Tenri, Japan
Tenri, Japan

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Tamaki S.,Takai Hospital | Yamanaka Y.,Takai Hospital | Shimomura H.,Takai Hospital | Kawashima W.,Takai Hospital | Sasahira T.,Nara Medical University
Asian Journal of Oral and Maxillofacial Surgery | Year: 2011

This report is the case report of a 48-year-old woman who referred to our hospital complaining of a mass at the left maxillary tuberosity and slight trismus. CT and MRI imagings showed a tumor like image with bone absorption of the left maxillary tuberosity. Under general anesthesia, the lesion was excised. Histopathological examination showed low grade mucoepidermoid carcinoma. There is no sign of recurrence or metastasis of the tumor in 5 year after the surgery. © 2010.


Matsukage T.,Tokai University | Masutani M.,Hyogo College of Medicine | Yoshimachi F.,Aomori Prefectural Central Hospital | Takahashi A.,Takahashi Hospital | And 17 more authors.
Catheterization and Cardiovascular Interventions | Year: 2010

Objectives: The aim of this study was to evaluate the safety and effectiveness of a 0.010-inch guidewire and a balloon catheter for treatment of chronic total occlusion (CTO). Background: Pathological studies have shown that 60-70% of CTO lesions have microchannels of sizes equal to or less than 0.010 inch. Methods: The PIKACHU registry is a prospective, multicenter registry study. A 0.010-inch guidewire had to be used as the first guidewire to attempt to pass the CTO lesion. The primary endpoint was device success using a 0.010 system. Results: A total of 141 patients with 141 lesions were enrolled. The median duration of occlusion was 9 months (range 3-156). Average guiding catheter size was 5.8 ± 0.7 Fr. and TRI was 76.6%. CTOs were mostly between 10-20 mm long, observed in 53 occlusions. There were 107 lesions (75.9%) with bending of more than 45 degrees. Calcification was seen in 91 lesions (64.5%). A 0.010-inch guidewire was successfully passed through in 97 of 141 lesions (68.8%). A 0.010-inch guidewire compatible balloon catheter was passed in 87 of the 97 lesions (88.7%) and final PCI success was achieved in all the cases. The overall clinical success rate was 87.9% (124/141). No MACE or bleeding complications were observed. Conclusion: The PIKACHU registry data suggest that the 0.010-inch system is safe and practicable for treatment of CTO lesions. © 2010 Wiley-Liss, Inc.


Iijima S.,National Rehabilitation Center for Persons with Disabilities | Aida N.,Nagoya University | Ito H.,Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology | Endo H.,National Center for Geriatrics and Gerontology | And 9 more authors.
Geriatrics and Gerontology International | Year: 2014

The Japan Geriatrics Society published a revised version of its position statement regarding the end-of-life care for elderly patients, based on the overall consensus by the members of the ethics committee in 2012. This revision is intended to catch up with current changes of views on the end-of-life care for older people over the past decade. There are many suggestive items regarding the matter in this statement, and the authors believe it will be of specific guidance for those who are caring for older people in their final stage of life in the super-aged society. Also, the statement can be useful in many other countries, where aging of the population is not yet an urgent concern, but will be so in the future. We believe that this "position statement" can offer guidance in an ethical respect for those who are or will be engaged in end-of-life care for older people. We also hope that the release of the current statement provides an avenue for broader discussion in a society with an increasing aged population. © 2014 Japan Geriatrics Society.


