result 732 件
| Title Alternative | Surgically treated Zenker’s diverticulum： Diverticulectomy and cricopharyngeal myotomy |
|---|---|
| FullText URL | 127_19.pdf |
| Author | Ninomiya, Takayuki| Kanaya, Nobuhiko| Katsuda, Koh| Tanakaya, Kohji| Aoki, Hideki| Takeuchi, Hitoshi| |
| Abstract | Zenker's diverticulum is a very rare disease among gastorointestinal diverticulum. We report a case of Zenker's diverticulum successfully treated with diverticulectomy and cricophalyngial myotomy. A 71-year-old male complained of aspirating water for two years. He was diagnosed as Zenker's diverticulum. Due to his severe symptoms, the operation was performed in an open-neck approach. The left recurrent laryngeal nerve was identified and preserved. An incision was made in the diverticulum wall, and the internal diameter of normal cervical esophagus was measured. The diverticulum was then excised with an automatic suture device in the minor axis direction of the esophagus. A cricopharyngeal myotomy was conducted, because this muscle was fibrotic and stiffened. The patient's symptoms disappeared after the operation. Diverticulectomy and cricopharyngeal myotomy through an open-neck approach is a safe and reliable method that follows, direct access to the diverticulum and recurrent laryngeal nerve. |
| Keywords | Zenker憩室（Zenker’s diverticulum） 輪状咽頭筋切開術（cricopharyngeal myotomy） 頚部アプローチ（open-neck approach） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2015-04-01 |
| Volume | volume127 |
| Issue | issue1 |
| Start Page | 19 |
| End Page | 23 |
| ISSN | 0030-1558 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2015 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.127.19 |
| NAID | 130005068344 |
| JaLCDOI | 10.18926/AMO/53124 |
|---|---|
| FullText URL | 69_1_65.pdf |
| Author | Ueno, Tsuyoshi| Yamashita, Motohiro| Sawada, Shigeki| Suehisa, Hiroshi| Kawamoto, Hiroaki| Takahata, Hiroyuki| |
| Abstract | Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm that occurs at different sites in the body. Pleural IMT in particular is especially rare. IMTs infrequently tend to have malignancy. We report a rare case of advanced diaphragmatic parietal pleural IMT with dissemination. A 30-year-old woman complained of right upper abdominal pain. Computed tomography showed a large lobulated mass over the right diaphragm, but no disseminated nodules were noted. Intraoperatively, we found the primary tumor arising from the diaphragmatic parietal pleura and a dozen disseminated nodules, and we removed them completely. The histopathological and immunohistochemical diagnosis was IMT. |
| Keywords | inflammatory myofibroblastic tumor pleura dissemination |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-02 |
| Volume | volume69 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 65 |
| End Page | 68 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2015 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25703173 |
| Web of Science KeyUT | 000349740300008 |
| JaLCDOI | 10.18926/AMO/53123 |
|---|---|
| FullText URL | 69_1_59.pdf |
| Author | Tsuchie, Hiroyuki| Miyakoshi, Naohisa| Nishi, Tomio| Abe, Hidekazu| Segawa, Toyohito| Shimada, Yoichi| |
| Abstract | Roughly half of the femoral fracture patients diagnosed with AFF according to the criteria suggested by a task force of the American Society for Bone and Mineral Research (ASBMR) have not undergone bisphosphonate (BP) therapy. One suspected cause of such fractures is severe bone loss due to osteomalacia, but the pathogenesis remains unknown. We report a case of an 84-year-old woman with AFF not treated by BP therapy, in whom underlying osteomalacia was histologically diagnosed. The involvement of femoral curvature and spino-pelvic malaligment in the fracture in the present case was considered. |
| Keywords | osteomalacia atypical fracture femur osteoporosis kyphosis |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-02 |
| Volume | volume69 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 59 |
| End Page | 63 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2015 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25703172 |
| Web of Science KeyUT | 000349740300007 |
| JaLCDOI | 10.18926/AMO/53028 |
|---|---|
| FullText URL | 68_6_379.pdf |
| Author | Doi, Shinichiro| Kimura, Shuhei| Morizane, Yuki| Hosogi, Mika| Hosokawa, Mio| Shiode, Yusuke| Kawata, Tetsuhiro| Kondo, Eisei| Shiraga, Fumio| |
