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Nishi-Tokyo-shi, Japan

Kinoshita T.,The Surgical Center | Iwamoto E.,The Surgical Center | Tsuda H.,National Cancer Center Hospital | Seki K.,JR Tokyo General Hospital
Breast Cancer

Purpose: To evaluate the safety and efficacy of radiofrequency ablation (RFA) as a local therapy for early breast carcinomas, we performed a phase I/II study at our institution. Patients and methods: Fifty patients with core-needle biopsy-proven breast carcinoma that was ≤3 cm in diameter on ultrasonography were enrolled in this study. Under ultrasound (US) guidance, the tumor and surrounding breast tissue were ablated with a saline-cooled RF electrode followed by immediate surgical resection. Resected specimens were examined by hematoxylin and eosin (H&E) staining and nicotinamide adenine dinucleotide (NADH) diaphorase staining to assess tumor viability. Results: Forty-nine patients completed the treatment. The mean tumor size was 1.70 cm. The mean ablation time was 8.7 min using a mean power of 48.5 W. Of the 49 treated patients, complete ablation was recognized in 30 patients (61%) by H&E staining and/or NADH diaphorase staining. The NADH viability staining was available for 38 patients, and in 29 (76.3%), there was no evidence of viable malignant cells. Of the 29 treated patients with breast carcinomas ≤2 cm in diameter examined by pathological examination, complete ablation was achieved in 24 patients (83%). Of the 26 treated patients with breast carcinomas without an extended intraductal component (EIC) according to pathological examination, complete ablation was determined in 22 patients (85%). RFA-related adverse events were observed in five cases: two with skin burn and three with muscle burns. Conclusion: RF ablation is a safe and promising minimally invasive treatment for small breast carcinomas with pathological tumor size ≤2 cm in diameter and without EIC. © 2010 The Japanese Breast Cancer Society. Source

Akiyama-Fukuda R.,JR Tokyo General Hospital | Akiyama-Fukuda R.,University of Tokyo | Usui T.,University of Tokyo | Yoshida T.,University of Tokyo | Yamagami S.,University of Tokyo

Purpose: To investigate tear meniscus dynamics using anterior segment swept-source optical coherence tomography (SS-OCT) after the instillation of topical solutions for dry eye. Design: Prospective, observational, cross-sectional study. Methods: Thirty-six healthy subjects (28 men and 8 women; mean age, 34.4 6 6.7 years) were enrolled in this study. The lower tear meniscus height, tear meniscus area, and tear meniscus volume were assessed using anterior SS-OCT. After baseline measurements, 40 mL of 0.1% sodium hyaluronate, 0.3% sodium hyaluronate, 3% diquafosol ophthalmic solution, or 2% rebamipide ophthalmic solution was instilled in one eye of 10 subjects each, whereas 40 mL saline was instilled in the other eye. Tear meniscus measurements were obtained using SS-OCT at 30 seconds and 1, 3, 5, 10, 15, 20, and 30 minutes after instillation. Results: The tear meniscus measurements showed a significant increase until 1, 3, 10, 10, and 3 minutes after the instillation of saline, 0.1% sodium hyaluronate, 0.3% sodium hyaluronate, 3% diquafosol, and 2% rebamipide, respectively, compared with the baseline levels (P , 0.05). Compared with those after saline instillation, the tear meniscus measurements were significantly higher until 30 seconds and 3, 30, and 15 minutes after the instillation of 0.1% sodium hyaluronate, 0.3% sodium hyaluronate, 3% diquafosol, and 2% rebamipide, respectively (P , 0.05). Conclusions: The instillation of ophthalmic solutions for the treatment of dry eye greatly increased tear meniscus measurements in healthy subjects. Thus, SS-OCT can be a practical tool for the quantitative evaluation of early-phase tear fluid dynamics. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. Source

Tashiro T.,JR Tokyo General Hospital | Seino S.,Kewpie Corporation | Sato T.,Kewpie Corporation | Matsuoka R.,Kewpie Corporation | And 2 more authors.
The Scientific World Journal

This study was conducted to investigate the efficacy of oral hyaluronic acid (HA) administration for osteoarthritis (OA) in knee joints. Sixty osteoarthritic subjects (Kellgren-Lawrence grade 2 or 3) were randomly assigned to the HA or placebo group. The subjects in the HA group were given 200 mg of HA once a day everyday for 12 months, while the subjects in the placebo group were given placebo. The subjects in both groups were requested to conduct quadriceps strengthening exercise everyday as part of the treatment. The subjects' symptoms were evaluated by the Japanese Knee Osteoarthritis Measure (JKOM) score. The symptoms of the subjects as determined by the JKOM score improved with time in both the HA and placebo groups. This improvement tended to be more obvious with the HA group, and this trend was more obvious with the subjects aged 70 years or less. For these relatively younger subjects, the JKOM score was significantly better than the one for the placebo group at the 2nd and 4th months after the initiation of administration. Oral administration of HA may improve the symptoms of knee OA in patients aged 70 years or younger when combined with the quadriceps strengthening exercise. © 2012 Toshiyuki Tashiro et al. Source

Hanaoka K.,JR Tokyo General Hospital
Japanese Journal of Anesthesiology

Cancer pain is very unpleasant often difficult to treat. Therefore, we should recognize the mechanisms of cancer pain and know the physical pain, psychological pain, social pain and spiritual pain as total pain. Besides, we must understand how to evaluate the cancer pain using the methods of assessment of cancer pain, and scales of pain degree (VAS, NRS, VRS, FRS, FVAS). New devices of pain measurement and the character of pain (McGill and Yatabe) are also introduced. The mechanism and grade of cancer pain often confuse us to recognize cancer pain. The articles in this special issue are useful for the evaluation and treatment of cancer pain. I feel happy if these articles contribute to the treatment of patients with cancer pain. Source

Nakai Y.,University of Tokyo | Isayama H.,University of Tokyo | Sasaki T.,University of Tokyo | Sasahira N.,University of Tokyo | And 11 more authors.
British Journal of Cancer

Background: This randomised phase II trial compared gemcitabine alone vs gemcitabine and S-1 combination therapy in advanced pancreatic cancer. Methods: Patients were randomly assigned to 4-week treatment with gemcitabine alone (1000, mg m -2 gemcitabine by 30-min infusion on days 1, 8, and 15) or gemcitabine and S-1 combination therapy (1000, mg m -2 gemcitabine by 30-min infusion on days 1 and 15 and 40 mg m -2 S-1 orally twice daily on days 1-15). The primary end point was progression-free survival (PFS). Results: Between July 2006 and February 2009, 106 patients were enrolled. The PFS in gemcitabine and S-1 combination arm was significantly longer than in gemcitabine arm (5.4 vs 3.6 months), with a hazard ratio of 0.64 (P=0.036). Overall survival (OS) for gemcitabine and S-1 combination was longer than that for gemcitabine monotherapy (13.5 vs 8.8 months), with a hazard ratio of 0.72 (P=0.104). Overall, grade 3 or 4 adverse events were similar in both arms. Conclusion: Gemcitabine and S-1 combination therapy demonstrated longer PFS in advanced pancreatic cancer. Improved OS duration of 4.7 months was found for gemcitabine and S-1 combination therapy, though this was not statistically significant. © 2012 Cancer Research UK All rights reserved. Source

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