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Kubota K, Kadomura T, Ohta K, Koyama K, Okuda H, Kobayashi M, Ishii C, Fujiwara Y, Nishiora T, Ohmae Y, Ohmae T, Kitajima M. Analyses of laboratory data and establishment of reference values and intervals for healthy elderly people. J Nutr Health Aging 2012; 16:412-6. [PMID: 22499467 DOI: 10.1007/s12603-011-0355-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Protein-energy malnutrition is a common disorder in the elderly. Although serum albumin is commonly used as a nutritional marker, data is lacking on serum albumin levels in the elderly. The purpose of this study was to determine whether serum albumin levels decrease with advancing age and to establish reference value and interval of laboratory data for elderly people (75 years and over). PARTICIPANTS Blood samples from 13821 healthy people, 42064 outpatients, and 15959 inpatients were collected during 2008. Blood from 127 of our nutrition support team (NST) patients was also collected during August 2006 and May 2009, and analyzed. MEASUREMENTS Serum albumin, hemoglobin, total cholesterol levels and lymphocyte count were determined. We analyzed the change in each parameter in accordance with age, compared the data for elderly people with younger people, and established new reference values. Clinical outcomes were examined depending on the improved reference values. RESULTS Albumin was lower in older persons than in younger persons. The estimated reference value and interval were 42 (48-36) g/l in older persons and was much lower in NST patients. Hemoglobin was decreased while cholesterol and lymphocyte count were not changed in older persons: all were markedly decreased in NST patients. Terms of hospital stay were significantly longer and mortality rates were significantly higher in older persons, comparing from above to below using a new reference value of albumin (36 g/l). CONCLUSIONS The serum albumin level decreases with advancing age, but it was maintained to some extent in healthy older people. Serum albumin levels related to the clinical outcome. Hemoglobin and cholesterol levels and lymphocyte count were all lower in NST patients. These measurements may be valuable markers of nutritional status and can help in guiding the need for nutritional support.
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Yanagi H, Nakamaru Y, Takagi D, Kubota K, Fukuda S. Extranodal natural killer/T-cell lymphoma: a diagnostic dilemma. Rhinology 2012. [DOI: 10.4193/rhin11.245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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103
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Sasahira N, Isayama H, Nagano R, Kogure H, Yamamoto K, Kawakubo K, Yamamoto N, Hirano K, Tada M, Kubota K, Koike K. Noncalcified pancreatic stone treated with electrohydraulic lithotripsy using SpyGlass pancreatoscopy. Endoscopy 2011; 43 Suppl 2 UCTN:E272. [PMID: 21837610 DOI: 10.1055/s-0030-1256600] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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104
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Ogawa Y, Kubota K, Tadokoro M, Yamanishi T, Aoyama N, Suzuki Y, Iwasa H, Kariya S, Nogami M, Nishioka A. KORTUC II - A New Image-guided, Enzyme-targeted, and Breast Cancer Stem Cell Targeted Radiosensitization Treatment for Patients with Stage I and II Breast Cancers. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Oqawa Y, Kubota K, Tadokoro M, Aoyama N, Suzuki Y, Ohgi K, Iwasa H, Yamanishi T, Kariya S, Nishioka A. 5020 POSTER DISCUSSION KORTUC II – a New Image-Guided, Enzyme-Targeted, and Breast Cancer Stem Cell-targeted Chemo-radiosensitization Treatment for Patients With Locally Advanced Breast Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71462-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Nishioka A, Ogawa Y, Suzuki Y, Miyatake K, Tadokoro M, Kariya S, Nogami M, Hamada N, Kubota K. 6540 POSTER The Impacts of Intraoperative Radiotherapy With Image-guided Enzyme Targeting Radiosensitization (KORTUC-IORT) for Stage IVa Pancreatic Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71851-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Iso Y, Sawada T, Kato M, Kita J, Shimoda M, Kubota K. 2513 POSTER Pancreatoduodenectomy With Portal Vein Resection and Recontruction. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71069-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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108
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Sekine I, Kubota K, Niho S, Sumi M, Nihei K, Sekiguchi R, Funai J, Enatsu S, Ohe Y, Tamura T. 9060 POSTER Phase I Trial of Pemetrexed and Cisplatin Combination Chemotherapy With Concurrent Thoracic Radiotherapy in Japanese Patients With Locally Advanced Non-Small-Cell Lung Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72372-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Furugen M, Sekine I, Tsuta K, Horinouchi H, Nokihara H, Yamamoto N, Kubota K, Tamura T. Combination Chemotherapy with Carboplatin and Paclitaxel for Advanced Thymic Cancer. Jpn J Clin Oncol 2011; 41:1013-6. [DOI: 10.1093/jjco/hyr089] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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110
