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Kawasaki disease without changes in inflammatory biomarkers:A case report

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World Journal of Clinical Cases 2022年第35期10卷 13038-13043页

作者： Kosei Yamashita Takeru Kanazawa Yoshifusa abe takuya Naruto Masaaki Mori Children’s Medical Center Showa University Koto Toyosu HospitalTokyo 135-8577Japan Lifetime Clinical Immunology Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyo 113-8510Japan Department of Rheumatology Clinical Immunology and AllergologySt.Marianna University School of MedicineKanagawa 216-8511Japan

BACKGROUND Kawasaki disease(KD)is diagnosed based on clinical *** tests and other tests are auxiliary diagnostic *** KD is a disease caused by arterial inflammation,many patients with KD have elevated levels of inflammatory biomarkers,such as C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),and serum amyloid A protein(SAA)in blood *** report our experience of a patient with KD who did not have elevated levels of inflammatory *** SUMMARY A 1-year-old boy presented with a 3-day history of *** of the six symptoms of KD were observed,except for changes in the lips and oral *** tests revealed no elevation in CRP,ESR,or SAA *** the blood test results were atypical,the patient was diagnosed with KD based on clinical symptoms and was admitted to the hospital for *** patient was administered intravenous immunoglobulin(IVIG)and *** commencing treatment,the fever persisted;therefore,additional IVIG was administered,the dosage of aspirin was increased,and ulinastatin was *** doses of IVIG were administered and the fever resolved on day 11 of KD symptoms *** tests performed during hospitalization showed normal levels of inflammatory *** examined leucine-rich alpha-2-glycoprotein 1-a protein that is elevated during the acute phase of *** protein levels did not increase during *** This case suggests the need to identify criteria and biomarkers for detecting KD conditions that do not require KD treatment.

关键词： Blood test C-reactive protein Erythrocyte sedimentation rate Intravenous immunoglobulin Kawasaki disease Case report

Change in arterial tumor perfusion is an early biomarker of lenvatinib efficacy in patients with unresectable hepatocellular carcinoma

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World Journal of Gastroenterology 2019年第19期25卷 2365-2372页

作者： Hidekatsu Kuorda Tamami abe Yudai Fujiwara takuya Okamoto Miki Yonezawa Hiroki Sato Kei Endo Takayoshi Oikawa Kei Sawara Yasuhiro Takikawa Division of Hepatology Department of Internal Medicine Iwate Medical University

BACKGROUND Lenvatinib is one of the first-line tyrosine kinase inhibitors used for unresectable hepatocellular carcinoma(HCC). In the present study, we evaluated the potential of early changes in the time-intensity curve(TIC) of arterial phase on contrastenhanced ultrasound(CEUS) as early imaging biomarkers of lenvatinib *** To evaluate the potential of the early changes in the TIC of CEUS as early imaging biomarkers of lenvatinib efficacy in patients with unresectable *** We analyzed 20 consecutive patients with unresectable HCC treated with lenvatinib from March to November 2018. Tumor response at 8 wk was assessed by computed tomography using the modified Response Evaluation Criteria in Solid Tumors(m RECIST). CEUS was performed at baseline before treatment(Day 0) and on day 7(Day 7), and the images were analyzed in the arterial phase for 20 seconds after the contrast agent arrived at the target tumor. Three perfusion parameters were extracted from the TICs: the slope of wash-in(Slope),time to peak(TTP) intensity, and the total area under the curve(AUC) during wash-in. The rate of change in the TIC parameters between Day 0 and Day 7 was compared between treatment responders and non-responders based on m *** The rate of change for all TIC parameters showed significant differences between the responders(n = 9) and non-responders(n = 11)(Slope, P = 0.025; TTP, P =0.004; and AUC, P = 0.0003). The area under the receiver operating curve values for slope, TTP, and AUC for the prediction of responders were 0.805, 0.869, and0.939, *** CEUS may be useful for the early prediction of tumor response to lenvatinib therapy in patients with unresectable HCC.

关键词： Hepatocellular carcinoma Lenvatinib Contrast-enhanced ultrasound Timeintensity curve

Enhancement of Visual Attention by Color Revealed Using Electroencephalography

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Open Journal of Therapy and Rehabilitation 2024年第1期12卷 1-9页

作者： Moemi Matsuo Takashi Higuchi takuya Ishibashi Ayano Egashira Toranosuke abe Hiroya Miyabara Faculty of Rehabilitation Sciences Nishikyushu University Kanzaki Japan Department of Physical Therapy Osaka University of Human Sciences Settsu Japan

