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
Published Date 2015-04
Publication Title Acta Medica Okayama
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 英語
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/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
Published Date 2016-08
Publication Title Acta Medica Okayama
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 英語
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/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
Published Date 2020-02
Publication Title Acta Medica Okayama
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 英語
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/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
Published Date 2015-04
Publication Title Acta Medica Okayama
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 英語
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/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
Published Date 2019-12
Publication Title Acta Medica Okayama
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 英語
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/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
Published Date 2015-10
Publication Title Acta Medica Okayama
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 英語
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
Published Date 2016-06
Publication Title Acta Medica Okayama
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 英語
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/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
Published Date 2014-02
Publication Title Acta Medica Okayama
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 英語
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24553490
JaLCDOI 10.18926/AMO/49041
FullText URL 66_6_449.pdf
Author Hanayama, Yoshihisa| Uchida, Haruhito Adam| Nakamura, Yoshio| Makino, Hirofumi|
Abstract Angiotensin receptor blockers (ARBs) are the first-line antihypertensive agents. In clinical practice, it is often difficult to achieve the recommended blood pressure level by ARBs in their ordinal dosages alone. This study examined the practical efficacy of a combination therapy of ARB with thiazide diuretics for lowering morning home blood pressure (MHBP) in comparison to high-dose ARB therapy in patients with morning hypertension administered an ordinal dosage of ARB. This study was performed in a prospective, randomized, open-labeled and blind-endpoint fashion. Patients were considered to have morning hypertension when their self-measured systolic MHBPs were 135mmHg or higher, irrespective of their diastolic MHBP and office blood pressures (OBPs). Forty-eight outpatients with morning hypertension receiving the ordinal dosage of ARB were given either losartan/hydrochlorothiazide (n=26) or high-dose ARB (n=22) in place of their previously prescribed ARB. No change in any medication was permitted during this period. Decreases of both systolic and diastolic MHBP after 3 months of treatment were significantly greater in the losartan/hydrochlorothiazide group than in the high-dose ARB group (p<0.05, respectively). The ratio of adverse events was somewhat high (23.1% in the losartan/hydrochlorothiazide group, 9.1% in the high-dose ARB group, respectively). However, there were no significant differences in any particular adverse event between groups. This study suggested losartan/hydrochlorothiazide might be superior to high-dose ARB for reducing morning home blood pressure.
Keywords losartan hydrochlorothiazide morning blood pressure angiotensin II hyperuricemia
Amo Type Original Article
Published Date 2012-12
Publication Title Acta Medica Okayama
Volume volume66
Issue issue6
Publisher Okayama University Medical School
Start Page 449
End Page 459
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2012 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 23254579
Web of Science KeyUT 000312966100004
Related Url http://ousar.lib.okayama-u.ac.jp/metadata/49736
JaLCDOI 10.18926/AMO/31860
FullText URL fulltext.pdf
Author Kaihara, Masanobu| Nakamura, Yoshio| Sugimoto, Taro| Uchida, Haruhito A.| Norii, Hisanao| Hanayama, Yoshihisa| Makino, Hirofumi|
Abstract <p>We investigated the impact of olmesartan and temocapril on pancreatic islet beta-cells during the development of diabetes mellitus using Otsuka-Long-Evans-Tokushima Fatty (OLETF) rats. Four-week-old male OLETF rats were fed standard chow (untreated:n5), or chow containing either 0.005% olmesartan(n5) or 0.01% temocapril (n5) until being sacrificed at 35 weeks of age. Pancreas sections were double-stained with anti-insulin and anti-glucagon antibodies. The percent areas of beta-cells, alpha-cells and non-alpha-non-beta-cells were compared among groups. In untreated OLETF rats, the fasting plasma glucose (FPG) level was elevated at the 18th week and remained elevated until the 35th week. On the other hand, no significant elevation in FPG levels was observed in olmesartan- or temocapril-treated rats. Pancreatic islets from olmesartan-treated rats were significantly smaller in size as compared with those from untreated OLETF rats. Furthermore, the average area occupied by beta-cells as a fraction of the total area of an individual islet was significantly higher in olmesartan- or temocapril-treated rats than that in untreated OLETF rats. Olmesartan and temocapril both prevented the development of hyperglycemia, possibly through the prevention of islet beta-cell loss in spontaneously diabetic OLETF rats.</p>
Keywords angiotensin II type-1 receptor blocker angiotensin converting enzyme inhibitor pancreas insulin secretion Type 2 diabetes mellitus
Amo Type Original Article
Published Date 2009-02
Publication Title Acta Medica Okayama
Volume volume63
Issue issue1
Publisher Okayama University Medical School
Start Page 35
End Page 42
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 19247421
Web of Science KeyUT 000263730300005
JaLCDOI 10.18926/AMO/57370
FullText URL 73_5_403.pdf
Author Ando, Akemi| Mitsuhashi, Toshiharu| Honda, Mitsugi| Hanayama, Yoshihisa| Hasegawa, Kou| Obika, Mikako| Kataoka, Hitomi| Otsuka, Fumio|
Abstract 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.
Keywords bone mineral density (BMD) body mass index (BMI) female gender hypercalcemia osteoporosis
Amo Type Original Article
Published Date 2019-10
Publication Title Acta Medica Okayama
Volume volume73
Issue issue5
Publisher Okayama University Medical School
Start Page 403
End Page 411
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2019 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 31649366
Web of Science KeyUT 000491886600005