Faculty Profiles - HANAYAMA Yoshihisa

後腹膜線維症49症例における臨床的特徴甲状腺機能に着目して

花山宜久, 安藤美穂, 大國皓平, 徳増一樹, 長谷川功, 萩谷英大, 大塚文男

日本内分泌学会雑誌 100 ( 1 ) 314 - 314 2024.5

後腹膜線維症49症例における臨床的特徴甲状腺機能に着目して

花山宜久, 安藤美穂, 大國皓平, 徳増一樹, 長谷川功, 萩谷英大, 大塚文男

日本内分泌学会雑誌 100 ( 1 ) 314 - 314 2024.5

Clinical Characteristics of Retroperitoneal Fibrosis Patients at a Tertiary Hospital in Japan.

Miho Ando, Yoshihisa Hanayama, Yoshito Nishimura, Hideharu Hagiya, Fumio Otsuka

Acta medica Okayama 77 ( 5 ) 527 - 536 2023.10

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

Retroperitoneal fibrosis (RPF) is a rare cause of hydronephrosis and progressive renal dysfunction with unidentified origin. RPF is categorized into idiopathic RPF with/without immunoglobulin G4 (IgG4)-related disease (IgG4-RD), and secondary RPF. Identifying the underlying cause is challenging and often associated with delayed diagnosis or therapeutic interventions. We investigated RPF's clinical characteristics based on different etiologies and factors that may help distinguish the underlying causes. We analyzed the cases of 49 patients with RPF that was radiographically diagnosed at our institution (2008-2022). The cohort was 77.6% males; 75.5% had idiopathic RPF and 24.5% had secondary RPF. Among the idiopathic patients, 54.1% had IgG4-RD. The patients were likely to have abdominal pain, lower back pain/lumbago, and constitutional symptoms including generalized fatigue and fever. The idiopathic patients were likely to have higher serum IgG4 and IgG levels and lower serum C3 levels compared to secondary RPF. The IgG4-RPF patients were likely to have higher serum IgG4 levels and lower serum C-reactive protein, ferritin, and C3 levels compared to the idiopathic RPF patients without IgG4-RD. These findings might reflect underlying systemic inflammatory responses. Comprehensive laboratory testing, including serum inflammatory markers and immunological panels, is recommended for radiologically diagnosed RPF patients.

DOI： 10.18926/AMO/65975

ビジュアルで見るプライマリ・ケア毒針毛による皮膚炎

病初期より関節リウマチの臨床像も有したリウマチ性多発筋痛症の一例

安藤航, 大塚勇輝, 副島佳晃, 川口満理奈, 大國皓平, 本多寛之, 長谷川功, 花山宜久, 勝山隆行, 大塚文男

日本病院総合診療医学会雑誌 19 ( 臨増2 ) 150 - 150 2023.8

当院総合内科・総合診療科における後腹膜線維症49症例の特徴の検討

花山宜久, 安藤美穂, 西村義人, 徳増一樹, 長谷川功, 萩谷英大, 大塚文男

日本病院総合診療医学会雑誌 19 ( 臨増2 ) 163 - 163 2023.8

病初期より関節リウマチの臨床像も有したリウマチ性多発筋痛症の一例

安藤航, 大塚勇輝, 副島佳晃, 川口満理奈, 大國皓平, 本多寛之, 長谷川功, 花山宜久, 勝山隆行, 大塚文男

日本病院総合診療医学会雑誌 19 ( 臨増2 ) 150 - 150 2023.8

当院総合内科・総合診療科における後腹膜線維症49症例の特徴の検討

花山宜久, 安藤美穂, 西村義人, 徳増一樹, 長谷川功, 萩谷英大, 大塚文男

日本病院総合診療医学会雑誌 19 ( 臨増2 ) 163 - 163 2023.8

大塚勇輝, 長岡寛和, 花山宜久, 大塚文男, 金森達也

日本プライマリ・ケア連合学会誌 46 ( 1 ) 33 - 34 2023.3

大腿骨頸部骨折を契機に発見されたビタミンD欠乏の1例

高瀬了輔, 本多寛之, 中野靖浩, 山本紘一郎, 大國皓平, 越智可奈子, 長谷川功, 三好智子, 花山宜久, 小川弘子, 森泰宏, 大塚文男

日本病院総合診療医学会雑誌 19 ( 臨増1 ) 223 - 223 2023.2

医療系学部教育でのIPE(Inter-professional Education:多職種連携教育)の実践を通した患者中心の医療の経験

三好智子, 岩室雅也, 花山宜久, 小川弘子, 小比賀美香子, 名倉弘哲, 大塚文男

医学教育 53 ( 6 ) 531 - 536 2022.12

Language：Japanese Publisher：(一社)日本医学教育学会

本研究では,医療系学生が小グループのIPEの実践を通して,患者中心のチーム医療を実践したと考えることができたかを検証した.医学科,薬学科,保健学科の臨床実習中の学部学生に対し,小グループで症例基盤型の臨床推論と治療・看護計画立案を行い,IPEに対するアンケートを行った.医学科生は臨床推論と治療計画立案が,薬学科生は治療の副作用対策を提案することが,看護学生は医療チームに必要な情報提供をすることが,医療チームとともに患者中心の医療が実践できたと感じていた.学部毎にチーム医療を実践したと考える項目が異なり,多学部合同IPEにはそれぞれの要素を組み込むことが重要である.(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J00050&link_issn=&doc_id=20230117110006&doc_link_id=%2Fed9jmded%2F2022%2F005306%2F007%2F0531-0536%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fed9jmded%2F2022%2F005306%2F007%2F0531-0536%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

男性2型糖尿病患者における血中アンドロゲン値とその意義

浜原潤, 本多寛之, 山本絋一郎, 中野靖浩, 徳増一樹, 花山宜久, 萩谷英大, 小比賀美香子, 植田圭吾, 岸田雅之, 大塚文男

糖尿病 65 ( 11 ) 633 - 633 2022.11

Prevalence of medical factors related to aging among older car drivers: a multicenter, cross-sectional, descriptive study Reviewed International journal

Hideharu Hagiya, Ryosuke Takase, Hiroyuki Honda, Yasuhiro Nakano, Yuki Otsuka, Hitomi Kataoka, Mika Uno, Keigo Ueda, Misa Takahashi, Hiroko Ogawa, Yoshihisa Hanayama, Fumio Otsuka

BMC Geriatrics 22 ( 1 ) 792 - 792 2022.10

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Aim

An increasing number of older adults in Japan are at an increased risk of road traffic crashes. This study aimed to investigate the prevalence of potential underlying medical factors that increase the risk of road traffic crashes among older people.

Methods

This cross-sectional observational study was conducted in 11 medical institutions in Japan using self-administered questionnaires and physical examination from January to May 2021. The background and social data, data on the use of nursing care insurance, and clinical data suggestive of polypharmacy, sarcopenia, cognitive impairment, and frailty/oral frailty were obtained. The prevalence of these factors was compared between everyday and occasional drivers.

Results

Data of 127 patients were collected; their median (interquartile range) age was 73 (70–78) years. Of the total participants, 82 were men (64.6%) and 45 were women (35.4%). There were 77 everyday drivers and 50 occasional drivers. Of these, 121 (95.3%) had not applied for nursing care insurance, but the numbers of those who required help 1 and 2 were 1 (0.8%) and 3 (2.4%), respectively. Prevalence of medical factors was as follows: polypharmacy, 27.6%; sarcopenia, 8.7%; dementia, 16.4%; frailty, 15.0%; and oral frailty, 54.3%; it was not significantly different between every day and occasional drivers. Intention to return the car license was significantly higher among the occasional drivers (2.6% vs. 14.0%; odds ratio: 6.7, 95% confidence interval: 1.2–70.6, p = 0.024).

Conclusion

We uncovered the prevalence of medical factors that can be associated with road traffic crashes among Japanese older people aged ≥ 65 years in our community.

DOI： 10.1186/s12877-022-03490-w

Other Link： https://link.springer.com/article/10.1186/s12877-022-03490-w/fulltext.html

Hormonal trends in patients suffering from long COVID symptoms Reviewed

Naruhiko Sunada, Hiroyuki Honda, Yasuhiro Nakano, Koichiro Yamamoto, Kazuki Tokumasu, Yasue Sakurada, Yui Matsuda, Toru Hasegawa, Yuki Otsuka, Mikako Obika, Yoshihisa Hanayama, Hideharu Hagiya, Keigo Ueda, Hitomi Kataoka, Fumio Otsuka

Endocrine Journal 69 ( 10 ) 1173 - 1181 2022.10

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Japan Endocrine Society

Symptoms of long COVID are complex and long-lasting, and endocrine dysfunction might be involved in the underlying mechanisms. In this study, to clarify the hormonal characteristics of long COVID patients, laboratory data for patients who visited the outpatient clinic for long COVID were evaluated. A retrospective analysis was performed for patients who visited Okayama University Hospital during the period from Feb 2021 to Dec 2021 with focus on the interrelationships between major symptoms and endocrine data. Information and laboratory data were obtained from medical records for 186 patients. The patients had various symptoms, and the most frequent symptoms were general malaise, dysosmia/dysgeusia, hair loss, headache, dyspnea, and sleeplessness. Patients who were suffering from fatigue and dysosmia/dysgeusia were younger, while hair loss was more frequent in older and female patients. As for the characteristics of patients suffering from general fatigue, the scores of depression and fatigue were positively correlated with serum levels of cortisol and free thyroxin (FT4), respectively. Also, patients suffering from general fatigue had lower levels of serum growth hormone and higher levels of serum FT4, while patients with dysosmia/dysgeusia had a significantly lower level of serum cortisol. Serum thyrotropin (TSH) levels were higher and the ratios of FT4/TSH were lower in the initially severe cases, suggesting occult hypothyroidism. In addition, the ratios of plasma adrenocorticotropin to serum cortisol were decreased in patients with relatively high titers of serum SARS-CoV-2 antibody. Thus, hormonal changes seem to be, at least in part, involved in the persistent symptoms of long COVID.

