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1.
Harada Hideyuki Omori Shota Mori Keita Konno Masahiro Murakami Haruyasu Imagumbai Toshiyuki Fukuda Haruyuki Nakamatsu Kiyoshi Kimura Tomoki Tanabe Hiroaki Fujita Hideki Tatebe Hitoshi Fujitaka Kazunori Nishimura Yasumasa 《International journal of clinical oncology / Japan Society of Clinical Oncology》2022,27(6):1025-1033
International Journal of Clinical Oncology - This multi-institutional clinical trial evaluated the feasibility of intensity-modulated radiotherapy (IMRT) for patients with locally advanced... 相似文献
2.
Yusuke Kagawa Hiromi Furuta Takehiro Uemura Naohiro Watanabe Junichi Shimizu Yoshitsugu Horio Hiroaki Kuroda Yoshitaka Inaba Takeshi Kodaira Katsuhiro Masago Shiro Fujita Akio Niimi Toyoaki Hida 《Cancer science》2020,111(12):4442
Immune checkpoint inhibitors (ICIs) have dramatically changed the strategy used to treat patients with non‐small‐cell lung cancer (NSCLC); however, the vast majority of patients eventually develop progressive disease (PD) and acquire resistance to ICIs. Some patients experience oligoprogressive disease. Few retrospective studies have evaluated clinical efficacy in patients with oligometastatic progression who received local therapy after ICI treatment. We conducted a retrospective analysis of advanced NSCLC patients who received PD‐1 inhibitor monotherapy with nivolumab or pembrolizumab to evaluate the effects of ICIs on the patterns of progression and the efficacy of local therapy for oligoprogressive disease. Of the 307 patients treated with ICIs, 148 were evaluated in our study; 42 were treated with pembrolizumab, and 106 were treated with nivolumab. Thirty‐eight patients showed oligoprogression. Male sex, a lack of driver mutations, and smoking history were significantly correlated with the risk of oligoprogression. Primary lesions were most frequently detected at oligoprogression sites (15 patients), and 6 patients experienced abdominal lymph node (LN) oligoprogression. Four patients showed evidence of new abdominal LN oligometastases. There was no significant difference in overall survival (OS) between the local therapy group and the switch therapy group (reached vs. not reached, P = .456). We summarized clinical data on the response of oligoprogressive NSCLC to ICI therapy. The results may help to elucidate the causes of ICI resistance and indicate that the use of local therapy as the initial treatment in this setting is feasible treatment option. 相似文献
3.
S. Fujita K. Yokoyama A. Hagiwara S. Kato C. Andica K. Kamagata N. Hattori O. Abe S. Aoki 《AJNR. American journal of neuroradiology》2021,42(3):471
BACKGROUND AND PURPOSE:Synthetic MR imaging creates multiple contrast-weighted images based on a single time-efficient quantitative scan, which has been mostly performed for 2D acquisition. We assessed the utility of 3D synthetic MR imaging in patients with MS by comparing its diagnostic image quality and lesion volumetry with conventional MR imaging.MATERIALS AND METHODS:Twenty-four patients with MS prospectively underwent 3D quantitative synthetic MR imaging and conventional T1-weighted, T2-weighted, FLAIR, and double inversion recovery imaging, with acquisition times of 9 minutes 3 seconds and 18 minutes 27 seconds for the synthetic MR imaging and conventional MR imaging sequences, respectively. Synthetic phase-sensitive inversion recovery images and those corresponding to conventional MR imaging contrasts were created for synthetic MR imaging. Two neuroradiologists independently assessed the image quality on a 5-point Likert scale. The numbers of cortical lesions and lesion volumes were quantified using both synthetic and conventional image sets.RESULTS:The overall diagnostic image quality of synthetic T1WI and double inversion recovery