JaLCDOI 10.18926/AMO/30375
FullText URL fulltext.pdf
Author Mimura, Yukari| Ogura, Toshio| Yamauchi, Takayoshi| Otsuka, Fumio| Oishi, Tetsuya| Harada, Kazushi| Hashimoto, Masami| Ota, Zensuke|
Abstract

We recently reported that stimulation of the arginine vasopressin (AVP) V1-receptor enhanced the pressor response in spontaneously hypertensive rats (SHR). In the present study, we investigated acute changes in systolic blood pressure (SBP) and heart rate (HR) after intravenous injections of AVP, OPC-21268 (a V1-receptor antagonist), and OPC-31260 (a V2-receptor antagonist), in anesthetized DOCA-salt hypertensive rats (DOCA) and age-matched sham-operated Wistar rats (control) to determine whether the pressor effect is specific to SHR or is present in other hypertensive animal models. SBP increased significantly in DOCA rats 9 min after injection of AVP 5 ng/kg without a concomitant increase in HR. Neither OPC-21268 3mg/kg nor OPC-31260 3mg/kg caused significant changes in SBP or HR. SBP tended to increase when AVP was administered after injection of OPC-31260. HR increased significantly 15 min after the combined treatment with OPC-31260 and AVP in DOCA rats compared with control rats. SBP did not change significantly when AVP was administered after injection of OPC-21268 in DOCA or control rats, but HR decreased significantly from 1 to 4 min after injection of AVP in DOCA rats. Our results suggest that V1-receptor stimulation does not enhance the pressor response in the DOCA rat, which is a model of volume-dependent hypertension, suggesting that the AVP system, especially V1-receptor, is not as important in the development or maintenance of hypertension in DOCA rats as in SHR.

Keywords vasopressin DOCA-salt hypertensive rat V1-and V2-receptor antagonist spontaneously hypertesive rat(SHR) OPC-21268
Amo Type Article
Publication Title Acta Medica Okayama
Published Date 1995-08
Volume volume49
Issue issue4
Publisher Okayama University Medical School
Start Page 187
End Page 194
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
File Version publisher
Refereed True
PubMed ID 7502678
Web of Science KeyUT A1995RR97800002
JaLCDOI 10.18926/AMO/40128
FullText URL 64_4_213.pdf
Author Otani, Hiroyuki| Otsuka, Fumio| Inagaki, Kenichi| Suzuki, Jiro| Makino, Hirofumi|
Abstract Aldosterone production occurs in the adrenal cortex, and is regulated primarily by angiotensin II (Ang II), potassium and adrenocorticotropin (ACTH). In the presence of the aldosterone stimulators, steroidogenesis is further governed by local autocrine and/or paracrine factors in the adrenal cortex. We reported the presence of functional bone morphogenetic protein (BMP) system in the adrenal cortex and also demonstrated that BMP-6 increases Ang II-induced aldosterone production, which could be involved in the "aldosterone breakthrough" phenomenon. Aldosterone breakthrough is the phenomenon by which circulating aldosterone concentrations increase above pre-treatment levels after long-term therapy with ACE inhibitors or Ang II type 1 receptor antagonists (ARB). This phenomenon may lead to important clinical consequences since increased aldosterone in a high-salt state facilitates cardiovascular and renal damage in hypertensive patients. We found that long-term ARB treatment reverses the reduction of aldosterone synthesis by adrenocortical cells, thereby causing "cellular aldosterone breakthrough". The availability of BMP-6 in the adrenal cortex may be at least partly involved in the occurrence of cellular escape from aldosterone suppression under chronic treatment with ARB.
