| JaLCDOI | 10.18926/AMO/65753 |
|---|---|
| FullText URL | 77_4_423.pdf |
| Author | Yamakawa, Yasuaki| Miyashita, Kohei| Morizane, Atsushi| Takeuchi, Masato| Kawashima, Yuta| Sugimura, Tomoko| Saisaka, Yuichi| |
| Abstract | We report a case of a patient with severe pelvic fracture who showed concurrent ST elevation on electrocardiogram. A 70-year-old man incurred an unstable pelvic fracture from a motorcycle accident. On admission, he was hemodynamically unstable, and massive transfusion and noradrenaline were administered immediately. Although ST elevation was present in leads II, III, aVF, V5, and V6, cardiac function was preserved; thus, trans-arterial embolization and external fixation for pelvic fracture were given priority. Four days after the injury, he suffered a cardiac arrest, and coronary angiography revealed that the cause of ST elevation and cardiac arrest was coronary vasospasm. Physicians should be aware that pain-related stress and platelet activation as well as use of noradrenaline in severe trauma cases can induce coronary vasospasm. |
| Keywords | coronary spasm angina noradrenaline severe trauma ST elevation treatment strategy |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-08 |
| Volume | volume77 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 423 |
| End Page | 427 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37635143 |
| Web of Science KeyUT | 001163659800004 |
| JaLCDOI | 10.18926/AMO/65746 |
|---|---|
| FullText URL | 77_4_371.pdf |
| Author | Iwamoto, Yosuke| Kaya, Mitsunori| Kijima, Hiroaki| Fujii, Masashi| Nagahata, Itsuki| Miyakoshi, Naohisa| |
| Abstract | In recent publications on greater trochanteric pain syndrome (GTPS), the pathology receiving the most attention has been gluteus medius muscle tendinous injury, and surgical techniques such as gluteus medius tendon repair and their outcomes for GTPS have been reported. In our department-related facilities, arthroscopic surgeries are routinely performed for the patients with recalcitrant GTPS. A total of 51 patients were diagnosed with GTPS. Surgical treatment was carried out 22 patients (24 joints; 4 males and 18 females; mean age at surgery of 52.0 years). Arthroscopic findings confirmed bursitis in all 24 joints. In all cases, debridement of the greater trochanter bursa provided rapid relief of greater trochanter pain. The Numerical Rating Scale showed significant improvement, from the preoperative mean of 7.8 (range, 6-10) to the postoperative day 7 mean of 1.6 (range, 0-3). The modified Harris Hip Score was significantly improved from the preoperative mean of 65.5 (range, 52.5-78.3) to the final follow-up (average 2.9 months) mean of 96.0 (range, 85.2-100). Fascial damage of the gluteus medius muscle was observed in 21 joints while only 2 patients had a gluteus medius tendinous injury. Greater trochanteric bursitis and fascia or muscle-fiber injury of the gluteus medius muscle are the most common pathologies in patients with lateral hip pain. |
| Keywords | greater trochanteric pain syndrome endoscopic findings bursitis |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-08 |
| Volume | volume77 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 371 |
| End Page | 375 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37635137 |
| Web of Science KeyUT | 001163659800005 |
| JaLCDOI | 10.18926/AMO/65748 |
|---|---|
| FullText URL | 77_4_377.pdf |
| Author | Morimoto, Kosaku| Takeuchi, Yasuto| Takaki, Akinobu| Wada, Nozomu| Oyama, Atsushi| Adachi, Takuya| Onishi, Hideki| Shiraha, Hidenori| Okada, Hiroyuki| |
