| 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 |
| 巻 | 73巻 |
| 号 | 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/56936 |
|---|---|
| フルテキストURL | 73_4_341.pdf |
| 著者 | Kitajima, Kazuhiro| Yamamoto, Shingo| Nakanishi, Yukako| Yamada, Yusuke| Hashimoto, Takahiko| Suzuki, Toru| Go, Shuken| Kanematsu, Akihiro| Nojima, Michio| Fujiwara, Masayuki| Kaida, Hayato| Tsurusaki, Masakatsu| Kanda, Tomonori| Tamaki, Yukihisa | Yamakado, Koichiro| |
| 抄録 | We investigated the effectiveness of 11C-choline-positron emission tomography/computed tomography (PET/CT) for evaluating treatment response in patients with prostate cancer or renal cell carcinoma. We performed 34 11C-choline PET/CT scans before/after a combined total of 17 courses of treatment in 6 patients with prostate cancer and 2 with renal cell carcinoma. The 17 treatments including hormonal therapy, radiotherapy, chemotherapy, radium-223, molecular target therapy, radiofrequency ablation, transcatheter arterial embolization, and cancer immunotherapy yielded 1 (5.9%) complete metabolic response (CMR), 3 (17.6%) partial metabolic responses (PMRs), 2 (11.8%) stable metabolic diseases (SMDs), and 11 (64.7%) progressive metabolic diseases (PMDs). Target lesions were observed in bone (n=14), lymph nodes (n=5), lung (n=2), prostate (n=2), and pleura (n=1), with CMR in 4, PMR in 10, SMD in 8 and PMD in 2 lesions. SUVmax values of the target lesions before and after treatment were 7.87±2.67 and 5.29±3.98, respectively, for a mean reduction of −35.4±43.6%. The response for the 8 prostate cancer-treatment courses was PMD, which correlated well with changes in serum prostatic specific antigen (PSA) (7 of 8 cases showed increased PSA). 11C-choline-PET/CT may be an effective tool for detecting viable residual tumors and evaluating treatment response in prostate cancer and renal cell carcinoma patients. |
| キーワード | treatment response 11C-choline PET/CT prostate cancer renal cell carcinoma |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-08 |
| 巻 | 73巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 341 |
| 終了ページ | 347 |
| 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 | 31439957 |
| JaLCDOI | 10.18926/AMO/56935 |
|---|---|
| フルテキストURL | 73_4_333.pdf |
| 著者 | Kuwaki, Kenji| Nouso, Kazuhiro| Miyashita, Manabi| Makino, Yasuhiro| Hagihara, Hiroaki| Moriya, Akio| Adachi, Takuya| Wada, Nozomu| Yasunaka, Yuki| Yasunaka, Tetsuya| Takeuchi, Yasuto| Onishi, Hideki| Nakamura, Shinichiro| Ikeda, Fusao| Shiraha, Hidenori| Takaki, Akinobu| Okada, Hiroyuki| |
| 抄録 | Steroids are often administered at the time of transcatheter arterial chemoembolization (TACE), a standard treatment of hepatocellular carcinoma (HCC), with the expectation of preventing postembolization syndrome. Here we investigated the precise effects of steroids on TACE. We prospectively enrolled 144 HCC patients from 10 hospitals who underwent TACE. Three hospitals used steroids (steroid group, n=77) and the rest did not routinely use steroids (control group, n=67). The occurrence of adverse events and the algetic degree at 1-5 days post-treatment were compared between the groups. Fever (grades 0-2) after TACE was significantly less in the steroid group (56/21/0) compared to the control group (35/29/3, p=0.005, Cochran-Armitage test for trend). The suppressive effect of steroids against fever was prominent in females (p=0.001). Vomiting (G0/G1/ G2-) was also less frequent in the steroid group (70/5/2) versus the control group (53/10/3), but not significantly (p=0.106). The algetic degree and the grade of hematological adverse events, including hyperglycemia, did not differ between the groups. We conclude that the administration of steroids was useful for the prevention of adverse events after TACE in patients with HCC. |
| キーワード | antipyretic hepatocellular carcinoma therapeutic chemoembolization steroid |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-08 |
| 巻 | 73巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 333 |
| 終了ページ | 339 |
| 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 | 31439956 |
| JaLCDOI | 10.18926/AMO/56934 |
