検索結果 279 件
| JaLCDOI | 10.18926/AMO/61431 |
|---|---|
| フルテキストURL | 75_1_31.pdf |
| 著者 | Miyamaru, Satoru| Murakami, Daizo| Nishimoto, Kohei| Saito, Haruki| Miyamoto, Yusuke| Hirota, Kaoruko| Ise, Momoko| Orita, Yorihisa| |
| 抄録 | Although the lung is the most common site of distant metastases from head and neck squamous cell carcinoma (HNSCC), the number of reports about the effects of pulmonary metastasectomy for the treatment of lung metastasis from HNSCC is limited. Metachronous pulmonary metastases were detected in 45 HNSCC patients at Kumamoto University Hospital from 1998 to 2018. Twenty-two patients underwent an operative resection (Ope group) and 23 underwent chemotherapy (Chemo group). The 3-year overall survival (OS) rate and median OS were evaluated. The effects of adjuvant chemotherapy after pulmonary metastasectomy and of new drugs (cetuximab and nivolumab), in the chemo group were also assessed. The 3-year OS rates and median OS were: Ope, 66.1% and 31.5 months; Chemo, 39.7% and 18 months, respectively. In the Ope group, addi-tional recurrences were significantly fewer in the patients who underwent adjuvant chemotherapy post-surgery versus the patients who underwent surgery alone (p = 0.013). In the Chemo group, the 3-year OS rate of the patients who received new drugs was significantly better than that of the patients who did not (p = 0.021). Adjuvant chemotherapy after pulmonary metastasectomy may be a preferable treatment option for preventing recurrences. Cetuximab and nivolumab have a potential to improve OS. |
| キーワード | pulmonary metastasis head and neck squamous cell carcinoma pulmonary metastasectomy adjuvant chemotherapy |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-02 |
| 巻 | 75巻 |
| 号 | 1号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 31 |
| 終了ページ | 37 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33649611 |
| JaLCDOI | 10.18926/AMO/61429 |
|---|---|
| フルテキストURL | 75_1_15.pdf |
| 著者 | Katsui, Kuniaki| Ogata, Takeshi| Tada, Akihiro| Sugiyama, Soichi| Yoshio, Kotaro| Kuroda, Masahiro| Kiura, Katsuyuki| Maeda, Yoshinobu| Toyooka, Shinichi| Hiraki, Takao| Kanazawa, Susumu| |
| 抄録 | The aim of this study was to investigate whether volumetric positron emission tomography (PET) parameters are prognostic predictors in stage III non-small cell lung cancer patients receiving definitive concurrent chemo-radiotherapy (CCRT) with cisplatin/docetaxel. Cases involving definitive CCRT were reviewed retrospectively, and the maximum standardized uptake value, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were calculated. The relationships between these PET parameters and prognosis were analyzed. MTV and TLG were significant predictors of distant metastasis-free survival (DMFS) (p = 0.0003 and 0.0005, respectively) and progression-free survival (PFS) (p = 0.001 and 0.0007, respectively). The three-year DMFS rates in patients with low and high MTV were 13.3% and 64.6%, respectively, and the corresponding values in those with low and high TLG were 13.3% and 65.2%, respectively. The three-year PFS rates in patients with low and high MTV were 13.3% and 57.8%, respectively, and the corresponding values in patients with low and high TLG were 13.3% and 57.8%, respectively. However, MTV and TLG were not predictors of local control or overall sur-vival. We demonstrated that volumetric PET parameters were predictors of patients receiving definitive CCRT. Our findings contradict the findings of previous reports and warrant further research to validate them. |
| キーワード | volumetric positron emission tomography parameters distant metastasis-free survival chemoradiotherapy cisplatin/docetaxel non-small cell lung cancer |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-02 |
| 巻 | 75巻 |
| 号 | 1号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 15 |
| 終了ページ | 23 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33649609 |
| JaLCDOI | 10.18926/AMO/61428 |
|---|---|
| フルテキストURL | 75_1_9.pdf |
| 著者 | Gobara, Hideo| Yamamoto, Akira| Komakic, Toshiyuki| Kitayama, Toshiaki| Sakurai, Jun| Iguchi, Toshihiro| Matsui, Yusuke| Uka, Mayu| Tomita, Koji| Hiraki, Takao| Kanazawa, Susumu| |
