2021/06/24 更新

写真a

ショウドウ リュウスケ
正道 隆介
SHODO Ryusuke
所属
医歯学総合病院 耳鼻咽喉・頭頸部外科 助教
職名
助教
外部リンク

学位

  • 博士(医学) ( 2017年9月   新潟大学 )

経歴

  • 新潟大学   医歯学総合病院 耳鼻咽喉・頭頸部外科   助教

    2020年4月 - 現在

 

論文

  • Comparison of Autofluorescence With Near-Infrared Fluorescence Imaging Between Primary and Secondary Hyperparathyroidism. 国際誌

    Mika Takeuchi, Takeshi Takahashi, Ryusuke Shodo, Hisayuki Ota, Yushi Ueki, Keisuke Yamazaki, Arata Horii

    The Laryngoscope131 ( 6 ) E2097-E2104   2021年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: To examine the role of autofluorescence (AF) monitoring with near-infrared fluorescence imaging (NIFI) in identifying parathyroid lesions in primary or secondary hyperparathyroidism (P-HPT or S-HPT) surgeries. STUDY DESIGN: Prospective study. METHODS: Twelve lesions each were resected from 12 and 3 patients with P-HPT and S-HPT, respectively. The mean and maximum AF intensities of the lesions normalized to that of the thyroid tissue for in situ and ex vivo preparations were compared between P-HPT and S-HPT. Subjective visual classifications of AF intensity were compared with postoperative quantitative assessments. The unevenness of AF distribution inside the lesions was assessed by determining the ratio of maximum to mean AF intensity and comparing them with the corresponding ratio for normal parathyroid glands (PGs). RESULTS: In all quantitative comparisons (in situ/ex vivo, mean, and maximum AF), AF intensities of P-HPT were stronger than those of S-PHT. The AF-positive rate in in situ subjective visual classification was higher for P-HPT (100% vs. 33%). Subjective visual classifications showed a positive correlation with AF intensities. The ratio of maximum to mean AF was higher in P-HPT and S-HPT than in normal PGs. CONCLUSIONS: For P-HPT, AF intensity in both in situ and ex vivo preparations was sufficiently high and correlated with the subjective visual classification, suggesting that NIFI may be useful for confirming P-HPT lesions. In contrast, NIFI may have only a minor role in S-HPT surgeries owing to the weak-AF of S-HPT lesions. HPT lesions show an uneven AF intensity distribution compared with normal PGs. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E2097-E2104, 2021.

    DOI: 10.1002/lary.29310

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  • Near-Infrared Fluorescence Imaging in the Identification of Parathyroid Glands in Thyroidectomy. 国際誌

    Takeshi Takahashi, Keisuke Yamazaki, Hisayuki Ota, Ryusuke Shodo, Yushi Ueki, Arata Horii

    The Laryngoscope131 ( 5 ) 1188 - 1193   2021年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES/HYPOTHESIS: To assess the ability of near-infrared fluorescence imaging (NIFI) to identify parathyroid glands (PGs) among histologically proven PG/non-PG specimens compared with a surgeon's visual acumen, and to determine NIFI sensitivity in detecting incidentally resected PGs from thyroidectomy specimens, compared to the surgeon's visual inspection. STUDY DESIGN: Prospective study. METHODS: With mean age of 61 years, 36 patients with various thyroid diseases were enrolled. Possible PGs (n = 28) and lymph nodes (n = 32) were identified by the experienced surgeon's visual inspection. Using NIFI, 15 PGs were further identified from thyroidectomy specimens. For these 75 specimens, the surgeon's judgments (PG vs. non-PG) were recorded. Histological evaluation was performed after examining the NIFI auto-fluorescence of each specimen. RESULTS: There were no significant differences in sensitivity, specificity, positive predictive value, and negative predictive value between the surgeon's visual inspection and NIFI in identifying PGs, with values of 100%/97.1%, 85.0%/87.5%, 85.4%/87.2%, and 100%/97.2%, respectively. The sensitivity of NIFI (82.9%) for detection of PGs from thyroidectomy specimens was significantly higher than that of the surgeon's visual inspection (61.0%). False negative specimens contained bleeding/congestion and/or encapsulation by thick tissues, whereas false positive specimens contained electrocoagulated tissues. CONCLUSIONS: NIFI showed results comparable to the experienced surgeon's visual inspection in identifying PGs. This could benefit novice surgeons. NIFI may be useful for experienced surgeons to locate incidentally resected PGs within thyroidectomy specimens for auto-transplantation. Prevention of intra-gland bleeding and congestion, careful removal of thick capsules, and bloodless surgeries without electrocoagulation are important for reducing false positive and false negative results. Laryngoscope, 131:1188-1193, 2021.

