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Steinfort DP, Kothari G, Wallace N, Hardcastle N, Rangamuwa K, Dieleman EMT, Lee P, Li P, Simpson JA, Yo S, Bashirdazeh F, Nguyen P, Jennings BR, Fielding D, Crombag L, Irving LB, Yasufuku K, Annema JT, Ost DE, Siva S. Systematic endoscopic staging of mediastinum to guide radiotherapy planning in patients with locally advanced non-small-cell lung cancer (SEISMIC): an international, multicentre, single-arm, clinical trial. Lancet Respir Med 2024:S2213-2600(24)00010-9. [PMID: 38490228 DOI: 10.1016/s2213-2600(24)00010-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/22/2023] [Accepted: 01/16/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Systematic mediastinal lymph node staging by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) improves accuracy of staging in patients with early-stage non-small-cell lung cancer (NSCLC). However, patients with locally advanced NSCLC commonly undergo only selective lymph node sampling. This study aimed to determine the proportion of patients with locally advanced NSCLC in whom systematic endoscopic mediastinal staging identified PET-occult lymph node metastases, and to describe the consequences of PET-occult disease on radiotherapy planning. METHODS This prospective, international, multicentre, single-arm, international study was conducted at seven tertiary lung cancer centres in four countries (Australia, Canada, the Netherlands, and the USA). Patients aged 18 years or older with suspected or known locally advanced NSCLC underwent systematic endoscopic mediastinal lymph node staging before combination chemoradiotherapy or high-dose palliative radiotherapy. The primary endpoint was the proportion of participants with PET-occult mediastinal lymph node metastases shown following systematic endoscopic staging. The study was prospectively registered with Australian New Zealand Clinical Trials Registry, ACTRN12617000333314. FINDINGS From Jan 30, 2018, to March 23, 2022, 155 patients underwent systematic endoscopic mediastinal lymph node staging and were eligible for analysis. 58 (37%) of patients were female and 97 (63%) were male. Discrepancy in extent of mediastinal disease identified by PET and EBUS-TBNA was observed in 57 (37% [95% CI 29-44]) patients. PET-occult lymph node metastases were identified in 18 (12% [7-17]) participants, including 16 (13% [7-19]) of 123 participants with clinical stage IIIA or cN2 NSCLC. Contralateral PET-occult N3 disease was identified in nine (7% [2-12]) of 128 participants staged cN0, cN1, or cN2. Identification of PET-occult disease resulted in clinically significant changes to treatment in all 18 patients. In silico dosimetry studies showed the median volume of PET-occult lymph nodes receiving the prescription dose of 60 Gy was only 10·1% (IQR 0·1-52·3). No serious adverse events following endoscopic staging were reported. INTERPRETATION Our findings suggests that systematic endoscopic mediastinal staging in patients with locally advanced or unresectable NSCLC is more accurate than PET alone in defining extent of mediastinal involvement. Standard guideline-recommended PET-based radiotherapy planning results in suboptimal tumour coverage. Our findings indicate that systematic endoscopic staging should be routinely performed in patients with locally advanced NSCLC being considered for radiotherapy to accurately inform radiation planning and treatment decision making in patients with locally advanced NSCLC. FUNDING None.
