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JaLCDOI 10.18926/AMO/65970
フルテキストURL 77_5_479.pdf
著者 Murata, Akiko| Matsumoto, Naomi| Miyaji, Chikara| Takao, Soshi| Yorifuji, Takashi|
抄録 For decades, the notion has persisted in developed countries that exclusive care by the mothers is best for the development of children up to 3 years of age. To examine the veracity of this “myth of the first three years” in Japan, we examined the effects of childcare facility use for children younger than 3 years on their development using the cohorts of the Longitudinal Survey of Newborns in the 21st Century conducted in Japan. Of the 47,015 respondents to the survey, we studied the children of 5,508 mothers with university/professional education to evaluate the relationships between primary early (< 2.5 years) childcare providers during weekday daytime hours and specific development indices for the ages of 2.5, 5.5, and 8 years. At the age of 2.5 and 5.5 years, children attending childcare facilities were judged as having more advanced developmental behaviors by their parents, such as being able to compose a two-word sentence (adjusted odds ratio [aOR]: 0.22) or to express emotions (aOR: 0.81), compared with those cared for by mothers. However, at the age of 8 years, children who attended childcare facilities as infants < 2.5 years showed more aggressive behavior in interrupting people (aOR: 1.20) and causing disturbances in public (aOR: 1.26) than those cared for by mothers (after adjustment for numerous child and parental factors). Although these results are generally consistent with previous studies, issues potentially involved with problem behavior such as quality of childcare require further investigation, as does the case of children of mothers with more modest educational attainment.
キーワード “myth of the first three years” childcare child development problem behavior educational attainment
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-10
77巻
5号
出版者 Okayama University Medical School
開始ページ 479
終了ページ 490
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 Copyright Ⓒ 2023 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 37899259
Web of Science KeyUT 001108661600005
JaLCDOI 10.18926/AMO/65969
フルテキストURL 77_5_471.pdf
著者 Oka, Shohei| Harada, Keita| Yamamoto, Shumpei| Yasutomi, Eriko| Igawa, Shoko| Ohmori, Masayasu| Hirai, Mami| Yamasaki, Yasushi| Inokuchi, Toshihiro| Kinugasa, Hideaki| Takahara, Masahiro| Hiraoka, Sakiko| Okada, Hiroyuki|
抄録 Although the clinical usefulness of colonoscopy has been established, the procedure remains painful for many patients. This study was designed to clarify the factors predicting colonoscopy-related pain. We evaluated 283 consecutive patients who completed a first-ever, total colonoscopy without sedatives or analgesics. The severity of pain symptoms was evaluated by a numeric rating scale (NRS) in a questionnaire immediately after the colonoscopy. Patient backgrounds and endoscopic findings were analyzed to evaluate their association with pain. Out of 283 patients, 53 scored their pain 0-1 on the NRS while 48 scored it 6-10. We defined the colonoscopies of the former and latter patients as painless and painful, respectively, and compared the two. Multivariate analyses revealed that low body weight (OR 4.95, 95%CI 1.89-12.99) and longer intubation time (OR 3.63, 95%CI 1.46-9.03) were significant risk factors for painful colonoscopy. To identify factors contributing to the increased intubation time, we divided subjects into short- and long-intubation-time groups based on a median insertion time of 7 min. Older age (OR 2.28, 95%CI 1.31-3.98), previous abdominal surgery (OR 1.93, 95%CI 1.13-3.32) and findings of invasive cancer (OR 10.90, 95%CI 1.34-88.90) were significant factors for longer intubation time.
