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Tsuji T, Asato R, Kada S, Kitamura M, Tamaki H, Mizuta M, Tanaka S, Watanabe Y, Hori R, Kojima T, Shinohara S, Takebayashi S, Maetani T, Harada H, Kitani Y, Kumabe Y, Tsujimura T, Honda K, Ichimaru K, Ushiro K, Omori K. A multi-institutional retrospective study of 340 cases of sinonasal malignant tumor. Auris Nasus Larynx 2024; 51:86-98. [PMID: 37248104 DOI: 10.1016/j.anl.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/10/2023] [Accepted: 05/14/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Sinonasal malignant tumors (SNMT) are relatively rare among head and neck malignant tumors. Most are squamous cell carcinomas, and malignant melanomas, olfactory neuroblastomas, adenoid cystic carcinomas, sarcomas, and others also occur. The most common primary site of nasal sinus squamous cell carcinoma is the maxillary sinus. In recent years, a decrease in incidence of maxillary sinus squamous cell carcinoma (MSSCC) has been reported along with a decrease in the incidence of sinusitis. MSSCC is treated with a combination of surgery, radiation, and chemotherapy. Treatment decisions are made according to the progression of the disease, the patient's general condition, and the patient's own wishes. There are variations in treatment policies among facilities due to the specialty of staff and cooperation with other departments at each facility. We conducted a multi-institutional retrospective study to compare outcomes by treatment strategy. METHODS In this study, 340 patients with SNMT who were treated at 13 Hospitals (Head and Neck Oncology Group (Kyoto-HNOG) ) during the 12-year period from January 2006 to December 2017 were included. There were 220 patients with squamous cell carcinoma, 32 with malignant melanoma, 21 with olfactory neuroblastoma, and 67 with other malignancies. Of the squamous cell carcinomas, 164 were of maxillary sinus origin. One hundred and forty cases of MSSCC that were treated radically were included in the detailed statistical analysis. RESULTS There were 5 cases of cStage I, 9 cases of cStage II, 36 cases of cStage III, 74 cases of cStage IVa, and 16 cases of cStage IVb. There were 92 cases without clinical lymph node metastasis (cN(-)) and 48 cases with clinical lymph node metastasis(cN(+)). Primary tumors were treated mainly by surgery in 85 cases (Surg) and by radical radiation therapy (with or without chemotherapy) of 6-70 Gy in 55 cases(non-Surg). The 5-year overall/disease-free survival rate (OS/DFS) for MSSCC was 65.1%/51.6%. Old age, renal dysfunction, and clinical T progression were independent risk factors for OS, and renal dysfunction was an independent risk factor for DFS. In cN(-) patients, OS and DFS were significantly better in Surg group than in non-Surg group. In cN(+) patients, there was no significant difference in OS and DFS between Surg and non-Surg groups. CONCLUSION For patients with MSSCC without lymph node metastasis, aggressive surgery on the primary tumor contributes to improved prognosis.
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Affiliation(s)
- Takuya Tsuji
- Department of Otolaryngology, Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan.
| | - Ryo Asato
- Department of Otolaryngology, Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan
| | - Shinpei Kada
- Department of Otolaryngology, Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan; Department of Otolaryngology, Head and Neck Surgery, Japanese Red Cross Otsu Hospital, 1-1-35, Nagara, Otsu-shi, Shiga, 520-8511, Japan
| | - Morimasa Kitamura
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; Department of Head and Neck-Thyroid Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa 920-0293, Japan
| | - Hisanobu Tamaki
- Department of Otolaryngology, Head and Neck Surgery, Japanese Red Cross Osaka Hospital, 5-30, Fudegasakicho, Tennouji-ku, Osaka-shi, Osaka 543-8555, Japan
| | - Masanobu Mizuta
- Department of Otolaryngology, Head and Neck Surgery, Japanese Red Cross Osaka Hospital, 5-30, Fudegasakicho, Tennouji-ku, Osaka-shi, Osaka 543-8555, Japan; Katsuragawa Mizuta ENT Clinic, 37 Shimotsubayashiminamidaihan-nya-cho, Nishikyo-ku, Kyoto-shi, Kyoto, 615-8036, Japan
| | - Shinzo Tanaka
- Department of Otolaryngology, Head and Neck Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan; Department of Otolaryngology, Head and Neck Surgery, Uji-Tokushukai Medical Center, 145 Ishibashi, Makishima-cho, Uji-shi, Kyoto, 611-0041, Japan
| | - Yoshiki Watanabe
- Department of Otolaryngology, Head and Neck Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Ryusuke Hori
- Department of Otolaryngology, Tenri Hospital, 200 Misima-cho, Tenri-shi, Nara, 632-8552, Japan; Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Occupational and Environmental Health
| | - Tsuyoshi Kojima
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; Department of Otolaryngology, Tenri Hospital, 200 Misima-cho, Tenri-shi, Nara, 632-8552, Japan
| | - Shogo Shinohara
- Department of Otolaryngology, Head and Neck Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo, 650-0047, Japan
| | - Shinji Takebayashi
- Department of Otolaryngology, Head and Neck Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo, 650-0047, Japan; Department of Otorhinolaryngology, Shiga General Hospital, 5-4-30, Moriyama, Moriyama-shi, Shiga, 524-8524, Japan
| | - Toshiki Maetani
- Department of Otolaryngology, Head and Neck Surgery, Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan
| | - Hiroyuki Harada
- Department of Otolaryngology, Head and Neck Surgery, Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan
| | - Yoshiharu Kitani
- Department of Otolaryngology, Head and Neck Surgery, Shizuoka General Hospital, 4-27-1 Kita Ando Aoi-ku, Shizuoka City, 420-8527, Japan
| | - Yohei Kumabe
- Department of Otolaryngology, Head and Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Nanba-cho, Amagasaki-shi, Hyogo, 660-8550, Japan
| | - Takashi Tsujimura
- Department of Otolaryngology, Head and Neck Surgery, Japanese Red Cross Otsu Hospital, 1-1-35, Nagara, Otsu-shi, Shiga, 520-8511, Japan; Department of Otolaryngology, Head and Neck Surgery, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama City, Wakayama, 640-8558, Japan
| | - Keigo Honda
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; Department of Otolaryngology, Head and Neck Surgery, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama City, Wakayama, 640-8558, Japan
| | - Kazuyuki Ichimaru
- Department of Otolaryngology, Head and Neck Surgery, Kokura Memorial Hospital, 3-2-1, Asano, Kokurakita-ku, Kitakyushu-shi, Fukuoka, 802-8555, Japan
| | - Koji Ushiro
- Department of Otolaryngology, Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan; Department of Otorhinolaryngology, Shiga General Hospital, 5-4-30, Moriyama, Moriyama-shi, Shiga, 524-8524, Japan
| | - Koichi Omori
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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Ushiro K, Watanabe Y, Kishimoto Y, Kawai Y, Fujimura S, Asato R, Tsujimura T, Hori R, Kumabe Y, Yasuda K, Tamaki H, Iki T, Kitani Y, Kurata K, Kojima T, Takata K, Kada S, Takebayashi S, Shinohara S, Hamaguchi K, Miyazaki M, Ikenaga T, Maetani T, Harada H, Haji T, Omori K. Impact of cervical lymph node metastasis on transoral surgery for hypopharyngeal squamous cell carcinoma: A retrospective multicenter study. Head Neck 2024. [PMID: 38294099 DOI: 10.1002/hed.27666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/11/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Hypopharyngeal carcinoma is likely to spread to the lymph nodes, but there is no established strategy for management in transoral surgery. METHODS We compared oncologic and functional outcomes in a retrospective multicenter study of patients who underwent transoral surgery for hypopharyngeal carcinoma between 2015 and 2021. RESULTS Two-hundred and thirty-two patients were included. Comparing patients with and without adjuvant radiotherapy, 3-year regional recurrence-free survival (RRFS) was not significantly different in pN2b and pN2c, but was significantly worse in pN3b without adjuvant radiotherapy. In patients without neck dissection, the 3-year RRFS was 85.6%, 76.8%, and 70.0% for T1, T2, and T3 primary lesions, respectively, and was significantly worse for T2 or higher (p = 0.035). CONCLUSIONS In the absence of extracapsular invasion, regional control did not deteriorate without adjuvant therapy. If prophylactic neck dissection is not performed, careful follow-up is necessary if the primary lesion is T2 or greater.