Keywords adrenal cortex angiotensin II aldosterone bone morphogenetic protein
Amo Type Review
Publication Title Acta Medica Okayama
Published Date 2010-08
Volume volume64
Issue issue4
Publisher Okayama University Medical School
Start Page 213
End Page 218
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 20802537
Web of Science KeyUT 000281384400001
JaLCDOI 10.18926/AMO/47015
FullText URL 65_5_329.pdf
Author Matsumoto, Yoshinori| Sada, Ken-ei| Takano, Mariko| Toyota, Noriko| Yamanaka, Ryutaro| Sugiyama, Koichi| Wakabayashi, Hiroshi| Kawabata, Tomoko| Otsuka, Fumio| Makino, Hirofumi|
Abstract It is well known that infection is one of the major causes of morbidity and mortality in rheumatic disease patients treated with high-dose glucocorticoids, especially in the early phase after achievement of disease remission. The aim of this study was to identify the risk factors for infection, with a focus on the dose of glucocorticoids administered, following the achievement of disease remission in rheumatic diseases patients. We retrospectively analyzed the medical records of rheumatic disease patients who had been treated with glucocorticoids. The primary endpoint was the incidence rate of infection during a period from 1 to 2 months after the commencement of treatment. From April 2006 to March 2010, 19 of 92 patients suffered from infection during the observation period. Age≧65 yrs, presence of interstitial pneumonia, diagnosis of systemic vasculitis and serum creatinine level≧2.0mg/dl were found to be univariate predictors for infection. However, only the presence of interstitial pneumonia was an independent risk factor for infection (HR=4.50, 95%CI=1.65 to 14.44) by the Cox proportional hazard model. Even after achievement of clinical remission, careful observation is needed for patients with interstitial pneumonia, more so than for those receiving high-dose glucocorticoids.
Keywords infection rheumatic disease glucocorticoids interstitial pneumonia risk factors
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-10
Volume volume65
Issue issue5
Publisher Okayama University Medical School
Start Page 329
End Page 334
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22037270
Web of Science KeyUT 000296116400007
JaLCDOI 10.18926/AMO/49665
FullText URL 67_2_75.pdf
Author Otsuka, Fumio|
Abstract New biological activities of bone morphogenetic proteins (BMPs) in the endocrine system have recently been revealed. The BMP system is composed of approximately 30 ligands and preferential combinations of type I and type II receptors. The BMP system not only induces bone formation but also plays unique tissue-specific roles in various organs. For instance, the ovarian BMP system is a physiological inhibitor of luteinization in growing ovarian follicles. In the ovary, the expression of oocyte-derived BMP-15 is critical for female reproduction. In the pituitary, BMP-4 is a key player for initial development of the anterior pituitary, while it is also functionally involved in some differentiated pituitary tumors, including prolactinoma and Cushingʼs disease. In the adrenal glands, BMP-6 and BMP-4 modulate aldosterone and catecholamine production, respectively, which contributes to a functional interaction between the cortex and medulla. In the present review, recent advances in BMP biology in the field of endocrinology are described and the possibility for clinical application of BMP activity is discussed.
Keywords bone morphogenetic protein folliculogenesis pituitary adenoma steroidogenesis transforming growth factor
Amo Type Review
Publication Title Acta Medica Okayama
Published Date 2013-04
Volume volume67
Issue issue2
Publisher Okayama University Medical School
Start Page 75
End Page 86
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2013 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 23603923
Web of Science KeyUT 000317801700001
JaLCDOI 10.18926/AMO/51067
FullText URL 67_4_227.pdf
Author Ryuko, Hiromasa| Otsuka, Fumio|
Abstract Primary care physicians often encounter patients with fever of unknown origin and without apparent causes. Recent advances in laboratory medicine have facilitated diagnostic procedures;however, it is still difficult to determine the critical febrile factor at an early stage. We reviewed the medical records of 174 patients who were admitted due to a chief complaint of fever (>37.5℃) to our hospital during the period from 2004 to 2010. The patients were categorized into patients with infection, inflammation, neoplasm and drug-induced fever. Based on the analysis done by category, it was revealed that the patient's age, body temperature and duration of fever were closely related to the final diagnosis. Serum CRP levels were significantly low in the nonbacterial infection group, while serum levels of sIL-2R were high in neoplasm and drug-induced cases. CRP level on admission was weakly but significantly correlated with body temperature, while duration of fever was inversely related to body temperature. The effectiveness of PET-CT and tissue biopsy for diagnosis was considerably high, particularly in the categories of neoplasm and nonspecific inflammation, respectively, though the effectiveness of bacterial culture was low. Thus, a careful review of physical and laboratory information including body temperature, CRP level, duration of fever, gender difference and history of medication is indispensable for diagnosis. Stepwise categorization and disease classification by comprehensive and systemic checkup are very helpful for determining the causes of fever.
