A New Technique for Improving Visualization of Mucosal Lesions During Endoscopic Photodynamic Therapy

A new device consisting of a conventional fiberscope and a new TV system (model OTV-S5, Olympus Optical Co., Tokyo, Japan) has been developed to achieve accurate irradiation of laser light in photodynamic therapy for gastric cancer. This model has high resolution and sensitivity, and its signal can be transmitted by red, green and blue. In front of the CCD we inserted a special interference filter which has specific absorption of red light with 2.3% transmissivity at a 630 nm wavelength and a 50 nm absorption band of full width at half maximum. The average transmittance in the visible region, except for at 630 nm, was 90%. A neutral density filter with 16% transmittance was added to adjust to the sensitivity of the CCD. The device makes it possible to perform accurate irradiation, because we can observe both the lesion and the laser spot on a monitor in original colors during irradiation

Safety and Efficacy of Tocilizumab for the Treatment of Rheumatoid Arthritis

Because of the pathological role of IL-6 in rheumatoid arthritis (RA), tocilizumab (TCZ), a humanized anti-IL-6 receptor monoclonal antibody, was expected to improve inflammation and joint destruction of RA. Indeed, randomized clinical trials demonstrated the clinical efficacy of TCZ as monotherapy or combined with methotrexate (MTX) for RA patients with inadequate responses to disease-modifying antirheumatic drugs, MTX or tumor necrosis factor (TNF) inhibitors. Although long-term tolerability for TCZ is superior to that for TNF inhibitors, information regarding the potency of drug free remission of TCZ is limited at present. In terms of its safety profile, the general risk of infection when using TCZ is comparable to that of TNF inhibitors. TCZ has some advantage in RA patients who can not use MTX and are non-responders to TNF inhibitors. In conclusion, TCZ is one of the most prospective next generation biologics for the treatment of RA

Accuracy of computed tomography-magnetic resonance imaging image fusion using a phantom for skull base surgery

13301乙第2109号博士（保健学）金沢大学博士論文要旨Abstract 以下に掲載予定：Journal of Neurosurgical Sciences, Edizioni Minerva Medica. 共著者：Toru Hirano, Katsuhiro Ichikawa, Masahiko Wanibuchi, Takeshi Mikami, Junpei Suzuki, Hiroshi Nagahama, Nobuhiro Mikun

A Lipid Bilayer Formed on a Hydrogel Bead for Single Ion Channel Recordings

Ion channel proteins play important roles in various cell functions, making them attractive drug targets. Artificial lipid bilayer recording is a technique used to measure the ion transport activities of channel proteins with high sensitivity and accuracy. However, the measurement efficiency is low. In order to improve the efficiency, we developed a method that allows us to form bilayers on a hydrogel bead and record channel currents promptly. We tested our system by measuring the activities of various types of channels, including gramicidin, alamethicin, alpha-hemolysin, a voltage-dependent anion channel 1 (VDAC1), a voltage- and calcium-activated large conductance potassium channel (BK channel), and a potassium channel from Streptomyces lividans (KcsA channel). We confirmed the ability for enhanced measurement efficiency and measurement system miniaturizion

Pathology of Avascular Necrosis in the Femoral Head of Spontaneously Hypertensive Rats

Naturally occurring avascular necrosis in the femoral head of SHR, which resembles Perthes\u27 disease in man, was observed histologically. Of 96 epiphyses from 48 SHR, 34 epiphyses from 27 SHR showed a hallmark of necrosis during the period of 10 to 40 weeks after birth. The complete necrosis over the whole epiphyseal nucleus without revascularization was seen at the age of 10 and 15 weeks. Then the necrotic epiphysis was gradually repaired by the invasion of vascularized granulation tissue, and finally the healing of the necrosis was complete before the age of 40 weeks. An investigation into the pathogenesis of the healing infarction seemed that it would be of use in elucidating the cause of Perthes\u27 disease

Minimally Invasive Spinal Stabilization with Denosumab before Total Spondylectomy for a Collapsing Lower Lumbar Spinal Giant Cell Tumor

A 21-year-old man consulted our hospital for treatment of a spinal giant cell tumor (GCT) of Enneking stage III. Lower lumbar-spine tumors and severe spinal canal stenosis are associated with high risk for surgical mor-bidity. Stability was temporarily secured with a percutaneous pedicle screw fixation in combination with deno-sumab, which shrank the tumor. Total en bloc spondylectomy was then performed 6 months after initiation of denosumab, and the patient was followed for 3 years. There was no local recurrence, and bony fusion was obtained. Minimally invasive surgery and denosumab allowed safer and easier treatment of a collapsing lower lumbar extra-compartmental GCT

Automatic evaluation of atlantoaxial subluxation in rheumatoid arthritis by a deep learning model

Background: This work aims to develop a deep learning model, assessing atlantoaxial subluxation (AAS) in rheumatoid arthritis (RA), which can often be ambiguous in clinical practice. Methods: We collected 4691 X-ray images of the cervical spine of the 906 patients with RA. Among these images, 3480 were used for training the deep learning model, 803 were used for validating the model during the training process, and the remaining 408 were used for testing the performance of the trained model. The two-dimensional key points’ detection model of Deep High-Resolution Representation Learning for Human Pose Estimation was adopted as the base convolutional neural network model. The model inferred four coordinates to calculate the atlantodental interval (ADI) and space available for the spinal cord (SAC). Finally, these values were compared with those by clinicians to evaluate the performance of the model. Results: Among the 408 cervical images for testing the performance, the trained model correctly identified the four coordinates in 99.5% of the dataset. The values of ADI and SAC were positively correlated among the model and two clinicians. The sensitivity of AAS diagnosis with ADI or SAC by the model was 0.86 and 0.97 respectively. The specificity of that was 0.57 and 0.5 respectively. Conclusions: We present the development of a deep learning model for the evaluation of cervical lesions of patients with RA. The model was demonstrably shown to be useful for quantitative evaluation.Okita Y., Hirano T., Wang B., et al. Automatic evaluation of atlantoaxial subluxation in rheumatoid arthritis by a deep learning model. Arthritis Research and Therapy 25, 181 (2023); 10.1186/s13075-023-03172-x