Researchers Database

sugawara hitoshi

    ComprehensiveMedicine1 Professor
Last Updated :2021/11/23

Researcher Information

Degree

  • PhD(1994/03 Asahikawa Medical University)
  • FACP(1994/06 American College of Physicians)

URL

ORCID ID

Researcher ID

  • Y-5081-2019

J-Global ID

Research Interests

  • Geriatrics   General Medicine   Extreme labodata   Case report   Internal Medicine   

Research Areas

  • Other / Other / Laboratory medicine
  • Life sciences / Internal medicine - General

Academic & Professional Experience

  • 2016/10 - Today  Saitama Medical Center, Jichi Medical UniversityDivision of General Medicine, Department of Comprehensive Medicine 1Division Head, Professor
  • 2008/04 - 2016/09  Saitama Medical Center, Jichi Medical UniversityDivision of General MedicineDivision Head, Associate Professor
  • 2004/04 - 2008/03  Omiya Medical CenterDivision of General MedicineAssistant Professor
  • 2003/01 - 2004/03  Omiya Medical Center, Jichi Medical UniversityDivision of General MedicineResearch Associate
  • 2001/09 - 2002/12  大宮医師会市民病院内科科長
  • 1998/06 - 2001/08  Omiya Medical Center, Jichi Medical UniversityDivision of General MedicineResearch Associate
  • 1997/06 - 1998/05  Hakodate Kyoaikai HospitalCardiologyDivision Head
  • 1996/06 - 1997/05  Jichi Medical University総合診療科助手
  • 1994/06 - 1996/03  Yale University, School of Medicine,Section of Immunology, Boyer Center for Molecular MedicinePostdoctoral fellow
  • 1994/06 - 1995/03  長寿科学振興財団平成6年度海外派遣 研究員
  • 1992/06 - 1994/05  RISHIRI Island National Health Insurance Center HospitalGeneral MedicineHospital Director
  • 1985/06 - 1994/03  Asahikawa Medical College1st Department of Internal MedicineResearch scholar
  • 1990/06 - 1992/05  Asahikawa Medical College1st Department of Internal MedicineMedical Staff Physician
  • 1988/06 - 1990/05  Hokkaido Prefectural Utoro ClinicSuperintendent
  • 1987/06 - 1988/05  Wakkanai Municipal HospitalMedicineMedical Staff Physician
  • 1986/10 - 1987/05  Asahikawa Medical College HospitalGeneral Surgery, Internal MedicineResident
  • 1986/04 - 1986/09  Asahikawa Municipal HospitalMedicineResident
  • 1985/06 - 1986/03  Asahikawa Medical College HospitalInternal Medicine, Anesthesiology, PediatricsResident

Education

  • 1994/06 - 1996/03  Yale University  School of Medicine  Section of Immunology, BCMM
  • 1985/04 - 1994/03  Asahikawa Medical University  Medicine  1st Department of Internal Medicine
  • 1979/04 - 1985/03  Jichi Medical University  School of Medicine  医学科

Association Memberships

  • THE JAPANESE ASSOCIATION FOR INFECTIOUS DISEASES   JAPAN PRIMARY CARE ASSOCIATION   日本老年医学会   American College of Physicians   日本循環器学会   日本内科学会   

Published Papers

  • Kai Saito, Hitoshi Sugawara, Tamami Watanabe, Akira Ishii, Takahiko Fukuchi
    Scientific Reports 11 (1) 1 - 10 2021/12 [Refereed]
     
    AbstractRisk factors associated with 72-h mortality in patients with extremely high serum aspartate aminotransferase levels (AST; ≥ 3000 U/L) are unknown. This single-centre, retrospective, case-controlled, cross-sectional study obtained data from medical records of adult patients treated at Saitama Medical Center, Japan, from 2005 to 2019. We conducted a multivariate logistic after adjusting for age, sex, height, weight, body mass index, Brinkman Index, vital signs, biochemical values, updated Charlson Comorbidity Index (CCI) score, CCI components, and underlying causes. A logistic regression model with selected validity risks and higher C-statistic for predicting 72-h mortality was established. During the 15-year period, 428 patients (133 non-survivors and 295 survivors [cases and controls by survival < 72 and ≥ 72 h, respectively]) with AST levels ≥ 3000 U/L were identified. The 72-h mortality rate was 133/428 (31.1%). The model used for predicting 72-h mortality through the assessment of alkaline phosphatase, creatine kinase, serum sodium, potassium, and phosphorus levels had a C-statistic value of 0.852 (sensitivity and specificity, 76.6%). The main independent risk factors associated with 72-h mortality among patients with AST levels ≥ 3000 U/L included higher serum values of alkaline phosphatase, creatine kinase, serum sodium, potassium, and phosphorus.
  • Ai Kawamura, Hitoshi Sugawara, Takahiko Fukuchi, Akira Tanaka
    Cureus 13 (10) e18967  2168-8184 2021/10 [Refereed][Not invited]
  • Hiroshi Hori, Takahiko Fukuchi, Masamitsu Sanui, Takashi Moriya, Hitoshi Sugawara
    PLOS ONE 16 (10) e0257513 - e0257513 2021/10 [Refereed][Not invited]
     
    Background Coronavirus disease (COVID-19) is associated with a high mortality rate in older adults; therefore, it is important for medical institutions to take measures to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. This study aimed to assess the risk of SARS-CoV-2 infection among healthcare workers (HCWs) and the effectiveness of infection control measures. Methods This study had a cross-sectional component and a prospective cohort component. The cross-sectional component comprised an anti-SARS-CoV-2 antibody survey among HCWs at a medical center in Saitama City, Japan. In the prospective cohort component, HCWs at the same medical center were tested for anti-SARS-CoV-2 antibodies monthly over a 3-month period (May to July 2020) to assess the effectiveness of infection prevention measures, including personal protective equipment use. All participants in the cohort study also participated in the antibody survey. The primary outcome was anti-SARS-CoV-2 antibody (measured using Elecsys® Anti-SARS-CoV-2) positivity based on whether participants were engaged in COVID-19-related medical care. Other risk factors considered included occupational category, age, and sex. Results In total, 607 HCWs participated in the antibody survey and 116 doctors and nurses participated in the cohort study. Only one of the 607 participants in the survey tested positive for anti-SARS-CoV-2 antibodies. All participants in the cohort study were anti-SARS-CoV-2 antibody negative at baseline and remained antibody negative. Engaging in the care of COVID-19 patients did not increase the risk of antibody positivity. During the study period, a total of 30 COVID-19 in-patients were treated in the hospital. Conclusions The infection control measures in the hospital protected HCWs from nosocomially acquired SARS-CoV-2 infection; thus, HCWs should engage in COVID-19-related medical care with confidence provided that they adhere to infectious disease precautions.
  • Ibuki Kurihara, Takahiko Fukuchi, Hanako Yoshihara, Kenichi Sakakura, Hitoshi Sugawara
    Journal of General and Family Medicine 2189-7948 2021/08 [Refereed]
  • Hiroshi Hori, Takahiko Fukuchi, Hitoshi Sugawara
    Journal of general internal medicine 2021/08 [Refereed]
  • Ibuki Kurihara, Katsuyuki Yoshida, Takahiko Fukuchi, Hitoshi Sugawara
    Clinical case reports 9 (7) e04476  2021/07 [Refereed][Not invited]
     
    In the era of a severely aging population, physicians should pay attention to look for both infective endocarditis and disseminated lesions when blood cultures reveal Staphylococcus warneri, especially in elderly people with valvular heart disease.
  • Takahiko Fukuchi, Hitoshi Sugawara
    Internal medicine (Tokyo, Japan) 2021/05 [Refereed][Not invited]
  • Yuki Kubota, Hiroshi Hori, Hitoshi Sugawara
    Internal medicine (Tokyo, Japan) 2021/03 [Refereed][Not invited]
  • Kai Saito, Hitoshi Sugawara, Kiyoshi Ichihara, Tamami Watanabe, Akira Ishii, Takahiko Fukuchi
    PLOS ONE 16 (2) e0246259 - e0246259 2021/02 [Refereed]
     
    The risk factors associated with mortality in patients with extremely high serum C-reactive protein (CRP) levels are controversial. In this retrospective single-center cross-sectional study, the clinical and laboratory data of patients with CRP levels ≥40 mg/dL treated in Saitama Medical Center, Japan from 2004 to 2017 were retrieved from medical records. The primary outcome was defined as 72-hour mortality after the final CRP test. Forty-four mortal cases were identified from the 275 enrolled cases. Multivariate logistic regression analysis (MLRA) was performed to explore the parameters relevant for predicting mortality. As an alternative method of prediction, we devised a novel risk predictor, “weighted average of risk scores” (WARS). WARS features the following: (1) selection of candidate risk variables for 72-hour mortality by univariate analyses, (2) determination of C-statistics and cutoff value for each variable in predicting mortality, (3) 0–1 scoring of each risk variable at the cutoff value, and (4) calculation of WARS by weighted addition of the scores with weights assigned according to the C-statistic of each variable. MLRA revealed four risk variables associated with 72-hour mortality—age, albumin, inorganic phosphate, and cardiovascular disease—with a predictability of 0.829 in C-statistics. However, validation by repeated resampling of the 275 records showed that a set of predictive variables selected by MLRA fluctuated occasionally because of the presence of closely associated risk variables and missing data regarding some variables. WARS attained a comparable level of predictability (0.837) by combining the scores for 10 risk variables, including age, albumin, electrolytes, urea, lactate dehydrogenase, and fibrinogen. Several mutually related risk variables are relevant in predicting 72-hour mortality in patients with extremely high CRP levels. Compared to conventional MLRA, WARS exhibited a favorable performance with flexible coverage of many risk variables while allowing for missing data.
  • Hiroshi Hori, Takahiko Fukuchi, Hitoshi Sugawara
    Internal Medicine 60 (4) 495 - 506 0918-2918 2021/02 [Refereed]
     
    The prevalence of atrial fibrillation (AF) increases with age, as does the proportion of patients with frailty. AF patients with frailty have a higher risk of stroke than those without frailty, and progressive frailty caused by stroke is also associated with a worse prognosis. Despite this, anticoagulant therapy tends to not be used in frail patients because of the risk of falls and bleeding complications. However, some studies have shown that anticoagulant therapy improves the prognosis in patients with frailty. An accurate assessment of the “netclinical-benefits” is needed in patients with frailty, with the aim of improving the prognoses of patients with frailty by selecting those who will benefit from anticoagulant therapy and actively reducing the risk of bleeding. A comprehensive intervention that includes a team of doctors and social resources is required. We herein review the effectiveness and bleeding risk associated with anticoagulant therapy in frail patients investigated in clinical studies.
  • Tamami Watanabe, Hitoshi Sugawara, Kai Saito, Akira Ishii, Takahiko Fukuchi, Kiyoka Omoto
    Medicine 100 (4) e24510 - e24510 0025-7974 2021/01 [Refereed]
     
    The risk factors associated with 72-hours mortality in patients with extremely high levels of random plasma glucose (RPG) remain unclear. To explore the risk factors predictive of 72-hours mortality in patients with extremely high RPG under heterogenos pathophysiological conditions. Retrospective, single-center, case-controlled cross-sectional study. University teaching hospital. Adults over age 18 were selected from the medical records of patients at the Saitama Medical Center, Japan, from 2004 to 2013. Extremely high RPG (≥500 mg/dl). Mortality at 72 hours following the RPG test, regardless of hospitalization or in an outpatient setting. Multivariate logistic regression analysis was performed with adjustment for age, sex, body mass index (BMI), and RPG level. The final prediction model was built using the logistic regression model with a higher C-statistic, specificity, and sensitivity. A total of 351 patients with RPG ≥500 mg/dl were identified within the 10-year period. The 72-hours mortality rate was 16/351 (4.6%). The C-statistics of the 72-hours mortality prediction model with serum albumin (ALB) and creatine kinase (CK) was 0.856. The probability of 72-hours mortality was calculated as follows: 1/[1 + exp (−5.142 + 0.901log (CK) −1.087 (ALB) + 0.293 (presence (1) or absence (0) of metastatic solid tumor)]. The sensitivity and specificity of this model was 75.5%. The independent risk factors associated with 72-hours mortality in patients with RPG ≥500 mg/dl are hypoalbuminemia, elevated CK, and presence of a metastatic solid tumour. Further research is needed to understand the mechanisms and possible interventions to prevent mortality associated with extremely high RPG.
  • Hiroshi Hori, Takahiko Fukuchi, Hitoshi Sugawara
    Journal of General and Family Medicine 22 (1) 51 - 52 2021/01 [Refereed]
     
    A 72‐year‐old woman presented with a 1‐day history of acute throat pain, hoarseness. On cervical ultrasonography (transverse view), the epiglottis was swollen with anterior‐posterior diameter of 3.5 and 3.8 mm at right and left edges, respectively. Laryngeal endoscopy showed marked swelling of the epiglottis, and acute epiglottitis was diagnosed.
  • Hiroshi Hori, Hiroki Yabe, Takahiko Fukuchi, Hitoshi Sugawara
    Clinical Case Reports 9 (1) 153 - 157 2021/01 [Refereed]
     
    Adult‐onset Still's disease may cause intestinal pseudo‐obstruction via a cytokine storm. Early diagnosis and treatment are the key for patient survival before the development of serious complications such as macrophage activation syndrome.
  • Hiroshi Hori, Yusuke Ozeki, Tsuyoshi Kobashigawa, Kazusige Futsuhara, Akira Tanaka, Eri Watanabe, Hiroki Yabe, Toru Yago, Takahiko Fukuchi, Hitoshi Sugawara, Shigeru Kotake
    Modern Rheumatology Case Reports 5 (1) 62 - 68 2021/01 [Refereed]
     
    A 71-year-old woman with dermatomyositis (DM) received glucocorticoid steroid (GCS) and tacrolimus treatment. Relapse of skin symptoms was observed after tapering the GCS dose, and the patient tested positive for anti-transcriptional intermediary factor-1 gamma (TIF1-γ) antibody. Examinations for malignancy were repeatedly performed. However, no obvious findings indicative of a tumour were observed. Two years after, a retroperitoneal tumour was detected and pathologically diagnosed as poorly differentiated adenocarcinoma. The patient developed intestinal and biliary obstruction and eventually died of sepsis. Herein, we report the presence of anti-TIF1-γ antibodies in a DM patient with cancer of unknown primary site.
  • Jumpei Taniguchi, Hitoshi Sugawara, Hodaka Yamada, Katsuyuki Yoshida, Ibuki Kurihara, Masashi Yoshida, Akira Ishii, Takahiko Fukuchi, Wilfred Y. Fujimoto
    Clinical Case Reports 8 (12) 3082 - 3087 2020/12 [Refereed]
     
    Physicians must recognize and treat adrenal crisis that may occur with acute viral illnesses such as influenza in women with Sheehan’s syndrome that has been undiagnosed and hence untreated, sometimes for many years, after postpartum hemorrhage.
  • Naoko Yukihira, Hiroshi Hori, Takeshi Yamashita, Ai Kawamura, Takahiko Fukuchi, Hitoshi Sugawara
    Internal medicine (Tokyo, Japan) 60 (10) 1621 - 1625 0918-2918 2020/12 [Refereed]
     
    Aggregatibacter actinomycetemcomitans, an etiological agent associated with periodontitis, endocarditis, and other infections, has rarely been implicated in spondylitis. A 70-year-old man with aortic valve replacement presented with a 4-month history of lower back pain and was diagnosed with spondylitis. Prolonged incubation of blood cultures and a biopsy yielded A. actinomycetemcomitans. Concurrent infective endocarditis (IE) was probable considering the infectious organism and the patients' prosthetic valve. The patient was treated with ceftriaxone and recovered well. Pyogenic spondylitis with possible concurrent IE may be caused by A. actinomycetemcomitans. Extended incubation and repeated cultures should be considered if HACEK infection is suspected.
  • Hiroshi Hori, Takahiko Fukuchi, Hitoshi Sugawara
    Journal of General and Family Medicine 21 (6) 272 - 273 2020/11 [Refereed]
     
    A 27-year-old woman complaining of persistent fever and sore throat was consulted. Examination of the laryngopharynx revealed multiple aphthous ulcers in the uvula, arytenoids, epiglottis, and laryngeal pyriform fossa. Crohn's disease was diagnosed by colonoscopy.
  • Hiroshi Hori, Takahiko Fukuchi, Hitoshi Sugawara
    European Journal of Internal Medicine 83 84 - 85 0953-6205 2020/11 [Refereed]
     
