JaLCDOI 10.18926/AMO/61443
フルテキストURL 75_1_109.pdf
著者 Xu, Xiaolei| Lu, Yanqiu| Harypursat, Vijay| Sun, Feng| Zhao, Ting| Zeng, Yanming| He, Xiaoqing| Chen, Yaokai|
抄録 The optimal timing of antiretroviral therapy (ART) initiation in human immunodeficiency virus (HIV)-infected patients with cryptococcal meningitis (HIV/CM) is controversial. We designed a clinical trial to inves-tigate the optimal timing for ART initiation in HIV/CM patients. This will be a multicenter, prospective, and randomized clinical trial. Each enrolled patient will be randomized into either the early ART arm or the deferred ART arm. We will compare the mortality and incident rates of immune reconstitution inflammatory syndrome between the two arms. We hope to elucidate the optimal timing for ART initiation in HIV/CM patients.
キーワード human immunodeficiency virus meningitis cryptococcal antiretroviral therapy
Amo Type Clinical Study Protocol
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 109
終了ページ 113
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649622
JaLCDOI 10.18926/AMO/61442
フルテキストURL 75_1_95.pdf
著者 Minato, Keitaro| Hirano, Toru| Kawashima, Hiroyuki| Yamagishi, Tetsuro| Watanabe, Keigo| Ohashi, Masayuki| Ogose, Akira| Endo, Naoto|
抄録 A 21-year-old man consulted our hospital for treatment of a spinal giant cell tumor (GCT) of Enneking stage III. Lower lumbar-spine tumors and severe spinal canal stenosis are associated with high risk for surgical mor-bidity. Stability was temporarily secured with a percutaneous pedicle screw fixation in combination with deno-sumab, which shrank the tumor. Total en bloc spondylectomy was then performed 6 months after initiation of denosumab, and the patient was followed for 3 years. There was no local recurrence, and bony fusion was obtained. Minimally invasive surgery and denosumab allowed safer and easier treatment of a collapsing lower lumbar extra-compartmental GCT.
キーワード spinal stabilization denosumab spondylectomy giant cell tumor
Amo Type Case Report
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 95
終了ページ 101
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649620
JaLCDOI 10.18926/AMO/61441
フルテキストURL 75_1_103.pdf
著者 Senoo, Mayumi| Tone, Atsuhito| Imai, Yusuke| Watanabe, Satoko| Kaneto, Mitsuhiro| Shimomura, Yasuyuki| Teshigawara, Sanae| Nakatou, Tatsuaki|
抄録 A 43-year-old male with type 2 diabetes, under treatment with 5 mg/day of dapagliflozin, was referred to our hospital with upper left abdominal pain and marked hypertriglyceridemia (triglycerides [TGs], 5,960 mg/dl). He was also on a low-carbohydrate diet that promoted ketosis under sodium glucose cotransporter 2 (SGLT2) inhibitor administration. Polyacrylamide gel electrophoresis revealed a remarkable increase in very-low-den-sity lipoprotein, a TG-rich lipoprotein particle synthesized in the liver using free fatty acids derived from adi-pose tissue. Although SGLT2 inhibitors generally improve the lipid profile, under certain conditions such as a low-carbohydrate diet, they may adversely exacerbate the lipid profile via ketosis.
キーワード sodium glucose cotransporter 2 inhibitor dyslipidemia hypertriglyceridemia type 2 diabetes mellitus
Amo Type Case Report
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 103
終了ページ 107
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649621
JaLCDOI 10.18926/AMO/61440
フルテキストURL 75_1_91.pdf
著者 Shiotania, Toshio| Yamamoto, Hiromasa| Katsube, Riko| Tomioka, Yasuaki| Suzawa, Ken| Miyoshi, Kentaroh| Otani, Shinji| Okazaki, Mikio| Sugimoto, Seiichiro| Sohb, Junichi| Yamane, Masaomi| Toyooka, Shinichi|
抄録 Bronchopleural fistula (BPF) is a severe complication following lung resection. We present the case of a patient with a history of advanced lung cancer, who had undergone induction chemoradiotherapy followed by right middle and lower lobectomy, and who developed BPF after completion right pneumonectomy. Although we had covered the bronchial stump with an omental pedicled flap, BPF was found on postoperative day 19. We covered the fistula with n-butyl-2-cyanoacrylate (NBCA) using bronchoscopy. Although we had to repeat the NBCA treatment, we ultimately cured the patient’s BPF and no recurrence was observed up to 15.2 months after surgery.
