検索結果 3928 件
| JaLCDOI | 10.18926/AMO/70075 |
|---|---|
| フルテキストURL | 80_1_069.pdf |
| 著者 | Wakatsuki, Shinya| Sakamoto, Shinya| Ueno, Akiko| Namba, Takaomi| Yamamoto, Yorito| Matsumoto, Manabu| Iwata, Jun| Okabayashi, Takehiro| |
| 抄録 | Patients with hepatocellular carcinoma (HCC) and extensive peritoneal dissemination generally have a poor prognosis and are often resistant to systemic therapy. We report the case of a 47-year-old woman with HCC and massive peritoneal dissemination who presented with malignant ascites requiring repeated cell-free and concentrated ascites reinfusion therapy and peritoneovenous shunt placement, as well as malignant pleural effusion requiring pleurodesis. Combined immunotherapy with durvalumab/tremelimumab was initiated;however, disease progression was observed after three treatment courses, prompting a switch to lenvatinib therapy. Two months after initiation of lenvatinib, CT imaging demonstrated complete disappearance of arterial enhancement in the primary hepatic lesion, along with reduction in the size of peritoneal dissemination nodules. Thirteen months after switching to lenvatinib (16 months after the initial diagnosis), the alpha-fetoprotein level continued to decrease, and the disease remained stable under treatment. Despite the extremely high tumor burden, lenvatinib achieved disease stabilization and symptomatic improvement. |
| キーワード | diagnostic laparoscopy hepatocellular carcinoma peritoneal dissemination lenvatinib |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2026-02 |
| 巻 | 80巻 |
| 号 | 1号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 69 |
| 終了ページ | 74 |
| 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 Ⓒ 2026 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 41748152 |
| Web of Science KeyUT | 001712986800001 |
| JaLCDOI | 10.18926/AMO/70074 |
|---|---|
| フルテキストURL | 80_1_063.pdf |
| 著者 | Takasu, Eri| Shiode, Yusuke| Kindo, Hiroya| Kimura, Shuhei| Hosokawa, Mio| Matoba, Ryo| Kanzaki, Yuki| Morita, Tetsuro| Adachi, Takuya| Otsuka, Motoyuki| Morizane, Yuki| |
| 抄録 | A 77-year-old man undergoing treatment for hepatocellular carcinoma (HCC) presented with blurred vision in his right eye, persisting for 2 months. Slit-lamp microscopy and fundus examination revealed inflammatory cells in the anterior chamber, severe vitreous opacities, and retinal vasculitis in the right eye. The patient underwent vitreous surgery with biopsy, and vitreous cytology confirmed a metastatic intraocular tumor originating from the HCC. Radiotherapy was administered to the right eye, with no recurrence of intraocular inflammation observed at 10 months post-irradiation. |
| キーワード | metastatic intraocular tumor hepatocellular carcinoma panuveitis uveitis masquerade syndrome |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2026-02 |
| 巻 | 80巻 |
| 号 | 1号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 63 |
| 終了ページ | 67 |
| 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 Ⓒ 2026 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 41748151 |
| Web of Science KeyUT | 001712997700001 |
| JaLCDOI | 10.18926/AMO/70073 |
|---|---|
| フルテキストURL | 80_1_055.pdf |
| 著者 | Akazawa, Hidemasa| Hagiya, Hideharu| Fukushima, Shinnosuke| Yamamoto, Shohei| Nakano, Yasuhiro| Otsuka, Fumio| |
| 抄録 | In Japan, antiviral agents for COVID-19 were freely available until September 2023 as part of national policy. This study evaluated changes in these agents’ prescribing patterns and the patient outcomes following the policy shift. We conducted a multicenter retrospective study at four hospitals in Japan’s Okayama and Kagawa prefectures from January 2022 to March 2024. The study period was divided into the public-expenditure phase (January 2022 to September 2023) and the post-expenditure phase (October 2023 to March 2024). We extracted the hospitalized patients’ clinical data from the electronic database. The study’s primary outcome was the antiviral prescription rate; the secondary outcome was in-hospital mortality. Among the 302 hospitalized patients (median age 85 years), 52.0% were classified as having a mild condition. Of the patients with