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1.
Cell ; 175(1): 266-276.e13, 2018 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-30166209

RESUMO

A fundamental challenge of biology is to understand the vast heterogeneity of cells, particularly how cellular composition, structure, and morphology are linked to cellular physiology. Unfortunately, conventional technologies are limited in uncovering these relations. We present a machine-intelligence technology based on a radically different architecture that realizes real-time image-based intelligent cell sorting at an unprecedented rate. This technology, which we refer to as intelligent image-activated cell sorting, integrates high-throughput cell microscopy, focusing, and sorting on a hybrid software-hardware data-management infrastructure, enabling real-time automated operation for data acquisition, data processing, decision-making, and actuation. We use it to demonstrate real-time sorting of microalgal and blood cells based on intracellular protein localization and cell-cell interaction from large heterogeneous populations for studying photosynthesis and atherothrombosis, respectively. The technology is highly versatile and expected to enable machine-based scientific discovery in biological, pharmaceutical, and medical sciences.


Assuntos
Citometria de Fluxo/métodos , Ensaios de Triagem em Larga Escala/métodos , Processamento de Imagem Assistida por Computador/métodos , Animais , Aprendizado Profundo , Humanos
2.
Osteoporos Int ; 35(4): 645-651, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38108858

RESUMO

We conduct a longitudinal study to examine how new VCF alter spinal sagittal balance. New VCF increased SVA by an average of 2.8 cm. Sagittal balance deteriorates as a VCF develops in the lower lumbar spine. A new fracture below L1 increased the relative risk of a deterioration of sagittal balance 2.9-fold compared to one above Th12. PURPOSE: Studies on the relationship between osteoporotic vertebral fractures and spinal sagittal balance have all been limited to cross-sectional studies. The aim of this study is to conduct a longitudinal study to examine how new vertebral compression fracture (VCF) alter spinal sagittal balance. METHODS: Subjects were patients undergoing periodic examinations after treatment of a vertebral fracture or lumbar spinal canal stenosis. Forty patients who developed a new VCF were included in this study. Full-spine standing radiographs were compared before and after the fracture to examine changes in spinopelvic parameters and factors determining the changes in sagittal balance. RESULTS: The mean age of the patients was 79.0 years. The mean interval between pre- and post-fracture radiographs was 22.7 months, and the mean time between development of a fracture and post-fracture radiographs was 4.6 months. After a fracture, sagittal vertical axis (SVA) increased an average of 2.78 cm and spino-sacral angle (SSA) decreased an average of 5.3°. Both ⊿SVA and ⊿SSA were not related to pre-fracture parameters. The wedge angle of the fractured vertebra was not related to changes in sagittal balance. ⊿SVA increased markedly in patients with a fracture of the lower lumbar vertebrae. receiver operating characteristic analysis revealed that the relative risk of a deterioration of sagittal balance was 2.9 times higher for a new fracture below L1 than for a fracture above Th12. CONCLUSION: New VCF increased SVA by an average of 2.8 cm. Sagittal balance deteriorates as a new fracture develops in the lower lumbar spine. Early intervention in osteoporosis is vital for the elderly.


Assuntos
Doenças Ósseas Metabólicas , Fraturas por Compressão , Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Humanos , Idoso , Fraturas por Compressão/complicações , Fraturas por Compressão/diagnóstico por imagem , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/diagnóstico por imagem , Estudos Longitudinais , Estudos Transversais , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/etiologia , Fraturas por Osteoporose/cirurgia , Vértebras Lombares/lesões , Estudos Retrospectivos
3.
Acta Neurochir (Wien) ; 166(1): 262, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38864938

