JaLCDOI 10.18926/AMO/57372
フルテキストURL 73_5_419.pdf
著者 Hishii, Shuhei| Miyatake, Nobuyuki| Nishi, Hiroyuki| Katayama, Akihiko| Ujike, Kazuhiro| Koumoto, Kiichi| Suzuki, Hiromi| Hashimoto, Hiroo|
抄録 We investigated the relationship between sedentary behavior and all-cause mortality in patients undergoing hemodialysis. A total of 71 patients (39 men, 32 women, aged 72.1±11.7 years) were enrolled in this longitudinal study. Their sedentary behavior was measured using a tri-accelerometer that provides relative values per daily wearing time. We classified the sedentary behavior time into 2 groups (under the median: short-sedentary behavior (SB) group; over the median: long-SB group) and compared the groups’ clinical parameters. We compared the groups’ survival rates by using Kaplan-Meier curves and the log-rank test, and we performed multivariate analyses by a Cox-proportional hazard model to evaluate the relationship between the sedentary behavior and the survival rate. Twenty patients (28.2%) died during the observation period. The survival rate of the short-SB group was significantly higher than that of the long-SB group. Sedentary behavior was thus an important factor for all-cause mortality even after adjusting for confounding factors by a Cox-proportional hazard model. Sedentary behavior is closely linked to all-cause mortality, especially total days and non-hemodialysis days, and reducing sedentary behavior may be beneficial to reduce the all-cause mortality of patients on chronic hemodialysis.
キーワード sedentary behavior hemodialysis mortality physical activity
Amo Type Original Article
発行日 2019-10
出版物タイトル Acta Medica Okayama
73巻
5号
出版者 Okayama University Medical School
開始ページ 419
終了ページ 425
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649368
Web of Science KeyUT 000491886600007
JaLCDOI 10.18926/AMO/57371
フルテキストURL 73_5_413.pdf
著者 Yanagihara, Yutaka| Nishida, Keigo| Watanabe, Ryuta| Koyama, Kanae| Sawada, Yuichiro| Noda, Terutaka| Asai, Seiji | Fukumoto, Tetsuya| Miura, Noriyoshi| Miyauchi, Yuki| Kikugawa, Tadahiko| Saika, Takashi|
抄録 Laparoscopic radical cystectomy (LRC) is a standard surgical treatment for muscle-invasive bladder cancer and high-risk non-muscle-invasive bladder cancer. LRC is a less invasive modality than conventional open surgery. Therefore, even elderly patients with invasive bladder cancer may be candidates for LRC. In this study, a comparative analysis of perioperative/oncological outcomes between elderly patients and younger patients who underwent LRC was performed to assess the feasibility of LRC in elderly patients. Sixty-eight consecutive patients who underwent LRC between October 2013 and March 2018 were enrolled and stratified into those younger than 75 years (n=37) and those ≥ 75 years old (n=31). The median follow-up period was 28.2 months. The preoperative and operative parameters and complications were similar in both groups. The 2-year overall survival (OS) was 64.4% in the younger vs. 76.4% in the elderly group (p=0.053), cancer-specific survival (CSS) was 79.3% vs. 81.7% (p=0.187), and recurrence-free survival (RFS) was 58.2% vs. 75.7% (p=0.174), respectively. No significant differences were observed in OS, CSS, or RFS between the groups. No significant differences were found between the groups with respect to peri-surgical/oncological outcomes. We conclude that LRC is feasible in elderly patients.
