| 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/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/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/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/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/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/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/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/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/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/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/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/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/60798 |
|---|---|
| FullText URL | 74_5_391.pdf |
| Author | Homma, Daisuke| Minato, Izumi| Imai, Norio| Miyasaka, Dai| Sakaif, Yoshinori| Horigome, Yoji| Suzuki, Hayato| Shimada, Hayato| Dohmae, Yoichiro| Endo, Naoto| |
| Abstract | Indexes for objectively evaluating abnormal gait in hip osteoarthritis (OA) patients and determining effective interventions are unclear. We analyzed the abnormal gait of hip OA patients by focusing on movements of the trunk and pelvis to establish an effective evaluation index for each direction of motion. We studied 28 patients with secondary hip OA due to developmental dysplasia of the hip and 16 controls. The trunk and pelvic movements during gait were measured in the medial-lateral (x), vertical (y), and back-and-forth (z) directions by a triaxial angular accelerometer. Gait speed, steps, step length, muscle strength, range of motion, and timed up-and-go (TUG) test performance were measured. We determined the correlations between physical function and the index of abnormal gait in the hip OA patients. Movements other than trunk and pelvic motions in the y-direction indicated abnormal gait in the patients. Significant correlations were found between abnormal gait and range of motions (extension, internal rotation), TUG score, stride length, and steps. The TUG test, stride length and steps were important for evaluating abnormal gait in hip OA patients. Individual interventions for each movement direction are required. |
| Keywords | hip osteoarthritis three-dimensional gait analysis abnormal gait timed up and go test range of motion |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 391 |
| End Page | 399 |
| 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 | 33106694 |
| Web of Science KeyUT | 000581970100003 |
| NAID | 120006892924 |
| JaLCDOI | 10.18926/AMO/60797 |
|---|---|
| FullText URL | 74_5_381.pdf |
| Author | Yamamoto, Koichiro| Hanayama, Yoshihisa| Hasegawa, Kou| Tokumasu, Kazuki| Miyoshi, Tomoko| Hagiya, Hideharu| Ogawa, Hiroko| Obika, Mikako| Itoshima, Koichi| Otsuka, Fumio| |
| Abstract | To clarify the relevance of prolactin (PRL) to clinical parameters in patients who visited our general medicine department, medical records of 353 patients in whom serum PRL levels were measured during the period from 2016 to 2018 were retrospectively reviewed. Data for 140 patients (M/F: 42/98) were analyzed after excluding patients lacking detailed records and patients taking dopaminergic agents. Median serum PRL levels were significantly lower in males than females: 6.5 ng/ml (IQR: 4.2-10.3) versus 8.1 ng/ml (5.9-12.9), respectively. Pain and general fatigue were the major symptoms at the first visit, and past histories of hypertension and dyslipidemia were frequent. Male patients with relatively high PRL levels (≥ 10 ng/ml) had significantly lower levels of serum albumin and significantly higher levels of serum LDH than those with low PRL (< 10 ng/ml). There were significant correlations of male PRL level with the erythrocyte sedimentation rate (R=0.62), serum LDH level (R=0.39) and serum albumin level (R=−0.52), while the level of serum CRP (R=0.33) showed an insignificant but weak positive correlation with PRL level. Collectively, these results show that PRL levels had gender-specific relevance to various clinical factors, with PRL levels in males being significantly related to inflammatory status. |
| Keywords | hormones hyperprolactinemia inflammation pituitary prolactin |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 381 |
| End Page | 389 |
| 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 | 33106693 |
| Web of Science KeyUT | 000581970100002 |
| NAID | 120006892923 |
| JaLCDOI | 10.18926/AMO/60796 |
|---|---|
| FullText URL | 74_5_371.pdf |
| Author | Makimoto, Go| Ohashi, Kadoaki| Maeda, Yoshinobu| Kiura, Katsuyuki| |
| Abstract | The prognosis of advanced non-small cell lung cancer (NSCLC) patients has improved in recent decades, especially for patients with an oncogenic driver mutation. Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) are effective for patients with the echinoderm microtubule-associated protein-like 4-ALK fusion gene. Several ALK-TKIs have been established: the first-generation ALK-TKI, crizotinib; second-generation ALK-TKIs, alectinib and ceritinib; and third-generation ALK-TKI, lorlatinib. Some ALK-TKIs are effective for tumors that are resistant to other ALK-TKIs; however, as is known in epidermal growth factor receptormutant lung cancer, tumor resistance is inevitable. ALK-positive NSCLCs acquire resistance via various mechanisms, making it a heterogeneous disease. Therefore, it is necessary to develop next-generation treatment strategies, such as the use of next-generation ALK-TKIs for secondary mutations, or combination therapies with ALK-TKIs and other TKIs. In this review, we summarize the development and use of ALK-TKIs, prior pivotal clinical trials, and resistance mechanisms. |
| Keywords | lung cancer anaplastic lymphoma kinase tyrosine kinase inhibitors resistance mechanism |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-10 |
| Volume | volume74 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 371 |
| End Page | 379 |
| 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 | 33106692 |
| Web of Science KeyUT | 000581970100001 |
| NAID | 120006892922 |
| JaLCDOI | 10.18926/AMO/60376 |
|---|---|
| FullText URL | 74_4_365.pdf |
| Author | Chuma, Masayuki| Kondo, Masateru| Zamami, Yoshito| Takechi, Kenshi| Goda, Mitsuhiro| Okada, Naoto| Shibata, Akitomo| Asada, Mizuho| Oto, Jun| Yanagawa, Hiroaki| Ishizawa, Keisuke| |
