岡山大学大学院教育学研究科Acta Medica Okayama1883-24231912026インドの小・中学校理科における気候変動に関する内容の取り扱い ― NCERT 発行の教科書に注目して ―119130ENKenKAWAIOkayama University Graduate School of Humanities and Social Sciences Science Doctoral CourseHirokiFUJIIFaculty of Education, Okayama University10.18926/bgeou/70201 本研究は，インドの国家教育政策2020および国家カリキュラム・フレームワーク2023に基づいて作成された NCERT 発行の学校教科書（第3～8 学年）を対象に，理科的内容を扱う教科の気候変動に関する内容の取り扱いの現状を分析した。分析では UNESCO による SDGs のための教育と Kagawa & Selby の「理解・緩和・適応」の考え方をもとに観点を設け，記述を抽出・分類した。その結果，初等教育段階の「The World Around Us」では生活世界に根ざした環境配慮の態度と行動の基礎形成が重視され，前期中等教育段階の「Science」では科学的な因果関係や気候変動対策の国際的枠組みが導入されており段階的深化が確認された。一方で，概念導入の遅れ，因果連鎖の不統一，行動変容に至る仕組みの弱さ，学際性の不足や語彙や概念の習得のスパイラルな学習の不足が明らかになった。現行教科書は，体系的かつ実効的な気候変動教育には未だ不十分であり，今後の改善が求められることを指摘した。No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0041-11322026Pediatric autologous peripheral blood stem cell collection without heparin using a highly concentrated sodium citrate anticoagulant: A retrospective comparison with standard ACD-AENKeikoFujiiDepartment of Hematology, Okayama University HospitalWataruKitamuraDepartment of Hematology, Okayama University HospitalKanaWashioDepartment of Pediatrics, Okayama University HospitalKazuhiroIkeuchiDepartment of Hematology, Okayama University HospitalJojiShimonoDepartment of Hematology, Okayama University HospitalHiroyukiMurakamiDepartment of Hematology, Okayama University HospitalFumioOtsukaDivision of Clinical Laboratory, Okayama University HospitalYoshinobuMaedaDepartment of Hematology, Okayama University HospitalNobuharuFujiiDepartment of Hematology, Okayama University HospitalBackground: Heparin combined with sodium citrate has been used in leukocytapheresis for pediatric patients. Since 2022, we have performed leukocytapheresis using a highly concentrated sodium citrate solution (HSC, 5.32%) instead of acid citrate dextrose solution A (ACD-A). We conducted this study to determine whether HSC use reduces run time and the total amount of anticoagulant solution in children.<br>
Study Design and Methods: We retrospectively analyzed data from consecutive autologous peripheral blood stem cell harvests (auto-PBSCHs) between June 2012 and May 2025, including patient characteristics, mobilization methods, protocol used, anticoagulant type, run time, total anticoagulant solution volume, and collection efficiency.<br>
Results: Auto-PBSCH was performed using the mononuclear cell collection (MNC) protocol in 28 procedures and the continuous MNC protocol in 20 procedures. ACD-A was used in 35 procedures and HSC in 13. The run time was significantly shorter (204 [range, 117–302] vs. 157 min [range, 103–227], p = .02) in the HSC group and also confirmed in multivariable regression analysis (coefficient, −55.6; 95% confidence interval, −106.2 to −5.04; p = .03). In a subgroup analysis of cMNC procedures, CD34+ collection efficiency showed a strong negative correlation with the proportion of run time devoted to establishing the initial interface (r = −.73, p = .0003).<br>
Conclusion: Delays in establishing the initial interface can reduce the duration of the effective MNC collection phase and may negatively affect collection efficiency. Careful attention to the initial interface phase is therefore warranted when using HSC.No potential conflict of interest relevant to this article was reported.Japanese Society of TribologistsActa Medica Okayama1881-21982042025Tribological Properties of Amorphous-SiC-Based Coatings on Al2O3 Substrates in Normal Saline212219ENTadashiShiotaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityDaikiTaniyaGraduate School of Natural Science and Technology, Okayama UniversityKazumaShimazakiGraduate School of Natural Science and Technology, Okayama UniversityChiyuNakanoDepartment of Comprehensive Technical Solutions, Okayama UniversityYuyaOmiyaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityMasahiroFujiiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityAmorphous SiC (a-SiC)-based coatings containing not only Si–C bonds but also C–Si–O, C–C, and Si–O2 bonds were deposited on Al2O3 substrates via pulsed laser deposition. Sliding tests using SiC ceramic balls in normal saline revealed that the coating exhibited a low friction coefficient of 0.05-0.06 at a shorter running-in process than SiC bulk ceramic plates. The specific wear rate of the coating was also lower than that of the SiC plate. Reactive molecular dynamics simulations revealed that the C–Si–O bonds in the coating facilitated the generation of Si–O units, which contained Si–O bonds but no Si-C bonds, through tribochemical reactions with water, resulting in superior tribological properties in normal saline compared to those of SiC plates. These findings demonstrate that a-SiC-based coatings containing C–Si–O bonds are promising as low-friction and low-wear coatings for biomedical implants such as ceramic joint prostheses.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2772-5723522026Feasibility and Diagnostic Utility of Mucosal T-Cell Flow Cytometry for Intestinal Graft-Versus-Host Disease100820ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakumiKondoDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNobuharuFujiiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMaiHiramatsuDivision of Medical Support, Okayama University HospitalArakiHirabataDivision of Medical Support, Okayama University HospitalTakahideTakahashiDivision of Medical Support, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground and Aims: Timely diagnosis of intestinal complications after hematopoietic stem cell transplantation (HSCT), including graft-versus-host disease (GVHD), transplant-associated thrombotic microangiopathy, and cytomegalovirus infection, is essential for appropriate management. This study evaluated whether mucosal T-cell profiling from endoscopic biopsies could support the diagnosis of these post-transplant conditions.<br>
Methods: We prospectively analyzed 58 intestinal biopsy specimens from 21 post-HSCT patients. Paired samples were obtained from the stomach and duodenum during upper endoscopy and from the ileum and large intestine during colonoscopy. Lymphocytes were isolated from each specimen and analyzed using flow cytometry. These data were integrated with those of a previously collected cohort (35 patients, 51 samples) for comparative immunophenotypic analysis across histologically defined groups.<br>
Results: Duodenal biopsies yielded more lymphocytes than did gastric biopsies (mean ± standard deviation: 532 ± 823 vs 233 ± 392 cells; P = .070), with comparable yields between the ileum and colon. Among 41 evaluable cases, the CD56+:CD3+ ratio was significantly lower in patients with GVHD (5.5 ± 2.2%) than in those with nonspecific or no inflammation (28.4 ± 16.3%; P = .006). A cutoff value of <11% provided 85.7% sensitivity and 83.3% specificity for diagnosing GVHD (area under the curve = 0.91).<br>
Conclusion: Mucosal T-cell profiling using endoscopic biopsies is feasible and may aid in the diagnosis of GVHD after HSCT. A decreased CD56+:CD3+ ratio is a promising marker for distinguishing GVHD from other post-transplant intestinal conditions.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0925-571012252025Intravenous umbilical cord-derived mesenchymal stromal cell therapy may improve overall survival in Japanese patients with idiopathic pneumonia syndrome after hematopoietic stem cell transplantation: a multicenter, single-arm, phase II trial733743ENNorikoDokiHematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalShinichiKakoDivision of Hematology, Jichi Medical University Saitama Medical CenterEmikoSakaidaDepartment of Hematology, Chiba University HospitalYoshinobuKandaDivision of Hematology, Department of Medicine, Jichi Medical UniversityIdiopathic pneumonia syndrome (IPS) is a serious complication of allogeneic hematopoietic stem cell transplantation (HSCT) and has a poor prognosis. Although IPS is often treated with steroids, the disease can become resistant to or dependent on steroid treatment, and there is no effective cure for patients with refractory or steroid-dependent IPS. This multicenter, open-label, single-arm, phase II clinical trial investigated the efficacy and safety of HLC-001 (allogeneic umbilical cord-derived mesenchymal stromal cells) in patients with progressive steroid-dependent or refractory IPS after HSCT. Seven male patients (all male; mean age: 43.3 years) received HLC-001 and three completed the trial. The survival rate at day 56 (primary endpoint) was 71.4% (5/7 patients; 95% confidence interval: 29.0%–96.3%) and was sustained at day 100, suggesting that HLC-001 was more effective than previously reported treatment. Three of the five patients with ≥ 100 days of follow-up died. Five patients experienced at least one adverse drug reaction, none of which were serious. These findings indicate that HLC-001 was potentially effective and generally well tolerated in Japanese patients with steroid-dependent or refractory IPS after HSCT. Given there is no effective cure for steroid-dependent or refractory IPS, HLC-001 may be a promising treatment option and further clinical evaluation is warranted.<br>
Trial registration: Japan Registry of Clinical Trials identifier: jRCT2063220014.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1465-32492782025Clinical outcomes of Japanese patients treated with out-of-specification tisagenlecleucel in a phase 3b trial938943ENKojiKatoDepartment of Hematology, Oncology, and Cardiovascular Medicine, Kyushu University HospitalJunKatoDivision of Hematology, Department of Medicine, Keio University School of MedicineHidekiGotoDivision of Laboratory and Transfusion Medicine, Hokkaido University HospitalTakeshiKobayashiHematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalYoshiyukiTakahashiDepartment of Pediatrics, Nagoya University Graduate School of MedicineEmikoSakaidaDepartment of Hematology, Chiba University HospitalHidefumiHiramatsuDepartment of Pediatrics, Graduate School of Medicine, Kyoto UniversityMasahideYamamotoDepartment of Hematology, Institute of Science Tokyo HospitalSatoshiYoshiharaDepartment of Hematology, Hyogo Medical University HospitalJunAndoDepartment of Cell Therapy and Transfusion Medicine, Juntendo University Graduate School of MedicineKatsuyoshiKohDepartment of Hematology/Oncology, Saitama Children’s Medical CenterKentaroFukushimaDepartment of Hematology and Oncology, Osaka University Graduate School of MedicineFumikoIwamotoMedical Affairs, Novartis Pharma K.K.RanjanTiwariDevelopment Advance Quantitative Sciences, Novartis Healthcare Private LimitedNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalBackground: The final manufactured tisagenlecleucel product should meet the commercial product release specifications to ensure the quality in terms of safety, purity, identity, and potency. However, it may occasionally fail to meet these specifications due to the nature of patient-derived cells with variable properties as starting material and the complex manufacturing process. The final product that does not meet at least one of the commercial release specifications is referred to as “out-of-specification” (OOS). However, the benefit-risk profile of OOS tisagenlecleucel has not yet been fully elucidated.<br>
Aims: To evaluate the safety and efficacy of OOS tisagenlecleucel in Japanese patients with relapsed or refractory (r/r) diffuse large B-cell lymphoma (DLBCL) and B-cell acute lymphoblastic leukemia (B-ALL).<br>
Methods: This is a single-arm, open-label, multicenter phase 3b study (NCT04094311). Patients consistent with label indication were enrolled and followed-up for 3 months.<br>
Results: Of the 29 patients enrolled between December 2019 and May 2022 across 13 qualified sites in Japan, 28 received tisagenlecleucel, and of these, 23 had r/r DLBCL and 5 had r/r B-ALL. The primary reasons for OOS were low cell viability (15 of 24 batches) and low dose (8 of 23 batches) tisagenlecleucel in the r/r DLBCL group, and high dose (4 of 5 batches) in the r/r B-ALL group. In patients with r/r DLBCL, the grade 3 or 4 cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome occurred in 3 and 1 patients, respectively. Response assessments were performed for 15 of 23 patients with r/r DLBCL: 6 achieved a complete response, and 1 achieved a partial response as the best response within 3 months.<br>
Conclusions: Despite the limited patient sample size, our findings affirm that the infusion of OOS tisagenlecleucel is a viable option, with no observed increase in toxicity and outcomes comparable to those of in-specification products in clinical and real-world studies.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291863132024Activated CD4+ T Cell Proportion in the Peripheral Blood Correlates with the Duration of Cytokine Release Syndrome and Predicts Clinical Outcome after Chimeric Antigen Receptor T Cell Therapy18631872ENWataruKitamuraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalShuntaroIkegawaDepartment of Hematology and Oncology, Okayama University Hospital, JapanHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalChihiroKamoiDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiCenter for Comprehensive Genomic Medicine, Okayama University HospitalHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDivision of Clinical Laboratory, Okayama University HospitalNobuharuFujiiDivision of Blood Transfusion, Okayama University HospitalKen-ichiMatsuokaDepartment of Hematology and Oncology, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalObjective Chimeric antigen receptor (CAR) T cell therapy is an emerging and effective therapy for relapsed or refractory diffuse large B cell lymphoma (R/R DLBCL). The characteristic toxicities of CAR T cell therapy include cytokine release syndrome (CRS) and prolonged cytopenia. We investigated the factors associated with these complications after CAR T cell therapy by analyzing lymphocyte subsets following CAR T cell infusion.<br>
Methods We retrospectively analyzed peripheral blood samples on days 7, 14, and 28 after tisagenlecleucel (tisa-cel) infusion by flow cytometry at our institution between June 2020 and September 2022.<br>
Patients Thirty-five patients with R/R DLBCL who received tisa-cel therapy were included.<br>
Results A flow cytometry-based analysis of blood samples from these patients revealed that the proportion of CD4+CD25+CD127+ T cells (hereafter referred to as "activated CD4+ T cells" ) among the total CD4+ T cells on day 7 after tisa-cel infusion correlated with the duration of CRS (r=0.79, p<0.01). In addition, a prognostic analysis of the overall survival (OS) using time-dependent receiver operating characteristic curves indicated a significantly more favorable OS and progression-free survival of patients with a proportion of activated CD4+ T cells among the total CD4+ T cells <0.73 (p=0.01, and p<0.01, respectively).<br>
Conclusion These results suggest that the proportion of activated CD4+ T cells on day 7 after tisa-cel infusion correlates with the CRS duration and predicts clinical outcomes after CAR T cell therapy. Further studies with a larger number of patients are required to validate these observations.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025Recurrence of FVIII Inhibitor during Surgery in a Patient with Severe Hemophilia A Receiving Emicizumab Prophylaxis451455ENMoeHagiharaDepartment of Hematology and Oncology, Okayama University HospitalKeisukeSeikeDepartment of Hematology and Oncology, Okayama University HospitalKentaHayashinoDepartment of Hematology and Oncology, Okayama University HospitalTakaoYasuharaDepartment of Neurological Surgery, Okayama University HospitalKyoheiKinDepartment of Neurological Surgery, Okayama University HospitalYuichiHirataDepartment of Neurological Surgery, Okayama University HospitalHirokiKobayashiDepartment of Hematology and Oncology, Okayama University HospitalWataruKitamuraDepartment of Hematology and Oncology, Okayama University HospitalHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDivision of Transfusion and Cell Therapy, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalCase Report10.18926/AMO/69848Emicizumab, a bispecific monoclonal antibody, benefits patients with severe hemophilia A. It alters laboratory assessments of coagulation activity, requiring anti-idiotype monoclonal antibodies for accurate monitoring. A 64-year-old man, receiving emicizumab regularly, was admitted for laminoplasty. We planned to use FVIII replacement during the perioperative period after confirming the disappearance of inhibitors, monitoring coagulation activity with anti-idiotype monoclonal antibodies. Activated partial thromboplastin time was prolonged on postoperative day 2, prompting an immediate switch to eptacog alfa. The patient recovered without bleeding. This case underscores the necessity of anti-idiotype monoclonal antibodies for accurate monitoring.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1473-05026442025Factors affecting the development of hypokalemia during apheresis in healthy donors104195ENWataruKitamuraDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDepartment of Hematology and Oncology, Okayama University HospitalHirokiKobayashiDepartment of Hematology and Oncology, Okayama University HospitalMasayaAbeDepartment of Hematology and Oncology, Okayama University HospitalTakuyaFukumiDepartment of Hematology and Oncology, Okayama University HospitalKazuhiroIkeuchiDepartment of Hematology and Oncology, Okayama University HospitalFumioOtsukaDivision of Clinical Laboratory, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalDespite being generally safe, apheresis for peripheral blood stem cell collection potentially disrupts electrolyte balance owing to the use of citric acid as an anticoagulant. As prior research has primarily studied hypocalcemia, information on the kinetics of potassium levels during apheresis in healthy donors is scarce. We investigated the fluctuation in potassium levels during apheresis and the risk factors for hypokalemia. This subanalysis used data from an open-label, randomized controlled trial of “oral calcium supplementation versus placebo in mitigating citrate toxicity” conducted between January 2021 and July 2022, at Okayama University Hospital. Potassium levels were significantly reduced after 5-day granulocyte colony-stimulating factor (G-CSF) administration (p < 0.0001), with seven patients (16.7 %) given oral potassium administration before apheresis because the treating physician deemed potassium levels potentially unsafe and three (7.1 %) presenting with hypokalemia at apheresis. Potassium levels after apheresis were significantly lower than those before apheresis (baseline; p < 0.0001), and 28 of 42 donors (66.7 %) experienced biochemical, clinically unapparent hypokalemia immediately after the completion of apheresis. A > 15 % reduction in potassium levels from baseline was associated with age and the acid citrate dextrose solution A (ACD-A) volume in univariate analysis. In the multivariable analysis, both factors were associated (hazard ratio [HR], 11.60; 95 % confidence interval [CI], 1.60–83.70; p = 0.02 and HR, 17.50; 95 % CI, 1.07–136.00; p = 0.04). In conclusion, G-CSF administration and apheresis ultimately induced hypokalemia in two-thirds of the donors. Older age and higher ACD-A volume may affect potassium levels during apheresis in healthy donors.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1473-05026462025Novel leukocytapheresis method using highly concentrated sodium citrate solution for the manufacturing of tisagenlecleucel104265ENWataruKitamuraDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDepartment of Hematology and Oncology, Okayama University HospitalMasayaAbeDepartment of Hematology and Oncology, Okayama University HospitalKazuhiroIkeuchiDepartment of Hematology and Oncology, Okayama University HospitalKanaWashioDepartment of Pediatrics, Okayama University HospitalFumioOtsukaDivision of Clinical Laboratory, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalFor the manufacturing of tisagenlecleucel (tisa-cel) requires the non-mobilized mononuclear cell collection (MNC). CD3+ cell collection is performed using the same protocol as autologous peripheral blood stem cell harvest (auto-PBSCH), but this procedure necessitates the same target CD3+ cell yields regardless of age or body weight, which may take several days especially in pediatric and small female patients with low white blood cell counts. We previously demonstrated a novel method using highly concentration sodium citrate (HSC), which reduced the need for an anticoagulant (AC) solution and shortened the procedure time in auto-PBSCH. This novel method was expected to offer advantages for smaller patients, prompting us to investigate its application in leukocytapheresis for the manufacturing of tisa-cel. We retrospectively analyzed consecutive leukocytapheresis data obtained using Spectra Optia continuous MNC mode between November 2022 and June 2024 at our institution (n = 9). In six of nine patients, pre-leukocytapheresis CD3+ cell counts were less than 500 /μL, but all could obtain the target CD3+ cell yields in one day upon processing blood volume adjustment. When we compared patients who had received CD3+ cell collection using normal-concentration sodium citrate (NSC) as our previously reported using propensity score-matched pair analysis, the total AC solution volume was significantly lower (1168 vs. 316 mL, p < 0.001) and procedure time was significantly shorter (254 vs. 228 min, p = 0.04) in the HSC group compared to the NSC group. In conclusion, this procedure was also useful for non-mobilized MNC. Our findings warrant validation in a larger patient cohort.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0041-11326592025Novel method for autologous peripheral blood stem cell harvest using highly concentrated sodium citrate solution replacing acid citrate dextrose solution A16621672ENWataruKitamuraDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDepartment of Hematology and Oncology, Okayama University HospitalMasayaAbeDepartment of Hematology and Oncology, Okayama University HospitalKazuhiroIkeuchiDepartment of Hematology and Oncology, Okayama University HospitalJojiShimonoDepartment of Hematology and Oncology, Okayama University HospitalKanaWashioDepartment of Pediatrics, Okayama University HospitalFumioOtsukaDivision of Clinical Laboratory, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalBackground: As the processed blood volume increases, a larger amount of anticoagulant (AC) is required, which leads to a serious issue of fluid dilution in large-volume leukocytapheresis (defined as ≥3-fold total blood volume). We previously reported a novel method for allogeneic peripheral blood stem cell harvest (PBSCH) using highly concentrated sodium citrate (HSC; 5.32%), which shortened the procedure time and reduced the need for an AC solution without heparin. In this study, we extended this novel method to autologous PBSCH (auto-PBSCH) and compared it with patients who received auto-PBSCH using normal concentrated sodium citrate (NSC; 2.2%).<br>
Study Design and Methods: We retrospectively analyzed consecutive auto-PBSCH data obtained using the Spectra Optia continuous mononuclear cell collection mode between May 2017 and May 2025 at our institution.<br>
Results: Leukocytapheresis was performed using NSC in 36 patients and HSC in 22. In the HSC group, patients tended to be younger, had significantly lower body weight, and had significantly fewer hematopoietic tumors as primary diseases compared to the NSC group. After propensity score-matched cohort adjusted for patient background, the total amount of AC solution was significantly lower (694 [range, 77–1648] vs. 298 mL [range, 64–797], p = .02), and procedure time was significantly shorter (224 [range, 117–395] vs. 181 min [range, 103–309], p = .048) in the HSC group. Furthermore, the loss rates of magnesium and potassium were lower in the HSC group.<br>
Conclusion: This novel leukocytapheresis method demonstrated the efficacy and safety in auto-PBSCH, while minimizing the patient burden.No potential conflict of interest relevant to this article was reported.Japanese Society of Radiological TechnologyActa Medica Okayama0369-43058222026放射線治療装置の回転座標系誤差が軸外targetの照射精度に及ぼす影響とTG142のトレランスの評価26-1566ENTakahiroNakayamaDepartment of Radiology, Public Mutual Aid Association Chugoku Central HospitalYoshinoriTanabeDepartment of Radiological Technology, Graduate School of Health Sciences, Okayama UniversityYasushiFujiiDepartment of Radiology, Public Mutual Aid Association Chugoku Central Hospital【目的】放射線治療装置の回転座標系の誤差が軸外targetの照射精度に及ぼす影響を定量的に評価し，TG142における回転座標系誤差（±1.0°）のトレランスの妥当性を検討する．【方法】Elekta社製放射線治療装置（Elekta, Stockholm, Sweden）とMultiMet-WL QAファントム（Sun Nuclear, Melbourne, FL, USA）を用いて，6個のtargetに対してoff isocenterのWinston–Lutz test（WL test）を実施した．Baselineの測定に加え，意図的にcollimator，gantry，couchに+0.5°, +1.0°回転誤差を加えた6条件で測定を行い，照射野中心とtarget中心のベクトル距離（S値）および各方向（gantry-target: GT, left-right: LR, anterior-posterior: AP）の位置ずれを解析した．【結果】Isocenterからの距離が大きいtargetほど位置ずれが顕著であった．特にcollimator回転誤差の影響が最も大きく，isocenterから7 cm離れたtargetでは0.5°の回転誤差でもS値が最大1.24 mmに達した．次に影響が大きかったのはcouch回転であり，gantry回転はtargetの配置が回転軸に近いものが多く相対的に影響が少なかった．回転座標系の誤差は幾何学的誤差の影響が強く，位置ずれに方向依存性があった．【結語】Collimatorやcouchの影響が大きく，0.5°の誤差でも1 mm以上の位置ずれが生じることがあった．Gantryの影響はtargetの配置依存があり，相対的に小さかった．軸外targetの照射において，TG142の±1.0°のトレランスは放射線治療装置の種類にかかわらず最低限遵守するべき基準であり，targetの配置次第では臨床的に十分なマージンを保証できない可能性が示された．Target配置に応じたより厳格な基準と定期的quality assurance（QA）の重要性が示唆された．No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0925-571012252025Cytomegalovirus reactivation in patients with large B-cell lymphoma treated with chimeric antigen receptor T-cell therapy689699ENKentaHayashinoDepartment of Hematology and Oncology, Okayama UniversityKeisukeSeikeDepartment of Hematology and Oncology, Okayama UniversityTaroMasunariDepartment of Hematology, Chugoku Central HospitalRisaHashidaDivision of Hematology, Ehime Prefectural Central HospitalSatoshiOkaDepartment of Hematology and Blood Transfusion, Kochi Health Science CenterYukiFujiwaraDepartment of Hematology and Oncology, Japanese Red Cross Society Himeji HospitalToshikiTeraoDepartment of Hematology and Oncology, Okayama UniversityWataruKitamuraDepartment of Hematology and Oncology, Okayama UniversityHirokiKobayashiDepartment of Hematology and Oncology, Okayama UniversityChihiroKamoiDepartment of Hematology and Oncology, Okayama UniversityTakumiKondoDepartment of Hematology and Oncology, Okayama UniversityHideakiFujiwaraDepartment of Hematology and Oncology, Okayama UniversityNoboruAsadaDepartment of Hematology and Oncology, Okayama UniversityDaisukeEnnishiDepartment of Hematology and Oncology, Okayama UniversityKeikoFujiiDepartment of Hematology and Oncology, Okayama UniversityNobuharuFujiiDepartment of Hematology and Oncology, Okayama UniversityYoshinobuMaedaDepartment of Hematology and Oncology, Okayama UniversityChimeric antigen receptor (CAR) T-cell therapy has improved outcomes of relapsed and/or refractory large B-cell lymphoma (r/r LBCL). However, its off-tumor effects result in severe prolonged humoral immune deficiency. Cytomegalovirus (CMV) is a latent virus that can be life-threatening in immunosuppressed patients. In the setting of CAR T-cell therapy, Asian race is a risk factor for clinically significant CMV infection. However, the effect of CAR T-cell therapy on CMV reactivation in Japanese patients remains unclear. Previous reports used polymerase chain reaction (PCR), but we used the pp65 antigenemia assay to retrospectively investigate long-term effects in patients with r/r LBCL. The study included 46 patients. Nine (19.6%) developed CMV reactivation, with a median onset of 13 days. Six of these patients received preemptive therapy, and none developed CMV end-organ disease. Primary refractory disease, grade 2–4 cytokine release syndrome, and high-dose corticosteroids were risk factors for CMV reactivation. Long-term follow-up showed that CMV reactivation rarely occurred later than 28 days post-infusion. Our study using the pp65 antigenemia assay showed a similar incidence of CMV reactivation, onset, and risk factors to those in the previous reports using PCR.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2688-6146652025Late‐Onset Invasive Aspergillosis With Pituitary Involvement and Dysfunction Following CD19 Chimeric Antigen Receptor T‐Cell Therapye70138ENDaisukeIkedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomohiroNawadaThe Center for Graduate Medical Education, Okayama University HospitalTakumiKondoDepartment of Hematology and Oncology, Okayama University HospitalTakayukiShinoharaDepartment of Fungal Infection, National Institute of Infectious DiseasesTomohiroNaganoDepartment of Hematology and Oncology, Okayama University HospitalSayaKubotaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyuichiroHiyamaDepartment of Hematology and Oncology, Okayama University HospitalMasayaUenoDepartment of Hematology and Oncology, Okayama University HospitalHirokiKobayashiDepartment of Hematology and Oncology, Okayama University HospitalKeisukeSeikeDepartment of Hematology and Oncology, Okayama University HospitalHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalMasanoriMakitaDepartment of Hematology, Chugoku Central HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalIntroduction: Invasive fungal infection (IFI) after chimeric antigen receptor (CAR) T-cell therapy is less common than bacterial and viral infections, but can be fatal once it develops. As most cases occur within 30 days after CAR T-cell infusion, late-onset IFI—particularly mould infection—appears to be under-recognised.<br>
Discussion: We report an illustrative case of pituitary aspergillosis developing as late as one year after CD19 CAR T-cell therapy, highlighting a persistent risk in certain patients with delayed immune reconstitution.<br>
Conclusion: This case underscores the need for continued vigilance and individualised antifungal strategies to prevent IFI beyond the early post-infusion period.<br>
Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0301-679X2142026The influence of lubricant additives and surface roughness and hardness of material on the damage behavior of gears111341ENTakuyaOhnoFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityTadashiShiotaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityMasahiroFujiiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityThis study investigates the influence of lubricant additives, surface roughness, and material hardness on gear damage behavior under boundary lubrication conditions. We conducted both the Short-term Test and the Standard Test using an FZG gear test machine to evaluate how lubricant additives and gear surface roughness influence damage progression when the surface roughness exceeds the oil-film thickness. Acid phosphate ester effectively suppressed micropitting through surface smoothing but led to severe damage such as pitting and scuffing during prolonged use. In contrast, sulfurized fatty oil promoted mild wear, delaying catastrophic failures and extending gear life. Higher surface roughness accelerated wear, while increased hardness reduced deformation but it expanded damage areas. The study found that initial surface roughness and its progress during load stages strongly correlate with gear durability. Measurement of arithmetic mean roughness after sufficient running-in under actual load conditions proved useful for predicting long-term performance. These findings highlight the importance of selecting lubricant formulations tailored to specific gear operating environments and damage modes. Understanding the interplay between lubrication chemistry and material properties enables the design of more durable gear systems.No potential conflict of interest relevant to this article was reported.Japanese Society of TribologistsActa Medica Okayama1881-21982032025Water Lubrication of Polysiloxane-Containing Polyimide Coatings on Stainless Steel Substrates124129ENYuelinFanGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTadashiShiotaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityYuyaOmiyaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityMasahiroFujiiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityThis study investigated the water-lubricated tribological properties of coatings made of a novel polysiloxane-containing polyimide (si-PI) material that was recently developed for the aerospace industry and can be diluted with the harmless and environmentally friendly ethanol or water. The si-PI coatings were deposited on stainless steel (JIS SUS304) substrates at curing temperatures ranging from 160°C to 275°C. Their water lubrication properties were measured by rubbing the coatings against each other in water at room temperature. The coatings exhibited lower friction than conventional polyimide materials, with a minimum friction coefficient of 0.04, which was lower than that of polytetrafluoroethylene (PTFE) measured under the same sliding conditions. Unlike the conventional polyimide, the coatings did not exhibit any obvious wear or damage. The results demonstrate that the si-PI coating is a promising low-friction and highly durable coating for water lubrication.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841772025Six-Year Remission With No Relapse After Four-Time Weekly Rituximab Only for Bilateral Ocular Adnexal Follicular Lymphomae88945ENToshihikoMatsuoOphthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, and Okayama University HospitalTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityNobuharuFujiiDivision of Transfusion and Cell Therapy, Department of Hematology and Oncology, Okayama University HospitalFollicular lymphoma mostly takes an indolent course, and thus, observation with watchful waiting is a main therapeutic strategy. Recent long-term studies suggest earlier treatment with rituximab monotherapy may benefit patients by delaying the need for treatment in the later phase of exacerbation. In this study, we reported a patient with bilateral orbital follicular lymphoma who received four-time weekly rituximab monotherapy as an induction therapy only and maintained the remission for 5 years with no treatment. The patient was a 51-year-old woman who developed a right upper orbital mass and was diagnosed with follicular lymphoma grade 1 by the excisional biopsy. Two years later, at the age of 53 years, she developed a left lacrimal gland mass and underwent excision. The pathological diagnosis was follicular lymphoma grade 1. She did not have any other systemic lesions by fluorodeoxyglucose positron emission tomography. At the age of 54 years, she developed a new mass on the nasal side of the right orbit and underwent weekly rituximab monotherapy (375 mg/m2) four times a month, leading to the reduction of the mass in 3 months. Two high uptake sites on the temporal and nasal side of the right superior orbit by fluorodeoxyglucose positron emission tomography disappeared one year later at the age of 55 years. She was followed with no treatment for 6 years until the age of 60 years at the latest visit. In case of a local orbital relapse, local radiotherapy would be the standard, but rituximab monotherapy as an induction therapy only was chosen in the present patient. Rituximab monotherapy in place of local radiotherapy would be a treatment option for orbital follicular lymphoma.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465712025イノベーションの発生源研究の再検討120ENQiHuangDaijiFujii10.18926/OER/69001 本論文は，イノベーションの発生源に関する先行研究を振り返り，「いつ」「どこで」「誰によって」イノベーションが生み出されるのかを理論的に考察することを目的とする。考察の結果，「B to B」の文脈においては，イノベーションの発生源が企業ユーザーへ移行するメカニズムとして，取引コスト理論，期待利益仮説，情報粘着性の仮説，企業内部の独自能力（吸収能力），および外部の産業構造（製品アーキテクチャ・エコシステム）といった複数の要素からなる経済的合理性の観点から分析されていることが明らかになった。一方，「B to C」の文脈では，エンドユーザーがイノベーションに向かう動機として，「ニッチ市場に対するメーカーの消極的な対応」「創造的活動の楽しさ」「ユーザーコミュニティとの繋がり」「知識・スキルの向上」など多種多様な要素が存在し，中でも創造的活動の楽しさが根源的な動機づけの1つであると確認された。一方で，イノベーターを突き動かす心理的要因をブラックボックス化したまま放置することは，単なる知的好奇心の問題に留まらず，社会科学としての経営学にとっても重要な問題であると考えられる。今後のイノベーションの発生源研究においては，起業家をはじめとするイノベーター個人の心理的側面にいかに目を向け，創造的活動におけるポジティブな感情が働くメカニズムをイノベーションの発生メカニズムにいかに位置づけるか，その研究アプローチの提示が求められる。No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0925-571012122024Outcomes of allogeneic SCT versus tisagenlecleucel in patients with R/R LBCL and poor prognostic factors232243ENKentaHayashinoDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityToshikiTeraoDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityWataruKitamuraDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityHirokiKobayashiDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityChihiroKamoiDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityKeisukeSeikeDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityNoboruAsadaDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityKeikoFujiiDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityNobuharuFujiiDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityKen-ichiMatsuokaDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University Hospital, Okayama UniversityThis study investigated the efficacy of tisagenlecleucel (tisa-cel) and allogeneic hematopoietic stem cell transplantation (allo-SCT) for patients with relapsed and/or refractory (r/r) large B-cell lymphoma (LBCL) with poor prognostic factors, defined as performance status (PS) ≥ 2, multiple extranodal lesions (EN), chemorefractory disease, or higher lactate dehydrogenase (LDH). Overall, the allo-SCT group demonstrated worse progression-free survival (PFS), higher non-relapse mortality, and a similar relapse/progression rate. Notably, the tisa-cel group showed better PFS than the allo-SCT group among patients with chemorefractory disease (3.2 vs. 2.0 months, p = 0.092) or higher LDH (4.0 vs. 2.0 months, p = 0.018), whereas PFS in the two cellular therapy groups was similar among those with PS ≥ 2 or multiple EN. Survival time after relapse post-cellular therapy in patients with poor prognostic factors was 1.6 with allo-SCT and 4.6 months with tisa-cel. These findings were confirmed in a propensity score matching cohort. In conclusion, tisa-cel resulted in better survival than allo-SCT in patients with poor prognostic factors. However, patients who relapsed post-cellular therapy had dismal outcomes regardless of therapy. Further strategies are warranted to improve outcomes in these patients.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025分布型光ファイバセンシング技術を用いた河川堤防の浸透流速および越水による破壊プロセスのモニタリングに関する研究ENHirokazuFUJIIGraduate School of Environmental and Life Science, Okayama UniversityNo potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0041-11322025Novel method of leukocytapheresis using a highly concentrated sodium citrate solution alternative to acid citrate dextrose solution AENMasayaAbeDivision of Transfusion and Cell Therapy, Okayama University HospitalKeikoFujiiDivision of Clinical Laboratory, Okayama University HospitalToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalWataruKitamuraDivision of Transfusion and Cell Therapy, Okayama University HospitalKazuhiroIkeuchiDivision of Transfusion and Cell Therapy, Okayama University HospitalTakuyaFukumiDivision of Transfusion and Cell Therapy, Okayama University HospitalKanaWashioDepartment of Pediatric Hematology and Oncology, Okayama University HospitalFumioOtsukaDivision of Clinical Laboratory, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDivision of Transfusion and Cell Therapy, Okayama University HospitalBackground: Large-volume leukocytapheresis is time consuming. The upper limit of the inlet flow rate is determined by the inlet: anticoagulant (AC) ratio and can be changed by combining the AC with heparin. Here, we devised a protocol to increase the AC ratio using a highly concentrated sodium citrate solution without heparin.<br>
Study Design and Methods: We collected data from 40 consecutive apheresis procedures performed using the Spectra Optia system on 40 donors for allogeneic peripheral blood stem cells between June 2022 and June 2023. We used AC containing 2.2% sodium citrate (normal concentrated sodium citrate [NSC]) and 5.32% sodium citrate (highly concentrated sodium citrate [HSC]). The AC ratios were set to 12:1 and 24:1 for the NSC and HSC, respectively.<br>
Results: The processed volume was not different; the maximum inlet flow rate increased, the total processing time was reduced, the AC solution used was reduced, and the product volume was reduced in the HSC group, compared to the NSC group. Although the CD34+ cell CE2 was reduced in the HSC group, no difference was observed in the number of collected CD34+ cells. The incidences of citrate-related reactions were similar.<br>
Discussion: We propose a novel leukocytapheresis method using HSC that shortens the procedure time and reduces the amount of AC solution used compared to the conventional methodNo potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0939-55552025A randomized controlled trial of conventional GVHD prophylaxis with or without teprenone for the prevention of severe acute GVHDENWataruKitamuraDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDepartment of Hematology and Oncology, Okayama University HospitalMitsuruTsugeDepartment of Pediatric Acute Diseases, Okayama University Academic Field of Medicine Dentistry, and Pharmaceutical SciencesToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalHirokiKobayashiDepartment of Hematology and Oncology, Okayama University HospitalChihiroKamoiDepartment of Hematology and Oncology, Okayama University HospitalAkiraYamamotoDepartment of Hematology and Oncology, Okayama University HospitalTakumiKondoDepartment of Hematology and Oncology, Okayama University HospitalKeisukeSeikeDepartment of Hematology and Oncology, Okayama University HospitalHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University HospitalKen-ichiMatsuokaDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalTherapies that effectively suppress graft-versus-host disease (GVHD) without compromising graft-versus-leukemia/lymphoma (GVL) effects is important in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for hematopoietic malignancies. Geranylgeranylacetone (GGA) is a main component of teprenone, a gastric mucosal protectant commonly used in clinical practice. In preclinical models, GGA suppresses proinflammatory cytokines, including interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α), which are associated with GVHD as well as induces thioredoxin-1 (Trx-1), which suppresses GVHD while maintaining GVL effects. Here, we investigated whether the addition of teprenone to standard GVHD prophylaxis could reduce the cumulative incidence of severe acute GVHD (aGVHD) without attenuating GVL effects. This open-label, randomized clinical trial enrolled 40 patients (21 control and 19 teprenone group) who received allo-HSCT between May 2022 and February 2023 in our institution. Patients in the teprenone group received 50 mg of teprenone orally thrice daily for 21 days from the initiation of the conditioning regimen. The cumulative incidence of severe aGVHD by day 100 after allo-HSCT was not significantly different in the two groups (27.9 vs. 16.1%, p = 0.25). The exploratory studies revealed no obvious changes in Trx-1 levels, but the alternations from baseline in IL-1β and TNF-α levels at day 28 after allo-HSCT tended to be lower in the teprenone group. In conclusion, we could not demonstrate that teprenone significantly prevented the development of severe aGVHD. Discrepancy with preclinical model suggests that appropriate dose of teprenone may be necessary to induce the expression of antioxidant enzymes that suppress severe aGVHD. Clinical Trial Registration number:jRCTs 061210072.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama0006-497114582025Oral Inflammation and Microbiome Dysbiosis Exacerbate Chronic Graft-versus-host Disease881896ENYuiKambaraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Medical SchoolHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalAkiraYamamotoDepartment of Hematology and Oncology, Okayama University HospitalKazuyoshiGotohDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesShumaTsujiDepartment of Microbiology and Genetics, Okayama University Graduate School of Health SciencesMariKunihiroDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTadashiOyamaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshikiTeraoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyameSatoDivision of Hospital Dentistry, Okayama University HospitalTakehiroTanakaDepartment of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDanielPeltierDivision of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Department of Pediatrics, Herman B Wells Center for Pediatric Research, Simon Cancer Center, Indiana University School of MedicineKeisukeSeikeDepartment of Hematology and Oncology, Okayama University HospitalHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiCenter for Comprehensive Genomic Medicine, Okayama University HospitalKeikoFujiiDepartment of Clinical Laboratory, Okayama University HospitalNobuharuFujiiDivision of Blood Transfusion, Okayama University HospitalKen-ichiMatsuokaDepartment of Hematology and Oncology, Okayama University HospitalYoshihikoSogaDivision of Hospital Dentistry, Okayama University HospitalPavanReddyDan L Duncan Comprehensive Cancer Center, Baylor College of MedicineMaedaYoshinobuDepartment of Hematology and Oncology, Okayama University HospitalThe oral microbiota, second in abundance to the gut, is implicated in chronic systemic diseases, but its specific role in graft-versus-host disease (GVHD) pathogenesis has been unclear. Our study finds that mucositis-induced oral dysbiosis in patients after hematopoietic cell transplantation (HCT) associated with increased chronic GVHD (cGVHD), even in patients receiving posttransplant cyclophosphamide. In murine HCT models, oral dysbiosis caused by bilateral molar ligatures exacerbated cGVHD and increased bacterial load in the oral cavity and gut, with Enterococcaceae significantly increasing in both organs. In this model, the migration of Enterococcaceae to cervical lymph nodes both before and after transplantation activated antigen-presenting cells, thereby promoting the expansion of donor-derived inflammatory T cells. Based on these results, we hypothesize that pathogenic bacteria increase in the oral cavity might not only exacerbate local inflammation but also enhance systemic inflammation throughout the HCT course. Additionally, these bacteria translocated to the gut and formed ectopic colonies, further amplifying systemic inflammation. Furthermore, interventions targeting the oral microbiome mitigated murine cGVHD. Collectively, our findings highlight the importance of oral dysbiosis in cGVHD and suggest that modulation of the oral microbiome during transplantation may be an effective approach for preventing or treating cGVHD.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465622024なぜ中間組織が必要なのか116ENDaijiFujiiTamakoOshima10.18926/OER/67705 This paper challenges a fundamental question, ‘Why is an intermediate organization necessary?’ Due to transaction costs and market failures on the one hand and the limitations of organizational control mechanisms on the other hand, many‘ intermediate organizations’ are observed in the real world. How can we tackle to explain the governance mechanism considered to be‘ intermediate?’
If we are to discuss such socioeconomic orders, this paper assumes that we should not be able to link micro-level explanations and macro-level ones concerning the third mode of governance mechanisms all at once. We need to stick to the meso-level at fi rst. The theoretical elaboration since Ouchi’s（1980） discussion of clan-type governance and cumulative empirical research on industrial agglomerations have allowed us to construct a more sophisticated theory called community capital.
In effective communities, members are ‘embedded as insiders’ who serve the purpose of the community, share experiences of failures and successes, and find and deepen their common identity. This limited membership is bound by‘ mutual trust to rely on each other’ for‘ distribution of short-term risks.’ In contrast to social norms that need to be abstract enough to be widely shared, the communal norms that are concrete enough to allow the members to understand without hesitation how they should behave in localized contexts are cumulatively cultivated along socializing process. Among the norms, sense of mutual obligation to incur intermittent costs for the whole community is a crucial norm for the sustainable development of the community. However, as a practical matter, membership control, mutual trust and short-term risk allocation may serve the communities in the short run, but they do not guarantee long-term accumulation of shared capital. As a result, the limits of community capital may need to be discussed once again, especially today when market liquidity is increasing, and its failures tend to become more apparent in a variety of areas.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama2213-0071512024Protracted coronavirus disease 2019 after chimeric antigen receptor-T cell therapy successfully treated with sequential multidrug therapy102104ENMasahiroYamashitaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalHisaoHigoDepartment of Allergy and Respiratory Medicine, Okayama University HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalChiakiMatsumotoDepartment of Allergy and Respiratory Medicine, Okayama University HospitalGoMakimotoDepartment of Allergy and Respiratory Medicine, Okayama University HospitalKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalMasanoriFujiiDepartment of Allergy and Respiratory Medicine, Okayama University HospitalKammeiRaiCenter for Innovative Clinical Medicine, Okayama University HospitalEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalKadoakiOhashiDepartment of Allergy and Respiratory Medicine, Okayama University HospitalKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalMasahiroTabataCenter for Clinical Oncology, 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 HospitalA 56-year-old woman who received CD19 chimeric antigen receptor-T cell therapy for refractory diffuse large B-cell lymphoma developed severe coronavirus disease 2019 (COVID-19) and was treated with nirmatrelvir/ritonavir in April 2022. However, she experienced persistent fatigue and cough and fever in June. Computed tomography revealed bilateral ground-glass opacities (GGO), and the patient was treated with corticosteroids for organizing pneumonia after COVID19. Partial improvement was observed, but new GGO appeared despite corticosteroid therapy. Genome analysis of severe acute respiratory syndrome coronavirus 2 detected Omicron variant BA.1.1.2, which was prevalent at the time of initial infection. The patient was diagnosed with protracted COVID-19 and was treated with remdesivir, molnupiravir, nirmatrelvir/ritonavir, and tixagevimab/cilgavimab. These treatments appeared to contribute to the improvement of protracted COVID-19.No potential conflict of interest relevant to this article was reported.Japan Concrete InstituteActa Medica Okayama1346-80142252024Freeze-thaw Resistance of Concrete using Ground Granulated Blast-furnace Slag and Blast-furnace Slag Sand in Salt Water253266ENToshikiAyanoFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityTakashiFujiiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityKanakoOkazakiDivision of Social Engineering and Environmental Management, Graduate School of Environmental and Life Science, Okayama UniversityThe freeze-thaw resistance of concrete is significantly lower in salt water than in fresh water. Concrete deteriorates through repeated freezing and thawing, but in salt water, freezing alone leads to destruction. This paper investigated the effect of calcium hydroxide in concrete on the failure of concrete under such low temperatures. Calcium hydroxide precipitates at the transition zone between aggregate and cement paste due to the hydration of cement. The lower the temperature and the higher the concentration of salt water, the more calcium hydroxide dissolves. From concrete, more calcium hydroxide is eluted in salt water than in fresh water. This accelerates the deterioration of mortar and concrete due to freeze-thaw action. Mortar and concrete using ground granulated blast-furnace slag produces less calcium hydroxide. In mortar and concrete using blast-furnace slag sand, calcium hydroxide precipitated around the aggregate reacts with cement paste and blast-furnace slag sand to modify the transition zone. From these results, it was clarified that concrete using blast-furnace slag exhibits high freeze-thaw resistance even in salt water.<br>
This paper is the English translation of the authors’ previous work [Ayano, T., Fujii, T. and Okazaki, K., (2023). “Freeze-thaw resistance of concrete using ground granulated blast-furnace and blast-furnace slag sand in salt water.” Japanese Journal of JSCE, 79(12), 23-00042. (in Japanese)].No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2688-6146542024Combination of reduced post-transplant cyclophosphamide and early tacrolimus initiation increases the incidence of chronic graft-versus-host disease in human leukocyte antigen-haploidentical peripheral blood stem-cell transplantation810814ENToshikiTeraoDepartment of Hematology and Oncology, Okayama University HospitalTakumiKondoDepartment of Hematology and Oncology, Okayama University HospitalMakotoNakamuraDepartment of Hematology and Oncology, Okayama University HospitalHirokiTakasukaDepartment of Hematology and Oncology, Okayama University HospitalHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University HospitalHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalKen-IchiMatsuokaDepartment of Hematology and Oncology, Okayama University HospitalWe evaluated the clinical impacts of the concurrent modification of post-transplant cyclophosphamide (PTCy) dose and tacrolimus (Tac)-initiation timing in 61 patients with human leukocyte antigen-haploidentical transplantation. Reduced-dose PTCy (80 mg/kg) was associated with a higher incidence of moderate-to-severe chronic graft-versus-host disease (GVHD) than standard-dose PTCy (100 mg/kg) (35.0% vs. 26.6%, p = 0.053). Notably, early-initiation Tac (day -1) increased moderate-to-severe chronic GVHD than standard-initiation Tac (day 5) in the reduced-dose PTCy group (p = 0.032), whereas Tac-initiation timing did not impact chronic GVHD in the standard-dose PTCy group. These data indicate that the combination of reduced-dose PTCy and early-initiation Tac can amplify chronic GVHD.No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1471-230X2412024Endoscopic manifestation of intestinal transplant-associated microangiopathy after stem cell transplantation140ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNobuharuFujiiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKen-IchiMatsuokaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshihiroInokuchiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSakikoHiraokaDepartment 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 Endoscopic features of intestinal transplant-associated microangiopathy (iTAM) have not been comprehensively investigated. This study aimed to examine the endoscopic characteristics of patients diagnosed with iTAM.<br>
Methods This retrospective analysis included 14 patients pathologically diagnosed with iTAM after stem cell transplantation for hematolymphoid neoplasms (n = 13) or thalassemia (n = 1). The sex, age at diagnosis, endoscopic features, and prognosis of each patient were assessed. Serological markers for diagnosing transplant-associated thrombotic microangiopathy were also evaluated.<br>
Results The mean age at the time of iTAM diagnosis was 40.2 years. Patients diagnosed based on the pathognomonic pathological changes of iTAM presented with diverse symptoms at the times of endoscopic examinations, including diarrhea (n = 10), abdominal pain (n = 5), nausea (n = 4), appetite loss (n = 2), bloody stools (n = 2), abdominal discomfort (n = 1), and vomiting (n = 1). At the final follow-up, six patients survived, while eight patients succumbed, with a median time of 100.5 days (range: 52-247) post-diagnosis. Endoscopic manifestations included erythematous mucosa (n = 14), erosions (n = 13), ulcers (n = 9), mucosal edema (n = 9), granular mucosa (n = 9), and villous atrophy (n = 4). Erosions and/or ulcers were primarily observed in the colon (10/14, 71%), followed by the ileum (9/13, 69%), stomach (4/10, 40%), cecum (5/14, 36%), duodenum (3/10, 30%), rectum (4/14, 29%), and esophagus (1/10, 10%). Cytomegalovirus infection (n = 4) and graft-versus-host disease (n = 2) coexisted within the gastrointestinal tract. Patients had de novo prolonged or progressive thrombocytopenia (6/14, 43%), decreased hemoglobin concentration (4/14, 29%), reduced serum haptoglobin level (3/14, 21%), and a sudden and persistent increase in lactate dehydrogenase level (2/14, 14%). Peripheral blood samples from 12 patients were evaluated for schistocytes, with none exceeding 4%.<br>
