記述言語：英語   掲載種別：研究論文（学術雑誌）  

Regulatory T cells (Tregs) play an important role in creating an immunosuppressive microenvironment in cancer tissues. However, the mechanisms by which Tregs are activated and suppress cancer immunity remain unclear. To elucidate these mechanisms, we performed a T cell receptor (TCR) repertoire analysis of Tregs and conventional T cells in peripheral blood, draining lymph nodes (DLNs), and cancer tissues of patients with head and neck squamous cell cancer (HNSCC). We found that the TCR repertoire was skewed in cancer tissue and metastatic DLNs (M-DLNs) compared with non-metastatic DLNs, and TCR repertoire similarities in Tregs and CD8+ T cells between M-DLNs and cancer tissue were high compared with those at other sites. These results suggest that Tregs and CD8+ T cells are activated in M-DLNs and cancer tissues by cancer antigens, such as neoantigens, and shared antigens and Tregs suppress CD8+ T cell function in a cancer antigen-specific manner in M-DLNs and cancer tissue. Moreover, M-DLNs might be a source of Tregs and CD8+ T cells recruited into the cancer tissue. Therefore, targeting Tregs in M-DLNs in an antigen-specific manner is expected to be a novel immunotherapeutic strategy for HNSCCs.

DOI： 10.1111/pin.13430

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J04195&link_issn=&doc_id=20240523380005&doc_link_id=1390863097401548544&url=https%3A%2F%2Fcir.nii.ac.jp%2Fcrid%2F1390863097401548544&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_2.gif

記述言語：日本語   出版者・発行元：耳鼻と臨床会  

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記述言語：英語  

OBJECTIVES/HYPOTHESIS: Some people who practice singing on a daily basis may be able to produce a voice higher than the upper limit of the normal range (extra high voice), but there is much regarding the movement of the larynx that remains unknown. We have been conducting dynamic analysis of the larynx using multi-row detection computed tomography (MD-CT) at our university and report herein an analysis of the extra high voice. STUDY DESIGN: Observational. METHODS: Images of a normal male participant capable of extremely high-frequency speech (the highest speech range is C7 [2093 Hz] and the singing application range is up to B5 [988 Hz]) during speech were captured by MD-CT. The acquisition time was 2 seconds, and the rise of the voice from low to high and then to very high tones was recorded. Ten frames per second were analyzed as three-dimensional images. RESULTS: In the fundamental frequency range from A3 to D5 (220-587 Hz), laryngeal elevation movements were observed as the voice rose in pitch. However, posterior upward displacement of the laryngeal cartilage was observed as the frequency range increased from E5 to B5 (659-988 Hz). CONCLUSIONS: In the E5-B5 range, laryngeal movements were different from those observed in the previous range. MD-CT analysis is useful in the study of this range because it allows visualization of laryngeal movements that are unclear using endoscopy or external examination.

DOI： 10.1016/j.jvoice.2023.07.025

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

In the treatment of head and neck cancer, cisplatin is often used as a therapeutic agent; however, its efficacy is limited and it can cause renal dysfunction as an adverse effect. For this reason, the use of cisplatin is limited in elderly patients with reduced renal function. Recently, artemisinin, which was developed as an antimalarial drug, was found to have antitumor effects and is effective in combination with other anticancer drugs. In the present study, the antitumor effects of artemisinin and its derivatives as well as their combination with cisplatin and iron on head and neck squamous cell carcinoma cell lines, were investigated. Cell viability was determined by a cell viability assay, the cell cycle was analyzed by flow cytometry, cell death was assessed with annexin V and propidium iodide staining, and western blotting was used to analyze retinoblastoma protein (Rb), phosphorylated (p‑)Rb, and other cell cycle‑associated molecules. A total of four artemisinin compounds were examined and it was found that artesunate and dihydroartemisinin had a significant inhibitory effect on growth. It was also identified that the combination of artesunate, cisplatin, and iron inhibited cell proliferation and caused S/G2‑M cell cycle arrest. In addition, western blotting of Rb, a molecule involved in the cell cycle, showed that artesunate induced the loss of not only Rb but also p‑Rb. These results suggested that artesunate is a useful drug in combination with cisplatin.

DOI： 10.3892/or.2023.8591

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Neck dissection for cervical lymph node metastasis is an established procedure for head and neck cancer (HNC). However, with the advent of immunotherapy, head and neck surgical oncologists need to rethink removing all lymph nodes, including those with immune function. We investigated the anti-cancer immune response of the cervical lymph nodes in four patients with human papillomavirus type 16 (HPV16)-positive head and neck squamous cell carcinoma. Using lymphocytes extracted from local, metastatic, and non-metastatic lymph nodes and peripheral blood from these patients, we performed an intracellular flow cytometric cytokine assay using anti-IFNγ and anti-TNF-α monoclonal antibodies to detect HPV16 E6- and E7-specific T cells. HPV status and p16 immunostaining were determined by in situ detection using the HPV RNAscope method and immunohistochemistry. In one case, E6-specific and E7-specific CD8+ T cells were detected in proximal metastatic nodes and distal non-metastatic nodes. This finding suggests that non-metastatic nodes should be preserved for their immune function during neck dissection and that the immune function of non-metastatic lymph nodes is important when administering immunotherapy. In this context, head and neck surgical oncologists treating HNC should consider the place of immunotherapy and neck dissection in the treatment of HNC.

DOI： 10.3390/jpm13071174

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Radical temporal bone resection (TBR) for lateral skull base malignancies is technically challenging because of the vital anatomical structures located at the medial part of the temporal bone and their limited exposure. A possible solution is to adopt an additional endoscopic approach for medial osteotomy to reduce blind spots. The authors aimed to describe a combined exoscopic and endoscopic approach (CEEA) for cranial dissection in radical TBR and to determine the usefulness of the endoscopic approach to the medial aspect of the temporal bone. Having utilized the CEEA in for cranial dissection in radical TBR since 2021, the authors included 5 consecutive patients who underwent the procedure between 2021 and 2022. All surgeries were successful and resulted in no significant complications. The additional use of an endoscope improved visualization of the middle ear in 4 patients and that of the inner ear and carotid canal in 1 patient, enabling precise and safe cranial dissection. Furthermore, surgeons experienced reduced intraoperative postural stress with CEEA than with a microscopic approach. The main advantage of CEEA in radical TBR was the extension of the viewing angles of the endoscope, which allowed observation of the medial aspect of the temporal bone and limited tumor exposure and injury to vital structures. Given the other benefits of exoscopes and endoscopes, including compact size, ergonomics, and surgical field accessibility, CEEA proved to be an efficient treatment option for cranial dissection in radical TBR.

DOI： 10.1097/SCS.0000000000009522

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：英語   出版者・発行元：(一社)日本内分泌学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

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記述言語：英語  

In 15-20% of cases, Graves' disease (GD) shifts to Hashimoto's thyroiditis (HT), while the shift from HT to GD is rare. We present a case of a patient in whom HT shifted to GD, along with a literature review. A 50-year-old woman with myxedema was diagnosed with Hashimoto's disease due to hypothyroidism and the presence of antibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb); she also had thyroid stimulating antibodies (TSAb) without any signs of GD. Although thyroid hormone replacement therapy improved her thyroid function, 2 months later, hyperthyroidism appeared and did not improve after discontinuation of the replacement therapy. The patient was diagnosed with GD, which improved with antithyroid agent administration. To date, only 50 cases regarding conversion from HT to GD have been reported. The median age is 44 years (range, 23-82 years), and the median time of conversion is 7 years (range, 0.1-27 years). The male-to-female ratio of HT conversion to GD is 1:9, closer to that of regular GD (1:10) than that of general HT (1:18). All patients received thyroid hormone replacement therapy for hypothyroidism due to HT. Continuous evaluation of TSAb levels is recommended in HT, particularly in cases of TSAb-positive and those under replacement, since it may help predict conversion to GD. Evaluating the clinical characteristics of patients with HT preceding GD is crucial to ensure appropriate treatment and reduce the risk of adverse events.

DOI： 10.3390/medicina59040757

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：英語  

Primary and metastatic malignancies arising in the sinuses are rare and histologically diverse. The role of fine-needle aspiration cytology (FNAC) and the cytomorphologic characteristics of these tumors have not been specifically addressed. We described two cases of suspected malignant maxillary sinus tumors in 85- and 90-year-old patients with comorbid conditions, both of whom underwent tissue biopsies that failed to yield a definitive diagnosis. We performed FNAC after imaging confirmed that the malignant tumors were outside the maxillary sinus. The 85- and 90-year-old patients were diagnosed with squamous cell carcinoma (SCC) and adenocarcinoma, respectively. In the latter, the cell block method was used to prepare the specimen, rendering individual cells identifiable. Atypia of the histological structure was confirmed without the influence of cell duplication, a known weakness of FNAC. Thus, the diagnosis was made quickly. We believe that FNAC would be utilized more frequently for the definitive diagnosis of sinonasal tumors as the technique and diagnostic technology improve further.

