Yonago acta medica最新文献

{"title":"Allogeneic Hematopoietic Stem Cell Transplantation for Older Patients with Hematological Malignancies.","authors":"Koji Kawamura","doi":"10.33160/yam.2025.08.001","DOIUrl":"10.33160/yam.2025.08.001","url":null,"abstract":"<p><p>Allogeneic hematopoietic stem cell transplantation (allo-HCT) has been established as a curative treatment for hematological malignancies such as acute myeloid leukemia and myelodysplastic syndrome. Patients aged ≥ 70 years have traditionally been considered ineligible for this procedure, because of concerns over high transplant-related mortality rates and difficulties managing post-transplant complications. However, recent advances in supportive care, expanded donor availability, and the development of reduced-intensity conditioning (RIC) regimens have increased the availability of allo-HCT for older patients. Notably, the number of allo-HCT procedures performed in patients aged ≥ 70 has been steadily increasing in Japan and Western countries, reflecting a re-evaluation of transplant eligibility in older patients. When assessing transplant eligibility in older patients, it is crucial to consider not only disease risk stratification and treatment response, but also comprehensive evaluations of general health status, comorbidities, cognitive function, and social backgrounds. In particular, indexes such as the Hematopoietic Cell Transplantation-Comorbidity Index and Comprehensive Geriatric Assessment have proven useful for predicting patient prognoses and non-relapse mortality. Donor selection and the intensity of the conditioning regimen used can both significantly influence transplant outcomes. RIC or non-myeloablative regimens are generally recommended for patients aged ≥ 70 years. Human leukocyte antigen-matched related or younger unrelated donors are preferred, while haploidentical donors or cord blood may be considered when matched donors are unavailable, although evidence in older patients is limited. This review provides a comprehensive overview of the current status of and challenges related to allo-HCT in patients aged ≥ 70 years. Patient eligibility, conditioning strategies, donor selection, and transplant outcomes are discussed in detail, based on the latest available evidence.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"68 3","pages":"169-179"},"PeriodicalIF":0.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localized Nodular Amyloidosis of the Buccal Mucosa Associated with Sjögren's Syndrome: A Case Report and Literature Review.","authors":"Rieko Doi, Kiharu Shimizu, Nobuyuki Fujii, Kosuke Sakai, Makoto Kawasaki, Takayuki Tamura, Isamu Kodani","doi":"10.33160/yam.2025.08.009","DOIUrl":"10.33160/yam.2025.08.009","url":null,"abstract":"<p><p>Amyloidosis is a group of disorders in which specific precursor proteins form insoluble amyloid fibrils are deposited in various organs and extracellular spaces. Sjögren's syndrome (SS) is a chronic inflammatory disease in which lymphocytes infiltrate the exocrine glands, such as the salivary and lacrimal glands, through an autoimmune mechanism. At advanced stages of SS, localized nodular amyloidosis has been reported in specific organs outside the glands. Herein, we report a case of localized nodular amyloidosis associated with SS. An 80-year-old woman, who had been biting her buccal mucosa for several years and was aware of the presence of a mass, which had increased in size since approximately 6 months, was referred to our hospital. The patient had a history of SS and systemic lupus erythematosus since her 50s. A needle biopsy was performed because malignancy was suspected by magnetic resonance imaging. The pathological diagnosis was ATTR-type amyloidosis. The patient underwent excision of the lesion to improve the swelling. The pathological findings showed plasma cell infiltration in some areas, which required differentiation from AL amyloidosis; therefore, the patient was referred to a facility specializing in amyloidosis. The pathological diagnosis was AL amyloidosis. Various clinical findings ruled out systemic involvement and the final pathological diagnosis was localized nodular amyloidosis. It has been reported that it may occur in the advanced stages of SS, and our patient had SS for 30 years. One year after the surgery, the patient's prognosis was good.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"68 3","pages":"289-296"},"PeriodicalIF":0.