JaLCDOI 10.18926/AMO/55594
FullText URL 71_6_547.pdf
Author Tanimizu, Masakuni| Mizuno, Kenji| Hashimoto, Masayuki|
Abstract We treated a 72-year-old Japanese female with sustained high fever and overall body exhaustion. An infectious liver cyst and right lung pneumonia were suspected causes. Hepatic cystectomy and various antibiotics did not resolve symptoms. Pneumonia exacerbation and ascitic fluid retention, left lumbar spinal osteomyelitis, and peri-gastric lymph node abscess penetrating the stomach were observed. Mycobacterium avium was identified in sputum, ascites, vertebral body abscess puncture specimen, and pus mucus secretion in the stomach. We diagnosed a disseminated nontuberculous mycobacterial infection. She seemed immunocompetent, without signs of AIDS or hematological malignancy. Serum anti-IFN-γ autoantibodies tested positive and were suspected to be involved in the illness onset.
Keywords disseminated nontuberculous mycobacterial infection anti-IFN-γ autoantibodies
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 547
End Page 552
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276230
JaLCDOI 10.18926/AMO/55593
FullText URL 71_6_543.pdf
Author Okahara, Shuji| Shimizu, Kazuyoshi| Morimatsu, Hiroshi|
Abstract The electrical activity of the diaphragm (EAdi) shows global diaphragmatic activation and power output from the central nervous system. We measured the EAdi as an indicator of breathing workload in a 40-year-old man suffering from severe acute respiratory distress syndrome (ARDS) secondary to influenza pneumonia in the process of weaning from extracorporeal membrane oxygenation (ECMO). Turning off the sweep gas flow immediately led to EAdi elevation, followed by hypoxia. The patient was successfully weaned from ECMO by reference to EAdi. This is the first case report to suggest that EAdi monitoring might be useful for ARDS patients during ECMO weaning.
Keywords electrical activity of the diaphragm breathing workload respiratory extracorporeal membrane oxygenation acute respiratory distress syndrome
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 543
End Page 546
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276229
JaLCDOI 10.18926/AMO/55592
FullText URL 71_6_539.pdf
Author Matoba, Ryo| Morizane, Yuki| Kimura, Shuhei| Toshima, Shinji| Shiraga, Fumio|
Abstract Internal limiting membrane (ILM) peeling is an important maneuver in vitrectomy for macular holes (MHs). A nitinol loop is a surgical instrument designed to create an edge on the ILM and peel the ILM safely and consistently. The effect of using a nitinol loop for ILM peeling on the retina is not clear. We report here on a case of an idiopathic full-thickness MH in an adult woman, in whom retinal damage was revealed after her ILM was peeled using a nitinol loop.
Keywords macular hole macular surgery internal limiting membrane peeling nitinol loop
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 539
End Page 542
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276228
JaLCDOI 10.18926/AMO/55591
FullText URL 71_6_531.pdf
Author Ooi, Mayu| Yanamoto, Fujio| Sato, Hitoaki| Takao, Yumiko| Okada, Masako| Egi, Moritoki| Mizobuchi, Satoshi|
Abstract Although spinal cord stimulation (SCS) is a useful treatment for chronic intractable pain, the optimal method of stimulation has not yet been established. In this prospective, crossover study, we compared the efficacy of using a constant current (CC) system with that of a constant voltage (CV) system for temporal SCS. Twenty patients were enrolled and divided into two groups. For 10 patients, a CV system was applied on Days 1-5, followed by the use of a CC system on Days 6-10. For the other 10 patients, a CC system was applied for the first five days, followed by a CV system for the subsequent five days. We evaluated the alteration of pain intensity using a visual analogue scale (VAS), the area of stimulation, the stability of effect, and patient satisfaction regarding treatment. The pain scores decreased significantly after the start of the SCS. There was no significant difference in the change in VAS between the two systems. The stimulation method used for temporal SCS did not affect the reduction of pain intensity. Patients felt a wider stimulation area by the CC system compared to the CV system.
