| JaLCDOI | 10.18926/AMO/56381 |
|---|---|
| FullText URL | 72_6_611.pdf |
| Author | Tsunoda, Koichi| Kobayashi, Rika| Kada, Akiko| Saito, Akiko M.| Misawa, Hayato| Horibe, Keizo| Goto, Fumiyuki| Tsunoda, Atsunobu| Sasaki, Toru| Takanosawa, Minako| Nishino, Hiroshi| Kondoh, Kenji| Sugiyama, Yoichiro| Hisa, Yasuo| |
| Abstract | The oropharynx is examined with a light source such as an electric light, a penlight, or a forehead mirror based on an acquired visual field using a tongue depressor. However, it is extremely difficult to obtain objective and reproducible images of tissue within the pharynx required in recent years with these methods, and insufficient progress in the examination tools has been made. There is an increasing need to develop a method for display during oropharyngeal examination. We conducted the present study to develop a novel oropharyngeal endoscope as an objective observation method. |
| Keywords | tongue depressor oropharyngeal scope oral pharyngeal otorhinolaryngology |
| Amo Type | Clinical Study Protocol |
| Publication Title | Acta Medica Okayama |
| Published Date | 2018-12 |
| Volume | volume72 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 611 |
| End Page | 614 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2018 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 30573918 |
| NAID | 120006545166 |
| JaLCDOI | 10.18926/AMO/56380 |
|---|---|
| FullText URL | 72_6_605.pdf |
| Author | Mitsui, Yosuke| Sadahira, Takuya| Maruyama, Yuki| Wada, Koichiro| Tanimoto, Ryuta| Sugimoto, Morito| Araki, Motoo| Watanabe, Masami| Yanai, Hiroyuki| Watanabe, Toyohiko| Nasu, Yasutomo| |
| Abstract | Metastatic prostate cancer (PCa) cases that cannot be detected on repeat prostate biopsy are extremely rare. Our patient was a 51-year-old Japanese man diagnosed as metastatic PCa by histopathological examination of lesions obtained bone biopsy and lymph node dissection. The primary tumor was not detected after repeated prostate biopsy. Metastatic PCa was diagnosed based on immunohistochemical staining: PSA, AR, P504S, and NKX3.1 of bone and lymph node with metastasis. We speculate that the primary PCa was “burned-out,” demonstrating remote metastases with no apparent primary tumor in the prostate. Burned-out PCa may be difficult to diagnose and treat due to its rarity. |
| Keywords | prostate cancer metastasis unknown primary tumor repeat biopsy CRPC |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2018-12 |
| Volume | volume72 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 605 |
| End Page | 609 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2018 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 30573917 |
| NAID | 120006545165 |
| JaLCDOI | 10.18926/AMO/56379 |
|---|---|
| FullText URL | 72_6_601.pdf |
| Author | Hashimoto, Kazuhiko| Nishimura, Shunji| Iemura, Shunki| Akagi, Masao| |
| Abstract | Salmonella osteomyelitis is extremely rare; only a few cases have been reported in healthy adults. We describe a case of salmonella osteomyelitis in an otherwise healthy 20-year-old Japanese woman who presented with distal tibial pain. X-ray and magnetic resonance imaging showed a lesion suspected to be a bone cyst. Osteomyelitis was diagnosed when pus was observed during an open biopsy. The bacterial culture examination yielded salmonella. Surgical drainage and antibiotic treatment were performed, after which no recurrence was observed. To our best knowledge, this is the first report of salmonella osteomyelitis of the distal tibia in an otherwise healthy individual. |
| Keywords | osteomyelitis salmonella tibia healthy woman |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2018-12 |
| Volume | volume72 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 601 |
| End Page | 604 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2018 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 30573916 |
| NAID | 120006545164 |
| JaLCDOI | 10.18926/AMO/56378 |
|---|---|
| FullText URL | 72_6_595.pdf |
| Author | Sugihara, Yuusaku| Harada, Keita| Kato, Ryo| Yamauchi, Kenji| Sakae, Hiroyuki| Kawano, Seiji| Hiraoka, Sakiko| Kawahara, Yoshiro| Otsuka, Fumio| Okada, Hiroyuki| |
| Abstract | The indications for peroral endoscopic myotomy (POEM) have been expanded to include diffuse esophageal spasm (DES). A 67-year-old Japanese man presented with a 4-year history of dysphagia. Endoscopy and upper gastrography revealed abnormal peristaltic movements involving interruption of normal peristalsis, and a diverticulum located at the 2 o’clock esophageal position. High-resolution manometry indicated DES. POEM with a long (15 cm) myotomy was performed for the abnormal contractions, which subsequently disappeared along with dysphagia improvement. Our results suggest that esophageal motility disorders accompanying a diverticulum may be eliminated by POEM without treating the diverticulum itself. We speculate that POEM ameliorates esophageal diverticulum by reducing internal esophageal pressure. |
