2021/07/12 更新

写真a

ミツハシ トシハル
三橋 利晴
MITSUHASHI Toshiharu
所属
岡山大学病院 助教
職名
助教
外部リンク

研究キーワード

  • 衛生学

研究分野

  • ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含む

  • ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含まない

  • ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含む

  • ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含まない

  • ライフサイエンス / 医療管理学、医療系社会学

 

論文

  • Survival Outcomes of Treatment with Radiofrequency Ablation, Stereotactic Body Radiotherapy, or Sublobar Resection for Patients with Clinical Stage I Non-Small-Cell Lung Cancer: A Single-Center Evaluation. 査読 国際誌

    Toshihiro Iguchi, Takao Hiraki, Yusuke Matsui, Toshiharu Mitsuhashi, Norihisa Katayama, Kuniaki Katsui, Junichi Soh, Jun Sakurai, Hideo Gobara, Shinichi Toyooka, Susumu Kanazawa

    Journal of vascular and interventional radiology : JVIR   31 ( 7 )   1044 - 1051   2020年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To retrospectively compare the outcomes of radiofrequency (RF) ablation, stereotactic body radiotherapy (SBRT), and sublobar resection (SLR) in patients with stage I non-small-cell lung cancer (NSCLC) at a single center. MATERIALS AND METHODS: Overall, 289 patients (38 RF ablation, 58 SBRT, and 193 SLR) were included. Kaplan-Meier curves were generated, multiple propensity score was estimated using a multinomial logistic regression model, and relationships between treatments and outcomes were assessed using a Cox proportional hazard model. Hazard ratios (HRs) for death from any cause and disease progression or death from any cause were examined by a crude model, an inverse probability of treatment weighting (IPTW) model, and an IPTW model adjusted for missing variables. RESULTS: The 5-year overall and progression-free survival rates were 58.9% and 39.9%, respectively, for RF ablation; 42.0% and 34.9%, respectively, for SBRT; and 85.5% and 75.9%, respectively, for SLR. Significantly longer survival time and lower HR were observed for SLR than other treatments. However, after statistical adjustment, these relationships were not significant except for reduced HR of disease progression or death from any cause of SLR compared to RF ablation in the IPTW model. The median hospital stays for RF ablation, SBRT, and SLR were 6.5, 6, and 16 days, respectively. Adverse events of grade 3 or higher occurred only in 11 SLR cases. CONCLUSIONS: SLR achieved the longest survival. However, after statistical adjustment, there were no significant outcome differences among RF ablation, SBRT, and SLR, except for 1 model. RF ablation or SBRT may be alternative treatments for selected patients with early-stage NSCLC.

    DOI: 10.1016/j.jvir.2019.11.035

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  • Difference in specimen weights with semi-automatic cutting biopsy needles. 査読

    Toshihiro Iguchi, Takao Hiraki, Yusuke Matsui, Toshiharu Mitsuhashi, Toshiyuki Komaki, Soichiro Okamoto, Shogo Fukuma, Koji Tomita, Mayu Uka, Susumu Kanazawa

    Japanese journal of radiology   38 ( 6 )   579 - 586   2020年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To assess specimen weight difference of six types of semi-automatic cutting biopsy needles. MATERIALS AND METHODS: We compared 18- and 20-gauge needles, one aspiration-type (STARCUT® aspiration-type, TSK Laboratory, Tochigi, Japan) and five non-aspiration-type (MISSION®, BARD, AZ; SuperCore™, Argon Medical Devices, TX; Temno Evolution®, Care Fusion, IL; FINE CORE®, Toray Medical, Tokyo, Japan; Quick-Core®, Cook, IN) needles. Four biopsies were performed with each needle with the longest throw length on an excised bovine liver. The biopsies were repeated with new needles, four times with four different livers. STARCUT® was used both with and without aspiration. RESULTS: Sixteen specimens were obtained with each needle. In needles of gauges, STARCUT® with aspiration provided the heaviest specimen and significantly heavier specimens were obtained with STARCUT® with aspiration (P < 0.05) than five non-aspiration-type needles. The specimen weight differed significantly (P < 0.001) among all 18- and 20-gauge needles. The specimen weights did not differ significantly between aspiration and non-aspiration biopsies with STARCUT® (6.32 vs. 5.97 mg with 18-gauge needle, P = 0.342; 1.95 vs. 1.92 mg with 20-gauge needle, P = 0.886). CONCLUSION: Although STARCUT® with aspiration provided the heaviest specimen, specimen weights were not significantly different between aspiration and non-aspiration biopsies. We assessed the specimen weight difference of six types of semi-automatic cutting biopsy needles. Significantly heavier specimens were obtained with STARCUT® with aspiration than the other needles. The specimen weight differed significantly among all 18- and 20-gauge needles but did not differ significantly between aspiration and non-aspiration biopsies with STARCUT®.

    DOI: 10.1007/s11604-020-00935-3

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  • Robotic CT-guided out-of-plane needle insertion: comparison of angle accuracy with manual insertion in phantom and measurement of distance accuracy in animals. 査読 国際誌

    Toshiyuki Komaki, Takao Hiraki, Tetsushi Kamegawa, Takayuki Matsuno, Jun Sakurai, Ryutaro Matsuura, Takuya Yamaguchi, Takanori Sasaki, Toshiharu Mitsuhashi, Soichiro Okamoto, Mayu Uka, Yusuke Matsui, Toshihiro Iguchi, Hideo Gobara, Susumu Kanazawa

    European radiology   30 ( 3 )   1342 - 1349   2020年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: To evaluate the accuracy of robotic CT-guided out-of-plane needle insertion in phantom and animal experiments. METHODS: A robotic system (Zerobot), developed at our institution, was used for needle insertion. In the phantom experiment, 12 robotic needle insertions into a phantom at various angles in the XY and YZ planes were performed, and the same insertions were manually performed freehand, as well as guided by a smartphone application (SmartPuncture). Angle errors were compared between the robotic and smartphone-guided manual insertions using Student's t test. In the animal experiment, 6 robotic out-of-plane needle insertions toward targets of 1.0 mm in diameter placed in the kidneys and hip muscles of swine were performed, each with and without adjustment of needle orientation based on reconstructed CT images during insertion. Distance accuracy was calculated as the distance between the needle tip and the target center. RESULTS: In the phantom experiment, the mean angle errors of the robotic, freehand manual, and smartphone-guided manual insertions were 0.4°, 7.0°, and 3.7° in the XY plane and 0.6°, 6.3°, and 0.6° in the YZ plane, respectively. Robotic insertions in the XY plane were significantly (p < 0.001) more accurate than smartphone-guided insertions. In the animal experiment, the overall mean distance accuracy of robotic insertions with and without adjustment of needle orientation was 2.5 mm and 5.0 mm, respectively. CONCLUSION: Robotic CT-guided out-of-plane needle insertions were more accurate than smartphone-guided manual insertions in the phantom and were also accurate in the in vivo procedure, particularly with adjustment during insertion. KEY POINTS: • Out-of-plane needle insertions performed using our robot were more accurate than smartphone-guided manual insertions in the phantom experiment and were also accurate in the in vivo procedure. • In the phantom experiment, the mean angle errors of the robotic and smartphone-guided manual out-of-plane needle insertions were 0.4° and 3.7° in the XY plane (p < 0.001) and 0.6° and 0.6° in the YZ plane (p = 0.65), respectively. • In the animal experiment, the overall mean distance accuracies of the robotic out-of-plane needle insertions with and without adjustments of needle orientation during insertion were 2.5 mm and 5.0 mm, respectively.

    DOI: 10.1007/s00330-019-06477-1

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  • Correction to: Risk of gastric cancer in the second decade of follow-up after Helicobacter pylori eradication. 査読

    Susumu Take, Motowo Mizuno, Kuniharu Ishiki, Chiaki Kusumoto, Takayuki Imada, Fumihiro Hamada, Tomowo Yoshida, Kenji Yokota, Toshiharu Mitsuhashi, Hiroyuki Okada

    Journal of gastroenterology   55 ( 3 )   289 - 290   2020年3月

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    記述言語:英語  

    In the original publication of the article, the figure 3 was published with errors. The corrected figure 3 should appear as in this correction.

    DOI: 10.1007/s00535-019-01654-x

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  • Risk of gastric cancer in the second decade of follow-up after Helicobacter pylori eradication. 査読

    Susumu Take, Motowo Mizuno, Kuniharu Ishiki, Chiaki Kusumoto, Takayuki Imada, Fumihiro Hamada, Tomowo Yoshida, Kenji Yokota, Toshiharu Mitsuhashi, Hiroyuki Okada

    Journal of gastroenterology   55 ( 3 )   281 - 288   2020年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND AIMS: Eradication of Helicobacter pylori reduces the risk of gastric cancer. In this study, we investigated the risk beyond 10 years after eradication of H. pylori. METHODS: We conducted a retrospective cohort study of 2737 patients who had yearly endoscopic follow-up after cure of H. pylori infection. For comparison of gastric cancer risk in the second decade of follow-up with that in the first decade, we calculated standardized incidence ratios (SIRs) by dividing the number of observed cases of gastric cancer in the second decade of follow-up by that of expected cases which was estimated using the incidence rate ratio of age in the first decade. RESULTS: During the follow-up for as long as 21.4 years (mean 7.1 years), gastric cancer developed in 68 patients (0.35% per year). The SIRs for diffuse-type gastric cancer was infinity (0 expected case and 4 observed cases) in patients with mild gastric mucosal atrophy and 10.9 (95% confidence interval 4.53-26.1) with moderate atrophy, whereas no significant increase of SIRs was observed in intestinal-type cancer regardless of the grade of baseline gastric atrophy or in diffuse-type cancer in patients with severe atrophy even though who had the highest risk. CONCLUSIONS: The longer the follow-up, the greater the risk of developing diffuse-type gastric cancer becomes in patients with mild-to-moderate gastric atrophy at baseline. Endoscopic surveillance should be continued beyond 10 years after cure of H. pylori irrespective of the severity of gastric atrophy.

    DOI: 10.1007/s00535-019-01639-w

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  • Effects of indium exposure on respiratory symptoms: a retrospective cohort study in Japanese workers using health checkup data. 査読 国際誌

    Toshiharu Mitsuhashi

    PeerJ   8   e8413   2020年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Indium compounds are known health hazards for lung cancer and interstitial pneumonia. Furthermore, they are related to emphysema, alveolar proteinosis, and cholesterol granuloma. In Japan, laws were revised in 2013 to tighten regulations on indium exposure in workplaces. However, its impact on the health of workers who handle indium has not been evaluated. This study aimed to investigate whether subjective respiratory symptoms in these workers have reduced after the 2013 amendment in the regulations. Methods: The subjects were workers from certain areas of Japan who had undergone health checkups between January 1, 2013, and June 30, 2015. Indium-handling and non-handling workers were categorized into the exposed and less-exposed groups, respectively. Based on the findings of health checkups during this period, the hazard ratio of subjective respiratory symptoms (cough, sputum production, shortness of breath, and palpitation) and its 95% confidence intervals (CIs) were calculated with the less-exposed group as the reference. The Prentice-Williams-Peterson model was used for calculation, and a model that adjusted for coarse analysis and potential confounding factors was adopted. Results: Overall, 2,561 workers (from 22 companies) who underwent 6,033 health checkups were included. The total person-years were 2,562.8 years, and 162 outcome events occurred. The hazard ratios of the exposed group were 1.65 (95% CI [1.14-2.39]: p = 0.008) and 1.61 (95% CI [1.04-2.50]: p = 0.032) in the crude and adjusted models, respectively. Conclusion: Indium-handling workers had a high hazard of the subjective respiratory symptoms than non-indium -handling workers despite stricter regulations on indium exposure in workplaces. This indicates the need for further changes to the legislation to protect the health of workers exposed to harmful substances in workplaces. Further studies including larger diverse cohorts are needed to validate our findings.

