Obihiro, Japan
Obihiro, Japan

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Takeda N.,Hokkaido University | Isu K.,Hokkaido Cancer Center | Hiraga H.,Hokkaido Cancer Center | Minami A.,Hokkaido University | Kamata H.,Hokuto Hospital
Journal of Orthopaedic Science | Year: 2012

Background: Renal cell carcinoma (RCC) is thought to respond unreliably to radiotherapy (RT). Zoledronic acid significantly reduces the risk of skeletal complications. This study investigated whether RT with zoledronic acid prolonged the time to bone-lesion progression in comparison with RT alone. Method: Twenty-seven patients (34 lesions) with bone metastases secondary to RCC undergoing treatment with RT with or without zoledronic acid were retrospectively evaluated at two institutions between 1999 and 2009. Twelve patients were treated with RT alone from 1999 to 2008 (RT group). Fifteen patients were treated with RT and zoledronic acid from 2006 to 2009 (RT + Z group). The time to skeletal-related events and pain progression were assessed from patients' medical records. Results: The median (range) follow-up was 26 (3-75) and 24 (3-55) months in the RT and RT + Z groups, respectively. Three patients (three lesions) in the RT + Z group had skeletal-related events (SREs). In contrast, six patients (eight lesions) in the RT group had SREs. SREs comprised pathological fractures in five, additional surgeries in three, spinal cord or cauda equine compression in two, and repeat RT in one. There was a significant difference in SRE-free survival time and duration of site-specific pain response between groups. Conclusions: RT combined with zoledronic acid significantly prolonged SRE-free survival and duration of pain response compared with RT alone in the treatment of osseous metastases from RCC. © 2012 The Japanese Orthopaedic Association.


PubMed | Hokuto Hospital, Nihon Medi Physics Corporation, Osaka City University, Kanazawa Institute of Technology and Ricoh Company
Type: Journal Article | Journal: PloS one | Year: 2016

Quantitative imaging of neuromagnetic fields based on automated region of interest (ROI) setting was analyzed to determine the characteristics of cerebral neural activity in ischemic areas.Magnetoencephalography (MEG) was used to evaluate spontaneous neuromagnetic fields in the ischemic areas of 37 patients with unilateral internal carotid artery (ICA) occlusive disease. Voxel-based time-averaged intensity of slow waves was obtained in two frequency bands (0.3-4 Hz and 4-8 Hz) using standardized low-resolution brain electromagnetic tomography (sLORETA) modified for a quantifiable method (sLORETA-qm). ROIs were automatically applied to the anterior cerebral artery (ACA), anterior middle cerebral artery (MCAa), posterior middle cerebral artery (MCAp), and posterior cerebral artery (PCA) using statistical parametric mapping (SPM). Positron emission tomography with 15O-gas inhalation (15O-PET) was also performed to evaluate cerebral blood flow (CBF) and oxygen extraction fraction (OEF). Statistical analyses were performed using laterality index of MEG and 15O-PET in each ROI with respect to distribution and intensity.MEG revealed statistically significant laterality in affected MCA regions, including 4-8 Hz waves in MCAa, and 0.3-4 Hz and 4-8 Hz waves in MCAp (95% confidence interval: 0.020-0.190, 0.030-0.207, and 0.034-0.213), respectively. We found that 0.3-4 Hz waves in MCAp were highly correlated with CBF in MCAa and MCAp (r = 0.74, r = 0.68, respectively), whereas 4-8 Hz waves were moderately correlated with CBF in both the MCAa and MCAp (r = 0.60, r = 0.63, respectively). We also found that 4-8 Hz waves in MCAp were statistically significant for misery perfusion identified on 15O-PET (p<0.05).Quantitatively imaged spontaneous neuromagnetic fields using the automated ROI setting enabled clear depiction of cerebral ischemic areas. Frequency analysis may reveal unique neural activity that is distributed in the impaired vascular metabolic territory, in which the cerebral infarction has not yet been completed.


Bandoh N.,Asahikawa Medical College | Bandoh N.,Hokuto Hospital | Ogino T.,Asahikawa Medical College | Katayama A.,Asahikawa Medical College | And 4 more authors.
Oncology Reports | Year: 2010

HLA class I antigen processing machinery plays a crucial role in the generation of peptides from endogeneously synthesized proteins and in their presentation to cytotoxic T lymphocytes. The purpose of this study was to analyze the downregulation of HLA class I antigen, transporter associated with antigen processing (TAP) and tapasin in primary and metastatic lesions of head and neck squamous cell carcinoma (HNSCC) and to compare TAP, tapasin and HLA class I antigen downregulation in metastatic lesions with that of primary lesions. We analyzed expression levels of TAP1, TAP2, tapasin and HLA class I antigen in 25 primary and autologous metastatic lesions by staining formalin-fixed, paraffin-embedded tissue sections in the immunoperoxidase reaction. We identified the expression levels of TAP1, TAP2, tapasin and HLA class I antigen were coordinately downregulated in both primary and metastatic lesions and were significantly lower in metastatic lesions than in autologous primary lesions tested. HLA class I antigen downregulation in metastatic lesion was significantly associated with reduced disease-free survival of patients (P<0.05). Multivariate Cox proportional hazards model analysis identified negativity of HLA class I antigen as an independent prognostic marker. HLA class I antigen and TAP are likely to be downregulated in metastatic lesions compared with primary lesions in HNSCC. The higher frequency of HLA class I antigen and TAP downregulation in metastases play a role in the clinical course of the disease.


