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High total Joule heat increases the risk of post-endoscopic submucosal dissection electrocoagulation syndrome after colorectal endoscopic submucosal dissection

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World Journal of Gastroenterology 2021年第38期27卷 6442-6452页

作者： Masanori Ochi Ryosuke Kawagoe Toshiro Kamoshida Yukako Hamano Haruka Ohkawara Atsushi Ohkawara Nobushige Kakinoki Yuji Yamaguchi shinji Hirai Akinori Yanaka Kiichiro Tsuchiya Department of Gastroenterology Hitachi General HospitalHitachi City 317-0077IbarakiJapan Department of Gastroenterology Faculty of MedicineUniversity of TsukubaTsukuba 305-8576IbarakiJapan

BACKGROUND We hypothesized that thermal damage accumulation during endoscopic submucosal dissection(ESD)causes the pathogenesis of post-ESD electrocoagulation syndrome(PECS).AIM To determine the association between Joule heat and the onset of *** We performed a retrospective cohort study in patients who underwent colorectal ESD from May 2013 to March 2021 in *** developed a novel device that measures swift coagulation time with a sensor adjacent to the electrosurgical coagulation unit foot switch,which enabled us to calculate total Joule *** was defined as localized abdominal pain(visual analogue scale≥30 mm during hospitalization or increased by≥20 mm from the baseline)and fever(temperature≥37.5 degrees or white blood cell count≥10000μ/L).Patients exposed to more or less than the median Joule heat value were assigned to the high and low Joule heat groups,*** analyses included Mann-Whitney U and chisquare tests and logistic regression and receiver operating characteristic curve(ROC)*** We evaluated 151 *** PECS incidence was 10.6%(16/151 cases),and all patients were followed conservatively and discharged without severe *** multivariate analysis,high Joule heat was an independent PECS risk *** area under the ROC curve showing the correlation between PECS and total Joule heat was high[0.788(95%confidence interval:0.666-0.909)].CONCLUSION Joule heat accumulation in the gastrointestinal wall is involved in the onset of ***-related thermal damage to the peeled mucosal surface is probably a major component of the mechanism underlying PECS.

关键词： Post-endoscopic submucosal dissection electrocoagulation syndrome Joule heat Colorectal endoscopic submucosal dissection Colorectal neoplasms Electrocoagulation Gastrointestinal tract

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Quest for the best endoscopic imaging modality for computer-assisted colonic polyp staging

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World Journal of Gastroenterology 2019年第10期25卷 1197-1209页

作者： Georg Wimmer Michael Gadermayr Gernot Wolkersdorfer Roland Kwitt Toru Tamaki Jens Tischendorf Michael Hafner Shigeto Yoshida shinji Tanaka Dorit Merhof Andreas Uhl Department of Computer Sciences University of Salzburg Interdisciplinary Imaging and Vision Institute Aachen RWTH Aachen Department of Internal Medicine I Paracelsus Medical University/Salzburger Landeskliniken(SALK) Department of Information Engineering Graduate School of EngineeringHiroshima University Internal Medicine and Gastroenterology University Hospital Aachen Department of Gastroenterologie and Hepatologie Krankenhaus St.Elisabeth Department of Endoscopy and Medicine Graduate School of Biomedical and Health ScienceHiroshima University Department of Endoscopy Hiroshima University Hospital

BACKGROUND It was shown in previous studies that high definition endoscopy, high magnification endoscopy and image enhancement technologies, such as chromoendoscopy and digital chromoendoscopy [narrow-band imaging(NBI), iScan] facilitate the detection and classification of colonic polyps during endoscopic sessions. However, there are no comprehensive studies so far that analyze which endoscopic imaging modalities facilitate the automated classification of colonic polyps. In this work, we investigate the impact of endoscopic imaging modalities on the results of computer-assisted diagnosis systems for colonic polyp *** To assess which endoscopic imaging modalities are best suited for the computerassisted staging of colonic *** In our experiments, we apply twelve state-of-the-art feature extraction methods for the classification of colonic polyps to five endoscopic image databases of colonic lesions. For this purpose, we employ a specifically designed experimental setup to avoid biases in the outcomes caused by differing numbers of images per image database. The image databases were obtained using different imaging modalities. Two databases were obtained by high-definition endoscopy in combination with i-Scan technology(one with chromoendoscopy and one without chromoendoscopy). Three databases were obtained by highmagnification endoscopy(two databases using narrow band imaging and one using chromoendoscopy). The lesions are categorized into non-neoplastic and neoplastic according to the histological *** Generally, it is feature-dependent which imaging modalities achieve high results and which do not. For the high-definition image databases, we achieved overall classification rates of up to 79.2% with chromoendoscopy and 88.9% without chromoendoscopy. In the case of the database obtained by high-magnification chromoendoscopy, the classification rates were up to 81.4%. For the combination of high-magnification endoscopy with NBI, results