キーワード colonoscopy colonoscopy-related pain comfortable colonoscopy
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-10
77巻
5号
出版者 Okayama University Medical School
開始ページ 471
終了ページ 478
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 Copyright Ⓒ 2023 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 37899258
Web of Science KeyUT 001108661600004
JaLCDOI 10.18926/AMO/65968
フルテキストURL 77_5_461.pdf
著者 Homma, Daisuke| Minato, Izumi| Imai, Norio| Miyasaka, Dai| Sakai, Yoshinori| Horigome, Yoji| Suzuki, Hayato| Dohmae, Yoichiro| Endo, Naoto|
抄録 This study aimed to determine which muscle the gluteus maximus, gluteus medius, gluteus minimus (Gmin), or tensor fasciae latae (TFL) contributes most to hip abduction strength and to identify effective sites for cross-sectional area (CSA) Gmin and TFL measurement in hip osteoarthritis (OAhip) patients. Twenty-eight patients with OAhip were included. The muscle CSA and volume were determined using magnetic resonance imaging. Peak isometric strength was determined using hand-held dynamometry. Muscle volumes were normalized to the total muscle volume of hip abductors. Multiple regression analysis was performed. The difference between the CSA of Gmin and TFL was calculated, and correlations with volume and muscle strength were determined. Gmin volume was related to abductor muscle strength (p=0.042). The peak CSA of the Gmin correlated with muscle volume and strength. The CSA of the TFL correlated with volume, with no difference between the CSA of the most protruding part of the lesser trochanter and peak CSA. Gmin volume was strongly related to abductor muscle strength. Peak CSA is a useful parameter for assessing the CSA of the Gmin among patients with OAhip. The CSA of the TFL should be measured at the most protruding part of the lesser trochanter.
キーワード gluteus minimus tensor fasciae latae cross-sectional area muscle volume hip osteoarthritis
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-10
77巻
5号
出版者 Okayama University Medical School
開始ページ 461
終了ページ 469
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 Copyright Ⓒ 2023 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 37899257
Web of Science KeyUT 001108661600003
フルテキストURL fulltext.pdf
著者 Mitsuhashi, Toshiharu|
キーワード case-only approach mass media public health social media suicidal risk suicide prevention suicide suicide-related tweets Twitter
発行日 2023-08-10
出版物タイトル JMIR Formative Research
7巻
出版者 JMIR Publications
開始ページ e47798
ISSN 2561-326X
資料タイプ 学術雑誌論文
言語 英語
OAI-PMH Set 岡山大学
著作権者 © Toshiharu Mitsuhashi.
論文のバージョン publisher
PubMed ID 37561553
DOI 10.2196/47798
Web of Science KeyUT 001051770000002
関連URL isVersionOf https://doi.org/10.2196/47798
JaLCDOI 10.18926/AMO/65757
フルテキストURL 77_4_439.pdf
著者 Shiwaku, Takahiro| Ishida, Hisashi| Tatebe, Yasuhisa| Tamefusa, Kosuke| Ochi, Motoharu| Fujiwara, Kaori| Kubo, Toshihide| Nakata, Eiji| Washio, Kana| Tsukahara, Hirokazu|
抄録 A three-year-old boy with Philadelphia chromosome-positive B-cell precursor acute lymphoblastic leukemia (Ph+ALL) presented with an osteolytic lesion in his right upper arm. Tyrosine kinase inhibitors (TKIs) such as imatinib and dasatinib are an essential component throughout the course of treatment for Ph+ALL. However, TKIs are reported to affect the bone metabolism. In the treatment course of the current patient, the osteolytic lesion quickly improved despite the continuous use of TKIs, even during the concomitant use of corticosteroids. This suggests that TKIs can be safely given with concomitant corticosteroids to children with Ph+ALL, even when osteolytic lesions are present.