| 抄録 | To assess the feasibility of needle tract ablation in liver tissue in ex vivo and in vivo animal models using a cryo-probe and electrosurgical device. The experimental device is made by inserting a cryoprobe through an intro-ducer sheath for insulation, with 2-cm of probe tip projecting out. A beagle liver was punctured by the device, and electric current was applied at 30-W with the electrosurgical knife touching the non-insulated device base. The discolored area of cut surface along the device was evaluated in 5 application-time groups (5 , 10 , 15 , 20, or 25 seconds). An ex vivo experiment was performed to determine an ablation algorithm with an appropriate application time by comparison with radiofrequency ablation (RFA) results. Thereafter, an in vivo experiment was performed to verify the algorithm’s feasibility. In the ex vivo model, the cut surface demonstrated different amounts of discolored area according to the application time. The total discolored area in the 20-seconds group was similar to that by RFA. In the in vivo model, the liver did not bleed, the total discolored area was similar to that ex vivo, and coagulation necrosis was confirmed by photomicrograph. Needle tract ablation can be per-formed using the experimental device and electrosurgical device. |
| キーワード | needle tract ablation cryoablation electrosurgical device animal liver |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-02 |
| 巻 | 75巻 |
| 号 | 1号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 9 |
| 終了ページ | 14 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33649608 |
| JaLCDOI | 10.18926/AMO/61424 |
|---|---|
| フルテキストURL | 75_1_1.pdf |
| 著者 | Hamahara, Jun| Honda, Hiroyuki| Yamamoto, Koichiro| Tokumasu, Kazuki| Hanayama, Yoshihisa| Hagiya, Hideharu| Obika, Mikako| Ueda, Keigo| Kishida, Masayuki| Otsuka, Fumio| |
| 抄録 | To determine the clinical characteristics of low androgen status in adult males with diabetes, we retrospectively analyzed the medical records of patients with type 2 diabetes mellitus in whom serum free testosterone (FT) levels were examined for 1 year. Among the 46 patients (56 ± 1.5 years old), decreases in serum FT levels to < 8.5 pg/ml (indicating the occurrence of late-onset hypogonadism [LOH]) were detected in 18 (39%). The per-centages of patients with low FT levels were high in the ≥ 50 years age group (83%), the HbA1c < 7% group (67%), and the 25 ≤ BMI < 30 kg/m2 group (56%). The serum FT levels tended to decrease age-dependently. The level of HbA1c was significantly correlated with the Heinemann Aging Male Symptoms (AMS) score (R = 0.47). The low-FT group had decreased levels of hemoglobin. Of note, the serum FSH level (R = −0.32) was negatively correlated with the serum FT level, whereas the serum TSH level (R = 0.36) was positively correlated with the serum FT level. Collectively, these results revealed that many diabetic males may have low FT levels and that the AMS score is related to the HbA1c level. A slightly anemic condition, thyroid dysfunction, and obesity (class 1) might be involved in LOH in middle-aged diabetic males. |
| キーワード | androgen diabetes mellitus late-onset hypogonadism testosterone thyroid function |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2021-02 |
| 巻 | 75巻 |
| 号 | 1号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 1 |
| 終了ページ | 8 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2021 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33649607 |
| JaLCDOI | 10.18926/AMO/61216 |
|---|---|
| フルテキストURL | 74_6_551.pdf |
| 著者 | Tanaka, Masato| Fujiwara, Yoshihiro| Uotani, Koji| Kadiri, Venkatesh| Yamauchi, Taro| |
| 抄録 | A minimally invasive posterolateral approach designed to avoid the lateral misplacement of midcervical pedicle screws was reported, but there is no technical report that describes this technique without C-arm fluoroscopy. We report the results of a 2.5 years follow-up of a 62-year-old female patient with C4 metastatic breast cancer. The patient suffered from severe neck pain and impending quadriplegia for 2 months after radiation therapy. We performed C-arm-free minimally invasive cervical pedicle screw fixation (MICEPS). The patient was suc-cessfully treated with surgery, and her neck pain was well controlled. She had neither neurological deficits nor neck pain at the final (2.5-year) follow-up. C-arm-free MICEPS is a useful technique; in addition, the sur-geons and staff have no risk of radiation exposure, there is a reduced need for postoperative imaging, and a decreased revision rate can be expected with C-arm-free MICEPS. |
| キーワード | cervical spine navigation surgery minimally invasive surgery cervical pedicle screw C-arm free |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-12 |
