検索結果 286 件
| JaLCDOI | 10.18926/AMO/65967 |
|---|---|
| フルテキストURL | 77_5_451.pdf |
| 著者 | Okita, Atsushi| Tsukuda, Kazunori| Ino, Hideo| Mitsui, Ema| Ikeya, Nanami| Yamamoto, Sumiharu| Yokoyama, Nobuji| Bulin, Aubra| |
| 抄録 | Using a Collaborative Action Research model, our research team established a one-month clinical resident training program for first- and second-year clinical residents. We created and implemented an assessment rubric to assess the residents’ progress toward independent practice in surgery, and thereby, to evaluate the program itself. The program included training in three areas: basic techniques and procedures in the operating room, surgical ward management, and academic activities. The rubric measured the residents’ performance according to three achievement levels: Level 1 (demonstration), Level 2 (active help) and Level 3 (passive help). The program and rubric implementation began in June 2019 and continued until March 2020, when the program outcomes and shortcomings were analyzed. Among nineteen clinical residents, a total of nine clinical residents participated in the study. Most participants reached achievement Level 3 for their performance of basic techniques in the operating room. Finally, we discussed ideas for improvement and drafted plans for an improved rubric to complete the action research cycle. Our research team found the rubric to be a useful tool in evaluating the status of the new clinical resident training program. |
| キーワード | resident program rubric assessment general surgery action research |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-10 |
| 巻 | 77巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 451 |
| 終了ページ | 460 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37899256 |
| Web of Science KeyUT | 001108661600002 |
| JaLCDOI | 10.18926/AMO/65757 |
|---|---|
| フルテキストURL | 77_4_439.pdf |
| 著者 | Shiwaku, Takahiro| Ishida, Hisashi| Tatebe, Yasuhisa| Tamefusa, Kosuke| Ochi, Motoharu| Fujiwara, Kaori| Kubo, Toshihide| Nakata, Eiji| Washio, Kana| Tsukahara, Hirokazu| |
| 抄録 | A three-year-old boy with Philadelphia chromosome-positive B-cell precursor acute lymphoblastic leukemia (Ph+ALL) presented with an osteolytic lesion in his right upper arm. Tyrosine kinase inhibitors (TKIs) such as imatinib and dasatinib are an essential component throughout the course of treatment for Ph+ALL. However, TKIs are reported to affect the bone metabolism. In the treatment course of the current patient, the osteolytic lesion quickly improved despite the continuous use of TKIs, even during the concomitant use of corticosteroids. This suggests that TKIs can be safely given with concomitant corticosteroids to children with Ph+ALL, even when osteolytic lesions are present. |
| キーワード | acute lymphoblastic leukemia children tyrosine kinase inhibitor osteolysis |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 439 |
| 終了ページ | 442 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635146 |
| Web of Science KeyUT | 001088434900002 |
| JaLCDOI | 10.18926/AMO/65752 |
|---|---|
| フルテキストURL | 77_4_415.pdf |
| 著者 | Jelcic, Dzenis| Puzovic, Velibor| Benzon, Benjamin| Palada, Ivan| Jerković, Jelena| Vulic, Marko| |
| 抄録 | The aim of our study was to determine whether the immunohistochemical expression of placental vitamin D receptors is altered in pregnancies complicated by preeclampsia. Vitamin D receptor expression was immunohistochemically analysed in the placentas of three groups: a control group, and early- and late-onset preeclampsia groups. Total immunohistochemical intensity staining of placentas showed that the control group had a median vitamin D receptor (VDR) expression significantly higher than the placentas of mothers with early- and late-onset preeclampsia. There was no difference among the three groups in a semiquantitative analysis of VDR staining of the stroma only. Vitamin D receptors showed lower median expression in preeclampsia-affected pregnancies, especially early-onset preeclampsia. Therefore, Vitamin D receptor expression may be an important marker for normal placentation and preeclampsia onset. |
| キーワード | vitamin D receptor immunohistochemistry early and late-onset preeclampsia |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77巻 |
| 号 | 4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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635142 |
| Web of Science KeyUT | 001163659800006 |
| JaLCDOI | 10.18926/AMO/65750 |
