result 732 件
| Title Alternative | A patient with primary malignant melanoma of the esophagus who underwent esophagectomy |
|---|---|
| FullText URL | 126_45.pdf |
| Author | Maeda, Naoaki| Shirakawa, Yasuhiro| Koujima, Takeshi| Ohara, Toshiaki| Tanabe, Shunsuke| Noma, Kazuhiro| Sakurama, Kazuhumi| Fujiwara, Toshiyosi| |
| Abstract | We report the case of a 61-old-man with a primary malignant melanoma of the esophagus, an extremely rare and highly aggressive malignancy. He presented with dysphagia, and we performed an upper gastrointestinal endoscopy that detected a tumor in the thoracic part of the esophagus. The biopsy showed malignant melanoma. PET/CT, endoscopy and an esophagogram showed that a 70-mm scaled type 2+1 tumor in the thoracic esophagus and no metastases. We diagnosed a cT3cN0cM0 cStage II tumor. We then performed a subtotal esophagectomy with two-field lymph node dissection and esophagogastrostomy via a retrosternal route. The pathological examination of the resected specimens confirmed that the type 2+1 tumor was PMME (pT2N0M0 pStage II). We administered six courses of postoperative adjuvant chemotherapy with dacarbazine, and the patient has had no recurrence for 17 months after the surgery. |
| Keywords | 食道（esophagus） 悪性黒色腫（malignant melanoma） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2014-04-01 |
| Volume | volume126 |
| Issue | issue1 |
| Start Page | 45 |
| End Page | 48 |
| ISSN | 0030-1558 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2014 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.126.45 |
| NAID | 130004505808 |
| Title Alternative | Complete response of primary esophageal endocrine cell carcinoma resected after neoadjuvant chemotherapy with docetaxel/cisplatin/5-fluorouracil |
|---|---|
| FullText URL | 126_39.pdf |
| Author | Maeda, Naoaki| Shirakawa, Yasuhiro| Koujima, Takeshi| Ohara, Toshiaki| Tanabe, Shunsuke| Noma, Kazuhiro| Sakurama, Kazuhumi| Fujiwara, Toshiyosi| |
| Abstract | Esophageal endocrine cell carcinoma is extremely rare. We report a case of esophageal endocrine cell carcinoma showing histological complete response to neoadjuvant chemotherapy with docetaxel/cisplatin/5-fluorouracil (DCF). A 66-year-old man had been experiencing epigastralgia, and a type 2 tumor in the thoracic part of esophagus was detected by upper endoscopy. The biopsy showed endocrine cell carcinoma. PET/CT, endoscopy and an esophagogram showed that the patient had a 70-mm scaled type 2 tumor in the middle thoracic esophagus, and they also revealed lymph node metastases (no. 106recR). We diagnosed a cT3cN1cM0 cStage III tumor. With two courses of DCF treatment, both the primary tumor and lymph node metastases showed a partial response. We performed a subtotal esophagectomy with three-field lymph node dissection. The pathological examination of the resected specimens revealed no malignant cells in the esophagus or lymph nodes, and we concluded that the pathological effect of the DCF treatment was Grade 3. |
| Keywords | 食道癌（esophageal cancer） 内分泌細胞癌（endocrine cell carcinoma） DCF療法（DCF treatment） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2014-04-01 |
| Volume | volume126 |
| Issue | issue1 |
| Start Page | 39 |
| End Page | 43 |
| ISSN | 0030-1558 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2014 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.126.39 |
| NAID | 130004505807 |
| Title Alternative | A case of colon lipoma presenting with intussusception |
|---|---|
| FullText URL | 126_35.pdf |
| Author | Ninomiya, Takayuki| Ojima, Yasutomo| Harano, Masao| Ohno, Satoshi| Shiozaki, Shigehiro| Ninomiya, Motoki| |
| Abstract | An 84-year-old man, who had been found to have a submucosal tumor in the ascending colon two years before, was admitted to our hospital for right lower quadrant abdominal pain and melena. An abdominal computed tomography (CT) scan showed intussusception in the ascending colon, resulting from a fat-density tumor. The intussusception was located by colonoscopy. Since the colonic tumor was enlarged in comparison with two years ago and had an ulcer at the top of the tumor, there was the possibility of malignancy and recurrence of intussusception. He underwent a laparoscopy-assisted right colectomy with lymph node dissection. Pathologically, the tumor of the ascending colon was a benign lipoma. |
