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JaLCDOI 10.18926/AMO/69851
フルテキストURL 79_6_469.pdf
著者 Tsujii, Teruyuki| Matsuda, Tatsuo| Kimura, Yuji| Katsube, Ryoichi| Iwadou, Hironori| Funabiki, Sadami| Kamikawa, Yasuaki| Matsuda, Tadakazu|
抄録 We report a rare case of ileus tube-related intussusception in an adult. A 56-year-old man with adhesive bowel obstruction was treated with a nasointestinal ileus tube. Although his condition initially improved, persistent abdominal pain led to the diagnosis of intussusception via CT imaging. Manual repositioning of the tube resolved the intussusception without the need for bowel resection. A review of 80 previously reported cases of ileus tube-associated intussusception (total 81 cases, 95 lesions) highlighted the timing of onset, treatment strategies, and precautions. Early detection and diagnosis are crucial to prevent severe complications and preserve bowel function.
キーワード nasointestinal ileus tube intussusception small bowel obstruction enterectomy conservative treatment
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2025-12
79巻
6号
出版者 Okayama University Medical School
開始ページ 469
終了ページ 474
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69850
フルテキストURL 79_6_463.pdf
著者 Asano, Yudai| Nishihara, Chika| Kitayama, Takahiro| Okawa, Nanako| Makimoto, Satoko| Higaki, Fumiyo| Kojima, Katsuhide| Sugihara, Hanako| Ida, Naoyuki| Yanai, Hiroyuki| Hiraki, Takao|
抄録 We present a case of a woman in her 70s who was diagnosed with mesonephric adenocarcinoma of the uterine cervix, following biopsy and surgery. Preoperative MRI revealed a 7-cm, well-defined circumferential cervical mass with left lateral wall predominance, bulging into the uterine cavity and vagina. The lesion showed intermediate signal intensity on T2-weighted images, diffusion restriction, and early contrast enhancement weaker than that of the myometrium, followed by washout on contrast-enhanced imaging. The circumferential growth pattern with the lateral wall predominance and its imaging characteristics may suggest this rare entity be routinely included in the differential diagnosis of cervical cancers.
キーワード mesonephric adenocarcinoma cervical cancer MRI imaging characteristics HPV-independent adenocarcinoma
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2025-12
79巻
6号
出版者 Okayama University Medical School
開始ページ 463
終了ページ 468
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69849
フルテキストURL 79_6_457.pdf
著者 Asakawa, Tomohiko| Uchida, Haruhito A.| Katayama, Yu| Sakurabu, Yoshimasa| Katayama, Katsuyoshi| Onishi, Yasuhiro| Matsuoka-Uchiyama, Natsumi| Takeuchi, Hidemi| Tanaka, Keiko| Tsuji, Kenji| Umebayashi, Ryoko| Takemoto, Rika| Wada, Jun|
抄録 This case involves a 23-year-old male who was diagnosed with Behçet’s disease 5 years ago and managed with colchicine. Two months ago, he underwent renal biopsy due to abnormal urinalysis and kidney dysfunction, leading to a diagnosis of IgA nephropathy. He subsequently underwent tonsillectomy followed by glucocorticoid pulse therapy. However, after the tonsillectomy, discontinuing colchicine led to increased proteinuria, despite the glucocorticoid pulse therapy. Upon reintroducing colchicine, urinary protein excretion decreased, achieving incomplete remission. These findings suggest that colchicine may be effective in decreasing proteinuria in patients with Behçet’s disease complicated by IgA nephropathy.
キーワード Behçet’s disease IgA nephropathy colchicine
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2025-12
79巻
6号
出版者 Okayama University Medical School
開始ページ 457
終了ページ 461
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69848
フルテキストURL 79_6_451.pdf
著者 Hagihara, Moe| Seike, Keisuke| Hayashino, Kenta| Yasuhara, Takao| Kin, Kyohei| Hirata, Yuichi| Kobayashi, Hiroki| Kitamura, Wataru| Fujiwara, Hideaki| Asada, Noboru| Fujii, Nobuharu| Maeda, Yoshinobu|
抄録 Emicizumab, a bispecific monoclonal antibody, benefits patients with severe hemophilia A. It alters laboratory assessments of coagulation activity, requiring anti-idiotype monoclonal antibodies for accurate monitoring. A 64-year-old man, receiving emicizumab regularly, was admitted for laminoplasty. We planned to use FVIII replacement during the perioperative period after confirming the disappearance of inhibitors, monitoring coagulation activity with anti-idiotype monoclonal antibodies. Activated partial thromboplastin time was prolonged on postoperative day 2, prompting an immediate switch to eptacog alfa. The patient recovered without bleeding. This case underscores the necessity of anti-idiotype monoclonal antibodies for accurate monitoring.