mild conditions, 37.7% were diagnosed in outpatient settings prior to hospitalization. During the public-expenditure phase, 47.4% of the patients received antivirals as outpatients, mainly molnupiravir (80.9%). In the post-expenditure period, 80.0% of the patients were prescribed antivirals, mostly molnupiravir (91.7%). The antiviral prescription rate was significantly higher after the policy change. The overall in-hospital mortality was 15.8%, with no significant difference between the two periods (17.0% vs. 10.5%). Despite the termination of government funding, antiviral prescriptions remained frequent at community hospitals located in highly aging regions of western Japan such as Okayama and Kagawa prefectures. Mortality remains high among the elderly, highlighting the need for continued antiviral therapy and booster vaccinations. |
| キーワード | coronavirus disease 2019 public expenditure prescribing pattern prognosis Japan |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2026-02 |
| 巻 | 80巻 |
| 号 | 1号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 55 |
| 終了ページ | 62 |
| 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 Ⓒ 2026 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 41748150 |
| Web of Science KeyUT | 001712994500007 |
| JaLCDOI | 10.18926/AMO/70072 |
|---|---|
| フルテキストURL | 80_1_047.pdf |
| 著者 | Eguchi, Yukiomi| Ushio, Soichiro| Irie, Keiichi| Yamashita, Yuta| Eguchi, Miyu| Nakano, Takafumi| Mishima, Kenichi| |
| 抄録 | Deregulation of cannabis use is gradually expanding in Europe and the United States. However, the biological processes driving tolerance to delta-9-tetrahydrocannabinol (Δ9-THC), the main psychoactive component of cannabis, remain unclear. Thus, this study aimed to investigate the mechanisms and time course of tolerance development and loss to Δ9-THC in mice. Male ICR mice (7 weeks old) were administered Δ9-THC once daily for 3 days and then divided into three groups according to the washout period (3-, 10-, and 17-day washout groups). After each washout, changes in body temperature and locomotor activity were measured following re-exposure to Δ9-THC. Furthermore, the mRNA expression levels of CB1 and CB2 receptors in the brain were evaluated using real-time PCR. On day 1, significant hypothermia and reduced spontaneous locomotor activity were observed in the Δ9-THC-treated mice compared with the vehicle-treated mice. Tolerance to the hypothermic and locomotor-suppressing effects of Δ9-THC developed on days 2 and 3, respectively, and dissipated after 3 and 11 days of washout, respectively. These differences in the rates of tolerance development and recovery may reflect distinct underlying mechanisms. No significant changes in receptor mRNA expression were observed. These findings highlight the complexity of Δ9-THC tolerance and its potential implications for long-term cannabis use. |
| キーワード | delta-9-tetrahydrocannabinol cannabis tolerance locomotor hypothermic |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2026-02 |
| 巻 | 80巻 |
| 号 | 1号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 47 |
| 終了ページ | 54 |
| 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 Ⓒ 2026 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 41748149 |
| Web of Science KeyUT | 001712994500006 |
| JaLCDOI | 10.18926/AMO/70071 |
|---|---|
| フルテキストURL | 80_1_039.pdf |
| 著者 | Tezel, Nihal| Can, Aslı Gençay| |
| 抄録 | The study aimed to determine the prevalence of kinesiophobia in patients who had undergone lumbar microdiscectomy and to examine its associations with pain intensity, disability, quality of life, depression, anxiety, and satisfaction with surgery. Forty-eight patients with microdiscectomy and 48 healthy controls were enrolled. The Tampa Scale for Kinesiophobia (TSK), Roland-Morris Disability Index (RMDI), Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), and Short Form-36 Health Survey (SF-36) were administered to both groups. The scores of TSK, RMDI, HADS-A, and HADS-D were significantly higher and SF-36 scores were significantly lower in the microdiscectomy than the control group (p<0.001 for all). In the microdiscectomy