    DOI: 10.7717/peerj.8413

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

    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

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    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

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  • Physical activity and incident dementia in older Japanese adults: The Okayama study. 査読 国際誌

    Yangyang Liu, Toshiharu Mitsuhashi, Michiyo Yamakawa, Megumi Sasai, Toshihide Tsuda, Hiroyuki Doi, Jun Hamada

    International journal of geriatric psychiatry   34 ( 10 )   1429 - 1437   2019年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: To evaluate the association between regular physical activity and the risk of incident dementia in older Japanese adults. METHODS: This was a retrospective cohort study performed in Okayama City, Japan. Overall, 51 477 older Japanese adults were followed from 2008 to 2014. A health checkup questionnaire was used to assess regular physical activity. The Dementia Scale of long-term care insurance was used as a measure of incident dementia. Cox proportional hazard models were used to calculate adjusted hazard ratios, with their 95% confidence intervals, for the incidence of dementia across the categories of physical activity. RESULTS: During a 7-year follow-up, 13 816 subjects were considered as having incident dementia. Compared with participants who performed physical activity less than or equal to one time per week, the multivariate adjusted hazard ratio values (95% confidence intervals) for participants who performed physical activity greater than or equal to two times per week but not every day and those who performed physical activity every day were 0.79 (0.75-0.84) and 0.94 (0.89-0.98), respectively. The interaction of physical activity and sex was statistically significant (P < .01). In subgroup analysis, the multivariate-adjusted hazard ratio values (95% confidence intervals) remained low, at 0.76 (0.70-0.84) in males and 0.81 (0.76-0.87) in females who performed physical activity greater than or equal to two times per week but not every day; they were 0.82 (0.76-0.89) in males and 1.01 (0.95-1.07) in females who performed physical activity every day. CONCLUSIONS: Regular physical activity could reduce the risk of incident dementia in older Japanese adults, except females who performed physical activity every day.

    DOI: 10.1002/gps.5135

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  • Alcohol consumption and incident dementia in older Japanese adults: The Okayama Study. 査読

    Yangyang Liu, Toshiharu Mitsuhashi, Michiyo Yamakawa, Megumi Sasai, Toshihide Tsuda, Hiroyuki Doi, Jun Hamada

    Geriatrics & gerontology international   19 ( 8 )   740 - 746   2019年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: To evaluate the association between the amount and frequency of alcohol consumption and incident dementia in older Japanese adults using large sample size data over a long follow-up period. METHODS: This was a retrospective cohort study carried out in Japan. A total of 53 311 older adults were followed from 2008 to 2014. A health checkup questionnaire was used to assess the amount and frequency of alcohol consumption. The Dementia Scale of long-term care insurance was used as a measure of incident dementia. Cox proportional hazards models were used to calculate adjusted hazard ratios, with their 95% confidence intervals, for the incidence of dementia across the categories of alcohol consumption by sex. RESULTS: During a 7-year follow-up period, 14 479 participants were regarded as having incident dementia. Compared with non-drinkers, the multivariate adjusted hazard ratios for participants with alcohol consumption ≤2 units per day, occasionally (0.88, 95% CI 0.81-0.96 in men and 0.84, 95% 0.79-0.90 in women) and daily (0.79, 95% 0.73-0.85 in men and 0.87, 95% 0.78-0.97 in women) were statistically significant, and the difference between occasional and daily consumption was only statistically significant in men; however, for participants with alcohol consumption >2 units per day, occasionally (0.91, 95% 0.71-1.16 in men and 1.09, 95% 0.72-1.67 in women) and daily (0.89, 95% 0.81-1.00 in men and 1.16, 95% 0.84-1.81 in women) were not significant. CONCLUSIONS: Alcohol consumption of ≤2 units per day, occasionally or daily, could reduce the risk of incident dementia, with greater benefit for men with such daily consumption. Geriatr Gerontol Int 2019; 19: 740-746.

    DOI: 10.1111/ggi.13694

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  • Simultaneous Integrated Boost Volumetric Modulated Arc Therapy for Middle or Lower Esophageal Cancer Using Elective Nodal Irradiation: Comparison with 3D Conformal Radiotherapy. 査読

    Kotaro Yoshio, Akihisa Wakita, Toshiharu Mitsuhashi, Takahiro Kitayama, Kento Hisazumi, Daisaku Inoue, Nobuhisa Tajiri, Tsuyoki Shiode, Shiro Akaki, Susumu Kanazawa

    Acta medica Okayama   73 ( 3 )   247 - 257   2019年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We investigated the feasibility of simultaneous integrated boost (SIB) volumetric modulated arc therapy (VMAT) using elective nodal irradiation (ENI) for middle or lower esophageal cancer and compared it with three-dimensional conformal radiotherapy (3D-CRT). The study included 15 patients. The prescribed doses included a standard dose (50.4 Gy) and a high dose (60 Gy) for the planning target volume (PTV) of the involved lesions. The objective of the whole lung volume receiving ≥ 20 Gy (V20Gy) was < 30%, and the mean lung dose (MLD) was < 20 Gy. The volumes of the lung receiving 5 Gy (V5Gy) and the heart receiving 30-50 Gy (V30-50Gy) were kept as low as reasonably achievable. As a result, SIB-VMAT showed superior dose conformity for the PTV (p<0.001). Although the lung V5Gy was significantly increased (p<0.001), the V20Gy and MLD showed no significant increase. The heart V30-50Gy showed a > 20% reduction in the mean against 3D-CRTs. Our results demonstrate the feasibility of SIB-VMAT for the treatment of middle or lower esophageal cancer with ENI. Although attention should be paid to the low-dose area of the lungs, SIB-VMAT would be a promising treatment option with improved outcomes for esophageal cancer.

    DOI: 10.18926/AMO/56868

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  • Combined effects of body mass index and unhealthy behaviors on disability in older Japanese adults: the Okayama study. 査読 国際誌

    Yangyang Liu, Toshiharu Mitsuhashi, Michiyo Yamakawa, Megumi Sasai, Toshihide Tsuda, Hiroyuki Doi, Jun Hamada

    PeerJ   7   e8146   2019年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Body mass index (BMI) is a significant predictor of functional disability in older adults. However, when evaluated, the association between BMI and incident functional disability, considering behaviors only as covariates or not, may not be appropriate. The primary purpose of the study was to investigate the combined effects of BMI and unhealthy behaviors on the risk of incident functional disability. Methods: This was a retrospective cohort study that took place in Okayama City, Japan. Data on BMI and unhealthy behaviors were obtained using the health check-up questionnaire. The certification of Long-Term Care Insurance was used to measure functional disability. Cox proportional hazard models were used; adjusted hazard ratios (HRs) with 95% confidence interval (CI) were calculated for incidence of functional disability across categories of BMI and number of unhealthy behaviors. Results: The relationship between BMI and incident functional disability was U-shaped (HR = 1.18, 95% CI [1.11-1.25], among the underweight range; and 1.26 [1.19-1.34] among the obesity range), and its risk was significantly higher within the normal-to-overweight range of BMI values with co-occurring unhealthy behaviors (with normal weight range and one, 1.17 [1.01-1.21]; two, 1.29 [1.18-1.41]; and three or four unhealthy behaviors 1.38 [1.24-1.54]; as well as among overweight range and one, 1.16 [1.05-1.27]; two, 1.26 [1.15-1.38]; and three or four unhealthy behaviors, 1.47 [1.31-1.64]). In each BMI category, the risk of incident functional disability increased with increasing number of unhealthy behaviors (p < 0.05 for linear tread), with the highest risk (1.87 [1.58-2.20]) occurring in combination with at least three unhealthy behaviors with BMI ≥ 27.5, for both sexes (2.20 [1.64-2.92] in men and 1.66 [1.35-2.04] in women). Conclusion: It is necessary to consider the combined effects of BMI and behaviors on incident functional disability. Furthermore, interventions targeting multiple behaviors should be considered as such interventions may offer greater benefits than simple interventions.

    DOI: 10.7717/peerj.8146

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  • Randomized Controlled Trial of Epidural versus Patient-controlled Intravenous Analgesia for Postoperative Pain Control after Laparoscopic Gastrectomy. 査読

    Satoru Kikuchi, Shinji Kuroda, Masahiko Nishizaki, Takashi Matsusaki, Toshiharu Mitsuhashi, Kazuya Kuwada, Shunsuke Kagawa, Hiroshi Morimatsu, Toshiyoshi Fujiwara

    Acta medica Okayama   72 ( 1 )   95 - 98   2018年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Although epidural analgesia (EDA) is considered standard postoperative analgesia for open gastrectomy, it has been unclear whether EDA has benefits in laparoscopic gastrectomy (LG) because postoperative pain after a laparoscopic procedure is significantly reduced. We are conducting a two-arm, single-center, prospective randomized non-inferiority trial to evaluate the postoperative pain relief of patient-controlled intravenous analgesia (PCIA) compared to EDA. A total of 132 patients undergoing LG will be randomized to EDA and PCIA groups (n=64 each) for postoperative pain control. The primary endpoint is postoperative pain at 24 h after surgery. This study will clarify the optimal pain management after LG.

    DOI: 10.18926/AMO/55671

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  • Plan quality comparison between 4-arc and 6-arc noncoplanar volumetric modulated arc stereotactic radiotherapy for the treatment of multiple brain metastases. 査読

    Yoshio K, Mitsuhashi T, Wakita A, Kitayama T, Hisazumi K, Inoue D, Shiode T, Akaki S, Kanazawa S

    Medical dosimetry : official journal of the American Association of Medical Dosimetrists   2018年1月

  • Effects of two-week e-learning on eHealth literacy: a randomized controlled trial of Japanese Internet users. 査読 国際誌

    Toshiharu Mitsuhashi

    PeerJ   6   e5251   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: The Internet is widely used as a source of information by people searching for medical or healthcare information. However, information found on the Internet has several drawbacks, and the ability to consume accurate health information on the Internet (eHealth literacy) is increasingly important. This study's goal was to clarify the extent to which eHealth literacy is improved after e-learning in a randomized controlled trial. Methods: Data were collected on 301 Japanese adults through an online survey. Participants were assigned to the intervention (e-learning about eHealth literacy) group or the control group in a 1:1 ratio. The intervention group included 148 participants, and 153 participants were in the control group. The participants provided information at baseline on demographic characteristics, self-rated health, and frequency of Internet searching. The eHealth Literacy Scale (eHEALS), which was the main measure of eHealth literacy, and data on secondary outcomes (the Healthy Eating Literacy Scale and skill for evaluating retrieved search results) were obtained at baseline and at follow-up. The score difference was calculated by subtracting the score at baseline from the score at follow-up. Linear regression analysis and multinomial regression analysis were performed using the differences in score as the dependent variables and the intervention as the explanatory variable. Intention-to-treat analysis was employed. Results: The results from participants who responded to all of the questions both times were analyzed (134 in the intervention group and 148 in the control group). eHEALS increased 1.57 points due to the intervention effect (Δ score change = 1.57; 95% CI [0.09-3.05]; p = 0.037). Skills for evaluating retrieved search results improved more in the intervention group than in the control group (relative risk ratio = 2.47; 95% Confidence Interval: 1.33, 4.59; p = 0.004). There were no large differences at baseline between the intervention and control groups in the eHEALS, Healthy Eating Literacy scale, or skill for evaluating retrieved search results. However, at follow-up, the intervention group had improved more than the control group on both the eHEALS and skill for evaluating retrieved search results. Discussion: eHealth literacy improved after the e-learning, as evidenced by the change to the eHEALS scores and increased skill for evaluating retrieved search results. There was no significant effect of e-learning, which did not include content on healthy eating, on the Healthy Eating Literacy Scale scores. This indicates that scores did not increase much due to effects other than e-learning, as is sometimes seen with the Hawthorne effect. Although it was statistically significant, the effect size was small. Therefore, future research is necessary to verify the clinical implications. In sum, this study suggests that e-learning is an effective way to improve eHealth literacy.