|---|---|
| フルテキストURL | 77_4_395.pdf |
| 著者 | Pavlovic, Marko| Babic, Dragan| Rastovic, Pejana| Arapovic, Jurica| Martinac, Marko| Jakovac, Sanja| Barbaric, Romana| |
| 抄録 | We investigated the relationship between serum tumor necrosis factor-alpha (TNF-α) levels and psychopathological symptoms, clinical and socio-demographic characteristics and antipsychotic therapy in individuals with schizophrenia. TNF-α levels were measured in 90 patients with schizophrenia and 90 healthy controls matched by age, gender, smoking status, and body mass index. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of psychopathology in patients. No significant differences in TNF-α levels were detected between the patients and controls (p=0.736). TNF-α levels were not correlated with total, positive, negative, general, or composite PANSS scores (all p>0.05). A significant negative correlation was observed between TNF-α levels and the PANSS cognitive factor (ρ=−0.222, p=0.035). A hierarchical regression analysis identified the cognitive factor as a significant predictor of the TNF-α level (beta=−0.258, t=−2.257, p=0.027). There were no significant differences in TNF-α levels among patients treated with different types of antipsychotics (p=0.596). TNF-α levels correlated positively with the age of onset (ρ=0.233, p=0.027) and negatively with illness duration (ρ=−0.247, p=0.019) and antipsychotic treatment duration (ρ=−0.256, p=0.015). These results indicate that TNF-α may be involved in cognitive impairment in schizophrenia, and would be a potential clinical-state marker in schizophrenia. |
| キーワード | tumor necrosis factor-alpha schizophrenia psychopathology immune system |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 395 |
| 終了ページ | 405 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635140 |
| Web of Science KeyUT | 001163659800010 |
| JaLCDOI | 10.18926/AMO/65749 |
|---|---|
| フルテキストURL | 77_4_387.pdf |
| 著者 | Kataoka, Takahiro| Habu, Hiroshi| Tanaka, Ayumi| Naoe, Shota| Murakami, Kaito| Fujimoto, Yuki| Yukimine, Ryohei| Takao, Soshi| Mitsunobu, Fumihiro| Yorifuji, Takashi| Yamaoka, Kiyonori| |
| 抄録 | No epidemiological studies have examined the health effects of daily bathing in radon hot springs. In this cross-sectional study, we investigated the associations between radon hot spring bathing and health conditions. The target population was 5,250 adults ≥ 20 years old in the town of Misasa, Japan. We collected information about the participants’ bathing habits and alleviation of a variety of disease symptoms, and their self-rated health (SRH). Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CI) were calculated. In both the adjusted and unadjusted models of hypertension, significant associations between the > 1×/week hot spring bathing and the alleviation of hypertension symptoms were observed compared to the group whose hot spring bathing was <1×/week: adjusted model, OR 5.40 (95%CI: 1.98-14.74); unadjusted model, 3.67 (1.50-8.99) and for gastroenteritis: adjusted model, 9.18 (1.15-72.96); unadjusted model, 7.62 (1.59-36.49). Compared to the no-bathing group, higher SRH was significantly associated with both bathing < 1×/week: unadjusted model, 2.27 (1.53-3.37) and > 1×/week: adjusted model, 1.91 (1.15-3.19). These findings suggest that bathing in radon hot springs is associated with higher SRH and the alleviation of hypertension and gastroenteritis. |
| キーワード | radon hot spring bathing habit self-rated health cross-section study |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 387 |
| 終了ページ | 394 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635139 |
| Web of Science KeyUT | 001163659800003 |
| JaLCDOI | 10.18926/AMO/65748 |
|---|---|
| フルテキストURL | 77_4_377.pdf |
| 著者 | Morimoto, Kosaku| Takeuchi, Yasuto| Takaki, Akinobu| Wada, Nozomu| Oyama, Atsushi| Adachi, Takuya| Onishi, Hideki| Shiraha, Hidenori| Okada, Hiroyuki| |
