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71.
Ogawa K Nakamura K Hatano K Uno T Fuwa N Itami J Kojya S Nakashima T Shinhama A Nakagawa T Toita T Sakai M Kodaira T Suzuki M Ito H Murayama S 《International journal of radiation oncology, biology, physics》2007,68(5):1326-1334
PURPOSE: To examine the relative roles of surgery, radiotherapy, and chemotherapy in the management of patients with squamous cell carcinomas of the external auditory canal and middle ear. METHODS AND MATERIALS: The records of 87 patients with histologically confirmed squamous cell carcinoma who were treated between 1984 and 2005 were reviewed. Fifty-three patients (61%) were treated with surgery and radiotherapy (S + RT group) and the remaining 34 patients with radiotherapy alone (RT group). Chemotherapy was administered in 34 patients (39%). RESULTS: The 5-year actuarial overall and disease-free survival (DFS) rates for all patients were 55% and 54%, respectively. On univariate analysis, T stage (Stell's classification), treatment modality, and Karnofsky performance status had significant impact on DFS. On multivariate analysis, T stage and treatment modality were significant prognostic factors. Chemotherapy did not influence DFS. The 5-year DFS rate in T1, T2, and T3 patients was 83%, 45%, and 0 in the RT group (p < 0.0001) and 75%, 75%, and 46% in the S + RT group (p = 0.13), respectively. The 5-year DFS rate in patients with negative surgical margins, those with positive margins, and those with macroscopic residual disease was 83%, 55%, and 38%, respectively (p = 0.007). CONCLUSIONS: Radical radiotherapy is the treatment of choice for early-stage (T1) diseases, whereas surgery (negative surgical margins if possible) with radiotherapy is recommended as the standard care for advanced (T2-3) disease. Further clarification on the role of chemotherapy is necessary. 相似文献
72.
73.
Yasumatsu R Nakashima T Yamauchi M Wakasaki T Masuda M Komune S 《Auris, nasus, larynx》2011,38(3):387-391
Objective
The aim of this study was to evaluate the immunohistochemical TS expression in patients with maxillary sinus SCC.Methods The value of immunohistochemical TS expression as a predictive indicator for 5-FU efficacy was retrospectively examined in 47 patients with maxillary sinus SCC.Results Of the 47 patients, 29 (62%) showed complete response for 5-FU based chemoradiotherapy. Seventeen of 19 (89%) TS low cases showed a complete response, whereas 12 of 28 (43%) TS high cases showed complete response for 5-FU based chemoradiotherapy. Low TS patients had significantly better response rates compared with high TS patients.Conclusion These findings suggest that TS expression affects the chemotherapeutic effect of 5-FU in patients with maxillary sinus SCC and the assessment of TS expression level might be useful both in the management and in the treatment of maxillary sinus SCC. 相似文献74.
75.
Masaru Morita MD PhD FACS Hiroyuki Kawano MD Hajime Otsu MD Yasue Kimura MD PhD Hiroshi Saeki MD PhD Koji Ando MD PhD Satoshi Ida MD PhD Eiji Oki MD PhD FACS Tetsuo Ikeda MD PhD Tetsuya Kusumoto MD PhD FACS Jun-ichi Fukushima MD PhD Torahiko Nakashima MD PhD Yoshihiko Maehara MD PhD FACS 《Annals of surgical oncology》2013,20(7):2434-2439
Background
Esophageal cancer is frequently associated with head and neck cancer, and esophagectomy is usually difficult in such a case. The purpose of this study was to clarify the clinical significance of esophagectomy for patients with esophageal cancer associated either synchronously or metachronously with head and neck cancer.Methods
The clinical outcomes of surgical resections for esophageal cancer were compared between 26 patients with head and neck cancer (double cancer group) and 176 without head and neck cancer (control group).Results
Staged operations were performed in 5 patients in the double cancer group, while microvascular anastomosis as well as a muscle flap was added for 3 and 4 patients, respectively. The mortality and morbidity of the double cancer group were 0 and 35 %, respectively, which were not significantly different from those of the control group (3 and 31 %, respectively). There were no significant differences in overall survival in the double cancer and control groups, which had 5-year survival rates of 59 and 49 %, respectively.Conclusions
Esophagectomy can be an effective treatment when techniques are adopted that are appropriate for each case, such as staged operations, muscular flaps, and microvascular anastomosis, even in patients with double cancers of the esophagus and the head and neck. 相似文献76.