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Affiliation(s)
- Koji Ushiro
- Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Yoshiki Watanabe
- Department of Otolaryngology - Head & Neck Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan
| | - Yo Kishimoto
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshitaka Kawai
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shintaro Fujimura
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryo Asato
- Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takashi Tsujimura
- Department of Otolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Ryusuke Hori
- Department of Otolaryngology - Head and Neck Surgery, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Otolaryngology - Head & Neck Surgery, Fujita Health University, Toyoake, Japan
- Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan
| | - Yohei Kumabe
- Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Kaori Yasuda
- Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Hisanobu Tamaki
- Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Takehiro Iki
- Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Yoshiharu Kitani
- Department of Otolaryngology - Head & Neck Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Keisuke Kurata
- Department of Otolaryngology - Head & Neck Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Tsuyoshi Kojima
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan
| | - Kuniaki Takata
- Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan
| | - Shinpei Kada
- Department of Otolaryngology - Head & Neck Surgery, Japanese Red Cross Otsu Hospital, Otsu, Japan
| | - Shinji Takebayashi
- Department of Otolaryngology - Head & Neck Surgery, Shiga General Hospital, Moriyama, Japan
| | - Shogo Shinohara
- Department of Otolaryngology - Head & Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kiyomi Hamaguchi
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Otolaryngology - Head & Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masakazu Miyazaki
- Department of Otolaryngology - Head & Neck Surgery, Nara Prefecture General Medical Center, Nara, Japan
| | - Tadashi Ikenaga
- Department of Otolaryngology - Head & Neck Surgery, Nara Prefecture General Medical Center, Nara, Japan
| | - Toshiki Maetani
- Department of Otolaryngology - Head & Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Hiroyuki Harada
- Department of Otolaryngology - Head & Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Tomoyuki Haji
- Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Koichi Omori
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Shimosato M, Kada S, Yase E, Sakane N. Oral candida lesions and Candida tropicalis: Potential prognostic markers in end-of-life cancer patients. Spec Care Dentist 2024. [PMID: 38168741 DOI: 10.1111/scd.12955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
Abstract
AIMS Oral candidosis is common in patients with end-of-life cancer; however, its prognosis is unclear. We aimed to assess oral candidosis and Candida species as prognostic indicators in palliative care for these patients. METHODS We consecutively included palliative care patients, assessed for candidosis via microbiological techniques, and classified into three groups by the extent of oral lesions. The association between oral candidosis and overall survival was assessed using a Cox proportional hazards model adjusted by performance status (PS). RESULTS We studied 142 patients (median age 77; 52.8% women) with a 76.1% oral candidosis prevalence. Candida albicans (80.6%) was the most common species. Oral lesions were classified as none, grade 1 (28.7%), or ≥ grade 2 (14.8%). During follow-up, Cox models identified ≥grade 2 lesions (aHR = 2.04; 95% CI: 1.18-3.54; p = .011) and Candida tropicalis (aHR = 2.38; 95% CI: 1.03-5.55; p = .044) as predictors. CONCLUSION The extent of oral candidosis lesions or the presence of C. tropicalis may serve as prognostic indicator in patients with end-of-life cancer. Therefore, solely concentrating on the prevalence and frequency of fungal species may be insufficient for predicting life prognosis; it is advisable to assess these parameters through both visual examination and culture.
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Affiliation(s)
- Maiko Shimosato
- Department of Oral and Maxillofacial Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Shinpei Kada
- Department of Otolaryngology-Head and Neck Surgery, Otsu Red Cross Hospital, Otsu, Shiga, Japan
- Division of Clinical Research Planning and Management, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Eriko Yase
- Department of Pharmacy, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Naoki Sakane
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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4
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Ushiro K, Watanabe Y, Kishimoto Y, Kawai Y, Fujimura S, Asato R, Tsujimura T, Hori R, Kumabe Y, Yasuda K, Tamaki H, Iki T, Kitani Y, Kurata K, Kojima T, Takata K, Kada S, Takebayashi S, Shinohara S, Hamaguchi K, Miyazaki M, Ikenaga T, Maetani T, Harada H, Haji T, Omori K. Local recurrence and metachronous multiple cancers after transoral nonrobotic surgery for pharyngeal and laryngeal squamous cell carcinoma: A retrospective multicenter study. Head Neck 2024; 46:118-128. [PMID: 37897205 DOI: 10.1002/hed.27564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/25/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Late laryngopharyngeal cancers after transoral surgery include not only local recurrences but also metachronous multiple cancers. METHODS We compared clinical information, surgical outcomes, and late laryngopharyngeal cancers in patients who underwent transoral nonrobotic surgery for laryngopharyngeal squamous cell carcinoma without lymph node metastases between 2015 and 2021 in a multicenter retrospective study. RESULTS Four hundred and fifty-seven patients were included. Positive surgical margins were found in 121 patients (26.5%). Twenty-two patients (4.8%) received additional treatment. Positive horizontal margins of invasive carcinoma (p = 0.003) and positive horizontal margins of carcinoma in situ only (p = 0.032) were independent risk factors for local recurrence, and prior radiotherapy (p = 0.001) for metachronous multiple cancers. Local control was significantly worse without additional treatment (p = 0.049), but there was no significant difference in survival. CONCLUSIONS Patients with positive margins had an increased frequency of local recurrence, but salvage therapy was effective.
