研究者詳細 - 相馬　智也

論文 - 相馬　智也

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Tooth extraction in mice administered zoledronate increases inflammatory cytokine levels and promotes osteonecrosis of the jaw.

Tomoya Soma, Ryotaro Iwasaki, Yuiko Sato, Tami Kobayashi, Satoshi Nakamura, Yosuke Kaneko, Eri Ito, Hiroyuki Okada, Hisato Watanabe, Kana Miyamoto, Morio Matsumoto, Masaya Nakamura, Seiji Asoda, Hiromasa Kawana, Taneaki Nakagawa, Takeshi Miyamoto

Journal of bone and mineral metabolism （Journal of Bone and Mineral Metabolism） 39 （ 3 ） 372 - 384 2020年11月

研究論文（学術雑誌）, 共著, 筆頭著者, 査読有り, ISSN 09148779

INTRODUCTION: Osteonecrosis of the jaw (ONJ) occurring after invasive dental treatment often adversely affects patients' activities of daily living. Long-term administration of strong anti-bone resorptive agents such as bisphosphonates prior to invasive dental treatment is considered an ONJ risk factor; however, pathological mechanisms underlying ONJ development remain unclear. MATERIALS AND METHODS: We developed an ONJ mouse model in which a tooth is extracted during treatment with the bisphosphonate zoledronate. RESULTS: We observed induction of apoptosis in osteocytes, resulting in formation of empty lacunae in jaw bones at sites of tooth extraction but not in other bones of the same mice. We also observed elevated levels of inflammatory cytokines such as TNFα, IL-6 and IL-1 in jaw bone at the extraction site relative to other sites in zoledronate-treated mice. We also report that treatment in vitro with either zoledronate or an extract from Porphyromonas gingivalis, an oral bacteria, promotes expression of inflammatory cytokines in osteoclast progenitor cells. We demonstrate that gene-targeting of either TNFα, IL-6 or IL-1 or treatment with etanercept, a TNFα inhibitor, or a neutralizing antibody against IL-6 can antagonize ONJ development caused by combined tooth extraction and zoledronate treatment. CONCLUSIONS: Taken together, the cytokine storm induced by invasive dental treatment under bisphosphonate treatment promotes ONJ development due to elevated levels of inflammatory cytokine-producing cells. Our work identifies novel targets potentially useful to prevent ONJ.

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Clear cell carcinoma in the retromolar area: A case report

Yuta Yasui, Seiji Asoda, Tomoya Soma, Hidetaka Miyashita, Toshihiro Hasegawa, Takehito Ouchi, Takeshi Karube, Takazumi Yasui, Katsuhiro Onizawa, Taneaki Nakagawa, Hiromasa Kawana

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology （Elsevier BV） 32 （ 6 ） 507 - 513 2020年08月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 2212-5558

Clear cell carcinoma (CCC) is a malignant neoplasm of epithelial origin classified in the 2017 World Health Organization (WHO) classification as a low-grade salivary gland tumor consisting of glycogen-rich clear cytoplasm. We report a case of a 34-year-old woman presented in our department following the complaint of a mass in her right retromolar area. The tumor measured 10-mm in diameter and was elastic and hard mass. Spontaneous pain or tenderness and desensitization of the tongue were not observed. Marginal resection of the mandible was performed under general anesthesia. The lesion was located in the minor salivary gland that is mainly composed of mucus glands and had a relatively clearly defined circular shape. However, there was no film fabrication in the surrounding resions. Additionally, atypical cells comprising a clear cytoplasm and irregularly shaped pyknotic nuclei were growing in sheet form or island form, and markedly hyalinized fascicles were observed between the alveolar walls of the atypical cells. Immunohistochemical stains revealed these tumor cells to be positive for epithelial cell markers but negative for myoepithelial ones. Considering the above findings, the tumor was diagnosed as CCC. The patient is currently free from disease 37 months after surgery.

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Pimozide combined with paclitaxel demonstrates a significant antitumor effect in head and neck squamous cell carcinoma

Nakamura Shintaro, Ozawa Hiroyuki, Yamasaki Juntaro, Okazaki Shogo, Yoshikawa Momoko, Soma Tomoya, Asoda Seiji, Nagano Osamu, Sekimizu Mariko, Saito Shin, Yoshihama Keisuke, Mikoshiba Takuya, Ogawa Kaoru, Saya Hideyuki

CANCER RESEARCH 80 （ 16 ） 2020年08月

ISSN 0008-5472

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Vitamin D protects against immobilization-induced muscle atrophy via neural crest-derived cells in mice.

