Kurume Medical Journal最新文献

{"title":"Difficulty in the Diagnosis of Biliary Atresia Splenic Malformation Syndrome In Utero.","authors":"Kunio So,&nbsp;Takaaki Shinagawa,&nbsp;Toshiyuki Yoshizato,&nbsp;Suguru Fukahori,&nbsp;Kimio Asagiri,&nbsp;Yasuki Maeno,&nbsp;Shintaro Hayashida,&nbsp;Kimio Ushijima","doi":"10.2739/kurumemedj.MS6834011","DOIUrl":"10.2739/kurumemedj.MS6834011","url":null,"abstract":"<p><p>The fetus of a 30-year-old pregnant Japanese woman was diagnosed with absence of inferior vena cava (IVC) and azygos continuation of interrupted IVC without cardiac anomalies at 34 weeks of gestation, and a healthy male neonate weighing 2,910 g was delivered at 37 weeks of gestation. On day 42 after birth, direct bilirubin predominant hyperbilirubinemia and high serum gamma-GTP levels were detected. Computed tomography revealed the presence of a lobulated and accessory spleen, and laparotomy demonstrated type III biliary atresia (BA), confirming the final diagnosis of BA splenic malformation (BASM) syndrome. In retrospect, non-visualization of the gallbladder was missed in utero. The combination of the absence of IVC and BA without cardiac anomalies is far less likely to occur in left isomerism. Although BA remains difficult to detect in utero, special attention should be paid to cases of BA associated with findings of left isomerism, including the absence of IVC, to enable early diagnosis and treatment of BASM.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"265-268"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9694700","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":"Duplication of the Hypoglossal Nerve Branch to the Thyrohyoid Muscle: A Case Report.","authors":"Craig Ballard,&nbsp;Grzegorz Wysiadecki,&nbsp;Jerzy A Walocha,&nbsp;R Shane Tubbs,&nbsp;Joe Iwanaga","doi":"10.2739/kurumemedj.MS6834002","DOIUrl":"10.2739/kurumemedj.MS6834002","url":null,"abstract":"<p><p>The motor fibers to the thyrohyoid muscle are provided by the anterior ramus of C1 via the hypoglossal nerve rather than via the ansa cervicalis. Knowledge of possible variations in the branching patterns of the nerves attached to the hypoglossal nerve is necessary to minimize iatrogenic injury to these structures during surgical procedures. We describe a rare anatomical variant of the nerve branch to the thyrohyoid muscle. To our knowledge, this particular variant has not been previously reported.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"247-250"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9614659","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":"Cone-Beam Computed Tomography-Guided Marking of Small Pulmonary Nodules with Surgical Clips.","authors":"Masahiro Mitsuoka,&nbsp;Masaki Kashihara,&nbsp;Tatsuya Nishi,&nbsp;Koichi Yoshiyama,&nbsp;Toshihiro Hashiguchi,&nbsp;Shintaro Yokoyama,&nbsp;Daigo Murakami,&nbsp;Fumihiko Fujita,&nbsp;Shinzo Takamori,&nbsp;Yoshito Akagi","doi":"10.2739/kurumemedj.MS6834006","DOIUrl":"10.2739/kurumemedj.MS6834006","url":null,"abstract":"BACKGROUND\u0000Preoperative computed tomography-guided marking can help identify small non-palpable pulmonary nodules during surgery. However, this technique is associated with the risk of air embolism. We retrospectively evaluated whether small pulmonary nodules could be intraoperatively localized using cone-beam computed tomography (CBCT).\u0000\u0000\u0000METHODS\u0000A hybrid operating room permitting stable lateral positioning and scanning from the pulmonary apex to the base was used in all patients. CBCT images were obtained using a 10-s protocol with 180º rotation of the C-arm flat panel detector around the patient. Clips were placed on the visceral pleura to help guide pulmonary nodule localization. Partial pulmonary resection was performed using video-assisted thoracoscopic surgery at the predicted nodule site.\u0000\u0000\u0000RESULTS\u0000Between July 2013 and June 2019, 132 patients with 145 lesions underwent this procedure at our center. The detection rate of lesions on CBCT was 100%. The pathological diagnoses were primary lung cancer, metastatic pulmonary tumors, and benign lesions. The average consolidation-to-tumor ratio was 0.65 for all nodules, with ratios of 0.33, 0.96, and 0.70 for primary lung cancer, metastatic pulmonary tumors, and benign lesions, respectively. No complications related to this localization method were observed.