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991.
Tozaki M Yamashiro N Suzuki T Kawano N Ozaki S Sakamoto N Abe S Ogawa T Katayama N Tsunoda Y Fukuma E 《Breast cancer (Tokyo, Japan)》2009,16(2):121-125
Background In the United States and Europe, MR-guided vacuum-assisted biopsy (VAB) is required for MR-only visible suspicious lesions
that cannot be identified with mammography or ultrasonography. However, it is controversial as to whether MR-guided VAB is
essential or not in Japan. The purpose of this study was to clarify the frequency of malignancy among the patients that underwent
MR-guided VAB, and to discuss the need for this technique in Japan.
Methods This study was approved by the Institutional Review Board of our hospital. A retrospective review was performed of 30 consecutive
patients who had undergone MR-guided 11-gauge VAB. The biopsies were performed on a 1.5 T MR scanner using a commercially
available biopsy system. All lesions seen with MRI could not be detected by mammography and second-look ultrasonography.
Results All 30 lesions were assessed as category 4 or 5. The average lesion size of a mass enhancement before biopsy was 0.7 cm, and
the average lesion size of a non-mass-like enhancement was 2.3 cm. The average number of cores of VAB was 19. The median time
required to perform the VAB procedure was 35 min. The biopsy was successfully performed without important side effects in
all patients. Histopathological findings were invasive ductal carcinoma in one (3%); ductal carcinoma in situ (DCIS) in seven
(23%); and benign in 22 (73%). In one case, atypical ductal hyperplasia at VAB was upgraded to DCIS at surgical excision.
Conclusion MR-guided VAB can be performed safely and it is needed for MR-only visible suspicious lesions in Japan. 相似文献
992.
Akiyama M Miyaaki H Miuma S Shibata H Fujimoto M Takeshita S Ozawa E Ichikawa T Nakao K Eguchi K 《Oncology reports》2008,20(2):353-357
Portal vein tumor thrombus (PVTT) is observed in a considerable number of hepatocellular carcinoma (HCC) cases. It is an exacerbating factor for patients afflicted with HCC. The sequelae of PVTT are considered to be a contraindication for the treatment of HCC in such patients. The survival of 10 HCC patients with PVTT treated with trans-hepatic arterial continuous injection chemotherapy was compared to 13 HCC patients with PVTT, who received best supportive care only, as a control to validate the efficacy of continuous trans-hepatic arterial injection chemotherapy using an implanted catheter for HCC with PVTT. There were no differences in the liver function and HCC stage between the two groups. The survival was significantly different between the two groups (P=0.01 by the log-rank test). The median survival time was 106 days in the treatment patients, whereas it was 65 days in the control patients. Multivariate analyses showed the therapy to be the only predictor for survival (risk ratio 0.144, P=0.016). The therapy was strongly associated with the PVTT prognosis. In conclusion, the importance of trans-arterial chemotherapy was demonstrated even in advanced dysfunctional cirrhotic HCC patients with PVTT. It is therefore necessary to develop a basic protocol to treat HCC with PVTT. 相似文献
993.
Tozaki M Sakamoto M Oyama Y O'uchi T Kawano N Suzuki T Yamashiro N Ozaki S Sakamoto N Higa K Abe S Ogawa T Fukuma E 《Journal of magnetic resonance imaging : JMRI》2008,28(2):420-427
PURPOSE: To assess the efficacy of (1)H MR spectroscopy (MRS) to evaluate early responses to neoadjuvant chemotherapy in breast cancer patients, as compared to that of the standardized uptake value (SUV) in (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET). MATERIALS AND METHODS: This retrospective study included seven patients with breast cancer who had both single-voxel (1)H MRS and PET/computed tomography (CT) acquired before, during, and after neoadjuvant chemotherapy. RESULTS: The averages of the Choline (Cho) integral value and peak SUV before chemotherapy were 2.5 (range, 1.2-5.3) and 7.5 (range, 1.9-19), respectively. Three cases became negative for both Cho and peak SUV after two cycles of chemotherapy, and one patient became negative before surgery. In the remaining three patients, the curves of both values paralleled the time course of chemotherapy treatment. The difference between Cho and peak SUV before, during, and after chemotherapy was r = 0.65 (P = 0.12), r = 0.80 (P = 0.03), and r = 0.99 (P < 0.001), respectively. The reduction rate (RR) of both values after chemotherapy was also correlated (r = 0.84, P = 0.02). CONCLUSION: A change in the Cho integral value is well correlated with that of peak SUV in the time course of neoadjuvant chemotherapy; thus, breast (1)H MRS is thought to be an alternative to sequential (18)F-FDG PET. 相似文献
994.
