BACKGROUND Since fat does not transmit electrical energy well,delayed perforation and postpolypectomy syndrome due to electrical thermal injury are concerns in the endoscopic removal of colonic lipoma.The endoscopic s...BACKGROUND Since fat does not transmit electrical energy well,delayed perforation and postpolypectomy syndrome due to electrical thermal injury are concerns in the endoscopic removal of colonic lipoma.The endoscopic submucosal dissection(ESD)technique concentrates electrical energy conducts to the submucosa,not the adipose tissue.This helps to minimize electrical thermal injury,especially in the case of large colonic lipomas.In rare cases,such as colonic lipomas accompanied by mucosal lesions,it is difficult for endoscopists to decide how to safely remove them.CASE SUMMARY A 78-year-old man underwent colonoscopy for colorectal cancer screening.During colonoscopy,a yellowish submucosal tumor with positive cushion sign was observed in the ascending colon measuring about 4.5 cm.A nodular mucosal lesion of about 2.5 cm was observed on the mucosal surface of the lipoma.The lipoma was so large that it occupied much of the inside of the colon,making it difficult to see the entire laterally spreading tumor(LST)at once.The LST was confined to the surface of the lipoma,which had a semipedunculated shape with a wide neck.The margin of the LST was not observed at the neck of the lipoma.ESD was performed and the colonic lipoma with the LST was successfully removed without complications.After 3 d of hospitalization,the patient was discharged without any symptoms.The final pathology report showed that the lesion consisted of submucosal lipoma and tubulovillous adenoma with lowgrade dysplasia.CONCLUSION ESD is effective and safe for treating a large colonic lipoma with an LST by minimizing electrical thermal injury.展开更多
AIM: To clarify differences in mucin phenotype, prolif- erative activity and oncogenetic alteration among sub- types of colorectal laterally spreading tumor (LST). METHODS: LSTs, defined as superficial elevated le...AIM: To clarify differences in mucin phenotype, prolif- erative activity and oncogenetic alteration among sub- types of colorectal laterally spreading tumor (LST). METHODS: LSTs, defined as superficial elevated lesions greater than 10 mm in diameter with a low vertical axis, were macroscopically classified into two subtypes: (1) a granular type (Gr-LST) composed of superficially spread- ing aggregates of nodules forming a fiat-based lesion with a granulonodular and uneven surface; and (2) a non-granular type (NGr-LST) with a flat smooth surface and an absence of granulonodular formation. A total of 69 LSTs, comprising 36 Gr-LSTs and 33 NGr-LSTs, were immunohistochemically stained with MUC2, MUC5AC, MUC6, CD10 (markers of gastrointestinal cell lineage), p53, 13-catenin and Ki-67 antibodies, and examined for alteration in exon 1 of v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) and exon 15 of v-raf murine sarcoma viral oncogene homologue B1 (BRAF) by poly- merase chain reaction followed by direct sequencing. RESULTS: Histologically, 15 Gr-LST samples were ad- enomas with low-grade dysplasia (LGD), 12 were high- grade dysplasia (HGD) and 9 were adenocarcinomas invading the submucosa (INV), while 12 NGr-LSTs demonstrated LGD, 14 HGD and 7 INV. In the proximal colon, MUC5AC expression was significantly higher in the Gr-type than the NGr-type. MUC6 was expressed only in NGr-LST. MUC2 or CD10 did not differ. P53 ex- pression demonstrated a significant stepwise increment in progression through LGD-HGD-INV with both types of LST. Nuclear β-catenin expression was significantly higher in the NGr-type. Ki-67 expression was signifi- cantly higher in the Gr-type in the lower one third zone of the tumor. In proximal, but not distal colon tumors, the incidence of KRAS provided mutation was signifi- cantly higher in the Gr-type harboring a specific muta- tional pattern (G12V). BRAF mutations (V600E) were detected only in two Gr-LSTs. CONCLUSION: The two subtypes of LST, especially in the proximal colon, have differing phenotypes of gastrointestinal cell lineage, proliferation and activa- tion of Wnt/β-catenin or RAS/RAF/extracellular signal- regulated kinase signaling.展开更多
AIM: To prospectively investigate the detection rate of laterally spreading tumors (LSTs) of the colorectum by computed tomography (CT) colonography (CTC).
BACKGROUND Colorectal mucosa-associated lymphoid tissue(MALT)lymphoma is a rare disease,and only a few cases have been reported to date.It has no specific clinical presentations and shows various endoscopic appearance...BACKGROUND Colorectal mucosa-associated lymphoid tissue(MALT)lymphoma is a rare disease,and only a few cases have been reported to date.It has no specific clinical presentations and shows various endoscopic appearances.There is no uniform consensus on its treatment.With the advancement of endoscopic technology,endoscopic treatment has achieved better results in individual case reports of early-stage patients.CASE SUMMARY We report a case of rectal MALT in a 57-year-old Chinese man with no symptoms who received endoscopy as part of a routine physical examination,which incidentally found a 25 mm×20 mm,laterally spreading tumor(LST)-like elevated lesion in the rectum.Therefore,he was referred to our hospital for further endoscopic treatment.Complete and curable removal of the tumor was performed by endoscopic submucosal dissection.We observed enlarged and dilated branch-like vessels similar to those of gastric MALT lymphoma on magnifying endoscopy with narrow-band imaging.And immunopathological staining showed hyperplastic capillaries in the mucosa.Histopathological findings revealed diffusely hyperplastic lymphoid tissue in the lamina propria,with a visible lymphoid follicle structure surrounded by a large number of diffusely infiltrated lymphoid cells that had a relatively simple morphology and clear cytoplasm.In addition,immunohistochemical analysis suggested strongly positive expression for CD20 and Bcl-2.Gene rearrangement results showed positivity for IGH-A,IGH-C,IGK-B,and IGL.Taking all the above findings together,we arrived at a diagnosis of extranodal marginal zone B-cell lymphoma of MALT lymphoma. Positron emission tomography-computed tomographyexamination showed no other lesions involved. The patient will be followed byperiodic endoscopic observation.CONCLUSIONIn conclusion, we report a case of rectal MALT with an LST-like appearancetreated by endoscopic submucosal dissection. Further studies will be needed toexplore the clinical behavior, endoscopic appearance, and treatment of rectalMALT.展开更多
BACKGROUND The management strategies for recurrent ampullary adenoma after endoscopic papillectomy are still controversial.Patients with the recurrent papillary lesions need to receive repetitive endoscopic interventi...BACKGROUND The management strategies for recurrent ampullary adenoma after endoscopic papillectomy are still controversial.Patients with the recurrent papillary lesions need to receive repetitive endoscopic interventions due to the limitations of conventional endoscopic techniques.AIM To assess the feasibility,efficacy,and safety of hybrid endoscopic submucosal dissection(ESD)by duodenoscope for recurrent,laterally spreading papillary lesions.METHODS We enrolled two patients with recurrent,laterally spreading,duodenal papillary adenomas with no intraductal extension confirmed by follow-up between March 2017 and September 2018.After marking the resection borders of the lesion using a dual knife,a submucosal cushion was created by injecting a mixture of saline solution,methylene blue,and adrenaline.A total circumferential incision and submucosal excision was performed by dual knife combined with insulated-tip diathermic knife,and then the lesion was ligated and resected using