| JaLCDOI | 10.18926/AMO/66158 |
|---|---|
| フルテキストURL | 77_6_651.pdf |
| 著者 | Watanabe, Daisuke| Hasebe, Yohei| Mitsui, Hiroshi| Oishi, Naoki| Kasai, Shin| Akahane, Koshi| Kojika, Satoru| Inukai, Takeshi| |
| 抄録 | A patient was born with a mass at the base of the thumb approximately 1.5 cm in diameter on the radial side of the fingers. The mass had globular swelling filled with hemorrhagic fluid and was dark red. X-rays and histology of the excised specimen suggested the diagnosis of gangrene and torsion of polydactyly. Prenatal torsion of polydactyly is not a common occurrence; moreover, prenatal torsion of polydactyly has only been found in ulnar polydactyly. Our case is a novel case of radial polydactyly that was gangrenous at birth owing to prenatal torsion. Diagnosing such a mass at the base of the thumb is important. |
| キーワード | infant fingers thumb polydactyly torsion abnormality |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-12 |
| 巻 | 77巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 651 |
| 終了ページ | 653 |
| 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 | 38145940 |
| Web of Science KeyUT | 001164631200011 |
| JaLCDOI | 10.18926/AMO/66157 |
|---|---|
| フルテキストURL | 77_6_647.pdf |
| 著者 | Kojima, Katsuhide| Takahashi, Yuka| Sugiyama, Soichi| Asano, Yudai| Okawa, Nanako| Makimoto, Satoko| Higaki, Fumiyo| Iguchi, Toshihiro| Hiraki, Takao| |
| 抄録 | A 67-year-old man was referred to our hospital for the diagnosis and treatment of prostate cancer. Multidisciplinary discussion led to intensity-modulated radiotherapy preceded by hormone therapy. Before radiotherapy, a biodegradable hydrogel spacer (HS) was placed between the prostate and rectum to reduce radiation injury risk. Three weeks postplacement, pelvic magnetic resonance imaging revealed HS migration into the pelvic vein. Subsequent whole-body contrast-enhanced computed tomography (CECT) revealed HS migration into the pulmonary artery. The patient showed no symptoms or clinical signs. Radiotherapy was completed uneventfully. Complete absorption of the migrated HS was confirmed using CECT images 5 months postplacement. |
| キーワード | hydrogel spacer prostate cancer radiotherapy pulmonary embolism |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-12 |
| 巻 | 77巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 647 |
| 終了ページ | 650 |
| 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 | 38145939 |
| Web of Science KeyUT | 001164631200010 |
| JaLCDOI | 10.18926/AMO/66156 |
|---|---|
| フルテキストURL | 77_6_635.pdf |
| 著者 | Ikeda, Tomohiro| Okamura, Kazunori| Hasegawa, Masaki| Tanaka, Satoshi| Kanai, Shusaku| |
| 抄録 | In the management of post-injury patients with activity limitations, methods to prevent musculoskeletal disorders and hasten recovery are important. This randomized controlled, single-blinded study was a preliminary investigation of the combined effect of nutritional support with neuromuscular electrical stimulation (NMES) on muscle strength and thickness. Healthy young adult males (median age, 21 years) were enrolled; each of their hands was randomly assigned to one of the following four groups: Placebo, Nutrition, NMES, and Nutrition + NMES. All participants received whey protein or placebo (3x/week for 6 weeks) and NMES training (3x/week for 6 weeks) on the abductor digiti minimi (ADM) muscle of either the left or right hand. ADM muscle strength and thickness were analyzed at baseline and at week 7. We analyzed 38 hands (9 Placebo, 10 Nutrition, 9 NMES, 10 Nutrition + NMES). There was significantly greater muscle strengthening in the Nutrition + NMES group compared to the Placebo group or the NMES group, but no significant difference in gain of muscle thickness. The combined intervention may be effective in improving muscle strength. Future clinical trials targeting various muscles after sports-related injuries are warranted. |
| キーワード | whey protein electrical stimulation muscle strength healthy volunteers |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-12 |
| 巻 | 77巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 635 |
| 終了ページ | 645 |
| 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 | 38145938 |
| Web of Science KeyUT | 001164631200009 |
| JaLCDOI | 10.18926/AMO/66155 |
|---|---|
| フルテキストURL | 77_6_627.pdf |
| 著者 | Hibino, Yumi| Okazawa-Sakai, Mika| Yokoyama, Takanori| Fujimoto, Etsuko| Okame, Shinichi| Teramoto, Norihiro| Takehara, Kazuhiro| |
