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Effectiveness of therapeutic barium enema for diverticular hemorrhage

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World Journal of Gastroenterology 2015年第18期21卷 5555-5559页

作者： Mizue Matsuura Masahiko Inamori Atsushi Nakajima Yasuhiko Komiya Yumi Inoh keigo kawasima Mai Naitoh Yuji Fujita Akiko Eduka Noriyoshi Kanazawa Shiori Uchiyama Rie Tani Kennichi Kawana Setsuya Ohtani Hajime Nagase Hepatology and Gastroenterology Yokohama City University Hospital Department of Gastroenterology Yokohama Rosai Hospital

AIM:To evaluate the effectiveness of barium impaction therapy for patients with colonic diverticular bleeding.METHODS:We reviewed the clinical charts of patients in whom therapeutic barium enema was performed for the control of diverticular bleeding between August2010 and March 2012 at Yokohama Rosai Hospital.Twenty patients were included in the review,consisting of 14 men and 6 women.The median age of the patients was 73.5 years.The duration of the followup period ranged from 1 to 19 mo(median:9.8 mo).Among the 20 patients were 11 patients who required the procedure for re-bleeding during hospitalization,6patients who required it for re-bleeding that developed after the patient left the hospital,and 3 patients who required the procedure for the prevention of rebleeding.Barium(concentration:150 w%/v%)was administered per the rectum,and the leading edge of the contrast medium was followed up to the cecum by fluoroscopy.After confirmation that the ascending colon and cecum were filled with barium,the enema tube was withdrawn,and the patient’s position was changed every 20 min for 3 h.RESULTS:Twelve patients remained free of rebleeding during the follow-up period(range:1-19mo)after the therapeutic barium enema,including 9men and 3 women with a median age of 72.0 years.Re-bleeding occurred in 8 patients including 5 men and 3 women with a median age of 68.5 years:4developed early re-bleeding,defined as re-bleeding that occurs within one week after the procedure,and the remaining 4 developed late re-bleeding.The DFI(disease-free interval)decreased 0.4 for 12 mo.Only one patient developed a complication from therapeutic barium enema(colonic perforation).CONCLUSION:Therapeutic barium enema is effective for the control of diverticular hemorrhage in cases where the active bleeding site cannot be identified by colonoscopy.

关键词： Non-steroidal antiinflammatory drugs Barium enema Diverticular hemorrhage Re-bleeding Barium impaction

Associations of body mass index and hospital-acquired disability with post-discharge mortality in older patients with acute heart failure

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Journal of Geriatric Cardiology 2022年第3期19卷 209-217页

作者： Akihiro Sakuyama Masakazu Saitoh Kentaro Hori Yuichi Adachi keigo Iwai Masatoshi Nagayama Department of Physical Therapy Faculty of Health ScienceJuntendo UniversityTokyoJapan Department of Rehabilitation Sakakibara Heart InstituteTokyoJapan Department of Cardiology Sakakibara Heart InstituteTokyoJapan

OBJECTIVES To investigate the effect of hospital-acquired disability(HAD)on all-cause mortality after discharge according to the body mass index(BMI)in older patients with acute decompensated heart failure.METHODS We included 408 patients aged≥65 years who were hospitalized for acute decompensated heart failure and had undergone an acute phase of cardiac rehabilitation at the Sakakibara Heart Institute between April 2013 and September 2015(me-dian age:82 years,interquartile range(IQR):76-86;52%male).Patients were divided into three groups based on BMI at hospital admission:underweight(<18.5 kg/m^(2)),normal weight(18.5 to 25 kg/m^(2)),and overweight(≥25 kg/m^(2)).HAD was defined as a decrease of at least five points at discharge compared to before hospitalization according to the Barthel Index.RESULTS The median follow-up period was 475(IQR:292-730)days,and all-cause mortality during the follow-up period was 84 deaths(21%).According to multivariate Cox regression analysis,being underweight(HR:1.941,95%CI:1.134−3.321,P=0.016)or overweight(HR:0.371,95%CI:0.171−0.803,P=0.012),with normal BMI as the reference,and HAD(HR:1.857,95%CI:1.062−3.250,P=0.030)were independently associated with all-cause mortality.Patients with HAD exhibited a significantly lower cumulative survival rate in the underweight group(P=0.001)and tended to have a lower cumulative survival rate in the normal weight group(P=0.072).HAD was not significantly associated with cumulative survival in the overweight group(P=0.392).CONCLUSIONS BMI and HAD independently predicted all-cause mortality after discharge in older patients with acute de-compensated heart failure.Furthermore,HAD was significantly associated with higher all-cause mortality after discharge,espe-cially in the underweight group.

