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Kawakubo Masateru,Nagao Michinobu,Nakao Risako,Watanabe Eri,Yoneyama Masami,Hagiwara Nobuhisa,Sakai Shuji 아시아심장혈관영상의학회 2022 Cardiovascular Imaging Asia Vol.6 No.1
Objective: In steady-state free precession (SSFP) cine imaging, signal loss can be observed as accelerated dark flow in patients with valvular disease and decelerated dark flow (DDF) in patients with severe left ventricular (LV) dysfunction. In our study, we measured DDF with optical flow calculations and investigated the relationship between DDF and myocardial strain or intraventricular dyssynchrony. Materials and Methods: Fifty-seven consecutive patients with heart failure were retrospectively enrolled. In the short-axis orientation, the optical flow magnitude vector of the DDF was calculated over a cardiac cycle. The maximum value of the mean magnitude vector in the LV blood region was defined as the DDF index. The systolic circumferential strain (CS) of the LV free-wall, as well as the absolute difference in systolic timing of the LV free-wall and interventricular septum (LV dyssynchrony, LVD), was measured using the feature-tracking method. Spearman’s correlation coefficients (ρ) were calculated between DDF and CS or LVD. Results: Median and interquartile ranges (25th to 75th percentile) of measured DDF, CS, and LVD in 57 patients were 14.0 (10.3 to 20.4), -8.0% (-13.3 to -3.2), and 40 ms (21 to 99), respectively. There were statistically significant correlations between the values of DDF and CS as well as LVD (0.60 and 0.48; p<0.01 for both). Conclusion: Measurement of DDF may provide a specific clinical picture of myocardial strain and intraventricular dyssynchrony. Furthermore, it is possible to cost-effectively measure DDF without additional image acquisition during routine MR examination.
Nationwide Assessment of City Performance Based on Environmental Efficiency
Kawakubo, Shun,Ikaga, Toshiharu,Murakami, Shuzo Sustainable Building Research Center 2011 International journal of sustainable building tech Vol.2 No.4
Cities must improve their quality without an increase, or ideally with a decrease, in the amount of environmental load to become more sustainable. In order to monitor city's progress towards sustainable development goals, a Comprehensive Assessment System for Built Environment Efficiency (CASBEE) tool, named CASBEE-City has been developed. All cities in Japan are assessed from the following two aspects: environmental load (L) on the external environment and quality (Q), which represents the citizens' quality of life inside the city. Built environment efficiency (BEE = Q/L) is then calculated for the comprehensive assessment of each city. A high BEE value indicates that the city has excellent environmental efficiency. The assessment results are visually displayed on the map by using a geographic information system so that citizens, local government officers, and all other stakeholders can easily understand the actual status of their city in comparison with other cities in the country. This assessment and the visualization of the results are expected to support the realization of future sustainable cities.
( Kazumichi Kawakubo ),( Kei Yane ),( Kazunori Eto ),( Hirotoshi Ishiwatari ),( Nobuyuki Ehira ),( Shin Haba ),( Ryusuke Matsumoto ),( Keisuke Shinada ),( Hiroaki Yamato ),( Taiki Kudo ),( Manabu Onod 대한소화기학회 2018 Gut and Liver Vol.12 No.3
Background/Aims: Although the risk of bleeding after endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is low, the safety of EUS-FNA in patients prescribed antithrombotic agents is unclear. Therefore, this study evaluated the incidence of bleeding after EUS-FNA in those patients. Methods: Between September 2012 and September 2015, patients who were prescribed antithrombotic agents underwent EUS-FNA at 13 institutions in Japan were prospectively enrolled in the study. The antithrombotic agents were managed according to the guidelines of the Japanese Gastrointestinal Endoscopy Society. The rate of bleeding events, thromboembolic events and other complications within 2 weeks after EUS-FNA were analyzed. Results: Of the 2,629 patients who underwent EUS-FNA during the study period, 85 (62 males; median age, 74 years) patients were included in this stduy. Two patients (2.4%; 95% confidence interval [CI], 0.6% to 8.3%) experienced bleeding events. One patient required surgical intervention for hemothorax 5 hours after EUS-FNA, and the other experienced melena 8 days after EUS-FNA and required red blood cell transfusions. No thromboembolic events occurred (0%; 95% CI, 0.0% to 4.4%). Three patients (3.5%; 95% CI, 1.2% to 10.0%) experienced peri-puncture abscess formation. Conclusions: The rate of bleeding after EUS-FNA in patients prescribed antithrombotic agents might be considerable. (Gut Liver 2018;12:353-359)
Current Status and Future Perspectives on Minimally Invasive Esophagectomy
Hirofumi Kawakubo,Hiryoya Takeuchi,Yuko Kitagawa 대한흉부외과학회 2013 Journal of Chest Surgery (J Chest Surg) Vol.46 No.4
Esophageal cancer has one of the highest malignant potentials of any type of tumor. The 3-field lymph node dissection is the standard procedure in Japan for surgically curable esophageal cancer in the middle or upper thoracic esophagus. Minimally invasive esophagectomy is being increasingly performed in many countries, and several studies report its feasibility and curability; further, the magnifying effect of the thoracoscope is another distinct advantage. However, few studies have reported that minimally invasive esophagectomy is more beneficial than open esophagectomy. A recent meta-analysis revealed that minimally invasive esophagectomy reduces blood loss, respiratory complications, the total morbidity rate, and hospitalization duration. A randomized study reported that the pulmonary infection rate, pain score, intraoperative blood loss, hospitalization duration, and postoperative 6-week quality of life were significantly better with the minimally invasive procedure than with other procedures. In the future, sentinel lymph node mapping might play a significant role by obtaining individualized information to customize the surgical procedure for individual patients’ specific needs.