| 巻 | 74巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 551 |
| 終了ページ | 556 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33361877 |
| Web of Science KeyUT | 000601203600013 |
| NAID | 120006948943 |
| JaLCDOI | 10.18926/AMO/61209 |
|---|---|
| フルテキストURL | 74_6_495.pdf |
| 著者 | Calliope, Simba Akintije| Yorifuji, Takashi| Wada, Takayuki| Mukakarake, Marie Goret| Mutesa, Leon| Yamamoto, Taro| |
| 抄録 | In many economically developing countries, and especially in the rural regions of sub-Saharan African coun-tries, there have been only limited investigations into the association between antenatal care (ANC) and adverse pregnancy outcomes. We obtained information on ANC and pregnancy outcomes between 2011 and 2016 from hospital files of pregnant women (n = 4,960) served at a rural hospital in Rwanda, and we examined the associa-tions between their ANC visits and the adverse pregnancy and neonatal outcomes by using univariate and mul-tivariate logistic regression models to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Most of the pregnant women had ≥ 4 ANC visits, but 39% (n = 1,911) did not have ≥ 3 visits before delivery. The prev-alence of low birth weight (LBW) and that of preterm birth (PTB) were 12% and 9.9%, respectively. Compared to the women who attended only one ANC visit, those who attended ≥ 4 ANC visits had lower risks of LBW (OR 0.20; 95%CI: 0.11-0.36) and PTB (OR 0.28; 95%CI: 0.11-0.76). Frequent ANC visits were also associ-ated with better postnatal outcomes of the newborns. Encouraging women to attend ANC visits before delivery can markedly reduce PTB-related and LBW-related complications, especially in resource-limited settings. |
| キーワード | antenatal care epidemiology low birth weight preterm birth rural |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-12 |
| 巻 | 74巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 495 |
| 終了ページ | 503 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33361869 |
| Web of Science KeyUT | 000601203600005 |
| NAID | 120006948958 |
| JaLCDOI | 10.18926/AMO/61207 |
|---|---|
| フルテキストURL | 74_6_483.pdf |
| 著者 | Miyagi, Yasunari| Miyake, Takahito| |
| 抄録 | We developed an artificial intelligence (AI) method for estimating fetal weights of Japanese fetuses based on the gestational weeks and the bi-parietal diameter, abdominal circumference, and femur length. The AI comprised of neural network architecture was trained by deep learning with a dataset that consists of ± 2 standard devia-tion (SD), ± 1.5SD, and ± 0SD categories of the approved standard values of ultrasonic measurements of the fetal weights of Japanese fetuses (Japan Society of Ultrasonics in Medicine [JSUM] data). We investigated the residuals and compared 2 other regression formulae for estimating the fetal weights of Japanese fetuses by t-test and Bland-Altman analyses, respectively. The residuals of the AI for the test dataset that was 12.5% of the JSUM data were 6.4 ± 2.6, −3.8 ± 8.6, and −0.32 ± 6.3 (g) at −2SD, +2SD, and all categories, respectively. The residu-als of another AI method created with all of the JSUM data, of which 20% were randomized validation data, were −1.5 ± 9.4, −2.5 ± 7.3, and −1.1 ± 6.7 (g) for −2SD, +2SD, and all categories, respectively. The residuals of this AI were not different from zero, whereas those of the published formulae differed from zero. Though vali-dation is required, the AI demonstrated potential for generating fetal weights accurately, especially for extreme fetal weights. |
| キーワード | deep learning artificial intelligence fetal weight neural network ultrasound biometry |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-12 |
| 巻 | 74巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 483 |
| 終了ページ | 493 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33361868 |
| Web of Science KeyUT | 000601203600004 |
| NAID | 120006948957 |
| JaLCDOI | 10.18926/AMO/61205 |
|---|---|
| フルテキストURL | 74_6_467.pdf |
| 著者 | Yokota, Yuya| Nishimura, Yoshito| Ando, Akemi| Hanayama, Yoshihisa| Hasegawa, Kou| Hagiya, Hideharu| Ogawa, Hiroko| Obika, Mikako| Ueda, Keigo| Otsuka, Fumio| |