DOI： 10.1507/endocrj.ej22-0093

中枢性尿崩症と眼瞼黄色腫から診断したErdheim-Chester病の3例

中枢性尿崩症と眼瞼黄色腫から診断したErdheim-Chester病の3例

山本紘一郎, 高瀬了輔, 大國皓平, 中野靖浩, 岡浩介, 本多寛之, 長谷川功, 花山宜久, 小比賀美香子, 大塚文男

日本内分泌学会雑誌 98 ( 2 ) 569 - 569 2022.10

COVID-19罹患後症状における内分泌機能に関する検討

砂田匠彦, 本多寛之, 中野靖浩, 山本絋一郎, 徳増一樹, 櫻田泰江, 松田祐依, 長谷川徹, 大塚勇輝, 小比賀美香子, 花山宜久, 萩谷英大, 植田圭吾, 片岡仁美, 大塚文男

日本内分泌学会雑誌 98 ( 2 ) 628 - 628 2022.10

山本紘一郎, 高瀬了輔, 大國皓平, 中野靖浩, 岡浩介, 本多寛之, 長谷川功, 花山宜久, 小比賀美香子, 大塚文男

日本内分泌学会雑誌 98 ( 2 ) 569 - 569 2022.10

腹腔動脈解離を合併した常染色体優性多発性嚢胞腎の1例

長谷川功, 花山宜久

日本高血圧学会総会プログラム・抄録集 44回 92 - 92 2022.10

新型コロナワクチン3回目接種後に菊池病を発症した1例

目瀬修, 山本幸近, 福島伸乃介, 大國皓平, 長谷川功, 萩谷英大, 花山宜久, 大塚文男

日本病院総合診療医学会雑誌 18 ( 臨増2 ) 210 - 210 2022.8

コロナ罹患後症状の特徴と内分泌機能の変化に関する検討

日本病院総合診療医学会雑誌 18 ( 臨増2 ) 244 - 244 2022.8

新型コロナワクチン3回目接種後に菊池病を発症した1例

目瀬修, 山本幸近, 福島伸乃介, 大國皓平, 長谷川功, 萩谷英大, 花山宜久, 大塚文男

日本病院総合診療医学会雑誌 18 ( 臨増2 ) 210 - 210 2022.8

Influence of protein intake on the changes in skeletal muscle mass after kidney transplantation. International journal

Akihiro Kosoku, Tomoaki Iwai, Takuma Ishihara, Kazuya Kabei, Shunji Nishide, Keiko Maeda, Yoshiko Hanayama, Eiji Ishimura, Junji Uchida

Clinical nutrition (Edinburgh, Scotland) 41 ( 9 ) 1881 - 1888 2022.7

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

BACKGROUND & AIMS: Skeletal muscle mass decreases in patients with chronic kidney disease, especially those on dialysis with end-stage kidney disease. On the other hand, the recovery of renal function due to successful kidney transplantation (KT) improves skeletal muscle mass loss. However, low protein intake may influence the changes in skeletal muscle mass after KT. The aim of the present study is to examine the association of the changes in skeletal muscle mass with protein intake in kidney transplant recipients (KTRs). METHODS: A cohort study was conducted in KTRs and living-kidney donors (LKDs). Skeletal muscle mass index (SMI) was measured using bioelectrical impedance analysis before KT and at 1 month and 12 months after KT. Protein intake was calculated with 24-h urine urea nitrogen from the Maroni formula at 12 months after KT. To evaluate the association between protein intake and the changes in SMI during the first year after KT, we performed a multivariable regression analysis adjusted for covariates including age, sex, cumulative glucocorticoids, cumulative hospitalization, diabetes mellitus, and SMI before KT. RESULTS: In KTRs (n = 64), the median SMI was 7.26 kg/m2 before KT, which decreased to 7.01 kg/m2 at 1 month after KT and increased to 7.55 kg/m2 at 12 months after KT. In LKDs (n = 17), the median SMI was 6.24 kg/m2 before KT which increased to 6.40 kg/m2 at 1 month after KT and further increased to 6.95 kg/m2 at 12 months after KT. The changes in SMI during the 1-year period after KT exhibited a positive correlation with protein intake (p = 0.015) after adjustment. The predicted value of protein intake in KTRs, whose values of SMI before KT and at 12 months after KT were the same, was 0.72 g/kg ideal body weight (IBW)/day using the multivariable non-linear regression model. CONCLUSIONS: In KTRs, insufficient protein intake adversely affected the recovery from skeletal muscle mass loss after KT. Therefore, a protein intake of at least more than 0.72 g/kg IBW/day, the predicted value obtained in the present study, might be recommended for KTRs suffering from skeletal muscle mass loss.

DOI： 10.1016/j.clnu.2022.07.028

Clinical utility of urinary levels of catecholamines and their fraction ratios related to heart rate and thyroid function Reviewed

Takayasu Arteritis Mimicking Phlegmon Reviewed

Yuki Taira, Yasuhiro Nakano, Yoshihisa Hanayama, Fumio Otsuka

Internal Medicine 2022.6

Droopy eyelid due to IgG4-related dacryoadenitis. Reviewed

Takase R, Hagiya H, Tokumasu K, Nishimura Y, Sakurai A, Hasegawa K, Hanayama Y, Otsuka F.

Postgraduate Medical Journal 97 ( 1147 ) 333 - 334 2022.5

Naruhiko Sunada, Yoshihisa Hanayama, Koichiro Yamamoto, Yasuhiro Nakano, Takahiro Nada, Hiroyuki Honda, Kou Hasegawa, Hideharu Hagiya, Fumio Otsuka

Endocrine Journal 69 ( 4 ) 417 - 425 2022.4

Relationship between patients’ characteristics and efficacy of calcimimetics for primary hyperparathyroidism in the elderly Reviewed

Koichiro Yamamoto, Yasuhiro Nakano, Kazuki Tokumasu, Hiroyuki Honda, Kou Hasegawa, Asuka Sato, Hiroko Ogawa, Mikako Obika, Yoshihisa Hanayama, Fumio Otsuka

Clinical Case Reports 10 ( 4 ) 2022.4

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Wiley

Calcimimetic treatment has been reported to be effective for primary hyperparathyroidism (PHPT). Nine elderly PH PT patients who had been treated with calcimimetics were retrospectively analyzed. It was found that calcimimetics can reduce elevated serum calcium levels in elderly PHPT patients with low femoral DEXA %YAM and low urinary cAMP levels.

DOI： 10.1002/ccr3.5713

Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ccr3.5713

精巣副腎遺残腫瘍に関連し性腺機能低下を来した21-水酸化酵素欠損症の2例

山本紘一郎, 本多寛之, 中野靖浩, 徳増一樹, 長谷川功, 小比賀美香子, 花山宜久, 大塚文男

日本内分泌学会雑誌 98 ( 1 ) 401 - 401 2022.4

原発性副甲状腺機能亢進症に対するカルシウム受容体作動薬の効果と関連因子

山本紘一郎, 中野靖浩, 徳増一樹, 本多寛之, 長谷川功, 小比賀美香子, 三好智子, 小川弘子, 花山宜久, 大塚文男

日本内分泌学会雑誌 98 ( 1 ) 374 - 374 2022.4

21-水酸化酵素欠損症(21-OHD)の経過中に性腺機能低下を生じた2例から

山本紘一郎, 本多寛之, 中野靖浩, 徳増一樹, 長谷川功, 小比賀美香子, 花山宜久, 大塚文男

ACTH RELATED PEPTIDES 33 17 - 18 2022.4

21-水酸化酵素欠損症(21-OHD)の経過中に性腺機能低下を生じた2例から

山本紘一郎, 本多寛之, 中野靖浩, 徳増一樹, 長谷川功, 小比賀美香子, 花山宜久, 大塚文男

ACTH RELATED PEPTIDES 33 17 - 18 2022.4

Detection of Male Hypogonadism in Patients with Post COVID-19 Condition Reviewed

Yukichika Yamamoto, Yuki Otsuka, Naruhiko Sunada, Kazuki Tokumasu, Yasuhiro Nakano, Hiroyuki Honda, Yasue Sakurada, Hideharu Hagiya, Yoshihisa Hanayama, Fumio Otsuka

Journal of Clinical Medicine 11 ( 7 ) 1955 - 1955 2022.3

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：MDPI AG

The pathogenesis and prognosis of post COVID-19 condition have remained unclear. We set up an outpatient clinic specializing in long COVID in February 2021 and we have been investigating post COVID-19 condition. Based on the results of our earlier study showing that “general fatigue” mimicking myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is the most common symptom in long COVID patients, a retrospective analysis was performed for 39 male patients in whom serum free testosterone (FT) levels were measured out of 61 male patients who visited our clinic. We analyzed the medical records of the patients’ backgrounds, symptoms and laboratory results. Among the 39 patients, 19 patients (48.7%) met the criteria for late-onset hypogonadism (LOH; FT < 8.5 pg/mL: LOH group) and 14 patients were under 50 years of age. A weak negative correlation was found between age and serum FT level (r = −0.301, p = 0.0624). Symptoms including general fatigue, anxiety, cough and hair loss were more frequent in the LOH group than in the non-LOH group (FT ≥ 8.5 pg/mL). Among various laboratory parameters, blood hemoglobin level was slightly, but significantly, lower in the LOH group. Serum level of FT was positively correlated with the levels of blood hemoglobin and serum total protein and albumin in the total population, whereas these interrelationships were blurred in the LOH group. Collectively, the results indicate that the incidence of LOH is relatively high in male patients, even young male patients, with post COVID-19 and that serum FT measurement is useful for revealing occult LOH status in patients with long COVID.

