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Acta Medica Okayama

Koichi Tsunoda, Rika Kobayashi, Akiko Kada, Akiko M Saito, Hayato Misawa, Keizo Horibe, Fumiyuki Goto, Atsunobu Tsunoda, Toru Sasaki, Minako Takanosawa, Hiroshi Nishino, Kenji Kondoh, Yoichiro Sugiyama, Yasuo Hisa
The oropharynx is examined with a light source such as an electric light, a penlight, or a forehead mirror based on an acquired visual field using a tongue depressor. However, it is extremely difficult to obtain objective and reproducible images of tissue within the pharynx required in recent years with these methods, and insufficient progress in the examination tools has been made. There is an increasing need to develop a method for display during oropharyngeal examination. We conducted the present study to develop a novel oropharyngeal endoscope as an objective observation method...
December 2018: Acta Medica Okayama
Yosuke Mitsui, Takuya Sadahira, Yuki Maruyama, Koichiro Wada, Ryuta Tanimoto, Morito Sugimoto, Motoo Araki, Masami Watanabe, Hiroyuki Yanai, Toyohiko Watanabe, Yasutomo Nasu
Metastatic prostate cancer (PCa) cases that cannot be detected on repeat prostate biopsy are extremely rare. Our patient was a 51-year-old Japanese man diagnosed as metastatic PCa by histopathological examination of lesions obtained bone biopsy and lymph node dissection. The primary tumor was not detected after repeated prostate biopsy. Metastatic PCa was diagnosed based on immunohistochemical staining: PSA, AR, P504S, and NKX3.1 of bone and lymph node with metastasis. We speculate that the primary PCa was "burned-out," demonstrating remote metastases with no apparent primary tumor in the prostate...
December 2018: Acta Medica Okayama
Kazuhiko Hashimoto, Shunji Nishimura, Shunki Iemura, Masao Akagi
Salmonella osteomyelitis is extremely rare; only a few cases have been reported in healthy adults. We describe a case of salmonella osteomyelitis in an otherwise healthy 20-year-old Japanese woman who presented with distal tibial pain. X-ray and magnetic resonance imaging showed a lesion suspected to be a bone cyst. Osteomyelitis was diagnosed when pus was observed during an open biopsy. The bacterial culture examination yielded salmonella. Surgical drainage and antibiotic treatment were performed, after which no recurrence was observed...
December 2018: Acta Medica Okayama
Yuusaku Sugihara, Keita Harada, Ryo Kato, Kenji Yamauchi, Hiroyuki Sakae, Seiji Kawano, Sakiko Hiraoka, Yoshiro Kawahara, Fumio Otsuka, Hiroyuki Okada
The indications for peroral endoscopic myotomy (POEM) have been expanded to include diffuse esophageal spasm (DES). A 67-year-old Japanese man presented with a 4-year history of dysphagia. Endoscopy and upper gastrography revealed abnormal peristaltic movements involving interruption of normal peristalsis, and a diverticulum located at the 2 o'clock esophageal position. High-resolution manometry indicated DES. POEM with a long (15 cm) myotomy was performed for the abnormal contractions, which subsequently disappeared along with dysphagia improvement...
December 2018: Acta Medica Okayama
Yuichiro Shimoyama, Osamu Umegaki, Satsuki Inoue, Tomoyuki Agui, Noriko Kadono, Toshiaki Minami
A neutrophil-to-lymphocyte ratio (NLR) > 7 is reportedly an independent marker of mortality in patients with bacteremia. However, no studies have shown an association between inflammation-based prognostic scores (including the Glasgow Prognostic Score, the NLR, the platelet-to-lymphocyte ratio, the Prognostic Nutritional Index, and the Prognostic Index) and mortality in patients with pneumonia. We retrospectively examined the cases of 33 patients diagnosed with pneumonia who were treated in the ICU of Osaka Medical College Hospital between January 2014 and June 2016...
December 2018: Acta Medica Okayama
Se-Jin Park, Hwa-Jae Jeong, Hun-Kyu Shin, Jai Hyung Park, Jaewook Lee, Yongun Cho, Seok Won Lee, Tsuyoshi Murase, Sumika Ikemoto, Kazuomi Sugamoto, Eugene Kim
We retrospectively evaluated the altered biomechanics of the talus in 15 adult patients (7 males, 8 females) with chronic lateral ankle instability when the ankle joint moved actively from full dorsiflexion to full plantarflexion under a non-weight bearing condition. CT images were taken for the unstable ankle and the contralateral normal (control) ankle. Three-dimensional surface models of both ankle joints were reconstructed from the CT data, and we used a computer simulation program to compare both ankle motions of inversion/eversion in the coronal plane, plantarflexion/dorsiflexion in the sagittal plane, and internal rotation/external rotation in the axial plane...
