JaLCDOI 10.18926/AMO/54423
FullText URL 70_3_223.pdf
Author Ebara, Shin| Kobayashi, Yasuyuki| Sasaki, Katsumi| Araki, Motoo| Sugimoto, Morito| Wada, Koichirou| Fujio, Kei| Takamoto, Atsushi| Watanabe, Toyohiko| Yanai, Hiroyuki| Nasu, Yasutomo|
Abstract The present case report describes a case of recurrent and advanced urachal carcinoma including neuroendocrine features with iliac bone metastasis after partial cystectomy and adjuvant chemotherapy consisting of irinotecan and cisplatin in a 32-year-old man. He received gemcitabine/cisplatin/ paclitaxel (GCP) combination chemotherapy, consisting of gemcitabin (1,000mg/m2) on day 1, 8, cisplatin (70mg/m2) on day 1, and paclitaxel (80mg/m2) on day 1 and 8. After three cycles of chemotherapy, PET-CT showed complete regression of the disease. So the patient underwent total cystourethrectomy, and histological examination showed an almost complete pathological response. External beam radiation therapy was also given to the ileac bone metastasis regions. However, PET-CT taken 17 months after the external beam radiation showed multiple lung metastases. He received GCP chemotherapy again, which resulted in a complete response again after three cycles of chemotherapy. This is the first report on GCP chemotherapy used not only as a salvage chemotherapy but also as a rechallenge regimen for metastatic urachal cancer including a neuroendocrine component.
Amo Type Case Report
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 223
End Page 227
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339213
Web of Science KeyUT 000379406100011
JaLCDOI 10.18926/AMO/54422
FullText URL 70_3_217.pdf
Author Waseda, Koichi| Ocho, Kazuki| Hasegawa, Kou| Kimura, Kosuke| Iwamuro, Masaya| Hanayama, Yoshihisa| Kondo, Eisei| Miyahara, Nobuaki| Otsuka, Fumio|
Abstract KL-6 is a glycoprotein found predominantly on type II pneumocytes and alveolar macrophages, and often shows increased serum levels in patients with interstitial pneumonia. We report a case of mycobacterium avium complex (MAC) infection whose disease activity was correlated with KL-6 levels in serum. During treatment of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) with prednisolone, chest image findings improved in association with decreased KL-6 levels. Following tapering of prednisolone, chest image findings deteriorated again as levels of KL-6 increased, suggesting recurrence of RA-ILD. Bronchoscopic examination revealed active MAC infection. Treatment of MAC infection not only improved chest image findings but also decreased KL-6 levels in serum, suggesting that KL-6 was increased by active MAC infection by itself, not by recurrence of RA-ILD. To the best of our knowledge, this is the first documentation of KL-6 elevation in serum in association with active MAC infection.
Keywords KL-6 mycobacterium avium complex pulmonary nontuberculous mycobacterium infection rheumatoid arthritis-associated interstitial lung disease bronchial alveolar lavage
Amo Type Case Report
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 217
End Page 221
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339212
Web of Science KeyUT 000379406100010
JaLCDOI 10.18926/AMO/54421
FullText URL 70_3_213.pdf
Author Kikuchi, Satoru| Kagawa, Shunsuke| Ohara, Toshiaki| Kubota, Tetsushi| Kuwada, Kazuya| Kagawa, Tetsuya| Kuroda, Shinji| Shirakawa, Yasuhiro| Nishizaki, Masahiko| Fujiwara, Toshiyoshi|
Abstract A 69-year-old man underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) at the lesser curvature in the angle of stomach. Histological examination revealed tub1, pM, ly0, v0, pLM(-), pVM(-), and the resection was considered curative. The scar after ESD was followed by esophagogastroduodenoscopy (EGD) and biopsy. Twenty months later, EGD showed an ulcerative lesion in the vicinity of the ESD scar, and histological examination of the biopsy specimen showed adenocarcinoma. A distal gastrectomy with lymph node dissection was then performed. Postoperative pathology showed tub1, pM, pN0, ly0, v0, and Stage 1A. Skip lesions were seen in the specimen resected by ESD, and the histological review confirmed so-called “dysplasia-like atypia” (DLA) between the lesions. It has been reported recently that in DLA, the dysplasia-like change involves only the bases of the pits, without upper pit or surface epithelium involvement, and it is said that the rate of DLA is higher in gastric cancer patients. We speculated that a precancerous lesion close to the resected cancer developed into a local recurrence.
