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Title Alternative Laparoscopic repair of an abdominal incisional hernia above the pubis
FullText URL 127_31.pdf
Author Nakano, Kanyu| Idani, Hitoshi| Asami, Shinya| Ookawa, Hiro| Yoshimoto, Masashi| Ito, Atene| Monden, Kazuteru| Kurose, Yohei| Hioki, Masayoshi| Ishii, Tatsuhiro| Sadamori, Hiroshi| Oono, Satoshi| Kin, Hitoshi| Takakura, Norihisa|
Abstract   Laparoscopic repair of a suprapubic hernia typically carries a high risk of recurrence, because fixation of the mesh in the peripubic area is difficult. We herein report a patient undergoing laparoscopic repair of a suprapubic hernia, along with a description of the surgical techniques employed.  A 78-year-old woman visited our hospital with a chief complaint of swelling at the median hypogastric incision site after surgery for an ovarian cyst performed at age 25 years. Laparoscopic examination revealed the hernia orifice to be 3.5×3.0 cm in size and that the distance between the caudal margin of the hernia orifice and the pubis was 2.5 cm. Parietex composite mesh was used for fixation through all layers of the abdominal wall with non-absorbable sutures and tack fixation. On the pubic side, after the pubis had been exposed by separating it from the bladder, we performed mesh fixation through all layers of the abdominal wall immediately above the pubis with the sutures placed inside the mesh, combined with tack mesh fixation directly to the pubis. This procedure enabled definite fixation of the mesh. Six days after surgery, she was discharged without complications. To date, two years and five months after surgery, no recurrence has been observed.
Keywords 腹壁瘢痕ヘルニア(incisional hernia) 恥骨上ヘルニア(suprapubic hernia) 腹腔鏡下修復術(laparoscopic repair)
Publication Title 岡山医学会雑誌
Published Date 2015-04-01
Volume volume127
Issue issue1
Start Page 31
End Page 34
ISSN 0030-1558
Related Url http://www.okayama-u.ac.jp/user/oma/
language Japanese
Copyright Holders Copyright (c) 2015 岡山医学会
File Version publisher
DOI 10.4044/joma.127.31
NAID 130005068354
Title Alternative Laparoscopic total colectomy with lymph node dissection for familial adenomatous polyposis with multiple colorectal cancers
FullText URL 127_25.pdf
Author Kato, Hiroshi| Oishi, Masahiro| Kodera, Masahito| Yamamura, Masao| Ikeda, Hideaki| Mizuno, Kenji| Yamashita, Yutaka|
Abstract  A 49-year-old Japanese man visited our hospital with chief complaints of difficulty with and bleeding during defecation. After a detailed examination, he was diagnosed with familial adenomatous polyposis (FAP) with multiple (five) colorectal cancers. The tumors were located in the right-sided, left-sided, and sigmoid colon, and the lower rectum. Regional lymph node involvement was observed, but no metastasis to other organs was detected. We, therefore, performed a laparoscopic total colectomy with superior mesenteric artery (SMA) and inferior mesenteric artery (IMA) lymph node dissection. We were able to perform minimally invasive and cosmetically acceptable surgery using laparoscopy instead of highly-invasive open abdominal surgery. Our search of the literature revealed no reported cases of laparoscopic total colectomy with lymph node dissection for FAP with multiple colorectal cancers, making the present case the first to be reported in the literature.
