| JaLCDOI | 10.18926/AMO/66150 |
|---|---|
| FullText URL | 77_6_589.pdf |
| Author | Omichi, Ryotaro| Kariya, Shin| Maeda, Yukihide| Fukushima, Kunihiro| Kataoka, Yuko| Sugaya, Akiko| Nishizaki, Kazunori| Ando, Mizuo| |
| Abstract | Choosing the optimal side for cochlear implantation (CI) remains a major challenge because of the lack of evidence. We investigated the choice of the surgery side for CI (i.e., the better- or poorer-hearing ear) in patients with asymmetric hearing. Audiological records of 74 adults with a unilateral hearing aid who had undergone surgery at Okayama University Hospital were reviewed. The definition of ‘better-hearing ear’ was the aided ear, and the unaided ear was considered the poorer-hearing ear. We performed a multiple regression analysis to identify potential predictors of speech recognition performance after unilateral CI in the patients. Fifty-two patients underwent CI in the poorer-hearing ear. The post-Ci bimodal hearing rate was far higher in the poorer-ear group (77.8% vs. 22.2%). A multivariate analysis revealed that prelingual hearing loss and the patient’s age at CI significantly affected the speech recognition outcome (beta coefficients: 24.6 and −0.33, 95% confidence intervals [11.75-37.45] and [−0.58 to −0.09], respectively), but the CI surgery side did not (−6.76, [−14.92-1.39]). Unilateral CI in the poorer-hearing ear may therefore be a reasonable choice for adult patients with postlingual severe hearing loss, providing a greater opportunity for postoperative bimodal hearing. |
| Keywords | cochlear implantation poorer hearing ear better hearing ear hearing aids speech recognition |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-12 |
| Volume | volume77 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 589 |
| End Page | 593 |
| 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 | 38145932 |
| Web of Science KeyUT | 001164631200003 |
| JaLCDOI | 10.18926/AMO/66149 |
|---|---|
| FullText URL | 77_6_577.pdf |
| Author | Liu, Siyu| Athurupana, Rukmali| Han, Hongmei| Yang, Titi| Nakatsuka, Mikiya| |
| Abstract | Bereavement care is conducted to meet the emotional needs of grieving couples who are devastated by the experience of a miscarriage or stillbirth. From January to April 2022, we distributed a questionnaire that assessed the knowledge and attitudes of Japanese nursing staff (nurses and midwives) in Japan’s Chugoku-Shikoku region toward bereavement care for couples with miscarriage/stillbirth. The 370 survey respondents’ answers revealed that the nursing staff’s knowledge regarding recurrent pregnancy loss and subsequent bereavement care was insufficient. About 41.1% and 64.1% of the respondents had received school and on-the-job education in bereavement care, respectively, and 79.2% expressed willingness to provide such care. Our analyses revealed that the following factors were associated with the nursing staff’s knowledge level: parent status, age, reproductive history, midwifery license, work experience and environment, and on-the-job education. The following were correlated with the staff’s willingness to provide bereavement care: work environment, midwifery license, bereavement care knowledge, and on-the-job education. Together our findings indicate that education plays a significant role in equipping caregivers to provide effective bereavement care for couples who have experienced a miscarriage or stillbirth. |
| Keywords | midwife nurse miscarriage bereavement knowledge |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-12 |
| Volume | volume77 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 577 |
| End Page | 587 |
| 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 | 38145931 |
| Web of Science KeyUT | 001164631200002 |
| JaLCDOI | 10.18926/AMO/66148 |
|---|---|
| FullText URL | 77_6_567.pdf |
| Author | Matsumoto, Naomi| Higuchi, Chigusa| Miyaji, Chikara| Mitsuhashi, Toshiharu| Hagiya, Hideharu| Takao, Soshi| Yorifuji, Takashi| |
| Abstract | This paper presents the results of a series of surveys conducted from July 2021 to March 2023 to investigate the post-vaccination adverse reactions to the mRNA-1273 (Moderna) vaccine among faculty, staff, and students at Okayama University. These studies complement the official surveys conducted by the Ministry of Health, Labour and Welfare (MHLW) and provide a more representative picture of adverse reactions in the general population including large numbers of healthy young people. Pain, swelling, redness at the injection site, fever, headache, and malaise were the main adverse reactions reported. The proportion of adverse reactions was generally higher after the second vaccination and decreased with each additional vaccination. No statistically significant differences in the adverse reactions were found for males and females and those with/without a history of allergy, but a lower proportion of fever was observed in older participants and those with underlying medical conditions. We also evaluated the association between adverse reactions and antibody titers after the third vaccination and found no significant differences in antibody levels one month after vaccination. This series of studies highlights the importance of conducting surveys in diverse populations to provide a more representative picture of post-vaccination adverse reactions during a pandemic. |
