JaLCDOI 10.18926/AMO/56937
フルテキストURL 73_4_349.pdf
著者 Isozaki, Hiroshi| Yamamoto, Yasuhisa| Murakami, Shigeki| Matsumoto, Sasau| Takama, Takehiro|
抄録 To clarify the surgical outcomes of breast cancer patients with a preoperative diagnosis of ductal carcinoma in situ (DCIS) by core needle biopsy (CNB) (abbreviated as CNBDCIS), we retrospectively analyzed the cases of 131 patients with CNBDCIS who underwent surgery at Oomoto Hospital (32 total mastectomies, 99 conservative mastectomies). Our analysis of underestimation and predictors of invasive breast cancer of CNBDCIS revealed that the underestimation rate of CNBDCIS was 40.5% (53/131). A logistic regression analysis revealed that palpable tumors (yes to no, odds ratio [OR] 3.25), mammography (MMG) category group (category 4 or 5 to categories 1 , 2, or 3, OR 4.69) and MMG microcalcifications (no to yes, OR 0.24) were significant predictive factors for CNBDCIS invasion. In our analysis of the predictors of positive margins during CNBDCIS surgery, 36 (27.5%) of the 131 patients had positive margins after postoperative pathological examination. A logistic regression analysis revealed that the operative procedure (conservative surgery to total mastectomy, OR 21.4) and MMG microcalcifications (yes to no, OR 3.35) were significant factors related to positive margins during CNBDCIS surgery. Thus, MMG microcalcifications are a negative predictor of upgrading of CNBDCIS and a positive predictor of positive surgical margins for CNBDCIS.
キーワード ductal carcinoma in situ core needle biopsy underestimation positive margins microcalcifications on mammography
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2019-08
73巻
4号
出版者 Okayama University Medical School
開始ページ 349
終了ページ 356
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31439958
JaLCDOI 10.18926/AMO/56938
フルテキストURL 73_4_357.pdf
著者 Maeda, Naoto| Kodama, Naoki| Manda, Yosuke| Kawakami, Shigehisa| Oki, Kazuhiro| Minagi, Shogo|
抄録 We investigated the characteristics of grouped discharge (GD) waveforms obtained from long-term masseter electromyogram (EMG) recording in 6 female temporomandibular disorder (TMD) patients with myofascial pain and 6 healthy females. The EMG measurement was performed from the morning of the experiment day until the subject woke up the next day. We observed a significantly larger number of GD waveforms in the TMD group compared to the control group (p=0.002). Our results indicate that the existence of GD waveforms in masseter EMGs might be a predictor of future TMD with myofascial pain.
キーワード temporomandibular disorder grouped discharge masseter muscle electromyography
Amo Type Short Communication
出版物タイトル Acta Medica Okayama
発行日 2019-08
73巻
4号
出版者 Okayama University Medical School
開始ページ 357
終了ページ 360
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31439959
JaLCDOI 10.18926/AMO/56939
フルテキストURL 73_4_361.pdf
著者 Watanabe, Ayako| Kadowaki, Yoshihiko| Hattori, Kenji| Ohmori, Mika| Tsukayama, Hiroyuki| Kubota, Nobuhito| Okumoto, Tatsuo| Ishido, Nobuhiro| Okino, Takeshi|
抄録 A 35-year-old man was referred to our hospital for chronic abdominal pain and diarrhea. Computed tomography showed wall thickening, poor contrast enhancement and calcification of the ascending colon, which were consistent with phlebosclerotic colitis. Malignant character was not detected from a biopsy specimen. Operatively, we observed a scirrhous mass of the ascending colon invading surrounding tissue, which was diagnosed as signet ring cell carcinoma based on analysis of an intraoperative frozen section. Right hemicolectomy with regional lymph node dissection was performed. This case was extremely similar to phlebosclerotic colitis in clinical findings; surgical resection was required for correct diagnosis.