Keywords 家族性大腸腺腫症(FAP)(familial adenomatous polyposis) 同時性多発大腸癌(synchronous colorectal cancer) 大腸全摘術(colorectal surgery) 腹腔鏡下手術(laparoscopic surgery)
Publication Title 岡山医学会雑誌
Published Date 2015-04-01
Volume volume127
Issue issue1
Start Page 25
End Page 29
ISSN 0030-1558
language Japanese
Copyright Holders Copyright (c) 2015 岡山医学会
File Version publisher
DOI 10.4044/joma.127.25
NAID 130005068353
Title Alternative Surgically treated Zenker’s diverticulum: Diverticulectomy and cricopharyngeal myotomy
FullText URL 127_19.pdf
Author Ninomiya, Takayuki| Kanaya, Nobuhiko| Katsuda, Koh| Tanakaya, Kohji| Aoki, Hideki| Takeuchi, Hitoshi|
Abstract  Zenker's diverticulum is a very rare disease among gastorointestinal diverticulum. We report a case of Zenker's diverticulum successfully treated with diverticulectomy and cricophalyngial myotomy. A 71-year-old male complained of aspirating water for two years. He was diagnosed as Zenker's diverticulum. Due to his severe symptoms, the operation was performed in an open-neck approach. The left recurrent laryngeal nerve was identified and preserved. An incision was made in the diverticulum wall, and the internal diameter of normal cervical esophagus was measured. The diverticulum was then excised with an automatic suture device in the minor axis direction of the esophagus. A cricopharyngeal myotomy was conducted, because this muscle was fibrotic and stiffened. The patient's symptoms disappeared after the operation. Diverticulectomy and cricopharyngeal myotomy through an open-neck approach is a safe and reliable method that follows, direct access to the diverticulum and recurrent laryngeal nerve.
Keywords Zenker憩室(Zenker’s diverticulum) 輪状咽頭筋切開術(cricopharyngeal myotomy) 頚部アプローチ(open-neck approach)
Publication Title 岡山医学会雑誌
Published Date 2015-04-01
Volume volume127
Issue issue1
Start Page 19
End Page 23
ISSN 0030-1558
language Japanese
Copyright Holders Copyright (c) 2015 岡山医学会
File Version publisher
DOI 10.4044/joma.127.19
NAID 130005068344
JaLCDOI 10.18926/ESR/53196
Title Alternative Precipitation characteristics and large-scale atmospheric fields on the heavy rainfall days in the eastern part of Japan (Climatological features in midsummer and the supplemental study for the Baiu season)
FullText URL esr_021_1_033_043.pdf
Author Matusmoto, Kengo| Kato, Kuranoshin| Otani, Kazuo|
Abstract  Rainfall characteristics and large-scale atmospheric fields on the “heavy rainfall days” (with more than 50mm/day) in midsummer, and so on, at Tokyo in the eastern Japan were examined for 1971 to 2010, succeeding to Matsumoto et al. (2013)  The present study firstly examined the rainfall features and the atmospheric fields for the “heavy rainfall days” at Tokyo with rather lower appearance frequency than in the typhoon related patterns in Matsumoto et al. (2013) and so on. In these cases (three cases in total), although the synoptic situations were rather different among each other, they seem to occur under the systems with relatively small zonal scale associated with the great meander of the upper-level westerly wind.  Next, the climatological analyses similar to Matsumoto et al. (2013) were performed for the "heavy rain days" at Tokyo in midsummer (1~31 August). The precipitation on the “heavy rainfall days” at Tokyo in midsummer was mainly brought by the intense rainfall with more than 10 mm/h, as in the western Japan in the mature stage of the Baiu season. The detailed examination of the rainfall features for the case on 10 August 2009, with use of the 10-minutes precipitation data and the Radar AMeDAS Composite Data by the JMA, revealed that the organized meso-β-scale convective rainfall systems as often appear in the western Japan in the mature stage of the Baiu season were just to the east of the typhoon, and brought the intense rainfall at Tokyo to result in the large daily precipitation.
Keywords rainfall characteristics in eastern Japan heavy rainfall in eastern Japan in the Baiu and midsummer seasons rainfall climatology
Publication Title Okayama University Earth Science Report
Published Date 2014-12-27
Volume volume21
Issue issue1
Start Page 33
End Page 43
ISSN 1340-7414
language Japanese
Copyright Holders © 2014 by Okayama University Earth Science Reports Editorial Committee All Rights Reserved
File Version publisher
NAID 120005567874
JaLCDOI 10.18926/AMO/53124
FullText URL 69_1_65.pdf
Author Ueno, Tsuyoshi| Yamashita, Motohiro| Sawada, Shigeki| Suehisa, Hiroshi| Kawamoto, Hiroaki| Takahata, Hiroyuki|
Abstract Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm that occurs at different sites in the body. Pleural IMT in particular is especially rare. IMTs infrequently tend to have malignancy. We report a rare case of advanced diaphragmatic parietal pleural IMT with dissemination. A 30-year-old woman complained of right upper abdominal pain. Computed tomography showed a large lobulated mass over the right diaphragm, but no disseminated nodules were noted. Intraoperatively, we found the primary tumor arising from the diaphragmatic parietal pleura and a dozen disseminated nodules, and we removed them completely. The histopathological and immunohistochemical diagnosis was IMT.
