1.Clinical study on the prevention of recurrent tonsillitis by acupuncture (II)
Keishi YOSHIKAWA ; Kazushi NISHIJO ; Kazuhiro YAZAWA ; Hidetoshi MORI ; Tomomi SAKAI ; Kazuo SASAKI ; Akihiro OGATA ; Toshikazu SHIMA ; Katsumi KURIHARA ; Takeshi TOMIYASU ; Shuichi KATAI ; Yoshitsugu OHIRA ; Seiichi KOBAYASHI ; Akemi YAMAMOTO
Journal of the Japan Society of Acupuncture and Moxibustion 1984;34(1):8-14
We have continued a study on the preventive effects of acupuncture on recurrent tonsillitis. Among 239 patients with tonsillitis examined in 1980, 200 were included in the category of recurrent tonsillitis, showing a fever four or more times a year.
The preventive effects of acupuncture in these 200 patients are reported in this paper.
The subjects were 200 patients with recurrent tonsillitis treated in our department in 1980. The frequency, number of days and severity of fever and other symptoms (conditions of the nose and throat, snoring, colds and general condition) were followed for one year after the acupuncture treatment.
Of the 200 patients, 171, excluding the 29 in whom the results of research could not be obtained, were analyzed. With regard to the frequency of fever, the number of patients with a fever 12 or more times a year decreased from 102 before acupuncture therapy to nine after the treatment. The number of patients who did not have any fever and who had a fever one to three times after treatment was 30 and 69, respectively. Thus, 40.4% were not included in the category of recurrent tonsillitis, even though fever was present. In addition, there was a decrease in the severity and number of days of fever.
Favorable effects of the treatment on symptoms other than fever, such as conditions of the nose and throat, snoring, resistance to colds and general condition, were noted in more than 50% of the patients who did not have any fever after treatment or had a fever half as frequently as before treatment.
When the preventive effects on fever were determined according to age, improvement was observed in all age groups. From the viewpoint of the prevention of repetition of a high fever, the best results were obtained in patients 6-11 years of age, followed by those five years old or less.
Acupuncture treatment for recurrent tonsillitis is not so effective as tonsillectomy. However, we consider that acupuncture treatment is worth using prior to tonsillectomy to prevent the relapse of recurrent tonsillitis, taking into account operative stress on the living body and economic and personal problems arising from tonsillectomy.
2.The Clinical Studies of the Protective Effects of Acupuncture on the Habitual Tonsilitis
Keishi Yoshikawa ; Kazushi Nisijo ; Kazuhiro Yazawa ; Hidetoshi Mori ; Tomomi Sakai ; Kozo Nemoto ; Kiyomi Gennai ; Kazuo Sasaki ; Akihiro Ogata ; Kyoko Oda ; Toshikazu Shima ; Kiyokazu Kubota ; Hiroshi Mineta ; Hideko Kamio ; Akemi Yamamoto
Journal of the Japan Society of Acupuncture and Moxibustion 1982;31(4):372-380
We administered electro-acupuncture with the purpose of preventing repeated attacks of repetitive tonsillities.
The majority of the 77 subjects were kindergarden and elementary shool children, who had high fiver more then 4 times a year.
The treatment method was as follows: 1Hz low frequency stimulation between Co 4 and lu 6 (and this bilateral) for 20 to 30 minutes.
The treatment interval was once a week, with 3 weeks constituting a treatment course.
And depending on the results of 1 course, the treatment was repeated or not. 53 patients followed 1 course, 24 patients followed 2 course.
The evaluaton of the results is based on a 1 year observation period.
RESULTS:
-9 patients (11.68%) didn't got any high fever.
-49 patients (63.63%) noticed a decrease of the high fever frequency [39 patients (50.64%) got less then 3 times a year a high fever.]
-19 patients (24.67%) didn't notice any effect [6 patients (7.79%) got tonsillectomy.]
This study showed the usefulness of acupuncture and as it's a general and easy to apply therapy, we can consider acupuncture as a first choice therapy for the prevention off repetitive tosillitis.
3.Clinical study on the prevention of recurrent tonshillitis by acupuncture (III)
Keishi YOSHIKAWA ; Kazushi NISHIJO ; Kazuhiro YAZAWA ; Hidetoshi MORI ; Tomomi SAKAI ; Akihiro OGATA ; Kazuo SASAKI ; Toshikazu SHIMA ; Hiroki SUGA ; Mikio NAKAMURA ; Shuichi KATAI ; Katsumi KURIHARA ; Takeshi TOMIYASU ; Masahiro KIMURA ; Takanori KAWANO ; Koki KOBAYASHI ; Koichi WADA ; Harumi TAKETANI ; Akemi YAMAMOTO
Journal of the Japan Society of Acupuncture and Moxibustion 1984;34(1):15-22
We have conducted acupuncture treatment for prevening the relapse of recurrent tonsillitis. We previously noted the effectiveness of this treatment in 121 of 239 patients treated in 1980, especially in elementary school children. In the present study, we compared the annual days of absence from school and the body dimensions of children with tonsillitis given acupuncture treatment with those having tonsillar hypertrophy chosen by a school study, although there is a question on the latter's propriety as a control group in a strict sense, in order to investigate the degree of spontaneous healing included in the preventive effects of acupuncture treatment on the relapse of recurrent tonsillitis.
