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Treatment of gastric outlet obstruction that results fromunresectable gastric cancer:Current evidence

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World Journal of Gastrointestinal Endoscopy 2016年第3期8卷 165-172页

作者： Yasuhiro Miyazaki Shuji Takiguchi tsuyoshi takahashi Yukinori Kurokawa Tomoki Makino Makoto Yamasaki,Kiyokazu Nakajima Masaki Mori Yuichiro Doki Department of Gastroenterological Surgery Osaka University Graduate School of MedicineSuita-shiOsaka 565-0871Japan

Malignant gastric outlet obstruction(GOO) is a common condition that results from locally advanced malignancies in the upper gastrointestinal tract, such as pancreatic, gastric, and other carcinomas. Two types of procedures for malignant GOO, namely, gastrojejunostomy(GJ) with laparotomy or a laparoscopic approach and endoscopic stenting(ES), are currently available. Although numerous previous reports have clarified the benefits and drawbacks of each procedure, whether GJ or ES should be used in patients with GOO that results from gastric cancer who may have a longer life expectancy than patients with other malignancies has not been determined. In this review, which focuses on gastric cancer-induced GOO, we analyzed the two systematic reviews and a meta-analysis that compared GJ and ES and outlined the current status of GOO treatment. We also provide an updated review that includes laparoscopic GJ. Various data from 13 studies in one review and 6 studies in another review were analyzed. Although the main results of the present review indicated that both GJ and ES were efficacious treatments in patients with GOO that resulted from gastric cancer, current evidence suggests that GJ may be the preferable procedure given its good performance status and improved prognosis in gastric cancer patients.

关键词： Gastric outlet obstruction Gastrojejunostomy Endoscopic stenting Gastric cancer Review

Application of Simple Adaptive Control to Water Hydraulic Servo Cylinder System

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Chinese Journal of Mechanical Engineering 2012年第5期25卷 882-888页

作者： ITO Kazuhisa YAMADA tsuyoshi IKEO Shigeru takahashi Koji College of Systems Engineering and Science Shibaura Institute of Technology Saitama 3378570 Japan Graduate School of Mechanical Engineering Tottori UniversityTottori 6808552 Japan Department of Mechanical Engineering Sophia UniversityTokyo 1028554 Japan

Although conventional model reference adaptive control （MRAC） achieves good tracking performance for cylinder control, the controller structure is much more complicated and has less robustness to disturbance in real applications. This paper discusses the use of simple adaptive control （SAC） for positioning a water hydraulic servo cylinder system. Compared with MRAC, SAC has a simpler and lower order structure, i.e., higher feasibility. The control performance of SAC is examined and evaluated on a water hydraulic servo cylinder system. With the recent increased concerns over global environmental problems, the water hydraulic technique using pure tap water as a pressure medium has become a new drive source comparable to electric, oil hydraulic, and pneumatic drive systems. This technique is also preferred because of its high power density, high safety against fire hazards in production plants, and easy availability. However, the main problems for precise control in a water hydraulic system are steady state errors and overshoot due to its large friction torque and considerable leakage flow. MRAC has been already applied to compensate for these effects, and better control performances have been obtained. However, there have been no reports on the application of SAC for water hydraulics. To make clear the merits of SAC, the tracking control performance and robustness are discussed based on experimental results. SAC is confirmed to give better tracking performance compared with PI control, and a control precision comparable to MRAC （within 10 μm of the reference position） and higher robustness to parameter change, despite the simple controller. The research results ensure a wider application of simple adaptive control in real mechanical systems.

关键词： water hydraulics servo cylinder system positioning control simple adaptive control

Nondestructive and active interrogation system for special nuclear material:proof of principle and initial results

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Nuclear Science and Techniques 2024年第5期35卷 216-225页

作者： Mahmoud Bakr Kai Masuda Yoshiyuki takahashi tsuyoshi Misawa Norio Yamakawa Tomas Scott Institute of Advanced Energy Kyoto UniversityGokashoUjiKyoto 611‑0011Japan School of Physics University of BristolBs81TL Tyndall AvenueBristolUK Physics Department Faculty of ScienceAssiut UniversityAssiut 71516Egypt Research Reactor Institute Kyoto University2 Asashiro‑NishiKumatoriOsaka 590‑0494Japan Pony Industry Co.Ltd. 2‑3‑6 Kitakyuhoji‑MachiChuo‑KuOsaka 541‑0057Japan Astral Neutronics LTD Unit H5HallenBristol BS107SBUK

