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Arata, Masanori,Takahashi, Norio,Fujita, Masafumi,Mochizuki, Motoyasu,Araki, Takashi,Hanai, Takashi The Korean Institute of Power Electronics 2012 JOURNAL OF POWER ELECTRONICS Vol.12 No.1
According to electrical output up rating of a permanent magnet motor and request to operate for a large variable speed range, resonance between structural natural vibration and electromagnetic force inside the motor can take place and make noise. This paper describes the mechanism of a resonance between them and noise lowering procedure by frequency shift when they are applied to the reluctance torque largely employed new motor named Permanent magnet Reluctance Motor (PRM).
Masanori Arata,Norio Takahashi,Masafumi Fujita,Motoyasu Mochizuki,Takashi Araki,Takashi Hanai 전력전자학회 2012 JOURNAL OF POWER ELECTRONICS Vol.12 No.1
According to electrical output up rating of a permanent magnet motor and request to operate for a large variable speed range, resonance between structural natural vibration and electromagnetic force inside the motor can take place and make noise. This paper describes the mechanism of a resonance between them and noise lowering procedure by frequency shift when they are applied to the reluctance torque largely employed new motor named Permanent magnet Reluctance Motor (PRM).
Arata Sakai,Hideyuki Shiomi,Takao Iemoto,Ryota Nakano,Takuya Ikegawa,Takashi Kobayashi,Atsuhiro Masuda,Yuzo Kodama 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.4
In this study, we assessed a series of our cases in which endoscopic self-expandable metal stents (SEMSs) were used to treat malignantafferent loop obstruction (ALO) that arose after pancreaticoduodenectomy (PD). We retrospectively examined the records of 7 patientswho underwent endoscopic SEMS placement for malignant ALO following PD. Clinical success was achieved in all cases. The medianprocedure time was 30 min (range, 15–50 min). There were no cases of stent occlusion, and no procedure-related adverse events wereencountered. All patients died of their primary disease, and the median overall survival period was 155 days (range, 96–374 days). Are-intervention involving endoscopic ultrasound-guided hepaticogastrostomy combined with antegrade stenting was performed forobstructive jaundice and acute cholangitis in 1 case. In conclusion, endoscopic SEMS placement may be an effective and safe treatmentfor malignant ALO that arises after PD.
Arata Sakai,Atsuhiro Masuda,Takaaki Eguchi,Keisuke Furumatsu,Takao Iemoto,Shiei Yoshida,Yoshihiro Okabe,Kodai Yamanaka,Ikuya Miki,Saori Kakuyama,Yosuke Yagi,Daisuke Shirasaka,Shinya Kohashi,Takashi Ko 대한소화기내시경학회 2024 Clinical Endoscopy Vol.57 No.3
Background/Aims: Endoscopic self-expandable metal stent (SEMS) placement is currently the standard technique for treating unresectable malignant distal biliary obstructions (MDBO). Therefore, covered SEMS with longer stent patency and fewer migrations are required. This study aimed to assess the clinical performance of a novel, fully covered SEMS for unresectable MDBO. Methods: This was a multicenter single-arm prospective study. The primary outcome was a non-obstruction rate at 6 months. The secondary outcomes were overall survival (OS), recurrent biliary obstruction (RBO), time to RBO (TRBO), technical and clinical success, and adverse events. Results: A total of 73 patients were enrolled in this study. The non-obstruction rate at 6 months was 61%. The median OS and TRBO were 233 and 216 days, respectively. The technical and clinical success rates were 100% and 97%, respectively. Furthermore, the rate of occurrence of RBO and adverse events was 49% and 21%, respectively. The length of bile duct stenosis (<2.2 cm) was the only significant risk factor for stent migration. Conclusions: The non-obstruction rate of a novel fully covered SEMS for MDBO is comparable to that reported earlier but shorter than expected. Short bile duct stenosis is a significant risk factor for stent migration.
Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome
Hideyuki Shiomi,Arata Sakai,Ryota Nakano,Shogo Ota,Takashi Kobayashi,Atsuhiro Masuda,Hiroko Iijima 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.6
Afferent loop syndrome (ALS) is a mechanical obstruction of the afferent limbs after gastrectomy with gastrojejunostomyreconstruction. Patients with cancer recurrence require immediate and less invasive treatment because of their poor condition. Percutaneous transhepatic/transluminal drainage (PTD) and endoscopic enteral stenting offer reasonable palliative treatment formalignant ALS but are not fully satisfactory in terms of patient quality of life (QoL) and stent patency. Endoscopic ultrasound-guidedgastroenterostomy (EUS-GE) using a lumen-apposing metal stent may address these shortcomings. Clinical data from 11 reportsshowed that all patients who had undergone EUS-GE had positive technical and clinical outcomes. The adverse event rate was11.4%, including only mild or moderate abdominal pain, with no severe adverse events. Indirect comparative studies indicated thatpatients who had undergone EUS-GE had a significantly superior QoL, a higher clinical success rate, and a lower reintervention ratethan those who had undergone PTD or endoscopic enteral stenting. Although the evidence is limited, EUS-GE may be consideredas a first-line treatment for malignant ALS because it has better clinical outcomes than other less invasive treatments, such as PTD orendoscopic enteral stenting. Further prospective randomized control trials are necessary to establish EUS-GE as a standard treatmentfor ALS.
Masashi Utsumi,Hideki Aoki,Seiichi Nagahisa,Seitaro Nishimura,Yuta Une,Yuji Kimura,Megumi Watanabe,Fumitaka Taniguchi,Takashi Arata,Koh Katsuda,Kohji Tanakaya 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.99 No.1
Purpose: Postoperative pancreatic fistula (POPF) is the most important factor affecting morbidity and mortality after pancreaticoduodenectomy (PD). Patients with a high controlling nutritional status (CONUT) score, which is used to assess nutritional status, are expected to have high morbidity rates. This study aimed to determine the usefulness of the CONUT score. Methods: Data from 97 consecutive cases of PD performed in the Department of Surgery of Iwakuni Clinical Center, from April 2008 to May 2018, were included. Preoperative patient data, including sex, age, and hypertension, and postoperative complication data were collected to analyze pancreatic fistula occurrence. Results: Of the 97 patients, 2 9 patients (29.8%) were diagnosed with POPF ≥ B, with 26 cases (26.8%) classified as grade B and 3 (3.1%) as grade C. The mortality rate was 2.1% (2 of 97). In the univariate analysis, a significant association was observed between POPF and the following factors: body mass index (BMI) ≥ 22 kg/m2, high CONUT score, nonpancreatic carcinoma, and CT attenuation values. In multivariate analysis, BMI ≥ 22 kg/m2 (odds ratio [OR], 6.16; P < 0.001), high CONUT score (OR, 3.77; P = 0.009), nonpancreatic carcinoma (OR, 5.72; P = 0.009), and CT attenuation values (late/early ratio) in the pancreas (OR, 9.07; P = 0.006) were independent risk factors for POPF. Conclusion: Patients with a high CONUT score are at high risk of POPF. Further study correlating preoperative nutritional intervention with risk of POPF is necessary