検索結果 1477 件
| JaLCDOI | 10.18926/AMO/69850 |
|---|---|
| フルテキストURL | 79_6_463.pdf |
| 著者 | Asano, Yudai| Nishihara, Chika| Kitayama, Takahiro| Okawa, Nanako| Makimoto, Satoko| Higaki, Fumiyo| Kojima, Katsuhide| Sugihara, Hanako| Ida, Naoyuki| Yanai, Hiroyuki| Hiraki, Takao| |
| 抄録 | We present a case of a woman in her 70s who was diagnosed with mesonephric adenocarcinoma of the uterine cervix, following biopsy and surgery. Preoperative MRI revealed a 7-cm, well-defined circumferential cervical mass with left lateral wall predominance, bulging into the uterine cavity and vagina. The lesion showed intermediate signal intensity on T2-weighted images, diffusion restriction, and early contrast enhancement weaker than that of the myometrium, followed by washout on contrast-enhanced imaging. The circumferential growth pattern with the lateral wall predominance and its imaging characteristics may suggest this rare entity be routinely included in the differential diagnosis of cervical cancers. |
| キーワード | mesonephric adenocarcinoma cervical cancer MRI imaging characteristics HPV-independent adenocarcinoma |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-12 |
| 巻 | 79巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 463 |
| 終了ページ | 468 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69848 |
|---|---|
| フルテキストURL | 79_6_451.pdf |
| 著者 | Hagihara, Moe| Seike, Keisuke| Hayashino, Kenta| Yasuhara, Takao| Kin, Kyohei| Hirata, Yuichi| Kobayashi, Hiroki| Kitamura, Wataru| Fujiwara, Hideaki| Asada, Noboru| Fujii, Nobuharu| Maeda, Yoshinobu| |
| 抄録 | Emicizumab, a bispecific monoclonal antibody, benefits patients with severe hemophilia A. It alters laboratory assessments of coagulation activity, requiring anti-idiotype monoclonal antibodies for accurate monitoring. A 64-year-old man, receiving emicizumab regularly, was admitted for laminoplasty. We planned to use FVIII replacement during the perioperative period after confirming the disappearance of inhibitors, monitoring coagulation activity with anti-idiotype monoclonal antibodies. Activated partial thromboplastin time was prolonged on postoperative day 2, prompting an immediate switch to eptacog alfa. The patient recovered without bleeding. This case underscores the necessity of anti-idiotype monoclonal antibodies for accurate monitoring. |
| キーワード | emicizumab eptacog alfa hemophilia A inhibitor anti-idiotype monoclonal antibodies to emicizumab |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-12 |
| 巻 | 79巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 451 |
| 終了ページ | 455 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69847 |
|---|---|
| フルテキストURL | 79_6_445.pdf |
| 著者 | Matsumi, Junya| |
| 抄録 | Our hospital began a PERIO program (perioperative patient management by a multi-disciplinary team from multiple departments) in 2016 to improve patient outcomes. We retrospectively analyzed the clinical effects of the PERIO program regarding the postoperative hospital stay (PHS) in the patients aged ≥ 18 years who underwent long lower-abdominal surgery at our hospital during the period April 2019 to March 2023. We excluded the cases of patients whose general anesthesia use was < 8 h, those for whom another surgery was performed simultaneously at another site, and emergency surgeries. The outcome was prolonged PHS, defined as exceeding the scheduled number of days specified in the patient’s clinical pathway. Among the 480 patients, prolonged PHS was observed for 270 patients (56.3%). In a multivariate logistic regression using advanced age, sex, high-risk general state, surgery requiring colon resection, serious adverse events (SAEs), and PERIO use, the following were associated with prolonged PHS: advance age (odds ratio [OR] 4.91, 95% confidence interval [CI]: 2.68-8.99, p=0.01), surgery requiring colon resection (OR 4.91, 95%CI: 2.68-8.99, p<0.001), SAE (OR 18.7, 95%CI: 7.22-48.2, p<0.001), and PERIO (OR 0.25, 95%CI: 0.13-0.47, p<0.001). The use of the PERIO program was thus beneficially associated with PHS after long lower-abdominal surgery. |
| キーワード | hospital stay ERAS surgery cancer perioperative management |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-12 |