Keywords dysplasia-like atypia early gastric cancer endoscopic submucosal dissection local recurrence
Amo Type Case Report
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 213
End Page 216
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339211
Web of Science KeyUT 000379406100009
JaLCDOI 10.18926/AMO/54420
FullText URL 70_3_205.pdf
Author Kozaki, Ken-ichi| Kawakami, Shigehisa| Konishi, Takayuki| Ohta, Keiji| Yano, Jitsuro| Onoda, Tomoo| Matsumoto, Hiroshi| Mizukawa, Nobuyoshi| Kimata, Yoshihiro| Nishizaki, Kazunori| Iida, Seiji| Gofuku, Akio| Abe, Masanobu| Minagi, Shogo| Okayama Dream Speech Project|
Abstract A palatal augmentation prosthesis (PAP) is used to facilitate improvement in the speech and swallowing functions of patients with tongue resection or tongue movement disorders. However, a PAPʼs effect is limited in cases where articulation disorder is severe due to wide glossectomy and/or segmental mandibulectomy. In this paper, we describe speech outcomes of a patient with an articulation disorder following glossectomy and segmental mandibulectomy. We used a palatal plate (PP) based on a PAP, along with an artificial tongue (KAT). Speech improvement was evaluated by a standardized speech intelligibility test consisting of 100 syllables. The speech intelligibility score was significantly higher when the patient wore both the PP and KAT than when he wore neither (p=0.013). The conversational intelligibility score was significantly improved with the PP and KAT than without PP and KAT (p=0.024). These results suggest that speech function can be improved in patients with hard tissue defects with segmental mandibulectomy using both a PP and a KAT. The nature of the design of the PP and that of the KAT will allow these prostheses to address a wide range of tissue defects.
Keywords palatal augmentation prosthesis artificial tongue articulation disorder glossectomy mandibulectomy
Amo Type Case Report
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 205
End Page 211
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339210
Web of Science KeyUT 000379406100008
JaLCDOI 10.18926/AMO/54419
FullText URL 70_3_197.pdf
Author Takagi, Kosei| Yagi, Takahito| Yoshida, Ryuichi| Shinoura, Susumu| Umeda, Yuzo| Nobuoka, Daisuke| Kuise, Takashi| Watanabe, Nobuyuki| Sui, Kenta| Fuji, Tomokazu| Fujiwara, Toshiyoshi|
Abstract The operative mortality and morbidity of pancreaticoduodenectomy (PD) remain high. We analyzed PD patientsʼ clinical characteristics and surgical outcomes and discuss how PD clinical outcomes could be improved. We retrospectively reviewed the cases of 400 patients who underwent a PD between January 1998 and April 2014 at Okayama University Hospital, a very-high-volume center. We identified and compared the clinical outcomes between two time periods (period 1: 1998-2006 vs. period 2: 2007-2014). The total postoperative mortality and major complication rates were 0.75 and 15.8 , respectively, and the median postoperative length of stay (LOS) was 32 days. Subsequently, patients who underwent a PD during period 2 had a significantly shorter LOS than those who underwent a PD during period 1 (29 days vs. 38.5 days, p<0.001). The incidence of mortality and major complications did not differ between the two periods. In our multivariate analysis, period 1 was an independent factor associated with a long LOS (p<0.001). The improvement of the surgical procedure and perioperative care might be related to the shorter LOS in period 2 and ot the consistently maintained low mortality rate after PD. The development of multimodal strategies to accelerate postoperative recovery may further improve PDʼs clinical outcomes.
Keywords pancreaticoduodenectomy surgical outcome mortality major complication length of stay
Amo Type Original Article
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 197
End Page 203
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339209
Web of Science KeyUT 000379406100007
JaLCDOI 10.18926/AMO/54418
FullText URL 70_3_189.pdf
Author Fujiwara, Hiroyasu| Arai, Yasuaki| Ishii, Hiroaki| Kanazawa, Susumu|
Abstract We retrospectively evaluated the safety and efficacy of artificial pneumothorax induction to perform computed tomography (CT)-guided radiofrequency ablation (RFA) for sub-diaphragm hepatocellular carcinomas (HCCs). From June 2008 to October 2010 at our institution, 19 HCCs (16 patients) were treated using CT-guided RFA after artificial pneumothorax induction. A 23-G needle was inserted into the liver surface at a site of 2 connected pleurae without lung tissue. After a small amount of air was injected, the pleural space widened, creating a small pneumothorax. Additional air was insufflated via a newly inserted 18-G cannula to raise the lung away from the planned puncture line for RFA. The electrode was then advanced transthoracically. Ablation was performed using a cool-tip electrode with manual impedance control mode. The injected air was then aspirated as much as possible. Artificial pneumothorax was successfully induced in all cases. The average total volume of injected air in each case was 238ml. No artificial pneumothorax-related complication occurred; lung injury occurred in one case during RF electrode insertion. No local progression occurred during follow-up. Recurring HCCs were observed in eight patients. Artificial pneumothorax induction is safe and effective for CT-guided RFA of sub-diaphragm HCCs, which are difficult to locate on US.