キーワード bronchopleural fistula pneumonectomy induction chemoradiotherapy n-butyl-2-cyanoacrylate (NBCA) omental pedicled flap
Amo Type Case Report
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 91
終了ページ 94
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649619
JaLCDOI 10.18926/AMO/61439
フルテキストURL 75_1_87.pdf
著者 Shiotani, Toshio| Sugimoto, Seiichiro| Araki, Kota| Tomioka, Yasuaki| Miyoshi, Kentaroh| Otani, Shinji| Yamane, Masaomi| Toyooka, Shinichi|
抄録 Although chronic kidney disease (CKD) commonly develops after lung transplantation (LT), living-donor kid-ney transplantation (LDKT) for CKD after LT is known to provide favorable outcomes. We describe the long-term follow-up findings of a patient who underwent LDKT after bilateral cadaveric LT. A 37-year-old male underwent LDKT for CKD 18 years after receiving bilateral cadaveric LT. He developed chronic lung allograft dysfunction (CLAD) 20 years after the LT; however, at 26 years after the initial LT, he is still alive with no pro-gression of CLAD or CKD. KT could be a viable option for CKD even after LT in Japan.
キーワード lung transplantation kidney transplantation chronic kidney disease non-tuberculous mycobacterial infection chronic lung allograft dysfunction
Amo Type Case Report
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 87
終了ページ 89
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649618
JaLCDOI 10.18926/AMO/61438
フルテキストURL 75_1_79.pdf
著者 Yoshio, Kotaro| Nagasaka, Hisako| Hisazumi, Kento| Okawa, Hiro| Tajiri, Nobuhisa| Shiode, Tsuyoki| Akaki, Shiro| Kanazawa, Susumu| Mitoma, Tomohiro| Yano, Yuri| Kobayashi, Emiko| Horiguchi, Ikuyo| Takata, Masayo| Hongo, Atsushi| Yonezawa, Masaru| Nakanishi, Yoshie|
抄録 The purposes of this retrospective study were to analyze local control of squamous cell carcinoma of the cervix treated with computed tomography (CT)-based image-guided brachytherapy (IGBT), as well as the factors affecting local control. A total of 39 patients were analyzed. The prescribed dose to the pelvis was 45-50 Gy with or without central shielding (CS). IGBT was delivered in 1-5 fractions. The total dose for high-risk clinical target volume (HR-CTV) was calculated as the biologically equivalent dose in 2-Gy fractions. The median follow-up period was 29.3 months. The 2-year overall survival and local control rates were 97% and 91%, respectively. In univariate analysis, the dose covering 90% of the HR-CTV (D90) and tumor size were found to be significant factors for local control. The cutoff values of tumor size and D90 for local control were 4.3 cm (area under the curve [AUC] 0.75) and 67.7 Gy (AUC 0.84) in the CS group and 5.3 cm (AUC 0.75) and 73.7 Gy (AUC 0.78) in the group without CS, respectively. However, though the local control of CT-based IGBT was favorable, the results suggested that the dose required for tumor control may differ depending on the presence of CS.