Conclusions This study provides a comprehensive exploration of the endoscopic characteristics of iTAM. Notably, all patients exhibited erythematous mucosa throughout the gastrointestinal tract, accompanied by prevalent manifestations, such as erosions (93%), ulcers (64%), mucosal edema (64%), granular mucosa (64%), and villous atrophy (29%). Because of the low positivity for serological markers of transplant-associated thrombotic microangiopathy in patients with iTAM, endoscopic evaluation and biopsy of these lesions are crucial, even in the absence of these serological features.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024Sigle Agent of Posttransplant Cyclophosphamide Without Calcineurin Inhibitor Controls Severity of Experimental Chronic GVHD123134ENKyosukeSaekiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalKeisukeSeikeDepartment of Hematology and Oncology, Okayama University HospitalTaigaKuroiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-ichiMatsuokaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuharuFujiiDivision of Transfusion, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/66915Chronic graft-versus-host disease (GVHD) is a major cause of late death and morbidity following allogeneic hematopoietic cell transplantation (HCT), but its pathogenesis remains unclear. Recently, haplo-identical HCT with post-transplant cyclophosphamide (Haplo-HCT with PTCY) was found to achieve a low incidence rate of acute GVHD and chronic GVHD. However, while the pathogenesis of acute GVHD following Haplo-HCT with PTCY has been well investigated, that of chronic GVHD remains to be elucidated, especially in HLA-matched HCT with PTCY. Based on its safety profile, PTCY is currently applied for the human leucocyte antigen (HLA)-matched HCT setting. Here, we investigated the mechanisms of chronic GVHD following HLA-matched HCT with PTCY using a well-defined mouse chronic GVHD model. PTCY attenuated clinical and pathological chronic GVHD by suppressing effector T-cells and preserving regulatory T-cells compared with a control group. Additionally, we demonstrated that cyclosporine A (CsA) did not show any additional positive effects on attenuation of GVHD in PTCY-treated recipients. These results suggest that monotherapy with PTCY without CsA could be a promising strategy for the prevention of chronic GVHD following HLA-matched HCT.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 Okayama2436-3227420242023年度における「先進病院実習」の取り組み3139ENMizukiMORITAFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTomoakiMORIFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityToshiakiAIDAFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityToyohikoWATANABEFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityDaijiFUJIIFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityNahokoHARADAFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityReiHAKAMADAFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityYasuyukiYOSHIBAFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama University10.18926/interdisciplinary/66896No potential conflict of interest relevant to this article was reported.American Society of HematologyActa Medica Okayama2473-95297242023Distribution and clinical impact of molecular subtypes with dark zone signature of DLBCL in a Japanese real-world study74597470ENTomohiroUrataDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeNaoiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAixiangJiangBritish Columbia Cancer, Centre for Lymphoid CancerMerrillBoyleBritish Columbia Cancer, Centre for Lymphoid CancerKazutakaSunamiDepartment of Hematology, NHO Okayama Medical CenterToshiImaiDepartment of Hematology and Blood Transfusion, Kochi Health Sciences CenterYuichiroNawaDivision of Hematology, Ehime Prefectural Central HospitalYasushiHiramatsuDepartment of Hematology and Oncology, Japanese Red Cross Society Himeji HospitalKazuhikoYamamotoDepartment of Hematology and Oncology, Okayama City HospitalSoichiroFujiiDepartment of Hematology, Japanese Red Cross Okayama HospitalIsaoYoshidaDepartment of Hematologic Oncology, NHO Shikoku Cancer CenterTomofumiYanoDepartment of Internal Medicine, Okayama Rosai HospitalRyotaChijimatsuCenter for Comprehensive Genomic Medicine, Okayama University HospitalHiroyukiMurakamiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroIkeuchiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokiKobayashiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsumaTaniDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidekiUjiieCenter for Comprehensive Genomic Medicine, Okayama University HospitalHirofumiInoueClinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceShutaTomidaCenter for Comprehensive Genomic Medicine, Okayama University HospitalAkiraYamamotoDepartment of Hematology and Oncology, Okayama University HospitalTakumiKondoDepartment of Hematology and Oncology, Okayama University HospitalHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalKen-ichiMatsuokaDepartment of Hematology and Oncology, Okayama University HospitalKeisukeSawadaDepartment of Pathology, Saitama Medical Center, Saitama Medical UniversityShujiMomoseDepartment of Pathology, Saitama Medical Center, Saitama Medical UniversityJun-ichiTamaruDepartment of Pathology, Saitama Medical Center, Saitama Medical UniversityAsamiNishikoriDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesYasuharuSatoDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesTadashiYoshinoDepartment of Pathology, Okayama UniversityYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDavid W.ScottBritish Columbia Cancer, Centre for Lymphoid CancerDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University HospitalThe distribution and clinical impact of cell-of-origin (COO) subtypes of diffuse large B-cell lymphoma (DLBCL) outside Western countries remain unknown. Recent literature also suggests that there is an additional COO subtype associated with the germinal center dark zone (DZ) that warrants wider validation to generalize clinical relevance. Here, we assembled a cohort of Japanese patients with untreated DLBCL and determined the refined COO subtypes, which include the DZ signature (DZsig), using the NanoString DLBCL90 assay. To compare the distribution and clinical characteristics of the molecular subtypes, we used a data set from the cohort of British Columbia Cancer (BCC) (n = 804). Through the 1050 patient samples on which DLBCL90 assay was successfully performed in our cohort, 35%, 45%, and 6% of patients were identified to have germinal center B-cell–like (GCB) DLBCL, activated B-cell–like (ABC) DLBCL, and DZsig-positive (DZsigpos) DLBCL, respectively, with the highest prevalence of ABC-DLBCL, differing significantly from the BCC result (P < .001). GCB-DLBCL, ABC-DLBCL, and DZsigpos-DLBCL were associated with 2-year overall survival rates of 88%, 75%, and 66%, respectively (P < .0001), with patients with DZsigpos-DLBCL having the poorest prognosis. In contrast, GCB-DLBCL without DZsig showed excellent outcomes after rituximab-containing immunochemotherapy. DZsigpos-DLBCL was associated with the significant enrichment of tumors with CD10 expression, concurrent MYC/BCL2 expression, and depletion of microenvironmental components (all, P < .05). These results provide evidence of the distinct distribution of clinically relevant molecular subtypes in Japanese DLBCL and that refined COO, as measured by the DLBCL90 assay, is a robust prognostic biomarker that is consistent across geographical areas.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2023Donor’s long-term quality of life following living-donor lobar lung transplantationENKentoFUJIIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo 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.Acta Medica Okayama2005金属酸化物複合型ヒドロキシアパタイトの創成と生理活物質の特異吸着現象ENNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7742023Feasibility of Flow Cytometry Analysis of Gastrointestinal Tract-Residing Lymphocytes in Hematopoietic Stem Cell Transplant Recipients347357ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakumiKondoDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuharuFujiiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-ichiMatsuokaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakahideTakahashiDivision of Medical Support, Okayama University HospitalArakiHirabataDivision of Medical Support, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/65740The feasibility of lymphocyte isolation and flow cytometry using a single endoscopic biopsy specimen from the gastrointestinal tract of patients who have undergone hematopoietic stem cell transplantation has not been investigated. We acquired 51 endoscopic biopsy specimens from the gastrointestinal tract of 35 patients. We divided the flow cytometry samples into two groups: group A, successful lymphocyte isolation (n=24), and group B, incomplete isolation (n=27). We compared the backgrounds of the samples between the groups to reveal crucial elements in the successful isolation of lymphocytes residing in the gastrointestinal tract. Comparison between the groups revealed lymphocyte isolation success rates differed between biopsy sites. Isolation was most successful in samples from the duodenum (8/9, 88.9%), followed by the ileum (4/8, 50.0%), large intestine (4/11, 36.4%), and stomach (8/23, 34.8%). Tacrolimus was used more frequently in group B (92.6%) than in group A (62.5%) (p=0.015). Logistic regression analysis revealed that isolation from the duodenum or ileum was a significant factor for successful isolation, while tacrolimus use was not statistically significant. In conclusion, the duodenum and ileum are more suitable sites than the stomach and colorectum for acquiring samples for flow cytometry.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465512023小田なら著『〈伝統医学〉が創られるとき：ベトナム医療政策史』（京都大学学術出版会，2022年）7787ENHiroshiKinoshitaDaijiFujii10.18926/OER/65686No potential conflict of interest relevant to this article was reported.SAGE PublicationsActa Medica Okayama2324-7096112023Bilateral Lacrimal Gland Mantle Cell Lymphoma in 11-Year Follow-Up: Case Report and Review of 48 Cases With Ocular Adnexal Presentation in the LiteratureENToshihikoMatsuoOkayama UniversityTakehiroTanakaOkayama UniversityKazuyaOkadaKurashiki Central HospitalKenjiNotoharaKurashiki Central HospitalKeikoFujiiOkayama University HospitalNobuharuFujiiOkayama University HospitalA 63-year-old woman, with 11-year history of breast cancer, showed bilateral lacrimal gland enlargement on magnetic resonance imaging. Gallium-67 scintigraphy, as the standard at that time in 2004, demonstrated abnormally high uptake only in bilateral lacrimal glands. The lacrimal glands were extirpated and the pathological diagnosis was mantle cell lymphoma (MCL). She underwent bilateral orbital radiation, based on no uptake of gallium-67 in other sites of the body. In a month, bone marrow biopsy revealed the infiltration with MCL, positive for cyclin D1. She showed hepatic lymphadenopathy and splenomegaly, and so received 2 cycles of alternating Hyper-CVAD therapy and high-dose methotrexate with cytarabine, combined with rituximab, in 2 months, leading to complete remission. She underwent autologous peripheral blood stem cell transplantation and was well until the age of 68 years when she showed a recurrent intratracheal submucosal lesion of lymphoma and underwent one course of reduced-dose CHOP combined with rituximab. Next year, the left rib resection revealed the metastasis of breast adenocarcinoma, leading to daily oral letrozole. Further 2 years later, computed tomographic scan demonstrated multiple submucosal nodular lesions in the trachea and bronchi, together with cervical and supraclavicular lymphadenopathy, and intratracheal lesion biopsy and bone marrow biopsy proved the involvement with MCL. She underwent 2 courses of bendamustine and rituximab, resulting in complete remission but died of metastatic breast cancer at the age of 74 years. Clinical features in 48 previous cases with ocular adnexal MCL in the literature were summarized in this study.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0041-11326372023Efficient granulocyte collection method using high concentrations of medium molecular weight hydroxyethyl starch13441353ENTakumiKondoDivision of Transfusion, Okayama University HospitalKeikoFujiiDivision of Clinical Laboratory, Okayama University HospitalNobuharuFujiiDivision of Transfusion, Okayama University HospitalYuichiSumiiDivision of Transfusion, Okayama University HospitalTomohiroUrataDivision of Transfusion, Okayama University HospitalMaikoKimuraDivision of Transfusion, Okayama University HospitalMasayukiMatsudaDivision of Transfusion, Okayama University HospitalShuntaroIkegawaDivision of Transfusion, Okayama University HospitalKanaWashioDepartment of Pediatrics/Pediatric Hematology and Oncology, Okayama University HospitalHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University HospitalHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalKen‐ichiMatsuokaDepartment of Hematology and Oncology, Okayama University HospitalFumioOtsukaDivision of Clinical Laboratory, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalBackground: Granulocyte transfusion therapy is a rational therapeutic option for patients with prolonged, severe neutropenia. Although high molecular weight hydroxyethyl starch (hHES) facilitates the separation of red blood cells during granulocyte collection, renal dysfunction has been noted as a potential side effect. HES130/0.4 (Voluven®) is a medium molecular weight HES (mHES) with superior safety profiles compared to hHES. Although HES130/0.4 is reportedly effective in the collection of granulocytes, we lack studies comparing the efficiency of granulocyte collection using HES130/0.4 and hHES.<br>
Study Design and Methods: We retrospectively collected the data from 60 consecutive apheresis procedures performed on 40 healthy donors at the Okayama University Hospital between July 2013 and December 2021. All procedures were performed using the Spectra Optia system. Based on the HES130/0.4 concentration in the separation chamber, granulocyte collection methods using HES130/0.4 were classified into m0.46, m0.44, m0.37, and m0.8 groups. We used HES130/0.4 and hHES groups to compare the various sample collection methods.<br>
Results: The median granulocyte collection efficiency (CE) was approximately 24.0% and 28.1% in the m0.8 and hHES groups, respectively, which were significantly higher than those in the m0.46, m0.44, and m0.37 groups. One month following granulocyte collection with HES130/0.4, no significant changes were observed in serum creatinine levels compared to those before the donation.<br>
Conclusion: Therefore, we propose a granulocyte collection approach employing HES130/0.4, which is comparable to the use of hHES in terms of the granulocyte CE. A high concentration of HES130/0.4 in the separation chamber was considered crucial for granulocyte collection.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2023Research on Sophistication and Improving Efficiency of Practical Security OperationsENShotaFUJIIGraduate School of Natural Science and Technology, Okayama universityNo 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幼稚園・保育所・幼保連携型認定こども園における｢専門職の学習共同体｣の醸成 ―教育・保育課程等編成のプロセスに着目して―6982ENYushiFujiiKurashiki Municipal Kurashiki Special Needs SchoolShinnosukeKumagaiFaculty of Education, Okayama University10.18926/CTED/65065 本研究では，幼稚園・保育所・幼保連携型認定こども園においてP L C 醸成をめざした際の，教育・保育課程等編成のプロセスを明らかにすることを目的とした。カリキュラム・マネジメントによる学校文化変革のプロセスとP T L C の関係性を整理した上で，PLC 醸成をめざしたカリキュラム編成のプロセスを示し，それをもとに， P L C 醸成にむけた教育・保育課程等編成のプロセスを示した。そして，『幼稚園教育要領解説』，『保育所保育指針解説』，『幼保連携型認定こども園教育・保育要領解説』で示された教育・保育課程等編成の手順と比較し，プロセスやリーダーシップのあり方に関する違いが確認できた。No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama1932-744712752023Uniform Formation of a Characteristic Nanocomposite Structure of Biogenous Iron Oxide for High Rate Performance as the Anode of Lithium-Ion Batteries22232230ENMasakuniTakahashiGraduate School of Natural Science and Technology, Okayama UniversityRyoSakumaGraduate School of Natural Science and Technology, Okayama UniversityHidekiHashimotoGraduate School of Natural Science and Technology, Okayama UniversityTatsuoFujiiGraduate School of Natural Science and Technology, Okayama UniversityJunTakadaGraduate School of Natural Science and Technology, Okayama UniversityRecently, Fe2O3 has been considered as an alternative anode material for lithium-ion batteries (LIBs) owing to its high theoretical capacity (approximately 1000 mA h g-1), low cost, and nontoxicity. However, its rate performance remains poor relative to that of the conventional graphite anode. In this study, Fe2O3-based anodes were prepared through the annealing of biogenous Fe2O3 (L-BIOX) samples produced by an aquatic Fe-oxidizing bacterium. The effect of the annealing temperature on the performance of the synthesized Fe2O3-based material as the anode of an LIB was investigated. Electrochemical measurements revealed that the annealed L-BIOX samples at 300-700 degrees C exhibited higher rate performances than the unannealed material. Particularly, the sample annealed at 700 degrees C exhibited the highest capacity among the synthesized materials and showed a higher performance than the previously reported Fe2O3-based anodes. It exhibited a capacity of 923 mA h g-1 even at a high current density of 2 A g-1. After annealing at 700 degrees C and discharging, the synthesized biogenous material had a uniform nanocomposite structure composed of alpha-Fe2O3 nanoparticles dispersed in an amorphous matrix of Li-Si-P oxide. To form this uniform nanostructure, the solid-state diffusion resistance of the Li+ ions in the active material was reduced, which consequently improved the rate performance of the electrode. Therefore, this study provides substantial insights into the development and improvement of the performance of novel Fe2O3-based nanomaterials as the anode of LIBs.No potential conflict of interest relevant to this article was reported.KargerActa Medica Okayama1662-65751532022Sequential Combination of FLAM and Venetoclax plus Azacitidine to Bridge to Cord Blood Transplantation in a Patient with Primary Induction Failure Acute Myeloid Leukemia974979ENHiroyukiMurakamiDepartment of Hematology and Oncology, Okayama University HospitalKen-IchiMatsuokaDepartment of Hematology and Oncology, Okayama University HospitalTakeruAsanoDepartment of Hematology and Oncology, Japanese Red Cross Society Himeji HospitalTakashiMoriyamaDepartment of Hematology and Oncology, Okayama University HospitalAkifumiMatsumuraDepartment of Hematology and Oncology, Okayama University HospitalHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University HospitalHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalTomohiroTojiDepartment of Pathology, Okayama University HospitalTadashiYoshinoDepartment of Pathology, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalVenetoclax (VEN) is an oral B-cell lymphoma-2 (BCL-2) inhibitor that has been widely used to treat various hematological disorders. Recent studies have demonstrated that VEN in combination with fludarabine-enhanced high-dose cytarabine (FLA) is effective for treating relapsed or refractory acute myeloid leukemia (AML). In the combination therapy, salvage chemotherapy and VEN are basically concurrently administrated; however, further optimization may enable the treatment to apply to larger numbers of patients with various clinical backgrounds. Here, we describe a case of refractory AML treated with a sequential combination of the intensive chemotherapy (fludarabine, cytarabine, and mitoxantrone; FLAM) and VEN/AZA to bridge to an unrelated cord blood transplantation (uCBT). By continuously adding VEN/AZA after FLAM, the patient achieved morphologic leukemia free state with only minor toxicities. Blood cell counts did not recover until the time of transplantation because of the deep myelosuppression caused by the treatment sequence, but the infection risk was safely managed during this period. After engraftment, maintenance therapy with VEN/AZA was performed, and the patient has survived without disease recurrence for over 9 months after transplantation. Our case suggests that bridging therapy with VEN and AZA from the time of the last chemotherapy to allogeneic transplantation may provide an effective and tolerable treatment strategy for refractory AML. Further studies of larger numbers of cases are needed to validate the effectiveness of this treatment.No potential conflict of interest relevant to this article was reported.岡山大学農学部附属山陽圏フィールド科学センターActa Medica Okayama0910-8742412019モモ‘紅清水’における赤肉果の音響振動法による非破壊判別技術の検討913ENFumioFukudaKenHiranoKunihisaMorinagaNo potential conflict of interest relevant to this article was reported.Public Library ScienceActa Medica Okayama1932-62031792022Prevention of non-infectious pulmonary complications after intra-bone marrow stem cell transplantation in micee0273749ENYoshikoYamasuji-MaedaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeisukeSeikeDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkiraYamamotoDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTaigaKuroiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKyosukeSaekiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukoFujinagaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSachiyoOkamotoDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-IchiMatsuokaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuharuFujiiDepartment of Transfusion Medicine, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasahiroFujiiDepartment of Animal Resources, Advanced Science Research Center, Okayama UniversityKatsumiMominokiDepartment of Animal Resources, Advanced Science Research Center, Okayama UniversityTakuroKanekuraDepartment of Dermatology, Kagoshima University Graduate School of Medical and Dental SciencesYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNon-infectious pulmonary complications including idiopathic pneumonia syndrome (IPS) and bronchiolitis obliterans syndrome (BOS), which are clinical and diagnostic manifestations of lung chronic graft-versus-host disease (GVHD), cause significant mortality after allogeneic stem cell transplantation (SCT). Increasing evidence suggests that alloantigen reactions in lung tissue play a central role in the pathogenesis of IPS and BOS; however, the mechanism is not fully understood. Several clinical and experimental studies have reported that intrabone marrow (IBM)-SCT provides high rates of engraftment and is associated with a low incidence of acute GVHD. In the present study, allogeneic SCT was conducted in mouse models of IPS and BOS, to compare intravenous (IV)-SCT with IBM-SCT. Allogeneic IBM-SCT improved the clinical and pathological outcomes of pulmonary complications compared to those of IV-SCT. The mechanisms underlying the reductions in pulmonary complications in IBM-SCT mice were explored. The infiltrating lung cells were mainly CD11b+ myeloid and CD3+ T cells, in the same proportions as in transplanted donor cells. In an in vivo bioluminescence imaging, a higher proportion of injected donor cells was detected in the lung during the early phase (1 h after IV-SCT) than after IBM-SCT (16.7 +/- 1.1 vs. 3.1 +/- 0.7 x 10(5) photons/s/animal, IV-SCT vs. IBM-SCT, P = 1.90 x 10(-10)). In the late phase (5 days) after SCT, there were also significantly more donor cells in the lung after IV-SCT than after IBM-SCT or allogeneic-SCT (508.5 +/- 66.1 vs. 160.1 +/- 61.9 x 10(6) photons/s/animal, IV-SCT vs. IBM-SCT, P = 0.001), suggesting that the allogeneic reaction induces sustained donor cell infiltration in the lung during the late phase. These results demonstrated that IBM-SCT is capable of reducing injected donor cells in the lung; IBM-SCT decreases donor cell infiltration. IBM-SCT therefore represents a promising transplantation strategy for reducing pulmonary complications, by suppressing the first step in the pathophysiology of chronic GVHD.No potential conflict of interest relevant to this article was reported.Japanese Society for Lymphoreticular Tissue ResearchActa Medica Okayama1346-42806232022CD19 immunostaining of a stored paraffin-embedded vitrectomy cell block of intraocular lymphoma contributing to chimera antigen receptor T-cell therapy187189ENToshihikoMatsuoRegenerative and Reconstructive Medicine (Ophthalmology), Okayama University Graduate School of Interdisciplinary Science and Engineering in Health SystemsTakehiroTanakaPathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNobuharuFujiiHematology/Oncology and Division of Blood Transfusion, Okayama University HospitalKentaroFujiiNeurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesEiseiKondoHematology/Oncology, Kawasaki Medical SchoolNo potential conflict of interest relevant to this article was reported.American Chemical SocietyActa Medica Okayama2470-13437152022Eco-Benign Orange-Hued Pigment Derived from Aluminum-Enriched Biogenous Iron Oxide Sheaths1279512802ENKatsunoriTamuraGraduate School of Natural Science and Technology, Okayama UniversityYuriOshimaGraduate School of Natural Science and Technology, Okayama UniversityYutaFuseGraduate School of Natural Science and Technology, Okayama UniversityNoriyukiNagaokaAdvanced Research Center for Oral and Craniofacial Sciences, Okayama UniversityTatsukiKunohGraduate School of Natural Science and Technology, Okayama UniversityMakotoNakanishiGraduate School of Natural Science and Technology, Okayama UniversityTatsuoFujiiGraduate School of Natural Science and Technology, Okayama UniversityTokuroNanbaGraduate School of Environmental and Life Science, Okayama UniversityJunTakadaGraduate School of Natural Science and Technology, Okayama UniversityInorganic pigments have been widely used due to their low cost of production, strong hiding power, and chemical resistance; nevertheless, they have limited hue width and chromaticity. To eliminate these disadvantages, we herein propose the use of an ingenious biotemplate technique to produce Al-enriched biogenic iron oxide (BIOX) materials. Spectrophotometric color analysis showed that high levels of Al inclusion on heat-treated BIOX samples produced heightened yellowish hues and lightness. The Al-enriched BIOX sheaths exhibited a stable tubular structure and excellent thermal stability of color tones after heating at high temperatures and repetitive heat treatments. Ultrastructural analysis and mechanical destruction experiments revealed that the highly chromatic orange-hue of these pigments are ascribed probably to an ingenious cylindrical nanocomposite architecture composed of putative Fe-included low crystalline Al oxide regions and hematite particles embedded therein. The present work therefore demonstrates that the bioengineered material can serve as an epochal orange-hued inorganic pigment with low toxicity and marked thermostability that should meet large industrial demand.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-4146533202219世紀ポーランド王国における鉄道建設 －ウッジ繊維工業地帯を中心に－4566ENKazuoFujii10.18926/OER/63486No 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 Okayama2436-322722022ビジネスケース：島根県隠岐郡海⼠町の⾏政改⾰19ENToshimitsuTsutsuiSatosho Town Hall, General Affairs Division, ChiefDaijiFujiiFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama University10.18926/interdisciplinary/63465The Oki Islands, located about 60 km off the coast of the Sea of Japan, north of Shimane Prefecture, constitute an administrative division called Oki District. One of the four manned islands, Nakanoshima, which has an area of 33.43 ㎢ and a circumference of 89.1 km, is called Ama Town as a basic municipality, and it is said that about 7,000 people lived around 1950 at its peak time. The number is, however, currently less than 2,300. The population by over 60 reaches 47.73% and the islanders call this situation a "microcosm of Japan." The climate is relatively warm, and it is a semi-agricultural and semi-fishing island. As is often the case, a traditional local food became the detonator of the island revitalization. The recent popular souvenir "Sazae Curry" was once a home-cooked dish for the islanders using turban shells and delivers the exquisiteness particular to the land and nostalgia of a sort. This is, however, memorabilia of the old days when the "Sazae" was a substitute meat for unwealthy fishermen. Today, on the contrary, the island's agriculture, forestry and fisheries has become known to deliver local specialities such as Oki beef of range cattle, farmed rock oysters from the natural coves, and squids that utilize the latest quick-freezing technology, etc. This economic restructuring is not the only achievement that the administrative reform of Ama Town has demonstrated, which also covers local finance and public education. As a business case, this paper provides a clearer picture of the process of the reform that was initiated in 2000s by the former town mayor, Michio Yamauchi.No potential conflict of interest relevant to this article was reported.The Japanese Society for Lymphoreticular Tissue ResearchActa Medica Okayama1346-42806212022Transformed diffuse large B-cell lymphoma from marginal zone lymphoma in the anterior mediastinum: A case report and review of the literature3540ENWataruKitamuraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalTetsuyaTabataDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesReiShibataDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTatsuyaNishiDepartment of Respiratory and Allergy, Okayama University HospitalYukaKatoCenter for Innovative Clinical Medicine, Okayama University HospitalHirokiTakasukaDepartment of Hematology and Oncology, Okayama University HospitalHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiCenter for Comprehensive Genomic Medicine, Okayama University HospitalHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Transfusion Medicine, Okayama University HospitalKen-IchiMatsuokaDepartment of Hematology and Oncology, Okayama University HospitalKatsuyukiKiuraDepartment of Respiratory and Allergy, Okayama University HospitalTadashiYoshinoDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalMarginal zone lymphoma (MZL) arising from the anterior mediastinum is rare. In the majority of reported cases, the tumor was incidentally discovered, reflecting its indolent clinical features. We present a 38-year-old woman who had no medical history, and presented with a bulky anterior mediastinal tumor complicated by life-threatening compression of the vasculature and bronchi. Biopsy specimens of the neoplasm suggested transformed diffuse large B-cell lymphoma (DLBCL) from MZL. To our best knowledge, this is the first case report of anterior mediastinum MZL associated with an aggressive clinical course and life-threatening complications likely due to transformation to DLBCL.No potential conflict of interest relevant to this article was reported.The Japanese Society of Internal MedicineActa Medica Okayama0918-291860192021Nodal Peripheral T-cell Lymphoma with T Follicular Helper Phenotype Presenting as Chorea During Treatment: A Case Report and Literature Review31553160ENWataruKitamuraDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiCenter for Comprehensive Genomic Medicine, Okayama University HospitalRyoyaYukawaDepartment of Hematology and Oncology, Okayama University HospitalRyoSasakiDepartment of Neurology, Okayama University HospitalChikamasaYoshidaDepartment of Hematology, Okayama City HospitalHirokiTakasukaDepartment of Hematology and Oncology, Okayama University HospitalHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDivision of Clinical Laboratory, Okayama University HospitalNobuharuFujiiDivision of Blood Transfusion, Okayama University HospitalKen-IchiMatsuokaDepartment of Hematology and Oncology, Okayama University HospitalKojiAbeDepartment of Neurology, Okayama University HospitalTadashiYoshinoDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalA 72-year-old man presented with chorea while undergoing treatment for recurrence of nodal peripheral T-cell lymphoma with T follicular helper (TFH) phenotype. An examination by brain N-isopropyl-p-iodoamphetamine (I-123-IMP)-single photon emission computed tomography (SPECT) revealed no abnormalities other than a decreased cerebral blood flow (CBF) in the left striatum. After four courses of salvage chemotherapy, his clinical symptoms and asymmetric cerebral perfusion improved, suggesting that the decreased CBF had caused chorea. The significance of brain SPECT has not been fully clarified in patients with chorea-associated malignant lymphoma, warranting further investigations. Brain SPECT is an alternative approach to identify abnormalities in such patients.No potential conflict of interest relevant to this article was reported.The Japanese Society of Internal MedicineActa Medica Okayama0918-291860172021Marginal Zone Lymphoma and Lung Adenocarcinoma with an EGFR Exon 19 E746-S752del Mutation in a Patient with IgG4-related Disease28312837ENSachiOkawaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKammeiRaiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuharuFujiiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukaGionDivision of Pathophysiology, Okayama University Graduate School of Health SciencesKiichiroNinomiyaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukaKatoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkihikoTaniguchiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshioKuboDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEikiIchiharaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKadoakiOhashiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuakiMiyaharaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiHottaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasahiroTabataDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiKiuraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesA 68-year-old man presented with a solid mass at the left renal pelvis and ureter with multiple systemic lymphadenopathies and a mass with a cavity in the right lower lobe of the lung. While a transbronchial lung biopsy revealed no malignancy, a biopsy of the renal pelvis showed marginal zone lymphoma with polyclonal IgG4-positive cells. The serum IgG4 level and presence of a bilateral orbital mass suggested Mikulicz disease. The lesions shrank following the administration of steroids. A rebiopsy confirmed lung adenocarcinoma, and its background showed IgG4-positive cells a year later. IgG4-related diseases require careful follow-up because they can be complicated by malignancy.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 Okayama1883-24231772021曲種に応じた発声観の調査 ― 児童を対象とした聴取評価の分析から ―6576ENRinkoHayakawaGraduate School of Education, Okayama UniversityKanakoFujiiOnomichi-city Kinosyohigashi Kindergarten10.18926/bgeou/62431The purpose of this study was to analyze the listening evaluation of elementary school students regarding their perceived value of appropriate vocalization for each type of song. Two strikingly different songs were selected: (1) "Hinomaru"， the educational song and (2) "Lift Your Palms Toward the Sun", a very familiar and popular song among Japanese children in and outside of Japan. In terms of vocalization, we conducted listening evaluation by presenting students with each song or sound source based on three frames of reference: (1) natural voice, (2) falsetto, and (3) sound created by artificial-voice technology. Most students perceived that the use of falsetto was suitable for "Hinomaru", while higher appropriateness scores tended to be dispersed in either natural voice or falsetto for "Let＇s Put Our Palm to the Sunshine." Interestingly, for "Hinomaru", the number of students who reported the use of falsetto as more appropriate increased for older students in higher school years. We peculate that this trend may be the outcome of their learning vocalization in elementary school.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama1466-80332021Single domain growth and charge ordering of epitaxial YbFe2O4 filmsENTakumiSakagamiDepartment of Applied Chemistry, Okayama UniversityReikaOtaDepartment of Applied Chemistry, Okayama UniversityJunKanoDepartment of Applied Chemistry, Okayama UniversityNaoshiIkedaDepartment of Physics, Okayama UniversityTatsuoFujiiDepartment of Applied Chemistry, Okayama UniversityYbFe2O4 is a charge-ordered ferroelectric that exhibits coupling between magnetization and electric polarization near room temperature and crystallizes in a rhombohedral structure (R3¯m). This study presents an attempt to fabricate stoichiometric and epitaxial YbFe2O4-δ films with a nearly single-domain structure using an RF magnetron sputtering method. The (0001)-oriented epitaxial films of YbFe2O4-δ on YSZ (111) substrates via reactive sputtering method exhibited clear three-fold symmetry normal to the substrate without the formation of twin domains rotated by 60°. The oxygen stoichiometry of the epitaxial YbFe2O4-δ was improved by controlling an oxygen partial pressure (PO2) during the deposition. The films showed a sharp ferrimagnetic transition, and the transition temperature (TN) increased linearly to approximately 245 K with decreasing PO2. The magnitude of magnetization of the obtained films was comparable to that of bulk single crystals. Further, the electron diffraction pattern of the stoichiometric films confirmed the presence of three-dimensional charge order, which is
