result 2861 件
| JaLCDOI | 10.18926/AMO/67549 |
|---|---|
| FullText URL | 78_4_331.pdf |
| Author | Furukawa, Chieko| Tachibana, Tomoyasu| Nobuhisa, Tetsuji| Kanie, Yuichiro| Wani, Yoji| Matsumoto, Jun-Ya| Kariya, Akifumi| Sato, Asuka| Ishikawa, Iichiro| Naoi, Yuto| Ando, Mizuo| |
| Abstract | No previous study has published magnetic resonance imaging (MRI) findings for a subglottic pleomorphic adenoma. Here, we describe the case of a 62-year-old man with a subglottic pleomorphic adenoma. Endoscopic findings revealed a smooth-surfaced tumor arising from the subglottic posterior wall. MRI revealed the lesion as an isointense region on T1-weighted images, which was homogeneously enhanced. This lesion showed a heterogeneously hyperintense region on T2-weighted images. Diffusion-weighted imaging (DWI) showed slightly high intensity in the same area, with a normal or only slightly high apparent diffusion coefficient (ADC). Laryngomicrosurgery was performed for transoral excision of the subglottic tumor, resulting in a postsurgical diagnosis of pleomorphic adenoma. |
| Keywords | subglottis pleomorphic adenoma MRI transoral surgery |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-08 |
| Volume | volume78 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 331 |
| End Page | 335 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 39198987 |
| Web of Science KeyUT | 001310557400001 |
| JaLCDOI | 10.18926/AMO/67548 |
|---|---|
| FullText URL | 78_4_323.pdf |
| Author | Katayama, Akira| Kimura, Satoshi| Matsusaki, Takashi| Morimatsu, Hiroshi| |
| Abstract | It has not been clear how recipient age affects the incidence of serious complications after pediatric living donor liver transplantation (LDLT). We investigated the records of 42 pediatric patients receiving LDLT, dividing our sample into two groups: the infant group (aged < 1 year) and the non-infant group (aged ≥ 1 year and ≤15 years). The primary outcome was postoperative complications assessed using the Clavien-Dindo classification. Multivariate analysis using the Cox regression model was applied to adjust for confounding factors in assessing the incidence of Clavien-Dindo grade ≥ III (C-D ≥ III) complications. The incidence of C-D ≥ III complications was higher in the non-infant group (46.2%) than in the infant group (12.5%) (odds ratio 6.00, 95% confidence interval [CI] 1.13-31.88, p=0.03). In multivariate analysis using the Cox regression model, the Graft-to-Recipient Weight Ratio (GRWR) was independently associated with the incidence of C-D ≥ III complications (hazard ratio [HR] 0.62, 95%CI 0.40-0.95, p=0.03), but being an infant was not (HR 0.84, 95%CI 0.35-1.98, p=0.68). In conclusion, the incidence of C-D ≥ III complications was higher in the non-infant group than in the infant group, but this was largely a function of GRWR: multivariate analysis revealed that GRWR was independently associated with complications. |
| Keywords | pediatric liver transplantation postoperative severe complications Graft-to-Recipient Weight Ratio |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-08 |
| Volume | volume78 |
| Issue | issue4 |
| 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 Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 39198986 |
| Web of Science KeyUT | 001310576400003 |
| JaLCDOI | 10.18926/AMO/67547 |
|---|---|
| FullText URL | 78_4_313.pdf |
| Author | Eto, Eriko| Maki, Jota| Yamashita, Noriyuki| Hasegawa, Toru| Suemori, Ayano| Nakato, Hikari| Oba, Hikaru| Mitoma, Tomohiro| Mishima, Sakurako| Kirino, Satoe| Ohira, Akiko| Masuyama, Hisashi| |
