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Hiroaki Kusunose,Shinsuke Koshita,Yoshihide Kanno,Takahisa Ogawa,Toshitaka Sakai,Keisuke Yonamine,Kazuaki Miyamoto,Fumisato Kozakai,Hideyuki Anan,Kazuki Endo,Haruka Okano,Masaya Oikawa,Takashi Tsuchiy 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.3
Background/Aims: This study aimed to clarify the efficacy and safety of pancreatic duct lavage cytology combined with a cell-block method (PLC-CB) for possible pancreatic ductal adenocarcinomas (PDACs). Methods: This study included 41 patients with suspected PDACs who underwent PLC-CB mainly because they were unfit for undergoing endoscopic ultrasonography-guided fine needle aspiration. A 6-Fr double lumen catheter was mainly used to perform PLC-CB. Final diagnoses were obtained from the findings of resected specimens or clinical outcomes during surveillance after PLC-CB. Results: Histocytological evaluations using PLC-CB were performed in 87.8% (36/41) of the patients. For 31 of the 36 patients, final diagnoses (invasive PDAC, 12; pancreatic carcinoma in situ, 5; benignancy, 14) were made, and the remaining five patients were excluded due to lack of surveillance periods after PLC-CB. For 31 patients, the sensitivity, specificity, and accuracy of PLC-CB for detecting malignancy were 94.1%, 100%, and 96.8%, respectively. In addition, they were 87.5%, 100%, and 94.1%, respectively, in 17 patients without pancreatic masses detectable using endoscopic ultrasonography. Four patients developed postprocedural pancreatitis, which improved with conservative therapy. Conclusions: PLC-CB has an excellent ability to detect malignancies in patients with possible PDACs, including pancreatic carcinoma in situ.
Ito Sadayuki,Sakai Yoshihito,Ando Kei,Nakashima Hiroaki,Machino Masaaki,Segi Naoki,Tomita Hiroyuki,Koshimizu Hiroyuki,Hida Tetsuro,Ito Kenyu,Harada Atsushi,Imagama Shiro 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.2
Study Design: Retrospective study.Purpose: Cervical laminoplasty is safe and effective for treating cervical myelopathy but has a higher frequency of postoperative axial pain compared to other methods. Several studies have reported on the causes of postoperative axial pain, but none have fully elucidated them. This study aimed to investigate the association between postoperative neck pain and intraoperative transcranial motor-evoked potential (MEP) waveforms of the trapezius muscles using transcranial MEPs.Overview of Literature: Few studies have investigated the association between postoperative neck pain and intraoperative transcranial MEP waveforms of the trapezius muscles in patients with cervical laminoplasty.Methods: A total of 79 patients with cervical myelopathy who underwent cervical laminoplasty at our facility between June 2010 and March 2013 were included in this study. Intraoperative control and final waveform were evaluated based on the trapezius muscle MEPs by measuring the latency and amplitude. A neck pain group comprised patients with higher neck pain Visual Analog Scale scores from preoperative value to 1 year postoperatively. The cross-sectional areas of the trapezius muscles and the MEP latencies and amplitudes were compared between patients with and without neck pain.Results: The latency and amplitude of the control waveforms were not significantly different between groups. The neck pain group had a significantly shorter final waveform latency (neck pain: 23.6±2.5, no neck pain: 25.8±4.5; p =0.019) and significantly larger amplitude (neck pain: 2,125±1,077, no neck pain: 1,630±966; p =0.041) than the no neck pain group.Conclusions: Postoperative neck pain was associated with the final waveform latency and amplitude of the trapezius muscle MEPs during cervical laminoplasty. Intraoperative electrophysiological trapezius muscle abnormalities could cause postoperative neck pain.
Ito Sadayuki,Sakai Yoshihito,Harada Atsushi,Ando Kei,Kobayashi Kazuyoshi,Nakashima Hiroaki,Machino Masaaki,Kambara Shunsuke,Inoue Taro,Hida Tetsuro,Ito Kenyu,Ishiguro Naoki,Imagama Shiro 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.5
Study Design: Retrospective study. Purpose: We aimed to use motor evoked potentials (MEPs) to examine the association of electrophysiological assessment of the trapezius muscle with neck pain. Overview of Literature: Previous reports on the association of neck pain with the trapezius muscle have focused on surface electromyograms and muscle oxygenation; however, to our knowledge, none of these studies included detailed data on MEPs. Methods: The study included 100 patients with cervical myelopathy who underwent surgery at the National Center for Geriatrics and Gerontology in Obu, Japan from June 2010 to March 2013. Before the surgery, neck pain was evaluated using a Visual Analog Scale (a score ≥50 indicated neck pain and a score <50 indicated no neck pain). The preoperative cross-sectional areas of the trapezius muscles were measured with cervical magnetic resonance imaging sagittal T2-weighted images. Cranial stimulation under general anesthesia was used to derive the MEPs, enabling the measurement of latency and amplitude, using preoperative MEPs of the trapezius muscles. Results: The MEP of the trapezius muscle in patients with neck pain had significantly shorter latencies than those in patients who did not have neck pain. However, there was no significant difference in the amplitude between patients with and without neck pain. However, this tended to be greater in patients with neck pain as compared to that in those without neck pain. The cross-sectional area of the trapezius muscle in patients with neck pain was significantly smaller than that in those who did not have neck pain. Conclusions: MEPs revealed electrophysiological abnormalities of the trapezius muscles in patients with neck pain, supporting a relationship of neck pain with the trapezius muscles.
