Keloids and Hypertrophic Scars Can Now Be Cured Completely: Recent Progress in Our Understanding of the Pathogenesis of Keloids and Hypertrophic Scars and the Most Promising Current Therapeutic Strategy.

Keloids and hypertrophic scars are fibroproliferative disorders of the skin that are caused by abnormal healing of injured or irritated skin. It is possible that they are both manifestations of the same fibroproliferative skin disorder and just differ in terms of the intensity and duration of inflammation. These features may in turn be influenced by genetic, systemic, and local risk factors.

Analysis of the surgical treatments of 63 keloids on the cartilaginous part of the auricle: effectiveness of the core excision method.

Background: Treatments for keloids on the cartilaginous part of the auricle (i.e., the upper part of the ear excluding the earlobe) include surgical excision, cryosurgery, postoperative radiation therapy, steroid injection, taping stabilization, and pressure therapy.

Analysis of surgical treatments for earlobe keloids: analysis of 174 lesions in 145 patients.

Background: Treatments for earlobe keloids include surgical excision, postoperative radiotherapy, steroid injection, taping stabilization, and pressure therapy. However, to date, there is no universally accepted treatment strategy for earlobe keloid therapy.

Methods: A total of 174 lesions in 145 patients who attended the keloid/scar specialist clinic at the Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School, between 2006 and 2011 were included and were classified as having primary keloids or recurring keloids.

Clinical clerkship course for medical students on lumbar puncture using simulators.

Lumbar puncture is a medical technique that physicians must learn and is, therefore, considered a basic medical procedure. The lumbar puncture simulators Lumbar-Kun (Lumbar Puncture Simulator) and Lumbar-Kun II (Lumbar Puncture Simulator II) (Kyoto Kagaku, Kyoto, Japan) are teaching aids designed for practicing spinal insertions. We describe and results of a lumbar puncture clerkship course, provided to 5th-year medical students during clinical clerkship activity.

Post-keloidectomy irradiation using high-dose-rate superficial brachytherapy.

A study was conducted to evaluate the early results of high-dose-rate superficial brachytherapy (HDR-SB) after keloidectomy. Between April 2008 and April 2009, 21 patients with 36 histologically confirmed keloids were treated with postoperative HDR-SB. The tube applicator was placed on the skin to match the area of the surgical wound, and a spacer 5 mm thick was placed between the skin and the applicator.

Target delineation of gross tumor volume for radiation therapy planning using fusion images of ¹⁸F-fluorodeoxyglucose positron emission tomography and computed tomography.

Modern radiation therapy planning (RTP) has been performed using a larger number of images obtained with computed tomography (CT), named 3-dimensional RTP. Recently, F-18-flurodeoxyglucose position emission tomography (FDG-PET) has been used for RTP. FDG-PET can often distinguish between benign and malignant lesions when CT and magnetic resonance cannot.

Is radiation therapy for keloids acceptable? The risk of radiation-induced carcinogenesis.

Background: Keloids have been treated by using radiation for over a century, and it is currently suggested that keloids are best treated by a combination of surgery and postoperative radiation therapy, although randomized controlled trials testing this are still lacking. However, plastic surgeons tend to avoid radiation therapy for keloids for fear of inducing malignant tumors. Thus, the authors searched for previous reports of associations between carcinogenesis and keloid radiation therapy, and examined the evidence-based opinions of radiation oncologists regarding the acceptability of using radiation to treat keloids.

Utility of sonography for evaluation of clinical T1 and T2 glottic carcinoma.

Objective: The aim of this study was to evaluate the prognostic impact of sonographically determined tumor features in relation to local control of clinical T1 and T2 glottic carcinoma treated by definitive radiation therapy.

Methods: Between 1999 and 2005, 72 patients with T1 and T2 glottic carcinoma were evaluated by percutaneous sonography in terms of tumor detectability, maximum tumor dimension, involvement of the anterior commissure, presence of supraglottic, subglottic, or paraglottic spread, and thyroid cartilage invasion. Factor analyses for local control included clinical features, sonographic findings, and treatment factors.

Postoperative radiation protocol for keloids and hypertrophic scars: statistical analysis of 370 sites followed for over 18 months.

Background: Before 2002, keloids and intractable hypertrophic scars were treated at our facility with postoperative irradiation of 15 Gy (the traditional protocol). Analysis of the therapeutic outcomes of patients treated with this protocol showed that the recurrence rates of keloids and intractable hypertrophic scars in the anterior chest wall, as well as the scapular and suprapubic regions, were statistically higher than at other sites, while the recurrence rates in earlobes were lower. Thus, we customized doses for various sites.

Implementation of integrated medical curriculum in Japanese medical schools.

Recently, various integrated medical curricula, which can be defined as courses with subject matter classified by organ systems rather than according to departments such as surgery and internal medicine, are beginning to be introduced to bedside-learning in Japan. For example, in such an integrated medical curriculum, lectures in the course on neurological diseases would be given by a team that would include neurosurgeons, neurologists, and pathologists. Using medical education on neurological diseases as an example of an integrated medical curriculum, we analyzed the factors related to the neurological disease course as an example of an integrated medical curriculum in the clinical medicine course at our school.

[A report of questionnaire survey asking teaching staff concerning evaluation of faculty teaching from the students in Nippon Medical School].

A questionnaire survey was conducted to ask teaching staffs about the present activities and opinions of evaluation of faculty teaching from the students (EFS). One hundred and eighty-eight among 336 members (56.1%) responded.

[Strategy to reduce esophageal cancer by dietary reformation].

Background And Objective: From 1920 to 1940, many people were affected by esophageal carcinoma in villages in the mountains of Nara Prefecture in Japan. However, a movement for the improvement of living conditions, especially concerning food, diminished the incidence of cancer of the esophagus. Today Xinjiang in China, esophageal cancer is also one of the main causes of death.

[Effect of nedaplatin, 5-FU, and leucovorin combined with radiation therapy in unresectable esophageal carcinoma].

A 51-year-old male was assessed as having esophageal squamous cell carcinoma with trachea invasion and cervical lymph node metastasis. After one course of chemotherapy using cisplatin (CDDP), 5-fluorouracil (5-FU) and Leucovorin (LV), the patient had progressive disease (PD) of the primary lesion and metastatic lymph nodes, and a side effect of severe nausea. One course of nedaplatin, 5-FU and LV combined with radiation was performed alternatively.

Ultrasonographic demonstration of retropharyngeal lymph nodes: preliminary report.

The aim of this study was to describe the results of ultrasonography of upper retropharyngeal lymph node (RPN) metastasis in patients with pharyngeal carcinomas. A total of 10 patients with metastatic RPN were examined using percutaneous ultrasound (US) with 3.5-MHz probes.

Breast-conserving therapy in the management of early stage breast cancer: Our experience in 103 cases.

Purpose: The aim of this study is to determine whether our results in breastconserving therapy of 103 patients with earlystage breast cancer are comparable to those of other facilities or not.

Materials And Methods: From January 1990 to October 1999, 103 patients with earlystage breast cancer were treated by breastconserving surgery and whole breast irradiation. All patients were of Stages I or II, and the greatest dimensions of primary tumor were less than 3 cm.