JaLCDOI 10.18926/AMO/58271
フルテキストURL 74_2_129.pdf
著者 Fukuma, Shogo| Shinya, Takayoshi| Soh, Junichi| Fukuhara, Ryuichiro| Ogawa, Nanako| Higaki, Fumiyo| Tanaka, Takehiro| Ichihara, Eiki| Hiraki, Takao| Toyooka, Shinichi| Kanazawa, Susumu|
抄録 The aim of this study was to explore enhancement patterns of different types of primary lung cancers on 2-phase dynamic computed tomography (CT). This study included 217 primary lung cancer patients (141 adenocarcinomas [ADs], 48 squamous cell carcinomas [SCCs], 20 small cell lung carcinomas [SCLCs], and 8 others) who were examined using a 2-phase dynamic scan. Regions of interest were identified and mean enhancement values were calculated. After excluding the 20 SCLCs because these lesions had different clinical stages from the other cancer types, the mean attenuation values and subtractions between phases were compared between types of non-small cell lung carcinomas (NSCLCs) using the Kruskal–Wallis test. Late phase attenuation and attenuation of the late minus unenhanced phase (LMU) of SCCs were significantly higher than those of ADs (p<0.05). To differentiate SCC and AD in the late phase, a threshold of 80.21 Hounsfield units (HU) gave 52.9% accuracy. In LMU, a threshold of 52.16 HU gave 59.3% accuracy. Dynamic lung CT has the potential to aid in differentiating among NSCLC types.
キーワード differentiation dynamic computed tomography primary lung cancer enhancement pattern
Amo Type Original Article
発行日 2020-04
出版物タイトル Acta Medica Okayama
74巻
2号
出版者 Okayama University Medical School
開始ページ 129
終了ページ 135
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 32341587
Web of Science KeyUT 000528278500006
JaLCDOI 10.18926/AMO/58270
フルテキストURL 74_2_123.pdf
著者 Fukuhara, Ryuichiro| Shinya, Takayoshi| Fukuma, Shogo| Ogawa, Nanako| Masaoka, Yoshihisa| Tanaka, Takehiro| Marunaka, Hidenori| Arioka, Tadashi| Hiraki, Takao| Kaji, Mitsumasa| Kanazawa, Susumu|
抄録 The aim of this study was to evaluate the ability of pretreatment 90-min 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to predict the extranodular spread of lymph node metastases in oral squamous cell carcinoma. We retrospectively reviewed the cases of 56 patients who underwent pretreatment 18F-FDG PET/CT and surgery with neck dissection. Maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis were measured for the 56 primary sites and maximum standardized uptake value was measured for 115 lymph node levels. Extranodular spread was present at 9 lymph node levels in 7 patients. Significant differences were found in metabolic tumor volume and total lesion glycolysis of the primary site, and in lymph node maximum standardized uptake value, between patients with and without extranodular spread (p<0.05). Combining primary site total lesion glycolysis and lymph node maximum standardized uptake volume at their respective optimal cutoffs, the sensitivity, specificity, and accuracy for predicting extranodular spread were 89%, 92%, and 92%, respectively. Pretreatment 18F-FDG PET/CT is useful for predicting extranodular spread in patients with oral squamous cell carcinoma. The combined use of primary site total lesion glycolysis and lymph node maximum standardized uptake value showed greater predictive value than either predictor singly.
