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JaLCDOI 10.18926/AMO/63405
FullText URL 76_2_121.pdf
Author Okazaki, Yuki| Furumatsu, Takayuki| Hiranaka, Takaaki| Kamatsuki, Yusuke| Nakata, Eiji| Tetsunaga, Tomonori| Yamane, Kentaro| Ozaki, Toshifumi|
Abstract Bone marrow edema (BME) after meniscus injury and risk factors for subchondral insufficiency fracture of the knee (SIFK) have been reported. However, their association with medial meniscus posterior root tear (MMPRT) remains unknown. We investigated the association of BME volume (BME-V), posterior shinycorner lesion (PSCL), and SIFK with MMPRT to examine the correlations between BME-V and medial meniscus extrusion (MME), PSCL and duration from injury to the time of magnetic resonance imaging (duration), and SIFK and duration. Twenty-nine patients who underwent surgery for MMPRT were included (mean age, 59.2; range, 39-84). The presence of PSCL, femoral BME-V (cm3), and SIFK grade (1-4) were evaluated. Preoperative factors, such as MME (mm) and duration (weeks), were investigated using multivariate linear/ logistic regression analyses. Multivariate linear regression analysis revealed duration as a significant factor for high-grade SIFK (p<0.01). Multivariate logistic regression analysis revealed duration as a significant factor for the presence of PSCL (odds ratio=0.94, p<0.05). A long duration of MMPRT leads to severe MME and highgrade SIFK (3 and 4), often resulting in knee arthroplasty. Early diagnosis of MMPRT and pullout repair can prevent severe MME and high-grade SIFK.
Keywords medial meniscus posterior root tear subchondral insufficiency fracture bone marrow edema meniscus extrusion
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2022-04
Volume volume76
Issue issue2
Publisher Okayama University Medical School
Start Page 121
End Page 127
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2022 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35503439
Web of Science KeyUT 000792374900003
JaLCDOI 10.18926/AMO/63403
FullText URL 76_2_105.pdf
Author Takaoka, Megumi| Ohsumi, Shozo| Ikejiri, Haruka| Shidahara, Tomohiro| Miyoshi, Yuichiro| Takahashi, Mina| Takashima, Seiki| Aogi, Kenjiro|
Abstract Cases of breast cancer metastasis after achieving a pathological complete response (pCR) with neoadjuvant chemotherapy (NAC) are sometimes encountered in clinical practice. We investigated the prognostic factors for pCR in patients with breast cancer after NAC. This retrospective cohort study included patients with localized breast cancer who underwent NAC followed by surgery between 2004 and 2020 and achieved a pCR. The associations between clinical factors and distant metastasis-free survival rate were statistically analyzed. We analyzed data for 127 patients. Twelve patients (9.4%) had distant metastases, and seven (5.5%) died. For estrogen receptor (ER)-positive patients, the distant metastasis-free survival rate was 94.6% for both 5 and 8 years. In contrast, ER-negative patients had a distant metastasis-free survival rate of 87.6% and 85.4% for 5 and 8 years (p=0.094), respectively. In cT0-2 patients, the distant metastasis-free survival rate was 92.4% for 5 years and 90.5% for 8 years, whereas in cT3-4 patients, the distant metastasis-free survival rate was 83.5% for 5 years and 83.5% for 8 years (p=0.301). This study suggested that patients with ER-negative, pre-NAC cT3 or T4 breast cancer who had achieved a pCR after NAC tended to have a worse prognosis.
Keywords breast carcinoma neoadjuvant therapy prognosis
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2022-04
Volume volume76
Issue issue2
Publisher Okayama University Medical School
Start Page 105
End Page 111
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2022 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35503437
Web of Science KeyUT 000792374900001
JaLCDOI 10.18926/63356
FullText URL biess_6_166_174.pdf
Author Kim, Dong Kwang| Leihy, Peodair| Teo, Ian| Freeman, Brigid|
Abstract Japan's National Universities are now subject to "corporate" structures that, by recognizing the universities as legal persons and not simply parts of the state apparatus, aim to more closely follow models in many Western countries. The COVID-19 pandemic has disrupted their development of more proactive institutional plans and indeed institutional identities. This study traces and explains vocabulary associated with current challenges for universities around the world, and argues that the broad concept of sustainability is a central theme around which a university may build and sustain an enduring self-image.