| Abstract | Cystatin C-guided vancomycin (VCM) dosing is useful in critically ill patients. Its usefulness in septic patients with bacterial meningitis remains unknown, as there are no published reports. In this study, we sought to clarify its benefit. Cystatin C was used to guide VCM dosing in a septic bacterial meningitis patient with normal kidney function, according to therapeutic drug monitoring (TDM). Using cystatin C, the Bayesian method-based TDM made optimal VCM dosing possible, and decreased the predicted error (4.85 mg/L) compared to serum creatinine (16.83 mg/L). We concluded TDM of VCM using cystatin C can be considered in sepsis patients with bacterial meningitis with normal kidney function. |
| Keywords | vancomycin, therapeutic drug monitoring cystatin C bacterial meningitis sepsis |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-08 |
| Volume | volume74 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 365 |
| End Page | 370 |
| 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 | 32843769 |
| Web of Science KeyUT | 000562508700013 |
| NAID | 120006880215 |
| JaLCDOI | 10.18926/AMO/60375 |
|---|---|
| FullText URL | 74_4_359.pdf |
| Author | Inaba, Mototaka| Naito, Hiromichi| Muramatsu, Tomoyoshi| Yamada, Taihei| Sakata, Taizo| Nakao, Atsunori| |
| Abstract | During major flooding in June/July 2018, the Mabi Memorial Hospital in Kurashiki, Okayama, Japan was flooded and patients were stranded in the hospital. Peace Winds Japan, a non-governmental organization, collaborated with the Japanese Disaster Medical Assistance Team and Self-Defense Force Public to transport 8 critical patients from the hospital by helicopter. Ultimately, 54 patients and hospital staff members were safely evacuated. The evacuation was accomplished without any casualties, despite the severe conditions. Public and private organizations can work together and continue to seek ways to collaborate and cooperate in disaster settings. |
| Keywords | natural disaster transportation rain relief work public-private sector partnerships |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-08 |
| Volume | volume74 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 359 |
| End Page | 364 |
| 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 | 32843768 |
| Web of Science KeyUT | 000562508700012 |
| NAID | 120006880214 |
| JaLCDOI | 10.18926/AMO/60374 |
|---|---|
| FullText URL | 74_4_351.pdf |
| Author | Utsumi, Masashi| Aoki, Hideki| Yabuki, Takayuki| Nagahisa, Seiichi| Nishimura, Seitaro| Une, Yuta| Kimura, Yuji| Watanabe, Megumi| Taniguchi, Fumitaka| Arataa, Takashi| Katsuda, Koh| Tanakaya, Kohji| Sato, Yumiko| |
| Abstract | Post-operative pancreatic fistula (POPF) remains the most common complication after distal pancreatectomy (DP). In this retrospective study, we reviewed the data from patients who underwent DP between 2008 and 2019 in our institute to determine whether the late phase/early phase ratio (L/E ratio) by preoperative computed tomography (CT) scan in the pancreas could predict POPF occurrence after DP. We examined the relationship between preoperative or intraoperative factors and the occurrence of POPF after DP using statistical methods in 23 males and 21 females with a mean age of 73. The mean L/E ratio was significantly lower in the POPF group than the non-POPF group (p=0.035). The L/E ratio had moderate diagnostic accuracy, with a calculated optimal cutoff value of 0.77. In univariate analysis, a significant association was noted between POPF and stump thickness ≥ 16.9, body mass index ≥ 27.5, and L/E ratio ≤ 0.77. In the multivariate analysis, the L/E ratio (odds ratio, 5.96; p=0.036) was an independent risk factor for POPF. Our findings suggest that the pancreatic L/E ratio may predict the occurrence of POPF after DP. This measure may be useful in preoperative risk stratification, patient counseling, and perioperative patient management, improving clinical outcomes after DP. |
| Keywords | late phase/early phase ratio pancreatic fistula distal pancreatectomy |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-08 |
| Volume | volume74 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 351 |
| End Page | 358 |
| 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 | 32843767 |
| Web of Science KeyUT | 000562508700011 |
| NAID | 120006880213 |
| JaLCDOI | 10.18926/AMO/60373 |
|---|---|
| FullText URL | 74_4_345.pdf |
| Author | Tanaka, Takaaki| Furumatsu, Takayuki| Hiranaka, Takaaki| Okazaki, Yuki| Masudaa, Kenji| Senoa, Noritaka| Ozaki, Toshifumi| |
| Abstract | The aim of this study was to evaluate tunnel coalition and inter-tunnel distance by comparing the tibial tunnel position in double-bundle anterior cruciate ligament (ACL) reconstruction performed with a conventional guide versus a posterolateral (PL) divergence (PLD) guide. Subjects were 43 patients (ACL tip aimer: 20 knees; PLD guide: 23 knees) who underwent double-bundle ACL reconstruction between September 2014 and December 2017. In all cases, the tibial tunnel position, tunnel edge distance and tunnel angles were evaluated based on CT images. Clinical outcome was evaluated using the Lachman test, pivot-shift test, and Lysholm score. Tibial tunnel positions were similar between the conventional and PLD guide groups, while tibial tunnel edge distance was significantly less in the conventional group. Tunnel coalition was observed in 5 knees in the conventional and no knees in the PLD guide group. Distance between two tibial tunnel centers was 9.1 mm for the tip aimer, and 10.5 mm for the PLD guide. Creation of the PL tunnel tended to involve insertion from a more medial aspect for the PLD guide group than the conventional guide group. No differences in clinical outcomes were noted. The PLD guide can be used to create anatomically-positioned PL tunnels, and reduce the probability of occurrence of tunnel coalition. |
| Keywords | anterior cruciate ligament reconstruction tibial tunnel position PL divergence guide tunnel coalition |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2020-08 |
| Volume | volume74 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 345 |
| End Page | 350 |
| 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 | 32843766 |
| Web of Science KeyUT | 000562508700010 |
| NAID | 120006880212 |