研究者詳細 - 河津　俊幸

Patency assessment of the internal jugular vein after neck dissection

T. Nagata, K. Matsunaga, T. Kawazu, S. Kawano, K. Oobu, M. Ohishi

International Journal of Oral and Maxillofacial Surgery 35 ( 5 ) 416 - 420 2006年5月

掲載種別：研究論文（学術雑誌）

Twenty-seven patients with oral malignant tumours, who underwent neck dissection with preservation of the internal jugular vein (IJV), were studied retrospectively to evaluate patency of the IJV. Twenty-three patients underwent ablative surgery of the primary lesion with neck dissection and 4 underwent neck dissection alone. Three patients received simple closure and skin grafting of the primary lesion, and 20 received reconstruction surgery (4 platysma flaps, 3 radial forearm flaps, 3 lateral upper arm flaps, 2 pectoralis major myocutaneous flaps and 8 rectus abdominis myocutaneous flaps). The maximum and minimum diameters of the IJV as measured on computed tomographic (CT) scans were used to assess patency. The cross-sectional area of the IJV and the ratio of its long axis to short axis (L/S ratio) were calculated. The relation between the change in IJV status and the type of flap used for reconstruction was also examined. Occlusion of the IJV was present in 3.7% of the patients, and 'narrowing' was present in 63.6%. The size of the flap significantly correlated with 'narrowing' of the IJV, suggesting that 'narrowing' was caused mainly by compression due to the flap. © 2005 International Association of Oral and Maxillofacial Surgeons.

DOI： 10.1016/j.ijom.2005.09.004

Scopus

PubMed

Correlation between diagnostic accuracy and perceptibility

K Yoshiura, K Okamura, K Tokumori, E Nakayama, T Chikui, TK Goto, M Shimizu, T Kawazu

DENTOMAXILLOFACIAL RADIOLOGY 34 ( 6 ) 350 - 352 2005年11月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BRITISH INST RADIOLOGY

Objectives: To correlate diagnostic accuracy for proximal caries with perceptibility of low contrast image details using regression analysis. The other purpose was to determine the attenuation range required for proximal caries diagnosis.
Methods: The results of the two types of observer performance tests described above were retrieved from previous studies. Recording media included in those studies were the Compuray and the Dixel, direct digital radiographic systems, and Ektaspeed Plus film. The average numbers of perceptibility of image details from five observers were calculated for each step and for every combination of contiguous steps of the aluminium test phantom from the perceptibility test. The average diagnostic accuracy for proximal caries from the same five observers was correlated with the total number of perceptible details from the phantom using regression analysis. Finally, attenuation range required for proximal caries diagnosis was calculated from the attenuation range of the phantom where the maximum correlation coefficient was obtained.
Results: Maximum correlation (r = 0.68) was obtained at the combination of five contiguous steps of the aluminium test phantom. Attenuation range required for proximal caries diagnosis corresponded to the 2 mm to 6 turn thickness of aluminium with acrylic block of 12 mm thickness.
Conclusions: There is a correlation between perceptibility of low contrast image details and diagnostic accuracy for proximal caries. There may be a possibility to simplify observer performance tests for proximal caries diagnosis by using the standardized phantom simulating its attenuation range.

DOI： 10.1259/dmfr/13550415

Effects of the automatic exposure compensation on the proximal caries diagnosis

K Yoshiura, E Nakayama, M Shimizu, TK Goto, T Chikui, T Kawazu, K Okamura

DENTOMAXILLOFACIAL RADIOLOGY 34 ( 3 ) 140 - 144 2005年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BRITISH INST RADIOLOGY