an electric snare.Endoscopic hemostasis was applied during the endoscopic procedures.Moreover,the endoscopic retrograde cholangiopancreatography(ERCP)procedures,including selective cannulation and stent implantation of biliary and pancreatic ducts,were performed.Additionally,we performed endoclip closure for mucosal defect after ESD.RESULTS Hybrid ESD using a duodenoscope and biliary and pancreatic stent placement were performed successfully in two patients.The endoscopic size of recurrent papillary lesions was no more than 2 cm.Generally,the average total procedure time was 95.5 min,and the procedure time of ESD and ERCP was 38.5 min and 15.5 min,respectively.No serious complications occurred during the intraoperative and postoperative periods.The histopathological examination revealed tubulovillous adenoma negative for neoplastic extension at the cut margin in both patients.The duodenoscopic follow-up and histopathology of biopsy specimens at 3 mo after ESD showed no residual or recurrent lesions in ampullary areas in both cases.Both cases have been followed up with no recurrence to June 2020.CONCLUSION Hybrid ESD by duodenoscope is technically challenging,and may be curative for recurrent,laterally spreading papillary adenomas<2 cm.It should be performed cautiously in selected patients by experienced endoscopists.展开更多
BACKGROUND Colorectal laterally spreading tumors(LSTs)with malignant potential require en bloc resection by endoscopic submucosal dissection(ESD),but lesions with deep submucosal invasion(SMI)are endoscopically unrese...BACKGROUND Colorectal laterally spreading tumors(LSTs)with malignant potential require en bloc resection by endoscopic submucosal dissection(ESD),but lesions with deep submucosal invasion(SMI)are endoscopically unresectable.AIM To investigate the factors associated with high-grade dysplasia(HGD)/carcinoma and deep SMI in colorectal LSTs.METHODS The endoscopic and histological results of consecutive patients who underwent ESD for colorectal LSTs in our hospital from June 2013 to March 2019 were retrospectively analyzed.The characteristics of LST subtypes were compared.Risk factors for HGD/carcinoma and deep SMI(invasion depth≥1000μm)were determined using multivariate logistic regression.RESULTS A total of 323 patients with 341 colorectal LSTs were enrolled.Among the four subtypes,non-granular pseudodepressed(NG-PD)LSTs(85.5%)had the highest rate of HGD/carcinoma,followed by the granular nodular mixed(G-NM)(77.0%),granular homogenous(29.5%),and non-granular flat elevated(24.2%)subtypes.Deep SMI occurred commonly in NG-PD LSTs(12.9%).In the adjusted multivariate analysis,NG-PD[odds ratio(OR=16.8,P<0.001)and G-NM(OR=7.8,P<0.001)subtypes],size≥2 cm(OR=2.2,P=0.005),and positive non-lifting sign(OR=3.3,P=0.024)were independently associated with HGD/carcinoma.The NG-PD subtype(OR=13.3,P<0.001)and rectosigmoid location(OR=8.7,P=0.007)were independent risk factors for deep SMI.CONCLUSION Because of their increased risk for malignancy,it is highly recommended that NG-PD and G-NM LSTs are removed en bloc through ESD.Given their substantial risk for deep SMI,surgery needs to be considered for NG-PD LSTs located in the rectosigmoid,especially those with positive nonlifting signs.展开更多
Due to the advent of the screening programs for colorectal cancer and the era of quality assurance colonoscopy the number the polyps that can be considered difficult,including large(>20 mm)laterally spreading tumor...Due to the advent of the screening programs for colorectal cancer and the era of quality assurance colonoscopy the number the polyps that can be considered difficult,including large(>20 mm)laterally spreading tumors(LSTs),has increased in the last decade.All LSTs should be assessed carefully,looking for suspicious areas of submucosal invasion(SMI),such as nodules or depressed areas,describing the morphology according to the Paris classification,the pit pattern,and vascular pattern.The simplest,most appropriate and safest endoscopic treatment with curative intent should be selected.For LST-granular homogeneous type,piecemeal endoscopic mucosal resection should be the first option due to its biological low risk of SMI.LST-nongranular pseudodepressed type has an increased risk of SMI,and en bloc resection should be mandatory.Underwater endoscopic mucosal resection is useful in situations where submucosal injection alters the operative field,e.g.,for the resection of scar lesions,with no lifting,adjacent tattoo,incomplete resection attempts,lesions into a colonic diverticulum,in ileocecal valve and lesions with intra-appendicular involvement.Endoscopic full thickness resection is very useful for the treatment of difficult to resect lesions of less than 20 up to 25 mm.Among the indications,we highlight the treatment of polyps with suspected malignancy because the acquired tissue allows an exact histologic risk stratification to assign patients individually to the best treatment and avoid surgery for low-risk lesions.Endoscopic submucosal dissection is the only endoscopic procedure that allows completes en bloc resection regardless of the size of the lesion.It should therefore be indicated in the treatment of lesions with risk of SMI.展开更多
Lateral spread of frozen ground crust over liquefied soil has caused extensive bridge foundation damage in the past winter earthquakes.A shake table experiment was conducted to investigate the performance of a model p...Lateral spread of frozen ground crust over liquefied soil has caused extensive bridge foundation damage in the past winter earthquakes.A shake table experiment was conducted to investigate the performance of a model pile in this scenario and revealed unique pile failure mechanisms.The modelling results provided valuable data for validating numerical models.This paper presents analyses and results of this experiment using two numerical modeling approaches: solid-fluid coupled finite element(FE) modeling and the beam-on-nonlinear-Winkler-foundation(BNWF) method.A FE model was constructed based on the experiment configuration and subjected to earthquake loading.Soil and pile response results were presented and compared with experimental results to validate this model.The BNWF method was used to predict the pile response and failure mechanism.A p-y curve was presented for modelling the frozen ground crust with the free-field displacement from the experiment as loading.Pile responses were presented and compared with those of the experiment and FE model.It was concluded that the coupled FE model was effective in predicting formation of three plastic hinges at ground surface,ground crust-liquefiable soil interface and within the medium dense sand layer,while the BNWF method was only able to predict the latter two.展开更多
The prediction of liquefaction-induced lateral spreading/displacement(Dh)is a challenging task for civil/geotechnical engineers.In this study,a new approach is proposed to predict Dh using gene expression programming(...The prediction of liquefaction-induced lateral spreading/displacement(Dh)is a challenging task for civil/geotechnical engineers.In this study,a new approach is proposed to predict Dh using gene expression programming(GEP).Based on statistical reasoning,individual models were developed for two topographies:free-face and gently sloping ground.Along with a comparison with conventional approaches for predicting the Dh,four additional regression-based soft computing models,i.e.Gaussian process regression(GPR),relevance vector machine(RVM),sequential minimal optimization regression(SMOR),and M5-tree,were developed and compared with the GEP model.The results indicate that the GEP models predict Dh with less bias,as evidenced by the root mean square error(RMSE)and mean absolute error(MAE)for training(i.e.1.092 and 0.815;and 0.643 and 0.526)and for testing(i.e.0.89 and 0.705;and 0.773 and 0.573)in free-face and gently sloping ground topographies,respectively.The overall performance for the free-face topology was ranked as follows:GEP>RVM>M5-tree>GPR>SMOR,with a total score of 40,32,24,15,and 10,respectively.For the gently sloping condition,the performance was ranked as follows:GEP>RVM>GPR>M5-tree>SMOR with a total score of 40,32,21,19,and 8,respectively.Finally,the results of the sensitivity analysis showed that for both free-face and gently sloping ground,the liquefiable layer thickness(T_(15))was the major parameter with percentage deterioration(%D)value of 99.15 and 90.72,respectively.展开更多