DOI： 10.7759/cureus.36506

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Patients with advanced/recurrent mucoepidermoid carcinoma (MEC) have a poor prognosis. This study aimed to establish and characterize human mucoepidermoid carcinoma cell lines from the initial surgical specimen and biopsy specimen upon recurrence from the same patient to provide a resource for MEC research. MEC specimens from the initial surgical procedure and biopsy upon recurrence were used to establish cell lines. The established cell lines were cytogenetically characterized using multi-color fluorescence in situ hybridization and detection, and the sequence of the CRTC1-MAML2 chimeric gene was determined. Furthermore, the susceptibility of head and neck mucoepidermoid carcinoma to standard treatment drugs such as cisplatin, 5-fluorouracil, and cetuximab was investigated. We successfully established unique MEC cell lines, AMU-MEC1, from an initial surgical specimen and AMU-MEC1-R1 and AMU-MEC1-R2 from the recurrent biopsy specimen in the same patient. These cell lines exhibited epithelial morphology and developed in vitro-like cobblestones. They shared eight chromosomal abnormalities, including der(19)ins(19;11)(p13;?), which resulted in a chimeric CRTC1-MAML2 gene, indicating the same origin of the cell lines. The susceptibility of all cell lines to cisplatin and 5-fluorouracil was low. Interestingly, EGFR dependency for cell growth decreased in AMU-MEC-R1 and AMU-MEC-R2 but was retained in AMU-MEC1. These cytogenetic and biochemical findings suggest that the established cell lines can be used to investigate the disease progression mechanisms and develop novel therapeutics for MEC.

DOI： 10.3390/ijms24021722

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Regulatory T-cells (Tregs) play a major role in suppressing anti-tumor immune responses. Mogamulizumab, an anti-CC chemokine receptor type 4 (CCR4) monoclonal antibody, depletes effector Tregs (eTregs). However, the clinical efficacy of mogamulizumab was limited in phase Ia/Ib studies for solid tumors (NCT01929486); the finding suggests that mogamulizumab may also deplete beneficial CCR4+CD8+ T-cells in patients. Therefore, we focused on CTLs and aimed to identify a way to protect CCR4+ CTLs. Here, we evaluated the association of CCR4 expression in cytotoxic T-lymphocytes (CTLs) with antigen and cytokine stimulations and kinase inhibition using cytomegalovirus antigen instead of tumor antigen. CCR4 expression in CTLs was induced by antigen stimulation (mean 3.14-29.0%), enhanced by transforming growth factor-β1 (TGF-β1) (mean 29.0-51.2%), and downregulated by trametinib with (mean 51.2-11.4%) or without TGF-β1 treatment (mean 29.0-6.98%). Phosphorylation of ERK in CD8+ T-cells was suppressed by trametinib. Regarding the effect on immunological function of CTL, trametinib reduced cytokine production but not affected cytotoxicity. Importantly, trametinib alleviated CTL reduction by anti-CCR4 antibody without affecting eTreg depletion because CCR4 expression in eTregs was not downregulated. In conclusion, combination therapy with trametinib may improve the clinical efficacy of mogamulizumab.

DOI： 10.1038/s41598-022-22773-1

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記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー感染症学会  

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J07545&link_issn=&doc_id=20230116470012&doc_link_id=%2Ffm9areka%2F2022%2F000204%2F012%2F0191-0196%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffm9areka%2F2022%2F000204%2F012%2F0191-0196%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語  

For decades, no clear consensus existed on the standard treatment option for malignant tumors of the external auditory canal, an extremely rare disease. Here we report the case of a 55-year-old female patient with secretory carcinoma that originated from the left external auditory canal. Magnetic resonance imaging (MRI) at baseline showed that the tumor had extended to the medulla oblongata despite surgical and radiation treatments for more than 20 years from the initial diagnosis. Based on the results of a next-generation sequencing test of a formalin-fixed paraffin-embedded surgical specimen indicating that the tumor harbored ETV6-NTRK3 fusion, the patient was enrolled in a global basket study of larotrectinib, an oral selective tropomyosin receptor kinase (TRK) inhibitor. Three weeks after the start of larotrectinib treatment, MRI showed only small remnants of the tumor in the medulla oblongata and the patient's headache before the treatment had disappeared. Subsequent MRI after 12 weeks of treatment confirmed the complete disappearance of the tumor. The patient repeated grade 2 flu-like symptoms related to treatment, but did not experience any other grade 2 or worse treatment-related adverse events. TRK inhibitors, such as larotrectinib, exert potent antitumor activity against neurotrophic tyrosine receptor kinase (NTRK) fusion-positive tumors in a tumor-agnostic manner. To the best of our knowledge, this is the first report on NTRK fusion-positive secretory carcinoma of the external auditory canal, and this report provides a valuable insight into the management of the extremely rare but now treatable malignancy.

DOI： 10.1007/s13691-022-00559-6

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記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND/AIM: The immunotherapy approach using anti-programmed cell death 1 (PD-1) antibody has been demonstrated in oral cancer treatment. However, serious immune-related adverse events (irAE) have been reported. If local administration of small doses of anti-PD-1 antibody via intraarterial chemoradiotherapy could have the same antitumor effect of systemic administration, this can reduce irAE and medical expenses. In this study, we investigate the antitumor effects of local and systemic administration of a small amount of anti-PD-1 antibody, the overall survival (OS), and the immune environment around cancer. MATERIALS AND METHODS: A mouse buccal mucosal oral squamous cell carcinoma cell line (Sq-1979) was used, and anti-mouse PD-1 was used as the drug. The cell line was transplanted to mouse, and the drug was locally (30 mg/body) and systemically (300 mg/body) administered in a dose. The tumor shrinkage rate and antitumor effect were examined 21 and 29 days after the start of administration. The OS was also compared in each of the groups. Furthermore, the subcutaneous growth of the tumors was inhibited, and the expressions of PD-L1, CD8T cells, perforin, and granzyme B were examined. RESULTS: We found that the local low-dose and systemic groups had the same antitumor effect, OS also showed a significant prolongation. In addition, indicated that the expression of granzyme B was higher in the local low-dose group. CONCLUSION: Local low-dose administration of anti-PD-1 antibody showed the same antitumor effect and OS as systemic normal-dose administration. Therefore, local low-dose administration in oral cancer can be useful.

DOI： 10.21873/anticanres.15929

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: To compare the decompressive effect around the optic nerve canal among 3 different decompression procedures (medial, balanced, and inferomedial) using 3D printed models. METHODS: In this experimental study, based on data obtained from 9 patients (18 sides) with dysthyroid optic neuropathy, a preoperative control model and 3 plaster decompression models were created using a 3D printer (total, 72 sides of 36 models). A pressure sensor was placed at the optic foramen, and the orbital space was filled with silicone. The surface of the silicone was pushed down directly, and changes in pressure were recorded at 2-mm increments of pushing. RESULTS: At 10 mm of pushing, there was significantly lower pressure in the medial (19,782.2 ± 4319.9 Pa, P = 0.001), balanced (19,448.3 ± 3767.4 Pa, P = 0.003), and inferomedial (15,855.8 ± 4000.7 Pa, P < 0.001) decompression models than in the control model (25,217.8 ± 6087.5 Pa). Overall, the statistical results for each 2-mm push were similar among the models up to 10 mm of pushing (P < 0.050). At each push, inferomedial decompression caused the greatest reduction in pressure (P < 0.050), whereas there was no significant difference in pressure between the medial and balanced decompression models (P > 0.050). CONCLUSION: All 3 commonly performed decompression procedures significantly reduced retrobulbar pressure. Because inferomedial decompression models obtained the greatest reduction in pressure on the optic nerve canal, inferomedial decompression should be considered the most reliable procedure for rescuing vision in dysthyroid optic neuropathy.

DOI： 10.1007/s00417-022-05645-2

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The expression of programmed death ligand-1 (PD-L1) is controlled by complex mechanisms. The elucidation of the molecular mechanisms of PD-L1 expression is important for the exploration of new insights into PD-1 blockade therapy. Detailed mechanisms of the in situ expression of PD-L1 in tissues of oral squamous cell carcinomas (OSCCs) have not yet been clarified. We examined the mechanisms of PD-L1 expression focusing on the phosphorylation of downstream molecules of epidermal growth factor (EGF) and interferon gamma (IFN-γ) signaling in vitro and in vivo by immunoblotting and multi-fluorescence immunohistochemistry (MF-IHC), respectively. The in vitro experiments demonstrated that PD-L1 expression in OSCC cell lines is upregulated by EGF via the EGF receptor (EGFR)/PI3K/AKT pathway, the EGFR/STAT1 pathway, and the EGFR/MEK/ERK pathway, and by IFN-γ via the JAK2/STAT1 pathway. MF-IHC demonstrated that STAT1 and EGFR phosphorylation was frequently shown in PD-L1-positive cases and STAT1 phosphorylation was correlated with lymphocyte infiltration and EGFR phosphorylation. Moreover, the phosphorylation pattern of the related molecules in PD-L1-positive cells differed among the cases investigated. These findings indicate that PD-L1 expression mechanisms differ depending on the tissue environment and suggest that the examination of the tissue environment and molecular alterations of cancer cells affecting PD-L1 expression make it necessary for each patient to choose the appropriate combination drugs for PD-1 blockade cancer treatment.