| 抄録 | Liver fibrosis is an important phenomenon in non-alcoholic fatty liver disease (NAFLD) progression. Standard markers reflecting liver fibrosis, including the FIB-4 index, increase with age. This study aimed to identify fibrosis progression-related markers that are diagnostically beneficial even in aged individuals. Serum levels of pro- and anti-inflammatory cytokines were measured by multiple enzyme-linked immunosorbent assay. Two standard NAFLD or fibrosis progression-related markers — the FIB-4 index and APRI score — were analyzed along with cytokine levels to define the best approach to discriminate advanced fibrosis. Ninety-eight NAFLD patients were enrolled: 59 and 39 patients with fibrosis stages 1-2 and 3-4 respectively. In addition to the FIB-4 index and APRI score, the following factors showed significant differences between stages 1-2 and stages 3-4 in a multivariate analysis: platelet counts, IP-10, and RANTES. The fibrosis stage, FIB-4, APRI, PDGF-BB, and RANTES were related to the prognosis. In aged patients, IP-10, GM-CSF, and RANTES differed between stages 1-2 and stages 3-4. FIB-4 and APRI were beneficial for their correlation with fibrosis. However, to stratify either young or elderly advanced fibrosis patients, and to identify patients likely to have a bad outcome, RANTES was the best marker. |
| キーワード | NAFLD NASH liver fibrosis chemokine FIB-4 |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 377 |
| 終了ページ | 385 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635138 |
| Web of Science KeyUT | 001163659800009 |
| JaLCDOI | 10.18926/AMO/65746 |
|---|---|
| フルテキストURL | 77_4_371.pdf |
| 著者 | Iwamoto, Yosuke| Kaya, Mitsunori| Kijima, Hiroaki| Fujii, Masashi| Nagahata, Itsuki| Miyakoshi, Naohisa| |
| 抄録 | In recent publications on greater trochanteric pain syndrome (GTPS), the pathology receiving the most attention has been gluteus medius muscle tendinous injury, and surgical techniques such as gluteus medius tendon repair and their outcomes for GTPS have been reported. In our department-related facilities, arthroscopic surgeries are routinely performed for the patients with recalcitrant GTPS. A total of 51 patients were diagnosed with GTPS. Surgical treatment was carried out 22 patients (24 joints; 4 males and 18 females; mean age at surgery of 52.0 years). Arthroscopic findings confirmed bursitis in all 24 joints. In all cases, debridement of the greater trochanter bursa provided rapid relief of greater trochanter pain. The Numerical Rating Scale showed significant improvement, from the preoperative mean of 7.8 (range, 6-10) to the postoperative day 7 mean of 1.6 (range, 0-3). The modified Harris Hip Score was significantly improved from the preoperative mean of 65.5 (range, 52.5-78.3) to the final follow-up (average 2.9 months) mean of 96.0 (range, 85.2-100). Fascial damage of the gluteus medius muscle was observed in 21 joints while only 2 patients had a gluteus medius tendinous injury. Greater trochanteric bursitis and fascia or muscle-fiber injury of the gluteus medius muscle are the most common pathologies in patients with lateral hip pain. |
| キーワード | greater trochanteric pain syndrome endoscopic findings bursitis |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 371 |
| 終了ページ | 375 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635137 |
| Web of Science KeyUT | 001163659800005 |
| JaLCDOI | 10.18926/AMO/65745 |
|---|---|
| フルテキストURL | 77_4_365.pdf |
| 著者 | Moldovan, Elena| Bănescu, Claudia| Cucerea, Manuela| Moldovan, Valeriu| Gozar, Liliana| Pușcașiu, Lucian| |
| 抄録 | Congenital heart disease is the most common malformative pathology in newborns, with a worldwide incidence at 0.4-5%. We investigated the possible relationship between variations in nucleotide sequences and specific cardiac malformations in the GATA-binding factor 4 (GATA4) exon 1 region by using Sanger sequencing. Forty-four newborns from a third-level neonatal intensive care unit who were diagnosed with nonsyndromic, ductal-dependent congenital heart disease (i.e., transposition of the great arteries or ductal-dependent coarctation of the aorta) were enrolled. Their DNA was extracted using commercial methods and tested using the multiplex ligation-dependent probe amplification (MLPA) technique. The Sanger sequencing for GATA4 exon 1 in the newborns’ DNA identified rs61277615, rs73203482, and rs35813172 variants not reported in the ClinVar archive of human variations in newborns previously diagnosed with transposition of the great arteries (n=5) and coarctation of the aorta (n=1). The identification of these novel variants in newborns with transposition of the great arteries or ductal-dependent coarctation of the aorta may be the first step in determining the variants’ contribution to the occurrence of congenital heart disease. However, these results may be inconclusive, since the observed variants within GATA4 gene were not previously reported. |
| キーワード | transposition of the great arteries ductal-dependent coarctation of the aorta GATA4 MLPA Sanger sequencing |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-08 |
