result 2895 件
| JaLCDOI | 10.18926/AMO/69442 |
|---|---|
| FullText URL | 79_5_399.pdf |
| Author | Isozaki, Hiroshi| Matsumoto, Sasau| Takama, Takehiro| Isozaki, Yuka| Murakami, Shigeki| |
| Abstract | Gastric cancer with lymphoid stroma (GCLS) accounts for 1%-7% of gastric cancers; ~80% are Epstein-Barr virus (EBV)-positive. The rate of lymph node metastasis is relatively low, even when an early GCLS has invaded the submucosa. We report an early GCLS with massive submucosal invasion mimicking a submucosal tumor (SMT), diagnosed by endoscopic submucosal resection (ESD) and treated with local resection and sentinel node navigation surgery (SNNS). The patient was a 40-year-old Japanese man. A protruding lesion on the greater curvature of the middle part of his stomach was detected by X-ray, and an endoscopic examination revealed a 2.5-cm protruding tumor covered with a normal mucosa and small ulcers at the apex. ESD was performed for a diagnosis. The pathological diagnosis was lymphoepithelioma-like gastric cancer (GCLS), pT1b(SM2), Ly0, V0, pHM1, pVM1. EBV infection in the cancer cells was confirmed pathologically by EBV-encoded RNA. The local resection was performed using SNNS. The patient has had no recurrence or post-gastrectomy syndrome 4 years postsurgery. EBV-associated early GCLS resembling an SMT is relatively rare, and clinicians need to be aware of this disease. Local resection using SNNS may be a surgical option for GCLS cases with a low rate of lymphatic metastasis. |
| Keywords | gastric cancer gastric cancer with lymphoid stroma lymphoepithelioma-like carcinoma Epstein Barr virus sentinel node navigation surgery |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-10 |
| Volume | volume79 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 399 |
| End Page | 404 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69441 |
|---|---|
| FullText URL | 79_5_393.pdf |
| Author | Masunaga, Akari| Takagi, Kosei| Nagai, Yasuo| Yasui, Kazuya| Fuji, Tomokazu| Yamada, Motohiko| Nishiyama, Takeyoshi| Kanehira, Noriyuki| Sota, Yumi| Fujiwara, Toshiyoshi| |
| Abstract | Pancreatoduodenectomy (PD) after esophagectomy with gastric conduit reconstruction is technically challenging. Preserving the blood supply of the gastric conduit is crucial in performing PD after esophagectomy. We report the case of a 66-year-old man who underwent gastroduodenal artery-preserving PD after esophagectomy with gastric conduit reconstruction for intraductal papillary mucinous neoplasm. The patient developed pseudoaneurysm rupture postoperatively, but was successfully treated with interventional radiology. Precise assessment is important in developing a surgical strategy depending on the patient’s specific anatomy and tumor characteristics. Moreover, special attention should be paid to avoid accidental injuries of the gastric conduit and gastric vessels during surgery. |
| Keywords | pancreatoduodenectomy esophagectomy gastric conduit fluorescence imaging |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-10 |
| Volume | volume79 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 393 |
| End Page | 398 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69440 |
|---|---|
| FullText URL | 79_5_387.pdf |
| Author | Mori, Yusuke| Otani, Yoshihiro| Omae, Ryo| Hirano, Shuichiro| Ishida, Joji| Fujii, Kentaro| Haruma, Jun| Hiramatsu, Masafumi| Matsushita, Toshi| Higaki, Fumiyo| Sugiu, Kenji| Tanaka, Shota| |
| Abstract | Trigonal meningiomas are rare and pose surgical challenges due to their deep location and proximity to critical neuroanatomical structures. We present the case of a 67-year-old woman with a growing trigonal meningioma successfully resected with guidance by a preoperative 3D imaging analysis system. Integration of CT and MRI including diffusion tensor imaging (DTI) enabled precise mapping of the optic radiation, guiding a middle temporal gyrus approach. Preoperative embolization reduced tumor vascularity, facilitating gross total resection with minimal blood loss. This case highlights the effectiveness of preoperative 3D imaging systems in optimizing surgical planning and improving outcomes in complex neurosurgical cases. |
| Keywords | trigonal meningioma imaging analysis diffusion tensor imaging |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-10 |
