| JaLCDOI | 10.18926/AMO/66668 |
|---|---|
| FullText URL | 78_1_029.pdf |
| Author | Kitayama, Takahiro| Tanaka, Takashi| Kanie, Yuichiro| Marukawa, Yohei| Kojima, Katsuhide| Tanaka, Takehiro| Takao, Soshi| Hiraki, Takao| |
| Abstract | This retrospective study investigated whether necrotic lesions detected on a computed tomography (CT) scan are more regressive than non-necrotic lesions after methotrexate withdrawal in patients pathologically diagnosed with methotrexate-associated lymphoproliferative disorders (MTX-LPD). In total, 89 lesions extracted from 24 patients on CT scans were included in the analysis. All patients had been evaluated for the presence of necrosis within lesions via CT scan upon first suspicion of MTX-LPD (baseline CT scan). The percentage lesion size reduction between the baseline and initial follow-up CT scan was calculated. The association between necrosis within lesions and size changes was estimated via linear regression analyses using both crude and adjusted models. Necrosis was significantly more common in extranodal lesions (27 out of 30 lesions, 90%) than in nodal lesions (9 out of 59 lesions, 15%, p<0.001). In the crude model, the regression of necrotic lesions was 58.5% greater than that of non-necrotic lesions; the difference was statistically significant (p<0.001). Additionally, the longest diameter of necrotic lesions at the baseline CT scan was significantly greater than that of non-necrotic lesions (p<0.001). Based on the adjusted model, necrotic lesions showed 49.3% greater regression than non-necrotic lesions (p=0.017). Necrosis detected on a CT scan was found to be an independent predictor of regression after MTX withdrawal in patients with MTX-LPD. |
| Keywords | methotrexate lymphoproliferative disorder computed tomography necrosis |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-02 |
| Volume | volume78 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 29 |
| End Page | 36 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38419312 |
| Web of Science KeyUT | 001203658200001 |
| JaLCDOI | 10.18926/AMO/66669 |
|---|---|
| FullText URL | 78_1_037.pdf |
| Author | Tanaka, Masato| Meena, Umesh| Taoka, Takuya| Fujiwara, Yoshihiro| Yokomizo, Daiichiro| Bashyal, Santosh Kumar| Sake, Naveen| Arataki, Shinya| |
| Abstract | In adult spinal deformity (ASD) surgery, one of the key factors working to prevent proximal junctional kyphosis is the proximal anchor. The aim of this study was to compare clinical and radiographic outcomes of triangular fixation with conventional fixation as proximal anchoring techniques in ASD surgery. We retrospectively evaluated 54 patients who underwent corrective spinal fusion for ASD. Fourteen patients underwent proximal triangular fixation (Group T; average 74.6 years), and 40 patients underwent the conventional method (Group C; average 70.5 years). Clinical and radiographic outcomes were assessed using visual analogue scale (VAS) values for back pain and the Oswestry disability index (ODI). Radiographic evaluation was also collected preoperatively and postoperatively. Surgical times and intraoperative blood loss of the two groups were not significantly different (493 vs 490 min, 1,260 vs 1,173 mL). Clinical outcomes such as VAS and ODI were comparable in the two groups. Proximal junctional kyphosis in group T was slightly lower than that of group C (28.5% vs 47.5%, p=0.491). However, based on radiology, proximal screw pullout occurred significantly less frequently in the triangular fixation group than the conventional group (0.0% vs 22.5%, p=0.049). Clinical outcomes in the two groups were not significantly different. |
| Keywords | adult spinal deformity proximal junctional kyphosis triangular fixation minimally invasive surgery C arm free |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-02 |
| Volume | volume78 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 37 |
| End Page | 46 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38419313 |
| Web of Science KeyUT | 001203658200003 |
| JaLCDOI | 10.18926/AMO/66670 |
|---|---|
| FullText URL | 78_1_047.pdf |
| Author | Shimomura, Manabu| Shinozaki, Katsunori| Yano, Takuya| Akabane, Shintaro| Ohdan, Hideki| Hiroshima Surgical study group of Clinical Oncology (HiSCO)| |
| Abstract | Oral fluoropyrimidines (FUs) have certain advantages over intravenous FUs, such as longer intervals between outpatient visits, no requirement for central venous port (CVP) implantation, and lower incidence of neutropenia. We previously reported the efficacy of S-1/oxaliplatin (SOX) with bevacizumab therapy as a first-line treatment for advanced colorectal cancer (CRC) in a prospective phase-II multi-institutional clinical trial (HiSCO-02 study). However, our prognostic data at the time lacked a sufficient observation period. Herein, we analyze the longer-term follow-up data, focusing on the status of eventual CVP implantation via an open-label, non-randomized, multicenter study. This study enrolled 55 patients (mean age, 64 years), of whom 43 died (41 of primary cancer). The median overall survival was 22.7 months (95% CI: 20.1-34.7 months). Post-treatment regimens after failure of first-line treatment were initiated in 43 patients; CPT11-based regimens were selected in most cases, and other oral FU combinations in nine. CVP was implanted in 35 patients prior to first-line treatment; eleven of the remaining 20 patients did not require CVP implantation. In conclusion, we report here the final prognostic update of the Phase II clinical trial examining the efficacy of SOX plus bevacizumab therapy, the results of which confirm the clinical efficacy of this regimen. |
