研究者詳細 - 大脇　哲洋

講演・口頭発表等 - 大脇　哲洋

分割表示 633 件中 361 - 380 件目／全件表示 >>

Amitani M., Amitani H., Suzuki H., Kawazu S., Mizuma K., Yamaguchi K., Oki T., Nitta H., Sonoda T., Kawano K., Tanaka Y., Uto N., Ibusuki R., Arita R., Takayama S., Mitsuma T., Takezaki T., Asakawa A., Owaki T. . Application of objective structured clinical examination (OSCE) for the evaluation of Kampo medicine training . BMC Medical Education 2022年12月 BMC Medical Education

記述言語：日本語

Background: The purpose of this study was to develop an objective, content-valid, and reliable assessment method for Kampo medicine using an objective structured clinical examination (OSCE) for the assessment of clinical competence in Kampo medicine. Methods: We developed a blueprint followed by a list of 47 assessment items and three task scenarios related to clinical competence in Kampo medicine. An eight-member test committee checked the relevance of the assessment items on a Likert scale. We calculated a content validity index and content validity ratio, and used the Angoff method to set the passing threshold. We trained a total of nine simulated patients with three assigned to each scenario. We conducted an OSCE for 11 candidates with varying medical abilities, and conducted three stations per person, which were evaluated by one evaluator in one room by direct observation. We used video recordings to test the inter-rater reliability of the three raters. We used the test results to verify the reliability of the assessment chart. Results: The inter-rater reliability (intraclass correlation coefficient [2,1]) was 0.973. The reliability of the assessment chart for each scenario (Cronbach’s α) was 0.86, 0.89, and 0.85 for Scenarios 1, 2, and 3, respectively. The reliability of the assessment chart for the whole OSCE (Cronbach’s α) was 0.90. Conclusions: We developed a content-valid new OSCE assessment method for Kampo medicine and obtained high inter-rater and test reliabilities. Our findings suggest that this is one of the most reliable evaluation methods for assessing clinical competence in Kampo medicine.

DOI： 10.1186/s12909-022-03264-3

Arigami T., Okumura H., Matsumoto M., Uchikado Y., Uenosono Y., Kita Y., Owaki T., Mori S., Kurahara H., Kijima Y., Ishigami S., Natsugoe S. . Analysis of the fibrinogen and neutrophil-lymphocyte ratio in esophageal squamous cell carcinoma . Medicine (United States) 2015年10月 Medicine (United States)

記述言語：日本語

Esophageal squamous cell carcinoma (ESCC) is one of the most aggressive malignancies in gastrointestinal tract cancers and even patients with early ESCC have a high metastatic potential. Difficulties are associated with clinically predicting tumor progression and prognosis based on conventional tumor markers determined from preoperative blood examinations. The aim of the present study was to measure plasma fibrinogen levels and the neutrophil-lymphocyte ratio (NLR) in blood and compare the clinical impacts of their combined values (fibrinogen and neutrophil-lymphocyte ratio score-F-NLR score) and the modified Glasgow Prognostic Score (mGPS) in patients with ESCC. We classified 238 patients with ESCC based on cut-off values for hyperfibrinogenemia (400 mg/dL) and high NLR (3.0) as F-NLR scores of 2 (both of these hematological abnormalities), 1 (one of these abnormalities), or 0 (neither abnormality). We also categorized patients based on cut-off values for high C-reactive protein (CRP) (0.5 mg/dL) and hypoalbuminemia (3.8 g/dL) as mGPS of 2 (elevated CRP and hypoalbuminemia), 1 (either elevated CRP or hypoalbuminemia), or 0 (neither elevated CRP nor hypoalbuminemia). The F-NLR score correlated with the depth of tumor invasion, lymph node metastasis, lymphovascular invasion, tumor size, and stage (all P0.05). Prognoses among the groups based on the F-NLR score and mGPS significantly differed (all P0.001). A multivariate analysis identified the depth of tumor invasion, lymph node metastasis, and FNLR score as independent prognostic factors (P=0.002, P=0.007, and P=0.037, respectively). The results of the present study showed that the F-NLR score is a promising blood predictor for tumor progression and outcomes in patients with ESCC.

