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Operative Benefits of Artificial Pneumothorax in Thoracoscopic Esophagectomy in the Left Lateral Decubitus Position for Esophageal Cancer

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International Journal of Clinical Medicine 2015年第12期6卷 967-974页

作者： Masashi takemura Nobuaki Kaibe Mamiko Takii Mitsuru Sasako Department of Upper Gastrointestinal Surgery Hyogo Collage of Medicine Hyogo Japan

Objectives: This study aimed to evaluate operative benefits of artificial pnuemothorax in thoracoscopic esophagectomy in the left lateral decubitus position. Methods: We retrospectively analyzed short-term surgical outcomes including learning curve of 60 consecutive patients who underwent thoracoscopic esophagectomy with artificial pnuemothorax in the left lateral decubitus position between April 2010 and November 2012 in our department. Results: The median operation time and intraoperative blood loss were 443 min and 220 ml, respectively, and these values were 174 min and 95 ml, respectively, in the thoracic phase of surgery. The median number of harvested lymph node was 37. Only 1 patient required conversion to open esophagectomy. The postoperative 30-day mortality rate was 1.7%. The thoracic operation time significantly decreased after an experience of 10 cases and intraoperative blood loss during thoracic phasesignificantly decreased after an experience of 20 cases (p < 0.05), and operation time remained constant for the following cases. The number of harvested lymph nodes did not exhibit significant changes with an increase in the number of case experienced. Conclusions: Artificial pneumothorax provided the shorting of learning curve at the thoracoscopic esophagectomy in the left lateral decubitus position.

关键词： Thoracoscopic Esophagectomy Artificial Pneumothorax Left Lateral Position

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

Report for Type 2 Bayes-Fuzzy Estimation in No-Data Problem

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Applied Mathematics 2024年第1期15卷 46-50页

作者： Houju Hori Jr. Kazuhisa takemura Yukio Matsumoto Nara Cmmunity Tsubakikishi Shrine Nara Japan Department of Psychology Waseda University Tokyo Japan The Institute of Mathematical Statistics Tachikawa Japan

It is well known that the system (1 + 1) can be unequal to 2, because this system has both observation error and system error. Furthermore, we must provide our mustered service within our cool head and warm heart, where two states of nature are existing upon us. Any system is regarded as the two-dimensional variable error model. On the other hand, we consider that the fuzziness is existing in this system. Though we can usually obtain the fuzzy number from the possibility theory, it is not fuzzy but possibility, because the possibility function is as same as the likelihood function, and we can obtain the possibility measure by the maximal likelihood method (i.e. max product method proposed by Dr. Hideo Tanaka). Therefore, Fuzzy is regarded as the only one case according to Vague, which has both some state of nature in this world and another state of nature in the other world. Here, we can consider that Type 1 Vague Event in other world can be obtained by mapping and translating from Type 1 fuzzy Event in this world. We named this estimation as Type 1 Bayes-Fuzzy Estimation. When the Vague Events were abnormal (ex. under War), we need to consider that another world could exist around other world. In this case, we call it Type 2 Bayes-Fuzzy Estimation. Where Hori et al. constructed the stochastic different equation upon Type 1 Vague Events, along with the general following probabilistic introduction method from the single regression model, multi-regression model, AR model, Markov (decision) process, to the stochastic different equation. Furthermore, we showed that the system theory approach is Possibility Markov Process, and that the making decision approach is Sequential Bayes Estimation, too. After all, Type 1 Bays-Fuzzy estimation is the special case in Bayes estimation, because the pareto solutions can exist in two stochastic different equations upon Type 2 Vague Events, after we ignore one equation each other (note that this is Type 1 case), we can obtain both its

关键词： Bayes-Fuzzy Estimation Possibility Markov Process Possibility Reserved Judgement

Detection of Damage and Crack in Railhead by Using Eddy Current Testing

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Journal of Electromagnetic Analysis and Applications 2011年第12期3卷 546-550页

作者： Zenglu Song Tsutomu Yamada Hideki Shitara Yasushi takemura Department of Electrical and Computer Engineering Yokohama National University Railway Technical Research Institute

Eddy current testing is a nondestructive testing method, which is used to detect discontinuities and defects in conductive materials. Using this technique, two different types of artificial defects in a railhead were evaluated in order to analyze the relationship between different types of defects and eddy current signals, and to obtain data on the size of the rail surface defects and crack location. The actually used rail sample was also studied. Surface cracks and defects were clearly observed as amplitude and phase changes of detected signals. This study succeeds in quantitatively analyzing and discriminating the damage types.

