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Determination of a Desirable Time Step for Quasi-Dynamic Urban Model with Sapporo Test Bed
Varameth Vichiensan, Kazuaki Miyamoto, Keiichi Kitazume 서울시립대학교 도시과학연구원 2003 International journal of urban sciences (IJUS) Vol. No.
This paper presents an application of the Sapporo GIS based Test Bed, which has been built to support urban model testing and development. It briefly describes TRANUS Sapporo model, which has been calibrated both at one time point and for a time interval. The model is quasi-dynamic, which runs its land-use and transportation submodels sequentially with time lag. In this study, Sapporo Test Bed was an efficient tool to identify the inputs and parameters that are the main cause of uncertainty of the model results. The uncertainty is accumulated by the quasi-dynamic structure, which is a usual structure of the most existing urban models. Moreover, this paper has proposed a heuristic approach to determine a desirable time step for quasi-dynamic urban model. This is achieved by a simplified Monte Carlo simulation technique. Uncertainty in the model output is evaluated from various statistical indexes. It is found that a time step of 3.3 years is most desirable by trading off between uncertainty and accuracy. However, a 3.3-year time step may not be desirable from a practical viewpoint, we evaluated that a time step of 5 years is also acceptable compared with 3.3 years based on our simulation results.
Keisuke Yonamine,Shinsuke Koshita,Yoshihide Kanno,Takahisa Ogawa,Hiroaki Kusunose,Toshitaka Sakai,Kazuaki Miyamoto,Fumisato Kozakai,Hideyuki Anan,Haruka Okano,Masaya Oikawa,Takashi Tsuchiya,Takashi Sa 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.4
Background/Aims: We aimed to investigate (1) promising clinical findings for the recognition of focal type autoimmune pancreatitis (FAIP) and (2) the impact of endoscopic ultrasound (EUS)-guided tissue acquisition (EUS-TA) on the diagnosis of FAIP. Methods: Twenty-three patients with FAIP were involved in this study, and 44 patients with resected pancreatic ductal adenocarcinoma (PDAC) were included in the control group. Results: (1) Multivariate analysis revealed that homogeneous delayed enhancement on contrast-enhanced computed tomography was a significant factor indicative of FAIP compared to PDAC (90% vs. 7%, p=0.015). (2) For 13 of 17 FAIP patients (76.5%) who underwent EUS-TA, EUS-TA aided the diagnostic confirmation of AIPs, and only one patient (5.9%) was found to have AIP after surgery. On the other hand, of the six patients who did not undergo EUS-TA, three (50.0%) underwent surgery for pancreatic lesions. Conclusions: Homogeneous delayed enhancement on contrast-enhanced computed tomography was the most useful clinical factor for discriminating FAIPs from PDACs. EUS-TA is mandatory for diagnostic confirmation of FAIP lesions and can contribute to a reduction in the rate of unnecessary surgery for patients with FAIP.
Hiroaki Kusunose,Shinsuke Koshita,Yoshihide Kanno,Takahisa Ogawa,Toshitaka Sakai,Keisuke Yonamine,Kazuaki Miyamoto,Fumisato Kozakai,Hideyuki Anan,Kazuki Endo,Haruka Okano,Masaya Oikawa,Takashi Tsuchiy 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.3
Background/Aims: This study aimed to clarify the efficacy and safety of pancreatic duct lavage cytology combined with a cell-block method (PLC-CB) for possible pancreatic ductal adenocarcinomas (PDACs). Methods: This study included 41 patients with suspected PDACs who underwent PLC-CB mainly because they were unfit for undergoing endoscopic ultrasonography-guided fine needle aspiration. A 6-Fr double lumen catheter was mainly used to perform PLC-CB. Final diagnoses were obtained from the findings of resected specimens or clinical outcomes during surveillance after PLC-CB. Results: Histocytological evaluations using PLC-CB were performed in 87.8% (36/41) of the patients. For 31 of the 36 patients, final diagnoses (invasive PDAC, 12; pancreatic carcinoma in situ, 5; benignancy, 14) were made, and the remaining five patients were excluded due to lack of surveillance periods after PLC-CB. For 31 patients, the sensitivity, specificity, and accuracy of PLC-CB for detecting malignancy were 94.1%, 100%, and 96.8%, respectively. In addition, they were 87.5%, 100%, and 94.1%, respectively, in 17 patients without pancreatic masses detectable using endoscopic ultrasonography. Four patients developed postprocedural pancreatitis, which improved with conservative therapy. Conclusions: PLC-CB has an excellent ability to detect malignancies in patients with possible PDACs, including pancreatic carcinoma in situ.