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidural Anesthesia Is Effective in Lower-Extremity Burn Pain Treatment: A Case Report.","authors":"Yusuke Minamigawa, Hiroshi Ichibakase, Tomofumi Ogoshi, Takahiro Ueda","doi":"10.33160/yam.2025.08.007","DOIUrl":"10.33160/yam.2025.08.007","url":null,"abstract":"<p><p>Burn wounds cause pain through various mechanisms, making pain management challenging. Although treatment and management strategies for healing burns have been developed, clear guidelines for analgesia in burn injuries are lacking. Opioids are commonly used for pain relief, but regional anesthesia performed by anesthesiologists has shown effectiveness in some cases. We encountered a case in which epidural anesthesia was effective for analgesia of a lower-extremity burn injury in a 19-year-old man. The patient with burn injuries to his lower extremities was transferred to the emergency department. On the day of the injury, an epidural catheter was administered for burn pain. The epidural anesthesia was removed during hospitalization, but the pain worsened, so it was placed again to provide adequate analgesia. In this case, epidural anesthesia proved effective for managing the lower-extremity burn pain and facilitated patient rehabilitation. Epidural anesthesia should be actively considered for the management of burn pain.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"68 3","pages":"280-283"},"PeriodicalIF":0.6,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Promotion and Digital Tools: Analysis of Consumer Demands.","authors":"Minoru Kouzuki","doi":"10.33160/yam.2025.08.003","DOIUrl":"10.33160/yam.2025.08.003","url":null,"abstract":"<p><strong>Background: </strong>A survey was conducted to determine the demand for the use of digital health content for health promotion, both among those interested in using digital tools and those interested in health promotion.</p><p><strong>Methods: </strong>This study targeted smartphone owners who attended a class on how to use a smartphone (CS) and/or a class on advancements in health (CH) held in Nanbu Town. The main questionnaire items included questions on age, gender, frailty, subjective cognitive decline (SCD), smartphone usage, and interest in health promotion using digital technology. An analysis was conducted on 33 participants in the CS and 33 participants from the CH who provided complete responses to the questionnaire.</p><p><strong>Results: </strong>The percentages of interest in using smartphones for accessing content on exercise, cognitive training, and nutrition management were 97.0%, 97.0%, and 87.9%, respectively, among CS participants and 69.7%, 78.8%, and 81.8%, respectively, among CH participants. The percentage of responses regarding interest in exercise content was significantly different between the two groups. Furthermore, some individuals responded that they were interested but concerned about how to use the services. No statistically significant differences were found with respect to the comparison of the percentages of responses by age group, frailty determination results, and SCD determination results among the participants of the CS and CR groups.</p><p><strong>Conclusion: </strong>Regardless of age or the risk of developing health problems, there is demand for content related to health promotion using digital tools for those who want to master digital tools and who want to improve their health. However, support should be provided to them to ensure that they correctly use those tools. Notably, some individuals who want to improve their health are not interested in using digital tools.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"68 3","pages":"187-196"},"PeriodicalIF":0.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Gabapentin for Paroxysmal Sympathetic Hyperactivity in Three Children with Severe Motor and Intellectual Disability due to Neonatal Hypoxic Ischemic Encephalopathy.","authors":"Go Yoshino, Tohru Okanishi, Hiroyuki Yamada, Tatsuya Kawaguchi, Masahiro Umeda, Yuto Arai, Yoshihiro Maegaki","doi":"10.33160/yam.2025.08.006","DOIUrl":"10.33160/yam.2025.08.006","url":null,"abstract":"<p><p>Paroxysmal sympathetic hyperactivity (PSH) is a clinical syndrome characterized by recurrent episodes of sympathetic overactivity, including hypertonia, tachycardia, hypertension, and hyperthermia, typically following severe brain injury. While PSH is well documented in adult populations, reports on pediatric patients, particularly those with severe motor and intellectual disabilities (SMID), remain limited. Here, we report three pediatric patients with SMID due to neonatal hypoxic-ischemic encephalopathy (NHIE) who developed PSH. All patients presented with characteristic PSH symptoms and were diagnosed according to the Pediatric Clinical Practice Guidelines based on the 2014 consensus criteria. Gabapentin (GBP) was initiated at low doses (5-10 mg/kg/day) in all patients, resulting in the rapid resolution of PSH symptoms. In two patients, symptoms partially recurred within several months but were controlled through GBP dose adjustment and the addition of clonidine or other agents. No severe adverse events were observed. To our knowledge, this is the first report describing the short-term efficacy of GBP in pediatric patients who developed PSH with SMID status due to NHIE. Our findings suggest that GBP is a valuable and well-tolerated therapeutic option for the management of PSH in children with these conditions.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"68 3","pages":"275-279"},"PeriodicalIF":0.