| JaLCDOI | 10.18926/AMO/65980 |
|---|---|
| フルテキストURL | 77_5_561.pdf |
| 著者 | Tsuchiya, Hiroki| Shibata, Takashi| Sasaki, Tatsuya| Inoue, Takushi| Date, Isao| Akiyama, Tomoyuki| Kobayashi, Katsuhiro| |
| 抄録 | West syndrome, an infantile developmental and epileptic encephalopathy with a deleterious impact on long-term development, requires early treatment to minimize developmental abnormality; in such cases, epilepsy surgery should be considered a powerful therapeutic option. We describe a 10-month-old female admitted with West syndrome associated with a hemispheric lesion following abusive head trauma. Her seizures were suppressed by hemispherotomy at 12 months of age, leading to developmental improvement. Surgical treatment of West syndrome following traumatic brain injury has not been reported previously but is worth considering as a treatment option, depending on patient age and brain plasticity. |
| キーワード | abusive head trauma developmental and epileptic encephalopathy epilepsy surgery epileptic spasms hemispherotomy |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 561 |
| 終了ページ | 566 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899268 |
| Web of Science KeyUT | 001110832700002 |
| JaLCDOI | 10.18926/AMO/65979 |
|---|---|
| フルテキストURL | 77_5_553.pdf |
| 著者 | Murokawa, Takahiro| Sakamoto, Shinya| Tabuchi, Motoyasu| Sui, Kenta| Ozaki, Kazuhide| Matsumoto, Manabu| Iwata, Jun| Okabayashi, Takehiro| Yoshida, Hiroshi| |
| 抄録 | Gastric cancer with peritoneal metastases is typically a devastating diagnosis. Ligamentum teres hepatis (LTH) metastasis is an extremely rare presentation with only four known cases. Herein, we report salvage surgery of successive metastases to the abdominal wall and LTH in a patient originally presenting with advanced gastric cancer with peritoneal metastasis, leading to long-term survival. A 72-year-old man with advanced gastric cancer underwent curative-intent distal gastrectomy with D2 lymph node dissection for gastric outlet obstruction. During this procedure, three small peritoneal metastases were detected in the lesser omentum, the small mesentery, and the mesocolon; however, intraoperative abdominal lavage cytology was negative. We added cytoreductive surgery for peritoneal metastasis. The pathological diagnosis of the gastric cancer was tubular adenocarcinoma with pT4aN1pM1(PER/P1b)CY0 stage IV (Japanese classification of gastric carcinoma/JCGC 15th), or T4N1M1b stage IV (UICC 7th). Post-operative adjuvant chemotherapy with S-1 (TS-1)+cisplatin (CDDP) was administered for 8 months followed by S-1 monotherapy for 4 months. At 28 months after the initial surgery, a follow-up computed tomography (CT) detected a small mass beneath the upper abdominal wall. The ass showed mild avidity on 18F-fluorodeoxyglucose positron-emission (FDG-PET) CT. Salvage resection was performed for diagnosis and treatment, and pathological findings were consistent with primary gastric cancer metastasis. At 49 months after the initial gastrectomy, a new lesion was detected in the LTH with a similar level of avidity on FDG-PET CT as the abdominal wall metastatic lesion. We performed a second salvage surgery for the LTH tumor, which also showed pathology of gastric cancer metastasis. There has been no recurrence up to 1 year after the LTH surgery. With multidisciplinary treatment the patient has survived almost 5 years after the initial gastrectomy. Curative-intent gastrectomy with cytoreductive surgery followed by adjuvant chemotherapy for advanced gastric cancer with localized peritoneal metastasis might have had a survival benefit in our patient. Successive salvage surgeries for oligometastatic lesions in the abdominal wall and the LTH also yielded favorable outcomes. |
| キーワード | gastric cancer peritoneal metastasis ligamentum teres hepatis oligometastasis salvage surgery |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 553 |
| 終了ページ | 559 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899267 |
| Web of Science KeyUT | 001110832700001 |
| JaLCDOI | 10.18926/AMO/65978 |
|---|---|
| フルテキストURL | 77_5_545.pdf |
| 著者 | Iwamuro, Masaya| Tanaka, Shouichi| Toyokawa, Tatsuya| Nishimura, Mamoru| Tsuzuki, Takao| Miyahara, Koji| Negishi, Shin| Ohya, Shogen| Tanaka, Takehiro| Otsuka, Motoyuki| |
