JaLCDOI 10.18926/AMO/54818
FullText URL 70_6_515.pdf
Author Fujii, Masataka| Furumatsu, Takayuki| Kadota, Yasutaka| Shimamura, Yoshinobu| Tsuchimochi, Shigeyuki| Ozaki, Toshifumi|
Abstract The present report describes the first known, case of a pseudoaneurysm of the perforating branch of the deep femoral artery following anterior cruciate ligament (ACL) reconstruction. A 19-year-old man underwent ACL reconstruction using the outside-in femoral tunnel-creation method. Seven days after the surgery, he complained of abnormal thigh pain and had swelling with local heat on the distal lateral thigh. Magnetic resonance imaging, computed tomography, and color Doppler ultrasonography showed the pseudoaneurysm in the thigh. Resection surgery was successfully performed by a vascular surgeon 12 days after ACL reconstruction. Careful examination and awareness of postoperative symptoms such as thigh pain and swelling after ACL reconstruction were critical for the early diagnosis of pseudoaneurysm.
Keywords pseudoaneurysm perforating branch of the deep femoral artery anterior cruciate ligament
Amo Type Case Report
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 515
End Page 518
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 28003680
JaLCDOI 10.18926/AMO/54817
FullText URL 70_6_511.pdf
Author Gobara, Hideo| Hiraki, Takao| Iguchi, Toshihiro| Fujiwara, Hiroyasu| Nagasaka, Takeshi| Kishimoto, Hiroyuki| Tanaka, Takehiro| Kanazawa, Susumu|
Abstract An 87-year-old Japanese man underwent percutaneous cryoablation (PCA) therapy for his renal cell tumor. We displaced the colon from the tumor using hydrodissection. Computed tomography (CT) immediately after PCA was indicative of iceball extension to the colon wall, and a discontinuous enhancement of the colon wall was observed. We therefore performed an emergency surgery. On laparotomy, we observed a dark-purple area on the affected area of the colon, and the resected specimen showed focal, deep ulceration on the mucosal surface. Photomicrography revealed mucosal necrosis, submucosal hemorrhage, and necrotic foci in the muscularis propria, corresponding to the discontinuous colon wall enhancement on CT and the deep ulceration and dark-purple area on laparotomy. He recovered from surgery and was discharged without any complications.
Keywords bowel injury complication cryoablation renal cell carcinoma thermal ablation
Amo Type Case Report
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 511
End Page 514
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 28003679
JaLCDOI 10.18926/AMO/54816
FullText URL 70_6_507.pdf
Author Torigoe, Hidejiro| Toyooka, Shinichi| Yamamoto, Hiromasa| Soh, Junichi| Miyoshi, Shinichiro|
Abstract We present the case of a 65-year-old Japanese man diagnosed with chronic empyema (without a bronchopleural fistula) that occurred 7 months after he underwent an extrapleural pneumonectomy for right malignant pleural mesothelioma (MPM). Following thoracic drainage and irrigation for 1 month, we performed surgery by a thoracoscopic approach, in light of his general condition. We performed debridement and removal of the Gore-Tex polytetrafluoroethylene (PTFE) patch that had been used for the reconstruction of the diaphragm and the pericardium. The empyema had not relapsed when he died from recurrence of the MPM at 4 months after the thoracoscopic surgery. This patientʼs case suggests that thoracoscopic debridement and patch removal can be a therapeutic option for not only early-stage (exudative or fibrinopurulent) empyema but also late-stage (organized and chronic) empyema without a bronchopleural fistula, particularly for patients in poor general condition.