|---|---|
| フルテキストURL | 73_4_325.pdf |
| 著者 | Ueno, Tsuyoshi| Maki, Yuho| Sugimoto, Ryujiro| Suehisa, Hiroshi| Yamashita, Motohiro| Harada, Daijiro| Kozuki, Toshiyuki| Nogami, Naoyuki| |
| 抄録 | Therapeutic approaches to bronchopleural fistula (BPF) closure after lung resection are surgical or endoscopic interventions. We evaluated therapeutic outcomes to determine the optimal approach. We reviewed 15 patients who had developed BPF after lung resection for thoracic malignant diseases at our institution in the 10 years since 2008. The patients were 11 men and 4 women (mean age 68 years). We performed one pneumonectomy, 6 lobectomies, 7 segmentectomies, and one partial resection for malignant diseases. The median interval from lung resection to the BPF diagnosis was 46 days. The BPF-associated mortality rate was 26.7% (4/15). The rate of successful BPF closure was 66.6% (10/15). The endoscopic and surgical intervention success rates were 14.2% (1/7) and 69.2% (9/13), respectively (p<0.01). Of 5 patients who had failed BPF treatments, 4 died, and one transferred out without BPF closure. The therapeutic outcomes were related to preoperative comorbidities, performance status at the BPF diagnosis, time intervals from lung resection to BPF diagnosis, and presence of active pneumonia. The difference between endoscopic and surgical outcomes was nonsignificant, although the surgical intervention success rate was somewhat higher. The selection of endoscopic or surgical intervention for BPF does not significantly affect therapeutic outcomes. |
| キーワード | bronchopleural fistula endoscopic intervention surgical intervention |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-08 |
| 巻 | 73巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 325 |
| 終了ページ | 331 |
| 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 | 31439955 |
| JaLCDOI | 10.18926/AMO/56933 |
|---|---|
| フルテキストURL | 73_4_315.pdf |
| 著者 | Ono, Shintaro| Nakayama, Masaaki| Tachibana, Masato| Abu Saleh Muhammad Shahriar| Heling, Wang| Takashiba, Shogo| Ohara, Naoya| |
| 抄録 | The periodontal pathogen Porphyromonas gingivalis shows colonial pigmentation on blood agar and produces gingipains (Kgp, RgpA, and RgpB), cysteine proteases involved in an organism’s virulence and pigmentation. We showed previously that deletion of the PGN_0300 gene abolished the pigmentation activity and reduced the proteolytic activity of gingipains. The role of the PGN_0297 gene, which consists of an operon with the PGN_0300 gene, is unclear. Herein we examined the effect of PGN_0297 gene deletion on the pigmentation and proteolytic activities and transcriptional levels of gingipains. A PGN_0297 gene deletion mutant (ΔPGN_0297) did not exhibit the pigmentation. The proteolytic activity of the gingipains was decreased in the culture supernatant and on the cell surface of ΔPGN_0297. The mutant ΔPGN_0297 failed to attenuate Akt phosphorylation at Thr308 and Ser473, but both phosphorylations were attenuated in the wild-type and its complementation strain. The deletion of PGN_0297 gene did not substantially affect the transcriptional levels of the gingipain genes kgp, rgpA, and rgpB. Taken together, these results indicate that PGN_0297 is closely involved in the secretion and maturation of gingipains. |
| キーワード | periodontitis Porphyromonas gingivalis gingipain C-terminal domain secretion system |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-08 |
| 巻 | 73巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 315 |
| 終了ページ | 323 |
| 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 | 31439954 |
| JaLCDOI | 10.18926/AMO/56932 |
|---|---|
| フルテキストURL | 73_4_307.pdf |
| 著者 | Takahashi, Sho| Akagi, Teiji| Toh, Norihisa| Takaya, Yoichi| Nakagawa, Koji| Nishii, Nobuhiro| Ito, Hiroshi| |