Satoshi Nakamura, Yuiko Sato, Tami Kobayashi, Yosuke Kaneko, Eri Ito, Tomoya Soma, Hiroyuki Okada, Kana Miyamoto, Akihito Oya, Morio Matsumoto, Masaya Nakamura, Arihiko Kanaji, Takeshi Miyamoto

Scientific reports （Scientific Reports） 10 （ 1 ） 12242 - 12242 2020年07月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 2045-2322

Vitamin D deficiency is a recognized risk factor for sarcopenia development, but mechanisms underlying this outcome are unclear. Here, we show that low vitamin D status worsens immobilization-induced muscle atrophy in mice. Mice globally lacking vitamin D receptor (VDR) exhibited more severe muscle atrophy following limb immobilization than controls. Moreover, immobilization-induced muscle atrophy was worse in neural crest-specific than in skeletal muscle-specific VDR-deficient mice. Tnfα expression was significantly higher in immobilized muscle of VDR-deficient relative to control mice, and was significantly elevated in neural crest-specific but not muscle-specific VDR-deficient mice. Furthermore, muscle atrophy induced by limb immobilization in low vitamin D mice was significantly inhibited in Tnfα-deficient mice. We conclude that vitamin D antagonizes immobilization-induced muscle atrophy via VDR expressed in neural crest-derived cells.

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A case of spindle cell/pleomorphic lipoma on inferior border of the mandible

Kanako Munakata, Seiji Asoda, Shin Usuda, Hidetaka Miyashita, Tomoya Soma, Toshihiro Hasegawa, Chiharu Ogawa, Sadao Ohyama, Tomohiro Yamauchi, Miho Kawaida, Kaori Kameyama, Taneaki Nakagawa, Hiromasa Kawana

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology （Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology） 32 （ 1 ） 49 - 52 2020年01月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 2212-5558

© 2019 Asian AOMS(+) ASOMP(+) JSOP(+) JSOMS(+) JSOM(+) and JAMI Spindle cell lipomas and pleomorphic lipomas are uncommon and distinct variants of benign lipomas. Although spindle cell lipomas and pleomorphic lipomas were originally considered different entities, the recent WHO classification defines them as spindle cell/pleomorphic lipoma (SCL/PL). This is because of their similar clinical features and the existence of intermediate histopathological features between them. A 77-year-old male presented to our clinic with a painless swelling on the left inferior border of the mandible. Computed tomography revealed a clearly defined mass in the subcutaneous lesion. With a histopathological diagnosis of myxolipoma, demonstrated by biopsy, excisional surgery was performed under general anesthesia. The histopathology revealed SCL/PL with the presence of spindle cells and mature adipocytes. No tumor recurrence had been noted at two year after surgery.

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Clinical study of octacalcium phosphate and collagen composite in oral and maxillofacial surgery

Tadashi Kawai, Shinji Kamakura, Keiko Matsui, Masayuki Fukuda, Hiroshi Takano, Mitsuyoshi Iino, Shigeo Ishikawa, Hiromasa Kawana, Tomoya Soma, Eisaku Imamura, Hideki Kizu, Aya Michibata, Izumi Asahina, Keiichiro Miura, Norifumi Nakamura, Toshiro Kibe, Osamu Suzuki, Tetsu Takahashi

Journal of Tissue Engineering （SAGE Publications） 11 204173141989644 - 204173141989644 2020年01月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 2041-7314

Octacalcium phosphate and its collagen composite have been recognized as bone substitute materials possessing osteoconductivity and biodegradation properties. We evaluated the effectiveness of octacalcium phosphate and its collagen composite used for bone augmentation in major oral and maxillofacial surgeries in a clinical trial. Octacalcium phosphate and its collagen composite were used in cases of sinus floor elevation in 1- and 2-stage, socket preservation, cyst, and alveolar cleft procedures. A total of 60 patients were evaluated for effectiveness after the implantation of octacalcium phosphate and its collagen composite. Although sinus floor elevation in 1-stage, cyst, and alveolar cleft cases met the criteria for the judgment of success, sinus floor elevation in 2-stage and socket preservation groups did not meet the criteria in the initial evaluation. However, an additional evaluation for reconfirmation revealed the effectiveness of octacalcium phosphate and its collagen composite in those groups, and all evaluation results ultimately indicated the success of this clinical trial. Therefore, this clinical trial suggested that application of octacalcium phosphate and its collagen composite for oral and maxillofacial surgery was safe and effective and that octacalcium phosphate and its collagen composite could be a bone substitute candidate instead of autologous bone.

