US East Asian Strategy and the Transformation of US-China Relations: Lessons Learned from the Russia-Ukraine War

( Kumiko Haba ) 한국EU학회 2023 Asia-Pacific Journal of EU Studies Vol.21 No.2

This paper argues what are current situation of US-China relations and why the Russia- Ukraine war has happened. It also explains what are strategies of the global super powers such as the US and China set their strategies to maintain and challenge their hegemony in the world. In fact, it is a transformation period in the world political economy from the West to the East. Therefore, protectionism has been intensified since the Trump administration that is caused by Chinese expansion particularly in the Asia-Pacific region. The US under the Biden government has responded by setting up Indo-Pacific Strategy (IPS) in order to check and control China in the region. As a result, the possibility of military confrontation between the two parties in the region has increased that is not the wish of East Asian countries. Therefore, East Asian countries must learn what are lessons of the Russia-Ukraine war.

Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography

Shin Haba,Kazuo Hara,Nobumasa Mizuno,Takamichi Kuwahara,Nozomi Okuno,Akira Miyano,Daiki Fumihara,Moaz Elshair 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.3

Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) is widely performed not only as an alternative to transpapillary biliarydrainage, but also as primary drainage for malignant biliary obstruction. For anatomical reasons, this technique carries an unavoidablerisk of mispuncturing intrahepatic vessels. We report a technique for troubleshooting EUS-guided portal vein coiling to preventbleeding from the intrahepatic portal vein after mispuncture during interventional EUS. EUS-HGS was planned for a 59-year-old malepatient with unresectable pancreatic cancer. The dilated bile duct (lumen diameter, 2.8 mm) was punctured with a 19-gauge needle,and a guidewire was inserted. After bougie dilation, the guidewire was found to be inside the intrahepatic portal vein. Embolizing coilswere placed to prevent bleeding. Embolization coils were successfully inserted under stabilization of the catheter using a double-lumencannula with a guidewire. Following these procedures, the patient was asymptomatic. Computed tomography performed the next dayrevealed no complications.

