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      • KCI등재

        Status of a Carbon-Ion Therapy Facility and Development for Advanced Treatment

        Atsushi Kitagawa,Takashi Fujita,Akifumi Fukumura,Takuji Furukawa,Taku Inaniwa,Yoshiyuki Iwata,Tatsuaki Kanai,Mitsutaka Kanazawa,Nobuyuki Kanematsu,Yuki Kase,Masataka Komori,Koji Noda,Yumiko Ohno,Shinj 한국물리학회 2008 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.53 No.6

        Over 3000 cancer patients have already been treated with 140- to 400-MeV/n carbon beams produced by the heavy ion medical accelerator in Chiba (HIMAC) at the National Institute of Radiological Sciences (NIRS) since 1994. These clinical results have clearly verified the advantages of carbon ions. Based on our experience at HIMAC, a hospital-specific facility optimized for carbon-ion therapy has been designed. The prototype developments of an electron cyclotron resonance (ECR) ion source, a radio frequency quadruple (RFQ) linac, an inter digital H (IH) linac, an acceleration system of synchrotron, a beam-delivery system and other key-technology parts have been successfully finished. Thus, in co-operation with NIRS, Gunma University has been constructing a carbon-therapy facility since April, 2006. If the present clinical results are to be improved, it is necessary to create a more accurate dose distribution on tumors without an undesired dose being deposited in normal tissue. Beam-scanning methods with respiration-gated irradiation are especially important to treat a cancer tumor located in the trunk of a patient. Over 3000 cancer patients have already been treated with 140- to 400-MeV/n carbon beams produced by the heavy ion medical accelerator in Chiba (HIMAC) at the National Institute of Radiological Sciences (NIRS) since 1994. These clinical results have clearly verified the advantages of carbon ions. Based on our experience at HIMAC, a hospital-specific facility optimized for carbon-ion therapy has been designed. The prototype developments of an electron cyclotron resonance (ECR) ion source, a radio frequency quadruple (RFQ) linac, an inter digital H (IH) linac, an acceleration system of synchrotron, a beam-delivery system and other key-technology parts have been successfully finished. Thus, in co-operation with NIRS, Gunma University has been constructing a carbon-therapy facility since April, 2006. If the present clinical results are to be improved, it is necessary to create a more accurate dose distribution on tumors without an undesired dose being deposited in normal tissue. Beam-scanning methods with respiration-gated irradiation are especially important to treat a cancer tumor located in the trunk of a patient.

      • Sound Quality Improvement by Embedding Position Grouping for Audio Watermarking Method Using Smearing Transformation

        Akio Ogihara,Takashi Iwamoto,Motoi Iwata,Akira Shiozaki 대한전자공학회 2008 ITC-CSCC :International Technical Conference on Ci Vol.2008 No.7

        The objective of this work is to improve the sound quality of the audio watermarking method using smearing transformation. In this paper, we propose “Embedding Position Grouping” to improve the sound quality of watermarked audio.

      • KCI등재

        Evaluation of CD4+ cells infiltration as a prognostic factor in cervical intraepithelial neoplasia 2

        Guanliang Chen,Takashi Iwata,Masaki Sugawara,Hiroshi Nishio,Yuki Katoh,Iwao Kukimoto,Daisuke Aoki 대한부인종양학회 2023 Journal of Gynecologic Oncology Vol.34 No.1

        Objective: To identify candidate predictors for the prognosis of cervical intraepithelial neoplasia 2 (CIN2) lesions and evaluate the prognostic value of the local immune response. Methods: One hundred fifteen CIN2 patients were enrolled. The percentage of p16-, minichromosome maintenance complex component 2- or apolipoprotein B mRNA editing enzyme catalytic subunit 3G (APOBEC3G)-positive cells was determined immunohistochemically. Tumor-infiltrating lymphocytes (TILs) in intertumoral lesions were scored using an automated system. CIN3 disease progression and regression rates were estimated by the Kaplan–Meier method. A case-control study was conducted to screen CIN2 prognostic factors in 10 regression and 10 progression patients. Selected factors were examined in a cohort study to determine their prognostic value for CIN2. Results: Among all participants, the cumulative progression and regression rates at 60 months were 0.477 and 0.510, respectively. In the case-control study, p16- and APOBEC3G-positive cells were higher in the progression group (p=0.043, p=0.023). Additionally, CD4+ cell infiltration was enhanced in the regression group (p=0.023). The cohort study revealed a significantly increased progression rate in patients with elevated p16-positive cells (p<0.001), and increased CD4+ TIL infiltration was associated with better regression (p=0.011). Kaplan–Meier analysis according to human papillomavirus (HPV) positivity revealed a greater CIN3 development risk in HPV16-positive patients than in HPV16-negative cases. Finally, multivariate analysis identified HPV16 infection and CD4+ TIL infiltration as independent prognostic factors in CIN2 regression. Conclusion: CD4+ TIL infiltration in intertumoral lesions was related with CIN2 regression. Our findings suggest CD4+ TIL infiltration may be useful for the triage of CIN2 patients.