| Abstract | Liver fibrosis is an important phenomenon in non-alcoholic fatty liver disease (NAFLD) progression. Standard markers reflecting liver fibrosis, including the FIB-4 index, increase with age. This study aimed to identify fibrosis progression-related markers that are diagnostically beneficial even in aged individuals. Serum levels of pro- and anti-inflammatory cytokines were measured by multiple enzyme-linked immunosorbent assay. Two standard NAFLD or fibrosis progression-related markers — the FIB-4 index and APRI score — were analyzed along with cytokine levels to define the best approach to discriminate advanced fibrosis. Ninety-eight NAFLD patients were enrolled: 59 and 39 patients with fibrosis stages 1-2 and 3-4 respectively. In addition to the FIB-4 index and APRI score, the following factors showed significant differences between stages 1-2 and stages 3-4 in a multivariate analysis: platelet counts, IP-10, and RANTES. The fibrosis stage, FIB-4, APRI, PDGF-BB, and RANTES were related to the prognosis. In aged patients, IP-10, GM-CSF, and RANTES differed between stages 1-2 and stages 3-4. FIB-4 and APRI were beneficial for their correlation with fibrosis. However, to stratify either young or elderly advanced fibrosis patients, and to identify patients likely to have a bad outcome, RANTES was the best marker. |
| Keywords | NAFLD NASH liver fibrosis chemokine FIB-4 |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-08 |
| Volume | volume77 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 377 |
| End Page | 385 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37635138 |
| Web of Science KeyUT | 001163659800009 |
| JaLCDOI | 10.18926/AMO/65749 |
|---|---|
| FullText URL | 77_4_387.pdf |
| Author | Kataoka, Takahiro| Habu, Hiroshi| Tanaka, Ayumi| Naoe, Shota| Murakami, Kaito| Fujimoto, Yuki| Yukimine, Ryohei| Takao, Soshi| Mitsunobu, Fumihiro| Yorifuji, Takashi| Yamaoka, Kiyonori| |
| Abstract | No epidemiological studies have examined the health effects of daily bathing in radon hot springs. In this cross-sectional study, we investigated the associations between radon hot spring bathing and health conditions. The target population was 5,250 adults ≥ 20 years old in the town of Misasa, Japan. We collected information about the participants’ bathing habits and alleviation of a variety of disease symptoms, and their self-rated health (SRH). Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CI) were calculated. In both the adjusted and unadjusted models of hypertension, significant associations between the > 1×/week hot spring bathing and the alleviation of hypertension symptoms were observed compared to the group whose hot spring bathing was <1×/week: adjusted model, OR 5.40 (95%CI: 1.98-14.74); unadjusted model, 3.67 (1.50-8.99) and for gastroenteritis: adjusted model, 9.18 (1.15-72.96); unadjusted model, 7.62 (1.59-36.49). Compared to the no-bathing group, higher SRH was significantly associated with both bathing < 1×/week: unadjusted model, 2.27 (1.53-3.37) and > 1×/week: adjusted model, 1.91 (1.15-3.19). These findings suggest that bathing in radon hot springs is associated with higher SRH and the alleviation of hypertension and gastroenteritis. |
| Keywords | radon hot spring bathing habit self-rated health cross-section study |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-08 |
| Volume | volume77 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 387 |
| End Page | 394 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37635139 |
| Web of Science KeyUT | 001163659800003 |
| JaLCDOI | 10.18926/AMO/65756 |
|---|---|
| FullText URL | 77_4_433.pdf |
| Author | Ono, Ryuki| Shiode, Yusuke| Kimura, Shuhei| Hosokawa, Mio| Matoba, Ryo| Kanzaki, Yuki| Kindo, Hiroya| Morita, Tetsuro| Morizane, Yuki| |
| Abstract | A 23-year-old woman presented with a 1-month history of visual abnormalities in her right eye. A visual field test revealed temporal abnormalities in the right eye. Optical coherence tomography revealed an indistinct ellipsoid zone (EZ) on the B-scan image and hyporeflective areas in the EZ layer on the en face image in the right eye. We diagnosed the patient with acute zonal occult outer retinopathy. Visual field tests and B-scan images improved to almost normal at 6 months, but hyporeflective areas remained on the en face images. Thus, en face images may be more sensitive at detecting abnormalities in the outer retina than other modalities. |
| Keywords | acute zonal occult outer retinopathy optical coherence tomography en face image ellipsoid zone |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-08 |
| Volume | volume77 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 433 |
| End Page | 437 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37635145 |
| Web of Science KeyUT | 001088434900001 |
