Kurume Medical Journal最新文献

{"title":"Papillary Fibroelastoma of the Aortic Valve:Acute Coronary Syndrome Due to Dynamic Obstruction of the Right Coronary Artery Ostium.","authors":"Hiroyuki Saisho, Satoru Tobinaga, Shigeaki Aoyagi, Yusuke Shintani, Hiroshi Yasunaga","doi":"10.2739/kurumemedj.MS7034004","DOIUrl":"10.2739/kurumemedj.MS7034004","url":null,"abstract":"<p><p>A 59-year-old woman, who had a history of acute coronary syndrome (ACS) but without obstructive coronary lesions 2 years previously, presented with vertigo. MRI revealed a left cerebellar embolism. TEE detected a mobile aortic valve tumor, suggesting a papillary fibroelastoma (PFE). Reviewing previous echocardiograms, it was discovered that the tumor was present at the time of the ACS event. At surgery, the PFE was present on the right coronary cusp. When the aortic valve was opened, it was found that the tumor was obstructing the right coronary artery (RCA) ostium. ACS was probably caused by PFE's dynamic obstruction of the RCA ostium.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"165-168"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid Training System Consisting of Synchronized Neuromuscular Electrical Stimulation for Voluntary Exercise Using an Articular Motion Sensor.","authors":"Hiroo Matsuse, Hiroshi Tajima, Eriko Baba, Sohei Iwanaga, Masayuki Omoto, Ryuki Hashida, Takeshi Nago, Naoto Shiba","doi":"10.2739/kurumemedj.MS7034006","DOIUrl":"10.2739/kurumemedj.MS7034006","url":null,"abstract":"<p><p>Neuromuscular electrical stimulation (NMES) is widely used for improving muscle strength, preventing muscle atrophy, and decreasing pain. Recently, NMES has become a substitute for exercise therapy for metabolism improvement and functional capacity improvement. However, NMES has several disadvantages. First, slow-twitch muscle contractions are insufficient because the recruitment pattern of NMES does not obey Henneman's size principle. Second, when using surface electrodes, it is difficult to contract deep skeletal muscles at the application site. Third, electrical stimulation causes discomfort. Therefore, we devised a simultaneous combination of NMES and voluntary muscle contractions to overcome the weak points of NMES. A hybrid training system (HTS) that resists the motion of a volitionally contracting agonist muscle with force generated by its electrically stimulated antagonist was developed as a technique to combine the application of NMES and volitional contractions. This motion sensor makes it possible to simultaneously combine voluntary movements with NMES. Our HTS synchronizes with voluntary movements, enhancing safety and reducing discomfort. This HTS enhances the exercise effect of even simple exercise. So far, our HTS has been reported to be effective for muscle strength enhancement, prevention of muscle atrophy, improvement of physical function, pain relief, enhancement of physical fitness, and improvement of metabolic function. HTS are expected to be useful methods in environments where sufficient exercise load is not available or for individuals with low exercise tolerance.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"83-89"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extrahepatic Portal Venous Gas Is the Strongest Predictor of Mortality in Patients with Portal Venous Gas and Pneumatosis Intestinalis.","authors":"Naohiro Yoshida, Yoshihiko Sadakari, Hiroyuki Nakane, Munehiro Yoshitomi, Kazuhito Tamehiro, Gentaro Hirokata, Takeshi Aoyagi, Toshiro Ogata, Masahiko Taniguchi","doi":"10.2739/kurumemedj.MS7034005","DOIUrl":"10.2739/kurumemedj.MS7034005","url":null,"abstract":"<p><strong>Background: </strong>Very few studies have examined the association between contrast-enhanced computed tomography (CT) findings observed in portal venous gas (PVG) and pneumatosis intestinalis (PI) and the underlying diseases in these conditions.</p><p><strong>Objectives: </strong>In this study, we analyzed this association and report the findings for predicting mortality.