キーワード emicizumab eptacog alfa hemophilia A inhibitor anti-idiotype monoclonal antibodies to emicizumab
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2025-12
79巻
6号
出版者 Okayama University Medical School
開始ページ 451
終了ページ 455
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69847
フルテキストURL 79_6_445.pdf
著者 Matsumi, Junya|
抄録 Our hospital began a PERIO program (perioperative patient management by a multi-disciplinary team from multiple departments) in 2016 to improve patient outcomes. We retrospectively analyzed the clinical effects of the PERIO program regarding the postoperative hospital stay (PHS) in the patients aged ≥ 18 years who underwent long lower-abdominal surgery at our hospital during the period April 2019 to March 2023. We excluded the cases of patients whose general anesthesia use was < 8 h, those for whom another surgery was performed simultaneously at another site, and emergency surgeries. The outcome was prolonged PHS, defined as exceeding the scheduled number of days specified in the patient’s clinical pathway. Among the 480 patients, prolonged PHS was observed for 270 patients (56.3%). In a multivariate logistic regression using advanced age, sex, high-risk general state, surgery requiring colon resection, serious adverse events (SAEs), and PERIO use, the following were associated with prolonged PHS: advance age (odds ratio [OR] 4.91, 95% confidence interval [CI]: 2.68-8.99, p=0.01), surgery requiring colon resection (OR 4.91, 95%CI: 2.68-8.99, p<0.001), SAE (OR 18.7, 95%CI: 7.22-48.2, p<0.001), and PERIO (OR 0.25, 95%CI: 0.13-0.47, p<0.001). The use of the PERIO program was thus beneficially associated with PHS after long lower-abdominal surgery.
キーワード hospital stay ERAS surgery cancer perioperative management
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2025-12
79巻
6号
出版者 Okayama University Medical School
開始ページ 445
終了ページ 449
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 Copyright Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69846
フルテキストURL 79_6_437.pdf
著者 Matsumi, Junya| Sato, Tetsufumi|
抄録 The optimal indications for intensive care unit (ICU) treatment for critically ill cancer survivors whose condition has deteriorated due to medical factors are unclear. To test our hypothesis that frailty before deterioration was associated with hospital mortality in this patient population, we retrospective analyzed the cases of the patients admitted to the ICU at the National Cancer Center Hospital, Japan (April 2014-March 2022). We excluded patients who underwent surgery within 28 days or were denied critical care within 24 h or admitted after cardiopulmonary arrest. Their Clinical Frailty Scale (CFS) scores at 1 month before ICU admission (Pre-ICU) were obtained. Frailty was defined as CFS scores ≥4 points. We analyzed 298 admissions and observed that the mortality rate at hospital discharge was significantly higher in the frailty group (n=119). A multivariate analysis demonstrated that the following factors were significantly associated with hospital mortality: Pre-ICU frailty (OR 2.00, 95%CI: 1.19-3.36, p=0.009), cancer type (hematological: OR 2.93, 95%CI: 1.42-6.05, p=0.004), and Sequential Organ Failure Assessment score at ICU admission (OR 0.88, 95%CI: 0.82-0.95, p=0.0008). Frailty retrospectively assessed using the CFS at 1 month pre-ICU admission is a risk factor for hospital mortality in these cancer survivors.
