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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
Ichiro Hamasaki, Kiyo Shibata, Takehiro Shimizu, Shin Morisawa, Shinji Toshima, Manabu Miyata, Takashi Furuse, Satoshi Hasebe, Hiroshi Ohtsuki, Yuki Morizane, Fumio Shiraga
We investigated variances in the stability and amount of postoperative exodrift among age groups of intermittent exotropia (XPT) patients who underwent unilateral lateral rectus muscle recession and medial rectus muscle resection. We analyzed the cases of 110 consecutive patients who underwent the surgery in 2004-2011, dividing the patients into groups by their age at surgery: <10, 10-19, and ≥20 years. We performed a regression analysis (dependent variable: postoperative exodrift (°); independent variable: number of days post-surgery) using the formula of curve lines...
October 2018: Acta Medica Okayama
Ken-Ichi Tanaka, Takao Yagi, Takeshi Nanba, Masato Asanuma
We tried to clarify the applicability of a single prolonged stress (SPS) protocol as post-traumatic stress disorder (PTSD) model in mice. To investigate PTSD pathophysiology, we conducted hypothalamo-pituitary-adrenal (HPA) negative feedback testing at 1, 4, 8 and 12 weeks after the SPS by administrating a dexamethasone (DEX) suppression test. The SPS induced over-suppression of the HPA system by DEX treatment at 8 and 12 weeks. To investigate PTSD-like behavioral characteristics, we subjected mice to testing in a light/dark box (to assess anxiety), a Y-maze (working memory), a cliff avoidance (visual cognition), and an open field (locomotor activity) at 1, 4, 8 and 12 weeks after the SPS...
October 2018: Acta Medica Okayama
Vika Fatafehi Hala'ufia Lemoto, Kentaro Sugimoto, Tomoyuki Kanazawa, Takashi Matsuzaki, Hiroshi Morimatsu
We investigated the incidence of desaturation during general anesthesia in preoperatively hypoxic (< 92%), and nonhypoxic (≥ 92%) pediatric (n=1,090) and adult (n=5,138) patients. We plotted the patients' SpO2 value time-courses and assessed desaturation in 6,228 patients. The crude overall incidence (95%CI) for desaturation was 11.1% (9.4-13.1) in the pediatric patients and 0.9% (0.6-1.2) in the adults. The crude incidence of desaturation in the hypoxic pediatric patients was 2.5 times the risk in the nonhypoxic patients: risk ratio (RR) 2...
October 2018: Acta Medica Okayama
Noriko Muto, Yoshikazu Matsuoka, Kyosuke Arakawa, Masako Kurita, Hiroki Omiya, Arata Taniguchi, Ryuji Kaku, Hiroshi Morimatsu
Quercetin is a flavonoid widely found in plants and marketed to the public as a supplement. Several studies have reported its effect on glial cells. This study aimed to examine the effect of quercetin on the development of neuropathic pain and the underlying mechanism in a spared nerve injury (SNI) rat model. Male Sprague-Dawley rats randomly assigned to the control or the quercetin group were subjected to SNI of the sciatic nerve. We measured pain behaviors on the hind paw and glial fibrillary acidic protein (GFAP) in the dorsal root ganglion (DRG) and spinal cord...
October 2018: Acta Medica Okayama
Kosuke Oka, Yoshihisa Hanayama, Asuka Sato, Daisuke Omura, Miho Yasuda, Ko Hasegawa, Mikako Obika, Fumio Otsuka
We retrospectively analyzed the cases of 148 febrile patients whose body temperature (BT) was ≥ 37.5°C at our hospital. We categorized them into seven groups; those with bacterial and viral infection, nonspecific inflammation, neoplasm, connective tissue disease (CTD), drug-induced disease, and unidentified causes. Our analysis revealed that the patient's BT at the 1st visit (BT-1st visit) and highest BT during the febrile period (BT-max) differed significantly among all categories except neoplasm. The greatest difference between BT-1st visit and BT-max was highest in the CTD group (1...
October 2018: Acta Medica Okayama
Daihei Kida, Hiroya Hashimoto, Akiko M Saito, Yukari Kito, Kouichi Mori, Kenya Terabe, Nobunori Takahashi, Yasushi Tomita
There is no assistive device for extramedullary surgery coordinated with 3D surgical assistive software for the total knee arthroplasty (TKA). We developed a novel extramedullary universal guide coordinated with 3D surgical assistive software and a novel extramedullary patient-specific assistive guide for the placement of femoral components by referring to an area not affected by cartilage or bone spurs, and filed a patent application. In this study, we visualize and reconstruct the total alignment of the lower extremity in TKA using these surgical devices, and validate their precision...
