result 279 件
| JaLCDOI | 10.18926/AMO/57712 |
|---|---|
| FullText URL | 73_6_487.pdf |
| Author | Kishimoto, Fumiko| Fujii, Chiaki| Okanouchi, Toshio| Ohtsuki, Hiroshi| |
| Abstract | We used spectral-domain optical coherence tomography (SD-OCT) to compare the foveal and parafoveal structures of 19 subjects aged 16-58 years (8 men, 11 women): 6 amblyopic patients with eccentric fixation, 5 amblyopic patients with central fixation, and 8 visually normal controls. We obtained foveal horizontal line scans using SD-OCT on all of the patients and controls. The total and layer thicknesses at foveal areas were analyzed. The mean (SD) ages of individuals in the eccentric fixation, central fixation, and control groups were 43.0 (13.9), 42.2 (16.3), and 38.5 (15.5) years, respectively. We observed no significant differences in the foveal or parafoveal retinal thicknesses at 500 and 1,500 μm from the foveal center among the 3 groups or between the amblyopic and fellow eyes. No significant differences were observed in the thickness of the ganglion cell complex layer or outer retinal layer at 500 and 1,500 μm from the foveal center among the three groups or between the two eyes. Overall, our SD-OCT analyses revealed no characteristic structural change in foveal regions in amblyopic eyes irrespective of the fixation behavior. |
| Keywords | foveal structure strabismic amblyopia optical coherence tomography eccentric fixation |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-12 |
| Volume | volume73 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 487 |
| End Page | 494 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31871330 |
| Web of Science KeyUT | 000503431400003 |
| JaLCDOI | 10.18926/AMO/57711 |
|---|---|
| FullText URL | 73_6_479.pdf |
| Author | Suganami, Yu| Oka, Kosuke| Hanayama, Yoshihisa| Honda, Hiroyuki| Hamahara, Jun| Obika, Mikako| Kariyama, Kazuya| Kishida, Masayuki| Otsuka, Fumio| |
| Abstract | To clarify the potential relevance of patients’ chief complaints at a general medicine department to their self-rating depression scale (SDS) and frequency scale for symptoms of gastroesophageal reflux disease (GERD) (FSSG) scores, we analyzed data of 478 patients who visited our general medicine department. The chief complaints (553 symptoms of 447 patients) were categorized into major symptom-based groups: respiratory (31%), circulatory (3%), gastrointestinal (GI) tract (26%), neurology (8%), orthopedic and skin (10%), and systemic (22%) symptoms. The SDS score tended to be higher in females and younger patients. The FSSG score did not differ by gender but was higher in younger patients. The patients receiving social welfare had higher SDS and FSSG scores. A close inter-relationship between the FSSG (including both degrees of reflux and dysmotility) and SDS was observed in all patients. Although the averages of the SDS and FSSG scores were not significantly different among the symptom-based categories, we observed significantly positive correlations between the FSSG and SDS in each category, suggesting that depressive status may be closely related to GERD-related symptoms regardless of the patients’ chief complaints. An initial checkup of patients’ psychological condition and/or GERD-like symptoms could help screen for latent disorders in outpatients with uncertain complaints. |
| Keywords | chief complaints frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) self-rating depression scale (SDS) welfare |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-12 |
| Volume | volume73 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 479 |
| End Page | 486 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31871329 |
| Web of Science KeyUT | 000503431400002 |
| JaLCDOI | 10.18926/AMO/57710 |
|---|---|
| FullText URL | 73_6_475.pdf |
| Author | Umebayashi, Ryoko| Uchida, Haruhito A.| Wada, Junzo| |
| Abstract | Abdominal aortic aneurysms (AAAs) usually expand asymptomatically until the occurrence of a life-threatening event such as aortic rupture, which is closely associated with high mortality. AAA and aortic dissection are ranked among the top 10 causes of death in Japan. The major risk factors for AAA are age over 65 years, male gender, family history, and smoking. Thus, for prevention, smoking cessation is the most important lifestyle-intervention. For treatment, since AAA generally affects elderly people, less invasive treatment is preferable. However, the only established treatment for AAA is open repair and endovascular repair. This review describes potential medical treatments to slow aneurysm growth or prevent AAA rupture. |