consistent with the behavior of the bulk crystals as well.No potential conflict of interest relevant to this article was reported.The Japanese Society of Internal MedicineActa Medica Okayama0918-291860142021Squamous Metaplasia of the Stomach Associated with Lymphoma Infiltration22292234ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNobuharuFujiiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroTanakaDepartment of Pathology, Okayama University HospitalHiromitsuKanzakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSeijiKawanoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Okayama University HospitalHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesWe herein report a patient who presented with follicular lymphoma. Although the stomach was initially intact, mucosal redness and multiple erosions appeared in the gastric body owing to infiltration of the follicular lymphoma cells. Subsequently, a slightly depressed, white area lacking gastric mucosal structure was detected in the lesser curvature of the gastric cardia and body, where lymphoma cell infiltration was also pathologically observed beneath the stratified squamous epithelium. This case indicated that, although infrequent, prolonged mucosal injury owing to lymphoma infiltration can cause squamous metaplasia in the stomach.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2021岡山県のモモ栽培における気象変動が生理障害発生に及ぼす影響の把握と対策技術の開発ENYuichiroFujiiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2021Coating method for smooth and reinforced surface layer of highly translucent zirconiaENYoshiroFujiiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2021Diagnostic Ability of Convex-Arrayed Endoscopic Ultrasonography for Major Vascular Invasion in Pancreatic CancerENYukiFujiiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-29186072021Acute Kidney Injury Caused by Evans Syndrome with Systemic Lupus Erythematosus and Systemic Sclerosis10551060ENNatsumiMatsuokaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNaokoKurookaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSumariKatoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesChikaHigashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKatsuyukiTanabeDivision of Hemodialysis and Apheresis, Okayama University HospitalMasaruKinomuraDivision of Hemodialysis and Apheresis, Okayama University HospitalNobuharuFujiiDepartment of Transfusion Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHitoshiSugiyamaDepartment of Human Resource Development of Dialysis Therapy for Kidney Disease, 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 SciencesA 65-year-old woman with systemic sclerosis and systemic lupus erythematosus developed acute kidney injury (AKI), Coombs-positive autoimmune hemolytic anemia and autoimmune thrombocytopenia; therefore, she was diagnosed with Evans syndrome (ES). Intravascular hemolysis was suggested as the cause of AKI based on the presence of acute tubular injury and trace hemosiderin deposits on the renal biopsy. The renal function, hemolytic anemia and thrombocytopenia were restored by an increased dose of glucocorticoids, hemodialysis, and plasma exchange. Although ES with severe hemolytic anemia is very rare, it is important to detect possible renal dysfunction when encountering patients with severe hemolysis.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ビジネスケース：しまなみ海道の観光資源化2128ENHikariNakaoJapan Broadcasting CorporationDaijiFujiiGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University10.18926/interdisciplinary/61887The Shimanami Kaido Expressway was visioned as a national project in the early 1970s after two tragic maritime accidents in the Setouchi Inner Sea. Since the express way connecting several islands between Hiroshima and Ehime prefecture was placed in use in 1999, it has always been a valuable means of transportation for islanders and commuters to date. In addition, with the proactive efforts made by local governments, such as Imabari City, Onomichi City, let alone with the central and prefectural governments, it has come to be acknowledged to be a sanctuary for sport cyclists. Eventually, it attracts attentions from all over Japan as a successful benchmark for both businesspeople as well as policy makers who are interested in destination management practices as part of promotion policies of reginal economies. This eventual success, however, had not been envisioned as such for a long time since the commencement of its public usage. It would rather seem that the plan had taken on its shape after a long period of many twists and turns. Furthermore, while local governments have been closely cooperating with different types of stakeholders including the actual islanders to promote the development plans, their ways of thinking are still far from unanimous. The purpose of this article is to provide business and policy students with materials that draw lessons for viewing lengthy socioeconomic processes like this case which eventually converted a nation-level, large-scale infrastructure development plan into an area-specific destination management project.No potential conflict of interest relevant to this article was reported.The Japanese Society of Internal MedicineActa Medica Okayama1349-723559192020Localized Lymph Node Light Chain Amyloidosis24152418ENAkiraYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuharuFujiiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikakoObikaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTaroYamashitaDepartment of Neurology, Graduate School of Medical Sciences, Kumamoto UniversityFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe prognosis of systemic amyloid light chain (AL) amyloidosis is generally poor, hence requiring chemotherapy or hematopoietic stem cell transplantation, while the prognosis of localized AL amyloidosis without an abnormal monoclonal immunoglobulin light chain is good. Localized AL amyloidosis has been previously reported to be observed in pulmonary, urinary tract, gastrointestinal, oropharyngeal, and laryngeal sites. However, only a few cases of localized lymph node AL amyloidosis have so far been reported. We herein present a case of localized lymph node AL amyloidosis that could possibly be misdiagnosed as systematic AL amyloidosis.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0918-291859162020Secondary Pulmonary Alveolar Proteinosis Associated with Primary Myelofibrosis and Ruxolitinib Treatment: An Autopsy Case20232028ENHiroyukiSugiuraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisakazuNishimoriDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyaNishiiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomohiroTojiDepartment of Pathology, Okayama University HospitalKeikoFujiiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuharuFujiiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-ichiMatsuokaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKohNakataDepartment of Bioscience Medical Research Center, Niigata University Medical & Dental HospitalKatsuyukiKiuraDepartment of Allergy and Respiratory Medicine, Okayama University HospitalYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPulmonary alveolar proteinosis (PAP) is an uncommon lung disorder characterized by the excessive accumulation of surfactant-derived lipoproteins in the pulmonary alveoli and terminal bronchiole. Secondary PAP associated with primary myelofibrosis (PMF) is extremely rare, and to our knowledge, no autopsy case has been reported. We herein report an autopsy case of secondary PAP occurring in a patient with PMF who was treated with the Janus kinase 1/2 inhibitor ruxolitinib. We confirmed a diagnosis of PAP with complications based on the pathological findings at the autopsy. Notably, this case might suggest an association between ruxolitinib treatment and PAP occurrence. No potential conflict of interest relevant to this article was reported.日本内科学会Acta Medica Okayama0918-291859212020Adult T-cell Leukemia-lymphoma with Primary Breast Involvement: A Case Report and Literature Review27572761ENHirokiKobayashiDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalTakuroIgawaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasayaAbeDepartment of Hematology and Oncology, Okayama University HospitalYusukeMeguriDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University HospitalHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Transfusion Medicine, Okayama University HospitalKen-ichiMatsuokaDepartment of Hematology and Oncology, Okayama University HospitalTadashiYoshinoDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalBreast involvement of Adult T-cell leukemia-lymphoma (ATLL) is extremely rare, and the data on the characteristics are limited. We herein describe a 49-year-old woman who presented with skin involvement of ATLL. Positron emission tomography/computed tomography showed bilateral breast lesions. Although the patient once achieved a complete metabolic response, a relapse of her ATLL occurred. The patient received subsequent allogeneic hematopoietic stem cell transplantation (HSCT). To our knowledge, only four cases of ATLL with breast involvement have previously been reported, and the prognoses have generally been poor. Breast lesions of ATLL have aggressive features, and intensive systemic chemotherapy and HSCT are required to improve survival. No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813222020ホジキンリンパ腫の治療により神経症状の改善を認めた傍腫瘍性神経症候群の1 例8790ENRyosukeIkemachiDepartment of Hematology, Okayama Red Cross HospitalKahoKondoDepartment of Hematology, Okayama Red Cross Hospital AkihumiMatumuraDepartment of Hematology, Okayama Red Cross Hospital SoichiroFujiiDepartment of Hematology, Okayama Red Cross Hospital MakotoTakeuchiDepartment of Hematology, Okayama Red Cross HospitalKoutaSatoDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiAbeDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTadashiYoshinoDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences An 86-year-old man was admitted to another hospital with ataxia and general fatigue. Brain MRI scan revealed a high-intensity area in the bilateral thalamus, and he was referred to Okayama University Hospital for detailed examination. Cerebrospinal fluid (CSF) and blood tests showed no evidence of infection or autoimmune encephalitis. An FDG-PET/CT scan revealed systemic lymphadenopathy, and cervical lymph node biopsy showed classical Hodgkin lymphoma. Neurological symptoms were suspicious of paraneoplastic neurological syndrome (PNS), but onco-neural antibodies were not detected in either serum or CSF. He was referred to our hospital, Okayama Red Cross Hospital, for treatment and administered 6 cycles of an ABVD regimen, and an FDG-PET/CT scan showed a complete remission. The brain lesion disappeared and neurological symptoms were improved, so he was diagnosed with PNS. PNS is rare complication associated with malignant lymphoma and early diagnosis is important because neurological symptoms can be improved with anti-cancer treatment. No potential conflict of interest relevant to this article was reported.Nature ResearchActa Medica Okayama2045-232210120205-aminolevulinic acid-mediated photodynamic therapy can target aggressive adult T cell leukemia/lymphoma resistant to conventional chemotherapy17237ENYasuhisaSandoDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-IchiMatsuokaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuichiSumiiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakumiKondoDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuntaroIkegawaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiSugiuraDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMakotoNakamuraDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikiIwamotoDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeMeguriDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNoboruAsadaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeikoFujiiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuharuFujiiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtaeUtsunomiyaDepartment of Hematology, Imamura General HospitalTakashiOkaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPhotodynamic therapy (PDT) is an emerging treatment for various solid cancers. We recently reported that tumor cell lines and patient specimens from adult T cell leukemia/lymphoma (ATL) are susceptible to specific cell death by visible light exposure after a short-term culture with 5-aminolevulinic acid, indicating that extracorporeal photopheresis could eradicate hematological tumor cells circulating in peripheral blood. As a bridge from basic research to clinical trial of PDT for hematological malignancies, we here examined the efficacy of ALA-PDT on various lymphoid malignancies with circulating tumor cells in peripheral blood. We also examined the effects of ALA-PDT on tumor cells before and after conventional chemotherapy. With 16 primary blood samples from 13 patients, we demonstrated that PDT efficiently killed tumor cells without influencing normal lymphocytes in aggressive diseases such as acute ATL. Importantly, PDT could eradicate acute ATL cells remaining after standard chemotherapy or anti-CCR4 antibody, suggesting that PDT could work together with other conventional therapies in a complementary manner. The responses of PDT on indolent tumor cells were various but were clearly depending on accumulation of protoporphyrin IX, which indicates the possibility of biomarker-guided application of PDT. These findings provide important information for developing novel therapeutic strategy for hematological malignancies.No potential conflict of interest relevant to this article was reported.岡山大学法文学部国語国文学研究室Acta Medica Okayama0386-312381980資料翻刻 松の屋旧蔵『湖月抄』の書入れ注記――藤井高尚の源氏物語研究――5163EN10.18926/okadaironkou/60693No potential conflict of interest relevant to this article was reported.岡山大学文学部国語国文学研究室Acta Medica Okayama0386-312391981藤井高尚判『十七番歌合』について――解説と翻刻――7180EN10.18926/okadaironkou/60678No potential conflict of interest relevant to this article was reported.岡山大学文学部国語国文学研究室Acta Medica Okayama0386-3123121984藤井高尚の鈴の屋入門――本居宣長との交渉をめぐって――144154EN10.18926/okadaironkou/60588No potential conflict of interest relevant to this article was reported.岡山大学文学部国語国文学研究室Acta Medica Okayama0386-3123161988藤井高尚文題索引7989EN10.18926/okadaironkou/60425No potential conflict of interest relevant to this article was reported.岡山大学文学部国語国文学研究室Acta Medica Okayama0386-3123191991藤井高尚の紀行文―『山つと』を中心として―6474EN10.18926/okadaironkou/60384No potential conflict of interest relevant to this article was reported.NatureActa Medica Okayama2045-23221012020Skewed electronic band structure induced by electric polarization in ferroelectric BaTiO310702ENNorihiroOshimeGraduate School of Natural Science and Technology, Okayama UniversityJunKanoGraduate School of Natural Science and Technology, Okayama UniversityEijiIkenagaJapan Synchrotron Radiation Research Institute, JASRIShintaroYasuiLaboratory for Materials and Structures, Tokyo Institute of TechnologyYosukeHamasakiLaboratory for Materials and Structures, Tokyo Institute of TechnologySouYasuharaLaboratory for Materials and Structures, Tokyo Institute of TechnologySatoshiHinokumaInnovative Oxidation Team, Interdisciplinary Research Center for Catalytic Chemistry, National Institute of Advanced Industrial Science and TechnologyNaoshiIkedaGraduate School of Natural Science and Technology, Okayama UniversityPierre-EymericJanolinUniversité Paris-Saclay,CentraleSupélec, CNRS, Laboratoire SPMSJean-MichelKiatUniversité Paris-Saclay,CentraleSupélec, CNRS, Laboratoire SPMSMitsuruItohLaboratory for Materials and Structures, Tokyo Institute of TechnologyTakayoshiYokoyaGResearch Institute for Interdisciplinary Science, Okayama UniversityTatsuoFujiiGraduate School of Natural Science and Technology, Okayama UniversityAkiraYasuiJapan Synchrotron Radiation Research Institute, JASRIHitoshiOsawaJapan Synchrotron Radiation Research Institute, JASRISkewed band structures have been empirically described in ferroelectric materials to explain the functioning of recently developed ferroelectric tunneling junction (FTJs). Nonvolatile ferroelectric random access memory (FeRAM) and the artificial neural network device based on the FTJ system are rapidly developing. However, because the actual ferroelectric band structure has not been elucidated, precise designing of devices has to be advanced through appropriate heuristics. Here, we perform angle-resolved hard X-ray photoemission spectroscopy of ferroelectric BaTiO3 thin films for the direct observation of ferroelectric band skewing structure as the depth profiles of atomic orbitals. The depth-resolved electronic band structure consists of three depth regions: a potential slope along the electric polarization in the core, the surface and interface exhibiting slight changes. We also demonstrate that the direction of the energy shift is controlled by the polarization reversal. In the ferroelectric skewed band structure, we found that the difference in energy shifts of the atomic orbitals is correlated with the atomic configuration of the soft phonon mode reflecting the Born effective charges. These findings lead to a better understanding of the origin of electric polarization.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813212020キメラ抗原受容体導入Ｔ細胞（CAR-T）療法3436ENNobuharuFujiiDivision of Blood Transfusion, Okayama University HospitalNo potential conflict of interest relevant to this article was reported.岡山大学 資源植物科学研究所 野生植物グループActa Medica OkayamaアゼオトギリENNo 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特別支援学校における「専門職の学習共同体」の醸成 : カリキュラム・マネジメントおよび専門性の継承・向上の実現との関係性に着目して107121ENYushiFUJIIShinnosukeKumagaiGraduate School of Education, Okayama UniversityRyoMisawaGraduate School of Education, Okayama University10.18926/CTED/58124 全国の特別支援学校〔聴覚障害部門〕を対象に，カリキュラム・マネジメントの実施や「専門職の学習共同体」の醸成，専門性の継承・向上の実現に関する質問紙調査を行った。収集したデータをもとに相互の関係性を分析した結果，「専門職の学習共同体」を醸成している学校においては専門性を継承・向上している実感が高いことが明らかとなった。また，実施するカリキュラム・マネジメントの質（内容）として「カリキュラムの『見える化』と共有の場づくり」，「カリキュラム開発のための協働の場づくり」等のカリキュラムを基軸に教職員間のつながりを深める取組を行っている学校においては，「専門職の学習共同体」の構成因子のうち「学校内の信頼関係」，「目標の共有」，「学校内外の協働」が醸成されていることが示された。このことから「専門職の学習共同体」を効果的に醸成していくためには，質の高いカリキュラム・マネジメントを実施する必要性が示唆された。No potential conflict of interest relevant to this article was reported.HindawiActa Medica Okayama0278-02402018Serum Procalcitonin Levels in Acute Encephalopathy with Biphasic Seizures and Late Reduced Diffusion2380179ENYosukeFujiiDepartment of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasatoYashiroDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMutsukoYamadaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomonobuKikkawaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuyukiNosakaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukieSaitoDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiTsukaharaDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry andMasanoriIkedaDepartment of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTsuneoMorishimaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokazuTsukaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesProcalcitonin (PCT) is used as a biomarker in severe infections. Here, we retrospectively investigated levels of serum PCT, C-reactive protein (CRP), and inflammatory cytokines (IL-6, TNF-alpha, and IFN-gamma) in the second phase of patients with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD). Nine AESD pediatric patients (4 men, 5 women; AESD group) admitted to Okayama University Hospital from 2010 to 2016 were compared with 10 control patients with febrile seizures (FS) (3 men, 7 women; FS group). Mean PCT concentrations (ng/mL) in the AESD and FS groups were significantly different, at 9.8 +/- 6.7 and 0.8 +/- 0.9, respectively (p = 0 0006). CRP (mg/dL) were 0.79 +/- 0.89 and 1.4 +/- 1.0 (p = 0 94), respectively; IL-6 (pg/mL) were 449.7 +/- 705.0 and 118.3 +/- 145.4 (p = 0 20), respectively; TNF-alpha (pg/mL) were 18.6 +/- 12.5 and 16.6 +/- 6.0 (p = 0 67), respectively; and IFN-gamma (pg/mL) were 79.6 +/- 158.5 and 41.9 +/- 63.7 (p = 0 56), respectively. Ratios of PCT to CRP were 27.5 +/- 34.2 and 3.2 +/- 6.8 (p < 0 0001), respectively. The sensitivity and specificity in the diagnosis of AESD using a cutoff of PCT/CRP ratio of 1.0 were 79% and 100%, respectively. These results suggest that PCT and the PCT/CRP ratio are useful in auxiliary diagnosis of the second stage of AESD, and in AESD, PCT is likely to increase through a different mechanism.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama2075-4701972019Effect of Lubrication and Forging Load on Surface Roughness, Residual Stress, and Deformation of Cold Forging Tools783ENNuwanKarunathilakaGraduate School of Natural Science and Technology, Okayama UniversityNaoyaTadaGraduate School of Natural Science and Technology, Okayama UniversityTakeshiUemoriGraduate School of Natural Science and Technology, Okayama UniversityRyotaHanamitsuGraduate School of Natural Science and Technology, Okayama UniversityMasahiroFujiiGraduate School of Natural Science and Technology, Okayama UniversityYuyaOmiyaGraduate School of Natural Science and Technology, Okayama UniversityMasahiroKawanoZeno Tech Co., LtdCold forging is a metal forming that which uses localized compressive force at room temperature. During the cold forging process, the tool is subjected to extremely high loads and abrasive wear. Lubrication plays an important role in cold forging to improve product quality and tool life by preventing direct metallic contact. Surface roughness and residual stress also greatly affects the service life of a tool. In this study, variations in surface roughness, residual stress, and specimen deformation with the number of cold forging cycles were investigated under different forging conditions. Specimens that were made of heat-treated SKH51 (59-61 HRC), a high-speed tool steel with a polished working surface, were used. The specimens were subjected to an upsetting process. Compressive residual stress, surface roughness, and specimen deformation showed a positive relationship with the number of forging cycles up to a certain limit and became almost constant in most of the forging conditions. A larger change in residual stress and surface roughness was observed at the center of the specimens in all the forging conditions. The effect of the magnitude of the forging load on the above discussed parameters is large when compared to the effect of the lubrication conditions.No potential conflict of interest relevant to this article was reported.Nature Publishing GroupActa Medica Okayama2045-232292019Intermittent parathyroid hormone 1-34 induces oxidation and deterioration of mineral and collagen quality in newly formed mandibular bone8041ENYohsukeYoshiokaDepartment of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEikiYamachikaDepartment of Oral and Maxillofacial Reconstructive Surgery, Okayama University HospitalMakotoNakanishiDepartment of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityTadashiNinomiyaDepartment of Anatomy, Nihon University School of DentistryShoAkashiDepartment of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeiKondoDepartment of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNorifumiMoritaniDepartment of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroKobayashiDivision of Hard Tissue Research, Institute for Oral Science, Matsumoto Dental UniversityTatsuoFujiiDepartment of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama UniversitySeijiIidaDepartment of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIntermittent parathyroid hormone (PTH) administration is known to promote bone healing after surgical procedures. However, the mechanism and influence of PTH on the mineral and collagen quality of the jaw are not well understood. Most studies have focused on analyzing the bone density and microstructure of the mandible, and have insufficiently investigated its mineral and collagen quality. Oxidative stress activates osteoclasts, produces advanced glycation end products, and worsens mineral and collagen quality. We hypothesized that PTH induces oxidation and affects the mineral and collagen quality of newly formed mandibular bone. To test this, we examined the mineral and collagen quality of newly formed mandibular bone in rats administered PTH, and analyzed serum after intermittent PTH administration to examine the degree of oxidation. PTH administration reduced mineralization and worsened mineral and collagen quality in newly formed bone. In addition, total anti-oxidant capacity in serum was significantly decreased and the oxidative-INDEX was increased among PTH-treated compared to vehicle-treated rats, indicating serum oxidation. In conclusion, intermittent administration of PTH reduced mineral and collagen quality in newly formed mandibular bone. This effect may have been induced by oxidation.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 Okayama1883-24231722019「専門職の学習共同体」としての学校の実現をめざしたカリキュラム・マネジメントに関する基礎研究19ENShinnosukeKumagai10.18926/bgeou/57560 本研究は，「専門職の学習共同体（以下：PLC）」としての学校の実現をめざしたカリキュラム・マネジメント（以下：CM）による実践研究を行うに当たって理論的な枠組みを構築することを目的とした。ベテラン教員の大量退職を控え，国内の多くの学校では専門性の継承・向上が課題とされている。それを教職員個人の問題として，個人の専門性のみに着目するのではなく，学校が組織として専門性を継承・向上できるようなPLCとしての学校文化を醸成していくことが重要であると考えた。そういった学校文化を醸成するためのヒントを，Sheinの文化の学習／変容のモデルから得て，PLCとしての学校文化変革のためのCMのプロセスを提案した。No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2019アルツハイマー型認知症患者の腸内細菌叢によるヒト型モデルマウスの構築とこの構築マウスの認知行動に腸内環境が及ぼす影響ENYusukeFujiiGraduate School of Environmental and Life Science, Okayama UniversityNo potential conflict of interest relevant to this article was reported.岡山大学文学部Acta Medica Okayama0285-4864712019地方社会解体の危機に抗するCSAの可能性 : ＜鳴子の米プロジェエクト＞を事例として115ENWasaFujii10.18926/okadai-bun-kiyou/56875No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2018Serum Procalcitonin Levels in Acute Encephalopathy with Biphasic Seizures and Late Reduced DiffusionENYosukeFujiiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo 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 Okayama1881-1671462018日本型知識創造の理論構築を目指して111ENDaijiFujii10.18926/56341No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465022018多数派内少数者の影響力：予備的考察110ENKakeruMoriyaDaijiFujii10.18926/OER/56317No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2017A20 (TNFAIP3) Alterations in Primary Intestinal Diffuse Large B-cell LymphomaENMasayoshiFujiiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41464922018公共部門の外部組織利用を通じた自己革新プロセスに関する予備的考察7581ENDaijiFujii10.18926/OER/55677No potential conflict of interest relevant to this article was reported.岡山大学農学部Acta Medica Okayama2186-77551072018アルツハイマー病の背景と発症 : ヒトマイクロバイオーム（細菌叢）との関連の視点から510ENYusukeFujiiHidetoshiMorita Alzheimer’s disease (AD) is a progressive, neurodegenerative disease characterized by memory and language disorder. The accumulation of senile plaques called β-amyloid and neurofibrillary tangles involving protein tau in the brains of AD patients have been considered as two hallmarks of AD. In AD, it is reported that accumulation of β-amyloid may be observed 25 years before onset, supporting early diagnosis and treatment by brain image analysis, because several techniques have recently been developed to detect β-amyloid and tau protein in brains of persons diagnosed with AD. AD patients are usually suffering from other diseases such as diabetes or periodontal disease, and there is accumulating data to show that these diseases associate with the human microbiome, such as gut and oral microbiota. In this report, the relation ship between AD and the human microbiome is reviewed.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812932017平成28年度岡山医学会賞 胸部・循環研究奨励賞（砂田賞）155157ENUtakoFujiiDepartment of Internal Medicine, Fukuyama City HospitalNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7142017Residual Femoral Deformity and Femoroacetabular Impingement after Intertrochanteric Osteotomy for Slipped Capital Femoral Epiphysis315323ENYosukeFujiiDepartment of Orthopaedic Surgery, Okayama University HospitalHirosukeEndoDepartment of Orthopaedic Surgery, Okayama University HospitalShigeruMitaniDepartment of Orthopaedic Surgery, Kawasaki Medical SchoolHirofumiAkazawaDepartment of Orthopaedic Surgery, Asahigawasou Rehabilitation and Medical CenterTomonoriTetsunagaDepartment of Orthopaedic Surgery, Okayama University HospitalTakamasaMiyakeDepartment of Orthopaedic Surgery, Okayama University HospitalKazukiYamadaDepartment of Orthopaedic Surgery, Okayama University HospitalKiyoshiAokiDepartment of Orthopaedic Surgery, Asahigawasou Rehabilitation and Medical CenterToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University HospitalOriginal Article10.18926/AMO/55308We retrospectively reviewed 29 hips in which intertrochanteric osteotomies were performed for severe slipped capital femoral epiphyses. Mean age at surgery: 12.6 years. Mean follow-up period: 6 years. At the final follow-up evaluation, one patient had coxalgia, and six hips showed a limited range of motion. A pistol-grip deformity was observed in 13 hips, osteoarthritis in two hips, and a bump existed in 19 hips on the latest radiographs. Gradual remodeling of the bumps was observed post-operatively in 22 hips. The mean α and β angles and offset α and β improved over time. The remodeling proceeded rapidly for 1 year post-surgery. We compared hips classified as β angles of ≥ 63° to < 63° at the final follow-up evaluation, the mean β angle 1 year post-surgery, and the mean ratio of improvement of the β angle per year from 1 year post-surgery to the final follow up, which differed significantly. Nearly all of the patients who underwent intertrochanteric osteotomies had residual morphologic abnormalities, but few had clinical symptoms. The β angle 1 year post-surgery and the ratio of remodeling of the bump from 1 year post-surgery to the final follow-up can be regarded as a potential predictor of morphologic results after intertrochanteric osteotomy.