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Gravity assistance enables liver stiffness measurements to detect liver fibrosis under congestive circumstances

World Journal of Hepatology 2022年第4期14卷 778-790页

作者： Takeshi Suda Ai Sugimoto Tsutomu Kanefuji Atsushi Abe Takeshi Yokoo Takahiro Hoshi Satoshi Abe shinichi morita Kazuyoshi Yagi Masashi Takahashi Shuji Terai Department of Gastroenterology and Hepatology Uonuma Institute of Community MedicineNiigata University Medical and Dental HospitalMinami Uonuma 949-7302NiigataJapan Division of Thoracic and Cardiovascular Surgery Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8122Japan Department of Gastroenterology and Hepatology Tsubame Rosai HospitalTsubame 959-1228NiigataJapan Department of Administration Joetsu-Area General Health Care CenterJoetsu 943-0803NiigataJapan Department of Preemptive Medicine for Digestive Diseases and Healthy Active Life Niigata University School of MedicineNiigata 951-8122Japan Division of Gastroenterology and Hepatology School of Medical and Dental SciencesNiigata UniversityNiigata 951-8122Japan

BACKGROUND As survival has been prolonged owing to surgical and medical improvements,liver failure has become a prognostic determinant in patients with congestive heart diseases.Congestive hepatopathy,an abnormal state of the liver as a result of congestion,insidiously proceed toward end-stage liver disease without effective biomarkers evaluating pathological progression.Regular measurements of shear wave elastography cannot qualify liver fibrosis,which is a prognosticator in any type of chronic liver disease,in cases of congestion because congestion makes the liver stiff without fibrosis.We hypothesized that the effects of congestion and fibrosis on liver stiffness can be dissociated by inducing architectural deformation of the liver to expose structural rigidity.To establish a strategy measuring liver stiffness as a reflection of architectural rigidity under congestion.METHODS Two-dimensional shear wave elastography(2dSWE)was measured in the supine(Sp)and left decubitus(Ld)positions in 298 consecutive cases as they were subjected to an ultrasound study for various liver diseases.Regions of interest were placed at twelve sites,and the median and robust coefficient of variation were calculated.Numerical data were compared using the Mann-Whitney U or Kruskal-Wallis test followed by Dunn's post-hoc multiple comparisons.The inferior vena cava(IVC)diameters at different body positions were compared using the Wilcoxon matched pairs signed rank test.The number of cases with cardiothoracic ratios greater than or not greater than 50%was compared using Fisher’s exact test.A correlation of 2dSWE between different body positions was evaluated by calculating Spearman correlation coefficients.RESULTS The IVC diameter was significantly reduced in Ld in subjects with higher 2dSWE values in Ld(LdSWE)than in Sp(SpSWE)(P=0.007,(average±SD)13.9±3.6 vs 13.1±3.4 mm)but not in those with lower LdSWE values(P=0.32,13.3±3.5 vs 13.0±3.5 mm).In 81 subjects,SpSWE was increased or decreased in Ld beyond the magnitude of robust coefficient o

关键词： Shear wave elastography Inferior vena cava diameter Congestive hepatopathy Liver fibrosis Body positions Fibrosis-4 index

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Experimental Study of the Flow in Helical Circular Pipes:Torsion Effect on the Flow Velocity and Turbulence

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Journal of Thermal Science 2008年第3期17卷 193-198页

作者： Yasutaka HAYAMIZU Kyoji YAMAMOTO shinichiroYANASE Toru HYAKUTAKE Toru SHINOHARA shinichi morita Department of Mechanical Engineering Yonago National College of Technology Graduate School of Natural Science and Technology Okayama University

现在的纸的一个目的是试验性地在螺旋状的圆形的管子中在流动上澄清扭转效果。我们使六成为了有不同程度和大约 0.1 的普通非维的弯曲 δ 的螺旋状的圆形的管子。被 β0=τ/(2 δ) 定义的扭转参数 β0, 有非维的扭转 τ 的 1/2 ，被拿是... 详细信息