| Keywords | abdominal aortic aneurysms medical treatment anti-platelet drugs |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-12 |
| Volume | volume73 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 475 |
| End Page | 477 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31871328 |
| Web of Science KeyUT | 000503431400001 |
| JaLCDOI | 10.18926/AMO/57375 |
|---|---|
| FullText URL | 73_5_441.pdf |
| Author | Watanabe, Toshiyuki| Sakurai, Toru| Mukai, Yuko| Kimata, Yoshihiro| Namba, Yuzaburo| |
| Abstract | Gender dysphoria is a condition in which a discrepancy between biological sex and gender identity causes distress. Many female-to-male transsexuals (FTMTS) are uncomfortable with female breasts. Chest wall contouring surgery is effective for obtaining a male-type chest, reducing mental stress, and increasing sexual satisfaction in such cases. At the Okayama University Hospital Gender Center, we have obtained positive results using an algorithm to determine the most appropriate surgical method for chest wall contouring in FTMTS patients. However, serious complications requiring reoperation, such as hematoma, may still occur. Postoperative hematomas were found in 15 (4.18%) of 358 FTMTS patients who underwent chest contouring surgery at our hospital between 2006 and 2018. Postoperative hematoma was examined retrospectively. The median time to the onset of hematoma was 7 (6-12) h after the initial surgery. The main blood vessels causing bleeding were those in the head-side skin flap region where visual confirmation was difficult and the perforator vessels from the pectoralis major muscle. Intraoperative bleeding and the operation time had a significant impact on the onset of postoperative hematoma. This is the first retrospective study that investigated the blood vessels and other factors contributing to postoperative hematoma development after chest wall contouring. |
| Keywords | female-to-male transsexuals chest wall contouring postoperative hematoma |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-10 |
| Volume | volume73 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 441 |
| End Page | 447 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31649371 |
| Web of Science KeyUT | 000491886600010 |
| JaLCDOI | 10.18926/AMO/57374 |
|---|---|
| FullText URL | 73_5_433.pdf |
| Author | Tamada, Shoko| Mitsui, Takashi| Ohira, Akiko| Tani, Kazumasa| Maki, Jota| Eguchi, Takeshi| Eto, Eriko| Hayata, Kei| Masuyama, Hisashi| |
| Abstract | An association between preeclampsia and (pro)renin was recently reported. Intracellular signaling of the (pro) renin receptor [(P)RR] increases the expressions of TGF-β and PAI-1. In this study we sought to clarify the involvement of (pro)renin in the pathogenesis of preeclampsia via the intracellular signaling of (P)RR on preeclampsia placentas. Activated (pro)renin plasma concentrations were compared between pregnant women with (n=15) and without (n=28) preeclampsia. The placentas were immunohistochemically evaluated with anti-HIF-1α and anti-(P)RR antibodies. HTR-8/SVneo cells were cultured under hypoxic conditions and treated with human recombinant (pro)renin. The mRNA expressions of HIF-1α, (P)RR, PAI-1, TGF-β, and ET-1 were also examined by real-time RCR. The activated (pro)renin plasma concentration was significantly higher in the third vs. the second trimester in the preeclampsia patients. HIF-1α and (P)RR expressions were significantly increased in the preeclampsia placentas. The mRNA expressions of PAI-1, TGF-β, and ET-1 were significantly increased in the experiments using recombinant (pro)renin vs. hypoxic conditions. (P)RR expression in preeclampsia placentas is increased by persistent hypoxia through the second and third trimesters, and PAI-1, TGF-β, and ET-1 production is increased via (P)RR. Our results suggest that ET-1 production via the intracellular signaling of (P)RR is important in the pathogenesis of preeclampsia. |
| Keywords | preeclampsia (pro)renin (pro)renin receptor endothelin-1 HTR-8/SVneo |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-10 |