| Abstract | During the coronavirus pandemic, face-to-face simulation education became impossible. Therefore, we aimed to develop remote-access simulation education with a sense of realism through Information and Communication Technology (ICT) using a perinatal whole-body management and delivery simulator. In September 2021, we administered a multi-center simultaneous remote simulation based on our developed model. Ten universities in the Chugoku–Shikoku region were connected via a web-conferencing system to a live broadcast of a virtual vaginal birth in which a fictional hospitalized pregnant woman experienced accelerated labor and gave birth through vacuum delivery for fetal distress. A Video on Demand (VOD) was made beforehand using a new simulator that allowed for a visual understanding of the process of the inter-vaginal examination. We provided a participatory program that enhanced the sense of realism by combining VOD and real-time lectures on each scenario, with two-way communication between participants and trainee doctors using a chat function. Most participants answered “satisfied” or “very satisfied” with the content, level of difficulty, and level of understanding. From November 2021, we have used the videos of all processes in face-to-face classes. Our construction of a high-flexibility education system using remote simulation in the field of obstetrics and gynecology, especially in the vaginal delivery module, is unique, creative, and sustainable. |
| Keywords | remote simulator education perinatal simulator information and communication technology high-flexibility education |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-08 |
| Volume | volume78 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 313 |
| End Page | 322 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 39198985 |
| Web of Science KeyUT | 001310576400002 |
| JaLCDOI | 10.18926/AMO/67546 |
|---|---|
| FullText URL | 78_4_307.pdf |
| Author | Sugihara, Naoya| Hashine, Katsuyoshi| Yamashita, Natsumi| Sakamoto, Miki| Terashita, Masato| Funaki, Keisuke| Saiki, Kaori| Sawada, Takatora| Kakuda, Toshio| Nishimura, Kenichi| Fukumoto, Tetsuya| Miura, Noriyosi| Miyauchi, Yuki| Kikugawa, Tadahiko| Saika, Takashi| |
| Abstract | The Briganti nomogram (cut-off value 5%) is commonly used to determine the indications for pelvic lymph node dissection (PLND) in patients with prostate cancer. We retrospectively analyzed the potential oncological benefit of PLND based on the 5% cut-off value on the Briganti nomogram. We obtained the data from the Medical Investigation Cancer Network (MICAN) Study, which included 3,463 patients who underwent a radical prostatectomy (RP) at nine institutions in Japan between 2010 and 2020. We included patients with Briganti scores ≥ 5% and a follow-up period ≥6 months and excluded patients categorized in the very high-risk group (based on NCCN categories); a final total of the cases of 1,068 patients were analyzed. The biochemical recurrence (BCR)-free survival was significantly worse in the patients who underwent PLND compared to those who did not (p=0.019). A multivariate analysis showed that high prostate-specific antigen (PSA) levels (p<0.001) and an advanced T-stage (p=0.018) were significant prognostic factors for BCR, whereas PLND had no effect on BCR (p=0.059). Thus, PLND in patients with prostate cancer whose Briganti score was 5% did not provide any oncological benefit. Further research is necessary to determine the indication criteria for conducting PLND. |
| Keywords | Briganti nomogram pelvic lymph node dissection prostate cancer radical prostatectomy |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-08 |
| Volume | volume78 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 307 |
| End Page | 312 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 39198984 |
| Web of Science KeyUT | 001310576400001 |
| JaLCDOI | 10.18926/AMO/67207 |
|---|---|
| FullText URL | 78_3_301.pdf |
| Author | Nakazaki, Kiyoshi| Hirai, Satoshi| Hishikawa, Tomohito| |
| Abstract | We report a case of a large vestibular schwannoma in an 80-year-old female patient that shrank after palliative Gamma Knife radiosurgery (GKS). Neurological symptoms included hearing deterioration and facial palsy. The tumor volume was 21.9 mL. Craniotomy was considered high-risk, and conventional GKS was risky, owing to the risk of transient enlargement. Therefore, GKS was performed on only a portion of the tumor. The marginal dose (12 Gy) volume was 3.8 mL (17.4%). The tumor began to shrink after transient enlargement. Sixty months later, the tumor volume was only 3.1 mL, and the patient was able to maintain independent activities of daily living without salvage treatment. |