    DOI: 10.1002/lary.29163

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  • In Response to Regarding Near-Infrared Fluorescence Imaging in the Identification of Parathyroid Glands in Thyroidectomy. 国際誌

    Takeshi Takahashi, Keisuke Yamazaki, Hisayuki Ota, Ryusuke Shodo, Yushi Ueki, Arata Horii

    The Laryngoscope131 ( 5 ) E1749   2021年5月

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    記述言語:英語  

    DOI: 10.1002/lary.29425

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  • 末梢挿入型中心静脈カテーテル先端位置・合併症の左右差比較

    高橋 優人, 正道 隆介, 高橋 剛史, 植木 雄志, 山崎 恵介, 堀井 新

    日本耳鼻咽喉科学会会報124 ( 2 ) 122 - 127   2021年2月

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

    末梢挿入型中心静脈カテーテル(peripherally inserted central catheter、PICC)は安全性が高く頭頸部癌の薬物療法でも用いられるが、留置側の左右差に着目した報告は少ない。PICC留置後の先端位置移動と合併症発生率の左右差について検討した。PICC留置を行った頭頸部癌145例172件を対象とし後方視的な調査を行った。留置側は右36件、左136件で、留置期間中央値は65日であった。121例137件でX線による留置時・留置後の先端位置評価が可能であった。先端位置をZone A:上大静脈下半分と右心房上部、Zone B:上大静脈上半分と左腕頭静脈合流部、Zone C:左腕頭静脈に分類し、Zone A・Bを適正位置とした。右側では留置時33件(100%)、留置後30件(91%)が適正位置であったのに対し、左側では留置時97件(93%)、留置後82件(79%)が適正位置で、留置時と留置後では有意な変化を認めた(p=0.001)。そのほかの合併症発生率に左右差は認めなかった。左側からのPICC留置では上大静脈右側壁にカテーテル先端が当たり、Zone Aへの留置率が低い。さらに留置後の体位・肢位の変化により先端が移動し、適正位置であるZone A・Bに留まりにくい。不適正な先端位置は遅発性の上大静脈壁損傷や血栓症を招くため、右側からのPICC留置が望ましいと考えられた。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01099&link_issn=&doc_id=20210226330006&doc_link_id=10.3950%2Fjibiinkoka.124.122&url=https%3A%2F%2Fdoi.org%2F10.3950%2Fjibiinkoka.124.122&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • 近赤外線装置を用いた副甲状腺の自家蛍光観察pde-neoとFLUOBEAM800の比較

    高橋 剛史, 山崎 恵介, 竹内 美香, 正道 隆介, 太田 久幸, 植木 雄志, 堀井 新

    頭頸部外科30 ( 3 ) 277 - 283   2021年2月

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    記述言語:日本語   出版者・発行元:(NPO)日本頭頸部外科学会  

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  • Role of programmed death-ligand 1 in predicting the treatment outcome of salvage chemotherapy after nivolumab in recurrent/metastatic head and neck squamous cell carcinoma. 国際誌

    Yushi Ueki, Takeshi Takahashi, Hisayuki Ota, Ryusuke Shodo, Keisuke Yamazaki, Arata Horii