DOI： 10.3390/jcm11071955

非機能性下垂体腺腫を伴った偽性クッシング症候群の1例

山本紘一郎, 花山宜久, 中野靖浩, 大村大輔, 本多寛之, 長谷川功, 大塚文男

日本内分泌学会雑誌 97 ( 5 ) 1262 - 1262 2022.3

非機能性下垂体腺腫を伴った偽性クッシング症候群の1例

山本紘一郎, 花山宜久, 中野靖浩, 大村大輔, 本多寛之, 長谷川功, 大塚文男

日本内分泌学会雑誌 97 ( 5 ) 1262 - 1262 2022.3

Serial Changes of Long COVID Symptoms and Clinical Utility of Serum Antibody Titers for Evaluation of Long COVID Reviewed

Yasue Sakurada, Naruhiko Sunada, Hiroyuki Honda, Kazuki Tokumasu, Yuki Otsuka, Yasuhiro Nakano, Yoshihisa Hanayama, Masanori Furukawa, Hideharu Hagiya, Fumio Otsuka

Journal of Clinical Medicine 11 ( 5 ) 1309 - 1309 2022.2

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：MDPI AG

Background: Various symptoms persist even after the acute symptoms in about one third of patients with COVID-19. In February 2021, we established an outpatient clinic in a university hospital for patients with long COVID and started medical treatment for sequelae that persisted one month or more after infection. Methods: To determine the key factors that affect the onset and clinical course of sequelae, a retrospective analysis was performed at Okayama University Hospital (Japan) between February and July 2021. We focused on changes in the numbers of symptoms and the background of the patients during a three-month period from the first outpatient visit. We also examined the relationship with SARS-CoV-2 antibody titers. Results: Information was obtained from medical records for 65 patients. The symptoms of sequelae were diverse, with more than 20 types. The most frequent symptoms were general malaise, dysosmia, dysgeusia, sleeplessness, and headache. These symptoms improved in about 60% of the patients after 3 months. Patients who required hospitalization and had a poor condition in the acute phase and patients who received oxygen/dexamethasone therapy had higher antibody titers at the time of consultation. Patients with antibody titers ≥200 U/mL showed significantly fewer improvements in long COVID symptoms in 1 month, but they showed improvements at 3 months after the first visit. Conclusion: Long COVID symptoms were improved at 3 months after the initial visit in more than half of the patients. Serum antibody titers were higher in patients who experienced a severe acute phase, but the serum antibody titers did not seem to be directly related to the long-term persistence of long COVID symptoms.

DOI： 10.3390/jcm11051309

Aging-related Characteristics of Subclinical Hypothyroidism Detected in General Practice.

Masao Takami, Koichiro Yamamoto, Yoshihisa Hanayama, Yasuhiro Nakano, Kou Hasegawa, Mikako Obika, Hideharu Hagiya, Masanori Furukawa, Fumio Otsuka

Acta medica Okayama 76 ( 1 ) 7 - 15 2022.2

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

Subclinical hypothyroidism (SCH) is diagnosed when serum thyrotropin (TSH) is elevated despite a normal thyroxine level and is known to increase the risk of metabolic disorders. This study was conducted to identify potential laboratory markers suspicious for latent SCH. We retrospectively reviewed 958 outpatients in whom thyroid functions had been examined. Eighty-five (9.1%) of the 939 analyzed subjects had SCH (73% females). In the SCH group, median serum TSH and FT4 levels were 5.04 μU/ml and 1.19 ng/dl, respectively, and auto-thyroid antibodies were detected in 53.8% of patients. SCH group patients were significantly older than patients in the euthyroid group, while there was no intergroup difference in BMI. However, 56.5% of the SCH patients were asymptomatic. In the SCH group, serum aspartate aminotransferase and low-density lipoprotein cholesterol (LDL-C) levels were significantly higher, and the estimated glomerular filtration rate (eGFR) was significantly lower than in the euthyroid group. Among patients less than 65 years of age, SCH patients tended to have lower eGFR and higher LDL-C than euthyroid patients. Age-dependent reductions of red blood cells and serum albumin were more prominent in the SCH than the euthyroid group. Biochemical changes with aging are useful as potential clues for suspecting latent SCH.

DOI： 10.18926/AMO/63203

Impact of the day of the week on the discontinuation of broad-spectrum antibiotic prescriptions; a multi-centered observational study Reviewed

カルシウム受容体作動薬で治療した原発性副甲状腺機能亢進症患者の臨床的特徴

山本紘一郎, 中野靖浩, 徳増一樹, 本多寛之, 長谷川功, 小比賀美香子, 三好智子, 小川弘子, 花山宜久, 大塚文男

日本内科学会雑誌 111 ( Suppl. ) 173 - 173 2022.2

蓄尿中カテコールアミン比測定の有用性と臨床的意義の検討

砂田匠彦, 花山宜久, 灘隆宏, 徳増一樹, 山本紘一郎, 中野靖浩, 長谷川功, 萩谷英大, 小比賀美香子, 大塚文男

日本病院総合診療医学会雑誌 18 ( 臨増1 ) O - 083 2022.2

蓄尿中カテコールアミン比測定の有用性と臨床的意義の検討

砂田匠彦, 花山宜久, 灘隆宏, 徳増一樹, 山本紘一郎, 中野靖浩, 長谷川功, 萩谷英大, 小比賀美香子, 大塚文男

日本病院総合診療医学会雑誌 18 ( 臨増1 ) O - 083 2022.2

Hiroyuki Honda, Hideharu Hagiya, Tsukasa Higashionna, Yuto Haruki, Mai Haruki, Shiho Kajita, Kengo Mukuda, Yuji Yokoyama, Yasuhiro Nakano, Hiroko Ogawa, Yasuyo Morimoto, Yoshihisa Hanayama, Setsuko Kanda, Hitomi Kataoka, Hitomi Muguruma, Fumio Otsuka

Scientific Reports 11 ( 1 ) 2021.12

Authorship：Corresponding author Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

<title>Abstract</title>To encourage and guide antimicrobial stewardship team (AST) activity and promote appropriate antibiotic use, we studied the impact of day of the week on the initiation and discontinuation of antibiotic administration. This was a multicenter observational study conducted at 8 Japanese hospitals from April 1 to September 30, 2019, targeting patients who underwent treatment with broad-spectrum antibiotics, such as anti-methicillin-resistant <italic>Staphylococcus aureus</italic> agents and anti-pseudomonal agents. We compared the weekly numbers of initiations and discontinuations of antibiotic prescription on each day of the week or on the days after a holiday. There was no statistical difference in the number of antibiotic initiations on both weekdays and the day after a holiday. However, antibiotic discontinuation was significantly higher from Tuesday onward than Monday and from the second day than the first day after a holiday. Similar trends were observed regardless of the categories of antibiotics, hospital and admission ward, and AST activity. This study suggests that broad-spectrum antibiotics tend to be continued during weekends and holidays and are most likely to be discontinued on Tuesday or the second day after a holiday. This was probably due to behavioral factors beyond medical indications, requiring further antimicrobial stewardship efforts in the future.

DOI： 10.1038/s41598-021-00206-9

総合診療における甲状腺機能低下状態の潜在とその特徴

Other Link： https://www.nature.com/articles/s41598-021-00206-9

高見優男, 山本紘一郎, 花山宜久, 中野靖浩, 長谷川功, 小比賀美香子, 萩谷英大, 大塚文男

日本内分泌学会雑誌 97 ( 4 ) 961 - 961 2021.12

Antimicrobial prescription practices for outpatients with acute respiratory tract infections: A retrospective, multicenter, medical record-based study Reviewed

Tomoharu Ishida, Hideharu Hagiya, Hiroyuki Honda, Yasuhiro Nakano, Hiroko Ogawa, Mikako Obika, Keigo Ueda, Hitomi Kataoka, Yoshihisa Hanayama, Fumio Otsuka

PLOS ONE 16 ( 11 ) e0259633 - e0259633 2021.11

Authorship：Corresponding author Publishing type：Research paper (scientific journal) Publisher：Public Library of Science (PLoS)

Antimicrobial stewardship for outpatients with acute respiratory tract infections (ARTIs) should be urgently promoted in this era of antimicrobial resistance. Previous large-sample studies were based on administrative data and had limited reliability. We aimed to identify current antimicrobial prescription practices for ARTIs by directly basing on medical records. This multicenter retrospective study was performed from January to December in 2018, at five medical institutes in Japan. We targeted outpatients aged ≥18 years whose medical records revealed International Classification of Diseases (ICD-10) codes suggesting ARTIs. We divided the eligible cases into three age groups (18–64 years, 65–74 years, and ≥75 years). We defined broad-spectrum antimicrobials as third-generation cephalosporins, macrolides, fluoroquinolones, and faropenem. Primary and secondary outcomes were defined as the proportion of antimicrobial prescriptions for the common cold and other respiratory tract infections, respectively. Totally, data of 3,940 patients were collected. Of 2,914 patients with the common cold, 369 (12.7%) were prescribed antimicrobials. Overall, compared to patients aged ≥75 years (8.5%), those aged 18–64 years (16.6%) and those aged 65–74 years (12.1%) were frequently prescribed antimicrobials for the common cold (odds ratio [95% confidential interval]; 2.15 [1.64–2.82] and 1.49 [1.06–2.09], respectively). However, when limited to cases with a valid diagnosis of the common cold by incorporating clinical data, no statistical difference was observed among the age groups. Broad-spectrum antimicrobials accounted for 90.2% of the antimicrobials used for the common cold. Of 1,026 patients with other respiratory infections, 1,018 (99.2%) were bronchitis, of which antimicrobials were prescribed in 49.9% of the cases. Broad-spectrum antimicrobials were the main agents prescribed, accounting for nearly 90% of prescriptions in all age groups. Our data suggested a favorable practice of antimicrobial prescription for outpatients with ARTIs in terms of prescribing proportions, or quantitative aspect. However, the prescriptions were biased towards broad-spectrum antimicrobials, highlighting the need for further antimicrobial stewardship in the outpatient setting from a qualitative perspective.