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Affiliation(s)
- Koji Ushiro
- Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Yoshiki Watanabe
- Department of Otolaryngology - Head & Neck Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan
| | - Yo Kishimoto
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshitaka Kawai
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shintaro Fujimura
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryo Asato
- Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takashi Tsujimura
- Department of Otolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Ryusuke Hori
- Department of Otolaryngology - Head and Neck Surgery, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Otolaryngology - Head & Neck Surgery, Fujita Health University, Toyoake, Japan
- Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan
| | - Yohei Kumabe
- Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Kaori Yasuda
- Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Hisanobu Tamaki
- Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Takehiro Iki
- Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Yoshiharu Kitani
- Department of Otolaryngology - Head & Neck Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Keisuke Kurata
- Department of Otolaryngology - Head & Neck Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Tsuyoshi Kojima
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan
| | - Kuniaki Takata
- Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan
| | - Shinpei Kada
- Department of Otolaryngology - Head & Neck Surgery, Japanese Red Cross Otsu Hospital, Otsu, Japan
| | - Shinji Takebayashi
- Department of Otolaryngology - Head & Neck Surgery, Shiga General Hospital, Moriyama, Japan
| | - Shogo Shinohara
- Department of Otolaryngology - Head & Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kiyomi Hamaguchi
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Otolaryngology - Head & Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masakazu Miyazaki
- Department of Otolaryngology - Head & Neck Surgery, Nara Prefecture General Medical Center, Nara, Japan
| | - Tadashi Ikenaga
- Department of Otolaryngology - Head & Neck Surgery, Nara Prefecture General Medical Center, Nara, Japan
| | - Toshiki Maetani
- Department of Otolaryngology - Head & Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Hiroyuki Harada
- Department of Otolaryngology - Head & Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Tomoyuki Haji
- Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Koichi Omori
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Kada S, Tanaka M, Yasoda A. Parathyroid Carcinoma in a Patient With Secondary Hyperparathyroidism and Thyroid Hemiagenesis: A Case Report and Review of the Literature. Ear Nose Throat J 2024; 103:NP25-NP30. [PMID: 34318689 DOI: 10.1177/01455613211036240] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Parathyroid carcinoma is a rare endocrine tumor. Parathyroid carcinoma in patients with secondary hyperparathyroidism due to chronic kidney disease is also rare. In addition, thyroid hemiagenesis is a rare congenital anomaly. We report an extremely rare case of parathyroid carcinoma in a patient with secondary hyperparathyroidism and thyroid hemiagenesis. We also present a review of the literature of this rare entity. We also discuss the surgical procedure performed for this patient. Our review of the literature found 34 case reports of parathyroid carcinoma in patients undergoing dialysis due to chronic renal failure; 14 reports of thyroid hemiagenesis with parathyroid disease; and no previous reports of thyroid hemiagenesis with secondary hyperparathyroidism and parathyroid carcinoma. Although surgical treatment of parathyroid carcinoma requires combined resection with the thyroid, peritracheal dissection with total parathyroidectomy, and monitoring intact parathyroid hormone as a tumor marker, our procedure preserved the patient's thyroid function. There has been no evidence of recurrence for over 8 years.
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Affiliation(s)
- Shinpei Kada
- Department of Otolaryngology-Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Department of Otolaryngology-Head and Neck Surgery, Otsu Red Cross Hospital, Otsu, Shiga, Japan
| | - Miho Tanaka
- Department of Otolaryngology-Head and Neck Surgery, Otsu Red Cross Hospital, Otsu, Shiga, Japan
| | - Akihiro Yasoda
- Division of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Kawai Y, Kishimoto Y, Tamaki H, Fujiwara T, Asato R, Ushiro K, Shinohara S, Kada S, Takebayashi S, Kojima T, Otsuki S, Miyazaki M, Kumabe Y, Omori K. Parathyroid carcinoma: impact of preoperative diagnosis on the choice of surgical procedure. Endocr J 2023; 70:969-976. [PMID: 37635058 DOI: 10.1507/endocrj.ej23-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
The operative procedure in the surgical treatment of parathyroid carcinoma differs from that of benign hyperparathyroidism. However, preoperative differentiation is often difficult. This study elucidated how clinicians diagnose parathyroid carcinoma and the relationship between preoperative diagnosis and the operative course. Using a retrospective chart review, twenty cases of parathyroid carcinoma from nine participating centers were examined. In 11 cases with preoperative suspicion of malignancy, at least one of these three features was found: elevated serum calcium level (>14 mg/dL), palpable mass, and irregular margin on ultrasonography. Although an intact parathyroid hormone (iPTH) threshold to suspect malignancy has not been established, six cases showed marked iPTH elevation exceeding 8.0 times the upper limit of normal. One case was excluded from analysis due to hemodialysis. Compared with the four cases that showed calcium elevation, the iPTH threshold might represent better sensitivity. Among 9 cases of benign preoperative diagnosis, six cases were performed with pericapsular resection. In three cases where malignancy was suspected in the middle of the operation, the recommended en bloc resection with ipsilateral thyroid lobectomy was not performed but a parathyroidectomy with surrounding soft tissue. In contrast, 10 preoperatively suspected cases underwent en bloc resection, and one case underwent pericapsular resection followed by supplementary ipsilateral hemithyroidectomy due to the uncertain pre- and intraoperative findings to determine the diagnosis. In conclusion, the surgical procedure for parathyroid carcinoma strongly depends on the preoperative diagnosis. The presence of excessive iPTH levels might contribute to improved preoperative diagnostic sensitivity for parathyroid carcinoma.
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Affiliation(s)
- Yoshitaka Kawai
- Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Yo Kishimoto
- Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Hisanobu Tamaki
- Department of Otolaryngology - Head and Neck Surgery, Kurashiki Central Hospital, Okayama 710-8602, Japan
| | - Takashi Fujiwara
- Department of Otolaryngology - Head and Neck Surgery, Kurashiki Central Hospital, Okayama 710-8602, Japan
| | - Ryo Asato
- Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto 612-0861, Japan
| | - Koji Ushiro
- Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto 612-0861, Japan
| | - Shogo Shinohara
- Department of Otolaryngology - Head & Neck Surgery, Kobe City Medical Center General Hospital, Hyogo 650-0047, Japan
| | - Shinpei Kada
- Department of Otolaryngology, Japanese Red Cross Otsu Hospital, Shiga 520-0046, Japan
| | - Shinji Takebayashi
- Department of Otorhinolaryngology - Head and Neck Surgery, Shiga General Hospital, Shiga 524-8524, Japan
| | - Tsuyoshi Kojima
- Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
- Department of Otolaryngology, Tenri Hospital, Nara 632-0015, Japan
| | - Shuya Otsuki
- Department of Otolaryngology, Tenri Hospital, Nara 632-0015, Japan
| | - Masakazu Miyazaki
- Department of Head and Neck Surgery, Nara Prefecture General Medical Center, Nara 630-8581, Japan
| | - Yohei Kumabe
- Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo 660-8550, Japan
| | - Koichi Omori
- Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
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Tsutsui T, Hayashi K, Oda M, Kada S, Yamazoe N, Saiki M. Pituitary metastasis of salivary gland carcinoma mimicking hypophysitis: A case report and literature review. Int J Surg Case Rep 2023; 109:108522. [PMID: 37524016 PMCID: PMC10407195 DOI: 10.1016/j.ijscr.2023.108522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/10/2023] [Accepted: 07/15/2023] [Indexed: 08/02/2023] Open
Abstract
INTRODUCTION Pituitary metastases from salivary gland carcinomas are rare. Moreover, pituitary metastasis and hypophysitis exhibit neuroimaging similarities that complicate the diagnosis in patients receiving immune checkpoint drugs. PRESENTATION OF CASE We present a case of pituitary metastasis derived from a sublingual gland carcinoma; this case posed a challenge in the differential diagnosis of hypophysitis. A 52-year-old male patient presented with anorexia and visual disturbances. The patient was previously diagnosed with sublingual gland carcinoma that necessitated surgical intervention consisting of tumor resection and residual lymph node dissection. Subsequently, the patient underwent immune checkpoint blockade therapy following platinum-based chemotherapy. Magnetic resonance imaging revealed the presence of an intrasellar tumor infiltrating the dura mater, cavernous sinus, and pituitary stalk with isointensity on T1 and T2 weighted images and homogeneous gadolinium enhancement. Despite the initial suspicion of hypophysitis, diagnostic treatment with systemic corticosteroids failed to induce significant tumor reduction. Diagnostic clarification was achieved via an endoscopic transsphenoidal biopsy, which confirmed the histological diagnosis of pituitary metastasis from the prior sublingual gland adenocarcinoma. Radiotherapy was administered as a therapeutic intervention. DISCUSSION The case report highlighted the rarity of metastases from salivary gland carcinoma to the pituitary gland and emphasized the challenges in distinguishing between pituitary metastasis and hypophysitis based on imaging studies alone, particularly in patients receiving immune checkpoint inhibitors. CONCLUSION Given the rarity of this condition and its neuroimaging similarities with hypophysitis, pathological confirmation is imperative for a definitive diagnosis.