    A 67-year-old man presented with a 15-year history of chronic urticaria. It was distributed symmetrically on the limb trunk (Fig. 1A and B) without pruritus. No fever or joint pain or headache is observed. He showed no signs of angioedema. He was referred to our hospital for treatment of chronic urticaria. An antihistamine was ineffective. He was diagnosed with mild sensorineural hearing loss. He had no family history of autoinflammatory diseases.
  • Mizuki Mogi, Hiroshi Hori, Takahiko Fukuchi, Hitoshi Sugawara
    Journal of General and Family Medicine 21 (6) 277 - 279 2189-7948 2020/11 [Refereed]
     
    We present a case of diffuse aspiration bronchiolitis (DAB) with a false‐positive Gaffky score. “Tree‐in‐bud” opacities detected after aspiration should be considered DAB rather than mycobacterial infection.
  • Takahiko Fukuchi, Hitoshi Sugawara
    Internal medicine (Tokyo, Japan) 60 (5) 821 - 821 0918-2918 2020/09 [Refereed]
  • Hiroshi Hori, Hanako Yoshihara, Takahiko Fukuchi, Hitoshi Sugawara
    Journal of General and Family Medicine 21 (5) 195 - 196 2020/09 [Refereed]
     
    It is important to suspect intracranial hypotension based on distinctly frequent orthostatic headaches and diffuse dural hyperplasia. Lumbar puncture is a procedure prone to complications, especially in patients with already existing intracranial hypotension.
  • Ibuki Kurihara, Masahiro Kashiura, Takashi Moriya, Hitoshi Sugawara
    Journal of General and Family Medicine 21 (5) 188 - 190 2020/09 [Refereed]
     
    An 82‐year‐old man with untreated diabetes mellitus (DM) had anterior chest wall swelling and ulcers 2 years following blunt chest trauma. Contrast‐enhanced computed tomography revealed sternal fracture with osteolytic change and subcutaneous abscess. Blood and sternal cultures were positive for methicillin‐susceptible Staphylococcus aureus (MSSA). Transesophageal echocardiogram showed vegetation on the right coronary cusp and moderate aortic regurgitation. The patient received a diagnosis of infective endocarditis associated with chronic sternal osteomyelitis complicated by subcutaneous abscess because of MSSA. This case report showed that trivial trauma in patients with uncontrolled DM can cause chronic sternal osteomyelitis resulting in infective endocarditis.
  • Hiroshi Hori, Takahiko Fukuchi, Hitoshi Sugawara
    Journal of General and Family Medicine 22 (1) 47 - 48 2189-7948 2020/08 [Refereed]
     
    Peritonsillar abscess should be considered as a differential in patients presenting with fever, sore throat, and other cold‐like symptoms. Point‐of‐care transcutaneous cervical ultrasound is effective for diagnosing peritonsillar abscess in place of computed tomography (CT) imaging. Tongue movement during ultrasound examination will help confirm the presence of anatomical lesions on tonsils, and comparing the affected and unaffected sides will improve proper diagnosis.
  • Toshio Demitsu, Yoshinori Jinbu, Hiroki Yabe, Tomoko Yamada, Masaaki Kawase, Maki Kakurai, Naoka Umemoto, Akira Tanaka, Hitoshi Sugawara
    International Journal of Dermatology 59 (12) e445 - e447 1365-4632 2020/06 [Refereed]
     
    A 49‐year‐old‐Japanese woman visited us with a 1‐year history of verrucous lesions on the oral mucosa and fingers. Her past medical history was unremarkable except for chilblain in winter. She had no family history of collagen disease. Physical examination showed a well‐defined, hyperkeratotic erythematous plaque with ulceration on the palate and verrucous nodules on the fingers (Fig. 1a,b). She had no butterfly rash or discoid lesions on any other sites. Histology from both oral mucosa and finger revealed similar features; marked hyperkeratosis and acanthosis with perivascular lymphocytic infiltrates in the dermis. Liquefaction degeneration with a few necrotic keratinocytes was also found (Fig. 1c,d). We regarded the patient as verrucous lupus erythematosus (LE). Then, leukopenia (2,820/μl) and thrombocytopenia (67,000/μl) were observed as well as positive antinuclear antibody (ANA). However, the diagnosis of systemic lupus erythematosus (SLE) was not confirmed by the negative finding of anti‐DNA antibody, and the lack of requirements in 1997 updated ACR criteria for SLE validated back at that time. She developed skin ulcers on the left lower leg in the next two months (Fig. 2a). Four months later, laboratory examination revealed leukopenia (2,850/μl), thrombocytopenia (89,000/μl), low C3/C4 level (27 mg/dl, 3 mg/dl, respectively), positivity for ANA (1 : 640, speckled type), and anti‐Sm antibody (1 : 2). Histology of the leg ulcer exhibited no vasculitis but the occlusion of the vessels (Fig. 2b). Direct immunofluorescence revealed IgM, C1q, and C3 depositions on vessel walls as well as linear IgM deposition at basement membrane zone (Fig. 2c). Seven months later, she had seizure attacks. Then, SLE was diagnosed based upon ACR (1997) and SLICC criteria. Even under 2019 EULAR/ACR classification criteria,1 she was classified as SLE from total 24 points scored by the findings of fever (38.9 °C), leukopenia, thrombocytopenia, seizure, low C3/C4, and anti‐Sm antibody. Then, the patient was transported to us for dyspnea and high fever. Methylprednisolone pulse therapy was performed. Chest roentgenogram revealed extensive lung infiltrates. Aspergillus fumigatus was isolated from the sputum. Invasive aspergillosis was diagnosed. She died of multiple organ failure 8 months after the first visit.
  • Hiroshi Hori, Tsuyoshi Kobashigawa, Takahiko Fukuchi, Hitoshi Sugawara
    BMJ Case Reports 13 (6) e234734 - e234734 2020/06 [Refereed]
     
    A 77-year-old man visited the hospital with a chronic cough persisting for 2.5 months accompanied with night sweats, weight loss (3.5 kg) and elevated C-reactive protein level. Chest CT of the lung field was normal, but aortic wall thickening accompanied by a contrast effect was noted. Positron emission tomography–CT (PET–CT) showed that the aorta and subclavian artery were inflamed, suggesting large-vessel vasculitis. Ultrasonography showed thickening of the superficial temporal artery wall (macaroni sign). Biopsy revealed lymphocytic infiltration in the tunica media and foreign-body giant cell reaction with the elastic lamina, resulting in a diagnosis of giant cell arteritis (GCA). The cough was considered a symptom of GCA as it resolved following prednisolone administration. Cough may rarely be an initial GCA symptom. However, for chronic cough accompanied with elevated inflammatory findings but with a normal lung field, imaging studies such as PET–CT are useful for the differential diagnosis.
  • Takahiko Fukuchi, Hitoshi Sugawara
    Internal medicine (Tokyo, Japan) 59 (10) 1341 - 1341 1349-7235 2020/05 [Refereed]
  • Hiroshi Hori, Takahiko Fukuchi, Hitoshi Sugawara
    International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 95 (Jun) 371 - 372 2020/04 [Refereed]
     
    A 66-year-old woman complaining of painless bulging in the right flank abdomen exhibited redness with belt-like scab formation in her right lower quadrant (Th11-12 level).
  • Hiroshi Hori, Takahiko Fukuchi, Hitoshi Sugawara
    Journal of general and family medicine 21 (4) 157 - 158 2020/04 [Refereed]
     
    A 66-year-old man complained of lower limb edema was diagnosed with mesenteric panniculitis because of fat ring sign and tumoral pseudocapsule sign on contrast-enhanced CT. Patient had edema due to protein-losing enteropathy associated with mesenteric panniculitis.
  • Takahiko Fukuchi, Hitoshi Sugawara
    Internal medicine (Tokyo, Japan) 59 (6) 881 - 881 1349-7235 2020/03 [Refereed]
  • Fukuchi T, Sugawara H
    Internal medicine (Tokyo, Japan) 59 (3) 463 - 463 2020/02 [Refereed][Not invited]
  • Fukuchi T, Sugawara H
    Internal medicine (Tokyo, Japan) 59 (1) 149 - 149 2020/01 [Refereed]
  • Fukuchi T, Sugawara H
    Internal medicine (Tokyo, Japan) 59 (3) 467 - 467 2020/01 [Refereed]
  • Takahiko Fukuchi, Hitoshi Sugawara
    Internal Medicine (Tokyo, Japan) 58 (23) 3501 - 3501 0918-2918 2019/12 [Refereed]
  • Takahiko Fukuchi, Hitoshi Sugawara
    Internal medicine (Tokyo, Japan) 58 (23) 3493 - 3493 1349-7235 2019/12 [Refereed]
  • Fukuchi T, Sugawara H
    Internal medicine (Tokyo, Japan) 58 (24) 3615 - 3615 2019/11 [Refereed]
  • Takahiko Fukuchi, Nobue Yanagihara, Koichi Imaoka, Hitoshi Sugawara
    International Medical Case Reports Journal 2019 (12) 313 - 317 2019/10 [Refereed]
     
    Background: Brucellosis, an important zoonotic disease, is endemic in various parts of the world. Patients diagnosed with brucellosis in developed countries are often travelers and immigrants from endemic areas. This pathogen is listed as biosafety level 3, which means that it is highly contagious and therefore a risk to clinical laboratory technicians. Case presentation: A 43-year-old Chinese man, who could not understand Japanese, visited our hospital because of an intermittent fever that had persisted for 5 months. Associated symptoms included muscle pain whenever he had a fever. He reported currently working as a welder in Japan. However, his previous employment working in animal husbandry in Heilongjiang, mainland China was not determined at the initial visit owing to language barriers. Two sets of blood culture showed nonfermenting gram-negative bacilli, initially misidentified as Ochrobactrum anthropi and subsequently identified as Brucella abortus. Six-week doxycycline and rifampicin were administered, with intravenous gentamicin for the initial 1 week. The patient recovered without relapse, confirmed by the negative result of a Brucella agglutination test. The patient’s wife and three laboratory technicians were required to undergo blood examinations, which revealed no evidence of infection; however, they received prophylaxis with 3 weeks’ doxycycline and rifampicin. Conclusion: In nonendemic countries, immigrants with imported brucellosis can be treated, to prevent secondary brucellosis infection, an occupational hazard among laboratory technicians. Greater attention is needed for positive findings of blood cultures, which may initially be misidentified as O. anthropi. When providing medical care for immigrants with fever of unknown origin, it is especially important for primary care physicians to overcome language barriers so as to assess pertinent information regarding their home country, such as previous employment, to prevent the spread the imported zoonoses in the era of a dramatically increasing number of immigrants and foreign travelers.
  • Fukuchi T, Sugawara H
    Internal medicine (Tokyo, Japan) 58 (18) 2775 - 2775 2019/09 [Refereed]
  • Takahiko Fukuchi, Hitoshi Sugawara
    Internal Medicine 58 (17) 2589 - 2589 0918-2918 2019/09 [Refereed]
  • Takahiko Fukuchi, Hitoshi Sugawara
    Internal Medicine (Tokyo, Japan) 58 (16) 2423 - 2423 0918-2918 2019/08 [Refereed]
  • Takahiko Fukuchi, Hitoshi Sugawara
    Internal Medicine (Tokyo, Japan) 58 (16) 2419 - 2419 0918-2918 2019/08 [Refereed]
  • Katsuyuki Yoshida, Ibuki Kurihara, Takahiko Fukuchi, Hitoshi Sugawara
    BMJ Case Reports 12 (7) e229387 - e229387 2019/07 [Refereed]
     
    Essential thrombocythaemia (ET) is characterised by elevated platelet count by a clonal stem cell disorder of megakaryocytes. Although thrombosis is a common complication of ET, splenic infarction (SI) is extremely rare. Here, we present the case of a 31-year-old Japanese man who presented with sudden-onset severe pain at the left hypochondrium on the day before admission. Enhanced abdominal CT revealed SI. The laboratory test results revealed a normal platelet count (439×109/L). Subsequently, the patient was diagnosed with ET because the platelet count gradually increased to 50.0×104/μL, and JAK2 V617F mutation was identified. Accordingly, low-dose aspirin was initiated, and no thrombotic episode occurred. Nevertheless, 6 months postdischarge, the platelet count gradually increased to >650 × 109/L, and anagrelide was initiated. This case demonstrates an unusual complication of acute SI due to ET under the rare situation of the normal platelet count.
  • Eri Watanabe, Akira Tanaka, Hitoshi Sugawara, Kumiko Nishina, Hiroki Yabe, Takahisa Gono, Chihiro Terai
    American Journal of Case Reports 20 886 - 895 2019/06 [Refereed]
     
    BACKGROUND: Systemic vasculitides constitute heterogenous conditions affecting many organs and systems through blood vessel inflammation. Although there are some classifications for vasculitis, several vasculitides are “unclassified” because they cannot be clearly assigned to one of the known entities. CASE REPORT: We report an autopsy case of a 67-year-old Japanese man who presented with fever, ocular pain, erythema, chest pain, and headache. The disease caused episcleritis, thrombophlebitis, extensive deep vein thrombosis, multiple pulmonary nodules and masses, hypertrophic pachymeningitis, and hyper-intensity areas in brain parenchyma on magnetic resonance images. Histopathology of the pulmonary nodule confirmed vasculitis affecting medium-to-small veins and arteries without necrotizing vasculitis or granulomatous inflammation. We diagnosed the patient with unclassified vasculitis based on the clinicopathological characteristics. Steroids in combination with immunosuppressants were used, but the disease was refractory and relapsing. The disease activity was eventually controlled with rituximab, but the patient died of bronchopneumonia. On autopsy, lung and brain findings indicated healed vascular inflammation. CONCLUSIONS: This is the first case report of unclassified vasculitis, which is characterized as medium-to-small-sized arteritis and phlebitis, causing episcleritis, thrombophlebitis, deep vein thrombosis, pulmonary vasculitis, and intracranial vasculitis. The clinical conditions share some similarities with granulomatosis with polyangiitis and Behçet’s disease; however, they meet no classification criteria of any specific vasculitis. More cases need to be analyzed to confirm our findings.
  • Tamami Watanabe, Takeshi Yamashita, Hitoshi Sugawara, Takahiko Fukuchi, Akira Ishii, Yoshiaki Nagai, Fumiyoshi Ohyanagi, Shinichiro Koyama, Junko Ushijima, Kenjiro Takagi, Akira Tanaka
    Internal Medicine (Tokyo, Japan) 58 (7) 991 - 997 0918-2918 2019/04 [Refereed]
     
    Our case patient was a 38-year-old pregnant Japanese woman who underwent emergency Caesarean section because of massive vaginal bleeding due to a low-lying placenta. Immediately after delivery, she presented with rapidly progressive dyspnea. Contrast-enhanced computed tomography revealed bilateral pleural effusion, lung nodules, multiple liver tumors, and multiple osteolytic lesions. Accordingly, epidermal growth factor receptor-mutant advanced lung adenocarcinoma was diagnosed. This report highlights the occurrence of rapid progression of lung cancer following delivery that led to postpartum acute respiratory failure, rather than due to pulmonary thromboembolism associated with the existing deep venous thrombosis of the inferior vena cava.
  • 湊 さおり, 山下 武志, 吉田 克之, 川村 愛, 渡辺 珠美, 石井 彰, 福地 貴彦, 菅原 斉, 川瀬 正昭, 出光 俊郎
    自治医科大学紀要 41 (1) 29 - 34 1881-252X 2019/03 [Refereed]
     