DOI： 10.3390/ijms23084077

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This article aims to describe the two cases in which chemotherapy and chemoradiotherapy were effective for advanced HPV-related lacrimal sac squamous cell carcinoma and avoided the need for radical surgery. This was an interventional study of two patients with advanced lacrimal sac squamous cell carcinoma. Two patients with advanced lacrimal sac squamous cell carcinoma were treated at our University Hospital between January 2020 and February 2021. Diagnosis of HPV-related lacrimal sac carcinoma was done by p16 immunostaining and RNA in situ hybridization. Received neoadjuvant chemotherapy and chemoradiotherapy, also minimally invasive surgery to remove any residual tumor if the final response, were unfavorable. HPV-related carcinoma was decided by checking p16 and RNA status. Response was assessed by computed tomography, magnetic resonance imaging, positron emission tomography-computed tomography, and endoscopic images. Both patients had positive p16 staining also HPV RNA in situ hybridization. Received definitive chemoradiotherapy instead of radical surgery after showing a partial response to neoadjuvant chemotherapy. A complete response was achieved in one patient and the other had a partial response, leaving a small residual tumor in the nose that was successfully removed by endonasal endoscopic surgery. Cure was achieved in two patients with HPV-related lacrimal sac squamous cell carcinoma by neoadjuvant chemotherapy followed by definitive chemoradiotherapy, with only one requiring minimally invasive surgery. This is a new direction in the treatment of p16-positive lacrimal sac carcinoma, especially for advanced cases, whereby molecular biological indicators can be used to avoid highly invasive surgery and preserve quality of life without compromising prognosis.

DOI： 10.1080/08820538.2021.1963458

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We determined the feasibility of the combined exoscopic-endoscopic technique (CEE) as an alternative to the microscope in craniofacial resection (CFR). This retrospective study was conducted at a single institution and included eight consecutive patients with head and neck tumors who underwent CFR between September 2019 and July 2021. During the transcranial approach, microsurgery was performed using an exoscope in the same manner as in traditional microscopic surgery, and an endoscope was used at the blind spot of the exoscope. The exoscope provided images of sufficient quality to perform microsurgery, while the sphenoid sinus lumen was the blind spot of the exoscope during anterior (n = 3) and anterolateral CFR (n = 2), and the medial aspect of the temporal bone was the blind spot of the exoscope during temporal bone resection (n = 2). These blind spots were visualized by the endoscope to facilitate accurate transection of the skull base. The advantages of the exoscope and endoscope include compact size, ergonomics, surgical field accessibility, and equal visual experience for neurosurgeons and head and neck surgeons, which enabled simultaneous transcranial and transfacial surgical procedures. All the surgeries were successful without any relevant complications. CEE is effective in transcranial skull base surgery, especially CFR involving simultaneous surgical procedures.

DOI： 10.3390/curroncol28050336

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

DOI： 10.1111/cas.15081

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1111/cas.15081

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objective  Craniofacial resection (CFR) and temporal bone resection (TBR) on malignant head and neck tumors (MHNTs) invading skull base require accurate and precise determination of the tumor invasion. We investigated tumor skull base invasion patterns and surgical results in CFR and TBR cases. Methods  We performed either CFR or TBR for 75 selected patients with the possibility of en bloc resection over the period between 2011 and 2018. The medical charts of the selected patients were reviewed. Results  Primary tumor onset site (TOS) groups were: (1) nasal cavity/ethmoid sinus, 20 cases; (2) orbit, 10 cases; (3) maxillary sinus, 28 cases; and (4) external ear/temporomandibular joint, 17 cases. Grades for tumor invasion depth (TID) included: (I) extracranial invasion and skull base bone invasion; (II) extradural invasion; or (III) intradural invasion. Patients in groups 1 and 2 had a significantly higher frequency of grade II and III invasions than patients in groups 3 and 4. The main invasion site was nasal cavity superior wall and ethmoid sinus superior wall for group 1 tumors, orbit superior wall, and lateral skull base sphenoid bone for group 2 and 3 tumors, and lateral skull base temporal bone for group 4 tumors. Positive resection margins represented a significant negative prognostic factor. TID and TOS did not affect skull base margin status. Conclusion  Skull base invasion of MHNTs exhibits certain fixed patterns in sites susceptible to invasion based on the TOS. The frequencies of extradural and intradural invasions differed, indicating the importance for accurate preoperative tumor evaluation.

DOI： 10.1055/s-0039-3402034

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Cholesteatoma is a clinically heterogeneous disease, with some patients showing spontaneous regression, while others experiencing an aggressive, lethal disease. Cholesteatoma in children can be divided into two types: congenital and acquired. Identifying good prognostic markers is needed to help select patients who will require immediate surgical intervention. Matrix metalloproteinase-2 (MMP2) was previously reported to play an important role in cholesteatoma progression, by promoting bone destruction and keratinocyte infiltration. Herein, we analyzed MMP2 mRNA expression level in cholesteatoma using RNA-in situ hybridization in formalin-fixed, paraffin-embedded (FFPE) tissue samples. METHODS: Sixty patients with cholesteatoma under 15 years old, who underwent their primary surgery at Aichi Medical University's Otolaryngology Department, were analyzed for MMP2 expression level, using RNA-in situ hybridization. RESULTS: There were no significant differences in MMP2 mRNA expression level between congenital cholesteatoma and acquired cholesteatomas. In congenital cholesteatoma, higher MMP2 signals were observed in the open type than in the closed type (p < 0.001). In acquired cholesteatoma, higher MMP2 signals were observed in the pars tensa than in the pars flaccida (p < 0.001). MMP2 mRNA expression level was almost exclusively found in the fibroblasts or in the inflammatory cells in the stroma, but not in the epithelium. CONCLUSION: Our study reveals that MMP2 mRNA expression level is strongly associated with the subtypes of cholesteatoma. The findings suggest that the level of expression of MMP2 mRNA may be related to the pathogenesis and aggressive features of cholesteatoma.

DOI： 10.1155/2021/6644897

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Society of Practical Otolaryngology  

DOI： 10.5631/jibirin.114.581

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Head and neck surgery sometimes causes small defects, and salvage surgery after chemoradiotherapy poses some risk because of damage to the surgical site from the previous treatment. We have developed a novel thyroid gland flap for head and neck surgical reconstruction and here we describe elevating the flap, including arc rotation, size, and suture technique, and our outcomes to date. Methods: Thyroid gland flap reconstruction was performed in 13 cases (11 patients) between July 2009 and May 2020. The clinical importance and adverse effects of the procedure were examined. Thyroid function and blood flow of the flap were assessed, and the status of the flap and irradiated recipient tissue was examined histopathologically. Results: Median age at surgery was 64.6 years (range 49-77 years). Two of the patients underwent reconstruction with a thyroid gland flap twice. There were 4 cases of primary head and neck cancer resection with neck dissection in which the flap was harvested from the thyroid gland as reinforcement. In 1 case, surgery was performed for cervical esophageal diverticulum. In all cases, the arc was limited to 6 cm and suturing was basic. There were no complications of the surgical procedure, and the postoperative course was uneventful. Contrast-enhanced computed tomography revealed adequate enhancement of the flap. Postoperative thyroid function was normal. The thyroid gland flap was firmly adapted and fused with the irradiated recipient tissue. Conclusion: The thyroid gland flap could be an effective tissue flap fed by the superior thyroid arteriovenous pedicle for head and neck reconstruction.

DOI： 10.1097/GOX.0000000000003297

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: A Killian-Jamieson diverticulum is a rare pharyngoesophageal diverticulum that is radically treated by diverticulectomy. However, there is no consensus on whether cricopharyngeal myotomy is necessary, and the optimal surgical methods that prevent postoperative complications such as leakage are undetermined. CASE PRESENTATION: A 49-year-old man was referred to our hospital with oropharyngeal dysphagia while eating. The patient was preoperatively diagnosed with a Killian-Jamieson diverticulum based on radiographic and clinical findings and underwent a transcervical diverticulectomy. The recurrent laryngeal nerves were preserved using an intraoperative nerve monitoring system, and the diverticulum was identified without difficulty. A partial cricopharyngeal myotomy was performed to expose the base of the diverticulum. The diverticulum was transected transversally using a linear stapler under the guidance of intraoperative upper intestinal endoscopy. A thyroid gland flap supplied by the superior thyroid artery was harvested and placed overlapping the area of the partial cricopharyngeal myotomy. Due to the proximity of the recurrent laryngeal nerve course to the diverticulum stump, the staple line was not buried with sutures. The thyroid gland flap with its rich vascular supply was fixed to completely cover the staple line on the cut surface of the thyroid gland. The postoperative course was uneventful, without vocal cord paralysis. The patient was discharged on postoperative day 8. He developed no clinical signs suggesting leakage, recurrence, or adverse events. CONCLUSION: Killian-Jamieson diverticulectomy using a thyroid gland flap and partial cricopharyngeal myotomy is a valid treatment option that may prevent complications and recurrence. Precise evaluation of the diverticulum using an intraoperative nerve monitoring system is crucial for the repair.

DOI： 10.1186/s40792-020-01060-z

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：英語  

Human papillomavirus (HPV)-related, p16-positive oropharyngeal carcinoma is considered to be sensitive to anticancer drugs, and the standard treatment is therefore chemoradiotherapy, rather than surgery, especially for aggressive disease. However, with this higher sensitivity, chemotherapy alone may achieve a pathological complete response (CR), making radiation therapy unnecessary. A 46-year-old man with p16-positive squamous cell carcinoma (SCC) of the lateral oropharynx (palatine tonsil) underwent neoadjuvant chemotherapy. This achieved clinically significant tumor shrinkage and therefore surgery was performed for subsequent definitive treatment. Clinical and CT findings indicated a good effect of neoadjuvant chemotherapy on the tumor. A biopsy prior to chemotherapy revealed SCC, which demonstrated p16 immunoreactivity and positive signals for high-risk HPV by RNA in situ hybridization. The post-chemotherapy surgical specimen showed pathological CR and no p16 positive cells nor positive signals for high-risk HPV those were detected in the pre-chemotherapy specimen. There are some reports of chemotherapy alone achieving pathological CR in cases of p16-positive oropharyngeal carcinoma, but none have included high-risk HPV RNA findings. This is the first report of the disappearance of cancer cells as well as p16 staining and a positive signal for high-risk HPV. Achieving pathological CR confirmed by immunohistochemistry and high-risk HPV RNA in situ hybridization in a solid tumor with chemotherapy alone suggests that chemotherapy may have both an antitumor effect and an antiviral effect. Forgoing subsequent radiotherapy and undergoing surgery might be unnecessary and follow-up instead might be sufficient in such cases. Into the future, in an optimal tailored treatment approach, the option of neoadjuvant chemotherapy should be considered for management of p16-positive oropharyngeal carcinoma. Other options such as tumor immunotherapy are also expected to be effective.

