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Screening for Lynch syndrome using risk assessment criteria in patients with ovarian cancer
Takashi Takeda,Kosuke Tsuji,Kouji Banno,Megumi Yanokura,Yusuke Kobayashi,Eiichiro Tominaga,Daisuke Aoki 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.3
Objective: Lynch syndrome is a cancer predisposition syndrome caused by germline mutation of DNA mismatch repair (MMR) genes. Lynch syndrome only causes about 0.4% of cases of ovarian cancer, which suggests that universal screening may not be cost-efficient. However, the frequency of Lynch syndrome in ovarian cancer is unclear in the Asian population. The goal of the study was to investigate a screening strategy using family history. Methods: The subjects were 129 patients with ovarian cancer. Clinical and family history were collected using a self-administered questionnaire, and Society of Gynecologic Oncology (SGO) criteria 2007 and PREMM5 were used for risk assessment. Microsatellite instability, immunohistochemistry, and methylation of MMR genes were analyzed. Results: Of the 129 cases, 25 (19.4%) met the SGO criteria, and 4 of these 25 had MSI-high and MMR deficiency. Two cases had loss of MSH2 and MSH6, indicating MSH2 mutation, and the other two had loss of MLH1 and PMS2, including one without MLH1 methylation indicating MLH1 mutation. These results show that screening using family history can detect Lynch syndrome in 12.0% (3/25) of ovarian cancer cases. The 3 cases were positive for PREMM5, but negative for Amsterdam II criteria and revised Bethesda guidelines. Genetic testing in one case with MSH2 and MSH6 deficiency confirmed the diagnosis of Lynch syndrome with MSH2 mutation. Conclusion: This is the first study of screening for Lynch syndrome in ovarian cancer using clinical and family history in an Asian population. This approach may be effective for diagnosis in these patients.
Welding Inspection with Image Processing
Takashi Murosaki,Takaha Naoki,Syuji Takeda,Akihiro Hayashiguchi,Fumiaki Sugiura 제어로봇시스템학회 2009 제어로봇시스템학회 국제학술대회 논문집 Vol.2009 No.8
We studied a welding inspection for alternator"s rectifier with image processing. The point ishow to apply the SVM method to the area and contrast of the welding extracted by the difference of good work-pieces. Usually, the judgment boundary of MahalanobisDistance isassumed to be a midway line from the good one"s distribution and the defective one"s distribution. But, the boundary has a problem that misjudged defective one to the good one. To solve this, we applied SVM (Support Vector Machine) with the process capability index.
Tsuyoshi Takeda,Takashi Sasaki,Takafumi Mie,Takeshi Okamoto,Chinatsu Mori,Takaaki Furukawa,Yuto Yamada,Akiyoshi Kasuga,Masato Matsuyama,Masato Ozaka,Naoki Sasahira 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.4
Background/Aims: Digital single-operator cholangioscopy (DSOC)-guided mapping biopsy (DMB) and tube-assisted mapping biopsy(TMB) are two techniques used for preoperative evaluation of biliary tract cancer (BTC). However, data regarding the diagnostic performanceof these techniques are limited. Methods: We retrospectively examined consecutive patients with BTC who underwent either technique at our institution between2018 and 2020. We evaluated the technical success rate, adequate tissue acquisition rate, and diagnostic performance of these techniquesfor the evaluation of lateral spread of BTC. Results: A total of 54 patients were included in the study. The technical success rate of reaching the target sites was 95% for DMB and100% for TMB. The adequate tissue acquisition rate was 61% for DMB and 69% for TMB. The adequate tissue acquisition rate was low,especially for target sites beyond the secondary biliary radicles. The sensitivity of DMB alone was 39%, which improved to 65% whencombined with visual impression. Experts demonstrated a higher negative predictive value and diagnostic accuracy with respect toboth DSOC visual impression and DMB for the evaluation of lateral spread of BTC compared to trainees. Conclusions: Adequate tissue acquisition rates were similar between the two techniques. Since DMB requires expertise, TMB may bean acceptable option when DSOC is unavailable or when DSOC expertise is limited.