キーワード phlebosclerotic colitis colorectal cancer signet ring cell carcinoma young colorectal cancer
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2019-08
73巻
4号
出版者 Okayama University Medical School
開始ページ 361
終了ページ 365
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31439960
JaLCDOI 10.18926/AMO/56940
フルテキストURL 73_4_367.pdf
著者 Mifune-Morioka, Tomoyo| A. Uchida, Haruhito| Fukushima, Kazuhiko| Watanabe, Mayu| Ouchi, Chihiro| Mise, Koki| Kawakita, Chieko| Kano, Yuzuki| Onishi, Akifumi| Toma, Kishio| Eguchi, Jun| Wada, Nozomu| Ikeda, Fusao| Sasaki, Erika| Suganami, Yu| Kishida, Masayuki| Sugiyama, Hitoshi| Okada, Hiroyuki| Wada, Jun|
抄録 Eight years prior to her present admission, a 61-year-old Japanese woman was diagnosed with autoimmune hepatitis, slowly progressive insulin-dependent diabetes mellitus, and chronic thyroiditis; she had been treated with oral prednisolone (PSL). After she suddenly discontinued PSL, she newly developed systemic lupus erythematosus. A combination therapy of oral PSL and intravenous cyclophosphamide resulted in remission. She was finally diagnosed with autoimmune polyglandular syndrome (APS) type 3 (3A ,3B, 3D), complicated with four different autoimmune diseases. Since patients with type 3 APS may present many manifestations over a long period of time, they should be carefully monitored.
キーワード autoimmune polyglandular syndrome type 3 systemic lupus erythematosus autoimmune hepatitis slowly progressive insulin-dependent diabetes mellitus chronic thyroiditis
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2019-08
73巻
4号
出版者 Okayama University Medical School
開始ページ 367
終了ページ 372
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31439961
JaLCDOI 10.18926/AMO/56941
フルテキストURL 73_4_373.pdf
著者 Oda, Yoshiaki| Yamauchi, Tarou| Tanaka, Masato|
抄録 A minimally invasive surgical (MIS) procedure is an ideal surgical procedure. Many MIS techniques have been reported in spinal surgery. In clinical practice, we often encounter two-level canal stenosis cases, in which one level shows instability and the other does not. In such a case, fusion surgery for one level and decompression surgery for the other level is ideal. LLIF/OLIF approached from the lateral side has been reported effective. MIS decompression techniques in the lateral decubitus position have never been reported. We devised a surgical method that can accomplish both fixation and decompression in a consistent lateral decubitus position.
キーワード microendoscopic surgery lateral position navigation minimally invasive surgery image free
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2019-08
73巻
4号
出版者 Okayama University Medical School
開始ページ 373
終了ページ 377
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31439962
JaLCDOI 10.18926/AMO/57379
フルテキストURL 73_5_469.pdf
著者 Yamasaki, Satoshi| Kada, Akiko| Nagai, Hirokazu| Yoshida, Isao| Choi, Ilseung| Saito, Akiko M.| Iwasakia, Hiromi|
抄録 Romidepsin is an important therapeutic option for patients with peripheral T-cell lymphoma (PTCL). However, the timing of romidepsin administration remains controversial. Romidepsin was launched in Japan as a consolidation therapy agent after conventional salvage chemotherapy with gemcitabine, dexamethasone, and cisplatin (GDP). GDP therapy will be administered every 3 weeks. If complete response, partial response, or stable disease is confirmed after 2-4 GDP cycles, romidepsin will be administered every 4 weeks. The primary endpoint is a 2-year progression-free survival rate. Patients participating in this study and undergoing treatment can expect results similar to or better than those of conventional therapies.