| Volume | volume73 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 433 |
| End Page | 440 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31649370 |
| Web of Science KeyUT | 000491886600009 |
| JaLCDOI | 10.18926/AMO/57372 |
|---|---|
| FullText URL | 73_5_419.pdf |
| Author | Hishii, Shuhei| Miyatake, Nobuyuki| Nishi, Hiroyuki| Katayama, Akihiko| Ujike, Kazuhiro| Koumoto, Kiichi| Suzuki, Hiromi| Hashimoto, Hiroo| |
| Abstract | We investigated the relationship between sedentary behavior and all-cause mortality in patients undergoing hemodialysis. A total of 71 patients (39 men, 32 women, aged 72.1±11.7 years) were enrolled in this longitudinal study. Their sedentary behavior was measured using a tri-accelerometer that provides relative values per daily wearing time. We classified the sedentary behavior time into 2 groups (under the median: short-sedentary behavior (SB) group; over the median: long-SB group) and compared the groups’ clinical parameters. We compared the groups’ survival rates by using Kaplan-Meier curves and the log-rank test, and we performed multivariate analyses by a Cox-proportional hazard model to evaluate the relationship between the sedentary behavior and the survival rate. Twenty patients (28.2%) died during the observation period. The survival rate of the short-SB group was significantly higher than that of the long-SB group. Sedentary behavior was thus an important factor for all-cause mortality even after adjusting for confounding factors by a Cox-proportional hazard model. Sedentary behavior is closely linked to all-cause mortality, especially total days and non-hemodialysis days, and reducing sedentary behavior may be beneficial to reduce the all-cause mortality of patients on chronic hemodialysis. |
| Keywords | sedentary behavior hemodialysis mortality physical activity |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-10 |
| Volume | volume73 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 419 |
| End Page | 425 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31649368 |
| Web of Science KeyUT | 000491886600007 |
| JaLCDOI | 10.18926/AMO/57370 |
|---|---|
| FullText URL | 73_5_403.pdf |
| Author | Ando, Akemi| Mitsuhashi, Toshiharu| Honda, Mitsugi| Hanayama, Yoshihisa| Hasegawa, Kou| Obika, Mikako| Kataoka, Hitomi| Otsuka, Fumio| |
| Abstract | Osteoporosis increases the risk of bone fractures. It is diagnosed based on an individual’s bone mineral density (BMD) or a fracture without trauma. BMD is usually measured by the dual energy X-ray absorptiometry (DXA) method. Here we investigated factors for the earliest possible prediction of decreased BMD by examining the relationships between patients’ BMD values and changes in the patients’ physical and laboratory values. We retrospectively reviewed the medical records of 149 patients who visited our department in 2014-2015 for a variety of reasons and underwent an area BMD examination by DXA. We analyzed the relationships between decreasing BMD and the patients’ gender, age, body mass index (BMI), medical background, hemoglobin, electrolytes, and thyroid function. Thirty-nine of the patients were diagnosed with osteoporosis based on their T-scores. An adjusted analysis showed that female gender, aging, and increased serum calcium level were significantly related to decreasing femoral BMD, whereas high BMI was associated with an increase in femoral BMD. Collectively the results indicate that for the early detection of low BMD, it is important for general-practice physicians to consider conducting a BMD checkup when treating female and elderly patients with a low BMI and/or elevated serum calcium level. |
| Keywords | bone mineral density (BMD) body mass index (BMI) female gender hypercalcemia osteoporosis |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-10 |
| Volume | volume73 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 403 |
| End Page | 411 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31649366 |
| Web of Science KeyUT | 000491886600005 |
| JaLCDOI | 10.18926/AMO/57369 |
|---|---|
| FullText URL | 73_5_393.pdf |
| Author | Yi Yi Cho Thein| Win, Myitzu| Thuzara, Moe| Matsumoto, Hiroshi| Yamada, Kiyoshi| Kimata, Yoshihiro| Leung, Michael| |