DOI： 10.1097/MD.0000000000001702

Nishi J., Yoshinaga M., Miyanohara H., Kawahara M., Kawabata M., Motoya T., Owaki T., Oiso S., Kawakami M., Kamewari S., Koyama Y., Wakimoto N., Tokuda K., Manago K., Maruyama I. . An epidemiologic survey of methicillin-resistant Staphylococcus aureus by combined use of mec-HVR genotyping and toxin genotyping in a University Hospital in Japan . Infection Control and Hospital Epidemiology 2002年9月 Infection Control and Hospital Epidemiology

記述言語：日本語

OBJECTIVE: To evaluate the usefulness of an assay using two polymerase chain reaction-based genotyping methods in the practical surveillance of methicillin-resistant Staphylococcus aureus (MRSA). METHODS: Nosocomial infection and colonization were surveyed monthly in a university hospital in Japan for 20 months. Genotyping with mec-HVR is based on the size of the mec-associated hypervariable region amplified by polymerase chain reaction. Toxin genotyping uses a multiplex polymerase chain reaction method to amplify eight staphylococcal toxin genes. RESULTS: Eight hundred nine MRSA isolates were classified into 49 genotypes. We observed differing prevalences of genotypes for different hospital wards, and could rapidly demonstrate the similarity of genotype for outbreak isolates. The incidence of genotype D: SEC/TSST1 was significantly higher in isolates causing nosocomial infections (49.5%; 48 of 97) than in nasal isolates (31.4%; 54 of 172) (P = .004), suggesting that this genotype may represent the nosocomial strains. CONCLUSION: The combined use of these two genotyping methods resulted in improved discriminatory ability and should be further investigated. © 2002 The Society for Healthcare Epidemiology of America.

DOI： 10.1086/502097

大脇哲洋, 吉中平次, 高松英夫, 臼井和恵, 村永文学, 宇都由美子, 熊本一朗 . インシデント報告におけるチューブトラブルの解析 . 医科器械学 2004年2月一般社団法人日本医療機器学会

Kijima Y., Matsukita S., Yoshinaka H., Owaki T., Aikou T. . Adenoma of the nipple: report of a case. . Breast cancer (Tokyo, Japan) 2006年日本乳癌学会

記述言語：英語

We report a case of an adenoma of the nipple in a 33-year-old Japanese woman who presented with a 2-year history of itching, eczema, and discharge from the left nipple. Examination revealed a firm, well defined and erosive tumor measuring 10 x 11 mm that was sore, crusted, and indurated. There was a slight serosanguineous discharge from the tumor. Cytological material from the tumor obtained from the discharge and by fine needle aspiration (FNA) and scraping showed a papillary cell cluster thought to be a benign papilloma.We performed a tumor resection with preservation of the nipple. The histological diagnosis was adenoma of the nipple. The patient was left with a cosmetically well-preserved nipple. No recurrent tumor has been observed for two years after surgery.

DOI： 10.2325/jbcs.13.95

辺木文平, 奥村浩, 尾本至, 松本正隆, 内門泰斗, 瀬戸山徹郎, 佐々木健, 大脇哲洋, 石神純也, 夏越祥次 . 巨大な胃壁内転移と4群リンパ節転移を伴った表層拡大型食道表在癌の1例 . 日本消化器外科学会雑誌 2012年一般社団法人日本消化器外科学会

記述言語：日本語

症例は51歳の女性で，上腹部違和感を主訴に近医受診された．内視鏡検査で，胸部食道に長径12 cmの不染帯を指摘され，生検で扁平上皮癌と診断後当院へ紹介となった．精査の結果，胃壁浸潤を伴う右噴門リンパ節（No. 1）転移および総肝動脈幹前上部リンパ節（No. 8a）転移を有する表層拡大型食道癌と診断され，3領域郭清を伴う右開胸開腹食道亜全摘術を施行した．術前に右噴門リンパ節への転移と診断した病変は長径53 mmの巨大胃壁内転移であった．最終病理組織学的検査所見は深達度T1a-MMの低分化型扁平上皮癌で，遠隔リンパ節転移を伴う計10個のリンパ節転移を認めた．また，原発巣にリンパ管新生因子VEGF-Cの高発現が確認され，本症例の高いリンパ行性転移能を裏づける結果であった．術後補助化学療法施行したが，術後9か月目に腹部リンパ節再発を認め，術後29か月で死亡された．食道粘膜癌からの胃壁内転移は本邦報告4例目であった．

DOI： 10.5833/jjgs.45.1005

Desaki R., Okumura H., Uchikado Y., Sasaki K., Owaki T., Nakajo A., Ishigami S., Kitajima S., Natsugoe S. . A case of synchronous thyroid metastasis from esophageal squamous cell carcinoma . Esophagus 2015年1月 Esophagus