Keywords post-coronial post-colonial Japanese National Universities corporatization identity sustainability
Publication Title Bulletin of Institute for Education and Student Services, Okayama University
Published Date 2021-12-30
Volume volume6
Start Page 166
End Page 174
ISSN 2432-9665
language English
File Version publisher
JaLCDOI 10.18926/AMO/63219
FullText URL 76_1_99.pdf
Author Naito, Yoichiro| Yoshikawa, Masaki| Nakamura, Kazufumi| Kubo, Motoki| Sugiyama, Hiroyasu| Suzuki, Hideyuki| Fujita, Shinpei| Arai, Yasunori| Takahashi, Sho| Kato, Yuichi| Yoshida, Yu| Akai, Hiroaki| Murakami, Shuhei| Ito, Hiroshi|
Abstract Rapidly progressive in-stent restenosis (ISR) after stent deployment from the left main trunk (LMT) to the left anterior descending artery (LAD) without plaque at the LMT ostium has not been reported. A 60-year-old Japanese man with a history of scleroderma, pulmonary fibrosis, and type 2 diabetes developed acute myocardial infarction of the right coronary artery (RCA) and was treated by emergency percutaneous coronary intervention (PCI) for RCA. Nine days later he underwent PCI from the LMT to the LAD. Follow-up coronary angiography (CAG) at 9 and 21 months post-PCI did not reveal ISR in any lesion, but the patient experienced cardiac arrest at 25 months post-PCI. Emergency CAG after resuscitation revealed ISR of the LMT ostium; emergency PCI was conducted. The development of ISR at the ostium of the LMT although the patient was free of plaque 4 months before is extremely unusual. This rare ISR of the LMT ostium progressed rapidly after follow-up CAG revealed no ISR at 21 months post-stent implantation.
Keywords left main trunk in-stent restenosis cardiopulmonary arrest
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2022-02
Volume volume76
Issue issue1
Publisher Okayama University Medical School
Start Page 99
End Page 104
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2022 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35237006
Web of Science KeyUT 000762933000003
JaLCDOI 10.18926/AMO/63218
FullText URL 76_1_93.pdf
Author Ishi, Yukitomo| Yamaguchi, Shigeru| Hatanaka, Kanako C.| Takakuwa, Emi| Motegi, Hiroaki| Honda, Taishi| Kobayashi, Hiroyuki| Terasaka, Shunsuke| Homma, Akihiro| Fujimura, Miki| Houkin, Kiyohiro|
Abstract A 66-year-old man underwent multimodal treatment for olfactory neuroblastoma (ONB). When he was 72 years old, a cystic intracranial lesion without accumulation on fluorine-18-fluorodeoxyglucose positron emission tomography was detected. Surgical resection was performed when the patient was 73 years old. The pathological examination revealed recurrence of ONB, and the patient underwent focal irradiation. At age 81, he presented with a second recurrence in the right occipital lobe with radiological and pathological findings similar to the prior recurrence. This case suggests that pathological confirmation should be considered in cases with atypical radiological findings following the treatment of ONB.
