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Postoperative bleeding in patients on antithrombotic therapy after gastric endoscopic submucosal dissection

World Journal of Gastroenterology 2017年第30期23卷 5557-5566页

作者： Chiko Sato Kingo Hirasawa Ryonho Koh ryosuke ikeda Takehide Fukuchi ryosuke Kobayashi Hiroaki Kaneko Makomo Makazu Shin Maeda Endoscopy Division Yokohama City University Medical Center Department of Gastroenterology Yokohama City University Graduate School of Medicine

To investigated the relationship between postoperative bleeding following gastric endoscopic submucosal dissection (ESD) and individual antithrombotic agents. METHODSA total of 2488 gastric neoplasms in 2148 consecutive patients treated between May 2001 and June 2016 were studied. The antithrombotic agents were categorized into antiplatelet agents, anticoagulants, and other antithrombotic agents, and we included combination therapies [e.g., dual antiplatelet therapy (DAPT)]. The risk factors associated with post-ESD bleeding, namely, antithrombotic agents overall, individual antithrombotic agents, withdrawal or continuation of antithrombotic agents, and bleeding onset period (during the first six days or thereafter), were analyzed using univariate and multivariate analyses. RESULTSThe en bloc resection and complete curative resection rates were 99.2% and 91.9%, respectively. Postoperative bleeding occurred in 5.1% cases. Bleeding occurred in 10.3% of the patients administered antithrombotic agents. Being male (P = 0.007), specimen size (P < 0.001), and antithrombotic agent used (P < 0.001) were independent risk factors for postoperative bleeding. Heparin bridging therapy (HBT) (P = 0.002) and DAPT/multidrug combinations (P < 0.001) were independent risk factors associated with postoperative bleeding. The bleeding rate of the antithrombotic agent continuation group was significantly higher than that of the withdrawal group (P < 0.01). Bleeding within postoperative day (POD) 6 was significantly higher in warfarin (P = 0.015), and bleeding after POD 7 was significantly higher in DAPT/multidrug combinations (P = 0.007). No thromboembolic events were reported. CONCLUSIONWe must closely monitor patients administered HBT and DAPT/multidrug combinations after gastric ESD, particularly those administered multidrug combinations after discharge.

关键词： Gastric cancer Endoscopic submucosal dissection Postoperative hemorrhages Antithrombotic agent Heparin

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Third-look endoscopy prevents delayed bleeding after endoscopic submucosal dissection under antithrombotic therapy

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World Journal of Gastroenterology 2020年第41期26卷 6475-6487页

作者： ryosuke ikeda Kingo Hirasawa Chiko Sato Yuichiro Ozeki Atsushi Sawada Masafumi Nishio Takehide Fukuchi ryosuke Kobayashi Makomo Makazu Masataka Taguri Shin Maeda Endoscopy Division Yokohama City University Medical CenterYokohama 232-0024Japan Endoscopy Division Yokohama Medical University Center HospitalYokohama 232-0024Japan Department of Data Science Yokohama City University School of Data ScienceYokohama 236-0004Japan Division of Gastroenterology Yokohama City University Graduate School of MedicineYokohama 236-0004Japan