| Keywords | diffuse esophageal spasm (DES) diverticulum, peroral endoscopic myotomy (POEM) high-resolution manometry (HRM) |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2018-12 |
| Volume | volume72 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 595 |
| End Page | 600 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2018 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 30573915 |
| NAID | 120006545163 |
| JaLCDOI | 10.18926/AMO/56377 |
|---|---|
| FullText URL | 72_6_591.pdf |
| Author | Shimoyama, Yuichiro| Umegaki, Osamu| Inoue, Satsuki| Agui, Tomoyuki| Kadono, Noriko| Minami, Toshiaki| |
| Abstract | A neutrophil-to-lymphocyte ratio (NLR) > 7 is reportedly an independent marker of mortality in patients with bacteremia. However, no studies have shown an association between inflammation-based prognostic scores (including the Glasgow Prognostic Score, the NLR, the platelet-to-lymphocyte ratio, the Prognostic Nutritional Index, and the Prognostic Index) and mortality in patients with pneumonia. We retrospectively examined the cases of 33 patients diagnosed with pneumonia who were treated in the ICU of Osaka Medical College Hospital between January 2014 and June 2016. A multivariate analysis revealed that the NLR was a significant predictor of mortality in these pneumonia patients. |
| Keywords | inflammation-based prognostic score pneumonia in-hospital mortality |
| Amo Type | Short Communication |
| Publication Title | Acta Medica Okayama |
| Published Date | 2018-12 |
| Volume | volume72 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 591 |
| End Page | 593 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2018 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 30573914 |
| NAID | 120006545162 |
| JaLCDOI | 10.18926/AMO/56376 |
|---|---|
| FullText URL | 72_6_583.pdf |
| Author | Park, Se-Jin| Jeong, Hwa-Jae| Shin, Hun-Kyu| Park, Jai Hyung| Lee, Jaewook| Cho, Yongun| Lee, Seok Won| Murase, Tsuyoshi| Ikemoto, Sumika| Sugamoto, Kazuomi| Kim, Eugene| |
| Abstract | We retrospectively evaluated the altered biomechanics of the talus in 15 adult patients (7 males, 8 females) with chronic lateral ankle instability when the ankle joint moved actively from full dorsiflexion to full plantarflexion under a non-weight bearing condition. CT images were taken for the unstable ankle and the contralateral normal (control) ankle. Three-dimensional surface models of both ankle joints were reconstructed from the CT data, and we used a computer simulation program to compare both ankle motions of inversion/eversion in the coronal plane, plantarflexion/dorsiflexion in the sagittal plane, and internal rotation/external rotation in the axial plane. This evaluation method provides in vivo, dynamic, and 3D results of ankle motion. In the ankles with chronic lateral instability and the controls, the average talar rotational movement of inversion (+)/eversion (−) was 19.0° and 15.5° and the internal rotation (+)/external rotation (−) was 30.4° and 20.7°, respectively. Paired t-tests revealed significant differences in the amount of inversion (+)/eversion (−) (p=0.012) and internal rotation (+)/external rotation (−) (p<0.001) between unstable and normal ankle joints. The difference of mean rotational movement in internal rotation (9.7°) was greater than that of inversion (3.5°). Rotational instability should be considered when evaluating chronic lateral ankle instability. |
| Keywords | three-dimensional motion analysis chronic lateral ankle instability talus ankle joint |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2018-12 |
| Volume | volume72 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 583 |
| End Page | 589 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2018 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 30573913 |
| NAID | 120006545161 |
| JaLCDOI | 10.18926/AMO/56375 |
|---|---|
| FullText URL | 72_6_577.pdf |
| Author | Makino, Takuma| Orita, Yorihisa| Tachibana, Tomoyasu| Marunaka, Hidenori| Miki, Kentaro| Akisada, Naoki| Akagi, Yusuke| Usui, Yoshiyuki| Sato, Yasuharu| Yoshino, Tadashi| Nishizaki, Kazunori| |
| Abstract | Since no diagnostic method has been established to distinguish follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA), surgery has been the only way to reach a diagnosis of follicular neoplasm. Here we investigated the computed tomography (CT) features of follicular neoplasms, toward the goal of being able to identify specific CT features allowing the preoperative differentiation of FTC from FTA. We retrospectively analyzed the cases of 205 patients who underwent preoperative CT of the neck and were histopathologically diagnosed with FTC (n=31) or FTA (n=174) after surgery between January 2002 and June 2016 at several hospitals in Japan. In each of these 205 cases, non-enhanced and contrast-enhanced CT images were obtained, and we analyzed the CT features. On univariate analysis, inhomogeneous features of tumor lesions on contrast-enhanced CT were more frequently observed in FTC than in FTA (p=0.0032). A multivariate analysis identified inhomogeneous features of tumor lesions on contrast-enhanced CT images as an independent variable indicative of FTC (p=0.0023). CT thus offers diagnostic assistance in distinguishing FTC from FTA. |
