Okayama University Medical SchoolActa Medica Okayama0386-300X8022026Involvement of ADAM12 in TGF-β1-Induced Proliferation of Rheumatoid Arthritis Synovial Fibroblasts7583ENDetingLinDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasahiroHoritaDepartment of Orthopaedic Surgery, Faculty of Medical Development Field, Okayama UniversityMasahitoWatanabeDepartment of Orthopaedic Surgery, Muscat Orthopaedic ClinicJoeHaseiMedical Information and Assistive Technology Development, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiOhtsukiMedical Technology, Graduate School of Health Sciences, Okayama UniversityNoriakiOtsukaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChinatsuIchikawaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNoriyukiShimizuDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuichiNaniwaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiichiroNishidaDivision of Chronic Pain Medicine and Division of Comprehensive Rheumatology, Locomotive Pain Center, Faculty of Medical Development Field, Okayama UniversityOriginal Article10.18926/AMO/70450A disintegrin and metalloproteinase 12 (ADAM12) is known to be involved in chondrocyte proliferation and is upregulated in the synovial tissue of osteoarthritis (OA). However, the underlying mechanisms of ADAM12 on rheumatoid arthritis (RA) synovial cell proliferation remain unknown. Here, we investigated the role of ADAM12 in the proliferation of RA synovial fibroblasts (RASFs). The expression and localization of ADAM12 in RA synovial tissues were examined by immunohistochemistry and compared with OA and healthy control (HC) synovial tissues. The effect of inflammatory cytokines (TNF-α, TGF-β1, and PDGF-BB) on ADAM12 expression in RASFs from RA patients was examined by real-time RT-PCR. The effect of ADAM12 knock-down by ADAM12 siRNA and ADAM12 overexpression on cell proliferation of RASFs were examined by WST-1 assay. ADAM12 was identified predominantly in RA synovial tissue rather than OA and HC synovial tissues. Stimulation with TGF-β1 upregulated the expression of ADAM12 and cell proliferation of RASFs. ADAM12 siRNA suppressed TGF-β1-induced cell proliferation of RASFs, while ADAM12 overexpression promoted the cell proliferation of RASFs. 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Calcif Tissue Int (2019) 105: 97-106.Rosengren S, Boyle DL and Firestein GS: Acquisition, culture, and phenotyping of synovial fibroblasts. Methods Mol Med (2007) 135: 365-375.Seidel MF, Koch FW and Vetter H: Macrophage-like synoviocytes display phenotypic polymorphisms in a serum-free tissue-culture medium. Rheumatol Int (2006) 26: 244-251.岡山大学教育推進機構 教師教育開発センターActa Medica Okayama2186-1323162026町づくりを考える実践事例の検討 ―総合的な学習の時間を通じた中学生の意識変化に着目して―191203ENAkemiKAMADAAnan City Anan First Junior High SchoolKazuakiKAJIIFaculty of Education, Okayama University10.18926/CTED/70369 本研究は，中学校総合的な学習の時間における町づくりにおいて，他者との協働や相互作用を通じて町づくりを構想し，実践の結果生じた学習者の変化からその効果を明らかにすることを目的としている。また，対話的な学びで重視される他者との相互作用を，中学校の実践に落とし込み，そのあり方についても検討する。本実践のねらいは，多様な視点から町の将来の姿やあり方を人との関わりについて読み解き，持続可能な町のあり方について自分事に引き寄せて考えることで，町に対する意識の変化を促すことにある。実践の結果，学習者の町に対する見方や考え方の意識変化が引き起こされ，町づくりの持つ地域課題について自分事に引き寄せて思考することができた。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構 教師教育開発センターActa Medica Okayama2186-1323162026立憲主義に対する認識の改善を目指した高等学校公民科の授業開発研究 ―米国公民教育センター開発『我ら合衆国人民』を手がかりにして―167180ENToshinoriKUWABARAFaculty of Education, Okayama UniversityAyuhaMIYAMOTOGraduate School of Humanities and Social Sciences, Okayama University10.18926/CTED/70367 本研究は、憲法理解の基本としての立憲主義に対する認識形成を目標とする、高等学校公民科で実践可能な授業の開発を目指したものである。従来の日本の社会科教育においては、憲法理解は日本国憲法の基本原則である国民主権、基本的人権の尊重、平和主義の理解を基本としていたが、近年、そもそも憲法とは何かを理解させるために、立憲主義の概念が注目されるようになり、教科書にも記述されている。本研究は、そのような立憲主義という概念について生徒に適切に理解させることを目指した授業の提案をしようとするものである。授業計画作成にあたっては、米国の公民教育センターが開発し、長年活用されている『我ら合衆国人民（原題 We the People）』を参照し、その一部を活用し、米国の歴史的背景に基づいて作られた教材を、日本の文脈にそって改変した。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構 教師教育開発センターActa Medica Okayama2186-1323162026初任保育教諭の語りに見る園児の在園時間の違いによる実践上の課題139152ENKazuyaHASUIFaculty of Health and Welfare， Kawasaki University of Medical WelfareMikaKATAYAMAFaculty of Education, Graduate School of Science, Okayama University10.18926/CTED/70365 本論では，幼保連携型認定こども園の特徴である園児の在園時間の違いに焦点を当て，初任保育教諭への面接調査により実践上の課題と対応について検討した。その結果，保育教諭が８つの課題を認識していることが明らかになった。また，『幼保連携型認定こども園教育・保育要領』に記述されている「遊びの連続性を保障する保育の展開」に関する課題に加えて，記述されていない「多様な在園時間や生活形態を考慮した園児理解」に関する新たな課題が見出された。認定区分による在園時間の違いは園生活における時間的スケジュールや場所，集団の違いを余儀なくされる。そのため，保育教諭が設定するねらいに基づいた園生活で何を共通経験とすべき内容として設定し，何を経験差として活かし，どのような保育を実践するか明確にすべく，これまで認定こども園で積み重ねられてきた好実践例を集積・整理し，指標を明示することが今後の課題である。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026発達障害を有する高校生の保護者による障害学生支援の認知度9199ENShinHARADAGeneral Education and Global Studies Field, Okayama UniversityKosukeIketaniGeneral Education and Global Studies Field, Okayama UniversityMegumiMATSUIGeneral Education and Global Studies Field, Okayama UniversityNaotoMOCHIZUKIHealth and Counseling Center, The University of Osaka10.18926/70114 本研究では，発達障害を有する高校生の保護者が，「大学等における障害学生支援や学生相談をどの程度知っているか」，「大学等における障害学生支援や学生相談の情報をどのように入手したか」，「大学等における障害学生支援や学生相談の情報収集をする上で，大学等にどのような情報発信を期待するか」について調査を行った。その結果，まだ保護者に対し，十分に大学の学生支援の情報が行き届いていないこと，学生支援に関する情報発信を行う説明会や相談会を行うことが保護者から期待されていること，発達障害を有する高校生の高大移行を促進するために，高校の先生方に対する情報発信も精力的に行ったり，高大連携の取り組みをより行う必要があること等が見出された。No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026The Preoperative Anterior Pelvic Plane Angle Predicts Cup Anteversion Changes at 1 Year after Total Hip Arthroplasty3137ENKyotaIshibashiDepartment of Orthopedic Surgery, Hachinohe City HospitalHirotakaOishiDepartment of Orthopedic Surgery, Hachinohe City HospitalRyoArakiDepartment of Orthopedic Surgery, Hachinohe City HospitalKosukeKawamuraDepartment of Orthopedic Surgery, Hachinohe City HospitalIsamuSasakiDepartment of Orthopedic Surgery, Hachinohe City HospitalEijiSasakiDepartment of Orthopedic Surgery, Hirosaki University Graduate School of MedicineHikaruKamadaDepartment of Orthopedic Surgery, Hachinohe City HospitalMasakazuKogawaDepartment of Orthopedic Surgery, Hachinohe City HospitalSunaoTanakaDepartment of Orthopedic Surgery, Hachinohe City HospitalTakuyaNumasawaDepartment of Orthopedic Surgery, Hachinohe City HospitalYasuyukiIshibashiDepartment of Orthopedic Surgery, Hirosaki University Graduate School of MedicineOriginal Article10.18926/AMO/70070We investigated global alignment changes following total hip arthroplasty (THA) and predictive alignment parameters for increased cup anteversion (CA) by retrospectively analyzing the primary THA data of 75 patients treated at our hospital (49 women, 26 men; age 65.1±5.7 years, BMI 28.3±3.4 kg/m2). Global alignment parameters, i.e., the anterior pelvic plane angle (APPa) and proximal femoral shaft angle (PFSa) and other alignment parameters were measured. CA was evaluated based on the patients’ standing coronal radiographs. ΔCA was defined as the difference in CA from 2 weeks before to 1 year after each THA. We classified the cases as stable (S) (CA < 10°; n=63) and pelvic retroversion (R) (CA ≥ 10°; n=12) groups. Associations between ΔCA and alignment parameters were evaluated by linear regression and a receiver operating characteristic (ROC) analysis. A significant decrease in the PFSa occurred between the 2-week and 1-year post-THA timepoints (7.8±4.3° vs. 4.2±3.6°, p<0.001), with no notable change in other alignment parameters. At 1-year post-THA, the CA of 12 (16%) patients had increased to 4.5±4.4°. Only the preoperative APPa was positively associated with ΔCA (β=0.165, p=0.020). The ROC analysis revealed that the optimal cut-off value for increased CA in the APPa is 2.1° (area under the curve, 0.700; p=0.020; odds ratio, 4.80). The APPa change predicted increased CA, which emphasizes the importance of the use of preoperative standing radiography for identifying the optimal cup positioning for post-THA changes in CA.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Development of a Stroke Discharge Support Evaluation Scale for Ward Nurses in Acute Care Hospitals1730ENHidekiYanoDepartment of Nursing, Faculty of Human Health Sciences, Niimi UniversityYokoTakahataGraduate School of Health Sciences, Okayama UniversityTakeshiYamaguchiFaculty of Nursing, Shikoku UniversityShinyaSaitoGraduate School of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/70069This study aimed to develop a scale enabling nurses to objectively evaluate their own stroke discharge support, as a basis for enhancing its overall effectiveness. A draft scale was created based on a literature review, and consisted of a 51-item, 5-point Likert-type questionnaire administered to ward nurses engaged in stroke discharge support at acute care hospitals. Factor analysis was performed to refine the scale. Construct validity was assessed using the known-groups method, and reliability was evaluated through internal consistency analysis. The resulting Stroke Discharge Support Evaluation Scale comprises 29 items across 5 factors, each rated on a 5-point Likert scale. Analysis of the data collected from 237 valid responses demonstrated good internal consistency and supported the scale’s construct validity. The Stroke Discharge Support Evaluation Scale is a reliable and valid tool enabling ward nurses in acute care hospitals to evaluate their own stroke discharge support.No potential conflict of interest relevant to this article was reported.The Editorial Committee of Annals of Vascular DiseasesActa Medica Okayama1881-641X1812025Successful Surgical Treatment of a Spontaneous Rupture of the Left Iliac Vein: What Is the Optimal and Radical Treatment?cr.25-00065ENKeiMoriokaDepartment of Cardiovascular Surgery, Okayama University HospitalMasanoriHirotaDepartment of Cardiovascular Surgery, Showa Medical University Fujigaoka HospitalShingoKasaharaDepartment of Cardiovascular Surgery, Okayama University HospitalSpontaneous rupture of the iliac vein (SRIV) requires surgical hemostasis and venous return restoration. We herein report a case treated with initial thrombus removal and direct venous repair. Because of early occlusion, a 2nd surgery was performed for iliac vein reconstruction using a 14-mm ringed Gore-Tex graft (W. L. Gore & Associates, Newark, DE, USA), and a 4-mm Gore-Tex arteriovenous shunt was created between the femoral artery and the femoral vein to prevent reocclusion. The patient had an uneventful recovery without recurrence. A single-stage procedure including hemostasis, vein replacement, and arteriovenous bypass may be ideal for radical SRIV treatment.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0013-87032025Artificial Selections for Life-History Traits Affect Effective Cumulative Temperature and Developmental Zero Point in Zeugoducus cucurbitaeENTakahisaMiyatakeGraduate School of Environment, Life, Natural Science and Technology, Okayama UniversityKentarouMatsumuraDepartment of General Systems Studies, Graduate School of Arts and Sciences, the University of TokyoEffective cumulative temperature and developmental zero point are important indicators for estimating the timing of organism development and the area of distribution. These indicators are generally considered to have unique values for different species of organisms and are also important for predicting the distribution range of animals and plants, especially insect pests. These values generally are species-specific, but there is variation within populations in traits having a genetic component. However, there are no studies on what kind of selection pressure affects these indicator values. To address this issue, it would be worthwhile to compare these values using individuals of strains that have been artificially selected for life-history traits by rearing them at various temperatures and calculating these indicators from developmental days and temperatures. In the present study, eggs were taken from adults of strains with many generations of artificial selection on two life-history traits (age at reproduction and developmental period) of the melon fly, Zeugodacus cucurbitae, under constant temperature conditions. Eggs were reared at five different temperatures, and the effective cumulative temperatures and developmental zero points of the larval and developmental periods were compared. The results demonstrate that artificial selection on life-history traits in Z. cucurbitae induces evolutionary changes in both the effective cumulative temperature and the developmental zero point across successive generations.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Advantages of Single-Position Surgery over Posterior Fusion for Single-Level Degenerative Lumbar Diseases359368ENTomohikoHiroseDepartment of Orthopedic Surgery, Kagawa Prefectural Central HospitalHisanoriIkumaDepartment of Orthopedic Surgery, Kagawa Prefectural Central HospitalKazutoshiOtsukaOtsuka Orthopedic ClinicKeisukeKawasakiDepartment of Orthopedic Surgery, Kagawa Prefectural Central HospitalOriginal Article10.18926/AMO/69437Single-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.No potential conflict of interest relevant to this article was reported.Ovid Technologies (Wolters Kluwer Health)Acta Medica Okayama1044-39833662025Causal Approaches to Disease Progression Analyses732740ENBronner P.GonçalvesFaculty of Health and Medical Sciences, University of SurreyEtsujiSuzukiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityEpidemiologic analyses that aim to quantify exposure effects on disease progression are not uncommon. Understanding the implications of these studies, however, is complicated, in part because different causal estimands could, at least in theory, be the target of such analyses. Here, to facilitate interpretation of these studies, we describe different settings in which causal questions related to disease progression can be asked, and consider possible estimands. For clarity, our discussion is structured around settings defined based on two factors: whether the disease occurrence is manipulable or not, and the type of outcome. We describe relevant causal structures and sets of response types, which consist of joint potential outcomes of disease occurrence and disease progression, and argue that settings where interventions to manipulate disease occurrence are not plausible are more common, and that, in this case, principal stratification might be an appropriate framework to conceptualize the analysis. Further, we suggest that the precise definition of the outcome of interest, in particular of what constitutes its permissible levels, might determine whether potential outcomes linked to disease progression are definable in different strata of the population. Our hope is that this paper will encourage additional methodological work on causal analysis of disease progression, as well as serve as a resource for future applied studies.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813722025令和６年度診療報酬改定を踏まえ急性期病院に今求められること7679ENTakahiroInoueOkayama University HospitalNo potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231892025性暴力を根絶するための性教育を問う5766ENIoriOHMORI (KAWASAKI)Faculty of Education，Okayama UniversityAyanoKOMATSUFaculty of Education，Okayama UniversityChihiroTAKADAFaculty of Education，Okayama University10.18926/bgeou/69237 性暴力は、被害者の心身の健康状態に長年にわたって重大な悪影響を及ぼすことが知られている。本研究の目的は、日本における性暴力の実態を文献・資料によって調査し、性暴力を根絶するために求められる性教育を提議することである。内閣府が実施したアンケート調査によると、言葉による性暴力被害は17.8％ 、同意のない性交等の被害は4.1％と報告されていた。被害を受けた場所は学校（ 22.5%）が最多であり、加害者との関係は、「通っていた（いる）学校・大学の関係者（教職員、先輩、同級生、クラブ活動の指導者など）」（ 36.0%）が最も多く、被害者の半数以上は誰にも相談していなかった。これらのデータは、学校においてこそ、性暴力を根絶するための性教育を実施すべきであることを物語っている。しかしながら、学習指導要領に「性的同意」に関する指導は含まれておらず、教科書の記述も極めて限定的であった。性暴力のない社会を実現するためには、幼少期から絵本等を用いた教育やロールプレイを通じた実践的学習が望まれる。No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Bloodstream Infections Caused by Gram-Negative Bacteria in Geriatric Patients: Epidemiology, Antimicrobial Resistance and The Factors Affecting Mortality231242ENM Enes KardanDepartment of Infectious Diseases, Faculty of Medicine, Namik Kemal UniversityIlknurErdemDepartment of Infectious Diseases, Faculty of Medicine, Namik Kemal UniversityEmreYildizDepartment of Infectious Diseases, Faculty of Medicine, Namik Kemal UniversityNuriKirazDepartment of Medical Microbiology, Faculty of Medicine, Namik Kemal UniversityAliyeÇelikkolDepartment of Biochemistry, Faculty of Medicine, Namik Kemal UniversityOriginal Article10.18926/AMO/69148Bloodstream infections (BSIs) are an important cause of morbidity and mortality in geriatric patients. We retrospectively analyzed the cases of geriatric patients who developed BSIs due to gram-negative bacteria in order to evaluate the epidemiology, antimicrobial resistance, and the factors affecting mortality. The cases of 110 patients aged ≥ 65 years admitted to our hospital between January 1, 2017, and December 31, 2022 were assessed; 70 (63.6%) of the BSIs were healthcare-associated BSIs. The urinary system was the most common detectable source of infection at 43.6%. The most frequently isolated bacteria were Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae, in that order. Carbapenem resistance was detected in 17 patients (15.5%), and extended-spectrum beta-lactamase (ESBL) production from Enterobacterales family members was detected in 37 (51.4%) patients. Multivariate analysis revealed that (i) the probability of mortality in the patients with total bilirubin was increased by approx. sixfold and (ii) the likelihood of mortality for those with a Pitt bacteremia score (PBS) ≥ 4 points was approx. 17 times higher. PBS and simplified qPitt scores can help predict mortality and manage geriatric patients. There is a significant increase in mortality among patients with procalcitonin (PCT) levels at ≥ 2 nm/ml.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0387-76044712025Hypotheses of pathophysiological mechanisms in epileptic encephalopathies: A review104318ENKatsuhiroKobayashiDepartment of Pediatrics, Asahigawaso Rehabilitation and Medical CenterTakashiShibataDepartment of Pediatric Neurology, Okayama University Hospital and Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirokiTsuchiyaDepartment of Pediatric Neurology, Okayama University Hospital and Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMariAkiyamaDepartment of Pediatric Neurology, Okayama University Hospital and Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomoyukiAkiyamaDepartment of Pediatric Neurology, Okayama University Hospital and Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIntroduction: Epileptic encephalopathy (EE) is a serious clinical issue that manifests as part of developmental and epileptic encephalopathy (DEE), particularly in childhood epilepsy. In EE, neurocognitive functions and behavior are impaired by intense epileptiform electroencephalogram (EEG) activity. Hypotheses of pathophysiological mechanisms behind EE are reviewed to contribute to an effective solution for EE.<br>
Review: Current hypotheses are as follows: 1) neuronal dysfunction based on genetic abnormalities that may affect neurocognitive functions and epilepsy separately; 2) impairment of synaptic homeostasis during sleep that may be responsible for DEE/EE with spike-and-wave activation in sleep; 3) abnormal subcortical regulation of the cerebral cortex; 4) abnormal cortical metabolism and hemodynamics with impairment of the neural network including default mode network; 5) neurotransmitter imbalance and disordered neural excitability; 6) the effects of neuroinflammation that may be caused by epileptic seizures and in turn aggravate epileptogenesis; 7) the interaction between physiological and pathological high-frequency EEG activity; etc. The causal relationship between epileptiform EEG activity and neurocognitive dysfunctions is small in DEE based on genetic abnormalities and it is largely unestablished in the other hypothetical mechanisms.<br>
Conclusion: We have not yet found answers to the question of whether the single-central or multiple derangements are present and what seizures and intense epileptiform EEG abnormalities mean in EE. We need to continue our best efforts in both aspects to elucidate the pathophysiological mechanisms of DEE/EE and further develop epilepsy treatment and precision medicine.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0919-81723212024What is the identity of Gerota fascia? Histological study with cadavers6268ENYasuyukiKobayashiMinimally Invasive Therapy Center, Okayama University HospitalKoheiEdamuraDepartment of Urology, Okayama University HospitalTakuyaSadahiraDepartment of Urology, Okayama University HospitalYusukeTominagaDepartment of Urology, Okayama University HospitalSatoshiKatayamaDepartment of Urology, Okayama University HospitalTakehiroIwataDepartment of Urology, Okayama University HospitalShingoNishimuraOrgan Transplant Center, Okayama University HospitalTomokoKobayashiDepartment of Urology, Okayama University HospitalKeitaSatoDepartment of Cytology and Histology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaakiKomiyamaDepartment of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyusukeMomotaDepartment of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideyoOhuchiDepartment of Cytology and Histology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesObjectives: The advancement of laparoscopic surgery has allowed surgeons to see finer anatomical structures during surgery. As a result, several issues have arisen regarding Gerota fascia that cannot be explained by previous interpretations, such as its various forms observed during surgery. To address these issues, we histologically examined the structure of Gerota fascia.<br>
Methods: Specimens for study were prepared from kidneys with Gerota fascia from four cadavers, and the structure was studied histologically. Its thickness and collagen fiber area ratios were measured using ImageJ and compared to those of the epimysium of the rectus abdominis muscle.<br>
Results: Connective tissue that appeared to be Gerota fascia was observed in 26 specimens. Histologically, the basic structure of Gerota fascia was a sandwich-like structure with a thin layer of thick, long collagen fibers in the central layer, and small granular collagen fibers scattered at the edges. However, not all areas observed had a similar structure; eight specimens were composed only of small granular collagen fibers. The average thickness of the Gerota fascia was 466 μm, and the area ratio of collagen was 27.1%. In contrast, the epimysium was much thicker than Gerota fascia, and its collagen fibers were much thicker and denser.<br>
Conclusions: Gerota fascia, unlike the epimysium, was a very thin and fragile layer of collagen fibers, and its structure was diverse. This explains why Gerota fascia was observed in various states during surgery. It is important for surgeons to understand the properties of Gerota fascia and to treat it appropriately.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465712025地域産業連関表における経済波及効果のNew Approach3550ENRyoheiNakamura10.18926/OER/69003 本稿では，まず経済波及効果の考え方について，産業連関表を用いたシミュレーションの結果が，しばしば過大評価になっていることを述べる。その理由として，経済波及効果をもたらす前提条件の考え方にしばしば誤解があることを指摘する。域内の居住者の消費はマネーの移転であり，真の経済効果ではない。波及効果とは，本来，所得が増えた結果の追加消費であって，所得が増えない状況では，代替消費や消費の先取りに過ぎないのである。また，一般にいう経済効果とは，売上高の積み上げであって同じマネーが何でも加算されているものであり，付加価値効果すなわち所得効果とは異なる。付加価値効果は，当初の域外から入ってきたマネー以上にはならない。こういった解釈の誤謬をもたらしているのは，大学での産業連関分析の教育が十分でないことも原因の1つであるが，シンクタンクや公的機関などで提供されている波及効果の計算ツールにも問題がある。そこで本稿では，これまで筆者が提唱してきた波及効果プロセスを見える化するモデルを更に精緻化し，イベントなど外生的インパクトが発生した後の事後的な産業連関表を構築する流れに関して実例を用いて説明を行う。特に自給率の変化の効果については，これまでの競争移入型連関表では効果が過大傾向になる問題点を解消するべく，「部分非競争移入型」の投入構造を提案し，新たな分析方法を提案する。No potential conflict of interest relevant to this article was reported.IEEEActa Medica Okayama2379-18962023Evaluation of Effectiveness of MAC Systems Based on LSM for Protecting IoT Devices161167ENMasatoMikiGraduate School of Natural Science and Technology, Okayama UniversityToshihiroYamauchiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversitySatoruKobayashiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityNumerous active attacks targeting Internet of Things (IoT) devices exist. They exploit the latest vulnerabilities discovered in IoT devices. Therefore, Mandatory Access Control (MAC) systems based on Linux Security Modules (LSM), such as SELinux and AppArmor, are effective security features for IoT devices because they can mitigate the impact of attacks even if software vulnerabilities are discovered. However, they are not adopted by most IoT devices. The existing approaches are insufficient for investigating the causes of this problem.In this study, we comprehensively investigated what factors can affect the applicability of MAC systems based on LSM in IoT devices. We focused on how frequently cases can occur where they cannot be adopted, owing to each factor. To increase the comprehensiveness of the factors affecting the adoption of MAC systems in IoT devices, we investigated the kernel version, CPU architecture, and support for BusyBox in addition to the investigation of resources, which conducted in previous studies. We also conducted simulated experiments based on the attack method of Mirai to investigate whether MAC systems can protect against IoT malware. Finally, we discuss the impact of a combination of these factors on MAC system adoption.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025Lower Work Engagement Is Associated with Insomnia, Psychological Distress, and Neck Pain among Junior and Senior High School Teachers in Japan93100ENRinaTsuchieDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMariFukudaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidekiTsumuraDepartment of Psychology, Graduate School of Technology, Industrial and Social Sciences, Tokushima UniversityMinakoKinutaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiHisamatsuDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideyukiKandaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/68647School teachers are subject to both physical and mental health problems. We examined cross-sectional relationships between work engagement and major health outcomes among junior and senior high school teachers in Japan via a nationwide survey in 2019-2020. A total of 3,160 respondents were included in the analyses (19.9% response rate). Work engagement was assessed with the Utrecht Work Engagement Scale-9 (UWES-9), and we thus divided the teachers into quartiles according to their UWES-9 scores. Based on validated questionnaires, we assessed insomnia, psychological distress, and neck pain as health outcomes. A binomial logistic regression adjusted for age, gender, school type, teacher’s roles, involvement in club activities, division of duties, employment status, and whether they lived with family demonstrated that the teachers with lower UWES-9 scores had higher burdens of insomnia, psychological distress, and neck pain (odds ratios [95% confidence intervals] in 4th vs. 1st quartile, 2.92 (2.34-3.65), 3.70 (2.81-4.88), and 2.12 (1.68-2.68), respectively; all trend p<0.001). There were no significant differences in these associations between full-time and part-time teachers. Our findings indicate that low work engagement may contribute to physical and mental health issues among junior and senior high school teachers, thus providing insights for preventing health problems in this profession.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama1880-65467522025Changes in adrenoceptor expression level contribute to the cellular plasticity of glioblastoma cells100016ENYutaroAsakaDepartment of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshioMasumotoDivision of Health Administration and Promotion, Department of Social Medicine, Faculty of Medicine, Tottori UniversityAtsuhitoUnedaDepartment of Neurosurgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesVanessa D.ChinUMass Chan Medical School, UMass Memorial Medical CenterYusukeOtaniDepartment of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolTirsoPenaDepartment of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolHaruyoshiKatayamaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakutoItanoDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTeruhikoAndoDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesRongshengHuangDepartment of Trauma Orthopedics, The Second Hospital of Dalian Medical UniversityAtsushiFujimuraDepartment of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesGlioblastoma cells are known to regulate their cellular plasticity in response to their surrounding microenvironment, but it is not fully understood what factors contribute to the cells' changing plasticity. Here, we found that glioblastoma cells alter the expression level of adrenoreceptors depending on their differentiation stage. Catecholamines are abundant in the central nervous system, and we found that noradrenaline, in particular, enhances the stemness of glioblastoma cells and promotes the dedifferentiation potential of already differentiated glioblastoma cells. Antagonist and RNAi experiments revealed that signaling through alpha 1D-adrenoreceptor is important for noradrenaline action on glioblastoma cells. We also found that high alpha 1Dadrenoreceptor expression was associated with poor prognosis in patients with gliomas. These data suggest that glioblastoma cells increase the expression level of their own adrenoreceptors to alter the surrounding tumor microenvironment favorably for survival. We believe that our findings will contribute to the development of new therapeutic strategies for glioblastoma.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666712025Tsetlin library on p-colored permutations and q-analogue133147ENYutoNakagawaMathematical Institute, Tohoku UniversityFumihikoNakanoMathematical Institute, Tohoku UniversityK. Brown [1] studied the random to top shuffle (the Tsetlin libary) by semigroup method. In this paper, (i) we extend his results to the colored permutation groups, and (ii) we consider a q-analogue of Tsetlin library which is different from what is studied in [1]. In (i), the results also extends those results for the top to random shuffle [4],[5], [6] to arbitrary distribution of choosing cards, but we still have derangement numbers in the multiplicity of each eigenvalues. In (ii), a version of q-analogue of derangement numbers by Chen-Rota [3] appears in the multiplicity of eigenvalues.No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671592025稲盛和夫のフィロソフィーと西郷南洲翁遺訓及び日新公いろは歌の連関についての考察2544ENHisashiMACHIDA10.18926/68539 一代で京セラやKDDIの前身となる第二電電（DDI）を創業し、合計数兆円企業に育て、倒産した日本航空（JAL）を3年で再建し、再上場に導いた稀代の経営者稲盛和夫は、アメーバ経営という独自の経営手法だけでなく、理念経営により数万人を導いてきた。中小企業の一経営者が経営の中から導き出した人生成功の処世術のルーツは何処にあるのか。生まれ育った薩摩の基礎となる郷中（ごじゅう）教育とは何か、などについて経営学の観点から関心が湧く。<br>
稲盛和夫が京セラ創業以降に出会い、自ら経営理念の基礎とした地元の偉人である西郷隆盛の言行録である西郷南洲翁遺訓及び16世紀に薩摩や日向など南九州を統一した島津家第15代領主島津貴久公の実父島津忠良（日新）が残した、島津日新公いろは歌とどのように連関があるのか。そもそも薩摩生まれの3名の思想にどのような連関があるのか、についても関心が湧く。この研究では、質的研究法であるグラウンデッド・セオリー・アプローチを援用して、稲盛和夫のフィロソフィーと西郷南洲翁遺訓及び日新公いろは歌の連関について分析した。結果的に3つの概念は400年の時代を超えて、連関していることが分析により明らかになった。特に稲盛和夫のフィロソフィーが稲盛和夫が敬愛する西郷隆盛の言行録である西郷南洲翁遺訓に正の影響を受けているだけでなく、薩摩での教育を背景に、400年前に遡る日新公いろは歌からも正の影響を受けていることが明らかになった。400年に渡り薩摩の人々が受け継いできた理念には、時代を超えても人が生きていく中で基礎とすべき、もしくは人生で重要なコアな思想・資質とすべき概念があると考えられる。No potential conflict of interest relevant to this article was reported.Frontiers MediaActa Medica Okayama1662-5102192025Acetoacetate, a ketone body, attenuates neuronal bursts in acutely-induced epileptiform slices of the mouse hippocampus1551700ENHaoWenDepartment of Biophysical Chemistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNagisaSadaDepartment of Biophysical Chemistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTsuyoshiInoueDepartment of Biophysical Chemistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThe ketogenic diet increases ketone bodies (beta-hydroxybutyrate and acetoacetate) in the brain, and ameliorates epileptic seizures in vivo. However, ketone bodies exert weak or no effects on electrical activity in rodent hippocampal slices. Especially, it remains unclear what kinds of conditions are required to strengthen the actions of ketone bodies in hippocampal slices. In the present study, we examined the effects of acetoacetate on hippocampal pyramidal cells in normal slices and epileptiform slices of mice. By using patch-clamp recordings from CA1 pyramidal cells, we first confirmed that acetoacetate did not change the membrane potentials and intrinsic properties of pyramidal cells in normal slices. However, we found that acetoacetate weakened spontaneous epileptiform bursts in pyramidal cells of epileptiform slices, which were acutely induced by applying convulsants to normal slices. Interestingly, acetoacetate did not change the frequency of the epileptiform bursts, but attenuated individual epileptiform bursts. We finally examined the effects of acetoacetate on excitatory synaptic barrages during epileptiform activity, and found that acetoacetate weakened epileptiform bursts by reducing synchronous synaptic inputs. These results show that acetoacetate attenuated neuronal bursts in epileptiform slices, but did not affect neuronal activity in normal slices, which leads to seizure-selective actions of ketone bodies.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025中学校理科教科書がつくり上げてきたきのこ像 ―通時的調査から得るきのこを巡る学習への示唆―133145ENRisaTAKAGIGraduate School of Education (Professional Degree Corse), Okayama UniversityMasafumiIKEDAFaculty of Education, Okayama UniversityMasayaYAMAMOTOHyogo University of Teacher Education10.18926/CTED/68487 本稿では，戦後中学校理科検定教科書におけるきのこの扱われ方，すなわち学習者が受け取ることになるきのこ像について，@どのようなきのこが扱われてきたのか，A植物に分類されているか否か，Bきのこのからだは何で形成されているのか，C生態系における働きの四つの観点から，通時的な調査によって明らかにした。全47種がこれまでの理科教科書で登場してきたが，近年は種への意識というよりも，きのこが分解者としての役割を持つことにのみ焦点が当てられてきていることを指摘した。また，これまで教科書においては菌根性のきのこ自体について取り上げられつつも，その生態系における相利共生の観点への言及はないことから，相利共生の理解を目指す学習の開発が可能性として浮かび上がってくることも指摘した。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025学校図書館の活用と司書教諭・学校司書との協働をめぐる国語教育思潮の展開 ―『教育科学国語教育』誌の調査から―119132ENYumiSAISHOGraduate School of Education（Professional Degree Corse），Okayama UniversityMasafumiIKEDAFaculty of Education，Okayama University10.18926/CTED/68486 学校図書館は，学習指導要領でも触れられており，国語科との関連も深い。また先行研究では，司書教諭や学校司書との協働の必要性が訴えられている。しかしこれまでの国語教育では，どのような協働がなされていたのかという検討がなされていない。そこで，本研究では，教育雑誌の調査をもとに，国語科においては，学校図書館がどのように活用されてきたのか，司書教諭や学校司書との協働はどのような態度がとられてきたのかを明らかにすることを目的とした。調査では，図書館に言及している論文や学校図書館を活用した実践・指導例を抽出し，分析した。実践・指導例の分析からは，小・中学校の国語科において学校図書館は活用されてきた一方で，司書教諭や学校司書との協働には着目が及んでいない状況が明らかになった。また，司書教諭や学校司書に関する言及からは，人的リソースにその原因を求める思潮が窺えたものの，価値ある協働も見受けられることを指摘した。No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465632025地方創生第１期における製造事業所の存続，発生，消失1533ENRyoheiNakamura10.18926/OER/68444 地方に位置する多くの自治体においては，従来からある事業所の活性化や新規事業所の誕生に加えて，製造工場の誘致は地域振興にとっていまも重要な政策となっている。今日，高度経済成長期における重厚長大型の産業の誘致とは異なり，地域優位性をできるだけ活用した企業誘致の傾向になっている。雇用創出効果は昔に比べて小さくなっているとはいえ，製造業の多くにおいて，地域の基盤産業としての位置づけは残っている。第1期の地方創生の期間で，どのような地域において，どのような製造工場が消失，撤退や出現，存続しているのかを識別し，それらの要因を分析する。<br>