BACKGROUND Postoperative delayed bleeding(PDB) after gastric endoscopic submucosal dissection(ESD) is the most common adverse event in patients receiving antithrombotics even with second-look endoscopy. Moreover, with the increasing prevalence of cardiovascular and cerebrovascular diseases in an aging population with associated lifestyle-related diseases, an increasing number of patients receive antithrombotics. Several attempts have been made to prevent PDB in aging population;however, a consensus has yet to be *** To examine the efficacy of third-look endoscopy(TLE) for PDB *** One hundred patients with early gastric neoplasms receiving antithrombotics were prospectively enrolled and subjected to ESD with TLE between February 2017 and July 2019. The primary endpoint was PDB rate, which was compared with our preset threshold. Furthermore, we divided the bleeding period into early-and late-onset PDB(E-PDB and L-PDB, respectively) and analyzed its rate. As a secondary analysis, we compared PDB rates with those of a historical control group, using propensity score matching, and calculated the PDB rates per antithrombotic agent use in each *** In total, 96 patients and 114 specimens were finally evaluated. The overall PDB rate was 7.9%(9/114) [90%CI: 4.7-13.1, P = 0.005], while the late-and early-onset PDB rates(L-PDB and E-PDB) were 5.3% [90%CI: 2.7-9.9, P < 0.0001] and 2.6% [90%CI: 1.1-6.4, P = 0.51], respectively. Propensity score matching generated 58 matched pairs for TLE and control groups. No differences were found in overall PDB incidence(10.3% vs 20.7%, P = 0.12), whereas L-PDB occurrence significantly differed(5.2% vs 17.2%, P = 0.04) between groups. Considering antithrombotics' use, the overall PDB rate was higher for direct oral anticoagulants and multiple antithrombotics in the control group, while L-PDB incidence was lower in the TLE group for these agents(8.7% vs 23.1% and 5.0% vs 29.4%, respectively).CONCLUSION TLE for g

关键词： Endoscopic submucosal dissection Postoperative delayed bleeding Third look endoscopy Antithrombotic agents Late phase bleeding Phase II

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Histopathological validation of magnifying endoscopy for diagnosis of mixed-histological-type early gastric cancer

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World Journal of Gastroenterology 2020年第36期26卷 5450-5462页

作者： Yuichiro Ozeki Kingo Hirasawa ryosuke Kobayashi Chiko Sato Yoko Tateishi Atsushi Sawada ryosuke ikeda Masafumi Nishio Takehide Fukuchi Makomo Makazu Masataka Taguri Shin Maeda Division of Endoscopy Yokohama City University Medical CenterYokohama 232-0024Japan Department of Pathology Yokohama City University Graduate School of MedicineYokohama 236-0004Japan Department of Data Science Yokohama City University School of Data ScienceYokohama 236-0004Japan Department of Gastroenterology Yokohama City University Graduate School of MedicineYokohama 236-0004Japan

BACKGROUND The undifferentiated-type(UDT)component profoundly affects the clinical course of early gastric cancers(EGCs).However,an accurate preoperative diagnosis of the histological types is *** date,few studies have investigated whether the UDT component within mixed-histological-type(MT)EGCs can be recognized *** To clarify the histopathological characteristics of the endoscopically-resected MT EGCs for investigating whether the UDT component could be recognized *** This was a single-center retrospective ***,we attempted to clarify the histopathological characteristics of the endoscopically-resected MT EGCs with emphasis on the UDT *** examination investigated each lesion’s UDT component:(1)Whole mucosal layer occupation of the UDT component;(2)UDT component exposure to the surface of the mucosa;and(3)existence of a clear border between the differentiated-type and UDT ***,preoperative endoscopic images with magnifying endoscopy with narrowband imaging(ME-NBI)were examined to identify whether the endoscopic UDT component finding was recognizable within the area where it was present in the histopathological *** preoperative biopsy results and comparative relationships between endoscopic and histopathological findings were also *** In the histopathological examination,the whole mucosal layer occupation of the UDT component and exposure of the UDT component to the mucosal surface were observed in 67.3%(33/49)and 79.6%(39/49)of samples,respectively.A clear distinction of the border between the differentiated-type and UDT components could not be drawn in 65.3%(32/49)of MT *** the endoscopic examination,the preoperative endoscopic images showed that only 24.5%(12/49)of MT EGCs revealed the UDT component within the area where it was present *** UDT predominance was the single significant factor associated with the

关键词： Early gastric cancer Endoscopic submucosal dissection Mixed-histologicaltype Undifferentiated-type Narrow-band imaging

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Investigation of Experimental Con6guration for Electron Bernstein Wave Heating on LHD

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Plasma Science and Technology 2009年第4期11卷 430-438页