August 2018: Acta Medica Okayama
Yuhki Koga, Shingo Baba, Reiji Fukano, Katsumasa Nakamura, Toshinori Soejima, Naoko Maeda, Shosuke Sunami, Junichi Ueyama, Tetsuo Mitsui, Takeshi Mori, Tomoo Osumi, Masahiro Sekimizu, Kentaro Ohki, Fumiko Tanaka, Michi Kamei, Naoto Fujita, Tetsuya Mori, Akiko M Saito, Akiko Kada, Ryoji Kobayashi
This trial enrolls patients with untreated Hodgkin's lymphoma aged<20 years at diagnosis and examines the effects of omitting radiation therapy if the FDG-positron emission tomography (PET) findings after two completed cycles of combination chemotherapy are negative. It thereby aims to determine whether patients who truly require radiation therapy can be identified by FDG-PET. If so, this modality could be used to omit radiation therapy for all other patients, decreasing the risk of serious long-term complications without affecting survival rates...
August 2018: Acta Medica Okayama
Masahiro Sekimizu, Tomoo Osumi, Reiji Fukano, Yuhki Koga, Akiko Kada, Akiko M Saito, Tetsuya Mori
Crizotinib is an inhibitor of multiple tyrosine kinases, including the anaplastic lymphoma kinase (ALK). Responses to crizotinib have also been reported in patients with ALK-positive anaplastic large-cell lymphoma (ALCL) and solid tumors with ALK-mutation, including neuroblastoma. Optimal treatment for patients with recurrent or refractory ALK-positive ALCL and neuroblastoma has not been established. There is a need to develop new drugs for these patients. The objectives of this trial are to evaluate the tolerability and safety of crizotinib in Japanese patients with recurrent/refractory ALK-positive ALCL or neuroblastoma (phase I) and its efficacy in recurrent/refractory ALK-positive ALCL (phase II)...
August 2018: Acta Medica Okayama
Masahiro Sekimizu, Junichiro Fujimoto, Tetsuya Takimoto, Masahito Tsurusawa, Keizo Horibe, Shosuke Sunami
Pediatric patients with lymphoblastic lymphoma are generally treated using the Berlin-Frankfurt-Munster (BFM) 90 protocol, which is the standard treatment strategy for pediatric acute lymphoblastic leukemia, and have a favorable outcome. However, this intense regimen includes high total doses of anthracycline and alkylating agents, and is known to cause late complications. We therefore planned a clinical trial to examine the efficacy and safety of a modified BFM regimen. We expect that this phase II, nationwide multicenter trial will help to establish an effective and safer standard therapy for stage I/II pediatric lymphoblastic lymphoma...
August 2018: Acta Medica Okayama
Kourin Sakakida, Fan-Yan Wei, Takafumi Senokuchi, Seiya Shimoda, Tatsuyuki Kakuma, Eiichi Araki, Kazuhito Tomizawa
Genetic variation in Cdk5 Regulatory Associated Protein 1-Like 1 (CDKAL1) is associated with the development of type 2 diabetes (T2D). Dysfunction of CDKAL1 impairs the translation of proinsulin, which leads to glucose intolerance. Eperisone, an antispasmodic agent, has been shown to ameliorate glucose intolerance in Cdkal1-deficient mice. We have launched a phase II clinical study to investigate the potential anti-diabetic effect of eperisone in T2D patients carrying risk or non-risk alleles of CDKAL1. The primary endpoint is the change of hemoglobin A1c (HbA1c) levels...
August 2018: Acta Medica Okayama
Susumu Miyake, Makio Sugita, Tomio Okazaki, Mieko Takenaka, Kentarou Kuwabara, Kazunori Ogawa
A 22-year-old Japanese male with trisomy 21 was diagnosed with West syndrome at 4 months old. After the suppression of epileptic spasms using adrenocorticotropic hormone therapy, he had complex partial seizures and bilateral frontal epileptic discharges on EEG. Although the introduction of topiramate (TPM) decreased the seizures during wakefulness, frequent episodes of brief eye-opening appeared during sleep while the patient was taking TPM (400 mg/day). EEG showed fast activity at the times of eye-opening...
August 2018: Acta Medica Okayama
Chanyul Jung, Suhun Jung, Min Ho Chun, Jong Min Lee, Shinsuk Park, Seung-Jong Kim
Gait rehabilitation training with robotic exoskeleton is drawing attention as a method for more advanced gait rehabilitation training. However, most of the rehabilitation robots are mainly focused on locomotion training in the sagittal plane. This study introduces a novel gait rehabilitation system with actuated pelvic motion to generate natural gait motion. The rehabilitation robot developed in this study, COWALK, is a lower-body exoskeleton system with 15 degrees of freedom (DoFs). The COWALK can generate multi-DoF pelvic movement along with leg movements...
August 2018: Acta Medica Okayama
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