images was noninferior to that of conventional images (P = .23 and .20, respectively), whereas that of synthetic T2WI and FLAIR was inferior to that of conventional images (both Ps < .001). There were no significant differences in the number of cortical lesions (P = .17 and .53 for each rater) or segmented lesion volumes (P = .61) between the synthetic and conventional image sets.CONCLUSIONS:Three-dimensional synthetic MR imaging could serve as an alternative to conventional MR imaging in evaluating MS with a reduced scan time.MS is a chronic, immune-mediated, demyelinating disorder of the CNS that usually affects young adults and leads to chronic disability.1,2 The diagnostic criteria for MS are based on the lesion number, size, and location.3 Although diffuse periventricular lesions are most commonly observed, previous studies have shown that the cortical and juxtacortical lesion load is associated with cognitive impairment.4,5 Additionally, the detection of cortical and juxtacortical lesions may contribute to early diagnosis because these lesions are characteristic of MS. MR imaging plays an integral role in the diagnosis and management of patients with MS through the in vivo detection and characterization of lesions. Although MR imaging is highly sensitive in detecting periventricular lesions and is considered as a standard biomarker in the monitoring of treatment response,6 conventional MR imaging techniques have a relatively low sensitivity for detecting (juxta)cortical lesions. Phase-sensitive inversion recovery (PSIR) and double inversion recovery (DIR) are recently developed imaging techniques useful for detecting MS lesions, especially (juxta)cortical ones.7,8 The PSIR preserves the positive and negative polarities of tissues as they recover from the inversion pulse, thus providing a T1-weighted contrast with higher SNR and GM-WM contrast. DIR is an imaging technique that suppresses both WM and CSF signals, thus significantly increasing lesion conspicuity in both GM and WM compared with FLAIR or T2-weighted images. PSIR and DIR have been shown to improve sensitivity compared with FLAIR or T2-weighted images in the detection of cortical lesions. However, the additional scanning time associated with PSIR and DIR has hindered the use of these techniques in clinical practice. Thus, a rapid imaging technique that can acquire these contrast-weighted images with high spatial resolution is desired.Quantitative synthetic MR imaging is a time-efficient MR imaging technique that enables simultaneous quantification of T1 and T2 relaxation times and proton attenuation and allows the creation of any contrast-weighted image, including DIR and PSIR, without additional scanning time.9–13 Previous studies have shown that synthetic MR imaging is useful for detecting and characterizing MS lesions.10,11,14 However, these studies were based on a multisection 2D acquisition, providing a relatively low resolution in the section direction. 3D quantitative synthetic MR imaging, enabling the simultaneous quantification of T1, T2, and proton attenuation of the whole brain in 3D,15–17 with smaller section thickness, should allow for more detailed delineation of MS lesions. With the combination of high spatial resolution 3D acquisition and DIR as well as PSIR contrasts, 3D quantitative synthetic MR imaging could serve as a clinically useful technique for monitoring MS lesions.Here, we assessed the utility of the recently developed 3D quantitative synthetic MR imaging for evaluating MS lesions by comparing the synthetic and conventional MR image sets. We hypothesized that 3D synthetic MR imaging would have a comparable diagnostic quality with that of a conventional image set (including 3D FLAIR and DIR) while shortening the total acquisition time. 相似文献
4.
