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Assistant skill in gastric endoscopic submucosal dissection using a clutch cutter

World Journal of Gastrointestinal Surgery 2021年第2期13卷 116-126页

作者： Mitsuru Esaki Toshiki Horii ryoji Ichijima Masafumi Wada Seiichiro Sakisaka Shuichi Abe Naru Tomoeda Yusuke Kitagawa Kei Nishioka Yosuke Minoda Shinichi Tsuruta Sho Suzuki Hirotada Akiho Eikichi Ihara Yoshihiro Ogawa Takuji Gotoda Department of Medicine and Bioregulatory Science Graduate School of Medical SciencesKyushu UniversityFukuoka 812-8582Japan Division of Gastroenterology and Hepatology Department of MedicineNihon University School of MedicineTokyo 101-8309Japan Department of Gastroenterology Kitakyushu Municipal Medical CenterKitakyushu 802-0077FukuokaJapan Department of Internal Medicine Saiseikai Fukuoka General HospitalFukuoka 810-0001Japan Department of Gastroenterology Hara-Sanshin HospitalFukuoka 812-0033Japan Department of Gastroenterology Clinical Research InstituteNational Hospital Organization Kyushu Medical CenterFukuoka 810-0065Japan Department of Anatomic Pathology Kyushu UniversityFukuoka 812-8582Japan Department of Gastroenterology and Metabolism Graduate School of Medical SciencesKyushu UniversityFukuoka 812-8582Japan

BACKGROUND A clutch cutter is a scissor-type knife used in endoscopic submucosal dissection(ESD)for gastrointestinal tract *** assistant during the ESD using a clutch cutter(ESD-C)needs to rotate the device and grasp the target tissue appropriately;therefore,the assistant’s skill may affect the technical outcomes of *** To determine how assistant skill level affected the technical outcomes of gastric ESD-C using an ex vivo porcine training *** In this pilot study,mock lesions of 15-30 mm in diameter were created in the middle or lower third of the porcine stomach.A total of 32 ESD-C procedures were performed by 16 *** trainee operator performed two ESD-C procedures;one ESD-C was assisted by an expert(ESD-C-E),and the other was assisted by a non-expert(ESD-C-NE).The total procedure time of the ESD was set as the primary outcome,and en bloc resection rate,complete procedure rate,perforation rate,and each procedure time/speed for mucosal incision or submucosal dissection were set as the secondary *** addition,we investigated factors associated with the difficulty of ESD including incompletion of ESD procedure,a long procedure time(≥20 min)or intraoperative *** The median total procedure time of the ESD-C-E was significantly shorter than that of the ESD-C-NE(12.9 min vs 21.9 min,P=0.001).The en bloc resection rate was 100%in both *** resection rates of the ESD-C-E and ESD-C-NE groups were 100%and 93.8%,*** intraoperative perforation was observed in both *** the multivariate analysis,assistant skill was significantly associated with the difficulty of ESD,with the highest odds ratio of *** Assistance by an expert is an important factor when trainees perform ESD-C procedures.

关键词： Endoscopic submucosal dissection Porcine training model Clutch cutter Assistant Skill level

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Asama火山冰冻灰积物的瑞利波速

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地质科学译丛 1997年第3期14卷 57-59页

作者： ryoji Sakurada 徐蓉 Akita National College of Technology AkitaOllJapan

在火山碎屑物沉积地区,道路的冻胀破坏大多与当地的水文地质条件相关。主要研究在道路的冻胀破坏中层状土的效应。在 Asama 火山山麓的灰积物上运用地质勘探中的瑞利波方法,将与地质条件相关的冰冻破坏归纳为两种形式:(1)冰冻破坏受厚... 详细信息

在火山碎屑物沉积地区,道路的冻胀破坏大多与当地的水文地质条件相关。主要研究在道路的冻胀破坏中层状土的效应。在 Asama 火山山麓的灰积物上运用地质勘探中的瑞利波方法,将与地质条件相关的冰冻破坏归纳为两种形式:(1)冰冻破坏受厚覆盖高胀土控制;(2)冰冻破坏受低胀土路床的排泄条件控制,低胀土层在地下水流入后易变为中胀土层。

关键词：瑞利波法冻胀火山灰冰冻破坏灰积物

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The Role of Serum Cytokeratin 19 Fragment in Transarterial Infusion against Invasive Bladder Cancer

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Open Journal of Urology 2013年第3期3卷 160-164页

