研究者詳細 - 大脇　哲洋

講演・口頭発表等 - 大脇　哲洋

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Amitani M., Amitani H., Suzuki H., Kawazu S., Fukumoto T., Yamaguchi K., Oki T., Nitta H., Sonoda T., Uto N., Numata M., Mizuma K., Ibusuki R., Takezaki T., Owaki T., Asakawa A. . Effective learning strategies for Japanese Kampo medicine using problem-based learning and simulator training for medical students: A questionnaire survey . Traditional and Kampo Medicine 2021年8月 Traditional and Kampo Medicine

記述言語：日本語

Background: Kampo medicine was introduced into the core curriculum model of medical education in Japan in 2007, and has been taught at all 80 medical universities across the country. However, as there are differences in terms of content and between universities, Kampo medicine education needs to be standardized. Therefore, this study aimed to examine the effects of combining multiple strategies, including lectures, problem-based learning (PBL), and simulator training for the development of a standardized educational curriculum for Kampo medicine. Methods: We offered a lectures-only class (Kampo strategy-lectures [Ks-L]), a class with lectures and decoction (Ks-LD), a class with lectures, decoction, and PBL (Ks-LDP), and a class with lectures, decoction, PBL, and simulator training (Ks-LDPS). We analyzed the data from a 12-item questionnaire conducted by the Faculty Development Committee of Kagoshima University Faculty of Medicine to evaluate the curriculum. Results: Ks-LDPS was rated significantly higher than the other modules in active learning, and overall satisfaction. Conclusions: The results of this study suggest that combining multiple strategies rather than offering classes with lectures promoted a positive attitude to Kampo medicine and deep self-learning among students, thereby improving the educational effects of Kampo medicine education.

DOI： 10.1002/tkm2.1281

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Kijima Y., Yoshinaka H., Owaki T., Aikou T. . Effect of nutritional state on postoperative axillary leakage after axillary lymph node dissection in a new rat model . Surgery Today 2005年4月 Surgery Today

記述言語：日本語

Purpose. Axillary leakage after axillary lymph node dissection (ALD) in breast cancer surgery is a frequent and troublesome complication. We conducted this study to establish an experimental model of axillary leakage after ALD; to evaluate axillary leakage in different nutritional states; and to examine the effects of dietary management on axillary leakage. Methods. Twenty-eight Wistar rats were divided into two groups according to whether they were fed a high-fat diet or a low-fat diet for 14 weeks before ALD. After ALD, a suction drain was placed in the axilla and continuous suction was started. Axillary leakage was monitored for 9 days, and the drainage fluid and serum were analyzed biochemically. Results. The body weights of the two groups were not significantly different before or after ALD. The amount of cumulative drainage fluid was significantly higher on postoperative days 7 and 9 in the high-fat group. The serum phosphate lipid, total cholesterol, and free cholesterol levels, and the free cholesterol level in the drainage fluid were also significantly higher in the high-fat group. Conclusions. This model is useful for reproducing lymphatic leakage after ALD. Our findings also suggest that a low-fat diet may be advantageous for patients undergoing ALD as part of breast cancer surgery. © Springer-Verlag 2005.

DOI： 10.1007/s00595-004-2933-z

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KIJIMA YUKO, YOSHINAKA HEIJI, OWAKI TETSUHIRO, AIKOU TAKASHI . Effect of Nutritional State on Postoperative Axillary Leakage After Axillary Lymph Node Dissection in a New Rat Model . 2005年4月

Matsumoto M., Matsuyama Y., Kashima S., Koike S., Okazaki Y., Kotani K., Owaki T., Ishikawa S., Iguchi S., Okazaki H., Maeda T. . Education policies to increase rural physicians in Japan: a nationwide cohort study . Human Resources for Health 2021年12月 Human Resources for Health

