Faculty Profiles - OTSUKA Fumio

Hypertrophic Pachymeningitis Accompanying Scleritis

Kosuke Oka, Kazuki Ocho, Masaya Iwamuro, Fumio Otsuka

Internal Medicine 56 ( 17 ) 2383 - 2384 2017

Paroxysmal Hypertension Induced by an Insulinoma. Reviewed

Ko Harada, Yoshihisa Hanayama, Kou Hasegawa, Masaya Iwamuro, Hideharu Hagiya, Ryuichi Yoshida, Fumio Otsuka

Internal medicine (Tokyo, Japan) 56 ( 4 ) 413 - 417 2017

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

Insulinoma is a rare, usually benign, pancreatic neuroendocrine tumor. The clinical features of an insulinoma are fasting hypoglycemia with neuroglycopenic symptoms including confusion and unusual behavior, while hypertension is usually not associated with the disease. We herein report a patient with insulinoma who manifested paroxysmal hypertension and neuroglycopenic symptoms. The possible etiology of hypertension induced by an insulinoma is catecholamine release in response to hypoglycemia, which may cause acute hypertension through activation of the sympatho-adrenal system. This case implies that sustained hyperinsulinemia due to insulinoma can be functionally linked to the induction of paroxysmal hypertension.

DOI： 10.2169/internalmedicine.56.7758

A Rare Case of Diffuse Large B-cell Lymphoma in a Patient with IgG4-Related Autoimmune Pancreatitis. Reviewed

Yoshito Nishimura, Masaya Iwamuro, Kazuki Ocho, Kou Hasegawa, Kosuke Kimura, Yoshihisa Hanayama, Eisei Kondo, Takehiro Tanaka, Fumio Otsuka

Acta medica Okayama 70 ( 4 ) 279 - 83 2016.8

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

A 61-year-old Japanese man with IgG4-related autoimmune pancreatitis was referred to our hospital because of perspiration during food intake. Abdominal computed tomography (CT) with contrast media revealed multiple mesenteric lymphadenopathies. An open surgical abdominal biopsy and subsequent histopathological analysis revealed abnormally large lymphoid cells that were negative for CD3, CD5, and c-myc and positive for CD20 and bcl-2, leading to a diagnosis of diffuse large B-cell lymphoma. Here, we discuss the risk of malignancies, particularly malignant lymphoma in patients with IgG4-related disease. The importance of pathological analysis to reach the appropriate diagnosis in such cases should be emphasized.

Increased Serum KL-6 Levels Induced by Pulmonary Mycobacterium Avium Complex Infection in a Patient with RA-associated Lung Disease. Reviewed

Koichi Waseda, Kazuki Ocho, Kou Hasegawa, Kosuke Kimura, Masaya Iwamuro, Yoshihisa Hanayama, Eisei Kondo, Nobuaki Miyahara, Fumio Otsuka

Acta medica Okayama 70 ( 3 ) 217 - 221 2016.6

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

KL-6 is a glycoprotein found predominantly on type II pneumocytes and alveolar macrophages, and often shows increased serum levels in patients with interstitial pneumonia. We report a case of mycobacterium avium complex (MAC) infection whose disease activity was correlated with KL-6 levels in serum. During treatment of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) with prednisolone, chest image findings improved in association with decreased KL-6 levels. Following tapering of prednisolone, chest image findings deteriorated again as levels of KL-6 increased, suggesting recurrence of RA-ILD. Bronchoscopic examination revealed active MAC infection. Treatment of MAC infection not only improved chest image findings but also decreased KL-6 levels in serum, suggesting that KL-6 was increased by active MAC infection by itself, not by recurrence of RA-ILD. To the best of our knowledge, this is the first documentation of KL-6 elevation in serum in association with active MAC infection.

Antiobesity Action of ACAM by Modulating the Dynamics of Cell Adhesion and Actin Polymerization in Adipocytes. Reviewed International journal

Kazutoshi Murakami, Jun Eguchi, Kazuyuki Hida, Atsuko Nakatsuka, Akihiro Katayama, Miwa Sakurai, Haruki Choshi, Masumi Furutani, Daisuke Ogawa, Kohji Takei, Fumio Otsuka, Jun Wada

Diabetes 65 ( 5 ) 1255 - 67 2016.5

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER DIABETES ASSOC

Coxsackie virus and adenovirus receptor-like membrane protein (CLMP) was identified as the tight junction-associated transmembrane protein of epithelial cells with homophilic binding activities. CLMP is also recognized as adipocyte adhesion molecule (ACAM), and it is upregulated in mature adipocytes in rodents and humans with obesity. Here, we present that aP2 promoter-driven ACAM transgenic mice are protected from obesity and diabetes with the prominent reduction of adipose tissue mass and smaller size of adipocytes. ACAM is abundantly expressed on plasma membrane of mature adipocytes and associated with formation of phalloidin-positive polymerized form of cortical actin (F-actin). By electron microscopy, the structure of zonula adherens with an intercellular space of approximate to 10-20 nm was observed with strict parallelism of the adjoining cell membranes over distances of 1-20 m, where ACAM and -actin are abundantly expressed. The formation of zonula adherens may increase the mechanical strength, inhibit the adipocyte hypertrophy, and improve the insulin sensitivity.