Keywords cystic recurrence esthesioneuroblastoma fluorine-18-fluorodeoxyglucose positron emission tomography intracranial recurrence olfactory neuroblastoma
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2022-02
Volume volume76
Issue issue1
Publisher Okayama University Medical School
Start Page 93
End Page 98
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2022 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35237005
Web of Science KeyUT 000762933000002
JaLCDOI 10.18926/AMO/63217
FullText URL 76_1_89.pdf
Author Ryuko, Tsuyoshi| Yamamoto, Hiromasa| Sugimoto, Seiichiro| Suzawa, Ken| Miyoshi, Kentaroh| Otani, Shinji| Okazaki, Mikio| Yamane, Masaomi| Toyooka, Shinichi|
Abstract Congenital lobar emphysema (CLE) is defined as the hyperinflation of pulmonary lobes due to obstruction of the flow of air via a known or unknown etiology, which causes pressure symptoms in the adjacent organs. CLE is mainly diagnosed in the neonatal period, and very few adult cases have been reported. Here we report a 34-year-old male with muscular dystrophy who was diagnosed with CLE on examination. He underwent a right lower lobectomy via 3-portal completely video-assisted thoracoscopic surgery, and his symptoms improved. Thoracoscopic surgery helped preserve the respiratory muscles and led to the improvement of respiratory function in this patient.
Keywords congenital lobar emphysema, adult, lobectomy, completely video-assisted thoracoscopic surgery, muscular dystrophy
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2022-02
Volume volume76
Issue issue1
Publisher Okayama University Medical School
Start Page 89
End Page 92
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2022 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35237004
Web of Science KeyUT 000762933000001
JaLCDOI 10.18926/AMO/63216
FullText URL 76_1_85.pdf
Author Omi, Hirotsugu| Tomita, Takashi| Ichinohe, Masayuki| Harada, Yoshifumi| Sato, Hideki| Ito, Junji|
Abstract A 75-year-old woman underwent L4-L5 lateral interbody fusion for L4-5 foraminal stenosis with the use of percutaneous pedicle screws. On the day after the surgery, she was in shock. Emergency contrast-enhanced CT showed active extravasation from the 4th lumbar artery with a transverse process fracture. A radiologist performed a successful transarterial embolization, and the patient then began walking training on the 4th day post-surgery. Close attention should be paid to the insertion of a percutaneous pedicle screw, as it may cause a lumbar artery injury; in such a case, transarterial embolization is the preferred treatment.
Keywords lumbar artery injury percutaneous pedicle screw transverse process fracture hematoma
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2022-02
Volume volume76
Issue issue1
Publisher Okayama University Medical School
Start Page 85
End Page 88
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2022 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35237003
Web of Science KeyUT 000762803800003
JaLCDOI 10.18926/AMO/63215
FullText URL 76_1_79.pdf
Author Tokumoto, Kana| Mino, Takuya| Kurosaki, Yoko| Izumi, Koji| Maekawa, Kenji| Nakano, Tomohito| Sejima, Junichi| Ueda, Akihiro| Kimura-Ono, Aya| Hyung Kim, Tae| Kuboki, Takuo|
Abstract We introduce a new digital workflow to fabricate a fixed partial denture (FPD) utilizing the three-dimensional surface morphology of provisional restoration (PR) and abutment teeth. Scanned images of the full maxilla with abutment teeth, full maxilla with PR, and PR alone were superimposed. The surfaces of the final FPD were designed based on the entire morphology of the PR and abutment teeth surfaces. The inner and outer surfaces converged at the margin lines of the abutment teeth. Fine modifications to the final FPD design were performed manually, and the final FPD was fabricated and successfully installed in the patient.
