検索結果 1505 件
| JaLCDOI | 10.18926/AMO/62820 |
|---|---|
| フルテキストURL | 75_6_763.pdf |
| 著者 | Iwata, Takehiro| Sadahira, Takuya| Maruyama, Yuki| Sekito, Takanori| Yoshinaga, Kasumi| Watari, Shogo| Nagao, Kentaro| Kawada, Tatsushi| Tominaga, Yusuke| Nishimura, Shingo| Takamoto, Atsushi| Sako, Tomoko| Edamura, Kohei| Kobayashi, Yasuyuki| Araki, Motoo| Ishii, Ayano| Watanabe, Masami| Watanabe, Toyohiko| Nasu, Yasutomo| Wada, Koichiro| |
| 抄録 | The aim of this ongoing trial is to evaluate the clinical efficacy and safety of sitafloxacin (STFX) 200 mg once daily (QD) for 7 days in patients with refractory genitourinary tract infections, which include recurrent or complicated cystitis, complicated pyelonephritis, bacterial prostatitis, and epididymitis. The primary endpoint is the microbiological efficacy at 5-9 days after the last administration of STFX. Recruitment began in February 2021, and the target total sample size is 92 participants. |
| キーワード | genitourinary tract infections fluoroquinolone resistance extended-spectrum beta-lactamase |
| Amo Type | Clinical Study Protocol |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-12 |
| 巻 | 75巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 763 |
| 終了ページ | 766 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | Copyright Ⓒ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34955548 |
| Web of Science KeyUT | 000735319800006 |
| NAID | 120007180272 |
| JaLCDOI | 10.18926/AMO/62819 |
|---|---|
| フルテキストURL | 75_6_759.pdf |
| 著者 | Shimizu, Dai| Yamamoto, Hiromasa| Shien, Kazuhiko| Taniguchi, Kohei| Miyoshi, Kentaroh| Namba, Kei| Mesaki, Kumi| Sugimoto, Seiichiro| Soh, Junichi| Yamane, Masaomi| Toyooka, Shinichi| |
| 抄録 | Pulmonary enteric adenocarcinoma (PEAC) is a rare subtype of lung cancer that should be differentiated from colorectal cancer metastasis. Little is known about its genetic background. An 84-year-old male with adenocarcinoma of the lung underwent left upper lobectomy. The histology of the surgical specimen was suggestive of PEAC. Gastrointestinal and colorectal fiberscopy revealed no evidence of colorectal cancer. Next-generation sequencing of the tumor identified a G469V substitution in serine/threonine-protein kinase B-raf (BRAF). Based on the higher prevalence of the G469 substitution in BRAF-mutant lung adenocarcinoma than in BRAFmutant colorectal cancer, the tumor likely originated from the lung. Identification of mutational genotype may be of some help in distinguishing PEAC from the lung metastasis of colorectal cancer. |
| キーワード | non-small cell lung cancer somatic mutations pulmonary adenocarcinoma with enteric differentiation non-V600E BRAF mutation next-generation sequencing |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-12 |
| 巻 | 75巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 759 |
| 終了ページ | 762 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | Copyright Ⓒ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34955547 |
| Web of Science KeyUT | 000735319800005 |
| NAID | 120007180273 |
| JaLCDOI | 10.18926/AMO/62816 |
|---|---|
| フルテキストURL | 75_6_745.pdf |
| 著者 | Hayata, Kei| Mishima, Sakurako| Ohira, Akiko| Tani, Kazumasa| Maki, Jota| Eto, Eriko| Ogawa, Chikako| Masuyama, Hisashi| |
| 抄録 | NIPT is non-definitive testing to estimate the possibility that fetuses have trisomy 21, trisomy 18, or trisomy 13. However, in NIPT-positive and indeterminate cases, rare chromosomal disease may become apparent, requiring advanced genetic considerations and counseling skills. We experienced two such cases, a trisomy 21 mosaicism case triggered by NIPT-positive status and 18q deletion syndrome triggered by NIPT-indeterminate status. These cases have two clinical implications for NIPT. First, it was revealed that trisomy mosaicism might be found in NIPT-positive cases that have lower Z-Scores than those inferred from the fraction of fetal cfDNA in the case of standard trisomy. Second, it is possible that microdeletion syndrome could be the reason for an indeterminate NIPT result. Today’s genetic counseling requires more expertise in ethics and communication as well as genetic science because NIPT can lead to totally unexpected results. |
