| JaLCDOI | 10.18926/AMO/59961 |
|---|---|
| FullText URL | 74_3_261.pdf |
| Author | Nakahara, Keiichi| Ikeda, Tokunori| Takamatsu, Koutaro| Tawara, Nozomu| Hara, Kentaro| Enokida, Yuki| Tanoue, Naomi| Narita, Sawana| Fujii, Akiko| Yamanouchi, Yoshinori| Morinaga, Jun| Yamashita, Satoshi| |
| Abstract | Muscle biopsy can be used to confirm the diagnosis of neuromuscular diseases. However, it is unclear whether antibiotic prophylaxis prior to muscle biopsy is needed to prevent surgical site infection (SSI). We are conducting a phase 2, single-center, open-labeled, prospective randomized trial to clarify the need for antibiotic prophylaxis in patients at low risk for SSI undergoing muscle biopsy. Patients will be randomized to an antibiotic prophylaxis group or a control group, and the incidence of SSI will be compared between the groups. Our findings will clarify the need for antibiotic prophylaxis in this patient population. |
| Keywords | muscle biopsy antibiotic prophylaxis |
| Amo Type | Clinical Study Protocol |
| Published Date | 2020-06 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 261 |
| End Page | 264 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32577026 |
| JaLCDOI | 10.18926/AMO/59960 |
|---|---|
| FullText URL | 74_3_257.pdf |
| Author | Hongo, Takashi| Ikeda, Fusao| Fujioka, Shinichi| Akatsuka, Riku| Fujiwara, Tosifumi| Yamamoto, Kazuhide| |
| Abstract | A 65-year-old Japanese woman developed vesicular eruptions on her right ear due to varicella zoster virus (VZV) reactivation, followed by cranial polyneuritis and meningitis affecting her right cranial nerves V, VII, VIII, IX, and X. After acyclovir administration, her facial paralysis worsened. Intravenous methylprednisolone and vitamin C were administered on Day 4 post-admission. Her symptoms steadily improved, and by Day 45 she had fully recovered. Cranial polyneuritis is a rare complication of VZV reactivation, and there is no established method of treatment. This is the first report of full recovery from cranial polyneuritis using intravenous vitamin C as ancillary treatment. |
| Keywords | varicella zoster virus polyneuritis vitamin C meningitis facial nerve palsy |
| Amo Type | Case Report |
| Published Date | 2020-06 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 257 |
| End Page | 260 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32577025 |
| JaLCDOI | 10.18926/AMO/59959 |
|---|---|
| FullText URL | 74_3_251.pdf |
| Author | Murakami, Takashi| Tokuda, Takanori| Nishimura, Shinsuke| Fujii, Hiromichi| Takahashi, Yosuke| Yamane, Kokoro| Inoue, Kazushige| Yamada, Koichi| Kakeya, Hiroshi| Shibata, Toshihiko| |
| Abstract | A 62-year-old Japanese male presented with graft infection by Staphylococcus schleiferi 50 days after debranching of the left subclavian artery and frozen elephant trunk repair for the entry closure of a Stanford type B aortic dissection. The graft was removed, and the patient was successfully treated using in situ reconstruction of the arch with omental flap coverage, removal of the debranching graft, autologous iliac artery grafting, and longterm antibiotics. Domino reconstruction of the infected debranching graft using autologous external iliac artery and a Dacron graft can thus be a good option in similar cases. |
| Keywords | autologous iliac artery graft Staphylococcus schleiferi graft infection domino reconstruction Dacron graft |
| Amo Type | Case Report |
| Published Date | 2020-06 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 251 |
| End Page | 255 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32577024 |
| JaLCDOI | 10.18926/AMO/59958 |
|---|---|
| FullText URL | 74_3_245.pdf |
| Author | Yamamoto, Shumpei| Takayama, Hiroshi| Shimodate, Yuichi| Takezawa, Rio| Nishimura, Naoyuki| Doi, Akira| Mouri, Hirokazu| Matsueda, Kazuhiro| Mizuno, Motowo| Okada, Hiroyuki| |
