| JaLCDOI | 10.18926/AMO/50414 |
|---|---|
| FullText URL | 67_3_197.pdf |
| Author | Yasuhara, Takao| Takahashi, Yuichi| Kumamoto, Shinji| Nakahara, Masayuki| Yoneda, Kotaro| Niimura, Tatsuomi| Tanoue, Takashi| Kusumegi, Akira| Sennari, Takashi| Hijikata, Yasukazu| Manabe, Hiroaki| Miyoshi, Yasuyuki| Date, Isao| Ogawa, Koichi| Nishida, Kenki| |
| Abstract | Some cases with lumbar degenerative diseases require multi-level fusion surgeries. At our institute, 27 and 4 procedures of 3- and 4-level fusion were performed out of a total 672 posterior lumbar interfusions (PLIFs) on patients with lumbar degenerative disease from 2005 to 2010. We present 2 osteoporotic patients who developed proximal vertebral body fracture after 4-level fusion. Both cases presented with gait disability for leg pain by degenerative lumbar scoliosis and canal stenosis at the levels of L1/2-4/5. After 4-level fusion using L1 as the upper instrumented vertebra, proximal vertebral body fractures were found along with the right pedicle fractures of L1 in both cases. One of these patients, aged 82 years, was treated as an outpatient using a hard corset for 24 months, but the fractures were exacerbated over time. In the other patient, posterolateral fusion was extended from Th10 to L5. Both patients can walk alone and have been thoroughly followed up. In both cases, the fracture of the right L1 pedicle might be related to the subsequent fractures and fusion failure. In consideration of multi-level fusion, L1 should be avoided as an upper instrumented vertebra to prevent junctional kyphosis, especially in cases with osteoporosis and flat back posture. |
| Keywords | degenerative lumbar scoliosis osteoporosis pedicle fracture posterior lumbar interbody fusion vertebral body fracture |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-06 |
| Volume | volume67 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 197 |
| End Page | 202 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23804144 |
| Web of Science KeyUT | 000320747900010 |
| JaLCDOI | 10.18926/AMO/50413 |
|---|---|
| FullText URL | 67_3_191.pdf |
| Author | Binti Md Nor, Nurliza| Kusumoto, Tomoyuki| Inoue, Seiji| Nakamura, Keiichiro| Seki, Noriko| Hongo, Atsushi| Kodama, Junichi| Hiramatsu, Yuji| |
| Abstract | Struma ovarii is a rare neoplasm that accounts for approximately 0.3ｵ of ovarian tumors. Due to its ultrasound morphology, which is quite similar to that of malignant ovarian carcinoma, most struma ovarii cases are open operated with laparotomy rather than laparoscopy. We present 3 cases of struma ovarii, which were diagnosed preoperatively by imaging studies and removed by laparoscopic surgery. All patients were premenopausal women between ages 31‒50. The magnetic resonance imaging (MRI) findings were complex masses composed of multiple cysts and solid components with T2-hypointense regions as well as multiple T1-hyperintense cystic areas, findings that are typical for struma ovarii. A combination of plain computed tomography (CT), positron emission tomography (PET)-CT, and scintigraphy was useful for diagnosis. Laboratory examination revealed elevated serum thyroglobulin, which led to the diagnosis of struma ovarii. Laparoscopic surgeries were performed without rupturing the tumors. Although it has been difficult to differentiate between struma ovarii and malignant tumors by conventional methods, recently MRI techniques appear make it possible to diagnose struma ovarii preoperatively from the abovementioned imaging characteristic, together with laboratory data. As for treatment, we think laparoscopy could be successful for struma ovarii, but the surgeon must be careful not to rupture the tumor intra-abdominally in order to prevent dissemination, which could lead to malignancy. |
| Keywords | struma ovarii ovarian neoplasms MRI laparoscopic surgery |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-06 |
| Volume | volume67 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 191 |
| End Page | 195 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23804143 |
| Web of Science KeyUT | 000320747900009 |
| JaLCDOI | 10.18926/AMO/50412 |
|---|---|
| FullText URL | 67_3_185.pdf |
| Author | Misawa, Haruo| Tanaka, Masato| Sugimoto, Yoshihisa| Koshimune, Kouichiro| Ozaki, Toshifumi| |
| Abstract | Cervical misalignment after upper cervical fusion including the occipital bone may cause trismus or dysphagia, because the occipito-atlanto joint is associated with most of the flex and extended motion of the cervical spine. There are no reports of dysphagia and trismus after C1-2 fusion. The purpose of this paper is to demonstrate the potential risk of dysphagia and trismus even after upper cervical short fusion without the occipital bone. The patient was a 69-year-old man with myelopathy caused by os odontoideum and Klippel-Feil syndrome, who developed dysphagia and trismus immediately after C1-2 fusion and C3-6 laminoplasty. Radiographs and CT revealed that his neck posture was extended, but his symptoms still existed a week after surgery. The fixation angle was hyperextended 12 days after the first surgery. His symptoms disappeared immediately after revision surgery. The fixation in the neck-flexed position is thought to be the main cause of the patientʼs post-operative dysphagia and trismus. Dysphagia and trismus may occur even after short upper cervical fusion without the occipital bone or cervical fusion in the neck-extended position. The pre-operative cervical alignment and range of motion of each segment should be thoroughly evaluated. |
