Okayama University Medical School Acta Medica Okayama 0386-300X 75 6 2021 Guideline-based Treatment of Glucocorticoid-induced Osteoporosis in Patients with Rheumatoid Arthritis: A Retrospective Study with the AORA Registry 699 704 EN Tetsuya Kawano Department of Orthopedic Surgery, Akita University Graduate School of Medicine Naohisa Miyakoshi Department of Orthopedic Surgery, Akita University Graduate School of Medicine Hiroyuki Tsuchie Department of Orthopedic Surgery, Akita University Graduate School of Medicine Takeshi Kashiwagura Department of Orthopedic Surgery, Akita City Hospital Moto Kobayashi Department of Orthopedic Surgery, Hiraka General Hospital Yokote City Hiroshi Aonuma Department of Orthopedic Surgery, Ogachi Central Hospital Yuzawa City Yusuke Sugimura Department of Orthopedic Surgery, Nakadori General Hospital Akita City Yoichi Shimada Department of Orthopedic Surgery, Akita University Graduate School of Medicine Original Article 10.18926/AMO/62809 Glucocorticoid-induced osteoporosis (GIOP) is one of the side effects associated with glucocorticoid (GC) therapy. In 2014, the Japanese Society for Bone and Mineral Research (JSBMR) provided new guidelines for the management and treatment of GIOP. The aim of the present study was to clarify the prevalence of patients with rheumatoid arthritis (RA) requiring treatment according to the new guidelines and to identify risk factors associated with lack of treatment in these patients. Patients in the 2018 Akita Orthopedic group on Rheumatoid Arthritis (AORA) database were enrolled. Of 2,234 patients with RA in the database, 683 (30.6%) met the 2014 JSBMR guideline treatment criteria, and 480 (70.3%) had been treated. The untreated group included a larger number of males, younger patients, and patients treated in clinics rather than hospital (p<0.001, p=0.015, and p<0.001, respectively). Multivariate analyses found that male sex, younger age, and clinic-based RA care were significant risk factors associated with lack of treatment (p<0.001, p=0.013, and p<0.001, respectively). Thus, male sex, younger age, and clinic-based care were identified as risk factors No potential conflict of interest relevant to this article was reported.

Japan Neurosurgical Soc. Acta Medica Okayama 0470-8105 61 7 2021 An Evaluation of the Safety and Feasibility of Adenosine-assisted Clipping Surgery for Unruptured Cerebral Aneurysms: Study Protocol 393 396 EN Tomohito Hishikawa Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Satoshi Murai Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masafumi Hiramatsu Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Jun Haruma Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazuhiko Nishi Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuki Ebisudani Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yu Sato Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takao Yasuhara Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kenji Sugiu Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazuyoshi Shimizu Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Motomu Kobayashi Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Koji Nakagawa Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Aya Kimura-Ono Center for Innovative Clinical Medicine, Okayama University Hospital Katsuyuki Hotta Center for Innovative Clinical Medicine, Okayama University Hospital Hiroshi Morimatsu Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Isao Date Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences The effectiveness of adenosine-induced flow arrest in surgical clipping for the cerebral aneurysms with difficulties in temporary clip placement to the proximal main trunk has been reported. This is the first clinical trial to evaluate the safety and feasibility of adenosine-assisted clipping surgery for unruptured cerebral aneurysms (UCAs) in Japan. The inclusion criteria are as follows: patients over 20 years old, patients who agree to be enrolled in this study after providing informed consent, patients who undergo clipping surgery for UCA in our institute, and patients in whom the surgeons (T.H. or I.D.) judge that decompression of the aneurysm is effective. The primary endpoint is a modified Rankin Scale (mRS) score 30 days after surgery. We plan to enroll 10 patients in this study. The original protocol of adenosine administration was established in this trial. Herein, we present the study protocol. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 26662507 3 2020 Bilateral segmental lung transplantation for children: Transplantation using split adult living-donor lower lobe 311 314 EN Takahiro Oto Transplant Center, Okayama University Hospital Yukiko Hikasa Anesthesiology and Resuscitology, Okayama University Hospital Akikazu Hagiyama Physical Medicine and Rehabilitation, Okayama University Hospital Motomu Kobayashi Anesthesiology and Resuscitology, Okayama University Hospital No potential conflict of interest relevant to this article was reported.