| Abstract | Although many surgical centers perform microsurgery routinely in developed countries, performing microsurgery is challenging in resource-poor developing countries, such as Myanmar. With the establishment of educational training programs and the assistance of volunteer plastic surgical teams, local plastic surgeons can learn the techniques of microsurgery and apply them clinically. The purpose of this study was to establish baseline data and define the challenges of performing microsurgery in Yangon General Hospital, Myanmar. Sixty-four patients underwent reconstruction with free flaps from January 2015 to January 2018. All clinical records of these cases were assessed. The number of free flap reconstructions performed increased from 11 in the first year to 24 in the third year. The anterolateral thigh flap was the most commonly used (42%). The most common sites of reconstruction were mandible and intraoral defects. Total flap survival occurred in 58 of 64 patients (89%). The total salvageable flap rate for revision surgery was 66.6%; the successful revision rate was highest in 2017, with fewer complications. The flap salvage rates increased and the operative duration decreased as clinical experience improved. Establishing a microsurgical center requires a strong multidisciplinary team, clinical experience, continuous learning, sensible clinical application, and effective interdepartmental and intradepartmental cooperation. |
| Keywords | microsurgery educational programs challenges of microsurgical free flaps reoperation flap salvageable rate |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-10 |
| Volume | volume73 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 393 |
| End Page | 401 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31649365 |
| Web of Science KeyUT | 000491886600004 |
| JaLCDOI | 10.18926/AMO/57367 |
|---|---|
| FullText URL | 73_5_383.pdf |
| Author | Fu, Li| Nishibori, Masahiro| |
| Abstract | High mobility group box-1 (HMGB1) is a non-histone, DNA-binding nuclear protein belonging to the family of damage-associated molecular patterns (DAMPs). HMGB1 has been reported to play an important role during epileptogenesis although the mechanisms of its actions are still not clear. Many hypotheses have been suggested especially about the relationship between HMGB1 and inflammation responses and blood-brain barrier disruption during epileptogenesis. In this review, we will mainly discuss the role of HMGB1 in epileptogenesis. |
| Keywords | HMGB1 epileptogenesis inflammation blood-brain barrier |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-10 |
| Volume | volume73 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 383 |
| End Page | 386 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31649363 |
| Web of Science KeyUT | 000491886600002 |
| FullText URL | J_Thorac_Oncol_201907017.pdf |
|---|---|
| Author | Makimoto, Go| Ohashi, Kadoaki| Tomida, Shuta| Nishii, Kazuya| Matsubara, Takehiro| Kayatani, Hiroe| Higo, Hisao| Ninomiya, Kiichiro| Sato, Akiko| Watanabe, Hiromi| Kano, Hirohisa| Ninomiya, Takashi| Kubo, Toshio| Rai, Kammei| Ichihara, Eiki| Hotta, Katsuyuki| Tabata, Masahiro| Toyooka, Shinichi| Takata, Minoru| Maeda, Yoshinobu| Kiura, Katsuyuki| |
| Keywords | ALK G1202R Alectinib Amphiregulin MET NSCLC |
| Published Date | 2019-07-30 |
| Publication Title | Journal of Thoracic Oncology |
| Volume | volume14 |
| Issue | issue11 |
| Publisher | Elsevier |
| Start Page | 2009 |
| End Page | 2018 |
| ISSN | 15560864 |
| NCID | AA12058455 |
| Content Type | Journal Article |
| language | English |
| OAI-PMH Set | 岡山大学 |
| Copyright Holders | © 2019 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved. |
| File Version | author |
| PubMed ID | 31374369 |
| DOI | 10.1016/j.jtho.2019.07.017 |
| Web of Science KeyUT | 000492678300025 |
| Related Url | isVersionOf https://doi.org/10.1016/j.jtho.2019.07.017 |
| JaLCDOI | 10.18926/AMO/56937 |
|---|---|
| FullText URL | 73_4_349.pdf |
| Author | Isozaki, Hiroshi| Yamamoto, Yasuhisa| Murakami, Shigeki| Matsumoto, Sasau| Takama, Takehiro| |