記述言語：日本語

Background: Japan has established comprehensive education-scholarship programs to supply physicians in rural areas. Their entrants now comprise 16% of all medical students, and graduates must work in rural areas for a designated number of years. These programs are now being adopted outside Japan, but their medium-term outcomes and inter-program differences are unknown. Methods: A nationwide prospective cohort study of newly licensed physicians 2014–2018 (n = 2454) of the four major types of the programs—Jichi Medical University (Jichi); regional quota with scholarship; non-quota with scholarship (scholarship alone); and quota without scholarship (quota alone)—and all Japanese physicians in the same postgraduate year (n = 40,293) was conducted with follow-up workplace information from the Physician Census 2018, Ministry of Health, Labour and Welfare. In addition, annual cross-sectional survey for prefectural governments and medical schools 2014–2019 was conducted to obtain information on the results of National Physician License Examination and retention status for contractual workforce. Results: Passing rate of the National Physician License Examination was highest in Jichi, followed in descending order by quota with scholarship, the other two programs, and all medical graduates. The retention rate for contractual rural service of Jichi graduates 5 years after graduation (n = 683; 98%) was higher than that of quota with scholarship (2868; 90%; P < 0.001) and scholarship alone (2220; 81% < 0.001). Relative risks of working in municipalities with the least population density quintile in Jichi, quota with scholarship, scholarship alone, and quota alone in postgraduate year 5 were 4.0 (95% CI 3.7–4.4; P < 0.001), 3.1 (2.6–3.7; < 0.001), 2.5 (2.1–3.0; < 0.001), and 2.5 (1.9–3.3; < 0.001) as compared with all Japanese physicians. There was no significant difference between each program and all physicians in the proportion of those who specialized in internal medicine or general practice in postgraduate years 3 to 5 Conclusions: Japan’s education policies to produce rural physicians are effective but the degree of effectiveness varies among the programs. Policymakers and medical educators should plan their future rural workforce policies with reference to the effectiveness and variations of these programs.

DOI： 10.1186/s12960-021-00644-6

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Kijima Y., Yoshinaka H., Owaki T., Aikou T. . Early experience of immediate reconstruction using autologous free dermal fat graft after breast conservational surgery . Journal of Plastic, Reconstructive and Aesthetic Surgery 2007年5月 Journal of Plastic, Reconstructive and Aesthetic Surgery

記述言語：日本語

Breast conservational therapy (BCT) has become a standard strategy for breast cancer, and ensures that local control with acceptable cosmetic results [Fisher B, Anderson S, Redmond CK, et al. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 1995;333:1456-61] and immediate reconstruction after BCT has become increasingly popular even for early-stage breast cancer [Berrino P, Campora E, Santi P. Post-quadrantectomy breast deformities: classification and techniques of surgical correction. Plast Reconstr Surg 1987;79(4):567-72; Cooperman AM, Dinner M. The rhomboid flap and partial mastectomy. Surg Clin North Am 1978;58:869-73]. The breasts of Japanese women are sometimes too small to maintain symmetry, even after partial resection, and an insufficient resection margin may increase local recurrence if too much attention is paid to cosmesis. Use of an autologous free dermal fat graft (FDFG) for defect reconstruction has proven popular for some areas of the body [Lexer E. Free transplantation. Ann Surg 1914;60:166-94; Peer LA. The neglected free fat graft. Plast Reconstr Surg 1956;18:233-50]. Immediate reconstruction of the surgical defect was performed in seven Japanese women using autologous free dermal fat graft (FDFG) from the lower abdomen after breast-conserving surgeries for six malignant lesions and two benign masses located in the medial or central area of the breasts. The mean amount of resected tissue was 56.4 g (range, 28-108 g), while mean FDFG weight was 78.3 g (range, 35-148 g). We obtained symmetry in the size of the whole breast, the position and level of the nipple, and shape. Autologous FDFG was useful for reconstruction, with a good cosmetic effect. This technique achieves better cosmetic results than the transposition of residual breast tissue, is more convenient than muscle flap grafting, and safer than implantation of foreign materials. This report documents our early experiences with seven patients who underwent BCT and immediate breast reconstruction using autologous FDFG. © 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons.