| 抄録 | Alkaline phosphatase (ALP) is an enzyme that is expressed in a variety of tissues. Among the isoforms of ALP, bone-specific alkaline phosphatase (BAP) is used as a marker for evaluating bone metabolism. We investigated the clinical usefulness of the ratio of serum BAP to total ALP for the diagnosis of various disorders in general practice. We retrospectively analyzed the cases of 107 Japanese patients whose serum BAP levels were exam-ined, focusing on clinical characteristics. We observed that the BAP/ALP ratios of the patients with fever and those with inflammatory diseases were significantly lower than the ratios of other patient groups. The BAP/ALP ratios of the patients with osteoporosis and those with metabolic bone diseases were higher than those of the patients with other conditions. The BAP/ALP ratio was found to be negatively correlated with age, a cor-relation that has not been found in other ethnicities. The serum BAP/ALP ratio was inversely correlated with serum CRP levels but was positively correlated with serum albumin levels and hemoglobin concentrations. Collectively, our results suggest that the BAP/ALP ratio could be a useful predictor for important geriatric con-ditions seen in general practice. |
| キーワード | alkaline phosphatase BAP CRP inflammation osteoporosis |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-12 |
| 巻 | 74巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 467 |
| 終了ページ | 474 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33361866 |
| Web of Science KeyUT | 000601203600002 |
| NAID | 120006948955 |
| JaLCDOI | 10.18926/AMO/61204 |
|---|---|
| フルテキストURL | 74_6_461.pdf |
| 著者 | Kono, Yoshiyasu| Kanzaki, Hiromitsu| Iwamuro, Masaya| Kawano, Seiji| Kawahara, Yoshiro| Okada, Hiroyuki| |
| 抄録 | Gastric cancer usually arises in middle-aged to older patients, and is rarely found in younger patients. The clin-ical characteristics, etiology, prognosis, preventive methods and treatment of gastric cancer in young patients have not been fully investigated because of its low prevalence. In this review, we discuss the current under-standing and clinical problems associated with gastric cancer in young patients. Helicobacter pylori (H. pylori), which is a major cause of gastric cancer, especially in older populations, is closely associated with gastric cancer in young patients as well as in older patients. Gastric cancer in young patients tends to be diagnosed at an advanced stage with alarm symptoms. However, young patients with advanced gastric cancer tend to have a favorable general condition and organ function, so they can tolerate intensive systematic chemotherapy. Unfortunately, the prognosis of gastric cancer in young patients with an advanced stage is not favorable. We should not take this rare disease lightly, given its poor prognosis if patients are diagnosed at an unresectable stage. The evaluation of the H. pylori infection status and performance of H. pylori eradication therapy to prevent gastric cancer in young patients as well as the development of more intensive chemotherapy regimens for unre-sectable gastric cancer in young patients are warranted. |
| キーワード | gastric cancer young patients Helicobacter pylori |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-12 |
| 巻 | 74巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 461 |
| 終了ページ | 466 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33361865 |
| Web of Science KeyUT | 000601203600001 |
| NAID | 120006948954 |
| JaLCDOI | 10.18926/AMO/60806 |
|---|---|
| フルテキストURL | 74_5_443.pdf |
| 著者 | Sekito, Takanori| Araki, Motoo| Hiraki, Takao| Uka, Mayu| Komaki, Toshiyuki| Matsui, Yusuke| Iguchi, Toshihiro| Katayama, Satoshi| Yoshinaga, Kasumi| Watari, Shogo| Maruyama, Yuki| Mitsui, Yosuke| Kubota, Risa| Sadahira, Takuya| Nishimura, Shingo| Wada, Koichiro| Takamoto, Atsushi| Edamura, Kohei| Sako, Tomoko| Kobayashi, Yasuyuki| Watanabe, Toyohiko| Kanazawa, Susumu| Nasu, Yasutomo| |
| 抄録 | We report a 47-year-old Japanese female with 10 previous treatments for multiple bilateral renal cell carcinoma (RCC) associated with von Hippel-Lindau disease. The 14-mm right lower pole renal tumor was in contact with the right ureter. Laparoscopic cryoablation was performed to protect the ureter wrapped with gauze. Computed tomography (CT) monitoring was used to confirm the precise ≥ 6 mm ice-ball margin. There was no local progression at 6-months post-surgery. The serum creatinine has been stable. This is apparently the first report of combined laparoscopic and CT monitoring of an ice-ball formation and its margin during cryoablation for RCC. |
| キーワード | laparoscopic cryoablation multiple renal masses nephron-sparing surgery renal cell carcinoma von Hippel-Lindau disease |
