Publications by authors named "Hiroshi Urakawa"

Background: Voriconazole-induced periostitis is predominantly reported in adults, with pediatric cases being exceedingly rare.

Case Presentation: This report describes an 8-year-old boy with voriconazole-induced periostitis presenting with finger pain and nodules, initially suspected to be bone tumors. The patient had been on voriconazole for two years and seven months to treat Aspergillus pneumonia and had been hospitalized for six months due to chronic graft-versus-host disease following hematopoietic stem cell transplantation and total body irradiation for severe congenital neutropenia.

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Background: Assessing the response to neoadjuvant chemotherapy is crucial for determining surgical treatment strategies and optimizing personalized postoperative care in osteosarcoma patients. The apparent diffusion coefficient, derived from diffusion-weighted imaging, reflects tumor aggressiveness; however, its role in evaluating neoadjuvant chemotherapy response remains unclear. This study aimed to evaluate the utility of apparent diffusion coefficient maps in assessing chemotherapy-induced necrosis and prognosis in osteosarcoma.

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Background: Nodular fasciitis (NF) shrinks spontaneously; however, few reports have focused on its self-regression. This study investigated NF shrinkage.

Methods: We retrospectively reviewed 55 patients with NF who visited Nagoya University Hospital.

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Objectives: The management of soft tissue sarcoma in patients aged ≥ 85 years remains a clinical dilemma, as evidence to guide treatment decisions in this population is limited. Here, we aimed to compare the clinical characteristics of patients aged ≥ 85 years who underwent surgery with those who did not, to identify factors influencing surgical decision-making. We also assessed the oncological outcomes and postoperative complications in the patients.

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Multiple osteochondromas (MO) occur in approximately 1 in 50,000 people/yr. One in 3 patients with MO will develop valgus knee deformity (VKD), but the predictive factors for VKD are unclear. The purpose of this study was to examine the factors associated with VKD in patients with MO.

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Background: The Compress is designed to achieve bone formation and stability by applying pressure at the bone-implant interface, minimizing the likelihood of aseptic loosening, which is a complication of stem implants. Herein, we report two cases of implant failure using the Compress.

Case Presentation: Case 1 describes a 36 year-old Japanese man who underwent extraarticular tumor resection, Compress arthroplasty, and reconstruction with a gastrocnemius flap after preoperative chemotherapy for a secondary malignant giant cell tumor in the right distal femur.

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Objective: In Japan, selumetinib is used in pediatric patients with neurofibromatosis type 1 (NF1) and symptomatic inoperable plexiform neurofibroma (PN). However, there have been no real-world reports on Japanese patients. In this study, we reported a single-center, short-term experience with selumetinib after its approval in Japan.

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Solid tumors harboring mutations in the Braf gene () are currently treated by combination Braf/MEK inhibitor therapy, and there is an extensive literature on patient response rates. Alternatively, few studies have documented the clinical response of mutation-positive solid tumors to MEK inhibitor monotherapy. We report the case of a 57-year-old female diagnosed with papillary thyroid carcinoma and progressive lung metastases initially treated by total thyroidectomy and subsequent thyroid-stimulating hormone suppression therapy.

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Article Synopsis
  • - The study aims to confirm findings about liver function by comparing signal intensity in gadoxetate-enhanced MRI and extracellular volume fraction (ECV) from CT in patients with Alcoholic Liver Disease (ALD) between January 2013 and September 2018.
  • - A total of 48 ALD patients were analyzed, with results showing various grades of gallbladder fossa necrosis (GBFN) and corresponding signal intensities and ECV ratios suggesting differences in liver function and fibrosis.
  • - The study finds a significant correlation between GBFN grades and both signal intensity and ECV ratios, indicating that higher grades of GBFN have more functioning liver cells and less fibrosis compared to the surrounding liver tissue.
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  • The study examines how proton pump inhibitors (PPIs) and potassium-competitive acid blockers (P-CABs) affect the absorption and efficacy of the oral drug pazopanib in patients with soft tissue sarcoma.
  • Researchers analyzed medical records of eight patients who were treated with pazopanib, considering those who also used PPIs/P-CABs.
  • Results indicated that while the use of PPIs/P-CABs did not significantly affect the time to treatment failure, it led to less frequent dose reductions/interruption of pazopanib and milder neutropenia, suggesting a potential decrease in pazopanib's pharmacological activity.
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  • The study assessed bleeding risks in COVID-19 patients on extracorporeal membrane oxygenation (ECMO) and evaluated the effectiveness of transcatheter arterial embolization (TAE) for controlling bleeding.
  • Out of 43 patients, 25 bleeding events were recorded, with older age linked to higher risks of bleeding and fatality; those with bleeding had longer hospital stays and higher death rates.
  • TAE was successful in managing bleeding in most cases, highlighting its role in treating elderly patients with COVID-19 experiencing severe complications while on ECMO.
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  • The study investigates gallbladder fossa nodularity (GBFN) in patients with alcoholic liver disease (ALD), proposing that reduced blood flow from portal veins due to cholecystic venous drainage (CVD) may cause this nodularity to arise, sparing affected liver tissue from alcohol-related damage.
  • Researchers analyzed CT scans from 45 ALD patients and 46 with chronic hepatitis C (CHC), noting that GBFN was more common and higher in grade among ALD patients; they also found significant correlations with alcohol consumption and liver function indicators.
  • The findings suggest GBFN could indicate liver tissue that avoids alcohol exposure, offering a specific but low-sensitivity marker for
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  • The study investigates the surgical outcomes and complications of removing deep-seated nodular plexiform neurofibromas in patients with neurofibromatosis type 1, based on a review of cases from 2015 to 2021.
  • Surgical methods included enucleation to preserve nerves and en bloc resection when nerves were entrapped, involving 24 tumors in 15 patients.
  • Post-surgery, all patients experienced symptom resolution, though some faced new but mild neurological deficits, suggesting the procedure is generally safe with a low risk of severe complications.
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Background: The treatment of choice for desmoid-type fibromatosis (DF) has been changed to active surveillance (AS). However, few studies have reported clinical outcomes of AS modality in Asian countries. This study aimed to clarify the significance of AS as a DF treatment modality.