Keywords spinal cord stimulation constant current system constant voltage system chronic intractable pain pain score
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 531
End Page 537
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276227
JaLCDOI 10.18926/AMO/55590
FullText URL 71_6_525.pdf
Author Sakoma, Yoshimasa| Hirooka, Takahiko|
Abstract We investigated the anatomical features of the axillary nerve and its accompanying vessels with respect to the lateral wall of the greater tuberosity, focusing on the relationship between the neurovascular bundle and the proximal humeral locking plates. Magnetic resonance images of 30 Japanese patients’ shoulders were examined. Oblique sagittal images across the greater tuberosity and the neurovascular bundle, which contain the axillary nerve and posterior circumflex humeral artery and vein, were obtained. The distance between the superior aspect of the greater tuberosity and the superior and inferior borders of the neurovascular bundles was measured at the anterior, middle, and posterior edges of the greater tuberosity. The neurovascular bundle was 28.5-36.7 mm, 32.6-41.3 mm, and 38.1-47.5 mm distal to the superior aspect of the greater tuberosity at the anterior, middle, and posterior edges, respectively. We evaluated the relationship between the neurovascular bundle and 3 different locking plates, which were placed at the lateral aspect of the greater tuberosity. Only 3 or four locking screws at the most proximal part could be safely inserted without axillary nerve interference.
Keywords proximal humeral fracture locking plate axillary nerve posterior circumflex humeral artery shoulder
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 525
End Page 529
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276226
JaLCDOI 10.18926/AMO/55589
FullText URL 71_6_519.pdf
Author Mizukawa, Nobuyoshi| Swe Swe Win| Zaw Moe Thein| Moe Thida Htwe| Yoshioka, Yohsuke| Kimata, Yoshihiro| Iida, Seiji| Khin, Myo| Okada, Shigeru| Sein, Than|
Abstract Oral cancer is a very common disease in South and Southeast Asia. Betel quid (BQ)- chewing and tobaccosmoking habits are etiological factors for oral cancer patients in these regions. We conducted an oral cancer screening in BQ-chewing endemic rural areas in South Myanmar for the early detection of oral cancer in BQ-chewing and smoking individuals. We examined 105 subjects who were at high risk of oral cancer due to their oral habits (BQ users and/or smokers). Three carcinoma cases were detected, and there were 8 dysplasia cases. The carcinoma detection rate was 2.9%, and the carcinoma and precancerous lesion detection rate was 10.5%. In Myanmar, oral cancer screening has been conducted sporadically on a voluntary basis, and nationwide surveys have never been performed. There are also few reports of oral cancer screening for high-risk groups among the general population in Myanmar. Our present findings highlight the need for further screening and surveys. Education on betel quid chewing- and tobacco- related oral diseases and screening for the early detection of oral cancer are of the utmost importance in the control and prevention of oral cancer.
Keywords oral cancer screening betel quid (BQ) Myanmar oral cancer smoking
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 519
End Page 524
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276225
JaLCDOI 10.18926/AMO/55588
FullText URL 71_6_513.pdf
Author Sawada, Shigeki| Sugimoto, Ryujiro| Ueno, Tsuyoshi| Yamashita, Motohiro|
Abstract We evaluated the feasibility of maintenance treatment using UFT (a combination of tegafur and uracil) after adjuvant platinum-based chemotherapy in patients with resected lung cancer. A prospective feasibility trial was conducted. Between 2010 and 2014, UFT was administered for 2 years sequentially after platinum-based adjuvant chemotherapy in 24 patients with resected Stage IIA-IIIA non-small cell lung cancer. The safety of UFT and the rate of treatment completion were then evaluated. The prior platinum-based chemotherapy regimens consisted of cisplatin+vinorelbine in 16 patients, carboplatin+paclitaxel in 5 and carboplatin+S-1 in one. During the subsequent UFT administration, a total of 3 patients required a dose reduction because of Grade 1 blood-stained sputum, Grade 2 numbness, and Grade 2 constipation, in one patient each. Eleven patients underwent the planned 2-year UFT administration, but 12 patients could not because of the recurrence of lung cancer in 5 patients, metachronous malignancy in one, and toxicities in 6. The completion rate for UFT administration was 64.7% (11/17). The most common type of toxicity was gastrointestinal toxicities. All of the toxicities were grade 1 or 2, and no severe toxicities were observed. UFT treatment after platinum-based chemotherapy was revealed to be feasible.