キーワード cervical cancer squamous cell cancer brachytherapy central shielding
Amo Type Original Article
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 79
終了ページ 85
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649617
JaLCDOI 10.18926/AMO/61437
フルテキストURL 75_1_71.pdf
著者 Sanki, Tomoaki| Tetsunaga, Tomonori| Furumatsu, Takayuki| Yamada, Kazuki| Kawamura, Yoshi| Ozaki, Toshifumi|
抄録 Intra-operative acetabular fracture is a total hip arthroplasty complication that can occur during cementless cup insertion, especially in osteoporotic patients. We conducted this biomechanical study to investigate the impact resistance of the acetabulum with simulated bones of different density by drop-weight impact testing. Low- and high-density polyurethane foam blocks were used as osteoporotic and healthy bone models, respectively. Polyurethane blocks were used as the acetabular cancellous bone. Composite sheets were used as the acetabu-lum’s medial cortex. The testing revealed that the osteoporotic bone model’s impact resistance was significantly lower than that the healthy bone model’. In the healthy bone model, even thin acetabular cancellous bone with ≥ 1 mm acetabulum medial cortex was less likely to fracture. In the osteoporotic bone model, fracture was pos-sible without ≥ 1 mm medial cortex of the acetabulum and thick acetabular cancellous bone. Although impac-tion resistance differs due to bone quality, the impaction resistance in this osteoporotic bone model was equiv-alent to that healthy bone model’s when a thick medial wall was present. To avoid intra-operative acetabulum fracture, surgeons should consider both the bone quality and the thicknesses of the medial cortex and acetabu-lar cancellous bone.
キーワード intra-operative acetabular fracture drop weight impact testing total hip arthroplasty impact resistance
Amo Type Original Article
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 71
終了ページ 77
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649616
JaLCDOI 10.18926/ATM/61436
フルテキストURL 75_1_63.pdf
著者 Tada, Katsuhiko| Miyagi, Yasunari| Nakamura, Kazue| Yorozu, Moe| Fukushima, Emi| Kumazawa, Kazumasa| Nakamura, Makoto| Kageyama, Misao|
抄録 We used a differential equation to identify the biological relationship between the maternal prepregnancy body mass index (BMI) and lactation on postpartum day 4 in Japanese women with neonatal separation. This retro-spective observational study included 252 mothers (135 primiparas, 117 multiparas) whose singleton neonates were admitted to a neonatal ICU. We formulated hypotheses based on breast anatomy to analyze the relation-ship between the expressed milk obtained on postpartum day 4 and the maternal prepregnancy BMI with the following differential equation: y’(x) = k y(x)/x, where k is the constant, x is the prepregnancy BMI, and y is the expressed milk volume. The formula was then obtained as y(x) = axk, where a is the constant. The Akaike information criterion (AIC) was used to estimate the regression equation with the maximum likelihood for primiparas and multiparas. The best criteria for BMI determined by the AIC were 20.89 kg/m2 in primiparas and 20.19 kg/m2 in multiparas. These were the optimal BMI values for lactation, coinciding with the median prepregnancy BMI in the study population (20.78 kg/m2 in primiparas and 20.06 kg/m2 in multiparas). The formula based on biomathematics might help establish the biological relationship between prepregnancy BMI and breastmilk volume.
キーワード biomathematics body mass index expressed milk lactation
Amo Type Original Article
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 63
終了ページ 69
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649615
JaLCDOI 10.18926/AMO/61435
フルテキストURL 75_1_55.pdf
著者 Kubo, Yujiro| Watanabe, Mototsugu| Choshi, Haruki| Matsubara, Kei| Shiotani, Toshio| Kataoka, Kazuhiko|
抄録 Small pulmonary lesions are often difficult to localize during thoracoscopic surgery. We describe a new com-puted tomography (CT)-guided pleural dye-marking method for small peripheral pulmonary lesions that does not involve a visceral pleural puncture. We used this technique for 23 lesions (22 patients) who underwent tho-racoscopic partial lung resection (Nov. 2016-Jan. 2018). With the patient in the lateral decubitus position, pre-operative CT-guided marking on the skin over the lesion was performed. During the surgery, we marked the visceral pleura with a skin marker directly or with an infant-size nutrition catheter with crystal violet at the tip through a venous indwelling needle inserted perpendicular to the skin marking. We localized and resected the lesions in all cases, without complications. The median nodule size measured histopathologically was 8 (4-20) mm overall, and 7 (0-20) mm of the solid part; the median distance from the visceral pleura to the nodule was 9 (1-33) mm. The median operation time was 67 (37-180) min. The median postoperative hospital stay was 3 (3-11) days. Our CT-guided pleural dye-marking method is useful and safe for the localization of small periph-eral pulmonary lesions in thoracoscopic partial lung resections.