| キーワード | NIPT massively parallel sequencing trisomy 21 mosaicism 18q-deletion syndrome genetic counseling |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-12 |
| 巻 | 75巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 745 |
| 終了ページ | 750 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | Copyright Ⓒ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34955544 |
| Web of Science KeyUT | 000735319800002 |
| NAID | 120007180276 |
| JaLCDOI | 10.18926/AMO/62813 |
|---|---|
| フルテキストURL | 75_6_725.pdf |
| 著者 | Matsumoto, Hiroshi| Kimata, Yoshihiro| Ota, Tomoyuki| Sugiyama, Narushi| Onoda, Satoshi| Makino, Takuma| Takeda, Seiko| Mizukawa, Nobuyoshi| |
| 抄録 | The long-term changes in tissues implanted in the oral cavity and pharynx after head and neck reconstruction have not been fully evaluated. This study aimed to clarify the morphological changes, long-term durability, and potential for secondary carcinogenesis in such tissues. In our single-center study, the rough morphological changes in 54 cases of intraoral and pharyngeal skin and mucosal flaps were evaluated more than 10 years after flap transfer. In addition, the literature on the development of second carcinomas from skin flaps was reviewed. The mean follow-up period for transferred flaps was 148 months. The reconstruction areas and the probability of morphological changes were significantly correlated (p=0.006), especially in cases with tongue, lower gingiva, and buccal mucosal reconstruction. Free jejunal flap surfaces were well maintained, whereas tubed skin flaps showed severe morphological changes in cases with pharyngeal reconstruction. None of the flaps in our series developed second primary carcinomas. Skin flaps generally had good durability for > 10 years in intraoral environments, while mucosal flaps had better durability for pharyngeal reconstruction. Second squamous carcinomas arising from skin flaps are extremely rare; however, surgeons should take this possibility into consideration and conduct meticulous and long-term follow-up. |
| キーワード | skin flap mucosal flap oral reconstruction morphological change second primary carcinoma |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-12 |
| 巻 | 75巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 725 |
| 終了ページ | 734 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | Copyright Ⓒ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34955541 |
| NAID | 120007180279 |
| JaLCDOI | 10.18926/AMO/62811 |
|---|---|
| フルテキストURL | 75_6_713.pdf |
| 著者 | Aoyama, Tatsuro| Ogiwara, Toshihiro| Ito, Kiyoshi| Miyaoka, Yoshinari| Fujii, Yu| Hanaoka, Yoshiki| Hasegawa, Takatoshi| Watanabe, Gen| Seguchi, Tatsuya| Hongo, Kazuhiro| |
| 抄録 | The consistency of spinal meningiomas is important to consider when performing tumor removal surgery. This study evaluated the correlations between spinal meningioma consistency and both preoperative computed tomography (CT) values and histopathological subtypes. Fifteen consecutive patients who underwent surgical resection of spinal meningioma at our institution were identified, and preoperative CT values and the signal intensity of T2-weighted magnetic resonance images of the tumor were determined retrospectively. The consistency of the spinal meningioma was defined based on the ultrasonic surgical aspirator output during tumor debulking. Patients were assigned to 2 groups: a soft group (n=4) and a hard group (n=11). The T2 signal intensity was significantly higher in the soft group than in the hard group (p=0.001). While the CT values were considerably higher in the hard group, the difference was not significant (p=0.19). Regarding the histopathological subtypes, psammomatous meningioma exhibited significantly higher CT values than meningothelial meningioma (p=0.019); however, there was a higher frequency of hard tumors in meningothelial meningioma cases than in psammomatous meningioma cases. Although neither robust correlations between tumor consistency and CT values nor a relationship between tumor consistency and histopathological subtype has been established, these results might help with the perioperative manegement of spinal tumors. |
| キーワード | calcification computed tomography psammoma body spinal meningioma |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-12 |