Oral administration of N-acetyl cysteine prevents osteoarthritis development and progression in a rat model.

Yosuke Kaneko, Nobuharu Tanigawa, Yuiko Sato, Tami Kobayashi, Satoshi Nakamura, Eri Ito, Tomoya Soma, Kana Miyamoto, Shu Kobayashi, Kengo Harato, Morio Matsumoto, Masaya Nakamura, Yasuo Niki, Takeshi Miyamoto

Scientific reports （Scientific Reports） 9 （ 1 ） 18741 - 18741 2019年12月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 2045-2322

The number of osteoarthritis patients is increasing with the rise in the number of elderly people in developed countries. Osteoarthritis, which causes joint pain and deformity leading to loss of activities of daily living, is often treated surgically. Here we show that mechanical stress promotes accumulation of reactive oxygen species (ROS) in chondrocytes in vivo, resulting in chondrocyte apoptosis and leading to osteoarthritis development in a rat model. We demonstrate that mechanical stress induces ROS accumulation and inflammatory cytokine expression in cultured chondrocytes in vitro and that both are inhibited by treatment with the anti-oxidant N-acetyl cysteine (NAC). In vivo, osteoarthritis development in a rat osteoarthritis model was also significantly inhibited by oral administration of NAC. MMP13 expression and down-regulation of type II collagen in chondrocytes, both of which indicate osteoarthritis, as well as chondrocyte apoptosis in osteoarthritis rats were inhibited by NAC. Interestingly, osteoarthritis development in sham-operated control sides, likely due to disruption of normal weight-bearing activity on the control side, was also significantly inhibited by NAC. We conclude that osteoarthritis development in rats is significantly antagonized by oral NAC administration. Currently, no oral medication is available to prevent osteoarthritis development. Our work suggests that NAC may represent such a reagent and serve as osteoarthritis treatment.

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Acute odontogenic infection combined with crowned dens syndrome: a case report.

Tomoya Soma, Seiji Asoda, Moemi Kimura, Kanako Munakata, Hidetaka Miyashita, Taneaki Nakagawa, Hiromasa Kawana

Journal of medical case reports （Journal of Medical Case Reports） 13 （ 1 ） 143 - 143 2019年05月

研究論文（学術雑誌）, 共著, 筆頭著者, 査読有り

BACKGROUND: Calcium pyrophosphate dihydrate crystal deposition disease is a condition in which calcium pyrophosphate dihydrate crystal is deposited in joint cartilage and ligaments. Calcium pyrophosphate dihydrate crystal deposition disease that involves calcification around the odontoid process of the second cervical vertebra is called crowned dens syndrome. Crowned dens syndrome is accompanied by fever in addition to acute and intense neck, posterior head, and temporal pain; thus, distinguishing crowned dens syndrome may be difficult in the presence of odontogenic infection. To the best of our knowledge, this is the first report describing a patient with crowned dens syndrome with coexisting odontogenic infection. CASE PRESENTATION: A 75-year-old Japanese woman was examined in the Emergency Department of this hospital due to a chief complaint of worsened buccal swelling on the left side. An odontogenic infection was considered, and she underwent her first examination. She presented with a body temperature of 37.4 °C, marked swelling and tenderness of her left lower eyelid through to her left cheek, and pain on the left temporal area. Blood tests revealed a leukocyte count of 6700/μL and a C-reactive protein level of 7.15 mg/dL. There was swelling and pain around the gingiva and acute purulent apical periodontitis of left maxillary second premolar. Cellulitis of the left cheek was diagnosed. After performing drainage of the pus, antibiotic treatment was initiated. Although her clinical symptoms improved, blood tests on day 9 of hospitalization revealed a leukocyte count of 6500/μL and a C-reactive protein level of 25.62 mg/dL, which were indicative of worsening symptoms. Computed tomography was performed to evaluate remote infection and images revealed a calcification around the odontoid process of her second cervical vertebra. When she was referred to the Orthopedic Surgery Department, pseudogout of the cervical spine was diagnosed. Subsequently, oral acetaminophen was initiated, and both her leukocyte count and C-reactive protein improved markedly. CONCLUSIONS: In the presence of persistent fever and abnormally high leukocyte and C-reactive protein indicative of an inflammatory reaction, coexistence of pseudogout should be considered. In particular, when symptoms of temporal pain are present, the possibility of pseudogout of the cervical spine must be considered in the differential diagnosis.

