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RISS 인기검색어
- 검색키워드
- 저자 : Ken Miyazawa (검색결과 4 건)
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Effectiveness of en-masse retraction using midpalatal miniscrews and a modified transpalatal arch
Jungkil Lee,Ken Miyazawa,Masako Tabuchi,Takuma Sato,Misuzu Kawaguchi,Shigemi Goto 대한치과교정학회 2014 대한치과교정학회지 Vol.44 No.2
Objective: The purpose of this study was to compare the treatment duration and dentoskeletal changes between two different anchorage systems used to treat maxillary dentoalveolar protrusion and to examine the effectiveness of en-masse retraction using two miniscrews placed in the midpalatal suture. Methods: Fifty-seven patients (9 men, 48 women), who had undergone level anchorage system treatment at Aichi-Gakuin University Dental Hospital (Nagoya, Japan) were divided into two groups according to the method of maxillary posterior anchorage reinforcement: midpalatal miniscrews (25 patients, mean age 22 years) and conventional anchorage (32 patients, mean age 19 years). The en-masse retraction period, overall treatment duration, pre-treatment effective ANB angle, and change in the effective ANB angle were compared with an independent-samples t -test. Results: Compared to the headgear group, the duration of en-masse retraction was longer by approximately 4 months in the miniscrew group (p < 0.001). However, we found no significant difference in the total treatment duration between the groups. Moreover, a greater change in the effective ANB angle was observed in patients treated with miniscrews than in those treated with the conventional method (p < 0.05). Conclusions: The level anchorage system treatment using miniscrews placed in the midpalatal area will allow orthodontists more time to control the anterior teeth during enmasse retraction, without increasing the total treatment duration. Furthermore, it achieves better dentoskeletal control than does the conventional anchorage method, thereby improving the quality of the treatment results.
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The Impact of Neoadjuvant Chemotherapy for Borderline Resectable Pancreatic Cancer
( Manabu Kawai ),( Seiko Hirono ),( Ken-ichi Okada ),( Motoki Miyazawa ),( Yuji Kitahata ),( Ryohei Kobayashi ),( Masaki Ueno ),( Shinya Hayami ),( Hiroki Yamaue ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Backgrounds: According to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines, pancre atic ductal adenocarcinoma (PDAC) can be classified as resectable, borderline resectable, or unresectable. Although borderline resectable PDAC (BRPC) may technically be resectable, it has particularly high risks of margin-positive resection and postoperative recurrence. Therefore, preoperative treatment is recommended for BRPC patients in both the NCCN Guidelines and an expert consensus statement. However, the establishment of the most appropriate neoadjuvant therapy is needed by further studies. The aim of these studies is to evaluate the impact of neoadjuvant chemotherapy for BRPC and confirm the safety and efficacy of two regimens of neoadjuvant therapy for BRPC. Our Clinical Trials: First, we evaluated the impact of neoadjuvant chemotherapy for BRPC. 143 BRPC-A patients un dergoing pancreatectomy were reviewed from among 330 pancreatic cancer patients, including 111 potentially resectable pancreatic cancer patients and 76 BRPC with portal vein involvement patients. We compared the clinico pathological factors of 40 BRPC-A patients treated with neoadjuvant treatment followed by surgery and those of 103 BRPC-A patients treated with upfront surgery. The R0 rate and progression-free survival of BRPC-A patients who received neoadjuvant therapy and subsequent surgical resection were significantly better compared to those who re ceived upfront surgery (R0: P = 0.041; progression-free survival: P = 0.033), but overall survival was not significantly different. Neoadjuvant treatment followed by surgery might provide clinical benefits for BRPC-A patients; however, the establishment of the most appropriate neoadjuvant treatment is needed by further studies. To evaluate appro priate neoadjuvant treatment, two prospective pilot trials were conducted as follows; modified FOLFIRINOX (without bolus 5-FU and LV, also decreased the dose of irinotecan; FIRINOX) and nab-paclitaxel plus gemcitabine therapy. Modified FOLFIRINOX was given to the first five patients in the 4-cycle group of the regimen and next five patients in the 8-cycle group. The primary end point was the toxicity of the therapy and one of the secondary end points were the optimal duration. The overall rate of grade 3 and 4 events was 80 %: 3 patients (60%) in the four-cycle group and five patients (100%) in the eight-cycle group had grade 3 or 4 adverse events. There was no incidence of seri ous adverse effect such as febrile neutropenia, sepsis, liver abscess or uncontrollable diarrhea. There was no clinically relevant morbidity presented in patients who underwent surgery. R0 rates by intention to treat were 60.0% in the four-cycle group and 40 % in the eight-cycle group (P = 0.999). The histopathologic treatment effect based on the Evans grade revealed grade I (n = 1), IIa (n = 3) in the four-cycle group and grade I (n = 2), IIa (n = 1) in the eight-cy cle group. Nab-paclitaxel plus gemcitabine therapy: the primary endpoint was the toxicity, and secondary endpoints were the resection rate, the R0 resection rate. The overall rate of any grade and grade 3-4 events were 100% and 90%. The majority of these adverse events represented expected neutropenia. The resection and R0 resection rates were 80% and 70%, respectively. Conclusion: FIRINOX therapy was feasible and safe for strictly selected patients with BRPC. On the other hand, nab-pa clitaxel plus gemcitabine therapy was safe and feasible without strict selection of patients with BRPC. A multicenter phase II study is in progress to investigate the efficacy of neoadjuvant nab-paclitaxel plus gemcitabine therapy on overall survival (UMIN000024154).
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