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Affiliation(s)
- Daniel P Steinfort
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia; Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
| | - Gargi Kothari
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia; Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Neil Wallace
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia; Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Nicholas Hardcastle
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia; Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
| | - Kanishka Rangamuwa
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia; Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Edith M T Dieleman
- Department of Radiation Oncology, Amsterdam UMC location AMC, Amsterdam, Netherlands
| | - Percy Lee
- Department of Radiation Oncology, City of Hope National Medical Center, Los Angeles, CA, USA
| | - Peixuan Li
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Julie A Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Shaun Yo
- Department of Lung and Sleep, Monash Health, Melbourne, VIC, Australia
| | - Farzad Bashirdazeh
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Phan Nguyen
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Barton R Jennings
- Department of Lung and Sleep, Monash Health, Melbourne, VIC, Australia
| | - David Fielding
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Laurence Crombag
- Department of Pulmonology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
| | - Louis B Irving
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia; Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Kazuhiro Yasufuku
- Division of Thoracic Surgery, Toronto General Hospital, Toronto, ON, Canada
| | - Jouke T Annema
- Department of Pulmonology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
| | - David E Ost
- Department of Pulmonary Medicine, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA
| | - Shankar Siva
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia; Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
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Siva S, Wallace N, Hardcastle N, Kothari G, Crombag L, Rangamuwa K, Annema J, Lee P, Dieleman EM, Jennings B, Yo S, Nguyen P, Bashirzadeh F, Fielding D, Yasufuku K, Ost D, Irving L, Steinfort D. Dosimetric Impact of Systematic Mediastinal Staging via Endobronchial Ultrasound for Patients with Locally Advanced Lung Cancer: The SEISMIC Trial. Int J Radiat Oncol Biol Phys 2023; 117:S29. [PMID: 37784468 DOI: 10.1016/j.ijrobp.2023.06.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The SEISMIC trial aims to find the best method for mediastinal staging in patients with lung cancer receiving chemoradiotherapy. Currently, CT or PET-CT scans are standard in clinical practice, but histological evaluation of the mediastinum is performed on a case-by-case basis. The study will examine the effect of systematic histological evaluation using Endobronchial Ultrasound (EBUS) on radiotherapy target volumes. The hypothesis of this study is that differences in staging between the diagnostic PET-CT and EBUS would result in reduced tumor coverage and/or increased doses to organs at risk (OAR). MATERIALS/METHODS SEISMIC is a prospective multicenter international cohort study. Patients were enrolled from Australia, the Netherlands, USA and Canada after regional IRB approvals. Patients were treated with 4DCT simulation. Two iGTV and PTV target volumes were delineated for each patient with discordant staging according to both PET-CT and EBUS, as were OARs. Two VMAT plans were generated for each patient based on either PET-CT or EBUS target volumes using knowledge-based planning methodology. Plans aimed to achieve institutional guidelines for target coverage and OAR dose constraints, with a prescribed dose of 60 Gy in 30 fractions. Target coverage and OAR doses for the PET- and EBUS-defined volumes were compared. RESULTS In 156 patients, EBUS showed a larger extent of disease than PET in 18 (11.5%) and a smaller extent of lymph node (LN) involvement than PET in 49 (31.4%). Out of 67 patients with PET-EBUS discordant results, 25 underwent upfront radiotherapy and were included in the study. EBUS revealed PET-occult LN involvement in 11/25 patients (44%). In these patients, 10/11 patients received <95% of the prescribed dose to PET-occult LN iGTVs; the median [range] minimum dose to the EBUS iGTV was 9.2 Gy [0.1 - 57.9 Gy]. When planning based on EBUS LN involvement, all patients received ≥95% of the prescribed dose to the iGTV (the median [range] minimum dose to the EBUS iGTV was 58.9 Gy [58.1 - 60.5 Gy]). This resulted in increased median [range] doses to OARs; mean lung dose increased by 1.1 Gy [0.3 - 8.4 Gy], esophagus mean dose increased by 3.6 Gy [0.2 - 24.8 Gy], and mean heart dose increased by 0.5 Gy [-0.6 - 8.5 Gy]. CONCLUSION Systematic endoscopic evaluation of the mediastinum had a significant effect on tumor coverage in a clinically meaningful proportion of cases and consequent plan adaptation impacted on organ-at-risk (OAR) doses. Results suggest systematic mediastinal LN staging should be considered in all patients prior to curative-intent radiotherapy. CLINICAL TRIAL ID ACTRN12617000333314.