| Abstract | We report a case of POEMS syndrome in a 20-year-old patient diagnosed after visiting an eye clinic with a chief complaint of reduced visual acuity. A male university student aged 20 years was referred to our department complaining of blurred vision in both eyes that had persisted for 1 month. He also noted headache, nausea, and paresthesia in the lower extremities around the same time. The visual acuity of his right and left eye was 20/40 and 20/20, respectively. Optic disc edema and serous retinal detachment were present. Brain magnetic resonance imaging showed no intracranial abnormalities, while elevated cerebrospinal fluid pressure, reduced nerve conduction velocity in both lower extremities, hepatosplenomegaly, M proteinemia, high blood VEGF levels, osteoblastic and osteolytic changes in the spine, and atypical plasma cells in bone lesions were noted. From the above findings, the patient was diagnosed with POEMS syndrome. He received high-dose dexamethasone, thalidomide, and radiotherapy on the sacral mass, followed by high-dose melphalan with autologous stem-cell support, and showed subsequent systemic and ophthalmologic improvement. Here, we report the youngest case ever of POEMS syndrome with ocular manifestation. If patients have optic disc edema in both eyes with no intracranial space-occupying lesion, POEMS syndrome should be considered in differential diagnosis, regardless of age. |
| Keywords | POEMS syndrome serous retinal detachment VEGF |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-12 |
| Volume | volume68 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 379 |
| End Page | 383 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25519033 |
| Web of Science KeyUT | 000346882200009 |
| JaLCDOI | 10.18926/AMO/53027 |
|---|---|
| FullText URL | 68_6_375.pdf |
| Author | Yamanaka, Reiko| Soga, Yoshihiko| Moriya, Yoshie| Okui, Akemi| Takeuchi, Tetsuo| Sato, Kenji| Morimatsu, Hiroshi| Morita, Manabu| |
| Abstract | We encountered a 74-year-old male patient with tongue laceration after convulsive seizures under intensive care. The tongue showed severe swelling, and the right ventral surface had been lacerated by his isolated and pointed right lower canine. Our university hospital has established a perioperative management center, and is promoting interprofessional collaboration, including dentists, in perioperative management. Dentists collaborating in the perioperative management center took dental impressions, with the support of anesthesiologists who opened the patientʼs jaw under propofol sedation, to produce a mouth protector. By raising the patientʼs bite, the completed mouth protector prevented the isolated tooth from contacting the tongue and protected the lacerated wound. Use of the mouth protector prevented the lacerated tongue from coming into contact with the pointed tooth, and the tongue healed gradually. These findings underscore that interprofessional collaboration including dentists can improve the quality of medical care. |
| Keywords | mouth protector tongue laceration |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-12 |
| Volume | volume68 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 375 |
| End Page | 378 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25519032 |
| Web of Science KeyUT | 000346882200008 |
| JaLCDOI | 10.18926/AMO/53026 |
|---|---|
| FullText URL | 68_6_369.pdf |
| Author | Iwamuro, Masaya| Miyashima, Yuichi| Yoshioka, Takahiro| Murata, Toshihiro| Miyabe, Yoshio| Kawai, Yoshinari| Urata, Haruo| Shiraha, Hidenori| Okada, Hiroyuki| Yamamoto, Kazuhide| |
| Abstract | A 67-year-old Japanese man underwent enterotomy because of enterolith ileus. Component analysis by infrared spectroscopy revealed that the enterolith was composed of a high concentration of deoxycholic acid. We further analyzed and compared the ultrastructure of the enterolith and a commercially available powdered form of deoxycholic acid by means of scanning electron microscopy and energy dispersive X-ray spectroscopy. Energy dispersive X-ray spectroscopy analysis revealed that the ratios of carbon and oxygen in the enterolith were equal to those in the deoxycholic acid powder. Scanning electron microscopy analysis showed rectangular prism-shaped particles on the surface of the enterolith. This structure was similar to that of the deoxycholic acid powder. The surgically removed enterolith had a twisted and coiled appearance. Possible mechanisms underlying the formation of this unique form are discussed. |
| Keywords | enterolith deoxycholic acid scanning electron microscopy infrared spectroscopy energy dispersive X-ray spectroscopy |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-12 |
