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Isolation of TCR genes with tumor-killing activity from tumor-infiltrating and circulating lymphocytes in a tumor rejection cynomolgus macaque model.（最新研究の紹介）
Get PDFpdfOthersMolecular Therapy – Oncolytics 2021 Dec 6;24:77-86.
DOI: 10.1016/j.omto.2021.12.003othe
Outcomes of Preserving the Hypertrophic Arachnoid Membrane in the Brain-meningioma Interface: Long-term Follow-up.
Get PDFpdfAbnormal hypertrophic arachnoid membranes are often observed in the brain-meningioma interface during microsurgery. They contain fibrosis and tumor cell clusters; however, preservation of the membranes does not always cause recurrence from the brain surface, and the optimal treatments in the interface remain unclear. We investigated the incidence of recurrence on the brain surface following extra-arachnoid dissection with an approach emphasizing preservation of the arachnoid membranes in meningiomas of World Health Organization (WHO) Grade I. The features of dissection cleavages in the interface were prospectively recorded at surgery. The patients were followed up with MR imaging regularly. In total, 111 patients were included. The median follow-up time was 97.0 (interquartile range [IQR] 70.0-124.0) months. The cleavages in the interface were classified into three subgroups: the Extra-H group (n = 56) with extra-arachnoid resection and preservation of hypertrophic arachnoid membranes, the Extra-N group (n = 39) with extra-arachnoid resection having normal membranes, and the Subpial resection group (n = 16). Tumors recurred in 13 (11.7%) patients at both the brain and dura mater (n = 1) or at the dura mater alone (n = 12). The median recurrence-free survival (RFS) of all recurrences was significantly related to the Simpson grades (P <0.01). For brain surface recurrence, the median RFS was not related to the subgroups. The Karnofsky Performance Scores (KPSs) significantly improved in the patients except for the Subpial group at 3 months after surgery. This study revealed that hypertrophic arachnoid membranes preserved on the brain surface rarely caused recurrence from the brain in WHO Grade I meningiomas after a long-term follow-up.Journal Articlejournal articl
Clinical outcomes of thoracic esophageal cancer Surgery in elderly patients over 80 years old
Get PDFpdf【はじめに】
超高齢社会が到来し高齢食道癌患者も増加している。食道癌手術は高侵襲で高齢者には併存疾患も多く、80歳以上の手術適応はより慎重な判断を要するため、当科での成績を基にその妥当性について考察する。
【対象】
2014年10月から2021月7月に手術を施行した80歳以上の食道癌8例の成績を検討した。当科では低侵襲を目指した胸腔鏡手術、当日抜管、翌日の離床を試みている。全例栄養瘻を造設し翌日より経腸栄養を開始している。
【結果】
80歳以上の食道癌は8例(男性7例、女性1例)、術前Performance status (PS)は全例0。全例併存疾患あり。腫瘍主占拠部位は胸部上部:1例、中部:4例、下部:3例。臨床病期はStage I:1例、Stage III:7例。全例で胸腔鏡下食道亜全摘、胸骨後胃管再建、開胸移行なし。リンパ節郭清範囲は2領域5例、3領域3例。手術時間中央値415分、出血量中央値203ml。術後合併症は縫合不全2例、肺炎3例、反回神経麻痺1例、せん妄1例、非閉塞性腸管虚血での在院死1例。術後在院日数中央値25日。生存退院7例中5例は同居家族のサポートのもと自宅退院、2例は独居であったが訪問看護を導入し自宅退院可能であった。
【結語】
一般的に食道癌手術は高度侵襲を伴う治療だが、80歳以上の高齢者でも家族の協力や社会的サービスなど在宅支援の充実により自宅退院が可能であった。高齢者は高率に併存疾患を有するため重篤な合併症を発症すると救命困難となる可能性があり、手術適応は慎重な判断を要する。Background:
The elderly patient with esophageal cancer is increasing. The surgical indications for esophageal cancer in elderly patients over 80 years old requires more careful judgement, because surgical resection of esophageal cancer is highly invasive and the elderly have many comorbidities.
Method:
We evaluated the surgical outcomes in 8 patients of esophageal cancer over 80 who underwent esophagectomy between October 2014 and July 2021. As perioperative management, thoracoscopic surgery aimed at minimally invasive, extubation on POD（postoperative day）0 were attempted. In all cases, we created transgastric jejunostomy and started enteral nutrition on POD1 for early recovery of intestinal peristalsis and suppression of increased catabolism.
