result 3875 件
| 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/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/65741 |
|---|---|
| FullText URL | 77_4_359.pdf |
| Author | Koshida, Tomohiro| Maruta, Toyoaki| Tanaka, Nobuhiko| Hidaka, Kotaro| Kurogi, Mio| Nemoto, Takayuki| Yanagita, Toshihiko| Takeya, Ryu| Tsuneyoshi, Isao| |
| Abstract | Pulsed radiofrequency (PRF) is a safe method of treating neuropathic pain by generating intermittent electric fields at the needle tip. Resiniferatoxin (RTX) is an ultrapotent agonist of transient receptor potential vanilloid subtype-1 (TRPV1) receptors. We investigated the mechanism of PRF using a rat model of RTX-induced neuropathic pain. After administering RTX intraperitoneally, PRF was applied to the right sciatic nerve. We observed the changes in TRPV1, calcitonin gene-related peptide (CGRP), and brain-derived neurotrophic factor (BDNF) in the dorsal root ganglia by western blotting. Expressions of TRPV1 and CGRP were significantly lower in the contralateral (RTX-treated, PRF-untreated) tissue than in control rats (p<0.0001 and p<0.0001, respectively) and the ipsilateral tissues (p<0.0001 and p<0.0001, respectively). BDNF levels were significantly higher in the contralateral tissues than in the control rats (p<0.0001) and the ipsilateral tissues (p<0.0001). These results suggest that, while TRPV1 and CGRP are decreased by RTX-induced neuronal damage, increased BDNF levels result in pain development. PRF may promote recovery from neuronal damage with concomitant restoration of TRPV1 and CGRP, and exert its analgesic effect by reversing BDNF increase. Further research is required to understand the role of TRPV1 and CGRP restoration in improving mechanical allodynia. |
| Keywords | pulsed radiofrequency resiniferatoxin transient receptor potential vanilloid subtype-1 (TRPV1) calcitonin gene-related peptide (CGRP) brain-derived neurotrophic factor (BDNF) |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-08 |
| Volume | volume77 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 359 |
| End Page | 364 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37635135 |
| Web of Science KeyUT | 001163659800011 |
| JaLCDOI | 10.18926/AMO/65740 |
|---|---|
| FullText URL | 77_4_347.pdf |
| Author | Iwamuro, Masaya| Kondo, Takumi| Ennishi, Daisuke| Fujii, Nobuharu| Matsuoka, Ken-ichi| Takahashi, Takahide| Hirabata, Araki| Tanaka, Takehiro| Otsuka, Fumio| Maeda, Yoshinobu| Okada, Hiroyuki| |
| Abstract | The feasibility of lymphocyte isolation and flow cytometry using a single endoscopic biopsy specimen from the gastrointestinal tract of patients who have undergone hematopoietic stem cell transplantation has not been investigated. We acquired 51 endoscopic biopsy specimens from the gastrointestinal tract of 35 patients. We divided the flow cytometry samples into two groups: group A, successful lymphocyte isolation (n=24), and group B, incomplete isolation (n=27). We compared the backgrounds of the samples between the groups to reveal crucial elements in the successful isolation of lymphocytes residing in the gastrointestinal tract. Comparison between the groups revealed lymphocyte isolation success rates differed between biopsy sites. Isolation was most successful in samples from the duodenum (8/9, 88.9%), followed by the ileum (4/8, 50.0%), large intestine (4/11, 36.4%), and stomach (8/23, 34.8%). Tacrolimus was used more frequently in group B (92.6%) than in group A (62.5%) (p=0.015). Logistic regression analysis revealed that isolation from the duodenum or ileum was a significant factor for successful isolation, while tacrolimus use was not statistically significant. In conclusion, the duodenum and ileum are more suitable sites than the stomach and colorectum for acquiring samples for flow cytometry. |
| Keywords | flow cytometry stem cell transplantation transplantation-associated microangiopathy |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-08 |
| Volume | volume77 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 347 |
| End Page | 357 |
| 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 | 37635134 |
| Web of Science KeyUT | 001163659800002 |
| JaLCDOI | 10.18926/AMO/65739 |
|---|---|
| FullText URL | 77_4_341.pdf |
| Author | Otsuka, Motoyuki| |
| Abstract | Hepatitis B virus is a pathogenic virus that infects 300 million people worldwide and causes chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Hepatitis B virus encodes four proteins. Among them, the HBx protein plays a central role in the HBV pathogenesis. Because the HBx protein is considered to play a central role in the induction of viral replication and hepatocarcinogenesis, the regulation of its function could be a key factor in the development of new interventions against hepatitis B. In this review, HBx protein-related viral replication and hepatocarcinogenesis mechanisms are described, with a focus on the recently reported viral replication mechanisms related to degradation of the Smc5/6 protein complex. We also discuss our recent discovery of a compound that inhibits HBx protein-induced degradation of the Smc5/6 protein complex, and that exerts inhibitory effects on both viral replication and hepatocarcinogenesis. Finally, prospects for future research on the HBx protein are described. |
| Keywords | HBx Smc5/6 DDB1 nitazoxianide DNA repair |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-08 |
| Volume | volume77 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 341 |
| End Page | 345 |
| 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 | 37635133 |
| Web of Science KeyUT | 001163659800007 |
| 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 |
| 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 |
| FullText URL | 77_2_233.pdf |
|---|---|
| Amo Type | Erratum |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-04 |
| Volume | volume77 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 233 |
| End Page | 233 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Others |
| language | English |
| Copyright Holders | Copyright Ⓒ 2023 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 37094964 |
| Web of Science KeyUT | 000982563800001 |
| JaLCDOI | 10.18926/AMO/65155 |
|---|---|
| FullText URL | 77_2_227.pdf |
| Author | Obayashi, Atsuto| Aoki, Kazuma| Wada, Tadayoshi| Furuie, Hiromi | Kuraoka, Kazuya| Hamamoto, Takao| Tatsukawa, Takaharu| |
| Abstract | We describe the use of the tyrosine kinase inhibitor lenvatinib in a patient with brain tumor metastases from anaplastic thyroid carcinoma (ATC). A 52-year-old Japanese male presented with consciousness loss. Imaging revealed a thyroid tumor and multiple brain lesions. After the brain tumor’s resection, pathology results provided the diagnosis of ATC. Total thyroidectomy was performed, followed by whole-brain irradiation. Additional brain lesions later developed, and lenvatinib therapy was initiated with no remarkable complications. However, the treatment effects were limited, and the patient died 2 months after starting lenvatinib, 202 days after the initial brain surgery. Relevant literature is discussed. |
| Keywords | anaplastic thyroid carcinoma brain metastasis lenvatinib |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2023-04 |
| Volume | volume77 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 227 |
| End Page | 232 |
| 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 | 37094963 |
| Web of Science KeyUT | 000982563800006 |
