DSpace コレクション: 2014年度博士論文
http://hdl.handle.net/10564/2717
2014年度博士論文
2024-03-29T14:38:50Z
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[¹⁸F]fluoro-2-deoxyglucose-positron emission tomography for the assessment of histopathological response after preoperative chemoradiotherapy in advanced oral squamous cell carcinoma.
http://hdl.handle.net/10564/2976
タイトル: [¹⁸F]fluoro-2-deoxyglucose-positron emission tomography for the assessment of histopathological response after preoperative chemoradiotherapy in advanced oral squamous cell carcinoma.
著者: Shimomura, Hiroyuki; Sasahira, Tomonori; Yamanaka, Yasutsugu; Kurihara, Miyako; Imai, Yuichiro; Tamaki, Shigehiro; Yamakawa, Nobuhiro; Shirone, Norihisa; Hasegawa, Masatoshi; Kuniyasu, Hiroki; Kirita, Tadaaki
抄録: 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.
内容記述: 博士(医学)・乙第1357号・平成27年3月16日; © Springer International Publishing AG, Part of Springer Science+Business Media; © Japan Society of Clinical Oncology 2014; To access the final edited and published work see http://dx.doi.org/10.1007/s10147-014-0711-5.
2014-06-18T15:00:00Z
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Comparison between Two Separate Injections and a Single Injection of Double-dose Contrast Medium for Contrast-enhanced MR Imaging of Metastatic Brain Tumors.
http://hdl.handle.net/10564/2975
タイトル: Comparison between Two Separate Injections and a Single Injection of Double-dose Contrast Medium for Contrast-enhanced MR Imaging of Metastatic Brain Tumors.
著者: Ochi, Tomoko; Taoka, Toshiaki; Matsuda, Ryosuke; Sakamoto, Masahiko; Akashi, Toshiaki; Tamamoto, Ttetsuo; Sugimoto, Tadashi; Sakaguchi, Hiroshi; Hasegawa, Masatoshi; Nakase, Hiroyuki; Kichikawa, Kimihiko
抄録: PURPOSE: As stereotactic radiotherapy (SRT) becomes widespread, precise information including number, location, and margin of lesions is required when magnetic resonance (MR) imaging of brain metastasis is performed. We compare methods using 2 separate injections and a single injection for the administration of a double dose of contrast medium for contrastenhanced MR imaging. MATERIALS AND METHODS: We divided 40 patients with brain metastasis into 2 groups of 20 patients. Group A received 2 separate injections (0.2 + 0.2 mL/kg) of contrast medium (gadoteridol); Group B received a single injection of the same total dose (0.4 mL/kg). Group A underwent spin echo (SE) T1-weighted imaging (T1WI) and magnetization prepared rapid acquisition with gradient echo sequence (MPRAGE) after each injection, and Group B underwent the same MR studies at the same timing as Group A. We evaluated the number, signal-to-noise ratio (SNR), diameter, margin delineation, and volume of lesions and compared them between early and delayed studies by the 2 methods. RESULTS: The number of detected lesions was largest in delayed studies of MPRAGE in both groups. The SNR of the lesions was statistically lower in early studies of Group A than other studies. Delayed studies of Group B showed statistically better margin delineation than other studies on both SE-T1WI and MPRAGE studies. Diameter and enhanced volume were statistically significantly larger on delayed phase than early phase in both groups. CONCLUSION: Use of a single injection of double-dose contrast medium and longer delay time may improve margin delineation of lesions for the study of brain metastasis. Enhanced volume was larger on delayed phase, and it may influence selection of therapeutic strategy.
内容記述: 博士(医学)・乙第1356号・平成27年3月16日; Copyright © 2014 by Japanese Society for Magnetic Resonance in Medicine; 著作権は日本磁気共鳴医学会に帰属; 日本磁気共鳴医学会及び著者(共著者も含む)の許諾を得て登録
2014-12-21T15:00:00Z
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Follow-up study of unilateral renal function after nephrectomy assessed by glomerular filtration rate per functional renal volume.
http://hdl.handle.net/10564/2974
タイトル: Follow-up study of unilateral renal function after nephrectomy assessed by glomerular filtration rate per functional renal volume.
