検索結果 3895 件
| JaLCDOI | 10.18926/AMO/54504 |
|---|---|
| フルテキストURL | 70_4_279.pdf |
| 著者 | Nishimura, Yoshito| Iwamuro, Masaya| Ocho, Kazuki| Hasegawa, Kou| Kimura, Kosuke| Hanayama, Yoshihisa| Kondo, Eisei| Tanaka, Takehiro| Otsuka, Fumio| |
| 抄録 | A 61-year-old Japanese man with IgG4-related autoimmune pancreatitis was referred to our hospital because of perspiration during food intake. Abdominal computed tomography (CT) with contrast media revealed multiple mesenteric lymphadenopathies. An open surgical abdominal biopsy and subsequent histopathological analysis revealed abnormally large lymphoid cells that were negative for CD3, CD5, and c-myc and positive for CD20 and bcl-2, leading to a diagnosis of diffuse large B-cell lymphoma. Here, we discuss the risk of malignancies, particularly malignant lymphoma in patients with IgG4-related disease. The importance of pathological analysis to reach the appropriate diagnosis in such cases should be emphasized. |
| キーワード | IgG4-related disease autoimmune pancreatitis immunophenotyping diffuse large B-cell lymphoma |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-08 |
| 巻 | 70巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 279 |
| 終了ページ | 283 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27549673 |
| Web of Science KeyUT | 000384748600008 |
| JaLCDOI | 10.18926/AMO/54503 |
|---|---|
| フルテキストURL | 70_4_273.pdf |
| 著者 | Makimoto, Go| Miyahara, Nobuaki| Yoshikawa, Mao| Taniguchi, Akihiko| Kanehiro, Arihiko| Tanimoto, Mitsune| Kiura, Katsuyuki| |
| 抄録 | Heerfordtʼs syndrome is a rare manifestation of sarcoidosis and is defined as a combination of facial palsy, parotid swelling, and uveitis, associated with a low-grade fever. We report a case of Heerfordtʼs syndrome presenting with a high fever and increased serum tumor necrosis factor alpha (TNF-α) levels. The patient had facial palsy, parotid swelling, uveitis, and swelling of the right supraclavicular and hilar lymph nodes. Corticosteroid therapy was initiated, and her symptoms soon resolved completely, in tandem with a decrease in TNF-α serum levels. |
| キーワード | Heerfordtʼs syndrome sarcoidosis TNF-α |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-08 |
| 巻 | 70巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 273 |
| 終了ページ | 277 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27549672 |
| Web of Science KeyUT | 000384748600007 |
| JaLCDOI | 10.18926/AMO/54502 |
|---|---|
| フルテキストURL | 70_4_269.pdf |
| 著者 | Takeuchi, Miharu| Maruyama, Hidehiko| Oura, Naoko| Kanazawa, Akane| Nakata, Yusei| Minami, Susumu| Kikkawa, Kiyoshi| |
| 抄録 | Twin anemia-polycythemia sequence (TAPS) is a group of disorders in monochorionic twins characterized by a large intertwin hemoglobin difference without amniotic fluid discordance. Reticulocyte count is used to diagnose this condition, but little is known about the role of erythroblasts, which are the prior stage of reticulocytes. In the present case of TAPS, the 25-yr-old Japanese mother showed no signs of oligohydramnios or polyhydramnios throughout gestation. The twins were born at 36 weeks and 6 days, weighing 2,648g and 1,994g. The intertwin hemoglobin difference in umbilical cord blood was (21.1－5.0＝) 16.1g/dL and the donor twin showed signs of chronic anemia, including myocardial hypertrophy and pericardial effusion. Erythroblastosis of the donor twin was prolonged (53,088.5, 42,114.8 and 44,217.9/μL on days 0, 1 and 2, respectively). Erythroblastosis, which indicates chronic anemia, is also a good diagnostic indicator of TAPS. |
| キーワード | anastomosis erythroblast monochorionic diamniotic twin reticulocyte twin anemia-polycythemia sequence |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-08 |
| 巻 | 70巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 269 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27549671 |
| Web of Science KeyUT | 000384748600006 |
| JaLCDOI | 10.18926/AMO/54501 |
|---|---|
| フルテキストURL | 70_4_261.pdf |
