検索結果 3725 件
| JaLCDOI | 10.18926/AMO/52009 |
|---|---|
| フルテキストURL | 67_6_359.pdf |
| 著者 | Katashima, Kazunori| Kuroda, Masahiro| Ashida, Masakazu| Sasaki, Takanori| Taguchi, Takehito| Matsuzaki, Hidenobu| Murakami, Jun| Yanagi, Yoshinobu| Hisatomi, Miki| Hara, Marina| Kato, Hirokazu| Ohmura, Yuichi| Kobayashi, Tomoki| Kanazawa, Susumu| Harada, Sosuke| Takemoto, Mitsuhiro| Ohno, Seiichiro| Mimura, Seiichi| Asaumi, Junichi| |
| 抄録 | It is well known that many tumor tissues show lower apparent diffusion coefficient (ADC) values, and that several factors are involved in the reduction of ADC values. The aim of this study was to clarify how much each factor contributes to decreases in ADC values. We investigate the roles of cell density, extracellular space, intracellular factors, apoptosis and necrosis in ADC values using bio-phantoms. The ADC values of bio-phantoms, in which Jurkat cells were encapsulated by gellan gum, were measured by a 1.5-Tesla magnetic resonance imaging device with constant diffusion time of 30sec. Heating at 42℃ was used to induce apoptosis while heating at 48℃ was used to induce necrosis. Cell death after heating was evaluated by flow cytometric analysis and electron microscopy. The ADC values of bio-phantoms including non-heated cells decreased linearly with increases in cell density, and showed a steep decline when the distance between cells became less than 3μm. The analysis of ADC values of cells after destruction of cellular structures by sonication suggested that approximately two-thirds of the ADC values of cells originate from their cellular structures. The ADC values of bio-phantoms including necrotic cells increased while those including apoptotic cells decreased. This study quantitatively clarified the role of the cellular factors and the extracellular space in determining the ADC values produced by tumor cells. The intermediate diffusion time of 30msec might be optimal to distinguish between apoptosis and necrosis. |
| キーワード | ADC apoptosis necrosis hyperthermia cell density |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-12 |
| 巻 | 67巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 359 |
| 終了ページ | 367 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 24356720 |
| Web of Science KeyUT | 000328915700004 |
| JaLCDOI | 10.18926/AMO/52008 |
|---|---|
| フルテキストURL | 67_6_351.pdf |
| 著者 | Yokoyama, Yusuke| Abe, Nobuhiro| Fujiwara, Kazuo| Suzuki, Masahiko| Nakajima, Yoshikazu| Sugita, Naohiko| Mitsuishi, Mamoru| Nakashima, Yoshio| Ozaki, Toshifumi| |
| 抄録 | A computer-assisted navigation system to be used for total knee arthroplasties (TKAs) was reported to improve the accuracy of bone resection and result in precise implant placement, but the concomitant surgical invasion and time consumption are clinical problems. We developed a computed tomography (CT)-based navigation system (NNS) to be used for minimally invasive TKA. It requires only the reference points from a small limited area of the medial femoral condyle and proximal tibia through a skin incision to obtain optical images. Here we evaluated the usefulness and accuracy of the NNS in comparison with the commercially available BrainLAB image-free navigation system (BLS). In a clinical experiment, the registration times obtained with the NNS tended to be shorter than those obtained with the BLS, but not significantly so. The NNS group tended to be in the extended position in the sagittal plane of the distal femur within 3 degrees, and the BLS group showed rather flexed deviation in the sagittal plane of the anterior femur. |
| キーワード | total knee arthroplasty navigation system minimally invasive surgery |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-12 |
| 巻 | 67巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 351 |
| 終了ページ | 358 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 24356719 |
| Web of Science KeyUT | 000328915700003 |
| 関連URL | http://ousar.lib.okayama-u.ac.jp/metadata/52515 |
| JaLCDOI | 10.18926/AMO/52007 |
|---|---|
| フルテキストURL | 67_6_343.pdf |
| 著者 | Yamane, Kentaro| Takigawa, Tomoyuki| Tanaka, Masato| Osaki, Syuhei| Sugimoto, Yoshihisa| Ozaki, Toshifumi| |