| Abstract | Antithrombotic therapy is a major risk factor for delayed bleeding after endoscopic submucosal dissection (ESD) for gastric neoplasia. A potassium-competitive acid blocker, vonoprazan, is expected to prevent delayed bleeding better than conventional proton pomp inhibitors (PPIs), but the evidence is controversial. We sought to clarify the efficacy of vonoprazan for prevention of delayed bleeding after gastric ESD in patients under antithrombotic therapy. We prospectively registered 50 patients who underwent gastric ESD while receiving antithrombotic therapy and vonoprazan in our institution between October 2017 and September 2018. The incidence of delayed bleeding was compared with that in a historical control group of 116 patients treated with conventional PPI. We also evaluated risk factors associated with delayed bleeding. Delayed bleeding was observed in 8 of 50 patients (16.0%), which was not dissimilar from the incidence in the historical control group (12.1%) (p=0.49). In the univariate analysis, age (> 70 years) (p=0.034), multiple antithrombotic drug use (p<0.01), procedure time (> 200 min) (p=0.038) and tumor size (> 40 mm) (p<0.01) were associated with delayed bleeding after gastric ESD, but vonoprazan was not (p=0.49). Vonoprazan may not be more effective than conventional PPIs in preventing delayed bleeding after gastric ESD in patients receiving antithrombotic therapy. |
| Keywords | vonoprazan endoscopic submucosal dissection antithrombotic drug gastric cancer |
| Amo Type | Original Article |
| Published Date | 2020-06 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 245 |
| End Page | 250 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32577023 |
| JaLCDOI | 10.18926/AMO/59957 |
|---|---|
| FullText URL | 74_3_237.pdf |
| Author | Oyama, Atsushi| Uchida, Daisuke| Shiraha, Hidenori| Sawahara, Hiroaki| Kato, Ryo| Iwamuro, Masaya| Horiguchi, Shigeru| Okada, Hiroyuki| |
| Abstract | The physiological role of the reduced expression of immortalized cells (REIC)/Dickkopf-3 (Dkk-3) protein in patients with hepatocellular carcinoma (HCC) remains unclear. In this study, we evaluated the effect of the REIC/Dkk-3 protein on HCC cell proliferation and assessed the relationship between the serum REIC/Dkk-3 protein level and the prognosis in patients with HCC. We evaluated the REIC/Dkk-3 protein-induced anticancer effects on Huh7 and Hep3B cells (HCC cell lines) in the presence of peripheral blood mononuclear cells (PBMCs), and found that combination treatment with REIC/Dkk-3 protein and PBMCs reduced the proliferation of HCC cells (Hep3B: 82.0%±16.3%; Huh7: 72.6%±9.1%). We also studied 194 HCC patients who underwent primary liver resection or primary radiofrequency ablation from 2008 to 2017. Serum REIC/Dkk-3 protein levels were measured by an enzyme-linked immunosorbent assay and compared to the prognostic data. The 3-year disease-free survival of the REIC/Dkk-3 high group was significantly higher than that in the REIC/Dkk-3 low group. In conclusion, this is the first study investigating the relationship between HCC patient survival and serum REIC/Dkk-3 protein levels in a large population. Based on the results, the serum REIC/Dkk-3 protein level should be considered a new prognostic marker for patients with HCC. |
| Keywords | enzyme-linked immunosorbent assay liver resection primary radiofrequency ablation Huh7 Hep3B |
| Amo Type | Original Article |
| Published Date | 2020-06 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 237 |
| End Page | 243 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32577022 |
| JaLCDOI | 10.18926/AMO/59956 |
|---|---|
| FullText URL | 74_3_229.pdf |
| Author | Shibata, Kiyo| Hamasaki, Ichiro| Toshima, Shinji| Shimizu, Takehiro| Kono, Reika| Miyata, Manabu| Morisawa, Shin| Furuse, Takashi| Hasebe, Satoshi| Ohtsuki, Hiroshi| Morizane, Yuki| Shiraga, Fumio| |
| Abstract | The purpose of this study was to derive new formulas to provide an optimal surgical procedure and optimal amount of recession-resection (RR) surgery in intermittent exotropia (IXT) with a disparity in angle of deviation depending on the fixation distance. The records of 117 consecutive patients with IXT who underwent RR surgery between March 2008 and December 2011 at Okayama University Hospital were retrospectively examined. Multivariable linear regression analysis was performed using the observed corrective angle of deviation at distance or near fixation as the dependent variable, and amounts of lateral rectus muscle (LR) recession (mm) and medial rectus muscle (MR) resection, and age at surgery (years) as independent variables. Two simultaneous formulas were derived: corrective angle of deviation at distance fixation (°)=1.8×recession (mm)+1.6× resection (mm)+0.15×age (years)–6.6, and corrective angle at near fixation (°)=1.5×recession (mm)+1.7× resection (mm)+0.18×age (years)–3.8. Comparisons of coefficient values of the formulas between distance and near fixation revealed that LR recession was more affected by the corrective angle in distance than near fixation. MR resection was more affected at near than distance fixation. We found that our new formulas estimated the appropriate amount of unilateral RR surgery. |