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Scagliotti G, Vynnychenko I, Ichinose Y, Park K, Kubota K, Blackhall FH, Pirker R, Galiulin R, Ciuleanu T, Sydorenko O, Dediu M, Papai-Szekely Z, Martinez Banaclocha N, McCoy S, Yao B, Hei YJ, Spigel DR. An international, randomized, placebo-controlled, double-blind phase III study (MONET1) of motesanib plus carboplatin/paclitaxel (C/P) in patients with advanced nonsquamous non-small cell lung cancer (NSCLC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.18_suppl.lba7512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA7512 Background: This study evaluated whether motesanib (a selective oral inhibitor of VEGFR 1, 2 and 3; PDGFR and Kit) plus C/P improved overall survival (OS) compared with placebo + C/P in patients (pts) with nonsquamous NSCLC and in a subset of pts with adenocarcinoma. Methods: Pts had stage IIIB/IV or recurrent nonsquamous NSCLC and no prior systemic therapy for advanced NSCLC. The study initially enrolled all histologies but was amended to exclude pts with squamous NSCLC owing to a high rate of hemoptysis. Pts were randomized 1:1 to receive up to six 3-wk cycles of C (AUC 6 mg/mL·min) and P (200 mg/m2) with either motesanib 125 mg QD (Arm A) or placebo QD (Arm B) orally continuously. The primary endpoint was OS; secondary endpoints included progression-free survival (PFS), adverse events (AEs), objective response rate (ORR) and association between placental growth factor (PLGF) change and OS. OS was evaluated using a stratified Cox model and 2-sided log-rank test (α=0.03 for nonsquamous pts and α=0.02 for adenocarcinoma pts). Results: 1090 pts with nonsquamous NSCLC were randomized (Arm A/B, n=541/549); 890 had adenocarcinoma (n=448/442). 61% were men; median age was 60 years (range 21–87); 83% had stage IV disease. At the time of analysis, 753 pts had died (608 pts with adenocarcinoma). Median follow-up was 10.6 mo. OS was not significantly improved in Arm A compared with Arm B (Table). In Arm A, PLGF analysis did not show an association with OS. The incidence of grade ≥3 AEs in Arms A/B was 73/59%. Grade ≥3 AEs occurring more frequently in Arm A than B included neutropenia (22/15%), diarrhea (9/1%), hypertension (7/1%) and cholecystitis (3/0%). The incidence of grade 5 AEs was 14/9% in Arms A/B. Conclusions: In pts with advanced nonsquamous NSCLC, treatment with motesanib + C/P did not significantly improve OS compared with C/P alone. [Table: see text]
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Ishizuka M, Kubota K, Kita J, Shimoda M, Kato M, Sawada T. Duration of hepatic vascular inflow clamping and survival after liver resection for hepatocellular carcinoma. Br J Surg 2011; 98:1284-90. [PMID: 21633950 DOI: 10.1002/bjs.7567] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2011] [Indexed: 12/27/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the influence of the duration of hepatic vascular inflow clamping (Pringle time) on the survival of patients with any type of liver background (not only cirrhosis) undergoing liver resection for hepatocellular carcinoma (HCC). METHODS Patients who underwent liver resection between April 2000 and December 2008 for HCC using the Pringle manoeuvre were identified retrospectively from an institutional database and divided into two groups: group 1 had a Pringle time of 60 min or less, and group 2 a Pringle time of more than 60 min. Univariable and multivariable analyses were performed to identify predictors of postoperative survival. Kaplan-Meier analysis was used to compare overall survival between the groups. RESULTS A total of 357 patients were enrolled; 242 patients had a Pringle time of 60 min or less (group 1), and 115 patients had a Pringle time of more than 60 min (group 2). Patients in group 2 had a shorter overall survival than those in group 1 (P = 0·010). Univariable analyses showed that type of HCC (primary versus recurrent), maximum tumour diameter, hepatic venous infiltration, platelet count, serum protein induced by vitamin K absence or antagonist II level, blood loss (700 ml or less versus more than 700 ml), duration of operation (300 min or less versus more than 300 min) and Pringle time (60 min or less versus more than 60 min) were predictive of postoperative survival. Multivariable analysis indicated that only Pringle time was associated with postoperative survival (odds ratio 1·83, 95 per cent confidence interval 1·08 to 3·10; P = 0·024). CONCLUSION Longer Pringle time is an important predictor of shorter postoperative survival in patients undergoing liver resection for HCC.