      • KCI등재

        Tumor volume and lymphovascular space invasion as a prognostic factor in early invasive adenocarcinoma of the cervix

        Isao Murakami,Takuma Fujii,Kaori Kameyama,Takashi Iwata,Miyuki Saito,Kaneyuki Kubushiro,Daisuke Aoki 대한부인종양학회 2012 Journal of Gynecologic Oncology Vol.23 No.3

        Objective: The aim of this study was to investigate the risk and recurrence of early invasive adenocarcinoma of the cervix, and to determine whether non-radical methods of management could be performed. Methods: The medical and histopathological records of 50 patients with early invasive adenocarcinoma of the cervix treated at Keio University Hospital between 1993 and 2005 were reviewed, and compared with the literature. Results: The median follow-up period was 64.3 months. The depth of stromal invasion was ≤3 mm in 33 cases and >3 mm, but ≤5 mm in 17 cases. The horizontal spread was ≤7 mm in 25 cases and >7 mm in 25 cases. One of the 33 cases that had tumor volumes of ≤500 mm^3, and three of the 17 cases with tumor volumes of >500 mm^3 were positive for lymph node metastasis. When our data were combined with previously reported results, statistically significant differences were observed between the tumor volume and the frequency of pelvic lymph node metastasis/the rate of recurrence (p<0.0001). The frequency of pelvic lymph node metastases was significantly higher in the lymphovascular space invasion (LVSI)-positive group than in the LVSI-negative group (p=0.02). No adnexal metastasis or parametrial involvement was noted. Conclusion: Assessment of the depth of stromal invasion, tumor volume, and LVSI is critical for selecting an appropriate therapeutic modality. Non-radical methods of management are considered suitable for patients with LVSI-negative adenocarcinoma of the cervix exhibiting a stromal invasion depth of ≤5 mm and a tumor volume of ≤500 mm^3. Objective: The aim of this study was to investigate the risk and recurrence of early invasive adenocarcinoma of the cervix, and to determine whether non-radical methods of management could be performed. Methods: The medical and histopathological records of 50 patients with early invasive adenocarcinoma of the cervix treated at Keio University Hospital between 1993 and 2005 were reviewed, and compared with the literature. Results: The median follow-up period was 64.3 months. The depth of stromal invasion was ≤3 mm in 33 cases and >3 mm, but ≤5 mm in 17 cases. The horizontal spread was ≤7 mm in 25 cases and >7 mm in 25 cases. One of the 33 cases that had tumor volumes of ≤500 mm^3, and three of the 17 cases with tumor volumes of >500 mm^3 were positive for lymph node metastasis. When our data were combined with previously reported results, statistically significant differences were observed between the tumor volume and the frequency of pelvic lymph node metastasis/the rate of recurrence (p<0.0001). The frequency of pelvic lymph node metastases was significantly higher in the lymphovascular space invasion (LVSI)-positive group than in the LVSI-negative group (p=0.02). No adnexal metastasis or parametrial involvement was noted. Conclusion: Assessment of the depth of stromal invasion, tumor volume, and LVSI is critical for selecting an appropriate therapeutic modality. Non-radical methods of management are considered suitable for patients with LVSI-negative adenocarcinoma of the cervix exhibiting a stromal invasion depth of ≤5 mm and a tumor volume of ≤500 mm^3.

      • KCI등재

        Satisfaction Survey on Antipsychotic Formulations by Schizophrenia Patients in Japan

        Masakazu Hatano,Ippei Takeuchi,Kanade Yamashita,Aoi Morita,Kaori Tozawa,Takashi Sakakibara,Genta Hajitsu,Manako Hanya,Shigeki Yamada,Nakao Iwata,Hiroyuki Kamei 대한정신약물학회 2021 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.19 No.4

        Objective: To identify factors affecting adherence to medication, a subjective questionnaire survey was administered to schizophrenia patients regarding the prescribed antipsychotic formulations. Methods: We evaluated the patients’ satisfaction and dissatisfaction with prescribed antipsychotic formulations, and patients answered the Drug Attitude Inventory-10 Questionnaire (DAI-10). Inclusion criteria for patients are as follows: age between 20 and 75 years and taking antipsychotic agents containing the same ingredients and formulations, for at least 1 month. Results: In total, 301 patients answered the questionnaire survey. Tablets were found to be the most commonly used antipsychotic formulations among schizophrenia patients (n = 174, 57.8%), followed by long-acting injections (LAIs, n = 93, 30.9%). No significant differences in the formulation satisfaction level and DAI-10 scores were observed between all formulations. Formulations, except for LAI, were selected by physicians in more than half of the patients. Patients who answered “Decided by consultation with physicians” had significantly higher satisfaction levels and DAI-10 scores compared to those who answered “Decided by physicians” (4.11 ± 0.77 vs. 3.80 ± 1.00, p = 0.0073 and 6.20 ± 3.51 vs. 4.39 ± 4.56, p < 0.001, respectively). Satisfaction levels moderately correlated with DAI-10 scores (r = 0.48, p < 0.001). Conclusion: No formulation had a high satisfaction level in all patients, and it is important to be reflect the patients’ individual preferences in pharmacotherapy. Shared decision-making in the selection of the formulations is seen to be useful for improving medication adherence.