DOI： 10.1016/j.bjps.2006.06.004

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Owaki T., Kijima Y., Yoshinaka H., Uenosono Y., Yoshioka T., Natsugoe S., Aikou T. . Ductal carcinoma in-situ of the breast detected by [F-18] fluorodeoxyglucose positron emission tomography. . Breast cancer (Tokyo, Japan) 2006年日本乳癌学会

記述言語：英語

A 48-year-old Japanese woman underwent [F-18] fluorodeoxyglucose positron emission tomography (FDG-PET) as part of her medical examination. A small hot spot was detected in her right breast. Quadrantectomy with sentinel lymph node (SN) biopsy using an endoscope was performed, and ductal carcinoma in-situ of the breast was diagnosed. The tumor size was 0.9 cm in its greatest diameter, and there were no cancer cells detected in the SN on frozen hematoxylin-eosin staining and cytokeratin immunohistochemical staining. We reported this rare case of ductal carcinoma in-situ detected by FDG-PET as past of a medical checkup.

DOI： 10.2325/jbcs.13.210

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櫻井俊秀, 大脇哲洋, 夏越祥次, 奥村浩, 松本正隆, 花園幸一, 瀬戸山徹郎, 愛甲孝 . DP-191-4 食道癌術後におけるシベレスタットの有用性(第107回日本外科学会定期学術集会) . 日本外科学会雑誌 2007年3月一般社団法人日本外科学会

大脇哲洋, 夏越祥次, 奥村浩, 花園幸一, 瀬戸山徹郎, 松本正隆, 甲斐敬子, 出口尚寿, 愛甲孝 . DP-190-3 通過障害を有する進行食道癌患者の術前栄養管理(第107回日本外科学会定期学術集会) . 日本外科学会雑誌 2007年3月一般社団法人日本外科学会

喜島祐子, 吉中平次, 舩迫和, 大脇哲洋, 愛甲孝 . DP-168-8 A領域病変乳房温存術後の整容性評価 : 遊離自家真皮脂肪片移植の有用性(第107回日本外科学会定期学術集会) . 日本外科学会雑誌 2007年3月一般社団法人日本外科学会

大脇哲洋, 夏越祥次, 松本正孝, 瀬戸山徹郎, 内門泰斗, 桜井俊秀, 尾本至, 奥村浩, 愛甲孝 . DP-142-3 糖尿病合併患者の食道癌切除術周術期における血糖コントロール(第108回日本外科学会定期学術集会) . 日本外科学会雑誌 2008年4月一般社団法人日本外科学会

佐々木健, 夏越祥次, 石神純也, 松本正隆, 奥村浩, 花園幸一, 瀬戸山徹郎, 内門泰斗, 喜多芳昭, 保清和, 櫻井俊秀, 大脇哲洋, 愛甲孝 . DP-081-8 食道粘膜下層癌の微小転移を含めたリンパ節転移に対するCXCL12とCXCR4の発現意義(第108回日本外科学会定期学術集会) . 日本外科学会雑誌 2008年4月一般社団法人日本外科学会

保清和, 夏越祥次, 奥村浩, 瀬戸山徹郎, 花園幸一, 坂元昭彦, 内門泰斗, 松本正隆, 大脇哲洋, 石神純也, 愛甲孝 . DP-043-2 食道癌の化学放射線療法後の組織学的効果とG2/M期関連因子の発現(第107回日本外科学会定期学術集会) . 日本外科学会雑誌 2007年3月一般社団法人日本外科学会

夏越祥次, 松本正隆, 瀬戸山徹郎, 内門泰斗, 柳田茂寛, 上之園芳一, 佐々木健, 櫻井俊秀, 奥村浩, 石神純也, 大脇哲洋, 愛甲孝 . 食道癌の微小転移診断と臨床応用 . 日本気管食道科学会会報 2008年特定非営利活動法人日本気管食道科学会

Mizuma K, Amitani M, Ibusuki R, Owaki T . Development, implementation, and evaluation of a local community-based ophthalmology sentinel surveillance system in a remote rural area in Japan. . Rural and remote health 2023年10月 Rural and Remote Health

