| JaLCDOI | 10.18926/AMO/70458 |
|---|---|
| FullText URL | 80_2_153.pdf |
| Author | Ueda, Yoshiyuki| Yumoto, Tetsuya| Hongo, Takashi| Obara, Takafumi| Nojima, Tsuyoshi| Tsukahara, Kohei| Hasegawa, Kosei| Futagawa, Natsuko| Naito, Hiromichi| Nakao, Atsunori| |
| Abstract | Adrenal crisis is a life-threatening endocrine emergency that can progress within hours despite a prior diagnosis and maintenance therapy. We describe a fatal influenza-triggered adrenal crisis in two patients: a child with panhypopituitarism and an adult with prior pituitary surgery, both presenting in cardiac arrest. Despite resuscitation and intravenous hydrocortisone, a fatal hypoxic-ischemic injury or multiorgan failure occurred. These cases highlight the fulminant course of an adrenal crisis and underscore the importance of early recognition, clinician awareness, prompt parenteral hydrocortisone administration, and reinforcement of education for patients, caregivers, and healthcare providers to improve preparedness and prevent avoidable deaths. |
| Keywords | adrenal insufficiency cardiac arrest hydrocortisone influenza shock |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-04 |
| Volume | volume80 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 153 |
| End Page | 157 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/70457 |
|---|---|
| FullText URL | 80_2_147.pdf |
| Author | Sakamoto, Shinya| Tabuchi, Motoyasu| Hamada, Akira| Yoshimatsu, Rika| Saisaka, Yuichi| Matsumoto, Manabu| Iwata, Jun| Okabayashi, Takehiro| |
| Abstract | Common bile duct (CBD) injury after blunt abdominal trauma is rare and difficult to diagnose. Delayed recognition leads to severe morbidity. A 70-year-old Japanese man was admitted after sustaining blunt abdominal trauma. Ultrasonography revealed intra-abdominal fluid, suggesting bleeding. Contrast-enhanced computed tomography revealed pancreatic head injury, intra-abdominal bleeding, and pseudoaneurysm of the anterior superior pancreatoduodenal artery (ASPDA). Bile duct injury was not evident. The application of transarterial embolization (TAE) controlled the bleeding. Canulation into the pancreatic or biliary duct was not possible during endoscopic retrograde cholangiopancreatography. An emergency laparotomy revealed severe pancreatic head and extrahepatic bile duct injuries. Pancreaticoduodenectomy/Child reconstruction was performed. Complete CBD transection was confirmed. The patient was ultimately discharged without complications. Early recognition, timely surgical management, and intensive care are essential for favorable outcomes in patients who have sustained abdominal trauma. |
| Keywords | blunt abdominal trauma intensive care emergency laparotomy pancreatoduodenectomy |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-04 |
| Volume | volume80 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 147 |
| End Page | 152 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/70456 |
|---|---|
| FullText URL | 80_2_141.pdf |
| Author | Sakamoto-Tokunaga, Moe| Katsuyama, Takayuki| Matoba, Masaki| Tamura, Tomokazu| Kubota, Natsuki| Terajima, Yuya| Shidahara, Kenta| Hirose, Kei| Matsumoto, Kazuya| Nawachi, Shoichi| Nakadoi, Takato| Katayama, Yu| Hayashi, Keigo| Miyawaki, Yoshia| Katsuyama, Eri| Watanabe, Haruki| Takano-Narazaki, Mariko| Matsumoto, Yoshinori| Sada, Ken-Ei| Tsuji, Shuma| Gotoh, Kazuyoshi| Fukushima, Shinnosuke| Hagiya, Hideharu| Wada, Jun| |
| Abstract | VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory somatic) syndrome has a poor prognosis, with infections being a major cause of death. Raoultella ornithinolytica is an environmental bacterium found predominantly in soil and water. Although R. ornithinolytica can cause various infections, necrotizing fasciitis due to this bacterium has not been reported. We describe the case of an 84-year-old Japanese male with VEXAS syndrome who developed septic shock and necrotizing fasciitis while he was under immunosuppressive therapy. The pathogen was initially misidentified as R. planticola by mass spectrometry but later confirmed by whole-genome sequencing as extended spectrum β-lactamase (ESBL) produced by R. ornithinolytica. Although a life-saving leg amputation was required, the patient recovered with appropriate antibiotic therapy. R. ornithinolytica is thus able to cause severe skin infections in immunocompromised individuals. |