キーワード peripheral T-cell lymphoma not otherwise specified angioimmunoblastic T-cell lymphoma gemcitabine cisplatin, romidepsin
Amo Type Clinical Study Protocol
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 469
終了ページ 474
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649375
Web of Science KeyUT 000491886600014
JaLCDOI 10.18926/AMO/57377
フルテキストURL 73_5_457.pdf
著者 Iwamuro, Masaya| Takahara, Masahiro| Yamazaki, Tatsuhiro| Tanaka, Takehiro| Kondo, Yoshitaka| Hiraoka, Sakiko| Okada, Hiroyuki|
抄録 A 60-year-old Caucasian male was diagnosed with lung adenocarcinoma and multiple metastases to the bone, spleen, and brain. He underwent radiotherapy for the brain and lumbar spine metastases, plus chemotherapy (cisplatin and pemetrexed). The chemotherapy was discontinued due to vomiting and hyponatremia, and nivolumab was then administered. Eight months later, 18F-fluorodeoxyglucose positron emission tomography showed tracer uptake in the colon. Colonoscopy revealed a reddish multinodular polyp in the sigmoid colon. The polyp showed irregular microvessels. No colonic mucosal surface structures were observed. Colonic metastasis of the lung carcinoma was highly suspected; the polyp was therefore surgically removed. The histological analysis revealed granulation tissue and suppurative inflammation without neoplastic changes. We diagnosed the lesion as a granulation polyp. Despite the difficulty in diagnosing these lesions due to their rarity and similarity to metastatic colon tumors, we suggest that recognizing the endoscopic features of the polyp surface may allow a preoperative diagnosis.
キーワード colonoscopy colonic neoplasms granulation polyp
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 457
終了ページ 461
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649373
Web of Science KeyUT 000491886600012
JaLCDOI 10.18926/AMO/57376
フルテキストURL 73_5_449.pdf
著者 Matsunaga, Kazuyuki| Takemaru, Makoto| Yamashiro, Keisuke| Yoshihara-Hirata, Chiaki| Inohara, Ken| Shimoe, Yutaka| Tanaka, Akio| Kuriyama, Masaru| Takashiba, Shogo|
抄録 We report a case of acute prevertebral abscess caused by traumatic tooth fractures in a 77-year-old Japanese man. After being transferred to our hospital the patient was initially diagnosed with a neck hematoma; however, blood culture showed Streptococcus parasanguinis, an oral bacterium, and an MRI examination suggested prevertebral abscesses. Tooth fractures, severe periodontitis, and peri-implantitis with Streptococcus parasanguinis were observed. Antibiotics were administered and fractured teeth were extracted. The patient's condition then gradually improved. We concluded that bacteremia caused by traumatic tooth fractures induced the acute prevertebral abscesses.
キーワード prevertebral abscess deep neck infection periodontal disease peri-implantitis Streptococcus parasanguinis
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 449
終了ページ 456
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649372
Web of Science KeyUT 000491886600011
JaLCDOI 10.18926/AMO/57375
フルテキストURL 73_5_441.pdf
著者 Watanabe, Toshiyuki| Sakurai, Toru| Mukai, Yuko| Kimata, Yoshihiro| Namba, Yuzaburo|
抄録 Gender dysphoria is a condition in which a discrepancy between biological sex and gender identity causes distress. Many female-to-male transsexuals (FTMTS) are uncomfortable with female breasts. Chest wall contouring surgery is effective for obtaining a male-type chest, reducing mental stress, and increasing sexual satisfaction in such cases. At the Okayama University Hospital Gender Center, we have obtained positive results using an algorithm to determine the most appropriate surgical method for chest wall contouring in FTMTS patients. However, serious complications requiring reoperation, such as hematoma, may still occur. Postoperative hematomas were found in 15 (4.18%) of 358 FTMTS patients who underwent chest contouring surgery at our hospital between 2006 and 2018. Postoperative hematoma was examined retrospectively. The median time to the onset of hematoma was 7 (6-12) h after the initial surgery. The main blood vessels causing bleeding were those in the head-side skin flap region where visual confirmation was difficult and the perforator vessels from the pectoralis major muscle. Intraoperative bleeding and the operation time had a significant impact on the onset of postoperative hematoma. This is the first retrospective study that investigated the blood vessels and other factors contributing to postoperative hematoma development after chest wall contouring.