| Volume | volume79 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 387 |
| End Page | 392 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69439 |
|---|---|
| FullText URL | 79_5_381.pdf |
| Author | Sakurai, Atsunobu| Yabuki, Takayuki| Aoki, Hideki| Iseki, Akiko| |
| Abstract | We report the case of a 72-year-old Japanese man with an incidental portal vein mass that was surgically resected and diagnosed as immunoglobulin G4 (IgG4)-related disease. The mass was discovered during an atrial fibrillation examination. The patient had a history of gastric cancer and was also diagnosed with rectal cancer, raising concerns about metastasis. Due to technical challenges, a biopsy was not feasible. Imaging findings suggested portal vein tumor thrombosis, complicating the diagnosis. This case highlights a rare presentation of IgG4-related disease mimicking portal vein tumor thrombus. |
| Keywords | immunoglobulin G4-related disease inflammatory pseudotumor mass portal vein pericarditis |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-10 |
| Volume | volume79 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 381 |
| End Page | 385 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69438 |
|---|---|
| FullText URL | 79_5_369.pdf |
| Author | Hisamatsu, Takashi| Kinuta, Minako| Munetomo, Sosuke| Fukuda, Mari| Kojima, Katsuhide| Taniguchi, Kaori| Nakahata, Noriko| Kanda, Hideyuki| |
| Abstract | We applied unsupervised machine learning to analyze blood pressure (BP) and resting heart rate (HR) patterns measured during a 1-year period to assess their cross-sectional relationships with subclinical cerebral and renal target damage. Dimension reduction via uniform manifold approximation and projection, followed by K-means++ clustering, was used to categorize 362 community-dwelling participants (mean age, 56.2 years; 54.9% women) into three groups: Low BP and Low HR (Lo-BP/Lo-HR), High BP and High HR (Hi-BP/Hi-HR), and Low BP and High HR (Lo-BP/Hi-HR). Cerebral vessel lesions were defined as the presence of at least one of the following magnetic resonance imaging findings: lacunar infarcts, white matter hyperintensities, cerebral microbleeds, or intracranial artery stenosis. A high urinary albumin-to-creatinine ratio (UACR) was defined as the top 10% (≥ 12 mg/g) of the mean value from ≥2 measurements. Poisson regression with robust error variance, adjusted for demographics, lifestyle, and medical history, showed that the Hi-BP/Hi-HR group had relative risks of 3.62 (95% confidence interval, 1.75-7.46) for cerebral vessel lesions and 3.58 (1.33-9.67) for high UACR, and the Lo-BP/Hi-HR group had a relative risk of 3.09 (1.12-8.57) for high UACR, compared with the Lo-BP/Lo-HR group. These findings demonstrate the utility of an unsupervised, data-driven approach for identifying physiological patterns associated with subclinical target organ damage. |
| Keywords | blood pressure heart rate subclinical disease uniform manifold approximation and projection unsupervised machine learning |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-10 |
| Volume | volume79 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 369 |
| End Page | 379 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69437 |
|---|---|
| FullText URL | 79_5_359.pdf |
| Author | Hirose, Tomohiko| Ikuma, Hisanori| Otsuka, Kazutoshi| Kawasaki, Keisuke| |
| Abstract | Single-position surgery with lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screws (PPSs) is gaining attention for its reduced invasiveness. We developed SPAPS, a technique allowing two surgeons to perform anterior LLIF and posterior PPS insertion simultaneously in a single lateral decubitus position. This retrospective study compared SPAPS (SPAPS-LLIF, Group SL) and minimally invasive posterior/transforaminal lumbar interbody fusion (MIS-PLIF/TLIF, Group PT) in patients treated between 2016 and 2019 with a two-year follow-up. Operative time, estimated blood loss (EBL), length of hospital stay (LOS), JOABPEQ and VAS scores, segmental lordotic angle, lumbar lordotic angle, segmental Cobb’s angle, PPS misplacement, PPS loosening, fusion status, and muscle cross-sectional areas were compared. Fifty-two patients were analyzed (Group SL: 25; Group PT: 27). SPAPS significantly reduced operative time (118.0 vs. 165.3 min, p <0.01) and estimated blood loss (8.6 vs. 164.1 mL, p<0.01). While clinical outcomes and hospital stay were comparable, Group SL had significantly lower PPS loosening (0% vs. 13%, p<0.01) and non-union rates (0% vs. 22.2%, p=0.02). Multifidus muscle atrophy was also less in Group SL (−14.3 vs. −121.5 mm2, p<0.01). SPAPS demonstrated advantages in reducing surgical invasiveness without compromising clinical efficacy, offering a promising alternative to conventional posterior fusion surgery. |