2014年と2019年の事業所の比較において，付加価値生産性の平均と分布を見ると2014年，2019年ともに存在する事業所の労働生産性が最も高い。次いで高いのが2019年に存在する事業所で，最も低かったのが2014年には存在したが2019年には存在していない事業所であった。またロジット分析の結果から，生産性が高く事業所規模が大きいと消滅しない傾向があり，また都市化の程度が高いと消滅傾向にあることが推定された。他方，発生した製造事業所について，産業別に同業種集積と人口規模で測った都市集積を説明変数とした市町村単位の回帰分析からは正の効果が示された。No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025Retrospective Analysis of the Safety of High-Volume Dental Articaine Preparations for Japanese Patients3137ENShigeruMaedaDepartment of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoAtiphanPimkhaokhamDepartment of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn UniversityMichihiroYoshidaData Science Division, Center for Innovative Clinical Medicine, Okayama University HospitalHirokiHosoiData Science Division, Center for Innovative Clinical Medicine, Okayama University HospitalAyakoOhshimaData Science Division, Center for Innovative Clinical Medicine, Okayama University HospitalRyokoKurisuDepartment of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoNozomiUtsumiDepartment of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoHitoshiHiguchiDepartment of Dental Anesthesiology and Special Care Dentistry, Okayama University HospitalTakuyaMiyawakiDepartment of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/68356We retrospectively analyzed the safety of the use of articaine, an amide-type local anesthetic, in Japanese dental patients (n=300) treated in Thailand in 2015-2017. The dosage, adverse events (AEs) caused by local anesthesia, and treatment efficacy were examined. Articaine, which is safe for patients with liver impairments due to its unique metabolism, has not been thoroughly tested in Japan for doses above 5.1 mL. Eighty of the present patients had undergone root canal treatment (RCT), 71 underwent tooth extraction, and 149 underwent implant-related surgery. More than three articaine cartridges were used in 41 patients, and no AEs occurred in these cases. The only AE occurred in a 52-year-old woman who was treated with three cartridges and presented with what appeared to be hyperventilation syndrome; she later recovered and received her dental treatment as scheduled. Most treatments were completed with three or fewer cartridges, suggesting that this number is generally sufficient. Our findings, particularly the low AE risk even with doses exceeding three cartridges, support the potential applicability of the overseas recommended maximum dose of articaine (7 mg/kg) in Japanese patients. This conclusion is significant for advancing dental anesthetic practices and ensuring patient safety and treatment efficacy in Japan.No potential conflict of interest relevant to this article was reported.岡山大学文明動態学研究所Acta Medica Okayama2436-832642025持続可能な開発のための教育とは―国際法制史の視点から―5363ENYokoKAWAKAMIPh.D in law, Université Toulouse Capitole研究ノート (Research note)10.18926/67955Throughout the history of international law, sustainable development has always been acknowledged as a global responsibility. In recent years, as global environmental concerns have escalated, this responsibility has become increasingly crucial. To fulfil this mandate, education policies must transcend national boundaries. Specifically, in light of pressing global environmental issues such as climate change, education on sustainable development is pivotal for the well-being of future generations. To delve deeper into this significance, the author examines the emergence of ESD (Education for Sustainable Development), its accomplishments, and the challenges the world is currently grappling with.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1871-40801832023Review: Nicotinic acetylcholine receptors to regulate important brain activity―what occurs at the molecular level?769774ENShigetoshiNaraGraduate School of Natural Science and Technology, Okayama UniversityYutakaYamagutiFaculty of Information Engineering, Fukuoka Institute of TechnologyIchiroTsudaChubu University Academy of Emerging Sciences/Center for Mathematical Science and Artificial Intelligence, Chubu UniversityHerein, we briefly review the role of nicotinic acetylcholine receptors in regulating important brain activity by controlled release of acetylcholine from subcortical neuron groups, focusing on a microscopic viewpoint and considering the nonlinear dynamics of biological macromolecules associated with neuron activity and how they give rise to advanced brain functions of brain.No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231872024意味づけするとは何か145151ENHiroshiMIYAZAKIFaculty of Education, Okayama UniversityTakuyaSOBUKAWAGlobal Education Center, Waseda University10.18926/bgeou/67901 人間はコミュニケーションの動物であると言われる。しかしその対象についての解釈（意味）が異なればコミュニケーションは成立しない。本論では意味づけするとはどういうことなのかについて考える。No potential conflict of interest relevant to this article was reported.Institute of Electrical and Electronics EngineersActa Medica Okayama2644-128452024Skewing Technology for Permanent Magnet Synchronous Motors: A Comprehensive Review and Recent Trends12511273ENRenTsunataGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMasatsuguTakemotoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThis article gives a comprehensive overview of the current research trends in the skewing technique for permanent magnet synchronous motors (PMSMs). The skewing technique has been widely used in many applications to reduce the cogging torque and torque ripple in PMSMs. There are many ways to implement the skew, and new techniques are continually being developed. First, this article summarizes the types of skew structures and presents a survey of existing techniques. Specific emphasis is placed on what kind of skew structure is selected depending on the PMSM configuration. Second, the optimal value of the skew angle for each structure is comprehensively explained, and the discrepancy between theory and finite element analysis is discussed. The definition of skew angle varies across the literature, and one of the purposes of this article is to organize the definition in an easy-to-understand manner. In addition, this article offers three-dimensional finite element analysis (3D-FEA) results of various PMSMs employing the skew for quantitative comparison. Then, this article discusses the properties of PMSMs using the skew by structure and the latest trends, and finally describes future prospects.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama2227-903212162024Postgraduate Year Two Medical Residents' Awareness of Personal Development as a Physician during the Management of Inpatients: A Qualitative Study1621ENKazukiTokumasuDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHaruoObaraDepartment of General Internal Medicine, Okinawa Chubu HospitalTakanobuHirosawaDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical UniversityHirokoOgawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesClinical experiences, helping relationships, and reflection are key factors for personal development for physicians. However, few studies have shown which experiences are important for personal growth and how medical residents specifically use their experiences for personal growth. The aim of this study was to identify from the medical residents' perspective which clinical experiences contribute to their personal development. We employed a qualitative design, conducting semi-structured interviews with ten postgraduate year two medical residents at a Japanese teaching hospital. The interviews were transcribed in interview memos, anonymized, and subjected to reflective thematic analysis to generate themes relevant to personal and professional development. Successful clinical experiences with autonomy and responsibility in clinical management were shown to be essential points for personal development as a physician. Autonomy in this study was the attitude of making one's own choices when managing patients. Responsibility was the obligation of the resident to take charge of a patient. Instructing junior trainees, appreciation received from patients, and approval granted by attending physicians reinforced their feelings of personal growth. The realization of what experiences and concepts influence medical residents' personal growth and development will make their professional development more effective.No potential conflict of interest relevant to this article was reported.National Academy of SciencesActa Medica Okayama0027-8424121252024Argonaute-independent, Dicer-dependent antiviral defense against RNA virusese2322765121ENYukiyoSatoInstitute of Plant Science and Resources, Okayama UniversityHidekiKondoInstitute of Plant Science and Resources, Okayama UniversityNobuhiroSuzukiInstitute of Plant Science and Resources, Okayama UniversityAntiviral RNA interference (RNAi) is conserved from yeasts to mammals. Dicer recognizes and cleaves virus-derived double-stranded RNA (dsRNA) and/or structured single-stranded RNA (ssRNA) into small-interfering RNAs, which guide effector Argonaute to homologous viral RNAs for digestion and inhibit virus replication. Thus, Argonaute is believed to be essential for antiviral RNAi. Here, we show Argonaute-independent, Dicer-dependent antiviral defense against dsRNA viruses using Cryphonectria parasitica (chestnut blight fungus), which is a model filamentous ascomycetous fungus and hosts a variety of viruses. The fungus has two dicer-like genes (dcl1 and dcl2) and four argonaute-like genes (agl1 to agl4). We prepared a suite of single to quadruple agl knockout mutants with or without dcl disruption. We tested these mutants for antiviral activities against diverse dsRNA viruses and ssRNA viruses. Although both DCL2 and AGL2 worked as antiviral players against some RNA viruses, DCL2 without argonaute was sufficient to block the replication of other RNA viruses. Overall, these results indicate the existence of a Dicer-alone defense and different degrees of susceptibility to it among RNA viruses. We discuss what determines the great difference in susceptibility to the Dicer-only defense.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024Effect of Lipopolysaccharide on the Duration of Zolpidem-Induced Loss of Righting Reflex in Mice227235ENYudaiWadaDepartment of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoichiroUshioDepartment of Pharmacy, Okayama University HospitalYoshihisaKitamuraDepartment of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshitoZamamiDepartment of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiakiSendoDepartment of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/67197Zolpidem, a non-benzodiazepine hypnotic, is primarily used to treat insomnia. In a previous study, pior treatment with non-benzodiazepine receptor agonists was associated with inflammation. The present study aimed to clarify the association between the effects of zolpidem and inflammation in mice treated with lipopolysaccharide (LPS), a known model of inflammation. We assessed the zolpidem-induced loss of righting reflex (LORR) duration 24 h after LPS treatment in mice. Additionally, the expressions of γ-aminobutyric acid (GABA)A receptor subunit and K+-Cl− cotransporter isoform 2 (KCC2) mRNA in the hippocampus and frontal cortex were examined in LPS-treated mice. Pretreatment with LPS was associated with significantly prolonged duration of zolpidem-induced LORR compared to control mice. This effect was significantly attenuated by administering bicuculline, a GABAA receptor antagonist, or flumazenil, a benzodiazepine receptor antagonist, in LPS-treated mice. Compared to controls, LPS-treated mice showed no significant change in the expression of GABAA receptor subunits in the hippocampus or frontal cortex. Bumetanide, an Na+-K+-2Cl− cotransporter isoform 1 blocker, attenuated the extended duration of zolpidem-induced LORR observed in LPS-treated mice. LPS significantly decreased Kcc2 mRNA expression in the hippocampus and the frontal cortex. These findings suggest that inflammation increases zolpidem-induced LORR, possibly through a reduction in KCC2 expression.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024Assessment of a New Elbow Joint Positioning Method Using Area Detector Computed Tomography215225ENTakuyaAkagawaDepartment of Radiological Technology, Tokushima Red Cross HospitalRyoheiFukuiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityKatsuhiroKidaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityRyutaroMatsuuraDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityMakotoShimadaDepartment of Radiology, Osaka International Cancer InstituteMitsuhiroKinoshitaDepartment of Radiology, Tokushima Red Cross HospitalYokoAkagawaDepartment of Radiology, Tokushima Red Cross HospitalSachikoGotoDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/67196We propose a sitting position that achieves both high image quality and a reduced radiation dose in elbow joint imaging by area detector computed tomography (ADCT), and we compared it with the ‘superman’ and supine positions. The volumetric CT dose index (CTDIvol) for the sitting, superman, and supine positions were 2.7, 8.0, and 20.0 mGy and the dose length products (DLPs) were 43.4, 204.7, and 584.8 mGy • cm, respectively. In the task-based transfer function (TTF), the highest value was obtained for the sitting position in both bone and soft tissue images. The noise power spectrum (NPS) of bone images showed that the superman position had the lowest value up to approx. 1.1 cycles/mm or lower, whereas the sitting position had the lowest value when the NPS was greater than approx. 1.1 cycles/mm. The overall image quality in an observer study resulted in the following median Likert scores for Readers 1 and 2: 5.0 and 5.0 for the sitting position, 4.0 and 3.5 for the superman position, and 4.0 and 2.0 for the supine position. These results indicate that our proposed sitting position with ADCT of the elbow joint can provide superior image quality and allow lower radiation doses compared to the superman and supine positions.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024Reduced Immunogenicity of COVID-19 Vaccine in Obese Patients with Type 2 Diabetes: A Cross-Sectional Study185191ENHirokoTakahashiDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunEguchiDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMayuWatanabeDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriNakayamaOffice of Innovative Medicine, Organization for Research Strategy and Development, Okayama UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/66927The global pandemic of coronavirus infection 2019 (COVID-19) was an unprecedented public health emergency. Several clinical studies reported that heart disease, lung disease, diabetes, hypertension, dyslipidemia, and obesity are critical risk factors for increased severity of and hospitalization for COVID-19. This is largely because patients with these underlying medical conditions can show poor immune responses to the COVID-19 vaccinations. Diabetes is one of the underlying conditions most highly associated with COVID-19 susceptibility and is considered a predictor of poor prognosis of COVID-19. We therefore investigated factors that influence the anti-SARS-CoV-2 spike IgG antibody titer after three doses of vaccination in patients with type 2 diabetes. We found that obesity was associated with low anti-SARS-CoV-2 spike IgG antibody titers following three-dose vaccination in type 2 diabetics. Obese patients with type 2 diabetes may have attenuated vaccine efficacy and require additional vaccination; continuous infection control should be considered in such patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024Photon-Counting Detector CT: Potential for 75% Reduction in Contrast Medium Amount: A Phantom Study135142ENFumiyoHigakiDepartment of Radiology, Okayama University HospitalYusukeMorimitsuDepartment of Radiological Technology, Okayama University HospitalToshihiroIguchiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityHayatoSaitoDepartment of Radiological Technology, Okayama University Medical SchoolHaruhikoTakakiDepartment of Radiological Technology, Okayama University Medical SchoolAyakoNakagoshiDepartment of Radiological Technology, Okayama University Medical SchoolMakiWadaDepartment of Radiological Technology, Okayama University Medical SchoolMayuUkaDepartment of Radiology, Okayama University HospitalNoriakiAkagiDepartment of Radiological Technology, Okayama University HospitalToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalYusukeMatsuiDepartment of Radiology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesTakaoHirakiDepartment of Radiology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/66916This study aimed to evaluate the potential reduction in contrast medium utilization using photon-counting detector computed tomography (PCD-CT). One PCD-CT scan (CT1) and three conventional (non-PCD-CT) CT scans (CT2-CT4) were performed using a multi-energy CT phantom that contained eight rods with different iodine concentrations (0.2, 0.5, 1, 2, 5, 10, 15, and 20 mg/ml). The CT values of the seven groups (CT1 for 40, 50, 60, and 70 keV; and CT2-4) were measured. Noise and contrast-to-noise ratio (CNR) were assessed for the eight rods at various iodine concentrations. CT2 and CT1 (40 keV) respectively required 20 mg/ml and 5 mg/ml of iodine, indicating that a comparable contrast effect could be obtained with approximately one-fourth of the contrast medium amount. The standard deviation values increased at lower energy levels irrespective of the iodine concentration. The CNR exhibited a decreasing trend with lower iodine concentrations, while it remained relatively stable across all iodine levels (40-70 keV). This study demonstrated that virtual monochromatic 40 keV images offer a similar contrast effect with a reduced contrast medium amount when compared to conventional CT systems at 120 kV.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024The Roles of Neuropeptide Y in Respiratory Disease Pathogenesis via the Airway Immune Response95106ENJunkoItanoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiKiuraDepartment of Allergy and Respiratory Medicine, Okayama University HospitalYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuakiMiyaharaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalReview10.18926/AMO/66912The lungs are very complex organs, and the respiratory system performs the dual roles of repairing tissue while protecting against infection from various environmental stimuli. Persistent external irritation disrupts the immune responses of tissues and cells in the respiratory system, ultimately leading to respiratory disease. Neuropeptide Y (NPY) is a 36-amino-acid polypeptide and a neurotransmitter that regulates homeostasis. The NPY receptor is a seven-transmembrane-domain G-protein-coupled receptor with six subtypes (Y1, Y2, Y3, Y4, Y5, and Y6). Of these receptors, Y1, Y2, Y4, and Y5 are functional in humans, and Y1 plays important roles in the immune responses of many organs, including the respiratory system. NPY and the Y1 receptor have critical roles in the pathogenesis of asthma, chronic obstructive pulmonary disease, and idiopathic pulmonary fibrosis. The effects of NPY on the airway immune response and pathogenesis differ among respiratory diseases. This review focuses on the involvement of NPY in the airway immune response and pathogenesis of various respiratory diseases.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323142024現行いじめアンケートの妥当性と課題 ―教師の「いじめの深刻さ認識」を指標として―207221ENSenaMIYAGAWAGraduate School of Education，Okayama University (Master Degree Course)TazukoAOKIFaculty of Education，Okayama University10.18926/CTED/66782 いじめ早期発見を目的としたアンケートが全国で実施されているが，いじめの認知件数は減少していない。そこで，全国14都道府県のいじめアンケートを集計し，内容を分析した。加えて，このいじめアンケートが「いじめに該当する」としている行為に着目し，いじめ行為に対する，教師の「いじめに対する深刻さの認識」を調査した。その際，宮川・青木（2023）が示した「いじめの深刻度」に関する知見を用いた。分析の結果，教師は「やり返せる行為」よりも，「やり返せない行為」をより深刻と捉えていることがわかった。つまり，教師は「深刻と捉えられるべきいじめ行為」を深刻だと捉えており，現行いじめアンケートが「いじめに該当する」としている行為は妥当であると考えた。このことは，現行いじめアンケートでは早期発見が難しいことを示唆している。よって，早期発見と言うよりは，未然防止につながる新しいアンケートの開発の必要性について考察した。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323142024小学校教師の社会科観の形成過程に関する研究 ―初任期教師に着目して―119133ENYukaFUKUTAGraduate School of Education, Okayama UniversityToshinoriKUWABARAFaculty of Education, Okayama University10.18926/CTED/66776 本研究は，初任期の小学校教師が何を拠り所として社会科観を形成しているのか，また自身の社会科観をどのように発展させていこうとしているのかを明らかにしようとするものである。調査の結果，初任期小学校教師は，大学時代の卒業論文を書くために所属したゼミでの学びが核となり，日々の授業での子供観察や教材研究，生徒指導の経験など，新しい経験や価値観に出会うことを通して不足している部分を補いながら自身の社会科観を形成しており，社会科観は流動的であることが明らかになった。また，社会科を通して育てたい子供像については，教師のよりよい未来社会への志向が，社会科の役割に対する考えの核となっており，社会科を生徒指導や生活指導と密接に関連する教科であると認識していた。No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7812024Regression of Necrotic Lesions after Methotrexate Withdrawal in Patients with Methotrexate-Associated Lymphoproliferative Disorders: A Retrospective CT Study2936ENTakahiroKitayamaDepartment of Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiTanakaDepartment of Radiology, Okayama City HospitalYuichiroKanieDepartment of Radiology, Okayama University HospitalYoheiMarukawaDepartment of Radiology, Okayama Saiseikai General HospitalKatsuhideKojimaDepartment of Radiology, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySoshiTakaoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakaoHirakiDepartment of Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOriginal Article10.18926/AMO/66668This retrospective study investigated whether necrotic lesions detected on a computed tomography (CT) scan are more regressive than non-necrotic lesions after methotrexate withdrawal in patients pathologically diagnosed with methotrexate-associated lymphoproliferative disorders (MTX-LPD). In total, 89 lesions extracted from 24 patients on CT scans were included in the analysis. All patients had been evaluated for the presence of necrosis within lesions via CT scan upon first suspicion of MTX-LPD (baseline CT scan). The percentage lesion size reduction between the baseline and initial follow-up CT scan was calculated. The association between necrosis within lesions and size changes was estimated via linear regression analyses using both crude and adjusted models. Necrosis was significantly more common in extranodal lesions (27 out of 30 lesions, 90%) than in nodal lesions (9 out of 59 lesions, 15%, p<0.001). In the crude model, the regression of necrotic lesions was 58.5% greater than that of non-necrotic lesions; the difference was statistically significant (p<0.001). Additionally, the longest diameter of necrotic lesions at the baseline CT scan was significantly greater than that of non-necrotic lesions (p<0.001). Based on the adjusted model, necrotic lesions showed 49.3% greater regression than non-necrotic lesions (p=0.017). Necrosis detected on a CT scan was found to be an independent predictor of regression after MTX withdrawal in patients with MTX-LPD.No potential conflict of interest relevant to this article was reported.岡山大学文明動態学研究所Acta Medica Okayama2436-832632024建白書ヲ読ミテ ―識語の語るもの―290298ENHiroshiYAMASHITA資料紹介 (Materials and data)10.18926/66200No potential conflict of interest relevant to this article was reported.SAGE PublicationsActa Medica Okayama1756-283X162023Optimal liver drainage rate for survival in patients with unresectable malignant hilar biliary obstruction using 3D-image volume analyzerENKosakuMorimotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiOdaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTatsuhiroYamazakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Drainage exceeding 50% of total liver volume is a beneficial prognostic factor in patients with unresectable malignant hilar biliary obstruction (UMHBO). However, it is unclear what threshold percentage of total liver volume drained ('liver drainage rate') significantly improves survival in patients with UMHBO who received systemic chemotherapy.<br>
Objectives: We aimed to assess the optimal liver drainage rate that improves survival in patients with UMHBO receiving chemotherapy using a three-dimensional (3D)-image volume analyzer.<br>
Design: This study was a single-center retrospective cohort study.<br>
Methods: Data from 90 patients with UMHBO who received chemotherapy after endoscopic biliary drainage using metal stents at Okayama University Hospital from January 2003 to December 2020 were reviewed. The liver drainage rate was calculated by dividing the drained liver volume by the total liver volume using a 3D-image volume analyzer. The primary endpoint was overall survival by liver drainage rate. The secondary endpoints were time to recurrent biliary obstruction (TRBO) and prognostic factors.<br>
Results: The median total liver volume was 1172 (range: 673-2032) mL, and the median liver drainage rate was 83% (range: 50-100). Overall survival was 376 (95% CI: 271-450) days, and patients with >80% drainage (n = 67) had significantly longer survival than those with <80% drainage (n = 23) (450 days versus 224 days, p = 0.0033, log-rank test). TRBO was 201 (95% CI: 155-327) days and did not differ significantly by liver drainage rate. Multivariate Cox proportional hazards regression analysis revealed >80% liver drainage [hazard ratio (HR): 0.35, 95% CI: 0.20-0.62, p = 0.0003] and hilar cholangiocarcinoma (HR: 0.30, 95% CI: 0.17-0.50, p < 0.0001) as significant prognostic factors.<br>
Conclusion: In patients with UMHBO scheduled for chemotherapy, >80% drainage is associated with improved survival. Further prospective multicenter studies are needed to verify the results of this study.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465522023地方公共サービス革新プロセスの視座の構築114ENDaijiFujiiHiroshiKanaji10.18926/OER/66033 When local governments develop public services, they often experience innovation processes. More often, the innovation processes referred to here seem to be the perceived needs for transformation faced with external pressures and the purposive responses to them. This article tries to depict this discourse from a different viewpoint. One of the perspectives that has been proposed so far is that the external environments are made up of multiple actors, and that the historical backgrounds and the relationships between these actors affect the structure of administrative organizations and the methods of providing public services. The transformation processes could be one-time events no matter how long the processes may take, but this article tries to argue they may connote a circular mechanism where both of the administrative organizations and the external actors feedback to each other. In order to elaborate this direction of theorizing, three steps are employed by applying existent literature of various types developed in rather a broader context of social sciences. First, if one of the goals of postmodern theorization is liberating the psychological energies of actors from the cramped social reality that structuralists postulated, then Actor-Network-Theory may be useful. Second, according to Sarasbathy’s research on entrepreneurial behaviors, the view that we effectuate our future through what we can do now is attractive in order to create a new discourse of social innovations, where we appreciate them as not springing out of nowhere all of sudden. Third, once this article accepts polyphonic views on social realities where congested discourses interact during abovementioned process, the role of civic entrepreneurs on the frontline can never be overstated enough. This is because such civic entrepreneurs could cooperate with minority opinions and raise them into broader contexts of dialogues within societies.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7752023Childcare and Child Development in Japan479490ENAkikoMurataDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaomiMatsumotoFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityChikaraMiyajiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoshiTakaoFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiYorifujiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOriginal Article10.18926/AMO/65970For decades, the notion has persisted in developed countries that exclusive care by the mothers is best for the development of children up to 3 years of age. To examine the veracity of this “myth of the first three years” in Japan, we examined the effects of childcare facility use for children younger than 3 years on their development using the cohorts of the Longitudinal Survey of Newborns in the 21st Century conducted in Japan. Of the 47,015 respondents to the survey, we studied the children of 5,508 mothers with university/professional education to evaluate the relationships between primary early (< 2.5 years) childcare providers during weekday daytime hours and specific development indices for the ages of 2.5, 5.5, and 8 years. At the age of 2.5 and 5.5 years, children attending childcare facilities were judged as having more advanced developmental behaviors by their parents, such as being able to compose a two-word sentence (adjusted odds ratio [aOR]: 0.22) or to express emotions (aOR: 0.81), compared with those cared for by mothers. However, at the age of 8 years, children who attended childcare facilities as infants < 2.5 years showed more aggressive behavior in interrupting people (aOR: 1.20) and causing disturbances in public (aOR: 1.26) than those cared for by mothers (after adjustment for numerous child and parental factors). Although these results are generally consistent with previous studies, issues potentially involved with problem behavior such as quality of childcare require further investigation, as does the case of children of mothers with more modest educational attainment.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7752023An Assessment Rubric for a Resident Training Program in Surgery: A Single-Institution Experience451460ENAtsushiOkitaDepartment of Surgery, Okayama City HospitalKazunoriTsukudaDepartment of Surgery, Okayama City HospitalHideoInoCenter for Education in Medicine and Health Science, Okayama UniversityEmaMitsuiDepartment of Surgery, Okayama City HospitalNanamiIkeyaDepartment of Surgery, Okayama City HospitalSumiharuYamamotoDepartment of Surgery, Okayama City HospitalNobujiYokoyamaDepartment of Surgery, Okayama City HospitalAubraBulinDiscovery Program for Global Learners, Okayama UniversityOriginal Article10.18926/AMO/65967Using a Collaborative Action Research model, our research team established a one-month clinical resident training program for first- and second-year clinical residents. We created and implemented an assessment rubric to assess the residents’ progress toward independent practice in surgery, and thereby, to evaluate the program itself. The program included training in three areas: basic techniques and procedures in the operating room, surgical ward management, and academic activities. The rubric measured the residents’ performance according to three achievement levels: Level 1 (demonstration), Level 2 (active help) and Level 3 (passive help). The program and rubric implementation began in June 2019 and continued until March 2020, when the program outcomes and shortcomings were analyzed. Among nineteen clinical residents, a total of nine clinical residents participated in the study. Most participants reached achievement Level 3 for their performance of basic techniques in the operating room. Finally, we discussed ideas for improvement and drafted plans for an improved rubric to complete the action research cycle. Our research team found the rubric to be a useful tool in evaluating the status of the new clinical resident training program.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2005What accounts for the relationship between social class and smoking cessation? Results of a path analysisENNo potential conflict of interest relevant to this article was reported.SpringerActa Medica Okayama2199-45361012023Data-driven evolutionary computation for service constrained inventory optimization in multi-echelon supply chains825846ENZiangLiuFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityTatsushiNishiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversitySupply chain digital twin has emerged as a powerful tool in studying the behavior of an actual supply chain. However, most studies in the field of supply chain digital twin have only focused on what-if analysis that compares several different scenarios. This study proposes a data-driven evolutionary algorithm to efficiently solve the service constrained inventory optimization problem using historical data that generated by supply chain digital twins. The objective is to minimize the total costs while satisfying the required service level for a supply chain. The random forest algorithm is used to build surrogate models which can be used to estimate the total costs and service level in a supply chain. The surrogate models are optimized by an ensemble approach-based differential evolution algorithm which can adaptively use different search strategies to improve the performance during the computation process. A three-echelon supply chain digital twin on the geographic information system (GIS) map in real-time is used to examine the efficiency of the proposed method. The experimental results indicate that the data-driven evolutionary algorithm can reduce the total costs and maintain the required service level. The finding suggests that our proposed method can learn from the historical data and generate better inventory policies for a supply chain digital twin.