Tetsuro Ohba Hiroki Oba Kensuke Koyama Kotaro Oda Nobuki Tanaka Koji Fujita Hirotaka Haro 《Journal of orthopaedic science》2021,26(4):678-683
BackgroundLocomotive syndrome (LS) was proposed by the Japanese Orthopedic Association and refers to a scenario in which imminent future nursing care services will be required by elderly adults to manage the functional deterioration of their locomotive organs. It is a social imperative to clarify the risk factors and treatment strategy for LS. However, the relationship between LS and adult spinal deformity (ASD) in those who are treated with spinal corrective surgery remains largely unknown.MethodsForty consecutive patients who had ASD and underwent spinal surgery for their disorder were included in this study. Locomotive dysfunction was evaluated using the 25-item Geriatric Locomotive Function Scale-25 (GLFS-25) questionnaire and physical performance tests including the one-legged standing test, the two-step test, the stand-up test, the handgrip strength, and gait speed test which were measured preoperatively, 6 months after surgery, and 1 year after surgery.ResultsOf the patients with ASD treated surgically, 95% of them had LS preoperatively and LS prevalence decreased significantly 1 year after surgery by 67.5% compared with the preoperative rate. Among physical performance tests, the walking stride and one-legged standing test improved significantly after spinal corrective surgery. The GLFS-25 items for the domains of pain, mobility, and domestic life improved overall postoperatively, whereas items in the self-care domain did not and the item for difficulty in putting on and taking off trousers and pants worsened.ConclusionsSpinal corrective surgery significantly improved physical performance tests as well as the frequency and severity of LS in patients with ASD. However, some GLFS-25 items can worsen after surgery and require attention. 相似文献
5.
6.
Takako Fujita Yukiko Ihara Hitomi Hayashi Atsushi Ishii Hiroshi Ideguchi Takahito Inoue Taichi Imaizumi Toshiyuki Yamamoto Shinichi Hirose 《Congenital anomalies》2020,60(6):189-193
Coffin-Siris syndrome (CSS) is a congenital anomaly syndrome characterized by developmental delay, coarse facial features, and hypoplasia of the fifth digit's nail or phalanges. Herein, we report a case of the 8-year-old female patient who showed developmental delay associated with dysplasia in the macular and large toe area. Comprehensive genomic analysis showed no possible candidate variants, but the subsequent genomic copy number analysis revealed a novel exonic deletion in the coding region of AT-rich interactive domain-containing protein 1B (ARID1B), a gene responsible for CSS. Genomic copy number analysis can aid in diagnosing CSS by confirming undiagnosed exonic deletions in ARID1B. Furthermore, this is the first report of CSS associated with bilateral macular dysplasia. 相似文献
7.
Ryosuke Ono Michio Yagi Akinobu Shoji Kayo Fujita Mizuki Yoshida William C. Ports Vivek S. Purohit 《The Journal of dermatology》2020,47(1):25-32
Crisaborole ointment, 2%, is a non-steroidal phosphodiesterase 4 inhibitor for the treatment of mild to moderate atopic dermatitis (AD). This parallel-cohort, phase 1 study was conducted to investigate skin irritation potential and safety of crisaborole in healthy Japanese adults (cohort 1) and the safety and pharmacokinetic profile of crisaborole and metabolites AN7602 and AN8323 in Japanese adults with mild to moderate AD (cohort 2). In cohort 1, 20 healthy volunteers received single applications of crisaborole and vehicle simultaneously on separate locations under 48-h occlusion. In cohort 2, 12 patients with mild to moderate AD received crisaborole (n = 10) or vehicle (n = 2) twice daily for 8 days. Skin irritation and safety were assessed in cohort 1. Pharmacokinetics and safety were assessed in cohort 2. Skin irritation index (scale 0–400) was 40.0 for crisaborole and 5.0 for vehicle. No treatment-emergent adverse events (TEAE) were reported in cohort 1. The most common TEAE in the crisaborole group in cohort 2 were application site irritation (n = 7) and application site pain (n = 4). Crisaborole was rapidly absorbed, with limited systemic exposure between days 1 and 8 that was comparable with that seen in US-based participants in previous trials. Crisaborole had higher skin irritation than vehicle under occlusion in healthy Japanese adults and had an acceptable safety profile in Japanese adults with mild to moderate AD. 相似文献
8.