キーワード 18F-fluorodeoxyglucose positron emission tomography/computed tomography extranodular spread metastasis oral squamous cell carcinoma
Amo Type Original Article
発行日 2020-04
出版物タイトル Acta Medica Okayama
74巻
2号
出版者 Okayama University Medical School
開始ページ 123
終了ページ 128
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 32341586
Web of Science KeyUT 000528278500005
JaLCDOI 10.18926/AMO/58269
フルテキストURL 74_2_115.pdf
著者 Kotani, Sayoko| Kamada, Yasuhiko| Shimizu, Keiko| Sakamoto, Ai| Nakatsuka, Mikiya| Hiramatsu, Yuji| Masuyama, Hisashi|
抄録 Thrombosis in decidual vessels is one of the mechanisms of pregnancy loss. However, few studies have assessed the relation between platelet activation, which is known to cause of thrombosis, and recurrent pregnancy loss (RPL). We investigated platelet activation in women with RPL compared to controls by measuring plasma levels of platelet factor 4 (PF4) and β-thromboglobulin (βTG), and assessed correlations between PF4/βTG and coagulative risk factors associated with RPL. The study group included 135 women who had experienced two or more consecutive pregnancy losses. The control group included 28 age-matched healthy women who had never experienced pregnancy loss. PF4 and βTG plasma levels were significantly higher in the women with RPL than controls (PF4: 14.0 [8.0-20.0] vs. 9.0 [6.0-12.0] ng/ml, p=0.043; βTG: 42.0 [24.3-59.8] vs. 31.5 [26.6-36.4] ng/ml, p=0.002). There was a significant association between βTG and anti-phosphatidylethanolamine antibody immunoglobulin M (aPE IgM) (p=0.048). Among the women with RPL, 18 of those who were positive for PF4 (45%) and 18 of those who were positive for βTG (37%) were negative for all known coagulative risk factors associated with RPL. Measurements of PF4 and βTG may be important because they help identify women who are at risk of RPL.
キーワード recurrent pregnancy loss platelet factor 4 β-thromboglobulin platelet activation
Amo Type Original Article
発行日 2020-04
出版物タイトル Acta Medica Okayama
74巻
2号
出版者 Okayama University Medical School
開始ページ 115
終了ページ 122
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 32341585
Web of Science KeyUT 000528278500004
JaLCDOI 10.18926/AMO/58268
フルテキストURL 74_2_109.pdf
著者 Ogawa, Chikako| Nakamura, Keiichiro| Matsuoka, Hirofumi| Matsubara, Yuko| Haraga, Junko| Masuyama, Hisashi|
抄録 This study aimed to determine whether the risk conferred by gynecologic cancer (GC) as second primary cancer (SPC) differs from that associated with GC as first primary cancer (FPC). We investigated the correlations between FPC/SPC and the characteristics and prognoses of 1,645 GC patients (701 with cervical cancer [CC], 641 with endometrial cancer [EM], and 303 with ovarian cancer [OV]). The χ2 test and the Kaplan–Meier method were used to determine whether FPC/SPC and the characteristics and prognoses of GC patients. Of the SPC patients, 26 (3.7%) had CC, 53 (8.3%) had EM, and 31 (10.2%) had OV. The most common previous cancer type in SPC of GC patients was breast cancer, which was observed in 13 patients (50.0%) with CC, 23 (43.4%) with EM, and 16 (51.6%) with OV. In all patients with CC, EM, and OV as SPC, the stage was significantly associated with recurrence. There were no significant differences in the morbidity or mortality of CC, EM, or OV patients between those with FPC and those with SPC. The risk of SPC development in GC patients varied, ranging from 3.5% (CC) to 10.3% (OV) of patients.
キーワード second primary cancer gynecologic cancer prognosis
Amo Type Original Article
発行日 2020-04
出版物タイトル Acta Medica Okayama
74巻
2号
出版者 Okayama University Medical School
開始ページ 109
終了ページ 114
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 32341584
Web of Science KeyUT 000528278500003
JaLCDOI 10.18926/AMO/58267
フルテキストURL 74_2_103.pdf
著者 Kawada, Yasumasa| Kubo, Toru| Baba, Yuichi| Hirota, Takayoshi| Tanioka, Katsutoshi| Yamasaki, Naohito| Kitaoka, Hiroaki|
抄録 This study examined whether switching from amlodipine and atorvastatin treatment using two pills to an equal dose of single-pill therapy is useful in Japanese outpatients. We retrospectively reviewed data obtained from 94 outpatients for whom treatment with two pills, namely amlodipine and atorvastatin, was switched to an equal dose of single-pill therapy in 11 hospitals. The criterion for enrollment in this study was that patients had switched their medication without changing other anti-hypertensive or anti-cholesterol drugs. Neither systolic nor diastolic blood pressure changed significantly after switching to an equal dose of single-pill therapy, whereas low-density lipoprotein (LDL) cholesterol levels significantly decreased after the medication was switched from 94±24 mg/dl to 89±17 mg/dl (p=0.015). A switch from medication with two separate pills of amlodipine and atorvastatin to an equal dose of single-pill therapy resulted in an overall decrease in LDL cholesterol. The results indicated that the switch to single-pill therapy might be a useful treatment.