Results:
There were 8 patients of esophageal cancer (7 males, 1 female), and preoperative performance status (PS) was 0 in all cases. The clinical stage was as follows: one case in Stage I, 7 cases in Stage III. All patients underwent thoracoscopic esophagectomy, posterior sternal gastric tube reconstruction, and no open chest transition. The lymph node dissection was as follows: two fields in 5 cases and three fields in 3 cases. Median operation time was 415 minutes, median intraoperative blood loss was 203 ml. Seven patients have some comorbidities. Postoperative complications were observed as follows: two cases of anastomotic leakage, 3 cases of pneumonia, 1 case of recurrent nerve palsy, and 1 case of hospital death due to non-occlusive intestinal ischemia, respectively. Median postoperative hospital stay was 25 days. Of the 7 patients who were discharged alive, 5 were discharged home with the support of their family, and 2 were discharged home with the using of home nursing.
Conclusions:
In the elderly with esophageal cancer, careful judgement of surgical resection was necessary, due to high rate of postoperative mortality and morbidity. Support of family or social services was necessary for elderly patients over 80 years old.Departmental Bulletin Paperdepartmental bulletin pape
Histamine depolarizes rat intracardiac ganglion neurons through the activation of TRPC non-selective cation channels
Get PDF滋賀医科大学博士（医学）pdfThesis or DissertationEuropean Journal of Pharmacology. 2020 Nov 5;886:173536.令和3年度thesi
Characterization and functional role of rapid- and slow-activating delayed rectifier K + currents in atrioventricular node cells of guinea pigs
Get PDF滋賀医科大学博士（医学）pdfThesis or DissertationPflügers Archiv - European Journal of Physiology. 2021 Dec;473(12):1885-1898.令和3年度thesi
A novel strategy to develop deep learning for image super-resolution using original ultra-high-resolution computed tomography images of lung as training dataset.
Get PDF滋賀医科大学博士（医学）pdfThesis or DissertationJapanese Journal of Radiology.. 2022 Jan;40(1):38-47.令和3年度thesi
Impact of statin therapy on late target lesion revascularization after everolimus-eluting stent implantation according to pre-interventional vessel remodeling and vessel size of treated lesion
Get PDF滋賀医科大学博士（医学）pdfThesis or DissertationHeart and Vessels. 2022 Nov;37(11):1817-1828.令和4年度thesi
Increased Difficulties in Maternal Perception of Decreased Fetal Movement in Cases of Severe Fetal Growth Restriction: A Population-Based Study in Japan
Get PDF滋賀医科大学博士（医学）pdfThesis or DissertationThe Tohoku Journal of Experimental Medicine. 2022 May 14;257(1):17-22.令和4年度thesi
Reliability of dynamic perfusion digital radiography as an alternative to pulmonary perfusion scintigraphy in predicting postoperative lung function and complications
No full textBackground:
Accurate perioperative risk assessment can enhance the perioperative management of patients undergoing radical surgery for lung cancer. In this study, we compared the accuracy of predicting perioperative complications by lung function values, estimated by blood flow ratios (BFRs), to determine whether dynamic perfusion digital radiography (DPDR) could substitute for pulmonary perfusion scintigraphy (PPS).Methods:
Patients scheduled for radical surgery for lung cancer who underwent simultaneous dynamic chest radiography (DCR) and lung perfusion scintigraphy were assessed. We confirmed the agreement between two methods in the assessment of the BFR and its predicted postoperative (ppo) value. Besides, the best spirometry thresholds for the risk of perioperative respiratory or cardiovascular complications were calculated from a receiver operating characteristic (ROC) analysis. The imaging methods were compared for sensitivity and specificity.Results:
Among the 44 cases enrolled, DPDR and PPS showed high correlations in BFR (r=0.868, P0.7] for respiratory complications within 1 month (with different cut-offs for same target cases). For predicting, respiratory complications within 1-3 months after surgery, these values were similar between two modalities. Furthermore, the ppoDLco values from both imaging methods were excellent indicators of the induction of postoperative long term oxygen therapy, with the AUC greater than 0.8.Conclusions:
This study showed that simple and less invasive DPDR can be a good alternative to PPS for predicting postoperative pulmonary function values and the risk of postoperative respiratory complications. This new imaging modality will offer new insights and possible functional analyses of pulmonary circulation.Journal Articlejournal articl