| JaLCDOI | 10.18926/AMO/65757 |
|---|---|
| FullText URL | 77_4_439.pdf |
| Author | Shiwaku, Takahiro| Ishida, Hisashi| Tatebe, Yasuhisa| Tamefusa, Kosuke| Ochi, Motoharu| Fujiwara, Kaori| Kubo, Toshihide| Nakata, Eiji| Washio, Kana| Tsukahara, Hirokazu| |
| Abstract | A three-year-old boy with Philadelphia chromosome-positive B-cell precursor acute lymphoblastic leukemia (Ph+ALL) presented with an osteolytic lesion in his right upper arm. Tyrosine kinase inhibitors (TKIs) such as imatinib and dasatinib are an essential component throughout the course of treatment for Ph+ALL. However, TKIs are reported to affect the bone metabolism. In the treatment course of the current patient, the osteolytic lesion quickly improved despite the continuous use of TKIs, even during the concomitant use of corticosteroids. This suggests that TKIs can be safely given with concomitant corticosteroids to children with Ph+ALL, even when osteolytic lesions are present. |
| Keywords | acute lymphoblastic leukemia children tyrosine kinase inhibitor osteolysis |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-08 |
| Volume | volume77 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 439 |
| End Page | 442 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37635146 |
| Web of Science KeyUT | 001088434900002 |
| JaLCDOI | 10.18926/AMO/65745 |
|---|---|
| FullText URL | 77_4_365.pdf |
| Author | Moldovan, Elena| Bănescu, Claudia| Cucerea, Manuela| Moldovan, Valeriu| Gozar, Liliana| Pușcașiu, Lucian| |
| Abstract | Congenital heart disease is the most common malformative pathology in newborns, with a worldwide incidence at 0.4-5%. We investigated the possible relationship between variations in nucleotide sequences and specific cardiac malformations in the GATA-binding factor 4 (GATA4) exon 1 region by using Sanger sequencing. Forty-four newborns from a third-level neonatal intensive care unit who were diagnosed with nonsyndromic, ductal-dependent congenital heart disease (i.e., transposition of the great arteries or ductal-dependent coarctation of the aorta) were enrolled. Their DNA was extracted using commercial methods and tested using the multiplex ligation-dependent probe amplification (MLPA) technique. The Sanger sequencing for GATA4 exon 1 in the newborns’ DNA identified rs61277615, rs73203482, and rs35813172 variants not reported in the ClinVar archive of human variations in newborns previously diagnosed with transposition of the great arteries (n=5) and coarctation of the aorta (n=1). The identification of these novel variants in newborns with transposition of the great arteries or ductal-dependent coarctation of the aorta may be the first step in determining the variants’ contribution to the occurrence of congenital heart disease. However, these results may be inconclusive, since the observed variants within GATA4 gene were not previously reported. |
| Keywords | transposition of the great arteries ductal-dependent coarctation of the aorta GATA4 MLPA Sanger sequencing |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-08 |
| Volume | volume77 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37635136 |
| Web of Science KeyUT | 001163659800008 |
| JaLCDOI | 10.18926/AMO/65750 |
|---|---|
| FullText URL | 77_4_395.pdf |
| Author | Pavlovic, Marko| Babic, Dragan| Rastovic, Pejana| Arapovic, Jurica| Martinac, Marko| Jakovac, Sanja| Barbaric, Romana| |
| Abstract | We investigated the relationship between serum tumor necrosis factor-alpha (TNF-α) levels and psychopathological symptoms, clinical and socio-demographic characteristics and antipsychotic therapy in individuals with schizophrenia. TNF-α levels were measured in 90 patients with schizophrenia and 90 healthy controls matched by age, gender, smoking status, and body mass index. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of psychopathology in patients. No significant differences in TNF-α levels were detected between the patients and controls (p=0.736). TNF-α levels were not correlated with total, positive, negative, general, or composite PANSS scores (all p>0.05). A significant negative correlation was observed between TNF-α levels and the PANSS cognitive factor (ρ=−0.222, p=0.035). A hierarchical regression analysis identified the cognitive factor as a significant predictor of the TNF-α level (beta=−0.258, t=−2.257, p=0.027). There were no significant differences in TNF-α levels among patients treated with different types of antipsychotics (p=0.596). TNF-α levels correlated positively with the age of onset (ρ=0.233, p=0.027) and negatively with illness duration (ρ=−0.247, p=0.019) and antipsychotic treatment duration (ρ=−0.256, p=0.015). These results indicate that TNF-α may be involved in cognitive impairment in schizophrenia, and would be a potential clinical-state marker in schizophrenia. |