| Keywords | coronavirus disease 2019 adverse reactions mRNA vaccine antibody titers young adults |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-12 |
| Volume | volume77 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 567 |
| End Page | 575 |
| 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 | 38145930 |
| Web of Science KeyUT | 001164631200001 |
| JaLCDOI | 10.18926/AMO/65980 |
|---|---|
| FullText URL | 77_5_561.pdf |
| Author | Tsuchiya, Hiroki| Shibata, Takashi| Sasaki, Tatsuya| Inoue, Takushi| Date, Isao| Akiyama, Tomoyuki| Kobayashi, Katsuhiro| |
| Abstract | West syndrome, an infantile developmental and epileptic encephalopathy with a deleterious impact on long-term development, requires early treatment to minimize developmental abnormality; in such cases, epilepsy surgery should be considered a powerful therapeutic option. We describe a 10-month-old female admitted with West syndrome associated with a hemispheric lesion following abusive head trauma. Her seizures were suppressed by hemispherotomy at 12 months of age, leading to developmental improvement. Surgical treatment of West syndrome following traumatic brain injury has not been reported previously but is worth considering as a treatment option, depending on patient age and brain plasticity. |
| Keywords | abusive head trauma developmental and epileptic encephalopathy epilepsy surgery epileptic spasms hemispherotomy |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-10 |
| Volume | volume77 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 561 |
| End Page | 566 |
| 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 | 37899268 |
| Web of Science KeyUT | 001110832700002 |
| JaLCDOI | 10.18926/AMO/65979 |
|---|---|
| FullText URL | 77_5_553.pdf |
| Author | Murokawa, Takahiro| Sakamoto, Shinya| Tabuchi, Motoyasu| Sui, Kenta| Ozaki, Kazuhide| Matsumoto, Manabu| Iwata, Jun| Okabayashi, Takehiro| Yoshida, Hiroshi| |
| Abstract | Gastric cancer with peritoneal metastases is typically a devastating diagnosis. Ligamentum teres hepatis (LTH) metastasis is an extremely rare presentation with only four known cases. Herein, we report salvage surgery of successive metastases to the abdominal wall and LTH in a patient originally presenting with advanced gastric cancer with peritoneal metastasis, leading to long-term survival. A 72-year-old man with advanced gastric cancer underwent curative-intent distal gastrectomy with D2 lymph node dissection for gastric outlet obstruction. During this procedure, three small peritoneal metastases were detected in the lesser omentum, the small mesentery, and the mesocolon; however, intraoperative abdominal lavage cytology was negative. We added cytoreductive surgery for peritoneal metastasis. The pathological diagnosis of the gastric cancer was tubular adenocarcinoma with pT4aN1pM1(PER/P1b)CY0 stage IV (Japanese classification of gastric carcinoma/JCGC 15th), or T4N1M1b stage IV (UICC 7th). Post-operative adjuvant chemotherapy with S-1 (TS-1)+cisplatin (CDDP) was administered for 8 months followed by S-1 monotherapy for 4 months. At 28 months after the initial surgery, a follow-up computed tomography (CT) detected a small mass beneath the upper abdominal wall. The ass showed mild avidity on 18F-fluorodeoxyglucose positron-emission (FDG-PET) CT. Salvage resection was performed for diagnosis and treatment, and pathological findings were consistent with primary gastric cancer metastasis. At 49 months after the initial gastrectomy, a new lesion was detected in the LTH with a similar level of avidity on FDG-PET CT as the abdominal wall metastatic lesion. We performed a second salvage surgery for the LTH tumor, which also showed pathology of gastric cancer metastasis. There has been no recurrence up to 1 year after the LTH surgery. With multidisciplinary treatment the patient has survived almost 5 years after the initial gastrectomy. Curative-intent gastrectomy with cytoreductive surgery followed by adjuvant chemotherapy for advanced gastric cancer with localized peritoneal metastasis might have had a survival benefit in our patient. Successive salvage surgeries for oligometastatic lesions in the abdominal wall and the LTH also yielded favorable outcomes. |
