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Promoting functional recovery by inhibition of repulsive guidance molecule-a after spinal cord injury

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Neural Regeneration Research 2018年第6期13卷 981-982页

作者： hiroshi Nakagawa Masahiko takada Sobell Department of Motor Neuroscience and Movement Disorders Institute of Neurology University College London Systems Neuroscience Section Primate Research Institute Kyoto University

Spinal cord injury（SCI）leads to permanent disability with motor and sensory *** mature mammalian central nervous system（CNS）possesses a limited capacity to regenerate/regrow after injury.

关键词： Promoting functional recovery by inhibition of repulsive guidance molecule-a after spinal cord injury SCI

Safety and efficacy of carbon dioxide insufflation during gastric endoscopic submucosal dissection

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World Journal of Gastroenterology 2015年第26期21卷 8195-8202页

作者： Jun takada hiroshi Araki Fumito Onogi Takayuki Nakanishi Masaya Kubota Takashi Ibuka Masahito Shimizu Hisataka Moriwaki Department of Gastroenterology Gifu University Graduate School of Medicine

AIM: To compare the safety and efficacy of carbon dioxide(CO2) and air insufflation during gastric endoscopic submucosal dissection(ESD).METHODS: This study involved 116 patients who underwent gastric ESD between January and December *** eliminating 29 patients who fit the exclusion criteria,87 patients,without known pulmonary dysfunction,were randomized into the CO2 insufflation(n = 36) or air insufflation(n = 51) *** ESD was performed with a CO2 regulation unit(constant rate of 1.4 L/min) used for patients undergoing CO2 *** received diazepam for conscious sedation and pentazocine for *** CO2 tension(Ptc CO2) was recorded 15 min before,during,and after ESD with *** CO2,the correlation between Ptc CO2 and procedure time,and ESD-related complications were compared between the two *** blood gases were analyzed after ESD in the first 30 patients(12 with CO2 and 18 with air insufflation) to assess the correlation between arterial blood CO2 partial pressure(Pa CO2) and Ptc ***: There were no differences in respiratoryfunctions,median sedative doses,or median procedure times between the ***,there was no significant difference in post-ESD blood gas parameters,including Pa CO2,between the CO2 and air groups(44.6 mm Hg vs 45 mm Hg).Both groups demonstrated median p H values of 7.36,and none of the patients exhibited *** significant differences were observed between the CO2 and air groups with respect to baseline Ptc CO2(39 mm Hg vs 40 mm Hg),peak Ptc CO2 during ESD(52 mm Hg vs 51 mm Hg),or median Ptc CO2 after ESD(50 mm Hg vs 50 mm Hg).There was a strong correlation between Pa CO2 and Ptc CO2(r = 0.66; P < 0.001).The incidence of Mallory-Weiss tears was significantly lower with CO2 insufflation than with air insufflation(0% vs 15.6%,P = 0.013).CO2 insufflation did not cause any adverse events,such as CO2 narcosis or gas ***: CO2 insufflation durin

关键词： Carbon dioxide Gastric endoscopic submucosaldissection Insufflation Mallory-Weiss tear Randomizedcontrolled trial

Inhibitory effects of carbon dioxide insufflation on pneumoperitoneum and bowel distension after percutaneous endoscopic gastrostomy

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World Journal of Gastroenterology 2012年第27期18卷 3565-3570页

作者： Shinji Nishiwaki hiroshi Araki Motoshi Hayashi Jun takada Masahide Iwashita Atsushi Tagami Hiroo Hatakeyama Takao Hayashi Teruo Maeda Koshiro Saito Department of Internal Medicine Nishimino Kosei HospitalGifu 503-1394Japan Department of Gastroenterology Graduate School of MedicineGifu UniversityGifu 501-1194Japan

AIM:To evaluate the inhibitory effects of carbon dioxide (CO2) insufflation on pneumoperitoneum and bowel distension after percutaneous endoscopic gastrostomy (PEG).METHODS:A total of 73 consecutive patients who were undergoing PEG were enrolled in our *** eliminating 13 patients who fitted our exclusion criteria,60 patients were randomly assigned to either CO2 (30 patients) or air insufflation (30 patients) *** was performed by pull-through technique after threepoint fixation of the gastric wall to the abdominal wall using a gastropexy *** blood gas analysis was performed immediately before and after the *** X-ray was performed at 10 min and at 24 h after PEG to assess the extent of bowel *** computed tomography was performed at 24 h after the procedure to detect the presence of *** outcomes of PEG for 7 d postprocedure were also ***:Among 30 patients each for the air and the CO2 groups,PEG could not be conducted in 2 patients of the CO2 group,thus they were *** of the remaining 58 patients showed that the patients' backgrounds were not significantly different between the two *** elevation values of arterial partial pressure of CO2 in the air group and the CO2 group were 2.67 mmHg and 3.32 mmHg,respectively (P = 0.408).The evaluation of bowel distension on abdominal X ray revealed a significant decrease of small bowel distension in the CO2 group compared to the air group (P < 0.001) at 10 min and 24 h after PEG,whereas there was no significant difference in large bowel distension between the two *** was observed only in the air group but not in the CO2 group (P = 0.003).There were no obvious differences in the laboratory data and clinical outcomes after PEG between the two ***:There was no adverse event associated with CO2 ***2 insufflation is considered to be safer and more comfortable for PEG patients bec