Attention constitutes a fundamental psychological feature guiding our mental effort toward specific objects, concurrent with processes such as memory, reasoning, and imagination. Visual attention, crucial for selecting surrounding information, often decreases in older adults and patients with cerebrovascular disorders. Effective methods to enhance attention are scarce. Here, we investigated whether color information influences visual attention and brain activity during task performance, utilizing EEG. We examined 13 healthy young adults (seven women and six men;mean age: 21.2 ± 0.58 years) using 19-electrode electroencephalograms to assess the impact of color information on visual attention. The Clinical Assessment for Attention cancellation test was conducted under the black, red, and blue color conditions. Wilcoxon’s signed-rank test was used to assess differences in task performance (task time and error) between conditions. Spearman’s rank correlation was utilized to examine the correlation in power levels between task performance and color conditions. Significant variations in total task errors were observed among color conditions. The black condition exhibited the highest error frequency (0.7 ± 0.9 times), followed by the red condition (0.5 ± 0.8 times), with the lowest error frequency occurring in the blue (0.2 ± 0.4 times) condition (black vs. red: P = 0.03;black vs. blue: P = 0.00;red vs. blue: P = 0.032). No time difference was observed. The black condition showed negative delta and high-gamma correlations in the central electrodes. The red condition revealed positive alpha and low-gamma correlations in the frontal and occipital areas. Although no correlations were observed in the blue condition, it enhanced attentional performance. Positive alpha and low-gamma waves might be crucial for spotting attentional errors in key areas. Our findings provide insights into the effects of color information on visual attention and potential neural correlates associated

关键词： Attention Higher Brain Function Electroencephalography Neuroimaging Rehabilitation

Electroencephalogram Signal Correlations between Default Mode Network and Attentional Functioning

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Journal of Behavioral and Brain Science 2024年第4期14卷 119-134页

作者： Moemi Matsuo Takashi Higuchi Toranosuke abe takuya Ishibashi Ayano Egashira Rio Kamashita Faculty of Rehabilitation Sciences Nishi Kyushu University Kanzaki Japan Department of Physical Therapy Osaka University of Human Sciences Settsu Japan Research Center for Child Mental Development Chiba University Chiba Japan

Attentional issues may affect acquiring new information, task performance, and learning. Cortical network activities change during different functional brain states, including the default mode network (DMN) and attention network. We investigated the neural mechanisms underlying attentional functions and correlations between DMN connectivity and attentional function using the Trail-Making Test (TMT)-A and -B. Electroencephalography recordings were performed by placing 19 scalp electrodes per the 10 - 20 system. The mean power level was calculated for each rest and task condition. Non-parametric Spearman’s rank correlation was used to examine the correlation in power levels between the rest and TMT conditions. The most significant correlations during TMT-A were observed in the high gamma wave, followed by theta and beta waves, indicating that most correlations were in the parietal lobe, followed by the frontal, central, and temporal lobes. The most significant correlations during TMT-B were observed in the beta wave, followed by the high and low gamma waves, indicating that most correlations were in the temporal lobe, followed by the parietal, frontal, and central lobes. Frontoparietal beta and gamma waves in the DMN may represent attentional functions.

关键词： Cortical Network Activities Electroencephalography Attention Default Mode Network

Effects of oral tacrolimus as a rapid induction therapy in ulcerative colitis

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World Journal of Gastroenterology 2015年第6期21卷 1880-1886页

作者： Ken Kawakami takuya Inoue Mitsuyuki Murano Ken Narabayashi Sadaharu Nouda Kumi Ishida Yosuke abe Koji Nogami Nobuyuki Hida Hirokazu Yamagami Kenji Watanabe Eiji Umegaki Shiro Nakamura Tetsuo Arakawa Kazuhide Higuchi Second Department of Internal Medicine Osaka Medical College Division of Lower Gastroenterology Department of Internal Medicine Hyogo College of Medicine Department of Gastroenterology Osaka City University Graduate School of Medicine

AIM:To determine the efficacy and safety of rapid induction therapy with oral tacrolimus without a meal in steroid-refractory ulcerative colitis(UC)***:This was a prospective,multicenter,observational *** May 2010 and August 2012,49 steroid-refractory UC patients(55 flare-ups)were consecutively *** patients were treated with oral tacrolimus without a meal at an initial dose of 0.1mg/kg per *** dose was adjusted to maintain trough whole-blood levels of 10-15 ng/m L for the first 2 *** of remission at 2 and 4 wk after tacrolimus treatment initiation was evaluated using Lichtiger’s clinical activity index(CAI).RESULTS:The mean CAI was 12.6±3.6 at *** the first 7 d,93.5%of patients maintained high trough levels(10-15 ng/m L).The CAI significantly decreased beginning 2 d after treatment *** 2wk,73.1%of patients experienced clinical *** tacrolimus initiation,31.4%and 75.6%of patients achieved clinical remission at 2 and 4 wk,*** was well ***:Rapid induction therapy with oral tacrolimus shortened the time to achievement of appropriate trough levels and demonstrated a high remission rate 28 d after treatment *** induction therapy with oral tacrolimus appears to be a useful therapy for the treatment of refractory UC.

