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Spontaneous necrosis of solid gallbladder adenocarcinoma accompanied with pancreaticobiliary maljunction

World Journal of Gastroenterology 2008年第38期14卷 5933-5937页

作者： Tomohide Hori Takashi Wagata Kenji takemoto Takanobu Shigeta Haruko Takuwa Koichiro Hata Shinji Uemoto Naoki Yokoo Department of Surgery Takayama Red Cross Hospital 3-11 Tenman-cho Takayama City Gifu Prefecture 506-8550 Japan Department of Hepato-pancreato-biliary and Transplant Surgery Kyoto University Hospital 54 Shogoinkawara-cho Sakyo-ku Kyoto 606-8507 Japan

A 71-year-old Japanese man with acute cholecystitis and an incarcerated gallbladder （GB） stone was admitted. Plain ultrasonography （US） incidentally detected a mass-like lesion in the fundus. Doppler US revealed that this elevated lesion had no blood flow. Computed tomography showed a relatively low-density mass, measuring 5 cm x 4 cm in diameter, with no positive enhancement. Magnetic resonance imaging showed a mass in the fundus with a slightly low intensity on Tl-weighted images and a slightly high intensity on T2-weighted images. We were agonized in making the qualitative diagnosis of mass-like lesions of the fundus, such as a benign tumor, cancer, or debris. We performed laparoscopic cholecystectomy, because the incarcerated GB stone clearly caused acute cholecystitis. Intra-operative cholangiography clearly revealed pancreaticobiliary maljunction. Amylase levels in the common bile duct and gallbladder were quite high. The elevated lesion in the fundus dearly showed severe necrosis. Although this necrotic nodule included non-viable adenocarcinoma cells, viable cancer cell nests were located in the muscularis propria and subcutaneous layer. Histopathological examination confirmed a solid adenocarcinoma. Thus, we diagnosed it as a gallbladder cancer, based on histopathological analysis of the resected specimen. We therefore undertook radical surgery, including wedge resection of the liver, radical dissection of regional lymph nodes, and resection of the extrahepatic bile duct. Histopathological findings revealed no cancer, hyperplasia or dysplasia in the additionally resected specimens. The patient was finally staged as T2, N0, H0, P0, M（-）, stage Ⅱ. We present the first case of spontaneous necrosis of solid gallbladder adenocarcinoma, with a review of previous studies.

关键词： Gallbladder carcinoma Pancreaticobiliary maljunction Spontaneous necrosis

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Isolated neutropenia caused by copper deficiency due to jejunal feeding and excessive zinc intake:A case report

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World Journal of Clinical Cases 2021年第29期9卷 8825-8830页

作者： Hiromitsu Ohmori Hiroko Kodama Masahiko takemoto Masami Yamasaki Tomio Matsumoto Masao Kumode Takafumi Miyachi Ryo Sumimoto Department of Pediatrics National Hospital Organization Yanai Medical CenterYanai 742-1352YamaguchiJapan Doctoral Program in Health and Dietetics Graduate School of Health SciencesTeikyo Heisei UniversityToshima-ku 170-8445TokyoJapan Department of Surgery National Hospital Organization Yanai Medical CenterYanai 742-1352YamaguchiJapan Department of Neurology National Hospital Organization Yanai Medical CenterYanai 742-1352YamaguchiJapan Department of Pediatrics Biwako Gakuen Kusatsu Medical and Welfare Center for Children and Persons with Severe Motor and Intellectual DisabilitiesKusatsu 525-0034ShigaJapan

BACKGROUND Percutaneous endoscopic gastrostomy with jejunal extension(PEG-J)is often used to treat patients with neurological impairment and difficulty in ***,these patients often develop copper *** report describes a case of isolated neutropenia,which is a rare manifestation of copper *** SUMMARY Our patient was a 19-year-old boy with neurological impairment and gastroesophageal *** received PEG-J feeding,including an enteral supplement containing copper and ***,as his serum zinc level was low(53μg/dL)at the age of 19 years and 2 mo,we changed to a zinc-rich supplement containing 22 mg/d of zinc and 1.0 mg/d of *** supplement comprised a mixture of isocal 1.0 junior(5 packs/d),Tezon[2 packs(250 mL)/d],and cocoa *** months later,he had neutropenia(606/mm^(3))with a serum copper level of 16μg/*** were no other manifestations of copper deficiency,including *** deficiency and neutropenia both improved following the administration of cocoa powder and *** In patients receiving long-term PEG-J feeds,white blood cell counts,hemoglobin,and serum levels of copper and zinc should be regularly monitored.