Comparison of Routine and Selective Endoscopic Retrograde Cholangiography before Laparoscopic Cholecystectomy 总被引:1,自引:0,他引:1
Masao Tanaka Masayuki Sada Toru Eguchi Hiroyuki Konomi Gen Naritomi Torahiko Takeda Yoshiaki Ogawa Kazuo Chijiiwa Georgi P. Deenitchin 《World journal of surgery》1996,20(3):267-271
p
< 0.05). It should be noted that a certain proportion of duct stones may be missed by selective ERC, necessitating laparotomy
when sphincterotomy fails. The routine use of preoperative ERC may be justified at institutions where the expertise is available,
at least until laparoscopic lithotomy becomes easy. 相似文献
77.
Effect of atropine on the biomechanical properties of the oesophageal wall in humans 总被引:2,自引:0,他引:2
Torahiko Takeda Ghassan Kassab Jianmin Liu Toshinaga Nabae Ravinder K. Mittal 《The Journal of physiology》2003,547(2):621-628
Recently, we reported a novel ultrasound technique to assess biomechanical properties of the oesophagus in human subjects. In the present study, we use the technique, in combination with atropine, to determine the active and passive biomechanical properties of the oesophagus in normal healthy humans. A manometric catheter equipped with a high-compliance bag and a high-frequency intraluminal ultrasonography probe was used to record pressure and oesophageal geometry. Oesophageal distensions with either isovolumic (5–20 ml water) or with isobaric (10–60 mmHg) technique were performed. Intra-bag pressure and ultrasound images of the oesophagus were recorded simultaneously. Following injection of atropine (15 μg kg−1 , i.v .), the oesophageal distensions were repeated. The oesophageal wall compliance, circumferential wall tension, stress, strain and elastic modulus were calculated. Atropine resulted in an increase in the oesophageal wall compliance during isobaric distension, but no change in compliance was observed during isovolumic distension. The stress–strain relationship was found to be linear during both types of distension, before as well as after atropine. The Young's modulus, which is the slope of a linear stress–strain relationship, was significantly higher after atropine in the isovolumic study but not in the isobaric study. The stress–strain relationship of the active component (muscle contraction) was different during isovolumic and isobaric distensions but the passive components were similar. The passive and active stress–strain relationships of the human oesophagus resemble those of other soft biological tissues. Furthermore, the method of oesophageal distension has significant influence on the active but not the passive biomechanical properties due to a strain-rate effect. 相似文献
78.
Torahiko Takeda Hiroyuki Konomi Gen Naritomi Junichi Yoshida Hiroaki Matsunaga Kouhei Akazawa Masao Tanaka 《Journal of gastroenterology》1996,31(3):323-328
An ultrasonographic study of ten healthy volunteers was carried out to evaluate the effect of cisapride on gastric antral
emptying. More than 1 week after the measurement of the baseline emptying rate, cisapride was given at a single oral dose
of 5 mg 30 minutes before intake of a balanced liquid test meal (5 ml/kg body weight). To determine the time to half emptying
(T1/2), an exponential curve was extrapolated for the elimination phase of the gastroantral sagittal cross-sectional area
plotted against time. The T1/2 was reduced by 18.5% after cisapride, from 62.6±4.3 to 51.0±4.4 min (P=0.0284). We conclude that a single oral dose of 5mg of cisapride significantly accelerates the gastric antral emptying rate
in healthy humans. 相似文献
79.
