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Direct Instruction by an Experienced Surgeon Can Shorten the Learning Curve for Laparoscopic-Assisted Distal Gastrectomy

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International Journal of Clinical Medicine 2013年第6期4卷 28-34页

作者： Masashi Takemura katsuyuki Mayumi Takashi Ikebe Sinya Tanimura Department of Gastrointestinal Surgery Osaka City General Hospital Osaka Japan Department of Surgery Gohshi Hospital Hyogo Japan

Aim: Laparoscopy-assisted distal gastrectomy (LADG) with regional lymph node dissection is a treatment option for patient with early gastric cancer. However, LADG is a technically complex and advanced procedure, which is challenging for inexperienced surgeons. In this report, we retrospectively evaluated the learning curve for LADG of a single surgeon with no previous experience in LADG and the usefulness of direct instruction by a surgeon experienced in LADG in shortening the learning curve. Patients and Methods: This study was analyzed 80 consecutive patients, who underwent LADG by a single surgeon (first assistant in 10 cases and operator in 70 cases) between January 2008 and December 2012. Patients were divided into 3 sequential groups of 10 (training period), 30 (learning period), and 40 (operating period) cases in each group. Median operation time and estimated blood loss for these 3 groups were determined. Other learning indicators, including transfusion requirement, postoperative complications, number of lymph node harvested, and rate of conversion open gastrectomy, were also evaluated. Results: During the training period, median operation time and estimated blood loss were 219.5 min and 83.0 ml, respectively. During the learning period, the operation time was significantly longer than that of training period. In the operating period, the operation time was significantly lesser than that during the learning period. However, the operation time was not different from that during the training period and reached a plateau. The estimated blood loss during the operating period was significantly lesser than that during the learning period. The difference in the number of lymph nodes retrieved between each group was not significant. Conclusions: Direct instructions by an experienced surgeon can decrease the number of cases required for learning. Because LADG is technically more complex than other laparoscopic procedures, standardization of LADG and an effective trai

关键词： Laparoscopic-Assisted Distal Gastrectomy Learning Training System

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Pain and Fatigue Perceptions of Patients with Systemic Autoimmune Myopathies before and during the COVID-19 Pandemic Period

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Open Journal of Rheumatology and Autoimmune Diseases 2022年第4期12卷 83-98页

作者： Rafael Giovani Missé Isabela Bruna Pires Borges Bruna Lindoso Correia Lorenza Rosa Silvério da Silva Marlise Sítima Mendes Simões Alexandre Moura dos Santos Samuel katsuyuki Shinjo Division of Rheumatology Faculdade de Medicina FMUSP Universidade de Sao Paulo Brazil

Objective: To assess general pain and fatigue and their association with the disease status of patients with systemic autoimmune myopathies (SAMs), in terms of the impact of the COVID-19 pandemic on these parameters. Methods: This is a cross-sectional and prospective cohort study that included 72 patients with SAMs who were matched by age and gender with 67 healthy individuals. The patients engaged in an interview via a validity survey to measure disease status, and assess a visual analog scale (VAS) for pain and fatigue in two periods: before (phase I) and during (phase II) of the Brazilian COVID-19 pandemic. For cross-sectional analysis, patients’ data from phase I were compared to healthy individuals’ information, whereas for prospective analysis, data of the patients who were assessed in phase II were compared to the same patients’ data from phase I. Results: The patients had significantly more pain perception, comparable fatigue perception and fatigue severity, when compared to the healthy individuals. During the COVID-19 pandemic period, the disease activity, pain and fatigue perceptions, and fatigue severity remained unchanged. Despite this, the pain and fatigue perceptions correlated significantly with patients’ VAS, the patient health outcome, and fatigue severity. In addition, the pain perception correlated to creatine phosphokinase, whereas fatigue perceptions correlated to physicians' VAS. Conclusions: The study showed that patients with SAMs have significantly increased pain perceptions compared to healthy individuals. During the COVID-19 pandemic period, the pain and fatigue perceptions remained unchanged in patients with SAMs but they correlated to several disease status parameters.

关键词： COVID-19 Pandemic Fatigue Inflammatory Myopathies Myositis Physical Activity

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Using mutual information to evaluate performance of medical imaging systems

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Health 2010年第4期2卷 279-285页

作者： Eri Matsuyama Du-Yih Tsai Yongbum Lee katsuyuki Kojima 不详

Information on physical image quality of medical images is important for imaging system assessment in order to promote and stimulate the development of state-of-the-art imaging systems. In this paper, we present a method for evaluating physical performance of medical imaging systems. In this method, mutual information (MI) which is a concept from information theory was used to measure combined properties of image noise and resolution of an imaging system. In our study, the MI was used as a measure to express the amount of information that an output image contains about an input object. The more the MI value provides, the better the image quality is. To validate the proposed method, computer simulations were per- formed to investigate the effects of noise and resolution degradation on the MI, followed by measuring and comparing the performance of two imaging systems. Our simulation and experimental results confirmed that the combined effect of deteriorated blur and noise on the images can be measured and analyzed using the MI metric. The results demonstrate the potential usefulness of the proposed method for evaluating physical quality of medical imaging systems.