| Keywords | necrotizing fasciitis Raoultella ornithinolytica VEXAS syndrome whole-genome sequence |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-04 |
| Volume | volume80 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 141 |
| End Page | 145 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/70455 |
|---|---|
| FullText URL | 80_2_131.pdf |
| Author | Nakata, Shunsuke| Takatsu, Fumiaki| Mikuriya, Yoshihiro| Kakishita, Tomokazu| Hato, Shinji| Ohta, Koji| Kobatake, Takaya| |
| Abstract | Colorectal surgery is associated with a high incidence of postoperative complications regardless of the advances in surgical techniques and multidisciplinary treatment. Proteinuria is common in patients with malignancies, but few studies have investigated the association between preoperative proteinuria and patient prognoses, especially postoperative complications. We investigated the impact of proteinuria on patients undergoing colorectal surgery in a single-center, retrospective cohort study of 767 patients who underwent surgical resection for colorectal cancer between January 2016 and December 2022 at the National Hospital Organization Shikoku Cancer Center. Among them, 81 patients with preoperative proteinuria were compared with the control group of 686 patients without proteinuria. Our analyses revealed that the patients with proteinuria had malnutrition with a significantly lower prognostic nutritional index compared to the no-proteinuria control group (p<0.001). The proteinuria group had a significantly advanced tumor stage (p=0.005), experienced more bleeding during the surgery (p=0.002), and required more transfusions (p<0.001). Postoperative complications were significantly more frequent in the proteinuria group (p=0.03), thus demonstrating that proteinuria was independently associated with postoperative complications (p=0.045). Proteinuria in patients undergoing colorectal cancer surgery can therefore be considered a risk factor for postoperative complications. |
| Keywords | colorectal cancer surgery proteinuria complication malnutrition |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-04 |
| Volume | volume80 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 131 |
| End Page | 139 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/70454 |
|---|---|
| FullText URL | 80_2_119.pdf |
| Author | Ikuma, Hisanori| Hirose, Tomohiko| Kawasaki, Keisuke| Otsuka, Kazutoshi| |
| Abstract | We evaluated the clinical outcomes and limitations of anterior and posterior combined surgery with a mini-open corpectomy applying an expandable cage (Xcore®) and percutaneous pedicle screw (PPS) fixation using single-position surgery in the lateral decubitus position in patients aged > 75 years with thoracolumbar vertebral collapse. The cases of 30 consecutive patients who underwent this procedure and had ≥ 1-year follow-up were retrospectively analyzed. The mean operative time was 78.8 min and the estimated blood loss was 115.7 ml per level. The complications included adjacent junctional failure (n=9, 30%), deep venous thrombosis (n=3, 10%), delirium (n=3, 10%), pleural injury (n=2, 6%), screw backout (n=1, 3%) kidney injury (n=1, 3%), chylothorax (n=1, 3%), and wound dehiscence (n=1, 3%). Seven cases (23.3%) required reoperation. Local kyphosis showed significant improvement (p<0.05) that was maintained at the final follow-up. The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire and a visual analogue scale indicated significant improvement in all categories at the final follow-up (p<0.05). The use of mini-open corpectomy and posterior fixation with SPAPS can thus provide reliable radiological correction and good postoperative clinical outcomes even in patients aged > 75 years. However, a limitation of this procedure is the rate of reoperation (23.3%) for osteoporosis-related adjacent segment fracture and screw backout. |
| Keywords | single postion surgery osteoporotic vertebral collapse anterior and posterior combined surgery minimum invasive surgery |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-04 |
| Volume | volume80 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 119 |
| End Page | 129 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/70453 |
|---|---|
| FullText URL | 80_2_109.pdf |
| Author | Sonoi, Mika| Sonoi, Norihiro| Koyama, Yoko| |
