| JaLCDOI | 10.18926/AMO/67878 |
|---|---|
| FullText URL | 78_6_475.pdf |
| Author | Xiang, Hongfei| Latka, Kajetan| Maste, Praful| Tanaka, Masato| Kumawat, Chetan| Arataki, Shinya| Fujiwara, Yoshihiro| Taoka, Takuya| Miyamoto, Akiyoshi| |
| Abstract | This report presents a new unilateral biportal endoscopic (UBE) technique for lumbar disc herniation without C-arm guidance. Lumbar disc herniation requires surgical intervention when conservative methods fail. Shifts towards minimally invasive percutaneous endoscopic lumbar discectomy, including uniportal and biportal approaches, have been hindered by challenges such as steep learning curves and reliance on radiation-intensive C-arm guidance. We here describe the use of standard intraoperative navigation in UBE to reduce radiation exposure and increase surgical accuracy. A 24-year-old man with low back and bilateral leg pain with gait disturbance was referred to our hospital. He had had conservative treatment for 12 months in another hospital before admission, but this proved unsuccessful. On admission he had low back pain (VAS 4/10) and bilateral leg pain (VAS 8/10), muscle weakness of the bilateral legs (manual muscle testing (MMT) grade of the extensor hallucis longus: 4/4), and numbness of the bilateral lower legs. Preoperative lumbar MRI showed L4/5 large central disc herniation. He underwent C-arm free UBE discectomy under the guidance of O-arm navigation. The surgery was successful, with postoperative lumbar MRI showing good decompression of the dural sac and bilateral L5 nerve roots. The MMT grade and sensory function of both legs had recovered fully on final follow-up at one year. The new UBE technique under navigation guidance was shown to be useful for lumbar disc herniation. This innovative technique was safe and accurate for the treatment of lumbar intervertebral disc herniation, and minimized radiation exposure to surgeons. |
| Keywords | lumbar disc herniation unilateral biportal endoscopic technique navigation O-arm minimally invasive spine surgery (MISS) |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-12 |
| Volume | volume78 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 475 |
| End Page | 483 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 39719322 |
| Web of Science KeyUT | 001397269500004 |
| JaLCDOI | 10.18926/AMO/67877 |
|---|---|
| FullText URL | 78_6_469.pdf |
| Author | Hirata, Yuichi| Nagase, Takayuki| Sasada, Susumu| Ayada, Yoshiyuki| Miyake, Hayato| Sugahara, Chiaki| Yamamoto, Hidetaka| Oda, Yoshinao| Yasuhara, Takao| Tanaka, Shota| |
| Abstract | Tenosynovial giant cell tumor (TGCT) is a fibrous histiocytic tumor originating in the synovial membrane. While cervical TGCT may not be considered a common diagnosis preoperatively because it is relatively rare, it has a high recurrence rate and should be considered. Total resection is preferable, but it can be challenging due to the risk of damaging the vertebral artery. Denosumab has shown effectiveness as a postoperative treatment for osteolytic bone lesion. Denosumab administration coupled with close follow-up might offer an effective postoperative treatment option for unresectable TGCT with bone invasion. |
| Keywords | tenosynovial giant cell tumor bone tumor spine |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-12 |
| Volume | volume78 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 469 |
| End Page | 474 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 39719321 |
| Web of Science KeyUT | 001397269500003 |
| JaLCDOI | 10.18926/AMO/67873 |
|---|---|
| FullText URL | 78_6_465.pdf |
| Author | Ocho, Kazuki| Hagiya, Hideharu| Ishikawa, Hisashi| Otsuka, Fumio| |
| Abstract | An 81-year-old Japanese man with a medical history of diabetes mellitus and hypertension was diagnosed with the novel coronavirus disease 2019 (COVID-19). The patient developed pain in the bilateral shoulders and hips 3 days after the disease onset and presented to our outpatient clinic after 1 month. Referring to diagnostic criteria, we diagnosed him with polymyalgia rheumatica (PMR). We initiated prednisolone at 15 mg per day and his symptoms improved immediately. The clinical course of the patient indicated that the SARS-CoV-2 infection triggered the onset of autoimmune disease, PMR in this case. |