    The" Stop! Syphilis Project" was started in Japan in 2018.A 29-year-old woman was admitted with fever, acute onset of posterior cervical pain, urodynia, and positive signs of meningeal irritation. Three months before admission, her heterosexual partner had been diagnosed with primary symptomatic syphilis with induration, but her initial serological screening tests for syphilis [rapid plasma reagin (RPR) test and Treponema pallidum hemagglutination (TPHA) test] were negative. She presented with a painless genital lesion at 2 months before the current hospitalization andwith skin rashes at 1 month before hospitalization; however, these were not recognized as symptomatic for syphilis. Additionally, urodynia appeared at 2 weeks before admission; the patient underwent serological rescreening for syphilis, which tested positive (RPR: 128-fold, TPHA: 640.0 titer unit), and posterior cervical pain appeared at 10 days before hospitalization. After emergent hospitalization, she was diagnosed with syphilitic meningitis without human immunodeficiency virus infection. Antimicrobial treatment with penicillin G was continued for 2 weeks, after which the fever, posterior cervical pain, urodynia, and rash subsided, and the patient was discharged on hospital day 16. On day 187 after starting treatment, RPR was 8-fold and TPHA was 262.4 titer unit. This case report highlights the fact that for the timely detection and appropriate treatment of syphilis, primary care physicians should recommend a repeated RPR test with incubation period taken into account, even in the absence of symptoms and even if initial screening results are negative.
  • Nozomu Yoshino, Ai Kawamura, Akira Ishii, Katsuyuki Yoshida, Tamami Watanabe, Takeshi Yamashita, Takahiko Fukuchi, Fumihiko Toyoda, Akihiko Kakehashi, Hitoshi Sugawara
    Internal Medicine (Tokyo, Japan) 57 (11) 1661 - 1665 0918-2918 2018/06 [Refereed]
     
    We herein report a case of a 31-year-old Japanese man who simultaneously had a positive influenza A virus antigen test result and Vogt-Koyanagi-Harada disease (VKHD), demonstrated by both diffuse multiple early hyperfluorescent points on fluorescein fundus photography and serous retinal detachments on optical coherence tomography. He had meningitis. It was difficult to determine whether the main cause of meningitis was influenza A or VKHD. After initial treatment with peramivir for influenza A and then methylprednisolone pulse with subsequent corticosteroid therapy for VKHD, his symptoms improved gradually. These findings suggest that influenza A virus infection contributes to the onset or exacerbation of VKHD.
  • Katsuyuki Yoshida, Takahiko Fukuchi, Hitoshi Sugawara
    BMJ Case Reports 2017 bcr - 2017 1757-790X 2017/11 [Refereed]
     
    Common adverse effects of serotonin-norepinephrine reuptake inhibitors are nausea, dry mouth, dizziness and headache. We describe the case of a patient with dysosmia and subsequent dysgeusia associated with duloxetine. A 68-year-old Japanese woman with a history of type 1 diabetes mellitus, hypertension, insomnia and reflux esophagitis presented to a local hospital with bilateral leg pain; she was treated with duloxetine. However, after 4 weeks, she sensed rotten egg smell, experienced nausea and vomiting and was admitted to our hospital. We diagnosed dysosmia using the T&T olfactometer threshold test and dysgeusia using filter paper disk method. Taste was assessed using electrogustometry. We suspected that dysosmia and dysgeusia were adverse effects of duloxetine. After stopping duloxetine, her symptoms gradually subsided and the above test results improved, despite continuing the other ongoing medication. To the best of our knowledge, this is the first case report of dysosmia and dysgeusia associated with duloxetine.
  • Mami Ishikawa, Hitoshi Sugawara, Toshiyuki Tsuji, Mutsumi Nagai, Gen Kusaka, Heiji Naritaka
    Clinical Neurology and Neurosurgery 163 179 - 185 0303-8467 2017/10 [Refereed]
     
    Objectives: Symptomatic cerebral infarction (CI) can occur in patients without main cerebral artery stenosis or occlusion. This study investigated the unique features of carotid artery plaque and white matter disease (WMD) in patients with symptomatic CI and transient ischemic attack (TIA) but without stenosis or occlusion of a main cerebral artery. Patients and methods: We studied 647 patients who underwent both carotid ultrasound examination and brain magnetic resonance images. Plaque score (PS), plaque number, maximal plaque intima-media thickness and grades of WMD were examined. Subjects were divided into four groups, the CI group, TIA group, myocardial infarction (MI) group and risk factor (RF) group. Plaque and WMD were analyzed in cerebral ischemia group (CI and TIA), compared to non-cerebral ischemia groups and to a high PS group and a high WMD grade group from the RF group. Results: Both of each value of plaque and grades of WMD in the cerebral ischemia group were significantly higher than those in other groups. Grades of WMD in the cerebral ischemia group were significantly higher than those in the high PS group, although there was no significant difference of the each value of plaque between the two groups. The each value of plaque in the cerebral ischemia group was also significantly higher than those in the high WMD grade group, although there was no significant difference of grade of WMD between the two groups. Conclusion: Simultaneous increases in carotid artery plaque and WMD are associated with symptomatic CI, which is not caused by stenosis or occlusion of a main cerebral artery.
  • Yuko Saito, Susumu Ookawara, Hisataka Uchima, Takeshi Ishida, Masafumi Kakei, Hitoshi Sugawara
    Case Reports in Medicine 2017 1 - 6 1687-9627 2017/07 [Refereed]
     
    A 54-year-old Japanese man noticed painful swelling and redness of his left leg. He was admitted for treatment of cellulitis, which was accompanied with increased anti-streptolysin O and anti-streptokinase titers in his clinical course. After Piperacillin/Tazobactam administration, the skin lesion resolved. However, the patient then developed arthritis, palpable purpura, and intermittent abdominal pain, later found to be secondary to a severe duodenal ulcer. He was diagnosed with cellulitis-associated anaphylactoid purpura and was given prednisolone, which dramatically improved his symptoms. The anaphylactoid purpura was likely caused by Streptococcus-induced cellulitis, which was successfully treated with prednisolone. Association between these diseases is rare.
  • Hitoshi Sugawara, Katsuhiko Matsuura, Akira Ishii, Takeshi Yamashita
    Journal of General and Family Medicine 18 (2) 88 - 89 2189-7948 2017/04 [Refereed]
     
    The causes of chronic unilateral leg swelling include common manifestations such as venous insufficiency, varicosis, deep vein thrombosis, and persistent cellulitis, less commonly are secondary lymphedema (tumor, radiation, and surgery), pelvic tumors or lymphoma causing pressure on the veins, and reflex sympathetic dystrophy, and rarely congenital venous malformation, pregnancy, and iliac vein compression syndrome. Here, we describe a 78‐year‐old nonsmoking man with history of type 2 diabetes mellitus, dyslipidemia, and hypertension presented with left leg swelling that had been getting worse over several months.
  • Mami Ishikawa, Hitoshi Sugawara, Mutsumi Nagai, Gen Kusaka, Yuichi Tanaka, Heiji Naritaka
    European Neurology 77 (1-2) 56 - 65 0014-3022 2017/01 [Refereed]
     
    Background: When an internal carotid artery (ICA) occludes, a patient may develop cerebral infarction (CI). We investigated whether CI caused by ICA occlusion (ICAO) is associated with collateral flow through the anterior and posterior communicating arteries (ACoA and PCoA). Methods: In 100 patients with ICAO, we investigated CI and white matter disease by performing an MRI and the anatomy of the ACoA and PCoA were investigated by performing magnetic resonance angiography. All patients were divided into the symptomatic CI group or the no-CI group. The collateral flow pathway was estimated by the anterior cerebral artery (ACA)-PCoA score and the collateral flow volume after ICAO was estimated by the middle cerebral artery (MCA) flow score, based on how well the MCA was visualized. Results: Of 100 patients with ICAO, the symptomatic CI group included 36 patients. ACA-PCoA score and white matter disease grades were significantly higher in the CI group (indicating poor collateral flow). More than 80% of patients with an ACA-PCoA score of 4 (poor collateral) experienced symptomatic CI. Thirty-one symptomatic CI patients (86%) had an MCA flow score of 1 or 2 (decreased MCA flow). Conclusion: The ACA-PCoA score and white matter disease grade may suggest an increased risk of CI following ICAO.
  • Masafumi Kakei, Masashi Yoshida, Katsuya Dezaki, Kiyonori Ito, Hodaka Yamada, Shunsuke Funazaki, Masanobu Kawakami, Hitoshi Sugawara, Toshihiko Yada
    Endocrine Journal 63 (10) 867 - 876 0918-8959 2016/10 [Refereed][Not invited]
     
    In pancreatic β-cells, glucose-induced closure of the ATP-sensitive K+ (KATP) channel is an initial process triggering glucose-stimulated insulin secretion (GSIS). This KATP-channel dependent pathway has been believed to be a central mechanism for GSIS. However, since the resting membrane potential of cells is determined by the balance of the net result of current amplitudes in outward and inward directions, it must be taken into consideration that not only KATP channel inhibition but also inward current via the basal opening of non-selective cation channels (NSCCs) plays a crucial role in membrane potential regulation. The basal activity of NSCCs is essential to effectively evoke depolarization in concert with KATP channel closure that is dependent on glucose metabolism. The present study summarizes recent findings regarding the roles of NSCCs in GSIS and GTP-binding protein coupled receptor-(GPCR) operated potentiation of GSIS.
  • Eri Watanabe, Hitoshi Sugawara, Takeshi Yamashita, Akira Ishii, Aya Oda, Chihiro Terai
    Case Reports in Medicine 2016 1 - 7 1687-9627 2016/09 [Refereed]
     
    We report the case of a 71-year-old Japanese woman with adult-onset Still’s disease (AOSD) in whom macrophage activation syndrome (MAS) developed despite therapy with oral high-dose prednisolone and intravenous methylprednisolone pulse therapy twice. She was successfully treated with tocilizumab (TCZ). Soon afterward, her fever ceased and high levels of both ferritin and C-reactive protein levels decreased. Her course was complicated by disseminated intravascular coagulation, cytomegalovirus infection, andPneumocystis jiroveciipneumonia. After these were resolved, AOSD-associated MAS was well controlled. She was discharged on hospital day 87. Although biologics such as TCZ are becoming established for the treatment of AOSD, there is no recommended therapy for AOSD-associated MAS. Several biologics have been tried for this complication, but their efficacy and safety remain controversial. We reviewed reported cases of AOSD-associated MAS successfully treated with various biologics. TCZ initiation after adequate nonselective immunosuppressive therapy, such as methylprednisolone pulse therapy or a prednisolone-based combination of immunosuppressants, can be an effective treatment for AOSD-associated MAS. On the other hand, biologics given after insufficient immunosuppressive therapy may cause MAS. A strategy combining adequate immunosuppression and a biologic could be safe if special attention is given to adverse events such as opportunistic infections or biologic-associated MAS.
  • Hitoshi Kuroda, Hitoshi Sugawara, Akira Ishii, Shunsuke Funazaki
    Internal Medicine (Tokyo, Japan) 55 (18) 2743 - 2744 0918-2918 2016/08 [Refereed]
  • Hitoshi Sugawara
    Internal Medicine 55 (16) 2327 - 2327 0918-2918 2016/08 [Refereed]
  • Hitoshi Sugawara, Katsuhiko Matsuura
    Internal Medicine 55 (15) 2127 - 2127 0918-2918 2016/08 [Refereed]
  • Akira Ishii, Hitoshi Sugawara, Mitsuhiro Nokubi, Tomohiro Nakamura, Tomohisa Okochi, Yousuke Taniguchi, Michiko Matsuzawa, Tamami Watanabe, Masafumi Kakei, Wilfred Y. Fujimoto, Shin-ichi Momomura
    Internal Medicine (Tokyo, Japan) 55 (7) 755 - 764 0918-2918 2016/07 [Refereed]
     
    An autopsy of a 70-year-old man with multiple bone metastases from a malignancy of unknown origin (MUO) and renovascular hypertension revealed an aortic intimal sarcoma (AIS) in the right renal artery accompanied by atherosclerotic changes. AIS appeared as aggregated mutton fat-like translucent particles arising from the intima of the branching portion of the right renal artery and was composed of undifferentiated, fine spindle cells with thicket-like proliferation. AIS was confirmed by immunohistopathology, showing the loss of the lumen lined by CD31-positive endothelium and the expression of CD31, keratin, and vimentin in the viable part of the tumor. In patients with MUO presenting with both bone metastases and an acute or sub-acute onset of renovascular hypertension, AIS in the renal artery may be responsible.
  • Hitoshi Sugawara, Akira Ishii, Tamami Watanabe
    Journal of General and Family Medicine 17 (2) 164 - 167 2189-7948 2016/06 [Refereed]
     
    A D-shaped left ventricle (D-LV), predominantly during systole, on a short axis view of two-dimensional echocardiography indicates pulmonary hypertension(PH). Here we describe a rare case involving a 35-year-oldmale smoker who developed typical D-LV secondary to fatal pulmonary Langerhans cell histiocytosis(PLCH)-related PH (PLCH-PH). To the best of our knowledge, there is no article to exhibit the image of D-LV caused by PLCH -PH.
  • Kenta Iijima, Michiko Matsuzawa, Ai Kawamura, Tamami Watanabe, Akira Ishii, Hitoshi Sugawara
    Jichi Medical University Journal (学)自治医科大学 38 (1) 53 - 58 1881-252X 2016/03 [Refereed][Not invited]
     
    Aortic graft infection is rare and carries a poor prognosis. Conventional management for prosthetic graft infection includes surgical debridement, removal of the infected graft, and reconstruction with a new graft prosthesis. However, these approaches are not feasible for some patients with anatomical difficulty for excision or severe comorbid medical illnesses. Here, we report a case of aortic prosthetic graft infection successfully treated with long-term appropriate antibiotics without surgical intervention. A 47-year-old man presented with high fever and back pain. He had undergone descending thoracic aortic reconstruction with a woven Dacron graft for post-ductal coarctation of the descending aorta at 15 years old. Contrasted-enhanced computed tomography (CT) of the chest demonstrated a low-density area around the graft. He was referred to our hospital for further treatment. The previous doctor reported that the blood cultures were positive for Staphylococcus aureus. Use of 67Ga scintigraphy detected a region of abnormal uptake around the graft. We initiated antibiotics with vancomycin, gentamicin, and piperacillin-tazobactam due to the possibility of both methicillin-resistant S. aureus and concomitant infections with anaerobic bacteria. After antimicrobial susceptibility testing revealed methicillin-susceptible S. aureus (MSSA), the antibiotics were switched to cefazolin. Cardiovascular surgeons did not recommend surgical intervention for the patient, so antibiotics were continued for a total of 8 weeks. Results from both a C-reactive protein test and CT showed improvement. The patient was discharged on hospital day 57, then continued oral cefaclor for 6 months thereafter and remained asymptomatic for over 6 months after the end of antibiotic therapy. The patient is now off antibiotics and free from re-infection without the use of any other antibiotics. Prosthetic aortic graft infections due to MSSA may circumvent surgical interventions with appropriate long-term antimicrobial therapies.
  • 渡辺 珠美, 石井 彰, 菅原 斉
    診断と治療 (株)診断と治療社 103 (12) 1652,1537 - 1655,1537 0370-999X 2015/12 [Not refereed]
  • Reina Suzuki, Hitoshi Kuroda, Hiroshi Matsubayashi, Akira Ishii, Fumihiko Toyoda, Alan Kawarai Lefor, Hitoshi Sugawara
    Internal Medicine (Tokyo, Japan) 54 (20) 2693 - 2698 0918-2918 2015/10 [Refereed]
     
    A 51-year-old Japanese woman developed candidemia as an outpatient secondary to a Candida albicans upper urinary tract infection complicated by previously undiagnosed type 2 diabetes mellitus with poor glycemic control and ureterolithiasis. The patient did not have any risk factors typically associated with candidemia, such as an indwelling vascular catheter, parenteral nutrition or broad-spectrum antibiotic use. During the clinical course, her condition was complicated by unilateral candida endophthalmitis, which progressed despite the administration of systemic antifungal agents and ultimately required vitreous surgery. The etiology of candidemia in this patient and the reason she developed progressive ocular symptoms after starting antifungal treatment are reviewed.
  • 高山千幸, 石井 彰, 菅原 斉
    診断と治療 (Diagnosis and Treatment) 診断と治療社 103 (7) 970 - 973 2015/07 [Not refereed]
  • Atsushi AOKI, Hitoshi SUGAWARA, Akira ISHII, Tamami WATANABE, Toshio DEMITSU, Kazuo SAITA, Masamitsu SANUI, Masafumi KAKEI, San-e ISHIKAWA, Masanobu KAWAKAMI
    Jichi Medical University Journal (学)自治医科大学 37 35 - 42 1881-252X 2015/03 [Refereed][Not invited]
     