| 抄録 | To explore the incidence of abnormal vaginal cytology after total laparoscopic hysterectomy for the treatment of cervical intraepithelial neoplasia 3, we retrospectively analyzed the medical records of patients treated at NHO Shikoku Cancer Center (Japan) in 2014-2019. The cases of 99 patients who underwent a laparoscopic (n=36) or open (n=63) hysterectomy and postoperative follow-up were examined. Abnormal vaginal cytology was detected in 13.9% (5/36) of the laparoscopic-surgery (LS) group and 14.3% (9/63) of the open-surgery (OS) group. A vaginal biopsy was performed at the physicians’ discretion; one LS patient and six OS patients were diagnosed with vaginal intraepithelial neoplasia. The cumulative incidence of abnormal vaginal cytology at 3 years post-hysterectomy was 21.4% (LS group) and 20.5% (OS group), a nonsignificant difference. A multivariate analysis showed that age > 50 years was the only independent risk factor for abnormal vaginal cytology among the covariates examined including age; body mass index; histories of vaginal delivery, abdominal surgery, and smoking; and surgical approach (hazard ratio 8.11; 95% confidence interval 1.73-37.98; p=0.01). These results suggest that the occurrence of abnormal vaginal cytology after a hysterectomy may not be influenced by the laparoscopic procedure but is associated with older age. |
| キーワード | total laparoscopic hysterectomy vaginal intraepithelial neoplasia cervical intraepithelial neoplasia vaginal cytology risk factor |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-12 |
| 巻 | 77巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 627 |
| 終了ページ | 634 |
| 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 | 38145937 |
| Web of Science KeyUT | 001164631200008 |
| JaLCDOI | 10.18926/AMO/66154 |
|---|---|
| フルテキストURL | 77_6_619.pdf |
| 著者 | Oe, Kenichi| Iida, Hirokazu| Sogawa, Shohei| Kobayashi, Fumito| Nakamura, Tomohisa| Saito, Takanori| |
| 抄録 | This study retrospectively evaluated 41 consecutive open reductions and internal fixations following primary or revision total hip arthroplasty, which required trochanteric claw plate fixation for greater trochanteric fracture or osteotomy between January 2008 and December 2020. The mean duration of clinical follow-up was 4.2 years (range, 1-13 years). The patients included 13 men and 28 women, with a mean age of 68 years (range, 32-87 years). The indications for intervention included trochanteric osteotomy, intraoperative fracture, and non-union including postoperative fracture in 6, 9, and 26 cases, respectively. The mean Merle d’Aubigné Clinical Score improved from 9.4 points (range, 5-15 points) pre-operatively, to 14.3 points (range, 9-18 points) at the last follow-up. Bone union occurred in 35 cases (85%), while implant breakage occurred in four cases. At the last follow-up, the mean Merle d’Aubigné Clinical Scores of bone union and non-union were 15.3 and 14.1, respectively (p=0.48). The Kaplan-Meier survival rate, with the endpoint being revision surgery for pain, non-union, dislocation, or implant breakage, at 10 years was 80.0% (95% confidence interval: 62.6-97.4%). Greater trochanteric fixation using a trochanteric claw plate yielded successful results. |
| キーワード | greater trochanteric fracture trochanteric osteotomy claw plate total hip arthroplasty |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-12 |
| 巻 | 77巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 619 |
| 終了ページ | 625 |
| 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 | 38145936 |
| Web of Science KeyUT | 001164631200007 |
| JaLCDOI | 10.18926/AMO/66153 |
|---|---|
| フルテキストURL | 77_6_613.pdf |
| 著者 | Miyake, Yoshiaki| Namba, Yoshifumi| Mitani, Shigeru| Umehara, Norifumi| Kawamoto, Toyohiro| Furuichi, Shuro| |
| 抄録 | The relationship between osteoarthritis (OA) of the lower extremity and shoulder OA has not been established. This study evaluated the prevalence of shoulder OA in patients with knee OA. We collected contrast-enhanced computed tomography (CECT) images of the shoulder joints of 105 patients with knee OA that were taken 1 week after they underwent primary knee arthroplasty to check for venous thromboembolism (VTE). The images were compared with CECT images of 110 control-group patients that were taken for the purpose of differentiating VTE. Shoulder OA was present in a significantly higher percentage of patients with knee arthroplasty than controls (29% versus 15%), and the difference was particularly pronounced in patients in their 70s (33%) compared to age-matched controls (11%). Patients with knee OA often use arm support to stand up or walk due to knee joint pain and muscle weakness, which places the weight-bearing shoulder at risk of developing OA. |
| キーワード | shoulder osteoarthritis knee osteoarthritis weight-bearing shoulder knee arthroplasty |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-12 |
| 巻 | 77巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 613 |
| 終了ページ | 618 |
| 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 | 38145935 |
| Web of Science KeyUT | 001164631200006 |