キーワード bladder cancer laparoscopic surgery radical cystectomy elderly patient
Amo Type Original Article
発行日 2019-10
出版物タイトル Acta Medica Okayama
73巻
5号
出版者 Okayama University Medical School
開始ページ 417
終了ページ 418
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649367
Web of Science KeyUT 000491886600006
JaLCDOI 10.18926/AMO/57370
フルテキストURL 73_5_403.pdf
著者 Ando, Akemi| Mitsuhashi, Toshiharu| Honda, Mitsugi| Hanayama, Yoshihisa| Hasegawa, Kou| Obika, Mikako| Kataoka, Hitomi| Otsuka, Fumio|
抄録 Osteoporosis increases the risk of bone fractures. It is diagnosed based on an individual’s bone mineral density (BMD) or a fracture without trauma. BMD is usually measured by the dual energy X-ray absorptiometry (DXA) method. Here we investigated factors for the earliest possible prediction of decreased BMD by examining the relationships between patients’ BMD values and changes in the patients’ physical and laboratory values. We retrospectively reviewed the medical records of 149 patients who visited our department in 2014-2015 for a variety of reasons and underwent an area BMD examination by DXA. We analyzed the relationships between decreasing BMD and the patients’ gender, age, body mass index (BMI), medical background, hemoglobin, electrolytes, and thyroid function. Thirty-nine of the patients were diagnosed with osteoporosis based on their T-scores. An adjusted analysis showed that female gender, aging, and increased serum calcium level were significantly related to decreasing femoral BMD, whereas high BMI was associated with an increase in femoral BMD. Collectively the results indicate that for the early detection of low BMD, it is important for general-practice physicians to consider conducting a BMD checkup when treating female and elderly patients with a low BMI and/or elevated serum calcium level.
キーワード bone mineral density (BMD) body mass index (BMI) female gender hypercalcemia osteoporosis
Amo Type Original Article
発行日 2019-10
出版物タイトル Acta Medica Okayama
73巻
5号
出版者 Okayama University Medical School
開始ページ 403
終了ページ 411
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649366
Web of Science KeyUT 000491886600005
JaLCDOI 10.18926/AMO/57369
フルテキストURL 73_5_393.pdf
著者 Yi Yi Cho Thein| Win, Myitzu| Thuzara, Moe| Matsumoto, Hiroshi| Yamada, Kiyoshi| Kimata, Yoshihiro| Leung, Michael|
抄録 Although many surgical centers perform microsurgery routinely in developed countries, performing microsurgery is challenging in resource-poor developing countries, such as Myanmar. With the establishment of educational training programs and the assistance of volunteer plastic surgical teams, local plastic surgeons can learn the techniques of microsurgery and apply them clinically. The purpose of this study was to establish baseline data and define the challenges of performing microsurgery in Yangon General Hospital, Myanmar. Sixty-four patients underwent reconstruction with free flaps from January 2015 to January 2018. All clinical records of these cases were assessed. The number of free flap reconstructions performed increased from 11 in the first year to 24 in the third year. The anterolateral thigh flap was the most commonly used (42%). The most common sites of reconstruction were mandible and intraoral defects. Total flap survival occurred in 58 of 64 patients (89%). The total salvageable flap rate for revision surgery was 66.6%; the successful revision rate was highest in 2017, with fewer complications. The flap salvage rates increased and the operative duration decreased as clinical experience improved. Establishing a microsurgical center requires a strong multidisciplinary team, clinical experience, continuous learning, sensible clinical application, and effective interdepartmental and intradepartmental cooperation.
キーワード microsurgery educational programs challenges of microsurgical free flaps reoperation flap salvageable rate
Amo Type Original Article
発行日 2019-10
出版物タイトル Acta Medica Okayama
73巻
5号
出版者 Okayama University Medical School
開始ページ 393
終了ページ 401
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649365
Web of Science KeyUT 000491886600004
JaLCDOI 10.18926/AMO/57368
フルテキストURL 73_5_387.pdf
著者 Inoue, Miyabi| Yokoyama, Teruhiko|
抄録 To assess the efficacy and safety of 2 drugs for overactive bladder (OAB), solifenacin and mirabegron. Fortyseven female OAB patients were randomized into 2 groups. Twenty-three patients were initially prescribed solifenacin for 4 weeks, followed by mirabegron for 4 weeks (group S). The other 24 patients were initially prescribed mirabegron for 4 weeks, followed by solifenacin for 4 weeks (group M). Evaluations included clinical determination of the OAB symptom score (OABSS), International Prostate Symptom Score (IPSS), and Visual Analog Scale. The IPSS significantly improved after the administration of solifenacin in both groups. The OABSS significantly improved in both groups after 4 weeks. In group M, the OABSS after eight weeks was significantly improved compared to that after 4 weeks. However, in group S, it was not significantly improved. Twelve patients experienced adverse events during the solifenacin treatment, while 2 patients experienced adverse events during the mirabegron treatment. Both solifenacin and mirabegron led to improved OAB symptoms. Switching from mirabegron to solifenacin significantly improved the OABSS. However, mirabegron led to fewer adverse events than solifenacin. We recommend that mirabegron be prescribed first for OAB patients. If patients are not satisfied with mirabegron, solifenacin should be used.