RESUMO

PURPOSE: Each institution or physician has to decide on an individual basis whether to continue or discontinue antiplatelet (AP) therapy before spinal surgery. The purpose of this study was to determine if perioperative AP continuation is safe during single-level microsurgical decompression (MSD) for treating lumbar spinal stenosis (LSS) and lumbar disc hernia (LDH) without selection bias. METHODS: Patients who underwent single-level MSD for LSS and LDH between April 2018 to December 2022 at our institute were included in this retrospective study. We collected data regarding baseline characteristics, medical history/comorbidities, epidural hematoma (EDH) volume, reoperation for EDH, differences between preoperative and one-day postoperative blood cell counts (ΔRBC), hemoglobin (ΔHGB), and hematocrits (ΔHCT), and perioperative thromboembolic complications. Patients were divided into two groups: the AP continuation group received AP treatment before surgery and the control group did not receive antiplatelet medication before surgery. Propensity scores for receiving AP agents were calculated, with one-to-one matching of estimated propensity scores to adjust for patient baseline characteristics and past histories. Reoperation for EDH, EDH volume, ΔRBC, ΔHGB, ΔHCT, and perioperative thromboembolic complications were compared between the groups. RESULTS: The 303 enrolled patients included 41 patients in the AP continuation group. After propensity score matching, the rate of reoperation for EDH, the EDH volume, ΔRBC, ΔHGB, ΔHCT, and perioperative thromboembolic complication rates were not significantly different between the groups. CONCLUSION: Perioperative AP continuation is safe for single-level lumbar MSD, even without biases.


Assuntos
Descompressão Cirúrgica , Deslocamento do Disco Intervertebral , Vértebras Lombares , Microcirurgia , Inibidores da Agregação Plaquetária , Estenose Espinal , Humanos , Feminino , Masculino , Estenose Espinal/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos , Vértebras Lombares/cirurgia , Idoso , Descompressão Cirúrgica/métodos , Descompressão Cirúrgica/efeitos adversos , Microcirurgia/métodos , Microcirurgia/efeitos adversos , Inibidores da Agregação Plaquetária/uso terapêutico , Inibidores da Agregação Plaquetária/administração & dosagem , Inibidores da Agregação Plaquetária/efeitos adversos , Deslocamento do Disco Intervertebral/cirurgia , Viés de Seleção , Herniorrafia/métodos , Herniorrafia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Resultado do Tratamento , Assistência Perioperatória/métodos
4.
Acta Neurochir (Wien) ; 166(1): 26, 2024 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-38252278

RESUMO

PURPOSE: Patients with lumbar spinal stenosis (LSS) require microsurgical decompression (MSD) surgery; however, MSD is often associated with postoperative instability at the operated level. Paraspinal muscles support the spinal column; lately, paraspinal volume has been used as a good indicator of sarcopenia. This study aimed to determine preoperative radiological factors, including paraspinal muscle volume, associated with postoperative slippage progression after MSD in LSS patients. METHODS: Patients undergoing single-level (L3/4 or L4/5) MSD for symptomatic LSS and followed-up for ≥ 5 years in our institute were reviewed retrospectively to measure preoperative imaging parameters focused on the operated level. Paraspinal muscle volumes (psoas muscle index [PMI] and multifidus muscle index [MFMI]) defined using the total cross-sectional area of each muscle/L3 vertebral body area in the preoperative lumbar axial CT) were calculated. Postoperative slippage in the form of static translation (ST) ≥ 2 mm was assessed on the last follow-up X-ray. RESULTS: We included 95 patients with average age and follow-up periods of 69 ± 8.2 years and 7.51 ± 2.58 years, respectively. PMI and MFMI were significantly correlated with age and significantly larger in male patients. Female sex, preoperative ST, dynamic translation, sagittal rotation angle, facet angle, pelvic incidence, lumbar lordosis, and PMI were correlated with long-term postoperative worsening of ST. However, as per multivariate analysis, no independent factor was associated with postoperative slippage progression. CONCLUSION: Lower preoperative psoas muscle volume in LSS patients is an important predictive factor of postoperative slippage progression at the operated level after MSD. The predictors for postoperative slippage progression are multifactorial; however, a well-structured postoperative exercise regimen involving psoas muscle strengthening may be beneficial in LSS patients after MSD.