キーワード Small pulmonary lesion ground glass nodule marking localization thoracocentesis
Amo Type Original Article
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 55
終了ページ 61
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649614
JaLCDOI 10.18926/AMO/61433
フルテキストURL 75_1_45.pdf
著者 Otsuka, Hiroaki| Miyoshi, Toru| Ejiri, Kentaro| Kohno, Kunihisa| Nakahama, Makoto| Doi, Masayuki| Munemasa, Mitsuru| Murakami, Masaaki| Nakamura, Kazufumi| Ito, Hiroshi|
抄録 Remote ischemic preconditioning (RIPC) is a promising strategy for protecting against ischemic reperfusion injury. This study is a secondary analysis of a randomized study that aimed to evaluate the effect of RIPC on the early increase in serum creatinine (SCr) following percutaneous coronary intervention (PCI), which is associ-ated with contrast-induced acute kidney injury. Patients with stable angina undergoing elective PCI were assigned to control, RIPC, and continuous infusion of nicorandil (nicorandil) groups. The endpoint of this study was the incidence of the early increase in SCr, a predictor of contrast-induced acute kidney injury, which was defined as either a > 20% or absolute increase by 0.3 mg/dl of SCr levels after 24 h of PCI. This study included 220 patients for whom a dataset of SCr values was available. The incidence of the early increase in SCr was significantly lower in the RIPC than in the control (1.3% vs 10.8%, p = 0.03) group, but was not significantly different between the nicorandil and control groups. In multivariate analysis, RIPC remained a significant fac-tor associated with a reduction in the incidence of early increase in SCr. RIPC reduces the incidence of early increase in SCr in patients with stable angina following elective PCI.
キーワード remote ischemic preconditioning stable angina serum creatinine acute kidney injury
Amo Type Original Article
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 45
終了ページ 53
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649613
JaLCDOI 10.18926/AMO/61432
フルテキストURL 75_1_39.pdf
著者 Akezaki, Yoshiteru| Nakata, Eiji| Kikuuchi, Masato| Tominaga, Ritsuko| Kurokawa, Hideaki| Hamada, Makiko| Aogi, Kenjiro| Ohsumi, Shozo| Sugihara, Shinsuke|
抄録 In this study, we examined whether axillary web syndrome (AWS) in patients with breast cancer following axil-lary lymph node dissection affects range of motion (ROM), upper extremity function, and quality of life (QOL). The risk factors for AWS were also evaluated in a total of 238 consecutive breast cancer patients follow-ing axillary lymph node dissection. At 1, 2, and 3 months after surgery, there were no significant differences between the AWS group and the non-AWS group in upper-limb function or QOL. At 2 months after surgery, shoulder flexion and abduction ROM were significantly higher in the AWS group than in the non-AWS group (p < 0.05). Self-training time at home was not significantly different between the groups at 1, 2, or 3 months. Only age was a significant predictor of AWS at 1 month after surgery (p < 0.05). The AWS group in the present study did not have worse results for shoulder joint ROM, upper-limb function, and QOL than the non-AWS group. Younger age should be useful for predicting the development of AWS in the early postoperative period.
キーワード breast cancer axillary web syndrome age upper limb function quality of life
Amo Type Original Article
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 39
終了ページ 44
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649612
JaLCDOI 10.18926/AMO/61431
フルテキストURL 75_1_31.pdf
著者 Miyamaru, Satoru| Murakami, Daizo| Nishimoto, Kohei| Saito, Haruki| Miyamoto, Yusuke| Hirota, Kaoruko| Ise, Momoko| Orita, Yorihisa|
抄録 Although the lung is the most common site of distant metastases from head and neck squamous cell carcinoma (HNSCC), the number of reports about the effects of pulmonary metastasectomy for the treatment of lung metastasis from HNSCC is limited. Metachronous pulmonary metastases were detected in 45 HNSCC patients at Kumamoto University Hospital from 1998 to 2018. Twenty-two patients underwent an operative resection (Ope group) and 23 underwent chemotherapy (Chemo group). The 3-year overall survival (OS) rate and median OS were evaluated. The effects of adjuvant chemotherapy after pulmonary metastasectomy and of new drugs (cetuximab and nivolumab), in the chemo group were also assessed. The 3-year OS rates and median OS were: Ope, 66.1% and 31.5 months; Chemo, 39.7% and 18 months, respectively. In the Ope group, addi-tional recurrences were significantly fewer in the patients who underwent adjuvant chemotherapy post-surgery versus the patients who underwent surgery alone (p = 0.013). In the Chemo group, the 3-year OS rate of the patients who received new drugs was significantly better than that of the patients who did not (p = 0.021). Adjuvant chemotherapy after pulmonary metastasectomy may be a preferable treatment option for preventing recurrences. Cetuximab and nivolumab have a potential to improve OS.