DOI： 10.2337/db15-1304

レボドパと酸化マグネシウムの同時内服で黒色痰・黒色尿を呈した1例 Reviewed

岩室雅也、灘隆宏、大塚文男

内科 117 ( 2 ) 2016.2

BMP-6 modulates somatostatin effects on luteinizing hormone production by gonadrotrope cells. Reviewed International journal

Kishio Toma, Fumio Otsuka, Kohei Oguni, Tomohiro Terasaka, Motoshi Komatsubara, Naoko Tsukamoto-Yamauchi, Kenichi Inagaki, Hirofumi Makino

Peptides 76 96 - 101 2016.2

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

The effects of somatostatin analogs and roles of BMP-6 in the regulation of luteinizing hormone (LH) secretion were investigated using mouse gonadotrope LβT2 cells. LH mRNA expression and LH secretion induced by GnRH were suppressed by treatments with somatostatin analogs, including octreotide and pasireotide, in LβT2 cells. Of note, the inhibitory effects of somatostatin analogs on LH secretion were enhanced by the action of BMP-6. BMP-6 increased the expression levels of somatostatin receptor (SSTR)5, suggesting that BMP-6 upregulates SSTR activity that leads to reduction of GnRH-induced LH secretion. In addition, GnRH-induced phosphorylation of MAPKs including ERK, but not P38 or SAPK, was suppressed by pasireotide in the presence of BMP-6. Given that each inhibitor of ERK, JNK or P38 signaling suppressed GnRH-induced LH transcription, MAPKs are individually involved in the induction of LH production by LβT2 cells. Somatostatin analogs also impaired BMP-6-induced Smad1/5/8 phosphorylation by suppressing BMPRs and augmenting Smad6/7 expression. Collectively, the results indicate that somatostatin analogs have dual effects on the modulation of GnRH-induced MAPK signaling and BMP activity. The pituitary BMP system may play a regulatory role in GnRH-induced LH secretion by tuning the responsiveness to somatostatin analogs in gonadotrope cells.

DOI： 10.1016/j.peptides.2016.01.011

Multiple Organomegaly Exhibited in a Patient with Graves' Hyperthyroidism

Eagle症候群の1例 Reviewed

岩室雅也、小牧稔幸、大塚文男

内科 117 ( 2 ) 2016.1

Kazuki Ocho, Masaya Iwamuro, Fumio Otsuka

Internal Medicine 55 ( 18 ) 2737 - 2738 2016

Xanthoma of the Duodenum

Masaya Iwamuro, Takehiro Tanaka, Fumio Otsuka, Hiroyuki Okada

Internal Medicine 55 ( 19 ) 2899 - 2900 2016

Emergence of Daptomycin-Resistant Staphylococcus aureus during Treatment. Reviewed

Hideharu Hagiya, Yuto Haruki, Taeko Uchida, Tomoko Wada, Sumiko Shiota, Tomoharu Ishida, Hiroko Ogawa, Tomoko Murase, Fumio Otsuka

Internal medicine (Tokyo, Japan) 55 ( 1 ) 73 - 8 2016

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

A 68-year-old man with persistent bacteremia accompanying a large iliopsoas abscess, vertebral osteomyelitis, discitis and central venous port infection caused by methicillin-resistant Staphylococcus aureus (MRSA) was admitted to our hospital. During the course of treatment, the emergence of a daptomycin (DAP)-resistant MRSA strain was confirmed; the minimum inhibitory concentration was 1 to 2 μg/mL for vancomycin and more than 1 μg/mL for DAP. Although the bacterial cell wall was not significantly thickened, an increased positive surface charge and single-nucleotide polymorphism within mprF have been confirmed in DAP-resistant strains. Still rare, but clinicians need to be cautious of the emergence of DAP-resistant MRSA during treatment.

DOI： 10.2169/internalmedicine.55.4763

White Feces Caused by the Administration of a Somatostatin Analogue. Reviewed

Iwamuro M, Terasaka T, Otsuka F, Okada H

Internal medicine (Tokyo, Japan) 55 ( 13 ) 1817 - 1817 2016

Invasive Intrasellar Plasmacytoma Mimicking Pituitary Adenoma. Reviewed

Terasaka T, Inagaki K, Otsuka F

Internal medicine (Tokyo, Japan) 55 ( 11 ) 1501 - 1502 2016

Reactivation of Human Herpes Virus-6 in the Renal Tissue of a Patient with Drug-induced Hypersensitivity Syndrome/Drug Rash with Eosinophilia and Systemic Symptoms (DIHS/DRESS). Reviewed

Hideharu Hagiya, Masaya Iwamuro, Takehiro Tanaka, Kou Hasegawa, Yoshihisa Hanayama, Maya Kimura, Fumio Otsuka

Internal medicine (Tokyo, Japan) 55 ( 13 ) 1769 - 74 2016

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

A 74-year-old man who had been administered trimethoprim-sulfamethoxazole for three weeks suffered from drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms (DIHS/DRESS). In the early stage of the clinical course, he developed renal dysfunction. A renal biopsy showed granulomatous tubulointerstitial nephritis accompanying the proliferation of human herpes virus ( HHV)-6 in tubular epithelial cells. With corticosteroid therapy, the systemic rash and renal function gradually improved. The present patient is the second case of DIHS/DRESS demonstrating a possible reactivation of HHV-6 in the renal tissue. The clinical role of viral reactivation in DIHS/DRESS must be further elucidated.

