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An international expert consensus of management of recurrent hepatocellular carcinoma: a viewpoint

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Hepatobiliary Surgery and Nutrition 2020年第3期9卷 394-396页

作者： Kuniya Tanaka yuki Takahashi Tetsuji Wakabayashi Department of Gastroenterological and General Surgery Showa University Fujigaoka HospitalYokohamaJapan

We read with great interest the article titled "Multidisciplinary management of recurrent and metastatic hepatocellular carcinoma after resection: an international expert consensus" (1) published in Hepato Biliary Sur... 详细信息

关键词： Surgery hepatocellular carcinoma

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后疫情时代如何重新定位护理专业

英国医学杂志中文版 2022年第3期25卷 128-132页

作者： Howard Catton Elizabeth iro 田策(译) 王乾贝(校) International Council of Nurses GenevaSwitzerland World Health Organization GenevaSwitzerland 中国医学科学院北乐协和医院

这场疫情大流行揭示了为全球健康和经济保障而投资护理的必要性。Howard Catton和Elizabeth iro概述了护理专业应该如何转型才能最大限度地提高其对患者照护和结局的影响。

关键词：护理专业全球健康疫情最大限度重新定位照护

Crucial anatomy and technical cues for laparoscopic transabdominal preperitoneal repair: Advanced manipulation for groin hernias in adults

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World Journal of Gastrointestinal Surgery 2020年第7期12卷 307-325页

作者： Daiki Yasukawa yuki Aisu Tomohide Hori Department of Surgery Shiga University of Medical ScienceOtsu 520-2192Japan Department of Surgery Kyoto University Graduate School of MedicineKyoto 606-8507Japan

Groin hernias include indirect inguinal, direct inguinal, and femoral hernias. Obturator and supravesical hernias appear very close to the groin. High-quality repairs are required for groin hernias. The concept of "tension-free repair" is generally accepted, and surgical repairs with mesh are categorized as "hernioplasties". Surgeons should have good knowledge of the relevant anatomy. Physicians generally focus on the preperitoneal space, myopectineal orifice, topographic nerves, and regional vessels. Currently, laparoscopic surgery has therapeutic potential in the surgical setting for hernioplasty, with laparoscopic transabdominal preperitoneal(TAPP) repair appearing to be a powerful tool for use in adult hernia patients. TAPP offers the advantages of accurate diagnoses, repair of bilateral and recurrent hernias, less postoperative pain, early recovery allowing work and activities, tension-free repair of the preperitoneal(posterior) space, ability to cover obturator hernias, and avoidance of potential injury to the spermatic cord. The disadvantages of TAPP are the need for general anesthesia, adhering to a learning curve, higher cost, unexpected complications related to abdominal organs, adhesion to the mesh, unexpected injuries to vessels, prolonged operative time, and as-yet-unknown long-term outcomes. Both technical skill and anatomical familiarity are important for safe, reliable surgery. With increasing awareness of the importance of anatomy during TAPP repair, we address the skills and pitfalls during laparoscopic TAPP repair in adult patients using illustrations and schemas. We also address debatable points on this subject.

关键词： Inguinal hernia Femoral hernia Obturator hernia Laparoscopic surgery Laparoscope Anatomy

Current clinical management of gastrointestinal stromal tumor

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World Journal of Gastroenterology 2018年第26期24卷 2806-2817页

作者： Kazuya Akahoshi Masafumi Oya Tadashi Koga yuki Shiratsuchi Department of Gastroenterology Aso Iizuka Hospital Department of Pathology Aso Iizuka Hospital Department of Surgery Aso Iizuka Hospital

Gastrointestinal stromal tumors(GISTs) are the most common malignant subepithelial lesions(SELs) of the gastrointestinal tract. They originate from the interstitial cells of Cajal located within the muscle layer and are characterized by over-expression of the tyrosine kinase receptor KIT. Pathologically, diagnosis of a GIST relies on morphology and immunohistochemistry [KIT and/or discovered on gastrointestinal stromal tumor 1(DOG1) is generally positive]. The prognosis of this disease is associated with the tumor size and mitotic index. The standard treatment of a GIST without metastasis is surgical resection. A GIST with metastasis is usually only treated by tyrosine kinase inhibitors without radical cure; thus, early diagnosis is the only way to improve its prognosis. However, a GIST is usually detected as a SEL during endoscopy, and many benign and malignant conditions may manifest as SELs. Conventional endoscopic biopsy is difficult for tumors without ulceration. Most SELs have therefore been managed without a histological diagnosis. However, a favorable prognosis of a GIST is associated with early histological diagnosis and R0 resection. Endoscopic ultrasonography(EUS) and EUS-guided fine needle aspiration(EUSFNA) are critical for an accurate diagnosis of SELs. EUSFNA is safe and effective in enabling an early histological diagnosis and adequate treatment. This review outlines the current evidence for the diagnosis and management of GISTs, with an emphasis on early management of small SELs.