December 2018: Acta Medica Okayama
Takuma Makino, Yorihisa Orita, Tomoyasu Tachibana, Hidenori Marunaka, Kentaro Miki, Naoki Akisada, Yusuke Akagi, Yoshiyuki Usui, Yasuharu Sato, Tadashi Yoshino, Kazunori Nishizaki
Since no diagnostic method has been established to distinguish follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA), surgery has been the only way to reach a diagnosis of follicular neoplasm. Here we investigated the computed tomography (CT) features of follicular neoplasms, toward the goal of being able to identify specific CT features allowing the preoperative differentiation of FTC from FTA. We retrospectively analyzed the cases of 205 patients who underwent preoperative CT of the neck and were histopathologically diagnosed with FTC (n=31) or FTA (n=174) after surgery between January 2002 and June 2016 at several hospitals in Japan...
December 2018: Acta Medica Okayama
Takahito Yagi, Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Toshiyoshi Fujiwara
Living donor liver transplantation (LDLT) is the final therapeutic arm for pediatric end-stage liver diseases. Toward the goal of achieving further improvement in LDLT survival, we investigated factors affecting recipient survival. We evaluated the prognostic factors of 60 pediatric recipients (< 16 years old) who underwent LDLT between 1997 and 2015. In a univariate analysis, non-cholestatic (NCS) disease, graft/recipient body weight ratio, cold and warm ischemic times, and intraoperative blood loss were significant factors impacting survival...
December 2018: Acta Medica Okayama
Yoshimi Katayama, Masuo Senda, Daisuke Kaneda, Toshifumi Ozaki
We studied phrenic nerve conduction times in 90 phrenic nerves of 45 normal subjects. The phrenic nerve was stimulated at the posterior border of the sternomastoid muscle in the supraclavicular fossa, just above the clavicle, with bipolar surface electrodes. For recording, positive and negative electrodes were placed on the xiphoid process and at the eighth intercostal bone-cartilage transition, respectively. We studied both the right and left sides to determine whether there was any difference between the two sides...
December 2018: Acta Medica Okayama
Daisuke Omura, Asuka Sato, Kosuke Oka, Yoshihisa Hanayama, Hiroko Ogawa, Mikako Obika, Fumio Otsuka
To clarify potential relationships between chief complaints of patients and laboratory data with a focus on aging-related changes, we retrospectively analyzed the data of 843 patients who visited a general medicine department for the first time. Their chief complaints were classified into 8 major symptoms: visceral pain, somatic pain, fever, cough, dizziness, fatigue, appetite loss, and edema. We compared the laboratory data obtained from the patients with complaints with the data of symptom-free (control) patients...
December 2018: Acta Medica Okayama
Akihisa Watanabe, Qana Ono, Tomohiko Nishigami, Takahiko Hirooka, Hirohisa Machida
Distinct anatomic variants of the scapula such as the critical shoulder angle (CSA) were found to be associated with rotator cuff tears (RCTs), but it is unclear whether the CSA is a risk factor in Japanese. Here we sought to determine whether the CSA is associated with RCTs in a Japanese population, and whether the CSA is a more useful parameter than the conventionally used parameters. Our RCT group and non-RCT group each consisted of 54 consecutive cases. We compared the groups' values of CSA, the acromion index (AI), and the lateral acromion angle (LAA) obtained by X-ray imaging...
December 2018: Acta Medica Okayama
Takao Hiraki, Tetsushi Kamegawa, Takayuki Matsuno, Toshiyuki Komaki, Jun Sakurai, Susumu Kanazawa
Since 2012, we have been developing a remote-controlled robotic system (Zerobot®) for needle insertion during computed tomography (CT)-guided interventional procedures, such as ablation, biopsy, and drainage. The system was designed via a collaboration between the medical and engineering departments at Okayama University, including various risk control features. It consists of a robot with 6 degrees of freedom that is manipulated using an operation interface to perform needle insertions under CT-guidance. The procedure includes robot positioning, needle targeting, and needle insertion...
December 2018: Acta Medica Okayama
Daisuke Sato, Tomohito Gohda, Masao Kihara, Yasuhiko Kanaguchi, Takashi Kobayashi, Satoshi Mano, Yu Sasaki, Nao Nohara, Maki Murakoshi, Junichiro Nakata, Hitoshi Suzuki, Seiji Ueda, Satoshi Horikoshi, Yusuke Suzuki
Some patients with chronic kidney disease (CKD) receiving hemodialysis develop erythropoietin-resistant anemia, possibly due to zinc deficiency. The frequency of zinc deficiency in CKD (stages 1-5 and 5D) and CKD improvement via zinc supplementation are not completely verified. Here 500 CKD patients (Stage 1/2, n=100; Stage 3, n=100; Stage 4, n=100, Stage n=5, 100; Stage 5D, n=100) will be recruited to determine the frequency of serum zinc deficiency at each CKD stage. Patients with serum zinc concentrations <80 μg/dL will be treated with zinc acetate dihydrate (NobelzinR) to evaluate its effects on hypozincemia, taste disturbances, and anemia...