    Head & neck42 ( 11 ) 3275 - 3281   2020年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: It was reported that treatment outcomes of the salvage chemotherapy (SCT) following nivolumab are fairly good compared with those of nivolumab itself. However, predictive factors of SCT for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) were not determined. METHODS: Twenty-one R/M HNSCC patients received SCT following nivolumab. The treatment outcome and predictive factors for the favorable response to SCT were investigated. RESULTS: The objective response rate (ORR) and the disease control rate of SCT were 52.4% and 81.0%, respectively. The median progression-free survival and the median overall survival time were 5.4 and 12.9 months, respectively. Patients with positive programmed death-ligand 1 (PD-L1) expression showed greater tumor shrinkage evaluated by the response evaluation criteria in solid tumors and higher ORR than those with negative PD-L1 expression. CONCLUSIONS: Treatment outcome of SCT following nivolumab in R/M HNSCC was favorable. PD-L1 expression may be a predictive factor of SCT.

    DOI: 10.1002/hed.26374

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  • Carotid blowout-a rare but fatal complication of endoscopic submucosal dissection of superficial hypopharyngeal carcinoma after radiotherapy. 国際誌

    Ryuichi Okabe, Yushi Ueki, Takeshi Takahashi, Ryusuke Shodo, Keisuke Yamazaki, Satoru Hashimoto, Arata Horii

    Auris, nasus, larynx   2020年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Endoscopic submucosal dissection (ESD) has gained wide acceptance as a minimally invasive and curative surgery for superficial head and neck carcinoma. However, the safety of ESD for superficial pharyngeal carcinoma after radiotherapy has not been elucidated. Superficial hypopharyngeal carcinoma of the left pyriform sinus developed in a 76-year-old man who had undergone concurrent chemoradiotherapy for T2N2bM0 pyriform sinus carcinoma on the opposite side 12 months before. He underwent ESD without complications. Because tumor invasion into the muscular layer was a concern, the muscular layer was partially resected with the tumor. Twelve days after discharge, he presented with a sore throat and difficulty in swallowing. Endoscopy and computed tomography revealed necrosis due to wound infection with abscess formation around the left carotid artery. The common carotid artery subsequently ruptured. Although the surgical intervention was performed, he passed away 46 days after ESD due to carotid blowout. ESD is a minimally invasive treatment for superficial head and neck carcinoma, but carotid blowout can occur in cases after radiation. Prior radiotherapy and deeper dissection into the muscular layer may hamper wound epithelization, resulting in infection-induced necrosis and carotid blowout. Diligent monitoring of wound healing is essential in patients who have previously undergone irradiation.

    DOI: 10.1016/j.anl.2020.08.020

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  • Sarcopenia predicts a poor treatment outcome in patients with head and neck squamous cell carcinoma receiving concurrent chemoradiotherapy. 国際誌

    Ryusuke Shodo, Keisuke Yamazaki, Yushi Ueki, Takeshi Takahashi, Arata Horii

    European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery   2020年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Sarcopenia, defined as a decrease in the skeletal muscle mass and its function, is associated with a poor clinical outcome in several malignancies. We aimed to examine whether sarcopenia can be a predictor of incompletion of concurrent chemoradiotherapy (CCRT) and survival for head and neck cancer (HNC) patients. METHODS: Forty-one male HNC patients who received CCRT were enrolled in the study. Cross-sectional muscle areas at the third lumbar vertebral level were normalized by the squared height of the patients and were termed the lumbar skeletal muscle index (LSMI, cm2/m2), a marker of sarcopenia. Patients were divided into high (30/41, 73%) and low (11/41, 27%) LSMI groups. The LSMI cut-off value was set at 39.7 cm2/m2 based on a receiver operating characteristic curve for incompletion of CCRT. The groups were compared for survival rate by the Kaplan-Meier method. Factors predicting incompletion of CCRT were investigated among several variables. RESULTS: Multivariate analysis showed that a pre-treatment low LSMI (P = 0.033) and age over 70 years (P = 0.023) were the only significant predictors for incompletion of CCRT. The 2-year disease-specific survival (DSS) rate was significantly lower in the low LSMI group (61%) than in the high LSMI group (97%, P = 0.012), whereas there were no differences in the DSS rate between the low and high body mass index groups. CONCLUSION: The prevalence of sarcopenia in HNC patients receiving CCRT was 27%. Its presence before treatment was a significant predictor of incomplete CCRT and poor DSS rate in HNC patients.