| Keywords | tumor necrosis factor-alpha schizophrenia psychopathology immune system |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-08 |
| Volume | volume77 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 395 |
| End Page | 405 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37635140 |
| Web of Science KeyUT | 001163659800010 |
| JaLCDOI | 10.18926/AMO/65497 |
|---|---|
| FullText URL | 77_3_319.pdf |
| Author | Kashihara, Kenichi| |
| Abstract | I report a case of arterial spine-labelled MR imaging (ASL)-detected cerebral hypoperfusion during migraine and panic attacks. A 20-year-old woman with a history of headache for 6 years and independent panic attacks for 3 years was transferred to Okayama Kyokuto Hospital for panic attacks. On that day, she had had severe headache that was improved by taking non-steroidal anti-inflammatory drug, but panic attacks initiated. On arrival, she also complained of a mild headache. ASL revealed cerebral hypoperfusion in the right temporo-occipital region. The threshold to induce panic attacks in migraine patients could be lowered by the physiopathology underlying migraine attacks. |
| Keywords | migraine panic attack arterial spine-labelled magnetic resonance imaging aura cortical spreading depression |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 319 |
| End Page | 321 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37357633 |
| Web of Science KeyUT | 001026279600010 |
| JaLCDOI | 10.18926/AMO/65502 |
|---|---|
| FullText URL | 77_3_323.pdf |
| Author | Makino, Keigo| Otani, Yoshihiro| Fujii, Kentaro| Ishida, Joji| Hirano, Shuichiro | Suruga, Yasuki| Washio, Kana| Nishida, Kenji| Yanai, Hiroyuki| Tomida, Shuta| Ennishi, Daisuke| Date, Isao| |
| Abstract | In the current World Health Organization classification of central nervous system tumors, comprehensive genetic and epigenetic analyses are considered essential for precise diagnosis. A 14-year-old male patient who presented with a cerebellar tumor was initially diagnosed with glioblastoma and treated with radiation and concomitant temozolomide chemotherapy after resection. During maintenance temozolomide therapy, a new contrast-enhanced lesion developed in the bottom of the cavity formed by the resection. A second surgery was performed, but the histological findings in specimens from the second surgery were different from those of the first surgery. Although genome-wide DNA methylation profiling was conducted using frozen tissue for a precise diagnosis, the proportion of tumor cells was insufficient and only normal cerebellum was observed. We then performed comprehensive genetic analysis using formalin-fixed paraffin-embedded sections, which revealed MYCN amplification without alteration of IDH1, IDH2, or Histone H3. Finally, the patient was diagnosed with pediatric-type diffuse high-grade glioma, H3-wildtype and IDH-wildtype. In conclusion, comprehensive genetic and epigenetic analysis should be considered in pediatric brain tumor cases. |
| Keywords | comprehensive genomic profiling pediatric brain tumor genome-wide DNA methylation MYCN |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 323 |
| End Page | 330 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37357634 |
| Web of Science KeyUT | 001025850000001 |
| JaLCDOI | 10.18926/AMO/65496 |
|---|---|
| FullText URL | 77_3_311.pdf |
| Author | Miura, Takanori| Kijima, Hiroaki| Tazawa, Hiroshi| Miyakoshi, Naohisa| |