DOI： 10.3390/microorganisms8101497

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Cisplatin is an important drug for the treatment of head and neck squamous cell carcinoma (HNSCC). Determining chemoresistant factors prior to treatment will lead to great benefits for clinicians and patients. Here, we evaluated chemoresistant factors by integrating proteomic and transcriptomic data using HNSCC cell lines to identify a more precise chemoresistant factor in HNSCC. We used four HNSCC cell lines: cisplatin-sensitive, acquired cisplatin resistance, naturally cisplatin-resistant, and acquired 5-FU resistance. Proteomic analysis was performed using iTRAQ, tandem mass spectrometry, and liquid chromatography-electrospray ionization-tandem mass spectrometry. Transcriptomic analysis was performed using microarrays. By integrating these independent data, common factors were addressed and functional analysis was performed using small interfering RNAs (siRNAs) to change the chemosensitivity. Using iTRAQ analysis, 7 proteins were identified as specific for cisplatin chemoresistance factors. Transcriptomic analysis revealed hundreds of potential candidate factors. By combining and integrating these data, S100A2 was identified as a potential cisplatin-specific chemoresistance factor. Functional analysis with siRNA revealed that the expression of S100A2 was reduced and cisplatin sensitivity recovered in the acquired and naturally cisplatin-resistant cell lines, but not in the cisplatin-sensitive cell lines. S100A2 was identified as a cisplatin-specific chemoresistance factor by integrating the transcriptomic and proteomic results obtained using HNSCC cell lines. This is a novel technique that allows for a precise identification, also known as a comprehensive analysis. Our findings indicate that these proteins could be used as biomarkers of HNSCC treatments, providing physicians with new treatment strategies for patients with HNSCC, showing chemoresistance.

DOI： 10.18999/nagjms.82.3.519

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記述言語：英語  

Wound infection is a major complication after supracricoid partial laryngectomy with cricohyoidoepiglottopexy (CHEP) for radiation therapy failure. A 60-year-old man received chemoradiotherapy for a glottic carcinoma. CHEP, reusing the thyroid gland flap (TF), was performed because the cancer recurred after a salvage vertical partial laryngectomy following radiation therapy failure. The TF was sutured to the supraglottis and cricoid cartilage mucosa to minimize mucosal defects before the hyoid bone and cricoid cartilage were sutured. Wound healing after CHEP was good without infection. After decannulation, oral food intake was possible without aspiration, and speech function was comparable to that of other patients who had supracricoid partial laryngectomies. Histopathological examination revealed a close connection between the TF and its surrounding tissues without fibrous scarring. TF may improve wound healing after CHEP for radiation failure by minimizing mucosal defects.

DOI： 10.1016/j.anl.2019.06.009

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記述言語：英語  

This case report describes resection without facial incision for aggressive Kadish stage C olfactory neuroblastoma (ONB). We performed resection via transcaruncular approach with combined endonasal and skull base surgery. This multidisciplinary team surgical approach is expected to lead to a new strategy for this type of tumor in the future.

DOI： 10.1002/ccr3.2906

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Summary: Dupilumab an inhibitor of the interleukin (IL)-4R-alpha subunit is used for the treatment of allergic diseases. The patient was a 49-year-old man who received dupilumab for the treatment of severe atopic dermatitis. He presented hyperthyroidism with elevated thyroglobulin and anti-thyroid antibody negativity at 4 months after the initiation of therapy. On scintigraphy, the thyroid radioiodine uptake was low. Ultrasonography showed a diffuse hypoechoic area in the thyroid gland. A pathological study revealed lymphocytic infiltration. The administration of dupilumab was continued because of his atopic dermatitis that showed an excellent response. The patient`s hyperthyroidism changed to hypothyroidism 3 weeks later. Six months later his thyroid function normalized without any treatment. We herein describe the case of a patient with atopic dermatitis who developed painless thyroiditis under treatment with dupilumab. To the best of our knowledge, this is the first report of this event in the literature. Learning points: Dupilumab, a fully human monoclonal antibody that blocks interleukin-4 and interleukin-13, has been shown to be effective in the treatment atopic dermatitis and asthma with eosinophilia. Painless thyroiditis is characterized by transient hyperthyroidism and hypothyroidism and recovery without anti-thyroid treatment. This is the first report of painless thyroiditis as an adverse effect of dupilumab, although conjunctivitis and nasopharyngitis are the main adverse effects of dupilumab.

DOI： 10.1530/EDM-20-0030

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: The availability of an audiological evaluation for the differential diagnosis of clinical otosclerosis (OS) was examined. METHODS: Included were 98 patients (107 ears) with OS and 19 patients (20 ears) with incudostapedial disconnection (ISD) diagnosed by surgery between 2009 and 2017 at Aichi University Hospital. Results of preoperative pure-tone audiometry and impedance audiometry were analyzed. The most reliable index for distinguishing the two diseases was evaluated, and the cut-off value, sensitivity, and specificity were calculated. RESULTS: In the univariate analysis, age, static compliance, reversed ipsilateral acoustic reflex (reversed IAR) at 0.5 kHz and 2 kHz, negative contralateral acoustic reflex (negative CAR), difference between the air-bone gap at 0.25 and 2 kHz (0.25-2 kHzABG) and that at 0.25 and 4 kHz (0.25-4 kHzABG) showed statistical significance between the two diseases, whereas the Carhart notch did not. Multivariate logistic regression analysis by the variable selection method showed that reversed IAR (0.5 kHz), negative CAR, and 0.25-4 kHzABG were statistically significantly better factors for the differential diagnosis of the two diseases. The receiver operating characteristic curve for diagnosing OS using the difference between air-bone gap at 0.25 kHz and 4 kHz showed moderate accuracy. If the cut-off value of 0.25-4 kHzABG was 10 dB, then the sensitivity and specificity were 81.1% and 55.0%, respectively. In other words, if the cut-off value of 0.25-4 kHzABG was less than 10 dB, then the possibility of diagnosing ISD becomes higher, and if greater than 10 dB, then the possibility of diagnosing OS becomes higher. CONCLUSION: The differences in the air-bone gap at low and high frequency in pure-tone audiometry, static compliance, and acoustic reflex in impedance audiometry are useful for distinguishing OS from ISD. However, combinations of several examinations including computed tomography imaging are needed for the differential diagnosis of other ear diseases and specific preoperative planning.

DOI： 10.1016/j.anl.2020.03.009

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Immune-checkpoint inhibitors improve the survival of head and neck squamous cell carcinoma (HNSCC) patients. Although recent studies have demonstrated that the tumor immune microenvironment (TIME) has critical roles in immunotherapy, the precise mechanisms involved are unclear. Therefore, further investigations of TIME are required for the improvement of immunotherapy. The frequency of effector regulatory T-cells (eTregs) and the expression of immune-checkpoint molecules (ICM) on eTregs and conventional T-cells (Tconvs) both in peripheral blood lymphocytes (PBL) and tumor-infiltrating lymphocytes (TIL) from HNSCC patients were analyzed by flow cytometry and their distributions were evaluated by multi-color immunofluorescence microscopy. High frequency eTreg infiltration into HNSCC tissues was observed and high expressions of CD25, FOXP3, stimulatory-ICM (4-1BB, ICOS, OX40 and GITR) and inhibitory-ICM (programmed cell death-1 [PD-1] and cytotoxic T-lymphocyte-associated protein-4 [CTLA-4]) were found on invasive eTregs. In contrast, the expression of stimulatory-ICM on Tconvs was low and the expression of inhibitory-ICM was high. In addition, ICM-ligands (programmed cell death-1 [PD-L1], galectin-9 and CEACAM-1) were frequently expressed on cancer cells. PD-L1 and galectin-9 were also expressed on macrophages. PD-1+ T-cells interacted with PD-L1+ cancer cells or PD-L1+ macrophages. This suggested that in TIL, eTregs are highly activated, but Tconvs are exhausted or inactivated by eTregs and immune-checkpoint systems, and ICM and eTregs are strongly involved in the creation of an immunosuppressive environment in HNSCC tissues. These suggested eTreg targeting drugs are expected to be a combination partner with immune-checkpoint inhibitors that will improve immunotherapy of HNSCC.

