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  • 1
    Online Resource
    Online Resource
    Improvement in Intraoperative Image Quality in Transcranial Magnetic Resonance-Guided Focused Ultrasound Surgery Using Transmitter Gain Adjustment
    S. Karger AG ; 2023
    In:  Stereotactic and Functional Neurosurgery Vol. 101, No. 4 ( 2023), p. 223-231
    Details
    In: Stereotactic and Functional Neurosurgery, S. Karger AG, Vol. 101, No. 4 ( 2023), p. 223-231
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Transcranial magnetic resonance-guided focused ultrasound surgery (TcMRgFUS) has the advantage of allowing immediate evaluation of therapeutic effects after each sonication and intraoperative magnetic resonance imaging (MRI) to visualize the lesion. When the image shows that the lesion has missed the planned target and the therapeutic effects are insufficient, the target of the subsequent ablation can be finely adjusted based on the image. The precision of this adjustment is determined by the image quality. However, the current intraoperative image quality with a 3.0T MRI system is insufficient for precisely detecting the lesion. Thus, we developed and validated a method for improving intraoperative image quality. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Because intraoperative image quality is affected by transmitter gain (TG), we acquired T2-weighted images (T2WIs) with two types of TG: the automatically adjusted TG (auto TG) and the manually adjusted TG (manual TG). To evaluate the character of images with 2 TGs, the actual flip angle (FA), the image uniformity, and the signal-to-noise ratio (SNR) were measured using a phantom. Then, to assess the quality of intraoperative images, T2WIs with both TGs were acquired during TcMRgFUS for 5 patients. The contrast-to-noise ratio (CNR) of the lesion was retrospectively estimated. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The images of the phantom with the auto TG showed substantial variations between the preset and actual FAs ( 〈 i 〉 p 〈 /i 〉 & lt; 0.01), whereas on the images with the manual TG, there were no variations between the two FAs ( 〈 i 〉 p 〈 /i 〉 & gt; 0.05). The total image uniformity was considerably lower with the manual TG than with the auto TG ( 〈 i 〉 p 〈 /i 〉 & lt; 0.01), indicating that the image’s signal values with the manual TG were more uniform. The manual TG produced significantly higher SNRs than the auto TG ( 〈 i 〉 p 〈 /i 〉 & lt; 0.01). In the clinical study, the lesions were clearly detected in intraoperative images with the manual TG, but they were difficult to identify in images with the auto TG. The CNR of lesions in images with manual TG was considerably higher than in images with auto TG ( 〈 i 〉 p 〈 /i 〉 & lt; 0.01). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Regarding intraoperative T2WIs using a 3.0T MRI system during TcMRgFUS, the manual TG method improved image quality and delineated the ablative lesion more clearly than the current method with auto TG.
    Type of Medium: Online Resource
    ISSN: 1011-6125 , 1423-0372
    URL: Article
    DOI: 10.1159/000531009
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1483576-9
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  • 2
    Online Resource
    Online Resource
    Ileal Neobladder for Urinary Bladder Replacement following Total Pelvic Exenteration for Rectal Carcinoma
    S. Karger AG ; 2001
    In:  Digestive Surgery Vol. 18, No. 1 ( 2001), p. 67-72
    Details
    In: Digestive Surgery, S. Karger AG, Vol. 18, No. 1 ( 2001), p. 67-72
    Abstract: 〈 i 〉 Objective: 〈 /i 〉 The aim of this study was to determine the feasibility of using the ileal neobladder as a substitute for the urinary bladder following total pelvic exenteration for rectal carcinoma. 〈 i 〉 Patients and Methods: 〈 /i 〉 Between 1992 and 1998, we performed total pelvic exenteration with ileal neobladder in 5 men with rectal carcinoma. Four patients had primary tumors, and one had recurrent disease after low anterior resection for rectal carcinoma. Histological types were adenocarcinoma in 4 and squamous cell carcinoma in 1. Invaded organs were: the urinary bladder in 1, the urinary bladder and prostate in 2, the prostate and seminal vesicle in 1, and the prostate in 1. 〈 i 〉 Results: 〈 /i 〉 There was no operative death. In 1 patient, an ileal conduit was needed because of partial necrosis of the neobladder. Minor leakage on the dorsal wall of the neobladder occurred in 2 patients, which was successfully stopped with simple closure and a gluteus maximus fasciocutaneous flap, respectively. All except one patient with the ileal conduit could void via the urethra. Complete daytime urinary continence was achieved, but nocturnal continence was maintained with voiding once or twice per night. As the urodynamic state, the mean maximum flow rate was 20.9 ml/s (range 9.0–34.1), the mean average flow rate was 7.7 ml/s (range 3.0–11.0), and the mean voided volume was 285.5 ml (range 160–432). The mean length of follow-up was 47.8 months. One patient died of local recurrence 38 months postoperatively, and 1 died of pneumonia 10 months postoperatively. Both patients could void via the urethra until death. The other three patients are currently alive without any evidence of recurrence. 〈 i 〉 Conclusions: 〈 /i 〉 Although total pelvic exenteration is a laborious surgical procedure, an ileal neobladder could be a good alternative to the urinary bladder enabling the patients to void via the urethra with urinary continence.