    DOI: 10.7717/peerj.5251

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  • Robotically Driven CT-guided Needle Insertion: Preliminary Results in Phantom and Animal Experiments. 査読 国際誌

    Takao Hiraki, Tetsushi Kamegawa, Takayuki Matsuno, Jun Sakurai, Yasuzo Kirita, Ryutaro Matsuura, Takuya Yamaguchi, Takanori Sasaki, Toshiharu Mitsuhashi, Toshiyuki Komaki, Yoshihisa Masaoka, Yusuke Matsui, Hiroyasu Fujiwara, Toshihiro Iguchi, Hideo Gobara, Susumu Kanazawa

    Radiology   285 ( 2 )   454 - 461   2017年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:RADIOLOGICAL SOC NORTH AMERICA  

    Purpose To evaluate the accuracy of the remote-controlled robotic computed tomography (CT)-guided needle insertion in phantom and animal experiments. Materials and Methods In a phantom experiment, 18 robotic and manual insertions each were performed with 19-gauge needles by using CT fluoroscopic guidance for the evaluation of the equivalence of accuracy of insertion between the two groups with a 1.0-mm margin. Needle insertion time, CT fluoroscopy time, and radiation exposure were compared by using the Student t test. The animal experiments were approved by the institutional animal care and use committee. In the animal experiment, five robotic insertions each were attempted toward targets in the liver, kidneys, lungs, and hip muscle of three swine by using 19-gauge or 17-gauge needles and by using conventional CT guidance. The feasibility, safety, and accuracy of robotic insertion were evaluated. Results The mean accuracies of robotic and manual insertion in phantoms were 1.6 and 1.4 mm, respectively. The 95% confidence interval of the mean difference was -0.3 to 0.6 mm. There were no significant differences in needle insertion time, CT fluoroscopy time, or radiation exposure to the phantom between the two methods. Effective dose to the physician during robotic insertion was always 0 μSv, while that during manual insertion was 5.7 μSv on average (P < .001). Robotic insertion was feasible in the animals, with an overall mean accuracy of 3.2 mm and three minor procedure-related complications. Conclusion Robotic insertion exhibited equivalent accuracy as manual insertion in phantoms, without radiation exposure to the physician. It was also found to be accurate in an in vivo procedure in animals. © RSNA, 2017 Online supplemental material is available for this article.

    DOI: 10.1148/radiol.2017162856

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  • Radiofrequency ablation of pulmonary tumors near the diaphragm 査読

    T. Iguchi, T. Hiraki, H. Gobara, H. Fujiwara, J. Sakurai, Y. Matsui, T. Mitsuhashi, S. Toyooka, S. Kanazawa

    Diagnostic and Interventional Imaging   98 ( 7-8 )   535 - 541   2017年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier Masson SAS  

    Purpose To retrospectively evaluate the feasibility, safety, and efficacy of radiofrequency ablation (RFA) of lung tumors located near the diaphragm. Materials and methods A total of 26 patients (15 men, 11 women
    mean age, 61.5 years ± 13.0 [SD]) with a total of 29 lung tumors near the diaphragm (i.e., distance &lt
     10 mm) were included. Mean tumor diameter was 11.0 mm ± 5.3 (SD) (range, 2–23 mm). Efficacy of RFA, number of adverse events and number of adverse events with a grade ≥ 3, based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0, were compared between patients with lung tumors near the diaphragm and a control group of patients with more distally located lung tumors (i.e., distance ≥ 10 mm). Results RFA was technically feasible for all tumors near the diaphragm. Four grade 3 adverse events (1 pneumothorax requiring pleurodesis and 3 phrenic nerve injuries) were observed. No grade ≥ 4 adverse events were reported. The median follow-up period for tumors near the diaphragm was 18.3 months. Local progression was observed 3.3 months after RFA in 1 tumor. The technique efficacy rates were 96.2% at 1 year and 96.2% at 2 years and were not different, from those observed in control subjects (186 tumors
    P = 0.839). Shoulder pain (P &lt
     0.001) and grade 1 pleural effusion (P &lt
     0.001) were more frequently observed in patients with lung tumor near the diaphragm. The rates of grade ≥ 3 adverse events did not significantly differ between tumors near the diaphragm (4/26 sessions) and the controls (7/133 sessions) (P = 0.083). Conclusion RFA is a feasible and effective therapeutic option for lung tumors located near the diaphragm. However, it conveys a higher rate of shoulder pain and asymptomatic pleural effusion by comparison with more distant lung tumors.

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  • Disappearance of Renal Cysts Included in Ice Ball During Cryoablation of Renal-Cell Carcinoma: A Potential Therapy for Symptomatic Renal Cysts? 査読 国際誌

    Mitsuko Yodoya, Takao Hiraki, Toshihiro Iguchi, Hiroyasu Fujiwara, Yusuke Matsui, Yoshihisa Masaoka, Jun Sakurai, Toshiharu Mitsuhashi, Hideo Gobara, Susumu Kanazawa

    Journal of vascular and interventional radiology : JVIR   28 ( 6 )   869 - 876   2017年6月

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

    PURPOSE: To retrospectively evaluate the effect of cryoablation of renal-cell carcinoma on nearby renal cysts with the goal to investigate the potential for an alternative therapy to treat symptomatic renal cysts. MATERIALS AND METHODS: The study population comprised 46 cysts (mean size, 12 mm; range, 5-43 mm) that were within or near the ice ball during cryoablation in 22 patients. Size change of each cyst was evaluated via enhanced CT or MR imaging before and 1, 3, 6, and 12 months after cryoablation. Forty-one cysts were also followed after 12 months. Variables including positional relationship between the cyst and the ice ball were evaluated via linear regression analysis using generalized estimating equation models to determine which factors affected cyst shrinkage rate at 12 months. RESULTS: Fifteen, 12, and 19 cysts were completely included in, partially included in, or excluded from the ice ball, respectively. The overall shrinkage rate was 62%, and 57% of cysts (26 of 46) had disappeared at 12 months. Only the relationship between the cyst and the ice ball was significantly (P < .001) associated with cyst shrinkage rate. Cyst disappearance rates at 12 months were 100% (15 of 15), 67% (8 of 12), and 16% (3 of 19) for cysts completely included, partially included, and excluded from the ice ball, respectively. Among the 22 cysts that disappeared at 12 months and continued to be followed, none recurred after 12 months. CONCLUSIONS: All renal cysts that were completely included in the ice ball disappeared after cryoablation, demonstrating the potential utility of cryoablation as an alternative therapy for symptomatic renal cysts.

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  • Lesion Size on Ultrasonography Predicts Potential Invasion in Ductal Carcinoma in situ Preoperatively Diagnosed by Breast Needle Biopsy. 査読

    Kyoko Shimoyama, Tomo Osako, Toshiharu Mitsuhashi, Futoshi Akiyama, Takuji Iwase

    Acta medica Okayama   71 ( 3 )   233 - 240   2017年6月

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    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  

    Ductal carcinoma in situ (DCIS) of the breast has no potential to metastasize, but over 20% of cases preoperatively diagnosed as DCIS are upstaged on final pathology. The rates of upstaging and the predictors for invasion on final pathology were evaluated. For 240 primary breast cancers, radiological findings on mammography, ultrasonography, and magnetic resonance imaging were investigated along with pathological and clinical information. Univariate and multivariate analyses were performed to identify predictors of potential invasion. Of the 240 breast cancers, 68 (28.3%) showed invasion on final pathology, and 5 (2.5%) had sentinel node metastasis. The multivariate analysis identified five independent predictors: non-mass lesions >2.4 cm on ultrasonography (odds ratio [OR] 2.84, 95% confidence interval [CI] 1.02-7.95, p=0.047), comedo-type histology (OR 6.89, 95% CI 1.89-25.08, p<0.01), solid-type histology (OR 7.97, 95% CI 2.08-30.49, p<0.01), palpable mass (OR 2.63, 95% CI 1.05-6.64, p=0.04), and bloody nipple discharge (OR 4.61, 95% CI 1.20-17.66, p=0.02). These five predictors were associated with invasion on final pathology and may help select candidates for sentinel node biopsy.

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  • One-year outcomes of a treat-and-extend regimen of intravitreal aflibercept for polypoidal choroidal vasculopathy. 査読

    Mio Hosokawa, Yuki Morizane, Masayuki Hirano, Shuhei Kimura, Fumiaki Kumase, Yusuke Shiode, Shinichiro Doi, Shinji Toshima, Mika Hosogi, Atsushi Fujiwara, Toshiharu Mitsuhashi, Fumio Shiraga

    Japanese journal of ophthalmology   61 ( 2 )   150 - 158   2017年3月

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    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 JAPAN KK  

    PURPOSE: To evaluate the 1-year treatment outcomes of intravitreal aflibercept injections (IVA) using a treat-and-extend regimen for polypoidal choroidal vasculopathy (PCV). METHODS: Thirty-seven eyes with treatment-naive PCV treated with IVA using a treat-and-extend regimen for 1 year were reviewed retrospectively. The main outcome measures were changes in the best-corrected visual acuity (BCVA) and central retinal thickness (CRT), and the treatment interval at 1 year. The predictive factors for patients who could not continue to extend the treatment interval because of poor response to IVA or recurrence were analyzed. RESULTS: The mean logarithm of the minimum angle of resolution BCVA improved from 0.37 at baseline to 0.21 at 1 year (P < 0.001). The mean CRT decreased from 342.3 μm at baseline to 196.6 μm at 1 year (P < 0.001). The mean treatment interval was 9.7 weeks at 1 year (4 weeks in 11 eyes [29.7%], 6 weeks in 1 eye [2.7%], 8 weeks in 2 eyes [5.4%], 10 weeks in 1 eye [2.7%], and 12 weeks in 22 eyes [59.5%]). A larger number of polypoidal lesions at baseline was predictive for patients who could not continue to extend the treatment interval. CONCLUSIONS: IVA using a treat-and-extend regimen is effective for improving BCVA and CRT in eyes with PCV.