作者： Ryo Takahashi ryoji Kimata Shunichiro Nomura Ichiro Matsuzawa Yasutomo Suzuki Tsutomu Hamasaki Yukihiro Kondo Department of Urology Nippon Medical School Tokyo Japan

Background: We used transcatheter arterial infusion chemotherapy (TAI) for patients with T1G3 and greater than T2 bladder cancer, which was diagnosed after extensive and deep transurethral resection of bladder tumor (TUR-BT), and we investigated the utility of serum cytokeratin 19 fragment (CYFRA) as a predictive factor of the response to therapy. Material and Methods: From November 2001 to November 2010, 56 patients (46 males and 10 females) with pathologically confirmed T1 G3 or greater than T2 bladder cancer after TUR-BT underwent two courses of TAI of cisplatin, methotrexate and doxorubicin as neoadjuvant setting. Then, patients underwent evaluation TUR-BT. Thereafter, the bladder was preserved in patients with superficial or undetectable tumors on TUR-BT. Advanced cases and residual bladder tumor cases were treated with total cystectomy or systemic chemotherapy. CYFRA levels were measured before and after performing TAI. Results: With this therapy, the 5-year survival rate was 85.7% in pT1G3, 82.3% in pT2, and 66.6% in greater than pT3 cases. Bladder preservation with no recurrence was observed in 58.7% of the patients. Grade III adverse events included leucopenia (6/56 patients: 10.7%). Serum CYFRA levels significantly decreased with treatment (in 4/6 patients with elevated CYFRA levels). Conclusion: These results suggest that although total cystictomy is usually indicated for T1G3 bladder cancers, bladder preservation and control of micrometastases can be achieved by performing TAI after extensive and deep TUR-BT. Our results also suggest the utility of monitoring serum CYFRA to assess the response to therapy.

关键词： Transcatheter Arterial Infusion (TAI) Invasive Bladder Cancer Cytokeratin 19 Fragment (CYFRA)

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ARID1A expression in gastric adenocarcinoma:Clinicopathological significance and correlation with DNA mismatch repair status

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World Journal of Gastroenterology 2015年第7期21卷 2159-2168页

作者： Ryo Inada Shigeki Sekine Hirokazu Taniguchi Hitoshi Tsuda Hitoshi Katai Toshiyoshi Fujiwara ryoji Kushima Pathology and Clinical Laboratory Division National Cancer Center Hospital Department of Gastroenterological Surgery Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Molecular Pathology Division National Cancer Center Research Institute Gastric Surgery Division National Cancer Center Hospital

AIM:To analyze the mismatch repair(MMR)status and the ARID1A expression as well as their clinicopathological significance in gastric ***:We examined the expressions of MMR proteins and ARID1A by immunohistochemistry in consecutive 489 primary gastric *** results were further correlated with clinicopathological ***:The loss of any MMR protein expression,indicative of MMR deficiency,was observed in 38cases(7.8%)and was significantly associated with an older age(68.6±9.2 vs 60.4±11.7,P<0.001),a female sex(55.3%vs 31.3%,P=0.004),an antral location(44.7%vs 25.7%,P=0.021),and a differentiated histology(57.9%vs 39.7%,P=0.023).Abnormal ARID1A expression,including reduced or loss of ARID1A expression,was observed in 109 cases(22.3%)and was significantly correlated with lymphatic invasion(80.7%vs 69.5%,P=0.022)and lymph node metastasis(83.5%vs 73.7%,P=0.042).The tumors with abnormal ARID1A expression more frequently indicated MMR deficiency(47.4%vs 20.2%,P<0.001).A multivariate analysis identified abnormal ARID1A expression as an independent poor prognostic factor(HR=1.36,95%CI:1.01-1.84;P=0.040).CONCLUSION:Our observations suggest that the AIRD1A inactivation is associated with lymphatic invasion,lymph node metastasis,poor prognosis,and MMR deficiency in gastric adenocarcinomas.