Takahashi Y.,Hokuto Hospital | Hashimoto N.,Osaka University | Akihiko H.,Saiseikai Shiga Hospital
Neurologia Medico-Chirurgica | Year: 2010

Epidural hematoma is typically caused by direct head trauma. Spontaneous epidural hematoma can be caused by infections of adjacent regions, vascular malformations of the dura mater, and disorders of blood coagulation. A 10-year-old girl with no history of head injury presented with complaints of headache and fever. On arrival at our hospital, her Glasgow Coma Scale score was 13 and neurological examination revealed right oculomotor palsy and left hemiparesis. Computed tomography (CT) showed an epidural hematoma in the right temporal base. Preoperative angiography identified no specific vascular lesions. Removal of the hematoma was undertaken immediately. Retrospective evaluation of the preoperative CT revealed sphenoid sinusitis and a bone defect between the temporal base and the sphenoid sinus. The epidural hematoma was probably caused by the spread of inflammation from the sphenoid sinus. Sphenoid sinusitis is one of the possible causes of acute epidural hematoma, especially if no traumatic episodes or risk factors can be identified.


Kitagawa E.,Hokuto Hospital
Journal of Japanese Dental Society of Anesthesiology | Year: 2013

Intravenous sedation (IVS) is frequently used in patients with a profound phobia of dental treatment. The present study examined whether IVS actually relieved patient fears, as well as the level of sedation, frequency of procedural accidents and the hemodynamics of phobic patients compared to non-phobic patients. A total of 1,834 patients underwent impacted tooth extraction under IVS in our department between 2000 and 2008. Sixty-four patients who admitted to having considerable tenseness, fear and anxiety before the treatment in a questionnaire survey were assigned to the "dental phobia" (DP) group, while the 340 patients who responded that they did not have any tenseness, fear and anxiety. The results were then compared retrospectively between the two groups. No significant differences were found in procedure duration, recovery time, local anesthesia effect, amnesic effect, incidence of respiratory depression, incidence of procedural accidents or patient impressions (pain, recollection of the procedure, drowsiness) (Table 1, 2, 3). Dose of propofol was significantly higher in the DP group, because a larger dose was deemed necessary to achieve optimal sedation. No significant intergroup differences in level of sedation at induction or during surgery were seen, but many patients in the DP group were heavily sedated at the end of the procedure. Hemodynamically, mean BP and HR remained significantly elevated in the DP group before and during the procedure (Fig. 1, 2). There was no significant difference in min SpO2 (Fig. 3). Fifty-nine of 64 patients in the DP group showed a diminished score of tenseness, fear and anxiety during sedation (Fig. 4). Postoperative patient impressions were virtually the same in both groups, with more than 95% of patients indicating no experience of any discomfort during the procedure and approximately 100% in the DP group stating that they would prefer IVS if undergoing the same procedure again. These study findings suggest that intravenous sedation enables a good level of sedation, safety and patient satisfaction, even in patients with dental phobia.


Kato Y.,Hokkaido University | Nishihara H.,Hokkaido University | Mohri H.,Hokuto Hospital | Kanno H.,Hokkaido University | And 5 more authors.
Brain Tumor Pathology | Year: 2014

Tumorigenic activity of cyclooxygenase-2 (COX-2), a rate-limiting enzyme in the production of prostaglandins (PGs), has been proved for some types of cancer, including brain tumors. We evaluated expression of COX-2 in meningioma, one of the most common intracranial tumors in adults which accounts for 24-30% of intracranial tumors. We performed immunostaining for COX-2 in 76 cases of meningioma consisting of 44 cases of low-grade (WHO Grade I) and 32 cases of high-grade (29 cases of Grade II and 3 cases of Grade III) meningioma, and evaluated COX-2 expression levels on the basis of staining intensity and proportion in tumor cells. The expression level of COX-2 in meningioma cells was significantly correlated with WHO grade ( P = 0.0153). In addition, COX-2 expression was significantly correlated with MIB-1 labeling index for all 76 cases of meningioma (P = 0.0075), suggesting tumor promotion by COX-2 in meningioma progression. Our results may indicate the therapeutic value of non-steroidal anti-inflammatory drugs against meningioma, especially for patients with elevated proliferation, to regulate the tumorigenic activity of COX-2 in meningioma cells. © The Japan Society of Brain Tumor Pathology 2012.