| Keywords | dysphagia trismus os odontoid Klippel-Feil syndrome atlantoaxial posterior fusion |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-06 |
| Volume | volume67 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 185 |
| End Page | 190 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23804142 |
| Web of Science KeyUT | 000320747900008 |
| JaLCDOI | 10.18926/AMO/50411 |
|---|---|
| FullText URL | 67_3_177.pdf |
| Author | Matsuo, Toshihiko| Yamasaki, Hanako| Yasuhara, Hirotaka| Hasebe, Kayoko| |
| Abstract | To test the effect of double vision on postural stability, we measured postural stability by electric stabilometry before prism-wearing and immediately, 15, 30, and 60min after continuous prism-wearing with 6 prism diopters in total (a 3-prism-diopter prism placed with the base up in front of one eye and with the base down in front of the other eye) in 20 normal adult individuals with their eyes open or closed. Changes in stabilometric parameters in the time course of 60min were analyzed statistically by repeated-measure analysis of variance. When subjectsｾ eyes were closed, the total linear length (cm) and the unit-time length (cm/sec) of the sway path were significantly shortened during the 60-minute prism-wearing (p＜0.05). No significant change was noted in any stabilometric parameters obtained with the eyes open during the time course. In conclusion, postural stability did not change with the eyes open in the condition of large vertical diplopia, induced by prism-wearing for 60min, while the stability became better when measured with the eyes closed. A postural control mechanism other than that derived from visual input might be reinforced under abnormal visual input such as non-fusionable diplopia. |
| Keywords | body sway postural stability (postural control) stabilometry prism vertical diplopia |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-06 |
| Volume | volume67 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 177 |
| End Page | 183 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23804141 |
| Web of Science KeyUT | 000320747900007 |
| JaLCDOI | 10.18926/AMO/50410 |
|---|---|
| FullText URL | 67_3_171.pdf |
| Author | Hashimoto, Atsunori| Ueda, Takahiro| Kuboyama, Kazutoshi| Yamada, Taihei| Terashima, Mariko| Miyawaki, Atsushi| Nakao, Atsunori| Kotani, Joji| |
| Abstract | On April 25, 2005, a Japanese express train derailed into a building, resulting in 107 deaths and 549 injuries. We used “First Impression Triage (FIT)”, our new triage strategy based on general inspection and palpation without counting pulse/respiratory rates, and determined the feasibility of FIT in the chaotic situation of treating a large number of injured people in a brief time period. The subjects included 39 patients who required hospitalization among 113 victims transferred to our hospital. After initial assessment with FIT by an emergency physician, patients were retrospectively reassessed with the preexisting the modified Simple Triage and Rapid Treatment (START) methodology, based on Injury Severity Score, probability of survival, and ICU stay. FIT resulted in shorter waiting time for triage. FIT designations comprised 11 red (immediate), 28 yellow (delayed), while START assigned six to red and 32 to yellow. There were no statistical differences between FIT and START in the accuracy rate calculated by means of probability of survival and ICU stay. Overall validity and reliability of FIT determined by outcome assessment were similar to those of START. FIT would be a simple and accurate technique to quickly triage a large number of patients. |
| Keywords | simple triage and rapid treatment injury severity score probability of survival |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-06 |
| Volume | volume67 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 171 |
| End Page | 176 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23804140 |
| Web of Science KeyUT | 000320747900006 |
| JaLCDOI | 10.18926/AMO/50409 |
|---|---|
| FullText URL | 67_3_165.pdf |
| Author | Shien, Tadahiko| Kinoshita, Takayuki| Seki, Kunihiko| Yoshida, Miwa| Hojo, Takashi| Shimizu, Chikako| Taira, Naruto| Doihara, Hiroyoshi| Akashi-Tanaka, Sadako| Tsuda, Hitoshi| Fujiwara, Yasuhiro| |