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  • Interfractional Seminal Vesicle Motion Relative to the Prostate Gland for Image-guided Radiotherapy for Prostate Cancer with/without Androgen Deprivation Therapy: A Retrospective Cohort Study. 査読

    Takahiro Waki, Kuniaki Katsui, Toshiharu Mitsuhashi, Takeshi Ogata, Norihisa Katayama, Mitsuhiro Takemoto, Yasutomo Nasu, Hiromi Kumon, Susumu Kanazawa

    Acta medica Okayama   71 ( 1 )   31 - 39   2017年2月

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    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 investigated differences in seminal vesicle (SV) length and interfractional SV motion relative to the prostate gland in prostate cancer patients. We compared 32 patients who received androgen deprivation therapy (ADT) before radiotherapy with 12 patients receiving radiotherapy alone at Okayama University Hospital in August 2008-July 2011. We examined the right and left SVs' length and motion by computed tomography (CT) to determine the ADT's effects and analyzed 347 CT scans in a multiple linear regression model. The ADT patients' SV length was significantly shorter than the non-ADT patients'. The differences in right and left SV lengths between the ADT and non-ADT patients were 6.8 mm (95% CI 2.0-11.7 mm) and 7.2 mm (95% CI 3.1- 11.3 mm) respectively in an adjusted regression model. SV motion did not differ between the ADT and non- ADT patients in terms of interfractional motion of the SV tips and the SVs' center relative to the prostate gland. The ADT patients had significantly shorter SVs compared to the non-ADT patients, but no difference in SV motion was observed. SV interfractional motion should thus be compensated using the same planning margins, regardless of whether ADT is used.

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  • Clinical Epidemiology and Treatment of Febrile and Afebrile Convulsions With Mild Gastroenteritis: A Multicenter Study. 査読 国際誌

    Yousuke Higuchi, Toshihide Kubo, Toshiharu Mitsuhashi, Naoko Nakamura, Ichiro Yokota, Osamu Komiyama, Isamu Kamimaki, Shigenori Yamamoto, Yasushi Uchida, Kyoko Watanabe, Hironori Yamashita, Shigeki Tanaka, Kosei Iguchi, Ryouji Ichimi, Shinichiro Miyagawa, Toshimitsu Takayanagi, Hiroshi Koga, Akinori Shukuya, Akiko Saito, Keizo Horibe

    Pediatric neurology   67   78 - 84   2017年2月

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

    BACKGROUND: We investigated features and responses to treatment in patients with febrile and afebrile convulsions with mild gastroenteritis and characterized convulsions with rotavirus and norovirus gastroenteritis. METHODS: We conducted a prospective, observational study to evaluate patients with febrile and afebrile convulsions with mild gastroenteritis who were hospitalized between November 2011 and March 2014 at 13 facilities in the National Hospital Organization. We classified the patients into two groups: presence or absence of fever. We investigated the background, clinical and laboratory characteristics, viral antigen in stool, and efficacy of anticonvulsant drugs. RESULTS: Of 126 patients enrolled in this study, 50 were febrile (Fc group) and 76 were afebrile (aFc group). A family history of febrile seizures was significantly more frequent in the Fc group than in the aFc group (28.0% vs 9.2%, P = 0.005). Clinical characteristics were similar between the rotavirus and norovirus groups, but fever was significantly more frequent in the rotavirus group (46.2% vs 8.3%, P < 0.001). Serum sodium levels were significantly negatively related to the number of seizures in the aFc group (β = -0.13; 95% confidence interval, -0.24, -0.03; P = 0.01). Carbamazepine was significantly more efficacious than diazepam suppositories in the aFc group (odds ratio = 49.3, 95% confidence interval, 2.35, 1037; P = 0.01). CONCLUSION: Febrile convulsions with mild gastroenteritis show characteristics of both febrile seizures and convulsions with mild gastroenteritis. Carbamazepine is optimal for convulsions with mild gastroenteritis. Clinical features of convulsions with rotavirus and norovirus gastroenteritis are similar, except for fever. Serum sodium levels may play a major role in the onset of convulsions with mild gastroenteritis.

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  • Radiofrequency ablation of pulmonary metastases from sarcoma: single-center retrospective evaluation of 46 patients. 査読

    Takuya Sato, Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Jun Sakurai, Yusuke Matsui, Toshiharu Mitsuhashi, Junichi Soh, Shinichi Toyooka, Susumu Kanazawa

    Japanese journal of radiology   35 ( 2 )   61 - 67   2017年2月

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    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  

    PURPOSE: This retrospective, single-center study evaluated radiofrequency (RF) ablation for pulmonary metastases of sarcoma. MATERIALS AND METHODS: Forty-six patients with sarcoma (144 pulmonary metastases) underwent 88 RF ablation sessions. Data regarding local tumor progression, efficacy, procedural adverse events (AEs; National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0), overall survival (OS), and OS-associated prognostic factors were retrospectively evaluated using univariate analyses. RESULTS: Local progression occurred in 22 of 144 tumors (15.3%). Primary and secondary efficacy rates were 83.5 and 90.0% at 1 year and 76.3 and 81.4% at 2 years, respectively. Seventy-three grade 1 AEs, 33 grade 2 AEs, and no grade ≥ 3 AEs were observed. Twenty-eight patients (60.9%) remained alive and 18 died, yielding 1-, 2-, and 3-year OS rates of 80.6, 70.1, and 47.1% (median survival time, 31.7 months). Univariate analysis revealed extrapulmonary metastasis (P = 0.005), noncurative RF ablation (P = 0.009), and a post-RF ablation disease-free interval of ≤12 months (P = 0.015) as significant negative prognostic factors. CONCLUSION: RF ablation is safe, offers good local control, and may be a viable treatment option for pulmonary metastasis of sarcoma.

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  • A typology of four notions of confounding in epidemiology. 査読

    Etsuji Suzuki, Toshiharu Mitsuhashi, Toshihide Tsuda, Eiji Yamamoto

    Journal of epidemiology   27 ( 2 )   49 - 55   2017年2月

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

    Confounding is a major concern in epidemiology. Despite its significance, the different notions of confounding have not been fully appreciated in the literature, leading to confusion of causal concepts in epidemiology. In this article, we aim to highlight the importance of differentiating between the subtly different notions of confounding from the perspective of counterfactual reasoning. By using a simple example, we illustrate the significance of considering the distribution of response types to distinguish causation from association, highlighting that confounding depends not only on the population chosen as the target of inference, but also on the notions of confounding in distribution and confounding in measure. This point has been relatively underappreciated, partly because some literature on the concept of confounding has only used the exposed and unexposed groups as the target populations, while it would be helpful to use the total population as the target population. Moreover, to clarify a further distinction between confounding "in expectation" and "realized" confounding, we illustrate the usefulness of examining the distribution of exposure status in the target population. To grasp the explicit distinction between confounding in expectation and realized confounding, we need to understand the mechanism that generates exposure events, not the product of that mechanism. Finally, we graphically illustrate this point, highlighting the usefulness of directed acyclic graphs in examining the presence of confounding in distribution, in the notion of confounding in expectation.

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  • Impact of Cushing's sign in the prehospital setting on predicting the need for immediate neurosurgical intervention in trauma patients: a nationwide retrospective observational study. 査読 国際誌

    Tetsuya Yumoto, Toshiharu Mitsuhashi, Yasuaki Yamakawa, Atsuyoshi Iida, Nobuyuki Nosaka, Kohei Tsukahara, Hiromichi Naito, Atsunori Nakao

    Scandinavian journal of trauma, resuscitation and emergency medicine   24 ( 1 )   147 - 147   2016年12月

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

    BACKGROUND: Cushing's reflex usually results from intracranial hypertension. Although Cushing's sign can implicate severe traumatic brain injury (TBI) in injured patients, no major investigations have been made. The purpose of this study was to assess the predictability of life-threatening brain injury requiring immediate neurosurgical intervention (LT-BI) among trauma patients with Cushing's sign in the prehospital setting. METHODS: This was a retrospective study using data from the Japan Trauma Data Bank from the period of 2010 to 2014. Patients 16 years old or older with blunt mechanisms of injury who were transported directly from the scene and Glasgow Coma Scale for eye opening of one in the prehospital setting were included. LT-BI was defined as patients requiring burr hole evacuation or craniotomy within 24 h of hospital arrival and patients who were non-survivors due to isolated severe TBI. Prehospital systolic blood pressure (pSBP) and heart rate (pHR) were assessed using area under the receiver operating characteristic curve (AUROC) and multiple logistic regression analysis to predict LT-BI. RESULTS: Of 6332 eligible patients, 1859 (29%) exhibited LT-BI. AUROC of LT-BI using pSBP and pHR was 0.666 (95% confidence interval (CI); 0.652-0.681, P < 0.001), and 0.578 (95% CI; 0.563-0.594, P < 0.001), respectively. AUROC of pSBP was the highest among the 60 ≤ pHR ≤ 99 subgroup, of which AUROC was 0.680 (95% CI; 0.662-0.699, P < 0.001). Multiple logistic regression analysis showed that the higher the pSBP and the lower the pHR, the more likely that the patients had LT-BI. In a group with pSBP ≥ 180 mmHg and pHR ≤ 59 beats/min, the odds ratio and 95% CI of LT-BI after adjusting for age, sex, and severity of injuries to other body regions was 4.77 (2.85-7.97), P < 0.001 was compared with the reference group, which was defined as patients with normal vital signs. DISCUSSION: Our study has found that the combination of hypertension and bradycardia, which are the components of Cushing's sign without eye opening in the prehospital setting was a weak but a significant predictor of LT-BI, or death due to possible isolated severe TBI. CONCLUSIONS: Prehospital Cushing's sign with disturbed level of consciousness in trauma patients was a weak but significant predictor of the need for immediate neurosurgical intervention.

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  • Fracture of totally implanted central venous access devices: a propensity-score-matched comparison of risks for Groshong silicone versus polyurethane catheters. 査読 国際誌

    Soichi Kojima, Takao Hiraki, Hideo Gobara, Toshihiro Iguchi, Hiroyasu Fujiwara, Yusuke Matsui, Toshiharu Mitsuhashi, Susumu Kanazawa

    The journal of vascular access   17 ( 6 )   535 - 541   2016年11月

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

    PURPOSE: To evaluate retrospectively the fracture risk of totally implanted venous access devices connected to Groshong silicone (SC) versus polyurethane (PU) catheters, inserted via the internal jugular vein. MATERIALS AND METHODS: The study population comprised 384 SC and 221 PU central venous catheters implanted via the internal jugular vein. The presence of catheter fracture was evaluated. Variables possibly related to catheter fracture were evaluated. First, in order to determine the factors associated with fracture, fracture rates were compared with the log-rank test between the two groups divided by each of the variables. Then, in order to adjust for potential confounders, propensity-score matching of the variables was employed in the two catheter groups. Finally, the rates of fracture were compared between the two propensity-score-matched catheter groups. RESULTS: There were 16 cases of catheter fracture, for an overall fracture percentage of 2.6% (16/605). All 16 cases of fracture occurred in the SC catheter group. Smaller patient body mass index (p = 0.039), deeper catheter tip position (p = 0.022), and SC catheters (p = 0.019) were significantly associated with fracture. With the propensity-score-matching method, 180 cases were selected in each catheter group. Comparison of the two propensity-score-matched groups showed that fracture rates for SC catheters remained significantly (p = 0.018) higher than those for PU catheters. CONCLUSIONS: Ports connected to Groshong SC catheters - when implanted via the internal jugular vein - posed a higher risk of fracture than did ports connected to PU catheters.