关键词： Nondestructive Testing Eddy Current Testing Railhead Crack

Soil Explorations and Groundwater Monitoring to Evaluate Subsurface Contamination Due to Chromium in District Kasur, Pakistan

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Journal of Environmental Science and Engineering 2011年第7期5卷 835-843页

作者： H. Rashid J. takemura A.M. Farooqi Department of Civil and Environmental Engineering Tokyo Institute of Technology Tokyo 152-8550 Japan Department of Environmental Sciences Fatima Jinnah Women University Rawalpindi 46000 Pakistan

Due to improper tannery wastewater management in district Kasur Pakistan, groundwater has been reported to be highly contaminated. It was aimed to find out the extent up to which subsurface has contaminated due to chromium in areas adjacent to the tannery units. Eight （8） soil bores were conducted up to the depth of 30.5 meters and soil samples were tested for total and hexavalent chromium concentrations retained in soil by aqua regia digestion at the every depth of 1.5 meters. Afterwards monitoring wells were installed in these eight （8） bores so as to monitor chromium concentrations in the groundwater on monthly basis. The main source of contamination was considered to be the four （4） drains carrying tanneries effluent therefore samples were collected from these drains so as to observe seasonal variation in chromium concentration.

关键词： Groundwater and soil contamination soil boring monitoring wells chromium tannery wastewater.

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

Fundamental Study on Alkali-Activated Slag System with Sodium Carbonate or Calcium Hydroxide

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Journal of Materials Science and Chemical Engineering 2024年第6期12卷 55-70页

作者： Seunghyun Na Wenyan Zhang Yuichi Ichikawa Masaya Komatsu Aoi takemura Department of Architecture Nishinippon Institute of Technology Fukuoka Japan School of Materials Science and Engineering Henan Polytechnic University Jiaozuo China Fukuya Corporation Fukuoka Japan

Cement as a building material, has high fluidity, compressive strength, and durability, but carbon dioxide emissions during cement production are a major problem. As one of the countermeasures, alkali-activated cement using blast furnace slag powder with alkaline stimulants is considered to be a very promising solution for reducing carbon dioxide emissions, but there is a lack of information about the fundamental properties of alkali-activated materials. This study presents an experimental investigation of the fundamental properties of an alkali-activated slag system with sodium carbonate (NC) and calcium hydroxide (CH). The effects of calcium sulfo-aluminate (CSA) and shrinkage reducing agent (SRA) on the properties of blast furnace slag (BFS) based alkali-activated mixture were also investigated. In the experiments, fundamental characteristics including compressive strength, drying shrinkage, and water penetration tests of mortar were evaluated. Porosity, pH, and ignition loss were measured to verify the effectiveness of the materials. The experimental investigation revealed that the compressive strength was increased with the increasing replacement rates of NC in the BFS mortar, and in the case of water to BFS ratio of 0.45 with sodium carbonation addition contents 10 wt.%, the compressive strength for 28 days of curing reaches more than 50 MPa. Low water to BFS ratio and higher addition ratio of NC had a positive effect on the compressive strength development of mortar. Incorporating NC into BFS would affect the decrease in porosity and increase in ignition loss, leading to higher compressive strength. There was a negligible change to the compressive strength, porosity, pH, and ignition loss of BFS samples made with CH, thus, the addition rates of CH to BFS have no or little significant effect on the fundamental properties of alkali-activated cement. From the results of drying shrinkage and water penetration tests, the addition of NC and CH only to BFS exhibited

关键词： Alkali-Activated Cement Compressive Strength Drying Shrinkage Water Penetration Characteristic

Short Term Operative Outcomes of Laparoscopic Gastric Mobilization in Esophagectomy for Esophageal Cancer: Comparison with Hand Assisted Technique

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Surgical Science 2016年第7期7卷 279-285页

作者： Masashi takemura Mamiko Takii Nobuaki Kaibe Tsutomu Oshima Mitsuru Sasako Department of Upper Gastrointestinal Surgery Hyogo College of Medicine Hyogo Japan