DOI： 10.1111/cas.14422

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: Descending necrotizing mediastinitis (DNM) resulting from oropharyngeal and cervical abscess is a life-threatening condition. This study attempted to improve our recognition of the extension and distribution of the abscess for ideal thoracic drainage. Methods: We performed a retrospective clinical analysis of seven patients who underwent thoracic drainage for DNM with available clinical data. For mapping and classification of the distribution of the abscess, computed tomography and intraoperative findings were utilized. Results: To cure patients, cervical drainage and thoracic drainage were performed 14 and 11 times, respectively. The operation time for thoracic drainage and intraoperative blood loss were 141±77 min and 103±103 g, respectively. The mean hospital stay was 66±41 days. All patients are alive without recurrence. We divided the abscess distribution into nine categories including the anterior thoracic wall, according to the computed tomography and intraoperative findings. The rate of abscess descended gradually toward the lower mediastinum. Abscesses were not necessarily continuous, and skipped lesions were occasionally noted. Conclusions: We were able to cure all seven patients with DNM. It might be helpful to recognize the exact distribution of the abscess and distribution-specific drainage using a new map and classification of thoracic abscess.

DOI： 10.21037/jtd.2020.03.82

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To compare postoperative changes in visual acuity between the transnasal endoscopic approach and the transcaruncular approach when comparison of preoperative values used for medial orbital wall decompression in patients with dysthyroid optic neuropathy. METHODS: We included 14 patients (23 sides) and divided them into a transnasal group (11 sides, 8 patients) and a transcaruncular group (12 sides, 6 patients). Visual acuity was examined preoperatively, on postoperative days 1, 3, and 7, and at a final follow-up visit. The differences in postoperative improvement of the logarithm of the minimum angle of resolution (logMAR) visual acuity and critical flicker frequency (CFF) between the two surgical groups at each time point were analyzed using the Mann-Whitney U test. RESULTS: Postoperative improvement in logMAR visual acuity on postoperative days 1 and 3 and that in CFF on postoperative day 1 were greater in the endonasal group than in the transcaruncular group (P < 0.050). Vision was improved or maintained in all patients in the transnasal group at the final follow-up. One patient in the transcaruncular group had loss of vision on one side and decreased vision on the other side after surgery. CONCLUSION: Medial orbital decompression appears to provide better postoperative vision when performed by the transnasal approach than by the transcaruncular approach in patients with dysthyroid optic neuropathy.

DOI： 10.1016/j.anl.2019.03.010

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記述言語：英語  

This case report describes larynx-preserving pharyngectomy after chemoradiotherapy using a thyroid gland flap. A thyroid gland flap has good blood supply and reconstruction can be done in the same surgical field. The thyroid gland flap has potential as a novel appropriate flap for use in head and neck surgery.

DOI： 10.1002/ccr3.2477

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記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

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記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

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記述言語：日本語   出版者・発行元：耳鼻と臨床会  

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Fortune Journals  

DOI： 10.26502/acmcr.96550152

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVEAlthough sphenoidotomy is more commonly performed via the transnasal approach than via the transcranial approach, transcranial sphenoidotomy (TCS) remains indispensable for en bloc resection of locally advanced sinonasal malignant tumors (SNMTs) extending to the skull base. TCS also enables transsphenoidal transposition of the temporoparietal galeal flap (TPGF) to compensate for the lack of vascularized reconstructive tissue after endoscopic transnasal skull base surgery. The objective of this study was to review the authors' surgical experience using TCS with an emphasis on the surgical anatomy of the sphenoid sinus and on the purpose of TCS. Relevant anatomy is further illustrated through cadaveric dissection and photo documentation.METHODSThe authors reviewed the records of 50 patients who underwent TCS at the Nagoya University Hospital, Fukushima Medical University Hospital, or Aichi Medical University Hospital over the course of 7 years (between January 2011 and November 2017). The authors also performed cadaveric dissection in 2 adult cadaveric skull base specimens.RESULTSOf the 50 patients included in this study, 44 underwent craniofacial resection (CFR) for en bloc resection of SNMTs involving the anterior and/or lateral skull base, and 6 underwent transsphenoidal transposition of the TPGF flap. The authors categorized the TCS procedures according to the portion of the sphenoid sinus wall involved (i.e., superior, lateral, and superolateral). Superior sphenoidotomy was used in patients requiring anterior CFR. Lateral sphenoidotomy was further divided into 2 subtypes, with type 1 procedures performed for the transsphenoidal transpositioning of the TPGF, and type 2 procedures used in patients requiring lateral CFR. Superolateral sphenoidotomy was used in anterolateral CFR.CONCLUSIONSTCS still represents a useful tool in the armamentarium of neurosurgeons treating central skull base lesions. The newly proposed surgical classification facilitates a profound understanding of TCS and how to incorporate this technique into clinical practice.

DOI： 10.3171/2018.6.JNS181013

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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掲載種別：研究論文（学術雑誌）  

DOI： 10.5631/jibirinsuppl.152.2

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記述言語：英語  

BACKGROUND: Invasive fungal sinusitis is usually associated with poor prognosis, but no clear guidelines have been established for surgical treatment. Here, we report the development and application of the endoscopic orbit-sinus combined approach (EOSCA), a novel surgical technique to approach the nasal cavity and orbit concurrently, in patients with invasive fungal sinusitis with orbital infiltration. MATERIAL AND METHODS: Two patients with invasive fungal sinusitis infiltrating the orbit underwent EOSCA. Transnasal endoscopy was performed for maximum debulking of tissues infiltrated by fungi in the nasal cavity and orbit, before making an incision into the palpebral conjunctiva. An endoscope was then inserted into the orbit through the incision in the palpebral conjunctiva to remove adipose tissue and muscles that had been infiltrated by fungi from the orbital regions where the transnasal approach was difficult or impossible. Another surgeon assisted the procedure by operating an endoscope concurrently via the nasal cavity (four-hands technique). RESULTS: We were able to remove lesions safely and with precision, preserving visual acuity and a functional eyeball in both cases. Currently, the patients are alive, with no postoperative complications, recurrence, or disfigurement. CONCLUSIONS: This novel method shows promise as a safe and reliable surgical procedure for patients with invasive fungal sinusitis infiltrating into the orbit, with no postoperative complications, recurrence, or disfigurement.

DOI： 10.1080/13645706.2017.1305971

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

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記述言語：英語  

BACKGROUND: Cholesterol granuloma of the middle ear is extremely rare in comparison to cholesterol granuloma of the petrous apex but sometimes shows an aggressive course. CASE REPORT: We report herein a case involving a large, aggressive cholesterol granuloma of the middle ear that eroded the middle cranial fossa. A 64-year-old woman presented with pain in the left ear and hearing loss. Cholesterol granuloma was finally diagnosed from diffusion-weighted imaging, and cortical mastoidectomy was performed with canal wall down tympanoplasty type III. Recovery was uneventful recovery and the patient well at the 3-year follow-up. CONCLUSION: This case demonstrates the rare but clinically important pathology of aggressive cholesterol granuloma of the middle ear.

DOI： 10.1155/2017/4793786

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記述言語：英語  

The aim of this study was to investigate the potential polysomnographic predictors of CPAP adherence using polysomnographic parameters at the time of obstructive sleep apnea diagnosis that distinguished between REM and NREM sleep. This was a retrospective cross-sectional study of 173 patients. Patients who used CPAP for more than 4 hours per night for at least 70% of nights over a 6-month period were considered to have good adherence. The poor adherence group included those who had used CPAP for 6 months from initiation, but did not fulfill the definition of good adherence or gave up the treatment within 6 months of treatment initiation. Of the 173 participants, 44 patients had good CPAP adherence and 129 patients had poor adherence. Univariate analysis showed that patients with good adherence had significantly higher apnea-hypopnea index during NREM sleep (p = 0.043), oxygen desaturation index during NREM sleep (p = 0.011), and cumulative percentage of time spent at saturations below 90% (CT90) during NREM sleep (p < .001). In multiple logistic regression analysis including all variables, CT90 during NREM sleep was the only factor independently associated with CPAP adherence (odds ratio, 0.693; 95% confidence interval, 0.582-0.824; p <.0001). The area under the receiver-operating characteristic curve of CT90 during NREM sleep was 0.823 (95% confidence interval, 0.745-0.901).Evaluating NREM sleep is important in reliably predicting CPAP adherence using polysomnographic parameters. CT90 during NREM sleep was the best predictor of CPAP adherence.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: Recurrence rates of oral cancer following primary treatment have been reported in the range of 25-48%. However, salvage therapy remains a critical challenge to improving outcomes. Here, we investigated prognostic factors and outcomes for salvage surgery in patients with recurrent oral tongue squamous cell carcinoma (OTSCC). METHODS: We retrospectively reviewed patients who were referred to Aichi Cancer Center, Japan, for the treatment of recurrent OTSCC. All patients included in the present study had undergone salvage surgery. Data to identify the predictive value of prognostic factors were available from 69 patients. Prognostic factors were assessed using Cox's proportional hazards regression analysis. Differences in overall survival between groups of patients were assessed by the log-rank test. RESULTS: In all, 36 patients (52%) developed second recurrence or died, of which 21 (58%) occurred within 12 months of salvage surgery. Univariate analysis indicated that survival was significantly worse in patients with recurrent stage III or IV tumors, two or more positive cervical lymph nodes, levels IV or V positive cervical lymph nodes, extracapsular spread (ECS) of positive cervical lymph nodes and a disease-free interval from initial treatment of less than 12 months. On multivariate analysis, ECS was an independent prognostic factor for overall survival after salvage surgery. CONCLUSION: Neck status at the time of salvage surgery, particularly ECS is a significant prognostic factor for surgical salvage. Survival was also influenced by the stage of the recurrent tumor and disease-free interval, suggesting that the biological features of recurrent tumors might impact on prognosis.