| 抄録 | Cervical spinal schwannoma is benign, and outcomes after surgical resection are generally excellent. A surgical dilemma sometimes arises as to whether to perform total tumor removal, which carries a risk of sacrificing the nerve root, or subtotal removal, where the risk can be tumor recurrence. The purpose of this study was to identify factors with the potential to predict clinical impairment after surgery for cervical spinal schwannomas. Thirty cases of cervical schwannomas treated surgically in our institute were retrospectively reviewed;initial symptoms, tumor location, Eden classification, surgical method, functional outcome, and tumor recurrence were investigated. All permanent motor deficits were the result of resecting functionally relevant nerve roots (i.e., C5-8). The rate of permanent sensory deficit was 11% after C1-4 nerve root resection, and 67% after C5-8 nerve root resection. Permanent neurological deficits occurred in 14% of patients younger than 40 years and 38% of those older than 40. Dumbbell tumors were associated with the need for total or ventral nerve root transection, as well as with a high incidence of tumor recurrence. The incidence of permanent neurological deficit was significantly higher in patients undergoing C5-8 nerve root resection, and tended to be higher in those over 40. |
| キーワード | cervical spinal schwannoma neurological deficit nerve root resection tumor resection tumor recurrence |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-12 |
| 巻 | 67巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 343 |
| 終了ページ | 349 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 24356718 |
| Web of Science KeyUT | 000328915700002 |
| JaLCDOI | 10.18926/AMO/52006 |
|---|---|
| フルテキストURL | 67_6_333.pdf |
| 著者 | Tazawa, Hiroshi| Kagawa, Shunsuke| Fujiwara, Toshiyoshi| |
| 抄録 | Autophagy is a catabolic process that produces energy through lysosomal degradation of intracellular organelles. Autophagy functions as a cytoprotective factor under physiological conditions such as nutrient deprivation, hypoxia, and interruption of growth factors. On the other hand, infection with pathogenic viruses and bacteria also induces autophagy in infected cells. Oncolytic virotherapy with replication-competent viruses is thus a promising strategy to induce tumor-specific cell death. Oncolytic adenoviruses induce autophagy and subsequently contribute to cell death rather than cell survival in tumor cells. We previously developed a telomerase-specific replication-competent oncolytic adenovirus, OBP-301, which induces cell lysis in tumor cells with telomerase activities. OBP-301-mediated cytopathic activity is significantly associated with induction of autophagy biomarkers. In this review, we focus on the tumor-suppressive role and molecular basis of autophagic machinery induced by oncolytic adenoviruses. Addition of tumor-specific promoters and modification of the fiber knob of adenoviruses supports the oncolytic adenovirus-mediated autophagic cell death. Autophagy is cooperatively regulated by the E1-dependent activation pathway, E4-dependent inhibitory pathway, and microRNA-dependent fine-tuning. Thus, future exploration of the functional role and molecular mechanisms underlying oncolytic adenovirus-induced autophagy would provide novel insights and improve the therapeutic potential of oncolytic adenoviruses. |
| キーワード | oncolytic adenovirus autophagy E2F1 microRNA |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-12 |
| 巻 | 67巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 333 |
| 終了ページ | 342 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 24356717 |
| Web of Science KeyUT | 000328915700001 |
| JaLCDOI | 10.18926/AMO/51909 |
|---|---|
| フルテキストURL | fulltext.pdf |
| 著者 | Mimura, Hidefumi| Kanazawa, Susumu| Yasui, Kotaro| Fujiwara, Hiroyasu| Hyodo, Tsuyoshi| Mukai, Takashi| Dendo, Shuichi| Iguchi, Toshihiro| Hiraki, Takao| Koshima, Isao| Hiraki, Yoshio| |
| 抄録 | This retrospective study evaluated the safety and efficacy of using polidocanol with X-ray fluoroscopy for percutaneous sclerotherapy of venous malformations of the limbs, head, and neck. The subjects were 16 of 18 patients who presented to our department with venous malformations. Two patients were excluded because they were unlikely to benefit from the treatment. Of the 16 included in the study, 1 could not be treated because of inaccessibility, and another was lost to follow-up. Among the 14 cases that we were able to follow-up, 11 cases had had pain as their primary symptom. Following treatment, this symptom remained unchanged in 1 patient, was improved in 4, and had disappeared in 6; however, there was a recurrence of pain for 3 of these patients. Two patients had sought treatment for cosmetic purposes; following treatment, the lesion disappeared in one and showed a significant reduction in the other. The remaining patient presented with a primary symptom of mouth bleeding, which disappeared following treatment. There were no critical complications. Percutaneous sclerotherapy of venous malformations using polidocanol is safe and effective, and permits repeat treatments. The efficacy is especially good for resolving pain, and complications are minor. It is desirable to use fluoroscopy for these procedures |