| 抄録 | The follow-up of patients with adult congenital heart disease (ACHD) at a specialized medical unit is necessary for the patients’ appropriate medical care. However, limited information is available about cardiovascular events among ACHD patients. Here we investigated the type and frequency of cardiovascular events in ACHD patients in relation to disease complexity. We retrospectively analyzed the cases of 535 patients (median age 35 years) referred to our ACHD center between 2014 and 2017. We divided the patients into 3 groups based on their disease complexity. To evaluate the relationship between disease complexity and cardiovascular events, we performed univariate and multivariate survival analyses. The Simple, moderate, and complex disease groups accounted for 62%, 19%, and 19% of the patients, respectively. Apart from events related to atrial septal defect (ASD) trans-catheter treatment, the frequency of cardiovascular events was dependent on the disease complexity (event-free survival rates at 3 years were 85%, 65%, and 58%, respectively). The hazard ratios were 4.0 and 5.1 in the moderate and complex groups, respectively. With the exception of scheduled transcatheter intervention, cardiovascular events were strongly related to the disease complexity of original heart disease. However, cardiovascular events were not rare even in the simple ACHD group. |
| キーワード | congenital heart defect congenital in adults hospitalization cardiovascular event |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-08 |
| 巻 | 73巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 307 |
| 終了ページ | 313 |
| 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 | 31439953 |
| JaLCDOI | 10.18926/AMO/56931 |
|---|---|
| フルテキストURL | 73_4_299.pdf |
| 著者 | Hiranaka, Takaaki| Nishida, Keiichiro| Konishiike, Taizo| Ozaki, Toshifumi| Mikasa, Motohiko| |
| 抄録 | The fixation technique of bony fragments is crucial for the bone union of the tuberosities after humeral head replacement (HHR) for a comminuted fracture of the proximal humerus. To increase the bone union rate, we reduce tuberosities to overlap on the humeral shaft by approx. 1 cm and fix them with cable wire. Herein, we retrospectively investigated the clinical and radiographic outcomes of our procedure. Twenty-six patients who underwent cementless HHR for the treatment of comminuted fractures of the proximal humerus were investigated. The Constant-Murley score, active shoulder mobility, and bone union rate were evaluated. The mean duration of follow-up was 56.3 months (range 24-197). At the final follow-up, the average Constant-Murley score was 58 (range 40-76). Forward elevation was 126° on average (range 35°-180°). Twenty-three cases (88%) showed bone union between the tuberosities and the shaft at an average follow-up of 4.1 months (range 4-5 months) after surgery. Non-union was noted in 1 case, and bone resorption was noted in 2 cases. The bone union rate and the clinical outcome of our procedure were relatively favorable |
| キーワード | humeral head replacement tuberosity-overlapping technique bone union of tuberosities cable wire cementless stem |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-08 |
| 巻 | 73巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 299 |
| 終了ページ | 305 |
| 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 | 31439952 |
| JaLCDOI | 10.18926/AMO/56930 |
|---|---|
| フルテキストURL | 73_4_285.pdf |
| 著者 | Otani, Yoshihiro| Ichikawa, Tomotsugu| Kurozumi, Kazuhiko| Date, Isao| |
| 抄録 | Gliomas are characterized as highly diffuse infiltrating tumors, and currently available treatments such as surgery, radiation and chemotherapy are unfeasible or show limited efficacy against these tumors. Recent genetic and epigenetic analyses of glioma have revealed increasing evidence of the role of driver genetic alterations in glioma development and led to the identification of prognostic factors. Despite these findings, the survival rates of glioma patients remain low, and alternative treatments and novel targets are needed. Recent studies identified neural stem cells as the possible origin of gliomas, and some evidence has revealed shared functions and mechanisms between glioma cells and neurons, also supporting their similarity. The cytoskeleton plays important roles in the migration of normal cells as well as cancer cells. Recent reports have described a role for microtubules, a component of the cytoskeleton, in glioma invasion. Notably, several factors that regulate microtubule functions, such as microtubule-associated proteins, plus-end tracking proteins, or motor proteins, are upregulated in glioma tissues compared with normal tissue, and upregulation of these factors is associated with high invasiveness of glioma cells. In this review, we describe the mechanism of microtubules in glioma invasion and discuss the possibility of microtubule-targeted therapy to inhibit glioma invasion. |