| Keywords | 結腸脂肪腫（lipoma of the colon） 腸重積（intussusception） 腹腔鏡下手術（laparoscopic surgery） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2014-04-01 |
| Volume | volume126 |
| Issue | issue1 |
| Start Page | 35 |
| End Page | 38 |
| ISSN | 0030-1558 |
| Related Url | http://www.okayama-u.ac.jp/user/oma/ |
| language | Japanese |
| Copyright Holders | Copyright (c) 2014 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.126.35 |
| Title Alternative | Metastatic breast cancer presenting as severe anemia, platelet reduction and abnormal cells in peripheral blood |
|---|---|
| FullText URL | 126_31.pdf |
| Author | Ota, Seisuke| Kasahara, Akinori| Mizuno, Shoma| Fukatsu, Haruka| Kinoshita, Osamu| Noguchi, Toshio| Kishimoto, Nobuyasu| Matsumura, Tadashi| |
| Abstract | Worldwide, breast cancer accounts for 22.9% of all cancers excluding non-melanoma skin cancers in women. More than 80% of breast cancer cases are discovered when a woman discovers a lump that feels different from the rest of the breast tissue. We report the case of a 60-year-old woman who had been treated for one year at a psychiatric hospital for suspected schizophrenia, and was referred to our hospital on March 23, 2011 for consultation regarding complete blood count abnormalities: hemoglobin, 4.8g/㎗ ; Plt, 1.9×104/μl ; WBC, 12,700/μl with 18.5% abnormal cells. Computed tomography revealed an enhanced, irregular mass in her right breast as well as right axillary lymph node swelling, suggestive of breast cancer. BM biopsy confirmed the presence of abnormal, keratin-positive cells, suggesting metastasis to the bone. CA15-3 was 300U/㎖ (normal range ＜25). The patient died on April 11, 2011, post-admission day 20. We found a rare case of terminal breast cancer that presented with peripheral blood abnormality. Breast cancer in patients who do not notice breast abnormality can present with peripheral blood abnormality. |
| Keywords | 乳癌（breast cancer） 初発症状（initial symptom） 貧血（anemia） 骨髄転移（bone marrow metastasis） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2014-04-01 |
| Volume | volume126 |
| Issue | issue1 |
| Start Page | 31 |
| End Page | 34 |
| ISSN | 0030-1558 |
| Related Url | http://www.okayama-u.ac.jp/user/oma/ |
| language | Japanese |
| Copyright Holders | Copyright (c) 2014 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.126.31 |
| JaLCDOI | 10.18926/AMO/52145 |
|---|---|
| FullText URL | 68_1_53.pdf |
| Author | Terasaka, Tomohiro| Ueta, Eijiro| Ebara, Hirotaka| Waseda, Koichi| Hanayama, Yoshihisa| Takaki, Akinobu| Kawabata, Tomoko| Sugiyama, Hitoshi| Hidan, Ko| Otsuka, Fumio| |
| Abstract | A 64-year-old man suffering polyarthralgia and bone pain was referred to our hospital. Renal dysfunction, hypophosphatemia and increased levels of bone alkaline phosphatase were found. The patientʼs serum creatinine level had gradually increased after the initiation of adefovir dipivoxil administration for hepatitis B. In agreement with multifocal uptakes of bone scintigraphy, iliac bone biopsy revealed an abnormal increase in osteoid tissues. Reducing the dose of adefovir and initiating the administration of eldecalcitol were effective for reducing proteinuria and glucosuria, and for ameliorating bone pain with an increase in serum phosphate level. This case first showed a clinical course of hypophosphatemic osteomalacia caused by secondary Fanconiʼs syndrome for 8 years after adefovir administration. Early diagnosis is important for the reversibility of bone damage and for a better renal prognosis. |
| Keywords | adefovir dipivoxil (ADV) eldecalcitol Fanconi's syndrome hypophosphatemia osteomalacia |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-02 |
| Volume | volume68 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 53 |
| End Page | 56 |