キーワード acute lymphoblastic leukemia children tyrosine kinase inhibitor osteolysis
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2023-08
77巻
4号
出版者 Okayama University Medical School
開始ページ 439
終了ページ 442
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 Copyright Ⓒ 2023 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 37635146
Web of Science KeyUT 001088434900002
JaLCDOI 10.18926/AMO/65756
フルテキストURL 77_4_433.pdf
著者 Ono, Ryuki| Shiode, Yusuke| Kimura, Shuhei| Hosokawa, Mio| Matoba, Ryo| Kanzaki, Yuki| Kindo, Hiroya| Morita, Tetsuro| Morizane, Yuki|
抄録 A 23-year-old woman presented with a 1-month history of visual abnormalities in her right eye. A visual field test revealed temporal abnormalities in the right eye. Optical coherence tomography revealed an indistinct ellipsoid zone (EZ) on the B-scan image and hyporeflective areas in the EZ layer on the en face image in the right eye. We diagnosed the patient with acute zonal occult outer retinopathy. Visual field tests and B-scan images improved to almost normal at 6 months, but hyporeflective areas remained on the en face images. Thus, en face images may be more sensitive at detecting abnormalities in the outer retina than other modalities.
キーワード acute zonal occult outer retinopathy optical coherence tomography en face image ellipsoid zone
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2023-08
77巻
4号
出版者 Okayama University Medical School
開始ページ 433
終了ページ 437
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 Copyright Ⓒ 2023 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 37635145
Web of Science KeyUT 001088434900001
JaLCDOI 10.18926/AMO/65753
フルテキストURL 77_4_423.pdf
著者 Yamakawa, Yasuaki| Miyashita, Kohei| Morizane, Atsushi| Takeuchi, Masato| Kawashima, Yuta| Sugimura, Tomoko| Saisaka, Yuichi|
抄録 We report a case of a patient with severe pelvic fracture who showed concurrent ST elevation on electrocardiogram. A 70-year-old man incurred an unstable pelvic fracture from a motorcycle accident. On admission, he was hemodynamically unstable, and massive transfusion and noradrenaline were administered immediately. Although ST elevation was present in leads II, III, aVF, V5, and V6, cardiac function was preserved; thus, trans-arterial embolization and external fixation for pelvic fracture were given priority. Four days after the injury, he suffered a cardiac arrest, and coronary angiography revealed that the cause of ST elevation and cardiac arrest was coronary vasospasm. Physicians should be aware that pain-related stress and platelet activation as well as use of noradrenaline in severe trauma cases can induce coronary vasospasm.
キーワード coronary spasm angina noradrenaline severe trauma ST elevation treatment strategy
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2023-08
77巻
4号
出版者 Okayama University Medical School
開始ページ 423
終了ページ 427
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 Copyright Ⓒ 2023 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 37635143
Web of Science KeyUT 001163659800004
JaLCDOI 10.18926/AMO/65752
フルテキストURL 77_4_415.pdf
著者 Jelcic, Dzenis| Puzovic, Velibor| Benzon, Benjamin| Palada, Ivan| Jerković, Jelena| Vulic, Marko|
抄録 The aim of our study was to determine whether the immunohistochemical expression of placental vitamin D receptors is altered in pregnancies complicated by preeclampsia. Vitamin D receptor expression was immunohistochemically analysed in the placentas of three groups: a control group, and early- and late-onset preeclampsia groups. Total immunohistochemical intensity staining of placentas showed that the control group had a median vitamin D receptor (VDR) expression significantly higher than the placentas of mothers with early- and late-onset preeclampsia. There was no difference among the three groups in a semiquantitative analysis of VDR staining of the stroma only. Vitamin D receptors showed lower median expression in preeclampsia-affected pregnancies, especially early-onset preeclampsia. Therefore, Vitamin D receptor expression may be an important marker for normal placentation and preeclampsia onset.