| Abstract | While clinical and pathologic responses are important prognostic parameters, biological markers from core needle biopsy (CNB) are needed to predict neoadjuvant chemotherapy (NAC) response, to individualize treatment, and to achieve maximal efficacy. We retrospectively evaluated the cases of 183 patients with primary breast cancer who underwent surgery after NAC (anthracycline and taxane) at the National Cancer Center Hospital (NCCH). We analyzed EGFR, HER2, and p53 expression and common clinicopathological features from the CNB and surgical specimens of these patients. These biological markers were compared between sensitive patients (pathological complete response;pCR) and insensitive patients (clinical no change;cNC and clinical progressinve disease;cPD). In a comparison between the 9 (5%) sensitive patients and 30 (16%) insensitive patients, overexpression of p53 but not overexpression of either HER2 or EGFR was associated with a good response to NAC. p53 (p＝0.045) and histological grade 3 (p＝0.011) were important and significant predictors of the response to NAC. The correspondence rates for histological type, histological grade 3, ER, PgR, HER2, p53, and EGFR in insensitive patients between CNB and surgical specimens were 70%, 73%, 67%, 70%, 80%, 93%, and 73%. The pathologic response was significantly associated with p53 expression and histological grade 3. The correspondence rate of p53 expression between CNB and surgical specimens was higher than that of other factors. We conclude that the level of p53 expression in the CNB was an effective and reliable predictor of treatment response to NAC. |
| Keywords | breast cancer neoadjuvant chemotherapy predictors |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-06 |
| Volume | volume67 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 165 |
| End Page | 170 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23804139 |
| Web of Science KeyUT | Pretreatment Specimen Predicts |
| JaLCDOI | 10.18926/AMO/50408 |
|---|---|
| FullText URL | 67_3_153.pdf |
| Author | Yamamoto, Masanao| Fujita, Hirofumi| Katase, Naoki| Inoue, Keiji| Nagatsuka, Hitoshi| Utsumi, Kozo| Sasaki, Junzo| Ohuchi, Hideyo| |
| Abstract | Ever since protoporphyrin IX (PpIX) was discovered to accumulate preferentially in cancer cells after 5-aminolevulinic acid (ALA) treatment, photodynamic treatment or therapy (PDT) has been developed as an exciting new treatment option for cancer patients. However, the level of PpIX accumulation in oral cancer is fairly low and insufficient for PDT. Ferrochelatase (FECH) and ATP-binding cassette transporter G2 (ABCG2) are known to regulate PpIX accumulation. In addition, serum enhances PpIX export by ABCG2. We investigated here whether and how inhibitors of FECH and ABCG2 and their combination could improve PpIX accumulation and PDT efficacy in an oral cancer cell line in serum-containing medium. ABCG2 inhibitor and the combination of ABCG2 and FECH inhibitors increased PpIX in the presence of fetal bovine serum (FBS) in an oral cancer cell line. Analysis of ABCG2 gene silencing also revealed the involvement of ABCG2 in the regulation of PpIX accumulation. Inhibitors of FECH and ABCG2, and their combination increased the efficiency of ALA-PDT even in the presence of FBS. ALA-PDT-induced cell death was accompanied by apoptotic events and lipid peroxidation. These results suggest that accumulation of PpIX is determined by the activities of ABCG2 and FECH and that treatment with a combination of their inhibitors improves the efficacy of PDT for oral cancer, especially in the presence of serum. |
| Keywords | 5-aminolevulinic acid protoporphyrin IX oncology photodynamic therapy apoptosis |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-06 |
| Volume | volume67 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 153 |
| End Page | 164 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23804138 |
| Web of Science KeyUT | 000320747900004 |
| Related Url | http://ousar.lib.okayama-u.ac.jp/metadata/50681 |
| JaLCDOI | 10.18926/AMO/50407 |
|---|---|
| FullText URL | 67_3_145.pdf |
| Author | Ishihara, Setsuko| Taira, Naruto| Kawasaki, Kensuke| Ishibe, Youichi| Mizoo, Taeko| Nishiyama, Keiko| Iwamoto, Takayuki| Nogami, Tomohiro| Motoki, Takayuki| Shien, Tadahiko| Matsuoka, Junji| Doihara, Hiroyoshi| Komoike, Yoshifumi| Sato, Shuhei| Kanazawa, Susumu| |