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A case of platelet transfusion refractoriness occurring after platelet transfusion for tooth extraction in myelodysplastic syndromes patient

Tomoya Soma, Seiji Asoda, Ryotaro Iwasaki, Hidetaka Miyashita, Mariko Inoue, Yuka Yamada, Kimio Uchiyama, Taneaki Nakagawa, Hiromasa Kawana

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology （Elsevier BV） 30 （ 6 ） 496 - 499 2018年11月

研究論文（学術雑誌）, 共著, 筆頭著者, 査読有り, ISSN 2212-5558

Myelodysplastic syndrome is an acquired hematopoietic disorder showing symptoms of pre-leukemia and refractory anemia. In the tooth extraction process of such cases, bleeding tendency due to pancytopenia, infection etc., becomes a problem. As such, a cautious approach is required. We have confirmed platelet transfusion refractoriness prior to tooth extraction in a myelodysplastic syndrome patient, and hereby report a case of tooth extraction following human leukocyte antigen (HLA)-compatible concentrated platelet transfusion. The patient was a 55-year-old female who was examined at our department due to a request for the extraction of tooth No. 36. Following consultation at the Hematology Department, platelet transfusion was performed as a pretreatment upon hospitalization. Increased body temperature, chills, shivers, and feelings of discomfort in the pharynx were observed. A close examination was performed due to a lack of increase in platelet count, and revealed platelet transfusion refractoriness caused by anti-HLA antibodies. Therefore, the patient was re-hospitalized and transfused with a platelet concentrate-HLA preparation. One hour later, an increase in platelet count was confirmed and the tooth extraction was performed. There was no evidence of bleeding or infection following extraction, and the prognosis was good.

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Dedifferentiated parosteal osteosarcoma of the maxilla: a case report and review of the literature.

Hidetaka Miyashita, Kazunari Yoshida, Tomoya Soma, Kaori Kameyama, Aya Sasaki, Masanori Hisaoka, Masaki Yazawa, Hideo Morioka, Moe Takahashi, Taneaki Nakagawa, Hiromasa Kawana

Journal of medical case reports （Journal of Medical Case Reports） 12 （ 1 ） 235 - 235 2018年08月

研究論文（学術雑誌）, 共著, 査読有り

BACKGROUND: Parosteal osteosarcomas are usually low-grade tumors, however, sometimes they transform to high-grade tumors, which is named dedifferentiation. This phenomenon has been reported in long bones. Recently, we encountered a patient with dedifferentiated parosteal osteosarcoma occurring in the maxilla. Here, we report a first case of dedifferentiated parosteal osteosarcoma of the head and neck region. CASE PRESENTATION: A 45-year-old Japanese woman with a refractory bone lesion in the maxilla presented to our hospital. A biopsy showed atypical spindle cell proliferation involving dedifferentiated high-grade component, which was diagnosed as dedifferentiated parosteal osteosarcoma. Three cycles of neoadjuvant chemotherapy using ifosfamide and pirarubicin were performed followed by sub-total maxillectomy. Histopathological results showed that neoadjuvant chemotherapy was effective for high-grade component. The decision to perform adjuvant chemotherapy (cisplatin and pirarubicin) was made because distant metastasis has been reported, even in cases with dedifferentiated parosteal osteosarcoma in which complete necrosis of high-grade component was achieved due to neoadjuvant chemotherapy. There was no recurrence 15 months after surgery. CONCLUSIONS: Dedifferentiated parosteal osteosarcoma can occur in the head and neck region. Chemotherapy including anthracycline anticancer agent could be effective for high-grade component of dedifferentiated parosteal osteosarcoma.