| 巻 | 79巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 445 |
| 終了ページ | 449 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69846 |
|---|---|
| フルテキストURL | 79_6_437.pdf |
| 著者 | Matsumi, Junya| Sato, Tetsufumi| |
| 抄録 | The optimal indications for intensive care unit (ICU) treatment for critically ill cancer survivors whose condition has deteriorated due to medical factors are unclear. To test our hypothesis that frailty before deterioration was associated with hospital mortality in this patient population, we retrospective analyzed the cases of the patients admitted to the ICU at the National Cancer Center Hospital, Japan (April 2014-March 2022). We excluded patients who underwent surgery within 28 days or were denied critical care within 24 h or admitted after cardiopulmonary arrest. Their Clinical Frailty Scale (CFS) scores at 1 month before ICU admission (Pre-ICU) were obtained. Frailty was defined as CFS scores ≥4 points. We analyzed 298 admissions and observed that the mortality rate at hospital discharge was significantly higher in the frailty group (n=119). A multivariate analysis demonstrated that the following factors were significantly associated with hospital mortality: Pre-ICU frailty (OR 2.00, 95%CI: 1.19-3.36, p=0.009), cancer type (hematological: OR 2.93, 95%CI: 1.42-6.05, p=0.004), and Sequential Organ Failure Assessment score at ICU admission (OR 0.88, 95%CI: 0.82-0.95, p=0.0008). Frailty retrospectively assessed using the CFS at 1 month pre-ICU admission is a risk factor for hospital mortality in these cancer survivors. |
| キーワード | frailty cancer survivor clinical frailty scale cancer critically ill |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-12 |
| 巻 | 79巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 437 |
| 終了ページ | 444 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69845 |
|---|---|
| フルテキストURL | 79_6_431.pdf |
| 著者 | Inoue, Takahiro| Kuwabara, Hiroyo| Yamamoto, Koh| |
| 抄録 | The effect of weekend admission on patient mortality has been investigated in several therapeutic areas, including acute myeloid leukemia (AML), but the investigations’ results are controversial. We evaluated the relationship between in-hospital mortality and weekend admission in adult patients with AML in Japan by conducting a retrospective observational study using administrative data from 144 acute care hospitals from which patients were discharged between April 2014 and March 2019. The primary endpoint was in-hospital mortality, compared between weekend and weekday admissions. Among the 1,340 eligible patients, 11% (150) were admitted during a weekend. The in-hospital mortality rates of the patients admitted during weekends and those admitted on a weekday were 28% (42/150) and 17% (204/1190), respectively. After an adjustment for covariates, weekend admission was associated with a significantly higher risk of in-hospital mortality than weekday admission (HR 1.70, 95%CI: 1.20-2.40; p=0.003). However, such an association was not observed in patients treated in a bio-clean room (HR 1.26, 95%CI: 0.65-2.42). Our results demonstrate that for patients with AML, weekend admission was independently associated with a higher risk of death during hospitalization. An appropriate system is necessary for these patients. |
| キーワード | acute leukemia weekend admission in-hospital mortality bio-clean room |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-12 |
| 巻 | 79巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 431 |
| 終了ページ | 436 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69844 |
|---|---|
| フルテキストURL | 79_6_421.pdf |
| 著者 | Tanaka, Ayumi| Naoe, Shota| Takenaka, Reiju| Kanzaki, Norie| Sakoda, Akihiro| Yamaoka, Kiyonori| Kataoka, Takahiro| |
