result 3716 件
| JaLCDOI | 10.18926/AMO/56867 |
|---|---|
| FullText URL | 73_3_241.pdf |
| Author | Utsumi, Masashi| Aoki, Hideki| Nishimura, Seitaro| Une, Yuta| Kashima, Hajime| Kimura, Yuji| Taniguchi, Fumitaka| Arata, Takashi| Katsuda, Koh| Tanakaya, Kohji| |
| Abstract | Gallbladder carcinoma (GBC) is a common malignancy with a poor prognosis. With the average life expectancy increasing globally, the incidence of GBC is predicted to increase as well. We investigated the safety and feasibility of surgical treatment for elderly patients with GBC. We retrospectively compared clinical pathological data and treatment outcomes in 45 consecutive GBC patients (23 patients ≥ 75 years [elderly group] and 22 patients < 75 years [younger group]) who underwent curative resection at the Iwakuni Center from January 2008 to December 2017. The proportion of preoperative comorbidities and anticoagulant use was significantly higher in the elderly group. The American Society of Anesthesiologists score was higher in the elderly versus the younger group, and the elderly group had significantly shorter operation times. Reduced activities of daily living was more common in the elderly versus younger group. The percentage of radical resection and overall 3-year survival (66.6% younger vs. 64.4% elderly) were similar between the groups. Controlling Nutritional Status (CONUT) score ≥ 3 and R0 resection were identified as prognostic factors for overall survival rate among all patients. After careful patient selection, |
| Keywords | elderly patient gallbladder carcinoma prognostic factor surgical treatment |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-06 |
| Volume | volume73 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 241 |
| End Page | 246 |
| 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 | 31235972 |
| 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/56865 |
|---|---|
| FullText URL | 73_3_229.pdf |
| Author | Hamasaki, Ichiro| Shibata, Kiyo| Shimizu, Takehiro| Kono, Reika| Morizane, Yuki| Shiraga, Fumio| |
| Abstract | During strabismus surgery using illumination from a light source, patients complain of photophobia. The NGENUITYⓇ (Alcon) system is equipped with a high-dynamic-range (HDR) camera. A 4K display viewed by wearing circularly polarized glasses provides clear three-dimensional images of the operative field. A light source is usually required for surgeries of the anterior segment (including strabismic surgery), but the digital processing function of the NGENUITYⓇ system allows image display in relatively dark regions even without a light source. We devised a novel ‘lights-out’ surgery that does not use a microscope’s light source, and we examined the usefulness of this technique in 2 cases of strabismic surgery. We performed strabismus surgery using the NGENUITYⓇ system in two patients between January and June 2018. The HDR function was used, and the aperture was opened to the maximum while the gain was adjusted. Surgery was conducted without using the microscope’s light source. We report the 2 cases’ results and evaluate the novel method. The surgeries were performed without problem even though the microscope’s light source was not used. The patients’ photophobia was alleviated. Lights-out surgery is a potentially useful modality for strabismus surgery. |
| Keywords | head-up surgery 3D vision system high dynamic range video enhancement strabismus surgery |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-06 |
| Volume | volume73 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 229 |
| End Page | 233 |
| 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 | 31235970 |
| JaLCDOI | 10.18926/AMO/56864 |
|---|---|
| FullText URL | 73_3_223.pdf |
| Author | Sugiu, Kazuhisa| Furumatsu, Takayuki| Kodama, Yuya| Kamatsuki, Yusuke| Okazaki, Yoshiki| Okazaki, Yuki| Hiranaka, Takaaki| Ozaki, Toshifumi| |