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Scagliotti G, Vynnychenko I, Ichinose Y, Park K, Kubota K, Blackhall FH, Pirker R, Galiulin R, Ciuleanu T, Sydorenko O, Dediu M, Papai-Szekely Z, Martinez Banaclocha N, McCoy S, Yao B, Hei YJ, Spigel DR. An international, randomized, placebo-controlled, double-blind phase III study (MONET1) of motesanib plus carboplatin/paclitaxel (C/P) in patients with advanced nonsquamous non-small cell lung cancer (NSCLC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.lba7512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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113
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Kenmotsu H, Niho S, Ito T, Ishikawa Y, Tada H, Sekine I, Watanabe S, Yoshimura M, Yamamoto N, Oshita F, Kubota K, Nagai K. A pilot study of adjuvant chemotherapy with cisplatin and irinotecan for high-grade pulmonary neuroendocrine carcinona (large cell neuroendocrine carcinoma and small cell lung cancer). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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114
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Ogawa Y, Kubota K, Tadokoro M, Yamanishi T, Hamada N, Kariya S, Nishioka A, Suzuki Y, Aoyama N, Nogami M, Yokota N, Sasaki T, Yaogawa S, Tsuzuki A, Akima R, Suzuki K, Tokuhiro S. 777 poster US-GUIDED & ENZYME-TARGETING RADIOSENSITIZATION TREATMENT (KORTUC II) WITHOUT ANY SURGERY FOR PATIENTS WITH BREAST CANCER OF STAGES I & II. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70899-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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115
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Toyama Y, Sahara R, Iino Y, Kubota K. pH Dependence of Rheological Properties of Gelatin Gel Mixed with Agar or Agarose. ACTA ACUST UNITED AC 2011. [DOI: 10.14723/tmrsj.36.383] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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116
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Syutsubo K, Yoochatchaval W, Tsushima I, Araki N, Kubota K, Onodera T, Takahashi M, Yamaguchi T, Yoneyama Y. Evaluation of sludge properties in a pilot-scale UASB reactor for sewage treatment in a temperate region. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2011; 64:1959-1966. [PMID: 22105115 DOI: 10.2166/wst.2011.762] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In this study, continuous operation of a pilot-scale upflow anaerobic sludge blanket (UASB) reactor for sewage treatment was conducted for 630 days to investigate the physical and microbial characteristics of the retained sludge. The UASB reactor with a working volume of 20.2 m(3) was operated at ambient temperature (16-29 °C) and seeded with digested sludge. After 180 days of operation, when the sewage temperature had dropped to 20 °C or lower, the removal efficiency of both total suspended solids (TSS) and total biochemical oxygen demand (BOD) deteriorated due to washout of retained sludge. At low temperature, the cellulose concentration of the UASB sludge increased owing to the rate limitation of the hydrolytic reaction of suspended solids in the sewage. However, after an improvement in sludge retention (settleability and concentration) in the UASB reactor, the process performance stabilized and gave sufficient results (68% of TSS removal, 75% of total BOD removal) at an hydraulic retention time (HRT) of 9.7 h. The methanogenic activity of the retained sludge significantly increased after day 246 due to the accumulation of Methanosaeta and Methanobacterium following the improvement in sludge retention in the UASB reactor. Acid-forming bacteria from phylum Bacteroidetes were detected at high frequency; thus, these bacteria may have an important role in suspended solids degradation.
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Yoochatchaval W, Kumakura S, Tanikawa D, Yamaguchi T, Yunus MFM, Chen SS, Kubota K, Harada H, Syutsubo K. Anaerobic degradation of palm oil mill effluent (POME). WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2011; 64:2001-2008. [PMID: 22105121 DOI: 10.2166/wst.2011.782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The biodegradation characteristics of palm oil mill effluent (POME) and the related microbial community were studied in both actual sequential anaerobic ponds in Malaysia and enrichment cultures. The significant degradation of the POME was observed in the second pond, in which the temperature was 35-37 °C. In this pond, biodegradation of major long chain fatty acids (LCFA), such as palmitic acid (C16:0) and oleic acid (C18:1), was also confirmed. The enrichment culture experiment was conducted with different feeding substrates, i.e. POME, C16:0 and C18:1, at 35 °C. Good recovery of methane indicated biodegradation of feeds in the POME and C16:0 enrichments. The methane production rate of the C18:1 enrichment was slower than other substrates and inhibition of methanogenesis was frequently observed. Denaturing gradient gel electrophoresis (DGGE) analyses indicated the existence of LCFA-degrading bacteria, such as the genus Syntrophus and Syntorophomonas, in all enrichment cultures operated at 35 °C. Anaerobic degradation of the POME under mesophilic conditions was stably processed as compared with thermophilic conditions.
