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Acta Medica Okayama

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Erratum to"The Incidence of Desaturation during Anesthesia in Adult and Pediatric Patients: A Retrospective Study", which appeared in the October 2018 issue, Vol.72,No.5, pp467-478.
February 2019: Acta Medica Okayama
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Erratum to "High-dose Dexamethasone Therapy as the Initial Treatment for Idiopathic Thrombocytopenic Purpura: Protocol for a Multicenter, Open-label, Single Arm Trial" Vol.72, No.2, pp197-201.
February 2019: Acta Medica Okayama
Yoshiyuki Abe, Kazutoshi Fujibayashi, Yuji Nishizaki, Naotake Yanagisawa, Shuko Nojiri, Soichiro Nakano, Kurisu Tada, Ken Yamaji, Naoto Tamura
Pneumocystis pneumonia (PCP) due to Pneumocystis jirovecii infection is the leading cause of fatal opportunistic infections in immunocompromised patients. We will determine whether a daily sulfamethoxazole-trimethoprim (SMX/TMP) dose of 200/40 mg was non-inferior to 400/80 mg for PCP prevention in patients with systemic rheumatic disease under immunosuppressive therapy. This is a randomized, open-label, multicenter controlled trial. The primary outcome is the rate of PCP prevention at 52 weeks. The secondary outcome is the discontinuation rate of SMX/TMP...
February 2019: Acta Medica Okayama
Yuusaku Sugihara, Keita Harada, Shohei Oka, Eriko Yasutomi, Yasushi Yamasaki, Toshihiro Inokuchi, Hideaki Kinugasa, Masahiro Takahara, Sakiko Hiraoka, Fumio Otsuka, Hiroyuki Okada
Endoscopic submucosal dissection (ESD) is reportedly one of the standard treatment strategies for large superficial colorectal neoplasms in Japan because of its high en bloc resection rate. A few technical issues regarding ESD should be considered, one of which is the selection of the Endo-cut I mode versus the Swift-coagulation mode as the electrosurgical unit mode setting during submucosal dissection. We seek to determine which of these two modes is more suitable for submucosal dissections of colorectal tumors with regard to procedure time and safety...
February 2019: Acta Medica Okayama
Mio Morita, Hiroshi Matsumoto, Yasuhiro Shirakawa, Kazuhiro Noma, Shunsuke Tanabe, Yoshihiro Kimata
Anterior cervical plate fixation is a common surgical treatment for cervical spine trauma, disc herniation, or cervical spondylosis. Esophageal perforation following anterior cervical plate fixation is a rare but serious complication. Management of esophageal perforation is controversial; however, we suggest treating most cases surgically because this condition is slow to heal and often fatal. We managed 2 cases of esophageal perforation following anterior cervical plate fixation by flap reconstruction with the pectoralis major muscle in one case and a jejunal free flap in the other...
February 2019: Acta Medica Okayama
Keiko Takahashi-Arimasa, Reiko Kohno-Yamanaka, Yoshihiko Soga, Rumi Miura, Manabu Morita
Preoperative oral care is helpful to prevent postoperative complications in patients who are undergoing esophagectomy. Here, we report the case of an 81-year-old Japanese man with an upper limb disability caused by post-polio syndrome who was receiving neoadjuvant chemotherapy for esophageal cancer. He had poor oral health status and developed oral complications as a side effect of chemotherapy. He could not brush his teeth by himself. However, infection control by oral care provided by an interprofessional collaboration successfully improved his oral hygiene, and his follow-up involved no severe complications...
February 2019: Acta Medica Okayama
Reika Kono, Takehiro Shimizu, Hiroshi Ohtsuki, Ichiro Hamasaki, Kiyo Shibata, Fumiko Kishimoto, Yuki Morizane, Fumio Shiraga
We report a case of congenital multiple ocular motor nerve palsy combined with splitting of the lateral rectus muscle (LR). A 59-year-old Japanese female was investigated for worsening esotropia after corrective surgery. She presented with left hypertropia (35Δ) and esotropia (45-50Δ). Orbital magnetic resonance imaging (MRI) showed reduced belly sizes in the superior rectus, inferior rectus, and superior oblique muscles and splitting of the LR, extending from the origin to the belly, in the left eye. Splitting of the LR belly was detected on MRI in a case of congenital multiple ocular motor nerve palsy...
February 2019: Acta Medica Okayama
Kosuke Tamefusa, Hisashi Ishida, Kana Washio, Toshiaki Ishida, Hirosuke Morita, Akira Shimada
Patients with multi-system (MS)-type langerhans cell histiocytosis (LCH) show poor outcomes, especially congenital MS LCH cases were shown in high mortality rate. We experienced a congenital case of MS LCH with high risk organs, who needed intensive respiratory support after birth. Even though intensive chemotherapy was discontinued, this patient's lung LCH lesions gradually became reduced and his respiratory condition recovered; therefore, we restarted and completed maintenance chemotherapy. The patient maintained complete remission for more than 4 years after the end of chemotherapy...
