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Higashi Hiroshima, Japan

Kawahara T.,Hiroshima University | Miyata Y.,Hiroshima University | Akayama K.,Higashi Hiroshima Medical Center | Okajima M.,Hiroshima University | Kaneko M.,Osaka University
IEEE/ASME Transactions on Mechatronics | Year: 2010

In video-assisted thoracic surgery (VATS), a surgeon cannot easily detect a lung tumor during surgical operation. This paper discusses a noncontact tumor imager capable of detecting a tumor position for application during VATS; this sensor is based on the phase differential technique. The developed sensor comprises an air supply system and an optical-fiber-based displacement sensor adjacent to the air nozzle. For a periodic air pressure, a displacement sensor provides sinusoidal outputs with individual phases. The phase difference varies according to the change in the mechanical impedance parameters of tissues between two points. We confirmed the validity of the sensor for the removed human lung through basic experiments. With regard to clinical applications, both the tumor detection capability and the safety to lung tissues of the developed sensor were confirmed through in vivo animal experiments using pig lungs. Finally, the sensor system was developed for clinical tests and the results of the clinical experiments are shown. © 2010 IEEE.

Matsuura K.,Hiroshima City Hospital | Okabe T.,Hiroshima City Hospital | Fujita K.,Higashi Hiroshima Medical Center | Tanimoto H.,Hiroshima City Asa Hospital | And 3 more authors.
Journal of Radiation Research | Year: 2012

A combination of external beam radiotherapy (EBRT) and intracavitary brachytherapy (ICBT) is well established as the standard radical radiotherapy (RT) for cervical cancer. However, it is sometimes necessary to perform EBRT alone for patients where ICBT is not feasible. For these patients, we initiated EBRT alone with three-dimensional conformal radiotherapy (3DCRT). The purpose of this study is to evaluate the results of EBRT alone without ICBT for patients with cervical cancer. Sixteen patients were treated with EBRT alone between 2002 and 2009. There were three stage IIB, six stage IIIB and seven patients with stage IVA disease. A total of 10 patients were treated with a median dose of 66 Gy with a median overall treatment time (OTT) of 40 days delivered by a concomitant boost (CCB), and a median dose of 60 Gy with a median OTT of 47 days was administered for six patients by conventional fractionation (CF). The 3-year overall survival (OAS) and local control (LC) rates were 43.8 and 75.0, respectively. The 3-year LC rate was 90.0 for the CCB group, 50.0 for the CF group (P = 0.0692); 100 for OTT ≤42 days, 42.9 for OTT ≥43 days (P = 0.0095). No severe acute and late adverse effects were encountered for any of the patients. These outcomes suggest that EBRT with a CCB program may be a promising radical treatment for cervical cancer that provides better LC with minimal complications, especially in cases where ICBT cannot be performed. © 2012 The Author 2012. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Therapeutic Radiology and Oncology.

Ito M.,Hiroshima University | Yoshihara M.,Hiroshima University | Takata S.,Hiroshima University | Wada Y.,Higashi Hiroshima Medical Center | And 4 more authors.
Journal of Gastroenterology and Hepatology (Australia) | Year: 2012

Background and Aim: Serum screening systems are beneficial for gastric cancer mass surveys; however, the marker for diffuse type gastric cancer (DGC) is not defined. We attempted to define the high-risk group for DGC by using serum markers of anti-Helicobacter pylori antibody and pepsinogens (PG). Methods: Forty-two patients in the early stage of DGC and 511 controls were enrolled. Fasting serum samples were collected, and anti-H.pylori antibody and PG were evaluated. The risk for DGC was calculated. Results: The prevalence of DGC was higher in H.pylori-positive patients (odds ratio [OR]=4.3 in men, 9.6 in women). DGC prevalence was significantly higher in the PG1+ group in women (OR=10.7); however, it was lower in the PG3+ group in both men and women. Patients with PG II≥30 revealed a significantly higher risk for DGC. By combining factors, higher OR (OR=12.5 in men, 42.7 in women) were obtained when we defined the risk group as H.pylori-positive, PG-negative, and having PG II≥30. Conclusion: The risk group for DGC can be defined by evaluating ordinary serum gastritis markers. © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

Suda K.,Kinki University | Murakami I.,Higashi Hiroshima Medical Center | Sakai K.,Kinki University | Tomizawa K.,Kinki University | And 4 more authors.
Lung Cancer | Year: 2016

Objectives: Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are used as a first line therapy for metastatic lung cancer harboring somatic EGFR mutation. However, acquisition of resistance to these drugs is almost inevitable. T790M (threonine to methionine substitution at codon 790 of the EGFR gene) and MET amplification are well-known resistance mechanisms, and we previously demonstrated that three of six autopsied patients showed inter-tumor heterogeneity in resistance mechanisms by analyzing T790M and MET gene copy number (Suda et al., 2010). To further elucidate the role of heterogeneity in acquired resistance, here we performed further analyses including additional five patients. Materials and methods: We analyzed somatic mutations in 50 cancer-related genes for 26 EGFR-TKI refractory lesions from four autopsied patients using target sequencing. MET and ERBB2 copy numbers were analyzed by real-time PCR. Data for additional one patient was obtained from our recent study (Suda et al., 2015). Relationship between heterogeneity in resistance mechanism(s) and time to treatment failure (TTF) of EGFR-TKI and post-progression survival (PPS) were analyzed. Results and conclusion: We observed heterogeneity of resistance mechanisms in two of four patients analyzed (T790M. +. MET gene copy number gain, and mutant EGFR loss + unknown). We also identified quantitative heterogeneity in EGFR T790M mutation ratio among EGFR-TKI refractory lesions. In analyzing patient outcomes, we found that patients who developed multiple resistance mechanisms had shorter TTF compared with those who developed single resistance mechanism (p = 0.022). PPS after EGFR-TKI treatment failure was compatible between these two groups (p = 0.42). These findings further our understanding of acquired resistance mechanisms to EGFR-TKIs, and may lead to better treatment strategies after acquisition of resistance to first generation EGFR-TKIs in lung cancer patients with EGFR mutations. © 2015 Elsevier Ireland Ltd.

Tsubata Y.,The University of Shimane | Sutani A.,The University of Shimane | Okimoto T.,The University of Shimane | Matsuura M.,Hiroshima City Hospital | And 10 more authors.
Anticancer Research | Year: 2012

Background: Pleomorphic carcinoma (PC) of the lung is a rare tumor that usually has an aggressive clinical course and a poor prognosis. In this study, 75 cases of PC were reviewed to identify its clinical features, and we examined the expression of angiogenic factors. Patients and Methods: We immunohistochemically examined the expression of angiogenic factors in tissue specimens of PC. Results: 66 males and 9 females were examined. The median survival time was 16.5 months. The stage and symptomatical diagnosis were significantly associated with the survival. In the immunohistochemical analyses, vascular endothelial growth factor (VEGF) was expressed in many cases of PC. A high score for angiogenesis was significantly related to a poorer prognosis. Conclusion: We conclude that PC should be considered an aggressive disease, and that the stage and symptomatical diagnosis are strong prognostic factors. Furthermore, tumor angiogenesis provides significant prognostic information about the clinical outcome in PC.

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