| Keywords | vestibular schwannoma Gamma Knife radiosurgery large volume palliative elderly patient |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 301 |
| End Page | 306 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902220 |
| Web of Science KeyUT | 001267340600001 |
| JaLCDOI | 10.18926/AMO/67206 |
|---|---|
| FullText URL | 78_3_295.pdf |
| Author | Okamoto, Sara| Shiode, Yusuke| Kimura, Shuhei| Hosokawa, Mio| Matoba, Ryo| Kanzaki, Yuki| Kindo, Hiroya| Morita, Tetsuro| Tsuji, Akihiro| Takahashi, Kosuke| Morizane, Yuki| |
| Abstract | A Japanese woman in her 70s was referred to our hospital for the evaluation and treatment of high intraocular pressure (IOP) in her right eye. She had undergone bilateral cataract surgeries and the insertion of hydrophilic acrylic intraocular lenses (IOLs). We performed trabeculotomy and trabeculectomy to lower her right IOP; thereafter, a circular opacity was observed on the right eye’s IOL surface. We removed the right IOL because that eye’s vision had decreased due to IOL opacification. The analysis of the removed IOL revealed that the main opacity component was calcium phosphate. This is the first post-glaucoma-surgery IOL calcification case report. |
| Keywords | intraocular lens IOL IOL calcification hydrophilic acrylic IOL glaucoma surgery |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 295 |
| End Page | 300 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902219 |
| Web of Science KeyUT | 001267339400001 |
| JaLCDOI | 10.18926/AMO/67205 |
|---|---|
| FullText URL | 78_3_291.pdf |
| Author | Minagi, Hitoshi| Aoki, Hideki| Doita, Susumu| Miyake, Eiki| Ogawa, Toshihiro| Taniguchi, Fumitaka| Watanabe, Megumi| Arata, Takashi| Katsuda, Koh| Tanakaya, Kohji| |
| Abstract | In the clinical course of malignant melanoma, which can metastasize to multiple organs, gallbladder metastases are rarely detected. A 69-year-old man who underwent resection of a primary malignant melanoma was subsequently treated with nivolumab for lung metastases and achieved complete response. Seven years after surgery, multiple nodules were found in the gallbladder, and he underwent laparoscopic cholecystectomy. The postoperative diagnosis was metastases of malignant melanoma. He has been recurrence-free 8 months after surgery. If radical resection is possible, such surgery should be performed for gallbladder metastases found in patients with other controlled lesions of malignant melanoma. |
| Keywords | malignant melanoma gallbladder metastasis laparoscopic cholecystectomy |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 291 |
| End Page | 294 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902218 |
| Web of Science KeyUT | 001267351900003 |
| JaLCDOI | 10.18926/AMO/67204 |
|---|---|
| FullText URL | 78_3_285.pdf |
| Author | Hirano, Shuichiro| Otani, Yoshihiro| Fujii, Kentaro| Date, Isao| |
| Abstract | Organized chronic subdural hematoma (OCSDH) is a relatively rare condition that forms over a longer period of time compared to chronic subdural hematoma and is sometimes difficult to diagnose with preoperative imaging. We resected an intracranial lesion in a 37-year-old Japanese man; the lesion had been increasing in size for >17 years. The preoperative diagnosis based on imaging findings was meningioma; however, pathological findings revealed OCSDH. Clinicians should be aware that OCSDH mimics other tumors and consider surgical strategies for this disease. |
| Keywords | meningioma organized chronic subdural hematoma |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 285 |
| End Page | 290 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902217 |
| Web of Science KeyUT | 001267351900002 |
| JaLCDOI | 10.18926/AMO/67203 |
|---|---|
| FullText URL | 78_3_281.pdf |
| Author | Okada, Kazuhiro| Maki, Yuho| Matsubara, Kei| Hirano, Yutaka| Fujiwara, Toshiya| Matsuura, Motoki| |