Interface State and Coercivity in Nd-Fe-B/Dy Films
Jin Umezawa,Yoshiki Sakai,Kunihiro Koike,Daisuke Ogawa,Yoshiyuki Mizuno,Hiroaki Kato,Takamichi Miyazaki,Yasuo Ando 한국물리학회 2013 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.63 No.3
We fabricated a model interface system, which consised of a Nd2Fe14B layer with Dy overlayers,in order to study the relationship between the microstructure near the interface and the coercivity. The coercivity Hc of the 1-µm-thick Nd-Fe-B films with a Dy overlayer was enhanced by thermaldiffusion of Dy atoms from the film’s surface into the Nd-Fe-B layer. The Nd-Fe-B/Dy films annealedat 700℃ showed a significant increase in the Hc of up to about 17 kOe. The maximum increasein the value of the coercivity ΔHc of the annealed films with a Dy overlayer was approximately 13kOe. The XRD measurement suggested the existence of rare-earth oxides (NdO and Dy2O3) in theDy-coated films with high value of the ΔHc.
Yoshihide Kanno,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Keisuke Yonamine,Yujiro Kawakami,Yuki Fujii,Kazuaki Miyamoto,Toji Murabayashi,Fumisato Kozakai,Jun Horaguchi 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.6
Background/Aims: In this study, we aimed to evaluate the predictive value of localized stenosis of the main pancreatic duct (MPD) forearly detection of pancreatic cancer. Methods: Among 689 patients who underwent endoscopic retrograde pancreatography from January 2008 to September 2018, 19patients with MPD findings were enrolled. These patients showed findings for indicating suspicious pancreatic cancer at an early stage(FiCE); FiCE was defined as a single, localized stenosis in the MPD without a detectable mass (using any other imaging methods) andwithout other pancreatic diseases, such as definite chronic pancreatitis, intraductal papillary mucinous neoplasm, and autoimmunepancreatitis. Final diagnoses were established by examining resected specimens or through follow-up examinations after an interval of>5 years. Results: Among 19 patients with FiCE, 11 underwent surgical resection and 8 were evaluated after a >5-year observation period. Thefinal diagnosis of the MPD stenosis was judged to be pancreatic cancer in 9 patients (47%), including 3 with intraepithelial cancer, andto be a non-neoplastic change in 10. The sensitivity, specificity, and accuracy of preoperative pancreatic juice cytology were 75%, 100%,and 88%, respectively. Conclusions: The predictive value of FiCE for pancreatic cancer prevalence was 47%. Histological confirmation with pancreatic juicecytology is necessary before surgical resection.
Yoshihide Kanno,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Keisuke Yonamine,Kazuaki Miyamoto,Toji Murabayashi,Fumisato Kozakai,Jun Horaguchi,Yutaka Noda,Kei Ito 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.6
Background/Aims: The aim of this study was to evaluate outcomes of inside plastic stents (iPSs) versus those of metal stents (MSs) for treating unresectable perihilar malignant obstructions. Methods: For all patients who underwent endoscopic suprapapillary placement of iPS(s) or MS(s) as the first permanent biliary drainage for unresectable malignant perihilar obstructions between January 2014 and August 2019, clinical outcomes using iPSs (n=20) and MSs (n=85), including clinical efficacy, adverse events, and time to recurrence of biliary obstruction (RBO), were retrospectively evaluated. Results: There were no differences in clinical effectiveness (95% for the iPS group vs. 92% for the MS group, p=1.00). Procedure-related adverse events, including pancreatitis, acute cholangitis, acute cholecystitis, and death, were observed for 8% of the MS group, although no patient in the iPS group developed such adverse events. The median time to RBO was 561 days (95% confidence interval, 0–1,186 days) for iPSs and 209 days (127–291 days) for MSs, showing a significant difference (p=0.008). Conclusions: Time to RBO after iPS placement was significantly longer than that after MS placement. IPSs, which are removable, unlike MSs, were an acceptable option.
