JaLCDOI 10.18926/AMO/56873
フルテキストURL 73_3_279.pdf
著者 Makimoto, Go| Nishimori, Hisakazu| Kondo, Reiko| Yanai, Hiroyuki| Sugimoto, Morito| Oda, Naohiro| Kubo, Toshio| Hotta, Katsuyuki| Tabata, Masahiro| Kiura, Katsuyuki| Maeda, Yoshinobu|
抄録 Urothelial carcinoma usually presents with hematuria, but cases of multiple lymphadenopathy with elevated S-pancreas-1 antigen (SPan-1) levels have not been reported. A 62-year-old Japanese man with lymphadenopathies was diagnosed with an adenocarcinoma of unknown origin and transferred to our hospital for further diagnosis. Serum carbohydrate antigen 19-9 and SPan-1 levels were extremely elevated. Uroplakin III immunostaining was positive in the inguinal lymph node, and cystoscopy revealed the presence of invasive urothelial carcinoma. Treatment with cisplatin and gemcitabine promoted a complete metabolic response for > 4 years. The detection of uroplakin III and serum SPan-1 might help diagnose urothelial carcinoma.
キーワード urothelial carcinoma uroplakin III s-pancreas-1 antigen carbohydrate antigen 19-9 chemotherapy
Amo Type Case Report
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 279
終了ページ 284
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235978
JaLCDOI 10.18926/AMO/56872
フルテキストURL 73_3_273.pdf
著者 Hayata, Kei| Masuyama, Hisashi| Eto, Eriko| Mitsui, Takashi| Tamada, Shoko| Eguchi, Takeshi| Maki, Jota| Tani, Kazumasa| Ohira, Akiko| Washio, Yosuke| Yoshimoto, Junko| Hasegawa, Kosei|
抄録 Nager syndrome is a rare disease involving severe micrognathia and upper limb shortening. In this report, we describe a case in which micrognathia of the fetus was suspected based on the observation of upper limb shortening during detailed B mode and 3D/4D ultrasonographic observation, and combined fetal MRI and 3D-CT led to a prenatal diagnosis of Nager syndrome. Upon birth, because severe micrognathia caused airway obstruction and made it difficult to spread the larynx for intubation, effective ventilation could not be carried out and a tracheostomy was necessary. Since a differential diagnosis of Nager syndrome can be made based on the fact that micrognathia typically co-occurs with upper limb shortening, it is possible to diagnose the disease before birth and prepare for life-saving measures accordingly.
キーワード Nager syndrome acrofacial dysostosis micrognathia jaw index SF3B4
Amo Type Case Report
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 273
終了ページ 277
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235977
JaLCDOI 10.18926/AMO/56871
フルテキストURL 73_3_269.pdf
著者 Tsuboi, Ichiro| Araki, Motoo| Fujiwara, Hiroyasu| Iguchi, Toshihiro| Hiraki, Takao| Arichi, Naoko| Kawamura, Kasumi| Maruyama, Yuki| Mitsui, Yosuke| Sadahira, Takuya| Kubota, Risa| Nishimura, Shingo| Sako, Tomoko| Takamoto, Atsushi| Wada, Koichiro| Kobayashi, Yasuyuki| Watanabe, Toyohiko| Yanai, Hiroyuki| Kitagawa, Masashi| Tanabe, Katsuyuki| Sugiyama, Hitoshi| Wada, Jun| Shiina, Hiroaki| Kanazawa, Susumu| Nasu, Yasutomo|
抄録 Nephron-sparing treatment should be offered whenever possible to avoid dialysis in allograph cases. Cryoablation is a new treatment option for treating small-sized renal cell cancer (RCCs). We report a case of RCC arising in a kidney allograft treated by cryoablation. To our knowledge, this is the first case in Asia of RCC in a renal allograft treated using cryoablation. Contrast-enhanced CT-guided percutaneous renal needle biopsy and cryoablation were used to identify the RCC, which could not be identified by other techniques. The postoperative course was uneventful. Contrast-enhanced CT also showed no recurrence or metastases at the 6-month follow-up.