| Abstract | Anterior cruciate ligament (ACL) reconstruction (ACLR) after ACL rupture improves the instability of the knee joint and decreases mechanical stress to the meniscus and articular cartilage. However, there are reports that post-traumatic osteoarthritis (PTOA) is observed over time following ACLR. In this study, we assessed changes in cartilage lesions by arthroscopic findings following anatomical double-bundle ACLR and at post-operative second-look arthroscopy about 14 months later. We retrospectively evaluated 37 knees in cases with patients <40 years of age who had undergone an anatomical double-bundle ACL reconstruction <1 year after ACL rupture injury from March 2012 to December 2016. Clinical results and arthroscopic cartilage/meniscal lesion were evaluated and compared between a cartilage lesion-detected group and intact-cartilage group. Surgery improved anteroposterior laxity and other clinical measures; however, cartilage lesions were detected at 11 sites during ACLR and at 54 sites at second-look arthroscopy. The periods from injury to second-look arthroscopy and from ACLR to second-look arthroscopy were significantly longer in the cartilage-lesion group (n=23) than in the intact-cartilage group (n=14). Conversely, 96% of meniscal damage observed during ACLR was cured at the time of second-look arthroscopy. Knee articular cartilage lesions after ACL rupture cannot be completely suppressed, even using the anatomical ACL reconstruction technique. This study suggested that articular cartilage lesions can progress to a level that can be confirmed arthroscopically at approximately 17 months after ACL injury. Therefore, in ACLR patients, the possibility of developing knee articular cartilage lesions and PTOA should be considered. |
| Keywords | anterior cruciate ligament reconstruction post-traumatic osteoarthritis meniscal lesion cartilage lesions second-look arthroscopy |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-06 |
| Volume | volume73 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 223 |
| End Page | 228 |
| 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 | 31235969 |
| 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 |
| JaLCDOI | 10.18926/AMO/56862 |
|---|---|
| FullText URL | 73_3_205.pdf |
| Author | Mukai, Yuko| Sakurai, Toru| Watanabe, Toshiyuki| Sako, Tomoko| Sugimoto, Morito| Kimata, Yoshihiro| Mori, Yoshiko| Nagasaka, Takeshi| Namba, Yuzaburo| |
| Abstract | Intestinal vaginoplasty has several advantageous features, such as scarless surgery, low incidence of contraction of the reconstructed vagina, maintenance of vaginal depth, spontaneous mucus production, and a low rate of complications. Therefore, this technique is becoming popular in many countries. Following the global trend, the demand for intestinal vaginoplasty for transsexuals is also increasing in Japan. However, there are few reports on intestinal vaginoplasty in Japan. In this study, we examined the safety and effectiveness of rectosigmoid colon vaginoplasty in the Japanese population. We retrospectively surveyed 18 male-to-female transsexuals who underwent laparoscopic rectosigmoid colon vaginoplasty at the Okayama University Hospital Gender Center between October 2012 and December 2017. One patient had developed an anastomotic leak and 2 patients experienced vaginal prolapse, which needed revision surgery. Both adverse outcomes were comparable with those from previous studies. The anastomotic leak was managed adequately with conservative treatment. To avoid vaginal prolapse, it is important to decide the length of the rectosigmoid segment so that a pull on it does not cause it to become lax, while excessive stress on the feeder vessels is avoided. Based on our study, we concluded that rectosigmoid vaginoplasty was a reliable technique in the Japanese population. |
| Keywords | vaginoplasty male-to-female transsexuals rectosigmoid colon |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-06 |
| Volume | volume73 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 205 |
| End Page | 211 |
| 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 | 31235967 |
| JaLCDOI | 10.18926/AMO/56861 |
|---|---|
| FullText URL | 73_3_197.pdf |
| Author | Nishimura, Takeshi| Naito, Hiromichi| Matsuyama, Shigenari| Ishihara, Satoshi| Nakao, Atsunori| Nakayama, Shinichi| |