| 著者 | Nagata, Kosei| Yamamoto, Shinichi| Miyoshi, Kota| Sato, Masaki| Arino, Yusuke| Mikami, Yoji| |
| 抄録 | Eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss syndrome) is a rare systemic vasculitis and is difficult to diagnose. EGPA has a number of symptoms including peripheral dysesthesia caused by mononeuropathy multiplex, which is similar to radiculopathy due to lumbar disc hernia or lumbar spinal stenosis. Therefore, EGPA patients with mononeuropathy multiplex often visit orthopedic clinics, but orthopedic doctors and spine neurosurgeons have limited experience in diagnosing EGPA because of its rarity. We report a consecutive series of patients who were initially diagnosed as having lumbar disc hernia or lumbar spinal stenosis by at least 2 medical institutions from March 2006 to April 2013 but whose final diagnosis was EGPA. All patients had past histories of asthma or eosinophilic pneumonia, and four out of five had peripheral edema. Laboratory data showed abnormally increased eosinophil counts, and nerve conduction studies of all patients revealed axonal damage patterns. All patients recovered from paralysis to a functional level after high-dose steroid treatment. We shortened the duration of diagnosis from 49 days to one day by adopting a diagnostic algorithm after experiencing the first case. |
| キーワード | eosinophilic granulomatosis with polyangiitis mononeuropathy multiplex lumbar disc hernia lumbar spinal stenosis nerve conduction study |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-08 |
| 巻 | 70巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 261 |
| 終了ページ | 268 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27549670 |
| Web of Science KeyUT | 000384748600005 |
| JaLCDOI | 10.18926/AMO/54500 |
|---|---|
| フルテキストURL | 70_4_255.pdf |
| 著者 | Nosaka, Nobuyuki| Fujiwara, Takeo| Knaup, Emily| Okada, Ayumi| Tsukahara, Hirokazu| |
| 抄録 | Estimation methods for pediatric weight have not been evaluated for Japanese children. This study aimed to assess the accuracy of mothersʼ reports of their childrenʼs weight in Japan. We also evaluated potential alternatives to the estimation of weight, including the Broselow tape (BT), Advanced Pediatric Life Support (APLS), and Parkʼs formulae. We prospectively collected cross-sectional data on a convenience sample of 237 children aged less than 10 years who presented to a general pediatric outpatient clinic with their mothers. Each weight estimation method was evaluated using Bland-Altman plots and by calculating the proportion within 10 and 20 of the measured weight. Mothersʼ reports of weight were the most accurate method, with 94.9 within 10 of the measured weight, the lowest mean difference (0.27kg), and the shortest 95 limit of agreement (－1.4 to 1.9kg). The BT was the most reliable alternative, followed by APLS and Parkʼs formulae. Mothersʼ reports of their children ʼs weight are more accurate than other weight estimation methods. When no report of a childʼs weight by the mother is available, BT is the best alternative. When an aged-based formula is the only option, the APLS formula is preferred. |
| キーワード | body weight child estimation techniques mothers, parents |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-08 |
| 巻 | 70巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 255 |
| 終了ページ | 259 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27549669 |
| Web of Science KeyUT | 000384748600004 |
| JaLCDOI | 10.18926/AMO/54499 |
|---|---|
| フルテキストURL | 70_4_243.pdf |
| 著者 | Osawa, Masahiro| Ohashi, Kadoaki| Kubo, Toshio| Ichihara, Eiki| Takata, Saburo| Takigawa, Nagio| Takata , Minoru| Tanimoto, Mitsune| Kiura, Katsuyuki| |