| Abstract | A high mammographic breast density is considered to be a risk factor for breast cancer. However, only a small number of studies on the association between breast density and lifestyle have been performed. A cross-sectional study was performed using a survey with 29 questions on life history and lifestyle. The breast density on mammography was classified into 4 categories following the BI-RADS criteria. The subjects were 522 women with no medical history of breast cancer. The mean age was 53.3 years old. On multivariate analysis, only BMI was a significant factor determining breast density in premenopausal women (parameter estimate, －0.403;p value, 0.0005), and the density decreased as BMI rose. In postmenopausal women, BMI (parameter estimate, －0.196;p value, 0.0143) and number of deliveries (parameter estimate, －0.388;p value, 0.0186) were significant factors determining breast density;breast density decreased as BMI and number of deliveries increased. Only BMI and number of deliveries were identified as factors significantly influencing breast density. BMI was inversely correlated with breast density before and after menopause, whereas the influence of number of deliveries on breast density was significant only in postmenopausal women in their 50 and 60s. |
| Keywords | breast cancer mammographic breast density life style body mass index |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-06 |
| Volume | volume67 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 145 |
| End Page | 151 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23804137 |
| Web of Science KeyUT | 000320747900003 |
| Related Url | http://ousar.lib.okayama-u.ac.jp/metadata/50646 |
| JaLCDOI | 10.18926/AMO/50406 |
|---|---|
| FullText URL | 67_3_135.pdf |
| Author | Ueno, Hiroshi| Shoshi, Chikafumi| Suemitsu, Shunsuke| Usui, Shinichi| Sujiura, Hiroko| Okamoto, Motoi| |
| Abstract | In the phenomenon known as cross-modal plasticity, the loss of one sensory system is followed by improved functioning of other intact sensory systems. MRI and functional MRI studies suggested a role of the prefrontal cortex and the temporal lobe in cross-modal plasticity. We used a mouse model to examine the effects of sensory deprivation achieved by whisker trimming and visual deprivation achieved by dark rearing in neonatal mice on the appearance of parvalbumin (PV) neurons and the formation of glutamic acid decarboxylase 67 (GAD67)-positive puncta around pyramidal neurons in the prefrontal cortex and hippocampus. Whisker trimming, but not dark rearing, decreased the density of PV neurons in the hippocampus at postnatal day 28 (P28). In the prefrontal cortex, whisker trimming and dark rearing decreased the density of PV neurons in layer 5/6 (L5/6) at P28 and in L2/3 at P56, respectively, whereas dark rearing increased the density of PV neurons in L5/6 at P56. Whisker trimming decreased the density of GAD67-positive puncta in CA1 of the hippocampus at both P28 and P56 and in L5/6 of the prefrontal cortex at P28. Dark rearing decreased the density of GAD67-positive puncta in CA1 of the hippocampus and in both L2/3 and L5/6 of the prefrontal cortex at P28, and in L2/3 of the prefrontal cortex at P56. These results demonstrate that somatosensory or visual deprivation causes changes in the PV-interneuronal network in the mouse prefrontal cortex and hippocampus. The results also suggest that the alteration of the PV-interneuronal network, especially in the prefrontal cortex, may contribute to cross-modal plasticity. |
| Keywords | sensory deprivation parvalbumin glutamate decarboxylase (GAD67) prefrontal cortex hippocampus |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-06 |
| Volume | volume67 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 135 |
| End Page | 143 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23804136 |
| Web of Science KeyUT | 000320747900002 |
| Related Url | http://ousar.lib.okayama-u.ac.jp/metadata/50870 |
| JaLCDOI | 10.18926/AMO/50405 |
|---|---|
| FullText URL | 67_3_129.pdf |
| Author | Nakatsuka, Atsuko| Wada, Jun| Makino, Hirofumi| |
| Abstract | In recent years, many researchers have emphasized the importance of metabolic syndrome based on its increasing prevalence and its adverse prognosis due to associated chronic vascular complications. Upstream of a cluster of metabolic and vascular disorders is the accumulation of visceral adipose tissue, which plays a central role in the pathophysiology. In the accumulation of adipose tissues, cell cycle regulation is tightly linked to cellular processes such as proliferation, hypertrophy and apoptosis. In addition, various cell cycle abnormalities have also been observed in other tissues, such as kidneys and the cardiovascular system, and they are critically involved in the progression of disease. Here, we discuss cell cycle abnormalities in metabolic syndrome in various tissues. Furthermore, we describe the role of nuclear receptors in cell growth and survival, and glucose and lipid metabolism in the whole body. Therapeutic strategies for modulating various cell cycles in metabolic disorders by targeting nuclear receptors may overcome obesity and its chronic vascular complications in the future. |
| Keywords | nuclear receptor cell cycle metabolic syndrome diabetic nephropathy |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-06 |
| Volume | volume67 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 129 |
| End Page | 134 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23804135 |
| Web of Science KeyUT | 000320747900001 |
