| JaLCDOI | 10.18926/AMO/60799 |
|---|---|
| FullText URL | 74_5_401.pdf |
| Author | Tsukioki, Takahiro| Shien, Tadahiko| Ohtani, Yusuke| Fujihara, Miwa| Suzuki, Yoko| Kajihara, Yukiko| Hatono, Minami| Kawada, Kengo| Kochi, Mariko| Iwamoto, Takayuki| Ikeda, Hirokuni| Taira, Naruto| Doihara, Hiroyoshi| |
| Abstract | Differentiated thyroid carcinoma (DTC) in juvenile patients is often an extensive and aggressive disease with a high frequency of recurrence. However, the prognosis is excellent, with a low mortality rate even when advanced disease is present, although prognostic factors and treatment strategy remain uncertain. Between April 2004 and March 2017, 33 juvenile patients (< 30 years old) were diagnosed with DTC and treated at our institution. We retrospectively investigated prognosis and factors including sex, reason for discovery, treatment, pathological factors and treatment progress to clarify the risk factors. All patients underwent curative surgical treatment. Pathologically, lymph node metastasis was identified in 25 patients (75%). Thirteen patients (39%) had bilateral cervical metastasis. In addition, 9 (27%) had more than 10 metastatic lymph nodes. The 2 patients with more than 20 metastatic lymph nodes were treated with radioactive iodine (RAI). Five patients (15%) had local recurrences and received surgery. There have been no further recurrences or deaths. However, no factors were determined to significantly predict the recurrence of juvenile DTC. Local recurrent disease was treated with surgery and/or RAI until remission, and survival was excellent in juvenile DTC. |
| Keywords | differentiated thyroid carcinoma juvenile children |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 401 |
| End Page | 406 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33106695 |
| Web of Science KeyUT | 000581970100004 |
| NAID | 120006892925 |
| JaLCDOI | 10.18926/AMO/60800 |
|---|---|
| FullText URL | 74_5_407.pdf |
| Author | Togo, Masaaki| Akazawa, Yuko| Akashi, Taro| Yamashita, Rika| Yoshitomi, Izumi| Ohba, Kazuo| Hashimoto, Satsuki| Iwashita, Hiroko| Kurogi, Tadafumi| Osada, Yukiko| Wada, Noriko| Imamura, Yoshifumi| Hashiguchi, Keiichi| Yamaguchi, Naoyuki| Kondo, Hisayoshi| Nakao, Kazuhiko| |
| Abstract | Endoscopic submucosal dissection (ESD) has become the first-line treatment for early gastric neoplasms; however, a subset of patients treated by this method develop aspiration pneumonia. We conducted a comprehensive prospective analysis of the factors contributing to post-ESD aspiration pneumonia in early gastric neoplasms in this study, with special focus on whether pre-treatment oral care can prevent aspiration pneumonia. Sixty-one patients who underwent ESD for gastric neoplasms were randomly assigned to the oral care or control groups. ESD was performed under deep sedation. Of 60 patients whose data were available for analysis, 5 (8.3%) experienced pneumonia confirmed either by chest radiography or computed tomography. Although no difference in the rate of pneumonia was found between the control and oral care groups, the post-oral care bacteria count was significantly higher in the saliva of patients who developed pneumonia compared to those without pneumonia. In addition, the presence of vascular brain diseases and the dose of meperidine were also significantly associated with the occurrence of pneumonia. These results suggest that the number of oral bacteria as well as pre-existing vascular brain diseases and high-dose narcotics can affect the incidence of post-ESD pneumonia. |
| Keywords | endoscopy oral bacteria respiratory disease pneumonia sedation |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 407 |
| End Page | 413 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33106696 |
| Web of Science KeyUT | 000581970100005 |
| NAID | 120006892926 |
| JaLCDOI | 10.18926/AMO/60801 |
|---|---|
| FullText URL | 74_5_415.pdf |
| Author | Narihiro, Naomasa| Oita, Masataka| Takeda, Yoshihiro| |
| Abstract | During radiation therapy, incident radiation oblique to the skin surface is high and may cause severe skin damage. Understanding the dose of radiation absorbed by the skin is important for predicting skin damage due to radiation. In this study, we used a high-energy (4 MV) X-ray system and an optically stimulated luminescence dosimeter (OSLD) that was developed for personal exposure dosimetry. We determined the dose variation and angular dependence, which are the characteristics of a small OSLD required to derive the calculation formula for the oblique surface dose. The dose variation was determined using the coefficient of variation. The maximum coefficient of variation for 66 small-field OSLDs was 1.71%. The angular dependence, obtained from the dose ratio of the dosimeter in the vertical direction, had a maximum value of 1.37. We derived a new equation in which the oblique surface dose can be calculated within the error range of −7.7-5.1%. |