    DOI: 10.1007/s00405-020-06273-4

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  • Predicting the treatment outcome of nivolumab in recurrent or metastatic head and neck squamous cell carcinoma: prognostic value of combined performance status and modified Glasgow prognostic score. 国際誌

    Yushi Ueki, Takeshi Takahashi, Hisayuki Ota, Ryusuke Shodo, Keisuke Yamazaki, Arata Horii

    European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery277 ( 8 ) 2341 - 2347   2020年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: The importance of nivolumab for recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) is rapidly increasing. However, prognostic factors have not been determined for predicting treatment outcome. We aimed to investigate the prognostic factors in R/M HNSCC patients treated with nivolumab. METHODS: This retrospective study included 42 patients with R/M HNSCC who received nivolumab therapy. Correlations of overall survival (OS) with various patient characteristics including age, recurrent/metastatic site, performance status (PS), programmed death-ligand 1 positivity, body mass index, neutrophil-to-lymphocyte ratio, modified Glasgow prognostic score (mGPS), previous cetuximab administration, and immune-related adverse events were investigated. RESULTS: The overall response rate and disease control rate were 16.7% and 45.2%, respectively. Estimated 1-year OS and progression-free survival (PFS) were 56.4% and 24.5%, respectively. Multivariate analysis revealed that PS = 2 (hazard ratio 0.147; 95% CI 0.041-0.527; p = 0.003) and mGPS = 2 (hazard ratio 0.188; 95% CI, 0.057-0.620; p = 0.006) were independent predictors of poor OS. Given that the PS and mGPS were independent prognostic factors, we classified patients into three groups according to PS and mGPS: Group 1, both PS and mGPS were 0 or 1 (n = 30); Group 2, either PS or mGPS was 2 (n = 9); Group 3, both PS and mGPS were 2 (n = 3). The OS curves were significantly stratified among the three groups. CONCLUSION: The combination of PS and mGPS accurately predicted OS after nivolumab therapy. Preventive intervention to maintain general condition without simultaneously exceeding level 2 of PS and mGPS might be important for improving treatment outcomes of nivolumab.

    DOI: 10.1007/s00405-020-05945-5

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  • 骨転移との鑑別を要したBrown tumor合併副甲状腺癌の一例

    植木 雄志, 高橋 剛史, 太田 久幸, 正道 隆介, 山崎 恵介, 梅津 哉, 堀井 新

    日本内分泌外科学会雑誌37 ( 1 ) 55 - 59   2020年3月

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    記述言語:日本語   出版者・発行元:(一社)日本内分泌外科学会  

    症例は71歳女性で、血液検査にてPTH-intactが1246pg/mlと著明高値であったため当院代謝内分泌内科を紹介初診となった。頸胸腹部CT上、甲状腺左葉背側の腫瘍性病変と硬化性、溶骨性の混在した多発性骨病変が指摘され、副甲状腺癌および多発骨転移が疑われた。高カルシウム血症の補正目的にシナカルセトが開始されたが改善が得られず、手術目的に当科紹介となった。術前画像所見からは副甲状腺腫瘍と甲状腺左葉の境界が不明瞭であったことから、副甲状腺腫瘍摘出の際に甲状腺左葉も合併切除した。病理所見では線維性の被膜を有し、好酸性細胞がシート状に増殖する像を認めた。核異型は軽度であるものの、脈管侵襲を認めること、Ki-67 indexは10%でhot spotを認めることから副甲状腺癌の診断となった。骨病変に対する治療については、腰椎病変に対してのみ病的骨折予防目的に放射線治療を行い、臨床経過から副甲状腺癌にBrown tumorを合併したものと判断した。

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  • The association between oral candidiasis and severity of chemoradiotherapy-induced dysphagia in head and neck cancer patients: A retrospective cohort study. 国際誌

