Stone Attenuation Value and Cross-Sectional Area on Computed Tomography Predict the Success of Shock Wave Lithotripsy

Michio Tanaka,Eisuke Yokota,Yoichiro Toyonaga2,Fumitaka Shimizu,Yoshiyuki Ishii,Makoto Fujime,Shigeo Horie 대한비뇨의학회 2013 Investigative and Clinical Urology Vol.54 No.7

Purpose: To identify the parameters on noncontrast computed tomography (NCCT)that best predict the success of shock wave lithotripsy (SWL). Materials and Methods: We reviewed the records of 75 patients who underwent SWL for urinary calculi measuring 5 to 20 mm. Using NCCT images, we estimated the largest stone cross-sectional area and contoured the inner edge of the stone. Clinical outcome was classified as successful (stone-free or <4 mm in diameter) or failed (stone fragments, ≥4 mm). The impact of preoperative parameters was evaluated by univariate and multivariate analysis. Results: The overall success rate was 73.3%. Average stone attenuation value, stone length, and stone cross-sectional area in the success and failure groups were 627.4±166.5 HU (Hounsfield unit) vs. 788.1±233.9 HU (p=0.002), 11.7±3.8 mm vs. 14.2±3.6 mm (p=0.015), and 0.31±0.17 cm2 vs. 0.57±0.41 cm2 (p<0.001), respectively. In the multivariate analysis, stone attenuation value was the only independent predictor of SWL success (p=0.023), although stone cross-sectional area had a tendency to be associated with SWL success (p=0.053). Patients were then classified into four groups by using cutoff values of 780 HU for stone attenuation value and 0.4 cm2 for cross-sectional area. By use of these cutoff values, the group with a low stone attenuation value and a low cross-sectional area was more than 11.6 times as likely to have a successful result on SWL as were all other groups (odds ratio, 11.6; 95% confidence interval, 3.9 to 54.7; p<0.001). Conclusions: Stone attenuation value and stone cross-sectional area are good predictors of extracorporeal SWL outcome.

Monthly Characteristics of Rainwater Chemistry at a Coastal Site in Southwestern Japan

Toyonaga, Satoshi,Zhang, Daizhou Korean Society for Atmospheric Environment 2017 Asian Journal of Atmospheric Environment (AJAE) Vol.10 No.2

Monthly characteristics of rainwater chemistry at a coastal site in southwestern Japan were examined based on an eight year record. In the period November-May when rain was mainly caused by cyclones, the monthly mean concentrations of $nss-{SO_4}^{2-}$, ${NO_3}^-$, ${NH_4}^+$, $nss-Ca^{2+}$, $Na^+$ and $Cl^-$ over the eight years were 25.1-57.8, 9.9-25.0, 11.3-31.4, 5.5-18.7, 24.2-154.9 and $30.0-178.5{\mu}eq\;L^{-1}$, respectively. In June and July when rain was mainly caused by stationary fronts, i.e. Meiyu fronts, the concentrations were 14.4-20.7, 7.2-9.5, 7.7-12.9, 4.1-6.8, 21.7-33.6 and $26.4-40.5{\mu}eq\;L^{-1}$, respectively. In August and September when typhoons contributed substantial rainfall, the respective concentrations of $Na^+$ and $Cl^-$ were as high as 97.7-105.3 and $116.8-122.9{\mu}eq\;L^{-1}$, while the concentrations of other ions were low. These results indicate a large variation of monthly rainwater chemistry, which is basically dependent on the synoptic weather patterns causing rain. From later autumn to early spring, rain contains ions in high concentration and large variation ranges. In the Meiyu season, rain contains less ions which vary in a range much smaller than that in later autumnearly spring. In summer and autumn, the concentrations are low, except $Na^+$ and $Cl^-$ which can be large due to typhoons' contribution.

PLACEMENT OPTIMIZATION BY TREMBLING SPOT-CHECK

Toyonaga, Masahiko,Okude, Hiroaki,Akino, Toshiro 대한전자공학회 1989 ICVC : International Conference on VLSI and CAD Vol.1 No.1

A new non-deterministic optimization method, Trembling Spot-Check (TSC) is described. This method is based on the mean field theory in physics and its mechanism consists of the random selection of a limited range (spot) and the iterative improvement procedure (check) with a fluctuation (trembling). The method of TSC requires no annealing processes, hence it needs less work than exhaustive search to achieve the solution. The experimental results for the primitive and standard-ell placement show that TSC requires almost 1/10 times less CPU time than SA to achieve the same level solution.

