1.A patient in whom metronidazole was effective for cancerous malodor related to pleural metastasis, involving the thoracic wall, from gastric cancer
Takahiro Sawada ; Go Hatachi ; Maiko Yasuda ; Koichi Tamai ; Miho Sakagawa ; Ihoko Ohto
Palliative Care Research 2009;4(2):339-345
Dermal ulcers related to infiltration of advanced cancer often release destruction-associated effluvia (cancerous malodor). We encountered a patient in whom metronidazole (MTZ) was effective for cancerous malodor at the dermal ulcer site related to pleural metastasis, involving the thoracic wall, from gastric cancer. The patient was a male in his 60's. As left subphrenic abscess associated with suture failure at the anastomotic site after surgery for gastric cancer led to pyothorax via the transdiaphragmatic route, a thoracic drain was inserted. Furthermore, bilateral pulmonary metastases and pleural dissemination were detected. Subsequently, the metastatic pleural focus infiltrated the thoracic wall via the space between the thoracic drain and chest wall. Its destruction resulted in fetid ulcer formation. The application of MTZ ointment relieved cancerous malodor. In addition to assessment using an odorimeter, the patient's subjective evaluation-based score confirmed the efficacy of this agent. Palliat Care Res 2009; 4(2): 339-345
2.Clinical Experience with Terumo Large Diameter Graft (Triplex)-Results of a Multicenter Clinical Trial-
Shinichi Takamoto ; Keishu Yasuda ; Koichi Tabayashi ; Shun-ei Kyo ; Tetsurou Miyata ; Teruhisa Kazui ; Toshikatsu Yagihara ; Shigeaki Aoyagi ; Tsuyoshi Itoh
Japanese Journal of Cardiovascular Surgery 2007;36(5):253-260
We conducted a clinical study on a newly developed large diameter vascular graft (Triplex®, Terumo Corporation, Tokyo, Japan) with a non-biodegradable material used as sealing material, to evaluate its effectiveness and safety. Triplex® grafts were implanted in 170 patients with either aneurysmal or occlusive arterial disease in either the thoracic artery, abdominal artery or iliac arteries, between October 2001 and March 2003. The patients consisted of 141 men and 29 women with an average age of 69.0±10.0 years old (mean±SD). In 82 patients, Triplex® was implanted for the thoracic artery area, in 88, for the abdominal artery area. The cumulative graft patency rate 12 months after implantation was 100.0% in each area, there was no any abnormality such as occlusion or rupture from the trunk of Triplex®. The distension ratio, which is the index of the dilatation resistance, was 1.03±0.06 as a whole (n=139), 1.03±0.06 in the thoracic artery area (n=73), 1.03±0.06 in the abdominal artery area (n=66). In other words the dilatation of Triplex® was hardly observed. As manipulability during the operation, the following characteristics were evaluated; anastomosis, resistance to fraying, hemorrhage, conformability with the host vessel. Triplex® was evaluated as “good” in 75% of all items accounted for 75% or more. A transitory rise thought to be due to the surgical stress immediately after the operation because of the change of temperature and laboratory findings (CRP, WBC) between implantation and discharge was observed, but then recovered to the normal levels of each patients at discharge and the re-elevation was not recognized. In 90 patients, 277 adverse events occurred. Although in 33 adverse events in 21 patients a causal relation with Triplex® could not be excluded, most of them were already known events as complications which could occur after operation on the aorta. Therefore, it was confirmed that Triplex® has certain advantages: 1) good manipulability, 2) good patency and dilatation resistance, 3) no inflammatory reaction related to Triplex®, as a graft for the aorta.
3.A-II-2 Techniques and Results of Intraoperative Myocardial Protection by Means of Antegrade and Retrograde Perfusion Cooling Method
Tosiaki Kawakami ; Hiroshi Takahashi ; Koichi Kawasaki ; Hiroshi Edasawa ; Toshikazu Tachiki ; Mikio Kawabata ; Junichiro Takahashi ; Hiromi Matsukura ; Osamu Matsunami ; Keishu Yasuda ; Keisuke Sakai ; Tatsuzo Tanabe
Japanese Journal of Cardiovascular Surgery 1984;14(2):93-96
4.Fluctuations in Blood Pressure in Hemiplegic Patients Measured by Using Digital Compact Wrist Blood Pressure Monitor.
Norifumi WADA ; Yo YASUDA ; Tadashi ARAI ; Yuji ITO ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Yukie NISHIOKA ; Sakiko TANIGUCHI ; Maki TSUJIMOTO ; Masaru IWAKOSHI ; Koichi MORII ; Yoshitomo KASHIKI
Journal of the Japanese Association of Rural Medicine 1999;48(2):152-155
With household digital compact wrist blood pressure monitors, blood pressure was measured in hemiplegic patients who were receiving kinesitherapy.
During the training program routinely worked out by physical therapists, most patients had shown elevated levels of both systolic and diastolic blood pressure. There were some patients whose blood pressure went up so high as to call doctors' attention.
As changes in blood pressure are affected by various factors, we cannot say at once that doing exercise alone adds to blood pressure. Nonetheless, by using a household blood pressure monitor, it would be easy to know the extent to which blood pressure rises in accordance with the amount of exercise, so that it would be possible to make patients and their family aware of the importance of blood pressure readings. We thought it possible to obtain an index of the amount of exercise at home.
5.Treatment options for solitary hepatocellular carcinoma ≤5 cm: surgery vs. ablation: a multicenter retrospective study
Kazuya KARIYAMA ; Kazuhiro NOUSO ; Atsushi HIRAOKA ; Hidenori TOYODA ; Toshifumi TADA ; Kunihiko TSUJI ; Toru ISHIKAWA ; Takeshi HATANAKA ; Ei ITOBAYASHI ; Koichi TAKAGUCHI ; Akemi TSUTSUI ; Atsushi NAGANUMA ; Satoshi YASUDA ; Satoru KAKIZAKI ; Akiko WAKUTA ; Shohei SHIOTA ; Masatoshi KUDO ; Takashi KUMADA
Journal of Liver Cancer 2024;24(1):71-80
Background:
/Aim: The aim of this study was to compare the therapeutic efficacy of ablation and surgery in solitary hepatocellular carcinoma (HCC) measuring ≤5 cm with a large HCC cohort database.
Methods:
The study included consecutive 2,067 patients with solitary HCC who were treated with either ablation (n=1,248) or surgery (n=819). Th e patients were divided into three groups based on the tumor size and compared the outcomes of the two therapies using propensity score matching.
Results:
No significant difference in recurrence-free survival (RFS) or overall survival (OS) was found between surgery and ablation groups for tumors measuring ≤2 cm or >2 cm but ≤3 cm. For tumors measuring >3 cm but ≤5 cm, RFS was significantly better with surgery than with ablation (3.6 and 2.0 years, respectively, P=0.0297). However, no significant difference in OS was found between surgery and ablation in this group (6.7 and 6.0 years, respectively, P=0.668).
Conclusion
The study suggests that surgery and ablation can be equally used as a treatment for solitary HCC no more than 3 cm in diameter. For HCCs measuring 3-5 cm, the OS was not different between therapies; thus, ablation and less invasive therapy can be considered a treatment option; however, special caution should be taken to prevent recurrence.
6.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.