| 抄録 | Vandetanib (ZactimaTM) is a novel, orally available inhibitor of both vascular endothelial growth factor receptor-2 (VEGFR-2) and epidermal growth factor receptor (EGFR) tyrosine kinase. In the present study, a line of transgenic mice with a mouse Egfr gene mutation (delE748-A752) corresponding to a human EGFR mutation (delE746-A750) was established. The transgenic mice developed atypical adenomatous hyperplasia to adenocarcinoma of the lung at around 5 weeks of age and died of lung tumors at approximately 17 weeks of age. In the mice treated with vandetanib (6mg/kg/day), these lung tumors disappeared and the phosphorylations of EGFR and VEGFR-2 were reduced in lung tissues to levels comparable to those of non-transgenic control mice. The median overall survival time of the transgenic mice was 28 weeks in the vandetanib-treated group and 17 weeks in the vehicle-treated group. Vandetanib significantly prolonged the survival of the transgenic mice (log-rank test, p＜0.01); resistance to vandetanib occurred at 20 weeks of age and the animals died from their lung tumors at about 28 weeks of age. These data suggest that vandetanib could suppress the progression of tumors harboring an activating EGFR mutation. |
| キーワード | vandetanib VEGFR EGFR nonsmall cell lung cancer transgenic mouse |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-08 |
| 巻 | 70巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 243 |
| 終了ページ | 253 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27549668 |
| Web of Science KeyUT | 000384748600003 |
| JaLCDOI | 10.18926/AMO/54498 |
|---|---|
| フルテキストURL | 70_4_237.pdf |
| 著者 | Kin, Kyohei| Ono, Yasuhiro| Fujimori, Takeshi| Kuramoto, Satoshi| Katsumata, Atsushi| Goda, Yuji| Kawauchi, Masamitsu| |
| 抄録 | Traumatic brain injury (TBI) has a complex and heterogeneous pathology. It is frequently difficult to predict the neurological deterioration of patients with TBI, and unpredictable change may occur even when TBI is mild to moderate. When computed tomography (CT) findings are considered to be inconsistent with the traumatic origin or with the neurological deterioration of patients observed on admission, magnetic resonance imaging (MRI) is employed based on the standards of our ethical committee. In this retrospective study, we compared CT and diffusion weighted imaging (DWI) of patients with mild to moderate TBI in the very acute phase. When the high-intensity lesions on DWI are larger than the high-density lesions on CT images, we defined the imaging finding as a ʻCT-DWI mismatchʼ. Between January 2010 and December 2013, 92 patients were inspected using both CT and MRI at admission, and we detected a CT-DWI mismatch in 35 patients. CT-DWI mismatch was 92.6 (95 confidence interval 79.8-97.9) sensitive and 84.6 (95 confidence interval 79.3-86.3) specific for the prediction of enlargement of the hemorrhagic lesions on repeat CT. CT-DWI mismatch is considered to be useful as one of the predictors of the enlargement of hemorrhagic lesions in patients with mild to moderate TBI. |
| キーワード | magnetic resonance imaging diffusion-weighted imaging traumatic brain injury head computed tomography scan mild head injury |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-08 |
| 巻 | 70巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 237 |
| 終了ページ | 242 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27549667 |
| Web of Science KeyUT | 000384748600002 |
| JaLCDOI | 10.18926/AMO/54497 |
|---|---|
| フルテキストURL | 70_4_229.pdf |
| 著者 | Hishikawa, Tomohito| Sugiu, Kenji| Date, Isao| |
| 抄録 | About 5 decades have passed since the concept of moyamoya disease (MMD) was established in Japan. In that time, many clinical MMD studies have been performed from several different points of view, such as epidemiology, pathophysiology, surgical procedures, and prognosis. In addition, rapid developments in MMD genetic analysis have occurred. In light of all this activity, clinicians must continually update their knowledge of MMD in order to improve the prognosis of MMD patients. In this review article, we summarize the clinical MMD studies and introduce cutting-edge findings regarding MMD. |
| キーワード | clinical research moyamoya disease |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-08 |
| 巻 | 70巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 229 |
| 終了ページ | 236 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27549666 |