    A 54-year-old Japanese man with diabetes mellitus (DM) since 41 years of age, was hospitalized due to warmth, swelling, and pain in both the lower left thigh and right wrist, and immobility. Although he had been on insulin therapy for 4 years, glycemic control was poor and he had developed diabetic retinopathy. For the preceding month, he had also been treated for diabetic foot gangrene involving the fifth toe of the right foot. Following hospitalization, microbiologic cultures of blood and pus from the posterior left thigh were positive for group A β -hemolytic Streptococcus. Empirical administration of penicillin G, clindamycin, vancomycin and γ-globulin proved ineffective and he developed necrotizing fasciitis, psoas abscess, and infectious spondylitis in the clinical course of streptococcal toxic shock-like syndrome (STSS). To treat STSS in this diabetic patient, general physicians of the Division of General Medicine worked in close coordination with specialists from emergency medicine, endocrinology, dermatology, orthopedics, and intensive care. We consider the following three factors to have been important in the successful management of this patient. The first factor was the inter- professional work among general physicians, specialists and other healthcare professionals. The second factor was the switch in antibacterial treatment to appropriate antibiotics. The third factor was the targeting of blood glucose levels to approximately 150 mg/dL. Thus, despite this very serious life-threatening illness, our patient was able to regain his ability to walk independently and was discharged on hospital day 106.
  • Sanayama H, Sakiyama Y, Hiramatu A, Ishii A, Sugawara H
    Jichi Medical University Journal (学)自治医科大学 37 43 - 47 1881-252X 2015/03 [Refereed][Not invited]
     
    The patient was a right-handed, 73-year-old female. She had mild memory dysfunction, but she could live independently. She had a past history of artificial aortic valve replacement and atrial fibrillation. However, she chose to discontinue warfarin. She was admitted to our hospital complaining of dizziness and visual dysfunction that had lasted for eight hours. A bedside neurological examination disclosed upper-field hemianopsia, central achromatopsia, and truncal ataxia. A cranial MRI showed acute infarcts in the posterior circulation, including the bilateral lower posterior lobes and the cerebellar vermis. Conservative treatment and bedside rehabilitation ameliorated her central achromatopsia and truncal ataxia. When she started gait training in the rehabilitation room on the 8th day of hospitalization, she could not return from the rehabilitation room to her hospital room by herself. Further examination suggested that she had developed landmark agnosia without prosopagnosia, so her family was advised to accompany her when she went out until there was improvement in her landmark agnosia. Six months later, she could walk around near her house by herself. Discovering landmark agnosia in a bedside check is so difficult that it might be missed, especially in people with cognitive decline. However, caregivers can be advised to support such patients so that they can go about their daily lives safely. When a patient has a large posterior lobe lesion, it is important to actively check for landmark agnosia and to advise the patient and family properly.
  • Matsubayashi H, Sugawara H
    Journal of the Japanese Society of Internal Medicine (一社)日本内科学会 103 (11) 2835 - 2840 0021-5384 2014/11 [Refereed][Not invited]
  • 石井 彰, 菅原 斉
    レジデントノート (株)羊土社 16 (6) 1098 - 1104 1344-6746 2014/07 [Not refereed][Not invited]
     
    (1)LDHは多くの組織に存在し疾患特異性は低い(2)LDHアイソザイムを測ることで肝臓, 心筋, 悪性腫瘍などどの組織由来かの推測が可能となる(3)LDH以外の検査データも参照して, 病態を考える(4)LDHがほかの検査値に比較して極端に上昇している場合やLDH増加スピードが速い場合には悪性腫瘍を強く示唆する「はじめに」LDH(lactate dehydrogenase:乳酸脱水素酵素)という検査は少しニガテという研修医も多いのではないか. 理由として, (1)頻繁に異常値がみられる(2)異常値の原因が多岐にわたる(3)異常値の範囲が, 「わずかに高値」から「びっくりするほど高値」までさまざま(4)異常値の原因に重篤な疾患が隠れていることもときにある といったことがあげられる. 今回はとびぬけてLDHが高かった症例を紹介しつつLDHの意味について考えていく. 「症例」80歳の女性が食欲不振で来院.
  • Yosida, M., Dezaki, K., Uchida, K., Kodera, S., Lam, N.V., Ito, K., Rita, R.S., Yamada, H., Shimomura, K., Ishikawa, S.-E., Sugawara, H., Kawakami, M., Tominaga, M., Yada, T., Kakei, M.
    Diabetes 63 (10) 3394 - 3403 0012-1797 2014/05 [Refereed][Not invited]
     
    In pancreatic beta-cells, closure of the ATP-sensitive K+ (K-ATP) channel is an initial process triggering glucose-stimulated insulin secretion. In addition, constitutive opening of background nonselective cation channels (NSCCs) is essentially required to effectively evoke depolarization as a consequence of K-ATP channel closure. Thus, it is hypothesized that further opening of NSCC facilitates membrane excitability. We identified a class of NSCC that was activated by exendin (ex)-4, GLP-1, and its analog liraglutide at picomolar levels. This NSCC was also activated by increasing the glucose concentration. NSCC activation by glucose and GLP-1 was a consequence of the activated cAMP/EPAC-mediated pathway and was attenuated in TRPM2-deficient mice. The NSCC was not activated by protein kinase A (PKA) activators and was activated by ex-4 in the presence of PKA inhibitors. These results suggest that glucose- and incretin-activated NSCC (TRPM2) works in concert with closure of the K-ATP channel to effectively induce membrane depolarization to initiate insulin secretion. The current study reveals a new mechanism for regulating electrical excitability in beta-cells and for mediating the action of glucose and incretin to evoke insulin secretion, thereby providing an innovative target for the treatment of type 2 diabetes.
  • Yabe
    Journal of Medical Cases 5 (4) 197 - 201 1923-4155 2014/04 [Refereed][Not invited]
     
    Parsonage-Turner syndrome (PTS), also known as neuralgic amyotrophy or brachial neuritis, consists of a complex set of symptoms including sudden onset shoulder pain, usually unilaterally, followed by progressive neurologic deficits such as motor weakness, dysesthesia and numbness. We report a case of a 45-year-old Japanese man with PTS, who was initially suspected of having orthopedic diseases, such as cervical spondylosis and suprascapular nerve entrapment syndrome. The patient presented with acute-onset severe pain in his right arm and neck, followed by muscle weakness. We diagnosed PTS by taking a detailed medical history, ruling out other differential diagnoses, and by considering the characteristic clinical symptoms and the denervation pattern identified by needle electromyography. High-dose corticosteroid therapy prednisolone (PSL) relieved the initial sharp pain and oral amitriptyline successfully relieved the residual nighttime pain. Doses of PSL and amitriptyline were tapered, pain was alleviated, and the patient returned to full-time work after discharge in one-and-a-half years. For prompt diagnosis, physicians should consider the possibility of PTS in patients with acute onset of severe arm pain or subsequent muscle weakness and muscle atrophy in the arm or shoulder girdle.
  • Michiko Matsuzawa, Akira Ishii, Toshio Demitsu, Hitoshi Sugawara
    Internal Medicine 53 (6) 643 - 644 0918-2918 2014/03 [Refereed]
  • Muneyuki, T., Sugawara, H., Suwa, K., Oshida, H., Saito, M., Hori, Y., Seta, S., Ishida, T., Kakei, M., Momomura, S.-I., Nakajima, K.
    Kidney International 84 (6) 1254 - 61 1523-1755 2013/12 [Refereed][Not invited]
     
    Although proteinuria is highly prevalent in obese individuals, the association between proteinuria and low body weight is equivocal. In this study we determine whether low body weight is more strongly associated with proteinuria compared with normal weight. The association between body mass index (BMI) and proteinuria was examined in a cross-sectional study of 62,582 asymptomatic individuals aged 20-70 years without known kidney diseases recruited, based on the results of medical checkups in 1999. We also examined the incidence of recurrent or nonrecurrent proteinuria in an 8-year longitudinal analysis of 12,493 individuals without proteinuria at baseline. The prevalence of proteinuria showed a J-shaped relationship with BMI. Multivariate regression analysis showed that BMI of 27.0 kg/m(2) and above or 18.9 kg/m(2) and less was significantly associated with proteinuria relative to BMI 21.0-22.9 kg/m(2), even after adjusting for relevant cardiometabolic risk factors. In the longitudinal study, similar J-shaped relationships between the incident rates of proteinuria and baseline BMI groups were observed at post-baseline checkups. Baseline BMI 27.0 kg/m(2) and above was associated with significantly greater risk for recurrent and nonrecurrent proteinuria, whereas BMI 18.9 kg/m(2) and less was only associated with nonrecurrent proteinuria. Thus, obesity and low body weight may be associated with different types of proteinuria independent of cardiometabolic risk factors.
  • 藤本 由貴, 中村 考伸, 塚原 理恵子, 飯田 絵理, 山田 朋子, 増田 麻里亜, 渡邉 萌理, 小山 尚俊, 中村 哲史, 出光 俊郎, 白石 守, 崎山 快夫, 大塚 美恵子, 菅原 斉, 加計 正文
    The journal of the Saitama Medical Society 埼玉県医学会 48 (1) 344 - 350 0389-0899 2013/10 [Refereed][Not invited]
     
    薬剤過敏症症候群(Drug-induced Hypersensitivity Syndrome,DIHS) は重症薬疹の一型である.本性の特徴は抗てんかん薬など特定の薬剤を 2 週間 から 8 週間内服後に発熱皮疹で発症し,原因薬剤中止後も症状改善せず遷延し, 重症な臓器障害を引き起こすことである.今回,さまざまな臨床経過を辿った DIHS の 3 症例を経験した.DIHS は原因薬剤,特徴的な経過,皮疹などから早 期に診断することが重要な疾患であり,またステロイドの漸減に際しては症状 の再燃が起こらないように慎重に行う必要がある.
  • Suzuki
    Journal of Medical Cases 4 (9) 627 - 632 1923-4155 2013/09 [Refereed]
     
    We report the case of a 68-year-old Japanese man with rheumatoid arthritis who had progressive fatigue associated with hypercalcemia complicated by peripheral T-cell lymphoma (PTCL)-type methotrexate-associated lymphoproliferative disorder (MTX-LPD). Epstein-Barr virus (EBV) studies indicated presence of the virus in peripheral blood; however, axillary lymph-node biopsy specimen was negative. After the discontinuation of MTX, the Disease Activity Score 28-C-Reactive Protein (DAS28-CRP) improved from 2.9 to 2.2 and both hypercalcemia and lymphadenopathy remitted. We presume that both EBV reactivation under immunosuppressive state and PTCL-type MTX-LPD developing coincidentally may have contributed to hypercalcemia and consequent fatigue.
  • Jun Nakamura, Hitoshi Sugawara, Akira Ishii, Rieko Tsukahara, Toshio Demitsu, Hidenori Sanayama, Tamami Watanabe, Mitsuhiko Nokubi
    The Journal of the Japanese Society of Internal Medicine(J Jpn Soc Int Med) (一社)日本内科学会 102 (8) 2053 - 2056 0021-5384 2013/08 [Refereed][Not invited]
     
    症例は53歳,女性.入院5カ月前から掌蹠膿疱症に対しミノサイクリン(MINO)とビオチンの投与開始.1カ月前に発熱と筋痛を自覚.階段昇降が困難となり,両側下腿に隆起性紅斑が出現し入院.両薬剤を中止後,発熱,筋痛,紅斑は速やかに消失.紅斑の皮膚生検病理は壊死性血管炎の所見.ビオチン再開後も発熱と筋痛の再燃なく,MINO誘発性結節性多発動脈炎(MIPN)と診断.MIPNの報告は24例に過ぎないが,MINO内服中の新たな発熱,筋痛,紅斑などの血管炎様症状出現時には,薬剤性血管炎,特にMIPNも考慮すべきである.
  • Fujiwara
    Journal of Medical Cases 4 (7) 507 - 510 1923-4155 2013/07 [Refereed]
     
    When evaluating pleural effusion of undetermined etiology, malignant disease cannot be ruled out even if the effusion is transudative. Measurement of tumor markers in transudative pleural effusion (TPE) may aid in diagnosis, but the exact utility of these markers is unclear. We report the case of a 78-year-old man with paramalignant pleural effusion (PMPE) due to prostate cancer diagnosed by measuring prostate-specific antigen (PSA) in TPE. Androgen blockade therapy was effective in treating the PMPE. We discuss the value of PSA elevated in TPE for diagnosis of prostate cancer induced-PMPE.
  • Yuki Fujimoto, Toshinobu Nakamura, Rieko Tsukahara, Eri Iida, Kuniko Yamada, Maria Masuda, Eri Watanebe, Naotoshi Koyama, Satoshi Nakamura, Toshio Demitsu, Mamoru Shiraishi, Yoshio Sakiyama, Mieko Oostuka, Hitoshi Sugawara, Masafumi Kakei
    The Journal of the Saitama Medical Sociey 2013 [Refereed][Not invited]
  • Hiroki Yabe, Akira Ishii, Naoko Niikawa, Hiroshi Matsubayashi, Masafumi Kakei, Masanobu Kawakami, Hitoshi Sugawara
    Internal medicine (Tokyo, Japan) 51 (11) 1429 - 1432 1349-7235 2012/11 [Refereed]
     
    Spontaneous spinal epidural hematoma (SSEH) is an uncommon but clinically important disease, and delayed diagnosis of this condition can have severe consequences. General physicians should consider the possibility of SSEH when they encounter a patient with a sudden onset of unexplained cervical or back pain or subsequent radicular symptoms during anticoagulant therapy. Immediate magnetic resonance imaging is essential for early diagnosis. In this article, we present a rare case of an 80-year-old man who developed cervical SSEH during warfarin therapy.
  • Tamami Watanabe, Hitoshi Sugawara, Hiroyuki Tamura, Akira Ishii, Hiroshi Matsubayashi, Masafumi Kakei, Shin-ichi Momomura
    Internal Medicine 51 (18) 2639 - 2643 0918-2918 2012/09 [Refereed]
     
    Acute pharyngitis is commonly encountered, but a definite etiological diagnosis is difficult. Although co-infection with Group A Streptococci (GAS) and Epstein-Barr virus (EBV) is uncommon, general physicians should consider the possibility of EBV co-infection in patients with GAS pharyngitis who fail to show prompt remission of symptoms following appropriate antibiotic treatment. In this article, we present a rare case of a 16-year-old girl who had co-infection with GAS and EBV. She developed acute glomerulonephritis and left ventricular dysfunction in an overlapping manner. We were able to follow her until she healed, and herein describe the pathogenesis of her systemic and pulmonary edema.
  • 百村 伸一, 菅原 斉, 石光 俊彦, 安村 良男
    Fluid Management Renaissance (株)メディカルレビュー社 2 (3) 217 - 225 2186-3008 2012/07 [Not refereed][Not invited]
  • Toshitaka Muneyuki, Kei Nakajima, Atsushi Aoki, Masashi Yoshida, Hiroshi Fuchigami, Hiromi Munakata, San-e Ishikawa, Hitoshi Sugawara, Masanobu Kawakami, Shin-ichi Momomura, Masafumi Kakei
    Cardiovascular Diabetology 11 (1) 80 - 80 1475-2840 2012/06 [Refereed]
     
    Background: Low serum amylase is likely to be associated with obesity and metabolic abnormalities, which are often accompanied by impaired insulin action. However, it is unclear whether low serum amylase is associated with impaired insulin action in clinical settings. Therefore, we investigated the associations of low serum amylase with plasma insulin levels, and obesity-related parameters, including leptin. Research design and methods: We measured serum amylase, plasma insulin, obesity-related parameters such as leptin, cardiometabolic risk factors, and anthropometric parameters in a cross-sectional study of 54 asymptomatic subjects (mean age 48.6 ± 7.6 years) who were not being treated for diabetes. Results: Body mass index (BMI) and plasma glucose at 120 min after a 75-g oral glucose tolerance test (OGTT) were significantly higher in subjects with low serum amylase (< 60 IU/l, n = 21) than in those with normal-to-high serum amylase (n = 33) (P = 0.04 and P = 0.004, respectively). In univariate correlation analysis, serum amylase was significantly correlated with BMI alone (r = -0.39, P = 0.004). By contrast, multivariate logistic analysis showed that each 1-SD increase in quantitative insulin sensitivity check index, and each 1-SD decrease in plasma insulin OGTT at 0 and 60 min, homeostasis model assessment of insulin resistance (HOMA)-R, and HOMA-β were significantly associated with low serum amylase, particularly after adjusting for BMI. When subjects were divided into three groups according to HOMA-R, serum amylase levels were significantly lower in subjects with HOMA-R > 2.5 (n = 23) compared with subjects with HOMA-R 1.6-2.5 (n = 10) (61.1 ± 13.6 U/ml versus 76.9 ± 20.5 U/ml, Bonferroni test, P = 0.02), but not compared with subjects with HOMA-R<1.6 (n = 21; 62.7 ± 17.6 U/ml). Similar trends were observed when subjects were divided according to plasma leptin and fasting plasma insulin levels. Conclusions: These results suggest that after adjusting for BMI, low serum amylase is associated with decreased basal insulin levels and insulin secretion, as well as high insulin resistance. The nature of these associations remains to be elucidated in further studies.
  • 川畑奈緒, 石井 彰, 茂木さつき, 手塚洋子, 長谷部忠史, 本多晴美, 三ツ橋美幸, 笹岡康子, 菅原 斉, 早田邦康
    日本病態栄養学会誌 日本病態栄養学会 15 (2) 185 - 191 2012/06 [Refereed][Not invited]
     