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Ishizuka M, Nagata H, Takagi K, Kubota K. Insufficient lymph node dissection is an independent risk factor for postoperative cancer death in patients undergoing surgery for stage II colorectal cancer. ACTA ACUST UNITED AC 2010; 46:57-64. [PMID: 21135561 DOI: 10.1159/000321318] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Accepted: 09/16/2010] [Indexed: 12/12/2022]
Abstract
BACKGROUND Surgical resection is the most effective treatment for patients with stage II colorectal cancer (CRC). However, a few patients with early-phase CRC suffer postoperative cancer death. AIMS To investigate the risk factors for postoperative cancer death in patients who undergo surgery for stage II CRC. METHODS Prognostic significance was analyzed by χ(2) test, univariate analyses, Kaplan-Meier analysis and log-rank test using clinicopathological factors from the database. RESULTS A total of 205 patients with stage II CRC were evaluated. Age (≤ 65/>65 years), venous invasion (negative/positive), number of dissected lymph nodes (≤ 9/≥ 10), grade of lymph node dissection (sufficient/insufficient) and albumin level (< 3.5/≥ 3.5 g/dl) were associated with shorter overall survival. Univariate analysis of the clinicopathological factors revealed that only the grade of lymph node dissection (sufficient/insufficient) was associated with postoperative cancer death (odds ratio 2.993, 95% confidence interval 1.216-7.368, p = 0.017).Kaplan-Meier analysis and log-rank test revealed that the group with insufficient lymph node dissection had a higher incidence of postoperative cancer death than the group with sufficient dissection (p < 0.001). CONCLUSIONS Insufficient lymph node dissection is an independent risk factor for postoperative cancer death in patients who undergo surgery for stage II CRC.
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Mawatari H, Yoneda M, Fujita K, Nozaki Y, Shinohara Y, Sasaki H, Iida H, Takahashi H, Inamori M, Abe Y, Kobayashi N, Kubota K, Kirikoshi H, Nakajima A, Saito S. Association between phospholipids and free cholesterol in high-density lipoprotein and the response to hepatitis C treatment in Japanese with genotype 1b. J Viral Hepat 2010; 17:859-65. [PMID: 20070501 DOI: 10.1111/j.1365-2893.2009.01253.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Pegylated interferon and ribavirin combination therapy is the standard treatment for patients with chronic hepatitis C (CHC), but treatment failure can be difficult to predict. We and others have reported a relation between lipid values and sustained viral responses in patients with CHC. However, the relationship between lipid values and treatment failure has not been previously reported. The present study investigated the association between the profiles of phospholipids and free cholesterol (FC), the main constitutive ingredients of the surface of lipoprotein, classified according to particle size and hepatitis C treatment, and determined the usefulness of these parameters for predicting the outcome of treatment. Fifty-five patients with CHC (33 men and 22 women) were included in the study. The serum total cholesterol, triglyceride, phospholipids, and FC levels in the lipoprotein subclasses were determined using high-performance liquid chromatography with gel permeation columns, enabling the lipoproteins to be classified into 13 subclasses according to particle size. According to a univariate analysis, the treatment failure group had a significantly higher serum phospholipid level overall in the high-density lipoprotein (HDL) and medium HDL fractions as well as a higher serum FC level in the HDL fraction and all HDL subclass fractions compared with the corresponding values in the non-nonvirological response group. Higher serum phospholipid and FC concentrations in the HDL subclasses were predictive of a failure to respond in patients with genotype 1b.
