result 3909 件
| 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/53122 |
|---|---|
| FullText URL | 69_1_51.pdf |
| Author | Mu Mu Shwe| Kyi Kyi Nyunt| Okada, Shigeru| Harano, Teruo| Hlaing Myat Thu| Hla Myat Mo Mo| Mo Mo Win| Khin Khin Oo| KhinThet Wai| Khin Saw Aye| Myo Khin| |
| Abstract | Persistent infection with oncogenic types of human papillomavirus (HPV) is the most important risk factor associated with cervical cancer. This study detected the oncogenic HPV genotypes in cervical neoplasia in relation to clinicopathological findings using a cross-sectional descriptive method in 2011 and 2012. Cervical swabs and colposcopy-directed cervical biopsy tissues were collected from 108 women (median age 45 years;range 20-78) showing cervical cytological changes at Sanpya General Hospital, Yangon, Myanmar. HPV DNA testing and genotyping were performed by polymerase chain reaction and restriction fragment length polymorphism. HPV was identified in women with cervical intraepithelial neoplasia (CIN) 1 (44.4%), CIN2 (63.2%), CIN3 (70.6%), and squamous cell carcinoma (SCC) (74.1%). The association between cervical neoplasia and HPV positivity was highly significant (p＝0.008). Most patients infected with HPV were between 40-49 years of age, and the youngest were in the 20- to 29-year-old age group. The most common genotype was HPV 16 (65.6%) with the following distribution:70% in CIN1, 41.7% in CIN2, 91.7% in CIN3, and 60% in SCC. HPV-31 was the second-most frequent (21.9%):30% in CIN1, 33.3% in CIN2, 8.3% in CIN3, and 15% in SCC. The third-most frequent-genotype was HPV-18 (7.8%):8.3% in CIN1, and 20% in SCC. Another genotype was HPV-58 (4.7%):16.7% in CIN1 and 5% in SCC. The majority of CIN/SCC cases were associated with HPV genotypes 16, 31, 18, and 58. If oncogenic HPV genotypes are positive, the possibility of cervical neoplasia can be predicted. Knowledge of the HPV genotypes distribution can predict the effectiveness of the currently used HPV vaccine. |
| Keywords | human papillomavirus genotyping Myanmar |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-02 |
| Volume | volume69 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 51 |
| End Page | 58 |
| 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 | 25703171 |
| Web of Science KeyUT | 000349740300006 |
| JaLCDOI | 10.18926/AMO/53121 |
|---|---|
| FullText URL | 69_1_45.pdf |
| Author | Iida, Tadayuki| Inoue, Ken| Ito, Yasuhiro| Ishikawa, Hiroaki| Kagiono, Miwa| Teradaira, Ryoji| Chikamura, Chiho| Harada, Toshihide| Ezoe, Satoko| Yatsuya, Hiroshi| |
| Abstract | This study aimed to clarify the association between depressive symptoms and a marker of oxidative stress-induced DNA damage in young females. Since the menstrual cycle may confound or modify this association, depressive symptoms and urinary levels of 8-hydroxy-2ʼ deoxyguanosine (8-OHdG) were evaluated during each menstrual phase. A total of 57 female fourth-year students (aged 21.6±0.8) from a Japanese health science university were studied. The menstrual cycle was divided into 3 phases:menstrual (days 1 to 3 after the onset of menses);proliferative (days 13 to 15);and secretory (days 24 to 26). Depressive symptoms were assessed by the self-rating depression scale (SDS). Positive depressive symptoms were defined as a score of 53 or more during 2 different menstrual phases. The association between the presence of depressive symptoms and 8-OHdG levels adjusting for the menstrual cycle was examined by two-way analysis of variance with the menstrual cycle (menstrual, proliferative, and secretory phases) as the within-individual factor. The menstrual cycle did not show a significant correlation with urinary 8-OHdG levels. On the other hand, the menstrual cycle-adjusted 8-OHdG level was significantly higher in those with depressive symptoms (7.01ng/mL) than in those without them (3.98ng/mL). The ROC curve analysis showed that urinary 8-OHdG levels had reasonably high discriminative performance throughout all the menstrual cycles (0.73-0.81;all p＜0.05). These results indicated the presence of oxidative stress in subjects with depressive symptoms independent of the menstrual cycle. |
