Anococcygeal Raphe Revisited: A Histological Study Using Mid-Term Human Fetuses and Elderly Cadavers

Yusuke Kinugasa,Takashi Arakawa,Hiroshi Abe,Shinichi Abe,조백환,Gen Murakami,Kenichi Sugihara 연세대학교의과대학 2012 Yonsei medical journal Vol.53 No.4

Purpose: We recently demonstrated the morphology of the anococcygeal ligament. As the anococcygeal ligament and raphe are often confused, the concept of the anococcygeal raphe needs to be re-examined from the perspective of fetal development,as well as in terms of adult morphology. Materials and Methods: We examined the horizontal sections of 15 fetuses as well as adult histology. From cadavers,we obtained an almost cubic tissue mass containing the dorsal wall of the anorectum, the coccyx and the covering skin. Most sections were stained with hematoxylin and eosin or Masson-trichrome solution. Results: The adult ligament contained both smooth and striated muscle fibers. A similar band-like structure was seen in fetuses, containing: 1) smooth muscle fibers originating from the longitudinal muscle coat of the anal canal and 2) striated muscle fibers from the external anal sphincter (EAS). However, in fetuses, the levator ani muscle did not attach to either the band or the coccyx. Along and around the anococcygeal ligament, we did not find any aponeurotic tissue with transversely oriented fibers connecting bilateral levator ani slings. Instead, in adults, a fibrous tissue mass was located at a gap between bilateral levator ani slings; this site corresponded to the dorsal side of the ligament and the EAS in the immediately deep side of the natal skin cleft. Conclusion: We hypothesize that a classically described raphe corresponds to the specific subcutaneous tissue on the superficial or dorsal side of the anococcygeal ligament.

Female Longitudinal Anal Muscles or Conjoint Longitudinal Coats Extend into the Subcutaneous Tissue along the Vaginal Vestibule: A Histological Study Using Human Fetuses

Yusuke Kinugasa,Takashi Arakawa,Hiroshi Abe,Jose Francisco Rodríguez-Vázquez,Gen Murakami,Kenichi Sugihara 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.3

Purpose: It is still unclear whether the longitudinal anal muscles or conjoint longitudinal coats (CLCs) are attached to the vagina, although such an attachment, if present, would appear to make an important contribution to the integrated supportive system of the female pelvic floor. Materials and Methods: Using immunohistochemistry for smooth muscle actin, we examined semiserial frontal sections of 1) eleven female late-stage fetuses at 28-37 weeks of gestation, 2) two female middle-stage fetus (2 specimens at 13 weeks), and, 3) six male fetuses at 12 and 37 weeks as a comparison of the morphology. Results: In late-stage female fetuses, the CLCs consistently (11/11) extended into the subcutaneous tissue along the vaginal vestibule on the anterior side of the external anal sphincter. Lateral to the CLCs, the external anal sphincter also extended anteriorly toward the vaginal side walls. The anterior part of the CLCs originated from the perimysium of the levator ani muscle without any contribution of the rectal longitudinal muscle layer. However, in 2 female middle-stage fetuses, smooth muscles along the vestibulum extended superiorly toward the levetor ani sling. In male fetuses, the CLCs were separated from another subcutaneous smooth muscle along the scrotal raphe (posterior parts of the dartos layer) by fatty tissue. Conclusion: In terms of topographical anatomy, the female anterior CLCs are likely to correspond to the lateral extension of the perineal body (a bulky subcutaneous smooth muscle mass present in adult women), supporting the vaginal vestibule by transmission of force from the levator ani.

Development of Dilated Esophagus, Sigmoid Esophagus, and Esophageal Diverticulum in Patients With Achalasia: Japan Achalasia Multicenter Study

Hiroki Sato,Yusuke Fujiyoshi,Hirofumi Abe,Hironari Shiwaku,Junya Shiota,Chiaki Sato,Hiroyuki Sakae,Masaki Ominami,Yoshitaka Hata,Hisashi Fukuda,Ryo Ogawa,Jun Nakamura,Tetsuya Tatsuta,Yuichiro Ikebuchi 대한소화기 기능성질환∙운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.2

