| 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 |
| JaLCDOI | 10.18926/AMO/61214 |
|---|---|
| FullText URL | 74_6_537.pdf |
| Author | Morimoto, Yusuke| Komatsu, Taichi| Tokuhashi, Yasuaki| |
| Abstract | Active treatment with intramedullary screw fixation is now common for athletes with Jones fracture. Outcomes are generally good, but complications can occur. We report 4 rare complications of intramedullary screw fixa-tion. Two cases developed osteomyelitis and pseudarthrosis caused by thermal necrosis. In the other two cases, screw-related complications occurred during the insertion of the tapered headless screw. Although thermal necrosis and screw insertion failures are considered rare complications and not widely reported in the litera-ture, they do occur occasionally. Knowing the mechanisms underlying these complications could help prevent them, and knowing their course could lead caregivers to appropriate interventions when they do occur. |
| Keywords | Jones fracture thermal necrosis tapered headless screw |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 537 |
| End Page | 544 |
| 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 | 33361875 |
| Web of Science KeyUT | 000601203600011 |
| NAID | 120006948953 |
| JaLCDOI | 10.18926/AMO/61215 |
|---|---|
| FullText URL | 74_6_545.pdf |
| Author | Tatebe, Yasuhisa| Kanamitsu, Kiichiro| Kanzaki, Hirotaka| Ishida, Hisashi| Fujiwara, Kaori| Washio, Kana| Kitamura, Yoshihisa| Sendo, Toshiaki| Shimada, Akira| Tsukahara, Hirokazu| |
| Abstract | Polymorphisms in methotrexate transporter pathways have been associated with methotrexate toxicities and clearance. Recent genome-wide association studies have revealed that the SLCO1B1 T521C variant is associated with methotrexate elimination. We present a case of a pediatric patient with acute lymphoblastic leukemia who suffered from persistently high plasma methotrexate concentrations and acute kidney injuries after the admin-istration of a medium dose of methotrexate. Subsequent genetic analysis showed that he was a carrier of dys-functional genetic variants associated with methotrexate clearance. This case highlights that polymorphisms of methotrexate transporter pathways can adversely affect methotrexate elimination in a clinically significant manner. |
| Keywords | methotrexate polymorphism drug elimination acute kidney injury acute lymphoblastic leukemia |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 545 |
| End Page | 550 |
| 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 | 33361876 |
| Web of Science KeyUT | 000601203600012 |
| NAID | 120006948942 |
| JaLCDOI | 10.18926/AMO/61216 |
|---|---|
| FullText URL | 74_6_551.pdf |
| Author | Tanaka, Masato| Fujiwara, Yoshihiro| Uotani, Koji| Kadiri, Venkatesh| Yamauchi, Taro| |
| Abstract | A minimally invasive posterolateral approach designed to avoid the lateral misplacement of midcervical pedicle screws was reported, but there is no technical report that describes this technique without C-arm fluoroscopy. We report the results of a 2.5 years follow-up of a 62-year-old female patient with C4 metastatic breast cancer. The patient suffered from severe neck pain and impending quadriplegia for 2 months after radiation therapy. We performed C-arm-free minimally invasive cervical pedicle screw fixation (MICEPS). The patient was suc-cessfully treated with surgery, and her neck pain was well controlled. She had neither neurological deficits nor neck pain at the final (2.5-year) follow-up. C-arm-free MICEPS is a useful technique; in addition, the sur-geons and staff have no risk of radiation exposure, there is a reduced need for postoperative imaging, and a decreased revision rate can be expected with C-arm-free MICEPS. |
| Keywords | cervical spine navigation surgery minimally invasive surgery cervical pedicle screw C-arm free |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 551 |
| End Page | 556 |
| 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 | 33361877 |
| Web of Science KeyUT | 000601203600013 |
| NAID | 120006948943 |
| JaLCDOI | 10.18926/AMO/61217 |
|---|---|
| FullText URL | 74_6_557.pdf |