| Keywords | metastatic colorectal cancer chemotherapy S-1 prospective phase II study |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-02 |
| Volume | volume78 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 47 |
| End Page | 52 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38419314 |
| Web of Science KeyUT | 001203658200005 |
| JaLCDOI | 10.18926/AMO/66671 |
|---|---|
| FullText URL | 78_1_053.pdf |
| Author | Ichikawa, Yukiko| Ogino, Tetsuya| |
| Abstract | Ice bags are frequently used in medical care settings for pain relief, comfort, and in some cases, whole-body cooling. This study quantifies heat energy transfer capacity of ice bags and evaluates their cooling effects on body temperature. Forty-eight healthy adults in their 20s were recruited. An ice bag wrapped in two layers of dry towel was applied to the forehead, neck, or palm of each participant for 10 min. The skin surface temperature, heat flow, and core temperature were recorded during the cooling and non-cooling periods, with energy transfer calculated by integrating heat flow over time. Over the non-cooling period, 31.4-53.6 kJ·m-2 of energy was dissipated over 10 min, whereas during the cooling period, the range increased to 180.0-218.7 kJ·m-2 over 10 min. Skin surface temperature decreased by 3.2-5.7°C, whereas core temperature was unchanged. Ice bag use augmented energy transfer by about 150-180 kJ·m-2 over 10 min, but this was insufficient for rapid whole body cooling due to the small skin-surface area in contact with the ice bag. The measured energy transfer indicated that topical ice bag application absorbs insufficient energy to affect core temperature. Quantitative assessment of energy transfer was shown to inform the safe and appropriate use of thermotherapy. |
| Keywords | cold compress fever hyperthermia thermal conductivity thermoregulation |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-02 |
| Volume | volume78 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 53 |
| End Page | 61 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38419315 |
| Web of Science KeyUT | 001203658200009 |
| JaLCDOI | 10.18926/AMO/66672 |
|---|---|
| FullText URL | 78_1_063.pdf |
| Author | Murakami, Daizo| Nishimoto, Kohei| Takao, Soshi| Miyamaru, Satoru| Kadowaki, Tomoka| Saito, Haruki| Takeda, Hiroki| Ise, Momoko| Suyama, Koichi| Orita, Yorihisa| |
| Abstract | The tyrosine kinase inhibitor lenvatinib has been confirmed as an effective treatment option for patients with unresectable thyroid carcinoma. We conducted a retrospective analysis of the significance of the effect of continued lenvatinib treatment for the longest duration possible at a reasonable daily dose and with a minimum discontinuation period in 42 patients with unresectable thyroid carcinoma treated with lenvatinib between 2015 and 2020. A Cox proportional hazard model-based analysis revealed that the overall survival of the patients treated with a <8 mg/day mean dose of lenvatinib was significantly better than that of the patients treated with 8-24 mg/day (hazard ratio [HR] 0.38 for 1.14-4.54 mg/day, and HR 0.01 for 4.56-7.97 mg/day) adjusted for various factors (e.g., sex, age, drug interruption period). The cumulative dose of lenvatinib administered tended to be higher in the patients treated with low doses (< 8 mg/day) than in the patients treated with relatively high doses (8-24 mg/day). Considering its adverse events, the continuation of lenvatinib treatment with an adequate daily dose and drug interruption may help prolong the survival of patients with unresectable thyroid carcinoma. |
| Keywords | thyroid carcinoma lenvatinib adverse effect survival |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-02 |
| Volume | volume78 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 63 |
| End Page | 70 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38419316 |
| Web of Science KeyUT | 001203658200007 |
| JaLCDOI | 10.18926/AMO/66673 |
|---|---|
| FullText URL | 78_1_071.pdf |
| Author | Kaneda, Daisuke| Nishida, Keiichiro| Nasu, Yoshihisa| Nakahara, Ryuichi| Harada, Ryozo| Hotta, Yoshifumi| Naniwa, Shuichi| Ozaki, Toshifumi| |