| Keywords | single-position surgery simultaneous lateral decubitus positioning lateral lumbar interbody fusion posterior lumbar interbody fusion |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-10 |
| Volume | volume79 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 359 |
| End Page | 368 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69436 |
|---|---|
| FullText URL | 79_5_353.pdf |
| Author | Chihara, Yuki| Hamasaki, Ichiro| Shibata, Kiyo| Morisawa, Shin| Kono, Reika| Kanenaga, Keisuke| Morizane, Yuki| |
| Abstract | To analyze and characterize the medial and lateral rectus muscles in patients with exotropia using anterior segment optical coherence tomography (AS-OCT). This study included 24 patients with exotropia (48 eyes) and 25 healthy individuals (50 eyes). Anterior segment optical coherence tomography was used to construct the en face images. The anterior chamber angle to the extraocular muscle insertion distance, muscle width, and muscle fiber angle from the muscle insertion sites were compared between the exotropia and the control groups. The correlation between these parameters and age or angle of deviation was evaluated. The mean ages were 13.2±4.1 years for the exotropia group and 17.6±7.2 years for the control group. The lateral rectus angle was significantly more inwardly rotated in the exotropia group than in the control group (1.6±6.3°, −1.4±4.0°, p=0.014). With increasing angle of deviation, the width of the lateral rectus increased (p=0.002). Our results indicate that the lateral rectus angle is significantly more inwardly rotated in patients with exotropia. These findings should contribute to a deeper understanding of the extraocular muscles in patients with this condition. |
| Keywords | exotropia AS-OCT anterior chamber angle to extraocular muscle insertion distance muscle width muscle fiber angle |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-10 |
| Volume | volume79 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 353 |
| End Page | 358 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69435 |
|---|---|
| FullText URL | 79_5_345.pdf |
| Author | Matsunaga, Nozomu| Egusa, Seira| Aono, Riyo| Tamai, Eiji| Hitusmoto, Yasuo| Katayama, Seiichi| |
| Abstract | Clostridium perfringens is a pathogenic anaerobe that causes gas gangrene and food poisoning. Although autolysin-mediated reorganization of the bacterial cell wall is crucial for cell division, excessive autolysin activity induced by stressors can lead to cell lysis. In C. perfringens, air exposure is a significant stressor that causes cell lysis, and Acp (N-acetylglucosaminidase) is known to be a major autolysin. To further facilitate C. perfringens research, a technology to prevent air-induced cell lysis must be developed. This study investigated the role of Acp in air-induced autolysis and explored potential inhibitors that would prevent cell lysis during experimental procedures. Morphological analyses confirmed that Acp functions as an autolysin in C. perfringens, as acpdeficient strains exhibited filamentous growth. The mutants exhibited negligible autolysis under air-exposure stress, confirming the involvement of Acp in the autolytic process. We also evaluated the effects of various divalent cations on Acp activity in vitro and identified Zn2+ as a potent inhibitor. Brief treatment with a Zn2+- containing buffer induced dose-dependent cell elongation and autolysis inhibition in C. perfringens. These findings demonstrate that simple Zn2+ treatment before experiments stabilizes C. perfringens cells, reducing autolysis under aerobic conditions and facilitating various biological studies, except morphological analyses. |
| Keywords | Clostridium perfringens autolysin zinc air-exposure autolysis |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-10 |