Keywords UFT adjuvant chemotherapy lung cancer resection
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 513
End Page 518
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276224
JaLCDOI 10.18926/AMO/55587
FullText URL 71_6_505.pdf
Author Honda, Yoshihiro| Takigawa, Nagio| Ichihara, Eiki| Ninomiya, Takashi| Kubo, Toshio| Ochi, Nobuaki| Yasugi, Masayuki| Murakami, Toshi| Yamane, Hiromichi| Tanimoto, Mitsune| Kiura, Katsuyuki|
Abstract (−)-Epigallocatechin-3-gallate (EGCG) has been shown to bind to several receptors including epidermal growth factor receptor (EGFR). EGFR tyrosine kinase inhibitors and anaplastic lymphoma kinase (ALK) inhibitors are effective for non-small cell lung cancers harboring activating EGFR mutations and ALK or c-ros oncogene 1 (ROS1) fusion genes, respectively. We investigated the effects of EGCG on EGFR- or fusion gene-driven lung cancer cells such as PC-9, RPC-9, H1975, H2228 and HCC78. The five cell lines had similar sensitivity to EGCG. Phosphorylated (p)EGFR, pAkt and pErk in PC-9, RPC-9 and H1975 cells were suppressed by EGCG (50 or 100 μM). EGCG also inhibited pALK in H2228, pROS1 in HCC78, and pErk and pAkt in both cell lines. All the xenograft tumors established using the 5 cell lines in EGCG-treated groups were significantly smaller than the tumors in the vehicle-treated groups. The numbers of tumor blood vessels of xenograft tissues in EGCG-treated mice were significantly lower than those in vehicle-treated mice. In conclusion, EGCG may be effective for EGFR-driven lung tumors irrespective of the presence of T790M, and for ALK or ROS1 fusion gene-driven lung tumors.
Keywords epigallocatechin-3-gallate lung cancer EGFR ALK ROS1
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 505
End Page 512
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276223
JaLCDOI 10.18926/AMO/55586
FullText URL 71_6_493.pdf
Author Aoe, Michinori| Ueno-Iio, Tomoe| Shibakura, Misako| Shinohata, Ryoko| Usui, Shinichi| Arao, Yujiro| Ikeda, Satoru| Miyahara, Nobuaki| Tanimoto, Mitsune| Kataoka, Mikio|
Abstract Lavender essential oil (Lvn) has anti-inflammatory effects in an ovalbumin-sensitized murine model of asthma, and inhibits inflammatory cell infiltration into the lungs. The anti-inflammatory effects of Lvn on cell adhesion molecules are not clear. Here we evaluated the effects of Lvn and its main constituents, linalyl acetate (LA) and linalool (LO), on the expression of tumor necrosis factor-alpha (TNF-α)-induced cell adhesion molecules in murine brain endothelial bEnd.3 cells and human umbilical vein endothelial cells (HUVECs). The bEnd.3 cells were treated with Lvn, LA, or LO and subsequently stimulated with TNF-α. The mRNA expression levels of cell adhesion molecules were detected using RT-PCR. E-selectin and P-selectin protein and phosphorylated-NF-κB p65 were detected by western blotting. The effects of Lvn on HUVECs were measured by RT-PCR. In bEnd.3 cells, Lvn and LA suppressed TNF-α-induced E-selectin, P-selectin, vascular cell adhesion molecule-1, intercellular adhesion molecule-1, and phosphorylated-NF-κB p65 in the nucleus; LO did not suppress P-selectin or phosphorylated-NF-κB p65. Lvn inhibited TNF-α-induced E-selectin mRNA in HUVECs. These results indicate that Lvn and LA inhibit TNF-α-induced cell adhesion molecules in endothelial cells through the suppression of NF-κB activation. Consequently, Lvn or other essential oils including LA may be useful as alternative anti-inflammatory medicines.