By May 1983, our reseach was completed in 22 children with tonsillitis given acupuncture treatment and 19 with tonsillar hypertrophy not given such therapy. In children with tonsillitis given acupuncture treatment, the average annual days of absence from school before treatment was 14.0, which was more than that for all children in the S elementary school, and that in the year after treatment was 6.5, approximating that for all children in the school. In children with tonsillar hypertrophy not given acupuncture treatment, the average number of days of absence was close to that for all children in the S elementary school in both years.
Among 14 children with tonsillitis given acupuncture treatment, lower values of height and weight were noted in eight and 12 children, respectively, at the beginning of treatment, as compared with the national averages. The body dimensions of children with tonsillar hypertrophy not given acupuncture treatment were similar to the national averages. Of 14 children with tonsillitis given acupuncture treatment, an increase to a value exceeding the national average was observed with both the height and weight in six children, the height in two and the weight in one within the year after treatment.
The above results show that children with tonsillitis have a problem from the educational and developmental standpoint, even if they do not have a focal tonsil. We think that acupuncture treatment is worth attempting prior to tonsillectomy, although it is not so surely effective as tonsillectomy, when the severity of operative stress on the living body due to tonsillectomy and the burden of medical expenses and the load on the patient's family caused by hospitalization are taken into consideration.
4.Measures to Prevent Accidents Involving Metal Brought into the MRI Room
Yoshitake ITO ; Akihiro MORI ; Eisaku YOKOYAMA ; Minoru TERAZAWA
Journal of the Japanese Association of Rural Medicine 2019;67(5):620-
Accidents involving metals brought into the MRI room are occurring with increasing frequency. The Japan Council for Quality Health Care has released medical safety information about bringing magnetic materials into the MRI room, showing that this is an important safety issue. In our hospital, there were 4 accidents involving metal brought into the MRI room between April 2012 and March 2016. One serious incident was a projectile accident involving scissors carried by a nurse. In response, we have adopted new preventive measures, including specialized uniforms and a color-coding scheme for indicating MRI-safe and MRI-unsafe items (using colored tape, etc.). Here we report on the effect of these accident prevention efforts.
5.Non-invasive continuous blood pressure monitoring using the ClearSight system for pregnant women at high risks of post-partum hemorrhage: comparison with invasive blood pressure monitoring during cesarean section
Takuya MISUGI ; Takashi JURI ; Koichi SUEHIRO ; Kohei KITADA ; Yasushi KURIHARA ; Mie TAHARA ; Akihiro HAMURO ; Akemi NAKANO ; Masayasu KOYAMA ; Takasi MORI ; Daisuke TACHIBANA
Obstetrics & Gynecology Science 2022;65(4):325-334
Objective:
This study aimed to investigate the accuracy and precision of continuous, non-invasive blood pressure obtained using the ClearSight system by comparing it with invasive arterial blood pressure, and to assess the hemodynamic changes using invasive methods and the ClearSight system in patients undergoing cesarean section.
Methods:
Arterial pressure was measured invasively with an intra-arterial catheter and non-invasively using the ClearSight system during cesarean section in patients with placenta previa or placenta accreta. Blood pressure measurements obtained using these two means were then compared.
Results:
Total 1,277 blood pressure measurement pairs were collected from 21 patients. Under Bland-Altman analysis, the ClearSight system demonstrated an acceptable accuracy with a bias and standard deviation of 8.8±13.4 mmHg for systolic blood pressure, -6.3±7.1 mmHg for diastolic blood pressure, and -2.7±8.0 mmHg for median blood pressure. Cardiac index levels were significantly elevated during fetal delivery and 5 minutes after placental removal, and systemic vascular resistance index levels were significantly decreased during fetal delivery and 40 minutes after placental removal.
Conclusion
In patients undergoing cesarean section, the ClearSight system showed excellent accuracy and precision compared to that of the currently used invasive monitoring system.