BMC Acta Medica Okayama 1471-2466 20 1 2020 Right single lung transplantation using an inverted left donor lung: interposition of pericardial conduit for pulmonary venous anastomosis-a case report 46 EN Haruchika Yamamoto Thoracic Surgery, Okayama University Hospital Kentaroh Miyoshi Organ Transplant Center, Okayama University Hospital Shinji Otani Thoracic Surgery, Okayama University Hospital Takeshi Kurosaki Organ Transplant Center, Okayama University Hospital Seiichiro Sugimoto Thoracic Surgery, Okayama University Hospital Masaomi Yamane Thoracic Surgery, Okayama University Hospital Shinichi Toyooka Thoracic Surgery, Okayama University Hospital Motomu Kobayashi Anesthesiology, Okayama University Hospital Takahiro Oto Organ Transplant Center, Okayama University Hospital BACKGROUND:<br/> Lung transplantation (LTx) is still limited by the shortage of suitable donor lungs. Developing flexible surgical procedures can help to increase the chances of LTx by unfolding recipient-to-donor matching options based on the pre-existing organ allocation concept. We report a case in which a successful left-to-right inverted LTx was completed using the interposition of a pericardial conduit for pulmonary venous anastomosis.<br/> CASE PRESENTATION:<br/> A left lung graft was offered to a 59-year-old male who had idiopathic pulmonary fibrosis with predominant damage in the right lung. He had been prescribed bed rest with constant oxygen inhalation through an oxymizer pendant and had been on the waiting list for 20 months. Considering the condition of the patient (LAS 34.3) and the scarcity of domestic organ offers, the patient was highly likely to be incapable of tolerating any additional waiting time for another donor organ if he was unable to accept the presently reported offer of a left lung. Eventually, we decided to transplant the left donor lung into the right thorax of the recipient. Because of the anterior-posterior position gap of the hilar structures, the cuff lengths of the pulmonary veins had to be adjusted. The patient did not develop any anastomotic complications after the transplantation.<br/> CONCLUSIONS:<br/> A left-to-right inverted LTx is technically feasible using an autologous pericardial conduit for pulmonary venous anastomosis in selected cases. This technique provides the potential benefit of resolving challenging situations in which surgeons must deal with a patient's urgency and the logistical limitations of organ allocation. No potential conflict of interest relevant to this article was reported.

Springer Acta Medica Okayama 0941-1291 49 3 2018 Feasibility of lung transplantation from donors mechanically ventilated for prolonged periods 254 260 EN Seiichiro Sugimoto Department of General Thoracic SurgeryOkayama University Hospital Takeshi Kurosaki Department of Organ Transplant CenterOkayama University Hospital Shinji Otani Department of Organ Transplant CenterOkayama University Hospital Shin Tanaka Department of General Thoracic SurgeryOkayama University Hospital Yukiko Hikasa Department of Anesthesiology and ResuscitologyOkayama University Hospital Masaomi Yamane Department of General Thoracic SurgeryOkayama University Hospital Shinichi Toyooka Department of General Thoracic SurgeryOkayama University Hospital Motomu Kobayashi Department of Anesthesiology and ResuscitologyOkayama University Hospital Takahiro Oto Department of Organ Transplant CenterOkayama University Hospital PURPOSE:<br/> When patients are mechanically ventilated for more than 5 days, they are usually declined as donors for lung transplantation (LTx); thus, the long-term outcomes of LTx from such donors remain unclear. We investigated the feasibility of LTx from donors that had been mechanically ventilated for prolonged periods.<br/> METHODS:<br/> The subjects of this retrospective comparative investigation were 31 recipients of LTx from donors who had been mechanically ventilated for < 5 days (short-term group) and 50 recipients of LTx from donors who had been mechanically ventilated for ≥ 5 days (long-term group).