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Endoscopic ultrasound-guided drainage for an abscess cavity
Nozomi Okuno,Kazuo Hara,Nobumasa Mizuno,Shin Haba,Takamichi Kuwahara,Yasuhiro Kuraishi,Takafumi Yanaidani,Sho Ishikawa,Tsukasa Yasuda,Masanori Yamada,Toshitaka Fukui 소화기인터벤션의학회 2022 International journal of gastrointestinal interven Vol.11 No.4
Endoscopic ultrasound (EUS)-guided interventions, including EUS-guided biliary drainage and EUS-guided cystic drainage, are now well developed and in widespread use. Intraperitoneal abscess requires drainage because mortality associated with an undrained abscess is high. Percutaneous or surgical drainage has traditionally been performed, but there have been numerous reports of EUS-guided drainage for intraperitoneal abscesses in recent years. EUS-guided abscess drainage has the advantage of being less invasive and enabling direct access to the cavity via the trans-luminal route as well as clear visualization of interposed vessels using color Doppler ultrasonography. It is necessary to consider the advantages and disadvantages when selecting a drainage method. This article reviews the current status of EUS-guided abscess drainage at three sites: the liver, pelvis, and mediastinum.
Infectious peritonitis after endoscopic ultrasound-guided biliary drainage in a patient with ascites
Nozomi Okuno,Kazuo Hara,Nobumasa Mizuno,Takamichi Kuwahara,Hiromichi Iwaya,Masahiro Tajika,Tsutomu Tanaka,Makoto Ishihara,Yutaka Hirayama,Sachiyo Onishi,Kazuhiro Toriyama,Ayako Ito,Naosuke Kuraoka,Shi 소화기인터벤션의학회 2018 Gastrointestinal Intervention Vol.7 No.1
Summary of Event Bacterial, mycotic peritonitis and Candida fungemia developed in a patient with moderate ascites who had undergone endoscopic ultrasound-guided biliary drainage (EUS-BD). Antibiotics and antifungal agent were administered and ascites drainage was performed. Although the infection improved, the patient’s general condition gradually deteriorated due to aggravation of the primary cancer and he died. Teaching Point This is the first report to describe infectious peritonitis after EUS-BD. Ascites carries the potential risk of severe complications. As such, in patients with ascites, endoscopic retrograde cholangiopancreatography (ERCP) is typically preferred over EUS-BD or percutaneous drainage to prevent bile leakage. However, ERCP may not be possible in some patients with tumor invasion of the duodenum or with surgically altered anatomy. Thus, in patients with ascites who require EUS-BD, we recommend inserting the drainage tube percutaneously and draining the ascites before and after the intervention in order to prevent severe infection.
Nozomi Okuno,Kazuo Hara,Nobumasa Mizuno,Shin Haba,Takamichi Kuwahara,Hiroki Koda,Masahiro Tajika,Tsutomu Tanaka,Sachiyo Onishi,Keisaku Yamada,Akira Miyano,Daiki Fumihara,Moaz Elshair 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.4
Background/Aims: The Japan Gastroenterological Endoscopy Society (JGES) has published guidelines for gastroenterologicalendoscopy in patients undergoing antithrombotic treatment. These guidelines classify endoscopic ultrasound-guided biliary drainage(EUS-BD) as a high-risk procedure. Nevertheless, the bleeding risk of EUS-BD in patients undergoing antithrombotic therapy isuncertain. Therefore, this study aimed to assess the bleeding risk in patients undergoing antithrombotic therapy. Methods: This single-center retrospective study included 220 consecutive patients who underwent EUS-BD between January 2013and December 2018. We managed the withdrawal and continuation of antithrombotic agents according to the JGES guidelines. Wecompared the bleeding event rates among patients who received and those who did not receive antithrombotic agents. Results: A total of 18 patients (8.1 %) received antithrombotic agents and 202 patients (91.8 %) did not. Three patients experiencedbleeding events, with an overall bleeding event rate of 1.3% (3/220): one patient was in the antithrombotic group (5.5%) and twopatients were in the non-antithrombotic group (0.9%) (p=0.10). All cases were moderate. The sole thromboembolic event (0.4%) wasa cerebral infarction in a patient in the non-antithrombotic group. Conclusions: The rate of EUS-BD-related bleeding events was low. Even in patients receiving antithrombotic therapy, the bleedingevent rates were not significantly different from those in patients not receiving antithrombotic therapy.