| Abstract | This study examined the effects of interprofessional education (IPE) on dietetics students during clinical training, focusing on changes in their attitudes toward IPE and their fundamental competencies. Eighty third-year female students (mean age, 21.0 years) at a Japanese women’s university participated. Self-administered surveys were conducted before and after clinical training to assess attitudes toward IPE using the Readiness for Interprofessional Learning Scale (RIPLS) and the Shakaijin Kisoryoku (SKL; Fundamental Competencies for Working Persons) scale. Quantitative data were analyzed using paired t-tests, chi-squared tests, and cluster analyses. Qualitative data from open-ended responses were analyzed thematically. RIPLS and SKL scores increased significantly, from 65.3 to 68.9, and from 28. 4 to 33. 2, respectively (p<0.001). All 12 SKL items showed significant improvement. In free responses, “initiative” (66 mentions), “communication” (10), and “execution” (8) were the most frequently cited as improved competencies. Cluster analysis identified three groups: increasing scores (n=25), high baseline (n=30), and minimal change (n=25). No significant correlation was found between changes in RIPLS and SKL scores (r=−0.108, p=0.355). IPE integrated into clinical training may enhance dietetics students’ attitudes toward interprofessional collaboration and contribute to the development of professional identity. Individualized, phased IPE implementation is recommended to accommodate differences in learner readiness. |
| Keywords | interprofessional education dietetics students clinical training professional competencies transformative learning |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-04 |
| Volume | volume80 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 109 |
| End Page | 117 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/70452 |
|---|---|
| FullText URL | 80_2_099.pdf |
| Author | Nguyen Trung Thanh| Nakamichi, Ryo| Shimamura, Yasunori| Saito, Taichi| Ishihara, Takeshi| Furutani, Tomoki| Shitozawa, Hisakazu| Noda, Tomoyuki| Ozaki, Toshifumi| |
| Abstract | Although the performance of minimally invasive plate osteosynthesis (MIPO) via the anteroinferior approach is increasingly adopted for midshaft clavicle fractures, the influence of fracture morphology on clinical outcomes under a standardized protocol is unclear. We retrospectively analyzed the cases of 54 patients who underwent anteroinferior MIPO for an acute midshaft clavicle fracture (AO/OTA types B1, B2, B3) performed by a single surgeon across three affiliated institutions (2009-2022). We evaluated the clinical outcomes, i.e., the surgical time, incision length, radiographic union, reduction accuracy, range of motion, pain (visual analog scale [VAS]), and complications and compared them among the three AO/OTA subtypes. The mean incision length (3.4 cm) and surgical time (71-79 min) were similar among the groups (both p>0.2). All fractures achieved radiographic union at a mean of 3.5 months. Postoperative alignment and clavicular length were maintained (length reduction −1.0±2.2 mm [B1], −0.5±2.0 mm [B2], −0.6±1.8 mm [B3]; p=0.825; angulation −0.8±3.4°, −1.1±3.1°, −0.3±3.3°; p=0.888). At 3 months, shoulder elevation and abduction were 169°-175° (p=0.079) and 164°-175° (p=0.324). Pain was minimal (100-mm VAS: ≤1 mm; p=0.782). One plate-fatigue failure occurred; no supraclavicular-nerve symptoms were recorded. Anteroinferior MIPO yielded consistent outcomes across AO/OTA types, with excellent union rates, functional recovery, and few complications, indicating that this technique is safe and reproducible for the surgical management of midshaft clavicle fractures. |
| Keywords | clavicle fracture minimally invasive plate osteosynthesis anteroinferior plating AO/OTA classification |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-04 |
| Volume | volume80 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 99 |
| End Page | 107 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/70451 |
|---|---|
| FullText URL | 80_2_085.pdf |
| Author | Shiba, Takahiko| Takamori, Mitsuhito| Katagiri, Sayaka| Kobayashi, Ryota| Kawauchi, Aki| Ohsugi, Yujin| Lin, Peiya| Ekuni, Daisuke| Egusa, Masahiko| Iwata, Takanori| Maeda, Shigeru| |
