{"title":"Feasibility of laparoscopic and endoscopic cooperative surgery for gastric gastrointestinal stromal tumor with tumor diameter of >5 cm.","authors":"Yosuke Iwakawa, Masaaki Nishi, Yuma Wada, Kozo Yoshikawa, Chie Takasu, Takuya Tokunaga, Toshihiro Nakao, Hideya Kashihara, Toshiaki Yoshimoto, Takayuki Noma, Mitsuo Shimada","doi":"10.2152/jmi.71.148","DOIUrl":"https://doi.org/10.2152/jmi.71.148","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic and endoscopic cooperative surgery (LECS) is an effective treatment for gastric gastrointestinal stromal tumors (GISTs). The utility of LECS for gastric GISTs of > 5 cm remains controversial. This study was performed to investigate the feasibility of LECS for gastric GISTs with a tumor diameter of >5 cm.</p><p><strong>Methods: </strong>We analyzed 43 patients with gastric GISTs who underwent LECS or laparoscopic partial gastrectomy (Lap-Partial Gx). We compared the surgical outcomes of LECS versus Lap-Partial Gx and of LECS for a tumor diameter of > 5 versus ≤ 5 cm.</p><p><strong>Results: </strong>In the comparison of LECS versus Lap-Partial Gx, there were no significant intergroup differences in the operative time or blood loss volume. The morbidity rate was similar between the groups. No postoperative mortality occurred in either group. In the comparison of LECS for a tumor diameter of > 5 versus ≤ 5 cm, there were no significant intergroup differences in operative time, or blood loss volume. The morbidity rate was similar between the > 5-cm and ≤ 5-cm groups (0.0% vs. 4.5%, respectively ; p = 0.56). Additionally, no recurrence or death occurred during follow-up in either group.</p><p><strong>Conclusion: </strong>LECS is a feasible option for gastric GISTs with a tumor diameter of > 5 cm. J. Med. Invest. 71 : 148-153, February, 2024.</p>","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":"71 1.2","pages":"148-153"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913003","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":"Full-endoscopic spine surgery in oldest old patients aged over 90 years:A case report.","authors":"Kazuya Kishima, Kiyoshi Yagi, Kazuta Yamashita, Fumitake Tezuka, Masatoshi Morimoto, Yoichiro Takata, Toshinori Sakai, Toru Maeda, Koichi Sairyo","doi":"10.2152/jmi.71.169","DOIUrl":"10.2152/jmi.71.169","url":null,"abstract":"<p><strong>Background: </strong>Transforaminal full-endoscopic spine surgery (FESS) is the least invasive spinal surgery and can be performed under local anesthesia. In Japan, the population is rapidly aging and the number of spinal surgeries performed in the elderly is also increasing.</p><p><strong>Object: </strong>In this report, we describe 3 patients aged 90 years or older in whom we performed FESS under local anesthesia.</p><p><strong>Case: </strong>The first case was a 90-year-old man who presented with severe leg pain. He had multiple medical comorbidities and was unsuitable for general anesthesia. We performed FESS. After surgery, the leg pain resolved with full recovery of muscle strength. He was discharged with no perioperative complications. The second case was a 90-year-old man who presented with severe leg pain. MRI showed a herniated nucleus pulposus and foraminal stenosis at L4/5. We performed FESS. The leg pain improved immediately after surgery. The third case was a 91-year-old woman in whom we diagnosed left L5 radiculopathy due to foraminal stenosis at L5/S1. After surgery, her leg pain was relieved.</p><p><strong>Conclusion: </strong>FESS is a good surgical procedure for elderly patients who are in a poor general condition because it is minimally invasive and can be performed under local anesthesia with early mobilization. J. Med. Invest. 71 : 169-173, February, 2024.</p>","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":"71 1.2","pages":"169-173"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913027","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":"Comparison of endogenous hypothalamic and serum OT levels between young and middle-aged perimenopausal female rats.","authors":"Rie Masaki, Yuri Yamamoto, Kou Tamura, Hidenori Aoki, Hiroki Noguchi, Asuka Takeda, Saki Minato, Risa Tanano, Erika Yamanaka, Takaaki Maeda, Tatsuo Sugimoto, Hikari Sasada, Hiroaki Inui, Tomohiro Kagawa, Atsuko Yoshida, Ayuka Mineda, Riyo Kinouchi, Kanako Yoshida, Takashi Kaji, Takeshi Iwasa","doi":"10.2152/jmi.71.246","DOIUrl":"https://doi.org/10.2152/jmi.71.246","url":null,"abstract":"<p><p>Oxytocin (OT) regulates food intake and body