| 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 | 24553490 |
| JaLCDOI | 10.18926/AMO/52144 |
|---|---|
| FullText URL | 68_1_47.pdf |
| Author | Ishikawa, Tsutomu| Araki, Motoo| Hirata, Takeshi| Watanabe, Masami| Ebara, Shin| Watanabe, Toyohiko| Nasu, Yasutomo| Kumon, Hiromi| |
| Abstract | We report 3 patients with the rare complication of an indwelling urethral catheter misdirected into the ureter. This is the largest series to date. Patients were referred to us for a variety of reasons following exchange of their chronic indwelling urinary catheters. CT in all cases demonstrated the urinary catheters residing in the left ureter. The ages of the patients were 37, 67 and 81 years old. All patients suffered from neurogenic bladder. Two patients were female, one was male, and 2 of the 3 had a sensory disorder inhibiting their pain response. The catheters were replaced with open-end Foley catheters. Extensive follow-up CT scans were obtained in one case, demonstrating improvement of hydronephrosis and no evidence of ureteral stenosis. Cystoscopy in this patient demonstrated normally positioned and functioning ureteral orifices. Although the placement of an indwelling urethral catheter is a comparatively safe procedure, one must keep in mind that this complication can occur, particularly in female patients with neurogenic bladder. CT without contrast is a noninvasive, definitive diagnostic tool. |
| Keywords | complication indwelling urethral catheter imaging computed tomography ureter |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-02 |
| Volume | volume68 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 47 |
| End Page | 51 |
| 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 | 24553489 |
| Web of Science KeyUT | 000331592800008 |
| JaLCDOI | 10.18926/AMO/52014 |
|---|---|
| FullText URL | 67_6_397.pdf |
| Author | Matsui, Yusuke| Mimura, Hidefumi| Fukazawa, Takuya| Morita, Ichiro| Suehiro, Mitsuhiko| Kawamoto, Hirofumi| Naomoto, Yoshio| |
| Abstract | We describe an interesting clinical course of a patient who developed severe ischemic liver injury due to acute embolism of the superior mesenteric artery (SMA) and celiac artery. A 70-year-old man was hospitalized for abdominal pain and diarrhea. Abdominal computed tomography demonstrated a variant common hepatic artery arising from the SMA and multiple thromboembolic occlusions of visceral arteries, including the SMA and celiac artery. Laboratory data showed markedly elevated hepatic enzymes, which increased after admission despite the initiation of systemic anticoagulant and thrombolytic therapy. The patient was successfully treated by endovascular recanalization of the SMA occlusion via transcatheter embolus aspiration, thrombolysis, balloon angioplasty, and stent placement. Severe ischemic liver injury may occur in the setting of synchronous embolism of the SMA and celiac artery, and these phenomena may have a critical impact on the choice of treatment strategies and prognosis. Endovascular treatment appears to an effective treatment option. |
| Keywords | superior mesenteric artery celiac artery embolism liver ischemia endovascular treatment |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-12 |
| Volume | volume67 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 397 |
| End Page | 402 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24356725 |
| Web of Science KeyUT | 000328915700009 |
| JaLCDOI | 10.18926/AMO/52013 |
|---|---|
| FullText URL | 67_6_391.pdf |
| Author | Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro| |
| Abstract | Thumb polydactyly is reported to be the most common congenital anomaly of the hand in Japan. The floating type is not particularly rare, accounting for 0.9 to 15% of all cases of thumb polydactyly. However, to the best of our knowledge, there has been only one case of thumb polydactyly with a floating ulnar thumb, reported by Onizuka. Herein, we report a case very similar to that reported by Onizuka. In our case, the vessels feeding the floating ulnar thumb branched from the superficial palmar arterial arch, and X-rays revealed triphalangism. In surgery, we not only reconstructed the morphology of the thumb, but also tried to preserve the sensation in the reconstructed thumb by transposing the digital nerve of the floating ulnar thumb to the radial thumb. In addition to thumb polydactyly, our case also showed hypoplasia of the thenar muscles. |