キーワード hypertension dyslipidemia single-pill therapy
Amo Type Original Article
発行日 2020-04
出版物タイトル Acta Medica Okayama
74巻
2号
出版者 Okayama University Medical School
開始ページ 103
終了ページ 108
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 32341583
Web of Science KeyUT 000528278500002
JaLCDOI 10.18926/AMO/58266
フルテキストURL 74_2_95.pdf
著者 Kuba, Sayaka| Yamanouchi, Kosho| Morita, Michi| Sakimura, Chika| Inamasu, Eiko| Hatachi, Toshiko| Otsubo, Ryota| Matsumoto, Megumi| Yano, Hiroshi| Miyamoto, Junya| Sato, Shuntaro| Nakagawa, Hiroo| Kanetaka, Kengo| Takatsuki, Mitsuhisa| Nagayasu, Takeshi| Eguchi, Susumu|
抄録 We assessed the usefulness of ChemoCalc, a software package for calculating drug costs, in helping patients understand these costs. We randomly assigned, in a 1 : 1 ratio, 20 women who had undergone surgery for early breast cancer to a group that discussed adjuvant treatment with their physicians using the ChemoCalc software (ChemoCalc group) or a group that discussed adjuvant treatment without ChemoCalc (Usual Explanation group). The participants completed a five-grade evaluation questionnaire after these discussions. The primary endpoint was the intergroup comparison of the questionnaire scores regarding participants’ understanding of their treatment-associated drug costs. Median age was not significantly different between the ChemoCalc group and Usual Explanation group (57 vs. 50, respectively; p=0.27). Patients in the ChemoCalc group had a significantly higher perceived level of understanding of the drug cost than those in the Usual Explanation group (5 [4-5] vs. 2.5 [1-5], respectively; p=0.002). Scores related to the patients’ perception that understanding drug costs is an important part of breast cancer treatment were also higher in the ChemoCalc group than the Usual Explanation group (5 [2-5] vs. 3 [1-5], respectively; p=0.049). ChemoCalc was found to be useful for understanding drug costs.
キーワード breast cancer drug costs ChemoCalc
Amo Type Original Article
発行日 2020-04
出版物タイトル Acta Medica Okayama
74巻
2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Ⓒ 2020 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 32341582
Web of Science KeyUT 000528278500001
JaLCDOI 10.18926/AMO/57959
フルテキストURL 74_1_89.pdf
著者 Kada, Akiko| Fukano, Reiji| Mori, Tetsuya| Kamei, Michi| Tanaka, Fumiko| Ueyama, Junichi| Sekimizu, Masahiro| Osumi, Tomoo| Mori, Takeshi| Koga, Yuhki| Ohki, Kentaro| Fujita, Naoto| Mitsui, Tetsuo| Saito, Akiko M.| Hashimoto, Hiroya| Kobayashi, Ryoji|
抄録 No standard treatment for relapsed or refractory anaplastic large-cell lymphoma (ALCL) has been established. This study is a multicenter, open-label trial to examine the effectiveness and safety of transplantation with reduced-intensity conditioning (RIC) for patients under 20 years old with relapsed or refractory ALCL. We defined RIC as the administration of fludarabine (30 mg/m2/day) for five days plus melphalan (70 mg/m2/day) for two days and total body irradiation at 4 Gy, followed by allogeneic hematopoietic stem cell transplantation.