| Volume | volume79 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 345 |
| End Page | 352 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69434 |
|---|---|
| FullText URL | 79_5_339.pdf |
| Author | Hamasaki, Ichiro| Shibata, Kiyo| |
| Abstract | To determine whether passing a pole suture through the sclera at two points provides fixation comparable to that of a sliding noose, we measured the tensile strength of the suture‒sclera interface during simulated traction. In this in vitro study, three suture patterns were evaluated in porcine eyeballs, using 6-0 polyglycolic acid sutures. Patterns A (control), B (second suture pass perpendicular), and C (second suture pass in the same direction) were compared. The tensile strength of each pattern was measured 20 times using a KANON TK300CN, and the results were analyzed using the Kruskal‒Wallis test. Pattern A showed a tensile strength of 2±4 gram-force (gf) (range: 0-12). Pattern B showed 112±38 gf (range: 61-184). Pattern C showed 139±31 gf (range: 97-204). Patterns B and C had significantly higher tensile strengths than Pattern A (p<0.001). Although Pattern C was not significantly different from Pattern B (p=0.363), it exhibited the highest tensile strength. Lifting the suture between the first and second suture passes allows for an adjustable suture length, suggesting that adjustability can be achieved using only the sclera. This scleral adjustment method with a second suture pass offers a durable means of securing extraocular muscles and may represent a valuable addition to adjustable suturing techniques. |
| Keywords | scleral adjustment method adjustable suture technique hang-loose method tensile strength polyglycolic acid sutures |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-10 |
| Volume | volume79 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 339 |
| End Page | 343 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69433 |
|---|---|
| FullText URL | 79_5_329.pdf |
| Author | Matsubara, Kei| Miyoshi, Kentaroh| Toyooka, Shinichi| |
| Abstract | Primary graft dysfunction (PGD) is one of the major risk factors affecting patients’ short- and long-term survival after lung transplantation. No particular management strategy has been established for PGD; supportive care is the mainstay of PGD treatment. When a supportive strategy fails, the patient may require the introduction of extracorporeal membrane oxygenation (ECMO) as the last-resort measure for severe PGD. A variety of study of ECMO as a PGD treatment was reported and the management of PGD patients developed so far. Early recognition of a patient’s need for ECMO and its prompt initiation are critical to improved outcomes. The use of venovenous-ECMO became the preferred procedure for PGD rather than venoarterial-ECMO. However, the current ECMO strategy has limitations, and using ECMO to manage patients with PGD is not sufficiently effective. Further studies are required to develop this promising technology. |
| Keywords | lung transplantation primary graft dysfunction extracorporeal membrane oxygenation ex vivo lung perfusion |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-10 |
| Volume | volume79 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 329 |
| End Page | 337 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69432 |
|---|---|
| FullText URL | 79_5_321.pdf |
| Author | Obata, Taisuke| Matsumoto, Kazuyuki| Otsuka, Motoyuki| |
| Abstract | Bile leak occurs in 2-25% of liver transplant, 3-27% of hepatic resection, and 0.1-4% of cholecystectomy cases. The clinical course of bile leak varies depending on the type of surgery that caused the fistula, as well as the type, severity, and timing of bile duct injury. Although infections resulting from bile leak can be life-threatening, the introduction of endoscopic treatment has enabled some patients to avoid reoperation and has reduced the negative impact on quality of life associated with external fistulas for percutaneous drainage. Endoscopic interventions, such as sphincterotomy and stent placement, reduce the pressure gradient between the bile duct and duodenum, facilitating bile drainage through the papilla and promoting the closure of the leak. We reviewed the literature from 2004 to 2024 regarding bile leak following cholecystectomy and liver surgery, examining recommended techniques, timing, and treatment outcomes. In cases of bile leak following cholecystectomy, clinical success was achieved in 72-96% of cases, while success rates for bile leak following liver surgery ranged from 50% to 100%. Although endoscopic treatment is effective, it is not universally applicable, and its limitations must be carefully considered. |