| Author | Ishiguro, Mikako| Takenaka, Ryuta| Ogura, Kenichiro| Hiratsuka, Akira| Takeda, Hiromasa| Kawai, Daisuke| Tsugeno, Hirofumi| Fujiki, Shigeatsu| Okada, Hiroyuki| |
| Abstract | A 63-year-old Japanese male with stomach adenocarcinoma received oral 5-fluorouracil derivative, cisplatin and trastuzumab chemotherapy. On day 8, severe diarrhea and mucositis developed; chemotherapy was stopped. On day 14, the patient developed renal dysfunction and febrile neutropenia. He also suffered from pneumonia due to Candida albicans. Systemic symptoms improved after intensive conservative treatment. Best supportive care was continued until the patient died from gastric cancer. The dihydropyrimidine dehydroge-nase protein level was low at 3.18 U/mg protein. The result of DPYD genotyping revealed three variants at posi-tions 1615 (G > A), 1627 (A > G), and 1896 (T > C) in exons 13, 13, and 14, respectively. |
| Keywords | 5-fluorouracil dihydropyrimidine dehydrogenase deficiency DPYD variant gastric cancer |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 557 |
| End Page | 562 |
| 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 | 33361878 |
| Web of Science KeyUT | 000601203600014 |
| NAID | 120006948944 |
| FullText URL | 74_6_563.pdf |
|---|---|
| Amo Type | Erratum |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-12 |
| Volume | volume74 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 563 |
| End Page | 563 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Others |
| language | English |
| Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33361879 |
| Web of Science KeyUT | 000601203600015 |
| 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/61442 |
|---|---|
| FullText URL | 75_1_95.pdf |
| Author | Minato, Keitaro| Hirano, Toru| Kawashima, Hiroyuki| Yamagishi, Tetsuro| Watanabe, Keigo| Ohashi, Masayuki| Ogose, Akira| Endo, Naoto| |
| Abstract | A 21-year-old man consulted our hospital for treatment of a spinal giant cell tumor (GCT) of Enneking stage III. Lower lumbar-spine tumors and severe spinal canal stenosis are associated with high risk for surgical mor-bidity. Stability was temporarily secured with a percutaneous pedicle screw fixation in combination with deno-sumab, which shrank the tumor. Total en bloc spondylectomy was then performed 6 months after initiation of denosumab, and the patient was followed for 3 years. There was no local recurrence, and bony fusion was obtained. Minimally invasive surgery and denosumab allowed safer and easier treatment of a collapsing lower lumbar extra-compartmental GCT. |
| Keywords | spinal stabilization denosumab spondylectomy giant cell tumor |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2021-02 |
| Volume | volume75 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 95 |
| End Page | 101 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2021 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33649620 |
| JaLCDOI | 10.18926/AMO/61440 |
|---|---|
| FullText URL | 75_1_91.pdf |
| Author | Shiotania, Toshio| Yamamoto, Hiromasa| Katsube, Riko| Tomioka, Yasuaki| Suzawa, Ken| Miyoshi, Kentaroh| Otani, Shinji| Okazaki, Mikio| Sugimoto, Seiichiro| Sohb, Junichi| Yamane, Masaomi| Toyooka, Shinichi| |
| Abstract | Bronchopleural fistula (BPF) is a severe complication following lung resection. We present the case of a patient with a history of advanced lung cancer, who had undergone induction chemoradiotherapy followed by right middle and lower lobectomy, and who developed BPF after completion right pneumonectomy. Although we had covered the bronchial stump with an omental pedicled flap, BPF was found on postoperative day 19. We covered the fistula with n-butyl-2-cyanoacrylate (NBCA) using bronchoscopy. Although we had to repeat the NBCA treatment, we ultimately cured the patient’s BPF and no recurrence was observed up to 15.2 months after surgery. |
| Keywords | bronchopleural fistula pneumonectomy induction chemoradiotherapy n-butyl-2-cyanoacrylate (NBCA) omental pedicled flap |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2021-02 |
| Volume | volume75 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 91 |
| End Page | 94 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2021 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33649619 |