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Affiliation(s)
- Takeyoshi Tsutsui
- Department of Neurosurgery, Japanese Red Cross Otsu Hospital, Shiga, Japan.
| | - Kosuke Hayashi
- Department of Neurosurgery, Japanese Red Cross Otsu Hospital, Shiga, Japan
| | - Masashi Oda
- Department of Neurosurgery, Japanese Red Cross Otsu Hospital, Shiga, Japan
| | - Shinpei Kada
- Department of Otolaryngology, Japanese Red Cross Otsu Hospital, Shiga, Japan
| | - Naohiro Yamazoe
- Department of Neurosurgery, Japanese Red Cross Otsu Hospital, Shiga, Japan
| | - Masaaki Saiki
- Department of Neurosurgery, Japanese Red Cross Otsu Hospital, Shiga, Japan
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Fujita K, Kada S, Kanai O, Hata H, Odagaki T, Satoh-Asahara N, Tagami T, Yasoda A. Quantitative SARS-CoV-2 Antibody Screening of Healthcare Workers in the Southern Part of Kyoto City During the COVID-19 Pre-pandemic Period. Front Public Health 2020; 8:595348. [PMID: 33365297 PMCID: PMC7750354 DOI: 10.3389/fpubh.2020.595348] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 11/17/2020] [Indexed: 01/08/2023] Open
Abstract
Background: The coronavirus disease-2019 (COVID-19) pandemic is associated with a heavy burden on the mental and physical health of patients, regional healthcare resources, and global economic activity. While understanding of the incidence and case-fatality rates has increased, there are limited data concerning seroprevalence of antibodies against the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) in healthcare workers during the pre-pandemic period. This study aimed to quantitatively evaluate seroprevalence of SARS-CoV-2 antibodies in healthcare workers in the southern part of Kyoto city, Japan. Methods: We prospectively recruited healthcare workers from a single hospital between April 10 and April 20, 2020. We collected serum samples from these participants and quantitatively evaluated SARS-CoV-2 IgG antibody levels using enzyme-linked immunosorbent assays. Results: Five (5.4%), 15 (16.3%), and 72 (78.3%) participants showed positive, borderline, and negative serum SARS-CoV-2 IgG antibody status, respectively. We found the mean titer associated with each antibody status (overall, positive, borderline, and negative) was clearly differentiated. Participants working at the otolaryngology department and/or with a history of seasonal common cold symptoms had a significantly higher SARS-CoV-2 IgG antibody titer (p = 0.046, p = 0.046, respectively). Conclusions: Five (5.4%) and 15 (16.3%) participants tested positive and borderline, respectively, for SARS-CoV-2 IgG antibody during the COVID-19 pre-pandemic period. These rates were higher than expected, based on government situation reports. These findings suggest that COVID-19 had already spread within the southern part of Kyoto city at the early stage of the pandemic.
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Affiliation(s)
- Kohei Fujita
- Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Department of Infectious Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Shinpei Kada
- Department of Infectious Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Department of Otolaryngology, Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Osamu Kanai
- Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Department of Infectious Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Hiroaki Hata
- Department of Infectious Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Department of Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takao Odagaki
- Department of Infectious Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Department of General Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Noriko Satoh-Asahara
- Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Division of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Tetsuya Tagami
- Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Division of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Akihiro Yasoda
- Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Division of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Kada S, Hamaguchi K, Ito J, Omori K, Nakagawa T. Bone Marrow Stromal Cells Accelerate Hearing Recovery via Regeneration or Maintenance of Cochlear Fibrocytes in Mouse Spiral Ligaments. Anat Rec (Hoboken) 2019; 303:478-486. [DOI: 10.1002/ar.24063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 04/14/2018] [Accepted: 04/26/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Shinpei Kada
- Department of Otolaryngology, Head and Neck SurgeryGraduate School of Medicine, Kyoto University Kyoto Japan
- Department of Otolaryngology, Head and Neck SurgeryNational Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Kiyomi Hamaguchi
- Department of Otolaryngology, Head and Neck SurgeryGraduate School of Medicine, Kyoto University Kyoto Japan
- Department of Otolaryngology, Head and Neck SurgeryShizuoka City Shizuoka Hospital Shizuoka Japan
| | - Juichi Ito
- Department of Otolaryngology, Head and Neck SurgeryGraduate School of Medicine, Kyoto University Kyoto Japan
- Shiga Medical Center Research Institute Moriyama Japan
| | - Koichi Omori
- Department of Otolaryngology, Head and Neck SurgeryGraduate School of Medicine, Kyoto University Kyoto Japan
| | - Takayuki Nakagawa
- Department of Otolaryngology, Head and Neck SurgeryGraduate School of Medicine, Kyoto University Kyoto Japan
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Honda K, Asato R, Tsuji J, Miyazaki M, Kada S, Kataoka Y, Taura A, Morita M. Sensory preservation in neck dissection: outcomes of a sub-sternocleidomastoid approach. Acta Otolaryngol 2018; 138:763-767. [PMID: 29656688 DOI: 10.1080/00016489.2018.1455008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Cutaneous anesthesia in early postoperative period is common after neck dissection even if the cervical nerve (CN) rootlets are preserved. The aim of this study was to evaluate if the preservation of the terminal branches of CNs using sub-sternocleidomastoid (SCM) approach combined with medially placed skin incision can prevent early postoperative anesthesia. MATERIAL AND METHODS A retrospective chart review was performed on 129 neck dissections in 87 head and neck cancer patients. RESULTS The early postoperative sensory preservation rates for the ear tab, submandibular, lateral neck, and sub-clavicular areas of CN rootlet-preserved necks (n = 86) were 75.6%, 20.9%, 74.4%, and 86.0%, respectively, compared with 37.2%, 2.3%, 2.3%, and 4.7%, respectively, in CN rootlet-resected necks (n = 43). In CN rootlet-preserved necks, the sub-SCM approach (n = 54) showed 81.5%, 27.8%, 92.6%, and 94.4% preservation rates, respectively, compared with 65.6%, 9.4%, 43.8%, and 71.9%, respectively, using the conventional subplatysmal approach (n = 32). The rates were significantly better in the submandibular, lateral neck, and sub-clavicular areas after sub-SCM approach. CONCLUSIONS Preservation of CN rootlets is a required element for sensory preservation in neck dissection. The sub-SCM approach can effectively prevent early postoperative cutaneous anesthesia following CN-preserving neck dissection.