关键词： Ulcerative colitis Tacrolimus Rapid induction ther

Clinical effects of adalimumab treatment with concomitant azathioprine in Japanese Crohn's disease patients

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World Journal of Gastroenterology 2013年第17期19卷 2676-2682页

作者： Kumi Ishida takuya Inoue Kaori Fujiwara Taisuke Sakanaka Ken Narabayashi Sadaharu Nouda Toshihiko Okada Kazuki Kakimoto Takanori Kuramoto Ken Kawakami Yosuke abe Toshihisa Takeuchi Mitsuyuki Murano Satoshi Tokioka Eiji Umegaki Kazuhide Higuchi the Second Department of Internal Medicine Osaka Medical College Takatsuki City

AIM:To assess adalimumab's efficacy with concomitant azathioprine (AZA) for induction and maintenance of clinical remission in Japanese Crohn's disease (CD) patients. METHODS:This retrospective, observational, singlecenter study enrolled 28 consecutive CD patients treated with adalimumab (ADA). Mean age and mean disease duration were 38.1 ± 11.8 years and 11.8 ± 10.1 years, respectively. The baseline mean Crohn's disease activity index (CDAI) and C-reactive protein were 177.8 ± 82.0 and 0.70 ± 0.83 mg/dL, respectively. Twelve of these patients also received a concomitant stable dose of AZA. ADA was subcutaneously administered:160 mg at week 0, 80 mg at week 2, followed by 40 mg every other week. Clinical response and remission rates were assessed via CDAI and C-reactive protein for 24 wk. RESULTS:The mean CDAI at weeks 2, 4, 8, and 24 was 124.4, 120.2, 123.6, and 135.1, respectively. The CDAI was significantly decreased at weeks 2 and 4 with ADA and was significantly suppressed at 24 wk with ADA/AZA. Overall clinical remission rates at weeks 4 and 24 were 66.7% and 63.2%, respectively. Although no statistically significant difference in C-reactive protein was demonstrated, ADA with AZA resulted in a greater statistically significant improvement in CDAI at 24 wk, compared to ADA alone. CONCLUSION:Scheduled ADA with concomitant AZA may be more effective for clinical remission achievement at 24 wk in Japanese Crohn's disease patients.

关键词： Crohn’s disease Adalimumab Immunomodulator Azathioprine Inflammatory bowel disease

Improving recognition of hepatic perivascular epithelioid cell tumor:Case report and literature review

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World Journal of Gastroenterology 2015年第17期21卷 5432-5441页

作者： Toshiya Maebayashi Katsumi abe takuya Aizawa Masakuni Sakaguchi Naoya Ishibashi Osamu abe Tadatoshi Takayama Hisashi Nakayama Shunichi Matsuoka Kazushige Nirei Hitomi Nakamura Masahiro Ogawa Masahiko Sugitani Department of Radiology Nihon University School of MedicineItabashi-kuTokyo 173-8610Japan Department of Digestive Surgery Nihon University School of MedicineItabashi-kuTokyo 173-8610Japan Department of Gastroenterology and Hepatology Nihon University School of MedicineItabashi-kuTokyo 173-8610Japan Department of Pathology Nihon University School of MedicineItabashi-kuTokyo 173-8610Japan

A 58-year-old man presented with the chief complaint of abdominal bloating and was incidentally found to have a liver *** diagnostic imaging studies could not rule out malignancy,the patient underwent partial resection of segment 3 of the *** lesion pathologically showed eosinophilic proliferation,in addition to immunohistochemical positivity for human melanoma black 45 and Melan-A,thereby leading to the diagnosis of a hepatic perivascular epithelioid cell tumor(PEComa).A PEComa arising from the liver is relatively ***,the name ‘PEComa' has not yet been widely recognized,and the same disease entity has been called epithelioid angiomyolipoma(EAML),further diminishing the recognition of *** addition,PEComa imaging findings mimic those of malignant liver tumors,and clinically,this tumor tends to ***,a PEComa is difficult to *** conducted a systematic review of PEComa and EAML cases and discuss the results,including findings useful for differentiating perivascular epithelioid cell tumors from malignant liver tumors.