现在的纸的一个目的是试验性地在螺旋状的圆形的管子中在流动上澄清扭转效果。我们使六成为了有不同程度和大约 0.1 的普通非维的弯曲 δ 的螺旋状的圆形的管子。被 β0=τ/(2 δ) 定义的扭转参数 β0, 有非维的扭转 τ 的 1/2 ，被拿是 0.02， 0.45， 0.69， 1.01， 1.38 和 1.89 盖住从对很大的沥青小。速度分布和流动的骚乱从 200 ～ 20000 在雷纳兹数字的范围用一张 X 类型热电线的风速表被测量。获得的结果如下被总结：在管子的生气的节的吝啬的第二等的流动模式从没有扭转(toroidal 管子) ，在之一以后在一根弄弯的管子中被看见到一种单个旋涡类型的一种平常的成双旋涡的类型变化成双旋涡当 β0 增加，逐渐地消失。单个旋涡的循环方向与管子的扭转的方向一样。轴流的吝啬的速度分发类似于在小 β0, 的 toroidal 管子的，但是当 β0 在一根笔直地圆形的管子中增加，并且到达类似于那的形状，改变它的形状什么时候 β0= 1.89。这也被发现批评雷纳兹数字，流动在显示出边缘的行为到骚乱，为小 β0, 作为 β0 增加减少然后在拿在 β0≈ 的最小以后增加1.4 作为 β0 增加。试验性地获得的批评雷纳兹数字的最小在 β0≈ 是大约 4001.4。

关键词：扭转效果螺旋管道湍流物理学

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Experimental Study of the Viscous Pump with a Helical Channel Rotor:Torsion Effect of the Channel

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Journal of Thermal Science 2010年第2期19卷 154-159页

作者： Yasutaka HAYAMIZU Kyoji YAMAMOTO shinichiro YANASE Toru HYAKUTAKE shinichi morita Shigeru OHTSUKA Department of Mechanical Engineering Yonago National College of Technology4448 Hikona-choYonago-shiTottori 683-8502 Graduate School of Natural Science and Technology Okayama University3-1-1 TushimanakaOkayama-shiOkayama 700-8530

The viscous pump,which has a rotor with a helical square channel,is studied experimentally.The non-dimen-sional channel curvature is taken to be about 0.1.Three types of torsion of the channel are made to investigate the torsion effect on the flow characteristics.We measure the flux through the channel at a constant rotor speed by changing the pressures at the entrance and exit of the pump.We also observe the secondary flow at a cross-section of the channel.Some of the results obtained are shown as follows:The friction factor along the channel to get the same flux is large for large channel torsion at a constant rotation,and becomes small when the favorable rotation of the rotor to the flow is applied.As for the secondary flow in a cross-section,there appear several types of vortex.When there is no rotation,the secondary flow is almost a symmetric two-vortex type for small flux as is the ordinary Dean vortex,but it changes to a four-vortex type when the flux is large.The secondary flow becomes asymmetric as the rotation is applied.We have unsteady flow patterns at large flux and rotation.

关键词：螺旋转子方形通道螺旋泵频道实验粘性扭转效应渠道流量

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World Journal of Clinical Cases 2019年第21期7卷 3553-3561页

作者： Takeshi Mizusawa Kenya Kamimura Hiroki Sato Takeshi Suda Hiroyuki Fukunari Go Hasegawa Osamu Shibata shinichi morita Akira Sakamaki Junji Yokoyama Yu Saito Yoshihisa Hori Yuduru Maruyama Fumitoshi Yoshimine Takahiro Hoshi shinichi morita Tsutomu Kanefuji Masaaki Kobayashi Shuji Terai Department of Internal Medicine Niigata Prefectural Tokamachi HospitalTokamachiNiigata 948-0065Japan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8122Japan Department of Gastroenterology and Hepatology Uonuma Institute of Community Medicine Niigata University HospitalMinami UonumaNiigata 949-7302Japan Department of Surgery Niigata Prefectural Tokamachi HospitalTokamachiNiigata 948-0065Japan Department of Pathology Uonuma Institute of Community Medicine Niigata University HospitalMinami UonumaNiigata 949-7302Japan Department of Internal Medicine Tokamachi Central ClinicTokamachiNiigata 948-0065Japan