| 巻 | 77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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37635136 |
| Web of Science KeyUT | 001163659800008 |
| JaLCDOI | 10.18926/AMO/65496 |
|---|---|
| フルテキストURL | 77_3_311.pdf |
| 著者 | Miura, Takanori| Kijima, Hiroaki| Tazawa, Hiroshi| Miyakoshi, Naohisa| |
| 抄録 | Japan’s hip fracture management guidelines now recommend the use of cemented stems in cases of bone fragility. However, the current stem selection practices in bipolar hemiarthroplasty (BHA) in a super-aging area in Japan remain unclear. This study aimed to examine the stem selection policies, the surgeons’ concerns about cemented stems, and factors affecting their confidence in their ability to coach others on cemented stem procedures. Ninety-four orthopedic surgeons (27 facilities) responded to our web-based questionnaire conducted in January/February 2022. Cementless stem was the first choice of 97.8% of the surgeons; <15% of the respondents expected to increase their use of cemented stems in the future. The cement technique was the greatest concern; almost half of the surgeons described having insufficient experience with cemented stems. The factor that most affected the surgeons’ expertise in using cemented stems is the number of surgeries they had conducted with a cemented stem (multivariable analysis odds ratio 8.42, p=0.001). Greater experience was associated with increased expertise of the surgeons in using cemented stems, with a threshold of 11 cases showing sensitivity of 41.7% and specificity of 98.3% for their confidence to instruct cemented stems. |
| キーワード | hip fracture arthroplasty bone cement questionnaire |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-06 |
| 巻 | 77巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 311 |
| 終了ページ | 318 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37357632 |
| Web of Science KeyUT | 001026279600009 |
| JaLCDOI | 10.18926/AMO/65493 |
|---|---|
| フルテキストURL | 77_3_281.pdf |
| 著者 | Mukai, Yuko| Taira, Naruto| Kajiwara, Yukiko| Iwamoto, Takayuki| Kitaguchi, Yohei| Saiga, Miho| Watanabe, Satoko| Shien, Tadahiko| Doihara, Hiroyoshi| Kimata, Yoshihiro| |
| 抄録 | Although immediate breast reconstruction following mastectomy has become increasingly common, its oncological safety has been debated. We enrolled patients with breast cancer who underwent surgery at Okayama University Hospital between 2007 and 2013. The primary outcome was relapse-free survival (RFS). Secondary outcomes were overall survival and the duration from the surgery to the initiation of adjuvant chemotherapy. We divided into immediate breast reconstruction, mastectomy alone, and breast conservative surgery groups. Outcomes were compared using Cox’s regression analysis. A total of 614 patients were included (reconstruction: 125, mastectomy: 128, breast conservative surgery: 361). The median follow-up duration was 79.0±31.9 months. The immediate-reconstruction patients were younger, had more lymph node metastases, and more often received postoperative chemotherapy. The RFS was better after the breast conservative surgery compared to after reconstruction (hazard ratio 0.33, 95% confidence interval: 0.144-0.763). The proportion of local recurrence was highest in the reconstruction group. No patients in the reconstruction group underwent postoperative radiation therapy. However, reconstruction did not affect overall survival or the time to the initiation of adjuvant chemotherapy. Surgeons should explain the risks of breast reconstruction to their patients preoperatively. Careful long-term follow-up is required after such procedures. |
| キーワード | immediate breast reconstruction oncological safety local recurrence postoperative radiation therapy time to initiation of adjuvant chemotherapy |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-06 |
| 巻 | 77巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 281 |
| 終了ページ | 290 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37357629 |
| Web of Science KeyUT | 001026279600006 |
| JaLCDOI | 10.18926/AMO/65491 |
|---|---|
| フルテキストURL | 77_3_263.pdf |
| 著者 | Guo, Yusheng| Kosaka, Junko| Morimatsu, Hiroshi| |