| キーワード | venous malformation sclerotherapy polidocanol fluoroscopy guidance |
| Amo Type | Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2003-10 |
| 巻 | 57巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 227 |
| 終了ページ | 234 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 14679400 |
| Web of Science KeyUT | 000186186000003 |
| JaLCDOI | 10.18926/AMO/51869 |
|---|---|
| フルテキストURL | 67_5_325.pdf |
| 著者 | Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro| |
| 抄録 | Since 2001, we have been performing phalloplasty with a radial forearm free flap as the flap of first choice in female-to-male transsexuals (FTMTS). In the present case, a 22-year-old FTMTS with a negative Allen test, we achieved good results by performing phalloplasty with an innervated island pedicled anterolateral thigh flap using the "tube within a tube" technique, in which the penis and urethra are constructed with a single flap. While phalloplasty with an island-pedicled or free anterolateral thigh flap has been reported previously, the present case seems to be the first of phalloplasty with an innervated island-pedicled anterolateral thigh flap using the "tube within a tube" technique. As compared to a forearm flap, use of an innervated island-pedicled flap may have the following advantages in phalloplasty:1) no need for a microsurgical technique;2) no scars at noticeable sites;3) small functional loss in the flap donor area;4) no sacrifice of major blood vessels. Thus, this technique seems to be a useful clinical alternative for phallic reconstruction. |
| キーワード | gender identity disorder sex reassignment surgery (SRS) phalloplasty |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-10 |
| 巻 | 67巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 325 |
| 終了ページ | 331 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 24145733 |
| Web of Science KeyUT | 000325836100007 |
| 関連URL | http://doi.org/10.18926/AMO/52660 |
| JaLCDOI | 10.18926/AMO/51868 |
|---|---|
| フルテキストURL | 67_5_319.pdf |
| 著者 | Murakawa, Kiminaka| Sato, Tomoaki| Maeda, Yoshinobu| Kitamura, Yoshihisa| Tanimoto, Mitsune| Sendo, Toshiaki| |
| 抄録 | Graft-versus-host disease (GVHD) is a major concern in transplantation patients. Gut GVHD is accompanied by diarrhea, abdominal pain, and/or melena. Although oral treatment with corticosteroids (CSs) is effective in treating gut GVHD, it can cause adverse reactions that affect the entire body. Topical administration of CSs can be effective in treating diseases in which lesions are limited locally, because adverse reactions can then be alleviated. In this study, we examine and discuss an enteric-coated beclomethasone dipropionate (BDP) capsule (BDP-EC) formulated at Okayama University Hospital. The BDP-EC did not dissolve in solution 1 (pH1.2), and began disintegrating in solution 2 (pH6.8) after 5min, with a mean dissolution rate at 15min of 85%. We then used the capsule to treat a patient who developed gut GVHD after allogeneic hematopoietic stem cell transplantation. Clinically, the frequency of diarrhea decreased after BDP-EC administration. In addition, we were able to decrease the prednisolone equivalent dose. Symptoms associated with adverse reactions to BDP were not observed during the hospitalization period. These findings suggest that the administration of BDP-EC in the early stages of gut GVHD may allow a reduction in the initial doses of systemic CSs. |
| キーワード | beclomethasone intestinal graft-versus-host disease enteric-coated capsule in-hospital formulation |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-10 |
| 巻 | 67巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 319 |
| 終了ページ | 324 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 24145732 |
| Web of Science KeyUT | 000325836100006 |
| JaLCDOI | 10.18926/AMO/51867 |
|---|---|
| フルテキストURL | 67_5_311.pdf |
