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Hyperfractionated radiotherapy for re-irradiation of recurrent esophageal cancer
Kazuya Takeda,Haruo Matsushita,Rei Umezawa,Takaya Yamamoto,Yojiro Ishikawa,Noriyoshi Takahashi,Yu Suzuki,Keiichi Jingu 대한방사선종양학회 2021 Radiation Oncology Journal Vol.39 No.4
Purpose: Re-irradiation is a treatment option for recurrent esophageal cancer patients with a history of radiotherapy, but there is a risk of severe late adverse effects. This study focused on the efficacy and safety of re-irradiation using hyperfractionated radiotherapy. Materials and Methods: Twenty-six patients who underwent re-irradiation by the hyperfraction technique using twice-daily irradiation of 1.2 Gy per fraction for recurrent esophageal cancer were retrospectively included in this study. The overall survival period after the start of secondary radiotherapy and the occurrence of late adverse effects were investigated. Results: Of 26 patients, 21 (81%) received re-irradiation with definitive intention and 21 (81%) underwent concurrent chemotherapy. The median re-irradiation dose was 60 Gy in 50 fractions in 25 treatment days, and the median accumulated irradiation dose in equivalent dose in 2 Gy per fraction was 85.4 Gy with an α/β value of 3. The median interval between two courses of radiotherapy was 21.0 months. The median overall survival period was 15.8 months and the 1-year and 3-year overall survival rates were 64.3% and 28.3%, respectively. Higher dose of re-irradiation and concurrent chemotherapy significantly improved survival (p < 0.001 and p = 0.019, respectively). Severe late adverse effects with the Common Terminology Criteria for Adverse Events grade 3 or higher were observed in 5 (19.2%) patients, and 2 (7.7%) of them developed a grade 5 late adverse effect. Conclusion: High-dose re-irradiation using a hyperfractionated schedule with concurrent chemotherapy might be related to good prognosis, while the rate of late severe adverse effects is not high compared with the rates in past reports.
Stochastic Mixture Modeling of Driving Behavior During Car Following
Angkititrakul, Pongtep,Miyajima, Chiyomi,Takeda, Kazuya The Korea Institute of Information and Commucation 2013 Journal of information and communication convergen Vol.11 No.2
This paper presents a stochastic driver behavior modeling framework which takes into account both individual and general driving characteristics as one aggregate model. Patterns of individual driving styles are modeled using a Dirichlet process mixture model, as a non-parametric Bayesian approach which automatically selects the optimal number of model components to fit sparse observations of each particular driver's behavior. In addition, general or background driving patterns are also captured with a Gaussian mixture model using a reasonably large amount of development data from several drivers. By combining both probability distributions, the aggregate driver-dependent model can better emphasize driving characteristics of each particular driver, while also backing off to exploit general driving behavior in cases of unseen/unmatched parameter spaces from individual training observations. The proposed driver behavior model was employed to anticipate pedal operation behavior during car-following maneuvers involving several drivers on the road. The experimental results showed advantages of the combined model over the model adaptation approach.
Miyu Tanaka,Yuta Yoshino,Shogo Takeda,Kazuya Toda,Hiroshi Shimoda,Kazuhiro Tsuruma,Masamitsu Shimazawa,Hideaki Hara 한국식품영양과학회 2017 Journal of medicinal food Vol.20 No.10
Sarcopenia, loss of muscle mass and function, is mainly observed in elderly people. In this study, we investigated whether fermented rice germ extract (FRGE) has some effects on the mouse gastrocnemius muscle by using behavioral and morphological analyses, Western blotting, and a murine model of immobilization-induced muscle atrophy. Daily oral FRGE administration increased muscle weight and strength. In addition, myofiber size in gastrocnemius muscle of FRGE-treated mice was increased as revealed by morphological quantification. Activation of AMP-activated protein kinase (AMPK) signaling, which inhibits protein synthesis and stimulates protein degradation in gastrocnemius muscle, was significantly attenuated in the FRGE-treated mice compared with control mice. Expression level of forkhead box 3a (FOXO3a) protein was also significantly decreased in the FRGE-treated group. Moreover, the decrease in mean myofiber cross-sectional area in immobilized hindlimb in vehicle-treated mice was inhibited by FRGE treatment in histological analysis. In conclusion, FRGE increased the strength and weight of gastrocnemius muscle and myofiber size, and reduced immobilization-induced muscle atrophy in mice. These findings indicated that FRGE might be beneficial in preventing motor dysfunction in a range of conditions, including sarcopenia.
Tomoyuki Hayashi,Yoshiro Asahina,Yasuhito Takeda,Masaki Miyazawa,Hajime Takatori,Hidenori Kido,Jun Seishima,Noriho Iida,Kazuya Kitamura,Takeshi Terashima,Sakae Miyagi,Tadashi Toyama,Eishiro Mizukoshi 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.5
Background/Aims: The necessity for pharyngeal anesthesia during upper gastrointestinal endoscopy is controversial. This study aimedto compare the observation ability with and without pharyngeal anesthesia under midazolam sedation. Methods: This prospective, single-blinded, randomized study included 500 patients who underwent transoral upper gastrointestinalendoscopy under intravenous midazolam sedation. Patients were randomly allocated to pharyngeal anesthesia: PA+ or PA– groups (250patients/group). The endoscopists obtained 10 images of the oropharynx and hypopharynx. The primary outcome was the non-inferiorityof the PA- group in terms of the pharyngeal observation success rate. Results: The pharyngeal observation success rates in the pharyngeal anesthesia with and without (PA+ and PA–) groups were 84.0%and 72.0%, respectively. The PA– group was inferior (p=0.707, non-inferiority) to the PA+ group in terms of observable parts (8.33 vs. 8.86, p=0.006), time (67.2 vs. 58.2 seconds, p=0.001), and pain (1.21±2.37 vs. 0.68±1.78, p=0.004, 0–10 point visual analog scale). Suitablequality images of the posterior wall of the oropharynx, vocal fold, and pyriform sinus were inferior in the PA– group. Subgroupanalysis showed a higher sedation level (Ramsay score ≥5) with almost no differences in the pharyngeal observation success rate betweenthe groups. Conclusions: Non-pharyngeal anesthesia showed no non-inferiority in pharyngeal observation ability. Pharyngeal anesthesia may improvepharyngeal observation ability in the hypopharynx and reduce pain. However, deeper anesthesia may reduce this difference.