| Abstract | Individuals with Down syndrome (DS) are more susceptible to periodontal disease; however, microbial changes following treatment remain insufficiently understood. This study evaluated the effects of nonsurgical periodontal therapy on clinical outcomes and oral microbiome dynamics in 6 patients with DS using 16S rRNA gene amplicon sequencing. Bacterial diversity, composition, network structure, and predicted functional pathways were analyzed using dental plaque samples. Bleeding on probing decreased significantly (p=0.047) after treatment, with a trend toward reduction in periodontal inflamed surface area (p=0.05). The abundance of Fusobacteria at the class level decreased significantly after treatment. The abundance of Mogibacterium timidum was higher in the pretreatment group than in the posttreatment group. M. timidum was positively correlated with Treponema denticola and associated with multiple bacterial taxa in the network during pretreatment. Predicted functional pathways related to aromatic compound degradation were more abundant in posttreatment samples than in pretreatment samples. An increase in the abundance of Fusobacterium and the positive correlation between T. denticola and M. timidum, together with their associations with other periodontal pathogens before treatment, may contribute to the development of periodontitis in individuals with DS. Nonsurgical periodontal therapy produces measurable clinical improvement and promotes microbial shifts in patients with DS. |
| Keywords | Down Syndrome 16S rRNA Gene Amplicon Sequencing periodontitis nonsurgical periodontal treatment oral microbiome |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-04 |
| Volume | volume80 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 85 |
| End Page | 97 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/70450 |
|---|---|
| FullText URL | 80_2_075.pdf |
| Author | Lin, Deting| Horita, Masahiro| Watanabe, Masahito| Hasei, Joe| Ohtsuki, Takashi| Otsuka, Noriaki| Ichikawa, Chinatsu| Shimizu, Noriyuki| Naniwa, Shuichi| Ozaki, Toshifumi| Nishida, Keiichiro| |
| Abstract | A disintegrin and metalloproteinase 12 (ADAM12) is known to be involved in chondrocyte proliferation and is upregulated in the synovial tissue of osteoarthritis (OA). However, the underlying mechanisms of ADAM12 on rheumatoid arthritis (RA) synovial cell proliferation remain unknown. Here, we investigated the role of ADAM12 in the proliferation of RA synovial fibroblasts (RASFs). The expression and localization of ADAM12 in RA synovial tissues were examined by immunohistochemistry and compared with OA and healthy control (HC) synovial tissues. The effect of inflammatory cytokines (TNF-α, TGF-β1, and PDGF-BB) on ADAM12 expression in RASFs from RA patients was examined by real-time RT-PCR. The effect of ADAM12 knock-down by ADAM12 siRNA and ADAM12 overexpression on cell proliferation of RASFs were examined by WST-1 assay. ADAM12 was identified predominantly in RA synovial tissue rather than OA and HC synovial tissues. Stimulation with TGF-β1 upregulated the expression of ADAM12 and cell proliferation of RASFs. ADAM12 siRNA suppressed TGF-β1-induced cell proliferation of RASFs, while ADAM12 overexpression promoted the cell proliferation of RASFs. These findings demonstrate that ADAM12 may have a key role in TGF-β1-induced cell proliferation of synovial fibroblasts in patients with RA. |
| Keywords | rheumatoid arthritis synovial tissue TGF-β1 ADAM12 cell proliferation |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-04 |
| Volume | volume80 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 75 |
| End Page | 83 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/70075 |
|---|---|
| FullText URL | 80_1_069.pdf |
| Author | Wakatsuki, Shinya| Sakamoto, Shinya| Ueno, Akiko| Namba, Takaomi| Yamamoto, Yorito| Matsumoto, Manabu| Iwata, Jun| Okabayashi, Takehiro| |
| Abstract | Patients with hepatocellular carcinoma (HCC) and extensive peritoneal dissemination generally have a poor prognosis and are often resistant to systemic therapy. We report the case of a 47-year-old woman with HCC and massive peritoneal dissemination who presented with malignant ascites requiring repeated cell-free and concentrated ascites reinfusion therapy and peritoneovenous shunt placement, as well as malignant pleural effusion requiring pleurodesis. Combined immunotherapy with durvalumab/tremelimumab was initiated;however, disease progression was observed after three treatment courses, prompting a switch to lenvatinib therapy. Two months after initiation of lenvatinib, CT imaging demonstrated complete disappearance of arterial enhancement in the primary hepatic lesion, along with reduction in the size of peritoneal dissemination nodules. Thirteen months after switching to lenvatinib (16 months after the initial diagnosis), the alpha-fetoprotein level continued to decrease, and the disease remained stable under treatment. Despite the extremely high tumor burden, lenvatinib achieved disease stabilization and symptomatic improvement. |
