumi ZHAO Qing-xiang Department of Environmental Engineering East China University of Science and TechnologyShanghai 200237China National Institute of Resources and Environment 16-3OnogawaTsukubaIbaraki 305Japan

The treatment of wastewater from pulp-paper plants in China by horseradish peroxidase was investigated in this study. The effects of horseradish peroxidase and coagulants were discussed in detail. The results indicated that enzymes might improve the removal of AOX, TOC and colour for pulp\|paper wastewater and modified chitosan is far more effective than Al\-2(SO\-4)\-3 to remove AOX, TOC and colour.

关键词： pulp\|paper wastewater coagulant horseradish peroxidase

Ultra-large-scale phase-field simulation study of ideal grain growth

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npj Computational Materials 2017年第1期3卷 247-252页

作者： Eisuke Miyoshi Tomohiro Takaki Munekazu Ohno Yasushi Shibuta shinji Sakane Takashi Shimokawabe Takayuki Aoki Graduate School of Science and Technology Kyoto Institute of TechnologyMatsugasakiSakyo-kuKyoto 606-8585Japan Faculty of Mechanical Engineering Kyoto Institute of TechnologyMatsugasakiSakyo-kuKyoto 606-8585Japan Division of Materials Science and Engineering Faculty of EngineeringHokkaido UniversityKita 13 Nishi 8Kita-kuSapporoHokkaido 060-8628Japan Department of Materials Engineering The University of Tokyo7-3-1 HongoBunkyo-kuTokyo 113-8656Japan The Supercomputing Division Information Technology CenterThe University of Tokyo2-11-16 YayoiBunkyo-kuTokyo 113-8658Japan Global Scientific Information and Computing Center Tokyo Institute of Technology2-12-1 i7-3 O-okayamaMeguro-kuTokyo 152-8550Japan

Grain growth,a competitive growth of crystal grains accompanied by curvature-driven boundary migration,is one of the most fundamental phenomena in the context of metallurgy and other scientific ***,the true picture of grain growth is still controversial,even for the simplest(or‘ideal’)*** problem can be addressed only by large-scale numerical ***,we analyze ideal grain growth via ultra-large-scale phase-field simulations on a supercomputer for elucidating the corresponding authentic statistical *** performed simulations are more than ten times larger in time and space than the ones previously considered as the largest;this computational scale gives a strong indication of the achievement of true steady-state growth with statistically sufficient number of ***,we provide a comprehensive theoretical description of ideal grain growth behaviors correctly quantified by the present *** findings provide conclusive knowledge on ideal grain growth,establishing a platform for studying more realistic growth processes.

关键词： grain field establishing

Characteristics of gas evolution profiles during coal pyrolysis and its relation with the variation of functional groups

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International Journal of Coal Science & Technology 2018年第4期5卷 452-463页

作者： Lu Zhang Shichao Qi Norihiro Takeda shinji Kudo Junichiro Hayashi Koyo Norinaga Department of Applied Science for Electronics and Materials Kyushu University6-1Kasuga KoenKasugaFukuoka 816-8580Japan Institute for Materials Chemistry and Engineering Kyushu University6-1Kasuga KoenKasugaFukuoka 816-8580Japan

Strict relation between the substituents or functional groups attached to the coal macromolecules and the generation of the volatile products, e.g., CH4 H2O, CO, CO2, etc., during the coal pyrolysis is an important but confusing subject. In this paper, quadrupole mass spectronletry, gas chromatography, and ^l3C nuclear magnetic resonance are applied to real-time monitoring the formations of volatile products, off-line quantitative determination of the total products from the pyrolysis of a sub-bituminous coal (SC), and the changes of diverse substitents in the SC along with coke foamation, respectively. These measurements are also performed for the pyrolysis of a caking coal to contrast SC. The qualitative and quantitative data reveal that, during coal pyrolysis, the functional groups related with the formation of CO, i.e., ether, carbonyl, and anhydride, can directly gen erate CO via bond breaking, or take a detour of the formation of other intermediates via condensation and recombination firstly. Moreover, the formations of CO2 and CH4 are related to the direct removal of -COO- and -CH3,respectively.

关键词： Light gas evolution Carbonization QMS GC ^13C NMR

Production and Accumulation of Xylooligosaccharides with Long Chains by Growing Culture and Xylanase of a Mutant Strain of Bacillus pumilus X-6-19

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生物工程学报 2008年第7期24卷 1221-1227页

作者： Qingzhu Yuan Tsuyoshi Adachi shinji Takenaka Shuichiro Murakami Machiko Tanaka Kenji Aoki Division of Life Science Graduate School of Science and Technology Kobe University Rokko Kobe 657-8501 Japan Department of Applied Biological Chemistry Graduate school of Agricultural Science Kobe University Rokko Kobe 657-8501 Japan Research ＆ Development Department Bunsen Co. Ltd. Shingu-cho Tatsuno 679-4393 Japan

Bacillus pumilus X-6-9 isolated from soil and subsequently identified, produced xylooligosaccharides with long chains from xylan and accumulated them in the culture. By improving the culture conditions and mutating the bacterium, a 3.2-fold increase in the production of the xylooligosaccharides was established, when compared to the original culture conditions of B. pumilus X-6-19. The addition of D-glucose to the culture of the mutant strain U-3 of B. pumilus X-6-9 repressed the synthesis of β-xylosidase, but not xylanase. Thus, it was revealed that strain U-3 was a good organism for the production and accumulation of xylooligosaccharides with long chains from xylan by a microbial culture. Xylanase produced by strain U-3 was purified to homogeneity and characterized. The hydrolyzates generated by the purified xylanase contained xylobiose, xylotriose, xylotetraose, and xylopentaose, but not xylose.

