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Proceedings of the 63Rd General Meeting of the Showa University Society

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Proceedings of the 63Rd General Meeting of the Showa University Society Showa Univ J Med Sci 2（8 4）, 393～420, December 2016 Proceedings of the 63rd General Meeting of the Showa University Society entity of IgG4-RD, has been reported to give rise to Educational Lecuture malignant neoplasms, including PDAC, and Type Ⅰ AIP Diagnosis and Treatment of Pancreatic Diseases, often relapses, alternative treatments are required and Including Presentation of Latest Concepts are being developed. Hitoshi YOSHIDA Key words: chronic pancreatitis, autoimmune pancreatitis, Department of Medicine, IgG4-related disease, pancreatic ductal ade- Division of Gastroenterology, nocarcinoma, intraductal papillary mucinous Showa University School of Medicine neoplasm Pancreatic diseases include pancreatitis and pancreatic Role of Fibroblast Cell Contraction in Wound neoplasms （PN）. Pancreatitis is induced by digestion Healing Processes of the pancreas itself. Japanese clinical criteria for ― Mechanisms of Contractile Responses Using 3-D chronic pancreatitis （CP） distinguish CP from both Reconstituted Fibroblast Fibers― autoimmune pancreatitis（ AIP ; Type Ⅰ, an IgG4-related Koji NOBE disease ［IgG4-RD］; Type Ⅱ, occasionally associated Department of Pharmacology, with inflammatory bowel disease） and conclusive duct Toxicology and Therapeutics, pancreatitis derived from pancreatic cancer. PNs, in Division of Pharmacology, particular pancreatic ductal adenocarcinoma （PDAC）, Showa University School of Pharmacy so-called pancreatic cancer, are mostly associated with fatal outcomes. In July 2016, National Cancer Institute Fibroblast cells play a central role in the proliferation disclosed that results of estimates of five-year survival phase of wound healing processes, contributing to force rate for Japanese people suffering from all malignant development: however, the regulatory mechanisms neoplasms had become first beyond 60％ from 2006 are not well known. We used a reconstituted fiber through 2008. Conversely, the survival rate for （broblast ber） formed by growing NIH 3T3 broblast pancreatic cancer, including PDAC, was 7.7％, the lowest cells in type-1 collagen to characterize non-muscle value. Classification of Pancreatic Carcinoma, Japan contractility and the intracellular signaling pathway Pancreas Society were revised and published as the 7th involved in wound healing. Addition of calf serum edition in 2016. T-classification representing size of （CS） to the fibers elicited reversible contractures that tumor was classied based on inltration to SMA and were repeated for ＞ 8 h. CS elicited dose-dependent celiac artery according to surgery aspect. Consistency increases in isometric force, with 30％ CS producing with the international standard was clarified about the largest force （106 ± 12 µN ; n ＝ 30）. From this, the staging classification, and pathohistologic classification force per cell cross-sectional area was estimated to be was described as differentiation types. Since intraductal 0.5 mN/mm2. CS （30％） induced a sustained broblast papillary mucinous neoplasm （IPMN） rst put forward fiber contraction that was accompanied by a transient 2＋ from Japan had been investigated and widely studied, increase in intracellular calcium concentration （［Ca ］i）. international consensus guidelines for the management However, pre-treating the fibroblast fibers with of IPMN and mucinous cystic neoplasm （MCN） was calcium channel blockers and protein kinase 2＋ revised 2012. IgG4-RD was assigned as an intractable inhibitors had no effect on contractions or ［Ca ］i. disease because the patient estimation increased and In contrast, Rho kinase, a key element in the reached 26,000 peoples. Because AIP, the representative Ca2＋-independent intracellular signaling pathway, 394 Proceedings of the 63rd General Meeting of the Showa University Society was involved in CS-induced fibroblast fiber patients are more valuable than Walk-in patients with contraction. The Rho kinase inhibitor Y-27632 regard to management of acute hospitals. depressed the CS-induced contractions in a dose- In this lecture, I will discuss the relationship between 2＋ dependent manner without affecting the ［Ca ］i new hospital patients and hospital management in the response. Rho kinase also enhanced actin stress ber acute hospital setting, and hope I can provide you with （ASF） formation: this was also suppressed by Y-27632. a strategy for gaining more Referred patients. We conclude that Rho kinase activation can regulate Key words: hospital management strategy, patient re - wound healing processes that are mediated by broblast ferral, hospitalized patient cell contraction. These ndings may contribute to the Original Sessions articial regulation of wound healing processes in scar tissues. 