Keywords inflammatory myofibroblastic tumor pleura dissemination
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2015-02
Volume volume69
Issue issue1
Publisher Okayama University Medical School
Start Page 65
End Page 68
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25703173
Web of Science KeyUT 000349740300008
JaLCDOI 10.18926/AMO/53123
FullText URL 69_1_59.pdf
Author Tsuchie, Hiroyuki| Miyakoshi, Naohisa| Nishi, Tomio| Abe, Hidekazu| Segawa, Toyohito| Shimada, Yoichi|
Abstract Roughly half of the femoral fracture patients diagnosed with AFF according to the criteria suggested by a task force of the American Society for Bone and Mineral Research (ASBMR) have not undergone bisphosphonate (BP) therapy. One suspected cause of such fractures is severe bone loss due to osteomalacia, but the pathogenesis remains unknown. We report a case of an 84-year-old woman with AFF not treated by BP therapy, in whom underlying osteomalacia was histologically diagnosed. The involvement of femoral curvature and spino-pelvic malaligment in the fracture in the present case was considered.
Keywords osteomalacia atypical fracture femur osteoporosis kyphosis
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2015-02
Volume volume69
Issue issue1
Publisher Okayama University Medical School
Start Page 59
End Page 63
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25703172
Web of Science KeyUT 000349740300007
JaLCDOI 10.18926/AMO/53028
FullText URL 68_6_379.pdf
Author Doi, Shinichiro| Kimura, Shuhei| Morizane, Yuki| Hosogi, Mika| Hosokawa, Mio| Shiode, Yusuke| Kawata, Tetsuhiro| Kondo, Eisei| Shiraga, Fumio|
Abstract We report a case of POEMS syndrome in a 20-year-old patient diagnosed after visiting an eye clinic with a chief complaint of reduced visual acuity. A male university student aged 20 years was referred to our department complaining of blurred vision in both eyes that had persisted for 1 month. He also noted headache, nausea, and paresthesia in the lower extremities around the same time. The visual acuity of his right and left eye was 20/40 and 20/20, respectively. Optic disc edema and serous retinal detachment were present. Brain magnetic resonance imaging showed no intracranial abnormalities, while elevated cerebrospinal fluid pressure, reduced nerve conduction velocity in both lower extremities, hepatosplenomegaly, M proteinemia, high blood VEGF levels, osteoblastic and osteolytic changes in the spine, and atypical plasma cells in bone lesions were noted. From the above findings, the patient was diagnosed with POEMS syndrome. He received high-dose dexamethasone, thalidomide, and radiotherapy on the sacral mass, followed by high-dose melphalan with autologous stem-cell support, and showed subsequent systemic and ophthalmologic improvement. Here, we report the youngest case ever of POEMS syndrome with ocular manifestation. If patients have optic disc edema in both eyes with no intracranial space-occupying lesion, POEMS syndrome should be considered in differential diagnosis, regardless of age.
Keywords POEMS syndrome serous retinal detachment VEGF
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2014-12
Volume volume68
Issue issue6
Publisher Okayama University Medical School
Start Page 379
End Page 383
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25519033
Web of Science KeyUT 000346882200009
JaLCDOI 10.18926/AMO/53027
FullText URL 68_6_375.pdf
Author Yamanaka, Reiko| Soga, Yoshihiko| Moriya, Yoshie| Okui, Akemi| Takeuchi, Tetsuo| Sato, Kenji| Morimatsu, Hiroshi| Morita, Manabu|
Abstract We encountered a 74-year-old male patient with tongue laceration after convulsive seizures under intensive care. The tongue showed severe swelling, and the right ventral surface had been lacerated by his isolated and pointed right lower canine. Our university hospital has established a perioperative management center, and is promoting interprofessional collaboration, including dentists, in perioperative management. Dentists collaborating in the perioperative management center took dental impressions, with the support of anesthesiologists who opened the patientʼs jaw under propofol sedation, to produce a mouth protector. By raising the patientʼs bite, the completed mouth protector prevented the isolated tooth from contacting the tongue and protected the lacerated wound. Use of the mouth protector prevented the lacerated tongue from coming into contact with the pointed tooth, and the tongue healed gradually. These findings underscore that interprofessional collaboration including dentists can improve the quality of medical care.