| JaLCDOI | 10.18926/AMO/61439 |
|---|---|
| FullText URL | 75_1_87.pdf |
| Author | Shiotani, Toshio| Sugimoto, Seiichiro| Araki, Kota| Tomioka, Yasuaki| Miyoshi, Kentaroh| Otani, Shinji| Yamane, Masaomi| Toyooka, Shinichi| |
| Abstract | Although chronic kidney disease (CKD) commonly develops after lung transplantation (LT), living-donor kid-ney transplantation (LDKT) for CKD after LT is known to provide favorable outcomes. We describe the long-term follow-up findings of a patient who underwent LDKT after bilateral cadaveric LT. A 37-year-old male underwent LDKT for CKD 18 years after receiving bilateral cadaveric LT. He developed chronic lung allograft dysfunction (CLAD) 20 years after the LT; however, at 26 years after the initial LT, he is still alive with no pro-gression of CLAD or CKD. KT could be a viable option for CKD even after LT in Japan. |
| Keywords | lung transplantation kidney transplantation chronic kidney disease non-tuberculous mycobacterial infection chronic lung allograft dysfunction |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2021-02 |
| Volume | volume75 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 87 |
| End Page | 89 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2021 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33649618 |
| JaLCDOI | 10.18926/AMO/61438 |
|---|---|
| FullText URL | 75_1_79.pdf |
| Author | Yoshio, Kotaro| Nagasaka, Hisako| Hisazumi, Kento| Okawa, Hiro| Tajiri, Nobuhisa| Shiode, Tsuyoki| Akaki, Shiro| Kanazawa, Susumu| Mitoma, Tomohiro| Yano, Yuri| Kobayashi, Emiko| Horiguchi, Ikuyo| Takata, Masayo| Hongo, Atsushi| Yonezawa, Masaru| Nakanishi, Yoshie| |
| Abstract | The purposes of this retrospective study were to analyze local control of squamous cell carcinoma of the cervix treated with computed tomography (CT)-based image-guided brachytherapy (IGBT), as well as the factors affecting local control. A total of 39 patients were analyzed. The prescribed dose to the pelvis was 45-50 Gy with or without central shielding (CS). IGBT was delivered in 1-5 fractions. The total dose for high-risk clinical target volume (HR-CTV) was calculated as the biologically equivalent dose in 2-Gy fractions. The median follow-up period was 29.3 months. The 2-year overall survival and local control rates were 97% and 91%, respectively. In univariate analysis, the dose covering 90% of the HR-CTV (D90) and tumor size were found to be significant factors for local control. The cutoff values of tumor size and D90 for local control were 4.3 cm (area under the curve [AUC] 0.75) and 67.7 Gy (AUC 0.84) in the CS group and 5.3 cm (AUC 0.75) and 73.7 Gy (AUC 0.78) in the group without CS, respectively. However, though the local control of CT-based IGBT was favorable, the results suggested that the dose required for tumor control may differ depending on the presence of CS. |
| Keywords | cervical cancer squamous cell cancer brachytherapy central shielding |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2021-02 |
| Volume | volume75 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 79 |
| End Page | 85 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2021 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33649617 |
| JaLCDOI | 10.18926/AMO/61424 |
|---|---|
| FullText URL | 75_1_1.pdf |
| Author | Hamahara, Jun| Honda, Hiroyuki| Yamamoto, Koichiro| Tokumasu, Kazuki| Hanayama, Yoshihisa| Hagiya, Hideharu| Obika, Mikako| Ueda, Keigo| Kishida, Masayuki| Otsuka, Fumio| |
| Abstract | To determine the clinical characteristics of low androgen status in adult males with diabetes, we retrospectively analyzed the medical records of patients with type 2 diabetes mellitus in whom serum free testosterone (FT) levels were examined for 1 year. Among the 46 patients (56 ± 1.5 years old), decreases in serum FT levels to < 8.5 pg/ml (indicating the occurrence of late-onset hypogonadism [LOH]) were detected in 18 (39%). The per-centages of patients with low FT levels were high in the ≥ 50 years age group (83%), the HbA1c < 7% group (67%), and the 25 ≤ BMI < 30 kg/m2 group (56%). The serum FT levels tended to decrease age-dependently. The level of HbA1c was significantly correlated with the Heinemann Aging Male Symptoms (AMS) score (R = 0.47). The low-FT group had decreased levels of hemoglobin. Of note, the serum FSH level (R = −0.32) was negatively correlated with the serum FT level, whereas the serum TSH level (R = 0.36) was positively correlated with the serum FT level. Collectively, these results revealed that many diabetic males may have low FT levels and that the AMS score is related to the HbA1c level. A slightly anemic condition, thyroid dysfunction, and obesity (class 1) might be involved in LOH in middle-aged diabetic males. |