Objective: To elucidate the effect of automatic exposure compensation (AEC) on the diagnostic accuracy of proximal caries by comparing several digital intraoral imaging systems with a film.
Materials and methods: Twenty-seven extracted teeth served as proximal caries samples. Three digital radiographic systems; the Compuray, the Dixel, and the Sens-A-Ray without scintillator layer, and Kodak Ekta-speed Plus films were used as recording media. Radiographs of the teeth samples were obtained with each recording medium under seven to eight different exposures including the optimum level. Six oral radiologists evaluated the possibility of proximal caries with the five-grade-confidence-scale. On digital radiographs, image manipulations were allowed after the initial assessment. Receiver operating characteristic (ROC) curves were obtained at each exposure in each recording medium. The area under the ROC curve (Az) was used as the representative value of diagnostic accuracy. Diagnostic accuracy (DA) curves were obtained by plotting averaged A, values from all observers as a function of incident exposure in each system.
Results: The effect of exposure variation on the DA was slight in the film while it was significantly larger in the digital systems without AEC. Among digital systems, the effect of exposure variation was smaller in the system with AEC than those without AEC. There was no significant effect on the diagnostic accuracy even if digital image manipulation was employed.
Conclusion: AEC minimizes the decrease of DA due to inadequate exposures. Since it compensates for the narrow exposure range in the digital intraoral sensor systems, the system with AEC may be preferable for the clinical diagnostic tasks.

コンピュータ診断支援(CAD)を利用した学生教育用教材の開発

河津俊幸, 徳森謙二, 吉浦一紀

歯科放射線 45 ( 1 ) 31 - 31 2005年3月

当科における口腔扁平上皮癌頸部リンパ節転移の診断および治療方法の変遷と治療成績の向上

中村誠司, 蔵原慎一, 筑井徹, 河津俊幸, 杉浦剛, 豊嶋健史, 林田淳之將, 白砂兼光

日本口腔科学会雑誌 54 ( 1 ) 84 - 85 2005年1月

口腔癌の頸部リンパ節転移に対する画像診断法とその診断能

神田重信, 筑井徹, 河津俊幸, 湯浅賢治

日本口腔腫瘍学会誌 = Journal of Japan Society for Oral Tumors 16 ( 3 ) 75 - 84 2004年9月

記述言語：日本語出版者・発行元：Japanese Society of Oral Oncology

頭頸部癌の頸部リンパ節転移に対する画像診断法として, CTや超音波診断法などが利用されている。著者らはこれらの画像診断法における転移の診断基準および診断精度 (感度, 特異度, 正診率) について文献考察を行った。また, これらの画像診断法により頸部リンパ節転移を予測するために, その診断効率を検討した。さらに, 著者らの分析結果によるCT, Bモード超音波診断法およびPowerDoppler法による診断基準, およびPPV, NPVについて述べるとともに, 当診療科における頸部リンパ節転移検索の方法を説明した。<BR>CTを用いた場合の診断能は, 感度は49%～100%, 特異度は38%～100%であった。Bモード超音波診断法を用いた場合の診断能は, 感度は58%～95%, 特異度は37%～96%であった。ドップラー超音波診断法では, 感度は55%～98%, 特異度は77%～100%であった。これらの結果から, CTにより頸部リンパ節転移を予測できるPPVは91%であり, Bモード超音波診断法のPPVは97%で, ドップラー超音波診断法のPPVは87%となった。

DOI： 10.5843/jsot.16.75

CiNii Books

内視鏡下唾石摘出術のためのＳｉａｌｅｎｄｏｓｃｏｐｙの開発とそれを使用した１例

その他リンク： http://search.jamas.or.jp/link/ui/2005078184

中山英二, 河津俊幸, 中村典史, 岡村和俊, 神田重信, 大石正道

日本口腔科学会雑誌 53 ( 2 ) 81 - 86 2004年

記述言語：日本語出版者・発行元：Japanese Stomatological Society

We developed two types of fine sialendoscope, which could be introduced to the submandibular duct through the opening of sublingual caruncula. One is a sialendoscope of 1.1-mm outer-diameter (POLYDIAGNOST GmbH, Germany) with 6000-pixels optic fibers, and it has a working channel to insert a basket forceps and an irrigation channel. The other is a sialendoscope of 1.2-mm outer-diameter (FiberTech Co., Ltd., Japan) with 1600-pixels optic fibers and a working channel. Using these newly developed sialendoscopy systems and a 1.9F basket forceps (Boston Scientific Corporation, USA), we could successfully remove a sialolith of the submandibular gland of a 9-year-old girl.