    要旨:著明な栄養障害に陥った強皮症患者に対して、病態解明に必要な医学的情報を多職種で共有し、栄養管理を基軸としたチーム医療を行うことで病状の改善が得られた症例を報告する。 症例は70歳女性。56歳時胃癌にて胃全摘術施行。68歳頃より低蛋白血症を指摘され、その後食欲低下が増強。低蛋白血症の原因精査と栄養状態の改善を目的に入院。入院後の精査により限局型全身性強皮症と診断された。栄養障害の主たる原因として、消化管蠕動不全による機能的通過障害と嘔吐による慢性的なエネルギー摂取不足が考えられた。成分栄養剤の併用にて栄養管理を開始したが、栄養状態や日常生活動作の改善がみられなかったため、中心静脈栄養併用により栄養障害の改善を 図ったところ、第34病日には改善が得られた。本症例では、NSTが早期から担当科と連携し、変化する患者の消化管機能に合わせた栄養管理を実施したことが栄養状態と日常生活動作の改善に寄与したと考えられた。
  • Yasutaka Watanabe, Shinichiro Koyama, Fumiaki Kudo, Chihiro Miwa, Tamami Watanabe, Akira Ishii, Hitoshi Sugawara, Tomohisa Okochi, Masanori Hiruta, Yoh Dobashi, Shigeki Yamada
    THE LUNG-perspectives (株)メディカルレビュー社 20 (2) 106 - 111 0919-5742 2012/05 [Refereed][Not invited]
  • Akira ISHII, Hitoshi SUGAWARA, Tamami WATANABE, Mitsuya MATSUMOTO, Hiroshi MATSUBAYASHI, Toshirou DEMITU, Takasi HYOUDOU, Shigeki YAMADA, Masanobu KAWAKAMI
    Jichi Medical University Journal (学)自治医科大学 34 (1) 129 - 134 1881-252X 2012/03 [Refereed][Not invited]
     
    A 78-year-old woman with a 3-month history of right nasal obstruction and an oppressive feeling in her right cheek was referred to an otolaryngologist at our center. Computed tomography (CT) scan showed a mass in the right nasal canal and maxillary sinus. Biopsy was performed through the right nasal canal; however, a diagnosis could not be made. On the admission day, she experienced a sudden loss of appetite and back discomfort. Subsequently, she was referred to the Division of General Internal Medicine. Review of systems (ROS) after the consultation indicated a weight loss of 10 kg within 2 months and a small subcutaneous nodule in the left lower abdomen. Tenderness of the thoracic vertebrae and right hypochondralgia were noted on examination. Enhanced CT scan showed multiple metastases to the liver and sacral bone. Immunohistochemical staining of the completely resected subcutaneous nodule was positive for S100, HMB45 and vimentin, but was negative for epithelial membrane antigen, cytokeratin, and CD30. The pathological diagnosis was that of an amelanotic melanoma. The performance status of the patient declined, and she died the 19th hospital day. At autopsy, the right nasal sinus was inundated with a white pultaceous mass, the histological findings of which were the same as those obtained from the previous biopsy of amelanotic melanoma, and extensive multiple metastases to the liver, lung, heart, thyroid, peritoneum, retroperitoneum, ribs, thoracic vertebrae, and iliac bone were observed. The TNM staging for malignant melanoma was pT4N0M1c. ROS is an important tool not only for diagnosis, but also for determining the patient’s general condition. Obtaining the ROS is an overarching approach for organ specialists who care for patients with malignancy; it enables them to evaluate metastasis to organs other than the target organ.
  • Atsushi Aoki, Takatoshi Muneyuki, Masashi Yoshida, Hiromi Munakata, San-e Ishikawa, Hitoshi Sugawara, Masanobu Kawakami, Masafumi Kakei
    Diabetes Research and Clinical Practice 92 (2) 181 - 186 0168-8227 2011/05 [Refereed][Not invited]
     
    We aimed to examine whether circulating levels of osteocalcin, bone formation marker secreted from osteoblast, are changed in glucose-intolerant subjects without taking glucose lowering agent, because bone metabolism is reportedly related to glucose metabolism in animal and human studies. According to 75 g oral glucose tolerance test (75 g-OGTT), all subjects (47.6 ± 10.2 years of age; 45 men and 10 women) were divided into three categories: normal glucose tolerance (NGT, n = 39), prediabetes (PDM, n = 11) that included impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), and diabetes (T2DM, n = 5). Serum osteocalcin levels were increased in T2DM as compared to NGT. In all the participants, simple regression analysis model revealed positive correlation of osteocalcin with plasma glucose at 120 min, G(120), on 75 g-OGTT, negative with both creatinine and Ln(CRP), but not significantly with fasting plasma glucose. Osteocalcin and leptin were independent variables for G(120) ( P = 0.026 and 0.035, respectively). In multinomial logistic analysis leptin (PDM vs. NGT: P = 0.02 Odds ratio (OR) of 1.05, 95% confidence intervals, 1.007–1.084) and osteocalcin (T2DM vs. NGT: P = 0.038, OR 10.8, 1.13–102.4) were independently associated. We conclude that circulating osteocalcin and leptin are related to glucose intolerant state.
  • Akira ISHII, Hitoshi SUGAWARA, Tamami WATANABE, Shuhei YOSHIKAWA, Ken TASHIRO, Haruhiko ISHIOKA, Ken HUKATU, Tetsu OONUMA, Mariko USHIKI, Hiromitu SANUI, Masanobu KAWAKAMI
    Jichi Medical University Journal 自治医科大学 33 (1) 141 - 146 1881-252X 2011/03 [Refereed][Not invited]
     
    The patient was a 31-year-old man with bipolar disorder who developed acute lithium toxicosis induced by the new onset of diabetes mellitus. He was being treated with lithium carbonate and presented with loss of consciousness. He had been drinking a large quantity of soft drinks because of increasing thirst over the previous 2 months. At a regular hospital visit, his HbA1c was found to be 13%. He was treated with oral hypoglycemic medication despite the presence of ketosis. Nine days later, he was transported to our hospital unconscious. His plasma lithium level was 4.0 mEq/L. When he finally regained consciousness, he had severe residual cerebellar ataxia. Hypovolemia induced by high blood glucose causes prerenal acute renal failure. Once renal dysfunction has occurred, the serum lithium level quickly reaches toxic levels. Lithium toxicosis related to diabetes mellitus has rarely been reported. The mechanism of cerebellar ataxia due to lithium poisoning is not yet clear. This instructive case is presented along with a review of the relevant literature.
  • Tamami WATANABE, Hitoshi SUGAWARA, Hiroshi MATSUBAYASHI, Akira ISHII, Atsushi AOKI, Shinya USHIMARU, Mitsuhiro NOKUBI, Junji NISHIDA, Yukio YOSHIDA, Masanobu KAWAKAMI
    Jichi Medical University Journal 自治医科大学 33 (1) 147 - 153 2011/03 [Refereed][Not invited]
     
    The case of a 42-year-old man with amoebic colitis associated with acquired immunodeficiency syndrome (AIDS) treated with tinidazole following an allergic reaction to metronidazole is presented. The patient had a 3-month history of persistent diarrhea. At another hospital, amoebic colitis was diagnosed by colonoscopy, and metronidazole was prescribed. A rash appeared on his limbs and chest 3 days after metronidazole was initiated, so it was discontinued. When the patient subsequently developed appetite loss, weight loss, exertional dyspnea, and palpitations, he was referred to our hospital. We found that he had Pneumocystis jiroveci pneumonitis associated with AIDS. The patient denied sexual intercourse with men. His HIV-RNA viral load was 2.0×106 copies/ml, and his CD4 cell count was 63 /μl. His symptoms improved with sulfamethoxazole-trimethoprim and prednisolone. On the 11th day after admission, his temperature rose to 38°C, and he had frequent, watery diarrhea. On the 15th day, colonoscopy showed erosive lesions along the entire colonic mucosa and amoebiasis in the specimen biopsy. On the 17th day, the patient began to take metronidazole. On the 22th day, his temperature rose to 38°C again, but no skin rash appeared. Because of the increased temperature, the medication was switched from metronidazole to tinidazole. As a result, his temperature returned to normal the next day, the frequent diarrhea decreased, and the results of the fecal occult blood tests became negative. The patient was discharged on the 43rd day, with a plan to receive highly active anti-retroviral therapy on an outpatient basis. Because both metronidazole and tinidazole are used to successfully treat amoebic colitis in Japan, we hope that the healthcare payment system will begin to cover the use of these drugs as soon as possible.
  • Sugawara H, Ishii A, Watanabe T, Matsubayashi H, Aoki A, Matsumoto Y, Kakei M, Momomura S, Kawakami M
    Jichi Medical University Journal (学)自治医科大学 33 (1) 183 - 190 1881-252X 2011/03 [Refereed][Not invited]
     
    Background: Since Japan's new compulsory clinical resident training system started in 2004, many medical students have visited the Division of General Medicine (G/M) at the Saitama Medical Center of Jichi Medical University. It is unclear which background factors influenced visiting medical students' (visitors) and residents' decisions to apply to the clinical training program for residents or continue into the subsequent clinical fellowship program. Purpose: The present study aimed to identify important background factors that influenced visitors' decisions to apply to both the clinical training program for residents and the subsequent clinical fellowship program, regardless of whether visitors participated in the G/M shadowing program. Participants and Methods: Logistic regression analyses were conducted to identify significant background factors among 581 visitors, 397 candidates for the clinical training program for residents, and 81 residents who had completed the clinical training program for residents from 2003 to 2009. Results: Older visitors were more likely to apply to the clinical training program for residents. Visitors or residents whose hometowns were outside of the Kanto metropolitan area were the least likely to apply to the clinical training program. Both the frequency of visits and the total number of days spent visiting increased the possibility of applying to the clinical training program and participating in the subsequent clinical fellowship program. These decisions were not influenced by participation in the G/M shadowing program. Conclusion: "Shared territorial bonding" between visitors and residents from hometowns nearby and the location of the teaching hospital were important factors affecting the decision to apply to the residency program or the subsequent clinical fellowship program.
  • Muneyuki Toshitaka, Sugawara Hitoshi, Yamada Shigeki
    Japanese journal of diagnostic pathology (一社)日本病理学会 27 (3) 240 - 243 1345-6431 2010/07 [Refereed][Not invited]
     
    症例はPTCAの既往をもつ70代女性で,糖尿病性腎症のため人工透析を受け ていた。化膿性脊椎炎に対する入院治療中,抗菌薬に対する反応は良好であったが,入 院5日目に急変死亡した。剖検では,大動脈弁に細菌性疵贅があり,左冠動脈前下行 枝の閉塞が認められた。閉塞部には偏心性プラークがあり強い好中球浸潤を認め,内 払は血栓のみにより閉塞していた。冠動脈の傍らには膿瘍があり,膿瘍の炎症波及に よりプラークの不安定性が増し血栓が形成されたものと考えられた。
  • Yoshio Sakiyama, Asuka Kuribara, Meiko Otsuka, Koichi Takashima, Tamami Watanabe, Hitoshi Sugawara, Akira Ueki
    The Journal of Movement Disorder and Disability 日本運動障害研究会 20 (1) 15 - 20 0917-5601 2010/07 [Refereed][Not invited]
     
    Stiff-person syndrome (SPS) is characterized by generalized stiffness of the muscles. Although the substratum responsible for producing stiffness is mainly concentrated in the spinal cord, a recent study using electromagnetic stimulation has revealed hyperexcitability of the cerebral motor cortex is related to SPS. ln this report,, we present a SPS patient with increased excitability of the cerebral motor cortex suggested by sensory evoked potentials (SEPs). The patient was a 70-year-old woman who first noticed stiffness of the legs 10 years ago. A local physician diagnosed the condition as “dystonia” and prescribed diazepam, which ameliorated the symptoms. She was admitted to our hospital at the age of 70 because of right hemiparesis and dysarthria. Cranial MRI showed infarct i n the left pre\Rolandic area. We diagnosed cerebral embolism and therapy with tissue plasminogen activator (tPA) dramatically ameliorated the patient’s neurological deficit. However, on the fourth day of admission, both the patient’s legs and trunk became markedly stiff, 1ike a board, probably due to the cessation of diazepam. Neurological exanimation showed rnarked stiffness of the lower limbs and trunk, and intermittent muscle spasms i n the femoral muscles. Stiffness was exacerbated by passive movement, but was not induced by touch stimuli or tapping the tendon. Deep tendon reflexes were normal and the sensory system was intact. Laboratory tests showed a high titer of anti-glutamate decarboxylase (GAD) antibody (69,000 U/ml) and a diagnosis of SPS was made. Surface electromyograms showed continuous and spontaneous discharges Iacking reciprocity between agonist and antagonist muscles. Giant SEPs were evoked by electrical stimulation of both tibial nerves (right 125, left 17.8 ptV). However, stimulation of the median nerves of both arms, where stiffness was absent, did not elicit giant SEPs (right 5.3, left 6.0 ptV). The waveforms of giant SEPs of this case were similar ’to those previously reported for cortical reflex myoclonus, suggesting hyperexcitability of the cerebral cortexes. Re-administration of diazepam ameliorated the stiffness and the amplitudes of the SEPs were reduced significantly to right 6,0 pt V, left 6,8 pt V. Our case results suggest that hyperexcitability in the primary motor cortex contributes to the pathophysiological mechanism underlying the “stiffness” in SPS.
  • Masashi Yoshida, Masanori Nakata, Shiho Yamato, Katsuya Dezaki, Hitoshi Sugawara, San e. Ishikawa, Masanobu Kawakami, Toshihiko Yada, Masafumi Kakei
    Biochemical and Biophysical Research Communications 396 (2) 304 - 309 0006-291X 2010/05 [Refereed][Not invited]
     
    Voltage-gated potassium channels (Kv channels) play a crucial role in formation of action potentials in response to glucose stimulation in pancreatic beta-ells. We previously reported that the Kv channel is regulated by glucose metabolism, particularly by MgATP. We examined whether the regulation of Kv channels is voltage-dependent and mechanistically related with phosphorylation of the channels. In rat pancreatic beta-cells, suppression of glucose metabolism with low glucose concentrations of 2.8 mM or less or by metabolic inhibitors decreased the Kv2.1-channel activity at positive membrane potentials, while increased it at potentials negative to -10 mV, suggesting that modulation of Kv channels by glucose metabolism is voltage-dependent. Similarly, in HEK293 cells expressing the recombinant Kv2.1 channels, 0 mM but not 10 mM MgATP modulated the channel activity in a manner similar to that in beta-cells. Both steady-state activation and inactivation kinetics of the channel were shifted toward the negative potential in association with the voltage-dependent modulation of the channels by cytosolic dialysis of alkaline phosphatase in beta-cells. The modulation of Kv-channel current-voltage relations were also observed during and after glucose-stimulated electrical excitation. These results suggest that the cellular metabolism including MgATP production and/or channel phosphorylation/dephosphorylation underlie the physiological modulation of Kv2.1 channels during glucose-induced insulin secretion. (C) 2010 Elsevier Inc. All rights reserved.
  • Lesson for Clinical Medicine 症候別フローで学ぶ治療&処置<胸痛>
    菅原 斉
    Kokutai 医学教育出版社 31 (4) 51 - 66 2010/05 [Not refereed][Invited]
  • 埼玉プライマリ・ケア研究会のこれまでの活動と今後に望むこと
    菅原 斉
    プライマリ・ケア 日本プライマリ・ケア学会 33 (1) 21 - 21 2010/03 [Not refereed]
  • 山中 健一, 松澤 真吾, 菅原 斉
    内科 (株)南江堂 104 (2) 365 - 365 0022-1961 2009/08 [Refereed]
  • Masashi Yoshida, Katsuya Dezaki, Shiho Yamato, Atsushi Aoki, Hitoshi Sugawara, Hideo Toyoshima, San-e Ishikawa, Masanobu Kawakami, Masanori Nakata, Toshihiko Yada, Masafumi Kakei
    FEBS Letters 583 (13) 2225 - 2230 0014-5793 2009/07 [Refereed]
     