| Keywords | androgen diabetes mellitus late-onset hypogonadism testosterone thyroid function |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2021-02 |
| Volume | volume75 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 1 |
| End Page | 8 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2021 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33649607 |
| JaLCDOI | 10.18926/AMO/61443 |
|---|---|
| FullText URL | 75_1_109.pdf |
| Author | Xu, Xiaolei| Lu, Yanqiu| Harypursat, Vijay| Sun, Feng| Zhao, Ting| Zeng, Yanming| He, Xiaoqing| Chen, Yaokai| |
| Abstract | The optimal timing of antiretroviral therapy (ART) initiation in human immunodeficiency virus (HIV)-infected patients with cryptococcal meningitis (HIV/CM) is controversial. We designed a clinical trial to inves-tigate the optimal timing for ART initiation in HIV/CM patients. This will be a multicenter, prospective, and randomized clinical trial. Each enrolled patient will be randomized into either the early ART arm or the deferred ART arm. We will compare the mortality and incident rates of immune reconstitution inflammatory syndrome between the two arms. We hope to elucidate the optimal timing for ART initiation in HIV/CM patients. |
| Keywords | human immunodeficiency virus meningitis cryptococcal antiretroviral therapy |
| Amo Type | Clinical Study Protocol |
| Publication Title | Acta Medica Okayama |
| Published Date | 2021-02 |
| Volume | volume75 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 109 |
| End Page | 113 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2021 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33649622 |
| JaLCDOI | 10.18926/AMO/61428 |
|---|---|
| FullText URL | 75_1_9.pdf |
| Author | Gobara, Hideo| Yamamoto, Akira| Komakic, Toshiyuki| Kitayama, Toshiaki| Sakurai, Jun| Iguchi, Toshihiro| Matsui, Yusuke| Uka, Mayu| Tomita, Koji| Hiraki, Takao| Kanazawa, Susumu| |
| Abstract | To assess the feasibility of needle tract ablation in liver tissue in ex vivo and in vivo animal models using a cryo-probe and electrosurgical device. The experimental device is made by inserting a cryoprobe through an intro-ducer sheath for insulation, with 2-cm of probe tip projecting out. A beagle liver was punctured by the device, and electric current was applied at 30-W with the electrosurgical knife touching the non-insulated device base. The discolored area of cut surface along the device was evaluated in 5 application-time groups (5 , 10 , 15 , 20, or 25 seconds). An ex vivo experiment was performed to determine an ablation algorithm with an appropriate application time by comparison with radiofrequency ablation (RFA) results. Thereafter, an in vivo experiment was performed to verify the algorithm’s feasibility. In the ex vivo model, the cut surface demonstrated different amounts of discolored area according to the application time. The total discolored area in the 20-seconds group was similar to that by RFA. In the in vivo model, the liver did not bleed, the total discolored area was similar to that ex vivo, and coagulation necrosis was confirmed by photomicrograph. Needle tract ablation can be per-formed using the experimental device and electrosurgical device. |
| Keywords | needle tract ablation cryoablation electrosurgical device animal liver |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2021-02 |
| Volume | volume75 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 9 |
| End Page | 14 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2021 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 33649608 |