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Factors Related to Social Exclusion of Hikikomori (Prolonged Social Withdrawal) Individuals by Local Residents.","authors":"Shinya Takeda, Maki Ota, Yuki Fujii, Kosuke Fujiyoshi, Jin Hiroe, Sumire Hiroe, Mae Hirosawa, Mitsue Kawakami, Rie Kikumoto, Yuri Maezawa, Kazuyoshi Morimoto, Yohei Nagami, Chisato Takashima, Hideyuki Tazumi, Mari Yamamoto, Reeya Komoda","doi":"10.33160/yam.2025.05.011","DOIUrl":"10.33160/yam.2025.05.011","url":null,"abstract":"<p><strong>Background: </strong>The number of hikikomori individuals has been increasing not only in Japan but also worldwide while few studies have looked into the societal elements that could lead to further isolation of hikikomori individuals. This study examines the psychological factors in local residents related to social exclusion of hikikomori individuals.</p><p><strong>Methods: </strong>365 participants living in Tottori, Japan were analyzed. The questionnaire includes key questions such as social exclusion of hikikomori individuals, daily lifestyle, personal opinions and attitudes towards hikikomori individuals.</p><p><strong>Results: </strong>Those who are unwilling to interact with people who have different sense of values were 3.6 times likely to exclude hikikomori individuals than those who did not. Those who believe that hikikomori is a family issue so that others should not intervene were 2.2 times likely to exclude them than those who did not. Conversely, those who think that people can make a fresh start in the society even after making mistakes were 0.5 times likely to exclude hikikomori than those who did not. Those who feel that they have something in common with hikikomori individuals were 0.4 times likely to exclude them than those who did not. Those who think that they can enjoy activities such as hobbies together with hikikomori individuals were 0.3 times likely to exclude them than those who did not.</p><p><strong>Conclusion: </strong>The analysis indicates that the tendency to reject relationships with people who have different sense of values and the opinion that hikikomori is a family issue are the risk factors for social exclusion of hikikomori individuals. Contrarily, the opinion that even if we make a mistake or fail, we can make a fresh start, awareness of the similarities between oneself and hikikomori individuals, and willingness to share enjoyable activities with them are shown to be the protective factors which could reduce social exclusion of hikikomori.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"68 2","pages":"144-151"},"PeriodicalIF":0.9,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Wnt/β-Catenin Inhibitor HC-1 Suppresses Liver Fibrosis by Inhibiting Activated Hepatic Stellate Cells and Inducing Matrix Metalloproteinase-1.","authors":"Daiki Hatakeyama, Noriko Itaba, Hiroki Shimizu, Minoru Morimoto, Goshi Shiota","doi":"10.33160/yam.2025.05.009","DOIUrl":"10.33160/yam.2025.05.009","url":null,"abstract":"<p><strong>Background: </strong>Liver fibrosis is characterized by the excessive accumulation of extracellular matrix (ECM) and is a risk factor for liver cancer. This study investigated the anti-fibrotic effect of the Wnt/β-catenin signalling inhibitor HC-1 in human hepatic stellate cells and a mouse liver fibrosis model.</p><p><strong>Methods: </strong>The effects of HC-1 on Wnt/β-catenin and transforming growth factor (TGF)-β/Smad signalings were examined by a reporter assay. The effects of HC-1 on the mRNA expression of fibrogenesis- and fibrolysis-related genes were analysed after 24 and 48 h of exposure of HC-1. In the animal study, 30 male C57/BL6 mice treated with CCl₄ for 4 weeks were divided into three groups, namely vehicle, 8.7 mg/kg HC-1 and 17.4 mg/kg HC-1, respectively. Mice in the vehicle group underwent continued treatment with CCl₄, whereas those in the HC-1 groups were treated with both CCl₄ and HC-1 for another 4 weeks. The livers of mice were examined by histological and biochemical analyses.</p><p><strong>Results: </strong>HC-1 decreased Wnt/β-catenin and TGF-β/Smad signallings. HC-1 potently reduced the mRNA expression of α-smooth muscle actin, collagen 1A1, TGF-β and lysyl oxidase. Conversely, HC-1 increased matrix metalloproteinase-1 expression in a concentration-dependent manner. In the animal model, HC-1 treatment significantly suppressed liver fibrosis in association with the inhibition of activated hepatic stellate cells. Although the Mmp-13, the murine functional homologue of MMP-1, was not increased, collagenase activity was increased in 8.7 mg/kg HC-1 group.</p><p><strong>Conclusion: </strong>HC-1 exerts potent anti-fibrotic effects on liver fibrosis.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"68 2","pages":"131-143"},"PeriodicalIF":0.