キーワード frailty cancer survivor clinical frailty scale cancer critically ill
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2025-12
79巻
6号
出版者 Okayama University Medical School
開始ページ 437
終了ページ 444
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69845
フルテキストURL 79_6_431.pdf
著者 Inoue, Takahiro| Kuwabara, Hiroyo| Yamamoto, Koh|
抄録 The effect of weekend admission on patient mortality has been investigated in several therapeutic areas, including acute myeloid leukemia (AML), but the investigations’ results are controversial. We evaluated the relationship between in-hospital mortality and weekend admission in adult patients with AML in Japan by conducting a retrospective observational study using administrative data from 144 acute care hospitals from which patients were discharged between April 2014 and March 2019. The primary endpoint was in-hospital mortality, compared between weekend and weekday admissions. Among the 1,340 eligible patients, 11% (150) were admitted during a weekend. The in-hospital mortality rates of the patients admitted during weekends and those admitted on a weekday were 28% (42/150) and 17% (204/1190), respectively. After an adjustment for covariates, weekend admission was associated with a significantly higher risk of in-hospital mortality than weekday admission (HR 1.70, 95%CI: 1.20-2.40; p=0.003). However, such an association was not observed in patients treated in a bio-clean room (HR 1.26, 95%CI: 0.65-2.42). Our results demonstrate that for patients with AML, weekend admission was independently associated with a higher risk of death during hospitalization. An appropriate system is necessary for these patients.
キーワード acute leukemia weekend admission in-hospital mortality bio-clean room
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2025-12
79巻
6号
出版者 Okayama University Medical School
開始ページ 431
終了ページ 436
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69844
フルテキストURL 79_6_421.pdf
著者 Tanaka, Ayumi| Naoe, Shota| Takenaka, Reiju| Kanzaki, Norie| Sakoda, Akihiro| Yamaoka, Kiyonori| Kataoka, Takahiro|
抄録 Radon (222Rn; Rn) and thoron (220Rn; Tn) inhalation have been reported to enhance antioxidant activity in various organs. However, the effects of Tn on the colon have not been investigated. This study aimed to clarify the effects of Tn inhalation, alone and in combination with cyclosporin A (CsA), on dextran sulfate sodium (DSS)-induced colitis, and the accompanying oxidative stress, in mice. Male BALB/c mice were subjected to continuous 8-day Tn inhalation (c-Tn, 533±128 Bq/m3) or alternate-day Tn inhalation over the same period (f-Tn, 577±63Bq/m3), followed by treatment with 3% DSS and either CsA or vehicle for 7 days. Although the disease activity index (DAI) decreased significantly by day 2 in the c-Tn group, scores remained significantly higher than those in the f-Tn group. In the c-Tn group, superoxide dismutase and catalase activity in the colon were significantly elevated compared with those in sham controls. Thus, DSS-induced damage was effectively inhibited in the earlier stages by the c-Tn mode of inhalation than by the f-Tn mode. These findings suggest that continuous Tn inhalation more effectively attenuated early colitis symptoms than alternate-day inhalation, potentially through upregulation of antioxidant defenses. Tn and CsA showed no combined effects.
キーワード thoron DSS antioxidant activity CsA colon
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2025-12
79巻
6号
出版者 Okayama University Medical School
開始ページ 421
終了ページ 429
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69843
フルテキストURL 79_6_413.pdf
著者 Jiang, Zhiyun| Xi, Ying|
抄録 Several observational studies suggested that migraine headache attacks were associated with coronavirus disease 2019 (COVID-19). We investigated genetic causal links between COVID-19 phenotypes and the development of headache and migraine, including migraine with aura (MA) and migraine without aura (MO). We conducted a two-sample Mendelian randomization (MR) analysis to estimate the genetic association in European populations. The inverse-variance weighted (IVW) method was used as the main approach in the MR analyses, together with weighted median and MR-Egger methods. We also performed a series of sensitivity tests to assess the robustness of the MR results. The MR results demonstrated that COVID-19 severity, hospitalization, and susceptibility had no causal effect on the risks of headache, migraine, MA, or MO. No horizontal pleiotropy was detected, and the results were robust as supported by the sensitivity analysis findings. Our analyses identified no casual effect of COVID-19 severity, hospitalization, or susceptibility on the risks of headache or migraine in European populations.