关键词： patients acute index

Adaptive Learning with Large Variability of Teaching Signals for Neural Networks and Its Application to Motion Control of an Industrial Robot

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International Journal of Automation and computing 2011年第1期8卷 54-61页

作者： Fusaomi Nagata keigo Watanabe Department of Mechanical Engineering Faculty of Engineering Tokyo University of Science Department of Intelligent Mechanical Systems Graduate School of Natural Science and Technology Okayama University

Recently, various control methods represented by proportional-integral-derivative （PID） control are used for robotic control. To cope with the requirements for high response and precision, advanced feedforward controllers such as gravity compensator, Coriolis/centrifugal force compensator and friction compensators have been built in the controller. Generally, it causes heavy computational load when calculating the compensating value within a short sampling period. In this paper, integrated recurrent neural networks are applied as a feedforward controller for PUMA560 manipulator. The feedforward controller works instead of gravity and Coriolis/centrifugal force compensators. In the learning process of the neural network by using back propagation algorithm, the learning coefficient and gain of sigmoid function are tuned intuitively and empirically according to teaching signals. The tuning is complicated because it is being conducted by trial and error. Especially, when the scale of teaching signal is large, the problem becomes crucial. To cope with the problem which concerns the learning performance, a simple and adaptive learning technique for large scale teaching signals is proposed. The learning techniques and control effectiveness are evaluated through simulations using the dynamic model of PUMA560 manipulator.

关键词： Neural networks large-scale teaching signal sigmoid function adaptive learning servo system PUMA560 manipulator trajectory following control nonlinear control.

Machining Robot with Vibrational Motion and 3D Printer-like Data Interface

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International Journal of Automation and computing 2018年第1期15卷 1-12页

作者： Fusaomi Nagata keigo Watanabe Maki K. Habib Department of Mechanical Engineering Faculty of Engineering Tokyo University of Science Yamaguchi 1-1-1 Daigaku-Dori Sanyo-Onoda 756-0884 Japan Department of Intelligent Mechanical Systems Division of Industrial Innovation Sciences Graduate School of Natural Science and Technology Okayama University 3-1-1 Tsushima-naka Kita-ku Okayama 700-8530 Japan American University 113 Kasr E1 Eini Street Cairo 11511 Egypt

In this paper, a vibration motion control is proposed and implemented on a foamed polystyrene machining robot to suppress the generation of undesirable cusp marks, and the basic performance of the controller is verified through machining experiments of foamed polystyrene. Then, a 3 dimensional （3D） printer-like data interface is proposed for the machining robot. The 3D data inter- face enables to control the machining robot directly using stereolithography （STL） data without conducting any computer-aided man- ufacturing （CAM） process. This is done by developing a robotic preprocessor that helps to remove the need for the conventional CAM process by directly converting the STL data into cutter location source data called cutter location （CL） or cutter location source （CLS） data. The STL is a file format proposed by 3D systems, and recently is supported by many computer aided design （CAD）/CAM soft- waxes. The STL is widely used for rapid prototyping with a 3D printer which is a typical additive manufacturing system. The STL deals with a triangular representation of a curved surface geometry. The developed 3D printer-like data interface allows to directly control the machining robot through a zigzag path, rectangular spiral path and circular spiral path generated according to the information included in STL data. The effectiveness and usefulness of the developed system are demonstrated through actual machining experiments.

关键词： Computer integrated manufacturing machining robot computer aided design （CAD）/computer-aided manufacturing（CAM） cutter location （CL） data vibrational motion stereolithography （STL） data preprocessor 3 dimensional （3D） printer-likedata interface.

Muscle hematoma:A critically important complication of alcoholic liver cirrhosis

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World Journal of Gastroenterology 2009年第35期15卷 4457-4460页

作者： Chiyo Sugiyama Akifumi Akai Noriyoshi Yamakita Tsuneko Ikeda keigo Yasuda Department of Internal Medicine Matsunami General Hospital185-1 DendaiKasamatsu-choHashima-gunGifu 501-6062Japan Department of Pathology Matsunami General Hospital185-1 DendaiKasamatsu-choHashima-gunGifu 501-6062Japan