| Web of Science KeyUT | 000384748600001 |
| JaLCDOI | 10.18926/AMO/54423 |
|---|---|
| フルテキストURL | 70_3_223.pdf |
| 著者 | Ebara, Shin| Kobayashi, Yasuyuki| Sasaki, Katsumi| Araki, Motoo| Sugimoto, Morito| Wada, Koichirou| Fujio, Kei| Takamoto, Atsushi| Watanabe, Toyohiko| Yanai, Hiroyuki| Nasu, Yasutomo| |
| 抄録 | The present case report describes a case of recurrent and advanced urachal carcinoma including neuroendocrine features with iliac bone metastasis after partial cystectomy and adjuvant chemotherapy consisting of irinotecan and cisplatin in a 32-year-old man. He received gemcitabine/cisplatin/ paclitaxel (GCP) combination chemotherapy, consisting of gemcitabin (1,000mg/m2) on day 1, 8, cisplatin (70mg/m2) on day 1, and paclitaxel (80mg/m2) on day 1 and 8. After three cycles of chemotherapy, PET-CT showed complete regression of the disease. So the patient underwent total cystourethrectomy, and histological examination showed an almost complete pathological response. External beam radiation therapy was also given to the ileac bone metastasis regions. However, PET-CT taken 17 months after the external beam radiation showed multiple lung metastases. He received GCP chemotherapy again, which resulted in a complete response again after three cycles of chemotherapy. This is the first report on GCP chemotherapy used not only as a salvage chemotherapy but also as a rechallenge regimen for metastatic urachal cancer including a neuroendocrine component. |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-06 |
| 巻 | 70巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 223 |
| 終了ページ | 227 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27339213 |
| Web of Science KeyUT | 000379406100011 |
| JaLCDOI | 10.18926/AMO/54422 |
|---|---|
| フルテキストURL | 70_3_217.pdf |
| 著者 | Waseda, Koichi| Ocho, Kazuki| Hasegawa, Kou| Kimura, Kosuke| Iwamuro, Masaya| Hanayama, Yoshihisa| Kondo, Eisei| Miyahara, Nobuaki| Otsuka, Fumio| |
| 抄録 | KL-6 is a glycoprotein found predominantly on type II pneumocytes and alveolar macrophages, and often shows increased serum levels in patients with interstitial pneumonia. We report a case of mycobacterium avium complex (MAC) infection whose disease activity was correlated with KL-6 levels in serum. During treatment of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) with prednisolone, chest image findings improved in association with decreased KL-6 levels. Following tapering of prednisolone, chest image findings deteriorated again as levels of KL-6 increased, suggesting recurrence of RA-ILD. Bronchoscopic examination revealed active MAC infection. Treatment of MAC infection not only improved chest image findings but also decreased KL-6 levels in serum, suggesting that KL-6 was increased by active MAC infection by itself, not by recurrence of RA-ILD. To the best of our knowledge, this is the first documentation of KL-6 elevation in serum in association with active MAC infection. |
| キーワード | KL-6 mycobacterium avium complex pulmonary nontuberculous mycobacterium infection rheumatoid arthritis-associated interstitial lung disease bronchial alveolar lavage |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-06 |
| 巻 | 70巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 217 |
| 終了ページ | 221 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27339212 |
| Web of Science KeyUT | 000379406100010 |
| JaLCDOI | 10.18926/AMO/54421 |
|---|---|
| フルテキストURL | 70_3_213.pdf |
| 著者 | Kikuchi, Satoru| Kagawa, Shunsuke| Ohara, Toshiaki| Kubota, Tetsushi| Kuwada, Kazuya| Kagawa, Tetsuya| Kuroda, Shinji| Shirakawa, Yasuhiro| Nishizaki, Masahiko| Fujiwara, Toshiyoshi| |
