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7 result(s) for "Akahani, Shiro"
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Proton Beam Therapy for the Treatment of Recurrent Human Papillomavirus-Related Multiphenotypic Sinonasal Carcinoma: A Case Report
Human papillomavirus-related multiphenotypic sinonasal carcinoma (HMSC) is a rare sinonasal tract tumor. Although HMSC has a favorable prognosis, patients tend to experience local recurrence after the initial therapy; therefore, careful follow-up is required after surgical dissection. Proton beam therapy is one of the therapeutic modalities used to treat sinonasal cancer. This is the first report on the use of proton beam therapy for definitive irradiation in HMSC. Herein, we report the case of a 30-year-old woman with HMSC. The right nasal tumor was surgically resected by endoscopy, and HMSC was diagnosed using pathology. The diagnosis of HMSC was made. Nine months after surgery, a recurrent invasive tumor was found in the right nasal cavity, and surgical treatment was not feasible. Proton beam therapy was administered to the recurrent lesion, resulting in radiographic complete response maintained for nine months. This case suggests that postoperative recurrence must be noted and that proton beam therapy is an option to treat locally advanced lesions.
Assessment of inner ear morphology and function in response to local positive pressure for Ménière’s disease: a nonrandomized controlled trial
Ménière’s disease (MD) is an inner ear disorder in which the main pathological feature is endolymphatic hydrops (EH). Positive pressure therapy (PPT) using a portable device is now a second-line therapy for intractable MD when initial medical treatment fails. However, it remains unknown whether PPT causes the morphological and functional changes of inner ear in patients with active MD in accordance with reduction of vertigo attacks. In this nonrandomized controlled trial of 52 patients with MD, the volume of EH significantly decreased with reduction of vertigo attacks during 8 months of PPT combined with medications while the volume of that significantly increased with medications alone. There was no difference between Control group (n = 26) and PPT group (n = 26) regarding the vertigo control, however, PPT group achieved a significant functional improvement of vertical semicircular canals. The effect of volume reduction by PPT has been firstly demonstrated and the functional changes of all semicircular canals during PPT have been firstly examined. Morphological and functional changes in the inner ear by administrating local positive pressure are quite different from those caused by medications alone. Clinical trial registration : UMIN-CTR UMIN000041164 (registered on July 20, 2020).
A Case Report of Pembrolizumab-Induced Allergic Hepatitis
The immune checkpoint inhibitor pembrolizumab is now considered a first-line treatment for recurrent or metastatic head and neck squamous cell cancer. Pembrolizumab is less toxic than conventional chemotherapy but may result in immune-related adverse events. We report a case in which liver injury occurred just two days after the administration of pembrolizumab plus chemotherapy. A 48-year-old woman achieved a complete response after chemoradiotherapy for cT2N3bM0 squamous cell carcinoma of the oropharynx with multiple lymph node metastases. However, the tumor recurred one year later, and she was started on pembrolizumab plus chemotherapy. On day 3, her alanine aminotransferase and aspartate transaminase concentrations markedly increased. She was initially diagnosed with drug-induced liver injury and all medications were withdrawn. Her liver function recovered within two weeks without intervention. The lymphocyte transformation test was only positive for pembrolizumab. Clinicians should consider pembrolizumab-induced allergic hepatitis as a possible cause of liver injury after excluding liver metastasis and immune-related adverse events.
Factors associated with spontaneous nystagmus changes in acute Ménière’s disease
Background Neuro-otological factors that influence changes in spontaneous nystagmus (SN) during vertigo attacks in Ménière’s disease (MD) remain unclear . Objective To identify neuro-otological factors that might influence the initial direction of SN and the directional change of SN. Methods A prospective, observational study of 22 patients with definite MD to evaluate the initial direction and directional change of SN during vertigo attacks, endolymphatic hydrops (EH) volume, and the function of horizontal semicircular canal and hearing levels. Results SN consistently began as irritative in 17 of 22 cases, and 9 of 17 cases showed a definite change in direction after onset. SN consistently began as paralytic in 5 of 22 cases, and 3 of 5 cases showed a definite change in direction after onset. Subjects in the irritative initial SN group had less severe degrees of hearing loss, smaller cochlear and vestibular EH volume than the paralytic initial SN group ( P  = 0.017, < 0.001, and 0.009, respectively). Subjects in the SN direction change group had significantly smaller maximum slow phase velocity, percentage of caloric weakness and canal paresis than the no SN direction change group ( P  = 0.001, 0.006, and 0.001, respectively). Simple logistic regression analysis showed that smaller EH volume was significantly associated with initial irritative SN (OR = 0.867, 95% CI 0.762–0.988, P  = 0.032) and that the degree of canal paresis was negatively associated with the presence of directional change of SN (OR = 0.022, 95% CI 0.002–0.289, P  = 0.004). Conclusions The morphology of EH and canal paresis may independently affect the characteristics of SN in patients with MD.