Manabu Fujimoto Jun Asai Yoshihide Asano Takayuki Ishii Yohei Iwata Tamihiro Kawakami Masanari Kodera Masatoshi Abe Masahiro Amano Ryuta Ikegami Taiki Isei Zenzo Isogai Takaaki Ito Yuji Inoue Ryokichi Irisawa Masaki Ohtsuka Yoichi Omoto Hiroshi Kato Takafumi Kadono Sakae Kaneko Hiroyuki Kanoh Masakazu Kawaguchi Ryuichi Kukino Takeshi Kono Monji Koga Keisuke Sakai Eiichi Sakurai Yasuko Sarayama Yoichi Shintani Miki Tanioka Hideaki Tanizaki Jun Tsujita Naotaka Doi Takeshi Nakanishi Akira Hashimoto Minoru Hasegawa Masahiro Hayashi Kuninori Hirosaki Hideki Fujita Hiroshi Fujiwara Takeo Maekawa Koma Matsuo Naoki Madokoro Sei-Ichiro Motegi Hiroshi Yatsushiro Osamu Yamasaki Yuichiro Yoshino Andres James LE Pavoux Takao Tachibana Hironobu Ihn Japanese Dermatological Association Guidelines 《The Journal of dermatology》2020,47(10):1071-1109
The Japanese Dermatological Association prepared guidelines focused on the treatment of skin ulcers associated with connective tissue disease/vasculitis practical in clinical settings of dermatological care. Skin ulcers associated with connective tissue diseases or vasculitis occur on the background of a wide variety of diseases including, typically, systemic sclerosis but also systemic lupus erythematosus (SLE), dermatomyositis, rheumatoid arthritis (RA), various vasculitides and antiphospholipid antibody syndrome (APS). Therefore, in preparing the present guidelines, we considered diagnostic/therapeutic approaches appropriate for each of these disorders to be necessary and developed algorithms and clinical questions for systemic sclerosis, SLE, dermatomyositis, RA, vasculitis and APS. 相似文献
9.
Immunotherapies targeting interleukin (IL)-17 greatly improve plaque psoriasis. Most previous studies on IL-17 focused on the T-helper (Th)17 immune response, but investigation of the effects of IL-17A on psoriatic epidermal structure are limited. Using an in vitro 3-D human epidermis model, we investigated the effects of IL-17A and IL-17C on morphological changes and gene expression. IL-17A directly suppressed the formation of the granular layer, whereas IL-17C did not. IL-17A significantly downregulated the gene expression of profilaggrin (FLG), which is a major component of keratohyalin granules in the granular layer. Global gene expression analysis of this 3-D epidermis model showed that both IL-17A and IL-17C upregulated S100A7A and type 1 interferon-related genes including MX1, IFI44L, XAF1 and IFIT1. However, only IL-17A directly downregulated keratinocyte differentiation-related and cornified envelope-related genes including FLG, LOR, C1ORF68, LCE1E, LCE1B, KRT10, CST6 and RPTN. In conclusion, IL-17A, a systemic inflammatory cytokine, affected keratinization in our 3-D epidermis model. In contrast, IL-17C, a locally produced cytokine, did not have strong effects on keratinization. Targeting IL-17A does not only reduce inflammation but it may also directly affect epidermal differentiation in psoriasis. 相似文献
10.
Hideta Nakamura Kazuya Miyagi Mariko Otsuki Yuuri Higure Naoya Nishiyama Takeshi Kinjo Masashi Nakamatsu Shusaku Haranaga Masao Tateyama Jiro Fujita 《Internal medicine (Tokyo, Japan)》2020,59(22):2945
Treatment with tocilizumab (TCZ) to block interleukin-6 (IL-6) signalling is predicted to mitigate cytokine release syndrome (CRS) caused by coronavirus disease 2019 (COVID-19). However, the adverse effects of TCZ on patients with COVID-19 remain unclear. We herein report a patient with COVID-19 treated with TCZ who developed acute hypertriglyceridaemia. Despite favipiravir treatment, acute respiratory distress syndrome developed in a 45-year-old patient with COVID-19; thus, TCZ was initiated. The triglyceride levels greatly increased after TCZ administration. Physicians should consider the negative impact of TCZ on the lipid profile in patients with COVID-19, although COVID-19-induced CRS itself may be an aggravating factor. 相似文献