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Affiliation(s)
- Keigo Honda
- Department of Otolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Ryo Asato
- Department of Otolaryngology – Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Jun Tsuji
- Department of Otolaryngology – Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Masakazu Miyazaki
- Department of Otolaryngology – Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Shinpei Kada
- Department of Otolaryngology – Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Yukiko Kataoka
- Department of Otolaryngology – Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Akiko Taura
- Department of Otolaryngology – Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Mami Morita
- Department of Otolaryngology – Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Kada S, Satinovic M, Booth L, Miller PK. Managing discomfort and developing participation in non-emergency MRI: Children's coping strategies during their first procedure. Radiography (Lond) 2018; 25:10-15. [PMID: 30599823 DOI: 10.1016/j.radi.2018.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 06/22/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Building on existing work, this paper aims to develop a detailed analysis of the practical coping strategies developed by children who had not previously experienced an MRI, regarding a non-emergency examination of the brain. METHODS Semi-structured interviews with 22 children, aged between eight and sixteen years, were conducted immediately post-procedure. Emergent data were thematically analysed in line with the core precepts of Grounded Theory, and triangulated against interview data with their parents where pertinent. RESULTS The primary concern among interviewees related to how they had coped with the discomfort of an unfamiliar medical procedure; this was recurrently managed through a process herein termed Participation Development. This comprised three phases. The first, preparative participation, describes the children's reported attempts to ready themselves for the examination (with parents) ahead of arriving in hospital. The second, enabling participation, describes how the children (with input from parents and radiographers) endeavoured to understand what was to come, and select viable distraction techniques. Finally, sustaining participation describes the children's reports of actualizing their preparations during the examination itself. Where the overall process of participation development was successful, the children reported a sense of mastery, growth and even joy. CONCLUSION While much work in the domain portrays children as relatively 'passive' agents during an MRI procedure, the findings herein point to how they can (with varying degrees of success) actively and constructively work with others. This, it is contended, has direct import for the improvement of support, both prior to and within a procedure itself.
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Affiliation(s)
- S Kada
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Postbox 7030, 5020 Bergen, Norway.
| | - M Satinovic
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Postbox 7030, 5020 Bergen, Norway.
| | - L Booth
- Department of Medical and Sport Sciences, University of Cumbria, Bowerham Road, Lancaster, LA1 3JD, UK.
| | - P K Miller
- Department of Medical and Sport Sciences, University of Cumbria, Bowerham Road, Lancaster, LA1 3JD, UK.
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Takada D, Tsukamoto T, Fuse M, Kada S, Yanagita M. The use of cinacalcet hinders the diagnosis of parathyroid carcinoma in a chronic dialysis patient: a case report. BMC Nephrol 2017; 18:315. [PMID: 29047366 PMCID: PMC5648519 DOI: 10.1186/s12882-017-0733-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 09/28/2017] [Indexed: 12/15/2022] Open
Abstract
Background Secondary hyperparathyroidism (SHPT) is a common complication in patients receiving chronic dialysis therapy. Although cinacalcet can control parathyroid function and bone turnover, preventing ectopic calcification remains challenging. Cinacalcet can also suppress PTH secretion due to parathyroid carcinoma in the same way as it does for parathyroid hyperplasia in the uremic condition. We present a case of parathyroid carcinoma partially controlled by cinacalcet, in which tumorous calcinosis was successfully resolved by total parathyroidectomy. Case presentation A female patient in her forties who had received dialysis for 12 years was referred to our hospital for painful ectopic calcifications on her right hip joint and both knees. Although she had been treated with alfacalcidol and cinacalcet for 2 years, this therapy had been discontinued 6 months earlier as a result of hypercalcemia. The patient exhibited normocalcemia (2.37 mmol/L) and hyperphosphatemia (2.42 mmol/L) with elevated intact parathyroid hormone (707,000 μg/L). Ultrasonography revealed an enlarged parathyroid gland on the left lower side of the thyroid gland. The otolaryngologist surgeons had to perform an en bloc excision to remove this parathyroid gland because of tight adhesions. Histological examination revealed that parathyroid cells had invaded the surrounding skeletal muscle through fibrous capsules, consistent with parathyroid carcinoma. Her joint pain disappeared 2 weeks after parathyroidectomy, and the tumorous calcinosis had largely resolved after 1 year. Conclusions Parathyroid carcinoma is a rare cause of hyperparathyroidism in end-stage kidney disease. Our case indicates that the use of cinacalcet hinders the diagnosis of parathyroid carcinoma in a chronic dialysis patient. When uncontrolled hypercalcemia and/or hyperphosphathemia develop during cinacalcet administration, parathyroidectomy should be considered to prevent a vicious exacerbation of ectopic calcification.
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Affiliation(s)
- Daisuke Takada
- Department of Nephrology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo, Kyoto, Japan. .,Department of Nephrology & Dialysis, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka, Japan.
| | - Tatsuo Tsukamoto
- Department of Nephrology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo, Kyoto, Japan.,Department of Nephrology & Dialysis, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Miho Fuse
- Department of Otorhinolaryngology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shinpei Kada
- Department of Otorhinolaryngology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Motoko Yanagita
- Department of Nephrology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo, Kyoto, Japan
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Booth L, Kada S, Satinovic M, Phillips P, Miller P. Student radiographers' attitudes towards the older patient – A longitudinal study. Radiography (Lond) 2017; 23:229-234. [DOI: 10.1016/j.radi.2017.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 03/22/2017] [Accepted: 03/26/2017] [Indexed: 11/15/2022]
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Honda K, Asato R, Tsuji J, Miyazaki M, Kada S, Tsujimura T, Kataoka M. Oncologic safety of cervical nerve preservation in neck dissection for head and neck cancer. Head Neck 2017; 39:1751-1755. [PMID: 28557102 DOI: 10.1002/hed.24826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 02/12/2017] [Accepted: 04/17/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Although the functional merits of preserving cervical nerves in neck dissection for head and neck cancer have been reported, the oncologic safety has not yet been determined. Therefore, the purpose of this study was to evaluate the safety of cervical nerve preservation. METHODS A retrospective chart review was performed on patients with head and neck cancer who had been treated by neck dissection between 2009 and 2014 at Kyoto Medical Center. Management of cervical nerves and clinical results were analyzed. RESULTS A total of 335 sides of neck dissection had been performed in 222 patients. Cervical nerves were preserved in 175 neck sides and resected in 160 sides. The 5-year overall survival (OS) rate calculated by the Kaplan-Meier method was 71%. The 5-year neck control rate was 95% in cervical nerve preserved sides and 89% in cervical nerve resected sides. CONCLUSION Preserving cervical nerves in neck dissection is oncologically safe in selected cases.