キーワード anaplastic large-cell lymphoma relapsed/refractory fludarabine melphalan total body irradiation
Amo Type Clinical Study Protocol
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 89
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Ⓒ 2020 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 32099255
JaLCDOI 10.18926/AMO/57958
フルテキストURL 74_1_83.pdf
著者 Sakurai, Toru| Watanabe, Toshiyuki| Manako, Kensuke| Komagoe, Syo| Mukai, Yuko| Kimata, Yoshiro| Namba, Yuzaburo|
抄録 Nosaka, NobuyukiMastectomy is usually the first and most important surgical procedure in female-to-male (FTM) individuals with gender identity disorder. Nipple reduction is also important in the process of reconstructing the chest wall for a more male appearance. If the nipples remain large after a mastectomy, the results may be disappointing to many FTM transsexuals. Nipple reduction enables these individuals to go to the beach or Japanese public baths, where they may go topless in public. We therefore consider that nipple reduction is indicated for all FTM transsexuals who desire it. There are a variety of methods for the reduction of enlarged nipples for women or non-FTM patients, but only a few reports have described the process used to create masculine-appearing nipples for FTM transsexuals. We developed a novel technique called the Eryngii method for creating male-like nipples using a 4-mm diameter dermal punch knife. The name of the method refers to the Eryngii king trumpet mushroom, which the nipple resembles after the surgical process. The main strength of this method is that it permits the creation of ideal nipples without difficulty. Here we introduce the technique and discuss our history of surgical methods for nipple reduction, including improvements and elaborations.
キーワード nipple reconstruction female-to-male transmen mastectomy top surgery
Amo Type Case Report
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 83
終了ページ 87
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 32099254
JaLCDOI 10.18926/AMO/57957
フルテキストURL 74_1_77.pdf
著者 Endo, Hirosuke| Akazawa, Hirofumi| Yashiro, Masato| Yamada, Kazuki| Sanki, Tomoaki| Tetsunaga, Tomonori| Nishida, Keiichiro| Furumatsu, Takayuki| Ozaki, Toshifumi|
抄録 Idiopathic chondrolysis of the hip (ICH), a very rare disorder of unknown etiology, occurs mainly in female adolescents. Characterized by pain, limp, stiffness and radiological narrowing joint space from the rapid destruction of the articular cartilage, ICH sometimes results in ankyloses. We present the case of a 10-year-old girl diagnosed with ICH based on arthroscopic inspection and synovium biopsy. The femoral deformity appeared gradually, like a cam-type femoroacetabular impingement. She was treated with intensive rehabilitation and immunosuppressive drug. We later performed an arthroscopic bumpectomy for residual symptoms. She achieved a favorable outcome as a 15-year-old at the latest follow-up.
キーワード idiopathic chondrolysis hip joint medication bump arthroscopy
Amo Type Case Report
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 77
終了ページ 81
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 32099253
JaLCDOI 10.18926/AMO/57956
フルテキストURL 74_1_73.pdf
著者 Yamane, Masaomi| Mandai, Yasuhiro| Ino, Hideo| Matsukawa, Akihiro| Toyooka, Shinichi|
抄録 In 2016, Gunma University Hospital’s Medical Accident Investigation Committee released a report reiterating the necessity of medical education and the need for surgeons to master non-technical skills. We designed a 17-h training course for surgical instructors, designed to teach participants how to sufficiently educate surgeon trainees and encourage their professional identity formation. A post-training survey showed that participants improved their awareness, and their behavioral changes led to favorable team performances. We then began offering a 3-h workshop focusing on the participants’ experiences. We propose that the training course using participant narratives is required and effective to establish surgeons’ self-reflection and professional identity as surgeons.
