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Usefulness of Detailed Analysis with Operative Procedure of Total Laparoscopic Hysterectomy (TLH) Done a Single Surgeon, to Master the Surgical Technique of TLH and Gain Higher Proficiency

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Open Journal of Obstetrics and Gynecology 2022年第11期12卷 1183-1190页

作者： Tsutomu Muramoto Shin Takenaka Ryo Koike Megumi sano Kyosuke Kamijo Reproductive Center Nagano Municipal Hospital Nagano Japan Department of Obstetrics and Gynecology Showa University Fujigaoka Hospital Yokohama Japan

Objective: To analyze the relationship between the numbers of cases experienced and the operation time for a single surgeon aiming to master the TLH surgical technique. Material and Methods: Retrospective data analysis of women who underwent TLH for benign diseases between April, 2014 and March, 2016 was conducted by a single surgeon in a single hospital (Showa University of Fujigaoka Hospital). We divided the main procedures of the TLH operation into five sections, and measured the time required for each section. These cases were divided into three groups, group 1, 2, and 3. Results: There were 54 cases of TLH over two years for a single surgeon, and 21 cases that included essential operative procedures were divided into three groups of seven cases each. The average duration of the surgery (min.) was 178.3 ± 48.2 in the group 1, 128.3 ± 15.6 in the group 2, and 111.3 ± 15.9 in the group 3. A significant reduction in the required time was observed between group 1, 2, and 3 groups. As the number of cases increased, the operation time became statistically significantly shorter for every section except B and D. The skill growth rate was different at each section. Conclusion: For a single surgeon, as the number of surgical cases increased, we recognized the increased skill with the procedure in every section and the rate of skill growth differed for different sections. The difference of growth rate for each section implied that the number of operative cases required for a surgeon in each section was different.

关键词： Total Laparoscopic Hysterectomy on the Job Training Learning Curve Surgical Technique of TLH

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Analysis of motorcycle microscopic characteristics at roundabouts under mixed traffic condition:A case study of Vietnam

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Journal of Traffic and Transportation Engineering(English Edition) 2021年第4期8卷 605-619页

作者： Linh Thanh Trinh Kazushi sano Kiichiro Hatoyama Chathura Kovida De Silva Urban Transport Engineering and Planning Laboratory Department of Civil and Environmental EngineeringNagaoka University of TechnologyNiigata 940-2188Japan

Recently,the demand for comprehension of mixed traffic in developing countries,particularly at roundabouts,which are highly interactive road junctions,has ***,we analyzed mixed traffic at roundabouts,considering Vietnam as a case *** two main objectives of this study were to characterize the mixed traffic in Vietnam and to determine the microscopic characteristics of motorcycles at ***,efforts were made to clarify the two constitutions of mixed traffic(the performance rule and the presence of small-sized vehicles),and the term“motorcycle-oriented mixed traffic”was *** when satisfying the two fundamental constitutions,this traffic state has unique features,e.g.,only one type of non-lane-based vehicle(the motorcycle)and the predominance of motorcycles in the traffic composition(91.7%).Second,four microscopic characteristics of motorcycles were obtained from a large dataset:the motorcycles’continuous changes in speed,the relationship between the turning angle rate and the speed,the critical gap,and the following *** relationship between the turning angle rate and the speed was first formulated as a power *** critical gap of motorcycles was estimated as a small value(1.25 s)in the case *** following spaces varied with respect to the speed and had an oval *** smallest lateral and longitudinal dimensions were 1.5 and 1.74 m,*** all the findings are meaningful,they are restricted to the case study(Ho Chi Minh City,Vietnam).