| Abstract | We retrospectively investigated the mid-term outcomes of arthroplasty using the AVANTA silicone implant for thumb metacarpophalangeal (MCP) joints with boutonniere deformity in patients with rheumatoid arthritis (RA). This study involved 36 thumbs of 33 RA patients with a mean follow-up period of 5.1 years (range, 2.0-13.3). Postoperatively, the mean extension was significantly increased and the mean flexion was significantly decreased (p<0.001, p<0.001, respectively), resulting in the mean arc of range of motion (ROM) shifting in the direction of extension after surgery. Implant fracture was observed in 10 thumbs (28%), and 4 of these (11%) underwent revision surgery. The survivorship with implant fracture and revision surgery as endpoints were 73.4% and 91.8% at 5 years, respectively. The preoperative arc of ROM and the postoperative flexion range of the implant-fracture group were significantly greater than those in the no-implant-fracture group (p=0.039, 0.034, respectively). These results suggest the importance of patient education and careful rehabilitation to prevent excessive flexion. Overall, the AVANTA silicone implant showed a relatively high rate of implant fracture at our institute. |
| Keywords | AVANTA silicone implant boutonniere deformity implant fracture thumb metacarpophalangeal joint arthroplasty rheumatoid arthritis |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-02 |
| Volume | volume78 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 71 |
| End Page | 78 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38419317 |
| Web of Science KeyUT | 001203658200011 |
| JaLCDOI | 10.18926/AMO/66674 |
|---|---|
| FullText URL | 78_1_079.pdf |
| Author | Takahara, Masahiro| Hiraoka, Sakiko| Ohmori, Masayasu| Takeuchi, Keiko| Takei, Kensuke| Aoyama, Yuki| Yasutomi, Eriko| Igawa, Shoko| Inokuchi, Toshihiro| Toyosawa, Junki| Yamasaki, Yasushi| Kinugasa, Hideaki| Harada, Keita| Onishi, Hideki| Okada, Hiroyuki| |
| Abstract | This study examined the utility of the combined use of transabdominal ultrasonography (TUS) and fecal immunochemical testing (FIT) to detect mucosal inflammation, vis-a-vis the Mayo endoscopic subscore (MES), in ulcerative colitis (UC). Sixty-three UC patients who underwent TUS and FIT were retrospectively enrolled. For TUS, the colon was divided into five segments, and the bowel wall thickness was measured and evaluated. The accuracy of FIT (> 100 ng/ml) in detecting mucosal inflammation (MES>0) was 0.93, whereas that of TUS (BWT>2 mm) in each segment was 0.84-0.97. The combined use of TUS and FIT may be helpful in noninvasive treatment strategies. |
| Keywords | transabdominal ultrasonography fecal immunochemical test ulcerative colitis Mayo endoscopic subscore |
| Amo Type | Short Communication |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-02 |
| Volume | volume78 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 79 |
| End Page | 83 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38419318 |
| Web of Science KeyUT | 001203658200004 |
| JaLCDOI | 10.18926/AMO/66675 |
|---|---|
| FullText URL | 78_1_085.pdf |
| Author | Miyake, Keisuke| Tanikawa, Tomohiro| Haruma, Ken| Kawada, Mayuko| Ishii, Katsunori| Urata, Noriyo| Nishino, Ken| Suehiro, Mitsuhiko| Kawanaka, Miwa| Manabe, Noriaki| Kawamoto, Hirofumi| |
| Abstract | A 30-year-old man with idiopathic peptic ulcer disease (IPUD) experienced repeated recurrence of ulcerative bleeding despite treatment with lansoprazole and then vonoprazan. Further evaluation suggested that the cause of the ulcer was strong contractile movements of the antrum. This prompted the co-administration of trimebutine maleate (TM) and vonoprazan to relieve the stomach contractions. TM was effective in preventing the recurrence of ulcerative bleeding, and the patient has remained in remission for 4 years. This case highlights the potential efficacy of TM in treating IPUD and the importance of considering hypercontractility as the underlying cause in cases of IPUD. |
| Keywords | gastric ulcer idiopathic peptic ulcerative disease trimebutine maleate |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-02 |
| Volume | volume78 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 85 |
| End Page | 88 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38419319 |
| Web of Science KeyUT | 001204421300002 |
| JaLCDOI | 10.18926/AMO/66676 |
|---|---|
| FullText URL | 78_1_089.pdf |
| Author | Toshima, Kei| Shien, Tadahiko| Nishimura, Midori Filiz| Suzuki, Yoko| Nakamoto, Shogo| Uno, Maya| Yoshioka, Ryo| Tsukioki, Takahiro| Takahashi, Yuko| Iwamoto, Takayuki| Iwatani, Tsuguo| Yanai, Hiroyuki| |
| Abstract | We report our experience with the diagnosis and treatment of an ectopic breast cancer arising within an axillary lymph node. The patient was a 65-year-old woman diagnosed breast cancer and axillary lymph node metastasis. We performed a partial mastectomy and axillary lymph node dissection. Postoperative pathology revealed no malignant lesions in the breast; however, a nodule in one of axillary lymph nodes had mixed benign and malignant components, leading to a diagnosis of invasive ductal carcinoma derived from ectopic mammary tissue. This case represents a very rare form of breast cancer, and the malignancy was difficult to distinguish from metastasis. |
| Keywords | breast cancer ectopic breast cancer axillary lymph node |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-02 |
| Volume | volume78 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 89 |
| End Page | 93 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38419320 |
| Web of Science KeyUT | 001204421300001 |