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  • Errors in causal inference: an organizational schema for systematic error and random error. 査読 国際誌

    Etsuji Suzuki, Toshihide Tsuda, Toshiharu Mitsuhashi, Mohammad Ali Mansournia, Eiji Yamamoto

    Annals of epidemiology   26 ( 11 )   788 - 793   2016年11月

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

    PURPOSE: To provide an organizational schema for systematic error and random error in estimating causal measures, aimed at clarifying the concept of errors from the perspective of causal inference. METHODS: We propose to divide systematic error into structural error and analytic error. With regard to random error, our schema shows its four major sources: nondeterministic counterfactuals, sampling variability, a mechanism that generates exposure events and measurement variability. RESULTS: Structural error is defined from the perspective of counterfactual reasoning and divided into nonexchangeability bias (which comprises confounding bias and selection bias) and measurement bias. Directed acyclic graphs are useful to illustrate this kind of error. Nonexchangeability bias implies a lack of "exchangeability" between the selected exposed and unexposed groups. A lack of exchangeability is not a primary concern of measurement bias, justifying its separation from confounding bias and selection bias. Many forms of analytic errors result from the small-sample properties of the estimator used and vanish asymptotically. Analytic error also results from wrong (misspecified) statistical models and inappropriate statistical methods. CONCLUSIONS: Our organizational schema is helpful for understanding the relationship between systematic error and random error from a previously less investigated aspect, enabling us to better understand the relationship between accuracy, validity, and precision.

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  • Single Center Prospective Phase II Trial of CT-guided Radiofrequency Ablation for Pulmonary Metastases from Colorectal Cancer (SCIRO-1401). 査読

    Jun Sakurai, Yusuke Matsui, Takao Hiraki, Toshihiro Iguchi, Hiroyasu Fujiwara, Hideo Gobara, Toshiharu Mitsuhashi, Takeshi Nagasaka, Susumu Kanazawa

    Acta medica Okayama   70 ( 4 )   317 - 21   2016年8月

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    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 present single center prospective phase II clinical trial is designed to evaluate the efficacy and safety of percutaneous radiofrequency (RF) ablation for colorectal lung metastases. Patients who have colorectal lung metastases without extrapulmonary metastases are included in this study. The primary endpoint is 3-year overall survival (OS) after RF ablation. The secondary endpoints are the prevalence of adverse events within 4 weeks, local tumor progression rate, 1- and 5-year OS, cause-specific survival, and relapse-free survival. The recruitment of patients commenced in July 2014, and the enrolment of 45 patients is intended over the 3 years of study period.

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  • A phase 1, dose-finding and pharmacokinetic study of gemcitabine with nab-paclitaxel in patients with metastatic breast cancer. 査読 国際誌

    Seiji Yoshitomi, Naruto Taira, Hiroyoshi Doihara, Taeko Mizoo, Tomohiro Nogami, Takayuki Iwamoto, Takayuki Motoki, Tadahiko Shien, Yutaka Ogasawara, Junji Matsuoka, Hisashi Tsuji, Toshiharu Mitsuhashi

    Cancer chemotherapy and pharmacology   78 ( 2 )   289 - 94   2016年8月

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    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  

    PURPOSE: Gemcitabine (Gem) with paclitaxel (Pac) is used for patients with metastatic breast cancer who require cytoreduction with manageable toxicities. Nanoparticle albumin-bound (nab)-Pac exhibits better efficacy and reduces the risk of hypersensitivity reactions associated with solvent-based Pac. Therefore, Gem plus nab-Pac (GA) therapy may be effective for metastatic breast cancer. The purpose of this study was to determine the maximum tolerated dose for GA therapy. METHODS: The subjects were patients with metastatic breast cancer with performance status 0 or 1 and normal hepatic, renal and marrow function. Leukopenia, neutropenia or thrombocytopenia of grade 4, neutropenic fever, or non-hematological toxicity of grade 3 or higher during the 1st cycle, and chemotherapy-induced peripheral neurotoxicity of grade 2 or higher at the end of the 1st cycle were defined as dose-limiting toxicities (DLTs). Gem (1250 mg/m(2)) was administered on days 1 and 8. nab-Pac was administered at a starting dose of 180 mg/m(2) (cohort 1) and escalated to 220 mg/m(2) (cohort 2) and 260 mg/m(2) (cohort 3) on day 1 of the 21-day cycle, using a 3 + 3 design. RESULTS: Nine patients (n = 3, 3, and 3 in cohorts 1, 2, and 3, respectively) were included in the study (median age 56 years; range 43-75 years). DLTs did not occur in any cohorts. CONCLUSIONS: The initial recommend dose in GA therapy is 1250 mg/m(2) Gem and 260 mg/m(2) nab-Pac. It is well known that nab-Pac has cumulative toxicities, and thus the efficacy and safety of GA therapy require validation in a phase 2 study.

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  • Chronic interstitial pneumonia in young patients undergoing lung transplantation or autopsy: clinico-radiologic-pathologic observations from a single institution. 査読

    Mayu Uka, Toshihiro Iguchi, Katsuya Kato, Hidehiro Hayashi, Ichiro Yamadori, Toshiharu Mitsuhashi, Takahiro Oto, Shuhei Sato, Susumu Kanazawa

    Japanese journal of radiology   34 ( 7 )   515 - 22   2016年7月

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    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  

    PURPOSE: To retrospectively evaluate high-resolution computed tomography (HRCT) findings and clinical diagnoses of chronic interstitial pneumonia (IP) with a poor prognosis in young patients (≤50 years). MATERIALS AND METHODS: HRCT images of 8 men and 7 women (mean age 34.8 years) obtained before lung transplantation or autopsy were reviewed. After reviewing whole lung specimens and pathologic diagnoses, all patients were clinically diagnosed according to the 2010 idiopathic pulmonary fibrosis/usual interstitial pneumonia (IPF/UIP) consensus statement. RESULTS: HRCT images revealed intralobular reticular opacity, air cysts, ground glass opacity, traction bronchiectasis, and interlobular septal thickening. Intralobular reticular opacity was the most extensive finding. Abnormal findings existed predominantly in both the peripheral and lower lung zones in only 1 patient. Classifications of HRCT patterns were "UIP" (n = 2), "inconsistent with UIP" (n = 11), and "indeterminate UIP" (n = 2). Multidisciplinary diagnoses were "IPF/UIP" (n = 1), "possible IPF/UIP" (n = 1), "IP with connective tissue disease" (n = 7), "fibrotic nonspecific IP" (n = 1), and "unclassified IP" (n = 5). CONCLUSION: The most extensive HRCT finding was intralobular reticular opacity. Most HRCT images differed from typical IPF/UIP, and IPF/UIP was uncommon in young patients with chronic IP with a poor prognosis.

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  • Individual risk alleles of susceptibility to schizophrenia are associated with poor clinical and social outcomes. 査読 国際誌

    Shinji Sakamoto, Manabu Takaki, Yuko Okahisa, Yutaka Mizuki, Masatoshi Inagaki, Hiroshi Ujike, Toshiharu Mitsuhashi, Soshi Takao, Masashi Ikeda, Yosuke Uchitomi, Nakao Iwata, Norihito Yamada

    Journal of human genetics   61 ( 4 )   329 - 34   2016年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:NATURE PUBLISHING GROUP  

    Many patients with schizophrenia have poor clinical and social outcomes. Some risk alleles closely related to the onset of schizophrenia have been reported to be associated with their clinical phenotypes, but the direct relationship between genetic vulnerability to schizophrenia and clinical/social outcomes of schizophrenia, as evaluated by both practical clinical scales and 'real-world' function, has not been investigated. We evaluated the clinical and social outcomes of 455 Japanese patients with schizophrenia by severity of illness according to the Clinical Global Impression-Severity Scale (CGI-S) and social outcomes by social adjustment/maladjustment at 5 years after the first visit. We examined whether 46 single nucleotide polymorphisms (SNPs) selected from a Japanese genome-wide association study of susceptibility to schizophrenia were associated with clinical and social outcomes. We also investigated the polygenic risk scores of 46 SNPs. Allele-wise association analysis detected three SNPs, including rs2623659 in the CUB and Sushi multiple domains-1 (CSMD1) gene, associated with severity of illness at end point. The severity of illness at end point was associated with treatment response, but not with the severity of illness at baseline. Three SNPs, including rs2294424 in the C6orf105 gene, were associated with social outcomes. Point estimates of odds ratios showed positive relationships between polygenic risk scores and clinical/social outcomes; however, the results were not statistically significant. Because these results are exploratory, we need to replicate them with a larger sample in a future study.

    DOI: 10.1038/jhg.2015.153

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  • Radiofrequency Ablation of Lung Tumors Using a Multitined Expandable Electrode: Impact of the Electrode Array Diameter on Local Tumor Progression. 査読 国際誌

    Hiroki Ihara, Hideo Gobara, Takao Hiraki, Toshiharu Mitsuhashi, Toshihiro Iguchi, Hiroyasu Fujiwara, Yusuke Matsui, Junichi Soh, Shinichi Toyooka, Susumu Kanazawa

    Journal of vascular and interventional radiology : JVIR   27 ( 1 )   87 - 95   2016年1月

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

    PURPOSE: To retrospectively investigate the impact of the electrode array diameter on local tumor progression after lung radiofrequency ablation. MATERIALS AND METHODS: This study included 651 lung tumors treated using multitined expandable electrodes and followed for ≥ 6 months. The mean long-axis tumor diameter was 12 mm ± 7 (range, 2-42 mm). The difference between electrode array diameter and tumor diameter (DAT) was used to investigate the impact of the electrode array diameter. All tumors were classified into 2 groups according to various variables including DAT (≥ 10 mm or < 10 mm). The primary technique efficacy rates were calculated using Kaplan-Meier analysis and compared between the 2 groups of each variable using the log-rank test. In addition, crude and multivariate multilevel survival analyses were performed by sequentially including DAT and the other variables in 5 models. RESULTS: The median DAT for 651 tumors was 12 mm (range, -15 to 24 mm). The technique efficacy rate was significantly lower in the < 10 mm DAT group than in the ≥ 10 mm group (P < .001). In the crude and multivariate multilevel survival analyses, < 10 mm DAT was a significant risk factor for local progression in all models except model 5 (P = .067). In the ≥ 10 mm group, the technique efficacy rates were not significantly different between the 2 ≥ 10 mm DAT subgroups (10 to <15 mm DAT vs ≥ 15 mm DAT). CONCLUSIONS: DAT is an important risk factor for local progression. We recommend an electrode that is ≥ 10 mm larger than the tumor diameter.

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  • Predicting pleural invasion using HRCT and 18F-FDG PET/CT in lung adenocarcinoma with pleural contact. 査読

    Takashi Tanaka, Takayoshi Shinya, Shuhei Sato, Toshiharu Mitsuhashi, Koichi Ichimura, Junichi Soh, Shinichi Toyooka, Mitsumasa Kaji, Shinichiro Miyoshi, Susumu Kanazawa

    Annals of nuclear medicine   29 ( 9 )   757 - 65   2015年11月

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    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  

    OBJECTIVE: To evaluate the relevance of high-resolution computed tomography (HRCT) findings and fluorine-18-fluorodeoxyglucose ((18)F-FDG) uptake for risk stratification of visceral pleural invasion by lung adenocarcinoma. METHODS: The HRCT findings and (18)F-FDG uptake for lung adenocarcinomas with pleural contact on CT were retrospectively analyzed in 208 consecutive patients (94 females and 114 males; median age, 69.0 years) between January 2009 and December 2013, with institutional review board approval. The HRCT findings and maximum standardized uptake value (SUV max) were recorded for each patient. Multivariate logistic regression was used for statistical analysis, and subgroup analysis stratified for whole tumor size ≤ 3 cm was also performed. RESULTS: Multivariate analysis showed that SUV max [odds ratio (OR) 1.09, 95 % confidence interval (CI) 1.02-1.16, P = 0.014] and obtuse angle (OR 4.14, 95 % CI 1.97-8.74, P < 0.001) were significant independent predictors for visceral pleural invasion. Receiver operating characteristic (ROC) analysis showed that, compared with the multivariate models [area under the curve (Az) 0.819-0.829], SUV max alone (Az 0.815) was useful in predicting visceral pleural invasion. In the subgroup analysis, multivariate analysis showed that SUV max (OR 1.29, 95 % CI 1.12-1.50, P = 0.001) and contact length with the pleura (OR 1.13, 95 % CI 1.05-1.22, P = 0.001) were significant independent predictors for visceral pleural invasion. ROC analysis showed that SUV max alone (Az 0.844) showed similar diagnostic performance to the multivariate models (Az 0.845-0.857). CONCLUSIONS: SUV max alone and multivariate models including SUV max are useful for the prediction of visceral pleural invasion by lung adenocarcinoma.