作者： Hiroe IGAMI ryosuke ikeda Hiromi TAKAHASHI Yasuo YOSHIMURA Takashi SHIMOZUMA Shin KUBO Hitoshi TANAKA Kazunobu NAGASAKI Takashi MUTOH the LHD Experiment Group National Institute for Fusion Science 509-5292 Toki Japan Graduate School of Energy Science Kyoto University 606-8502 Kyoto Japan Institute of Advanced Energy Kyoto University 611-0011 Uji Japan

Investigation of experimental configuration for the electron Bernstein wave （EBW） heating by using the existing electron cyclotron heating （ECH） antennas on LHD was performed. By using an antenna installed in the lower port, direct oblique launching of the extraordinary （X-） mode from the high magnetic field side （HFS） is available. Since the parallel component of the refractive index （NIF） varies during propagation because of the inhomogeneity of the magnetic field, NH can be zero when the launched X-mode crosses the fundamental electron cyclotron resonance （ECR） layer even NⅡ is noonzero initially. In such a condition, if the electron density is above a certain level the obliquely launched X-mode can pass the fundamental ECR layer without being damped out and can be mode-converted to EBW that is absorbed at the Doppler shifted ECR layer. By using an antenna installed in the horizontal port, oblique launching from the lower magnetic field side （LFS） toward the over-dense plasma is available. Excitation of EBW via the mode conversion process of ordinary mode（O）-extraordinary mode（X）-electron Bernstein wave （B） is expected with the O-mode launching toward an appropriate direction. The O-X-B mode conversion rate and the region of power deposition were surveyed by varying the magnetic field strength and the launching direction. The results of the survey suggest that efficient heating in the core region is difficult by using the existing antenna. Rearrangement of the final mirror of the launching antenna may be needed.

关键词： LHD electron cyclotron heating (ECH) electron Bernstein wave (EBW),high density plasma

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Clinicopathological features of early gastric cancers arising in Helicobacter pylori uninfected patients

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World Journal of Gastroenterology 2020年第20期26卷 2618-2631页

作者： Chiko Sato Kingo Hirasawa Yoko Tateishi Yuichiro Ozeki Atsushi Sawada ryosuke ikeda Takehide Fukuchi Masafumi Nishio ryosuke Kobayashi Makomo Makazu Hiroaki Kaneko Yoshiaki Inayama Shin Maeda Endoscopy Division Yokohama City University Medical CenterYokohama 232-0024Japan Department of Histopathology Yokohama City University Graduate School of MedicineYokohama 236-0004Japan Department of Gastroenterology Yokohama City University Graduate School of MedicineYokohama 236-0004Japan Division of Pathological Diagnosis Yokohama City University Medical CenterYokohama 232-0024Japan

BACKGROUND Persistent Helicobacter pylori(***)infection causes chronic inflammation,atrophy of the gastric mucosa,and a high risk of developing gastric *** recent years,awareness of eradication therapy has increased in *** *** infections decrease,the proportion of gastric cancers arising from *** uninfected gastric mucosa will *** emergence of gastric cancer arising in *** uninfected patients though rarely reported,is a concern to be addressed and needs elucidation of its clinicopathological *** To evaluate the clinicopathological features of early gastric cancer in *** *** A total of 2462 patients with 3375 instances of early gastric cancers that were treated by endoscopic submucosal dissection were enrolled in our study between May 2000 and September *** these,30 lesions in 30 patients were diagnosed as ***-uninfected gastric cancer(Hp UIGC).We defined a patient as ***-uninfected using the following three criteria:(1)The patient did not receive treatment for ***,which was determined by investigating medical recordsand conducting patient interviews;(2)Lack of endoscopic atrophy;and(3)The patient was negative for *** after being tested at least twice using various diagnostic methods,including serum ***-Ig G antibody,urease breath test,rapid urease test,and microscopic *** The frequency of Hp UIGC was 1.2%(30/2462)for the patients in our *** study included 19 males and 11 females with a mean age of 59 *** location of the stomach lesions was divided into three sections;upper third(U),middle third(M),lower third(L).Of the 30 lesions,15 were U,1 was M,and 14 were ***,17 lesions were protruded and flat elevated type(0-I,0-IIa,0-IIa+IIc),and 13 lesions were flat and depressed type(0-IIb,0-IIc).The median tumor diameter was 8 mm(range 2-98 mm).Histological analysis revealed that22 lesions(73.3%)were differentiated ***