| 抄録 | Continuous renal replacement therapy (CRRT) is widely used to control fluid balance, but the optimal fluid balance to improve the prognosis of patients remains debated. Appropriate fluid management may depend on hemodynamic status. We investigated the association between 90-day mortality and fluid balance/mean arterial pressure (MAP) in patients receiving CRRT. This single-center retrospective study was conducted between May 2018 and March 2021. Based on the cumulative fluid balance at 72 h after initiation of CRRT, the cases were divided into negative (< 0 mL) and positive (> 0 mL) fluid balance groups. Ninety-day mortality was higher in the positive fluid balance group (p=0.009). At 4 h before and after CRRT initiation, the mean MAP was lower in the positive fluid balance group (p<0.05). After multivariate cox adjustment, 72-h positive fluid balance was independently associated with 90-day mortality (p=0.004). In addition, the cumulative fluid balance was associated with 90-day mortality (p<0.05) in cases without shock, high APACHE II score, sepsis, dialysis dependence, or vasopressor use. A 72-h positive fluid balance was associated with 90-day mortality in patients receiving CRRT. |
| キーワード | fluid management continuous renal replacement therapy mortality mean arterial pressure daily cumulative fluid balance |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-06 |
| 巻 | 77巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 263 |
| 終了ページ | 272 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37357627 |
| Web of Science KeyUT | 001026279600004 |
| JaLCDOI | 10.18926/AMO/65490 |
|---|---|
| フルテキストURL | 77_3_255.pdf |
| 著者 | Fukushima, Shinnosuke| Hagiya, Hideharu| Uda, Kazuhiro| Gotoh, Kazuyoshi| Otsuka, Fumio| |
| 抄録 | Antimicrobial resistance is an emerging global threat that must be addressed using a multidisciplinary approach. This study aimed to raise awareness of high-level antimicrobial-resistant (AMR) pathogens in Japan by comparing their recent prevalences among prefectures, particularly Okayama. Data for the isolation proportions of meropenem-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium, cefotaxime-resistant Escherichia coli and Klebsiella pneumoniae, and levofloxacin-resistant E. coli and K. pneumoniae were collected from the Japan Nosocomial Infections Surveillance, a national database sponsored by the Japanese Ministry of Health, Labour, and Welfare, between 2018 and 2021. The average isolated proportions of the seven AMR pathogens were higher in Okayama compared to other prefectures: the worst (19.9%) was meropenem-resistant P. aeruginosa, the sixth worst (57.2%) was methicillin-resistant S. aureus, the eighth worst (3.3%) was vancomycin-resistant E. faecium, the second (37.8%) and fifth worst (17.6%) were cefotaxime-resistant E. coli and K. pneumoniae, respectively, and the fourth (49.9%) and third worst (8.7%) were levofloxacin-resistant E. coli and K. pneumoniae, respectively. Our study highlights the notably high prevalences of representative AMR pathogens in Okayama, suggesting the need for fundamental infection prevention and control by healthcare professionals, promoting antimicrobial stewardship, and educating undergraduates and postgraduates in Okayama. |
| キーワード | antimicrobial resistance antimicrobial stewardship epidemiology infection prevention and control Japan Nosocomial Infections Surveillance |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-06 |
| 巻 | 77巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 255 |
| 終了ページ | 262 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37357626 |
| Web of Science KeyUT | 001026279600003 |
| JaLCDOI | 10.18926/AMO/65489 |
|---|---|
| フルテキストURL | 77_3_243.pdf |
| 著者 | Shibata, Yusuke| Eguchi, Jun| Wada, Jun| |
| 抄録 | Brown adipose tissue (BAT) plays a critical role in metabolic homeostasis. BAT dysfunction is associated with the development of obesity through an imbalance between energy expenditure and energy intake. The nuclear receptor peroxisome proliferator-activated receptor gamma (PPARγ) is the master regulator of adipogenesis. However, the roles of PPARγ and thiazolidinediones (TZDs) in the regulation of BAT metabolism remain unclear. TZDs, which are selective PPARγ activators, improve systemic insulin resistance in animals and humans. In the present study, we generated brown adipocyte-specific PPARγ-deficient mice (BATγKO) to examine the in vivo roles of PPARγ and TZDs in BAT metabolism. In electron microscopic examinations, brown adipocyte-specific PPARγ deletion promoted severe whitening of brown fat and morphological alteration of mitochondria. Brown adipocyte-specific PPARγ deletion also reduced mRNA expression of BAT-selective genes. Although there was no difference in energy expenditure between control and BATγKO mice in calorimetry, norepinephrine-induced thermogenesis was impaired in BATγKO mice. Moreover, pioglitazone treatment improved diet-induced insulin resistance in the control mice but not in the BATγKO mice. These findings suggest that BAT PPARγ is necessary for the maintenance of brown adipocyte function and for the insulin-sensitizing action of TZDs. |