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7742023Association of Tumor Necrosis Factor-Alpha with Psychopathology in Patients with Schizophrenia395405ENMarkoPavlovicUniversity Hospital Center Mostar, University of MostarDraganBabicUniversity Hospital Center Mostar, University of MostarPejanaRastovicUniversity Hospital Center Mostar, University of MostarJuricaArapovicUniversity Hospital Center Mostar, University of MostarMarkoMartinacHealth Care Center Mostar, University of MostarSanjaJakovacUniversity Hospital Center Mostar, University of MostarRomanaBarbaricUniversity Hospital Center Mostar, University of MostarOriginal Article10.18926/AMO/65750We investigated the relationship between serum tumor necrosis factor-alpha (TNF-α) levels and psychopathological symptoms, clinical and socio-demographic characteristics and antipsychotic therapy in individuals with schizophrenia. TNF-α levels were measured in 90 patients with schizophrenia and 90 healthy controls matched by age, gender, smoking status, and body mass index. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of psychopathology in patients. No significant differences in TNF-α levels were detected between the patients and controls (p=0.736). TNF-α levels were not correlated with total, positive, negative, general, or composite PANSS scores (all p>0.05). A significant negative correlation was observed between TNF-α levels and the PANSS cognitive factor (ρ=−0.222, p=0.035). A hierarchical regression analysis identified the cognitive factor as a significant predictor of the TNF-α level (beta=−0.258, t=−2.257, p=0.027). There were no significant differences in TNF-α levels among patients treated with different types of antipsychotics (p=0.596). TNF-α levels correlated positively with the age of onset (ρ=0.233, p=0.027) and negatively with illness duration (ρ=−0.247, p=0.019) and antipsychotic treatment duration (ρ=−0.256, p=0.015). These results indicate that TNF-α may be involved in cognitive impairment in schizophrenia, and would be a potential clinical-state marker in schizophrenia.No potential conflict of interest relevant to this article was reported.Taylor and Francis Group Acta Medica Okayama0951-83983762023Anti-oppressive global citizenship education in English language teaching: a three-pillar approach17721787ENShawna M.CarrollGraduate School of Education, Okayama UniversityAnti-oppressive global citizenship education (GCE), a specific strand of critical GCE, is a new field, especially concerning empirical studies within English classrooms. Based on an anti-oppressive GCE framework and the research question, “what does anti-oppressive theory look like in practice in English classrooms and how can this be woven into GCE?”, this paper explains the results of a project which used a portraiture methodology to collect and analyze approximately 6 hours of semi-structured interviews, detailed impressionistic records, and several lessons collected with one secondary school English teacher in Ontario, Canada. The portrait showcases how the educator implements a three-pillar approach to anti-oppressive GCE language education and the need to shine light on minoritized identities, create healthy soil for the foundation of learning about systemic oppression, and give the proper amounts of water/support to each student.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7732023Associations between Comorbidities and Acute Exacerbation of Interstitial Lung Disease after Primary Lung Cancer Surgery301309ENTakahideKatoDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineSeigoMiyoshiDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineChizuruHamadaDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineYoshifumiSanoDepartment of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of MedicineNaoyukiNogamiDepartment of Community Medicine, Pulmonology and Cardiology, Ehime University Graduate School of MedicineOsamuYamaguchiDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineNaohikoHamaguchiDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineOriginal Article10.18926/AMO/65495Acute exacerbation (AE) of interstitial lung disease (ILD) is a severe complication of lung resection in lung cancer patients with ILD (LC-ILD). This study aimed to assess the predictive value of comorbidities other than ILD for postoperative AE in patients with LC-ILD. We retrospectively evaluated 68 patients with LC-ILD who had undergone lung resection. We classified them into two groups: those who had developed postoperative AE within 30 days after resection and those who had not. We analyzed patient characteristics, high-resolution computed tomography findings, clinical data, pulmonary function, and intraoperative data. The incidence of postoperative AEs was 11.8%. In univariate analysis, performance status (PS), honeycombing, forced vital capacity (FVC), and high hemoglobin A1c (HbA1c) levels without comorbidities were significantly associated with postoperative AE. Patients were divided into two groups according to cutoff levels of those four variables as determined by receiver operating characteristic curves, revealing that the rates of patients without postoperative AE differed significantly between groups. The present results suggested that preoperative comorbidities other than ILD were not risk factors for postoperative AE in patients with LC-ILD. However, a high preoperative HbA1c level, poor PS, low FVC, and honeycombing may be associated with postoperative AE of LC-ILD.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7732023Brown Adipose Tissue PPARγ Is Required for the Insulin-Sensitizing Action of Thiazolidinediones243254ENYusukeShibataDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunEguchiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/65489Brown adipose tissue (BAT) plays a critical role in metabolic homeostasis. BAT dysfunction is associated with the development of obesity through an imbalance between energy expenditure and energy intake. The nuclear receptor peroxisome proliferator-activated receptor gamma (PPARγ) is the master regulator of adipogenesis. However, the roles of PPARγ and thiazolidinediones (TZDs) in the regulation of BAT metabolism remain unclear. TZDs, which are selective PPARγ activators, improve systemic insulin resistance in animals and humans. In the present study, we generated brown adipocyte-specific PPARγ-deficient mice (BATγKO) to examine the in vivo roles of PPARγ and TZDs in BAT metabolism. In electron microscopic examinations, brown adipocyte-specific PPARγ deletion promoted severe whitening of brown fat and morphological alteration of mitochondria. Brown adipocyte-specific PPARγ deletion also reduced mRNA expression of BAT-selective genes. Although there was no difference in energy expenditure between control and BATγKO mice in calorimetry, norepinephrine-induced thermogenesis was impaired in BATγKO mice. Moreover, pioglitazone treatment improved diet-induced insulin resistance in the control mice but not in the BATγKO mice. These findings suggest that BAT PPARγ is necessary for the maintenance of brown adipocyte function and for the insulin-sensitizing action of TZDs.No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322732023相互行為としての〈迷惑〉意識：贈与論的アプローチからの考察1527ENRyozoSUZUKIGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University10.18926/interdisciplinary/65461This paper examines elderly people’s Feelings of "Meiwaku / Burden" from the perspective of the act of gift-giving. In Japanese, the word "Morau" is used not only in receiving a concrete object, but also in having something done by someone. Both acts lead to the human relationship and the reciprocity. Both cases can cause a burden on receivers and others. We use then “Sumimasen”. This is not as the same as English words “Thank You”. But this usage of Japanese can be explained from a Gift-giving-theoretic point of view. Because, in terms of the outcome, they are the same thing from this theory. Therefore, we will examine the meaning of the word "receive" based on discussions by Kunio Yanagida, Michizo Toida, Ruth Benedict, Marcel Mauss, and others. We hope to clarify what is elderly people’s Feelings of "Meiwaku / Burden" by analyzing the meaning of human relationships brought about by the act of gift-giving in general.No potential conflict of interest relevant to this article was reported.Public Library of ScienceActa Medica Okayama1932-62031832023Identification of illness representational patterns and examining differences of self-care behavior in the patterns in chronic kidney diseasee0283701ENYukiKajiwaraFaculty of Health Sciences, Okayama UniversityMichikoMorimotoFaculty of Health Sciences, Okayama UniversitySelf-care behavior is considered important for preventing the progression of chronic kidney disease (CKD). Although lifestyle interventions are popular, they have not been sufficiently effective. According to studies on other chronic diseases, illness representation has been found to formulate a pattern, and self-care behavior could differ depending on the pattern, which suggests difference in self-care behavior based on illness representation. This study examined what kind of illness representational patterns exist among CKD patients and whether there is a difference in self-care behavior depending on the pattern. A survey was conducted from the beginning of June to the end of October 2019 on 274 CKD patients who were either outpatients or hospitalized at general hospitals in Western Japan. The Illness Perception Questionnaire-Revised was used to assess illness representation and the Japanese Chronic Kidney Disease Self-Care scale was used to assess self-care behavior. Two-stage cluster analysis was used to identify clusters. Cluster features were examined using analysis of variance and Tukey HSD tests. Differences in self-care behavior scores among identified clusters were investigated. Two hundred and forty-four questionnaires were received, and 212 were analyzed. Participants were aged 64.9 +/- 12.9, and the estimated glomerular filtration rate was 33.7 +/- 15.8. Three clusters were identified: Cluster 1 represented the difficulty of making sense of the changed condition caused by the disease and easily falling into misunderstanding; Cluster 2 represented patients with disease conditions that impacted their daily life and emotional responses; Cluster 3 represented the controllability and understandability of the disease. Total self-care behavior scores indicated a significant difference between Cluster 1 (52.1 +/- 9.7) and Cluster 3 (57.7 +/- 8.2). In conclusion, we showed that three representational patterns exist among CKD patients. In addition, a difference was found in self-care behavior depending on the illness representational pattern, suggesting the need to focus on illness representation.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7722023Prolonged Sedentary Bouts Are Critically Involved in All-Cause Mortality in Patients on Chronic Hemodialysis: A Prospective Cohort Study139145ENKeiichiNamioDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityTakashiKondoInnoshima General HospitalNobuyukiMiyatakeDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityShuheiHishiiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityHiroyukiNishiInnoshima General HospitalAkihikoKatayamaFaculty of Social Studies, Shikokugakuin UniversityKazuhiroUjikeInnoshima General HospitalHiromiSuzukiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityKiichiKoumotoInnoshima General HospitalOriginal Article10.18926/AMO/65143We investigated the link between prolonged sedentary bouts and all-cause mortality in patients on chronic hemodialysis, using a prospective cohort. A total of 104 outpatients on chronic hemodialysis from 2013 to 2019, aged 71.4±11.4 years, were enrolled. Prolonged sedentary bouts (≥ 30 min and ≥60 min) (min and bouts) and relative prolonged sedentary bouts (≥ 30 min and ≥ 60 min) (%) on the patients’ non-hemodialysis days were measured by a tri-accelerometer, and we also analyzed the patients’ clinical parameters. The relationship between prolonged sedentary bouts and all-cause mortality was evaluated by a survival analysis and the Cox proportional hazard model. Thirty-five patients died during the follow-up period. A Kaplan-Meier analysis detected significant differences in the survival rate between two groups stratified by the median for all prolonged sedentary-bout parameters. After the adjustment for confounding factors, all of the prolonged sedentary-bout parameters were determinant factors for all-cause mortality. These results indicate that prolonged sedentary bouts on non-hemodialysis days were closely related to all-cause mortality in the patients
on hemodialysis.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323132023リコーダー演奏に対する音楽教師の視線の特徴 ―アイトラッカーを用いた動画調査による予備実験―233244ENRinkoHayakawaFaculty of Education, Okayama UniversityMihoImotoFaculty of Education, Okayama University of ScienceNorikoKoyamaFaculty of Education, Fukuyama City UniversityYokoOgawaFaculty of Education, Okayama UniversityMarikoSasakuraFaculty of Natural Science and Technology, Okayama University10.18926/CTED/65076本研究は，音楽熟達教師は学習者の何をいかに見ているのか，リコーダー演奏場面に対する教師の視線分析を通してその特徴について明らかにしたものである。今回は予備実験として，リコーダー演奏場面の動画を刺激として用い，被験者20 名（音楽専門家10 名，音楽専門の小学校教師２名，大学生８名）を対象にアイトラッカーを装着して動画の視聴調査を実施した。その結果，（１）被験者は未熟な演奏に対して注視する傾向にあること，（２）音楽専門家と小学校教師は「手元」または「顔」に視線が集中する傾向があること，一方で（３）音楽専門家と小学校教師の視線は，「手元」または「顔」に視線が集中するものの，指導助言の言及内容にはそれ以外の内容も多く含まれていることが明らかとなった。また，演奏者を捉えるときには，視線が優位ではない場合があることが示唆された。No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231822023大学部活動におけるチームリーダーシップの影響―“ 活気あるチームづくり”のためにリーダーにできること ―111ENRyoMisawaFaculty of Education, Okayama UniversityYokoNishi株式会社ドコモCS中国 総務部10.18926/bgeou/64978本研究では，学生が主体的に参加・運営する大学部活動をチームととらえ，その活性化に寄与するチームリーダーシップの影響を検討した。リーダーシップの発揮主体として，部長・キャプテン等の役職者に着目し，先行研究の議論を参考に測定項目を作成した。また“活気あるチーム”の状態をとらえる指標として，Hackman（1987）のチームの効果性の枠組みを基に，集団効力感，心理的安全性，活動意欲，活動満足感の４つを採用した。質問紙調査により，部活動に所属する大学生109名から有効回答が得られた。分析の結果，チームリーダーシップの「建設的な後押し」は集団効力感と活動満足感，「メンバーの意見尊重」は全ての指標を促進する効果を示した。また，「コミュニケーションの促進」は，「メンバーの意見尊重」が集団効力感と心理的安全性を高める機能の下支えをしていることが示唆された。No potential conflict of interest relevant to this article was reported.ROYAL SOC CHEMISTRYActa Medica Okayama2046-20691382023Convergent evolution of animal and microbial rhodopsins53675381ENKeiichiKojimaFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiSudoFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRhodopsins, a family of photoreceptive membrane proteins, contain retinal as a chromophore and were firstly identified as reddish pigments from frog retina in 1876. Since then, rhodopsin-like proteins have been identified mainly from animal eyes. In 1971, a rhodopsin-like pigment was discovered from the archaeon Halobacterium salinarum and named bacteriorhodopsin. While it was believed that rhodopsin- and bacteriorhodopsin-like proteins were expressed only in animal eyes and archaea, respectively, before the 1990s, a variety of rhodopsin-like proteins (called animal rhodopsins or opsins) and bacteriorhodopsin-like proteins (called microbial rhodopsins) have been progressively identified from various tissues of animals and microorganisms, respectively. Here, we comprehensively introduce the research conducted on animal and microbial rhodopsins. Recent analysis has revealed that the two rhodopsin families have common molecular properties, such as the protein structure (i.e., 7-transmembrane structure), retinal structure (i.e., binding ability to cis- and trans-retinal), color sensitivity (i.e., UV- and visible-light sensitivities), and photoreaction (i.e., triggering structural changes by light and heat), more than what was expected at the early stages of rhodopsin research. Contrastingly, their molecular functions are distinctively different (e.g., G protein-coupled receptors and photoisomerases for animal rhodopsins and ion transporters and phototaxis sensors for microbial rhodopsins). Therefore, based on their similarities and dissimilarities, we propose that animal and microbial rhodopsins have convergently evolved from their distinctive origins as multi-colored retinal-binding membrane proteins whose activities are regulated by light and heat but independently evolved for different molecular and physiological functions in the cognate organism.No potential conflict of interest relevant to this article was reported.The Japanese Society of Internal MedicineActa Medica Okayama0918-29186232023Actual Telemedicine Needs of Japanese Patients with Neurological Disorders in the COVID-19 Pandemic365371ENRyoSasakiDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTaijunYunokiDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYumikoNakanoDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYusukeFukuiDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMamiTakemotoDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyutaMoriharaDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKojiAbeDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToruYamashitaDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityObjective During the coronavirus disease 2019 (COVID-19) pandemic, many social activities have moved online using applications for digital devices (e.g. computers, smartphones). We investigated the needs of telemedicine and trends in medical status and social care situations of Japanese patients with neurological disorders in order to estimate their affinity for an online telemedicine application. Methods We designed an original questionnaire for the present study that asked participants what problems they had with hospital visits, how the COVID-19 pandemic had affected their lives, and whether or not they would like to receive telemedicine.Patients The present study included volunteer caregivers, participants with Parkinson's disease (PD), epiamyotrophic lateral sclerosis (ALS), headache, myopathy, and other neurological diseases from Okayama University Hospital. Results A total of 29.6% of patients wanted to use telemedicine. Patients with ultheadaches (60.0%) and epilepsy (38.1%) were more likely to want to use telemedicine than patients with PD (17.8%) or stroke (19.0%). Almost 90% of patients had access to a digital device, and there was no association between favoring telemedicine, ownership of a digital device, hospital visiting time, or waiting time at the hospital, although age was associated with motivation to telemedicine use (52.6 vs. 62.2 years old, p < 0.001). Conclusion We can contribute to the management of the COVID-19 pandemic and the medical economy by promoting telemedicine, especially for young patients with headaches or epilepsy.No potential conflict of interest relevant to this article was reported.Frontiers MediaActa Medica Okayama1662-5196162023A method for reconstruction of interpretable brain networks from transient synchronization in resting-state BOLD fluctuations960607ENYusukeNoroDepartment of Biosciences and Informatics, Keio UniversityRuixiangLiDepartment of Physiology, The University of Tokyo School of MedicineTeppeiMatsuiDepartment of Biology, Okayama UniversityKojiJimuraDepartment of Informatics, Gunma UniversityResting-state (rs) fMRI has been widely used to examine brain-wide large-scale spatiotemporal architectures, known as resting-state networks (RSNs). Recent studies have focused on the temporally evolving characteristics of RSNs, but it is unclear what temporal characteristics are reflected in the networks. To address this issue, we devised a novel method for voxel-based visualization of spatiotemporal characteristics of rs-fMRI with a time scale of tens of seconds. We first extracted clusters of dominant activity-patterns using a region-of-interest approach and then used these temporal patterns of the clusters to obtain voxel-based activation patterns related to the clusters. We found that activation patterns related to the clusters temporally evolved with a characteristic temporal structure and showed mutual temporal alternations over minutes. The voxel-based representation allowed the decoding of activation patterns of the clusters in rs-fMRI using a meta-analysis of functional activations. The activation patterns of the clusters were correlated with behavioral measures. Taken together, our analysis highlights a novel approach to examine brain activity dynamics during rest.No potential conflict of interest relevant to this article was reported.岡山大学大学院法務研究科Acta Medica Okayama1881-1485242022緊急逮捕手続書の虚偽記載が重大な違法にあたるとされた事例 ―山形地裁令和4年2月21日判決―115ENMihoKoura10.18926/OLR/64259No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama1520-6106126382022Roles of the Flexible Primary Coordination Sphere of the Mn4CaOx Cluster: What Are the Immediate Decay Products of the S-3 State?72127228ENHiroshiIsobeResearch Institute for Interdisciplinary Science, Okayama UniversityMitsuoShojiCenter for Computational Science, University of Tsukuba,TakayoshiSuzukiResearch Institute for Interdisciplinary Science, Okayama UniversityJian-RenShenResearch Institute for Interdisciplinary Science, Okayama UniversityKizashiYamaguchiInstitute for NanoScience Design, Osaka UniversityThe primary coordination sphere of the multinuclear cofactor (Mn4CaOx) in the oxygen-evolving complex (OEC) of photosystem II is absolutely conserved to maintain its structure and function. Recent time-resolved serial femtosecond crystallography identified large reorganization of the primary coordination sphere in the S-2 to S-3 transition, which elicits a cascade of events involving Mn oxidation and water molecule binding to a putative catalytic Mn site. We examined how the crystallographic fields, created by transient conformational states of the OEC at various time points, affect the thermodynamics of various isomers of the Mn cluster using DFT calculations, with an aim of comprehending the functional roles of the flexible primary coordination sphere in the S-2 to S-3 transition and in the recovery of the S-2 state. The results show that the relative movements of surrounding residues change the size and shape of the cavity of the cluster and thereby affect the thermodynamics of various catalytic intermediates as well as the ability to capture a new water molecule at a coordinatively unsaturated site. The implication of these findings is that the protein dynamics may serve to gate the catalytic reaction efficiently by controlling the sequence of Mn oxidation/reduction and water binding/release. This interpretation is consistent with EPR experiments; g similar to 5 and g similar to 3 signals obtained after near-infrared (NIR) excitation of the S-3 state at 4 K and a g similar to 5 only signal produced after prolonged incubation of the S-3 state at 77 K can be best explained as originating from water-bound S-2 clusters (S-total = 7/2) under a S-3 ligand field, i.e., the immediate one-electron reduction products of the oxyl-oxo (S-total = 6) and hydroxo-oxo (S-total = 3) species in the S-3 state.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7652022Hip Function Was Not Associated with the Incidence of Preoperative Deep Vein Thrombosis in Patients Undergoing Primary Total Hip Arthroplasty577584ENYukiOkutaniDepartment of Orthopaedic Surgery, Kyoto Katsura HospitalHiroshiFujitaCenter for Hip and Knee reconstruction, Rakuyo HospitalHidetoHaradaDepartment of Orthopaedic Surgery, Kyoto Katsura HospitalMasanaoKataokaDepartment of Orthopaedic Surgery, Kyoto Katsura HospitalYoshikiMurotaniDepartment of Orthopaedic Surgery, Faculty of Medicine, Kyoto UniversityYuShimizuDepartment of Orthopaedic Surgery, Kyoto City HospitalOriginal Article10.18926/AMO/64039The prevalence of preoperative deep vein thrombosis (DVT) has been reported to be relatively high in patients undergoing total hip arthroplasty. We investigated the prevalence of DVT, the association between hip function and preoperative DVT, and the effect of a history of surgery in patients who underwent primary total hip arthroplasty. We retrospectively analyzed the cases of the patients who underwent primary total hip arthroplasty between April 2013 and February 2020 at our institution. We evaluated the prevalence of preoperative DVT based on the results of the patients’ ultrasound screening. We performed univariate and multivariate analyses to investigate the association between the incidence of DVT and patient factors including age, sex, hip function, medical histories, and American Society of Anesthesiologists Physical Status classification. We analyzed 451 patients (494 hips). The prevalence of DVT was 14.2% (64 patients). The multivariate analysis demonstrated that increased age was an independent significant risk factor for DVT. The prevalence of preoperative DVT was relatively high among patients who underwent primary total hip arthroplasty. Preoperative DVT tended to be more prevalent in older patients. Hip function was not associated with the incidence of DVT.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7652022Correlation between Mean Arterial Pressure and Regional Cerebral Oxygen Saturation on Cardiopulmonary Bypass in Pediatric Cardiac Surgery557564ENYuPanDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesQingqingSongDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyukiKanazawaDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/64037Some pediatric cardiac patients might experience low regional cerebral oxygen saturation (rSO2) during surgery. We investigated whether a pediatric patient’s mean arterial pressure (MAP) can affect the rSO2 value during cardiopulmonary bypass (CPB). We retrospectively analyzed the cases of the pediatric patients who underwentcardiac surgery at our hospital (Jan. –Dec. 2019; n=141). At each MAP stage, we constructed line charts through the mean of the rSO2 values corresponding to each MAP and then calculated the correlation coefficients. We next divided the patients into age subgroups (neonates, infants, children) and into cyanotic congenital heart disease (CHD) and acyanotic CHD groups and analyzed these groups in the same way. The analyses of all 141 patients revealed that during CPB the rSO2 value increased with an increase in MAP (r=0.1626). There was a correlation between rSO2 and MAP in the children (r=0.2720) but not in the neonates (r=0.06626) or infants (r=0.05260). Cyanotic CHD or acyanotic CHD did not have a significant effect on the rSO2/MAP correlation. Our analysis demonstrated different patterns of a correlation between MAP and rSO2 in pediatric cardiac surgery patients, depending on age. MAP was positively correlated with rSO2 typically in children but not in neonate or infant patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7652022Viral Sequences Are Repurposed for Controlling Antiviral Responses as Non-Retroviral Endogenous Viral Elements503510ENHirohitoOgawaDepartment of Virology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomoyukiHondaDepartment of Virology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityReview10.18926/AMO/64025Eukaryotic genomes contain numerous copies of endogenous viral elements (EVEs), most of which are considered endogenous retrovirus (ERV) sequences. Over the past decade, non-retroviral endogenous viral elements (nrEVEs) derived from ancient RNA viruses have been discovered. Several functions have been proposed for these elements, including antiviral defense. This review summarizes the current understanding of nrEVEs derived from RNA viruses, particularly endogenous bornavirus-like elements (EBLs) and endogenous filovirus-like elements (EFLs). EBLs are one of the most extensively studied nrEVEs. The EBL derived from bornavirus nucleoprotein (EBLN) is thought to function as a non-coding RNA or protein that regulates host gene expression or inhibits virus propagation. Ebolavirus and marburgvirus, which are filoviruses, induce severe hemorrhagic fever in humans and nonhuman primates. Although the ecology of filoviruses remains unclear, bats are believed to be potential reservoirs. Based on the knowledge from EBLs, it is postulated that EFLs in the bat genome help to maintain the balance between filovirus infection and the bat’s defense system, which may partially explain why bats act as potential reservoirs. Further research into the functions of nrEVEs could reveal novel antiviral systems and inspire novel antiviral approaches.No potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155282022算数の事象を統合的•発展的に捉えて問題設定する方略一What if Not方略の援用を通して一2938EN変動の激しい時代を見据えて算数科では「数学的な見方・考え方を働かせ、数学的活動を通して、数学的に考える」という方向性が示されている。その実現に向け「事象を数理的に捉え、数学の問題を見いだし、自立的、協働的に解決し、解決過程を振り返る」という問題発見・解決の過程が提言されている。変革の時代では、変化し続ける事象で何が問題かを見つける力が重要であり、算数の授業においても、問題発見力を育むことが不可欠である。ところが問題発見は軽視されがちで、問題設定は、教師主導で教科書通りの日常事象を数理化する問題設定が大半で、子どもが「算数の事象を統合的•発展的に捉えて問題発見する」という授業研究は進んでいない。算数は指導の系統性を重視する教科である。ゼロベースではなく、既習事項を基礎にして算数の事象を統合の観点から発展的に関わり、子ども自らが「問題発見・設定する授業」を探究することが喫緊の課題である。No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231802022認定こども園５歳児学級における藍の栽培と染色による保育実践―領域「環境」に関わる子どもの学びと保育者の捉え―6980ENNorikoBabaFaculty of Education, Okayama UniversityKeiTakahashiThe Faculty of Childhood Education, Kurashiki Sakuyo UniversityYuzoWatanabeMinan Manmaru childcare center10.18926/bgeou/63925本論では，天然素材（植物染料）の藍を園内で子どもが栽培する活動や，藍染めの驚きや感動，面白さを味わいながら制作物を生活に取り入れる保育実践を行うとともに，その教育的な意義や価値を検討した。その結果，子ども自らが藍を育て，育てた藍葉を用いた藍染め活動を行うことは，領域「環境」や，「幼児期の終わりまでに育ってほしい姿」の「自然との関わり・生命尊重」の観点から見て，子どもにいくつもの感動や学びを与え，保育の教材として大きな価値を持つと考えられた。今後も，草木染めの中でも，藍染めにしかない魅力や特性に着目した保育実践の意義について検討し，保育現場に発信していきたい。No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7642022Effects of Exercise Therapy and Nutrition Therapy on Patients with Possible Malnutrition and Sarcopenia in a Recovery Rehabilitation Ward423428ENSatoshiTakahashiDepartment of Rehabilitation Medicine, Saiseikai Imabari Daini HospitalTakuyaKushibeDepartment of Rehabilitation Medicine, Saiseikai Imabari Daini HospitalYoshiteruAkezakiDivision of Physical Therapy, Kochi Professional University of RehabilitationNorioHoriikeDepartment of Internal Medicine, Saiseikai Imabari Daini HospitalOriginal Article10.18926/AMO/63901We compared the effects of an exercise intervention with that of exercise combined with nutrition therapy in patients with possible malnutrition and sarcopenia admitted to a recovery rehabilitation ward, and we examined the differences in the patients’ physical function and activities of daily living (ADLs). There were 16 patients in the Exercise group with exercise therapy and ADL exercises, and 14 patients in the Combined intervention group with exercise therapy, ADL exercises, and nutrition therapy. The survey items were body weight, body mass index, grip strength, lower-leg circumference, gait speed, and ADLs, each of which was measured at the baseline and at 2 weeks, 4 weeks, and at discharge. Significant improvements in grip strength were observed in the Combined intervention group as follows: at 4 weeks>at 2 weeks (p<0.05), and at discharge>baseline and 2 weeks (p<0.05). There were no significant changes in the Exercise group, and an interaction was recognized in both groups. Comprehensive rehabilitation including nutrition therapy is necessary for patients with possible malnutrition and/or sarcopenia, as our results indicate that nutrition therapy in addition to exercise therapy has the effect of promoting improvements of physical function in such patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7642022Postoperative Urinary Retention in Japanese Elderly Males with a Femoral Neck or Trochanteric Fracture409414ENToshihiroHigashikawaDepartment of Geriatric Medicine, Kanazawa Medical University Himi Municipal HospitalKenjiShigemotoDepartment of Orthopedics and Joint Reconstructive Surgery, Juntendo University Nerima HospitalKenichiGoshimaDepartment of Orthopedics and Joint Reconstructive Surgery, Juntendo University Nerima HospitalShintarouIwaiDepartment of Orthopedics and Joint Reconstructive Surgery, Juntendo University Nerima HospitalManabuMoriyamaDepartment of Urology, Kanazawa Medical University Himi Municipal HospitalDaisukeUsudaDepartment of Emergency and Critical Care Medicine, Juntendo University Nerima HospitalMasahiroHangyouToyama Municipal HospitalHiromiInujimaToyama Municipal HospitalKakeruNozakiToyama Municipal HospitalMiyakoYamaguchiToyama Municipal HospitalKimikoUsudaToyama Municipal HospitalTakeshiNakahashiDepartment of Geriatric Medicine, Kanazawa Medical UniversityTadamiMatsumotoDepartment of Orthopedic Medicine, Kanazawa Medical UniversityShigekiTakashimaKanazawa Medical UniversityTsugiyasuKandaKanazawa Medical UniversityTakeshiHoriiDepartment of Orthopedics and Joint Reconstructive Surgery, Juntendo University Nerima HospitalMasashiOkuroDepartment of Geriatric Medicine, Kanazawa Medical UniversityTakeshiSawaguchiDepartment of Orthopedics and Joint Reconstructive Surgery, Juntendo University Nerima HospitalOriginal Article10.18926/AMO/63895We assessed risk factors for postoperative urinary retention (UR) in elderly males with femoral bone fractures: 169 Japanese males (mean age 81.95 ± 1.19 years) who had undergone hip surgery at a municipal hospital (Toyama, Japan). A multiple logistic regression analysis was used to test possible risk factors for UR: age, body mass index, serum albumin, cognitive impairment, activities of daily living (ADL), and history of diabetes mellitus (DM). UR occurred in 24 (14.2%) of the 169 patients. A multivariate logistic regression analysis with age adjustment showed that ADL (odds ratio [OR] 3.88; 95% confidence interval [CI]: 1.2-12.5, p=0.023) was significantly associated with the development of UR, and a history of DM showed marginal significance for UR occurrence (OR 0.36, 95%CI: 0.11-10, p=0.064). These results suggests that ADL is a risk factor for UR development in elderly males who have undergone surgery for femoral neck or trochanter fractures.