| Volume | volume68 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 369 |
| End Page | 374 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25519031 |
| Web of Science KeyUT | 000346882200007 |
| JaLCDOI | 10.18926/AMO/53025 |
|---|---|
| FullText URL | 68_6_363.pdf |
| Author | Ota, Seisuke| Hiramatsu, Yasushi| Kondo, Eisei| Kasahara, Akinori| Takada, Saimon| Umena, Sachio| Noguchi, Toshio| Tanimoto, Mitsune| Matsumura, Tadashi| |
| Abstract | Leukocytosis is occasionally seen in patients with presumptive but undiagnosed myeloproliferative disorders (MPD). A 74-year-old woman was admitted to our hospital for tarry stools, anemia, and marked peripheral leukocytosis of 1.4×105/μL. Gastroenteroscopy revealed an acute gastric and duodenal mucosal lesion that was treated successfully via endoscopic hemoclipping. Bone marrow aspiration revealed marked megakaryocyte proliferation with atypia of naked nuclei and marrow hypercellularity (90% cellularity). A fluorescence in situ hybridization test could not detect the BCR-ABL fusion gene. Bone marrow aspiration later revealed further abnormalities of megakaryocytes. The patient died from cerebral bleeding. The present case fulfilled 2 of the 3 major criteria of primary myelofibrosis according to the World Health Organization 2008 classification:namely, megakaryocytic hyperplasia with hypercellular marrow and granulocytic hyperplasia. However, the megakaryocytic abnormality was not strictly compatible with the criteria. Instead, we considered prefibrotic primary myelofibrosis as a possibility, although myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable (MDS/MPN-U) was technically the correct diagnosis. The present case shows that MPN diagnosis remains difficult and suggests that other cases of peripheral leukocytosis with diagnosed MDS/MPN-U might include similar findings. |
| Keywords | prefibrotic primary myelofibrosis leukocytosis anemia acute gastric mucosal lesion multiple cerebral hemorrhages |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-12 |
| Volume | volume68 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 363 |
| End Page | 368 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25519030 |
| Web of Science KeyUT | 000346882200006 |
| Title Alternative | A case of microscopic low-grade appendiceal mucinous neoplasm complicated with appendicitis resected by reduced-port laparoscopic surgery |
|---|---|
| FullText URL | 126_223.pdf |
| Author | Suzuki, Hiromitsu| Kimura, Kouji| Kinoshita, Sigeki| Okano, Kazuo| |
| Abstract | Appendicitis is a benign disease for which surgical treatment is widely provided. The complication of neoplastic lesions may be discovered only after resection. However, in some cases, specimens are not submitted to histopathological examination in Japan because of an extreme deficiency of pathologists. We report our experience with one patient who experienced the complication of latent low-grade appendiceal mucinous neoplasm (LAMN) after surgery for appendicitis. Our patient was an 85-year-old woman. Conservative treatment failed to relieve fever and lower abdominal pain and it was decided to treat her surgically. Abdominal computed tomography (CT) showed appendicitis with severe inflammation and suspected adhesion. We decided to explore the abdominal cavity using a reduced-port laparoscopic approach. We found no mucous debouchment or clear tumors in the specimen. Histopathological findings indicated the coexistence of appendicitis and LAMN. At one year and a half after surgery, there was no evidence of the development of pseudomyxoma peritonei. In appendectomy, it is thought that careful perioperative treatment and a postoperative pathological search are important when there are no preoperative findings suggesting a neoplastic lesion. |
| Keywords | 虫垂炎（appendicitis） 減孔式腹腔鏡手術（reduced-port laparoscopic surgery） 虫垂粘液嚢胞腺腫（low-grade appendiceal mucinous neoplasm (LAMN)） 腹膜偽粘液腫（pseudomyxoma peritonei） 腹腔鏡下虫垂切除術（laparoscopic appendectomy） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2014-12-01 |
| Volume | volume126 |
| Issue | issue3 |
| Start Page | 223 |
| End Page | 226 |
| ISSN | 0030-1558 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2014 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.126.223 |
| NAID | 130004903238 |
| Title Alternative | Giant rectal gastrointestinal stromal tumor successfully resected by abdominoperineal resection combined with posterior vaginal wall resection |
|---|---|
| FullText URL | 126_217.pdf |