| 抄録 | A 69-year-old man underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) at the lesser curvature in the angle of stomach. Histological examination revealed tub1, pM, ly0, v0, pLM(-), pVM(-), and the resection was considered curative. The scar after ESD was followed by esophagogastroduodenoscopy (EGD) and biopsy. Twenty months later, EGD showed an ulcerative lesion in the vicinity of the ESD scar, and histological examination of the biopsy specimen showed adenocarcinoma. A distal gastrectomy with lymph node dissection was then performed. Postoperative pathology showed tub1, pM, pN0, ly0, v0, and Stage 1A. Skip lesions were seen in the specimen resected by ESD, and the histological review confirmed so-called “dysplasia-like atypia” (DLA) between the lesions. It has been reported recently that in DLA, the dysplasia-like change involves only the bases of the pits, without upper pit or surface epithelium involvement, and it is said that the rate of DLA is higher in gastric cancer patients. We speculated that a precancerous lesion close to the resected cancer developed into a local recurrence. |
| キーワード | dysplasia-like atypia early gastric cancer endoscopic submucosal dissection local recurrence |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-06 |
| 巻 | 70巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 213 |
| 終了ページ | 216 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27339211 |
| Web of Science KeyUT | 000379406100009 |
| JaLCDOI | 10.18926/AMO/54420 |
|---|---|
| フルテキストURL | 70_3_205.pdf |
| 著者 | Kozaki, Ken-ichi| Kawakami, Shigehisa| Konishi, Takayuki| Ohta, Keiji| Yano, Jitsuro| Onoda, Tomoo| Matsumoto, Hiroshi| Mizukawa, Nobuyoshi| Kimata, Yoshihiro| Nishizaki, Kazunori| Iida, Seiji| Gofuku, Akio| Abe, Masanobu| Minagi, Shogo| Okayama Dream Speech Project| |
| 抄録 | A palatal augmentation prosthesis (PAP) is used to facilitate improvement in the speech and swallowing functions of patients with tongue resection or tongue movement disorders. However, a PAPʼs effect is limited in cases where articulation disorder is severe due to wide glossectomy and/or segmental mandibulectomy. In this paper, we describe speech outcomes of a patient with an articulation disorder following glossectomy and segmental mandibulectomy. We used a palatal plate (PP) based on a PAP, along with an artificial tongue (KAT). Speech improvement was evaluated by a standardized speech intelligibility test consisting of 100 syllables. The speech intelligibility score was significantly higher when the patient wore both the PP and KAT than when he wore neither (p＝0.013). The conversational intelligibility score was significantly improved with the PP and KAT than without PP and KAT (p＝0.024). These results suggest that speech function can be improved in patients with hard tissue defects with segmental mandibulectomy using both a PP and a KAT. The nature of the design of the PP and that of the KAT will allow these prostheses to address a wide range of tissue defects. |
| キーワード | palatal augmentation prosthesis artificial tongue articulation disorder glossectomy mandibulectomy |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-06 |
| 巻 | 70巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 205 |
| 終了ページ | 211 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27339210 |
| Web of Science KeyUT | 000379406100008 |
| JaLCDOI | 10.18926/AMO/54419 |
|---|---|
| フルテキストURL | 70_3_197.pdf |
| 著者 | Takagi, Kosei| Yagi, Takahito| Yoshida, Ryuichi| Shinoura, Susumu| Umeda, Yuzo| Nobuoka, Daisuke| Kuise, Takashi| Watanabe, Nobuyuki| Sui, Kenta| Fuji, Tomokazu| Fujiwara, Toshiyoshi| |
| 抄録 | The operative mortality and morbidity of pancreaticoduodenectomy (PD) remain high. We analyzed PD patientsʼ clinical characteristics and surgical outcomes and discuss how PD clinical outcomes could be improved. We retrospectively reviewed the cases of 400 patients who underwent a PD between January 1998 and April 2014 at Okayama University Hospital, a very-high-volume center. We identified and compared the clinical outcomes between two time periods (period 1: 1998-2006 vs. period 2: 2007-2014). The total postoperative mortality and major complication rates were 0.75 and 15.8 , respectively, and the median postoperative length of stay (LOS) was 32 days. Subsequently, patients who underwent a PD during period 2 had a significantly shorter LOS than those who underwent a PD during period 1 (29 days vs. 38.5 days, p＜0.001). The incidence of mortality and major complications did not differ between the two periods. In our multivariate analysis, period 1 was an independent factor associated with a long LOS (p＜0.001). The improvement of the surgical procedure and perioperative care might be related to the shorter LOS in period 2 and ot the consistently maintained low mortality rate after PD. The development of multimodal strategies to accelerate postoperative recovery may further improve PDʼs clinical outcomes. |