Herein,we employ the threshold energy neutron analysis(TENA)technique to introduce the world's first active interrogation system to detect special nuclear materials(SNMs),including U-235 and *** system utilizes a DD neutron generator based on inertial electrostatic confinement(IEC)to interrogate suspicious *** detect secondary neutrons produced during fission reactions induced in SNMs,a tensioned metastable fluid detector(TMFD)is *** current status of the system's development is reported in this paper,accompanied by the results from experiments conducted to detect 10 g of highly enriched uranium(HEU).Notably,the experimental findings demonstrate a distinct difference in the count rates of measurements with and without *** difference in count rates surpasses two times the standard deviation,indicating a confidence level of more than 96% for identifying the presence of *** paper presents and extensively discusses the proof-of-principle experimental results,along with the system's planned trajectory.

关键词： Special nuclear materials Uranium detection Inertial electrostatic confinement fusion TENA HEU CTMFD

Optical spectroscopy and photometry of main-belt asteroids with a high orbital inclination

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Research in Astronomy and Astrophysics 2017年第2期17卷 43-50页

作者： Aya Iwai Yoichi Itoh tsuyoshi Terai Ranjan Gupta Asoke Sen Jun takahashi National Institute of Advanced Industrial Science and Technology Ibaraki 305-8563Japan Nishi-Harima Astronomical Observatory Center for AstronomyUniversity of HyogoISIyogo 679-5313Japan National Astronomical Observatory of Japan HiloHawaii 96720USA Inter-University Centre for Astronomy and Astrophysics GaneshkhindPune 411 007India Department of Physics Assam UniversitySilchar 788 001India

We carried out low-resolution optical spectroscopy of 51 main-belt asteroids, most of which have highly-inclined orbits. They are selected from D-type candidates in the SDSS-MOC 4 catalog. Using the University of Hawaii 2.2 m telescope and the Inter-University Centre for Astronomy and Astrophysics 2 m telescope in India, we determined the spectral types of 38 asteroids. Among them, eight asteroids were classified as D-type asteroids. Fractions of D-type asteroids are 3.0 ± 1.1% for low orbital inclination main-belt asteroids and 7.3 ± 2.0% for high orbital inclination main-belt asteroids. The results of our study indicate that some D-type asteroids were formed within the ecliptic region between the main belt and Jupiter, and were then perturbed by Jupiter.

关键词： minor planets, asteroids general -- techniques spectroscopic

Arthroscopic approach to the posterior compartment of the knee using a posterior transseptal portal

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World Journal of Orthopedics 2015年第7期6卷 505-512页

作者： tsuyoshi Ohishi Masaaki takahashi Daisuke Suzuki Yukihiro Matsuyama Department of Orthopedic Surgery Enshu Hospital Joint Center Jyuzen Memorial Hospital Department of Orthopedic Surgery Hamamatsu University School of Medicine

Arthroscopic surgery of the posterior compartment ofthe knee is difficult when only two anterior portals are used for access because of the inaccessibility of the back of the knee. Since its introduction, the posterior transseptal portal has been widely employed to access lesions in the posterior compartment. However, special care should be taken to avoid neurovascular injuries around the posteromedial, posterolateral, and transseptal portals. Most importantly, popliteal vessel injury should be avoided when creating and using the transseptal portal during surgery. Purpose of the present study is to describe how to avoid the neurovascular injuries during establishing the posterior three portals and to introduce our safer technique to create the transseptal portal. To date, we have performed arthroscopic surgeries via the transseptal portal in the posterior compartments of 161 knees and have not encountered nerve or vascular injury. In our procedure, the posterior septum is perforated with a 1.5-3.0-mm Kirschner wire that is protected by a sheath inserted from the posterolateral portal and monitored from the posteromedial portal to avoid popliteal vessel injury.