| Keywords | optically stimulated luminescent dosimeter radiotherapy oblique surface dose high-energy X-ray therapy angular dependence |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 415 |
| End Page | 422 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33106697 |
| Web of Science KeyUT | 000581970100006 |
| NAID | 120006892927 |
| JaLCDOI | 10.18926/AMO/60802 |
|---|---|
| FullText URL | 74_5_423.pdf |
| Author | Hirabae, Atsuko| Ichihara, Eiki| Sunami, Ryota| Ota, Moeko| Iwamoto, Yoshitaka| Maeda, Yoshinobu| Kiura, Katsuyuki| |
| Abstract | We report a case of late-onset hyperprogressive disease after cessation of a PD-1 inhibitor. A male was diagnosed with metastatic lung adenocarcinoma with little progression for 2 months before treatment. He received pembrolizumab as a second-line treatment and was subsequently prescribed docetaxel for 3 months until a slight increase in pleural effusion. At the time of progression to docetaxel, he commenced prednisolone because of immune-system-related diarrhea. After that, his general condition rapidly worsened with severe fatigue and hypoxia. Computed tomography revealed a massive increase of pleural effusion and replacement of almost the entire liver with cancer over a period of 5 weeks. |
| Keywords | lung cancer immune checkpoint inhibitors pembrolizumab hyperprogression |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 423 |
| End Page | 425 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33106698 |
| Web of Science KeyUT | 000581970100007 |
| NAID | 120006892928 |
| JaLCDOI | 10.18926/AMO/60803 |
|---|---|
| FullText URL | 74_5_427.pdf |
| Author | Hiraoka, Tomohiro| Senoo, Haruka| Yamazaki, Yuka| Suenobu, Kosaku| Tsukahara, Hirokazu| |
| Abstract | Polydactyly is one of the most common foot congenital anomalies. It is often detected immediately after birth, but the diagnosis can sometimes be delayed if the symptoms are less evident. A 2-year-old girl with a complaint of recurrent bleeding from the right toenail was diagnosed with foot polydactyly. She underwent corrective surgery, and her family was satisfied with the outcome. Although the diagnosis of polydactyly may be difficult in cases with minor nail problems, further radiographic evaluation will be needed for the improvement of the patient’s quality of life. |
| Keywords | polydactyly hyperdactyly hexadactyly |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 427 |
| End Page | 429 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33106699 |
| Web of Science KeyUT | 000581970100008 |
| NAID | 120006892929 |
| JaLCDOI | 10.18926/AMO/60804 |
|---|---|
| FullText URL | 74_5_431.pdf |
| Author | Miura, Akihiro| Shien, Kazuhiko| Toji, Tomohiro| Otani, Shinji| Yamamoto, Hiromasa| Okazaki, Mikio| Sugimoto, Seiichiro| Soh, Junichi| Yamane, Masaomi| Toyooka, Shinichi| |
| Abstract | We encountered a rare case of thymic cyst accompanied by mediastinitis. A 39-year-old Japanese male presented with fever and chest pain. The chest CT revealed a mass composed of a lobular cystic lesion with inflammation, suggesting the onset of mediastinitis. A definitive histological diagnosis was not obtained, and we performed a thymectomy. Pathologically, the thymic cyst was accompanied by multiple cavities, mimicking thymic cysts, caused by the inflammatory abscess. The surrounding adipose tissue showed inflammatory cell infiltrations with chronic fibrosis. These findings indicate that clinicians should be aware that thymic cysts may cause severe mediastinitis. |
| Keywords | thymic cyst multilocular thymic cyst mediastinitis |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 431 |
| End Page | 433 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33106700 |
| Web of Science KeyUT | 000581970100009 |
| NAID | 120006892930 |
| JaLCDOI | 10.18926/AMO/60805 |
|---|---|
| FullText URL | 74_5_435.pdf |
| Author | Fujishita, Keigo| Oka, Satoshi| Kamei, Katsuhiko| Tani, Katsuma| Fujisawa, Yuka| Kitamura, Wataru| Machida, Takuya| Imai, Toshi| |
