Publications by authors named "Akihiro Sakai"

Objectives: In recent years, there has been a notable increase in syphilis cases in Japan and Western countries. Syphilis, a classic sexually transmitted disease caused by treponemas, presents diagnostic challenges due to its diverse clinical manifestations. This study explores the diagnosis of syphilis in patients treated at our hospital.

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  • * Two cases highlighted in the report demonstrate that switching to BRAF and MEK inhibitors after initial treatment led to tumor shrinkage and one patient becoming a candidate for surgery, with manageable side effects.
  • * The study advocates for BRAF gene testing at diagnosis since it can help identify patients who might benefit from these targeted therapies, making outpatient treatment feasible and potentially improving outcomes for those with unresectable ATC.
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Background: Recurrent or metastatic squamous cell carcinoma of the head and neck (R/MHNSCC) is a challenging malignancy with a poor prognosis and limited treatment options. Nivolumab, an immune checkpoint inhibitor (ICI) targeting the programmed cell death/programmed cell death ligand 1 (PD-1/PD-L1) pathway, has emerged as a promising therapy for these patients. However, identifying biomarkers predictive of response to nivolumab remains critical for optimizing treatment strategies.

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  • Pembrolizumab, an immune checkpoint inhibitor, shows effectiveness in treating recurrent and metastatic salivary gland carcinoma (SGC), but no predictive biomarkers for its efficacy have been established prior to this study.
  • A study involving 27 patients identified optimal cut-off values for the combined positive score (CPS) and tumor proportion score (TPS) of PD-L1, which were found to significantly predict treatment outcomes.
  • The overall response rate for SGC was 25.9%, with higher response rates in patients with high CPS and TPS, and a lower platelet-lymphocyte ratio correlated with improved progression-free survival, while the treatment demonstrated a good safety profile with no severe adverse events.
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Many researchers have focused on the role of the autonomic nervous system in the tumor microenvironment. Autonomic nerves include the sympathetic and parasympathetic nerves, which are known to induce cancer growth and metastasis. However, in salivary duct carcinoma (SDC), a rare and highly malignant tumor, the issue should be investigated from both biological and therapeutic perspectives.

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Purpose: Hepatocellular carcinoma (HCC) frequently recurs after radical resection, resulting in a poor prognosis. This study assessed the prognostic value of Mac-2 binding protein glycosylation isomer (M2BPGi) for early recurrence (ER) in patients with HCC.

Methods: Patients who underwent radical resection for HCC between 2015 and 2021.

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  • * Initially, she presented with symptoms like runny nose and nasal blockage, leading to a diagnosis of AFRS in one sinus, followed by a postoperative diagnosis of CGIFS in another sinus.
  • * The report emphasizes the challenges in diagnosing and managing these fungal infections, particularly in patients with existing health complications like chronic rhinosinusitis and GVHD, and notes that treatment with voriconazole resulted in significant improvement.
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Background/aim: There have been many studies on skeletal muscle depletion before surgery, and skeletal muscle depletion is a known risk factor for poor prognosis. However, reports on the association between changes in skeletal muscle mass and prognosis after surgery for pancreatic cancer are very few.

Patients And Methods: The data of 137 patients who underwent pancreatectomy for pancreatic cancer between 2005 and 2022 were reviewed.

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Background: It is controversial whether transoral resection for early pharyngolaryngeal cancer preserves swallowing function and quality of life. We investigated swallowing function and quality of life before and after transoral videolaryngoscopic surgery (TOVS).

Methods: Seventy-three patients with pharyngolaryngeal cancer who underwent TOVS between July 2012 and July 2022 were enrolled in this prospective analysis.

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  • Salivary duct carcinoma (SDC) has a low 5-year survival rate of 40%, and the impact of brain metastasis (BM) on patient outcomes is not well understood.
  • A study of 464 SDC patients revealed that 14% had BM, with a median overall survival (mOS) of 13.1 months, and several factors linked to poorer survival, including performance status and uncontrolled disease.
  • A new prognostic tool, the SDC-graded prognostic assessment (GPA) score, shows varying mOS estimates based on different scores, demonstrating its effectiveness in estimating outcomes for patients with BM.
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We present two rare cases of parathyroid carcinomas associated with multiple brown tumours. Plain radiographs, computed tomography, and neck ultrasonography revealed the presence of bone and parathyroid tumours. Despite the use of 99m Tc-methoxy isobutyl isonitrile (99mTc-MIBI) or F-fluorodeoxyglucose-positron emission tomography (18F-FDG PET)/CT, it was difficult to differentiate bone metastases from brown tumours.

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Background: The abscopal effect is a rare phenomenon in which localized radiation therapy triggers tumor reduction in nontargeted areas. Although this phenomenon has been observed in various cancer types, it remains infrequent and not fully understood.

Case: Two patients with maxillary sinus cancer with distant metastases were treated with radiotherapy after immune checkpoint inhibitor (ICI) therapy.

