74 results match your criteria: "Japanese Red Cross Society Kyoto Daiichi Hospital[Affiliation]"

Eosinophilic granulomatosis with polyangiitis (EGPA) refers to systemic vasculitis in patients with bronchial asthma and eosinophilic rhinosinusitis. Dupilumab has been approved for the treatment of asthma, eosinophilic rhinosinusitis, and atopic dermatitis. A man in his 50s with a history of asthma and eosinophilic rhinosinusitis with nasal polyposis developed high fever and dyspnea while undergoing dupilumab treatment.

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  • A new compact and cost-effective 3-color LED endoscopic system (ELUXEO-Lite) was evaluated for diagnosing colorectal tumors using magnified blue light imaging (BLI-LED).
  • The study analyzed data from 37 lesions, comparing diagnostic accuracy and image quality between the new LED system and a traditional blue laser imaging (BLI-LASER) system.
  • Results showed that BLI-LED was just as effective as BLI-LASER in characterizing colorectal tumors, with similar diagnostic accuracy and image quality metrics among both experts and non-experts.
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The usefulness of combining the pocket-creation method with a traction device using a scissor-type knife for colorectal endoscopic submucosal dissection.

Indian J Gastroenterol

April 2022

Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.

Article Synopsis
  • The study investigates the impact of combining the pocket-creation method (PCM) with a traction device (S-O clip) and a scissor-type knife (Clutch Cutter) on procedure times for colorectal endoscopic submucosal dissection (ESD).
  • A total of 95 cases using the PCM+SO+CC technique were compared to 103 cases using PCM+CC alone, with results showing that the combined method significantly reduced ESD procedure times.
  • Key findings indicated that shorter ESD times occurred regardless of tumor size, location, morphology, endoscopist experience, and fibrosis severity, highlighting the effectiveness of the combined approach in enhancing procedural efficiency.
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  • A multicenter randomized trial compared the diagnostic effectiveness of 22-gauge standard needles and 22-gauge Franseen needles in EUS-guided tissue acquisition for solid pancreatic lesions.
  • The study included 523 patients, with both needle types showing high technical success rates, but the Franseen needle demonstrated significantly better diagnostic accuracy and sensitivity on the first pass as well as in subsequent passes.
  • The findings suggest that using the Franseen needle not only improves diagnostic outcomes, especially for patients needing immunostaining, but also requires fewer needle passes compared to the standard needle.
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This study evaluated the technical aspects of colorectal endoscopic submucosal dissection (ESD) with the Clutch Cutter (CC) (Fujifilm Co., Tokyo, Japan), a scissor-type knife, and the S-O clip (SO) as a traction clip, and compared the safety and efficacy to ESD using a needle-type knife. This was a single-center retrospective study.

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  • Hemophilia A is a bleeding disorder caused by the lack of coagulation factor VIII, making invasive procedures risky for patients.
  • A 32-year-old man with severe hemophilia A and walled-off necrosis (WON) due to acute pancreatitis successfully underwent a minimally invasive drainage procedure utilizing a new metallic stent, with careful monitoring of his clotting factors.
  • The treatment highlights that EUS-guided drainage can be a safe and effective option for managing WON in patients with severe hemophilia when monitored properly.
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Prognostic risk factors associated with esophageal squamous cell carcinoma patients undergoing endoscopic submucosal dissection: a multi-center cohort study.

Surg Endosc

April 2022

Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kawaramachi Hirokoji Kamigyo-ku, Kyoto, 602-8566, Japan.

Background: Long-term outcomes of endoscopic submucosal dissection (ESD) for esophageal squamous cell carcinoma (ESCC) have not been assessed in a large, multicenter cohort. We aimed to evaluate long-term outcomes of ESD for ESCC in a real-world setting.

Methods: We retrospectively recruited 659 patients who underwent ESD for ESCC at ten institutions from January 2007 to December 2015.