DOI： 10.1371/journal.pone.0259633

Clinical Manifestations of Patients with Influenza Differ by Age : A Prospective, Multi-centered Study in the Setouchi Marine Area. Reviewed

Ryosuke Takase, Hideharu Hagiya, Hiroyuki Honda, Yasuhiro Nakano, Hiroko Ogawa, Mikako Obika, Keigo Ueda, Hitomi Kataoka, Yoshihisa Hanayama, Fumio Otsuka

Acta medica Okayama 75 ( 5 ) 567 - 574 2021.10

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

Influenza potentially has a high mortality rate when it affects the elderly. We aimed to examine the differences in clinical manifestations in patients with influenza according to their age. This multicenter prospective study was performed in six medical institutions in Okayama and Kagawa prefectures (Japan). Between December 1, 2019 and March 31, 2020, we collected data on adult patients diagnosed with influenza type A, who were strat-ified into younger (20-49 years), middle-aged (50-64 years), and older groups (≥ 65 years). We compared the presence or absence of fever, respiratory symptoms, and extrapulmonary symptoms according to age group. In total, 203 patients (113, younger; 51, middle-aged; and 39, older) were eligible for the analysis. The maxi-mum body temperature and temperature at first physician visit in the older group were significantly lower than those in the younger group. The incidence of respiratory symptoms was not different among the three groups. Chills, muscle pain, and arthralgia as systemic symptoms were noted significantly more frequently in the younger (80.9%) and middle-aged (75.5%) groups than in the older group (51.3%) (p = 0.002). Fever and sys-temic symptoms were less likely to appear in older patients, possibly resulting in the delaying of hospital visits among older adults.

DOI： 10.18926/AMO/62769

Gender-Dependent Characteristics of Serum 1,25-Dihydroxyvitamin D/25-Hydroxyvitamin D Ratio for the Assessment of Bone Metabolism Reviewed

Manami Fujita-Yamashita, Koichiro Yamamoto, Hiroyuki Honda, Yoshihisa Hanayama, Kazuki Tokumasu, Yasuhiro Nakano, Kou Hasegawa, Hideharu Hagiya, Mikako Obika, Hiroko Ogawa, Fumio Otsuka

Cureus 2021.9

Pseudo-Cushing’s state in a patient with non-functioning pituitary adenoma Reviewed

Koichiro Yamamoto, Yoshihisa Hanayama, Fumio Otsuka

BMJ Case Reports 14 ( 7 ) e244438 - e244438 2021.7

Interrelationships Between Serum Levels of Procalcitonin and Inflammatory Markers in Patients Who Visited a General Medicine Department. Reviewed

Jo Araki, Kosuke Oka, Koichiro Yamamoto, Yoshihisa Hanayama, Kazuki Tokumasu, Hideharu Hagiya, Hiroko Ogawa, Koichi Itoshima, Fumio Otsuka

Acta medica Okayama 75 ( 3 ) 299 - 306 2021.6

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

Various laboratory markers of inflammation are utilized in general practice, but their clinical diagnostic significance is often ambiguous. In the present study, we determined the clinical significance of the examination of serum levels of procalcitonin (PCT) by comparing the PCT levels with the levels of other inflammatory markers, based on a retrospective review of 332 PCT-positive patients, including cases of bacterial infection (20.5%), non-specific inflammation (20.8%), neoplasm (9.9%), connective tissue diseases (8.4%), and non-bacterial infection (7.2%), were analyzed. The serum PCT level was highest in the bacterial infection group (1.94 ng/ml) followed by the non-specific inflammatory group (0.58 ng/ml) and neoplastic diseases group (0.34 ng/ml). The serum PCT level was positively correlated with serum levels of C-reactive protein (rho=0.62), soluble interleukin-2 receptor (sIL-2R; rho=0.69), and ferritin, the plasma level of D-dimer, and white blood cell count, and negatively correlated with the serum albumin level (rho=-0.52), hemoglobin concentration, and platelet count. The serum PCT level showed a stronger positive correlation with the serum sIL-2R level than the other biomarkers. The results suggest that an increased PCT level may indicate not only an infectious state but also a non-bacterial inflammatory condition in the diagnostic process in general practice.

DOI： 10.18926/AMO/62221

Ulcer-like Projection Accompanied by Giant Cell Arteritis.

Otsuka Y, Oka K, Hanayama Y, Otsuka F.

Internal Medicine 60 ( 5 ) 819 - 820 2021.5

Droopy eyelid due to IgG4-related dacryoadenitis Reviewed

Ryosuke Takase, Hideharu Hagiya, Kazuki Tokumasu, Yoshito Nishimura, Atsunobu Sakurai, Kou Hasegawa, Yoshihisa Hanayama, Fumio Otsuka

Postgraduate Medical Journal 97 ( 1147 ) 333 - 334 2021.5

Clinical Utility of the Ratio of Urinary Free Cortisol to Aldosterone as an Index for Inflammatory and Metabolic Dysregulation Reviewed

Otsuka Y, Nakano Y, Tokumasu K, Honda H, Obika M, Hasegawa K, Hanayama Y, Itoshima K, Otsuka F

Ann Clin Lab Sci 51 ( 3 ) 352 - 358 2021.5

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: Urinary free cortisol (UFC) is a reliable marker to avoid cortisol fluctuation and the effects of binding proteins. However, UFC levels are affected by fluid intake and urine volume, and the normal levels range widely. METHODS: To discover the utility of the ratio of urinary cortisol to aldosterone excretions, 246 patients in whom daily excretions of UFC and aldosterone (UAC) were measured were retrospectively analyzed. RESULTS: The UFC/UAC ratio showed significant positive and negative correlations with the levels of serum cortisol (R=0.287) and aldosterone (R=-0.762), respectively. The UFC/UAC ratio increased with aging in female patients, while it was not altered by the level of BMI in either gender. Markers for metabolic and inflammatory status, including hemoglobin A1c (R=0.327), albumin (R=-0.331), C-reactive protein (R=0.317), ferritin (R=0.473), and D-dimer (R=0.569), showed correlations with the ratio of UFC/UAC that were more significant than the correlations with the serum level of cortisol or UFC alone. Of note, the UFC/UAC ratio was shown to be an indicator for the risk of diabetes (AUC: 0.765), hypoalbuminemia (0.839), hyper-CRPemia (0.748), and thrombophilia (0.824), in which the cut-off levels of the UFC/UAC ratio were around 12. CONCLUSION: The UFC/UAC ratio is a variable for detecting metabolic and inflammatory complications related to adrenocortical dysfunction.

An adrenal incidentaloma caused by synchronous and isolated metastasis Reviewed

Koichiro Yamamoto, Kosuke Oka, Hiroyuki Honda, Kou Hasegawa, Yoshihisa Hanayama, Tomofumi Watanabe, Yusuke Tominaga, Atsushi Takamoto, Takayuki Hara, Fumio Otsuka

Clinical Case Reports 9 ( 4 ) 2494 - 2495 2021.4

Authorship：Corresponding author Publishing type：Research paper (scientific journal) Publisher：Wiley

Abstract

We report a patient with adrenal incidentaloma due to synchronous and isolated metastasis from lung cancer, which is a relatively rare condition. Close checkups for incidentaloma in oncologic patients are mandatory, leading to successful operation.

DOI： 10.1002/ccr3.3996

Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ccr3.3996

Ulcer-like Projection Accompanied by Giant Cell Arteritis Reviewed

Yuki Otsuka, Kosuke Oka, Yoshihisa Hanayama, Fumio Otsuka

Internal Medicine 60 ( 5 ) 819 - 820 2021.3

Clinical Characteristics of Low Androgen Status in Males with Type 2 Diabetes Mellitus. Reviewed

Jun Hamahara, Hiroyuki Honda, Koichiro Yamamoto, Kazuki Tokumasu, Yoshihisa Hanayama, Hideharu Hagiya, Mikako Obika, Keigo Ueda, Masayuki Kishida, Fumio Otsuka

Acta medica Okayama 75 ( 1 ) 1 - 8 2021.2

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

To determine the clinical characteristics of low androgen status in adult males with diabetes, we retrospectively analyzed the medical records of patients with type 2 diabetes mellitus in whom serum free testosterone (FT) levels were examined for 1 year. Among the 46 patients (56 ± 1.5 years old), decreases in serum FT levels to < 8.5 pg/ml (indicating the occurrence of late-onset hypogonadism [LOH]) were detected in 18 (39%). The per-centages of patients with low FT levels were high in the ≥ 50 years age group (83%), the HbA1c < 7% group (67%), and the 25 ≤ BMI < 30 kg/m2 group (56%). The serum FT levels tended to decrease age-dependently. The level of HbA1c was significantly correlated with the Heinemann Aging Male Symptoms (AMS) score (R = 0.47). The low-FT group had decreased levels of hemoglobin. Of note, the serum FSH level (R = -0.32) was negatively correlated with the serum FT level, whereas the serum TSH level (R = 0.36) was positively correlated with the serum FT level. Collectively, these results revealed that many diabetic males may have low FT levels and that the AMS score is related to the HbA1c level. A slightly anemic condition, thyroid dysfunction, and obesity (class 1) might be involved in LOH in middle-aged diabetic males.