キーワード headache migraine Mendelian randomization COVID-19
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2025-12
79巻
6号
出版者 Okayama University Medical School
開始ページ 413
終了ページ 419
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69842
フルテキストURL 79_6_405.pdf
著者 Ouchi, Chihiro| Morizane Hosokawa, Mio| Kimura, Shuhei| Shiode, Yusuke| Matoba, Ryo| Morita, Tetsuro| Morizane, Yuki|
抄録 We investigated the treatment outcomes of patients aged ≥85 years with neovascular age-related macular degeneration (nAMD) who received anti-vascular endothelial growth factor (anti-VEGF) therapy using either treat-and-extend (TAE) or pro re nata (PRN) regimens for 1 year in real-world clinical practice. Eighty-five eyes from 85 patients were included. Among them, types 1, 2, and 3 macular neovascularization and polypoidal choroidal vasculopathy were present in 27.1%, 17.6%, 18.8%, and 36.5%, respectively. TAE and PRN regimens were used in 43.5% and 56.5% of patients, respectively. At baseline, the PRN group was older and had worse best-corrected visual acuity (BCVA), greater central retinal thickness, and more intraretinal fluid than the TAE group. In the TAE group, the mean number of injections was 7.6, BCVA improved significantly, and all retinal fluid rates decreased. In the PRN group, the mean number of injections was 3.9, BCVA remained unchanged, and the rates of macular fibrosis and atrophy increased. No serious adverse events were observed in either group. Anti-VEGF therapy was safe for patients aged ≥ 85 years with nAMD, and the TAE regimen effectively improved BCVA in this population. BCVA remained unchanged in the PRN-treated patients, with baseline disease severity and/or undertreatment potentially influencing the outcomes.
キーワード anti-vascular endothelial growth factor therapy neovascular age-related macular degeneration age treat-and-extend pro re nata
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2025-12
79巻
6号
出版者 Okayama University Medical School
開始ページ 405
終了ページ 412
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69442
フルテキストURL 79_5_399.pdf
著者 Isozaki, Hiroshi| Matsumoto, Sasau| Takama, Takehiro| Isozaki, Yuka| Murakami, Shigeki|
抄録 Gastric cancer with lymphoid stroma (GCLS) accounts for 1%-7% of gastric cancers; ~80% are Epstein-Barr virus (EBV)-positive. The rate of lymph node metastasis is relatively low, even when an early GCLS has invaded the submucosa. We report an early GCLS with massive submucosal invasion mimicking a submucosal tumor (SMT), diagnosed by endoscopic submucosal resection (ESD) and treated with local resection and sentinel node navigation surgery (SNNS). The patient was a 40-year-old Japanese man. A protruding lesion on the greater curvature of the middle part of his stomach was detected by X-ray, and an endoscopic examination revealed a 2.5-cm protruding tumor covered with a normal mucosa and small ulcers at the apex. ESD was performed for a diagnosis. The pathological diagnosis was lymphoepithelioma-like gastric cancer (GCLS), pT1b(SM2), Ly0, V0, pHM1, pVM1. EBV infection in the cancer cells was confirmed pathologically by EBV-encoded RNA. The local resection was performed using SNNS. The patient has had no recurrence or post-gastrectomy syndrome 4 years postsurgery. EBV-associated early GCLS resembling an SMT is relatively rare, and clinicians need to be aware of this disease. Local resection using SNNS may be a surgical option for GCLS cases with a low rate of lymphatic metastasis.
キーワード gastric cancer gastric cancer with lymphoid stroma lymphoepithelioma-like carcinoma Epstein Barr virus sentinel node navigation surgery
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2025-10
79巻
5号
出版者 Okayama University Medical School
開始ページ 399
終了ページ 404
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69441
フルテキストURL 79_5_393.pdf
著者 Masunaga, Akari| Takagi, Kosei| Nagai, Yasuo| Yasui, Kazuya| Fuji, Tomokazu| Yamada, Motohiko| Nishiyama, Takeyoshi| Kanehira, Noriyuki| Sota, Yumi| Fujiwara, Toshiyoshi|
抄録 Pancreatoduodenectomy (PD) after esophagectomy with gastric conduit reconstruction is technically challenging. Preserving the blood supply of the gastric conduit is crucial in performing PD after esophagectomy. We report the case of a 66-year-old man who underwent gastroduodenal artery-preserving PD after esophagectomy with gastric conduit reconstruction for intraductal papillary mucinous neoplasm. The patient developed pseudoaneurysm rupture postoperatively, but was successfully treated with interventional radiology. Precise assessment is important in developing a surgical strategy depending on the patient’s specific anatomy and tumor characteristics. Moreover, special attention should be paid to avoid accidental injuries of the gastric conduit and gastric vessels during surgery.