| Abstract | Japan’s hip fracture management guidelines now recommend the use of cemented stems in cases of bone fragility. However, the current stem selection practices in bipolar hemiarthroplasty (BHA) in a super-aging area in Japan remain unclear. This study aimed to examine the stem selection policies, the surgeons’ concerns about cemented stems, and factors affecting their confidence in their ability to coach others on cemented stem procedures. Ninety-four orthopedic surgeons (27 facilities) responded to our web-based questionnaire conducted in January/February 2022. Cementless stem was the first choice of 97.8% of the surgeons; <15% of the respondents expected to increase their use of cemented stems in the future. The cement technique was the greatest concern; almost half of the surgeons described having insufficient experience with cemented stems. The factor that most affected the surgeons’ expertise in using cemented stems is the number of surgeries they had conducted with a cemented stem (multivariable analysis odds ratio 8.42, p=0.001). Greater experience was associated with increased expertise of the surgeons in using cemented stems, with a threshold of 11 cases showing sensitivity of 41.7% and specificity of 98.3% for their confidence to instruct cemented stems. |
| Keywords | hip fracture arthroplasty bone cement questionnaire |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 311 |
| End Page | 318 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37357632 |
| Web of Science KeyUT | 001026279600009 |
| JaLCDOI | 10.18926/AMO/65493 |
|---|---|
| FullText URL | 77_3_281.pdf |
| Author | Mukai, Yuko| Taira, Naruto| Kajiwara, Yukiko| Iwamoto, Takayuki| Kitaguchi, Yohei| Saiga, Miho| Watanabe, Satoko| Shien, Tadahiko| Doihara, Hiroyoshi| Kimata, Yoshihiro| |
| Abstract | Although immediate breast reconstruction following mastectomy has become increasingly common, its oncological safety has been debated. We enrolled patients with breast cancer who underwent surgery at Okayama University Hospital between 2007 and 2013. The primary outcome was relapse-free survival (RFS). Secondary outcomes were overall survival and the duration from the surgery to the initiation of adjuvant chemotherapy. We divided into immediate breast reconstruction, mastectomy alone, and breast conservative surgery groups. Outcomes were compared using Cox’s regression analysis. A total of 614 patients were included (reconstruction: 125, mastectomy: 128, breast conservative surgery: 361). The median follow-up duration was 79.0±31.9 months. The immediate-reconstruction patients were younger, had more lymph node metastases, and more often received postoperative chemotherapy. The RFS was better after the breast conservative surgery compared to after reconstruction (hazard ratio 0.33, 95% confidence interval: 0.144-0.763). The proportion of local recurrence was highest in the reconstruction group. No patients in the reconstruction group underwent postoperative radiation therapy. However, reconstruction did not affect overall survival or the time to the initiation of adjuvant chemotherapy. Surgeons should explain the risks of breast reconstruction to their patients preoperatively. Careful long-term follow-up is required after such procedures. |
| Keywords | immediate breast reconstruction oncological safety local recurrence postoperative radiation therapy time to initiation of adjuvant chemotherapy |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 281 |
| End Page | 290 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37357629 |
| Web of Science KeyUT | 001026279600006 |
| JaLCDOI | 10.18926/AMO/65492 |
|---|---|
| FullText URL | 77_3_273.pdf |
| Author | Shimizu, Yudai| Kuroda, Masahiro| Nakamitsu, Yuki| Al-Hammad, Wlla E.| Yoshida, Suzuka| Fukumura, Yuka| Nakamura, Yoshihide| Kuroda, Kazuhiro| Kamizaki, Ryo| Imajoh, Satoshi| Tanabe, Yoshinori| Sugimoto, Kohei| Oita, Masataka| Sugianto, Irfan| Bamgbose, Babatunde O.| Yanagi, Yoshinobu| Asaumi, Junichi| |