weight, particularly in obese individuals. Decreases in the effects of OT have recently been implicated in metabolic disturbances, and the administration of estradiol (E2) increased serum OT levels. Although weight gain is frequently observed in perimenopausal women, endogenous OT levels remain unclear. Therefore, we herein compared endogenous levels of hypothalamic and serum OT between young and middle-aged perimenopausal female rats and examined the relationship between serum estrogen and leptin levels. Body weight and visceral and subcutaneous fat weights were higher in middle-aged rats. Although no significant differences were observed in serum OT and E2 levels, serum leptin levels and hypothalamic mRNA levels of OT and the OT receptor (OTR) were significantly higher in middle-aged rats than in young rats. Serum OT levels did not correlate with hypothalamic OT mRNA levels or serum E2 levels. E2 maintains serum OT levels in perimenopausal rats, and other factors may elevate hypothalamic OT/OTR mRNA levels. Increases in body and fat weights in perimenopausal rats may be attributed to factors other than OT. Therefore, the administration of OT alone may not be sufficient to prevent metabolic disorders induced by the perimenopausal status. J. Med. Invest. 71 : 246-250, August, 2024.</p>","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":"71 3.4","pages":"246-250"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510225","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":"Cardiac arrest as an unusual complication in transforaminal full-endoscopic spine surgery under local anesthesia:a case report.","authors":"Takahiro Ogawa, Masatoshi Morimoto, Fumitake Tezuka, Kazuta Yamashita, Kosuke Sugiura, Shutaro Fujimoto, Michael Castro, Junzo Fujitani, Koichi Sairyo","doi":"10.2152/jmi.71.314","DOIUrl":"10.2152/jmi.71.314","url":null,"abstract":"<p><strong>Background: </strong>Transforaminal full-endoscopic surgery can be performed under local anesthesia, which is safer than general anesthesia, especially in the elderly. However, emergencies can still occur under local anesthesia. We describe a case of cardiac arrest at the start of full-endoscopic spine surgery under local anesthesia.</p><p><strong>Case presentation: </strong>The patient was an 80-year-old woman with right lower leg pain caused by two-level lumbar spinal canal stenosis. Two-stage full-endoscopic spine surgery under local anesthesia was planned. The first surgery was completed uneventfully. However, during the second surgery, cardiac arrest occurred because of Mobitz type II atrioventricular block. Percutaneous pacing was started immediately, followed by insertion of a temporary pacemaker via the femoral artery as a life-saving measure. Four days later, a permanent pacemaker was implanted. One month later, the second-stage decompression was completed without complications.</p><p><strong>Conclusion: </strong>Elderly patients require careful intraoperative monitoring for emergencies during surgery under local anesthesia as under general anesthesia. J. Med. Invest. 71 : 314-319, August, 2024.</p>","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":"71 3.4","pages":"314-319"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510223","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 histopathologically diagnosed case of hypoglycemic encephalopathy due to insulin overdose.","authors":"Hitomi Umemoto, Hideyuki Nushida, Asuka Ito, Hiromitsu Kurata, Itsuo Tokunaga, Hirofumi Iseki, Akiyoshi Nishimura","doi":"10.2152/jmi.71.340","DOIUrl":"10.2152/jmi.71.340","url":null,"abstract":"<p><p>A 70-year-old man presented with cardiopulmonary arrest. Previous medical history included orally medicated diabetes mellitus, hypertension, stroke, and depression. The family observed that the patient had been sleeping for approximately 10 h. He was brought to the hospital and pronounced dead. Postmortem blood examinations revealed a blood insulin level of 0.54 μU/mL, C-peptide level of 0.14 ng/mL, and blood glucose of 9 mg/dL. Autopsy revealed an injection scar with intradermal hemorrhage and a subcutaneous hemorrhage in the left abdomen measuring 0.2 cm in diameter. Histopathological analysis revealed hemorrhage and inflammatory cell infiltration in the scar. Furthermore, subcutaneous adipose tissue, perivascular area, and neurons stained positive for anti-insulin antibody. HE staining of the brain revealed mild edema, and anti-GFAP antibody revealed clasmatodendrosis with bead-like staining of astrocyte subdivisions in the cerebral gray matter. Postmortem blood glucose evaluation is difficult because blood glucose levels are not stable and blood insulin is degraded relatively quickly. However, the cause of death was determined to be hypoglycemic encephalopathy due to insulin overdose because insulin was detected in the skin at the injection site. Furthermore, immunohistochemical examination of the brain revealed findings that were consistent with hypoglycemic encephalopathy. Therefore, histological examination was useful for postmortem diagnosis. J. Med. Invest. 