Acta medica Okayama最新文献

Hemorrhage from a Jejunal Lymphangioma. 空肠淋巴管瘤出血。

IF 0.8 4区医学

Acta medica Okayama Pub Date : 2026-08-01 DOI: 10.18926/AMO/71069

Sachiko Ishikami, Shuta Tamura, Motoyasu Tabuchi, Nao Yamamoto, Yuki Okamoto, Rika Yoshimatsu, Manabu Matsumoto, Jun Iwata, Takehiro Okabayashi

{"title":"Hemorrhage from a Jejunal Lymphangioma.","authors":"Sachiko Ishikami, Shuta Tamura, Motoyasu Tabuchi, Nao Yamamoto, Yuki Okamoto, Rika Yoshimatsu, Manabu Matsumoto, Jun Iwata, Takehiro Okabayashi","doi":"10.18926/AMO/71069","DOIUrl":"10.18926/AMO/71069","url":null,"abstract":"Lymphangioma is a benign tumor arising from lymphatic vessel proliferation and most commonly occurs in the head, neck, or axilla. Involvement of the small intestine is rare and is often overlooked as a source of obscure gastrointestinal bleeding. Because jejunal lymphangiomas frequently present with nonspecific symptoms and may escape detection by conventional upper and lower gastrointestinal endoscopy or cross-sectional imaging, diagnosis is often delayed. Advances in balloon-assisted enteroscopy have enabled direct visualization of small intestinal lesions, facilitating accurate diagnosis and appropriate therapeutic decision-making. Here, we report a case of jejunal lymphangioma presenting with severe anemia due to active bleeding, which was detected by double-balloon endoscopy and successfully managed by laparoscopic-assisted resection. This case highlights the importance of considering small intestinal lymphangioma in the differential diagnosis of unexplained gastrointestinal bleeding and underscores the clinical utility of deep enteroscopy in identifying rare but clinically significant small bowel tumors.","PeriodicalId":7017,"journal":{"name":"Acta medica Okayama","volume":"80 4","pages":"253-257"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Post-Tracheostomy Fistula Formation Between the Trachea and Left Common Carotid Artery in a Pediatric Patient with Trisomy 18. 小儿18三体患者气管造口术后气管与左颈总动脉间瘘管形成。

IF 0.8 4区医学

Acta medica Okayama Pub Date : 2026-08-01 DOI: 10.18926/AMO/71068

Tsuyoshi Shiina, Hirokazu Watanabe, Junko Yoshimoto, Takeshi Sato, Daisaku Morimoto, Tomoka Okamura, Terutaka Tanimoto, Yosuke Washio, Takanori Oyama, Hirokazu Tsukahara, Takuo Noda

引用次数: 0

The Impact of Migraine on Cerebral Artery Dissection. 偏头痛对脑动脉夹层的影响。

IF 0.8 4区医学

Acta medica Okayama Pub Date : 2026-08-01 DOI: 10.18926/AMO/71065

Kenichi Kashihara, Toshikazu Hamaguchi, Yasuko Takeda

{"title":"The Impact of Migraine on Cerebral Artery Dissection.","authors":"Kenichi Kashihara, Toshikazu Hamaguchi, Yasuko Takeda","doi":"10.18926/AMO/71065","DOIUrl":"https://doi.org/10.18926/AMO/71065","url":null,"abstract":"The impact of migraines as a risk factor for cervicocerebral artery dissection was retrospectively investigated in patients who had a cervicocerebral artery dissection. We first evaluated the patients' medical records and history of migraine and then calculated the proportion of patients with migraine as well as the relevant vascular risk factors. The prevalence of migraine with respect to the location of the cervicocerebral artery dissection was also identified. Sixty-two patients (37 men, 25 women) had both a cerebral artery dissection and a record of migraine. Among them, 93.5% presented with an isolated headache, and 6.5% presented with a related stroke. Regarding the locations of the artery dissection, 56 (90.3%) were in the intracranial vertebral artery (VA), three (4.8%) were in the internal carotid artery, and one case each (1.6%) was in an anterior cerebral artery, basilar artery (BA), and both the VA and BA. Among the patients with VA dissection, 42 (73.7%) presented with migraines. Among the four patients with dissection of an artery of anterior circulation, only one (25%) had a migraine history. The frequency of migraines tended to be higher in the patients with VA dissection compared to those with a dissection of arteries of anterior circulation. These data suggest that (i) migraine is a potent risk factor for cerebral artery dissection, especially intracranial VA dissection, and (ii) the intracranial VA may be more susceptible to dissection compared to arteries of anterior circulation.","PeriodicalId":7017,"journal":{"name":"Acta medica Okayama","volume":"80 4","pages":"227-231"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Regional Prevalence of Carbapenemase-Producing Enterobacterales and Extended-Spectrum Beta-Lactamase-Producing Enterobacterales in Okayama and Neighboring Prefectures, Japan. 产碳青霉烯酶肠杆菌和广谱产β -内酰胺酶肠杆菌在日本冈山县及邻近地区的区域流行