    Regulation of delayed rectifier-type K+ channels (Kv-channels) by glucose was studied in rat pancreatic β-cells. The Kv-channel current was increased in amplitudes by increasing glucose concentration from 2.8 to 16.6 mM, while it was decreased by 2.8 mM glucose in a reversible manner (down-regulation) in both perforated and conventional whole-cell modes. The current was decreased by FCCP, intrapipette 0 mM ATP or AMPPNP. Glyceraldehyde, pyruvic acid, 2-ketoisocaproic acid, and 10 mM MgATP prevented the down-regulation induced by 2.8 mM or less glucose. The residual current after treatment with Kv2.1-specific blocker, guangxitoxin-1E, was unchanged by lowering or increasing glucose concentration. We conclude that glucose metabolism regulates Kv2.1 channels in rats β-cells via altering MgATP levels.
  • Yuri Hayashi, Hitoshi Sugawara, Mieko Otsuka, Sigeki Yamada, Kaoru Tabei, Akira Ueki
    Internal Medicine (Tokyo, Japan) 47 (11) 1061 - 1063 0918-2918 2008 [Refereed]
  • Hitoshi Sugawara
    The Journal of the Japanese Society of Internal Medicine 日本内科学会 96 (4) 784 - 786 0021-5384 2007/04 [Refereed][Not invited]
  • Satoshi Suzuki, Hitoshi Sugawara, Osamu Tanaka
    Internal medicine (Tokyo, Japan) 45 (18) 1075 - 1076 0918-2918 2006/09 [Refereed][Not invited]
  • Masato Moriguchi, Keisuke Naka, Tokutaro Tsuda, Hitoshi Sugawara, Hiroshi Kajiyama, Chihiro Terai, Kaoru Tabei, Masanobu Kawakami
    Internal medicine (Tokyo, Japan) 44 (10) 1112 - 1113 0918-2918 2005/10 [Refereed][Not invited]
  • Masuzawa A, Moriguchi M, Tsuda T, Sugawara H, Otsuka M, Yamada S, Tabei K, Kawakami M
    Internal medicine (Tokyo, Japan) 44 (5) 496 - 498 0918-2918 2005/05 [Refereed][Not invited]
     
    Acetaminophen is a widely used antipyretic drug. We describe a 64-year-old Japanese woman who developed typical Churg-Strauss syndrome after frequent use of acetaminophen. Following the ingestion of acetaminophen, she exhibited various allergic reactions such as asthmatic attacks, pyrexia and petechiae on legs. In the lymphocyte transformation test, a positive reaction to acetaminophen was detected. A muscle biopsy revealed massive extravascular eosinophil infiltration and a necrotizing vasculitis. Hypersensitivity to acetaminophen may be implicated in the development of Churg-Strauss syndrome in this case.
  • 鷺原規喜, 菅原斉, 村山淳子, 田代 友之, 中野 真, 仲 公正, 谷澤 徹, 北見 翼
    診断と治療(Diagnosis and Treatment) 診断と治療社 92 (8) 1440 - 1442 0370-999X 2004 [Not refereed][Not invited]
     
    80歳男.76歳,胃潰瘍の診断で,H.pyloriの除菌療法を他院で行った.この時の上部消化管内視鏡検査で,上部食道狭窄のため挿入が困難と指摘された.食欲低下を認め,上腹部痛,嘔気,嘔吐のため,入院となった.腹部超音波検査では,胃内に多量の残渣と左胸水を認めた.上部消化管内視鏡検査では門歯列より15cmの食道狭窄と,食道胃接合部口側の左側壁に直径1.5cmの食道破裂口,及び幽門狭窄を呈する3型胃癌を認めた.全身状態不良のため手術療法は選択できなかった.保存的治療により,状態が改善したため,食道破裂口の閉鎖を目的に,食道カバーステントを内視鏡的に挿入した.カバーステント留置後,嘔吐症状が再発することはなく,胸腔からの排液に血液は混じなくなっていた.CRPは減少傾向であったが,全身状態の悪化で第30病日に死亡した。
  • Takahiko Fukuchi, Hitoshi Sugawara, M Nakahara, Junji Nishida, Masanobu Kawakami
    Jichi Medical University Journal 25 (1) 91 - 96 2002/12 [Refereed][Not invited]
     
    A 60-year-old woman with acute type adult T-cell leukemia (ATL) complicated with malignancy-associated hypercalcemia (MAH) was well controlled by peroral administration of sobuzoxane and etoposide supplemented in addition to weekly intravenous bisphosphonate injection after failing to get remission by a conventional protocol of intensive chemotherapy with granulocytic colony-stimulating factor (G-CSF). By this treatment at outpatient clinic, she could stay at home with psychological well being her life as long as six weeks until the very end stage of this fatal diseases. The combination of the two peroral drugs, sobuzoxane and etoposide may be one of considerable choice in ATL patients, when the conventional intensive chemotherapy with G-CSF is not effective enough.
  • 菅原 斉
    看護学雑誌 医学書院 66 (9) 823 - 830 0386-9830 2002/09 [Not refereed][Not invited]
  • Naoka Umemoto, Suao Toda, Hitoshi Sugawara, Yasuyuki Kobayashi, Tomoharu Kiyosawa, Toshio Demitsu
    Skin surgery : the journal of Japanese Society for Dermatologic Surgery 11 (1) 7 - 9 2002/06 [Refereed][Not invited]
     
    A 67-year-old Japanese male was referred to us for the examination of a large mass on the buttock. He has suffered from chronic renal failure and diabetes mellitus. He had noted a tumor on his left buttock since his childhood.
  • 胃管からの多量胃液流出に伴う低Cl血性低K血性代謝性アルカローシスが、プロトンポンプ阻害薬の投与により著明に改善した慢性腎不全の1症例「(共著)」
    臨床体液 27 (1) 27 - 32 2000 [Not refereed][Not invited]
  • Sugawara, H, Shiraiwa, H, Otsuka, M, Ueki, A
    Clinical Neurology 40 (5) 446 - 451 0009-918X 2000 [Refereed][Not invited]
  • Ishiai M, Sugawara H, Kurosaki M, Kurosaki T
    JOURNAL OF IMMUNOLOGY 163 (4) 1746 - 1749 0022-1767 1999/08 [Refereed][Not invited]
     
    To explore the mechanism(s) by which phospholipase C (PLC)-gamma 2 participates in B cell Ag receptor (BCR) signaling, we have studied the function of PLC-gamma 2 mutants in B cells deficient in PLC-gamma 2. Mutation of the N-terminal Src homology 2 domain [SH2(N)] resulted in the complete loss of inositol 1,4,5-trisphosphate generation upon BCR engagement. A possible explanation for the SH2(N) requirement was provided by findings that this mutation abrogates the association of PLC-gamma 2 with an adaptor protein BLNK. Moreover, expression of a membrane-associated form (CD16/PLC-gamma 2) with SH2(N) mutation required coligation of BCR and CD16 for inositol 1,4,5-trisphosphate generation. Together, our results suggest a central role for the SH2(N) domain in directing PLC-gamma 2 into the close proximity of BCR signaling complex by its association with BLNK, whereby PLC-gamma 2 becomes tyrosine phosphorylated and thereby activated.
  • Sugawara H, Kurosaki M, Takata M, Kurosaki T
    EMBO JOURNAL 16 (11) 3078 - 3088 0261-4189 1997/06 [Refereed][Not invited]
     
    Stimulation of B-cell antigen receptor (BCR) induces a rapid increase in cytoplasmic free calcium due to its release from intracellular stores and influx from the extracellular environment. Inositol 1,4,5-trisphosphate receptors (IP(3)Rs) are ligand-gated channels that release intracellular calcium stores in response to the second messenger, inositol 1,4,5-trisphosphate. Most hematopoietic cells, including B cells, express at least two of the three different types of IP3R. We demonstrate here that B cells in which a single type of IP3R has been deleted still mobilize calcium in response to BCR stimulation, whereas this calcium mobilization is abrogated hi B cells lacking all three types of IP3R. Calcium mobilization by a transfected G protein-coupled receptor (muscarinic M1 receptor) was also abolished in only triple-deficient cells, Capacitative Ca2+ entry, stimulated by thapsigargin, remains unaffected by loss of all three types of IP3R. These data establish that IP(3)Rs are essential and functionally redundant mediators for both BCR- and muscarinic receptor-induced calcium mobilization, but not for thapsigargin-induced Ca2+ influx. We further show that the BCR-induced apoptosis is significantly inhibited by loss of all three types of IP3R, suggesting an important role for Ca2+ in the process of apoptosis.
  • Shigeru Yanagi, Hitoshi Sugawara, Mari Kurosaki, Hisataka Sabe, Hirohei Yamamura, Tomohiro Kurosaki
    The Journal of Biological Chemistry 271 (48) 30487 - 30492 0021-9258 1996/11 [Refereed][Not invited]
     
    CD45 is a tyrosine phosphatase that is required for normal B cell receptor (BCR)-mediated signaling. It has been shown that Src-family tyrosine kinases such as Lyn could be a potential substrate for CD45. In vitro studies indicate that activities of Src family tyrosine kinases are regulated by tyrosine phosphorylation; C-terminal phosphorylation is inhibitory, and autophosphorylation is stimulatory. We report here that both autophosphorylation and C-terminal negative regulatory tyrosines of Lyn were hyperphosphorylated in CD45-deficient DT40 B cells, In this mutant cell, BCR-induced protein-tyrosine phosphorylation and calcium mobilization were severely compromised, as seen in Lyn-deficient cells. Consistent with this observation, Lyn activation upon receptor ligation was profoundly decreased in CD45-deficient cells. Taken together, our results suggest that dephosphorylation of tyrosine residues at both autophosphorylation and negative regulatory sites is mediated by CD45 in vivo, and that dephosphorylation of C-terminal tyrosine is a prerequisite for participation of Lyn in BCR signaling.
  • Hitoshi Sugawara, Katsuyuki Tobise, Kenjiro Kikuchi
    Hypertension Research 19 (4) 223 - 228 0916-9636 1996/08 [Refereed][Not invited]
     
    We studied the antioxidant effects of nine calcium antagonists (nisoldipine, benidipine, nilvadipine, felodipine, nicardipine, nitrendipine, nifedipine, verapamil, and diltiazem) by means of rat myocardial membrane lipid peroxidation with a nonenzymatic active oxygen-generating system (DHF/FeCl3-ADP). The order of antioxidant potency of these agents was nilvadipine > nisoldipine > felodipine > nicardipine > verapamil > benidipine. Their IC50 values (microM) were 25.1, 28.2, 42.0, 150.0, 266.1, and 420.0, respectively. In contrast, nitrendipine, nifedipine, and diltiazem had little inhibitory effect on lipid peroxidation. These six calcium antagonists could be divided into four types on the basis of their antioxidant mechanisms. Nilvadipine, nisoldipine, and verapamil, which showed antioxidant effects both before and after the addition of active oxygen, and reduced the dihydroxyfumarate (DHF) auto-oxidation rate, were chain-breaking and preventive antioxidants. Felodipine, which showed antioxidant effects both before and after exposure to active oxygen and increased the DHF auto-oxidation rate, was only a chain-breaking antioxidant. Nicardipine, which showed an antioxidant effect only before exposure to active oxygen and reduced the DHF auto-oxidation rate, was mainly a preventive antioxidant. Benidipine, which showed an antioxidant effect only before exposure to active oxygen and had no appreciable effect on the DHF auto-oxidation rate, could interrupt the chain reaction of lipid peroxidation at the initial step alone. Although these results suggest that the antioxidant properties of some calcium antagonists may be beneficial clinically in protecting against cellular damage caused by lipid peroxidation, further studies are required to establish the antioxidant effects of these agents in vivo.
  • 菅原 斉
    循環器専門医 : 日本循環器学会専門医誌 社団法人日本循環器学会 3 (1) 221 - 224 0918-9599 1995/03 [Not refereed][Not invited]
  • Hirohisa Yamashita, Yoshinao Ishii, Junichi Kato, Yuji Ogawa, Hironobu Matsuhashi, Hiroaki Minami, Eiji Kawashima, Takanori Harada, Tomoya Hirayama, Akira Ido, Nobuyuki Sato, Yasuhiro Nakamura, Takahiro Shiokoshi, Kazumi Akasaka, Shunsuke Natori, Nobuharu Ohi, Tomoyuki Matsuzaka, Maiko Taneichi, Tomoaki Nomura, Kei Takahashi, Yushi Takahara, Hiroyuki Kakuchi, Fumihiko Takahashi, Nbusuke Kido, Hitoshi Sugawara, Saiji Masukawa, Tadato Nagane, Jun Fukuzawa, Yuichirou Kawamura, Naoyuki Hasebe, Kenjiro Kikuchi, Sokichi Onodera
    Progress in Medicine 1995 [Refereed][Not invited]
  • H Sugawara, Katsuyuki Tobise, Sokichi Onodera
    Biochemical Pharmacology 47 (5) 887 - 892 0006-2952 1994/03 [Refereed][Not invited]
     
    Both the production of active oxygen species and cellular damage due to concurrent lipid peroxidation are believed to be important factors in the pathogenesis of cardiovascular diseases and the ageing process. Since cardiovascular drugs are often administered over a long term, it might be advantageous if they reduced lipid peroxidation. There have been conflicting reports concerning the antiperoxidant effect of nifedipine. Therefore, we investigated whether nifedipine could inhibit lipid peroxidation in a nonenzymatic active oxygen-generating system, utilizing rat crude myocardial membranes, and compared its effect with those of propranolol, nisoldipine, and diltiazem. Nifedipine and diltiazem had no inhibitory effects on the lipid peroxidation of myocardial membranes. In contrast, nisoldipine and propranolol had a concentration-dependent antiperoxidant effect, with IC50 values of 28.2 and 50.1 mu M, respectively. In addition, nisoldipine appeared to possess dual antiperoxidant mechanisms, involving both preventive and chain-breaking properties.
  • Minami H, Nagane T, Sugawara H, Takeuchi K, Masukawa S, Yahara O
    Japanese Journal of Geriatrics (一社)日本老年医学会 30 (7) 617 - 621 0300-9173 1993/07 [Refereed][Not invited]
     
    Minami H, Nagane T, Sugawara H, Takeuchi K, Masukawa S, Yahara O, Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics, 1993, vol. 30, no. 7, pp. 617-621
  • SATO NOBUYUKI, KAWAMURA YUICHIRO, FUJITA MASAAKI, OKAMOTO KIYOTAKA, SUGAWARA HITOSHI, KAWASHIMA EIJI, ISHII YOSHINAO, ONODERA SOKICHI, YAMAMURA KOTARO
    心電図 12 (6) 781 - 788 0285-1660 1992/11 [Refereed][Not invited]
  • SUGAWARA HITOSHI, TOBISE KATSUYUKI, MINAMI HIROAKI, UEKITA KAZUMI, YOSHIE HIROMITSU, ONODERA SOKICHI
    医学のあゆみ 医歯薬出版(株) 163 (4) 237 - 238 0039-2359 1992/10 [Refereed][Not invited]
  • UEKITA KAZUMI, TOBISE KATSUYUKI, YOSHIE HIROMITSU, FUJITA MASAAKI, SUGAWARA HITOSHI, MORITA KAZUTO, OGAWA YUJI, ONODERA SOKICHI, MIKAMO KAZUYA
    心筋の構造と代謝 14(1991) 35 - 41 1992/09 [Refereed][Not invited]
  • SUGAWARA HITOSHI, ONODERA SOKICHI
    月刊地域医学 (公社)地域医療振興協会 6 (1) 835 - 846 0914-4277 1992/01 [Refereed][Not invited]
     