| Abstract | Japan's population has been skewing toward the elderly, but the outcomes of advanced elderly trauma are not clear. Here we compared the outcomes of very elderly trauma patients (≧85 years old) with those of 65- to 84-year-old trauma patients. We retrospectively reviewed the medical records of patients treated at Hyogo Emergency Medical Center from August 2010 to August 2016; 631 patients were entered in the study. We divided them into the younger geriatrics (YG group, 65-84 years old: n=534) and older geriatrics (OG group, ≧85 years old: n=97). The group’s patient characteristics, mortality, 1-year survival rate, and Barthel index were tabulated and compared. The patients’ mean age was 75.6±7.5 years. There was no significant difference in mortality between the YG and OG groups (9.6% vs. 15.1%, odds ratio [OR] 1.73; 95% confidence interval [CI] 0.93-3.23, p=0.083). The 1-year survival rate (94.4% vs. 77.8%, OR 0.19, 95% CI 0.07-0.51; p<0.01) and Barthel index (Median score; 100 (IQR: 85-100) vs. 80 (IQR: 15-95), OR 0.98, 95% CI 0.97 to 0.99, p<0.01) differed significantly between the groups. Our study did not find a significant difference in-hospital mortality between patients in the YG group and those in the OG group. |
| Keywords | aged injury mortality morbidity trauma |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-06 |
| Volume | volume73 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 197 |
| End Page | 203 |
| 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 | 31235966 |
| reference | Leskovan JJ, Justiniano CF, Bach JA, Cook CH, Lindsey DE, Eiferman DS, Papadimos TJ, Steinberg SM, Bergese SD, Stawicki SP and Evans DC: Anion gap as a predictor of trauma outcomes in the older trauma population: correlations with injury severity and mortality. Am Surg (2013) 79: 1203-1206.| Tornetta P, 3rd, Mostafavi H, Riina J, Turen C, Reimer B, Levine R, Behrens F, Geller J, Ritter C and Homel P: Morbidity and mortality in elderly trauma patients. J Trauma (1999) 46: 702-706.| Aitken LM, Burmeister E, Lang J, Chaboyer W and Richmond TS: Characteristics and outcomes of injured older adults after hospital admission. J Am Geriatr Soc (2010) 58: 442-449. | Mahoney FI and Barthel DW: Functional Evaluation: The Barthel Index. Md State Med J (1965) 14: 61-65.| Mondello S, Cantrell A, Italiano D, Fodale V, Mondello P and Ang D: Complications of trauma patients admitted to the ICU in level I academic trauma centers in the United States. Biomed Res Int (2014) 473419.| Hammer PM, Storey AC, Bell T, Bayt D, Hockaday MS, Zarzaur BL Jr., Feliciano DV and Rozycki GS: Improving geriatric trauma outcomes: A small step toward a big problem. J Trauma Acute Care Surg (2016) 81: 162-167.| Prin M and Li G: Complications and in-hospital mortality in trauma patients treated in intensive care units in the United States, 2013. Injury Epidemiology (2016) 3.| Zielinski MD, Kuntz MM, Polites SF, Boggust A, Nelson H, Khasawneh MA, Jenkins DH, Harmsen S, Ballman KV and Pieper R: A prospective analysis of urinary tract infections among elderly trauma patients. J Trauma Acute Care Surg (2015) 79: 638-642.| Polites SF, Habermann EB, Thomsen KM, Amr MA, Jenkins DH, Zietlow SP and Zielinski MD: Urinary tract infection in elderly trauma patients: review of the Trauma Quality Improvement Program identifies the population at risk. J Trauma Acute Care Surg (2014) 77: 952-959.| Magnotti LJ, Croce MA and Fabian TC: Is ventilator-associated pneumonia in trauma patients an epiphenomenon or a cause of death? Surg Infect (Larchmt) (2004) 5: 237-242.| Hyllienmark P, Brattstrom O, Larsson E, Martling CR, Petersson J and Oldner A: High incidence of post-injury pneumonia in intensive care-treated trauma patients. Acta Anaesthesiol Scand (2013) 57: 848-854.| Kisat M, Villegas CV, Onguti S, Zafar SN, Latif A, Efron DT, Haut ER, Schneider EB, Lipsett PA, Zafar H and Haider AH: Predictors of sepsis in moderately severely injured patients: an analysis of the National Trauma Data Bank. Surg Infect (Larchmt) (2013) 14: 62-68.| Wafaisade A, Lefering R, Bouillon B, Sakka SG, Thamm OC, Paffrath T, Neugebauer E and Maegele M: Epidemiology and risk factors of sepsis after multiple trauma: an analysis of 29,829 patients from the Trauma Registry of the German Society for Trauma Surgery. Crit Care Med (2011) 39: 621-628.| Bukur M, Habib F, Catino J, Parra M, Farrington R, Crawford M and Puente I: Does unit designation matter? A dedicated trauma intensive care unit is associated with lower postinjury complication rates and death after major complication. J Trauma Acute Care Surg (2015) 78: 920-927.| Reiff DA, Shoultz T, Griffin RL, Taylor B and Rue LW 3rd: Use of a Bundle Checklist Combined With Physician Confirmation Reduces Risk of Nosocomial Complications and Death in Trauma Patients Compared to Documented Checklist Use Alone. Ann Surg 2015 (262): 647-652.| Searle SD, Mitnitski A, Gahbauer EA, Gill TM and Rockwood K: A standard procedure for creating a frailty index. BMC Geriatr (2008) 8: 24.| Joseph B, Pandit V, Zangbar B, Kulvatunyou N, Hashmi A, Green DJ, OʼKeeffe T, Tang A, Vercruysse G, Fain MJ, Friese RS and Rhee P: Superiority of frailty over age in predicting outcomes among geriatric trauma patients: a prospective analysis. JAMA Surg (2014) 149: 766-772.| |