| Abstract | Diffusion kurtosis (DK) imaging (DKI), a type of restricted diffusion-weighted imaging, has been reported to be useful for tumor diagnoses in clinical studies. We developed a software program to simultaneously create DK images with apparent diffusion coefficient (ADC) maps and conducted an initial clinical study. Multi-shot echo-planar diffusion-weighted images were obtained at b-values of 0, 400, and 800 sec/mm2 for simple DKI, and DK images were created simultaneously with the ADC map. The usefulness of the DK image and ADC map was evaluated using a pixel analysis of all pixels and a median analysis of the pixels of each case. Tumor and normal tissues differed significantly in both pixel and median analyses. In the pixel analysis, the area under the curve was 0.64 for the mean kurtosis (MK) value and 0.77 for the ADC value. In the median analysis, the MK value was 0.74, and the ADC value was 0.75. The MK and ADC values correlated moderately in the pixel analysis and strongly in the median analysis. Our simple DKI system created DK images simultaneously with ADC maps, and the obtained MK and ADC values were useful for differentiating head and neck tumors from normal tissue. |
| Keywords | simple diffusion kurtosis imaging mean kurtosis clinical trial head and neck tumor magnetic resonance imaging |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 273 |
| End Page | 280 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37357628 |
| Web of Science KeyUT | 001026279600005 |
| JaLCDOI | 10.18926/AMO/65494 |
|---|---|
| FullText URL | 77_3_291.pdf |
| Author | Himei, Hitomi| Kato, Hironari| Saragai, Yosuke| Fujii, Yuki| Yamazaki, Tatsuhiro| Uchida, Daisuke| Matsumoto, Kazuyuki| Horiguchi, Shigeru| Tsutsumi, Koichiro| Okada, Hiroyuki| |
| Abstract | We investigated the efficacy and safety of endoscopic plastic stent (PS) placement for hilar benign biliary strictures (BBSs) and compared cases with PS placement above (inside stent, IS) and across (usual stent, US) the sphincter of Oddi. Patients who underwent initial endoscopic PS placement for hilar BBSs between August 2012 and December 2021 were retrospectively analyzed. Hilar BBSs in 88 patients were investigated. Clinical success was achieved in 81 of these cases (92.0%), including 38 patients in the IS group and 43 patients in the US group. Unexpected stent exchange (uSE) before the first scheduled PS exchange occurred in 18 cases (22.2%). The median time from first stent placement to uSE was 35 days. There was no significant difference in the rate and median time to uSE between the two groups. The rates of adverse events such as pancreatitis or cholangitis in the two groups did not significantly differ. However, the rate of difficult stent removal in the IS group (15.8%) was significantly higher than that in the US group (0%) (p=0.0019). US placement is preferable to IS placement for scheduled stent exchange, as it offers the same effectiveness and risk of adverse events with easier stent removal. |
| Keywords | benign biliary stricture inside stent plastic stent |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 291 |
| End Page | 299 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37357630 |
| Web of Science KeyUT | 001026279600007 |
| JaLCDOI | 10.18926/AMO/65503 |
|---|---|
| FullText URL | 77_3_331.pdf |
| Author | Watanabe, Mototsugu| Yamamoto, Hiromasa| Miyoshi, Kentaroh| Sugimoto, Seiichiro| Toyooka, Shinichi| |
| Abstract | Masaoka stage I type A thymomas rarely recur. We report the case of an 82-year-old man who developed endobronchial metastasis after thymothymectomy for Masaoka stage I type A thymoma. Twenty years after surgery, the patient developed bloody sputum, and chest computed tomography revealed a neoplasm obstructing the right upper lobe bronchus of the lung with enlarged mediastinal lymph nodes. He underwent right upper lobectomy and mediastinal lymph node dissection. Although preoperative pathological diagnosis was squamous cell carcinoma of the lung, postoperative histopathology revealed endobronchial metastasis of the thymoma. Nine years later, at age 89, the patient is alive and well. |
| Keywords | endobronchial metastasis type A thymoma bloody sputum |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 331 |
| End Page | 334 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37357635 |
| Web of Science KeyUT | 001026663400001 |
| JaLCDOI | 10.18926/AMO/65495 |
|---|---|
| FullText URL | 77_3_301.pdf |
| Author | Kato, Takahide| Miyoshi, Seigo| Hamada, Chizuru| Sano, Yoshifumi| Nogami, Naoyuki| Yamaguchi, Osamu| Hamaguchi, Naohiko| |