| 抄録 | Radon (222Rn; Rn) and thoron (220Rn; Tn) inhalation have been reported to enhance antioxidant activity in various organs. However, the effects of Tn on the colon have not been investigated. This study aimed to clarify the effects of Tn inhalation, alone and in combination with cyclosporin A (CsA), on dextran sulfate sodium (DSS)-induced colitis, and the accompanying oxidative stress, in mice. Male BALB/c mice were subjected to continuous 8-day Tn inhalation (c-Tn, 533±128 Bq/m3) or alternate-day Tn inhalation over the same period (f-Tn, 577±63Bq/m3), followed by treatment with 3% DSS and either CsA or vehicle for 7 days. Although the disease activity index (DAI) decreased significantly by day 2 in the c-Tn group, scores remained significantly higher than those in the f-Tn group. In the c-Tn group, superoxide dismutase and catalase activity in the colon were significantly elevated compared with those in sham controls. Thus, DSS-induced damage was effectively inhibited in the earlier stages by the c-Tn mode of inhalation than by the f-Tn mode. These findings suggest that continuous Tn inhalation more effectively attenuated early colitis symptoms than alternate-day inhalation, potentially through upregulation of antioxidant defenses. Tn and CsA showed no combined effects. |
| キーワード | thoron DSS antioxidant activity CsA colon |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-12 |
| 巻 | 79巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 421 |
| 終了ページ | 429 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69843 |
|---|---|
| フルテキストURL | 79_6_413.pdf |
| 著者 | Jiang, Zhiyun| Xi, Ying| |
| 抄録 | Several observational studies suggested that migraine headache attacks were associated with coronavirus disease 2019 (COVID-19). We investigated genetic causal links between COVID-19 phenotypes and the development of headache and migraine, including migraine with aura (MA) and migraine without aura (MO). We conducted a two-sample Mendelian randomization (MR) analysis to estimate the genetic association in European populations. The inverse-variance weighted (IVW) method was used as the main approach in the MR analyses, together with weighted median and MR-Egger methods. We also performed a series of sensitivity tests to assess the robustness of the MR results. The MR results demonstrated that COVID-19 severity, hospitalization, and susceptibility had no causal effect on the risks of headache, migraine, MA, or MO. No horizontal pleiotropy was detected, and the results were robust as supported by the sensitivity analysis findings. Our analyses identified no casual effect of COVID-19 severity, hospitalization, or susceptibility on the risks of headache or migraine in European populations. |
| キーワード | headache migraine Mendelian randomization COVID-19 |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-12 |
| 巻 | 79巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 413 |
| 終了ページ | 419 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| フルテキストURL | fulltext.pdf |
|---|---|
| 著者 | Hamada, Masanori| Nakata, Eiji| Nakahara, Ryuichi| Sugihara, Shinsuke| Katayama, Haruyoshi| Itano, Takuto| Inoue, Tomohiro| Takihira, Shota| Akezaki, Yoshiteru| Ozaki, Toshifumi| |
| 発行日 | 2025-08-14 |
| 出版物タイトル | PLoS One |
| 巻 | 20巻 |
| 号 | 8号 |
| 出版者 | Public Library of Science |
| 開始ページ | e0328792 |
| ISSN | 1932-6203 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| OAI-PMH Set | 岡山大学 |
| 著作権者 | © 2025 Hamada et al. |
| 論文のバージョン | publisher |
| PubMed ID | 40811154 |
| DOI | 10.1371/journal.pone.0328792 |
| Web of Science KeyUT | 001551423500023 |
| 関連URL | isVersionOf https://doi.org/10.1371/journal.pone.0328792 |
| フルテキストURL | fulltext.pdf |
|---|---|
| 著者 | Matsumoto, Naomi| Matsuo, Rumi| Yamamura, Yuka| Tsuge, Takahiro| Kadowaki, Tomoka| Uraguchi, Kensuke| Tamai, Kei| Nakamura, Kazue| Takeuchi, Akihito| Yorifuji, Takashi| |
| キーワード | breastfeeding child health environmental exposure longitudinal studies perinatal |
| 発行日 | 2025-01 |
| 出版物タイトル | Pediatrics International |
| 巻 | 67巻 |
| 号 | 1号 |
| 出版者 | Wiley |
| 開始ページ | e70258 |
| ISSN | 1328-8067 |
| NCID | AA11320483 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| OAI-PMH Set | 岡山大学 |
| 著作権者 | © 2025 The Author(s). |
| 論文のバージョン | publisher |
| PubMed ID | 41215463 |
| DOI | 10.1111/ped.70258 |
| Web of Science KeyUT | 001611492800001 |
| 関連URL | isVersionOf https://doi.org/10.1111/ped.70258 |
| JaLCDOI | 10.18926/AMO/69440 |
|---|---|
| フルテキストURL | 79_5_387.pdf |
| 著者 | Mori, Yusuke| Otani, Yoshihiro| Omae, Ryo| Hirano, Shuichiro| Ishida, Joji| Fujii, Kentaro| Haruma, Jun| Hiramatsu, Masafumi| Matsushita, Toshi| Higaki, Fumiyo| Sugiu, Kenji| Tanaka, Shota| |