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7632022The Impact of Medical Students Teaching Basic Life Support to Laypersons265271ENYoshinoriKosakiDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAtsuyoshiIidaDepartment of Emergency Medicine, Japanese Red Cross Okayama HospitalHiromiIhoriyaDepartment of General Medicine, Okayama University HospitalTsuyoshiNojimaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTaiheiYamadaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHirotsuguYamamotoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShunsukeNakamuraDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYasuhiroMandaiDepartment of Emergency Medicine, The JIKEI UniversityAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesOriginal Article10.18926/AMO/63720Basic life support (BLS) courses for laypersons, including cardiopulmonary resuscitation (CPR) training, is known to improve outcomes of out-of-hospital cardiac events. We asked medical students to provide BLS training for laypersons as a part of their emergency medicine education and evaluated the effects of training on the BLS skills of laypersons. We also used a questionnaire to determine whether the medical students who provided the BLS training were themselves more confident and motivated to perform BLS compared to students who did not provide BLS training. The proportions of laypersons who reported confidence in checking for a response, performing chest compressions, and automated external defibrillator (AED) use were significantly increased after the BLS training. The proportions of medical students who reported increased confidence/motivation in terms of understanding BLS, checking for a response, chest compression, use of AED, and willingness to perform BLS were significantly greater among medical students who provided BLS instructions compared to those who did not. BLS instruction by medical students was associated with an improvement in laypersons’ CPR accuracy and confidence in responding to cardiac arrest. The results indicate that medical students could gain understanding, confidence, and motivation in regard to their BLS skills by teaching BLS to laypersons.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7632022Roles of Transmembrane Protein 97 (TMEM97) in Adipose Tissue and Skeletal Muscle235245ENMasafumiTentaDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunEguchiDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/63717The combination of sarcopenia and obesity (sarcopenic obesity) is associated with the development of metabolic syndrome and cardiovascular events. The molecular pathways that develop sarcopenic obesity have studied intensively. Transmembrane protein 97 (TMEM97) is 176 amino acids conserved integral membrane protein with four transmembrane domains that is expressed in several types of cancer. Its physiological significance in adipose tissue and skeletal muscle has been unclear. We studied TMEM97-transgenic mice and mice lacking TMEM97, and our findings indicate that TMEM97 expression is regulated in adipose tissue and skeletal muscle from obesity. TMEM97 represses adipogenesis and promotes myogenesis in vitro. Fat-specific TMEM97 transgenic mice showed systemic insulin resistance. Mice overexpressing TMEM97 in skeletal muscle exhibited systemic insulin resistance. Mice lacking TMEM97 were protected against diet-induced obesity and insulin resistance. These phenotypes are associated with the effects of TMEM97 on inflammation genes in adipose tissue and skeletal muscle. Our findings indicates that there is a link between TMEM97 and chronic inflammation in obesity.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7622022Safety and Effectiveness of Perospirone in Comparison to Risperidone for Treatment of Delirium in Patients with Advanced Cancer: A Multicenter Prospective Observational Study in Real-World Psycho-Oncology Settings195202ENShinichiroInoueDepartment of Neuropsychiatry, Okayama University HospitalIssekiMaedaDepartment of Palliative Care, Senri-Chuo HospitalAsaoOgawaDepartment of Psycho-Oncology Service, National Cancer Center Hospital EastKazuhiroYoshiuchiDepartment of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of TokyoSeishiTeradaOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNorihitoYamadaOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/63414The clinical benefit of perospirone for treatment of delirium in patients with advanced cancer is not sufficiently clear. The objective of this study was to compare the safety and effectiveness of perospirone to those of risperidone for the treatment of delirium in patients with advanced cancer. This is a secondary analysis of a multicenter prospective observational study in nine psycho-oncology consultation services in Japan. The study used the Delirium Rating Scale (DRS) Revised-98 to measure effectiveness and the CTCAE (Common Terminology Criteria for Adverse Events) version 4 to assess safety. Data from 16 patients who received perospirone and 53 patients who received risperidone were analyzed. The mean age was 70 years in the perospirone group and 73 years in the risperidone group. Both groups showed a significant decrease in the total score of DRS-R-98 after three days of treatment (perospirone: 11.7 (7.9-15.4) to 7.0 (3.3-10.7), difference −4.7, effect size=0.72, p=0.003; risperidone: 15.5 (13.6-17.4) to 12.2 (10.1-14.2), difference −3.3, effect size=0.55, p=0.00). The risperidone group showed significant improvements in sleep-wake cycle disturbance, orientation, attention, and visuospatial ability. In the perospirone group, there was a significant improvement of sleep-wake cycle disturbance. The median daily dose of perospirone was 4 mg/day. There were fewer episodes of somnolence as an adverse event in the perospirone group. Low-dose perospirone was thus found to be effective for the treatment of delirium in patients with advanced cancer and may be associated with fewer episodes of over-sedation as an adverse event.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323122022日本語教育副専攻コースにおけるオンライン実習の試み ―日本語教師に求められる資質・能力の養成を目指して―359373ENMiwaSueshigeInstitute for Education and Student Services, Okayama University10.18926/CTED/63319本稿は，日本語教育副専攻コースにおいて，日本語教師に求められる資質・能力を養うことを目的とし行ったオンラインによる教育実習の実践報告である。オンライン実習において，1）実習生がどのような気づきや学びを得たか，2）問題点や改善すべき課題は何か，の2 点について考察するため，実習生の振り返りレポートをKJ 法を用いて分析した。その結果，@授業・教材作りに関する技術，A状況・相手に応じたやり取りの技術，B学習者の視点・背景の理解，C言語教育者としての態度，D精神面のセルフコントロールの5つのカテゴリーに関する気づき・学びならびに実施上の問題が観察されることが分かった。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323122022令和３年度「工業科教育法（応用T，応用U）」の実践報告329341ENSeitaroKobayashiCenter for Teacher Education and Development, Okayama UniversityKyogoAkagiOkayama University Academic Research Institute Education Department (Practice of teaching profession)10.18926/CTED/63317「工業科教育法（応用T，応用U）」は令和３年度に初めて受講生があり，２名の教員で授業を行った。この授業では，学生に教科指導力を身に付けさせるとともに，幅広く工業に関する知識を養うことを目的としている。このため，「何ができるようになるのか」「何を学ぶのか」「どのように学ぶのか」「一人一人の発達をどのように支援するのか」「何が身に付いたのか」「実施するために何が必要か」の６つの観点で，授業をつくり上げる力の育成を目指した。実践報告を通じて成果と課題を明確にし，改善を図ることで来年度以降の授業の充実に繋げたい。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323122022主観的幸福感を高める共感性と自己受容性の関係 −他者とのよりよい関わりとは−257269ENNaoUmemotoGraduate School of Education，Okayama University (Master Degree Course)TazukoAokiGraduate School of Education, Okayama University10.18926/CTED/63312本研究では他者との関わりを円滑にするものとして共感性に着目した。共感性には，自己指向的な共感，他者指向的な共感といった複数の側面がある。先行研究から，この指向性の違いにより主観的幸福感が違ってくることが示されている。本研究では，主観的幸福感を高める共感性に，自己受容性が関わっているのではないかと考えた。そこで，本研究では，共感性，自己受容性，主観的幸福感の関連を高校生と大学生を調査対象に検討した。分析の結果，高校生は，他者理解への意欲，他者への感情移入が主観的幸福感に影響していた。大学生は，他者理解への意欲が主観的幸福感に影響していた。さらに，主観的幸福感を高めるこれらの共感性に，高校生は自己受容性のうち自己理解が影響していた。一方，大学生は主観的幸福感を高める共感性に，自己受容性は影響していなかった。これらの結果には，高校生と大学生の環境の違いや発達差が関わっていることが考えられた。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323122022保育教諭の保育観に関する研究動向と課題―幼稚園教諭・保育所保育士としての保育経験の違いに着目して―243255ENKazuyaHasuiKojo Certified Center for Early childhood Education and Care, Okayama CityAyakoNakahiraKojo Certified Center for Early childhood Education and Care, Okayama CityToshiyukiTakahashiGraduate School of Education, Okayama UniversityMikaKatayamaGraduate School of Education, Okayama University10.18926/CTED/63311『子ども・子育て支援法』改正以降，認定こども園は大幅に増加し，それに伴い様々な保育経験（幼稚園教諭・保育所保育士）をもった保育教諭が同じ園で勤務する状況も増えている。そこで本論では，保育教諭の保育経験の違いに着目し，保育観に関する研究動向と課題について考察した。先行研究を内容ごとに分類して概観すると，幼稚園教諭は教育的要素を，保育所保育士は養護的要素をもつ保育観をそれぞれに重視する傾向が示唆された。しかし，保育経験の違いがどのような保育内容や保育場面において保育観の相違をもたらすかについて十分な検討がされていないことが明らかになった。保育観の共有が保育の質の向上に繋がることから，保育経験による保育教諭の保育観の詳細な相違点を明らかにすることが今後の課題である。No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2045-23221212022Current status of delirium assessment tools in the intensive care unit: a prospective multicenter observational survey2185ENKenzoIshiiDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKosukeKurodaDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChikaTokuraDepartment of Anesthesia, Kagawa Rosai HospitalMasaakiMichidaDepartment of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School General Medical CenterKentaroSugimotoDepartment of Anesthesia, Chikamori HospitalTetsufumiSatoDepartment of Anesthesia and Intensive Care, National Cancer Center HospitalTomokiIshikawaDepartment of Anesthesia, Okayama Red Cross General HospitalShingoHagiokaDepartment of Anesthesia, Tsuyama Chuo HospitalNobukiManabeDepartment of Anesthesia, Saiseikai Imabari HospitalToshiakiKurasakoDepartment of Anesthesiology, Japanese Red Cross Society Himeji HospitalTakashiGotoDepartment of Anesthesia, Hiroshima City Hiroshima Citizens HospitalMasakazuKimuraDepartment of Anesthesia, Okayama City HospitalKazuharuSunamiDepartment of Internal Medicine, Okayama Kyoritsu HospitalKazuyoshiInoueDepartment of Anesthesia, Kagawa Prefectural Central HospitalTakashiTsukijiDepartment of Anesthesia, Takasago Municipal HospitalTakeshiYasukawaDepartment of Anesthesia, Okayama Kyokuto HospitalSatoshiNogamiDepartment of Anesthesia, National Hospital Organization Okayama Medical CenterMitsunoriTsukiokiDepartment of Anesthesia, Onomichi Municipal HospitalDaisukeOkabeDepartment of Anesthesia, Himeji St. Mary’s HospitalMasaakiTaninoDepartment of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School HospitalHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDelirium is a critical challenge in the intensive care unit (ICU) or high care unit (HCU) setting and is associated with poor outcomes. There is not much literature on how many patients in this setting are assessed for delirium and what tools are used. This study investigated the status of delirium assessment tools of patients in the ICU/HCU. We conducted a multicenter prospective observational study among 20 institutions. Data for patients who were admitted to and discharged from the ICU/HCU during a 1-month study period were collected from each institution using a survey sheet. The primary outcome was the usage rate of delirium assessment tools on an institution- and patient-basis. Secondary outcomes were the delirium prevalence assessed by each institution's assessment tool, comparison of delirium prevalence between delirium assessment tools, delirium prevalence at the end of ICH/HCU stay, and the relationship between potential factors related to delirium and the development of delirium. Result showed that 95% of institutions used the Intensive Care Delirium Screening Checklist (ICDSC) or the Confusion Assessment Method for the ICU (CAM-ICU) to assess delirium in their ICU/HCU, and the remaining one used another assessment scale. The usage rate (at least once during the ICU/HCU stay) of the ICDSC and the CAM-ICU among individual patients were 64.5% and 25.1%, and only 8.2% of enrolled patients were not assessed by any delirium assessment tool. The prevalence of delirium during ICU/HCU stay was 17.9%, and the prevalence of delirium at the end of the ICU/HCU stay was 5.9%. In conclusion, all institutions used delirium assessment tools in the ICU/HCU, and most patients received delirium assessment. The prevalence of delirium was 17.9%, and two-thirds of patients had recovered at discharge from ICU/HCU.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7612022In Vivo Microwave Ablation of Normal Swine Lung at High-power, Short-duration Settings5762ENToshihiroIguchiDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaoHirakiDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeMatsuiDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomohiroTojiDepartment of Pathology, Okayama University HospitalMayuUkaDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiTomitaDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyukiKomakiDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNoriyukiUmakoshiDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalSusumuKanazawaDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/63212To evaluate the volume and heat-sink effects of microwave ablation (MWA) in the ablation zone of the normal swine lung. MWA at 100 W was performed for 1, 2, and 3 min in 7, 5, and 5 lung zones, respectively. We assessed the histopathology in the ablation zones and other outcome measures: namely, length of the longest long and short axes, sphericity, ellipsoid area, and ellipsoid volume. The mean long- and short-axis diameters were 22.0 and 14.1 mm in the 1-min ablation zone, 27.6 and 20.2 mm in the 2-min ablation zone; and 29.2 and 21.2 mm in the 3-min ablation zone, respectively. All measures, except sphericity, were significantly less with 1-min ablation than with either 2- or 3-min ablation. There were no significant differences between the 2- and 3-min ablation zones, but all measures except sphericity were larger with 3-min ablation. Although there were no blood vessels that resulted in a heat-sink effect within the ablation zones, the presence of bronchi nearby in 5 lung ablation zones resulted in reduced ablation size. In high-power, short-duration MWA, the lung ablation volume was affected by ablation time. Some ablations showed that a heat-sink effect by a neighboring bronchus might occur.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7612022Aging-related Characteristics of Subclinical Hypothyroidism Detected in General Practice715ENMasaoTakamiDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiroYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihisaHanayamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKouHasegawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikakoObikaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriFurukawaDepartment of Laboratory Medicine, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/63203Subclinical hypothyroidism (SCH) is diagnosed when serum thyrotropin (TSH) is elevated despite a normal thyroxine level and is known to increase the risk of metabolic disorders. This study was conducted to identify potential laboratory markers suspicious for latent SCH. We retrospectively reviewed 958 outpatients in whom thyroid functions had been examined. Eighty-five (9.1%) of the 939 analyzed subjects had SCH (73% females). In the SCH group, median serum TSH and FT4 levels were 5.04 μU/ml and 1.19 ng/dl, respectively, and auto-thyroid antibodies were detected in 53.8% of patients. SCH group patients were significantly older than patients in the euthyroid group, while there was no intergroup difference in BMI. However, 56.5% of the SCH patients were asymptomatic. In the SCH group, serum aspartate aminotransferase and low-density lipoprotein cholesterol (LDL-C) levels were significantly higher, and the estimated glomerular filtration rate (eGFR) was significantly lower than in the euthyroid group. Among patients less than 65 years of age, SCH patients tended to have lower eGFR and higher LDL-C than euthyroid patients. Age-dependent reductions of red blood cells and serum albumin were more prominent in the SCH than the euthyroid group. Biochemical changes with aging are useful as potential clues for suspecting latent SCH.No potential conflict of interest relevant to this article was reported.Frontiers MediaActa Medica Okayama1664-302X122021Comprehensive Comparative Genomics and Phenotyping of Methylobacterium Species740610ENOlaAlessaInstitute of Plant Science and Resources, Okayama UniversityYoshitoshiOguraDivision of Microbiology, Department of Infectious Medicine, Kurume University School of MedicineYoshikoFujitaniInstitute of Plant Science and Resources, Okayama UniversityHidetoTakamiAtmosphere and Ocean Research Institute, The University of TokyoTetsuyaHayashiDepartment of Bacteriology, Graduate School of Medical Sciences, Kyushu UniversityNurettinSahinEgitim Fakultesi, Mugla Sitki Kocman UniversityAkioTaniInstitute of Plant Science and Resources, Okayama UniversityThe pink-pigmented facultative methylotrophs (PPFMs), a major bacterial group found in the plant phyllosphere, comprise two genera: Methylobacterium and Methylorubrum. They have been separated into three major clades: A, B (Methylorubrum), and C. Within these genera, however, some species lack either pigmentation or methylotrophy, which raises the question of what actually defines the PPFMs. The present study employed a comprehensive comparative genomics approach to reveal the phylogenetic relationship among the PPFMs and to explain the genotypic differences that confer their different phenotypes. We newly sequenced the genomes of 29 relevant-type strains to complete a dataset for almost all validly published species in the genera. Through comparative analysis, we revealed that methylotrophy, nitrate utilization, and anoxygenic photosynthesis are hallmarks differentiating the PPFMs from the other Methylobacteriaceae. The Methylobacterium species in clade A, including the type species Methylobacterium organophilum, were phylogenetically classified into six subclades, each possessing relatively high genomic homology and shared phenotypic characteristics. One of these subclades is phylogenetically close to Methylorubrum species; this finding led us to reunite the two genera into a single genus Methylobacterium. Clade C, meanwhile, is composed of phylogenetically distinct species that share relatively higher percent G+C content and larger genome sizes, including larger numbers of secondary metabolite clusters. Most species of clade C and some of clade A have the glutathione-dependent pathway for formaldehyde oxidation in addition to the H4MPT pathway. Some species cannot utilize methanol due to their lack of MxaF-type methanol dehydrogenase (MDH), but most harbor an XoxF-type MDH that enables growth on methanol in the presence of lanthanum. The genomes of PPFMs encode between two and seven (average 3.7) genes for pyrroloquinoline quinone-dependent alcohol dehydrogenases, and their phylogeny is distinctly correlated with their genomic phylogeny. All PPFMs were capable of synthesizing auxin and did not induce any immune response in rice cells. Other phenotypes including sugar utilization, antibiotic resistance, and antifungal activity correlated with their phylogenetic relationship. This study provides the first inclusive genotypic insight into the phylogeny and phenotypes of PPFMs.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7562021Testosterone Recovery after Neoadjuvant Gonadotropin-Releasing Hormone Antagonist versus Agonist on Permanent Iodine-125 Seed Brachytherapy in Prostate Cancer Patients: A Propensity Score Analysis705711ENTakehiroIwataDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMaruyamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTatsushiKawadaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaSadahiraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKatayamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsushiTakamotoDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoSakoDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiroWadaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiEdamuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuyukiKobayashiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasamiWatanabeDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToyohikoWatanabeDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasutomoNasuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/62810Optimal 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.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7552021The Effect of Peer Instruction Lectures on Learning Attitudes in Epidemiology Education601609ENToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalOriginal Article10.18926/AMO/62773Research 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.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7552021Factors for Acute Kidney Injury Following Total Arch Replacement and Association with Temperature Management During Cardiopulmonary Bypass: A Single-center Retrospective Observational Study585593ENHirokiOmiyaDepartment of Anesthesiology and Critical Care Medicine, Hiroshima Citizens HospitalMakotoTakatoriDepartment of Anesthesiology and Critical Care Medicine, Hiroshima Citizens HospitalKeijiYunokiDepartment of Cardiovascular Surgery, Hiroshima Citizens HospitalHiroshiMorimatsuDepartment of Anesthesiology and Resuscitation, Okayama University HospitalOriginal Article10.18926/AMO/62771Many 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.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7542021Differences in Attitudes and Practices of Cancer Pain Management between Medical Oncologists and Palliative Care Physicians431437ENToshikiKunitomiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunichirouNasuDepartment of Internal Medicine, Okayama Saiseikai General HospitalDaisukeMinamiPalliative Care Team, Okayama University HospitalTakayukiIwamotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiNishiePalliative Care Team, Okayama University HospitalShinyaSaitoPalliative Care Team, Okayama University HospitalToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunjiMatsuokaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/62394This study aimed to evaluate whether there are differences in the attitudes and practices of cancer pain manage-ment between medical oncologists and palliative care physicians. An online nationwide survey was used to collect responses from board-certified medical oncologists and palliative care physicians in Japan. The survey questionnaire comprised 30 questions. The differences in responses between medical oncologists and palliative care physicians were examined. Out of the 1,227 questionnaires sent, 522 (42.5%) were returned. After apply-ing the exclusion criteria, 445 questionnaires (medical oncologists: n = 283; palliative care physicians: n = 162) were retained for analysis. Among the questions about potential barriers to optimal cancer pain man-agement, both medical oncologists and palliative care physicians considered the reluctance of patients to take opioids due to fear of adverse effects as the greatest barrier. Significantly different ratings between medical oncologists and palliative care physicians were observed on 5 of the 8 questions in this area. Significantly differ-ent ratings were observed for all questions concerning pain specialists and their knowledge. For effective cancer pain management, it is important to account for differences in attitudes and practice between medical oncolo-gists and palliative care physicians.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0217-45613942021Foreign investment or divestment as a near-term solution to performance shortfalls? The moderating role of vicarious learning14811509ENKent Ngan-CheungHuiSchool of Management, Xiamen UniversityYuanyuanGong Discovery Program for Global Learners, Okayama UniversityQiCuiDepartment of Organization and Human Resources, Renmin UniversityNaipengJiangTourism Department, Fudan UniversityMost studies on problemistic search do not pay sufficient attention to how below-aspiration organizations decide what types of strategic actions to use to cope with performance shortfalls. In this study, we examine the preferences of multinational corporations (MNCs) for selecting foreign investment or divestment as a near-term solution to performance shortfalls. We first argue that foreign divestment is generally a more preferred performance solution. Drawing on the literature on vicarious learning, we further argue that MNCs are more likely to engage in foreign investment or foreign divestment to combat large performance shortfalls if peers recently and actively undertook the same type of strategic action. Moreover, they are less likely to undertake the other type of strategic action simultaneously because they adopt the satisficing principle and time constraints deter them from implementing multiple types of strategic action substantially. The analysis of the data about Japanese manufacturing MNCs reveals that vicarious learning influences MNCs’ selection preferences in certain conditions, thereby extending the literature on problemistic search.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama2073-89941352021Effects of Asymmetry between Design Models and User Models on Subjective Comprehension of User Interface795ENToshihisaDoiDepartment of Intelligent Mechanical Systems, Okayama UniversityThis study attempted to discuss the design principles for enhancing usability in terms of asymmetry of mental models between users and designers. If the user model is asymmetrical to the design model, i.e., the degree of agreement between models is low and the user's mental model is not compatible with the actual system, the user cannot operate the system properly, which may cause errors. The aim of this study was to investigate the characteristics of users who have asymmetrical mental models and identify what such users did not understand. Twenty-four subjects participated in an experiment that involved a digital camera operation task and mental model tests that measure the level of the agreement of the mental model construction in terms of functional and structural models. Initially, the participants were grouped based on mental model test scores: symmetrical mental model group (n = 17) and asymmetrical mental model group (n = 7). Then, the groups were compared in terms of performance and subjective comprehension. The comparison indicated that the symmetrical mental model group performed more quickly and accurately than the asymmetrical group. The results also confirmed that the asymmetrical mental model group had a lower level of comprehension in terms of understanding the device status, detecting and responding to device status changes, and understanding the hierarchical structure of the screen.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama2227-9032952021Prevalence of Psychological Distress and Its Risk Factors in Patients with Primary Bone and Soft Tissue Tumors566ENMasatoIseDepartment of Orthopaedic Surgery, Okayama University HospitalEijiNakataDepartment of Orthopaedic Surgery, Okayama University HospitalYoshimiKatayamaDepartment of Rehabilitation Medicine, Okayama University HospitalMasanoriHamadaDepartment of Rehabilitation Medicine, Okayama University HospitalToshiyukiKunisadaDepartment of Orthopaedic Surgery, Okayama University HospitalTomohiroFujiwaraDepartment of Orthopaedic Surgery, Okayama University HospitalRyuichiNakaharaDepartment of Orthopaedic Surgery, Okayama University HospitalShoutaTakihiraDepartment of Orthopaedic Surgery, Okayama University HospitalKoheiSatoDepartment of Orthopaedic Surgery, Okayama University HospitalYoshiteruAkezakiDivision of Physical Therapy, Kochi Professional University of RehabilitationMasuoSendaDepartment of Rehabilitation Medicine, Okayama University HospitalToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University HospitalPsychological distress is common in patients with soft tissue and bone tumors. We first investigated its frequency and the associated risk factors in patients with pre-operative bone and soft tissue tumors. Participants included 298 patients with bone and soft tissue tumors who underwent surgery in our institution between 2015 and 2020. Psychological distress was evaluated by the Distress and Impact Thermometer (DIT) that consists of two types of questions (questions about the severity of the patient's distress (DIT-D) and its impact (DIT-I)). We used a cut-off point of 4 on the DIT-D and 3 on the DIT-I for screening patients with psychological distress. We therefore investigated: (1) the prevalence of psychological distress as assessed with DIT or distress thermometer (DT), which can be decided by DIT-D >= 4, (2) what are the risk factors for the prevalence of psychological distress, and (3) what is the number of patients who consulted a psychiatrist for psychological distress in patients with pre-operative bone and soft tissue tumors. With DIT and DT, we identified 64 patients (21%) and 95 patients (32%), respectively, with psychological distress. Multivariate logistic regression revealed that older age, sex (female), malignancy (malignant or intermediate tumor), a lower Barthel Index, and higher numeric rating scale were risk factors for psychological distress. Two patients (3%) consulted a psychiatrist after surgery. In conclusion, careful attention to psychological distress is needed, especially for female patients, older patients, and those with malignant soft or bone tissue tumors who have more than moderate pain.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama0951-08937512020Teacher and student-created videos in English language teaching97102ENNeilCowieDepartment of Foreign Languages, Okayama UniversityKeikoSakuiKobe Shoin Women’s UniversityIn this series, we explore technology-related themes and topics. The series aims to discuss and demystify what may be new areas for some readers and to consider their relevance for English language teachers.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7522021Histological Analysis of Repaired Tissue after Pullout Repair of a Medial Meniscus Posterior Root Tear225230ENHaoweiXueDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiFurumatsuDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuki OkazakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaakiHiranakaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeisuke KintakaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesXimingZhangDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkiYoshidaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/61905A 65-year-old man presented with a left medial meniscus (MM) posterior root tear (PRT). Unicompartmental knee arthroplasty was performed 12 months after transtibial pullout repair of the MMPRT. Repaired MM posterior root tissue was subjected to histological analysis. Immunostaining and picrosirius red staining showed sufficient deposition of type I collagen, and hematoxylin-eosin staining using a polarized microscope showed well-aligned fiber orientation in the repaired tissue. The repaired posterior root (post-transtibial pullout repair) showed mature and well-aligned ligament-like tissue. Preserving the MM posterior root remnant to mimic the original posterior root tissue might be useful when performing pullout repair.No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322712021看護場⾯における確認不⾜を引き起こす要因の認識に関する検討2945ENWanxinZuoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityYoshimiHyodoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTomokoTanakaGraduate School of Humanities and Social Sciences, Okayama UniversityAkioGofukuGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University10.18926/interdisciplinary/61888In the work process of nurses with high risk, it is very urgent to take countermeasures against the “lack of confirmation” of the main factors. Therefore, the purpose of this study is to clarify the details of the factors leading to the lack of confirmation, grasp the number of near misses, and to explore what kind of factors the individual characteristics of the nurse who acts as a stopper. We recruited 500 nurses on the Web and asked about the frequency of near misses due to lack of confirmation, the awareness of the causes of lack of confirmation, self-evaluation of stoppers, and the reasons why near misses did not lead to accidents. As a result, three factors were extracted regarding the recognition of the factors of lack of confirmation: "lack of consciousness", "inability to concentrate", and "lack of knowledge / experience". Three factors were extracted for self-evaluation of stopper characteristics: "awareness," "verification," and "cautiousness". In order to reduce the lack of confirmation, it is necessary to secure and allocate appropriate personnel and create an environment where treatment can be concentrated. Nurses should also raise knowledge and the awareness of the importance of confirmation. In addition, it is necessary to improve the clinical judgment of new nurses in order to prevent near misses. And it is thought that new nurses will