| JaLCDOI | 10.18926/AMO/56860 |
|---|---|
| FullText URL | 73_3_189.pdf |
| Author | Sakamoto, Shinji| Kawai, Hiroki| Okahisa, Yuko| Tsutsui, Ko| Kanbayashi, Takashi| Tanaka, Keiko| Mizuki, Yutaka| Takaki, Manabu| Yamada, Norihito| |
| Abstract | Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a recently-discovered autoimmune disorder in which antibodies target NMDAR in the brain. The number of reported cases of anti-NMDAR encephalitis has increased rapidly. Anti-NMDAR encephalitis can be mistakenly diagnosed as psychiatric disorders because many patients present with prominent psychiatric symptoms and visit psychiatric institutions first. Thus, psychiatrists should cultivate a better understanding of anti-NMDAR encephalitis. In this review, we present the mechanisms, epidemiology, symptoms and clinical course, diagnostic tests, treatment and outcomes of patients with anti-NMDAR encephalitis. Furthermore, we discuss the diversity of clinical spectra of anti-NMDAR encephalitis, and demonstrate a differential diagnosis of psychiatric disease from the perspective of psychiatry. |
| Keywords | NMDAR encephalitis psychiatric symptom schizophrenia mood disorder |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-06 |
| Volume | volume73 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 189 |
| End Page | 195 |
| 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 | 31235965 |
| JaLCDOI | 10.18926/AMO/56655 |
|---|---|
| FullText URL | 73_2_181.pdf |
| Author | Okamura, Tomoka| Washio, Yousuke| Yoshimoto, Junko| Tani, Kazumasa| Tsukahara, Hirokazu| Shimada, Akira| |
| Abstract | Most cases of transient abnormal myelopoiesis (TAM) in neonates with Down syndrome (DS) resolve spontaneously; however, DS-TAM neonates with hydrops fetalis (HF) show poor clinical outcomes. We report three infants with DS-TAM and HF who were treated with exchange transfusion (ET) followed by low-dose cytarabine (LD-CA). All of them survived without developing liver failure, acute leukemia, or other serious adverse events. Our results suggest that this combination treatment with ET and LD-CA would be safe, tolerable and effective as an novel approach for DS-TAM patients with HF. |
| Keywords | cytarabine Down syndrome exchange transfusion hydrops fetalis transient abnormal myelopoiesis |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-04 |
| Volume | volume73 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 181 |
| End Page | 188 |
| 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 | 31015754 |
| JaLCDOI | 10.18926/AMO/56654 |
|---|---|
| FullText URL | 73_2_177.pdf |
| Author | Okita, Atsushi| Ohtani, Jun| |
| Abstract | We report a rare case of fistulation to the jejunum after percutaneous endoscopic gastrostomy (PEG). An 85-year-old man with previous cerebral infarction and swallowing disturbance underwent PEG. Nine months later, he developed a high fever and discharge around the gastrostomy button. He was diagnosed with aspiration pneumonia, and administered antibiotic therapy. Examination showed digestive fluid around the gastrostomy button. Gastrointestinal contrast-enhanced CT revealed a gastrojejunocutaneous fistula. The button was removed, and the fistula closed naturally. PEG was performed again. The patient’s postoperative course was uneventful. Gastrojejunocutaneous fistula should be considered in cases involving increased discharge from a gastrostomy fistula. |
| Keywords | percutaneous endoscopic gastrostomy gastrojejunocutaneous fistula |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-04 |
| Volume | volume73 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 177 |
| End Page | 180 |
| 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 | 31015753 |
| JaLCDOI | 10.18926/AMO/56653 |
|---|---|
| FullText URL | 73_2_173.pdf |
| Author | Tamada, Shoko| Masuyama, Hisashi| Hayata, Kei| Eto, Eriko| Mitsui, Takashi| Eguchi, Takeshi| Maki, Jota| Tani, Kazumasa| |