| 著者 | Nishida, Keiichiro| Hashizume, Hiroyuki| Matsukawa, Akihiro| Hashizume, Kenzo| Shimamura, Yasunori| Torigoe, Yasuyuki| Ozaki, Toshifumi| |
| 抄録 | We report a case of 4th metacarpal head collapse of a 19-year-old healthy man. MRI revealed T1 low and T2 high regions in the collapsed 4th metacarpal head, as well as in the right 3rd and left 4th metacarpal head. Our initial diagnosis was occult compression fracture due to avascular necrosis, known as Dieterich's disease. However, pathological findings of surgically resected right 4th metacarpal head were compatible with transient osteoporosis and metacarpal head fracture followed by active tissue repair. The autologous osteochondral transplants from costchondral junction survived and maintained their size and shape even at 10-year follow-up. |
| キーワード | occult compression fracture metacarpal head avascular necrosis osteochondral autograft |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-10 |
| 巻 | 67巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 311 |
| 終了ページ | 317 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 24145731 |
| Web of Science KeyUT | 000325836100005 |
| JaLCDOI | 10.18926/AMO/51866 |
|---|---|
| フルテキストURL | 67_5_305.pdf |
| 著者 | Tachibana, Motomi| Mukouhara, Naoki| Hirami, Ryouichi| Fujio, Hideki| Yumoto, Akihisa| Watanuki, Yutaka| Hayashi, Aiko| Suminoe, Isao| Koudani, Hiroshi| |
| 抄録 | Congenital coronary pulmonary artery fistula (CAF) is rare, and systemic-to-pulmonary artery fistula (SPAF) is even more so. Furthermore, congenital coronary pulmonary fistula associated with congenital SPAF is extremely rare. As far as we know, CAF and SPAF connected with an aneurysm have not been described very often. We described an 83-year-old woman with an aneurysm originating from a CAF connected to an aortopulmonary artery fistula. Chest radiography revealed a shadow at the left edge of the heart line. Multi-detector-row computed tomography (MDCT) with contrast enhancement and coronary cine angiography revealed that the shadow was an aneurysm connected to a tortuous fistula at the left anterior descending coronary artery. The aneurysm was formed by congenital coronary pulmonary and aortopulmonary artery fistulae. Echocardiography revealed predominantly systolic blood flow in the fistula from the left anterior descending coronary artery (LAD). Although neither MDCT, echocardiography nor coronary angiography alone could provide a comprehensive image of the anomaly, including the hemodynamics in the fistulae and their relationship with surrounding organs and tissues, their combination could provided important facts the led to a deeper understanding of this very uncommon occurrence. |
| キーワード | coronary pulmonary artery fistula aortopulmonary artery fistula aneurysm |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-10 |
| 巻 | 67巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 305 |
| 終了ページ | 309 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 24145730 |
| Web of Science KeyUT | 000325836100004 |
| JaLCDOI | 10.18926/AMO/51865 |
|---|---|
| フルテキストURL | 67_5_293.pdf |
| 著者 | Takeuchi, Akihito| Ogino, Tatsuya| Hanafusa, Kaoru| Morooka, Teruko| Oka, Makio| Yorifuji, Takashi| Ohtsuka, Yoko| |
| 抄録 | To clarify the relationship between attention deficit/hyperactivity disorder (AD/HD) and pervasive developmental disorders (PDD), we investigated the common features and differences of these disorders in neuropsychological profiles. The subjects were 4 groups of Japanese boys aged 6 to 15 years, categorized by diagnosis:AD/HD (n＝20), PDD with comorbid AD/HD (PDD＋:n＝16), PDD without comorbid AD/HD (PDD－:n＝8), and typically developing (n＝60). We evaluated executive function (EF) through verbal and visuospatial memory tasks, the Go/NoGo task, and the color-word matching Stroop task. We performed a categorical analysis to estimate the effects of the 3 disorders on EF and a dimensional analysis to estimate the effects of symptom scales on EF. We found that the AD/HD and PDD＋ subjects had negative effects on verbal working memory and intra-individual response variability. The severity of these impairments was positively correlated with the inattentiveness score. The subjects with a PDD＋ or PDD－ diagnosis had poorer scores on interference control;the severity of this impairment was correlated with the PDD symptom score. Impairments in visuospatial working memory were detected in the AD/HD and PDD－ groups but not in the PDD＋ group. Impairments in inhibition of the pre-potent response were noted in all 3 categories. AD/HD and PDD share neuropsychological features, though each disorder has a specific impairment pattern. Our findings partially support the idea that AD/HD and PDD are on a spectrum. |