| 巻 | 75巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 713 |
| 終了ページ | 718 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | Copyright Ⓒ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34955539 |
| Web of Science KeyUT | 000735297900007 |
| NAID | 120007180281 |
| JaLCDOI | 10.18926/AMO/62810 |
|---|---|
| フルテキストURL | 75_6_705.pdf |
| 著者 | Iwata, Takehiro| Maruyama, Yuki| Kawada, Tatsushi| Sadahira, Takuya| Katayama, Satoshi| Takamoto, Atsushi| Sako, Tomoko| Wada, Koichiro| Edamura, Kohei| Kobayashi, Yasuyuki| Araki, Motoo| Watanabe, Masami| Watanabe, Toyohiko| Nasu, Yasutomo| |
| 抄録 | Optimal neoadjuvant hormone therapy (NHT) for reducing prostate cancer (PC) patients’ prostate volume pre-brachytherapy is controversial. We evaluated the differential impact of neoadjuvant gonadotropin-releasing hormone (GnRH) antagonist versus agonist on post-brachytherapy testosterone recovery in 112 patients treated pre-brachytherapy with NHT (GnRH antagonist, n=32; GnRH agonists, n=80) (Jan. 2007-June 2019). We assessed the effects of patient characteristics and a GnRH analogue on testosterone recovery with logistic regression and a propensity score analysis (PSA). There was no significant difference in the rate of testosterone recovery to normal levels (> 300 ng/dL) between the GnRH antagonist and agonists (p=0.07). The GnRH agonists induced a significantly more rapid testosterone recovery rate at 3 months post-brachytherapy versus the GnRH antagonist (p<0.0001); there was no difference in testosterone recovery at 12 months between the GnRH antagonist/agonists (p=0.8). In the multivariate analysis, no actor was associated with testosterone recovery. In the PSA, older age and higher body mass index (BMI) were significantly associated with longer testosterone recovery. Post-brachytherapy testosterone recovery was quicker with the neoadjuvant GnRH agonists than the antagonist, and the testosterone recovery rate was significantly associated with older age and higher BMI. Long-term follow-ups are needed to determine any differential effects of GnRH analogues on the quality of life of brachytherapy-treated PC patients. |
| キーワード | testosterone recovery GnRH antagonist GnRH agonist brachytherapy prostate cancer |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-12 |
| 巻 | 75巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 705 |
| 終了ページ | 711 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | Copyright Ⓒ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34955538 |
| Web of Science KeyUT | 000735297900006 |
| NAID | 120007180282 |
| JaLCDOI | 10.18926/AMO/62809 |
|---|---|
| フルテキストURL | 75_6_699.pdf |
| 著者 | Kawano, Tetsuya| Miyakoshi, Naohisa| Tsuchie, Hiroyuki| Kashiwagura, Takeshi| Kobayashi, Moto| Aonuma, Hiroshi| Sugimura, Yusuke| Shimada, Yoichi| |
| 抄録 | 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 |
| キーワード | glucocorticoid glucocorticoid-induced osteoporosis rheumatoid arthritis osteoporosis osteopenia |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-12 |
| 巻 | 75巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 699 |
| 終了ページ | 704 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | Copyright Ⓒ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34955537 |
| Web of Science KeyUT | 000735297900005 |
| NAID | 120007180283 |
| JaLCDOI | 10.18926/AMO/62808 |
|---|---|
| フルテキストURL | 75_6_691.pdf |
| 著者 | Kato, Yuji| Hayashi, Takeshi| Kato, Ritsushi| Uchino, Akira| Takao, Masaki| Takahashi, Shinichi| |
| 抄録 | Although diagnostic and therapeutic strategies for acute stroke patients in Japan depend largely on magnetic resonance imaging (MRI), patients with cardiac implantable electronic devices (CIED) must still rely on com-puted tomography (CT). We retrospectively analyzed clinical and neuroimaging data of ischemic stroke patients with CIED treated at our hospital. Forty-five patients were enrolled in the study. Patients were divided into two groups according to whether corresponding lesions were detected (group A, n = 21) or not detected (group B, n = 24) by the first brain CT. We also evaluated in detail the clinical courses of patients who arrived at hospital within therapeutic time windows for recanalization therapy. Negative fresh infarct in the first CT was associated, though not significantly, with early onset-to-arrival time and subcortical white matter infarction. Five patients did not undergo recanalization therapy because their families did not agree to the procedure. The reasons for their lack of consent included inadequate information about the safety and efficacy of recanalization therapy because MRI could not be performed. Our study confirmed delayed detection of the corresponding lesion and undertreatment for acute stroke in patients with CIED. |