71 : 340-342, August, 2024.</p>","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":"71 3.4","pages":"340-342"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510219","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":"Acute myeloid leukemia developed through myeloproliferative features during immunosuppressive therapy for juvenile idiopathic arthritis.","authors":"Masahiro Oura, Ryohei Sumitani, Yusaku Maeda, Hikaru Yagi, Mamiko Takahashi, Takeshi Harada, Shiro Fujii, Hirokazu Miki, Taiki Hori, Jumpei Murai, Kumiko Kagawa, Masahiro Abe, Shingen Nakamura","doi":"10.2152/jmi.71.335","DOIUrl":"10.2152/jmi.71.335","url":null,"abstract":"<p><p>A 17-year-old male with thrombocytosis and exacerbation of arthralgia during intensified immunosuppressive therapy with tocilizumab, prednisolone, and methotrexate for juvenile idiopathic arthritis (JIA) was referred to our department. Bone marrow examination revealed myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable (MDS/MPN-U). Peripheral myeloblasts disappeared temporarily after discontinuation of tocilizumab but progressed to acute myeloid leukemia six months after the development of MDS/MPN-U. The patient sustained complete remission after unrelated bone marrow stem cell transplantation, followed by chemotherapy. The arthralgia also improved after chemotherapy. The possibility of developing malignancies during immunosuppressive therapy in patients with JIA should be considered. J. Med. Invest. 71 : 335-339, August, 2024.</p>","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":"71 3.4","pages":"335-339"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510221","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":"Five Years of Follow-up after Posterior Cervical Fusion Surgery for Hirayama Disease:A Case Report.","authors":"Kosuke Sugiura, Toshinori Sakai, Masatoshi Morimoto, Hiroaki Manabe, Fumitake Tezuka, Kazuta Yamashita, Koichi Sairyo","doi":"10.2152/jmi.71.298","DOIUrl":"10.2152/jmi.71.298","url":null,"abstract":"<p><strong>Background: </strong>Hirayama disease (HD) is characterized by slow progression of muscle atrophy without sensory disturbance in a single upper extremity in adolescent boys. HD can be treated using both conservative measures and surgery. However, the optimal treatment remains controversial.</p><p><strong>Case presentation: </strong>We have encountered an 18-year-old man with HD who presented to us with a 2-year history of progressive muscle atrophy and weakness of the left upper extremity. He underwent posterior cervical fusion surgery in the extended position without decompression. As of 5 years postoperatively, there has been no deterioration of his muscular atrophy and weakness and his condition has mildly improved. He was able to return to daily life and work with no difficulty.</p><p><strong>Conclusions: </strong>Although cervical fusion surgery has several risks, including adjacent segment disease, posterior spinal fusion surgery without decompression in the short segment can be considered as a surgical option for HD. J. Med. Invest. 71 : 298-302, August, 2024.</p>","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":"71 3.4","pages":"298-302"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510230","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":"Successful dilation using a Non-Slip Element Percutaneous Transluminal Angioplasty Scoring Balloon to treat in-stent restenosis of carotid artery stenting with inadequate dilation during balloon angioplasty:A case report.","authors":"Manabu Yamamoto, Shigeomi Yokoya, Takuma Kato, Hidesato Takezawa","doi":"10.2152/jmi.71.303","DOIUrl":"10.2152/jmi.71.303","url":null,"abstract":"<p><strong>Background: </strong>Carotid artery stenting (CAS) is commonly performed to treat internal carotid artery (ICA) stenosis;however, it is associated with high recurrence rates. The treatment of in-stent restenosis (ISR) following CAS poses several challenges, and percutaneous transluminal angioplasty (PTA) is a possible treatment option. Scoring balloons used in the cardiovascular field can prevent slipping and plaque incisions during balloon expansion;however, their efficacy in treating cervical ICA ISR remains uncertain.