关键词： Early gastric cancer Helicobacter pylori Un-infection Negative Clinicopathological features Endoscopic submucosal dissection Mucins Phenotype

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Spectrally resolved Franson interference

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Science China(Physics,Mechanics & Astronomy) 2024年第5期67卷 11-17页

作者： Rui-Bo Jin Zi-Qi Zeng Dan Xu Chen-Zhi Yuan Bai-Hong Li You Wang ryosuke Shimizu Masahiro Takeoka Mikio Fujiwara Masahide Sasaki Pei-Xiang Lu Hubei Key Laboratory of Optical Information and Pattern Recognition Wuhan Institute of TechnologyWuhan 430205China School of Physics and Information Science Shaanxi University of Science and TechnologyXi'an 710021China Southwest Institute of Technical Physics Chengdu 610041China Graduate School of Informatics and Engineering University of Electro-CommunicationsTokyo 182-8585Japan Department of Electronics and Electrical Engineering Keio UniversityKanagawa 223-8522Japan National Institute of Information and Communications Technology Tokyo 184-8795Japan

Franson interference can be used to test the nonlocal features of energy-time entanglement and has become a standard in quantum ***,most of the previous Franson interference experiments were demonstrated in the time domain,and the spectral properties of Franson interference have not been fully ***,we theoretically and experimentally demonstrate spectrally resolved Franson interference using biphotons with different correlations,including positive correlation,negative correlation,and *** is found that the joint spectral intensities of the biphotons can be modulated along both the signal and idler directions,which has potential applications in generating high-dimensional frequency entanglement and time-frequency grid *** work may provide a new perspective for understanding the spectral-temporal properties of the Franson interferometer.

关键词： resolved correlation spectral

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Study on the transport of suspended sediment in an open channel flow with permeable spur dikes

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International Journal of Sediment Research 2011年第1期26卷 96-111页

作者： ryosuke AKAHORI Syunsuke ikeda Civil Engineering Research Institute for Cold Region Public Works Research InstituteJapan CTI Engineering Co. Ltd.JapanTokyo Institute of TechnologyJapan

The transport of suspended sediment in rivers with spur dikes is an important issue for bank protection and environmental *** experiments were performed to study the characteristics of the flow and the transport of suspended sediment in an open channel with permeable ***,the essentials of these characteristics were studied by comparing results of flume experiments on permeable and impermeable *** influence of the aspect ratio(d/l) of the interval between dikes(d) to the length of dikes(l) on these characteristics was then *** these experiments,the properties of horizontal eddies,turbulence structures,and suspended sediment concentrations were *** results show that the development of large-scale horizontal eddies requires some distance in a shear layer for permeable dikes,although they are periodically generated from the first dike in the case of impermeable *** basic structures of horizontal eddies are independent of the aspect ratio in the equilibrium region for permeable *** suspended sediment concentrations for cases of permeable dikes gradually decrease between the several upstream dikes and they approach a uniform distribution in the downstream region,although those in the case of the impermeable dikes are relatively uniform in the downstream direction.

关键词： Suspended sediment Permeable spur dike Eddy structure Velocity distribution Power spectrum

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An integrated model to simulate sown area changes for major crops at a global scale

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Science China Earth Sciences 2008年第3期51卷 370-379页