| Abstract | To clarify the surgical outcomes of breast cancer patients with a preoperative diagnosis of ductal carcinoma in situ (DCIS) by core needle biopsy (CNB) (abbreviated as CNBDCIS), we retrospectively analyzed the cases of 131 patients with CNBDCIS who underwent surgery at Oomoto Hospital (32 total mastectomies, 99 conservative mastectomies). Our analysis of underestimation and predictors of invasive breast cancer of CNBDCIS revealed that the underestimation rate of CNBDCIS was 40.5% (53/131). A logistic regression analysis revealed that palpable tumors (yes to no, odds ratio [OR] 3.25), mammography (MMG) category group (category 4 or 5 to categories 1 , 2, or 3, OR 4.69) and MMG microcalcifications (no to yes, OR 0.24) were significant predictive factors for CNBDCIS invasion. In our analysis of the predictors of positive margins during CNBDCIS surgery, 36 (27.5%) of the 131 patients had positive margins after postoperative pathological examination. A logistic regression analysis revealed that the operative procedure (conservative surgery to total mastectomy, OR 21.4) and MMG microcalcifications (yes to no, OR 3.35) were significant factors related to positive margins during CNBDCIS surgery. Thus, MMG microcalcifications are a negative predictor of upgrading of CNBDCIS and a positive predictor of positive surgical margins for CNBDCIS. |
| Keywords | ductal carcinoma in situ core needle biopsy underestimation positive margins microcalcifications on mammography |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-08 |
| Volume | volume73 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 349 |
| End Page | 356 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31439958 |
| JaLCDOI | 10.18926/AMO/56936 |
|---|---|
| FullText URL | 73_4_341.pdf |
| Author | Kitajima, Kazuhiro| Yamamoto, Shingo| Nakanishi, Yukako| Yamada, Yusuke| Hashimoto, Takahiko| Suzuki, Toru| Go, Shuken| Kanematsu, Akihiro| Nojima, Michio| Fujiwara, Masayuki| Kaida, Hayato| Tsurusaki, Masakatsu| Kanda, Tomonori| Tamaki, Yukihisa | Yamakado, Koichiro| |
| Abstract | We investigated the effectiveness of 11C-choline-positron emission tomography/computed tomography (PET/CT) for evaluating treatment response in patients with prostate cancer or renal cell carcinoma. We performed 34 11C-choline PET/CT scans before/after a combined total of 17 courses of treatment in 6 patients with prostate cancer and 2 with renal cell carcinoma. The 17 treatments including hormonal therapy, radiotherapy, chemotherapy, radium-223, molecular target therapy, radiofrequency ablation, transcatheter arterial embolization, and cancer immunotherapy yielded 1 (5.9%) complete metabolic response (CMR), 3 (17.6%) partial metabolic responses (PMRs), 2 (11.8%) stable metabolic diseases (SMDs), and 11 (64.7%) progressive metabolic diseases (PMDs). Target lesions were observed in bone (n=14), lymph nodes (n=5), lung (n=2), prostate (n=2), and pleura (n=1), with CMR in 4, PMR in 10, SMD in 8 and PMD in 2 lesions. SUVmax values of the target lesions before and after treatment were 7.87±2.67 and 5.29±3.98, respectively, for a mean reduction of −35.4±43.6%. The response for the 8 prostate cancer-treatment courses was PMD, which correlated well with changes in serum prostatic specific antigen (PSA) (7 of 8 cases showed increased PSA). 11C-choline-PET/CT may be an effective tool for detecting viable residual tumors and evaluating treatment response in prostate cancer and renal cell carcinoma patients. |
| Keywords | treatment response 11C-choline PET/CT prostate cancer renal cell carcinoma |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-08 |
| Volume | volume73 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 341 |
| End Page | 347 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31439957 |
| JaLCDOI | 10.18926/AMO/56934 |
|---|---|
| FullText URL | 73_4_325.pdf |
| Author | Ueno, Tsuyoshi| Maki, Yuho| Sugimoto, Ryujiro| Suehisa, Hiroshi| Yamashita, Motohiro| Harada, Daijiro| Kozuki, Toshiyuki| Nogami, Naoyuki| |
| Abstract | Therapeutic approaches to bronchopleural fistula (BPF) closure after lung resection are surgical or endoscopic interventions. We evaluated therapeutic outcomes to determine the optimal approach. We reviewed 15 patients who had developed BPF after lung resection for thoracic malignant diseases at our institution in the 10 years since 2008. The patients were 11 men and 4 women (mean age 68 years). We performed one pneumonectomy, 6 lobectomies, 7 segmentectomies, and one partial resection for malignant diseases. The median interval from lung resection to the BPF diagnosis was 46 days. The BPF-associated mortality rate was 26.7% (4/15). The rate of successful BPF closure was 66.6% (10/15). The endoscopic and surgical intervention success rates were 14.2% (1/7) and 69.2% (9/13), respectively (p<0.01). Of 5 patients who had failed BPF treatments, 4 died, and one transferred out without BPF closure. The therapeutic outcomes were related to preoperative comorbidities, performance status at the BPF diagnosis, time intervals from lung resection to BPF diagnosis, and presence of active pneumonia. The difference between endoscopic and surgical outcomes was nonsignificant, although the surgical intervention success rate was somewhat higher. The selection of endoscopic or surgical intervention for BPF does not significantly affect therapeutic outcomes. |