| Keywords | polydactyly floating ulnar thumb thumb hypoplasia |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-12 |
| Volume | volume67 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 391 |
| End Page | 395 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24356724 |
| Web of Science KeyUT | 000328915700008 |
| JaLCDOI | 10.18926/AMO/52012 |
|---|---|
| FullText URL | 67_6_385.pdf |
| Author | Tanaka, Masato| Arataki, Shinya| Sugimoto, Yoshihisa| Takigawa, Tomoyuki| Tetsunaga, Tomoko| Ozaki, Toshifumi| |
| Abstract | Craniometaphyseal dysplasia is a rare genetic condition characterized by progressive thickening of bones in the skull and metaphyseal abnormalities in the long bones. This disorder often causes progressively symptomatic cranial nerve compression, but in rare cases foramen magnum stenosis may lead to quadriplegia. Chiari I malformation with craniometaphyseal dysplasia is extremely rare. The authors report on a 25-year-old woman with myelopathy due to Chiari I malformation along with craniometaphyseal dysplasia. There are only four previous case reports of this condition. The authors present here the fifth case report of this rare condition and summarize its characteristics. |
| Keywords | craniometaphyseal dysplasia Chiari malformation cervicomedullary compression |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-12 |
| Volume | volume67 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 385 |
| End Page | 389 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24356723 |
| Web of Science KeyUT | 000328915700007 |
| Author | Ninomiya, Takayuki| Ojima, Yasutomo| Harano, Masao| Ohno, Satoshi| Shiozaki, Shigehiro| Ninomiya, Motoki| |
|---|---|
| Published Date | 2013-12-02 |
| Publication Title | 岡山医学会雑誌 |
| Volume | volume125 |
| Issue | issue3 |
| Content Type | Journal Article |
| Author | Maeda, Naoaki| Kondo, Hidenori| |
|---|---|
| Published Date | 2013-12-02 |
| Publication Title | 岡山医学会雑誌 |
| Volume | volume125 |
| Issue | issue3 |
| Content Type | Journal Article |
| JaLCDOI | 10.18926/AMO/51869 |
|---|---|
| FullText URL | 67_5_325.pdf |
| Author | Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro| |
| Abstract | Since 2001, we have been performing phalloplasty with a radial forearm free flap as the flap of first choice in female-to-male transsexuals (FTMTS). In the present case, a 22-year-old FTMTS with a negative Allen test, we achieved good results by performing phalloplasty with an innervated island pedicled anterolateral thigh flap using the "tube within a tube" technique, in which the penis and urethra are constructed with a single flap. While phalloplasty with an island-pedicled or free anterolateral thigh flap has been reported previously, the present case seems to be the first of phalloplasty with an innervated island-pedicled anterolateral thigh flap using the "tube within a tube" technique. As compared to a forearm flap, use of an innervated island-pedicled flap may have the following advantages in phalloplasty:1) no need for a microsurgical technique;2) no scars at noticeable sites;3) small functional loss in the flap donor area;4) no sacrifice of major blood vessels. Thus, this technique seems to be a useful clinical alternative for phallic reconstruction. |
| Keywords | gender identity disorder sex reassignment surgery (SRS) phalloplasty |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-10 |
| Volume | volume67 |
| Issue | issue5 |
| 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Ⓒ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24145733 |
| Web of Science KeyUT | 000325836100007 |
| Related Url | http://doi.org/10.18926/AMO/52660 |
| JaLCDOI | 10.18926/AMO/51868 |