become more confident by accumulating experience and affirming their abilities from their superiors, seniors and colleagues.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7522021Evaluation of the Imaging Process for a Novel Subtraction Method Using Apparent Diffusion Coefficient Values139145ENKentaroHamadaRadiological Technology, Graduate School of Health Sciences, Okayama UniversityMasahiroKurodaRadiological Technology, Graduate School of Health Sciences, Okayama UniversityYuuki YoshimuraRadiological Technology, Graduate School of Health Sciences, Okayama UniversityAbdullahKhasawnehDepartment of Oral and Maxillofacial Radiology, Okayama University HospitalMajdBarhamDepartment of Oral and Maxillofacial Radiology, Okayama University HospitalNouhaTekikiDepartment of Oral and Maxillofacial Radiology, Okayama University HospitalIrfanSugiantoDepartment of Oral and Maxillofacial Radiology, Okayama University HospitalBabatunde O.BamgboseDepartment of Oral and Maxillofacial Radiology, Okayama University HospitalKoheiKonishiRadiological Technology, Graduate School of Health Sciences, Okayama UniversityKoheiSugimotoRadiological Technology, Graduate School of Health Sciences, Okayama UniversityHinataIshizakaRadiological Technology, Graduate School of Health Sciences, Okayama UniversityAkiraKurozumiCentral Division of Radiology, Okayama University HospitalToshi MatsushitaCentral Division of Radiology, Okayama University HospitalSeiichiroOhnoCentral Division of Radiology, Okayama University HospitalSusumuKanazawaDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunichiAsaumiDepartment of Oral and Maxillofacial Radiology, Okayama University HospitalOriginal Article10.18926/AMO/61880Diffusion-weighted imaging may be used to obtain the apparent diffusion coefficient (ADC), which aids the diagnosis of cerebral infarction and tumors. An ADC reflects elements of free diffusion. Diffusion kurtosis imaging (DKI) has attracted attention as a restricted diffusion imaging technique. The ADC subtraction method (ASM) was developed to visualize restricted diffusion with high resolution by using two ADC maps taken with different diffusion times. We conducted the present study to provide a bridge between the reported basic ASM research and clinical research. We developed new imaging software for clinical use and evaluated its performance herein. This software performs the imaging process automatically and continuously at the pixel level, using ImageJ software. The new software uses a macro or a plugin which is compatible with various operating systems via a Java Virtual Machine. We tested the new imaging software’s performance by using a Jurkat cell bio-phantom, and the statistical evaluation of the performance clarified that the ASM values of 99.98% of the pixels in the bio-phantom and physiological saline were calculated accurately (p<0.001). The new software may serve as a useful tool for future clinical applications and restricted diffusion imaging research.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323112021保育所４歳児学級における子どもの人間関係形成能力を育む共同造形制作による双六遊び179193ENMinoriYAMAGUCHIMinan Manmaru childcare centerKeiTAKAHASHIhe Major of Child Education, The Department of Music, Sakuyo Junior College of MusicNorikoBABAThe Department of Childhood Education, The Faculty of Childhood Education, Kurashiki Sakuyo UniversityYuzoWATANABEMinan Manmaru childcare centerToshiyukiTAKAHASHIGraduate School of Education，Okayama University10.18926/CTED/61573人間関係形成能力を育むための活動の１つとして，共同造形制作が考えられる。共同造形制作は，１人では作ることができない大きな作品で，着想を多く必要とする「寄せがき方式」の制作遊びを設定して行うことが望ましい。そこで，具体的な保育実践案として双六遊びを行い，人間関係形成能力育成における有効性の検証と，保育者に求められる指導・援助方法の考察を行った。双六の制作は，友達の発言や行動に関心を持ちやすい環境で行われ，話し合いによって色や形を工夫することができた。また，双六遊びの偶然性やルール作りの必要性から，発達過程に適合した楽しい遊びを通して友達と深く関われる活動であったと言える。保育者の援助においては，子どもが人間関係を形成する上で，イメージの共有を促す声掛けが必要であると共に，保育者が介入しない見守りも重要であった。 No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323112021小学校プログラミング教育の光と影―実践的な検討課題の導出―5973ENYoshitakaNISHIKAWAYakage Municipal Yakage Elementary School/ Graduate School of Education(Professional Degree Course), Okayama UniversityRyoMISAWAGraduate School of Education, Okayama UniversityGraduate School of Education, Okayama University10.18926/CTED/615652020 年度から全面実施された新学習指導要領において，小学校プログラミング教育が必修化された。しかしプログラミング教育が児童のどのような資質・能力の向上に資するのか，授業を適切に設計・実施するために考慮すべきことは何か，といった点は必ずしも明確ではない。そこで本研究では，既往知見に基づき，小学校プログラミング教育の光と影，すなわち期待される効果と実施に伴う懸念や不安を整理した。それらを踏まえ，今後の小学校プログラミング教育を充実させていくための実践的な検討課題として，授業設計，評価規準・評価方法の立案，ICT 環境整備，教員への働きかけを導出し，議論した。 No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1472-69202112021What impact does postgraduate clinical training have on empathy among Japanese trainee dentists?53ENToshikoYoshidaCenter for Education in Medicine and Health Sciences (Dental Education), Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityShoWatanabeComprehensive Dental Clinic, Okayama University HospitalTakayukiKonoComprehensive Dental Clinic, Okayama University HospitalHiroakiTaketaComprehensive Dental Clinic, Okayama University HospitalNorikoShiotsuComprehensive Dental Clinic, Okayama University HospitalHajimeShiraiComprehensive Dental Clinic, Okayama University HospitalYukieNakaiDepartment of Dental Hygiene, University of Shizuoka, Junior CollegeYasuhiroToriiComprehensive Dental Clinic, Okayama University HospitalBackground</br>
Enhancing empathy in healthcare education is a critical component in the development of a relationship between healthcare professionals and patients that would ensure better patient care; improved patient satisfaction, adherence to treatment, patients’ medication self-efficacy, improved treatment outcomes, and reduced patient anxiety. Unfortunately, however, the decline of empathy among students has been frequently reported. It is especially common when the curriculum transitions to a clinical setting. However, some studies have questioned the significance and frequency of this decline. Thus, the purpose of this study was to determine the impact of postgraduate clinical training on dental trainees’ empathy from cognitive, behavioral, and patients’ perspective.</br>
Methods</br>
This study included 64 trainee dentists at Okayama University Hospital and 13 simulated patients (SPs). The trainee dentists carried out initial medical interviews with SPs twice, at the beginning and the end of their clinical training. The trainees completed the Japanese version of the Jefferson Scale of Empathy for health professionals just before each medical interview. The SPs evaluated the trainees’ communication using an assessment questionnaire immediately after the medical interviews. The videotaped dialogue from the medical interviews was analyzed using the Roter Interaction Analysis System.</br>
Results</br>
No significant difference was found in the self-reported empathy score of trainees at the beginning and the end of the clinical training (107.73 [range, 85–134] vs. 108.34 [range, 69–138]; p = 0.643). Considering the results according to gender, male scored 104.06 (range, 88–118) vs. 101.06 (range, 71–122; p = 0.283) and female 109.17 (range, 85–134) vs. 111.20 (range, 69–138; p = 0.170). Similarly, there was no difference in the SPs’ evaluation of trainees’ communication (10.73 vs. 10.38, p = 0.434). Communication behavior in the emotional responsiveness category for trainees in the beginning was significantly higher than that at the end (2.47 vs. 1.14, p = 0.000).</br>
Conclusions</br>
Overall, a one-year postgraduate dental training program neither reduced nor increased trainee dentists’ empathy levels. Providing regular education support in this area may help trainees foster their empathy.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7512021The Optimal Prepregnancy Body Mass Index for Lactation in Japanese Women with Neonatal Separation as Analyzed by a Differential Equation6369ENKatsuhikoTadaDepartment of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical CenterYasunariMiyagiMiyake Ofuku ClinicKazueNakamuraDepartment of Neonatology, National Hospital Organization, Okayama Medical CenterMoeYorozuDepartment of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical CenterEmiFukushimaDepartment of Nursing, National Hospital Organization, Okayama Medical CenterKazumasaKumazawaDepartment of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical CenterMakotoNakamuraDepartment of Neonatology, National Hospital Organization, Okayama Medical CenterMisaoKageyamaDepartment of Neonatology, National Hospital Organization, Okayama Medical CenterOriginal Article10.18926/ATM/61436We used a differential equation to identify the biological relationship between the maternal prepregnancy body mass index (BMI) and lactation on postpartum day 4 in Japanese women with neonatal separation. This retro-spective observational study included 252 mothers (135 primiparas, 117 multiparas) whose singleton neonates were admitted to a neonatal ICU. We formulated hypotheses based on breast anatomy to analyze the relation-ship between the expressed milk obtained on postpartum day 4 and the maternal prepregnancy BMI with the following differential equation: y’(x) = k y(x)/x, where k is the constant, x is the prepregnancy BMI, and y is the expressed milk volume. The formula was then obtained as y(x) = axk, where a is the constant. The Akaike information criterion (AIC) was used to estimate the regression equation with the maximum likelihood for primiparas and multiparas. The best criteria for BMI determined by the AIC were 20.89 kg/m2 in primiparas and 20.19 kg/m2 in multiparas. These were the optimal BMI values for lactation, coinciding with the median prepregnancy BMI in the study population (20.78 kg/m2 in primiparas and 20.06 kg/m2 in multiparas). The formula based on biomathematics might help establish the biological relationship between prepregnancy BMI and breastmilk volume.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7512021Treatment Outcomes of Pulmonary Metastases from Head and Neck Squamous Cell Carcinoma3137ENSatoruMiyamaruDepartment of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kumamoto UniversityDaizoMurakamiDepartment of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kumamoto UniversityKoheiNishimotoDepartment of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kumamoto UniversityHarukiSaitoDepartment of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kumamoto UniversityYusukeMiyamotoDepartment of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kumamoto UniversityKaorukoHirotaDepartment of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kumamoto UniversityMomokoIseDepartment of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kumamoto UniversityYorihisaOritaDepartment of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kumamoto UniversityOriginal Article10.18926/AMO/61431Although the lung is the most common site of distant metastases from head and neck squamous cell carcinoma (HNSCC), the number of reports about the effects of pulmonary metastasectomy for the treatment of lung metastasis from HNSCC is limited. Metachronous pulmonary metastases were detected in 45 HNSCC patients at Kumamoto University Hospital from 1998 to 2018. Twenty-two patients underwent an operative resection (Ope group) and 23 underwent chemotherapy (Chemo group). The 3-year overall survival (OS) rate and median OS were evaluated. The effects of adjuvant chemotherapy after pulmonary metastasectomy and of new drugs (cetuximab and nivolumab), in the chemo group were also assessed. The 3-year OS rates and median OS were: Ope, 66.1% and 31.5 months; Chemo, 39.7% and 18 months, respectively. In the Ope group, addi-tional recurrences were significantly fewer in the patients who underwent adjuvant chemotherapy post-surgery versus the patients who underwent surgery alone (p = 0.013). In the Chemo group, the 3-year OS rate of the patients who received new drugs was significantly better than that of the patients who did not (p = 0.021). Adjuvant chemotherapy after pulmonary metastasectomy may be a preferable treatment option for preventing recurrences. Cetuximab and nivolumab have a potential to improve OS.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama2227-9717912020Cancer Stem Cell Microenvironment Models with Biomaterial Scaffolds In Vitro45ENGhmkinHassanGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversitySaid M.AfifyGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityShiroKitanoTechnical Research Institute, Toppan Printing Co., Ltd.AkimasaSenoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityHirokoIshiiGSP Enterprise, Inc.YuchengShangDepartment of Applied Chemistry, Graduate School of Engineering, Osaka UniversityMichiyaMatsusakiDepartment of Applied Chemistry, Graduate School of Engineering, Osaka UniversityMasaharuSenoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityDefined by its potential for self-renewal, differentiation and tumorigenicity, cancer stem cells (CSCs) are considered responsible for drug resistance and relapse. To understand the behavior of CSC, the effects of the microenvironment in each tissue are a matter of great concerns for scientists in cancer biology. However, there are many complicated obstacles in the mimicking the microenvironment of CSCs even with current advanced technology. In this context, novel biomaterials have widely been assessed as in vitro platforms for their ability to mimic cancer microenvironment. These efforts should be successful to identify and characterize various CSCs specific in each type of cancer. Therefore, extracellular matrix scaffolds made of biomaterial will modulate the interactions and facilitate the investigation of CSC associated with biological phenomena simplifying the complexity of the microenvironment. In this review, we summarize latest advances in biomaterial scaffolds, which are exploited to mimic CSC microenvironment, and their chemical and biological requirements with discussion. The discussion includes the possible effects on both cells in tumors and microenvironment to propose what the critical factors are in controlling the CSC microenvironment focusing the future investigation. Our insights on their availability in drug screening will also follow the discussion.No potential conflict of interest relevant to this article was reported.American Society for Biochemistry and Molecular BiologyActa Medica Okayama0021-9258295142020In vivo crystals reveal critical features of the interaction between cystic fibrosis transmembrane conductance regulator (CFTR) and the PDZ2 domain of Na+/H+ exchange cofactor NHERF144644476ENEleanor R.MartinSchool of Biological Sciences, Faculty of Biology Medicine and Health, Michael Smith Building, The University of ManchesterAlessandroBarbieriSchool of Biological Sciences, Faculty of Biology Medicine and Health, Michael Smith Building, The University of ManchesterRobert C.FordSchool of Biological Sciences, Faculty of Biology Medicine and Health, Michael Smith Building, The University of ManchesterRobert C.RobinsonResearch Institute for Interdisciplinary Science, Okayama UniversityCrystallization of recombinant proteins has been fundamental to our understanding of protein function, dysfunction, and molecular recognition. However, this information has often been gleaned under extremely nonphysiological protein, salt, and H+ concentrations. Here, we describe the development of a robust Inka1-Box (iBox)–PAK4cat system that spontaneously crystallizes in several mammalian cell types. The semi-quantitative assay described here allows the measurement of in vivo protein-protein interactions using a novel GFP-linked reporter system that produces fluorescent readouts from protein crystals. We combined this assay with in vitro X-ray crystallography and molecular dynamics studies to characterize the molecular determinants of the interaction between the PDZ2 domain of Na+/H+ exchange regulatory cofactor NHE-RF1 (NHERF1) and cystic fibrosis transmembrane conductance regulator (CFTR), a protein complex pertinent to the genetic disease cystic fibrosis. These experiments revealed the crystal structure of the extended PDZ domain of NHERF1 and indicated, contrary to what has been previously reported, that residue selection at positions −1 and −3 of the PDZ-binding motif influences the affinity and specificity of the NHERF1 PDZ2-CFTR interaction. Our results suggest that this system could be utilized to screen additional protein-protein interactions, provided they can be accommodated within the spacious iBox-PAK4cat lattice.No potential conflict of interest relevant to this article was reported.日本内科学会Acta Medica Okayama0918-29185922020Managing Lung Cancer with Comorbid Interstitial Pneumonia163167ENEikiIchiharaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalNobuakiMiyaharaDepartment of Medical Technology, Okayama University Graduate School of Health SciencesYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKatsuyukiKiuraDepartment of Allergy and Respiratory Medicine, Okayama University HospitalSystemic therapy for advanced non-small cell lung cancer (NSCLC) has dramatically changed in the latest 15 years. Molecular-targeted therapy has brought about an era of precision medicine, and immune checkpoint inhibitors have brought hope for a cure for advanced NSCLC. In the wake of this remarkable advancement, lung cancer with comorbid interstitial pneumonia (IP) has been completely left behind, as most clinical trials exclude patients with comorbid IP. IP, especially idiopathic pulmonary fibrosis (IPF), is often accompanied by lung cancer, and acute exacerbation can develop during various cancer therapies, including surgery, radiotherapy and pharmacotherapy. In this review, we focus on the clinical questions concerning pharmacotherapy in cases of advanced lung cancer with comorbid IP and discuss what we can do with the currently available data.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7462020Potential of Artificial Intelligence for Estimating Japanese Fetal Weights483493ENYasunariMiyagiMedical Data LaboTakahitoMiyakeDepartment of Obstetrics and Gynecology, Miyake ClinicOriginal Article10.18926/AMO/61207We developed an artificial intelligence (AI) method for estimating fetal weights of Japanese fetuses based on the gestational weeks and the bi-parietal diameter, abdominal circumference, and femur length. The AI comprised of neural network architecture was trained by deep learning with a dataset that consists of ± 2 standard devia-tion (SD), ± 1.5SD, and ± 0SD categories of the approved standard values of ultrasonic measurements of the fetal weights of Japanese fetuses (Japan Society of Ultrasonics in Medicine [JSUM] data). We investigated the residuals and compared 2 other regression formulae for estimating the fetal weights of Japanese fetuses by t-test and Bland-Altman analyses, respectively. The residuals of the AI for the test dataset that was 12.5% of the JSUM data were 6.4 ± 2.6, −3.8 ± 8.6, and −0.32 ± 6.3 (g) at −2SD, +2SD, and all categories, respectively. The residu-als of another AI method created with all of the JSUM data, of which 20% were randomized validation data, were −1.5 ± 9.4, −2.5 ± 7.3, and −1.1 ± 6.7 (g) for −2SD, +2SD, and all categories, respectively. The residuals of this AI were not different from zero, whereas those of the published formulae differed from zero. Though vali-dation is required, the AI demonstrated potential for generating fetal weights accurately, especially for extreme fetal weights.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7462020Prevention of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis by Endoscopic Pancreatic Stenting after Insertion of Self-Expandable Metal Stent for Malignant Distal Biliary Stricture475481ENRyoHaradaDepartment of Gastroenterology and Hepatology, Japanese Red Cross Okayama HospitalRyosukeSatoDepartment of Gastroenterology and Hepatology, Japanese Red Cross Okayama HospitalTomoakiTsutsuiDepartment of Gastroenterology and Hepatology, Japanese Red Cross Okayama HospitalNaoHattoriDepartment of Gastroenterology and Hepatology, Japanese Red Cross Okayama HospitalMasafumiInoueDepartment of Gastroenterology and Hepatology, Japanese Red Cross Okayama HospitalHaruhikoKobashiDepartment of Gastroenterology and Hepatology, Japanese Red Cross Okayama HospitalOriginal Article10.18926/AMO/61206The insertion of a self-expandable metal stent (SEMS) for nonpancreatic cancer is a factor predicting the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). We evaluated the efficacy of endo-scopic pancreatic stenting (EPS) to prevent PEP after SEMS insertion in patients with malignant distal biliary stricture and without main pancreatic duct (MPD) obstruction. We performed a single-center, retrospective, historically controlled investigation to assess the outcomes of 33 consecutive patients who underwent SEMS insertion. From March 2013 to June 2015, 13 patients did not undergo EPS (Non-EPS group). The other 20 patients underwent EPS (EPS group) between July 2015 and August 2018. The background data demonstrated no significant differences. Except for one patient in the Non-EPS group, all patients underwent biliary sphinc-terotomy. The EPS group’s PEP incidence was significantly lower (n = 1, 5%) than that of the Non-EPS group (n = 4, 31%) (p = 0.04). The median serum amylase and lipase levels after the procedure were significantly lower in the EPS group than in the Non-EPS group (amylase: 104 vs. 262 U/L; p < 0.01, lipase: 102 vs. 666 U/L; p = 0.01). The use of EPS decreased the incidence of PEP after SEMS insertion in individuals with malignant distal biliary stricture and without MPD obstruction.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama0168-17022442018A neo-virus lifestyle exhibited by a (+)ssRNA virus hosted in an unrelated dsRNA virus: Taxonomic and evolutionary considerations7583ENSakaeHisanoInstitute of Plant Science and Resources (IPSR), Okayama UniversityRuiZhangInstitute of Plant Science and Resources (IPSR), Okayama UniversityMd. IqbalFarukInstitute of Plant Science and Resources (IPSR), Okayama UniversityHidekiKondoInstitute of Plant Science and Resources (IPSR), Okayama UniversityNobuhiroSuzukiInstitute of Plant Science and Resources (IPSR), Okayama UniversityRecent studies illustrate that fungi as virus hosts provides a unique platform for hunting viruses and exploring virus/virus and virus/host interactions. Such studies have revealed a number of as-yet-unreported viruses and virus/virus interactions. Among them is a unique intimate relationship between a (+)ssRNA virus, yado-kari virus (YkV1) and an unrelated dsRNA virus, yado-nushi virus (YnV1). YkV1 dsRNA, a replicated form of YkV1, and RNA-dependent RNA polymerase, are trans-encapsidated by the capsid protein of YnV1. While YnV1 can complete its replication cycle, YkV1 relies on YnV1 for its viability. We previously proposed a model in which YkV1 diverts YnV1 capsids as the replication sites. YkV1 is neither satellite virus nor satellite RNA, because YkV1 appears to encode functional RdRp and enhances YnV1 accumulation. This represents a unique mutualistic virus/virus interplay and similar relations in other virus/host fungus systems are detectable. We propose to establish the family Yadokariviridae that accommodates YkV1 and recently discovered viruses phylogenetically related to YkV1. This article overviews what is known and unknown about the YkV1/YnV1 interactions. Also discussed are the YnV1 Phytoreo_S7 and YkV1 2A-like domains that may have been captured via horizontal transfer during the course of evolution and are conserved across extant diverse RNA viruses. Lastly, evolutionary scenarios are envisioned for YkV1 and YnV1.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7452020Clinical Relevance of Serum Prolactin Levels to Inflammatory Reaction in Male Patients381389ENKoichiroYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihisaHanayamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKouHasegawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiTokumasuDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoMiyoshiDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokoOgawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikakoObikaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiItoshimaDepartment of Laboratory Medicine, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/60797To clarify the relevance of prolactin (PRL) to clinical parameters in patients who visited our general medicine department, medical records of 353 patients in whom serum PRL levels were measured during the period from 2016 to 2018 were retrospectively reviewed. Data for 140 patients (M/F: 42/98) were analyzed after excluding patients lacking detailed records and patients taking dopaminergic agents. Median serum PRL levels were significantly lower in males than females: 6.5 ng/ml (IQR: 4.2-10.3) versus 8.1 ng/ml (5.9-12.9), respectively. Pain and general fatigue were the major symptoms at the first visit, and past histories of hypertension and dyslipidemia were frequent. Male patients with relatively high PRL levels (≥ 10 ng/ml) had significantly lower levels of serum albumin and significantly higher levels of serum LDH than those with low PRL (< 10 ng/ml). There were significant correlations of male PRL level with the erythrocyte sedimentation rate (R=0.62), serum LDH level (R=0.39) and serum albumin level (R=−0.52), while the level of serum CRP (R=0.33) showed an insignificant but weak positive correlation with PRL level. Collectively, these results show that PRL levels had gender-specific relevance to various clinical factors, with PRL levels in males being significantly related to inflammatory status.No potential conflict of interest relevant to this article was reported.European Society of Surgical OncologyActa Medica Okayama0748-79834722020The adequacy of resection margin for non-infiltrative soft-tissue sarcomas429435ENTomohiroFujiwaraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesJonathanStevensonOncology Service, The Royal Orthopaedic HospitalMichaelParryOncology Service, The Royal Orthopaedic HospitalYusukeTsudaOncology Service, The Royal Orthopaedic HospitalYoichiKaneuchiOncology Service, The Royal Orthopaedic HospitalLeeJeysOncology Service, The Royal Orthopaedic HospitalObjectives</br>
There remains no consensus on what constitutes an adequate margin of resection for non-infiltrative soft-tissue sarcomas (STSs). We aimed to investigate the role of resection margins in millimetres for non-infiltrative STSs.</br>
Methods</br>
502 patients who underwent surgical resection for a localized, non-infiltrative, high-grade STSs were studied. The prognostic significance of margin width was analysed and compared with the conventional R- and R+1-classification of surgical margins.</br>
Results</br>
The overall local recurrence (LR) rate was 13%; 9% and 27% with negative and positive margins, respectively (p < 0.001). In patients with negative margins, the LR rates were greater than 10% in patients with margins ≤5.0 mm but reduced to less than 4% with margins >5.0 mm. When classified by the R- (or R+1)-classification, the 5-year cumulative LR incidence was 8%, 23% (16%), and 31% for R0, R1, and R2, respectively, which did not stratify the LR risk with negative margins. On the other hand, an accurate risk stratification was possible by metric distance; the 5-year cumulative incidence of LR was 29%, 10%, and 1% with 0 mm, 0.1–5.0 mm, and >5.0 mm, respectively (p < 0.001). This classification also stratified the LR risk in patients with or without adjuvant radiotherapy.</br>
Conclusion</br>
While a negative margin is essential to optimize local control in patients with non-infiltrative STSs, surgical margin width greater than 5 mm minimises the risk of local failure regardless of the use of adjuvant radiotherapy.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama0960-7404352020Low-grade soft-tissue sarcomas: What is an adequate margin for local disease control?303308ENTomohiroFujiwaraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoichiKaneuchiOncology Service, The Royal Orthopaedic Hospital NHS Foundation TrustYusukeTsudaOncology Service, The Royal Orthopaedic Hospital NHS Foundation TrustJonathanStevensonOncology Service, The Royal Orthopaedic Hospital NHS Foundation TrustMichaelParryOncology Service, The Royal Orthopaedic Hospital NHS Foundation TrustLeeJeysOncology Service, The Royal Orthopaedic Hospital NHS Foundation TrustBackground</br>
Whilst the resection margin is an established factor predictive of local control of soft-tissue sarcomas (STSs), the adequacy of margin width for low-grade STSs has been rarely described. We aimed to investigate the margin adequacy and its prognostic relevance in low-grade STSs.</br>
Methods</br>
109 patients who underwent surgical treatment for a low-grade STS were studied. The prognostic value of margin status was evaluated according to the R–, R+1–classification, and width in millimetres.</br>
Results</br>
The 10-year local recurrence (LR) rates were 6%, 27%, 54% in R0, R1, and R2, respectively (p < 0.001), according to the R–classification. The R+1–classification resulted in a decreased LR rate in R1, but no major differences in LR rates in R0 and R2; 7%, 14%, 54% in R0, R1, and R2, respectively (p < 0.001). When classified by metric distance, 10-year LR rates were 0%, 8%, and 38% by ≥ 2.0 mm, 0.1–1.9 mm, and 0 mm margins, respectively (p < 0.001). Patients with close margins (0.1–1.9 mm) who received adjuvant radiotherapy had a trend toward lower LR risk than those without radiotherapy (10-year, 4% vs. 12%; p = 0.406). The 5 and 10-year disease-specific mortality was 9% and 13%, respectively; margin width was not associated with disease-specific mortality but LR was a poor prognostic factor for survival (p = 0.003).</br>
Conclusion</br>
Whilst negative margin provided local control over 90%, excellent local control was achieved with microscopic margins ≥2 mm. The role of margins is more important than radiotherapy in local control. Margins do not determine survival, but LR is associated with a poor prognosis.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7442020Comparison of Two Different Intensive Care Unit Systems for Severely Ill Children in Japan: Data from the JaRPAC Registry285291ENKoheiTsukaharaDepartment of Emergency, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiromichiNaitouDepartment of Emergency, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiYorifujiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuyukiNosakaDepartment of Pediatrics, Cedars-Sinai Medical CenterHirotsuguYamamotoDepartment of Emergency, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaakiOsakoDepartment of Emergency, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsunoriNakaoDepartment of Emergency, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciencesthe JaRPAC Study GroupOriginal Article10.18926/AMO/60365The importance of centralizing treatment services for severely ill children has been well established, but such entralization remains difficult in Japan. We aimed to compare the trauma and illness severity and mortality of children admitted to two common types of ICUs for children. According to the type of management and disposition of the medical provider, we classified ICUs as pediatric ICUs [PICUs] or general ICUs, and analyzed differences in endogenous and exogenous illness settings between them. Overall, 1,333 pediatric patients were included, with 1,143 patients admitted to PICUs and 190 patients to general ICUs. The Pediatric Cerebral Performance Category score (PCPC) at discharge was significantly lower in the PICU group (adjusted OR: 0.45; 95%CI: 0.23-0.88). Death and unfavorable neurological outcomes occurred less often in the PICU group (adjusted OR: 0.29; 95%CI: 0.14-0.60). However, when limited to exogenous illness, PCPC scores (adjusted OR: 0.38; 95%CI: 0.07-1.99) or death/unfavorable outcomes (adjusted OR: 0.72; 95%CI: 0.08-6.34) did not differ between the groups. PCPC deterioration and overall sequelae/death rates were lower in PICUs for children with endogenous illnesses, although the outcomes of exogenous illness were similar between the 2 unit types. Further studies on the necessity of centralization are warranted.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813212020多変量解析で何を調整するべきか―観察研究におけるバイアスの整理―1824ENTakashiYorifujiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama1877-056810632020Transtibial pullout repair of the lateral meniscus posterior root tear combined with anterior cruciate ligament reconstruction reduces lateral meniscus extrusion: A retrospective study469473ENYukiOkazakiDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakayukiFurumatsuDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYusukeKamatsukiDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshikiOkazakiDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShinMasudaDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakaakiHiranakaDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYuyaKodamaDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShinichiMiyazawaDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground</br>
Lateral meniscus (LM) posterior root tear (PRT) is often associated with anterior cruciate ligament (ACL) injury and can result in rotational instability, joint overloading, and degenerative changes in the knee. Improved rotational stability and kinematics have been reported after LMPRT repair. However, it is unclear what repair technique can achieve the greatest reduction in LM extrusion (LME).</br>
Hypothesis</br>
We hypothesized that transtibial pullout repair would decrease LME to a greater extent than other repair techniques.</br>
Patients and methods</br>
Seventeen patients with ACL injury and complete LMPRT were evaluated. Nine underwent ACL reconstruction (ACLR) and transtibial pullout repair, and eight underwent ACLR and other repairs such as inside-out suturing. Double-bundle ACLR was performed using hamstring tendons, and LMPRT pullout repair was performed through the bone tunnel for the posterolateral bundle. Magnetic resonance imaging was performed immediately preoperatively and at > 6 months postoperatively, and LME was measured from coronal images only.</br>
Results</br>
A significantly greater decrease in the value of LME from pre- to postoperative measurement was observed in the transtibial pullout repair group (−0.5 ± 0.7 mm) than in the other-repair group (1.0 ± 0.9 mm, p < 0.01). Pre- and postoperative LME measurements were not significantly different between the two groups.</br>
Discussion</br>