| Keywords | bronchopleural fistula endoscopic intervention surgical intervention |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-08 |
| Volume | volume73 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 325 |
| End Page | 331 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31439955 |
| JaLCDOI | 10.18926/AMO/56932 |
|---|---|
| FullText URL | 73_4_307.pdf |
| Author | Takahashi, Sho| Akagi, Teiji| Toh, Norihisa| Takaya, Yoichi| Nakagawa, Koji| Nishii, Nobuhiro| Ito, Hiroshi| |
| Abstract | The follow-up of patients with adult congenital heart disease (ACHD) at a specialized medical unit is necessary for the patients’ appropriate medical care. However, limited information is available about cardiovascular events among ACHD patients. Here we investigated the type and frequency of cardiovascular events in ACHD patients in relation to disease complexity. We retrospectively analyzed the cases of 535 patients (median age 35 years) referred to our ACHD center between 2014 and 2017. We divided the patients into 3 groups based on their disease complexity. To evaluate the relationship between disease complexity and cardiovascular events, we performed univariate and multivariate survival analyses. The Simple, moderate, and complex disease groups accounted for 62%, 19%, and 19% of the patients, respectively. Apart from events related to atrial septal defect (ASD) trans-catheter treatment, the frequency of cardiovascular events was dependent on the disease complexity (event-free survival rates at 3 years were 85%, 65%, and 58%, respectively). The hazard ratios were 4.0 and 5.1 in the moderate and complex groups, respectively. With the exception of scheduled transcatheter intervention, cardiovascular events were strongly related to the disease complexity of original heart disease. However, cardiovascular events were not rare even in the simple ACHD group. |
| Keywords | congenital heart defect congenital in adults hospitalization cardiovascular event |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-08 |
| Volume | volume73 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 307 |
| End Page | 313 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31439953 |
| JaLCDOI | 10.18926/AMO/56931 |
|---|---|
| FullText URL | 73_4_299.pdf |
| Author | Hiranaka, Takaaki| Nishida, Keiichiro| Konishiike, Taizo| Ozaki, Toshifumi| Mikasa, Motohiko| |
| Abstract | The fixation technique of bony fragments is crucial for the bone union of the tuberosities after humeral head replacement (HHR) for a comminuted fracture of the proximal humerus. To increase the bone union rate, we reduce tuberosities to overlap on the humeral shaft by approx. 1 cm and fix them with cable wire. Herein, we retrospectively investigated the clinical and radiographic outcomes of our procedure. Twenty-six patients who underwent cementless HHR for the treatment of comminuted fractures of the proximal humerus were investigated. The Constant-Murley score, active shoulder mobility, and bone union rate were evaluated. The mean duration of follow-up was 56.3 months (range 24-197). At the final follow-up, the average Constant-Murley score was 58 (range 40-76). Forward elevation was 126° on average (range 35°-180°). Twenty-three cases (88%) showed bone union between the tuberosities and the shaft at an average follow-up of 4.1 months (range 4-5 months) after surgery. Non-union was noted in 1 case, and bone resorption was noted in 2 cases. The bone union rate and the clinical outcome of our procedure were relatively favorable |
| Keywords | humeral head replacement tuberosity-overlapping technique bone union of tuberosities cable wire cementless stem |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-08 |