group, median (min-max) RMDI, HADS-A, and HADS-D scores were 19 (4-34), 10 (0-18), and 9 (0-18), respectively, in kinesiophobic patients, and were significantly higher than 6 (2-20), 3 (0-11), 2.5 (0-11) in non-kinesiophobic patients (all p<0.001). The median (min-max) SF-36 PCS, SF-36 MCS, and VAS scores for surgery satisfaction were 36.5 (8.7-75), 52.1 (11-95), 5, 5 (0-10), respectively, in kinesiophobic patients and were significantly lower than 71 (28-95), 85.5 (9-93), 8.5 (3-10) in non-kinesiophobic patients (all p<0.05). TSK scores were significantly correlated with RMDI, HADS-A, HADS-D, SF-36, and surgery satisfaction scores (all p<0.05). Kinesiophobic patients with lumbar microdiscectomy therefore showed greater disability and psychological morbidity, poorer quality of life, and lower satisfaction with surgery. |
| キーワード | kinesiophobia microdiscectomy disability quality of life depression |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2026-02 |
| 巻 | 80巻 |
| 号 | 1号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 39 |
| 終了ページ | 46 |
| 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 Ⓒ 2026 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 41748148 |
| Web of Science KeyUT | 001712994500005 |
| JaLCDOI | 10.18926/AMO/70070 |
|---|---|
| フルテキストURL | 80_1_031.pdf |
| 著者 | Ishibashi, Kyota| Oishi, Hirotaka| Araki, Ryo| Kawamura, Kosuke| Sasaki, Isamu| Sasaki, Eiji| Kamada, Hikaru| Kogawa, Masakazu| Tanaka, Sunao| Numasawa, Takuya| Ishibashi, Yasuyuki| |
| 抄録 | We investigated global alignment changes following total hip arthroplasty (THA) and predictive alignment parameters for increased cup anteversion (CA) by retrospectively analyzing the primary THA data of 75 patients treated at our hospital (49 women, 26 men; age 65.1±5.7 years, BMI 28.3±3.4 kg/m2). Global alignment parameters, i.e., the anterior pelvic plane angle (APPa) and proximal femoral shaft angle (PFSa) and other alignment parameters were measured. CA was evaluated based on the patients’ standing coronal radiographs. ΔCA was defined as the difference in CA from 2 weeks before to 1 year after each THA. We classified the cases as stable (S) (CA < 10°; n=63) and pelvic retroversion (R) (CA ≥ 10°; n=12) groups. Associations between ΔCA and alignment parameters were evaluated by linear regression and a receiver operating characteristic (ROC) analysis. A significant decrease in the PFSa occurred between the 2-week and 1-year post-THA timepoints (7.8±4.3° vs. 4.2±3.6°, p<0.001), with no notable change in other alignment parameters. At 1-year post-THA, the CA of 12 (16%) patients had increased to 4.5±4.4°. Only the preoperative APPa was positively associated with ΔCA (β=0.165, p=0.020). The ROC analysis revealed that the optimal cut-off value for increased CA in the APPa is 2.1° (area under the curve, 0.700; p=0.020; odds ratio, 4.80). The APPa change predicted increased CA, which emphasizes the importance of the use of preoperative standing radiography for identifying the optimal cup positioning for post-THA changes in CA. |
| キーワード | total hip arthroplasty global alignment anterior pelvic plane cup anteversion pelvic tilt |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2026-02 |
| 巻 | 80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 Ⓒ 2026 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 41748147 |
| Web of Science KeyUT | 001712994500004 |
| JaLCDOI | 10.18926/AMO/70069 |
|---|---|
| フルテキストURL | 80_1_017.pdf |
| 著者 | Yano, Hideki| Takahata, Yoko| Yamaguchi, Takeshi| Saito, Shinya| |
| 抄録 | This study aimed to develop a scale enabling nurses to objectively evaluate their own stroke discharge support, as a basis for enhancing its overall effectiveness. A draft scale was created based on a literature review, and consisted of a 51-item, 5-point Likert-type questionnaire administered to ward nurses engaged in stroke discharge support at acute care hospitals. Factor analysis was performed to refine the scale. Construct validity was assessed using the known-groups method, and reliability was evaluated through internal consistency analysis. The resulting Stroke Discharge Support Evaluation Scale comprises 29 items across 5 factors, each rated on a 5-point Likert scale. Analysis of the data collected from 237 valid responses demonstrated good internal consistency and supported the scale’s construct validity. The Stroke Discharge Support Evaluation Scale is a reliable and valid tool enabling ward nurses in acute care hospitals to evaluate their own stroke discharge support. |