    DOI: 10.1007/s12149-015-0999-x

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  • Risk factors for systemic air embolism as a complication of percutaneous CT-guided lung biopsy: multicenter case-control study. 査読 国際誌

    Hiroaki Ishii, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Hidefumi Mimura, Kotaro Yasui, Tetsuya Doke, Takashi Mukai, Hironori Kurokawa, Yoshitomo Ando, Soichiro Hase, Toshihiro Iguchi, Takayuki Yabuki, Kenichi Omae, Nobuhisa Tajiri, Toshiharu Mitsuhashi, Susumu Kanazawa

    Cardiovascular and interventional radiology   37 ( 5 )   1312 - 20   2014年10月

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    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  

    PURPOSE: To determine risk factors for systemic air embolism by percutaneous computed tomography (CT)-guided lung biopsy. METHODS: This case-control study used data from 2216 percutaneous lung biopsy procedures performed over 11 years at 12 institutions in Japan. Systemic air embolism was identified by retrospective review of CT images obtained during and immediately after the procedures. To fulfill our objective, multiple variables were compared between cases and controls with univariate analyses by using Student's t test and Fisher's exact test for numerical and categorical values, respectively. Multivariate logistic regression analysis was then performed using selected variables. RESULTS: Ten cases of systemic air embolism and 2,206 controls were identified. Univariate analyses showed that the lesions in the lower lobe (P = 0.025) and occurrence of parenchymal hemorrhage (P = 0.019) were significant risk factors. Multivariate analysis showed that the use of a larger biopsy needle was a significant risk factor (P = 0.014). CONCLUSION: Parenchymal hemorrhage during the procedure, lesions in the lower lobe, and the use of larger biopsy needles may be risk factors for systemic air embolism by percutaneous CT-guided lung biopsy. Our findings may provide clues toward minimizing the risk of this complication.

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  • A simple example as a pedagogical device? 査読 国際誌

    Etsuji Suzuki, Toshiharu Mitsuhashi, Toshihide Tsuda, Eiji Yamamoto

    Annals of epidemiology   24 ( 7 )   560 - 1   2014年7月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    DOI: 10.1016/j.annepidem.2014.04.003

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  • Alternative definitions of "proportion eliminated". 査読 国際誌

    Etsuji Suzuki, Toshiharu Mitsuhashi, Toshihide Tsuda, Eiji Yamamoto

    Epidemiology (Cambridge, Mass.)   25 ( 2 )   308 - 9   2014年3月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    DOI: 10.1097/EDE.0000000000000050

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  • A counterfactual approach to bias and effect modification in terms of response types. 査読 国際誌

    Etsuji Suzuki, Toshiharu Mitsuhashi, Toshihide Tsuda, Eiji Yamamoto

    BMC medical research methodology   13   101 - 101   2013年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The counterfactual approach provides a clear and coherent framework to think about a variety of important concepts related to causation. Meanwhile, directed acyclic graphs have been used as causal diagrams in epidemiologic research to visually summarize hypothetical relations among variables of interest, providing a clear understanding of underlying causal structures of bias and effect modification. In this study, the authors aim to further clarify the concepts of bias (confounding bias and selection bias) and effect modification in the counterfactual framework. METHODS: The authors show how theoretical data frequencies can be described by using unobservable response types both in observational studies and in randomized controlled trials. By using the descriptions of data frequencies, the authors show epidemiologic measures in terms of response types, demonstrating significant distinctions between association measures and effect measures. These descriptions also demonstrate sufficient conditions to estimate effect measures in observational studies. To illustrate the ideas, the authors show how directed acyclic graphs can be extended by integrating response types and observed variables. RESULTS: This study shows a hitherto unrecognized sufficient condition to estimate effect measures in observational studies by adjusting for confounding bias. The present findings would provide a further understanding of the assumption of conditional exchangeability, clarifying the link between the assumptions for making causal inferences in observational studies and the counterfactual approach. The extension of directed acyclic graphs using response types maintains the integrity of the original directed acyclic graphs, which allows one to understand the underlying causal structure discussed in this study. CONCLUSIONS: The present findings highlight that analytic adjustment for confounders in observational studies has consequences quite different from those of physical control in randomized controlled trials. In particular, the present findings would be of great use when demonstrating the inherent distinctions between observational studies and randomized controlled trials.

    DOI: 10.1186/1471-2288-13-101

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  • Shift work and diabetes mellitus among male workers in Japan: does the intensity of shift work matter? 査読

    Katsuhiko Ika, Etsuji Suzuki, Toshiharu Mitsuhashi, Soshi Takao, Hiroyuki Doi

    Acta medica Okayama   67 ( 1 )   25 - 33   2013年

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    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 purpose of this study was to examine the association between shift work and diabetes mellitus by separating shift workers according to the intensity of their shift work (seasonal shift work and continuous shift work). Between May and October 2009, we collected data from annual health checkups and questionnaires at a manufacturing company in Shizuoka, Japan. Questionnaires were returned by 1,601 workers (response rate: 96.2%, men/women = 1,314/287). Diabetes mellitus was defined as hemoglobin A1c ≥ 6.5% and fasting blood sugar ≥ 126 mg/dl. After exclusions, which included all the women and clerical workers because they did not work in shifts, we analyzed 475 skilled male workers. After adjusting for age, smoking status, frequency of alcohol consumption, and cohabitation status, odds ratios for diabetes mellitus were 0.98 (95% confidence interval [CI]: 0.28-4.81) and 2.10 (95% CI: 0.77-5.71) among seasonal shift workers and continuous shift workers, respectively, compared with non-shift workers. In an age-stratified analysis (<45 years vs. ≥45 years), the association between continuous shift work and diabetes mellitus was more pronounced among older participants. Compared with non-shift workers, the risk of diabetes mellitus was increased among continuous shift workers, whereas its effect is limited among seasonal shift workers.

    DOI: 10.18926/AMO/49254

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  • Influence of radiofrequency ablation of lung cancer on pulmonary function. 査読 国際誌

    Akihiro Tada, Takao Hiraki, Toshihiro Iguchi, Hideo Gobara, Hidefumi Mimura, Shinichi Toyooka, Katsuyuki Kiura, Toshihide Tsuda, Toshiharu Mitsuhashi, Susumu Kanazawa

    Cardiovascular and interventional radiology   35 ( 4 )   860 - 7   2012年8月

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    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  

    PURPOSE: The purpose of this study was to evaluate altered pulmonary function retrospectively after RFA. METHODS: This retrospective study comprised 41 ablation sessions for 39 patients (22 men and 17 women; mean age, 64.8 years). Vital capacity (VC) and forced expiratory volume in 1 s (FEV(1)) at 1 and 3 months after RFA were compared with the baseline (i.e., values before RFA). To evaluate the factors that influenced impaired pulmonary function, univariate analysis was performed by using multiple variables. If two or more variables were indicated as statistically significant by univariate analysis, these variables were subjected to multivariate analysis to identify independent factors. RESULTS: The mean VC and FEV(1) before RFA and 1 and 3 months after RFA were 3.04 and 2.24 l, 2.79 and 2.11 l, and 2.85 and 2.13 l, respectively. The values at 1 and 3 months were significantly lower than the baseline. Severe pleuritis after RFA was identified as the independent factor influencing impaired VC at 1 month (P = 0.003). For impaired FEV(1) at 1 month, only severe pleuritis (P = 0.01) was statistically significant by univariate analysis. At 3 months, severe pleuritis (VC, P = 0.019; FEV(1), P = 0.003) and an ablated parenchymal volume ≥20 cm(3) (VC, P = 0.047; FEV(1), P = 0.038) were independent factors for impaired VC and FEV(1). CONCLUSIONS: Pulmonary function decreased after RFA. RFA-induced severe pleuritis and ablation of a large volume of marginal parenchyma were associated with impaired pulmonary function.

    DOI: 10.1007/s00270-011-0221-z

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  • Phrenic nerve injury after radiofrequency ablation of lung tumors: retrospective evaluation of the incidence and risk factors. 査読 国際誌

    Yusuke Matsui, Takao Hiraki, Hideo Gobara, Mayu Uka, Yoshihisa Masaoka, Akihiro Tada, Shinichi Toyooka, Toshiharu Mitsuhashi, Hidefumi Mimura, Susumu Kanazawa

    Journal of vascular and interventional radiology : JVIR   23 ( 6 )   780 - 5   2012年6月

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

    PURPOSE: To retrospectively investigate the incidence of and risk factors for phrenic nerve injury after radiofrequency (RF) ablation of lung tumors. MATERIALS AND METHODS: The study included 814 RF ablation procedures of lung tumors. To evaluate the development of phrenic nerve injury, chest radiographs obtained before and after the procedure were examined. Phrenic nerve injury was assumed to have developed if the diaphragmatic level was elevated after the procedure. To identify risk factors for phrenic nerve injury, multiple variables were compared between cases of phrenic nerve injury and randomly selected controls by using univariate analyses. Multivariate analysis was then performed to identify independent risk factors. RESULTS: Evaluation of phrenic nerve injury from chest radiographs was possible after 786 procedures. Evidence of phrenic nerve injury developed after 10 cases (1.3%). Univariate analysis revealed that larger tumor size (≥ 20 mm; P = .014), proximity of the phrenic nerve to the tumor (< 10 mm; P < .001), the use of larger electrodes (array diameter or noninsulated tip length ≥ 3 cm; P = .001), and higher maximum power applied during ablation (≥ 100 W; P < .001) were significantly associated with the development of phrenic nerve injury. Multivariate analysis demonstrated that the proximity of the phrenic nerve to the tumor (< 10 mm; P < .001) was a significant independent risk factor. CONCLUSIONS: The incidence of phrenic nerve injury after RF ablation was 1.3%. The proximity of the phrenic nerve to the tumor was an independent risk factor for phrenic nerve injury.