关键词： Endoscopy Colonic polyps Automated diagnosis system Narrow-band imaging Chromoendoscopy Imaging modalities Image enhancement technologies

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Unexpected metastasis of intraductal papillary neoplasm of the bile duct without an invasive component to the brain and lungs:A case report

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World Journal of Gastroenterology 2020年第3期26卷 366-374页

作者： Nguyen Hai Nam Kojiro Taura Masashi Kanai Keita Fukuyama Norimitsu Uza Hirona Maeda Yojiro Yutaka Toyofumi F Chen-Yoshikawa Manabu Muto shinji Uemoto Division of Hepato-Biliary-Pancreatic Surgery and Transplantation Department of SurgeryGraduate School of MedicineKyoto UniversityKyoto 606-8501Japan Department of Clinical Oncology Pharmacogenomicsand Palliative MedicineGraduate School of MedicineKyoto UniversityKyoto 606-8507Japan Department of Gastroenterology and Hepatology Graduate School of MedicineKyoto UniversityKyoto 606-8507Japan Department of Diagnostic Pathology Kyoto University HospitalKyoto 606-8507Japan Toyofumi F Chen-Yoshikawa Department of Thoracic.SurgeryGraduate School of MedicineKyoto UniversityKyoto 606-8507Japan Department of Therapeutic Oncology Graduate School of MedicineKyoto UniversityKyoto 606-8507Japan

BACKGROUND Despite an expanding number of studies on intraductal papillary neoplasm of the bile duct(IPNB),distant metastasis remains unexplained especially in cases of carcinoma in *** the present study,we report a rare and interesting case of IPNB without invasive components that later metastasized to lungs and *** SUMMARY A 69-year-old male was referred to our hospital due to suspected *** tests on admission reported a mild elevation of alkaline phosphatase,γ-glutamyl transpeptidase,and total bilirubin in *** retrograde cholangiography revealed a filling defect in the common bile duct(CBD)extending to the left hepatic *** cholangioscopy delineated a tumor in the CBD that had a papillary *** computed tomography and magnetic resonance cholangiopancreatography detected partial blockage ot interlude in the CBD leading to cholestasis without evidence of ***,a diagnosis of IPNB cT1N0M0 was *** hepatectomy with bile duct reconstruction was *** examination confirmed an intraepithelial neoplasia pattern without an invasive component and an R0 resection *** patient was monitored carefully by regular ***,at 32 mo after the operation,a 26 mm tumor in the lungs and a 12 mm lesion in the brain were detected following a suspicious elevated CA 19-9 ***-assisted thoracoscopic surgery of left upper lobectomy and stereotactic radiotherapy are *** addition to histopathological results,a genomic profiling analysis using whole exome sequencing subsequently confirmed lung metastasis originating from bile duct *** This case highlights the important role of genomic profiling analysis using whole exome sequencing in identifying the origin of metastasis in patients with IPNB.

关键词： Intraductal papillary neoplasm of the bile duct Distant metastasis Invasive component Whole exome sequencing CA 19-9 Case report

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Hydrogen Production Technologies Overview

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Journal of Power and Energy Engineering 2019年第1期7卷 107-154页

作者： Mostafa El-Shafie shinji Kambara Yukio Hayakawa Environmental and Renewable Energy Systems Division Gifu University Gifu City Japan

Hydrogen energy became the most significant energy as the current demand gradually starts to increase. Hydrogen energy is an important key solution to tackle the global temperature rise. The key important factor of hydrogen production is the hydrogen economy. Hydrogen production technologies are commercially available, while some of these technologies are still under development. This paper reviews the hydrogen production technologies from both fossil and non-fossil fuels such as (steam reforming, partial oxidation, auto thermal, pyrolysis, and plasma technology). Additionally, water electrolysis technology was reviewed. Water electrolysis can be combined with the renewable energy to get eco-friendly technology. Currently, the maximum hydrogen fuel productions were registered from the steam reforming, gasification, and partial oxidation technologies using fossil fuels. These technologies have different challenges such as the total energy consumption and carbon emissions to the environment are still too high. A novel non-fossil fuel method [ammonia NH3] for hydrogen production using plasma technology was reviewed. Ammonia decomposition using plasma technology without and with a catalyst to produce pure hydrogen was considered as compared case studies. It was showed that the efficiency of ammonia decomposition using the catalyst was higher than ammonia decomposition without the catalyst. The maximum hydrogen energy efficiency obtained from the developed ammonia decomposition system was 28.3% with a hydrogen purity of 99.99%. The development of ammonia decomposition processes is continues for hydrogen production, and it will likely become commercial and be used as a pure hydrogen energy source.