| Author | Iwakawa, Kazuhide| Nishie, Manabu| Tokunaga, Naoyuki| Miyaso, Hideaki| Iwagaki, Hiromi| |
| Abstract | We report a case of giant rectal gastrointestinal stromal tumor (GIST) successfully resected by abdominoperineal resection combined with posterior vaginal wall resection. Our patient was a 79-year-old woman had been diagnosed as having von Recklinghausen disease at the age of 30 years. In 2006, a computed tomography (CT) scan revealed a tumor originating from the posterior wall of the rectum. In June 2010, she was admitted to our hospital with the chief complaint of bloody stool. A CT scan revealed a giant tumor that had increased to 9cm in size. Colonoscopy demonstrated a submucosal tumor, which was subsequently diagnosed by biopsy as a GIST. Due to the patient's continuous bleeding and abdominal pain, an emergent abdominoperineal resection was performed at that time. The tumor, which measured 8×9cm, was immunohistochemically positive for c-kit and CD34. Concomitant resection of the posterior wall of the vagina via the perineal approach provided a wide area to expose the tumor for a safe operation. The patient has been well with no sign of recurrence since the operation. This procedure is recommended as a useful approach for giant rectal GISTs or rectal cancer with invasion of the posterior pelvic wall. |
| Keywords | 巨大直腸GIST（giant rectal GIST） 腹会陰式直腸切断術（abdominoperineal resection） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2014-12-01 |
| Volume | volume126 |
| Issue | issue3 |
| Start Page | 217 |
| End Page | 221 |
| ISSN | 0030-1558 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2014 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.126.217 |
| NAID | 130004903245 |
| JaLCDOI | 10.18926/AMO/52901 |
|---|---|
| FullText URL | 68_5_313.pdf |
| Author | Yamane, Kentaro| Tanaka, Masato| Sugimoto, Yoshihisa| Ichimura, Kouichi| Ozaki, Toshifumi| |
| Abstract | Ossified meningioma is classified histologically as a phenotype of metaplastic meningioma, and it is extremely rare. There are only 12 cases involving ossified spinal meningiomas in the literature. We present the case of a 61-year-old female with a primary tumor within the ventral spinal canal at T12. Although we performed a total tumor excision using an ultrasonic bone aspirator, a temporary deterioration of motor evoked potentials (MEPs) was observed during curettage with a Kerrison rongeur. The neurologic findings worsened immediately after surgery. Histologically, the tumor was diagnosed as a metaplastic meningioma with osseous differentiation. In order to avoid spinal cord injury, great care must be taken when removing an ossified meningioma located on the ventral spinal cord. |
| Keywords | spinal metaplastic meningioma osseous differentiation ossified meningioma ultrasonic bone aspirator post-operative course |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-10 |
| Volume | volume68 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 313 |
| End Page | 316 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25338489 |
| Web of Science KeyUT | 000343269300009 |
| JaLCDOI | 10.18926/AMO/52900 |
|---|---|
| FullText URL | 68_5_307.pdf |
| Author | Muro, Shinichiro| Nasu, Junichiro| Harada, Ryo| Matsubara, Minoru| Nakarai, Asuka| Kanzaki, Hiromitsu| Tsutsumi, Kouichiro| Kato, Hironari| Tanaka, Takehiro| Fujiwara, Hiroyasu| Uno, Masatoshi| Okada, Hiroyuki| Yamamoto, Kazuhide| |
| Abstract | A 45-year-old female who presented with loss of consciousness and a cold sweat was found to have a pancreatic tumor and multiple liver metastases. Laboratory studies showed marked hypoglycemia and inappropriately elevated serum insulin, C-peptide, and serum tumor markers. Fine needle aspiration revealed Grade 3 small-cell type primary pancreatic neuroendocrine carcinoma. Consequently, the diagnosis of malignant insulinoma was made. Transarterial embolization (TAE) for hepatic metastases resulted in the reduction of tumor volume and prompt resolution of hypoglycemic attacks, whereas diazoxide and systemic chemotherapy had been ineffective for controlling blood glucose levels, and octreotide was unavailable due to the allergic effect. This case report highlights the potential usefulness of TAE for malignant insulinomas in the management of hypoglycemia. |
| Keywords | malignant insulinoma hypoglycemia liver metastases transarterial embolization neuroendocrinetumor |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-10 |
| Volume | volume68 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 307 |