Keywords hepatocellular carcinoma liver radiofrequency ablation CT fluoroscopy artificial pneumothorax
Amo Type Original Article
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 189
End Page 195
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339208
Web of Science KeyUT 000379406100006
JaLCDOI 10.18926/AMO/54417
FullText URL 70_3_183.pdf
Author Sawada, Shigeki| Hiroshi, Suehisa| Ueno, Tsuyoshi| Yamashita, Motohiro|
Abstract We reviewed post-operative complication and mortality rates from 1995 through 2014 and evaluated the changes in those rates across that 20-year period. Two thousand and three hundred sixteen patients with lung cancer underwent resection at our institution between 1995 and 2014. This timespan was divided into four 5-year periods. Each patientʼs age, Charlson comorbidity index score, and extent of surgery in each 5-year period were summarized, and the changes in these factors over the 20-year span were evaluated. The complication and mortality rates were calculated for each 5-year period, and the changes in those rates over the 20-years were evaluated. The number of patients with higher Charlson comorbidity index scores increased during the 20-year period. Of the 455 patients who developed complications, 97 developed life-threating complications. There were 16 post-operative deaths and 23 in-hospital deaths. There were no significant changes in the complication rate or mortality rate during the 20-year period. Both rates were significantly correlated with the extent of resection. Although the number of patients with comorbidities increased in the 20-year period, the post-operative complication and mortality rates, as well as in-hospital mortality, did not change significantly.
Keywords post-operative complication post-operative mortality lung cancer surgery outcomes
Amo Type Original Article
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 183
End Page 188
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339207
Web of Sience KeyUT 000379406100005
JaLCDOI 10.18926/AMO/54416
FullText URL 70_3_175.pdf
Author Setiawan, Heri| Nagaoka, Kenjiro| Kubo, Masayuki| Fujikura, Yoshihisa| Ogino, Keiki|
Abstract Oxidative stress is widely known to play a role in asthma. However, the contribution of xanthine oxidoreductase (XOR) as a source of the superoxide anion radical (O2-) in oxidative stress associated with asthma has not yet been examined in detail. Here we investigated pathophysiological changes in XOR in an experimental model of asthma induced by the house dust mite Dermatophagoides farinae (Df). In the lungs of Df-treated mice, the production of O2- from XOR increased and the nitrite concentrations decreased, whereas the protein expression of XOR remained unchanged. Moreover, the protein expression levels of XOR and the hydrogen peroxide (H2O2) concentrations in bronchoalveolar lavage fluid (BALF) were higher in the Df-treated mice than in saline-treated mice. Immunohistochemically, although XOR was highly localized in the bronchial epithelial cells of the saline-treated mice, immunostaining for XOR was absent in the bronchial epithelium of Df-treated mice. These results suggest that oxidative stress is up-regulated by increases in the conversion of the dehydrogenase form (xanthine dehydrogenase; XDH) of XOR to the oxidase form (xanthine oxidase; XOD).
Keywords xanthine oxidase oxidative stress asthma
Amo Type Original Article
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 175
End Page 182
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339206
Web of Science KeyUT 000379406100004
JaLCDOI 10.18926/AMO/54415
FullText URL 70_3_167.pdf
Author Sugihara, Satoshi| Doi, Hiroyuki| Kato, Masahiko| Mitoh, Yoshihiro| Tsuda, Toshihide| Ikeda, Satoru|
Abstract Aflatoxin (AFT) contamination is frequent in foods grown in tropical regions, including rice. Although AFTs are generally not found in temperate-region foods, global warming has affected typical temperate-region climates, potentially permitting the contamination of foods with AFT-producing Aspergillus flavus (A. flavus). Here we investigated the AFT production in rice during storage under natural climate conditions in Japan. We examined AFTs in brown rice and rough rice artificially contaminated with A. flavus for 1 year in Japan, and we subjected AFTs in white rice to the same treatment in airtight containers and examined the samples in warm and cold seasons, simulating the storage of white rice in general households. In the brown rice, AFTs increased after 2 months (March) and peaked after 9 months (October). The AFT contamination in the rough rice was minimal. After the polishing and cooking of the brown rice, AFTs were undetectable. In the white rice stored in airtight containers, AFTs increased after 1 month (August) and peaked after 2 months (September). Minimal AFTs were detected in the cold season. Thus, AFT contamination in rice may occur in temperate regions following A. flavus contamination. The storage of rice as rough rice could provide be useful for avoiding AFT contamination.