キーワード cryoablation partial nephrectomy renal cell carcinoma renal allograft renal transplantation
Amo Type Case Report
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 269
終了ページ 272
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235976
JaLCDOI 10.18926/AMO/56870
フルテキストURL 73_3_263.pdf
著者 Shimoyama, Yuichiro| Umegaki, Osamu| Ooi, Yukimasa| Shigemoto, Sho| Agui, Tomoyuki| Kadono, Noriko| Minami, Toshiaki|
抄録 A previously healthy 40-year-old Japanese male was urgently admitted with a 2-month history of dysphagia, 30-kg weight loss, and fever. Human immunodeficiency virus (HIV) antibodies and cytomegalovirus antigenemia were positive. Pneumocystis pneumonia and cytomegalovirus pneumonia were suspected. The patient was diagnosed with acquired immune deficiency syndrome (AIDS). Cytomegalovirus antigenemia became negative 20 days after the positive result. On hospital day 41, he experienced cardiopulmonary arrest. The clinical diagnosis was fulminant type 1 diabetes mellitus. He later developed hypoglycemia and was diagnosed with adrenal insufficiency accompanied by septic shock. He died of multiple organ failure 29 h post-admission to our ICU.
キーワード fulminant type 1 diabetes mellitus human immunodeficiency virus cytomegalovirus hypoglycemia
Amo Type Case Report
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 263
終了ページ 267
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235975
JaLCDOI 10.18926/AMO/56869
フルテキストURL 73_3_255.pdf
著者 Seki, Daisuke| Takeshita, Nobuo| Seiryu, Masahiro| Deguchi, Toru| Takano-Yamamoto, Teruko|
抄録 Orthodontists need to understand the orthodontic risks associated with systemic disorders. Axenfeld-Rieger syndrome (ARS) is a rare autosomal dominant disorder with genetic and morphological variability. The risks of orthodontic treatment in ARS patients have been unclear. Here we describe the correction of an anterior open bite in a 15-year-old Japanese female ARS patient by molar intrusion using sectional archwires with miniscrew implants. An undesirable development of external apical root resorption (EARR) was observed in all intrusive force-applied posterior teeth during the patient’s orthodontic treatment, suggesting that ARS patients have a higher risk of EARR than the general population.
キーワード Axenfeld-Rieger syndrome external apical root resorption miniscrew implant anterior open bite
Amo Type Case Report
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
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 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235974
JaLCDOI 10.18926/AMO/56868
フルテキストURL 73_3_247.pdf
著者 Yoshio, Kotaro| Wakita, Akihisa| Mitsuhashi, Toshiharu| Kitayama, Takahiro| Hisazumi, Kento| Inoue, Daisaku| Tajiri, Nobuhisa| Shiode, Tsuyoki| Akaki, Shiro| Kanazawa, Susumu|
抄録 We investigated the feasibility of simultaneous integrated boost (SIB) volumetric modulated arc therapy (VMAT) using elective nodal irradiation (ENI) for middle or lower esophageal cancer and compared it with three-dimensional conformal radiotherapy (3D-CRT). The study included 15 patients. The prescribed doses included a standard dose (50.4 Gy) and a high dose (60 Gy) for the planning target volume (PTV) of the involved lesions. The objective of the whole lung volume receiving ≥ 20 Gy (V20Gy) was < 30%, and the mean lung dose (MLD) was < 20 Gy. The volumes of the lung receiving 5 Gy (V5Gy) and the heart receiving 30-50 Gy (V30-50Gy) were kept as low as reasonably achievable. As a result, SIB-VMAT showed superior dose conformity for the PTV (p<0.001). Although the lung V5Gy was significantly increased (p<0.001), the V20Gy and MLD showed no significant increase. The heart V30-50Gy showed a > 20% reduction in the mean against 3D-CRTs. Our results demonstrate the feasibility of SIB-VMAT for the treatment of middle or lower esophageal cancer with ENI. Although attention should be paid to the low-dose area of the lungs, SIB-VMAT would be a promising treatment option with improved outcomes for esophageal cancer.