| キーワード | attention deficit/hyperactivity disorder pervasive developmental disorder executive function working memory color-word matching Stroop task |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-10 |
| 巻 | 67巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 293 |
| 終了ページ | 303 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 24145729 |
| Web of Science KeyUT | 000325836100003 |
| 関連URL | http://ousar.lib.okayama-u.ac.jp/metadata/52244 |
| JaLCDOI | 10.18926/AMO/51864 |
|---|---|
| フルテキストURL | 67_5_285.pdf |
| 著者 | Akita, Mitsuhiro| Hiraoka, Sakiko| Kaji, Eisuke| Takemoto, Koji| Nagahara, Yasuhiro| Yamamoto, Hiroshi| Yamamoto, Kazuhide| Kato, Jun| |
| 抄録 | Whether presence or history of extracolonic primary malignancy is a risk for colorectal neoplasia is not fully known. In this study, 26,452 first-time colonoscopy cases were examined using a colonoscopy database. Among the analyzed subjects, 3,026 (11%) subjects had history or concomitance of extracolonic primary malignancy, while the remaining 23,426 subjects did not. Colorectal neoplasia was observed in 39% of all the subjects. A crude comparison showed that the prevalence of any type of colorectal neoplasia was higher in subjects with extracolonic malignancy than in those without (42% vs. 39%, p＝0.0012). However, after adjusting for confounding factors, the odds ratios (ORs) of subjects with extracolonic malignancy for having colorectal neoplasia, advanced neoplasia, and cancer were all less than 1.0, and all significantly different from those of subjects without extracolonic malignancy. Analysis according to the type of extracolonic malignancy revealed that gastric cancer cases had a significantly lower risk for colorectal advanced neoplasia (OR:0.81;95% CI:0.67-0.99). Among major malignancies, only esophageal squamous cell cancer cases had increased risk for colorectal neoplasia (OR:1.66;95% CI:1.20-2.29). Patients with presence or history of extracolonic malignancy did not carry a higher risk of occurrence of colorectal neoplasia. |
| キーワード | colorectal cancer colonoscopy risk factor database |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-10 |
| 巻 | 67巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 285 |
| 終了ページ | 292 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 24145728 |
| Web of Science KeyUT | 000325836100002 |
| JaLCDOI | 10.18926/AMO/51863 |
|---|---|
| フルテキストURL | 67_5_277.pdf |
| 著者 | Murakami, Takashi| Fujii, Akihito| Kawabata, Yuya| Takakura, Hiroaki| Yamaue, Rie| Tarek Abdulsamad Ali Balam| Kuroda, Shingo| Kawanabe, Noriaki| Kamioka, Hiroshi| Yamashiro, Takashi| |
| 抄録 | The aims of this study were to investigate how the Peer Assessment Rating (PAR index) predicts the perceived need for orthodontic treatment of mandibular protrusion in Japanese subjects, and to elucidate whether the perceived need for treatment was affected by the ratersʼ orthodontic expertise. The subjects were 110 dental students and 32 orthodontists. We showed them casts of 10 untreated mandibular protrusion cases and gave them a questionnaire in which they had to describe their perceptions of the orthodontic treatment needs using a 10-point visual analog scale (VAS). The PAR index was used for cast evaluation. The PAR index scores showed significant correlations with the VAS scores. In casts with a low PAR score, there were no differences in the VAS scores between orthodontists and students. In casts with a PAR score greater than 23, the orthodontists perceived a significantly greater treatment need than did the students;for scores of 22, 28, and 29, students who had received orthodontic treatment themselves were more likely to perceive the treatment need. The PAR index is a good clinical predictor for assessing the perceived treatment needs for mandibular protrusion. Perception of the need for orthodontic treatment for mandibular protrusion depended on the degree of orthodontic expertise in Japanese subjects. |
| キーワード | orthodontic expertise treatment need PAR index mandibular protrusion |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-10 |
| 巻 | 67巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 277 |