| 抄録 | Trigonal meningiomas are rare and pose surgical challenges due to their deep location and proximity to critical neuroanatomical structures. We present the case of a 67-year-old woman with a growing trigonal meningioma successfully resected with guidance by a preoperative 3D imaging analysis system. Integration of CT and MRI including diffusion tensor imaging (DTI) enabled precise mapping of the optic radiation, guiding a middle temporal gyrus approach. Preoperative embolization reduced tumor vascularity, facilitating gross total resection with minimal blood loss. This case highlights the effectiveness of preoperative 3D imaging systems in optimizing surgical planning and improving outcomes in complex neurosurgical cases. |
| キーワード | trigonal meningioma imaging analysis diffusion tensor imaging |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-10 |
| 巻 | 79巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 387 |
| 終了ページ | 392 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69438 |
|---|---|
| フルテキストURL | 79_5_369.pdf |
| 著者 | Hisamatsu, Takashi| Kinuta, Minako| Munetomo, Sosuke| Fukuda, Mari| Kojima, Katsuhide| Taniguchi, Kaori| Nakahata, Noriko| Kanda, Hideyuki| |
| 抄録 | We applied unsupervised machine learning to analyze blood pressure (BP) and resting heart rate (HR) patterns measured during a 1-year period to assess their cross-sectional relationships with subclinical cerebral and renal target damage. Dimension reduction via uniform manifold approximation and projection, followed by K-means++ clustering, was used to categorize 362 community-dwelling participants (mean age, 56.2 years; 54.9% women) into three groups: Low BP and Low HR (Lo-BP/Lo-HR), High BP and High HR (Hi-BP/Hi-HR), and Low BP and High HR (Lo-BP/Hi-HR). Cerebral vessel lesions were defined as the presence of at least one of the following magnetic resonance imaging findings: lacunar infarcts, white matter hyperintensities, cerebral microbleeds, or intracranial artery stenosis. A high urinary albumin-to-creatinine ratio (UACR) was defined as the top 10% (≥ 12 mg/g) of the mean value from ≥2 measurements. Poisson regression with robust error variance, adjusted for demographics, lifestyle, and medical history, showed that the Hi-BP/Hi-HR group had relative risks of 3.62 (95% confidence interval, 1.75-7.46) for cerebral vessel lesions and 3.58 (1.33-9.67) for high UACR, and the Lo-BP/Hi-HR group had a relative risk of 3.09 (1.12-8.57) for high UACR, compared with the Lo-BP/Lo-HR group. These findings demonstrate the utility of an unsupervised, data-driven approach for identifying physiological patterns associated with subclinical target organ damage. |
| キーワード | blood pressure heart rate subclinical disease uniform manifold approximation and projection unsupervised machine learning |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-10 |
| 巻 | 79巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 369 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69437 |
|---|---|
| フルテキストURL | 79_5_359.pdf |
| 著者 | Hirose, Tomohiko| Ikuma, Hisanori| Otsuka, Kazutoshi| Kawasaki, Keisuke| |
| 抄録 | Single-position surgery with lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screws (PPSs) is gaining attention for its reduced invasiveness. We developed SPAPS, a technique allowing two surgeons to perform anterior LLIF and posterior PPS insertion simultaneously in a single lateral decubitus position. This retrospective study compared SPAPS (SPAPS-LLIF, Group SL) and minimally invasive posterior/transforaminal lumbar interbody fusion (MIS-PLIF/TLIF, Group PT) in patients treated between 2016 and 2019 with a two-year follow-up. Operative time, estimated blood loss (EBL), length of hospital stay (LOS), JOABPEQ and VAS scores, segmental lordotic angle, lumbar lordotic angle, segmental Cobb’s angle, PPS misplacement, PPS loosening, fusion status, and muscle cross-sectional areas were compared. Fifty-two patients were analyzed (Group SL: 25; Group PT: 27). SPAPS significantly reduced operative time (118.0 vs. 165.3 min, p <0.01) and estimated blood loss (8.6 vs. 164.1 mL, p<0.01). While clinical outcomes and hospital stay were comparable, Group SL had significantly lower PPS loosening (0% vs. 13%, p<0.01) and non-union rates (0% vs. 22.2%, p=0.02). Multifidus muscle atrophy was also less in Group SL (−14.3 vs. −121.5 mm2, p<0.01). SPAPS demonstrated advantages in reducing surgical invasiveness without compromising clinical efficacy, offering a promising alternative to conventional posterior fusion surgery. |