| Keywords | diagnostic laparoscopy hepatocellular carcinoma peritoneal dissemination lenvatinib |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-02 |
| Volume | volume80 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 69 |
| End Page | 74 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 41748152 |
| Web of Science KeyUT | 001712986800001 |
| JaLCDOI | 10.18926/AMO/70074 |
|---|---|
| FullText URL | 80_1_063.pdf |
| Author | Takasu, Eri| Shiode, Yusuke| Kindo, Hiroya| Kimura, Shuhei| Hosokawa, Mio| Matoba, Ryo| Kanzaki, Yuki| Morita, Tetsuro| Adachi, Takuya| Otsuka, Motoyuki| Morizane, Yuki| |
| Abstract | A 77-year-old man undergoing treatment for hepatocellular carcinoma (HCC) presented with blurred vision in his right eye, persisting for 2 months. Slit-lamp microscopy and fundus examination revealed inflammatory cells in the anterior chamber, severe vitreous opacities, and retinal vasculitis in the right eye. The patient underwent vitreous surgery with biopsy, and vitreous cytology confirmed a metastatic intraocular tumor originating from the HCC. Radiotherapy was administered to the right eye, with no recurrence of intraocular inflammation observed at 10 months post-irradiation. |
| Keywords | metastatic intraocular tumor hepatocellular carcinoma panuveitis uveitis masquerade syndrome |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-02 |
| Volume | volume80 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 63 |
| End Page | 67 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 41748151 |
| Web of Science KeyUT | 001712997700001 |
| JaLCDOI | 10.18926/AMO/70073 |
|---|---|
| FullText URL | 80_1_055.pdf |
| Author | Akazawa, Hidemasa| Hagiya, Hideharu| Fukushima, Shinnosuke| Yamamoto, Shohei| Nakano, Yasuhiro| Otsuka, Fumio| |
| Abstract | In Japan, antiviral agents for COVID-19 were freely available until September 2023 as part of national policy. This study evaluated changes in these agents’ prescribing patterns and the patient outcomes following the policy shift. We conducted a multicenter retrospective study at four hospitals in Japan’s Okayama and Kagawa prefectures from January 2022 to March 2024. The study period was divided into the public-expenditure phase (January 2022 to September 2023) and the post-expenditure phase (October 2023 to March 2024). We extracted the hospitalized patients’ clinical data from the electronic database. The study’s primary outcome was the antiviral prescription rate; the secondary outcome was in-hospital mortality. Among the 302 hospitalized patients (median age 85 years), 52.0% were classified as having a mild condition. Of the patients with mild conditions, 37.7% were diagnosed in outpatient settings prior to hospitalization. During the public-expenditure phase, 47.4% of the patients received antivirals as outpatients, mainly molnupiravir (80.9%). In the post-expenditure period, 80.0% of the patients were prescribed antivirals, mostly molnupiravir (91.7%). The antiviral prescription rate was significantly higher after the policy change. The overall in-hospital mortality was 15.8%, with no significant difference between the two periods (17.0% vs. 10.5%). Despite the termination of government funding, antiviral prescriptions remained frequent at community hospitals located in highly aging regions of western Japan such as Okayama and Kagawa prefectures. Mortality remains high among the elderly, highlighting the need for continued antiviral therapy and booster vaccinations. |
| Keywords | coronavirus disease 2019 public expenditure prescribing pattern prognosis Japan |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-02 |
| Volume | volume80 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 55 |
| End Page | 62 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 41748150 |
| Web of Science KeyUT | 001712994500007 |
| JaLCDOI | 10.18926/AMO/70072 |
|---|---|
| FullText URL | 80_1_047.pdf |
| Author | Eguchi, Yukiomi| Ushio, Soichiro| Irie, Keiichi| Yamashita, Yuta| Eguchi, Miyu| Nakano, Takafumi| Mishima, Kenichi| |