Assuntos
Região Lombossacral , Músculos Paraespinais , Animais , Humanos , Feminino , Masculino , Músculos Paraespinais/diagnóstico por imagem , Músculos Paraespinais/cirurgia , Estudos Retrospectivos , Músculos , Descompressão
5.
Appl Opt ; 62(16): 4180-4186, 2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-37706902

RESUMO

In mode-division multiplexing (MDM) optical transmission systems and MDM networks, the gain must be kept nearly constant even when the input signal power of the few-mode (FM), erbium-doped fiber amplifier (EDFA) changes. This paper investigates controllability of the gain in a 4-LP mode EDFA, whose EDF has signal modes of L P 01, L P 11, L P 21, and L P 02 or L P 01, L P 11, L P 21, and L P 31, by using analytical and full models. The results of calculation using the analytical model and a gain simulation using the full model show that the gain can be kept almost constant with an error less than 0.25 dB simply by adjusting the L P 01 pump power of the EDFA with signal modes of L P 01, L P 11, L P 21, and L P 31. This result suggests that it is possible to control the gain simply by adjusting the pump power in FM-EDFAs where all signal modes have a radial mode number of one.

6.
Dig Surg ; 40(3-4): 114-120, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37459840

RESUMO

INTRODUCTION: Splenectomy for proximal gastric cancer was found to offer no survival benefit in a randomized trial clarifying the role of splenectomy (JCOG0110 study). Although many studies have explored risk factors for morbidities following total gastrectomy, none have assessed the risk factors for postoperative complications in spleen-preserving total gastrectomy. METHODS: Using data from 505 patients enrolled in a previous randomized trial, risk factors for postoperative complications were identified by multivariable logistic regression analysis. Then, the risk factors were assessed separately between splenectomy and spleen-preserving total gastrectomy. RESULTS: Postoperative complications were identified in 119 patients (23.6%) and were more common following splenectomy than following spleen-preserving surgery (30.7% and 16.1%, respectively, p < 0.01). Multivariable analysis revealed that age ≥65 years (p = 0.032), body mass index ≥25 (p = 0.003), and blood loss ≥350 (p = 0.019) were independent risk factors for postoperative complications in the entire cohort. Among them, only body mass index was a significant independent risk factor for complications in both spleen preservation (p = 0.047) and splenectomy groups (p = 0.017). CONCLUSION: Risk factors for postoperative complications were essentially the same between splenectomy and spleen preservation. Being overweight increased the risk of postoperative complications.


Assuntos
Esplenectomia , Neoplasias Gástricas , Humanos , Idoso , Esplenectomia/efeitos adversos , Baço/cirurgia , Neoplasias Gástricas/cirurgia , Gastrectomia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Excisão de Linfonodo , Fatores de Risco , Estudos Retrospectivos
7.
Gastric Cancer ; 25(2): 422-429, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34550490

RESUMO

BACKGROUND: Our previous report showed that surgical palliation maintained quality of life (QOL), improved solid food intake, and had an acceptable surgical safety among patients with malignant bowel obstruction (MBO) caused by advanced gastric cancer. This study performed a survival analysis stratified by the patients' QOL to elucidate its impact on survival. METHODS: Patients who underwent resection or bypass of the small intestine/colon or ileostomy/colostomy for bowel obstruction caused by peritoneal dissemination of gastric cancer were included. Validated instruments (EuroQoL-5 Dimensions) were used to assess QOL at baseline and 2 weeks, 1 month, and 3 months following surgical palliation. Postoperative improvement in oral intake was also evaluated using the Gastric Outlet Obstruction Scoring System (GOOSS). Univariate and multivariate survival analyses were performed using baseline characteristics and changes in QOL and GOOSS scores 2 weeks after surgery to determine prognostic factors. RESULTS: We enrolled 60 patients with a median survival time of 6.64 (95% CI 4.76-10.28) months. Patients who received postoperative chemotherapy and had lower baseline C-reactive protein (CRP) levels, higher baseline albumin levels, better baseline EuroQoL-5 Dimensions (EQ-5D) scores, and improved oral intake after palliative surgery exhibited significantly better survival. Multivariate analysis identified postoperative chemotherapy, lower baseline CRP levels, and improved oral intake as independent prognostic factors. CONCLUSIONS: The current study revealed that baseline QOL and postoperative QOL changes did not affect survival. Moreover, improved oral intake, lower baseline CRP levels, and postoperative chemotherapy were significant prognostic factors in patients who underwent palliative surgery for advanced gastric cancer with MBO.