Keywords prosthodontics computer-aided design digital dentistry fixed partial denture dental restoration
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2022-02
Volume volume76
Issue issue1
Publisher Okayama University Medical School
Start Page 79
End Page 84
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2021 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35237002
Web of Science KeyUT 000762803800002
JaLCDOI 10.18926/AMO/63213
FullText URL 76_1_63.pdf
Author Zhang, Bei| Pei, Zhixin| Wang, Hongxia| Wu, Huimin| Wang, Junjie| Bai, Junjun| Song, Qinglin|
Abstract We analyzed the treatment effects of chidamide and decitabine in combination with a HAG (homoharringtonine, cytarabine, G-CSF) priming regimen (CDHAG) in acute myeloid leukemia (AML) patients with TP53 mutation. Seven TP53 mutated AML patients were treated with CDHAG. The treatment effects were assessed using hemogram detection and bone marrow aspirate. The possible side effects were evaluated based on both hematological and non-hematological toxicity. Four of the seven patients were classified as having achieved complete remission after CDHAG treatment; one patient was considered to have achieved partial remission, and the remaining two patients were considered in non-remission. The overall response rate (ORR) to CDHAG was 71.4%. Regarding the side effects, the hematological toxicity level of the seven patients ranged from level III to level IV, and infections that occurred at lung, blood, and skin were recorded. Nausea, vomiting, liver injury, and kidney injury were also detected. However, all side effects were attenuated by proper management. The CDHAG regimen clearly improved the ORR (71.4%) of TP53-mutated AML patients, with no severe side effects.
Keywords acute myeloid leukemia chidamide decitabine HAG TP53 mutation
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2022-02
Volume volume76
Issue issue1
Publisher Okayama University Medical School
Start Page 63
End Page 70
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2022 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35237000
Web of Science KeyUT 000762812700009
JaLCDOI 10.18926/AMO/63206
FullText URL 76_1_33.pdf
Author Zhou, Jia-Yi| Hou, Hai-Tao| Wang, Shi-Fu| Yang, Qin| He, Guo-Wei|
Abstract Trace elements selenium (Se) and cobalt (Co) are essential in the human body, and a correlation between Se and cardiac surgery has been suggested. We investigated the plasma concentrations of Se and Co during and after coronary artery bypass grafting (CABG) surgery under cardiopulmonary bypass (CPB). From December 2019 to January 2020, preoperative plasma samples from isolated first-time CABG patients (n=20; 10 males, 10 females) were prospectively collected post-anesthesia and before CPB (T1), 45 min after CPB started (T2), 90 min after CPB started (T3), and postoperative days 1 (T4), and day 4 (T5). The plasma concentrations of Se and Co were measured. The Se concentration was significantly decreased at T2 (105.24±4.08 vs. 68.56±2.42 μg/L, p<0.001) and T3 (105.24±4.08 vs. 80.41±3.40 μg/L, p<0.001). The Co concentration was significantly decreased at T4 (0.35±0.19 vs. 0.26±0.13 μg/L, p<0.01) and T5 (0.35±0.19 vs. 0.23±0.11 μg/L, p<0.001). Five patients developed atrial fibrillation (AF); there was no other operative mortality or major morbidity. This is the first report of alterations of plasma Se and Co concentrations during and after CABG surgery. Our results may indicate that Se supplementation before or during CABG and Co supplementation after CABG may become necessary for patients undergoing CABG.
Keywords trace element CABG cardiopulmonary bypass selenium cobalt
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2022-02
Volume volume76
Issue issue1
Publisher Okayama University Medical School
Start Page 33
End Page 39
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2022 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35236996
Web of Science KeyUT 000762812700005
JaLCDOI 10.18926/AMO/63205
FullText URL 76_1_25.pdf
Author Sugimoto, Kohei| Kuroda, Masahiro| Yoshimura, Yuuki| Hamada, Kentaro| Khasawneh, Abdullah| Barham, Majd| Tekiki, Nouha| Konishi, Kohei| Ishizaka, Hinata| Shimizu, Yudai| Nakamitsu, Yuki| Al-Hammad, Wlla E. | Kamizaki, Ryo| Kanazawa, Susumu| Asaumi, Junichi|
Abstract The apparent diffusion coefficient subtraction method (ASM) was developed as a new restricted diffusionweighted imaging technique for magnetic resonance imaging (MRI). The usefulness of the ASM has been established by in vitro basic research using a bio-phantom, and clinical research on the application of the ASM for the human body is needed. Herein, we developed a short-time sequence for ASM imaging of the heads of healthy volunteers (n=2), and we investigated the similarity between the obtained ASM images and diffusion kurtosis (DK) images to determine the utility of the ASM for clinical uses. This study appears to be the first to report ASM images of the human head. We observed that the short-time sequence for the ASM imaging of the head can be scanned in approx. 3 min at 1.5T MRI. The noise reduction effect of median filter processing was confirmed on the ASM images scanned by this sequence. The obtained ASM images showed a weak correlation with the DK images, indicating that the ASM images are restricted diffusion-weighted images. The new shorttime imaging sequence could thus be used in clinical studies applying the ASM.