| End Page | 311 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25338488 |
| Web of Science KeyUT | 000343269300008 |
| JaLCDOI | 10.18926/AMO/52899 |
|---|---|
| FullText URL | 68_5_303.pdf |
| Author | Tanaka, Masato| Sugimoto, Yoshihisa| Arataki, Shinya| Takigawa, Tomoyuki| Ozaki, Toshifumi| |
| Abstract | Spinal deformity is an important clinical manifestation of Chiari I malformation (CM-I) and syringomyelia. Here we report the result of an 8-year follow-up of a 13-year-old girl with severe scoliosis associated with Chiari malformation and a large syringomyelia. The patient presented at our hospital at the age of 13 with a 68° scoliosis. Magnetic resonance imaging showed Chiari malformation and a large syringomyelia. Neurosurgical treatment involved foramen magnum decompression and partial C1 laminectomy, but the scoliosis still progressed. We present the first case report of a rare course of scoliosis in a patient with CM-I and a large syringomyelia. |
| Keywords | Chiari I malformation syringomyelia scoliosis |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-10 |
| Volume | volume68 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 303 |
| End Page | 306 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25338487 |
| Web of Science KeyUT | 000343269300007 |
| JaLCDOI | 10.18926/AMO/52791 |
|---|---|
| FullText URL | 68_4_249.pdf |
| Author | Ogawara, Yuya| Tachibana, Tomoyasu| Orita, Yorihisa| Uchino, Kaori| Wani, Yoji| Nagahiro, Itaru| Matsuyama, Yuko| Abe, Iku| Fujisawa, Masayoshi| Nishizaki, Kazunori| |
| Abstract | We describe an extremely rare case of tracheal stenosis caused by unnoticed microscopic fiber-like foreign bodies. A 66-year-old woman complained of dyspnea with inspiratory stridor. Magnifying electroendoscopy and computed tomography revealed stenosis involving the entire circumference of the tracheal lumen. Tracheotomy and biopsy were performed. Histologically, the lesion showed chronic inflammation with a deposition of fiber-like foreign bodies. The patient had no history of trauma or inhalation injury, but had undergone intratracheal intubation on 4 occasions. The lesion was incised using semiconductor laser photoresection, and the postoperative course was good. To the best of our knowledge, this represents the first report in the English literature of tracheal stenosis caused by unnoticed foreign bodies. The origin of these fiber-like foreign bodies remains unclear but might be related to chronic inflammation resulting from intratracheal intubations. |
| Keywords | tracheal stenosis fibrous foreign body intubation tracheotomy laser |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-08 |
| Volume | volume68 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 249 |
| End Page | 252 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25145411 |
| Web of Science KeyUT | 000340687500007 |
| Title Alternative | A case of asymptomatic right-sided adult Bochdalek hernia presented incidentally with rectal tumor |
|---|---|
| FullText URL | 126_137.pdf |
| Author | Kato, Hiroshi| Oishi, Masahiro| Kodera, Masahito| Yamamura, Masao| Ikeda, Hideaki| Mizuno, Kenji| Yamashita, Yutaka| Suzuki, Kazunori| |
| Abstract | We encountered a patient with an adult Bochdalek hernia discovered asymptomatically. A 77-year-old Japanese woman visited a local clinic with chief complaints of melena and difficulty in defecation. Based on the results of the detailed examination in our hospital, she was diagnosed with a rectal gastrointestinal stromal tumor (GIST) with a concurrent asymptomatic adult right-sided Bochdalek hernia. Because the tumor was large, laparoscopic abdominoperineal rectal amputation was performed after systemic imatinib therapy. During the surgery, we found a right diaphragmatic defect more than 13cm in long dia., through which the right hepatic lobe, colon, and greater omentum had prolapsed into the right thoracic cavity. No visceral adhesions were noted. No hernia sac was observed. Adult Bochdalek hernia is a relatively rare condition, and only three (incidentally discovered) cases of asymptomatic Bochdalek hernia, including the present case, have been reported in Japan. Here we provide a case report for the patient, who was followed-up without hernia surgery, plus a review of the literature. |
| Keywords | 成人Bochdalek孔ヘルニア（adult Bochdalek hernia） 腹腔鏡下手術（laparoscopic surgery） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2014-08-01 |
| Volume | volume126 |
| Issue | issue2 |
| Start Page | 137 |
| End Page | 141 |