DOI： 10.1111/ajco.12087

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: To examine the effects of patient age, canalicular obstruction, mode of anesthesia, and duration of nasolacrimal intubation on the outcomes of endoscopic endonasal dacryocystorhinostomy (DCR). METHODS: Totally 56 eyes of 46 patients with prolonged epiphora underwent minimally invasive endoscopic endonasal DCR. A successful surgical outcome was defined as a significant improvement in symptoms, adequate water passage from the puncta to the nasal cavity, and patency of the DCR ostium. All outcomes were assessed at least 6mo after extubation. Fisher's exact test was used to discuss the factors, and then the logistic regression analysis was made by SAS 9.4 software. RESULTS: The overall success rate was 75.0%, and complete resolution was observed in 27 eyes. The success rate was higher for patients with ≥6mo intubation than for those with <6mo intubation. However, there were no significant differences in outcomes between groups stratified by age (<65 or ≥65y), presence or absence of canalicular obstruction, mode of anesthesia (local or general), and use or nonuse of a radiowave unit. One patient developed subcutaneous emphysema around the eye and nose and one developed subcutaneous hemorrhage after surgery. CONCLUSION: Endoscopic endonasal DCR can be considered safe and minimally invasive with reasonable success rates, particularly when the duration of nasolacrimal intubation is ≥6mo.

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Society of Practical Otolaryngology  

DOI： 10.5631/jibirinsuppl.141.54

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: To preserve laryngeal function in early-stage laryngeal cancer, chemotherapy and radiotherapy are performed more often than surgery as initial treatment. However, in recurrent cases, complex salvage surgery is often required as patients who received aggressive chemoradiotherapy are susceptible to postoperative complications. We report here salvage therapy that preserved laryngeal function in a recurrent case. METHODS: A 52-year-old man with recurrent laryngeal cancer (rT2N0M0) after chemoradiotherapy and followed by induction chemotherapy underwent partial vertical laryngectomy and right vocal cord reconstruction with a thyroid flap. RESULTS: Laryngeal functions were successfully preserved and the patient was discharged 2 months after surgery. CONCLUSION: The number of salvage surgeries performed after high-dose chemotherapy and radiation is expected to increase in the future. A thyroid gland flap promises to be an effective treatment option for vocal cord reconstruction especially for patients at high risk of postchemoradiotherapy complications.

DOI： 10.1002/hed.23525

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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担当区分：責任著者   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

DOI： 10.1038/bjc.2014.395

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その他リンク： http://www.nature.com/articles/bjc2014395

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J06217&link_issn=&doc_id=20140811250012&doc_link_id=%2Fai1tokec%2F2014%2F000201%2F012%2F0055-0057%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fai1tokec%2F2014%2F000201%2F012%2F0055-0057%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Acquired chemoresistance to 5-fluorouracil (5-FU) remains one of the obstacles for the success of 5-FU-based cancer chemotherapy, and some molecular mechanisms of acquired 5-FU resistance are still unknown. The main action of 5-FU is the suppression of DNA replication by inhibiting Thymidylate Synthase (TS). MATERIALS AND METHODS: We analyzed 5-FU resistance mechanisms using the head and neck squamous cell carcinoma cell lines, UM-SCC-23, and two different resistant cell lines, UM-SCC-23/WR and UM-SCC-23/MR, which were procured from UM-SCC-23 cells. To acquire resistance, the two cells underwent repeated treatment of 5-FU with different durations and frequency. We determined differences in the cell-cycle distribution and the expression of TS proteins in the three cell lines. Moreover, cell-cycle distribution in cells which acquired resistance after 5-FU treatment, was compared to that of parental cells, using flow cytometric analysis. RESULTS: There was a remarkable increase in TS protein expression levels in UM-SCC-23/WR following 5-FU treatment. S-phase cells of UM-SCC-23 and UM-SCC-23/WR cells were immediately increased after treatment with 5-FU, whereas UM-SCC-23/MR were accumulated to the S-phase slightly later. CONCLUSION: The cell-cycle perturbation or elevation of TS protein expression may be involved in acquired 5-FU resistance and identifies 5-FU resistance mechanisms in the two different 5-FU treatment regimens.

PubMed

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Acute epiglottitis may trigger death because of serious airway obstruction. It is necessary to perform emergency and accurate airway intervention. In this retrospective study we present 216 cases of acute epiglottitis in adults. Airway management was done in 39 cases (18.1%), but most cases were treated conservatively. The mean patient age was 53 years and the male-to-female ratio was 1.9 to 1.0. The most frequent symptoms were sore throat (88%). The mean duration from symptom onset to consultation to our hospital was 1.9 days in the airway management group and 2.9 days in the conservatively treated group, which was statistically significant (p<0.05). Focusing on epiglottal swelling seen under the flexible laryngoscope, the percentage of airway management was 52.6% for swelling of the unilateral false vocal cords and 12.9% for swelling of the aryepiglottic fold. A statistically significant difference was also seen in complaints of respiratory difficulties (p<0.01), the rise of WBC (p<0.01), the rise of CRP (p<0.01), and diabetes mellitus (p<0.01).

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: It is known that benign tumors have the potential for malignant transformation. Malignant transformation of vagus nerve schwannoma to angiosarcoma is very rare. METHODS: We report a case of malignant transformation in which the initial diagnosis was subsequently altered to angiosarcoma originating from the vagus nerve. We compared the findings of MRI and fine-needle aspiration (FNA) at initial diagnosis with those after malignant transformation. RESULTS: MRI revealed that the mass property had been changed from the initial tumor; also the FNA findings were significantly different from those in the previous ones. The patient had significant clinical progression with multiple cranial neuropathies and died. CONCLUSION: Schwannomas sometimes undergo malignant transformation; therefore, surgery should be recommended. If follow-up observation is chosen, MRI and FNA should be regular and patients should sign a statement acknowledging awareness of the potential for malignant transformation.

DOI： 10.1002/hed.23390

PubMed

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Society of Practical Otolaryngology  

DOI： 10.5631/jibirin.107.735

Scopus

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Head and neck squamous cell carcinoma (HNSCC) may be curable with surgery, radiation and chemotherapy in its early stages. However, recurrence and metastasis often prevail following primary treatment in advanced stage cases and are associated with significant morbidity and mortality. In this study we investigated the combination therapy of gemcitabine and cetuximab for HNSCC. The UM-SCC-6 and UM-SCC-23 HNSCC cell lines were analyzed following treatment with gemcitabine and cetuximab. To determine the mechanism of action of this combination treatment, the cell cycle distributions following gemcitabine and/or cetuximab treatment were analyzed by flow cytometry and apoptosis assay. Gemcitabine and cetuximab combination treatment exerted an enhanced cytotoxic effect. The cell cycle analysis demonstrated that cells accumulated in the S phase following gemcitabine treatment and G1 arrest occurred following cetuximab treatment. An increase in sub-G1 phase cells was also observed following treatment with the two drugs. In an apoptosis assay, caspase 3/7 activity was found to be higher when administering a combination of gemcitabine and cetuximab compared to each agent administered alone. Gemcitabine and cetuximab are individually effective against HNSCC and an enhanced growth inhibitory effect may be expected when these agents are used in combination.

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Web of Science

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記述言語：日本語   出版者・発行元：JAPAN SOCIETY FOR HEAD AND NECK SURGERY  

術前に上皮内癌であるボーエン病と診断された鼻腔扁平上皮癌の1例を経験した。症例は21歳男性，鼻閉を自覚し来院。生検でボーエン病（上皮内癌）と診断された。CT，MRIにて右鼻腔を主体とした腫瘤性病変，圧排増殖性の陰影を認めた。腫瘤は前頭蓋底，上咽頭に達していた。上皮内癌としての対応が必要で，充分な安全域を確保し病変を残さず摘出する外科的治療が第一選択と考えた。外鼻切開鼻腔内腫瘍摘出術，前頭蓋底切除術，前腕皮弁再建術を施行。永久病理結果は扁平上皮癌であった。本症例のように術前に上皮内癌と診断されていても，画像上で浸潤癌を疑う症例に対しては拡大切除を含めた根治性を考慮した最善の手術を行うことが望ましいと考える。

DOI： 10.5106/jjshns.20.201

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2011158645

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2010&ichushi_jid=J00580&link_issn=&doc_id=20100216180006&doc_link_id=10.5631%2Fjibirin.103.131&url=https%3A%2F%2Fdoi.org%2F10.5631%2Fjibirin.103.131&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

掲載種別：研究論文（学術雑誌）  

DOI： 10.5631/jibirin.103.131

Scopus

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Resistance to platinum-based chemotherapy frequently poses a serious problem in the treatment of head and neck squamous cell carcinoma. In this study, we isolated cisplatin-resistant cells from a head and neck squamous cell carcinoma cell line. The mismatch repair (MMR) system is known as one of the cisplatin-resistant mechanisms. When the expression levels of hMLH1 and hMSH2, a mismatch repair gene and its gene product, were analyzed, the hMLH1 mRNA and protein expression levels were significantly decreased in the cisplatin-resistant cell lines compared with a cisplatin-sensitive cell line. In addition, the microsatellite instability (MSI) phenotype was examined for the absence of MMR. Our data support the hypothesis that hMLH1 mRNA and protein expression levels are predictors of cisplatin sensitivity, but MSI was not involved in cisplatin resistance. The status of hMLH1 predicts the sensitivity of head and neck squamous cell carcinoma to platinum-based chemotherapy.

PubMed

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Web of Science

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00280-007-0658-6

Web of Science

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3892/mmr_00000015

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：The Oto-Rhino-Laryngological Society of Japan, Inc.  