关键词： Image Quality Medical Imaging Mutual Information

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Tofacitinib as a Treatment for Refractory Dermatomyositis: A Case Report

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Open Journal of Rheumatology and Autoimmune Diseases 2020年第1期10卷 39-43页

作者： Samuel katsuyuki Shinjo Fernando Henrique Carlos de Souza Division of Rheumatology Faculdade de Medicina FMUSP Universidade de Sao Paulo Sao Paulo Brazil

In very scarce case reports and case series, tofacitinib has been a therapeutic alternative for dermatomyositis. To corroborate the literature, we described a refractory dermatomyositis that had a good outcome with tofacitinib. Case Report: An adult female patient presented with definite dermatomyositis and with refractoriness to high doses of intravenous and oral glucocorticoids, intravenous human immunoglobulin, several immunosuppressive drugs (methotrexate, azathioprine, and leflunomide) and two previous immunobiological drugs (rituximab and abatacept). However, the patient had a good outcome with tofacitinib. Conclusions: Tofacitinib appears to be a promising alternative therapy for refractory dermatomyositis.

关键词： Dermatomyositis Immunosuppressive Agents Muscle Diseases Myositis Therapeutics

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Investigation of Noise-Resolution Tradeoff for Digital Radiographic Imaging: A Simulation Study

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Journal of Software Engineering and Applications 2010年第10期3卷 926-932页

作者： Eri Matsuyama Du-Yih Tsai Yongbum Lee katsuyuki Kojima 不详

In digital radiographic systems, a tradeoff exists between image resolution (or blur) and noise characteristics. An imaging system may only be superior in one image quality characteristic while being inferior to another in the other characteristic. In this work, a computer simulation model is presented that is to use mutual-information (MI) metric to examine tradeoff behavior between resolution and noise. MI is used to express the amount of information that an output image contains about an input object. The basic idea is that when the amount of the uncertainty associated with an object before and after imaging is reduced, the difference of the uncertainty is equal to the value of MI. The more the MI value provides, the better the image quality is. The simulation model calculated MI as a function of signal-to-noise ratio and that of resolution for two image contrast levels. Our simulation results demonstrated that MI associated with overall image quality is much more sensitive to noise compared to blur, although tradeoff relationship between noise and blur exists. However, we found that overall image quality is primarily determined by image blur at very low noise levels.

关键词： Modeling and Simulation Medical Imaging Image Quality Evaluation Mutual Information

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Case of pancreatic metastasis from colon cancer in which cell block using the Trefle^■ endoscopic scraper enables differential diagnosis from pancreatic cancer

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World Journal of Gastrointestinal Oncology 2018年第3期10卷 91-95页

作者： Akihisa Kato Itaru Naitoh Hiroyuki Kato Kazuki Hayashi katsuyuki Miyabe Michihiro Yoshida Yasuki Hori Makoto Natsume Naruomi Jinno Takeshi Yanagita Shuji Takiguchi Satoru Takahashi Takashi Joh Department of Gastroenterology and Metabolism Nagoya City University Graduate School of Medical Sciences Department of Experimental Pathology and Tumor Biology Nagoya City University Graduate School of Medical Sciences Department of Gastroenterological Surgery Nagoya City University Graduate School of Medical Sciences

Endoscopic transpapillary brush cytology and forceps biopsy during endoscopic retrograde cholangiopancreatology are generally used to obtain pathological evidence of biliary strictures. Recently, the new endoscopic scraper Trefle~? has been reported and demonstrated high cancer detectability in malignant biliary strictures. This device is used to scrape the stricture over the guidewire, and, in the original method, the tissue and/or cell samples obtained are subjected to histological and/or cytological analysis separately. However, discrimination of chunks of tissue is hampered by the opacity of the surrounding fluid. We have developed a cell block technique for the Trefle~? device without dividing obtained specimens into tissue and cellular components, which is the simplest method and enables immunohistochemical analysis. We present a case of obstructive jaundice diagnosed immunohistochemically as pancreatic metastasis from colon cancer using cell block sections obtained with the Trefle~? device, which procedure is as easy as conventional brush cytology.