キーワード professional identity instructor training narrative
Amo Type Short Communication
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 73
終了ページ 76
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 32099252
JaLCDOI 10.18926/AMO/57955
フルテキストURL 74_1_65.pdf
著者 Akiyama, Tomoyuki| Saigusa, Daisuke| Hyodo, Yuki| Umeda, Keiko| Saijo, Reina| Koshiba, Seizo| Kobayashi, Katsuhiro|
抄録 To characterize metabolic profiles within the central nervous system in epilepsy, we performed gas chromatography-tandem mass spectrometry (GC-MS/MS)-based metabolome analysis of the cerebrospinal fluid (CSF) in pediatric patients with and without epilepsy. The CSF samples obtained from 64 patients were analyzed by GC-MS/MS. Multivariate analyses were performed for two age groups, 0-5 years of age and 6-17 years of age, to elucidate the effects of epilepsy and antiepileptic drugs on the metabolites. In patients aged 0-5 years (22 patients with epilepsy, 13 without epilepsy), epilepsy patients had reduced 2-ketoglutaric acid and elevated pyridoxamine and tyrosine. In patients aged 6-17 years (12 with epilepsy, 17 without epilepsy), epilepsy patients had reduced 1,5-anhydroglucitol. Valproic acid was associated with elevated 2-aminobutyric acid, 2-ketoisocaproic acid, 4-hydroxyproline, acetylglycine, methionine, N-acetylserine, and serine. Reduced energy metabolism and alteration of vitamin B6 metabolism may play a role in epilepsy in young children. The roles of 1,5-anhydroglucitol in epilepsy in older children and in levetiracetam and zonisamide treatment remain to be explained. Valproic acid influenced the levels of amino acids and related metabolites involved in the metabolism of serine, methionine, and leucine.
キーワード antiepileptic drugs gas chromatography-tandem mass spectrometry metabolome analysis metabolomics
Amo Type Original Article
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 65
終了ページ 72
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 32099251
JaLCDOI 10.18926/AMO/57954
フルテキストURL 74_1_59.pdf
著者 Owari, Yutaka| Miyatake, Nobuyuki| Suzuki, Hiromi|
抄録 Few studies have considered the causal relationship between psychological distress and social participation in elderly people. Here we investigated this relationship based on an initial survey and a follow-up survey. In 2016, a survey was distributed to 86 participants. A follow-up survey of 80 of those participants was performed in 2017. We adopted the following variables: psychological distress and social participation as represented by the Kessler psychological distress scale and social participation scores, respectively. By using cross-lagged and synchronous effects models, we found that the 2016 Kessler psychological distress scale had a significant influence on the 2017 social participation scores (standardization factor=−0.221, p=0.020) and the 2017 Kessler psychological distress scale significantly influenced the 2017 social participation scores (standardization factor=−0.345, p=0.039). The results suggest that psychological distress may affect social participation one year later.
キーワード causal relationship elderly people psychological distress social participation structural equation modeling (SEM)
Amo Type Original Article
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 59
終了ページ 63
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 32099250
JaLCDOI 10.18926/AMO/57953
フルテキストURL 74_1_53.pdf
著者 Kubota, Risa| Araki, Motoo| Wada, Koichiro| Kawamura, Kasumi| Maruyama, Yuki| Mitsui, Yosuke| Sadahira, Takuya| Ariyoshi, Yuichi| Iwata, Takehiro| Nishimura, Shingo| Takamoto, Atsushi| Sako, Tomoko| Edamura, Kohei| Kobayashi, Yasuyuki| Kano, Yuzuki| Kitagawa, Masashi| Tanabe, Katsuyuki| Sugiyama, Hitoshi| Wada, Jun| Watanabe, Masami| Watanabe, Toyohiko| Nasu, Yasutomo|
抄録 We investigated the feasibility of robotic renal autotransplantation (RAT) in a porcine model to reduce invasiveness of RAT. Five pigs underwent robotic RAT using the da Vinci® robotic system. A robotic left nephrectomy was performed in all cases. Robotic RAT was performed on the left side in all but one case. Four ports were used. In 3 cases, the kidney was taken out through the GelPort® and irrigated on ice with Ringer’s solution. In 2 cases, a complete intracorporeal robotic RAT was performed. An end-to-side anastomosis was performed between the renal vein and the external iliac vein and between the renal artery and the external iliac artery. Ureteroneocystostomy was also performed in 2 cases. All cases were performed robotically without open conversion. The median (IQR) console time was 3.1 (0.7) h, and the operative time was 3.8 (1.1) h. The estimated blood loss was 30 (0) ml. The warm ischemia time was 4.0 (0.2) min, and the cold ischemia time was 97 (17) min. Intracorporeal transarterial hypothermic renal perfusion was feasible in the 2 complete intracorporeal robotic RAT cases by using a perfusion catheter through a laparoscopic port. Robotic RAT has the potential to be a new minimally invasive substitute for conventional open surgery.