キーワード pulmonary metastasis head and neck squamous cell carcinoma pulmonary metastasectomy adjuvant chemotherapy
Amo Type Original Article
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 31
終了ページ 37
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649611
JaLCDOI 10.18926/AMO/61430
フルテキストURL 75_1_25.pdf
著者 Tetsunaga, Tomonori| Tetsunaga, Tomoko| Yamada, Kazuki| Sanki, Tomoaki| Kawamura, Yoshi| Ozaki, Toshifumi|
抄録 In bipolar hemiarthroplasty (BHA), it is important to preserve soft tissue to reduce the risk of postoperative dislocation. A variety of surgical approaches for BHA are available, but extra care is needed with muscle- and tendon-preserving approaches in geriatric patients. We investigated the usefulness of BHA using a conjoined tendon-preserving posterior (CPP) approach, in which only the external obturator muscle is dissected, in geri-atric patients. We retrospectively analyzed the cases of 40 femoral neck fracture patients (10 men, 30 women) aged ≥ 80 years who underwent BHA using the CPP approach. The patients’ average age was 85.8 years (80-94 years). We examined the operation time, bleeding, preservation of short external rotator muscles, complica-tions, and stem alignment and subsidence from postoperative radiographs. Although gemellus inferior muscle injury was detected in 4 patients (10%), the hip joint stability was very excellent in all cases. There was no intraoperative fracture or postoperative dislocation. On postoperative radiographs, all femoral stems were in a neutral position. There was no stem subsidence in all 40 patients. BHA using the CPP approach appeared to be useful even in geriatric patients.
キーワード bipolar hip arthroplasty geriatric patient conjoined tendon-preserving posterior approach
Amo Type Original Article
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 25
終了ページ 30
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649610
JaLCDOI 10.18926/AMO/61429
フルテキストURL 75_1_15.pdf
著者 Katsui, Kuniaki| Ogata, Takeshi| Tada, Akihiro| Sugiyama, Soichi| Yoshio, Kotaro| Kuroda, Masahiro| Kiura, Katsuyuki| Maeda, Yoshinobu| Toyooka, Shinichi| Hiraki, Takao| Kanazawa, Susumu|
抄録 The aim of this study was to investigate whether volumetric positron emission tomography (PET) parameters are prognostic predictors in stage III non-small cell lung cancer patients receiving definitive concurrent chemo-radiotherapy (CCRT) with cisplatin/docetaxel. Cases involving definitive CCRT were reviewed retrospectively, and the maximum standardized uptake value, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were calculated. The relationships between these PET parameters and prognosis were analyzed. MTV and TLG were significant predictors of distant metastasis-free survival (DMFS) (p = 0.0003 and 0.0005, respectively) and progression-free survival (PFS) (p = 0.001 and 0.0007, respectively). The three-year DMFS rates in patients with low and high MTV were 13.3% and 64.6%, respectively, and the corresponding values in those with low and high TLG were 13.3% and 65.2%, respectively. The three-year PFS rates in patients with low and high MTV were 13.3% and 57.8%, respectively, and the corresponding values in patients with low and high TLG were 13.3% and 57.8%, respectively. However, MTV and TLG were not predictors of local control or overall sur-vival. We demonstrated that volumetric PET parameters were predictors of patients receiving definitive CCRT. Our findings contradict the findings of previous reports and warrant further research to validate them.