In this research,two shake table experiments were conducted to study the effects of non-liquefiable crust layer and superstructure mass on the responses of two sets of 22 pile groups to liquefactioninduced lateral spr...In this research,two shake table experiments were conducted to study the effects of non-liquefiable crust layer and superstructure mass on the responses of two sets of 22 pile groups to liquefactioninduced lateral spreading.In this regard,an inclined base layer overlain by a very loose liquefiable layer was constructed in both models;while only in one model,a non-liquefiable crust layer was built.A lumped mass,being representative of a superstructure,was attached to the cap of one pile group in both models.The models were fully instrumented with various sensors,including acceleration,displacement,and pore water pressure transducers.Also,the piles were instrumented with pair strain gauges to measure pure bending moments induced by cyclic and monotonic loadings associated with ground shaking and lateral spreading,respectively.The results showed that the existence of the non-liquefiable crust layer increases both the maximum and residual soil displacements at the free field and also the maximum bending moments in the piles.The results of the experiments indicated that the crust layer induces a high kinematic lateral soil pressure and force on the piles which are not present in the crustless case.The crust layer increases the pile cap displacement before liquefaction,albeit decreases it after liquefaction,due to the elastic rebound of the piles in the liquefiable layer.The crust layer postpones both liquefaction triggering and dissipation of excess pore water pressure.The existence of the superstructure mass on the pile caps decreases the acceleration amplitude of the pile caps,while increases their maximum displacement.展开更多
BACKGROUND The management of polyps involving the appendiceal orifice(AO)presents notable challenges.Endoscopic resection is frequently hindered by operational complexities,a heightened risk of incomplete removal,and ...BACKGROUND The management of polyps involving the appendiceal orifice(AO)presents notable challenges.Endoscopic resection is frequently hindered by operational complexities,a heightened risk of incomplete removal,and an elevated risk of procedural complications,including appendicitis.Conversely,surgical resection may entail unnecessary excision of intestinal segments,leading to potential morbidity.CASE SUMMARY Here,we reported two patients who presented with polyps deeply situated within the AO,with indistinct boundaries making it challenging to ensure completeness using traditional endoscopic resection.To overcome these challenges,we em-ployed combined endo-laparoscopic surgery(CELS),achieving curative resection without postoperative complications.CONCLUSION The application of CELS in managing polyps involving the AO is emerging as a safe and effective treatment modality.展开更多
This paper evaluates the seismic vulnerability of different classes of typical bridges in California when subjected to seismic shaking or liquefaction-induced lateral spreading. The detailed structural configurations ...This paper evaluates the seismic vulnerability of different classes of typical bridges in California when subjected to seismic shaking or liquefaction-induced lateral spreading. The detailed structural configurations in terms of superstructure type, connection, continuity at support and foundation type, etc. render different damage resistant capability. Six classes of bridges are established based on their anticipated failure mechanisms under earthquake shaking. The numerical models that are capable of simulating the complex soil-structure interaction effects, nonlinear behavior of columns and connections are developed for each bridge class. The dynamic responses are obtained using nonlinear time history analyses for a suite of 250 earthquake motions with increasing intensity. An equivalent static analysis procedure is also implemented to evaluate the vulnerability of the bridges when subjected to liquefaction-induced lateral spreading. Fragility functions for each bridge class are derived and compared for both seismic shaking (based on nonlinear dynamic analyses) and lateral spreading (based on equivalent static analyses) for different performance states. The study finds that the fragility functions due to either ground shaking or lateral spreading show significant correlation with the structural characterizations, but differences emerge for ground shaking and lateral spreading conditions. Structural properties that will mostly affect the bridges' damage resistant capacity are also identified.展开更多
The response of pile foundations near a quay wall under liquefaction-induced lateral spreading remains a complex problem. This study presents the results of a shake-table test on a 2×2 pile group behind a sheet-p...The response of pile foundations near a quay wall under liquefaction-induced lateral spreading remains a complex problem. This study presents the results of a shake-table test on a 2×2 pile group behind a sheet-pile quay wall that was subjected to lateral spreading. The quay wall was employed to trigger liquefaction-induced large lateral ground deformation. The discussions focus on the behavior of the pile and the soil and on the bending moment distributions within the group pile and the restoring force characteristics at the superstructure. Overall, the piles exhibited apparent pinning effects that reduced soil deformation. In addition, the rear-row piles near the quay wall experienced larger bending moments than did the front-row piles, indicating significant pile group effects. The tests showed that lateral spreading could be a primary cause of larger monotonic deformations and bending moments. It can also be concluded that the monotonic bending moments were significantly decreased due to the presence of slow soil flow. The stiffness at the superstructure was reduced because of accumulated excess pore pressure before liquefaction, and it was recovered during lateral spreading. The present study further enhances current understanding of the behavior of low-cap pile foundations under lateral spreading.展开更多
A revised empirical model has been developed for predicting liquefaction-induced lateral spreading displacement (LD) as a function of both response spectral acceleration derived from strong-motion attenuation models...A revised empirical model has been developed for predicting liquefaction-induced lateral spreading displacement (LD) as a function of both response spectral acceleration derived from strong-motion attenuation models and geotechnical parameters from Youd's LD data set (Youd website). This revised model is different from the model of Zhang and Zhao, which overcame some drawbacks of earlier models for predicting lateral spreading and was primarily used in Japan and the western U.S. The revised model can potentially be applied anywhere if ground shaking (in terms of 5% damped acceleration or displacement response spectra) can be estimated using local strong-motion attenuation relationships. The revised model is examined using data from Japan and the western U.S. and applied to Turkey and New Zealand, where the ground shaking is estimated using appropriate strong-motion attenuation relationships for each region. The accuracy of the revised model is evaluated by comparing its predicted lateral displacements with those measured in actual earthquakes. The results show that the revised model can account for the effects of local seismicity on lateral spreading displacements and is comparable with existing prediction models.展开更多