Assuntos
Obstrução da Saída Gástrica , Neoplasias Gástricas , Obstrução da Saída Gástrica/etiologia , Humanos , Cuidados Paliativos/métodos , Estudos Prospectivos , Qualidade de Vida , Estudos Retrospectivos , Neoplasias Gástricas/complicações , Neoplasias Gástricas/cirurgia , Análise de Sobrevida
8.
Appl Opt ; 61(10): 2750-2756, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35471347

RESUMO

Fringe projection profilometry is a high-precision method used to measure the 3D shape of an object by projecting sinusoidal fringes onto an object. However, fringes projected onto a metallic or shiny object are distorted nonlinearly, which causes significant measurement errors. A high-precision measurement method for shiny objects that employs computer graphics (CG) and deep learning is proposed. We trained a deep neural network by projecting fringes on a shiny object in CG space. Our results show that the method can reduce the nonlinear fringe distortion caused by gloss in real space.

9.
Gastric Cancer ; 24(2): 492-502, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33200303

RESUMO

BACKGROUND: Specific treatment strategies are sorely needed for scirrhous-type gastric cancer still, which has poor prognosis. Based on the promising results of our previous phase II study (JCOG0210), we initiated a phase III study to confirm the efficacy of neoadjuvant chemotherapy (NAC) in type 4 or large type 3 gastric cancer. METHODS: Patients aged 20-75 years without a macroscopic unresectable factor as confirmed via staging laparoscopy were randomly assigned to surgery followed by adjuvant chemotherapy with S-1 (Arm A) or NAC (S-1plus cisplatin) followed by D2 gastrectomy plus adjuvant chemotherapy with S-1 (Arm B). The primary endpoint was overall survival (OS). RESULTS: Between October 2005 and July 2013, 316 patients were enrolled, allocating 158 patients to each arm. In Arm B, in which NAC was completed in 88% of patients. Significant downstaging based on tumor depth, lymph node metastasis, and peritoneal cytology was observed using NAC. Excluding the initial 16 patients randomized before the first revision of the protocol, 149 and 151 patients in arms A and B, respectively, were included in the primary analysis. The 3-year OS rates were 62.4% [95% confidence interval (CI) 54.1-69.6] in Arm A and 60.9% (95% CI 52.7-68.2) in Arm B. The hazard ratio of Arm B against Arm A was 0.916 (95% CI 0.679-1.236). CONCLUSIONS: For type 4 or large type 3 gastric cancer, NAC with S-1 plus cisplatin failed to demonstrate a survival benefit. D2 surgery followed by adjuvant chemotherapy remains the standard treatment.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Cisplatino/administração & dosagem , Gastrectomia/mortalidade , Terapia Neoadjuvante/mortalidade , Neoplasias Gástricas/terapia , Adulto , Idoso , Quimioterapia Adjuvante/métodos , Quimioterapia Adjuvante/mortalidade , Combinação de Medicamentos , Feminino , Gastrectomia/métodos , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante/métodos , Estadiamento de Neoplasias , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Taxa de Sobrevida , Resultado do Tratamento , Adulto Jovem
10.
Gastric Cancer ; 24(5): 1131-1139, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33791885

