検索結果 3869 件
| JaLCDOI | 10.18926/AMO/51073 |
|---|---|
| フルテキストURL | 67_4_271.pdf |
| 著者 | Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro| |
| 抄録 | In the postoperative treatment of hand surgery, it is important to start exercise therapy as early as possible. In conventional negative pressure wound therapy, the fingers are immobilized by the film dressing covering the wound and hand, thereby preventing sufficient rehabilitation. Here, we devised a bag-type negative pressure wound therapy that makes it possible to start finger exercises almost immediately, and we applied it to 4 patients:one each with hand burns, symmetrical peripheral gangrene, a crush injury accompanied by extensive skin defects and a fingertip degloving injury. The duration of the bag-type negative pressure wound therapy ranged from three to eight weeks, and good granulation was achieved, so that a skin graft was not required. In addition, particularly in the case of the fingertip degloving injury, good nail regeneration was achieved. Except for the case of symmetrical peripheral gangrene, a good range of joint motion with a percent total active motion (%TAM) of 94.7% or more was achieved. Our therapy was performed by inserting the hand into a sealing bag;sufficient exercise therapy was made possible by expanding the bag during rehabilitation. |
| キーワード | negative pressure wound therapy early exercise therapy wound healing hand surgery |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 271 |
| 終了ページ | 276 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970327 |
| Web of Science KeyUT | 000323470100010 |
| JaLCDOI | 10.18926/AMO/51072 |
|---|---|
| フルテキストURL | 67_4_265.pdf |
| 著者 | Hanakawa, Hiroyuki| Orita, Yorihisa| Sato, Yasuharu| Uno, Kinya| Nishizaki, Kazunori| Yoshino, Tadashi| |
| 抄録 | We present a case of a 67-year-old Japanese man with a serious oropharyngeal ulceration that at first seemed to be destructive malignant lymphoma or oropharyngeal carcinoma. We suspected methotrexate (MTX)-associated lymphoproliferative disorder (LPD) induced by MTX treatment for rheumatoid arthritis (RA). About 3 weeks after simple discontinuation of MTX, complete regression of the disease was observed, confirming our diagnosis. |
| キーワード | ulceration methotrexate oropharynx lymphoproliferative disorders |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 265 |
| 終了ページ | 269 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970326 |
| Web of Science KeyUT | 000323470100009 |
| JaLCDOI | 10.18926/AMO/51071 |
|---|---|
| フルテキストURL | 67_4_259.pdf |
| 著者 | Idani, Hitoshi| Nakano, Kanyu| Asami, Shinya| Kubota, Tetsushi| Komoto, Satoshi| Kurose, Yohei| Kubo, Shinichiro| Nojima, Hiroki| Hioki, Katsuyoshi| Kin, Hitoshi| Takakura, Norihisa| |
| 抄録 | We describe a new simple and easy technique called the "Hook and roll technique" (HRT) that uses an articulating hook cautery to provide a critical view during single incision laparoscopic cholecystectomy (SILC). A 2-cm incision is made at the umbilicus to insert three 5-mm trocars or a multichannel port. After dissection of the serosa of the dorsal and ventral sides of the gall bladder, including Calot's triangle, the angled tip of the hook cautery is inserted between the cystic artery and duct with its tip placed dorsally. The tip is then rotated in a clockwise manner to avoid bile duct injury, allowing the connective tissue between them to be hooked, coagulated and cut. This procedure is repeated several times, followed by dissection between the cystic artery and the liver bed to achieve a critical view. From December 2008 to May 2011, 121 patients underwent SILC using HRT in our hospital without any serious complications. This technique is suitable for SILC, as it is consists of simple procedures that can be performed safely and easily, even by left hand in a cross-over approach, and it allows complete dissection of Calot's triangle to achieve a critical view without using any dissector under dangerous in-line viewing. |