キーワード esophageal cancer middle and lower thoracic volumetric modulated arc therapy, 3D-CRT elective nodal irradiation
Amo Type Original Article
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 247
終了ページ 257
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235973
JaLCDOI 10.18926/AMO/56867
フルテキストURL 73_3_241.pdf
著者 Utsumi, Masashi| Aoki, Hideki| Nishimura, Seitaro| Une, Yuta| Kashima, Hajime| Kimura, Yuji| Taniguchi, Fumitaka| Arata, Takashi| Katsuda, Koh| Tanakaya, Kohji|
抄録 Gallbladder carcinoma (GBC) is a common malignancy with a poor prognosis. With the average life expectancy increasing globally, the incidence of GBC is predicted to increase as well. We investigated the safety and feasibility of surgical treatment for elderly patients with GBC. We retrospectively compared clinical pathological data and treatment outcomes in 45 consecutive GBC patients (23 patients ≥ 75 years [elderly group] and 22 patients < 75 years [younger group]) who underwent curative resection at the Iwakuni Center from January 2008 to December 2017. The proportion of preoperative comorbidities and anticoagulant use was significantly higher in the elderly group. The American Society of Anesthesiologists score was higher in the elderly versus the younger group, and the elderly group had significantly shorter operation times. Reduced activities of daily living was more common in the elderly versus younger group. The percentage of radical resection and overall 3-year survival (66.6% younger vs. 64.4% elderly) were similar between the groups. Controlling Nutritional Status (CONUT) score ≥ 3 and R0 resection were identified as prognostic factors for overall survival rate among all patients. After careful patient selection,
キーワード elderly patient gallbladder carcinoma prognostic factor surgical treatment
Amo Type Original Article
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 241
終了ページ 246
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235972
JaLCDOI 10.18926/AMO/56866
フルテキストURL 73_3_235.pdf
著者 Horita, Masahiro| Nishida, Keiichiro| Hashizume, Kenzo| Sugimoto, Yoshihisa| Nasu, Yoshihisa| Nakahara, Ryuichi| Harada, Ryozo| Ozaki, Toshifumi|
抄録 We investigated the prevalence of and risk factors for the progression of upper cervical lesions (UCLs) in patients with rheumatoid arthritis (RA). A retrospective analysis of 49 patients with RA (4 males, 45 females) was conducted. The UCLs included atlanto-axial subluxation and vertical subluxation. We investigated the clinical factors including the Disease Activity Score 28 based on C-reactive protein (DAS28-CRP) and the modified Health Assessment Questionnaire-Disability Index as well as radiographic changes between the baseline (at May 2010 to April 2013) and final follow-up. Forty patients (81.6%) were classified as the non-progressive group, and the other 9 patients (18.4%) comprised the progressive group. The progressive group’s final CRP values, baseline or final MMP-3 levels, DAS28-CRP, and rate of pre-existing lesions at baseline were all significantly higher than those of the non-progressive group (p=0.017, p=0.043, p=0.002, p=0.008, p<0.001, and p=0.008 respectively). A multivariate logistic regression analysis demonstrated that DAS28-CRP at baseline was a risk factor for radiographic progression (p=0.018, odds ratio: 2.54, 95% confidence interval: 1.17-5.51). Our findings indicate that higher disease activity might influence the progression of UCLs in patients with RA.