| 抄録 | To determine the endoscopic and clinical features of localized gastric amyloid light-chain (AL) amyloidosis, we retrospectively examined the characteristics of nine patients (eight men and one woman) encountered by the hospitals in our network. Lesions were predominantly flat and depressed with surface vascular dilatation (n=5); others were characterized by subepithelial lesions (n=2), mucosal color change (n=1), and a mass-like morphology with swollen mucosal folds (n=1). Colonoscopy (n=7), video capsule enteroscopy (n=2), serum (n=5) and urine immunoelectrophoresis (n=4), and bone marrow examination (n=3) were performed to exclude involvement of organs other than the stomach. As treatment for gastric lesions of AL amyloidosis, one patient each underwent endoscopic submucosal dissection (n=1) and argon plasma coagulation (n=1), while the remaining seven patients underwent no specific treatment. During a mean follow-up of 4.2 years, one patient died 3.2 years after diagnosis, but the cause of death, which occurred in another hospital, was unknown. The remaining eight patients were alive at the last visit. In conclusion, although localized gastric AL amyloidosis can show various macroscopic features on esophagogastroduodenoscopy, flat, depressed lesions with vascular dilatation on the surface are predominant. |
| キーワード | esophagogastroduodenoscopy gastric lesion amyloidosis light chain |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 545 |
| 終了ページ | 552 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899266 |
| Web of Science KeyUT | 001094245100001 |
| JaLCDOI | 10.18926/AMO/65976 |
|---|---|
| フルテキストURL | 77_5_537.pdf |
| 著者 | Song, Qingqing| Pan, Yu| Kanazawa, Tomoyuki| Morimatsu, Hiroshi| |
| 抄録 | Elderly patients are at higher risk of postoperative hypoxemia due to their decreased respiratory function. The aim of this study was to investigate the relationship of intraoperative oxygen saturation (SpO2) and end-expiratory carbon dioxide (ETCO2) values with postoperative hypoxemia in elderly patients. The inclusion criteria were: 1) patients aged≥75 years; 2) underwent general anesthesia in non-cardiac surgery; 3) operative time longer than two hours; and 4) admission to the intensive care unit (ICU) following surgery performed between January and December 2019. Intraoperative SpO2 and ETCO2 values were collected every minute for the first two hours during surgery. The 253 patients were divided into two groups: SpO2≥92% and SpO2<92%. The time-weighted averages of intraoperative SpO2 and ETCO2 were used to compare differences between the two groups. The incidence of postoperative hypoxemia was 22.5%. For similar ventilator settings, patients with postoperative hypoxemia had lower intraoperative SpO2 and higher ETCO2 values. Sex, ASA classification, and intraoperative SpO2 were independent risk factors for postoperative hypoxemia. In conclusion, postoperative SpO2<92% was a frequent occurrence (> 20%) in elderly patients who underwent major non-cardiac surgery. Postoperative hypoxemia was associated with low intraoperative SpO2 and relatively higher ETCO2. |
| キーワード | oxygen saturation end-expiratory carbon dioxide postoperative hypoxemia |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 537 |
| 終了ページ | 543 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899265 |
| Web of Science KeyUT | 001108661600011 |
| JaLCDOI | 10.18926/AMO/65975 |
|---|---|
| フルテキストURL | 77_5_527.pdf |
| 著者 | Ando, Miho| Hanayama, Yoshihisa| Nishimura, Yoshito| Hagiya, Hideharu| Otsuka, Fumio| |
| 抄録 | Retroperitoneal fibrosis (RPF) is a rare cause of hydronephrosis and progressive renal dysfunction with unidentified origin. RPF is categorized into idiopathic RPF with/without immunoglobulin G4 (IgG4)-related disease (IgG4-RD), and secondary RPF. Identifying the underlying cause is challenging and often associated with delayed diagnosis or therapeutic interventions. We investigated RPF’s clinical characteristics based on different etiologies and factors that may help distinguish the underlying causes. We analyzed the cases of 49 patients with RPF that was radiographically diagnosed at our institution (2008-2022). The cohort was 77.6% males; 75.5% had idiopathic RPF and 24.5% had