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Promyelocytic Leukemia Diagnosed Due to Pericoronitis: A Case Report.","authors":"Yu Yoshida, Makoto Kawasaki, Takayuki Shingu, Isamu Kodani","doi":"10.33160/yam.2025.05.010","DOIUrl":"10.33160/yam.2025.05.010","url":null,"abstract":"<p><p>Herein, we report the case of a 60-year-old female patient diagnosed with acute promyelocytic leukemia (APL) following pericoronitis. The patient was referred to our department for the extraction of a wisdom tooth. On initial examination, tissue swelling and necrosis were observed in the gingiva around the right mandibular wisdom tooth. After 1 week of no improvement, purpura were observed on the patient's forearms and lower legs, signifying the presence of a blood disorder. Following the detection of pancytopenia, the patient was referred to the Department of Hematology and Oncology. Bone marrow aspiration confirmed the diagnosis of APL. Chemotherapy with all-trans retinoic acid was started immediately, and the patient is currently in complete molecular remission. The mandibular wisdom tooth was extracted after complete molecular remission and the patient is doing well.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"68 2","pages":"165-168"},"PeriodicalIF":0.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic Dysfunction in a Child Who Experienced Drowning Following COVID-19 Infection: A Patient Report.","authors":"Masahiro Umeda, Tohru Okanishi, Kentaro Okada, Yuto Arai, Kento Ohta, Yoshihiro Maegaki","doi":"10.33160/yam.2025.05.006","DOIUrl":"10.33160/yam.2025.05.006","url":null,"abstract":"<p><p>Coronavirus disease 2019 (COVID-19) is a significant risk factor for autonomic dysfunction, with approximately 20% of COVID-19-infected children suffering from post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC). The autonomic nervous system regulates functions like blood pressure and heart rate, and the disruption of the system can lead to issues such as postural orthostatic tachycardia syndrome (POTS) and orthostatic dysregulation (OD). Individuals with autonomic dysfunction may have a heightened risk of sudden death during diving activities. We report the case of a patient who drowned after diving in a bathtub following COVID-19 infection. The patient exhibited findings consistent with POTS during the head-up tilt test (HUTT), suggesting the influence of autonomic dysregulation. A healthy 9-year-old boy had a mild COVID-19 infection. He recovered but experienced difficulty getting out of bed. Nevertheless, his daily activities remained largely unaffected. On the 11th day post-infection, he lost consciousness while diving in a bathtub and was quickly rescued by his father. Initial assessments revealed mild aspiration pneumonia and OD. On day 20, a HUTT revealed tachycardia, confirming POTS. Bathing alone was prohibited, and a reevaluation three months later indicated subjective symptom improvement, with no evidence of POTS during HUTT. This case highlights the potential association between mild autonomic dysfunction post-COVID-19 and increased drowning risk during cardiovascular-intensive activities like diving. Even when subjective symptoms are minimal, using tests such as HUTT to assess potential underlying autonomic dysfunction can help prevent secondary accidents.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"68 2","pages":"158-160"},"PeriodicalIF":0.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Developmental Disorders, Early Seizure Onset, and Polytherapy in Childhood Epilepsy.","authors":"Kento Ohta, Tohru Okanishi, Yoshihiro Maegaki","doi":"10.33160/yam.2025.05.007","DOIUrl":"10.33160/yam.2025.05.007","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy patients often exhibit symptoms of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). This study aimed to compare the clinical characteristics of epilepsy in patients comorbid with ADHD/ASD and those diagnosed with ADHD/ASD after epilepsy onset.</p><p><strong>Methods: </strong>We retrospectively reviewed patients under 18 years of age with epilepsy who visited Tottori University Hospital's Child Neurology Department during 2013-2022. Eligible patients had at least 2 years of follow-up after epilepsy onset and were taking antiseizure medication (ASM). We excluded those with epileptic encephalopathy, abnormal perinatal history, imaging abnormalities, or intellectual disabilities. We compared clinical characteristics between epilepsy patients with and without ADHD/ASD.</p><p><strong>Results: </strong>Data were collected from 28 patients with ADHD/ASD and 87 without. Patients with ADHD/ASD had an earlier seizure onset (6.6 ± 3.9 vs. 8.7 ± 4.1 years, <i>P</i> = 0.018) and were more likely to receive ASM polytherapy (39% vs. 16%, <i>P</i> = 0.010). Seizure outcomes did not differ between the two groups. Of the 28 patients with ADHD/ASD, 11 were diagnosed after epilepsy onset, and these patients were more likely to require multiple ASMs than those without ADHD/ASD (45% vs. 16%, <i>P</i> = 0.035).</p><p><strong>Conclusion: </strong>Patients comorbid with ADHD/ASD tend to have earlier seizure onset and require more ASM, while those diagnosed with ADHD/ASD after epilepsy onset also often need polytherapy. These findings suggest that severe early epilepsy can lead to developmental disorders, though long-term seizure outcomes are not necessarily poor in these patients.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"68 2","pages":"123-130"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}