| キーワード | pancreaticoduodenectomy surgical outcome mortality major complication length of stay |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-06 |
| 巻 | 70巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 197 |
| 終了ページ | 203 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27339209 |
| Web of Science KeyUT | 000379406100007 |
| JaLCDOI | 10.18926/AMO/54418 |
|---|---|
| フルテキストURL | 70_3_189.pdf |
| 著者 | Fujiwara, Hiroyasu| Arai, Yasuaki| Ishii, Hiroaki| Kanazawa, Susumu| |
| 抄録 | We retrospectively evaluated the safety and efficacy of artificial pneumothorax induction to perform computed tomography (CT)-guided radiofrequency ablation (RFA) for sub-diaphragm hepatocellular carcinomas (HCCs). From June 2008 to October 2010 at our institution, 19 HCCs (16 patients) were treated using CT-guided RFA after artificial pneumothorax induction. A 23-G needle was inserted into the liver surface at a site of 2 connected pleurae without lung tissue. After a small amount of air was injected, the pleural space widened, creating a small pneumothorax. Additional air was insufflated via a newly inserted 18-G cannula to raise the lung away from the planned puncture line for RFA. The electrode was then advanced transthoracically. Ablation was performed using a cool-tip electrode with manual impedance control mode. The injected air was then aspirated as much as possible. Artificial pneumothorax was successfully induced in all cases. The average total volume of injected air in each case was 238ml. No artificial pneumothorax-related complication occurred; lung injury occurred in one case during RF electrode insertion. No local progression occurred during follow-up. Recurring HCCs were observed in eight patients. Artificial pneumothorax induction is safe and effective for CT-guided RFA of sub-diaphragm HCCs, which are difficult to locate on US. |
| キーワード | hepatocellular carcinoma liver radiofrequency ablation CT fluoroscopy artificial pneumothorax |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-06 |
| 巻 | 70巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 189 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27339208 |
| Web of Science KeyUT | 000379406100006 |
| JaLCDOI | 10.18926/AMO/54417 |
|---|---|
| フルテキストURL | 70_3_183.pdf |
| 著者 | Sawada, Shigeki| Hiroshi, Suehisa| Ueno, Tsuyoshi| Yamashita, Motohiro| |
| 抄録 | We reviewed post-operative complication and mortality rates from 1995 through 2014 and evaluated the changes in those rates across that 20-year period. Two thousand and three hundred sixteen patients with lung cancer underwent resection at our institution between 1995 and 2014. This timespan was divided into four 5-year periods. Each patientʼs age, Charlson comorbidity index score, and extent of surgery in each 5-year period were summarized, and the changes in these factors over the 20-year span were evaluated. The complication and mortality rates were calculated for each 5-year period, and the changes in those rates over the 20-years were evaluated. The number of patients with higher Charlson comorbidity index scores increased during the 20-year period. Of the 455 patients who developed complications, 97 developed life-threating complications. There were 16 post-operative deaths and 23 in-hospital deaths. There were no significant changes in the complication rate or mortality rate during the 20-year period. Both rates were significantly correlated with the extent of resection. Although the number of patients with comorbidities increased in the 20-year period, the post-operative complication and mortality rates, as well as in-hospital mortality, did not change significantly. |