Keywords computed tomography (CT) C-reactive protein (CRP) fluorodeoxyglucose positron emission tomography (FDG-PET) fever of unknown origin (FUO) soluble interleukin-2 receptor (sIL-2R)
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2013-08
Volume volume67
Issue issue4
Publisher Okayama University Medical School
Start Page 227
End Page 237
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2013 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 23970321
Web of Science KeyUT 000323470100004
Related Url http://ousar.lib.okayama-u.ac.jp/metadata/51947
JaLCDOI 10.18926/AMO/52145
FullText URL 68_1_53.pdf
Author Terasaka, Tomohiro| Ueta, Eijiro| Ebara, Hirotaka| Waseda, Koichi| Hanayama, Yoshihisa| Takaki, Akinobu| Kawabata, Tomoko| Sugiyama, Hitoshi| Hidan, Ko| Otsuka, Fumio|
Abstract A 64-year-old man suffering polyarthralgia and bone pain was referred to our hospital. Renal dysfunction, hypophosphatemia and increased levels of bone alkaline phosphatase were found. The patientʼs serum creatinine level had gradually increased after the initiation of adefovir dipivoxil administration for hepatitis B. In agreement with multifocal uptakes of bone scintigraphy, iliac bone biopsy revealed an abnormal increase in osteoid tissues. Reducing the dose of adefovir and initiating the administration of eldecalcitol were effective for reducing proteinuria and glucosuria, and for ameliorating bone pain with an increase in serum phosphate level. This case first showed a clinical course of hypophosphatemic osteomalacia caused by secondary Fanconiʼs syndrome for 8 years after adefovir administration. Early diagnosis is important for the reversibility of bone damage and for a better renal prognosis.
Keywords adefovir dipivoxil (ADV) eldecalcitol Fanconi's syndrome hypophosphatemia osteomalacia
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2014-02
Volume volume68
Issue issue1
Publisher Okayama University Medical School
Start Page 53
End Page 56
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24553490
JaLCDOI 10.18926/AMO/52402
FullText URL 68_2_57.pdf
Author Hagiya, Hideharu| Naito, Hiromichi| Hagioka, Shingo| Okahara, Shuji| Morimoto, Naoki| Kusano, Nobuchika| Otsuka, Fumio|
Abstract The effect of antibiotics during the perioperative period of percutaneous dilatational tracheostomy (PDT) is still controversial. A total of 297 patients who underwent the PDT procedure were divided into 2 groups:those administered antibiotics perioperatively and those not administered antibiotics. Wound infections were noted in 7 cases (incidence rate, 2.36%) and no death was recorded. Of the 69 patients without antibiotics, 5 developed wound infections (incidence rate, 7.25%), while only 2 of the 228 patients with antibiotics developed wound infections (incidence rate, 0.88%) (p=0.002;risk ratio, 8.82;95% confidence interval, 1.67-46.6). Of the 7 cases of wound infection, 5 cases occurred during the early period after PDT (within 7 days). Collectively, the present results suggest that prophylactic administration of antibiotics may prevent the incidence of PDT-induced wound infection, especially in the early phase after the PDT procedures. The need for antibiotics in PDT should be reconsidered.
