研究者詳細 - 大村　大輔

論文 - 大村　大輔

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COVID-19後遺症状の診療において大学病院総合内科が果たせる役割

大塚勇輝, 徳増一樹, 中野靖浩, 本多寛之, 萩谷英大, 砂田匠彦, 櫻田泰江, 山本幸近, 大村大輔, 松田祐依, 長谷川功, 小比賀美香子, 植田圭吾, 片岡仁美, 大塚文男

日本病院総合診療医学会雑誌 18 ( 臨増1 ) N - 010 2022年2月

Clinical Characteristics of Japanese Patients Who Visited a COVID-19 Aftercare Clinic for Post-Acute Sequelae of COVID-19/Long COVID. 査読国際誌

Otsuka Y, Tokumasu K, Nakano Y, Honda H, Sakurada Y, Sunada N, Omura D, Hasegawa K, Hagiya H, Obika M, Ueda K, Kataoka H, Otsuka F.

Cureus 13 ( 10 ) 2021年10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）

Introduction The long-term clinical course, prognosis, and optimal management of symptoms and conditions after the acute phase of coronavirus disease 2019 (COVID-19) remain to be elucidated. The purpose of this study was to clarify the characteristics of patients referred to a COVID-19 aftercare (CAC) clinic established at a tertiary academic hospital in Japan. Methods This study was a descriptive case series study. All patients who visited the CAC clinic between February 15 and September 17 in 2021 were included. Patients' background, chief complaints, and clinical courses after the onset of COVID-19 were described. Results A total of 87 Japanese patients (median age, 40.0 years; interquartile range [IQR], 26.5-53.0 years; 52.9% women) were referred to the CAC clinic. The median interval between the onset of COVID-19 and the visit to the clinic was 79.0 (IQR, 52.5-112.0) days. Referral sources were hospitals (36 patients), clinics (47 patients), a local healthcare center (3 patients), and other (1 patient). The most common chief complaint was general fatigue (50.4%) followed by dysosmia (28.7%), dysgeusia (26.4%), hair loss (18.4%), headache (17.2%), dyspnea (16.1%), and dyssomnia (13.1%). Respiratory symptoms were common in the early stages of the disease but were less common as the chief complaints when visiting the clinic. On the other hand, neurological, psychiatric, and extremity symptoms were predominant one month after the onset of COVID-19. Conclusions Regardless of the severity in the acute phase, patients visiting our CAC clinic suffered from a variety of symptoms. General physicians skilled in using a comprehensive approach would be optimal to see patients with such complex symptoms.

DOI： 10.7759/cureus.18568

その他リンク： https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571943/

A patient with human coronavirus NL63 falsely diagnosed with COVID-19; Lesson learned for the importance of definitive diagnosis. 査読

Otsuka Y, Hagiya H, Nakano Y, Omura D, Hasegawa K, Yamada H, Iio K, Honda T, Otsuka F.

Journal of Infection and Chemotherapy 27 ( 7 ) 1126 - 1128 2021年7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）

The gold standard for the diagnosis of coronavirus disease 2019 (COVID-19) is a nucleic acid detection test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which may occasionally reveal false-positive or false-negative results. Herein, we describe a case of a patient infected with human coronavirus NL63 (HCoV-NL63) who was falsely diagnosed with COVID-19 using the Ampdirect™ 2019-nCoV detection kit (Shimadzu Corporation, Japan) and SARS-CoV-2 Detection Kit (TOYOBO co., ltd.), and was admitted to a COVID-19 hospital ward. We suspected a cross-reaction between HCoV-NL63 and SARS-CoV-2; however, the reported genome sequences of HCoV-NL63 and N1/N2 primers for SARS-CoV-2 do not correspond. Thus, the PCR result was supposed to be a false positive possibly due to contamination or human error. Although the issue of a false-negative result has been the focus of much attention to prevent the spread of the disease, a false positive is fraught with problems as well. Physicians should recognize that unnecessary isolation violates human rights and a careful diagnosis is indispensable when the results of laboratory testing for COVID-19 are unclear. Generally, in cases such as a duplicate PCR test was partially positive, either N1 or N2 alone was positive, PCR testing for two or more target regions resulted in a positive only for single region, a high cycle threshold >35 was obtained, a false positive should be suspected. Especially, when these conditions coincide, we should recognize the high likelihood of a false positive.