| キーワード | post-operative complication post-operative mortality lung cancer surgery outcomes |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-06 |
| 巻 | 70巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 183 |
| 終了ページ | 188 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27339207 |
| Web of Science KeyUT | 000379406100005 |
| JaLCDOI | 10.18926/AMO/54416 |
|---|---|
| フルテキストURL | 70_3_175.pdf |
| 著者 | Setiawan, Heri| Nagaoka, Kenjiro| Kubo, Masayuki| Fujikura, Yoshihisa| Ogino, Keiki| |
| 抄録 | Oxidative stress is widely known to play a role in asthma. However, the contribution of xanthine oxidoreductase (XOR) as a source of the superoxide anion radical (O2－) in oxidative stress associated with asthma has not yet been examined in detail. Here we investigated pathophysiological changes in XOR in an experimental model of asthma induced by the house dust mite Dermatophagoides farinae (Df). In the lungs of Df-treated mice, the production of O2－ from XOR increased and the nitrite concentrations decreased, whereas the protein expression of XOR remained unchanged. Moreover, the protein expression levels of XOR and the hydrogen peroxide (H2O2) concentrations in bronchoalveolar lavage fluid (BALF) were higher in the Df-treated mice than in saline-treated mice. Immunohistochemically, although XOR was highly localized in the bronchial epithelial cells of the saline-treated mice, immunostaining for XOR was absent in the bronchial epithelium of Df-treated mice. These results suggest that oxidative stress is up-regulated by increases in the conversion of the dehydrogenase form (xanthine dehydrogenase; XDH) of XOR to the oxidase form (xanthine oxidase; XOD). |
| キーワード | xanthine oxidase oxidative stress asthma |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-06 |
| 巻 | 70巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 175 |
| 終了ページ | 182 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27339206 |
| Web of Science KeyUT | 000379406100004 |
| JaLCDOI | 10.18926/AMO/54415 |
|---|---|
| フルテキストURL | 70_3_167.pdf |
| 著者 | Sugihara, Satoshi| Doi, Hiroyuki| Kato, Masahiko| Mitoh, Yoshihiro| Tsuda, Toshihide| Ikeda, Satoru| |
| 抄録 | Aflatoxin (AFT) contamination is frequent in foods grown in tropical regions, including rice. Although AFTs are generally not found in temperate-region foods, global warming has affected typical temperate-region climates, potentially permitting the contamination of foods with AFT-producing Aspergillus flavus (A. flavus). Here we investigated the AFT production in rice during storage under natural climate conditions in Japan. We examined AFTs in brown rice and rough rice artificially contaminated with A. flavus for 1 year in Japan, and we subjected AFTs in white rice to the same treatment in airtight containers and examined the samples in warm and cold seasons, simulating the storage of white rice in general households. In the brown rice, AFTs increased after 2 months (March) and peaked after 9 months (October). The AFT contamination in the rough rice was minimal. After the polishing and cooking of the brown rice, AFTs were undetectable. In the white rice stored in airtight containers, AFTs increased after 1 month (August) and peaked after 2 months (September). Minimal AFTs were detected in the cold season. Thus, AFT contamination in rice may occur in temperate regions following A. flavus contamination. The storage of rice as rough rice could provide be useful for avoiding AFT contamination. |
| キーワード | Aspergillus flavus aflatoxin rice temperate region storage |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-06 |
| 巻 | 70巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 167 |
| 終了ページ | 173 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27339205 |
| Web of Science KeyUT | 000379406100003 |