DOI： 10.11277/stomatology1952.53.81

Interventional sialendoscopy: A new procedure for noninvasive insertion and a minimally invasive sialolithectomy 査読

Eiji Nakayama, Kenji Yuasa, Mahiro Beppu, Toshiyuki Kawazu, Kazutoshi Okamura, Shigenobu Kanda

Journal of Oral and Maxillofacial Surgery 61 ( 10 ) 1233 - 1236 2003年10月

ANFISを応用したコンピュータ診断支援システム

田中武昌, 河津俊幸, 神田重信

バイオメディカル・ファジィ・システム学会誌 5 ( 1 ) 49 - 54 2003年

記述言語：日本語出版者・発行元：バイオメディカル・ファジィ・システム学会

近年、ファジィ理論やニューラルネットワークを診断支援に応用する試みが報告されているが、臨床家に幅広く認知されているわけではない。一般的な臨床家にはファジイやニューラルネットワークの理論は難しく、また診断支援システムを開発する技術もないためである。そこで、著者らは日常の臨床経験を元にした簡潔な推論を設定するだけで、診断支援が最適化される手法を提案する。それは標準的なPC環境で運用でき、一般的なアプリケーションを利用するので、プログラミングの知識がない者でもシステムを構築できる。また、内部的にはファジィ理論にニューラルネットワークのアルゴリズムを組み合わせたadaptive neuro-fuzzy inference system (ANFIS)を応用しており、最初に暫定的に設定されたメンバシップ関数がニューラルネットワークのバックプロパゲーションにより自動的に最適化され、診断支援システムが向上されるようになっている。今回はその概要を超音波診断への試用を例に解説する。

DOI： 10.24466/jbfsa.5.1_49

CiNii Books

The combined use of US and MR imaging for the diagnosis of masses in the parotid region

TK Goto, K Yoshiura, E Nakayama, K Yuasa, O Tabata, T Nakano, T Kawazu, T Tanaka, K Miwa, M Shimizu, T Chikui, K Okamura, S Kanda

ACTA RADIOLOGICA 42 ( 1 ) 88 - 95 2001年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：MUNKSGAARD INT PUBL LTD

Purpose: To evaluate the usefulness of the combination of the two non-invasive modalities US and MR imaging to diagnose masses in the parotid region.
Material and Methods: The US and MR findings of 21 patients with parotid masses were analyzed retrospectively by two radiologists without any clinical or histopathological information. The specific points evaluated were location, shape, margin, internal architecture, and intensity level on both US and MR, posterior echo enhancement on US, and capsule-like lining of the tumor on MR.
Results: The findings concerning the shape and margin on US and MR were in fairly good agreement. Concerning the findings of the internal architecture. US could reveal the minute structures of the tumor while MR demonstrated differences in the signal intensities of histological tissue types of the various tumors. The posterior echo enhancement on US and the capsule-like lining on MR of the tumors were also useful for the diagnosis.
Conclusion: Our results suggest that the combination of US and MR is useful for examining soft tissue masses in the parotid region to make a more accurate diagnosis, and not just differentiate malignant lesions from those which are benign.

Computed tomography and ultrasonography of metastatic cervical lymph nodes in oral squamous cell carcinoma 査読

K Yuasa, T Kawazu, T Nagata, S Kanda, M Ohishi, K Shirasuna

DENTOMAXILLOFACIAL RADIOLOGY 29 ( 4 ) 238 - 244 2000年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：NATURE PUBLISHING GROUP