    Hirotake Saito, Ryusuke Shodo, Keisuke Yamazaki, Kouji Katsura, Yushi Ueki, Toshimichi Nakano, Tomoya Oshikane, Nobuko Yamana, Satoshi Tanabe, Satoru Utsunomiya, Atsushi Ohta, Eisuke Abe, Motoki Kaidu, Ryuta Sasamoto, Hidefumi Aoyama

    Clinical and translational radiation oncology20   13 - 18   2020年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background and purpose: Concurrent chemoradiotherapy (CCRT) for head and neck cancer (HNC) is a risk factor for oral candidiasis (OC). As Candida spp. are highly virulent, we conducted a retrospective study to determine whether OC increases the severity of dysphagia related to mucositis in HNC patients. Patients and methods: We retrospectively analyzed the cases of consecutive patients with carcinomas of the oral cavity, pharynx, and larynx who underwent CCRT containing cisplatin (CDDP) at our hospital. The diagnosis of OC was based on gross mucosal appearance. We performed a multivariate analysis to determine whether OC was associated with the development of grade 3 dysphagia in the Radiation Therapy Oncology Group (RTOG) Acute Toxicity Criteria. The maximum of the daily opioid doses was compared between the patients with and without OC. Results: We identified 138 HNC patients. OC was observed in 51 patients (37%). By the time of their OC diagnosis, 19 (37%) had already developed grade 3 dysphagia. Among the 30 patients receiving antifungal therapy, 12 (40%) showed clinical deterioration. In the multivariate analysis, OC was independently associated with grade 3 dysphagia (OR 2.75; 95%CI 1.22-6.23; p = 0.015). The patients with OC required significantly higher morphine-equivalent doses of opioids (45 vs. 30 mg/day; p = 0.029). Conclusion: Candida infection causes refractory dysphagia. It is worth investigating whether antifungal prophylaxis reduces severe dysphagia related to candidiasis.

    DOI: 10.1016/j.ctro.2019.10.006

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  • 頭頸部癌外来化学療法における上腕ポートと末梢挿入型中心静脈カテーテルの比較

    正道 隆介, 山崎 恵介, 植木 雄志, 岡部 隆一, 松山 洋, 本田 耕平, 堀井 新

    頭頸部外科29 ( 2 ) 123 - 128   2019年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本頭頸部外科学会  

    再発転移頭頸部癌に対する外来化学療法の増加に伴い、安全な血管アクセスデバイス(VAD)が求められている。VADとしての末梢挿入型中心静脈カテーテル(PICC)27例と埋込型PICCである上腕ポート13例の安全性について比較した。両者に患者背景や治療内容に有意差を認めなかった。合併症発生数は上腕ポート群0例(0%、0/1,000カテーテル留置日)、PICC群8例(30%、1.8/1,000カテーテル留置日)で、上腕ポート群で有意に少なかった(p=0.037)。PICC群の合併症内訳はカテーテル閉塞4例、血栓症2例、カテーテル関連血流感染症1例、自己抜去1例であった。上腕ポートは安全なVADであり、頭頸部癌の外来化学療法において有用な選択肢と考えられた。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J04210&link_issn=&doc_id=20191115330005&doc_link_id=10.5106%2Fjjshns.29.123&url=https%3A%2F%2Fdoi.org%2F10.5106%2Fjjshns.29.123&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • バセドウ病術後に嚥下障害が遷延しANCA関連血管炎と診断した一例

    山崎 恵介, 植木 雄志, 正道 隆介, 高橋 剛史

    日本内分泌外科学会雑誌36 ( Suppl.3 ) S339 - S339   2019年9月

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    記述言語:日本語   出版者・発行元:(一社)日本内分泌外科学会  

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  • 【二次出版】ANL Secondary Publication 日本人頭頸部扁平上皮癌に対する高用量シスプラチン併用化学放射線療法の多施設共同第I/II相試験