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Recurrent Spindle Cell Carcinoma Shows Features of Mesenchymal Stem Cells

T. Ouchi, S. Morikawa, S. Shibata, M. Takahashi, M. Yoshikawa, T. Soma, H. Miyashita, W. Muraoka, K. Kameyama, H. Kawana, Y. Arima, H. Saya, H. Okano, T. Nakagawa, S. Asoda

Journal of Dental Research （SAGE Publications Inc.） 97 （ 7 ） 779 - 786 2018年07月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 1544-0591

This study investigated a case of spindle cell carcinoma (SpCC) in tongue pathological lesions. The patient experienced a local recurrence and distant metastasis after surgical intervention. Although standard chemotherapy was administered, a granulomatous mass continued to develop. This aggressive growth led to survival of the tumor. Secondary debulking surgery was performed to improve the patient’s quality of life at the request of the patient. Using a tissue sample derived from the secondary debulking surgery, we performed an analysis of the tumor’s cell surface antigens, differentiation potential, metastatic ability, and inhibition potential by anticancer reagents. In vitro analysis revealed that the cell population grown under adherent culture conditions expressed the mesenchymal stem cell (MSC) markers CD73, CD90, and CD105. The cell line established from this SpCC contained colony-forming unit fibroblasts (CFU-Fs) and exhibited multipotent differentiation into several mesenchymal lineages, including bone, cartilage, and fat. The SpCC cells also displayed vigorous mobilization. These characteristics suggested that they had the differentiation potential of mesenchymal cells, especially MSCs, rather than that of epithelial cells. The surgical specimen analyzed in this study resisted the molecular target reagent cetuximab, which is an epidermal growth factor receptor inhibitor. This clinical insight revealed that chemotherapy-resistant SpCC cells have different characteristics compared to most other cancer cells, which are sensitive to cetuximab. Our cell death assay revealed that SpCC cell death was induced by the anticancer drug imatinib, which is known to inhibit protein tyrosine kinase activity of ABL, platelet-derived growth factor receptor α (PDGFRα), and KIT. Here, we report recurrent SpCC with characteristics of MSCs and potential for treatment with imatinib.

本態性血小板血症患者に発生した口底癌の1例

長谷川稔洋, 宗像花楠子, 小川千晴, 家崎憲博, 莇生田整治, 宮下英高, 相馬智也, 福田仁, 吉田俊一, 内田育宏, 寺尾保信, 大山定男

日本口腔腫瘍学会誌（(一社)日本口腔腫瘍学会） 30 （ 4 ） 59‐166(J‐STAGE) - 166 2018年

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0915-5988

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The onset risk of carcinoma in patients continuing tacrolimus topical treatment for oral lichen planus: a case report

Mayu Morita, Seiji Asoda, Kazuyuki Tsunoda, Tomoya Soma, Taneaki Nakagawa, Masayori Shirakawa, Hirofumi Shoji, Hisao Yagishita, Takeji Nishikawa, Hiromasa Kawana

Odontology （Springer Tokyo） 105 （ 2 ） 262 - 266 2017年04月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 1618-1247

Oral lichen planus is a chronic inflammatory mucocutaneous disease. Topical use of steroids and other immuno-modulating therapies have been tried for this intractable condition. Nowadays, tacrolimus ointment is used more commonly as a choice for treatment. However, a number of discussions have taken place after tacrolimus was reported to be carcinogenic. This report describes a patient who applied tacrolimus ointment to the lower lip after being diagnosed with oral lichen planus in 2008, and whose lesion developed squamous cell carcinoma in 2010. Since the relationship between tacrolimus and cancer development has been reported in only a few cases, including this case report, the clinician must be careful selecting tacrolimus as a second-line treatment for oral lichen planus.

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IGF-II産生非膵島細胞腫瘍性低血糖症を発症した上顎歯肉癌の1例

宮下英高, 莇生田整治, 森泰昌, 山田有佳, 相馬智也and 河奈裕正

日本口腔外科学会雑誌 62 （ 9 ） 448 - 453 2016年09月

共著, ISSN 0021-5163

72歳男。上顎左側歯肉の腫脹・疼痛を主訴に受診し、諸検査により歯肉癌(中分化型扁平上皮癌)と診断した。手術を勧めたが、同意が得られず、他院での治療を希望したため当科での治療はいったん終了としたが、他院を受診することなく、初診の4ヵ月後に当科を再受診した。腫瘍は増大しており、鼻腔や外側翼突筋に浸潤していた。手術は希望しなかったため化学放射線療法を行い、治療終了3週間後に突然見当識障害が出現した。血糖値の著明な低下を認めたため精査を行い、低血糖発作時にインスリンの過剰分泌を認めないことや、血中IGF-I分泌が抑制されていることに加え、大きな膵外腫瘍(歯肉癌)を認めていることからIGF-II産生非膵島細胞腫瘍性低血糖症と診断した。診断後に追加で歯肉癌生検標本のIGF-II免疫染色を行ったところ陽性であった。