キーワード pancreatoduodenectomy esophagectomy gastric conduit fluorescence imaging
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2025-10
79巻
5号
出版者 Okayama University Medical School
開始ページ 393
終了ページ 398
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69440
フルテキストURL 79_5_387.pdf
著者 Mori, Yusuke| Otani, Yoshihiro| Omae, Ryo| Hirano, Shuichiro| Ishida, Joji| Fujii, Kentaro| Haruma, Jun| Hiramatsu, Masafumi| Matsushita, Toshi| Higaki, Fumiyo| Sugiu, Kenji| Tanaka, Shota|
抄録 Trigonal meningiomas are rare and pose surgical challenges due to their deep location and proximity to critical neuroanatomical structures. We present the case of a 67-year-old woman with a growing trigonal meningioma successfully resected with guidance by a preoperative 3D imaging analysis system. Integration of CT and MRI including diffusion tensor imaging (DTI) enabled precise mapping of the optic radiation, guiding a middle temporal gyrus approach. Preoperative embolization reduced tumor vascularity, facilitating gross total resection with minimal blood loss. This case highlights the effectiveness of preoperative 3D imaging systems in optimizing surgical planning and improving outcomes in complex neurosurgical cases.
キーワード trigonal meningioma imaging analysis diffusion tensor imaging
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2025-10
79巻
5号
出版者 Okayama University Medical School
開始ページ 387
終了ページ 392
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 英語
著作権者 Copyright Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69439
フルテキストURL 79_5_381.pdf
著者 Sakurai, Atsunobu| Yabuki, Takayuki| Aoki, Hideki| Iseki, Akiko|
抄録 We report the case of a 72-year-old Japanese man with an incidental portal vein mass that was surgically resected and diagnosed as immunoglobulin G4 (IgG4)-related disease. The mass was discovered during an atrial fibrillation examination. The patient had a history of gastric cancer and was also diagnosed with rectal cancer, raising concerns about metastasis. Due to technical challenges, a biopsy was not feasible. Imaging findings suggested portal vein tumor thrombosis, complicating the diagnosis. This case highlights a rare presentation of IgG4-related disease mimicking portal vein tumor thrombus.
キーワード immunoglobulin G4-related disease inflammatory pseudotumor mass portal vein pericarditis
Amo Type Case Report
出版物タイトル Acta Medica Okayama
発行日 2025-10
79巻
5号
出版者 Okayama University Medical School
開始ページ 381
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69438
フルテキストURL 79_5_369.pdf
著者 Hisamatsu, Takashi| Kinuta, Minako| Munetomo, Sosuke| Fukuda, Mari| Kojima, Katsuhide| Taniguchi, Kaori| Nakahata, Noriko| Kanda, Hideyuki|
抄録 We applied unsupervised machine learning to analyze blood pressure (BP) and resting heart rate (HR) patterns measured during a 1-year period to assess their cross-sectional relationships with subclinical cerebral and renal target damage. Dimension reduction via uniform manifold approximation and projection, followed by K-means++ clustering, was used to categorize 362 community-dwelling participants (mean age, 56.2 years; 54.9% women) into three groups: Low BP and Low HR (Lo-BP/Lo-HR), High BP and High HR (Hi-BP/Hi-HR), and Low BP and High HR (Lo-BP/Hi-HR). Cerebral vessel lesions were defined as the presence of at least one of the following magnetic resonance imaging findings: lacunar infarcts, white matter hyperintensities, cerebral microbleeds, or intracranial artery stenosis. A high urinary albumin-to-creatinine ratio (UACR) was defined as the top 10% (≥ 12 mg/g) of the mean value from ≥2 measurements. Poisson regression with robust error variance, adjusted for demographics, lifestyle, and medical history, showed that the Hi-BP/Hi-HR group had relative risks of 3.62 (95% confidence interval, 1.75-7.46) for cerebral vessel lesions and 3.58 (1.33-9.67) for high UACR, and the Lo-BP/Hi-HR group had a relative risk of 3.09 (1.12-8.57) for high UACR, compared with the Lo-BP/Lo-HR group. These findings demonstrate the utility of an unsupervised, data-driven approach for identifying physiological patterns associated with subclinical target organ damage.