| キーワード | glioma cytoskeletons invasion microtubules |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-08 |
| 巻 | 73巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 285 |
| 終了ページ | 297 |
| 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 | 31439951 |
| JaLCDOI | 10.18926/AMO/56873 |
|---|---|
| フルテキストURL | 73_3_279.pdf |
| 著者 | Makimoto, Go| Nishimori, Hisakazu| Kondo, Reiko| Yanai, Hiroyuki| Sugimoto, Morito| Oda, Naohiro| Kubo, Toshio| Hotta, Katsuyuki| Tabata, Masahiro| Kiura, Katsuyuki| Maeda, Yoshinobu| |
| 抄録 | Urothelial carcinoma usually presents with hematuria, but cases of multiple lymphadenopathy with elevated S-pancreas-1 antigen (SPan-1) levels have not been reported. A 62-year-old Japanese man with lymphadenopathies was diagnosed with an adenocarcinoma of unknown origin and transferred to our hospital for further diagnosis. Serum carbohydrate antigen 19-9 and SPan-1 levels were extremely elevated. Uroplakin III immunostaining was positive in the inguinal lymph node, and cystoscopy revealed the presence of invasive urothelial carcinoma. Treatment with cisplatin and gemcitabine promoted a complete metabolic response for > 4 years. The detection of uroplakin III and serum SPan-1 might help diagnose urothelial carcinoma. |
| キーワード | urothelial carcinoma uroplakin III s-pancreas-1 antigen carbohydrate antigen 19-9 chemotherapy |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-06 |
| 巻 | 73巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 279 |
| 終了ページ | 284 |
| 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 | 31235978 |
| JaLCDOI | 10.18926/AMO/56872 |
|---|---|
| フルテキストURL | 73_3_273.pdf |
| 著者 | Hayata, Kei| Masuyama, Hisashi| Eto, Eriko| Mitsui, Takashi| Tamada, Shoko| Eguchi, Takeshi| Maki, Jota| Tani, Kazumasa| Ohira, Akiko| Washio, Yosuke| Yoshimoto, Junko| Hasegawa, Kosei| |
| 抄録 | Nager syndrome is a rare disease involving severe micrognathia and upper limb shortening. In this report, we describe a case in which micrognathia of the fetus was suspected based on the observation of upper limb shortening during detailed B mode and 3D/4D ultrasonographic observation, and combined fetal MRI and 3D-CT led to a prenatal diagnosis of Nager syndrome. Upon birth, because severe micrognathia caused airway obstruction and made it difficult to spread the larynx for intubation, effective ventilation could not be carried out and a tracheostomy was necessary. Since a differential diagnosis of Nager syndrome can be made based on the fact that micrognathia typically co-occurs with upper limb shortening, it is possible to diagnose the disease before birth and prepare for life-saving measures accordingly. |
| キーワード | Nager syndrome acrofacial dysostosis micrognathia jaw index SF3B4 |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-06 |
| 巻 | 73巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 273 |
| 終了ページ | 277 |
| 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 | 31235977 |
| JaLCDOI | 10.18926/AMO/56871 |
|---|---|
| フルテキストURL | 73_3_269.pdf |
| 著者 | Tsuboi, Ichiro| Araki, Motoo| Fujiwara, Hiroyasu| Iguchi, Toshihiro| Hiraki, Takao| Arichi, Naoko| Kawamura, Kasumi| Maruyama, Yuki| Mitsui, Yosuke| Sadahira, Takuya| Kubota, Risa| Nishimura, Shingo| Sako, Tomoko| Takamoto, Atsushi| Wada, Koichiro| Kobayashi, Yasuyuki| Watanabe, Toyohiko| Yanai, Hiroyuki| Kitagawa, Masashi| Tanabe, Katsuyuki| Sugiyama, Hitoshi| Wada, Jun| Shiina, Hiroaki| Kanazawa, Susumu| Nasu, Yasutomo| |