| JaLCDOI | 10.18926/AMO/66152 |
|---|---|
| フルテキストURL | 77_6_607.pdf |
| 著者 | Tani, Yasunari| Kashima, Saori| Mitsuhashi, Toshiharu| Suzuki, Etsuji| Takao, Soshi| Yorifuji, Takashi| |
| 抄録 | Many studies have shown an association between long-term exposure to particulate matter having an aerodynamic diameter of 2.5 μm or less (PM2.5) and diabetes mellitus (DM), but few studies have focused on Asian subjects. We thus examined the association between long-term exposure to PM2.5 and DM prevalence in Okayama City, Japan. We included 76,591 participants who had received basic health checkups in 2006 and 2007. We assigned the census-level modeled PM2.5 data from 2006 and 2007 to each participant and defined DM using treatment status and the blood testing. PM2.5 was associated with DM prevalence, and the prevalence ratio (95% confidence interval) was 1.10 (1.00-1.20) following each interquartile range increase (2.1 μg/m3) in PM2.5. This finding is consistent with previous results and suggests that long-term exposure to PM2.5 is associated with an increased prevalence of DM in Okayama City, Japan, where the PM2.5 level is lower than in other cities in Asian countries. |
| キーワード | air pollution diabetes mellitus epidemiology glycosylated hemoglobin particulate matter |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-12 |
| 巻 | 77巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 607 |
| 終了ページ | 612 |
| 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 | 38145934 |
| Web of Science KeyUT | 001164631200005 |
| JaLCDOI | 10.18926/AMO/66151 |
|---|---|
| フルテキストURL | 77_6_595.pdf |
| 著者 | Bando, Takashi| Chuma, Masayuki| Hamano, Hirofumi| Niimura, Takahiro| Okada, Naoto| Kondo, Masateru| Izumi, Yuki| Ishida, Shunsuke| Yoshioka, Toshihiko| Asada, Mizuho| Zamami, Yoshito| Takechi, Kenshi| Goda, Mitsuhiro| Miyata, Koji| Yagi, Kenta| Izawa-Ishizawa, Yuki| Azuma, Momoyo| Yanagawa, Hiroaki| Tasaki, Yoshikazu| Ishizawa, Keisuke| |
| 抄録 | There is a growing concern about the relationship between vancomycin-associated nephrotoxicity (VAN) and concomitant use of nephrotoxins. We examined this relationship by combined retrospective analyses of two real-world databases. Initially, the FDA Adverse Event Reporting System (FAERS) was analyzed for the effects of concomitant use of one or more nephrotoxins on VAN and the types of combinations of nephrotoxins that exacerbate VAN. Next, electronic medical records (EMRs) of patients who received vancomycin (VCM) at Tokushima University Hospital between January 2006 and March 2019 were examined to confirm the FAERS analysis. An elevated reporting odds ratio (ROR) was observed with increases in the number of nephrotoxins administered (VCM + one nephrotoxin, adjusted ROR (95% confidence interval [CI]) 1.67 [1.51-1.85]; VCM + ≥2 nephrotoxins, adjusted ROR [95% CI] 1.54 [1.37-1.73]) in FAERS. EMRs analysis showed that the number of nephrotoxins was associated with higher incidences of VAN [odds ratio: 1.99; 95% CI: 1.42-2.78]. Overall, concomitant use of nephrotoxins was associated with an increased incidence of VAN, especially when at least one of those nephrotoxins was a renal hypoperfusion medication (furosemide, non-steroidal anti-inflammatory drugs, and vasopressors). The concomitant use of multiple nephrotoxins, especially including renal hypoperfusion medication, should be avoided to prevent VAN. |
| キーワード | vancomycin-associated nephrotoxicity polypharmacy nephrotoxin spontaneous adverse event reporting database electronic medical records |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-12 |
| 巻 | 77巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 595 |
| 終了ページ | 605 |
| 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 | 38145933 |
| Web of Science KeyUT | 001164631200004 |
| JaLCDOI | 10.18926/AMO/66150 |
|---|---|
| フルテキストURL | 77_6_589.pdf |
| 著者 | Omichi, Ryotaro| Kariya, Shin| Maeda, Yukihide| Fukushima, Kunihiro| Kataoka, Yuko| Sugaya, Akiko| Nishizaki, Kazunori| Ando, Mizuo| |
| 抄録 | Choosing the optimal side for cochlear implantation (CI) remains a major challenge because of the lack of evidence. We investigated the choice of the surgery side for CI (i.e., the better- or poorer-hearing ear) in patients with asymmetric hearing. Audiological records of 74 adults with a unilateral hearing aid who had undergone surgery at Okayama University Hospital were reviewed. The definition of ‘better-hearing ear’ was the aided ear, and the unaided ear was considered the poorer-hearing ear. We performed a multiple regression analysis to identify potential predictors of speech recognition performance after unilateral CI in the patients. Fifty-two patients underwent CI in the poorer-hearing ear. The post-Ci bimodal hearing rate was far higher in the poorer-ear group (77.8% vs. 22.2%). A multivariate analysis revealed that prelingual hearing loss and the patient’s age at CI significantly affected the speech recognition outcome (beta coefficients: 24.6 and −0.33, 95% confidence intervals [11.75-37.45] and [−0.58 to −0.09], respectively), but the CI surgery side did not (−6.76, [−14.92-1.39]). Unilateral CI in the poorer-hearing ear may therefore be a reasonable choice for adult patients with postlingual severe hearing loss, providing a greater opportunity for postoperative bimodal hearing. |