キーワード blood pressure heart rate subclinical disease uniform manifold approximation and projection unsupervised machine learning
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2025-10
79巻
5号
出版者 Okayama University Medical School
開始ページ 369
終了ページ 379
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69437
フルテキストURL 79_5_359.pdf
著者 Hirose, Tomohiko| Ikuma, Hisanori| Otsuka, Kazutoshi| Kawasaki, Keisuke|
抄録 Single-position surgery with lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screws (PPSs) is gaining attention for its reduced invasiveness. We developed SPAPS, a technique allowing two surgeons to perform anterior LLIF and posterior PPS insertion simultaneously in a single lateral decubitus position. This retrospective study compared SPAPS (SPAPS-LLIF, Group SL) and minimally invasive posterior/transforaminal lumbar interbody fusion (MIS-PLIF/TLIF, Group PT) in patients treated between 2016 and 2019 with a two-year follow-up. Operative time, estimated blood loss (EBL), length of hospital stay (LOS), JOABPEQ and VAS scores, segmental lordotic angle, lumbar lordotic angle, segmental Cobb’s angle, PPS misplacement, PPS loosening, fusion status, and muscle cross-sectional areas were compared. Fifty-two patients were analyzed (Group SL: 25; Group PT: 27). SPAPS significantly reduced operative time (118.0 vs. 165.3 min, p <0.01) and estimated blood loss (8.6 vs. 164.1 mL, p<0.01). While clinical outcomes and hospital stay were comparable, Group SL had significantly lower PPS loosening (0% vs. 13%, p<0.01) and non-union rates (0% vs. 22.2%, p=0.02). Multifidus muscle atrophy was also less in Group SL (−14.3 vs. −121.5 mm2, p<0.01). SPAPS demonstrated advantages in reducing surgical invasiveness without compromising clinical efficacy, offering a promising alternative to conventional posterior fusion surgery.
キーワード single-position surgery simultaneous lateral decubitus positioning lateral lumbar interbody fusion posterior lumbar interbody fusion
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2025-10
79巻
5号
出版者 Okayama University Medical School
開始ページ 359
終了ページ 368
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69436
フルテキストURL 79_5_353.pdf
著者 Chihara, Yuki| Hamasaki, Ichiro| Shibata, Kiyo| Morisawa, Shin| Kono, Reika| Kanenaga, Keisuke| Morizane, Yuki|
抄録 To analyze and characterize the medial and lateral rectus muscles in patients with exotropia using anterior segment optical coherence tomography (AS-OCT). This study included 24 patients with exotropia (48 eyes) and 25 healthy individuals (50 eyes). Anterior segment optical coherence tomography was used to construct the en face images. The anterior chamber angle to the extraocular muscle insertion distance, muscle width, and muscle fiber angle from the muscle insertion sites were compared between the exotropia and the control groups. The correlation between these parameters and age or angle of deviation was evaluated. The mean ages were 13.2±4.1 years for the exotropia group and 17.6±7.2 years for the control group. The lateral rectus angle was significantly more inwardly rotated in the exotropia group than in the control group (1.6±6.3°, −1.4±4.0°, p=0.014). With increasing angle of deviation, the width of the lateral rectus increased (p=0.002). Our results indicate that the lateral rectus angle is significantly more inwardly rotated in patients with exotropia. These findings should contribute to a deeper understanding of the extraocular muscles in patients with this condition.
