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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
FullText URL O0004494_abstract_review.pdf O0004494_summary.pdf O0004494_fulltext.pdf
Author Goto, Shinichiro|
Published Date 2018-12-27
Content Type Thesis or Dissertation
Grant Number 乙第4494号
Granted Date 2018-12-27
Thesis Type Doctor of Philosophy in Medical Science
Grantor 岡山大学
language English
FullText URL K0005861_abstract_review.pdf K0005861_summary.pdf K0005861_fulltext.pdf
Author Kashihara, Naoko|
Published Date 2018-12-27
Content Type Thesis or Dissertation
Grant Number 甲第5861号
Granted Date 2018-12-27
Thesis Type Doctor of Philosophy in Medical Science
Grantor 岡山大学
language English
FullText URL K0005852_abstract_review.pdf K0005852_summary.pdf K0005852_fulltext.pdf
Author Ogata, Takeshi|
Published Date 2018-12-27
Content Type Thesis or Dissertation
Grant Number 甲第5852号
Granted Date 2018-12-27
Thesis Type Doctor of Philosophy in Medical Science
Grantor 岡山大学
language English
JaLCDOI 10.18926/AMO/56466
FullText URL 73_1_93.pdf
Amo Type Errata
Publication Title Acta Medica Okayama
Published Date 2019-02
Volume volume73
Issue issue1
Publisher Okayama University Medical School
Start Page 93
End Page 93
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
JaLCDOI 10.18926/AMO/56465
FullText URL 73_1_91.pdf
Abstract In the article by Takase K et al. entitled “High-dose Dexamethasone Therapy as the Initial Treatment for Idiopathic Thrombocytopenic Purpura: Protocol for a Multicenter, Open-label, Single Arm Trial”, which appeared in the December 2018 issue, Vol.72, No.2, pp197-201, regarding the authors’ information in the first page, following corrections should be added as below.
Amo Type Errata
Publication Title Acta Medica Okayama
Published Date 2019-02
Volume volume73
Issue issue1
Publisher Okayama University Medical School
Start Page 91
End Page 91
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
JaLCDOI 10.18926/AMO/56464
FullText URL 73_1_85.pdf
Author Abe, Yoshiyuki| Fujibayashi, Kazutoshi| Nishizaki, Yuji| Yanagisawa, Naotake| Nojiri, Shuko| Nakano, Soichiro| Tada, Kurisu| Yamaji, Ken| Tamura, Naoto|
Abstract Pneumocystis pneumonia (PCP) due to Pneumocystis jirovecii infection is the leading cause of fatal opportunistic infections in immunocompromised patients. We will determine whether a daily sulfamethoxazole-trimethoprim (SMX/TMP) dose of 200/40 mg was non-inferior to 400/80 mg for PCP prevention in patients with systemic rheumatic disease under immunosuppressive therapy. This is a randomized, open-label, multicenter controlled trial. The primary outcome is the rate of PCP prevention at 52 weeks. The secondary outcome is the discontinuation rate of SMX/TMP. The trial will evaluate the optimal dose of SMX/TMP for PCP prevention in patients with systemic rheumatic disease under immunosuppressive therapy.
Keywords pneumocystis pneumonia prophylaxis systemic rheumatic disease sulfamethoxazole-trimethoprim conventional-dose versus half-dose
Amo Type Clinical Study Protocol
Publication Title Acta Medica Okayama
Published Date 2019-02
Volume volume73
Issue issue1
Publisher Okayama University Medical School
Start Page 85
End Page 89
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 30820060
JaLCDOI 10.18926/AMO/56463
FullText URL 73_1_81.pdf
Author Sugihara, Yuusaku| Harada, Keita| Oka, Shohei| Yasutomi, Eriko| Yamasaki, Yasushi| Inokuchi, Toshihiro| Kinugasa, Hideaki| Takahara, Masahiro| Hiraoka, Sakiko| Otsuka, Fumio| Okada, Hiroyuki|
Abstract Endoscopic submucosal dissection (ESD) is reportedly one of the standard treatment strategies for large superficial colorectal neoplasms in Japan because of its high en bloc resection rate. A few technical issues regarding ESD should be considered, one of which is the selection of the Endo-cut I mode versus the Swift-coagulation mode as the electrosurgical unit mode setting during submucosal dissection. We seek to determine which of these two modes is more suitable for submucosal dissections of colorectal tumors with regard to procedure time and safety.
Keywords endoscopic submucosal dissection electrosurgical mode colorectal tumor
Amo Type Clinical Study Protocol
Publication Title Acta Medica Okayama
Published Date 2019-02
Volume volume73
Issue issue1
Publisher Okayama University Medical School
Start Page 81
End Page 84
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 30820059
JaLCDOI 10.18926/AMO/56462
FullText URL 73_1_77.pdf
Author Morita, Mio| Matsumoto, Hiroshi| Shirakawa, Yasuhiro| Noma, Kazuhiro| Tanabe, Shunsuke| Kimata, Yoshihiro|
Abstract Anterior cervical plate fixation is a common surgical treatment for cervical spine trauma, disc herniation, or cervical spondylosis. Esophageal perforation following anterior cervical plate fixation is a rare but serious complication. Management of esophageal perforation is controversial; however, we suggest treating most cases surgically because this condition is slow to heal and often fatal. We managed 2 cases of esophageal perforation following anterior cervical plate fixation by flap reconstruction with the pectoralis major muscle in one case and a jejunal free flap in the other. Here, we report our experience and review the surgical indications.