IF 0.8 4区医学

Acta medica Okayama Pub Date : 2026-08-01 DOI: 10.18926/AMO/71066

Sakura Ogawa, Shinnosuke Fukushima, Hidemasa Akazawa, Sachie Namba, Chiyoko Hirota, Tomoyoshi Kishiue, Shohei Ibara, Takayuki Kondo, Genshi Fukuda, Koji Iio, Shuma Tsuji, Kazuyoshi Gotoh, Fumio Otsuka, Hideharu Hagiya

{"title":"Regional Prevalence of Carbapenemase-Producing Enterobacterales and Extended-Spectrum Beta-Lactamase-Producing Enterobacterales in Okayama and Neighboring Prefectures, Japan.","authors":"Sakura Ogawa, Shinnosuke Fukushima, Hidemasa Akazawa, Sachie Namba, Chiyoko Hirota, Tomoyoshi Kishiue, Shohei Ibara, Takayuki Kondo, Genshi Fukuda, Koji Iio, Shuma Tsuji, Kazuyoshi Gotoh, Fumio Otsuka, Hideharu Hagiya","doi":"10.18926/AMO/71066","DOIUrl":"https://doi.org/10.18926/AMO/71066","url":null,"abstract":"Carbapenemase-producing Enterobacterales (CPE) and extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (ESBL-E) are representative antimicrobial-resistant pathogens. We investigated the prevalence of CPE and ESBL-E in Okayama, Japan to clarify their current epidemiology and potential clinical burden. Active surveillance for CPE and ESBL-E was performed first, using stool samples submitted to the Okayama Medical Laboratory (Japan) in the years 2024-2025. Screening was performed using a selective agar (CHROMagar mSuper CARBA/ESBL). Phenotypic identification was conducted with the use of a modified carbapenem inactivation method and double-disk phenotypic confirmatory tests. Clinical information including patient age, sex, sampling date, and hospital address were collected, and the data were analyzed according to specimen origin (hospitals, clinics, and health checkups). A total of 2,000 stool samples were screened, of which two CPE isolates (0.1%) and 285 ESBL-E isolates (14.3%) were identified. By specimen origin, the ESBL-E positivity rate was significantly higher in hospitals (17.4%) than in clinics (11.8%). By age category, the late elderly (> 75 years) exhibited the highest ESBL-E positivity rate (22.6%) compared to other age groups. In the clinics and health checkups, infants (0 years) demonstrated high ESBL-E positivity rates (18.2% and 14.3%, respectively). Escherichia coli was the most common ESBL-E organism in the hospitals (77.2%), clinics (88.8%), and health checkups (87.5%). Our active screening demonstrated that the prevalences of CPE and ESBL-E were within the reported ranges; however, in this era of increasing internationalization, continuous surveillance of these notifiable pathogens is warranted.","PeriodicalId":7017,"journal":{"name":"Acta medica Okayama","volume":"80 4","pages":"233-240"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Video-Assisted Thoracoscopic Resection of an Upper Mediastinal Ectopic Parathyroid Adenoma. 电视胸腔镜切除上纵隔异位甲状旁腺瘤1例。

IF 0.8 4区医学

Acta medica Okayama Pub Date : 2026-08-01 DOI: 10.18926/AMO/71067

Yuta Hasegawa, Hironori Tsujimoto, Naoyuki Uehata, Risa Kariya, Asuma Ide, Takafumi Suzuki, Seiichiro Fujishima, Keita Kouzu, Yoshihisa Yaguchi, Kosuke Miyai, Ayumu Kurihara, Sho Ogata, Susumu Matsukuma, Hideki Ueno