Fueda Y.,Himeji Dokkyo University | Fueda Y.,Nara Institute of Science and Technology | Katayama T.,Himeji Dokkyo University | Sato T.,Nara Institute of Science and Technology | And 3 more authors.
Transactions of Japanese Society for Medical and Biological Engineering | Year: 2014

Intradialytic hypotension occurred in about 20 to 30% of treatments. Therefore, it is important to observe the variation of intravascular volume and blood pressure to prevent intradialytic hypotension during hemodialysis (HD). In this study, we constructed a mathematical model to understand the variation of intravascular volume in HD patients. Then, we examined the validity of the model. By applying this model, we proposed a method for identifying patients in need of pharmacotherapy to prevent intradialytic hypotension during HD. In 14 patients with end-stage renal disease (ESRD), we measured the variation of intravascular volume through blood volume monitoring (BVM) during HD. Then, we estimated the water movement rate, r, and the maximum excess volume in extravascular, VO. max, using nonlinear least-squares method. The relation of the mathematical model and the BVM value showed a high correlation. The correlation coefficient R (=0.95) could be used to detect patients in need of observation. Further, the relation of the maximum excess volume in extravascular, VO. max, and difference between body weight and dry weight showed also a high correlation. The model expressed correctly the variation of the intravascular volume. The correlation coefficient R of the mathematical model and the BVM value and the maximum excess volume in extravascular, VO. max were important parameters to manage HD. We proposed the mathematical model and new index to control HD efficiently.


PubMed | Karolinska Institutet, Instituto Ortopedico Rizzoli, Shiga University of Medical Science, CNR Institute of Molecular Genetics and 2 more.
Type: Journal Article | Journal: Oncotarget | Year: 2016

Current therapy of osteosarcoma (OS), the most common primary bone malignancy, is based on a combination of surgery and chemotherapy. Multidrug resistance mediated by P-glycoprotein (P-gp) overexpression has been previously associated with treatment failure and progression of OS, although other mechanisms may also play a role. We considered the typical acidic extracellular pH (pHe) of sarcomas, and found that doxorubicin (DXR) cytotoxicity is reduced in P-gp negative OS cells cultured at pHe 6.5 compared to standard 7.4. Short-time (24-48 hours) exposure to low pHe significantly increased the number and acidity of lysosomes, and the combination of DXR with omeprazole, a proton pump inhibitor targeting lysosomal acidity, significantly enhanced DXR cytotoxicity. In OS xenografts, the combination treatment of DXR and omeprazole significantly reduced tumor volume and body weight loss. The impaired toxicity of DXR at low pHe was not associated with increased autophagy or lysosomal acidification, but rather, as shown by SNARF staining, with a reversal of the pH gradient at the plasma membrane (pHcm), eventually leading to a reduced DXR intracellular accumulation. Finally, the reversal of pHcm in OS cells promoted resistance not only to DXR, but also to cisplatin and methotrexate, and, to a lesser extent, to vincristine. Altogether, our findings show that, in OS cells, short-term acidosis induces resistance to different chemotherapeutic drugs by a reversal of pHcm, suggesting that buffer therapies or regimens including proton pump inhibitors in combination to low concentrations of conventional anticancer agents may offer novel solutions to overcome drug resistance.


Uto F.,Takai Hospital | Uto F.,Nara Medical University | Shiba E.,Takai Hospital | Onoue S.,Takai Hospital | And 7 more authors.
Journal of Radiation Research | Year: 2010

We assessed the usefulness of PET/CT images to determine the target volume in radiotherapy planning by evaluating the standardized uptake value (SUV). We evaluated the imaging conditions and image- reconstruction conditions of PET/CT useful for treatment planning by collecting 18F-FDG images of acrylic spheres (10-48 mm in diameter) in a phantom. The 18F-FDG concentration in the spheres was 10- fold higher than that of the phantom. The contours were delineated according to the SUV by the threshold and regions of interest (ROI) methods. Comparisons of two- and three-dimensional (2D and 3D) acquisition images indicated that the sharpness and quantitative qualities of the sphere boundaries were better in the former than in the latter. In the extraction of outlines using the SUV, outlines obtained at an SUV of 40-50% of the maximum agreed well with the actual acrylic sphere size. 2D acquisition images are more suitable for delineating target volume contours, although 3D acquisition images are more popular in diagnostic imaging. An SUV of 40-50% of the maximum is suggested to be appropriate for GTV contouring of sphere tumors with homogenously distributed 18F-FDG.