| キーワード | PPARγ brown adipose tissue thiazolidinediones |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-06 |
| 巻 | 77巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 243 |
| 終了ページ | 254 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37357625 |
| Web of Science KeyUT | 001026279600002 |
| JaLCDOI | 10.18926/AMO/65152 |
|---|---|
| フルテキストURL | 77_2_209.pdf |
| 著者 | Sakamoto, Masaki| Teraishi, Fuminori| Shigeyasu Kunitoshi| Kagawa, Shunsuke| Fujiwara, Toshiyoshi| |
| 抄録 | A 70-year-old male with anal pain and fever was diagnosed with rectal cancer perforation and abscess in the right gluteus maximus (GM) muscle. He underwent a transverse colon colostomy followed by preoperative capecitabine+oxaliplatin. Some local control was achieved but a residual abscess was observed in the right GM muscle. To secure circumferential resection margin by tumor reduction, he received chemoradiotherapy as total neoadjuvant therapy (TNT) and underwent laparoscopic abdominoperineal resection, D3 lymph node dissection, combined coccyx resection, and partial resection of the right GM muscle. The skin defect and pelvic dead space were filled with a right lateral vastus lateral great muscle flap. Histopathologically, the resected specimen showed no tumor cells in the primary tumor or lymph nodes, indicating a pathological complete response (pCR). This case suggests that TNT might improve the R0 resection and pCR rates and overall survival. |
| キーワード | locally advanced rectal cancer total neoadjuvant therapy lateral vastus lateral great muscle flap |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-04 |
| 巻 | 77巻 |
| 号 | 2号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 209 |
| 終了ページ | 213 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37094960 |
| Web of Science KeyUT | 000982563800003 |
| JaLCDOI | 10.18926/AMO/65148 |
|---|---|
| フルテキストURL | 77_2_185.pdf |
| 著者 | Sugihara, Akiko| Okada, Ayumi| Horiuchi, Makiko| Yabe, Mayumi| Shigeyasu, Yoshie| Fujii, Chikako| Tanaka, Chie| Yorifuji, Takashi| Tsukahara, Hirokazu| |
| 抄録 | Psychosomatic disorders are influenced by psychosocial factors such as interpersonal relationships. Coping behaviors, especially in frustrating situations, reflect a patient’s ability to cope with stress, and it is important to assess these behaviors for the treatment of psychosomatic diseases. This study aimed to clarify the interpersonal relationships and coping behaviors of pediatric patients with psychosomatic diseases during frustrating situations simulated using the Rosenzweig Picture-Frustration study. This retrospective study included 126 patients (41 male, 85 female) with an average age of 12.9 (6-16) years who were consulted at the Department of Pediatric Psychosomatic Medicine at Okayama University Hospital from 2013 to 2018 and underwent the P-F study. Each score was compared with a standardization sample. The mean group conformity rating did not differ significantly between the participants and healthy children. Compared with healthy children, those with psychosomatic diseases were less likely to explain their perspective. The children with psychosomatic disorders responded to frustrating situations in a sensible and age-appropriate manner. However, they were less likely to respond by explaining their perspective to protect themselves. |
| キーワード | psychosomatic disorder picture-frustration study children projective technique group conformity rating |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-04 |
| 巻 | 77巻 |
| 号 | 2号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 185 |
| 終了ページ | 192 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37094956 |
| Web of Science KeyUT | 000982503800008 |
| JaLCDOI | 10.18926/AMO/65146 |
|---|---|
| フルテキストURL | 77_2_169.pdf |
| 著者 | Inoue, Kanae| Fujita, Rio| Nagahara, Takatoshi| Murakami, Shiho| Nagai, Yuta| Moriwake, Rina| Miyake, Nozomi| Wakuta, Akiko| Kariyama, Kazuya| Nishimura, Mamoru| Nouso, Kazuhiro| |
