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経後頭顆到達法における後顆導出静脈の微小解剖学的破格に関する研究
Get PDFBACKGROUND:
It is essential to identify and be aware of the anatomy of the posterior condylar emissary vein (PCEV) for achieving an adequate operative field for the transcondylar fossa approach (TCFA).
OBJECTIVE:
To describe the variations in the drainage patterns of PCEVs and the technical issues encountered in such cases.
METHODS:
This was a retrospective analysis of the anatomy of PCEVs in 104 sides in 52 cases treated by the TCFA. Preoperative findings of multidetector-row computed tomography (CT) and CT venography (CTV) were compared with the intraoperative findings. The drainage patterns were classified as 5 types: the sigmoid sinus (SS), jugular bulb (JB), occipital sinus (OS), anterior condylar emissary vein (ACEV), and marginal sinus (MS).
RESULTS:
The SS, JB, ACEV, and OS types were observed in 33 (31.7%), 42 (40.3%), 8 (7.7%), and 1 (1.0%) side(s), respectively. One side (1.0%) each had combined drainage from MS and JB, and ACEV and JB, respectively. In 17 sides (16.3%), the PCEVs and posterior condylar canals could not be identified on CT and CTV.
CONCLUSIONS:
Preoperative CT and CTV findings correlated well with the intraoperative findings. To make a sufficient operative field for TCFA, PCEVs should be appropriately dealt with based on the preoperative knowledge of their running course, pattern, and origin.博士（医学）旭川医科大
一次化学療法としてゲムシタビン＋シスプラチン併用療法を施行した進行胆道癌の予後因子に関する検討
Get PDFBACKGROUND:
Few studies have clearly identified the prognostic factors in patients with advanced biliary tract cancer (BTC) receiving gemcitabine plus cisplatin (GC) which is acknowledged as standard chemotherapy regimen.
OBJECTIVES:
The aim of this study was to identify predictive factors of the overall survival (OS) in advanced BTC patients receiving GC therapy.
METHODS:
Data of 307 patients with advanced BTC who received GC therapy as the first-line chemotherapy at our institution from January 2007 to June 2017 were reviewed retrospectively. The patients were randomly assigned to the investigation or the validation dataset at the ratio of 2:1. Multivariate analysis was conducted to identify the prognostic factors, a prognostic index is proposed from the investigation dataset, and the usefulness of this index was confirmed in the validation dataset.
RESULTS:
Multivariate analysis identified poor performance status, elevated serum lactate dehydrogenase, and elevated neutrophil-to-lymphocyte ratio as independent unfavorable predictors. The patients could be classified into three groups according to these factors, and it was found that the outcomes differed significantly among the three groups (P = 0.0002, good- vs. intermediate-prognosis groups; P = 0.005, intermediate- vs. poor-prognosis groups). When this index was applied to the validation dataset, the OS was confirmed to differ significantly among the three groups (P = 0.04, good- vs. intermediate-prognosis groups, P < 0.0001, intermediate- vs. poor-prognosis groups).
CONCLUSIONS:
We identified three predictors of the OS in patients with advanced BTC receiving GC therapy in this study, based on which we could classify the patients into three risk groups.博士（医学）旭川医科大
かぐらおか 第174号
Get PDF第7回医学科白衣式 2/ 平成30年度外国人留学生交流事業が実施されました 3/ 授業評価(平成30年度前期) 5/ 第3回先輩看護師と行う看護技術スキルアップトレーニング 30/ 医学科第5学年地域枠学生との懇談会を開催 31/ 新歓行事等における飲酒事故の防止について 32/ ソーシャルメディアの適切な利用について 33/ 平成31年度保健管理センター健康相談日・行事予定 34/ 国民年金の学生納付特例制度について 37/ 平成31年度日本学生支援機構奨学生の募集について 38/ 教員の異動 38/ 今後のスケジュール 38