Takafumi Mie,Takashi Sasaki,Ryo Kanata,Takaaki Furukawa,Tsuyoshi Takeda,Akiyoshi Kasuga,Masato Matsuyama,Masato Ozaka,Naoki Sasahira 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.5
Background/Aims: Several fine-needle biopsy (FNB) needles are available for endoscopic ultrasound (EUS)-guided tissueacquisition. However, there is disagreement on which type of needle has the best diagnostic yield. The aim of this study was tocompare the performance and safety of two commonly used EUS-FNB needles. Methods: We retrospectively analyzed consecutive patients who underwent EUS-FNB between June 2016 and March 2020 in ourhospital. Two types of needles were evaluated: a 20-gauge Menghini needle with a lateral forward bevel and a 22-gauge Franseenneedle. Rapid on-site evaluation was performed in all the cases. A multivariate analysis was performed to clarify the negativepredictive factors for obtaining a histological diagnosis. Propensity score matching was performed to compare the diagnostic yieldsof these two needles. Results: We analyzed 666 patients and 690 lesions. The overall diagnostic rate of histology alone was 88.8%, and the overall adverseevent rate was 1.5%. Transduodenal access and small lesions (≤2 cm) were identified as negative predictive factors for obtaining ahistological diagnosis. After propensity score matching, 482 lesions were analyzed. The diagnostic accuracy rates of histology in theM and F needle groups were 89.2% and 88.8%, respectively (p=1.00). Conclusions: Both the needles showed high diagnostic yield, and no significant difference in performance was observed between thetwo.
Takeshi Okamoto,Takashi Sasaki,Tsuyoshi Takeda,Takafumi Mie,Chinatsu Mori,Takaaki Furukawa,Yuto Yamada,Akiyoshi Kasuga,Masato Matsuyama,Masato Ozaka,Naoki Sasahira 대한소화기내시경학회 2024 Clinical Endoscopy Vol.57 No.1
Background/Aims: Selective bile duct or pancreatic duct cannulation remains a significant initial hurdle in endoscopic retrograde cholangiopancreatography (ERCP) despite advances in endoscopy and accessories. This study evaluated our experience with a rotatable sphincterotome in cases of difficult cannulation. Methods: We retrospectively reviewed ERCP cases using TRUEtome, a rotatable sphincterotome, as a rescue device for cannulation at a cancer institute in Japan from October 2014 to December 2021. Results: TRUEtome was used in 88 patients. Duodenoscopes were used for 51 patients, while single-balloon enteroscopes (SBE) were used for 37 patients. TRUEtome was used for biliary and pancreatic duct cannulation (84.1%), intrahepatic bile duct selection (12.5%), and strictures of the afferent limb (3.4%). Cannulation success rates were similar in the duodenoscope and SBE groups (86.3% vs. 75.7%, p=0.213). TRUEtome was more commonly used in cases with steep cannulation angles in the duodenoscope group and in cases requiring cannulation in different directions in the SBE group. There were no significant differences in adverse events between the two groups. Conclusions: The cannulation sphincterotome was useful for difficult cannulations in both unaltered and surgically altered anatomies. It may be an option to consider before high-risk procedures such as precut and endoscopic ultrasound-guided rendezvous techniques.