RESUMO

BACKGROUND: Patients with peritoneal dissemination of gastric cancer have poor oral intake caused by malignant bowel obstruction (MBO). Palliative surgery has often been undertaken to improve quality of life (QOL), but few prospective studies on palliative surgery in this patient population have been published. PATIENTS AND METHODS: We prospectively investigated the significance of palliative surgery using patient-reported QOL measures. Patients underwent palliative surgery by small intestine/colon resection or small intestine/colon bypass or ileostomy/colostomy for MBO. The primary endpoint was change in QOL assessed at baseline, 14 days, 1 month, and 3 months following palliative surgery using the Euro QoL Five Dimensions (EQ-5D™) questionnaire and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire gastric cancer module (QLQ-STO22). Secondary endpoints were postoperative improvement in oral intake and surgical complications. RESULTS: Between April 2013 and March 2018, 63 patients were enrolled from 14 institutions. The mean EQ-5D™ utility index baseline score of 0.6 remained consistent. Gastric-specific symptoms mostly showed statistically significant improvement from baseline. Forty-two patients (67%) were able to eat solid food 2 weeks after palliative surgery and 36 patients (57%) tolerated it for 3 months. The rate of overall morbidity of ≥ grade III according to the Clavien-Dindo classification was 16% (10 patients) and the 30-day postoperative mortality rate was 3.2% (2 patients). CONCLUSIONS: In patients with MBO caused by peritoneal dissemination of gastric cancer, palliative surgery did not improve QOL while improving solid food intake, with an acceptable postoperative morbidity and mortality rate.


Assuntos
Qualidade de Vida , Neoplasias Gástricas , Humanos , Cuidados Paliativos , Estudos Prospectivos , Estudos Retrospectivos , Neoplasias Gástricas/complicações , Neoplasias Gástricas/cirurgia
11.
Appl Opt ; 60(30): 9419-9424, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34807081

RESUMO

We have proposed a broadband hybrid light source that combines a super luminescent diode (SLD) and thulium-doped fiber amplifier (TDFA) and operates in the 1.8 µm band. This light source can improve the characteristics of the output spectrum by amplifying the output light of the SLD with TDFA. In this study, we investigate the dependence of the output spectral characteristics of the hybrid broadband light source on the thulium-doped fiber (TDF) length used in the TDFA as well as the output spectra of three newly developed SLDs of 1660, 1690, and 1730 nm bands. In the evaluation of the output bandwidth, there are various definitions of output bandwidth, but we adopted the bandwidth with power density of over -40dBm/0.1nm. This is because it is possible to evaluate in this band with a dynamic range of "30 dB/0.1 nm" by using a general optical spectrum analyzer. The hybrid light source achieves the bandwidth of 332 nm, from 1579 to 1911 nm, and a high total output power of over 15 dBm. The maximum ripple was less than ∼0.1dB, which is similar to the maximum value of that of the SLD, without any deterioration in the ripple characteristics owing to the hybrid configuration of the SLD and TDFA.

12.
Bioinformatics ; 35(14): i427-i435, 2019 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-31510671

RESUMO

MOTIVATION: Finding non-linear relationships between biomolecules and a biological outcome is computationally expensive and statistically challenging. Existing methods have important drawbacks, including among others lack of parsimony, non-convexity and computational overhead. Here we propose block HSIC Lasso, a non-linear feature selector that does not present the previous drawbacks. RESULTS: We compare block HSIC Lasso to other state-of-the-art feature selection techniques in both synthetic and real data, including experiments over three common types of genomic data: gene-expression microarrays, single-cell RNA sequencing and genome-wide association studies. In all cases, we observe that features selected by block HSIC Lasso retain more information about the underlying biology than those selected by other techniques. As a proof of concept, we applied block HSIC Lasso to a single-cell RNA sequencing experiment on mouse hippocampus. We discovered that many genes linked in the past to brain development and function are involved in the biological differences between the types of neurons. AVAILABILITY AND IMPLEMENTATION: Block HSIC Lasso is implemented in the Python 2/3 package pyHSICLasso, available on PyPI. Source code is available on GitHub (https://github.com/riken-aip/pyHSICLasso). SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.


Assuntos
Biomarcadores , Estudo de Associação Genômica Ampla , Software , Animais , Genoma , Genômica , Camundongos
13.
Neural Comput ; 32(2): 447-484, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31835002

RESUMO

Recently, a set of tensor norms known as coupled norms has been proposed as a convex solution to coupled tensor completion. Coupled norms have been designed by combining low-rank inducing tensor norms with the matrix trace norm. Though coupled norms have shown good performances, they have two major limitations: they do not have a method to control the regularization of coupled modes and uncoupled modes, and they are not optimal for couplings among higher-order tensors. In this letter, we propose a method that scales the regularization of coupled components against uncoupled components to properly induce the low-rankness on the coupled mode. We also propose coupled norms for higher-order tensors by combining the square norm to coupled norms. Using the excess risk-bound analysis, we demonstrate that our proposed methods lead to lower risk bounds compared to existing coupled norms. We demonstrate the robustness of our methods through simulation and real-data experiments.