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Affiliation(s)
- Keigo Honda
- Japanese Red Cross Hospital, Wakayama Medical Center, Department of Otolaryngology, Wakayama, Japan
| | - Ryo Asato
- National Hospital Organization, Kyoto Medical Center, Department of Head and Neck Surgery, Otolaryngology, Kyoto, Japan
| | - Jun Tsuji
- National Hospital Organization, Kyoto Medical Center, Department of Head and Neck Surgery, Otolaryngology, Kyoto, Japan
| | - Masakazu Miyazaki
- National Hospital Organization, Kyoto Medical Center, Department of Head and Neck Surgery, Otolaryngology, Kyoto, Japan
| | - Shinpei Kada
- National Hospital Organization, Kyoto Medical Center, Department of Head and Neck Surgery, Otolaryngology, Kyoto, Japan
| | - Takashi Tsujimura
- National Hospital Organization, Kyoto Medical Center, Department of Head and Neck Surgery, Otolaryngology, Kyoto, Japan
| | - Michiko Kataoka
- National Hospital Organization, Kyoto Medical Center, Department of Head and Neck Surgery, Otolaryngology, Kyoto, Japan
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Kada S, Lion S. Superinfection and the coevolution of parasite virulence and host recovery. J Evol Biol 2015; 28:2285-99. [PMID: 26353032 DOI: 10.1111/jeb.12753] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 07/16/2015] [Accepted: 07/18/2015] [Indexed: 12/25/2022]
Abstract
Parasite strategies of host exploitation may be affected by host defence strategies and multiple infections. In particular, within-host competition between multiple parasite strains has been shown to select for higher virulence. However, little is known on how multiple infections could affect the coevolution between host recovery and parasite virulence. Here, we extend a coevolutionary model introduced by van Baalen (Proc. R. Soc. B, 265, 1998, 317) to account for superinfection. When the susceptibility to superinfection is low, we recover van Baalen's results and show that there are two potential evolutionary endpoints: one with avirulent parasites and poorly defended hosts, and another one with high virulence and high recovery. However, when the susceptibility to superinfection is above a threshold, the only possible evolutionary outcome is one with high virulence and high investment into defence. We also show that within-host competition may select for lower host recovery, as a consequence of selection for more virulent strains. We discuss how different parasite and host strategies (superinfection facilitation, competitive exclusion) as well as demographic and environmental parameters, such as host fecundity or various costs of defence, may affect the interplay between multiple infections and host-parasite coevolution. Our model shows the interplay between coevolutionary dynamics and multiple infections may be affected by crucial mechanistic or ecological details.
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Affiliation(s)
- S Kada
- Centre d'Écologie Fonctionnelle et Évolutive - UMR 5175, CNRS - Université de Montpellier - Université Paul-Valéry Montpellier - EPHE, Montpellier Cedex 5, France
| | - S Lion
- Centre d'Écologie Fonctionnelle et Évolutive - UMR 5175, CNRS - Université de Montpellier - Université Paul-Valéry Montpellier - EPHE, Montpellier Cedex 5, France
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Tateya I, Ki Muto M, Kitamura M, Kada S, Morita S, Ito J, Hirano S. Submucosal Dissection for Superficial Pharyngeal Cancer. Otolaryngol Head Neck Surg 2011. [DOI: 10.1177/0194599811415823a155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: We have previously reported that narrow band imaging (NBI) combined with magnifying endoscopy is useful in detecting early superficial pharyngeal cancers, which are difficult to detect with a standard endoscopy. In this study, we investigated the usefulness of submucosal dissection for such superficial lesions of pharyngeal cancer retrospectively. Method: Fifty patients with superficial pharyngeal cancer were treated since September 2007. Under general anesthesia, a curved laryngoscope was inserted trans-orally, the extent of the lesion was determined by the NBI endoscope, and the lesion was dissected with an orally inserted curved electric knife. Results: Tracheostomy was performed in 5 cases, which had synchronous multiple lesions in the hypopharynx. Regarding adverse effects, postoperative bleeding occurred in one case, which needed emergency tracheostomy. With a median follow-up period of 20 months, metachronous multiple laryngo-pharyngeal cancer occurred in 4 cases and recurrence occurred in 2 cases. All the metachronous cancer cases and the recurrent case were controlled with additional endoscopic submucosal dissection. The cause-specific survival rates at 2 years were 100%. All the patients retained their pharynx and their speaking, breathing, and swallowing functions. Conclusion: Endoscopic submucosal dissection for early pharyngeal cancer allows excellent survival and preservation of swallowing and voice functions. Early detection of superficial pharyngeal cancer with narrow band imaging technology and treatment with endoscopic submucosal dissection can be a new treatment strategy for head and neck cancer.
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Kitamura M, Hirano S, Tateya I, Kada S, Ishikawa S, Kanda T, Asato R, Ito J. Ten years single institutional experience of treatment for oral cancer in Kyoto University. Acta Otolaryngol 2010:74-8. [PMID: 20879823 DOI: 10.3109/00016489.2010.490239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS The prognosis of patients was related to the initial stage at diagnosis. These results suggest that early diagnosis and treatment are the most important factors to improve the prognosis in oral cancer patients. Adjuvant treatment is also warranted to improve locoregional control of advanced cases. OBJECTIVES To update the therapeutic outcome of oral cancer. METHODS In all, 129 cases with oral cancer were treated at Kyoto University Hospital during 2000-2008. Surgery with/without irradiation was performed for 34 cases in stage I, 27 in stage II, 15 in stage III, 42 in stage IVa, and 1 case in stage IVb. Brachytherapy was performed for three cases in stage II. Definitive radiotherapy was performed for three cases in stage III and five cases in stage IV. The follow-up period varied from 12 to 96 months (mean 30 months). RESULTS The 5-year cumulative overall and disease-specific survival (DSS) rates were 74.5% and 75.3%. DSS was 86.2% in stage I, 91.6% in stage II, 70.7% in stage III, 60.2% in stage IVa, and 0% in stage IVb. DSS shows worse prognosis with advanced nodal status. Locoregional recurrence occurred in 32 of 129 cases, including local recurrence in 8 cases, nodal recurrence in 18, retropharyngeal node metastasis in 1, and local and nodal recurrence in 5 cases. Salvage operation with/without postoperative radiotherapy was performed for 22 cases with locoregional recurrence and 7 of them have survived.
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Affiliation(s)
- Morimasa Kitamura
- Department of Otolaryngology Head and Neck Surgery, Kyoto University, Kyoto, Japan.
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Abstract
CONCLUSIONS Once-daily radiotherapy for stage I glottic cancer and hyperfractionated radiotherapy for stage II glottic cancer achieved satisfactory results in terms of prognosis and laryngeal preservation. The treatment strategy for stage II glottal cancer with subglottal invasion needs to be reconsidered to further improve the outcome. OBJECTIVES Although early glottic carcinomas are highly curable by radiation therapy, the laryngeal preservation rate is not always sufficient. We reviewed the stage I/II glottal cancer treated in our institute during a recent 15-year period to improve the outcome and prognosis. METHODS In all, 113 cases of stage I/II glottic cancer (81 stage I cases and 32 stage II cases) were treated in Kyoto University hospital from 1994 to 2008. In 81 cases with stage I glottic cancer, radiation was performed for 66 cases, transoral laser excision (TLE) was performed for 14 cases, and hyperfractionated radiotherapy was done for one case. Among 32 cases with stage II glottic cancer, 24 cases were treated with hyperfractionated radiotherapy, 6 cases were treated with radiation, and one case with partial laryngectomy. Total laryngectomy was performed for one patient who suffered mixed connective tissue disease. Kaplan-Meier estimates were used for the analysis of survival rate and laryngeal preservation rate. RESULTS The 5-year overall survival rates were 88.4% in stage I cases and 89.1% in stage II cases. The 5-year disease-specific survival rates were 100% in stage I cases and 93% in stage II cases. The 5-year laryngeal preservation rates were 99% in stage I cases and 90% in stage II cases. Two cases of stage II glottal cancer with subglottal invasion failed to be controlled and the patients died from local recurrence and mediastinum lymph node metastasis, respectively.