6.Safety Management Through Cooperation Between a Radiological Technologist and Pharmacist in Radiopharmaceutical Preparation
Naoya AKATSUKA ; Akihiro MORI ; Shinji ENDO ; Minoru TERAZAWA
Journal of the Japanese Association of Rural Medicine 2021;69(5):541-548
The use of pharmaceuticals requires establishing a safe environment and securing a system to reduce risk. In our isotope inspections, the operational system for using radiopharmaceuticals was insufficient, which became a problem. For this reason, through cooperation between a radiological technologist responsible for radiation safety management and a pharmacist responsible for medicine safety management, we considered the operational system for the preparation and management of radiopharmaceuticals at our hospital. In accordance with the guidelines for handling radiopharmaceuticals, we established a system to reduce risks by reviewing pharmaceuticals, creating checklists, and improving the work environment. By reviewing and improving the system of safety management and safe use in cooperation with other disciplines, it became possible to reduce risk through double checks and to improve the work environment for routine operations. This report describes the efforts made in our hospital.
7.Impact of adaptive radiotherapy on survival in locally advanced nasopharyngeal carcinoma treated with concurrent chemoradiotherapy
Yusuke UCHINAMI ; Koichi YASUDA ; Hideki MINATOGAWA ; Yasuhiro DEKURA ; Noboru NISHIKAWA ; Rumiko KINOSHITA ; Kentaro NISHIOKA ; Norio KATOH ; Takashi MORI ; Manami OTSUKA ; Naoki MIYAMOTO ; Ryusuke SUZUKI ; Keiji KOBASHI ; Yasushi SHIMIZU ; Jun TAGUCHI ; Nayuta TSUSHIMA ; Satoshi KANO ; Akihiro HOMMA ; Hidefumi AOYAMA
Radiation Oncology Journal 2024;42(1):74-82
Purpose:
To investigate the clinical significance of adaptive radiotherapy (ART) in locally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT).
Materials and Methods:
Eligible patients were treated with concurrent chemoradiotherapy using IMRT. Planning computed tomography in ART was performed during radiotherapy, and replanning was performed. Since ART was started in May 2011 (ART group), patients who were treated without ART up to April 2011 (non-ART group) were used as the historical control. The Kaplan-Meier method was used to calculate overall survival (OS), locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and distant metastasis-free survival (DMFS). LRFS for the primary tumor (LRFS_P) and regional lymph node (LRFS_LN) were also studied for more detailed analysis. Statistical significance was evaluated using the log-rank test for survival.
Results:
The ART group tended to have higher radiation doses. The median follow-up period was 127 months (range, 10 to 211 months) in the non-ART group and 61.5 months (range, 5 to 129 months) in the ART group. Compared to the non-ART group, the ART group showed significantly higher 5-year PFS (53.8% vs. 81.3%, p = 0.015) and LRFS (61.2% vs. 85.3%, p = 0.024), but not OS (80.7% vs. 80.8%, p = 0.941) and DMFS (84.6% vs. 92.7%, p = 0.255). Five-year LRFS_P was higher in the ART group (61.3% vs. 90.6%, p = 0.005), but LRFS_LN did not show a significant difference (91.9% vs. 96.2%, p = 0.541).
Conclusion
Although there were differences in the patient backgrounds between the two groups, this study suggests the potential effectiveness of ART in improving locoregional control, especially in the primary tumor.
8.A Case of Advanced Carcinoma of the Tongue Extending to the Base Successfully Treated with Intra-arterial Chemoradiotherapy
Akio YASUI ; Takeshi WAKITA ; Yoshihito MATSUI ; Daiki KOIDE ; Hisanobu MARUO ; Shoichiro KITAJIMA ; Akihiro MORI ; Wataru HAYAMI ; Kiyotada TOKIDA ; Minoru TERAZAWA
Journal of the Japanese Association of Rural Medicine 2021;70(1):62-68
Intra-arterial chemoradiotherapy for advanced oral cancer has recently been reported and can preserve the form and function of the tongue by avoiding surgery at the primary site. We report here a case of advanced tongue cancer treated with intra-arterial chemoradiotherapy that preserved phonation and swallowing function. A 71-year-old man presented with an ulcerative mass, 43×28 mm in size, extending from the left lingual margin to the base of the tongue. The pathological diagnosis was squamous cell carcinoma based on biopsy results, and the clinical diagnosis was left lingual carcinoma (cT3N0M0, stage III) based on imaging findings. A polyurethane catheter was inserted into the left lingual artery, and intra-arterial chemotherapy was administered using docetaxel (15 mg/m2/week, total dose 60 mg/m2) and cisplatin (5 mg/m2/ day, total dose 125 mg/m2) with concurrent radiotherapy (2 Gy/day, total dose 50 Gy). Posttreatment biopsy results showed no tumor cells, and complete response was achieved, thus avoiding surgical resection of the primary site. Six years after completing treatment, the patient remains in good health with no recurrence, metastasis, phonation problems, or dysphagia.