BACKGROUND Immunosuppression is effective in treating a number of diseases,but adverse effects such as bone marrow suppression,infection,and oncogenesis are of concern.Methotrexate is a key immunosuppressant used to treat rheumatoid arthritis.Although it is effective for many patients,various side effects have been reported,one of the most serious being methotrexate-related lymphoproliferative disorder.While this may occur in various organs,liver involvement is rare.Information on these liver lesions,including clinical characteristics,course,and imaging studies,has not been summarized to date.CASE SUMMARY We present a case of 70-year-old woman presented with a 2-wk history of fever and abdominal pain.She had had rheumatoid arthritis for 5 years and was being treated with medication including methotrexate.Contrast-enhanced computed tomography revealed multiple low density tumors in the liver and the histological analyses showed significant proliferation of lymphocytes in masses that were positive on immunohistochemical staining for CD3,CD4,CD8,and CD79a but negative for CD20 and CD56.Staining for Epstein-Barr virus-encoded RNA was negative.And based on these findings,the liver tumors were diagnosed as Methotrexate-related lymphoproliferative disorders.A timedependent disappearance of the liver tumors after stopping methotrexate supported the diagnoses.CONCLUSION The information obtained from our case and a review of 9 additional cases reported thus far assist physicians who may face the challenge of diagnosing and managing this disorder.

关键词： Arthritis Rheumatoid Methotrexate Malignant lymphoma Case report

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Micro T-Mixer with Baffles: Effect of Baffle Height and Setting Angle on Mixing

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Open Journal of Fluid Dynamics 2023年第4期13卷 206-215页

作者： Miah Md Ashraful Alam Taichi Hirano Yasutaka Hayamizu Takuya Masuda Tatsuki Hamada shinichi morita Manabu Takao Department of Mechanical Engineering for Transportation Faculty of Engineering Osaka Sangyo University Osaka Japan Advanced Engineering Faculty National Institute of Technology Yonago College Tottori Japan Department of Mechanical Engineering National Institute of Technology Yonago College Tottori Japan Department of Mechanical Engineering Kitami Institute of Technology Hokkaido Japan Department of Mechanical Engineering National Institute of Technology Matsue College Shimane Japan

Chaotic mixing in eight different types of micro T-mixer flow has been studied experimentally and numerically. The present experimental study was performed to visualize two-liquid flows in a micro T-mixer with baffles. The Reynolds number, baffle height and setting angle were varied to investigate their effect on the mixing performance. Three micro T-mixer models were produced, which are several centimeters long and have a rectangular cross-section of few millimeters a side. The mixing of two-liquid was measured using the laser induced fluorescence (LIF) technique. Moreover, three-dimensional numerical simulations were conducted with the open-source CFD solver, OpenFOAM, for the same configuration as used in the experiments to investigate the detailed mechanism of the chaotic mixing. As a result, it was found that the mixing of two-liquid is greatly improved in the micro T-mixer with baffle. The baffle height and setting angle show a significant influence on the mixing performance.

关键词： Micromixer Baffles Liquid-Liquid Mixing LIF CFD

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Pulmonary tumor thrombotic microangiopathy of hepatocellular carcinoma: A case report and review of literature

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World Journal of Gastroenterology 2019年第48期25卷 6949-6958页

作者： shinichi morita Kenya Kamimura Hiroyuki Abe Yukari Watanabe-Mori Chiyumi Oda Takamasa Kobayashi Yoshihisa Arao Yusuke Tani Riuko Ohashi Yoichi Ajioka Shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8510Japan Division of Molecular and Diagnostic Pathology Niigata University Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8510Japan Histopathology Core Facility Niigata University Faculty of MedicineNiigata UniversityNiigata 951-8510Japan

BACKGROUND Pulmonary tumor thrombotic microangiopathy(PTTM)is a rare condition in patients with hepatocellular carcinoma(HCC);to date,few cases have been reported.While hepatic dysfunction has been focused on the later stages of HCC,the management of symptoms in PTTM is important for supportive care of the cases.For the better understanding of PTTM in HCC,the information of our recent case and reported cases have been summarized.CASE SUMMARY A patient with HCC exhibited acute and severe respiratory failure.Radiography and computed tomography of the chest revealed the multiple metastatic tumors and a frosted glass–like shadow with no evidence of infectious pneumonia.We diagnosed his condition as acute respiratory distress syndrome caused by the lung metastases and involvement of the pulmonary vessels by tumor thrombus.Administration of prednisolone to alleviate the diffuse alveolar damages including edematous changes of alveolar wall caused by the tumor cell infiltration and ischemia showed mild improvement in his symptoms and imaging findings.An autopsy showed the typical pattern of PTTM in the lung with multiple metastases.CONCLUSION PTTM is caused by tumor thrombi in the arteries and thickening of the pulmonary arterial endothelium leading to the symptoms of dyspnea in terminal staged patients.Therefore,supportive management of symptoms is necessary in the cases with PTTM and hence we believe that the information presented here is of great significance for the diagnosis and management of symptoms of PTTM with HCC.