| キーワード | critical view of safety single incision laparoscopic cholecystectomy articulating hook cautery |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 259 |
| 終了ページ | 263 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970325 |
| Web of Science KeyUT | 000323470100008 |
| JaLCDOI | 10.18926/AMO/51070 |
|---|---|
| フルテキストURL | 67_4_253.pdf |
| 著者 | Shiota, Yutaro| Taniguchi, Akihiko| Yuzurio, Syota| Horita, Naokatsu| Hosokawa, Shinobu| Watanabe, Yoichi| Tohmori, Hidetoshi| Ono, Tetsuya| |
| 抄録 | Dental infection can be an important source for septic pulmonary embolism (SPE), but only a few cases of SPE accompanying dental infection have been reported. The aim of this study was to characterize the clinical features of SPE induced by dental infection. Patients who fulfilled the diagnostic criteria described in the text were recruited in a retrospective fashion. All 9 patients were men, with a median age of 59 years (range:47 to 74 years). Eight patients had chest pain (88.9%), 5 had a preceding toothache (55.6%) and 3 had preceding gingival swelling (33.3%). Blood cultures obtained from 7 patients were negative. Periodontitis was found in all of the cases, periapical periodontitis in 5 cases, and gingival abscess in 3 cases. The median duration of hospitalization was 15 days, and symptoms were mild in some cases. In addition to antimicrobial therapy, tooth extraction was performed in 3 cases, tooth scaling in 6. SPE induced by dental infection has prominent clinical characteristics such as male preponderance, chest pain, preceding toothache, and mild clinical course. |
| キーワード | bacteremia chest pain multiple nodular shadows periodontitis septic pulmonary embolism |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 253 |
| 終了ページ | 258 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970324 |
| Web of Science KeyUT | 000323470100007 |
| JaLCDOI | 10.18926/AMO/51069 |
|---|---|
| フルテキストURL | 67_4_245.pdf |
| 著者 | Araki, Tohru| Monden, Koichi| Araki, Motoo| |
| 抄録 | A crossover study was conducted to identify the best α1-adrenoceptor (α1AR) antagonist for individual patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). One hundred thirteen patients (mean age 70.8 years) were enrolled. All patients met BPH clinical study guidelines. Seven agents were utilized:tamsulosin 0.2mg, silodosin 8mg, urapidil 60mg, naftopidil 50mg, prazosin 1mg, terazosin 2mg, and doxazosin 1mg. Patients were initially prescribed tamsulosin or silodosin for a week and then urapidil for a week. Two weeks later, they were prescribed the better of the 2 agents for a week and a new agent for the next week. This cycle was repeated until all 7 agents were tested. Efficacy was evaluated with the International Prostate Symptom Score. The agent rankings were doxazosin (25 [22%]), silodosin (22 [19%]), urapidil (19 [17%]), naftopidil (17 [15%]), terazosin (12 [11%]), tamsulosin (11 [10%]), prazosin (7 [6%]). Only 12 patients (11%) changed agents after the crossover study was completed. The major reason was adverse events (83%). We found that each of the 7 α1AR antagonists has its own supporters. Further, the one-week crossover study was useful in identifying the best agent for the treatment of each individual with LUTS. |
| キーワード | alpha-1 blockers alpha1-adrenoceptor antagonists lower urinary tract symptoms benign prostatic hyperplasia crossover study |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 245 |
| 終了ページ | 251 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970323 |
| Web of Science KeyUT | 000323470100006 |
| JaLCDOI | 10.18926/AMO/51068 |
|---|---|
| フルテキストURL | 67_4_239.pdf |
| 著者 | Nakamura, Shinichiro| Nouso, Kazuhiro| Kobayashi, Yoshiyuki| Shiraha, Hidenori| Ohnishi, Hideki| Toshimori, Junichi| Kuwaki, Kenji| Hagihara, Hiroaki| Takayama, Hiroki| Yamamoto, Kazuhide| |