| ISSN | 0030-1558 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2014 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.126.137 |
| NAID | 130004685265 |
| Title Alternative | Treatment for a non-compliant patient with cancer and epilepsy |
|---|---|
| FullText URL | 126_133.pdf |
| Author | Minami, Daisuke| Ichihara, Eiki| Okabe, Nobuyuki| Yokomichi, Naosuke| Kouge, Noriko| Kajizono, Makoto| Akimoto, Yutaka| Hori, Keisuke| Matsubara, Minoru| Nasu, Junichiro| Tanimoto, Mitsune| Kiura, Katsuyuki| Matsuoka, Junzi| |
| Abstract | A 58-year-old man with cervical esophageal cancer and a history of epilepsy was treated with chemoradiotherapy from May of 2013. When tube feeding was initiated due to aspiration pneumonitis, the patient showed a degree of irritability that affected routine staff work and treatment compliance. We attempted to perform supportive care for maladjustment by the notice, the fast, and the tube feeding, but there was no improvement. After we added carbamazepine, primidone, and propericiazine (which had been canceled at the initiation of the tube feeding) to the patient's intravenous phenytoin, the symptoms and treatment compliance improved significantly. We concluded that the causes of the patient's irritability were maladjustment and his epilepsy. |
| Keywords | てんかん（epilepsy） 易怒性（irritability） 適応障害（maladjustment） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2014-08-01 |
| Volume | volume126 |
| Issue | issue2 |
| Start Page | 133 |
| End Page | 135 |
| ISSN | 0030-1558 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2014 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.126.133 |
| NAID | 130004685264 |
| Title Alternative | Fermented persimmon extract (kaki-shibu) is useful as a standard for component analyses of persimmon phytobezoars |
|---|---|
| FullText URL | 126_127.pdf |
| Author | Iwamuro, Masaya| Okamoto, Yuko| Murata, Toshihiro| Kawai, Yoshinari| Shiraha, Hidenori| Okada, Hiroyuki| Yamamoto, Kazuhide| |
| Abstract | The definite diagnosis of persimmon phytobezoar (i.e., diospyrobezoar) is often accomplished by a component analysis using infrared spectroscopy. However, no studies have been conducted to investigate which substance is the best as a standard for the component analysis. Here we analyzed tannic acid, Japanese persimmon (kaki), fermented persimmon extract (kaki-shibu), conventional dried persimmon, and dried persimmon smoked in sulfur (ampo-kaki) by infrared spectroscopy to determine which would be optimal as a component analysis standard. The spectrum between 1,600 to 600cm－1 of a persimmon phytobezoar was quite similar to the spectrum of kaki-shibu rather than that of tannic acid. Consequently, we conclude that kaki-shibu should be used as a standard for infrared spectroscopy analyses of persimmon phytobezoars. |
| Keywords | 柿胃石（gastric phytobezoar） タンニン酸（tannic acid） 消化管異物（gastrointestinal foreign body） 成分分析（component analysis） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2014-08-01 |
| Volume | volume126 |
| Issue | issue2 |
| Start Page | 127 |
| End Page | 131 |
| ISSN | 0030-1558 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2014 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.126.127 |
| NAID | 130004685263 |
| JaLCDOI | 10.18926/AMO/52659 |
|---|---|
| FullText URL | 68_3_177.pdf |
| Author | Mizuno, Shoma| Ota, Seisuke| Tanaka, Takehiro| Shiomi, Kohei| Matsumura, Tadashi| Kishimoto, Nobuyasu| |
| Abstract | Primary tracheal malignant lymphoma is a rare disease;only 30 cases have been reported to date. A 73-year-old Japanese man with a history of asbestos exposure was undergoing biannual chest computed tomography (CT) twice a year as a routine procedure for those previously exposed to asbestos. He had been smoking since the age of 32. In September 2010, chest CT during this regular checkup revealed a polypoid lesion in his trachea and pleural plaques, which were suspected to be caused by asbestos. Bronchoscopy performed in October revealed a polypoid lesion with granules and nodules in the trachea. A diagnosis of non-Hodgkin lymphoma (NHL) and extranodal marginal-zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) was confirmed by histological analysis of the biopsy specimens. To our knowledge, this is the first case of primary tracheal lymphoma associated with a history of asbestos exposure. Several reports have documented no correlation between asbestos and malignant lymphoma. In addition, the correlation between smoking and NHL is weak. Although we cannot exclude the possibility of a simple coincidence of asbestos, smoking, and tracheal lymphoma, this case suggests that asbestos and smoking might have multiplicative effects in the development or progression of tracheal lymphoma. |