( Kazumichi Kawakubo ),( Hiroyuki Isayama ),( Yousuke Nakai ),( Naoki Sasahira ),( Hirofumi Kogure ),( Takashi Sasaki ),( Kenji Hirano ),( Minoru Tada ),( Kazuhiko Koike ) The Editorial Office of Gut and Liver 2012 Gut and Liver Vol.6 No.3
Patients with pancreatic cancer frequently suffer from both biliary and duodenal obstruction. For such patients, both bili-ary and duodenal self-expandable metal stent placement is necessary to palliate their symptoms, but it was difficult to cross two metal stents. Recently, endoscopic ultrasonogra-phy-guided choledochoduodenostomy (EUS-CDS) was report-ed to be effective for patients with an inaccessible papilla. We report two cases of pancreatic cancer with both biliary and duodenal obstructions treated successfully with simul-taneous duodenal metal stent placement and EUS-CDS. The first case was a 74-year-old man with pancreatic cancer. Duodenoscopy revealed that papilla had been invaded with tumor and duodenography showed severe stenosis in the horizontal portion. After a duodenal uncovered metal stent was placed across the duodenal stricture, EUS-CDS was per-formed. The second case was a 63-year-old man who previ-ously had a covered metal stent placed for malignant biliary obstruction. After removing the previously placed metal stent, EUS-CDS was performed. Then, a duodenal covered metal stent was placed across the duodenal stenosis. Both patients could tolerate a regular diet and did not suffer from stent occlusion. EUS-CDS combined with duodenal metal stent placement may be an ideal treatment strategy in pa-tients with pancreatic cancer with both duodenal and biliary malignant obstruction. (Gut Liver 2012;6:399-402)
( Hiroharu Kawakubo ),( Yuichiro Tanaka ),( Nanae Tsuruoka ),( Megumi Hara ),( Koji Yamamoto ),( Hidenori Hidaka ),( Yasuhisa Sakata ),( Ryo Shimoda ),( Ryuichi Iwakiri ),( Motoyasu Kusano ),( Kazuma 대한소화기기능성질환·운동학회 2016 Journal of Neurogastroenterology and Motility (JNM Vol.22 No.2
Background/Aims Upper gastrointestinal symptoms are more frequent and severe in female than in male outpatients in Japan. This study compared the upper gastrointestinal symptoms between healthy male and female young adult volunteers using a questionnaire. Methods In total, 581 third-grade medical students at Saga Medical School aged 22 to 30 years underwent upper gastrointestinal endoscopy and completed a questionnaire (frequency scale for symptoms of gastroesophageal reflux disease) from 2007 to 2013. Of these 581 students, 298 who were negative for Helicobacter pylori infection and had no particular lesions on endoscopic examination were enrolled in the present evaluation. A symptom was defined as positive when the subject evaluated the frequency of the symptom as sometimes, often, or always. Results The subjects comprised of 163 males (average age, 23.7 years) and 135 females (average age, 23.1 years). Upper gastrointestinal symptoms were more frequent in the females (75 of 135, 55.6%) than males (69 of 163, 42.3%; P < 0.05), with a high score for 4 symptoms (bloated stomach, heavy feeling in the stomach after meals, subconscious rubbing of the chest with the hand, and feeling of fullness while eating meals). Of the 144 subjects (69 males and 75 females) who complained of these symptoms, the females complained of dysmotility symptoms more often than did the males, but this was not true for reflux symptoms. Conclusions This study suggests that females develop upper gastrointestinal symptoms more frequently than do males among the young healthy Japanese population. (J Neurogastroenterol Motil 2016;22:248-253)
( Kazumichi Kawakubo ),( Hiroshi Kawakami ),( Masaki Kuwatani ),( Shin Haba ),( Taiki Kudo ),( Yoko Abe ),( Shuhei Kawahata ),( Manabu Onodera ),( Nobuyuki Ehira ),( Hiroaki Yamato ),( Kazunori Eto ) 대한소화기학회 2014 Gut and Liver Vol.8 No.3
Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) are essential for diagnosing and treating pancreatobiliary diseases. Single-session EUS and ERCP are considered to be essential in reducing the duration of hospital stays; however, complications are a primary concern. The aim of this study was to evaluate the safety and efficacy of single-session EUS and ERCP. Sixty-eight patients underwent single-session EUS and ERCP at a tertiary referral center between June 2008 and December 2012. We retrospectively reviewed patient data from a prospectively maintained EUS-ERCP database and evaluated the procedural characteristics and complications. Thirty-eight patients (56%) underwent diagnostic EUS, and 30 patients (44%) underwent EUS fine-needle aspiration, which had an overall accuracy of 100%. Sixty patients (89%) underwent therapeutic ERCP, whereas the remaining eight procedures were diagnostic. Thirteen patients underwent biliary stone extraction, and 48 underwent biliary drainage. The median total procedural time was 75 minutes. Complications were observed in seven patients (10%). Six complications were post-ERCP pancreatitis, which were resolved using conservative management. One patient developed Mallory-Weiss syndrome, which required endoscopic hemostasis. No sedation-related cardiopulmonary complications were observed. Single-session EUS and ERCP provided accurate diagnosis and effective management with a minimal complication rate.