| Keywords | surgical amount intermittent exotropia recession and resection procedure strabismus surgery recurrent exotropia |
| Amo Type | Original Article |
| Published Date | 2020-06 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 229 |
| End Page | 236 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32577021 |
| JaLCDOI | 10.18926/AMO/59954 |
|---|---|
| FullText URL | 74_3_221.pdf |
| Author | Yagura, Takuma| Oe, Kenichi| Paku, Masaaki| Tajima, Takeshi| Nakamura, Masaya| Iida, Hirokazu| Saito, Takanori| |
| Abstract | We retrospectively evaluated the cases of 169 hip fracture patients, their previous fractures, and the contralateral hip joint’s morphology. A history of contralateral hip fracture was present in 23 patients (Contra group). The other patients had a unilateral hip fracture: a trochanteric fracture (Troch group, n=73) or a femoral neck fracture (Neck group, n=73). In the Troch and Neck groups, we used anteroposterior and cross-table axialview radiographs of the contralateral hip to evaluate the proximal femur’s anatomy. In the Contra group, the concordance rate between the first and second types of hip fracture was 65.2%, and the second hip fracture’s morphology indicated that the trochanteric fracture had a cam deformity in terms of the femoral head-neck ratio. The average alpha angle and femoral head-neck offset in the Troch group were significantly larger than those in the Neck group. In the Neck group, pistol-grip deformities of Arbeitsgemeinschaft für Osteosynthesefragen types B1 (subcapital), B2 (transcervical), and B3 (displaced) were observed in 42.1%, 75%, and 6% of cases, respectively. There was a smaller alpha angle and a larger femoral head-neck offset in the contralateral hip of femoral neck fractures; thus, the “cam deformity” may protect against femoral neck fractures. |
| Keywords | cam deformity femoral neck fracture trochanteric fracture bilateral hip fractures |
| Amo Type | Original Article |
| Published Date | 2020-06 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 221 |
| End Page | 227 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32577020 |
| JaLCDOI | 10.18926/AMO/59952 |
|---|---|
| FullText URL | 74_3_215.pdf |
| Author | Chou, Hsi-Hsien| |
| Abstract | Due to cultural traditions, most Taiwanese do not have an advance directive or healthcare proxy. We explored how patients with mild dementia in Taiwan may still make self-determined decisions concerning advance directives for their healthcare and end-of-life care choices as the disease progresses. We examined 260 respondents with mild dementia at a Taiwan medical center: 199 patients who agreed (and 61 patients who disagreed) with the concept of advance directives completed a structured questionnaire. Multiple logistic regression models to determine the between-group differences revealed that the following were positively associated with approval of end-of-life directives: maintaining one’s quality of life (adjusted odds ratio [AOR], 2.44; 95% CI: 1.07-5.53), discussion with family members (AOR, 3.50; 95% CI: 1.49-8.26), and friend support networks (AOR, 3.36; 95% CI: 1.34-8.43). Cardiopulmonary resuscitation (AOR, 0.27; 95% CI: 0.09-0.79) was negatively associated with approval. There was also a positive association between the support of the legal validity of end-of-life directives (OR, 1.93; 95% CI: 1.07-3.48), without other confounding factors. In Taiwanese society, we remain mindful of cultural influences that may impact patients, including maintaining one’s quality of life, discussion with family members, and friend/support networks. These influences may help dementia patients complete their advance directives. |
| Keywords | advance directive dementia patient autonomy quality of life culture |
| Amo Type | Original Article |
| Published Date | 2020-06 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 215 |
| End Page | 220 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32577019 |
| JaLCDOI | 10.18926/AMO/59951 |
|---|---|
| FullText URL | 74_3_209.pdf |
| Author | Matsui, Yusuke| Hiraki, Takao| Iguchi, Toshihiro| Sakurai, Jun| Uka, Mayu| Masaoka, Yoshihisa| Gobara, Hideo| Kanazawa, Susumu| |