キーワード vitamin D receptor immunohistochemistry early and late-onset preeclampsia
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-08
77巻
4号
出版者 Okayama University Medical School
開始ページ 415
終了ページ 422
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 Copyright Ⓒ 2023 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 37635142
Web of Science KeyUT 001163659800006
JaLCDOI 10.18926/AMO/65751
フルテキストURL 77_4_407.pdf
著者 Hotta, Kensuke| Kobayashi, Takaomi|
抄録 This study aimed to investigate the usefulness of force-controlled pelvic stress radiographs in the evaluation and treatment of fragility fractures of the pelvis (FFP) using a functional treatment strategy. We conducted a retrospective study of 55 geriatric patients with FFP who underwent pelvic stress radiographs on admission. The differences in the sacral width, pelvic ring width, and medial femoral head width between the radiographs with and without the Sam Sling II M size were defined as Δ sacral width, Δ pelvic ring width, and Δ medial femoral head width, respectively. We used Pearson’s correlation test to assess the relationship between the degree of radiographic instability and the Johns Hopkins highest level of mobility scale (JH-HLM) at 10-days postadmission. Conventional receiver-operating-characteristic curve analysis was used to identify cases requiring surgery using the best cutoff value for radiographic instability. The JH-HLM was significantly correlated with Δ sacral width (r=−0.401, p=0.017), but not with Δ pelvic ring width (r=−0.298, p=0.080) nor with Δ medial femoral head width (r= −0.261, p=0.128). The best cutoff value of Δ sacral width in identifying surgical cases was 10.7 mm (sensitivity 75.0%, specificity 98.0%). Force-controlled pelvic stress radiographs could be helpful in assessing the need for surgery on admission.
キーワード fragility fracture of the pelvis functional treatment strategy Sam Sling stress radiograph Johns Hopkins highest level of mobility scale
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-08
77巻
4号
出版者 Okayama University Medical School
開始ページ 407
終了ページ 414
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 Copyright Ⓒ 2023 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 37635141
Web of Science KeyUT 001163659800001
JaLCDOI 10.18926/AMO/65750
フルテキストURL 77_4_395.pdf
著者 Pavlovic, Marko| Babic, Dragan| Rastovic, Pejana| Arapovic, Jurica| Martinac, Marko| Jakovac, Sanja| Barbaric, Romana|
抄録 We investigated the relationship between serum tumor necrosis factor-alpha (TNF-α) levels and psychopathological symptoms, clinical and socio-demographic characteristics and antipsychotic therapy in individuals with schizophrenia. TNF-α levels were measured in 90 patients with schizophrenia and 90 healthy controls matched by age, gender, smoking status, and body mass index. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of psychopathology in patients. No significant differences in TNF-α levels were detected between the patients and controls (p=0.736). TNF-α levels were not correlated with total, positive, negative, general, or composite PANSS scores (all p>0.05). A significant negative correlation was observed between TNF-α levels and the PANSS cognitive factor (ρ=−0.222, p=0.035). A hierarchical regression analysis identified the cognitive factor as a significant predictor of the TNF-α level (beta=−0.258, t=−2.257, p=0.027). There were no significant differences in TNF-α levels among patients treated with different types of antipsychotics (p=0.596). TNF-α levels correlated positively with the age of onset (ρ=0.233, p=0.027) and negatively with illness duration (ρ=−0.247, p=0.019) and antipsychotic treatment duration (ρ=−0.256, p=0.015). These results indicate that TNF-α may be involved in cognitive impairment in schizophrenia, and would be a potential clinical-state marker in schizophrenia.
キーワード tumor necrosis factor-alpha schizophrenia psychopathology immune system
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-08
77巻
4号
出版者 Okayama University Medical School
開始ページ 395
終了ページ 405
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 37635140
Web of Science KeyUT 001163659800010
JaLCDOI 10.18926/AMO/65748
フルテキストURL 77_4_377.pdf
著者 Morimoto, Kosaku| Takeuchi, Yasuto| Takaki, Akinobu| Wada, Nozomu| Oyama, Atsushi| Adachi, Takuya| Onishi, Hideki| Shiraha, Hidenori| Okada, Hiroyuki|
抄録 Liver fibrosis is an important phenomenon in non-alcoholic fatty liver disease (NAFLD) progression. Standard markers reflecting liver fibrosis, including the FIB-4 index, increase with age. This study aimed to identify fibrosis progression-related markers that are diagnostically beneficial even in aged individuals. Serum levels of pro- and anti-inflammatory cytokines were measured by multiple enzyme-linked immunosorbent assay. Two standard NAFLD or fibrosis progression-related markers — the FIB-4 index and APRI score — were analyzed along with cytokine levels to define the best approach to discriminate advanced fibrosis. Ninety-eight NAFLD patients were enrolled: 59 and 39 patients with fibrosis stages 1-2 and 3-4 respectively. In addition to the FIB-4 index and APRI score, the following factors showed significant differences between stages 1-2 and stages 3-4 in a multivariate analysis: platelet counts, IP-10, and RANTES. The fibrosis stage, FIB-4, APRI, PDGF-BB, and RANTES were related to the prognosis. In aged patients, IP-10, GM-CSF, and RANTES differed between stages 1-2 and stages 3-4. FIB-4 and APRI were beneficial for their correlation with fibrosis. However, to stratify either young or elderly advanced fibrosis patients, and to identify patients likely to have a bad outcome, RANTES was the best marker.