| 抄録 | The aim of this study was to evaluate the histologic diagnosis of hypovascular hepatic lesions showing hypointensity on hepatobiliary phase images of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI (EOB-MRI). In 38 patients with hepatocellular carcinoma (HCC) after curative treatments and 18 patients with liver cirrhosis, 105 hypovascular nodules that were hypointense at the hepatobiliary phase of EOB-MRI were biopsied and the clinical usefulness of these EOB-MRI findings for the diagnosis of HCC was examined. Of the 105 nodules (median diameter＝12mm), 78 (74.3%), 11 (10.5%), and 16 (15.2%) were diagnosed as HCC, dysplastic, and non-neoplastic, respectively. The positive predictive value (PPV) of hypointensity at the hepatobiliary phase of EOB-MRI for the diagnosis of HCC increased to 77-90% when combined with the following factors: washout appearance on the delayed phase of triple-phase CT, hyperintensity in diffusion-weighted image of MRI, or the appearance of a hypoechoic part in ultrasonography. PPV increased to 100% when all 3 factors were positive. A relatively large proportion of hypovascular lesions that showed hypo-intensity in the hepatobiliary phase were confirmed to be HCC, and the accuracy of HCC increased when combined with other imaging findings. |
| キーワード | hepatocellular carcinoma hypovascular diagnosis gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 239 |
| 終了ページ | 244 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970322 |
| Web of Science KeyUT | 000323470100005 |
| JaLCDOI | 10.18926/AMO/51067 |
|---|---|
| フルテキストURL | 67_4_227.pdf |
| 著者 | Ryuko, Hiromasa| Otsuka, Fumio| |
| 抄録 | Primary care physicians often encounter patients with fever of unknown origin and without apparent causes. Recent advances in laboratory medicine have facilitated diagnostic procedures;however, it is still difficult to determine the critical febrile factor at an early stage. We reviewed the medical records of 174 patients who were admitted due to a chief complaint of fever (＞37.5℃) to our hospital during the period from 2004 to 2010. The patients were categorized into patients with infection, inflammation, neoplasm and drug-induced fever. Based on the analysis done by category, it was revealed that the patient's age, body temperature and duration of fever were closely related to the final diagnosis. Serum CRP levels were significantly low in the nonbacterial infection group, while serum levels of sIL-2R were high in neoplasm and drug-induced cases. CRP level on admission was weakly but significantly correlated with body temperature, while duration of fever was inversely related to body temperature. The effectiveness of PET-CT and tissue biopsy for diagnosis was considerably high, particularly in the categories of neoplasm and nonspecific inflammation, respectively, though the effectiveness of bacterial culture was low. Thus, a careful review of physical and laboratory information including body temperature, CRP level, duration of fever, gender difference and history of medication is indispensable for diagnosis. Stepwise categorization and disease classification by comprehensive and systemic checkup are very helpful for determining the causes of fever. |
| キーワード | computed tomography (CT) C-reactive protein (CRP) fluorodeoxyglucose positron emission tomography (FDG-PET) fever of unknown origin (FUO) soluble interleukin-2 receptor (sIL-2R) |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 227 |
| 終了ページ | 237 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970321 |
| Web of Science KeyUT | 000323470100004 |
| 関連URL | http://ousar.lib.okayama-u.ac.jp/metadata/51947 |
| JaLCDOI | 10.18926/AMO/51066 |
|---|---|
| フルテキストURL | 67_4_219.pdf |
| 著者 | Maruyama, Hidehiko| Nakamura, Makoto| Yonemoto, Naohiro| Kageyama, Misao| |