キーワード renal autotransplantation robotic porcine model transplantation
Amo Type Original Article
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 53
終了ページ 58
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 32099249
JaLCDOI 10.18926/AMO/57952
フルテキストURL 74_1_49.pdf
著者 Takeuchi, Takashi| Okumura, Yasuyuki| Ichikura, Kanako|
抄録 The use of alcohol or drug(s) prior to self-injury is a possible inducing factor for suicidal self-injuries among patients with adjustment disorder. We analyzed the cases of 175 individuals who were admitted to the intensive care unit (ICU) of Tokyo Medical and Dental University Medical Hospital for suicidal self-injury to determine whether alcohol consumption or an excessive use of prescribed psychotropic medications prior to self-injury is more common in patients with adjustment disorder. During a 7-year period (July 2006 to June 2013) following their deliberate self-injuries, 971 patients were admitted to the ICU. Our study sample (n=175) was restricted to patients with adjustment disorder (n=48), major depressive disorder (n=90), or schizophrenia (n=37). The outcome variable was alcohol consumption or excessive use of medications prior to suicidal self-injury. A logistic regression analysis revealed that the patients with adjustment disorder more commonly showed alcohol consumption or excessive medication use prior to their suicidal self-injury compared to those with schizophrenia (odds ratio: 8.10; 95%CI: 2.97-24.60). To inhibit suicidal self-injury among patients with adjustment disorder, it is important to continue efforts to provide psychoeducation about alcohol use and to instruct the patients to take their prescribed medication(s) only as directed by their physician.
キーワード alcohol psychotropic medications self-injury adjustment disorder
Amo Type Original Article
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 49
終了ページ 52
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 32099248
JaLCDOI 10.18926/AMO/57951
フルテキストURL 74_1_41.pdf
著者 Amano, Hoichi| Fujimoto, Kenichi| Fujimori, Makoto| Saka, Natsumi| Nomura, Kyoko| Tanihara, Shinichi|
抄録 We aimed to clarify the prevalence of polypharmacy among elderly individuals in Japan. We used the data obtained from a large-scale population-based representative database of health insurance claims in a single prefecture in Japan. We examined all of the outpatient and pharmaceutical health insurance claims for National Health Insurance and those for Late-stage Elderly Health Insurance in Nagasaki Prefecture, Japan between April and June 2016. When two or more claim forms were issued for a patient in a single month, we combined the data and identified the number of prescribed drugs for each person. The definition of polypharmacy is a the prescription of six or more drugs per month. We investigated the prevalence of polypharmacy among the beneficiaries of the two insurance systems. Of the 605,406 beneficiaries of the 2 insurance systems, 121,033 (20.0%) patients with polypharmacy were identified. The prevalence of polypharmacy increased with age, especially among the beneficiaries aged > 85 years, with about half of the beneficiaries having polypharmacy status. About half of the people aged > 85 years in the database had polypharmacy status. When a drug is prescribed to an elderly individual, it is necessary to consider the possibility of polypharmacy-related problems.