| 抄録 | Nephron-sparing treatment should be offered whenever possible to avoid dialysis in allograph cases. Cryoablation is a new treatment option for treating small-sized renal cell cancer (RCCs). We report a case of RCC arising in a kidney allograft treated by cryoablation. To our knowledge, this is the first case in Asia of RCC in a renal allograft treated using cryoablation. Contrast-enhanced CT-guided percutaneous renal needle biopsy and cryoablation were used to identify the RCC, which could not be identified by other techniques. The postoperative course was uneventful. Contrast-enhanced CT also showed no recurrence or metastases at the 6-month follow-up. |
| キーワード | cryoablation partial nephrectomy renal cell carcinoma renal allograft renal transplantation |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-06 |
| 巻 | 73巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 269 |
| 終了ページ | 272 |
| 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 | 31235976 |
| JaLCDOI | 10.18926/AMO/56870 |
|---|---|
| フルテキストURL | 73_3_263.pdf |
| 著者 | Shimoyama, Yuichiro| Umegaki, Osamu| Ooi, Yukimasa| Shigemoto, Sho| Agui, Tomoyuki| Kadono, Noriko| Minami, Toshiaki| |
| 抄録 | A previously healthy 40-year-old Japanese male was urgently admitted with a 2-month history of dysphagia, 30-kg weight loss, and fever. Human immunodeficiency virus (HIV) antibodies and cytomegalovirus antigenemia were positive. Pneumocystis pneumonia and cytomegalovirus pneumonia were suspected. The patient was diagnosed with acquired immune deficiency syndrome (AIDS). Cytomegalovirus antigenemia became negative 20 days after the positive result. On hospital day 41, he experienced cardiopulmonary arrest. The clinical diagnosis was fulminant type 1 diabetes mellitus. He later developed hypoglycemia and was diagnosed with adrenal insufficiency accompanied by septic shock. He died of multiple organ failure 29 h post-admission to our ICU. |
| キーワード | fulminant type 1 diabetes mellitus human immunodeficiency virus cytomegalovirus hypoglycemia |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-06 |
| 巻 | 73巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 263 |
| 終了ページ | 267 |
| 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 | 31235975 |
| JaLCDOI | 10.18926/AMO/56869 |
|---|---|
| フルテキストURL | 73_3_255.pdf |
| 著者 | Seki, Daisuke| Takeshita, Nobuo| Seiryu, Masahiro| Deguchi, Toru| Takano-Yamamoto, Teruko| |
| 抄録 | Orthodontists need to understand the orthodontic risks associated with systemic disorders. Axenfeld-Rieger syndrome (ARS) is a rare autosomal dominant disorder with genetic and morphological variability. The risks of orthodontic treatment in ARS patients have been unclear. Here we describe the correction of an anterior open bite in a 15-year-old Japanese female ARS patient by molar intrusion using sectional archwires with miniscrew implants. An undesirable development of external apical root resorption (EARR) was observed in all intrusive force-applied posterior teeth during the patient’s orthodontic treatment, suggesting that ARS patients have a higher risk of EARR than the general population. |
| キーワード | Axenfeld-Rieger syndrome external apical root resorption miniscrew implant anterior open bite |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-06 |
| 巻 | 73巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 255 |
| 終了ページ | 262 |
| 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 | 31235974 |
| JaLCDOI | 10.18926/AMO/56868 |
|---|---|
| フルテキストURL | 73_3_247.pdf |
| 著者 | Yoshio, Kotaro| Wakita, Akihisa| Mitsuhashi, Toshiharu| Kitayama, Takahiro| Hisazumi, Kento| Inoue, Daisaku| Tajiri, Nobuhisa| Shiode, Tsuyoki| Akaki, Shiro| Kanazawa, Susumu| |