Background/AimsPatients with achalasia-related esophageal motility disorders (AEMDs) frequently present with dilated and sigmoid esophagus, and develop esophageal diverticulum (ED), although the prevalence and patients characteristics require further elucidation. MethodsWe conducted a multicenter cohort study of 3707 patients with AEMDs from 14 facilities in Japan. Esophagography on 3682 patients were analyzed. ResultsStraight (n = 2798), sigmoid (n = 684), and advanced sigmoid esophagus (n = 200) were diagnosed. Multivariate analysis revealed that long disease duration, advanced age, obesity, and type I achalasia correlate positively, whereas severe symptoms and integrated relaxation pressure correlate negatively with development of sigmoid esophagus. In contrast, Grade II dilation (3.5-6.0 cm) was the most common (52.9%), while grade III dilation (≥ 6 cm) was rare (5.0%). We found early onset, male, obesity, and type I achalasia correlated positively, while advanced age correlated negatively with esophageal dilation. Dilated and sigmoid esophagus were found mostly in types I and II achalasia, but typically not found in spastic disorders. The prevalence of ED was low (n = 63, 1.7%), and non-dilated esophagus and advanced age correlated with ED development. Patients with right-sided ED (n = 35) had a long disease duration (P = 0.005) with low integrated relaxation pressure values (P = 0.008) compared with patients with left-sided ED (n = 22). Patients with multiple EDs (n = 6) had lower symptom severity than patients with a single ED (P = 0.022). ConclusionsThe etiologies of dilated esophagus, sigmoid esophagus, and ED are considered multifactorial and different. Early diagnosis and optimal treatment of AEMDs are necessary to prevent these conditions.

New method to measure whole-wavelength transmittance of TCO substrates for thin-film silicon solar cells

Masanobu Isshiki,Porponth Sichanugrist,Yusuke Abe,Takuji Oyama,Hidefumi Odaka,Makoto Konagai 한국물리학회 2014 Current Applied Physics Vol.14 No.12

High transmittance of transparent conductive oxide (TCO) substrates is one of the most important factors for achieving high efficiency in thin-film silicon solar cells. Immersion (IM) method with CH2I2 liquid is widely used for the evaluation of optical properties (transmittance, reflectance and absorption) for TCO substrates with textured surface in order to reduce the scattering at the TCO surface. However, in order to measure transmittance accurately, three problems have been found. (1) CH2I2 liquid itself absorbs the light in short wavelength region. (2) The transmittance around the absorption edge of CH2I2 liquids is very sensitive to its amount. (3) Scattering cannot be suppressed when the scattering surfaces are more than 2 surfaces (for example, TCO on reactive ion etching (RIE) processed glass). To overcome these problems, we proposed a new setup to measure optical properties of TCO substrates by holding the samples inside the integral sphere. As the results, we have confirmed that their absorption in all wavelength could be measured accurately and the transmittance measured by the new method was well consistent with the external quantum efficiency (EQE) of the fabricated cell while the transmittance measured with conventional IM method showed differently. Therefore, this new method could be a useful tool to evaluate TCO substrates for thin-film silicon solar cells.

Subtype of Achalasia and Integrated Relaxation Pressure Measured Using the Starlet High-resolution Manometry System: A Multicenter Study in Japan

Tetsuya Tatsuta,Hiroki Sato,Yusuke Fujiyoshi,Hirofumi Abe,Akio Shiwaku,Junya Shiota,Chiaki Sato,Masaki Ominami,Yoshitaka Hata,Hisashi Fukuda,Ryo Ogawa,Jun Nakamura,Yuichiro Ikebuchi,Hiroshi Yokomichi 대한소화기 기능성질환∙운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.4

Background/Aims ManoScan and Sandhill high-resolution manometry (HRM) systems are used worldwide; however, the diagnosis of achalasia on the Starlet HRM system is not fully characterized. Furthermore, the impact of calcium channel blockers and nitrites in treating achalasia has not been investigated using HRM. Management of recurrent cases is a priority issue, although few studies have examined patient characteristics. Methods We conducted a multicenter, large-scale database analysis. First, the diagnosis of treatment-naive achalasia in each HRM system was investigated. Next, patient characteristics were compared between type I-III achalasia, and the impact of patient characteristics, including calcium channel blocker and nitrite use for integrated relaxation pressure (IRP) values, were analyzed. Finally, patient characteristics with recurrent achalasia were elucidated. Results The frequency of type I achalasia with Starlet was significantly higher than that with ManoScan and Sandhill HRM systems. In achalasia, multivariate analysis identified male sex, advanced age, long disease duration, obesity, type I achalasia, and sigmoid type as risk factors related to normal IRP values (< 26 mmHg). Calcium channel blockers and nitrites use had no significant impact on the IRP values, although achalasia symptoms were indicated to be alleviated. In recurrent cases, the IRP value was significantly lower, and advanced age, long disease duration, and sigmoid type were more common than in treatment-naive patients. Conclusions We should cautiously interpret the type of achalasia and IRP values in the Starlet HRM system. Symptoms of recurrent cases are related to disease progression rather than IRP values, which should be considered in decision making.