記述言語：日本語

Thyroid metastasis of esophageal cancer is rare. We report herein a case of synchronous thyroid metastasis of esophageal squamous cell carcinoma. A 54-year-old man with lower thoracic esophageal cancer and left thyroid tumor was admitted to our hospital. We diagnosed synchronous double cancer comprising esophagus squamous cell carcinoma and thyroidal papillary cancer. Simultaneous excision of both tumors after neoadjuvant chemoradiotherapy to the esophageal cancer was planned. Intraoperatively, thyroid tumor and cervical lymph nodes were pathologically diagnosed as metastases of esophageal cancer. We then converted the treatment strategy to perform total thyroidectomy, merging excision of the larynx and trachea with construction of an eternal trachea aperture without lymphadenectomy and esophagectomy, followed by chemoradiotherapy and chemotherapy. The patient has remained alive as of 18 months after neoadjuvant chemoradiotherapy. We recommend that once synchronous thyroid metastasis of esophageal squamous cell carcinoma has been confirmed, multimodal treatment should be taken into consideration.

DOI： 10.1007/s10388-013-0412-6

Tanoue K., Okumura H., Uchikado Y., Owaki T., Matsumoto M., Setoyama T., Kita Y., Omoto I., Sasaki K., Arigami T., Uenosono Y., Ishigami S., Natsugoe S. . A case of superficial esophageal squamous cell carcinoma invading the lamina propria mucosa with a metastatic lymph node along the celiac artery . Esophagus 2015年7月 Esophagus

記述言語：日本語

A 62-year-old man was diagnosed with superficial esophageal cancer on upper endoscopy during health screening. Endoscopic examination with iodine staining and narrow-band imaging revealed three superficial erosive lesions in the middle and lower thoracic esophagus. The depth of tumor invasion was diagnosed as shallow invasion into the submucosal layer on endoscopic ultrasonography. Since enhanced computed tomography showed a markedly swollen lymph node at the right cardia, with higher F-deoxyglucose uptake on F-deoxyglucose positron emission tomography, lymph node metastasis was suspected. Then esophagectomy with lymph node dissection was performed, and histopathologic examination of the resected specimen revealed metastasis of squamous cell carcinoma in the huge lymph node along the celiac artery. In superficial esophageal cancer with a distinct depressed lesion, horizontal extension, and especially with erosive esophagitis, the possibility of lymph node metastases should be kept in mind even the depth of tumor invasion was lamina propria mucosa.

DOI： 10.1007/s10388-014-0425-9

Omoto I., Owaki T., Okumura H., Uchikado Y., Matsumoto M., Kita Y., Sasaki K., Setoyama T., Arigami T., Uenosono Y., Ishigami S., Natsugoe S. . A case of superficial esophageal carcinoma with papilloma resected by en bloc endoscopic submucosal dissection . Esophagus 2014年7月 Esophagus

記述言語：日本語

A 71-year-old man underwent upper gastrointestinal endoscopy, and a slightly protruded lesion was detected 26 cm from the incisors. Biopsy specimen revealed chronic esophagitis. One year later, re-examination with upper gastrointestinal endoscopy showed persistence of the protruded lesion and also new findings of a slightly depressed and erythematous lesion at the opposite side. He was admitted to our hospital, and histological examination of the biopsy specimens from upper gastrointestinal endoscopy revealed concomitant squamous cell papilloma and squamous cell carcinoma. [18F]- fluorodeoxyglucose (FDG) accumulated in the squamous cell papilloma and/or in the mucosal squamous cell cancer. Endoscopic submucosal dissection was performed. Human papillomavirus (HPV) 16/18 was not detected in either lesion. Concomitant esophageal papilloma and esophageal squamous cell carcinoma is extremely rare. Additional study is required to characterize the etiology, diagnosis (including FDG accumulation), and clinical course of this phenomenon. The relationship between HPV infection and esophageal squamous cell carcinoma is reviewed. © 2013 The Japan Esophageal Society and Springer.

DOI： 10.1007/s10388-013-0403-7

尾本至, 奥村浩, 松本正隆, 佐々木健, 喜多芳昭, 小園勉, 前村公成, 大脇哲洋, 石神純也, 夏越祥次 . １期的切除再建と集学的治療を行った食道癌穿孔の１例 . 日本消化器外科学会雑誌 2009年一般社団法人日本消化器外科学会