キーワード NAFLD NASH liver fibrosis chemokine FIB-4
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-08
77巻
4号
出版者 Okayama University Medical School
開始ページ 377
終了ページ 385
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 37635138
Web of Science KeyUT 001163659800009
JaLCDOI 10.18926/AMO/65745
フルテキストURL 77_4_365.pdf
著者 Moldovan, Elena| Bănescu, Claudia| Cucerea, Manuela| Moldovan, Valeriu| Gozar, Liliana| Pușcașiu, Lucian|
抄録 Congenital heart disease is the most common malformative pathology in newborns, with a worldwide incidence at 0.4-5%. We investigated the possible relationship between variations in nucleotide sequences and specific cardiac malformations in the GATA-binding factor 4 (GATA4) exon 1 region by using Sanger sequencing. Forty-four newborns from a third-level neonatal intensive care unit who were diagnosed with nonsyndromic, ductal-dependent congenital heart disease (i.e., transposition of the great arteries or ductal-dependent coarctation of the aorta) were enrolled. Their DNA was extracted using commercial methods and tested using the multiplex ligation-dependent probe amplification (MLPA) technique. The Sanger sequencing for GATA4 exon 1 in the newborns’ DNA identified rs61277615, rs73203482, and rs35813172 variants not reported in the ClinVar archive of human variations in newborns previously diagnosed with transposition of the great arteries (n=5) and coarctation of the aorta (n=1). The identification of these novel variants in newborns with transposition of the great arteries or ductal-dependent coarctation of the aorta may be the first step in determining the variants’ contribution to the occurrence of congenital heart disease. However, these results may be inconclusive, since the observed variants within GATA4 gene were not previously reported.
キーワード transposition of the great arteries ductal-dependent coarctation of the aorta GATA4 MLPA Sanger sequencing
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-08
77巻
4号
出版者 Okayama University Medical School
開始ページ 365
終了ページ 370
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 37635136
Web of Science KeyUT 001163659800008
JaLCDOI 10.18926/AMO/65741
フルテキストURL 77_4_359.pdf
著者 Koshida, Tomohiro| Maruta, Toyoaki| Tanaka, Nobuhiko| Hidaka, Kotaro| Kurogi, Mio| Nemoto, Takayuki| Yanagita, Toshihiko| Takeya, Ryu| Tsuneyoshi, Isao|
抄録 Pulsed radiofrequency (PRF) is a safe method of treating neuropathic pain by generating intermittent electric fields at the needle tip. Resiniferatoxin (RTX) is an ultrapotent agonist of transient receptor potential vanilloid subtype-1 (TRPV1) receptors. We investigated the mechanism of PRF using a rat model of RTX-induced neuropathic pain. After administering RTX intraperitoneally, PRF was applied to the right sciatic nerve. We observed the changes in TRPV1, calcitonin gene-related peptide (CGRP), and brain-derived neurotrophic factor (BDNF) in the dorsal root ganglia by western blotting. Expressions of TRPV1 and CGRP were significantly lower in the contralateral (RTX-treated, PRF-untreated) tissue than in control rats (p<0.0001 and p<0.0001, respectively) and the ipsilateral tissues (p<0.0001 and p<0.0001, respectively). BDNF levels were significantly higher in the contralateral tissues than in the control rats (p<0.0001) and the ipsilateral tissues (p<0.0001). These results suggest that, while TRPV1 and CGRP are decreased by RTX-induced neuronal damage, increased BDNF levels result in pain development. PRF may promote recovery from neuronal damage with concomitant restoration of TRPV1 and CGRP, and exert its analgesic effect by reversing BDNF increase. Further research is required to understand the role of TRPV1 and CGRP restoration in improving mechanical allodynia.