Endoscopic ultrasound-guided drainage for an abscess cavity
Nozomi Okuno,Kazuo Hara,Nobumasa Mizuno,Shin Haba,Takamichi Kuwahara,Yasuhiro Kuraishi,Takafumi Yanaidani,Sho Ishikawa,Tsukasa Yasuda,Masanori Yamada,Toshitaka Fukui 소화기인터벤션의학회 2022 Gastrointestinal Intervention Vol.11 No.4
Endoscopic ultrasound (EUS)-guided interventions, including EUS-guided biliary drainage and EUS-guided cystic drainage, are now well developed and in widespread use. Intraperitoneal abscess requires drainage because mortality associated with an undrained abscess is high. Percutaneous or surgical drainage has traditionally been performed, but there have been numerous reports of EUS-guided drainage for intraperitoneal abscesses in recent years. EUS-guided abscess drainage has the advantage of being less invasive and enabling direct access to the cavity via the trans-luminal route as well as clear visualization of interposed vessels using color Doppler ultrasonography. It is necessary to consider the advantages and disadvantages when selecting a drainage method. This article reviews the current status of EUS-guided abscess drainage at three sites: the liver, pelvis, and mediastinum.
Correlation between Cr Distribution and Ferromagnetism in Iodine-Doped (Zn,Cr)Te
Nozomi Nishizawa,Koichiro Ishikawa,Shinji Kuroda,Koki Takita,Masanori Mitome,Yoshio Bando,Tomasz Dietl 한국물리학회 2008 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.53 No.5
zation measurements and structural and chemical characterizations were performed on a series of epitaxial lms grown by molecular beam epitaxy. The magnetic properties of (Zn,Cr)Te films were altered significantly by co-doping charge impurities or by changing Zn and Te flux supplies during epitaxy. The nano-scale probing of the constituent elements using energy-dispersive X-ray spectroscopy (EDS) revealed that the Cr distribution in the crystal was clearly correlated with the ferromagnetic properties and the origin of high-temperature ferromagnetism was the formation of nano-scale Cr-rich regions in inhomogeneous Cr distributions. As an origin of the variation of the uniformity of Cr distribution, it is proposed that the aggregation energy of Cr ions is modified by the deviation of the Cr charge state which is manipulated by the co-doping or the deviation from stoichiometry.
Development of a learning support system with PaPeRo
Nozomi Fujiwara,Yoshinobu Hagiwara,Yongwoon Choi 제어로봇시스템학회 2012 제어로봇시스템학회 국제학술대회 논문집 Vol.2012 No.10
We propose a learning support system with a robot for asynchronous learning. The proposed system consists of a teacher, a user, a robot, a personal computer, an educational material, and a web camera. In asynchronous learning, the timing to provide the supports such as hints and answers in learning is one of important factors. Here, we endowed a robot with this roll on the timing estimated by extracting the features of usual facial expressions or behaviors of a user in an image captured by a web camera. Thus, we can expect that the robot may give a user learning supports in real time. In fact, we developed the base system that a robot provides hints in the timing estimated by extracting the human general feature tilting own head when we don’t understand something. We attempted to evaluate the usefulness for the base system through the experiments of English words learning and some questionnaires for college students. In these experiments, we used a communication robot, PaPeRo, for confirming the counteraction and effect of users. This paper is discussed on the experimental results of the questionnaires and the possibility that user’s motivation can be improved by the affinity of the robot in the system.