Lateral current spreading in the 4H-SiC Schottky barrier diode(SBD)chip is investigated.The 4H-SiC SBD chips with the same vertical parameters are simulated and fabricated.The results indicate that there is a fixed sp...Lateral current spreading in the 4H-SiC Schottky barrier diode(SBD)chip is investigated.The 4H-SiC SBD chips with the same vertical parameters are simulated and fabricated.The results indicate that there is a fixed spreading resistance at on-state in current spreading region for a specific chip.The linear specific spreading resistance at the on-state is calculated to be 8.6Ω/cm in the fabricated chips.The proportion of the lateral spreading current in total forward current(Psp)is related to anode voltage and the chip area.Psp is increased with the increase in the anode voltage during initial on-state and then tends to a stable value.The stable values of Psp of the two fabricated chips are 32%and 54%.Combined with theoretical analysis,the proportion of the terminal region and scribing trench in a whole chip(Ksp)is also calculated and compared with Psp.The Ksp values of the two fabricated chips are calculated to be 31.94%and 57.75%.The values of Ksp and Psp are close with each other in a specific chip.The calculated Ksp can be used to predict that when the chip area of SiC SBD becomes larger than 0.5 cm2,the value of Psp would be lower than 10%.展开更多
High incidence(10.2%)and mortality(9.2%)rates led to the ranking of colorectal cancer(CRC)as the second most malignant tumor spectrum worldwide in 2020.Treatment strategies are becoming highly dependent on the molecul...High incidence(10.2%)and mortality(9.2%)rates led to the ranking of colorectal cancer(CRC)as the second most malignant tumor spectrum worldwide in 2020.Treatment strategies are becoming highly dependent on the molecular characteristics of CRC.The classical theories accept two models depicting the origin of CRC:The progression of adenoma to cancer and transformation from serrated polyps to cancer.However,the molecular mechanism of CRC development is very complex.For instance,CRCs originating from laterally spreading tumors(LST)do not adhere to any of these models and exhibit extremely serious progression and poor outcomes.In this article,we present another possible pathway involved in CRC development,particularly from LST,with important molecular characteristics,which would facilitate the design of a novel strategy for targeted therapy.展开更多
This study focuses on the field reconnaissance efforts for investigating ground deformation behavior and building foundation performance in Iskenderun.Many structures experienced significant damage or collapsed due to...This study focuses on the field reconnaissance efforts for investigating ground deformation behavior and building foundation performance in Iskenderun.Many structures experienced significant damage or collapsed due to strong ground shaking in the coastal Iskenderun district of Hatay during the 2023 Kahramanmaras earthquake sequence.Many buildings were also impacted by ground failure due to liquefaction of deposits in the area.Preliminary information regarding the general subsurface profile and post-earthquake data collected during the reconnaissance was used to perform simplified liquefaction and lateral spreading analyses.The empirical methods provide first order estimations of settlements and lateral spreading but are not sufficient when the nature of the structure-soil-structure interaction and earthquake sequence is considered.Measurements of vertical displacements and building tilt,liquefaction manifestations,and structural and foundation parameters potentially affecting foundation settlements including foundation geometry,building contact pressure,and building elastic period were used to evaluate seismic response of the ground and the structures through empirical procedures.Most of the buildings exhibited poor to mediocre foundation performance due to liquefaction-prone subsurface profiles,especially on the coastline.Ongoing field and numerical research will reveal the cause of significant ground failure in the area as well as refined estimates for the seismic deformations.展开更多
AIM:To evaluate the usefulness of a balloon overtube to assist colorectal endoscopic submucosal dissection(ESD)using a gastroscope.METHODS:The results of 45 consecutive patients who underwent colorectal ESD were analy...AIM:To evaluate the usefulness of a balloon overtube to assist colorectal endoscopic submucosal dissection(ESD)using a gastroscope.METHODS:The results of 45 consecutive patients who underwent colorectal ESD were analyzed in a single tertiary endoscopy center.In preoperative evaluation of access to the lesion,difficulties were experienced in the positioning and stabilization of a gastroscope in 15 patients who were thus assigned to the balloonguided ESD group.A balloon overtube was placed with a gastroscope to provide an endoscopic channel to the lesion in cases with preoperatively identified difficulties related to accessibility.Colorectal ESD was performed following standard procedures.A submucosal fluid bleb was created with hyaluronic acid solution.A circumferential mucosal incision was made to marginate the lesion.The isolated lesion was finally excised from the deeper layers with repetitive electrosurgical dissections with needle knives.The success of colorectal ESD,procedural feasibility,and procedure-related complications were the main outcomes and measurements.RESULTS:The overall en bloc excision rate of colorectal ESD during this study at our institution was 95.6%.En bloc excision of the lesion was successfully achieved in 13 of the 15 patients(86.7%)in the balloon overtube-guided colorectal ESD group,which was comparable to the results of the standard ESD group with better accessibility to the lesion(30/30,100%,not statistically significant).CONCLUSION:Use of a balloon overtube can improve access to the lesion and facilitate scope manipulation for colorectal ESD.展开更多
Two full-scale experiments using controlled blasting were conducted in the Port of Tokachi on Hokkaido Island, Japan,to assess the behavior of piles and pipelines subjected to lateral spreading.Test specimens were ext...Two full-scale experiments using controlled blasting were conducted in the Port of Tokachi on Hokkaido Island, Japan,to assess the behavior of piles and pipelines subjected to lateral spreading.Test specimens were extensively instrumented with strain gauges to measure the distribution of moment during lateral spreading.This allowed us to compute the loading condition,as well as to conduct damage and performance assessments on the piles and pipelines.This paper presents the test results and discussions on the response of single piles and pipelines observed from the full-scale experiments.Based on the test results,it can be concluded that using controlled blasting successfully liquefied the soil,and subsequently induced lateral spreading.The movements of the single pile,as well as the transverse pipelines,were approximately the same as the free field soil movement.Observed moment distribution of the single pile indicated that global translation of the liquefied soil layer provided insignificant force to the pile.In addition,the degree of fixity at the pile tip significantly affected the moment along the pile as well as the pile head displacement.The pile with a higher degree of fixity at the pile tip had smaller pile head displacement but larger maximum moment.展开更多