Keywords mouth protector tongue laceration
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2014-12
Volume volume68
Issue issue6
Publisher Okayama University Medical School
Start Page 375
End Page 378
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25519032
Web of Science KeyUT 000346882200008
JaLCDOI 10.18926/AMO/53026
FullText URL 68_6_369.pdf
Author Iwamuro, Masaya| Miyashima, Yuichi| Yoshioka, Takahiro| Murata, Toshihiro| Miyabe, Yoshio| Kawai, Yoshinari| Urata, Haruo| Shiraha, Hidenori| Okada, Hiroyuki| Yamamoto, Kazuhide|
Abstract A 67-year-old Japanese man underwent enterotomy because of enterolith ileus. Component analysis by infrared spectroscopy revealed that the enterolith was composed of a high concentration of deoxycholic acid. We further analyzed and compared the ultrastructure of the enterolith and a commercially available powdered form of deoxycholic acid by means of scanning electron microscopy and energy dispersive X-ray spectroscopy. Energy dispersive X-ray spectroscopy analysis revealed that the ratios of carbon and oxygen in the enterolith were equal to those in the deoxycholic acid powder. Scanning electron microscopy analysis showed rectangular prism-shaped particles on the surface of the enterolith. This structure was similar to that of the deoxycholic acid powder. The surgically removed enterolith had a twisted and coiled appearance. Possible mechanisms underlying the formation of this unique form are discussed.
Keywords enterolith deoxycholic acid scanning electron microscopy infrared spectroscopy energy dispersive X-ray spectroscopy
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2014-12
Volume volume68
Issue issue6
Publisher Okayama University Medical School
Start Page 369
End Page 374
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25519031
Web of Science KeyUT 000346882200007
JaLCDOI 10.18926/AMO/53025
FullText URL 68_6_363.pdf
Author Ota, Seisuke| Hiramatsu, Yasushi| Kondo, Eisei| Kasahara, Akinori| Takada, Saimon| Umena, Sachio| Noguchi, Toshio| Tanimoto, Mitsune| Matsumura, Tadashi|
Abstract Leukocytosis is occasionally seen in patients with presumptive but undiagnosed myeloproliferative disorders (MPD). A 74-year-old woman was admitted to our hospital for tarry stools, anemia, and marked peripheral leukocytosis of 1.4×105/μL. Gastroenteroscopy revealed an acute gastric and duodenal mucosal lesion that was treated successfully via endoscopic hemoclipping. Bone marrow aspiration revealed marked megakaryocyte proliferation with atypia of naked nuclei and marrow hypercellularity (90% cellularity). A fluorescence in situ hybridization test could not detect the BCR-ABL fusion gene. Bone marrow aspiration later revealed further abnormalities of megakaryocytes. The patient died from cerebral bleeding. The present case fulfilled 2 of the 3 major criteria of primary myelofibrosis according to the World Health Organization 2008 classification:namely, megakaryocytic hyperplasia with hypercellular marrow and granulocytic hyperplasia. However, the megakaryocytic abnormality was not strictly compatible with the criteria. Instead, we considered prefibrotic primary myelofibrosis as a possibility, although myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable (MDS/MPN-U) was technically the correct diagnosis. The present case shows that MPN diagnosis remains difficult and suggests that other cases of peripheral leukocytosis with diagnosed MDS/MPN-U might include similar findings.