The most important finding of this study was that transtibial pullout repair resulted in a greater decrease in LME than other repair techniques in patients with ACL injury and LMPRT. This technique might be useful for restoring hoop tension by decreasing LME.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama1420-30492552020Systematic Investigations of Annealing and Functionalization of Carbon Nanotube Yarns1144ENMaikScholzLeibniz Institute for Solid State and Material Research Dresden, Helmholtzstr. 20YasuhikoHayashiGraduate School of Natural Science and Technology, Okayama UniversityVictoriaEckertLeibniz Institute for Solid State and Material Research Dresden, Helmholtzstr. 20VyacheslavKhavrusLeibniz Institute for Solid State and Material Research Dresden, Helmholtzstr. 20AlbrechtLeonhardtLeibniz Institute for Solid State and Material Research Dresden, Helmholtzstr. 20BerndBüchnerLeibniz Institute for Solid State and Material Research Dresden, Helmholtzstr. 20MichaelMertigInstitute for Physical Chemistry, Technische Universität DresdenSilkeHampelLeibniz Institute for Solid State and Material Research Dresden, Helmholtzstr. 20Carbon nanotube yarns (CNY) are a novel carbonaceous material and have received a great deal of interest since the beginning of the 21st century. CNY are of particular interest due to their useful heat conducting, electrical conducting, and mechanical properties. The electrical conductivity of carbon nanotube yarns can also be influenced by functionalization and annealing. A systematical study of this post synthetic treatment will assist in understanding what factors influences the conductivity of these materials. In this investigation, it is shown that the electrical conductivity can be increased by a factor of 2 and 5.5 through functionalization with acids and high temperature annealing respectively. The scale of the enhancement is dependent on the reducing of intertube space in case of functionalization. For annealing, not only is the highly graphitic structure of the carbon nanotubes (CNT) important, but it is also shown to influence the residual amorphous carbon in the structure. The promising results of this study can help to utilize CNY as a replacement for common materials in the field of electrical wiring.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama17485983152020How Networks Among Frontline Offices Influence Regulatory Enforcement : Diffusion and Justification of Interpretation of Risk13881405ENAyakoHirataFaculty of Law, Okayama University Street‐level interpretation and enforcement are critical to defining the meaning of law. To understand street‐level regulatory decisions, prior studies have highlighted internal office conditions, neglecting the influence that peer offices can have. This study examines the role of horizontal inter‐office interaction among frontline offices and illustrates how and under what conditions it shapes the meaning of law. Drawing on qualitative and quantitative data on Japan's Soil Contamination Countermeasures Act, this study reveals that inter‐office interaction occurs within fixed groups and comes to shape shared interpretations of law that regulators believe are legally valid. This implies that under legal ambiguity, inter‐office interactions develop institutionalized notions of appropriateness and reinforce the perception of legal consistency, which bolster the legitimacy of enforcement. Although peer office networks encourage convergence on the interpretation of law, because of their clustered structure, legal meanings develop differently across various groups.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7422020Non-traumatic Atypical Peri-implant Femoral Fracture at the Distal Screw after Short Femoral Nail Fixation for a Pertrochanteric Fracture151157ENNorioYamamotoDepartment of Orthopedic Surgery, Unnan City HospitalTomoyukiDan’uraDepartment of Orthopedic Surgery, Unnan City HospitalTomoyukiNodaDepartment of Musculoskeletal Traumatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/58274 This is the second report of an atypical peri-implant femoral fracture occurring at the distal screw after intramedullary nail fixation of a pertrochanteric fracture. A 94-year-old Japanese female with a 5-year history of alendronate intake presented with prodromal pain in her right thigh after intramedullary nail fixation. Plain radiographs showed an incomplete noncomminuted transverse fracture at the distal screw, suggesting an atypical peri-implant femoral fracture. The pathogenesis of an atypical peri-implant femoral fracture could be a combined systemic bone metabolism disorder and repetitive overloading at the screw, similar to the pathogenesis of an atypical periprosthetic femoral fracture around stem implantation.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7422020The Efficacy of Mirabegron for the Relief of Ureteral Stent-Related Symptoms145150ENHideoOtsukiDepartment of Urology, Abiko Toho HospitalTomoyaYamasakiDepartment of Urology, Abiko Toho HospitalShunsukeHoriDepartment of Urology, Abiko Toho HospitalHiroshiAokiDepartment of Urology, Abiko Toho HospitalTakeoKosakaDepartment of Urology, Keio UniversityShinyaUeharaDepartment of Urology, Kawasaki Medical School General Medical CenterKeiFujioDepartment of Urology, Abiko Toho HospitalOriginal Article10.18926/AMO/58273 To investigate the efficacy of mirabegron for lower urinary tract symptoms in patients with an indwelling ureteral stent after ureterorenoscopic lithotripsy. This was a prospective follow-up study of 76 patients with stent-related symptoms (SRSs). Patients with upper urinary calculi who were pre-stented for > 2 weeks before lithotripsy were examined for the presence of SRSs by tests including the International Prostate Symptom Score (IPSS), OAB Symptom Score (OABSS), and urinary bother and pain measured by a Visual Analogue Scale (VAS) before lithotripsy. Mirabegron (50 mg/day) was prescribed post-lithotripsy for 2 weeks. SRSs were assessed at the time of stent removal. The IPSS scores improved significantly from 16.2 to 14.3 (p<0.001) and the IPSS-QoL scores decreased significantly from 5.0 to 4.6 (p=0.012). The OABSS scores improved significantly from 7.7 to 6.8 (p=0.006), and the urinary urgency scores (OABSS-Q3) decreased significantly from 3.24 to 2.68 (p<0.001). The number of nocturia episodes decreased significantly from 2.5 to 2.2 (p=0.045). Urinary bother and pain assessed by the VAS declined from 4.2 and 3.1 to 3.8 (p=0.15) and 2.5 (p=0.075), respectively. Mirabegron significantly improved SRSs and the number of nocturia episodes due to a ureteral stent.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323102020ケア的思考の活用による道徳科の授業改善 : 共同的に探求する子供をめざして215229ENMasamiOzaki10.18926/CTED/58133 「特別の教科 道徳」となり，「考え，議論する道徳」への授業の質的転換が求められている。学習指導要領には，道徳科として目指す学びが具体的に示されており，現場の教員にも授業の質を改善するという意識が高まってきた。そこで，子供が共同的に自己のよりよい生き方を探求していくことができる授業となるよう，マシュー・リップマンの提唱する多元的思考アプローチの一つであるケア的思考を重視して道徳科の授業に応用し，授業改善に取り組んだ。筆者が創造的思考，批判的思考を段階的に取り入れてきたこれまでの実践と比較しながら実践を進め，道徳科の授業に，ケア的思考を意識的に取り入れることにより，創造的思考や批判的思考が活性化され，さらには三つの思考が作用し合うことが明らかになった。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323102020子どもの主体的な身体表現を引き出すリトミックの保育実践研究（第一報）: 保育施設における１･２･３歳児学級の事例を中心にして183197ENSaoriKOTAKENorikoBABAKeiTAKAHASHIYuzoWATANABEToshiyukiTAKAHASHI10.18926/CTED/58131 近年の先行研究を「身体表現」「音楽教育」「リトミック」「遊戯」をキーワードに概観すると，100 年を超える歴史の中で，リトミックの捉え方が変容していることと，リトミックの新しい保育実践研究が必要であることが，明らかになった。そこで本論では，保育施設におけるリトミックの実践から，子どもが何を学び，何が育っているのかを論考した。その結果，以下のことが示唆された。(1)１歳児学級の子どもは，保育者の模倣を活発に行う段階である。(2)２歳児学級においては，子どもが自由に想像し表現できるよう，保育者は，配慮する必要がある。(3)３歳児学級においては，表現することの楽しさを通して心が解放される気持ち良さを感じることや，リトミックの主題や保育者の姿に集中することや，何かを達成する喜びを感じること等が重要である。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323102020生活単元学習の単元設定・単元構成の在り方 : 2 年間実践された単元の授業評価結果からの検討7990ENAkitakaNAKAYAHironoriINOUERyokoNOSE10.18926/CTED/58122 本研究では、知的障害特別支援学校中学部において、同一集団、同一指導者によって2年間実践された「生活上の課題をもとにした」22 の生活単元学習の授業評価を行い、その結果を踏まえて、単元設定や単元構成の在り方について検討した。3 観点からなる観点別個別評価結果を基に各単元の評価を行った結果、観点別評価による各単元の特徴及び生徒個々の活動への取り組み方を確かめることができた。また、個々の単元の評価結果と、単元の活動経験の有無、活動の種類、単元目的の具体性、教師と生徒のいずれが提案した単元であるかという視点との明確な関連性は見られなかった。一方で、生徒が見通しをもつことのできる単純な単元構成、集団全体の課題解決場面の設定、人と関わりの多い場面設定と単元の評価結果との関連性が見られ、単元設定、単元構成におけるこれらの重要性が示唆された。No potential conflict of interest relevant to this article was reported.岡山大学全学教育・ 学生支援機構Acta Medica Okayama2432-966542019岡山大学における留学生宿舎の在り方 : 国際学生シェアハウスの実態と課題を中心に168185ENMarikoUZUKAMasumiOKAMasumiFUJIMOTO10.18926/58044 岡山大学の留学生宿舎の36 年の歴史の中で、寮規則の遵守、人間関係の構築、施設や人的リソース不足など多種多様な課題が指摘されてきた。3 年前に開所した混住型の国際学生シェアハウスにおいて新たに日本人学生が関与する問題が追加発生したこともあり、教育資源として寮を活用する視点から一転して、効率化のために管理を外注化する方向に舵を切った。留学生活の基盤となる住環境を整えることは元来、費用や労力のかかることであり、日常的に起こる課題を解決するためには、責任感のあるリーダー的日本人学生の果たす役割が小さくない。その一方で、課題解決できる日本人学生の育成には、きめ細かい指導・助言に加えて、教育資源としての寮の活用という大学のビジョンと推進力が必要である。No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7412020Examination of the Causality Relationship between Psychological Distress and Social Participation in Elderly People: A Pilot Study5963ENYutakaOwariShikoku Medical CollegeNobuyukiMiyatakeDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityHiromiSuzukiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityOriginal Article10.18926/AMO/57954 Few studies have considered the causal relationship between psychological distress and social participation in elderly people. Here we investigated this relationship based on an initial survey and a follow-up survey. In 2016, a survey was distributed to 86 participants. A follow-up survey of 80 of those participants was performed in 2017. We adopted the following variables: psychological distress and social participation as represented by the Kessler psychological distress scale and social participation scores, respectively. By using cross-lagged and synchronous effects models, we found that the 2016 Kessler psychological distress scale had a significant influence on the 2017 social participation scores (standardization factor=−0.221, p=0.020) and the 2017 Kessler psychological distress scale significantly influenced the 2017 social participation scores (standardization factor=−0.345, p=0.039). The results suggest that psychological distress may affect social participation one year later.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7412020Relationship between a High-inspired Oxygen Concentration and Dorsal Atelectasis in High-energy Trauma Patients1726ENKenzoIshiiDepartment of Anesthesiology and Oncological Pain Medicine, Fukuyama City HospitalHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazumiOnoDepartment of Anesthesiology and Oncological Pain Medicine, Fukuyama City HospitalKojiMiyasho Department of Critical Care and Emergency Medicine, Fukuyama City HospitalOriginal Article10.18926/AMO/57948 We performed a retrospective cohort study of 911 high-energy trauma patients who underwent chest CT scans at least twice after admission. We hypothesized that in high-energy trauma patients, a high-inspired oxygen concentration delivered after admission results in dorsal atelectasis. The study’s primary outcome was dorsal atelectasis formation diagnosed based on CT images. We defined dorsal atelectasis as the presence of atelectasis at ≥ 10 mm thick on CT images. We defined high-inspired oxygen concentration as >60% oxygen delivered between two CT scans. Four hundred sixty-five patients (51.0%) developed atelectasis according to the second CT scan, and 338 (37.1%) received a high-inspired oxygen concentration. A univariate analysis showed that the rate of the high-inspired oxygen concentration in the atelectasis group was significantly higher than that in the non-atelectasis group (43.4% vs. 30.1%, p<0.001). However, a logistic regression analysis showed that there was no significant relationship between the oxygen concentration and the formation of dorsal atelectasis (OR: 1.197, 95%CI: 0.852-1.683, p=0.30). Age, the Injury Severity Score, BMI, and smoking were found to be risk factors of dorsal atelectasis formation in high-energy trauma patients. There was no relationship between the oxygen concentration and atelectasis formation in our series of high-energy trauma patients.No potential conflict of interest relevant to this article was reported.Lippincott, Williams & WilkinsActa Medica Okayama0009-921X47782019Temporary External External Fixation Can Stabilize Hip Transposition Arthroplasty After Resection of Malignant Periacetabular Bone Tumors18921901ENToshiyukiKunisadaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomohiroFujiwaraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesJoeHaseiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesEijiNakataDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasuoSendaDepartment of Rehabilitation, Okayama University HospitalToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground: The choice of reconstructive procedure to restore limb function is challenging after internal hemipelvectomy. Hip transposition arthroplasty, also known as resection arthroplasty, removes a malignant or aggressive tumor of the pelvis and acetabulum after which the remaining femoral head is moved proximally to the lateral surface side of the sacrum or the underside of the resected ilium after internal hemipelvectomy. It may provide reasonable functional results and have some advantages such as lowering the risk of an infected implant compared with other reconstructions because no foreign implants are used. Hip transposition is generally managed with prolonged bed rest or immobilization postoperatively to stabilize the soft tissue surrounding the remaining femur. Because enabling patients to be mobile while the soft tissues heal might be advantageous, we reviewed our experience with an external fixation for this procedure.<br/>
Questions/purposes: (1) Does temporary external fixation facilitate postoperative physiotherapy in patients who undergo hip transposition arthroplasty? (2) What functional Musculoskeletal Tumor Society (MSTS) scores were achieved at short term in a small series of patients treated with hip transposition and temporary external fixation? (3) What were the complications of using external fixation in a small series of patients who received it for malignant tumors?<br/>
Methods: Between 2008 and 2012, we treated seven patients (three men and four women; median age, 37 years; age range, 18-53 years) with acetabular resection for malignant bone tumors; all were managed with a hip transposition, initially stabilized using external fixation. No other types of procedures were used for this indication in this period. Minimum followup in this retrospective study was 45 months, except for one patient who died at 18 months (range of followup duration, 18-90 months; median followup, 57 months), and no patients were lost to followup. The pins for external fixation were inserted into the affected side of the femur and the healthy contralateral ilium. External fixation was removed 6 weeks postoperatively and weightbearing was started at that time. Preoperative chemotherapy was administrated in four patients, but postoperative chemotherapy was delayed since it was given after external fixation removal in three patients. The postoperative rehabilitation course and functional results were assessed by chart review, functional results were determined using MSTS scores, tallied by physiotherapists who were not part of the surgical team, and complications were ascertained through chart review. Major complications were defined as complications that were treated with additional operations, such as deep infection, or ones that could cause severe postoperative dysfunction, such as nerve injury.<br/>
Results: With temporary external fixation, standing next to a bed was achieved in median 7 days (range, 6-9 days) postoperatively, transferring to a wheel chair in median 8 days (range, 6-28 days), and gait training using parallel bars in median 15 days (range, 7-48 days). At most recent followup, three patients could walk without a crutch or cane, three could walk with a cane, and one could walk with a crutch. The median MSTS score at most recent followup (median, 57 months) was 63%. Two patients had complications that resulted in reoperations; one had a wound dehiscence, and one had an abdominal herniation that gradually developed, and which was reconstructed using polypropylene mesh 2 years after pelvic resection. Two patients had nerve palsies that recovered by the end of the first year. All patients had pin tract infections that resolved with nonsurgical approaches.<br/>
Conclusions: Hip transposition with temporary external fixation can stabilize the bone soft tissue after pelvic resection. Although we did not have a comparison group of patients, we believe that external fixation facilitates early postoperative physiotherapy and rehabilitation and provides good functional results without major surgical complications. Because it delays the resumption of chemotherapy, more patients with longer followup are needed to determine whether this will be associated with poorer oncologic results.No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671482019Study of U Hla’s Experiences in Japan in 1936171189ENEi Thandar Aung10.18926/57768 In this paper, I focus on the characteristics of Japan and the Japanese people as portrayed in his writings by U Hla, a trader from Myanmar who studied the Japanese economy and industry, and the behaviour of the Japanese people during his visit to Japan in 1936. The aim of this paper is to know why U Hla wanted to visit Japan, what he learnt during his business trip to Japan, what kind of knowledge he acquired from Japan, why he was interested in the banking system, and how he applied the knowledge he gained in Japan after he returned to Myanmar. The primary and secondary sources for this study came from the National Library of Myanmar, Universities’Central Library, University of Yangon Library, University of Maubin Library, and Internet archives.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7362019Correlations between Depressive Condition and Gastroesophageal Reflux Symptoms in Patients Visiting a Department of General Medicine479486ENYuSuganamiDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKosukeOkaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihisaHanayamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiHondaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunHamaharaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikakoObikaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyaKariyamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasayukiKishidaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/57711 To clarify the potential relevance of patients’ chief complaints at a general medicine department to their self-rating depression scale (SDS) and frequency scale for symptoms of gastroesophageal reflux disease (GERD) (FSSG) scores, we analyzed data of 478 patients who visited our general medicine department. The chief complaints (553 symptoms of 447 patients) were categorized into major symptom-based groups: respiratory (31%), circulatory (3%), gastrointestinal (GI) tract (26%), neurology (8%), orthopedic and skin (10%), and systemic (22%) symptoms. The SDS score tended to be higher in females and younger patients. The FSSG score did not differ by gender but was higher in younger patients. The patients receiving social welfare had higher SDS and FSSG scores. A close inter-relationship between the FSSG (including both degrees of reflux and dysmotility) and SDS was observed in all patients. Although the averages of the SDS and FSSG scores were not significantly different among the symptom-based categories, we observed significantly positive correlations between the FSSG and SDS in each category, suggesting that depressive status may be closely related to GERD-related symptoms regardless of the patients’ chief complaints. An initial checkup of patients’ psychological condition and/or GERD-like symptoms could help screen for latent disorders in outpatients with uncertain complaints.No potential conflict of interest relevant to this article was reported.European Society of Surgical OncologyActa Medica Okayama0748-79834622019What is an adequate margin for infiltrative soft-tissue sarcomas?277281ENTomohiroFujiwaraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesJonathanStevensonDepartment of Oncology, The Royal Orthopaedic HospitalMichaelParryDepartment of Oncology, The Royal Orthopaedic HospitalYusukeTsudaDepartment of Oncology, The Royal Orthopaedic HospitalKimTsoiDepartment of Oncology, The Royal Orthopaedic HospitalLeeJeysDepartment of Oncology, The Royal Orthopaedic HospitalObjectives</br>
What constitutes an adequate margin of resection for infiltrative subtypes of soft-tissue sarcomas remains unclear. We aimed to determine the prognostic significance of the margin in millimetres for myxofibrosarcoma (MFS) and undifferentiated pleomorphic sarcoma (UPS).</br>
Methods</br>
305 patients diagnosed with either a high-grade, localised MFS (n = 98) or UPS (n = 207) were included. The relationship of closest margin in millimetres to viable tumour and oncological outcomes was analysed.</br>
Results</br>
The overall local recurrence (LR) rate for all patients were 12%: 19% with positive margin and 10% with negative margin (p = 0.051). The LR rate was similar in patients with negative but <10 mm margin; 13%, 6%, 15%, 17% with 0.1–0.9 mm, 1.0–1.9 mm, 2.0–4.9 mm, and 5.0–9.9 mm margin, respectively. However, the LR rate decreased to 3% if the margin was ≥10 mm. By the R- or R+1-classification, the 10-year cumulative probability of LR was 9%, 15%, 48% for R0, R1, R2 resections, respectively, which was not sensitive enough to stratify the LR risk in patients with negative margins. However, the cumulative probability of LR was significantly stratified by metric distance; the 10-year cumulative LR probability was 3%, 14%, 25% with ≥10.0 mm, 0.1–9.9 mm, and 0 mm, respectively (p = 0.026). A trend towards improved local control by adjuvant radiotherapy was seen in patients with 0–9.9 mm margin (p = 0.078).</br>
Conclusion</br>
The resection margin, when measured as a metric distance, correlates with a reduction in LR, and appears to be more significant on local control than radiotherapy. To minimise the risk of LR, a margin distance of at least 10 mm is advocated for MFS and UPS.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7352019Relationship between Intracellular Signaling of the (Pro)renin Receptor and the Pathogenesis of Preeclampsia433440ENShokoTamadaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiMitsuiDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkikoOhiraDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazumasaTaniDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJotaMakiDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakeshiEguchiDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesErikoEtoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiHayataDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisashiMasuyamaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/57374 An association between preeclampsia and (pro)renin was recently reported. Intracellular signaling of the (pro) renin receptor [(P)RR] increases the expressions of TGF-β and PAI-1. In this study we sought to clarify the involvement of (pro)renin in the pathogenesis of preeclampsia via the intracellular signaling of (P)RR on preeclampsia placentas. Activated (pro)renin plasma concentrations were compared between pregnant women with (n=15) and without (n=28) preeclampsia. The placentas were immunohistochemically evaluated with anti-HIF-1α and anti-(P)RR antibodies. HTR-8/SVneo cells were cultured under hypoxic conditions and treated with human recombinant (pro)renin. The mRNA expressions of HIF-1α, (P)RR, PAI-1, TGF-β, and ET-1 were also examined by real-time RCR. The activated (pro)renin plasma concentration was significantly higher in the third vs. the second trimester in the preeclampsia patients. HIF-1α and (P)RR expressions were significantly increased in the preeclampsia placentas. The mRNA expressions of PAI-1, TGF-β, and ET-1 were significantly increased in the experiments using recombinant (pro)renin vs. hypoxic conditions. (P)RR expression in preeclampsia placentas is increased by persistent hypoxia through the second and third trimesters, and PAI-1, TGF-β, and ET-1 production is increased via (P)RR. Our results suggest that ET-1 production via the intracellular signaling of (P)RR is important in the pathogenesis of preeclampsia.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7342019Tuberosity-overlapping Fixation of the Humeral Shaft in Humeral Head Replacement Surgery299305ENTakaakiHiranakaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Density and Pharmaceutical SciencesKeiichiroNishidaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Density and Pharmaceutical SciencesTaizoKonishiikeDepartment of Orthopaedic Surgery, Japanese Red Cross Okayama HospitalToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Density and Pharmaceutical SciencesMotohikoMikasacDepartment of Orthopaedic Surgery, Matsudo Orthopaedic HospitalOriginal Article10.18926/AMO/56931 The fixation technique of bony fragments is crucial for the bone union of the tuberosities after humeral head replacement (HHR) for a comminuted fracture of the proximal humerus. To increase the bone union rate, we reduce tuberosities to overlap on the humeral shaft by approx. 1 cm and fix them with cable wire. Herein, we retrospectively investigated the clinical and radiographic outcomes of our procedure. Twenty-six patients who underwent cementless HHR for the treatment of comminuted fractures of the proximal humerus were investigated. The Constant-Murley score, active shoulder mobility, and bone union rate were evaluated. The mean duration of follow-up was 56.3 months (range 24-197). At the final follow-up, the average Constant-Murley score was 58 (range 40-76). Forward elevation was 126° on average (range 35°-180°). Twenty-three cases (88%) showed bone union between the tuberosities and the shaft at an average follow-up of 4.1 months (range 4-5 months) after surgery. Non-union was noted in 1 case, and bone resorption was noted in 2 cases. The bone union rate and the clinical outcome of our procedure were relatively favorableNo potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231712019成人期以降の性的マイノリティ当事者が学校生活を振り返って，学校教育に求めること3946ENArataSASAKIThe Joint Graduate School in Science of School Education (Doctor’s Course), Hyogo University of Teacher EducationYumiAMANOGraduate School of Education (Master’s Course), Okayama UniversityIoriOHMORIDivision of Developmental Studies and Support, Graduate School of Education, Okayama University10.18926/bgeou/56922 本研究の目的は，カミングアウトが難しい性的マイノリティ当事者が学校教育にどのような支援を望んでいるのか明らかにすることである。方法として質問紙調査を行った。質問紙作成にあたり，当事者への学校での支援について文献検索を行い，主に授業外で取り組む支援例を収集した。収集した支援例の評価を当事者18 名に依頼した。学校教育に求めていることは，相談してきた児童生徒の気持ちに寄り添うこと，第三者に知られないよう配慮すること，性の多様性と正しい知識を教えることであった。また，「開示しようとしまいと，いることを前提とする」学校になってほしいと希望していることが伺えた。教員は性的マイノリティの児童生徒が抱える困難さを重要な課題と捉え，いつでも誰でも相談できる環境づくりや，児童生徒の気持ちを尊重する努力が必要とされていると考える。No potential conflict of interest relevant to this article was reported.岡山実験動物研究会Acta Medica Okayama352019母マウスが望む環境エンリッチメントとは？ : 環境エンリッチメント選びを考える1821ENSumireIshiharaAdvanced Science Research Center, Okayama University Environmental enrichment, whose material is commercially available, is today thought to improve animal welfare, for instance, control of stress. There were some reports that these report contribution of suppression of stress, which the mother mice suffer during nursing their pup. However, the effects on stress-suppression by introducing the enrichment materials is unknown. In this study, determined plasma and urinary corticosterone in the mother mice with or without the materials from their making to weaning.No potential conflict of interest relevant to this article was reported.岡山実験動物研究会Acta Medica Okayama352019色素細胞系 : 生命機能発現機構解明の１モデルシステム28ENHiroakiYamamotoFaculty of Bioscience Nagahama Institute of Bio-Science and Technology There are two cell lineages of mammalian melanin pigment cells, one that leads to retinal pigment epithelium (RPE) cells in the eye from the optic cup and the other leading to melanocytes from vertebrate-specific neural crest cells. Melanocyte precursors have high mobility and migrate and settle into various tissues and organs, including the skin, choroid, inner ear, heart, brain, adipose tissue, lung, etc. It is well known that RPE cells are essential for visual acuity and that melanocytes in the skin provide protection against UV-damage. So, what is the function of extracutaneous melanocytes that are distributed elsewhere in the body where only very small amounts of light illuminate their existence? Here I would like to briefly introduce our research history and then discuss the important roles of melanocytes in the inner ear that are indispensable for hearing ability and those in the choroid where they seem to contribute to maintaining the structures of their habitats.No potential conflict of interest relevant to this article was reported.岡山大学文学部Acta Medica Okayama0285-4864692018世界は何でできている？ : Paul Auster が描く白い世界曼荼羅3347ENHitomiNakatani10.18926/okadai-bun-kiyou/56091No potential conflict of interest relevant to this article was reported.岡山実験動物研究会Acta Medica Okayama342018冬眠する哺乳類シリアンハムスターに学ぶ、冬眠可能な生体状態とは？1016ENYoshifumiYamaguchiDepartment of Genetics, Graduate School of Pharmaceutical Science, University of TokyoHibernation is an adaptive strategy for surviving during periods with little or no food availability, by profoundly reducing the metabolic rate and the core body temperature (Tb). Mammalian hibernators store fat extensively in white adipose tissues (WATs) during pre-hibernation period to prepare for hibernation. Thus, they undergo adaptive body remodelling in autumn, the pre-hibernation period, prior to hibernation, whereas little is known about the physiological and molecular mechanisms of the pre-hibernation remodelling. Syrian hamsters (Mesocricetus auratus) are facultative hibernators that can hibernate irrespective of seasons when exposed to prolonged short photoperiod and cold ambient temperature (SD-Cold) conditions. We found that before the initiation of hibernation, the body mass of Syrian hamsters decreased below a threshold, indicating that hibernation in this species depends on body condition. Global profiling of gene expression in various tissues of animals during the pre-hibernation period and hibernation period identified adaptive changes for hibernation at molecular level. Thus, Syrian hamsters as a model animal to study hibernation provide us a unique and convenient opportunity to analyse molecular and physiological mechanisms of adaptive pre-hibernation remodelling under a laboratory condition.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7222018Descriptive Study of Gender Dysphoria in Japanese Individuals with Male-to-Female Gender Identity Disorder143151ENYoshieShinoharaGraduate School of Health Sciences, Okayama UniversityMikiyaNakatsukaDepartment of Obstetrics and Gynecology and Gender Clinic, Okayama University Hospital,Original Article10.18926/AMO/55855 We focus on Japanese individuals with gender identity disorder (GID), especially male-to-female (MTF) GID, who have experienced difficulty in adapting to social life. We clarify what gender dysphoria is, and we examine methods of intervention. Semi-structured interviews were conducted with 11 individuals with MTF-GID from August 2015 to April 2017. We categorized the subjects’experiences regarding dysphoria into the ‘Onset of gender dysphoria,’ ‘Experience of feeling gender dysphoria,’ and ‘Changes due to receiving medical care.’ The subjects reported experiencing great pain and distress because they did not fully understand that they were experiencing dysphoria and could not align their gender identity and their self-identity. All subjects described their experiences of dysphoria as negative. Additionally, all said that the dysphoria was alleviated by a medical intervention such as visiting a gender clinic, receiving a diagnosis and treatment, and changing their physical sex to the sex congruent with their gender identity. The provision of information at the gender clinic and the physical changes achieved by medical intervention exerted a positive effect both mentally and socially on the subjects, who suffered various physical, mental and social problems.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-132382018これからの道徳性を問う : 教育哲学の視点から考える新たな道徳性への追求114ENKiyohiroSkudaWaseda University institute of teacher educationYoshikazuNakayamaOkayama University whole school education and student support organization10.18926/CTED/55803 戦後の近代化と共に進む、非人道的な課題に及ぶ道徳性の著しい衰退により、今日の日本では、真の道徳性について見直す時にきている。本稿では、「道徳性」とはどのようなことなのか、現在の大学生によるアンケート調査をもとに、今日、成人を遂げ、新たに社会に巣立とうとしている大学生の真意を探ると共に、今後の課題と学校教育における道徳教育の在り方について検討した。
その結果、今日の大学生における道徳性と今後の課題が見出され、「生命への尊重」「規範意識」「信頼関係」などが今後の道徳性として重要であることが示唆された。なお、これらの道徳性について、歴史上の思想家（教育哲学者）の理論をもとに検証し、今後の未来に必要な道徳性について明らかとした。No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41464932018満洲国における白系ロシア人の位置付け : 東洋人と西洋人の共存共栄・民族協和社会の実態79108ENElena Dmitrieva10.18926/OER/55746 The positioning of White Russians in Manchukuo society is an important topic, especially taking into account that they were announced as“ citizens” of a New State. This article examines the actual economic and social condition of White Russians comparing to other ethnic groups in Manchukuo society, especially to Japanese and Manchurians/Chinese. The author will present the differences between the public propaganda for White Russians and the reality which they had experienced in Manchukuo. It is hoped that this article will show what kind of“ Racial Harmony （minzoku kyowa）” and“ Harmony of the Five Races（ gozoku kyowa）” society were created in the New State in case of minority group such as White Russians.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41464932018フランスにおけるメトロポールの誕生と開発評議会 : ストラスブール・ユーロメトロポールを一例に6577ENYasushiIwabuchi10.18926/OER/55745 This article shows the relation between urban development and local democracy in France by analyzing Metropole City and the Development Council. Metropole City supports its innovation industry through contracts with the State-Metropole City, French Tech, and university investment in different stakeholders such as economic groups and universities. This article puts forward the following questions. First, what kinds of networks does Metropole City create to win global city competitions? Second, how does the Development Council function after the MAPTAM law of 2014 and the NOTRe law of 2015? To answer these questions, this article uses Strasbourg Eurométropole as an example.No potential conflict of interest relevant to this article was reported. Japanese College of CardiologyActa Medica Okayama0914-50877012017Complete right bundle branch block and QRS-T discordance can be the initial clue to detect S-ICD ineligibility2328ENMotomiTachibanaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuhiroNishiiDepartment of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshimasaMorimotoDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKawadaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkihitoMiyoshiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyasuSugiyamaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiNakagawaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsuyukiWatanabeDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazufumiNakamuraDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiMoritaDepartment of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiItoDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBACKGROUND:
In order to minimize inappropriate shocks of subcutaneous implantable cardioverter-defibrillators (S-ICD), it is important to recognize who is suitable for S-ICD indication. This study aimed to clarify what types of cardiac disease are likely to fulfill the S-ICD screening criteria and ineligible factors for S-ICD in the standard 12-lead electrocardiogram (ECG).