    松山 洋, 山崎 恵介, 岡部 隆一, 植木 雄志, 正道 隆介, 尾股 丈, 佐藤 雄一郎, 太田 久幸, 高橋 剛史, 富田 雅彦, 横山 侑輔, 富樫 孝文, 青山 英史, 阿部 英輔, 西條 康夫, 勝良 剛詞, 曽我 麻里恵, 杉田 公, 松本 康男, 土田 恵美子, 堀井 新

    日本耳鼻咽喉科学会会報122 ( 9 ) 1269 - 1270   2019年9月

  • Multicenter phase I/II study of chemoradiotherapy with high-dose CDDP for head and neck squamous cell carcinoma in Japan. 国際誌

    Hiroshi Matsuyama, Keisuke Yamazaki, Ryuichi Okabe, Yushi Ueki, Ryusuke Shodo, Jo Omata, Yuichiro Sato, Hisayuki Ota, Takeshi Takahashi, Masahiko Tomita, Yusuke Yokoyama, Takafumi Togashi, Hidefumi Aoyama, Eisuke Abe, Yasuo Saijo, Kouji Katsura, Marie Soga, Tadashi Sugita, Yasuo Matsumoto, Emiko Tsuchida, Arata Horii

    Auris, nasus, larynx45 ( 5 ) 1086 - 1092   2018年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Recent data indicated that concurrent chemoradiotherapy (CCRT) using high dose cisplatin (CDDP) is the most useful treatment for advanced head and neck squamous cell carcinoma (SCC). Regarding the dose of CDDP, 100mg/m2 is most recommended in Western countries. However, in terms of a balance of efficacy and adverse events, appropriate dose of cytotoxic drugs such as CDDP may be different among the different ethnic groups. In this multicenter phase I/II study, we aimed to identify the optimal dose of CDDP in CCRT for patients with advanced head and neck SCC in the Japanese. METHODS: Patients were eligible for inclusion if they had head and neck SCC that was treated with radical CCRT comprising whole-neck irradiation of the primary lesion and level II-IV lymph nodes on both sides. For the phase I study, a CDDP dose was 70mg/m2 for level 0, 80mg/m2 for level 1, and 100mg/m2 for level 2. Maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) were examined by phase I trial, by which CDDP dose for phase II was determined. The primary endpoint for the phase II was CCRT completion rate, and the secondary endpoint was full-dose-CCRT completion rate, the percentage of patients receiving a total CDDP dose of ≥200mg/m2, response rate, and incidences of adverse events. RESULTS: A CDDP dose of 100mg/m2 was the MTD for phase I, and the recommended dose for phase II was 80 mg/m2. Forty-seven patients were evaluated in the phase II trial. CCRT completion rate, full-dose-CCRT rate, and the percentage of patients receiving a total CDDP dose of ≥200mg/m2, were 93.6%, 78.7%, and 93.6%, respectively. One patient (2.1%) developed grade 2 renal dysfunction, and no patient developed febrile neutropenia or a grade 4 adverse event. CONCLUSION: The present phase I study indicated that a CDDP dose of 80mg/m2 is the optimal dose in terms of safety. The phase II study revealed that CCRT completion rate, response rate, and rates of adverse events were not inferior for a CDDP dose of 80mg/m2 as compared with a dose of 100mg/m2, and a dose of 80mg/m2 is therefore recommended in CCRT for the Japanese. This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR; identification No. UMIN000010369).

    DOI: 10.1016/j.anl.2018.02.008

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  • Asymptomatic diffuse idiopathic skeletal hyperostosis as a potential risk for severe dysphagia following partial laryngopharyngectomy

    Ryusuke Shodo, Yuichiro Sato, Hisayuki Ota, Yushi Ueki, Arata Horii

    ACTA OTO-LARYNGOLOGICA CASE REPORTS3 ( 1 ) 29 - 33   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:TAYLOR & FRANCIS LTD  