| Keywords | depression 8-OHdG menstrual cycle |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-02 |
| Volume | volume69 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 45 |
| End Page | 50 |
| 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 | 25703170 |
| Web of Science KeyUT | 000349740300005 |
| JaLCDOI | 10.18926/AMO/53120 |
|---|---|
| FullText URL | 69_1_37.pdf |
| Author | Iwamuro, Masaya| Okada, Hiroyuki| Takata, Katsuyoshi| Kawai, Yoshinari| Kawano, Seiji| Nasu, Junichiro| Kawahara, Yoshiro| Tanaka, Takehiro| Yoshino, Tadashi| Yamamoto, Kazuhide| |
| Abstract | The sensitivity and specificity of magnified endoscopic features for differentiating follicular lymphoma from other diseases with duodenal whitish lesions have never been investigated. Here we compared the magnified endoscopic features of duodenal follicular lymphoma with those of other whitish lesions. We retrospectively reviewed the cases of patients with follicular lymphoma (n＝9), lymphangiectasia (n＝7), adenoma (n＝10), duodenitis (n＝4), erosion (n＝1), lymphangioma (n＝1), and hyperplastic polyp (n＝1). The magnified features of the nine follicular lymphomas included enlarged villi (n＝8), dilated microvessels (n＝5), and opaque white spots of various sizes (n＝9). The lymphangiectasias showed enlarged villi, dilated microvessels, and white spots, but the sizes of the white spots were relatively homogeneous and their margin was clear. Observation of the adenoma and duodenitis revealed only whitish villi. Although the lymphangioma was indistinguishable from the follicular lymphomas by magnified features, it was easily diagnosed based on the macroscopic morphology. In conclusion, magnified endoscopic features, in combination with macroscopic features, are useful for differentiating follicular lymphomas from other duodenal diseases presenting whitish lesions. |
| Keywords | duodenal neoplasm follicular lymphoma gastrointestinal lymphoma magnifying endoscopy |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-02 |
| Volume | volume69 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 37 |
| End Page | 44 |
| 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 | 25703169 |
| Web of Science KeyUT | 000349740300004 |
| JaLCDOI | 10.18926/AMO/53119 |
|---|---|
| FullText URL | 69_1_29.pdf |
| Author | Nakahara, Ryuichi| Nishida, Keiichiro| Hashizume, Kenzo| Harada, Ryouzou| Machida, Takahiro| Horita, Masahiro| Ohtsuka, Aiji| Ozaki, Toshifumi| |
| Abstract | The outcome measures in rheumatology clinical trials (OMERACT) scores are the most mature quantitation system for rheumatoid arthritis (RA) on magnetic resonance imaging (MRI). Direct measuring techniques of synovial volume have been reported with good reproducibility, although few reports have demonstrated the changes of these measures in response to treatment. To assess these clinical responses, we evaluated the correlation of the changes of clinical activity score 28-joints disease activity score (DAS28-CRP) with the changes of OMERACT scores and with synovial volume measurements. Eight RA patients who were treated by biologic agents were examined with MRI of the dominant affected wrist and finger joints before and one year after the treatment. The total OMERACT score was reduced from 48.0 to 41.3, and synovial volume was reduced from 15.4 to 8.8 milliliters. Positive correlations were seen between the changes of DAS28-CRP and the changes of OMERACT synovitis score (r＝0.27), OMERACT total score (r＝0.43) and synovial volume (r＝0.30). Limited to synovium assessment, synovial volume showed a better correlation with DAS28-CRP than the OMERACT synovitis score. On the other hand, the OMERACT total score showed a higher correlation with DAS28-CRP than synovial volume, probably because the OMERACT total score includes scores for bone erosion and bone edema as well. |