DOI： 10.18926/AMO/61424

血中骨型アルカリホスファターゼ/アルカリホスファターゼ(BAP/ALP)比の臨床的有用性に関する検討

横田雄也, 西村義人, 安藤明美, 花山宜久, 長谷川功, 萩谷英大, 小川弘子, 小比賀美香子, 植田圭吾, 大塚文男

日本病院総合診療医学会雑誌 17 ( 臨増1 ) 187 - 187 2021.2

血中骨型アルカリホスファターゼ/アルカリホスファターゼ(BAP/ALP)比の臨床的有用性に関する検討

横田雄也, 西村義人, 安藤明美, 花山宜久, 長谷川功, 萩谷英大, 小川弘子, 小比賀美香子, 植田圭吾, 大塚文男

日本病院総合診療医学会雑誌 17 ( 臨増1 ) 187 - 187 2021.2

Involvement of serum dehydroepiandrosterone sulfate in erythropoietic activity Reviewed

Ko Harada, Yoshihisa Hanayama, Mikako Obika, Koichi Itoshima, Ken Okada, Fumio Otsuka

The Aging Male 23 ( 5 ) 756 - 763 2020.12

Authorship：Corresponding author Publishing type：Research paper (scientific journal) Publisher：Informa UK Limited

Purpose: The aim of the present study was to determine how age-related decreases in serum dehydroepiandrosterone sulfate (DHEAS) levels affect various physiological processes. Methods: We retrospectively reviewed the medical records of patients in whom serum DHEAS levels were measured in our department and assessed the relationships between serum DHEAS levels and various patient characteristics. Results: Among the 149 patients included in our analysis (mean age: 52.7 ± 17.6 years, range: 15–84 years), 54 (36.2%) were men. Serum DHEAS levels inversely correlated with age in men (R = −0.810, p <.01) and to a lesser extent in women (R = −0.391, p <.01). Of note, there were significant positive associations between DHEAS levels and hemoglobin (R = 0.317, p ≤.01) and hematocrit (R = 0.324, p ≤.01) levels, which were observed in men, but not in women. Conclusions: Our study suggests that reduced DHEAS secretion inhibits erythropoietic activity in aging men, perhaps owing to the erythropoietic androgenic actions of DHEAS. Importantly, it suggests that the age-associated decline in DHEAS secretion might decrease erythropoietic activity in aging men. It is also possible that the adrenal cortex, the source of DHEAS, is dysfunctional in anemic men.

DOI： 10.1080/13685538.2019.1592151

Clinical relevance of insulin-like growth factor-1 to cardiovascular risk markers Reviewed

Ko Harada, Yoshihisa Hanayama, Mikako Obika, Koichi Itoshima, Ken Okada, Fumio Otsuka

The Aging Male 23 ( 5 ) 1030 - 1038 2020.12

Authorship：Corresponding author Publishing type：Research paper (scientific journal) Publisher：Informa UK Limited

Objective: Insulin-like growth factor-1 (IGF-1) is an anabolic hormone, the levels of which decline with age. The present study aimed to determine the impact of age-related declines in serum IGF-1 levels on various physiological processes. Design: We retrospectively reviewed the medical records of patients whose serum IGF-1 levels were estimated in our department, and assessed the relationships between serum IGF-1 levels and various physiological parameters. Results: A total of 427 patients with a mean (± standard deviation) age of 52.8 (± 17.1) years were included in the analysis. The levels of serum IGF-1 showed significant positive correlation with those of hemoglobin and hematocrit, and negative correlation with the presence of inflammatory and fibrin-related markers including C-reactive protein (CRP) and procalcitonin (PCT), and D-dimer and fibrin degradation products (FDP). These tendencies persisted after exclusion of patients with pituitary disease. Conclusions: In this study population of diverse diseases and backgrounds, a decline in serum IGF-1 levels with age was associated with an increase in inflammatory and fibrin-related markers. This may explain the correlation between low serum IGF-1 levels and an increased risk of cardiovascular events. Our findings suggest that serum IGF-1 is a clinically relevant marker of cardiovascular risk, particularly in males.

DOI： 10.1080/13685538.2019.1657083

Association of sarcopenia with phase angle and body mass index in kidney transplant recipients Reviewed

Akihiro Kosoku, Junji Uchida, Shunji Nishide, Kazuya Kabei, Hisao Shimada, Tomoaki Iwai, Keiko Maeda, Yoshiko Hanayama, Takuma Ishihara, Toshihide Naganuma, Yoshiaki Takemoto, Tatsuya Nakatani

Scientific Reports 10 ( 1 ) 2020.12

Authorship：Corresponding author Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Malnutrition is an important risk factor for the development of sarcopenia. Recently, phase angle (PhA) obtained from the bioelectrical impedance analysis is increasingly becoming known as a nutritional status marker and may be considered a good indicator to identify elderly patients at risk of sarcopenia. In this study, we investigated the prevalence of sarcopenia and the relationship between sarcopenia and PhA or body mass index (BMI) as nutritional factors, and evaluated the discrimination performance of these nutritional factors for sarcopenia in 210 kidney transplant recipients. The median age was 55 years and 11.1% had sarcopenia. This prevalence of sarcopenia was lower than previous reports in kidney transplant recipients, maybe because of the differences in sarcopenia definitions and population demographics such as age, sex, race, and comorbidities. Both PhA and BMI were negatively correlated with sarcopenia after adjusting for age, sex, dialysis vintage, time after transplant, presence of diabetes mellitus, hemoglobin, estimated glomerular filtration rate, and the other nutritional factor. The discrimination performance for PhA and BMI had enough power to detect sarcopenia. These results suggest that PhA and BMI can be used in clinical practice to predict sarcopenia in kidney transplant patients.

DOI： 10.1038/s41598-019-57195-z

Other Link： http://www.nature.com/articles/s41598-019-57195-z

Clinical Application of the Ratio of Serum Bone Isoform to Total Alkaline Phosphatase in General Practice. Reviewed

Yuya Yokota, Yoshito Nishimura, Akemi Ando, Yoshihisa Hanayama, Kou Hasegawa, Hideharu Hagiya, Hiroko Ogawa, Mikako Obika, Keigo Ueda, Fumio Otsuka

Acta medica Okayama 74 ( 6 ) 467 - 474 2020.12

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

Alkaline phosphatase (ALP) is an enzyme that is expressed in a variety of tissues. Among the isoforms of ALP, bone-specific alkaline phosphatase (BAP) is used as a marker for evaluating bone metabolism. We investigated the clinical usefulness of the ratio of serum BAP to total ALP for the diagnosis of various disorders in general practice. We retrospectively analyzed the cases of 107 Japanese patients whose serum BAP levels were exam-ined, focusing on clinical characteristics. We observed that the BAP/ALP ratios of the patients with fever and those with inflammatory diseases were significantly lower than the ratios of other patient groups. The BAP/ALP ratios of the patients with osteoporosis and those with metabolic bone diseases were higher than those of the patients with other conditions. The BAP/ALP ratio was found to be negatively correlated with age, a cor-relation that has not been found in other ethnicities. The serum BAP/ALP ratio was inversely correlated with serum CRP levels but was positively correlated with serum albumin levels and hemoglobin concentrations. Collectively, our results suggest that the BAP/ALP ratio could be a useful predictor for important geriatric con-ditions seen in general practice.

DOI： 10.18926/AMO/61205

Clinical Relevance of Serum Prolactin Levels to Inflammatory Reaction in Male Patients. Reviewed

Koichiro Yamamoto, Yoshihisa Hanayama, Kou Hasegawa, Kazuki Tokumasu, Tomoko Miyoshi, Hideharu Hagiya, Hiroko Ogawa, Mikako Obika, Koichi Itoshima, Fumio Otsuka

Acta medica Okayama 74 ( 5 ) 381 - 389 2020.10

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

To clarify the relevance of prolactin (PRL) to clinical parameters in patients who visited our general medicine department, medical records of 353 patients in whom serum PRL levels were measured during the period from 2016 to 2018 were retrospectively reviewed. Data for 140 patients (M/F: 42/98) were analyzed after excluding patients lacking detailed records and patients taking dopaminergic agents. Median serum PRL levels were significantly lower in males than females: 6.5 ng/ml (IQR: 4.2-10.3) versus 8.1 ng/ml (5.9-12.9), respectively. Pain and general fatigue were the major symptoms at the first visit, and past histories of hypertension and dyslipidemia were frequent. Male patients with relatively high PRL levels (≥ 10 ng/ml) had significantly lower levels of serum albumin and significantly higher levels of serum LDH than those with low PRL (< 10 ng/ml). There were significant correlations of male PRL level with the erythrocyte sedimentation rate (R=0.62), serum LDH level (R=0.39) and serum albumin level (R=-0.52), while the level of serum CRP (R=0.33) showed an insignificant but weak positive correlation with PRL level. Collectively, these results show that PRL levels had gender-specific relevance to various clinical factors, with PRL levels in males being significantly related to inflammatory status.

DOI： 10.18926/AMO/60797

ALP高値から上縦隔に発見されたMEN1疑い副甲状腺機能亢進症の1例

大塚勇輝, 西村義人, 原田洸, 岡浩介, 長谷川功, 小川弘子, 三好智子, 花山宜久, 枝園忠彦, 平沢晃, 大塚文男

日本内分泌学会雑誌 96 ( 2 ) 549 - 549 2020.10

Clinical and biochemical characteristics of patients having general symptoms with increased serum IgG4 Reviewed

Kou Hasegawa, Yoshihisa Hanayama, Mikako Obika, Tomoko Miyoshi, Hiroko Ogawa, Eisei Kondo, Hitomi Kataoka, Yasuharu Sato, Fumio Otsuka

Modern Rheumatology 30 ( 4 ) 721 - 728 2020.7

Authorship：Corresponding author Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Objective: To differentiate patients with IgG4-related diseases (RD) from patients with other hyper IgG4 conditions who visit general medicine department. Methods: Fifty-six patients with high serum IgG4 levels (>135 mg/dL) were classified into three groups based on the final diagnosis: definite and possible IgG4-RD and others. Clinical and laboratory characteristics of the three groups of patients were retrospectively analyzed. Results: Major manifestations were renal dysfunction and general malaise, while thirst was the most frequent symptom in the definite group, in which submandibular glands and lymph nodes were likely to be affected. Biopsy of minor salivary glands was the least diagnostic for IgG4-RD despite the high frequency of biopsy. In the definite group, serum levels of IgG4 and IgG, IgG4/IgG ratio and basophil number were increased, while serum levels of CRP, IgA and complements were decreased. A negative correlation between serum levels of IgG4 and IgM was found in the definite group. Conclusion: The results indicated that in patients with renal dysfunction, malaise, thirst or weight loss, measurements of the levels of basophils, immunoglobulins and complements are helpful for diagnosing IgG4-RD. Considering distribution of affected tissues and localization of diagnostic biopsies, physical examination and laboratory workup are required for early diagnosis.