|---|---|
| FullText URL | 67_5_319.pdf |
| Author | Murakawa, Kiminaka| Sato, Tomoaki| Maeda, Yoshinobu| Kitamura, Yoshihisa| Tanimoto, Mitsune| Sendo, Toshiaki| |
| Abstract | Graft-versus-host disease (GVHD) is a major concern in transplantation patients. Gut GVHD is accompanied by diarrhea, abdominal pain, and/or melena. Although oral treatment with corticosteroids (CSs) is effective in treating gut GVHD, it can cause adverse reactions that affect the entire body. Topical administration of CSs can be effective in treating diseases in which lesions are limited locally, because adverse reactions can then be alleviated. In this study, we examine and discuss an enteric-coated beclomethasone dipropionate (BDP) capsule (BDP-EC) formulated at Okayama University Hospital. The BDP-EC did not dissolve in solution 1 (pH1.2), and began disintegrating in solution 2 (pH6.8) after 5min, with a mean dissolution rate at 15min of 85%. We then used the capsule to treat a patient who developed gut GVHD after allogeneic hematopoietic stem cell transplantation. Clinically, the frequency of diarrhea decreased after BDP-EC administration. In addition, we were able to decrease the prednisolone equivalent dose. Symptoms associated with adverse reactions to BDP were not observed during the hospitalization period. These findings suggest that the administration of BDP-EC in the early stages of gut GVHD may allow a reduction in the initial doses of systemic CSs. |
| Keywords | beclomethasone intestinal graft-versus-host disease enteric-coated capsule in-hospital formulation |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-10 |
| Volume | volume67 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 319 |
| End Page | 324 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24145732 |
| Web of Science KeyUT | 000325836100006 |
| JaLCDOI | 10.18926/AMO/51867 |
|---|---|
| FullText URL | 67_5_311.pdf |
| Author | Nishida, Keiichiro| Hashizume, Hiroyuki| Matsukawa, Akihiro| Hashizume, Kenzo| Shimamura, Yasunori| Torigoe, Yasuyuki| Ozaki, Toshifumi| |
| Abstract | We report a case of 4th metacarpal head collapse of a 19-year-old healthy man. MRI revealed T1 low and T2 high regions in the collapsed 4th metacarpal head, as well as in the right 3rd and left 4th metacarpal head. Our initial diagnosis was occult compression fracture due to avascular necrosis, known as Dieterich's disease. However, pathological findings of surgically resected right 4th metacarpal head were compatible with transient osteoporosis and metacarpal head fracture followed by active tissue repair. The autologous osteochondral transplants from costchondral junction survived and maintained their size and shape even at 10-year follow-up. |
| Keywords | occult compression fracture metacarpal head avascular necrosis osteochondral autograft |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-10 |
| Volume | volume67 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 311 |
| End Page | 317 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24145731 |
| Web of Science KeyUT | 000325836100005 |
| JaLCDOI | 10.18926/AMO/51866 |
|---|---|
| FullText URL | 67_5_305.pdf |
| Author | Tachibana, Motomi| Mukouhara, Naoki| Hirami, Ryouichi| Fujio, Hideki| Yumoto, Akihisa| Watanuki, Yutaka| Hayashi, Aiko| Suminoe, Isao| Koudani, Hiroshi| |
| Abstract | Congenital coronary pulmonary artery fistula (CAF) is rare, and systemic-to-pulmonary artery fistula (SPAF) is even more so. Furthermore, congenital coronary pulmonary fistula associated with congenital SPAF is extremely rare. As far as we know, CAF and SPAF connected with an aneurysm have not been described very often. We described an 83-year-old woman with an aneurysm originating from a CAF connected to an aortopulmonary artery fistula. Chest radiography revealed a shadow at the left edge of the heart line. Multi-detector-row computed tomography (MDCT) with contrast enhancement and coronary cine angiography revealed that the shadow was an aneurysm connected to a tortuous fistula at the left anterior descending coronary artery. The aneurysm was formed by congenital coronary pulmonary and aortopulmonary artery fistulae. Echocardiography revealed predominantly systolic blood flow in the fistula from the left anterior descending coronary artery (LAD). Although neither MDCT, echocardiography nor coronary angiography alone could provide a comprehensive image of the anomaly, including the hemodynamics in the fistulae and their relationship with surrounding organs and tissues, their combination could provided important facts the led to a deeper understanding of this very uncommon occurrence. |