关键词： Arthroscopic surgery Knee Posterolateral portal Posteromedial portal Transseptal portal

MUC5AC/β-catenin expression and KRAS gene alteration in laterally spreading colorectal tumors

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World Journal of Gastroenterology 2012年第39期18卷 5551-5559页

作者： Kosaburo Nakae Hiroyuki Mitomi tsuyoshi Saito Michiko takahashi Takashi Morimoto Yasuhiro Hidaka Naoto Sakamoto Takashi Yao Sumio Watanabe Department of Gas-troenterology Juntendo University School of Medicine2-1-1 HongoBunkyo-kuTokyo 113-8421Japan Department of Human Pathology Juntendo University School of Medicine1-1-19 HongoBunkyo-kuTokyo 113-0033Japan

AIM： To clarify differences in mucin phenotype, prolif- erative activity and oncogenetic alteration among sub- types of colorectal laterally spreading tumor （LST）. METHODS： LSTs, defined as superficial elevated lesions greater than 10 mm in diameter with a low vertical axis, were macroscopically classified into two subtypes：（1） a granular type （Gr-LST） composed of superficially spread- ing aggregates of nodules forming a fiat-based lesion with a granulonodular and uneven surface; and （2） a non-granular type （NGr-LST） with a flat smooth surface and an absence of granulonodular formation. A total of 69 LSTs, comprising 36 Gr-LSTs and 33 NGr-LSTs, were immunohistochemically stained with MUC2, MUC5AC, MUC6, CD10 （markers of gastrointestinal cell lineage）, p53, 13-catenin and Ki-67 antibodies, and examined for alteration in exon 1 of v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog （KRAS） and exon 15 of v-raf murine sarcoma viral oncogene homologue B1 （BRAF） by poly- merase chain reaction followed by direct sequencing. RESULTS： Histologically, 15 Gr-LST samples were ad- enomas with low-grade dysplasia （LGD）, 12 were high- grade dysplasia （HGD） and 9 were adenocarcinomas invading the submucosa （INV）, while 12 NGr-LSTs demonstrated LGD, 14 HGD and 7 INV. In the proximal colon, MUC5AC expression was significantly higher in the Gr-type than the NGr-type. MUC6 was expressed only in NGr-LST. MUC2 or CD10 did not differ. P53 ex- pression demonstrated a significant stepwise increment in progression through LGD-HGD-INV with both types of LST. Nuclear β-catenin expression was significantly higher in the NGr-type. Ki-67 expression was signifi- cantly higher in the Gr-type in the lower one third zone of the tumor. In proximal, but not distal colon tumors, the incidence of KRAS provided mutation was signifi- cantly higher in the Gr-type harboring a specific muta- tional pattern （G12V）. BRAF mutations （V600E） were detected only in two Gr-LSTs. CONCLUSION： The two subtypes of LST,

关键词： Laterally spreading tumor Mucin core pro-tein Colon β-catenin Immunohistochemistry v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog Directsequencing Adenoma-carcinoma sequence

A case of primary biliary cirrhosis complicated by Behcet's disease and palmoplantar pustulosis

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World Journal of Gastroenterology 2006年第13期12卷 2136-2138页

作者： Haruyo Iwadate Hiromasa Ohira Hironobu Saito Atsushi takahashi tsuyoshi Rai Junko Takiguchi Tomomi Sasajima Hiroko Kobayashi Hiroshi Watanabe Yukio Sato Department of Internal Medicine Ⅱ Fukushima Medical University School of Medicine Fukushima Japan

A 46-year-old woman was diagnosed with palmoplantar pustulosis （PPP） at the Department of Dermatology, Fukushima Medical University Hospital in 2000, and was treated with ointment. However, because liver dysfunction developed in 2003, she was referred to our department, where primary biliary cirrhosis （PBC） was also diagnosed on the basis of clinical findings. One year later, at the age of 49, she developed manifestations of Behcet＇s disease （BD）, including erythema nodosum in the lower extremities. Because she had a history of uveitis, recurrent oral ulceration was present, and the HLA typing was positive for B51, BD was additionally diagnosed. Liver function normalized within three months of the start of treatment with ursodesoxycholic acid （UDCA）. This is the first case of PBC associated with BD and PPP.

关键词： Primary biliary cirrhosis Behcet's disease Palmoplantar pustulosis

Preoperative albumin-bilirubin score and liver resection percentage determine postoperative liver regeneration after partial hepatectomy

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World Journal of Gastroenterology 2024年第14期30卷 2006-2017页

作者： Kazuhiro takahashi Masahiko Gosho Yoshihiro Miyazaki Hiromitsu Nakahashi Osamu Shimomura Kinji Furuya Manami Doi Yohei Owada Koichi Ogawa Yusuke Ohara Yoshimasa Akashi tsuyoshi Enomoto Shinji Hashimoto Tatsuya Oda Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery University of TsukubaTsukuba 3058-575IbarakiJapan Department of Biostatistics University of TsukubaTsukuba 3058-575IbarakiJapan