Objectives: To define criteria for CT and US in differentiating cervical lymph node metastases in oral squamous cell carcinoma (SCC).
Materials and methods: CT and/or US of 230 metastatic lymph nodes and 228 benign lymph nodes in 147 patients with oral SCC were retrospectively evaluated. The CT and US findings of each lymph node were compared with the histopathological findings. A metastasis was defined on Ci as a lymph node with rim or heterogeneous enhancement, or measuring 10 mm or more in the short axis. regardless of enhancement pattern, and on US as having definite internal echoes. regardless of size, or without definite internal or hilar echoes, but measuring 10 mm or more in the short axis. A lymph node with hilar echoes or a ratio of the long to short axis (L/S ratio, of 3.5 or more was considered benign. A lymph node failing to conform to any of these categories was termed questionable.
Results: The positive predictive value (PPV) for CT was 90.8% and the negative predictive value (NPV) was 70.4%. However, 65.7% of all lymph nodes could not be classified as either metastastic or benign. PPV for US was 96.5% and NPV was 88.1%. 25.5% of all lymph nodes could not be classified as either metastatic or benign.
Conclusions: Despite limitations in detecting metastses, by including a third category 'questionable' our criteria appear clinically more useful than other current methods based on two groups only.

口腔癌頚部リンパ節転移に対する画像診断法のアプローチ

神田重信, 湯浅賢治, 中山英二, 河津俊幸

歯科放射線 40 ( 2 ) 109 - 121 2000年

記述言語：日本語出版者・発行元：特定非営利活動法人日本歯科放射線学会

Palpation and imaging procedures such as computed tomography (CT), ultrasonography (US), magnetic resonance imaging (MR), radioisotope imaging (RI) and lymphography are examined for predicting cervical lymph node metastasis in head and neck cancer patients. We reviewed the criteria for metastasis and diagnostic accuracy (sensitivity, specificity and accuracy) of these diagnostic procedures in previous reports. We then discussed the efficiency of these diagnostic procedures for predicting cervical metastasis. Furthermore, our criteria and its positive predictive value (PPV) and negative predictive value (NPV) with CT, B-mode US and power Doppler US, and the methods of CT and US examinations in our department were reported. In previous reports, it was reported that sensitivity was 47%-97%, specificity was 38-92%, accuracy was 69-88% with palpation. The diagnostic efficiency of lympography was considered to be low. Now this procedure is not used in diagnosing cervical metastasis. ¹⁸FDG-PET was preformed mainly. Its sensitivity and specificity were 50-93% and 77-100%, respectively. With CT, sensitivity and specificity were 49%-100%, 38%-100%, respectively. With MR, sensitivity and specificity were 47%-100%, 48%-100%, respectively. With B-mode US, sensitivity and specificity were 58%-95%, 37%-96%, respectively. With Doppler US, sensitivity and specificity were 55%-98%, 77%-100%, respectively. In the results of our study, PPV for predicting metastasis with CT was 91%. PPV for predicting metastasis with B-mode US were 97%. PPV for predicting metastasis with power Doppler US were 87%.

DOI： 10.11242/dentalradiology1960.40.109

Clinical evaluation of "veraviewpocs" digital panoramic X-ray system.

M. Tatsumi, K. Yoshiura, K. Yuasa, O. Tabata, E. Nakayama, T. Kawazu, T. Chikui, M. Katoh, S. Kanda

International journal of computerized dentistry 3 ( 3 ) 183 - 195 2000年

A new, simple method of making a spacer in interstitial brachytherapy for mobile tongue cancer 査読

Kenji Yuasa, Toshiyuki Kawazu, Masahiro Morita, Satoru Uehara, Naonobu Kunitake, Shigenobu Kanda

Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 89 ( 4 ) 519 - 521 2000年

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: This article demonstrates a new method of making a spacer that increases the distance between the mandible and implanted radioactive sources in interstitial brachytherapy for patients with mobile tongue cancer. STUDY DESIGN: Fifty-three patients with mobile tongue cancer underwent interstitial brachytherapy with spacers made by this new technique. RESULTS: Our spacer is not difficult to create or to use. The spacer was made from a plastic splint by using thermoforming techniques and quick self-curing resin, which did not need waxing, wiring, or casting. The surface of the spacer, which comes in contact with the tongue, is smooth because it is covered with tissue-conditioning material. There were no complaints of pain from the patients. Osteoradionecrosis of the mandible developed in only 1 (1.9%) of these patients. CONCLUSIONS: This spacer is simple to make and prevented osteoradionecrosis.

DOI： 10.1016/S1079-2104(00)70134-X

Scopus

PubMed