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Affiliation(s)
- Ichiro Tateya
- Department of Otolaryngology-Head and Neck Surgery, Kyoto University Hospital, Kyoto, Japan.
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Kada S, Hirano S, Tateya I, Kitamura M, Ishikawa S, Kanda T, Asato R, Tanaka S, Ito J. Ten years single institutional experience of treatment for advanced laryngeal cancer in Kyoto University. Acta Otolaryngol 2010:68-73. [PMID: 20879822 DOI: 10.3109/00016489.2010.492237] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION It is important to suppress lymph node recurrence and distant metastasis to achieve better survival of advanced laryngeal cancer, especially supraglottic cancer. OBJECTIVE The therapeutic outcomes of 33 cases with advanced laryngeal cancer treated at Kyoto University Hospital between 2000 and 2008 were reviewed. METHODS Thirty-one males and two females were involved. Their ages ranged from 49 to 81 years (average 65.6 years). All tumors were squamous cell carcinoma, arising at the glottis in 21 cases and the supraglottis in 12 cases. Most glottic cancers (90.5%) and supraglottic cancers (83.3%) were classified as T3 or T4. Total laryngectomy with neck dissection was performed in the treatment of T3 or T4 cases. Two cases of T2 cancers were treated by radiotherapy (66-72 Gy) with neck dissection, and one case of T2 cancer was treated by radiotherapy (66 Gy). Partial laryngectomy with neck dissection was performed in one T3 case. RESULTS Five-year overall survival rates for stage III of glottic cancer, stage IV of glottic cancer, stage III of supraglottic cancer, and stage IV of supraglottic cancer were 100%, 40.9%, 100%, and 24.2%, respectively. Five-year disease-specific survival rates for stage III of glottic cancer, stage IV of glottic cancer, stage III of supraglottic cancer, and stage IV of supraglottic cancer were 100%, 56.3%, 100%, and 28.1%, respectively. No local recurrence occurred. Regional lymph node recurrence occurred in two cases- one patient with glottic cancer and one with supraglottic cancer. Both of them died of disease despite undergoing chemotherapy. One case initially had lung metastasis, and post-treatment distant metastasis occurred in the lung in four cases, in the skin in one, and in multiple organs in one case.
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Affiliation(s)
- Shinpei Kada
- Department of Otolaryngology-Head & Neck Surgery, Kyoto University, Kyoto, Japan.
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21
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Abstract
CONCLUSION Organ preservation surgery with partial pharyngectomy preserving the larynx is feasible for the treatment of advanced hypopharyngeal cancer with comparable local control and preservation of function. OBJECTIVES To examine the feasibility and therapeutic effects of organ preservation surgery for advanced hypopharyngeal cancer. METHODS Fourteen patients with stage III/IV hypopharyngeal cancer were treated by partial pharyngectomy with or without partial laryngectomy to preserve the larynx. Ten cases were T1/2 primary while four cases had T3/4 tumors. Reconstruction of the pharyngolarynx was completed by primary mucosal suture in six, while free forearm flap was used in eight cases. Induction chemotherapy was administered for six cases including three with T3/4 tumors. RESULTS Five-year overall survival and disease-specific survival rates were 57.1% and 66.7%, respectively. The 5-year locoregional control rate was 66.7% and the larynx preservation rate was 100%. No patients presented with local recurrence at the pharyngolaryngeal segment, while two cases showed nodal recurrence, from which they died. Tracheal stoma was closed in 9 of 14 cases. Vocal function was excellent in five cases, moderate in five, and poor in three. Swallowing function was excellent to moderate in eight cases and poor in six.
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Affiliation(s)
- Shigeru Hirano
- Department of Otolaryngology Head and Neck Surgery, Kyoto University, Kyoto, Japan.
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Abstract
CONCLUSIONS It is suggested that radiotherapy might be the first choice for stage I/II hypopharyngeal cancer, and that adjuvant treatment might be necessary for stage II patients to prevent distant metastasis. OBJECTIVES To update the therapeutic outcome of early hypopharyngeal cancer. METHODS Twenty-eight patients with stage I/II hypopharyngeal cancer (8 in stage I, 20 in stage II) were treated at Kyoto University Hospital between 1995 and 2007. Of 8 cases in stage I, radiotherapy was applied for 4 cases, and surgical treatment for another 4, while 13 of 20 cases in stage II underwent radiotherapy and the remaining 7 cases underwent surgery. RESULTS The 5-year cumulative disease-specific survival and larynx preservation rates were 74.6% and 73.2%, respectively. Recurrent tumors were found in two cases in stage I treated by surgery and in five cases in stage II treated with radiotherapy. Two of five recurrent cases in stage II were rescued by salvage surgery. Distant metastasis to the lung appeared in two cases in stage II after initial treatment.
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Affiliation(s)
- Morimasa Kitamura
- Department of Otolaryngology Head and Neck Surgery, Kyoto University, Kyoto, Japan.
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Hirano S, Tateya I, Kitamura M, Kada S, Ishikawa S, Kanda T, Tanaka S, Ito J. Ten years single institutional experience of treatment for advanced hypopharyngeal cancer in Kyoto University. Acta Otolaryngol 2010:56-61. [PMID: 20879820 DOI: 10.3109/00016489.2010.487495] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Treatment of advanced hypopharyngeal cancer has become more conservative and more multidisciplinary, and the prognosis has been improved. Induction chemotherapy has the potential to extend organ preservation therapy even in cases with locally advanced primary lesion. It is also important to develop a strategy to reduce distant metastasis and to keep track of second primary cancers. OBJECTIVES To update the therapeutic outcome of advanced hypopharyngeal cancer. METHODS A total of 72 cases with stage III/IV hypopharyngeal cancer were treated at Kyoto University Hospital during 2000-2008. Surgery was performed in 56 cases; total pharyngolaryngoesophagectomy (TPLE) in 39 cases and partial pharyngectomy (PPX) preserving the larynx in 17 cases. Radiotherapy (RT) with or without concurrent chemotherapy was applied in 16 cases. Induction chemotherapy (ICT) has been applied for 14 cases since 2006 to achieve organ preservation and reduction of distant metastasis. The follow-up period varied from 12 months to 96 months (mean 32 months). Therapeutic outcomes were chart reviewed. RESULTS Five years cumulative overall and disease-specific survival (DSS) rates were 52.1% and 63.8%, respectively. DSS rates in cases treated with surgery and those with RT were 65.1% and 56.1%, respectively. N2c status showed the worst prognosis according to nodal disease classification. Local control rates for cases treated with TPLE, PPX, and RT were 97.3%, 100%, and 80.4%, respectively. The effective rate of ICT was 79%, and laryngeal preservation was achieved in 79% of the cases with ICT. Recurrence occurred in 20 cases. Approximately half of the recurrence was distant disease. In the end, 17 cases died of the primary disease, while 10 cases died of other causes, mainly second primary cancers.