secondary RPF. Among the idiopathic patients, 54.1% had IgG4-RD. The patients were likely to have abdominal pain, lower back pain/lumbago, and constitutional symptoms including generalized fatigue and fever. The idiopathic patients were likely to have higher serum IgG4 and IgG levels and lower serum C3 levels compared to secondary RPF. The IgG4-RPF patients were likely to have higher serum IgG4 levels and lower serum C-reactive protein, ferritin, and C3 levels compared to the idiopathic RPF patients without IgG4-RD. These findings might reflect underlying systemic inflammatory responses. Comprehensive laboratory testing, including serum inflammatory markers and immunological panels, is recommended for radiologically diagnosed RPF patients. |
| キーワード | retroperitoneal fibrosis IgG4-related disease malignancy |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 527 |
| 終了ページ | 536 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899264 |
| Web of Science KeyUT | 001108661600010 |
| JaLCDOI | 10.18926/AMO/65974 |
|---|---|
| フルテキストURL | 77_5_517.pdf |
| 著者 | Horiguchi, Shigeru| Matsumoto, Kazuyuki| Morimoto, Kosaku| Matsumi, Akihiro| Terasawa, Hiroyuki| Fujii, Yuki| Yamazaki, Tatsuhiro| Tsutsumi, Koichiro| Kato, Hironari| |
| 抄録 | We investigated the effect of modified FOLFIRINOX (mFFX) in unresectable pancreatic cancer by retrospectively analyzing the cases of 43 patients who underwent BRCA testing (germline, n=11; somatic, n=26; both germline and somatic, n=6). The association between BRCA mutations and therapeutic effect was clarified. Six patients tested positive for germline pathogenic variants. Familial pancreatic cancer (33% vs. 3%, p=0.006) and peritoneal disseminated lesions (66% vs. 8%, p<0.001) were significantly more common in patients with germline pathogenic variants. The partial response (PR) rate was 100% in the germline BRCA-positive patients, and 27% in the germline BRCA-negative patients (p<0.001). The median progression-free survival (PFS) was not reached for any germline BRCA-positive patients but was 9.0 months for the germline BRCA-negative patients (p=0.042). Patients with stage IV BRCA-associated pancreatic cancer had better overall survival than those with non-BRCA-associated pancreatic cancer, although the difference was nonsignificant (not reached vs. 655 days, p=0.061). Our results demonstrate that a PR and prolonged PFS can be expected in germline BRCA-positive patients after treatment with mFFX. Our findings also suggest that germline BRCA pathogenic variants may be useful as biomarkers for the therapeutic effect of mFFX in patients with pancreatic cancer. |
| キーワード | BRCA FOLFIRINOX pancreatic cancer progression-free survival pathogenic variant |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 517 |
| 終了ページ | 525 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899263 |
| Web of Science KeyUT | 001108661600009 |
| JaLCDOI | 10.18926/AMO/65973 |
|---|---|
| フルテキストURL | 77_5_511.pdf |
| 著者 | Sato, Kohei| Tsuji, Hironori| Yorimitsu, Masanori| Uehara, Takenori| Okazaki, Yuki| Takao, Shinichiro| Hata, Toshiaki| Fukuoka, Shiro| Noda, Tomoyuki| Kanda, Hideyuki| Ozaki, Toshifumi| |
| 抄録 | Sarcopenia and malnutrition are increasing in older adults and are reported risk factors for functional impairment after hip fracture surgery. This study aimed to investigate the associations between skeletal muscle mass loss, malnutrition, and postoperative walking ability in patients with hip fracture. We retrospectively reviewed patients who underwent intertrochanteric fracture surgery at our institute. The psoas muscle index, controlling nutritional status score, and functional ambulation category (FAC) were used to evaluate skeletal muscle mass, nutritional status, and walking ability, respectively. Six months after surgery, walking ability was assessed as either “gait disturbance” or “independent gait”. Multivariate binomial logistic regression analysis, with skeletal muscle mass, nutritional status, and other factors, was used to predict the risk of being assigned to the gait disturbance group. This study included 95 patients (mean age, 85.2 years; 70 women). Sixty-six patients had low skeletal muscle mass, 35 suffered from malnutrition, and 28 had both. Malnutrition and low skeletal muscle mass were significantly associated with postoperative gait disturbance (FAC < 3). Preoperative low skeletal muscle mass and malnutrition were risk factors for postoperative poor walking ability. Further preventive interventions focusing on skeletal muscle mass and nutritional status are required. |