Keywords apparent diffusion coefficient apparent diffusion coefficient subtraction method diffusion kurtosis imaging restricted diffusion short-time imaging
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2022-02
Volume volume76
Issue issue1
Publisher Okayama University Medical School
Start Page 25
End Page 32
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2022 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35236995
Web of Science KeyUT 000762812700004
JaLCDOI 10.18926/AMO/63204
FullText URL 76_1_17.pdf
Author Fujishita, Keigo| Yasuhisa, Sando| Oka, Satoshi| Fujisawa, Yuka| Machida, Takuya| Imai, Toshi|
Abstract R-CHOP therapy is generally performed every 3 weeks. We investigated the effects of extending the interval of R-CHOP therapy for > 1 week on the prognoses of patients with non-indolent non-Hodgkin’s B-cell lymphoma. Among the 338 patients with non-indolent non-Hodgkin’s B-cell lymphoma who received initial chemotherapy at our institution, we focused on 178 patients who received R-CHOP therapy and analyzed the outcomes of the patients stratified by the treatment intervals. The estimated 3-year overall survival (OS) for the entire population was 82.1%. Patients treated at intervals of ≥ 4 weeks were significantly older, and they had significantly longer follow-up periods and lower relative dose intensity. But the estimated 3-year OS was comparable to those treated at <4 weeks (83.3% vs. 80.5% p=0.947). In a multivariate analysis, age and the dose of anti-cancer agents had significant impacts on OS, but there was no significant relationship regarding the treatment intervals. Propensity score matching confirmed the same result. R-CHOP therapy every around 4 weeks could achieve relatively good survival in some selected patients with non-indolent non-Hodgkin’s B-cell lymphoma.
Keywords R-CHOP therapy relative dose intensity non-Hodgkin’s lymphoma
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2022-02
Volume volume76
Issue issue1
Publisher Okayama University Medical School
Start Page 17
End Page 24
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2022 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35236994
Web of Science KeyUT 000762812700003
JaLCDOI 10.18926/AMO/63203
FullText URL 76_1_7.pdf
Author Takami, Masao| Yamamoto, Koichiro| Hanayama, Yoshihisa| Nakano, Yasuhiro| Hasegawa, Kou| Obika, Mikako| Hagiya, Hideharu| Furukawa, Masanori| Otsuka, Fumio|
Abstract Subclinical hypothyroidism (SCH) is diagnosed when serum thyrotropin (TSH) is elevated despite a normal thyroxine level and is known to increase the risk of metabolic disorders. This study was conducted to identify potential laboratory markers suspicious for latent SCH. We retrospectively reviewed 958 outpatients in whom thyroid functions had been examined. Eighty-five (9.1%) of the 939 analyzed subjects had SCH (73% females). In the SCH group, median serum TSH and FT4 levels were 5.04 μU/ml and 1.19 ng/dl, respectively, and auto-thyroid antibodies were detected in 53.8% of patients. SCH group patients were significantly older than patients in the euthyroid group, while there was no intergroup difference in BMI. However, 56.5% of the SCH patients were asymptomatic. In the SCH group, serum aspartate aminotransferase and low-density lipoprotein cholesterol (LDL-C) levels were significantly higher, and the estimated glomerular filtration rate (eGFR) was significantly lower than in the euthyroid group. Among patients less than 65 years of age, SCH patients tended to have lower eGFR and higher LDL-C than euthyroid patients. Age-dependent reductions of red blood cells and serum albumin were more prominent in the SCH than the euthyroid group. Biochemical changes with aging are useful as potential clues for suspecting latent SCH.