| 抄録 | We investigated the feasibility of simultaneous integrated boost (SIB) volumetric modulated arc therapy (VMAT) using elective nodal irradiation (ENI) for middle or lower esophageal cancer and compared it with three-dimensional conformal radiotherapy (3D-CRT). The study included 15 patients. The prescribed doses included a standard dose (50.4 Gy) and a high dose (60 Gy) for the planning target volume (PTV) of the involved lesions. The objective of the whole lung volume receiving ≥ 20 Gy (V20Gy) was < 30%, and the mean lung dose (MLD) was < 20 Gy. The volumes of the lung receiving 5 Gy (V5Gy) and the heart receiving 30-50 Gy (V30-50Gy) were kept as low as reasonably achievable. As a result, SIB-VMAT showed superior dose conformity for the PTV (p<0.001). Although the lung V5Gy was significantly increased (p<0.001), the V20Gy and MLD showed no significant increase. The heart V30-50Gy showed a > 20% reduction in the mean against 3D-CRTs. Our results demonstrate the feasibility of SIB-VMAT for the treatment of middle or lower esophageal cancer with ENI. Although attention should be paid to the low-dose area of the lungs, SIB-VMAT would be a promising treatment option with improved outcomes for esophageal cancer. |
| キーワード | esophageal cancer middle and lower thoracic volumetric modulated arc therapy, 3D-CRT elective nodal irradiation |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-06 |
| 巻 | 73巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 247 |
| 終了ページ | 257 |
| 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 | 31235973 |
| JaLCDOI | 10.18926/AMO/56867 |
|---|---|
| フルテキストURL | 73_3_241.pdf |
| 著者 | Utsumi, Masashi| Aoki, Hideki| Nishimura, Seitaro| Une, Yuta| Kashima, Hajime| Kimura, Yuji| Taniguchi, Fumitaka| Arata, Takashi| Katsuda, Koh| Tanakaya, Kohji| |
| 抄録 | Gallbladder carcinoma (GBC) is a common malignancy with a poor prognosis. With the average life expectancy increasing globally, the incidence of GBC is predicted to increase as well. We investigated the safety and feasibility of surgical treatment for elderly patients with GBC. We retrospectively compared clinical pathological data and treatment outcomes in 45 consecutive GBC patients (23 patients ≥ 75 years [elderly group] and 22 patients < 75 years [younger group]) who underwent curative resection at the Iwakuni Center from January 2008 to December 2017. The proportion of preoperative comorbidities and anticoagulant use was significantly higher in the elderly group. The American Society of Anesthesiologists score was higher in the elderly versus the younger group, and the elderly group had significantly shorter operation times. Reduced activities of daily living was more common in the elderly versus younger group. The percentage of radical resection and overall 3-year survival (66.6% younger vs. 64.4% elderly) were similar between the groups. Controlling Nutritional Status (CONUT) score ≥ 3 and R0 resection were identified as prognostic factors for overall survival rate among all patients. After careful patient selection, |
| キーワード | elderly patient gallbladder carcinoma prognostic factor surgical treatment |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-06 |
| 巻 | 73巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 241 |
| 終了ページ | 246 |
| 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 | 31235972 |
| JaLCDOI | 10.18926/AMO/56866 |
|---|---|
| フルテキストURL | 73_3_235.pdf |
| 著者 | Horita, Masahiro| Nishida, Keiichiro| Hashizume, Kenzo| Sugimoto, Yoshihisa| Nasu, Yoshihisa| Nakahara, Ryuichi| Harada, Ryozo| Ozaki, Toshifumi| |
| 抄録 | We investigated the prevalence of and risk factors for the progression of upper cervical lesions (UCLs) in patients with rheumatoid arthritis (RA). A retrospective analysis of 49 patients with RA (4 males, 45 females) was conducted. The UCLs included atlanto-axial subluxation and vertical subluxation. We investigated the clinical factors including the Disease Activity Score 28 based on C-reactive protein (DAS28-CRP) and the modified Health Assessment Questionnaire-Disability Index as well as radiographic changes between the baseline (at May 2010 to April 2013) and final follow-up. Forty patients (81.6%) were classified as the non-progressive group, and the other 9 patients (18.4%) comprised the progressive group. The progressive group’s final CRP values, baseline or final MMP-3 levels, DAS28-CRP, and rate of pre-existing lesions at baseline were all significantly higher than those of the non-progressive group (p=0.017, p=0.043, p=0.002, p=0.008, p<0.001, and p=0.008 respectively). A multivariate logistic regression analysis demonstrated that DAS28-CRP at baseline was a risk factor for radiographic progression (p=0.018, odds ratio: 2.54, 95% confidence interval: 1.17-5.51). Our findings indicate that higher disease activity might influence the progression of UCLs in patients with RA. |