Naomi Sakamoto Yukari Ogawa Yuko Tsunoda Eisuke Fukuma 《Breast cancer (Tokyo, Japan)》2017,24(4):585-592
Purpose
To evaluate the usefulness of the UltraClip® dual trigger breast tissue marker (UltraClip) for sonographic localization, we investigate the sonographic visibility and sonographic appearance of the UltraClip placed in phantoms and patients.Materials and methods
Ten UltraClips were placed in the target lesions in the phantoms. After the ultrasound examination of the UltraClip, the ultrasound images were compared to the real appearance of the UltraClip obtained by cutting the phantoms. In the patient, the UltraClip markers were placed after biopsy of a suspicious breast lesion or before or during neoadjuvant chemotherapy. The patients consented to return 1–3 weeks after the procedure for ultrasound imaging of the UltraClip.Results
The UltraClip placed in the phantom appeared as a hyperechoic structure with a mean maximum diameter of 5.5 mm, which was found to correspond to the metallic clip in 90% (9/10) of the cases, and as a hyperechoic tubular structure with a maximum diameter of 9.0 mm corresponded to the expanded polyvinyl alcohol polymer in the remaining 10% (1/10) of cases. On the other hand, the UltraClip was detected as a hyperechoic structure measuring 3.5 mm in size only in 9 of the 15 (60%) patients. The sonographic visibility of the UltraClip was not affected depending on whether the target lesion or post-biopsy scar was sonographically detectable or not [60% (6/10) vs. 60% (3/5)].Conclusions
While sonographic localization by targeting the UltraClip may be useful in 60% of the patients, another localization technique will be needed in the remaining patients.995.
996.
Kumi Shidara Eisuke Inoue Daisuke Hoshi Naoki Sugimoto Yohei Seto 《Modern rheumatology / the Japan Rheumatism Association》2017,27(3):430-434
Objective: To validate the minimally important difference (MID) of physical function using the Japanese version of the Health Assessment Questionnaire (J-HAQ) in a cohort of rheumatoid arthritis (RA).Methods: Patients who participated in a cohort study in both October 2008 and April 2009 were analyzed. Patients self-rated their change in overall status over 6 months using a 5-point Likert scale (“much better”, “somewhat better”, “same”, “somewhat worse”, or “much worse”). The MID for J-HAQ score was defined as the mean J-HAQ score change in patients who rated themselves “somewhat better”. An effect size (ES) of 0.2–0.5 was considered to be suitable for MID.Results: A total of 4560 patients were analyzed. The mean (standard deviation [SD]) MID for J-HAQ score was ?0.06 (0.29), corresponding to an ES of 0.08. As exploratory analysis, 1999 patients with a J-HAQ score?≥0.5 and 28-joint disease activity score (DAS28)?≥?2.6 at baseline were assessed. The mean (SD) MID for J-HAQ score of these patients was 0.13 (0.01), corresponding to an ES of 0.21.Conclusions: The MID for J-HAQ score was 0.13 in patients with baseline J-HAQ score?≥0.5 and DAS28?≥?2.6. The MID for J-HAQ score was influenced by disease status and functional disability. 相似文献
997.
Satoshi Sato Yoji Uejima Meika Nanbu Eisuke Suganuma Tadamasa Takano Risa Tanaka 《Modern rheumatology / the Japan Rheumatism Association》2017,27(4):652-656
Objectives: The aim of this study was to determine the clinical phenotype and outcome of interstitial lung disease (ILD) complicated with juvenile dermatomyositis (JDM) or juvenile polymyositis (JPM).Methods: This was a single-center retrospective study. From 1984 to 2015, we retrospectively reviewed 29 patients who were diagnosed with JDM/JPM, among whom eight cases were ILD and 21 were non-ILD. The clinical features and laboratory findings included chest computed tomography (CT) images that were compared between the patients with ILD and non-ILD.Results: Eight cases (27.6%) were complicated with ILD. The mean age was 6.3 years, and 75% of the patients were women. We found that high fever, arthralgia, muscle weakness, and high serum Krebs von den Lungen-6 (KL-6) level were significantly associated with the presence of ILD (p?0.05). Two patients were positive for the anti-Jo-1 antibody, and two other patients were positive for the anti-MDA5 antibody. Three cases were identified as rapidly progressive (RP)-ILD. The chest CT images of the ILD patients appeared to show ground glass opacity (GGO) with a lower lobe predominance, reticulation, and traction bronchiectasis consolidation. Three patients with RP-ILD showed random subpleural GGO with/without consolidation patterns. Further, three patients with RP-ILD died of respiratory failure (p?0.01).Conclusion: ILD is one of the most serious complications of JDM/JPM. In the early phase of ILD, high levels of serum KL-6 can be detected, regardless of the respiratory symptoms. Additionally, RP-ILD can be predicted based on the presence of anti-MDA5 antibodies and the chest CT findings, including random subpleural GGO with/without consolidation patterns. 相似文献
998.