DOI： 10.1016/j.jiac.2021.05.001.

その他リンク： https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106895/

Barium appendicitis. 査読国際誌

Omura D, Yunoki N, Otsuka Y, Nakano Y, Hagiya H, Otsuka F.

Clinical Case Report 9 ( 7 ) 2021年7月

担当区分：筆頭著者,　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）

We have presented a case of barium appendicitis, which is a rare complication of barium enema studies. Barium sulfate is used widely for gastrointestinal radiographic studies and is associated with few complications. Clinicians need to be fully aware of this complication.

DOI： 10.1002/ccr3.4583

その他リンク： https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299263/

Angina Simultaneously Diagnosed with the Recurrence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. 査読国際誌

Li K, Otsuka Y, Nakano Y, Omura D, Hasegawa K, Obika M, Ueda K, Kataoka H, Otsuka F.

Diagnostics 11 ( 3 ) 460 - 460 2021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）

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) mainly affects young adults and can have a potential impact on social functioning. As this syndrome is associated with endothelial dysfunction, the heart can be damaged via ischemia due to endothelial damage. This might potentially lead to heart failure, which accounts for approximately 20% of deaths among patients with ME/CFS. While cardiac ischemia is thought be a pathophysiologically important manifestation of this syndrome, this is not yet reported. Herein, we present a case of a young female with newly diagnosed vasospastic or microvascular angina and concurrent exacerbation of ME/CFS severity. Her anginal symptoms, including exertional chest pain and transient chest discomfort, mimicked those of ME/CFS but were relieved after the administration of a calcium channel blocker. We emphasize the possibility of concurrent angina and exacerbation of ME/CFS and the importance of detecting cardiac ischemia to avoid unfavorable outcomes.

DOI： 10.3390/diagnostics11030460

その他リンク： https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8001656/

複数の基礎疾患を有した超高齢者COVID-19の一例

孫麗那, 藤田茉奈美, 山本紘一郎, 岡浩介, 山根真衣, 大塚勇輝, 高瀬了輔, 中野靖浩, 大村大輔, 榮浩行, 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 17 ( 臨増1 ) 149 - 149 2021年2月

COVID-19外国人患者の受入れで明らかとなった課題と病院総合医に求められる役割

大塚勇輝, 大村大輔, 李皓生, 藤田茉奈美, 山根真衣, 山本紘一郎, 孫麗那, 高瀬了輔, 中野靖浩, 岡浩, 榮浩行, 徳増一樹, 長谷川功, 萩谷英大, 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 17 ( 臨増1 ) 109 - 109 2021年2月

COVID-19外国人患者の受入れで明らかとなった課題と病院総合医に求められる役割

日本病院総合診療医学会雑誌 17 ( 臨増1 ) 109 - 109 2021年2月

Simultaneous hot and cold thyroid nodules: Which is malignant? 査読国際誌

Otsuka Y, Nakano Y, Omura D, Iwamoto T, Hayashi R, Otsuka F.

Clinical Case Report 9 ( 3 ) 1810 - 1811 2021年1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）

Physicians should be aware of the risk of malignancy in patients with toxic multinodular goiter. Radionuclide scan cannot be used to predict the malignant potential of thyroid nodules. A comprehensive evaluation of imaging studies is needed.

DOI： 10.1002/ccr3.3843.

その他リンク： https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7981636/

Recurrence of Hypoglycemic Coma in a Patient with Anorexia Nervosa. 査読

Yamamoto K, Omura D, Yamane M, Son R, Hasegawa K, Honda H, Obika M, Minao N, Edahiro S, Yamada N, Otsuka F.