| Keywords | magnetic resonance imaging rheumatoid arthritis outcome measures in rheumatology clinical trials scoring system direct volume measuring medical work station |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-02 |
| Volume | volume69 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 29 |
| End Page | 35 |
| 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 | 25703168 |
| Web of Science KeyUT | 000349740300003 |
| Related Url | http://ousar.lib.okayama-u.ac.jp/metadata/53113 |
| JaLCDOI | 10.18926/AMO/53118 |
|---|---|
| FullText URL | 69_1_17.pdf |
| Author | Suzuki, Norihiro| Takata, Minoru| Shirafuji, Yoshinori| Otsuka, Masaki| Yamasaki, Osamu| Asagoe, Kenji| Hatta, Naohito| Iwatsuki, Keiji| |
| Abstract | Sentinel lymph node (SLN) biopsies have widely been used for the detection of occult LN metastasis of malignant melanoma (MM). In addition to conventional biomarkers, we assessed the diagnostic and prognostic significance of melanoma-initiating cell (MIC) markers in SLNs of MM. We examined the expressions of gp100, MART-1 and tyrosinase mRNA for routine diagnosis and those of ABCB5, CD133, nestin, KDM5B, NGFR and RANK mRNA as MIC markers. The presence of micrometastasis was confirmed immunohistochemically using antibodies to S-100, HMB-45, MART-1, and tyrosinase. Discordance between immunohistochemical and molecular data was observed in 14 of 70 (20.0%) patients, among whom five (7.1%) were positive for only molecular markers;two of these five patients tested positive for micrometastasis by repeated immunohistochemical stainings. The quantitative expression levels of gp100, MART-1, and tyrosinase mRNA were significantly higher in the metastatic LNs;the cut-off values remain to be elucidated. ABCB5 mRNA expression was detected more frequently in the metastatic SLNs (p＜0.05) and in the group of patients with recurrence. To make a definite diagnosis of metastasis, we still need a combination of immunohistochemical and molecular probes. ABCB5 might be a suitable molecular marker for the detection of melanoma-initiating cells in SLNs. |
| Keywords | melanoma cancer-initiating cell sentinel lymph node ABCB5 |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-02 |
| Volume | volume69 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 17 |
| End Page | 27 |
| 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 | 25703167 |
| Web of Science KeyUT | 000349740300002 |
| Related Url | http://ousar.lib.okayama-u.ac.jp/metadata/53114 |
| JaLCDOI | 10.18926/AMO/53117 |
|---|---|
| FullText URL | 69_1_1.pdf |
| Author | Watatani, Hiroyuki| Yamasaki, Hiroko| Maeshima, Yohei| Nasu, Tatsuyo| Hinamoto, Norikazu| Ujike, Haruyo| Sugiyama, Hitoshi| Sakai, Yoshiki| Tanabe, Katsuyuki| Makino, Hirofumi| |
| Abstract | Diabetic nephropathy is the most common pathological disorder predisposing patients to end-stage renal disease. Considering the increasing prevalence of type 2 diabetes mellitus worldwide, novel therapeutic approaches are urgently needed. ONO-1301 is a novel sustained-release prostacyclin analog that inhibits thromboxane A2 synthase. Here we examined the therapeutic effects of the intermittent administration of slow-release ONO-1301 (SR-ONO) on diabetic nephropathy in obese type 2 diabetes mice, as well as its direct effects on mesangial cells. The subcutaneous injection of SR-ONO (3mg/kg) every 3 wks did not affect the obesity or hyperglycemia in the db/db obese mice used as a model of type 2 diabetes, but it significantly ameliorated their albuminuria, glomerular hypertrophy, glomerular accumulation of type IV collagen, and monocyte/macrophage infiltration, and also the increase of TGF-β1, α-smooth muscle actin (α-SMA) and MCP-1 compared to vehicle treatment. In cultured mouse mesangial cells, ONO-1301 concentration-dependently suppressed the increases in TGF-β, type IV collagen, α-SMA, MCP-1 and fibronectin induced by high ambient glucose, at least partly through prostacyclin (PGI2) receptor-mediated signaling. Taken together, these results suggest the potential therapeutic efficacy of the intermittent administration of SR-ONO against type 2 diabetic nephropathy, possibly through protective effects on mesangial cells. |