| Abstract | An aspiration-type semi-automatic cutting biopsy needle enables tissue cutting during application of negative pressure, which is expected to contribute to a larger amount of specimen. The aim of the present study was to evaluate this novel needle in a clinical setting. Patients who underwent image-guided percutaneous biopsy for lung or renal masses were enrolled. Cutting biopsy was performed with and without aspiration during each procedure. The specimens were weighed using an electronic scale. The weights were compared between specimens obtained with and without aspiration using a paired t-test. The data from 45 lung and 30 renal biopsy procedures were analyzed. In lung biopsy, the mean±standard deviation weights of specimens obtained with and without aspiration were 2.20±1.05 mg and 2.24±1.08 mg, respectively. In renal biopsy, the mean weights were 6.52±2.18 mg and 6.42±1.62 mg, respectively. The weights were not significantly different between specimens obtained with and without aspiration either in lung (p=0.799) or renal (p=0.789) biopsies. The application of negative pressure with the aspiration-type semi-automatic cutting biopsy needle did not contribute to an increase in the amount of the specimen obtained in lung and renal biopsies. |
| Keywords | biopsy cutting needle aspiration clinical study |
| Amo Type | Original Article |
| Published Date | 2020-06 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 209 |
| End Page | 214 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32577018 |
| JaLCDOI | 10.18926/AMO/59950 |
|---|---|
| FullText URL | 74_3_199.pdf |
| Author | Fujita, Hirofumi| Bando, Tetsuya| Oyadomari, Seiichi| Ochiai, Kazuhiko| Watanabe, Masami| Kumon, Hiromi| Ohuchi, Hideyo| |
| Abstract | Dickkopf 3 (Dkk3) is a secreted protein belonging to the Dkk family and encoded by the orthologous gene of REIC. Dkk3/REIC is expressed by mouse and human adrenal glands, but the understanding of its roles in this organ is still limited. To determine the functions of Dkk3 in the mouse adrenal gland, we first identified that the mouse Dkk3 protein is N-glycosylated in the adrenal gland as well as in the brain. We performed proteome analysis on adrenal glands from Dkk3-null mice, in which exons 5 and 6 of the Dkk3 gene are deleted. Twodimensional polyacrylamide gel electrophoresis of adrenal proteins from wild-type and Dkk3-null mice revealed 5 protein spots whose intensities were altered between the 2 genotypes. Mass spectrometry analysis of these spots identified binding immunoglobulin protein (BiP), an endoplasmic reticulum (ER) chaperone. To determine whether mouse Dkk3 is involved in the unfolded protein response (UPR), we carried out a reporter assay using ER-stress responsive elements. Forced expression of Dkk3 resulted in the induction of distinct levels of reporter expression, showing the UPR initiated by the ER membrane proteins of activating transcription factor 6 (ATF6) and inositol-requring enzyme 1 (IRE1). Thus, it is possible that Dkk3 is a physiological ER stressor in the mouse adrenal gland. |
| Keywords | Dkk3 knockout mouse adrenal gland glucose-regulated protein 78 proteome endoplasmic reticulum stress |
| Amo Type | Original Article |
| Published Date | 2020-06 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 199 |
| End Page | 208 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32577017 |
| JaLCDOI | 10.18926/AMO/59949 |
|---|---|
| FullText URL | 74_3_191.pdf |
| Author | Ohashi, Keiji| Sada, Ken-Ei| Asano, Yosuke| Hayashi, Keigo| Yamamura, Yuriko| Asano, Sumie Hiramatsu| Miyawaki, Yoshia| Morishita, Michiko| Katsuyama, Eri| Watanabe, Haruki| Tatebe, Noriko| Narazaki, Mariko| Matsumoto, Yoshinori| Sunahori-Watanabe, Katsue| Kawabata, Tomoko| Yajima, Nobuyuki| Wada, Jun| |
| Abstract | Chronic damage accumulation affects not only mortality but also quality of life in patients with systemic lupus erythematosus (SLE). Risk factors for chronic damage were explored in SLE through different onset eras. Two hundred forty-five patients at Okayama University Hospital and Showa University Hospital were divided into three groups based on the onset era: a past-onset group (onset before 1995; n=83), middle-onset group (1996-2009; n=88), and recent-onset group (after 2010; n=74). The mean Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) score as an index of chronic damage was 1.93, 1.24, and 0.53 in the past-, middle-, and recent-onset groups, respectively. In the pastonset group, the total SDI score was significantly associated with glucocorticoid monotherapy by linear regression analysis (β-coefficient [β]=0.63; 95% confidence interval [CI], 0.21-1.05) and C-reactive protein levels (β=0.67; 95% CI, 0.27-1.07). In the middle-onset group, the total SDI score was significantly associated with the SLE Disease Activity Index at registration (β=0.09; 95% CI, 0.03-0.12). Reducing the accumulation of chronic damage in SLE patients might be possible with the concomitant use of immunosuppressants and tight control of disease activity. |