| Abstract | Deregulation of cannabis use is gradually expanding in Europe and the United States. However, the biological processes driving tolerance to delta-9-tetrahydrocannabinol (Δ9-THC), the main psychoactive component of cannabis, remain unclear. Thus, this study aimed to investigate the mechanisms and time course of tolerance development and loss to Δ9-THC in mice. Male ICR mice (7 weeks old) were administered Δ9-THC once daily for 3 days and then divided into three groups according to the washout period (3-, 10-, and 17-day washout groups). After each washout, changes in body temperature and locomotor activity were measured following re-exposure to Δ9-THC. Furthermore, the mRNA expression levels of CB1 and CB2 receptors in the brain were evaluated using real-time PCR. On day 1, significant hypothermia and reduced spontaneous locomotor activity were observed in the Δ9-THC-treated mice compared with the vehicle-treated mice. Tolerance to the hypothermic and locomotor-suppressing effects of Δ9-THC developed on days 2 and 3, respectively, and dissipated after 3 and 11 days of washout, respectively. These differences in the rates of tolerance development and recovery may reflect distinct underlying mechanisms. No significant changes in receptor mRNA expression were observed. These findings highlight the complexity of Δ9-THC tolerance and its potential implications for long-term cannabis use. |
| Keywords | delta-9-tetrahydrocannabinol cannabis tolerance locomotor hypothermic |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-02 |
| Volume | volume80 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 47 |
| End Page | 54 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 41748149 |
| Web of Science KeyUT | 001712994500006 |
| JaLCDOI | 10.18926/AMO/70071 |
|---|---|
| FullText URL | 80_1_039.pdf |
| Author | Tezel, Nihal| Can, Aslı Gençay| |
| Abstract | The study aimed to determine the prevalence of kinesiophobia in patients who had undergone lumbar microdiscectomy and to examine its associations with pain intensity, disability, quality of life, depression, anxiety, and satisfaction with surgery. Forty-eight patients with microdiscectomy and 48 healthy controls were enrolled. The Tampa Scale for Kinesiophobia (TSK), Roland-Morris Disability Index (RMDI), Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), and Short Form-36 Health Survey (SF-36) were administered to both groups. The scores of TSK, RMDI, HADS-A, and HADS-D were significantly higher and SF-36 scores were significantly lower in the microdiscectomy than the control group (p<0.001 for all). In the microdiscectomy group, median (min-max) RMDI, HADS-A, and HADS-D scores were 19 (4-34), 10 (0-18), and 9 (0-18), respectively, in kinesiophobic patients, and were significantly higher than 6 (2-20), 3 (0-11), 2.5 (0-11) in non-kinesiophobic patients (all p<0.001). The median (min-max) SF-36 PCS, SF-36 MCS, and VAS scores for surgery satisfaction were 36.5 (8.7-75), 52.1 (11-95), 5, 5 (0-10), respectively, in kinesiophobic patients and were significantly lower than 71 (28-95), 85.5 (9-93), 8.5 (3-10) in non-kinesiophobic patients (all p<0.05). TSK scores were significantly correlated with RMDI, HADS-A, HADS-D, SF-36, and surgery satisfaction scores (all p<0.05). Kinesiophobic patients with lumbar microdiscectomy therefore showed greater disability and psychological morbidity, poorer quality of life, and lower satisfaction with surgery. |
| Keywords | kinesiophobia microdiscectomy disability quality of life depression |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-02 |
| Volume | volume80 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 39 |
| End Page | 46 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 41748148 |
| Web of Science KeyUT | 001712994500005 |
| JaLCDOI | 10.18926/AMO/70070 |
|---|---|
| FullText URL | 80_1_031.pdf |
| Author | Ishibashi, Kyota| Oishi, Hirotaka| Araki, Ryo| Kawamura, Kosuke| Sasaki, Isamu| Sasaki, Eiji| Kamada, Hikaru| Kogawa, Masakazu| Tanaka, Sunao| Numasawa, Takuya| Ishibashi, Yasuyuki| |