キーワード rheumatoid arthritis upper cervical spine lesion risk factor radiological progression
Amo Type Original Article
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 235
終了ページ 240
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235971
JaLCDOI 10.18926/AMO/56865
フルテキストURL 73_3_229.pdf
著者 Hamasaki, Ichiro| Shibata, Kiyo| Shimizu, Takehiro| Kono, Reika| Morizane, Yuki| Shiraga, Fumio|
抄録 During strabismus surgery using illumination from a light source, patients complain of photophobia. The NGENUITYⓇ (Alcon) system is equipped with a high-dynamic-range (HDR) camera. A 4K display viewed by wearing circularly polarized glasses provides clear three-dimensional images of the operative field. A light source is usually required for surgeries of the anterior segment (including strabismic surgery), but the digital processing function of the NGENUITYⓇ system allows image display in relatively dark regions even without a light source. We devised a novel ‘lights-out’ surgery that does not use a microscope’s light source, and we examined the usefulness of this technique in 2 cases of strabismic surgery. We performed strabismus surgery using the NGENUITYⓇ system in two patients between January and June 2018. The HDR function was used, and the aperture was opened to the maximum while the gain was adjusted. Surgery was conducted without using the microscope’s light source. We report the 2 cases’ results and evaluate the novel method. The surgeries were performed without problem even though the microscope’s light source was not used. The patients’ photophobia was alleviated. Lights-out surgery is a potentially useful modality for strabismus surgery.
キーワード head-up surgery 3D vision system high dynamic range video enhancement strabismus surgery
Amo Type Original Article
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 229
終了ページ 233
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235970
JaLCDOI 10.18926/AMO/56864
フルテキストURL 73_3_223.pdf
著者 Sugiu, Kazuhisa| Furumatsu, Takayuki| Kodama, Yuya| Kamatsuki, Yusuke| Okazaki, Yoshiki| Okazaki, Yuki| Hiranaka, Takaaki| Ozaki, Toshifumi|
抄録 Anterior cruciate ligament (ACL) reconstruction (ACLR) after ACL rupture improves the instability of the knee joint and decreases mechanical stress to the meniscus and articular cartilage. However, there are reports that post-traumatic osteoarthritis (PTOA) is observed over time following ACLR. In this study, we assessed changes in cartilage lesions by arthroscopic findings following anatomical double-bundle ACLR and at post-operative second-look arthroscopy about 14 months later. We retrospectively evaluated 37 knees in cases with patients <40 years of age who had undergone an anatomical double-bundle ACL reconstruction <1 year after ACL rupture injury from March 2012 to December 2016. Clinical results and arthroscopic cartilage/meniscal lesion were evaluated and compared between a cartilage lesion-detected group and intact-cartilage group. Surgery improved anteroposterior laxity and other clinical measures; however, cartilage lesions were detected at 11 sites during ACLR and at 54 sites at second-look arthroscopy. The periods from injury to second-look arthroscopy and from ACLR to second-look arthroscopy were significantly longer in the cartilage-lesion group (n=23) than in the intact-cartilage group (n=14). Conversely, 96% of meniscal damage observed during ACLR was cured at the time of second-look arthroscopy. Knee articular cartilage lesions after ACL rupture cannot be completely suppressed, even using the anatomical ACL reconstruction technique. This study suggested that articular cartilage lesions can progress to a level that can be confirmed arthroscopically at approximately 17 months after ACL injury. Therefore, in ACLR patients, the possibility of developing knee articular cartilage lesions and PTOA should be considered.