| Keywords | bronchus-associated lymphoid tissue tracheal lymphoma regular checkup asbestos smoking |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-06 |
| Volume | volume68 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 177 |
| End Page | 181 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24942797 |
| Web of Science KeyUT | 000337655600008 |
| JaLCDOI | 10.18926/AMO/52658 |
|---|---|
| FullText URL | 68_3_171.pdf |
| Author | Hagiya, Hideharu| Matsumoto, Mitsuaki| Yamasawa, Takahiko| Haruki, Yuto| Otsuka, Fumio| |
| Abstract | A 79-year-old man who had undergone a right femoropopliteal (FP) bypass operation 6 weeks previously was diagnosed with vascular graft infection caused by Staphylococcus lugdunensis. Another FP bypass operation was performed, with long-term administration of antibiotics, and the patient eventually recovered well without any recurrences for over 2 years. Although S. lugdunens is classified as coagulase-negative Staphylococcus, its pathogenicity has been reported to be equal to that of S. aureus. Based on the literature review, the organism characteristically colonizes the inguinal area of human skin;thus, operations such as FP bypass grafting may place patients at a relatively high risk for infection by S. lugdunensis, a potentially high-pathogenicity organism. |
| Keywords | coagulase-negative Staphylococcus (CNS) femoropopliteal (FP) bypass Staphylococcus lugdunensis vacuum-assisted closure (VAC) therapy vascular graft infection (VGI) |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-06 |
| Volume | volume68 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 171 |
| End Page | 175 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24942796 |
| Web of Science KeyUT | 000337655600007 |
| JaLCDOI | 10.18926/AMO/52409 |
|---|---|
| FullText URL | 68_2_125.pdf |
| Author | Young Jin Chang| Wol Seon Jung| Woon Rak Son| Youn Yi Jo| |
| Abstract | A 47-year-old woman with amyotrophic lateral sclerosis was scheduled for total thyroidectomy with cervical node dissection. During anesthetic management by total intravenous anesthesia using remifentanil, propofol, and rocuronium, train-of-four (TOF) monitoring findings were not consistent with clinical signs. Sugammadex successfully reversed shallow respiration. |
| Keywords | amyotrophic lateral sclerosis train-of-four sugammadex |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-04 |
| Volume | volume68 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 125 |
| End Page | 127 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24743788 |
| Web of Science KeyUT | 000334652700008 |
| JaLCDOI | 10.18926/AMO/52408 |
|---|---|
| FullText URL | 68_2_119.pdf |
| Author | Takeda, Akiko| Shimada, Akira| Hamamoto, Kazuko| Yoshino, Syuuji| Nagai, Tomoko| Fujii, Yousuke| Yamada, Mutsuko| Nakamura, Yoshimi| Watanabe, Toshiyuki| Watanabe, Yuki| Yamamoto, Yuko| Sakakibara, Kanae| Oda, Megumi| Morishima, Tsuneo| |
| Abstract | Acute megakaryocytic leukemia (AMKL) with t(1;22)(p13;q13) is a distinct category of myeloid leukemia by WHO classification and mainly reported in infants and young children. Accurate diagnosis of this type of AMKL can be difficult, because a subset of patients have a bone marrow (BM) blast percentage of less than 20% due to BM fibrosis. Therefore, it is possible that past studies have underestimated this type of AMKL. We present here the case of a 4-month-old female AMKL patient who was diagnosed by presence of the RBM15-MKL1 (OTT-MAL) fusion transcript by RT-PCR. In addition, we monitored RBM15-MKL1 fusion at several time points as a marker of minimal residual disease (MRD), and found that it was continuously negative after the first induction chemotherapy even by nested RT-PCR. Detection of the RBM15-MKL1 fusion transcript thus seems to be useful for accurate diagnosis of AMKL with t(1;22)(p13;q13). We recommend that the RBM15-MKL1 fusion transcript be analyzed for all suspected AMKL in infants and young children. Furthermore, monitoring of MRD using this fusion transcript would be useful in treatment of AMKL with t(1;22)(p13;q13). |
| Keywords | AMKL infant RBM15-MKL1 OTT-MAL |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-04 |
| Volume | volume68 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 119 |
| End Page | 123 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24743787 |
| Web of Science KeyUT | 000334652700007 |
