研究者詳細 - 大塚　文男

論文 - 大塚　文男

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高度のQT延長が副腎摘除術後に改善した原発性アルドステロン症の1例

高瀬了輔, 中野靖浩, 須山敦仁, 加藤篤之, 佐住洋祐, 長谷川功, 前川清明, 大塚文男

日本内分泌学会雑誌 99 ( 5 ) 1500 - 1500 2024年4月

副腎摘除後に血糖コントロールが著明に改善した高齢クッシング症候群の1例

長谷川功, 山本紘一郎, 大國皓平, 中野靖浩, 安田美帆, 本多寛之, 小比賀美香子, 片岡仁美, 大塚文男

糖尿病 67 ( Suppl.1 ) S - 299 2024年4月

腰椎圧迫骨折を契機に低アンドロゲン血症が判明した中年男性の1例

副島佳晃, 大塚勇輝, 川口満理奈, 大國晧平, 中野靖浩, 安田美帆, 徳増一樹, 植田圭吾, 大塚文男

日本内分泌学会雑誌 99 ( 5 ) 1500 - 1500 2024年4月

NVX-CoV2373ワクチン投与後に血管浮腫様の眼瞼浮腫を生じた1例

松本真理, 川上佳夫, 三宅智子, 平井陽至, 森実真, 片岡仁美, 大塚文男

西日本皮膚科 86 ( 2 ) 198 - 198 2024年4月

腰椎圧迫骨折を契機に低アンドロゲン血症が判明した中年男性の1例

副島佳晃, 大塚勇輝, 川口満理奈, 大國晧平, 中野靖浩, 安田美帆, 徳増一樹, 植田圭吾, 大塚文男

日本内分泌学会雑誌 99 ( 5 ) 1500 - 1500 2024年4月

下垂体後葉ホルモンによる顆粒膜細胞のプロゲステロン合成調節と卵胞BMPの関与

山本紘一郎, 中野靖浩, 岩田菜穂子, 副島佳晃, 須山敦仁, 大塚文男

日本内分泌学会雑誌 99 ( 5 ) 1545 - 1545 2024年4月

慢性甲状腺炎と副腎クリーゼを背景に発症した麻痺性イレウスにLT4静注が奏効した1例

中野靖浩, 大國皓平, 長谷川功, 越智可奈子, 大塚文男

日本内分泌学会雑誌 99 ( 5 ) 1288 - 1288 2024年4月

腺腫様結節による甲状腺中毒症を呈したPlummer病の1例

加藤篤之, 大國皓平, 中野靖浩, 長谷川功, 越智可奈子, 大塚文男

日本内分泌学会雑誌 99 ( 5 ) 1295 - 1295 2024年4月

Enhancing Medical Interview Skills through AI Simulated Patient Interactions: Non-Randomized Controlled Trial 査読

Akira Yamamoto, Masahide Koda, Hiroko Ogawa, Tomoko Miyoshi, Yoshinobu Maeda, Fumio Otsuka, Hideo Ino

JMIR Med Educ 10 ( e58753 ) 1 - 12 2024年3月

出版者・発行元：JMIR Publications Inc.

BACKGROUNDMedical interviewing is a critical skill in clinical practice, yet opportunities for practical training are limited in Japanese medical schools, necessitating urgent measures. Given advancements in AI technology, its application in the medical field is expanding. However, reports on its application in medical interviews in medical education are scarce. OBJECTIVEThis study aimed to investigate whether medical students' interview skills could be improved by engaging with AI-simulated patients using large language models (LLMs), including the provision of feedback. METHODSA simulation program using LLMs was provided to 35 fourth-year medical students in Japan in 2023. As a control group, 110 fourth-year medical students from 2022 who did not participate in the intervention were selected. The primary outcome was the score on the pre-Clinical Clerkship Objective Structured Clinical Examination (pre-CC OSCE), a national standardized clinical skills examination, in medical interviewing. Secondary outcomes included surveys such as Simulation-Based Training Quality Assurance Tool (SBT-QA10). RESULTSThe AI intervention group showed significantly higher scores on medical interviews than the control group (AI group vs. control group: median 28.0 vs. 27.0, p = 0.01). There was a trend of inverse correlation between the SBT-QA10 and pre-CC OSCE scores (regression coefficient -2.0 to -2.1). No significant safety concerns were observed. CONCLUSIONSEducation through medical interviews using AI-simulated patients has demonstrated safety and a certain level of educational effectiveness, suggesting promising prospects for multifaceted applications in the field of medical education.