14.
Gastric Cancer ; 23(2): 293-299, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31515693

RESUMO

BACKGROUND: Preoperative chemotherapy with cisplatin plus S-1 (CS) followed by gastrectomy with D2 plus para-aortic lymph node (PAN) dissection is regarded as a standard treatment in Japan for advanced gastric cancer with bulky lymph node (BN) and/or PAN metastasis. In the JCOG1002, we added docetaxel to CS (DCS) to further improve long-term outcomes. However, the primary endpoint, clinical response rate (RR), did not reach the expected level (Ito et al. in Gastric Cancer 20:322-31, 2017). Herein, we report our long-term survival results. METHODS: Patients with BN and/or PAN metastasis received 2 or 3 cycles of DCS therapy (docetaxel at 40 mg/m2 and cisplatin at 60 mg/m2 on day 1 and S-1 at 80 mg/m2 per day for 2 weeks, followed by a 2-week rest) followed by gastrectomy with D2 plus PAN dissection and postoperative S-1 for 1 year. RESULTS: Between July 2011 and May 2013, 53 patients were enrolled. Clinically, 17.0% had both PAN and BN metastasis, and the rest had either PAN (26.4%) or BN (56.6%) metastasis. Among all eligible patients, the 5-year overall survival was 54.9% (95% confidence interval 40.3-67.3%) at the last follow-up in May 2018. Among 44 eligible patients with R0 resection, the 5-year relapse-free survival was 47.7% (95% confidence interval 32.5-61.5%). CONCLUSIONS: Adding docetaxel to CS in preoperative chemotherapy for extensive nodal metastasis improved neither short-term outcomes nor long-term survival. Preoperative chemotherapy with CS followed by D2 + PAN dissection and postoperative S-1 remains the standard of care for patients with extensive nodal metastasis.


Assuntos
Adenocarcinoma/mortalidade , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cuidados Pré-Operatórios , Neoplasias Gástricas/mortalidade , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/secundário , Adulto , Idoso , Cisplatino/administração & dosagem , Docetaxel/administração & dosagem , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Japão , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Ácido Oxônico/administração & dosagem , Prognóstico , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia , Taxa de Sobrevida , Tegafur/administração & dosagem , Adulto Jovem
15.
No Shinkei Geka ; 48(4): 323-328, 2020 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-32312933

RESUMO

Lumbar foraminal schwannomas occasionally present as giant lesions in the retroperitoneal cavity. Here, we report a case of a L5 giant foraminal schwannoma that was laparoscopically excised. A 26-year-old man visited our hospital with the complaint of numbness of the left leg that had persisted for 2 years. Magnetic resonance imaging scans revealed a dumbbell tumor originating from the left L5/L6 intervertebral foramen. The tumor mass in the retroperitoneum extended to 6 cm and was buried in the iliopsoas, pressing superiorly on the L4 nerve root. During the surgical procedure, the ventral portion of the tumor was first excised outside the intervertebral foramen, using the anterior approach to laparoscopically enter the retroperitoneum. Postoperatively, the left leg pain disappeared. The residual tumor in the posterior portion was resected microsurgically with the Wiltse paraspinal approach. The tumor was a schwannoma originating from the dorsal ramus of the L5 nerve root. Postoperatively, the patient resumed ambulation and was discharged with no exacerbation of the neurological symptoms.