DOI： 10.1080/14397595.2019.1642291

Comparison of the clinical characteristics of TAFRO syndrome and idiopathic multicentric Castleman disease in general internal medicine: a 6‐year retrospective study Reviewed

【総合診療から高齢者医療の在り方を探る】総合診療医育成の場で行う老年医学教育 Invited

花山宜久, 横田雄也, 萩谷英大, 小比賀美香子, 大塚文男

Geriatric Medicine 58 ( 7 ) 591 - 598 2020.7

Yoshito Nishimura, Yoshihisa Hanayama, Nobuharu Fujii, Eisei Kondo, Fumio Otsuka

Internal Medicine Journal 50 ( 2 ) 184 - 191 2020.2

Clinical Relevance of Blood Glucose and Gastroesophageal Reflux Symptoms to Depressive Status in Patients with Type 2 Diabetes Mellitus. Reviewed

Hiroyuki Honda, Yoshihisa Hanayama, Mikako Obika, Kou Hasegawa, Jun Hamahara, Masayuki Kishida, Hideharu Hagiya, Hiroko Ogawa, Hitomi Kataoka, Fumio Otsuka

Acta medica Okayama 74 ( 1 ) 33 - 40 2020.2

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

A relationship between diabetes and depression is apparent. To clarify the clinical relevance of diabetic patients' gastroesophageal symptoms to their psychological status, we retrospectively analyzed the data from a Selfrating Depression Scale (SDS) and a Frequency Scale for Symptoms of Gastroesophageal reflux disease (FSSG) among 143 type 2 diabetic patients who visited a general medicine department. Among the 45 Japanese patients enrolled, the group with relatively high SDS scores (≥ 36) showed higher (FSSG) dysmotility symptom scores versus the low-SDS (< 36) group, although the 2 groups' characteristics and laboratory data were not significantly different. Positive correlations of postprandial plasma glucose (PPG) levels with FSSG scores (R=0.321, p<0.05), particularly with reflux scores (R=0.455, p<0.01) were revealed. PPG and HbA1c levels were not correlated with SDS scores. The patients' SDS scores were significantly correlated with their FSSG scores (R=0.41, p<0.01), suggesting that depressive status is linked to GERD-related manifestations. Considering that the patients' PPG levels were correlated with GERD-related symptoms, diabetic patients' blood glucose levels are associated with depressive status. Collectively, key symptoms related to GERD and glucose level values would be helpful.

DOI： 10.18926/AMO/57950

数年来,慢性疲労症候群として加療されていたACTH単独欠損症の1例

筒井ほのか, 徳増一樹, 原田洸, 安田美帆, 長谷川功, 萩谷英大, 花山宜久, 大塚文男

日本病院総合診療医学会雑誌 16 ( 臨増1 ) 113 - 113 2020.2

繰り返しセルブロック標本を作製することにより原発性滲出性リンパ腫様リンパ腫と診断した1例

長谷井稜子, 佐住洋祐, 徳増一樹, 長谷川功, 萩谷英大, 藤井伸治, 花山宜久, 大塚文男

日本病院総合診療医学会雑誌 16 ( 臨増1 ) 166 - 166 2020.2

Correlations between Depressive Condition and Gastroesophageal Reflux Symptoms in Patients Visiting a Department of General Medicine. Reviewed

Yu Suganami, Kosuke Oka, Yoshihisa Hanayama, Hiroyuki Honda, Jun Hamahara, Mikako Obika, Kazuya Kariyama, Masayuki Kishida, Fumio Otsuka

Acta medica Okayama 73 ( 6 ) 479 - 486 2019.12

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

To clarify the potential relevance of patients' chief complaints at a general medicine department to their self-rating depression scale (SDS) and frequency scale for symptoms of gastroesophageal reflux disease (GERD) (FSSG) scores, we analyzed data of 478 patients who visited our general medicine department. The chief complaints (553 symptoms of 447 patients) were categorized into major symptom-based groups: respiratory (31%), circulatory (3%), gastrointestinal (GI) tract (26%), neurology (8%), orthopedic and skin (10%), and systemic (22%) symptoms. The SDS score tended to be higher in females and younger patients. The FSSG score did not differ by gender but was higher in younger patients. The patients receiving social welfare had higher SDS and FSSG scores. A close inter-relationship between the FSSG (including both degrees of reflux and dysmotility) and SDS was observed in all patients. Although the averages of the SDS and FSSG scores were not significantly different among the symptom-based categories, we observed significantly positive correlations between the FSSG and SDS in each category, suggesting that depressive status may be closely related to GERD-related symptoms regardless of the patients' chief complaints. An initial checkup of patients' psychological condition and/or GERD-like symptoms could help screen for latent disorders in outpatients with uncertain complaints.

DOI： 10.18926/AMO/57711

侵襲性肺炎球菌感染症の治療中に発症した感染性腹部大動脈瘤の一例

治療抵抗性リンパ増殖性好酸球増多症候群の1例 Reviewed

加藤あずさ, 三宅智子, 濱田利久, 花山宜久, 森実真, 岩月啓氏

臨床皮膚科 73 ( 12 ) 983 - 989 2019.11

福島伸乃介, 原田洸, 徳増一樹, 長谷川功, 萩谷英大, 花山宜久, 大塚文男

日本病院総合診療医学会雑誌 15 ( 6 ) 587 - 587 2019.11

リンパ節の再生検からHodgkinリンパ腫の診断に至った不明熱の1例

荒木晴, 徳増一樹, 原田洸, 山本晃, 高原政宏, 長谷川功, 萩谷英大, 花山宜久, 大塚文男

日本病院総合診療医学会雑誌 15 ( 6 ) 602 - 602 2019.11

Risk Factors for Low Bone Mineral Density Determined in Patients in a General Practice Setting. Reviewed

Akemi Ando, Toshiharu Mitsuhashi, Mitsugi Honda, Yoshihisa Hanayama, Kou Hasegawa, Mikako Obika, Hitomi Kataoka, Fumio Otsuka

Acta medica Okayama 73 ( 5 ) 403 - 411 2019.10

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

Osteoporosis increases the risk of bone fractures. It is diagnosed based on an individual's bone mineral density (BMD) or a fracture without trauma. BMD is usually measured by the dual energy X-ray absorptiometry (DXA) method. Here we investigated factors for the earliest possible prediction of decreased BMD by examining the relationships between patients' BMD values and changes in the patients' physical and laboratory values. We retrospectively reviewed the medical records of 149 patients who visited our department in 2014-2015 for a variety of reasons and underwent an area BMD examination by DXA. We analyzed the relationships between decreasing BMD and the patients' gender, age, body mass index (BMI), medical background, hemoglobin, electrolytes, and thyroid function. Thirty-nine of the patients were diagnosed with osteoporosis based on their T-scores. An adjusted analysis showed that female gender, aging, and increased serum calcium level were significantly related to decreasing femoral BMD, whereas high BMI was associated with an increase in femoral BMD. Collectively the results indicate that for the early detection of low BMD, it is important for general-practice physicians to consider conducting a BMD checkup when treating female and elderly patients with a low BMI and/or elevated serum calcium level.

DOI： 10.18926/AMO/57370

2型糖尿病患者における血糖値・胃食道逆流症状とうつ状態の関連

本多寛之, 花山宜久, 小比賀美香子, 岸田雅之, 安田美帆, 長谷川功, 小川弘子, 三好智子, 大塚文男

日本内分泌学会雑誌 95 ( 2 ) 753 - 753 2019.10

18歳時に経皮的腎動脈形成術を行い10年以上経過して血圧上昇をきたした高安動脈炎の1例

内田治仁, 戸田洋伸, 藤本竜一, 大塚寛昭, 花山宜久, 武本梨佳, 大西康博, 高杉佳奈子, 梅林亮子, 吉田賢司, 和田淳

脈管学 59 ( Suppl. ) S226 - S226 2019.10

総合内科診療における主訴と生化学データの関連浸透圧マーカーに着目して

大村大輔, 佐藤明香, 岡浩介, 小川弘子, 花山宜久, 小比賀美香子, 大塚文男

日本病院総合診療医学会雑誌 15 ( 3 ) 175 - 175 2019.5

変視を契機に発見され脈絡膜転移を呈した舌下腺原発腺様嚢胞癌の1例

中野靖浩, 中田圭一, 徳増一樹, 長谷川功, 小比賀美香子, 小川弘子, 花山宜久, 大塚文男

日本病院総合診療医学会雑誌 15 ( 3 ) 265 - 265 2019.5

アザチオプリンによる汎血球減少に感染性心内膜炎を合併した一例

塩飽孝宏, 山本晃, 長尾聡子, 徳増一樹, 高原政宏, 長谷川功, 三好智子, 小比賀美香子, 花山宜久, 大塚文男

日本病院総合診療医学会雑誌 15 ( 3 ) 260 - 260 2019.5

著明な好酸球増多を伴った膵性胸水の一例

今村竜太, 原田洸, 徳増一樹, 長谷川功, 小比賀美香子, 花山宜久, 大塚文男

日本病院総合診療医学会雑誌 15 ( 3 ) 305 - 305 2019.5

40年間の増悪を経て診断治療に至ったBarre-Lieou症候群の一例

大塚勇輝, 徳増一樹, 山本晃, 長谷川功, 小比賀美香子, 花山宜久, 片岡仁美, 大塚文男

日本病院総合診療医学会雑誌 15 ( 3 ) 301 - 301 2019.5

The clinical efficacy of angiotensin II type1 receptor blockers on inflammatory markers in patients with hypertension: a multicenter randomized-controlled trial; MUSCAT-3 study Reviewed