Yuki Fujii,Yoshihide Kanno,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Keisuke Yonamine,Yujiro Kawakami,Toji Murabayashi,Fumisato Kozakai,Yutaka Noda,Hiroyuki Okada,Kei 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.2
Background/Aims: This study aimed to identify the predictive factors for inaccurate endoscopic ultrasound-guided fine needleaspiration (EUS-FNA) diagnosis of swollen lymph nodes without rapid on-site cytopathological evaluation. Methods: Eighty-three consecutive patients who underwent EUS-FNA for abdominal or mediastinal lymph nodes from January2008 to June 2017 were included from a prospectively maintained EUS-FNA database and retrospectively reviewed. The sensitivity,specificity, and accuracy of EUS-FNA for the detection of neoplastic diseases were calculated. Candidate factors for inaccurate diagnosis(lymph node size and location, needle type, puncture route, number of passes, and causative disease) were evaluated by comparisonbetween accurately diagnosed cases and others. Results: The final diagnosis of the punctured lymph node was classified as neoplastic (65 cases: a metastatic lymph node, malignantlymphoma, or Crow-Fukase syndrome) or non-neoplastic (18 cases: a reactive node or amyloidosis). The sensitivity, specificity, andaccuracy were 83%, 94%, and 86%, respectively. On multivariate analyses, small size of the lymph node was the sole predictive factor forinaccurate EUS-FNA diagnosis with a significant difference (odds ratios, 19.8; 95% confidence intervals, 3.15–124; p=0.0015). Conclusions: The lymph node size of <16 mm was the only independent factor associated with inaccurate EUS-FNA diagnosis ofswollen lymph nodes.
Keisuke Yonamine,Shinsuke Koshita,Yoshihide Kanno,Takahisa Ogawa,Hiroaki Kusunose,Toshitaka Sakai,Kazuaki Miyamoto,Fumisato Kozakai,Hideyuki Anan,Haruka Okano,Masaya Oikawa,Takashi Tsuchiya,Takashi Sa 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.4
Background/Aims: We aimed to investigate (1) promising clinical findings for the recognition of focal type autoimmune pancreatitis (FAIP) and (2) the impact of endoscopic ultrasound (EUS)-guided tissue acquisition (EUS-TA) on the diagnosis of FAIP. Methods: Twenty-three patients with FAIP were involved in this study, and 44 patients with resected pancreatic ductal adenocarcinoma (PDAC) were included in the control group. Results: (1) Multivariate analysis revealed that homogeneous delayed enhancement on contrast-enhanced computed tomography was a significant factor indicative of FAIP compared to PDAC (90% vs. 7%, p=0.015). (2) For 13 of 17 FAIP patients (76.5%) who underwent EUS-TA, EUS-TA aided the diagnostic confirmation of AIPs, and only one patient (5.9%) was found to have AIP after surgery. On the other hand, of the six patients who did not undergo EUS-TA, three (50.0%) underwent surgery for pancreatic lesions. Conclusions: Homogeneous delayed enhancement on contrast-enhanced computed tomography was the most useful clinical factor for discriminating FAIPs from PDACs. EUS-TA is mandatory for diagnostic confirmation of FAIP lesions and can contribute to a reduction in the rate of unnecessary surgery for patients with FAIP.
Yoshihide Kanno,Kei Ito,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Toji Murabayashi,Sho Hasegawa,Fumisato Kozakai,Yujiro Kawakami,Yuki Fujii,Yutaka Noda 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.3
Background/Aims: Although both radial- and convex-arrayed endoscopic ultrasonography (EUS) scopes are widely used forobservational EUS examinations, there have been few comparative studies on their power of visualization. The aim of this study was toevaluate the capability of these EUS scopes for observation of the pancreatobiliary junction. Methods: The rate of successful visualization of the pancreatobiliary junction was retrospectively compared between a radial-arrayedand a convex-arrayed echoendoscope, from a prospectively maintained database. Study periods were defined as January 2010 toDecember 2012 for the radial group, and February 2015 to October 2016 for the convex group because the respective scope wasmainly used during those periods. Results: During the study period, 1,660 cases with radial EUS and 1,984 cases with convex EUS were recruited. The success rates ofobservation of the pancreatobiliary junction were 80.0% and 89.5%, respectively (p<0.0001). Conclusions: The capability of visualization of the pancreatobiliary junction in observational EUS was found to be better with aconvex-arrayed than with a radial-arrayed echoendoscope