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Kinugasa Yuki,Ida Mitsuru,Nakatani Shohei,Uyama Kayo,Kawaguchi Masahiko 대한마취통증의학회 2023 Korean Journal of Anesthesiology Vol.76 No.6
Background: The Quality of Recovery-15 (QoR-15) and 12-item World Health Organization Disability Assessment Schedule 2.0 scales are post-surgery patient-reported outcome measures. We aimed to evaluate the association between immediate in-hospital postoperative recovery and mid-term disability-free survival (DFS) after discharge.Methods: We conducted a prospective observational study at a university hospital and enrolled 260 patients aged ≥ 65 years with cancer who were undergoing elective major abdominal surgery. The association between poor postoperative recovery, defined as a QoR-15 score < 90 on postoperative day (POD) 2, and the DFS three months later was assessed using Fisher’s exact test. The odds ratio of poor recovery on POD 2 to DFS was calculated using multiple logistic regression analysis adjusted for prominent factors (age, preoperative frailty, preoperative DFS, surgical duration, and intraoperative blood loss volume).Results: A total of 230 patients completed the 3-month follow-up. On POD 2, 27.3% of the patients (63/230) had poor recovery. A greater number of patients without poor recovery on POD 2 had DFS at three months after surgery (79.6%) than those with poor recovery (65.1%) (P = 0.026). The adjusted odds ratio of poor recovery on POD 2 to DFS at three months was 0.481 (95% CI [0.233, 0.994]).Conclusions: Patients with poor recovery on POD 2 were less likely to have DFS three months after abdominal surgery. These findings may allow for early and effective interventions to be initiated based on each patient’s condition after abdominal surgery.
A Study on Adaptive Notch Filter Using Fourier Sine Series Expansion
Y. Kinugasa,M. Kobayashi,Chi WANG,Y. Itoh 대한전자공학회 2008 ITC-CSCC :International Technical Conference on Ci Vol.2008 No.7
In this paper, new adaptive notch filter that realized the phase shift of the all-pass circuit by the Fourier sine series expansion and the adaptive algorithm was proposed. The proposed adaptive notch filter was always stable since the all-pass filter was composed by an exponential filter. The degree of the all-pass filter only depended on the required steepness of the elimination characteristic and did not depend on the number of narrowband signals that should be eliminated.
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.
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.
Maneuverability of Flexible Mono-tread Mobile Track(FMT)
Takafumii Haji,Tetsuya Kinugasa,Koji Yoshida,Hisanori Amano,Koichi Osuka 제어로봇시스템학회 2009 제어로봇시스템학회 국제학술대회 논문집 Vol.2009 No.8
In the past decade, search robots in rescue operations have been focused on and developed for the purpose of finding survivors trapped in the rubble of collapsed buildings. Most of them adopt serpentine Mechanisms. However, they might gather to catch debris between tracks or become stuck due to the mechanisms. To get over the problems, a new mobile mechanism have been proposed: flexible mono-tread mobile track (FMT), and a prototype "Rescue mobile track No.2(RT-02) WORM" was developed. The machine is composed of a "flexible chain" and vertebral structure, the body flexes in 3D. As a result of the specific turning mechanism, steering performance of FMT is different from the usual differential-type tracked vehicle (DTV). The purpose of this paper si to show the maneuverability of FMT comparing with that of DTV through some experiments.
Jeong, Yeon Jun,Cho, Baik Hwan,Kinugasa, Yusuke,Song, Chang Ho,Hirai, Ichiro,Kimura, Wataru,Fujimiya, Mineko,Murakami, Gen Wiley Subscription Services, Inc., A Wiley Company 2009 Clinical anatomy Vol.22 No.6
<P>The developing mesocolon transversum was investigated using hematoxylin and eosin-stained semiserial sections derived from 17 human fetuses between 12 and 30 weeks of gestation. The mesocolon was attached to the mesoduodenum and greater omentum until 12 weeks. However, the fetal duodenal attachment appeared not to correspond to the right colic flexure in adults. The greater omentum and mesocolon were likely to be irregularly folded at the attachment site possibly because the developing transverse colon “ran into” and pushed up the greater omentum and pancreatic head. Lymphatic vessels invaded the indistinct fusion plane to destroy the primary configuration. Moreover, the mesocolon seemed to “seize” or take-over some parts of the splenic side of the greater omentum, but the thick gastric side containing the right gastroepiploic artery and vein remained along the greater curvature. Until 20 weeks, the left colic flexure was fixed to the pancreatic tail, and near the flexure the mesocolon also fused with the renal fascia. The left splenic end of the greater omentum was folded and fused together to form a thick ligament-like structure, i.e., the gastrocolic ligament. In addition, near the duodenojejunal junction, a peritoneal bridge was often seen containing the inferior mesenteric artery or vein. Although surgeons generally believe that the mesocolon can be gently detached from the greater omentum, the fusion plane in adults appears to be the result of secondary modification and simplification by vascular development. Clin. Anat. 22:716–729, 2009. © 2009 Wiley-Liss, Inc.</P>