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Bonding and debonding behavior of FRP sheets under fatigue loading
Iwashita, Kentaro,Wu, Zhishen,Ishikawa, Takashi,Hamaguchi, Yasumasa,Suzuki, Toshio The Korean Society for Composite Materials 2007 Advanced composite materials Vol.16 No.1
The purpose of this study is to improve the examining and understanding of the bonding behavior of Fiber Reinforced Polymer (FRP) sheets bonded to concrete blocks and steel plates under fatigue loading. First, a series of experimental investigations is summarized in the paper. The fatigue behavior of bonding surface between FRP sheets and concrete is finally characterized by the conducted P-S-N diagram representing the relationship among the probability of FRP debonding (P), the bond stress amplitudes (S), and the number of cycles (N) at debonding on a semi-logarithmic scale. The different debonding modes for various fracturing surface are also investigated and evaluated.
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Fetal growth and insulin-like growth factor system
( Mitsutoshi Iwashita ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
Migration of subpopulation of the placental trophoblast known as extravillous trophoblast (EVT) cells into the maternal endometrium is one of the fundamental components of the human implantation and placentation. Insulin-like growth factors (IGF-I and IGF-II) stimulate EVT cells migration and invasion into uterine wall . Since these cells produce IGF-II and possess IGF-I receptor, it is suggested that IGFs regulate EVT cells invasion into endometrium in an autocrine fashion. In contrast, one of IGF binding proteins (IGFBPs), IGFBP-1 is produced in decidualized endometrium that inhibits IGF action thereby regulating EVT cells invasion negatively. Thus, appropriate placentation is determined by the balance of IGF in trophoblast and IGFBP-1 in endometrium. IGF and IGFBPs in maternal-fetal interface are involved in not only placentation but also placental function. IGF-I stimulates glucose and amino acid uptake by trophoblast cells in vitro and enhances the transfer of maternal amino acid to the fetus in vivo. In contrast, IGFBP-1 inhibits IGF-I action in placenta in terms of maternal amino acid transfer to the fetus. In mother, circulating levels of IGF-I are increased during pregnancy and correlates with fetal birth weight while IGFBP-1 gradually increased throughout pregnancy and negatively correlates with fetal weight. Thus, maternal IGF-I and IGFBP-1 are tightly involved in fetal growth presumably by regulating placental nutrient transfer to the fetus. Although maternal IGF-I and IGFBP-1 are not transferred through placenta, fetal circulating levels of IGF-I is positively and IGFBP-1 is negatively correlated with birth weight. Cell culture and animal experiments clearly demonstrated that fetal IGF-I and IGFBP-1 are regulated by nutritional factors and oxygen concentration where fetus stimulates IGF-I and inhibits IGFBP-1 production under enough supply of nutrition and oxygen from placenta and promotes its own growth. A condition that decreases supply of these substances such as placental dysfunction, fetus produces more IGFBP-1 and inhibits IGF-I production in order to inhibit own growth to survive.
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Chihiro Iwashita,Yoshimasa Miura,Hiroyuki Osawa,Takahito Takezawa,Yuji Ino,Masahiro Okada,Alan K. Lefor,Hironori Yamamoto 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.1
Barrett’s adenocarcinoma may occur in multiple sites, and recurrence and metachronous lesions are the major problems with endoscopic resection. Therefore, early detection of such lesions is ideal to achieve complete resection and obtain improved survival rates with minimally invasive treatment. Laser imaging systems allow multiple modalities of endoscopic imaging by using white light laser, flexible spectral imaging color enhancement (FICE), blue laser imaging (BLI), and linked color imaging even at a distant view. However, the usefulness of these modalities has not been sufficiently reported regarding Barrett’s adenocarcinoma. Here, we report on a patient with three synchronous lesions followed by one metachronous lesion in a long segment with changes of Barrett’s esophagus, all diagnosed with this new laser endoscopic imaging system and enhanced by using FICE and/or BLI with high contrast compared with the surrounding mucosa. Laser endoscopic imaging may facilitate the detection of malignancies in patients with early Barrett’s adenocarcinoma.