Hiroaki Saito Kimitake Tsuchiya Sahoko Chiba Tomoyuki Ogata Reina Imase Tamon Yagi Yuka Mishima Torahiko Jinta Kazuhito Saito Reiko Taki Susumu Isogai Yasuto Jin Tsutomu Kawasaki Ichiro Natsume Yoshihiro Miyashita Jun Takagiwa Nobuo Ishiwata Tomoshige Chiaki Yasunari Miyazaki 《Respiratory investigation》2019,57(2):126-132
Background
Cigarette smoking in patients with asthma leads to poor symptom control. As patients who are current smokers have been excluded from enrollment in many clinical trials on asthma, there are few reports on the treatment in current smokers with asthma. In this study, we aimed to assess how respiratory physicians manage asthma in current smokers in Japan.Methods
Respiratory physicians in 16 Japanese hospitals answered a questionnaire on treatment for patients with asthma between December 2014 and February 2015. Medical records were reviewed for 1756 patients with asthma.Results
The mean patient age was 61.1 years, and 62.9% of the patients were female. A total of 102 patients (5.8%) were current smokers, and 546 patients (31.1%) were former smokers. Long-acting muscarinic antagonists (LAMA) were prescribed more frequently for current smokers with asthma than for former smokers and never smokers with asthma (10.8% vs 4.6%, p = 0.01, 10.8% vs 3.8%, p < 0.01). In contrast, macrolides were prescribed more frequently for former smokers and never smokers with asthma than for current smokers with asthma (7.7% vs 1.0%, p = 0.01, 6.4% vs 1.0%, p = 0.03). Triple therapy, i.e., inhaled corticosteroids, long-acting beta agonists, and LAMA concomitantly, was prescribed for current smokers with asthma more frequently than for former smokers and never smokers with asthma (9.8% vs 4.0%, p = 0.01, 9.8% vs 3.3%, p < 0.01).Conclusions
According to this survey, current smokers with asthma received more intensive therapy, including LAMA, than did former smokers with asthma. 相似文献80.
Masao Tanaka Hiroyuki Konomi Hiroaki Matsunaga Kazunori Yokohata Naruhiro Utsunomiya Torahiko Takeda 《Journal of hepato-biliary-pancreatic sciences》1997,4(1):16-19
Technical improvements, such as mechanical lithotripsy, stenting or nasobiliary drainage, and wire-guided cannulation, have reduced the risk of complications in endoscopic sphincterotomy. To determine the extent of this reduction in risk, we assessed the medical records of 1352 patients with common bile duct stones in whom the procedure was conducted. Complications examined were: acute cholangitis and pancreatitis. Stone clearance was achieved in 1256 patients (92.8%), with an overall morbidity rate of 7.7% and a mortality rate of 0.15%. One hundred and forty-two patients had stones with a diameter greater than 20mm; 97 of these patients did not undergo lithotripsy. Cholangitis occurred in 10 of these 97 patients (10.3%), whereas, in the 45 patients who underwent lithotripsy, there were no cases of cholangitis (P=0.02). Stone removal was not immediately accomplished or attempted in 396 patients. In 82 of these patients in whom a stent or a nasobiliary drain was placed in the common bile duct, the incidence of cholangitis was 1.2%, significantly less (P=0.045) than the incidence of 6.4% in the other 314 patients given no stenting or nasobiliary drain. To overcome difficult cannulation, precut sphincterotomy was conducted in 134 patients and wireguided sphincterotomy, a recently introduced procedure, was conducted in 55 patients. When the precutting technique was used, the incidence of acute pancreatitis was significantly higher (8/134; 6.0%) than that in the patients in whom the standard procedure was conducted, i.e., neither the precut technique nor wire-guided ES was used (23/1218; 1.9%) (P=0.008). There were no cases of pancreatitis in the 55 patients in whom wire-guided sphincterotomy was performed, although the difference was not statistically significant because of the small number of patients (P=0.06). Based on these findings, we conclude that improved technologies have led to a significant reduction of complications in endoscopic sphincterotomy. 相似文献