Keywords aging renal function cholesterol subclinical hypothyroidism thyroid function
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2022-02
Volume volume76
Issue issue1
Publisher Okayama University Medical School
Start Page 7
End Page 15
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2022 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35236993
Web of Science KeyUT 000762812700002
JaLCDOI 10.18926/AMO/62819
FullText URL 75_6_759.pdf
Author Shimizu, Dai| Yamamoto, Hiromasa| Shien, Kazuhiko| Taniguchi, Kohei| Miyoshi, Kentaroh| Namba, Kei| Mesaki, Kumi| Sugimoto, Seiichiro| Soh, Junichi| Yamane, Masaomi| Toyooka, Shinichi|
Abstract Pulmonary enteric adenocarcinoma (PEAC) is a rare subtype of lung cancer that should be differentiated from colorectal cancer metastasis. Little is known about its genetic background. An 84-year-old male with adenocarcinoma of the lung underwent left upper lobectomy. The histology of the surgical specimen was suggestive of PEAC. Gastrointestinal and colorectal fiberscopy revealed no evidence of colorectal cancer. Next-generation sequencing of the tumor identified a G469V substitution in serine/threonine-protein kinase B-raf (BRAF). Based on the higher prevalence of the G469 substitution in BRAF-mutant lung adenocarcinoma than in BRAFmutant colorectal cancer, the tumor likely originated from the lung. Identification of mutational genotype may be of some help in distinguishing PEAC from the lung metastasis of colorectal cancer.
Keywords non-small cell lung cancer somatic mutations pulmonary adenocarcinoma with enteric differentiation non-V600E BRAF mutation next-generation sequencing
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2021-12
Volume volume75
Issue issue6
Publisher Okayama University Medical School
Start Page 759
End Page 762
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2021 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 34955547
Web of Science KeyUT 000735319800005
NAID 120007180273
JaLCDOI 10.18926/AMO/62813
FullText URL 75_6_725.pdf
Author Matsumoto, Hiroshi| Kimata, Yoshihiro| Ota, Tomoyuki| Sugiyama, Narushi| Onoda, Satoshi| Makino, Takuma| Takeda, Seiko| Mizukawa, Nobuyoshi|
Abstract The long-term changes in tissues implanted in the oral cavity and pharynx after head and neck reconstruction have not been fully evaluated. This study aimed to clarify the morphological changes, long-term durability, and potential for secondary carcinogenesis in such tissues. In our single-center study, the rough morphological changes in 54 cases of intraoral and pharyngeal skin and mucosal flaps were evaluated more than 10 years after flap transfer. In addition, the literature on the development of second carcinomas from skin flaps was reviewed. The mean follow-up period for transferred flaps was 148 months. The reconstruction areas and the probability of morphological changes were significantly correlated (p=0.006), especially in cases with tongue, lower gingiva, and buccal mucosal reconstruction. Free jejunal flap surfaces were well maintained, whereas tubed skin flaps showed severe morphological changes in cases with pharyngeal reconstruction. None of the flaps in our series developed second primary carcinomas. Skin flaps generally had good durability for > 10 years in intraoral environments, while mucosal flaps had better durability for pharyngeal reconstruction. Second squamous carcinomas arising from skin flaps are extremely rare; however, surgeons should take this possibility into consideration and conduct meticulous and long-term follow-up.