( Hiroyuki Isayama ),( Kazumichi Kawakubo ),( Yousuke Nakai ),( Kouta Inoue ),( Chimyon Gon ),( Saburo Matsubara ),( Hirofumi Kogure ),( Yukiko Ito ),( Takeshi Tsujino ),( Suguru Mizuno ),( Tsuyoshi H The Editorial Office of Gut and Liver 2013 Gut and Liver Vol.7 No.6
Background/Aims: Stent migration occurs frequently, but the prevention of complications resulting from covered self-expandable metal stents (C-SEMSs) remains unresolved. We prospectively assessed a newly developed C-SEMS, a modi-fied covered Zeo stent (m-CZS), in terms of its antimigration effect. Methods: Between February 2010 and January 2011, an m-CZS was inserted into 42 patients (31 initial drainage cases and 11 reintervention cases) at a tertiary referral center and three affiliated hospitals. The laser-cut stent was flared for 1.5 cm at both ends, with a 1 cm raised bank located 1 cm in from each flared end. The main outcome of this study was the rate of stent migration, and second-ary outcomes were the rate of recurrent biliary obstruction (RBO), the time to RBO, the frequencies of complications, and overall survival. Results: Of the 31 patients with initial drainage, stent migration occurred in four (12.9%, 95% con-fidence interval, 5.1% to 29.0%), with a mean time of 131 days. RBO occurred in 18 (58%), with a median time to RBO of 107 days. Following previous C-SEMS migration, seven of 10 patients (70%) did not experience m-CZS migration until death. Conclusions: m-CZSs with antimigration properties ef-fectively, although not completely, prevented stent migration after stent insertion. (Gut Liver 2013;7:725-730)
Jun Sasaki,Shusuke Kawakubo,Hangil Kim,Ok-Kyung Kim,Kazuo Yamashita,Hanako Shimura,Chikara Masuta 한국식물병리학회 2022 Plant Pathology Journal Vol.38 No.4
In Japan, the P1 protein (S-type) encoded by leek yellow stripe virus (LYSV) isolates detected in Honshu and southward is shorter than the P1 (N-type) of LYSV isolates from garlic grown in Hokkaido due to a large deletion in the N-terminal half. In garlic fields in Hokkaido, two types of LYSV isolate with N- and S-type P1s are sometimes found in mixed infections. In this study, we confirmed that N- and S-type P1 sequences were present in the same plant and that they belong to different evolutionary phylogenetic groups. To investigate how LYSV with S-type P1 (LYSV-S) could have invaded LYSV with N-type P1 (LYSV-N)-infected garlic, we examined wild Allium spp. plants in Hokkaido and found that LYSV was almost undetectable. On the other hand, in Honshu, LYSV-S was detected at a high frequency in Allium spp. other than garlic, suggesting that the LYSV-S can infect a wider host range of Allium spp. compared to LYSV-N. Because P1 proteins of potyviruses have been reported to promote RNA silencing suppressor (RSS) activity of HC-Pro proteins, we analyzed whether the same was true for P1 of LYSV. In onion, contrary to expectation, the P1 protein itself had RSS activity. Moreover, the RSS activity of S-type P1 was considerably stronger than that of N-type P1, suggesting that LYSV P1 may be able to enhance its RSS activity when the deletion is in the N-terminal half and that acquiring S-type P1 may have enabled LYSV to expand its host range.