1． Review of the Showa University Head and Neck Key words: wound healing, broblast cells, collagen, non- Oncology Center 1, 2） 1, 2） muscle contraction, rho kinase Shunya EGAWA , Yukiomi KUSHIHASHI , 1, 2） 1, 3） Kenichiro IKEDA , Yuya KURASAWA , 1, 3） 1, 3） A Strategy for Gaining New Hospital Patients in Atsutoshi YASO , Hideyuki KATSUTA , 4） 2） Acute Hospitals Tatsuo SHIROTA , Hitome KOBAYASHI , 1, 2, 3） Yumi KAMIJO Toshikazu SHIMANE Showa University 1） Head and Neck Oncology Center, Graduate School of Health Sciences Showa University 2） Department of Otorhinolaryngology, There is a positive correlation between increases Showa University School of Medicine in inpatient numbers with improvements in hospital 3） Department of Oral and Maxillofacial Surgery, management ; however, this correlation has not been Division of Oral Oncology, well studied. The purpose of this study was to devise Showa University School of Dentistry a strategy for gaining new hospital patients for acute 4） Department of Oral and Maxillofacial Surgery, hospitals. Division of Craniofacial Surgery, Patients are encouraged to see clinical specialists; Showa University School of Dentistry therefore, collaborations between hospitals and local clinics is important so that continuity in health It has been one year since a team of doctors in the and medical services is maintained for all patients. Otorhinolaryngology and Dentistry and Oral Surgery However, encouraging the transfer of patients from established the Showa University Head and Neck acute hospitals to rehabilitation and chronic hospitals Oncology Center. This center inspects, diagnoses, and has led to shortened lengths of stay at acute hospitals, treats head/neck and oral diseases by cooperating resulting in fewer patients. Due to the high turnover Otorhinolaryngology and Oral Surgery. The Oral rate of hospitalized patients in acute medical institutes, Health Care Center also offers oral rehabilitation it is necessary to admit new patients to keep patient to address pronunciation or swallowing issues in the numbers constant. Here, we propose a strategy for perioperative period as well as treatments focused maintaining patient numbers in the acute hospital on patient quality of life （QOL）. In this study, we setting. compared cases of head and neck tumors between Patients are divided into those with a referral those diagnosed during one year before and after （Referred patients） and those without a referral （Walk- establishing the center. There were 232 cases of head in patients） during their initial medical examination. and neck tumors in 2015 compared with 155 cases in Referred patients are more likely to be admitted into 2014 （increase of 149.7％）; benign tumors increased in hospital than Walk-in patients. Referred patients are number from 68 to 92 cases （135.2％） while malignant more likely to undergo operations and receive highly tumors were increased from 87 to 140 cases （160.9％）. advanced medical treatment. Therefore, Referred The average number of hospitalization days was 20.9 Proceedings of the 63rd General Meeting of the Showa University Society 395 days in 2015 as compared with 25.8 days in 2014. In changes such as sternotomies required in any more detail, there were 60 cases of oral cancer in case. Postoperative pathological diagnosis showed 2015 compared to 8 cases in 2014 （750％ increase）. adenomatous goiter in three patients and follicular With respect to treatment method, 87 cases underwent adenoma in one patient, with all diagnosed as benign. surgery in 2015 compared to 26 cases in 2014 （327％ Surgery with neck dissection was deemed suitable for increase）. In conclusion, oral cancer diagnoses increased the cases presented herein. We therefore recommend in number after establishing this center, and accordingly, consulting with the departments of thoracic surgery the percentage of surgical treatment cases per total and cardiovascular surgery when preparing for similar patients also increased. This outcome could lead to cases such as those with malignant tumors, difculty in shortened hospitalizations. enucleation, or unexpected bleeding. Key words: oral oncology, team medical care, head and Key words: mediastinal goiter, mediastinal goiter surgery, neck oncology center thyroid surgery, neck dissection 2． A Study on Mediastinal Goiter Patients Who 3． A Prospective Observational Study of Patients’ Had Surgery at Our Newly Established Medical Quality of Life and Risk Factors of Chemotherapy- Center induced Nausea and Vomiting in Patients with 1, 2） 1, 3） Yukiomi KUSHIHASHI , Hideyuki KATSUTA , Breast Cancer Undergoing Highly Emetogenic 1, 2） 1, 3） Kenichirou IKEDA , Atsutoshi YASO , Chemotherapy 1, 2） 2） 1, 2） 2） Syunya EGAWA , Yoichi IKENOYA , Jumpei TOKUMARU , Satoko HANDA , 1, 3） 1, 3） 2） Yuya KURASAWA , Yoshiro SAITO , Yasuhisa KATO 2） 1, 2, 3） 1） Hitome KOBAYASHI
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