| 抄録 | Alcoholic liver disease is a risk factor for non-virus-related hepatocellular carcinoma (HCC), which is increasing in prevalence. This study aimed to identify the factors for recovery from alcoholic liver failure. Sixty-two consecutive patients hospitalized for alcoholic liver failure at Okayama City Hospital were enrolled. The characteristics of patients who survived to the 1-month follow-up and whose liver function improved to Child–Pugh A at 3 months (CPA3) and 12 months (CPA12) were compared with the rest of the patients. The survivors at 1 month (50 patients) were significantly younger than the deceased patients and had better liver and renal function with higher levels of γ-glutamyl transferase (GGT). The same factors, except renal function, were correlated with achieving CPA3. High AST, ALT, and GGT levels as well as short spleen length, total abstinence, and good Child–Pugh scores at admission were identified as factors for achieving CPA12. The extent of alcohol intake before admission was not identified as a risk factor in any analysis. In conclusion, baseline liver function is crucial for survival and achieving CPA3, whereas high transaminase and γ-GTP levels, the absence of splenomegaly, and total abstinence are significant factors for achieving CPA12. |
| キーワード | alcoholic liver failure risk factors recovery |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-04 |
| 巻 | 77巻 |
| 号 | 2号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 169 |
| 終了ページ | 177 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37094954 |
| Web of Science KeyUT | 000982503800006 |
| JaLCDOI | 10.18926/AMO/65145 |
|---|---|
| フルテキストURL | 77_2_161.pdf |
| 著者 | Yamanoi, Tomoko| Suzuki, Satoshi| Kaku, Ryuji| Morimatsu, Hiroshi| |
| 抄録 | An intraoperative double-low condition is defined as concurrent low values for bispectral index (BIS) and mean arterial pressure (MAP), and may predict perioperative outcomes. We hypothesized that prolonged double-low times might be associated with an increased incidence of postoperative delirium. We conducted a single-center retrospective observational study on patients who had been admitted to our hospital’s intensive care unit (ICU) after surgery and whose BIS and MAP data had been recorded during general anesthesia. The primary outcome was the incidence of postoperative delirium. A double-low condition was defined as BIS < 45 and MAP <75 mmHg. The total double-low time was calculated in 1-min increments and used to divide the patients into quintiles. Multiple logistic regression analyses were conducted. Among the 334 patients included in the study, the incidence of postoperative delirium was 15.6% (n=52). Multiple logistic regression analysis revealed that a prolonged double-low time, defined as a total double-low time of > 42 min (i.e., third, fourth, and fifth quintiles), was significantly associated with an increased incidence of postoperative delirium (adjusted odds ratio: 2.61, 95% confidence interval: 1.27-5.37, p=0.009). Prolonged double-low time during general anesthesia was independently associated with an increased incidence of postoperative delirium in surgical ICU patients. |
| キーワード | postoperative delirium bispectral index hypotension double-low condition general anesthesia |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-04 |
| 巻 | 77巻 |
| 号 | 2号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 161 |
| 終了ページ | 167 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37094953 |
| Web of Science KeyUT | 000982503800005 |
| JaLCDOI | 10.18926/AMO/65144 |
|---|---|
| フルテキストURL | 77_2_147.pdf |
| 著者 | Arias, Zulema| Haines, Stephanie| Yamamoto, Tadashi| Hatanaka, Kazu| Yamashiro, Keisuke| Sonoi, Norihiro| Takashiba, Shogo| |
| 抄録 | The curriculum at the Department of Pathophysiology in the Periodontal Sciences program at Okayama University includes normative preclinical training (NPT) using phantoms. NPT is given to the whole class of 5 th year students divided in groups of 8 students/instructor. In 2019, an innovative personalized preclinical training (PPT) pilot study was implemented for this group of students whereby two students, each with their own dental unit, were coached by one instructor. The main topics covered were dental ergonomics and endodontics. We aimed to evaluate the effectiveness of PPT in dental ergonomics and endodontics toward increasing the knowledge and future clinical skills of students who had already undergone NPT. A test on endodontics was taken before and after PPT. A questionnaire was completed to assess their perception of improvement regarding the above-mentioned topics. Test scores and questionnaire results both showed that the students’ level of knowledge and awareness of future clinical skills was significantly higher after PPT. This pilot study demonstrated that PPT increased the students’ knowledge and future clinical skills. As preclinical training forms the foundation for clinical practice, investment in future research regarding this personalized approach is likely to enhance students’ understanding and clinical performance. |