| Amo Type | Case Report |
| 備考 | Fig. 1B is replaced on Dec. 23, 2020.| |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-10 |
| 巻 | 74巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 443 |
| 終了ページ | 448 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33106702 |
| Web of Science KeyUT | 000581970100011 |
| NAID | 120006892932 |
| JaLCDOI | 10.18926/AMO/60801 |
|---|---|
| フルテキストURL | 74_5_415.pdf |
| 著者 | Narihiro, Naomasa| Oita, Masataka| Takeda, Yoshihiro| |
| 抄録 | During radiation therapy, incident radiation oblique to the skin surface is high and may cause severe skin damage. Understanding the dose of radiation absorbed by the skin is important for predicting skin damage due to radiation. In this study, we used a high-energy (4 MV) X-ray system and an optically stimulated luminescence dosimeter (OSLD) that was developed for personal exposure dosimetry. We determined the dose variation and angular dependence, which are the characteristics of a small OSLD required to derive the calculation formula for the oblique surface dose. The dose variation was determined using the coefficient of variation. The maximum coefficient of variation for 66 small-field OSLDs was 1.71%. The angular dependence, obtained from the dose ratio of the dosimeter in the vertical direction, had a maximum value of 1.37. We derived a new equation in which the oblique surface dose can be calculated within the error range of −7.7-5.1%. |
| キーワード | optically stimulated luminescent dosimeter radiotherapy oblique surface dose high-energy X-ray therapy angular dependence |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-10 |
| 巻 | 74巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 415 |
| 終了ページ | 422 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33106697 |
| Web of Science KeyUT | 000581970100006 |
| NAID | 120006892927 |
| JaLCDOI | 10.18926/AMO/60799 |
|---|---|
| フルテキストURL | 74_5_401.pdf |
| 著者 | Tsukioki, Takahiro| Shien, Tadahiko| Ohtani, Yusuke| Fujihara, Miwa| Suzuki, Yoko| Kajihara, Yukiko| Hatono, Minami| Kawada, Kengo| Kochi, Mariko| Iwamoto, Takayuki| Ikeda, Hirokuni| Taira, Naruto| Doihara, Hiroyoshi| |
| 抄録 | Differentiated thyroid carcinoma (DTC) in juvenile patients is often an extensive and aggressive disease with a high frequency of recurrence. However, the prognosis is excellent, with a low mortality rate even when advanced disease is present, although prognostic factors and treatment strategy remain uncertain. Between April 2004 and March 2017, 33 juvenile patients (< 30 years old) were diagnosed with DTC and treated at our institution. We retrospectively investigated prognosis and factors including sex, reason for discovery, treatment, pathological factors and treatment progress to clarify the risk factors. All patients underwent curative surgical treatment. Pathologically, lymph node metastasis was identified in 25 patients (75%). Thirteen patients (39%) had bilateral cervical metastasis. In addition, 9 (27%) had more than 10 metastatic lymph nodes. The 2 patients with more than 20 metastatic lymph nodes were treated with radioactive iodine (RAI). Five patients (15%) had local recurrences and received surgery. There have been no further recurrences or deaths. However, no factors were determined to significantly predict the recurrence of juvenile DTC. Local recurrent disease was treated with surgery and/or RAI until remission, and survival was excellent in juvenile DTC. |
| キーワード | differentiated thyroid carcinoma juvenile children |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-10 |
| 巻 | 74巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 401 |
| 終了ページ | 406 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33106695 |
| Web of Science KeyUT | 000581970100004 |
| NAID | 120006892925 |
| JaLCDOI | 10.18926/AMO/60796 |
|---|---|
| フルテキストURL | 74_5_371.pdf |
| 著者 | Makimoto, Go| Ohashi, Kadoaki| Maeda, Yoshinobu| Kiura, Katsuyuki| |
