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      • KCI등재

        Diagnostic Ability of Convex-Arrayed Endoscopic Ultrasonography for Major Vascular Invasion in Pancreatic Cancer

        Yuki Fujii,Kazuyuki Matsumoto,Hironari Kato,Yosuke Saragai,Saimon Takada,Sho Mizukawa,Shinichiro Muro,Daisuke Uchida,Takeshi Tomoda,Shigeru Horiguchi,Noriyuki Tanaka,Hiroyuki Okada 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.5

        Background/Aims: This study aimed to examine the diagnostic ability of endoscopic ultrasonography (EUS) for major vascularinvasion in pancreatic cancer and to evaluate the relationship between EUS findings and pathological distance. Methods: In total, 57 consecutive patients who underwent EUS for pancreatic cancer before surgery were retrospectively reviewed. EUSimage findings were divided into four types according to the relationship between the tumor and major vessel (types 1 and 2: invasion,types 3 and 4: non-invasion). We also compared the EUS findings and pathologically measured distances between the tumors andevaluated vessels. Results: The sensitivity, specificity, and accuracy of EUS diagnosis for vascular invasion were 89%, 92%, and 91%, respectively, in theveins and 83%, 94%, and 93%, respectively, in the arteries. The pathologically evaluated distances of cases with type 2 EUS findings weresignificantly shorter than those of cases with type 3 EUS findings in both the major veins (median [interquartile range], 96 [0–742] µmvs. 2,833 [1,076–5,694] µm, p=0.012) and arteries (623 [0–854] µm vs. 3,097 [1,396–6,000] µm, p=0.0061). All cases with a distance of≥1,000 µm between the tumors and main vessels were correctly diagnosed. Conclusions: Tumors at a distance ≥1,000 µm from the main vessels were correctly diagnosed by EUS.

      • Design and Construction of GINZA KABUKIZA

        Kawamura, Hiroshi,Ishibashi, Yoji,Morofushi, Tsutomu,Saragai, Yasuyuki,Inubushi, Akira,Yasutomi, Ayako,Fuse, Naohiko,Yoshifuku, Manabu,Saitoh, Kouji Council on Tall Building and Urban Habitat Korea 2016 International journal of high-rise buildings Vol.5 No.3

        This paper describes the structural solution for the design of a 29-story high-rise tower, which features a large office space above the Kabukiza Theatre. Kabuki is a type of Japanese traditional drama, and Kabukiza is the home building of Kabuki. GINZA KABUKIZA is the fifth generation of the Kabukiza Theatre, the first of which was built in 1889. In order to support 23 stories of office space above the theater - featuring a large void in plan - two 13-meter-deep mega-trusses, spanning 38.4 meters, are installed at the fifth floor of the building. Steelwork is used as a primary material for the structure above-ground, and a hybrid response control system using a buckling-restrained brace and oil damper is adopted in order to achieve a high seismic performance. This paper also describes the erection process of installing hydraulic jacks directly above the mega-truss at column bases, in order to keep the structure above the truss level during construction. The temple architecture of the previous Kabukiza is carefully restored by incorporating contemporary light-weight materials supported by steelwork.

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        Comparison of Bilateral and Trisegment Drainage in Patients with High-Grade Hilar Malignant Biliary Obstruction: A Multicenter Retrospective Study

        Matsumoto Kazuyuki,Kato Hironari,Morimoto Kosaku,Miyamoto Kazuya,Saragai Yosuke,Kawamoto Hirofumi,Okada Hiroyuki 거트앤리버 소화기연관학회협의회 2023 Gut and Liver Vol.17 No.1

        Background/Aims: Bilateral endoscopic drainage with self-expanding metallic stent (SEMS) can be used to effectively manage hilar malignant biliary obstruction. However, the benefits of using a trisegment drainage method remain unknown. Methods: This study retrospectively reviewed the data of 125 patients with Bismuth type IIIa or IV unresectable malignant strictures who underwent bilateral endoscopic drainage using SEMSs at four tertiary centers. The patients were divided into the bilateral and trisegment drainage groups for comparison. The primary endpoint was stent patency and the secondary endpoints were technical success, technical and clinical success of reintervention, and overall survival. Results: The technical success rates of the bilateral and trisegment drainage groups were 95% (34/36) and 90% (80/89) (p=0.41), respectively, with median stent patency durations of 226 and 170 days (p=0.26), respectively. Although the technical success of reintervention was not significantly different between the two groups (p=0.51), the clinical success rate of reintrvention was significantly higher in the trisegment drainage group (73% [11/15] vs 96% [47/49], p=0.009). The median survival times were 324 and 323 days in the bilateral and trisegment drainage groups, respectively (p=0.72). Multivariate Cox hazards model revealed no stent patency-associated factor; however, chemotherapy was associated with longer survival. Conclusions: Although no significant difference was noted with respect to stent patency, significantly higher clinical success rates were achieved with reintervention using the trisegment drainage method than using the bilateral drainage method alone.

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        Utility of Endoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Local Recurrence of Pancreaticobiliary Cancer after Surgical Resection

        Kazuyuki Matsumoto,Hironari Kato,Shigeru Horiguchi,Takeshi Tomoda,Akihiro Matsumi,Yuki Ishihara,Yosuke Saragai,Saimon Takada,Shinichiro Muro,Daisuke Uchida,Hiroyuki Okada 거트앤리버 소화기연관학회협의회 2020 Gut and Liver Vol.14 No.5

        Background/Aims: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA; EUS-FNA) allows for diagnostic tissue specimens from various regions to be analyzed. However, diagnosing recurrent pancreaticobiliary cancer after surgery is sometimes difficult. We evaluated the efficacy of EUS-FNA in the diagnosis of local recurrence of pancreaticobiliary cancer and analyzed the factors associated with falsenegative results. Methods: Fifty-one consecutive patients who underwent EUS-FNA due to suspected recurrence of pancreaticobiliary cancer after surgery in an academic center were retrospectively analyzed. The criteria for EUS-FNA were a resected margin or remnant pancreas mass, round swollen lymph node (≥10 mm in diameter), and soft-tissue enhancement around a major artery. Patients with suspected liver metastasis or malignant ascites were excluded. Results: Thirty-nine of the 51 patients had pancreatic cancer; the remaining 12 had biliary cancer. The target sites for EUS-FNA were the soft tissue around a major artery (n=22, 43%), the resected margin or remnant pancreas (n=12, 24%), and the lymph nodes (n=17, 33%). The median size of the suspected recurrent lesions was 15 mm (range, 8 to 40 mm). The overall sensitivity, specificity and accuracy of EUS-FNA for the diagnosis of recurrence was 84% (32/38), 100% (13/13), and 88% (45/51), respectively. FNA of the soft tissue around major arteries (odds ratio, 8.23; 95% confidence interval, 1.2 to 166.7; p=0.033) was significantly associated with a falsenegative diagnosis in the multivariate analysis. Conclusions: EUS-FNA is useful for diagnosing recurrent cancer, even after pancreaticobiliary surgery. The diagnoses of recurrence at soft-tissue sites should be interpreted with caution.

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