关键词： Hydrogen Technology Hydrogen Production Steam Reforming Plasma Ammonia Decomposition

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Pancreatic neuroendocrine tumor accompanied with multiple liver metastases

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World Journal of Hepatology 2014年第8期6卷 596-600页

作者： Tomohide Hori Kyoichi Takaori shinji Uemoto Department of Hepato-Pancreato-Biliary and Transplant Surgery Kyoto Uni-versity Hospital Kyoto 606-8507 Japan

Pancreatic neuroendocrine tumor(P-NET) is rare and slow-growing. Current classifications predict its progno-sis and postoperative recurrence. Curative resection is ideal, although often difficult, because over 80% of pa-tients have unresectable multiple liver metastases and extrahepatic metastasis. Aggressive surgery for liver metastases is important to improve survival. Aggressive or cytoreductive surgery for liver metastases is indi-cated to reduce hormone levels and improve symptoms and prognosis. Liver transplantation was originally con-ceived as an ideal therapy for unresectable liver metas-tases. Unfortunately, there is no clear consensus on the role and timing of surgery for primary tumor and liver metastases. Surgeons still face questions in deciding the best surgical scenario in patients with P-NET with unresectable liver metastases.

关键词： Gastroenteropancreatic neuroendocrine tumor Pancreas Liver metastasis Liver surgery Liver transplantation

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Semiconductor Optical Amplifier (SOA)-Fiber Ring Laser and Its Application to Stress Sensing

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Optics and Photonics Journal 2011年第4期1卷 167-171页

作者： Yoshitaka Takahashi shinji Sekiya Tatsuro Suemune 不详

We have developed a novel optical fiber ring laser using a semiconductor optical amplifier (SOA) as the gain medium, and taking advantage of polarization anisotropy of its gain. The frequency difference of the bi-directional laser is controlled by birefringence which is introduced in the ring laser cavity. The beat frequency generated by combining two counter-propagating oscillations is proportional to the birefringence, the fiber ring laser of the present study is, therefore, applicable to the fiber sensor. The sensing signal is obtained in a frequency domain with the material which causes the retardation change by a physical phenomenon to be measured. For the application to stress sensing, the present laser was investigated with a photoelastic material.

关键词： Fiber Laser Fiber Sensor Ring Laser Semiconductor Optical Amplifier Optical Sensor

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Development of Multi-Fingered Prosthetic Hand Using Shape Memory Alloy Type Artificial Muscle

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Computer Technology and Application 2012年第7期3卷 477-484页

作者： Jae Hoon Lee Shingo Okamoto shinji Matsubara Mechanical Engineering Course Graduate School of Science and Engineering Ehime University Matsuyama 790-8577 Japan Terumo Corporation Tokyo 151-0072 Japan

A new prosthetic hand with a fixed thumb and four fingers actuated by Shape Memory Alloy （SMA） type artificial muscle has been developed in this paper. Different from typical geared motor, SMA actuator is lightweight and silent, however shows a little short stroke and small attracting force per each unit. In order to achieve enough output force and motion range of each finger, multiple SMA type artificial muscles with special device which facilitates enough length are equipped in the hand. The fundamental properties of the SMA type artificial muscle including output force and electrical response were determined experimentally and considered for the design of hand mechanism. Besides, the structure of each finger and whole system has been designed based on observation of human hand. The electrical hardware to control multiple shape memory alloy type artificial muscles has been also developed. Finally, the usefulness of the prosthetic hand has been investigated through experiments for grasping several types of objects.

关键词： Prosthetic hand prosthetic finger shape memory alloy mechanism design grasping experiment.

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BACK ANALYSIS OF ASSESSING FOR SLOPE STABILITY BASED ON DISPLACEMENT MEASUREMENTS

BACK ANALYSIS OF ASSESSING FOR SLOPE STABILITY BASED ON DISP...

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复杂岩石中的建筑物国际学术讨论会

作者： Tatsutoshi KONDOH Masato shinji OYO Corporation Chief Engineer Director OYO Corporation Ichigaya Chiyoda-kuTokyoJAPAN EngineerPh.D

＜正＞This paper deals with the result of consideration and its reasonability about the mechanical model to examine the slope stability, applying the back analysis to the actual results of displacements,and the brief consideration concerning to some utilization of discontinuity characteristics of rocks by measuring techniques.