| Abstract | Radical trachelectomy (RT) is a fertility-sparing surgery for cervical cancer. Postoperative pregnancies have a high risk of abortion and prematurity. To prevent this, a procedure involving transabdominal cerclage (TAC) was devised for shortened cervical canals post-RT. Here we describe the successful management of a pregnancy after abdominal RT (ART). The 34-year-old patient was gravida 1, para 0. When she was 27, she underwent ART for stage Ib1 cervical cancer, and she became pregnant 7 years later. Because her cervical canal was 16.7 mm during early pregnancy, we performed TAC at 12 weeks of pregnancy. Post-surgery, we administered an infusion of ritodrine hydrochloride for tocolysis. A selective caesarean section was performed at 36 weeks, with the delivery of a healthy infant. |
| Keywords | cervical cancer radical trachelectomy pregnancy transabdominal cerclage |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-04 |
| Volume | volume73 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 173 |
| End Page | 176 |
| 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 | 31015752 |
| JaLCDOI | 10.18926/AMO/56652 |
|---|---|
| FullText URL | 73_2_161.pdf |
| Author | Okamoto, Sachiyo| Matsuoka, Ken-ichi| Sakamoto, Maiko| Usui, Yoshiaki| Fujiwara, Yuki| Kondo, Takumi| Tani, Katsuma| Saeki, Kyosuke| Meguri, Yusuke| Asada, Noboru| Ennishi, Daisuke| Nishimori, Hisakazu| Fujii, Keiko| Fujii, Nobuharu| Maeda, Yoshinobu| |
| Abstract | Second allogeneic stem cell transplantation (allo-SCT) is a potentially curative therapy for patients who relapse after first allo-SCT. Human leukocyte antigen (HLA)-haploidentical related donors provide the broad opportunity to conduct second SCT at the appropriate time, but the efficacy of second SCT from haploidentical donors after relapse has not been established. We retrospectively analyzed the records of 33 patients who underwent second SCT. Twenty patients underwent haplo-SCT with low-dose antithymocyte globulin (ATG), and the other 13 patients underwent conventional- SCTs, including HLA-matched related peripheral blood, unrelated bone marrow or cord blood. Three years after the second SCT, the overall survival (OS) and progression-free survival (PFS) of all patients were 32.5% and 23.9%. Multivariate analyses indicated that non-complete response at second SCT, less than 1-year interval to relapse after first- SCT, and total score ≥ 3 on the hematopoietic cell transplantation-specific comorbidity index were significantly associated with a lower PFS rate. The haplo- and conventional- SCT groups showed equivalent results regarding OS, PFS, cumulative incidences of relapse, non-relapse mortality and graft-versus-host disease. The neutropenic period after transplantation was significantly shorter in haplo- SCT than conventional- SCT (10.5 days vs. 16 days, p=0.001). Our analysis revealed that haplo-SCT could be an alternative therapeutic option for relapsed patients after first SCT. |
| Keywords | allogeneic stem cell transplantation haploidentical stem cell transplantation relapse anti-T lymphocyte globulin |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-04 |
| Volume | volume73 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 161 |
| End Page | 171 |
| 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 | 31015751 |
| JaLCDOI | 10.18926/AMO/56651 |
|---|---|
| FullText URL | 73_2_155.pdf |
| Author | Minami, Daisuke| Kayatani, Hiroe| Sato, Ken| Fujiwara, Keiichi| Shibayama, Takuo| Yonei, Toshiro| Sato, Toshio| |
| Abstract | We investigated the clinical characteristics of refractory asthma associated with the effectiveness of bronchial thermoplasty (BT). We retrospectively evaluated data from 10 patients who underwent BT between June 2016 and December 2017 at Okayama Medical Center. The following were measured before and 6 months post-BT: forced expiratory volume in 1.0 s (FEV1), fractional exhaled nitric oxide (FeNO), immunoglobulin E (IgE) level, blood eosinophil counts (Eosi), Asthma Quality of Life Questionnaire (AQLQ) score, and preventive medication use. At baseline, the mean post-bronchodilator FEV1 was 80.9% of the predicted value (range 45.6-115.7%). All patients were being treated with moderate- or high-dose inhaled corticosteroids and long-acting β2 agonists. The AQLQ improved from 4.26±1.67 at baseline to 5.59±0.94 at 6 months post-BT (p<0.05). The %FEV1, FeNO, IgE, and Eosi did not change significantly between baseline and 6 months post-BT. No severe complications were reported. BT was effective for non-allergic and non-eosinophilic in 3 patients, and allergic or eosinophilic in 4 patients. Their AQLQ improved by > 0.5 points post-BT. For both allergic and eosinophilic asthmatics following mepolizumab, BT was not useful. BT was effective for non-allergic and non-eosinophilic or allergic asthmatics, but insufficient for both allergic and eosinophilic following mepolizumab. |