</p><p><strong>Case description: </strong>An 81-year-old man underwent CAS for carotid artery stenosis and subsequently developed ISR. Initial PTA with a noncompliant balloon failed to achieve sufficient dilation. However, the employment of a non-slip-element (NSE) PTA scoring balloon for additional expansion resulted in successful dilation, indicating its effectiveness in treating cervical ICA ISR. The patient was discharged postoperatively without any new neurological deficits, although magnetic resonance imaging revealed new ischemic lesions.</p><p><strong>Conclusion: </strong>The NSE PTA balloon could be considered as a valuable and effective treatment option for ISR when conventional balloon catheters face challenges in achieving dilation, although potential risks such as debris embolization should be considered. J. Med. Invest. 71 : 303-305, August, 2024.</p>","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":"71 3.4","pages":"303-305"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510269","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":"Schizophrenia and cognitive dysfunction.","authors":"Tomoya Takeda, Hidehiro Umehara, Yui Matsumoto, Tomohiro Yoshida, Masahito Nakataki, Shusuke Numata","doi":"10.2152/jmi.71.205","DOIUrl":"https://doi.org/10.2152/jmi.71.205","url":null,"abstract":"<p><p>Schizophrenia is a psychiatric disorder with cognitive dysfunction as a core symptom along with positive and negative symptoms. Cognitive dysfunction in schizophrenia can be broadly classified into neurocognitive and social cognitive deficits, with these deficits significantly influencing social functioning. Therapeutic interventions aiming to enhance neurocognition and social cognition have been developed. In this review, we describe the characteristics of cognitive dysfunction in patients with schizophrenia, its relationship to social function, and intervention strategies. J. Med. Invest. 71 : 205-209, August, 2024.</p>","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":"71 3.4","pages":"205-209"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510254","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":"Practices and Challenges of Home Care Pressure Ulcer Management;Perception of Home-visit Nurses Who Have Completed the Specified Medical Acts Training.","authors":"Ruriko Yamashita, Reiko Hisada, Miki Mori, Saori Nishino, Mitsunori Daibatake","doi":"10.2152/jmi.71.346","DOIUrl":"https://doi.org/10.2152/jmi.71.346","url":null,"abstract":"<p><strong>Purpose of the study: </strong>This study aims to clarify practices and challenges on pressure ulcer management as perceived by home-visit nurses who have completed the specified medical acts training.</p><p><strong>Methods: </strong>We gathered 8 home-visit nurses who have completed the training in Japan. First-author conducted in-depth, semi-structured individual interviews, asking for their insights on home care pressure ulcer management.</p><p><strong>Findings: </strong>We found that the home-visit nurses conducted the following practices;[having understandings and empathy as a health care professional who engage with client's lives with developing/worsening pressure ulcer], [pressure ulcer care at its best within limited resources], [systematic advice and guidance to caregivers and other professionals], and [demonstration of nursing as the post-training nurse of the specified medical acts]. We also learn that the home-visit nurses were faced with following challenges:[difficulties in smoothly collaborating with multiple professionals from different organizations], [not reaching a high level of expertise or skill], [limitations under the long-term care and medical insurance systems] and [impact of COVID-19].</p><p><strong>Conclusion: </strong>Home-visit nurses who have completed the specified medical acts training provided the nurses worked toward raising community's awareness of the care by providing leaderships to those involved in health care teams and collaborating with other professionals. J. Med. Invest. 71 : 346-355, August, 2024.</p>","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":"71 3.4","pages":"346-355"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510252","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}