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Shigenobu Emoto,Keisuke Hata,Hiroaki Nozawa,Kazushige Kawai,Toshiaki Tanaka,Takeshi Nishikawa,Yasutaka Shuno,Kazuhito Sasaki,Manabu Kaneko,Koji Murono,Yuuki Iida,Hiroaki Ishii,Yuichiro Yokoyama,Hiroyu 대한장연구학회 2022 Intestinal Research Vol.20 No.3
Background/Aims: Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis and handsewn anastomosis for ulcerative colitis requires pulling down of the ileal pouch into the pelvis, which can be technically challenging. We examined risk factors for the pouch not reaching the anus.Methods: Clinical records of 62 consecutive patients who were scheduled to undergo RPC with handsewn anastomosis at the University of Tokyo Hospital during 1989–2019 were reviewed. Risk factors for non-reaching were analyzed in patients in whom hand sewing was abandoned for stapled anastomosis because of nonreaching. Risk factors for non-reaching in laparoscopic RPC were separately analyzed. Anatomical indicators obtained from presurgical computed tomography (CT) were also evaluated.Results: Thirty-seven of 62 cases underwent laparoscopic procedures. In 6 cases (9.7%), handsewn anastomosis was changed to stapled anastomosis because of non-reaching. Male sex and a laparoscopic approach were independent risk factors of non-reaching. Distance between the terminal of the superior mesenteric artery (SMA) ileal branch and the anus > 11 cm was a risk factor for non-reaching.Conclusions: Laparoscopic RPC with handsewn anastomosis may limit extension and induction of the ileal pouch into the anus. Preoperative CT measurement from the terminal SMA to the anus may be useful for predicting non-reaching.
An Immune-Based Energy-Efficient Hierarchical Routing Protocol for Wireless Sensor Networks
Nabil Sabor,Shigenobu Sasaki,Mohammed Abo-Zahhad,Sabah M. Ahmed 보안공학연구지원센터 2016 International Journal of Future Generation Communi Vol.9 No.9
The energy-efficiency is the primary design issue, which greatly affects the lifetime of Wireless Sensor Network (WSNs). The hierarchical-based routing is a feasible solution for reducing the energy consumption in WSNs due to reduction of the redundant data transmission. In the hierarchical routing, the network is partitioned into clusters, where each cluster consists of a head node and many member nodes. Selection of the best head nodes, that improve the lifetime and the performance of WSNs, is a NP-hard problem. Thus, this paper proposes an Immune-based Energy-Efficient hierarchical Routing Protocol (IEERP) to improve the lifetime of WSNs. IEERP utilizes the Multi-Objective Immune Algorithm (MOIA) to partition the network into optimum clusters and find locations of the best cluster heads on the basis of balancing the consumption energy among the sensor nodes and minimizing the dissipated energy in communication and overhead control packets. The operation of the proposed IEERP protocol is divided into rounds, where each round consists of two phases. The first phase is the cluster building phase, in which sink uses the MOIA algorithm to find locations of the optimum cluster heads, followed by the data transmission phase, in which the sensor nodes transfer their sensed data to the sink via the determined cluster heads. Simulation results cleared that the IEERP is more reliable protocol because it improvers the stability period and the lifetime of the homogeneous and the heterogeneous WSNs as compared to the other protocols.