| Keywords | bronchial thermoplasty non-allergic asthma non-eosinophilic asthma airway hyper-responsiveness patient selection |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-04 |
| Volume | volume73 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 155 |
| End Page | 160 |
| 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 | 31015750 |
| JaLCDOI | 10.18926/AMO/56650 |
|---|---|
| FullText URL | 73_2_147.pdf |
| Author | Hayashi, Masao| Taniguchi, Arata| Kaku, Ryuji| Fujimoto, Shusaku| Isoyama, Satoshi| Manabe, Sei| Yoshida, Tsubasa| Suzuki, Satoshi| Shimizu, Kazuyoshi| Morimatsu, Hiroshi| Momota, Ryusuke| |
| Abstract | Tachycardia is common in intensive care units (ICUs). It is unknown whether tachycardia or prolonged tachycardia affects patient outcomes. We investigated the association between tachycardia and mortality in critically ill patients. This retrospective cohort study’s primary outcome was patient mortality in the ICU and the hospital. We stratified the patients (n=476) by heart rate (HR) as LowHR, MediumHR, and HighHR groups. We also stratified them by their durations of HR >100 (prolonged HR; tachycardia): MildT, ModerateT, and SevereT groups. We determined the six groups’ mortality. The ICU mortality rates of the LowHR, MediumHR, and HighHR groups were 1.0%, 1.5%, and 7.9%, respectively; significantly higher in the HighHR vs. LowHR group. The in-hospital mortality rates of these groups were 1%, 4.5%, and 14.6%, respectively; significantly higher in the HighHR vs. LowHR group. The ICU mortality rates of the MildT, ModerateT, and SevereT groups were 0.9%, 5.6%, and 57.1%, respectively. The mortality of the HRT=0 (i.e., all HR ≤ 100) patients was 0%. The in-hospital mortality rates of the MildT, ModerateT, and SevereT groups were 1.8%, 16.7%, and 85.7%, respectively; that of the HRT=0 patients was 0.5%. Both higher HR and prolonged tachycardia were associated with poor outcomes. |
| Keywords | tachycardia mortality ICU in-hospital |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-04 |
| Volume | volume73 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 147 |
| End Page | 153 |
| 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 | 31015749 |
| JaLCDOI | 10.18926/AMO/56649 |
|---|---|
| FullText URL | 73_2_135.pdf |
| Author | Maeba, Takahiro| Yonezawa, Tomoko| Ono, Mitsuaki| Tomono, Yasuko| Heljasvaara, Ritva| Pihlajaniemi, Taina| Inagawa, Kiichi| Oohashi, Toshitaka| |
| Abstract | The basement membrane (BM) is composed of various extracellular molecules and regulates tissue regeneration and maintenance. Here, we demonstrate that collagen XVIII was spatiotemporally expressed in the BM during skin wound healing in a mouse excisional wound-splinting model. Re-epithelialization was detected at days 3 and 6 post-wounding. The ultrastructure of epidermal BM was discontinuous at day 3, whereas on day 6 a continuous BM was observed in the region proximal to the wound edge. Immunohistochemistry demonstrated that collagen XVIII was deposited in the BM zone beneath newly forming epidermis in day 3 and 6 wounds. Laminin-332, known to be the earliest BM component appearing in wounds, was colocalized with collagen XVIII in the epidermal BM zone at days 3 and 6. The deposition of α1(IV) collagen and nidogen-1 in the epidermal BM zone occurred later than that of collagen XVIII. We also observed the short isoform of collagen XVIII in the epidermal BM zone at day 3 post-wounding. Collectively, our results suggested that collagen XVIII plays a role in the formation of the dermal-epidermal junction during re-epithelialization, and that it is the short isoform that is involved in the early phase of re-epithelialization. |