| キーワード | stroke cardiac implantable electronic device computed tomography magnetic resonance imaging |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-12 |
| 巻 | 75巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 691 |
| 終了ページ | 697 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | Copyright Ⓒ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34955536 |
| Web of Science KeyUT | 000735297900004 |
| NAID | 120007180284 |
| JaLCDOI | 10.18926/AMO/62807 |
|---|---|
| フルテキストURL | 75_6_685.pdf |
| 著者 | Yamashita, Mampei| Kuroki, Tamotsu| Hamada, Takashi| Hirayama, Takanori| Tokunaga, Takayuki| Yamanouchi, Kosho| Takeshita, Hiroaki| Maeda, Shigeto| |
| 抄録 | Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive imaging technique that provides high-quality visualization of the biliary tree, including the gallbladder. This study aimed to evaluate the useful-ness of preoperative MRCP for acute cholecystitis in predicting technical difficulties during laparoscopic chole-cystectomy (LC). A total of 168 patients who underwent LC with preoperative MRCP were enrolled in this study. Patients were divided into two groups according to preoperative MRCP findings: the visualized group (n = 126), in which the entire gallbladder could be visualized; and the non-visualized group (n = 42), in which the entire gallbladder could not be visualized. The perioperative characteristics and postoperative complica-tions of the two groups were retrospectively analyzed. Operation time was longer in the non-visualized group (median 101.5 vs. 143.5 min; p < 0.001). The non-visualized group had significantly more intraoperative blood loss than the visualized group (median 5 vs. 10 g; p = 0.05). The rate of conversion to open cholecystectomy was significantly higher in the non-visualized group (1.6 vs. 9.5%; p = 0.03). In conclusion, patients in the non- visualized group showed higher difficulty in performance of LC. Our MRCP-based classification is a simple and effective means of predicting difficulties in performing LC for acute cholecystitis. |
| キーワード | laparoscopic cholecystectomy magnetic resonance cholangiopancreatography acute cholecystitis gallbladder disease non-invasive imaging |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-12 |
| 巻 | 75巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 685 |
| 終了ページ | 689 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | Copyright Ⓒ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34955535 |
| Web of Science KeyUT | 000735297900003 |
| NAID | 120007180285 |
| JaLCDOI | 10.18926/AMO/62806 |
|---|---|
| フルテキストURL | 75_6_677.pdf |
| 著者 | Tani Kazumasa| Mitsui, Takashi| Mishima, Sakurako| Ohira, Akiko| Maki, Jota| Eto, Eriko| Hayata, Kei| Nakamura, Keiichiro| Masuyama, Hisashi| |
| 抄録 | Extravillous trophoblast (EVT) invasion is important for embryo implantation, placental development, and successful remodeling of the uterine spiral artery. Endocrine gland derived-vascular endothelial growth factor (EG-VEGF) and matrix metalloproteinases (MMPs) are implicated in EVT invasion; however, the high con-centrations found in pregnancy pathologies have not been investigated in non-tumor trophoblasts. The roles of EG-VEGF, prokineticin receptors (PROKR1/2), MMP-2, and MMP-9 in EVT invasion during spiral artery remodeling were evaluated using human EVT from HTR-8/SVneo cell lines. The expression of MMP-2, MMP-9, and mitogen-activated protein kinase (MAPK), and Akt pathways in HTR-8/SVneo cells treated with recom-binant EG-VEGF alongside anti-PROKR1 and/or anti-PROKR2 antibodies was evaluated using quantitative reverse transcription-PCR and western blotting. Wound-healing and cell invasion assays were performed to assess the migration and invasion of these treated cells. Interestingly, 20 nM EG-VEGF activated ERK1/2 sig-naling and upregulated MMP-2 and MMP-9. This effect was suppressed by anti-PROKR2 antibody via ERK1/2 downregulation. Anti-PROKR2 antibody inhibited the migration and invasion of EG-VEGF-stimulated HTR-8/SVneo cells. Elevated concentrations of EG-VEGF enhance EVT invasion in a human trophoblast cell line by upregulating MMP-2 and MMP-9 via PROKR2. These new insights into the regulation of epithelial cell invasion may help in developing therapeutic interventions for placental-related diseases during pregnancy. |