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Assessment of cardiac output in liver transplantation recipients

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Hepatobiliary & Pancreatic Diseases International 2008年第4期7卷 362-366页

作者： Tomohide Hori Chiduru Yamamoto Shintaro Yagi Taku Iida Kentaro Taniguchi Takashi Hasegawa Koichiro Yamakado Yukinobu Hori Kan Takeda Kazuo Maruyama shinji Uemoto Department of Hepato-Pancreato-Biliary Surgery and Transplantation Kyoto University Hospital54 Shogoinkawara- choSakyo-kuKyoto606-8507Japan Department of Hepatobiliary Pancreatic Surgery Mie University Hospital2-174 EdobashiTsu CityMie Prefecture514-8507 Japan Department of Anesthesiology and Critical Care Medicine Mie University Graduate School of Medicine2-174 EdobashiTsu CityMie Prefecture514-8507Japan Department of Radiology Mie University Graduate School of Medicine2-174 EdobashiTsu CityMie Prefecture514-8507Japan Nagoya Economic University Graduate School of Law 61-1 UchikuboInuyama City Aichi Prefecture 484-8504Japan

BACKGROUND:Liver cirrhosis causes peculiar systemic hemodynamics,and accurate evaluation of systemic hemodynamic state is important for cirrhotic recipients who underwent living donor liver transplantation(LDLT). We investigated the clinical advantages of a novel non- invasive method for measuring systemic hemodynamic parameters using indocyanine green(ICG). METHODS:Twenty-eight LDLT recipients were evaluated. Simultaneous measurements of cardiac output(CO)using Swan-Ganz catheters and pulse dye densitometry(PDD) were performed every 12 hours after LDLT.A total of 155 sets of simultaneous CO measurements were obtained. RESULTS:The CO values obtained by PDD correlated well with those obtained by the invasive catheter *** addition,none of the recipients developed any side-effects, and we verified the safety of repeated ICG *** is safe,even for repeated use over time in the same recipient. Moreover,PDD can measure the blood volume(BV).CONCLUSIONS:Since the cirrhotic systemic hemody- namics characterized by high CO and large BV remains, even after LDLT,the ability to measure CO and BV in a non-invasive,simple and real-time manner using PDD has advantages for cirrhotic LDLT recipients.

关键词： liver transplantation indocyanine green pulse dye densitometry blood volume cardiac output liver cirrhosis

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Switching of GnRH Agent from Agonist to Antagonist in Patients with Castration-Resistant Prostate Cancer

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Open Journal of Urology 2016年第12期6卷 190-198页

作者： shinji Fukui Yasushi Nakai Yoriaki Kagebayashi Shoji Samma Department of Urology Nara Prefecture General Medical Center Nara Japan

Objectives: To evaluate the efficacy of alteration from gonadotropin-releasing hormone (GnRH) agonist to antagonist in patients with castration-resistant prostate cancer (CRPC). Methods: Fourteen patients with CRPC were switched from GnRH agonist to GnRH antagonist. CRPC was defined as 3 consecutive rises of PSA values under androgen deprivation therapy despite a testosterone level at the castration level. No patient underwent a change in oral anti-androgen agent or any additional therapy. Patients who showed increase of the PSA value within 10% or showed decrease in the PSA value compared to the baseline were defined as responders. We measured serum PSA, testosterone, follicular stimulating hormone (FSH), and leutenizing hormone (LH) at the time of alteration and 3 months after alteration. Results: The mean age at diagnosis was 74.8 ± 6.3 years with a mean initial PSA level of 537.3 ± 999.1 ng/mL. The mean age at alteration to GnRH antagonist was 81.4 years with a mean PSA level of 28.6 ng/mL. Two out of 14 patients (14%) were judged as responders based on PSA after alteration to GnRH antagonist, although they did not show any further reduction of the serum testosterone level (remain less than 0.03). Six patients showed further reduction of the serum FSH level after alteration;however, they showed no PSA response (from 46.4 ± 42.6 to 69.4 ± 70.3). Conclusions: The switch from GnRH agonist to GnRH antagonist affected 14% of the patients (2 out of 14 patients) with CRPC at 3 months based on PSA. Larger and longer-term studies are required to determine the efficacy of alteration to GnRH antagonist in patients with CRPC.

关键词： CRPC GnRH Antagonist PSA FSH

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