| 抄録 | The prognosis of advanced non-small cell lung cancer (NSCLC) patients has improved in recent decades, especially for patients with an oncogenic driver mutation. Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) are effective for patients with the echinoderm microtubule-associated protein-like 4-ALK fusion gene. Several ALK-TKIs have been established: the first-generation ALK-TKI, crizotinib; second-generation ALK-TKIs, alectinib and ceritinib; and third-generation ALK-TKI, lorlatinib. Some ALK-TKIs are effective for tumors that are resistant to other ALK-TKIs; however, as is known in epidermal growth factor receptormutant lung cancer, tumor resistance is inevitable. ALK-positive NSCLCs acquire resistance via various mechanisms, making it a heterogeneous disease. Therefore, it is necessary to develop next-generation treatment strategies, such as the use of next-generation ALK-TKIs for secondary mutations, or combination therapies with ALK-TKIs and other TKIs. In this review, we summarize the development and use of ALK-TKIs, prior pivotal clinical trials, and resistance mechanisms. |
| キーワード | lung cancer anaplastic lymphoma kinase tyrosine kinase inhibitors resistance mechanism |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-10 |
| 巻 | 74巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 371 |
| 終了ページ | 379 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 33106692 |
| Web of Science KeyUT | 000581970100001 |
| NAID | 120006892922 |
| JaLCDOI | 10.18926/AMO/60376 |
|---|---|
| フルテキストURL | 74_4_365.pdf |
| 著者 | Chuma, Masayuki| Kondo, Masateru| Zamami, Yoshito| Takechi, Kenshi| Goda, Mitsuhiro| Okada, Naoto| Shibata, Akitomo| Asada, Mizuho| Oto, Jun| Yanagawa, Hiroaki| Ishizawa, Keisuke| |
| 抄録 | Cystatin C-guided vancomycin (VCM) dosing is useful in critically ill patients. Its usefulness in septic patients with bacterial meningitis remains unknown, as there are no published reports. In this study, we sought to clarify its benefit. Cystatin C was used to guide VCM dosing in a septic bacterial meningitis patient with normal kidney function, according to therapeutic drug monitoring (TDM). Using cystatin C, the Bayesian method-based TDM made optimal VCM dosing possible, and decreased the predicted error (4.85 mg/L) compared to serum creatinine (16.83 mg/L). We concluded TDM of VCM using cystatin C can be considered in sepsis patients with bacterial meningitis with normal kidney function. |
| キーワード | vancomycin, therapeutic drug monitoring cystatin C bacterial meningitis sepsis |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-08 |
| 巻 | 74巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 365 |
| 終了ページ | 370 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 32843769 |
| Web of Science KeyUT | 000562508700013 |
| NAID | 120006880215 |
| JaLCDOI | 10.18926/AMO/60374 |
|---|---|
| フルテキストURL | 74_4_351.pdf |
| 著者 | Utsumi, Masashi| Aoki, Hideki| Yabuki, Takayuki| Nagahisa, Seiichi| Nishimura, Seitaro| Une, Yuta| Kimura, Yuji| Watanabe, Megumi| Taniguchi, Fumitaka| Arataa, Takashi| Katsuda, Koh| Tanakaya, Kohji| Sato, Yumiko| |
| 抄録 | Post-operative pancreatic fistula (POPF) remains the most common complication after distal pancreatectomy (DP). In this retrospective study, we reviewed the data from patients who underwent DP between 2008 and 2019 in our institute to determine whether the late phase/early phase ratio (L/E ratio) by preoperative computed tomography (CT) scan in the pancreas could predict POPF occurrence after DP. We examined the relationship between preoperative or intraoperative factors and the occurrence of POPF after DP using statistical methods in 23 males and 21 females with a mean age of 73. The mean L/E ratio was significantly lower in the POPF group than the non-POPF group (p=0.035). The L/E ratio had moderate diagnostic accuracy, with a calculated optimal cutoff value of 0.77. In univariate analysis, a significant association was noted between POPF and stump thickness ≥ 16.9, body mass index ≥ 27.5, and L/E ratio ≤ 0.77. In the multivariate analysis, the L/E ratio (odds ratio, 5.96; p=0.036) was an independent risk factor for POPF. Our findings suggest that the pancreatic L/E ratio may predict the occurrence of POPF after DP. This measure may be useful in preoperative risk stratification, patient counseling, and perioperative patient management, improving clinical outcomes after DP. |
| キーワード | late phase/early phase ratio pancreatic fistula distal pancreatectomy |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-08 |
| 巻 | 74巻 |
| 号 | 4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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 32843767 |
| Web of Science KeyUT | 000562508700011 |
| NAID | 120006880213 |
| JaLCDOI | 10.18926/AMO/60369 |
|---|---|
| フルテキストURL | 74_4_307.pdf |