    DOI: 10.1016/j.jvir.2012.02.014

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  • Maternal working hours and early childhood overweight in Japan: a population-based study. 査読 国際誌

    Toshiharu Mitsuhashi, Etsuji Suzuki, Soshi Takao, Hiroyuki Doi

    Journal of occupational health   54 ( 1 )   25 - 33   2012年

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    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 OCCUPATIONAL HEALTH  

    OBJECTIVES: There has been a growing concern that maternal employment could have adverse or beneficial effects on children's health. Although recent studies demonstrated that maternal employment was associated with a higher risk of childhood overweight, the evidence remains sparse in Asian countries. We sought to examine the relationship between maternal working hours and early childhood overweight in a rural town in Okayama Prefecture. METHODS: In February 2008, questionnaires were sent to parents of all preschool children aged ≥3 yr in the town to assess maternal working status (working hours and form of employment), children's body mass index, and potential confounders. Childhood overweight was defined following the age and sex-specific criteria of the International Obesity Task Force. Odds ratios (ORs) and 95% confidence intervals (CIs) for childhood overweight were estimated in a logistic regression. We used generalized estimating equations with an exchangeable correlation matrix, considering the correlation between siblings. RESULTS: We analyzed 364 preschool children. Adjusting for each child's characteristics (age, sex), mother's characteristics (age, obesity, educational attainment, smoking status, and social participation), and family's characteristics (number of siblings), children whose mothers work <8 h/day had a substantially lower risk for being overweight (OR: 0.28, 95% CI: 0.09, 0.93) compared with children of non-working mothers, whereas the relationship was less pronounced among children whose mothers work ≥8 h/day (OR: 0.71, 95% CI: 0.19, 2.68). We observed similar patterns in a stratified analysis by the form of maternal employment. CONCLUSION: Short maternal working hours are associated with a lower odds of early childhood overweight.

    DOI: 10.1539/joh.11-0100-OA

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  • Preoperative graft volume assessment with 3D-CT volumetry in living-donor lobar lung transplantations. 査読

    Katsuhide Kojima, Katsuya Kato, Takahiro Oto, Toshiharu Mitsuhashi, Takayoshi Shinya, Tetsuro Sei, Yoshihiro Okumura, Shuhei Sato, Shinichiro Miyoshi, Susumu Kanazawa

    Acta medica Okayama   65 ( 4 )   265 - 8   2011年8月

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    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 effectiveness of living-donor lobar lung transplantation (LDLLT), it is necessary to predict the recipient's postoperative lung function. Traditionally, Date's formula, also called the segmental ratio, has used the number of lung segments to estimate the forced vital capacity (FVC) of grafts in LDLLT. To provide a more precise estimate of graft FVC, we calculated the volumes of the lower lobe and total lung using three-dimensional computed tomography (3D-CT) and the volume ratio between them. We calculated the volume ratio in 52 donors and tested the difference between the segmental volume ratios with a one-tailed t-test. We also calculated the predicted graft FVC in 21 LDLLTs using the segmental ratio pFVC(c) and the volume ratio pFVC(v), and then found the Pearson's correlation coefficients for both pFVC(c) and pFVC(v) with the recipients' actual FVC (rFVC) measured spirometrically 6 months after surgery. Significant differences were found between the segmental ratio and the average volume ratio for both sides (right, p=0.03;left, p=0.0003). Both pFVC(c) and pFVC(v) correlated significantly with rFVC at 6 months after surgery (p=0.007 and 0.006). Both the conventional and the volumetric methods provided FVC predictions that correlated significantly with measured postoperative FVC.

    DOI: 10.18926/AMO/46852

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  • Evaluation of an internet-based self-help program for better quality of sleep among Japanese workers: a randomized controlled trial. 査読 国際誌

    Etsuji Suzuki, Masao Tsuchiya, Kumi Hirokawa, Toshiyo Taniguchi, Toshiharu Mitsuhashi, Norito Kawakami

    Journal of occupational health   50 ( 5 )   387 - 99   2008年

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    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 OCCUPATIONAL HEALTH  

    The effectiveness of Internet-based self-help programs for insomnia is still unclear. A randomized controlled trial was conducted to evaluate the effect of an Internet-based self-help program for better quality of sleep among adult workers. Forty-three volunteers were recruited and randomly assigned to either an intervention group (n=21) or a waiting-list group (n=22). The intervention group participated in a two-week Internet-based program, including selecting and daily practicing sleep-related target behaviors and monitoring those behaviors along with sleep quality. At the same time, each participant received automatically generated, personalized messages and reports both daily and weekly. A total of 12 intervention group participants and 18 waiting-list group participants completed questionnaires at baseline, post-intervention, and at a 3-wk follow-up. Subjective sleep quality was measured by a self-reported questionnaire developed for this study. The sleep quality score increased in the intervention group at post-intervention, with a significant interaction effect [F(1,28)=5.19, p=0.031]. Sleep-related behaviors also greatly increased in the intervention group at post-intervention, with a significant interaction effect [F(1,28)=7.14, p=0.012]. Sleep-onset latency reduced in the intervention group at follow-up, with a marginally significant effect [F(1,28)=3.52, p=0.071]. The Internet-based self-help program improves subjective sleep quality and sleep-onset latency among adult workers.

    DOI: 10.1539/joh.L7154

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  • [Utilization, needs, and related factors for e-learning and its application to education and training in occupational safety and health among enterprises in Japan]. 査読

    Toshiharu Mitsuhashi, Soshi Takao, Akizumi Tsutsumi, Norito Kawakami

    Sangyo eiseigaku zasshi = Journal of occupational health   48 ( 5 )   183 - 91   2006年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    In order to know utilization, needs, and related factors for e-learning and its application to education and training in occupational safety and health (OSH) among enterprises in Japan, a questionnaire survey was conducted of enterprises randomly selected from those with 1,000 or more employees and those with 999 or less (500 for each). Data from 134 (56 and 78, respectively) enterprises were analyzed (response rate, 13%). Among total enterprises, 19% had introduced and 16% planned to introduce e-learning. However, only 7% of larger enterprises and less than 3% of smaller enterprises used e-learning for education and training in OSH. On the other hand, 80-90% of enterprises responded positively to considering the use of e-learning for education and training on various OSH topics for various users. Highly rated merits of e-learning were "can use whenever", "can use anywhere"; and its highly rated obstacles were "cost", "individual PC not available", "insufficient information on efficacy". However, the merit "can monitor training" was significantly associated with the use/plan of e-learning. "Good contents not available" was more frequent among enterprises which used/planned e-learning. The study indicated a greater need for e-learning based OSH education and training, despite a currently low rate of its use. Improvement of e-learning platforms and contents, reduction of cost, and improvement of e-learning infrastructure at work may be needed to facilitate the use of e-learning in OSH.

    DOI: 10.1539/sangyoeisei.48.183

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MISC

  • 総合内科診療における骨密度低下に関する要因の検討

    安藤 明美, 三橋 利晴, 花山 宜久, 長谷川 功, 小比賀 美香子, 片岡 仁美, 大塚 文男

    日本内科学会雑誌   108 ( Suppl. )   270 - 270   2019年2月

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    記述言語:日本語   出版者・発行元:(一社)日本内科学会  

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  • eラーニングによるヘルスリテラシーへの教育効果 無作為化比較試験による検討

    三橋 利晴

    日本公衆衛生学会総会抄録集   77回   222 - 222   2018年10月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • 食物アレルギーと診断されることに伴う経済負担についての研究

    吉川 知伸, 三橋 利晴, 籔内 俊彦, 斎藤 有希惠, 藤井 洋輔, 津下 充, 八代 将登, 池田 政憲, 塚原 宏一

    日本小児アレルギー学会誌   32 ( 3 )   607 - 607   2018年8月

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    記述言語:日本語   出版者・発行元:日本小児アレルギー学会  

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  • 食物アレルギーと診断されることに伴う経済負担についての研究

    吉川 知伸, 三橋 利晴, 籔内 俊彦, 斎藤 有希惠, 藤井 洋輔, 津下 充, 八代 将登, 池田 政憲, 塚原 宏一

    日本小児アレルギー学会誌   32 ( 3 )   607 - 607   2018年8月

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    記述言語:日本語   出版者・発行元:(一社)日本小児アレルギー学会  

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  • 総合内科診療に診られた骨密度低下および骨粗鬆症発生の要因と特徴

    安藤 明美, 三橋 利晴, 花山 宜久, 灘 隆宏, 長谷川 功, 頼 冠名, 小比賀 美香子, 片岡 仁美, 大塚 文男

    日本病院総合診療医学会雑誌   14 ( 4 )   354 - 354   2018年7月

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    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  

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  • 総合内科診療に診られた骨密度低下および骨粗鬆症発生の要因と特徴

    安藤 明美, 三橋 利晴, 花山 宜久, 灘 隆宏, 長谷川 功, 頼 冠名, 小比賀 美香子, 片岡 仁美, 大塚 文男

    日本病院総合診療医学会雑誌   14 ( 4 )   354 - 354   2018年7月

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    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  

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  • エチルベンゼン業務従事による尿検査有所見への影響 後向きコホート研究

    三橋 利晴

    日本公衆衛生学会総会抄録集   76回   284 - 284   2017年10月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • 本邦のさまざまな医療機関における倫理委員会の現状と課題 臨床研究が効率よく実施されるために

    藤原 智洋, 藤井 政孝, 吉原 久美子, 大野 彩, 三橋 利晴, 丸山 貴之, 桑木 健司, 伊東 孝, 難波 志穂子, 尾崎 敏文, 樋之津 史郎

    日本整形外科学会雑誌   91 ( 2 )   S303 - S303   2017年3月

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  • 特定健診受診者の地域社会への態度に関連する因子の検討

    芳我 ちより, 三橋 利晴

    日本公衆衛生学会総会抄録集   75回   528 - 528   2016年10月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • 臨床研究デザインワークショップ参加者を対象とした統計学学習に関する調査研究

    三橋 利晴

    日本公衆衛生学会総会抄録集   75回   314 - 314   2016年10月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • インジウム曝露による呼吸器に関する自覚症状への影響 後向きコホート研究

    三橋 利晴

    産業衛生学雑誌   58 ( 臨増 )   283 - 283   2016年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • インジウム曝露による呼吸器に関する自覚症状への影響 後向きコホート研究

    三橋 利晴

    産業衛生学雑誌   58 ( 臨増 )   283 - 283   2016年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 新しい統合指針の導入により倫理審査体制はどう変化したか 倫理審査を兼任する整形外科医が読み取る倫理申請の現状とこれから

    藤原 智洋, 吉原 久美子, 大野 彩, 三橋 利晴, 丸山 貴之, 桑木 健志, 加藤 有加, 伊東 孝, 難波 志穂子, 樋之津 史郎, 尾崎 敏文

    日本整形外科学会雑誌   90 ( 3 )   S657 - S657   2016年3月

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    記述言語:日本語   出版者・発行元:(公社)日本整形外科学会  

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  • 「人を対象とする医学系研究に関する倫理指針」に対応する、研究責任者の手順書の作成

    角 栄里子, 三橋 利晴, 土井 麻理子, 片島 るみ, 武重 榮子, 藤井 比佐子, 中島 佐和子, 遠藤 佑輔, 二川 俊隆, 大村 美幸, 猪原 登志子, 横出 正之

    臨床薬理   46 ( Suppl. )   S153 - S153   2015年11月

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    記述言語:日本語   出版者・発行元:(一社)日本臨床薬理学会  

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  • 自殺予防期間中には自殺関連ツイート数の変動があるか? 時系列分析による検討結果

    三橋 利晴

    医療情報学連合大会論文集   35回   226 - 229   2015年11月

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    記述言語:日本語   出版者・発行元:(一社)日本医療情報学会  

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  • HPへのstaged CASは有効か? 日本からの発信 「過灌流症候群高リスク例に対する頸動脈ステント留置術に関する後ろ向き研究」結果報告

    菱川 朋人, 杉生 憲志, 三橋 利晴, 早川 幹人, 山上 宏, 坂井 信幸, 飯原 弘二, 小笠原 邦昭, 大石 英則, 伊藤 靖, 松丸 祐司, 吉村 紳一, STOP CHS研究班

    JNET: Journal of Neuroendovascular Therapy   9 ( 6 )   S200 - S200   2015年11月

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    記述言語:日本語   出版者・発行元:(NPO)日本脳神経血管内治療学会  

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  • オタク趣味は個人の主観的健康に影響を与えるか? ウェブアンケートを用いた横断研究

    三橋 利晴, 縄稚 翔一

    日本公衆衛生学会総会抄録集   74回   233 - 233   2015年10月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • 記述統計の結果を報告する際の検定の扱いについて CONSORT 2010声明とSTROBE声明を踏まえて

    鈴木 越治, 三橋 利晴, 高尾 総司, 津田 敏秀

    産業衛生学雑誌   57 ( 臨増 )   466 - 466   2015年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 検索語に「産業医」を用いたTwitterにおける話題成分の可視化 パイロット研究

    三橋 利晴

    産業衛生学雑誌   57 ( 臨増 )   434 - 434   2015年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • Twitterにおける検索語「産業医」を用いたメンションネットワーク パイロット研究

    三橋 利晴

    産業衛生学雑誌   56 ( 臨増 )   508 - 508   2014年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • EXTENDED CAUSAL DIAGRAMS INTEGRATING RESPONSE TYPES AND OBSERVED VARIABLES.