The pile-soil system interaction computational model in liquefaction-induced lateral spreading ground was established by the finite difference numerical method.Considering an elastic-plastic subgrade reaction method,n...The pile-soil system interaction computational model in liquefaction-induced lateral spreading ground was established by the finite difference numerical method.Considering an elastic-plastic subgrade reaction method,numerical methods involving finite difference approach of pile in liquefaction-induced lateral spreading ground were derived and implemented into a finite difference program.Based on the monotonic loading tests on saturated sand after liquefaction,the liquefaction lateral deformation of the site where group piles are located was predicted.The effects of lateral ground deformation after liquefaction on a group of pile foundations were studied using the fmite difference program mentioned above,and the failure mechanism of group piles in liquefaction-induced lateral spreading ground was obtained.The applicability of the program was preliminarily verified.The results show that the bending moments at the interfaces between liquefied and non-liquefied soil layers are larger than those at the pile's top when the pile's top is embedded.The value of the additional static bending moment is larger than the peak dynamic bending moment during the earthquake,so in the pile foundation design,more than the superstructure's dynamics should be considered and the effect of lateral ground deformation on pile foundations cannot be neglected.展开更多
文摘BACKGROUND Since fat does not transmit electrical energy well,delayed perforation and postpolypectomy syndrome due to electrical thermal injury are concerns in the endoscopic removal of colonic lipoma.The endoscopic submucosal dissection(ESD)technique concentrates electrical energy conducts to the submucosa,not the adipose tissue.This helps to minimize electrical thermal injury,especially in the case of large colonic lipomas.In rare cases,such as colonic lipomas accompanied by mucosal lesions,it is difficult for endoscopists to decide how to safely remove them.CASE SUMMARY A 78-year-old man underwent colonoscopy for colorectal cancer screening.During colonoscopy,a yellowish submucosal tumor with positive cushion sign was observed in the ascending colon measuring about 4.5 cm.A nodular mucosal lesion of about 2.5 cm was observed on the mucosal surface of the lipoma.The lipoma was so large that it occupied much of the inside of the colon,making it difficult to see the entire laterally spreading tumor(LST)at once.The LST was confined to the surface of the lipoma,which had a semipedunculated shape with a wide neck.The margin of the LST was not observed at the neck of the lipoma.ESD was performed and the colonic lipoma with the LST was successfully removed without complications.After 3 d of hospitalization,the patient was discharged without any symptoms.The final pathology report showed that the lesion consisted of submucosal lipoma and tubulovillous adenoma with lowgrade dysplasia.CONCLUSION ESD is effective and safe for treating a large colonic lipoma with an LST by minimizing electrical thermal injury.
基金Supported by A grant-in-aid for General Scientific Research from the Ministry of Education, Science, Sports and Culture to Hiroyuki Mitomi, No. 21590394to Tsuyoshi Saito, No. 23590434, To-kyo, Japan
文摘AIM: To clarify differences in mucin phenotype, prolif- erative activity and oncogenetic alteration among sub- types of colorectal laterally spreading tumor (LST). METHODS: LSTs, defined as superficial elevated lesions greater than 10 mm in diameter with a low vertical axis, were macroscopically classified into two subtypes: (1) a granular type (Gr-LST) composed of superficially spread- ing aggregates of nodules forming a fiat-based lesion with a granulonodular and uneven surface; and (2) a non-granular type (NGr-LST) with a flat smooth surface and an absence of granulonodular formation. A total of 69 LSTs, comprising 36 Gr-LSTs and 33 NGr-LSTs, were immunohistochemically stained with MUC2, MUC5AC, MUC6, CD10 (markers of gastrointestinal cell lineage), p53, 13-catenin and Ki-67 antibodies, and examined for alteration in exon 1 of v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) and exon 15 of v-raf murine sarcoma viral oncogene homologue B1 (BRAF) by poly- merase chain reaction followed by direct sequencing. RESULTS: Histologically, 15 Gr-LST samples were ad- enomas with low-grade dysplasia (LGD), 12 were high- grade dysplasia (HGD) and 9 were adenocarcinomas invading the submucosa (INV), while 12 NGr-LSTs demonstrated LGD, 14 HGD and 7 INV. In the proximal colon, MUC5AC expression was significantly higher in the Gr-type than the NGr-type. MUC6 was expressed only in NGr-LST. MUC2 or CD10 did not differ. P53 ex- pression demonstrated a significant stepwise increment in progression through LGD-HGD-INV with both types of LST. Nuclear β-catenin expression was significantly higher in the NGr-type. Ki-67 expression was signifi- cantly higher in the Gr-type in the lower one third zone of the tumor. In proximal, but not distal colon tumors, the incidence of KRAS provided mutation was signifi- cantly higher in the Gr-type harboring a specific muta- tional pattern (G12V). BRAF mutations (V600E) were detected only in two Gr-LSTs. CONCLUSION: The two subtypes of LST, especially in the proximal colon, have differing phenotypes of gastrointestinal cell lineage, proliferation and activa- tion of Wnt/β-catenin or RAS/RAF/extracellular signal- regulated kinase signaling.
文摘AIM: To prospectively investigate the detection rate of laterally spreading tumors (LSTs) of the colorectum by computed tomography (CT) colonography (CTC).
文摘BACKGROUND Colorectal mucosa-associated lymphoid tissue(MALT)lymphoma is a rare disease,and only a few cases have been reported to date.It has no specific clinical presentations and shows various endoscopic appearances.There is no uniform consensus on its treatment.With the advancement of endoscopic technology,endoscopic treatment has achieved better results in individual case reports of early-stage patients.CASE SUMMARY We report a case of rectal MALT in a 57-year-old Chinese man with no symptoms who received endoscopy as part of a routine physical examination,which incidentally found a 25 mm×20 mm,laterally spreading tumor(LST)-like elevated lesion in the rectum.Therefore,he was referred to our hospital for further endoscopic treatment.Complete and curable removal of the tumor was performed by endoscopic submucosal dissection.We observed enlarged and dilated branch-like vessels similar to those of gastric MALT lymphoma on magnifying endoscopy with narrow-band imaging.And immunopathological staining showed hyperplastic capillaries in the mucosa.Histopathological findings revealed diffusely hyperplastic lymphoid tissue in the lamina propria,with a visible lymphoid follicle structure surrounded by a large number of diffusely infiltrated lymphoid cells that had a relatively simple morphology and clear cytoplasm.In addition,immunohistochemical analysis suggested strongly positive expression for CD20 and Bcl-2.Gene rearrangement results showed positivity for IGH-A,IGH-C,IGK-B,and IGL.Taking all the above findings together,we arrived at a diagnosis of extranodal marginal zone B-cell lymphoma of MALT lymphoma. Positron emission tomography-computed tomographyexamination showed no other lesions involved. The patient will be followed byperiodic endoscopic observation.CONCLUSIONIn conclusion, we report a case of rectal MALT with an LST-like appearancetreated by endoscopic submucosal dissection. Further studies will be needed toexplore the clinical behavior, endoscopic appearance, and treatment of rectalMALT.