| 抄録 | Cholestasis and thrombocytopenia are complications that affect infants born small for gestational age (SGA). In SGA infants, other vital organs develop at the expense of the liver, and the thrombopoietin produced by the liver is low, often resulting in cholestasis. We hypothesized that thrombocytopenia at birth can be used to predict cholestasis in very-low-birth-weight infants (VLBWIs) with SGA. This retrospective cohort study enrolled VLBWIs with SGA admitted to a tertiary neonatal intensive care unit. A platelet cutoff value predictive of cholestasis was determined using receiver operating characteristic analysis. Multivariate logistic regression analysis was performed to evaluate the platelet cutoff value, and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Regarding the onset of cholestasis, survival analysis was performed by calculating the adjusted hazard ratios (HRs) and 95% CIs. A total of 87 infants were evaluated, and the platelet cutoff value was determined as 88×10(3) cells/μl. The adjusted OR for this platelet cutoff value was 10.52 (95% CI 2.26-55.93, p＝0.003), and the adjusted HR was 7.76 (95% CI 2.51-23.50, p＝0.0006). Thrombocytopenia is a useful predictor for cholestasis in VLBWIs with SGA. |
| キーワード | cholestasis platelet small for gestational age thrombocytopenia very low birth weight |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 219 |
| 終了ページ | 225 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970320 |
| Web of Science KeyUT | 000323470100003 |
| JaLCDOI | 10.18926/AMO/51065 |
|---|---|
| フルテキストURL | 67_4_213.pdf |
| 著者 | Kawahara, Michiko| Sato, Shuhei| Ida, Yukiko| Watanabe, Masao| Fujishima, Mamoru| Ishii, Hiroaki| Hori, Keisuke| Kanazawa, Susumu| |
| 抄録 | A relatively large number of women in their 40s with high-density breasts, in which it can be difficult to detect lesions, are encountered in mammography cancer screenings in Japan. Here, we retrospectively investigated factors related to breast density. Two hundred women (40-49 years old) were examined at the screening center in our hospital. Multivariate analysis showed that factors such as small abdominal circumference, high HDL cholesterol, and no history of childbirth were related to high breast density in women in their 40s undergoing mammography. Other non-mammographic screening methods should be considered in women with abdominal circumferences ＜76cm, HDL-C >53mg/dl, and no history of childbirth, as there is a strong possibility of these women having high-density breasts that can make lesion detection difficult. |
| キーワード | high-density breasts abdominal circumference high-density lipoprotein cholesterol childbirth mammography |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 213 |
| 終了ページ | 217 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970319 |
| Web of Science KeyUT | 000323470100002 |
| JaLCDOI | 10.18926/AMO/51064 |
|---|---|
| フルテキストURL | 67_4_203.pdf |
| 著者 | Ohuchi, Hideyo| |
| 抄録 | A central issue of evolutionary developmental biology is how the eye is diverged morphologically and functionally. However, the unifying mechanisms or schemes that govern eye diversification remain unsolved. In this review, I first introduce the concept of evolutionary developmental biology of the eye with a focus on photoreception, the fundamental property of retinal cells. Second, I summarize the early development of vertebrate eyes and the role of a homeobox gene, Lhx1, in subdivision of the retina into 2 domains, the neural retina and retinal pigmented epithelium of the optic primordium. The 2 retinal domains are essential components of the eye as they are found in such prototypic eyes as the extant planarian eye. Finally, I propose the presence of novel retinal cell subtypes with photosensory functions based on our recent work on atypical photopigments (opsins) in vertebrates. Since human diseases are attributable to the aberration of various types of cells due to alterations in gene expression, understanding the precise mechanisms of cellular diversification and unraveling the molecular profiles of cellular subtypes are essential to future regenerative medicine. |