    Etsuji Suzuki, Toshiharu Mitsuhashi, Toshihide Tsuda, Eiji Yamamoto

    AMERICAN JOURNAL OF EPIDEMIOLOGY   177   S100 - S100   2013年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:OXFORD UNIV PRESS INC  

    Web of Science

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  • 企業におけるメタボリックシンドローム対策実施が労働者のBMIに及ぼす影響 傾向スコアを用いた解析

    三橋 利晴

    産業衛生学雑誌   55 ( 臨増 )   473 - 473   2013年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • ADC値と子宮頸癌放射線治療後の局所再発との関連性の検討

    勝井 邦彰, 中村 圭一郎, 尾形 毅, 三橋 利晴, 片山 敬久, 井田 健太郎, 武本 充広, 本郷 淳司, 上者 郁夫, 金澤 右

    日本医学放射線学会学術集会抄録集   72回   S344 - S345   2013年2月

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    記述言語:日本語   出版者・発行元:(公社)日本医学放射線学会  

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  • 日本人男性労働者における交替勤務と糖尿病の関連 不定期および常時交替勤務の比較

    井家 克彦, 鈴木 越治, 三橋 利晴, 小林 朋子, 高尾 総司

    産業衛生学雑誌   54 ( 臨増 )   444 - 444   2012年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 母親の労働時間と小児の過体重の関連 追加報告

    三橋 利晴, 鈴木 越治, 高尾 総司, 津田 敏秀, 土居 弘幸

    産業衛生学雑誌   54 ( 臨増 )   362 - 362   2012年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 個人レベルソーシャルキャピタルと主観的不健康 リソースジェネレーターを用いて

    小林 朋子, 岩瀬 敏秀, 三橋 利晴, 高尾 総司, 鈴木 越治

    産業衛生学雑誌   54 ( 臨増 )   503 - 503   2012年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 考察「しごとと健康」 職場における健康情報の管理

    三橋 利晴, 高尾 総司

    健康管理   ( 694 )   42 - 43   2012年4月

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    記述言語:日本語   出版者・発行元:(株)保健文化社  

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  • 考察「しごとと健康」 健康診断・事後措置の問題解決(5)

    高尾 総司, 三橋 利晴

    健康管理   ( 690 )   40 - 41   2011年12月

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    記述言語:日本語   出版者・発行元:(株)保健文化社  

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  • 日本の病院におけるソーシャル・ネットワークと看護師の主観的不健康

    岩瀬 敏秀, 三橋 利晴, 高尾 総司, 津田 敏秀, 土居 弘幸

    産業衛生学雑誌   53 ( 臨増 )   500 - 500   2011年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 交代勤務による糖尿病への影響

    井家 克彦, 鈴木 越治, 三橋 利晴, 小林 朋子, 高尾 総司

    産業衛生学雑誌   53 ( 臨増 )   470 - 470   2011年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 母親の就業時間と小児の肥満の関連

    三橋 利晴, 鈴木 越治, 高尾 総司, 津田 敏秀

    産業衛生学雑誌   53 ( 臨増 )   552 - 552   2011年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 日本の職場における安全衛生の取り組みと従業員の主観的不健康 岡山県働き盛りの健康支援のための実態調査

    岩瀬 敏秀, 三橋 利晴, 植嶋 一宗, 井家 克彦, 小林 朋子, 鈴木 越治, 高尾 総司

    産業衛生学雑誌   52 ( 臨増 )   613 - 613   2010年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 岡山県における企業の健康管理体制と従業員による客観的評価

    小林 朋子, 岩瀬 敏秀, 三橋 利晴, 植嶋 一宗, 井家 克彦, 鈴木 越治, 高尾 総司

    産業衛生学雑誌   52 ( 臨増 )   612 - 612   2010年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 企業の健康管理体制と実施状況の関連 サンプリング方法による相違

    井家 克彦, 三橋 利晴, 植嶋 一宗, 岩瀬 敏秀, 小林 朋子, 鈴木 越治, 高尾 総司

    産業衛生学雑誌   52 ( 臨増 )   611 - 611   2010年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 企業の安全衛生管理について取り組みと従業員のBMIと喫煙割合の関連 岡山県働き盛りの健康支援のための実態調査

    三橋 利晴, 植嶋 一宗, 岩瀬 敏秀, 井家 克彦, 小林 朋子, 鈴木 越治, 高尾 総司

    産業衛生学雑誌   52 ( 臨増 )   613 - 613   2010年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 職場における安全衛生の取り組みと従業員の主観的健康 岡山県働き盛りの健康支援のための実態調査

    高尾 総司, 鈴木 越治, 三橋 利晴, 岩瀬 敏秀, 植嶋 一宗, 井家 克彦, 小林 朋子, 土居 弘幸

    産業衛生学雑誌   52 ( 臨増 )   612 - 612   2010年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 産業医選任の有無と肥満と喫煙の関連性 ランダムサンプル群とコンビニエントサンプル群における対比

    植嶋 一宗, 岩瀬 敏秀, 三橋 利晴, 井家 克彦, 小林 朋子, 鈴木 越治, 高尾 総司

    産業衛生学雑誌   52 ( 臨増 )   614 - 614   2010年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • ソーシャル・キャピタルと健康に関する調査 リソースジェネレータ結果記述

    三橋 利晴, 岩瀬 敏秀, 高尾 総司, 浜田 淳, 松岡 宏明, 中瀬 克己, 則安 俊昭

    日本公衆衛生学会総会抄録集   68回   239 - 239   2009年10月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • ソーシャル・キャピタルと健康に関する調査

    岩瀬 敏秀, 三橋 利晴, 高尾 総司, 松岡 宏明, 中瀬 克己, 則安 俊昭, 土居 弘幸

    日本公衆衛生学会総会抄録集   68回   238 - 238   2009年10月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • 生体部分肺移植における術後呼吸機能予測のCTボリュームメトリーによる検討

    児島 克英, 加藤 勝也, 金澤 右, 大藤 剛宏, 山根 正修, 佐野 由文, 三橋 利晴

    移植   44 ( 3 )   267 - 267   2009年6月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 職場におけるリスクマネジメントに基づく過重労働対策の構築

    高尾 総司, 鈴木 越治, 神里 英吾, 三橋 利晴, 植嶋 一宗, 岩瀬 敏秀, 土居 弘幸

    産業衛生学雑誌   51 ( 臨増 )   639 - 639   2009年3月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 岡山県の企業における健康管理と従業員の主観的健康

    三橋 利晴, 高尾 総司, 土居 弘幸

    産業衛生学雑誌   51 ( 臨増 )   453 - 453   2009年3月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 小規模企業就労者の健康と職域健康増進への取り組みが企業業績に与える影響 製造業2社での予備調査を踏まえた質問紙票調査の設計

    川村 尚也, 濱井 和子, 三橋 利晴

    産業衛生学雑誌   51 ( 臨増 )   435 - 435   2009年3月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 生体部分肺移植における術後呼吸機能予測のCTボリュームメトリーによる検討

    児島 克英, 加藤 勝也, 金澤 右, 三橋 利晴, 大藤 剛宏

    日本医学放射線学会学術集会抄録集   68回   S188 - S189   2009年2月

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    記述言語:日本語   出版者・発行元:(公社)日本医学放射線学会  

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  • 企業の健康管理方針と従業員の主観的健康およびBMIの関連

    三橋 利晴, 高尾 総司, 土居 弘幸

    日本公衆衛生学会総会抄録集   67回   625 - 625   2008年10月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • わが国の企業におけるeラーニングとこれによる労働安全衛生教育の利用状況、ニーズおよび関連要因

    三橋 利晴, 高尾 総司, 堤 明純, 川上 憲人

    産業衛生学雑誌   48 ( 5 )   183 - 191   2006年9月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

    わが国の企業におけるeラーニングとこれによる労働安全衛生教育の利用状況、ニーズおよびその促進・阻害要因を明らかにするために、従業員1,000人以上と同999人以下の企業それぞれから500社を抽出し、質問票による調査を実施し、有効回答した合計134社(回答率13%、企業規模それぞれ56社、78社)のデータを分析した。全体で19%の企業がeラーニングを導入済み、さらに16%の企業が導入を検討中であった。しかしeラーニングによる労働安全衛生教育の実施は従業員1,000人以上の企業でも7%、999人以下の企業では3%未満と低かった。一方eラーニングによる労働安全衛生教育についてはどの対象者、コンテンツでも8〜9割の企業が受講させることを考えると回答していた。eラーニングの利点としては「いつでも受講できる」、「どこからでも受講できる」が、導入の問題点としては「コスト」、「パソコンが1人に1台ずつない」、「学習効果が不明確」であった。しかしeラーニングの導入済みあるいは検討中には、「受講状況が把握できる」が有意な関連を示した。「優良なコンテンツが得られない」という問題点は、eラーニング導入済み・検討中の企業に多かった。eラーニングによる労働安全衛生教育はまだ導入している企業は少ないが、そのニーズは高い。eラーニングおよびこれによる労働安全衛生教育の推進のために、eラーニングのシステムおよびコンテンツの改善、導入コストの低減、企業のeラーニング導入インフラの改善が必要と考えた。(著者抄録)

    DOI: 10.1539/sangyoeisei.48.183

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  • 職場における適正飲酒の行動介入プログラムの開発と評価 無作為化比較試験の途中経過

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  • D220 eラーニングによる労働安全衛生教育に関するニーズ・課題調査

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    産業衛生学雑誌   47 ( 0 )   511 - 511   2005年

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  • P3023 職場における適正飲酒の行動介入プログラムの開発と評価 : 無作為化比較試験の途中経過

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  • 赤血球による過酸化水素の分解について(9) 無カタラーゼ血液症が溶血に及ぼす影響

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共同研究・競争的資金等の研究

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担当授業科目

  • 生命倫理学入門2 (2021年度) 第4学期  - 金5~6

  • 社会医歯科学 (2021年度) 集中  - その他

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  • 疫学統計パッケージ演習 (2020年度) 特別  - その他

  • 社会医歯科学 (2020年度) 集中  - その他

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