| Keywords | collagen XVIII basement membrane wound healing re-epithelialization skin |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-04 |
| Volume | volume73 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 135 |
| End Page | 146 |
| 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 | 31015748 |
| JaLCDOI | 10.18926/AMO/56648 |
|---|---|
| FullText URL | 73_2_127.pdf |
| Author | Iwasaki, Yukari| Miyahara, Kimiko| Miyatake, Nobuyuki| Nakatsuka, Mikiya| |
| Abstract | We aimed to clarify the state of thyroid function in female high school long-distance runners. We evaluated the associations between thyroid function and menstrual condition, bone mineral density (BMD), nutritious status, and body composition. The subjects’ height and weight were measured, along with fat percentage, fat mass, muscle mass, and BMD with dual-energy X-ray absorptiometry. A nutrition and dietary survey measured the subjects’ intake of energy and nutrients based on meals provided at the subjects’ dorm for 3 days in July of 2016 and 2017. Blood parameters including thyroid hormone and estradiol were measured. Most of the subjects (81.3%) were underweight (body mass index <18.5). The thyroid hormone free T3 value was decreased, but TSH was not increased and was similar to that observed in individuals with anorexia nervosa. In our subjects, thyroid hormone was associated with BMD and nutritional intake. To improve the menstruation abnormality of female athletes and to increase their bone density, the athletes’ weight should be managed by proper nutrient intake and the maintenance of their thyroid function. |
| Keywords | thyroid function nutritious status female high school long-distance runners bone mineral density menstrual condition |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-04 |
| Volume | volume73 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 127 |
| End Page | 133 |
| 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 | 31015747 |
| JaLCDOI | 10.18926/AMO/56647 |
|---|---|
| FullText URL | 73_2_117.pdf |
| Author | Yamasaki, Yukie| Tamiya, Nanako| Yamamoto, Hideki| Miyaishi, Satoru| |
| Abstract | According to the World Health Organization’s World Report, approx. 950,000 children and young people < 18 years old die from an injury each year, and unintentional injury deaths account for a large portion of these cases. Here we used medico-legal documents to epidemiologically analyze the cases of unintentional injury deaths among children < 5 years old in Okayama Prefecture, Japan from 2001 to 2015. Age, sex, manner/cause of death, and various circumstances of the incident were investigated. There were 73 unintentional injury deaths during the study period. Drowning (n=29), suffocation (n=24), and transport accidents (n=13) were the major categories of unintentional injury deaths. Twenty-two cases (30.1%) were autopsied. Differences in the characteristics of the unintentional injury deaths by age were observed. Information which cannot be obtained from Vital Statistics was available from medico-legal documents, and detailed characteristics of unintentional injury deaths among children < 5 years old were elucidated. Investigating medico-legal information is one of the meaningful measures for the prevention of unintentional injury deaths among children in Japan. |
| Keywords | child death unintentional injury prevention medico-legal document |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-04 |
| Volume | volume73 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 117 |
| End Page | 125 |
| 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 | 31015746 |
| JaLCDOI | 10.18926/AMO/56646 |
|---|---|
| FullText URL | 73_2_109.pdf |
| Author | Abe, Makoto| Iwamuro, Masaya| Kawahara, Yoshiro| Kanzaki, Hiromitsu| Kawano, Seiji| Tanaka, Takehiro| Tsumura, Munechika| Makino, Takuma| Noda, Yohei| Marunaka, Hidenori| Nishizaki, Kazunori| Okada, Hiroyuki| |