Keywords lavender essential oil linalyl acetate inflammation cell adhesion molecule NF-κB
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 493
End Page 503
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276222
JaLCDOI 10.18926/AMO/55585
FullText URL 71_6_485.pdf
Author Okano, Ayaka| Masuhara, Shun| Ota, Sonoka| Motegi, Chie| Takabayashi, Noriko| Ogino, Tetsuya|
Abstract We examined postprandial body positions’ effects on gastrointestinal motility, the autonomic nervous system and subjective comfort, i.e., whether lowering the head after a meal is beneficial for gastrointestinal motility and the prevention of pressure ulcer. We examined 10 healthy subjects and compared 3 body positions: (1) Seated upright. (2) Lying on a bed with the head at 60° and knees up by 20° (60° position). (3) Identical to (2) until post-meal; the head was then lowered to 30° (60°-30° position). Gastrointestinal motility was assessed as gastrointestinal sounds measured by sound-editing software. Digital plethysmography assessed autonomic nerve function as heart rate variability. The pressure ulcer risk was estimated as subjective comfort/discomfort using a visual analog scale. Gastrointestinal sounds increased post-meal. The 60°-30° position showed the highest number of sounds and longest cumulative sound duration. Post-meal, sympathetic activation was suggested in the 60° position, whereas vagal activity was relatively preserved in the 60°-30° position. The 60°-30° position was the most comfortable, and the 60° position was least comfortable. Lowering the head after a meal is beneficial to augment gastrointestinal motility and decrease the pressure ulcer risk. The 60° head-up position increases the pressure ulcer risk.
Keywords gastrointestinal sound body position autonomic nerve pressure ulcer patient care
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 485
End Page 491
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276221
JaLCDOI 10.18926/AMO/55584
FullText URL 71_6_475.pdf
Author Takei, Daisuke| Harada, Keita| Takashima, Shiho| Inokuchi, Toshihiro| Nakarai, Asuka| Sugihara, Yusaku| Takahara, Masanobu| Hiraoka, Sakiko| Okada, Hiroyuki|
Abstract Several reports discussed colonoscopic surveillance after polypectomy and endoscopic mucosal resection (EMR) for colorectal polyps, but only a few reports focused on prognostic analyses, and none involved metachronous neoplasia after colorectal endoscopic submucosal dissection (ESD). We conducted the present study to assess the risk of adenoma recurrence requiring endoscopic treatment, and to establish appropriate post-ESD colonoscopic surveillance. We enrolled 116 patients who had undergone colorectal ESD at Okayama University Hospital between February 2008 and July 2014 and had been followed-up >12 months. We retrospectively analyzed clinicopathological features of 101 lesions from 101 patients. Metachronous adenomas were detected in 21 cases (20.8%). We divided the patients into 2 groups according to the occurrence of metachronous adenomas. Our comparison of clinicopathological characteristics between these groups showed that in the metachronous adenomas group the number of synchronous adenomas at index colonoscopy was high and the rate of laterally spreading tumor-nongranular (LST-NG) was higher. A multivariate analysis indicated that the number of synchronous adenomas was significantly associated with metachronous adenomas (HR: 2.54, 95%CI: 1.04-6.52, p<0.05). The colonoscopic surveillance planning after colorectal ESD should be more meticulous for patients with more synchronous adenomas.