Keywords airway management critically ill patient percutaneous dilatational tracheostomy surgical site infection
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2014-04
Volume volume68
Issue issue2
Publisher Okayama University Medical School
Start Page 57
End Page 62
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24743781
Web of Science KeyUT 000334652700001
JaLCDOI 10.18926/AMO/52658
FullText URL 68_3_171.pdf
Author Hagiya, Hideharu| Matsumoto, Mitsuaki| Yamasawa, Takahiko| Haruki, Yuto| Otsuka, Fumio|
Abstract A 79-year-old man who had undergone a right femoropopliteal (FP) bypass operation 6 weeks previously was diagnosed with vascular graft infection caused by Staphylococcus lugdunensis. Another FP bypass operation was performed, with long-term administration of antibiotics, and the patient eventually recovered well without any recurrences for over 2 years. Although S. lugdunens is classified as coagulase-negative Staphylococcus, its pathogenicity has been reported to be equal to that of S. aureus. Based on the literature review, the organism characteristically colonizes the inguinal area of human skin;thus, operations such as FP bypass grafting may place patients at a relatively high risk for infection by S. lugdunensis, a potentially high-pathogenicity organism.
Keywords coagulase-negative Staphylococcus (CNS) femoropopliteal (FP) bypass Staphylococcus lugdunensis vacuum-assisted closure (VAC) therapy vascular graft infection (VGI)
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2014-06
Volume volume68
Issue issue3
Publisher Okayama University Medical School
Start Page 171
End Page 175
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24942796
Web of Science KeyUT 000337655600007
JaLCDOI 10.18926/AMO/53341
FullText URL 69_2_119.pdf
Author Terasaka, Tomohiro| Hagiya, Hideharu| Kimura, Kosuke| Nada, Takahiro| Nakamura, Eri| Hanayama, Yoshihisa| Sugiyama, Hitoshi| Kobayashi, Yasuyuki| Yanai, Hiroyuki| Otsuka, Fumio|
Abstract We report the case of a 46-year-old hypertensive Japanese female with renal insufficiency related to unilateral renal hypoplasia. The patient was found to have developed paraganglioma in the retroperitoneal space over a 5-year period. Catecholamine-producing tumors are not usually recognized as conditions associated with renal hypoplasia. Our long-term observation of the patient eventually led us to the diagnosis of paraganglioma. In hypertensive patients with chronic kidney disease, not only the renin-angiotensin-aldosterone system but also catecholamine activity may be involved, particularly in the patients whose cases are complicated with unilateral renal hypoplasia.
Keywords catecholamine paraganglioma renal hypoplasia renovascular hypertension secondary hypertension
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2015-04
Volume volume69
Issue issue2
Publisher Okayama University Medical School
Start Page 119
End Page 122
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25899634
Web of Science KeyUT 000353181700007
JaLCDOI 10.18926/AMO/53342
FullText URL 69_2_123.pdf
Author Waseda, Koichi| Hagiya, Hideharu| Hanayama, Yoshihisa| Terasaka, Tomohiro| Kimura, Kosuke| Tsuzuki, Takao| Hasegawa, Kou| Nada, Takahiro| Nakamura, Eri| Murakami, Kazutoshi| Kondo, Eisei| Otsuka, Fumio|
Abstract An 81-year-old Japanese male with primary Sjögren syndrome (pSS) developed a low-grade fever and productive cough which were refractory to antibiotic therapy. Based on the high level of eosinophils observed in his bronchial alveolar lavage, he was diagnosed with chronic eosinophilic pneumonia (CEP) and successfully treated by oral prednisolone. Interstitial lung diseases associated with pSS (pSS-ILDs) usually present as nonspecific interstitial pneumonia or usual interstitial pneumonia; therefore, the present case is extremely unique in that the patientʼs condition was complicated with CEP. A diagnosis of advanced gallbladder cancer was made in the patientʼs clinical course, suggesting the advisability of a whole-body workup in cases of pSS, especially in elderly patients.