Keywords empyema chronic extrapleural pneumonectomy thoracoscopic debridement patch removal
Amo Type Case Report
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 507
End Page 510
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 28003678
JaLCDOI 10.18926/AMO/54815
FullText URL 70_6_503.pdf
Author Kanazawa, Yui| Yamashita, Yuka| Fujiwara, Mitsuhiro| Muraoka, Michiko| Washio, Kana| Kanamitsu, Kiichiro| Ishida, Hisashi| Nakano, Takae| Yamada, Miho| Horibe, Keizo| Tanaka, Takehiro| Yoshino, Tadashi| Shimada, Akira|
Abstract Childhood anaplastic large cell lymphoma (ALCL) accounts for approx. 10–30 of cases of non-Hodgkin lymphoma, and the ALCL99 study reported 60–75 disease-free survival; however, a relatively high relapse rate was observed (25–30 ). We report 2 patients with Stage III ALCL who relapsed 6–18 months after the end of ALCL99 chemotherapy. A retrospective molecular analysis identified the nucleophosmin (NPM)-anaplastic lymphoma kinase (ALK) fusion gene in the first diagnostic bone marrow samples taken from both patients. However, antibodies against the ALK protein appeared to be relatively low in the serum of both patients (×100 and ×750). An increase in chemotherapy intensity may be beneficial if Stage III ALCL patients are shown to be NPM-ALK chimera-positive in the first diagnostic bone marrow sample.
Keywords ALCL NPM-ALK fusion lymphoma
Amo Type Case Report
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 503
End Page 506
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 28003677
JaLCDOI 10.18926/AMO/54814
FullText URL 70_6_497.pdf
Author Hikasa, Yukiko| Hayashi, Masao| Suzuki, Satoshi| Morimatsu, Hiroshi|
Abstract A 32-year-old woman, pregnant with twins, presented with a chief complaint of general fatigue. Her general condition had rapidly deteriorated since her last visit to the primary obstetrician; the patient was then referred to our hospital because of suspected fetal death. She underwent emergency cesarean section because fetal death had indeed occurred, and she was then admitted to the intensive care unit (ICU). On ICU admission, she was found to be in shock. Laboratory analysis revealed extreme hemoconcentration and a low albumin level, and initially, septic shock with obstetric complications was suspected. However, because she did not respond to conventional therapy but instead, rapidly developed severe generalized edema, systemic capillary leak syndrome (SCLS) was diagnosed. The patient remained in shock for several days until undergoing plasma exchange (PE), despite some earlier empirical treatments. She eventually recovered from profound shock status and was discharged from the ICU without sequelae. Among potentially effective treatments, PE seemed to be the most reasonable choice for the treatment of her SCLS.
Keywords systemic capillary leak syndrome plasma exchange pregnancy
Amo Type Case Report
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 497
End Page 501
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 28003676
JaLCDOI 10.18926/AMO/54813
FullText URL 70_6_493.pdf
Author Yasuhara, Takao| Kuwahara, Ken| Sasada, Susumu| Toyoshima, Atsuhiko| Morimoto, Jun| Kin, Kyohei| Manabe, Hiroaki| Miyoshi, Yasuyuki| Kusumegi, Akira| Takahashi, Yuichiro| Ito, Kiyoshi| Date, Isao|
Abstract Unexpected injuries can have a profound effect on a surgeonʼs performance and thus on patients and surgical departments. Here we describe a technique for performing surgery in the standing position, as done by a surgeon with an Achilles tendon rupture. During his prescribed 45-day non-weight-bearing period for the left ankle after surgery for an Achilles tendon rupture, the surgeon was able to participate in 15 surgeries as an operator or assistant, due to his use of a combination of injured-leg genuflection on a stool and a ʻSurgical Body Supportʼ device. Similarly injured surgeons may benefit from such support.