| Abstract | A 24-year-old Japanese female with anorexia nervosa presented to our hospital for bilateral pneumothorax, and 12-Fr thoracostomy catheters were inserted into the bilateral pleural cavities. On hospital day 9, a thoracoscopic bullectomy was performed. However, air leakage relapsed on both sides on postoperative day 1. The air leakage on the right side was particularly persistent, and we switched the drainage to a Heimlich valve. Both lungs expanded gradually and the chest tube was removed on postoperative day 19. Passive pleural drainage might be an option for prolonged air leakage after a bullectomy in patients with anorexia nervosa. |
| Keywords | spontaneous pneumothorax anorexia nervosa Heimlich valve |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 281 |
| End Page | 284 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902216 |
| Web of Science KeyUT | 001267351900001 |
| JaLCDOI | 10.18926/AMO/67202 |
|---|---|
| FullText URL | 78_3_271.pdf |
| Author | Ye, Mengjiao| Zhang, Renwei| |
| Abstract | We investigated how humidified high-flow nasal cannula oxygen therapy (HFNC) with a pulmonary infection control (PIC) window as a ventilation switching indication in combination with atomizing inhalation of terbutaline affects the lung function of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We examined 140 hospitalized AECOPD patients randomized to control and observation groups. Conventional supportive therapy and invasive mechanical ventilation with tracheal intubation were conducted in both groups, with a PIC window as the indication for ventilation switching. Noninvasive positive pressure ventilation (NIPPV) plus atomizing inhalation of terbutaline was used in the control group. In the observation group, HFNC combined with atomizing inhalation of terbutaline was used. Compared to the control group, after 48-hr treatment and treatment completion, the observation group had significantly increased levels of lung function indicators (maximal voluntary ventilation [MVV] plus forced vital capacity [FVC], p<0.05) and oxygen metabolism indicators (arterial oxygen partial pressure [PaO2], arterial oxygen content [CaO2], and oxygenation index, p<0.05). The comparison of the groups revealed that the levels of airway remodeling indicators (matrix metalloproteinase-2 [MMP-2], tissue inhibitor of metalloproteinase 2 [TIMP-2] plus MMP-9) and inflammatory indicators (interferon gamma [IFN-γ] together with interleukin-17 [IL-17], IL-10 and IL-4) were significantly lower after 48 h of treatment as well as after treatment completion (both p<0.05). These results demonstrate that HFNC with a PIC window as the indication for ventilation switching combined with atomizing inhalation of terbutaline can relieve the disorder of oxygen metabolism and correct airway hyper-reactivity. |
| Keywords | chronic obstructive pulmonary disease inhalation oxygen therapy pulmonary function ventilation |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 271 |
| End Page | 279 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902215 |
| Web of Science KeyUT | 001267351000008 |
| JaLCDOI | 10.18926/AMO/67201 |
|---|---|
| FullText URL | 78_3_259.pdf |
| Author | Vural, Gonul| Demir, Esra| Gumusyayla, Sadiye| Eren, Funda| Barakli, Serdar| Neselioglu, Salim| Erel, Ozcan| |
| Abstract | The aim of this study is to investigate the relationship of the lipid profile, dysfunctional high-density lipoprotein, ischaemia-modified albumin and thiol–disulfide homeostasis with cognitive impairment, fatigue and sleep disorders in patients with multiple sclerosis. The cognitive functions of patients were evaluated with the Brief International Cognitive Assessment for Multiple Sclerosis battery. Fatigue was evaluated with the Fatigue Severity Scale and the Fatigue Impact Scale. The Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale were used to assess patients’ sleep disturbance. Peripheral blood samples were collected, and lipid levels and myeloperoxidase and paraoxonase activity were measured. The myeloperoxidase/paraoxonase ratio, which indicates dysfunctional high-density lipoprotein, was calculated. Thiol–disulfide homeostasis and ischaemia-modified albumin were measured. We did not identify any relationship between dysfunctional high-density lipoprotein and the physical disability, cognitive decline, fatigue and sleep problems of multiple sclerosis. Thiol–disulfide homeostasis was associated with cognitive scores. The shift of the balance towards disulfide was accompanied by a decrease in cognitive scores. On the other hand, we did not detect any relationship between fatigue and sleep disorders and thiol–disulfide homeostasis. Our findings revealed a possible correlation between cognitive dysfunction and thiol–disulfide homeostasis in multiple sclerosis patients. |