Keywords bronchial alveolar lavage eosinophilic pneumonia eosinophilia interstitial lung diseases Sjögren syndrome
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2015-04
Volume volume69
Issue issue2
Publisher Okayama University Medical School
Start Page 123
End Page 127
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25899635
Web of Science KeyUT 000353181700008
JaLCDOI 10.18926/AMO/53679
FullText URL 69_5_319.pdf
Author Hagiya, Hideharu| Iwamuro, Masaya| Tanaka, Takehiro| Hanayama, Yoshihisa| Otsuka, Fumio|
Abstract A 60-year-old woman with rheumatoid arthritis treated with methotrexate for a decade complained of slight epigastric discomfort. A positive cytomegalovirus (CMV) antigenemia test indicated the probability of CMV-related gastrointestinal infection, for which esophagogastroduodenoscopy was performed. Endoscopic findings showed a non-specific duodenal mucosal lesion;however, pathological investigation revealed evidence of CMV duodenitis. There is scarce information on the clinical and pathological features of CMV-related duodenitis, likely due to its low prevalence. CMV infection in the upper gastrointestinal tract should be considered as a differential diagnosis in high-risk individuals, particularly those with symptoms relating to the digestive system. Biopsy examinations are preferable for the definitive diagnosis of CMV gastrointestinal infection, even without specific endoscopic features.
Keywords antigenemia cytomegalovirus (CMV) gastrointestinal infection methotrexate opportunistic infection
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2015-10
Volume volume69
Issue issue5
Publisher Okayama University Medical School
Start Page 319
End Page 323
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26490030
Web of Science KeyUT 000365519600009
JaLCDOI 10.18926/AMO/54422
FullText URL 70_3_217.pdf
Author Waseda, Koichi| Ocho, Kazuki| Hasegawa, Kou| Kimura, Kosuke| Iwamuro, Masaya| Hanayama, Yoshihisa| Kondo, Eisei| Miyahara, Nobuaki| Otsuka, Fumio|
Abstract KL-6 is a glycoprotein found predominantly on type II pneumocytes and alveolar macrophages, and often shows increased serum levels in patients with interstitial pneumonia. We report a case of mycobacterium avium complex (MAC) infection whose disease activity was correlated with KL-6 levels in serum. During treatment of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) with prednisolone, chest image findings improved in association with decreased KL-6 levels. Following tapering of prednisolone, chest image findings deteriorated again as levels of KL-6 increased, suggesting recurrence of RA-ILD. Bronchoscopic examination revealed active MAC infection. Treatment of MAC infection not only improved chest image findings but also decreased KL-6 levels in serum, suggesting that KL-6 was increased by active MAC infection by itself, not by recurrence of RA-ILD. To the best of our knowledge, this is the first documentation of KL-6 elevation in serum in association with active MAC infection.
Keywords KL-6 mycobacterium avium complex pulmonary nontuberculous mycobacterium infection rheumatoid arthritis-associated interstitial lung disease bronchial alveolar lavage
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2016-06
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 217
End Page 221
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339212
Web of Science KeyUT 000379406100010
JaLCDOI 10.18926/AMO/54504
FullText URL 70_4_279.pdf
Author Nishimura, Yoshito| Iwamuro, Masaya| Ocho, Kazuki| Hasegawa, Kou| Kimura, Kosuke| Hanayama, Yoshihisa| Kondo, Eisei| Tanaka, Takehiro| Otsuka, Fumio|
Abstract A 61-year-old Japanese man with IgG4-related autoimmune pancreatitis was referred to our hospital because of perspiration during food intake. Abdominal computed tomography (CT) with contrast media revealed multiple mesenteric lymphadenopathies. An open surgical abdominal biopsy and subsequent histopathological analysis revealed abnormally large lymphoid cells that were negative for CD3, CD5, and c-myc and positive for CD20 and bcl-2, leading to a diagnosis of diffuse large B-cell lymphoma. Here, we discuss the risk of malignancies, particularly malignant lymphoma in patients with IgG4-related disease. The importance of pathological analysis to reach the appropriate diagnosis in such cases should be emphasized.