An iliopsoas hematoma can occur either spontaneously or secondary to trauma or bleeding tendency due to hemophilia and anticoagulant therapy.Although liver cirrhosis is commonly associated with coagulopathy, iliopsoas hematoma is very rare.We herein,present a case of bilateral iliopsoas hematoma in a patient with alcoholic cirrhosis,and review the literature on muscle hematoma associated with cirrhosis.A 56-year-old man with alcoholic cirrhosis was admitted in a state of shock with anemia.The cause of anemia could not be detected,and the patient was treated conservatively. The site of bleeding was not detected with either gastroduodenal endoscopy or upper abdominal computed tomography,the latter of which did not include the iliopsoas muscle.He died on the 10th day of admission and bilateral iliopsoas hematomas were found on autopsy.An iron stain was positive in the iliopsoas muscle.Eight cases of muscle hematoma associated with cirrhosis,including the present case, were found in a review of the literature.Four of these cases involved the rectus abdominis muscle,3 involved the iliopsoas muscle and 1 involved combined muscles.Alcoholic cirrhosis accounted for 75%of the cases.One case(12.5%)was associated with virus- related cirrhosis,and another with combined virus- and alcohol-related cirrhosis.The mortality rate was 75%despite early diagnosis and low risk scores for cirrhosis.Muscle hematoma in patients with cirrhosis isclosely related to alcoholism,and the mortality rate of the condition is extremely high.In conclusion,muscle hematoma should be recognized as an important complication of cirrhosis.

关键词：并发症酒精性化极血肿肌肉肝

Water-assisted self-sustained burning of metallic single-walled carbon nanotubes for scalable transistor fabrication

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Nano Research 2017年第9期10卷 3248-3260页

作者： keigo Otsuka Taiki Inoue Yuki Shimomura Shohei Chiashi Shigeo Maruyama Department of Mechanical Engineering The University of Tokyo 7-3-1 Hongo Bunkyo-ku Tokyo 113-8656 Japan Energy NanoEngineering Lab. National Institute of Advanced Industrial Science and Technology (AIST) 1-2-1 Namiki Tsukuba 305-8564 Japan

Although aligned arrays of semiconducting single-walled carbon nanotubes (s-SWNTs) are promising for use in next-generation electronics owing to their ultrathin bodies and ideal electrical properties, even a small portion of metallic (m-) counterparts causes excessive leakage in field-effect transistors (FETs). To fully exploit the benefits of s-SWNTs for use in large-scale systems, it is necessary to completely eliminate m-SWNTs from as-grown SWNT arrays and thereby obtain purely semiconducting large-area arrays, wherein numerous FETs can be flexibly built. In this study, we performed electrical burning of m-SWNTs assisted by water vapor and polymer coating to eliminate m-SWNTs over a long length for the scalable fabrication of transistors from the remaining s-SWNT arrays. During the electrical-breakdown process, the combination of water vapor and the polymer coating significantly enhanced the burning of the SWNTs, resulting in a self-sustained reaction along the nanotube axis. We found that m-SWNT segments partially remaining on the anode side resulted from one-way burning from the initial breakdown position, where Joule-heating-induced oxidation first occurred. The s-SWNT-enriched arrays obtained were used to fabricate multiple FETs with a high on-off current ratio. The results indicate the advantages of this approach over conventional electrical breakdown for the large-scale purification of s-SWNTs.

关键词： single-walled carbon nanotubes field-effect transistor selective removal electrical breakdown one-way burning

Coaxial boron nitride nanotubes as interfacial dielectric layers to lower interface trap density in carbon nanotube transistors

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Nano Research 2023年第11期16卷 12840-12848页

作者： keigo Otsuka Taiki Sugihara Taiki Inoue Weijie Jia Satoru Matsushita Takanobu Saito Minhyeok Lee Takashi Taniguchi Kenji Watanabe Gregory Pitner Ming-Yang Li Tzu-Ang Chao Rong Xiang Shohei Chiashi Shigeo Maruyama Department of Mechanical Engineering The University of TokyoTokyo 113-8656Japan Department of Applied Physics Osaka UniversityOsaka 565-0871Japan Research Center for Materials Nanoarchitectonics National Institute for Materials ScienceTsukuba 305-0044Japan Research Center for Electronic and Optical Materials National Institute for Materials ScienceTsukuba 305-0044Japan Corporate Research Taiwan Semiconductor Manufacturing CompanySan JoseCA 95134USA Corporate Research Taiwan Semiconductor Manufacturing CompanyHsinchu 30078