キーワード health insurance claims late-stage elderly health insurance national health insurance Japan polypharmacy
Amo Type Original Article
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 41
終了ページ 48
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 32099247
JaLCDOI 10.18926/AMO/57950
フルテキストURL 74_1_33.pdf
著者 Honda, Hiroyuki| Hanayama, Yoshihisa| Obika, Mikako| Hasegawa, Kou| Hamahara, Jun| Kishida, Masayuki| Hagiya, Hideharu| Ogawa, Hiroko| Kataoka, Hitomi| Otsuka, Fumio|
抄録 A relationship between diabetes and depression is apparent. To clarify the clinical relevance of diabetic patients’ gastroesophageal symptoms to their psychological status, we retrospectively analyzed the data from a Selfrating Depression Scale (SDS) and a Frequency Scale for Symptoms of Gastroesophageal reflux disease (FSSG) among 143 type 2 diabetic patients who visited a general medicine department. Among the 45 Japanese patients enrolled, the group with relatively high SDS scores (≥ 36) showed higher (FSSG) dysmotility symptom scores versus the low-SDS (< 36) group, although the 2 groups’ characteristics and laboratory data were not significantly different. Positive correlations of postprandial plasma glucose (PPG) levels with FSSG scores (R=0.321, p<0.05), particularly with reflux scores (R=0.455, p<0.01) were revealed. PPG and HbA1c levels were not correlated with SDS scores. The patients’ SDS scores were significantly correlated with their FSSG scores (R=0.41, p<0.01), suggesting that depressive status is linked to GERD-related manifestations. Considering that the patients’ PPG levels were correlated with GERD-related symptoms, diabetic patients’ blood glucose levels are associated with depressive status. Collectively, key symptoms related to GERD and glucose level values would be helpful
キーワード blood glucose type 2 diabetes mellitus gastroesophageal reflux depressive status postprandial plasma glucose
Amo Type Original Article
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 33
終了ページ 40
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 32099246
JaLCDOI 10.18926/AMO/57949
フルテキストURL 74_1_27.pdf
著者 Toda, Kazukiyo| Yagata, Yukihisa| Kikuchi, Takeshi| Takigawa, Tomoyuki| Ito, Yasuo|
抄録 Pelvic fractures occur with high-energy trauma, and the patient’s clinical status is unstable. Although a number of surgical methods for unstable pelvic fractures are available, none can achieve strong fixation with minimal invasiveness. We describe a surgical transiliac rod and screw fixation (TIF) procedure that provides minimally invasive fixation using a spinal implant for unstable pelvic ring fractures, and we retrospectively analyzed the procedure’s outcomes in 27 patients with type B or C1 fractures (based on the AO/ATO classification system). Small skin incisions are made above the posterior superior iliac spines on both sides. The ilium is partially resected, and two iliac screws are inserted on each side. The spinous process of the sacral spine is then shaved, and the iliac screws are connected to 2 rods, one placed caudal to the other. Corrective manipulation is performed at the fracture site, and the rods are connected with connectors. Favorable fracture reduction, defined as a rating of ‘excellent’ or ‘good,’ was achieved in 77.8% of the patients. Transiliac rod and screw fixation (TIF) will be a useful therapeutic option for unstable pelvic ring fractures.