| Volume | volume73 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 299 |
| End Page | 305 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31439952 |
| JaLCDOI | 10.18926/AMO/56930 |
|---|---|
| FullText URL | 73_4_285.pdf |
| Author | Otani, Yoshihiro| Ichikawa, Tomotsugu| Kurozumi, Kazuhiko| Date, Isao| |
| Abstract | Gliomas are characterized as highly diffuse infiltrating tumors, and currently available treatments such as surgery, radiation and chemotherapy are unfeasible or show limited efficacy against these tumors. Recent genetic and epigenetic analyses of glioma have revealed increasing evidence of the role of driver genetic alterations in glioma development and led to the identification of prognostic factors. Despite these findings, the survival rates of glioma patients remain low, and alternative treatments and novel targets are needed. Recent studies identified neural stem cells as the possible origin of gliomas, and some evidence has revealed shared functions and mechanisms between glioma cells and neurons, also supporting their similarity. The cytoskeleton plays important roles in the migration of normal cells as well as cancer cells. Recent reports have described a role for microtubules, a component of the cytoskeleton, in glioma invasion. Notably, several factors that regulate microtubule functions, such as microtubule-associated proteins, plus-end tracking proteins, or motor proteins, are upregulated in glioma tissues compared with normal tissue, and upregulation of these factors is associated with high invasiveness of glioma cells. In this review, we describe the mechanism of microtubules in glioma invasion and discuss the possibility of microtubule-targeted therapy to inhibit glioma invasion. |
| Keywords | glioma cytoskeletons invasion microtubules |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-08 |
| Volume | volume73 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 285 |
| End Page | 297 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31439951 |
| JaLCDOI | 10.18926/AMO/56869 |
|---|---|
| FullText URL | 73_3_255.pdf |
| Author | Seki, Daisuke| Takeshita, Nobuo| Seiryu, Masahiro| Deguchi, Toru| Takano-Yamamoto, Teruko| |
| Abstract | Orthodontists need to understand the orthodontic risks associated with systemic disorders. Axenfeld-Rieger syndrome (ARS) is a rare autosomal dominant disorder with genetic and morphological variability. The risks of orthodontic treatment in ARS patients have been unclear. Here we describe the correction of an anterior open bite in a 15-year-old Japanese female ARS patient by molar intrusion using sectional archwires with miniscrew implants. An undesirable development of external apical root resorption (EARR) was observed in all intrusive force-applied posterior teeth during the patient’s orthodontic treatment, suggesting that ARS patients have a higher risk of EARR than the general population. |
| Keywords | Axenfeld-Rieger syndrome external apical root resorption miniscrew implant anterior open bite |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-06 |
| Volume | volume73 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 255 |
| End Page | 262 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31235974 |
| JaLCDOI | 10.18926/AMO/56868 |
|---|---|
| FullText URL | 73_3_247.pdf |
| Author | Yoshio, Kotaro| Wakita, Akihisa| Mitsuhashi, Toshiharu| Kitayama, Takahiro| Hisazumi, Kento| Inoue, Daisaku| Tajiri, Nobuhisa| Shiode, Tsuyoki| Akaki, Shiro| Kanazawa, Susumu| |
| Abstract | We investigated the feasibility of simultaneous integrated boost (SIB) volumetric modulated arc therapy (VMAT) using elective nodal irradiation (ENI) for middle or lower esophageal cancer and compared it with three-dimensional conformal radiotherapy (3D-CRT). The study included 15 patients. The prescribed doses included a standard dose (50.4 Gy) and a high dose (60 Gy) for the planning target volume (PTV) of the involved lesions. The objective of the whole lung volume receiving ≥ 20 Gy (V20Gy) was < 30%, and the mean lung dose (MLD) was < 20 Gy. The volumes of the lung receiving 5 Gy (V5Gy) and the heart receiving 30-50 Gy (V30-50Gy) were kept as low as reasonably achievable. As a result, SIB-VMAT showed superior dose conformity for the PTV (p<0.001). Although the lung V5Gy was significantly increased (p<0.001), the V20Gy and MLD showed no significant increase. The heart V30-50Gy showed a > 20% reduction in the mean against 3D-CRTs. Our results demonstrate the feasibility of SIB-VMAT for the treatment of middle or lower esophageal cancer with ENI. Although attention should be paid to the low-dose area of the lungs, SIB-VMAT would be a promising treatment option with improved outcomes for esophageal cancer. |