Desmoid-type fibromatosis of the head and neck in children: A case report and review of the literature

Hidetaka Miyashita, Seiji Asoda, Tomoya Soma, Kanako Munakata, Masaki Yazawa, Taneaki Nakagawa, Hiromasa Kawana

Journal of Medical Case Reports （BioMed Central Ltd.） 10 （ 1 ） 173 2016年06月

共著, 査読有り, ISSN 1752-1947

Background: Desmoid-type fibromatosis is defined as an intermediate tumor that rarely occurs in the head and neck of children. There is no doubt as to the value of complete surgical excision for desmoid-type fibromatosis. However, in pediatric patients, surgeons may often be concerned about making a wide excision because of the potential for functional morbidity. Some studies have reported a lack of correlation between margin status and recurrence. Therefore, we discussed our findings with a focus on the state of surgical margins. Case presentation: We report an unusual case of a 9-month-old Japanese girl who prior to presenting at our hospital underwent debulking surgery twice with chemotherapy for desmoid-type fibromatosis of the tongue at another hospital. We performed a partial glossectomy and simultaneous reconstruction with local flap and achieved microscopic complete resection. We also reviewed available literature of pediatric desmoid-type fibromatosis in the head and neck. Conclusions: We described successful treatment for the refractory case of pediatric desmoid-type fibromatosis. The review results showed that some microscopic incomplete resections of tumors in pediatric patients with desmoid-type fibromatosis tended to be acceptable with surgical treatment.

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口腔癌患者に対するDocetaxel、Nedaplatin(5日間分割投与)、5-Fluorouracil併用化学療法時の悪心に対する効果的なAprepitant投与タイミングの検討

内山公男, 山田学, 小松俊一, 相馬智也, 岩渕博史, 鬼澤勝弘, 安居孝純 and 中山成一

癌と化学療法 42 （ 10 ） 1191 - 1195 2015年10月

共著, ISSN 0385-0684

口腔癌に対してdocetaxel、nedaplatin(5日間分割投与)、5-fluorouracilの3剤併用化学療法を実施した患者を対象に、aprepitantをコース初日から投与した場合とコース3日目から投与した場合の制吐効果を比較し、適切なaprepitantの投与タイミングを明らかにすることを目的とした。1.嘔吐は両群ともほとんどみられず、比較できなかった。2.最大悪心gradeは初日群が平均0.78±0.22であったのに対し、3日目群では平均2.33±0.71と有意(p=0.002、U-test)に高かった。3.経日的な悪心gradeの推移下面積(AUC)も初日群が平均3.11±3.59であったのに対し、3日目群では平均13.44±9.58と有意(p=0.019、U-test)に高かった。4.3日目群ではgrade 2以上の悪心が8/9例(88.9%)にみられたのに対し、初日群では1/9(11.1%)と有意(p<0.001、χ2test)に低かった。aprepitantは初日から投与することで悪心の発現をよく抑えることが確認された。(著者抄録)

[Determination of the Appropriate Timing of Aprepitant Administration for Nausea in Patients with Head and Neck Cancer Receiving Combination Chemotherapy with Docetaxel, Nedaplatin（Divided Doses for 5 Days), and 5-fluorouracil].

Kimio Uchiyama, Manabu Yamada, Shunichi Komatsu, Tomoya Souma, Hiroshi Iwabuchi, Katsuhiro Onizawa, Takazumi Yasui, Seiichi Nakayama

Gan to kagaku ryoho. Cancer & chemotherapy 42 （ 10 ） 1191 - 5 2015年10月

研究論文（学術雑誌）, 共著, ISSN 0385-0684

The objective of this study was to determine the appropriate timing of aprepitant administration in patients with oral cancer by comparing the antiemetic effect of aprepitant administered on the first day (first-day group) and third day (third-day group) of combination chemotherapy with docetaxel, nedaplatin (divided doses for 5 days), and 5-fluorouracil. 1. In both groups, very few cases of vomiting were observed. Therefore, we could not compare the incidence of vomiting. 2. The mean highest grade of nausea in the third-day group was significantly higher than that in the first-day group (2.33±0.71 vs 0.78±0.22, p=0.002; U-test). 3. In addition, the mean area under the curve of the chronological changes in the grade of nausea in the third-day group was significantly higher than that in the first-day group (13.44±9.58 vs 3.11±3.59, p=0.019; U-test). 4. The incidence of nausea of grade 2 or higher in the first-day group was significantly lower than that in the third-day group (11.1% [1/9] vs 88.9% [8/9], p<0.001; c 2 test). These results indicate that initiation of aprepitant administration on the first day of combination chemotherapy with docetaxel, nedaplatin, and 5-fluorouracil successfully prevented the development of nausea in patients with oral cancer.

