Faculty Profiles - OTSUKA Fumio

FDG uptake in toxic multinodular goiter．

Ocho K, Hasegawa K, Otsuka F

J. Hosp. Gen. Med. 1 ( 2 ) 14 - 15 2019.7

Factors related to burnout in resident physicians in Japan. International journal

Yoshito Nishimura, Tomoko Miyoshi, Mikako Obika, Hiroko Ogawa, Hitomi Kataoka, Fumio Otsuka

International journal of medical education 10 129 - 135 2019.7

Language：English Publishing type：Research paper (scientific journal) Publisher：INT JOURNAL MEDICAL EDUCATION-IJML

Objectives: We explore the prevalence and characteristics of burnout among Japanese resident physicians and identifies factors associated with burnout. Methods: A cross-sectional study was conducted three times between April 2017 and March 2018 at a Japanese teaching hospital. Resident physicians were invited to answer an online survey that included existing valid instruments related to burnout, depression, and empathy. Demographic, background, occupational, and socioeconomic data were also collected. Participants were prompted to report the average daily work hours and the specialty they wish to pursue. Results: Overall, 39/76 (51%), 27/76 (36%), and 21/76 (28%) resident physicians responded to surveys in April 2017, October 2017, and March 2018, respectively. The percentages of participants with burnout for surveys in April 2017, October 2017, and March 2018 were 7/39 (18%), 6/27 (22%), and 7/21 (33.3%). Emotional exhaustion (EE) was the only burnout component strongly correlated with the severity of depression (r = .615, p < .001; r = .706, p < .001; r = .601, p < .01). EE and depersonalization (DP) had no significant correlation with average daily working hours (β = .156, p = .343 for EE; β = .061, p = .711 for DP). Conclusions: The results suggest that capping working hours alone may not be effective in reducing burnout in Japanese resident physicians. Medical educators might need to consider not only working hours but also individual job quality and satisfaction to address burnout. Future studies may need to incorporate qualitative methods to explore the characteristics of burnout.

DOI： 10.5116/ijme.5caf.53ad

Swollen Hands and "Fist Sign" in Acromegaly. International journal

Ko Harada, Kou Hasegawa, Fumio Otsuka

The American journal of medicine 132 ( 7 ) e618-e619 - E619 2019.7

A Huge Liver Cyst Manifesting Dyspnea and Edema.

Satoko Nagao, Masaya Iwamuro, Hidenori Shiraha, Fumio Otsuka

Internal medicine (Tokyo, Japan) 58 ( 12 ) 1811 - 1812 2019.6

Histidine-rich glycoprotein augments natural killer cell function by modulating PD-1 expression via CLEC-1B. International journal

Yoshito Nishimura, Hidenori Wake, Kiyoshi Teshigawara, Dengli Wang, Masakiyo Sakaguchi, Fumio Otsuka, Masahiro Nishibori

Pharmacology research & perspectives 7 ( 3 ) e00481 - e00481 2019.6

Language：English Publishing type：Research paper (scientific journal) Publisher：JOHN WILEY & SONS LTD

Augmentation of natural killer (NK) cell cytotoxicity is one of the greatest challenges for cancer immunotherapy. Although histidine-rich glycoprotein (HRG), a 75-kDa glycoprotein with various immunomodulatory activities, reportedly elicits antitumor immunity, its effect on NK cell cytotoxicity is unclear. We assessed NK cell cytotoxicity against K562 cells. We also measured concentrations of cytokines and granzyme B in the cell supernatant. The proportion of CD56bright NK cells and NK cell surface PD-1 expression was assessed with flow cytometry. The neutralizing effects of anti-C-type lectin-like receptor (CLEC) 1B against HRG were also measured. NK cell morphological changes were analyzed via confocal microscopy. HRG significantly increased NK cell cytotoxicity against K562 cell lines. HRG also increased the release of granzyme B and the proportion of CD56bright NK cells. Further, HRG was able to decrease NK cell surface PD-1 expression. The effects of HRG on NK cells were reversed with anti-CLEC-1B antibodies. Additionally, we confirmed NK cell nuclear morphology and F-actin distribution, which are involved in the regulation of cytotoxic granule secretion. Because both PD-1 and CLEC-1B are associated with prognosis during malignancy, HRG incorporates these molecules to exert the antitumor immunity role. These facts indicate the potential of HRG to be a new target for cancer immunotherapy.