| 終了ページ | 283 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 24145727 |
| Web of Science KeyUT | 000325836100001 |
| JaLCDOI | 10.18926/AMO/51073 |
|---|---|
| フルテキストURL | 67_4_271.pdf |
| 著者 | Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro| |
| 抄録 | In the postoperative treatment of hand surgery, it is important to start exercise therapy as early as possible. In conventional negative pressure wound therapy, the fingers are immobilized by the film dressing covering the wound and hand, thereby preventing sufficient rehabilitation. Here, we devised a bag-type negative pressure wound therapy that makes it possible to start finger exercises almost immediately, and we applied it to 4 patients:one each with hand burns, symmetrical peripheral gangrene, a crush injury accompanied by extensive skin defects and a fingertip degloving injury. The duration of the bag-type negative pressure wound therapy ranged from three to eight weeks, and good granulation was achieved, so that a skin graft was not required. In addition, particularly in the case of the fingertip degloving injury, good nail regeneration was achieved. Except for the case of symmetrical peripheral gangrene, a good range of joint motion with a percent total active motion (%TAM) of 94.7% or more was achieved. Our therapy was performed by inserting the hand into a sealing bag;sufficient exercise therapy was made possible by expanding the bag during rehabilitation. |
| キーワード | negative pressure wound therapy early exercise therapy wound healing hand surgery |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 271 |
| 終了ページ | 276 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970327 |
| Web of Science KeyUT | 000323470100010 |
| JaLCDOI | 10.18926/AMO/51072 |
|---|---|
| フルテキストURL | 67_4_265.pdf |
| 著者 | Hanakawa, Hiroyuki| Orita, Yorihisa| Sato, Yasuharu| Uno, Kinya| Nishizaki, Kazunori| Yoshino, Tadashi| |
| 抄録 | We present a case of a 67-year-old Japanese man with a serious oropharyngeal ulceration that at first seemed to be destructive malignant lymphoma or oropharyngeal carcinoma. We suspected methotrexate (MTX)-associated lymphoproliferative disorder (LPD) induced by MTX treatment for rheumatoid arthritis (RA). About 3 weeks after simple discontinuation of MTX, complete regression of the disease was observed, confirming our diagnosis. |
| キーワード | ulceration methotrexate oropharynx lymphoproliferative disorders |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 265 |
| 終了ページ | 269 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970326 |
| Web of Science KeyUT | 000323470100009 |
| JaLCDOI | 10.18926/AMO/51071 |
|---|---|
| フルテキストURL | 67_4_259.pdf |
| 著者 | Idani, Hitoshi| Nakano, Kanyu| Asami, Shinya| Kubota, Tetsushi| Komoto, Satoshi| Kurose, Yohei| Kubo, Shinichiro| Nojima, Hiroki| Hioki, Katsuyoshi| Kin, Hitoshi| Takakura, Norihisa| |
| 抄録 | We describe a new simple and easy technique called the "Hook and roll technique" (HRT) that uses an articulating hook cautery to provide a critical view during single incision laparoscopic cholecystectomy (SILC). A 2-cm incision is made at the umbilicus to insert three 5-mm trocars or a multichannel port. After dissection of the serosa of the dorsal and ventral sides of the gall bladder, including Calot's triangle, the angled tip of the hook cautery is inserted between the cystic artery and duct with its tip placed dorsally. The tip is then rotated in a clockwise manner to avoid bile duct injury, allowing the connective tissue between them to be hooked, coagulated and cut. This procedure is repeated several times, followed by dissection between the cystic artery and the liver bed to achieve a critical view. From December 2008 to May 2011, 121 patients underwent SILC using HRT in our hospital without any serious complications. This technique is suitable for SILC, as it is consists of simple procedures that can be performed safely and easily, even by left hand in a cross-over approach, and it allows complete dissection of Calot's triangle to achieve a critical view without using any dissector under dangerous in-line viewing. |
| キーワード | critical view of safety single incision laparoscopic cholecystectomy articulating hook cautery |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 259 |
| 終了ページ | 263 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970325 |
| Web of Science KeyUT | 000323470100008 |
| JaLCDOI | 10.18926/AMO/51070 |
|---|---|
| フルテキストURL | 67_4_253.pdf |