노자의 정치·윤리 철학 : 함께 하는 삶과 `有爲無位 無爲有位 Live Together and `Youwei-wuwei Wuwei-youwei

이하배 동양철학연구회 2003 東洋哲學硏究 Vol.34 No.-

노자를 사변적이고 신비롭게 읽어 나간다면, 이는 노자를 드러내는 일보다 감추는 일이 되기 쉬울 젓이다. 노자는 작고 직접적이고 감각적인 것에 묻혀 이들만을 보고들을 수 있으며 욕심부리고 추구하는 세상 인들의 사고·행동방식과 이를 뒤집는 “성인”의 그것을 강하게 대립시킨다. 노자가 추구하는 “무지”와 “무위”는 세상적 지식과 행위의 없음이지, 지식과 행위 일반을 부정하지 않는다. 노자는 당시의 통치가 백성들의 삶에 “짐”이 되거나 “유해”한 것이라고 비판한다. 노자는 치자가 가는 길과 ‘가야 할 길’에 대해 얘기한다. 이 크고 영원한 무위의 도를 알고 몸에 닦아 체득하여 내적으로 커 가는 일이 노자의 修身이다. ‘외적으로 큰’ 王'이 ‘내적으로(도) 큰’ “성인”이 되어 “무위이지만 無不爲”인 도를 벗어나지 않고 “지킬 수” 있다면, 천하는 “스스로 고르고 바르게 감화되어”, 그를 “무겁거나 해롭다 하지 않으면서 기꺼이 위로 밀어 올린다.” 그러니까 ‘아레로 내리는’ 것이 ‘위일 수 있는’ 길이다. 노자의 정치·윤리 철학의 핵심은 ‘無爲의 힘’을 통한 권력 혹은 ‘큰 자리’를 조직·관리하는 有位의 논리에 있다. 이는 ‘有爲하면 無位하고 無爲하면 有位할 수 있다’는 논리다. 결국, 上이 자신을 낮추는 것은 자신을 (계속) 올리는 결과를 초래하고, 下가 자신을 낮추는 것은 자신을 (계속) 내리는 결과를 초래한다. 상이 자신을 낮추든 하가 자신을 낮추든, 외적 상하관계 구도는 변하지 않고 오히려 고정되는 것이다. 이는 ‘올리기’와 ‘내리기’의 상호작용 논리로써 下의 ‘자발적 복종을 생산해 내는 기술/예술’로서의 도에 맞는 ‘위-이기’의 논리요, 내적 크기 논리를 이용하여 외적 크기가 관리되는 하나의 이데올로기 논리다. 여기에서 세상을 ‘벗어나’ 사고하는 노자가 어떻게 다시 세상 ‘속에서’ 사고할 수 있는지 드러난다. If the Laotzu is read speculatively and mystically, the real meaning of Laotzu will be hidden rather than revealed. Laotzu compares the thinking and behaviors of worldly people against those of a “sage”. In the world, people are surrounded by direct and sensuous things so that they can see and hear only these things and pursue these things in greed. But, a sage is totally different. The “Wuzbi(Ignorance)” and the “Wuwei(Non-action)” pursued by Laotzu mean the non-having of worldly knowledge and the non-having of worldly action, respectively. These ideas do not deny the knowledge and the actions in general. Laotzu criticized that the ruling in his days was “burdensome” or “harmful”to the public. He talked about the way that the ruler was going and the way that the ruler should go. The way that the ruler should go is Tao of Wuwei. In the Xiusben(修身, moral training) of Laotzu, you should know and understand this eternal and great value of Tao of Wuwei and keep it in mind for internal growth. If a king who is ‘great external’ is also a ”sage” who is ‘great interal' and “can keep” the “Tao of Wuwei but wei bu wei(Non-action but not non-action)”, the world “will be impressed and transformed in a right way in itself and raise the king, saying he is not heavy or harmful”. In other words, putting himself down is the way to be raised above. The key of politics and ethics of Laotzu philosophy lies in the logic of Youwei, which through the ‘power of Wuwei' organizes and manages power or ‘the great position’. This logic can be said to be “Youwei-wuwei Wuwei-youwei(有爲無位 無爲有位: Non-action gives the great position and action gives no position.)”. In the end, lowering position of Shang(上, above, king) results in raised position (continuously) and lowering position of Xia(下, below, subordinates) results in owered position (continuously). Whether Shang or Xia lowers his position, the external hierarchy will not be changed. Rather, it will be fixed. This is the logic of ‘being above’ according to Tao, which is the technique to make Xia obey to Shang voluntarily rhrough the logic of interaction of ‘Raising’ and ‘lowering’. This is also the logic of an ideology to manage ‘external growth’ using ‘internal growth’. Here, how Laotzu, who thinks “away from” the world, thinks “within” the world is revealed.

Major elements and noble gases of the Jinju (H5) meteorite, an observed fall on March 9, 2014, in South Korea

Nagao, K.,Haba, M. K.,Lee, J. I.,Kim, T.,Lee, M. J.,Park, C.,Jwa, Y. J.,Choi, B.-G. THE GEOCHEMICAL SOCIETY OF JAPAN 2016 Geochemical journal Vol.50 No.4

<P>The Jinju (H5) meteorite fell as four fragments in the Jinju area, Gyeonsangnam-do, South Korea, on March 9, 2014. The major element concentrations and noble gas isotopic compositions were determined for Jinju-1 and Jinju-2, stones of the first and second discoveries, respectively, by using X-ray fluorescence (XRF) analysis and noble gas mass spectrometry combined with total melting and stepwise heating noble gas extraction. The major element composition agrees well with that of equilibrated H chondrites. Very low contamination from terrestrial atmospheric noble gases was detected, which may be attributed to the rapid recovery of the stones within two days after the fall of the Jinju meteorite. A short cosmic ray exposure age of 2.4 My was obtained. The (U, Th)-He, and K-Ar ages are concordant at ca. 4.0 Gy, which suggests that no severe heating event occurred to cause a loss of He after the resetting at 4.0 Gy. Overabundances of trapped Ar and Kr, which were released at 800 degrees C, were found in addition to 'normal' Q gas of Ar, Kr and Xe at >= 1400 degrees C. The low-temperature component could be explained by Ar and Kr supplied by an adjacent impact region that were trapped when the minerals of the Jinju meteorite were formed during cooling. The heavy shock event that occurred at 4.0 Gy might have produced the observed numerous vugs and vapor growth crystals in this meteorite (Choi et al., 2015) and could have supplied the Ar and Kr to thermally weak minerals.</P>