| Abstract | The efficacy and safety of endoscopic submucosal dissection (ESD) for superficial cancer of the pharynx are still unclear. To identify clinicopathological features of superficial pharyngeal cancer, and the efficacy and safety of ESD, we retrospectively assessed 70 pharyngeal cancers in 59 patients who underwent ESD. Of these patients, 61.0% and 50.8% had a history of esophageal cancer and head and neck cancer, respectively. The median tumor size was 15 mm, and 75.7% of the lesions were located at the piriform sinus. The en bloc resection rate was 94.9%. Treatment-related adverse events occurred in 8 cases, but there was no treatment-related death. The lateral margin was positive for neoplasm in 3 lesions (4.3%) and inconclusive in 27 lesions (38.6%), but no local recurrence was observed. Cervical lymph node metastasis was observed in 6 patients, and was successfully treated by cervical lymph node dissection. The three-year overall survival rate was 91.5% (95%CI: 76.6-97.3%) and the cause-specific survival rate was 97.6% (95%CI: 84.9-99.7%). In conclusion, ESD for superficial pharyngeal cancer was safe and effective. “Resect and watch” is probably a feasible and rational strategy for treatment of patients with superficial pharyngeal cancer. |
| Keywords | endoscopic submucosal dissection superficial cancer pharynx endoscopic resection |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-04 |
| Volume | volume73 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 109 |
| End Page | 115 |
| 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 | 31015745 |
| JaLCDOI | 10.18926/AMO/56645 |
|---|---|
| FullText URL | 73_2_101.pdf |
| Author | Iida, Atsuyoshi| Naito, Hiromichi| Yorifuji, Takashi| Zamami, Yoshito| Yamada, Akane| Koga, Tadashi| Imai, Toru| Sendo, Toshiaki| Nakao, Atsunori| Ichiba, Shingo| |
| Abstract | Sedatives are administered during extracorporeal membrane oxygenation (ECMO) therapy to ensure patient safety, reduce the metabolic rate and correct the oxygen supply-demand balance. However, the concentrations of sedatives can be decreased due to absorption into the circuit. This study examined factors affecting the absorption of a commonly used sedative, midazolam (MDZ). Using multiple ex vivo simulation models, three factors that may influence MDZ levels in the ECMO circuit were examined: polyvinyl chloride (PVC) tubing in the circuit, use of a membrane oxygenator in the circuit, and heparin coating of the circuit. We also assessed changes in drug concentration when MDZ was re-injected in a circuit. The MDZ level decreased to approximately 60% of the initial concentration in simulated circuits within the first 30 minutes. The strongest factor in this phenomenon was contact with the PVC tubing. Membrane oxygenator use tended to increase MDZ loss, whereas heparin circuit coating had no influence on MDZ absorption. Similar results were obtained when a second dose of MDZ was injected to the second-use circuits. |
| Keywords | sedatives ECMO polyvinyl chloride pharmacokinetics pharmacodynamics |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-04 |
| Volume | volume73 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 101 |
| End Page | 107 |
| 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 | 31015744 |
| JaLCDOI | 10.18926/AMO/56644 |
|---|---|
| FullText URL | 73_2_95.pdf |
| Author | Ercan, Sabriye| Başkurt, Ferdi| Başkurt, Zeliha| Çetin, Cem| |
| Abstract | The aim of this study was to examine effect of fatigue levels on functional mobility and balance in middle-aged obese females. The study included 98 healthy females aged 40-60 years with BMI ≥ 30 kg/m2. Self-perceived fatigue was evaluated with a self-administered questionnaire, the Checklist of Individual Strength in Turkish (CIS-T), on which 62.3% of the study subjects identified themselves as fatigued. The body weight and BMI values of fatigued subjects were found to be higher than those of the non-fatigue group (p<0.05). The reported exercise habits of the fatigue group were found to be significantly lower than their non-fatigued peers (p<0.05). The level of functional mobility (Timed Up and Go Test), static balance (One-Legged Stance Test with Eyes Open) and dynamic balance (Functional Reach Test and the 3-meter Timed Tandem Walk Test) were measured, and statistically significant differences were found between fatigue and non-fatigue groups on all of them (p<0.05). In addition, correlations were found between the sub-parameters of the CIS-T scale and the functional tests at |
| Keywords | fatigue obesity mobility balance woman |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2019-04 |
| Volume | volume73 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 95 |
| End Page | 100 |
| 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 | 31015743 |