| キーワード | stroke discharge support scale development |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2026-02 |
| 巻 | 80巻 |
| 号 | 1号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 17 |
| 終了ページ | 30 |
| 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 Ⓒ 2026 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 41748146 |
| Web of Science KeyUT | 001712994500003 |
| JaLCDOI | 10.18926/AMO/70068 |
|---|---|
| フルテキストURL | 80_1_009.pdf |
| 著者 | Sugahara, Kentaro| Kondo, Takashi| Miyatake, Nobuyuki| Nishi, Hiroyuki| Ujike, Kazuhiro| Koumoto, Kiichi| Namio, Keiichi| Hishii, Shuhei| Katayama, Akihiko| Suzuki, Hiromi| Yamamoto, Yorimasa| |
| 抄録 | Appropriate treatments for chronic hemodialysis patients are a public health challenge in Japan. Sedentary behavior appears to be closely associated with these patients’ survival. We thus sought to develop a nomogram that predicts survival based on the duration of chronic hemodialysis patients’ sedentary behavior. One hundred twenty-four patients under chronic hemodialysis (73 men, 51 women, age 71.7±11.1 years) were enrolled in this cohort study. The patients wore a triaxial accelerometer that measured both their sedentary behavior, i.e., total sedentary behavior (minutes) and their maximum sedentary bouts (min) on non-hemodialysis days. We obtained the Kaplan-Meier curve and used the log-rank test and a Cox proportional hazards model to evaluate the relationship between the patients’ sedentary behavior and their survival. We also used a Cox proportional hazards model to develop a nomogram for the patients’ 5-year survival rate. Forty-six patients died during the follow-up period. When we stratified the patients by the medians of total sedentary behavior and maximum sedentary bouts, we observed significant between-group differences. After adjustment for confounding factors in a Cox proportional hazards model, total sedentary behavior and maximum sedentary bouts were identified as critical survival factors, and we generated a nomogram using an index of sedentary behavior. Our analysis results demonstrated that sedentary behavior on non-dialysis days was closely associated with the survival of the chronic hemodialysis patients, suggesting that a decrease in sedentary behavior would prolong their survival. The nomogram developed herein based on sedentary behavior may be useful for predicting the outcomes of chronic hemodialysis patients. |
| キーワード | nomogram chronic hemodialysis sedentary behavior Cox proportional hazards model Kaplan- Meier curve |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2026-02 |
| 巻 | 80巻 |
| 号 | 1号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 9 |
| 終了ページ | 16 |
| 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 Ⓒ 2026 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 41748145 |
| Web of Science KeyUT | 001712994500002 |
| JaLCDOI | 10.18926/AMO/70067 |
|---|---|
| フルテキストURL | 80_1_001.pdf |
| 著者 | Yamaoka, Hidenaru| Yoshida, Masashi| Sarashina, Toshihiro| Akagi, Satoshi| Miyoshi, Toru| Munemasa, Mitsuru| Nakamura, Kazufumi| Ito, Hiroshi| Yuasa, Shinsuke| |
| 抄録 | Venous thromboembolism (VTE) is a serious complication in patients with cancer. In this population, the presence of thrombi is often assessed at cancer diagnosis by measuring D-dimer levels, which have high sensitivity but low specificity for identifying VTE at this clinical time point. However, the usefulness of D-dimer measurement during anticoagulation therapy has not been fully established, despite its widespread use. In this retrospective observational study, we investigated whether D-dimer measurement during anticoagulation therapy in cancer patients could predict overt VTE at follow-up. The study included patients