| キーワード | sarcopenia nutrition geriatric hip fracture psoas muscle index controlling nutritional status score |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 511 |
| 終了ページ | 516 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899262 |
| Web of Science KeyUT | 001108661600008 |
| JaLCDOI | 10.18926/AMO/65972 |
|---|---|
| フルテキストURL | 77_5_499.pdf |
| 著者 | Hatakeyama, Yuji| Hongo, Michio| Kido, Tadato| Urayama, Masakazu| Kasukawa, Yuji| Sasaki, Hiroshi| Aizawa, Toshiaki| Kudo, Daisuke| Kimura, Ryota| Ono, Yuichi| Kasama, Fumihito| Miyakoshi, Naohisa| |
| 抄録 | This study aimed to clarify neurological differences among the epiconus, conus medullaris, and cauda equina syndromes. Eighty-seven patients who underwent surgery for acute thoracolumbar spinal injuries were assessed. We defined the epiconus as the region from the terminal end of the spinal cord to the proximal 1.0 to 2.25 vertebral bodies, the conus medullaris as the region proximal to < 1.0 vertebral bodies, and the cauda equina as the distal part of the nerve roots originating from the spinal cord. On the basis of the distance from the terminal end of the spinal cord to the narrowest level of the spinal canal, the narrowest levels were ordered as follows: the epiconus followed by the conus medullaris and cauda equina. The narrowest levels were the epiconus in 22 patients, conus medullaris in 37 patients, and cauda equina in 25 patients. On admission, significantly more patients had a narrowed epiconus of Frankel grades A-C than a narrowed cauda equina. At the final follow-up, there were no significant differences in neurological recovery among those with epiconus, conus medullaris, or cauda equina syndrome. Anatomically classifying the narrowest lesion is useful for clarifying the differences and similarities among these three syndromes. |
| キーワード | thoracolumbar spinal injury terminal end of spinal cord conus medullaris epiconus syndrome cauda equina syndrome |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 499 |
| 終了ページ | 509 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899261 |
| Web of Science KeyUT | 001108661600007 |
| JaLCDOI | 10.18926/AMO/65971 |
|---|---|
| フルテキストURL | 77_5_491.pdf |
| 著者 | Habu, Hiroshi| Takao, Soshi| Miyaji, Chikara| Matsumoto, Naomi| Aoo, Ken| Nishita, Yosuke| Tsuri, Masao| Yorifuji, Takashi| |
| 抄録 | Arts festivals have become increasingly popular in various parts of Japan in recent years. The purpose of this study was to investigate the relationships between arts festival activities participation at the Setouchi Triennale and the health of residents in the town of Naoshima. This was a cross-sectional study. Questionnaires were distributed to all residents of Naoshima who were 20 years old or older (n=2,588). We analyzed responses from 708 people. The associations between arts festival activities participation and health (measured by self-rated health) were analyzed using logistic regression analysis as the primary outcome. Kessler’s psychological distress scale scores were also analyzed in the same manner as the primary outcome. The participating group had an adjusted odds ratio of 1.86 (95% confidence interval: 1.03-3.33) for higher self-rated health compared with those who did not participate. Kessler’s psychological distress scale results showed that the participating group had an adjusted odds ratio of 3.23 (95% confidence interval: 1.19-8.81) for lower psychological distress compared with those who did not participate. In conclusion, arts festival activities participation was associated with higher self-rated health and lower psychological distress. However, caution must be taken in regard to generalizability and causality when interpreting these results. |
| キーワード | art arts in public health arts festival self-rated health Setouchi Triennale |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 491 |
| 終了ページ | 497 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899260 |