| Abstract | We investigated global alignment changes following total hip arthroplasty (THA) and predictive alignment parameters for increased cup anteversion (CA) by retrospectively analyzing the primary THA data of 75 patients treated at our hospital (49 women, 26 men; age 65.1±5.7 years, BMI 28.3±3.4 kg/m2). Global alignment parameters, i.e., the anterior pelvic plane angle (APPa) and proximal femoral shaft angle (PFSa) and other alignment parameters were measured. CA was evaluated based on the patients’ standing coronal radiographs. ΔCA was defined as the difference in CA from 2 weeks before to 1 year after each THA. We classified the cases as stable (S) (CA < 10°; n=63) and pelvic retroversion (R) (CA ≥ 10°; n=12) groups. Associations between ΔCA and alignment parameters were evaluated by linear regression and a receiver operating characteristic (ROC) analysis. A significant decrease in the PFSa occurred between the 2-week and 1-year post-THA timepoints (7.8±4.3° vs. 4.2±3.6°, p<0.001), with no notable change in other alignment parameters. At 1-year post-THA, the CA of 12 (16%) patients had increased to 4.5±4.4°. Only the preoperative APPa was positively associated with ΔCA (β=0.165, p=0.020). The ROC analysis revealed that the optimal cut-off value for increased CA in the APPa is 2.1° (area under the curve, 0.700; p=0.020; odds ratio, 4.80). The APPa change predicted increased CA, which emphasizes the importance of the use of preoperative standing radiography for identifying the optimal cup positioning for post-THA changes in CA. |
| Keywords | total hip arthroplasty global alignment anterior pelvic plane cup anteversion pelvic tilt |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-02 |
| Volume | volume80 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 31 |
| End Page | 37 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 41748147 |
| Web of Science KeyUT | 001712994500004 |
| JaLCDOI | 10.18926/AMO/70069 |
|---|---|
| FullText URL | 80_1_017.pdf |
| Author | Yano, Hideki| Takahata, Yoko| Yamaguchi, Takeshi| Saito, Shinya| |
| Abstract | This study aimed to develop a scale enabling nurses to objectively evaluate their own stroke discharge support, as a basis for enhancing its overall effectiveness. A draft scale was created based on a literature review, and consisted of a 51-item, 5-point Likert-type questionnaire administered to ward nurses engaged in stroke discharge support at acute care hospitals. Factor analysis was performed to refine the scale. Construct validity was assessed using the known-groups method, and reliability was evaluated through internal consistency analysis. The resulting Stroke Discharge Support Evaluation Scale comprises 29 items across 5 factors, each rated on a 5-point Likert scale. Analysis of the data collected from 237 valid responses demonstrated good internal consistency and supported the scale’s construct validity. The Stroke Discharge Support Evaluation Scale is a reliable and valid tool enabling ward nurses in acute care hospitals to evaluate their own stroke discharge support. |
| Keywords | stroke discharge support scale development |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-02 |
| Volume | volume80 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 17 |
| End Page | 30 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 41748146 |
| Web of Science KeyUT | 001712994500003 |
| JaLCDOI | 10.18926/AMO/70068 |
|---|---|
| FullText URL | 80_1_009.pdf |
| Author | Sugahara, Kentaro| Kondo, Takashi| Miyatake, Nobuyuki| Nishi, Hiroyuki| Ujike, Kazuhiro| Koumoto, Kiichi| Namio, Keiichi| Hishii, Shuhei| Katayama, Akihiko| Suzuki, Hiromi| Yamamoto, Yorimasa| |
| Abstract | Appropriate treatments for chronic hemodialysis patients are a public health challenge in Japan. Sedentary behavior appears to be closely associated with these patients’ survival. We thus sought to develop a nomogram that predicts survival based on the duration of chronic hemodialysis patients’ sedentary behavior. One hundred twenty-four patients under chronic hemodialysis (73 men, 51 women, age 71.7±11.1 years) were enrolled in this cohort study. The patients wore a triaxial accelerometer that measured both their sedentary behavior, i.e., total sedentary behavior (minutes) and their maximum sedentary bouts (min) on non-hemodialysis days. We obtained the Kaplan-Meier curve and used the log-rank test and a Cox proportional hazards model to evaluate the relationship between the patients’ sedentary behavior and their survival. We also used a Cox proportional hazards model to develop a nomogram for the patients’ 5-year survival rate. Forty-six patients died during the follow-up period. When we stratified the patients by