| Keywords | computed tomography follicular thyroid carcinoma follicular thyroid adenoma preoperative diagnosis |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2018-12 |
| Volume | volume72 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 577 |
| End Page | 581 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2018 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 30573912 |
| NAID | 120006545160 |
| JaLCDOI | 10.18926/AMO/56374 |
|---|---|
| FullText URL | 72_6_567.pdf |
| Author | Yagi, Takahito| Takagi, Kosei| Umeda, Yuzo| Yoshida, Ryuichi| Nobuoka, Daisuke| Kuise, Takashi| Fujiwara, Toshiyoshi| |
| Abstract | Living donor liver transplantation (LDLT) is the final therapeutic arm for pediatric end-stage liver diseases. Toward the goal of achieving further improvement in LDLT survival, we investigated factors affecting recipient survival. We evaluated the prognostic factors of 60 pediatric recipients (< 16 years old) who underwent LDLT between 1997 and 2015. In a univariate analysis, non-cholestatic (NCS) disease, graft/recipient body weight ratio, cold and warm ischemic times, and intraoperative blood loss were significant factors impacting survival. In a multivariate analysis, NCS disease was the only significant factor worsening survival (p=0.0021). One-and 5-year survival rates for the cholestatic disease (CS, n=43) and NCS (n=17) groups were 100% vs. 70.6% and 97.4% vs. 58.8% (p=0.004, log-rank). Intergroup comparisons revealed that CS was significantly associated with operation time, cold ischemia, hepatomegaly of the native liver, and portal plasty. These data suggest that a cirrhotic, swollen, artery-dominant liver did not increase graft size-related risks despite the surgical complexity of preceding operations. The NCS group’s poorer survival originated from recurrence of the primary disease and liver manifestation of systemic disease untreatable by transplantation. Improving the survival of pediatric recipients requires intensive efforts to prevent primary disease relapse and more rapid diagnoses to exclude contraindications from NCS disease. |
| Keywords | liver transplantation living donor pediatrics prognostic factor cholestatic disease |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2018-12 |
| Volume | volume72 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 567 |
| End Page | 576 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2018 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 30573911 |
| NAID | 120006545159 |
| JaLCDOI | 10.18926/AMO/56373 |
|---|---|
| FullText URL | 72_6_563.pdf |
| Author | Katayama, Yoshimi| Senda, Masuo| Kaneda, Daisuke| Ozaki, Toshifumi| |
| Abstract | We studied phrenic nerve conduction times in 90 phrenic nerves of 45 normal subjects. The phrenic nerve was stimulated at the posterior border of the sternomastoid muscle in the supraclavicular fossa, just above the clavicle, with bipolar surface electrodes. For recording, positive and negative electrodes were placed on the xiphoid process and at the eighth intercostal bone-cartilage transition, respectively. We studied both the right and left sides to determine whether there was any difference between the two sides. The mean onset latency (± SD) of the right compound muscle action potentials (CMAPs) (5.99±0.39 msec) was significantly shorter than that of the left CMAPs (6.45±0.50 msec). The mean peak latency was significantly shorter in the right CMAPs (10.22±1.33 msec) than the left CMAPs (12.48±2.02 msec). The mean (± SD) amplitude was significantly lower in the left CMAPs (0.42±0.11 mV) than the right CMAPs (0.49±0.10 mV). The difference between the length of the nerve on the right and left sides might have affected the difference in latency between the two sides. |
| Keywords | phrenic nerve right left difference healthy subject nerve conduction |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2018-12 |
| Volume | volume72 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 563 |
| End Page | 566 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2018 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 30573910 |
| NAID | 120006545158 |
| JaLCDOI | 10.18926/AMO/56372 |
|---|---|
| FullText URL | 72_6_553.pdf |
| Author | Omura, Daisuke| Sato, Asuka| Oka, Kosuke| Hanayama, Yoshihisa| Ogawa, Hiroko| Obika, Mikako| Otsuka, Fumio| |