キーワード female-to-male transsexuals chest wall contouring postoperative hematoma
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 441
終了ページ 447
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649371
Web of Science KeyUT 000491886600010
JaLCDOI 10.18926/AMO/57374
フルテキストURL 73_5_433.pdf
著者 Tamada, Shoko| Mitsui, Takashi| Ohira, Akiko| Tani, Kazumasa| Maki, Jota| Eguchi, Takeshi| Eto, Eriko| Hayata, Kei| Masuyama, Hisashi|
抄録 An association between preeclampsia and (pro)renin was recently reported. Intracellular signaling of the (pro) renin receptor [(P)RR] increases the expressions of TGF-β and PAI-1. In this study we sought to clarify the involvement of (pro)renin in the pathogenesis of preeclampsia via the intracellular signaling of (P)RR on preeclampsia placentas. Activated (pro)renin plasma concentrations were compared between pregnant women with (n=15) and without (n=28) preeclampsia. The placentas were immunohistochemically evaluated with anti-HIF-1α and anti-(P)RR antibodies. HTR-8/SVneo cells were cultured under hypoxic conditions and treated with human recombinant (pro)renin. The mRNA expressions of HIF-1α, (P)RR, PAI-1, TGF-β, and ET-1 were also examined by real-time RCR. The activated (pro)renin plasma concentration was significantly higher in the third vs. the second trimester in the preeclampsia patients. HIF-1α and (P)RR expressions were significantly increased in the preeclampsia placentas. The mRNA expressions of PAI-1, TGF-β, and ET-1 were significantly increased in the experiments using recombinant (pro)renin vs. hypoxic conditions. (P)RR expression in preeclampsia placentas is increased by persistent hypoxia through the second and third trimesters, and PAI-1, TGF-β, and ET-1 production is increased via (P)RR. Our results suggest that ET-1 production via the intracellular signaling of (P)RR is important in the pathogenesis of preeclampsia.
キーワード preeclampsia (pro)renin (pro)renin receptor endothelin-1 HTR-8/SVneo
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 433
終了ページ 440
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649370
Web of Science KeyUT 000491886600009
JaLCDOI 10.18926/AMO/57373
フルテキストURL 73_5_427.pdf
著者 Owari, Yutaka| Suzuki, Hiromi| Miyatake, Nobuyuki|
抄録 The aim of this study was to examine in a randomized controlled trial how much the sedentary behavior (sitting time) of community-dwelling elderly Japanese subjects decreased as a result of using the “Active Guide” brochure published by the Ministry of Health, Labour and Welfare (2013) and additional documents related to the benefits of reducing sedentary behavior. A total of 86 elderly people who participated in health-club activities for one year were randomly allocated to two groups. Subjects in the intervention group received explanations of the importance of physical activity using the “Active Guide” brochure (n=42) and additional documents, while subjects in the control group did not (n=44). Physical activity was measured using a triaxial accelerometer for two weeks at baseline and again after one year. After one year of intervention, the difference in the sedentary behavior rate from baseline was −2.2% for the intervention group (n=40) and +2.5% for controls (n=40) (Welch’s t-test, p=0.007). Use of the “Active Guide” brochure and additional documents may reduce the sedentary behavior of community dwelling elderly people in Japan.