キーワード volumetric positron emission tomography parameters distant metastasis-free survival chemoradiotherapy cisplatin/docetaxel non-small cell lung cancer
Amo Type Original Article
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 15
終了ページ 23
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649609
JaLCDOI 10.18926/AMO/61428
フルテキストURL 75_1_9.pdf
著者 Gobara, Hideo| Yamamoto, Akira| Komakic, Toshiyuki| Kitayama, Toshiaki| Sakurai, Jun| Iguchi, Toshihiro| Matsui, Yusuke| Uka, Mayu| Tomita, Koji| Hiraki, Takao| Kanazawa, Susumu|
抄録 To assess the feasibility of needle tract ablation in liver tissue in ex vivo and in vivo animal models using a cryo-probe and electrosurgical device. The experimental device is made by inserting a cryoprobe through an intro-ducer sheath for insulation, with 2-cm of probe tip projecting out. A beagle liver was punctured by the device, and electric current was applied at 30-W with the electrosurgical knife touching the non-insulated device base. The discolored area of cut surface along the device was evaluated in 5 application-time groups (5 , 10 , 15 , 20, or 25 seconds). An ex vivo experiment was performed to determine an ablation algorithm with an appropriate application time by comparison with radiofrequency ablation (RFA) results. Thereafter, an in vivo experiment was performed to verify the algorithm’s feasibility. In the ex vivo model, the cut surface demonstrated different amounts of discolored area according to the application time. The total discolored area in the 20-seconds group was similar to that by RFA. In the in vivo model, the liver did not bleed, the total discolored area was similar to that ex vivo, and coagulation necrosis was confirmed by photomicrograph. Needle tract ablation can be per-formed using the experimental device and electrosurgical device.
キーワード needle tract ablation cryoablation electrosurgical device animal liver
Amo Type Original Article
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 9
終了ページ 14
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649608
JaLCDOI 10.18926/AMO/61424
フルテキストURL 75_1_1.pdf
著者 Hamahara, Jun| Honda, Hiroyuki| Yamamoto, Koichiro| Tokumasu, Kazuki| Hanayama, Yoshihisa| Hagiya, Hideharu| Obika, Mikako| Ueda, Keigo| Kishida, Masayuki| Otsuka, Fumio|
抄録 To determine the clinical characteristics of low androgen status in adult males with diabetes, we retrospectively analyzed the medical records of patients with type 2 diabetes mellitus in whom serum free testosterone (FT) levels were examined for 1 year. Among the 46 patients (56 ± 1.5 years old), decreases in serum FT levels to < 8.5 pg/ml (indicating the occurrence of late-onset hypogonadism [LOH]) were detected in 18 (39%). The per-centages of patients with low FT levels were high in the ≥ 50 years age group (83%), the HbA1c < 7% group (67%), and the 25 ≤ BMI < 30 kg/m2 group (56%). The serum FT levels tended to decrease age-dependently. The level of HbA1c was significantly correlated with the Heinemann Aging Male Symptoms (AMS) score (R = 0.47). The low-FT group had decreased levels of hemoglobin. Of note, the serum FSH level (R = −0.32) was negatively correlated with the serum FT level, whereas the serum TSH level (R = 0.36) was positively correlated with the serum FT level. Collectively, these results revealed that many diabetic males may have low FT levels and that the AMS score is related to the HbA1c level. A slightly anemic condition, thyroid dysfunction, and obesity (class 1) might be involved in LOH in middle-aged diabetic males.
キーワード androgen diabetes mellitus late-onset hypogonadism testosterone thyroid function
Amo Type Original Article
発行日 2021-02
出版物タイトル Acta Medica Okayama
75巻
1号
出版者 Okayama University Medical School
開始ページ 1
終了ページ 8
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2021 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33649607
フルテキストURL 74_6_563.pdf
Amo Type Erratum
発行日 2020-12
出版物タイトル Acta Medica Okayama
74巻
6号
出版者 Okayama University Medical School
開始ページ 563
終了ページ 563
ISSN 0386-300X
NCID AA00508441
資料タイプ その他
言語 English
著作権者 CopyrightⒸ 2020 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33361879
Web of Science KeyUT 000601203600015
JaLCDOI 10.18926/AMO/61217
フルテキストURL 74_6_557.pdf
著者 Ishiguro, Mikako| Takenaka, Ryuta| Ogura, Kenichiro| Hiratsuka, Akira| Takeda, Hiromasa| Kawai, Daisuke| Tsugeno, Hirofumi| Fujiki, Shigeatsu| Okada, Hiroyuki|
抄録 A 63-year-old Japanese male with stomach adenocarcinoma received oral 5-fluorouracil derivative, cisplatin and trastuzumab chemotherapy. On day 8, severe diarrhea and mucositis developed; chemotherapy was stopped. On day 14, the patient developed renal dysfunction and febrile neutropenia. He also suffered from pneumonia due to Candida albicans. Systemic symptoms improved after intensive conservative treatment. Best supportive care was continued until the patient died from gastric cancer. The dihydropyrimidine dehydroge-nase protein level was low at 3.18 U/mg protein. The result of DPYD genotyping revealed three variants at posi-tions 1615 (G > A), 1627 (A > G), and 1896 (T > C) in exons 13, 13, and 14, respectively.