Keywords Achilles tendon rupture electromyogram genuflection injured leg standing position
Amo Type Short Communication
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 493
End Page 496
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 28003675
JaLCDOI 10.18926/AMO/54812
FullText URL 70_6_485.pdf
Author Hirano, Yumika| Masuyama, Hisashi| Hayata, Kei| Eto, Eriko| Nobumoto, Etsuko| Hiramatsu, Yuji|
Abstract Interrupted aortic arch (IAA) is fatal if not diagnosed. Prenatal diagnosis is helpful, but it is difficult to detect IAA and even more so to differentiate types A and B prenatally. Our objectives were to find a way to detect IAA using 2 views—three-vessel view (3VV) and four-chamber view (4CV)—and to differentiate between types A and B. We retrospectively analyzed fetal echocardiographic images and medical records of eight IAA patients. All eight patients had a ventricular septal defect (VSD) on 4CV. The aorta/main pulmonary artery (Ao/MPA) diameter ratio on 3VV was significantly low, which is characteristic of type B IAA. The left/right ventricular diameter (LV/RV) ratio on 4CV was 0.61± 0.17 for type A and almost 1.0 for type B. The thymus was not observed on 3VV in some type B IAA patients. These findings suggest that we could increase the number of prenatal diagnoses of IAA using the Ao/MPA ratio on 3VV and the presence of VSD on 4CV. Additionally, we could differentiate types A and B with the LV/RV ratio on 4CV, the Ao/MPA ratio, and the presence of a thymus on 3VV, which results in better management of IAA after birth.
Keywords interrupted aortic arch three-vessel view four-chamber view aortic diameter/main pulmonary artery diameter ratio ventricular septal defect
Amo Type Original Article
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 485
End Page 491
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 28003674
JaLCDOI 10.18926/AMO/54811
FullText URL 70_6_477.pdf
Author Nishida, Keiichiro| Machida, Takahiro| Horita, Masahiro| Hashizume, Kenzo| Nakahara, Ryuichi| Nasu, Yoshihisa| Ohashi, Hideki| Saiga, Kenta| Ozaki, Toshifumi|
Abstract The metatarsophalangeal (MTP) joints are often and predominantly affected in rheumatoid arthritis. The aim of the current study was to describe surgical techniques of shortening oblique osteotomy for lesser metatarsal bone with screw fixation at the osteotomy site, and to investigate the short-term clinical outcomes of our procedure. Twenty-seven feet (78 toes) of 24 RA patients underwent the shortening oblique osteotomy for the correction of deformity at the lesser MTP joints. The average Japanese Society of Surgery of the Foot (JSSF) standard rating system for the RA foot and ankle scale improved significantly from 59.6 points preoperatively to 88.3 points postoperatively (p<0.001). Twenty-four feet (89 ) were free from metatarsalgia and symptomatic callosities at the lesser MTP joint after surgery. Our present findings showed satisfactory early clinical outcomes of the shortening oblique osteotomy of the metatarsal bone with screw fixation for RA forefoot.
Keywords shortening oblique osteotomy rheumatoid arthritis forefoot screw fixation
Amo Type Original Article
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 477
End Page 483
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 28003673
JaLCDOI 10.18926/AMO/54810
FullText URL 70_6_469.pdf
Author Yamasaki, Yasushi| Takenaka, Ryuta| Hori, Keisuke| Takemoto, Koji| Kawano, Seiji| Kawahara, Yoshiro| Fujiki, Shigeatsu| Okada , Hiroyuki|
Abstract The usefulness of endoscopy in marginal ulcer bleeding has rarely been studied, and the optimal method for preventing rebleeding is unclear. Here we assessed the efficacy of endoscopy in marginal ulcer bleeding and examined the efficacy of proton pump inhibitors (PPIs) in the prevention of rebleeding. A total of 28 patients with marginal ulcer bleeding (21 men, 7 women; median age 58.5 years) were treated by endoscopy. We analyzed the clinical characteristics, results of endoscopic therapy, characteristics of rebleeding patients, and relation between the use of PPIs and the duration of rebleeding. Sixteen patients had active bleeding. Initial hemostasis was achieved in all patients. There were no procedure-related adverse events. Rebleeding occurred in one patient within the first month and in 7 patients thereafter. There was a significant difference in the rebleeding rate between the patients who received a PPI and those who did not. In a multivariate analysis, the non-use of PPIs was a risk factor for rebleeding (hazard ratio, 6.22). Therapeutic endoscopy is effective in achieving hemostasis from marginal ulcer bleeding. PPIs may prevent rebleeding from marginal ulcers.