キーワード Active Guide sedentary behavior elderly people randomized controlled trial health promotion
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 427
終了ページ 432
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649369
Web of Science KeyUT 000491886600008
JaLCDOI 10.18926/AMO/57372
フルテキストURL 73_5_419.pdf
著者 Hishii, Shuhei| Miyatake, Nobuyuki| Nishi, Hiroyuki| Katayama, Akihiko| Ujike, Kazuhiro| Koumoto, Kiichi| Suzuki, Hiromi| Hashimoto, Hiroo|
抄録 We investigated the relationship between sedentary behavior and all-cause mortality in patients undergoing hemodialysis. A total of 71 patients (39 men, 32 women, aged 72.1±11.7 years) were enrolled in this longitudinal study. Their sedentary behavior was measured using a tri-accelerometer that provides relative values per daily wearing time. We classified the sedentary behavior time into 2 groups (under the median: short-sedentary behavior (SB) group; over the median: long-SB group) and compared the groups’ clinical parameters. We compared the groups’ survival rates by using Kaplan-Meier curves and the log-rank test, and we performed multivariate analyses by a Cox-proportional hazard model to evaluate the relationship between the sedentary behavior and the survival rate. Twenty patients (28.2%) died during the observation period. The survival rate of the short-SB group was significantly higher than that of the long-SB group. Sedentary behavior was thus an important factor for all-cause mortality even after adjusting for confounding factors by a Cox-proportional hazard model. Sedentary behavior is closely linked to all-cause mortality, especially total days and non-hemodialysis days, and reducing sedentary behavior may be beneficial to reduce the all-cause mortality of patients on chronic hemodialysis.
キーワード sedentary behavior hemodialysis mortality physical activity
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 419
終了ページ 425
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649368
Web of Science KeyUT 000491886600007
JaLCDOI 10.18926/AMO/57371
フルテキストURL 73_5_413.pdf
著者 Yanagihara, Yutaka| Nishida, Keigo| Watanabe, Ryuta| Koyama, Kanae| Sawada, Yuichiro| Noda, Terutaka| Asai, Seiji | Fukumoto, Tetsuya| Miura, Noriyoshi| Miyauchi, Yuki| Kikugawa, Tadahiko| Saika, Takashi|
抄録 Laparoscopic radical cystectomy (LRC) is a standard surgical treatment for muscle-invasive bladder cancer and high-risk non-muscle-invasive bladder cancer. LRC is a less invasive modality than conventional open surgery. Therefore, even elderly patients with invasive bladder cancer may be candidates for LRC. In this study, a comparative analysis of perioperative/oncological outcomes between elderly patients and younger patients who underwent LRC was performed to assess the feasibility of LRC in elderly patients. Sixty-eight consecutive patients who underwent LRC between October 2013 and March 2018 were enrolled and stratified into those younger than 75 years (n=37) and those ≥ 75 years old (n=31). The median follow-up period was 28.2 months. The preoperative and operative parameters and complications were similar in both groups. The 2-year overall survival (OS) was 64.4% in the younger vs. 76.4% in the elderly group (p=0.053), cancer-specific survival (CSS) was 79.3% vs. 81.7% (p=0.187), and recurrence-free survival (RFS) was 58.2% vs. 75.7% (p=0.174), respectively. No significant differences were observed in OS, CSS, or RFS between the groups. No significant differences were found between the groups with respect to peri-surgical/oncological outcomes. We conclude that LRC is feasible in elderly patients.
キーワード bladder cancer laparoscopic surgery radical cystectomy elderly patient
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 417
終了ページ 418
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649367
Web of Science KeyUT 000491886600006
JaLCDOI 10.18926/AMO/57370
フルテキストURL 73_5_403.pdf
著者 Ando, Akemi| Mitsuhashi, Toshiharu| Honda, Mitsugi| Hanayama, Yoshihisa| Hasegawa, Kou| Obika, Mikako| Kataoka, Hitomi| Otsuka, Fumio|
抄録 Osteoporosis increases the risk of bone fractures. It is diagnosed based on an individual’s bone mineral density (BMD) or a fracture without trauma. BMD is usually measured by the dual energy X-ray absorptiometry (DXA) method. Here we investigated factors for the earliest possible prediction of decreased BMD by examining the relationships between patients’ BMD values and changes in the patients’ physical and laboratory values. We retrospectively reviewed the medical records of 149 patients who visited our department in 2014-2015 for a variety of reasons and underwent an area BMD examination by DXA. We analyzed the relationships between decreasing BMD and the patients’ gender, age, body mass index (BMI), medical background, hemoglobin, electrolytes, and thyroid function. Thirty-nine of the patients were diagnosed with osteoporosis based on their T-scores. An adjusted analysis showed that female gender, aging, and increased serum calcium level were significantly related to decreasing femoral BMD, whereas high BMI was associated with an increase in femoral BMD. Collectively the results indicate that for the early detection of low BMD, it is important for general-practice physicians to consider conducting a BMD checkup when treating female and elderly patients with a low BMI and/or elevated serum calcium level.