    Type of Medium: Online Resource
    ISSN: 0253-4886 , 1421-9883
    URL: Article
    DOI: 10.1159/000050100
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2001
    detail.hit.zdb_id: 1468560-7
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  • 3
    Online Resource
    Online Resource
    A 24-Week, Randomized, Controlled Study to Evaluate the Tolerability, Safety and Efficacy of 2 Different Titration Schemes of the Rivastigmine Patch in Japanese Patients with Mild to Moderate Alzheimer's Disease
    S. Karger AG ; 2015
    In:  Dementia and Geriatric Cognitive Disorders Extra Vol. 5, No. 3 ( 2015-9-29), p. 361-374
    Details
    In: Dementia and Geriatric Cognitive Disorders Extra, S. Karger AG, Vol. 5, No. 3 ( 2015-9-29), p. 361-374
    Abstract: 〈 b 〉 〈 i 〉 Aim: 〈 /i 〉 〈 /b 〉 To investigate whether 1-step titration of the rivastigmine patch (initiated at 5 cm 〈 sup 〉 2 〈 /sup 〉 and titrated to 10 cm 〈 sup 〉 2 〈 /sup 〉 after 4 weeks) is well tolerated in Japanese patients with Alzheimer's disease (AD) as compared to 3-step titration (initiated at 2.5 cm 〈 sup 〉 2 〈 /sup 〉 and titrated by 2.5 cm 〈 sup 〉 2 〈 /sup 〉 every 4 weeks to 10 cm 〈 sup 〉 2 〈 /sup 〉 ). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A 24-week, multicenter, randomized, double-blind study was conducted in Japan between July 2012 and May 2014. Patients with mild to moderate AD aged 50-85 years were randomized 1:1 to 1-step or 3-step titration of the rivastigmine once-daily patch. The primary endpoint was the proportion of patients with adverse events leading to discontinuation. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of 216 patients randomized, 215 (1-step, n = 107; 3-step, n = 108) were included in the safety analysis. The primary endpoint outcome was 15.0% in the 1-step group and 18.5% in the 3-step group. The observed treatment difference was −3.6% (95% confidence interval: −17.0, 9.6), falling within the prespecified acceptance range. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The tolerability of two different titration schemes was similar in Japanese patients with AD.
    Type of Medium: Online Resource
    ISSN: 1664-5464
    URL: Article
    DOI: 10.1159/000439269
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 2621464-7
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  • 4
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    Online Resource
    Distant Metastasis from Benign Solitary Fibrous Tumor of the Kidney
    S. Karger AG ; 2013
    In:  Case Reports in Nephrology and Dialysis Vol. 3, No. 1 ( 2013-1-24), p. 1-8
    Details
    In: Case Reports in Nephrology and Dialysis, S. Karger AG, Vol. 3, No. 1 ( 2013-1-24), p. 1-8
    Abstract: Solitary fibrous tumor (SFT) rarely occurs in the kidneys, and only one reported case of renal SFT has shown distant metastasis. We report the second case of renal SFT exhibiting distant metastasis. A 48-year-old man was referred to our hospital because of a right renal mass. An abdominal CT scan detected a large renal tumor, which was suspected to be a renal cell carcinoma. Right radical nephrectomy was performed, and the tumor was found to measure 28 × 18 × 10 cm. The pathological diagnosis was benign solitary fibrous tumor of the kidney. Eight years after the operation, lung and liver metastases developed. Pulmonary segmentectomy and partial hepatectomy were performed. The pathological diagnoses of these resected tissue specimens were compatible with benign SFT.