Keywords IgG4-related disease autoimmune pancreatitis immunophenotyping diffuse large B-cell lymphoma
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2016-08
Volume volume70
Issue issue4
Publisher Okayama University Medical School
Start Page 279
End Page 283
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27549673
Web of Science KeyUT 000384748600008
JaLCDOI 10.18926/AMO/54977
FullText URL 71_2_97.pdf
Author Iwamuro, Masaya| Kondo, Eisei| Tanaka, Takehiro| Hagiya, Hideharu| Kawano, Seiji| Kawahara, Yoshiro| Otsuka, Fumio| Okada, Hiroyuki|
Abstract We retrospectively analyzed the cases of 14 patients (9 women, 5 men, mean age: 51.6 years) with cytomegalovirus (CMV) involvement in the esophagus, stomach, and/or duodenum diagnosed at a single center, to determine their endoscopic features and clinical backgrounds. Thirteen patients (92.9%) had hematologic disease; the other had rheumatoid arthritis. Of the former, 12 patients underwent allogeneic hematopoietic stem cell transplantation, and 9 of these patients had graft-versus-host disease (GVHD) before undergoing esophagogastroduodenoscopy (EGD). All 14 patients had been taking one or more immunosuppressive agents including cyclosporine (n=10), corticosteroids (n=9), mycophenolic acid (n=6), tacrolimus (n=3), and methotrexate (n=1). Tests for CMV antigenemia were positive in 11 patients (78.6%). EGD examinations revealed esophageal (n=3), gastric (n=9), and duodenal involvement (n=6). Macroscopically, esophageal lesions by CMV infection presented as redness (n=1), erosions (n=1), and ulcers (n=1). Gastric lesions manifested as redness (n=7), erosions (n=3), exfoliated mucosa (n=2), and verrucous erosions (n=1). Mucosal appearances in the duodenum varied: redness (n=2), ulcers (n=2), multiple erosions (n=2), single erosion (n=1), edema (n=1). CMV was detected even in the intact duodenal mucosa (n=1). In conclusion, physicians must recall the relevance of CMV infection when any mucosal alterations exist in the upper gastrointestinal tract of immunosuppressed patients.
Keywords cytomegalovirus duodenum esophagogastroduodenoscopy esophagus stomach
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2017-04
Volume volume71
Issue issue2
Publisher Okayama University Medical School
Start Page 97
End Page 104
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 28420890
JaLCDOI 10.18926/AMO/57711
FullText URL 73_6_479.pdf
Author Suganami, Yu| Oka, Kosuke| Hanayama, Yoshihisa| Honda, Hiroyuki| Hamahara, Jun| Obika, Mikako| Kariyama, Kazuya| Kishida, Masayuki| Otsuka, Fumio|
Abstract To clarify the potential relevance of patients’ chief complaints at a general medicine department to their self-rating depression scale (SDS) and frequency scale for symptoms of gastroesophageal reflux disease (GERD) (FSSG) scores, we analyzed data of 478 patients who visited our general medicine department. The chief complaints (553 symptoms of 447 patients) were categorized into major symptom-based groups: respiratory (31%), circulatory (3%), gastrointestinal (GI) tract (26%), neurology (8%), orthopedic and skin (10%), and systemic (22%) symptoms. The SDS score tended to be higher in females and younger patients. The FSSG score did not differ by gender but was higher in younger patients. The patients receiving social welfare had higher SDS and FSSG scores. A close inter-relationship between the FSSG (including both degrees of reflux and dysmotility) and SDS was observed in all patients. Although the averages of the SDS and FSSG scores were not significantly different among the symptom-based categories, we observed significantly positive correlations between the FSSG and SDS in each category, suggesting that depressive status may be closely related to GERD-related symptoms regardless of the patients’ chief complaints. An initial checkup of patients’ psychological condition and/or GERD-like symptoms could help screen for latent disorders in outpatients with uncertain complaints.