Hironaka Y.,Nara Medical University | Morimoto T.,Takai Hospital | Motoyama Y.,Nara Medical University | Park Y.-S.,Nara Medical University | Nakase H.,Nara Medical University
Neurologia Medico-Chirurgica | Year: 2013

Surgical treatment for degenerative spinal disorders is controversial, although lumbar fusion is considered an acceptable option for disabling lower back pain. Patients underwent instrumented minimally invasive anterior lumbar interbody fusion (mini-ALIF) using a retroperitoneal approach except for requiring multilevel fusions, severe spinal canal stenosis, high-grade spondylolisthesis, and a adjacent segments disorders. We retrospectively reviewed the clinical records and radiographs of 142 patients who received mini-ALIF for L4-5 degenerative lumbar disorders between 1998 and 2010. We compared preoperative and postoperative clinical data and radiographic measurements, including the modified Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score for back and leg pain, disc height (DH), whole lumbar lordosis (WL), and vertebral wedge angle (WA). The mean follow-up period was 76 months. The solid fusion rate was 90.1% (128/142 patients). The average length of hospital stay was 6.9 days (range, 3-21 days). The mean blood loss was 63.7 ml (range, 10-456 ml). The mean operation time was 155.5 min (range, 96-280 min). The postoperative JOA and VAS scores for back and leg pain were improved compared with the preoperative scores. Radiological analysis showed significant postoperative improvements in DH, WL, and WA, and the functional and radiographical outcomes improved signif-cantly after 2 years. The 2.8% complication rate included cases of wound infection, liquorrhea, vertebral body fractures, and a misplaced cage that required revision. Mini-ALIF was found to be associated with improved clinical results and radiographic findings for L4-5 disorders. A retroperitoneal approach might therefore be a valuable treatment option. © 2013 by The Japan Neurosurgical Society.


Shimomura H.,Nara Medical University | Sasahira T.,Nara Medical University | Yamanaka Y.,Takai Hospital | Kurihara M.,Nara Medical University | And 7 more authors.
International Journal of Clinical Oncology | Year: 2015

Background: [18F]fluoro-2-deoxyglucose-positron emission tomography (FDG-PET) is widely used to evaluate tumor metabolic activity. The aim of this study was to evaluate the usefulness of FDG-PET in assessing the histopathological response to preoperative concurrent chemoradiotherapy (CRT) in patients with oral squamous cell carcinoma (OSCC). Methods: Forty-five patients with resectable advanced OSCC who had received preoperative CRT followed by tumor ablative surgery between January 2004 and December 2011 were included in the study. All patients underwent FDG-PET before and after preoperative CRT. The maximum standardized uptake value (SUVmax) before (pre-SUV) and after preoperative CRT (post-SUV) and the SUVmax reduction rate (ΔSUV %) were used to evaluate the response to preoperative CRT. Correlations among SUVmax, histopathological response, and expression of cancer antigen Ki-67 and hypoxia-inducible factor-1α (HIF-1α) were analyzed. Results: Preoperative CRT significantly reduced intratumoral FDG uptake (P < 0.001). The pre-SUV and post-SUV were significantly lower in patients with a pathological complete response (pCR) than in those with a non-pCR (pre-SUV P = 0.037; post-SUV P = 0.001). ΔSUV % was higher in patients with pCR than in those with non-pCR (P = 0.029). The pre-SUV was significantly correlated with Ki-67 and HIF-1α expression in pretreatment biopsy specimens (Ki-67 P = 0.046, R = 0.292; HIF-1α P = 0.007, R = 0.385). The expression of both Ki-67 and HIF-1α was significantly lower in patients with pCR than in those with non-pCR (Ki-67 P < 0.001; HIF-1α P < 0.001). Conclusions: Low pre-SUV and post-SUV and high ΔSUV % may predict a good histopathological response to preoperative CRT. Ki-67 and HIF-1α expression in pretreatment biopsy specimens were predictors of histopathological response to preoperative CRT. © 2014, Japan Society of Clinical Oncology.

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