キーワード pulsed radiofrequency resiniferatoxin transient receptor potential vanilloid subtype-1 (TRPV1) calcitonin gene-related peptide (CGRP) brain-derived neurotrophic factor (BDNF)
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-08
77巻
4号
出版者 Okayama University Medical School
開始ページ 359
終了ページ 364
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 37635135
Web of Science KeyUT 001163659800011
JaLCDOI 10.18926/AMO/65504
フルテキストURL 77_3_335.pdf
著者 Fujii, Kentaro| Hirano, Shuichiro| Kurozumi, Kazuhiko| Date, Isao|
抄録 An 85-year-old woman presented with aphasia due to an occupying lesion in the left frontal lobe near the language area. Complete resection of the contrast-enhancing lesion was performed under awake conditions. The pathological diagnosis was anaplastic astrocytoma, and postoperative radiochemotherapy was administered. Awake surgery is a useful technique to reduce postoperative neurological sequelae and to maximize surgical resection. Although the patient was elderly, which is generally considered high risk, she did not have any severe neurological deficits and had a good outcome. Even in the extreme elderly, awake surgery can be useful for gliomas in language cortices.
キーワード awake surgery high-grade glioma eloquent area elderly patient
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2023-06
77巻
3号
出版者 Okayama University Medical School
開始ページ 335
終了ページ 340
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 37357636
Web of Science KeyUT 001026663400002
JaLCDOI 10.18926/AMO/65497
フルテキストURL 77_3_319.pdf
著者 Kashihara, Kenichi|
抄録 I report a case of arterial spine-labelled MR imaging (ASL)-detected cerebral hypoperfusion during migraine and panic attacks. A 20-year-old woman with a history of headache for 6 years and independent panic attacks for 3 years was transferred to Okayama Kyokuto Hospital for panic attacks. On that day, she had had severe headache that was improved by taking non-steroidal anti-inflammatory drug, but panic attacks initiated. On arrival, she also complained of a mild headache. ASL revealed cerebral hypoperfusion in the right temporo-occipital region. The threshold to induce panic attacks in migraine patients could be lowered by the physiopathology underlying migraine attacks.
キーワード migraine panic attack arterial spine-labelled magnetic resonance imaging aura cortical spreading depression
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2023-06
77巻
3号
出版者 Okayama University Medical School
開始ページ 319
終了ページ 321
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 37357633
Web of Science KeyUT 001026279600010
JaLCDOI 10.18926/AMO/65496
フルテキストURL 77_3_311.pdf
著者 Miura, Takanori| Kijima, Hiroaki| Tazawa, Hiroshi| Miyakoshi, Naohisa|
抄録 Japan’s hip fracture management guidelines now recommend the use of cemented stems in cases of bone fragility. However, the current stem selection practices in bipolar hemiarthroplasty (BHA) in a super-aging area in Japan remain unclear. This study aimed to examine the stem selection policies, the surgeons’ concerns about cemented stems, and factors affecting their confidence in their ability to coach others on cemented stem procedures. Ninety-four orthopedic surgeons (27 facilities) responded to our web-based questionnaire conducted in January/February 2022. Cementless stem was the first choice of 97.8% of the surgeons; <15% of the respondents expected to increase their use of cemented stems in the future. The cement technique was the greatest concern; almost half of the surgeons described having insufficient experience with cemented stems. The factor that most affected the surgeons’ expertise in using cemented stems is the number of surgeries they had conducted with a cemented stem (multivariable analysis odds ratio 8.42, p=0.001). Greater experience was associated with increased expertise of the surgeons in using cemented stems, with a threshold of 11 cases showing sensitivity of 41.7% and specificity of 98.3% for their confidence to instruct cemented stems.