キーワード anterior cruciate ligament reconstruction post-traumatic osteoarthritis meniscal lesion cartilage lesions second-look arthroscopy
Amo Type Original Article
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 223
終了ページ 228
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235969
JaLCDOI 10.18926/AMO/56863
フルテキストURL 73_3_213.pdf
著者 Nishina, Saori| Matsuura, Koji| Naruse, Keiji|
抄録 We investigated the relationship between human sperm rheotaxis and motile sperm trajectories by using poly-(dimethylsiloxane) (PDMS)-based cylindrical microfluidic channels with inner diameters of 100 μm, 50 μm, and 70 μm, which corresponded to the inner diameter of the human isthmus, the length of a sperm and a diameter intermediate between the two, respectively. We counted the number of rheotaxic sperm and sperm with spiral motion. We also analyzed motile sperm trajectories. As the cylindrical channel diameter was decreased, the percentage of sperm cells exhibiting rheotaxis, the percentage of sperm cells exhibiting spiral motion, the frequency-to-diameter ratio of the sperm cells’ spiral trajectories, and the surface area of the microfluidic channel increased, while the flagellar motion at the channel wall decreased. The percentage of sperm exhibiting a spiral trajectory and the frequency-to-diameter ratio of the sperm cells’ spiral trajectories were thus affected by the channel diameter. Our findings suggest that the oviduct structure affects the swimming properties of sperm cells, guiding them from the uterus to the ampulla for egg fertilization. These results could contribute to the development of motile sperm-sorting microfluidic devices for assisted reproductive technologies.
キーワード sperm motility trajectory microfluidic channel rheotaxis oviduct structure
Amo Type Original Article
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 213
終了ページ 221
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235968
JaLCDOI 10.18926/AMO/56862
フルテキストURL 73_3_205.pdf
著者 Mukai, Yuko| Sakurai, Toru| Watanabe, Toshiyuki| Sako, Tomoko| Sugimoto, Morito| Kimata, Yoshihiro| Mori, Yoshiko| Nagasaka, Takeshi| Namba, Yuzaburo|
抄録 Intestinal vaginoplasty has several advantageous features, such as scarless surgery, low incidence of contraction of the reconstructed vagina, maintenance of vaginal depth, spontaneous mucus production, and a low rate of complications. Therefore, this technique is becoming popular in many countries. Following the global trend, the demand for intestinal vaginoplasty for transsexuals is also increasing in Japan. However, there are few reports on intestinal vaginoplasty in Japan. In this study, we examined the safety and effectiveness of rectosigmoid colon vaginoplasty in the Japanese population. We retrospectively surveyed 18 male-to-female transsexuals who underwent laparoscopic rectosigmoid colon vaginoplasty at the Okayama University Hospital Gender Center between October 2012 and December 2017. One patient had developed an anastomotic leak and 2 patients experienced vaginal prolapse, which needed revision surgery. Both adverse outcomes were comparable with those from previous studies. The anastomotic leak was managed adequately with conservative treatment. To avoid vaginal prolapse, it is important to decide the length of the rectosigmoid segment so that a pull on it does not cause it to become lax, while excessive stress on the feeder vessels is avoided. Based on our study, we concluded that rectosigmoid vaginoplasty was a reliable technique in the Japanese population.
キーワード vaginoplasty male-to-female transsexuals rectosigmoid colon
Amo Type Original Article
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 205
終了ページ 211
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235967
JaLCDOI 10.18926/AMO/56861
フルテキストURL 73_3_197.pdf
著者 Nishimura, Takeshi| Naito, Hiromichi| Matsuyama, Shigenari| Ishihara, Satoshi| Nakao, Atsunori| Nakayama, Shinichi|
抄録 Japan's population has been skewing toward the elderly, but the outcomes of advanced elderly trauma are not clear. Here we compared the outcomes of very elderly trauma patients (≧85 years old) with those of 65- to 84-year-old trauma patients. We retrospectively reviewed the medical records of patients treated at Hyogo Emergency Medical Center from August 2010 to August 2016; 631 patients were entered in the study. We divided them into the younger geriatrics (YG group, 65-84 years old: n=534) and older geriatrics (OG group, ≧85 years old: n=97). The group’s patient characteristics, mortality, 1-year survival rate, and Barthel index were tabulated and compared. The patients’ mean age was 75.6±7.5 years. There was no significant difference in mortality between the YG and OG groups (9.6% vs. 15.1%, odds ratio [OR] 1.73; 95% confidence interval [CI] 0.93-3.23, p=0.083). The 1-year survival rate (94.4% vs. 77.8%, OR 0.19, 95% CI 0.07-0.51; p<0.01) and Barthel index (Median score; 100 (IQR: 85-100) vs. 80 (IQR: 15-95), OR 0.98, 95% CI 0.97 to 0.99, p<0.01) differed significantly between the groups. Our study did not find a significant difference in-hospital mortality between patients in the YG group and those in the OG group.