| キーワード | endocrine gland-derived vascular endothelial growth factor prokineticin extravillous trophoblast matrix metalloproteinase obstetric diseases |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-12 |
| 巻 | 75巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 677 |
| 終了ページ | 684 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | Copyright Ⓒ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34955534 |
| Web of Science KeyUT | 000735297900002 |
| NAID | 120007180286 |
| JaLCDOI | 10.18926/AMO/62780 |
|---|---|
| フルテキストURL | 75_5_653.pdf |
| 著者 | Tsuchie, Hiroyuki | Miyakoshi, Naohisa| Nagasawa, Hiroyuki| Nanjo, Hiroshi| Shimada, Yoichi| |
| 抄録 | We present an extremely rare case of deep angiomyxoma (DAM) in the thigh that was misdiagnosed as desmoid-type fibromatosis. A 40-year-old Japanese woman presented with a mass on the left thigh. The histological diagnosis by needle biopsy was desmoid-type fibromatosis; the tumor grew slowly and was resected 4 years later. The histological diagnosis from the resected tumor was DAM. As of 16 months post-surgery, the patient has not noticed any local recurrence. Although DAM in a lower extremity is extremely rare, clinicians must be aware of its possible occurrence in areas relatively close to the pelvis. |
| キーワード | deep angiomyxoma thigh desmoid-type fibromatosis |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-10 |
| 巻 | 75巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 653 |
| 終了ページ | 657 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34703050 |
| Web of Science KeyUT | 000711568400005 |
| NAID | 120007166665 |
| JaLCDOI | 10.18926/AMO/62776 |
|---|---|
| フルテキストURL | 75_5_631.pdf |
| 著者 | Yamamoto, Koichiro| Omura, Daisuke| Yamane, Mai| Son, Reina| Hasegawa, Kou| Honda, Hiroyuki| Obika, Mikako| Minao, Nozomu| Edahiro, Satoru| Yamada, Norihito| Otsuka, Fumio| |
| 抄録 | Anorexia nervosa (AN) is occasionally complicated with hypoglycemic coma, which may cause sudden death by unknown mechanisms. We present the case of a 36-year-old woman with recurrent comas and a nineteen-year history of AN. She was found in a coma with remarkable hypoglycemia (28 mg/dL). Her BMI was 11.1 kg/m2. Endocrine workup revealed extremely low serum levels of glucagon, IGF-I and insulin. Asymptomatic hypoglycemia occurred with liver injury in the refeeding process. An aberrant glucose metabolism due to liver damage might have been involved in her susceptibility to hypoglycemia. This case suggests a possible mechanism of hypoglycemic coma in AN. |
| キーワード | anorexia nervosa glucagon hypoglycemic coma insulin-like growth factor-I liver injury |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-10 |
| 巻 | 75巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 631 |
| 終了ページ | 636 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34703046 |
| Web of Science KeyUT | Recurrence of Hypoglycemic Coma in a Patient with Anorexia Nervosa Recurrence of Hypoglycemic Coma in a Patient with Anorexia Nervosa 000711568400001 |
| NAID | 120007166676 |
| JaLCDOI | 10.18926/AMO/62775 |
|---|---|
| フルテキストURL | 75_5_625.pdf |
| 著者 | Iwamuro, Masaya| Yamasaki, Yasushi| Tanaka, Takehiro| Asada, Noboru| Matsuoka, Ken-ichi| Hiraoka, Sakiko| Kawahara, Yoshiro| Okada, Hiroyuki| |
| 抄録 | A 77-year-old Japanese woman who had been treated for follicular lymphoma for 8 years developed abdominal pain and intra-abdominal lymphadenopathies. Colonoscopy revealed an elevated lesion in the rectum, which presented as two humps with erosions. A diagnosis of histologic transformation of follicular lymphoma to diffuse large B-cell lymphoma was made by endoscopic biopsy. This case underscores the importance of endoscopy examinations and biopsy of newly emerged gastrointestinal lesions for the prompt diagnosis of histologic transformation, since salvage chemotherapy must be initiated quickly in such cases. |