Keywords endoscopic submucosal dissection laterally spreading tumor metachronous recurrence local recurrence post-ESD colonoscopic surveillance
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 475
End Page 483
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276220
JaLCDOI 10.18926/AMO/55583
FullText URL 71_6_467.pdf
Author Obata, Kengo| Yumoto, Tetsuya| Fuke, Soichiro| Tsukahara, Kohei| Naito, Hiromichi| Iida, Atsuyoshi| Takahashi, Tetsuya| Ujike, Yoshihito| Nakao, Atsunori|
Abstract Early mobilization is advocated to prevent intensive care unit-acquired physical weakness, but the patient's workload and its changes in response to body position changes have not been established. We used indirect calorimetry to determine the energy expenditure (EE) in response to body position changes, and we assessed EE's correlation with respiratory parameters in healthy volunteers: 8 males and 8 females, mean age 23.4±1.3 years. The subjects started in the resting supine position followed by a 30° head-up position, a 60° head-up position, an upright sitting position, a standing position, and the resting supine position. EE was determined in real time by indirect calorimetry monitoring the subject’s respiratory rate, tidal volume (VT), and minute volume (MV). The highest values were observed immediately after the subjects transitioned from standing to supine, and this was significantly higher compared to the original supine position (1,450±285 vs. 2,004±519 kcal/day, p<0.01). Moderate correlations were observed between VT and EE (r=0.609, p<0.001) and between MV and EE (r=0.576, p<0.001). Increasing VT or MV indicates an increasing patient workload during mobilization. Monitoring these parameters may contribute to safe rehabilitation. Further studies should assess EE in critically ill patients.
Keywords early mobilization energy expenditure indirect calorimetry rehabilitation body position
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 467
End Page 473
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276219
JaLCDOI 10.18926/AMO/55582
FullText URL 71_6_459.pdf
Author Sakaguchi, Masakiyo| Kinoshita, Rie| Endy Widya Putranto| I Made Winarsa Ruma| I Wayan Sumardika| Youyi, Chen| Tomonobu, Naoko| Yamamoto, Ken-ichi| Murata, Hitoshi|
Abstract The receptor for advanced glycation end products (RAGE) is involved in inflammatory pathogenesis. It functions as a receptor to multiple ligands such as AGEs, HMGB1 and S100 proteins, activating multiple intracellular signaling pathways with each ligand binding. The molecular events by which ligand-activated RAGE controls diverse signaling are not well understood, but some progress was made recently. Accumulating evidence revealed that RAGE has multiple binding partners within the cytoplasm and on the plasma membrane. It was first pointed out in 2008 that RAGE’s cytoplasmic tail is able to recruit Diaphanous-1 (Dia-1), resulting in the acquisition of increased cellular motility through Rac1/Cdc42 activation. We also observed that within the cytosol, RAGE’s cytoplasmic tail behaves similarly to a Toll-like receptor (TLR4)-TIR domain, interacting with TIRAP and MyD88 adaptor molecules that in turn activate multiple downstream signals. Subsequent studies demonstrated the presence of an alternative adaptor molecule, DAP10, on the plasma membrane. The coupling of RAGE with DAP10 is critical for enhancing the RAGE-mediated survival signal. Interestingly, RAGE interaction on the membrane was not restricted to DAP10 alone. The chemotactic G-protein-coupled receptors (GPCRs) formyl peptide receptors1 and 2 (FPR1 and FPR2) also interacted with RAGE on the plasma membrane. Binding interaction between leukotriene B4 receptor 1 (BLT1) and RAGE was also demonstrated. All of the interactions affected the RAGE signal polarity. These findings indicate that functional interactions between RAGE and various molecules within the cytoplasmic area or on the membrane area coordinately regulate multiple ligand-mediated RAGE responses, leading to typical cellular phenotypes in several pathological settings. Here we review RAGE’s signaling diversity, to contribute to the understanding of the elaborate functions of RAGE in physiological and pathological contexts.
Keywords receptor for advanced glycation end products RAGE adaptor protein signal transduction inflammatory pathogenesis
Amo Type Review
Publication Title Acta Medica Okayama
Published Date 2017-12
Volume volume71
Issue issue6
Publisher Okayama University Medical School
Start Page 459
End Page 465
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29276218