    観光シーズン中,北海道立ウトロ診療所の初診患者数はオフ・シーズンの1.6倍,時間外診療患者数は2.5倍,救急車出動件数は2.5倍であり,医師の深夜帯と休日の勤務時間はそれぞれ2.0倍,4.3倍に増加した.特に,外傷の初診患者数は4.3倍で,住民以外の時間外診療患者数,救急車出動件数もそれぞれ5.0倍,3.3倍となった.観光シーズン中に著増していたのは観光客と季節労働者である.そのうち外傷患者の特色についてみると,時間外受診者,救急車搬入例,他院への転送を要した例が多かった.また1人当たりの受傷部位の数や外傷の種類も多く,比較的重傷の比率が高いことがわかった.受傷の原因として交通事故とカムイワッカの滝のぼりがそれぞれ1, 2位を占めた.「リゾートヘルスケアシステム」とは,観光地・リゾート地の住民の「ヘルス」の維持,増進はいうに及ばず,そこに短期間滞在する観光客や季節労働者のプライマリケアに加えて,医療従事者やその家族の「ヘルス」をも確保し,「システム」として維持していこうとする考え方である
  • Nobuyuki Sato, Yuichiro Kawamura, Masaaki Fujita, Kiyotaka Okamoto, Hitoshi Sugawara, Eiji Kawashima, Yoshinao Ishii, Hirohisa Yamashita, Katsuyuki Tobise, Sokichi Onodera, Kohtaroh Yamamura
    Japanese Journal of Electrocardiology 1992 [Refereed][Not invited]
     
    肥大型心筋症(HCM)の不整脈発現に関与する因子を明らかにするため,HCM症例の ホルター心電図所見と心血行動態諸指標および心エコー所見との関連性について検討した. 対象はHCM症例40名で,説明変数として心血行動態指標13項目,心エコー所見4項目お よび心胸郭比を,目的変数として,(1)心房期外収縮数,(2)心室期外収縮数,(3)心室期外収 縮連発数,(4)心室頻拍数を用い,4個の目的変数別の重回帰分析と正準相関分析を行った. 個々の目的変数に強く関与する因子は,(1)では心室後壁厚,肺動脈収縮期圧,肺動脈楔入 圧,(2)では心室中隔壁厚,右室収縮期圧,平均肺動脈圧,心係数,(3)では肺動脈楔入圧, 心拍出量,左室拡張期圧,(4)では右室拡張末期圧,左室駆出率であった.以上より,HCM では不整脈と心血行動態の重相関関係は有意であること,不整脈の種類によって有意な偏 回帰係数を示す指標は異なることが示され,心血行動態因子が不整脈発現に関与する可能 性が示唆された.
  • HANEDA TAKASHI, TANAKA HIDEICHI, OBATA HIROMI, MIYATA SETSUO, FUKUZAWA JUN, SUGAWARA HITOSHI, TAKEDA HIROKI, OKAMOTO KIYOTAKA, ONODERA SOKICHI
    薬理と治療 18 (Suppl 13) S.3417-S.3424  0386-3603 1990/12 [Not refereed][Not invited]
  • SUGAWARA HITOSHI, KOIKE YUJI, HASHIMOTO MASAAKI
    月刊地域医学 (公社)地域医療振興協会 4 (10) 590 - 594 0914-4277 1990/10 [Refereed][Not invited]
     
    73歳女,脳外科医がいる都市部から150 kmも離れた僻地において,ショック状態で無床診療所に搬入され救急車内での蘇生の後,後方病院との連携により脳動脈瘤破裂によるクモ膜下出血の患者を救命できたので,その必要条件について検討した.地理的な悪条件を克服していくためには,僻地診療所においても重篤な救急疾患の初期治療にいつでも対応できるシステム(患者・消防署・医療機関の間の連絡手段の整備,医療設備の充足,道路交通網の整備,時間外診療にも対応できるだけのスタッフの確立)を確立し,かつ携帯できる蘇生器具,薬品を常備しておくとともに,日頃から後方病院との信頼関係(いわゆる病診連携)を築いておくことが必要である
  • HANEDA TOSHI, ONODERA SOKICHI, FUKUZAWA JUN, SUGAWARA HITOSHI, TAKEDA HIROKI, ABE MASAHIKO, TANAKA HIDEKAZU, OBATA HIROMI, MORGAN H E
    心筋の構造と代謝 12(1989) 741 - 756 1990/09 [Refereed][Not invited]
  • SUGAWARA HITOSHI, ISHIZAKI TADAFUMI, HIRASAWA KUNIHIKO, MURAKAMI TADASHI, ONODERA SOKICHI
    月刊地域医学 (公社)地域医療振興協会 4 (9) 580 - 585 0914-4277 1990/09 [Refereed][Not invited]
     
    症例は68歳女.1987年10月5日から前胸部圧迫感が持続した.翌6日,発症場所の札幌から400 kmの距離を長距離バスで稚内へ戻った後,10月7日市立稚内病院に緊急入院した.病歴,身体所見,心電図,血液学的所見,心エコー検査,右心カテーテル検査などより,心室中隔穿孔を合併した急性広範囲前壁心筋梗塞と診断した.左右短絡率は74.5%であったが,心不全徴候は認めなかった.開心術を早晩必要とする病態であるため,一晩経過を観察し心機能が安定していることを確認した後,発症3日目の10月8日に250 km離れた旭川のCCUへ搬送することに決定した.救急車による長距離搬送を行うにあたり,心不全の進行や不測の事態を配慮して準備をした.搬送は無事終えたが,搬送直後に肺動脈拡張期圧の上昇や心係数の低下を認めた.直ちにIABPを開始したにもかかわらず徐々に心不全が悪化したため,心筋梗塞発症7日目の10月12日に心室中隔穿孔部閉鎖兼左心室瘤切除術を行い生存退院に至った
  • SUGAWARA HITOSHI
    月刊地域医学 (公社)地域医療振興協会 4 (7) 552 - 558 0914-4277 1990/07 [Refereed][Not invited]
  • Takashi Haneda, Hideichi Tanaka, Hiromi Obata, Setsuya Miyata, Jun Fukuzawa, Hitoshi Sugawara, Hiroki Takeda, Kiyotaka Okamoto, Masahiko Abe, Sokichi Onodera
    Japanese Pharmacology & Therapeutics 1990 [Refereed][Not invited]
  • 地域中核病院におけるペースメーカークリニックーホルター心電図によって確認された無症候性不整脈ー
    菅原 斉, 石崎忠文, 阿部昌彦, 尾畑弘美, 川村祐一郎, 小野寺壮吉
    月刊地域医学 3 (12) 449 - 453 1989/12 [Refereed][Not invited]
  • H. Sugawara, K. Hirasawa, R. Yoshioka, K. Yozawa, K. Tateda, J. Shibata, Y. Ikeda, E. Sakai, Y. Ohsaki, S. Onodera
    Kekkaku (一社)日本結核・非結核性抗酸菌症学会 64 (6) 413 - 419 0022-9776 1989/06 [Not refereed][Not invited]
     
    70歳女,71歳男,NaClの補充と抗結核療法とが有効であった.低Na血症改善後の頭部CTでは,ともに橋・延髄領域および脳底槽に異常を認めなかった
  • Hitoshi Sugawara, Kunihiko Hirasawa, Rei Yoshioka, Koichi Yozawa, Kunihiko Tateda, Junichi Shibata, Yuji Ikeda, Eiichi Sakai, Yoshinobu Ohsaki, Sokichi Onodera
    Kekkaku 64 (6) 413 - 419 0022-9776 1989 [Refereed][Not invited]
  • Hitoshi Sugawara, Yoshinobu Ohsaki, Yasuhiro Yamazaki, Hirotsuka Sakai, Hitoshi Nakano, Toshiaki Fujikane, Nobuhiro Sasaki, Sokichi Onodena, Masahiro Fujita, Tadayuki Akashi
    Journal of the Japan Society for Bronchology (NPO)日本呼吸器内視鏡学会 10 (5) 562 - 568 0287-2137 1988/12 [Refereed][Not invited]
     
    A 65 year-old female case of paratracheal cavernous hemangioma in the mediastinum was reported. She had suffered from hoarseness repeatedly for 3 years. Bronchofiberscopy disclosed a lusterless and erosive mucosa, loss of folds with bleeding tendency from below the vocal cord to the left main bronchus. A gray coarse nodule was located in the upper trachea below the vocal cord. These findings raised the very strong suspicion of primary malignant tracheal tumor or malignant invasion from the mediastinum. CT scan demonstrated a paratracheal mass with a calcification nodule. Bronchioarteriography showed increased vascularity and pooling of the contrast media along the trachea. No malignant cells were found in several cytological examinations of sputum. A biopsy of the tracheal mucosa displayed metaplastic changes. Mediastinoscopy and open biopsy were performed. Fat-like shrunk tissue with a strong bleeding tendency surrounded the trachea, and the tissue could be removed easily from the trachea. Microscopically the tissue consisted of wide cavernous spaces with a monomorph endthelial lining. This case was diagnosed as mediastinal cavernous hemangioma. Cavernous hemangioma is rare with a low incidence of approximately 1-1.5% of all mediastinal tumors.
  • 菅原 斉, 幸村 近, 平沢 邦彦
    ICUとCCU 医学図書出版(株) 12 (10) 907 - 912 0389-1194 1988/10 [Refereed][Not invited]
     
    発症後24時間以内に収容されたAMIの457例について,初診時Killip分類と収容までに要した時間あるいは予後との検討をした.1)初診時Killip分類別に発症後30日までの死亡率をみると,Killip 1群7.8%,Killip 2・3群29.1%,Killip 4群76.8%で,Killip分類の重症例ほど予後は不良であった.2) AMI発症から収容までの時間とKillip分類との関係では,院内発症例にKillip 1群が多く,0〜1時間の収容例ではKillip 4群の比率が,また1〜3時間の収容例ではKillip 2・3群の比率が増していた.AMI発症後の心不全は心原性ショックよりも遅れて生ずることが推測された.3)発症から収容までの時間と死亡率の関係をみると,発症後0〜1時間で収容された例の死亡率が最も高く,これはこの時間帯でKillip 4群の占める割合が高いためと思われた
  • Hitoshi Sugawara, Chikashi Koumura, Kunihiko Hirasawa, Kunihiko Tateda, Junichi Shibata
    Japanese Journal of Intensive Care Medicine (ICU and CCU) 1988/10 [Refereed][Not invited]
  • NAKAMURA KAZUHIRO, SUGAWARA HITOSHI, YOSHIOKA REI, YUKIMURA CHIKASHI, HIRASAWA KUNIHIKO, TATEDA KUNIHIKO, SHIBATA JUN'ICHI
    旭川市立病院医誌 市立旭川病院 19 (1) 75 - 78 0287-024X 1987/07 [Not refereed][Not invited]