Endoscopic ultrasound-guided drainage for an abscess cavity

Nozomi Okuno,Kazuo Hara,Nobumasa Mizuno,Shin Haba,Takamichi Kuwahara,Yasuhiro Kuraishi,Takafumi Yanaidani,Sho Ishikawa,Tsukasa Yasuda,Masanori Yamada,Toshitaka Fukui 소화기인터벤션의학회 2022 International journal of gastrointestinal interven Vol.11 No.4

Endoscopic ultrasound (EUS)-guided interventions, including EUS-guided biliary drainage and EUS-guided cystic drainage, are now well developed and in widespread use. Intraperitoneal abscess requires drainage because mortality associated with an undrained abscess is high. Percutaneous or surgical drainage has traditionally been performed, but there have been numerous reports of EUS-guided drainage for intraperitoneal abscesses in recent years. EUS-guided abscess drainage has the advantage of being less invasive and enabling direct access to the cavity via the trans-luminal route as well as clear visualization of interposed vessels using color Doppler ultrasonography. It is necessary to consider the advantages and disadvantages when selecting a drainage method. This article reviews the current status of EUS-guided abscess drainage at three sites: the liver, pelvis, and mediastinum.

Safety of endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction and ascites

Tsukasa Yasuda,Kazuo Hara,Nobumasa Mizuno,Shin Haba,Takamichi Kuwahara,Nozomi Okuno,Yasuhiro Kuraishi,Takafumi Yanaidani,Sho Ishikawa,Masanori Yamada,Toshitaka Fukui 대한소화기내시경학회 2024 Clinical Endoscopy Vol.57 No.2

Background/Aims: Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS) is useful for patients with biliary cannulation failure or inaccessible papillae. However, it can lead to serious complications such as bile peritonitis in patients with ascites; therefore, development of a safe method to perform EUS-HGS is important. Herein, we evaluated the safety of EUS-HGS with continuous ascitic fluid drainage in patients with ascites. Methods: Patients with moderate or severe ascites who underwent continuous ascites drainage, which was initiated before EUS-HGS and terminated after the procedure at our institution between April 2015 and December 2022, were included in the study. We evaluated the technical and clinical success rates, EUS-HGS-related complications, and feasibility of re-intervention. Results: Ten patients underwent continuous ascites drainage, which was initiated before EUS-HGS and terminated after completion of the procedure. Median duration of ascites drainage before and after EUS-HGS was 2 and 4 days, respectively. Technical success with EUS-HGS was achieved in all 10 patients (100%). Clinical success with EUS-HGS was achieved in 9 of the 10 patients (90%). No endoscopic complications such as bile peritonitis were observed. Conclusions: In patients with ascites, continuous ascites drainage, which is initiated before EUS-HGS and terminated after completion of the procedure, may prevent complications and allow safe performance of EUS-HGS.

Clinical utility of endoscopic ultrasound-guided tissue acquisition for comprehensive genomic profiling of pancreatic cancer

Nozomi Okuno,Kazuo Hara,Nobumasa Mizuno,Shin Haba,Takamichi Kuwahara,Yasuhiro Kuraishi,Daiki Fumihara,Takafumi Yanaidani 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.2

Background/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is essential for the diagnosis of pancreatic cancer. The feasibility of comprehensive genomic profiling (CGP) using samples obtained by EUS-TA has been under recent discussion. This study aimed to evaluate the utility of EUS-TA for CGP in a clinical setting. Methods: CGP was attempted in 178 samples obtained from 151 consecutive patients with pancreatic cancer at the Aichi Cancer Center between October 2019 and September 2021. We evaluated the adequacy of the samples for CGP and determined the factors associated with the adequacy of the samples obtained by EUS-TA retrospectively. Results: The overall adequacy for CGP was 65.2% (116/178), which was significantly different among the four sampling methods (EUS-TA vs. surgical specimen vs. percutaneous biopsy vs. duodenal biopsy, 56.0% [61/109] vs. 80.4% [41/51] vs. 76.5% [13/17] vs. 100.0% [1/1], respectively; p=0.022). In a univariate analysis, needle gauge/type was associated with adequacy (22 G fine-needle aspiration vs. 22 G fine-needle biopsy [FNB] vs. 19 G-FNB, 33.3% (5/15) vs. 53.5% (23/43) vs. 72.5% (29/40); p=0.022). The sample adequacy of 19 G-FNB for CGP was 72.5% (29/40), and there was no significant difference between 19 G-FNB and surgical specimens (p=0.375). Conclusions: To obtain adequate samples for CGP with EUS-TA, 19 G-FNB was shown to be the best in clinical practice. However, 19 G-FNB was not still sufficient, so further efforts are required to improve adequacy for CGP.