关键词： Gastrointestinal stromal tumor Endoscopic ultrasonography-guided fine needle aspiration Endoscopic ultrasonography Diagnosis Therapy

Influence of Additive Gas on Electrical and Optical Characteristics of Non-equilibrium Atmospheric Pressure Argon Plasma Jet

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Plasma Science and Technology 2011年第5期13卷 575-582页

作者：费小猛 Shin-ichi KURODA yuki KONDO Tamio MORI Katsuhiko HOSOI Department of Advanced Production Science and Technology Graduate School of EngineeringGunma University Cresur Corporation

Electrical and optical properties of an argon plasma jet were characterized. In particular, effects of an additive gas, namely nitrogen or oxygen, on these properties were studied in detail. The plasma jet was found to be of a glow-like discharge, which scarcely changed upon the injection of an additive gas, either directly or through a glass capillary. Optical emission spectroscopy characterization revealed that excited argon atoms were the predominant active species in this plasma jet. Metastable argon atoms were highly quenched, and N2（C3yIu） became the main energy carrier following nitrogen injection. When oxygen was added to the afterglow zone through a glass capillary, no significant quenching effect was observed and the number of oxygen atoms decreased with the increase in oxygen concentration. Finally, to demonstrate an application of this plasma jet, a high-density polyethylene surface was treated with argon, argon/nitrogen, and argon/oxygen plasmas.

关键词： atmospheric pressure Ar plasma jet additive gas discharge optical emission spectroscopy

Comparison of decompression tubes with metallic stents for the management of right-sided malignant colonic obstruction

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World Journal of Gastroenterology 2019年第16期25卷 1975-1985页

作者： Yoshiyuki Suzuki Konosuke Moritani yuki Seo Takayuki Takahashi Department of Surgery Ashikaga Red Cross HospitalTochigi 326-0843Japan

BACKGROUND Emergency surgical resection is a standard treatment for right-sided malignant colonic obstruction; however, the procedure is associated with high rates of mortality and morbidity. Although a bridge to surgery can be created to obviate the need for emergency surgery, its effects on long-term outcomes and the most practical management strategies for right-sided malignant colonic obstruction remain *** To determine the appropriate management approach for right-sided malignant colonic *** Forty patients with right-sided malignant colonic obstruction who underwent curative resection from January 2007 to April 2017 were included in the *** compared the perioperative and long-term outcomes of patients who received bridges to surgery established using decompression tubes and those created using self-expandable metallic stents(SEMS). The primary outcome was the overall survival duration(OS) and the secondary endpoints were the diseasefree survival(DFS) duration and the preoperative and postoperative morbidity rates. Analysis was performed on an intention-to-treat *** There were 21 patients in the decompression tube group and 19 in the SEMS group. There were no significant differences in the perioperative morbidity rates of the two groups. The OS rate was significantly higher in the decompression tube group than in the SEMS group(5-year OS rate; decompression tube 79.5%,SEMS 32%, P = 0.043). Multivariate analysis revealed that the bridge to surgery using a decompression tube was significantly associated with the OS(hazard ratio, 17.41; P = 0.004). The 3-year DFS rate was significantly higher in thedecompression tube group than in the SEMS group(68.9% vs 45.9%; log-rank test,P = 0.032). A propensity score–adjusted analysis also demonstrated that the prognosis was significantly better in the decompression tube group than in the SEMS *** The bridge to surgery using trans-nasal and trans-anal decompression tubes for

关键词： Right-sided colon cancer Large bowel obstruction Self-expandable metallic stent Trans-anal tube Trans-nasal tube

Exploration behavior of group-in-a-box layouts

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Visual Informatics 2019年第1期3卷 38-47页

作者： yuki Ueno Hiroaki Natsukawa Nozomi Aoyama Koji Koyamada Department of Electrical Engineering Kyoto UniversityKyotoJapan Academic Center for Computing and Media Studies Kyoto UniversityKyotoJapan