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Objectives: This study aimed to evaluate the pathological features and imaging findings of pancreatic carcinoma in situ (PCIS).

Methods: Twenty patients with PCIS were categorized as flat (F) (n = 6) and low papillary (LP) (n = 14) types.

Results: None of F type and 8 (57%) of 14 with LP type lesions showed intraductal infiltrations of the main pancreatic duct (MPD) greater than 10 mm.

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To acquire reference data for setting an appropriate compressed sensitivity encoding (CS) for brain lesion detectability, the effects of contrast and noise on contrast-enhanced magnetic resonance imaging (MRI) were evaluated. Gadobutrol at various concentrations and manganese chloride tetrahydrate were used as a phantom. Various CS factors (0-10) and denoising levels (weak, medium, and strong) were assessed.

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Most patients with homozygous or compound heterozygous pathogenic ACO2 variants present with muscular hypotonia features, namely, infantile cerebellar-retinal degeneration. Recently, two studies reported rare familial cases of ACO2 variants presenting as complex hereditary spastic paraplegia (HSP) with broad clinical spectra. Here, we report the case of a 20-year-old Japanese woman with complex HSP caused by compound heterozygous ACO2 variants, revealing a new phenotype of episodic visual loss during febrile illness.

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Fibulin-4 is a matricellular protein required for extracellular matrix (ECM) assembly. Mice deficient in fibulin-4 ( ) have disrupted collagen and elastin fibers and die shortly after birth from aortic and diaphragmatic rupture. The function of fibulin-4 in ECM assembly, however, remains elusive.

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We present a patient with Stanford type A aortic dissection with malperfusion of the left kidney and lower extremity, and rupture of a common iliac artery aneurysm. After establishing lower extremity reperfusion using a percutaneous femorofemoral shunt in the emergency room, simultaneous open aortic arch repair and open abdominal aorta repair were performed. Our approach allowed concomitant repair of proximal dissection, limb ischemia, and iliac artery aneurysm rupture, all of which are critical predictors of mortality.

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  • The study focused on using plastic bead bags to achieve uniform total body irradiation (TBI) with dose accuracy within ±10%.
  • A specialized TBI bed and a 10 MV photon beam were employed, with multiple corrections and measurements to ensure treatment precision, including in vivo dosimetry.
  • Results showed that calculated doses correlated well with measured doses, and the treatment planning system (TPS) can provide rough estimations of patient doses during TBI.
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  • The study investigates the effectiveness of magnifying blue laser imaging (M-BLI) in accurately identifying the demarcation line (DL) of gastric tumors before endoscopic submucosal dissection (ESD).
  • Researchers compared results from two groups: one relying solely on M-BLI and the other combining M-BLI with biopsy confirmation, enrolling 96 adenocarcinomas and 32 adenomas.
  • Findings show M-BLI achieved high diagnostic accuracy of 100% for the M-BLI group and 95% for the biopsy group, suggesting that biopsy confirmation may not be necessary when M-BLI clearly indicates the DL of these lesions.
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  • Identifying the depth of invasion (DOI) in superficial esophageal squamous cell carcinoma (SESCC) is essential for deciding if endoscopic resection is needed, with a study comparing the effectiveness of magnifying blue laser imaging (M-BLI) to other imaging techniques.
  • The study analyzed 160 patients who underwent endoscopic submucosal dissection, using three types of imaging: white-light imaging (WLI), M-BLI, and magnifying narrow-band imaging (M-NBI), to evaluate DOI accuracy.
  • Results showed that combined WLI with M-BLI or M-NBI improved diagnostic accuracy significantly compared to WLI alone, indicating both M-BLI and M-NBI can reliably predict DOI in
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Response.

Gastrointest Endosc

July 2020

Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.

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Background: Vonoprazan (VPZ) has the potential to prevent delayed bleeding and promote ulcer healing after endoscopic submucosal dissection (ESD) similar to proton pump inhibitors (PPIs).

