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Maki Namura Hiroko Tsunoda Daiki Kobayashi Katsutoshi Enokido Atsushi Yoshida Tadashi Watanabe Koyu Suzuki Seigo Nakamura Hideko Yamauchi Naoki Hayashi 《Clinical breast cancer》2019,19(4):278-285
BackgroundAxillary lymph node (LN) dissection after neoadjuvant chemotherapy (NAC) still remains a standard treatment of initially LN-positive primary breast cancer because of the difficulty of assessment of LN status. The aim of this study was to assess the LN status after NAC in initially LN-positive primary breast cancer patients who were assessed as clinically LN-negative after NAC (ycN0) and identify factors associated with loss of LN metastasis.Patients and MethodsThe study cohort comprised 279 patients with cytology-proven LN-positivity before NAC. LN status was assessed by ultrasonography. Regional recurrence-free survival and overall survival according to pathologic LN after NAC (ypN) status were assessed in patients with ycN0.ResultsOf the 279 patients, 179 patients (64.2%) had ycN0. High nuclear grade, estrogen receptor-negative (ER?), and human epidermal growth factor receptor 2-positive (HER2+), were significant predictors of ycN0/ypN0 (P < .001, .007, and .046, respectively). Metastases persisted in 1 or 2 LNs for 5 (20.0%) of 25 patients with ER?/HER2+ and for 4 (21.1%) of 19 patients with ER?/HER2?, and in 3 or more LNs for 0 (0%) of 25 patients with ER?/HER2+ and for 1 (5.3%) of 19 patients with ER?/HER2?. Patients with ER+ tumors had more numerous residual LN metastases than those with ER? tumors (P < .001). Among patients with ycN0, ypN status was not associated with regional recurrence-free survival or overall survival.ConclusionsThree or more residual LN metastases were rare in patients with ER? tumors if assessed as ycN0 by ultrasonography. Prospective studies are needed to confirm the prognostic impact of not performing axillary lymph node dissection in such patients. 相似文献
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Daisuke Nakajima Yui Watanabe Akihiro Ohsumi Mauricio Pipkin Manyin Chen Pierre Mordant Takashi Kanou Tomohito Saito Ryan Lam Rafael Coutinho Lindsay Caldarone Stephen Juvet Tereza Martinu Rohin K. Iyer John E. Davies David M. Hwang Thomas K. Waddell Marcelo Cypel Shaf Keshavjee 《The Journal of heart and lung transplantation》2019,38(11):1214-1223
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Kenji Takagishi Tetsuya Matsuura Takashi Masatomi Etsuo Chosa Tsuyoshi Tajika Tetsu Iwama Mikihiko Watanabe Toshiro Otani Katsunori Inagaki Hiroyasu Ikegami Mitsuhiro Aoki Toru Okuwaki Yasushi Kameyama Maeda Akira Koji Kaneoka Masaaki Sakamoto Moroe Beppu 《Journal of orthopaedic science》2019,24(4):708-714
BackgroundDespite proposals and guidelines to prevent baseball injuries in young players by societies and organizations, many shoulder and elbow injuries continue to occur among junior high school baseball players. In order to investigate the training conditions of junior high school baseball players and the risk factors for shoulder and elbow pain in the players, we conducted a questionnaire survey among junior high school baseball players throughout the country.MethodsThe questionnaire survey was conducted among junior high school baseball players in September 2016.ResultsA total of 11,134 junior high school baseball players belonging to 495 teams responded to the survey. Among these, 4004 players trained every day of the week and 1151 players played baseball games every month with no off-season. Among 9752 players who did not have shoulder and/or elbow pain in the spring and summer of 2015, 19.2% of players experienced elbow pain over the course of one year, 13.6% of players experienced shoulder pain, and 28.0% complained of shoulder and/or elbow pain. The frequency of elbow pain was more than that of shoulder pain. At risk for shoulder pain were pitchers and catchers and second-year students, while risk factors for elbow pain were playing pitcher and catcher positions, pitching or throwing ≥300 balls per week, playing ≥10 games on average per month and being left-handed.ConclusionRisk factors for shoulder pain were different from those for elbow pain. To prevent elbow pain, coaches should pay attention to pitchers and catchers and left-handed players and not allow players to pitch or throw ≥300 full-power balls per week or participate in ≥10 games per month. They should also pay attention to pitchers and catchers and second-year students to prevent shoulder pain. It is important for coaches to train multiple pitchers and catchers. 相似文献
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Yoshikazu Takaesu Koichiro Watanabe Shusuke Numata Masaaki Iwata Noriko Kudo Satoru Oishi Takeya Takizawa Kiyotaka Nemoto Yuka Yasuda Hiromi Tagata Takashi Tsuboi Naohisa Tsujino Naoki Hashimoto Yuki Matsui Hikaru Hori Hidenaga Yamamori Nobuhiro Sugiyama Taro Suwa Taishiro Kishimoto Akitoyo Hishimoto Masahide Usami Ryuji Furihata Kunihiro Iwamoto Hiroshige Fujishiro Toshinori Nakamura Kentaro Mizuno Takahiko Inagaki Eiichi Katsumoto Hiroaki Tomita Kazutaka Ohi Hiroyuki Muraoka Kiyokazu Atake Hitoshi Iida Tatsuya Nagasawa Junichi Fujita Satoshi Yamamura Toshiaki Onitsuka Atsunobu Murata Yoichiro Takayanagi Hokuto Noda Yukiko Matsumura Kenji Takezawa Jun‐ichi Iga Kayo Ichihashi Kazuyoshi Ogasawara Hisashi Yamada Ken Inada Ryota Hashimoto 《Psychiatry and clinical neurosciences》2019,73(10):642-648