关键词： Percutaneous endoscopic gastrostomy with jejunal extension feeding Neutropenia Copper Zinc Deficiency Case report

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Vacuum Insulation and Achievement of 980 keV,185 A/m^2 H-Ion Beam Acceleration at JAEA for the ITER Neutral Beam Injector

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Plasma Science and Technology 2013年第2期15卷 179-183页

作者： Hiroyuki TOBARI Masaki TANIGUCHI Mieko KASHIWAGI Masayuki DAIRAKU Naotaka UMEDA Haruhiko YAMANAKA Kazuki TSUCHIDA Jumpei takemoto Kazuhiro WATANABE Takashi INOUE Keishi SAKAMOTO Japan Atomic Energy Agency (JAEA) Mukouyama 801-1 Naka Ibaraki 311-1093 Japan

Abstract Vacuum insulation of -1 MV is a common issue for the HV bushing and the accel- erator for the ITER neutral beam injector （NBI）. The HV bushing as an insulating feedthrough has a five-stage structure and each stage consists of double-layered insulators. To sustain -1 MV in vacuum, reduction of electric field at several triple points existing around the double-layered insulators is a critical issue. To reduce electric field simultaneously at these points, three types of stress ring have been developed. In a voltage holding test of a full-scale mockup equipped with these stress rings, 120% of rated voltage was sustained and the voltage holding capability required in ITER was verified. In the MeV accelerator, whose target is the acceleration of a H- ion beam of 1 MeV, 200 A/mS, the gap between the grid support was extended to suppress breakdowns triggered by electric field concentration at the edge and corner of the grid support. This modi- fication improved the voltage holding capability in vacuum, and the MeV accelerator succeeded in sustaining -1 MV stably, b-~rthermore, it appeared that the H- ions beam was deflected and a part of the beam was intercepted at the acceleration grid, This causes high heat load on the grids and breakdowns during beam acceleration. To suppress the direct interception, a new grid was designed with proper aperture displacement based on a three dimensional beam trajectory analysis, As a result, 980 keV, 185 A/ms H- ion beam acceleration has been demonstrated, which is close to the ITER requirement.

关键词： neutral beam injector (NBI) negative ion beam HV bushing vacuum insu-lation

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The Recent Trend in Environmentally Conscious Electronics Assembly

The Recent Trend in Environmentally Conscious Electronics As...

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第十次全国焊接会议

作者： Tadashi takemoto Collaborative Research Center for Advanced Science and Technology Osaka University

＜正＞ The environmentally conscious manufacturing technology is important to keep the sustainable development. In electronic packaging, the lead-free micro-soldering technology has been widely developed as one of the environmentally conscious process. The progress and the recent situation in lead-free solders and soldering has been reviewed under consideration of regulation of the use of lead. The progress of : the solder development, activities of national project, major alloy systems and their characteristics were indicated. Many national projects recommended the use of Sn-Ag-Cu system, however the compositions are slightly different. The standardization of lead-free solder and the test methods for evaluation of leas-free solder was started. Japan is one of the most advanced countries in producing lead-free solder products now.

关键词： Lead-free solder Micro-soldering Environmentally conscious assembly

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Phosphorus Transfer in the Ash through Acid or AlkaliExtraction Processes

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材料科学与工程（中英文A版） 2020年第1期10卷 24-29页

作者： Masaaki Takahashi Yukimasa takemoto Eiji Yuki Yokkaichi University Research Laboratory on Environmental TechnologyKayo-cho 1200YokkaichiMieJapan Mie Chuo Kaihatsu Co. LtdHachiya 4713YonoIgaMie 518-1152Japan

In order to find the best method of the phosphorus recovery, some kinds of the phosphorus recovery methods were applied using the same raw material. The acid treatment shows the highest recovery performance, on the contrary, the alkali treatment indicates the lowest recovery rate. The recovery rate was improved by the application of the heat treatment or hydrothermal method. In the acid treatment, the recovered phosphorus is mainly composed of aluminum phosphate, conversely, in alkali treatment, recovered phosphorus was mainly composed of sodium phosphate containing a small amount of aluminum. But the aluminum content in the phosphorus decreased by introduction of the heat treatment or hydrothermal method.