キーワード bone mineral density (BMD) body mass index (BMI) female gender hypercalcemia osteoporosis
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 403
終了ページ 411
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649366
Web of Science KeyUT 000491886600005
JaLCDOI 10.18926/AMO/57369
フルテキストURL 73_5_393.pdf
著者 Yi Yi Cho Thein| Win, Myitzu| Thuzara, Moe| Matsumoto, Hiroshi| Yamada, Kiyoshi| Kimata, Yoshihiro| Leung, Michael|
抄録 Although many surgical centers perform microsurgery routinely in developed countries, performing microsurgery is challenging in resource-poor developing countries, such as Myanmar. With the establishment of educational training programs and the assistance of volunteer plastic surgical teams, local plastic surgeons can learn the techniques of microsurgery and apply them clinically. The purpose of this study was to establish baseline data and define the challenges of performing microsurgery in Yangon General Hospital, Myanmar. Sixty-four patients underwent reconstruction with free flaps from January 2015 to January 2018. All clinical records of these cases were assessed. The number of free flap reconstructions performed increased from 11 in the first year to 24 in the third year. The anterolateral thigh flap was the most commonly used (42%). The most common sites of reconstruction were mandible and intraoral defects. Total flap survival occurred in 58 of 64 patients (89%). The total salvageable flap rate for revision surgery was 66.6%; the successful revision rate was highest in 2017, with fewer complications. The flap salvage rates increased and the operative duration decreased as clinical experience improved. Establishing a microsurgical center requires a strong multidisciplinary team, clinical experience, continuous learning, sensible clinical application, and effective interdepartmental and intradepartmental cooperation.
キーワード microsurgery educational programs challenges of microsurgical free flaps reoperation flap salvageable rate
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 393
終了ページ 401
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649365
Web of Science KeyUT 000491886600004
JaLCDOI 10.18926/AMO/57368
フルテキストURL 73_5_387.pdf
著者 Inoue, Miyabi| Yokoyama, Teruhiko|
抄録 To assess the efficacy and safety of 2 drugs for overactive bladder (OAB), solifenacin and mirabegron. Fortyseven female OAB patients were randomized into 2 groups. Twenty-three patients were initially prescribed solifenacin for 4 weeks, followed by mirabegron for 4 weeks (group S). The other 24 patients were initially prescribed mirabegron for 4 weeks, followed by solifenacin for 4 weeks (group M). Evaluations included clinical determination of the OAB symptom score (OABSS), International Prostate Symptom Score (IPSS), and Visual Analog Scale. The IPSS significantly improved after the administration of solifenacin in both groups. The OABSS significantly improved in both groups after 4 weeks. In group M, the OABSS after eight weeks was significantly improved compared to that after 4 weeks. However, in group S, it was not significantly improved. Twelve patients experienced adverse events during the solifenacin treatment, while 2 patients experienced adverse events during the mirabegron treatment. Both solifenacin and mirabegron led to improved OAB symptoms. Switching from mirabegron to solifenacin significantly improved the OABSS. However, mirabegron led to fewer adverse events than solifenacin. We recommend that mirabegron be prescribed first for OAB patients. If patients are not satisfied with mirabegron, solifenacin should be used.
キーワード overactive bladder, randomized crossover study solifenacin mirabegron
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 387
終了ページ 392
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649364
Web of Science KeyUT 000491886600003
JaLCDOI 10.18926/AMO/57367
フルテキストURL 73_5_383.pdf
著者 Fu, Li| Nishibori, Masahiro|
抄録 High mobility group box-1 (HMGB1) is a non-histone, DNA-binding nuclear protein belonging to the family of damage-associated molecular patterns (DAMPs). HMGB1 has been reported to play an important role during epileptogenesis although the mechanisms of its actions are still not clear. Many hypotheses have been suggested especially about the relationship between HMGB1 and inflammation responses and blood-brain barrier disruption during epileptogenesis. In this review, we will mainly discuss the role of HMGB1 in epileptogenesis.