Acta Medica Okayama 75 ( 5 ) 631 - 636 2021年

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）

Anorexia nervosa (AN) is occasionally complicated with hypoglycemic coma, which may cause sudden death by unknown mechanisms. We present the case of a 36-year-old woman with recurrent comas and a nineteen-year history of AN. She was found in a coma with remarkable hypoglycemia (28 mg/dL). Her BMI was 11.1 kg/m2. Endocrine workup revealed extremely low serum levels of glucagon, IGF-I and insulin. Asymptomatic hypoglycemia occurred with liver injury in the refeeding process. An aberrant glucose metabolism due to liver damage might have been involved in her susceptibility to hypoglycemia. This case suggests a possible mechanism of hypoglycemic coma in AN.

DOI： 10.18926/AMO/62776.

その他リンク： https://ousar.lib.okayama-u.ac.jp/ja/62776

Intra-arterial gas, a clue for diagnosis of peri-aortic inflammation due to infection. 査読国際誌

Omura D, Ogata M, Sakane Y, Matsuo R, Nakatsukasa H, Hagiya H, Otsuka F.

Clinical Case Report 8 ( 12 ) 3619 - 3620 2020年9月

担当区分：筆頭著者,　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）

We have presented a case of Salmonella-induced infective aortic aneurysm in which the presence of peri-aortic gas was a clue for diagnosis. The disease is clinically infrequent but potentially has a high mortality rate. Clinicians should consider this fatal disease from any trivial findings.

DOI： 10.1002/ccr3.3367.

その他リンク： https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752411/

Anterior Cutaneous Nerve Entrapment Syndrome Possibly Triggered by Oral Contraceptives. 査読

Omura D, Obika M, Iwamuro M, Nagao S, Nada T, Matsuzaki T, Kondo Y, Otsuka F.

Internal Medicine 58 ( 10 ) 1507 - 1509 2019年5月

担当区分：筆頭著者,　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）

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

DOI： 10.2169/internalmedicine.1361-18.

その他リンク： https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6548911/

Symptomatic Adrenal Myelolipoma. 査読

Omura D, Nakano Y, Takase R, Otsuka F

Internal Medicine 58 ( 8 ) 1181 - 1181 2019年4月

Loss of bone mineral density following sepsis using Hounsfield units by computed tomography. 国際誌

Takashi Hongo, Kazumasa Kotake, Hirotada Muramatsu, Daisuke Omura, Yudai Yano, Daisuke Hasegawa, Noriya Momoki, Kenji Takahashi, Satoshi Nozaki, Toshifumi Fujiwara

Acute medicine & surgery 6 ( 2 ) 173 - 179 2019年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

AIM: To examine the change in vertebral bone mineral density (BMD) using abdominal computed tomography in patients treated for sepsis. METHODS: A single-center, retrospective, observational study was undertaken to evaluate BMD after critical care at Okayama Saiseikai General Hospital (Okayama, Japan) from January 2016 to April 2018. Sepsis was defined as an absolute increase of ≥2 in Sequential Organ Failure Assessment score in the intensive care unit or high care unit. Bone mineral density was evaluated in Hounsfield units (HU) by computed tomography. Patients were divided into groups based on the presence or absence of osteoporosis, which was defined as average vertebral body HU <110. Paired t-tests were used to compare the mean BMD of each vertebra between before and after critical care. We also analyzed accidental bone fracture events after discharge. The survival rate was analyzed as an outcome using the Kaplan-Meier method. RESULTS: Fifty-two of 188 patients met the inclusion criteria. We found significant differences between admission and follow-up vertebral BMD values in the spine at the thoracic 12, lumbar 1-5, and sacrum 1 levels (P < 0.05), especially in the non-osteoporosis groups. No difference in mortality was observed between patients with osteoporosis and those without. Two of 19 patients with osteoporosis developed a bone fracture. CONCLUSION: We found that sepsis was associated with loss in BMD following critical care.