| Keywords | gastric cancer peritoneal metastasis ligamentum teres hepatis oligometastasis salvage surgery |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-10 |
| Volume | volume77 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 553 |
| End Page | 559 |
| 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 | 37899267 |
| Web of Science KeyUT | 001110832700001 |
| JaLCDOI | 10.18926/AMO/65978 |
|---|---|
| FullText URL | 77_5_545.pdf |
| Author | Iwamuro, Masaya| Tanaka, Shouichi| Toyokawa, Tatsuya| Nishimura, Mamoru| Tsuzuki, Takao| Miyahara, Koji| Negishi, Shin| Ohya, Shogen| Tanaka, Takehiro| Otsuka, Motoyuki| |
| Abstract | To determine the endoscopic and clinical features of localized gastric amyloid light-chain (AL) amyloidosis, we retrospectively examined the characteristics of nine patients (eight men and one woman) encountered by the hospitals in our network. Lesions were predominantly flat and depressed with surface vascular dilatation (n=5); others were characterized by subepithelial lesions (n=2), mucosal color change (n=1), and a mass-like morphology with swollen mucosal folds (n=1). Colonoscopy (n=7), video capsule enteroscopy (n=2), serum (n=5) and urine immunoelectrophoresis (n=4), and bone marrow examination (n=3) were performed to exclude involvement of organs other than the stomach. As treatment for gastric lesions of AL amyloidosis, one patient each underwent endoscopic submucosal dissection (n=1) and argon plasma coagulation (n=1), while the remaining seven patients underwent no specific treatment. During a mean follow-up of 4.2 years, one patient died 3.2 years after diagnosis, but the cause of death, which occurred in another hospital, was unknown. The remaining eight patients were alive at the last visit. In conclusion, although localized gastric AL amyloidosis can show various macroscopic features on esophagogastroduodenoscopy, flat, depressed lesions with vascular dilatation on the surface are predominant. |
| Keywords | esophagogastroduodenoscopy gastric lesion amyloidosis light chain |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-10 |
| Volume | volume77 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 545 |
| End Page | 552 |
| 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 | 37899266 |
| Web of Science KeyUT | 001094245100001 |
| 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/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/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/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/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/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/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/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/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/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/65491 |
|---|---|
| FullText URL | 77_3_263.pdf |
| Author | Guo, Yusheng| Kosaka, Junko| Morimatsu, Hiroshi| |
| Abstract | Continuous renal replacement therapy (CRRT) is widely used to control fluid balance, but the optimal fluid balance to improve the prognosis of patients remains debated. Appropriate fluid management may depend on hemodynamic status. We investigated the association between 90-day mortality and fluid balance/mean arterial pressure (MAP) in patients receiving CRRT. This single-center retrospective study was conducted between May 2018 and March 2021. Based on the cumulative fluid balance at 72 h after initiation of CRRT, the cases were divided into negative (< 0 mL) and positive (> 0 mL) fluid balance groups. Ninety-day mortality was higher in the positive fluid balance group (p=0.009). At 4 h before and after CRRT initiation, the mean MAP was lower in the positive fluid balance group (p<0.05). After multivariate cox adjustment, 72-h positive fluid balance was independently associated with 90-day mortality (p=0.004). In addition, the cumulative fluid balance was associated with 90-day mortality (p<0.05) in cases without shock, high APACHE II score, sepsis, dialysis dependence, or vasopressor use. A 72-h positive fluid balance was associated with 90-day mortality in patients receiving CRRT. |
| Keywords | fluid management continuous renal replacement therapy mortality mean arterial pressure daily cumulative fluid balance |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-06 |
| Volume | volume77 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 263 |
| End Page | 272 |
| 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 | 37357627 |
| Web of Science KeyUT | 001026279600004 |
| 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/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 |
