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Recent developments in endoscopic ultrasonography-guided gastroenterostomy
Kenjiro Yamamoto,Takao Itoi 소화기인터벤션의학회 2020 Gastrointestinal Intervention Vol.9 No.4
Gastric outlet obstruction (GOO) can be caused by benign and malignant diseases. GOO often leads to a decreased quality of life, because of nausea, vomiting, and problems with oral food intake. Traditionally, surgical gastrojejunostomy (SGJ) has been the primary treatment for GOO. Endoscopic enteral stenting (EES) has also been carried out for the treatment of malignant GOO. In recent years, endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) using a lumen apposing metal stent has emerged as a procedure to treat patients with GOO, as an alternative to surgery or to standard endoscopy when EES is not possible. Various techniques, such as direct EUS-GE, assisted EUS-GE, and EUS-guided balloon-occluded gastrojejunostomy bypass have been established to perform EUS-GE safety and accurately. Previous reports of EUS-GE with lumen apposing metal stent demonstrated that the technical and clinical success rates were 87% to 100% and 84% to 100%, respectively, without differentiating the various procedural techniques. The adverse events rate ranged from 0% to 18.1%, and included stent misdeployment, bleeding, peritonitis, leakage, abdominal pain, etc. In addition, the reintervention rate ranged from 0% to 15.1%. Moreover, a comparison of EUS-GE and SGJ showed that there was no significant difference in clinical success, rate of adverse events, or need for reintervention between these procedures. On the other hand, studies comparing EUS-GE with EES showed that EUS-GE may have higher clinical success and a lower rate of stent failure requiring repeated intervention than EES. Furthermore, EUS-GE has been used in several clinical scenarios, such as the management of endoscopic retrograde cholangiopancreatography in patients who underwent Roux-en-Y gastric bypass, or for the treatment of afferent loop syndrome. The present review describes the presently available EUS-GE techniques and introduces the recent clinical advances in the treatment of GOO.
τ-curve: introduction of cusps to aesthetic curves
Kenjiro T. Miura,Sho Suzuki,Shin Usuki,R.U. Gobithaasan 한국CDE학회 2020 Journal of computational design and engineering Vol.7 No.2
Yan, Schiller, Wilensky, Carr, and Schaefer pointed out that one of the demerits of clothoid interpolation is a jumping behavior during the deformation of the curve. This phenomenon occurs because the clothoid curve cannot have a cusp, where the curve is kinked or the direction of the curve is abruptly changed. We discuss how to introduce cusps for the log-aesthetic curve including the clothoid curve and propose to use for the representation of a curve the direction angle instead of curvature and define a new curve named τ-curve, which is defined by the direction angle of the curve.
Recent developments in endoscopic ultrasonography-guided gastroenterostomy
Kenjiro Yamamoto,Takao Itoi 소화기인터벤션의학회 2020 International journal of gastrointestinal interven Vol.9 No.4
Gastric outlet obstruction (GOO) can be caused by benign and malignant diseases. GOO often leads to a decreased quality of life, because of nausea, vomiting, and problems with oral food intake. Traditionally, surgical gastrojejunostomy (SGJ) has been the primary treatment for GOO. Endoscopic enteral stenting (EES) has also been carried out for the treatment of malignant GOO. In recent years, endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) using a lumen apposing metal stent has emerged as a procedure to treat patients with GOO, as an alternative to surgery or to standard endoscopy when EES is not possible. Various techniques, such as direct EUS-GE, assisted EUS-GE, and EUS-guided balloon-occluded gastrojejunostomy bypass have been established to perform EUS-GE safety and accurately. Previous reports of EUS-GE with lumen apposing metal stent demonstrated that the technical and clinical success rates were 87% to 100% and 84% to 100%, respectively, without differentiating the various procedural techniques. The adverse events rate ranged from 0% to 18.1%, and included stent misdeployment, bleeding, peritonitis, leakage, abdominal pain, etc. In addition, the reintervention rate ranged from 0% to 15.1%. Moreover, a comparison of EUS-GE and SGJ showed that there was no significant difference in clinical success, rate of adverse events, or need for reintervention between these procedures. On the other hand, studies comparing EUS-GE with EES showed that EUS-GE may have higher clinical success and a lower rate of stent failure requiring repeated intervention than EES. Furthermore, EUS-GE has been used in several clinical scenarios, such as the management of endoscopic retrograde cholangiopancreatography in patients who underwent Roux-en-Y gastric bypass, or for the treatment of afferent loop syndrome. The present review describes the presently available EUS-GE techniques and introduces the recent clinical advances in the treatment of GOO.
( Kenjiro Hattori ),( Ok Cheol Jeon ),( Hyun Tae Moon ) 조선대학교 공학기술연구원 2010 공학기술논문지 Vol.3 No.3
Asymmetric reduction of aromatic keto acid was achieved with sodium borohydride (NaBH4) in the presence of newly prepared 6-deoxy-phenylethylamino-β-cyclodextrin (PEACD) gave a high optical yields of around 40% enantiomeric excess (40% e.e.). Based upon the dependence of asymmetric selectivity of PEACD with benzoyl formic acid (BFA), p-hydroxyphenylpyruvic acid (pHPPA) and indole-3-pyruvic acid (IPA) controlled asymmetric reaction which indicates the balance between the electrostatic interaction, hydrogen bonding and steric hindrance enhanced the host-guest complexes. Furthermore, the orientation of various guest molecules in host CD cavity were governed by the molecular shape of the guest or by interaction between the guest α-keto acid and the cavity shape of host CD. This provides multiple interaction, and the induced mechanism of asymmetric selective differentiating reduction which was suggested with the host-guest inclusion complexes on molecule recognition.