| 著者 | Nagamine, Yuichi| Hasibul, Khaleque| Ogawa, Takaaki| Tada, Ayano| Kamitori, Kazuyo| Hossain, Akram| Yamaguchi, Fuminori| Tokuda, Masaaki| Kuwahara, Tomomi| Miyake, Minoru| |
| 抄録 | We examined the effect of D-Tagatose on the growth of oral bacteria including Streptococcus mutans (S. mutans). Saliva collected from 10 healthy volunteers was plated on BHI medium (to culture total oral bacteria) and MBS medium (to culture S. mutans, specifically). Agar plates of BHI or MBS containing xylitol or D-Tagatose were cultured under aerobic or anaerobic conditions. We then counted the number of colonies. In BHI plates containing D-Tagatose, a complete and significant reduction of bacteria occurred under both aerobic and anaerobic conditions. In MSB medium, significant reduction of S. mutans was also observed. We then performed a doubleblind parallel randomized trial with 19 healthy volunteers. They chewed gum containing xylitol, D-Tagatose, or both for 4 weeks, and their saliva was collected weekly and plated on BHI and MSB media. These plates were cultured under anaerobic conditions. Total bacteria and S. mutans were not effectively reduced in either the D-Tagatose or xylitol gum group. However, S. mutans was significantly reduced in volunteers chewing gum containing both D-Tagatose and xylitol. Thus, D-Tagatose inhibited the growth of S. mutans and many types of oral bacteria, indicating that D-Tagatose intake may help prevent dental caries, periodontitis, and many oral diseases. |
| キーワード | D-Tagatose xylitol Streptococcus mutans oral bacteria chewing gum |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-08 |
| 巻 | 74巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 307 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 32843762 |
| Web of Science KeyUT | 000562508700006 |
| NAID | 120006880208 |
| JaLCDOI | 10.18926/AMO/60365 |
|---|---|
| フルテキストURL | 74_4_285.pdf |
| 著者 | Tsukahara, Kohei| Naitou, Hiromichi| Yorifuji, Takashi| Nosaka, Nobuyuki| Yamamoto, Hirotsugu| Osako, Takaaki| Nakao, Atsunori| the JaRPAC Study Group| |
| 抄録 | The importance of centralizing treatment services for severely ill children has been well established, but such entralization remains difficult in Japan. We aimed to compare the trauma and illness severity and mortality of children admitted to two common types of ICUs for children. According to the type of management and disposition of the medical provider, we classified ICUs as pediatric ICUs [PICUs] or general ICUs, and analyzed differences in endogenous and exogenous illness settings between them. Overall, 1,333 pediatric patients were included, with 1,143 patients admitted to PICUs and 190 patients to general ICUs. The Pediatric Cerebral Performance Category score (PCPC) at discharge was significantly lower in the PICU group (adjusted OR: 0.45; 95%CI: 0.23-0.88). Death and unfavorable neurological outcomes occurred less often in the PICU group (adjusted OR: 0.29; 95%CI: 0.14-0.60). However, when limited to exogenous illness, PCPC scores (adjusted OR: 0.38; 95%CI: 0.07-1.99) or death/unfavorable outcomes (adjusted OR: 0.72; 95%CI: 0.08-6.34) did not differ between the groups. PCPC deterioration and overall sequelae/death rates were lower in PICUs for children with endogenous illnesses, although the outcomes of exogenous illness were similar between the 2 unit types. Further studies on the necessity of centralization are warranted. |
| キーワード | kids critical care mortality morbidity centralization |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-08 |
| 巻 | 74巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 285 |
| 終了ページ | 291 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 32843759 |
| Web of Science KeyUT | 000562508700003 |
| NAID | 120006880204 |
| JaLCDOI | 10.18926/AMO/60364 |
|---|---|
| フルテキストURL | 74_4_275.pdf |
| 著者 | Muro, Taiko| Nakamura, Shinichiro| Takaki, Akinobu| Onishi, Hideki| Wada, Nozomu| Yasunaka, Tetsuya| Uchida, Daisuke| Oyama, Atsushi| Adachi, Takuya| Shiraha, Hidenori| Okada, Hiroyuki| |