Fumisato Kozakai,Yoshihide Kanno,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Toshitaka Sakai,Keisuke Yonamine,Kazuaki Miyamoto,Haruka Okano,Yuto Matsuoka,Kento Hosokawa,Hidehito Sumiya,Kei Ito 대한소화기내시경학회 2024 Clinical Endoscopy Vol.57 No.5
Background/Aims: Endoscopic biliary drainage using self-expandable metallic stents (SEMSs) for malignant biliary strictures occasionally induces acute cholecystitis (AC). This study evaluated the efficacy of prophylactic gallbladder stents (GBS) during SEMS placement. Methods: Among 158 patients who underwent SEMS placement for malignant biliary strictures between January 2018 and March 2023, 30 patients who attempted to undergo prophylactic GBS placement before SEMS placement were included. Results: Technical success was achieved in 21 cases (70.0%). The mean diameter of the cystic duct was more significant in the successful cases (6.5 mm vs. 3.7 mm, p<0.05). Adverse events occurred for 7 patients (23.3%: acute pancreatitis in 7; non-obstructive cholangitis in 1; perforation of the cystic duct in 1 with an overlap), all of which improved with conservative treatment. No patients developed AC when the GBS placement was successful, whereas 25 of the 128 patients (19.5%) without a prophylactic GBS developed AC during the median follow-up period of 357 days (p=0.043). In the multivariable analysis, GBS placement was a significant factor in preventing AC (hazard ratio, 0.61; 95% confidence interval, 0.37-0.99; p=0.045). Conclusions: GBS may contribute to the prevention of AC after SEMS placement for malignant biliary strictures.
Yoshihide Kanno,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Keisuke Yonamine,Yujiro Kawakami,Yuki Fujii,Kazuaki Miyamoto,Toji Murabayashi,Fumisato Kozakai,Jun Horaguchi 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.6
Background/Aims: In this study, we aimed to evaluate the predictive value of localized stenosis of the main pancreatic duct (MPD) forearly detection of pancreatic cancer. Methods: Among 689 patients who underwent endoscopic retrograde pancreatography from January 2008 to September 2018, 19patients with MPD findings were enrolled. These patients showed findings for indicating suspicious pancreatic cancer at an early stage(FiCE); FiCE was defined as a single, localized stenosis in the MPD without a detectable mass (using any other imaging methods) andwithout other pancreatic diseases, such as definite chronic pancreatitis, intraductal papillary mucinous neoplasm, and autoimmunepancreatitis. Final diagnoses were established by examining resected specimens or through follow-up examinations after an interval of>5 years. Results: Among 19 patients with FiCE, 11 underwent surgical resection and 8 were evaluated after a >5-year observation period. Thefinal diagnosis of the MPD stenosis was judged to be pancreatic cancer in 9 patients (47%), including 3 with intraepithelial cancer, andto be a non-neoplastic change in 10. The sensitivity, specificity, and accuracy of preoperative pancreatic juice cytology were 75%, 100%,and 88%, respectively. Conclusions: The predictive value of FiCE for pancreatic cancer prevalence was 47%. Histological confirmation with pancreatic juicecytology is necessary before surgical resection.