| Abstract | To clarify potential relationships between chief complaints of patients and laboratory data with a focus on aging-related changes, we retrospectively analyzed the data of 843 patients who visited a general medicine department for the first time. Their chief complaints were classified into 8 major symptoms: visceral pain, somatic pain, fever, cough, dizziness, fatigue, appetite loss, and edema. We compared the laboratory data obtained from the patients with complaints with the data of symptom-free (control) patients. The serum sodium and potassium levels in the fever group were decreased compared to those in the control group. In the fever group, the serum sodium level was inversely correlated with age. The ratio of serum urea nitrogen to creatinine (UN/Cr) was increased in the appetite-loss group. There were significant age-dependent increases in the UN/Cr ratio in the appetite-loss and edema groups. Of note, serum levels of free thyroxin were lower in the dizziness group compared to the control group. In addition, the free thyroxin level was inversely correlated with age in the dizziness group but not in the asymptomatic control group. Collectively, the results indicated that osmolality-related laboratory data are strongly associated with individual primary symptoms at the first visit regardless of the final diagnosis. The consideration of age-dependent changes of these markers is helpful for diagnosing latent disorders based on various primary symptoms. |
| Keywords | dizziness fever osmolality serum sodium thyroid dysfunction |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2018-12 |
| Volume | volume72 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 553 |
| End Page | 562 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2018 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 30573909 |
| NAID | 120006545157 |
| JaLCDOI | 10.18926/AMO/56371 |
|---|---|
| FullText URL | 72_6_547.pdf |
| Author | Watanabe, Akihisa| Ono, Qana| Nishigami, Tomohiko| Hirooka, Takahiko| Machida, Hirohisa| |
| Abstract | Distinct anatomic variants of the scapula such as the critical shoulder angle (CSA) were found to be associated with rotator cuff tears (RCTs), but it is unclear whether the CSA is a risk factor in Japanese. Here we sought to determine whether the CSA is associated with RCTs in a Japanese population, and whether the CSA is a more useful parameter than the conventionally used parameters. Our RCT group and non-RCT group each consisted of 54 consecutive cases. We compared the groups’ values of CSA, the acromion index (AI), and the lateral acromion angle (LAA) obtained by X-ray imaging. Receiver operating characteristic (ROC) analyses were performed to determine cutoff values and the area under the curve (AUC), and to assess the odds ratio. The means of the CSA and the AI in the RCT group were significantly larger (36.3° vs. 33.7°, 0.74 vs 0.68), but the LAA did not show a significant between-group difference. The AUCs for the CSA and AI were 0.678 and 0.658, the cutoff values were 35.0° and 0.72, and the odds ratios were 3.1 and 2.5, respectively. In conclusion, the CSA was a strong risk factor compared to the AI and LAA for rotator cuff tears. |
| Keywords | rotator cuff tear risk factor critical shoulder angle acromion index lateral acromion angle |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2018-12 |
| Volume | volume72 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 547 |
| End Page | 551 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2018 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 30573908 |
| NAID | 120006545156 |
| JaLCDOI | 10.18926/AMO/56370 |
|---|---|
| FullText URL | 72_6_539.pdf |
| Author | Hiraki, Takao| Kamegawa, Tetsushi| Matsuno, Takayuki| Komaki, Toshiyuki| Sakurai, Jun| Kanazawa, Susumu| |
| Abstract | Since 2012, we have been developing a remote-controlled robotic system (Zerobot®) for needle insertion during computed tomography (CT)-guided interventional procedures, such as ablation, biopsy, and drainage. The system was designed via a collaboration between the medical and engineering departments at Okayama University, including various risk control features. It consists of a robot with 6 degrees of freedom that is manipulated using an operation interface to perform needle insertions under CT-guidance. The procedure includes robot positioning, needle targeting, and needle insertion. Phantom experiments have indicated that robotic insertion is equivalent in accuracy to manual insertion, without physician radiation exposure. Animal experiments have revealed that robotic insertion of biopsy introducer needles and various ablation needles is safe and accurate in vivo. The first in vivo human trial, therefore, began in April 2018. After its completion, a larger clinical study will be conducted for commercialization of the robot. This robotic procedure has many potential advantages over a manual procedure: 1) decreased physician fatigue; 2) stable and accurate needle posture without tremor; 3) procedure automation; 4) less experience required for proficiency in needle insertion skills; 5) decreased variance in technical skills among physicians; and 6) increased likelihood of performing the procedure at remote hospitals (i.e., telemedicine). |
| Keywords | robot needle insertion CT-guided interventional radiology |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2018-12 |
| Volume | volume72 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 539 |
| End Page | 546 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2018 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 30573907 |
| NAID | 120006545155 |