关键词： Pulmonary tumor thrombotic microangiopathy Hepatocellular carcinoma Respiratory dysfunction Prednisolone Supportive care Case report

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Rational arrangement of measuring shear wave speed in the liver

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World Journal of Gastroenterology 2019年第20期25卷 2503-2513页

作者： Takeshi Yokoo Tsutomu Kanefuji Takeshi Suda Itsuo Nagayama Takahiro Hoshi Satoshi Abe shinichi morita Hiroteru Kamimura Kenya Kamimura Atsunori Tsuchiya Masaaki Takamura Kazuyoshi Yagi Shuji Terai Department of Preemptive Medicine for Digestive Diseases and Healthy Active Life Niigata University School of MedicineNiigataNiigata 951-8122Japan Division of Gastroenterology and Hepatology Niigata Tokamachi HospitalTokamachiNiigata 948-0065Japan Department of Gastroenterology and Hepatology Uonuma Institute of Community MedicineNiigata University Medical and Dental HospitalMinami UonumaNiigata 949-7302Japan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8122Japan

BACKGROUND Shear wave speed has been widely applied to quantify a degree of liver fibrosis. However, there is no standardized procedure, which makes it difficult to utilize the speed universally. AIM To provide procedural standardization of shear wave speed measurement. METHODS Point shear wave elastography (pSWE) was measured in 781 patients, and twodimensional shear wave elastography (2dSWE) was measured on the same day in 18 cases. Regions-of-interest were placed at 12 sites, and the median and robust coefficient-of-variation (CVR) were calculated. A residual sum-of-square (Σdi2) was computed for bootstrap values of 1000 iterations in 18 cases with each assumption of 1 to 12 measurements. The proportion of the Σdi2 (%Σdi2) was calculated as the ratio of Σdi2 to pSWE after converting it based on the correlation between pSWE and 2dSWE. RESULTS The CVR showed a significantly broader distribution in the left lobe (P < 0.0001),and the smallest CVR in the right anterior segment that covered 95% cases was 40.4%. pSWE was significantly higher in the left lobe than in the right lobe (1.63 ± 0.78 m/s vs 1.61 ± 0.78 m/s, P = 0.0004), and the difference between the lobes became further discrete when the subjects were limited to the cases with a CVR less than 40.4% in any segment (1.76 ± 0.80 m/s vs 1.70 ± 0.82 m/s, P < 0.0001). The highest values of the CVR in every 0.1 m/s interval were plotted in convex upward along pSWE and peaked at 1.93 m/s. pSWE and 2dSWE were significantly correlated (P < 0.0001, r = 0.95). In 216000 resamples from 18 cases, the %Σdi2 of 12 sites was 8.0% and gradually increased as the acquisition sites decreased to reach a significant difference with a %Σdi2 of 7 sites (P = 0.027). CONCLUSION These data suggest that shear wave speed should be measured at 8 or more sites of spreading in both lobes.

关键词： Liver stiffness Ultrasound Shear wave elastography Acoustic radiation force impulse Heterogeneity

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A Micromixer Using the Chaos of Secondary Flow: Rotation Effect of Channel on the Chaos of Secondary Flow

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Open Journal of Fluid Dynamics 2012年第4期2卷 195-201页

作者： Yasutaka Hayamizu shinichiro Yanase shinichi morita Shigeru Ohtsuka Takeshi Gonda Kazunori Nishida Kyoji Yamamoto Department of Mechanical Engineering Yonago National College of Technology Tottori Japan Graduate School of Natural Science and Technology Okayama University Okayama Japan