关键词： Adenocarcinoma ARID1A Mismatch Repair Stomach Immu

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Hot Spring Hydro Therapy Regulates Peripheral Leukocyte Together with Emotional Hormone and Receptor Positive Lymphocytes According to Each Constitution/Condition

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Open Journal of Rheumatology and Autoimmune Diseases 2013年第3期3卷 140-153页

作者： Yoshihiko kitada Kazuhiro Okamoto Takafumi Takei Xiufeng Jia Rui Chen Nobuo Yamaguchi Misao Tsubokawa Wen Hsin Wu Tsugiya Murayama Kenji Kawakita Deaprtment of Microbiology and Immunology Faculty of Pharmaceutical Sciences Hokuriku University Kanazawa Japan Deaprtment of Physiology Meiji University of Integrative Medicine Kyoto Japan. Department of Rehabilitation Kanazawa Medical University Uchinada-machi Japan Ishikawa Medicinal Products Research Center Kanazawa Japan Medical School College of Medicine Taipei Medical University Taiwan Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China

Two primary defense systems develop in vertebrates, innate and adaptive. Despite those defense systems, the overwhelming problems of possessing this dual system, the innate or adoptive do not seem to guard or even prevent the development of one internal threat to survival, moreover sometimes direct to autoimmunity accompanying hypersensitivity. Further, every individual exposes to the risk of immunodeficiency in daily life with both internal and external stimuli. In this report, we tried to report the suitable menu for regulating the immune system modulate and discuss how we can compare and select each menu by evidence-based manner more than VAS. In a series of investigation, we have assessed the various health promoting menus such as hot spring hydrotherapy, acupuncture & moxibustion, light walking, independent to the western medicine. In this report, we try to summarize the regulatory effect of hot spring hydrotherapy as our representative menu under the influence of hypothalamus system. Their effects of elements were evaluated by the total number of peripheral leukocyte, its subsets, granulocyte and lymphocyte ratio, emotional hormones, receptor positive lymphoid cells. The regulative effects were confirmed also by other menu than hydrotherapy, acupuncture, walking etc. However, just by the simple comparison between the group before and after the hydrotherapy, we cannot exhibit the real regulatory effect by each menu. So we tried to show the effect by trying to indicate the constitution/condition dependent manner. Because the effect was not uniformly to each individual but it was dependent on each condition/constitution before the start of the menu. This is the one of the main proposes of this report for summaries that it is important to regulate the number and levels of each factor as ideal value. In other words, the regulation of each factor affected under the hypothalamus system is regulated with each constitution, under the influence of daily circumstances. T

关键词： Hot Spring Hydrotherapy Peripheral Leukocyte Leukocyte Subsets Ratio Adrenaline Dopamine β2-Adrenergic Receptor Flow-Cytometry Constitution CAM Therapeutic Menu

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Effects of water flow volume on the isolation of bacteria from motion sensor faucets

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Health 2011年第3期3卷 146-150页

作者： Y. Nakamura M. Watanabe E. Kubo A. Suzuki H. Igari M. kitada T. Sato 不详

Water outlets for washing hands and medical equipment are essential for preventing hospital infection. The present study clarified the effects of water flow volume on the identification and quantitative evaluation of bacteria found around spouts in the 17 hand-washing stations. Pseu-domonas aeruginosa was detected from 4 sta-tions before adjustment and 2 after adjustment. Although no significant difference was identified in the detection rate of P. aeruginosa (p = 0.368), when combining P. aeruginosa and glucose non-fermentative Gram-negative bacilli (NFB), the number of stations with P. aeruginosa and/or NFB decreased significantly from 15 before adjustment to 9 after adjustment (p = 0.023). Before adjust-ment, quantity of bacteria was “2+” for 3 stations and “1+” for 7 stations, but was “1+” for 3 stations and “2+” for 0 stations after adjustment. These results show that quantity of bacteria could be reduced from spouts by adjusting flow volume. These results were also supported by experiments for cleanliness using Adenosine 5’-triphosphate bioluminescence me- thod.

关键词： Infection Control Water Flow Volume Motion Sensor Faucets

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Usefulness of the DL in ME with NBI for determining the expanded area of early-stage differentiated gastric carcinoma

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World Journal of Gastrointestinal Endoscopy 2012年第8期4卷 362-367页

作者： Kouichi Nonaka Masaaki Namoto Hideki kitada Michio Shimizu Yasutoshi Ochiai Osamu Togawa Masamitsu Nakao Makoto Nishimura Keiko Ishikawa Shin Arai Hiroto Kita Department of Gastroenterology Saitama Medical University International Medical Center Saitama 350-1298 Japan Department of Gastroenterology Kitakyushu Municipal Medical Center Fukuoka 802-0077 Japan Department of Gastroenterology Japanese Red Cross Kumamoto Hospital Kumamoto 861-8520 Japan Department of Pathology Saitama Medical University International Medical Center Saitama 350-1298 Japan