キーワード hip fracture arthroplasty bone cement questionnaire
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-06
77巻
3号
出版者 Okayama University Medical School
開始ページ 311
終了ページ 318
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 37357632
Web of Science KeyUT 001026279600009
JaLCDOI 10.18926/AMO/65495
フルテキストURL 77_3_301.pdf
著者 Kato, Takahide| Miyoshi, Seigo| Hamada, Chizuru| Sano, Yoshifumi| Nogami, Naoyuki| Yamaguchi, Osamu| Hamaguchi, Naohiko|
抄録 Acute exacerbation (AE) of interstitial lung disease (ILD) is a severe complication of lung resection in lung cancer patients with ILD (LC-ILD). This study aimed to assess the predictive value of comorbidities other than ILD for postoperative AE in patients with LC-ILD. We retrospectively evaluated 68 patients with LC-ILD who had undergone lung resection. We classified them into two groups: those who had developed postoperative AE within 30 days after resection and those who had not. We analyzed patient characteristics, high-resolution computed tomography findings, clinical data, pulmonary function, and intraoperative data. The incidence of postoperative AEs was 11.8%. In univariate analysis, performance status (PS), honeycombing, forced vital capacity (FVC), and high hemoglobin A1c (HbA1c) levels without comorbidities were significantly associated with postoperative AE. Patients were divided into two groups according to cutoff levels of those four variables as determined by receiver operating characteristic curves, revealing that the rates of patients without postoperative AE differed significantly between groups. The present results suggested that preoperative comorbidities other than ILD were not risk factors for postoperative AE in patients with LC-ILD. However, a high preoperative HbA1c level, poor PS, low FVC, and honeycombing may be associated with postoperative AE of LC-ILD.
キーワード lung cancer interstitial lung disease acute exacerbation comorbidity
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-06
77巻
3号
出版者 Okayama University Medical School
開始ページ 301
終了ページ 309
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 37357631
Web of Science KeyUT 001026279600008
JaLCDOI 10.18926/AMO/65493
フルテキストURL 77_3_281.pdf
著者 Mukai, Yuko| Taira, Naruto| Kajiwara, Yukiko| Iwamoto, Takayuki| Kitaguchi, Yohei| Saiga, Miho| Watanabe, Satoko| Shien, Tadahiko| Doihara, Hiroyoshi| Kimata, Yoshihiro|
抄録 Although immediate breast reconstruction following mastectomy has become increasingly common, its oncological safety has been debated. We enrolled patients with breast cancer who underwent surgery at Okayama University Hospital between 2007 and 2013. The primary outcome was relapse-free survival (RFS). Secondary outcomes were overall survival and the duration from the surgery to the initiation of adjuvant chemotherapy. We divided into immediate breast reconstruction, mastectomy alone, and breast conservative surgery groups. Outcomes were compared using Cox’s regression analysis. A total of 614 patients were included (reconstruction: 125, mastectomy: 128, breast conservative surgery: 361). The median follow-up duration was 79.0±31.9 months. The immediate-reconstruction patients were younger, had more lymph node metastases, and more often received postoperative chemotherapy. The RFS was better after the breast conservative surgery compared to after reconstruction (hazard ratio 0.33, 95% confidence interval: 0.144-0.763). The proportion of local recurrence was highest in the reconstruction group. No patients in the reconstruction group underwent postoperative radiation therapy. However, reconstruction did not affect overall survival or the time to the initiation of adjuvant chemotherapy. Surgeons should explain the risks of breast reconstruction to their patients preoperatively. Careful long-term follow-up is required after such procedures.