February 2019: Acta Medica Okayama
Masakuni Fujii, Kenji Fujimoto, Syuntaro Yabe, Junichiro Nasu, Jiro Miyaike, Masao Yoshioka, Junji Shiode, Kazuhide Yamamoto, Shinya Matsuda
 We investigated the relationship between body mass index (BMI) and postoperative outcomes in 450 gallbladder cancer patients in Japan. We collected patient information, including sex, age, underlying disease, BMI, stage, surgery method, postoperative time to discharge, and postoperative Medicare fees, from the Japanese administrative database associated with the Diagnosis Procedure Combination system. We classified patient BMIs as underweight (BMI<18.5 kg/m2), normal (BMI≥18.5 kg/m2 and <25 kg/m2) or overweight/obese (BMI≥25 kg/m2), then investigated the relationship between these categories and two postoperative outcomes: time to discharge and postoperative Medicare fees...
February 2019: Acta Medica Okayama
Ailee Ikeda, Akinobu Takaki, Tetsuya Yasunaka, Atsushi Oyama, Takuya Adachi, Nozomu Wada, Hideki Onishi, Fusao Ikeda, Hidenori Shiraha, Kazuhiro Yoshida, Takashi Kuise, Daisuke Nobuoka, Ryuichi Yoshida, Yuzo Umeda, Takahito Yagi, Toshiyoshi Fujiwara, Hiroyuki Okada
Post-orthotopic liver transplantation (OLT) hepatitis B recurrence is well-controlled with a nucleos(t)ide analogue and hepatitis B immunoglobulin (HBIG) combination, but the high cost and the potential risk of unknown infection associated with HBIG remain unresolved issues. Low-cost recombinant hepatitis B virus (HBV) vaccine administration is a potential solution to these problems. We retrospectively analyzed the rate and predictive factors of HBV vaccine success in 49 post-OLT patients: liver cirrhosis-type B (LC-B), n=28 patients; acute liver failure-type B (ALF-B), n=8; and non-HBV-related end-stage liver disease (non-B ESLD) who received a liver from anti-hepatitis B core antibody-positive donors, n=13...
February 2019: Acta Medica Okayama
Atsushi Matsumoto, Takehiro Nakamura, Aya Shinomiya, Kenya Kawakita, Masahiko Kawanishi, Keisuke Miyake, Yasuhiro Kuroda, Richard F Keep, Takashi Tamiya
Cerebral vasospasm (CVS) is a major contributor to the high morbidity and mortality of aneurysmal subarachnoid hemorrhage (aSAH) patients. We measured histidine-rich glycoprotein (HRG), a new biomarker of aSAH, in cerebrospinal fluid (CSF) to investigate whether HRG might be an early predictor of CVS. A total of seven controls and 14 aSAH patients (8 males, 6 females aged 53.4±15.4 years) were enrolled, and serial CSF and serum samples were taken. We allocated these samples to three phases (T1-T3) and measured HRG, interleukin (IL)-6, fibrinopeptide A (FpA), and 8-hydroxy-2'-deoxyguanosine (8OHdG) in the CSF, and the HRG in serum...
February 2019: Acta Medica Okayama
Yuko Oiwa, Toyohiko Watanabe, Takuya Sadahira, Ayano Ishii, Tomoko Sako, Miyabi Inoue, Koichiro Wada, Yasuyuki Kobayashi, Motoo Araki, Yasutomo Nasu
We measured basal clitoral blood flow by Doppler sonography to determine whether tension-free vaginal mesh(TVM) affects the clitoral blood flow and sexual function in women with pelvic organ prolapse (POP). We performed a prospective study of 22 patients who underwent TVM for POP. Clitoral blood flow was measured by Doppler ultrasound. The resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end-diastolic velocity (EDV) of the clitoral arteries were measured preoperatively and at 1, 3, and 6 months postoperatively...
February 2019: Acta Medica Okayama
Naohiro Shioji, Tomoyuki Kanazawa, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tomohiko Suemori, Yasutoshi Kuroe, Hiroshi Morimatsu
We compared the reintubation rate in children who received high-flow nasal cannula (HFNC) therapy to the rate in children who received noninvasive ventilation (NIV) therapy for acute respiratory failure (ARF) after cardiac surgery. This was a retrospective analysis of 35 children who received HFNC therapy for ARF after cardiac surgery in 2014-2015 (the HFNC group). We selected 35 children who had received NIV therapy for ARF after cardiac surgery in 2009-2012 as a control group. The matching parameters were body weight and risk adjustment for congenital heart surgery category 1...
February 2019: Acta Medica Okayama
Norio Fukumori, Motoki Sonohata, Masaru Kitajima, Shunsuke Kawano, Tsuyoshi Kurata, Yuta Sakanishi, Takashi Sugioka, Masaaki Mawatari
We evaluated the analgesic effects of multimodal pain control in which intravenous acetaminophen (IV APAP) was added to the standard protocol for Japanese patients who had undergone a total hip arthroplasty (THA). We performed a retrospective cohort study of 180 patients aged 66.4±10.5 years (30% male) who had undergone a THA (Oct. 2014 to Feb. 2015) at our hospital. The control patients were administered the standard analgesic protocol: flurbiprofen axetil as a continuous intravenous infusion and oral celecoxib (NAPAP; n=109)...
February 2019: Acta Medica Okayama
Shin Morizane
Excessive protease activity is a characteristic abnormality that affects the epidermal barrier in patients with atopic dermatitis (AD). Kallikrein-related peptidases (KLKs) are excessively expressed in AD lesions, and it is suggested that the abnormal action of KLKs is involved in the skin barrier dysfunction in AD. In other words, overexpressed KLKs disrupt the normal barrier function, and due to that breakdown, external substances that can become antigens of AD easily invade the epidermis, resulting in dermatitis, coupled with the induction of Th2 cytokines...
February 2019: 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
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