キーワード overactive bladder, randomized crossover study solifenacin mirabegron
Amo Type Original Article
発行日 2019-10
出版物タイトル Acta Medica Okayama
73巻
5号
出版者 Okayama University Medical School
開始ページ 387
終了ページ 392
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649364
Web of Science KeyUT 000491886600003
JaLCDOI 10.18926/AMO/57367
フルテキストURL 73_5_383.pdf
著者 Fu, Li| Nishibori, Masahiro|
抄録 High mobility group box-1 (HMGB1) is a non-histone, DNA-binding nuclear protein belonging to the family of damage-associated molecular patterns (DAMPs). HMGB1 has been reported to play an important role during epileptogenesis although the mechanisms of its actions are still not clear. Many hypotheses have been suggested especially about the relationship between HMGB1 and inflammation responses and blood-brain barrier disruption during epileptogenesis. In this review, we will mainly discuss the role of HMGB1 in epileptogenesis.
キーワード HMGB1 epileptogenesis inflammation blood-brain barrier
Amo Type Review
発行日 2019-10
出版物タイトル Acta Medica Okayama
73巻
5号
出版者 Okayama University Medical School
開始ページ 383
終了ページ 386
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649363
Web of Science KeyUT 000491886600002
JaLCDOI 10.18926/AMO/57366
フルテキストURL 73_5_379.pdf
著者 Wake, Hidenori|
抄録 Histidine-rich glycoprotein (HRG) is a 75 kDa glycoprotein synthesized in the liver whose plasma concentration is 100-150 μg/ml. HRG has been shown to modulate sepsis-related biological reactions by binding to several substances and cells, including heparin, factor XII, fibrinogen, thrombospondin, plasminogen, C1q, IgG, heme, LPS, dead cells, bacteria, and fungi. Therefore, reduction of plasma HRG levels in sepsis leads to dysregulation of coagulation, fibrinolysis, and immune response, resulting in disseminated intravascular coagulation and multiple organ failure. This review summarizes the binding and functional properties of HRG in sepsis.
キーワード htidine-rich glycoprotein septic pathogenesis immunothrombosis
Amo Type Review
発行日 2019-10
出版物タイトル Acta Medica Okayama
73巻
5号
出版者 Okayama University Medical School
開始ページ 379
終了ページ 382
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649362
Web of Science KeyUT 000491886600001
JaLCDOI 10.18926/AMO/56941
フルテキストURL 73_4_373.pdf
著者 Oda, Yoshiaki| Yamauchi, Tarou| Tanaka, Masato|
抄録 A minimally invasive surgical (MIS) procedure is an ideal surgical procedure. Many MIS techniques have been reported in spinal surgery. In clinical practice, we often encounter two-level canal stenosis cases, in which one level shows instability and the other does not. In such a case, fusion surgery for one level and decompression surgery for the other level is ideal. LLIF/OLIF approached from the lateral side has been reported effective. MIS decompression techniques in the lateral decubitus position have never been reported. We devised a surgical method that can accomplish both fixation and decompression in a consistent lateral decubitus position.