Keywords marginal ulcer upper gastrointestinal bleeding endoscopic hemostasis proton-pump inhibitor
Amo Type Original Article
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 469
End Page 475
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 28003672
JaLCDOI 10.18926/AMO/54809
FullText URL 70_6_461.pdf
Author Shiozaki, Kyoko| Morimatsu, Hiroshi| Matsusaki, Takashi| Iwasaki, Tatsuo|
Abstract Many patients suffer from postoperative serious adverse events (SAEs). Here we sought to determine the incidence of SAEs, assess the accuracy of currently used scoring systems in predicting postoperative SAEs, and determine whether a combination of scoring systems would better predict postoperative SAEs. We prospectively evaluated patients who underwent major surgery. We calculated 4 scores: American Society of Anesthesiologists physical status (ASA-PS) score, the Charlson Score, the POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity) score, and the Surgical Apgar Score (SAS). We assessed the occurrence of SAEs. We assessed the association between each score and SAEs. We combined these scoring systems to find the best combination to predict the occurrence of SAEs. Among 284 patients, 43 suffered SAEs. All scoring systems could predict SAEs. However, their predictive power was not high (the area under the receiver operating characteristic curves [AUROC] 0.6-0.7). A combination of the ASA-PS score and the SAS was the most predictive of postoperative SAEs (AUROC 0.714). The incidence of postoperative SAEs was 15.1 . The combination of the ASA-PS score and the SAS may be a useful tool for predicting postoperative serious adverse events after major surgery.
Keywords serious adverse events preoperative assessment intraoperative assessment ASA-PS surgical Apgar score
Amo Type Original Article
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 461
End Page 467
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 28003671
JaLCDOI 10.18926/AMO/54808
FullText URL 70_6_455.pdf
Author Tanino, Masaaki| Kobayashi, Motomu| Sasaki, Toshihiro| Takata, Ken| Takeda, Yoshimasa| Mizobuchi, Satoshi| Morita, Kiyoshi| Nagai, Taku| Morimatsu, Hiroshi|
Abstract Postoperative cognitive dysfunction (POCD) occurs in nearly one-third of patients after non-cardiac surgery. Many animal behavior studies have investigated the effect of general anesthesia on cognitive function. However, there have been no studies examining the effects on working memory specifically, with a focus on the retention of working memory. We demonstrate here that isoflurane anesthesia induces deficits in the retention of spatial working memory in rats, as revealed by an increase in isoflurane-induced across-phase errors in the delayed spatial win-shift (SWSh) task with a 30-min delay in an 8-arm radial arm maze on post-anesthesia days (PADs) 1,2,4, and 10. A post-hoc analysis revealed a significant increase in across-phase errors on PAD 1 and recovery on PAD 10 in the isoflurane group. In contrast, within-phase errors independent of the retention of working memory were unaffected by isoflurane. These results demonstrate that isoflurane anesthesia transiently impairs the retention of spatial working memory in rats.
Keywords postoperative cognitive dysfunction isoflurane spatial working memory retention delayed spatial win-shift task
Amo Type Original Article
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 455
End Page 460
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 28003670
JaLCDOI 10.18926/AMO/54807
FullText URL 70_6_449.pdf
Author Watanabe, Noriyuki| Sugimoto, Yoshihisa| Tanaka, Masato| Mazaki, Tetsuro| Arataki, Shinya| Takigawa, Tomoyuki| Kataoka, Masaki| Kunisada, Toshiyuki| Ozaki, Toshifumi|
Abstract Metastatic epidural spinal cord compression (MESCC) is a common complication in patients with a malignant tumor, but it is difficult to decide the proper time to perform the necessary surgery. Here we analyzed the prognostic factors for postoperative walking ability. We retrospectively reviewed the cases of 112 MESCC patients treated surgically at our institute and divided them into ambulatory (n= 88) and non-ambulatory (n=24) groups based on their American Spinal Injury Association (ASIA) Impairment Scale grades at the final follow-up. We also classified the patients preoperatively using the revised Tokuhashi score. We assessed the correlation between preoperative or intraoperative factors and postoperative walking ability in both groups. Of the 10 patients classified preoperatively as grade A or B, 2 (20 ) were ambulatory at the final follow-up. Of the 102 patients classified preoperatively as grade C, D or E, 86 (84 ) were ambulatory at the final follow-up (p<0.001). There were no significant differences between the groups in the average total Tokuhashi score. Our analysis revealed that the severity of paralysis significantly affects neurological recovery in patients with MESCC. Patients with MESCC should receive surgery before the preoperative ASIA Impairment Scale grade falls below grade C.