記述言語：日本語

症例は46歳の男性で，胸部食道癌の診断で精査入院中，突然の右側胸部から季肋部に至る激痛と発熱が出現した．胸部CTで縦隔気腫および右側胸水を認め，食道癌穿孔と診断された．当科に紹介入院後，緊急手術が施行された．右胸腔内に黄白色胸水の貯留があり，食道癌の穿孔の所見を認めた．手術は右開胸開腹による食道亜全摘，胸壁前経路胃管再建および右胸腔内の洗浄ドレナージを行った．摘出標本では胸部中下部食道に7.5×4.0 cmの2型食道癌を認め，潰瘍底に穿孔部が確認された．病理組織学的には中分化型扁平上皮癌，pT3，infβ，ly3，v2と診断され，胃周囲リンパ節に計12個の転移を認めた．術後経過は良好で，追加治療として化学放射線療法を行い，さらに再発病変に対して化学療法を行い，22か月間生存された．今回，1期的切除再建により救命し，その後集学的に治療ができた食道癌穿孔症例について文献的考察を含め報告する．

DOI： 10.5833/jjgs.42.1371

喜多芳昭, 喜島祐子, 吉中平次, 舩迫和, 大脇哲洋, 愛甲孝 . Ｇ‐ＣＳＦ産生乳癌の１例 . 日本臨床外科学会雑誌 2006年日本臨床外科学会

記述言語：日本語

症例は, 48歳,女性.左乳房の腫瘤を主訴に来院した.マンモグラフィ,乳房超音波検査,穿刺吸引細胞診にて乳癌と診断された.検血にて,白血球が18,200/μl, 腫瘍マーカーのCA15-3が64.5U/ml, 血清G-CSF値は67pg/mlと高値を示していた.乳癌の存在と,白血球の増加,血清G-CSF値の上昇,明らかな感染巣がないことより, G-CSF産生腫瘍を疑い手術を施行した.白血球数は第1病日より低下し1週間後には正常に復した.血清G-CSF値は,10pg/ml未満まで低下した.術後は良好に経過し8病日に退院した.手術を契機に白血球数および血清G-CSFが正常化し,また,腫瘍細胞がG-CSF免疫組織染色にて染色されたことより, G-CSF産生乳癌と診断した.

DOI： 10.3919/jjsa.67.33

Sasaki K., Okumura H., Uchikado Y., Minami K., Ijichi T., Owaki T., Ishigami S., Natsugoe S. . A case of esophageal cancer with septic disseminated intravascular coagulation treated with recombinant human soluble thrombomodulin during chemoradiation therapy . Japanese Journal of Cancer and Chemotherapy 2013年9月 Japanese Journal of Cancer and Chemotherapy

記述言語：日本語

A 70-year-old woman was diagnosed with synchronous advanced esophageal cancer and early renal cancer. During chemo-radiation therapy for the esophageal cancer, she suffered from septic shock due to pneumonia. She got worse despite the administration of antibiotics and rglobulin. On the following day, she was diagnosed with septic disseminated intravascular coagulation (DIC) on the basis of the diagnostic criterion for acute DIC. Recombinant human soluble thrombomodulin (rTM) was administered to treat the DIC. The patient responded promptly to rTM treatment and recovered from the DIC in just 1 day. rTM is thought to be an effective drug for sepsis-induced DIC during chemoradiation therapy.

Megumi K., Okumura H., Shimonosono M., Ijichi T., Uchikado Y., Omoto I., Yo H., Kita Y., Uenosono Y., Arigami T., Mori S., Baba K., Ishigami S., Owaki T., Natsugoe S. . A case of esophageal cancer in a patient with CMV reactivation after neoadjuvant chemoradiation therapy . Japanese Journal of Cancer and Chemotherapy 2015年10月 Japanese Journal of Cancer and Chemotherapy

記述言語：日本語

A 68-year-old woman was diagnosed with advanced esophageal cancer with lymph node metastasis, for which she received neoadjuvant chemoradiotherapy. During therapy, she had loss of appetite and weight; therefore, we inserted a nasal feeding tube for her nutrition, after which, she gained weight soon. After therapy, she had a high fever with lymphocytopenia and was diagnosed with cytomegalovirus infection because of significantly high CMV antigenemia. Ganciclovir was administered immediately, and she recovered soon Two months later, we performed esophagectomy, and she recovered without complications. Immediate diagnosis of CMV infection, ganciclovir administration, and nutrition through a feeding tube were useful for the esophageal cancer patient in this report who had immunosuppression and malnutrition during chemoradiation.