| キーワード | colorectal lymphoma follicular lymphoma diffuse large B-cell lymphoma histologic transformation |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-10 |
| 巻 | 75巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 625 |
| 終了ページ | 629 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34703045 |
| Web of Science KeyUT | 000711561300001 |
| NAID | 120007166675 |
| JaLCDOI | 10.18926/AMO/62774 |
|---|---|
| フルテキストURL | 75_5_611.pdf |
| 著者 | Zhou, Yu| Furutani, Michiyo| Athurupana, Rukmali| Nakatsuka, Mikiya| |
| 抄録 | Family members are critical mediators of the experiences of transgender people. We studied whether transgen-der subjects had disclosed their identity to their families and their families’ reactions after the disclosure. We also evaluated the subjects’ mental state and its association with disclosure status. Transgender people were recruited for this anonymous questionnaire survey in the Okayama University Hospital gender clinic. Subjects disclosed their identity to family members at the following rates: 68.7% to the father, 89.1% to the mother, 59.1% to a brother, 77.8% to a sister, and 47.6% to grandparents. Fathers had the lowest rate (26.7%) of posi-tive reactions, while over 50% of fathers showed an ambiguous response. Approximately 20% of parents showed a negative response. The majority of parents agreed to hormonal treatment and sex-reassignment sur-gery and that the transgender child should live with the gender they wanted to express. However, the rate of subjects with mood and anxiety disorders according to the Kessler 6 scale was significantly higher in those who experienced negative or ambiguous reactions from family members compared to those who experienced posi-tive reactions. Educational and mental health professionals should support the disclosure process of transgen-der people as well as their family members. |
| キーワード | disclosure family functioning gender nonconformity mental health transgender |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-10 |
| 巻 | 75巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 611 |
| 終了ページ | 623 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34703044 |
| Web of Science KeyUT | 000711561600008 |
| NAID | 120007166674 |
| JaLCDOI | 10.18926/AMO/62773 |
|---|---|
| フルテキストURL | 75_5_601.pdf |
| 著者 | Mitsuhashi, Toshiharu| |
| 抄録 | Research suggests that the fundamental concepts of epidemiology cannot be sufficiently learned in traditional lectures, and interactive learning is necessary. However, few studies have investigated interactive epidemiology education in general, or peer instruction (PI) in particular. This study investigated the effect of PI. Study par-ticipants were fourth-year medical students. The attitude of participants in regard to PI learning was examined in a non-PI and a PI group. The Survey of Attitudes Toward Statistics (SATS) (containing six sub-categories) was conducted as a learning-attitudes index. The pre- and post-lecture scores were compared between the non-PI and PI groups using double robust (DR) estimation. The non-PI and PI groups consisted of 20 and 121 student participants, respectively. In DR estimation, affect exhibited the lowest SATS score changes, at −0.51 (95% confidence interval −0.78 to −0.24; p-value < 0.001), whereas effort exhibited the highest score changes of 0.01 (95% confidence interval −0.30 to 0.32; p-value = 0.952). The epidemiology lecture with PI did not increase the SATS scores. This might be due to issues related to the experimental design. Further research investigating the effects of interactive epidemiology education, it will be necessary to develop tools for assessing the learning of epidemiological concepts and to improve the research design. |
| キーワード | medical students peer instruction epidemiological education learning attitude double robust esti-mation |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-10 |
| 巻 | 75巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 601 |