| Keywords | prostacyclin ONO-1301 diabetic nephropathy TGF-β1 diabetes mellitus |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-02 |
| Volume | volume69 |
| Issue | issue1 |
| Publisher | Okayama University Medical School |
| Start Page | 1 |
| End Page | 15 |
| 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 | 25703166 |
| Web of Science KeyUT | 000349740300001 |
| Related Url | http://ousar.lib.okayama-u.ac.jp/metadata/53128 |
| FullText URL | K0005064_abstract_review.pdf K0005064_fulltext.pdf |
|---|---|
| Author | Suzuki, Norihiro| |
| Published Date | 2014-12-31 |
| Content Type | Thesis or Dissertation |
| Grant Number | 甲第5064号 |
| Granted Date | 2014-12-31 |
| Thesis Type | Doctor of Philosophy in Medical Science |
| Grantor | 岡山大学 |
| language | Japanese English |
| FullText URL | K0004063_abstract_review.pdf K0004063_fultext.pdf |
|---|---|
| Author | Nakahara, Ryuichi| |
| Published Date | 2014-12-31 |
| Content Type | Thesis or Dissertation |
| Grant Number | 甲第5063号 |
| Granted Date | 2014-12-31 |
| Thesis Type | Doctor of Philosophy in Medical Science |
| Grantor | 岡山大学 |
| language | Japanese English |
| 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 |
| JaLCDOI | 10.18926/AMO/53024 |
|---|---|
| FullText URL | 68_6_349.pdf |
| Author | Yamamoto, Tsuyoshi| Kajikawa, Yutaka| Otani, Satoru| Yamada, Yuki| Takemoto, Syunji| Hirota, Minoru| Ikeda, Masae| Iwagaki, Hiromi| Saito, Shinya| Fujiwara, Toshiyoshi| |
| Abstract | Accumulated studies have shown that ω-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) have protective roles against inflammatory responses such as hyperlipidemia, diabetes mellitus (DM) and cardiovascular diseases. Here we examined the effects of administering EPA to hyperlipidemic patients and other patients undergoing cardiac surgery to determine whether this treatment would increase plasma EPA levels and to clarify the association between EPA treatment and adiponectin production in hyperlipidemic patients. We also assessed the effect of preoperative EPA administration on postoperative adverse events such as postoperative atrial fibrillation (POAF) and postoperative infection in the cardiac surgery patients. The EPA administration significantly increased the serum EPA concentrations in both patient populations (p＜0.001). In the hyperlipidemic patients, the EPA administration significantly increased plasma adiponectin levels (p＜0.05), accompanied by a decrease in insulin resistance designated by the HOMA-IR (homeostasis model assessment of insulin resistance) score (p＜0.05) and Hs-CRP (high sensitivity C-reactive protein) value (p＜0.05). In the cardiac surgery patients, no significant effect of EPA on cardiac adverse events such as POAF was observed. However, our results clearly demonstrated that both the neutrophil-to-lymphocyte ratio and the 2nd-line antibiotic requirement in the EPA group were significantly decreased compared to the untreated control group (p＜0.05). We suggest that EPA administration may exert anti-inflammatory effects in patients with hyperlipidemia and in those undergoing cardiac surgery, possibly through an increase in plasma adiponectin levels. |
| Keywords | eicosapentaenoic acid adiponectin hyperlipidemic patients cardiac surgery atrial fibrillation |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-12 |
| Volume | volume68 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 349 |
| End Page | 361 |
| 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 | 25519029 |
| Web of Science KeyUT | 000346882200005 |