キーワード immediate breast reconstruction oncological safety local recurrence postoperative radiation therapy time to initiation of adjuvant chemotherapy
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-06
77巻
3号
出版者 Okayama University Medical School
開始ページ 281
終了ページ 290
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 37357629
Web of Science KeyUT 001026279600006
JaLCDOI 10.18926/AMO/65491
フルテキストURL 77_3_263.pdf
著者 Guo, Yusheng| Kosaka, Junko| Morimatsu, Hiroshi|
抄録 Continuous renal replacement therapy (CRRT) is widely used to control fluid balance, but the optimal fluid balance to improve the prognosis of patients remains debated. Appropriate fluid management may depend on hemodynamic status. We investigated the association between 90-day mortality and fluid balance/mean arterial pressure (MAP) in patients receiving CRRT. This single-center retrospective study was conducted between May 2018 and March 2021. Based on the cumulative fluid balance at 72 h after initiation of CRRT, the cases were divided into negative (< 0 mL) and positive (> 0 mL) fluid balance groups. Ninety-day mortality was higher in the positive fluid balance group (p=0.009). At 4 h before and after CRRT initiation, the mean MAP was lower in the positive fluid balance group (p<0.05). After multivariate cox adjustment, 72-h positive fluid balance was independently associated with 90-day mortality (p=0.004). In addition, the cumulative fluid balance was associated with 90-day mortality (p<0.05) in cases without shock, high APACHE II score, sepsis, dialysis dependence, or vasopressor use. A 72-h positive fluid balance was associated with 90-day mortality in patients receiving CRRT.
キーワード fluid management continuous renal replacement therapy mortality mean arterial pressure daily cumulative fluid balance
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-06
77巻
3号
出版者 Okayama University Medical School
開始ページ 263
終了ページ 272
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 Copyright Ⓒ 2023 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 37357627
Web of Science KeyUT 001026279600004
JaLCDOI 10.18926/AMO/65490
フルテキストURL 77_3_255.pdf
著者 Fukushima, Shinnosuke| Hagiya, Hideharu| Uda, Kazuhiro| Gotoh, Kazuyoshi| Otsuka, Fumio|
抄録 Antimicrobial resistance is an emerging global threat that must be addressed using a multidisciplinary approach. This study aimed to raise awareness of high-level antimicrobial-resistant (AMR) pathogens in Japan by comparing their recent prevalences among prefectures, particularly Okayama. Data for the isolation proportions of meropenem-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium, cefotaxime-resistant Escherichia coli and Klebsiella pneumoniae, and levofloxacin-resistant E. coli and K. pneumoniae were collected from the Japan Nosocomial Infections Surveillance, a national database sponsored by the Japanese Ministry of Health, Labour, and Welfare, between 2018 and 2021. The average isolated proportions of the seven AMR pathogens were higher in Okayama compared to other prefectures: the worst (19.9%) was meropenem-resistant P. aeruginosa, the sixth worst (57.2%) was methicillin-resistant S. aureus, the eighth worst (3.3%) was vancomycin-resistant E. faecium, the second (37.8%) and fifth worst (17.6%) were cefotaxime-resistant E. coli and K. pneumoniae, respectively, and the fourth (49.9%) and third worst (8.7%) were levofloxacin-resistant E. coli and K. pneumoniae, respectively. Our study highlights the notably high prevalences of representative AMR pathogens in Okayama, suggesting the need for fundamental infection prevention and control by healthcare professionals, promoting antimicrobial stewardship, and educating undergraduates and postgraduates in Okayama.
キーワード antimicrobial resistance antimicrobial stewardship epidemiology infection prevention and control Japan Nosocomial Infections Surveillance
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2023-06
77巻
3号
出版者 Okayama University Medical School
開始ページ 255
終了ページ 262
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 Copyright Ⓒ 2023 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 37357626
Web of Science KeyUT 001026279600003