| Abstract | Acute exacerbation (AE) of interstitial lung disease (ILD) is a severe complication of lung resection in lung cancer patients with ILD (LC-ILD). This study aimed to assess the predictive value of comorbidities other than ILD for postoperative AE in patients with LC-ILD. We retrospectively evaluated 68 patients with LC-ILD who had undergone lung resection. We classified them into two groups: those who had developed postoperative AE within 30 days after resection and those who had not. We analyzed patient characteristics, high-resolution computed tomography findings, clinical data, pulmonary function, and intraoperative data. The incidence of postoperative AEs was 11.8%. In univariate analysis, performance status (PS), honeycombing, forced vital capacity (FVC), and high hemoglobin A1c (HbA1c) levels without comorbidities were significantly associated with postoperative AE. Patients were divided into two groups according to cutoff levels of those four variables as determined by receiver operating characteristic curves, revealing that the rates of patients without postoperative AE differed significantly between groups. The present results suggested that preoperative comorbidities other than ILD were not risk factors for postoperative AE in patients with LC-ILD. However, a high preoperative HbA1c level, poor PS, low FVC, and honeycombing may be associated with postoperative AE of LC-ILD. |
| Keywords | lung cancer interstitial lung disease acute exacerbation comorbidity |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 301 |
| End Page | 309 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37357631 |
| Web of Science KeyUT | 001026279600008 |
| JaLCDOI | 10.18926/AMO/65504 |
|---|---|
| FullText URL | 77_3_335.pdf |
| Author | Fujii, Kentaro| Hirano, Shuichiro| Kurozumi, Kazuhiko| Date, Isao| |
| Abstract | An 85-year-old woman presented with aphasia due to an occupying lesion in the left frontal lobe near the language area. Complete resection of the contrast-enhancing lesion was performed under awake conditions. The pathological diagnosis was anaplastic astrocytoma, and postoperative radiochemotherapy was administered. Awake surgery is a useful technique to reduce postoperative neurological sequelae and to maximize surgical resection. Although the patient was elderly, which is generally considered high risk, she did not have any severe neurological deficits and had a good outcome. Even in the extreme elderly, awake surgery can be useful for gliomas in language cortices. |
| Keywords | awake surgery high-grade glioma eloquent area elderly patient |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 335 |
| End Page | 340 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37357636 |
| Web of Science KeyUT | 001026663400002 |
| JaLCDOI | 10.18926/AMO/65490 |
|---|---|
| FullText URL | 77_3_255.pdf |
| Author | Fukushima, Shinnosuke| Hagiya, Hideharu| Uda, Kazuhiro| Gotoh, Kazuyoshi| Otsuka, Fumio| |
| Abstract | Antimicrobial resistance is an emerging global threat that must be addressed using a multidisciplinary approach. This study aimed to raise awareness of high-level antimicrobial-resistant (AMR) pathogens in Japan by comparing their recent prevalences among prefectures, particularly Okayama. Data for the isolation proportions of meropenem-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium, cefotaxime-resistant Escherichia coli and Klebsiella pneumoniae, and levofloxacin-resistant E. coli and K. pneumoniae were collected from the Japan Nosocomial Infections Surveillance, a national database sponsored by the Japanese Ministry of Health, Labour, and Welfare, between 2018 and 2021. The average isolated proportions of the seven AMR pathogens were higher in Okayama compared to other prefectures: the worst (19.9%) was meropenem-resistant P. aeruginosa, the sixth worst (57.2%) was methicillin-resistant S. aureus, the eighth worst (3.3%) was vancomycin-resistant E. faecium, the second (37.8%) and fifth worst (17.6%) were cefotaxime-resistant E. coli and K. pneumoniae, respectively, and the fourth (49.9%) and third worst (8.7%) were levofloxacin-resistant E. coli and K. pneumoniae, respectively. Our study highlights the notably high prevalences of representative AMR pathogens in Okayama, suggesting the need for fundamental infection prevention and control by healthcare professionals, promoting antimicrobial stewardship, and educating undergraduates and postgraduates in Okayama. |