Ryoko Umebayashi, Haruhito A. Uchida, Yuka Okuyama, Yuki Kakio, Yoshihisa Hanayama, Kenichi Shikata, Jun Wada

Biomarkers 24 ( 3 ) 255 - 261 2019.4

【DIHS】臨床例 DIHS発症後皮膚にGVHD様反応が長期に続いた例 Reviewed

三宅智子, 木村摩耶, 花山宜久, 青山裕美, 岩月啓氏, 森実真

皮膚病診療 41 ( 3 ) 245 - 248 2019.3

Changes in Serum Biochemical Markers in Relation to Chief Complaints and Aging in General Medicine. Reviewed

Daisuke Omura, Asuka Sato, Kosuke Oka, Yoshihisa Hanayama, Hiroko Ogawa, Mikako Obika, Fumio Otsuka

Acta medica Okayama 72 ( 6 ) 553 - 562 2018.12

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

To clarify potential relationships between chief complaints of patients and laboratory data with a focus on aging-related changes, we retrospectively analyzed the data of 843 patients who visited a general medicine department for the first time. Their chief complaints were classified into 8 major symptoms: visceral pain, somatic pain, fever, cough, dizziness, fatigue, appetite loss, and edema. We compared the laboratory data obtained from the patients with complaints with the data of symptom-free (control) patients. The serum sodium and potassium levels in the fever group were decreased compared to those in the control group. In the fever group, the serum sodium level was inversely correlated with age. The ratio of serum urea nitrogen to creatinine (UN/Cr) was increased in the appetite-loss group. There were significant age-dependent increases in the UN/Cr ratio in the appetite-loss and edema groups. Of note, serum levels of free thyroxin were lower in the dizziness group compared to the control group. In addition, the free thyroxin level was inversely correlated with age in the dizziness group but not in the asymptomatic control group. Collectively, the results indicated that osmolality-related laboratory data are strongly associated with individual primary symptoms at the first visit regardless of the final diagnosis. The consideration of age-dependent changes of these markers is helpful for diagnosing latent disorders based on various primary symptoms.

DOI： 10.18926/AMO/56372

巨大な機能性甲状腺結節にBasedow病を合併した1例

塩飽孝宏, 安田美帆, 岡浩介, 長谷川功, 三好智子, 小比賀美香子, 花山宜久, 片岡仁美, 大塚文男

日本病院総合診療医学会雑誌 14 ( 6 ) 617 - 617 2018.11

Clinical Characteristics of Febrile Outpatients : Possible Involvement of Thyroid Dysfunction in Febrile Tachycardia. Reviewed

Kosuke Oka, Yoshihisa Hanayama, Asuka Sato, Daisuke Omura, Miho Yasuda, Ko Hasegawa, Mikako Obika, Fumio Otsuka

Acta medica Okayama 72 ( 5 ) 447 - 456 2018.10

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

We retrospectively analyzed the cases of 148 febrile patients whose body temperature (BT) was ≥ 37.5°C at our hospital. We categorized them into seven groups; those with bacterial and viral infection, nonspecific inflammation, neoplasm, connective tissue disease (CTD), drug-induced disease, and unidentified causes. Our analysis revealed that the patient's BT at the 1st visit (BT-1st visit) and highest BT during the febrile period (BT-max) differed significantly among all categories except neoplasm. The greatest difference between BT-1st visit and BT-max was highest in the CTD group (1.5°C). Positive correlations of heart rate and C-reactive protein (CRP) level with BT-max and a negative correlation between serum sodium level with BT-max were uncovered. The serum thyroid-stimulating hormone (TSH) level and the ratio of TSH/free thyroxine were negatively correlated with BT-max, especially in the viral infection group, suggesting the existence of occult thyrotoxicosis in accord with a febrile condition, possibly leading to febrile tachycardia. A febrile gap between BT-1st visit and BT-max (except in the neoplasm group) was shown, in which BT-max was correlated with thyroid function. Clinicians should recognize the fluctuation of BT when diagnosing febrile patients, and tachycardia in such febrile patients may be, at least in part, associated with subclinical thyroid dysfunction.

DOI： 10.18926/AMO/56242

Enterovaginal and colovesical fistulas as late complications of pelvic radiotherapy Reviewed

Masaya Iwamuro, Kou Hasegawa, Yoshihisa Hanayama, Hitomi Kataoka, Takehiro Tanaka, Yoshitaka Kondo, Fumio Otsuka

Journal of General and Family Medicine 19 ( 5 ) 166 - 169 2018.9

巨大な甲状腺腫を呈したMarine-Lenhart症候群の1例

安田美帆, 岡浩介, 長谷川功, 三好智子, 小比賀美香子, 花山宜久, 枝園忠彦, 大塚文男

日本内分泌学会雑誌 94 ( 2 ) 696 - 696 2018.9

外来発熱患者における体温の特徴と頻脈及び臨床パラメーターとの関連

岡浩介, 花山宜久, 小比賀美香子, 片岡仁美, 大塚文男

日本病院総合診療医学会雑誌 14 ( 4 ) 388 - 388 2018.7

Clinical relevance of low androgen to gastroesophageal reflux symptoms Reviewed

Ko Harada, Yoshihisa Hanayama, Miho Yasuda, Kou Hasegawa, Mikako Obika, Hitomi Kataoka, Koichi Itoshima, Ken Okada, Fumio Otsuka

Endocrine Journal 65 ( 10 ) 1039 - 1047 2018

バセドウ病の増悪を契機に中枢性尿崩症を来した1例

中道晶子, 大重和樹, 岡浩介, 安田美帆, 長谷川功, 小比賀美香子, 花山宜久, 頼冠名, 大塚文男

日本内分泌学会雑誌 93 ( 4 ) 1232 - 1232 2017.12

The Clinical and Hormonal Characteristics of Primary Adrenal Lymphomas: The Necessity of Early Detection of Adrenal Insufficiency Reviewed

Ko Harada, Kosuke Kimura, Masaya Iwamuro, Tomohiro Terasaka, Yoshihisa Hanayama, Eisei Kondo, Eiko Hayashi, Tadashi Yoshino, Fumio Otsuka

Internal Medicine 56 ( 17 ) 2261 - 2269 2017.9

Successful treatment with glucocorticoid for secondary Fanconi syndrome caused by sarcoidosis

Daisuke Omura, Hideharu Hagiya, Yoshihisa Hanayama, Kou Hasegawa, Hiroshi Morinaga, Atsue Kikuta, Hitomi Kataoka, Fumio Otsuka

Modern Rheumatology 27 ( 3 ) 545 - 547 2017.5

Practical efficacy of olmesartan versus azilsartan in patients with hypertension Reviewed

Yuki Kakio, Haruhito A. Uchida, Ryoko Umebayashi, Hidemi Takeuchi, Yuka Okuyama, Yoshihisa Hanayama, Jun Wada

Blood Pressure Monitoring 22 ( 2 ) 59 - 67 2017.4

Idiopathic adult ileo-colonic intussusception Reviewed

Masaya Iwamuro, Takahiro Nada, Kosuke Kimura, Yoshihisa Hanayama, Fumio Otsuka

Journal of General and Family Medicine 18 ( 2 ) 94 - 95 2017.4

Paroxysmal Hypertension Induced by an Insulinoma Reviewed

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

Internal Medicine 56 ( 4 ) 413 - 417 2017.4

Hypersensitivity Pneumonitis Caused by a Home Ultrasonic Humidifier Contaminated with <i>Candida guilliermondii</i> Reviewed

Akemi Ando, Hideharu Hagiya, Takahiro Nada, Kosuke Kimura, Koichi Waseda, Kammei Rai, Yoshihisa Hanayama, Fumio Otsuka

Internal Medicine 56 ( 22 ) 3109 - 3112 2017

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

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

Acta Medica Okayama 70 ( 4 ) 279 - 283 2016.8

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 55 ( 13 ) 1769 - 1774 2016.7

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

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

Acta Medica Okayama 70 ( 3 ) 217 - 221 2016.6

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

Harada Ko, Iwamuro Masaya, Hanayama Yoshihisa, Otsuka Fumio

Acta Medica Okayama 70 ( 2 ) 145 - 149 2016.4

Pheochromocytoma Manifesting Persistent Right Shoulder Pain and Hypochondralgia

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-Blackwell

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

A Paraganglioma in a Hypertensive Patient with Unilateral Renal Hypoplasia

Cytomegalovirus as an Insidious Pathogen Causing Duodenitis Reviewed

Hagiya Hideharu, Iwamuro Masaya, Tanaka Takehiro, Hanayama Yoshihisa, Otsuka Fumio

Acta Medica Okayama 69 ( 5 ) 319 - 323 2015.10

Gastric pseudopolyposis formed after recovery from gastric gangrene

Masaya Iwamuro, Yoshihisa Hanayama, Fumio Otsuka, Hiroyuki Okada

Digestive and Liver Disease 47 ( 6 ) e9 - e9 2015.6

Terasaka Tomohiro, Hagiya Hideharu, Kimura Kosuke, Nada Takahiro, Nakamura Eri, Hanayama Yoshihisa, Sugiyama Hitoshi, Kobayashi Yasuyuki, Yanai Hiroyuki, Otsuka Fumio

Acta Medica Okayama 69 ( 2 ) 119 - 122 2015.4

Complication of Chronic Eosinophilic Pneumonia in an Elderly Patient with Sjögren Syndrome

Waseda Koichi, Hagiya Hideharu, Hanayama Yoshihisa, Terasaka Tomohiro, Kimura Kosuke, Tsuzuki Takao, Hasegawa Kou, Nada Takahiro, Nakamura Eri, Murakami Kazutoshi, Kondo Eisei, Otsuka Fumio

Acta Medica Okayama 69 ( 2 ) 123 - 127 2015.4

Language：English Publisher：Okayama University Medical School

An 81-year-old Japanese male with primary Sjögren syndrome (pSS) developed a low-grade fever and productive cough which were refractory to antibiotic therapy. Based on the high level of eosinophils observed in his bronchial alveolar lavage, he was diagnosed with chronic eosinophilic pneumonia (CEP) and successfully treated by oral prednisolone. Interstitial lung diseases associated with pSS (pSS-ILDs) usually present as nonspecific interstitial pneumonia or usual interstitial pneumonia; therefore, the present case is extremely unique in that the patientʼs condition was complicated with CEP. A diagnosis of advanced gallbladder cancer was made in the patientʼs clinical course, suggesting the advisability of a whole-body workup in cases of pSS, especially in elderly patients.