| Abstract | A 53-year-old man was diagnosed with acute myeloid leukemia, which was refractory to chemotherapies. Systemic papules appeared afterward. The skin biopsies revealed filamentous fungal infection including fusariosis. Despite antifungal therapy, the infection did not resolve, because neutropenia persisted with the leukemia. He underwent hematopoietic stem cell transplantation (HSCT) to overcome the leukemia and restore normal hematopoiesis but died from fusariosis just before engraftment. Fusarium fujikuroi species complex was detected in blood cultures with poor antifungal susceptibility. Because restoring normal hematopoiesis is important in the treatment of fusariosis, HSCT might be considered for patients with persistent pancytopenia. |
| Keywords | disseminated fusariosis Fusarium fujikuroi species complex allogeneic hematopoietic stem cell transplantation acute myeloid leukemia |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 435 |
| End Page | 441 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33106701 |
| Web of Science KeyUT | 000581970100010 |
| NAID | 120006892931 |
| JaLCDOI | 10.18926/AMO/60806 |
|---|---|
| FullText URL | 74_5_443.pdf |
| Author | Sekito, Takanori| Araki, Motoo| Hiraki, Takao| Uka, Mayu| Komaki, Toshiyuki| Matsui, Yusuke| Iguchi, Toshihiro| Katayama, Satoshi| Yoshinaga, Kasumi| Watari, Shogo| Maruyama, Yuki| Mitsui, Yosuke| Kubota, Risa| Sadahira, Takuya| Nishimura, Shingo| Wada, Koichiro| Takamoto, Atsushi| Edamura, Kohei| Sako, Tomoko| Kobayashi, Yasuyuki| Watanabe, Toyohiko| Kanazawa, Susumu| Nasu, Yasutomo| |
| Abstract | We report a 47-year-old Japanese female with 10 previous treatments for multiple bilateral renal cell carcinoma (RCC) associated with von Hippel-Lindau disease. The 14-mm right lower pole renal tumor was in contact with the right ureter. Laparoscopic cryoablation was performed to protect the ureter wrapped with gauze. Computed tomography (CT) monitoring was used to confirm the precise ≥ 6 mm ice-ball margin. There was no local progression at 6-months post-surgery. The serum creatinine has been stable. This is apparently the first report of combined laparoscopic and CT monitoring of an ice-ball formation and its margin during cryoablation for RCC. |
| Keywords | laparoscopic cryoablation multiple renal masses nephron-sparing surgery renal cell carcinoma von Hippel-Lindau disease |
| Amo Type | Case Report |
| Note | Fig. 1B is replaced on Dec. 23, 2020.| |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 443 |
| End Page | 448 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33106702 |
| Web of Science KeyUT | 000581970100011 |
| NAID | 120006892932 |
| JaLCDOI | 10.18926/AMO/60807 |
|---|---|
| FullText URL | 74_5_449.pdf |
| Author | Tsuchiya, Junpei| Kondo, Naoki| Fujimoto, Atsushi| Kondo, Rie| Yamada, Masahiko| Kuraishi, Tatsuya| Yoda, Takuya| Abe, Riichiro| Endo, Naoto| |
| Abstract | We report a case of psoriatic arthritis where oligoarthritis preceded the skin lesions. A 57-year-old man complained of left third-finger pain. Laboratory examinations were negative for anti-cyclic citrullinated peptide antibodies and rheumatoid factor; he was treated for suspected rheumatoid arthritis. Six years later, X-ray revealed enthesitis of his fingers and wrist joint. At 9.5 years after the initial visit, skin lesions appeared in the left auricular region and buttock and dermatopathology findings indicated psoriasis vulgaris. The final diagnosis was psoriatic arthritis. In cases of seronegative oligoarthritis, psoriatic arthritis must be considered because some patients demonstrate osteoarticular lesions preceding skin lesions. |
| Keywords | enthesitis psoriatic arthritis seronegative oligoarthritis classification criteria for psoriatic arthritis |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 449 |
| End Page | 453 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33106703 |
| Web of Science KeyUT | 000581970100012 |
| NAID | 120006892933 |
| JaLCDOI | 10.18926/AMO/60808 |
|---|---|
| FullText URL | 74_5_455.pdf |
| Author | Yamanouchi, Kosho| Kuba, Sayaka| Matsumoto, Megumi| Yano, Hiroshi| Morita, Michi| Sakimura, Chika| Otsubo, Ryota| Kanetaka, Kengo| Nagayasu, Takeshi| Eguchi, Susumu| |