作者： SHIBASAKI ryosuke Center for Spatial Information Science University of Tokyo

Dynamics of land use systems have attracted much attention from scientists around the world due to their ecological and socio-economic implications. An integrated model to dynamically simulate future changes in sown areas of four major crops (rice, maize, wheat and soybean) on a global scale is pre- sented. To do so, a crop choice model was developed on the basis of Multinomial Logit (Logit) model to model land users' decisions on crop choices among a set of available alternatives with using a crop utility function. A GIS-based Environmental Policy Integrated Climate (EPIC) model was adopted to simulate the crop yields under a given geophysical environment and farming management conditions, while the International Food Policy and Agricultural Simulation (IFPSIM) model was utilized to estimate crop price in the international market. The crop choice model was linked with the GIS-based EPIC model and the IFPSIM model through data exchange. This integrated model was then validated against the FAO statistical data in 2001-2003 and the Moderate Resolution Imaging Spectroradiometer (MODIS) global land cover product in 2001. Both validation approaches indicated reliability of the model for ad- dressing the dynamics in agricultural land use and its capability for long-term scenario analysis. Finally, the model application was designed to run over a time period of 30 a, taking the year 2000 as baseline. The model outcomes can help understand and explain the causes, locations and consequences of land use changes, and provide support for land use planning and policy making.

关键词： land use change crop sown area simulation crop choice global scale

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Fully automatic DOM generation method based on optical flow field dense image matching

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Geo-Spatial Information Science 2023年第2期26卷 242-256页

作者： Wei Yuan Xiuxiao Yuan Yang Cai ryosuke Shibasaki School of Remote Sensing and Information Engineering Wuhan UniversityWuhanChina Center for Spatial Information Science University of TokyoKashiwaJapan

Automatic Digital Orthophoto Map(DOM)generation plays an important role in many downstream works such as land use and cover detection,urban planning,and disaster *** DOM generation methods can generate promising results but always need ground object filtered DEM generation before otho-rectification;this can consume much time and produce building facade contained *** address this problem,a pixel-by-pixel digital differential rectification-based automatic DOM generation method is proposed in this ***,3D point clouds with texture are generated by dense image matching based on an optical flow field for a stereo pair of images,***,the grayscale of the digital differential rectification image is extracted directly from the point clouds element by element according to the nearest neighbor method for matched ***,the elevation is repaired grid-by-grid using the multi-layer Locally Refined B-spline(LR-B)interpolation method with triangular mesh constraint for the point clouds void area,and the grayscale is obtained by the indirect scheme of digital differential rectification to generate the pixel-by-pixel digital differentially rectified image of a single image ***,a seamline network is automatically searched using a disparity map optimization algorithm,and DOM is smartly *** qualitative and quantitative experimental results on three datasets were produced and evaluated,which confirmed the feasibility of the proposed method,and the DOM accuracy can reach 1 Ground Sample Distance(GSD)*** comparison experiment with the state-of-the-art commercial softwares showed that the proposed method generated DOM has a better visual effect on building boundaries and roof completeness with comparable accuracy and computational efficiency.

关键词： Digital Orthophoto Map(DOM) dense image matching based on optical flow field(OFFDIM) 3D point clouds with texture seamline network accuracy

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Completing density functional theory by machine learning hidden messages from molecules

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npj Computational Materials 2020年第1期6卷 1306-1313页

作者： Ryo Nagai ryosuke Akashi Osamu Sugino Department of Physics The University of TokyoHongoBunkyo-KuTokyo 113-0033Japan Institute for Solid State Physics The University of TokyoKashiwaChiba 277-8581Japan

Kohn–Sham density functional theory(DFT)is the basis of modern computational approaches to electronic *** accuracy heavily relies on the exchange-correlation energy functional,which encapsulates electron–electron interaction beyond the classical *** its universal form remains undiscovered,approximated functionals constructed with heuristic approaches are used for practical ***,there are problems in their accuracy and transferability,while any systematic approach to improve them is yet *** this study,we demonstrate that the functional can be systematically constructed using accurate density distributions and energies in reference molecules via machine ***,a trial functional machine learned from only a few molecules is already applicable to hundreds of molecules comprising various first-and second-row elements with the same accuracy as the standard *** is achieved by relating density and energy using a flexible feed-forward neural network,which allows us to take a functional derivative via the back-propagation *** addition,simply by introducing a nonlocal density descriptor,the nonlocal effect is included to improve accuracy,which has hitherto been *** approach thus will help enrich the DFT framework by utilizing the rapidly advancing machine-learning technique.

关键词： technique functional theory

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