Different Associations of Plasma Biomarkers in Alzheimer’s Disease, Mild Cognitive Impairment, Vascular Dementia, and Ischemic Stroke

Jingwei Shang,Toru Yamashita,Yusuke Fukui,Dongjing Song,Xianghong Li,Yun Zhai,Yumiko Nakano,Ryuta Morihara,Nozomi Hishikawa,Yasuyuki Ohta,Koji Abe 대한신경과학회 2018 Journal of Clinical Neurology Vol.14 No.1

Background and Purpose Cognitive and cerebrovascular diseases are common in the elderly, but differences in the plasma levels and associations of plasma biomarkers in these diseases remain elusive. Methods The present study investigated differences in plasma fatty acids [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)], adiponectin, reptin, plasma markers of inflammation [high-sensitivity C-reactive protein (hsCRP) and serum amyloid A (serum AA)], and plasma lipids [high-density lipoprotein and low-density lipoprotein (LDL)] in patients with Alzheimer’s disease (AD) (n=266), mild cognitive impairment (MCI) (n=44), vascular dementia (VaD) (n=33), and ischemic stroke (IS) (n=200) in comparison to normal controls (n=130). Results The serological data showed that lower EPA and DHA levels and higher reptin and LDL levels were associated with AD and IS, the reptin/adiponectin ratio was strongly associated with IS, the hsCRP level was more strongly associated with VaD and IS, and the serum AA level was associated with all three cognitive diseases and IS. Conclusions This is the first report of differences in the expression levels of plasma biomarkers and peripheral arterial tonometry among AD, MCI, VaD, and IS patients and normal controls. These different associations indicate that diverse pathological mechanisms underlie these diseases

Numerical Analysis on the Effect of Angle of Attack on Evaluating Radio-Frequency Blackout in Atmospheric Reentry

Minseok Jung,Hisashi Kihara,Ken-ichi Abe,Yusuke Takahashi 한국물리학회 2016 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.68 No.11

A three-dimensional numerical simulation model that considers the effect of the angle of attack was developed to evaluate plasma flows around reentry vehicles. In this simulation model, thermochemical nonequilibrium of flowfields is considered by using a four-temperature model for high-accuracy simulations. Numerical simulations were performed for the orbital reentry experiment of the Japan Aerospace Exploration Agency, and the results were compared with experimental data to validate the simulation model. A comparison of measured and predicted results showed good agreement. Moreover, to evaluate the effect of the angle of attack, we performed numerical simulations around the Atmospheric Reentry Demonstrator of the European Space Agency by using an axisymmetric model and a three-dimensional model. Although there were no differences in the flowfields in the shock layer between the results of the axisymmetric and the three-dimensional models, the formation of the electron number density, which is an important parameter in evaluating radio-frequency blackout, was greatly changed in the wake region when a non-zero angle of attack was considered. Additionally, the number of altitudes at which radio-frequency blackout was predicted in the numerical simulations declined when using the three-dimensional model for considering the angle of attack.

Risk Factors for Complications after Reconstructive Surgery for Sternal Wound Infection

Ichiro Hashimoto,Mitsuru Takaku,Shinji Matsuo,Yoshiro Abe,Hiroshi Harada,Hiroaki Nagae,Yusuke Fujioka,Kuniaki Anraku,Kiichi Inagawa,Hideki Nakanishi 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.3

Background: Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections. Methods: A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected. Results: The patients’ BMI ranged from 15.2 to 33.6 kg/m2 (mean, 23.1±3.74 kg/m2). Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041). A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048). The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively. Conclusions: Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study.

Computation and Analysis of the Electron Transport Properties for Nitrogen and Air Inductively-coupled Plasmas

Minghao Yu,Hisashi Kihara,Ken-ichi Abe,Yusuke Takahashi 한국물리학회 2015 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.66 No.12

A relatively simple method for calculating accurately the third-order electron transport properties of nitrogen and air thermal plasmas is presented. The electron transport properties, such as the electrical conductivity and the electron thermal conductivity, were computed with the best and latest available collision cross-section data in the temperature and pressure ranges of T = 300 - 15000 K and p = 0.01 - 1.0 atm, respectively. The results obtained under the atmospheric pressure condition showed good agreements with the experimental and the high-accuracy theoretical results. The presently-introduced method has good application potential in numerical simulations of nitrogen and air inductively-coupled plasmas.

Risk Factors for Complications after Reconstructive Surgery for Sternal Wound Infection

Hashimoto, Ichiro,Takaku, Mitsuru,Matsuo, Shinji,Abe, Yoshiro,Harada, Hiroshi,Nagae, Hiroaki,Fujioka, Yusuke,Anraku, Kuniaki,Inagawa, Kiichi,Nakanishi, Hideki Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.3

Background Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections. Methods A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected. Results The patients' BMI ranged from 15.2 to $33.6kg/m^2$ (mean, $23.1{\pm}3.74kg/m^2$). Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041). A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048). The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively. Conclusions Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study.