    Diffuse idiopathic skeletal hyperostosis (DISH) is a common disease in which ossification lesions occur in the bones including the vertebrae. Dysphagia may occur in advanced cases, but there are few cases that require treatment. A 68-year-old man was diagnosed with hypopharyngeal cancer of the left pyriform sinus and asymptomatic DISH on the anterior cervical vertebrae. Due to prior history of radiation, partial laryngopharyngectomy was performed. After surgery, severe dysphagia and aspiration pneumonia occurred, and the patient needed to undergo total laryngectomy. It was determined that dysphagia was due to multiple factors, including insufficient laryngeal elevation and esophageal compression by osteophytes of DISH. Asymptomatic DISH can cause severe dysphagia after partial laryngopharyngectomy. We suggest that evaluation of the swallowing function and surgical options, including laryngeal suspension and cricopharyngeal myotomy should be considered when performing partial laryngopharyngectomy in patients with DISH, even if they demonstrated no difficulties in swallowing before treatment.

    DOI: 10.1080/23772484.2018.1477508

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  • Clavicle fracture with osteomyelitis after neck dissection and post-operative radiotherapy: case report. 国際誌

    R Shodo, Y Sato, H Ota, A Horii

    The Journal of laryngology and otology131 ( 11 ) 1026 - 1029   2017年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Non-traumatic bone fractures in cancer patients are usually pathological fractures due to bone metastases. In head and neck cancer patients, clavicle stress fractures may occur as a result of atrophy of the trapezius muscle after neck dissection in which the accessory nerve becomes structurally or functionally damaged. CASE REPORT: A 71-year-old man underwent modified radical neck dissection with accessory nerve preservation and post-operative radiotherapy for submandibular lymph node metastases of tongue cancer. Four weeks after the radiotherapy, a clavicle fracture, with osteomyelitis and abscess formation in the pectoralis major muscle, occurred. Unlike in simple stress fracture, long-term antibiotic administration and drainage surgery were required to suppress the inflammation. CONCLUSION: As seen in the present patient, clavicle stress fractures may occur even after neck dissection in which the accessory nerve is preserved, and may be complicated by osteomyelitis and abscess formation owing to risk factors such as radiotherapy, tracheostomy and contiguous infection.

    DOI: 10.1017/S0022215117001748

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  • Three-dimensional reconstruction of root cells and interdental cells in the rat inner ear by serial section scanning electron microscopy.

    Ryusuke Shodo, Manabu Hayatsu, Daisuke Koga, Arata Horii, Tatsuo Ushiki

    Biomedical research (Tokyo, Japan)38 ( 4 ) 239 - 248   2017年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    In the cochlea, a high K+ environment in the endolymph is essential for the maintenance of normal hearing function, and the transport of K+ ions through gap junctions of the cochlear epithelium is thought to play an important role in endolymphatic homeostasis. The aim of the present study was to demonstrate the three-dimensional (3D) ultrastructure of spiral ligament root cells and interdental cells, which are located at both ends of the gap junction system of the cochlea epithelium. Serial semi-thin sections of plastic-embedded rat cochlea were mounted on glass slides, stained with uranyl acetate and lead citrate, and observed by scanning electron microscopy (SEM) using the backscattered electron (BSE) mode. 3D reconstruction of BSE images of serial sections revealed that the root cells were linked together to form a branched structure like an elaborate "tree root" in the spiral ligament. The interdental cells were also connected to each other, forming a comb-shaped cellular network with a number of cellular strands in the spiral limbus. Furthermore, TEM studies of ultra-thin sections revealed the rich presence of gap junctions in both root cells and interdental cells. These findings suggest the possibility that both root cells and interdental cells contribute to K+ circulation as the end portion of the epithelial cell gap junction system of the cochlea.