| Keywords | esophageal cancer middle and lower thoracic volumetric modulated arc therapy, 3D-CRT elective nodal irradiation |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-06 |
| Volume | volume73 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 247 |
| End Page | 257 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31235973 |
| JaLCDOI | 10.18926/AMO/56866 |
|---|---|
| FullText URL | 73_3_235.pdf |
| Author | Horita, Masahiro| Nishida, Keiichiro| Hashizume, Kenzo| Sugimoto, Yoshihisa| Nasu, Yoshihisa| Nakahara, Ryuichi| Harada, Ryozo| Ozaki, Toshifumi| |
| Abstract | We investigated the prevalence of and risk factors for the progression of upper cervical lesions (UCLs) in patients with rheumatoid arthritis (RA). A retrospective analysis of 49 patients with RA (4 males, 45 females) was conducted. The UCLs included atlanto-axial subluxation and vertical subluxation. We investigated the clinical factors including the Disease Activity Score 28 based on C-reactive protein (DAS28-CRP) and the modified Health Assessment Questionnaire-Disability Index as well as radiographic changes between the baseline (at May 2010 to April 2013) and final follow-up. Forty patients (81.6%) were classified as the non-progressive group, and the other 9 patients (18.4%) comprised the progressive group. The progressive group’s final CRP values, baseline or final MMP-3 levels, DAS28-CRP, and rate of pre-existing lesions at baseline were all significantly higher than those of the non-progressive group (p=0.017, p=0.043, p=0.002, p=0.008, p<0.001, and p=0.008 respectively). A multivariate logistic regression analysis demonstrated that DAS28-CRP at baseline was a risk factor for radiographic progression (p=0.018, odds ratio: 2.54, 95% confidence interval: 1.17-5.51). Our findings indicate that higher disease activity might influence the progression of UCLs in patients with RA. |
| Keywords | rheumatoid arthritis upper cervical spine lesion risk factor radiological progression |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-06 |
| Volume | volume73 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 235 |
| End Page | 240 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31235971 |
| JaLCDOI | 10.18926/AMO/56863 |
|---|---|
| FullText URL | 73_3_213.pdf |
| Author | Nishina, Saori| Matsuura, Koji| Naruse, Keiji| |
| Abstract | We investigated the relationship between human sperm rheotaxis and motile sperm trajectories by using poly-(dimethylsiloxane) (PDMS)-based cylindrical microfluidic channels with inner diameters of 100 μm, 50 μm, and 70 μm, which corresponded to the inner diameter of the human isthmus, the length of a sperm and a diameter intermediate between the two, respectively. We counted the number of rheotaxic sperm and sperm with spiral motion. We also analyzed motile sperm trajectories. As the cylindrical channel diameter was decreased, the percentage of sperm cells exhibiting rheotaxis, the percentage of sperm cells exhibiting spiral motion, the frequency-to-diameter ratio of the sperm cells’ spiral trajectories, and the surface area of the microfluidic channel increased, while the flagellar motion at the channel wall decreased. The percentage of sperm exhibiting a spiral trajectory and the frequency-to-diameter ratio of the sperm cells’ spiral trajectories were thus affected by the channel diameter. Our findings suggest that the oviduct structure affects the swimming properties of sperm cells, guiding them from the uterus to the ampulla for egg fertilization. These results could contribute to the development of motile sperm-sorting microfluidic devices for assisted reproductive technologies. |
| Keywords | sperm motility trajectory microfluidic channel rheotaxis oviduct structure |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-06 |
| Volume | volume73 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 213 |
| End Page | 221 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2019 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 31235968 |