Yoshihide Kanno,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Keisuke Yonamine,Kazuaki Miyamoto,Toji Murabayashi,Fumisato Kozakai,Jun Horaguchi,Yutaka Noda,Kei Ito 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.6
Background/Aims: The aim of this study was to evaluate outcomes of inside plastic stents (iPSs) versus those of metal stents (MSs) for treating unresectable perihilar malignant obstructions. Methods: For all patients who underwent endoscopic suprapapillary placement of iPS(s) or MS(s) as the first permanent biliary drainage for unresectable malignant perihilar obstructions between January 2014 and August 2019, clinical outcomes using iPSs (n=20) and MSs (n=85), including clinical efficacy, adverse events, and time to recurrence of biliary obstruction (RBO), were retrospectively evaluated. Results: There were no differences in clinical effectiveness (95% for the iPS group vs. 92% for the MS group, p=1.00). Procedure-related adverse events, including pancreatitis, acute cholangitis, acute cholecystitis, and death, were observed for 8% of the MS group, although no patient in the iPS group developed such adverse events. The median time to RBO was 561 days (95% confidence interval, 0–1,186 days) for iPSs and 209 days (127–291 days) for MSs, showing a significant difference (p=0.008). Conclusions: Time to RBO after iPS placement was significantly longer than that after MS placement. IPSs, which are removable, unlike MSs, were an acceptable option.
Yoshihide Kanno,Tetsuya Ohira,Yoshihiro Harada,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Yoshiki Koike,Taku Yamagata,Toshitaka Sakai,Kaori Masu,Keisuke Yonamine,Kazuaki Miyamoto,Megumi Tanaka,T 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.3
Background/Aims: The aim of this study was to evaluate the safety of sedation with propofol as an alternative to benzodiazepinedrugs in outpatient endoscopy. Methods: In this prospective study, examinees who underwent outpatient endoscopy under propofol sedation and submitted a nextdayquestionnaire with providing informed consent were evaluated. Periprocedural acute responses, late adverse events within 24hours, and examinee satisfaction were evaluated. Results: Among the 4,122 patients who received propofol in the 17,978 outpatient-based endoscopic examinations performedbetween November 2016 and March 2018, 2,305 eligible examinees (esophagogastroduodenoscopy for 1,340, endoscopicultrasonography for 945, and total colonoscopy for 20) were enrolled, and their responses to a questionnaire were analyzed. Themean propofol dose was 69.6±24.4 mg (range, 20–200 mg). Diazepam, midazolam, and/or pentazocine in combination withpropofol was administered to 146 examinees. Mild oxygen desaturation was observed in 59 examinees (2.6%); and mild bradycardia,in 2 (0.09%). Other severe reactions or late events did not occur. After eliminating 181 invalid responses, 97.7% (2,065/2,124) of thepatients desired propofol sedation in future examinations. Conclusions: Propofol sedation was found to be safe-without severe adverse events or accidents-for outpatient endoscopy on thebasis of the patients’ next-day self-evaluation. Given the high satisfaction level, propofol sedation might be an ideal tool for painlessendoscopic screening.
Fumisato Kozakai,Yoshihide Kanno,Kei Ito,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Toji Murabayashi,Keisuke Yonamine,Yujiro Kawakami,Yuki Fujii,Kazuaki Miyamoto,Yutak 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.3
Background/Aims: It is often diffcult to manage acute cholecystitis after metal stent (MS) placement in unresectable malignant biliarystrictures. The aim of this study was to evaluate the feasibility of endoscopic ultrasonography-guided gallbladder drainage (EUS-GBD)for acute cholecystitis. Methods: The clinical outcomes of 10 patients who underwent EUS-GBD for acute cholecystitis after MS placement between January2011 and August 2018 were retrospectively evaluated. The procedural outcomes of percutaneous transhepatic gallbladder drainage(PTGBD) with tube placement (n=11 cases) and aspiration (PTGBA) (n=27 cases) during the study period were evaluated as a reference. Results: The technical success and clinical effectiveness rates of EUS-GBD were 90% (9/10) and 89% (8/9), respectively. Severe bileleakage that required surgical treatment occurred in one case. Acute cholecystitis recurred after stent dislocation in 38% (3/8) of thecases. Both PTGBD and PTGBA were technically successful in all cases without severe adverse events and clinically effective in 91% and63% of the cases, respectively. Conclusions: EUS-GBD after MS placement was a feasible option for treating acute cholecystitis. However, it was a rescue techniquefollowing the established percutaneous intervention in the current setting because of the immature technical methodology, includingdedicated devices, which need further development.