Longitudinal up‐regulation of endolymphatic hydrops in patients with Meniere's disease during medical treatment
Objective/Hypothesis Meniere's disease (MD) is a common inner ear disease characterized by repeated episodic vertigo, fluctuating sensorineural hearing loss, and tinnitus. Its pathology is defined as endolymphatic hydrops (EH) in the inner ear and EH has been hypothesized to correlate with the clinical symptoms of MD. We presented the dynamics of in vivo EH in MD patients during medical treatments. Study Design Prospective, single‐arm repeated measures Methods Eleven MD patients were enrolled. All subjects prospectively underwent gadolinium‐enhanced inner ear magnetic resonance (MR) imaging and neuro‐otological testing before and after medical treatment. The volume of EH was quantitatively evaluated by processing MR images. All MD patients were administered continuous medication and followed up for more than 12 months. Results The frequency of vertigo episodes decreased in all patients and vestibular function decreased to 13–91% of the pre‐treatment level. The volume ratio of post‐treatment EH‐to‐pre‐treatment EH ranged from 1.01–3.22. The total volume of pre‐treatment EH was significantly correlated with cochlear symptom disease duration and the affected ear's hearing level. Conclusion EH in MD patients developed longitudinally with deterioration of inner ear function during medical treatment. The natural course of MD may progress with development of EH at least for a certain period. Level of Evidence 2b.
Overexpression of the Wilms′tumor gene WT1 in head and neck squamous cell carcinoma
The expression levels of the Wilms' tumor gene WT1 were examined in 56 cases of head and neck squamous cell carcinoma (HNSCC) using quantitative real‐time reverse transcriptase‐polymerase chain reaction (RT‐PCR). They included 4 cases of floor of mouth, 9 of gingiva, 25 of tongue, 10 of oropharynx, 3 of hypopharynx, and 5 larynx squamous cell carcinoma (SCC). All (100%) of 4 cases of floor of mouth, 5 (56%) of 9 gingiva, 17 (68%) of 25 tongue, 8 (80%) of 10 oropharynx, all (100%) of 3 hypopharynx, and all (100%) of 5 larynx SCC overexpressed the WT1 gene in the range of 3.07×10−4‐8.60×10−1 levels (the WT1 expression level in K562 leukemie cells was defined as 1.0). Thus, 42 (75%) out of 56 cases of HNSCC overexpressed the WT1 gene. The high expression level of the WT1 gene significantly correlated with poor histological tumor differentiation and high tumor stage of HNSCC. Immunohistochemical analysis confirmed the expression of WT1 protein in 6 cases (one floor of mouth, 2 tongue, 2 oropharynx, and one larynx SCC) with Overexpression of the WT1 gene. The direct sequencing analysis of the WT1 genomic DNA showed no mutations in any of 10 exons of the WT1 gene in 5 different HNSCC. These findings suggest an important role of the wild‐type WT1 gene in the tumorigenesis of HNSCC.
Galectin-3 Induces Endothelial Cell Morphogenesis and Angiogenesis
Increasing evidence suggests that carbohydrate-binding proteins play an essential role in tumor growth and metastasis. However, conflicting results on their function in the regulation of cell proliferation and differentiation during angiogenesis have been reported. We have examined the role of galectin-3 in the regulation of human umbilical vein endothelial cell proliferation, differentiation, migration, and neovascularization. Galectin-3, a carbohydrate-binding protein, with specificity for type 1 and 11 ABH blood group epitopes and polylactosamine glycan containing cell surface glycoproteins, is the major nonintegrin cellular laminin-binding protein. Because galectin-3 expression was shown to be associated in some tumor systems with metastasis, we questioned whether it induces endothelial cell morphogenesis. Here we show that galectin-3 affects chemotaxis and morphology and stimulates capillary tube formation of HUV-EC-C in vitro and angiogenesis in vivo. Endothelial cell morphogenesis is a carbohydrate-dependent process, as it is neutralized by specific sugars and antibodies. These findings demonstrate that endothelial cell surface carbohydrate recognition event(s) can induce a signaling cascade leading to the differentiation and angiogenesis of endothelial cells.