| Keywords | systemic lupus erythematosus chronic damage glucocorticoids, disease activity disease duration |
| Amo Type | Original Article |
| Published Date | 2020-06 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 191 |
| End Page | 198 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32577016 |
| NAID | 120006862791 |
| JaLCDOI | 10.18926/AMO/59948 |
|---|---|
| FullText URL | 74_3_185.pdf |
| Author | Sano, Toshikazu| Ishigami, Shuta| Ito, Tatsuo| Sano, Shunji| |
| Abstract | Heart diseases are one of the major causes of morbidity and mortality worldwide. Despite major advances in drug and interventional therapies, surgical procedures, and organ transplantation, further research into new therapeutic options is still necessary. Stem cell therapy has emerged as one option for the treatment of a variety of heart diseases. Although a large number of clinical trials have shown stem cell therapy to be a promising therapeutic approach, the results obtained from these clinical studies are inconsistent, and stem cell-based improvements of heart performance and cardiac remodeling were found to be quite limited. Since the precise mechanisms underlying the therapeutic actions of stem cells are still under debate, researchers have developed a variety of strategies to improve and boost the potency of stem cells in repair. In this review, we summarize both the current therapeutic strategies using stem cells and future directions for enhancing stem cell potency. |
| Keywords | heart disease stem cell myocardial regeneration |
| Amo Type | Review |
| Published Date | 2020-06 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 185 |
| End Page | 190 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32577015 |
| JaLCDOI | 10.18926/AMO/58279 |
|---|---|
| FullText URL | 74_2_179.pdf |
| Author | Abe, Yoshiyuki| Fujibayashi, Kazutoshi| Nishizaki, Yuji| Yanagisawa, Naotake| Nojiri, Shuko| Kon, Takayuki| Tada, Kurisu| Yamaji, Ken| Tamura, Naoto| |
| Abstract | Glucocorticoids (GCs) have long played a central role in the treatment of systemic lupus erythematosus (SLE), but these drugs have many adverse effects. We will determine whether rapid weekly GC tapering is non-inferior to conventional biweekly tapering in patients with severe SLE. This is a randomized, open-label, multicenter controlled trial. The primary outcome is the relapse-free survival rate at 52 weeks. The main secondary outcome is the prevalence of the Lupus Low Disease Activity State at 52 weeks. The trial will determine the optimal method of tapering GCs in patients with severe SLE. |
| Keywords | systemic lupus erythematosus relapse-free survival rate glucocorticoid, tapering Lupus Low Disease Activity State |
| Amo Type | Clinical Study Protocol |
| Published Date | 2020-04 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 179 |
| End Page | 183 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32341595 |
| Web of Science KeyUT | 000528278500014 |
| JaLCDOI | 10.18926/AMO/58278 |
|---|---|
| FullText URL | 74_2_175.pdf |
| Author | Yu, Zhikang| Lin, Wenfeng| Xu, Abai| Liu, Chunxiao| Li, Hulin| Huang, Peng| |
| Abstract | Urolithiasis, a common condition in patients with spinal deformity, poses a challenge to surgical procedures and anesthetic management. A 51-year-old Chinese male presented with bilateral complex renal calculi. He was also affected by severe kyphosis deformity and spinal stiffness due to ankylosing spondylitis. Dr. Li performed the percutaneous nephrolithotomy under local infiltration anesthesia with the patient in a kneeling prone position, achieving satisfactory stone clearance with no severe complications. We found this protocol safe and effective to manage kidney stones in patients with spinal deformity. Local infiltration anesthesia may benefit patients for whom epidural anesthesia and intubation anesthesia are difficult. |
| Keywords | percutaneous nephrolithotomy local infiltration anesthesia kneeling prone position spinal deformity |
| Amo Type | Case Report |