| Keywords | multiple sclerosis dysfunctional HDL thiol–disulfide homeostasis cognitive decline |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 259 |
| End Page | 270 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902214 |
| Web of Science KeyUT | 001267351000007 |
| JaLCDOI | 10.18926/AMO/67200 |
|---|---|
| FullText URL | 78_3_251.pdf |
| Author | Murofushi, Koji| Mitomo, Sho| Hirohata, Kenji| Furuya, Hidetaka| Katagiri, Hiroki| Kaneoka, Koji| Yagishita, Kazuyoshi| |
| Abstract | There have been few investigations into the effectiveness of thoracic spine exercises for improving thoracic range of motion (ROM) in any plane. This study assessed the effectiveness of two thoracic spine exercises: one in the quadruped position and one in the thoracic standing position. We determined how these exercises affect thoracic spine mobility ROM over a 2-week intervention period. Thirty-nine healthy participants were enrolled and assigned to a Quadruped Thoracic Rotation group (n=17 participants: 9 females and 8 males) or Flamenco Thoracic Spine Rotation group (n=22: 14 females and 8 males). All participants were administered a KOJI AWARENESSTM screening test, and the initial thoracic spine ROM before intervention exercise was measured in a laboratory setting. Quadruped Thoracic Rotation was performed as the quadruped exercise and Flamenco Thoracic Spine Rotation as the standing exercise. The KOJI AWARENESSTM thoracic spine test and ROM were evaluated on the day after the first exercise session and again after the program. Despite their different approaches to thoracic mobility, the quadruped exercise and standing exercise achieved equivalent improvement in thoracic ROM after 2 weeks. Practitioners have a range of exercise options for enhancing thoracic mobility based on their environmental or task-specific needs. |
| Keywords | thoracic spine thoracic rotation range of motion exercise intervention |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 251 |
| End Page | 258 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902213 |
| Web of Science KeyUT | 001267351000006 |
| JaLCDOI | 10.18926/AMO/67199 |
|---|---|
| FullText URL | 78_3_245.pdf |
| Author | Akagawa, Manabu| Saito, Hidetomo| Takahashi, Yasuhiro| Iwamoto, Yosuke| Iida, Junpei| Yoshikawa, Takayuki| Abe, Toshiki| Saito, Kimio| Kijima, Hiroaki| Kasukawa, Yuji| Hongo, Michio| Miyakoshi, Naohisa| |
| Abstract | Although several studies have suggested a possible association between sarcopenia and knee osteoarthritis (OA) in the elderly, there remains no definitive evidence. Recently, however, the serum creatinine/cystatin C ratio (sarcopenia index: SI) was reported to correlate with skeletal muscle mass. The present retrospective study therefore investigated the impact of reduced skeletal muscle mass on advanced knee OA using SI. In 55 individuals scheduled for knee osteotomy or knee arthroplasty, correlations between SI and patient-reported outcomes such as the Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Oxford Knee Score (OKS) were explored. Significant associations were found between SI and the KSS functional activity score (β=0.37; p=0.022), KOOS subscale for activities of daily living (β=0.42; p=0.0096), and OKS (β=0.42; p=0.0095). This study underscores the role of reduced muscle mass in functional outcomes and introduces SI as a valuable marker for assessing muscle loss in knee OA patients. |
| Keywords | knee osteoarthritis sarcopenia index reduced muscle mass activities of daily living functional activity |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 245 |
| End Page | 250 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902212 |
| Web of Science KeyUT | 001267351000005 |
| JaLCDOI | 10.18926/AMO/67198 |
|---|---|
| FullText URL | 78_3_237.pdf |