文摘BACKGROUND The management strategies for recurrent ampullary adenoma after endoscopic papillectomy are still controversial.Patients with the recurrent papillary lesions need to receive repetitive endoscopic interventions due to the limitations of conventional endoscopic techniques.AIM To assess the feasibility,efficacy,and safety of hybrid endoscopic submucosal dissection(ESD)by duodenoscope for recurrent,laterally spreading papillary lesions.METHODS We enrolled two patients with recurrent,laterally spreading,duodenal papillary adenomas with no intraductal extension confirmed by follow-up between March 2017 and September 2018.After marking the resection borders of the lesion using a dual knife,a submucosal cushion was created by injecting a mixture of saline solution,methylene blue,and adrenaline.A total circumferential incision and submucosal excision was performed by dual knife combined with insulated-tip diathermic knife,and then the lesion was ligated and resected using an electric snare.Endoscopic hemostasis was applied during the endoscopic procedures.Moreover,the endoscopic retrograde cholangiopancreatography(ERCP)procedures,including selective cannulation and stent implantation of biliary and pancreatic ducts,were performed.Additionally,we performed endoclip closure for mucosal defect after ESD.RESULTS Hybrid ESD using a duodenoscope and biliary and pancreatic stent placement were performed successfully in two patients.The endoscopic size of recurrent papillary lesions was no more than 2 cm.Generally,the average total procedure time was 95.5 min,and the procedure time of ESD and ERCP was 38.5 min and 15.5 min,respectively.No serious complications occurred during the intraoperative and postoperative periods.The histopathological examination revealed tubulovillous adenoma negative for neoplastic extension at the cut margin in both patients.The duodenoscopic follow-up and histopathology of biopsy specimens at 3 mo after ESD showed no residual or recurrent lesions in ampullary areas in both cases.Both cases have been followed up with no recurrence to June 2020.CONCLUSION Hybrid ESD by duodenoscope is technically challenging,and may be curative for recurrent,laterally spreading papillary adenomas<2 cm.It should be performed cautiously in selected patients by experienced endoscopists.
基金Supported by Beijing Nova Program,No.Z201100006820147Beijing Municipal Administration of Hospitals’Youth Program,No.QML20180102。
文摘BACKGROUND Colorectal laterally spreading tumors(LSTs)with malignant potential require en bloc resection by endoscopic submucosal dissection(ESD),but lesions with deep submucosal invasion(SMI)are endoscopically unresectable.AIM To investigate the factors associated with high-grade dysplasia(HGD)/carcinoma and deep SMI in colorectal LSTs.METHODS The endoscopic and histological results of consecutive patients who underwent ESD for colorectal LSTs in our hospital from June 2013 to March 2019 were retrospectively analyzed.The characteristics of LST subtypes were compared.Risk factors for HGD/carcinoma and deep SMI(invasion depth≥1000μm)were determined using multivariate logistic regression.RESULTS A total of 323 patients with 341 colorectal LSTs were enrolled.Among the four subtypes,non-granular pseudodepressed(NG-PD)LSTs(85.5%)had the highest rate of HGD/carcinoma,followed by the granular nodular mixed(G-NM)(77.0%),granular homogenous(29.5%),and non-granular flat elevated(24.2%)subtypes.Deep SMI occurred commonly in NG-PD LSTs(12.9%).In the adjusted multivariate analysis,NG-PD[odds ratio(OR=16.8,P<0.001)and G-NM(OR=7.8,P<0.001)subtypes],size≥2 cm(OR=2.2,P=0.005),and positive non-lifting sign(OR=3.3,P=0.024)were independently associated with HGD/carcinoma.The NG-PD subtype(OR=13.3,P<0.001)and rectosigmoid location(OR=8.7,P=0.007)were independent risk factors for deep SMI.CONCLUSION Because of their increased risk for malignancy,it is highly recommended that NG-PD and G-NM LSTs are removed en bloc through ESD.Given their substantial risk for deep SMI,surgery needs to be considered for NG-PD LSTs located in the rectosigmoid,especially those with positive nonlifting signs.
文摘Due to the advent of the screening programs for colorectal cancer and the era of quality assurance colonoscopy the number the polyps that can be considered difficult,including large(>20 mm)laterally spreading tumors(LSTs),has increased in the last decade.All LSTs should be assessed carefully,looking for suspicious areas of submucosal invasion(SMI),such as nodules or depressed areas,describing the morphology according to the Paris classification,the pit pattern,and vascular pattern.The simplest,most appropriate and safest endoscopic treatment with curative intent should be selected.For LST-granular homogeneous type,piecemeal endoscopic mucosal resection should be the first option due to its biological low risk of SMI.LST-nongranular pseudodepressed type has an increased risk of SMI,and en bloc resection should be mandatory.Underwater endoscopic mucosal resection is useful in situations where submucosal injection alters the operative field,e.g.,for the resection of scar lesions,with no lifting,adjacent tattoo,incomplete resection attempts,lesions into a colonic diverticulum,in ileocecal valve and lesions with intra-appendicular involvement.Endoscopic full thickness resection is very useful for the treatment of difficult to resect lesions of less than 20 up to 25 mm.Among the indications,we highlight the treatment of polyps with suspected malignancy because the acquired tissue allows an exact histologic risk stratification to assign patients individually to the best treatment and avoid surgery for low-risk lesions.Endoscopic submucosal dissection is the only endoscopic procedure that allows completes en bloc resection regardless of the size of the lesion.It should therefore be indicated in the treatment of lesions with risk of SMI.
基金US Department of Transportation through Alaska University Transportation Centerthe State of Alaska Department of Transportation and Public Facilities(AK DOT&PF)under Project AUTC#410015
文摘Lateral spread of frozen ground crust over liquefied soil has caused extensive bridge foundation damage in the past winter earthquakes.A shake table experiment was conducted to investigate the performance of a model pile in this scenario and revealed unique pile failure mechanisms.The modelling results provided valuable data for validating numerical models.This paper presents analyses and results of this experiment using two numerical modeling approaches: solid-fluid coupled finite element(FE) modeling and the beam-on-nonlinear-Winkler-foundation(BNWF) method.A FE model was constructed based on the experiment configuration and subjected to earthquake loading.Soil and pile response results were presented and compared with experimental results to validate this model.The BNWF method was used to predict the pile response and failure mechanism.A p-y curve was presented for modelling the frozen ground crust with the free-field displacement from the experiment as loading.Pile responses were presented and compared with those of the experiment and FE model.It was concluded that the coupled FE model was effective in predicting formation of three plastic hinges at ground surface,ground crust-liquefiable soil interface and within the medium dense sand layer,while the BNWF method was only able to predict the latter two.
