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      • A Strategy Using Photodynamic Therapy and Clofibric Acid to Treat Peritoneal Dissemination of Ovarian Cancer

        Yokoyama, Yoshihito,Shigeto, Tatsuhiko,Miura, Rie,Kobayashi, Asami,Mizunuma, Makito,Yamauchi, Aisa,Futagami, Masayuki,Mizunuma, Hideki Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.2

        Background: The current study examined the effectiveness of concurrent therapy using photodynamic therapy (PDT) and clofibric acid (CA) to treat peritoneal carcinomatosis resulting from ovarian cancer. Materials and Methods: Nude rats were used to create a model of peritoneal carcinomatosis resulting from ovarian cancer and the effectiveness of PDT with 5-aminolevulinic acid methyl ester hydrochloride (methyl-ALA-PDT) was determined. The survival time of rats receiving that therapy was compared to the survival time of a control group. Rats with peritoneal carcinomatosis resulting from ovarian cancer were divided into 3 groups: a group that received debulking surgery (DS) alone, a group that received DS+methyl-ALA-PDT, and a group that received DS+methyl-ALA-PDT+CA. The survival time of the 3 groups was compared. Protoporphyrin, a metabolite of methyl-ALA, produces a photochemical action when activated by light. The level of protoporphyrin (the concentration) that reached organs in the abdomen was measured with HPLC. Results: Rats receiving methyl-ALA-PDT had a significantly longer survival time compared to the controls. Rats with peritoneal carcinomatosis that received DS+methyl-ALA-PDT+CA had a significantly longer survival time compared to the rats that received DS alone. Some of the rats that received concurrent therapy survived for a prolonged period. Protoporphyrin was highly concentrated in peritoneal metastases, but only small amounts reached major organs in the abdomen. PDT was not found to result in necrosis in the intestines. Conclusions: The results indicated that concurrent therapy consisting of PDT with methyl-ALA and CA is effective at treating peritoneal carcinomatosis resulting from ovarian cancer without damaging organs.

      • KCI등재

        Decreased ARID1A expression is correlated with chemoresistance in epithelial ovarian cancer

        Yoshihito Yokoyama,Yoko Matsushita,Tatsuhiko Shigeto,Masayuki Futagami,Hideki Mizunuma 대한부인종양학회 2014 Journal of Gynecologic Oncology Vol.25 No.1

        Objective: Loss of ARID1A is related to oncogenic transformation of ovarian clear cell adenocarcinoma. The present study was conducted in epithelial ovarian cancer of all tissue types to investigate whether an increased or decreased expression level of ARID1A can be a prognostic factor for ovarian cancer or can influence the sensitivity to anticancer drugs. Methods: The expression level of ARID1A was investigated in 111 patients with epithelial ovarian cancer who received initial treatment at the Hirosaki University Hospital between 2006 and 2011. The expression level of ARID1A was immunohistochemically graded using staining scores, which were calculated by multiplying the staining intensity of the nuclei by the stain-positive area. Results: The level of ARID1A was significantly lower in clear cell adenocarcinoma than in other histologic types. Among the patients with stage III, IV cancer (n=46), the level of ARID1A was significantly lower (p=0.026) in patients who did not achieve complete response (CR; n=12) than in patients who achieved CR (n=34). The level of ARID1A was relatively lower (p=0.07) in patients who relapsed after achieving CR (n=21) than in patients who did not relapse (n=13). When the staining score of 0 was defined as ARID1A-negative and other staining scores were defined as ARID1A-positive, there was significant difference in progression-free survival between ARID1A-negative (n=11) and ARID1A-positive (n=35) patients in stage III, IV disease. Conclusion: The result suggests that decreased ARID1A expression is correlated with chemoresistance and may be a predictive factor for the risk of relapse of advanced cancer after achieving CR.

      • Palliative Care for Patients with Gynecologic Cancer in Japan: A Japan Society of Gynecologic Palliative Medicine (JSGPM) Survey

        Futagami, Masayuki,Yokoyama, Yoshihito,Sato, Tetsumi,Hirota, Kazuyoshi,Shimada, Muneaki,Miyagi, Etsuko,Suzuki, Nao,Fujimura, Masaki Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.10

        Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care, provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer, was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29.0%) had a palliative care ward. End-of-life care was managed by obstetricians and gynecologists in 72.0% of the facilities. The site where end-of-life care was provided was most often a ward in the department where the respondent worked. The waiting period for transfer to a hospice was 2 weeks or more in 52% of facilities. Before the start of primary treatment, pain control was managed by obstetrians and gynecologists in 98.0% of facilities. Palliative radiation therapy or chemotherapy was administered at 93.9% and 92.0% of facilities, respectively. Of the 115 facilities, 34.0 (29.6%) reported cases of death from gynecological cancer. There were 1,134 cases of death. The median time between the last cycle of chemotherapy and death was 85 days for all gynecological cancers. The proportion of patients receiving chemotherapy in the last 30 and 14 days of life were 17.4% and 7.1%, respectively. Conclusions: This large-scale survey showed characteristics of palliative care given to patients with gynecologic cancer in Japan. Assessment of death cases showed that the median time between the last cycle of chemotherapy and death was relatively short.

      • KCI등재

        Severe C8 or T1 Symptoms after Cervical Laminoplasty and Related Factors: Are There Any Differences between C3–C6 Laminoplasty and C3–C7 Laminoplasty?

        Hitoshi Kudo,Kazunari Takeuchi,Toru Yokoyama,Yoshihito Yamasaki,Kanichiro Wada,Gentaro Kumagai,Toru Asari,Hironori Otsuka,Yasuyuki Ishibashi 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.4

        Study Design: Retrospective study. Purpose: We experienced the situation wherein some patients had new-onset pain or dysesthesia around the ring and little fingers (C8 symptom) or ulnar aspect of the forearm (T1 symptom) after cervical laminoplasty (LP). We investigated the incidence and the cause of new C8 or T1 symptoms and the clinical outcomes after C3–C6 LP or C3–C7 LP. Overview of Literature: There were some reports regarding complications after cervical LP. However, there was no report regarding C8 or T1 symptoms after cervical LP. Methods: Among the 33 patients enrolled in this study, 11 and 22 patients were treated with C3–C6 LP and C3–C7 LP, respectively. We prospectively evaluated C8 or T1 symptoms daily postoperatively for 1 week. The distance of the posterior spinal cord shifting and posterior subarachnoid space from C2 to T1 was measured by T2-weighted midsagittal magnetic resonance imaging (MRI). We evaluated pre- and postoperative axial neck pain, Japanese Orthopaedic Association (JOA) score, and JOA score improvement rate. Results: C8 or T1 symptoms occurred in five and three patients with C3–C6 LP (45.5%) and C3–C7 LP (13.6%), respectively. The distance of the posterior subarachnoid space in C3–C6 LP at C7 was significantly shorter than that in C3–C7 LP at T1 on MRI 24 hours postoperatively (p=0.0448). Postoperative axial neck pain, pre- and postoperative JOA scores, and JOA score improvement rate were not significantly different. Conclusions: The incidence of C8 or T1 symptoms in C3–C6 LP was higher than that in C3–C7 LP. C8 or T1 symptoms would be caused by the posterior fila radicularia and spinal cord impingement on the intact lower end of the lamina.

      • KCI등재

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