关键词： Phosphorus recovery rate sewage sludge extraction method.

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Estimating Emotion for Each Personality by Analyzing BVP

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Journal of Mechanics Engineering and Automation 2018年第2期8卷 92-102页

作者： Emi takemoto Yusuke Kajiwara Hiromitsu Shimakawa Graduate School of Information Science and Engineering Ritsumeikan University Kusatsu 525-0059 Japan Faculty of Production Systems Engineering and Sciences Komatsu University Komatsu 923-0921 Japan College of Information Science and Engineering Ritsumeikan University Kusatsu 525-0059 Japan

This research estimates emotions of university students from their BVP （blood volume pulse）. Negative emotion of university students causes school dropout, which is becoming a serious problem in Japan. It is indispensable for school staffs and counselors to know when and where students have negative emotion in the campus. Since BVP signals along with emotion changes vary with personality types, we build a model dependent on personality type, to estimate student emotion from characteristics of blood volume signals. Experimental results show that the model for each personality type improves the accuracy of emotion estimation for new students. Positive or negative emotion estimated from BVP signals contributes to enhancement of campus environment by school counselors.

关键词： Emotion school dropout BVP personality Big Five.

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COST REDUCTION THROUGH APPLICATION OF ADVANCED TECHNOLOGY

COST REDUCTION THROUGH APPLICATION OF ADVANCED TECHNOLOGY

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1985北京国际水泥及混凝土学术会议

作者： Kunihiro takemoto Yoshiharu Fukuda Executive Senior Managing Director Onoda Cement Co. Ltd.TokyoJapan Dr.Eng. General Manager of Business Development Division Onoda Engineering and Consulting Co.Ltd.TokyoJapan Director

There are two different ways of reducing production cost. One is the efficiency improvement of existing plant with minor modifications, when necessary, based on thorough diagnosis of existing operation. Another way is modernization of the plant by replacing of operating equipment to a equipment with much higher efficiency. The former way is sometimes more economical under certain limited conditions even though the attainable effectiveness may be less than the latter way. In this article, results of application of advanced technology developed by Onoda Cement Co., are described. Coal firing, especially low grade coal firing Is a matter of great interest to cement producer. Onoda Cement had conducted operation to clarify the effect in changing heat value of coal for four levels from 6,700 kcal/kg coal to 4,500 kcal/kg coal by using a 1,700 t/d RSP kiln in Onoda Works. It was confirmed that operation was very smooth and satisfactorily high quality clinker was produced in each level abovementioned under similar production and heat consumption. The use of low volatile matter coal as well as the use of waste fuel have contributed to cost reduction. Cement producers in many countries are now focussing their interest towards the roller mill for finish grinding as a powerful tool for power savings. Further to the development of high efficiency air separator O-SEPA, Onoda Cement has developed a roller mill named OK roller mill for finish grinding. It consumes about 20?0% less power for normal portland cement grinding than modern ball mill system in addition to about 30% lower maintenance cost. As the results of her energy saving efforts, Onoda has achieved about 20% reduction of energy per ton of cement during the past five years.

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Potassium Phosphate Recovery from Incinerated Ash of Sewage Sludge

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材料科学与工程（中英文B版） 2017年第4期7卷 149-154页

作者： Masaaki Takahashi Yukimasa takemoto Eiji Yuki Koichi Seno Faculty of Environmental and Information Science Yokkaichi University Yokkaichi 512-8512 Japan Mie Chuo Kaihatsu Co. Ltd Hachiya 4713 Iga Mie 518-1152 Japan

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Clinical differentiation of acute appendicitis and right colonic diverticulitis: A case-control study

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World Journal of Clinical Cases 2019年第12期7卷 1393-1402页

作者： Yosuke Sasaki Fumiya Komatsu Naoyasu Kashima Takahiro Sato Ikutaka takemoto Sho Kijima Tadashi Maeda Takamasa Ishii Taito Miyazaki Yoshiko Honda Nagato Shimada Yoshihisa Urita Department of General Medicine and Emergency Care Toho University School of Medicine