A semiconductor/dielectric interface is one of the dominant factors in device characteristics,and a variety of oxides with high dielectric constants and low interface trap densities have been used in carbon nanotube transistors.Given the crystal structure of nanotubes with no dangling bonds,there remains room to investigate unconventional dielectric materials.Here,we fabricate carbon nanotube transistors with boron nitride nanotubes as interfacial layers between channels and gate dielectrics,where a single semiconducting nanotube is used to focus on switching behaviors at the subthreshold regime.The subthreshold swing of 68 mV·dec^(−1)is obtained despite a 100-nm-thick Sio_(2)dielectric,corresponding to the effective interface trap density of 5.2×10^(11)cm^(−2)·eV^(−1),one order of magnitude lower than those of carbon nanotube devices without boron nitride passivation.The interfacial layers also result in the mild suppression of threshold voltage variation and hysteresis.We achieve Ohmic contacts through the selective etching of boron nitride nanotubes with XeF2 gas,overcoming the trade-off imposed by wrapping the inner nanotubes.Negligible impacts of fluorinating carbon nanotubes on device performances are also confirmed as long as the etching is applied exclusively at source/drain regions.Our results represent an important step toward nanoelectronics that exploit the advantage of one-dimensional van der Waals heterostructures.

关键词： carbon nanotubes hexagonal boron nitride van der Waals interfaces field-effect transistors subthreshold swing selective etching

Gastric cancer mortality related to direct radiographic and endoscopic screening:A retrospective study

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World Journal of Gastroenterology 2021年第33期27卷 5595-5609页

作者： Hiroaki Hagiwara Fumitaka Moki Yukiko Yamashita Kazuki Saji keigo Iesaki Hiromitsu Suda Department of Internal Medicine Hagiwara ClinicMaebashi 379-2106GunmaJapan Maebashi Medical Association Maebashi 371-0035GunmaJapan Gunma Health Foundation Maebashi 371-0005GunmaJapan Department of Internal Medicine and Surgery Yamashita ClinicMaebashi 371-0016GunmaJapan Department of Internal Medicine Saji ClinicMaebashi 371-0133GunmaJapan Department of Internal Medicine Iesaki ClinicMaebashi 371-0805GunmaJapan Department of Pediatrics Suda Kids ClinicMaebashi 371-0813GunmaJapan

BACKGROUND Despite its decreased incidence in Japan,gastric cancer continues among the leading causes of cancer-related deaths in both men and women.Accordingly,efforts are still required to lower the mortality rate of gastric cancer in Japan.Maebashi City introduced endoscopic gastric cancer screening in 2004,and participants are able to choose between direct radiography and endoscopy.Hence,we expected to see a decrease in mortality rate from gastric cancer after introducing endoscopic screening and a difference in mortality rate reduction between screening methods.AIM To evaluate the impact on gastric cancer mortality rate of two types of gastric cancer screening in Maebashi City,Japan.METHODS Participants aged 40 to 79 years of the Maebashi City gastric cancer screening program in 2006 who were screened by direct radiography(n=11155)or endoscopy(n=10747)were included.Participants were followed until March 31,2012,by cross-referencing their data against the Gunma Prefecture cancer registry data.We compared the detection rate of gastric cancers.Then,we compared the mortality rate between the two groups.The Cox proportional hazards model was used to estimate the hazard ratio(HR)of gastric cancer death.Finally,the reduction in gastric cancer mortality rate associated with each screening method was evaluated.RESULTS Gastric cancer was detected in 22 participants undergoing direct radiography(detection rate,0.20%)and in 52 participants undergoing endoscopy(detection rate,0.48%).However,most gastric cancers detected by endoscopic screening were early cancers that may not have resulted in death.We found no significant difference in gastric cancer mortality rate between participants receiving annual screening and those who do not.When the number of gastric cancer deaths in the direct radiography group was set as 1 in the Cox proportional hazard analysis,the HR of gastric cancer death was 1.368(95%CI:0.7308-2.562)in the overall group of participants.The results showed no significant difference between the two screening

关键词： Gastric cancer Radiography Endoscopy Population-based cancer screening Mortality reduction

Crowned dens syndrome developed after an endoscopic retrograde cholangiopancreatography procedure

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World Journal of Gastroenterology 2016年第39期22卷 8849-8852页

作者： Hiroyasu Nakano Kazunari Nakahara Yosuke Michikawa keigo Suetani Ryo Morita Nobuyuki Matsumoto Fumio Itoh Division of Gastroenterology and Hepatology Department of Internal Medicine St. Marianna University School of Medicine

We present a unique case of crowned dens syndrome(CDS) that developed after endoscopic retrograde cholangiopancreatography(ERCP) in a patient who presented with fever and neck pain. Administration of non-steroidal anti-inflammatory drugs was extremely effective for relieving fever and neck pain, and in the improvement of inflammatory markers. To the best of our knowledge, this is the first case report of CDS caused by an ERCP procedure. In a patient with fever and neck pain after an ERCP procedure, CDS should be considered in the differential diagnosis.

关键词：尖锐胆管炎 Pseudogout 内视镜后退 cholangiopancreatograhy 使圆满的兽穴症候群