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Primary Adenocarcinoma of the Minor Duodenal Papilla
Takeru Wakatsuki,Atsushi Irisawa,Tadayuki Takagi,Yoshihisa Koyama,Sayuri Hoshi,Seiichi Takenoshita,Masafumi Abe,Hiromasa Ohira 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.2
A 70-year-old man was admitted to our institution due to aggravation of blood-sugar level control and because an abdominal CT showed dilatation of the main pancreatic duct. Upper gastrointestinal endoscopy revealed a flat elevated tumor with central ulceration in the second portion of the duodenum. Subsequent duodenoscopy for a more detailed examination showed that the tumor had originated in the minor duodenal papilla. A biopsy specimen showed moderately differentiated adenocarcinoma. Endoscopic retrograde pancreatography via the major duodenal papilla revealed a slightly dilated main pancreatic duct and obstruction of the accessory pancreatic duct. Endoscopic ultrasonography showed a hypoechoic mass in the minor duodenal papilla with retention of the muscularis propria of the duodenum. These findings suggest that the tumor existed only to a limited extent in the minor duodenal papilla, and that the tumor did not infiltrate into the pancreas. For treatment, pylorus-preserving pancreatoduodenectomy was performed, and histological findings revealed a well- differentiated adenocarcinoma that originated in the minor duodenal papilla. Primary adenocarcinoma of the minor duodenal papilla is extremely rare. Our case is the first report of primary adenocarcinoma of the minor duodenal papilla at an early stage with no infiltration into muscularis propria of the duodenum and pancreas.
Configuration Method of P2P Network System with Transfer Support Nodes
Takeru Hiraishi,Hideki Tode 한국멀티미디어학회 2009 한국멀티미디어학회 국제학술대회 Vol.2009 No.-
The content distribution services via the Internet have become popular. However these services have some problems that prevent users from getting a file efficiently and there still remains much room for improving. In this paper, we focus on representative hybrid P2P[1] network application, BitTorrent[2], and try to resolve these problems. We propose the method for placing transfer support nodes, called "SupportNode", by service providers to allow users to get contents efficiently and evaluate the method by using computer simulation.