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Search Results: 1 - 10 of 3005 matches for " Norihiko Watanabe "
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Coinhibitory Molecules in Autoimmune Diseases
Norihiko Watanabe,Hiroshi Nakajima
Clinical and Developmental Immunology , 2012, DOI: 10.1155/2012/269756
Abstract: Coinhibitory molecules such as CTLA-4, PD-1 and BTLA negatively regulate immune responses. Multiple studies indicate that the deficiency or mutation of coinhibitory molecules leads to the development of autoimmune diseases in mice and humans, indicating that the negative signals from coinhibitory molecules are crucial for the prevention of autoimmunity. In some conditions, the administration of decoy coinhibitory receptors (e.g., CTLA-4 Ig) or mAb against coinhibitory molecules suppresses the responses of self-reactive T cells in autoimmune diseases. Therefore, modulation of coinhibitory signals seems to be an attractive approach to induce tolerance in autoimmune diseases in humans where the disease-inducing self-antigens are not known. Particularly, administration of CTLA-4 Ig has shown great promise in animal models of autoimmune diseases and has been gaining increasing attention in clinical investigation in several autoimmune diseases in humans.
Coinhibitory Molecules in Autoimmune Diseases
Norihiko Watanabe,Hiroshi Nakajima
Journal of Immunology Research , 2012, DOI: 10.1155/2012/269756
Abstract: Coinhibitory molecules such as CTLA-4, PD-1 and BTLA negatively regulate immune responses. Multiple studies indicate that the deficiency or mutation of coinhibitory molecules leads to the development of autoimmune diseases in mice and humans, indicating that the negative signals from coinhibitory molecules are crucial for the prevention of autoimmunity. In some conditions, the administration of decoy coinhibitory receptors (e.g., CTLA-4?Ig) or mAb against coinhibitory molecules suppresses the responses of self-reactive T cells in autoimmune diseases. Therefore, modulation of coinhibitory signals seems to be an attractive approach to induce tolerance in autoimmune diseases in humans where the disease-inducing self-antigens are not known. Particularly, administration of CTLA-4?Ig has shown great promise in animal models of autoimmune diseases and has been gaining increasing attention in clinical investigation in several autoimmune diseases in humans. 1. Introduction The immune system has developed multiple mechanisms to prevent harmful activation of immune cells. One such mechanism is the balance between costimulatory and coinhibitory signals delivered to T cells. The B7-1 (CD80)/B7-2 (CD86)-CTLA-4 pathway is the best-characterized inhibitory pathway for T-cell activation [1–3]. Another inhibitory pathway involves programmed death-1 (PD-1), which interacts with PD-L1 (B7-H1) and PD-L2 (B7-DC) and negatively regulates T cell activation [1, 3, 4]. B and T lymphocyte attenuator (BTLA), the third coinhibitory molecule for T-cell activation, is a cell surface molecule with similarities to CTLA-4 and PD-1 [5]. The ligand for BTLA is herpesvirus-entry mediator (HVEM), a TNF receptor family protein, and the ligation of BTLA with HVEM attenuates T-cell activation [6–9]. Since these inhibitory coreceptors inhibit proliferation and cytokine production of T cells in vitro and in vivo, they are thought to play important roles in maintaining immunological homeostasis and tolerance [10–12]. Autoimmune diseases occur because of a failure of the immune system to maintain nonresponsiveness or tolerance to self-antigens. Accumulating evidence indicates that coinhibitory molecules are key in the prevention of autoimmune diseases, because a defect or a functional mutation in these molecules promotes autoimmunity and polymorphisms of these genes are associated with genetic susceptibility to autoimmune diseases in humans. Once an autoimmune disease developed, whether it is organ specific or nonorgan specific, in most cases corticosteroids and/or immunosuppressants are used for
Single-Incision Robotic Surgery  [PDF]
Norihiko Ishikawa, Masahiko Kawaguchi, Hideki Moriyama, Go Watanabe
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.32015
Abstract: Introduction: Single Incision Laparoscopic Surgery (SILSTM) has been developed as a less invasive laparoscopic surgery. On the other hand, robotically assisted surgical technology has offered new options for minimally invasive surgery. In this study, we report a new surgical technology to perform SILS using the da Vinci S surgical system (Intuitive Surgical Inc., Sunnyvale, CA). Materials and Surgical Technique: A porcine liver with gallbladder was placed on an endoscopic surgery trainer, and a 25 mm incision was made for one robotic camera and two instruments at the umbilicus position. Both instruments were crossed while preventing them from colliding with each other, and Robot-assisted single-incision cholecyctectomy was perfumed. Discussion: This technique is expected to contribute to the development of a number of procedures in the future.