キーワード aged injury mortality morbidity trauma
Amo Type Original Article
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 197
終了ページ 203
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235966
JaLCDOI 10.18926/AMO/56860
フルテキストURL 73_3_189.pdf
著者 Sakamoto, Shinji| Kawai, Hiroki| Okahisa, Yuko| Tsutsui, Ko| Kanbayashi, Takashi| Tanaka, Keiko| Mizuki, Yutaka| Takaki, Manabu| Yamada, Norihito|
抄録 Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a recently-discovered autoimmune disorder in which antibodies target NMDAR in the brain. The number of reported cases of anti-NMDAR encephalitis has increased rapidly. Anti-NMDAR encephalitis can be mistakenly diagnosed as psychiatric disorders because many patients present with prominent psychiatric symptoms and visit psychiatric institutions first. Thus, psychiatrists should cultivate a better understanding of anti-NMDAR encephalitis. In this review, we present the mechanisms, epidemiology, symptoms and clinical course, diagnostic tests, treatment and outcomes of patients with anti-NMDAR encephalitis. Furthermore, we discuss the diversity of clinical spectra of anti-NMDAR encephalitis, and demonstrate a differential diagnosis of psychiatric disease from the perspective of psychiatry.
キーワード NMDAR encephalitis psychiatric symptom schizophrenia mood disorder
Amo Type Review
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 189
終了ページ 195
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235965
JaLCDOI 10.18926/AMO/56655
フルテキストURL 73_2_181.pdf
著者 Okamura, Tomoka| Washio, Yousuke| Yoshimoto, Junko| Tani, Kazumasa| Tsukahara, Hirokazu| Shimada, Akira|
抄録 Most cases of transient abnormal myelopoiesis (TAM) in neonates with Down syndrome (DS) resolve spontaneously; however, DS-TAM neonates with hydrops fetalis (HF) show poor clinical outcomes. We report three infants with DS-TAM and HF who were treated with exchange transfusion (ET) followed by low-dose cytarabine (LD-CA). All of them survived without developing liver failure, acute leukemia, or other serious adverse events. Our results suggest that this combination treatment with ET and LD-CA would be safe, tolerable and effective as an novel approach for DS-TAM patients with HF.
キーワード cytarabine Down syndrome exchange transfusion hydrops fetalis transient abnormal myelopoiesis
Amo Type Case Report
発行日 2019-04
出版物タイトル Acta Medica Okayama
73巻
2号
出版者 Okayama University Medical School
開始ページ 181
終了ページ 188
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31015754
JaLCDOI 10.18926/AMO/56654
フルテキストURL 73_2_177.pdf
著者 Okita, Atsushi| Ohtani, Jun|
抄録 We report a rare case of fistulation to the jejunum after percutaneous endoscopic gastrostomy (PEG). An 85-year-old man with previous cerebral infarction and swallowing disturbance underwent PEG. Nine months later, he developed a high fever and discharge around the gastrostomy button. He was diagnosed with aspiration pneumonia, and administered antibiotic therapy. Examination showed digestive fluid around the gastrostomy button. Gastrointestinal contrast-enhanced CT revealed a gastrojejunocutaneous fistula. The button was removed, and the fistula closed naturally. PEG was performed again. The patient’s postoperative course was uneventful. Gastrojejunocutaneous fistula should be considered in cases involving increased discharge from a gastrostomy fistula.