</p><p><strong>Materials and methods: </strong>Overall, 50 patients diagnosed with PVG or PI, observed on contrast-enhanced CT, underwent treatment at our hospital. Based on the underlying disease, we divided the patients into three groups, those with ischemic disease, infectious disease, or gastrointestinal dilatation. Furthermore, cases that underwent surgical treatment or needed surgery but were inoperable were assigned to the high risk group (n=16) and patients who received conservative treatment were assigned to the low risk group (n=34). We reviewed the patients' medical charts, laboratory data, and CT images retrospectively, and analyzed the relationship between CT findings, underlying disease, and association with the high risk or low risk group in each case.</p><p><strong>Results: </strong>Poor enhancement of the intestinal wall, mesenteric fat stranding, extrahepatic PVG, advanced age, and renal disease were significantly associated with ischemic disease (p=0.02, p=0.02, p=0.005, p=0.008 and p=0.049, respectively). PI alone was strongly associated with gastrointestinal dilatation (p=0.009). Patients in the low risk group had more favorable outcomes with conservative treatment. In multivariate analysis, extrahepatic PVG was the only factor associated with the high risk group (p=0.002).</p><p><strong>Conclusion: </strong>Extrahepatic PVG associated with ischemic disease was the strongest predictive factor of mortality. Other CT findings, though useful in diagnosing the underlying disease, were not significant predictive factors.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"121-130"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right Parasternal Approach for Aortic Valve Replacement After Presternal Gastropexy.","authors":"Hiroyuki Otsuka, Hiroyuki Saisho, Tohru Takaseya, Hiromasa Fujita, Hiroyuki Tanaka, Eiki Tayama","doi":"10.2739/kurumemedj.MS7034009","DOIUrl":"10.2739/kurumemedj.MS7034009","url":null,"abstract":"<p><p>Due to bicuspid aortic valve aortic stenosis, a 78-year-old man with a history of esophagectomy and presternal gastric tube reconstruction required aortic valve replacement (AVR). AVR with a bioprosthetic valve was performed through a right parasternal thoracotomy. Despite the unfavorable conditions for conventional median sternotomy, AVR was successfully performed through an alternate approach. The right parasternal approach was excellent for AVR in patients with presternal gastric tube reconstruction for esophageal cancer (EC).</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"169-172"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Cognitive Task During Unstable Walking on the Frontal Cerebral Blood Flow in Elderly Retirement Home Residents Leading an Independent Daily Life.","authors":"Seigou Hashiguchi, Hiroo Matsuse, Kenichi Ito, Chika Kamura, Yoshio Takano","doi":"10.2739/kurumemedj.MS7034003","DOIUrl":"10.2739/kurumemedj.MS7034003","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine the effects of cognitive tasks during walking with perturbation on the cerebral blood flow.</p><p><strong>Methods: </strong>The subjects were a total of 20 persons, consisting of 12 healthy adults aged 21-47 years (adult group) and 8 retirement home residents aged 67-85 years who led an independent daily life and could walk independently (elderly group). Oxyhemoglobin was measured using wireless functional near-infrared spectroscopy (fNIRS). An analysis was conducted using the Wilcoxon rank sum test to compare the variation of oxyhemoglobin between walking with perturbation (WP) and walking with perturbation and cognitive tasks (WPC) in each group. In addition, we compared the variation of oxyhemoglobin between groups by analysis of covariance adjusting for the value of WP.</p><p><strong>Results: </strong>In the adult group, the left and right oxyhemoglobin significantly increased under WPC (p=0.0122, 0.0015, respectively). On the other hand, in the elderly group, the right and left oxyhemoglobin did not significantly change under WPC.