| キーワード | eye development evolution opsin photoreceptor |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 203 |
| 終了ページ | 212 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970318 |
| Web of Science KeyUT | 000323470100001 |
| フルテキストURL | K0004799.pdf K0004799_honbun.pdf |
|---|---|
| 著者 | 上野 浩司| |
| 発行日 | 2013-03-25 |
| 資料タイプ | 学位論文 |
| 学位授与番号 | 甲第4799号 |
| 学位授与年月日 | 2013-03-25 |
| 学位・専攻分野 | 博士（保健学） |
| 授与大学 | 岡山大学 |
| 言語 | 日本語 英語 |
| フルテキストURL | K0004710.pdf K0004710_honbun.pdf |
|---|---|
| 著者 | 井家 克彦| |
| 発行日 | 2013-03-25 |
| 資料タイプ | 学位論文 |
| 学位授与番号 | 甲第4710号 |
| 学位授与年月日 | 2013-03-25 |
| 学位・専攻分野 | 博士（医学） |
| 授与大学 | 岡山大学 |
| 言語 | 日本語 英語 |
| フルテキストURL | K0004706.pdf K0004706_honbun.pdf |
|---|---|
| 著者 | 阿拉法特 艾尔肯| |
| 発行日 | 2013-03-25 |
| 資料タイプ | 学位論文 |
| 学位授与番号 | 甲第4706号 |
| 学位授与年月日 | 2013-03-25 |
| 学位・専攻分野 | 博士（医学） |
| 授与大学 | 岡山大学 |
| 言語 | 日本語 英語 |
| フルテキストURL | K0004701.pdf K0004701_honbun.pdf |
|---|---|
| 著者 | 山本 昌直| |
| 発行日 | 2013-03-25 |
| 資料タイプ | 学位論文 |
| 学位授与番号 | 甲第4701号 |
| 学位授与年月日 | 2013-03-25 |
| 学位・専攻分野 | 博士（医学） |
| 授与大学 | 岡山大学 |
| 言語 | 日本語 英語 |
| フルテキストURL | K0004674.pdf K0004674_honbun.pdf |
|---|---|
| 著者 | 渡邉 益宜| |
| 発行日 | 2013-03-25 |
| 資料タイプ | 学位論文 |
| 学位授与番号 | 甲第4674号 |
| 学位授与年月日 | 2013-03-25 |
| 学位・専攻分野 | 博士（医学） |
| 授与大学 | 岡山大学 |
| 言語 | 日本語 英語 |
| フルテキストURL | K0004673.pdf K0004673_honbun.pdf |
|---|---|
| 著者 | 石原 節子| |
| 発行日 | 2013-03-25 |
| 資料タイプ | 学位論文 |
| 学位授与番号 | 甲第4673号 |
| 学位授与年月日 | 2013-03-25 |
| 学位・専攻分野 | 博士（医学） |
| 授与大学 | 岡山大学 |
| 言語 | 日本語 英語 |
| フルテキストURL | K0004671.pdf K0004671_honbun.pdf |
|---|---|
| 著者 | 御川 安仁| |
| 発行日 | 2013-03-25 |
| 資料タイプ | 学位論文 |
| 学位授与番号 | 甲第4671号 |
| 学位授与年月日 | 2013-03-25 |
| 学位・専攻分野 | 博士（医学） |
| 授与大学 | 岡山大学 |
| 言語 | 日本語 英語 |
| JaLCDOI | 10.18926/AMO/50414 |
|---|---|
| フルテキストURL | 67_3_197.pdf |
| 著者 | Yasuhara, Takao| Takahashi, Yuichi| Kumamoto, Shinji| Nakahara, Masayuki| Yoneda, Kotaro| Niimura, Tatsuomi| Tanoue, Takashi| Kusumegi, Akira| Sennari, Takashi| Hijikata, Yasukazu| Manabe, Hiroaki| Miyoshi, Yasuyuki| Date, Isao| Ogawa, Koichi| Nishida, Kenki| |
| 抄録 | Some cases with lumbar degenerative diseases require multi-level fusion surgeries. At our institute, 27 and 4 procedures of 3- and 4-level fusion were performed out of a total 672 posterior lumbar interfusions (PLIFs) on patients with lumbar degenerative disease from 2005 to 2010. We present 2 osteoporotic patients who developed proximal vertebral body fracture after 4-level fusion. Both cases presented with gait disability for leg pain by degenerative lumbar scoliosis and canal stenosis at the levels of L1/2-4/5. After 4-level fusion using L1 as the upper instrumented vertebra, proximal vertebral body fractures were found along with the right pedicle fractures of L1 in both cases. One of these patients, aged 82 years, was treated as an outpatient using a hard corset for 24 months, but the fractures were exacerbated over time. In the other patient, posterolateral fusion was extended from Th10 to L5. Both patients can walk alone and have been thoroughly followed up. In both cases, the fracture of the right L1 pedicle might be related to the subsequent fractures and fusion failure. In consideration of multi-level fusion, L1 should be avoided as an upper instrumented vertebra to prevent junctional kyphosis, especially in cases with osteoporosis and flat back posture. |
| キーワード | degenerative lumbar scoliosis osteoporosis pedicle fracture posterior lumbar interbody fusion vertebral body fracture |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-06 |
| 巻 | 67巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 197 |
| 終了ページ | 202 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23804144 |
| Web of Science KeyUT | 000320747900010 |
