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Complications of Posterior Fusion for Atlantoaxial Instability in Children With Down Syndrome
Yoshiki Takeoka,Kenichiro Kakutani,Hiroshi Miyamoto,Teppei Suzuki,Takashi Yurube,Izumi Komoto,Masao Ryu,Shinichi Satsuma,Koki Uno 대한척추신경외과학회 2021 Neurospine Vol.18 No.4
Objective: To clarify the complications of posterior fusion for atlantoaxial instability (AAI) in children with Down syndrome and to discuss the significance of surgical intervention. Methods: Twenty pediatric patients with Down syndrome underwent posterior fusion for AAI between February 2000 and September 2018 (age, 6.1±1.9 years). C1–2 or C1–3 fusion and occipitocervical fusion were performed in 14 and 6 patients, respectively. The past medical history, operation time, estimated blood loss (EBL), duration of Halo vest immobilization, postoperative follow-up period, and intra- and perioperative complications were examined. Results: The operation time was 257.9±55.6 minutes, and the EBL was 101.6±77.9 mL. Complications related to the operation occurred in 6 patients (30.0%). They included 1 major complication (5.0%): hydrocephalus at 3 months postoperatively, possibly related to an intraoperative dural tear. Other surgery-related complications included 3 cases of superficial infections, 1 case of bone graft donor site deep infection, 1 case of C2 pedicle fracture, 1 case of Halo ring dislocation, 1 case of pseudoarthrosis that required revision surgery, and 1 case of temporary neurological deficit after Halo removal at 2 months postoperatively. Complications unrelated to the operation included 2 cases of respiratory infections and 1 case of implant loosening due to a fall at 9 months postoperatively. Conclusion: The complication rate of upper cervical fusion in patients with Down syndrome remained high; however, major complications decreased substantially. Improved intra- and perioperative management facilitates successful surgical intervention for upper cervical instability in pediatric patients with Down syndrome.
Gene Therapy Approach for Intervertebral Disc Degeneration: An Update
Yoshiki Takeoka,Takashi Yurube,Kotaro Nishida 대한척추신경외과학회 2020 Neurospine Vol.17 No.1
Intervertebral disc degeneration is the primary cause of back pain and associated with neurological disorders including radiculopathy, myelopathy, and paralysis. The currently available surgical treatments predominantly include the excision of pathological discs, resulting in the function loss, immobilization, and potential additional complications due to the altered biomechanics. Gene therapy approach involves gene transfer into cells, affects RNA and protein synthesis of the encoded genes in the recipient cells, and facilitates biological treatment. Relatively long-exerting therapeutic effects by gene therapy are potentially advantageous to treat slow progressive degenerative disc disease. In gene therapy, the delivery method and selection of target gene(s) are essential. Although gene therapy was first mediated by viral vectors, technological progress has enabled to apply nonviral vectors and polyplex micelles for the disc. While RNA interference successfully provides specific downregulation of multiple genes in the disc, clustered regularly interspaced short palindromic repeats (CRISPR) system has increased attention to alter the process of intervertebral disc degeneration. Then, more recent findings of our studies have suggested autophagy, the intracellular self-digestion, and recycling system under the negative regulation by the mammalian target of rapamycin (mTOR), as a gene therapy target in the disc. Here we briefly review backgrounds and applications of gene therapy for the disc, introducing strategies of autophagy and mTOR signaling modulation through selective RNA interference.
Atsushi Takeoka,Takuya Kimura,Shintaro Hara,Toyohiro Hamaguchi,Shin Fukudo,Jun Tayama 대한소화기 기능성질환∙운동학회 2023 Journal of Neurogastroenterology and Motility (JNM Vol.29 No.2
Background/AimsSymptoms of irritable bowel syndrome (IBS), a common gut-brain interaction disorder, deteriorate patients’ quality of life and increase medical needs; therefore, IBS represents a significant global burden. The estimated global prevalence is approximately 10%; however, accumulated evidence shows international heterogeneity. In this study, we have described and compared the prevalence of IBS in 3 East Asian countries: Japan (Tokyo and Fukuoka), China (Beijing), and South Korea (Seoul). MethodsWe conducted an internet-based cross-sectional survey of the urban population aged > 20 years in the abovementioned countries. We recruited equal numbers of age- (20s-60s) and sex-matched participants (3910 residents). IBS was diagnosed according to the Rome III criteria, and the subtypes were analyzed. ResultsThe overall prevalence of IBS with 95% CI was 12.6% (11.6-13.7); the prevalence was significantly different across Japan, China, and South Korea (14.9% [13.4-16.5], 5.5% [4.3-7.1], and 15.6% [13.3-18.3], respectively) (P < 0.001). Furthermore, 54.9% of patients were male. IBS-mixed was the most prevalent subtype; the prevalence of other subtypes varied. ConclusionsThe overall prevalence of IBS in the 3 countries was slightly higher than the global prevalence, and it was significantly lower in China than in Japan and South Korea. IBS prevalence was the highest and lowest among individuals in their 40s and 60s, respectively. Male individuals had a higher prevalence of IBS with diarrhea. Further studies are needed to elucidate the factors associated with this regional heterogeneity.
M.Rikukawa,Y.Takeoka,K. Kikuchi,K.Sanui 한국물리학회 2004 Current Applied Physics Vol.4 No.6
Phenethylammonium-based perovskites, which can be regarded as a semiconductor/insulator multiple quantum well consisting oflead halide semiconductor layers sandwiched between phenethylammonium insulator layers were prepared. To investigate the eectsof the electronic state and the orientation of organic insulator layers on the optical properties of layered perovskites, uorinesubstituted analogues were also prepared. The structure and optical properties were investigated by the XRD, UVVis absorption,and uorescence measurements. The exciton absorption peak was shifted by the substitution of uorine atoms in organic ammo-nium compounds. It became clear that the optical properties of two-dimensional perovskite compounds were controlled by the substitution of fluorine atoms.
작은 만에서 식물플랑크톤 생체량과 생산력 변화에 대한 외부 물의 정기적인 침입 효과의 모델링
( Hayami Yuichi ),( Shu Ougiyama ),( Tsuneyoshi Koizumi ),( Hidetaka Takeoka ) 한국하천호수학회 2004 생태와 환경 Vol.37 No.4
Effects of the different strengths and intervals of the periodic outer water intrusions (kyuchos and bottom intrusions) on the dynamics of phytoplankton biomass in a small embayment were examined with a simple numerical model. Environmental conditions of Kitanada Bay in the Bungo Channel were applied to the model. As the interval of the intrusion became longer and the amplitude became smaller, phytoplankton biomass in the bay became higher. On the other hand, as the interval became shorter and the amplitude became larger, the growth rate of the phytoplankton became higher. It suggested that when the intrusion was weaker, water exchange of the bay decreased and the phytoplankton in the bay accumulated at a high density. When water exchange was improved by active intrusions, availability of light would become more efficient and the growth rate of the phytoplankton was enhanced.