who underwent D-dimer testing and contrast-enhanced computed tomography between 30 and 100 days after initiation of anticoagulation therapy. Eighty-two patients were included: 60 with cancer and 22 without. The diagnostic performance of D-dimer for overt VTE was as follows: sensitivity, 85.7%; specificity, 87.2%; positive predictive value, 78.3%; and negative predictive value, 89.2%. These findings suggest that D-dimer measurement at follow-up has high sensitivity and specificity for overt VTE in cancer patients and may aid in assessing thrombotic status. Clinically, if anticoagulation therapy is continued until D-dimer levels become negative, the absence of overt VTE could be inferred without additional invasive testing. |
| キーワード | D-dimer venous thromboembolism cancer |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2026-02 |
| 巻 | 80巻 |
| 号 | 1号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 1 |
| 終了ページ | 7 |
| 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 Ⓒ 2026 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 41748144 |
| Web of Science KeyUT | 001712994500001 |
| JaLCDOI | 10.18926/AMO/69851 |
|---|---|
| フルテキストURL | 79_6_469.pdf |
| 著者 | Tsujii, Teruyuki| Matsuda, Tatsuo| Kimura, Yuji| Katsube, Ryoichi| Iwadou, Hironori| Funabiki, Sadami| Kamikawa, Yasuaki| Matsuda, Tadakazu| |
| 抄録 | We report a rare case of ileus tube-related intussusception in an adult. A 56-year-old man with adhesive bowel obstruction was treated with a nasointestinal ileus tube. Although his condition initially improved, persistent abdominal pain led to the diagnosis of intussusception via CT imaging. Manual repositioning of the tube resolved the intussusception without the need for bowel resection. A review of 80 previously reported cases of ileus tube-associated intussusception (total 81 cases, 95 lesions) highlighted the timing of onset, treatment strategies, and precautions. Early detection and diagnosis are crucial to prevent severe complications and preserve bowel function. |
| キーワード | nasointestinal ileus tube intussusception small bowel obstruction enterectomy conservative treatment |
| 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 | 469 |
| 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 Ⓒ 2025 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 41443810 |
| Web of Science KeyUT | 001674277500010 |
| 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 |
| PubMed ID | 41443809 |
| Web of Science KeyUT | 001674277500009 |
| JaLCDOI | 10.18926/AMO/69849 |
|---|---|
| フルテキストURL | 79_6_457.pdf |
| 著者 | Asakawa, Tomohiko| Uchida, Haruhito A.| Katayama, Yu| Sakurabu, Yoshimasa| Katayama, Katsuyoshi| Onishi, Yasuhiro| Matsuoka-Uchiyama, Natsumi| Takeuchi, Hidemi| Tanaka, Keiko| Tsuji, Kenji| Umebayashi, Ryoko| Takemoto, Rika| Wada, Jun| |
| 抄録 | This case involves a 23-year-old male who was diagnosed with Behçet’s disease 5 years ago and managed with colchicine. Two months ago, he underwent renal biopsy due to abnormal urinalysis and kidney dysfunction, leading to a diagnosis of IgA nephropathy. He subsequently underwent tonsillectomy followed by glucocorticoid pulse therapy. However, after the tonsillectomy, discontinuing colchicine led to increased proteinuria, despite the glucocorticoid pulse therapy. Upon reintroducing colchicine, urinary protein excretion decreased, achieving incomplete remission. These findings suggest that colchicine may be effective in decreasing proteinuria in patients with Behçet’s disease complicated by IgA nephropathy. |
| キーワード | Behçet’s disease IgA nephropathy colchicine |
| 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 | 457 |
| 終了ページ | 461 |
| 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 |
| PubMed ID | 41443808 |
| Web of Science KeyUT | 001674277500008 |
| 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 |
| PubMed ID | 41443807 |
| Web of Science KeyUT | 001674277500007 |
| 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 |
| PubMed ID | 41443806 |
| Web of Science KeyUT | 001674277500006 |
| 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 |
| PubMed ID | 41443805 |