关键词： Angiomyolipoma Tuberous sclerosis Melan-A Perivascular epithelioid cell tumor Humanmelanoma black 45 Imaging

The Reproducibility of Patient Setup for Head and Neck Cancers Treated with Image-Guided and Intensity-Modulated Radiation Therapies Using Thermoplastic Immobilization Device

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2013年第4期2卷 117-124页

作者： Akihiro Nakata Kunihiko Tateoka Kazunori Fujimoto Yuichi Saito takuya Nakazawa Tadanori abe Masaki Yano Koichi Sakata 1Department of Medical Physics Graduate School of Medicine Sapporo Medical University Sapporo Japan 4Radiation Therapy Research Institute Social Medical Corporation Teishinkai Sapporo Japan Department of Medical Physics Graduate School of Medicine Sapporo Medical University Sapporo Japan Department of Medical Physics Graduate School of Medicine Sapporo Medical University Sapporo Japan Department of Radiology Sapporo Medical University Sapporo Japan Department of Medical Physics Graduate School of Medicine Sapporo Medical University Sapporo Japan Nikko Memorial Hospital Muroran Japan

The reproducibility of patient setup is an important issue for head and neck cancers treated with intensity-modulated radiation therapy (IMRT). In this study, an image-guided radiation therapy (IGRT) system has been used to minimize the uncertainty of patient setup while standard thermoplastic masks were used to provide adequate immobilization for the head and neck. However, they do not provide sufficient immobilization of the shoulders, which is an important requirement in comprehensive nodal irradiation. Therefore, we investigated the setup and rotational shifts in head and neck cancer patients undergoing IMRT for which this immobilization device had been used together with an IGRT system. The setup and rotational shifts of patients were analyzed using the ExacTrac X-ray 6D IGRT system. The patients were classified as having head and neck tumors in the upper or lower regions. The upper neck nodes included lymph nodal level II while the lower neck nodes included lymph nodal levels III and IV. Clinical data from 227 treatment sessions of 12 head and neck cancer patients were analyzed. The random translational error in inter-and intra-fraction errors of the anterio-posterior (AP) direction might influence the rotational errors of pitch and roll in the upper region. At the same time, the random translational error in the inter-and intra-fraction errors of the AP direction might influence the rotational error of roll in the lower region. We believe that these random translational errors should be considered during treatment. We found variability in random translational errors for different regions in the anatomy of head and neck cancer patients due to rotational shifts. Depending on the location of the primary lesion or the selected nodal treatment targets, these relative positional variations should be considered when setup and rotational shifts are corrected with IGRT systems before treatment.

关键词： IMRT IGRT Radiation Therapy Immobilization Head and Neck Cancer

Method for Converting Cone-Beam CT Values into Hounsfield Units for Radiation Treatment Planning

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2017年第4期6卷 361-375页

作者： Tadanori abe Kunihiko Tateoka Yuichi Saito takuya Nakazawa Masaki Yano Kensei Nakata Masanori Someya Masakazu Hori Koichi Sakata Depertment of Radiation Oncology and Medical Physics Graduate School of Medicine Sapporo Medical University Sapporo Japan Department of Radiology KKR Sapporo Medical Center Sapporo Japan Preparatory Office for Proton Therapy Center Radiation Therapy Research Institute Social Medical Corporation Teishinkai Sapporo Japan Department of Radiology National Hospital Organization Hokkaido Cancer Center Sapporo Japan Department of Radiology Kushiro City General Hospital Kushiro Japan Department of Radiation Oncology School of Medicine Sapporo Medical University Sapporo Japan

Cone-beam CT (CBCT) images acquired during radiation treatment can be used to recalculate the dose distribution as well as to confirm the treatment location. However, it is difficult to obtain the electron densities (EDs) necessary for dose calculation from CBCT images because of the effects of scatter contamination during CBCT image acquisition. This paper presents a mathematical method for converting the pixel values of CBCT images (CBCT values) into Hounsfield units (HUs) of radiation treatment simulation CT (simCT) images for use in radiation treatment planning. CBCT values are converted into HUs by matching the histograms of the CBCT values with the histograms of the HUs for each slice via linear scaling of the CBCT values. For prostate cancer and head-and-neck cancer patients, the EDs obtained from converted CBCT values (mCBCT values) show good agreement with the EDs obtained from HUs, within approximately 3.0%, and the dose calculated on the basis of CBCT images shows good agreement with the dose calculated on the basis of the simCT images, within approximately 2.0%. Because the CBCT values are converted for each slice, this conversion method can account for variation in the CBCT values associated with differences in body size, body shape, and inner tissue structures, as well as in longitudinally displaced positions from the isocenter, unlike conventional methods that use electron density phantoms. This method improves on conventional CBCT-ED conversion and shows considerable potential for improving the accuracy of radiation treatment planning using CBCT images.

关键词： Cone-Beam Computed Tomography Hounsfield Unit Electron Density Ra-diation Treatment Planning