| 終了ページ | 609 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34703043 |
| Web of Science KeyUT | 000711561600007 |
| NAID | 120007166673 |
| JaLCDOI | 10.18926/AMO/62771 |
|---|---|
| フルテキストURL | 75_5_585.pdf |
| 著者 | Omiya, Hiroki| Takatori, Makoto| Yunoki, Keiji| Morimatsu, Hiroshi| |
| 抄録 | Many patients develop acute kidney injury (AKI) after vascular surgery. In this retrospective observational study, we investigated the risk factors for AKI defined using the Kidney Disease Improving Global Outcomes criteria after total arch replacement (TAR). Additionally, we investigated the influence of temperature manage-ment during cardiopulmonary bypass (CPB) on postoperative renal function by propensity score-matched anal-ysis. We retrospectively analyzed 161 consecutive patients who underwent TAR between 2016 and 2019. Postoperative AKI occurred in 48.7% of the patients. In the multivariate analysis, male sex (odds ratio [OR] 3.95, 95% confidence interval [95%CI] 1.56-8.27, p = 0.002), ACE inhibitors/ARB medication (OR 3.19, 95%CI 1.49-6.82, p = 0.003), preoperative chronic kidney disease (OR 2.47, 95%CI 1.17-5.23, p = 0.02), pro-longed CPB time (OR 2.36, 95%CI 1.05-5.34, p = 0.04), and lower body ischemic time during CPB (OR 2.20, 95%CI 1.05-4.46, p = 0.04) were identified as independent risk factors for AKI. Propensity score-matched anal-ysis showed no significant difference in the risk of AKI following TAR between mild hypothermia or normo-thermia and moderate hypothermia (37.2% vs. 41.9%, p = 0.83). In conclusion, modifiable risk factors for AKI included prolonged CPB time and lower body ischemic time. Temperature management during CPB had no clear effect on outcomes. |
| キーワード | acute kidney injury total arch replacement cardiopulmonary bypass lower body ischemic time |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-10 |
| 巻 | 75巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 585 |
| 終了ページ | 593 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34703041 |
| Web of Science KeyUT | 000711561600005 |
| NAID | 120007166671 |
| JaLCDOI | 10.18926/AMO/62770 |
|---|---|
| フルテキストURL | 75_5_575.pdf |
| 著者 | Suzuki, Hayato| Imai, Norio| Hirano, Yuki| Endo, Naoto| |
| 抄録 | HipCOMPASS, a mechanical intraoperative support device used in total hip arthroplasty (THA), improves the cup-alignment accuracy. However, the alignment accuracy achieved by HipCOMPASS has not been specifically examined in obese patients. In this study, we retrospectively evaluated the relation between alignment accuracy and several obesity-related parameters in 448 consecutive patients who underwent primary THA using HipCOMPASS. We used computed tomography (CT) to measure the preoperative soft-tissue thickness of the anterior-superior iliac spine (ASIS) and pubic symphysis and the differences between preoperative and postoperative cup angle based on the cup-alignment error. We found significant correlations between the absolute value of radiographic anteversion difference and body mass index (r = 0.205), ASIS thickness (r = 0.419), and pubic symphysis thickness (r = 0.434). The absolute value of radiographic inclination difference was significantly correlated with ASIS (r = 0.257) and pubic symphysis thickness (r = 0.202). The receiver operating characteristic curve showed a pubic symphysis thickness of 37.2 mm for a ≥ 5° implantation error in both radiographic inclination and anteversion simultaneously. The cup-alignment error for HipCOMPASS was large in patients whose pubic symphysis thickness was ≥ 37.2 mm on preoperative CT. Our results indicate that methods other than HipCOMPASS, including computed tomography-based navigation systems, might be preferable in obese patients. |
| キーワード | HipCOMPASS total hip arthroplasty cup-alignment accuracy body mass index soft-tissue thickness |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-10 |
| 巻 | 75巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 575 |
| 終了ページ | 583 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34703040 |
| Web of Science KeyUT | 000711561600004 |
| NAID | 120007166670 |
| JaLCDOI | 10.18926/AMO/62768 |
|---|---|
| フルテキストURL | 75_5_557.pdf |
| 著者 | Takeshima Kohara, Hiroko| Ikeda, Mitsunori | Okawa, Masami| |