| キーワード | single-position surgery simultaneous lateral decubitus positioning lateral lumbar interbody fusion posterior lumbar interbody fusion |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-10 |
| 巻 | 79巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 359 |
| 終了ページ | 368 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69436 |
|---|---|
| フルテキストURL | 79_5_353.pdf |
| 著者 | Chihara, Yuki| Hamasaki, Ichiro| Shibata, Kiyo| Morisawa, Shin| Kono, Reika| Kanenaga, Keisuke| Morizane, Yuki| |
| 抄録 | To analyze and characterize the medial and lateral rectus muscles in patients with exotropia using anterior segment optical coherence tomography (AS-OCT). This study included 24 patients with exotropia (48 eyes) and 25 healthy individuals (50 eyes). Anterior segment optical coherence tomography was used to construct the en face images. The anterior chamber angle to the extraocular muscle insertion distance, muscle width, and muscle fiber angle from the muscle insertion sites were compared between the exotropia and the control groups. The correlation between these parameters and age or angle of deviation was evaluated. The mean ages were 13.2±4.1 years for the exotropia group and 17.6±7.2 years for the control group. The lateral rectus angle was significantly more inwardly rotated in the exotropia group than in the control group (1.6±6.3°, −1.4±4.0°, p=0.014). With increasing angle of deviation, the width of the lateral rectus increased (p=0.002). Our results indicate that the lateral rectus angle is significantly more inwardly rotated in patients with exotropia. These findings should contribute to a deeper understanding of the extraocular muscles in patients with this condition. |
| キーワード | exotropia AS-OCT anterior chamber angle to extraocular muscle insertion distance muscle width muscle fiber angle |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-10 |
| 巻 | 79巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 353 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69434 |
|---|---|
| フルテキストURL | 79_5_339.pdf |
| 著者 | Hamasaki, Ichiro| Shibata, Kiyo| |
| 抄録 | To determine whether passing a pole suture through the sclera at two points provides fixation comparable to that of a sliding noose, we measured the tensile strength of the suture‒sclera interface during simulated traction. In this in vitro study, three suture patterns were evaluated in porcine eyeballs, using 6-0 polyglycolic acid sutures. Patterns A (control), B (second suture pass perpendicular), and C (second suture pass in the same direction) were compared. The tensile strength of each pattern was measured 20 times using a KANON TK300CN, and the results were analyzed using the Kruskal‒Wallis test. Pattern A showed a tensile strength of 2±4 gram-force (gf) (range: 0-12). Pattern B showed 112±38 gf (range: 61-184). Pattern C showed 139±31 gf (range: 97-204). Patterns B and C had significantly higher tensile strengths than Pattern A (p<0.001). Although Pattern C was not significantly different from Pattern B (p=0.363), it exhibited the highest tensile strength. Lifting the suture between the first and second suture passes allows for an adjustable suture length, suggesting that adjustability can be achieved using only the sclera. This scleral adjustment method with a second suture pass offers a durable means of securing extraocular muscles and may represent a valuable addition to adjustable suturing techniques. |
| キーワード | scleral adjustment method adjustable suture technique hang-loose method tensile strength polyglycolic acid sutures |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-10 |
| 巻 | 79巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 339 |
| 終了ページ | 343 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69433 |
|---|---|
| フルテキストURL | 79_5_329.pdf |
| 著者 | Matsubara, Kei| Miyoshi, Kentaroh| Toyooka, Shinichi| |