| Author | Muraoka, Osamu| Imai, Norio| Kuraishi, Tatsuya| Imai, Makoto| Fukuhara, Takashi| Yoshimine, Toshifumi| |
| Abstract | Fracture liaison services (FLS) have been introduced in Japan and several other countries to reduce medical complications and secondary fractures. We aimed to evaluate the effects of the implementation of an FLS approach on patient outcomes during hospitalization at our hospital and over a 2-year follow-up post-injury. This retrospective cohort study included patients ≥ 60 years admitted to our hospital for hip fragility fractures between October 1, 2016, and July 31, 2020. Patient groups were defined as those treated before (control group, n=238) and after (FLS group, n=196) establishment of the FLS protocol at our institution. The two groups were compared in terms of time to surgery, length of hospital stay, and the incidence of complications after admission, including secondary hip fracture and mortality rates. The follow-up period was 24 months. FLS focuses on early surgery within 48 h of injury and assessing osteoporosis treatment before injury to guide post-discharge anti-osteoporosis medication. FLS reduced the length of hospital stay (p<0.001) and the prevalence of complications after admission (p<0.001), particularly cardiovascular disease, and it increased adherence to anti-osteoporosis medication. These FLS effects resulted in lower secondary hip fracture and mortality rates at 12 and 24 months post-injury. FLS for fragility hip fractures can improve patient outcomes during hospitalization and over a 2-year follow-up period. |
| Keywords | fracture liaison services complications after admission secondary hip fracture mortality |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 237 |
| End Page | 243 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902211 |
| Web of Science KeyUT | 001267351000004 |
| JaLCDOI | 10.18926/AMO/67197 |
|---|---|
| FullText URL | 78_3_227.pdf |
| Author | Wada, Yudai| Ushio, Soichiro| Kitamura, Yoshihisa| Zamami, Yoshito| Sendo, Toshiaki| |
| Abstract | Zolpidem, a non-benzodiazepine hypnotic, is primarily used to treat insomnia. In a previous study, pior treatment with non-benzodiazepine receptor agonists was associated with inflammation. The present study aimed to clarify the association between the effects of zolpidem and inflammation in mice treated with lipopolysaccharide (LPS), a known model of inflammation. We assessed the zolpidem-induced loss of righting reflex (LORR) duration 24 h after LPS treatment in mice. Additionally, the expressions of γ-aminobutyric acid (GABA)A receptor subunit and K+-Cl− cotransporter isoform 2 (KCC2) mRNA in the hippocampus and frontal cortex were examined in LPS-treated mice. Pretreatment with LPS was associated with significantly prolonged duration of zolpidem-induced LORR compared to control mice. This effect was significantly attenuated by administering bicuculline, a GABAA receptor antagonist, or flumazenil, a benzodiazepine receptor antagonist, in LPS-treated mice. Compared to controls, LPS-treated mice showed no significant change in the expression of GABAA receptor subunits in the hippocampus or frontal cortex. Bumetanide, an Na+-K+-2Cl− cotransporter isoform 1 blocker, attenuated the extended duration of zolpidem-induced LORR observed in LPS-treated mice. LPS significantly decreased Kcc2 mRNA expression in the hippocampus and the frontal cortex. These findings suggest that inflammation increases zolpidem-induced LORR, possibly through a reduction in KCC2 expression. |
| Keywords | lipopolysaccharide zolpidem GABAA receptor K+-Cl− cotransporters |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 227 |
| End Page | 235 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902210 |
| Web of Science KeyUT | 001267351000003 |
| JaLCDOI | 10.18926/AMO/67196 |
|---|---|
| FullText URL | 78_3_215.pdf |
| Author | Akagawa, Takuya| Fukui, Ryohei| Kida, Katsuhiro| Matsuura, Ryutaro| Shimada, Makoto| Kinoshita, Mitsuhiro| Akagawa, Yoko| Goto, Sachiko| |