記述言語：英語

Introduction: Solid and sensitive infectious disease surveillance systems need to be developed and implemented to prevent and control epidemics. Although statutory national infectious disease surveillance systems have been developed in many countries, some challenges remain, such as their limited timeliness, representativeness, and sensitivity, as well as the fact that they annot capture all local outbreaks that occur in small communities. To overcome these limitations, local community-based infectious disease surveillance systems that meet local needs and can operate with constrained resources need to be developed, especially in remote and rural low-resource areas. This study aimed community-based ophthalmology sentinel surveillance system in Isa city (OSSS-Isa), a remote rural area in Japan. Methods: For the development of OSSS-Isa, one hospital in Isa city assumed a leading role and developed a network with all medical institutions – 20 hospitals and clinics in the local community, including two ophthalmology clinics – as sentinel reporting sites. Surveillance was conducted on a weekly basis from Monday to Sunday. The collection, aggregation, and reporting of the surveillance data were implemented promptly on the same day, Monday, using a paper-based form and fax. For the evaluation of OSSS-Isa, the study followed the updated guidelines for evaluating public health surveillance systems proposed by the Centers for Disease Control and Prevention to select the evaluation criteria and develop a questionnaire. The questionnaires were then distributed to 20 hospitals and clinics, with the responses evaluated on a five-point Likert scale. Results: For the implementation of OSSS-Isa, the system issued alerts twice to the networked hospitals and clinics when signs of an increase in the prevalence of a target infectious eye disease appeared in Isa city. After the alerts, the number of cases decreased in the community. Regarding the evaluation survey, physicians from 18 hospitals and clinics responded to the questionnaire (response rate 90%). In contrast to flexibility, more than 75% of the respondents gave high ratings to simplicity, data quality, acceptability, timeliness, and stability in evaluating OSSSIsa, with the mean score for these evaluation criteria higher than 3.67. Conclusion: The present results indicate that OSSS-Isa has high simplicity, data quality, acceptability, timeliness, and stability, which is highly embedded with the local healthcare providers in Isa city. OSSS-Isa contributed to the early and accurate detection of signs of infectious eye disease outbreaks emerging in a small remote rural local community. The success factors seem to include its simple well-designed implementation methods, good external factors, and active human factors suited to the characteristics of the small remote rural community. The OSSS-Isa initiative appears to be a meaningful practical example of successful health advocacy by healthcare providers by developing a system at the local social level while going beyond the boundaries of routine medical practice. If voluntary small-scale surveillance systems can complement statutory large-scale ones and work together locally, nationally, and internationally, it might be possible to detect small, unusual happenings that occur in the community, such as emerging infectious diseases, and thereby help avert global outbreaks.

DOI： 10.22605/RRH8005

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Takatori H, Natsugoe S, Okumura H, Matsumoto M, Uchikado Y, Setoyama T, Sasaki K, Tamotsu K, Owaki T, Ishigami S, Aikou T . Cyclooxygenase-2 expression is related to prognosis in patients with esophageal squamous cell carcinoma. . European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 2008年4月

Nerome Y., Kojyo K., Ninomiya Y., Ishikawa T., Ogiso A., Takei S., Kawano Y., Douchi T., Takezaki T., Owaki T. . Current human T-cell lymphotropic virus type 1 mother-to-child transmission prevention status in Kagoshima . Pediatrics International 2014年 Pediatrics International

記述言語：日本語

The aim of this study was to assess the current human T-cell lymphotropic virus type 1 (HTLV-I) mother-to-child transmission (MTCT) prevention system in Kagoshima Prefecture. We investigated the rate of carrier pregnant women from obstetrics facilities in Kagoshima by mail in 2012 and compared our results with previous study results. We interviewed carrier pregnant women about their choices for infant nutrition, and we interviewed midwives about the follow-up system. In 2012, 8719 screening tests were performed, covering 58.1% of all pregnant women in Kagoshima; the rate of carrier pregnant women was 1.3%. Of 59 carriers, 39 chose short-term breast-feeding. The HTLV-I carrier rate among pregnant women in Kagoshima has declined. The current HTLV-I MTCT prevention system in Kagoshima is effective, but not sufficient. To bring the nutrition methods to completion, various types of support are needed. Further studies will elucidate many unsolved problems concerning MTCT.