Laparoscopic Hernioplasty Using Omega-3 Coating Mesh  [PDF]
Masahiko Kawaguchi, Norihiko Ishikawa, Youji Nishida, Hideki Moriyama, Masahiro Kaneki, Go Watanabe
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.38077
Abstract: Background: Laparoscopic hernioplasty has gained popularity with significant advances in prostheses. Omega-3 coating mesh (C-Qur) is a prosthesis that can be used in the abdominal cavity, and the coating prevents adhesion of the mesh to the viscera. We planned a prospective observational study of laparoscopic hernioplasty using C-Qur. Methods: C-Qur was used in laparoscopic hernioplasty over the course of 1 year. We considered laparoscopic approaches as our primary treatment method for abdominal wall hernias. Although only a single incision was made for the majority of the laparoscopic hernioplasties, additional incisions were made when severe adhesions were encountered. For incisional or ventral hernias, a lateral lower incision was made. For inguinal hernias, an umbilical incision was made. Sex, age, diagnosis, number of incisions, additional incisions, morbidity, and follow-up period were evaluated. Results: Twenty-four patients who underwent surgery between May 2010 and April 2011 were included in this study. The median follow-up period was 14 months. The most common early complications included wound pain and edema; however, there were no persistent complications.
The da Vinci Surgical System versus the Radius Surgical System  [PDF]
Norihiko Ishikawa, Go Watanabe, Noriyuki Inaki, Hideki Moriyama, Masanari Shimada, Masahiko Kawaguchi
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.37070
Abstract: Objective: Kanazawa University introduced the da Vinci surgical system and the Radius surgical system. In this study, we compared the advantages and disadvantages of each system. Methods: The da Vinci system is a master-slave tele-manipulation system, which provides hi-resolution 3D images. The Radius system is pair of hand-guided surgical manipulators. In this study we focus on the operability of both instruments rather than their 3D optical systems. Results: The Radius was originally developed specifically focused on ligation and suturing with suture sizes bigger than 4-0, it is more effective, less expensive compared with the da Vinci. Although the da Vinci system is bulky, it allows surgeons to perform endoscopic surgeries only if ports are properly placed to prevent each arm from colliding with the other arms. A crucial difference between the Radius and the da Vinci is not limited to anastomose small vessels but is extended to multidirectional dissection. Currently, the cost including initial investment is the biggest issue; however, the da Vinci is absolutely necessary to implement delicate cardiac surgeries endoscopically and less-invasively. Early approval of robotic surgery by the government is urgently required in Japan. Conclusions: Although both the da Vinci and the Radius have endoscopic instruments with a multi-degree of freedom, applications need to be differentiated depending on the procedures and indications. Therefore, it can be clearly said that these unique innovative systems will never compete against each other.
Outcomes of Single-Incision Laparoscopic Appendectomy at a Single Center  [PDF]
Takahiro Watanabe, Hidetosi Wada, Masanori Sato, Yuichirou Miyaki, Junpei Tochikubo, Norihiko Shiiya
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.410083
Abstract:

Background and Objectives: Recently, single-incision laparoscopic surgery has been popular for minimally invasive surgery and cosmetic improvement. We studied outcomes of single-incision laparoscopic appendectomy (SILA) in accordance with our strategy for acute appendicitis. Methods: Clinical outcomes were revealed in each of nine emergency SILA (e-SILA) cases and eight interval SILA (i-SILA) cases performed for the treatment of acute appendicitis between September 2010 and August 2012 at our hospital. Results: The male to female ratio was 6:3 for e-SILA and 5:3 for i-SILA cases. Mean ages were 33.1 ± 17.8 years and 41 ± 21.6 years for e-SILA and i-SILA, respectively. The pretreatment white blood cell (WBC) count and C-reactive protein (CRP) levels were 14960 ± 4080/μL and 1.4 ± 2.3 mg/d, respectively, for e-SILA and 12657 ± 4290/μL and 6.7 ± 8.3 mg/d, respectively, for i-SILA. The maximum transverse diameter of appendix was 12.6 ± 3.5 mm for e-SILA and 11.6 ± 3.5 mm for i-SILA. Appendiceal abscesses were encountered in one (11%) e-SILA and three (38%) i-SILA cases. Perforation of the appendix at operation occurred in two (22%) e-SILA cases and no i-SILA cases. Generalized peritonitis occurred in 4 (44%) e-SILA cases but in none of the i-SILA cases. The postoperative hospital stay was 5.3 days for e-SILA, 2.7 days for i-SILA. Conversion to laparotomy was not required in either group. One additional trocar was needed for an e-SILA case, and paralytic ileus occurred as a postoperative complication in one e-SILA case. Conclusion: The outcomes of SILA performed under our strategy w

Laparoscopic Observations in Acquired Inguinal Hernia before and after Robotic-Assisted Laparoscopic Prostatectomy  [PDF]
Masahiko Kawaguchi, Yoshifumi Kadono, Masanari Shimada, Hideki Moriyama, Norihiko Ishikawa, Go Watanabe
Surgical Science (SS) , 2014, DOI: 10.4236/ss.2014.54030
Abstract: Background: The mechanism of the development of acquired inguinal hernia, especially indirect inguinal hernia, is not well known. Although anatomical studies have been performed to explain development of inguinal hernia, they have mainly involved autopsy or temporal findings at the time of hernioplasty. To elucidate the pattern of development of acquired inguinal hernia, we studied the occurrence of inguinal hernia after robotic-assisted laparoscopic prostatectomy (RALP). Methods: From March 2009 to November 2011, RALP for prostatic cancer was performed on 60 patients in our institute. The RALP was performed by one urologist using the da Vinci Surgical System. The postsurgical development of inguinal hernia was diagnosed based on patients’ symptoms. Seven patients were treated with laparoscopic hernioplasty, and one underwent mesh-plug repair. Using video recordings, the laparoscopic findings during RALP and laparoscopic hernioplasty were compared among all patients. Results: Seven of 59 patients (11.9%) developed an inguinal hernia. One patient had a pre-existing pantaloon inguinal hernia at the time of RALP. Eleven inguinal lesions in the seven patients who underwent laparoscopic hernioplasty were reviewed, and all were indirect inguinal hernias. Conclusion: A main factor in the development of inguinal hernia after RALP could be a combination of outer-side intact layers and inner-side hard scar of the inguinal ring, which seems like “out swing door”.