| 抄録 | Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is a promising method for controlling tumors, although it does not entirely eliminate recurrence. Oxidative stress is associated with the progression of hepatocarcinogenesis, while also acting as an anticancer response. The objective of the present study was to investigate the factors influencing post-RFA outcomes. We recruited 235 newly diagnosed HCC patients who received RFA for single tumors. The patients with recurrence were sub-grouped into early and segmental recurrence groups. The characteristics of the sub-grouped patients were evaluated, including by measuring oxidative stress marker reactive oxygen metabolites and antioxidant marker OXY-adsorbent tests. The factors associated with poor survival were a high Child-Pugh score and early recurrence within 2 years in the same segment. The patients who experienced recurrence within 2 years in the same segment showed a larger tumor diameter than did others. According to a multivariate analysis, the OXY values were also significantly low in these patients. In conclusion, maintaining the antioxidant reservoir function with a high OXY value might be necessary to prevent early recurrence within the RFA-treated segment. |
| キーワード | oxidative stress hepatocellular carcinoma recurrence, radiofrequency ablation |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-08 |
| 巻 | 74巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 275 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 32843758 |
| Web of Science KeyUT | 000562508700002 |
| NAID | 120006880203 |
| JaLCDOI | 10.18926/AMO/60363 |
|---|---|
| フルテキストURL | 74_4_265.pdf |
| 著者 | Inokuchi, Toshihiro| Hiraoka, Sakiko| Yasutomi, Eriko| Oka, Shohei| Yamasaki, Yasushi| Kinugasa, Hideaki| Takahar, Masahiro| Kawano, Seiji| Harada, Keita| Okada, Hiroyuki| Kato, Jun| |
| 抄録 | Determining factors that predict a favorable disease course without anti-tumor necrosis factor (TNF) agents would help establish a more cost-effective strategy for Crohn’s disease (CD). A retrospective chart review was performed for CD patients with disease durations > 10 years who had not received anti-TNF agents as first-line therapy. Patients were divided into 2 groups: those who received neither anti-TNF agents nor bowel resection (G1), and those who had received an anti-TNF agent and/or bowel resection (G2). The patient backgrounds, therapies and clinical courses were compared between the groups. A total of 62 CD patients met the inclusion criteria (males: 71%; median duration of follow-up: 19 years). Six patients were included in G1; they were significantly less likely to have upper gastrointestinal lesions than G2 (p=0.007). A multivariate analysis revealed that the significant factors for avoidance of bowel resection without anti-TNF treatment were non-stricturing and non-penetrating behaviors, and absence of upper gastrointestinal lesions at the diagnosis (hazard ratios 0.41 and 0.52; p=0.004 and 0.04, respectively). In consideration of the long treatment course of CD, patients with non-stricturing and non-penetrating behaviors and no upper gastrointestinal lesions should not be treated with anti-TNF agents as first-line therapy. |
| キーワード | Crohn’s disease anti-TNF agent upper gastrointestinal lesion bamboo joint-like appearance |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-08 |
| 巻 | 74巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 265 |
| 終了ページ | 274 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 32843757 |
| Web of Science KeyUT | 000562508700001 |
| NAID | 120006880202 |
| JaLCDOI | 10.18926/AMO/59960 |
|---|---|
| フルテキストURL | 74_3_257.pdf |
| 著者 | Hongo, Takashi| Ikeda, Fusao| Fujioka, Shinichi| Akatsuka, Riku| Fujiwara, Tosifumi| Yamamoto, Kazuhide| |
| 抄録 | A 65-year-old Japanese woman developed vesicular eruptions on her right ear due to varicella zoster virus (VZV) reactivation, followed by cranial polyneuritis and meningitis affecting her right cranial nerves V, VII, VIII, IX, and X. After acyclovir administration, her facial paralysis worsened. Intravenous methylprednisolone and vitamin C were administered on Day 4 post-admission. Her symptoms steadily improved, and by Day 45 she had fully recovered. Cranial polyneuritis is a rare complication of VZV reactivation, and there is no established method of treatment. This is the first report of full recovery from cranial polyneuritis using intravenous vitamin C as ancillary treatment. |
| キーワード | varicella zoster virus polyneuritis vitamin C meningitis facial nerve palsy |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-06 |
| 巻 | 74巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 257 |
| 終了ページ | 260 |
| 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Ⓒ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 32577025 |
| Web of Science KeyUT | 000543363400010 |
| NAID | 120006862801 |