Hiroshima Journal of Medical Sciences
Online ISSN : 2433-7668
Print ISSN : 0018-2052
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  • Miftahul Akhyar LATIEF, Diah Gemala IBRAHIM, Ulfah RIMAYANTI, Tomoyuki ...
    2019 Volume 68 Issue 2-3 Pages 19-26
    Published: 2019
    Released: December 12, 2019
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    Purpose: The purpose of this study was to examine the outer retinal layer thicknesses in normal and glaucomatous eyes with a Topcon 3D spectral domain optical coherence tomography (SD-OCT) instrument.

    Methods: Fifty-nine normal eyes and 139 glaucomatous eyes were included in this study. The SD-OCT images were assessed to determine the overall average, superior, and inferior thicknesses of the inner and outer retinal layers. The macula was examined in an area of 7 × 7 mm centered on the fovea and divided into 10 × 10 grids. The thicknesses of the inner and outer macular layers in each square of the ten grids horizontally aligned below the fovea were plotted in a line graph.

    Results: The findings indicated that all the inner retinal parameters decreased with increasing glaucoma severity. The difference in outer retinal layer thickness between the normal and all the glaucoma groups was not significant. However, the outer retinal layer thickness was significantly different for different glaucoma severity subgroups (P < 0.05). The changes in thickness in the outer retinal layer in the ten small squares horizontally aligned under the fovea revealed significant differences between the normal control group and the various glaucoma severity subgroups.

    Conclusions: Changes in the thickness of the outer macular retinal layer can be detected using a Topcon 3D SD-OCT 2000. The findings of this study indicate that the outer retinal layer might be involved in glaucomatous eyes.

  • Hiromi FURUIE, Takao HAMAMOTO, Nobuyuki CHIKUIE, Takashi KONO, Takayuk ...
    2019 Volume 68 Issue 2-3 Pages 27-34
    Published: 2019
    Released: December 12, 2019
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    Concurrent chemoradiotherapy (CRT) for head and neck cancer (HNC) is associated with substantial side effects, most notably those related to swallowing function. Recently, early implementation of protective exercises has been recommended as an important intervention in patients treated with chemoradiotherapy. Several studies, including randomized controlled trials, have evaluated prophylactic swallowing exercises and swallowing outcomes. Although several clinical outcome measures to assess the severity of swallowing dysfunction are available, they are indirect measures. Videofluorography is the most popular and efficient examination that visually demonstrates the dynamic state of swallowing. This study aimed to determine whether prophylactic swallowing rehabilitation provided to HNC patients receiving CRT would result in better swallowing outcomes. Thirty patients were enrolled in this study. Fifteen patients (the control group) received swallowing rehabilitation after CRT on demand, and the other 15 (the rehabilitation group) received prophylactic swallowing rehabilitation from the beginning. Swallowing motion was evaluated with motion analysis software. There were statistically significant differences in hyoid bone displacement, duration of swallowing onset, larynx elevation time, and total swallowing time between the control and rehabilitation groups. Based on the results of this study, prophylactic swallowing rehabilitation seems to reduce the extent and severity of the functional problems that occur after CRT.

  • Akinori SHIMIZU, Yasutaka ISHII, Masahiro SERIKAWA, Tomofumi TSUBOI, K ...
    2019 Volume 68 Issue 2-3 Pages 35-41
    Published: 2019
    Released: December 12, 2019
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    Background and Purpose: The concept of early chronic pancreatitis was proposed in Japan with the aim to improve the prognosis of patients with chronic pancreatitis. Endoscopic ultrasonography plays an important role in early diagnoses, but is limited by its invasiveness and poor objectivity. Hence, this study aimed to determine the usefulness of transabdominal ultrasound real-time tissue elastography as a screening method for early chronic pancreatitis.

    Methods: We retrospectively examined 73 patients who underwent simultaneous ultrasound real-time tissue elastography and endoscopic ultrasonography from 2011 to 2014. The correlation between feature values (MEAN, %AREA, COMP) calculated by real-time tissue elastography and the Rosemont classification of endoscopic ultrasonography diagnostic criteria for chronic pancreatitis, and the diagnostic ability of ultrasound real-time tissue elastography to recognize “indeterminate for chronic pancreatitis” findings, which correspond to early chronic pancreatitis, were evaluated.

    Main Results: Based on the Rosemont classification, 26 patients were “normal”, 16 were “indeterminate for chronic pancreatitis”, 13 were “suggestive of chronic pancreatitis”, and 18 were “consistent with chronic pancreatitis”. There were significant correlations between the feature values (MEAN, %AREA, COMP) and the Rosemont classification (p < 0.001; ρ = –0.788, 0.779, and 0.489, respectively). The area under the curve for the ability of MEAN to diagnose “indeterminate for chronic pancreatitis” was 0.889 (sensitivity, 93.8%; specificity, 76.9%).

    Conclusions: The feature values calculated by ultrasound real-time tissue elastography were correlated with the Rosemont classification. Ultrasound real-time tissue elastography may be a useful screening method for early chronic pancreatitis.

  • Hidenori MITANI, Yasutaka BABA, Toru HIGAKI, Keigo CHOSA, Kazuo AWAI
    2019 Volume 68 Issue 2-3 Pages 43-47
    Published: 2019
    Released: December 12, 2019
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    Splenic injury is common in blunt trauma. As post-injury splenic volume changes are unclear, the aim of this study was to elucidate such changes. This retrospective study included 18 patients (14 males, median age 24.5 years) with a splenic injury treated between January 2009 and December 2016. All underwent computed tomography (CT) during admission to our hospital and at the last follow-up visit. The splenic volumes on the first and last enhanced delayed-phase CT scans were compared. The fluid response, transfusion, injury severity score, trauma grade, and extent of splenic artery embolization (SAE) were obtained from medical records. The volume change was assessed with a Mann-Whitney U-test. The volume change in patients treated conservatively was also evaluated to study the natural course after injury. On the first and last scans, the median splenic volume was 105.8 (interquartile range [IQR] 65.4–139.7) and 123.6 (IQR 102.0–225.0) cm3, respectively. The volume increased by 67 (-0.4 ± 120.0) %. SAE was the only factor significantly related to the volume change (p < 0.05). The median follow-up period was 13 (IQR 6–20) days. In conservatively treated patients, the splenic volume change was correlated with the interval between the first and last CT studies. Our findings suggest that the volume of the injured spleen increases in the natural course after trauma. SAE resulted in a decrease in the splenic volume.

  • Nobuyuki CHIKUIE, Takao HAMAMOTO, Takashi ISHINO, Tsutomu UEDA, Akira ...
    2019 Volume 68 Issue 2-3 Pages 49-53
    Published: 2019
    Released: December 12, 2019
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    Ganglioneuroma, which rarely occurs in the neck region, is a well-differentiated benign tumor of the sympathetic nervous system. A 39-year-old man presented with neck swelling for a year. A giant tumor was located on the left side of the neck. Schwannoma was suspected on preoperative cytology and core needle biopsy, and the postoperative diagnosis on pathological examination was ganglioneuroma. The origin of the tumor was considered to be the sympathetic nervous system based on the postoperative appearance of Horner’s syndrome. The treatment choice for ganglioneuromas is complete surgical resection, contrary to the nerve-sparing resection of schwannomas. Therefore, making the definitive diagnosis before surgical resection could be important. In this report, we focus on the differential diagnosis obtained with radiological findings and the treatment strategy for the tumor with a literature review.

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