キーワード percutaneous endoscopic gastrostomy gastrojejunocutaneous fistula
Amo Type Case Report
発行日 2019-04
出版物タイトル Acta Medica Okayama
73巻
2号
出版者 Okayama University Medical School
開始ページ 177
終了ページ 180
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31015753
JaLCDOI 10.18926/AMO/56653
フルテキストURL 73_2_173.pdf
著者 Tamada, Shoko| Masuyama, Hisashi| Hayata, Kei| Eto, Eriko| Mitsui, Takashi| Eguchi, Takeshi| Maki, Jota| Tani, Kazumasa|
抄録 Radical trachelectomy (RT) is a fertility-sparing surgery for cervical cancer. Postoperative pregnancies have a high risk of abortion and prematurity. To prevent this, a procedure involving transabdominal cerclage (TAC) was devised for shortened cervical canals post-RT. Here we describe the successful management of a pregnancy after abdominal RT (ART). The 34-year-old patient was gravida 1, para 0. When she was 27, she underwent ART for stage Ib1 cervical cancer, and she became pregnant 7 years later. Because her cervical canal was 16.7 mm during early pregnancy, we performed TAC at 12 weeks of pregnancy. Post-surgery, we administered an infusion of ritodrine hydrochloride for tocolysis. A selective caesarean section was performed at 36 weeks, with the delivery of a healthy infant.
キーワード cervical cancer radical trachelectomy pregnancy transabdominal cerclage
Amo Type Case Report
発行日 2019-04
出版物タイトル Acta Medica Okayama
73巻
2号
出版者 Okayama University Medical School
開始ページ 173
終了ページ 176
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31015752
JaLCDOI 10.18926/AMO/56652
フルテキストURL 73_2_161.pdf
著者 Okamoto, Sachiyo| Matsuoka, Ken-ichi| Sakamoto, Maiko| Usui, Yoshiaki| Fujiwara, Yuki| Kondo, Takumi| Tani, Katsuma| Saeki, Kyosuke| Meguri, Yusuke| Asada, Noboru| Ennishi, Daisuke| Nishimori, Hisakazu| Fujii, Keiko| Fujii, Nobuharu| Maeda, Yoshinobu|
抄録 Second allogeneic stem cell transplantation (allo-SCT) is a potentially curative therapy for patients who relapse after first allo-SCT. Human leukocyte antigen (HLA)-haploidentical related donors provide the broad opportunity to conduct second SCT at the appropriate time, but the efficacy of second SCT from haploidentical donors after relapse has not been established. We retrospectively analyzed the records of 33 patients who underwent second SCT. Twenty patients underwent haplo-SCT with low-dose antithymocyte globulin (ATG), and the other 13 patients underwent conventional- SCTs, including HLA-matched related peripheral blood, unrelated bone marrow or cord blood. Three years after the second SCT, the overall survival (OS) and progression-free survival (PFS) of all patients were 32.5% and 23.9%. Multivariate analyses indicated that non-complete response at second SCT, less than 1-year interval to relapse after first- SCT, and total score ≥ 3 on the hematopoietic cell transplantation-specific comorbidity index were significantly associated with a lower PFS rate. The haplo- and conventional- SCT groups showed equivalent results regarding OS, PFS, cumulative incidences of relapse, non-relapse mortality and graft-versus-host disease. The neutropenic period after transplantation was significantly shorter in haplo- SCT than conventional- SCT (10.5 days vs. 16 days, p=0.001). Our analysis revealed that haplo-SCT could be an alternative therapeutic option for relapsed patients after first SCT.