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7142017An Analysis of the Characteristics and Improved Use of Newly Developed CT-based Navigation System in Total Hip Arthroplasty279289ENYosukeFujiiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuoFujiwaraDepartment of Intelligent Orthopaedic System Development, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomonoriTetsunagaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakamasaMiyakeDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiYamadaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirosukeEndoDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuhiroAbeDepartment of Orthopaedic Surgery, Kawasaki Medical schoolNaohikoSugitaDepartment of Mechanical Engineering, School of Engineering, The University of TokyoMamoruMitsuishiDepartment of Mechanical Engineering, School of Engineering, The University of TokyoTakayukiInoueTEIJIN NAKASHIMA MEDICAL CO., LTDYoshioNakashimaTEIJIN NAKASHIMA MEDICAL CO., LTDToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/55304We developed a surface matching-type computed tomography (CT)-based navigation system for total hip arthroplasty (the N-navi; TEIJIN NAKASHIMA MEDICAL, Okayama, Japan). In the registration step, surface matching was performed with digitizing points on the pelvic bone surface after coarse paired matching. In the present study, we made model bones from the CT data of patients whose acetabular shapes had various deformities. We measured the distances and angles after surface matching from the fiducial points and evaluated the ability to correct surface-matching registration on each pelvic form, using several areas and numbers of points. When the surface-matching points were taken on the superior area of the acetabulum, the correction was easy for the external direction, but it was difficult to correct for the anterior and proximal directions. The correction was difficult for external and proximal directions on the posterior area. Each area of surface-matching points has particular directions that are easily corrected and other directions that are difficult to correct. The shape of the pelvis also affected the correction ability. Our present findings suggest that checking the position after coarse paired matching and choosing the surface-matching area and points that are optimal to correct will improve the accuracy of total hip arthroplasty and reduce surgical times.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2017An Analysis of the Characteristics and Improved Use of Newly Developed CT- based Navigation System in Total Hip ArthroplastyENYosukeFujiiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2017血管新生因子Angiogeninのリンパ管新生に果たす役割に関する研究ENYukikoFujiiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7122017Intracranial Pressure Monitoring for Pediatric Acute Encephalopathy179180ENNobuyukiNosakaAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalKoheiTsukaharaAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalEmilyKnaupAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalToshihikoYabuuchiDepartment of Pediatrics, Okayama University HospitalTomonobuKikkawaDepartment of Pediatrics, Okayama University HospitalYosukeFujiiDepartment of Pediatrics, Okayama University HospitalMasatoYashiroDepartment of Pediatrics, Okayama University HospitalTakaoYasuharaDepartment of Neurological Surgery, Okayama University HospitalAyumiOkadaDepartment of Pediatrics, Okayama University HospitalToyomuUgawaAdvanced Emergency and Critical Care Center of Okayama University HospitalAtsunoriNakaoAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalHirokazuTsukaharaDepartment of Pediatrics, Okayama University HospitalIsaoDateDepartment of Neurological Surgery, Okayama University HospitalShort Communication10.18926/AMO/54987Newly published clinical practice guidelines recommend intracranial pressure (ICP) monitoring in critical care for the management of pediatric acute encephalopathy (pAE), but the utility of ICP monitoring for pAE has been poorly studied. We recently performed direct ICP monitoring for two patients. We observed that although the direct ICP monitoring had clinical benefits with less body weight gain and no vasopressor use in both cases, this monitoring technique is still invasive. Future studies should determine the utility of non-invasive ICP monitoring systems in pAE to further improve the quality of intensive-care management.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2016IL-23 Is Essential for the Development of Elastase-Induced Pulmonary Inflammation and EmphysemaENUtakoFujiiNo potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30694822016インタビュー録 ： GaN系青色LED開発の先駆者Herbert Paul Maruska博士 （2）5565ENDaijiFujii10.18926/OER/54707No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812832016リンパ節転移を伴う甲状腺癌を疑ったIgG4関連甲状腺炎（準確診群）の1 切除例213216ENKentaKobashiDepartment of Surgery, Saiseikai Saijo HospitalHiroshiIshiiDepartment of Surgery, Saiseikai Saijo HospitalKanakoNishiyamaBreast Center, Ehime University HospitalYukiMatsumiDepartment of Surgery, Saiseikai Saijo HospitalMasahideHatanoDepartment of Surgery, Saiseikai Saijo HospitalMasamitsuFujiwaraDepartment of Surgery, Imabariishikaishimin HospitalTatsuoKurokawaDepartment of Surgery, Saiseikai Saijo HospitalKensukeTsunemitsuDepartment of Surgery, Saiseikai Saijo Hospital We present a case of probably IgG4-related thyroiditis with lymphadenopathy. The patient was a 70-year-old Japanese female who was undergoing hemodialysis and had undergone a right hemi-thyroidectomy in 1989 due to carcinoma. In December 2010, an ultrasonography study revealed a hypoechoic small lesion in thyroid gland. When the patient was admitted to our hospital in November 2013, the lesion and regional lymph nodes had enlarged and we suspected that they were metastatic thyroid cancer. We performed a residual total thyroidectomy and regional lymph node dissection in August 2014. At that time, lymphoplasmacytic infiltration and fibrosis were observed histopathologically in thyroid tissue. Immunohistochemical studies revealed infiltrated lymphocytes and plasma cells were markedly IgG-positive, and the ratio of IgG4-positive to IgG-positive cells was over 40%. We therefore diagnosed the patient with IgG4-related thyroiditis. The cervical lymph nodes were metastases of papillary carcinoma from 25 years earlier. The patient remains well without any recurrences 33 months after the surgery.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30694812016インタビュー録：GaN系青色LED開発の先駆者Herbert Paul Maruska博士（1）6177ENDaijiFujii10.18926/OER/54475No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2015Analysis of the Synthetic-HTP drawing test about Developmental DisordersENChikakoFujiiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812732015Rituximab併用CHOP療法が奏効した肝原発びまん性大細胞型Ｂ細胞リンパ腫の１例209212ENHiroshiOkadaSoichiroFujiiKentaroWatanabeTerunobuShigematuKatsuhiroMiyashitaMorihiroOkazakiHaruhikoKobashiMotohiroYokoyamaTadashiYoshino A 78-year-old Japanese man was referred to our hospital after experiencing black feces. No abnormal finding was detected in the endoscopic examination of his stomach and large intestines. Computed tomography (CT) of the abdomen revealed a tumor lesion in the right lobe of the liver. A needle biopsy of the tumor under ultrasound guidance was performed. A pathological examination of the biopsy specimen showed a diffuse proliferation of lymphoma cells, which was compatible with diffuse large B-cell lymphoma (DLBCL). F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)-CT demonstrated increased FDG uptake only in the liver tumor. We made the diagnosis of primary DLBCL of the liver. After six cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP), the patient achieved complete remission and has maintained remission for 2 years since the diagnosis. The R-CHOP regimen might be effective therapy for primary DLBCL of the liver.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6952015For Vol.69, No.4, pp205-212 Venous Thromboembolism after Total Hip Arthroplasty Diagnosed by Enhanced Computed Tomography : Comparison of Selective Thromboprophylaxis and No Thromboprophylaxis325325ENYoshikiOkadaHirosukeEndoShigeruMitaniKazuoFujiwaraTomonoriTetsunagaYoheiKagawaYosukeFujiiToshiyukiKunisadaToshifumiOzakiErratum10.18926/AMO/53680Total hip arthroplasty (THA) is the most effective treatment for advanced or end-stage hip osteoarthritis. However, venous thromboembolism (VTE) remains one of its unresolved complications. We reviewed the records of 322 patients undergoing primary THA and investigated the efficacy of anticoagulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no anticoagulants, 100 patients who received a factor Xa inhibitor (fondaparinux), 100 patients who received low molecular weight heparin (enoxaparin), and 62 patients who selectively received no anticoagulant prophylaxis due to perioperative bleeding, weight, and/or hemoglobin concentration. Enhanced 64-slice multidetector row computed tomography was performed postoperatively for 7 days in all cases. The incidence of VTE in the four groups was 15%, 9.0%, 6.0%, and 6.4%, respectively. The incidence of VTE was significantly lower in the groups receiving anticoagulant prophylaxis and the group selectively receiving no anticoagulant prophylaxis than in the group receiving no anticoagulants. Complications of fondaparinux therapy included hepatic dysfunction in 4 cases (4.0%), minor bleeding in 2 cases (2.0%), persistent wound drainage in 3 cases (3.0%), and eruption in 1 case (1.0%). The complications of enoxaparin therapy were persistent wound drainage in 1 case (1.0%) and progression of anemia in 1 case (1.0%). The incidence of VTE was low in patients who selectively received no anticoagulant prophylaxis, so we conclude that anticoagulant prophylaxis should be used selectively in THA cases.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6952015Primary Duodenal Follicular Lymphoma Treated With Rituximab Monotherapy and Followed-up for 15 Years301306ENAnnaSekiMasayaIwamuroMasaoYoshiokaNobuharuFujiiHiroyukiOkadaSoichiroNoseKatsuyoshiTakataTadashiYoshinoKazuhideYamamotoCase Report10.18926/AMO/53676A 41-year-old woman was diagnosed with duodenal follicular lymphoma. She had no other lesions and was assigned to a "watch and wait" policy. Swelling of the inguinal lymph nodes appeared 45 months later, and rituximab monotherapy resulted in complete remission. However, follicular lymphoma recurred in the stomach, rectum and mesenteric and external iliac lymph nodes 81 months after the therapy. The patient received rituximab monotherapy again and has remained in complete remission in the fifteenth year after the initial diagnosis. This case suggests the usefulness of rituximab monotherapy in the long-term management of intestinal follicular lymphoma.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6952015Inhibitory Effects of Edaravone, a Free Radical Scavenger, on Cytokine-induced Hyperpermeability of Human Pulmonary Microvascular Endothelial Cells:A Comparison with Dexamethasone and Nitric Oxide Synthase Inhibitor279290ENYukieSaitoYousukeFujiiMasatoYashiroMitsuruTsugeNobuyukiNosakaNobukoYamashitaMutsukoYamadaHirokazuTsukaharaTsuneoMorishimaOriginal Article10.18926/AMO/53674Lung hyperpermeability affects the development of acute respiratory distress syndrome (ARDS), but therapeutic strategies for the control of microvascular permeability have not been established. We examined the effects of edaravone, dexamethasone, and N-monomethyl-L-arginine (L-NMMA) on permeability changes in human pulmonary microvascular endothelial cells (PMVEC) under a hypercytokinemic state. Human PMVEC were seeded in a Boyden chamber. After monolayer confluence was achieved, the culture media were replaced respectively by culture media containing edaravone, dexamethasone, and L-NMMA. After 24-h incubation, the monolayer was stimulated with tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β). Fluorescein-labeled dextran was added. Then the trans-human PMVEC leak was measured. Expressions of vascular endothelial-cadherin (VE-cadherin) and zonula occludens-1 protein (ZO-1) were evaluated using real-time quantitative polymerase chain reaction and immunofluorescence microscopy. The results showed that TNF-α＋IL-1β markedly increased pulmonary microvascular permeability. Pretreatment with edaravone, dexamethasone, or L-NMMA attenuated the hyperpermeability and inhibited the cytokine-induced reduction of VE-cadherin expression on immunofluorescence staining. Edaravone and dexamethasone increased the expression of ZO-1 at both the mRNA and protein levels. Edaravone and dexamethasone inhibited the permeability changes of human PMVEC, at least partly through an enhancement of VE-cadherin. Collectively, these results suggest a potential therapeutic approach for intervention in patients with ARDS.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6942015Venous Thromboembolism after Total Hip Arthroplasty Diagnosed by Enhanced Computed Tomography : Comparison of Selective Thromboprophylaxis and No Thromboprophylaxis205212ENYoshikiOkadaHirosukeEndoShigeruMitaniKazuoFujiwaraTomonoriTetsunagaYoheiKagawaYosukeFujiiToshiyukiKunisadaToshifumiOzakiOriginal Article10.18926/AMO/53556Total hip arthroplasty (THA) is the most effective treatment for advanced or end-stage hip osteoarthritis. However, venous thromboembolism (VTE) remains one of its unresolved complications. We reviewed the records of 322 patients undergoing primary THA and investigated the efficacy of anticoagulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no anticoagulants, 100 patients who received a factor Xa inhibitor (fondaparinux), 100 patients who received low molecular weight heparin (enoxaparin), and 62 patients who selectively received no anticoagulant prophylaxis due to perioperative bleeding, weight, and/or hemoglobin concentration. Enhanced 64-slice multidetector row computed tomography was performed postoperatively for 7 days in all cases. The incidence of VTE in the four groups was 15ｵ, 9.0ｵ, 6.0ｵ, and 6.4ｵ, respectively. The incidence of VTE was significantly lower in the groups receiving anticoagulant prophylaxis and the group selectively receiving no anticoagulant prophylaxis than in the group receiving no anticoagulants. Complications of fondaparinux therapy included hepatic dysfunction in 4 cases (4.0ｵ), minor bleeding in 2 cases (2.0ｵ), persistent wound drainage in 3 cases (3.0ｵ), and eruption in 1 case (1.0ｵ). The complications of enoxaparin therapy were persistent wound drainage in 1 case (1.0ｵ) and progression of anemia in 1 case (1.0ｵ). The incidence of VTE was low in patients who selectively received no anticoagulant prophylaxis, so we conclude that anticoagulant prophylaxis should be used selectively in THA cases.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30694712015資源循環型経済へのパラダイム転換試論： プラスチック製食品用トレーの事例分析1530ENDaijiFujii10.18926/OER/53549No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812722015超高齢者（95歳）の進行盲腸癌に対して腹腔鏡下回盲部切除を施行した1例117121ENAyakoWatanabeRyoInadaTakeshiNagasakaTomohikoYagiHijiriMatsumotoToshiakiToshimaSatoruKikuchiShinshiKurodaYoshitakaKondoYoshikoMoriHiroyukiKishimotoToshiyoshiFujiwaraWe report a successful laparoscopic resection of a cecal tumor in a 95-year-old Japanese man. The patient visited an initial hospital with a complaint of constipation in March 2014. Computed tomography scan and colonoscopy showed a stenotic ileocecal cancer with pericolic lymph node metastases, and he was referred to our department for management. Since his general condition was maintained, we performed a laparoscopic ileocecal resection with regional lymph node dissection for the patient. The operation achieved curative resection, and the tumor was diagnosed as a moderately differentiated adenocarcinoma and graded as pStage IIIa (pT3, pN0, pM0) according to the Japanese Classification of Colorectal Carcinoma, eighth edition. He was discharged on the 11th postoperative day without perioperative complications. Several large-scale randomized controlled trials （RCTs） revealed that laparoscopic surgeries for colorectal cancers have some advantages compared to open surgeries, including superior short-term outcomes and comparable long-term outcomes. Unfortunately, since these RCTs did not include enough elderly patients, the safety and feasibility of laparoscopic surgery for extremely elderly patients are still unknown. With respect to less-invasive procedures, these advantages of laparoscopic surgery are also thought to be the advantages for elderly colorectal cancer patients.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2015Chondromodulin-I Derived from the Inner Meniscus Prevents Endothelial Cell ProliferationENMasatakaFujiiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812712015藤井病院6768ENNo 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 Okayama2186-132352015養護教諭が推進する組織的で継続可能な小学校の喫煙・飲酒・薬物乱用防止教育プログラムの開発と実践139148ENYoshikoUenoTakaeNishimuraSayuriHosakaMasaeYamamotoRieAkasakaAyumiArimatuHarueFujiiMakotoYuguchiKanakoTorigoeMarikaOonishiYumikoNanbaAyakoMoriHiroeWashidaKeikoNishimotoYukoHinoTomokoMatumotoTomokoIshiharaMarikoTodoKumikoYamamotoNatukiSadamoriNaoYamagamiKanakoOkamotoHiromiMatsuoShizukaKobayashiKanakoHayashiNozomiMizushimaKen-ichiSekiyamaTakashiFukushimaHirokoKamimuraKayoTakahashi10.18926/CTED/53244 学校における喫煙・飲酒・薬物乱用防止教育の充実には，問題行動が顕在化する中学校期だけでなく小学校期
における指導の推進が重要であり，系統的な指導計画を立て，指導者や時間の確保，教材作成などに組織的に取
組み，継続可能なプログラム開発を行う必要がある。そこで，地区内12 校の養護教諭が協働して，発達段階に応
じた系統的・組織的かつ継続可能な地区共通の指導計画を開発し，各校の教育課程・年間計画に位置付けた実践
研究を行った。その結果，指導計画の実施状況は，小学校11 校中，学級活動10 校，ミニ保健指導10 校，長期
休業前指導6 校，広報活動9 校となり，特別支援学校1 校では広報活動のみを行うことができた。小学校におけ
る喫煙・飲酒・薬物乱用防止教育の推進には，学校保健活動の中核的役割を担う養護教諭が専門性を活かし協働
して，系統的な指導計画を各校の教育課程に位置付け組織的で継続可能なプログラムとする取組が有効であった。No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30694622014社会福祉協議会による災害復旧・復興支援活動：岡山県から宮城県への職員派遣の事例233253ENAkiraYoshidaDaijiFujii10.18926/OER/53106No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812632014Reduced Port Surgeryで切除した高度炎症を伴う虫垂中に発見された潜在性虫垂粘液嚢胞腺腫の１例223226ENHiromitsuSuzukiKoujiKimuraSigekiKinoshitaKazuoOkanoAppendicitis is a benign disease for which surgical treatment is widely provided. The complication of neoplastic lesions may be discovered only after resection. However, in some cases, specimens are not submitted to histopathological examination in Japan because of an extreme deficiency of pathologists. We report our experience with one patient who experienced the complication of latent low-grade appendiceal mucinous neoplasm (LAMN) after surgery for appendicitis.
Our patient was an 85-year-old woman. Conservative treatment failed to relieve fever and lower abdominal pain and it was decided to treat her surgically. Abdominal computed tomography (CT) showed appendicitis with severe inflammation and suspected adhesion. We decided to explore the abdominal cavity using a reduced-port laparoscopic approach. We found no mucous debouchment or clear tumors in the specimen. Histopathological findings indicated the coexistence of appendicitis and LAMN. At one year and a half after surgery, there was no evidence of the development of pseudomyxoma peritonei.
In appendectomy, it is thought that careful perioperative treatment and a postoperative pathological search are important when there are no preoperative findings suggesting a neoplastic lesion.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0046-81774572014Low-grade B-cell lymphoma presenting primarily in the bone marrow13791387ENKayokoIwataniKatsuyoshiTakataYasuharuSatoTomokoMiyata-TakataNorikoIwakiWeiCuiSeikoSawada-KitamuraHiroshiSonobeMaikoTamuraKatsuhikoSaitoKatsuyaMiyataniRieYamasakiIchiroYamadoriNobuharuFujiiYasushiTerasakiYoshinobuMaedaMitsuneTanimotoNaoyaNakamuraTadashiYoshinoCases of low-grade B-cell lymphoma presenting primarily in the bone marrow are rare, and its clinicopathology remains unclear. We retrospectively examined patients with low-grade B-cell lymphoma presenting primarily in the bone marrow. Fourteen patients met the inclusion criteria, including 5 with lymphoplasmacytic lymphoma (LPL), 3 with chronic lymphocytic leukemia/small lymphocytic lymphoma, 2 with follicular lymphoma (FL), and 4 with low-grade B-cell lymphoma not otherwise specified (LGBCL-NOS). The median age was 69.5 years (range, 42-89 years), and a slight male predominance was noted (9 men and 5 women, 1.8: 1). Immunohistochemically, all cases were positive for CD20. One case was positive for CD138. Both cases of FL were positive for CD10 and B-cell lymphoma 2 (BCL-2), and immunoglobulin heavy locus (IgH)/B-cell lymphoma 2 rearrangement was observed by fluorescence in situ hybridization. The myeloid differentiation primary response gene (88) leucine to proline mutation was observed in 3 of 5 LPL, 1 of 2 FL, and 2 of 4 LGBCL-NOS patients. Paraproteinemia was observed in 10 patients; IgM and IgG paraproteinemia were observed in 6 and 3 patients, respectively. In this patient series, 3 patients had died at a median follow-up of 36.5 months; the cause of death of 1 LPL patient was malignant lymphoma itself. Thus, low-grade B-cell lymphoma presenting primarily in the bone marrow has various subtypes, and approximately one-third of the patients had LGBCL-NOS. The immunophenotypic features and myeloid differentiation primary response gene (88) leucine to proline mutation data of LGBCL-NOS suggested that some cases present with characteristics similar to those of LPL or marginal zone lymphoma.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama1083-87912022014Mammalian Target of Rapamycin Inhibitors Permit Regulatory T Cell Reconstitution and Inhibit Experimental Chronic Graft-versus-Host Disease183191ENHarukoSugiyamaYoshinobuMaedaHisakazuNishimoriYoshikoYamasujiKen-ichiMatsuokaNobuharuFujiiEiseiKondoKatsujiShinagawaTakehiroTanakaKengoTakeuchiTakanoriTeshimaMitsuneTanimotoChronic graft-versus-host disease (GVHD) remains a major late complication of allogeneic bone marrow transplantation (BMT). In a previous study, impaired thymic negative selection of the recipients permitted the emergence of pathogenic T cells that cause chronic GVHD using MHC class II-deficient (H2-Ab1 KO) B6 into OH model and CD4(+) T cells isolated from chronic GVHD mice caused chronic GVHD when administered into the secondary recipients. In this study, we evaluated the kinetics of regulatory T cell (Treg) reconstitution in wild type B6 into C3H model. After myeloablative conditioning, host Tregs disappeared rapidly, followed by expansion of Tregs derived from the donor splenic T cell inoculum. However, the donor splenic T cell derived Treg pool contracted gradually and was almost completely replaced by newly generated donor bone marrow (BM)-derived Tregs in the late post-transplantation period. Next, we compared the effects of cyclosporine (CSA) and mammalian target of rapamycin (mTOR) inhibitors on Treg reconstitution. Administration of CSA significantly impaired Treg reconstitution in the spleen and thymus. In contrast, BM-derived Treg reconstitution was not impaired in mTOR inhibitor-treated mice. Histopathological examination indicated that mice treated with GSA, but not mTOR inhibitors, showed pathogenic features of chronic GVHD on day 120. Mice treated with CSA until day 60, but not mTOR inhibitors, developed severe chronic GVHD followed by adoptive transfer of the pathogenic CD4(+) T cells isolated from H2-Ab1 KO into C3H model. These findings indicated that long-term use of CSA impairs reconstitution of BM-derived Tregs and increases the liability to chronic GVHD. The choice of immunosuppression, such as calcineurin inhibitor-free GVHD prophylaxis with mTOR inhibitor, may have important implications for the control of chronic GVHD after BMT.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama1618-124710022012Histological and immunohistochemical features of gingival enlargement in a patient with AML254257ENNorihiroSonoiYoshihikoSogaHiroshiMaedaKoichiIchimuraTadashiYoshinoKazutoshiAoyamaNobuharuFujiiYoshinobuMaedaMitsuneTanimotoRichardLoganJudithRaber-DurlacherShogoTakashibaHere, we discuss the pathophysiology of leukemia-associated gingival enlargement based on a case of acute myelomonocytic leukemia (AML-M4) with typical gingival enlargement. Uniquely, this patient was well enough to allow full periodontal examination and incisional gingival biopsy to be performed both before and after chemotherapy. The patient was a 39-year-old Japanese woman with AML-M4 showing gingival enlargement. Histological and immunohistochemical features of gingiva and bacterial counts in the periodontal pockets were examined before and after chemotherapy. The results were as follows: (1) infiltration of myelomonocytic blasts in enlarged gingiva; (2) resolution of gingival enlargement with complete remission of AML by anticancer chemotherapy; and (3) the numbers of bacteria in the periodontal pockets were not high and were not altered before or after chemotherapy. In patients with AML-M4, remarkable mucosal enlargement is not generally observed in the body except in the gingiva. We hypothesized that antigens derived from periodontal bacteria, even if they are not present in large numbers, could act as chemoattractants for myelomonocytic leukemic cells.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2014The integrin inhibitor cilengitide enhances the anti-glioma efficacy of vasculostatin-expressing oncolytic virusENKentaroFujiiNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama0008-94433921996先天股脱保存療法後の造影所見 特に前方関節唇と股関節成長の関連について332339EN観血的治療を加えた先天股脱症例で術中所見の得られた2方向造影を参考として,保存的治療例の造影所見を検討した.対象は保存的治療後10年以上経過観察した27例32股と観血的治療をした14例15股である.2方向造影分類は藤井の分類に従い,最終調査時評価はSeverinのX線判定基準を用いた.保存的治療例のType A-1は18股で最終調査時は全てSeverin Iであった.観血的治療を受けた14例の術中所見は全例手術時臼底に介在物を認めた.前方関節唇の2方向造影所見と手術所見では15股中13股で一致した.以上より,2方向造影像は術中所見とよく一致する為,遺残性亜脱臼に対する手術適応を決定する一つの指標となりうるNo potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30694532013`Flexible Specialization' Revisited: A Case Study of Denim Jeans Production in a Japanese Industrial District1731ENDaijiFujiiGraduate School of Humanities and Social Sciences, Okayama University10.18926/OER/52079No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2013Management of Occluded Metallic Stents in Malignant Hilar Biliary StrictureENMasakuniFujiiNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2013Strength and Durability of Concrete with Blast Furnace SlagT4-6 2ENPaweenaJARIYATHITIPONGKazuyoshiHOSOTANITakashiFUJIIToshikiAYANOThe properties of concrete using blast furnace as binder and fine aggregate have been
investigated in this study. The experiments focus on the properties of concrete such as
compressive strength and young's modulus, carbonation, diffusion of chloride ions,
resistance to sulfate attack and resistance to freeze and thaw. The experimental results show
that when blast furnace slag is used in concrete, it improves the durability properties of
concrete. However, the combination of using both blast furnace slag as binder and fine
aggregate shows a greater improvement of those properties of concrete.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2013Effect of chemical admixture on property of fresh mortar using sludge waterW1-7 3ENTakashiFUJIITadashiSAITOToshikiAYANOAddition of sludge water as a part of mixing water had little influence on strength and
durability of hardened concrete, but caused a slump decrease of fresh concrete. The decrease
of slump was improved by addition of a certain set retarder such as gluconate into sludge
water due to control of cement hydration. Some of polymers were also effective in
improvement of slump. However hydration of cement was observed in those cases of
polymers. Therefore it is presumed such the polymers improve slump not by hydration
control effect but by another one.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2013THE SULFURIC ACID RESISTANCE OF CONCRETE WITH BLAST FURNACE SLAG581586ENPaweenaJARIYATHITIPONGKazuyoshiHOSOTANITakashiFUJIIToshikiAYANOThe deterioration of concrete by sulfuric acid attack in sewage environments has become a serious problem. In this
study, it was shown that the resistance to sulfuric acid of mortar and concrete can be improved by using a
blast-furnace slag fine aggregate to the total amount of fine aggregate. When mortar or concrete reacts to sulfuric
acid, dihydrated gypsum film is formed around the particulate of the fine aggregate. This dihydrated gypsum film
could retard the penetration of sulfuric acid, thus improving the resistance to sulfuric acid. However, the resistance
to sulfuric acid depends on the hardness of the dihydrated gypsum film.No potential conflict of interest relevant to this article was reported.日本材料学会Acta Medica Okayama132013コンクリートの耐久性に及ぼす高炉スラグ細骨材の影響16ENTakashiFUJIIPaweenaJARIYATHITIPONGKazuyoshiHOSOTANIToshikiAYANO本研究は，高炉スラグを用いたコンクリートの中性化，耐硫酸塩性および凍結融解
抵抗性の検討を行ったものである．高炉スラグを細骨材に用いることで，細骨材周辺に集
積する水酸化カルシウムがなくなり，骨材表面とペーストとの界面が強固なものとなるた
め，コンクリートの中性化および耐硫酸塩性が向上する．また，結合材の一部を高炉スラ
グ微粉末に置き換えるか，または，細骨材に高炉スラグ細骨材を用いたコンクリートでは，
AE 剤を用いることなく，また，蒸気養生を行っても，十分な凍結融解抵抗性が得られる．No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812522013マウスインフルエンザ肺炎におけるレドックス制御蛋白チオレドキシン（TRX-1）の治療的効果109112ENMasatoYashiroHirokazuTsukaharaAkihiroMatsukawaMutsukoYamadaYosukeFujiiYoshiharuNagaokaMitsuruTsugeNobukoYamashitaToshihiroItoMasaoYamadaHiroshiMasutaniJunjiYodoiTsuneoMorishimaNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama0007-096316722012Detection of antibodies against the non-calcium-dependent epitopes of desmoglein 3 in pemphigus vulgaris and their pathogenic significance252261ENKKamiyaYAoyamaYShirafujiTHamadaSMorizaneKFujiiKHisataKIwatsukiBackground Antidesmoglein (anti-Dsg) 3 serum antibody titres are usually correlated with the disease activity of pemphigus vulgaris (PV), but some patients retain high titres even in remission.
