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Articles by H Takayama
Total Records ( 3 ) for H Takayama
  Y Nakai , N Nonomura , A Kawashima , M Mukai , A Nagahara , M Nakayama , H Takayama , K Nishimura and A. Okuyama
  Objective

Non-muscle-invasive high-grade (T1G3) bladder cancers have high potential for progression. The objective of this study is to clarify the clinicopathological factors affecting the outcome of T1G3 bladder cancer.

Methods

We retrospectively reviewed 60 cases of T1G3 bladder cancer between 1994 and 2006. The correlations of both intravesical recurrence and progression with prognostic factors, such as T stage, history of bladder cancer, multiplicity, concomitant carcinoma in situ, tumor size, intravesical instillation of bacillus Calmette–Guérin and intravesical chemotherapy, were evaluated by multivariate analysis with the Cox proportional hazards model.

Results

Median follow-up period was 52 months (4–105 months). Thirty-seven cases of intravesical recurrence (61.7%) were observed during follow-up. Two- and 5-year recurrence-free survival rates were 44.1% and 36.1%, respectively. Tumor multiplicity and instillation of bacillus Calmette–Guérin were significantly correlated with intravesical recurrence on multivariate analysis. Ten cases of progression (16.7%) were observed during the follow-up period. Two- and 5-year progression-free survival rates were 87.7% and 83.4%, respectively. Only tumor multiplicity was significantly correlated with progression on multivariate analysis.

Conclusions

T1G3 cancers with multiple lesions showed high risks of intravesical recurrence and progression. Although bacillus Calmette–Guérin instillation reduced the risk of intravesical recurrence, no effect was observed on disease progression.

  B Wei , H Takayama and M. D. Bacchetta
 

Left ventricular assist devices (LVADs) are increasingly being used as both bridge-to-transplantation and destination therapy in patients with severe congestive heart failure. Performing noncardiac surgical procedures in patients with LVADs represents a unique challenge given the anatomic, hemodynamic, and hematologic considerations in these patients. We present the case of a man with an LVAD who successfully underwent right upper lobectomy for a pulmonary nodule. The literature on thoracic surgery procedures in LVAD patients and the intraoperative and postoperative management of these patients are also reviewed.

  M Tabata , H Takayama , M. E Bowdish , C. R Smith and A. S. Stewart
 

A conduit was made by sewing a bovine pericardial valve into a graft conduit with the pseudo-sinuses of Valsalva. The graft collar below the valve cuff ring was sewn to the aortic annulus with interrupted pledgeted sutures. From August 2005 to February 2008, 68 patients underwent aortic root replacements with this technique. Operative mortality was 2.9% (2 acute aortic dissection patients died). During median follow-up of 11 months, 1 patient had reoperation for conduit failure due to infectious endocarditis. This technique is safe and feasible with favorable early outcomes. Because the valve is sewn above the outflow tract, superior hemodynamics are achieved. Reoperation may be accomplished by removal of the valve rather than full root re-replacement.

 
 
 
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