| 抄録 | Primary graft dysfunction (PGD) is one of the major risk factors affecting patients’ short- and long-term survival after lung transplantation. No particular management strategy has been established for PGD; supportive care is the mainstay of PGD treatment. When a supportive strategy fails, the patient may require the introduction of extracorporeal membrane oxygenation (ECMO) as the last-resort measure for severe PGD. A variety of study of ECMO as a PGD treatment was reported and the management of PGD patients developed so far. Early recognition of a patient’s need for ECMO and its prompt initiation are critical to improved outcomes. The use of venovenous-ECMO became the preferred procedure for PGD rather than venoarterial-ECMO. However, the current ECMO strategy has limitations, and using ECMO to manage patients with PGD is not sufficiently effective. Further studies are required to develop this promising technology. |
| キーワード | lung transplantation primary graft dysfunction extracorporeal membrane oxygenation ex vivo lung perfusion |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-10 |
| 巻 | 79巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 329 |
| 終了ページ | 337 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69432 |
|---|---|
| フルテキストURL | 79_5_321.pdf |
| 著者 | Obata, Taisuke| Matsumoto, Kazuyuki| Otsuka, Motoyuki| |
| 抄録 | Bile leak occurs in 2-25% of liver transplant, 3-27% of hepatic resection, and 0.1-4% of cholecystectomy cases. The clinical course of bile leak varies depending on the type of surgery that caused the fistula, as well as the type, severity, and timing of bile duct injury. Although infections resulting from bile leak can be life-threatening, the introduction of endoscopic treatment has enabled some patients to avoid reoperation and has reduced the negative impact on quality of life associated with external fistulas for percutaneous drainage. Endoscopic interventions, such as sphincterotomy and stent placement, reduce the pressure gradient between the bile duct and duodenum, facilitating bile drainage through the papilla and promoting the closure of the leak. We reviewed the literature from 2004 to 2024 regarding bile leak following cholecystectomy and liver surgery, examining recommended techniques, timing, and treatment outcomes. In cases of bile leak following cholecystectomy, clinical success was achieved in 72-96% of cases, while success rates for bile leak following liver surgery ranged from 50% to 100%. Although endoscopic treatment is effective, it is not universally applicable, and its limitations must be carefully considered. |
| キーワード | bile leak cholecystectomy hepatic surgery endoscopic retrograde cholangiography bridging stent placement |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-10 |
| 巻 | 79巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 321 |
| 終了ページ | 328 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69159 |
|---|---|
| フルテキストURL | 79_4_311.pdf |
| 著者 | Matsubara, Kei| Matsubara, Kei| Hirano, Yutaka| Fujiwara, Toshiya| |
| 抄録 | A 55-year-old obese Japanese male with left pneumothorax presented to our hospital. Bilateral pulmonary emphysema was confirmed. Persistent air leakage was observed, and a thoracoscopic bullectomy was performed. Although the thoracoscopic bullectomy was completed uneventfully, pre-extubation chest X-ray imaging indicated hyper-lucency occupying the right upper part of the thoracic cavity, suggesting right-sided pneumothorax. CT imaging indicated a right-upper-lobe expanded bulla. Extubation was performed, and the hyperinflated bulla gradually deflated. Careful management of bulla expansion and respiratory status may be necessary for patients with obesity and large bullae, especially in one-lung ventilation cases. |
| キーワード | giant bulla pneumothorax obesity positive pressure ventilation one lung ventilation |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-08 |
| 巻 | 79巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 311 |
| 終了ページ | 315 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69155 |
|---|---|
| フルテキストURL | 79_4_287.pdf |
| 著者 | Tanimoto, Shun| Sasaki, Tatsuya| Kawai, Koji| Saijo, Tomoya| Kin, Kyohei| Sasada, Susumu| Tanaka, Shota| |
