Faculty Profiles - TOKUMASU Kazuki

Impact of the COVID-19 Pandemic on the Psychological Distress of Medical Students in Japan: Cross-sectional Survey Study Reviewed International journal

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

JOURNAL OF MEDICAL INTERNET RESEARCH 23 ( 2 ) e25232 2021.2

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

De-escalation concept and MIC literacy among medical students and clinical residents. Reviewed International journal

Hideharu Hagiya, Kazuki Tokumasu, Mikako Obika, Fumio Otsuka

Postgraduate medical journal 98 ( e3 ) e183-e184 2021.1

Without a silhouette Reviewed International journal

Yosuke Sazumi, Kazuki Tokumasu, Hideharu Hagiya, Fumio Otsuka

CLINICAL CASE REPORTS 9 ( 1 ) 574 - 575 2021.1

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

Primary effusion lymphoma (PEL) is a kind of malignant lymphoma that develops without a tumor mass. A fluid smear is of no use for the diagnosis of miscellaneous condition. Repeated cell-block smear with immunostaining is useful for the diagnosis of PEL.

DOI： 10.1002/ccr3.3469

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

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

ACTA MEDICA OKAYAMA 74 ( 5 ) 381 - 389 2020.10

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

Antibiotic literacy among Japanese medical students Reviewed International journal

Hideharu Hagiya, Hideo Ino, Kazuki Tokumasu, Hiroko Ogawa, Tomoko Miyoshi, Kanako Ochi, Fumio Otsuka

JOURNAL OF INFECTION AND CHEMOTHERAPY 26 ( 10 ) 1107 - 1109 2020.10

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

Antimicrobial resistance (AMR) is an urgent global issue. After the AMR action plan was introduced in 2016, a study on antibiotic literacy (i.e., awareness, knowledge, and attitude relating to antimicrobial use) among clinicians and lay people was conducted in Japan. However, no studies have hitherto targeted medical students who are expected to have a high level of antibiotic literacy. The present study was conducted between September 2019 and February 2020, enrolling undergraduate students at Okayama University Medical School. We collected data using a paper-based questionnaire form with 11 questions about antibiotic literacy. The response rate was 93.8% (661/705 students). Overall, 92.6% of the students knew that antibiotics inhibit the growth of bacteria. Student reporting that antibiotics could treat the common cold accounted for 77.0% (Year 1), 50.9% (Year 2), 48.2% (Year 3), 49.1% (Year 4), 23.8% (Year 5), and 26.2% (Year 6). Only 43 (6.5%) had heard about the AMR action plan. The study data suggested that medical students' level of literacy on antimicrobial use should be further enhanced to address AMR and promote antimicrobial stewardship. (C) 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jiac.2020.06.021

Mycobacterium chelonae bloodstream infection induced by osteomyelitis of toe: A case report Reviewed International journal

Yayoi Ueda, Kazuki Tokumasu, Hideharu Hagiya, Koji Iio, Takumi Fujimori, Ayaka Kakehi, Mami Okura, Hiroshi Minabe, Fumio Otsuka

JOURNAL OF INFECTION AND CHEMOTHERAPY 26 ( 8 ) 843 - 846 2020.8

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

Mycobacterium chelonae is a rapidly growing mycobacterium that has the potential to cause refractory infections in humans. Mycobacteremia resulting from the organism is extremely rare, and its clinical features are yet to be uncovered. We herein present a case of M. chelonae bloodstream infection involving an immunocompromised older patient. A 79-year-old woman, on a long-term treatment with prednisolone plus tacrolimus for rheumatoid arthritis, visited our outpatient department complaining of deteriorating pain and swelling at her right 1st toe. Laboratory parameters showed elevated C-reactive protein and leukocytosis, and magnetic resonance imaging indicated osteomyelitis at the proximal phalanx of her right 1st toe. Considering the refractory course, the infected toe was immediately amputated. M. chelonae was isolated from bacterial cultures of the resected tissue and blood (BD BAC-TECT (TM) FX blood culture system, Becton Dickinson, Sparks, MD, USA), leading to a diagnosis of disseminated M. chelonae infection. We treated the patient with an antibiotic combination of clarithromycin, minocycline, and imipenem (2 weeks), which was converted to oral therapy of clarithromycin, doxycycline, and levofloxacin. This case highlighted the potential pathogenesis of M. chelonae to cause mycobacteremia in an immunocompromised patient. (C) 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jiac.2020.03.004

【パンデミック下の医学教育-現在進行形の実践報告-】卒後教育 COVID-19パンデミック下における初期研修医教育 Reviewed

橋本忠幸, 小杉俊介, 徳増一樹

医学教育 51 ( 3 ) 320 - 322 2020.6

Calciphylaxis of the fingers Reviewed

Ko Harada, Jo Araki, Kazuki Tokumasu, Hideharu Hagiya, Fumio Otsuka

JOURNAL OF GENERAL AND FAMILY MEDICINE 21 ( 2 ) 25 - 26 2020.3

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

A 69-year-old Japanese man with a 10-year history of hemodialysis for end-stage renal disease presented with painful necrosis of the fingers of his right hand. A plain radiograph of the right hand revealed severely calcified arteries, particularly in the ring finger, suggesting the diagnosis of calciphylaxis of the fingers.

DOI： 10.1002/jgf2.296

Myxedema coma accompanied by sick sinus syndrome and hypoventilation: A case report Reviewed

Ko Harada, Shuntaro Murakami, Kazuki Tokumasu, Yu Togawa, Fumio Otsuka

JOURNAL OF GENERAL AND FAMILY MEDICINE 20 ( 5 ) 206 - 208 2019.9

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

Myxedema coma is an emergency presentation of hypothyroidism, and cardiopulmonary manifestations of the disease are related to a high mortality rate. We herein report a case of myxedema coma accompanied by sick sinus syndrome requiring temporary cardiac pacing and hypercapnic respiratory failure in an 87-year-old woman. This case is unique because both of the cardiac and pulmonary manifestations were reversible and successfully treated with thyroid hormone replacement. Our case indicates that early detection of the condition and administration of levothyroxine are essential to improve the life-threatening condition and avoid invasive treatment such as permanent pacemaker implantation or intubation.

DOI： 10.1002/jgf2.267

初期研修後の勤務先はどのようにして決めましたか?(研修4ヵ月) Invited

徳増一樹

岡山医学会雑誌 131 ( 1 ) 46 - 46 2019.4

インフルエンザウイルス感染後に二次性肺炎でMSSA菌血症に至った1例 Reviewed

白壁勝大, 永田恵蔵, 板野雄基, 徳増一樹

沖縄医学会雑誌 56 ( 4 ) 22 - 24 2018

Language：Japanese Publisher：沖縄県医師会医学会

78歳女性。インフルエンザB型感染後、一旦は解熱したが、再度40℃の発熱を認め、湿性咳嗽や喀痰の増加、頻呼吸が出現したため当院へ救急外来となった。受診時、検査および胸部X線・CT、喀痰グラム染色より、インフルエンザウイルス感染に合併した黄色ブドウ球菌性肺炎と診断され、入院の上、バンコマイシン、セファゾリンの投与を開始した。入院2日目にMSSA菌血症が確認され、4日目に感受性の結果からバンコマイシンを中止し、その後は解熱し、徐々に呼吸状態の安定を認め、血液培養も陰性化し、抗菌薬は合計28日間使用し終了した。

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