キーワード allogeneic stem cell transplantation haploidentical stem cell transplantation relapse anti-T lymphocyte globulin
Amo Type Original Article
発行日 2019-04
出版物タイトル Acta Medica Okayama
73巻
2号
出版者 Okayama University Medical School
開始ページ 161
終了ページ 171
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31015751
JaLCDOI 10.18926/AMO/56651
フルテキストURL 73_2_155.pdf
著者 Minami, Daisuke| Kayatani, Hiroe| Sato, Ken| Fujiwara, Keiichi| Shibayama, Takuo| Yonei, Toshiro| Sato, Toshio|
抄録 We investigated the clinical characteristics of refractory asthma associated with the effectiveness of bronchial thermoplasty (BT). We retrospectively evaluated data from 10 patients who underwent BT between June 2016 and December 2017 at Okayama Medical Center. The following were measured before and 6 months post-BT: forced expiratory volume in 1.0 s (FEV1), fractional exhaled nitric oxide (FeNO), immunoglobulin E (IgE) level, blood eosinophil counts (Eosi), Asthma Quality of Life Questionnaire (AQLQ) score, and preventive medication use. At baseline, the mean post-bronchodilator FEV1 was 80.9% of the predicted value (range 45.6-115.7%). All patients were being treated with moderate- or high-dose inhaled corticosteroids and long-acting β2 agonists. The AQLQ improved from 4.26±1.67 at baseline to 5.59±0.94 at 6 months post-BT (p<0.05). The %FEV1, FeNO, IgE, and Eosi did not change significantly between baseline and 6 months post-BT. No severe complications were reported. BT was effective for non-allergic and non-eosinophilic in 3 patients, and allergic or eosinophilic in 4 patients. Their AQLQ improved by > 0.5 points post-BT. For both allergic and eosinophilic asthmatics following mepolizumab, BT was not useful. BT was effective for non-allergic and non-eosinophilic or allergic asthmatics, but insufficient for both allergic and eosinophilic following mepolizumab.
キーワード bronchial thermoplasty non-allergic asthma non-eosinophilic asthma airway hyper-responsiveness patient selection
Amo Type Original Article
発行日 2019-04
出版物タイトル Acta Medica Okayama
73巻
2号
出版者 Okayama University Medical School
開始ページ 155
終了ページ 160
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31015750
JaLCDOI 10.18926/AMO/56650
フルテキストURL 73_2_147.pdf
著者 Hayashi, Masao| Taniguchi, Arata| Kaku, Ryuji| Fujimoto, Shusaku| Isoyama, Satoshi| Manabe, Sei| Yoshida, Tsubasa| Suzuki, Satoshi| Shimizu, Kazuyoshi| Morimatsu, Hiroshi| Momota, Ryusuke|
抄録 Tachycardia is common in intensive care units (ICUs). It is unknown whether tachycardia or prolonged tachycardia affects patient outcomes. We investigated the association between tachycardia and mortality in critically ill patients. This retrospective cohort study’s primary outcome was patient mortality in the ICU and the hospital. We stratified the patients (n=476) by heart rate (HR) as LowHR, MediumHR, and HighHR groups. We also stratified them by their durations of HR >100 (prolonged HR; tachycardia): MildT, ModerateT, and SevereT groups. We determined the six groups’ mortality. The ICU mortality rates of the LowHR, MediumHR, and HighHR groups were 1.0%, 1.5%, and 7.9%, respectively; significantly higher in the HighHR vs. LowHR group. The in-hospital mortality rates of these groups were 1%, 4.5%, and 14.6%, respectively; significantly higher in the HighHR vs. LowHR group. The ICU mortality rates of the MildT, ModerateT, and SevereT groups were 0.9%, 5.6%, and 57.1%, respectively. The mortality of the HRT=0 (i.e., all HR ≤ 100) patients was 0%. The in-hospital mortality rates of the MildT, ModerateT, and SevereT groups were 1.8%, 16.7%, and 85.7%, respectively; that of the HRT=0 patients was 0.5%. Both higher HR and prolonged tachycardia were associated with poor outcomes.
キーワード tachycardia mortality ICU in-hospital
Amo Type Original Article
発行日 2019-04
出版物タイトル Acta Medica Okayama
73巻
2号
出版者 Okayama University Medical School
開始ページ 147
終了ページ 153
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31015749