Keywords chief complaints frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) self-rating depression scale (SDS) welfare
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2019-12
Volume volume73
Issue issue6
Publisher Okayama University Medical School
Start Page 479
End Page 486
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2019 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 31871329
Web of Science KeyUT 000503431400002
JaLCDOI 10.18926/AMO/57950
FullText URL 74_1_33.pdf
Author Honda, Hiroyuki| Hanayama, Yoshihisa| Obika, Mikako| Hasegawa, Kou| Hamahara, Jun| Kishida, Masayuki| Hagiya, Hideharu| Ogawa, Hiroko| Kataoka, Hitomi| Otsuka, Fumio|
Abstract A relationship between diabetes and depression is apparent. To clarify the clinical relevance of diabetic patients’ gastroesophageal symptoms to their psychological status, we retrospectively analyzed the data from a Selfrating Depression Scale (SDS) and a Frequency Scale for Symptoms of Gastroesophageal reflux disease (FSSG) among 143 type 2 diabetic patients who visited a general medicine department. Among the 45 Japanese patients enrolled, the group with relatively high SDS scores (≥ 36) showed higher (FSSG) dysmotility symptom scores versus the low-SDS (< 36) group, although the 2 groups’ characteristics and laboratory data were not significantly different. Positive correlations of postprandial plasma glucose (PPG) levels with FSSG scores (R=0.321, p<0.05), particularly with reflux scores (R=0.455, p<0.01) were revealed. PPG and HbA1c levels were not correlated with SDS scores. The patients’ SDS scores were significantly correlated with their FSSG scores (R=0.41, p<0.01), suggesting that depressive status is linked to GERD-related manifestations. Considering that the patients’ PPG levels were correlated with GERD-related symptoms, diabetic patients’ blood glucose levels are associated with depressive status. Collectively, key symptoms related to GERD and glucose level values would be helpful
Keywords blood glucose type 2 diabetes mellitus gastroesophageal reflux depressive status postprandial plasma glucose
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2020-02
Volume volume74
Issue issue1
Publisher Okayama University Medical School
Start Page 33
End Page 40
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2020 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 32099246
Web of Science KeyUT 000516606200005
NAID 120006795617
JaLCDOI 10.18926/AMO/60797
FullText URL 74_5_381.pdf
Author Yamamoto, Koichiro| Hanayama, Yoshihisa| Hasegawa, Kou| Tokumasu, Kazuki| Miyoshi, Tomoko| Hagiya, Hideharu| Ogawa, Hiroko| Obika, Mikako| Itoshima, Koichi| Otsuka, Fumio|
Abstract To clarify the relevance of prolactin (PRL) to clinical parameters in patients who visited our general medicine department, medical records of 353 patients in whom serum PRL levels were measured during the period from 2016 to 2018 were retrospectively reviewed. Data for 140 patients (M/F: 42/98) were analyzed after excluding patients lacking detailed records and patients taking dopaminergic agents. Median serum PRL levels were significantly lower in males than females: 6.5 ng/ml (IQR: 4.2-10.3) versus 8.1 ng/ml (5.9-12.9), respectively. Pain and general fatigue were the major symptoms at the first visit, and past histories of hypertension and dyslipidemia were frequent. Male patients with relatively high PRL levels (≥ 10 ng/ml) had significantly lower levels of serum albumin and significantly higher levels of serum LDH than those with low PRL (< 10 ng/ml). There were significant correlations of male PRL level with the erythrocyte sedimentation rate (R=0.62), serum LDH level (R=0.39) and serum albumin level (R=−0.52), while the level of serum CRP (R=0.33) showed an insignificant but weak positive correlation with PRL level. Collectively, these results show that PRL levels had gender-specific relevance to various clinical factors, with PRL levels in males being significantly related to inflammatory status.
