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Takashi Tamura,Yasunobu Yamashita,Kazuki Ueda,Yuki Kawaji,Masahiro Itonaga,Shin-ichi Murata,Kaori Yamamoto,Takeichi Yoshida,Hiroki Maeda,Takao Maekita,Mikitaka Iguchi,Hideyuki Tamai,Masao Ichinose,Jun 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.4
Background/Aims: Endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) has been used to diagnose gastrointestinal submucosal tumors (SMTs). Although rapid on-site evaluation (ROSE) has been reported to improve the diagnostic accuracy of EUS-FNA for pancreatic lesions, on-site cytopathologists are not routinely available. Given this background, the usefulness of ROSE by endosonographers themselves for pancreatic tumors has also been reported. However, ROSE by endosonographers for diagnosis of SMT has not been reported. The aim of this study was to evaluate the diagnostic accuracy of EUS-FNA with ROSE by endosonographers for SMT, focusing on diagnosis of gastrointestinal stromal tumor (GIST), compared with that of EUS-FNA alone. Methods: Twenty-two consecutive patients who underwent EUS-FNA with ROSE by endosonographers for SMT followed by surgical resection were identified. Ten historical control subjects who underwent EUS-FNA without ROSE were used for comparison. Results: The overall diagnostic accuracy for SMT was significantly higher in cases with than without ROSE (100% vs. 80%, p=0.03). The number of needle passes by FNA with ROSE by endosonographers tended to be fewer, although accuracy was increased (3.3±1.3 vs. 5.9±3.8, p=0.06). Conclusions: ROSE by endosonographers during EUS-FNA for SMT is useful for definitive diagnosis, particularly for GIST.
Contrast Enhanced Endoscopic Ultrasound Imaging for Gastrointestinal Subepithelial Tumors
Takashi Tamura,Masayuki Kitano 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.4
Subepithelial tumors are divided into benign subepithelial and potentially malignant gastrointestinal stromal tumors. It is difficultto distinguish between these tumor types. Contrast-enhanced harmonic endoscopic ultrasound is reportedly useful for diagnosingsubepithelial tumors, can be safely and easily performed by understanding the principle and method, and can be used to distinguishbetween tumor types with high sensitivity on the basis of differences in contrast effect. The generated image shows a hyperenhancementpattern in gastrointestinal stromal tumors (sensitivity, 78%–100%; specificity, 60%–100%; accuracy, 60%–100%) and hypoenhancementpattern in benign subepithelial tumors. Contrast-enhanced harmonic endoscopic ultrasound can be used to estimatethe malignancy potential of gastrointestinal stromal tumors by evaluating the uniformity of the contrast and the blood vessels insidethe tumor, with abnormal intra-tumor blood vessels, heterogeneous enhancement, and non-enhancing spots suggesting malignancy. Contrast-enhanced harmonic endoscopic ultrasound has a higher sensitivity than other imaging modalities for the detection ofvascularity within gastrointestinal stromal tumors. Additionally, it has been reported that treatment effects can be estimated byevaluating the blood flow in the gastrointestinal stromal tumor before and after treatment with tyrosine kinase inhibitors using contrastenhancedultrasound. However, there will be subjective-bias and the results depends on the performer’s skill.
Prevalence and Self-recognition of Chronic Constipation: Results of an Internet Survey
( Akio Tamura ),( Toshihiko Tomita ),( Tadayuki Oshima ),( Fumihiko Toyoshima ),( Takahisa Yamasaki ),( Takuya Okugawa ),( Takashi Kondo ),( Tomoaki Kono ),( Katsuyuki Tozawa ),( Hisatomo Ikehara ),( 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2016 Journal of Neurogastroenterology and Motility (JNM Vol.22 No.4
Background/Aims Although chronic constipation is a common symptom, to date no international consensus has been reached regarding its definition. The aims of this study were (1) to investigate defecation habits and (2) to examine the prevalence of constipation using the Japanese Society of Internal Medicine (JSIM) and the Rome III criteria using an online survey. Methods An online questionnaire composed of items on the frequency, interval, form of defecation, the management, and self-recognition of constipation (reference standard of constipation) was created. A total of 5155 valid responses were received. In addition, constipation symptoms were evaluated through a survey using the JSIM and the Rome III criteria. Results In the internet survey, 28.4% of the respondents considered themselves to be constipated. Stratified by sex, significantly more females (37.5%) than males (19.1%) considered themselves to be constipated (P < 0.001). The prevalence of constipation among the respondents was 28.0% using the Rome III, but only 10.1% using the JSIM. The diagnostic accuracy was 73.2% for the Rome III and 78.1% for the JSIM, while the diagnostic specificity was 81.1% for the Rome III and 97.5% for the JSIM. However, the diagnostic sensitivities for both measures were low, at 52.2% and 29.2% for the Rome III and the JSIM, respectively. Conclusions The online survey developed for this study was able to provide clarification regarding defecation patterns. The results also suggest a discrepancy between the self-recognized prevalence of constipation in Japan and prevalence of constipation based on the JSIM criteria.