| Published Date | 2020-04 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 175 |
| End Page | 178 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32341594 |
| Web of Science KeyUT | 000528278500013 |
| JaLCDOI | 10.18926/AMO/58277 |
|---|---|
| FullText URL | 74_2_171.pdf |
| Author | Okita, Atsushi| Yoshida, Osamu| Murakami, Masakazu| |
| Abstract | A 76-year-old Japanese man was transferred to our hospital to undergo rehabilitation after traffic accident-related injuries. Seven days post-admission, he presented with abdominal pain and an 8-cm lump in the right inguinal region. He was diagnosed with an incarcerated inguinal hernia and underwent elective surgery the day after manual reduction. He had a normal vermiform appendix which was observed to have adhered to the right indirect hernia sac. An appendectomy and hernia repair using lightweight mesh were performed. We discuss the surgical management of this rare incarcerated Amyand’s hernia and the relevant literature. |
| Keywords | Amyand’s hernia incarcerated inguinal hernia appendectomy |
| Amo Type | Case Report |
| Published Date | 2020-04 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 171 |
| End Page | 174 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32341593 |
| Web of Science KeyUT | 000528278500012 |
| JaLCDOI | 10.18926/AMO/58276 |
|---|---|
| FullText URL | 74_2_165.pdf |
| Author | Umemura, Hiroshi| Miura, Katsuhiro | Naruse, Hiromu| Hatta, Yoshihiro| Takei, Masami| Nakayama, Tomohiro| |
| Abstract | Hereditary hemorrhagic telangiectasia (HHT; also known as Osler-Weber-Rendu disease) is an autosomal dominant genetic disorder that causes frequent epistaxis, mucocutaneous telangiectasia, and visceral arteriovenous malformations. Four genes (ENG, ACVRL1, SMAD4, and GDF2) have been identified as pathogenic in HHT. We describe the case of a 50-year-old Japanese man highly suspected of having HHT due to recurrent epistaxis, mucocutaneous telangiectasia, and a family history. Genomic analysis revealed a novel missense mutation of c.100T>A, p.Cys34Ser in the patient’s ACVRL1 gene. We used 6 freeware programs to perform an in silico analysis of this mutation. The results demonstrated the mutation’s high pathogenicity. |
| Keywords | ACVRL1 hereditary hemorrhagic telangiectasia in silico analysis missense mutation Osler-Weber- Rendu disease |
| Amo Type | Case Report |
| Published Date | 2020-04 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 165 |
| End Page | 169 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32341592 |
| Web of Science KeyUT | 000528278500011 |
| JaLCDOI | 10.18926/AMO/58275 |
|---|---|
| FullText URL | 74_2_159.pdf |
| Author | Thar Htet San| Ota, Yoko| Fushimi, Soichiro| Fujisawa, Masayoshi| Yanai, Hiroyuki| Toda, Hiroko| Kunitomo, Tadayoshi| Kodama, Keisuke| Matsukawa, Akihiro| |
| Abstract | Juvenile granulosa cell tumors (JGCTs) are rare ovarian tumors with overall good prognoses. They differ from adult granulosa cell tumors (AGCTs), which are well known for late recurrence. Most JGCTs (～97%) occur in individuals <30 years old. We report a recurrent JGCT in a 40-year-old woman 5 years after initial presentation. The histological appearance and lack of 402C>G missense point mutation of FOXL2 gene (characteristic of AGCT but absent in JGCT) allowed differentiation from AGCT. This is the first comprehensive report of JGCT with late recurrence. Although rare, late recurrence of JGCT can occur; long-term surveillance is suggested. |
| Keywords | juvenile granulosa cell tumor late recurrence adult granulosa cell tumor |
| Amo Type | Case Report |
| Published Date | 2020-04 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 159 |
| End Page | 163 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32341591 |
| Web of Science KeyUT | 000528278500010 |
| JaLCDOI | 10.18926/AMO/58274 |
|---|---|
| FullText URL | 74_2_151.pdf |
| Author | Yamamoto, Norio| Dan’ura, Tomoyuki| Noda, Tomoyuki| Ozaki, Toshifumi| |
| Abstract | This is the second report of an atypical peri-implant femoral fracture occurring at the distal screw after intramedullary nail fixation of a pertrochanteric fracture. A 94-year-old Japanese female with a 5-year history of alendronate intake presented with prodromal pain in her right thigh after intramedullary nail fixation. Plain radiographs showed an incomplete noncomminuted transverse fracture at the distal screw, suggesting an atypical peri-implant femoral fracture. The pathogenesis of an atypical peri-implant femoral fracture could be a combined systemic bone metabolism disorder and repetitive overloading at the screw, similar to the pathogenesis of an atypical periprosthetic femoral fracture around stem implantation. |
