HUMAN INTERFACE TO MULTIMEDIA DATABASE SYSTEMS

( Kazuhide Higuchi ),( Masahiro Tada ),( Akihiro Ogino ),( Ayumi Sato ),( Emi Yano ),( Hayato Kobayashi ),( Toshikazu Kato ) 한국감성과학회 2002 춘계학술대회 Vol.2002 No.-

To transmit users`` intentions that vary with each person, intuitive and bi-directional interactions between users and a computer are necessary. We considered these interactions by dividing them into two spaces, physical space and informational space. Informational space supports human thinking process by arranging and visualizing much information. Physical space reproduces the real world where various restrictions exist to virtual space. From the viewpoint of three aspects - contents model, kansei model and context model - we defmed the style of the interaction between user and multimedia database. In this paper, for the purpose of examining the way to realize the interaction based on these models, we developed interior design coordination support system and garden coordination system, and then evaluated them.

Technical Review of Developments in Endoscopic Ultrasound- Guided Hepaticogastrostomy

Takeshi Ogura,Kazuhide Higuchi 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.5

Endoscopic ultrasound-guided biliary drainage has been developed as an alternative method for biliary drainage. EUS-guidedhepaticogastrostomy (EUS-HGS) can be attempted via the trans-gastric route. These procedures are technically complex for tworeasons. First, puncture of the intrahepatic bile duct via the trans-gastric route can be more difficult than that by other approachesbecause of the small diameter of the target site, and guidewire insertion or manipulation is challenging during EUS-HGS. Second,critical adverse events, such as stent migration into the abdominal cavity, could occur because of the greater mobility of the stomachcompared to the duodenum. Therefore, endoscopists should be cautious when performing EUS-HGS. An advantage of EUS-HGSis that it can be performed in patients with complications such as duodenal bulb obstruction or surgically altered anatomy. Recentadvances in technique and improvements in devices and stents for EUS-HGS have shown promise for improving the technicalsuccess rate of EUS-HGS and reducing the rate of adverse events. However, endoscopists should remain aware of the possibility ofcritical adverse events such as stent migration.

Endoscopic Ultrasound-Guided Hepaticogastrostomy: Technical Review and Tips to Prevent Adverse Events

( Takeshi Ogura ),( Kazuhide Higuchi ) 대한소화기학회 2021 Gut and Liver Vol.15 No.2

Most patients who require biliary drainage can be treated by endoscopic retrograde cholangiopancreatography (ERCP)-guided procedures. However, ERCP can be challenging in patients with complications, such as malignant duodenal obstruction, or a surgically-altered anatomy, such as a Roux-en-Y anastomosis, which prevent advancement of the duodenoscope into the ampulla of Vater. Recently, endoscopic ultrasound (EUS)-guided biliary drainage via transhepatic or transduodenal approaches has emerged as an alternative means of biliary drainage. Typically, EUS-guided gallbladder drainage or choledochoduodenostomy can be performed via both approaches, as can EUS-guided hepaticogastrostomy (HGS). EUS-HGS, because of its transgastric approach, can be performed in patients with malignant duodenal obstruction. Technical tips for EUS-HGS have reached maturity due to device and technical developments. Although the technical success rates of EUS-HGS are high, the rate of adverse events is not low, with stent migration still being reported despite many preventive efforts. In this review, we described technical tips for EUS-HGS related to bile duct puncture, guidewire insertion, fistula dilation, and stent deployment, along with a literature review. Additionally, we provided technical tips to improve the technical success of EUS-HGS. (Gut Liver 2021;15:196-205)

Endoscopic Ultrasound-Guided Pancreatic Transmural Stenting and Transmural Intervention

Takeshi Ogura,Hideko Ohama,Kazuhide Higuchi 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.4

Endoscopic ultrasound (EUS)-guided pancreatic access is an emergent method that can be divided into the two main techniques ofEUS-guided rendezvous and pancreatic transmural stenting (PTS). While many reports have described EUS-guided procedures, theindications, technical tips, clinical effects, and safety of EUS-guided pancreatic duct drainage (EUS-PD) remain controversial. Thisreview describes the current status of and problems associated with EUS-PD, particularly PTS. We reviewed clinical data derived froma total of 334 patients. Rates of technical and clinical success ranged from 63% to 100% and 76% to 100%, respectively. In contrast, therate of procedure-related adverse events was high at 26.7% (89/334). The most frequent adverse events comprised abdominal pain (n=38),acute pancreatitis (n=15), bleeding (n=9), and issues associated with pancreatic juice leakage such as perigastric fluid, pancreatic fluidcollection, or pancreatic juice leaks (n=8). In conclusion, indications for EUS-PTS are limited, as is the evidence of its viability, due tothe scarcity of expert operators. Despite improvements made to various devices, EUS-PTS remains technically challenging. Therefore,a long-term, large-scale, multicenter study is required to establish this technique as a viable alternative drainage method.

Endoscopic Ultrasound-Guided Pancreatic Duct Drainage: Techniques and Literature Review of Transmural Stenting

Akira Imoto,Takeshi Ogura,Kazuhide Higuchi 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.5

Endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) has emerged as an option in patients with failure of retrogradeaccess to the pancreatic duct (PD) because of difficulty in cannulation or surgically altered anatomy. This article provides acomprehensive review of the techniques and outcomes of EUS-PD, especially EUS-guided pancreatic transmural stenting. Theclinical data derived from a total of 401 patients were reviewed in which the overall technical and clinical success rates were 339/401(85%, range 63%–100%) and 328/372 (88%, range 76%–100%), respectively. Short-term adverse events occurred in 25% (102/401) ofthe cases, which included abdominal pain (n=45), acute pancreatitis (n=17), bleeding (n=10), and issues associated with pancreaticjuice leakage such as perigastric or peripancreatic fluid collection (n=9). In conclusion, although EUS-PD remains a challengingprocedure with a high risk of adverse events such as pancreatic juice leakage, perforation, and severe acute pancreatitis, the procedureseems to be a promising alternative for PD drainage in patients with altered anatomy or unsuccessful endoscopic retrogradepancreatography.