| Keywords | coronary pulmonary artery fistula aortopulmonary artery fistula aneurysm |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-10 |
| Volume | volume67 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 305 |
| End Page | 309 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24145730 |
| Web of Science KeyUT | 000325836100004 |
| JaLCDOI | 10.18926/AMO/51073 |
|---|---|
| FullText URL | 67_4_271.pdf |
| Author | Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro| |
| Abstract | In the postoperative treatment of hand surgery, it is important to start exercise therapy as early as possible. In conventional negative pressure wound therapy, the fingers are immobilized by the film dressing covering the wound and hand, thereby preventing sufficient rehabilitation. Here, we devised a bag-type negative pressure wound therapy that makes it possible to start finger exercises almost immediately, and we applied it to 4 patients:one each with hand burns, symmetrical peripheral gangrene, a crush injury accompanied by extensive skin defects and a fingertip degloving injury. The duration of the bag-type negative pressure wound therapy ranged from three to eight weeks, and good granulation was achieved, so that a skin graft was not required. In addition, particularly in the case of the fingertip degloving injury, good nail regeneration was achieved. Except for the case of symmetrical peripheral gangrene, a good range of joint motion with a percent total active motion (%TAM) of 94.7% or more was achieved. Our therapy was performed by inserting the hand into a sealing bag;sufficient exercise therapy was made possible by expanding the bag during rehabilitation. |
| Keywords | negative pressure wound therapy early exercise therapy wound healing hand surgery |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-08 |
| Volume | volume67 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 271 |
| End Page | 276 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23970327 |
| Web of Science KeyUT | 000323470100010 |
| JaLCDOI | 10.18926/AMO/51072 |
|---|---|
| FullText URL | 67_4_265.pdf |
| Author | Hanakawa, Hiroyuki| Orita, Yorihisa| Sato, Yasuharu| Uno, Kinya| Nishizaki, Kazunori| Yoshino, Tadashi| |
| Abstract | We present a case of a 67-year-old Japanese man with a serious oropharyngeal ulceration that at first seemed to be destructive malignant lymphoma or oropharyngeal carcinoma. We suspected methotrexate (MTX)-associated lymphoproliferative disorder (LPD) induced by MTX treatment for rheumatoid arthritis (RA). About 3 weeks after simple discontinuation of MTX, complete regression of the disease was observed, confirming our diagnosis. |
| Keywords | ulceration methotrexate oropharynx lymphoproliferative disorders |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-08 |
| Volume | volume67 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 265 |
| End Page | 269 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23970326 |
| Web of Science KeyUT | 000323470100009 |
| Author | Haisa, Minoru| Sakai, Ryo| Kurihara, Eisuke| Teramoto, Atsushi| Shouga, Kazuhiko| Mitsuoka, Shintarou| Nishimura, Mamoru| Satou, Yuuki| Nanba, Jiro| |
|---|---|
| Published Date | 2013-08-01 |
| Publication Title | 岡山医学会雑誌 |
| Volume | volume125 |
| Issue | issue2 |
| Content Type | Journal Article |
| JaLCDOI | 10.18926/AMO/50414 |
|---|---|
| FullText URL | 67_3_197.pdf |