| 著者 | Shiota, Yutaro| Taniguchi, Akihiko| Yuzurio, Syota| Horita, Naokatsu| Hosokawa, Shinobu| Watanabe, Yoichi| Tohmori, Hidetoshi| Ono, Tetsuya| |
| 抄録 | Dental infection can be an important source for septic pulmonary embolism (SPE), but only a few cases of SPE accompanying dental infection have been reported. The aim of this study was to characterize the clinical features of SPE induced by dental infection. Patients who fulfilled the diagnostic criteria described in the text were recruited in a retrospective fashion. All 9 patients were men, with a median age of 59 years (range:47 to 74 years). Eight patients had chest pain (88.9%), 5 had a preceding toothache (55.6%) and 3 had preceding gingival swelling (33.3%). Blood cultures obtained from 7 patients were negative. Periodontitis was found in all of the cases, periapical periodontitis in 5 cases, and gingival abscess in 3 cases. The median duration of hospitalization was 15 days, and symptoms were mild in some cases. In addition to antimicrobial therapy, tooth extraction was performed in 3 cases, tooth scaling in 6. SPE induced by dental infection has prominent clinical characteristics such as male preponderance, chest pain, preceding toothache, and mild clinical course. |
| キーワード | bacteremia chest pain multiple nodular shadows periodontitis septic pulmonary embolism |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 253 |
| 終了ページ | 258 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970324 |
| Web of Science KeyUT | 000323470100007 |
| JaLCDOI | 10.18926/AMO/51069 |
|---|---|
| フルテキストURL | 67_4_245.pdf |
| 著者 | Araki, Tohru| Monden, Koichi| Araki, Motoo| |
| 抄録 | A crossover study was conducted to identify the best α1-adrenoceptor (α1AR) antagonist for individual patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). One hundred thirteen patients (mean age 70.8 years) were enrolled. All patients met BPH clinical study guidelines. Seven agents were utilized:tamsulosin 0.2mg, silodosin 8mg, urapidil 60mg, naftopidil 50mg, prazosin 1mg, terazosin 2mg, and doxazosin 1mg. Patients were initially prescribed tamsulosin or silodosin for a week and then urapidil for a week. Two weeks later, they were prescribed the better of the 2 agents for a week and a new agent for the next week. This cycle was repeated until all 7 agents were tested. Efficacy was evaluated with the International Prostate Symptom Score. The agent rankings were doxazosin (25 [22%]), silodosin (22 [19%]), urapidil (19 [17%]), naftopidil (17 [15%]), terazosin (12 [11%]), tamsulosin (11 [10%]), prazosin (7 [6%]). Only 12 patients (11%) changed agents after the crossover study was completed. The major reason was adverse events (83%). We found that each of the 7 α1AR antagonists has its own supporters. Further, the one-week crossover study was useful in identifying the best agent for the treatment of each individual with LUTS. |
| キーワード | alpha-1 blockers alpha1-adrenoceptor antagonists lower urinary tract symptoms benign prostatic hyperplasia crossover study |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 245 |
| 終了ページ | 251 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970323 |
| Web of Science KeyUT | 000323470100006 |
| JaLCDOI | 10.18926/AMO/51068 |
|---|---|
| フルテキストURL | 67_4_239.pdf |
| 著者 | Nakamura, Shinichiro| Nouso, Kazuhiro| Kobayashi, Yoshiyuki| Shiraha, Hidenori| Ohnishi, Hideki| Toshimori, Junichi| Kuwaki, Kenji| Hagihara, Hiroaki| Takayama, Hiroki| Yamamoto, Kazuhide| |
| 抄録 | The aim of this study was to evaluate the histologic diagnosis of hypovascular hepatic lesions showing hypointensity on hepatobiliary phase images of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI (EOB-MRI). In 38 patients with hepatocellular carcinoma (HCC) after curative treatments and 18 patients with liver cirrhosis, 105 hypovascular nodules that were hypointense at the hepatobiliary phase of EOB-MRI were biopsied and the clinical usefulness of these EOB-MRI findings for the diagnosis of HCC was examined. Of the 105 nodules (median diameter＝12mm), 78 (74.3%), 11 (10.5%), and 16 (15.2%) were diagnosed as HCC, dysplastic, and non-neoplastic, respectively. The positive predictive value (PPV) of hypointensity at the hepatobiliary phase of EOB-MRI for the diagnosis of HCC increased to 77-90% when combined with the following factors: washout appearance on the delayed phase of triple-phase CT, hyperintensity in diffusion-weighted image of MRI, or the appearance of a hypoechoic part in ultrasonography. PPV increased to 100% when all 3 factors were positive. A relatively large proportion of hypovascular lesions that showed hypo-intensity in the hepatobiliary phase were confirmed to be HCC, and the accuracy of HCC increased when combined with other imaging findings. |