</p><p><strong>Conclusions: </strong>These results suggest that the effect of a cognitive task during unstable walking conditions differs between healthy adults and elderly persons, and that this may be important when considering postural control strategies, especially in the elderly.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"115-120"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comminuted Transverse Femoral Shaft Fractures Are at Risk for Nonunion.","authors":"Toru Matsugaki, Hideki Mizu-Uchi, Yuji Aratake, Keitarou Yasumoto","doi":"10.2739/kurumemedj.MS7112005","DOIUrl":"https://doi.org/10.2739/kurumemedj.MS7112005","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to investigate the effect of the main fragment fracture type (oblique or transverse) on the union rate of femoral shaft fractures.</p><p><strong>Methods: </strong>Patients who underwent surgical treatment with an antegrade intramedullary nail for femoral shaft fracture (Arbeitsgemeinschaft für Osteosynthesefragen / Orthopaedic Trauma Association; AO/OTA type 32 type B or C) between January 2009 and March 2021 were included in this study. Patients with oblique fractures of the two main fragments on radiographs immediately after surgery were classified into the oblique fracture group. Patients with at least one of the two main fractures being transverse fractures were classified into the transverse fracture group. We investigated age, sex, height, weight, body mass index (BMI), AO/OTA classification, time from fracture to surgery, intramedullary nail length and diameter, number of interlocking screws, and bone union rate.</p><p><strong>Results: </strong>A total of 55 fractures were included. The mean age was 34.4 ± 16.7 (range, 16-77) years. There were 41 fractures classified into the oblique fracture group and 14 fractures classified into the transverse fracture group. There was a significantly higher proportion of men in the transverse fracture group. Patients in the transverse fracture group were significantly younger and taller. Only 1 of 41 (2.4%) patients in the oblique group experienced nonunion, while 3 of 14 (21.4%) patients in the transverse group experienced nonunion (p = 0.030).</p><p><strong>Conclusion: </strong>Comminuted femoral shaft fractures with transverse fracture components are more prone to nonunion.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Treatment of Simultaneous Common Femoral and Profunda Femoris Artery Aneurysms.","authors":"Yusuke Shintani, Satoru Tobinaga, Hiroyuki Saisho, Shigeaki Aoyagi, Eiki Tayama, Hiroshi Yasunaga","doi":"10.2739/kurumemedj.MS7112006","DOIUrl":"https://doi.org/10.2739/kurumemedj.MS7112006","url":null,"abstract":"<p><p>Profunda femoris artery aneurysms (PFAAs) are rare because of the histo-anatomical characteristics of the profunda femoris arteries. We present a case of simultaneous PFAA and common femoral artery aneurysm (CFAA) incidentally detected on computed tomography in a 58-year-old man with diverticular bleeding. Images revealed a 37-mm right PFAA and a 24-mm right CFAA. According to the report, PFAAs >20 mm are a surgical indication, and surgery should be decided based on the patient's general condition. We resected the aneurysms and reconstructed the arteries using vascular prostheses. The postoperative course was uneventful, and the patient was discharged 8 days postoperatively.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Expression of NDRG1 is a Poor Prognostic Factor in Patients with Endometrial Endometrioid Carcinoma with Long-Term Observation.","authors":"Morio Ijichi, Kimio Ushijima, Tomohiko Yamaguchi, Naoyo Nishida, Kazuto Tasaki, Jongmyung Park, Shin Nishio, Toshiharu Kamura, Jun Akiba, Tatsuyuki Kakuma, Michihiko Kuwano, Naotake Tsuda","doi":"10.2739/kurumemedj.MS7112004","DOIUrl":"https://doi.org/10.2739/kurumemedj.MS7112004","url":null,"abstract":"<p><p>N-myc downstream regulated gene-1 (NDRG1) has attracted much attention as a protein associated with angiogenesis. This study investigated the associations of NDRG1 expression, determined by immunohistochemical analysis, with other clinicopathological factors and prognosis in patients with endometrial endometrioid carcinoma (EEC). Surgical specimens were obtained from 113 patients with EEC. High NDRG1 expression was correlated with advanced stage, poor differentiation, lymph node metastasis, and significantly poorer survival compared with patients with low expression. High expression of NDRG1 was also correlated with high levels of angiogenesis and low expression of the estrogen receptor. These results suggest that high expression of NDRG1 is associated with angiogenesis and is an indicator of a poor prognosis in women with EEC.