| キーワード | rheumatoid arthritis upper cervical spine lesion risk factor radiological progression |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-06 |
| 巻 | 73巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 235 |
| 終了ページ | 240 |
| 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 | 31235971 |
| JaLCDOI | 10.18926/AMO/56865 |
|---|---|
| フルテキストURL | 73_3_229.pdf |
| 著者 | Hamasaki, Ichiro| Shibata, Kiyo| Shimizu, Takehiro| Kono, Reika| Morizane, Yuki| Shiraga, Fumio| |
| 抄録 | During strabismus surgery using illumination from a light source, patients complain of photophobia. The NGENUITYⓇ (Alcon) system is equipped with a high-dynamic-range (HDR) camera. A 4K display viewed by wearing circularly polarized glasses provides clear three-dimensional images of the operative field. A light source is usually required for surgeries of the anterior segment (including strabismic surgery), but the digital processing function of the NGENUITYⓇ system allows image display in relatively dark regions even without a light source. We devised a novel ‘lights-out’ surgery that does not use a microscope’s light source, and we examined the usefulness of this technique in 2 cases of strabismic surgery. We performed strabismus surgery using the NGENUITYⓇ system in two patients between January and June 2018. The HDR function was used, and the aperture was opened to the maximum while the gain was adjusted. Surgery was conducted without using the microscope’s light source. We report the 2 cases’ results and evaluate the novel method. The surgeries were performed without problem even though the microscope’s light source was not used. The patients’ photophobia was alleviated. Lights-out surgery is a potentially useful modality for strabismus surgery. |
| キーワード | head-up surgery 3D vision system high dynamic range video enhancement strabismus surgery |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-06 |
| 巻 | 73巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 229 |
| 終了ページ | 233 |
| 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 | 31235970 |
| JaLCDOI | 10.18926/AMO/56864 |
|---|---|
| フルテキストURL | 73_3_223.pdf |
| 著者 | Sugiu, Kazuhisa| Furumatsu, Takayuki| Kodama, Yuya| Kamatsuki, Yusuke| Okazaki, Yoshiki| Okazaki, Yuki| Hiranaka, Takaaki| Ozaki, Toshifumi| |
| 抄録 | Anterior cruciate ligament (ACL) reconstruction (ACLR) after ACL rupture improves the instability of the knee joint and decreases mechanical stress to the meniscus and articular cartilage. However, there are reports that post-traumatic osteoarthritis (PTOA) is observed over time following ACLR. In this study, we assessed changes in cartilage lesions by arthroscopic findings following anatomical double-bundle ACLR and at post-operative second-look arthroscopy about 14 months later. We retrospectively evaluated 37 knees in cases with patients <40 years of age who had undergone an anatomical double-bundle ACL reconstruction <1 year after ACL rupture injury from March 2012 to December 2016. Clinical results and arthroscopic cartilage/meniscal lesion were evaluated and compared between a cartilage lesion-detected group and intact-cartilage group. Surgery improved anteroposterior laxity and other clinical measures; however, cartilage lesions were detected at 11 sites during ACLR and at 54 sites at second-look arthroscopy. The periods from injury to second-look arthroscopy and from ACLR to second-look arthroscopy were significantly longer in the cartilage-lesion group (n=23) than in the intact-cartilage group (n=14). Conversely, 96% of meniscal damage observed during ACLR was cured at the time of second-look arthroscopy. Knee articular cartilage lesions after ACL rupture cannot be completely suppressed, even using the anatomical ACL reconstruction technique. This study suggested that articular cartilage lesions can progress to a level that can be confirmed arthroscopically at approximately 17 months after ACL injury. Therefore, in ACLR patients, the possibility of developing knee articular cartilage lesions and PTOA should be considered. |