Tomohiro Nishinaka MD Eisuke Tatsumi MD Nobumasa Katagiri MS Hiroyuki Ohnishi MD Toshihide Mizuno VMD Kyoko Shioya VMD Tomonori Tsukiya PhD Akihiko Homma PhD Susumu Kashiwabara MS Hidenori Tanaka MS Masaki Sato MS Yoshiyuki Taenaka MD 《Journal of artificial organs》2007,10(4):240-244
We developed a new coating material (Toyobo-National Cardiovascular Center coating) for medical devices that delivers high
antithrombogenicity and long-term durability. We applied this coating to an extracorporeal membrane oxygenation (ECMO) system,
including the circuit tube, cannulae, a seal-less centrifugal pump, and a diffusion membrane oxygenator, to realize prolonged
cardiopulmonary support with trivial anticoagulant infusion. The oxygenator consisted of a hollow-fiber membrane made of polymethylpentene,
which allows the transfer of gas by diffusion through the membrane. The centrifugal pump was free of seals and had a pivot
bearing. We performed a venoarterial bypass in a goat using this ECMO system, and the system was driven for 151 days with
trivial anticoagulant infusion. Plasma leakage from the oxygenator did not occur and sufficient gas-exchange performance was
well maintained. In the oxygenator, thrombus formation was present around the top and the distributor of the inlet portion
and was very slight in the outlet portion. In the centrifugal blood pump, there was some wear in the female pivot region and
quite small amounts of thrombus formation on the edge of the shroud; the pivot wear seemed to be the cause of the hemolysis
observed after 20 weeks of perfusion and which resulted in the termination of the perfusion. However, no significant amounts
of thrombus were observed in other parts of the system. This ECMO system showed potential for long-term cardiopulmonary support
with minimal use of systemic anticoagulants. 相似文献
999.
1000.
Daisuke Horio Toshiyuki Minami Hidemi Kitai Hirotoshi Ishigaki Yoko Higashiguchi Nobuyuki Kondo Seiichi Hirota Kazuhiro Kitajima Yasuhiro Nakajima Yuichi Koda Eriko Fujimoto Yoshiki Negi Maiko Niki Shingo Kanemura Eisuke Shibata Koji Mikami Ryo Takahashi Takashi Yokoi Kozo Kuribayashi Takashi Kijima 《Cancer science》2020,111(8):2895-2906
Malignant pleural mesothelioma (MPM) is an asbestos‐related aggressive malignant neoplasm. Due to the difficulty of achieving curative surgical resection in most patients with MPM, a combination chemotherapy of cisplatin and pemetrexed has been the only approved regimen proven to improve the prognosis of MPM. However, the median overall survival time is at most 12 mo even with this regimen. There has been therefore a pressing need to develop a novel chemotherapeutic strategy to bring about a better outcome for MPM. We found that expression of interleukin‐1 receptor (IL‐1R) was upregulated in MPM cells compared with normal mesothelial cells. We also investigated the biological significance of the interaction between pro‐inflammatory cytokine IL‐1β and the IL‐1R in MPM cells. Stimulation by IL‐1β promoted MPM cells to form spheroids along with upregulating a cancer stem cell marker CD26. We also identified tumor‐associated macrophages (TAMs) as the major source of IL‐1β in the MPM microenvironment. Both high mobility group box 1 derived from MPM cells and the asbestos‐activated inflammasome in TAMs induced the production of IL‐1β, which resulted in enhancement of the malignant potential of MPM. We further performed immunohistochemical analysis using clinical MPM samples obtained from patients who were treated with the combination of platinum plus pemetrexed, and found that the overexpression of IL‐1R tended to correlate with poor overall survival. In conclusion, the interaction between MPM cells and TAMs through a IL‐1β/IL‐1R signal could be a promising candidate as the target for novel treatment of MPM (Hyogo College of Medicine clinical trial registration number: 2973). 相似文献