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Uchiyama T, Goto A, Sakai E, Sekino Y, Iida H, Endo H, Hosono K, Sakamoto Y, Koide T, Takahashi H, Yoneda M, Tokoro C, Abe Y, Shimamura T, Kobayashi N, Kubota K, Maeda S, Nakajima A, Ichikawa Y, Inamori M. Endoscopic hemostasis through gastrostomy. Endoscopy 2010; 42 Suppl 2:E270. [PMID: 20931478 DOI: 10.1055/s-0030-1255772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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121
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Tuzuki A, Ogawa Y, Kubota K, Nishioka A, Akima R, Tokuhiro S, Yaogawa S, Yamada Y, Sasaki T, Geshi H. Evaluation of Changes of Tumor Shadows and Micro-calcifications on Mammography following a New Radiosensitization Treatment (KORTUCII) for Aged Patients with Breast Cancer of Stages I and II. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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122
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Nishioka A, Ogawa Y, Kariya S, Miyatake K, Tadokoro M, Ue H, Matsui R, Hamada N, Kubota K. Safety and Efficacy of New Enzyme Targeting Intraoperative Radiotherapy for Locally Advanced Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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123
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Oshima A, Ito S, Abe Y, Uchiyama T, Iida H, Endo H, Hosono K, Sakamoto Y, Fujita K, Yoneda M, Takahashi H, Koide T, Tokoro C, Goto A, Inamori M, Kobayashi N, Kubota K, Saito S, Nakajima A. Mesenteric phlebosclerosis. Endoscopy 2010; 42 Suppl 2:E156-7. [PMID: 20556711 DOI: 10.1055/s-0029-1244147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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124
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Yoneda K, Takahashi H, Abe Y, Inamori M, Kato S, Uchiyama T, Iida H, Mawatari H, Hosono K, Endo H, Nozaki Y, Akiyama T, Fujita K, Yoneda M, Kobayashi N, Kirikoshi H, Kubota K, Saito S, Nakajima A. A mucosa-associated lymphoid tissue (MALT) lymphoma of the small intestine that was difficult to diagnose endoscopically. Endoscopy 2010; 42 Suppl 2:E175. [PMID: 20560120 DOI: 10.1055/s-0029-1214857] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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125
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Abe T, Shinohara N, Muranaka M, Sazawa A, Maruyama S, Osawa T, Harabayashi T, Kubota K, Matsuno Y, Shibata T, Toyada Y, Shinno Y, Minami K, Sakashita S, Kumagai A, Takada N, Togashi M, Sano H, Mori T, Nonomura K. Role of lymph node dissection in the treatment of urothelial carcinoma of the upper urinary tract: multi-institutional relapse analysis and immunohistochemical re-evaluation of negative lymph nodes. Eur J Surg Oncol 2010; 36:1085-91. [PMID: 20832972 DOI: 10.1016/j.ejso.2010.08.134] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Revised: 06/11/2010] [Accepted: 08/19/2010] [Indexed: 01/11/2023] Open
Abstract
AIM To determine the role of lymph node dissection (LND) in the treatment of urothelial carcinoma (UC) of the upper urinary tract (UUT). PATIENTS AND METHODS [Study-1] A retrospective multi-institutional study evaluated 293 patients undergoing predominantly nephroureterectomy for UC of the UUT. Of 293 patients, 267 patients had pure UC and 26 demonstrated other histological components. Regarding the pathological node status, 130 patients had pN0 disease, 141 patients had pNx disease and 22 patients had pN+ disease. The sites of initial recurrence and time to first recurrence were reviewed. The sites of recurrence were classified as locoregional or distant recurrence. The relationship between node status and future recurrence was analyzed. [Study-2] Fifty-one patients treated by nephroureterectomy at Hokkaido University Hospital were included. All had LND and all LNs were negative on hematoxylin and eosin staining. We re-evaluated the presence of micrometastasis in LND specimens by anti-cytokeratin immunohistochemistory. RESULTS [Study-1] Of 293 patients, 76 developed disease relapse. Regional lymph node recurrence was the most common site (34 patients). On multivariate analyses that adjusted for the effect of tumor stage and tumor grade, pNx (skipping LND) was an adverse factor not only for locoregional recurrence, but also for distant relapse. [Study-2] Immunohistochemistry identified micrometastases in 7 (14%) of 51 patients. Regarding survival, 5 of these 7 patients with micrometastases were alive at last follow-up. CONCLUSIONS On relapse analysis, skipping LND was an adverse factor not only for locoregional recurrence, but also for distant relapse. Immunohistochemistry detected micrometastases in about 14% of patients previously diagnosed as pN0. These findings further support a potential therapeutic benefit of LND by eliminating micrometastases.
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