关键词：木聚糖酶菌株细菌堆积作用

Impact of lymph node micrometastasis in hilar bile duct carcinoma patients

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World Journal of Gastroenterology 2006年第16期12卷 2549-2555页

作者： Kentaro Taniguchi Taku Iida Tomohide Hori Shintaro Yagi Hiroshi Imai Taizo Shiraishi shinji Uemoto First Department of Surgery Mie University School of Medicine2-174EdobashiTsu CityMie Prefecture514-8507Japan Second Department of Pathology Mie University School of Medicine2-174EdobashiTsu CityMie Prefecture514-8507Japan

AIM- To immunohistochemicaUy examine micrometastasis and VEGF-C expression in hilar bile duct carcinoma （HBDC） and to evaluate the clinical significance of the results. METHODS： A total of 361 regional lymph nodes from 25 patients with node-negative HBDC were immunostained with an antibody against cytokeratins 8 and 18 （CAM 5.2）, and immunohistochemical staining of VEGF-C was performed in 34 primary resected tumors. RESULTS： Lymph node micrometastasis was detected in 6 （24%） of the 25 patients and 10 （2.8%） of the 361 lymph nodes. Patients with micrometastasis showed significantly poorer survival rates than those without （P= 0.025）. VEGF-C expression was positive in 17 （50%） of 34 HBDC, and significantly correlated with lymph node metastasis （P=0.042） and microscopic venous invasion （P=0.035）. CONCLUSIONS： It is suggested that immunohistochemically detected lymph node micrometastasis has an impact on the outcome of HBDC. VEGF-C expression is highly correlated with lymph node metastasis in HBDC and might therefore be a useful predictor.

关键词： Hilar bile duct carcinoma Lymph node metastasis Micrometastasis Vascular endothelial growth factor-C

Taurolithocholate impairs bile canalicular motility and canalicular bile secretion in isolated rat hepatocyte couplets

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World Journal of Gastroenterology 2006年第33期12卷 5320-5325页

作者： Norihito Watanabe Tatehiro Kagawa Sei-ichiro Kojima shinji Takashimizu Naruhiko Nagata Yasuhiro Nishizaki Tetsuya Mine Division of Gastroenterology Department of In-ternal Medicine Tokai University School of Medicine Japan

AIM: To investigate the effects of taurolithocholate (TLC)on the canalicular motility in isolated rat hepatocyte cou-plets (IRHC).METHODS: TLC was added to IRHC at concentrationsof 10 and 50 μmol/L, respectively. In each group, fi vetime-lapse movies containing 3 representative bile cana-liculi were taken under phase-contrast microscopy for12 h. The number of bile canalicular contractions andthe intervals between consecutive canalicular contrac-tions were calculated. Furthermore, the effects of TLC onIRHC were examined by transmission electron ***: The bile canalicular contractions were spon-taneous and forceful in the controls. Active vesicularmovement was observed in the pericanalicular *** after the addition of TLC, the bile canaliculiwere deformed, and canalicular bile was incorporatedinto the vacuoles. The canaliculi were gradually dilated,and canalicular contractions were markedly inhibited byTLC. The vesicular movements became extremely slowin the pericanalicular region. The number of canalicularcontractions significantly decreased in the TLC-treatedgroups, as compared with that in the controls. The timeintervals were prolonged, as the TLC dosage increased,indicating that bile secretion into the canaliculi wasimpaired with TLC. Transmission electron microscopyrevealed the lamellar transformation of the canalicularmembranes in IRHC treated with ***: TLC impairs both the bile canalicularcontractions and the canalicular bile secretion, possiblyby acting directly on the canalicular membranes in TLC-induced cholestasis.

关键词： Taurolithocholate Bile canaliculi Canalicularcontraction Bile secretion Isolated rat hepatocyte couplets Canalicular membrane Contractile protein

Defensive medicine practices among gastroenterologists in Japan

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World Journal of Gastroenterology 2006年第47期12卷 7671-7675页

作者： Toru Hiyama Masaharu Yoshihara shinji Tanaka Yuji Urabe Yoshihiko Ikegami Tatsuma Fukuhara Kazuaki Chayama Health Service Center Hiroshima University Higashihiroshima Japan Department of Endoscopy Hiroshima University Hospital Hiroshima Japan Department of Medicine and Molecular Science Division of Frontier Medical Science Programs for Biomedical Research Graduate School of Biomedical Sciences Hiroshima University Hiroshima Japan

AIM： To clarify the prevalence of defensive medicine and the specific defensive medicine practices among gastroenterologists in Japan. METHODS： A survey of gastroenterologists in Hiroshima, Japan, was conducted by mail in March 2006. The number of gastroenterologists reporting defensive medicine behaviors or changes in their scope of practice and the reported defensive medicine practices, i.e., assurance and avoidance behaviors, were examined. RESULTS： A total of 131 （77%） out of 171 gastroenterologists completed the survey. Three （2%） respondents were sued, and most respondents （96%） had liability insurance. Nearly all respondents （98%） reported practicing defensive medicine. Avoidance behaviors, such as avoiding certain procedures or interventions and avoiding caring for high-risk patients, were very common （96%）. Seventy-five percent of respondents reported often avoiding certain procedures or interventions. However, seasoned gastroenterologists （those in practice for more than 20 years） adopted avoidance behaviors significantly less often than those in practice for less than 10 years. Assurance behaviors, i.e., supplying additional services of marginal or no medical value, were also widespread （91%）. Sixty-eight percent of respondents reported that they sometimes or often referred patients to other specialists unnecessarily. CONCLUSION： Defensive medicine may be highly prevalent among gastroenterologists throughout 3apan, with potentially serious implications regarding costs, access, and both technical and interpersonal quality of care.

关键词： Defensive medicine Gastroenterologist Japan Survey Clinical practice