Keywords metastatic epidural spinal cord compression American Spinal Injury Association Impairment Scale Tokuhashi score walking ability prognostic factor
Amo Type Original Article
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 449
End Page 453
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 28003669
JaLCDOI 10.18926/AMO/54806
FullText URL 70_6_441.pdf
Author Kashihara, Naoko| Furumatsu, Takayuki| Kodama, Yuya| Tanaka, Takaaki| Ozaki, Toshifumi|
Abstract Concurrent meniscal repair with anterior cruciate ligament (ACL) reconstruction has shown good clinical outcomes, but it has a considerable risk of progressing to post-traumatic osteoarthritis of the knee. Here we investigated postoperative changes in the position of the lateral meniscus (LM) and assessed the short-term clinical results after concurrent LM repair with ACL reconstruction. Twentyseven patients underwent LM repair of a peripheral longitudinal tear concomitant with ACL reconstruction. We evaluated the preoperative and postoperative values of the Lysholm score and anteroposterior instability. The length and width of the lateral tibial plateau were determined by radiographic images. The length, width, body width, extrusion, and height of the LM were measured in magnetic resonance images and compared between the preoperative and postoperative measurements. Our analysis revealed that concurrent LM repair with ACL reconstruction improved the shortterm clinical outcomes. Although the body width and height of the LM did not change, the postoperative LM extrusion and LM width were significantly increased after the surgery. The post-traumatic transposition of the LM may not be completely prevented by LM repair concomitant with ACL reconstruction.
Keywords lateral meniscus meniscal extrusion meniscal repair anterior cruciate ligament reconstruction
Amo Type Original Article
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 441
End Page 448
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 28003668
JaLCDOI 10.18926/AMO/54805
FullText URL 70_6_435.pdf
Author Yamashita, Miho| Hasegawa, Kosei| Higuchi, Yousuke| Miyai, Takayuki| Okada, Ayumi| Tanaka, Hiroyuki| Tsukahara, Hirokazu|
Abstract The urinary cross-linked N-terminal telopeptide of type I collagen (uNTx) levels in infantile osteogenesis imperfecta (OI) have not been well studied. Here we investigated the levels of uNTx in infants with OI and healthy infants. We collected spot urine samples from 30 infants with OI (male/female, 14/16; Sillence classification, I/II/III/IV: 15/3/6/6; age, 5.2±4.4 months) and 120 healthy infants (male/female, 75/45; age, 5.1±4.1 months) for the measurement of uNTx levels. The uNTx levels of the OI infants were significantly lower than those of the healthy infants (mean±SD, 1,363.7±530.1 vs. 2,622.2±1,202.6 nmol BCE/mmol Cr; p<0.001). The uNTx levels of the infants with type I OI were significantly lower than those of the age-matched healthy infants, although an overlap was observed between the 2 groups. Among the 1-month-old infants, the uNTx levels of the infants with types I, III or IV OI were significantly lower than those of the healthy infants, without overlap (1,622.5±235.8 vs. 3,781.0±1,027.1 nmol BCE/mmol Cr; p<0.001). These results indicate that uNTx levels are significantly lower in infants with OI than in healthy infants, and they suggest that uNTx might be useful as a reference for diagnosing OI.
Keywords bone resorption marker bone turnover bone mass
Amo Type Original Article
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 435
End Page 439
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 28003667