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Recent traction methods for endoscopic submucosal dissection

World Journal of Gastroenterology 2016年第26期22卷 5917-5926页

作者： Kunihiro Tsuji Naohiro Yoshida Hiroyoshi Nakanishi kenichi takemura Shinya Yamada Hisashi Doyama Department of Gastroenterology Ishikawa Prefectural Central Hospital

Endoscopic mucosal resection(EMR) is problematic with regard to en bloc and curable resection *** in endoscopic techniques have enabled novel endoscopic approaches such as endoscopic submucosal dissection(ESD), which has overcome some EMR problems, and has become the standard treatment for gastrointestinal tumors. However, ESD is technically difficult. Procedure time is longer and complications such as intraoperative perforation and bleeding occur more frequently than in EMR. Recently various traction methods have been introduced to facilitate ESD procedures, such as clip with line, external forceps, clip and snare, internal traction, double scope, and magnetic anchor. Each method must be used appropriately according to the anatomical characteristics. In this review we discuss recently proposed traction methods for ESD based on the characteristics of various anatomical sites.

关键词： Endoscopic submucosal dissection Traction Pharyngeal cancer Esophageal cancer Gastric cancer Colorectal cancer

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The Zinc Story under High Pressure

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Journal of Minerals and Materials Characterization and Engineering 2019年第5期7卷 354-372页

作者： kenichi takemura Institute of Materials Structure Science (IMSS) High Energy Accelerator Research Organization (KEK) Tsukuba Japan

A historical review is presented on the experimental and theoretical studies on Zn under high pressure. Based on our high-pressure powder x-ray diffraction experiments that have been done for nearly a decade, we describe the structural change of Zn up to 126 GPa at room temperature. Although several experimental and theoretical studies indicated an anomalous change of the c/a axial ratio with pressure, we found no such an anomaly within our experimental uncertainty. Our high-pressure low-temperature experiments up to 18 GPa at 40 K also gave no evidence of the c/a anomaly. We suspect that the pressure-transmitting media played an important role in producing the anomaly. The structural anisotropy of Zn is drastically reduced at high pressures, which would be a general trend for hexagonal close-packed (hcp) metals.

关键词： Zinc High Pressure Crystal Structure Electronic Topological Transition

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Preoperative endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors, including magnifying endoscopy

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World Journal of Gastroenterology 2015年第41期21卷 11832-11841页

作者： Shigetsugu Tsuji Hisashi Doyama Kunihiro Tsuji Sho Tsuyama Kei Tominaga Naohiro Yoshida kenichi takemura Shinya Yamada Hideki Niwa Kazuyoshi Katayanagi Hiroshi Kurumaya Toshihide Okada Department of Gastroenterology Ishikawa Prefectural Central Hospital Kanazawa Department of Diagnostic Pathology Ishikawa Prefectural Central Hospital Kanazawa

Superficial non-ampullary duodenal epithelial tumor(SNADET) is defined as a sporadic tumor that is confined to the mucosa or submucosa that does not arise from Vater's papilla, and it includes adenoma a n d a d e n o c a r c i n o m a. R e c e n t d e v e l o p m e n t s i n endoscopic technology, such as high-resolution endoscopy and image-enhanced endoscopy, may increase the chances of detecting SNADET lesions. However, because SNADET is rare, little is known about its preoperative endoscopic diagnosis. The use of endoscopic resection for SNADET, which has no risk of metastasis, is increasing, but the incidence of complications, such as perforation, is significantly higher than in any other part of the digestive tract. A preoperative diagnosis is required to distinguish between lesions that should be followed up and those that require treatment. Retrospective studies have revealed certain endoscopic findings that suggest malignancy. In recent years, several new imaging modalities have been developed and explored for realtime diagnosis of these lesion types. Establishing an endoscopic diagnostic tool to differentiate between adenoma and adenocarcinoma in SNADET lesions is required to select the most appropriate treatment. This review describes the current state of knowledge about preoperative endoscopic diagnosis of SNADETs, such as duodenal adenoma and duodenal adenocarcinoma. Newer endoscopic techniques, including magnifying endoscopy, may help to guide these diagnostics, but their additional advantages remain unclear, and further studies are required to clarify these issues.

关键词： Endoscopy Duodenoscopy Duodenal neoplasms Narrow b

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Effectiveness of clip-and-snare method using pre-looping technique for gastric endoscopic submucosal dissection

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World Journal of Gastrointestinal Endoscopy 2016年第12期8卷 451-457页

作者： Naohiro Yoshida Hisashi Doyama Ryosuke Ota Yasuhito Takeda Hiroyoshi Nakanishi Kei Tominaga Shigetsugu Tsuji kenichi takemura Department of Gastroenterology Ishikawa Prefectural Central Hospital

AIM:To evaluate efficacy and safety of clip-and-snare method using pre-looping technique(CSM-PLT)for gastric endoscopic submucosal dissection(ESD).METHODS:In the CSM-PLT method,a clip attached to the lesion side was strangulated with a snare,followed by application of an appropriate tension to the lesion independent of an *** consecutive lesions were resected by ESD using CSM-PLT(CSM-PLT group)and compared with a control group,including20 lesions that were resected by conventional *** control group was matched based on the size and location of the lesion,presence of pathologic fibrosis,and experience of *** procedure time of ESD,proportion of en bloc resection,and complications were ***:The total procedure time for the CSM-PLT group was significantly shorter than that for the control group(38.5 min vs 59.5 min,P=0.023);all lesions were resected en bloc by *** was no significant difference in complications between the two ***,there was no complication in the CSM-PLT *** one large lesion(size:74 mm)that underwentextensive CSM-PLT during ESD,we used an additional CSM-PLT on another edge of the lesion after achieving submucosal resection to the maximum extent possible during initial *** two lesions,the snare came off the lesion together with the clip after a sudden pull;nevertheless,ESD was successful in all ***:CSM-PLT was an effective and safe method for gastric ESD.

关键词： Endoscopic submucosal dissection Clipand-snare method Pre-looping technique Endoscope Dissection

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