Conversion to complete resection with mFOLFOX6 with bevacizumab or cetuximab based on K‐RAS status for unresectable colorectal liver metastasis (BECK study): Long‐term results of survival

[Background/Purpose]To investigate the long‐term outcome and entire treatment course of patients with technically unresectable CRLM who underwent conversion hepatectomy and to examine factors associated with conversion to hepatectomy. [Methods]Recurrence and survival data with long‐term follow‐up were analyzed in the cohort of a multi‐institutional phase II trial for technically unresectable colorectal liver metastases (the BECK study). [Results]A total of 22/12 patients with K‐RAS wild‐type/mutant tumors were treated with mFOLFOX6 + cetuximab/bevacizumab. The conversion R0/1 hepatectomy rate was significantly higher in left‐sided primary tumors than in right‐sided tumors (75.0% vs 30.0%, P = .022). The median follow‐up was 72.6 months. The 5‐year overall survival (OS) rate in the entire cohort was 48.1%. In patients who underwent R0/1 hepatectomy (n = 21), the 5‐year RFS rate and OS rate were 19.1% and 66.3%, respectively. At the final follow‐up, seven patients had no evidence of disease, five were alive with disease, and 20 had died from their original cancer. All 16 patients who achieved 5‐year survival underwent conversion hepatectomy, and 11 of them underwent further resection for other recurrences (median: 2, range: 1‐4). [Conclusions]Conversion hepatectomy achieved a similar long‐term survival to the results of previous studies in initially resectable patients, although many of them experienced several post‐hepatectomy recurrences. Left‐sided primary was found to be the predictor for conversion hepatectomy

Oral health in the Japan self-defense forces - a representative survey

<p>Abstract</p> <p>Background</p> <p>The oral health of military populations is usually not very well characterized compared to civilian populations. The aim of this study was to investigate two physical oral health characteristics and one perceived oral health measure and their correlation in the Japan self-defense forces (JSDF).</p> <p>Methods</p> <p>Number of missing teeth, denture status, and OHRQoL as evaluated by the Japanese 14-item version of the Oral Health Impact Profile (OHIP-J14) as well as the correlation between these oral health measures was investigated in 911 personnel in the JSDF.</p> <p>Results</p> <p>Subjects did not have a substantial number of missing teeth and only 4% used removable dentures. The mean OHIP-J14 score was 4.6 ± 6.7 units. The magnitude of the correlation between the number of missing teeth with OHIP-J14 scores was small (r = 0.22, p < 0.001). Mean OHIP-J14 scores differed between subjects with and without dentures (8.6 and 4.4, p < 0.001).</p> <p>Conclusions</p> <p>Compared to Japanese civilian populations, personnel of the JSDF demonstrated good oral health. Two physical oral health characteristics were associated with perceived oral health.</p

サイボウ カン セッチャク ノ セイギョ オ カイシタ E - Cadherin ノ スイガン ノ フクマク ハシュ ニ オケル ヤクワリ : スイガン サイボウカブ Panc - 1 オ モチイテ

京都大学0048新制・課程博士博士(医学)甲第9088号医博第2396号新制||医||777(附属図書館)UT51-2001-G808京都大学大学院医学研究科分子医学系専攻(主査)教授 千葉 勉, 教授 月田 承一郎, 教授 今村 正之学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDA

<原著>後方からの直腸粘膜切除と回腸貫通術式 : 新しい大腸全摘再建法

We reported a new method of restorative proctocolectomy using posterior approach and pull through reconstruction. This method obviated transanal manipulation, a major factor causing damage to the internal sphincter, thus preventing fecal incontinence due to sphincter dysfunction. Also, temporary ileostomy was not necessary becaasue the spout of an S-pouch was pulled down below the anal verge and its distal free end acted as a diverting stoma while the more proximal, healing zone (future anastomotic line) was kept from fecal contamination. This method was applied to a 32-year-old woman with familial polyposis coli and a 50 year old woman with ulcerative colitis. Their bowel movements steadily decreased to three times and five times a day, respectively. There was no fecal leakage or perianal excoriation. The advantages as well as disadvantages of this method compared with the conventional techniques were discussed.後方からの直腸到達法と貫通術式による新しい大腸全摘再建法を報告した. 本法は内肛門括約筋損傷の主因である経肛門操作を必要とせず, 括約筋障害による便失禁を予防できる. またS型貯留嚢の下方遊離断端が肛門外に引き出されて人工肛門の役割を果たし, 口側の回腸肛門癒合帯(将来の吻合線)の便汚染を防ぐために, 一時的回腸瘻造設も不必要である. 本法を32歳の家族性結腸腺腫症の女性と50歳の潰瘍性大腸炎の女性に施行した. 術後便回数は着実に減少し各々1日3回と5回となった. また肛門からの便漏れや皮膚びらんも認めなかった. 本法の利点や欠点を他の方法と比較検討した

CO2 absorption characteristics of a blanket candidate material Li2TiO3 under exposure to different gas mixture

In order to investigate the CO2 absorption characteristics of the low- and high-density Li2TiO3 samples, X-ray diffraction (XRD) and non-Rutherford backscattering spectroscopy (NRBS) analyses have been performed. Crystallographic structure of a sintered sample is decided by the XRD analysis, and the NRBS analysis has evaluated the amount of CO2 absorption quantitatively. The amount of CO2 absorption of the low-density Li2TiO3 samples is increased with increase of the humidity. We find that the humidity has effect on CO2 absorption to the low-density Li2TiO3 samples. On the other hand, the high-density samples sintered at temperatures higher than 1,470K absorb very little CO2 under high humidity conditions

The Impact of Changed Strategies for Patients with Cholangiocarcinoma in This Millenium

Background. Cholangiocarcinoma is a cancer with a poor prognosis. In this millennium there are new diagnostic and therapeutic strategies for these patients. Aim. The aim of this study was to find if these changes influenced survival of individuals with proximal cholangiocarcinoma. Material. 627 individuals with a diagnosis of cholangiocarcinoma (not including distal common duct cancer) during the period from 2000 to 2011 were registered in Sweden’s Western Region. The material was divided into three consecutive time periods. Results. The overall survival curves for individuals with cholangiocarcinoma improved over the three time periods (n=627) (P=0.0013). Median survival increased from 2.6 months in the first period (2000–2003) to 3.6 months in the final four years (2008–2011). Patients with perihilar cholangiocarcinoma (PHC) had longer median survival than those with intrahepatic cholangiocarcinoma (IHC): 6.8 versus 3.2 months (P=0.0003). An improvement in the survival curves over time was seen for those with IHC (P=0.034) but not for patients with PHC (P=0.38). Nine percent of the patients with IHC had potential curative surgical therapy. The three-year survival rate after liver resection for patients with IHC was 35% and 60% after liver transplantation. Among patients with PHC, 15.3% had potential curative bile duct resection with a concomitant liver resection and 6.1% bile duct resection alone. The three-year survival rate for these two groups was 32% and 20%, respectively. Conclusion. Overall survival for individuals with PHC was better than for those with IHC. Over time survival in IHC patients improved but not in those with PHC