| キーワード | hepatocellular carcinoma hypovascular diagnosis gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 239 |
| 終了ページ | 244 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970322 |
| Web of Science KeyUT | 000323470100005 |
| JaLCDOI | 10.18926/AMO/51067 |
|---|---|
| フルテキストURL | 67_4_227.pdf |
| 著者 | Ryuko, Hiromasa| Otsuka, Fumio| |
| 抄録 | Primary care physicians often encounter patients with fever of unknown origin and without apparent causes. Recent advances in laboratory medicine have facilitated diagnostic procedures;however, it is still difficult to determine the critical febrile factor at an early stage. We reviewed the medical records of 174 patients who were admitted due to a chief complaint of fever (＞37.5℃) to our hospital during the period from 2004 to 2010. The patients were categorized into patients with infection, inflammation, neoplasm and drug-induced fever. Based on the analysis done by category, it was revealed that the patient's age, body temperature and duration of fever were closely related to the final diagnosis. Serum CRP levels were significantly low in the nonbacterial infection group, while serum levels of sIL-2R were high in neoplasm and drug-induced cases. CRP level on admission was weakly but significantly correlated with body temperature, while duration of fever was inversely related to body temperature. The effectiveness of PET-CT and tissue biopsy for diagnosis was considerably high, particularly in the categories of neoplasm and nonspecific inflammation, respectively, though the effectiveness of bacterial culture was low. Thus, a careful review of physical and laboratory information including body temperature, CRP level, duration of fever, gender difference and history of medication is indispensable for diagnosis. Stepwise categorization and disease classification by comprehensive and systemic checkup are very helpful for determining the causes of fever. |
| キーワード | computed tomography (CT) C-reactive protein (CRP) fluorodeoxyglucose positron emission tomography (FDG-PET) fever of unknown origin (FUO) soluble interleukin-2 receptor (sIL-2R) |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 227 |
| 終了ページ | 237 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970321 |
| Web of Science KeyUT | 000323470100004 |
| 関連URL | http://ousar.lib.okayama-u.ac.jp/metadata/51947 |
| JaLCDOI | 10.18926/AMO/51066 |
|---|---|
| フルテキストURL | 67_4_219.pdf |
| 著者 | Maruyama, Hidehiko| Nakamura, Makoto| Yonemoto, Naohiro| Kageyama, Misao| |
| 抄録 | Cholestasis and thrombocytopenia are complications that affect infants born small for gestational age (SGA). In SGA infants, other vital organs develop at the expense of the liver, and the thrombopoietin produced by the liver is low, often resulting in cholestasis. We hypothesized that thrombocytopenia at birth can be used to predict cholestasis in very-low-birth-weight infants (VLBWIs) with SGA. This retrospective cohort study enrolled VLBWIs with SGA admitted to a tertiary neonatal intensive care unit. A platelet cutoff value predictive of cholestasis was determined using receiver operating characteristic analysis. Multivariate logistic regression analysis was performed to evaluate the platelet cutoff value, and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Regarding the onset of cholestasis, survival analysis was performed by calculating the adjusted hazard ratios (HRs) and 95% CIs. A total of 87 infants were evaluated, and the platelet cutoff value was determined as 88×10(3) cells/μl. The adjusted OR for this platelet cutoff value was 10.52 (95% CI 2.26-55.93, p＝0.003), and the adjusted HR was 7.76 (95% CI 2.51-23.50, p＝0.0006). Thrombocytopenia is a useful predictor for cholestasis in VLBWIs with SGA. |
| キーワード | cholestasis platelet small for gestational age thrombocytopenia very low birth weight |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-08 |
| 巻 | 67巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 219 |
| 終了ページ | 225 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23970320 |
| Web of Science KeyUT | 000323470100003 |