| 抄録 | This study examined the relationship between skin physiological indices and pressure ulcers in elderly people. The subjects were 55 bedridden elderly Japanese patients with a median age of 85 years. The following parame-ters were measured using non-invasive devices: skin surface temperature, moisture content in the stratum corneum, moisture content in the dermis, transepidermal water loss as an index of skin barrier function, skin erythema and skin elasticity. The sacral and 2 heel areas were observed as sites predisposed to pressure ulcers. Within one month after measuring the skin physiological indices, we confirmed pressure ulcers of National Pressure Ulcer Advisory Panel classification Stage II or worse based on medical records. Among the 55 patients, 4 (7.3%) prospectively developed a total of 5 pressure ulcers within 16 days. Only the skin erythema score was significantly higher with than without pressure ulcers (p < 0.001). We performed a binary logistic regression analysis and confirmed a significant relationship between pressure-ulcer development and the level of erythema (odds ratio = 1.026; 95% confidence interval: 1.011-1.042). Skin erythema increased before the development of pressure ulcers. Taken together, our results show that the high skin erythema score can be a predictive indicator of pressure ulcers. |
| キーワード | elderly people erythema pressure ulcer skin |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-10 |
| 巻 | 75巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 557 |
| 終了ページ | 565 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34703038 |
| Web of Science KeyUT | 000711561600002 |
| NAID | 120007166668 |
| JaLCDOI | 10.18926/AMO/62767 |
|---|---|
| フルテキストURL | 75_5_549.pdf |
| 著者 | Isooka, Nami| Miyazaki, Ikuko| Asanuma, Masato| |
| 抄録 | Parkinson’s disease (PD) is the second most common neurodegenerative disease worldwide. The loss of nigrostriatal dopaminergic neurons produces its characteristic motor symptoms, but PD patients also have non-motor symptoms such as constipation and orthostatic hypotension. The pathological hallmark of PD is the presence of α-synuclein-containing Lewy bodies and neurites in the brain. However, the PD pathology is observed in not only the central nervous system (CNS) but also in parts of the peripheral nervous system such as the enteric nervous system (ENS). Since constipation is a typical prodromal non-motor symptom in PD, often preceding motor symptoms by 10-20 years, it has been hypothesized that PD pathology propagates from the ENS to the CNS via the vagal nerve. Discovery of pharmacological and other methods to halt this progression of neurodegeneration in PD has the potential to improve millions of lives. Astrocytes protect neurons in the CNS by secretion of neurotrophic and antioxidative factors. Similarly, astrocyte-like enteric glial cells (EGCs) are known to secrete neuroprotective factors in the ENS. In this article, we summarize the neuroprotective function of astrocytes and EGCs and discuss therapeutic strategies for the prevention of neurodegeneration in PD targeting neurotrophic and antioxidative molecules in glial cells. |
| キーワード | Parkinson’s disease astrocyte enteric glial cell neurotrophic factor antioxidative molecule |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-10 |
| 巻 | 75巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 549 |
| 終了ページ | 556 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 34703037 |
| Web of Science KeyUT | 000711561600001 |
| NAID | 120007166678 |
| フルテキストURL | fulltext.pdf |
|---|---|
| 著者 | Naito, Hiromichi| Yumoto, Tetsuya| Yorifuji, Takashi| Nojima, Tsuyoshi| Yamamoto, Hirotsugu| Yamada, Taihei| Tsukahara, Kohei| Inaba, Mototaka| Nishimura, Takeshi| Uehara, Takenori| Nakao, Atsunori| |
| キーワード | Mortality Trauma care Cardiac arrest Time-to-treatment |
| 発行日 | 2021-09-16 |
| 出版物タイトル | BMC Emergency Medicine |
| 巻 | 21巻 |
| 号 | 1号 |
| 出版者 | BMC |
| 開始ページ | 104 |
| ISSN | 1471-227X |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| OAI-PMH Set | 岡山大学 |
| 著作権者 | © The Author(s). 2021 |
| 論文のバージョン | publisher |
| PubMed ID | 34530735 |
| DOI | 10.1186/s12873-021-00499-z |
| Web of Science KeyUT | 000696533900001 |
| 関連URL | isVersionOf https://doi.org/10.1186/s12873-021-00499-z |