Keywords prefibrotic primary myelofibrosis leukocytosis anemia acute gastric mucosal lesion multiple cerebral hemorrhages
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2014-12
Volume volume68
Issue issue6
Publisher Okayama University Medical School
Start Page 363
End Page 368
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25519030
Web of Science KeyUT 000346882200006
Author Mizoo, Taeko| Taira, Naruto| Nishiyama, Keiko| Nogami, Tomohiro| Iwamoto, Takayuki| Motoki, Takayuki| Shien, Tadahiko| Matsuoka, Junji| Doihara, Hiroyoshi| Ishihara, Setsuko| Kawai, Hiroshi| Kawasaki, Kensuke| Ishibe, Youichi| Ogasawara, Yutaka| Komoike, Yoshifumi| Miyoshi, Shinichiro|
Published Date 2013-12-01
Publication Title BMC Cancer
Volume volume13
Content Type Journal Article
Author Mazaki, Tetsuro| Shiozaki, Yasuyuki| Yamane, Kentaro| Yoshida, Aki| Nakamura, Mariko| Yoshida, Yasuhiro| Zhou, Di| Kitajima, Takashi| Tanaka, Masato| Ito, Yoshihiro| Ozaki, Toshifumi| Matsukawa, Akihiro|
Published Date 2014-03-25
Publication Title Scientific Reports
Volume volume4
Content Type Journal Article
Title Alternative A case of microscopic low-grade appendiceal mucinous neoplasm complicated with appendicitis resected by reduced-port laparoscopic surgery
FullText URL 126_223.pdf
Author Suzuki, Hiromitsu| Kimura, Kouji| Kinoshita, Sigeki| Okano, Kazuo|
Abstract Appendicitis is a benign disease for which surgical treatment is widely provided. The complication of neoplastic lesions may be discovered only after resection. However, in some cases, specimens are not submitted to histopathological examination in Japan because of an extreme deficiency of pathologists. We report our experience with one patient who experienced the complication of latent low-grade appendiceal mucinous neoplasm (LAMN) after surgery for appendicitis. Our patient was an 85-year-old woman. Conservative treatment failed to relieve fever and lower abdominal pain and it was decided to treat her surgically. Abdominal computed tomography (CT) showed appendicitis with severe inflammation and suspected adhesion. We decided to explore the abdominal cavity using a reduced-port laparoscopic approach. We found no mucous debouchment or clear tumors in the specimen. Histopathological findings indicated the coexistence of appendicitis and LAMN. At one year and a half after surgery, there was no evidence of the development of pseudomyxoma peritonei. In appendectomy, it is thought that careful perioperative treatment and a postoperative pathological search are important when there are no preoperative findings suggesting a neoplastic lesion.
Keywords 虫垂炎(appendicitis) 減孔式腹腔鏡手術(reduced-port laparoscopic surgery) 虫垂粘液嚢胞腺腫(low-grade appendiceal mucinous neoplasm (LAMN)) 腹膜偽粘液腫(pseudomyxoma peritonei) 腹腔鏡下虫垂切除術(laparoscopic appendectomy)
Publication Title 岡山医学会雑誌
Published Date 2014-12-01
Volume volume126
Issue issue3
Start Page 223
End Page 226
ISSN 0030-1558
language Japanese
Copyright Holders Copyright (c) 2014 岡山医学会
File Version publisher
DOI 10.4044/joma.126.223
NAID 130004903238
Title Alternative Giant rectal gastrointestinal stromal tumor successfully resected by abdominoperineal resection combined with posterior vaginal wall resection
FullText URL 126_217.pdf
Author Iwakawa, Kazuhide| Nishie, Manabu| Tokunaga, Naoyuki| Miyaso, Hideaki| Iwagaki, Hiromi|
Abstract We report a case of giant rectal gastrointestinal stromal tumor (GIST) successfully resected by abdominoperineal resection combined with posterior vaginal wall resection. Our patient was a 79-year-old woman had been diagnosed as having von Recklinghausen disease at the age of 30 years. In 2006, a computed tomography (CT) scan revealed a tumor originating from the posterior wall of the rectum. In June 2010, she was admitted to our hospital with the chief complaint of bloody stool. A CT scan revealed a giant tumor that had increased to 9cm in size. Colonoscopy demonstrated a submucosal tumor, which was subsequently diagnosed by biopsy as a GIST. Due to the patient's continuous bleeding and abdominal pain, an emergent abdominoperineal resection was performed at that time. The tumor, which measured 8×9cm, was immunohistochemically positive for c-kit and CD34. Concomitant resection of the posterior wall of the vagina via the perineal approach provided a wide area to expose the tumor for a safe operation. The patient has been well with no sign of recurrence since the operation. This procedure is recommended as a useful approach for giant rectal GISTs or rectal cancer with invasion of the posterior pelvic wall.