关键词： Trefle? Cell block Endoscopic scraper Pancreatic metastasis Biliary strictures

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Traditional and Non-Traditional Risk Factors Involved with Endothelial Dysfunction and Arterial Stiffness in Autoimmune Rheumatic Diseases

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Open Journal of Rheumatology and Autoimmune Diseases 2019年第3期9卷 85-100页

作者： Rafael Giovani Misse Isabela Bruna Pires Borges Samuel katsuyuki Shinjo Division of Rheumatology Faculdade de Medicina FMUSP Universidade de Sao Paulo Sao Paulo Brazil

Autoimmune rheumatic diseases (ARDs) have been closely associated with accelerated plaque progression and the development of atherosclerosis, which lead to high morbidity and mortality rates for cardiovascular diseases. Endothelial dysfunction and arterial stiffness are greatly evidenced in several studies in the early phase of atherosclerosis. In ARDs, endothelial dysfunction and arterial stiffness are related to traditional and non-traditional risk factors. To date, no studies have clearly analyzed the main parameter involved in endothelial dysfunction and arterial stiffness. In this context, the present narrative review’s purpose was to describe the main factor in endothelial dysfunction and arterial stiffness in different ARDs. Endothelial dysfunction and arterial stiffness are related to traditional risk factors (i.e., hypertension, diabetes, dyslipidemia, metabolic syndrome, sedentary behavior) and non-traditional risk factors (linked to the immune mechanisms involved in these diseases). Moreover, in the present study, these associations were systemically analyzed in ankylosing spondylitis, antiphospholipid syndrome, rheumatoid arthritis, psoriatic arthritis, systemic autoimmune myopathies, systemic lupus erythematosus and systemic sclerosis. The present review shows that the relationship of traditional risk factors and non-traditional risk factors related to ARDs works in the worsening of function and structural properties of arterial vessels, leading to high cardiovascular morbidity and mortality.

关键词： Arterial Stiffness Atherosclerosis Autoimmune Endothelial Dysfunction Rheumatic Diseases

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带激射窗口区的1.57μm InGaAsP/InP分布反馈隐埋异质结激光器

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半导体光电 1983年第1期 41-42页

作者： K. utaka 程阜民日本国际电信电话公司

InGaAsP/InP分布反馈(DFB)激光器是1.5～1.6μm波段单模光纤通信中一种很有希望的光源。最近研制成了室温连续工作的隐埋异质结分布反馈激光器。GaAs/AlGaAs分布反馈激光器有人曾经作过介绍。本文报导一种带激射窗口区的InGaAsP/InP分... 详细信息

InGaAsP/InP分布反馈(DFB)激光器是1.5～1.6μm波段单模光纤通信中一种很有希望的光源。最近研制成了室温连续工作的隐埋异质结分布反馈激光器。GaAs/AlGaAs分布反馈激光器有人曾经作过介绍。本文报导一种带激射窗口区的InGaAsP/InP分布反馈隐埋异质结激光器(DFBWH-WR)。该激光器能有效抑制法布里—珀罗模,而且输出—电流特性良好,既无扭折,也无磁后。

关键词：分布反馈 DFB m InGaAsP/InP 异质结激光器半导体激光器激射

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质子交换膜燃料电池内含水气体扩散层的冻结特性研究

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化工学报 2021年第4期72卷 2276-2282页

作者：宇高义郎许竞莹王国卓陈志豪天津大学机械工程学院天津300350 中低温热能高效利用教育部重点实验室(天津大学) 天津300350

为了研究含水气体扩散层(GDL)的冻结特性及水分迁移规律,设计并搭建了含水GDL冻结过程的可视化观测系统。制备了不同润湿性的含水GDL,并对含水GDL的冻结过程进行了可视化实验研究,分析了含水GDL冻结过程中的温度变化,以及润湿性和过冷... 详细信息

为了研究含水气体扩散层(GDL)的冻结特性及水分迁移规律,设计并搭建了含水GDL冻结过程的可视化观测系统。制备了不同润湿性的含水GDL,并对含水GDL的冻结过程进行了可视化实验研究,分析了含水GDL冻结过程中的温度变化,以及润湿性和过冷度对于结冰概率的影响。实验结果表明:含水GDL中的某点突然结冰引发整个GDL内水的过冷状态释放,随后在液固相变的体积膨胀作用下,尚未冻结的过冷水被挤压到GDL孔隙外;疏水性GDL会在更高过冷度下产生冻结现象;随着含水GDL温度的降低,内部过冷水的冻结概率不断增加。本研究探索了含水GDL的冻结特性,可为今后解决质子交换膜燃料电池(PEMFC)冷启动过程中GDL低温冻结问题奠定基础。

关键词：燃料电池成核气体扩散层冻结特性润湿性多孔介质

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Synthesis and Evaluation of Calcium-Deficient Hydroxyapatite with SiO<sub>2</sub>

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Materials Sciences and Applications 2011年第9期2卷 1194-1198页

作者： Atsushi Nakahira Kentaro Nakata Chiya Numako Hidenobu Murata katsuyuki Matsunaga 不详

Effect of SiO2 addition on the microstructures of calcium-deficient hydroxyapatite prepared by the heat-treatments was examined. Obtained hydroxyapatites substituted with Si ion were characterized by XRD, FT-IR and XAFS measurements. XANES results of Si K-edge and P K-edge in these modified hydroxyapatites indicated the shift of peaks of P K-edge with the SiO2 contents, although no change of Si local structures. In this study, the effect of Si ion on micro- and local structure of hydroxyapatite with SiO2 addition was mainly clarified.

关键词： Hydroxyapatite SiO2 XAFS Local Structure

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