| キーワード | anterior cruciate ligament reconstruction post-traumatic osteoarthritis meniscal lesion cartilage lesions second-look arthroscopy |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-06 |
| 巻 | 73巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 223 |
| 終了ページ | 228 |
| 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 | 31235969 |
| JaLCDOI | 10.18926/AMO/56863 |
|---|---|
| フルテキストURL | 73_3_213.pdf |
| 著者 | Nishina, Saori| Matsuura, Koji| Naruse, Keiji| |
| 抄録 | We investigated the relationship between human sperm rheotaxis and motile sperm trajectories by using poly-(dimethylsiloxane) (PDMS)-based cylindrical microfluidic channels with inner diameters of 100 μm, 50 μm, and 70 μm, which corresponded to the inner diameter of the human isthmus, the length of a sperm and a diameter intermediate between the two, respectively. We counted the number of rheotaxic sperm and sperm with spiral motion. We also analyzed motile sperm trajectories. As the cylindrical channel diameter was decreased, the percentage of sperm cells exhibiting rheotaxis, the percentage of sperm cells exhibiting spiral motion, the frequency-to-diameter ratio of the sperm cells’ spiral trajectories, and the surface area of the microfluidic channel increased, while the flagellar motion at the channel wall decreased. The percentage of sperm exhibiting a spiral trajectory and the frequency-to-diameter ratio of the sperm cells’ spiral trajectories were thus affected by the channel diameter. Our findings suggest that the oviduct structure affects the swimming properties of sperm cells, guiding them from the uterus to the ampulla for egg fertilization. These results could contribute to the development of motile sperm-sorting microfluidic devices for assisted reproductive technologies. |
| キーワード | sperm motility trajectory microfluidic channel rheotaxis oviduct structure |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-06 |
| 巻 | 73巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 213 |
| 終了ページ | 221 |
| 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 | 31235968 |
| JaLCDOI | 10.18926/AMO/56862 |
|---|---|
| フルテキストURL | 73_3_205.pdf |
| 著者 | Mukai, Yuko| Sakurai, Toru| Watanabe, Toshiyuki| Sako, Tomoko| Sugimoto, Morito| Kimata, Yoshihiro| Mori, Yoshiko| Nagasaka, Takeshi| Namba, Yuzaburo| |
| 抄録 | Intestinal vaginoplasty has several advantageous features, such as scarless surgery, low incidence of contraction of the reconstructed vagina, maintenance of vaginal depth, spontaneous mucus production, and a low rate of complications. Therefore, this technique is becoming popular in many countries. Following the global trend, the demand for intestinal vaginoplasty for transsexuals is also increasing in Japan. However, there are few reports on intestinal vaginoplasty in Japan. In this study, we examined the safety and effectiveness of rectosigmoid colon vaginoplasty in the Japanese population. We retrospectively surveyed 18 male-to-female transsexuals who underwent laparoscopic rectosigmoid colon vaginoplasty at the Okayama University Hospital Gender Center between October 2012 and December 2017. One patient had developed an anastomotic leak and 2 patients experienced vaginal prolapse, which needed revision surgery. Both adverse outcomes were comparable with those from previous studies. The anastomotic leak was managed adequately with conservative treatment. To avoid vaginal prolapse, it is important to decide the length of the rectosigmoid segment so that a pull on it does not cause it to become lax, while excessive stress on the feeder vessels is avoided. Based on our study, we concluded that rectosigmoid vaginoplasty was a reliable technique in the Japanese population. |
| キーワード | vaginoplasty male-to-female transsexuals rectosigmoid colon |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2019-06 |
| 巻 | 73巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 205 |
| 終了ページ | 211 |
| 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 | 31235967 |