著者: Hosokawa, Yukinari; Tanaka, Nobumichi; Mibu, Hisakazu; Anai, Satoshi; Torimoto, Kazumasa; Yoneda, Tatsuo; Hirayama, Akihide; Yoshida, Katsunori; Hayashi, Yoshiki; Hirao, Yoshihiko; Fujimoto, Kiyohide
抄録: BACKGROUND: To evaluate the clinical usefulness of estimated glomerular filtration rate (eGFR) divided by functional renal volume (FRV) measured by three-dimensional image reconstruction (eGFR/FRV) for the prediction of functional outcomes after nephrectomy. METHODS: Eighty-three patients who underwent nephrectomy were enrolled. The FRV of each patient was measured before surgery. Preoperative medical information on proteinuria, blood pressure, blood glucose level, body mass index (BMI), hemoglobin level and serum cholesterol level were also obtained. We evaluated the relationships between eGFR/FRV and each of these parameters before surgery. We also assessed the potential relationship between eGFR/FRV and the 3-year postoperative eGFR. Stepwise multiple regression analyses were conducted to elucidate independent factors. RESULTS: The median FRV and eGFR were 310.15 cm3 and 79.0 ml/min/1.73 m² before surgery, respectively. The correlation between FRV and eGFR was statistically significant (r = 0.465, P < 0.001). The median eGFR/FRV was 0.24 ml/min/1.73 m²/cm³. Stepwise multiple regression analysis showed that the independent parameters (multiple correlation coefficient, r = 0.389, P = 0.031) associated with eGFR/FRV were proteinuria, BMI, age and hypertension. Proteinuria was statistically associated with eGFR/FRV, and the independent parameters (multiple correlation coefficient, r = 0.694, P < 0.001) associated with the 3-year postoperative eGFR were age, BMI and eGFR/FRV. The eGFR/FRV was statistically associated with the 3-year postoperative eGFR (r = 0.559, P < 0.001). CONCLUSION: The present results demonstrated that patients with proteinuria are expected to have a lower eGFR/FRV than those without proteinuria. The present study also supports the notion that eGFR/FRV is the primary determinant of the long-term functional outcome after nephrectomy. It should be taken into consideration that patients with a low eGFR/FRV may develop chronic kidney disease after nephrectomy.
内容記述: 博士(医学)・乙第1354号・平成27年3月16日; © 2014 Hosokawa et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
2014-03-18T15:00:00Z
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Risk factors for the development of gastric mucosal lesions in rheumatoid arthritis patients receiving long-term nonsteroidal anti-inflammatory drug therapy and the efficacy of famotidine obtained from the FORCE study.
http://hdl.handle.net/10564/2972
タイトル: Risk factors for the development of gastric mucosal lesions in rheumatoid arthritis patients receiving long-term nonsteroidal anti-inflammatory drug therapy and the efficacy of famotidine obtained from the FORCE study.
著者: Kobata, Yasunori; Yajima, Hiroshi; Yamao, Junichi; Tanaka, Yasuhito; Fukui, Hiroshi; Takakura, Yoshinori
抄録: The objective of this study was to investigate the prevalence of gastric mucosal injury induced by nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with rheumatoid arthritis (RA). Upper gastrointestinal endoscopy was performed on 100 RA patients treated with NSAIDs. Patient factors potentially contributing to the development of NSAID-induced gastric mucosal injury were identified by logistic regression analysis; gastric mucosal injury and ulcers were used as objective variables. Gastric mucosal injury was detected in 62 of 100 patients, and eight of these patients had ulcers. Previous history of ulcers, lifestyle, NSAID dosage, and body mass index were associated with the development of gastric mucosal injury, and the use of diclofenac and steroid dose were associated with the development of ulcers. Disease-modifying antirheumatic drugs (DMARDs) did not appear to influence the risk of NSAID-induced gastric mucosal injury. RA patients treated for long periods with NSAIDs for RA symptoms should be controlled with DMARDs, without consideration of increased doses of steroids, in terms of risk for NSAID-induced gastric mucosal injury. Simultaneously, concomitant use of histamine-2 receptor antagonists (H2RA) such as famotidine should be considered.
内容記述: 博士(医学)・乙第1354号・平成27年3月16日; © Japan College of Rheumatology 2009; © Springer International Publishing AG, Part of Springer Science+Business Media
2009-11-30T15:00:00Z