Assuntos
Laparoscopia , Neurilemoma/cirurgia , Adulto , Humanos , Vértebras Lombares , Região Lombossacral , Imageamento por Ressonância Magnética , Masculino
16.
Gastric Cancer ; 22(5): 1044-1052, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30827001

RESUMO

BACKGROUND: The prognosis of patients with linitis plastica (type 4) and large (≥ 8 cm) ulcero-invasive-type (type 3) gastric cancer is extremely poor, even after extended surgery and adjuvant chemotherapy. Given the promising results of our previous phase II study evaluating neoadjuvant chemotherapy (NAC) with S-1 plus cisplatin (JCOG0210), we performed a phase III study to confirm the efficacy of NAC in these patients, with the safety and surgical results are presented here. METHODS: Eligible patients were randomized to gastrectomy plus adjuvant chemotherapy with S-1 (Arm A) or NAC followed by gastrectomy + adjuvant chemotherapy (Arm B). The primary endpoint was the overall survival (OS). This trial is registered at the UMIN Clinical Trials Registry as C000000279. RESULTS: From February 2007 to July 2013, 300 patients were randomized (Arm A 149, Arm B 151). NAC was completed in 133 patients (88%). Major grade 3/4 adverse events during NAC were neutropenia (29.3%), nausea (5.4%), diarrhea (4.8%), and fatigue (2.7%). Gastrectomy was performed in 147 patients (99%) in Arm A and 139 patients (92%) in Arm B. The operation time was significantly shorter in Arm B than in Arm A (median 255 vs. 240 min, respectively; p = 0.024). There were no significant differences in Grade 2-4 morbidity and mortality (25.2% and 1.3% in Arm A and 15.8% and 0.7% in Arm B, respectively). CONCLUSIONS: NAC for type 4 and large type 3 gastric cancer followed by D2 gastrectomy can be safely performed without increasing the morbidity or mortality.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Gastrectomia/mortalidade , Terapia Neoadjuvante/mortalidade , Neoplasias Peritoneais/terapia , Neoplasias Gástricas/terapia , Adulto , Idoso , Cisplatino/administração & dosagem , Terapia Combinada , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Ácido Oxônico/administração & dosagem , Neoplasias Peritoneais/secundário , Neoplasias Gástricas/patologia , Taxa de Sobrevida , Tegafur/administração & dosagem , Adulto Jovem
17.
Appl Opt ; 58(9): 2366-2371, 2019 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-31044941

RESUMO

Optical fiber sensors have numerous advantages over electrical sensors. However, in some cases, sensing systems based on optical fiber sensors are inferior to electrical sensors in terms of cost because expensive instruments are required. Therefore, cost-effective options must be developed. Here, inexpensive optical transceivers (OTRs) for Ethernet were used instead of a broadband light source and optical spectrum analyzer, and a CO2 laser-induced long-period fiber grating (LPFG) was used as a temperature sensor. The sensing system was implemented introducing OTRs and LPFG in an experimental internet protocol (IP) over Ethernet. The results showed that a low-cost sensing system can estimate the ambient temperature of the LPFG based on the no-reply rate for the internet control message protocol echo request. Regarding the sensing performance, the measurable range was ∼100°C with ±4.5°C errors.

18.
Environ Health Prev Med ; 24(1): 10, 2019 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-30732577

RESUMO

BACKGROUND: Although fat accumulation in human organs is associated with a variety of diseases, there is little evidence about the effect of a fatty pancreas on the development of subclinical chronic pancreatitis over the clinical course. METHODS: We conducted a prospective cohort study from 2008 to 2014 of patients who underwent a medical checkup consultation for fat accumulated in the pancreas. Patients included in the analysis were divided into a non-fatty pancreas group (n = 9710) and fatty pancreas group (n = 223). The primary end point was the odds ratio (OR) for chronic pancreatitis associated with fatty pancreas, which was diagnosed using ultrasonography. We used a multiple logistic regression model to estimate the OR and the corresponding 95% confidence interval (CI). RESULTS: Ninety-two people were diagnosed with chronic pancreatitis, including both presumptive and definitive diagnoses. Twelve people were diagnosed with chronic pancreatitis by ultrasonography among the 223 patients with fatty pancreas, and 80 patients among 9710 were diagnosed with non-fatty pancreas. The crude OR was 6.85 (95% CI 3.68, 12.75), and the multiple adjusted OR was 3.96 (95% CI 2.04, 7.66). CONCLUSIONS: Fat accumulation in the pancreas could be a risk factor for developing subclinical chronic pancreatitis.