| Abstract | Taxanes are key drugs for patients with breast cancer. A major adverse effect associated with the administration of the taxane docetaxel is chemotherapy-induced peripheral neuropathy (CIPN). We are conducting a singlecenter, single-arm, open-label historical control trial to evaluate the ability of compression therapy using stockings or sleeves to prevent CIPN due to docetaxel treatment. The primary endpoint is the incidence of all-grade CIPN according to patients’ records until 3 weeks after the fourth docetaxel administration. This study’s results will clarify whether compression therapy using stockings or sleeves can prevent CIPN in breast cancer patients. |
| Keywords | breast cancer docetaxel neuropathy compression |
| Amo Type | Clinical Study Protocol |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 455 |
| End Page | 459 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33106704 |
| Web of Science KeyUT | 000581970100013 |
| NAID | 120006892934 |
| JaLCDOI | 10.18926/AMO/60880 |
|---|---|
| FullText URL | 74_6_505.pdf |
| Author | Ohara, Toshiaki| Sakurama, Kazufumi| Hiramatsu, Satoshi| |
| Abstract | Vascular-access interventions are necessary for the continuation of hemodialysis, and they are performed under X-ray guidance. During interventions, patients’ accidental falls from the bed are a serious problem, and spe-cialized fixation systems for hemodialysis patients to prevent their falls from the bed have been lacking. We developed a new fixation plate made of polypropylene homopolymer and tested its ability to prevent such falls retrospectively. This plate, which we named the ‘vascular-access intervention assistance plate,’ offers functional features such as the concurrent fixation of the body and either arm and an arm space with serrations for fixing a forearm strap. We performed computer simulations to examine the strength of the plate, and we evaluated the efficacy of fall prevention by reviewing patients’ medical records. The results demonstrated that the functional design of the plate provides good operability via accurate concurrent fixations of the body and arm. The com-puter simulation analysis results indicated the plate’s sufficient strength. The medical records analysis revealed three accidental falls before the plate’s introduction (401 patients, 1,437 interventions), and none after plate introduction (683 patients, 1,872 interventions). Accidental falls were significantly prevented by use of the plate (p < 0.05). The dementia rate and type of procedure were not significantly different between the patients who fell and those who did not. This vascular-access intervention assisted plate provides good operability and safety by preventing accidental falls among hemodialysis patients. |
| Keywords | hemodialysis fall accident incident vascular access |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 505 |
| End Page | 511 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33361870 |
| Web of Science KeyUT | 000601203600006 |
| NAID | 120006948959 |
| JaLCDOI | 10.18926/AMO/61204 |
|---|---|
| FullText URL | 74_6_461.pdf |
| Author | Kono, Yoshiyasu| Kanzaki, Hiromitsu| Iwamuro, Masaya| Kawano, Seiji| Kawahara, Yoshiro| Okada, Hiroyuki| |
| Abstract | Gastric cancer usually arises in middle-aged to older patients, and is rarely found in younger patients. The clin-ical characteristics, etiology, prognosis, preventive methods and treatment of gastric cancer in young patients have not been fully investigated because of its low prevalence. In this review, we discuss the current under-standing and clinical problems associated with gastric cancer in young patients. Helicobacter pylori (H. pylori), which is a major cause of gastric cancer, especially in older populations, is closely associated with gastric cancer in young patients as well as in older patients. Gastric cancer in young patients tends to be diagnosed at an advanced stage with alarm symptoms. However, young patients with advanced gastric cancer tend to have a favorable general condition and organ function, so they can tolerate intensive systematic chemotherapy. Unfortunately, the prognosis of gastric cancer in young patients with an advanced stage is not favorable. We should not take this rare disease lightly, given its poor prognosis if patients are diagnosed at an unresectable stage. The evaluation of the H. pylori infection status and performance of H. pylori eradication therapy to prevent gastric cancer in young patients as well as the development of more intensive chemotherapy regimens for unre-sectable gastric cancer in young patients are warranted. |
| Keywords | gastric cancer young patients Helicobacter pylori |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 461 |
| End Page | 466 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33361865 |