Keywords skin flap mucosal flap oral reconstruction morphological change second primary carcinoma
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2021-12
Volume volume75
Issue issue6
Publisher Okayama University Medical School
Start Page 725
End Page 734
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2021 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 34955541
NAID 120007180279
JaLCDOI 10.18926/AMO/62811
FullText URL 75_6_713.pdf
Author Aoyama, Tatsuro| Ogiwara, Toshihiro| Ito, Kiyoshi| Miyaoka, Yoshinari| Fujii, Yu| Hanaoka, Yoshiki| Hasegawa, Takatoshi| Watanabe, Gen| Seguchi, Tatsuya| Hongo, Kazuhiro|
Abstract The consistency of spinal meningiomas is important to consider when performing tumor removal surgery. This study evaluated the correlations between spinal meningioma consistency and both preoperative computed tomography (CT) values and histopathological subtypes. Fifteen consecutive patients who underwent surgical resection of spinal meningioma at our institution were identified, and preoperative CT values and the signal intensity of T2-weighted magnetic resonance images of the tumor were determined retrospectively. The consistency of the spinal meningioma was defined based on the ultrasonic surgical aspirator output during tumor debulking. Patients were assigned to 2 groups: a soft group (n=4) and a hard group (n=11). The T2 signal intensity was significantly higher in the soft group than in the hard group (p=0.001). While the CT values were considerably higher in the hard group, the difference was not significant (p=0.19). Regarding the histopathological subtypes, psammomatous meningioma exhibited significantly higher CT values than meningothelial meningioma (p=0.019); however, there was a higher frequency of hard tumors in meningothelial meningioma cases than in psammomatous meningioma cases. Although neither robust correlations between tumor consistency and CT values nor a relationship between tumor consistency and histopathological subtype has been established, these results might help with the perioperative manegement of spinal tumors.
Keywords calcification computed tomography psammoma body spinal meningioma
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2021-12
Volume volume75
Issue issue6
Publisher Okayama University Medical School
Start Page 713
End Page 718
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2021 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 34955539
Web of Science KeyUT 000735297900007
NAID 120007180281
JaLCDOI 10.18926/AMO/62807
FullText URL 75_6_685.pdf
Author Yamashita, Mampei| Kuroki, Tamotsu| Hamada, Takashi| Hirayama, Takanori| Tokunaga, Takayuki| Yamanouchi, Kosho| Takeshita, Hiroaki| Maeda, Shigeto|
Abstract Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive imaging technique that provides high-quality visualization of the biliary tree, including the gallbladder. This study aimed to evaluate the useful-ness of preoperative MRCP for acute cholecystitis in predicting technical difficulties during laparoscopic chole-cystectomy (LC). A total of 168 patients who underwent LC with preoperative MRCP were enrolled in this study. Patients were divided into two groups according to preoperative MRCP findings: the visualized group (n = 126), in which the entire gallbladder could be visualized; and the non-visualized group (n = 42), in which the entire gallbladder could not be visualized. The perioperative characteristics and postoperative complica-tions of the two groups were retrospectively analyzed. Operation time was longer in the non-visualized group (median 101.5 vs. 143.5 min; p < 0.001). The non-visualized group had significantly more intraoperative blood loss than the visualized group (median 5 vs. 10 g; p = 0.05). The rate of conversion to open cholecystectomy was significantly higher in the non-visualized group (1.6 vs. 9.5%; p = 0.03). In conclusion, patients in the non- visualized group showed higher difficulty in performance of LC. Our MRCP-based classification is a simple and effective means of predicting difficulties in performing LC for acute cholecystitis.
Keywords laparoscopic cholecystectomy magnetic resonance cholangiopancreatography acute cholecystitis gallbladder disease non-invasive imaging
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2021-12
Volume volume75
Issue issue6
Publisher Okayama University Medical School
Start Page 685
End Page 689
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2021 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 34955535
Web of Science KeyUT 000735297900003
NAID 120007180285
JaLCDOI 10.18926/AMO/62781
FullText URL 75_5_659.pdf
Author Ino, Riku| Sada, Ken-ei | Miyauchi, Atsushi| Hashimoto, Daisuke| Nojima, Shigeru| Yamanaka, Shingo| Kawamura, Masafumi|
Abstract A 77-year-old woman with no history of malignancy presented with anorexia and bilateral lower extremity weakness. Her consciousness level worsened daily, so we performed a lumbar puncture. Cerebrospinal fluid (CSF) analysis indicated meningitis, but three rounds of CSF cytology showed no malignant cells. The patient’s carcinoembryonic antigen (CEA) level was highly elevated in CSF, but normal in serum. Through gadolinium-enhanced brain/spinal magnetic resonance imaging and gastrointestinal endoscopy, she was diagnosed with leptomeningeal carcinomatosis (LC) from gastric cancer. CEA level in CSF facilitated the diagnosis of LC from gastric cancer because there were no malignant cells on CSF cytology.