AIM: To investigate whether magnifying endoscopy with narrow band imaging (ME-NBI) is useful for evaluating the area of superficial, depressed- or flat-type differentiated adenocarcinoma of the stomach. METHODS: This procedure was performed in Saitama Medical University International Medical Center, Japanese Red Cross Kumamoto Hospital and Kitakyushu Municipal Medical Center. The subjects were 31 patients in whom biopsy findings, from superficial, depressed- or flat-type gastric lesion, suggested differentiated adenocarcinoma in the above 3 hospitals between January and December 2009. Biopsy was performed on the lesion and non-lesion sides of a boundary (imaginary boundary) visualized on ME-NBI. The results were pathologically investigated. We evaluated the accuracy of estimating a demarcation line (DL) on ME-NBI in comparison with biopsy findings as a gold standard. RESULTS: The DL that could be recognized at 2 points on the orifice and anal sides of each lesion during ME-NBI was consistent with the pathological findings in 22 patients with 0-IIc lesions, 7 with 0-IIb lesions, and 2 with 0-IIb + IIc lesions, showing an accuracy of 100%. CONCLUSION: The results suggest the usefulness of ME-NBI for evaluating the area of superficial, depressed- and flat-type differentiated adenocarcinoma of the stomach.

关键词： Narrow band imaging Magnifying endoscopy Endoscopic submucosal dissection Gastric carcinoma

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Measurements of Reactivity Worth of Rare-Earth Elements

Measurements of Reactivity Worth of Rare-Earth Elements

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作者： K.Shimozato K.Ieyama T.kitada H.Okochi A.Yamamoto H.Unesaki Graduate School of Engineering Osaka University Graduate School of Engineering Nagoya University

INTRODUCTION:Rare-earth elements are considered as a candidate of advanced burnable ***, few critical experiments have been carried out so far to validate the accuracy of their nuclear *** critical experiments loaded with rare-earth elements(Dy,Ho,Er and Tm) were carried out and their reactivity worth were measured at the KUCA B *** experiments were performed on B3/8"P36EU(3) core and B1/8"P60EU-EU *** critical experiments attempt to estimate the validity of nuclear data of the rare-earth elements.

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下水道用低强度垫层砂浆的力学性能

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国外建材科技 2000年第4期21卷 19-22页

作者：涂成厚 ryoji sakurada 武汉理工大学材料学院 430070

坑砂一直被用于制作下水管的密实填充料。然而这类密实砂质填料易被渗漏流所冲蚀,从而导致路基下沉并使冲出的砂石流入下水道中,另外,酸性土壤和渗透到地下的氯化物也会引起下水管的腐蚀。因此开发一种新型的流动性好的填料以取代传统... 详细信息

坑砂一直被用于制作下水管的密实填充料。然而这类密实砂质填料易被渗漏流所冲蚀,从而导致路基下沉并使冲出的砂石流入下水道中,另外,酸性土壤和渗透到地下的氯化物也会引起下水管的腐蚀。因此开发一种新型的流动性好的填料以取代传统砂石很有必要。在美国,受控低强度材料,即人们所熟知的易流动填料、控制密度填料等,已经证明可适用于管道垫层、填隙和控制侵蚀等。与传统砼相比,这些易流动填料的抗压强度较低,因而混合物的耐久性就不能和砼相提并论,但作为回填料还是能满足预期要求的。

关键词：下水道垫层砂浆密实填充料力学性能

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胆道闭锁治疗的进展

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国际消化病杂志 1986年第1期 36-38页

作者： ryoji Ohi 葛人铨

胆道闭锁因施行肝门-肠吻合术而取得了明显疗效,但仍然是一种难治的婴儿疾病.1953～1983年作者共治疗胆道闭锁238例,其中214例作了手术,88例存活至今,70例无黄疸存活.对统计材料的回顾性分析表明下列因素与手术疗效有明显关系:早期手术... 详细信息

胆道闭锁因施行肝门-肠吻合术而取得了明显疗效,但仍然是一种难治的婴儿疾病.1953～1983年作者共治疗胆道闭锁238例,其中214例作了手术,88例存活至今,70例无黄疸存活.对统计材料的回顾性分析表明下列因素与手术疗效有明显关系:早期手术,在肝门部对胆管残余组织精确解剖及充分的横断,术后胆管炎的预防,术后监护的改进,必要时早期再手

关键词：胆道闭锁胆管炎胆管疾病肠吻合术肝门部胆汁排泄

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