| 抄録 | We report a case of drug-resistant parieto-occipital lobe epilepsy successfully treated with parieto-occipital disconnection (POD). An 18-year-old left-handed female, who had undergone surgery for an acute subdural hematoma at 10 months of age, developed drug-resistant epilepsy at age 15. Despite antiepileptic drug treatment, her seizures remained uncontrolled, and at age 18 she was referred to our hospital for evaluation. Magnetic resonance imaging (MRI) revealed atrophy in the left occipital and parietal lobes. Ictal electroencephalography (EEG) confirmed occipital onset of seizures without temporal lobe involvement. She had pre-existing homonymous hemianopsia. POD surgery was performed, carefully preserving the temporal lobe structures. Postoperatively, she experienced transient right-sided paresis, which fully resolved, and achieved complete seizure control at 3 years without memory loss. This case demonstrates that POD, a rare surgical approach, is a viable option for parieto-occipital lobe epilepsy, effectively controlling seizures while minimizing functional impairment in the absence of temporal lobe involvement. |
| キーワード | parieto-occipital lobe epilepsy parieto-occipital disconnection (POD) |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-08 |
| 巻 | 79巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 287 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69151 |
|---|---|
| フルテキストURL | 79_4_261.pdf |
| 著者 | Hirata, Yuichi| Sugahara, Chiaki| Sasada, Susumu| Miyake, Hayato| Nagase, Takayuki| Yasuhara, Takao| Tanaka, Shota| |
| 抄録 | Cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) increase the likelihood of spinal cord injury without radiographic evidence of trauma (SCIWORET). Opinions regarding the optimal timing for surgery in such cases vary, however. We retrospectively investigated the demographics and outcomes of patients with SCIWORET who underwent surgery shortly after experiencing rapid neurological deterioration, and we matched patients who underwent standby surgery for CSM or OPLL. Although the optimal timing of surgery for SCIWORET remains unclear, our findings suggest that early stage surgery for SCIWORET may yield favorable neurological improvements. |
| キーワード | spinal trauma SCIWORET timing of surgery cervical spondylotic myelopathy ossification of the posterior longitudinal ligament |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-08 |
| 巻 | 79巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 261 |
| 終了ページ | 267 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| JaLCDOI | 10.18926/AMO/69150 |
|---|---|
| フルテキストURL | 79_4_253.pdf |
| 著者 | Miyake, Yoshiaki| Takagi, Toru| Konishiike, Taizo| |
| 抄録 | This study investigated the risk factors for bone fragility and perioperative periprosthetic femoral stem fractures in patients undergoing hip arthroplasty for femoral neck fractures. The records of 215 patients (42 male, 173 female; mean age, 84.4 years) were analyzed to assess correlations among periprosthetic fracture rates and sex, age, body mass index (BMI), Dorr classification, femoral stem fixation type (cemented/cementless), and bone mineral density (BMD) of the contralateral proximal femur. The overall prevalence of perioperative periprosthetic fractures was 4.7%. All patients with periprosthetic fractures were female, and all but one were ≥ 80 years of age. Fracture rates were higher in patients with lower BMI, although this difference was not significant. The fracture rates were 0%, 4.7%, and 7.9% for Dorr types A, B, and C, respectively, and 0% and 5.3% for patients who received cemented and cementless stems, respectively. The findings indicated that female patients, those of advanced age, those with lower BMI, and those with Dorr type C had lower BMDs. Although BMD was significantly lower in patients who received cemented stems compared to those who received cementless stems, no fractures were observed in the former group, suggesting that the use of cemented stems is safe for this high-risk population. |
| キーワード | bone mineral density cemented stem Dorr classification femoral neck fracture periprosthetic femoral stem fracture |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2025-08 |
| 巻 | 79巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 253 |
| 終了ページ | 259 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |