研究者詳細 - 小比賀　美香子

論文 - 小比賀　美香子

分割表示 >> ／全件表示 132 件中 1 - 132 件目

Effectiveness of professional-identity-formation and clinical communication-skills programs on medical students' empathy in the COVID-19 context: comparison between pre-pandemic in-person classes and during-pandemic online classes. 国際誌

Hitomi Kataoka, Akiko Tokinobu, Chikako Fujii, Mayu Watanabe, Mikako Obika

BMC medical education 25 ( 1 ) 39 - 39 2025年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Enhancing students' empathy is critical in medical school education. The COVID-19 pandemic necessitated a shift from in-person to online classes. However, the effectiveness of online classes for enhancing medical students' empathy has not been investigated sufficiently and the evidence is limited. This study compared the effectiveness of enhancing empathy between pre-pandemic in-person classes and during-pandemic online classes among medical students in Japan using pre-pandemic and during-pandemic data. METHODS: This is a retrospective observational study. This study measured students' empathy using the Japanese translation of the Jefferson Scale of Empathy-Student Version (JSE-S) before and after the special programs for professional identity formation and clinical communication among first- and second-year students who matriculated from 2015-2021. This study categorized the matriculation year groups as "pre-pandemic" and "during-pandemic" groups for the first- and second-year students. This study estimated the adjusted mean score differences of the JSE-S and 95% confidence intervals (CIs) from the pre- to post-program between the pre-pandemic and during-pandemic groups in the first and second years using linear regression analysis. RESULTS: This study's participants included 653 first-year students and 562 second-year students. In the first year, the during-pandemic group had a significantly higher mean score difference from the pre- to post-program compared to the pre-pandemic group. The adjusted regression coefficient (95% CI) was 7.6 (5.7 - 9.5), with the pre-pandemic group as the reference. In the second year, there were no significant differences between the two groups. CONCLUSIONS: The results suggest that online classes are not inferior to in-person classes or even slightly better in enhancing medical students' empathy, which should be clarified by further studies. This study's findings have important implications for medical education and implementing hybrid class formats to enhance students' empathy.

DOI： 10.1186/s12909-024-06597-3

様々な気づき・自己省察、深く考える力を育むためのビジュアルアート授業

木股敬裕, 小比賀美香子, 大塚益美, 福冨幸, 森弥生, 加藤基, 松本洋

医学教育 55 ( Suppl. ) 259 - 259 2024年7月

コロナ禍における医学生のストレス知覚についての研究対面とオンラインのコミュニケーションによる違い(Medical students' stress perception on in-person/online communication during the COVID-19 pandemic)

徳増一樹, 西村義人, 坂本陽子, 小比賀美香子, 片岡仁美, 大塚文男

医学教育 55 ( Suppl. ) 223 - 223 2024年7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例査読

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

チルゼパチド導入が治療負担感軽減に有用と思われた若年肥満2型糖尿病男性の2例査読

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

糖尿病 67 ( Suppl.1 ) S - 336 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

チルゼパチド導入が治療負担感軽減に有用と思われた若年肥満2型糖尿病男性の2例

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

糖尿病 67 ( Suppl.1 ) S - 336 2024年4月

成人成長ホルモン分泌不全症に関する医療者教育と総合診療科における実践査読

越智可奈子, 徳増一樹, 中野靖浩, 須山敦仁, 副島佳晃, 大塚勇輝, 安田美帆, 小比賀美香子, 大塚文男

日本病院総合診療医学会雑誌 20 ( 1 ) 7 - 17 2024年1月

成人成長ホルモン分泌不全症に関する医療者教育と総合診療科における実践

越智可奈子, 徳増一樹, 中野靖浩, 須山敦仁, 副島佳晃, 大塚勇輝, 安田美帆, 小比賀美香子, 大塚文男

日本病院総合診療医学会雑誌 20 ( 1 ) 7 - 17 2024年1月

記述言語：日本語出版者・発行元：(一社)日本病院総合診療医学会

成人成長ホルモン分泌不全症(AGHD)は下垂体前葉機能低下症の中で成長ホルモン(GH)不足により様々な代謝異常をきたす疾患である。治療にはGH製剤の自己注射を要することから,患者の予後改善にはAGHDの早期診断・治療とともに多職種連携や患者教育が重要である。本研究では,AGHD診療における多職種での医療連携や専門医の育成を目的とし,AGHDに関する講義や専攻医に対するAGHD患者のマネジメント指導において,その教育効果を検討した。まず多職種へのAGHD教育実践と効果の検討として,医師・看護師・検査技師・医薬情報担当者・医学生・看護学生・医療技術専門学生(作業療法学科・理学療法学科)に対してAGHDに関する講義を行い,講義前後でAGHDの理解度を評価する目的でアンケートを実施した。アンケート内容を(1)基礎的事項,(2)合併症に関する事項,(3)診断に関する事項,(4)治療・マネジメントに関する事項の4分野に分類して検討したところ,全職種において講義後の正答率が上昇し,各職種の正答率上昇率は分野ごとに違いを認めた。次に,内科専攻医に対してのAGHD診療の実践教育を内科専攻医4名に対して行い,AGHDの新規患者における診断・治療・GH自己注射指導およびマネジメント教育を実施し評価を行った。GH自己注射指導に関しては,自己注射練習用器材を用いて実践的トレーニングを行ったところ,全専攻医において診療能の向上を認めた。AGHD患者の診断やGH自己注射を含めた治療継続においては多職種連携や専門医育成などの医療者教育が非常に重要である。診療においては総合診療科における全人的・総合的診療の一環としての教育実践により,医療者のAGHD診療に対する理解が向上しており教育効果が示された。(著者抄録)

その他リンク： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J05937&link_issn=&doc_id=20240228380002&doc_link_id=%2Ffg3byoin%2F2024%2F002001%2F003%2F0007-0017%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffg3byoin%2F2024%2F002001%2F003%2F0007-0017%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

The effectiveness of simulation-based education combined with peer-assisted learning on clinical performance of first-year medical residents: a case-control study 査読

Taku Murakami, Akira Yamamoto, Hideharu Hagiya, Mikako Obika, Yasuhiro Mandai, Tomoko Miyoshi, Hitomi Kataoka, Fumio Otsuka

BMC Medical Education 23 ( 1 ) 2023年11月

掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

Abstract

Background

Simulation-based education and peer-assisted learning (PAL) are both known as useful educational methods. Previous research has reported that combining these two methods are effective for training medical residents in short-term evaluation. This study was aimed to evaluate the middle- to long-term effects of simulation-based education combined with PAL on the performance of medical residents during emergency department duties.

Methods

This study was designed as a case-control study and conducted over three years at Okayama University Hospital in Japan. Postgraduate-year-one medical residents were assigned to three groups: a simulation group that received simulation-based education, a lecture group that received traditional lecture-based education, and a control group that received no such prior trainings. Prior training in emergency department duties using PAL was performed as an educational intervention for the simulation and lecture groups during the clinical orientation period. The residents’ medical knowledge was assessed by written examinations before and after the orientation. The performance of residents during their emergency department duties was assessed by self-evaluation questionnaires and objective-assessment checklists, following up with the residents for three months after the orientation period and collecting data on their 1st, 2nd, and 3rd emergency department duties. All the datasets collected were statistically analyzed and compared by their mean values among the three groups.

Results

A total of 75 residents were included in the comparative study: 27 in the simulation group, 24 in the lecture group, and 24 in the control group. The simulation and lecture groups obtained significantly higher written examination scores than the control group. From the self-evaluation questionnaires, the simulation group reported significantly higher satisfaction in their prior training than the lecture group. No significant differences were found in the emergency department performance of the residents among the three groups. However, when evaluating the improvement rate of performance over time, all three groups showed improvement in the subjective evaluation, and only the simulation and lecture groups showed improvement in the objective evaluation.

Conclusion

Simulation-based education combined with PAL is effective in improving the knowledge and satisfaction of medical residents, suggesting the possibility of improving work performance during their emergency department duties.

DOI： 10.1186/s12909-023-04798-w

その他リンク： https://link.springer.com/article/10.1186/s12909-023-04798-w/fulltext.html

医学における「ビジュアルアート教育」の展開第3ステップ岡山県立美術館の協力による対話型鑑賞の導入査読

木股敬裕, 小比賀美香子, 久保卓也, 大塚益美, 岡本裕子, 福冨幸, 松本洋

岡山医学会雑誌 135 ( 2 ) 85 - 88 2023年8月

眼内炎診療における病院総合医の役割査読

川口満理奈, 大塚勇輝, 副島佳晃, 安藤航, 高木桃李, 大國皓平, 長谷川功, 本多寛之, 萩谷英大, 小比賀美香子, 森田哲郎, 森實祐基, 大塚文男

日本病院総合診療医学会雑誌 19 ( 臨増2 ) 142 - 142 2023年8月

自動車運転中の失神・交通事故の原因精査に詳細な血糖測定が有用であった一例査読

佐藤啓介, 高瀬了輔, 森田悟, 加藤篤之, 須山敦仁, 佐住洋祐, 大塚勇輝, 大國皓平, 長谷川功, 本多寛之, 小比賀美香子, 大塚文男

日本病院総合診療医学会雑誌 19 ( 臨増2 ) 181 - 181 2023年8月

MOCA-Jを用いたCOVID-19罹患後症状のブレインフォグの臨床的特徴の解明査読

長谷川徹, 大塚勇輝, 櫻田泰江, 徳増一樹, 砂田匠彦, 小西隆之, 中野靖浩, 本多寛之, 萩谷英大, 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 19 ( 臨増2 ) 168 - 168 2023年8月

自動車運転中の失神・交通事故の原因精査に詳細な血糖測定が有用であった一例査読

佐藤啓介, 高瀬了輔, 森田悟, 加藤篤之, 須山敦仁, 佐住洋祐, 大塚勇輝, 大國皓平, 長谷川功, 本多寛之, 小比賀美香子, 大塚文男

日本病院総合診療医学会雑誌 19 ( 臨増2 ) 181 - 181 2023年8月

眼内炎診療における病院総合医の役割査読

川口満理奈, 大塚勇輝, 副島佳晃, 安藤航, 高木桃李, 大國皓平, 長谷川功, 本多寛之, 萩谷英大, 小比賀美香子, 森田哲郎, 森實祐基, 大塚文男

日本病院総合診療医学会雑誌 19 ( 臨増2 ) 142 - 142 2023年8月

Acute arthritis caused by sarcoidosis. 査読

Rio Ogami, Yuki Otsuka, Kou Hasegawa, Kazuki Tokumasu, Mikako Obika, Masanori Fujii, Fumio Otsuka

Journal of general and family medicine 24 ( 4 ) 264 - 265 2023年7月

記述言語：英語

Here we report a case of sarcoidosis which demonstrated with bilateral ankle arthritis. We usually do not consider sarcoidosis routinely for the differential diagnosis of acute arthritis, however, up to 15 to 25% of sarcoidosis complicate arthritis, typically in ankle joints. Sarcoid arthritis is reported to occur mainly in young northern Europe women, whereas this case intimate that we should take sarcoidosis into account as the differential diagnosis of ankle arthralgia also among Asian men especially when combining upper respiratory symptoms.

DOI： 10.1002/jgf2.621

正解なき対話で「生き方」を深く考えるビジュアルアート授業査読

木股敬裕, 小比賀美香子, 久保卓也, 大塚益美, 岡本裕子, 福冨幸, 松本洋

医学教育 54 ( Suppl. ) 213 - 213 2023年7月

成人成長ホルモン分泌不全症における医療者教育実践に関する検討査読

越智可奈子, 徳増一樹, 大塚勇輝, 中野靖浩, 小比賀美香子, 大塚文男

医学教育 54 ( Suppl. ) 296 - 296 2023年7月

Manifestation of Headache Affecting Quality of Life in Long COVID Patients. 査読国際誌

Kana Fujita, Yuki Otsuka, Naruhiko Sunada, Hiroyuki Honda, Kazuki Tokumasu, Yasuhiro Nakano, Yasue Sakurada, Mikako Obika, Hideharu Hagiya, Fumio Otsuka

Journal of clinical medicine 12 ( 10 ) 2023年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

Objectives: The present study aimed to elucidate the characteristics of long COVID patients with headaches. Methods: A single-center retrospective observational study was performed for long COVID outpatients who visited our hospital from 12 February 2021 to 30 November 2022. Results: A total of 482 long COVID patients, after excluding 6, were divided into two groups: the Headache group of patients with complaints of headache (113 patients: 23.4%) and the remaining Headache-free group. Patients in the Headache group were younger (median age: 37 years) than patients in the Headache-free group (42 years), while the ratio of females (56%) in the Headache group was nearly the same as that in the Headache-free group (54%). The proportion of patients in the Headache group who were infected in the Omicron-dominant phase (61%) was larger than the proportions of patients infected in the Delta (24%) and preceding (15%) phases, and that trend was significantly different from the trend in the Headache-free group. The duration before the first visit for long COVID was shorter in the Headache group (71 days) than in the Headache-free group (84 days). The proportions of patients in the Headache group with comorbid symptoms, including general fatigue (76.1%), insomnia (36.3%), dizziness (16.8%), fever (9.7%), and chest pain (5.3%) were larger than the proportions of patients in the Headache-free group, whereas blood biochemical data were not significantly different between the two groups. Interestingly, patients in the Headache group had significant deteriorations of scores indicating depression and scores for quality of life and general fatigue. In multivariate analysis, headache, insomnia, dizziness, lethargy, and numbness were shown to be involved in the quality of life (QOL) of long COVID patients. Conclusions: The manifestation of headaches related to long COVID was found to have a significant impact on social and psychological activities. Alleviation of headaches should be a priority for the effective treatment of long COVID.

DOI： 10.3390/jcm12103533

多発骨折を契機に発見され、社会的介入を要したビタミンD欠乏の1例査読

須山敦仁, 大塚勇輝, 中野靖浩, 松田祐依, 櫻田泰江, 小比賀美香子, 豊川達也, 大塚文男

日本内分泌学会雑誌 99 ( 1 ) 389 - 389 2023年5月

【Common diseaseの処方箋ファイル-臨床経過から学ぶ20症例】(CASE 12)糖尿病 2型糖尿病での内服治療継続が難しくなってきた76歳女性

小比賀美香子, 本多寛之

Medicina 60 ( 6 ) 874 - 880 2023年5月

Symptomatic Characteristics of Hypozincemia Detected in Long COVID Patients. 査読国際誌

Yui Matsuda, Kazuki Tokumasu, Yuki Otsuka, Naruhiko Sunada, Hiroyuki Honda, Yasue Sakurada, Yasuhiro Nakano, Toru Hasegawa, Mikako Obika, Keigo Ueda, Fumio Otsuka

Journal of clinical medicine 12 ( 5 ) 2023年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: The aim of this study was to determine the characteristics of hypozincemia in long COVID patients. METHODS: This study was a single-center retrospective observational study for outpatients who visited the long COVID clinic established in a university hospital during the period from 15 February 2021 to 28 February 2022. Characteristics of patients with a serum zinc concentration lower than 70 μg/dL (10.7 μmol/L) were compared with characteristics of patients with normozincemia. RESULTS: In a total of 194 patients with long COVID after excluding 32 patients, hypozincemia was detected in 43 patients (22.2%) including 16 male patients (37.2%) and 27 female patients (62.8%). Among various parameters including the background characteristics of the patients and medical histories, the patients with hypozincemia were significantly older than the patients with normozincemia (median age: 50 vs. 39 years). A significant negative correlation was found between serum zinc concentrations and age in male patients (R = -0.39; p < 0.01) but not in female patients. In addition, there was no significant correlation between serum zinc levels and inflammatory markers. General fatigue was the most frequent symptom in both male patients with hypozincemia (9 out of 16: 56.3%) and female patients with hypozincemia (8 out of 27: 29.6%). Patients with severe hypozincemia (serum zinc level lower than 60 μg/dL) had major complaints of dysosmia and dysgeusia, which were more frequent complaints than general fatigue. CONCLUSIONS: The most frequent symptom in long COVID patients with hypozincemia was general fatigue. Serum zinc levels should be measured in long COVID patients with general fatigue, particularly in male patients.

DOI： 10.3390/jcm12052062

Eleven years of data on the Jefferson Scale of Empathy – medical student version: Japanese norm data and tentative cutoff scores 査読

Hitomi U. Kataoka, Akiko Tokinobu, Chikako Fujii, Mayu Watanabe, Mikako Obika

BMC Medical Education 23 ( 1 ) 2023年2月

掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

Abstract

Background

More and more studies investigate medical students’ empathy using the Jefferson Scale of Empathy (JSE). However, no norm data or cutoff scores of the JSE for Japanese medical students are available. This study therefore explored Japanese norm data and tentative cutoff scores for the Japanese translation of the JSE-medical student version (JSE-S) using 11 years of data obtained from matriculants from a medical school in Japan.

Methods

Participants were 1,216 students (836 men and 380 women) who matriculated at a medical school in Japan from 2011 to 2021. The JSE-S questionnaire was administered to participants prior to the start of the program. Data were summarized using descriptive statistics and statistical tests were performed to show the norm data and tentative cutoff scores for male and female students separately.

Results

The score distributions of the JSE-S were moderately skewed and leptokurtic for the entire sample, with indices -0.75 and 4.78, respectively. The mean score (standard deviation) for all participants was 110.8 (11.8). Women had a significantly higher mean score (112.6) than men (110.0; p < 0.01). The effect size estimate of gender difference was 0.22, indicating a small effect size. The low and high cutoff scores for men were ≤ 91 and ≥ 126, respectively, and the corresponding scores for women were ≤ 97 and ≥ 128, respectively.

Conclusions

This study provides JSE-S norm data and tentative cutoff scores for Japanese medical school matriculants, which would be helpful in identifying those who may need further training to enhance their empathy.

DOI： 10.1186/s12909-022-03977-5

その他リンク： https://link.springer.com/article/10.1186/s12909-022-03977-5/fulltext.html

COVID-19罹患後にME/CFSに移行する症例の臨床的特徴血清ferritinと内分泌系に注目した検討査読

山本幸近, 大塚勇輝, 徳増一樹, 萩谷英大, 砂田匠彦, 本多寛之, 中野靖浩, 櫻田泰江, 松田祐依, 長谷川徹, 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 19 ( 臨増1 ) 173 - 173 2023年2月

COVID-19罹患後症状と血清亜鉛濃度の関連査読

松田祐依, 徳増一樹, 大塚勇輝, 砂田匠彦, 本多寛之, 櫻田泰江, 中野靖浩, 長谷川徹, 萩谷英大, 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 19 ( 臨増1 ) 168 - 168 2023年2月

Differences in Stress Perception of Medical Students Depending on In-Person Communication and Online Communication during the COVID-19 Pandemic: A Japanese Cross-Sectional Survey. 査読国際誌

Kazuki Tokumasu, Yoshito Nishimura, Yoko Sakamoto, Mikako Obika, Hitomi Kataoka, Fumio Otsuka

International journal of environmental research and public health 20 ( 2 ) 2023年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Excessive psychological stress in medical students affects their mental health and causes problems such as burnout and depression. Furthermore, changes in the learning environment to online learning due to the COVID-19 pandemic have had a psychological effect on medical students. However, the relationships between medical students' perceived stress and different methods of communication, including in-person and online communication, remain unclear. The purpose of this study was to investigate the differences in stress perception of medical students depending on in-person communication and online communication during the COVID-19 pandemic. METHODS: This study was a cross-sectional study conducted from September to October in 2020. All of the students of Okayama University School of Medicine were asked to participate in a questionnaire survey. The explanatory variables were the frequency and length of communications with others (by in-person or online communication), empathy, and lifestyle. The main outcome measure was perceived stress. Subgroup analysis was conducted for students who preferred to be by themselves and students who preferred to study together and interact with other people. Univariate analysis and multivariate multiple regression analysis were conducted. Gender and grade, which have been shown to be associated with stress in previous studies, were used as covariates for multiple regression analysis. RESULTS: Valid responses to the questionnaire survey were received from 211 (29.4%) of the 717 students. There was no significant association between perceived stress and online communication, but the number of people with which students had in-person communication (1-2 people compared to 0 as a control, regression coefficient [B] = -4.4, 95% confidence interval [CI]; -7.8, -1.1, more than 10 people, B = -12, 95% CI: -18, -5.8) and the length of communication (more than 120 min, B = -4.5, 95% CI: -8.1, -0.92) were associated with a reduction in perceived stress. In subgroup analysis, the number of people with in-person communication and the length of communication had significant associations with stress reduction even in the group of students who had a preference for being by themselves. CONCLUSION: In-person communications rather than online communications were associated with a lower level of perceived stress. In subgroup analysis, this trend was statistically significant in the group of students who had a preference for being by themselves.

DOI： 10.3390/ijerph20021579

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年12月

記述言語：日本語出版者・発行元：(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)

その他リンク： 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

Letter to the Editor From Yamamoto et al: “Whole Body, Whole Life, Whole Family: Patients’ Perspectives on X-Linked Hypophosphatemia” 国際誌

Koichiro Yamamoto, Daisuke Omura, Keiji Soga, Mikako Obika, Fumio Otsuka

Journal of the Endocrine Society 7 ( 1 ) bvac162 2022年11月

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年11月

Hormonal trends in patients suffering from long COVID symptoms.

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年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN ENDOCRINE SOC

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

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年10月

心室期外収縮を契機に判明した反応性低血糖の1例

本多寛之, 田中秀一, 中野靖弘, 長谷川功, 萩谷英大, 小比賀美香子, 大塚文男

日本内分泌学会雑誌 98 ( 2 ) 619 - 619 2022年10月

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年10月

COVID-19罹患後の全身倦怠感に潜在する加齢性性腺機能低下(LOH)症候群と病院総合診療医の役割

山本幸近, 大塚勇輝, 徳増一樹, 中野靖浩, 本多寛之, 砂田匠彦, 櫻田泰江, 松田祐依, 大村大輔, 長谷川功, 萩谷英大, 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2 ) 100 - 100 2022年8月

神経サルコイドーシス増悪と鑑別を要したクリプトコッカス髄膜炎の一例

福島伸乃介, 萩谷英大, 山本幸近, 大國浩平, 長谷川功, 小比賀美香子, 小川弘子, 片岡仁美, 大塚文男

日本病院総合診療医学会雑誌 18 ( 臨増2 ) 185 - 185 2022年8月

コロナ後遺症外来におけるCOVID-19罹患後症状の特徴と抗体価との関連

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

日本病院総合診療医学会雑誌 18 ( 臨増2 ) 243 - 243 2022年8月

神経サルコイドーシス増悪と鑑別を要したクリプトコッカス髄膜炎の一例

福島伸乃介, 萩谷英大, 山本幸近, 大國浩平, 長谷川功, 小比賀美香子, 小川弘子, 片岡仁美, 大塚文男

日本病院総合診療医学会雑誌 18 ( 臨増2 ) 185 - 185 2022年8月

COVID-19罹患後の全身倦怠感に潜在する加齢性性腺機能低下(LOH)症候群と病院総合診療医の役割

山本幸近, 大塚勇輝, 徳増一樹, 中野靖浩, 本多寛之, 砂田匠彦, 櫻田泰江, 松田祐依, 大村大輔, 長谷川功, 萩谷英大, 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2 ) 100 - 100 2022年8月

コロナ後遺症外来におけるCOVID-19罹患後症状の特徴と抗体価との関連

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

日本病院総合診療医学会雑誌 18 ( 臨増2 ) 243 - 243 2022年8月

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

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

日本病院総合診療医学会雑誌 18 ( 臨増2 ) 244 - 244 2022年8月

「哲学カフェ」は医師のどのような能力を涵養するか

小比賀美香子, 松川えり, 徳増一樹, 大塚文男

医学教育 53 ( Suppl. ) 145 - 145 2022年7月

「筋痛性脳脊髄炎/慢性疲労症候群(ME/CFS)」岡山大学病院総合内科・総合診療科におけるME/CFS診療

片岡仁美, 大塚勇輝, 本多寛之, 砂田匠彦, 櫻田泰江, 松田祐依, 徳増一樹, 長谷川功, 小比賀美香子, 植田圭吾, 大塚文男

日本疲労学会誌 18 ( 1 ) 37 - 37 2022年6月

胸鎖関節炎・頸部膿瘍を契機に診断した2型糖尿病の1例

中本健太, 本多寛之, 平佑貴, 庵谷紘美, 中野靖浩, 長谷川功, 萩谷英大, 小比賀美香子, 片岡仁美, 大塚文男

糖尿病 65 ( 6 ) 337 - 337 2022年6月

維持透析中の2型糖尿病患者に発症したフルニエ壊疽の1例

庵谷紘美, 本多寛之, 平佑貴, 中本健太, 中野靖浩, 長谷川功, 萩谷英大, 小比賀美香子, 片岡仁美, 大塚文男

糖尿病 65 ( 6 ) 337 - 337 2022年6月

医学生の自覚ストレスとコミュニケーションの関連横断研究

徳増一樹, 西村義人, 坂本陽子, 小比賀美香子, 片岡仁美, 大塚文男

日本プライマリ・ケア連合学会学術大会 13回 O - 90 2022年6月

「筋痛性脳脊髄炎/慢性疲労症候群(ME/CFS)」岡山大学病院総合内科・総合診療科におけるME/CFS診療

片岡仁美, 大塚勇輝, 本多寛之, 砂田匠彦, 櫻田泰江, 松田祐依, 徳増一樹, 長谷川功, 小比賀美香子, 植田圭吾, 大塚文男

日本疲労学会誌 18 ( 1 ) 37 - 37 2022年6月

Application of Kampo Medicines for Treatment of General Fatigue Due to Long COVID. 国際誌

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

Medicina (Kaunas, Lithuania) 58 ( 6 ) 2022年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：MDPI

Evidence regarding treatment for the acute phase of COVID-19 has been accumulating, but specific treatment for long COVID/post-COVID-19 condition has not yet been established. Treatment with herbal medicine might be one treatment option for long COVID, but there has been little research on the effectiveness of herbal medicine for long COVID. The aim of this study was to clarify the prescription patterns of Kampo medicines, which are herbal medicines that originated in China and were developed in Japan, for the treatment of general fatigue due to long COVID. A retrospective descriptive study was performed for patients who visited a COVID-19 aftercare clinic established in Okayama University Hospital during the period from Feb 2021 to Dec 2021 with a focus on symptoms accompanying general fatigue and prescriptions of Kampo medicine. Among the clinical data obtained from medical records of 195 patients, clinical data for 102 patients with general fatigue and accompanying symptoms were analyzed. The patients had various symptoms, and the most frequent symptoms accompanying general fatigue were dysosmia, dysgeusia, headache, insomnia, dyspnea, and hair loss. Prescriptions of Kampo medicine accounted for 24.1% of the total prescriptions (n = 609). The most frequently prescribed Kampo medicine was hochuekkito (71.6%) and other prescribed Kampo medicines were tokishakuyakusan, ryokeijutsukanto, juzentaihoto, hangekobokuto, kakkonto, ninjin'yoeito, goreisan, rikkunshito, and keishibukuryogan. Since the pathophysiology of general fatigue after an infectious disease is, in general, considered a qi deficiency in Kampo medicine, treatments with such compensation agents can be the major prescription as a complement for the qi. In conclusion, Kampo medicine can be one of the main pharmacological treatments for long COVID accompanying general fatigue.

DOI： 10.3390/medicina58060730

Inconsistency of the "Sogo-Shinryo" department in Japanese hospitals.

Yuki Otsuka, Mikako Obika, Fumio Otsuka

Journal of general and family medicine 23 ( 3 ) 201 - 202 2022年5月

記述言語：英語出版者・発行元：WILEY

The inconsistency of Japanese names of "Sogo-Shinryo" departments is also a greater problem in this country, and we are afraid that it may cause anxiety to patients, residents, and students. As one of the "Sogo-Shinryo" departments in Japan, we want to provide them comprehensive learning environments regardless of the boundaries of academic cliques and societies, and, as a result, relieve them, foster general minds, and build their careers.

DOI： 10.1002/jgf2.522

Processes of increasing medical residents' intrinsic motivation: a qualitative study. 国際誌

Kazuki Tokumasu, Mikako Obika, Haruo Obara, Makoto Kikukawa, Yoshito Nishimura, Fumio Otsuka

International journal of medical education 13 115 - 123 2022年4月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：INT JOURNAL MEDICAL EDUCATION-IJML

Objectives: This study aimed to determine qualitatively how medical residents develop intrinsic motivation to learn and work in clinical training settings. Methods: This study was a descriptive qualitative study, which is widely used in healthcare research. We conducted a semi-structured interview aimed to explore key participants' in-depth experiences and perspectives regarding intrinsic motivation. The authors interviewed seven postgraduate Japanese medical residents. The transcripts were analyzed using the sequential and thematic qualitative data analysis technique steps for coding and theorization, which entails coding steps from open to selective, writing a storyline using the final selective codes, and offering theories. Results: External stimulations (a self-handle environment and a near-peer role model) triggered the medical residents' cognitive process (gap recognition, awareness, and internalization) to intrinsic motivation. The residents' awareness of autonomy, responsibility, and independence played a vital role in this process. Furthermore, a psychological feeling of competence also reinforced their intrinsic motivation. Positive feedback and approval from attending physicians and patients' gratitude promoted residents' sense of competence. Conclusions: We illustrated a process for increasing medical residents' intrinsic motivation. The intrinsic motivation was triggered by external stimulations (a self-handle environment and a near-peer role model), which caused the cognitive process: gap recognition, awareness of important attitudes as a doctor (autonomy, responsibility, and independence), and internalization. Since the first step of this process was an external factor, there are potential benefits of designing an appropriate training environment for increasing medical residents' intrinsic motivation.

DOI： 10.5116/ijme.6250.1017

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

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 ) e05713 2022年4月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Wiley

Calcimimetic treatment has been reported to be effective for primary hyperparathyroidism (PHPT). Nine elderly PHPT 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

その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ccr3.5713

骨粗鬆症精査を契機に診断されたTurner症候群の1成人例

長谷川徹, 越智可奈子, 中野靖浩, 山本紘一郎, 小比賀美香子, 植田圭吾, 長谷川高誠, 大塚文男

日本内分泌学会雑誌 98 ( 1 ) 402 - 402 2022年4月

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年4月

コロナ・アフターケア外来における加齢性腺機能低下(LOH)症候群の潜在とその特徴

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

日本内分泌学会雑誌 98 ( 1 ) 292 - 292 2022年4月

骨粗鬆症精査を契機に診断されたTurner症候群の1成人例

長谷川徹, 越智可奈子, 中野靖浩, 山本紘一郎, 小比賀美香子, 植田圭吾, 長谷川高誠, 大塚文男

日本内分泌学会雑誌 98 ( 1 ) 402 - 402 2022年4月

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年4月

重度の化膿性胸鎖関節炎から発見された2型糖尿病の1例

高瀬了輔, 本多寛之, 中本健太, 平佑貴, 庵谷紘美, 中野靖浩, 長谷川功, 萩谷英大, 小比賀美香子, 片岡仁美, 大塚文男

日本内分泌学会雑誌 98 ( 1 ) 363 - 363 2022年4月

コロナ・アフターケア(CAC)外来における後遺症の特徴と抗体価との関連

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

日本内分泌学会雑誌 98 ( 1 ) 301 - 301 2022年4月

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年4月

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年4月

初期研修医の卒後ローテーションにおける「感染症研修の必須化」に関するアンケート調査

萩谷英大, 徳増一樹, 小比賀美香子, 大塚文男

感染症学雑誌 96 ( 2 ) 61 - 64 2022年3月

初期研修医の卒後ローテーションにおける「感染症研修の必須化」に関するアンケート調査

萩谷英大, 徳増一樹, 小比賀美香子, 大塚文男

感染症学雑誌 96 ( 2 ) 61 - 64 2022年3月

記述言語：日本語出版者・発行元：(一社)日本感染症学会

初期研修医の卒後ローテーションにおける「感染症研修の必須化」に関する意識などを明らかにすることを目的に、岡山県内で初期研修プログラムを有する16の研修病院に所属する初期研修医(卒後1・2年)、および専攻医(卒後3・4・5年)を対象にウェブ・アンケートを行い、127名(男性64名、女性60名、無回答3名)より回答を得た。その結果、初期研修医制度における「感染症研修の必須化」(例:最低1ヵ月ローテーションするなど)について84名(66.1%)が賛成すると回答した。一方、18名(14.2%)は必須化に反対しており、その理由として、「ローテーション選択の自由度を損なうため」(15名)などが挙げられた。

DOI： 10.11150/kansenshogakuzasshi.96.61

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2022&ichushi_jid=J00276&link_issn=&doc_id=20220406400006&doc_link_id=1390010292792199424&url=https%3A%2F%2Fcir.nii.ac.jp%2Fcrid%2F1390010292792199424&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_3.gif

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年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

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

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年2月

岡山大学病院におけるCOVID-19アフターケア外来の取り組み

大塚勇輝, 徳増一樹, 中野靖浩, 本多寛之, 萩谷英大, 砂田匠彦, 大村大輔, 櫻田泰江, 小比賀美香子, 大塚文男

日本内科学会雑誌 111 ( Suppl. ) 214 - 214 2022年2月

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年2月

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年2月

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

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年2月

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

Interest in Infectious Diseases specialty among Japanese medical students amidst the COVID-19 pandemic: A web-based, cross-sectional study. 国際誌

Hideharu Hagiya, Yuki Otsuka, Kazuki Tokumasu, Hiroyuki Honda, Yoshito Nishimura, Mikako Obika, Fumio Otsuka

PloS one 17 ( 4 ) e0267587 2022年

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: The emergence of the novel coronavirus disease of 2019 (COVID-19) has led to huge disruptions in the medical field and society. The significance of training and education for experts has been increasingly acknowledged in Japan, where the number of infectious disease (ID) specialists is reportedly insufficient. In this paper, we report the results of a web-based survey that was conducted to reveal the ways in which the COVID-19 pandemic has influenced medical students' awareness of ID specialists and future career choices. METHOD: This cross-sectional descriptive study was conducted in March 2021 and targeted 717 medical students belonging to Medical School of Okayama University, Japan. The questionnaire consisted of four questions meant to assess students' knowledge and future intentions of becoming ID specialists. RESULTS: We obtained 328 eligible questionnaires (response rate: 45.7%). Of 227 (69.2%) students who were aware of ID specialists, 99 (43.6%) answered that they came to know about them only after the pandemic, 12 (3.7%) answered that their interest in being an ID specialist arose during the pandemic, while 36 (11.0%) responded that they would rather not become ID specialists. At the time of the survey, 5 students (1.5%) were aiming to become ID specialists. CONCLUSION: We observed a very low rate of interest to be an ID specialist among medical students. The experience of the pandemic does not seem to have influenced Japanese medical students to choose ID as a specialty for their careers. Continuous efforts to increase the number of ID specialists are necessary in Japan as a countermeasure against the coming pandemic.

DOI： 10.1371/journal.pone.0267587

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

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年12月

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

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年12月

新型コロナウイルス感染症対策における慰労金交付事業の影響およびその評価

萩谷英大, 三好智子, 西村義人, 徳増一樹, 本多寛之, 長谷川功, 小比賀美香子, 頼藤貴志, 大塚文男

日本病院総合診療医学会雑誌 17 ( 6 ) 608 - 616 2021年11月

記述言語：日本語出版者・発行元：(一社)日本病院総合診療医学会

新型コロナウイルス感染症対策の一環として,「新型コロナウイルス感染症対応従事者慰労金交付事業」が実施されたが,その影響・有効性に関するデータは乏しい。2021年4月26日〜5月31日に,岡山県・香川県・広島県の医療機関に勤務する職員を対象にウェブ・アンケートによる横断調査を実施した。1001名からの回答において,慰労金受給率は95.8%であり,59.5%は本事業に満足したと回答した。職種別満足度は,医師(60.8%),メディカルスタッフ(63.9%)に比べて看護職(46.3%)で低かった(p<0.001)。医療機関内職員のみならず,救急隊員,保健所職員,高齢者介護施設の職員も慰労金が支払われるべき業種として高率に理解を得た。慰労金交付事業は,医療従事者等の外的モチベーションとして概ね機能したと考えられるが,給付金額や対象者の選定に関しては検討の余地がある。(著者抄録)

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

Yuki Otsuka, Kazuki Tokumasu, Yasuhiro Nakano, Hiroyuki Honda, Yasue Sakurada, Naruhiko Sunada, Daisuke Omura, Kou Hasegawa, Hideharu Hagiya, Mikako Obika, Keigo Ueda, Hitomi Kataoka, Fumio Otsuka

Cureus 13 ( 10 ) e18568 2021年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：CUREUS INC

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

虹彩炎が治療導入の契機となった2型糖尿病の1例

中本健太, 本多寛之, 平佑貴, 庵谷紘美, 中野靖浩, 長谷川功, 萩谷英大, 小比賀美香子, 片岡仁美, 大塚文男

日本内分泌学会雑誌 97 ( 2 ) 555 - 555 2021年10月

総合診療におけるカテコールアミン測定の有用性とその解釈

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

日本内分泌学会雑誌 97 ( 2 ) 560 - 560 2021年10月

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

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

Cureus 13 ( 9 ) e18070 2021年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：CUREUS INC

Objectives Vitamin D deficiency, which is common worldwide, increases the risks of falls and fractures and can lead to increased morbidity and mortality. However, the clinical utility and relevance of vitamin D activation remain unknown. The aim of the present study was to clarify the clinical usefulness of serum 1,25-dihydroxyvitamin D (1,25D)/25-hydroxyvitamin D (25D) ratio for assessment of the extent of bone metabolism. Methods We retrospectively screened data for 87 patients whose serum 1,25D and 25D levels were measured. Eight patients who were taking vitamin D preparations were excluded, and data for 79 patients (33 males and 46 females) were analyzed. Since menopausal status can be associated with serum vitamin D level, we divided the patients by gender and divided the female patients into two groups at the age of 50 years. Results The median serum 1,25D/25D ratio was significantly lower in males than in females, with the most considerable difference in all males [4.1 (interquartile range: 2.3-5.8) × 10-3] versus elderly females (aged ≧50 years) [7.9 (3.3-10.1) × 10-3). Main disorders were endocrine (30.6%), inflammatory (18.5%), and bone-related (16.7%) disorders. The ratios of serum 1,25D/25D had significant negative correlations with femoral dual-energy X-ray absorptiometry % young adult mean (DEXA %YAM) (R=-0.35) and lumbar DEXA %YAM (R=-0.32). Significant correlations were found between the 1,25D/25D ratio and serum levels of inorganic phosphate (iP), parathyroid hormone, and alkaline phosphatase (ALP). The 1,25D/25D ratio had gender-specific characteristics: the ratio was significantly correlated with age in males (R=-0.49), while it was significantly correlated with BMI in females (R=0.34). Conclusions The results of this study suggested that vitamin D activity is negatively correlated with bone mineral density, being reduced in aged males but enhanced in obese females.

DOI： 10.7759/cureus.18070

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

Yuki Otsuka, Yasuhiro Nakano, Kazuki Tokumasu, Hiroyuki Honda, Mikako Obika, Kou Hasegawa, Yoshihisa Hanayama, Koichi Itoshima, Fumio Otsuka

Annals of clinical and laboratory science 51 ( 3 ) 352 - 358 2021年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：ASSOC CLINICAL SCIENTISTS

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.

どのように臨床研修医のモチベーションは上がるのか? プライマリ・ケア主体的診療の重要性

徳増一樹, 小比賀美香子, 尾原晴雄, 菊川誠, 大塚文男

日本プライマリ・ケア連合学会学術大会 12回 np637 - np637 2021年5月

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

Koki Li, Yuki Otsuka, Yasuhiro Nakano, Daisuke Omura, Kou Hasegawa, Mikako Obika, Keigo Ueda, Hitomi Kataoka, Fumio Otsuka

Diagnostics (Basel, Switzerland) 11 ( 3 ) 2021年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：MDPI

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

Impact of the COVID-19 Pandemic on the Psychological Distress of Medical Students in Japan: Cross-sectional Survey Study. 国際誌

Yoshito Nishimura, Kanako Ochi, Kazuki Tokumasu, Mikako Obika, Hideharu Hagiya, Hitomi Kataoka, Fumio Otsuka

Journal of medical Internet research 23 ( 2 ) e25232 2021年2月

記述言語：英語出版者・発行元：JMIR PUBLICATIONS, INC

BACKGROUND: The COVID-19 pandemic has negatively affected medical education. However, little data are available about medical students' distress during the pandemic. OBJECTIVE: This study aimed to provide details on how medical students have been affected by the pandemic. METHODS: A cross-sectional study was conducted. A total of 717 medical students participated in the web-based survey. The survey included questions about how the participants' mental status had changed from before to after the Japanese nationwide state of emergency (SOE). RESULTS: Out of 717 medical students, 473 (66.0%) participated in the study. In total, 29.8% (141/473) of the students reported concerns about the shift toward online education, mostly because they thought online education would be ineffective compared with in-person learning. The participants' subjective mental health status significantly worsened after the SOE was lifted (P<.001). Those who had concerns about a shift toward online education had higher odds of having generalized anxiety and being depressed (odds ratio [OR] 1.97, 95% CI 1.19-3.28) as did those who said they would request food aid (OR 1.99, 95% CI 1.16-3.44) and mental health care resources (OR 3.56, 95% CI 2.07-6.15). CONCLUSIONS: Given our findings, the sudden shift to online education might have overwhelmed medical students. Thus, we recommend that educators inform learners that online learning is not inferior to in-person learning, which could attenuate potential depression and anxiety.

DOI： 10.2196/25232

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

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年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

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

De-escalation concept and MIC literacy among medical students and clinical residents. 国際誌

Hideharu Hagiya, Kazuki Tokumasu, Mikako Obika, Fumio Otsuka

Postgraduate medical journal 98 ( e3 ) e183-e184 2021年1月

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

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年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

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

Recurrence of Hypoglycemic Coma in a Patient with Anorexia Nervosa.

Koichiro Yamamoto, Daisuke Omura, Mai Yamane, Reina Son, Kou Hasegawa, Hiroyuki Honda, Mikako Obika, Nozomu Minao, Satoru Edahiro, Norihito Yamada, Fumio Otsuka

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

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

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

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

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 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

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 relevance of insulin-like growth factor-1 to cardiovascular risk markers. 国際誌

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

The aging male : the official journal of the International Society for the Study of the Aging Male 23 ( 5 ) 1030 - 1038 2020年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：TAYLOR & FRANCIS LTD

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

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

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年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

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

Involvement of serum dehydroepiandrosterone sulfate in erythropoietic activity. 国際誌

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

The aging male : the official journal of the International Society for the Study of the Aging Male 23 ( 5 ) 756 - 763 2020年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：TAYLOR & FRANCIS LTD

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

Comparison of the Clinico-Microbiological Characteristics of Culture-Positive and Culture-Negative Septic Pulmonary Embolism: A 10-Year Retrospective Study. 国際誌

Yoshito Nishimura, Hideharu Hagiya, Mikako Obika, Fumio Otsuka

Pathogens (Basel, Switzerland) 9 ( 12 ) 1 - 9 2020年11月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：MDPI

Septic pulmonary embolism (SPE) is a rare yet serious infectious disorder with nonspecific clinical findings due to microorganism-containing emboli disseminating from extrapulmonary infectious foci. It is unknown whether a positive blood culture correlates with a worse clinical outcome. We compared the clinical and microbiologic characteristics of patients with SPE divided into the culture-positive group and the culture-negative one. This study was a retrospective observational study of the patients diagnosed with SPE and treated in an academic hospital from April 2010 to May 2020. We identified six culture-positive and four culture-negative patients with SPE during the study period. The culture-positive group had significantly longer periods of hospitalization (median: 75 days, range: 45-125 days) than the culture-negative group (median: 14.5 days, range: 3-43 days) (p < 0.05), as well as significantly elevated serum C-reactive protein and procalcitonin. Patients with culture-negative SPE more commonly had odontogenic infections as the primary infectious foci. Our study highlights the importance of giving extra attention to SPE patients who have a positive blood culture, as they may have worse clinical outcomes. Physicians need to collaborate with dentists when faced with patients with culture-negative SPE, since they may have primary odontogenic infections.

DOI： 10.3390/pathogens9120995

Localized Lymph Node Light Chain Amyloidosis.

Akira Yamamoto, Nobuharu Fujii, Mikako Obika, Taro Yamashita, Fumio Otsuka

Internal medicine (Tokyo, Japan) 59 ( 19 ) 2415 - 2418 2020年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN SOC INTERNAL MEDICINE

The prognosis of systemic amyloid light chain (AL) amyloidosis is generally poor, hence requiring chemotherapy or hematopoietic stem cell transplantation, while the prognosis of localized AL amyloidosis without an abnormal monoclonal immunoglobulin light chain is good. Localized AL amyloidosis has been previously reported to be observed in pulmonary, urinary tract, gastrointestinal, oropharyngeal, and laryngeal sites. However, only a few cases of localized lymph node AL amyloidosis have so far been reported. We herein present a case of localized lymph node AL amyloidosis that could possibly be misdiagnosed as systematic AL amyloidosis.

DOI： 10.2169/internalmedicine.4651-20

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

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年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

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

Invasive non-typeable Haemophilus influenzae infection due to endometritis associated with adenomyosis. 国際誌

Yoshito Nishimura, Hideharu Hagiya, Kaoru Kawano, Yuya Yokota, Kosuke Oka, Koji Iio, Kou Hasegawa, Mikako Obika, Tomoko Haruma, Sawako Ono, Hisashi Masuyama, Fumio Otsuka

BMC infectious diseases 20 ( 1 ) 521 - 521 2020年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMC

BACKGROUND: The widespread administration of the Haemophilus influenzae type b vaccine has led to the predominance of non-typable H. influenzae (NTHi). However, the occurrence of invasive NTHi infection based on gynecologic diseases is still rare. CASE PRESENTATION: A 51-year-old Japanese woman with a history of adenomyoma presented with fever. Blood cultures and a vaginal discharge culture were positive with NTHi. With the high uptake in the uterus with 67Ga scintigraphy, she was diagnosed with invasive NTHi infection. In addition to antibiotic administrations, a total hysterectomy was performed. The pathological analysis found microabscess formations in adenomyosis. CONCLUSIONS: Although NTHi bacteremia consequent to a microabscess in adenomyosis is rare, this case emphasizes the need to consider the uterus as a potential source of infection in patients with underlying gynecological diseases, including an invasive NTHi infection with no known primary focus.

DOI： 10.1186/s12879-020-05193-2

物語能力(narrative competence)に注目した取り組み(第2報) 査読

小比賀美香子, 徳増一樹, 大塚文男

医学教育 51 ( Suppl. ) 119 - 119 2020年7月

Vision loss, tractional retinal detachment, and profound anemia due to rectal carcinoma. 国際誌

Akira Yamamoto, Yoshito Nishimura, Mikako Obika, Yuki Morizane, Fumio Otsuka

Clinical case reports 8 ( 7 ) 1304 - 1305 2020年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：WILEY

Profound anemia can cause severe proliferative retinopathy and tractional retinal detachment; therefore, it is important to closely investigate the cause of anemia. Endoscopy and computed tomography are valuable tools for this purpose.

DOI： 10.1002/ccr3.2833

Clinical and biochemical characteristics of patients having general symptoms with increased serum IgG4. 国際誌

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年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：TAYLOR & FRANCIS LTD

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

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

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年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

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

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

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年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

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

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

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

Acta medica Okayama 73 ( 5 ) 403 - 411 2019年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

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

Factors related to burnout in resident physicians in Japan. 国際誌

Yoshito Nishimura, Tomoko Miyoshi, Mikako Obika, Hiroko Ogawa, Hitomi Kataoka, Fumio Otsuka

International journal of medical education 10 129 - 135 2019年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：INT JOURNAL MEDICAL EDUCATION-IJML

Objectives: We explore the prevalence and characteristics of burnout among Japanese resident physicians and identifies factors associated with burnout. Methods: A cross-sectional study was conducted three times between April 2017 and March 2018 at a Japanese teaching hospital. Resident physicians were invited to answer an online survey that included existing valid instruments related to burnout, depression, and empathy. Demographic, background, occupational, and socioeconomic data were also collected. Participants were prompted to report the average daily work hours and the specialty they wish to pursue. Results: Overall, 39/76 (51%), 27/76 (36%), and 21/76 (28%) resident physicians responded to surveys in April 2017, October 2017, and March 2018, respectively. The percentages of participants with burnout for surveys in April 2017, October 2017, and March 2018 were 7/39 (18%), 6/27 (22%), and 7/21 (33.3%). Emotional exhaustion (EE) was the only burnout component strongly correlated with the severity of depression (r = .615, p < .001; r = .706, p < .001; r = .601, p < .01). EE and depersonalization (DP) had no significant correlation with average daily working hours (β = .156, p = .343 for EE; β = .061, p = .711 for DP). Conclusions: The results suggest that capping working hours alone may not be effective in reducing burnout in Japanese resident physicians. Medical educators might need to consider not only working hours but also individual job quality and satisfaction to address burnout. Future studies may need to incorporate qualitative methods to explore the characteristics of burnout.

DOI： 10.5116/ijme.5caf.53ad

Anterior Cutaneous Nerve Entrapment Syndrome Possibly Triggered by Oral Contraceptives.

Daisuke Omura, Mikako Obika, Masaya Iwamuro, Satoko Nagao, Takahiro Nada, Takashi Matsuzaki, Yoshitaka Kondo, Fumio Otsuka

Internal medicine (Tokyo, Japan) 58 ( 10 ) 1507 - 1509 2019年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN SOC INTERNAL MEDICINE

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

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査読

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年5月

Effects on postgraduate-year-I residents of simulation-based learning compared to traditional lecture-style education led by postgraduate-year-II residents: a pilot study. 国際誌

Akira Yamamoto, Mikako Obika, Yasuhiro Mandai, Taku Murakami, Tomoko Miyoshi, Hideo Ino, Hitomi Kataoka, Fumio Otsuka

BMC medical education 19 ( 1 ) 87 - 87 2019年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMC

BACKGROUND: Simulation-based learning plays an important role in contemporary medical education, although there are problems providing tutors. Peer-assisted learning has begun being formally adopted in medical education. Although it is considered useful for simulation-based learning, its effectiveness remains unclear. This study was designed to compare the effect of simulation-based learning with that of traditional lectures conducted by postgraduate-year (PGY)-II residents on PGY-I residents. METHODS: This study was conducted at Okayama University Hospital over three years, for one week each year, before residents entered clinical practice. The study enrolled 76 PGY-I residents, who were randomized into two groups: simulation and lecture groups. PGY-II residents volunteered to conduct simulations and lectures. Knowledge evaluation was performed using pre- and post-tests, and self-evaluation of competence and behaviour-change and program evaluations were conducted using questionnaires. RESULTS: In both groups, knowledge test scores were found to improve significantly, and the score difference between pre- and post-tests in both the groups was not significant. Self-evaluation of competence and behaviour-change was found to be higher in the simulation group than the lecture group. The trainees in the simulation group valued the program and the PGY-II residents as teaching staff more than those in the lecture group. CONCLUSIONS: The combination of simulation-based learning and peer-assisted learning led by PGY-II residents is potentially more effective in improving the postgraduate education of PGY-I residents than the combination of lecture and peer-assisted learning.

DOI： 10.1186/s12909-019-1509-y

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

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：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

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

Clinical relevance of low androgen to gastroesophageal reflux symptoms.

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年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN ENDOCRINE SOC

The aim of this study was to determine the relationships between free testosterone (FT) level and parameters including laboratory data and data from questionnaires and to determine symptoms leading to the detection of late onset hypogonadism (LOH). We retrospectively reviewed medical records of patients in whom serum FT was measured in our hospital. Aging Male Symptoms (AMS) score, self-rating depression scale (SDS) and frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) score were used for questionnaires. A total of 205 patients were included in the analysis (55.2 ± 15.6 years of age, mean ± SD). Among them, 119 patients (58.0%) had an FT level of less than 8.5 pg/mL, which fulfills the diagnostic criterion of LOH syndrome according to the clinical practice manual for LOH in Japan. It was revealed that FSSG score was inversely correlated to serum FT levels (r = -0.3395, p < 0.001), although SDS and AMS scales did not show significant correlations to FT levels. Our study revealed a high prevalence of LOH syndrome among patients in whom the majority complained of general symptoms. Although GERD symptoms are generally not considered to be typical symptoms of LOH, our study indicates that those symptoms might be clues for the detection of LOH.

DOI： 10.1507/endocrj.EJ18-0187

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

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：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

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

Manifestation of Central Diabetes Insipidus in a Patient with Thyroid Storm.

Akiko Nakamichi, Kazuki Ocho, Kosuke Oka, Miho Yasuda, Kou Hasegawa, Masaya Iwamuro, Mikako Obika, Kammei Rai, Fumio Otsuka

Internal medicine (Tokyo, Japan) 57 ( 13 ) 1939 - 1942 2018年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN SOC INTERNAL MEDICINE

We herein report a case of central diabetes insipidus complicated with thyroid storm. A middle-aged woman who was receiving treatment for Graves' disease suddenly complained of polydipsia, polyuria and general fatigue. Laboratory tests showed hyperthyroidism, hypernatremia, hypoosmolar urine and a decreased plasma vasopressin level. The occurrence of central diabetes insipidus with hyperthyroidism was revealed on the basis of pituitary magnetic resonance imaging, a water deprivation test and a desmopressin test. The clinical co-existence of diabetes insipidus and hyperthyroidism is very rare; however, the complication should be considered when hypernatremia and/or dehydration progress in patients with Graves's disease as a common autoimmune-related etiology.

DOI： 10.2169/internalmedicine.0063-17

Clinical relevance of low androgen to gastroesophageal reflux symptoms 査読

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

ENDOCRINE JOURNAL 65 ( 10 ) 1039 - 1047 2018年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN ENDOCRINE SOC

The aim of this study was to determine the relationships between free testostemne (FT) level and parameters including laboratory data and data from questionnaires and to determine symptoms leading to the detection of late onset hypogonadism (LOH). We retrospectively reviewed medical records of patients in whom serum FT was measured in our hospital. Aging Male Symptoms (AMS) score, self-rating depression scale (SDS) and frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) score were used for questionnaires. A total of 205 patients were included in the analysis (55.2 +/- 15.6 years of age, mean +/- SD). Among them, 119 patients (58.0%) had an FT level of less than 8.5 pg/mL, which fulfills the diagnostic criterion of LOH syndrome according to the clinical practice manual for LOH in Japan. It was revealed that FSSG score was inversely correlated to serum FT levels (r = -0.3395, p < 0.001), although SDS and AMS scales did not show significant correlations to FT levels. Our study revealed a high prevalence of LOH syndrome among patients in whom the majority complained of general symptoms. Although GERD symptoms are generally not considered to be typical symptoms of LOH, our study indicates that those symptoms might be clues for the detection of LOH.

DOI： 10.1507/endocrj.EJ18-0187

症例報告典型的な経過を辿った急性食道粘膜病変の1例査読

岩室雅也, 大田剛由, 岡田裕之, 山岡英功, 柏原尚子, 大重和樹, 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 10 ( 2 ) 41 - 45 2016年6月

記述言語：日本語出版者・発行元：日本病院総合診療医学会

症例は発熱とコーヒー残渣様嘔吐を呈した75歳女性。糖尿病、腎後性腎不全、腎盂腎炎および菌血症、肺血栓塞栓症、深部静脈血栓症などの多数の基礎疾患を有していた。上部消化管内視鏡検査では下部食道に全周性の潰瘍を認めたほか、十二指腸にも広範な潰瘍がみられ、急性食道粘膜病変および十二指腸潰瘍と診断した。絶食とし酸分泌抑制薬と胃粘膜保護薬を投与するとともに基礎疾患の治療を行ったところ、食道および十二指腸の潰瘍は急速に改善した。(著者抄録)

その他リンク： http://search.jamas.or.jp/link/ui/2017072974

女性医師のライフイベントを考慮したキャリア支援：岡山大学アンケート調査査読

片岡仁美, 関明穂, 川畑智子, 勅使川原早苗, 岩瀬敏秀, 小比賀美香子, 大西弘高

医学教育 47 ( 2 ) 111 - 123 2016年4月

記述言語：日本語出版者・発行元：日本医学教育学会

<p>目的 : 女性医師のライフイベントとキャリアについて調査し支援に必要な要素を検討する.</p><p>方法 : 岡山大学卒業・入局の女性医師1,374名にライフイベント, 就労, 満足度等についての質問票を送付した.</p><p>結果 : 臨床医360名の解析を行った. 結婚, 出産時期は多くが適切としたが (82.1%, 65.2%), 若年層で遅くなる傾向があった. 子どもがいる医師 (70.2%) では臨床の満足度は変わらなかったが, 研究, 教育の満足度が低かった. 常勤の原職復帰者 (32.2%) は非常勤者と比べ満足度が高かった. 復職時に上司の理解, 家族のサポート等が必要とされた.</p><p></p><p>考察 : 理解の促進を含む環境整備とキャリア教育・支援が望まれる.</p>

DOI： 10.11307/mededjapan.47.2_111

その他リンク： http://search.jamas.or.jp/link/ui/2016270204

特別座談会子育て世代の女性医師のワークライフバランス-真の男女共同参画とは- 査読

西村真紀, 村田亜紀子, 小比賀美香子, 森敬良

治療 97 ( 12 ) 1646 - 1653 2015年12月

Extracurricular activities to promote English skills at Okayama University Medical School (Special feature : extracurricular activities) 査読

Mahmood Sabina, Obika Mikako, Miyoshi Tomoko

Journal of medical English education = 日本医学英語教育学会会誌 : official journal of Japan Society for Medical English Education 14 ( 3 ) 113 - 116 2015年10月

Nurturing the Art of Professionalism in Japanese Medical Students at Okayama University Medical School 査読

International Journal of School and Cognitive Psychology 2 ( 2 ) 128 - 128 2015年6月

Medical Students' Opinion of a Web-based Module to Teach Clinical Reasoning and Knowledge

Gerald H. Stein, Hironobu Tokunaga, Hirotaka Ando, Mikako Obika, Tomoko Miyoshi, Yasuharu Tokuda, Yoshinori Noguchi, Hitomi Kataoka, Hidekazu Terasawa

JOURNAL OF GENERAL AND FAMILY MEDICINE 16 ( 2 ) 76 - 83 2015年6月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：WILEY

Background: Japanese medical student education lacks emphasis on teaching clinical reasoning skills. To partially remedy this situation, we developed a prototypic web-based module for tutors to teach clinical reasoning. We report the medical students' opinions of this module.Methods: Twenty-four students from two Japanese medical universities were randomly assigned to the two tutored virtual classrooms, each classroom with six students, or to the self-study group, 12 students, after taking the Internetbased Sequential Question and Answer pretest. After four weeks, each of the 24 students took the Sequential Question and Answer posttest. The entire 24 students answered a questionnaire about the Sequential Question and Answer tests; all 12 tutored students answered a questionnaire about the web-based tutored module.Results: Although both tutored and self-study Sequential Question and Answer posttest scores increased, the increases of the tutored group's posttest compared to the self-study posttest group were not statistically significant (p = 0.066).Ninety-two percent of the students rated the Sequential Question and Answer tests as an improved way to learn case presentation and clinical reasoning. Moreover, 79% of students felt that the Sequential Question and Answer tests were an effective way to learn clinical information. The tutored students rated the web-based tutored seminars as an 'excellent to fair' method to learn clinical reasoning using a five-point 'excellent to poor' scale.Conclusions: We developed a prototypic web-based module for tutors to teach clinical reasoning to medical students. The students' opinion supported the modular components of the web-based seminar format, Sequential Question and Answer test, and the tutoring syllabus as an effective way to improve learning clinical reasoning, case presentation, and medical information. Students also suggested refinements of the prototypic module.

Clinical Reasoning Web-based Prototypic Module for Tutors Teaching 5th Grade Medical Students : A Pilot Randomized Study

Gerald H. Stein, Hironobu Tokunaga, Hirotaka Ando, Mikako Obika, Tomoko Miyoshi, Yasuharu Tokuda, Yoshinori Noguchi, Mitsuyo Kinjo, Shun Kohsaka, Hitoshi Honda, Yuka Kitano, Hidetaka Kitazono, Hitomi Kataoka, Hidekazu Terasawa

JOURNAL OF GENERAL AND FAMILY MEDICINE 16 ( 1 ) 13 - 25 2015年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：WILEY

Background: At present clinical reasoning skills are not systematically taught in Japanese medical universities. We developed a prototypic preliminary module for clinical tutors to introduce clinical reasoning to Japanese medical students. We hypothesized that tutored medical students would outperform self-study students.Method: Using the web-based Sequential Question and Answer test that rewarded history and differential diagnosis as proxies for clinical reasoning, we compared the pre and posttest scores of 12 randomized fifth grade tutored students at two universities during four tutor-led 1.5-hour web-based seminars using a structured syllabus to 12 randomized self-study students.Results: The tutored and self-study groups' pretest scores were statistically similar at about 40 out of 100 weighted correct points. The tutored students' posttest scores were 62 points, significantly greater (p = 0.007) than the pretest mean 42 points, compared to the self-study students' posttest scores of 52 points, significantly greater (p = 0.012) than pretest mean 40 points. The difference between the two posttest groups was of borderline statistical significance (p = 0.08).Conclusions: We successfully assessed a prototypic module for tutors to introduce clinical reasoning to Japanese medical students. The tutored students achieved higher scores than the self-study students. Further research is needed to exploit the potential of our modular clinical reasoning system.

DOI： 10.14442/general.16.13

Factors Associated with Remission and/or Regression of Microalbuminuria in Type 2 Diabetes Mellitus 査読

Tetsuichiro Ono, Kenichi Shikata, Mikako Obika, Nobuyuki Miyatake, Ryo Kodera, Daisyo Hirota, Jun Wada, Hitomi Kataoka, Daisuke Ogawa, Hirofumi Makino

Acta Med. Okayama 68 ( 4 ) 235 - 241 2014年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

The aim of this study was to clarify the factors associated with the remission and/or regression of microalbuminuria in Japanese patients with type 2 diabetes mellitus. We retrospectively analyzed the data of 130 patients with type 2 diabetes mellitus with microalbuminuria for 2-6 years (3.39 +/- 1.31 years). Remission was defined as improving from microalbuminuria to normoalbuminuria using the albumin/creatinine ratio (ACR), and regression of microalbuminuria was defined as a decrease in ACR of 50% or more from baseline. Progression of microalbuminuria was defined as progressing from microalbuminuria to overt proteinuria during the follow-up period. Among 130 patients with type 2 diabetes mellitus with microalbuminuria, 57 and 13 patients were defined as having remission and regression, respectively, while 26 patients progressed to overt proteinuria. Sex (female), higher HDL cholesterol and lower HbAlc were determinant factors associated with remission/regression of microalbuminuria by logistic regression analysis. Lower systolic blood pressure (SBP) was also correlated with remission/regression, but not at a significant level. These results suggest that proper control of blood glucose, BP and lipid profiles may be associated with remission and/or regression of type 2 diabetes mellitus with microalbuminuria in clinical practice.

Preliminary report of a Web-based instrument to assess and teach knowledge and clinical thinking to medical student. 国際誌

Gerald H Stein, Hironobu Tokunaga, Hirotaka Ando, Mikako Obika, Tomoko Miyoshi, Yasuharu Tokuda, Miho Bautista, Hitomi Kataoka, Hidekazu Terasawa

International journal of medical education 5 1 - 6 2014年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：INT JOURNAL MEDICAL EDUCATION-IJML

OBJECTIVE: We report the preliminary development of a unique Web-based instrument for assessing and teaching knowledge and developing clinical thinking called the "Sequential Questions and Answers" (SQA) test. Included in this feasibility report are physicians' answers to the Sequential Questions and Answers pre- and posttests and their brief questionnaire replies. METHODS: The authors refined the SQA test case scenario for content, ease of modifications of case scenarios, test uploading and answer retrieval. Eleven geographically distant physicians evaluated the SQA test, taking the pretest and posttest within two weeks. These physicians completed a brief questionnaire about the SQA test. RESULTS: Eleven physicians completed the SQA pre- and posttest; all answers were downloaded for analysis. They reported the ease of website login and navigating within the test module together with many helpful suggestions. Their average posttest score gain was 53% (p=0.012). CONCLUSIONS: We report the successful launch of a unique Web-based instrument referred to as the Sequential Questions and Answers test. This distinctive test combines teaching organization of the clinical narrative into an assessment tool that promotes acquiring medical knowledge and clinical thinking. We successfully demonstrated the feasibility of geographically distant physicians to access the SQA instrument. The physicians' helpful suggestions will be added to future SQA test versions. Medical schools might explore the integration of this multi-language-capable SQA assessment and teaching instrument into their undergraduate medical curriculum.

DOI： 10.5116/ijme.52a7.7280

Factors associated with remission and/or regression of microalbuminuria in type 2 diabetes mellitus.

Tetsuichiro Ono, Kenichi Shikata, Mikako Obika, Nobuyuki Miyatake, Ryo Kodera, Daisyo Hirota, Jun Wada, Hitomi Kataoka, Daisuke Ogawa, Hirofumi Makino

Acta medica Okayama 68 ( 4 ) 235 - 41 2014年

記述言語：英語掲載種別：研究論文（学術雑誌）

The aim of this study was to clarify the factors associated with the remission and/or regression of microalbuminuria in Japanese patients with type 2 diabetes mellitus. We retrospectively analyzed the data of 130 patients with type 2 diabetes mellitus with microalbuminuria for 2-6 years (3.39±1.31 years). Remission was defined as improving from microalbuminuria to normoalbuminuria using the albumin/creatinine ratio (ACR), and regression of microalbuminuria was defined as a decrease in ACR of 50% or more from baseline. Progression of microalbuminuria was defined as progressing from microalbuminuria to overt proteinuria during the follow-up period. Among 130 patients with type 2 diabetes mellitus with microalbuminuria, 57 and 13 patients were defined as having remission and regression, respectively, while 26 patients progressed to overt proteinuria. Sex (female), higher HDL cholesterol and lower HbA1c were determinant factors associated with remission/regression of microalbuminuria by logistic regression analysis. Lower systolic blood pressure (SBP) was also correlated with remission/regression, but not at a significant level. These results suggest that proper control of blood glucose, BP and lipid profiles may be associated with remission and/or regression of type 2 diabetes mellitus with microalbuminuria in clinical practice.

Content analysis of medical students' seminars: a unique method of analyzing clinical thinking. 国際誌

Yukari Takata, Gerald H Stein, Kuniyuki Endo, Akiko Arai, Shun Kohsaka, Yuka Kitano, Hitoshi Honda, Hidetaka Kitazono, Hironobu Tokunaga, Yasuharu Tokuda, Mikako Obika, Tomoko Miyoshi, Hitomi Kataoka, Hidekazu Terasawa

BMC medical education 13 156 - 156 2013年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMC

BACKGROUND: The study of communication skills of Asian medical students during structured Problem-based Learning (PBL) seminars represented a unique opportunity to assess their critical thinking development. This study reports the first application of the health education technology, content analysis (CA), to a Japanese web-based seminar (webinar). METHODS: The authors assigned twelve randomly selected medical students from two universities and two clinical instructors to two virtual classrooms for four PBL structured tutoring sessions that were audio-video captured for CA. Both of the instructors were US-trained physicians. This analysis consisted of coding the students' verbal comments into seven types, ranging from trivial to advanced knowledge integration comments that served as a proxy for clinical thinking. RESULTS: The most basic level of verbal simple responses accounted for a majority (85%) of the total students' verbal comments. Only 15% of the students' comments represented more advanced types of critical thinking. The male students responded more than the female students; male students attending University 2 responded more than male students from University 1. The total mean students' verbal response time for the four sessions with the male instructor was 6.9%; total mean students' verbal response time for the four sessions with the female instructor was 19% (p < 0.05). CONCLUSIONS: This report is the first to describe the application of CA to a multi-university real time audio and video PBL medical student clinical training webinar in two Japanese medical schools. These results are preliminary, mostly limited by a small sample size (n = 12) and limited time frame (four sessions). CA technology has the potential to improve clinical thinking for medical students. This report may stimulate improvements for implementation.

DOI： 10.1186/1472-6920-13-156

Content analysis of medical students’ seminars: a unique method of analyzing clinical thinking 査読

Yukari Takata, Gerald H Stein, Kuniyuki Endo, Akiko Arai, Shun Kohsaka, Yuka Kitano, Hitoshi Honda, Hidetaka Kitazono, Hironobu Tokunaga, Yasuharu Tokuda, Mikako Obika, Tomoko Miyoshi, Hitomi Kataoka, Hidekazu Terasawa

BMC Medical Education 13 ( 1 ) 2013年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

<title>Abstract</title>
<sec>
<title>Background</title>
The study of communication skills of Asian medical students during structured Problem-based Learning (PBL) seminars represented a unique opportunity to assess their critical thinking development. This study reports the first application of the health education technology, content analysis (CA), to a Japanese web-based seminar (webinar).

</sec>
<sec>
<title>Methods</title>
The authors assigned twelve randomly selected medical students from two universities and two clinical instructors to two virtual classrooms for four PBL structured tutoring sessions that were audio-video captured for CA. Both of the instructors were US-trained physicians. This analysis consisted of coding the students’ verbal comments into seven types, ranging from trivial to advanced knowledge integration comments that served as a proxy for clinical thinking.

</sec>
<sec>
<title>Results</title>
The most basic level of verbal simple responses accounted for a majority (85%) of the total students’ verbal comments. Only 15% of the students’ comments represented more advanced types of critical thinking. The male students responded more than the female students; male students attending University 2 responded more than male students from University 1. The total mean students’ verbal response time for the four sessions with the male instructor was 6.9%; total mean students’ verbal response time for the four sessions with the female instructor was 19% (p < 0.05).

</sec>
<sec>
<title>Conclusions</title>
This report is the first to describe the application of CA to a multi-university real time audio and video PBL medical student clinical training webinar in two Japanese medical schools. These results are preliminary, mostly limited by a small sample size (n = 12) and limited time frame (four sessions). CA technology has the potential to improve clinical thinking for medical students. This report may stimulate improvements for implementation.

</sec>

DOI： 10.1186/1472-6920-13-156

その他リンク： http://link.springer.com/article/10.1186/1472-6920-13-156/fulltext.html

Diagnosis and evaluation of nonalcoholic fatty liver disease. 国際誌

Mikako Obika, Hirofumi Noguchi

Experimental diabetes research 2012 145754 - 145754 2012年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：HINDAWI LTD

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of elevated liver function tests results, after the commonly investigated causes have been excluded, and frequently coexists with type 2 diabetes mellitus (T2DM) because the conditions have common risk factors. As both T2DM and NAFLD are related to adverse outcomes of the other, diagnosis and valuation of fatty liver is an important part of the management of diabetes. Although noninvasive methods, such as biomarkers, panel markers, and imaging, may support a diagnostic evaluation of NAFLD patients, accurate histopathological findings cannot be achieved without a liver biopsy. As it is important to know whether steatohepatitis and liver fibrosis are present for the management of NAFLD, liver biopsy remains the gold standard for NAFLD diagnosis and evaluation. Therefore, new investigations of the pathogenesis of NAFLD are necessary to develop useful biomarkers that could provide a reliable noninvasive alternative to liver biopsy.

DOI： 10.1155/2012/145754

COMPARISON OF TYPE 2 DIABETES CARE IN THE UNITED STATES AND JAPAN

Mikako Obika, Dace L. Trence

ENDOCRINE PRACTICE 16 ( 4 ) 707 - 711 2010年7月

Association of Serum Testosterone with CT- and MRS-Liver Fat in Relation to Insulin Resistance and Body Fat

Mikako Obika, Edward J. Boyko, Elaine C. Tsai

DIABETES 59 A489 - A490 2010年6月

Comparison of MR Spectroscopy and CT in Liver Fat: Assessment and Association with Insulin Resistance

Mikako Obika, Edward J. Boyko, Elaine C. Tsai

DIABETES 58 A251 - A252 2009年6月

Hepatitis B virus DNA in liver tissue and risk for hepatocarcinogenesis in patients with hepatitis C virus-related chronic liver disease 査読

Mikako Obika, Toshiyuki Shinji, Shin-ichi Fujioka, Ryo Terada, Hiromasa Ryuko, Aye Aye Lwin, Hidenori Shiraha, Norio Koide

INTERVIROLOGY 51 ( 1 ) 59 - 68 2008年12月

担当区分：筆頭著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：KARGER

Aims: To prospectively study whether occult hepatitis B virus (HBV) infection can promote the development of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related chronic liver disease. In addition, to evaluate the difference among HBV DNA-negative patients and patients with high and low HBV copy numbers. Methods: A total of 167 patients with HCV-related chronic liver disease without HBV surface antigen ( HBsAg) were studied. HBV DNA in liver tissue was determined using polymerase chain reaction (PCR). Results: HBV DNA was detected in 9 of 167 patients (5.4%) by single PCR and in 25 patients (15.0%) by nested PCR. HCC developed in 12 of 167 patients (7.2%). Ten of 142 HBV DNA-negative patients (7.0%) and 2 of 9 patients with a high HBV copy number (22.2%) developed HCC, whereas none of 16 patients with a low HBV copy number developed HCC. The incidence rate of HCC in patients with a high HBV copy number was significantly higher than in HBV DNA-negative patients and patients with low HBV copy number. Conclusion: A high amount of HBV DNA in liver tissue of HBsAg-negative patients with HCV-related liver disease might be associated with HCC development. Copyright (c) 2008 S. Karger AG, Basel.

DOI： 10.1159/000121363

Hepatitis B virus DNA in liver tissue and risk for hepatocarcinogenesis in patients with hepatitis C virus-related chronic liver disease. A prospective study. 国際誌

Mikako Obika, Toshiyuki Shinji, Shin-Ichi Fujioka, Ryo Terada, Hiromasa Ryuko, Aye Aye Lwin, Hidenori Shiraha, Norio Koide

Intervirology 51 ( 1 ) 59 - 68 2008年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：W B SAUNDERS CO-ELSEVIER INC

AIMS: To prospectively study whether occult hepatitis B virus (HBV) infection can promote the development of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related chronic liver disease. In addition, to evaluate the difference among HBV DNA-negative patients and patients with high and low HBV copy numbers. METHODS: A total of 167 patients with HCV-related chronic liver disease without HBV surface antigen (HBsAg) were studied. HBV DNA in liver tissue was determined using polymerase chain reaction (PCR). RESULTS: HBV DNA was detected in 9 of 167 patients (5.4%) by single PCR and in 25 patients (15.0%) by nested PCR. HCC developed in 12 of 167 patients (7.2%). Ten of 142 HBV DNA-negative patients (7.0%) and 2 of 9 patients with a high HBV copy number (22.2%) developed HCC, whereas none of 16 patients with a low HBV copy number developed HCC. The incidence rate of HCC in patients with a high HBV copy number was significantly higher than in HBV DNA-negative patients and patients with low HBV copy number. CONCLUSION: A high amount of HBV DNA in liver tissue of HBsAg-negative patients with HCV-related liver disease might be associated with HCC development.

DOI： 10.1159/000121363

Hepatitis C virus genotype distribution in Myanmar: Predominance of genotype 6 and existence of new genotype 6 subtype. 国際誌

Aye Aye Lwin, Toshiyuki Shinji, Myo Khin, Ne Win, Mikako Obika, Shigeru Okada, Norio Koide

Hepatology research : the official journal of the Japan Society of Hepatology 37 ( 5 ) 337 - 45 2007年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：WILEY

AIM: This study was performed to determine the prevalence and distribution of hepatitis C virus (HCV) genotypes in Myanmar. METHODS: A total of 1333 peripheral blood samples were collected from four different border cities of Myanmar. The anti-HCV antibody-positive serum samples were identified. HCV was genotyped by reverse transcriptase polymerase chain reaction, direct DNA sequencing and phylogenetic analysis on the partial core genome. RESULTS: The overall prevalence of HCV infection was 11.6% (154/1333). Regionally, it was 13.5% (47/349) in the north-eastern city, 12.8% (64/501) in the north-western city, 4.2% (16/380) in the southern city and 26.2% (27/103) in the western city. HCV was genotyped in 145/154 (94.2%) samples. Genotype 6 was the most prevalent genotype in this study (71/145, 49%), followed by genotype 3 (57/145, 39.3%), genotype 1 (16/145, 11%), and genotype 2 (1/145, 0.7%). Genotype 6 was mostly found in the northern cities and genotype 3 in the southern and western cities of Myanmar. Multiple HCV genotypes/subtypes were successfully characterized as 1a, 1b, 2a, 3a, 3b, 6m, 6n, and a new 6 subtype. Among them, subtype 6n was the most predominant subtype (38.6%), followed by subtype 3b (29.7%), 3a (9.6%), 6m (9%), 1b (6.9%), 1a (4.1%), new 6 subtype (1.4%) and 2a (0.7%). Subtype 6n was more widely distributed in the northern cities whereas subtype 3b was more common in the western city. The newly discovered genotype 6 subtype was from the northern cities. CONCLUSIONS: The results indicate there are regional differences of HCV genotype distribution in Myanmar. There is a distinct geographic variation from other South-East Asian countries in terms of the existence of the new genotype 6 subtype.

DOI： 10.1111/j.1872-034X.2007.00053.x

Hepatitis C virus genotype distribution in Myanmar: Predominance of genotype 6 and existence of new genotype 6 subtype 査読

Aye Aye Lwin, Toshiyuki Shinji, Myo Khin, Ne Win, Mikako Obika, Shigeru Okada, Norio Koide

Hepatology Research ( 37 ) 337 - 354 2007年4月

Molecular epidemiology of hepatitis C virus in Myanmar with identification of new genotype 6 subtype

Aye Aye Lwin, Toshiyuki Shinji, Myo Khin, Ne Win, Mikako Obika, Shigent Okada, Norio Koide

GASTROENTEROLOGY 132 ( 4 ) A777 - A777 2007年4月

Three type 6 hepatitis C virus subgroups among blood donors in the Yangon area of Myanmar are identified as subtypes 6m and 6n, and a novel subtype by sequence analysis of the core region.

Toshiyuki Shinji, Aye Aye Lwin, Katsunori Gokan, Mikako Obika, Hiromasa Ryuko, Myo Khin, Shigeru Okada, Norio Koide

Acta medica Okayama 60 ( 6 ) 345 - 9 2006年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

Previously, using phylogenetic analysis of NS5b sequences, we found that three type 6 variant subgroups (M6-1, M6-2 and M6-3) exist in Myanmar. According to the new nomenclature of hepatitis C, M6-1 and M6-2 belong to subtypes 6m and 6n, respectively, but M6-3 is unassigned. In this study, we sequenced and phylogenetically analyzed the core region of these type 6 variant subgroups. Serum samples assigned as 6m or 6n by NS5b sequence were also identified as 6 m or 6n by core region analysis. The M6-3 (sample name MYAN-3E-3) remained unassigned to a subgroup based on its core region analysis. The findings of this study suggest that either the core region or the NS5b region can be analyzed for HCV subtype classification.

Tumor-specific expression of the RGD-alpha3(IV)NC1 domain suppresses endothelial tube formation and tumor growth in mice. 査読

Miyoshi T, Hirohata S, Ogawa H, Doi M, Obika M, Yonezawa T, Sado Y, Kusachi S, Kyo S, Kondo S, Shiratori Y, Hudson BG, Ninomiya Y

FASEB journal : official publication of the Federation of American Societies for Experimental Biology 20 ( 11 ) 1904 - 1906 2006年9月

　前のページ - 次のページ　

1