| Web of Science KeyUT | 001108661600006 |
| JaLCDOI | 10.18926/AMO/65970 |
|---|---|
| フルテキストURL | 77_5_479.pdf |
| 著者 | Murata, Akiko| Matsumoto, Naomi| Miyaji, Chikara| Takao, Soshi| Yorifuji, Takashi| |
| 抄録 | For decades, the notion has persisted in developed countries that exclusive care by the mothers is best for the development of children up to 3 years of age. To examine the veracity of this “myth of the first three years” in Japan, we examined the effects of childcare facility use for children younger than 3 years on their development using the cohorts of the Longitudinal Survey of Newborns in the 21st Century conducted in Japan. Of the 47,015 respondents to the survey, we studied the children of 5,508 mothers with university/professional education to evaluate the relationships between primary early (< 2.5 years) childcare providers during weekday daytime hours and specific development indices for the ages of 2.5, 5.5, and 8 years. At the age of 2.5 and 5.5 years, children attending childcare facilities were judged as having more advanced developmental behaviors by their parents, such as being able to compose a two-word sentence (adjusted odds ratio [aOR]: 0.22) or to express emotions (aOR: 0.81), compared with those cared for by mothers. However, at the age of 8 years, children who attended childcare facilities as infants < 2.5 years showed more aggressive behavior in interrupting people (aOR: 1.20) and causing disturbances in public (aOR: 1.26) than those cared for by mothers (after adjustment for numerous child and parental factors). Although these results are generally consistent with previous studies, issues potentially involved with problem behavior such as quality of childcare require further investigation, as does the case of children of mothers with more modest educational attainment. |
| キーワード | “myth of the first three years” childcare child development problem behavior educational attainment |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 479 |
| 終了ページ | 490 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899259 |
| Web of Science KeyUT | 001108661600005 |
| JaLCDOI | 10.18926/AMO/65969 |
|---|---|
| フルテキストURL | 77_5_471.pdf |
| 著者 | Oka, Shohei| Harada, Keita| Yamamoto, Shumpei| Yasutomi, Eriko| Igawa, Shoko| Ohmori, Masayasu| Hirai, Mami| Yamasaki, Yasushi| Inokuchi, Toshihiro| Kinugasa, Hideaki| Takahara, Masahiro| Hiraoka, Sakiko| Okada, Hiroyuki| |
| 抄録 | Although the clinical usefulness of colonoscopy has been established, the procedure remains painful for many patients. This study was designed to clarify the factors predicting colonoscopy-related pain. We evaluated 283 consecutive patients who completed a first-ever, total colonoscopy without sedatives or analgesics. The severity of pain symptoms was evaluated by a numeric rating scale (NRS) in a questionnaire immediately after the colonoscopy. Patient backgrounds and endoscopic findings were analyzed to evaluate their association with pain. Out of 283 patients, 53 scored their pain 0-1 on the NRS while 48 scored it 6-10. We defined the colonoscopies of the former and latter patients as painless and painful, respectively, and compared the two. Multivariate analyses revealed that low body weight (OR 4.95, 95%CI 1.89-12.99) and longer intubation time (OR 3.63, 95%CI 1.46-9.03) were significant risk factors for painful colonoscopy. To identify factors contributing to the increased intubation time, we divided subjects into short- and long-intubation-time groups based on a median insertion time of 7 min. Older age (OR 2.28, 95%CI 1.31-3.98), previous abdominal surgery (OR 1.93, 95%CI 1.13-3.32) and findings of invasive cancer (OR 10.90, 95%CI 1.34-88.90) were significant factors for longer intubation time. |
| キーワード | colonoscopy colonoscopy-related pain comfortable colonoscopy |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 471 |
| 終了ページ | 478 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899258 |
| Web of Science KeyUT | 001108661600004 |
| JaLCDOI | 10.18926/AMO/65968 |
|---|---|
| フルテキストURL | 77_5_461.pdf |
| 著者 | Homma, Daisuke| Minato, Izumi| Imai, Norio| Miyasaka, Dai| Sakai, Yoshinori| Horigome, Yoji| Suzuki, Hayato| Dohmae, Yoichiro| Endo, Naoto| |