| JaLCDOI | 10.18926/AMO/54414 |
|---|---|
| フルテキストURL | 70_3_159.pdf |
| 著者 | Yoshioka, Takashi| Otsuki, Hideo| Uehara, Shinya| Shimizu, Toshihiro| Murao, Wataru| Fujio, Koji| Fujio, Kei| Wada, Koichiro| Araki, Motoo| Nasu, Yasutomo| |
| 抄録 | Upper urinary tract calculi are common; however, there is no recommended treatment selection for elderly patients. Ureteroscopic holmium laser lithotripsy (URS lithotripsy) is minimally invasive, and it provides a high stone-free rate (SFR) treatment for upper urinary tract calculi. Here, we retrospectively evaluated the surgical outcomes of URS lithotripsy after dividing the 189 cases into 3 groups by patient age: the ʻ＜65 groupʼ (＜65 years old, n＝108), the ʻ65-74 groupʼ (65-74 years old, n＝42), and the ʻ 75 groupʼ ( 75 years old, n＝39). The patientsʼ characteristics, stone status, and perioperative outcomes were assessed. The 65-74 group and the 75 group had a significantly higher prevalence of hypertension compared to the＜65 group. Compared to the＜65 group, the 65-74 group had a significantly higher prevalence of hyperlipidemia, and the 75 group had significantly higher the American Society of Anesthesiologists (ASA) scores. Despite these preoperative risk factors, SFR and postoperative pyelonephritis in the 65-74 group and the 75 group were similar to those of the＜65 group. In conclusion, URS lithotripsy is the preferred treatment for upper urinary tract calculi, even for elderly patients who have multiple preoperative risk factors. |
| キーワード | upper urinary tract calculi ureteroscopy (URS) holmium laser lithotripsy elderly patients stone-free rate (SFR) |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-06 |
| 巻 | 70巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 159 |
| 終了ページ | 166 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27339204 |
| Web of Science KeyUT | 000379406100002 |
| JaLCDOI | 10.18926/AMO/54413 |
|---|---|
| フルテキストURL | 70_3_151.pdf |
| 著者 | Wada, Jun| Nakatsuka, Atsuko| |
| 抄録 | The mitochondria are involved in active and dynamic processes, such as mitochondrial biogenesis, fission, fusion and mitophagy to maintain mitochondrial and cellular functions. In obesity and type 2 diabetes, impaired oxidation, reduced mitochondrial contents, lowered rates of oxidative phosphorylation and excessive reactive oxygen species (ROS) production have been reported. Mitochondrial biogenesis is regulated by various transcription factors such as peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α), peroxisome proliferator-activated receptors (PPARs), estrogen-related receptors (ERRs), and nuclear respiratory factors (NRFs). Mitochondrial fusion is promoted by mitofusin 1 (MFN1), mitofusin 2 (MFN2) and optic atrophy 1 (OPA1), while fission is governed by the recruitment of dynamin-related protein 1 (DRP1) by adaptor proteins such as mitochondrial fission factor (MFF), mitochondrial dynamics proteins of 49 and 51 kDa (MiD49 and MiD51), and fission 1 (FIS1). Phosphatase and tensin homolog (PTEN)-induced putative kinase 1 (PINK1) and PARKIN promote DRP1-dependent mitochondrial fission, and the outer mitochondrial adaptor MiD51 is required in DRP1 recruitment and PARKIN-dependent mitophagy. This review describes the molecular mechanism of mitochondrial dynamics, its abnormality in diabetes and obesity, and pharmaceuticals targeting mitochondrial biogenesis, fission, fusion and mitophagy. |
| キーワード | fusion fission oxidative stress mitochondria diabetes |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-06 |
| 巻 | 70巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 151 |
| 終了ページ | 158 |
| 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Ⓒ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27339203 |
| Web of Science KeyUT | 000379406100001 |
| フルテキストURL | K0005297_abstract_review.pdf K0005297_fulltext.pdf |
|---|---|
| 著者 | HERI SETIAWAN| |
| 発行日 | 2016-03-25 |
| 資料タイプ | 学位論文 |
| 学位授与番号 | 甲第5297号 |
| 学位授与年月日 | 2016-03-25 |
| 学位・専攻分野 | 博士（医学） |
| 授与大学 | 岡山大学 |
| 言語 | 英語 |