Wet Deposition Fluxes of Ions Contributed by Cyclone-, Stationary Front- and Typhoon-associated Rains at the Southwestern Japan Coast

Toyonaga, Satoshi,Zhang, Daizhou Korean Society for Atmospheric Environment 2016 Asian Journal of Atmospheric Environment (AJAE) Vol.10 No.2

Wet deposition fluxes of ions at a coastal site in southwestern Japan in the period 1996-2003 were investigated to quantify the respective contributions of cyclone-, stationary front- and typhoon-associated rains. On average, the deposition fluxes of terrigenous-origin ions, nss-$SO_4{^{2-}}$, $NO_3{^-}$, $NH_4{^+}$ and nss-$Ca^{2+}$ were $37.6{\pm}7.3$, $16.3{\pm}4.2$, $19.0{\pm}3.4$ and $9.6{\pm}4.8meq\;m^{-2}yr^{-1}$, and those of $Na^+$ and $Cl^-$, the major ions in sea water, were $97.0{\pm}38.2$ and $115.2{\pm}48.2meq\;m^{-2}yr^{-1}$, respectively. Cyclone-associated rain constituted more than 50% of the fluxes of the terrigenous ions in almost all years. Stationary front-associated rain also contributed significantly, although the contribution was lower than the contribution by Cyclone-associated rain in almost all years. In particular, the wet deposition flux of nitrogen compounds of $NO_3{^-}$ and $NH_4{^+}$, which are important nutrients for micro-bioactivities in sea surface water, was dominated by cyclone-associated rain. Due to the extreme abundance of $Na^+$ and $Cl^-$ in the rainwater of typhoons, the fluxes of $Na^+$ and $Cl^-$ were contributed substantially by typhoons in years with typhoons' passage although cyclones were still the largest contributor to the fluxes. These results indicate the dominance of cyclones in the wet deposition to the East China Sea areas and the necessity to take rain types into account for a more accurate elucidation of the temporal and spatial variation of the wet deposition.

Monthly Characteristics of Rainwater Chemistry at a Coastal Site in Southwestern Japan

Satoshi Toyonaga,Daizhou Zhang 한국대기환경학회 2017 Asian Journal of Atmospheric Environment (AJAE) Vol.11 No.2

Monthly characteristics of rainwater chemistry at a coastal site in southwestern Japan were examined based on an eight year record. In the period November- May when rain was mainly caused by cyclones, the monthly mean concentrations of nss-SO4 2-, NO3 -, NH4 +, nss-Ca2+, Na+ and Cl- over the eight years were 25.1-57.8, 9.9-25.0, 11.3-31.4, 5.5-18.7, 24.2-154.9 and 30.0-178.5 μeq L-1, respectively. In June and July when rain was mainly caused by stationary fronts, i.e. Meiyu fronts, the concentrations were 14.4-20.7, 7.2-9.5, 7.7-12.9, 4.1-6.8, 21.7- 33.6 and 26.4-40.5 μeq L-1, respectively. In August and September when typhoons contributed substantial rainfall, the respective concentrations of Na+ and Cl- were as high as 97.7-105.3 and 116.8-122.9 μeq L-1, while the concentrations of other ions were low. These results indicate a large variation of monthly rainwater chemistry, which is basically dependent on the synoptic weather patterns causing rain. From later autumn to early spring, rain contains ions in high concentration and large variation ranges. In the Meiyu season, rain contains less ions which vary in a range much smaller than that in later autumnearly spring. In summer and autumn, the concentrations are low, except Na+ and Cl- which can be large due to typhoons’ contribution.

Wet Deposition Fluxes of Ions Contributed by Cyclone-, Stationary Front- and Typhoon-associated Rains at the Southwestern Japan Coast

Satoshi Toyonaga,Daizhou Zhang 한국대기환경학회 2016 Asian Journal of Atmospheric Environment (AJAE) Vol.10 No.2

Wet deposition fluxes of ions at a coastal site in southwestern Japan in the period 1996-2003 were investigated to quantify the respective contributions of cyclone-, stationary front- and typhoon-associated rains. On average, the deposition fluxes of terrigenous- origin ions, nss-SO4 2-, NO3 -, NH4 + and nss-Ca2+ were 37.6±7.3, 16.3±4.2, 19.0±3.4 and 9.6±4.8 meq m-2 yr-1, and those of Na+ and Cl-, the major ions in sea water, were 97.0±38.2 and 115.2±48.2 meq m-2 yr-1, respectively. Cyclone-associated rain constituted more than 50% of the fluxes of the terrigenous ions in almost all years. Stationary frontassociated rain also contributed significantly, although the contribution was lower than the contribution by Cyclone-associated rain in almost all years. In particular, the wet deposition flux of nitrogen compounds of NO3 - and NH4 +, which are important nutrients for micro-bioactivities in sea surface water, was dominated by cyclone-associated rain. Due to the extreme abundance of Na+ and Cl- in the rainwater of typhoons, the fluxes of Na+ and Cl- were contributed substantially by typhoons in years with typhoons’ passage although cyclones were still the largest contributor to the fluxes. These results indicate the dominance of cyclones in the wet deposition to the East China Sea areas and the necessity to take rain types into account for a more accurate elucidation of the temporal and spatial variation of the wet deposition.