DOI： 10.18926/AMO/53342

CiNii Article

CiNii Books

Infective Internal Iliac Artery Aneurysm Caused by <i>Campylobacter fetus</i>

Other Link： http://search.jamas.or.jp/link/ui/2016077633

Myopathy and Eosinophilic Pneumonia Coincidentally Induced by Treatment with Daptomycin

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

Internal Medicine 54 ( 5 ) 525 - 529 2015

Hideharu Hagiya, Hiroko Ogawa, Yusuke Takahashi, Kou Hasegawa, Yoshihisa Hanayama, Fumio Otsuka

Internal Medicine 54 ( 16 ) 2021 - 2024 2015

Aortic vascular graft infection caused by Cardiobacterium valvarum: A case report

Hideharu Hagiya, Susumu Kokeguchi, Hiroko Ogawa, Tomohiro Terasaka, Kosuke Kimura, Koichi Waseda, Yoshihisa Hanayama, Kaori Oda, Hisatoshi Mori, Toru Miyoshi, Fumio Otsuka

Journal of Infection and Chemotherapy 20 ( 12 ) 804 - 809 2014.12

Gingival overgrowth caused by vitamin C deficiency associated with metabolic syndrome and severe periodontal infection: a case report

Kazuhiro Omori, Yoshihisa Hanayama, Koji Naruishi, Kentaro Akiyama, Hiroshi Maeda, Fumio Otsuka, Shogo Takashiba

Clinical Case Reports 2 ( 6 ) 286 - 295 2014.12

難治性MRSA感染症に対して高用量ダプトマイシンとリファンピシンの併用療法が有効であった一例

萩谷英大, 寺坂友博, 木村耕介, 佐藤明香, 浅野喜久子, 早稲田公一, 花山宜久, 近藤英生, 大塚文男

日本病院総合診療医学会雑誌 6 ( 2 ) 105 - 105 2014.6

本態性高血圧の初期治療における第一選択薬決定のアルゴリズム作成と有用性の検討

萱野由佳, 三好智子, 水島孝明, 花山宜久, 黒田真生, 尾上洋, 相良英憲, 座間味義人, 大塚文男, 名倉弘哲

Progress in Medicine 34 ( 3 ) 527 - 536 2014.3

Language：Japanese Publisher：(株)ライフ・サイエンス

本態性高血圧症は本邦において極めて患者数の多い疾患であり、その治療は食事・運動療法に加えて薬物治療が重要である。『高血圧治療ガイドライン2009』では、本態性高血圧に対する5種類の第一選択薬であるカルシウム拮抗薬、アンジオテンシンII受容体拮抗薬、アンジオテンシン変換酵素阻害薬、β遮断薬、利尿薬が提示されている。本態性高血圧の初期治療での薬剤選択に際して医師が考慮すべき事項は極めて煩雑であり、医師の処方薬決定を困難にしている。本研究では、本態性高血圧初期治療における処方決定に役立つためのアルゴリズムの作成を試みた。さらに、調査対象となる総合内科医師と保険薬剤師にアルゴリズムを配付し、一定の試用期間後にアルゴリズムの使用感に関する有用性の評価を実施したところ、本アルゴリズムは総合内科医師、保険薬剤師それぞれから高い評価を得た。また、医師の処方決定時の思考をおおむね反映していることが検証できた。したがって、作成したアルゴリズムは医師の処方決定の理解の手助けとなる可能性が示唆された。加えて、本アルゴリズムは薬剤師が処方解析を行ううえでもその有用性は高いと考えられた。(著者抄録)

Long-term Observation of Osteomalacia Caused by Adefovir-Induced Fanconi's Syndrome

Terasaka Tomohiro, Ueta Eijiro, Ebara Hirotaka, Waseda Koichi, Hanayama Yoshihisa, Takaki Akinobu, Kawabata Tomoko, Sugiyama Hitoshi, Hidan Ko, Otsuka Fumio

Acta Medica Okayama 68 ( 1 ) 53 - 56 2014.2

Fosfomycin for the Treatment of Prostate Infection

Hideharu Hagiya, Megumi Ninagawa, Kou Hasegawa, Tomohiro Terasaka, Kosuke Kimura, Koichi Waseda, Yoshihisa Hanayama, Toshiaki Sendo, Fumio Otsuka

Internal Medicine 53 ( 22 ) 2643 - 2646 2014

Successful Treatment of Persistent MRSA Bacteremia using High-dose Daptomycin Combined with Rifampicin

Hideharu Hagiya, Tomohiro Terasaka, Kosuke Kimura, Asuka Satou, Kikuko Asano, Koichi Waseda, Yoshihisa Hanayama, Fumio Otsuka

Internal Medicine 53 ( 18 ) 2159 - 2163 2014

Filarial Chyluria as a Rare Cause of Urinary Retention

Hideharu Hagiya, Tomohiro Terasaka, Kosuke Kimura, Asuka Satou, Kikuko Asano, Koichi Waseda, Yoshihisa Hanayama, Takahide Takahashi, Michinori Aoe, Koji Iio, Toshiyuki Watanabe, Eisei Kondo, Fumio Otsuka

Internal Medicine 53 ( 17 ) 2001 - 2005 2014

Triangle Sign on Neck MRI

Kosuke Kimura, Hideharu Hagiya, Yoshihisa Hanayama, Fumio Otsuka

Internal Medicine 53 ( 9 ) 1035 - 1036 2014

Recurrent Stenotrophomonas maltophilia bacteremia after iliac crest bone graft harvest. Reviewed

Hideharu Hagiya, Hiroko Ogawa, Tomoharu Ishida, Tomohiro Terasaka, Kosuke Kimura, Koichi Waseda, Yoshihisa Hanayama, Masahiro Horita, Yasunori Shimamura, Eisei Kondo, Fumio Otsuka

Internal medicine (Tokyo, Japan) 53 ( 15 ) 1693 - 8 2014

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

We describe a rare case of recurrent Stenotrophomonas maltophilia bacteremia in a previously healthy 45-year-old man. The infection was caused by osteomyelitis at the site of an iliac crest bone graft harvest. A genetic analysis using enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) revealed that the blood isolates and pathogens obtained from the surgical wound were identical. Initial treatment with levofloxacin and cefozopran was ineffective, but the patient's infection was successfully treated by long-term administration of latamoxef and trimethoprim-sulfamethoxazole. The present case suggests that attention should be given to the possibility of S. maltophilia infection in any situations.

DOI： 10.2169/internalmedicine.53.1995

Disseminated Gonococcal Infection in An Elderly Japanese Man

不明熱診断における検査の有効性とその進め方

立古浩雅, 草野展周, 片岡仁美, 三好智子, 花山宜久, 金森達也, 江原弘貴, 小川弘子, 小比賀美香子, 大塚文男

日本病院総合診療医学会雑誌 5 ( 2 ) 78 - 78 2013.12

Hideharu Hagiya, Nobuhiko Onishi, Hirotaka Ebara, Yoshihisa Hanayama, Susumu Kokeguchi, Motoko Nose, Nobuchika Kusano, Fumio Otsuka

Internal Medicine 52 ( 23 ) 2669 - 2673 2013

Losartan/Hydrochlorothiazide Combination Therapy Surpasses High-dose Angiotensin Receptor Blocker in the Reduction of Morning Home Blood Pressure in Patients with Morning Hypertension Reviewed

Hanayama Yoshihisa, Uchida Haruhito Adam, Nakamura Yoshio, Makino Hirofumi

Acta Medica Okayama 66 ( 6 ) 449 - 459 2012.12

IgG4関連疾患第4回日本病院総合診療学会で発表されたIgG4関連疾患より

水島孝明, 片岡仁美, 村上和敏, 花山宜久, 金森達也, 江原弘貴, 廣田大昌, 甘利悠, 竹嶋功人, 三好智子, 大塚文男, 池田貴英, 家城隆次, 牧野寛史, 平松万尚, 五十野桃子, 谷合啓明, 大高行博

日本病院総合診療医学会雑誌 3 ( 2 ) 48 - 52 2012.12

Language：Japanese Publisher：(一社)日本病院総合診療医学会

IgG4関連疾患は近年注目されている。今回、病態の解明に寄与することを目的に、第4階日本病院総合診療医学会で発表されたIgG4関連疾患39症例を集積、検討、解析した。診断時の平均年齢は63.0歳で男女比は33:6で男性に多く、主訴は顎下腺腫大と糖尿病の悪化、発熱が多く、病変部位は膵、次いで顎下腺、後腹膜、涙腺の順であった。血中のIgG4は907.4±846.0mg/dlで135mg/dl以下も4例認められた。PET-CTは17例で実施されうち2例(11.8%)(前立腺、顎下腺、膵臓、リンパ節)で集積が指摘されなかった。ガリウムシンチも7例で実施され、うち3例(28.6%)は集積が指摘されなかった。生検は侵襲の少ない部位が選択される傾向にあった。組織のIgG4/IgG細胞比は生検部位別に一定の傾向を認めなかった。薬物治療は32例で実施7例は経過観察中。薬物はプレドニゾロンが31例。再発は5例に認められた。1例で本態性M蛋白血症の合併が認められた。本疾患は多様な症状で発症するため、本疾患を念頭に置いた診療が重要となる。またIgGの値は本疾患のスクリーニングには適さない。(著者抄録)