METHODS:
A total of 348 patients with heart disease were enrolled. They were assessed by supine and standing ECG recording to simulate the 3 S-ICD sensing vectors and standard 12-lead ECG, simultaneously. Clinical and ECG characteristics were analyzed to compare the patients who are eligible and ineligible with S-ICD screening ECG indication.
RESULTS:
The mean age of study patients was 49±21 years and 244 (70%) were men. Nineteen percent of patients were unsuitable for S-ICD. There was no significant difference in ineligibility for S-ICD among cardiac diseases (p=0.48). Univariate analysis showed complete right bundle branch block (CRBBB), QRS-T discordance in lead II, and QRS-T discordance in 3 leads (I, II, and aVF) were more frequent in patients who were ineligible for S-ICD than in the eligible group. Multivariate regression analysis showed CRBBB and QRS-T discordance in 3 leads were independent predictors for ineligibility of S-ICD.
CONCLUSION:
There are no differences in eligibility of S-ICD among types of cardiac diseases. CRBBB and QRS-T discordance were independent predictors for ineligibility.No potential conflict of interest relevant to this article was reported.岡山大学法学会Acta Medica Okayama0386-30506722017政党システム中心の選挙制度改革論と地方自治 : 異なる価値前提を巡る若干の考察334305ENSatomiTaniNo potential conflict of interest relevant to this article was reported.岡山大学全学教育・ 学生支援機構Acta Medica Okayama2432-966512016From ‛What do you want to learn in this class?’ to ‛What did you learn in this class?’ Exploring Before and After Implications of Students’ Responses107122ENIanNakamuraOkayama University10.18926/55371 Looking back at over my years of teaching English at university, I noticed that despite the many changes, two things have remained the same in my classroom practice: the first day questionnaire and end of term reflective report. Out of the 14 questions on the first class inquiry, my favorite question is ‘What do you want to learn in this class?’ I find the most interesting answers are located here in terms of revealing students’ initial expectations of the course. Near the end of the term, I assign a reflective report on what they learned in this class. What makes the initial responses even more memorable is placing them into a learning opportunity perspective with their final self-perceived notion of what they achieved.No potential conflict of interest relevant to this article was reported.岡山大学全学教育・ 学生支援機構Acta Medica Okayama2432-966512016A Three-day CLIL Workshop : what was learned and produced1728ENAkemiMoriokaOkayama UniversityCarolINUGAI-DIXONUniversity of TsukubaKaoruMitaJissen Women’s Junior CollegeYukoHoshinoTokyo University of Pharmacy and Life Sciences10.18926/55364 現在多くの日本の大学では、グローバルな教育内容と環境を促進することが火急の課題である。岡山大学では英語教育の質の向上と授業科目の英語での提供の２つに取り組んでいるが、その実践においてCLIL（内容言語統合型学習）が有用であると考えられる。また日本の高等教育機関において、CLIL を既に実践あるいは導入を検討している教育関係者と経験やアイデアを共有し、ネットワークを作って今後の情報交換を行うことも非常に重要である。そこで岡山大学では2016 年2 月にフィンランドから２名の講師を招き、３日間のCLIL ワークショップを開催した。この論文では４大学の参加者４名がワークショップで紹介された２つの大学の異なったCLIL モデルについて報告する。またワークショップで行った様々なアクティビティを通して参加者が学び取ったことや成果についても記述する。No potential conflict of interest relevant to this article was reported.American Physical SocietyActa Medica Okayama1539-37559112015Reply to “Comment on ‘Spontaneous liquid-liquid phase separation of water’ ”016302ENTakumaYagasakiDepartment of Chemistry, Faculty of Science, Okayama University MasakazuMatsumotoDepartment of Chemistry, Faculty of Science, Okayama UniversityHidekiTanakaDepartment of Chemistry, Faculty of Science, Okayama University Two different scenarios have been proposed on the phase separation occurring in the deeply supercooled liquid water. We discuss what we can derive from our simulation results for the two scenarios and propose a way for future investigation. We also demonstrate that the phase separation in the supercooled liquid water looks like the separation of liquid water and vapor just below the conventional critical point.No potential conflict of interest relevant to this article was reported.岡山大学理学部地球科学教室Acta Medica Okayama1340-74142312016航空レーザ傾斜量図を用いた斜面・土石流危険箇所抽出の試み17ENShigeyukiSuzukiGraduate School of Natural Science and Technology, Okayama UniversityMasashiMiyashitaWESCO co.TakeshiHirakawaWESCO co.MiekoFujiwaraWESCO co.SatoshiNishiyamaGraduate School of Environmental and Life Science, Okayama University10.18926/ESR/55321 The slope gradation map which is obtained from airborne laser scanning is very important tool to detect hazardous sites of landslide, debris flow and others. The features of the images (what the images are represented) in the map were confirmed by field survey. The study area, Tamagashi is situated in the Kibi Plateau area, Okayama City, Japan. The map helps to distinguish between artificial microrelief and natural microtopography very well. Small scarps (even 0.5m high), rocky cliffs and large blocks (larger than 2m) are identified in the map. The detail images of the microrelief suggest threatening sites. The merit of the map leads us to find the site in the field easily. We will not miss the threatening sites by using the map.No potential conflict of interest relevant to this article was reported.InTechActa Medica Okayama2016Bioethics and the Experiences of Hansen’s Disease Survivors69105ENMarikoKondoGraduate School of Health Sciences, Okayama University.KazuoMoriNational Hansen’s Disease Sanatorium Residents’ Council, National Sanatorium Oshima-Seisho-enHiroshiNomuraNational Hansen’s Disease Sanatorium Residents’ Council, National Sanatorium Oshima-Seisho-enHanakoKadowakiNational Sanatorium Oshima-Seisho-enMakikoWatanabeNational Sanatorium Oshima-Seisho-enAkemiDoiNational Sanatorium Oshima-Seisho-enSayakaShimaYodogawa Christian HospitalHistorically, Hansen’s disease patients suffered from discrimination because their physical features changed due to the bacterium Mycobacterium leprae (M. leprae) and made them “ugly” in the eyes of society. Former Japanese governments saw them as a national disgrace and forced them to reside in leprosaria. Since the law requiring isolation continued after the silver bullet was developed, survivors could not leave the leprosaria and return to society. Currently, survivors’ average age is 82 and they live in 13 national sanatoriums. When they pass away, the history of Hansen’s disease in Japan will end, so we must record their experiences. We conducted qualitative and inductive studies with survivors. In this chapter, we reconstruct them from the perspective of bioethics and propose several theories surrounding them: (1) How former leprosaria and medical administrations in Japan threatened bioethical principles; (2) the wisdom of aging survivors, who lived through extreme situations, and what real restoration of their rights might look like; and (3) the ethical dilemmas of how we will care for the survivors―who have multiple severe sequelae―until they all pass away. Finally, we will introNo potential conflict of interest relevant to this article was reported.岡山大学大学院文化科学研究科Acta Medica Okayama1880-9162162017清国貿易による海外飛躍を目指した一日本人の実像 : 福岡県直方市の向野堅一記念館は何を目指すか3141ENMasahiroKohno10.18926/54955No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812912017薬物相互作用 （ 38 - 新規睡眠薬 : ラメルテオン, スボレキサントの相互作用）5357ENKazukoKuboDepartment of Pharmacy, Okayama University HospitalSatoruEsumiDepartment of Pharmacy, Okayama University HospitalYoshihisaKitamuraDepartment of Pharmacy, Okayama University HospitalToshiakiSendoDepartment of Pharmacy, Okayama University HospitalNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812912017骨盤臓器脱に対するTVM 手術前後の性機能に関する検討1722ENYukoMatsumotoDepartment of Urology, Okayama University Graduate School of Medicne, Dentistry and Pharmaceutical Sciences We prospectively assessed sexual function before and after a tension-free vaginal mesh ( TVM) procedure for pelvic organ prolapse ( POP) . From April 2007 to March 2009, a total of 42 patients, who reported having an active sex life preoperatively underwent TVM for POP. Female sexual function was evaluated with the self-reporting, multiple-domain Female Sexual Function Index (FSFI) . We administered the FSFI to all of the patients before and at 3, 6, and 12 months after surgery. The mean age at surgery was 61.3±7.1 years. Before the TVM surgery, the FSFI score was very low ( 12.5±9.0) . The total FSFI score was improved significantly at 12 months after surgery ( 17.4±7.7) . The Arousal, Lubrication and Orgasm domains were significantly improved at 12 months after surgery. POP appears to have a significant negative impact on female sexual function. Our findings indicate that TVM for POP improved sexual function in a group of Japanese women with POP.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812832016模擬患者（SP）参加型教育の実践221225ENToshikoYoshidaCenter for the Development of Medical and Health Care Education（ Dental Education）, Okayama UniversityNo potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30694732016平成の市町村合併の効果に関する考察141154ENSayuriNishida10.18926/OER/54164No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30694722016Value Relevanceとは何か129140ENToyotakaNakagawa10.18926/OER/54148No potential conflict of interest relevant to this article was reported.岡山大学法学会Acta Medica Okayama0386-3050653・42016組織再編成における課税関係の継続と断絶9491004ENMasahiroKOZUKAGraduate School of Humanities and Social Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812812016原発性十二指腸粘液癌の一例― 本邦報告16例の検討―2125ENIkumiHamanoYusukeMatsumotoYoshikatsuEndoNaokiWatanabeKyouheiKaiShizouSatoYojiWani Primary mucinous adenocarcinoma of the duodenum is rare. Here we report a case we recently encountered, and we review 16 cases reported in Japan. An 82-year-old Japanese woman was admitted to our hospital complaining of abdominal pain and heartburn. An endoscopic examination revealed a Type 2 tumor in the descending limb of the duodenum, and endoscopically obtained specimens revealed a poorly differentiated adenocarcinoma. We performed a curative pancreatoduodenectomy with lymph node resection, and the surgical specimen revealed that the duodenum was the primary site of the mucinous adenocarcinoma. The patient is currently alive ＞ 1 year after the operation without any evidence of recurrence. Of the 16 patients reviewed, all patients had advanced tumors those depth were T3-T4. 9 patients had lymph node metastasis and 4 patients had peritoneal dissemination at the time of surgery. Since mucinous adenocarcinoma of the duodenum is often progressive cancer at a diagnosis, which is tend to have a worse prognosis than other histological types.No potential conflict of interest relevant to this article was reported.岡山大学文学部Acta Medica Okayama0285-4864492008スキナー以後の心理学(18): 「したいことをする」と「しなければならないことをする」1329ENYoshinoriHasegawa10.18926/okadai-bun-kiyou/53884No potential conflict of interest relevant to this article was reported.日本静脈経腸栄養学会Acta Medica Okayama1344-49802942014粉砕法による経管投与における薬剤量損失に対する簡易懸濁法の有用性についての検討10271033ENYoshitoZamamiToshihiroKoyamaTetsuyaAibaManabuAmanoTetsuakiAndoNaomiKurataHidekiNawaHironoriNakuraYoshihisaKitamuraToshiakiSendo【目的】従来の薬剤経管投与法である粉砕法は薬効の減少につながる薬剤量の損失が指摘されている。そこで粉砕法による薬剤量損失に対する簡易懸濁法の有用性について検討した。
【方法】頻繁に粉砕指示がなされる5種類の薬剤を用いて粉砕・分包による薬物含量減少、薬剤調製時の懸濁性および実際の経管投与を想定した薬物含量について2つの方法を比較した。
【結果】薬剤を粉砕・分包するとそれぞれの薬物含量は減少した。またワーファリン®錠を粉砕して水に溶解すると完全には懸濁せず、小さな塊が生じたが、簡易懸濁法では均一に懸濁した。ワーファリン®錠の経管投与を想定した実験において粉砕法では薬物含量が大幅に減少したが、簡易懸濁法では、ほとんど損失が認められなかった。【結論】簡易懸濁法は粉砕法に比べて薬剤損失の面で有用性が高いことが示唆され、ワーファリン®錠のように安定性が悪い薬剤では特に適正な薬物投与に貢献出来ると考えられる。No potential conflict of interest relevant to this article was reported.岡山実験動物研究会Acta Medica Okayama312015抗体の分子進化（親和性成熟）の研究： 面白い結果は思いがけなく訪れる23ENHitoshiOhmoriAntibodies are unique proteins in that they improve their affinity for antigens during
antibody responses. This process termed “affinity maturation” is the result of random
hypermutation of immunoglobulin genes in B cells followed by selection of the clones that acquired
high-affinity antibodies. However, what mechanisms are responsible for the induction of
hypermutation and the subsequent B cell selection in germinal centers has remained unknown in
many respects. I would like to talk about our long-lasting studies on these immunologic
mechanisms focusing on the functional role of follicular dendritic cellsNo potential conflict of interest relevant to this article was reported.岡山大学大学院文化科学研究科Acta Medica Okayama1880-9162132014東アジア飛翔人材に求められるものとは316ENMasumiOka10.18926/52361No potential conflict of interest relevant to this article was reported.岡山大学国際センター, 岡山大学教育開発センター, 岡山大学言語教育センター, 岡山大学キャリア開発センターActa Medica Okayama1881-595292013Reflective Practice for Professional Development: A Preliminary Consideration of What We Can Learn about Teaching from Movies about Teachers155168ENIanNakamura10.18926/52199 This exploratory study will begin with a review of cinematic portrayals of teachers
and their situations by establishing three categories: thought-provoking stories of
teachers and students trying to overcome social barriers, entertainment first productions
with an uplifting resolution of conflict, and documentaries that track the real-life
struggles and successes of educational practitioners and their students through projectbased
training and performance. Then I will use forms of reflective practice and
discourse analysis to delve deeper into the details of teaching and context. This working
paper will conclude with some thoughts on what ‘good’ teachers do.No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671362013消滅の技法（１）― Daniel Quinn, Maria Turner, Sophie Calleを手がかりに119ENHitomiNakatani10.18926/52094No potential conflict of interest relevant to this article was reported.岡山大学文学部Acta Medica Okayama0285-4864602013「連帯」とは何か ―アジア主義の理論解析―118110ENKeshiJiang10.18926/okadai-bun-kiyou/52051No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812532013横行結腸憩室穿通による腸間膜膿瘍に対して手術を施行した２症例235238ENNaoakiMaedaHidenoriKondoWe encountered 2 cases of penetration of fecal matter through a diverticulum of the transverse colon, which is a rare disease. Case 1 was a 33-year-old man who was examined in the clinic with a complaint of epigastralgia. Tenderness and muscular defense were found in the upper abdomen. On abdominal CT examination, wall thickening and increased fat concentration were seen in the transverse colon. He was diagnosed with peritonitis and underwent emergency surgery. On laparotomy, a tumor mass was found in the transverse colon close to the liver curvature. The patient was diagnosed with mesenteric abscess due to penetration of fecal matter through a diverticulum of the transverse colon. Right hemicolectomy was carried out. Case 2 was a 43-year-old woman who was examined in the clinic with a complaint of right lower abdominal pain. Muscular defense and rebound tenderness were found in the lower abdomen. On abdominal CT examination, abscess formation was seen in the right lower abdomen. She was diagnosed with peritonitis and underwent emergency surgery. On laparotomy, a tumor mass was found in the transverse colon. The patient was diagnosed with mesenteric abscess due to penetration of the transverse colon associated with a diverticulum. Partial removal of the transverse colon was carried out.No potential conflict of interest relevant to this article was reported.岡山大学大学院文化科学研究科Acta Medica Okayama1880-9162122013もしFanshaweが日本人だったら ― Paul Austerの言語探究者の自殺をめぐって ―2137ENHitomiNakatani10.18926/49540No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-132332013今，岡山の学校教育は 中学校現場で起きていること，そして改善に向けて19ENHideakiIwadou10.18926/CTED/49481 文部科学省の調査（児童生徒の問題行動等生徒指導上の諸課題に関する調査H24）によると，岡山県内の小・中学校の暴力行為，不登校の出現率が全国比較では大変高く，学力・学習状況調査でも国語，数学ともに通過率が低いことが報告され，憂慮される事態にある。その原因は複雑多岐に渡っており，教育委員会や学校現場は解決に向け総力をあげて取り組んでいるが、大変困難な状況が見られる。県下の教育関係者すべては当事者意識と責任をもってかけがえのない一人ひとりの子どもたちに焦点を当てた本来の教育を再生することが急務である。
私は，平成23年3月に中学校長を最後に定年退職し，現在は教育現場を離れているが，現役時代（幼・小・中学校・特別支援学校）を自己反省する意味も含め，中学校を中心としてその現状と改善に向けた方策についてまとめてみた。No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231522013『ダニエル・デロンダ』22章を読む： オースティンの遺産とエリオットの創造1121ENShintetsuFukunaga10.18926/bgeou/49306The present paper aims at making clear how George Eliot owes a debt in style to
Jane Austen in her character portrayal. Taking up Austen’s Emma and Eliot’s Daniel
Deronda, we consider the qualities of prose style that are characteristic of the respective
writers as seen in these novels. A comparative analysis of their discourses has brought
to light a marked tendency on both sides to use negative expressions and the subjunctive.
These common traits are surmised to meet an artistic challenge of creating ambiguity
in the characters’psychological situations. Eliot, while inheriting Austen’s stylized
English, utilizes scientific phraseology to give voice to the human drama in late
nineteenth century England. Thus she adds physiological dimensions to what Austen has
established. We attempt to prove this point on the basis of discourse analysis.No potential conflict of interest relevant to this article was reported.岡山大学国際センター, 岡山大学教育開発センター, 岡山大学言語教育センター, 岡山大学キャリア開発センターActa Medica Okayama1881-595282012中級日本語学習者が望む学習とは何か −高等教育機関におけるアンケート調査−6172ENYukakoUchimaru10.18926/49291本稿は，アンケート調査を通じて高等教育機関で学ぶ学習者の中級レベルに対する学習
ニーズを明らかにすることを目的とする。アンケート調査結果は４点にまとめられる。（１）
教科書の説明および内容：初級に比べ評価が低くなる。母語による解説が望まれている。
（２）学習項目：アカデミックな日本語，日常生活での日本語の両方に対するニーズがある。
会話学習への要望が最も多く，次いで文法・文型，語彙が同数だった。（３）教え方に対
する要望：@既習表現と比較しながら説明する。A文型・表現は共通する意味・用法でま
とめて効率的に教える。B文型・語彙の硬さ・柔らかさの区別を示す。（４）教室活動に
対する要望：短い会話練習，作文，ゲーム要素を取り入れた練習も増やす。No potential conflict of interest relevant to this article was reported.American Society for Clinical InvestigationActa Medica Okayama0021-9738119102009A simple biological imaging system for detecting viable human circulating tumor cells31723181ENToruKojimaYuuriHashimotoYuichiWatanabeShunsukeKagawaFutoshiUnoShinjiKurodaHiroshiTazawaSatoruKyoHiroyukiMizuguchiYasuoUrataNoriakiTanakaToshiyoshiFujiwaraThe presence of circulating tumor cells (CTCs) in the peripheral blood is associated with short survival, making the detection of CTCs clinically useful as a prognostic factor of disease outcome and/or a surrogate marker of treatment response. Recent technical advances in immunocytometric analysis and quantitative real-time PCR have made it possible to detect a few CTCs in the blood; however, there is no sensitive assay to specifically detect viable CTCs. Here, we report what we believe to be a new approach to visually detect live human CTCs among millions of peripheral blood leukocytes, using a telomerase-specific replication-selective adenovirus expressing GFP. First, we constructed a GFP-expressing attenuated adenovirus, in which the telomerase promoter regulates viral replication (OBP-401; TelomeScan). We then used OBP-401 to establish a simple ex vivo method that was able to detect viable human CTCs in the peripheral blood. The detection method involved a 3-step procedure, including the lysis of rbc, the subsequent addition of OBP-401 to the cell pellets, and an automated scan using fluorescence microscopy. OBP-401 infection increased the signal-to-background ratio as a tumor-specific probe, because the fluorescent signal was amplified only in viable, infected human tumor cells, by viral replication. This GFP-expressing virus-based method is remarkably simple and allows precise enumeration of CTCs.No potential conflict of interest relevant to this article was reported.岡山大学法学会Acta Medica Okayama0386-30505512005Shifting Japanese Party Politics after the End of the 1955 System −An Analysis of What Some Aggregate Data Indicate−246230ENSatomiTaniNo potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1880-847692012経済成長の「中国モデル」は存在するか111ENYuhuiWu10.18926/48332No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-132322012持続可能な社会についての認識形成をめざす小学校環境学習単元開発研究―世代間の公平性に着目して―8291ENAkiraMoriyaToshinoriKuwabara10.18926/CTED/48196本研究は、小学校環境学習において持続可能な社会についての認識形成を図る授業構成の原理と、それをふまえた具体的な授業プランを提案しようとするものである。持続可能な社会を論じる視点はいくつか考えられるが、本研究においては、世代間の公平性に着目し、それを実現し得る社会とはどのようなものか、そのために何が必要かを児童自身に考えさせる授業を提案していく。授業の題材は、倉敷美観地区の伝統的な町並み保存活動である。その活動を支えているものは何か、活動は何を目指しているかを捉えさせることで先の目標を達成していきたい。No potential conflict of interest relevant to this article was reported.Faculty of Engineering, Okayama UniversityActa Medica Okayama1349-6115462012Optimal Computation of 3-D Similarity: Gauss-Newton vs.Gauss-Helmert2133ENKenichiKanataniHirotakaNiitsuma10.18926/48127Because 3-D data are acquired using 3-D sensing such as stereo vision and laser range finders, they have inhomogeneous and anisotropic noise. This paper studies optimal computation of the similarity (rotation, translation, and scale change) of such 3-D data. We first point out that the Gauss-Newton and the Gauss-Helmert methods, regarded as different techniques, have similar structures. We then combine them to define what we call the modified Gauss-Helmert method and do stereo vision simulation to show that it is superior to either of the two in convergence performance. Finally, we show an application to real GPS geodetic data and point out that the widely used homogeneous and isotropic noise model is insufficient and that GPS geodetic data are prone to numerical problems.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155840121928脾臟ト甲状腺トノ交互作用ニ關スル研究 第4囘報告 脾動靜脉ノ白血球,血色素,網状赤血球等血液成分竝ニ造血臟器ノ組織像ニ就テ24652475ENYoshitoTsunashimaHaving studied, as mentioned in the previous report, the changes of blood-platelets in the splenic arteries and veins, I extended my investigation into white corpuscles, hemoglobin and reticulated red cells: and with the object of ascertainning what their changes mean, I carried out an histological research of the spleen, the liver and the bonemarrow in the above-stated procedures and came to the following conclusions. 1) In the case of a normal rabbit, the number of the white corpuscles especially the lymphocytes in the splenic veins exceeds that in the splenic arteries. 2) After thyroidectomy and the injection of phenylhydrazin the white corpuscles in splenic veins increase more remarkably than those in splenic arteries, the lymphocytes and monocytes also showing a remarkable augmentation. 3) When adrenalin or silver-elecroid is injected, the white corpuscles in splenic veins outnumber exceedingly those in splenic arteries. When adrenalin is injected, the lymphocytes and monocytes increase especially. When silver-elecroid is injected, the augmentation of the lymphocytes is not comparatively remarkable, while on the other hand, the pseudoeosinophile-leucocytes increase. 4) In the case of a normal rabbit, as well as in that where the thyroidectomy is performed, a greater quantity of hemoglobin is found in the splenic veins than in the splenic arteries, and it is especially so when phenylhydrazin is injected. But the continuous injection of silver-elecroid does not cause any remarkable change of the contents of splenic veins and arteries. The quantity of the hemoglobin fluctuates almost in the same way as the number of the red blood corpuscles does. 5) No remarkable change of the reticulated red cells occurs in splenic arteries and veins. 6) After thyroidectomy and the injection of phenylhydrazin, the appearance of the megacaryocytes in the spleen is demonstrable, but no remarkable change occurs in the liver. 7) Thyroidectomy gives rise to the atrophy of the bone-marrow, the proliferation of adipose tissue and the decrease of megacaryocytes. A similar tendency is recognizable when phenylhydrazin is injected. 8) From these above-stated blood pictures of the splenic arteries and veins, as well as the histological researches of the blood-making organs, it may be inferred that from thyroidectomical causes, the spleen regains, in a compensatory sense, its blood-making function outside the bone-marrow.No potential conflict of interest relevant to this article was reported.Faculty of Engineering, Okayama UniversityActa Medica Okayama0475-00713712002For Geometric Inference from Images, What Kind of Statistical Model Is Necessary?1523ENKenichiKanatani10.18926/46969In order to facilitate smooth communications with researchers in other fields including statistics, this paper investigates the meaning of "statistical methods" for geometric inference based on image feature points, We point out that statistical analysis does not make sense unless the underlying "statistical ensemble" is clearly defined. We trace back the origin of feature uncertainty to image processing operations for computer vision in general and discuss the implications of asymptotic analysis for performance evaluation in reference to "geometric fitting", "geometric model selection", the "geometric AIC", and the "geometric MDL". Referring to such statistical concepts as "nuisance parameters", the "Neyman-Scott problem", and "semiparametric models", we point out that simulation experiments for performance evaluation will lose meaning without carefully considering the assumptions involved and intended applications.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155842121930人臍帯血管及ビ胎盤血管ノ藥理學的研究 第1囘報告 植物性神經毒ノ作用ニ就テ30593080ENKensukeMurakamiThis paper deals with pharmacological studies of the blood vessels of the human umbilical cord and placenta, for the purpose of investigating the innervation of those vessels and their pharmacological reactions, a matter which is as yet not established. In the research on this subject, the following results were obtained: 1. Adrenalin manifests vasoconstrictor action on the arteries of the umbilical cord and placenta, as well as on the vein of the cord. Also this action may be depressed or reversed by the use of atropin or ergotamine. Adrenalin in high concentration causes all of these vessels to dilate, while the vein of the placenta is dilated by adrenalin in any degree of concentration, within the limits of an efficient dose. The constrictor and dilator action of this drug on the blood vessels is understood to be due to the stimulation of the motor and inhibitory fibres of the sympathetic nerve respectively. 2. Acethyl-cholin acts as vasoconstrictor on the arteries of the cord and placenta. This action may be attributed to the stimulation of the parasympathetic nerve, as it is antagonized by a small dose of atropin. This suggests that the arteries of the cord and placenta are innervated by the vasoconstrictor fibres of the parasympathetic nerve. Despite these facts, it was not possible to recognize the vasoconstrictor action of acethylcholin on the veins of the cord. and placenta. Acethyl-cholin in high concentration dilates both kinds of the blood vessels of the cord and placenta. This dilating action is due not to the paralysis of the muscles of the vessels, but probably to the stimulation of the vasodilator fibres of the sympathetic nerve. 3. The action of pilocarpin on the blood vessels of the umbilical cord and placenta is to dilate them, and its point of attack seems to be the vasodilator of the sympathetic nerve. The effect of this drug on the parasympathetic nerve in these vessels was not observed in this experiment. 4. Physostigmin shows itself to be a vasoconstrictor on the vessels of the cord and placenta. It affects the muscles chiefly and the parasympathetic nerve of the vessels to some extent. 5. Atropin by itself does not have any definite action on the vessels of the cord and placenta, but it can depress the effect of acethyl-cholin by a very small dose, and it can also depress or reverse the effect of adranalin by a larger dose. So, it is clearly seen that the parasympathetic nerve and the motor fibre of the sympathetic nerve are paralyzed by a certain concentration of atropin, but the inhibitory fibre of the latter is not influenced by this drug. Atropin in very high concentration dilates these vessels, owing to the paralysis of the muscle. 6. From the facts learned in this research regarding the pharmacological reactions, it may be concluded that the arteries of both umbilical cord and placenta are innervated by the vasoconstrictor fibre of the sympathetic and parasympathetic nerves, and the dilatation of these vessels is controlled by the dilator fibre of the sympathetic nerve. The existence of the constrictor fibre of the parasympathetic nerve in the vein of the cord could not be proved. The sympathetic constrictor in the vein is inferior in its developement to the same in the artery. In the vein of the placenta, it was not possible to confirm the innervation of the vasoconstrictor of either the parasympathetic or the sympathetic nerve. 7. The arteries of the umbilical cord and placenta show similar pharmacological reaction to the drugs. Therefore it may be concluded that they are under the same innervation. The vein of the placenta reacts to the drugs in a somewhat different way from what the arteries do. The action of the drugs on the vein of the cord coincides partly with the action observed on the arteries, and partly with that on the placental vein. 8. These embryonic blood vessels manifest nearly the same pharmacological reactions as in the general blood vessels of the body, though there is more or less difference between them.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155849111937岡山縣下ニ於ケル腸チフス豫防ニ對スル異種菌經口免疫實施成績ニ就テ23232333ENM.ShimizuY.MikiK.AsanumaK.AbeF.MiyagawaS. Murakami, Y. Miki, and F. Miyagawa proved that there is a remarkable output of heteroantibody against typhoid, paratyphoid A and B, and dysentery bacilli in the animal experiment, they proceeded in 1934 to experiment with cocktyphoid-bacilli which had been obtained from cocks that had died of cocktyphoid. They were also highly successful in bringing about a state of immunity from typhoid when applying the same bacilli to rabbits. We therefore resolved to use it upon human beings, and put it into practice, per os, with 9252 peoples in all, in April, 1936. Those treated were ordinary citizens and factory-hands.
As to the result, we knew that we might disregard such by-effect of the vaccinationstomach-ache, headache, diarrhoea, etc. -as we found in a mild form. When, at the end of the November of the same year, we investigated the cases of 7486 of those who had been thus vaccinated whit a view to ascertaining if there had been any outbreak of typhoid, paratyphoid A and B, or dysentery (for we cousidered that the vaccine has some influence on the latter disease also), we found among the workmen-class no outbreak of the above-mentioned diseases in the case of those who had taken the cocktyphoid-vaccine, while there were 2 dysentery patients among those who had taken Heterogen. In the case of the ordinary citizens there had occurred one typhoid and one dysentery case among those who had taken bile and the cocktyphoid-vaccine. The number of victims was, moreover, far less than among those who had not been vaccinated. What is more, the patients made very good progress. Thus we believe that the cocktyphoid-vaccine may be successfully applied orally to the human body. As for its effect upon dysentery, we consider that this should be made the subject of further study in the future.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155850119381. Vitamin Cト細胞分裂誘起線 2. 腦下垂體前葉及ビ脾臟浸出液ノ酵母菌増殖ニ及ボス影響3. 2, 6 Dichlorphenolindophenolノ筋肉ニ對スル作用147153ENKenitiKawamuraThe results of the author's experiments are roughly as follows:
1. When tested according to the yeast method, it is doubtful whether vitamin C generates "Mitogenetische Strahlen" when it is oxidized. But when there is a large amount of oxidizable substance, the radiation is sure to occur. 2. What influences have the extracts of the anterior lobe of the pituitary gland, and of the spleen on the increase of yeasts? When this was tested the former was seen to accelerate their multiplication while the latter on the yeast checks it.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587611-121964犬腎培養細胞による麻疹ウイルスの研究 第2編 麻疹ウイルスに対する犬腎細胞と各種培養細胞との感受性及び病理形態学的変化の比較647654ENTakeoUtsumiA comparative study on the susceptibility of measles virus and pathological changes of cells in culture was carried out with dog kidney cells and many other cultured cells by inoculating measles virus into the media of cultures. As the result it was found that FL cells and HeLa cells demonstrated the highest infectivity, followed by that of dog kidney cells. Monkey cells (MS cells) and human amnion cells (JJC-3 cells) also showed a fair degree of infectivity to measles virus (the report on such cells has not yet been made public). On the other hand, L cells and hamster kidney cells, what had been generally reported to be readily infected by measles virus were found to show a low infectivity only, indicating them to be not suitable cells for such a study.