| Keywords | COVID-19 SARS-CoV-2 polymyalgia rheumatica autoimmune diseases human leukocyte antigen |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-12 |
| Volume | volume78 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 465 |
| End Page | 468 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 39719320 |
| Web of Science KeyUT | 001397269500002 |
| JaLCDOI | 10.18926/AMO/67872 |
|---|---|
| FullText URL | 78_6_459.pdf |
| Author | Sakamoto, Shinya| Tabuchi, Motoyasu| Yoshimatsu, Rika| Matsumoto, Manabu| Iwata, Jun| Okabayashi, Takehiro| |
| Abstract | Traumatic neuroma is an abnormal proliferation of injured nerves resulting from trauma or surgery. We present a case of traumatic neuroma arising in the cystic duct after cholecystectomy. A 66-year-old man was referred to our department due to a biliary tumor. He had undergone cholecystectomy 20 years prior. Cholangioscopy showed an elevated lesion covered with smooth mucosa. Histological examination revealed normal bile duct mucosa. Although benign disease was suspected, the possibilities of malignant disease could not be excluded. Extrahepatic bile duct resection was planned to include intraoperative rapid-freezing of a biopsy specimen followed by histopathological examination. These intraoperative histology results showed proliferation of nerve and fibrous tissue only, resulting in the diagnosis of traumatic neuroma, so no lymph nodes were removed. To avoid excessive surgical intervention, histopathological examination of an intraoperative rapid-frozen biopsy specimen may be important for diagnosing traumatic neuroma. |
| Keywords | traumatic neuroma biliary stricture cholecystectomy cholangiography intraoperative rapid-frozen biopsy |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-12 |
| Volume | volume78 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 459 |
| End Page | 464 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 39719319 |
| Web of Science KeyUT | 001397269500001 |
| JaLCDOI | 10.18926/AMO/67871 |
|---|---|
| FullText URL | 78_6_453.pdf |
| Author | Kawata, Yujiro| Watanabe, Kenta| Tokiya, Ryoji| Matsuno, Takeshi| Tanaka, Ryo| Taira, Naruto| Katsui, Kuniaki| |
| Abstract | Radiation-induced angiosarcoma (RIAS) is a rare, late adverse event of radiotherapy comprising approximately half of all radiation-induced sarcomas. It has a relatively short latency period and generally unfavorable prognosis. This study presents a case of RIAS that developed 5 years and 11 months after the completion of hypofractionated radiotherapy (42.56 Gy/16 fractions) following partial mastectomy. The patient was diagnosed with RIAS 10 months after the onset of skin redness. She underwent skin tumor resection, followed by paclitaxel, then pazopanib administration, but no radiotherapy. At 6 years and 2 months after surgery, no RIAS recurrence has been detected. |
| Keywords | breast cancer hypofractionated radiotherapy radiation-induced angiosarcoma |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-12 |
| Volume | volume78 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 453 |
| End Page | 458 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 39719318 |
| Web of Science KeyUT | 001397808000001 |
| JaLCDOI | 10.18926/AMO/67870 |
|---|---|
| FullText URL | 78_6_449.pdf |
| Author | Kato, Gentaro| Ogawa, Tatsuya| Hayashida, Tomohiro| Shimizu, Shuji| Yamamoto, Shu| Shichijo, Takeshi| |
| Abstract | A 73-year-old man who had undergone esophagectomy and retrosternal gastric tube reconstruction for esophageal cancer 8 years prior was transferred to our hospital for the treatment of an acute myocardial infarction. Emergent percutaneous coronary intervention for the left anterior descending artery (#7) was successfully performed. However, echocardiography revealed a ventricular septal rupture (25×27 mm). Seventeen days after admission, the rupture was successfully treated with a double-patch closure via a left anterolateral thoracotomy to avoid a surgical injury to his retrosternal gastric tube. Determining the best surgical approach to the heart is important for safe cardiac surgery in patients after esophageal reconstruction. |