Keywords 巨大直腸GIST(giant rectal GIST) 腹会陰式直腸切断術(abdominoperineal resection)
Publication Title 岡山医学会雑誌
Published Date 2014-12-01
Volume volume126
Issue issue3
Start Page 217
End Page 221
ISSN 0030-1558
language Japanese
Copyright Holders Copyright (c) 2014 岡山医学会
File Version publisher
DOI 10.4044/joma.126.217
NAID 130004903245
Author MINOWA, Hirotsugu| MUNESAWA, Yoshiomi| SUZUKI, Kazuhiko|
Published Date 2012-10-15
Publication Title 安全工学
Volume volume51
Issue issue5
Content Type Journal Article
JaLCDOI 10.18926/AMO/52901
FullText URL 68_5_313.pdf
Author Yamane, Kentaro| Tanaka, Masato| Sugimoto, Yoshihisa| Ichimura, Kouichi| Ozaki, Toshifumi|
Abstract Ossified meningioma is classified histologically as a phenotype of metaplastic meningioma, and it is extremely rare. There are only 12 cases involving ossified spinal meningiomas in the literature. We present the case of a 61-year-old female with a primary tumor within the ventral spinal canal at T12. Although we performed a total tumor excision using an ultrasonic bone aspirator, a temporary deterioration of motor evoked potentials (MEPs) was observed during curettage with a Kerrison rongeur. The neurologic findings worsened immediately after surgery. Histologically, the tumor was diagnosed as a metaplastic meningioma with osseous differentiation. In order to avoid spinal cord injury, great care must be taken when removing an ossified meningioma located on the ventral spinal cord.
Keywords spinal metaplastic meningioma osseous differentiation ossified meningioma ultrasonic bone aspirator post-operative course
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2014-10
Volume volume68
Issue issue5
Publisher Okayama University Medical School
Start Page 313
End Page 316
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25338489
Web of Science KeyUT 000343269300009
JaLCDOI 10.18926/AMO/52900
FullText URL 68_5_307.pdf
Author Muro, Shinichiro| Nasu, Junichiro| Harada, Ryo| Matsubara, Minoru| Nakarai, Asuka| Kanzaki, Hiromitsu| Tsutsumi, Kouichiro| Kato, Hironari| Tanaka, Takehiro| Fujiwara, Hiroyasu| Uno, Masatoshi| Okada, Hiroyuki| Yamamoto, Kazuhide|
Abstract A 45-year-old female who presented with loss of consciousness and a cold sweat was found to have a pancreatic tumor and multiple liver metastases. Laboratory studies showed marked hypoglycemia and inappropriately elevated serum insulin, C-peptide, and serum tumor markers. Fine needle aspiration revealed Grade 3 small-cell type primary pancreatic neuroendocrine carcinoma. Consequently, the diagnosis of malignant insulinoma was made. Transarterial embolization (TAE) for hepatic metastases resulted in the reduction of tumor volume and prompt resolution of hypoglycemic attacks, whereas diazoxide and systemic chemotherapy had been ineffective for controlling blood glucose levels, and octreotide was unavailable due to the allergic effect. This case report highlights the potential usefulness of TAE for malignant insulinomas in the management of hypoglycemia.