\u0000\u0000\u0000CONCLUSIONS\u0000CBCT-guided intraoperative localization is safe and feasible for non-palpable small pulmonary nodules. This technique may eliminate the risk of serious complications such as air embolism.","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"183-189"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9630286","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":"Preoperative Chemotherapy Followed by Hepatectomy for Potentially Resectable UICC7 Stage IIIA, IIIB Hepatocellular Carcinoma; A Phase II Clinical Trial.","authors":"Yuichi Goto,&nbsp;Takashi Niizeki,&nbsp;Shogo Fukutomi,&nbsp;Tomotake Shirono,&nbsp;Shigeo Shimose,&nbsp;Hideki Iwamoto,&nbsp;Satoki Kojima,&nbsp;Hiroki Kanno,&nbsp;Yoshihiro Uchino,&nbsp;Shin Sasaki,&nbsp;Nobuhisa Shirahama,&nbsp;Daisuke Muroya,&nbsp;Yoriko Nomura,&nbsp;Masanori Akashi,&nbsp;Goichi Nakayama,&nbsp;Yusuke Hirakawa,&nbsp;Toshihiro Sato,&nbsp;Munehiro Yoshitomi,&nbsp;Hisamune Sakai,&nbsp;Toru Hisaka,&nbsp;Tatsuyuki Kakuma,&nbsp;Hironori Koga,&nbsp;Takuji Torimura,&nbsp;Yoshito Akagi,&nbsp;Koji Okuda","doi":"10.2739/kurumemedj.MS6834010","DOIUrl":"10.2739/kurumemedj.MS6834010","url":null,"abstract":"<p><strong>Background: </strong>The Japanese guideline for therapeutic strategy in HCC does not recognize any benefit of preoperative chemotherapy for potentially resectable hepatocellular carcinoma (HCC), and only upfront resec tion is recommended even for an advanced HCC. Data on preoperative chemotherapy for advanced HCC is still limited. Poor prognostic factors of HCC after resection are tumor more than 5 cm in diameter, multiple lesions, and gross tumor thrombosis, which constitute UICC7 Stage IIIA and IIIB HCC. There are no prospective studies about preoperative chemotherapy in these patients.</p><p><strong>Aim: </strong>To evaluate the benefit of preoperative chemotherapy for UICC7 Stage IIIA and IIIB potentially resectable HCC.</p><p><strong>Discussion: </strong>Our recent study demonstrated that the 5-year overall survival rate (OS) of patients diagnosed as UICC7 Stage IIIA and IIIB who had received upfront resection was only 16.5%. In contrast, the 5-year OS of UICC7 Stage IIIA and IIIB initially unresectable patients who had achieved conversion from unresectable to resect able status under successful hepatic infusion chemotherapy prior to resection was as high as 61.3%. Additionally, recent studies reported transarterial chemoembolization achieved outcomes comparable with those of resection. Therefore, we believe that patients with UICC7 Stage IIIA and IIIB should be considered borderline resectable. To evaluate this hypothesis we registered the present phase II clinical trial to assess the benefit of preoperative chemo therapy followed by hepatectomy in potentially resectable UICC7 Stage IIIA and IIIB HCC patients.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"239-245"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9899807","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":"Risk Factors for Surgical Site Infection in Spinal Surgery and Interventions: A Retrospective Study.","authors":"Rikiya Saruwatari,&nbsp;Kei Yamada,&nbsp;Kimiaki Sato,&nbsp;Kimiaki Yokosuka,&nbsp;Tatsuhiro Yoshida,&nbsp;Ichiro Nakae,&nbsp;Takahiro Shimazaki,&nbsp;Shinji Morito,&nbsp;Naoto Shiba","doi":"10.2739/kurumemedj.MS6834004","DOIUrl":"10.2739/kurumemedj.MS6834004","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infection following spinal surgery causes prolonged delay in recovery after surgery, increases cost, and sometimes leads to additional surgical procedures. We investigated risk factors for the occurrence of surgical site infection events in terms of patient-related, surgery-related, and postoperative factors.</p><p><strong>Methods: </strong>This retrospective study included 1000 patients who underwent spinal surgery in our hospital between April 2016 and March 2019.</p><p><strong>Results: </strong>Patient-related factors were dementia, length of preoperative hospital stay (≥ 14 days), and diagnosis at the time of surgery (traumatic injury or deformity). The one surgery-related factor was multilevel surgery (≥ 9 intervertebral levels), and the one postoperative factor was time to ambulation (≥ 7 days) were statistically significant risk factors for spinal surgical site infection.</p><p><strong>Conclusion: </strong>One risk factor identified in this study that is amenable to intervention is time to ambulation. As delayed ambulation is a risk factor for postoperative surgical site infection, how medical staff can intervene in postoperative ambulation to further reduce the incidence of surgical site infection is a topic for future research.