Objectives The aim of our study was to determine whether anti-Dsg3 antibodies in PV sera recognized calcium (Ca2+)-dependent or non-Ca2+-dependent epitopes, and to evaluate their pathogenicity.
Methods Dsg3 baculoprotein-coated enzyme-linked immunosorbent assay (ELISA) plates were treated with 0.5 mmol L-1 ethylenediaminetetraacetic acid (EDTA). The binding ability of anti-Dsg3 monoclonal antibodies (mAbs) was analysed. Eight of the 83 patients with PV who were screened had elevated Dsg3 ELISA index values > 100 in remission. The binding ability of these PV sera was analysed. We evaluated the pathogenicity of anti-Dsg3 serum antibodies against the non-Ca2+-dependent epitopes using a dissociation assay.
Results The reactivity of pathogenic anti-Dsg3 mAbs against the Ca2+-dependent epitopes diminished markedly in the EDTA-treated ELISA, whereas no such reduction was observed in mAbs against the non-Ca2+-dependent epitopes. The sera of all the patients contained antibodies against both Ca2+-dependent and non-Ca2+-dependent epitopes. In six out of the eight patients, the ratio of antibodies against Ca2+-dependent to non-Ca2+-dependent epitopes decreased in remission. EDTA-treated Dsg3 baculoproteins adsorbed anti-Dsg3 serum antibodies against the non-Ca2+-dependent epitopes, but the remnant PV antibodies retained the ability to induce acantholysis in the dissociation assay.
Conclusions We have established an assay to measure indirectly the titres of anti-Dsg3 serum antibodies against the Ca2+-dependent epitopes, based on the differences between EDTA-untreated and EDTA-treated ELISA index values, as a routine laboratory test to reflect the pathogenic anti-Dsg3 serum antibody titres more accurately.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0941-43551832010Total bacterial counts on oral mucosa after using a commercial saliva substitute in patients undergoing hematopoietic cell transplantation395398ENYukoSugiuraYoshihikoSogaKokoroYamabeSoichiroTsutaniIchiroTanimotoHiroshiMaedaSusumuKokeguchiNobuharuFujiiFumihikoIshimaruMitsuneTanimotoFusanoriNishimuraShogoTakashibaThe commercial saliva substitute OralbalanceA (R) has been reported to alleviate symptoms of postradiotherapy xerostomia in head and neck cancer patients. OralbalanceA (R) may also be effective for xerostomia in patients undergoing hematopoietic cell transplantation (HCT) with high-dose chemotherapy and total-body irradiation. However, HCT patients are in a severely compromised condition, and saliva substitute must not promote infection. We reported previously that OralbalanceA (R) has antimicrobial effects against microbial species detected during HCT in vitro. This study was performed to determine the in vivo effects of OralbalanceA (R) on oral mucosal total bacterial counts in patients undergoing HCT.
A total of 18 neutropenic patients undergoing HCT were enrolled in this study. Before and after 1 week of OralbalanceA (R) use, bacterial samples were obtained from patients by wiping an area of I center dot 1 cm on the buccal mucosa with sterilized cotton swabs. Total bacterial counts of the obtained samples were examined by quantitative polymerase chain reaction amplification of the bacterial 16S ribosomal RNA gene. As controls, bacterial samples were also obtained from ten healthy subjects, and total bacterial counts were examined.
No significant increase in bacterial count was observed with use of OralbalanceA (R). None of the patients showed bacterial counts above the range found in healthy controls after using OralbalanceA (R).
In neutropenic patients undergoing HCT, OralbalanceA (R) did not increase the total counts of oral mucosal bacteria beyond the range found in healthy controls. Oral care using OralbalanceA (R) may alleviate the symptoms induced by hyposalivation without promoting infection.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0941-435516102008Evaluation of xerostomia in hematopoietic cell transplantation by a simple capacitance method device11971200ENYukoSugiuraYoshihikoSogaSachikoNishideKotoeKonoKanayoTakahashiNobuharuFujiiFumihikoIshimaruMitsuneTanimotoFusanoriNishimuraShogoTakashibaGoals Hematopoietic cell transplantation (HCT) may lead to the development of xerostomia. However, there have been few reports of xerostomia in HCT patients based on objective data. We investigated moisture in the oral mucosa in patients undergoing HCT by the capacitance method using a convenient device, Moisture Checker for Mucus (R) (MCM; Life Co., Ltd., Saitama, Japan).
Subjects and methods Thirty-six patients undergoing HCT at Okayama University Hospital of Medicine and Dentistry (Male=22, Female=14; age=41.6 +/- 16.2 years old) were enrolled in this study. Moisture in the oral mucosa was measured by MCM in accordance with the manufacturer's instructions. The results were obtained as MCM values (%), which are the weight percentage of water content in the oral mucosal epithelium. As controls, moisture of the oral mucosa was also examined in healthy volunteers (Male=27, Female=35; age=43.0 +/- 14.6 years old).
Main results Throughout the examination period, MCM values were significantly lower in patients who underwent HCT than in controls. The degree of mucosal moisture in HCT patients showed wide interindividual differences.
Conclusion The degree of mucosal moisture in HCT patients was low and showed wide interindividual differences. Evaluation of xerostomia using such a device may contribute to appropriate oral care with saliva substitute.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0941-43551642008Antimicrobial effects of the saliva substitute, Oralbalance (R), against microorganisms from oral mucosa in the hematopoietic cell transplantation period421424ENYukoSugiuraYoshihikoSogaIchiroTanimotoSusumuKokeguchiSachikoNishideKotoeKonoKanayoTakahashiNobuharuFujiiFumihikoIshimaruMitsuneTanimotoKokoroYamabeSoichiroTsutaniFusanoriNishimuraShogoTakashibaGoals The commercially available saliva substitute Oralbalance (R) has been reported to alleviate symptoms of post-radiotherapy xerostomia in head and neck cancer patients. Oralbalance (R) may also be effective for xerostomia in patients undergoing hematopoietic cell transplantation (HCT) with high-dose chemotherapy and total-body irradiation. However, HCT patients are severely compromised, and saliva substitute must therefore not promote infection. This study was performed to determine the effects of Oralbalance (R) on microbial species identified during HCT.
Patients and methods Microbial identification of oral mucosa was performed in 28 patients undergoing HCT. The antimicrobial effects of Oralbalance (R) against bacteria and fungi detected in the HCT period were examined in vitro. Briefly, bacteria and fungi were spread on agar plates, and 0.1g of Oralbalance (R) gel was applied (about phi 1cm). After incubation at 37 degrees C for 24h, the presence of a transparent zone of inhibition around Oralbalance (R) was observed.
Main results Not only bacterial species constituting normal flora of the oral mucosa but also those not usually constituting normal flora, e.g., coagulase-negative Staphylococcus, were detected. A transparent zone was observed around Oralbalance (R) in all bacterial species examined. No transparent zone was observed for Candida albicans, but growth was inhibited in the area where Oralbalance (R) was applied.
Conclusions Oralbalance (R) does not facilitate increases in microorganisms in the HCT period. Oral care with Oralbalance (R) does not promote infection in patients undergoing HCT.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812422012術前診断し得た大網裂孔ヘルニアの一例―本邦報告203例の臨床病理学的検討―149153ENYujiKimuraKazuhideIwakawaManabuNishieMasaruInagakiHiromiIwagakiTransomental hernia often develops into strangulated ileus. We report on an 81-year-old man with strangulated ileus due to transomental hernia, diagnosed preoperatively by abdominal CT. The patient was referred to our surgical division because of progressive abdominal pain and vomiting. He had no history of laparotomy. An abdominal CT scan showed dilated small intestinal loops with intraluminal air and strangulated small intestinal loops with engorged mesenteric vessels. We diagnosed this as a strangulated internal hernia due to transomental hernia and conducted an emergency laparotomy. The jejunum had herniated through an abnormal hiatus of the greater omentum to the peritoneal cavity. The strangulated intestinal loop, about 15 cm long, was released and the postoperative course was uneventful. In the absence of a previous laparotomy, the differential diagnosis of intestinal obstruction should include internal hernia. An abdominal CT scan is useful for the preoperative and prompt diagnosis of transomental hernia.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2012衝撃式粉砕法による米粉の製パン性に関する研究ENKumikoFujiiNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2012血管周囲交感神経におけるSerotonin(5-HT)の取込み遊離および神経機能に及ぼす影響に関する神経薬理学的研究ENHirohitoFujiiNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2012Dickkopf (Dkk)-3 and β-catenin expressions increased in the transition from normal oral mucosal to oral squamous cell carcinomaENMasaeFujiiNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2012Aberrant DNA methylation profile in pleural fluid for differential diagnosis of malignant pleural mesotheliomaENMasanoriFujiiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812412012Damus-Kaye-Stansel吻合913ENYasuhiroFujiiShunjiSanoSadahikoAraiShingoKasaharaAtsushiTateishiMasamiTakagakiYasufumiFujitaSusumuOzawaNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558343911922遺傳性視神經萎縮ノ一家系ニ就テ470479ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558353961923「アクロメガリー」ノ二例「アクロメガリー」ノ眼症状ニ就イテ1523ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558374241925結節状角膜變性症ニ就テ538548ENK.HudiiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558384421926家兎ニ見ラレタル遺傳性眼畸形ニ就テ12141254ENK.HuddiVerfasser machte eine eingehende Züchtungsversuche mit einer Kaninchenfamilie durch, welche sich im Auge mit der eigentlichen hereditären Missbildungen versehen war. In bezug auf die pathologisch-histologische Erkenntnisse ist es besonders genauer untersucht. Zusammenfassende Resultate sind wie folgende: 1) Unter den 98 Kaninchen, die betreffedem Stammbaume gehörten, haben 30 Tiere (52 Augen) die verschiedenen Missbildungen. 2) Hauptformen der Missbildungen waren Hydrophthalmus oder Microphthalmus je mit staphylomatösem Aussehen. 3) Ausser der Strangbildung von Nervenelemente, die sich ophthalmoskopisch dem Arteria hyaloidea ähnliches Aussehen darstellt, waren noch dazu einzeln Bulbuscyste und Linsentrübung kombiniert. 4) Mit dem Augenmissbildungen gleichzeitig fand man immer noch die Hydrocephalus imfolge der Entwickelungshemmung im Seite von Telencephalon; das heisst nicht anders als Persistens der microcephalischen und physiologische hydrocephalische Zustandes beim Embryo. 5) Alle Missbildungen dieses Stammes müssen von der Entwickelungshemmung der Augenblase herbeigeführt sein. 6) Die Entwickelungshemmungen im Gebiete von Auge und Gehirn sind ohne Zweifel auf die Folgezustände des Entwickelungsenergiemangels im Zentralnervensysteme zurück zuführen. 7) Beim gesunden Organismus kann noch die Entwickelungsenergie nicht immer gleich sein.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558384371926角膜ノ假眠細胞ニ關スル實驗的研究633667ENK.HudiiGrawitz und seine Schüler behaupteten, dass alle in der Entzündung auftretenen Zellen Produkte des Gewebes selbst sein. Nach seiner Ansicht entsteht die Intercellularsubstanz aus hoch-differenzierten Zellprotoplasma, in dem das Chromatin der Kerne nicht nachweisbar ist (Schlummerzellen), und unter gewissen Reizzuständen z. B. bei Entzündungen können diese Intercellularsubstanz im zelligen Zustand wieder zurückkehren (Erwachen der Schlummerzellen). Demnach alle bei der Keratitis und der Hornhauttransplantation in der Hornhaut auftretenen Zellen müssen die sog. erwachene Schlummerzellen sein. Ich machte einige experimentelle Untersuchungen über Zell-auftreten in die Hornhäute. 1. Untersuchungen über experimentellen Keratitis. Durch die Untersuchungen über experimentellen Keratitis nach Kauterisation mit einem Paquelinschen Brenner, nach der Aetzung mit den Silbernitratlösung, und nach der Karmininjektion in dem Glaskörper bemerkte ich die folgende Tatsachen. 1. Nach der Reizung am frühesten an dem Hornhautgeschwür auftreten die Entzündungsspiesse, die grösstenteils aus pseudoeosinophile Leukocyten entgestanden sind. 2. Später beginnt die Einwanderung der Leukocyten von der Peripherie der Hornhaut. 3. Und die Regenerationsspiesse kommen am spätsten zum Vorschein. 4. Bei dem Panophthalmie die Zellinfiltration tritt sehr rasch und hochgradig sofort nach der Hornhautruptur auf. 2. Transplantation der beschädigten Hornhaut. Durch den Transplantationsversuch der Hornhäute, die im voraus mit der Hitze (auf 50°C-100°C), Vertrocknung, Kochsalzlösung, Formalin, Sublimat, Alkohol, Salpetersäure und Natronlauge auf verschiedenen Grad geschädigt werden, hatte ich die folgenden Resultaten beklommen. 1. Unterschied des Schädigungsgrades hat keine grosse Bedeutung für den Auftreten der Zellen in der Hornhaut. 2. Im früheren Stadium der Transplantation ist die Infiltration mit polymorphkernigen Leukocyten beherschend aber im späteren Stadium wird die Organisation vorwiegend. 3. Wenn die Reizbarkeit der implantierte Hornhaut für den Organismus schwächer ist, so tritt die Organisation früher ein. 4. Wenn bei Schädigung der Hornhäute die Aufquellung wirkte ein, so tritt die Organisation leicht ein. 5. Die Zellinfiltration beginn immer am Schnittrande oder an der Zerreissungsstelle. 6. Bei Keratitis auftretende Zellen sind vollständig gleich mit der Zellarten, die in Transplantierter Hornhaut einwandern. Aus den obenerwähnten Tatsachen möchte ich behaupten dass bei den Keratitis auftretende Infiltrationszellen (die Entzündungs- und Regenerationsspiesse) seine Ursprung von Leukocyten, Hornhautkörperchen und Gefässendothel haben und die Grawitzsche Schlummerzellentheorie nicht annehmbar ist.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2011砂地盤の不飽和化による液状化対策に関する研究ENNaoFujiiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812332011FDG-PET/CTが診断に有用であった大動脈炎症候群の1例217219ENKazuyaNishiiTerunobuShigematsuSoichiroFujiiKatsuhiroMiyashitaMorihiroOkazakiMotofumiSasakiNobuhikoHayakawaA 60-year-old female patient was admitted to our hospital in April, 2010 because of low-grade fever and malaise for several months. Physical examination on admission revealed no abnormalities except for a body temperature of 37.2℃. Blood examinations showed moderate anemia and a high erythrocyte sedimentation rate. There were no other specific abnormal findings. A systemic CT scan study disclosed diffuse thickening of the artery wall through the ascending, descending and abdominal aorta to the bilateral iliac arteries. In order to evaluate the quality of the vessel lesions, a FDG-PET/CT study was performed and revealed abnormal accumulation of 18F-FDG in the thickened wall, suggesting an inflammatory process in the lesion. Taking all these findings into consideration, we made the diagnosis of Takayasu's arteritis, and treated the patient with prednisolone. The treatment was effective and her symptoms improved. A later CT scan revealed that the artery wall became somewhat thinner. Takayasu's arteritis is a disease whose diagnosis is difficult to make because there are neither specific signs nor diagnostic laboratory findings in its early stage. We found that FDG-PET/CT was helpful in the diagnosis and evaluation of lesions in a patient with Takayasu's arteritis.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155846111934植物性神經ノ含水炭素新陳代謝ニ及ボス影響ニ就テ（第2報）副交感神經ノ含水炭素新陳代謝ニ及ボス影響ニ就テ29262951ENM.FujiiObwohl schon viele Forscher den Einfluss des Parasympathicus auf den Kohlenhydratstoffwechsel untersucht haben, so sind sie bisher doch noch nicht zu einem einheitlichen Resultat gekommen.
Nach der Iujektion von Pilocarpin und Atropin oder nach dem in der Bauchhohle ausgefuhrten abschneiden eines einseitigen N. vagus injizierte ich gesunden Hunden Traubenzucker in die Vena und Kam dabei zu folgenden Resultaten: 1) Injektion von Pilocarpin. Dabei wird die Senkung der Hyperglykämie nach der Injektion des Traubenzuckers 60 Minuten lang ein wenig gefördert, doch zeigt der Blutzucker nach Verlauf dieser Zeit keine Veränderung. Das Leberglykogen vermehrt sich gegenüber einer Kontrolle, doch erfährt das Muskelglykogen keine quantitative Veranderung. 2) Injektiou von Atropin. Dabei senkt sich die nach der Injektion des Traubenzuckers erscheinende Hyperglykämie langsam. Das Leber- und Muskelglykogen vermindert sich auffallend. 3) Abschneiden eines einseitigen N. vagus. Dabei senkt sich die nach der Injektion des Traubenzuckers erscheinende Hyperglykämie ziemlich langsam. Das Leberglykogen vermiudert sich mehr als bei eiuer Kontrolle, aber das Muskelglykogenzeigt gegnuber einer Kontrolle keinen Unterschied.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155846101934植物性神經ノ含水炭素新陳代謝ニ及ボス影響ニ就テ（第1報）交感神經ノ含水炭素新陳代謝ニ及ボス影響ニ就テ26092644ENM.FujiiDie meisten Kliniker injizieren gern Traubenzucker, um die Funktion des Herzens zu verstärken, Gift abzutreiben, Nahrung zu vermitteln oder Wasser in den mensch lichen Körper einzuführen. Es ist von vielen Forschern versichert worden, dasz Traubenzucker nach seiner intravenösen Injektion in Kurzer Zeit in den Venen unerkennbar wird. Da es auch unverkennbar ist, dasz dabei die innere Sekretionen verrichtenden Organe eine Rolle spielen, so untersuchte ich, welche Einflüsse die vegetativen Nerven, die jene Organe verwalten, auf die im körper erscheinende Anhäufung des Traubenzuckers ausüben. Zuerst stellte ich fest wie sich bei und nach der intravenösen Injektion von Traubenzucker Blutzucker, Harnzucker, Muskel-und Leberglykogen verhalten. Dann injizierte ich, um das Verhaltnis zwischen dem Sympathicus und dem Kohlenhydratstoffwechsel klar zu machen, Adrenalin und Yohimbin in gesunde Hunde, oder schnitt einen einseitigen N. splanchnicus ab und bestimmte bei denselben Hunden nach der Injektion des Traubenzuckers die Menge des Blutzuckers und des Leber-und Muskelglykogens. Bei den obigen Experimenten kam ich zu folgenden Ergebnissen. 1) 60 bis 90 minuten nach der intravenösen Injektion des Traubenzuckers erscheint mit Sicherheit die vorläufige Hypoglykämie. 2) Wenn der Blutzucker nach der intravenösen Injektion des Traubenzuckers über 0.3% hinaufgeht, so vermehrt sich der Harnzucker auffallend; der Harnzucker findet sich aber in nur ganz geringer Menge, wenn der Blutzucker unter 0.14% bleibt. 3) Injektion von Adrenalin. Dabei zeigt die durch die Injektion des Traubenzuckers hervorgebrachte Hyperglykämie eine langsame Senkung, doch vermindert sich das Leber-und Muskelglykogen auffallend. 4) Injektion von Yohimbin. Dabei wird die Senkung dieser Hyperglykämie gefördert. Das Leberglykogen vermehrt sich jedoch gegenüber einer Kontrolle, das Muskelglykogen vermindert sich gegenüber einer Kontrolle etwas, aber nicht so auffallend. 5) Abschneiden eines einseitigen N. splanchnicus. Dabei wird die Senkung dieser Hyperglykamie ein wenig gefördert, die Hypoglykämie ist bedeutender als vor dem Abschneiden und dauert länger. Das Leberglykogen vermehrt sich gegenüber einer Kontrolle und das Muskelglykogen vermindert sich gegenüber einer Kontrolle, aber nicht so heftig.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155847111935脾臟ノ含水炭素新陳代謝ニ及ボス影響ニ就テ（實驗的研究）29462972ENMasanobuFujiiDas Verhältnis der Milz zum Kohlenhydratstoffwechsel ist bisher zwar von vielen Forschern untersucht und ziemlich geklärt worden; man findet aber, wenn man jedes einzelne Versuchsresultat genau betrachtet, widersprechendes unter denjenigen Resultaten, die man unter denselben Versuchsbedingungen erreicht, und dazu herrscht noch eine Unklarheit darüber Bestandteil des Hormons der Milz auf den Kohlenhydratstoffwechsel einwirkt. Infolgedessen stellte ich mit gesunden Hunden verschiedenartige Experimente an, um obenerwähnte Probleme zu lösen, und kam zu folgenden Ergebnissen. 1) Milzexstirpation. Dabei senkt sich die nach der Injektion des Traubenzuckers erscheinende Hyperglykämie langsam. Das Leberglykogen vermindert sich mehr als bei einer Kontrolle, aber des Muskelglykogen zeigt gegenüber einer Kontrolle keinen Unterschied. Der histologische Befund stimmt mit durch chemische Mittel erreichten Versuchsresultaten überein. 2) Injektion von Milzextrakt. Dabei wird die Senkung dieser Hyperglykämie gefördert. Das Leberglykogen vermehrt sich gegenüber einer Kontrolle, doch erfährt das Muskelglykogen keine quantitative Veränderung. Der histologische Befund stimmt mit durch chemische Mittel erreichten Versuchsresultaten überein. 3) Injektion von Cholin. Dabei wird die Senkung dieser Hyperglykämie gefödert. Das Leberglykogen vermehrt sich gegenüber einer Kontrolle, aber das Muskelglykogen zeigt gegenüber einer Kontrolle keinen Unterschied. Der histologische Befund stimmt mit durch chemische Mittel erreichten Versuchsresultaten überein. 4) In Milzextrakt ist eine cholinartige Substanz enthalten, welche auf den Kohlenhydratstoffwechsel fördernd einwirkt.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155847101935植物性神經ノ含水炭素新陳代謝ニ及ボス影響ニ就テ（第3報）肝臟竝ニ筋肉ノ組織學的所見26552673ENMasanobuFujiiIch untersuchte histologisch Leber-und Muskelglykogen bei einem Hunde, dem man nach der Injektion von Adrenalin oder nach der Abschneidung eines einseitigen N. Splachnicus oder Vagus Traubenzucker injizierte, und erreichte dabei genau dieselben Resultate wie bei den in der 1. und 2. Mitteilung berichteten Versuchen, wo ich mich eines chemischen Mittels bediente.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15585031938所謂線状體血液症候ニ就テ745754ENFujioNakataToshioFujiiIm Jahre 1923 beobachteteu Sato und Yoshimatsu ein eigenartiges Blutbild bei zwei Fällen von akuter Encephalitis epidemica, d.h. während die Oxydasereaktiou nach Winkler und Schultze positiv siud, war die Peroxydasereaktion nach Sato uud Sekiya (Kupfervitriollosung, danu Benzidin und H(2)O(2)) in den rnyeloischeu Leukozyten des strömenden Blutes negativ. In weiteren Versuchen mit Schädigung des Striatum von Kaninchen konnten sie das gleiche Blutbild hervorrufeu (sog. Peroxydasestich). Deshalb kam Sato nun auf die Vermutung, dass es sich bei diesem Blutsyndrom um Funktionestöungeu des Striatum irn Hirustamm handelu könnte, und nannte dieses Phänomen "striäres Blutsyndrom". Sie stellten dieses Blutsyndrom nur auf der Höhe des Krankheitsstadiums fest; bei Besserung des Krankheitsprozesses verschwand es wieder. Aus diesem Grunde machte Sato eiuen Vorschlag, dieses striäre Blutsyndrom auf die kliuische Herddiagnose des Hirns und die Prognosenbestimmung des Krankheitsprozesses anzuwenden. Hierauf untersuchten wir 83 Patienten mit akuter Encephalitis epidemica in verschiedenen Krankheitsstadieu, 16 P. mit Extrapyramidalsystemerkraukungen, 56 P. mit andereu akuten uud chroniechen Erkrankungen und Tiere nach Zerstörung des Striatum auf des sog. striäre Blutsyndrom, fanden es aber niemals.