关键词： Percutaneous endoscopic gastrostomy Car-bon dioxide insufflation Pneumoperitoneum Abdomi-nal distension Randomized control study

Predicting Delivery Error Using a DICOM-RT Plan for Volumetric Modulated Arc Therapy

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2014年第2期3卷 82-87页

作者： Hideharu Miura Masao Tanooka Masayuki Fujiwara Yasuhiro takada hiroshi Doi Soichi Odawara Kengo Kosaka Norihiko Kamikonya Shozo Hirota Department of Radiological Technology Hyogo College of Medicine College Hospital Hyogo Mukogawa-cho Nishinomiya City Hyogo Japan Department of Radiology Hyogo College of Medicine 1-1 Mukogawa-cho Nishinomiya City Hyogo Japan

The purpose of this study was to investigate the prediction of mechanical error using DICOM-RT plan parameters for volumetric modulated arc therapy (VMAT). We created plans for gantry rotation arcs of 360° and 180° (full-arc and half-arc VMAT) for six maxillary sinus cancer cases using a Monaco treatment planning system, and delivered the doses with a linear accelerator. We calculated DICOM-RT plan parameters, including gantry, multileaf collimator (MLC) positions and Monitor Units (MU). We compared plans with regard to gantry angle per MU (degrees/MU) and MLC travel per MU (mm/MU) for each segment. Calculated gantry angle/MLC position speeds and errors were evaluated by comparison with the log file. On average, the half-arc VMAT plan resulted in 47% and 35% fewer degrees/MU and mm/MU than the full-arc VMAT plan, respectively. The root mean square (r.m.s.) gantry and MLC speeds showed a linear relationship with calculated degrees/MU and mm/MU, with coefficients of determination (R2) of 0.86 and 0.72, respectively. The r.m.s. gantry angle and MLC position errors showed a linear relationship with calculated degrees/MU and mm/MU with R2 of 0.63 and 0.76, respectively. Deviations from plan parameters were related to mechanical error for VMAT, and provided quantitative information without the need for VMAT delivery. These parameters can be used in the selection of treatment planning.

关键词： Volumetric-Modulated Arc Therapy DICOM-RT Plan Patient-Specific QA Radiotherapy Planning Computer-Assisted

Effectiveness of probiotic therapy for the prevention of relapse in patients with inactive ulcerative colitis

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World Journal of Gastroenterology 2015年第19期21卷 5985-5994页

作者： Yasushi Yoshimatsu Akihiro Yamada Ryuichi Furukawa Koji Sono Aisaku Osamura Kentaro Nakamura hiroshi Aoki Yukiko Tsuda Nobuo Hosoe Nobuo takada Yasuo Suzuki Department of Internal Medicine Faculty of MedicineToho University Toho University Sakura Medical Center

AIM: to evaluate the effectiveness of probiotic therapy for suppressing relapse in patients with inactive ulcerative colitis(UC).METHODS: Bio-Three tablets, each containing 2 mg of lactomin(Streptococcus faecalis T-110), 10 mg of Clostridium butyricum TO-A, and 10 mg of Bacillus mesentericus TO-A, were used as probiotic *** outpatients with UC in remission were randomly assigned to receive 9 Bio-Three tablets/day(BioThree group) or 9 placebo tablets/day(placebo group)for 12 mo in addition to their ongoing *** symptoms were evaluated monthly or on the exacerbation of symptoms or need for additional medication. Fecal samples were collected to analyze bacterial DNA at baseline and 3-mo intervals. Terminal restriction fragment length polymorphism and cluster analyses were done to examine bacterial components of the fecal ***: Forty-six patients, 23 in each group,completed the study, and 14 were excluded. The relapse rates in the Bio-Three and placebo groups were respectively 0.0% vs 17.4% at 3 mo(P = 0.036), 8.7%vs 26.1% at 6 mo(P = 0.119), and 21.7% vs 34.8%(P = 0.326) at 9 mo. At 12 mo, the remission rate was 69.5% in the Bio-Three group and 56.6% in the placebo group(P = 0.248). On cluster analysis of fecal flora, 7 patients belonged to cluster Ⅰ, 32 to cluster Ⅱ,and 7 to cluster Ⅲ.CONCLUSION: Probiotics may be effective formaintaining clinical remission in patients with quiescent UC, especially those who belong to cluster Ⅰ on fecal bacterial analysis.