| JaLCDOI | 10.18926/AMO/50413 |
|---|---|
| フルテキストURL | 67_3_191.pdf |
| 著者 | Binti Md Nor, Nurliza| Kusumoto, Tomoyuki| Inoue, Seiji| Nakamura, Keiichiro| Seki, Noriko| Hongo, Atsushi| Kodama, Junichi| Hiramatsu, Yuji| |
| 抄録 | Struma ovarii is a rare neoplasm that accounts for approximately 0.3ｵ of ovarian tumors. Due to its ultrasound morphology, which is quite similar to that of malignant ovarian carcinoma, most struma ovarii cases are open operated with laparotomy rather than laparoscopy. We present 3 cases of struma ovarii, which were diagnosed preoperatively by imaging studies and removed by laparoscopic surgery. All patients were premenopausal women between ages 31‒50. The magnetic resonance imaging (MRI) findings were complex masses composed of multiple cysts and solid components with T2-hypointense regions as well as multiple T1-hyperintense cystic areas, findings that are typical for struma ovarii. A combination of plain computed tomography (CT), positron emission tomography (PET)-CT, and scintigraphy was useful for diagnosis. Laboratory examination revealed elevated serum thyroglobulin, which led to the diagnosis of struma ovarii. Laparoscopic surgeries were performed without rupturing the tumors. Although it has been difficult to differentiate between struma ovarii and malignant tumors by conventional methods, recently MRI techniques appear make it possible to diagnose struma ovarii preoperatively from the abovementioned imaging characteristic, together with laboratory data. As for treatment, we think laparoscopy could be successful for struma ovarii, but the surgeon must be careful not to rupture the tumor intra-abdominally in order to prevent dissemination, which could lead to malignancy. |
| キーワード | struma ovarii ovarian neoplasms MRI laparoscopic surgery |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-06 |
| 巻 | 67巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 191 |
| 終了ページ | 195 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23804143 |
| Web of Science KeyUT | 000320747900009 |
| JaLCDOI | 10.18926/AMO/50412 |
|---|---|
| フルテキストURL | 67_3_185.pdf |
| 著者 | Misawa, Haruo| Tanaka, Masato| Sugimoto, Yoshihisa| Koshimune, Kouichiro| Ozaki, Toshifumi| |
| 抄録 | Cervical misalignment after upper cervical fusion including the occipital bone may cause trismus or dysphagia, because the occipito-atlanto joint is associated with most of the flex and extended motion of the cervical spine. There are no reports of dysphagia and trismus after C1-2 fusion. The purpose of this paper is to demonstrate the potential risk of dysphagia and trismus even after upper cervical short fusion without the occipital bone. The patient was a 69-year-old man with myelopathy caused by os odontoideum and Klippel-Feil syndrome, who developed dysphagia and trismus immediately after C1-2 fusion and C3-6 laminoplasty. Radiographs and CT revealed that his neck posture was extended, but his symptoms still existed a week after surgery. The fixation angle was hyperextended 12 days after the first surgery. His symptoms disappeared immediately after revision surgery. The fixation in the neck-flexed position is thought to be the main cause of the patientʼs post-operative dysphagia and trismus. Dysphagia and trismus may occur even after short upper cervical fusion without the occipital bone or cervical fusion in the neck-extended position. The pre-operative cervical alignment and range of motion of each segment should be thoroughly evaluated. |
| キーワード | dysphagia trismus os odontoid Klippel-Feil syndrome atlantoaxial posterior fusion |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-06 |
| 巻 | 67巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 185 |
| 終了ページ | 190 |
| 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Ⓒ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23804142 |
| Web of Science KeyUT | 000320747900008 |