Takafumi Mie,Takashi Sasaki,Takeshi Okamoto,Tsuyoshi Takeda,Chinatsu Mori,Yuto Yamada,Takaaki Furukawa,Akiyoshi Kasuga,Masato Matsuyama,Masato Ozaka,Naoki Sasahira 대한소화기내시경학회 2024 Clinical Endoscopy Vol.57 No.2
Background/Aims: Hepaticojejunostomy anastomotic stricture (HJAS) is a feared adverse event associated with hepatopancreatobiliary surgery. Although balloon dilation for benign HJAS during endoscopic retrograde cholangiopancreatography with balloon-assisted enteroscopy has been reported to be useful, the treatment strategy remains controversial. Therefore, we evaluated the outcomes and risk factors of recurrent stenosis after balloon dilation alone for benign HJAS. Methods: We retrospectively analyzed consecutive patients who underwent balloon-assisted enteroscopy-endoscopic retrograde cholangiopancreatography for benign HJAS at our institution between July 2014 and December 2020. Results: Forty-six patients were included, 16 of whom had recurrent HJAS after balloon dilation. The patency rates at 1 and 2 years after balloon dilation were 76.8% and 64.2%, respectively. Presence of a residual balloon notch during balloon dilation was an independent predictor of recurrence (hazard ratio, 2.80; 95% confidence interval, 1.01–7.78; p=0.048), whereas HJAS within postoperative 1 year tended to be associated with recurrence (hazard ratio, 2.43; 95% confidence interval, 0.85–6.89; p=0.096). The patency rates in patients without a residual balloon notch were 82.1% and 73.1% after 1 and 2 years, respectively. Conclusions: Balloon dilation alone may be a viable option for patients with benign HJAS without residual balloon notches on fluoroscopy.
Multivariate survival analysis of the patients with recurrent endometrial cancer
Tetsuji Odagiri,Hidemichi Watari,Masayoshi Hosaka,Takashi Mitamura,Yousuke Konno,Tatsuya Kato,Noriko Kobayashi,Satoko Sudo,Mahito Takeda,Masanori Kaneuchi,Noriaki Sakuragi 대한부인종양학회 2011 Journal of Gynecologic Oncology Vol.22 No.1
Objective: Few studies on the prognosticators of the patients with recurrent endometrial cancer after relapse have been reported in the literature. The aim of this study was to determine the prognosticators after relapse in patients with recurrent endometrial cancer who underwent primary complete cytoreductive surgery and adjuvant chemotherapy. Methods: Thirty-five patients with recurrent endometrial cancer were included in this retrospective analysis. The prognostic significance of several clinicopathological factors including histologic type, risk for recurrence, time to relapse after primary surgery, number of relapse sites, site of relapse, treatment modality, and complete resection of recurrent tumors were evaluated. Survival analyses were performed by Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by multivariate Cox regression analysis. Results: Among the clinicopathological factors analyzed, histologic type (p=0.04), time to relapse after primary surgery (p=0.03), and the number of relapse sites (p=0.03) were significantly related to survival after relapse. Multivariate analysis revealed that time to relapse after primary surgery (hazard ratio, 6.8; p=0.004) and the number of relapse sites (hazard ratio, 11.1; p=0.002) were independent prognostic factors for survival after relapse. Survival after relapse could be stratified into three groups by the combination of two independent prognostic factors. Conclusion: We conclude that time to relapse after primary surgery, and the number of relapse sites were independent prognostic factors for survival after relapse in patients with recurrent endometrial cancer. Objective: Few studies on the prognosticators of the patients with recurrent endometrial cancer after relapse have been reported in the literature. The aim of this study was to determine the prognosticators after relapse in patients with recurrent endometrial cancer who underwent primary complete cytoreductive surgery and adjuvant chemotherapy. Methods: Thirty-five patients with recurrent endometrial cancer were included in this retrospective analysis. The prognostic significance of several clinicopathological factors including histologic type, risk for recurrence, time to relapse after primary surgery, number of relapse sites, site of relapse, treatment modality, and complete resection of recurrent tumors were evaluated. Survival analyses were performed by Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by multivariate Cox regression analysis. Results: Among the clinicopathological factors analyzed, histologic type (p=0.04), time to relapse after primary surgery (p=0.03), and the number of relapse sites (p=0.03) were significantly related to survival after relapse. Multivariate analysis revealed that time to relapse after primary surgery (hazard ratio, 6.8; p=0.004) and the number of relapse sites (hazard ratio, 11.1; p=0.002) were independent prognostic factors for survival after relapse. Survival after relapse could be stratified into three groups by the combination of two independent prognostic factors. Conclusion: We conclude that time to relapse after primary surgery, and the number of relapse sites were independent prognostic factors for survival after relapse in patients with recurrent endometrial cancer.