| Keywords | bile leak cholecystectomy hepatic surgery endoscopic retrograde cholangiography bridging stent placement |
| Amo Type | Review |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-10 |
| Volume | volume79 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 321 |
| End Page | 328 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69160 |
|---|---|
| FullText URL | 79_4_317.pdf |
| Author | Morioka, Kei| Kuroko, Yosuke| Kadowaki, Sachiko| Kobayashi, Junko| Kotani, Yasuhiro| Kasahara, Shingo| |
| Abstract | A 65-year-old man was referred to our hospital for the annual assessment of the diameter and dilation of a pulmonary artery (PA) aneurysm. He had a small ventricular septal defect (VSD) that had closed naturally. Echocardiography revealed a dilated main PA, mild pulmonary regurgitation and no VSD. Computed tomography confirmed the dilation of the main PA (66.7×47.8 mm), right PA (37.1×32.9 mm), and left PA (36.7×34.0 mm). The patient underwent pulmonary artery replacement using a prosthetic vascular graft. A quadricuspid pulmonary valve was identified intraoperatively. Early surgical intervention could help to prevent rupture and dissection of PA aneurysms. |
| Keywords | pulmonary artery aneurysm quadricuspid pulmonary valve pulmonary valve regurgitation and stenosis congenital heart disease pulmonary artery graft replacement |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-08 |
| Volume | volume79 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 317 |
| End Page | 320 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69159 |
|---|---|
| FullText URL | 79_4_311.pdf |
| Author | Matsubara, Kei| Matsubara, Kei| Hirano, Yutaka| Fujiwara, Toshiya| |
| Abstract | A 55-year-old obese Japanese male with left pneumothorax presented to our hospital. Bilateral pulmonary emphysema was confirmed. Persistent air leakage was observed, and a thoracoscopic bullectomy was performed. Although the thoracoscopic bullectomy was completed uneventfully, pre-extubation chest X-ray imaging indicated hyper-lucency occupying the right upper part of the thoracic cavity, suggesting right-sided pneumothorax. CT imaging indicated a right-upper-lobe expanded bulla. Extubation was performed, and the hyperinflated bulla gradually deflated. Careful management of bulla expansion and respiratory status may be necessary for patients with obesity and large bullae, especially in one-lung ventilation cases. |
| Keywords | giant bulla pneumothorax obesity positive pressure ventilation one lung ventilation |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-08 |
| Volume | volume79 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 311 |
| End Page | 315 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69158 |
|---|---|
| FullText URL | 79_4_305.pdf |
| Author | Senoo, Satoru| Niman, Eito| Tsuji, Ryoko| Takata, Kohei| Matsumori, Shunsuke| Murano, Fumika| Sugisaki, Yuka| Omori, Hiroki| Taniguchi, Akihiko| Omote, Rika| Ichihara, Eiki| Takahashi, Kenji| Okada, Toshiaki| |
| Abstract | Pneumonic-type adenocarcinoma (P-ADC) can closely mimic pneumonia. We report a P-ADC initially diagnosed as pneumonia which developed into a pulmonary abscess and empyema. A 50-year-old Japanese male diagnosed with pneumonia, pulmonary abscess, and empyema was administered antibiotics and a chest tube for drainage, which improved his symptoms and blood test results. However, chest computed tomography showed an enlarged infiltrative shadow. The patient underwent bronchoscopy and was diagnosed with an adenocarcinoma. This case highlights the importance of considering P-ADC in differential diagnoses when a pneumonia-like shadow enlarges post-empyema treatment. Diagnostic and clinical tests, e.g., bronchoscopy, should be performed in such cases. |
| Keywords | pneumonic type adenocarcinoma empyema bronchoscopy lung cancer diagnosis cavity formation |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-08 |