| Related Url | http://ousar.lib.okayama-u.ac.jp/metadata/53125 |
| JaLCDOI | 10.18926/AMO/53023 |
|---|---|
| FullText URL | 68_6_339.pdf |
| Author | Nishie, Hiroyuki| Mizobuchi, Satoshi| Suzuki, Etsuji| Sato, Kenji| Toda, Yuichiro| Matsuoka, Junji| Morimatsu, Hiroshi| |
| Abstract | The main purpose of this study was to determine the relationships between Japanese individualsʼ interest in living wills and their preferred end-of-life care and death locations. Questionnaires were mailed to 1,000 individuals aged ｧ50 to measure these 2 factors. We examined the associations between the respondentsʼ characteristics and their preferred care and death locations by using multinomial logistic regression models. The response rate was 74%. Home was the most frequently preferred place for end-of-life care (64%), and a palliative care unit (PCU) was the most commonly preferred place to die (51%). Living will interest was associated with a preference for care (odds ratio [OR] 4.74, 95% confidence interval [CI] 1.95-12.1) and death (OR 2.75, 95% CI 1.70-4.47) in a PCU rather than a hospital, but it was not associated with the choice between receiving care or dying at home instead of a hospital. We must consider why Japanese people think home death is impracticable. The Japanese palliative care system should be expanded to meet patientsʼ end-of-life needs, and this includes not only facilitating home care but also increasing access to PCU care. |
| Keywords | advance healthcare directive living will end-of-life care palliative care unit place of death |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-12 |
| Volume | volume68 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 339 |
| End Page | 348 |
| 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 | 25519028 |
| Web of Science KeyUT | 000346882200004 |
| Related Url | http://ousar.lib.okayama-u.ac.jp/metadata/53134 |
| JaLCDOI | 10.18926/AMO/53022 |
|---|---|
| FullText URL | 68_6_331.pdf |
| Author | Ohtsu, Tadahiro| Kaneita, Yoshitaka| Osaki, Yoneatsu| Kokaze, Akatsuki| Ochiai, Hirotaka| Shirasawa, Takako| Nanri, Hinako| Ohida, Takashi| |
| Abstract | The purposes of this study were to evaluate the mental health status of Japanese medical students and to examine differences based on gender, as well as on university type and location, using the results of a nationwide survey. Between December 2006 and March 2007, we conducted a questionnaire survey among fourth-year medical students at 20 randomly selected medical schools in Japan. The data from 1,619 students (response rate:90.6%;male:1,074;female:545) were analyzed. We used the Japanese version of the 12-item General Health Questionnaire (GHQ-12) to measure mental health status. Poor mental health status (GHQ-12 score of 4 points or higher) was observed in 36.6% and 48.8% of the male and female medical students, respectively. The ratio of the age-adjusted prevalence of poor mental health status in female versus male medical students was 1.33 (95% confidence interval:1.10-1.62). The universities were categorized into two groups based on the university type (national/public:15 vs. private:5) or location (in a large city:7 vs. in a local city:13 cities). The prevalence of poor mental health status in both men and women differed between these groups, although not significantly. The GHQ-12 scores in men significantly differed between the categorized groups of universities. These results suggest that adequate attention must be paid to the mental health of medical students, especially females, and that a system for providing mental health care for medical students must be established in the context of actual conditions at each university. |
| Keywords | medical students mental health 12-item General Health Questionnaire gender difference Japan |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-12 |
| Volume | volume68 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 331 |