| Web of Science KeyUT | 000601203600001 |
| NAID | 120006948954 |
| JaLCDOI | 10.18926/AMO/61205 |
|---|---|
| FullText URL | 74_6_467.pdf |
| Author | Yokota, Yuya| Nishimura, Yoshito| Ando, Akemi| Hanayama, Yoshihisa| Hasegawa, Kou| Hagiya, Hideharu| Ogawa, Hiroko| Obika, Mikako| Ueda, Keigo| Otsuka, Fumio| |
| Abstract | Alkaline phosphatase (ALP) is an enzyme that is expressed in a variety of tissues. Among the isoforms of ALP, bone-specific alkaline phosphatase (BAP) is used as a marker for evaluating bone metabolism. We investigated the clinical usefulness of the ratio of serum BAP to total ALP for the diagnosis of various disorders in general practice. We retrospectively analyzed the cases of 107 Japanese patients whose serum BAP levels were exam-ined, focusing on clinical characteristics. We observed that the BAP/ALP ratios of the patients with fever and those with inflammatory diseases were significantly lower than the ratios of other patient groups. The BAP/ALP ratios of the patients with osteoporosis and those with metabolic bone diseases were higher than those of the patients with other conditions. The BAP/ALP ratio was found to be negatively correlated with age, a cor-relation that has not been found in other ethnicities. The serum BAP/ALP ratio was inversely correlated with serum CRP levels but was positively correlated with serum albumin levels and hemoglobin concentrations. Collectively, our results suggest that the BAP/ALP ratio could be a useful predictor for important geriatric con-ditions seen in general practice. |
| Keywords | alkaline phosphatase BAP CRP inflammation osteoporosis |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 467 |
| End Page | 474 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33361866 |
| Web of Science KeyUT | 000601203600002 |
| NAID | 120006948955 |
| JaLCDOI | 10.18926/AMO/61206 |
|---|---|
| FullText URL | 74_6_475.pdf |
| Author | Harada, Ryo| Sato, Ryosuke| Tsutsui, Tomoaki| Hattori, Nao| Inoue, Masafumi| Kobashi, Haruhiko| |
| Abstract | The insertion of a self-expandable metal stent (SEMS) for nonpancreatic cancer is a factor predicting the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). We evaluated the efficacy of endo-scopic pancreatic stenting (EPS) to prevent PEP after SEMS insertion in patients with malignant distal biliary stricture and without main pancreatic duct (MPD) obstruction. We performed a single-center, retrospective, historically controlled investigation to assess the outcomes of 33 consecutive patients who underwent SEMS insertion. From March 2013 to June 2015, 13 patients did not undergo EPS (Non-EPS group). The other 20 patients underwent EPS (EPS group) between July 2015 and August 2018. The background data demonstrated no significant differences. Except for one patient in the Non-EPS group, all patients underwent biliary sphinc-terotomy. The EPS group’s PEP incidence was significantly lower (n = 1, 5%) than that of the Non-EPS group (n = 4, 31%) (p = 0.04). The median serum amylase and lipase levels after the procedure were significantly lower in the EPS group than in the Non-EPS group (amylase: 104 vs. 262 U/L; p < 0.01, lipase: 102 vs. 666 U/L; p = 0.01). The use of EPS decreased the incidence of PEP after SEMS insertion in individuals with malignant distal biliary stricture and without MPD obstruction. |
| Keywords | post-endoscopic retrograde cholangiopancreatography pancreatitis endoscopic pancreatic stent main pancreatic duct obstruction self-expandable metal stent distal biliary stricture |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 475 |
| End Page | 481 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33361867 |
| Web of Science KeyUT | 000601203600003 |
| NAID | 120006948956 |
| JaLCDOI | 10.18926/AMO/61207 |
|---|---|
| FullText URL | 74_6_483.pdf |
| Author | Miyagi, Yasunari| Miyake, Takahito| |