キーワード exotropia AS-OCT anterior chamber angle to extraocular muscle insertion distance muscle width muscle fiber angle
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2025-10
79巻
5号
出版者 Okayama University Medical School
開始ページ 353
終了ページ 358
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69435
フルテキストURL 79_5_345.pdf
著者 Matsunaga, Nozomu| Egusa, Seira| Aono, Riyo| Tamai, Eiji| Hitusmoto, Yasuo| Katayama, Seiichi|
抄録 Clostridium perfringens is a pathogenic anaerobe that causes gas gangrene and food poisoning. Although autolysin-mediated reorganization of the bacterial cell wall is crucial for cell division, excessive autolysin activity induced by stressors can lead to cell lysis. In C. perfringens, air exposure is a significant stressor that causes cell lysis, and Acp (N-acetylglucosaminidase) is known to be a major autolysin. To further facilitate C. perfringens research, a technology to prevent air-induced cell lysis must be developed. This study investigated the role of Acp in air-induced autolysis and explored potential inhibitors that would prevent cell lysis during experimental procedures. Morphological analyses confirmed that Acp functions as an autolysin in C. perfringens, as acpdeficient strains exhibited filamentous growth. The mutants exhibited negligible autolysis under air-exposure stress, confirming the involvement of Acp in the autolytic process. We also evaluated the effects of various divalent cations on Acp activity in vitro and identified Zn2+ as a potent inhibitor. Brief treatment with a Zn2+- containing buffer induced dose-dependent cell elongation and autolysis inhibition in C. perfringens. These findings demonstrate that simple Zn2+ treatment before experiments stabilizes C. perfringens cells, reducing autolysis under aerobic conditions and facilitating various biological studies, except morphological analyses.
キーワード Clostridium perfringens autolysin zinc air-exposure autolysis
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2025-10
79巻
5号
出版者 Okayama University Medical School
開始ページ 345
終了ページ 352
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69434
フルテキストURL 79_5_339.pdf
著者 Hamasaki, Ichiro| Shibata, Kiyo|
抄録 To determine whether passing a pole suture through the sclera at two points provides fixation comparable to that of a sliding noose, we measured the tensile strength of the suture‒sclera interface during simulated traction. In this in vitro study, three suture patterns were evaluated in porcine eyeballs, using 6-0 polyglycolic acid sutures. Patterns A (control), B (second suture pass perpendicular), and C (second suture pass in the same direction) were compared. The tensile strength of each pattern was measured 20 times using a KANON TK300CN, and the results were analyzed using the Kruskal‒Wallis test. Pattern A showed a tensile strength of 2±4 gram-force (gf) (range: 0-12). Pattern B showed 112±38 gf (range: 61-184). Pattern C showed 139±31 gf (range: 97-204). Patterns B and C had significantly higher tensile strengths than Pattern A (p<0.001). Although Pattern C was not significantly different from Pattern B (p=0.363), it exhibited the highest tensile strength. Lifting the suture between the first and second suture passes allows for an adjustable suture length, suggesting that adjustability can be achieved using only the sclera. This scleral adjustment method with a second suture pass offers a durable means of securing extraocular muscles and may represent a valuable addition to adjustable suturing techniques.
キーワード scleral adjustment method adjustable suture technique hang-loose method tensile strength polyglycolic acid sutures
Amo Type Original Article
出版物タイトル Acta Medica Okayama
発行日 2025-10
79巻
5号
出版者 Okayama University Medical School
開始ページ 339
終了ページ 343
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/69433
フルテキストURL 79_5_329.pdf
著者 Matsubara, Kei| Miyoshi, Kentaroh| Toyooka, Shinichi|
抄録 Primary graft dysfunction (PGD) is one of the major risk factors affecting patients’ short- and long-term survival after lung transplantation. No particular management strategy has been established for PGD; supportive care is the mainstay of PGD treatment. When a supportive strategy fails, the patient may require the introduction of extracorporeal membrane oxygenation (ECMO) as the last-resort measure for severe PGD. A variety of study of ECMO as a PGD treatment was reported and the management of PGD patients developed so far. Early recognition of a patient’s need for ECMO and its prompt initiation are critical to improved outcomes. The use of venovenous-ECMO became the preferred procedure for PGD rather than venoarterial-ECMO. However, the current ECMO strategy has limitations, and using ECMO to manage patients with PGD is not sufficiently effective. Further studies are required to develop this promising technology.
キーワード lung transplantation primary graft dysfunction extracorporeal membrane oxygenation ex vivo lung perfusion
Amo Type Review
出版物タイトル Acta Medica Okayama
発行日 2025-10
79巻
5号
出版者 Okayama University Medical School
開始ページ 329
終了ページ 337
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 Ⓒ 2025 by Okayama University Medical School
論文のバージョン publisher
査読 有り