キーワード microendoscopic surgery lateral position navigation minimally invasive surgery image free
Amo Type Case Report
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
4号
出版者 Okayama University Medical School
開始ページ 373
終了ページ 377
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31439962
JaLCDOI 10.18926/AMO/56940
フルテキストURL 73_4_367.pdf
著者 Mifune-Morioka, Tomoyo| A. Uchida, Haruhito| Fukushima, Kazuhiko| Watanabe, Mayu| Ouchi, Chihiro| Mise, Koki| Kawakita, Chieko| Kano, Yuzuki| Onishi, Akifumi| Toma, Kishio| Eguchi, Jun| Wada, Nozomu| Ikeda, Fusao| Sasaki, Erika| Suganami, Yu| Kishida, Masayuki| Sugiyama, Hitoshi| Okada, Hiroyuki| Wada, Jun|
抄録 Eight years prior to her present admission, a 61-year-old Japanese woman was diagnosed with autoimmune hepatitis, slowly progressive insulin-dependent diabetes mellitus, and chronic thyroiditis; she had been treated with oral prednisolone (PSL). After she suddenly discontinued PSL, she newly developed systemic lupus erythematosus. A combination therapy of oral PSL and intravenous cyclophosphamide resulted in remission. She was finally diagnosed with autoimmune polyglandular syndrome (APS) type 3 (3A ,3B, 3D), complicated with four different autoimmune diseases. Since patients with type 3 APS may present many manifestations over a long period of time, they should be carefully monitored.
キーワード autoimmune polyglandular syndrome type 3 systemic lupus erythematosus autoimmune hepatitis slowly progressive insulin-dependent diabetes mellitus chronic thyroiditis
Amo Type Case Report
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
4号
出版者 Okayama University Medical School
開始ページ 367
終了ページ 372
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31439961
JaLCDOI 10.18926/AMO/56939
フルテキストURL 73_4_361.pdf
著者 Watanabe, Ayako| Kadowaki, Yoshihiko| Hattori, Kenji| Ohmori, Mika| Tsukayama, Hiroyuki| Kubota, Nobuhito| Okumoto, Tatsuo| Ishido, Nobuhiro| Okino, Takeshi|
抄録 A 35-year-old man was referred to our hospital for chronic abdominal pain and diarrhea. Computed tomography showed wall thickening, poor contrast enhancement and calcification of the ascending colon, which were consistent with phlebosclerotic colitis. Malignant character was not detected from a biopsy specimen. Operatively, we observed a scirrhous mass of the ascending colon invading surrounding tissue, which was diagnosed as signet ring cell carcinoma based on analysis of an intraoperative frozen section. Right hemicolectomy with regional lymph node dissection was performed. This case was extremely similar to phlebosclerotic colitis in clinical findings; surgical resection was required for correct diagnosis.
キーワード phlebosclerotic colitis colorectal cancer signet ring cell carcinoma young colorectal cancer
Amo Type Case Report
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
4号
出版者 Okayama University Medical School
開始ページ 361
終了ページ 365
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31439960
JaLCDOI 10.18926/AMO/56938
フルテキストURL 73_4_357.pdf
著者 Maeda, Naoto| Kodama, Naoki| Manda, Yosuke| Kawakami, Shigehisa| Oki, Kazuhiro| Minagi, Shogo|
抄録 We investigated the characteristics of grouped discharge (GD) waveforms obtained from long-term masseter electromyogram (EMG) recording in 6 female temporomandibular disorder (TMD) patients with myofascial pain and 6 healthy females. The EMG measurement was performed from the morning of the experiment day until the subject woke up the next day. We observed a significantly larger number of GD waveforms in the TMD group compared to the control group (p=0.002). Our results indicate that the existence of GD waveforms in masseter EMGs might be a predictor of future TMD with myofascial pain.
キーワード temporomandibular disorder grouped discharge masseter muscle electromyography
Amo Type Short Communication
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
4号
出版者 Okayama University Medical School
開始ページ 357
終了ページ 360
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31439959
JaLCDOI 10.18926/AMO/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
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
4号
出版者 Okayama University Medical School
開始ページ 349
終了ページ 356
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
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
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
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 English
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
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
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 English
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
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
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 English
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
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
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 English
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
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
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 English
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
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
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 English
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
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
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 English
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
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
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 English
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