笠崎真悟, 三友啓介,相馬智也, 山田学, 岩渕絵美, 岩渕博史 and 内山公男

栃木県歯科医学会誌 65 53 - 58 2013年04月

共著

症例1は65歳男性で、原発不明癌・多発骨転移のためゾレドロン酸水和物の静脈注射を受けていたが、左側下顎臼歯部舌側の骨露出を指摘された。CTで腐骨を認め、ビスホスホネート関連顎骨壊死と診断した。ビスホスホネート(BP)製剤は休薬として抗菌薬による消炎、局所洗浄を行ったが腐骨露出範囲は大きくなり、外科的治療を施行した。健康な骨を一部含めて腐骨を除去し、減張切開を加え完全閉創した。症例2は85歳女性で、骨粗鬆症のためリセドロン酸ナトリウム水和物を内服していたが、以前抜歯後義歯装着した右側上顎第一・第二大臼歯部に疼痛、排膿、骨露出が出現した。CTで右側上顎骨に腐骨を認め、上顎洞粘膜に中等度の肥厚がみられた。症例1と同様の診断でBP製剤は休薬し、抗菌薬で消炎した後、腐骨除去術、瘻孔閉鎖術を行い、粘膜欠損部は頬脂肪体で完全閉創した。症例1は術後4ヵ月、症例2は6ヵ月経過し、術創は上皮で覆われ、新たな顎骨壊死は認めない。

化学療法後に敗血症性ショックを起こし救命しえた一例

相馬智也, 小松俊一, 杉山健太郎, 山田学, 岩渕絵美, 岩渕博史 and 内山公男

栃木県歯科医学会誌 64 81 - 86 2012年04月

共著, 筆頭著者

53歳女。右側舌側縁部腫瘤(潰瘍部)精査加療依頼で受診した。右側舌側縁部〜口底に周囲に硬結を伴う潰瘍性病変を認め、血液検査、画像検査所見より舌・口底扁平上皮癌(T3N1M0)、高分化型扁平上皮癌と診断された。術前化学療法(TPF療法)2クール後、腫瘍切除術(舌亜全摘)・頸部郭清術・再建術の方針としたが、化学療法開始後8日目に好中球数低下と38℃の発熱を認めた。また、化学療法開始後30日目より全身状態が悪化をしてショック・急性腎不全の状態となり、血液培養にてFusobacterium nucleatumが検出された。一連の経過より、同菌による敗血症性ショックとそれに伴う急性腎不全の合併と考えられたが、膿瘍は確認できず、敗血症の原因は不明であった。

12年間にわたった多発性口腔癌の1例

小松俊一,相馬智也, 杉山健太郎, 山田学, 岩渕絵美, 岩渕博史 and 内山公男

栃木県歯科医学会誌（(一社)栃木県歯科医師会） 64 161 - 167 2012年04月

共著

61歳男。右上顎第2大臼歯遠心部歯肉潰瘍精査依頼および疼痛と主訴とした。初診時には右上顎に潰瘍を伴う歯肉の腫脹を認め、右上顎歯肉癌(T2N0M0、扁平上皮癌)と診断された。化学療法と外科的切除を行い、病理組織診断は中分化型・浸潤様式2型の扁平上皮癌であった。1次癌の術後1年2ヵ月に左下顎第1大臼歯部頬側歯肉にびらん形成と周囲の白斑を認め、左下顎歯肉癌(T2N0M0、扁平上皮癌)と診断された。化学療法と外科的切除を行い、病理組織診断は中分化型扁平上皮癌であった。2次癌の術後8年10ヵ月に右下顎第2小臼歯・第1大臼歯舌側歯肉に外向性の腫瘤を認め、右下顎歯肉癌(T2N0M0、扁平上皮癌)と診断された。化学療法と外科的切除を行い、現在まで再発・転移を認めず経過良好である。自験例は12年間にわたって上下顎歯肉に異所性、異時性に発生した典型的な多発性癌であった。

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