Clinicopathological Evaluation and Prognostic Analysis in Breast Cancer Patients with Brain Metastasis  [PDF]
Naoko Minatani, Hirokazu Tanino, Yoshimasa Kosaka, Mariko Kikuchi, Hiroshi Nishimiya, Mina Waraya, Hiroshi Katoh, Takumo Enomoto, Norihiko Sengoku, Masahiko Watanabe
Journal of Cancer Therapy (JCT) , 2015, DOI: 10.4236/jct.2015.68079
Abstract: Background: Brain metastases are diagnosed in 5% - 15% of patients with breast cancer. Clinical management of brain metastases appears to be crucial in improving the prognosis of patients with breast cancer that has metastasized to the brain. However, few studies have investigated whether treatment of metastatic brain tumors would lead to improved prognosis. Methods: A total of 41 breast cancer patients whose tumors metastasized to the brain and who were diagnosed and treated at our hospital were enrolled. This study was conducted to determine the characteristics of brain metastases and to identify the factors that may affect the treatment and prognosis of patients with brain metastases. Results: There were more patients with HER2 and triple negative subtypes than of the luminal subtype. The median time from the initiation of breast cancer treatment to the onset of brain metastasis was 31 months (range, 7 - 134 months). Significantly greater disease-specific survival (DSS) was observed in patients who had a performance status of 0 - 2 at the time of diagnosis of metastatic brain tumors than those with a performance status of 3 - 4 (p = 0.04). DSS was also significantly greater in patients who underwent surgery to remove brain metastases and in patients treated with systemic therapy (p = 0.0007 and 0.0001, respectively). Conclusions: It may be possible to improve the prognosis of patients with brain metastases if lesions are detected early enough when the patients’ performance status is still good. In order for these findings to be definitive, however, results of future prospective studies are eagerly awaited.
Remote Management for Multipoint Sensing Systems Using Hetero-Core Spliced Optical Fiber Sensors
Lee See Goh,Yuji Anoda,Watanabe Kazuhiro,Norihiko Shinomiya
Sensors , 2014, DOI: 10.3390/s140100468
Abstract: This paper describes the design and experimental verification of a multipoint sensing system with hetero-core spliced optical fiber sensors and its remote management using an internet-standard protocol. The study proposes two different types of design and conducts experiments to verify those systems’ feasibility. In order to manage the sensing systems remotely, the management method uses a standard operation and maintenance protocol for internet: the Simple Network Management Protocol is proposed. The purpose of this study is to construct a multipoint sensing system remote management tool by which the system can also determine the status and the identity of fiber optic sensors. The constructed sensing systems are verified and the results have demonstrated that the first proposed system can distinguish the responses from different hetero-core spliced optical fiber sensors remotely. The second proposed system shows that data communications are performed successfully while identifying the status of hetero-core spliced optical fiber sensors remotely.
Cloud Service Provisioning Based on Peer-to-Peer Network for Flexible Service Sharing and Discovery  [PDF]
Andrii Zhygmanovskyi, Norihiko Yoshida
Journal of Computer and Communications (JCC) , 2014, DOI: 10.4236/jcc.2014.210003
Abstract:

In this paper, we present an approach to establish efficient and scalable service provisioning in the cloud environment using P2P-based infrastructure for storing, sharing and discovering services. Unlike most other P2P-based approaches, it allows flexible search queries, since all of them are executed against internal database presenting at each overlay node. Various issues concerning using this approach in the cloud environment, such as load-balancing, queuing, dealing with skewed data and dynamic attributes, are addressed in the paper. The infrastructure proposed in the paper can serve as a base for creating robust, scalable and reliable cloud systems, able to fulfill client’s QoS requirements, and at the same time introduce more efficient utilization of resources to the cloud provider.

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