Utility of forward-view endoscopic ultrasound in fine-needle aspiration in patients with a surgically altered upper gastrointestinal anatomy

Asmaa Bakr,Kazuo Hara,Moaz Elshair,Shin Haba,Takamichi Kuwahara,Nozomi Okuno,Daiki Fumihara,Takafumi Yanaidani,Samy Zaky,Hanaa Omar 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.3

Background/Aims: Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) using oblique-view EUS in patients with a surgically altered anatomy (SAA) of the upper gastrointestinal tract is limited because of difficult scope insertion due to the disturbed anatomy. This study aimed to investigate the efficiency of forward-view (FV)-EUS in performing FNA in patients with a SAA. Methods: We retrospectively investigated 32 patients with a SAA of the upper gastrointestinal tract who visited Aichi Cancer Center Hospital in Nagoya, Japan, between January 2014 and December 2020. We performed upper gastrointestinal EUS-FNA using FV-EUS combined with fluoroscopic imaging to confirm tumor recurrence or to make a decision before chemotherapy or after a failure of diagnosis by radiology. Results: We successfully performed EUS-FNA in all studied patients (100% technical success), with the specificity, sensitivity, and accuracy of 100%, 87.5%, and 87.8%, respectively, with no complications. Conclusions: EUS-FNA using FV-EUS combined with fluoroscopic imaging is an effective and safe technique for tissue acquisition in patients with a SAA.

Forward viewing liner echoendoscopy for therapeutic interventions

Kazuo Hara,Nozomi Okuno,Shin Haba,Takamichi Kuwahara 대한소화기내시경학회 2024 Clinical Endoscopy Vol.57 No.2

Therapeutic endoscopic ultrasonography (EUS) procedures using the forward-viewing convex EUS (FV-EUS) have been reviewed based on the articles reported to date. The earliest reported procedure is the drainage of pancreatic pseudocysts using FV-EUS. However, the study on drainage of pancreatic pseudocysts focused on showing that drainage is possible with FV-EUS rather than leveraging its features. Subsequently, studies describing the characteristics of FV-EUS have been reported. By using FV-EUS in EUS-guided choledochoduodenostomy, double punctures in the gastrointestinal tract can be avoided. In postoperative modified anatomical cases, using the endoscopic function of FV-EUS, procedures such as bile duct drainage from anastomosis, pancreatic duct drainage from the afferent limb, and abscess drainage from the digestive tract have been reported. When a perpendicular puncture to the gastrointestinal tract is required or when there is a need to insert the endoscope deep into the gastrointestinal tract, FV-EUS is considered among the options.

Safety and Utility of Single-Session Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography for the Evaluation of Pancreatobiliary Diseases

( Kazumichi Kawakubo ),( Hiroshi Kawakami ),( Masaki Kuwatani ),( Shin Haba ),( Taiki Kudo ),( Yoko Abe ),( Shuhei Kawahata ),( Manabu Onodera ),( Nobuyuki Ehira ),( Hiroaki Yamato ),( Kazunori Eto ) 대한소화기학회 2014 Gut and Liver Vol.8 No.3

Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) are essential for diagnosing and treating pancreatobiliary diseases. Single-session EUS and ERCP are considered to be essential in reducing the duration of hospital stays; however, complications are a primary concern. The aim of this study was to evaluate the safety and efficacy of single-session EUS and ERCP. Sixty-eight patients underwent single-session EUS and ERCP at a tertiary referral center between June 2008 and December 2012. We retrospectively reviewed patient data from a prospectively maintained EUS-ERCP database and evaluated the procedural characteristics and complications. Thirty-eight patients (56%) underwent diagnostic EUS, and 30 patients (44%) underwent EUS fine-needle aspiration, which had an overall accuracy of 100%. Sixty patients (89%) underwent therapeutic ERCP, whereas the remaining eight procedures were diagnostic. Thirteen patients underwent biliary stone extraction, and 48 underwent biliary drainage. The median total procedural time was 75 minutes. Complications were observed in seven patients (10%). Six complications were post-ERCP pancreatitis, which were resolved using conservative management. One patient developed Mallory-Weiss syndrome, which required endoscopic hemostasis. No sedation-related cardiopulmonary complications were observed. Single-session EUS and ERCP provided accurate diagnosis and effective management with a minimal complication rate.