Objective: We aimed to evaluate the outcomes of VPZ-treated patients after ESD and compared the efficacy and feasibility in preventing a delayed bleeding and in healing an artificial ulcer after ESD between the VPZ and PPI therapies.

Methods: This was a prospective, observation study in 11 Japanese medical institutions.

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  • - This study analyzed data from Varian C-series linear accelerators to assess the reliability of average beam data as reference points for verifying radiotherapy treatment planning systems.
  • - Researchers collected and averaged data from 20 machines for 4, 6, and 10 MV photon beams, focusing on percent depth dose (PDD), off-center ratio (OCR), and output factor (OPF).
  • - Results showed that dose differences from the average were very small (less than 1.0%), indicating that the average data can generally serve as reliable reference data for most field sizes in commissioning processes, except for small field sizes.
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  • * Eleven TrueBeam systems from nine institutions were analyzed, utilizing a VMAT plan created in Eclipse. Various measurements were conducted, including dose metrics from an ionization chamber and film dosimetry.
  • * The findings revealed a low mean point dose difference (1.0% ± 0.6%) and high gamma pass rates (over 99% for 3%/2 mm criteria), suggesting reliable agreement between measured and calculated doses. This supports using consistent multi-leaf collimator parameters across institutions to enhance radiation treatment uniformity.
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Background And Aim: Mucosal healing is an important clinical goal in patients with inflammatory bowel disease. Recently, short-chain fatty acids (SCFAs) have been reported to have multifaceted effects to host. However, the effects of SCFAs on wound healing in intestinal epithelial cells are unclear.

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The aim of this study is to evaluate the patient positioning uncertainty in noncoplanar stereotactic radiosurgery or stereotactic radiotherapy (SRS/SRT) for intracranial lesions with the frameless 6D ExacTrac system. In all, 28 patients treated with SRS/SRT of 70 treatment plans at our institution were evaluated in this study. Two X-ray images with the frameless 6D ExacTrac system were first acquired to correct (XC) and verify (XV) the patient position at a couch angle of 0º.

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  • Modern treatment machines like the TrueBeam have minimal differences in beam data across units, but lack specific multi-leaf collimator (MLC) parameters like leaf transmission factor (LTF) and dosimetric leaf gap (DLG) in their average data provided by vendors.
  • A survey involving 69 sets of linear accelerator data from 58 institutions explored MLC measurement protocols for intensity-modulated (IMRT) and volumetric modulated radiotherapy (VMAT).
  • Findings reveal that while LTF values showed small variability across units, DLG values varied significantly, with many institutions adjusting DLG upwards and standardizing measurement conditions, ultimately providing median values to improve MLC installation accuracy.
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Purpose: Detector-dependent interinstitutional variations of the beam data may lead to uncertainties of the delivered dose to patients. Here we evaluated the inter-unit variability of the flattened and flattening filter-free (FFF) beam data of multiple TrueBeam (Varian Medical Systems) linear accelerators focusing on the small-field dosimetry.

Methods: The beam data of 6- and 10-MV photon beams with and without flattening filter measured for modeling of an iPLAN treatment planning system (BrainLAB) were collected from 12 institutions - ten HD120 Multileaf Collimator (MLC) and two Millennium120 MLC.

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  • - This study investigates how different types of detectors affect the variability in specific beam parameters for TrueBeam™ linear accelerators across 19 institutions, focusing on metrics like percent depth dose (PDD), off-center ratio (OCR), and output factor (OPF).
  • - Data collected from 24 beam datasets revealed that while ionization chambers (CC13 and PTW31010) generally showed larger penumbra widths and consistent measurements, diode and diamond detectors exhibited significantly smaller penumbra values.
  • - Overall, findings indicated that most beam-specific parameters, excluding penumbra measurements, had minimal inter-institutional variability, showing less than 1% differences, suggesting reliability in these measurements across various detectors, despite some exceptions in
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