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Affiliation(s)
- S Siva
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - N Wallace
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - N Hardcastle
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - G Kothari
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - L Crombag
- Department of Pulmonology, Amsterdam UMC, Amsterdam, Netherlands
| | - K Rangamuwa
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - J Annema
- Department of Pulmonology, Amsterdam UMC, Amsterdam, Netherlands
| | - P Lee
- MD Anderson Cancer Center, The University of Texas, Houston, TX
| | - E M Dieleman
- Department of Radiation Oncology, Amsterdam UMC, Amsterdam, Netherlands
| | - B Jennings
- Department of Lung and Sleep, Monash Health, Melbourne, VIC, Australia
| | - S Yo
- Department of Lung and Sleep, Monash Health, Melbourne, VIC, Australia
| | - P Nguyen
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, VIC, Australia
| | - F Bashirzadeh
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - D Fielding
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Brisbane, VIC, Australia
| | - K Yasufuku
- Division of Thoracic Surgery, Toronto General Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - D Ost
- MD Anderson Cancer Center, The University of Texas, Houston, TX
| | - L Irving
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - D Steinfort
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia
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Yo S, Granton J. 13 Pulmonary Hypertension in Pregnancy. Obstet Med 2022. [DOI: 10.1515/9783110615258-013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Pulmonary arterial hypertension is associated with tyrosine kinase inhibitors used in the
treatment of chronic myeloid leukemia. Dasatinib is a known cause of drug-induced
pulmonary arterial hypertension. There have been case reports linking Bosutinib with
deterioration of pre-existing pulmonary arterial hypertension. Here, we present a case of
a 37-year-old woman with chronic myeloid leukemia treated with Bosutinib who was diagnosed
with pulmonary arterial hypertension. Prior to Bosutinib, she had received Dasatinib
without documented cardiopulmonary toxicity. Withdrawal of Bosutinib led to partial
reversal of pulmonary arterial hypertension, and with the addition of pulmonary arterial
hypertension-targeted treatment, there was near normalization of hemodynamics.
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Affiliation(s)
- Shaun Yo
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - John Thenganatt
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jeffrey Lipton
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - John Granton
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Heffernan A, Malik U, Cheng R, Yo S, Narang I, Ryan CM. Transition to Adult Care for Obstructive Sleep Apnea. J Clin Med 2019; 8:jcm8122120. [PMID: 31810317 PMCID: PMC6947540 DOI: 10.3390/jcm8122120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 11/01/2019] [Revised: 11/26/2019] [Accepted: 11/26/2019] [Indexed: 01/10/2023] Open
Abstract
Obstructive sleep apnea may occur throughout the lifespan, with peak occurrences in early childhood and during middle and older age. Onset in childhood is overwhelmingly due to adeno-tonsillar hypertrophy, while in adulthood, contributors include risk factors, such as obesity, male sex, and aging. More recently, there has been a precipitous increase in the prevalence of obstructive sleep apnea in youth. Drivers of this phenomenon include both increasing obesity and the survival of children with complex medical conditions into adulthood. Appropriate treatment and long-term management of obstructive sleep apnea is critical to ensure that these youth maintain well-being unfettered by secondary comorbidities. To this end, patient engagement and seamless transition of care from pediatric to adult health care systems is of paramount importance. To date, this is an unacknowledged and unmet need in most sleep programs. This article highlights the need for guideline-driven sleep disorder transition processes and illustrates the authors’ experience with the development of a program for sleep apnea.
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Affiliation(s)
- Austin Heffernan
- Sleep Research Laboratory, Toronto Rehabilitation Institute, University Health Network, Toronto, ON M5G2A2, Canada; (A.H.); (U.M.); (R.C.)
| | - Uzair Malik
- Sleep Research Laboratory, Toronto Rehabilitation Institute, University Health Network, Toronto, ON M5G2A2, Canada; (A.H.); (U.M.); (R.C.)
| | - Russell Cheng
- Sleep Research Laboratory, Toronto Rehabilitation Institute, University Health Network, Toronto, ON M5G2A2, Canada; (A.H.); (U.M.); (R.C.)
| | - Shaun Yo
- Sleep Research Laboratory, Toronto Rehabilitation Institute, University Health Network, Toronto, ON M5G2A2, Canada; (A.H.); (U.M.); (R.C.)
| | - Indra Narang
- Department of Pediatrics, Division of Respirology, University of Toronto, Toronto, ON M5G1X8, Canada;
- Sleep Laboratory, Hospital for Sick Children, Toronto, ON M5G1X8, Canada
| | - Clodagh M. Ryan
- Sleep Research Laboratory, Toronto Rehabilitation Institute, University Health Network, Toronto, ON M5G2A2, Canada; (A.H.); (U.M.); (R.C.)