キーワード pelvic ring fractures sacral fracture transiliac rod and screw fixation spinal fixation system minimally invasive surgery
Amo Type Original Article
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 27
終了ページ 32
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 32099245
JaLCDOI 10.18926/AMO/57948
フルテキストURL 74_1_17.pdf
著者 Ishii, Kenzo| Morimatsu, Hiroshi| Ono, Kazumi| Miyasho, Koji|
抄録 We performed a retrospective cohort study of 911 high-energy trauma patients who underwent chest CT scans at least twice after admission. We hypothesized that in high-energy trauma patients, a high-inspired oxygen concentration delivered after admission results in dorsal atelectasis. The study’s primary outcome was dorsal atelectasis formation diagnosed based on CT images. We defined dorsal atelectasis as the presence of atelectasis at ≥ 10 mm thick on CT images. We defined high-inspired oxygen concentration as >60% oxygen delivered between two CT scans. Four hundred sixty-five patients (51.0%) developed atelectasis according to the second CT scan, and 338 (37.1%) received a high-inspired oxygen concentration. A univariate analysis showed that the rate of the high-inspired oxygen concentration in the atelectasis group was significantly higher than that in the non-atelectasis group (43.4% vs. 30.1%, p<0.001). However, a logistic regression analysis showed that there was no significant relationship between the oxygen concentration and the formation of dorsal atelectasis (OR: 1.197, 95%CI: 0.852-1.683, p=0.30). Age, the Injury Severity Score, BMI, and smoking were found to be risk factors of dorsal atelectasis formation in high-energy trauma patients. There was no relationship between the oxygen concentration and atelectasis formation in our series of high-energy trauma patients.
キーワード trauma patient dorsal atelectasis oxygen concentration
Amo Type Original Article
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 17
終了ページ 26
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 32099244
JaLCDOI 10.18926/AMO/57947
フルテキストURL 74_1_7.pdf
著者 Sanki, Tomoaki| Endo, Hirosuke| Tetsunaga, Tomonori| Furumatsu, Takayuki| Yamada, Kazuki| Ozaki, Toshifumi|
抄録 We investigated the relationship between the initial contact status and stress shielding in total hip arthroplasty (THA) using fit-and-fill type straight-stem implants. In addition we evaluated the clinical and radiographic outcomes. Subjects were 100 hips of 94 patients who underwent THA and were followed-up for ≥10 years. Contact areas with the femoral cortical bone were investigated according to the zonal distribution of Gruen using postoperative CT images. Depending on the number of contact areas, the patients were classified into high contact [HC], medium contact [MC], and low contact [LC] groups. Radiographic and clinical outcomes were evaluated. In the HC group (20 hips), severe stress shielding was observed in 12 hips, which was statistically significant (p=0.008). In the LC group (29 hips), mild stress shielding was observed in 27 hips which was statistically significant (p<0.001). No significant differences were observed among the 3 groups in clinical outcomes, Harris hip score (p=0.719) or Japanese Orthopedic Association (JOA) score (p=0.301). In insertion of cementless collared fit-and-fill type straight-stem implants, severe late stress shielding of the femoral bone may occur if high contact of the femoral component is achieved. However, the degree of stress shielding does not result in adverse clinical outcomes.
キーワード fit-and-fill stress shielding cementless straight stem total hip arthroplasty
Amo Type Original Article
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 7
終了ページ 15
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 32099243
JaLCDOI 10.18926/AMO/57946
フルテキストURL 74_1_1.pdf
著者 Chen, Yuehua| Ohara, Toshiaki| Xing, Boyi| Qi, Jiping| Noma, Kazuhiro| Matsukawa, Akihiro|
抄録 Iron is a trace but vital element in the human body and is necessary for a multitude of crucial processes in life. However, iron overload is known to induce carcinogenesis via oxidative stress. Cancer cells require large amounts of iron for their rapid division and cell growth. Iron was recently found to play a role in cancer stem cells (CSCs); it maintains stemness during development. Iron also plays an important role in stemness by moderating reactive oxygen species. Thus, iron metabolism in CSCs is a promising therapeutic target. In this review, we summarize the roles of iron in cancer cells and CSCs. We also summarize anti-cancer therapeutic studies with iron chelators and describe our expectation of a new therapeutic strategy for CSCs on the basis of our findings.
キーワード cancer stem cell stemness iron chelation chemotherapy
Amo Type Review
発行日 2020-02
出版物タイトル Acta Medica Okayama
74巻
1号
出版者 Okayama University Medical School
開始ページ 1
終了ページ 6
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 32099242