| Keywords | acute myocardial infarction ventricular septal rupture retrosternal gastric tube reconstruction esophageal cancer left anterolateral thoracotomy |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-12 |
| Volume | volume78 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 449 |
| End Page | 452 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 39719317 |
| Web of Science KeyUT | 001397799300003 |
| JaLCDOI | 10.18926/AMO/67869 |
|---|---|
| FullText URL | 78_6_439.pdf |
| Author | Yamashita, Mampei| Tanaka, Takayuki| Sumida, Yorihisa| Yamazaki, Shoto| Hara, Yuki| Fukuda, Akiko| Hisanaga, Makoto| Wakata, Koki| Araki, Masato| Eguchi, Susumu| |
| Abstract | Gangrenous cholecystitis (GC) is classified as moderate acute cholecystitis according to the Tokyo Guidelines from 2018 (TG18). We evaluated the risk factors for GC and the outcomes of early cholecystectomy. A total of 136 patients who underwent emergency cholecystectomy for acute cholecystitis were retrospectively analyzed; 58 of these patients (42.6%) were diagnosed with GC (GC group) based on our retrospective pathologic diagnosis. We comparatively evaluated the patient backgrounds and surgical outcomes between the GC group and non-GC group. The GC group was significantly older and included more hypertensive patients than the non-GC group. The GC group was prescribed more antibiotics as initial treatment than the non-GC group, and they had more days between onset and surgery. The preoperative white blood cell count and C-reactive protein values were significantly higher in the GC group than in the non-GC group, and these values were predictive factors for GC. Cholecystectomy required a longer operation time and caused greater blood loss in the GC group. The GC group also had longer hospitalization times than the non-GC group; however, no significant differences were observed in terms of postoperative complications. In conclusion, gangrenous changes should be assessed when diagnosing cholecystitis, and appropriate treatment, such as surgery or drainage, should be undertaken. |
| Keywords | gangrenous cholecystitis acute cholecystitis laparoscopic cholecystectomy |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-12 |
| Volume | volume78 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 439 |
| End Page | 447 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 39719316 |
| Web of Science KeyUT | 001397799300002 |
| JaLCDOI | 10.18926/AMO/67868 |
|---|---|
| FullText URL | 78_6_429.pdf |
| Author | Kubota, Risa| Bekku, Kensuke| Katayama, Satoshi| Iwata, Takehiro| Nishimura, Shingo| Edamura, Kohei| Kobayashi, Tomoko| Kobayashi, Yasuyuki| Araki, Motoo| |
| Abstract | Although partial nephrectomy (PN) is preferred over radical nephrectomy (RN) for preserving renal function in patients with cT1 renal cancer, its impact on cardiovascular events (CVe) remains controversial. This study aimed to compare PN and RN in regard to the occurrence of CVe, including cerebrovascular events and exacerbation of hypertension (HT). We retrospectively analyzed 418 consecutive patients who underwent PN or RN for cT1 renal cancer. Propensity score-matching analysis was used to adjust for imbalances between patients who underwent PN and RN, leaving 102 patients in each group. The 5-year probability of cumulative CVe incidence was 6% in the PN group and 12% in the RN group (p=0.03), with a median follow-up of 73.5 months. The statistical significance was retained after propensity score matching for patients without preoperative proteinuria (p=0.03). For all CVe including cerebrovascular events and exacerbation of HT analyzed, PN provided a lower probability of occurrence than RN in patients with small renal cancers. |
| Keywords | chronic kidney disease hypertension nephrectomy proteinuria |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2024-12 |
| Volume | volume78 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 429 |
| End Page | 437 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2024 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 39719315 |
| Web of Science KeyUT | 001397799300001 |