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Purpose: To verify the hypothesis that extracellular volume fraction (ECV) and precontrast CT density are the main determinants of washout of hepatocellular carcinoma (HCC) at the equilibrium phase CT.

Materials And Methods: Between 2018 and 2020, patients with surgically resected HCC were recruited who had undergone preoperative 4-phase CT. Those larger than 6 cm were excluded to minimize the possibility of intratumoral hemorrhage or degeneration.

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  • Hyaluronan (HA) is important for maintaining cartilage, but its changes in osteoarthritis (OA) and osteonecrosis of the femoral head (ONFH) need more research.
  • The study focused on how KIAA1199, a hyaluronidase, affects HA metabolism in OA and ONFH by analyzing human cartilage samples.
  • Findings revealed that KIAA1199 is overexpressed in OA, leading to changes in HA levels, while ONFH showed lower KIAA1199 expression and a less active HA metabolism.
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  • The JCOG1610 trial aimed to compare preoperative denosumab treatment to curettage with local therapy for patients with giant cell tumor of bone, focusing on relapse-free survival as the main outcome.
  • Patient enrollment started in October 2017 but was halted in December 2020 due to low participant numbers, with only 18 patients registered across 13 institutions at that time.
  • Results indicated that preoperative denosumab did not show superiority over the traditional method in preventing tumor relapse, with similar relapse-free survival rates observed in both treatment groups after one and two years.
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Giant-cell tumor of bone is a rare, locally aggressive and rarely metastasizing primary bone tumor. The mainstay of treatment remains controversial and is decided by the balance between adequate surgical margin and sufficient adjacent joint function. Although curettage with a high-speed burr and local adjuvants can maintain normal joint function, many reports have revealed a high local recurrence rate.

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  • The study investigates how diffusion-weighted imaging (DWI) can help differentiate between benign plexiform neurofibromas (pNF) and malignant peripheral nerve sheath tumors (MPNST) in patients with neurofibromatosis type 1 (NF1).
  • Researchers analyzed 29 NF1 cases, comparing diagnostic features and apparent diffusion coefficient (ADC) values using magnetic resonance imaging (MRI).
  • Results showed significant differences in tumor characteristics between pNF and MPNST, with DWI providing a valuable tool for differentiation, increasing diagnostic accuracy when used alongside standard MRI evaluations.
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The mainstay of treatment for desmoid has been shifted to active surveillance (AS). However, surgery is still being performed on abdominal wall desmoid with a wide surgical margin. The purposes of this study are to clarify the treatment results of less-invasive, fascia preserving surgery for patients with abdominal wall desmoid, and to propose a new treatment modality.

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Purpose: To clarify clinico-radiological factors for high-risk esophago-gastric varices (EGV), including extracellular volume fraction (ECV) of the liver, pancreas, and the spleen.

Methods: Between 2014 and 2018, 70 chronic liver disease patients who underwent 4-phase CT of the upper abdomen and either of upper gastrointestinal tract endoscopy, or actual treatment for bleeding EGV, within three months after CT, were retrospectively included. Patients were subdivided into high-risk EGV group (HRG), who had high-risk endoscopic findings or actual hemostatic treatments, and non-high-risk EGV group (NHRG).

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  • Osteochondral destruction and high recurrence rates post-surgery are significant challenges in treating tenosynovial giant cell tumors, prompting a study of 80 surgically treated patients with intra-articular tumors.
  • The study found a 5-year local recurrence-free survival rate of 71.4%, with diffuse tumor type and knee location identified as key risk factors for recurrence and destruction.
  • Additionally, local recurrence is associated with greater chances of osteochondral destruction, highlighting the importance of tumor type and location in managing these tumors.
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  • Reconstruction of the lower lumbar region is difficult for surgeons due to limited options for locoregional flaps.
  • The standard latissimus dorsi muscle flap has limitations, particularly related to its blood supply and mobility.
  • A novel surgical technique is introduced that extends the rotation arc of reverse latissimus dorsi flaps, improving their reach and allowing for effective lower back reconstruction while maintaining blood supply.
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Background: Hyaluronan (HA) has been shown to play important roles in the growth, invasion, and metastasis of malignant tumors. KIAA1199, which has potent HA-degrading activity, has been reported to be expressed in various malignancies and associated with patient prognosis. However, there are no reports on the expression of KIAA1199 in osteosarcoma.

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