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endoscopic submucosal dissection of a rectal carcinoid tumor using grasping type scissors forceps

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World Journal of Gastroenterology 2009年第17期15卷 2162-2165页

作者： Kazuya Akahoshi Yasuaki Motomura Masaru Kubokawa Noriaki Matsui Manami Oda Risa Okamoto Shingo endo Naomi Higuchi Yumi Kashiwabara Masafumi Oya Hidefumi Akahane Haruo Akiba Department of Gastroenterology Aso Iizuka Hospital Iizuka 820-8505 Japan Department of Pathology Aso Iizuka Hospital Iizuka 820-8505 Japan Fujifilm Corporation Saitama 331-9624 Japan

endoscopic submucosal dissection （ESD） with a knife is a technically demanding procedure a ssociated with ahigh complication rate. The shortcomings of this meth-od are the inability to fix the knife to the target lesion,and compression of the lesion. These can lead to major complications such as perforation and bleeding. To reduce the risk of complications related to ESD, we developed a new grasping type scissors forceps （GSF）,which can grasp and incise the targeted tissue using electrosurgical current. Colonoscopy on a 55-year-old woman revealed a 10-ram rectal submucosal *** histological diagnosis of the specimen obtained by biopsy was carcinoid tumor. endoscopic ultrasonog-raphy demonstrated a hypoechoic solid tumor limitedto the submucosa without lymph node involvement. Itwas safely and accurately resected without unexpectedincision by ESD using a GSF. No delayed hemorrhage or perforation occurred. Histological examination confirmed the carcinoid tumor was completely excisedwith negative resection margin.

关键词： endoscopic submucosal dissection New device Rectal carcinoid Grasping type scissors forceps endoscopic therapy

Safety advantage of endocut mode over endoscopic sphincterotomy for choledocholithiasis

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World Journal of Gastroenterology 2006年第13期12卷 2086-2088页

作者： Hirotada Akiho Yorinobu Sumida Kazuya Akahoshi Atsuhiko Murata Jiro Ouchi Yasuaki Motomura Taisuke Toyomasu Mitsuhide Kimura Masaru Kubokawa Masahiro Matsumoto Shingo endo Kazuhiko Nakamura Division of Gastroenterology Aso Iizuka Hospital JapanDepartment of Medicine and Bioregulatory ScienceGraduate School of Medical SciencesKyushu UniversityJapan Division of Gastroenterology Aso Iizuka Hospital Japan Division of Surgery Aso Iizuka Hospital Japan Division of Qastroenterology Aso Iizuka Hospital Japan Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu UniversityJapan

AIM： To evaluate whether an automatically controlled cut system （endocut mode） could reduce the complication rate of endoscopic sphincterotomy （EST） and serum hyperamylasemia after EST compared to the conventional blended cut mode. METHODS： From January 2001 to October 2003, 134 patients with choledocholithiasis were assigned to either endocut mode group or conventional blended cut mode group at the time of sphincterotomy. The two groups were retrospectively compared for the complications after EST and serum amylase level before and 24 h after the procedure. RESULTS： Of the 134 patients treated, 79 were assigned to conventional blended cut mode group and 55 to endocut mode group. There was no significant difference in age, sex, and serum amylase level before EST between the two groups. Complications were found in 5 patients of the endocut mode group （9%）： hyperamylasemia （5 times higher than normal） in 4 and moderate pancreatitis in 1. Complications were found in 13 patients of the conventional blended cut mode group （16%）： hyperamylasemia in 12 and moderate pancreatitis in 1. Serum amylase levels were elevated in both groups 24 h after EST （P〈0.02）. The average serum amylase level 24 h after EST in the conventional blended cut mode group was significantly higher than that in the endocut mode group （P〈 0.05）. CONCLUSION： endocut mode offers a safety advantage over conventional blended cut mode for pancreatitis after EST by reducing hyperamylasemia.