October 2018: Acta Medica Okayama
Naoki Kondo, Junichi Fujisawa, Katsumitsu Arai, Rika Kakutani, Naoto Endo
A 60-year-old Japanese woman with severe osteoporosis presented with a history of right buttock pain and right lateral lower leg pain in an L5 distribution. She had been treated with methotrexate and methylprednisolone for rheumatoid arthritis (RA) and interstitial pneumonia. Computed tomography demonstrated a sacral stress fracture in the right sacral ala. The right L5 nerve root was compressed by the fracture site. This case is rare in that L5 radiculopathy was complicated by a sacral stress fracture. Clinicians should suspect sacral stress fractures when RA or osteoporosis is present in women who experiences lumbar pain and lumbar radiculopathy...
October 2018: Acta Medica Okayama
Rika Kakutani, Naoki Kondo, Tomoharu Mochizuki, Junichi Fujisawa, Naoto Endo
The bilateral shoulder pain of an 81-year-old Japanese woman due to falls persisted despite celecoxib treatment, and plain X-rays later showed bilateral collapsed humeral heads. After ruling out osteoarthritis, infectious arthritis, crystal-induced arthritis, neuropathic arthropathy, and osteonecrosis, we diagnosed bilateral shoulder joint rapidly destructive arthrosis (RDA). Lumbar bone mineral density showed very low T-score (-4.1). Primary osteoporosis was observed. Histology of biopsied humeral head indicated the features of fracture healing process: callus formation and osteoclasts without empty lacunae...
October 2018: Acta Medica Okayama
Hiroyuki Miyahara, Hironobu Tokumasu, Masaki Chin, Kenji Waki, Yoshio Arakaki
Cases of recurrent meningitis in elderly patients with a spontaneous cerebrospinal fistula have been reported, and in some of these patients, cystic lesions were thought to be the underlying cause. We report a case of recurrent meningitis in an 11-year-old Japanese girl with an arachnoid cyst in the petrous apex. Pulsation of the cystic lesion was thought to cause bone erosion, leading to the formation of a fistula. Magnetic resonance imaging was useful in evaluating the arachnoid cyst and fistula. During 2 years of follow-up, the osteolytic lesion enlarged and the rate of bone erosion was higher than expected...
October 2018: Acta Medica Okayama
Kiichiro Kanamitsu, Kousuke Chayama, Kana Washio, Ryuichi Yoshida, Yuzo Umeda, Takahito Yagi, Akira Shimada
Hepatitis-associated aplastic anemia (HAAA) is an acquired bone marrow failure syndrome that develops after seronegative fulminant hepatitis. Abnormal cytotoxic T-cell activation with cytokine release is a possible pathophysiology. We present the case of a 16-month-old Japanese male who developed HAAA following living-donor liver transplantation for fulminant hepatitis. His aplastic anemia was successfully treated with immunosuppressive therapy. He had been administered tacrolimus for prophylaxis against hepatic allograft rejection...
October 2018: Acta Medica Okayama
Takeshi Ogata, Kuniaki Katsui, Kotaro Yoshio, Hiroki Ihara, Norihisa Katayama, Junichi Soh, Masahiro Kuroda, Katsuyuki Kiura, Yoshinobu Maeda, Shinichi Toyooka, Susumu Kanazawa
To clarify the relationship between dose-volume histogram (DVH) parameters and radiation pneumonitis (RP) after surgery in cases of non-small cell lung cancer (NSCLC) treated with induction concurrent chemoradiotherapy (CCRT). Patients with NSCLC treated with induction CCRT (chemotherapy: cisplatin and docetaxel; radiotherapy: 2.0 Gy fractions once daily for a total of 46 Gy) before surgery were reviewed. We calculated the percentage of lung volume receiving at least 20 Gy (V20) and the mean lung dose (MLD) for the total lung volume and the lung remaining after resection...
October 2018: Acta Medica Okayama
Yuya Kodama, Takayuki Furumatsu, Ami Maehara, Toshifumi Ozaki
Cell clusters, or groups of cells sharing a single chondron-like structure, are frequently found in degenerated areas of the osteoarthritic (OA) meniscus. However, little is known about these meniscal clusters in humans. The aim of our study was to determine the composition of the extracellular matrix deposition around cell clusters in human OA menisci. Twenty-six menisci were obtained through total knee arthroplasty from patients with OA knee joints. The specimens were subjected to safranin O staining and immunostaining for Sry-type HMG box 9 (SOX9), type II collagen, and aggrecan...
October 2018: Acta Medica Okayama
Yuki Okazaki, Takayuki Furumatsu, Shin Masuda, Shinichi Miyazawa, Yuya Kodama, Yusuke Kamatsuki, Tomohito Hino, Yoshiki Okazaki, Toshifumi Ozaki
Medial meniscus (MM) posterior root tear (PRT) results in joint overloading and degenerative changes in the knee. MM root repair is recommended to prevent subsequent cartilage degeneration following MMPRT. Favorable clinical outcomes have been reported after transtibial pullout repair of MMPRT. However, it is unclear whether pullout repair can cause compositional change in the MM posterior segment. We examined this question in 14 patients who underwent MMPRT pullout repair. Magnetic resonance imaging examinations were performed preoperatively and 3 months postoperatively at 10° knee flexion...
October 2018: Acta Medica Okayama
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