| Abstract | We propose a sitting position that achieves both high image quality and a reduced radiation dose in elbow joint imaging by area detector computed tomography (ADCT), and we compared it with the ‘superman’ and supine positions. The volumetric CT dose index (CTDIvol) for the sitting, superman, and supine positions were 2.7, 8.0, and 20.0 mGy and the dose length products (DLPs) were 43.4, 204.7, and 584.8 mGy • cm, respectively. In the task-based transfer function (TTF), the highest value was obtained for the sitting position in both bone and soft tissue images. The noise power spectrum (NPS) of bone images showed that the superman position had the lowest value up to approx. 1.1 cycles/mm or lower, whereas the sitting position had the lowest value when the NPS was greater than approx. 1.1 cycles/mm. The overall image quality in an observer study resulted in the following median Likert scores for Readers 1 and 2: 5.0 and 5.0 for the sitting position, 4.0 and 3.5 for the superman position, and 4.0 and 2.0 for the supine position. These results indicate that our proposed sitting position with ADCT of the elbow joint can provide superior image quality and allow lower radiation doses compared to the superman and supine positions. |
| Keywords | area detector computed tomography elbow joint sitting position dose reduction image quality assessment |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 215 |
| End Page | 225 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902209 |
| Web of Science KeyUT | 001267351000002 |
| JaLCDOI | 10.18926/AMO/67195 |
|---|---|
| FullText URL | 78_3_205.pdf |
| Author | Hagiya, Hideharu| |
| Abstract | The global pandemic of COVID-19 has underscored the significance of establishing and sustaining a practical and efficient infection control system for the benefit and welfare of society. Infectious disease (ID) specialists are expected to take on leadership roles in enhancing organizational infrastructures for infection prevention and control (IPC) at the hospital, community, and national levels. However, due to an absolute shortage and an uneven distribution, many core hospitals currently lack the ID specialists. Given the escalating global risk of emerging and re-emerging infectious diseases as well as antimicrobial resistance pathogens, the education and training of ID specialists constitutes an imperative concern. As demonstrated by historical changes in the healthcare reimbursement system, the establishment and enhancement of IPC measures is pivotal to ensuring medical safety. The existing structure of academic society-driven certification and training initiatives for ID specialists, contingent upon the discretionary decisions of individual physicians, possesses both quantitative and qualitative shortcomings. In this article, I first address the present situations and challenges related to ID specialists and then introduce my idea of securing ID specialists based on the new concepts and platforms; (i) ID Specialists as National Credentials, (ii) Establishment of the Department of Infectious Diseases in Medical and Graduate Schools, (iii) Endowed ID Educative Courses Funded by Local Government and Pharmaceutical Companies, and (iv) Recruitment of Young Physicians Engaged in Healthcare Services in Remote Areas. As clarified by the COVID-19 pandemic, ID specialists play a crucial role in safeguarding public health. Hopefully, this article will advance the discussion and organizational reform for the education and training of ID specialists. |
| Keywords | antimicrobial resistance emerging infectious diseases infection prevention and control medical education silent pandemic |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-06 |
| Volume | volume78 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 205 |
| End Page | 213 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38902208 |
| Web of Science KeyUT | 001267351000001 |
| JaLCDOI | 10.18926/AMO/66931 |
|---|---|
| FullText URL | 78_2_201.pdf |
| Author | Masunaga, Akari| Tabuchi, Motoyasu| Sakamoto, Shinya| Yoshimatsu, Rika| Matsumoto, Manabu| Iwata, Jun| Okabayashi, Takehiro| |