Infectious peritonitis after endoscopic ultrasound-guided biliary drainage in a patient with ascites
Nozomi Okuno,Kazuo Hara,Nobumasa Mizuno,Takamichi Kuwahara,Hiromichi Iwaya,Masahiro Tajika,Tsutomu Tanaka,Makoto Ishihara,Yutaka Hirayama,Sachiyo Onishi,Kazuhiro Toriyama,Ayako Ito,Naosuke Kuraoka,Shi 소화기인터벤션의학회 2018 International journal of gastrointestinal interven Vol.7 No.1
Summary of Event Bacterial, mycotic peritonitis and Candida fungemia developed in a patient with moderate ascites who had undergone endoscopic ultrasound-guided biliary drainage (EUS-BD). Antibiotics and antifungal agent were administered and ascites drainage was performed. Although the infection improved, the patient’s general condition gradually deteriorated due to aggravation of the primary cancer and he died. Teaching Point This is the first report to describe infectious peritonitis after EUS-BD. Ascites carries the potential risk of severe complications. As such, in patients with ascites, endoscopic retrograde cholangiopancreatography (ERCP) is typically preferred over EUS-BD or percutaneous drainage to prevent bile leakage. However, ERCP may not be possible in some patients with tumor invasion of the duodenum or with surgically altered anatomy. Thus, in patients with ascites who require EUS-BD, we recommend inserting the drainage tube percutaneously and draining the ascites before and after the intervention in order to prevent severe infection. Summary of Event Bacterial, mycotic peritonitis and Candida fungemia developed in a patient with moderate ascites who had undergone endoscopic ultrasound-guided biliary drainage (EUS-BD). Antibiotics and antifungal agent were administered and ascites drainage was performed. Although the infection improved, the patient’s general condition gradually deteriorated due to aggravation of the primary cancer and he died. Teaching Point This is the first report to describe infectious peritonitis after EUS-BD. Ascites carries the potential risk of severe complications. As such, in patients with ascites, endoscopic retrograde cholangiopancreatography (ERCP) is typically preferred over EUS-BD or percutaneous drainage to prevent bile leakage. However, ERCP may not be possible in some patients with tumor invasion of the duodenum or with surgically altered anatomy. Thus, in patients with ascites who require EUS-BD, we recommend inserting the drainage tube percutaneously and draining the ascites before and after the intervention in order to prevent severe infection.
Nozomi Okuno,Kazuo Hara,Nobumasa Mizuno,Shin Haba,Takamichi Kuwahara,Yasuhiro Kuraishi,Daiki Fumihara,Takafumi Yanaidani 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.2
Background/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is essential for the diagnosis of pancreatic cancer. The feasibility of comprehensive genomic profiling (CGP) using samples obtained by EUS-TA has been under recent discussion. This study aimed to evaluate the utility of EUS-TA for CGP in a clinical setting. Methods: CGP was attempted in 178 samples obtained from 151 consecutive patients with pancreatic cancer at the Aichi Cancer Center between October 2019 and September 2021. We evaluated the adequacy of the samples for CGP and determined the factors associated with the adequacy of the samples obtained by EUS-TA retrospectively. Results: The overall adequacy for CGP was 65.2% (116/178), which was significantly different among the four sampling methods (EUS-TA vs. surgical specimen vs. percutaneous biopsy vs. duodenal biopsy, 56.0% [61/109] vs. 80.4% [41/51] vs. 76.5% [13/17] vs. 100.0% [1/1], respectively; p=0.022). In a univariate analysis, needle gauge/type was associated with adequacy (22 G fine-needle aspiration vs. 22 G fine-needle biopsy [FNB] vs. 19 G-FNB, 33.3% (5/15) vs. 53.5% (23/43) vs. 72.5% (29/40); p=0.022). The sample adequacy of 19 G-FNB for CGP was 72.5% (29/40), and there was no significant difference between 19 G-FNB and surgical specimens (p=0.375). Conclusions: To obtain adequate samples for CGP with EUS-TA, 19 G-FNB was shown to be the best in clinical practice. However, 19 G-FNB was not still sufficient, so further efforts are required to improve adequacy for CGP.
Extraction of Cervical Lymph Nodes using Improved U-Net++
Nozomi Shime,Tohru Kamiya,Takayuki Ishida 제어로봇시스템학회 2022 제어로봇시스템학회 국제학술대회 논문집 Vol.2022 No.11
Early detection and treatment of the lymph node are important since swelling of the neck is a likely factor in systemic metastasis of cancer. One of the diagnoses of cervical swelling is a CT scan, which has a beneficial influence on the diagnosis of the disease. However, the reading of CT images is burdened by the large number of images, which increases the physicians workload. In addition, since it is based on the subjective judgment of the physician, there may be discrepancies in diagnostic results and undetected cases due to differences in experience. A means of solving these problems requires a CAD system that provides a second opinion to the physician. Therefore, this paper proposes a segmentation method of cervical lymph node region for the purpose of developing a CAD system for the diagnosis of cervical lymphadenopathy from CT images. The proposal method is a CNN model with U-Net++ as the backbone, introducing CBAM (convolution block attention module) and dual-branch multi-scale attention module. The proposed method was applied to CT images of 11 cases, yielding IoU of 62.29, confirming its validity.