DOI： 10.1111/ped.12385

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Uto N., Amitani M., Amitani H., Kurazono S., Kobayashi Y., Sakaki M., Suzuki H., Inui A., Owaki T., Asakawa A. . Corrigendum to “Survey of problems in Kampo curriculum and the need for interdisciplinary collaboration education in Japanese medical, pharmacy, dental, and nursing departments” [Neuropeptides 92 (2022) 102225] (Neuropeptides (2022) 92, (S0143417921001116), (10.1016/j.npep.2021.102225)) . Neuropeptides 2022年8月 Neuropeptides

記述言語：日本語

The authors regret that in the abstract ‘Fisher's exact test and Cochrane's Q test were used to compare response frequency among departments and desired collaborators in each faculty, respectively.’ should be replaced to ‘Chi-square test and Kruskal-wallis test were used to test the comparison of response rate and time of classes among departments. The Cochran's Q test was used for paired data to compare the frequency of responses of the desired collaborators in each faculty.’. Furthermore, in the data analysis ‘Fisher's exact test was used to compare response frequency among departments. The Cochran's Q test was used for paired data to compare the frequency of responses of the desired collaborators in each faculty.’ should be replaced to ‘Chi-square test and Kruskal-wallis test were used to test the comparison of response rate and time of classes among departments. The Cochran's Q test was used for paired data to compare the frequency of responses of the desired collaborators in each faculty. P value less than 0.05 was considered statistically significant.’ The authors would like to apologise for any inconvenience caused.

DOI： 10.1016/j.npep.2022.102249

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Tamotsu K., Okumura H., Uchikado Y., Kita Y., Sasaki K., Omoto I., Owaki T., Arigami T., Uenosono Y., Nakajo A., Kijima Y., Ishigami S., Natsugoe S. . Correlation of Aurora-A expression with the effect of chemoradiation therapy on esophageal squamous cell carcinoma . BMC Cancer 2015年4月 BMC Cancer

記述言語：日本語

Background: Chemoradiation therapy (CRT) is one of the most useful treatments for esophageal squamous cell carcinoma (ESCC). However, because some patients respond well to CRT and others do not, it is important to be able to predict response to CRT before beginning treatment by using markers. Aurora-A encodes a cell cycle regulated serine/threonine kinase that has essential functions in centrosome maturation and chromosome segregation. In this study, we investigated the relationship between the expression of Aurora-A and the response to CRT in patients with ESCC. Methods: We immunohistochemically investigated the expression of Aurora-A in biopsy specimens of untreated primary tumors of 78 patients with ESCC and determined the relationship between Aurora-A levels and patient responses to CRT, which consisted of 5-fluorouracil plus cisplatin and 40 Gy of radiation. Results: Tumors were judged as Aurora-A positive when more than 10% of the cancer cells displayed a distinct positive nuclear anti-Aurora-A immunoreaction by immunohistochemical evaluation. The tumors of 46 of 78 patients (58.9%) displayed positive expression of Aurora-A. In terms of clinical response the percentage of patients showing complete response (CR), incomplete response/stable disease of primary lesion (IR/SD), and progressive disease (PD) was 19.2, 69.2, and 11.5%, respectively. In terms of histological response the tumor grade of the 41 patients who underwent surgery was as follows: grade 1, 48.8%; grade 2, 29.2%; grade 3, 22.0%. CRT was effective for patients who had Aurora-A (+) tumors (clinically: P=0.0003, histologically: P=0.036). Conclusions: Our results suggest that Aurora-A expression in biopsy specimens of primary tumors is associated with CRT efficacy in patients with ESCC. Assessment of Aurora-A expression in biopsy specimens maybe useful for regarding the potential utility of CRT therapy for patients with ESCC before treatment.