キーワード 5-fluorouracil dihydropyrimidine dehydrogenase deficiency DPYD variant gastric cancer
Amo Type Case Report
発行日 2020-12
出版物タイトル Acta Medica Okayama
74巻
6号
出版者 Okayama University Medical School
開始ページ 557
終了ページ 562
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2020 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33361878
Web of Science KeyUT 000601203600014
NAID 120006948944
JaLCDOI 10.18926/AMO/61216
フルテキストURL 74_6_551.pdf
著者 Tanaka, Masato| Fujiwara, Yoshihiro| Uotani, Koji| Kadiri, Venkatesh| Yamauchi, Taro|
抄録 A minimally invasive posterolateral approach designed to avoid the lateral misplacement of midcervical pedicle screws was reported, but there is no technical report that describes this technique without C-arm fluoroscopy. We report the results of a 2.5 years follow-up of a 62-year-old female patient with C4 metastatic breast cancer. The patient suffered from severe neck pain and impending quadriplegia for 2 months after radiation therapy. We performed C-arm-free minimally invasive cervical pedicle screw fixation (MICEPS). The patient was suc-cessfully treated with surgery, and her neck pain was well controlled. She had neither neurological deficits nor neck pain at the final (2.5-year) follow-up. C-arm-free MICEPS is a useful technique; in addition, the sur-geons and staff have no risk of radiation exposure, there is a reduced need for postoperative imaging, and a decreased revision rate can be expected with C-arm-free MICEPS.
キーワード cervical spine navigation surgery minimally invasive surgery cervical pedicle screw C-arm free
Amo Type Case Report
発行日 2020-12
出版物タイトル Acta Medica Okayama
74巻
6号
出版者 Okayama University Medical School
開始ページ 551
終了ページ 556
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2020 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33361877
Web of Science KeyUT 000601203600013
NAID 120006948943
JaLCDOI 10.18926/AMO/61215
フルテキストURL 74_6_545.pdf
著者 Tatebe, Yasuhisa| Kanamitsu, Kiichiro| Kanzaki, Hirotaka| Ishida, Hisashi| Fujiwara, Kaori| Washio, Kana| Kitamura, Yoshihisa| Sendo, Toshiaki| Shimada, Akira| Tsukahara, Hirokazu|
抄録 Polymorphisms in methotrexate transporter pathways have been associated with methotrexate toxicities and clearance. Recent genome-wide association studies have revealed that the SLCO1B1 T521C variant is associated with methotrexate elimination. We present a case of a pediatric patient with acute lymphoblastic leukemia who suffered from persistently high plasma methotrexate concentrations and acute kidney injuries after the admin-istration of a medium dose of methotrexate. Subsequent genetic analysis showed that he was a carrier of dys-functional genetic variants associated with methotrexate clearance. This case highlights that polymorphisms of methotrexate transporter pathways can adversely affect methotrexate elimination in a clinically significant manner.
キーワード methotrexate polymorphism drug elimination acute kidney injury acute lymphoblastic leukemia
Amo Type Case Report
発行日 2020-12
出版物タイトル Acta Medica Okayama
74巻
6号
出版者 Okayama University Medical School
開始ページ 545
終了ページ 550
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2020 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 33361876
Web of Science KeyUT 000601203600012
NAID 120006948942