<br/> RESULTS:<br/> The median duration of donor mechanical ventilation was 3 days in the short-term group and 8.5 days in the long-term group. However, other than the difference in the duration of donor ventilation, there were no significant differences in the clinical characteristics of the donors or recipients between the groups. The overall survival rate after LTx was comparable between the long-term group and short-term group (5-year survival rate, 66.6% vs. 75.2%).<br/> CONCLUSION:<br/> The potential inclusion of donors who have been on mechanical ventilation for more than 5 days could be a feasible strategy to alleviate donor organ shortage. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 73 6 2019 Local Anesthetic Systemic Toxicity Following General and Epidural Anesthesia in A patient with a History of Muscle Relaxant-induced Anaphylaxis 543 546 EN Asuka Kubo Department of anesthesiology, National Hospital Organization Iwakuni Clinical Center Kazuyoshi Shimizu Department of Anesthesiology and Resuscitology, Okayama University Hospital Kosuke Kuroda Department of Anesthesiology and Resuscitology, Okayama University Hospital Tomoyuki Kanazawa Department of Anesthesiology and Resuscitology, Okayama University Hospital Motomu Kobayashi Department of Anesthesiology and Resuscitology, Okayama University Hospital Hiroshi Morimatsu Department of Anesthesiology and Resuscitology, Okayama University Hospital Case Report 10.18926/AMO/57721 We here report that a 71-year-old Japanese woman with a history of anaphylaxis induced by muscle relaxants had local anesthetic systemic toxicity (LAST) following an abdominal surgery under general anesthesia with combined spinal-epidural anesthesia without muscle relaxants. The total dosages of local anesthetics reached 0.67 mg/kg of ropivacaine and 11.5 mg/kg of lidocaine over 12.5 h to obtain sufficient muscle relaxation for surgery. Regional anesthesia is useful in cases in which muscle relaxants are to be avoided during a surgery. However, especially for a patient with risk factors and prolonged surgery, precautions should be taken to prevent LAST. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 70 6 2016 Isoflurane Induces Transient Impairment of Retention of Spatial Working Memory in Rats 455 460 EN Masaaki Tanino Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Motomu Kobayashi Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toshihiro Sasaki Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ken Takata Department of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School Yoshimasa Takeda Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Satoshi Mizobuchi Division of Anesthesiology, Department of Surgery Related, Kobe University Graduate School of Medicine Kiyoshi Morita Okayama University Taku Nagai Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine Hiroshi Morimatsu Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/54808 Postoperative cognitive dysfunction (POCD) occurs in nearly one-third of patients after non-cardiac surgery. Many animal behavior studies have investigated the effect of general anesthesia on cognitive function. However, there have been no studies examining the effects on working memory specifically, with a focus on the retention of working memory. We demonstrate here that isoflurane anesthesia induces deficits in the retention of spatial working memory in rats, as revealed by an increase in isoflurane-induced across-phase errors in the delayed spatial win-shift (SWSh) task with a 30-min delay in an 8-arm radial arm maze on post-anesthesia days (PADs) 1,2,4, and 10. A post-hoc analysis revealed a significant increase in across-phase errors on PAD 1 and recovery on PAD 10 in the isoflurane group. In contrast, within-phase errors independent of the retention of working memory were unaffected by isoflurane. These results demonstrate that isoflurane anesthesia transiently impairs the retention of spatial working memory in rats. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2007 Quantitative Evaluation of the Neuroprotective Effects of Thiopental Sodium, Propofol and Halothane on Brain Ischemia in the Gerbil: Effects of the Anesthetics on Ischemic Depolarization and Extracellular Glutamate Concentration EN Motomu Kobayashi No potential conflict of interest relevant to this article was reported.