| 抄録 | This study aimed to determine which muscle the gluteus maximus, gluteus medius, gluteus minimus (Gmin), or tensor fasciae latae (TFL) contributes most to hip abduction strength and to identify effective sites for cross-sectional area (CSA) Gmin and TFL measurement in hip osteoarthritis (OAhip) patients. Twenty-eight patients with OAhip were included. The muscle CSA and volume were determined using magnetic resonance imaging. Peak isometric strength was determined using hand-held dynamometry. Muscle volumes were normalized to the total muscle volume of hip abductors. Multiple regression analysis was performed. The difference between the CSA of Gmin and TFL was calculated, and correlations with volume and muscle strength were determined. Gmin volume was related to abductor muscle strength (p=0.042). The peak CSA of the Gmin correlated with muscle volume and strength. The CSA of the TFL correlated with volume, with no difference between the CSA of the most protruding part of the lesser trochanter and peak CSA. Gmin volume was strongly related to abductor muscle strength. Peak CSA is a useful parameter for assessing the CSA of the Gmin among patients with OAhip. The CSA of the TFL should be measured at the most protruding part of the lesser trochanter. |
| キーワード | gluteus minimus tensor fasciae latae cross-sectional area muscle volume hip osteoarthritis |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 461 |
| 終了ページ | 469 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899257 |
| Web of Science KeyUT | 001108661600003 |
| JaLCDOI | 10.18926/AMO/65967 |
|---|---|
| フルテキストURL | 77_5_451.pdf |
| 著者 | Okita, Atsushi| Tsukuda, Kazunori| Ino, Hideo| Mitsui, Ema| Ikeya, Nanami| Yamamoto, Sumiharu| Yokoyama, Nobuji| Bulin, Aubra| |
| 抄録 | Using a Collaborative Action Research model, our research team established a one-month clinical resident training program for first- and second-year clinical residents. We created and implemented an assessment rubric to assess the residents’ progress toward independent practice in surgery, and thereby, to evaluate the program itself. The program included training in three areas: basic techniques and procedures in the operating room, surgical ward management, and academic activities. The rubric measured the residents’ performance according to three achievement levels: Level 1 (demonstration), Level 2 (active help) and Level 3 (passive help). The program and rubric implementation began in June 2019 and continued until March 2020, when the program outcomes and shortcomings were analyzed. Among nineteen clinical residents, a total of nine clinical residents participated in the study. Most participants reached achievement Level 3 for their performance of basic techniques in the operating room. Finally, we discussed ideas for improvement and drafted plans for an improved rubric to complete the action research cycle. Our research team found the rubric to be a useful tool in evaluating the status of the new clinical resident training program. |
| キーワード | resident program rubric assessment general surgery action research |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 451 |
| 終了ページ | 460 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899256 |
| Web of Science KeyUT | 001108661600002 |
| JaLCDOI | 10.18926/AMO/65966 |
|---|---|
| フルテキストURL | 77_5_443.pdf |
| 著者 | Miyaji, Chikara| Takao, Soshi| Habu, Hiroshi| Matsumoto, Naomi| Aoo, Ken| Nishita, Yosuke| Tsuri, Masao| Yorifuji, Takashi| |
| 抄録 | This study examined whether participation in an art project was associated with higher social capital (SC). We conducted a questionnaire survey from November 2021 to March 2022 among residents aged 20 years or older of Naoshima, an island in Kagawa Prefecture, Japan. Before the survey, the Setouchi Triennale had been held on Naoshima four times, starting in 2010. We calculated propensity scores for Triennale participation and performed propensity score matching. We then compared cognitive and structural SC by Triennale participation and found significant differences, respectively. We adopted a conditional ordered logistic regression analysis with propensity score matching for cognitive or structural SC, and found adjusted odd ratios of 2.913 (95%CI, 1.846-4.596) for cognitive SC and 4.535 (95%CI, 2.839-7.244) for structural SC. Our findings suggest that Triennale participation enhanced the cognitive aspect of SC while also building structural SC. |