    DOI: 10.2220/biomedres.38.239

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  • High-resolution imaging by scanning electron microscopy of semithin sections in correlation with light microscopy. 国際誌

    Daisuke Koga, Satoshi Kusumi, Ryusuke Shodo, Yukari Dan, Tatsuo Ushiki

    Microscopy (Oxford, England)64 ( 6 ) 387 - 94   2015年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    In this study, we introduce scanning electron microscopy (SEM) of semithin resin sections. In this technique, semithin sections were adhered on glass slides, stained with both uranyl acetate and lead citrate, and observed with a backscattered electron detector at a low accelerating voltage. As the specimens are stained in the same manner as conventional transmission electron microscopy (TEM), the contrast of SEM images of semithin sections was similar to TEM images of ultrathin sections. Using this technique, wide areas of semithin sections were also observed by SEM, without the obstruction of grids, which was inevitable for traditional TEM. This study also applied semithin section SEM to correlative light and electron microscopy. Correlative immunofluorescence microscopy and immune-SEM were performed in semithin sections of LR white resin-embedded specimens using a FluoroNanogold-labeled secondary antibody. Because LR white resin is hydrophilic and electron stable, this resin is suitable for immunostaining and SEM observation. Using correlative microscopy, the precise localization of the primary antibody was demonstrated by fluorescence microscopy and SEM. This method has great potential for studies examining the precise localization of molecules, including Golgi- and ER-associated proteins, in correlation with LM and SEM.

    DOI: 10.1093/jmicro/dfv042

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  • Therapeutic outcome after resection of pulmonary metastasis from head and neck carcinomas. 国際誌

    Keisuke Yamazaki, Ryusuke Shodo, Yushi Ueki, Hiroshi Matsuyama, Sugata Takahashi

    Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India67 ( Suppl 1 ) 124 - 8   2015年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Hematogenous metastasis is the most common form of metastasis in head and neck cancer, and reports have described successful resection of pulmonary metastases of such cancers. We report treatment outcomes after surgical resection of pulmonary metastases of head and neck cancer and identify prognostic factors. This clinicopathologic study investigated the clinical records of 16 patients with pulmonary metastases of head and neck cancer (excepting cases of thyroid cancer) who had undergone metastasectomy at our center during the period 2001-2012. The mean age of the 16 patients (11 men and 5 women) was 62.1 years. The mean interval between completion of successful treatment of the primary tumor and detection of pulmonary metastasis was 21 months (range, 6-56 months). All patients underwent pulmonary resection. The overall 1-year survival rate was 79.4 %, and the 2- to 5-year survival rate was 63.2 %. These rates compare favorably to those in previous reports on resection of pulmonary metastases. When prognostic factors for survival rates were compared, the factors associated with a negative prognosis were a disease-free interval of <12 months and partial resection of pulmonary metastases. Multivariate analysis did not reveal any prognostic factors associated with negative outcomes. Surgical resection of pulmonary metastases of head and neck cancer might improve outcomes.

    DOI: 10.1007/s12070-014-0799-y

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共同研究・競争的資金等の研究

  • 蝸牛外側壁構成細胞の加齢性変化-連続切片走査型電子顕微鏡法による3次元解析-

    研究課題/領域番号:18K16835  2018年04月 - 2021年03月

    日本学術振興会  科学研究費助成事業 若手研究  若手研究

    正道 隆介

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    配分額:3250000円 ( 直接経費:2500000円 、 間接経費:750000円 )

    加齢性難聴はコミュニケーション障害をきたし高齢者の孤立、抑うつ、認知機能低下にも繋がり、国民的課題であると言えるが、有効な予防法や治療法は確立されていない。加齢性難聴の組織学的所見については過去にも報告があり血管条の萎縮はそのひとつとして挙げられるが、血管条を含む蝸牛外側壁の立体構造についての研究はほとんど行われていない。研究者は連続切片走査型電子顕微鏡法により、これまで観察が困難であった蝸牛外側壁の構成細胞、特に根細胞の立体配列について、蝸牛外側壁のラセン靭帯下部領域において樹木根状の細胞集塊を形成し、II型線維細胞が分布するラセン靭帯下部領域に伸展していることを既に示し報告した(Shodo et al. Biomed Res 2017)。この手法を応用し、蝸牛外側壁構成細胞の加齢性変化を3次元的に解明することを目的とする。研究計画に基づき、平成31年(令和元年)度は正常モデルと加齢性難聴モデルの観察を行った。光学顕微鏡での観察を主に行い、電子顕微鏡での観察は遅れている。総合的に進捗状況としては遅れている。

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