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Background: Transoral videolaryngoscopic surgery (TOVS) is widely used in Japan, and conventional two-dimensional (2D) endoscopic methods have been established. Three-dimensional (3D) endoscopic surgery offers superior distance perception because it provides stereoscopic views. Recently, we have developed 3D endoscopy for TOVS (3D TOVS).

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Reactive lymphoid hyperplasia (RLH) of the liver is extremely rare. Despite advancements in diagnostic imaging technology, it is still difficult to distinguish from hepatocellular carcinoma (HCC). Herein, we present a case of hepatic RLH mimicking HCC that was postoperatively diagnosed using several imaging modalities.

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Background: Total pharyngolaryngectomy (TPL) is standard treatment for hypopharyngeal cancer. However, extensive thyroidectomy and paratracheal nodal dissection (PTND) can cause hypoparathyroidism. We sought to determine the optimum extent of resection.

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Background: Shoulder syndrome can be reduced by preserving the spinal accessory nerve (SAN). However, it is unclear whether performing level IIb preservation will decrease the risk of SAN injury and shoulder syndrome.

Aims/objectives: We investigated whether neck dissection with level IIb preservation can reduce shoulder dysfunction and postoperative quality of life (QOL) in head and neck cancer patients.

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Background: Immune checkpoint inhibitors might cause immune-related adverse events that are still largely unknown.

Case Presentation: An 80-year-old Asian female was diagnosed with cervical lymph node metastasis from lip cancer (cT1N0M0) and underwent right cervical neck dissection. Subsequently, she developed right cervical lymph node relapse and lung metastasis.

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Objective: This study aimed to evaluate the clinical effectiveness of chemotherapy following immune checkpoint inhibitors (ICI). The association between inflammatory and nutritional factors and prognosis has also been investigated.

Methods: We retrospectively reviewed the medical records of recurrent or metastatic head and neck squamous cell carcinoma (RMHNSCC) patients who received chemotherapy following ICI therapy.

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Patients with aortic arch malformations may present with recurrent inferior laryngeal nerve abnormalities that require special attention. Herein, we reported a case of thyroid surgery in a patient with a right aortic arch. The left inferior laryngeal nerve was presumed to be the right inferior laryngeal nerve by confirming the location of the aortic arch and subclavian artery, and the presence of the ductus arteriosus on preoperative computed tomography.

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  • * A specific case involving a 4-year-old boy showed that despite treatment, he developed severe bilateral hearing loss after Kawasaki disease, affecting his cognitive and speech development.
  • * Cochlear implantation was performed and significantly improved his hearing and communication, indicating that prolonged hearing loss may be a serious complication of Kawasaki disease.
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A 69-year-old male patient was referred to our hospital for further examination of hypoglycemia, splenomegaly, and para-aortic lymphadenopathy. The patient was diagnosed with diffuse large B-cell lymphoma (DLBCL) by para-aortic lymph node biopsy. Hypoglycemia was refractory to glucose supplementation but improved shortly after chemotherapy.

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  • Salivary duct carcinoma (SDC) is an aggressive salivary gland cancer, and recent advancements in immunotherapy targeting immune checkpoints (like PD1 and CTLA4) show promise for treatment.
  • * The study analyzed 175 SDC cases, focusing on various immune markers and their correlation with tumor behavior, indicating that high levels of certain markers (CD8, PD-L1, etc.) relate to more aggressive cancer features and worse outcomes.
  • * Interestingly, there were no cases with microsatellite instability (MSI-high), suggesting that a mix of immune activity in SDC may hinder effective T-cell function and highlight potential strategies for immune checkpoint combination therapies.*
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Background: Transoral salvage surgery has the potential to preserve a patient's quality of life. Therefore, we investigated the outcomes, safety, and risk factors for postoperative complications of salvage transoral videolaryngoscopic surgery (TOVS) for recurrent hypopharyngeal carcinoma after radiotherapy (RT) or chemoradiotherapy (CRT).

Methods: This retrospective analysis enrolled patients with hypopharyngeal cancer who had a history of RT or CRT and underwent TOVS from January 2008 to June 2021.

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This study aimed to determine the prognostic value of inflammatory and nutritional biomarkers of immune checkpoint inhibitor (ICI) therapy for recurrent or metastatic squamous cell carcinoma of the head and neck (RMHNSCC) and to identify the most useful factor for prognosis assessment. We retrospectively reviewed the medical records of patients with RMHNSCC who received ICI therapy. The response rate for ICI therapy and the relationship between inflammatory and nutritional biomarkers and overall survival were examined.

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Magnetic resonance imaging (MRI) is a more useful diagnostic modality for detecting paranasal tumors compared with computed tomography (CT). We encountered a case of malignant lymphoma of the maxillary sinus. Although CT findings suggested malignancy, MRI findings indicated an inflammatory disease.

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