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Diagnosis and management of preterm birth in Japan
( Mitsutoshi Iwashita ) 대한산부인과학회 2017 대한산부인과학회 학술대회 Vol.103 No.-
Preterm birth rate in Japan is around 5% of total birth in which majority of preterm birth has been between 32 and 36 weeks of gestation. On the other hand, perinatal mortality rate as well as neonatal mortality rate has been rapidly improved by progress of perinatal medicine. Neonatal mortality rate in extremely low body weight (ELBW) infant (<1000 g) has been improved from42.7% in 1950 to 8.1% in 2010 in Japan. However, approximately 50% of survived ELBW infants have neurological problems including cerebral palsy and/or mental retardation due to prematurity. Therefore, it is one of most urgent issues in perinatal medicine to reduce preterm birth especially between 22 and 27 weeks of gestation. Various examinations for high risk pregnancy and prognosis of threatened preterm birth have been introduced and measurement of cervical length (CL) between 18 and 24weeks is recommended by guideline issued by JSOG. Other than measurement of CL, several biochemical markers are also used for prognosis of threatened preterm birth such as fetal fibronectin, IGFBP-1, interleukin6, 8 and granulocyte elastase in majority of perinatal center in Japan. JSOG guideline also recommended examinations for bacterial vaginosis (BV) such as Nugent score and/or Amsel criteria before 20 weeks. Using these examinations, high risk group and prognosis of preterm birth could judge relatively correct. On the other hand, prevention and treatment of preterm birth are not established yet. Although many trials have been reported, it is difficult to compare clinical results since the sample group in each report is different. Among them, betamimetics such as ritodrine and magnesium sulfate have been used as tocolytic agents in Japan. It is generally accepted that ritodorine is useful for prevention of preterm birth within 48 hours, but the long-term intravenous administration is routinely performed in hospitalized patient in Japan. Magnesium sulfate is also frequently used in Japan with careful observation on side effects due to over dosage although clinical evidence for prevention of preterm birth is poor. Several RCT suggested that vaginal progesterone suppository might be more effective than intramuscular injection of 17alpha hydroxyprogesterone caproate. However, clinical trial of vaginal suppository of progesterone is just begun in Japan and there was no substantial evidence that treatment with progesterone is effective to prevent preterm birth in Japan. BV is considered as one of causes of preterm birth and JSOG guideline recommended to treat with metronidazole or clindamycine, however, clinical results by treatment with antibiotics are controversial. Similarly, JSOG guideline recommends to use “suitable” antibiotics when cervicitis and chorioamnionitis are suspected although there was no indisputable evidence. Administration of betamethasone is recommended by JSOG guideline to improve neurological prognosis of infant when preterm birth between 22 and 33 weeks is expected within one week as obtaining consensus internationally. Preventive cerclage after 12 weeks of gestation is one of alternatives for pregnant women with past history of preterm birth in JSOG guideline. Similarly, therapeutic cerclage is one of alternatives in pregnant women with short cervix at present pregnancy although a newest report indicates that therapeutic cerclage for short cervix does not prevent preterm birth. Examinations for diagnosis is almost established to find high risk group for preterm birth and prognosis of threatened preterm birth but further well-designed RCT is necessary to establish treatment for prevention of preterm birth.
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No fault compensation in perinatal medicine in Japan-from results for 8 years
( Mitsutoshi Iwashita ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2
No fault compensation in perinatal medicine has been established to provide aid to patients in the event of disability due to a medical accident during delivery and to strive to resolve disputes quickly that contributes to reduce medical malpractice suit in the field of perinatal medicine. Furthermore, this system is aimed to establish a mechanism that achieves higher quality of obstetric care by analyzing the causes of accidents. This system is operated by Japan Council for Quality Health Care and 99.9% of childbirth facilities in Japan registered with this compensation system. Compensation system has two major functions including compensation and cause analysis and recurrence prevention based on cases. Compensation eligibility is reviewed in the Review Committee at the organization in Japan Council for Quality Health Care and currently 1,717 cases are judged as eligible cases out of 2,250 since 2009. The cause of each eligible case is analyzed in the Cause Analysis Committee one by one. The Cause Analysis Committee has 7 independent subcommittee and each subcommittee members are consistent of obstetricians, neonatologists, pediatricians, midwives and lawyers. Original cause analysis report is sent to childbirth facility and patient`s family. Questionnaire survey demonstrated that 73% of childbirth facilities and 65% of patient family were satisfied with the cause analysis report. The number of medical lawsuit in obstetrics and gynecology is significantly decreased compared to those in all medical departments since the compensation system was introduced suggesting that these cause analysis reports may contribute the decrease in medical lawsuits. The major purpose of the Recurrence Prevention Committee is striving to prevent future cases of cerebral palsy and to improve the quality of obstetric care. To accomplish the purpose, the committee routinely collect information from individual cases and analyze quantitatively and epidemiologically. Furthermore the committee choose subject from cases to discuss for future prevention and provide wide public disclosure of the information with recommendation. The committee issued 6 reports until now and these reports have been distributed to childbirth facilities, perinatal medicine-related scientific society and administrative agencies.
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