| キーワード | social capital art project propensity score matching |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 443 |
| 終了ページ | 449 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899255 |
| Web of Science KeyUT | 001108661600001 |
| JaLCDOI | 10.18926/AMO/65757 |
|---|---|
| フルテキストURL | 77_4_439.pdf |
| 著者 | Shiwaku, Takahiro| Ishida, Hisashi| Tatebe, Yasuhisa| Tamefusa, Kosuke| Ochi, Motoharu| Fujiwara, Kaori| Kubo, Toshihide| Nakata, Eiji| Washio, Kana| Tsukahara, Hirokazu| |
| 抄録 | A three-year-old boy with Philadelphia chromosome-positive B-cell precursor acute lymphoblastic leukemia (Ph+ALL) presented with an osteolytic lesion in his right upper arm. Tyrosine kinase inhibitors (TKIs) such as imatinib and dasatinib are an essential component throughout the course of treatment for Ph+ALL. However, TKIs are reported to affect the bone metabolism. In the treatment course of the current patient, the osteolytic lesion quickly improved despite the continuous use of TKIs, even during the concomitant use of corticosteroids. This suggests that TKIs can be safely given with concomitant corticosteroids to children with Ph+ALL, even when osteolytic lesions are present. |
| キーワード | acute lymphoblastic leukemia children tyrosine kinase inhibitor osteolysis |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 439 |
| 終了ページ | 442 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635146 |
| Web of Science KeyUT | 001088434900002 |
| JaLCDOI | 10.18926/AMO/65756 |
|---|---|
| フルテキストURL | 77_4_433.pdf |
| 著者 | Ono, Ryuki| Shiode, Yusuke| Kimura, Shuhei| Hosokawa, Mio| Matoba, Ryo| Kanzaki, Yuki| Kindo, Hiroya| Morita, Tetsuro| Morizane, Yuki| |
| 抄録 | A 23-year-old woman presented with a 1-month history of visual abnormalities in her right eye. A visual field test revealed temporal abnormalities in the right eye. Optical coherence tomography revealed an indistinct ellipsoid zone (EZ) on the B-scan image and hyporeflective areas in the EZ layer on the en face image in the right eye. We diagnosed the patient with acute zonal occult outer retinopathy. Visual field tests and B-scan images improved to almost normal at 6 months, but hyporeflective areas remained on the en face images. Thus, en face images may be more sensitive at detecting abnormalities in the outer retina than other modalities. |
| キーワード | acute zonal occult outer retinopathy optical coherence tomography en face image ellipsoid zone |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 433 |
| 終了ページ | 437 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635145 |
| Web of Science KeyUT | 001088434900001 |
| JaLCDOI | 10.18926/AMO/65755 |
|---|---|
| フルテキストURL | 77_4_429.pdf |
| 著者 | Sasanami, Misa| Iida, Atsuyoshi| Iwamuro, Masaya| Hirai, Ryousuke| Obara, Takashi| Tsukahara, Kohei| Yumoto, Tetsuya| Naito, Hiromichi| Nakao, Atsunori| |
| 抄録 | Intramural esophageal dissection (IED), characterized by bleeding into the submucosal space, leads to mucosal separation and dissection. The most prevalent symptoms are sudden chest or retrosternal pain, hematemesis, and dysphagia. Therefore, acute coronary syndrome and aortic dissection are among its most notable differential diagnoses. A 31-year-old pregnant woman presented with acute chest pain, laryngeal discomfort, and hematemesis. Emergency esophagogastroscopy revealed longitudinal mucosal dissection (upper esophagus to esophagogastric junction). The patient was successfully treated by avoiding the ingestion of solid foods. Clinicians should consider a diagnosis of IED for pregnant patients with acute chest pain, especially if hematemesis is present. |
| キーワード | chest pain dysphagia esophageal dissection hematemesis |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 429 |
| 終了ページ | 431 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635144 |
| Web of Science KeyUT | 001163659800012 |
| JaLCDOI | 10.18926/AMO/65753 |
|---|---|
| フルテキストURL | 77_4_423.pdf |
| 著者 | Yamakawa, Yasuaki| Miyashita, Kohei| Morizane, Atsushi| Takeuchi, Masato| Kawashima, Yuta| Sugimura, Tomoko| Saisaka, Yuichi| |