| Author | Yasuhara, Takao| Takahashi, Yuichi| Kumamoto, Shinji| Nakahara, Masayuki| Yoneda, Kotaro| Niimura, Tatsuomi| Tanoue, Takashi| Kusumegi, Akira| Sennari, Takashi| Hijikata, Yasukazu| Manabe, Hiroaki| Miyoshi, Yasuyuki| Date, Isao| Ogawa, Koichi| Nishida, Kenki| |
| Abstract | Some cases with lumbar degenerative diseases require multi-level fusion surgeries. At our institute, 27 and 4 procedures of 3- and 4-level fusion were performed out of a total 672 posterior lumbar interfusions (PLIFs) on patients with lumbar degenerative disease from 2005 to 2010. We present 2 osteoporotic patients who developed proximal vertebral body fracture after 4-level fusion. Both cases presented with gait disability for leg pain by degenerative lumbar scoliosis and canal stenosis at the levels of L1/2-4/5. After 4-level fusion using L1 as the upper instrumented vertebra, proximal vertebral body fractures were found along with the right pedicle fractures of L1 in both cases. One of these patients, aged 82 years, was treated as an outpatient using a hard corset for 24 months, but the fractures were exacerbated over time. In the other patient, posterolateral fusion was extended from Th10 to L5. Both patients can walk alone and have been thoroughly followed up. In both cases, the fracture of the right L1 pedicle might be related to the subsequent fractures and fusion failure. In consideration of multi-level fusion, L1 should be avoided as an upper instrumented vertebra to prevent junctional kyphosis, especially in cases with osteoporosis and flat back posture. |
| Keywords | degenerative lumbar scoliosis osteoporosis pedicle fracture posterior lumbar interbody fusion vertebral body fracture |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-06 |
| Volume | volume67 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 197 |
| End Page | 202 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23804144 |
| Web of Science KeyUT | 000320747900010 |
| JaLCDOI | 10.18926/AMO/50413 |
|---|---|
| FullText URL | 67_3_191.pdf |
| Author | Binti Md Nor, Nurliza| Kusumoto, Tomoyuki| Inoue, Seiji| Nakamura, Keiichiro| Seki, Noriko| Hongo, Atsushi| Kodama, Junichi| Hiramatsu, Yuji| |
| Abstract | Struma ovarii is a rare neoplasm that accounts for approximately 0.3ｵ of ovarian tumors. Due to its ultrasound morphology, which is quite similar to that of malignant ovarian carcinoma, most struma ovarii cases are open operated with laparotomy rather than laparoscopy. We present 3 cases of struma ovarii, which were diagnosed preoperatively by imaging studies and removed by laparoscopic surgery. All patients were premenopausal women between ages 31‒50. The magnetic resonance imaging (MRI) findings were complex masses composed of multiple cysts and solid components with T2-hypointense regions as well as multiple T1-hyperintense cystic areas, findings that are typical for struma ovarii. A combination of plain computed tomography (CT), positron emission tomography (PET)-CT, and scintigraphy was useful for diagnosis. Laboratory examination revealed elevated serum thyroglobulin, which led to the diagnosis of struma ovarii. Laparoscopic surgeries were performed without rupturing the tumors. Although it has been difficult to differentiate between struma ovarii and malignant tumors by conventional methods, recently MRI techniques appear make it possible to diagnose struma ovarii preoperatively from the abovementioned imaging characteristic, together with laboratory data. As for treatment, we think laparoscopy could be successful for struma ovarii, but the surgeon must be careful not to rupture the tumor intra-abdominally in order to prevent dissemination, which could lead to malignancy. |
| Keywords | struma ovarii ovarian neoplasms MRI laparoscopic surgery |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2013-06 |
| Volume | volume67 |
| Issue | issue3 |
| Publisher | Okayama University Medical School |
| Start Page | 191 |
| End Page | 195 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2013 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 23804143 |
| Web of Science KeyUT | 000320747900009 |