The 5th Seoul International Digestive Disease Symposium : Interleukin-1beta and tumor necrosis factor-alpha cause recurrence of experimental gastric ulcer : A key mechanism

(Tetsuo Arakawa),(Toshio Watanabe),(Kazunari Tominaga),(Yasuhiro Fujiwara),(Kazuhide Higuchi) 대한소화기학회 1999 SIDDS Vol.5 No.-

The aim of this paper is to review recent data pertaining to mechanisms of ulcer recurrence. Production of inflammatory cytokines is stimulated by ulcerogenic factors such as stress as well as NSAIDs and H. pylori infection. Therefore, the cytokines may be a common key factor to cause ulcer recurrence. When interleukin-1beta or tumor necrosis factor-alpha is administered to rats with healed chronic gastric ulcer, the ulcer recurs at the same site of previous ulcer (ulcer scar site) like most of human peptic ulcers. Excessive macrophages exist at the regenerated mucosa of ulcer scar site compared with normal mucosa adjacent to the site. Monocytes/macrophages are the major cell type responsible for production of inflammatory cytokines that activate leukocytes and stimulate expression of adhesion molecules. Therefore, the accumulation of such cells at the ulcer scar may explain why ulcers tend to recur usually at the same site. Neutrophils may contribute to the final step of recurrence of ulcer because antibody against neutrophils completely inhibits the recurrence caused by IL-1beta. Two possibly mechanisms are concerned: their cytotoxic effects to the mucosal cells via production of active oxygen species, elastase, and TNF-alpha, and microcirculatory disturbance due to neutrophil-endothelial cell interaction.

Clinical Impact of Recombinant Soluble Thrombomodulin for Disseminated Intravascular Coagulation Associated with Severe Acute Cholangitis

( Atsushi Okuda ),( Takeshi Ogura ),( Miyuki Imanishi ),( Akira Miyano ),( Nobu Nishioka ),( Kazuhide Higuchi ) 대한간학회 2018 Gut and Liver Vol.12 No.4

Background/Aims: Recently, recombinant human soluble thrombomodulin (rTM) has been developed as a new drug for disseminated intravascular coagulation (DIC). This study aims to evaluate the clinical benefit of rTM in patients with sepsis-induced DIC caused by acute cholangitis who underwent biliary drainage. Methods: Patients were divided into two groups: the rTM therapy group and the non-rTM therapy group. The primary outcome was the DIC resolution rate at 7 days, and the secondary outcome was 28-day mortality rate. Results: Thirty-five patients were treated by rTM, and 36 patients were treated without rTM for DIC. The rate of resolution of DIC at day 7 was significantly higher in the rTM group than in the non-rTM group (82.9% vs 55.6%, p=0.0012). Compared with the non-rTM group, the 28-day survival rate of the r-TM group was significantly higher (rTM vs non-rTM, 91.4% vs 69.4%, p=0.014). According to multivariate analysis, non-rTM (hazard ratio [HR], 2.681) and CRP (HR, 2.370) were factors related to decreased survival. Conclusions: rTM treatment may have a positive impact on improving DIC and survival rates in patients with severe acute cholangitis. (Gut Liver 2018;12:471-477)

Electrohydraulic Lithotripsy for Difficult Bile Duct Stones under Endoscopic Retrograde Cholangiopancreatography and Peroral Transluminal Cholangioscopy Guidance

( Rieko Kamiyama ),( Takeshi Ogura ),( Atsushi Okuda ),( Akira Miyano ),( Nobu Nishioka ),( Miyuki Imanishi ),( Wataru Takagi ),( Kazuhide Higuchi ) 대한간학회 2018 Gut and Liver Vol.12 No.4

Background/Aims: Electrohydraulic lithotripsy (EHL) under endoscopic retrograde cholangiopancreatography (ERCP) guidance can be an option to treat difficult stones. Recently, a digital, single-operator cholangioscope (SPY-DS) has become available. Peroral transluminal cholangioscopy (PTLC) using SPY-DS has also been reported. In this retrospective study, the technical feasibility and clinical effectiveness of EHL for difficult bile duct stones under ERCP guidance and under PTLC guidance was examined. Methods: In this pilot study, patients with difficult bile duct stones between July 2016 and July 2017 were retrospectively enrolled. Results: Forty-two consecutive patients underwent EHL using a SPY-DS; 34 patients underwent EHL under ERCP guidance, and the other 8 patients underwent EHL under PTLC guidance. Median procedure time was 31 minutes (range, 19 to 66 minutes). The median number of EHL sessions was 1 (range, 1 to 2), and that of ERCP sessions was also 1 (range, 1 to 3). The rate of complete stone clearance was 98% (41/42). Adverse events such as cholangitis and acute pancreatitis were seen in 14% (6/42), which could be treated conservatively. Conclusions: EHL using SPY-DS was technically feasible, not only under ERCP guidance, but also PTLC guidance. A prospective clinical study of EHL using SPY-DS is needed. (Gut Liver 2018;12:457-462)