| Volume | volume79 |
| Issue | issue4 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69157 |
|---|---|
| FullText URL | 79_4_299.pdf |
| Author | Feng, Ruibin| Zhu, Bikang| Wei, Danyun| Zhu, Dingjiao| Chen, Cairu| |
| Abstract | Pulmonary cement embolism (PCE) is a rare but severe complication following percutaneous vertebroplasty (PVP). Calcium phosphate cement (CPC) has emerged as an alternative to traditional materials for vertebral augmentation. There appear to be no established guidelines for managing symptomatic PCE, and there is scarce literature on CPC embolisms. This is a first report of a case of pulmonary CPC embolism following PVP. The patient, a 63-year-old Chinese female, was administered anticoagulant treatment and achieved a satisfactory outcome. Her case highlights the severe potential morbidity associated with CPC leakage and emphasizes the efficacy of anticoagulant treatment for managing pulmonary CPC embolisms. |
| Keywords | percutaneous vertebroplasty thoracic vertebrae fracture calcium phosphate cement pulmonary embolism |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-08 |
| Volume | volume79 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 299 |
| End Page | 303 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69156 |
|---|---|
| FullText URL | 79_4_293.pdf |
| Author | Kawai, Koji| Sasaki, Tatsuya| Tanimoto, Shun| Saijo, Tomoya| Sasada, Susumu| Akiyama, Tomoyuki| Hiraide, Takuya| Saitsu, Hirotomo| Tanaka, Shota| |
| Abstract | GNAO1 variant affects primarily the brain and neurodevelopment, leading to a range of motor disorders including seizures beginning in infancy and involuntary movements such as dyskinesia and dystonia. Our patient, a 15-year-old Japanese female, began exhibiting involuntary movements at age 4. A de novo missense mutation (NM_020988.3: c.228C>G, NP_066268.1: p.(Asn76Lys)) in the GNAO1 gene was identified when the patient was 15, and during the same year she developed influenza pneumonia, accompanied by dystonic storm. She required intensive care with mechanical ventilation and underwent a tracheostomy. She also developed posterior reversible encephalopathy syndrome. Globus pallidal stimulation was administered, leading to an improvement in the dystonic storm. Early consideration of globus pallidal stimulation is recommended when treating difficult-to-manage dystonic storms. |
| Keywords | GNAO1 variant dystonic storm globus pallidal stimulation posterior reversible encephalopathy syndrome |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-08 |
| Volume | volume79 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 293 |
| End Page | 297 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69155 |
|---|---|
| FullText URL | 79_4_287.pdf |
| Author | Tanimoto, Shun| Sasaki, Tatsuya| Kawai, Koji| Saijo, Tomoya| Kin, Kyohei| Sasada, Susumu| Tanaka, Shota| |
| Abstract | We report a case of drug-resistant parieto-occipital lobe epilepsy successfully treated with parieto-occipital disconnection (POD). An 18-year-old left-handed female, who had undergone surgery for an acute subdural hematoma at 10 months of age, developed drug-resistant epilepsy at age 15. Despite antiepileptic drug treatment, her seizures remained uncontrolled, and at age 18 she was referred to our hospital for evaluation. Magnetic resonance imaging (MRI) revealed atrophy in the left occipital and parietal lobes. Ictal electroencephalography (EEG) confirmed occipital onset of seizures without temporal lobe involvement. She had pre-existing homonymous hemianopsia. POD surgery was performed, carefully preserving the temporal lobe structures. Postoperatively, she experienced transient right-sided paresis, which fully resolved, and achieved complete seizure control at 3 years without memory loss. This case demonstrates that POD, a rare surgical approach, is a viable option for parieto-occipital lobe epilepsy, effectively controlling seizures while minimizing functional impairment in the absence of temporal lobe involvement. |
| Keywords | parieto-occipital lobe epilepsy parieto-occipital disconnection (POD) |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-08 |
| Volume | volume79 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 287 |
| End Page | 292 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69154 |