the medians of total sedentary behavior and maximum sedentary bouts, we observed significant between-group differences. After adjustment for confounding factors in a Cox proportional hazards model, total sedentary behavior and maximum sedentary bouts were identified as critical survival factors, and we generated a nomogram using an index of sedentary behavior. Our analysis results demonstrated that sedentary behavior on non-dialysis days was closely associated with the survival of the chronic hemodialysis patients, suggesting that a decrease in sedentary behavior would prolong their survival. The nomogram developed herein based on sedentary behavior may be useful for predicting the outcomes of chronic hemodialysis patients. |
| Keywords | nomogram chronic hemodialysis sedentary behavior Cox proportional hazards model Kaplan- Meier curve |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-02 |
| Volume | volume80 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 9 |
| End Page | 16 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 41748145 |
| Web of Science KeyUT | 001712994500002 |
| JaLCDOI | 10.18926/AMO/70067 |
|---|---|
| FullText URL | 80_1_001.pdf |
| Author | Yamaoka, Hidenaru| Yoshida, Masashi| Sarashina, Toshihiro| Akagi, Satoshi| Miyoshi, Toru| Munemasa, Mitsuru| Nakamura, Kazufumi| Ito, Hiroshi| Yuasa, Shinsuke| |
| Abstract | Venous thromboembolism (VTE) is a serious complication in patients with cancer. In this population, the presence of thrombi is often assessed at cancer diagnosis by measuring D-dimer levels, which have high sensitivity but low specificity for identifying VTE at this clinical time point. However, the usefulness of D-dimer measurement during anticoagulation therapy has not been fully established, despite its widespread use. In this retrospective observational study, we investigated whether D-dimer measurement during anticoagulation therapy in cancer patients could predict overt VTE at follow-up. The study included patients who underwent D-dimer testing and contrast-enhanced computed tomography between 30 and 100 days after initiation of anticoagulation therapy. Eighty-two patients were included: 60 with cancer and 22 without. The diagnostic performance of D-dimer for overt VTE was as follows: sensitivity, 85.7%; specificity, 87.2%; positive predictive value, 78.3%; and negative predictive value, 89.2%. These findings suggest that D-dimer measurement at follow-up has high sensitivity and specificity for overt VTE in cancer patients and may aid in assessing thrombotic status. Clinically, if anticoagulation therapy is continued until D-dimer levels become negative, the absence of overt VTE could be inferred without additional invasive testing. |
| Keywords | D-dimer venous thromboembolism cancer |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2026-02 |
| Volume | volume80 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 1 |
| End Page | 7 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2026 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 41748144 |
| Web of Science KeyUT | 001712994500001 |
| JaLCDOI | 10.18926/AMO/69851 |
|---|---|
| FullText URL | 79_6_469.pdf |
| Author | Tsujii, Teruyuki| Matsuda, Tatsuo| Kimura, Yuji| Katsube, Ryoichi| Iwadou, Hironori| Funabiki, Sadami| Kamikawa, Yasuaki| Matsuda, Tadakazu| |
| Abstract | 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. |
| Keywords | nasointestinal ileus tube intussusception small bowel obstruction enterectomy conservative treatment |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-12 |
| Volume | volume79 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 41443810 |
| Web of Science KeyUT | 001674277500010 |
| JaLCDOI | 10.18926/AMO/69850 |
|---|---|
| FullText URL | 79_6_463.pdf |
| Author | Asano, Yudai| Nishihara, Chika| Kitayama, Takahiro| Okawa, Nanako| Makimoto, Satoko| Higaki, Fumiyo| Kojima, Katsuhide| Sugihara, Hanako| Ida, Naoyuki| Yanai, Hiroyuki| Hiraki, Takao| |
| Abstract | 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. |
| Keywords | mesonephric adenocarcinoma cervical cancer MRI imaging characteristics HPV-independent adenocarcinoma |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-12 |
| Volume | volume79 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 463 |
| End Page | 468 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 41443809 |
| Web of Science KeyUT | 001674277500009 |