- Department of Medicine, Division of Respirology, University of Toronto, Toronto, ON M5G2N2, Canada
- Correspondence:
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Yo S, Wimaleswaran H, Deshpande S, Cheung T, Buzacott H, Serraglio C, Wong AM, Landry S, Thomson L, Edwards B, Mansfield D, Joosten S, Hamilton G. Sleeping position during unattended home polysomnography compared to habitual sleeping position and the potential impact on measured sleep apnea severity. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Yo S, Fuller L, Martin C, Naughton M, Snell G, Dabscheck E. Prevalence and Associations of Insomnia in Lung Transplant Recipients: A Cross-Sectional Study. Chest 2017. [DOI: 10.1016/j.chest.2017.08.1142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Patel H, Yo S, Nanayakkara S, Selkrig L, Kaye D, Mariani J, Naughton M. Chronotropic Incompetence in Patients with Cardiac Rhythm Devices Undergoing Evaluation for Cardiac Transplantation. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nishio J, Iwasaki H, Ishiguro M, Ohjimi Y, Yo S, Isayama T, Naito M, Kikuchi M. Supernumerary ring chromosome in a Bednar tumor (pigmented dermatofibrosarcoma protuberans) is composed of interspersed sequences from chromosomes 17 and 22: a fluorescence in situ hybridization and comparative genomic hybridization analysis. Genes Chromosomes Cancer 2001; 30:305-9. [PMID: 11170290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Cytogenetic analysis of Bednar tumor (pigmented dermatofibrosarcoma protuberans) has not been reported previously. Here, we report the identification of a supernumerary ring chromosome in a Bednar tumor by chromosome painting with fluorescence in situ hybridization (FISH) and comparative genomic hybridization (CGH). Chromosome painting with FISH demonstrated that the supernumerary ring chromosome was composed of discontinuous, interwoven sequences from chromosomes 17 and 22. Amplification of chromosomes 17 and 22 sequences was confirmed by CGH. These results indicate that Bednar tumor and dermatofibrosarcoma protuberans are characterized by the same chromosomal features. To our knowledge, this is the first report that the ring chromosome in Bednar tumor is composed of amplified material from chromosomes 17 and 22.
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Affiliation(s)
- J Nishio
- Department of Pathology, School of Medicine, Fukuoka University, Japan
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Affiliation(s)
- K Okubo
- National Tokyo Medical Center, Department of Cardiology, Japan
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Sakai Y, Miyasaka Y, Yo S, Nagayama K, Fukasaku T, Kusano F, Sakuma I, Maekawa N, Sazaki N, Tazawa J. [New combination therapy with FTM [5-FU, pirarubicin (THP) and MMC] for treatment of inoperable advanced gastric cancer]. Gan To Kagaku Ryoho 1997; 24:2233-8. [PMID: 9422067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Clinical usefulness of a new combination FTM therapy consisting of 5-FU, Pirarubicin (THP) and MMC for the treatment of advanced gastric cancers was investigated. 5-FU, THP or MMC was administered at a dose of 600 mg/m2 on day 1, 8, 22 and 29, 30 mg/m2 on days 1 and 22, and 10 mg/m2 on day one only of each course, respectively. Eighteen patients with inoperable advanced gastric cancer were treated with FTM. All drugs were investigated by intravenously by one shot. The tumor response rate was 50% [9 of 18 showed PR]. The survival rate was higher in responders than in nonresponders (18.1% vs 11.1%) (p < 0.05). Side effects in the gastrointestinal tract were minimal. Cardiotoxicity and nephrotoxicity were not detected, but myelosuppression was prominent in most cases. G-CSF was given in sixteen patients (88%), and platelet transfusion was performed in two patients (11%). New combination FTM therapy is an effective treatment regimen even for advanced inoperable gastric cancer.