| Abstract | We developed an artificial intelligence (AI) method for estimating fetal weights of Japanese fetuses based on the gestational weeks and the bi-parietal diameter, abdominal circumference, and femur length. The AI comprised of neural network architecture was trained by deep learning with a dataset that consists of ± 2 standard devia-tion (SD), ± 1.5SD, and ± 0SD categories of the approved standard values of ultrasonic measurements of the fetal weights of Japanese fetuses (Japan Society of Ultrasonics in Medicine [JSUM] data). We investigated the residuals and compared 2 other regression formulae for estimating the fetal weights of Japanese fetuses by t-test and Bland-Altman analyses, respectively. The residuals of the AI for the test dataset that was 12.5% of the JSUM data were 6.4 ± 2.6, −3.8 ± 8.6, and −0.32 ± 6.3 (g) at −2SD, +2SD, and all categories, respectively. The residu-als of another AI method created with all of the JSUM data, of which 20% were randomized validation data, were −1.5 ± 9.4, −2.5 ± 7.3, and −1.1 ± 6.7 (g) for −2SD, +2SD, and all categories, respectively. The residuals of this AI were not different from zero, whereas those of the published formulae differed from zero. Though vali-dation is required, the AI demonstrated potential for generating fetal weights accurately, especially for extreme fetal weights. |
| Keywords | deep learning artificial intelligence fetal weight neural network ultrasound biometry |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 483 |
| End Page | 493 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33361868 |
| Web of Science KeyUT | 000601203600004 |
| NAID | 120006948957 |
| JaLCDOI | 10.18926/AMO/61209 |
|---|---|
| FullText URL | 74_6_495.pdf |
| Author | Calliope, Simba Akintije| Yorifuji, Takashi| Wada, Takayuki| Mukakarake, Marie Goret| Mutesa, Leon| Yamamoto, Taro| |
| Abstract | In many economically developing countries, and especially in the rural regions of sub-Saharan African coun-tries, there have been only limited investigations into the association between antenatal care (ANC) and adverse pregnancy outcomes. We obtained information on ANC and pregnancy outcomes between 2011 and 2016 from hospital files of pregnant women (n = 4,960) served at a rural hospital in Rwanda, and we examined the associa-tions between their ANC visits and the adverse pregnancy and neonatal outcomes by using univariate and mul-tivariate logistic regression models to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Most of the pregnant women had ≥ 4 ANC visits, but 39% (n = 1,911) did not have ≥ 3 visits before delivery. The prev-alence of low birth weight (LBW) and that of preterm birth (PTB) were 12% and 9.9%, respectively. Compared to the women who attended only one ANC visit, those who attended ≥ 4 ANC visits had lower risks of LBW (OR 0.20; 95%CI: 0.11-0.36) and PTB (OR 0.28; 95%CI: 0.11-0.76). Frequent ANC visits were also associ-ated with better postnatal outcomes of the newborns. Encouraging women to attend ANC visits before delivery can markedly reduce PTB-related and LBW-related complications, especially in resource-limited settings. |
| Keywords | antenatal care epidemiology low birth weight preterm birth rural |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 495 |
| End Page | 503 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33361869 |
| Web of Science KeyUT | 000601203600005 |
| NAID | 120006948958 |
| JaLCDOI | 10.18926/AMO/61210 |
|---|---|
| FullText URL | 74_6_513.pdf |
| Author | Ageta, Kohei| Naito, Hiromichi| Yorifuji, Takashi| Obara, Takafumi| Nojima, Tsuyoshi| Yamada, Taihei| Tsukahara, Kohei| Yakushiji, Hiromasa| Nakao, Atsunori| |
| Abstract | Few studies have investigated the influence of the Coronavirus Disease 2019 (COVID-19) pandemic on emer-gency medical service (EMS) systems, especially in areas less affected or unaffected by COVID-19. In this study, we investigated changes in prehospital EMS activity and transport times during the COVID-19 pandemic. All patients transported by EMS in the city of Okayama from March–May 2019 or March–May 2020 were included. Interfacility transports were excluded. The primary outcome was the time from a patient’s first emergency call until hospital arrival (total prehospital time). Secondary outcomes included three segments of total prehospital time: the response time, on-scene time, and transportation time. Total prehospital time and the durations of each segment were compared between corresponding months in 2020 (COVID19-affected) and 2019 (control). The results showed that total prehospital times in April 2020 were significantly higher than those in 2019 (33.8 ± 11.6 vs. 32.2 ± 10.8 min, p < 0.001). Increases in total prehospital time were caused by longer response time (9.3 ± 3.8 vs. 8.7 ± 3.7 min, p < 0.001) and on-scene time (14.4 ± 7.9 vs. 13.5 ± 6.2min, p < 0.001). The COVID-19 pandemic was thus shown to affect EMS and delayed arrival/response even in a minimally affected region. A system to minimize transportation delays should be developed for emerging pandemics. |