Amatatsu M., Okumura H., Uchikado Y., Megumi K., Kita Y., Uenosono Y., Arigami T., Mori S., Ishigami S., Owaki T., Natsugoe S. . A case of concurrent cancer of the esophagus and stomach with severe sepsis following chemotherapy . Japanese Journal of Cancer and Chemotherapy 2015年10月 Japanese Journal of Cancer and Chemotherapy

記述言語：日本語

A 66-year-old man was diagnosed with synchronous early esophageal cancer and advanced gastric cancer. He received CDDP-based combination chemotherapy (docetaxcel, CDDP, and TS-1). During chemotherapy for gastric cancer, he suddenly developed septic shock, requiring intensive treatment with antibiotics, intravenous immunoglobulin, circulatory and respiratory care, and hemoperfusion with a polymyxin B column. He also had disseminated intravascular coagulation (DIC), complicated by sepsis. Recombinant human soluble thrombomodulin (rTM) was administered to treat DIC. The intensive treatments described above allowed the patient to recover from septic shock and DIC several days later. Early and adequate treatment could be used to rescue a compromised cancer-bearing patient from septic shock following chemotherapy.

Kijima Y., Umekita Y., Yoshinaka H., Owaki T., Sakamoto A., Yoshida H., Takashi A. . A case of breast carcinoma with cartilaginous and osseous metaplasia. . Breast cancer (Tokyo, Japan) 2006年日本乳癌学会

記述言語：英語

We report a case of a 49-year-old Japanese woman diagnosed with breast carcinoma with osseous and cartilaginous metaplasia with a poor outcome. Histological examination revealed invasive ductal carcinoma with undifferentiated sarcomatous components including chondrosarcomatous areas. Osseous metaplasia was also noted in a very limited area. Neither axillary lymph node metastases nor vessel invasion were observed. Immunohistochemical examination was negative for estrogen receptor, progesterone receptor and HER2 overexpression. Stage II A T2N0M0 carcinoma was diagnosed postoperatively. Five months after the operation, she developed lung metastases. Although she received systemic chemotherapy, the lesions increased in number and grew rapidly. She died of pulmonary distress 5 months after relapse.

DOI： 10.2325/jbcs.13.214

Kijima Y., Yoshinaka H., Higuchi I., Owaki T., Aikou T. . A case of amyotrophic lateral sclerosis and breast cancer . Breast Cancer 2005年日本乳癌学会

記述言語：英語

We report a case of breast cancer occurring in a patient with amyotrophic lateral sclerosis (ALS). A 58-year-old Japanese woman diagnosed with ALS 6 years previously noticed a mass in the left breast. We performed a modified radical mastectomy for the mass lesion. Invasive ductal carcinoma without lymph node metastasis was diagnosed. During the operation, she had no worsening of her neurological symptoms. The patient has been cancer-free for 11 months since her operation and no improvement has been seen in her neurological condition. To the best of our knowledge, this is the first case of breast cancer occurring in a patient with ALS in Japan.

DOI： 10.2325/jbcs.12.57

Tsuruda Y., Okumura H., Uchikado Y., Megumi K., Urata M., Kawagoe K., Satake S., Kita Y., Uenosono Y., Arigami T., Mori S., Baba K., Ishigami S., Owaki T., Natsugoe S. . A Case of Advanced Esophageal Cancer Patient with Schizophrenia Successfully Treated with Chemoradiation Therapy with S-1 and CDDP . Gan to kagaku ryoho. Cancer & chemotherapy 2015年11月 Gan to kagaku ryoho. Cancer & chemotherapy

記述言語：日本語

A 67-year-old man who was hospitalized at a mental hospital because of schizophrenia was admitted to our hospital with a complaint of dysphagia and vomiting. He was found to have advanced cancer in the middle thoracic esophagus. With the cooperation of a radiologist, a psychiatrist, and a nurse, we successfully performed chemoradiation therapy with S-1 and CDDP. The patient had adverse events of esophagitis and anuria during chemoradiation therapy. However, such adverse events were well controlled through the cooperation with a palliative care team and a urologist. Finally, we were able to enforce chemoradiation therapy with S-1 and CDDP without interruption.

Uchikado Y., Matsumoto M., Okumura H., Owaki T., Natsugoe S. . [Surgical treatment for abdominal esophageal cancer]. . Nihon rinsho. Japanese journal of clinical medicine 2011年8月 Nihon rinsho. Japanese journal of clinical medicine

Uchikado Y, Matsumoto M, Okumura H, Owaki T, Natsugoe S . [Surgical treatment for abdominal esophageal cancer]. . Nihon rinsho. Japanese journal of clinical medicine 2011年8月

Ishigami S, Arigami T, Uenosono Y, Okumura H, Uchikado Y, Owaki T, Kijima Y, Nakajo A, Maemura K, Ueno S, Hokita S, Hiraki Y, Nakajo M, Natsugoe S . [Outcomes of advanced gastric cancer patients treated with chemoradiation therapy]. . Gan to kagaku ryoho. Cancer & chemotherapy 2013年6月

　前のページ - 次のページ　