BACKGROUND The success of liver resection relies on the ability of the remnant liver to *** of the knowledge regarding the pathophysiological basis of liver regeneration comes from rodent studies,and data on humans are ***,there is limited knowledge about the preoperative factors that influence postoperative *** To quantify postoperative remnant liver volume by the latest volumetric software and investigate perioperative factors that affect posthepatectomy liver *** A total of 268 patients who received partial hepatectomy were *** were grouped into right hepatectomy/trisegmentectomy(RH/Tri),left hepa-tectomy(LH),segmentectomy(Seg),and subsegmentectomy/nonanatomical hepatectomy(Sub/Non)*** regeneration index(RI)and late rege-neration rate were defined as(postoperative liver volume)/[total functional liver volume(TFLV)]×100 and(RI at 6-months-RI at 3-months)/RI at 6-months,*** lower 25th percentile of RI and the higher 25th percentile of late regeneration rate in each group were defined as“low regeneration”and“delayed regeneration”.“Restoration to the original size”was defined as regeneration of the liver volume by more than 90%of the TFLV at 12 months *** The numbers of patients in the RH/Tri,LH,Seg,and Sub/Non groups were 41,53,99 and 75,*** RI plateaued at 3 months in the LH,Seg,and Sub/Non groups,whereas the RI increased until 12 months in the RH/Tri *** to our multivariate analysis,the preoperative albumin-bilirubin(ALBI)score was an independent factor for low regeneration at 3 months[odds ratio(OR)95%CI=2.80(1.17-6.69),P=0.02;per 1.0 up]and 12 months[OR=2.27(1.01-5.09),P=0.04;per 1.0 up].Multivariate analysis revealed that only liver resection percentage[OR=1.03(1.00-1.05),P=0.04]was associated with delayed ***,multivariate analysis demonstrated that the preoperative ALBI score[OR=2.63(1.00-1.05),P=0.02;per 1.

关键词： Liver regeneration Albumin-bilirubin score Liver resection percentage Partial hepatectomy Human Regeneration index

Conversion hepatectomy for hepatocellular carcinoma with main portal vein tumour thrombus after lenvatinib treatment: A case report

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World Journal of Hepatology 2021年第3期13卷 384-392页

作者： Kazuhiro takahashi Jaejeong Kim Amane takahashi Shinji Hashimoto Manami Doi Kinji Furuya Ryosuke Hashimoto Yohei Owada Koichi Ogawa Yusuke Ohara Yoshimasa Akashi Katsuji Hisakura tsuyoshi Enomoto Osamu Shimomura Masayuki Noguchi Tatsuya Oda Department of Gastrointestinal and Hepatobiliary Pancreatic Surgery University of TsukubaTsukuba 3058575IbarakiJapan Department of Gastroenterological Surgery Saitama Cancer CenterSaitama 3620806SaitamaJapan Department of Diagnostic Pathology University of TsukubaTsukuba 3058575IbarakiJapan

BACKGROUND Hepatocellular carcinoma(HCC)accompanied by portal vein tumour thrombus(PVTT)presents an aggressive disease course,worsening liver function reserve,and a high recurrence *** practice guidelines recommend systemic therapy as the first-line option for HCC with portal ***,to achieve longer survival in these patients,the treatment strategy should be concluded with removal of the tumour by locoregional *** experienced a case of initially unresectable HCC with main PVTT converted to radical hepatectomy after lenvatinib *** SUMMARY A 59-year-old male with chronic hepatitis C infection visited our clinic as a regular post-surgery ***-enhanced abdominal computed tomography revealed a liver mass diffusely located at the lateral segment with a massive PVTT extending from the umbilical portion to the main and contralateral third-order portal *** the diagnosis of unresectable HCC with Vp4(main trunk/contralateral branch)PVTT,lenvatinib was started at 12 mg/*** computed tomography taken 3 mo after starting lenvatinib showed regression of the PVTT,which had retreated to the contralateral first-order portal *** tolerated the full dose without major adverse *** cessation of lenvatinib for 7 d,radical left lobectomy and PVTT thrombectomy were *** patient’s postoperative course was ***,the primary lesion showed fibrotic changes,with moderately to poorly differentiated tumour cells surrounded by granulation tissues in some *** majority of the PVTT showed *** was alive without recurrence for 8 *** This is the first case of HCC with Vp4 PVTT in which radical conversion hepatectomy was succeeded after lenvatinib treatment.

关键词： Hepatocellular carcinoma Lenvatinib Portal vein tumour thrombus Conversion hepatectomy Case report