      • KCI등재

        Development of a prognostic prediction support system for cervical intraepithelial neoplasia using artificial intelligence-based diagnosis

        Takayuki Takahashi,Hikaru Matsuoka,Rieko Sakurai,Jun Akatsuka,Yusuke Kobayashi,Masaru Nakamura,Takashi Iwata,Kouji Banno,Motomichi Matsuzaki,Jun Takayama,Daisuke Aoki,Yoichiro Yamamoto,Gen Tamiya 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.5

        Objective: Human papillomavirus subtypes are predictive indicators of cervical intraepithelial neoplasia (CIN) progression. While colposcopy is also an essential part of cervical cancer prevention, its accuracy and reproducibility are limited because of subjective evaluation. This study aimed to develop an artificial intelligence (AI) algorithm that can accurately detect the optimal lesion associated with prognosis using colposcopic images of CIN2 patients by utilizing objective AI diagnosis. Methods: We identified colposcopic findings associated with the prognosis of patients with CIN2. We developed a convolutional neural network that can automatically detect the rate of high-grade lesions in the uterovaginal area in 12 segments. We finally evaluated the detection accuracy of our AI algorithm compared with the scores by multiple gynecologic oncologists. Results: High-grade lesion occupancy in the uterovaginal area detected by senior colposcopists was significantly correlated with the prognosis of patients with CIN2. The detection rate for high-grade lesions in 12 segments of the uterovaginal area by the AI system was 62.1% for recall, and the overall correct response rate was 89.7%. Moreover, the percentage of high-grade lesions detected by the AI system was significantly correlated with the rate detected by multiple gynecologic senior oncologists (r=0.61). Conclusion: Our novel AI algorithm can accurately determine high-grade lesions associated with prognosis on colposcopic images, and these results provide an insight into the additional utility of colposcopy for the management of patients with CIN2.

      • KCI등재

        p16INK4a immunohistochemistry is a promising biomarker to predict the outcome of low grade cervical intraepithelial neoplasia: comparison study with HPV genotyping

        Sakiko Nishio,Takuma Fujii,Hiroshi Nishio,Kaori Kameyama,Miyuki Saito,Takashi Iwata,Kaneyuki Kubushiro,Daisuke Aoki 대한부인종양학회 2013 Journal of Gynecologic Oncology Vol.24 No.3

        Objective: In cervical intraepithelial neoplasia (CIN), p16INK4a immunohistochemistry has been reported to be a useful diagnostic biomarker. However, limited information is available about the association between the p16INK4a immunohistochemistry and the outcomes of CIN. Here, we report p16INK4a immunohistochemistry as an effective biomarker to predict the outcomes of CIN. Methods: p16INK4a immunohistochemistry was performed in patients with CIN from January 2000 to August 2009. Among these patients, we have performed a retrospective analysis of the medical records to evaluate the outcome of CIN 1-2 and performed statistical analysis to determine the correlation between p16INK4a expression and the outcomes. We also performed HPV genotyping and analyzed the relation between the infecting human papillomavirus (HPV) genotype and the outcomes. Results: A total of 244 patients, including 82 with CIN 1, 60 with CIN 2, and 102 with CIN 3, were examined. The rate of p16INK4a overexpression increased with increasing CIN grade, 20.7% for CIN 1, 80.0% for CIN 2, and 89.2% for CIN 3, with significant differences between CIN 1 and CIN 2-3 group. In the 131 CIN 1-2 patients, the progression rate was significantly higher for the patients showing p16INK4a overexpression than for those not showing p16INK4a overexpression (p=0.005); the regression rate was also found to be significantly lower for the patients showing p16INK4a overexpression (p=0.003). High-risk HPV genotypes were detected in 73 patients (73.7%). Both progression and regression rates were not significantly different between the high-risk HPV-positive and HPV-negative groups (p=0.401 and p=0.381, respectively). Conclusion: p16INK4a overexpression was correlated with the outcome of CIN 1-2, and p16INK4a is considered to be a superior biomarker for predicting the outcome of CIN 1-2 compared with HPV genotyping.

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