Keywords anterior cervical plate fixation esophageal perforation reconstruction pectoralis major flap jejunal free flap
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2019-02
Volume volume73
Issue issue1
Publisher Okayama University Medical School
Start Page 77
End Page 80
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 30820058
JaLCDOI 10.18926/AMO/56461
FullText URL 73_1_71.pdf
Author Takahashi-Arimasa, Keiko| Kohno-Yamanaka, Reiko| Soga, Yoshihiko| Miura, Rumi| Morita, Manabu|
Abstract Preoperative oral care is helpful to prevent postoperative complications in patients who are undergoing esophagectomy. Here, we report the case of an 81-year-old Japanese man with an upper limb disability caused by post-polio syndrome who was receiving neoadjuvant chemotherapy for esophageal cancer. He had poor oral health status and developed oral complications as a side effect of chemotherapy. He could not brush his teeth by himself. However, infection control by oral care provided by an interprofessional collaboration successfully improved his oral hygiene, and his follow-up involved no severe complications. Interprofessional collaboration is useful especially for patients with upper limb disability.
Keywords esophageal cancer preoperative oral care post-polio syndrome neoadjuvant chemotherapy oral mucositis
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2019-02
Volume volume73
Issue issue1
Publisher Okayama University Medical School
Start Page 71
End Page 76
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 30820057
JaLCDOI 10.18926/AMO/56460
FullText URL 73_1_67.pdf
Author Kono, Reika| Shimizu, Takehiro| Ohtsuki, Hiroshi| Hamasaki, Ichiro| Shibata, Kiyo| Kishimoto, Fumiko| Morizane, Yuki| Shiraga, Fumio|
Abstract We report a case of congenital multiple ocular motor nerve palsy combined with splitting of the lateral rectus muscle (LR). A 59-year-old Japanese female was investigated for worsening esotropia after corrective surgery. She presented with left hypertropia (35Δ) and esotropia (45-50Δ). Orbital magnetic resonance imaging (MRI) showed reduced belly sizes in the superior rectus, inferior rectus, and superior oblique muscles and splitting of the LR, extending from the origin to the belly, in the left eye. Splitting of the LR belly was detected on MRI in a case of congenital multiple ocular motor nerve palsy.
Keywords multiple ocular motor nerve palsy congenital cranial dysinnervation disorder lateral rectus muscle splitting orbital connective tissue magnetic resonance imaging
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2019-02
Volume volume73
Issue issue1
Publisher Okayama University Medical School
Start Page 67
End Page 70
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 30820056
JaLCDOI 10.18926/AMO/56459
FullText URL 73_1_61.pdf
Author Tamefusa, Kosuke| Ishida, Hisashi| Washio, Kana| Ishida, Toshiaki| Morita, Hirosuke| Shimada, Akira|
Abstract Patients with multi-system (MS)-type langerhans cell histiocytosis (LCH) show poor outcomes, especially congenital MS LCH cases were shown in high mortality rate. We experienced a congenital case of MS LCH with high risk organs, who needed intensive respiratory support after birth. Even though intensive chemotherapy was discontinued, this patient’s lung LCH lesions gradually became reduced and his respiratory condition recovered; therefore, we restarted and completed maintenance chemotherapy. The patient maintained complete remission for more than 4 years after the end of chemotherapy. Our case suggests that congenital MS LCH even with severe organ involvement can be treated successfully with chemotherapy.
Keywords Langerhans-cell histiocytosis congenital multisystem type
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2019-02
Volume volume73
Issue issue1
Publisher Okayama University Medical School
Start Page 61
End Page 65
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 30820055
JaLCDOI 10.18926/AMO/56458
FullText URL 73_1_51.pdf
Author Fujii, Masakuni| Fujimoto, Kenji| Yabe, Syuntaro| Nasu, Junichiro| Miyaike, Jiro| Yoshioka, Masao| Shiode, Junji| Yamamoto, Kazuhide| Matsuda, Shinya|
Abstract  We investigated the relationship between body mass index (BMI) and postoperative outcomes in 450 gallbladder cancer patients in Japan. We collected patient information, including sex, age, underlying disease, BMI, stage, surgery method, postoperative time to discharge, and postoperative Medicare fees, from the Japanese administrative database associated with the Diagnosis Procedure Combination system. We classified patient BMIs as underweight (BMI<18.5 kg/m2), normal (BMI≥18.5 kg/m2 and <25 kg/m2) or overweight/obese (BMI≥25 kg/m2), then investigated the relationship between these categories and two postoperative outcomes: time to discharge and postoperative Medicare fees. The median postoperative time to discharge was 12 days in all patients, and 12 days in each of the three weight groups (p=0.62, n.s.). The median postoperative Medicare fees from surgery until discharge were (USD): all patients, $5,002; underweight, $5,875; normal weight, $4,797; and overweight/obese, $5,179 (p=0.146, n.s.). A multivariate analysis with adjustment for competing risk factors revealed that BMI was not associated with increased risk of longer postoperative time to discharge (normal weight: HR 1.17, p=0.29; overweight/obese: HR 1.17, p=0.37) or higher postoperative Medicare fees (OR 0.99, p=0.86, n.s.). Thus, high BMI was not found to be a factor for poor postoperative outcomes in Japanese patients with gallbladder cancer.
Keywords body mass index gallbladder cancer surgery obesity
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2019-02
Volume volume73
Issue issue1
Publisher Okayama University Medical School
Start Page 51
End Page 59
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 30820054