关键词： Ulcerative colitis Probiotics Inflammatorybowel disease Cluster analysis

Feasibility of Estimating Patient-Specific Dose Verification Results Directly from Linear Accelerator Log Files in Volumetric Modulated Arc Therapy

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2016年第4期5卷 317-328页

作者： Kengo Kosaka Masao Tanooka hiroshi Doi Hiroyuki Inoue Kazuo Tarutani Hitomi Suzuki Yasuhiro takada Masayuki Fujiwara Norihiko Kamikonya Shozo Hirota Department of Radiology Hyogo College of Medicine Nishinomiya Japan Department of Radiological Technology Hyogo College of Medicine College Hospital Nishinomiya Japan

The feasibility of estimating patient-specific dose verification results directly from linear accelerator (linac) log files has been investigated for prostate cancer patients who undergo volumetric modulated arc therapy (VMAT). Twenty-six patients who underwent VMAT in our facility were consecutively selected. VMAT plans were created using Monaco treatment planning system and were transferred to an Elekta linac. During the beam delivery, dynamic machine parameters such as positions of the multi-leaf collimator and the gantry were recorded in the log files;subsequently, root mean square (rms) values of control errors, speeds and accelerations of the above machine parameters were calculated for each delivery. Dose verification was performed for all the plans using a cylindrical phantom with diodes placed in a spiral array. The gamma index pass rates were evaluated under 3%/3 mm and 2%/2 mm criteria with a dose threshold of 10%. Subsequently, the correlation coefficients between the gamma index pass rates and each of the above rms values were calculated. Under the 2%/2 mm criteria, significant negative correlations were found between the gamma index pass rates and the rms gantry angle errors (r = 0.64, p < 0.001) as well as the pass rates and the rms gantry accelerations (r = 0.68, p < 0.001). On the other hand, the rms values of the other dynamic machine parameters did not significantly correlate with the gamma index pass rates. We suggest that the VMAT quality assurance (QA) results can be directly estimated from the log file thereby providing potential to simplify patient-specific prostate VMAT QA procedure.

关键词： Radiotherapy VMAT Log File Patient Specific QA Correlation Gamma Index

DICOM-RT Plan Complexity Verification for Volumetric Modulated Arc Therapy

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2014年第3期3卷 117-124页

作者： Hideharu Miura Masao Tanooka Hiroyuki Inoue Masayuki Fujiwara Kengo Kosaka hiroshi Doi Yasuhiro takada Soichi Odawara Norihiko Kamikonya Shozo Hirota Department of Radiological Technology Hyogo College of Medicine College Hospital Nishinomiya City Japan Department of Radiology Hyogo College of Medicine Nishinomiya City Japan

The purpose of this study was to investigate the relationship between plan parameters verified with DICOM-RT and dosimetric results for volumetric modulated arc therapy (VMAT). We investigated three treatment locations: prostate cancer (ten cases), maxillary sinus cancer (four cases), and malignant pleura mesothelioma (four cases) with treatment plans generated by a MonacoTM treatment planning system (TPS), and delivered with an Elekta SynergyTM linear accelerator. We calculated plan parameters, including gantry and multileaf collimator (MLC) positions, Monitor Units (MU), and millimeters of MLC motion per degree of gantry rotation (mm/degree), and performed quality assurance (QA) with a DICOM-RT plan verification system. We measured the VMAT dose with a two-dimensional diode array detector. The average gamma passing rate with percent dose acceptance criteria and distance to agreement criteria of 2 mm and 2% (2 mm/2%) were 97.4%, 97.8% and 92.0% for prostate cancer, maxillary sinus cancer, and malignant pleural mesothelioma, respectively. The mean 95th percentile value for DICOM-calculated mm/degree was 4.0, 5.2, and 11.1 for prostate cancer, maxillary sinus cancer, and malignant pleural mesothelioma, respectively. The gamma passing rate showed a correlation with calculated mm/degree, with a coefficient of determination (R2) of 0.60. Higher calculated mm/degree values led to increased dosimetric errors. We conclude that dose distribution calculated by a TPS is more reliable at smaller mm/degree.

关键词： Volumetric Modulated Arc Therapy Quality Assurance Radiation Treatment Planning Radiation Dosimetry