Takahashi Y.,Kumamoto University | Takahashi Y.,Hokuto Hospital | Nakamura H.,Kumamoto University | Makino K.,Kumamoto University | And 4 more authors.
World Journal of Surgical Oncology | Year: 2013

Background: To determine the prognostic value of isocitrate dehydrogenase 1 (IDH1) mutation, O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation, and 1p/19q co-deletion in Japanese patients with malignant gliomas.Methods: We studied 267 malignant gliomas, which included 171 glioblastomas (GBMs), 40 anaplastic astrocytomas (AAs), 30 anaplastic oligodendrogliomas (AOs), and 26 anaplastic oligoastrocytomas (AOAs). These malignant gliomas were divided into 2 groups (Group 1: GBM + AA, Group 2: AO + AOA) according to the presence of the oligodendroglioma component. We examined IDH1 mutation and MGMT promoter methylation in each group by direct sequencing and methylation-specific PCR, respectively. We further examined 1p/19q co-deletion in Group 2 by fluorescence in situ hybridization. Survival between groups was compared by Kaplan-Meier analysis.Results: In Group 1, patients with IDH1 mutations exhibited a significantly longer survival time than patients with wild-type IDH1. However, no significant difference was observed in Group 2, although patients with IDH1 mutations tended to show prolonged survival. For both Group 1 and Group 2, patients with MGMT methylation survived longer than those without this methylation. Further, patients with 1p/19q co-deletion showed significantly better outcome in Group 2.Conclusions: Our study confirms the utility of IDH1 mutations and MGMT methylation in predicting the prognosis of Group 1 patients (GBM + AA) and demonstrated that IDH1 mutations may serve as a more reliable prognostic factor for such patients. We also showed that MGMT methylation and 1p/19q co-deletion rather than IDH1 mutations were prognostic factors for Group 2 patients (AOA + AO). Our study suggests that patients survive longer if they have IDH1 mutations and undergo total resection. Further, irrespective of MGMT promoter methylation status, the prognosis of glioma patients can be improved if total resection is performed. Moreover, our study includes the largest number of Japanese patients with malignant gliomas that has been analyzed for these three markers. We believe that our findings will increase the awareness of oncologists in Japan of the value of these markers for predicting prognosis and designing appropriate therapeutic strategies for treating this highly fatal disease. © 2013 Takahashi et al.; licensee BioMed Central Ltd.


Takahashi Y.,Hokuto Hospital | Bandoh N.,Hokuto Hospital | Miyamoto A.,Hokuto Hospital | Kamada H.,Hokuto Hospital
Journal of Oral and Maxillofacial Surgery | Year: 2016

Ameloblastic carcinoma (AC) is a rare malignant odontogenic tumor. Surgical resection of the tumor is the mainstay of its treatment. To date, radiotherapy for this tumor remains controversial. This report describes a case of AC with intracranial extension and provides the first report of the efficacy of single-fraction helical tomotherapy for the treatment of residual AC after surgical resection. © 2016 American Association of Oral and Maxillofacial Surgeons.


PubMed | Asahikawa University, Hokuto Hospital and Hokkaido University
Type: Evaluation Studies | Journal: Diagnostic cytopathology | Year: 2016

Cervical lymphadenopathy is a symptom that is frequently seen among outpatients, and it is important to differentiate malignant lesions from reactive lymphoid hyperplasia. Fine needle aspiration (FNA) cytology has been widely used for the diagnosis of cervical lymphadenopathy. However, some limitations of the diagnostic accuracy using conventional smear (CS) cytology have been pointed out. The diagnostic value of liquid-based cytology (LBC) with FNA specimens has not yet been fully proven.Forty-two patients with cervical lymphadenopathy who underwent FNA with CS cytology from 2007 to 2011 and 123 patients who underwent FNA with LBC utilizing LBCPREP2 from 2011 to 2015 were studied. Diagnostic values were compared between the CS and the LBC groups.Of the total 165 patients representing the combined CS and LBC groups, 81 (49.1%) were diagnosed as benign lymph node and 84 (50.9%) were malignant diseases including 37 (22.4%) of metastatic carcinoma except for thyroid carcinoma, 30 (18.2%) of metastatic thyroid carcinoma, and 17 (10.3%) of malignant lymphoma. The overall statistical values including sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the CS were 75%, 100%, 100%, 78.9%, and 87.1%, respectively, whereas those values for LBC were 91.2%, 100%, 100%, 90.7%, and 95.3%, respectively. The sensitivity of LBC for malignant diseases tended to be higher than that of CS cytology (p=0.081).LBC with FNA specimens from cervical lymphadenopathy is a useful and reliable method for the diagnosis of malignant diseases, especially of metastatic carcinomas, due to its increased sensitivity compared with CS cytology.


PubMed | Hokuto Hospital
Type: Case Reports | Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons | Year: 2016

Ameloblastic carcinoma (AC) is a rare malignant odontogenic tumor. Surgical resection of the tumor is the mainstay of its treatment. To date, radiotherapy for this tumor remains controversial. This report describes a case of AC with intracranial extension and provides the first report of the efficacy of single-fraction helical tomotherapy for the treatment of residual AC after surgical resection.

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