关键词： endocut mode endoscopic sphincterotomy Choledocholithiasis

Narrow pelvic inlet plane area and obesity as risk factors for anastomotic leakage after intersphincteric resection

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World Journal of Gastrointestinal Surgery 2020年第10期12卷 425-434页

作者： Akira Toyoshima Toshihiro Nishizawa Eiji Sunami Ryuji Akai Takahiro Amano Akiyoshi Yamashita Shin Sasaki Takeshi endo Yoshihiro Moriya Osamu Toyoshima Department of Colorectal Surgery Japanese Red Cross Medical CenterTokyo 150-8935Japan Department of Gastroenterology International University of Health and WelfareNarita HospitalNarita 286-8520Japan Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Surgery The University of KyorinTokyo 113-8655Japan Department of Radiology Japanese Red Cross Medical CenterTokyo 150-8935Japan Tokyo Midtown Clinic Tokyo 107-6206Japan Miki Hospital Iwate 029-4201Japan

BACKGROUND Intersphincteric resection(ISR)has been increasingly used as the ultimate sphincter-preserving procedure in extremely low rectal *** most critical complication of this technique is anastomotic *** incidence rate of anastomotic leakage after ISR has been reported to range from 5.1%to 20%.AIM To investigate risk factors for anastomotic leakage after ISR based on clinicopathological variables and *** This study was conducted at Department of Colorectal Surgery,Japanese Red Cross Medical Center,Tokyo,Japan,with a total of 117 *** enrolled 117 patients with extremely low rectal cancer who underwent laparotomic and laparoscopic ISRs at our *** conducted retrospective univariate and multivariate regression analyses on 33 items to elucidate the risk factors for anastomotic leakage after *** dimensions were measured using threedimensional reconstruction of computed tomography *** optimal cutoff value of the pelvic inlet plane area that predicts anastomotic leakage was determined using a receiver operating characteristic(ROC)*** We observed anastomotic leakage in 10(8.5%)of the 117 *** the multivariate analysis,we identified high body mass index(odds ratio 1.674;95%confidence interval:1.087-2.58;P=0.019)and smaller pelvic inlet plane area(odds ratio 0.998;95%confidence interval:0.997-0.999;P=0.012)as statistically significant risk factors for anastomotic *** to the receiver operating characteristic curves,the optimal cutoff value of the pelvic inlet plane area was 10074 *** pelvic inlet plane area(≤10074 mm2)predicted anastomotic leakage with a sensitivity of 90%,a specificity of 85.9%,and an accuracy of 86.3%.CONCLUSION Narrow pelvic inlet and obesity were independent risk factors for anastomotic leakage after *** leakage after ISR may be predicted from a narrow pelvic inlet plane area(≤10074 mm2).

关键词： Intersphincteric resection Anastomotic leakage Pelvimetry Pelvic dimensions Pelvic inlet plane area Rectal cancer

Effect of Axial Clearance on the Flow Structure around a Rotating Disk Enclosed in a Cylindrical Casing

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Journal of Flow Control, Measurement & Visualization 2016年第1期4卷 1-12页

作者： Takashi Watanabe Hiroyuki Furukawa Shohei Fujisawa Soma endo Graduate School of Information Science Nagoya University Nagoya Japan Faculty of Science and Technology Meijo University Nagoya Japan

Numerical study is performed to investigate the swirling flow around a rotating disk in a cylindrical casing. The disk is supported by a thin driving shaft and it is settled at the center of the casing. The flow develops in the radial clearance between the disk tip and the side wall of the casing as well as in the axial clearance between the disk surfaces and the stationary circular end walls of the casing. Keeping the geometry of the casing and the size of the radial clearance constant, we compared the flows developing in the fields with small, medium and large axial clearances at the Reynolds number from 6000 to 30,000. When the rotation rate of the disk is small, steady Taylor vortices appear in the radial clearance. As the flow is accelerated, several tens of small vortices emerge around the disk tip. The axial position of these small vortices is near the end wall or the axial midplane of the casing. When the small vortices appear on one side of the end walls, the flow is not permanent but transitory, and a polygonal flow with larger several vortices appears. With further increase of the rotation rate, spiral structures emerge. The Reynolds number for the onset of the spiral structures is much smaller than that for the onset of the spiral rolls in rotor-stator disk flows with no radial clearance. The spiral structures in the present study are formed by the disturbances that are driven by a centrifugal instability in the radial clearance and they are penetrated radially inward along the circular end walls of the casing.

关键词： Rotating Disk Cylindrical Casing Bead-Like Flow Polygonal Flow

Diffusion Process of High Concentration Spikes in a Quasi-Homogeneous Turbulent Flow

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Open Journal of Fluid Dynamics 2016年第4期6卷 371-390页

作者： Masaya endo Qianqian Shao Takahiro Tsukahara Yasuo Kawaguchi Department of Mechanical Engineering Tokyo University of Science Chiba Japan

When a mass spreads in a turbulent flow, areas with obviously high concentration of the mass compared with surrounding areas are formed by organized structures of turbulence. In this study, we extract the high concentration areas and investigate their diffusion process. For this purpose, a combination of Planar Laser Induced Fluorescence (PLIF) and Particle Image Velocimetry (PIV) techniques was employed to obtain simultaneously the two fields of the concentration of injected dye and of the velocity in a water turbulent channel flow. With focusing on a quasi-homogeneous turbulence in the channel central region, a series of PLIF and PIV images were acquired at several different downstream positions. We applied a conditional sampling technique to the PLIF images to extract the high concentration areas, or spikes, and calculated the conditional-averaged statistics of the extracted areas such as length scale, mean concentration, and turbulent diffusion coefficient. We found that the averaged length scale was constant with downstream distance from the diffusion source and was smaller than integral scale of the turbulent eddies. The spanwise distribution of the mean concentration was basically Gaussian, and the spanwise width of the spikes increased linearly with downstream distance from the diffusion source. Moreover, the turbulent diffusion coefficient was found to increase in proportion to the spanwise distance from the source. These results reveal aspects different from those of regular mass diffusion and let us conclude that the diffusion process of the spikes differs from that of regular mass diffusion.

关键词： Turbulent Transport High Concentration Spikes Quasi-Homogeneous Turbulent Flow Conditional Sampling Technique PIV and PLIF Measurements Passive Scalar Diffusion

Analysis of High Concentration Spikes Appearing in Mass Plume in Nearly Homogeneous Turbulent Flow Based on the PDF Transport Equation

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Open Journal of Fluid Dynamics 2016年第4期6卷 472-495页

作者： Masaya endo Qianqian Shao Takahiro Tsukahara Yasuo Kawaguchi Department of Mechanical Engineering Tokyo University of Science Chiba Japan

To evaluate the pollutant dispersion in background turbulent flows, most researches focus on statistical variation of concentrations or its fluctuations. However, those time-averaged quantities may be insufficient for risk assessment, because there emerge many high-intensity pollutant areas in the instantaneous concentration field. In this study, we tried to estimate the frequency of appearance of the high concentration areas in a turbulent flow based on the Probability Density Function (PDF) of concentration. The high concentration area was recognized by two conditions based on the concentration and the concentration gradient values. We considered that the estimation equation for the frequency of appearance of the recognized areas consisted of two terms based on each condition. In order to represent the two terms with physical quantities of velocity and concentration fields, simultaneous PIV (Particle Image Velocimetry) and PLIF (Planar Laser-Induced Fluorescence) measurement and PLIF time-serial measurement were performed in a quasi-homogeneous turbulent flow. According to the experimental results, one of the terms, related to the condition of the concentration, was found to be represented by the concentration PDF, while the other term, by the streamwise mean velocity and the integral length scale of the turbulent flow. Based on the results, we developed an estimation equation including the concentration PDF and the flow features of mean velocity and integral scale of turbulence. In the area where the concentration PDF was a Gaussian one, the difference between the frequencies of appearance estimated by the equation and calculated from the experimental data was within 25%, which showed good accuracy of our proposed estimation equation. Therefore, our proposed equation is feasible for estimating the frequency of appearance of high concentration areas in a limited area in turbulent mass diffusion.

关键词： High Concentration Spikes Quasi-Homogeneous Turbulence Turbulent Mass Diffusion Concentration PDF Transport Equation PIV and PLIF Simultaneous Measurement

A constitutional jumping translocation involving the Y and acrocentric chromosomes

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Asian Journal of Andrology 2019年第1期21卷 101-103页

作者： Makiko Tsutsumi Naoko Fujita Fumihiko Suzuki Takashi Mishima Satoko Fujieda Michiko Watari Nobuhiro Takahashi Hidefumi Tonoki Osamu Moriwaka Toshiaki endo Hiroki Kuraliashi Division of Molecular Genetics Institute for Comprehensive Medical Science Fujita Health UniversityToyoake 470-1192Japan Genome and Transcriptome Analysis Center Fujita Health UniversityToyoake 470-1192Japan Center for Collaboration in Research and Education Fujita Health UniversityToyoake 470-1192Japan Department of Obstetrics and Gynecology Tenshi Hospital Sapporo 065-8611Japan Department of Pediatrics Tenshi Hospital Sapporo 065-8611Japan Kamlya Ladies Clinic Sapporo 060-0003Japan Department of Obstetrics and Gynecology Sapporo Medical University Sapporo 060-8556Japan.

Dear Editor, Translocations of the same chromosomal fragments to two or more different chromosomes in different somatic cell lineages are referred to as jumping translocations (JTs).JTs have been mainly reported in hematological malignancies but have been observed in rare instances also as constitutional chromosomal aberrations.2 The underlying JT mechanism remains unclear,however.

关键词： acrocentric chromosomes jumping translocation

Measurement of Shear Stress Acting on Flat Plate Using Oil Film Interferometry

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Open Journal of Fluid Dynamics 2023年第S1期13卷 217-225页

作者： Takamitsu Fujino Masaki endo Hiromasa Suzuki Yoko Sakakibara Mechanical Engineering Tokyo Denki University Saitama Japan Division of Mechanical Engineering Tokyo Denki University Saitama Japan Production Systems Engineering Course Tokyo Metropolitan College of Industrial Technology Tokyo Japan

Measurements of frictional resistance play an important role in engineering practice. There are several types of air resistance acting on an aircraft, for example. One of them, frictional resistance, accounts for half of the air resistance. Oil film interferometry is one of methods for measuring the frictional resistance. Oil dropped on an object is thinly stretched by the frictional resistance. The bright and dark fringe pattern is generated when monochromatic light is applied to the oil film. The gradient of the oil thickness decreases with the lapse of time, and thus the spacing between neighboring the dark lines increases. The rate at which the spacing increases is proportional to the frictional resistance. In this study, the frictional resistance acting on a small area on a plate was measured and compared with the theoretical value. As a result, these results qualitatively agree well with each other.

关键词： Oil Film Interferometry Fluid Friction Turbulent Flow Interference Fringes

Recent trends in the prevalence and distribution of colonic diverticula in Japan evaluated using computed tomography colonography

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World Journal of Gastroenterology 2021年第27期27卷 4441-4452页

作者： Noriyuki Isohata Koichi Nagata Kenichi Utano Ryoichi Nozaki Satoshi Nozu Takashi Kato Shigeyoshi Kijima Hiroshi Matsumoto Kenichiro Majima Yasuji Ryu Michiaki Hirayama Shungo endo Department of Coloproctology Fukushima Medical UniversityAizu Medical CenterAizuwakamatsu 969-3492FukushimaJapan Department of Gastroenterology Fukushima Medical UniversityFukushima 960-1295FukushimaJapan Department of Radiology Fukushima Medical UniversityAizu Medical CenterAizuwakamatsu 969-3492FukushimaJapan Department of Gastroenterology Takano HospitalColoproctology CenterKumamoto 862-0971KumamotoJapan Department of Radiology Saitama Cancer CenterIna 362-0806SaitamaJapan Department of Gastroenterology National Hospital Organization Hokkaido Medical CenterSapporo 063-0005HokkaidoJapan Department of Radiology Jichi Medical UniversityShimotsuke 329-0498TochigiJapan Division of Gastroenterology Kawasaki Medical School HospitalKurashiki 701-0192OkayamaJapan Department of Health Management Kameda Medical CenterKamogawa 296-8602ChibaJapan Department of Radiology Tonami General HospitalTonami 939-1395ToyamaJapan Department of Gastroenterology Tonan HospitalSapporo 060-0004HokkaidoJapan

BACKGROUND Computed tomography colonography(CTC)may be superior to colonoscopy and barium enema for detecting ***,few studies have used CTC to diagnose *** To evaluate the current prevalence and distribution of colonic diverticula in Japan using *** This study was conducted as part of the Japanese National Computed Tomographic Colonography Trial,which included 1181 participants from 14 hospitals in *** analyzed the prevalence and distribution of colonic diverticula and their relationships with age and *** relationship between the diverticula and the length of the large intestine was also *** Diverticulosis was present in 48.1%of the *** prevalence of diverticulosis was higher in the older participants(P<0.001 for trend).The diverticula seen in younger participants were predominantly located in the right-sided *** participants had a higher frequency of bilateral type(located in the rightand left-sided colon)diverticulosis(P<0.001 for trend).The length of the large intestine with multiple diverticula in the sigmoid colon was significantly shorter in those without diverticula(P<0.001).CONCLUSION The prevalence of colonic diverticulosis in Japan is higher than that previously *** prevalence was higher,and the distribution tended to be bilateral in older participants.

关键词： Computed tomography colonography Diverticulosis Diverticular disease Colon