Keywords hormones hyperprolactinemia inflammation pituitary prolactin
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2020-10
Volume volume74
Issue issue5
Publisher Okayama University Medical School
Start Page 381
End Page 389
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2020 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 33106693
Web of Science KeyUT 000581970100002
NAID 120006892923
JaLCDOI 10.18926/AMO/61424
FullText URL 75_1_1.pdf
Author Hamahara, Jun| Honda, Hiroyuki| Yamamoto, Koichiro| Tokumasu, Kazuki| Hanayama, Yoshihisa| Hagiya, Hideharu| Obika, Mikako| Ueda, Keigo| Kishida, Masayuki| Otsuka, Fumio|
Abstract To determine the clinical characteristics of low androgen status in adult males with diabetes, we retrospectively analyzed the medical records of patients with type 2 diabetes mellitus in whom serum free testosterone (FT) levels were examined for 1 year. Among the 46 patients (56 ± 1.5 years old), decreases in serum FT levels to < 8.5 pg/ml (indicating the occurrence of late-onset hypogonadism [LOH]) were detected in 18 (39%). The per-centages of patients with low FT levels were high in the ≥ 50 years age group (83%), the HbA1c < 7% group (67%), and the 25 ≤ BMI < 30 kg/m2 group (56%). The serum FT levels tended to decrease age-dependently. The level of HbA1c was significantly correlated with the Heinemann Aging Male Symptoms (AMS) score (R = 0.47). The low-FT group had decreased levels of hemoglobin. Of note, the serum FSH level (R = −0.32) was negatively correlated with the serum FT level, whereas the serum TSH level (R = 0.36) was positively correlated with the serum FT level. Collectively, these results revealed that many diabetic males may have low FT levels and that the AMS score is related to the HbA1c level. A slightly anemic condition, thyroid dysfunction, and obesity (class 1) might be involved in LOH in middle-aged diabetic males.
Keywords androgen diabetes mellitus late-onset hypogonadism testosterone thyroid function
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2021-02
Volume volume75
Issue issue1
Publisher Okayama University Medical School
Start Page 1
End Page 8
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2021 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 33649607
JaLCDOI 10.18926/AMO/64355
FullText URL 77_1_1.pdf
Author Nahar, Lutfun| Hagiya, Hideharu| Nada, Takahiro| Iio, Koji| Gotoh, Kazuyoshi| Matsushita, Osamu| Otsuka, Fumio|
Abstract Inducible resistance to the macrolide, lincosamide, and streptogramin B (iMLSB) antibiotic family is a latent mechanism for antimicrobial resistance in Staphylococcus aureus. We here investigated the frequency and genotypic profiles of iMLSB resistance in clindamycin (CLDM)-susceptible S. aureus isolated in Okayama University Hospital from June 2020 to June 2021. We phenotypically screened the iMLSB resistance via D-zone test and performed PCR testing for the erythromycin ribosomal methylase (erm) genes: ermA and ermC. Among 432 CLDM-susceptible S. aureus isolates, 138 (31.9%) exhibited an iMLSB-resistance phenotype, with methicillinresistant S. aureus isolates (MRSA; 61 isolates: 58.6%) exhibiting higher positivity than methicillin-sensitive S. aureus isolates (MSSA; 77 isolates: 23.5%) (p<0.001). Male patients had a higher frequency of iMLSB resistance than females (OR [95%CI]: 1.8 [1.2-2.8]; p=0.007). Genotypically, ermA predominated in both MSSA (70.1%) and MRSA (86.9%) compared to ermC (14.3% in MSSA and 11.5% in MRSA). A single strain of MRSA possessed both ermA and ermC, while 12 (15.6%) MSSA isolates were negative for both ermA and ermC, suggesting the presence of other genetic mechanisms. Collectively, these results show that approximately 33% of CLDM-susceptible S. aureus isolates at our university hospital exhibited iMLSB resistance, predominantly caused by ermA in both MSSA and MRSA.
Keywords antimicrobial resistance clindamycin erm D-zone test inducible MLSB
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2023-02
Volume volume77
Issue issue1
Publisher Okayama University Medical School
Start Page 1
End Page 9
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2023 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 36849140
Web of Science KeyUT 000953663800001
FullText URL K001796.pdf
Author 大塚 文男|
Published Date 1998-03-31
Content Type Thesis or Dissertation
Grant Number 甲第1796号
Granted Date 1998-03-31
Thesis Type Doctor of Philosophy in Medical Science
Grantor 岡山大学
language Japanese