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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.
Gastric Xanthomas and Fundic Gland Polyps as Endoscopic Risk Indicators of Gastric Cancer
Kentaro Yamashita,Ryo Suzuki,Toshiyuki Kubo,Kei Onodera,Tomoya Iida,Mayuko Saito,Yoshiaki Arimura,Takao Endo,Masanori Nojima,Hiroshi Nakase 거트앤리버 소화기연관학회협의회 2019 Gut and Liver Vol.13 No.4
Background/Aims: Fundic gland polyps (FGPs), hyperplastic polyps (HPs), and xanthomas (XTs) are common benign gastric lesions that can be diagnosed by endoscopic appearance alone in most cases. The aim of this study was to evaluate associations between gastric cancer and these benign lesions. Methods: Two expert endoscopists reviewed a series of gastroscopy images. FGPs, HPs, and XTs were diagnosed by endoscopic appearance, whereas all gastric cancers were confirmed pathologically. Results: Of the 1,227 patients reviewed, 114 (9.3%) had a concurrent or past history of gastric cancer. The overall prevalences of FGPs, HPs and XTs were 9.4%, 6.3% and 14.2%, respectively. HPs and XTs coexisted in 1.6% of patients, whereas other combinations were rarer. XTs were observed in 39.3% and 11.5% of patients with and without gastric cancer, respectively (p<0.001). In contrast, no gastric cancer patients had FGPs, whereas 10.4% of patients without cancer had FGPs (p<0.001). The prevalence of HPs was similar between the two groups (8.8% and 6.0% of patients with and without cancer, respectively, p=0.29). Multivariate and Mantel-Haenszel analyses demonstrated that XTs were positively associated and FGPs were negatively associated with gastric cancer. Conclusions: XTs and FGPs might be useful as endoscopic risk indicators for monitoring gastric cancer.
Wave and Storm Surge Simulations for Hurricane Katrina using Coupled Process Based Models
김경옥,Han Soo Lee,Takao Yamashita,Byung Ho Choi 대한토목학회 2008 KSCE JOURNAL OF CIVIL ENGINEERING Vol.12 No.1
Coupled process based model incorporating the atmosphere-wave-ocean interactions has been developed to investigate wave andstorm surge in the region of extremely shallow waters. An additional shear stress, due to wave energy dissipation using the rollerconcept within the surface boundary layer, is introduced in this system to consider the processes of energy transfer from wind tocurrent through wave process. Hindcast simulation of storm surge for 2005 Hurricane Katrina in this study has demonstrated theimportance of energy transfer path via whitecap dissipation of wind waves in the generation mechanism of mean current in theshallow waters. It is also shown that the atmosphere-wave-ocean coupling model system using designed coupler adopted in this studyis a feasible system for understanding wave and storm surge dynamics.
Control of an Artificial-Hip-Joint Simulator to Evaluate Dislocation
Kazuo Kiguchi,Akira Yamashita,Makoto Sasaki,Masaru Ueno,Tsuneyuki Kobayashi,Masaaki Mawatari,Takao Hotokebuchi 제어로봇시스템학회 2008 제어로봇시스템학회 국제학술대회 논문집 Vol.2008 No.10
Total hip arthroplasty (THA) is performed to replace all or part of a human hip joint with an artificial joint for patients who have rheumatoid arthritis or osteoarthritis of the hip joint. Although THA might result in postoperative complications of dislocation, wear and/or loose, their mechanisms have not been analyzed enough. We have developed an artificial-hip-joint simulator that can generate the same joint posture and joint contact force as those in daily life motion in order to evaluate the performance of the artificial-hip-joint. Dislocation of the artificial-hip-joint during daily living activities was generated by the simulator in order to analyze its mechanism.
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.