Aggregation States of Polyamide 4 Thin Films under an Aqueous Environment
Shunta Tamura,Haruki Mokudai,Takashi Masaki,Norifumi L. Yamada,Hisao Matsuno,Keiji Tanaka 한국고분자학회 2021 한국고분자학회 학술대회 연구논문 초록집 Vol.46 No.2
Polyamide 4 (PA4) having only four carbons between neighboring amide groups exhibits enhanced biodegradability, and thus, has been studied as one of candidates for eco-friendly structural materials. However, the biodegradation mechanism for PA4 is far clear for a moment. We here examined the aggregation states of PA4 thin films coated on a hydrophobized SiOx substrate using atomic force microscopy (AFM) and neutron reflectivity (NR) analyses in air and water environments. AFM observation revealed that the outermost surface of the PA4 film was featureless and flat at a nanometer level. Once the film was immersed into water, the thickness increased by approximately 1.1 times. NR made it clear that the PA4 film was swollen due to the water sorption in the film, and that there existed multiple layers having different densities along the direction normal to the interface. Effect of annealing temperature on such the aggregation states and the degradability will be also discussed.
Behavior of R/C cylindrical shell under lateral load
Hara, Takashi,Shigematsu, Tsunemi,Tamura, Takahiro Techno-Press 2003 Structural Engineering and Mechanics, An Int'l Jou Vol.16 No.3
In this paper, the structural behavior of R/C cylindrical panel is analyzed by experimental results. To avoid the geometric imperfection, R/C shell specimens are made by use of a stiff steel mold. From experimental results, the load carrying behavior of R/C cylindrical panel is presented under an external lateral pressure. Even if R/C shell does not posses geometric imperfections, the inaccuracy of the reinforcement position strongly affects to the ultimate strength and the failure patterns of such shells. To explain these effects, FEM nonlinear analyses are done under the same conditions as those of experiments. The behavior of R/C cylindrical shells are well simulated under the consideration of both the geometric imperfection and several inaccuracies.
Yasunobu Yamashita,Kazuki Ueda,Yuki Kawaji,Takashi Tamura,Masahiro Itonaga,Takeichi Yoshida,Hiroki Maeda,Hirohito Magari,Takao Maekita,Mikitaka Iguchi,Hideyuki Tamai,Masao Ichinose,Jun Kato 거트앤리버 소화기연관학회협의회 2016 Gut and Liver Vol.10 No.4
Background/Aims: Transpapillary forceps biopsy is an effective diagnostic technique in patients with biliary stricture. This prospective study aimed to determine the usefulness of the wire-grasping method as a new technique for forceps biopsy. Methods: Consecutive patients with biliary stricture or irregularities of the bile duct wall were randomly allocated to either the direct or wire-grasping method group. In the wiregrasping method, forceps in the duodenum grasps a guidewire placed into the bile duct beforehand, and then, the forceps are pushed through the papilla without endoscopic sphincterotomy. In the direct method, forceps are directly pushed into the bile duct alongside a guide-wire. The primary endpoint was the success rate of obtaining specimens suitable for adequate pathological examination. Results: In total, 32 patients were enrolled, and 28 (14 in each group) were eligible for analysis. The success rate was significantly higher using the wire-grasping method than the direct method (100% vs 50%, p=0.016). Sensitivity and accuracy for the diagnosis of cancer were comparable in patients with the successful procurement of biopsy specimens between the two methods (91% vs 83% and 93% vs 86%, respectively). Conclusions: The wire-grasping method is useful for diagnosing patients with biliary stricture or irregularities of the bile duct wall.
Yasunobu Yamashita,Kensuke Tanioka,Yuki Kawaji,Takashi Tamura,Junya Nuta,Keiichi Hatamaru,Masahiro Itonaga,Takeichi Yoshida,Yoshiyuki Ida,Takao Maekita,Mikitaka Iguchi,Masayuki Kitano 거트앤리버 소화기연관학회협의회 2020 Gut and Liver Vol.14 No.5
Background/Aims: Rosemont classification (RC) with endoscopic ultrasonography (EUS) is important for diagnosing chronic pancreatitis (CP) but is based only on subjective judgement. EUS shear wave measurement (EUS-SWM) is a precise modality based on objective judgment, but its usefulness has not been extensively studied yet. This study evaluated the utility of EUS-SWM for diagnosing CP and estimating CP severity by determining the presence of endocrine dysfunction along with diabetes mellitus (DM). Methods: Between June 2018 and December 2018, 52 patients who underwent EUS and EUS-SWM were classified into two groups according to RC: non-CP (indeterminate CP and normal) and CP (consistent and suggestive of CP). The EUSSWM value by shear wave velocity was evaluated with a median value. The EUS-SWM value was compared with RC and the number of EUS features. The diagnostic accuracy and cutoff value of EUS-SWM for CP and DM and its sensitivity and specificity were calculated. Results: The EUS-SWM value significantly positively correlated with the RC and the number of EUS features. The EUS-SWM values that were consistent and suggestive of CP were significantly higher than that of normal. The area under the receiver operating characteristic (AUROC) curve for the diagnostic accuracy of EUS-SWM for CP was 0.97. The cutoff value of 2.19 had 100% sensitivity and 94% specificity. For endocrine dysfunction in CP, the AUROC was 0.75. The cutoff value of 2.78 had 70% sensitivity and 56% specificity. Conclusions: EUS-SWM provides an objective assessment and can be an alternative diagnostic tool for diagnosing CP. EUS-SWM may also be useful for predicting the presence of endocrine dysfunction.