|---|---|
| FullText URL | 79_4_283.pdf |
| Author | Imamura, Yuta| Shiode, Yusuke| Kimura, Shuhei| Hosokawa, Mio| Matoba, Ryo| Kanzaki, Yuki| Kindo, Hiroya| Morita, Tetsuro| Murai, Aya| Ando, Mizuo| Morizane, Yuki| |
| Abstract | A 76-year-old man presented with right eyelid swelling and deteriorated vision. Examination revealed anterior uveitis with hypopyon and a visual acuity of 20/2,000 in the right eye, with no abnormalities in the left. Computed tomography revealed enlargement of the right maxillary sinus and internal fluid accumulation, suggesting a postoperative maxillary cyst (POMC). Nasal endoscopic surgery drained the pus by opening the lower wall of the maxillary cyst. Following the procedure, intraocular inflammation resolved, and visual acuity in the right eye improved to 24/20. This is the first reported case of uveitis secondary to POMC. |
| Keywords | anterior uveitis hypopyon maxillary sinus postoperative maxillary cyst |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-08 |
| Volume | volume79 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 283 |
| End Page | 286 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69153 |
|---|---|
| FullText URL | 79_4_279.pdf |
| Author | Yoshikawa, Mao| Tao, Hiroyuki| |
| Abstract | An 80-year-old male underwent an extended cholecystectomy for node-positive gallbladder adenocarcinoma. Two weeks later, hemoptysis revealed a left hilar tumor obstructing the bronchus, which was diagnosed as adenocarcinoma. Three months post-cholecystectomy, a left upper pulmonary lobectomy was performed. Histological similarity and positive thyroid transcription factor-1 (TTF-1) immunostaining in both tumors confirmed lung adenocarcinoma with gallbladder metastasis. Despite the generally poor prognosis for gallbladder metastasis from lung cancer, the patient achieved 3 years of survival. Patients with isolated synchronous gallbladder metastasis from lung cancer may benefit from oligometastasectomy. |
| Keywords | gallbladder metastasis lung cancer oligometastatic disease |
| Amo Type | Case Report |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-08 |
| Volume | volume79 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 279 |
| End Page | 282 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| JaLCDOI | 10.18926/AMO/69152 |
|---|---|
| FullText URL | 79_4_269.pdf |
| Author | Imai, Norio| Hirano, Yuki| Homma, Daisuke| Endo, Yuki| Horigome, Yoji| Suzuki, Hayato| Kawashima, Hiroyuki| |
| Abstract | The global femoral offset (the sum of the acetabular and femoral offsets) influences outcomes after total hip arthroplasty (THA). The optimal offset using plain radiographs has been reported, but internal and external rotations of the hip affect the offset value, producing unclear results when the nonsurgical side is not intact. We investigated the relationship between a functional hip score, i.e., the Harris Hip Score (HHS) and its effect on the post-THA anteroposterior and lateral offsets, and we sought to identify the optimal offset value. The cases of 158 patients with hemilateral hip osteoarthritis who underwent THA at a single center were retrospectively analyzed in this cross-sectional study. Three-dimensional pelvic and femoral models generated from computed tomography were used to examine several parameters, and the results revealed a significant binomial correlation among the modified HHS and femoral and global femoral offsets, with maximum values of 21.3 mm and 40 mm/100 cm body height, respectively. Pelvic and femoral parameters were measured and evaluated via alignment with a specific coordinate system. Our findings indicate that preoperative planning using these parameters may improve postoperative hip function, even when the nonoperative side is unsuitable for use as a reference, as in bilateral hip osteoarthritis cases. |
| Keywords | total hip arthroplasty global femoral offset postoperative outcome three-dimensional analysis anteroposterior offset |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2025-08 |
| Volume | volume79 |
| Issue | issue4 |
| Publisher | Okayama University Medical School |
| Start Page | 269 |
| End Page | 278 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | Copyright Ⓒ 2025 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