To improve visualization,it is necessary to optimize the design by analyzing the behavior of users as well as improving the evaluation index of the computational experiment and the task performance(e.g.,the correct answer rate and completion time)in the user *** various studies have investigated the influence of user behavior on the evaluation of visualization,majority of these studies focused on simple visualization tasks.A simple task does not indicate a simple visualization comprising a few visualization elements but a task in which the information obtained from visualization is the only clue for completing the ***,a few studies have targeted complicated tasks in which multiple information obtained from visualization is considered to be a clue for completing the task regardless of the number of elements that are contained in the ***,in this study,we investigated the behavior of the participants who have performed complicated *** selected two types of group-in-a-box(GIB)layouts,which can be considered to be a complicated visualization method,as the target of the user *** the user experiment,participants were asked to perform an exploration task specific to GIB layouts;which group has the maximum number of intra-edges?We also collected the eye-tracking data in addition to task *** results showed that the correct answer rate is considerably affected by the visualization factor;whether the correct answer,the box with maximum number of intra-edges,is the box with the largest ***,an analysis of the collected eye-tracking data revealed that this visualization factor affected the exploration behavior of the participants;however,it did not affect the location at which the participants were focused *** obtained results indicated that the visualization elements that were not considered by the visualization designer can influence the task of extracting information from the ***

关键词： Visual search Eye-tracking Group-in-a-box layout

Transferring pose and augmenting background for deep humanimage parsing and its applications

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Computational Visual Media 2018年第1期4卷 43-54页

作者： Takazumi Kikuchi yuki Endo Yoshihiro Kanamori Taisuke Hashimoto Jun Mitani University of Tsukuba 1-1-1 TennohdaiTsukuba CityIbarakiJapan

Parsing of human images is a fundamental task for determining semantic parts such as the face,arms, and legs, as well as a hat or a dress. Recent deep-learning-based methods have achieved significant improvements, but collecting training datasets with pixel-wise annotations is labor-intensive. In this paper,we propose two solutions to cope with limited ***, to handle various poses, we incorporate a pose estimation network into an end-to-end humanimage parsing network, in order to transfer common features across the domains. The pose estimation network can be trained using rich datasets and can feed valuable features to the human-image parsing network. Secondly, to handle complicated backgrounds,we increase the variation in image backgrounds automatically by replacing the original backgrounds of human images with others obtained from large-scale scenery image datasets. Individually, each solution is versatile and beneficial to human-image parsing, while their combination yields further improvement. We demonstrate the effectiveness of our approach through comparisons and various applications such as garment recoloring, garment texture transfer, and visualization for fashion analysis.

关键词： image segmentation semantic segmentation human-image parsing deep convolutional neural network

Laparoscopic and endoscopic cooperative surgery for gastric tumors: Perspective for actual practice and oncological benefits

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World Journal of Gastrointestinal Oncology 2018年第11期10卷 381-397页

作者： yuki Aisu Daiki Yasukawa Yusuke Kimura Tomohide Hori Department of Digestive Surgery Tenri Hospital Department of Surgery Shiga University of Medical Science Department of Hepato-Biliary-Pancreatic Surgery and Transplantation Graduate School of Medicine Kyoto University Department of Surgery Shiga General Hospital

Laparoscopic and endoscopic cooperative surgery(LECS) is a surgical technique that combines laparoscopic partial gastrectomy and endoscopic submucosal dissection. LECS requires close collaboration between skilled laparoscopic surgeons and experienced endoscopists. For successful LECS, experience alone is not sufficient. Instead, familiarity with the characteristics of both laparoscopic surgery and endoscopic intervention is necessary to overcome various technical problems. LECS was developed mainly as a treatment for gastric submucosal tumors without epithelial lesions, including gastrointestinal stromal tumors(GISTs). Local gastric wall dissection without lymphadenectomy is adequate for the treatment of gastric GISTs. Compared with conventional simple wedge resection with a linear stapler, LECS can provide both optimal surgical margins and oncological benefit that result in functional preservation of the residual stomach. As technical characteristics, however, classic LECS involves intentional opening of the gastric wall, resulting in a risk of tumor dissemination with contamination by gastric juice. Therefore, several modified LECS techniques have been developed to av-oid even subtle tumor exposure. Furthermore, LECS for early gastric cancer has been attempted according tothe concept of sentinel lymph node dissection. LECS is a prospective treatment for GISTs and might become a future therapeutic option even for early gastric cancer. Interventional endoscopists and laparoscopic surgeons collaboratively explore curative resection. Simultaneous intraluminal approach with endoscopy allows surgeons to optimizes the resection area. LECS, not simple wedge resection, achieves minimally invasive treatment and allows for oncologically precise resection. We herein present detailed tips and pitfalls of LECS and discuss various technical considerations.

关键词： Minimally invasive surgery Laparoscopic and endoscopic cooperative surgery Facility-based Gastrointestinal stromal tumor Early gastric cancer