| Web of Science KeyUT | 001674277500005 |
| 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 |
| PubMed ID | 41443804 |
| Web of Science KeyUT | 001674277500004 |
| 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 |
| PubMed ID | 41443803 |
| Web of Science KeyUT | 001674277500003 |
| 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 |
| PubMed ID | 41443802 |
| Web of Science KeyUT | 001674277500002 |
| JaLCDOI | 10.18926/AMO/69842 |
|---|---|
| フルテキストURL | 79_6_405.pdf |
| 著者 | Ouchi, Chihiro| Morizane Hosokawa, Mio| Kimura, Shuhei| Shiode, Yusuke| Matoba, Ryo| Morita, Tetsuro| Morizane, Yuki| |
| 抄録 | We investigated the treatment outcomes of patients aged ≥85 years with neovascular age-related macular degeneration (nAMD) who received anti-vascular endothelial growth factor (anti-VEGF) therapy using either treat-and-extend (TAE) or pro re nata (PRN) regimens for 1 year in real-world clinical practice. Eighty-five eyes from 85 patients were included. Among them, types 1, 2, and 3 macular neovascularization and polypoidal choroidal vasculopathy were present in 27.1%, 17.6%, 18.8%, and 36.5%, respectively. TAE and PRN regimens were used in 43.5% and 56.5% of patients, respectively. At baseline, the PRN group was older and had worse best-corrected visual acuity (BCVA), greater central retinal thickness, and more intraretinal fluid than the TAE group. In the TAE group, the mean number of injections was 7.6, BCVA improved significantly, and all retinal fluid rates decreased. In the PRN group, the mean number of injections was 3.9, BCVA remained unchanged, and the rates of macular fibrosis and atrophy increased. No serious adverse events were observed in either group. Anti-VEGF therapy was safe for patients aged ≥ 85 years with nAMD, and the TAE regimen effectively improved BCVA in this population. BCVA remained unchanged in the PRN-treated patients, with baseline disease severity and/or undertreatment potentially influencing the outcomes. |
| キーワード | anti-vascular endothelial growth factor therapy neovascular age-related macular degeneration age treat-and-extend pro re nata |
| 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 | 405 |
| 終了ページ | 412 |
| 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 |
| PubMed ID | 41443801 |
| Web of Science KeyUT | 001674277500001 |
| JaLCDOI | 10.18926/AMO/69442 |
|---|---|
| フルテキストURL | 79_5_399.pdf |
| 著者 | Isozaki, Hiroshi| Matsumoto, Sasau| Takama, Takehiro| Isozaki, Yuka| Murakami, Shigeki| |
| 抄録 | Gastric cancer with lymphoid stroma (GCLS) accounts for 1%-7% of gastric cancers; ~80% are Epstein-Barr virus (EBV)-positive. The rate of lymph node metastasis is relatively low, even when an early GCLS has invaded the submucosa. We report an early GCLS with massive submucosal invasion mimicking a submucosal tumor (SMT), diagnosed by endoscopic submucosal resection (ESD) and treated with local resection and sentinel node navigation surgery (SNNS). The patient was a 40-year-old Japanese man. A protruding lesion on the greater curvature of the middle part of his stomach was detected by X-ray, and an endoscopic examination revealed a 2.5-cm protruding tumor covered with a normal mucosa and small ulcers at the apex. ESD was performed for a diagnosis. The pathological diagnosis was lymphoepithelioma-like gastric cancer (GCLS), pT1b(SM2), Ly0, V0, pHM1, pVM1. EBV infection in the cancer cells was confirmed pathologically by EBV-encoded RNA. The local resection was performed using SNNS. The patient has had no recurrence or post-gastrectomy syndrome 4 years postsurgery. EBV-associated early GCLS resembling an SMT is relatively rare, and clinicians need to be aware of this disease. Local resection using SNNS may be a surgical option for GCLS cases with a low rate of lymphatic metastasis. |
| キーワード | gastric cancer gastric cancer with lymphoid stroma lymphoepithelioma-like carcinoma Epstein Barr virus sentinel node navigation surgery |
| 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 | 399 |
| 終了ページ | 404 |
| 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 |
| PubMed ID | 41126472 |
| Web of Science KeyUT | 001606012000001 |