关键词： Mixed traffic Microscopic traffic characteristics Roundabout Turning angle rate Critical gap Following space

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Ambipolar device simulation based on the drift-diffusion model in ion-gated transition metal dichalcogenide transistors

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npj Computational Materials 2020年第1期6卷 1446-1454页

作者： Akiko Ueda Yijin Zhang Nobuyuki sano Hiroshi Imamura Yoshihiro Iwasa National Institute of Advanced Industrial Science and Technology(AIST) Spintronics Research CenterTsukuba 305-8568Japan Department of Electrical Engineering Columbia UniversityNew YorkNYUSA The Institute of Scientific and Industrial Research Osaka UniversityOsaka 067-0047Japan Max Planck Institute for Solid State Research 70569 StuttgartGermany Institute of Applied Physics University of TsukubaTsukuba 305-8573Japan Department of Applied Physics and Quantum-Phase Electronics(QPEC)Center The University of TokyoTokyo 113-8656Japan RIKEN Center for Emergent Matter Science(CEMS)Wako 351-0198Japan

Ionic gating is known as a powerful tool for investigation of electronic functionalities stemming from low voltage transistor operation to gate-induced electronic phase control including ***-dimensional(2D)material is one of the archetypal channel materials which exhibit a variety of gate-induced ***,the device simulations on such iongated transistor devices have never been reported,despite its importance for the future design of device *** this paper,we developed a drift-diffusion(DD)model on a 2D material,WSe2 monolayer,attached with an ionic liquid,and succeeded in simulating the transport properties,potential profile,carrier density distributions in the transistor configuration.

关键词： transistor bipolar diffusion

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Post-colonoscopy colorectal cancer rate in the era of highdefinition colonoscopy

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World Journal of Gastroenterology 2017年第42期23卷 7609-7617页

作者： Mineo Iwatate Tomoyuki Kitagawa Yasumi Katayama Naohiko Tokutomi Shinichi Ban Santa Hattori Noriaki Hasuike Wataru sano Yasushi sano Masaya Tamano Gastrointestinal Center and Institute of Minimally-Invasive Endoscopic Care Sano Hospital Department of Gastroenterology Dokkyo Medical University Koshigaya Hospital Department of Pathology Dokkyo Medical University Koshigaya Hospital

AIM To investigate the post-colonoscopy colorectal cancer(PCCRC) rate for high-definition(HD) colonoscopy compared with that for standard-definition colonoscopy reported *** Using medical records at sano Hospital(SH) and Dokkyo Medical University Koshigaya Hospital(DMUKH), we retrospectively obtained data on consecutive patients diagnosed as having CRC between January 2010 andDecember 2015. The definition of PCCRC was diagnosis of CRC between 7 and 36 mo after initial high-definition colonoscopy that had detected no cancer, and patients were divided into a PCCRC group and a non-PCCRC group. The primary outcome was the rate of PCCRC for HD colonoscopy. The secondary outcomes were factors associated with PCCRC and possible reason for occurrence of early and advanced *** Among 892 CRC patients, 11 were diagnosed as having PCCRC and 881 had non-PCCRC. The PCCRC rate was 1.7%(8/471) at SH and 0.7%(3/421) at DMUKH. In comparison with the non-PCCRC group, the PCCRC group had a significantly higher preponderance of smaller tumors(39 mm vs 19 mm, P = 0.002), a shallower invasion depth(T1 rate, 25.4% vs 63.6%, P = 0.01), a non-polypoid macroscopic appearance(39.0% vs 85.7%, P = 0.02) and an earlier stage(59.7% vs 90.9%, P = 0.03). Possible reasons for PCCRC were "missed or new" in 9 patients(82%), "incomplete resection" in 1(9%), and "inadequate examination'" in 1(9%). Among 9 "missed or new" PCCRC, the leading cause was non-polypoid shape for early PCCRC and blinded location for advanced *** The PCCRC rate for HD colonoscopy was 0.7%-1.7%, being lower than that for standard-definition colonoscopy(1.8%-9.0%) reported previously employing the same methodology.

关键词： Post-colonoscopy colorectal cancer Highdefinition Post-colonoscopy colorectal cancer rate Associated factor Possible explanation

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Prospective real-time evaluation of diagnostic performance using endocytoscopy in differentiating neoplasia from nonneoplasia for colorectal diminutive polyps(≤ 5 mm)

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World Journal of Gastrointestinal Oncology 2018年第4期10卷 96-102页

作者： Takahiro Utsumi Yasushi sano Mineo Iwatate Hironori Sunakawa Akira Teramoto Daizen Hirata Santa Hattori Wataru sano Noriaki Hasuike Kazuhito Ichikawa Takahiro Fujimori Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care (iMEC) Sano Hospital Department of Pathology Shinko Hospital

AIM To clarify the diagnostic performance of endocytoscopy for differentiation between neoplastic and nonneoplastic colorectal diminutive *** Patients who underwent endocytoscopy between October and December 2016 at sano Hospital were prospectively recruited. When diminutive polyps(≤5 mm) were detected, the lesions were evaluated by endocytoscopy after being stained with 0.05% crystal violet and 1% methylene blue. The diminutivepolyps were classified into five categories(EC 1 a, 1 b, 2, 3 a, and 3 b). Endoscopists were asked to take a biopsy from any lesion diagnosed as EC1 b(indicator of hyperplastic polyp) or EC2(indicator of adenoma). We have assessed the diagnostic performance of endocytoscopy for EC2 and EC1 b lesions by comparison with the histopathology of the biopsy specimen. RESULTS A total of 39 patients with 63 diminutive polyps were analyzed. All polyps were evaluated by endocytoscopy. The mean polyp size was 3.3 ± 0.9 mm. Among the 63 diminutive polyps, 60 were flat and 3 were pedunculated. The mean time required for EC observation, including the time for staining with crystal violet and methylene blue, was 3.0 ± 1.9 min. Histopathologic evaluation showed that 13 polyps were hyperplastic and 50 were adenomas. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of EC2 for adenoma compared with EC1 b for hyperplastic polyp were 98.0%, 92.3%, 96.8%, 98.0% and 92.3%, respectively. There were only two cases of disagreement between the endoscopic diagnosis made by endocytoscopy and the corresponding histopathological *** Endocytoscopy showed a high diagnostic performance for differentiating between neoplastic and non-neoplastic colorectal diminutive polyps, and therefore has the potential to be used for "real-time histopathology".

关键词： Endocytoscopy Diagnostic performance Diminutive polyp Endocytoscopic classification Realtime histopathology

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Application for developing countries:Estimating trip attraction in urban zones based on centrality

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Journal of Traffic and Transportation Engineering(English Edition) 2017年第5期4卷 464-476页

作者： Amila Jayasinghe Kazushi sano Kasemsri Rattanaporn Department of Civil and Environmental Engineering Nagaoka University of TechnologyNagaoka 940-2137Japan

This paper introduced a network centrality-based method to estimate the volume of trip attraction in traffic analysis zones. Usually trip attraction volumes are estimated based on land use characteristics. However, executing of land use-based trip attraction models are severely constrained by the lack of updated land use data in developing countries. The proposed method used network centrality-based explanatory variables as ＂connectivity＂, ＂local integration＂ and ＂global integration＂. Space syntax tools were used to compute the centrality of road segments. GIS-based kernel density estimation method was used to transform computed road segrnent-based centrality values into traffic analysis zone. Trip attraction values exhibited significant high correlation with connectivity, global and local integration values. The study developed and validated model to estimate trip attraction by using connectivity, local integration and global integration values as endogenous variables with an accepted level of accuracy （R2 〉 0.75）. The proposed approach required minimal data, and it was easily executed using a geographic information system. The study rec- ommended the proposed method as a practical tool for transport planners and engineers, especially who work in developing countries and where updated land use data is unavailable.

关键词： Trip attraction Centrality Space syntax Land use Developing country

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A Case of Low-Grade Appendiceal Mucinous Neoplasm of Its Difficultly to Distinguish from a Right Ovarian Tumor Due to Postmenopause

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Open Journal of Obstetrics and Gynecology 2022年第11期12卷 1140-1146页

作者： Tsutomu Muramoto Kyosuke Kamijo Megumi sano Yuki Ibuki Atushi Mori Yaeko Kobayashi Nagano Municipal Hospital Department of Obstetrics and Gynecology Nagano Japan

We here present a rare case of appendiceal tumor mimicking ovarian tumor in menopause woman. The patient was a 56-year-old woman, G1P1, who presented to our hospital with a right adnexal cyst diagnosed at another hospital. Transvaginal echocardiography showed a cyst in the right adnexal region, and pelvic contrast-enhanced MRI revealed a small cyst in the same region. The left ovary was atrophic and identifiable. It was unclear whether the cyst was contiguous with the gastrointestinal tract. Blood tests showed no elevation of tumor markers. We considered its possibility of a gastrointestinal origin, but since right normal ovary was not found, we thought the tumor was of ovarian origin and decided on a laparoscopic resection of the right adnexa. Intraoperatively, we observed atrophied bilateral normal ovaries, and the pelvic tumor was contiguous to the appendix. Surgeons performed a laparoscopic appendectomy after consultation with us. After resection we searched the abdominal and pelvic cavities, but found no obvious disseminated lesions. The histological diagnosis was low-grade appendiceal mucinous neoplasm (LAMN), a rare benign tumor of the appendix. Appendiceal tumors can be difficult to differentiate from right ovarian tumors due to their close anatomic location in the pelvis. It is possible to determine whether the tumor is of ovarian or appendiceal origin by identifying normal ovaries and the location of the feeding vessels into the tumors. In our case, there were no lesions other than the appendix, but LAMN can metastasize to the ovary, cause pseudomyoxoma peritonei, or be an overlapping tumor with an ovarian tumor. If an appendiceal tumor is diagnosed after surgery for ovarian tumor, the intra-abdominal cavity should be searched for metastasis or dissemination, and a thorough search for ovarian lesions should be performed with the possibility of an overlapping tumor in mind.

关键词： Low-Grade Appendiceal Mucinous Neoplasm Ovarian Tumor Menopause Woman

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Improvement of Impeller Blade Structure for Gas Injection Refining under Mechanical Sirring

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Journal of Iron and Steel Research(International) 2014年第2期21卷 135-143页

作者： Yan LIU Zi-mu ZHANG sano MASAMICHI Jun ZHANG Pin SHAO Ting-an ZHANG Key Laboratory of Ecological Utilization of Multi-metal Intergrown Ores of Ministry of Education School of Materials and MetallurgyNortheastern University Nagoya University

Abstract： The impeller blade structure for gas injection refining under mechanical stirring has been explored by water model experiments. A sloped swept-back blade impeller is＇proposed for the purpose. The central part of the impeller is disk- or plate-shaped, and the blades are fitted to the side of the disk or plate. In addition, a disk is put on the top side of the impeller blades. The impeller can strengthen the radial and downward flow between the blades and weaken the swirl flow in the zone above the impeller. These effects on flow phenomena are favorable for disintegration and wide dispersion of bubbles which are injected from a nozzle attached to the center of the underside of the impeller. In addition, the sloped swept-back impeller requires less power consumption. The impeller shaft should be placed away from the vessel center so as to disperse the injected bubbles widely in the bath under mechanical stirring even with unidi- rectional impeller rotation and without installing baffles. The number of gas holes in the nozzle and the direction of gas injection have a little effect on the bubble disintegration and dispersion in the bath. Highly efficient gas injection refining can be established under the conditions of proper impeller size, larger nozzle immersion depth, larger eccen- tricity and rotation speed of the impeller. The sloped swept back blade impeller can decrease the power consumption and vet improve the bubble disintegration and wide dist^ersion in the bath.

关键词： gas injection refining cold model eccentric mechanical stirring impeller structure power consump-tion bubble disintegration bubble dispersion

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Crustal Signature of δ^(13)C and Nitrogen Content in Microdiamonds from Erzgebirge, Germany: Ion Microprobe Studies

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Journal of Earth Science 2010年第5期21卷 623-634页

作者： Larissa F Dobrzhinetskaya Harry W Green II Naoto Takahata Yuji sano Korato Shirai Department of Earth Sciences University of California at Riverside Riverside 92521 USA Division of Ocean-Earth Systems Atmosphere and Ocean Research Institute University of Tokyo Kashiwanoha Chiba 277-8564 Japan

The study of δ13CCpDB （Pee Dee Belemnite） and nitrogen contents in 1 to 5-pm-diameter microdinmonds included in garnets from the qnartz-feldspathic gneisses （Erzgehirge, Germany） was performed in situ with the Nano-scale Secondary Ion Mass Spectrometer. The results revealed that there were two stages of diamond crystallization from a C-O-H supeeritical fluid rich in biogenic carbon and diverse minor elements of crustal origin. The δ13CCpDB Of the Erzgebirge diamond of the first stage falls in the range -17‰ to 19‰, with an average value of -17.8‰; the average content of nitrogen is 820 ppm. Diamonds of the second stage are characterized by δ13CPDB=-21.5‰ to -25.5‰, with an average value of -23.24‰; the average nitrogen content is non-homogeneously scattered from 740 ppm to 3 370 ppm among 6 diamonds situated in garnets within the same polished rock slide. Both diamond of the first stage and diamond of the second stage carbon reservoirs belong to biogenic matter, therefore confirming deep subduction of the continental crust sediments and their subsequent exhumation during the Variscan orogeny.

关键词： metamorphic diamond carbon isotope nitrogen content geochemistry.

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Effects of Chinese herbal medicine on plasma glucose,protein and energy metabolism in sheep

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Journal of Animal Science and Biotechnology 2014年第3期5卷 325-332页

作者： Xi Liang Kyota Yamazaki Mohammad Kamruzzaman Xue Bi Arvinda Panthee Hiroaki sano Faculty of Agriculture Iwate University

Background： The use of antibiotics in animal diets is facing negative feedback due to the hidden danger of drug residues to human health. Traditional Chinese herbal medicine has been used to replace antibiotics in the past two decades and played an increasingly important role in livestock production. The present study was carried out to assess the feeding effects of a traditional nourishing Chinese herbal medicine mixture on kinetics of plasma glucose, protein and energy metabolism in sheep. Ruminal fermentation characteristics were also determined. Methods： Four sheep were fed on either mixed hay （MH-diet） or MH-diet supplemented with 2% of Chinese herbal medicine （mixture of Astragalus root, Angelica root and Atractylodes rhizome; CHM-diet） over two 3S-day periods using a crossover design. The turnover rate of plasma glucose was measured with an isotope dilution method using [U-^13C]glucose. The rates of plasma leucine turnover and leucine oxidation, whole body protein synthesis （WBPS） and metabolic heat production were measured using the [1-^13C]leucine dilution and open circuit calorimetry. Results： Body weight gain of sheep was higher （P = 0.03） for CHM-diet than for MH-diet. Rumen pH was lower （P = 0.02）, concentration of rumen total volatile fatty acid tended to be higher （P = 0.05） and acetate was higher （P = 0.04） for CHM-diet than for MH-diet. Turnover rates of plasma glucose and leucine did not differ between diets. Oxidation rate of leucine tended to be higher （P = 0.06） for CHM-diet than for MH-diet, but the WBPS did not differ between diets. Metabolic heat production tended to be greater （P = 0.05） for CHM-diet than for MH-diet. Conclusions： The sheep fed on CHM-diet had a higher body weight gain and showed positive impacts on rumen fermentation and energy metabolism without resulting in any adverse response. Therefore, these results suggested that the Chinese herbal medicine mixture should be considered as a potential feed additive for sheep.

关键词： Chinese herbal medicine Glucose metabolism Heat production Protein metabolism Ruminal fermentation characteristics Sheep

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