DOI： 10.2169/internalmedicine.55.6287

An Uncommon Manifestation of Fitz-Hugh-Curtis Syndrome with Right-side Chest Pain. Reviewed

Ko Harada, Masaya Iwamuro, Yoshihisa Hanayama, Fumio Otsuka

Acta medica Okayama 70 ( 2 ) 145 - 9 2016

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

Fitz-Hugh-Curtis syndrome is characterized by an inflammation of the perihepatic capsules associated with pelvic inflammatory disease. The typical symptom is severe right upper quadrant abdominal pain. We report a patient with Fitz-Hugh-Curtis syndrome who presented with an atypical chief complaint of right-side chest pain unaccompanied by symptoms specific to pelvic inflammatory disease. This case indicates that Fitz-Hugh-Curtis syndrome should be considered in the differential diagnosis of right-side chest pain in young women, because early diagnosis and treatment of the disease are essential to prevent chronic complications.

Detection of Minute Duodenal Follicular Lymphoma Lesions Using Magnifying Endoscopy. Reviewed

Masaya Iwamuro, Eisei Kondo, Fumio Otsuka, Katsuyoshi Takata, Tadashi Yoshino, Yoshiro Kawahara, Hiroyuki Okada

Acta medica Okayama 70 ( 2 ) 139 - 44 2016

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

Esophagogastroduodenoscopy revealed small duodenal lesions in a 56-year-old Japanese man and a 92-year-old Japanese woman with stage IV follicular lymphoma. Magnifying endoscopy examination revealed tiny white deposits in the second duodenal portion of the former patient and slightly enlarged duodenal villi in the latter. In both cases, biopsy revealed infiltration of follicular lymphoma cells and incipient formation of neoplastic follicles. Here, we discuss the usefulness of magnifying endoscopy and narrow-band imaging for the detection of small duodenal lesions in follicular lymphoma cases.

Endoscopic detection of the gastric lesions of peripheral T-cell lymphoma. Reviewed International journal

Masaya Iwamuro, Kosuke Kimura, Eisei Kondo, Takahiro Nada, Eri Nakamura, Katsuyoshi Takata, Takehiro Tanaka, Fumio Otsuka, Tadashi Yoshino, Hiroyuki Okada

Ecancermedicalscience 10 625 - 625 2016

Language：English Publishing type：Research paper (scientific journal) Publisher：CANCER INTELLIGENCE LTD

An 82-year-old Japanese man presented with a gastric involvement of peripheral T-cell lymphoma, not otherwise specified. Although gastrointestinal lesions were not detected on computed tomography, oesophagogastroduodenoscopy revealed a slight elevation of the gastric mucosa, with changes in mucosal colour and the presence of abnormal microvessels. This led to the prompt detection of gastric involvement in lymphoma. This case highlights the usefulness of detailed observation of the gastric mucosa for the endoscopic detection of gastric involvement of peripheral T-cell lymphoma.

DOI： 10.3332/ecancer.2016.625

Hypoparathyroidism Solely Manifesting Otological Symptoms. Reviewed

Tokiko Urabe, Hideharu Hagiya, Eri Nakamura, Fumio Otsuka

Internal medicine (Tokyo, Japan) 55 ( 2 ) 211 - 2 2016

Pheochromocytoma Manifesting Persistent Right Shoulder Pain and Hypochondralgia Reviewed

Hideharu Hagiya, Eri Nakamura, Tomohiro Terasaka, Kou Hasegawa, Kikuko Asano, Takahiro Nada, Kosuke Kimura, Koichi Waseda, Yoshihisa Hanayama, Fumio Otsuka

JOURNAL OF GENERAL AND FAMILY MEDICINE 16 ( 4 ) 292 - 296 2015.12

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

We report a 42-year-old female who initially complained of sub-acute onset of right upper quadrant abdominal pain with right shoulder pain. A CT scan incidentally revealed an adrenal tumor, and a final diagnosis of pheochromocytoma was made on the basis of endocrinological examinations. Symptomatically, the pheochromocytoma in our patient mimicked a hepato-biliary disease by presenting abdominal pain accompanying right shoulder pain that was assumed to be referred pain via the right phrenic nerve. Physicians may need to consider the possibility of pheochromocytoma in patients with abdominal symptoms.

DOI： 10.14442/jgfm.16.4_292