Aus diesen Uutersuchungen kameu wir zun folgenden Schluss : Das sog. striäre Blutsyudrom uach Sato und Yoshimatsu ist für klinische Lokalisationsdiagnose des Hirns und Prognosenbestimmungen des Kraukheitsprozesses ungeeignet.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15585161939Paratyphus=Bト赤痢トノ混合感染症例13861397ENTadaitiSakanakaTosioHuziiDas Zusammeutreffen von Typhus abdominalis bzw. Paratyphus mit Dysenterie wird nur selten beobachiet. Im Japan sind bis heute im ganzen 10 solcher Fälle mitgeteilt worden. Wir hatten im Sommer 1937 in unserem Hospital Gelegenheit, 2 solcher Fälle zu beobachten. Der erste Fall war eine Mischinfektion von Paratyphus-B und Dysenterie bei einem 23 jährigen Mann, der mit Verdacht auf Dysenterie in unserem Hospital aufgenommen worden war. Der Pat. zeigte starke Hirnsymptome und Leukopenie, nebeu aubaltendem Fieber und heftiger Diarrhöe, die jedoch erst am dritteu Kraukheitstage auftrat. Auf grund dieser symptome haben wir ein Zusammentreffen von typhöser Krankheit mit Dysenterie angenommen und wiosen in der Tat Kawase'sche Dysenteriebazillen im Stuhl und Paratyphus-B-bazillen im Blut nach. Der Pat. erlag rasch trotz aller symptomatischen Behandlung der schweren Symptome. Zweiter Fall: Bei einem 12 jährigen Knaben, der wegen Typhus abdominalis im unserer Behandlung stand, zeigten sich plötzlich während seiner Rekonvaleszenz dysenterische Symptome, wie Diarrboe mit Tenesmus, Drückempfindlichkeit am als Strang fühlbdren S-Romanum usw. Wir konnten nicht nur aus dem Kot Dysenteriebazillen (Komagome-B) isolieren, sondern es wurden nach Hauptagglutinine gegen Dysenterieund Typhusbazillen im Krankenserum nacbgewiesen und damit Dysenterie als seltene Komplikation im Verlaufe des Typhus abdominalis festgestellt. Es war bei diesen Kuaben bald Besserung eingetraten.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155853121941岡山縣産HynobiuSニ於ケル嗅器竝ニJacobson'sches Organノ發生學的研究24882505ENMasakazuFujiiDas Geruchsorgan der Amphibien ist seit alters her ontogenetisch Gegenstand lebhafter Erörterungen gewesen. Dieses Organ ist jedoch, wie allgemein wohl bekannt, je nach dem einzelnen Organismus mehr oder minder anders gestaltet. Der verf. hat nun bei Hynobius, das im Bezirk von Okayama-ken allein zu treffen ist, das Geruchsorgan vom ntogenetischen Standpunkt ans systematisch untersucht. Dabei benutzte er 12 Embryo nen des Hynobius, deren Körperlange von 6.5mm ab bis zn 71, 0mm betrug. Die Ergebnisse waren wie folgt. 1) Bei Hynobius tritt die erste Anlage des Geruchsorganes bei einem Embryo von 9,5mm Körperlänge auf, und zwar als eine teilweise Verdickung des Ektodermas, welches. vom Gehirnsack verläuft. 2) Die Enstehung der Geruchsplatte beruht auf der Verdickung der Schicht der Organa sensuum; die äusserste Schicht des Ektodermas stehb mit dieser Entstehung in keiner Beziehung. 3) Bei der Geruchsplatte erfolgt sodann eine Einsenkung, die in einer von der Mitte etwas kaudalwarts entfernten Stelle stattfindet. Durch diese Einsenkung entsteht die Foveola olfactorius. 4) Die Foveola olfactorius bildet bei einem Embryo von 8,5mm Körperlänge das Säckchen der Nase aus. Die erste Anlage der Nasenhöhle wird bei einem Embryo von 9,0 mm Körperlänge beobachtet. 5) Durch die Differenzierung der Wand des Nasensäckchens wird auf der Lumenoberfläche der Organa sensuum eine durchsichtige Schicht gebildet. Bei weiterer Entwicklung geschicht eine Organisation an der Wand des Nasensäckchens, wodurch mehrere Wölbungen an derselben Wand entstehen. 6) Die erste Anlage des Ausführungsganges ist bei einem Embryo von 15,0mm Körperlänge erkennbar. Bei. einem Embryo von 40,5mm Körperlange scheint sie verschwunden zu sein, nachdem sie sehr kurz geworden war. 7) Das Jacobsonsche Organ des Hynobius bringt bei einem Embryo von 20, 0mm Körperlänge seine erste Anlage zum Vorschein, welche wie das Divertikel der Nasenhöhle aussieht. Die Jacobsonsche sowie die Bowmansche Druse treten erst bei einem Embryo von 25,0mm Korperlange in die Erscheinung: die beiden stellen tubulare Drüsen dar. 8) Bei einem Embryo von 12,5mm Körperlänge treibt das Nasensackchen aus seinem kaudalen Ende eine Epithelknospe. Dieser Knospe entgegen schickt das Epithel der Mundhohle einen Empfangshugel zur Verbindung mit der Knospe aus. Bei einem Embryo von 16,0mm Körperläuge sind die Epithelkanälchen durchbrochen, wodurch die Anlage des hinteren Nasenlochs gebildet wird., 9) Bei einem Embryo von 20,0mm Körperlänge treten an dei Innenwand des hinteren Nasenlochs klappenartige Falten auf, welche indes bei einem Embryo von 40,5mm Körperlänge spurlos verschwinden. 10) Die Anlage des Tränenkanals tritt bei einem Embryo von 25, 0mm Körperlänge in die Erscheinung. Sie gelangt bei einem Embryo von 27, 0mm Körperlänge als ein Tränenkanal fast zur vollen Entwicklung.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155853111941哺乳動物ノJacobson'sches Organノ形態學的發生ニ關スル研究（其ノ4）（殊ニ家兎胎兒ニ於ケル檢索）22482262ENMasakazuFujiiFernerhin hat der Verf. bei Embryonen von Kaninchen, welche sich in 9 Entwicklungsstudien von 6,0mm Sch. -St. -L. befunden, die Entwicklungsvorgange des Jacobsonschen Organes systematisch und morphogenetisch untersucht. Aus dem Vergleich der Ergebnisse mit den Vorhergehenden drei Ergebnissen kam der Verf. zu folgendem Schluss: 1) Die erste Anlage des Jacobsonschen Organes wird bei einem Embryo von 6,0mm Sch. -St. -L. beobachtet. Sie ist zunächst als eine Verdickung des Epithels, welches an einem Übergangsteil der Innenwand des Sulcus Olfactorius zur Oberhaut vorhanden ist, angedeutet. Hierauf folgt dann die Einsenkung des mittleren Teiles der verdickten Partie. 2) Das Lumen entsteht dadurch, dass sich die beiden Seiten der eingesunkenen Furche dammartig erbeben und dann vom kaudalen Ende der Anlage her allmählich oral- wärts eingeschnürt und von der Wand der Nasenhöhle abgetrennt werden. 3) Die Differenzierung der Lumenwand beginnt bei einem Embryo von 8,5mm Sch. -St. -L. Die ventral Innenwand ist dick, während die dorsale Aussenwand dünn ist, an der auch keine Furche anzutreffen ist. 4) Das Jacobsonsche Organ der Embryonen von Kaninchen mündet durch einen rundlichen Ausführungsgang in die Innenwand der Nasenhöhle, und zwar am oralen Ende der Innenwand in der Nähe des Bodens der Nasenhöhle. 5) Die Nebendrüse bringt zuerst ihre dorsale Drüse bei einem Embryo von 20,0mm Sch. -St. -L. zum Vorschein. Darauf tritt dann die Enddrüse bei einem Embryo von 26,0 mm Sch. -St. -L. in die Erscheinung. 6) Der Jacobsonsche Knorpel ist zum erstenmal bei einem Embryo von 2,0mm Sch. -St. -L. erkennbar. Er entwickelt sich dann bei einem Embryo von 20,0mm Sch. -St. -L. sehr rasch, nimmt eine Hufeisenform an und umhullt das Jacobsonsche Organ ausschliesslich eines Teiles der dorsalen Partie.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155853101941哺乳動物ノJacobson'sches Organノ形態學的發生ニ關スル研究（其ノ3）Meerschweinchenembryonenニ於ケル檢索20822094ENMasakazuFujiiIn dieser Abteilung hat der Verf. die Entwicklung des Jacobsonschen Organes bei 8 Embryonen der Meerschweinchen von 7, 0mm ab bis zu 56, 0mm Sch. -St. -L. systematisch und morphogenetisch untersucht. Aus dem Vergleich der Ergebnisse mit den vorherge. henden kam er zu folgendem, Schlues: 1) Bei Embryonen von Meerschweinchen ist die erste Spur des Jacobsonschen Organes als eine Divertikelbildung an der medialen Wand des Sulcus Olfactorius bei einem Embryo von 7, 0mm Sch. -St. -L. angedentet. Beim Auftritt dieser Anlage nimmt die mediale Wand mehr oder weniger an Dicke zu. 2) Das Lumen des Jacobsonschen Organes tritt bei einem Embryo von 8,0mm Sch. -St. -L. zunächst am kaudalen Ende des Embryos auf und entwickelt sich dann allmahlich oralwärte hin. 3) Die Differenzierung der Lumenwand findet schon bei einem Embryo von 10,5mm Sch. -St. -L. statt. In diesem Stadium ist die dorsale Innenwand des Lumens dick, wäh- rend die ventrale Aussenwand des Lumens eine ausserordentlich dünne ist. 4) Erst bei einem Embryo von 11,0mm Sch. -St. -L. wird eine Furche auf der Aussenwand beobachtet. 5) Das Lumen des Jacobsonschen Organes gelangt bei einem Embryo von 15,0mm Sch. -St. -L. zur vollen Entwicklung. 6) Bei Embryonen von Meerschweinchen kommt die Enddrüse am frühesten zum Vorschein. Ihre erste Spur ist bei einem Embryo von 17, 0mm Sch. -St. -L. erkennbar. Etwas epäter tritt die ventrale Drüse in die Erscheinung, am spätesten die dorsale Drüse. 7) Die dorsale Innenwand des Lumens besteht aus einem mehrschichtigen Zylinderepithel. Die ventrale Aussenwand ist mit einem dünnen, einoder zweischichtigen. Zylinderepithel überzogen. Die Nebendrüse hängt kontinuierlich mit dem Grenzteile der beiden Drüsen zusammen und kommuniziert mit ihnen.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15585391941哺乳動物ノJacobson'sches Organノ形態學的發生ニ關スル研究（其ノ2）Mus molosseimusニ於ケル檢索18341848ENMasakazuFujiiIm Anschluss an den vorhergehenden Bericht hat der Verf. in dieser Abteilung bei 10 Embryonen von Mus molosseimus von 4,0mm an bis zu 25,0mm Sch. -St. -L. (d. h. bis zum Alter von einem Tag nach der Geburt) das Jacobsonsche Organ morphogenetisch untersucht und kam zu folgendem Schluss: 1) Bei diesen Mäusen wird das erste Anzeichen des Jacobsonschen Organes bei einem Embryo von 4,0mm Sch. -St. -L. als eine Verdickung der lateralen Wand der Nasenhöhle angedeutet. In die verdickte Partie hinein sinkt sodann das innere Lumen des Sulcus olfactroius ein und bildet dadurch die erste Anlage des inneren Lumens des Jacobsonschen Organes. 2) Der Schlauch des Jacobsonschen Organes bildet sich aus der Anlage des betr. Organes, indem die Anlage, gerade wie bei der Ratte, vom kaudalen Ende her nach dem kranialen Teile hin allmählich eingeschnürt und schliesslich von der Wand des Sulcus olfactorius abgetrennt wird. 3) Das Jacobsonsche Organ der Mäuse sieht wie ein Stäbchen aus. An beiden Seiten des Cartilago septi nasi verläuft es entlang der Körperachse in kaudal-kranialer Richtung fast propotional zur inneren Seitenwand der Nasenhöhle, und zwar an der Mitte der dorsoventralen Linie der Seitenwand. Das kraniale Ende des Organes öffnet sich durch einen engen Ausfuhrüngsgang am kranialen Ende der inneren Wand der Nasenhöhle. Das kaudale Ende des Organes läuft in ein Blindende ungefahr an der Mitte kranial-kaudalwärts verlaufender Linie der Nasenhöhle aus. 4) Das Jacobsonsche Organ dreht sich, gerade wie bei der Ratte, ein wenig um seine eigene Längsachse. Die Längsfurche, welche auf der Aussenwand des Organes in die Erscheinung tritt, bringt ihre erste Spur schon bei einem Embryo von 6,2mm Sch. -St. -L. zum Vorschein. Mit der Entwicklung des Embryos nimmt sie an Tiefe zu. 5) Bei einem Embryo von 14,2mm Sch. -St. -L. werden die Anlage der Enddrüse und die der dorsoventralen Glandula erkennbar. Die Anlage der ventralen Glandula tritt etwas später auf. 6) Das Epithel der Schlauchwand ist am dünnen Teile der äusseren Furche von einem dünnen Respirationsepithel umhult, die innere Wand des Schlauches ist mit einem dicken Geruchsepithel überzogen. 7) Bei Emgryonen von Mausen ist die Enddrüse am besten ausgebildet.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15585381941哺乳動物ノJacobson'sches Organノ形態學的發生ニ關スル研究（其ノ1）（Rattus albusニ於ケル檢索）15471560ENMasakazuFujiiDas Jacobsonsche Organ ist ein Nasenorgan, das am Boden der Nasenhöhle, zu beiden Seiten der Scheidewand gelegen ist. Seitdem es im Jahre 1811 von dem dänischen Gelehrten Jacobson zum erstenmal entdeckt und von ihm selbst unter der Bezeichnung "Organo vomeronsale Jacobsoni" bekannt gegeben worden war, erregte es eine allgemeine Aufmerksamkeit und hat eine kaum mehr zu überschauende Fülle von Arbeiten in die Öffentlichkeit befördert. Als die bekanntesten unter den Forschern sind Namen zu nennen wie Roserthal (1826), Balogh (1860), Dursy (1869), Klein (1882), Harvey-Reuden (1882), Löwe (1888), Herzbeld (1888), Range (1893), Garnault (1895), Röse (1893), Mihalkovics (1868), Broman (1920), Navratil (1926) u.a.m. Trotzdem konnte der Verf. in der Literatur, soweit sie ihm zugänglich war, keinen Bericht finden, der in die Funktion dieser Organe klare Einsicht gewährte. Broman nämlich hat auf Grund der Ergebnisse seine Tierexperimente die Behauptung aufgestellt, dass dieses Organ ein Wassergeruchsorgan darstelle, Navratil konnte trotz seiner ausgedehntesten Studien noch koine bindende Erklärung bezüglich der physiologischen Funktion dieses Organes geben. Wenn man einmal an die Enge des Ausfuhrungsganges dieses Organes denkt, erscheint es kaum möglich, dass die Luft und irgendein Geruch durch diesen engen Gang hindurch zum betr. Organ gelangen. Man kann jedoch dabei auch die Möglichkeit nicht in Abrede. stellen, dass sich im lebenden Organismus das Organ gelegentlich mehr oder weniger erweitert. Die Annahme, welche das einschlägige Organ für ein Geruchsorgan hält, darf man deshalb nicht ganz von der Hand weisen. Um das Wesen dieses funktionell noch nicht völlig aufgeklärten Organes festzustellen, ist es erforderlich, histologisch-anatomische Untersuchungen, wie unsere Värganger getan haben, gründlich auszuführen. Aber es ist auch ohne wciteres klar, dass eine systematisch angeordnete morphogenetische Vergleichsuntersuchung über das in Rede stehende Organ sicher zur Aufklärung seines Wesens vieles beitragen kann. Diese morphogenetische Untersuchung erschien dem Verf. um so interessanter, weil er in der bisherigen sowohl japanischen als auch europäischen Literatur keinen Bericht finden konnte. Zur Untersuchung wählte er Säugetiere, von denen er zunächst 10 Embryonen von Ratten von 6, 2mm an bis zu 36, 0mm Sch -St. -L. benutzte und kam zu folgendem Schluss: 1) Das Jacobsonsche Organ von Ratten ist bei einem Embryo von 6, 2mm Sch. -St.-L. als die erste Spur angedeutet, und zwar in der Gestalt von einer kleinen halbkugligen Ausbuchtung in der Mitte der inneren Seitenwand des Sulcus olfactorius. Diese Ausbuchtung entwickelt sich allmählich und wird schliesslich zu einer Längsfurche, die entlang an der Längsachse des Sulcus olfactorius liegt. 2) Die vertikale Furche wird vom kaudalen Ende her allmahlich eingeschnürt, bildet sich dann bei eiuem Embryo von 10, 2mm Sch, -St. -L. zu einem Lumen, dessen Blindende kaudalwärts gerichtet ist. Das kraniale Ende dieses Lumen öffnet sich am kranialen Ende der Innenwand, welches nahe am Boden der Nasenhöhle liegt. 3) Mit der weiteren Entwicklung des Embryos wird an der äusseren Seite des Lumens eine Längsfurche gebildet, indem die Aussenwand des Lumens in dasselbe hineinsinkt. Das Lumen selbst dreht sich dabei allmählich um die Längsachse. 4) Das Epithel der Lumenwand besteht in früheren Stadium aus mehrschichtigem Zylinderepithel, welehes dem Epithel der Nasenhöhle an Beschaffenheit und Dicke gleich ist.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586131949急性「バリウム」中毒の1例5760ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586441952ビリルビンの腸管内吸收に関する実驗的研究 第三篇 腸管内直接ビリルビンの間接化に関する検討645654ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586441952ビリルビンの腸管内吸收に関する実驗的研究 第二篇 ビリルビンの腸管内吸收部位に就て639645ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586441952ビリルビンの腸管内吸收に関する実驗的研究 第一篇 ビリルビンの腸管内吸收機転に就て627638ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155865111953梅毒における含水炭素代謝の研究 第3報 各期梅毒における血糖と血漿蛋白分屑19871999ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155865111953梅毒における含水炭素代謝の研究 第2報 駆梅療法による血糖の消長19731986ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155865111953梅毒における含水炭素代謝の研究（第1報）各期梅毒の遊離及び結合血糖量の消長について19491971ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155865101953泌尿器結核に対するISCOTINの効果17971801ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586561953柵原鑛山に於ける珪肺症の研究 第II報 珪肺症患者に於ける心臟機能検査789792ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586561953柵原鑛山に於ける珪肺症の研究 第I報 珪肺症患者の血液像並びに臨床像783788ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586521953昭和22，23，24年度岡山縣下流行日本腦炎に関する統計的臨床観察309322ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586521953ワクチン接種による岡山縣下の日本腦炎予防に就て298308ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586521953Phenosulfazoleに依る日本腦炎の治療及予防に関する実驗的研究289297ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586671954脳下垂体埋沒療法の効果並に副作用に関する研究 第1編 埋沒に有効な牛脳下垂体の研究並に埋沒療法の効果について14951499ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586671954皮膚内総ビタミンCの研究 第5編 テラマイシン注射による血液内および皮膚内総ビタミンC量の消長について14891493ENMasatoFujii1) By injecting Terramycin 20mg/kg intravenously, Total V. C. content within blood decreased 16.5% in an hour; after 2 hours' duration, experienced an increase of 8.9% on the contrary. Within skin, it has increased 8.2% in an hour, 28.4% in 2 hours; on the contrary, it has proved a decrease after 5 hours. 2) In case 60 mg/kg Terramycin has been intravenously injected, Total V. C. amount in blood kept on decreasing from 2 hours after, but returned to its normal state after 24 hours. In skin, it has also undergone a similar slight decrease, but has recovered to its normal state after 24 hours, without any noticeable influences.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586671954皮膚内総ビタミンCの研究 第4編 クロロマイセチン注射による血液内および皮膚内総ビタミンC量の消長について14831487ENMasatoFujii1) When 40mg/kg of Chloromycetin is injected, Total V.C. within blood indicated a decrease, still showing the same tendency even after 24 hours. In skin, after 2 hours, there happened an increase of 30.3%, but after 5 hours, decreased on the contrary. 2) When Chloromycetin 120 mg/kg has been injected, Total V.C. amount in blood decreased to an extent of 18.7% after two hours, but showed an increase of 21.7% after 5 hours, and again proved a decrease of 27.1% after 10 hours. In skin, it has decreased ever since 2 hours. After 24 hours' lapse, Total V.C. amount within blood and skin has been recovered to its normal state.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586671954皮膚内総ビタミンCの研究 第3編 ストレプトマイシン注射による血液内および皮膚内総ビタミンC量の消長について14771482ENMasatoFujii1) In case 20 mg/kg Streptomycin has been injected, Total V. C. content in blood indicated a decrease of 24.3% Within 2 hours, 44.0% increase after 5 hours on the contrary, but again a decrease happened after 10 hours. The changes that occurred to Total V. C. in skin proved a decrease of 6.2% in 2 hours, 22.8% in 5 hours, but in 10 hours, indicated an increase on the contrary. 2) In case 60 mg/kg Streptomycin has been injected, Total V. C. content within blood proved a decrease in 2 hours, but on the contrary, an increase of 22.5% in 10 hours; after 24 hours, itagain showed a decrease. Total V. C. content within skin kept on decreasing since 2 hours.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586671954皮膚内総ビタミンCの研究 第2編 結晶ペニシリンK注射による血液内および皮膚内総ビタミンC量の消長について14691475ENMasatoFujii1) In half an hour after the injection of Penicillin, Total V. C. in blood proved an increase, which after 5 hours, reached 102.6% at the highest, and showed still an increase after 24 hours. The Total V. C. amount in skin has risen to 21.9% in an hour after the injection. 81.0% at highest after an hour, and still indicated an increase even after 24 hours. 2) The increasing tendency occurred for total amount after the injection of Penicillin has proved to lower in the course of time, yet showed an increase even after 7 days' durati on. 3) By the injection of Penicillin, the rabbit fed with vitamine-C-less food had been stimulated its formating faculty of Vitamine C.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586671954皮膚内総ビタミンCの研究 第1編 正常家兎の血液内および皮膚内総ビタミンC量並にそれに対する採皮採血の影響について14611468ENMasatoFujii1) I have conducted a V. C. determination in blood and skin of a rabbit, due to revised method adopted by Fujita & Ebihara. 2) The total V. C. content in the blood of a rabbit fed with vitamine-C-less food proved 6.51mg% at maximum, 1.39mg% at minimum, in average, 3.08mg%; 93% of total instances indicated between 2 and 5mg% 3) The Total V. C. content in the skin of a rabbit fed with vitamine-C-less food proved 12.79mg% at maximum, 1.52mg% at minimum, while, In average, proved to be 5.35mg% The 86.6% of total cases proved between 4 and 7mg% 4) The curve of changes due to lapse of time attributed to Total V. C. within blood and skin of a rabbit fed with vitamine-C-less food, when it has been pealed skin and picked blood, proved a glass-picture in a parallel state, as it indicated a slight increase for the estimated within blood, while, a slight decrease when estimated within skin; the ratio both of increase and decrease shown by this increase-decrease curve, is very small; and proved almost no influence on the V. C. amount due to pealing skin and picking blood. 5) The effect of such-like operations on Total V. C. metabolism within blood and skin, though slight in degree, continues for a considerable duration of time; besides, effects due to temperature, though slight too, is thought to occur to a certain extent.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586611954興味ある腸閉塞症の3例竝に完全内臟転錯症について3136ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586611954帯状疱疹の治療特にIrgapyrinの効果について2730ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586711955骨髓自家融解液の骨髓造血に及ぼす影響 第3編 骨髄体外組織培養への添加実験2942ENMasatomiFujiiThe author, about the improvement of bone-marrow hematopoiesis, presumed in Part I that the blood vessel function might be one cause; in Part II, concluded that the reticuloendotherial system should be sound a prior, and as was told in the so-called "autohormone theory" it might be due to the particular hormone-like function which is proper to that extract. Accordingly, in this part, in order to exactly verify whether the bone-marrow extract would be influenced directly to the medullary parenchymal Hematopoiesis or not, the author added that extract to bone-marrow tissue culture and inspected its growth rate, wandering velosity, and changes in quantity of hemoglobin as well as in number of blood cells. First, taking observations of the growth rate of bone-marrow tissue, and the wandering velocity of intramedullary pseudoeosinocytes, under culture in cover slips, it was known that the addition of extract in a proper density improves remarkably the growth of tissue, and that the main purport of its growing process roughly coincides with non-added case as well as with controls. Also, the wandering velocity as well as time of continuance of the pseudoeosinocytes, though it was remarkably inhibited when the extract proved very dense, almost receive no other influence, and no significant differences with the controls could be discovered; i.e., the author could perceive that the increase in tissue growth rate by adding the bone-marrow extract was no result of activation of cell wandering, but it owes to the stimulation of growth in parenchymal cells themselves. Moreover, taking observation of the effect of bone marrow extract on the increase of hemoglobin as well as red blood cell number, under the culture in fluid medium, it was clarified that a certain of extract in a proper density brought about a marked increase in the amount, proving the existence of direct function by the extract. All through 3 reports the author have vindicated the fact that the improvement of medullary hematopoiesis by parenteral administration of so-called bone-marrow substances, may be caused not only by the vessel function, but also by the function of bone-marrow substance which has power to advance hematopoietic function.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586711955骨髓自家融解液の骨髓造血に及ぼす影響 第2編 剔脾，肝障碍，網内糸填塞の影響1327ENMasatomiFujiiIn the previous report, the author stated that there should happen a remarkably stimulated medullary hematopoiesis if the intra-abdominal injection of bone-marrow extract were successively rendered for a normal rabbit; this time, I conducted the following experiments in order to clarify whether these phenomena would activate indirectly through liver, spleen, or reticuloendotherial syetem, which are said to keep close relation with hematopoiesis, or, as Miyakawa maintained in this so-called "autohormone tbeory", functionate directly. First, having successively injected "bone-marrow extract" at 48 hours as well as 7 days after the splenectomy, the author examined its peripheral blood picture: this time, as was seen in the case of normal rabbit, biphasic blood cell increase was observed to take place, and an increase of reticulocytes number as well as a left shift of leucocytes were observed conspicuously, under the secondary blood cell increase. Consequently, it was verified that the same extract could stimulated the medullary hematopoiesis even under the influence of splenectomy. Next, by injecting likewise at 24 hours after the liver parenchymal disturbance, biphasic blood cell increase, an increase of reticulocytes number, and a left shift of leucocytes were noticed; moreover, even in case when the functions both of liver and spleen were removed at the same time, almost the same result as in the normal rabbit was obtained. In case the reticuloendotherial system was blocked with India-ink, even successive injection could not cause either increase of blood cell as well as left shift of leucocyte or improvement of intramedullary blood stream; that is to say, no medullary hematopoiesis was brought about. From the above results, the author concludes that the improvement of medullary hematopoiesis by successive intraabdominal injection of bone-marrow extract has no concern with either splenectomy or liver parenchymal disturbance, that the soundness of bone-marrow reticuloendotherial system should be indispensable requisite, and that this phenomenon might occur owing to the direct stimulation to bone-marrow parenchymal function.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586711955骨髓自家融解液の骨髓造血に及ぼす影響 第1編 腹腔内注射並に骨髄灌流実験111ENMasatomiFujiiThe author, as a link in the serial study on improvement of medullary hematopoiesis by so-called bone-marrow substance, tried to investigate both effects and functions of parenteral administration of rabbit's red bone-marrow autolysate (called simply as "bone-marrow extract" hereafter); so that, having injected its certain amount into normal rabbit's abdominal cavity, the author inspected its hourly effect on peripheral blood picture as well as on blood picture of V. nuturitica femoralis, and also took observations of certain changes that occurred to intramedullary circulation. As a result, the author discovered that: 1) the biphasic blood cell increase was induced in both cases of single and successive injection alike; 2) in its secondary blood cell increase, the increase was more remarkable in case of successive, than in case of single, injection; 3) above all, an increase of reticulocytes, a comparative increase of pseudoeosinocytes, and a left shift of leucocytes, were remarkably induced. Moreover, in case of the primary blood cell increase, an expansion of medullary nutric vessels, a marked blood cell increase in nutric veinal blood, and a comparative increase of pseudoeosinocytes --- i. e. a liberation of accumulated blood cells within bone-marrow --- were brought about; and further, the blood stream within bone-marrow under the two phases of blood cell increase was noticed to be remarkably stimulated, as compared with the case in normal rabbit. From the above results, it may roughly be said that, in case the bone-marrow extract should be intraabdominally injected, a biphasic blood cell increase occures in both cases of single and successive injection, the latter being more powerful in stimulating medullary hematopoiesis; and that the primary blood cell increase is caused by the mobilization as well as the liberation of accumulated blood cells which is due to the stimulation to blood stream within bone-marrow, while the secondary blood cell increase owes much to the hematopoietic function of bone-marrow which is originated in the continuance of stimulation to blood stream within bone-marrow.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586981957胆汁酸の微生物学的分解 (XV) 胆汁酸を分解する一土壤菌について21212125ENTakaoFujiiA Gram-negative bacterium which was isolated from the soil of a slaughter-yard and was able to degrade cholic acid has been identified to be quite similar to Erwinia rhapontici.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586971957家兎骨髓体外組織培養に於ける蛋白代謝の研究 第3編 各種疾患患者血清の家兎骨髄蛋白代謝に及ぼす影響16991710ENYukioFujiiBy loading the tissue culture (Carrel flask method) of the bone marrow of normal rabbits with sera of Patients suffering from various diseases, various factors involved in multiplication of the bone marrow at the same time the influences of these of these sera on the protein metabolism in the rabbit bone marrow have been investigated and the following are the results: (1) Sera of hypolastic anemia, Banti's disease, and of leukemia act directly on the bone marrow, and the presence of the substances inhibiting the marrow functions has been recognized, inhibiting the production of γ-globulin and fibrinogen by the marrow. (2) No substance acting directly on the bone marrow has been recognized in the sera of such blood disorders as essential hypochromic anemia, hookworm disease, Werlhof's disease, as well as in liver and kidney diseases or tuberculosis, and the loading of such sera to the marrow culture exerts no influence on the protein metabolism. (3) In the serum of cancer patient, the presence of substance slightly inhibiting the marrow functions has been recognized.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586971957家兎骨髓体外組織培養に於ける蛋白代謝の研究 第2編 実験的貧血家兎骨髄の蛋白代謝16851698ENYukioFujiiThe protein metabolism of the bone marrow in experimental anemic rabbits had been studied with explanted bone marrow culture (Carrel flask method) and the following results were obtained: (1) The consumption of albumin and the production of globulin and fibrinogen, have been found to have rather decreased in the bone marrow of the rabbits given benzol for a short period of time. Next, in the case of the rabbits given benzol for a longer period of time. hypolasia of the bone marrow has been quite marked, namely, the consumption of albumin is low and production of globulin or of fibrinogen can hardly be noticed. (2) In the rabbits given saponin, the findings have been almost identical with those of the normal. (3) In the rabbits administered with phenylhydrazin or collargol, the marrow functions are low, the consumption of albumin slack, and the production of globulin and fibrinogen has been markedly low. (4) In the rabbits irradiated by x-rays, the marrow function have been completely deteriorated; namely, neither the consumption of albumin nor the production of globulin and fibrinogen can at all been seen.