Assuntos
Tecido Adiposo/patologia , Pancreatite Crônica/epidemiologia , Pancreatite Crônica/etiologia , Tecido Adiposo/diagnóstico por imagem , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Feminino , Humanos , Japão/epidemiologia , Estilo de Vida , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pâncreas/diagnóstico por imagem , Pâncreas/patologia , Pancreatite Crônica/diagnóstico , Exame Físico , Estudos Prospectivos , Fatores de Risco , Fumar/epidemiologia
19.
Biochem Biophys Res Commun ; 506(4): 962-969, 2018 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-30401562

RESUMO

(Aim) Bacterial infection underlies the pathogenesis of many human diseases, including acute and chronic inflammation. Here, we investigated a possible role for bacterial infection in the progression of chronic pancreatitis. (Materials and Methods) Pancreatic juice was obtained from patients with pancreatic cancer (n = 20) or duodenal cancer/bile duct cancer (n = 16) and subjected to PCR using universal primers for the bacterial 16S ribosomal RNA gene. Bacterial species were identified by PCR using bile samples from four pancreatic cancer patients. PCR products were subcloned into T-vectors, and the sequences were then analyzed. Immunohistochemical and serologic analyses for Enterococcus faecalis infection were performed on a large cohort of healthy volunteers and patients with chronic pancreatitis or pancreatic cancer and on mice with caerulein-induced chronic pancreatitis. The effect of E. faecalis antigens on cytokine secretion by pancreatic cancer cells was also investigated. (Results) We found that 29 of 36 pancreatic juice samples were positive for bacterial DNA. Enterococcus and Enterobacter species were detected primarily in bile, which is thought to be a pathway for bacterial infection of the pancreas. Enterococcus faecalis was also detected in pancreatic tissue from chronic pancreatitis and pancreatic cancer patients; antibodies to E. faecalis capsular polysaccharide were elevated in serum from chronic pancreatitis patients. Enterococcus-specific antibodies and pancreatic tissue-associated E. faecalis were detected in mice with caerulein-induced chronic pancreatitis. Addition of Enterococcus lipoteichoic acid and heat-killed bacteria induced expression of pro-fibrotic cytokines by pancreatic cancer cells in vitro. (Conclusion) Infection with E. faecalis may be involved in chronic pancreatitis progression, ultimately leading to development of pancreatic cancer.


Assuntos
Infecções Bacterianas/microbiologia , Enterococcus/fisiologia , Neoplasias Pancreáticas/microbiologia , Pancreatite Crônica/microbiologia , Adenocarcinoma/genética , Adenocarcinoma/patologia , Animais , Anticorpos Antibacterianos/sangue , Modelos Animais de Doenças , Enterococcus/efeitos dos fármacos , Enterococcus/genética , Enterococcus/imunologia , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Temperatura Alta , Humanos , Interleucina-8/genética , Interleucina-8/metabolismo , Lipopolissacarídeos/farmacologia , Masculino , Pessoa de Meia-Idade , Suco Pancreático/microbiologia , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/genética , Pancreatite Crônica/sangue , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , RNA Ribossômico 16S/genética , Ácidos Teicoicos/farmacologia , Fator A de Crescimento do Endotélio Vascular/genética , Fator A de Crescimento do Endotélio Vascular/metabolismo
20.
Neural Comput ; 30(11): 3095-3127, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30148706

RESUMO

We propose a set of convex low-rank inducing norms for coupled matrices and tensors (hereafter referred to as coupled tensors), in which information is shared between the matrices and tensors through common modes. More specifically, we first propose a mixture of the overlapped trace norm and the latent norms with the matrix trace norm, and then, propose a completion model regularized using these norms to impute coupled tensors. A key advantage of the proposed norms is that they are convex and can be used to find a globally optimal solution, whereas existing methods for coupled learning are nonconvex. We also analyze the excess risk bounds of the completion model regularized using our proposed norms and show that they can exploit the low-rankness of coupled tensors, leading to better bounds compared to those obtained using uncoupled norms. Through synthetic and real-data experiments, we show that the proposed completion model compares favorably with existing ones.

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