Objective: This study evaluated the safety and operative utilities of the laparoscopic gastric mobilization compared with hand-assisted laparoscopic gastric mobilization. Patients and Methods: From April 2010 to November 2015, 125 patients with esophageal cancer have been performed laparoscopic mobilization;33 under hand-assisted laparoscopic gastric mobilization (HLG group) and 92 under laparoscopic gastric mobilization without hand-assisted technique (LG group). Preoperative data and surgical outcomes of 2 groups were compared. Results: Preoperative data were not significantly different except for BMI. Operation time in abdominal procedure of LG group is significantly longer than HLG group (P < 0.0001). Otherwise, the blood loss and number of dissected nodes of abdominal procedure was not significantly different in two groups. The perioperative blood transfusions were needed in 7 cases (21.2%) in HLG group and 25 (27.1%) in LG group. The postoperative complications and mortality within 30 days after surgery were not significantly different in two groups. The length of hospital stay was 29 days in HLG group and 31 days in HG group, respectively. Conclusions: Our results suggested that laparoscopic gastric mobilization was safe technique and the short-term operative outcomes were comparable with that of hand-assisted laparoscopic mobilization.

关键词： Laparoscopic Gastric Mobilization Minimally Invasive Esophagectomy Esophageal Cancer

Image quality and diagnostic performance of free-breathing diffusion-weighted imaging for hepatocellular carcinoma

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World Journal of Hepatology 2017年第14期9卷 657-666页

作者： Yukihisa Takayama Akihiro Nishie Yoshiki Asayama Kousei Ishigami Daisuke Kakihara Yasuhiro Ushijima Nobuhiro Fujita Ken Shirabe Atsushi takemura Hiroshi Honda Department of Radiology Kitakyushu Municipal Medical Center Department of Clinical Radiology Graduate School of Medical SciencesKyushu University Department of Hepatobiliary and Pancreatic Surgery Gunma UniversityGraduate School of Medicine Philips Electronics Japan

To retrospectively evaluate the diagnostic performance of free-breathing diffusion-weighted imaging (FB-DWI) with modified imaging parameter settings for detecting hepatocellular carcinomas (HCCs). METHODSFifty-one patients at risk for HCC were scanned with both FB-DWI and respiratory-triggered DWI with the navigator echo respiratory-triggering technique (RT-DWI). Qualitatively, the sharpness of the liver contour, the image noise and the chemical shift artifacts on each DWI with b-values of 1000 s/mm2 were independently evaluated by three radiologists using 4-point scoring. We compared the image quality scores of each observer between the two DWI methods, using the Wilcoxon signed-rank test. Quantitatively, we compared the signal-to-noise ratios (SNRs) of the liver parenchyma and lesion-to-nonlesion contrast-to-noise ratios (CNRs) after measuring the signal intensity on each DWI with a b-factor of 1000 s/mm2. The average SNRs and CNRs between the two DWI methods were compared by the paired t-test. The detectability of HCC on each DWI was also analyzed by three radiologists. The detectability provided by the two DWI methods was compared using McNemar’s test. RESULTSFor all observers, the averaged image quality scores of FB-DWI were: Sharpness of the liver contour [observer (Obs)-1, 3.08 ± 0.81; Obs-2, 2.98 ± 0.73; Obs-3, 3.54 ± 0.75], those of the distortion (Obs-1, 2.94 ± 0.50; Obs-2, 2.71 ± 0.70; Obs-3, 3.27 ± 0.53), and the chemical shift artifacts (Obs-1, 3.38 ± 0.60; Obs-2, 3.15 ± 1.07; Obs-3, 3.21 ± 0.85). The averaged image quality scores of RT-DWI were: Sharpness of the liver contour (Obs-1, 2.33 ± 0.65; Obs-2, 2.37 ± 0.74; Obs-3, 2.75 ± 0.81), distortion (Obs-1, 2.81 ± 0.56; Obs-2, 2.25 ± 0.74; Obs-3, 2.96 ± 0.71), and the chemical shift artifacts (Obs-1, 2.92 ± 0.59; Obs-2, 2.21 ± 0.85; Obs-3, 2.77 ± 1.08). All image quality scores of FB-DWI were significantly higher than those of RT-DWI (P < 0.05). The average SNR of the normal liver

关键词： Diffusion weighted-imaging Liver Magnetic resonance imaging Hepatocellular carcinoma Free-breathing technique