Principles of Quality Controlled Endoscopic Submucosal Dissection with Appropriate Dissection Level and High Quality Resected Specimen

Takashi Toyonaga,Eisei Nishino,Mariko Man-i,James E. East,Takeshi Azuma 대한소화기내시경학회 2012 Clinical Endoscopy Vol.45 No.4

Endoscopic submucosal dissection (ESD) has enabled en bloc resection of early stage gastrointestinal tumors with negligible risk of lymph node metastasis, regardless of tumor size, location, and shape. However, ESD is a relatively difficult technique compared with conventional endoscopic mucosal resection, requiring a longer procedure time and potentially causing more complications. For safe and reproducible procedure of ESD, the appropriate dissection of the ramified vascular network in the level of middle submucosal layer is required to reach the avascular stratum just above the muscle layer. The horizontal approach to maintain the appropriate depth for dissection beneath the vascular network enables treatment of difficult cases with large vessels and severe fibrosis. The most important aspect of ESD is the precise evaluation of curability. This approach can also secure the quality of the resected specimen with enough depth of the submucosal layer.

Aerial joint technology to realize large scale optical network construction

Masanobu Toyonaga,Osamu Yamauchi,Mitsuo Kama 대한전자공학회 2006 ITC-CSCC :International Technical Conference on Ci Vol.2006 No.1

Feasibility and safety of endoscopic submucosal dissection for lesions in proximity to a colonic diverticulum

Nobuaki Ikezawa,Takashi Toyonaga,Shinwa Tanaka,Tetsuya Yoshizaki,Toshitatsu Takao,Hirofumi Abe,Hiroya Sakaguchi,Kazunori Tsuda,Satoshi Urakami,Tatsuya Nakai,Taku Harada,Kou Miura,Takahisa Yamasaki,Stu 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.3

Background/Aims: Endoscopic submucosal dissection (ESD) for diverticulum-associated colorectal lesions is generally contraindicatedbecause of the high risk of perforation. Several studies on patients with such lesions treated with ESD have been reported recently. However, the feasibility and safety of ESD for lesions in proximity to a colonic diverticulum (D-ESD) have not been fully clarified. Theaim of this study was to evaluate the feasibility and safety of D-ESD. Methods: D-ESD was defined as ESD for lesions within approximately 3 mm of a diverticulum. Twenty-six consecutive patients whounderwent D-ESD were included. Two strategic approaches were used depending on whether submucosal dissection of the diverticulum-related part was required (strategy B) or not (strategy A). Treatment outcomes and adverse events associated with each strategywere analyzed. Results: The en bloc resection rate was 96.2%. The R0 and curative resection rates were 76.4% and 70.6% in strategy A and 88.9% and77.8% in strategy B, respectively. Two cases of intraoperative perforation and one case of delayed perforation occurred. The delayed perforationcase required emergency surgery, but the other cases were managed conservatively. Conclusions: D-ESD may be a feasible treatment option. However, it should be performed in a high-volume center by expert handsbecause it requires highly skilled endoscopic techniques.

Management of esophageal neoplasms by endoscopic submucosal dissection: experience over 100 consecutive procedures

Josué Aliaga Ramos,Yoshinori Morita,Takashi Toyonaga,Danilo Carvalho,Moises Salgado Pedrosa,Vitor N. Arantes 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.5

Background/Aims: Endoscopic submucosal dissection (ESD) is currently considered the first-line treatment for the eradication of superficialneoplasms of the esophagus in Eastern countries. However, in the West, particularly in Latin America, the experience withesophageal ESD is still limited because of the high technical complexity required for its execution. This study aimed to present the resultsof the clinical application of ESD to manage superficial esophageal neoplasms in a Latin American center in over 100 consecutivecases. Methods: This retrospective study included consecutive patients who underwent endoscopic ESD for superficial esophageal neoplasmsbetween 2009 and 2022. The following clinical outcomes were assessed: en bloc, complete, and curative resection rates, local recurrence,adverse events, and procedure-related mortality. Results: Esophageal ESD was performed mainly for squamous cell carcinoma (66.6%), high-grade intraepithelial neoplasia (17.1%),and adenocarcinoma (11.4%). En bloc and complete resection rates were 96.2% and 81.0%, respectively. The curative resection rate was64.8%. Adverse events occurred in six cases (5.7%). Endoscopic follow-up was performed for an average period of 29.7 months. Conclusions: ESD performed by trained operators is feasible, safe, and clinically effective for managing superficial neoplastic lesions ofthe esophagus in Latin America.