Keywords leptomeningeal carcinomatosis gastric cancer carcinoembryonic antigen cerebrospinal fluid cytology
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2021-10
Volume volume75
Issue issue5
Publisher Okayama University Medical School
Start Page 659
End Page 661
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2021 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 34703051
Web of Science KeyUT 000711568400006
NAID 120007166666
JaLCDOI 10.18926/AMO/62776
FullText URL 75_5_631.pdf
Author Yamamoto, Koichiro| Omura, Daisuke| Yamane, Mai| Son, Reina| Hasegawa, Kou| Honda, Hiroyuki| Obika, Mikako| Minao, Nozomu| Edahiro, Satoru| Yamada, Norihito| Otsuka, Fumio|
Abstract Anorexia nervosa (AN) is occasionally complicated with hypoglycemic coma, which may cause sudden death by unknown mechanisms. We present the case of a 36-year-old woman with recurrent comas and a nineteen-year history of AN. She was found in a coma with remarkable hypoglycemia (28 mg/dL). Her BMI was 11.1 kg/m2. Endocrine workup revealed extremely low serum levels of glucagon, IGF-I and insulin. Asymptomatic hypoglycemia occurred with liver injury in the refeeding process. An aberrant glucose metabolism due to liver damage might have been involved in her susceptibility to hypoglycemia. This case suggests a possible mechanism of hypoglycemic coma in AN.
Keywords anorexia nervosa glucagon hypoglycemic coma insulin-like growth factor-I liver injury
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2021-10
Volume volume75
Issue issue5
Publisher Okayama University Medical School
Start Page 631
End Page 636
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2021 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 34703046
Web of Science KeyUT Recurrence of Hypoglycemic Coma in a Patient with Anorexia Nervosa Recurrence of Hypoglycemic Coma in a Patient with Anorexia Nervosa 000711568400001
NAID 120007166676
JaLCDOI 10.18926/AMO/62773
FullText URL 75_5_601.pdf
Author Mitsuhashi, Toshiharu|
Abstract Research suggests that the fundamental concepts of epidemiology cannot be sufficiently learned in traditional lectures, and interactive learning is necessary. However, few studies have investigated interactive epidemiology education in general, or peer instruction (PI) in particular. This study investigated the effect of PI. Study par-ticipants were fourth-year medical students. The attitude of participants in regard to PI learning was examined in a non-PI and a PI group. The Survey of Attitudes Toward Statistics (SATS) (containing six sub-categories) was conducted as a learning-attitudes index. The pre- and post-lecture scores were compared between the non-PI and PI groups using double robust (DR) estimation. The non-PI and PI groups consisted of 20 and 121 student participants, respectively. In DR estimation, affect exhibited the lowest SATS score changes, at −0.51 (95% confidence interval −0.78 to −0.24; p-value < 0.001), whereas effort exhibited the highest score changes of 0.01 (95% confidence interval −0.30 to 0.32; p-value = 0.952). The epidemiology lecture with PI did not increase the SATS scores. This might be due to issues related to the experimental design. Further research investigating the effects of interactive epidemiology education, it will be necessary to develop tools for assessing the learning of epidemiological concepts and to improve the research design.
Keywords medical students peer instruction epidemiological education learning attitude double robust esti-mation
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2021-10
Volume volume75
Issue issue5
Publisher Okayama University Medical School
Start Page 601
End Page 609
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2021 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 34703043
Web of Science KeyUT 000711561600007
NAID 120007166673