| Abstract | Trousseau syndrome is characterized by cancer-associated systemic thrombosis. We describe the first case of a successfully treated gallbladder adenocarcinoma accompanied by Trousseau syndrome. A 66-year-old woman presented with right hemiplegia. Magnetic resonance imaging identified multiple cerebral infarctions. Her serum carbohydrate antigen 19-9 and D-dimer levels were markedly elevated, and a gallbladder tumor was detected via abdominal computed tomography. Venous ultrasonography of the lower limbs revealed a deep venous thrombus in the right peroneal vein. These findings suggested that the brain infarctions were likely caused by Trousseau syndrome associated with her gallbladder cancer. Radical resection of the gallbladder tumor was performed. The resected gallbladder was filled with mucus and was pathologically diagnosed as an adenocarcinoma. Her postoperative course was uneventful, and she received a one-year course of adjuvant therapy with oral S-1. No cancer recurrence or thrombosis was noted 26 months postoperatively. Despite concurrent Trousseau syndrome, a radical cure of the primary tumor and thrombosis could be achieved with the appropriate treatment. |
| Keywords | gallbladder cancer Trousseau syndrome radical surgery |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-04 |
| Volume | volume78 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 201 |
| End Page | 204 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38688839 |
| Web of Science KeyUT | 001227932200001 |
| JaLCDOI | 10.18926/AMO/66930 |
|---|---|
| FullText URL | 78_2_197.pdf |
| Author | Teraishi, Fuminori| Matsumi, Yuki| Tachibana, Kota| Watanabe, Toshiyuki| Fujiwara, Toshiyoshi| |
| Abstract | A 90-year-old Japanese woman who had been aware of a subcutaneous mass on the right perineal region for 5 years was referred to our hospital for further examination and treatment because of the rapid growth of the mass and bleeding that began 3 months earlier. A biopsy of the mass revealed a diagnosis of well-differentiated squamous cell carcinoma. On preoperative examination, the tumor was 90×40 mm in size and was suspected to have partially invaded the levator ani muscle and external sphincter. Since a preoperative cardiac evaluation indicated severe aortic stenosis, we performed transcatheter aortic valve implantation. A radical resection was then performed with general anesthesia. The skin and subcutaneous tissue defects were reconstructed with a posterior gluteal-thigh propeller flap, and a sigmoid colostomy was created. The patient had a good postoperative course and was transferred to a rehabilitation facility 28 days after the surgery. Epidermal cysts are a common benign tumor, and clinicians should keep in mind that these cysts can become malignant. |
| Keywords | squamous cell carcinoma epidermoid cyst gluteal thigh flap |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-04 |
| Volume | volume78 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 197 |
| End Page | 200 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38688838 |
| Web of Science KeyUT | 001227932200004 |
| JaLCDOI | 10.18926/AMO/66928 |
|---|---|
| FullText URL | 78_2_193.pdf |
| Author | Kashima, Hajime| Teraishi, Fuminori| Matsumi, Yuki| Shimamura, Hiroshi| Fujiwara, Toshiyoshi| |
| Abstract | Tailgut cyst is a rare cystic disease of the anterior sacral surface and the remains of an embryonic tail gut. Tailgut cysts have a potential for malignancy, and complete resection with an adequate surgical margin is necessary. Even if incomplete resection does not result in recurrence of malignant disease, there is a risk of local infection leading to refractory fistulas. The optimal treatment for such refractory recurrent lesions has not been reported. We describe a case in which the combination of laparoscopic and transsacral approaches was effective for resecting a recurrent refractory fistula after incomplete resection of a tail gut cyst. |
| Keywords | tailgut cyst laparoscopic resection fistula formation |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-04 |
| Volume | volume78 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 193 |
| End Page | 196 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 38688837 |
| Web of Science KeyUT | 001227932200003 |