Keywords malignant insulinoma hypoglycemia liver metastases transarterial embolization neuroendocrinetumor
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2014-10
Volume volume68
Issue issue5
Publisher Okayama University Medical School
Start Page 307
End Page 311
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25338488
Web of Science KeyUT 000343269300008
JaLCDOI 10.18926/AMO/52899
FullText URL 68_5_303.pdf
Author Tanaka, Masato| Sugimoto, Yoshihisa| Arataki, Shinya| Takigawa, Tomoyuki| Ozaki, Toshifumi|
Abstract Spinal deformity is an important clinical manifestation of Chiari I malformation (CM-I) and syringomyelia. Here we report the result of an 8-year follow-up of a 13-year-old girl with severe scoliosis associated with Chiari malformation and a large syringomyelia. The patient presented at our hospital at the age of 13 with a 68° scoliosis. Magnetic resonance imaging showed Chiari malformation and a large syringomyelia. Neurosurgical treatment involved foramen magnum decompression and partial C1 laminectomy, but the scoliosis still progressed. We present the first case report of a rare course of scoliosis in a patient with CM-I and a large syringomyelia.
Keywords Chiari I malformation syringomyelia scoliosis
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2014-10
Volume volume68
Issue issue5
Publisher Okayama University Medical School
Start Page 303
End Page 306
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25338487
Web of Science KeyUT 000343269300007
JaLCDOI 10.18926/AMO/52791
FullText URL 68_4_249.pdf
Author Ogawara, Yuya| Tachibana, Tomoyasu| Orita, Yorihisa| Uchino, Kaori| Wani, Yoji| Nagahiro, Itaru| Matsuyama, Yuko| Abe, Iku| Fujisawa, Masayoshi| Nishizaki, Kazunori|
Abstract We describe an extremely rare case of tracheal stenosis caused by unnoticed microscopic fiber-like foreign bodies. A 66-year-old woman complained of dyspnea with inspiratory stridor. Magnifying electroendoscopy and computed tomography revealed stenosis involving the entire circumference of the tracheal lumen. Tracheotomy and biopsy were performed. Histologically, the lesion showed chronic inflammation with a deposition of fiber-like foreign bodies. The patient had no history of trauma or inhalation injury, but had undergone intratracheal intubation on 4 occasions. The lesion was incised using semiconductor laser photoresection, and the postoperative course was good. To the best of our knowledge, this represents the first report in the English literature of tracheal stenosis caused by unnoticed foreign bodies. The origin of these fiber-like foreign bodies remains unclear but might be related to chronic inflammation resulting from intratracheal intubations.
Keywords tracheal stenosis fibrous foreign body intubation tracheotomy laser
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2014-08
Volume volume68
Issue issue4
Publisher Okayama University Medical School
Start Page 249
End Page 252
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25145411
Web of Science KeyUT 000340687500007
Title Alternative A case of asymptomatic right-sided adult Bochdalek hernia presented incidentally with rectal tumor
FullText URL 126_137.pdf
Author Kato, Hiroshi| Oishi, Masahiro| Kodera, Masahito| Yamamura, Masao| Ikeda, Hideaki| Mizuno, Kenji| Yamashita, Yutaka| Suzuki, Kazunori|
Abstract  We encountered a patient with an adult Bochdalek hernia discovered asymptomatically. A 77-year-old Japanese woman visited a local clinic with chief complaints of melena and difficulty in defecation. Based on the results of the detailed examination in our hospital, she was diagnosed with a rectal gastrointestinal stromal tumor (GIST) with a concurrent asymptomatic adult right-sided Bochdalek hernia. Because the tumor was large, laparoscopic abdominoperineal rectal amputation was performed after systemic imatinib therapy. During the surgery, we found a right diaphragmatic defect more than 13cm in long dia., through which the right hepatic lobe, colon, and greater omentum had prolapsed into the right thoracic cavity. No visceral adhesions were noted. No hernia sac was observed. Adult Bochdalek hernia is a relatively rare condition, and only three (incidentally discovered) cases of asymptomatic Bochdalek hernia, including the present case, have been reported in Japan. Here we provide a case report for the patient, who was followed-up without hernia surgery, plus a review of the literature.
Keywords 成人Bochdalek孔ヘルニア(adult Bochdalek hernia) 腹腔鏡下手術(laparoscopic surgery)
Publication Title 岡山医学会雑誌
Published Date 2014-08-01
Volume volume126
Issue issue2
Start Page 137
End Page 141
ISSN 0030-1558
language Japanese
Copyright Holders Copyright (c) 2014 岡山医学会
File Version publisher
DOI 10.4044/joma.126.137
NAID 130004685265