BACKGROUND Acute right colonic diverticulitis (ARCD) is an important differential diagnosis of acute appendicitis (AA) in Asian countries because of the unusually high prevalence of right colonic diverticula. Due to qualitative improvement and the high penetration rate of computed tomography (CT) scanning in Japan, differentiation of ARCD and AA mainly depends on this modality. But cost, limited availability, and concern for radiation exposure make CT scanning problematic. Differential findings of ARCD from AA are based on several small studies that used univariate comparisons from Korea and Taiwan. Previous studies on clinical and laboratory differences between AA and ARCD are limited. AIM To determine clinical differences between AA and ARCD for differentiation of these two diagnoses by creating a logistic regression model. METHODS We performed an exploratory single-center retrospective case-control study evaluating 369 Japanese patients (age ≥ 16 years), 236 (64.0%) with AA and 133 (36.0%) with ARCD, who were hospitalized between 2012 and 2016. Diagnoses were confirmed by CT images. We compared age, sex, onset-to-visit interval, epigastric/periumbilical pain, right lower quadrant (RLQ) pain, nausea/vomiting, diarrhea, anorexia, medical history, body temperature, blood pressure, heart rate, RLQ tenderness, peritoneal signs, leukocyte count, and levels of serum creatinine, serum C-reactive protein (CRP), and serum alanine aminotrans-ferase. We subsequently performed logistic regression analysis for differentiating AA from ARCD based on the results of the univariate *** In the AA and ARCD groups, median ages were 35.5 and 41.0 years, respectively (p=0.011);median onset-to-visit intervals were 1 [interquartile range (IQR): 0-1] and 2 (IQR: 1-3) days, respectively (P < 0.001);median leukocyte counts were 12600 and 11500/mm3, respectively (P = 0.002);and median CRP levels were 1.1 (IQR: 0.2-4.1) and 4.9 (IQR: 2.9-8.5) mg/dL, respectively (P < 0.001). In th

关键词： Abdominal pain Acute abdomen Appendicitis Clinical difference Creactive protein Diverticulitis Right lower quadrant pain

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A Combination of Endoscopic CO<sub>2</sub>Laser Microsurgery and Radiotherapy for Treatment of T2N0M0 Glottic Carcinoma

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International Journal of Otolaryngology and Head & Neck Surgery 2012年第2期1卷 28-33页

作者： Motohiro Sawatsubashi Toshiro Umezaki takemoto Shin Shizuo Komune Department of Otolaryngology-Head and Neck Surgery Graduate School of Medical Sciences Kyushu University Fukuoka Japan Saga Medical School Saga Japan

The aims of this study were to evaluate the results of CO2 laser surgery alone and CO2 laser surgery combined with radiotherapy in patients with T2N0M0 glottic carcinoma. A retrospective analysis was conducted of 35 cases of T2N0M0 glottic carcinoma. Fourteen patients with normal vocal cord mobility were treated with endoscopic CO2 laser surgery alone. The remaining 21 patients were treated with CO2 laser surgery followed by radiotherapy (44 - 70 Gy, including low-dose carboplatin chemoradiotherapy). Main outcome measures were local control, organ preservation, recurrence, 5-year survival, and successful salvage in cases of recurrence. We evaluated the patient’s voice with the psychoacoustics GRBAS scale, maximum phonation time (MPT), and airflow rate (AFR) obtained by aerodynamic tests. Mean follow-up period was 5 years. Among the 35 T2N0M0 patients, 5-year survival and 5-year voice preservation rates were 97% and 89%, respectively. Local recurrence occurred in 7 of these patients (20%);4 of 7 local recurrences were successfully re-treated by laser surgery. Total laryngectomy was necessary for salvage treatment in the remaining 3 patients. The post-treatment voice qualities were judged to be the same or improved over pretreatment qualities. There was little change in MPT and AFR after treatment in non-recurrence patients. CO2 laser microsurgery is an excellent tool for treating selected cases of T2N0M0

关键词： T2 Glottic Carcinoma Laryngeal Cancer Endoscopic Laser Surgery Chemoradiotherapy

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