| Keywords | antimicrobial resistance antimicrobial stewardship epidemiology infection prevention and control Japan Nosocomial Infections Surveillance |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 255 |
| End Page | 262 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37357626 |
| Web of Science KeyUT | 001026279600003 |
| JaLCDOI | 10.18926/AMO/65488 |
|---|---|
| FullText URL | 77_3_235.pdf |
| Author | Kuraoka, Sakiko| Iwamuro, Masaya| Satomi, Takuya| Yamazaki, Tatsuhiro| Hamada, Kenta| Kono, Yoshiyasu| Kanzaki, Hiromitsu| Kato, Hironari| Otsuka, Fumio| Okada, Hiroyuki| |
| Abstract | Changes in hormone levels in patients with cancer cachexia after anamorelin administration have not been fully investigated. This study aimed to determine how anamorelin affects the endocrine system in patients with gastrointestinal cancer and cachexia. We prospectively enrolled 13 patients and comprehensively investigated their body weight and levels of serum albumin, hemoglobin A1c (HbA1c), and hormones before (week 0) and 3 and 12 weeks after anamorelin administration. The variables were evaluated at week 3 in 9 patients and at week 12 in 5 patients. At week 3, anamorelin administration resulted in body weight gain and increased the levels of growth hormone and HbA1c, as well as insulin-like growth factor-1 standard deviation scores (IGF-1 SD scores). At the same time, negative correlations were observed between ΔIGF-1 SD score and Δthyroidstimulating hormone (TSH) and between ΔIGF-1 SD score and Δfree testosterone. ΔBody weight and ΔIGF-1 SD score correlated positively at week 12. These results suggest that TSH and free testosterone levels can be affected 3 weeks after anamorelin administration; however, those variables tend to return to a state of equilibrium, and anabolic effects of anamorelin appear in long-term (≥ 12 weeks) users. |
| Keywords | anamorelin body weight cancer cachexia endocrine system |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 235 |
| End Page | 241 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37357624 |
| Web of Science KeyUT | 001026279600001 |
| JaLCDOI | 10.18926/AMO/65489 |
|---|---|
| FullText URL | 77_3_243.pdf |
| Author | Shibata, Yusuke| Eguchi, Jun| Wada, Jun| |
| Abstract | Brown adipose tissue (BAT) plays a critical role in metabolic homeostasis. BAT dysfunction is associated with the development of obesity through an imbalance between energy expenditure and energy intake. The nuclear receptor peroxisome proliferator-activated receptor gamma (PPARγ) is the master regulator of adipogenesis. However, the roles of PPARγ and thiazolidinediones (TZDs) in the regulation of BAT metabolism remain unclear. TZDs, which are selective PPARγ activators, improve systemic insulin resistance in animals and humans. In the present study, we generated brown adipocyte-specific PPARγ-deficient mice (BATγKO) to examine the in vivo roles of PPARγ and TZDs in BAT metabolism. In electron microscopic examinations, brown adipocyte-specific PPARγ deletion promoted severe whitening of brown fat and morphological alteration of mitochondria. Brown adipocyte-specific PPARγ deletion also reduced mRNA expression of BAT-selective genes. Although there was no difference in energy expenditure between control and BATγKO mice in calorimetry, norepinephrine-induced thermogenesis was impaired in BATγKO mice. Moreover, pioglitazone treatment improved diet-induced insulin resistance in the control mice but not in the BATγKO mice. These findings suggest that BAT PPARγ is necessary for the maintenance of brown adipocyte function and for the insulin-sensitizing action of TZDs. |
| Keywords | PPARγ brown adipose tissue thiazolidinediones |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 243 |
| End Page | 254 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37357625 |
| Web of Science KeyUT | 001026279600002 |