DOI： 10.1002/prp2.481

Anterior Cutaneous Nerve Entrapment Syndrome Possibly Triggered by Oral Contraceptives.

Daisuke Omura, Mikako Obika, Masaya Iwamuro, Satoko Nagao, Takahiro Nada, Takashi Matsuzaki, Yoshitaka Kondo, Fumio Otsuka

Internal medicine (Tokyo, Japan) 58 ( 10 ) 1507 - 1509 2019.5

Language：English Publishing type：Research paper (scientific journal) Publisher：JAPAN SOC INTERNAL MEDICINE

We herein report a teenage girl who had been taking oral contraceptive pills for three months and complained of left lower abdominal pain that had continued for two months. A physical examination indicated anterior cutaneous nerve entrapment syndrome (ACNES), although no abnormality was found in various biochemical and imaging examinations. The pain was only transiently ameliorated by trigger-point injection, and neurectomy surgery was eventually effective. Sex steroids can be involved in the progress of local tissue edema causing ACNES. ACNES should be considered in cases of abdominal pain in patients taking oral contraceptives.

DOI： 10.2169/internalmedicine.1361-18

Retention cysts due to latent pancreatic cancer．

Oka K, Horiguchi S, Obika M, Otsuka F

J. Hosp. Gen. Med. ( 1 ) 6 - 6 2019.5

Cardiac Computed Tomography of Aortic Infective Endocarditis．

Harada K, Otsuka F

QJM 112 ( 5 ) 377 - 378 2019.5

Diffuse Vascular FDG Uptake in Late Onset Takayasu Arteritis. International journal

Ko Harada, Kou Hasegawa, Fumio Otsuka

The American journal of medicine 132 ( 5 ) e560-e561 - E561 2019.5

Mesenteric follicular lymphoma. International journal

Yoshito Nishimura, Akira Yamamoto, Masahiro Takahara, Fumio Otsuka

Clinical case reports 7 ( 5 ) 1108 - 1109 2019.5

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY

When you see a patient with solid mesenteric tumors, malignant lymphoma should be considered as an important differential diagnosis. It is essential to include abdominal CT and 18F-FDG PET/CT examinations in these patients for early diagnosis of malignant lymphoma, giving extra weight on patients' complaints.

DOI： 10.1002/ccr3.2148

Septic pulmonary emboli caused by infected central venous port. International journal

Ko Harada, Fumio Otsuka

Postgraduate medical journal 95 ( 1123 ) 282 - 282 2019.5

Symptomatic Adrenal Myelolipoma.

Daisuke Omura, Yasuhiro Nakano, Ryosuke Takase, Fumio Otsuka

Internal medicine (Tokyo, Japan) 58 ( 8 ) 1181 - 1181 2019.4

Renal intravascular lymphoma diagnosed by FDG-PET.

J. Hosp. Gen. Med. 2019.4

Axillary lymph node tuberculosis in the elderly．

Ocho K, Tanimoto S, Shioji Y, Fujita K, Otsuka F

J. Hosp. Gen. Med. 15 106 - 107 2019.4

FDG PET/CT findings in infected abdominal aortic aneurysm．

Harada K, Fukushima F, Tokumasu K, Hagiya H, Otsuka F

J. Hosp. Gen. Med. 1 ( 4 ) 59 - 60 2019.4

Fever of unknown origin without increase of serum C-reactive protein in a patient with acute lymphoblastic leukemia/ lymphoblastic lymphoma．

Oka K, Fujimura T, Horiguchi S, Yano T, Kondo E, Otsuka F

J. Hosp. Gen. Med 1 ( 3 ) 45 - 49 2019.4

Peripartum cardiomyopathy with marked pulmonary edema: A case report．

Harada K, Otsuka F

J. Hosp. Gen. Med. 1 ( 3 ) 26 - 30 2019.4

Delayed postoperative hyponatremia after endoscopic transsphenoidal surgery for pituitary adenoma. International journal