| End Page | 337 |
| 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 | 25519027 |
| Web of Science KeyUT | 000346882200003 |
| JaLCDOI | 10.18926/AMO/53021 |
|---|---|
| FullText URL | 68_6_323.pdf |
| Author | Hirayama, Takahiro| Nagano, Osamu| Shiba, Naoki| Yumoto, Tetsuya| Sato, Keiji| Terado, Michihisa| Ugawa, Toyomu| Ichiba, Shingo| Ujike, Yoshihito| |
| Abstract | In adult high-frequency oscillatory ventilation (HFOV), stroke volume (SV) and mean lung pressure (PLung) are important for lung protection. We measured the airway pressure at the Y-piece and the lung pressure during HFOV using a lung model and HFOV ventilators for adults (R100 and 3100B). The lung model was made of a 20-liter, airtight rigid plastic container (adiabatic compliance: 19.3ml/cmH2O) with or without a resistor (20cmH2O/l/sec). The ventilator settings were as follows: mean airway pressure (MAP), 30cmH2O;frequency, 5-15Hz (every 1Hz);airway pressure amplitude (AMP), maximum;and % of inspiratory time (IT), 50% for R100, 33% or 50% for 3100B. The measurements were also performed with an AMP of 2/3 or 1/3 maximum at 5, 10 and 15Hz. The PLung and the measured MAP were not consistently identical to the setting MAP in either ventilator, and decreasing IT decreased the PLung in 3100B. In conclusion, we must pay attention to the possible discrepancy between the PLung and the setting MAP during adult HFOV. |
| Keywords | HFOV mean lung pressure mean airway pressure |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-12 |
| Volume | volume68 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 323 |
| End Page | 329 |
| 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 | 25519026 |
| Web of Science KeyUT | 000346882200002 |
| Related Url | http://ousar.lib.okayama-u.ac.jp/metadata/53132 |
| JaLCDOI | 10.18926/AMO/53020 |
|---|---|
| FullText URL | 68_6_317.pdf |
| Author | Kasahara, Kyosuke| Miyoshi, Ko| Murakami, Shinki| Miyazaki, Ikuko| Asanuma, Masato| |
| Abstract | In vertebrates, almost all somatic cells extend a single immotile cilium, referred to as a primary cilium. Increasing evidence suggests that primary cilia serve as cellular antennae in many types of tissues by sensing chemical or mechanical stimuli in the milieu surrounding the cells. In rodents an antibody to adenylyl cyclase 3 (AC3) has been widely used to label the primary cilia of neurons in vivo by immunostaining, whereas the lack of markers for the primary cilia of astrocytes has made it difficult to observe astrocytic primary cilia in vivo. Here, we obtained a visualization of astrocytic primary cilia in the mouse brain. In the somatosensory cortex, a large portion of neurons and astrocytes at postnatal day 10 (P10), and of neurons at P56 had AC3-positive primary cilia, whereas only approx. one-half of the astrocytes in the P56 mice carried primary cilia weakly positive for AC3. In contrast, the majority of astrocytes had ADP-ribosylation factor-like protein 13B (Arl13b)-positive primary cilia in the somatosensory cortex and other brain regions of P56 mice. The lengths of astrocytic primary cilia positive for Arl13b varied among the brain regions. Our data indicate that Arl13b is a noteworthy marker of astrocytic primary cilia in the brain. |
| Keywords | primary cilia astrocyte ADP-ribosylation factor-like protein 13B |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-12 |
| Volume | volume68 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 317 |
| End Page | 322 |
| 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 | 25519025 |
| Web of Science KeyUT | 000346882200001 |
| FullText URL | K0005024_abstract_review.pdf K0005024_fulltext.pdf |
|---|---|
| Author | Morisada, Sunao| |
| Published Date | 2014-09-30 |
| Content Type | Thesis or Dissertation |
| Grant Number | 甲第5024号 |
| Granted Date | 2014-09-30 |
| Thesis Type | Doctor of Philosophy in Medical Science |
| Grantor | 岡山大学 |
| language | Japanese English |