    Type of Medium: Online Resource
    ISSN: 2296-9705
    URL: Article
    DOI: 10.1159/000346850
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
    detail.hit.zdb_id: 2809879-1
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  • 5
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    Deletion of 〈b〉〈i〉PIN4〈/i〉〈/b〉 Suppresses the Protein Transport Defects Caused by 〈b〉〈i〉sec12-4〈/i〉〈/b〉 Mutation in 〈b〉〈i〉Saccharomyces cerevisiae〈/i〉〈/b〉
    S. Karger AG ; 2020
    In:  Microbial Physiology Vol. 30, No. 1-6 ( 2020), p. 25-35
    Details
    In: Microbial Physiology, S. Karger AG, Vol. 30, No. 1-6 ( 2020), p. 25-35
    Abstract: Newly synthesized secretory proteins are released into the lumen of the endoplasmic reticulum (ER). The secretory proteins are surrounded by coat protein complex II (COPII) vesicles, and transported from the ER and reach their destinations through the Golgi apparatus. Sec12p is a guanine nucleotide exchange factor for Sar1p, which initiates COPII vesicle budding from the ER. The activation of Sar1p by Sec12p and the subsequent COPII coat assembly have been well characterized, but the events that take place upstream of Sec12p remain unclear. In this study, we isolated the novel extragenic suppressor of 〈 i 〉 sec12-4 〈 /i 〉 , 〈 i 〉 PIN4/MDT1 〈 /i 〉 , a cell cycle checkpoint target. A yeast two-hybrid screening was used to identify Pin4/Mdt1p as a binding partner of the casein kinase I isoform Hrr25p, which we have previously identified as a modulator of Sec12p function. Deletion of 〈 i 〉 PIN4 〈 /i 〉 suppressed both defects of temperature-sensitive growth and the partial protein transport observed in 〈 i 〉 sec12-4 〈 /i 〉 mutants. The results of this study suggest that Pin4p provides novel aspects of Sec12p modulations.
    Type of Medium: Online Resource
    ISSN: 2673-1665 , 2673-1673
    URL: Article
    DOI: 10.1159/000509633
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 3042601-7
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  • 6
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    Online Resource
    Hemobilia Derived from Cystic Artery Pseudoaneurysm
    S. Karger AG ; 2019
    In:  Case Reports in Gastroenterology Vol. 13, No. 1 ( 2019-2-26), p. 89-94
    Details
    In: Case Reports in Gastroenterology, S. Karger AG, Vol. 13, No. 1 ( 2019-2-26), p. 89-94
    Abstract: Cystic artery pseudoaneurysm (CAP) is a rare disease, with small number of previous reports related to CAP. Besides, it is frequently prone to critical condition due to arterial bleeding. Here, we presented a case of ruptured CAP with acute calculus cholecystitis and its subsequent successful management with temporary endoscopic biliary drainage for obstructive jaundice and embolization for the culprit artery without cholecystectomy. Since CAP is at high risk of bleeding, intravascular treatment, which is only one currently available therapeutic option, is urgently required in the clinical sites.
    Type of Medium: Online Resource
    ISSN: 1662-0631
    URL: Article
    DOI: 10.1159/000497097
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2019
    detail.hit.zdb_id: 2440540-1
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  • 7
    Online Resource
    Online Resource
    Immunoglobulin Gene Rearrangement in T-Cell-Rich Reactive Pleural Effusion of a Patient with B-Cell Chronic Lymphocytic Leukemia
    S. Karger AG ; 1996
    In:  Acta Haematologica Vol. 96, No. 1 ( 1996), p. 41-44
    Details
    In: Acta Haematologica, S. Karger AG, Vol. 96, No. 1 ( 1996), p. 41-44
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    URL: Article
    DOI: 10.1159/000203713
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1996
    detail.hit.zdb_id: 1481888-7
    detail.hit.zdb_id: 80008-9
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  • 8
    Online Resource
    Online Resource
    Antenatal Sonographic Detection of Vesicoureteral Reflux
    S. Karger AG ; 2002
    In:  Fetal Diagnosis and Therapy Vol. 17, No. 5 ( 2002), p. 277-280
    Details
    In: Fetal Diagnosis and Therapy, S. Karger AG, Vol. 17, No. 5 ( 2002), p. 277-280
    Abstract: We report a case with vesicoureteral reflux (VUR), diagnosed antenatally. A 31-year-old Japanese woman was referred at 37 weeks’ gestation because of the fetus having unilateral renal pelvis dilatation. The real-time ultrasound revealed a right renal pyelectasia with periodic changes in size over intervals lasting several minutes. The simultaneous examinations of both anteroposterior dimension of the renal pelvis and the ellipse size of urine-filled bladder area demonstrated that they varied in size in a reciprocal fashion, leading us to diagnose the fetus as having VUR. Postnatally, bilateral VUR was confirmed by the voiding cystogram. This case has typical ultrasonographic findings of fetal VUR, in which both the renal pelvis and urinary bladder dimensions change periodically in a reciprocal manner with each other, when the reflux really occurred.