The micromixer, which has a rotor with a curved channel, is studied experimentally. The secondary flow in a curved channel of rectangular cross-section is investigated using PIV (Particle Image Velocimetry) and LIF (Laser Induced Fluorescence) methods. Two walls of the channel (the inner and top walls) rotate around the center of curvature and a pressure gradient is imposed in the direction of the exit of the channel. The non-dimensional channel curvature δ=a/R is taken to be about 0.1, where 2a is the width of the channel, R the curvature radius of the channel. Other non-dimensional parameters concerned are the Dean number De=Reδ1/2, the Reynolds number Re=qdh/v, where q is the mean flow velocity in the channel axis direction, ν the kinematic viscosity, dh the hydraulic diameter of the channel, and the Taylor number Tr=2(2δ)1/2Ωa2/(δv), where Ω is the angular velocity of the rotor. Photographs of the flow in a cross-section at 180° downstream from the curved channel entrance are taken by changing the flux (De) at a constant rotational speed (Tr) of the channel walls. It is found that good mixing performance is obtained in the case of De≤0.1|Tr| and for that case secondary flows show chaotic behaviors. And then we have confirmed the occurrence of reversal of the mean axial flow.

关键词： Chaos Rotation Effect Secondary Flow PIV LIF

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A Micromixer Using the Taylor-Dean Flow: Effect of Inflow Conditions on the Mixing

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Open Journal of Fluid Dynamics 2014年第5期4卷 463-471页

作者： Toshihiko Kawabe Yasutaka Hayamizu shinichiro Yanase Takeshi Gonda shinichi morita Shigeru Ohtsuka Kyoji Yamamoto Technical Division Tsurumi Manufacturing Co. Ltd. Tottori Japan Department of Mechanical Engineering Yonago National College of Technology Tottori Japan Graduate School of Natural Science and Technology Okayama University Okayama Japan

Chaotic mixing in a curved-square channel flow is studied experimentally and numerically. Two walls of the channel (inner and top walls) rotate around the center of curvature and a pressure gradient is imposed in the direction toward the exit of the channel. This flow is a kind of Taylor-Dean flows. There are two parameters dominating the flow, the Dean number De (∝ the pressure gradient or the Reynolds number) and the Taylor number Tr (∝ the angular velocity of the wall rotation). In the present paper, we analyze the physical mechanism of chaotic mixing in the Taylor-Dean flow by comparing experimental and numerical results. We produced a micromixer model of the curved channel several centimeters long with square cross section of a few millimeters side. The secondary flow was measured using laser induced fluorescence (LIF) method to examine secondary flow characteristics. We also performed three-dimensional numerical simulations for the exactly same configuration as the experimental system to study the mechanism of chaotic mixing. It is found that good mixing performance is achieved for the case of De ≤ 0.1Tr, and that mixing efficiency changes according to the difference in inflow conditions. The flow is studied both experimentally and numerically, and both results agree with each other very well.

关键词： Taylor-Dean Flow Chaotic Mixing Secondary Flow LIF CFD

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A Micromixer Using the Taylor-Dean Flow: Effects of Aspect Ratio and Inflow Condition on the Mixing

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Open Journal of Fluid Dynamics 2015年第3期5卷 256-264页

作者： Yasutaka Hayamizu Toshihiko Kawabe shinichiro Yanase Takeshi Gonda shinichi morita Shigeru Ohtsuka Kyoji Yamamoto Department of Mechanical Engineering Yonago National College of Technology Tottori Japan Technical Division Tsurumi Manufacturing Co. Ltd. Tottori Japan Graduate School of Natural Science and Technology Okayama University Okayama Japan

Chaotic mixing in three different types of curved-rectangular channels flow has been studied experimentally and numerically. Two walls of the channel (inner and top walls) rotate around the center of curvature and a pressure gradient are imposed in the direction toward the exit of the channel. This flow is a kind of Taylor-Dean flow. There are two parameters dominating the flow, the Dean number De (∝ the pressure gradient or the Reynolds number) and the Taylor number Tr (∝ the angular velocity of the wall rotation). In this paper, we analyze the physical mechanism of chaotic mixing in the Taylor-Dean flow by comparing experimental results and numerical ones. We produced three micromixer models of the curved channel, several centimeters long, with rectangular cross-section of a few millimeters side. The secondary flow is measured using laser induced fluorescence (LIF) method to examine secondary flow characteristics. Also we performed three-dimensional numerical simulations with the open source CFD solver, OpenFOAM, for the same configuration as the experimental system to study the mechanism of chaotic mixing. It is found that good mixing performance is obtained in the case of De ≤ 0.1 Tr, and it becomes more remarkable when the aspect ratio tends to large. And it is found that the mixing efficiency changes according to the aspect ratio and inflow condition.

关键词： Component Taylor-Dean Flow Chaotic Mixing Secondary Flow LIF CFD

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