頭頸部扁平上皮癌の病期診断に際して, FDG-PET施行159例とFDG-PET/CT施行116例の診断能を検討した. 原発巣・頸部リンパ節転移・遠隔転移について, FDG-PETもしくはFDG-PET/CTからの画像診断結果と臨床診断結果を比較検討した. また両検査による頸部リンパ節転移の診断能も検討した. 両検査ともに, 原発巣・頸部リンパ節転移・遠隔転移の精度は80%超で, 頸部リンパ節転移陰性と診断した症例の陰性的中率は90%超であった. FDG-PETで頸部リンパ節転移陽性と診断された症例の陽性的中率は78%, FDG-PET/CTでは82%であった. FDG-PETで頸部リンパ節転移単発と診断された症例の陽性的中率は63%であり, 比較的低いと考えられた. 両検査は頭頸部扁平上皮癌の病期診断において高い診断能があり, 今後FDG-PET/CTの普及に伴って高い診断能を有するスクリーニング検査になる可能性があると考えられた. しかし, 両検査は全身の悪性腫瘍画像ではなく全身の糖代謝分布画像である. 少なからず偽陽性や偽陰性例が存在することに常に留意しなければならない.

DOI： 10.3950/jibiinkoka.110.629

CiNii Books

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その他リンク： https://jlc.jst.go.jp/DN/JALC/00300592922?from=CiNii

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Induction chemotherapy or concomitant chemoradiotherapy has been used increasingly to improve survival, organ preservation and function in patients with head and neck cancer (HNC). However, this regimen encounters significant side effects with potential adverse reactions causing many disadvantages for patients. Therefore, reliable chemosensitivity assays are needed to accurately predict the response to chemotherapy and guide the selection and treatment of patients with HNC. The main purpose of this study was to examine the optimal drug concentrations for evaluating in vitro chemosensitivity using the histoculture drug response assay (HDRA). The tested tumor specimens included 7 from oral cavities (14.3%), 12 from oropharynx (24.5%), 10 hypopharynx (20.4%), 3 larynx (6.1%), 5 sinonasal (10.2%), 2 salivary glands (4.1%), and 10 from metastatic lymph nodes (20.4%), respectively. Histopathologic types of all 49 specimens were squamous cell carcinoma. We investigated the optimal drug concentrations in HDRA searching at doses of 4-100 microg/ml for cisplatin and 60-1500 microg/ml for 5-FU. We considered the concentration of 20 microg/ml to be appropriate for evaluating cisplatin sensitivity in HNC among the tested dosages. As for cisplatin sensitivity in vitro, the 50% cut-off inhibition index (I.I.) was found to have a significant association with the clinical response to chemotherapy, with an accurate prediction rate of 77.8%. The HDRA shows a predictive value for chemosensitivity in HNC patients using the optimal drug concentration cut-off with this site specificity.

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.oraloncology.2006.09.003

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記述言語：日本語   出版者・発行元：The Oto-Rhino-Laryngological Society of Japan, Inc.  

近年, 頭頸部癌に対する治療として, 機能や形態温存を考慮し, 化学放射線療法を行う症例が増加傾向にある. 腫瘍が残存や再発した場合, 当科では可能であれば救済手術を選択しているが, 口腔・中下咽頭癌における救済手術に関する報告は少なく, その有効性や問題点について明らかとなっていない.<br>今回, われわれは照射後に原発部位の残存や再発を認め, 救済手術を施行した口腔・中下咽頭癌症例の術後合併症とその予後について検討した.<br>[対象] 1994年から2003年の10年間に, 根治照射後に原発部位が残存または再発した舌24例, 口腔底5例, 中咽頭4例, 下咽頭4例の扁平上皮癌37例を対象とした.<br>[結果] 術後合併症は37例中14例 (37.8%) に認め, 創部感染9例, 咽頭皮膚瘻6例, 誤嚥性肺炎2例, 皮弁部分壊死2例, 皮弁全壊死, リンパ漏, 頸動脈破裂がそれぞれ1例であった. 各因子と合併症の発生に関して有意差を検討した結果, 再建手術施行群 (p=0.031) と化学療法併用群 (p=0.049) が有意に関連していた. 術後の5年粗生存率は全体で70.7%であった. また, 有意ではなかったが初発時の病期が早期の症例群で予後が良好であった.<br>[結論] 口腔・咽頭癌症例における照射後の救済治療として, 手術療法が有効であると考えられる. 再建手術施行例と化学療法併用例では術後合併症への対策が必要である.

DOI： 10.3950/jibiinkoka.110.461

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その他リンク： https://jlc.jst.go.jp/DN/JALC/00296448968?from=CiNii

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1159/000120998

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIMS: The main purpose of the current study was to find predictive biomarkers that can be routinely used for the response to chemotherapy in head and neck squamous cell carcinoma (HNSCC). METHODS: From this standpoint, we selected the histoculture drug response assay (HDRA) to assess in vitro chemosensitivity, and real-time reverse transcription polymerase chain reaction to investigate the gene expression profile of individual tumors as available predictive biomarkers. Using both surgery and biopsy specimens, we analyzed their gene expression profiles using the 18 markers that we thought were likely predictors of the response to anti-cancer agents. RESULTS: Statistically significant associations were found between 5-fluorouracil (5-FU) sensitivity in HDRA and HER-2 mRNA expression level (p = 0.0030). Moreover, HER-2 expression was significantly associated with cisplatin sensitivity (p = 0.0089). Cisplatin sensitivity in HDRA was also demonstrated to have a significant association with epidermal growth factor receptor (EGFR) expression in which the group with cisplatin resistance tended to have a higher expression level than the sensitive group (p = 0.0385). CONCLUSION: HER-2 and EGFR may be possible reliable predictive biomarkers for anti-cancer therapy, and might help in the decision-making process for individual patients with HNSCC.

DOI： 10.1159/000120998

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.5981/jjhnc.33.314

Scopus

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The sentinel node concept has become one of the most interesting topics in the treatment of head and neck cancer. The aim of this article is to report the results of our feasibility study and clinical application of sentinel lymph node (SLN) radiolocalization and biopsy in patients with clinically negative neck oral cancer. METHODS: Individuals with previously untreated N0 oral cancer participated in the study. The radioactive tracer used was 99m Tc phytate. Lymphoscintigrams were taken in the feasibility study, and fusion images of SPECT and CT were obtained in the clinical SLN biopsy (SLNB) group. In the feasibility study, metastases to SLNs and other nodes were analyzed in permanent specimens. In the clinical application group, we investigated the comparative effectiveness of multi-slice frozen section analysis and imprint cytology for the intraoperative diagnosis of SLNB. RESULTS: Fifteen individuals participated in the feasibility study. Six SLNs in five patients were cancer-positive, and two thirds of the SLNs were micrometastases. The SLN concept was established, and SLNs with the highest to the third highest radioactivity reflected the patients' neck status accurately. Twelve patients participated in the clinical application group of SLNB. Intraoperative diagnosis of the three hottest SLNs correctly predicted the neck status of 10 patients. Three patients underwent modified radical neck dissection on the basis of the intraoperative diagnosis of cancer metastasis to SLNs, whereas neck dissections were spared in patients with no evidence of such metastases. There were two false-negative cases. One involved a failure of the intraoperative diagnosis of SLNB, and the other had cancer-negative SLNs and cancer-positive non-SLNs. Considering intraoperative diagnosis, multi-slice frozen section analysis was found to be superior to imprint cytology in its sensitivity, specificity, and overall accuracy on a lymph node basis. No differences were found in any of these indices of intraoperative SLNB on a patient basis. The fusion images of SPECT and CT proved very useful during intraoperative SLNB. CONCLUSIONS: The sentinel node concept was established in the head and neck region. Analyzing the three hottest SLNs suffices to predict a patient's neck status. Multi-slice frozen section analysis was shown to be superior to imprint cytology for detecting micrometastasis to SLN. Intraoperative SLNB based on fusion images of SPECT and CT proved to be an easy, accurate, and reliable method.

PubMed

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記述言語：日本語   出版者・発行元：The Japan Laryngological Association  

The preservation of larynx function is a particularly important challenge in head and neck cancer therapy. We considered adaptation and problems associated with vertical partial laryngectomies in particular in reviewing the results of functional preservation operations until present.<BR>Vertical partial laryngectomies show a high incidence of complications, such as postoperative fistulation, but in most cases the complications were minor in nature.<BR>There were no cases with grave complications, such as postoperative hemorrhaging or total laryngectomies with necrosis of the remnant cartilage.<BR>We came to the conclusion that the vertical partial laryngectomy operative method could be safely performed even for a recurrence after radical cure treatment.

DOI： 10.5426/larynx1989.18.2_65

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記述言語：日本語   出版者・発行元：耳鼻と臨床会  

当院では、2001年10月から2005年6月までの間に上顎悪性腫瘍切除術を37例施行した。28例で遊離皮弁を用いた即時再建を施行し、9例では義顎を用いた。皮弁再建例の内、27例で腹直筋皮弁を用い上顎部分切除を行った1例で腓骨皮弁を用いた。皮弁再建例の、手術後から経口摂取までに至る期間の平均は15.0日 (8-44日) であった。一方、義顎例の手術後から経口摂取までに至る期間の平均は14.3日 (5-23日) であった。両者に有意差はなかった。当院で施行した皮弁による上顎再建例において、追加手術を要するほどの大きな口腔内の縫合不全や皮弁壊死が少なく、縫合不全が生じても保存的に治癒したため経口摂取までの期間を延長することが少なかったためと考えられた。

DOI： 10.11334/jibi1954.52.5Supplement3_S220

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記述言語：日本語   出版者・発行元：The Oto-Rhino-Laryngological Society of Japan, Inc.  