| Keywords | emergency medical services health care system emergency transport coronavirus infection |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 513 |
| End Page | 520 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33361871 |
| Web of Science KeyUT | 000601203600007 |
| NAID | 120006948949 |
| JaLCDOI | 10.18926/AMO/61211 |
|---|---|
| FullText URL | 74_6_521.pdf |
| Author | Itazaki, Yujiro| Tsujimoto, Hironori| Sugasawa, Hidekazu| Yaguchi, Yoshihisa| Nomura, Shinsuke| Ito, Nozomi| Harada, Manabu| Sugihara, Takao| Tsuchiya, Satoshi| Ishibashi, Yusuke| Kouzu, Keita| Kishi, Yoji| Ueno, Hideki | |
| Abstract | We report a successful dissection of metastatic posterior thoracic para-aortic lymph node (No. 112aoP) via bilateral thoracoscopic surgery. With the anesthetized patient (a 73-year-old Japanese woman) in the prone position, two working ports were inserted for the left-side approach, and artificial pneumothorax was created. Thoracoscopic examination revealed a swollen LN posterior to the descending aorta. Fat and metastatic LNs posterior to the aorta were dissected from the aortic arch level to the diaphragm while preserving intercostal arteries. For the right-side approach, two working ports were inserted and a routine thoracoscopic esophagec-tomy was performed. Gastric conduit reconstruction was achieved laparoscopically. Operation time for the left thoracic procedure: 54 min; estimated blood loss: almost none. No recurrence was detected 24 months post-operatively. There are several surgical options for approaching No. 112aoP, including transhiatal, left thora-cotomy, and thoracoscopy. Although a wide dissection of the posterior thoracic para-aortic area has not been reported, it may be feasible and safe if the artery of Adamkiewicz and intercostal arteries are preserved. A min-imally invasive bilateral thoracoscopic approach for a thoracoscopic esophagectomy is safe and useful for esophageal cancer patients with solitary No. 112aoP metastasis. |
| Keywords | bilateral approach posterior thoracic para-aortic lymph node thoracoscopic esophagectomy |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 521 |
| End Page | 524 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33361872 |
| Web of Science KeyUT | 000601203600008 |
| NAID | 120006948950 |
| JaLCDOI | 10.18926/AMO/61212 |
|---|---|
| FullText URL | 74_6_525.pdf |
| Author | Aoki, Hideki| Utsumi, Masashi| Kimura, Yuji| Takahashi, Yosuke| Nagahisa, Seiichi| Nishimura, Seitaro| Une, Yuta| Watanabe, Megumi| Taniguchi, Fumitaka| Arata, Takashi| Katsuda, Koh| Tanakaya, Kohji| |
| Abstract | Cardiac metastasis originating from hepatocellular carcinoma (HCC) is a rare condition with a poor prognosis. No therapeutic standards for cardiac metastasis originating from HCC have been established. At 19 months after a curative hepatectomy, a 64-year-old Japanese hepatitis B virus-positive male patient experienced solitary cardiac metastasis originating from HCC. The cardiac tumor was discovered in the right ventricle. The patient received three courses of radiotherapy and chemotherapy and survived > 3 years after the initial diagnosis of cardiac metastasis. His case demonstrates that radiotherapy combined with chemotherapy can be an effective treatment for cardiac metastasis. |
| Keywords | hepatocellular carcinoma cardiac metastasis radiotherapy chemotherapy |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 525 |
| End Page | 530 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33361873 |
| Web of Science KeyUT | 000601203600009 |
| NAID | 120006948951 |
| JaLCDOI | 10.18926/AMO/61213 |
|---|---|
| FullText URL | 74_6_531.pdf |
| Author | Hashimoto, Kazuhiko| Nishimura, Shunji| Chikugo, Takaaki| Kakinoki, Ryosuke| Akagi, Masao| |
| Abstract | Soft tissue myoepitheliomas are often misdiagnosed due to their rarity. Herein, we describe a case of soft tissue myoepithelioma of the shoulder. A 72-year-old woman had a suspected sarcoma on her shoulder and under-went open biopsy. She was referred to our hospital, where the tumor was widely resected and the diagnosis of myoepithelioma was histologically confirmed. No recurrence has been observed in the 3 years since the sur-gery. Careful and prompt planning is necessary for the effective treatment of myoepithelioma. |
| Keywords | soft tissue myoepithelioma unplanned resection shoulder |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 531 |
| End Page | 535 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33361874 |
| Web of Science KeyUT | 000601203600010 |
| NAID | 120006948952 |