DOI： 10.1186/s12885-015-1329-3

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Noda M., Okumura H., Uchikado Y., Omoto I., Sasaki K., Kita Y., Mori S., Owaki T., Arigami T., Uenosono Y., Nakajo A., Kijima Y., Ishigami S., Maemura K., Natsugoe S. . Correlation Between Biomarker Candidate Proteins with the Effect of Neoadjuvant Chemoradiation Therapy on Esophageal Squamous Cell Carcinoma . Annals of Surgical Oncology 2018年2月 Annals of Surgical Oncology

記述言語：日本語

Background: While chemoradiation therapy (CRT) is one of the most useful treatments for esophageal squamous cell carcinoma (ESCC), it is important to predict response prior to treatment by using markers because some patients respond well and others do not. Methods: Fifty-nine patients with ESCC were treated with neoadjuvant CRT at the Kagoshima University Hospital. The expression of seven types of biomarker candidate proteins in biopsy specimens of untreated primary tumors was evaluated to determine whether it correlated with response and prognosis. Results: The positive expression rates were 47% for p53, 83% for CDC25B, 68% for 14-3-3sigma, 76% for p53R2, 75% for ERCC1, 32% for Gli-1, and 54% for Nrf2. In terms of histological response, tumor grade of the 59 patients was 48.8% for grade 1 as the non-responder, 29.2% for grade 2, and 22.0% for grade 3 as the responder. CRT was significantly effective in p53(−), p53R2(−), ERCC1(−), and Nrf2(−) tumors, while p53(−), p53R2(−), and ERCC1(−) were factors independently correlated with effective histological response. Their combined expression of two or three negative expressions had 100% effective response and was a significant prognostic factor. Conclusion: Our results suggest that two or three negative expressions of p53, p53R2, and ERCC1 in biopsy specimens of primary tumors were associated with a favorable response to CRT for ESCC. Assessment of tumor suppressor and DNA repair protein expressions in biopsy specimens may be useful for the potential utility of CRT therapy for patients with ESCC prior to treatment.

DOI： 10.1245/s10434-017-6271-y

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Kijima T., Arigami T., Uchikado Y., Uenosono Y., Kita Y., Owaki T., Mori S., Kurahara H., Kijima Y., Okumura H., Maemura K., Ishigami S., Natsugoe S. . Combined fibrinogen and neutrophil-lymphocyte ratio as a prognostic marker of advanced esophageal squamous cell carcinoma . Cancer Science 2017年2月 Cancer Science

記述言語：日本語

Patients with advanced esophageal squamous cell carcinoma (ESCC) is received chemoradiotherapy or chemotherapy for clinical management. However, it is difficult to predict tumor response and prognosis using blood markers before starting treatments. The purpose of this study was to investigate the pre-treatment plasma fibrinogen and neutrophil–lymphocyte ratio (NLR) in patients with advanced ESCC treated with chemoradiotherapy or chemotherapy, and to assess the clinical utility of a combined score using these blood markers, named as the F-NLR (fibrinogen and NLR) score, as a predictor of tumor response and prognosis. A total of 98 advanced ESCC patients, treated with chemoradiotherapy or chemotherapy, were classified into three groups: F-NLR score of 2, having both hyperfibrinogenemia (>400 mg/dL) and high NLR (>3.0), score of 1, one of these hematological abnormalities, and score of 0, having neither hyperfibrinogenemia nor high NLR. Fibrinogen and NLR were significantly higher in the progressive disease (PD) group than the non-PD group (P = 0.0419, and P = 0.0001, respectively). A significantly higher F-NLR score was found in the PD group than the non-PD group (P = 0.0140). Overall survival was significantly lower in patients with an F-NLR score of 2 than in those with an F-NLR score of 0 or 1 (P < 0.0001). Multivariate analysis showed that the F-NLR score was one of the independent prognostic factors (P = 0.0081). Our study demonstrates that the F-NLR score is promising as a predictive marker for therapeutic effects and prognosis in patients with advanced ESCC.

DOI： 10.1111/cas.13127

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講演・口頭発表等 - 大脇 哲洋

<大脇　哲洋>

講演・口頭発表等 - 大脇　哲洋