| 抄録 | We report a case of a patient with severe pelvic fracture who showed concurrent ST elevation on electrocardiogram. A 70-year-old man incurred an unstable pelvic fracture from a motorcycle accident. On admission, he was hemodynamically unstable, and massive transfusion and noradrenaline were administered immediately. Although ST elevation was present in leads II, III, aVF, V5, and V6, cardiac function was preserved; thus, trans-arterial embolization and external fixation for pelvic fracture were given priority. Four days after the injury, he suffered a cardiac arrest, and coronary angiography revealed that the cause of ST elevation and cardiac arrest was coronary vasospasm. Physicians should be aware that pain-related stress and platelet activation as well as use of noradrenaline in severe trauma cases can induce coronary vasospasm. |
| キーワード | coronary spasm angina noradrenaline severe trauma ST elevation treatment strategy |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 423 |
| 終了ページ | 427 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635143 |
| Web of Science KeyUT | 001163659800004 |
| JaLCDOI | 10.18926/AMO/65752 |
|---|---|
| フルテキストURL | 77_4_415.pdf |
| 著者 | Jelcic, Dzenis| Puzovic, Velibor| Benzon, Benjamin| Palada, Ivan| Jerković, Jelena| Vulic, Marko| |
| 抄録 | The aim of our study was to determine whether the immunohistochemical expression of placental vitamin D receptors is altered in pregnancies complicated by preeclampsia. Vitamin D receptor expression was immunohistochemically analysed in the placentas of three groups: a control group, and early- and late-onset preeclampsia groups. Total immunohistochemical intensity staining of placentas showed that the control group had a median vitamin D receptor (VDR) expression significantly higher than the placentas of mothers with early- and late-onset preeclampsia. There was no difference among the three groups in a semiquantitative analysis of VDR staining of the stroma only. Vitamin D receptors showed lower median expression in preeclampsia-affected pregnancies, especially early-onset preeclampsia. Therefore, Vitamin D receptor expression may be an important marker for normal placentation and preeclampsia onset. |
| キーワード | vitamin D receptor immunohistochemistry early and late-onset preeclampsia |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 415 |
| 終了ページ | 422 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635142 |
| Web of Science KeyUT | 001163659800006 |
| JaLCDOI | 10.18926/AMO/65751 |
|---|---|
| フルテキストURL | 77_4_407.pdf |
| 著者 | Hotta, Kensuke| Kobayashi, Takaomi| |
| 抄録 | This study aimed to investigate the usefulness of force-controlled pelvic stress radiographs in the evaluation and treatment of fragility fractures of the pelvis (FFP) using a functional treatment strategy. We conducted a retrospective study of 55 geriatric patients with FFP who underwent pelvic stress radiographs on admission. The differences in the sacral width, pelvic ring width, and medial femoral head width between the radiographs with and without the Sam Sling II M size were defined as Δ sacral width, Δ pelvic ring width, and Δ medial femoral head width, respectively. We used Pearson’s correlation test to assess the relationship between the degree of radiographic instability and the Johns Hopkins highest level of mobility scale (JH-HLM) at 10-days postadmission. Conventional receiver-operating-characteristic curve analysis was used to identify cases requiring surgery using the best cutoff value for radiographic instability. The JH-HLM was significantly correlated with Δ sacral width (r=−0.401, p=0.017), but not with Δ pelvic ring width (r=−0.298, p=0.080) nor with Δ medial femoral head width (r= −0.261, p=0.128). The best cutoff value of Δ sacral width in identifying surgical cases was 10.7 mm (sensitivity 75.0%, specificity 98.0%). Force-controlled pelvic stress radiographs could be helpful in assessing the need for surgery on admission. |
| キーワード | fragility fracture of the pelvis functional treatment strategy Sam Sling stress radiograph Johns Hopkins highest level of mobility scale |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 407 |
| 終了ページ | 414 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635141 |
| Web of Science KeyUT | 001163659800001 |