キーワード HMGB1 epileptogenesis inflammation blood-brain barrier
Amo Type Review
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 383
終了ページ 386
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649363
Web of Science KeyUT 000491886600002
JaLCDOI 10.18926/AMO/57366
フルテキストURL 73_5_379.pdf
著者 Wake, Hidenori|
抄録 Histidine-rich glycoprotein (HRG) is a 75 kDa glycoprotein synthesized in the liver whose plasma concentration is 100-150 μg/ml. HRG has been shown to modulate sepsis-related biological reactions by binding to several substances and cells, including heparin, factor XII, fibrinogen, thrombospondin, plasminogen, C1q, IgG, heme, LPS, dead cells, bacteria, and fungi. Therefore, reduction of plasma HRG levels in sepsis leads to dysregulation of coagulation, fibrinolysis, and immune response, resulting in disseminated intravascular coagulation and multiple organ failure. This review summarizes the binding and functional properties of HRG in sepsis.
キーワード htidine-rich glycoprotein septic pathogenesis immunothrombosis
Amo Type Review
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 379
終了ページ 382
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649362
Web of Science KeyUT 000491886600001
JaLCDOI 10.18926/AMO/57378
フルテキストURL 73_5_463.pdf
著者 Shibata, Kiyo| Hamasaki, Ichiro| Shimizu, Takehiro| Kono, Reika| Ohtsuki, Hiroshi| Morizane, Yuki| Shiraga, Fumio|
抄録 To permit noose movement without fraying the sutures following strabismus surgery, we designed a new sliding noose, the “twist knot” and investigated its advantages and disadvantages. We measured the tensile strength required to move the twist knot in a tightly tied state (134±19 gf) and in a loosened state (21±7 gf), and that required to move the conventional sliding noose in a tightly tied state (48±14 gf), and used the Kruskal-Wallis test to compare them. A significant difference was observed among the three tensile strengths (p<0.001). The twist knot technique allowed easy sliding without the multifilament braided suture becoming frayed and a knot to be firmly fixed without slipping. However, if the 2 strings of the pole sutures exit from the sclera at 2 widely separated positions, the sliding noose may become slack. Therefore, the distance between the pole sutures should be small. The simple twist knot technique was found to be an effective approach following adjustable surgery of strabismus.
キーワード adjustable suture the new sliding noose method tensile strength strabismus surgery esotropia
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2019-10
73巻
5号
出版者 Okayama University Medical School
開始ページ 463
終了ページ 468
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649374
Web of Science KeyUT 000491886600013
JaLCDOI 10.18926/AMO/57721
フルテキストURL 73_6_543.pdf
著者 Kubo, Asuka| Shimizu, Kazuyoshi| Kuroda, Kosuke| Kanazawa, Tomoyuki| Kobayashi, Motomu| Morimatsu, Hiroshi|
抄録 We here report that a 71-year-old Japanese woman with a history of anaphylaxis induced by muscle relaxants had local anesthetic systemic toxicity (LAST) following an abdominal surgery under general anesthesia with combined spinal-epidural anesthesia without muscle relaxants. The total dosages of local anesthetics reached 0.67 mg/kg of ropivacaine and 11.5 mg/kg of lidocaine over 12.5 h to obtain sufficient muscle relaxation for surgery. Regional anesthesia is useful in cases in which muscle relaxants are to be avoided during a surgery. However, especially for a patient with risk factors and prolonged surgery, precautions should be taken to prevent LAST.
キーワード muscle relaxant-induced anaphylaxis local anesthetic systemic toxicity epidural anesthesia abdominal surgery
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2019-12
73巻
6号
出版者 Okayama University Medical School
開始ページ 543
終了ページ 546
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31871339
Web of Science KeyUT 000503431400012