| Keywords | atypical femoral fracture insufficiency fracture bisphosphonate atypical peri-implant femoral fracture, atypical periprosthetic femoral fracture |
| Amo Type | Case Report |
| Published Date | 2020-04 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 151 |
| End Page | 157 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32341590 |
| Web of Science KeyUT | 000528278500009 |
| JaLCDOI | 10.18926/AMO/58273 |
|---|---|
| FullText URL | 74_2_145.pdf |
| Author | Otsuki, Hideo| Yamasaki, Tomoya| Hori, Shunsuke| Aoki, Hiroshi| Kosaka, Takeo| Uehara, Shinya| Fujio, Kei| |
| Abstract | To investigate the efficacy of mirabegron for lower urinary tract symptoms in patients with an indwelling ureteral stent after ureterorenoscopic lithotripsy. This was a prospective follow-up study of 76 patients with stent-related symptoms (SRSs). Patients with upper urinary calculi who were pre-stented for > 2 weeks before lithotripsy were examined for the presence of SRSs by tests including the International Prostate Symptom Score (IPSS), OAB Symptom Score (OABSS), and urinary bother and pain measured by a Visual Analogue Scale (VAS) before lithotripsy. Mirabegron (50 mg/day) was prescribed post-lithotripsy for 2 weeks. SRSs were assessed at the time of stent removal. The IPSS scores improved significantly from 16.2 to 14.3 (p<0.001) and the IPSS-QoL scores decreased significantly from 5.0 to 4.6 (p=0.012). The OABSS scores improved significantly from 7.7 to 6.8 (p=0.006), and the urinary urgency scores (OABSS-Q3) decreased significantly from 3.24 to 2.68 (p<0.001). The number of nocturia episodes decreased significantly from 2.5 to 2.2 (p=0.045). Urinary bother and pain assessed by the VAS declined from 4.2 and 3.1 to 3.8 (p=0.15) and 2.5 (p=0.075), respectively. Mirabegron significantly improved SRSs and the number of nocturia episodes due to a ureteral stent. |
| Keywords | stent-related symptoms overactive bladder mirabegron ureterorenoscopic lithotripsy ureteral stent |
| Amo Type | Original Article |
| Published Date | 2020-04 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 145 |
| End Page | 150 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32341589 |
| Web of Science KeyUT | 000528278500008 |
| JaLCDOI | 10.18926/AMO/58272 |
|---|---|
| FullText URL | 74_2_137.pdf |
| Author | Isozaki, Hiroshi| Yamamoto, Yasuhisa| Sakai, Kunihiko| Sho, Tatuo| Ishihara, Kiyohiro| Murakami, Shigeki| Matsumoto, Sasau| Takama, Takehiro| |
| Abstract | Mucinous carcinoma (MC) of the breast is a rare and special type of malignancy, with a substantial amount of extracellular mucin. We compared the clinicopathological features and the long-term survival of MC patients with those of invasive ductal carcinoma-no special type (IDC-NST) patients, and we examined prognostic factors of MC. A total of 116 patients with mucinous carcinoma and 3,258 patients with IDC-NST who underwent surgery at our hospital (1977-2008) were enrolled. The 10-year overall survival rate and breast cancer-specific survival rate (BSS) of the MC patients (88.3%, 93.7%) were both significantly higher than those of IDC-NST patients (81.6%, 85.0%) (p=0.015, p=0.005, respectively). A Cox regression analysis demonstrated that MC tended to be an independent prognostic factor (hazard ratio 0.44, p=0.098). The BSS of the MC patients with positive lymph node (LN) metastasis was significantly poorer than that of the patients without it, by univariate analysis (p=0.002). The tumor size in the MC patients with positive LN metastasis (mean 3.2 cm) was significantly larger than that in the patients without it (mean 1.9 cm) (p=0.0004). Although a Cox regression analysis revealed no independent factor, MC patients with positive LN metastasis should be treated for advanced invasive ductal breast cancer. |
| Keywords | breast cancer mucinous carcinoma clinicopathological features long-term prognosis |
| Amo Type | Original Article |
| Published Date | 2020-04 |
| Publication Title | Acta Medica Okayama |
| Volume | volume74 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 137 |
| End Page | 143 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | 英語 |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 32341588 |
| Web of Science KeyUT | 000528278500007 |