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"201-207"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9630285","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":"Double Inferior Vena Cava with Major Predominance of the Left Inferior Vena Cava: A Cadaver Case Report.","authors":"Yoko Tabira,&nbsp;Tsuyoshi Saga,&nbsp;Joe Iwanaga,&nbsp;Akihiro Yamashita,&nbsp;Aya Han,&nbsp;Yuto Haikata,&nbsp;Keishiro Kikuchi,&nbsp;Kunimitsu Nooma,&nbsp;Eiko Inoue,&nbsp;Koichi Watanabe","doi":"10.2739/kurumemedj.MS6834013","DOIUrl":"10.2739/kurumemedj.MS6834013","url":null,"abstract":"<p><p>We encountered a case of a double inferior vena cava with major predominance of the left inferior vena cava during an anatomical dissection course for medical students in 2015. The right inferior vena cava (normal inferior vena cava) was 2.0 mm wide, and the left inferior vena cava was 23.2 mm wide. The fine right inferior vena cava began at the right common iliac vein, ascended along the right side of the abdominal aorta, and then joined the left inferior vena cava at the level of the lower margin of the first lumbar vertebra. The dominant left inferior vena cava started from the left common iliac vein and ascended along the left side of the abdominal aorta. Most patients with a double inferior vena cava are asymptomatic, and these variants are incidentally detected by computed tomography or magnetic resonance imaging. Their presence may have significant implications for surgery, particularly abdominal surgery in patients with paraaortic lymphadenopathy and in those undergoing laparoscopic radical nephrectomy or inferior vena cava filter placement. We herein discuss the embryology of a double inferior vena cava based on detailed anatomical data of the variations of a double inferior vena cava, including those that require clinical attention.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"269-275"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9694697","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":"Chitinase 3-Like-1 Expression Is Upregulated Under Inflammatory Conditions in Human Oral Epithelial Cells.","authors":"Yui Teratani","doi":"10.2739/kurumemedj.MS6834014","DOIUrl":"10.2739/kurumemedj.MS6834014","url":null,"abstract":"<p><strong>Objective: </strong>Chitinase 3-like-1 (CHI3L1), also known as YKL-40, is a partially secreted glycoprotein and is involved in inflammatory disorders, including inflammatory bowel diseases. CHI3L1 is known to play a role in biological responses such as cell proliferation, tissue remodeling, and inflammation. CHI3L1 forms an immune complex (known as a Chitosome complex) with IL-13 receptor alpha 2 (IL-13 Rα2) and transmembrane protein 219 (TMEM219) to activate the MAPK/ERK and PKB/AKT signaling pathways. The objective of this study is to investigate how the expressions of CHI3L1 and a Chitosome complex in human oral cavity epithelial cells are linked with intraoral inflammatory diseases.</p><p><strong>Method: </strong>CHI3L1 and Chitosome complex mRNA expressions were analyzed using human oral squamous cancer cell lines, HSC3 and HSC4 cells. Signaling activation in HSC4 cells was analyzed by using the western blot technique. Immunohistological analysis was performed using surgical samples obtained from patients with benign oral cavity tumors and cysts.</p><p><strong>Results: </strong>Increased expression of CHI3L1 was observed in both HSC3 and HSC4 cells after TNFα stimulation. The expression of Chitosome complex factors increased as CHI3L1 levels increased, resulting in the activation of a downstream signaling pathway. Among the intraoral tissues, the epithelial cells from inflammatory lesions, but not benign tumors, were found to be intensively stained with the anti-CHI3L1 antibody.</p><p><strong>Conclusion: </strong>It was indicated that the formation of a Chitosome complex is induced during inflammation, leading to the activation of signaling pathways.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"221-228"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10070977","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":"Annual Increase of Acute Inpatients with Both Cancer and Cardiovascular Diseases in Japan 2011-2015: Analysis From National Database of Health Insurance Claims and Specific Health Checkups of Japan.","authors":"Yume Nohara-Shitama,&nbsp;Kazuo Ishii,&nbsp;Nagisa Morikawa,&nbsp;Shoichiro Nohara,&nbsp;Yoshihiro Fukumoto","doi":"10.2739/kurumemedj.MS6834012","DOIUrl":"10.2739/kurumemedj.MS6834012","url":null,"abstract":"<p><strong>Background: </strong>Patients with cancer were able to live longer due to improvements in cancer treatment. Additionally, cardiovascular disease (CVD) is the second leading cause of mortality in cancer survivors. However, epidemiological data on onco-CVD have not been sufficiently provided. We aimed to investigate the clinical characteristics of cancer in CVD patients using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB).</p><p><strong>Method and results: </strong>The NDB sampling dataset used in this study was randomly sampled 10% from the whole Diagnosis Procedure Combination (DPC) records from every January, April, July, and October from 2011 to 2015. The significance of the increase trend in the percentage of records in each disease group to the total number of all DPC records from 2011 to 2015 was checked with Chi-square test with a Bonferroni correction. The percentage of records in cancer with the CVD group to the total number of all DPC records significantly increased over time, and their average age also increased since 2011. Their proportion over 75 years was approximately 56 % in 2015. There was no difference in the cancer sites. However, the prevalence of heart failure dramatically elevated.</p><p><strong>Conclusion: </strong>We were able to assess the increase in cancer among CVD patients using DPC inpatient records obtained from the NDB. Both cardiologists and oncologists should be more aware of this phenomenon.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"209-220"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10000126","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":"Rothia Aeria Endocarditis Complicated with Multiple Systemic Embolisms.","authors":"Shigeaki Aoyagi,&nbsp;Satoru Tobinaga,&nbsp;Kumiko Wada,&nbsp;Shin-Ichi Nata,&nbsp;Hiroshi Yasunaga","doi":"10.2739/kurumemedj.MS6834009","DOIUrl":"10.2739/kurumemedj.MS6834009","url":null,"abstract":"<p><p>Rothia aeria is part of the normal flora in the human oral cavity and rarely causes serious systemic infection in healthy hosts. We report a case of infective endocarditis of the mitral valve due to Rothia aeria. A 53-year-old man suffered a cut on his left thumb. At the time, the patient licked the wound as a conventional way to accelerate its cure. Thereafter, he developed a recurrent fever, which was temporarily lysed with treatment using an intravenous antibiotic, over a period of 2 months after the injury. On admission, the patient had no dental caries and denied any dental procedures before onset of the fever. Auscultation revealed a systolic cardiac murmur. Echocardiography showed torn chordae of the posterior mitral leaflet with a small vegetation and severe mitral regurgitation. Two sets of blood cultures were positive for Rothia aeria. Computed tomography revealed splenic and left renal infarctions but no cerebral infarction. After resolution of the inflammation by 6 weeks of penicillin treatment, mitral valve repair was successfully performed.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"259-263"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9630280","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":"Weakened Grip Strength Over 40 Years in a Community-Dwelling Cohort in Tanushimaru, Japan.","authors":"Takahiro Yoshikawa,&nbsp;Ken-Ichiro Sasaki,&nbsp;Hisashi Adachi,&nbsp;Tatsuyuki Kakuma,&nbsp;Sachiko Hatada-Katakabe,&nbsp;Yuuki Takata,&nbsp;Yoshihiro Fukumoto","doi":"10.2739/kurumemedj.MS6834005","DOIUrl":"10.2739/kurumemedj.MS6834005","url":null,"abstract":"<p><strong>Background: </strong>An epidemiological survey has been periodically performed since 1977 among the adult population in Tanushimaru, a typical farming town in Japan. We aimed in this study to retrospectively investigate changes of grip strength (GS) and its correlates over 40 years in the same cohort of community-dwelling adults. We used pooled data from the survey to deduce essential correlates of GS in community-dwelling adults.</p><p><strong>Methods: </strong>We retrospectively compared serial correlates of GS in the adult population in Tanushimaru between a population tested in 1977 and 1979 (Cohort A, n=2,452) and another population tested in 2016 and 2018 (Cohort B, n=1,505), to identify essential correlates of GS for investigating changes in GS during the past 40 years in community-dwelling adults.</p><p><strong>Results: </strong>Age, height, weight, and the occupation of the subjects remained as correlates of GS in both genders during the past 40 years. In males, abdominal circumference also remained as a correlate of GS. Serum albumin levels in males and systolic blood pressure in females were identified as new correlates. GS after adjustment for the above correlates weakened in both genders, and the serial change in GS was particularly remarkable in subjects whose occupations were Class-1 and Class-2, which were defined as moderately hard work.</p><p><strong>Conclusions: </strong>From a periodically-performed epidemiological survey of a community-dwelling cohort in a Japanese typical farming town, age, height, weight, and occupation were deduced as essential correlates of GS. GS in the community dwelling cohort weakened in both genders over 40 years, possibly affected by their occupation.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"191-200"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9630284","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}