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Affiliation(s)
- Y Sakai
- Dept. of Internal Medicine, Tsuchiura Kyodo General Hospital
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Shirakusa T, Tsutsui M, Araki Y, Motonaga R, Yoshimine K, Takada S, Kondo K, Yo S. [Anterior rib strut grafting in the treatment of a malignant lesion of the thoracic spine under thoracotomy]. Kyobu Geka 1988; 41:1040-5. [PMID: 3221581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Yo S. [The status of nurse-practitioners in the United States]. Kango Tenbo 1988; 13:1451-4. [PMID: 3230950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Takafuji S, Inokuma S, Seino Y, Yo S, Kudo S, Tanaka A. [Allergic granulomatosis and angitis: report on a case who died in a fulminant course]. Arerugi 1987; 36:879-85. [PMID: 2893599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Shiramizu M, Yo S, Hirai H, Hatase T, Yano S, Tsunawaki A, Yakushiji M, Kato T. [Studies on the management of CIN accompanied by infertility]. Nihon Sanka Fujinka Gakkai Zasshi 1985; 37:1064-70. [PMID: 4031565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We performed cytological examinations on 863 of the 969 patients (89.3%). In the final diagnosis, 4 patients had carcinoma in situ (0.5%) and 1 patient had microinvasive carcinoma (0.1%). Therefore, it is important to perform cytological examinations on infertility out-patient s, and conduct routine cytological examinations when infertility treatment is being continued over long periods. The detection rate for the 18 patients who required detailed examination did not differ between primary and secondary infertility, or with the period of infertility or the factor causing infertility. The follow up after conization should be done carefully, and the patient should be encouraged to become pregnant as early as possible. Unlike fertile women, in infertile women, conization should be performed, even in the case of carcinoma in situ, provided: There is a specialist well-experienced in cytology, colposcopy, and histology; the patient and family are fully satisfied with the physician's explanation; the physician can maintain good contact with the patient and family and continue to provide adequate follow up treatment, and the lesion is in the ectocervix, and the whole lesion can be removed by conization without leaving intact foci.
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Abstract
A case of juvenile xanthogranuloma in the hand is reported. The lesion was atypical clinically, being sited in the hand and the tumour was so large that it extended from the palmar to the dorsal surface. Curettage was performed at seven weeks after birth and histological examination established a diagnosis of juvenile xanthogranuloma. The post-operative course was uneventful, and the residual lesion had disappeared spontaneously four years after operation.
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Abe J, Sugita A, Hamasaki M, Nakamura K, Iwanaga S, Nagae K, Atsuji K, Tsunawaki A, Abe T, Matsumoto T, Yo S, Murakami M. Scanning electron microscopic observations of the myoepithelial cells of normal and contracting status in the rat harderian gland. Kurume Med J 1981; 28:103-112. [PMID: 7329029 DOI: 10.2739/kurumemedj.28.103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Abstract
During the past 27 years from 1944 to 1970 splenectomy was performed on 53 patients including 33 idiopathic thrombocytopenic purpura (ITP), 13 hereditary spherocytosis and 7 hypoplastic anemia. Their clinical and laboratory findings in immediate and late postoperative periods were compared with those received medical treatment alone. In the chronic form of ITP the effect of medical treatment alone is only transitory and not curative. Splenectomy seems to be the treatment of choice in this situation which produces long term favorable results regardless of patient's response to preoperative steroid treatment. In hereditary spherocytosis the improvement in the morphology of red blood cells was limited after splenectomy, but considerable improvement was achieved in hemolytic tendency. Therefore, splenectomy would be the first choice. In hypoplastic anema splenectomy did not produce, in general, favorable results as compared in ITP or hereditary spherocytosis. However, when the patient responded to steroid treatment preoperatively, splenectomy could have reduced the frequency and amount of blood transfusion. Splenectomy would then be contemplated in such situations.
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Koie H, Tsushimi K, Tatimichi K, Sugitani A, Yo S. Surgery for acquired mitral valve disease. I. Long-term result. Nihon Geka Hokan 1969; 38:638-45. [PMID: 5388328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Yo S, Kinoshita K, Sugitani A, Muranaka H, Itani S. [Case of multiple jejunal leiomyomatosis and reported cases of leiomyomatosis of the digestive tracts in Japan]. Naika 1969; 23:972-8. [PMID: 4980024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Yo S, Yamane M, Ishigami K. Carcinoma associated with anal fistula. Nihon Geka Hokan 1968; 37:902-905. [PMID: 5751731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Yo S, Glaviano VV. [Circulatory response to bilateral common carotid artery occlusion in hemorrhagic shock]. Jpn Circ J 1966; 30:907-13. [PMID: 6012861 DOI: 10.1253/jcj.30.907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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