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Affiliation(s)
- Shigeru Hirano
- Department of Otolaryngology Head and Neck Surgery, Kyoto University, Sakyo-ku, Kyoto, Japan.
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Sekiya T, Matsumoto M, Kojima K, Ono K, Kikkawa YS, Kada S, Ogita H, Horie RT, Viola A, Holley MC, Ito J. Mechanical stress-induced reactive gliosis in the auditory nerve and cochlear nucleus. J Neurosurg 2010; 114:414-25. [PMID: 20367075 DOI: 10.3171/2010.2.jns091817] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Hearing levels following microsurgical treatment gradually deteriorate in a number of patients treated for vestibular schwannoma (VS), especially in the subacute postoperative stage. The cause of this late-onset deterioration of hearing is not completely understood. The aim of this study was to investigate the possibility that reactive gliosis is a contributory factor. METHODS Mechanical damage to nerve tissue is a feature of complex surgical procedures. To explore this aspect of VS treatment, the authors compressed rat auditory nerves with 2 different degrees of injury while monitoring the compound action potentials of the auditory nerve and the auditory brainstem responses. In this experimental model, the axons of the auditory nerve were quantitatively and highly selectively damaged in the cerebellopontine angle without permanent compromise of the blood supply to the cochlea. The temporal bones were processed for immunohistochemical analysis at 1 week and at 8 weeks after compression. RESULTS Reactive gliosis was induced not only in the auditory nerve but also in the cochlear nucleus following mechanical trauma in which the general shape of the auditory brainstem response was maintained. There was a substantial outgrowth of astrocytic processes from the transitional zone into the peripheral portion of the auditory nerve, leading to an invasion of dense gliotic tissue in the auditory nerve. The elongated astrocytic processes ran in parallel with the residual auditory neurons and entered much further into the cochlea. Confocal images disclosed fragments of neurons scattered in the gliotic tissue. In the cochlear nucleus, hypertrophic astrocytic processes were abundant around the soma of the neurons. The transverse diameter of the auditory nerve at and proximal to the compression site was considerably reduced, indicating atrophy, especially in rats in which the auditory nerve was profoundly compressed. CONCLUSIONS The authors found for the first time that mechanical stress to the auditory nerve causes substantial reactive gliosis in both the peripheral and central auditory pathways within 1-8 weeks. Progressive reactive gliosis following surgical stress may cause dysfunction in the auditory pathways and may be a primary cause of progressive hearing loss following microsurgical treatment for VS.
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Affiliation(s)
- Tetsuji Sekiya
- Department of Otolaryngology, Head and Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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Okano T, Nakagawa T, Kita T, Kada S, Yoshimoto M, Nakahata T, Ito J. Bone marrow-derived cells expressing Iba1 are constitutively present as resident tissue macrophages in the mouse cochlea. J Neurosci Res 2008; 86:1758-67. [PMID: 18253944 DOI: 10.1002/jnr.21625] [Citation(s) in RCA: 107] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Immune-mediated inner ear disorder has been well established as a clinical entity; however, the innate immune system of the inner ear is a poorly understood area of research with high clinical and immunological importance. Although the presence of resident tissue macrophages in the inner ear has been suggested, there has been some controversy. In this study, we analyzed the origin of cochlear resident macrophages and the contribution of hematopoietic bone marrow (BM) to the recruitment of macrophages in the cochlea. To visualize the localization of BM-derived cells, BM chimeric mice were made by transplantation of hematopoietic stem cells, which were genetically labeled with enhanced green fluorescent protein, into lethally irradiated C57BL/6 mice. The distribution and characteristics of BM-derived cells in the mouse cochlea were studied immunohistochemically. We successfully identified the constitutive presence of tissue resident macrophages in the spiral ligament and spiral ganglion that are derived from BM in larger numbers than previously reported. Moreover, cochlear resident macrophages gradually turn over for several months during steady-state replacement by BM-derived cells, and the number of cochlear macrophages immediately increased in response to local surgical stress. The present findings demonstrate the hematopoietic origin of cochlear resident and infiltrating macrophages. Our study provides a novel anatomical and immunological basis for the inner ear and indicates that the cochlear resident macrophages would be a therapeutic target in inner ear disorders.
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Affiliation(s)
- Takayuki Okano
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Kimata-Ariga Y, Matsumura T, Kada S, Fujimoto H, Fujita Y, Endo T, Mano J, Sato F, Hase T. Differential electron flow around photosystem I by two C(4)-photosynthetic-cell-specific ferredoxins. EMBO J 2000; 19:5041-50. [PMID: 11013207 PMCID: PMC302093 DOI: 10.1038/sj.emboj.7593319] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2000] [Revised: 07/06/2000] [Accepted: 08/03/2000] [Indexed: 11/09/2022] Open
Abstract
In the C(4) plant maize (Zea mays L.), two ferredoxin isoproteins, Fd I and Fd II, are expressed specifically in mesophyll and bundle-sheath cells, respectively. cDNAs for these ferredoxins were introduced separately into the cyanobacterium Plectonema boryanum with a disrupted endogenous ferredoxin gene, yielding TM202 and KM2-9 strains expressing Fd I and Fd II. The growth of TM202 was retarded under high light (130 micromol/m(2)/s), whereas KM2-9 grew at a normal rate but exhibited a nitrogen-deficient phenotype. Measurement of photosynthetic O(2) evolution revealed that the reducing power was not efficiently partitioned into nitrogen assimilation in KM2-9. After starvation of the cells in darkness, the P700 oxidation level under far-red illumination increased significantly in TM202. However, it remained low in KM2-9, indicating an active cyclic electron flow. In accordance with this, the cellular ratio of ATP/ADP increased and that of NADPH/NADP(+) decreased in KM2-9 as compared with TM202. These results demonstrated that the two cell type-specific ferredoxins differentially modulate electron flow around photosystem I.
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Affiliation(s)
- Y Kimata-Ariga
- Division of Enzymology, Institute for Protein Research, Osaka University, 3-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Uesato S, Tokunaga T, Mizuno Y, Fujioka H, Kada S, Kuwajima H. Absolute stereochemistry of gastric antisecretory compound P371A1 and its congener P371A2 from streptomyces species P371. J Nat Prod 2000; 63:787-792. [PMID: 10869202 DOI: 10.1021/np990533p] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Absolute configurations of the gastric antisecretory compound P371A1 (1) and its congener P371A2 (2) from Streptomyces sp. P371 were determined on the basis of identification of the methyl glycosides 9, 10, and 11 obtained by the acid degradation of 1 and 2, as well as application of the modified Mosher method to the P371A2 C-glycoside MTPA esters 7 and 8 and observation of the excitation chiralities in the P371A2 C-glycoside benzoate derivatives 5 and 6.
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Affiliation(s)
- S Uesato
- Department of Biotechnology, Faculty of Engineering, Kansai University, Suita, Osaka 564-8680, Japan.
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