Yusuke Tomita, Kazuhiko Kurozumi, Kenichi Inagaki, Masahiro Kameda, Joji Ishida, Takao Yasuhara, Tomotsugu Ichikawa, Tomoko Sonoda, Fumio Otsuka, Isao Date

Acta neurochirurgica 161 ( 4 ) 707 - 715 2019.4

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER WIEN

BACKGROUND: Hyponatremia generally occurs after transsphenoidal surgery (TSS) in a delayed fashion. Most patients with delayed postoperative hyponatremia (DPH) are asymptomatic or only express non-specific symptoms; consequently, DPH is associated with prolonged hospitalization. No consensus has been reached on which patients are at greatest risk of developing DPH. We reviewed patients with DPH and evaluated predictive factors for DPH. METHODS: We retrospectively analyzed 107 consecutive patients who underwent endoscopic TSS for pituitary adenoma (January 2010-December 2016). Patients with DPH (hyponatremia group) and without DPH (normonatremia group) were compared according to their nadir sodium levels on postoperative days 3 to 10. We documented the patients' demographics, clinical features, and postoperative physiological characteristics. RESULTS: Twenty-five (23.4%) patients developed DPH after endoscopic TSS. The patients' mean age was 54 ± 17 years, and 63.6% of the patients were female. The overall prevalence of DPH was 23.4%. The non-parametric χ2 test and the Mann-Whitney U test revealed statistically significant differences in age, use of antihypertensive drugs, nonfunctioning pituitary adenoma, and higher yet normal preoperative thyroid-stimulating hormone level between the hyponatremia and normonatremia groups (P < 0.05). Logistic regression analysis revealed that only older age was a useful independent predictive factor for DPH (odds ratio, 1.05; 95% confidence interval, 1.01-1.08; P = 0.01). The serum sodium levels on postoperative day 2 were significantly lower in the hyponatremia than normonatremia group (P < 0.01) and were negatively correlated with age (r = - 0.25, P < 0.05). The cut-off age for predicting DPH was 55 years. The hospital stay was significantly longer in the hyponatremia than normonatremia group (P < 0.01). CONCLUSIONS: Age of more than 55 years was an independent predictive factor for DPH even after adjusting for potential confounders. Older age was negatively correlated with the serum sodium level on postoperative day 2. Preventing early decreases in the sodium level could reduce the risk of DPH. TRIAL REGISTRATION: 1707-027.

DOI： 10.1007/s00701-019-03818-3

Effects on postgraduate-year-I residents of simulation-based learning compared to traditional lecture-style education led by postgraduate-year-II residents: a pilot study. International journal

Akira Yamamoto, Mikako Obika, Yasuhiro Mandai, Taku Murakami, Tomoko Miyoshi, Hideo Ino, Hitomi Kataoka, Fumio Otsuka

BMC medical education 19 ( 1 ) 87 - 87 2019.3

Language：English Publishing type：Research paper (scientific journal) Publisher：BMC

BACKGROUND: Simulation-based learning plays an important role in contemporary medical education, although there are problems providing tutors. Peer-assisted learning has begun being formally adopted in medical education. Although it is considered useful for simulation-based learning, its effectiveness remains unclear. This study was designed to compare the effect of simulation-based learning with that of traditional lectures conducted by postgraduate-year (PGY)-II residents on PGY-I residents. METHODS: This study was conducted at Okayama University Hospital over three years, for one week each year, before residents entered clinical practice. The study enrolled 76 PGY-I residents, who were randomized into two groups: simulation and lecture groups. PGY-II residents volunteered to conduct simulations and lectures. Knowledge evaluation was performed using pre- and post-tests, and self-evaluation of competence and behaviour-change and program evaluations were conducted using questionnaires. RESULTS: In both groups, knowledge test scores were found to improve significantly, and the score difference between pre- and post-tests in both the groups was not significant. Self-evaluation of competence and behaviour-change was found to be higher in the simulation group than the lecture group. The trainees in the simulation group valued the program and the PGY-II residents as teaching staff more than those in the lecture group. CONCLUSIONS: The combination of simulation-based learning and peer-assisted learning led by PGY-II residents is potentially more effective in improving the postgraduate education of PGY-I residents than the combination of lecture and peer-assisted learning.

DOI： 10.1186/s12909-019-1509-y