文摘The prediction of liquefaction-induced lateral spreading/displacement(Dh)is a challenging task for civil/geotechnical engineers.In this study,a new approach is proposed to predict Dh using gene expression programming(GEP).Based on statistical reasoning,individual models were developed for two topographies:free-face and gently sloping ground.Along with a comparison with conventional approaches for predicting the Dh,four additional regression-based soft computing models,i.e.Gaussian process regression(GPR),relevance vector machine(RVM),sequential minimal optimization regression(SMOR),and M5-tree,were developed and compared with the GEP model.The results indicate that the GEP models predict Dh with less bias,as evidenced by the root mean square error(RMSE)and mean absolute error(MAE)for training(i.e.1.092 and 0.815;and 0.643 and 0.526)and for testing(i.e.0.89 and 0.705;and 0.773 and 0.573)in free-face and gently sloping ground topographies,respectively.The overall performance for the free-face topology was ranked as follows:GEP>RVM>M5-tree>GPR>SMOR,with a total score of 40,32,24,15,and 10,respectively.For the gently sloping condition,the performance was ranked as follows:GEP>RVM>GPR>M5-tree>SMOR with a total score of 40,32,21,19,and 8,respectively.Finally,the results of the sensitivity analysis showed that for both free-face and gently sloping ground,the liquefiable layer thickness(T_(15))was the major parameter with percentage deterioration(%D)value of 99.15 and 90.72,respectively.
基金support by the Construction and Development of Transportation Infrastructures Company affiliated with the Ministry of Roads and Urban Development of Iran and partial financial support granted by the Research Deputy of the Sharif University of Technology are acknowledged.
文摘In this research,two shake table experiments were conducted to study the effects of non-liquefiable crust layer and superstructure mass on the responses of two sets of 22 pile groups to liquefactioninduced lateral spreading.In this regard,an inclined base layer overlain by a very loose liquefiable layer was constructed in both models;while only in one model,a non-liquefiable crust layer was built.A lumped mass,being representative of a superstructure,was attached to the cap of one pile group in both models.The models were fully instrumented with various sensors,including acceleration,displacement,and pore water pressure transducers.Also,the piles were instrumented with pair strain gauges to measure pure bending moments induced by cyclic and monotonic loadings associated with ground shaking and lateral spreading,respectively.The results showed that the existence of the non-liquefiable crust layer increases both the maximum and residual soil displacements at the free field and also the maximum bending moments in the piles.The results of the experiments indicated that the crust layer induces a high kinematic lateral soil pressure and force on the piles which are not present in the crustless case.The crust layer increases the pile cap displacement before liquefaction,albeit decreases it after liquefaction,due to the elastic rebound of the piles in the liquefiable layer.The crust layer postpones both liquefaction triggering and dissipation of excess pore water pressure.The existence of the superstructure mass on the pile caps decreases the acceleration amplitude of the pile caps,while increases their maximum displacement.
基金Supported by the National High-Level Hospital Clinical Research Funding,No.2022-PUMCH-B-024 and No.2022-PUMCH-A-020Undergraduate Teaching Reform and Innovation Project,No.2022zlgc0108.
文摘BACKGROUND The management of polyps involving the appendiceal orifice(AO)presents notable challenges.Endoscopic resection is frequently hindered by operational complexities,a heightened risk of incomplete removal,and an elevated risk of procedural complications,including appendicitis.Conversely,surgical resection may entail unnecessary excision of intestinal segments,leading to potential morbidity.CASE SUMMARY Here,we reported two patients who presented with polyps deeply situated within the AO,with indistinct boundaries making it challenging to ensure completeness using traditional endoscopic resection.To overcome these challenges,we em-ployed combined endo-laparoscopic surgery(CELS),achieving curative resection without postoperative complications.CONCLUSION The application of CELS in managing polyps involving the AO is emerging as a safe and effective treatment modality.
基金Supported by:Pacific Earthquake Engineering Research Center Lifelines Program Under Project Task No.9C
文摘This paper evaluates the seismic vulnerability of different classes of typical bridges in California when subjected to seismic shaking or liquefaction-induced lateral spreading. The detailed structural configurations in terms of superstructure type, connection, continuity at support and foundation type, etc. render different damage resistant capability. Six classes of bridges are established based on their anticipated failure mechanisms under earthquake shaking. The numerical models that are capable of simulating the complex soil-structure interaction effects, nonlinear behavior of columns and connections are developed for each bridge class. The dynamic responses are obtained using nonlinear time history analyses for a suite of 250 earthquake motions with increasing intensity. An equivalent static analysis procedure is also implemented to evaluate the vulnerability of the bridges when subjected to liquefaction-induced lateral spreading. Fragility functions for each bridge class are derived and compared for both seismic shaking (based on nonlinear dynamic analyses) and lateral spreading (based on equivalent static analyses) for different performance states. The study finds that the fragility functions due to either ground shaking or lateral spreading show significant correlation with the structural characterizations, but differences emerge for ground shaking and lateral spreading conditions. Structural properties that will mostly affect the bridges' damage resistant capacity are also identified.
基金National Natural Science Foundation of China under Grant Nos.51378161 and 51108134
文摘The response of pile foundations near a quay wall under liquefaction-induced lateral spreading remains a complex problem. This study presents the results of a shake-table test on a 2×2 pile group behind a sheet-pile quay wall that was subjected to lateral spreading. The quay wall was employed to trigger liquefaction-induced large lateral ground deformation. The discussions focus on the behavior of the pile and the soil and on the bending moment distributions within the group pile and the restoring force characteristics at the superstructure. Overall, the piles exhibited apparent pinning effects that reduced soil deformation. In addition, the rear-row piles near the quay wall experienced larger bending moments than did the front-row piles, indicating significant pile group effects. The tests showed that lateral spreading could be a primary cause of larger monotonic deformations and bending moments. It can also be concluded that the monotonic bending moments were significantly decreased due to the presence of slow soil flow. The stiffness at the superstructure was reduced because of accumulated excess pore pressure before liquefaction, and it was recovered during lateral spreading. The present study further enhances current understanding of the behavior of low-cap pile foundations under lateral spreading.
基金National Natural Science Foundation SF of China Under Grant No.41030742NBRP of China Under Grant No. 2011CB013605the Foundation for Research and Science and Technology of New Zealand Under Grant No.C05X0402
文摘A revised empirical model has been developed for predicting liquefaction-induced lateral spreading displacement (LD) as a function of both response spectral acceleration derived from strong-motion attenuation models and geotechnical parameters from Youd's LD data set (Youd website). This revised model is different from the model of Zhang and Zhao, which overcame some drawbacks of earlier models for predicting lateral spreading and was primarily used in Japan and the western U.S. The revised model can potentially be applied anywhere if ground shaking (in terms of 5% damped acceleration or displacement response spectra) can be estimated using local strong-motion attenuation relationships. The revised model is examined using data from Japan and the western U.S. and applied to Turkey and New Zealand, where the ground shaking is estimated using appropriate strong-motion attenuation relationships for each region. The accuracy of the revised model is evaluated by comparing its predicted lateral displacements with those measured in actual earthquakes. The results show that the revised model can account for the effects of local seismicity on lateral spreading displacements and is comparable with existing prediction models.
基金This work was supported in part by National Natural Science Foundation of China(62004161)in part by Natural Science Basic Research Plan in Shaanxi Province of China(2020JQ-636)+2 种基金in part by Scientific Research Project of Education Department of Shaanxi Province(20JK0796)in part by Youth talent lift project of Xi’an Science and Technology Association(095920201318)in part by Bidding Project of Shanxi Province(20201101017).
