研究者詳細 - 大村　大輔

MISC - 大村　大輔

分割表示 76 件中 41 - 60 件目／全件表示 >>

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

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

Acta medica Okayama 72 ( 6 ) 553 - 562 2018年12月

記述言語：英語

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

その他リンク： https://search.jamas.or.jp/link/ui/2019286375

回腸末端に潰瘍病変を認めた不明熱の1例

栗山裕, 徳増一樹, 山本紘一郎, 中野靖浩, 大村大輔, 高原政宏, 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 14 ( 6 ) 663 - 663 2018年11月

回腸末端に潰瘍病変を認めた不明熱の1例

栗山裕, 徳増一樹, 山本紘一郎, 中野靖浩, 大村大輔, 高原政宏, 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 14 ( 6 ) 663 - 663 2018年11月

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

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

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

記述言語：英語

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://search.jamas.or.jp/link/ui/2019206207

意識障害で発症し一過性全健忘を生じた下垂体機能低下症の1例

山本紘一郎, 徳増一樹, 中野靖浩, 大村大輔, 安田美帆, 長谷川功, 三好智子, 小比賀美香子, 花山宜久, 大塚文男

日本内分泌学会雑誌 94 ( 2 ) 684 - 684 2018年9月