1985年から2002年までに愛知県がんセンター頭頸部外科を受診した原発不明頸部リンパ節転移症例36例について検討した.<BR>初診時原発不明であった症例は56例であり, そのうち治療開始までに原発不明であった症例を対象とした. また, 治療開始後に原発巣が判明した症例が11例であった.<BR>Random Biopsyを施行したのは56例中35例 (62.5%) であった. そのうち35例中5例 (14.3%) にて原発巣が判明した.<BR>初期治療として頸部郭清術を施行した症例は36例中24例 (61.5%) であった.<BR>治療開始後に原発巣が判明した症例について, 判明した原発部位は中咽頭が最も多かった.<BR>治療開始時に原発不明であり, 1年以上経過が明らかな31例についてKaplan-Meyer法にて生存率を検討した. 粗生存率は63.7%, 疾患特異生存率は69.2%, 無病生存率は46.8%であった. N分類, 組織型, 原発判明の有無, 頸部郭清術施行の有無, 化療施行の有無, 放財線照射施行の有無について生存率を検討したが, 有意差が見られたのは頸部郭清術施行の有無であった.

DOI： 10.3950/jibiinkoka.108.1083

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その他リンク： https://jlc.jst.go.jp/DN/JALC/00271513575?from=CiNii

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The clinicopathological significance of cell-cycle proteins has remained unclear in oral tongue squamous cell carcinomas (OTSCC). In the current study, we evaluated several cell-cycle proteins in relation to clinicopathological parameters and disease outcome for OTSCC. A total of 123 previously untreated patients with OTSCC, who underwent surgical treatment, were enrolled. Tumor specimens were examined for expression of p21, p27, p16, p53, and p63 using immunohistochemistry, with reference to clinicopathological factors and disease outcome. It is noteworthy that differences in p21 immunoreactivity were evident between the shallow region and invasive front of tumors within the same specimens. Loss of p21 expression in invasive fronts was found to be associated with clinicopathological factors of tumor progression and poor prognosis. p21 expression in invasive fronts is a significant indicator for impact on survival. Moreover, p21 is one of the important factors that regulate the progression of malignant cells in OTSCC.

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Stage I and II oral tongue cancers (OTC) generally have a favorable prognosis, but there are some early OTC cases with a poor prognosis. OTC is known for its propensity for subclinical nodal metastasis and, moreover, we must devise a strategy that takes account of the possibility of recurrence and distant metastasis. In the current study, 90 previously untreated patients with stage I or II OTC who underwent surgical treatment were eligible for review. The authors investigated the associations of their clinico-pathologic factors with disease outcomes, and also examined the postoperative course for patients with a poor prognosis. The most common cause of death was distant metastasis and late cervical lymph node metastasis (LCM) was the significantly independent prognostic variable. Since LCM can be treated with salvage surgery, the central issue is to control patients with distant metastises who are free of disease in their loco-regional sites.

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1097/01.PRS.0000130940.46400.7F

Scopus

PubMed

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記述言語：日本語   出版者・発行元：The Society of Practical Otolaryngology  

Background.<br>This is a retrospective review of medical and financial records, conducted to test the hypothesis that the use of clinical pathways specifically designed for the management of the operation for thyroid and parotid tumors will result in the improved outcomes of patients.<br>Methods.<br>Twenty-six patients before implementation of a clinical pathway for thyroid tumor were compared with forty-six patients after implementation of the pathway. Also, twenty-five patients before implementation of a clinical pathway for parotid tumor were compared with twenty-nine patients after implementation of the pathway. Analyses of clinical outcome, length of hospitalization, and cost were performed. An unpaired t-test was used for statistical analysis.<br>Results.<br>‹Thyroid tumor clinical pathway›<br>For pathway patients, the average number of days using a drain tube was decreased to 2.8±1.1 days, versus 3.5±1.2 days for prepathway patients (p=0.03). The average length of hospitalization was decreased to 10.8±3.5 days, versus 15.2±4.7 days (p<0.0001). The average length of postoperative hospitalization was decreased to 6.5±2.3 days, versus 8.5±3.0 days (p=0.004). The average cost was decreased to 56, 994±15, 296 points (1 point=10 yen), versus 65, 619±18, 083 points (p=0.03).<br>‹Parotid tumor clinical pathway›<br>For pathway patients, the average length of hospitalization was decreased to 12.0±1.0 days, versus 22.0±3.2 days for prepathway patients (p=0.002). The average length of post-operative hospitalization was decreased to 6.9±0.8 days, versus 13.1±2.5 days (p=0.01). The average cost was decreased to 60, 424±3, 217 points (1 point=10 yen), versus 86, 286±12, 801 points (p=0.04).<br>Conclusions.<br>In using clinical pathways for thyroid and parotid tumors, we have maintained the quality of the operation and patient care, and have decreased the length and cost of hospitalization. With this study, we have concluded that implementing clinical pathways for thyroid and parotid tumors is beneficial for all parties.

DOI： 10.5631/jibirin.97.555

CiNii Books

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その他リンク： https://jlc.jst.go.jp/DN/JALC/00239517645?from=CiNii

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/S0385-8146(99)00036-X

Scopus

PubMed

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記述言語：日本語   出版者・発行元：The Oto-Rhino-Laryngological Society of Japan, Inc.  

当科では中•下咽頭癌の進行例において原発巣切除,頸部郭清術に加えて咽頭後リンパ節の郭清術を行っている.<br>今回我々は,1992年から1996年に当科にて咽頭後リンパ節の郭清を施行した中咽頭癌H例.下咽頭癌29例に臼後三角癌2例を加えた計42例について咽頭後リンパ節転移の有無および術術前画像診断の検討を行った.<br>画像の診断基準はＣT,MＲＩともに長径10mm以上もしくは中心壌死を認めるものを転移陽性として診断した.<br>42例中の6例(14.3%)が病理組織診断で咽頭後リンパ節転移を認め,その6例中の5例は,CT,MRIのいずれかで術前に咽頭後1タンパ節転移陽性と診断することができた.<br>画像診断の成績は,CT(感度100%,特異度100%,精度100%)およびMRI(感度83.3%,特異度100%,精度97.0%)とともに良好で,術前画像診断の有用性が示された.

DOI： 10.3950/jibiinkoka.101.5_573

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/1998198129

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3950/jibiinkoka.101.5_595

Scopus

PubMed

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：特定非営利活動法人日本臨床細胞学会  

DOI： 10.5795/jjscc.36.424

CiNii Books

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Society of Practical Otolaryngology  

DOI： 10.5631/jibirin.90.573

Scopus

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記述言語：日本語   出版者・発行元：Japan Society for Head and Neck Cancer  

上皮小体を意識せず甲状腺全摘を行うと永続的な機能低下を招く。機能低下を避けるためには少なくとも1腺の血流を確実に温存するか, あるいは2腺以上移植することが必要である。上上皮小体は大部分が crico-tracheal junction の高さで甲状腺後縁に位置している。生ウニ色でやや光沢のある5mm位の楕円形の組織である。温存法: 上上皮小体の確認後下甲状腺動脈を同定し本幹より末梢に向かい上上皮小体まで血管を丁寧に剥離する。上甲状腺動脈の後枝からの血行が明かであればこれを温存する。移植法: 甲状腺全摘後ただちに移植可能な上皮小体を摘出する。一部を迅速標本とし, 上皮小体と確認する。眼科用剪刀を用いて薄切 (10～15片) する。頸胸部の筋肉 (胸鎖乳突筋, 後頸筋, 大胸筋) にモスキートで小ポケットを3～4個所作り, この移植床に上皮小体片を埋没する。上皮小体の手術において必要なことは解剖の知識と丁寧な手術操作である。

DOI： 10.5981/jjhnc1974.22.406

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2012315384

J-GLOBAL

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J-GLOBAL

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）  

Web of Science

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J-GLOBAL

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J-GLOBAL

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）  

Web of Science

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）  

Web of Science

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記述言語：日本語   出版者・発行元：耳鼻と臨床会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

DOI： 10.3950/jibiinkoka.121.582

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）  

Web of Science

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記述言語：英語   出版者・発行元：日本癌学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

DOI： 10.5631/jibirin.110.445

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2017&ichushi_jid=J00580&link_issn=&doc_id=20170710320003&doc_link_id=10.5631%2Fjibirin.110.445&url=https%3A%2F%2Fdoi.org%2F10.5631%2Fjibirin.110.445&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

DOI： 10.3950/jibiinkoka.120.567

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記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

DOI： 10.3950/jibiinkoka.119.643

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：(株)医学書院  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

DOI： 10.3950/jibiinkoka.118.613

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記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：愛知医科大学医学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

DOI： 10.5631/jibirin.106.582

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2013286008

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

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記述言語：日本語   出版者・発行元：愛知医科大学医学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児がん学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J00638&link_issn=&doc_id=20090323080084&doc_link_id=%2Fex9syoni%2F2009%2Fs04601%2F078%2F0069-0069%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fex9syoni%2F2009%2Fs04601%2F078%2F0069-0069%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(NPO)日本小児がん学会  

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記述言語：日本語  

CiNii Books

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記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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