文摘Lateral current spreading in the 4H-SiC Schottky barrier diode(SBD)chip is investigated.The 4H-SiC SBD chips with the same vertical parameters are simulated and fabricated.The results indicate that there is a fixed spreading resistance at on-state in current spreading region for a specific chip.The linear specific spreading resistance at the on-state is calculated to be 8.6Ω/cm in the fabricated chips.The proportion of the lateral spreading current in total forward current(Psp)is related to anode voltage and the chip area.Psp is increased with the increase in the anode voltage during initial on-state and then tends to a stable value.The stable values of Psp of the two fabricated chips are 32%and 54%.Combined with theoretical analysis,the proportion of the terminal region and scribing trench in a whole chip(Ksp)is also calculated and compared with Psp.The Ksp values of the two fabricated chips are calculated to be 31.94%and 57.75%.The values of Ksp and Psp are close with each other in a specific chip.The calculated Ksp can be used to predict that when the chip area of SiC SBD becomes larger than 0.5 cm2,the value of Psp would be lower than 10%.
基金Supported by the National Natural Science Foundation of China,No.72171170 and 82071964.
文摘High incidence(10.2%)and mortality(9.2%)rates led to the ranking of colorectal cancer(CRC)as the second most malignant tumor spectrum worldwide in 2020.Treatment strategies are becoming highly dependent on the molecular characteristics of CRC.The classical theories accept two models depicting the origin of CRC:The progression of adenoma to cancer and transformation from serrated polyps to cancer.However,the molecular mechanism of CRC development is very complex.For instance,CRCs originating from laterally spreading tumors(LST)do not adhere to any of these models and exhibit extremely serious progression and poor outcomes.In this article,we present another possible pathway involved in CRC development,particularly from LST,with important molecular characteristics,which would facilitate the design of a novel strategy for targeted therapy.
文摘This study focuses on the field reconnaissance efforts for investigating ground deformation behavior and building foundation performance in Iskenderun.Many structures experienced significant damage or collapsed due to strong ground shaking in the coastal Iskenderun district of Hatay during the 2023 Kahramanmaras earthquake sequence.Many buildings were also impacted by ground failure due to liquefaction of deposits in the area.Preliminary information regarding the general subsurface profile and post-earthquake data collected during the reconnaissance was used to perform simplified liquefaction and lateral spreading analyses.The empirical methods provide first order estimations of settlements and lateral spreading but are not sufficient when the nature of the structure-soil-structure interaction and earthquake sequence is considered.Measurements of vertical displacements and building tilt,liquefaction manifestations,and structural and foundation parameters potentially affecting foundation settlements including foundation geometry,building contact pressure,and building elastic period were used to evaluate seismic response of the ground and the structures through empirical procedures.Most of the buildings exhibited poor to mediocre foundation performance due to liquefaction-prone subsurface profiles,especially on the coastline.Ongoing field and numerical research will reveal the cause of significant ground failure in the area as well as refined estimates for the seismic deformations.
基金Supported by The Jikei University School of Medicine and Kanto Medical Center NTT EC
文摘AIM:To evaluate the usefulness of a balloon overtube to assist colorectal endoscopic submucosal dissection(ESD)using a gastroscope.METHODS:The results of 45 consecutive patients who underwent colorectal ESD were analyzed in a single tertiary endoscopy center.In preoperative evaluation of access to the lesion,difficulties were experienced in the positioning and stabilization of a gastroscope in 15 patients who were thus assigned to the balloonguided ESD group.A balloon overtube was placed with a gastroscope to provide an endoscopic channel to the lesion in cases with preoperatively identified difficulties related to accessibility.Colorectal ESD was performed following standard procedures.A submucosal fluid bleb was created with hyaluronic acid solution.A circumferential mucosal incision was made to marginate the lesion.The isolated lesion was finally excised from the deeper layers with repetitive electrosurgical dissections with needle knives.The success of colorectal ESD,procedural feasibility,and procedure-related complications were the main outcomes and measurements.RESULTS:The overall en bloc excision rate of colorectal ESD during this study at our institution was 95.6%.En bloc excision of the lesion was successfully achieved in 13 of the 15 patients(86.7%)in the balloon overtube-guided colorectal ESD group,which was comparable to the results of the standard ESD group with better accessibility to the lesion(30/30,100%,not statistically significant).CONCLUSION:Use of a balloon overtube can improve access to the lesion and facilitate scope manipulation for colorectal ESD.
文摘Two full-scale experiments using controlled blasting were conducted in the Port of Tokachi on Hokkaido Island, Japan,to assess the behavior of piles and pipelines subjected to lateral spreading.Test specimens were extensively instrumented with strain gauges to measure the distribution of moment during lateral spreading.This allowed us to compute the loading condition,as well as to conduct damage and performance assessments on the piles and pipelines.This paper presents the test results and discussions on the response of single piles and pipelines observed from the full-scale experiments.Based on the test results,it can be concluded that using controlled blasting successfully liquefied the soil,and subsequently induced lateral spreading.The movements of the single pile,as well as the transverse pipelines,were approximately the same as the free field soil movement.Observed moment distribution of the single pile indicated that global translation of the liquefied soil layer provided insignificant force to the pile.In addition,the degree of fixity at the pile tip significantly affected the moment along the pile as well as the pile head displacement.The pile with a higher degree of fixity at the pile tip had smaller pile head displacement but larger maximum moment.
基金Project(51109208)supported by the National Natural Science Foundation of ChinaProject(2013M531688)supported by the Postdoctoral Science Foundation of China+1 种基金Project(Z012009)supported by the Open Research Fund of State Key Laboratory of Geomechanics and Geotechnical Engineering(Institute of Rock and Soil Mechanics,Chinese Academy of Sciences)Project(CKSF2012054)supported by the Foundation of Changjiang River Scientific Research Institute,China
文摘The pile-soil system interaction computational model in liquefaction-induced lateral spreading ground was established by the finite difference numerical method.Considering an elastic-plastic subgrade reaction method,numerical methods involving finite difference approach of pile in liquefaction-induced lateral spreading ground were derived and implemented into a finite difference program.Based on the monotonic loading tests on saturated sand after liquefaction,the liquefaction lateral deformation of the site where group piles are located was predicted.The effects of lateral ground deformation after liquefaction on a group of pile foundations were studied using the fmite difference program mentioned above,and the failure mechanism of group piles in liquefaction-induced lateral spreading ground was obtained.The applicability of the program was preliminarily verified.The results show that the bending moments at the interfaces between liquefied and non-liquefied soil layers are larger than those at the pile's top when the pile's top is embedded.The value of the additional static bending moment is larger than the peak dynamic bending moment during the earthquake,so in the pile foundation design,more than the superstructure's dynamics should be considered and the effect of lateral ground deformation on pile foundations cannot be neglected.