DOI： 10.1002/ams2.401

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Loss of bone mineral density following sepsis using Hounsfield units by computed tomography. 査読

Hongo T, Kotake K, Muramatsu H, Omura D, Yano Y, Hasegawa D, Momoki N, Takahashi K, Nozaki S, Fujiwara T.

Acute Medicine & Surgery 6 ( 2 ) 173 - 179 2019年2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）

Aim: To examine the change in vertebral bone mineral density (BMD) using abdominal computed tomography in patients treated for sepsis.

Methods: A single-center, retrospective, observational study was undertaken to evaluate BMD after critical care at Okayama Saiseikai General Hospital (Okayama, Japan) from January 2016 to April 2018. Sepsis was defined as an absolute increase of ≥2 in Sequential Organ Failure Assessment score in the intensive care unit or high care unit. Bone mineral density was evaluated in Hounsfield units (HU) by computed tomography. Patients were divided into groups based on the presence or absence of osteoporosis, which was defined as average vertebral body HU <110. Paired t-tests were used to compare the mean BMD of each vertebra between before and after critical care. We also analyzed accidental bone fracture events after discharge. The survival rate was analyzed as an outcome using the Kaplan-Meier method.

Results: Fifty-two of 188 patients met the inclusion criteria. We found significant differences between admission and follow-up vertebral BMD values in the spine at the thoracic 12, lumbar 1-5, and sacrum 1 levels (P < 0.05), especially in the non-osteoporosis groups. No difference in mortality was observed between patients with osteoporosis and those without. Two of 19 patients with osteoporosis developed a bone fracture.

Conclusion: We found that sepsis was associated with loss in BMD following critical care.

DOI： 10.1002/ams2.401

その他リンク： https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442538/

Actinomycosis-induced Trismus with Orbital Involvement. 査読

Omura D, Rai K, Kusano N, Otsuka F

Internal Medicine 58 ( 1 ) 153 - 154 2019年1月

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

Oka K, Hanayama Y, Sato A, Omura D, Yasuda M, Hasegawa K, Obika M, Otsuka F

Acta Medica Okayama 72 ( 5 ) 447 - 456 2018年10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）

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.

その他リンク： https://ousar.lib.okayama-u.ac.jp/ja/56242

著明な心嚢液を呈したメサラジンアレルギーの1例

中野靖浩, 杉原雄策, 小寺順久, 西村義人, 大村大輔, 堀口繁, 頼冠名, 小比賀美香子, 大塚文男

日本病院総合診療医学会雑誌 14 ( 4 ) 408 - 408 2018年7月

Successful treatment with glucocorticoid for secondary Fanconi syndrome caused by sarcoidosis 査読国際誌

Omura D, Hagiya H, Hanayama Y, Hasegawa K, Morinaga H, Kikuta A, Kataoka H, Otsuka F.

Modern Rheumatology 27 ( 3 ) 545 - 547 2017年5月

担当区分：筆頭著者,　最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

A 77-year-old female with renal dysfunction, hypercalcemia, and hypercalciuria was presented. Systemic investigations including renal biopsy showed that the patient had Fanconi syndrome secondary to renal sarcoidosis. Treatment with 25 mg per day of prednisolone was initiated and her condition improved. Complication of Fanconi syndrome in patients with sarcoidosis is extremely rare. Although the pathological mechanism is still unknown, corticosteroid therapy was effective for ameliorating proteinuria, glycosuria, hypercalciuria, and aminoaciduria.

DOI： 10.3109/14397595.2014.1002163

その他リンク： https://academic.oup.com/mr/article-lookup/doi/10.3109/14397595.2014.1002163

Successful treatment with glucocorticoid for secondary Fanconi syndrome caused by sarcoidosis. 国際誌

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

Modern rheumatology 27 ( 3 ) 545 - 547 2017年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

DOI： 10.3109/14397595.2014.1002163

PubMed

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