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of High-Dose-Rate Interstitial Brachytherapy as Monotherapy for Mobile Tongue Cancer in Terms of the Acute Mucosal Reaction.","authors":"Hironori Akiyama, Ken Yoshida, Tadayuki Kotsuma, Koji Masui, Tadashi Takenaka, Manabu Kano, Fumiaki Isohashi, Yuji Seo, Taiju Shimbo, Naoya Murakami, Yui Mori, Shinya Kotaki, Hitoshi Yoshimoto, Eiichi Tanaka, Nikolaos Tselis, Zoltán Takácsi-Nagy, Hideya Yamazaki, Satoaki Nakamura, Noboru Tanigawa, Kimishige Shimizutani, Kazuhiko Ogawa, Yoshiko Ariji","doi":"10.2739/kurumemedj.MS7112003","DOIUrl":"https://doi.org/10.2739/kurumemedj.MS7112003","url":null,"abstract":"<p><strong>Background: </strong>The present study investigated the acute mucosal reaction (AMR) after high-dose-rate interstitial brachytherapy at 54 Gy/9 fractions (HDR54) as monotherapy administered twice a day for tongue cancer in 13 patients, and attempted to validate HDR54 by comparing the AMR with that of our previously reported HDR at 60 Gy/10 fractions (HDR60), and low-dose-rate interstitial brachytherapy at approximately 70 Gy (LDR70).</p><p><strong>Methods: </strong>The European Organization for Research on Treatment of Cancer/ Radiation Therapy Oncology Group scoring system with modifications (score: 1-4.5) was used to evaluate AMR. The time courses of the AMR scores of HDR54 were recorded. The time courses of the AMR of HDR54, HDR 60, and LDR70 were each divided into 6 phases and compared.</p><p><strong>Results: </strong>The number of cases in the HDR54 group with a lower score (1-2) at the time of the initial response was significantly higher (12 cases) than those in the HDR60 group (1 case) (p=0.0077) and LDR70 group (1 case) (p=0.0077). In the HDR54 group, the time between the end of treatment and appearance of the first response was significantly longer (median: 3 days) than those in the HDR60 group (median: 1 day) (p<0.001) and LDR70 group (median: 1 day) (p<0.001). No significant differences were observed in the maximum score, its duration, or other parameters.</p><p><strong>Conclusions: </strong>The results indicated that the AMR of HDR54 started later and was gentler and more easily tolerated than the other two methods, suggesting the validity of HDR54 in terms of AMR.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Sarcoid Reaction in Subcarinal Lymph Node in A Postoperative Breast Cancer Diagnosed by Thoracoscopic Biopsy.","authors":"Kunihiro Ozaki, Shintaro Yokoyama, Toshihiro Hashiguchi, Kensuke Tajiri, Kou Shigemura, Daigo Murakami, Yutaka Nishimura, Maki Tanaka, Ryouzou Hayashida, Fumihiko Fujita","doi":"10.2739/kurumemedj.MS7112009","DOIUrl":"https://doi.org/10.2739/kurumemedj.MS7112009","url":null,"abstract":"<p><p>Lymph node recurrence is common in patients with breast cancer, and breast surgeons often diagnose it based solely on computed tomography (CT) or fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT). In this case report, we present a patient with breast cancer having a false positive lymph node detected by FDG-PET/CT, which was later identified as a sarcoid reaction through thoracoscopic surgery. This pathological diagnosis allowed the patient to avoid unnecessary long-term cancer therapies, such as chemotherapy and hormone therapy. In conclusion, lymph nodes in patients with breast cancer should undergo pathological diagnosis, and thoracoscopic surgery is a valuable approach for accurate diagnosis, even when FDG-PET/CT shows positive results.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}