{"title":"Video-Assisted Thoracoscopic Resection of an Upper Mediastinal Ectopic Parathyroid Adenoma.","authors":"Yuta Hasegawa, Hironori Tsujimoto, Naoyuki Uehata, Risa Kariya, Asuma Ide, Takafumi Suzuki, Seiichiro Fujishima, Keita Kouzu, Yoshihisa Yaguchi, Kosuke Miyai, Ayumu Kurihara, Sho Ogata, Susumu Matsukuma, Hideki Ueno","doi":"10.18926/AMO/71067","DOIUrl":"https://doi.org/10.18926/AMO/71067","url":null,"abstract":"Primary hyperparathyroidism (pHPT) is typically caused by a parathyroid adenoma, although some cases arise from ectopic glands. Accurate preoperative localization is essential for guiding surgical strategy, particularly for mediastinal lesions. We report successful video-assisted thoracoscopic surgery (VATS) for an upper mediastinal parathyroid adenoma. A 68-year-old woman was referred for hypercalcemia during evaluation for recurrent ureteral stones. Laboratory tests revealed elevated serum calcium (13.2 mg/dl) and intact parathyroid hormone (iPTH) levels (266 pg/ml). Contrast-enhanced computed tomography, magnetic resonance imaging, and 99mTc-methoxyisobutylisonitrile scintigraphy identified a 20-mm mass adjacent to the right esophageal wall. VATS was performed due to the tumor's mediastinal location. The lesion was resected with intraoperative nerve monitoring (IONM) to avoid recurrent laryngeal nerve damage. Postoperatively, iPTH and calcium levels rapidly normalized. Transient hypocalcemia and mild hoarseness occurred but resolved with calcium supplementation and conservative management. Pathological examination confirmed a parathyroid adenoma without malignancy. VATS offers a safe and minimally invasive approach for upper mediastinal parathyroid adenomas. IONM and vigilant calcium management are crucial for minimizing these complications. This case highlights the importance of comprehensive imaging, surgical planning, and postoperative care in managing upper mediastinal pHPT.","PeriodicalId":7017,"journal":{"name":"Acta medica Okayama","volume":"80 4","pages":"241-246"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spinous Process Plate Fixation Alone for an AO Spine Osteoporotic Fracture (OF) 5 Diffuse Idiopathic Skeletal Hyperostosis (DISH)-Associated Thoracolumbar Fracture in a Nonagenarian. 单独棘突钢板固定治疗AO脊柱骨质疏松性骨折（OF） 5例老年弥漫性特发性骨骼肥厚（DISH）相关胸腰椎骨折。

IF 0.8 4区医学

Acta medica Okayama Pub Date : 2026-08-01 DOI: 10.18926/AMO/71070

Satoru Yabuno, Masatoshi Yunoki, Saori Takeuchi, Koji Hirashita

{"title":"Spinous Process Plate Fixation Alone for an AO Spine Osteoporotic Fracture (OF) 5 Diffuse Idiopathic Skeletal Hyperostosis (DISH)-Associated Thoracolumbar Fracture in a Nonagenarian.","authors":"Satoru Yabuno, Masatoshi Yunoki, Saori Takeuchi, Koji Hirashita","doi":"10.18926/AMO/71070","DOIUrl":"https://doi.org/10.18926/AMO/71070","url":null,"abstract":"Diffuse idiopathic skeletal hyperostosis (DISH) predisposes the spine to highly unstable fractures because of long lever-arm biomechanics. Unstable injuries, including AO Spine Osteoporotic Fracture (OF) type 5, are typically treated with long-segment posterior instrumentation; however, pedicle-screw fixation may be infeasible in very elderly patients with severe osteoporosis, critically narrow pedicles, and/or significant comorbidities. A 93-year-old Japanese woman presented with severe back pain without apparent trauma. Computed tomography (CT) revealed a T12 fracture with DISH, classified as OF5. The pedicles were critically narrow (3.7-4.1 mm), and dual-energy X-ray absorptiometry confirmed severe osteoporosis. Because conventional pedicle-screw fixation was considered technically unsafe and excessively invasive, limited posterior stabilization was performed using a single spinous process plate spanning T10-L1. The operative time was 48 min and the estimated blood loss was 10 ml. Immediate postoperative CT confirmed appropriate implant positioning and maintained alignment. At the 1-year follow-up, CT demonstrated solid bony union with preserved alignment and no implant failure; the patient had remained pain-free and ambulatory. This case demonstrates that spinous process-plate fixation can be a minimally invasive salvage option for carefully selected very-elderly patients with DISH when pedicle-screw instrumentation is not feasible.","PeriodicalId":7017,"journal":{"name":"Acta medica Okayama","volume":"80 4","pages":"259-264"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transcanal Cochlear Implantation Under Endoscopic Guidance with Canal Closure in a Pediatric Patient with CHARGE Syndrome: A Case Report and Surgical Technique. 内镜引导下经鼻人工耳蜗植入并关闭耳管治疗小儿CHARGE综合征：一例报告及手术技术。