    Type of Medium: Online Resource
    ISSN: 1015-3837 , 1421-9964
    URL: Article
    DOI: 10.1159/000063178
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2002
    detail.hit.zdb_id: 1482292-1
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  • 9
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    Evaluation of the Antidiabetic Effects of Dipeptidyl Peptidase-IV Inhibitor ASP8497 in Streptozotocin-Nicotinamide-Induced Mildly Diabetic Mice
    S. Karger AG ; 2009
    In:  Pharmacology Vol. 83, No. 3 ( 2009), p. 177-187
    Details
    In: Pharmacology, S. Karger AG, Vol. 83, No. 3 ( 2009), p. 177-187
    Abstract: Gastrointestinal hormone glucagon-like peptide-1 (GLP-1) has a potent glucose-dependent insulinotropic effect and is rapidly degraded by dipeptidyl peptidase (DPP)-IV. Therefore, the use of DPP-IV inhibitors is being actively explored as a novel approach to the treatment of type 2 diabetes. The present study investigated the antidiabetic effects of the DPP-IV inhibitor ASP8497 in streptozotocin-nicotinamide-induced mildly diabetic mice which possess aggravation of glucose tolerance due to loss of early-phase insulin secretion. ASP8497 exhibited good oral bioavailability with potent inhibition of plasma DPP-IV activity. This inhibitory activity lasted up to 24 h when administered at 5 mg/kg twice a day or 10 mg/kg once a day. A single oral administration of ASP8497 (0.3–3 mg/kg) significantly improved glucose tolerance by increasing plasma insulin and GLP-1 levels during the oral glucose or liquid meal tolerance tests. These effects were seen not only immediately, but also 8 h after administration. In contrast, ASP8497 (0.3–10 mg/kg) had no significant effect on blood glucose and plasma insulin levels under fasting conditions. Furthermore, repeated administration of ASP8497 (5 mg/kg twice a day or 10 mg/kg once a day) for 25 days significantly decreased nonfasting blood glucose and HbA 〈 sub 〉 1c 〈 /sub 〉 levels. These results suggest that ASP8497 is a potent and long-acting DPP-IV inhibitor that improves glucose tolerance through glucose-dependent insulinotropic action via the elevation of the GLP-1 level in streptozotocin-nicotinamide-induced mildly diabetic mice. It is expected to be useful as a therapeutic agent for impaired glucose tolerance and type 2 diabetes.
    Type of Medium: Online Resource
    ISSN: 0031-7012 , 1423-0313
    URL: Article
    DOI: 10.1159/000196813
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 1483550-2
    SSG: 15,3
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  • 10
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    Different and Shared Brain Volume Abnormalities in Late- and Early-Onset Schizophrenia
    S. Karger AG ; 2014
    In:  Neuropsychobiology Vol. 70, No. 3 ( 2014), p. 142-151
    Details
    In: Neuropsychobiology, S. Karger AG, Vol. 70, No. 3 ( 2014), p. 142-151
    Abstract: The differences in clinical characteristics between late- (LOS) and early-onset schizophrenia (EOS) are well documented. However, very little is known about the neural mechanisms underlying these differences. Here, we compared morphometric abnormalities between patients with EOS and those with LOS. A total of 22 patients with LOS, 24 patients with EOS and 41 healthy control subjects were included in this magnetic resonance imaging study. Brain images were analyzed using DARTEL preprocessing for voxel-based morphometry in SPM8. We tested a main effect of diagnosis in the whole-brain analysis and compared the results among the three groups. We also carried out correlation analyses between regional volumes and clinical variables. Patients with LOS showed larger gray matter (GM) volume of the left precuneus compared with healthy subjects and patients with EOS. Patients with LOS and EOS showed decreased GM volumes in the right insula, left superior temporal gyrus and left orbitofrontal gyrus compared with healthy subjects. A longer duration of illness was associated with reduced GM volume in the temporal pole in patients with EOS. Our findings may help improve our understanding of schizophrenia pathophysiology and shed light on the different and shared neurobiological underpinnings of LOS and EOS.
    Type of Medium: Online Resource
    ISSN: 0302-282X , 1423-0224
    URL: Article
    DOI: 10.1159/000364827
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1483094-2
    SSG: 5,2
    SSG: 15,3
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