Keywords Aspergillus flavus aflatoxin rice temperate region storage
Amo Type Original Article
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 167
End Page 173
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339205
Web of Science KeyUT 000379406100003
JaLCDOI 10.18926/AMO/54414
FullText URL 70_3_159.pdf
Author Yoshioka, Takashi| Otsuki, Hideo| Uehara, Shinya| Shimizu, Toshihiro| Murao, Wataru| Fujio, Koji| Fujio, Kei| Wada, Koichiro| Araki, Motoo| Nasu, Yasutomo|
Abstract Upper urinary tract calculi are common; however, there is no recommended treatment selection for elderly patients. Ureteroscopic holmium laser lithotripsy (URS lithotripsy) is minimally invasive, and it provides a high stone-free rate (SFR) treatment for upper urinary tract calculi. Here, we retrospectively evaluated the surgical outcomes of URS lithotripsy after dividing the 189 cases into 3 groups by patient age: the ʻ<65 groupʼ (<65 years old, n=108), the ʻ65-74 groupʼ (65-74 years old, n=42), and the ʻ 75 groupʼ ( 75 years old, n=39). The patientsʼ characteristics, stone status, and perioperative outcomes were assessed. The 65-74 group and the 75 group had a significantly higher prevalence of hypertension compared to the<65 group. Compared to the<65 group, the 65-74 group had a significantly higher prevalence of hyperlipidemia, and the 75 group had significantly higher the American Society of Anesthesiologists (ASA) scores. Despite these preoperative risk factors, SFR and postoperative pyelonephritis in the 65-74 group and the 75 group were similar to those of the<65 group. In conclusion, URS lithotripsy is the preferred treatment for upper urinary tract calculi, even for elderly patients who have multiple preoperative risk factors.
Keywords upper urinary tract calculi ureteroscopy (URS) holmium laser lithotripsy elderly patients stone-free rate (SFR)
Amo Type Original Article
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 159
End Page 166
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339204
Web of Science KeyUT 000379406100002
JaLCDOI 10.18926/AMO/54413
FullText URL 70_3_151.pdf
Author Wada, Jun| Nakatsuka, Atsuko|
Abstract The mitochondria are involved in active and dynamic processes, such as mitochondrial biogenesis, fission, fusion and mitophagy to maintain mitochondrial and cellular functions. In obesity and type 2 diabetes, impaired oxidation, reduced mitochondrial contents, lowered rates of oxidative phosphorylation and excessive reactive oxygen species (ROS) production have been reported. Mitochondrial biogenesis is regulated by various transcription factors such as peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α), peroxisome proliferator-activated receptors (PPARs), estrogen-related receptors (ERRs), and nuclear respiratory factors (NRFs). Mitochondrial fusion is promoted by mitofusin 1 (MFN1), mitofusin 2 (MFN2) and optic atrophy 1 (OPA1), while fission is governed by the recruitment of dynamin-related protein 1 (DRP1) by adaptor proteins such as mitochondrial fission factor (MFF), mitochondrial dynamics proteins of 49 and 51 kDa (MiD49 and MiD51), and fission 1 (FIS1). Phosphatase and tensin homolog (PTEN)-induced putative kinase 1 (PINK1) and PARKIN promote DRP1-dependent mitochondrial fission, and the outer mitochondrial adaptor MiD51 is required in DRP1 recruitment and PARKIN-dependent mitophagy. This review describes the molecular mechanism of mitochondrial dynamics, its abnormality in diabetes and obesity, and pharmaceuticals targeting mitochondrial biogenesis, fission, fusion and mitophagy.
Keywords fusion fission oxidative stress mitochondria diabetes
Amo Type Review
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 151
End Page 158
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339203
Web of Science KeyUT 000379406100001