IF 0.8 4区医学

Acta medica Okayama Pub Date : 2026-08-01 DOI: 10.18926/AMO/71071

Takuto Yamasaki, Akiko Sugaya, Yuto Naoi, Shin Kariya, Mizuo Ando

引用次数: 0

A Novel Flap Design to Reduce Urethral Complications in Anterolateral Thigh Phalloplasty: The Pipe Flap Technique. 减少股前外侧阴茎成形术中尿道并发症的新型皮瓣设计：管状皮瓣技术。

IF 0.8 4区医学

Acta medica Okayama Pub Date : 2026-06-01 DOI: 10.18926/AMO/70857

Toshiro Imai, Toshiyuki Watanabe, Shiho Watanabe, Masanobu Hayashi, Yusuke Tominaga, Yuzaburo Namba

引用次数: 0

HIP COMPASS®: A Mechanical Intraoperative Navigation Guide Associated with Improved Revision-Free Implant Survivorship after Ceramic-on-Ceramic Total Hip Arthroplasty at Minimum 10-Year Follow-up. HIP COMPASS®：一种机械术中导航指南与陶瓷对陶瓷全髋关节置换术后至少10年随访中无修复种植体存活的改善相关。

IF 0.8 4区医学

Acta medica Okayama Pub Date : 2026-06-01 DOI: 10.18926/AMO/70855

Yoshiaki Tei, Norio Imai, Keishi Kimura, Yuki Hirano, Yoji Horigome, Ken Suda, Hiroyuki Kawashima

{"title":"HIP COMPASS®: A Mechanical Intraoperative Navigation Guide Associated with Improved Revision-Free Implant Survivorship after Ceramic-on-Ceramic Total Hip Arthroplasty at Minimum 10-Year Follow-up.","authors":"Yoshiaki Tei, Norio Imai, Keishi Kimura, Yuki Hirano, Yoji Horigome, Ken Suda, Hiroyuki Kawashima","doi":"10.18926/AMO/70855","DOIUrl":"https://doi.org/10.18926/AMO/70855","url":null,"abstract":"HIP COMPASS® has demonstrated improved accuracy in intraoperative support for the acetabular component insertion angle. We assessed long-term revision-free implant survivorship following total hip arthroplasty (THA) using HIP COMPASS, with ≥10 years of follow-up. We retrospectively analyzed 210 hips of 186 patients who underwent cementless THA with ceramic-on-ceramic bearing couples, with or without HIP COMPASS. The mean follow-up duration was 10.8 years in the HIp COMPASS group and 12.7 years in the control group. Overall, 86.0% and 78.2% of cups were placed within Lewinnek's safe zone with and without HIP COMPASS, respectively. Variability in radiographic inclination and anteversion was greater in the control group than in the HIP COMPASS group. Dislocation rates were 3.2% in the control group and 1.2% in the HIP COMPASS group, with no significant difference between groups. The control group had a significantly higher revision rate than the HIP COMPASS group (7.3% vs. 1.2%). Use of HIP COMPASS was associated with improved long-term revision-free implant survivorship over ≥ 10 years and more consistent acetabular component positioning at an appropriate insertion angle, which may contribute to stable initial fixation.","PeriodicalId":7017,"journal":{"name":"Acta medica Okayama","volume":"80 3","pages":"195-202"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Common Bile Duct Stone Formed Around an Ingested Fish Bone. 胆总管结石形成周围摄入鱼骨。

IF 0.8 4区医学

Acta medica Okayama Pub Date : 2026-06-01 DOI: 10.18926/AMO/70858

Kaitaro Higashi, Motoyasu Tabuchi, Shinya Sakamoto, Shuta Tamura, Sunao Uemura, Teppei Tokumaru, Takehiro Okabayashi

引用次数: 0