DOI： 10.2196/preprints.58753

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Calcium polystyrene sulfonate-induced rectal ulcer causing E. coli native-valve infective endocarditis. 査読

Shinnosuke Fukushima, Hideharu Hagiya, Hiroyuki Honda, Tomoharu Ishida, Ryohei Shoji, Kou Hasegawa, Fumio Otsuka

Clinical Journal of Gastroenterology 2024年3月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

Escherichia coli-associated native-valve infective endocarditis is a rare disease that affects elderly patients with underlying risk factors such as diabetes mellitus, malignancy, and renal failure. Long-term use of calcium polystyrene sulfonate is a potential risk factor for gastrointestinal mucosal damage or even colorectal ulcers. Herein, we describe a fatal case of a 66-year-old Japanese man with diabetes mellitus and renal failure who was prescribed calcium polystyrene sulfonate (CPS) for 11 years and developed a CPS-induced rectal ulcer, leading to E. coli native-valve infective endocarditis. The patient was admitted to our hospital due to acute-onset impaired consciousness. As a result of the systemic investigation, he was diagnosed with E. coli bacteremia accompanied by multiple cerebral infarctions and an acute hemorrhagic rectal ulcer. Transesophageal echocardiography revealed a 20-mm vegetative structure on the mitral valve, resulting in a final diagnosis of E. coli-associated infective endocarditis. After rectal resection, mitral valve replacement surgery was performed; however, the patient died shortly after surgery. Pathological findings of the resected rectum showed deposition of a basophilic crystalline material suggesting the presence of CPS. Our case highlights the potential risk of colorectal ulcers in a long-term CPS user, which can trigger bacterial translocation and endocarditis as fatal complications.

DOI： 10.1007/s12328-024-01949-4

PubMed

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Idiopathic ventricular tachycardia detected after coronavirus disease 2019 査読

Koichiro Yamamoto, Koji Nakagawa, Fumio Otsuka

Journal of General and Family Medicine 2024年3月

Zinc deficiency is a potential risk factor for COVID-19 progression to pneumonia requiring oxygen therapy. 査読国際誌

Koji Fujita, Kazuki Ocho, Tomoka Kadowaki, Takashi Yorifuji, Hideharu Hagiya, Fumio Otsuka

Journal of Infection and Chemotherapy 30 ( 10 ) 978 - 982 2024年3月

担当区分：最終著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: Various risk factors for developing severe coronavirus disease 2019 (COVID-19) have been reported. However, studies on the nutritional-related risk factors are limited. In this study, we investigated the effects of serum zinc deficiency on the severity of COVID-19. METHODS: The study included a total of 60 COVID-19 patients who were admitted to Tsuyama Chuo Hospital between March 2020 and April 2021. We divided the patients into two categories based on serum levels of zinc (normal and latent zinc deficiency vs. zinc deficiency [<60 μg/dL]) at the time of diagnosis. Severity of COVID-19 was defined as the most exaggerated disease status during admission. The associations between serum zinc deficiency and the severity of COVID-19 were examined using a logistic regression model adjusted for potential confounders. RESULTS: Patients who required oxygen therapy had a higher prevalence of comorbidities and poorer nutritional status, including zinc deficiency, than those who did not require oxygen therapy. Zinc deficiency was associated with an increased risk of COVID-19 severity, with an adjusted odds ratio of 7.29 (95% confidence interval: 1.70-31.18). This result remained significant in the sensitivity analyses conducted after adjusting for patient background factors. CONCLUSIONS: Zinc deficiency at the time of COVID-19 diagnosis is an independent risk factor for severe disease. Our findings need to be validated in external studies.

DOI： 10.1016/j.jiac.2024.03.007

PubMed

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Occult endocrine disorders newly diagnosed in patients with post-COVID-19 symptoms. 査読国際誌

Yasuhiro Nakano, Naruhiko Sunada, Kazuki Tokumasu, Hiroyuki Honda, Yuki Otsuka, Yasue Sakurada, Yui Matsuda, Toru Hasegawa, Daisuke Omura, Kanako Ochi, Miho Yasuda, Hideharu Hagiya, Keigo Ueda, Fumio Otsuka

Scientific reports 14 ( 1 ) 5446 - 5446 2024年3月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

Determination of long COVID requires ruling out alternative diagnoses, but there has been no report on the features of alternative diagnoses. This study was a single-center retrospective study of outpatients who visited our clinic between February 2021 and June 2023 that was carried out to determine the characteristics of alternative diagnoses in patients with post-COVID-19 symptoms. In a total of 731 patients, 50 patients (6.8%) were newly diagnosed with 52 diseases requiring medical intervention, and 16 (32%) of those 50 patients (2.2% of the total) were considered to have priority for treatment of the newly diagnosed disorders over long COVID treatment. The proportion of patients with a new diagnosis increased with advance of age, with 15.7% of the patients aged 60 years or older having a new diagnosis. Endocrine and metabolic diseases and hematological and respiratory diseases were the most common, being detected in eight patients (16%) each. Although 35 of the 52 diseases (67%) were related to their symptoms, endocrine and metabolic diseases were the least associated with specific symptoms. Other disorders that require attention were found especially in elderly patients with symptomatic long COVID. Thus, appropriate assessment and differentiation from alternative diagnoses are necessary for managing long COVID.

DOI： 10.1038/s41598-024-55526-3

PubMed

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【-え、ウソ!実は○○だった!?-"コモンディジーズ"の診断ピットフォール】(Pitfall 23)症状・所見は常に非特異的…!?

大塚勇輝, 大塚文男

総合診療 34 ( 3 ) 298 - 300 2024年3月