In the case of dog kidney cells infected with measles virus, viral proliferation could be observed clearly during the period 4 to 7 days after the inoculation.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155866121954流行性肝炎の疫学研究 第2報 赤磐地区における流行性肝炎の疫学観察（其の二）23572362ENKiyowoKosakaKeitaroSetoToshioYuasaShigemiOginoKazuhikoInuiMasaoIwaharaMasuoHinoNaokiYamamotoTatsuoIshidaComparing the epidemic of infectious hepatitis that took place in Toyoda, Onoda, as well as Kumayama in Akaiwa County, during the period ranging from march 1951 to sept. do., with the previous report on the epidemic of malignant hepatitis submitted by february 1951, following results were obtained: 1. Number of patients, 120; total ever since the first. occurence, 213 cases; For the total populace, rate of occurence, Toyoda-39%, Onoda-3.1%, Kama-mura, 2.4%. 2. As for the type of disease. contrary to the previous occasion in which typical form was predominant, this time saw the predominaney of abortive form, of which the mortality rate proved only 0.83%, in comparison to 13.9% estimated in the former time. 3. As for state of starting estimated by month, as previous occasion, maximum occurrence took place in July and August. 4. As for age, showing similar trend as before, 21-30 occupying most cases, evenly has diffused from 10 to 60. There were actually 7 cases that were above 61, which verifies that contamination in old age is not so seldom. 5. As has been in the previous occasion, as to state of contamination, what may be called village infection occupied the majority of cases; where, a special increase of familiary infection has drawn our attention, amounting to the rate of 38.3%, in comparison to former 20.4%, Which, as the infection spread itself, increases in number. 6. Familiary infection may be explained by propagated epidemic form. Its three cases had been delivered. 7. On taking a bird's'-eye-view over the whole area that was infected, the special phase for this season will come under two heads; area in which new patients have emerged around those affected formerly., and the other, which has been contaminated with a fixed current toward areas not yet. infected. The latter is considered to take shift into the former form after a while. 8. Though rare, sporadic infection could be found in this epidemic too, each of which was a case infections being pressed onward into uncontaminated area, and 6 out of 9 cases have become the source for later infection. If theses poradic infections were considered in detail, these would be clear to have a connection with that of epidemic places and also able to come under propagated epidemic form.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586681954アミラーゼ作用に及ぼす「レ」線の影響17031712ENMitsuharuKoreedaIn order to clarify what change might occur to starch saccharification in case 80, 200, or 400r X-Ray has been applied immediately after mixing of starch, taka-diastase and buffer-solution, we have conducted experiment, employing 5.0 and 20.0 cc respectively of 2.0, 1.0 as well as 0.5% starch solution, together with 1.0 and 4.0 cc each of 1.0, 0.5 and 0.1% taka-diastase solution, and obtained the following conclusions; 1) The starch saccharification of taka-diastase is to be either activated or inhibited due to the doses of the applied X-Rays, i.e., activated at 80r iradiation, while, inhibited at 200 and 400r. 2) In case auy starch saccharification due to taka-diastase should reach its limit the quantity of glucose in saccharification solution indicates none of effects shown in cases when 80, 200, and 400r have been iradiated. 3) The effect of X-Ray on starch saccharification of taka-diastase appears rather poignantly in areas of low-concentration (from 0.1 to 1.0%). Also, if we compare 80r (activated case) with 200 & 400r (cases of inhibition), the cases of activation seem to have been influenced more strongly than in cases of inhibition. 4) When X-Ray has been iradiated on the mixture of taka-diastase, starch and buffer solution, the percentage both of decrease as well as increase that has happened to the supar quantity within 3 hours after the iradiation, proves greater than that observed 6 hours later. 5) If the concentration of starch and taka-diastase solutions proves equal, in case these quantities have been augmented 4 times, almost no difference whatever should occur to the chnges of sugar quantity percentage.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586651954レ線の酵素作用に及ぼす影響 レ線の蓄積作用に就いて883885ENShizuoImamuraPreviously the author carried out experiments on the effects of X-irradiation upon enzyme activity and found that X-irradiation with small doses increases catalytic activity of enzyme, that middle doses inhibits, and what is influenced by X-rays is enzyme itself and not the substrate. Therefore, in order to clarify whether catalytic activity might be increased additionally, or be accumulated gradually until it might have inhibited the enzyme action as well as one middle dose, in case it has reached one middle dose by repeating several small doses with certain interval, so that it should reach irradiation due to one middle dose or not, using papayotin as an enzyme, gelatin as a substrate and the amount of non-protein nitrogen which increased by the gelatin decomposition, was measured. Then the author assured that when irradiation with small doses reached to middle dose by fractional irradiation same as one time of irradiation with middle doses enzyme action was inhibited and X-irradiation accumulated gradually within enzyme.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586631954アミラーゼ作用に及ぼす単糖類の影響471478ENMitsuharuKoreedaTo investigate what effects would be brought about on starch saccharification by adding certain monosaccharides, we have given 1.0 cc of 1.0% taka-diastase solution to 2.0% starch solution 5.0 cc; moreover. have conducted some saccharification tests by adding 1/1000, 1/100, 1/10 and 1.0 mol solution of glucose, galactose, fructose or mannose, and obtained the following results. (1) The starch saccharification by taka-diastase has been inhibited by an addition of the above-mentioned monosaccharide; especially, most marked in the case of glucose addition, next, galactose, then fructose and mannose, the last being feeblest of them all. After that, we have paid observations on this inhibition degree as well as on the kind of monosaccharides, in comparison with certain structural formulas ascribed to various saccharides. (2) In case 1/1000 mol solution 1.0 cc (the content of each saccharide is 0.18 mg in all cases) is added, in either case where 1.0% taka-diastase solution 1.0 cc or 2.0% starch solution 5.0 cc is concerned (which is same to the bottom), suffer no effect on its saccharification; yet, it has been inhibited considerably in case 1/10 mol solution 1.0 cc (the content of each monosaccharide 18.00 mg) has been added, and has been inhibited to a great degree in case 1.0 mol solution 1.0 cc (the contenl of each monosaccharide 180.00 mg) has been added; on the other hand, in view to an addition of 1/100 mol solution 1.0 cc (the content of each monosaccharide 1.80 mg) it is thought almost out of question on account of very slight difference it has proved against the controls, which is hard to detect any inhibition. At any rate, from 1/1000 to 1.0 mol solution 1.0 cc, i.e., within the range of from 0.18 to 180.00 mg., as the amount of saccharide added becomes greater, the starch saccharification by taka-diastase has proved more and more to suffer inhibition. (3) The content of glucose, galactose, fructose or mannose in each 1.0 mol solution 10 cc being 180.00 mg, corresponds to 1.83 times the amount of the final product of starch hydrolysis (by Liebermann's method), i.e., 98.22mg.; even if such a comparatively considerable amount of monosaccharicde as this is added, there takes place no inhibition whatever for the early stage of starch saccharification. (4) The inhibition of starch saccharification caused by taka-diastase may be, not only owing to glucose, galactose, fructose or mannose, but also owing to various kinds of intermediate products formed in saccharification solution, which have power to thwart starch saccharification caused by taka-diastase.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558673-41955人体に於ける電気災害に由る聽器障碍例に就て749751ENMasuoUetsukaThere are two types in human auditory disturbances owing to electric disasters, one of which is what one may call immediate injury, appearing on the heel of those disasters; the other, used to appear days or months after disaster, and often spoken of as after injury. The author have had chance to take a survey of 4 cases that suffered violent electric disaster. 1) 65 years-old male; has become victim to A. C. 300V. immediately after the event, felt right-ear tinnitus, slight vertigo and tendency to fall down on the right side. Though he could recover in a few days from symptoms, a tinnitus as well as difficult-hearing of right ear began a year afterward. By examination, it has been proved that his right ear had a marked auditory disability in the area higher than c(2) and complete deaf at c(6). 2) 50 years-old male; experienced 4 electric shocks, i. e.,
A. C. 3.300V. 3 times; A. C. 60.000V. once.
In every time, he felt an obstruction feeling of ear, tinnitus, as well as vertigo after the disaster. These symptoms disappeared spontaneously in a few days, and at present he enjoys normal hearing. 3) 20 years-old male; struck with A. C. 3.300V. No otologic symptoms felt after the accident. At present, his hearing is normal. 4) 28 years-old male; struck with A. C. 3.300V. No sensible diorder happened. At present, normal hearing. Cases 1) and 2) may be said as immediate injuries due to electric disaster, and Case 1) may be considered to have induced after injury besides.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586711955実験的化膿性骨髓炎発生に関する研究 第1編 骨の血管構造について231238ENShigeruTomochikaThis experiment was planned to study to see at what part of the metaphysis osteomyelitis purulenta started, how it developed, and what course it took. The femur of young rabit was used in this experiment and the normal blood vessel system in the femur was clarified.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586711955骨髓埋沒に関する実験的並に臨床的研究 第1編 骨髓埋沒による血液像の変動と鉄代謝及び網内系機能との関係115135ENTakuyaOkanoIncrease of blood cells, decrease of serum iron quantity and a slight degree of over-function of reticuloendothelial system will be induced, by transplantating some suitable amount (Prokg. 0.5g) of bone marrow in a dog's subfascia of femur. This has been caused in urging to utilize the accumulated iron owing to promotion of hematopoetic fanction; if we investigate it about organic iron, when the blood showing an increase, ferritin in the spleen showed a tendency toward decrease, but the deposits of hemosiderin in tissue has proved little alteration from its normal state, Contrary to this, any decrease in serum iron observed under infected state, would rightly be ascribed to the retained stock of iron due to excessive function of reticuloendothelial system, due to protecting infection; esp., what comes from the absorption and deposits of hemosiderin produced along with excited breakage of hemoglobin, or resulted from imperfect utilization of iron, in hematopoetic organs; so that, there is seen certain essential differences between the excessive function of reticulo endothelial system when hematopoetic organs is stimulated, and decrease in serum iron; further, on occasion when hematopoetic function is urged according to the bone marrow transplantation, we could realize that a close connection exists between the iron metabolism and function of reticuloendothelial system: at the same time, could verify partly the mechanism in creating blood cells the occasion.No potential conflict of interest relevant to this article was reported.岡山大学環境管理センターActa Medica Okayama0917-1533312009東アジア気候環境とその変調を捉える視点の育成へ向けた学際的授業開発の取り組み（多彩な季節感を接点に）920ENKuranoshinKatoHarukoKatoAkioBetchakuTo the change in the global environment, such as the Global Warming, regional climate systems will show rather different response from region to region. It is necessary for many people to be able to remark, as early as possible, what kind of regional climate change is going on, in order to mitigate the climate change itself or coming damage of the change in each region. In East Asia, the complicated seasonal variations are seen influenced by the Asian monsoon, resulting in the variety of "seasonal feeling". The present paper will discuss on the joint activity of
meteorology with music, and so on, toward development of students' sensitivity to the climate change in East Asia with attention also to the "seasonal feeling". Firstly, some important viewpoints for understanding the seasonal cycle of climate systems in East Asia will be reviewed. We will also review the rapid temperature increase around the beginning of April in the Japan Islands in association with the "seasonal feel ing", together with the reports of a lecture on that topic in a primary school. Next, another lecture on the seasonal cycle in East Asia and its climate change there
in the secondary school will be reported. Finally, the future joint research plan will be discussed.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155869101957大黒鼠脳組織呼吸の活性化エネルギー 第1篇 未処置大黒鼠全脳ホモジネート呼吸酵素系の活性化エネルギーについて25112518ENSeigoUsuiThe author measured the activation energy of the respiration of whole brain homogenate of rats by a Warburg's manometer and obtained the following results. The oxygen absorption of the whole brain homogenate of rats under the experimental conditions was determined following the Arrhenius equation; and the activation energy was found to be about 11, 000 ± 500 cal. However, with what reaction this value might be associated remains still uncertain.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586981957岡山県北部山間地方に続発した「ビールス」肺炎に就いて21052110ENMichioYamamotoTamotsuTaziriHiroshiKawaharaSadaoFunabikiMasaoEgawaSoichiNishishitaEver since June 1956 mainly centering around Hayashino, Mimasakacho, the mountain regions in the northern part of Okayama Prefecture we have frequently encountered virus pneumonia which by their roentgenographs were misdiagnosed for pulmonary tuberculosis. By November of the same year there appeared the patients indicative of virus pneumonia from their roentgenographs of chest, among pupils of such grade schools as Hayashino, Toyokuni, Toyoda, Narahara, and Kumon Grade Schools, all around Hayashino. Therefore, indirect x-ray photographs had been taken of 2, 019 pupils and found 381 cases whose shadow indicated what might be thought to be of virus pneumonia. We present herewith a report on x-ray findings of thes cases, percentage of the position of shadow appearance, clinical symptoms as well as on x-ray differentiation.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586981957Porzellangallenblaseと考えられる二例に就いて20972104ENMichioYamamotoSoichiNishishitaRyoAndoYoshikiMorimotoMasahiroWakimotoTadashiHashigamiMinoruYasudaTamotsuTaziriSadaoFunabikiThe application of x-rays in the diagnosis of gall-bladder diseases is an old, well-known method, but since this is used mainly in taking a simple photograph, it is difficult to obtain a good roentgenological picture. Recently with the successive advent of excellent opaque substances such as Biligrafin, Telepaque and Priodax the diagnosis of gall bladder diseases has become quite easy, but two cases on which we report here are, on the contrary, the cases whose diagnosis has been made more difficult on account of the appearance of these excellent contrast media. This "Porzellangallenblase" is an extremely rare disease and it was first reported by H. D. Flörchen (1929) in the "Zentralblatt d. Chirurgie". It presents a piture identical with the one taken at the time when opaque substance is administered. As for the symptoms, the patient mainly complains of something similar to gall-stone; and in our cases, one was suspected of kidney stone and the other was of gall-bladder disease. Both of these were discovered at the x-ray examinations of the stomach, and each in their roentgenograph presented the stone in their bile duct. In addition their roentgenograph of the gall-bladder gave the picture identical with the one taken when opaque substance had been given. We present this case report as these are very rare cases among Japanese people in the light of available literatures.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586981957岡山県下に発生した流行性肝炎 特に病原体に関する研究 第一編 流行性肝炎の予防及び治療に関する実験的研究19331945ENKatsumiEnsakoRecently γ-globulin is widely used for the prevention of infectious hepatitis in the field of clinical medicine, but its conclusive effect is still in question. In the prcsent part, the author studied what changes the administration of γ-globulin produced in the infectious aspect of hepatitis. The γ-globulin obtained from the healthy men and the one from the convalescents of hepatitis were used, and the infectious aspect was judged by the pathological findings in the mouse. It is noteworthy that the γ-globulin of convalescent sera showed a little noticeable preventive effect, though not a remarkable one. Consequently, it is inferred that more reliable effect will be obtained by using the γ-globulin containing a sufficient amount of antibody, and also by employing other various methods.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586961957骨髓の病態生理に関する研究 第三編 網内系墨汁填塞家兎骨髄静脈竇に於ける色素透過阻止について15791590ENHyoyeSatoFujii, Fujita, and Soejima of our laboratory, after a series of experiments with adult rabbits, have already made it clear that retension or mobilization of the marrow blood by the marrow circulation of active substances in the marrow is controlled by contraction or dilatation of the marrow blood vessels, namely, by the vascular actions: and they further have mentioned that no such retension or mobilization is observable in the rabbits blocked of the reticul-endothelial system by indian ink. Therefore, in order to investigate by what mechanism the blocking of the reticulo-endothelial system inhibits vascular actions, the author has performed the following experiment. Namely, by pouring 1% Patent blue, Tripan blue, or Berlin blue dissolved in saline in intact adult rabbits and in the rabbits blocked of the reticulo-endothelial system by indial ink. Splteholz's preparates and tissue specimens of the femur have been made, and the permeability through blood vessels of the dyes mentioned above has been observed: and the following interesting results have been obtained: 1) Any one of these dyes can readily pemeate from venous sinuses of the bone marrow if intact rabbits while none permeates in the case of the rabbits blocked of the reticulo-endothelial system by indian ink. 2) From the above fact, it seems that all the active substances of the bone marrow permeate through venous sinusess into the marrow parenchyma on which they act, at the sametime exerting influences on the marrow nerves; while in the cases whose reticuloendothelial system is blocked by indian ink, that is, when the walls of venous sinus are blocked with indian ink, the permeability of such active substances is inhibited and consequently no action takes place.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586951957パーキンソン症候群に対する前脈絡動脈血行遮断の治療効果機転に関する実験的研究 第1編 前脈絡動脈の分布領域について13791389ENToshioMiyamuraSeveral surgical attacks have recently been carried out for Parkinsonism. In 1954, J. Browder reported improvement in Parkinsonism by occulusion of the anterior chorioidal artery, but it was not obvious what was the effective mechanism of the therapy. Therfore, the auther tried to solve the problem and the following results habe been obtained. Cat was used for experimental study. After the injection of gelatin India-ink into the anterior chorioidal artery, the area of its distribution was determined by microscopy of the specimens of serial section. The most common area was as follows: 1. A part of Tractus optics. 2. Capsula interna (posterior to Nucleus praethl. ant.) 3. About the half of Globus pallidus (posterior to Nucleus praethl. ant.) 4. Nucleus amygdalae (about the medial two-thirds). 5. Cornus ammonis. 6. Lobus piriformis. 7. Plexus chorioidea. 8. A part of Ganglion geniculatum laterale, a part of Radiatio optica, and a part of thalamus. Thus, there is almost no difference between the blood supply of the anterior chorioidal artery of man and that of cats.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586951957臟器酵素におよぼすレ線の影響について13351340ENMizuhoKandaYoshioNakanishiKimimasaMimuraMasajiIshikawaSeiichiKogataYoshinoriMiyoshiShimizuYoshiiMichioYamamotoThe paper is the report on the results obtained from the experimental studies to find out what extent does the influence of X-Ray affect the enzymic action of organ, the basic metabolic process of living organism. Summary of the results: 1. In healthy mature rabbits, with three organs, namely, the brain, liver and kidney, the amount found of Kateptase, Amylase and Urease were highest in the kidneys and the livers came the next, while the brains contained the least. With Arginase, it was found to be highest in the livers, and kidneys were the next, but the brains had the least. 2. Healthy mature rabbits were submitted with daily X Ray radiaton of 300 r for a period of 10 days and the animals were killled when the total dosage had reached 3000 r, and respective action of Kateptase, Amylase, Arginase and Urease in brain, liver and kidney were compared with the nonirradiated rabbits. It was found that the action of Kateptase, Arginase and Urease of these three organs have been markedly increased by the X Ray radiation and degree of influence was the highest in the brains: with Amylase action in respective organ, it was decreased and its effect was most noticeable in the brain.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586911957間脳症と思われる一臨床例229235ENHiroyukiNasuSusumuHigashiHirosukeNishiokaThe authors encountered an interesting case who had had the periodic attacks of twilight state, with accompaniment of marked autonomic deficiencies (flushing of the face, sweating, polydipsia, abdominal pains, pollakiuria, polyuria, and insomnia), 10 times since the age of twelve. Somatically and neurologically, no striking changes other than vagotonia and adrenalinresponse blood-sugar curve belonging to what Kato et al. call First Curve Group B type, have been observed; yet by dividing the duration of periodic attacks into five phases and studying the progress and the genetic factors of this disease both from the psychiatric and the somatic standpoints, it leads to the conclusion that the case might possibly be included in the diencephalic syndrome. Chlorpromazine therapy offers markedly beneficial effects on this case as shown by the disapperarance of twilight state and the stabilization of autonomic deficiencies. And since the decrease in the amount of urine and the rate of its stabilization parallel with the amounts of chlorpromazine administered, it can be assumed that this drug is quite efficacious to diabetes insipidus.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30691421982中流階層帰属意識の分析―大学生の出身階層調査を素材として―357386ENSyunsukeFujimori10.18926/OER/42164No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30691511983（続）中流階層帰属意織の分析―大学生の出身階層調査を素材として―199233ENSyunsukeFujimori10.18926/OER/42121No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-3069223-41991地域開発は何をもたらしたか―岡山県南地区の経済・財政の変貌を通じて考える―4769ENChujiSakamoto10.18926/OER/41882No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30692331991年功制と企業成長―均衡成長率の変化から読み取れること―3750ENToshioKobayashi10.18926/OER/41852No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30692841997公企業投資の決定要因317330ENNarioSasaki10.18926/OER/41658We can find many books and articles discussing about public investments or fiscal policy, especially at a time when there are recessions as the Japanese Economy in 1990's. But it seems to be that there have been fewer studies about how the scale of public investments were determined or what was the determinants of them. This paper is devoted to investigating the elements which have determined investments of public sectors, supposing an simple but important assumption; civil servants try to maximize their own utilities which usually are surpluses after required expenditures are paid. Subject to this assumption an investment model of public corporations is made and compared with Model maximizing social welfare. Finally, some interpretations and problems of this analysis are presented.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30692841997貨幣の必然性論の4類型275292ENYutakaWada10.18926/OER/41656In this paper, Marxian attempts to demonstrate the necessity of money in market economy are classified into the four types of theory as
follows : (1) one which focuses on money as the measure of value and does not use the concept of labour-value in the demonstration (2) one which focuses on money as the means of circulation and uses the concept of labour-value in the demonstration (3) one which focuses on money as the means of circulation and does not use the concept of labour-value in the demonstration (4) one which focuses on money as the measure of value and uses the concept of labour-value in the demonstration. The author thinks that the second type of theory should be adopted for two reasons. First, the concept of labour-value makes it possible to find out what set of social relations among individual labours makes money necessary as a means of social reproduction. Second, money as the measure of value can be meaningful only in an economy where money as the means of circulation is necessitated by indirect exchanges of commodities.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30692841997多期間政策インプリメンテーション・モデルについて5978ENToshimiFujimoto10.18926/OER/41647It is intended here to investigate the basic structures and functions of the so-called "reputation" regime of macroeconomic policy-making by making use of a simple macro-model as composed of aggregate Lucas-type supply and ordinary demand functions in a familiar static framework of two targets and one policy instrument. The regime is conceived as one of
many possible compromises between commitment and discretion, possible in a multi-period setting of the intrinsically static model, and the private
sector's way of rational expectations is shown to be decisive in what reputation regime is concretely effected as a substitute for unrealistic commitment.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30693041999現場が作る組立ライン(II)―田原第1組立工場の事例―303331ENKoichiShimizu10.18926/OER/41574Since the beginning of 1990 s, Toyota has been pursuing a new direction in its human resource management and assembly work. After encountering a labor crisis-labor shortage and high turn over of young workers-during the economic boom provoked by the "financial bubble" toward the end of 1980 s, Toyota's management and Union discussed
ways of making the work more attractive. Based on this discussion, the production engineering division developed a new assembly line concept realized firstly at Toyota Kyushu plant (1992), applied also to Toyota's Motomachi No.2 plant (1994), Tahara No.1 plant (1995) and Motomachi No.1 plant (1996). Among these plants, the construction of the assembly line at Tahara No.1 Plant constitutes a unique case in the fact that it was not the production engineering division, but the foremen, supervisors and engineers belonging to the plant who conceived and constructed this new assembly line. Moreover, in order to realize what they considered as their ideal assembly line, they proposed to the product development center an important change of car structure and parts design from the very beginning of product development where the so called "concurrent engineering" has started. The second part of this paper deals with the 'Kaizen' activities in order to realize their "ideal assembly line" after construction. In the concluding section, I emphasize the fact that the
'Kaizen' activities at Toyota are now centered on humanization of work certainly without renouncing efforts towards cost reduction.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30693041999育児休業利用に関する企業･事業所の違い185211ENAkiraWakisaka10.18926/OER/41570This paper analyses actual uses of child-care leave program by workers based upon two data sources. This is the first research which focus on firm-level use of child-care leave program. One of the interesting findings is a negative relationship between women's share of firms and use of child-care leave program. My conclusion is that an introduction of child-care leave program leads firms to hesitate to hire women workers
because women cost relatively high.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30693031999現場が作る組立ライン（I）―田原第1取立工場の事例―125162ENKoichiShimizu10.18926/OER/41550Since the Beginning of 1990 s, Toyota has been pursuing a new direction in its human resource management and assembly work. After encountering a labor crisis-labor shortage and high turn over of young workers-during the economic boom provoked by the "financial bubble" toward the end of 1980 s, Toyota's management and Union discussed
ways of making the work more attractive. Based on this discussion, the production eugineering division developed a new kssembly line concept realized firstly at Toyota Kyushu plant (1992), applied also to Toyota's Motomachi No.2 plant (1994), Tahara No.1 plant (1995) and Motomachi
No.1 plant (1996). Among these plants, the construcion of the assembly line at Tahara No. 1 plant constitutes a unique case in the fact that it was not the production engineering division, but the foremen, supervisors and engineers belonging to the plant who conceived and constructed this new assembly line. Moreover, in order to realize what they considered as their ideal assembly line, they proposed to the product development center an important change of car structure and parts design from the very beginning of product development where the so called "concurrent engineering" has started. The first part of this paper explains, and thus why and how they conceived and constructed their own assembly line after presenting this assembly line concept and work orgnaization in this plant.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30693142000A Note on Capital Commitment and Cournot Competition with Labour-Managed and Profit-Maximising Firms285302ENShojiHaruna10.18926/OER/41522This paper shows that the discussion of Lambertini and Rossini (1998) as to the strategic investment levels oflabour-managed firms in a
labour-managed (LM) duopoly is misleading. This is due to the fact that there is no duality between the conditions for maximisation and
minimisation, and what is worse, an equilibrium needed for comparison is interior when the investment behaviour of the firms is discussed along the conventional method. We reconsider whether they overinvest or underinvest in R&D, employing a more general model with R&D spillovers. It is demonstrated that results obtained in the LM duopoly are similar to those in a conventional duopoly of profit-maximising firms.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30693142000The Structure and Implications of the Three Dimensional Double Entry Accounting System133151ENMichimasaSatoh10.18926/OER/41515The essence of the Statement of cash flows required by FASB's Statement of financial accounting standards No. 95 in 1987 is the cash basis statement of changes in a financial position, because it must show the reconciliation between net income and CFO (Cash flow from
operations) in the main body or in the footnote of the statement. The year 1987 when the new basic financial statement appeared was the starting point from which the effort should be made to formulate new conceptual framework of financial accounting that accommodates three basic financial statements: the Balance sheet, Income statement, and the Statement of cash flows. However, little argument has been aroused toward this direction in the U. S. It is mainly because the traditional and conventional double entry bookkeeping system that is designed to prepare only the Balance sheet and the Income statements are deeply rooted to the conventional
accounting philosophy. This system can be called "two dimensional accounting system", one dimension for the Balance sheet and another dimension for the Income statement. What we need now is to construct an accounting system that can
produce all three basic financial statement at the same time. Such a system can be called "three dimensional double entry accounting system", and will be demonstrated in this paper. This 3 D accounting system can provide underlying basis for the Statement of cash flows as the basic
financial statement, in terms of the system of accounts as well as the conceptual structure.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30693131999The Bubble and Monetary Policy in Japan: 1984-1989133ENAtsushiIchinose10.18926/OER/41497There will be no great opposition, among Japanese people, to the assertion that the problem of non-performing debt was the most important inducement to the present serious depression in Japan. The
non-performing debt problem was brought about by the huge swell of the bubble in the later 1980's and its collapse after entering 1990's. As for the
causes ofthe bubble formation several useful books were published rather intensively during 1992-93. But in February 1994, Mr. Mieno, the then
Governor of the Bank of Japan, stated at a lecturing speech that the causes of the bubble had not been clarified yet. He enumerated some
problems to be solved, for example why bubbles took place almost simultaneously over the world, and why such tremendous rise of asset prices occurred. Basically this reflection seems to be right. Relevant researches, which were published mostly during 1992-1993, if we dare to simplify, pointed out two factors as the important causes of
the bubble: various financial de-regulations and long-lasted cheap money policy which was closely concerned with the so-called "international cooperation of economic policy" in 1986-87. This paper is not against these arguments at all. However it calls attentions to the fact that preceding researches have overlooked an important problem to be solved: that is to say, the problem of the correlation between the rapid appreciation of yen and the soaring up of asset prices. The paper tries to analyze the simultaneous development of yen appreciation and asset inflation. Consequently it points out that the
key factor was the massive inflow of foreign short-term capital. In other words, banks took in huge short-term money from abroad and lent it to firms as impact loan, which is presumably a peculiar Japanese financial instrument. Firms converted borrowed dollar into yen and invested it in asset markets. In the case of stocks, Tokkin & Fan-tora, deposited with trust banks, played an important role as the intermediary. Thus the prices of assets rose steeply. The banks' huge taking-in of foreign short-term money resulted in a strong selling pressure on US dollar in the exchange market. Thus the dollar fell and the yen rose. A pioneering work along this line is S. Nakao (1991). Unfortunately he confines his interest to the relation between the
activities of banks and the appreciation of yen, putting the codevelopment of yen appreciation and the asset inflation out of his argument. In addition, preceding researches, which stress the financial deregulations as the most important cause of the bubble, tend only to enumerate various de-regulations. And they seem to have been
unsuccessful in clarifying what part of the deregulations was crucial. This paper deems the abolitions of regulations on impact loan and on yenten as crucial. It was these de-regulations that played by far the most important roles in the formation ofthe bubble. Finally, the reader will see some concluding remarks at the end of the
paper. The main concern of the paper lies, however, in the field of fact verification. What to learn or derive from verified facts belongs rather to a role of politicians and high officials.No potential conflict of interest relevant to this article was reported.