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586971957家兎骨髓体外組織培養に於ける蛋白代謝の研究 第1編 正常家兎骨髄蛋白代謝並びに該代謝に及ぼす各種薬物の影響16691684ENYukioFujiiBy carrying out a series of observations on the protein metabolism by bone marrow culture (Carrel flask method) and on the effect of various drugs acting directly on the bone marrow, the following results have been obtained: (1) Albumin is utilized for multiplication of the bone marrow tissue while globulin is produced by the bone marrow. Consequently, the increase of globulin has a correlation with marrow functions in direct proportion. (2) In globulin fractions, γ-globulin seems to play the most important rôle. (3) Both α- and β-globulins seem to play no important rôle. (4) Fibrinogen is produced by the bone marrow, and it has a close relationship with marrow functions. (5) Folic acid, vitamin B12, and bone marrow extract directly stimulate marrow functions, and they promote the production of globulin, especially of γ-globulin and fibrinogen on one hand, and the consumption of albumin on the other hand. (6) Nitromin (Nitrogen mustard-N-oxyde) lowers functions of the bone marrow and inhibits the production of globulin, paricularly γ-globulin and fibrinogen, and the consumption of albumin.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-3069931978藤本利躬著 「最適経済政策のモデル」171178ENT.FujiiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581011-21989病原性大腸菌（EPEC）の鞭毛構造の多様性201212ENTakashiFujiiThe ultrastructure of flagella of enteropathogenic E. coli was analysed by electron microscopy. The flagella of E. coli 0126, 026, 0114 and 0128, each of which have different H antigen types, were tentatively classified into four types according to their ultrastructural similarity. The appearence of most flagella structures were homologous in each H type and identical with a previous report (Lawn, AM, 1977). However, the structure of H31, H25 and H48 were different from the previous ones and H11 (026K60) and H25 (026K60) showed two different types of flagella structure in a single H type. Immuno-electron microscopy using gold-labeled anti-rabbit IgG goat antibody disclosed that there were anti H type sera reactive flagella and non reactive flagella in both Hll and H25, although the molecular weight of each flagellin showed one homologous band by SDS-PAGE. The result suggests that there is a certain diversity in the manner of self assembly of flagellin to form flagella structures.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812232010胆道癌診療ガイドライン249251ENMasakuniFujiiHirofumiKawamotoKazuhideYamamotoNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812232010手術時手洗いにおける従来法とツーステージ・サージカルスクラブ法，ウォーターレス法の比較について225229ENYukaKobayashiMisaYamadaHiromiFujiiYukikoKoIzumiUotaniMarikoTamotoMasakoNadaHiroyukiMuraiEiKadoHiromiIwagakiJunTomodaShinyaSaitoTo evaluate the usefulness of the waterless hand washing method for surgical anti-sepsis, we conducted a microbial sampling study, comparing it to a conventional surgical scrub method. A total of 18 operating-room nurses were undertaking the following three-hand washing protocols : scrubbing with blushes using 4w/v% chlorhexidine gluconate (CHG) and also rubbing with CHG, followed by application of a 0.2w/v% CHG with ethanol (HS) preparation. (conventional method); rubbing with CHG and application of HS (two-stage surgical scrub method; TSS); rubbing with anti-septic soap and application of HS (waterless method; WL). Microbial sampling was conducted after hand washing using the glove juice method. No statistically significant differences in bacterial numbers were found among these three methods. The number of bacterially positive subjects was significantly higher in the conventional method than the TSS method. These results indicate that there are adverse effects of blush-scrubbing, as the detected bacteria were related to normal skin flora. As such, the WL method for hand anti-sepsis appears to be equivalent to the conventional surgical scrubbing method in terms of microbial detection. The WL method should therefore be introduced as a standard hand anti-sepsis method at the time of surgery because it is cost-effective as well as time-efficient.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30693612004『ファイナル・ファンタジー』の誕生―株式会社スクウェアによる家庭用ゲーム・ソフト開発の事例―4162ENDaijiFujii10.18926/OER/40522No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30693732005研究開発におけるインセンティブ－青色LED 裁判のケーススタディ－1331ENDaijiFujii10.18926/OER/40513The purpose of this paper is to bring an institutional perspective onto the recent debates about incentive planning for R&D workers in Japan. This purpose is fulfilled through a case study of the recent civil trials in which an ex−employee as a plaintiff claimed any compensation for the corporate in−house inventions about blue light emitting diodes (LED). As long as technical achievements are to belong to an individual worker, the incentive planning which his or her employer may design will have to face two difficult tasks. Firstly, marginal analyses commonly applied in micro economics have certain utilities under the strict assumption of decreasing returns to productive inputs, but not applicable, in principle, to R&D activities. It is because such features as experiential learning and teamwork by technical professionals may increase returns to marginal inputs of technical labor. Secondly, negotiation transactions on the arms lengths basis are alternatively applied instead of the first, but incur many transaction costs between opportunistic players. Recent Japan seems oriented toward the second planning arrangement, but this paper suggests that the economic assessments of corporate in−house inventions should be complemented by peer reviews on the
expectation that professional communities of technical experts share certain paradigms to tell us which inventions are more nascent and valuable and which are not. So far, it is said that these peer reviews have been submitted to courts after plaintiffs file complaints for compensations, but preliminary reviews at the time of patent applications may effectively decrease the probability of unexpected lawsuits and reprieve undue legal costs.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30693712005The Birth of “Final Fantasy”: Square Corporation6388ENDaijiFujii10.18926/OER/40488No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30693712005ゲームソフト開発における戦略オプションの選択1934ENDaijiFujii10.18926/OER/40446The purpose of this paper is to examine one of the functions which entrepreneurs may play in the course of industrial development through a case study of Japan’s RPG development race. As Japan’s toy manufacturers often said, their market was characteristic of its small size and considerable demand volatility in comparison to other consumer products. Entrepreneurs must have seen any commitment to a cutting edge product, video games, as only a gamble and therefore behaved in a trial−and−error way. Furthermore, judging from the fact that no one could imagine the video game would come to turn over ¥1500 billion in 20 years, the firm level trial−and−errors and their subsequent variety of strategies on the industry level must have been the key to understand the unexpected market growth and technical evolution. However, recent management thoughts told us that the strategic variety in an industry could be possibly indulged by various pressures towards homogeneity. Such counter powers are referred to as organizational isomorphism, strategic bandwagon effects and so on. To examine those pressures which drive entrepreneurs back and forth towards strategic variety, this paper looks at the structural characteristics which underlie the way entrepreneurs see things in an uncertain environment. The case analysis takes the view that the video game industry was so uncertain that nothing could affect so deterministically entrepreneurs’ behaviours other than their perceptions. As a conclusion here, this paper points out some tradeoffs underlying the two different strategies which the twin peaks of Japanese RPG producers, Square and Enix, employed to meet with the uncertainty of the infant RPG market. It also argues that these tradeoffs based on two different perceptions might have kept their startups from the isomorphic indulgence. As a more prospective argument, questioned is the quality of strategic variety which is often deemed as an unquestionable remedy to industrial stagnation.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010変形性股関節症159162ENKazuoFujiwaraHirosukeEndoYoshiakiMiyakeToshifumiOzakiNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5842004A spectrum of clinical manifestations caused by host immune responses against Epstein-Barr virus infections.169180ENKeijiIwatsukiTakenobuYamamotoKazuhideTsujiDaisukeSuzukiKazuyasuFujiiHironoriMatsuuraTakashiOonoArticle10.18926/AMO/32089<p>Epstein-Barr virus (EBV), or human herpesvirus 4 (HHV-4), infects the vast majority of adults worldwide, and establishes both nonproductive (latent) and productive (lytic) infections. Host immune responses directed against both the lytic and latent cycle-associated EBV antigens induce a diversity of clinical symptoms in patients with chronic active EBV infections who usually contain an oligoclonal pool of EBV-infected lymphocyte subsets in their blood. Episomal EBV genes in the latent infection utilize an array of evasion strategies from host immune responses: the minimized expression of EBV antigens targeted by host cytotoxic T lymphocytes (CTLs), the down-regulation of cell adhesion molecule expression, and the release of virokines to inhibit the host CTLs. The oncogenic role of latent EBV infection is not yet fully understood, but latent membrane proteins (LMPs) expressed during the latency cycle have essential biological properties leading to cellular gene expression and immortalization, and EBV-encoded gene products such as viral interleukin-10 (vIL-10) and bcl-2 homologue function to survive the EBV-infected cells. The subsequent oncogenic DNA damage may lead to the development of neoplasms. EBV-associated NK/T cell lymphoproliferative disorders are prevalent in Asia, but quite rare in Western countries. The genetic immunological background, therefore, is closely linked to the development of EBV-associated neoplasms.</p>No potential conflict of interest relevant to this article was reported.岡山大学温泉研究所Acta Medica Okayama0369-7142531983内視鏡的protein plug除去術により寛解を得た慢性膵炎の一例6165ENMasahikoTakedaJuntaroTanakaKiyoshiTakasugiHideoHaradaTadatomiManjiHiroshiMorinagaTetsuyaTsurumiYasuhisaFujii10.18926/21124Presented here is a case report of a 56 years old male patient with chronic pancreatitis in which a dramatic improvement in symptoms and objective findings were noted after endoscopic elimination of protein plugs. In September, 1979, he had an acute onset of pancreatitis followed by pseudocyst formation and the following combined operations were performed: resection of the pseudocyst, resection of the body and tail of the pancreas along with the spleen, partial resection of the stomach and the transverse colon, and gastroenterostomy according to Billroth I method. He had been followed up at out-patient clinic for chronic pancreatitis and diabetes until January 14,1979 when he was hospitalized for anorexia, loss of weight, pretibial edema, and upper-abdominal pain. The patient's condition was characterized by emaciation (height 152 cm, weight 37 kg), anemia (Hb 7.9g/dl), hypoproteinemia (serum protein 4.2 g/dl) , and hypolipidemia (total cholesterol 73 mg/dl). Abdominal ultrasound, abdominal CT and ERCP revealed stones in the pancreatic duct. Symptoms and objective findings were only partially improved by medical regimens. Subsequently we performed endoscopic cannulation of the pancreatic duct for elimination of pancreatic stones. Successful elimination of large numbers of protein plugs resulted in dramatic improvement of symptoms and objective findings. This procedure proved to add a new important tool in the treatment of chronic pancreatitis.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 Okayama1880-847682010経営学における比較事例研究法に関する一考察 (2)120ENDaijiFujii10.18926/20307No potential conflict of interest relevant to this article was reported.岡山実験動物研究会Acta Medica Okayama212004高血圧自然発症ラットの血圧および学習行動に及ぼす紅麹の影響3133ENKazuakiShinomiyaYutakaAdachiYukiShigemotoIsatoKounoYokoFujiiChiakiKamei1)紅麹投与群は米粉を投与した対照群と比べ､体重増加に対しては有意な差は認められなかった｡ 2)紅麹投与群は対照群と比べ2週目より有意な血圧下降作用が認められた｡ 3)紅麹投与群は､対照群に比べ総エラー数および参照記憶エラー数の減少､すなわち学習獲得能が高いことが判明した｡ 4)以上の成績より､紅麹の投与により生じた血圧下降が二次的に学習獲得能を上昇させたのではないかと考えられる｡No potential conflict of interest relevant to this article was reported.岡山大学農学部Acta Medica Okayama0474-0254 9912010トマトの防根給水ひも栽培における肥効調節型肥料と根域拡張に伴う「紐」の適用4347ENMasaharuMasudaYukiFujiiTakafumiKinoshitaThis study was conducted to investigate the effects of controlled-release fertilizers and wick addition to the root-zone on plant growth and yield of medium-fruit sized tomato up to the 18(th) truss in long-term forcing culture. The set-up consisted of a box partitioned by a board into two halves, named box 1 and box 2. Box 1 contained 2.8 ℓ of growth medium (soil : bark : perlite : peat=2 : 2 : 1 : 1). Plant was grown in box 1 with a capillary wick, and at flowering of the 8(th) truss, the partition was removed and box 2 filled with 2.8 ℓ of the medium. There were two treatments, with or without capillary wick in box 2, namely, single wick (S) and double wicks (D). Plant height was greater in D than S in January, and the difference increased gradually thereafter. Flowering time of 18(th) truss in D was 10 days earlier and decapitated shoot weight was twice that of S. Fruit yield per plant was 8 kg in S and 9 kg in D with similar value of Brix and titratable acidity. There was no difference between S and D in dry root weight (7g/plant) or in xylem exudates (8ml/h), while in S in April plant growth was inferior, leaf color yellow greenish and fruit colour uneven towards the end of growth of plants. Xylem sap analysis showed that NO(3)-N was 10 me/ℓ in S and 6 me/ℓ in D. This concentration is weaker than that of Enshi standard nutrient solution generally used in hydroponics. These results suggest that application of controlled-release fertilizers and wick addition to box 2 with root-zone extended was effective for plant growth performance and fruit yield.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558681-41956白血球自家融解液の所謂直接作用の特異性に関する研究 第3編 骨髄並に淋巴節 体外組織培養への添加実験 附,全編を通じての考察並に結論95107ENSeijiFujiiIn the previous chapters, I have described the so-called direct functions indicated by pseudoeosinocytes, eosinophil leukocytes, as well as lymphocytes, at the same time examining their mechanism. In this, I am going to discuss the case in which the above mentioned leukocytic extract has been added to the tissue culture of the bone-marrow and lymphnodes. 1) In case pseudoeosinocyte extract are added to any tissue culture of rabbit's bone-marrow, an improvement of tissue growth rate (i.e., an increase in pseudoeosinocytes) as well as an excitement in their wandering velocity are achieved in comparative particularity. 2) If I add lymphocytic extract to a rabbit's lymphnode culture, there happens in comparative unique mode, an improvement in the tissue growth rate (i.e., lymphocytic increase), and the lymphocyte rises in its wandering velocity. 3) If I add guinea-pig's eosinophil leukocytes extract on the culture of the same animal's bone-marrow, it induce an increase of eosinophil leukocytes in the growth zone, together with a rise in the wandering velocity of the same. 4) I evidenced that the direct influence of leukocyte extract explained in 1st and 2nd chapter, acts on the bone-marrow and lymphnodes in a direct manner. Conclusions. Owing to those ezperimental results obtained throughout these chapters, I can conclude as folllows: i.e. The extracts stimulate the bone-marrow or lymphnode directly with comparative specifity, no matter how the liver and spleen might stand, and induce the
increase of each sort of leukocytes respectively and of their. wandering velocity so that they appear in the peripheral blood in short time, though it is better that the reticuloendothelial system is normal.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558681-41956白血球自家融解液の所謂直接作用の特異性に関する研究 第2編 別脾，肝細胞障碍及び網内系填塞の各動物群に就いての実験7393ENSeijiFujiiI reported in the 1st chapter the fact, that tle specific increase of each leukocyte is evidenced in the peripheral blood, bone-marrow and in the lymphatic tissue of the normal rabbit or guinea-pig injected with the extract from pseudoeosinophil, eosinophil or lymphatic leukocytes. ln this chapter, I, employing such animals as have undergone either splenectomy, liver parenchymal disturbance, or reticuloendothelial blockade, examined to get certain detailed notions as to their functions, from which, results as follows were obtained. 1) When the extracts out of the pseudoeosinocytes or eosinophil leukocytes have been applied to splenectomized or disturbed liver parenchy animal, an increase of each leukocyte was induced respectively, same as was seen in 1st chapter. 2) When the pseudoeosinocyte extract or eosinophil leukocyte extract was applied to animals of reticaloendothelial blockade, different from the case in 1st chapter, a feeble sort of increase took place in case of pseudoeosinocyte extract, While with the latter, no brieftime increase has appeared, but only when 24 hours have lapsed. 3) If lymphocyte extract was injected in animals with splenectomy, liver parenchymal disturbance or reticuloendothelial blockade, though the was seen no blood lymphocyte increase, same remarkable proliferation as stated in 1st chapter was detected.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558714-21959癲癇痙攣伝導路としての遠淡蒼球線維に関する生理学的研究19691988ENShinichiroFujiiIn this study, the auther has attempt to study electrophysiologically the aspect of pallidofugal fibers which are intermediated by the pallidum to the fibers arising from the motor area as the conduction system of epileptic discharge. Action potentials of motor cortex, basal ganglia, nuclei of the midbrain and spinal cord were recorded during major convulsive or subclinical seizures which are elicited by local administration of metrazol to the motor cortex or the thalamus of dogs. For subcortical recordings, a pair of bipor needle electrodes made of steel wire, mapproximately 200 μ in diameter on tungsten microelectrodes approximately 20 μ in diameter at the tip were used. Both steel and tungsten electrodes insulated by baking enamel except the tip. Spike discharges (duration of each spike is 20-60 msec. amplitude 50-100 μV recorded by abovementioned electrodes) are accounted for the epileptic discharges in this study. The results were as follows: 1) There are two different pathways transmitting the discharges from the motor area to the pallidum, one is direct connection between the motor cortex to the pallidum and the other has some relays the nuclei, thalamus and caudate nucleus, between them. These different pathways are connected separately to two different pallidofugal fiber group at the pallidum. 2) The pallidofugal fiber group, which is connected to the former pathways at the pallidum, are relayed at the contralateral substantia nigra and then terminated to anterior horn cells of the spinal cord. There is a fiber crossing to the other side at the midbrain between the pallidum and substantia nigra. 3) The pallidofugal fiber group connected to the latter at the pallidum does not show crossing to the other side on its course to the homolateral substantia nigra. But the downward fibers from the substantia nigra show a crossing to the other side at the pons and terminate in the contralateral anterior horn cells.No potential conflict of interest relevant to this article was reported.岡山大学文学部Acta Medica Okayama92008「岡山大学生のジェンダー意識に関する調査」報告書1190ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587310-121961筋電図によるkineticなるびにtonic motor unitの特性に関する研究733747ENTakaoFujiiIt became recently known that there are two types of characteristic spikes in EMG at voluntary contruction of skeletal muscle; the one is of low voltage and long duration, and the other, of high voltage and short duration. In this study a detailed observation was done for analysis of these spikes. 1) They would not be changed in duration by alternation of the recording electrode position. 2) In the histograms of the voltage and duration of the spikes recorded separately from flexor digitorum profudus muscle and soleus muscle, it was revealed that the one from the first muscle was of 50-550 μV in voltage range with two peaks at 100-200 μV and 300-450 μV and of 0.5-5.5 ms in duration range with also two peaks at 1.0-1.5 ms and 2.0-3.0 ms. The one from the latter muscle was ranged in similar manner as in the first, but the peak was found solely at 100-150 μV in voltage and 2.5-3.5 ms in duration. 3) In another figure drawn both voltage and duration, it is interesting to know that the first group was subgrouped into two; the one is of short duration and high voltage and the other is of long duration and low voltage. In contrast to it, the latter was of low voltage and long duration. 4) In the r-s curve based on average discharge interval and standard deviation of its irregular variation of these spikes, the one of high voltage and short duration manifested a sharp increment and the other of low voltage and long duration, a slow increment. 5) Two types of such characteristic diphasic spikes were also obtained in M wave of provocation EMG. The latency appeared to be short in the spike of high voltage and short duration compared with the other. 6) The reflactory periods, both in absolute and relative, were also found to be short in the spike of high voltage and short duration incomparison with the other. 7) It is to be noted that the intermediate spike between these two types was found, although relatively in few incidence, both at voluntary contruction and in M wave at provocation. It seem to be concluded that the spike of high voltage and short duration corresponds with the one of kinetic NMU and the other, with the one of tonic NMU.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15588011-121968生物学的活性 Polypeptide "CORNIN" の細胞分裂に及ぼす影響（IV）12111222ENKatsuhikoKimotoTakashiFujitaYoshijiKobayashiSeiichiroTakahashiYoshinobuFujiiToshisukeYamadaYoshikoChikataHisashiOhtsukiTetuhideMurakamiIsamuNisidaThe difference of the effect of cornins extracted from various kinds of living tissues was examined by employing several cell lines in vitro. And the inhibitory effect on tumor growth of the cornins was tested on the mice transplanted with Ehrlich ascites carcinoma. The results are as follows: 1) The antimitotic effect of canine intestine cornin (CIC) was more effective on Ehrlich ascites carcinoma cells in vitro (JTC-11) than that of bovine intestine cornin (BIC) and that of porcine intestine cornin (PIC). 2) Dialysable fraction, undialysable fraction and crude of CIC showed similar activities on the JTC-11 cell line. 3) The antigenicity of CIC was not proved by the hemagglutination test and no mice injected intraperitoneally with large doses of CIC showed any intoxication and disturbance. 4) The inhibitory effect of CIC on tumor growth was the strongest in the three kinds of the intestine cornins with Ehrlich ascites carcinoma and some of tumor-bearing mice were cured completly by the intraperitoneal injections of CIC. 5) The cornin extracted from liver of normal rats (RLC) had marked inhibitory effect on the cell growth of the short-term cultured cell line (RLM-1) and the long-term cultured cell line (RLN-10) originated from normal rat liver, but no effect was observed on the cell line in culture which came from the DAB ascites hepatoma of the same line rat.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15588211-121970筋肉コルニンの細胞分裂調節作用と，そのin vivo応用への基礎的研究549560ENYoshinobuFujiiThe sterilizing effect and hemolytic effect of cornin, extracted from skeletal muscle of rabbit were studied in vivo and in vitro. The results are summarized as follows: 1. Muscle cornin has no effect whatever on sterility when administrated into new born mice and adult mice. 2. There is no difference on the period of pregnancy and on the new born numbers as compared with no treated control. 3. When the erythrocytes are incubated with muscle cornin and then transfered into the hypotonic salt solution, the hemolytic effect occurs below 0.7 per cent salt solution.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558829-101970acatalasemiaマウス血液の網状赤血球と成熟赤血球に含まれるカタラーゼのheat stability acatalasemiaマウス血液の残余カタラーゼの研究，第一報417420ENToyokoFujiiIn order to know the beat stability of catalse in non-acatalasemic and acatalasemic reticulocyte, phenylhydrazine anemia and depleted anemia were induced both in non-acataltasemic and acatalasemic mice. The hemolysates from anemic blood diluted ten times with distilled water were incubated at 44℃ for 10min., thereafter changes in catalase activity were determined. (1) Both in non-acatalsemic and acatalasemic mice, the heat stability of catalase in anemic blood containing about 50 per cent of reticulocyte is lower than that of catalase in non-anemic blood containing about 2 per cent of reticulocyte. (2) Catalase in anemic blood containing about 50 per cent of reticulocyte in acatalasemic mice is more unstable for heat than that in non-acatalasemic mice. In the case of non-anemic blood rich in erythrocytes, the similar results were obtaind. (3) From the results, it is recognized that the catalase in acatalasemic reticulocyte is more unstable for heat than that in non-acatalasemic reticulocyte, suggesting that the catalase in acatalasemic mouse blood has the structural changes due to the structural gene mutation.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558867-81974Goldthioglucose肥満マウスにおける脂酸代謝に関する研究 第2編 (U)-14C-palmitic acid, 1-14C-linoleic acidおよび1-14C-γ-linolenic acidの脂酸代謝について385392ENYasuhisaFujiiFatty acids synthesis from acetate in goldthioglucose obese (GTG) mice was described in part Ⅰ. In this report, the incorporation of (14)C from (U)-(14)C-palmitic acid, 1-(14)C-linoleic acid and 1-(14)C-γlinolenic acid into individual fatty acids and major lipid classes of liver was determined in vivo. Results were as follows. 1) No significant differences between GTG and control mice were found in the incorporation of (14)C into saponifiable fraction of lipids (total fatty acids) from (14)C-palmitic acid, (14)C-linoleic acid and (14)C-γ-linolenic acid. 2) In the percentage distribution of (14)C in malor lipid classes in both groups of mice, it was found that (14)C come from (14)C-palmitic acid was incorporated mainly into triglyceride, (14)C from (14)C-linoleic acid into triglyceride and phospholipids, and (14)C from (14)C-γ-linolenic acid. mainly into phospholipids. A few differences between. GTG and control mice were found in the percentage distribution of (14)C from (14)C-palmltic acid, (14)C-linoleic acid and (14)C-γ-linolenic acid in triglyceride and phospholipids. 3) In regard to the study on the incorporation of (14)C into individual fatty acids of saponifiable fraction of lipids, the percentage of (14)C recovered in palmitic acid from (14)C-palmitic acid more increased and that in stearic acid more decreased in GTG mice than in control mice. When (14)C-linoleic acid was used as precursor the percentage of (14)C recovered in linoleic acid was 55-62% and that in arachidonic acid was about 12% of 14C in total fatty acids, in both groups of mice. However, the percentage distribution of (14)C in γ-linolenic acid from (14)C-γ-linolenic acid was 10% and that in arachidonic acid was 46-58% , in both groups of mice. The rate of conversion from γ-linolenic acid to arachidonic acid more increased in GTG mice than control mice. 4) In regard to the esterification of individual fatty acids into major lipid classes, it was
found in both groups of mice that linoleic acid was more esterified into tryglyceride than into phospholipids, and arachidonic acid was esterified mainly into phospholipids. From these results, metabolism of palmitic acid and essential fatty acids in GTG mice is characterized by increased palmitic acid pool and increased ratio of the conversion from γ-linolenic acid to arachidonic acid.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558867-81974Goldthioglucose肥満マウスにおける脂酸代謝に関する研究 策1編 1-(14)C-acetateよりの脂酸合成について369383ENYasuhisaFujiiInjection of goldthioglucose (GTG) destroys the bilateral ventro-medial nucleus, the "satiety area" and gives rise to hypothalamic obesity in mice (abbreated later as GTG mice). A considerable number of papers have been published on lipid metabolism of liver and adipose tissue in these obese animal. However, little is known about individual fatty acids synthesis in GTG mice. In this report, the author disclosed the individual fatty acids synthesis of liver and adipose tissue in GTG mice. Observations were performed both in vitro and in vivo, with analysis of the incorporation and distribution of 1-(14)C-acetate in individual fatty acids of major lipid classes Results were as follows. Experiment on liver; 1) Liver of GTG mice incorporated significantly more 1-(14)C-acetate in saponifiable fraction of lipids (=total fatty acids) than liver of control mice did. 2) In regard to the study on the distribution of 1-(14)C-acetate in individual fatty acids separated by gaschromatography, the percentage of radioactivity recovered in oleic acid significantly increased in GTG mice. On the other hand, the percentage of radioactivity in fatty acids with retention time corresponding to arachidic acid or longer relatively decreased. 3) After four hours' incubation of liver with 1-(14)C-acetate in vitro, the percentage distribution of radioactivity recovered in triglyceride significantly increased in GTG mice comparedd with control mice. In vivo, the percentage distribution of radioactivity increased in liver triglyceride with time from one hour to four hours after administration of 1-(14)C-acetate in GTG mice. 4) It is conspicuous that the amount of radioactivity recovered in oleic acid of GTG mice was always significantly higher than in that of control mice, on analysis of (14)C distribution in individual fatty acids esterified into triglyceride, both in vitro and in vivo. The percentage distribution of (14)C in oleic acid of triglyceride in GTG mice was increasing with time up to four hours in vivo, too. 5) In individual fatty acids esterified into phospholipids, the percentage of (14)C found in oleic acid of GTG mice was also higher than in that of control mice. 6) In vitro, fasted animals incorporated less (14)C into total fatty acids than fed animals in both GTG and control mice and significant decrease was observed in the percentage of (14)C in myristic acid and palmitic acid.
Experiment on adipose tissue; There was a highly significant increase in the incorporation of (14)C into total fatty acids in the tissue of GTG mice compared with control mice. However, no significant differences were found in the percentage distribution of (14)C in major lipid classes nor in individual fatty acids of saponifiable fraction of lipids between both groups of mice. From these results, the author advocates a possibility that obesity of these animals is due to the increased synthesis of fatty acids and increaed accumulation of triglyceride esterified with oleic acid.No potential conflict of interest relevant to this article was reported.