| キーワード | preclinical personalized education dental ergonomics endodontics clinical skills improvement undergraduate students |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-04 |
| 巻 | 77巻 |
| 号 | 2号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 147 |
| 終了ページ | 159 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37094952 |
| Web of Science KeyUT | 000982503800004 |
| JaLCDOI | 10.18926/AMO/65143 |
|---|---|
| フルテキストURL | 77_2_139.pdf |
| 著者 | Namio, Keiichi| Kondo, Takashi| Miyatake, Nobuyuki| Hishii, Shuhei| Nishi, Hiroyuki| Katayama, Akihiko| Ujike, Kazuhiro| Suzuki, Hiromi| Koumoto, Kiichi| |
| 抄録 | We investigated the link between prolonged sedentary bouts and all-cause mortality in patients on chronic hemodialysis, using a prospective cohort. A total of 104 outpatients on chronic hemodialysis from 2013 to 2019, aged 71.4±11.4 years, were enrolled. Prolonged sedentary bouts (≥ 30 min and ≥60 min) (min and bouts) and relative prolonged sedentary bouts (≥ 30 min and ≥ 60 min) (%) on the patients’ non-hemodialysis days were measured by a tri-accelerometer, and we also analyzed the patients’ clinical parameters. The relationship between prolonged sedentary bouts and all-cause mortality was evaluated by a survival analysis and the Cox proportional hazard model. Thirty-five patients died during the follow-up period. A Kaplan-Meier analysis detected significant differences in the survival rate between two groups stratified by the median for all prolonged sedentary-bout parameters. After the adjustment for confounding factors, all of the prolonged sedentary-bout parameters were determinant factors for all-cause mortality. These results indicate that prolonged sedentary bouts on non-hemodialysis days were closely related to all-cause mortality in the patients on hemodialysis. |
| キーワード | sedentary bout mortality hemodialysis survival analysis |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-04 |
| 巻 | 77巻 |
| 号 | 2号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 139 |
| 終了ページ | 145 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37094951 |
| Web of Science KeyUT | 000982503800003 |
| JaLCDOI | 10.18926/AMO/65141 |
|---|---|
| フルテキストURL | 77_2_121.pdf |
| 著者 | Iguchi, Toshihiro| Matsui, Yusuke| Tomita, Koji| Uka, Mayu| Umakoshi, Noriyuki| Kawabata, Takahiro| Munetomo, Kazuaki| Nagata, Shoma| Araki, Motoo| Hiraki, Takao| |
| 抄録 | Percutaneous cryoablation of renal tumors is widely used because of its high efficacy and safety. This high safety can be attributed, at least in part, to the visibility of the ablated area as an “ice ball”. This therapy has fewer complications (incidence, 0-7.2%) and is less invasive than surgery. Minor bleeding is inevitable in most kidney-related procedures, and indeed the most common complication of this therapy is bleeding (hematoma and hematuria). However, patients require treatment such as transfusion or transarterial embolization in only 0-4% of bleeding cases. Various other complications such as ureteral or collecting system injury, bowel injury, nerve injury, skin injury, infection, pneumothorax, and tract seeding also occur, but they are usually minor and asymptomatic. However, operators should know and avoid the various complications associated with this therapy. This study aimed to summarize the complications of percutaneous cryoablation for renal tumors and provide some techniques for achieving safe procedures. |
| キーワード | cryosurgery kidney neoplasms carcinoma renal cell complication |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2023-04 |
| 巻 | 77巻 |
| 号 | 2号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 121 |
| 終了ページ | 129 |
| 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 Ⓒ 2023 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 37094949 |
| Web of Science KeyUT | 000982503800001 |