| キーワード | cochlear implantation poorer hearing ear better hearing ear hearing aids speech recognition |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-12 |
| 巻 | 77巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 589 |
| 終了ページ | 593 |
| 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 | 38145932 |
| Web of Science KeyUT | 001164631200003 |
| JaLCDOI | 10.18926/AMO/66149 |
|---|---|
| フルテキストURL | 77_6_577.pdf |
| 著者 | Liu, Siyu| Athurupana, Rukmali| Han, Hongmei| Yang, Titi| Nakatsuka, Mikiya| |
| 抄録 | Bereavement care is conducted to meet the emotional needs of grieving couples who are devastated by the experience of a miscarriage or stillbirth. From January to April 2022, we distributed a questionnaire that assessed the knowledge and attitudes of Japanese nursing staff (nurses and midwives) in Japan’s Chugoku-Shikoku region toward bereavement care for couples with miscarriage/stillbirth. The 370 survey respondents’ answers revealed that the nursing staff’s knowledge regarding recurrent pregnancy loss and subsequent bereavement care was insufficient. About 41.1% and 64.1% of the respondents had received school and on-the-job education in bereavement care, respectively, and 79.2% expressed willingness to provide such care. Our analyses revealed that the following factors were associated with the nursing staff’s knowledge level: parent status, age, reproductive history, midwifery license, work experience and environment, and on-the-job education. The following were correlated with the staff’s willingness to provide bereavement care: work environment, midwifery license, bereavement care knowledge, and on-the-job education. Together our findings indicate that education plays a significant role in equipping caregivers to provide effective bereavement care for couples who have experienced a miscarriage or stillbirth. |
| キーワード | midwife nurse miscarriage bereavement knowledge |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-12 |
| 巻 | 77巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 577 |
| 終了ページ | 587 |
| 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 | 38145931 |
| Web of Science KeyUT | 001164631200002 |
| JaLCDOI | 10.18926/AMO/66148 |
|---|---|
| フルテキストURL | 77_6_567.pdf |
| 著者 | Matsumoto, Naomi| Higuchi, Chigusa| Miyaji, Chikara| Mitsuhashi, Toshiharu| Hagiya, Hideharu| Takao, Soshi| Yorifuji, Takashi| |
| 抄録 | This paper presents the results of a series of surveys conducted from July 2021 to March 2023 to investigate the post-vaccination adverse reactions to the mRNA-1273 (Moderna) vaccine among faculty, staff, and students at Okayama University. These studies complement the official surveys conducted by the Ministry of Health, Labour and Welfare (MHLW) and provide a more representative picture of adverse reactions in the general population including large numbers of healthy young people. Pain, swelling, redness at the injection site, fever, headache, and malaise were the main adverse reactions reported. The proportion of adverse reactions was generally higher after the second vaccination and decreased with each additional vaccination. No statistically significant differences in the adverse reactions were found for males and females and those with/without a history of allergy, but a lower proportion of fever was observed in older participants and those with underlying medical conditions. We also evaluated the association between adverse reactions and antibody titers after the third vaccination and found no significant differences in antibody levels one month after vaccination. This series of studies highlights the importance of conducting surveys in diverse populations to provide a more representative picture of post-vaccination adverse reactions during a pandemic. |
| キーワード | coronavirus disease 2019 adverse reactions mRNA vaccine antibody titers young adults |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-12 |
| 巻 | 77巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 567 |
| 終了ページ | 575 |
| 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 | 38145930 |
| Web of Science KeyUT | 001164631200001 |
| 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 |