Conference Activities & Talks

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    平田 まりの, 栗原 維吹, 末田 敬志朗, 石井 彰, 福地 貴彦, 菅原 斉
    第671回日本内科学会関東地方会  2021/09
  • Adult Still's Disease Diagnosed at Age 90
    Ai Kawamura, Takeshi Yamashita, Hiroshi Hori, Takahiko Fukuchi, Hitoshi Sugawara
    ACP Japan 2021  2021/06
  • 新型コロナウイルス感染症の急性期病院での対応と課題  [Not invited]
    吉原花子, 堀 博志, 福地貴彦
    第63回日本老年医学会学術集会  2021/06
  • Home-visit nursing care to prevent the infectious diseases for an alcoholic patient living alone  [Not invited]
    Yoko Matsumoto, Ai Kawamura, Ibuki Kurihara, Hiroshi Hori, Michiko Adachi, Takeshi Yamashita, Tamami Watanabe, Hanako Yoshihara, Akira Ishii, Takahiko Fukuchi, Hitoshi Sugawara
    第12回日本プライマリ・ケア連合学会学術大会 International session  2021/05
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    渡辺 珠美, 山下 武志, 吉原 花子, 菅原 斉
    感染症学雑誌  2021/04  (一社)日本感染症学会
  • 悪寒の経過で診断に至った発熱の無い感染性心内膜炎の一例
    福岡 謙徳, 吉原 花子, 堀 博志, 菅原 斉
    埼玉県医学会雑誌  2021/01  埼玉県医学会
  • 臨床検査データベース(DB)二次利用による極端外れ高値と72時間転帰に関する研究
    菅原 斉, 斉藤 開, 渡辺 珠美, 中村 香代子, 石井 彰, 福地 貴彦
    埼玉県医学会雑誌  2021/01  埼玉県医学会
  • 骨髄癌腫症が疑われ、急速な転帰で死亡に至った肺癌の剖検例
    齊藤 亜実, 福岡 なつみ, 川村 愛, 福地 貴彦, 菅原 斉
    日本内科学会関東地方会  2020/11  日本内科学会-関東地方会
  • 腎膿瘍を合併した気腫性膀胱炎の1例
    南 亮悟, 栗原 維吹, 川村 愛, 福地 貴彦, 菅原 斉
    日本内科学会関東地方会  2020/11  日本内科学会-関東地方会
  • 前立腺癌多発骨転移に感染性動脈瘤を併発したが、高度急性期病院からすみやかに在宅看取りへ退院調整した高齢者の1例
    吉原 花子, 高嶋 紗衣, 堀 博志, 渡辺 珠美, 菅原 斉
    日本老年医学会雑誌  2020/10  (一社)日本老年医学会
  • COVID-19陽性血液透析患者に対する入院対応の経験
    伊藤 聖学, 植田 裕一郎, 福地 貴彦, 内田 隆行, 草浦 理恵, 栗原 維吹, 吉原 花子, 百瀬 直樹, 大河原 晋, 菅原 斉, 森下 義幸
    日本腎臓学会誌  2020/09  (一社)日本腎臓学会
  • ランダム皮膚生検(RSB)で血管内リンパ腫(IVL)の診断に至った高齢患者におけるリスク要因の検討
    渡辺 珠美, 吉田 克之, 菅原 斉, 梅本 尚可, 出光 俊郎, 田中 亨
    日本老年医学会雑誌  2020/07  (一社)日本老年医学会
  • 副鼻腔炎から生じたFusobacteriumによる髄膜炎および菌血症の2例
    山下 武志, 福地 貴彦, 菅原 斉
    感染症学雑誌  2020/03  (一社)日本感染症学会
  • 毒素性ショック症候群(TSS)の経過中に重篤なICU-acquired weakness(ICUAW)を認めたものの、軽快に向かった1例
    南 亮悟, 吉原 花子, 福地 貴彦, 菅原 斉
    感染症学雑誌  2020/03  (一社)日本感染症学会
  • 神経性食思不振症による低血糖、ショックの治療中にカテーテル関連血流感染による感染性心内膜炎および真菌血症を併発した1例
    山下 武志, 吉原 花子, 吉田 克之, 福地 貴彦, 菅原 斉
    感染症学雑誌  2020/03  (一社)日本感染症学会
  • 高次機能障害を来した特発性上矢状静脈洞血栓症の1例
    四宮田 悠, 吉原 花子, 松本 葉子, 福地 貴彦, 菅原 斉
    日本内科学会関東地方会  2019/09  日本内科学会-関東地方会
  • TAFRO症候群との鑑別を要したAITLの1例
    高谷 拓武, 望月 美岐, 川村 愛, 渡辺 珠美, 福地 貴彦, 菅原 斉, 三崎 柚季子
    日本内科学会関東地方会  2019/09  日本内科学会-関東地方会
  • 血糖の超極端外れ値の短期的転帰とそのリスク因子
    渡辺 珠美, 菅原 斉, 上羽 洋人, 尾本 きよか
    自治医科大学紀要  2019/03  (学)自治医科大学
  • 眼瞼下垂と複視で発症した脾原発B細胞辺縁帯リンパ腫(SMZL)の一例
    栗原 維吹, 吉田 克之, 川村 愛, 山下 武志, 松本 葉子, 福地 貴彦, 菅原 斉, 玉置 雅治, 遠藤 祐平, 田中 亨
    日本内科学会雑誌  2019/02  (一社)日本内科学会
  • 副鼻腔炎から生じた肺炎球菌性髄膜炎、心内膜炎の1例
    山下 武志, 吉田 克之, 福地 貴彦, 菅原 斉
    感染症学雑誌  2019/01  (一社)日本感染症学会
  • カンジダ感染性心内膜炎の1例
    吉田 克之, 福地 貴彦, 栗原 維吹, 山下 武志, 菅原 斉
    感染症学雑誌  2019/01  (一社)日本感染症学会
  • 当医療センター2017年医師臨床研修マッチング成否要因分析 2016年医師臨床研修マッチング成否との比較
    菅原 斉, 大河原 晋, 桑田 知之, 市橋 光, 讃井 将満, 遠山 信幸, 力山 敏樹, 小山 信一郎, 百村 伸一
    埼玉県医学会雑誌  2018/11  埼玉県医学会
  • 高齢発症の腸リンパ管拡張症による蛋白漏出性胃腸症の1例
    寺師 義英, 山下 武志, 石井 彰, 松本 葉子, 栗原 維吹, 川村 愛, 吉田 克之, 渡辺 珠美, 菅原 斉
    日本内科学会関東地方会  2018/07  日本内科学会-関東地方会
  • セフトリアキソン(CTRX)投与による偽胆石症の二例
    吉原 花子, 菅原 斉, 福地 貴彦
    日本化学療法学会雑誌  2018/04  (公社)日本化学療法学会
  • 高齢発症の抗内因子抗体陽性ビタミンB12欠乏症性神経障害をビタミンB12経口薬で治療し得た2例  [Not invited]
    山下 武志, 吉田 克之, 川村 愛, 松沢 迪子, 渡辺 珠美, 石井 彰, 福地 貴彦, 菅原 斉
    日本内科学会雑誌  2017/02  (一社)日本内科学会
  • 短期間で多彩な症状が異時性に出現したサルコイドーシスの1例  [Not invited]
    木村 恭彰, 吉田 克之, 福地 貴彦, 石井 彰, 浅野 岳晴, 秋山 達, 蛭田 昌宏, 野首 光弘, 田中 亨, 菅原 斉
    日本内科学会関東地方会  2016/12  日本内科学会-関東地方会
  • 摂食障害により心肺停止をきたした警鐘的症例  [Not invited]
    瀬戸 那由太, 小林 千夏, 山下 武志, 渡辺 珠美, 吉田 克之, 川村 愛, 石井 彰, 福地 貴彦, 岡島 美朗, 菅原 斉
    日本内科学会関東地方会  2016/10  日本内科学会-関東地方会
  • 急性漿膜炎で発症した全身性エリテマトーデス(SLE)の1例  [Not invited]
    塩谷 竜之介, 川村 愛, 森野 諄紀, 杉谷 直大, 渡辺 晋二, 渡辺 萌理, 石井 彰, 飯塚 悠祐, 菅原 斉, 寺井 千尋
    日本内科学会関東地方会  2016/10  日本内科学会-関東地方会
  • 異時性に心筋梗塞、脳塞栓、急性門脈・上腸間膜静脈血栓症を順次併発した睡眠時無呼吸症候群の1例  [Not invited]
    菊地 望, 石井 洋輝, 松沢 迪子, 池田 奈保子, 眞山 英徳, 山下 武志, 石井 彰, 菅原 斉
    日本内科学会関東地方会  2016/03
  • 急性肺炎による呼吸不全が筋緊張性ジストロフィーの診断契機となった2例  [Not invited]
    山下 武志, 菅原 斉, 吉田 克之, 松沢 迪子, 渡辺 珠美, 石井 彰, 加計 正文
    日本内科学会雑誌  2016/02
  • 腰椎圧迫骨折を契機に診断し得たKlinefelter症候群の1例  [Not invited]
    山下 武志, 菅原 斉, 松沢 迪子, 石井 彰, 石川 三衛, 加計 正文
    日本内科学会関東地方会  2015/10
  • 亜急性壊死性リンパ節炎に無菌性髄膜炎を併発した1症例  [Not invited]
    後明 晃由美, 菅原 斉, 渡辺 珠美, 石井 彰, 松沢 迪子, 川村 愛, 松林 洋志, 山下 武志, 山田 茂樹, 野首 光弘
    日本内科学会関東地方会  2015/10
  • 関節リウマチ加療中に生じたリステリア敗血症の1例  [Not invited]
    井上 公太, 川村 愛, 渡辺 珠美, 石井 彰, 松林 洋志, 松沢 迪子, 山下 武志, 菅原 斉, 加計 正文, 百村 伸一
    日本内科学会関東地方会  2014/12
  • Positive Association of Circulating Osteocalcin Levels with Glucose Intolerance in Normal and Mild Untreated Diabetes Subjects  [Not invited]
    Atsushi Aoki, Masashi Yoshida, Toshitaka Muneyuki, Hideo Toyoshima, Hitoshi Sugawara, San-E Ishikawa, Masafumi Kakei, Masanobu Kawakami
    DIABETES  2010/06  AMER DIABETES ASSOC
  • The ratio of glycated albumin to glycohemoglobin on admission is increased in atherothrombotic-stroke patients  [Not invited]
    Masashi Yoshida, Ken Tsuboi, Hitoshi Sugawara, San-E Ishikawa, Masafumi Kakei, Masanobu Kawakami
    ENDOCRINE JOURNAL  2010/03  JAPAN ENDOCRINE SOC
  • Voltage-Gated Potassium Channels in Pancreatic beta-Cells Are Regulated by Glucose Metabolism  [Not invited]
    Masashi Yoshida, Katsuya Dezaki, Atsushi Aoki, Hitoshi Sugawara, Hideo Toyoshima, San-E Ishikawa, Masanobu Kawakami, Masanori Nakata, Toshihiko Yada, Masafumi Kakei
    DIABETES  2009/06  AMER DIABETES ASSOC
  • 柳 茂, 菅原 斉, 佐邊 壽孝, 山村 博平, 黒崎 知博
    日本分子生物学会年会プログラム・講演要旨集  1996/08
  • 長根 忠人, 南 宏明, 菅原 斉, 小川 裕二, 石井 良直, 川嶋 栄司, 松橋 浩伸, 山下 裕久, 飛世 克之, 小野寺 壮吉
    Japanese circulation journal  1994/04
  • 名取 俊介, 佐藤 伸之, 川嶋 栄司, 石井 良直, 菅原 斉, 南 宏明, 山下 裕久, 飛世 克之, 竹内 克呂, 平沢 邦彦, 舘田 邦彦
    Japanese circulation journal  1994/04
  • 南 宏明, 長根 忠人, 早川 拓治, 竹内 克呂, 幸村 近, 石井 良直, 川嶋 栄司, 中村 泰浩, 井門 明, 塩越 隆広, 菅原 斉, 名取 俊介, 松橋 浩伸, 箭原 修, 山下 祐久, 菊池 健次郎
    Japanese circulation journal  1994/03
  • 名取 俊介, 中村 泰浩, 菅原 斉, 川嶋 栄司, 石井 良直, 南 宏明, 山下 裕久, 飛世 克之, 菊池 健次郎
    Japanese circulation journal  1993/03
  • 名取 俊介, 石井 良直, 川嶋 栄司, 菅原 斉, 中村 泰浩, 山下 裕久, 飛世 克之, 菊池 健次郎
    Japanese circulation journal  1993/03
  • 菅原 斉, 川嶋 栄司, 松橋 浩伸, 赤坂 和美, 石井 良直, 本田 肇, 小川 裕二, 川村 祐一郎, 羽根田 俊, 山下 裕久, 飛世 克之, 小野寺 壮吉, 青木 秀俊, 村上 忠司
    Japanese circulation journal  1992/07
  • 石井 良直, 阿部 昌彦, 川嶋 栄司, 菅原 斉, 原田 貴之, 井門 明, 高塩 哲也, 松橋 浩伸, 羽根田 俊, 山下 裕久, 飛世 克之, 小野寺 壮吉
    Japanese circulation journal  1992/07
  • 菅原 斉, 飛世 克之, 吉江 浩光, 上北 和実, 小野寺 壮吉
    Japanese circulation journal  1992/03
  • 武田 寛樹, 羽根田 俊, 岡本 清貴, 宮田 節也, 大崎 純三, 福澤 純, 酒井 博司, 菅原 斉, 小野寺 壮吉
    Japanese circulation journal  1992/03
  • 佐藤 伸之, 川村 祐一郎, 藤田 雅章, 岡本 清貴, 菅原 斉, 川嶋 栄司, 石井 良直, 小野寺 壮吉
    Japanese circulation journal  1992/03
  • 小川 裕二, 森田 一豊, 原田 貴之, 平山 智也, 武田 昭範, 菅原 斉, 吉江 浩光, 飛世 克之, 小野寺 壮吉
    Japanese circulation journal  1992/03
  • 南 宏明, 長根 忠人, 菅原 斉, 箭原 修, 小野寺 壮吉
    Japanese circulation journal  1992/03
  • 石井 良直, 川辺 淳一, 佐藤 元彦, 川嶋 栄司, 原田 貴之, 平山 智也, 菅原 斉, 小川 裕二, 松橋 浩伸, 山下 裕久, 飛世 克之, 小野寺 壮吉
    Japanese circulation journal  1992/03
  • TAKEDA Hiroki, HANEDA Takashi, MIYATA Setsuya, SUGAWARA Hitoshi, OKAMOTO Kiyotaka, FUKUZAWA Jun, ABE Masahiko, TANAKA Hideichi, OBATA Hiromi, ONODERA Sokichi
    Journal of pharmacobio-dynamics  1991/01
  • OKAMOTO Kiyotaka, HANEDA Takashi, Miyata Setsuya, FUKUZAWA Jun, SUGAWARA Hitoshi, TAKEDA Hiroki, ABE Masahiko, TANAKA Hideichi, OBATA Hiromi, ONODERA Sokichi
    Journal of pharmacobio-dynamics  1991/01
  • 幸村 近, 布施川 哲, 吉田 行範, 合田 晶, 菅原 斉, 平沢 邦彦, 館田 邦彦, 柴田 淳一
    Japanese circulation journal  1989/12
  • 棚沢 哲, 中村 一博, 蒔田 泰弘, 菅原 斉, 吉岡 礼, 平沢 邦彦, 館田 邦彦, 柴田 淳一
    Japanese circulation journal  1989/04

MISC

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    中村 香代子, 望月 美岐, 鈴木 貴之, 吉田 克之, 安達 迪子, 川村 愛, 福地 貴彦, 菅原 斉, 仲矢 丈雄, 田中 亨  日本内科学会関東地方会  640回-  30  -30  2018/03
  • 古典的不明熱の精査で判明したHaemophilus parainfluenzae菌血症の1例
    望月 美岐, 鈴木 貴之, 福地 貴彦, 菅原 斉  感染症学雑誌  92-  (2)  257  -257  2018/03
  • D-dimerが基準値を大きく外れた極端な高値を呈した患者の短期的転帰に関するケース・コントロール研究
    中村 香代子, 菅原 斉  日本内科学会雑誌  107-  (Suppl.)  246  -246  2018/02
  • 下腹部痛と水様便を主訴に来院し、腹水セルブロックの免疫染色パネルで腹膜癌と考えられた1例
    織田 恭子, 山下 武志, 渡辺 珠美, 石井 彰, 菅原 斉, 春名 佑美, 近澤 研郎, 今野 良, 野首 光弘, 田中 亨  埼玉県医学会雑誌  52-  (1)  np43  -np43  2017/12
  • 化膿性脊椎炎と感染性心内膜炎に対するセフトリアキソン(CTRX)長期間治療が原因となったと考えられる急性胆嚢炎の1例
    吉原 花子, 山下 武志, 渡辺 珠美, 中村 晃久, 福地 貴彦, 石井 彰, 菅原 斉, 藤原 純一, 山中 健一, 眞嶋 浩聡  日本内科学会関東地方会  636回-  36  -36  2017/10
  • 黄疸、大球性貧血、血小板減少がバセドウ病加療のみで改善した1例
    野口 友里, 山下 武志, 川村 愛, 中村 香代子, 吉原 花子, 福地 貴彦, 石井 彰, 菅原 斉  日本内科学会関東地方会  636回-  45  -45  2017/10
  • 渡辺 珠美, 菅原 斉, 上羽 洋人, 尾本 きよか  臨床病理  65-  (補冊)  172  -172  2017/10
  • プロトンポンプ阻害薬(PPI)内服とチーズ・スモークサーモン頻回摂食が原因と考えられたリステリア感染症の高齢男性例
    吉原 花子, 山下 武志, 渡辺 珠美, 中村 晃久, 野口 友里, 吉田 泰徳, 福地 貴彦, 石井 彰, 菅原 斉  日本内科学会関東地方会  634回-  32  -32  2017/07
  • 4ヵ月の短期間で弱視聾となり嚥下障害のため胃瘻造設に至った2型糖尿病合併Cogan症候群の1例
    中村 晃久, 山下 武志, 渡辺 珠美, 吉原 花子, 菅原 斉, 豊田 文彦, 梯 彰弘, 田中 享  日本内科学会関東地方会  634回-  40  -40  2017/07
  • inoculum effectを実感した多発膿瘍を伴うKlebsiella pneumoniae感染症の1例
    栗原 維吹, 福地 貴彦, 吉田 克之, 菅原 斉  感染症学雑誌  91-  (3)  452  -452  2017/05
  • 脾動静脈瘻と脾動静脈瘻-脾静脈シャントによる二次性門脈圧亢進症から高アンモニア血症を来し意識障害を呈した1例
    川村 愛, 伊藤 みゆき, 山下 武志, 眞山 英徳, 松林 洋志, 石井 彰, 黒田 仁, 菅原 斉, 小野澤 裕昌  日本内科学会関東地方会  605回-  25  -25  2014/05
  • 肺炎、意識障害を契機に判明したACTH単独欠損症の1例
    永井 康平, 小林 瑠美子, 小糸 雄大, 江藤 宏幸, 山下 武志, 黒田 仁, 菅原 斉, 生駒 亜希, 草鹿 育代, 石川 三衛  日本内科学会関東地方会  605回-  27  -27  2014/05
  • 抗凝固および抗血小板療法中に生じた十二指腸粘膜下血腫
    石井 彰, 眞山 英徳, 松沢 迪子, 松林 洋志, 渡辺 珠美, 黒田 仁, 菅原 斉  日本内科学会関東地方会  604回-  43  -43  2014/03
  • 急性腎盂腎炎からCandida albicans血症を来し、片側性真菌性眼内炎を併発した未治療の2型糖尿病女性の1例
    鈴木 伶奈, 黒田 仁, 松林 洋志, 石井 彰, 菅原 斉  感染症学雑誌  88-  (2)  248  -248  2014/03
  • 膵外分泌機能不全による低栄養状態にパンクレリパーゼが著効し、切除し得た膵癌の一例
    和泉 香代子, 野田 弘志, 渡辺 文昭, 市田 晃佑, 黒田 仁, 高山 千幸, 菅原 斉, 力山 敏樹  日本臨床外科学会雑誌  74-  (増刊)  1030  -1030  2013/10
  • インスリン、ステロイドおよび抗真菌薬投与中に発症したNocardia大腿部筋肉内膿瘍の1例
    黒田 仁, 石井 彰, 松林 洋志, 渡辺 珠美, 菅原 斉  感染症学雑誌  87-  (臨増)  286  -286  2013/05
  • ワーファリン内服中に頸椎硬膜外血腫を発症した高齢者の1例
    矢部 寛樹, 石井 彰, 新川 尚子, 松林 洋志, 加計 正文, 川上 正舒, 菅原 斉  日本老年医学会雑誌  49-  (6)  809  -809  2012/11
  • 一過性の上方水平半盲と中枢性色覚異常および街並失認を来した両側後頭葉と右小脳虫部の脳塞栓症の1例
    平松 綾子, 眞山 英徳, 坪井 基浩, 小林 瑠美子, 津久井 卓伯, 石井 彰, 渡辺 珠美, 菅原 斉, 崎山 快夫, 大塚 美恵子  日本内科学会関東地方会  590回-  43  -43  2012/09
  • 発熱、筋痛、下肢の紅斑・硬結を主症状としたミノサイクリン誘発性結節性多発動脈炎の1例
    中村 潤, 石井 彰, 塚原 理恵子, 出光 俊郎, 眞山 英徳, 渡辺 珠美, 菅原 斉, 野首 光弘  日本内科学会関東地方会  590回-  45  -45  2012/09
  • 【心腎連関を考慮した利尿薬の使い方】浮腫と利尿薬
    百村 伸一, 菅原 斉  Circulation  2-  (9)  68  -73  2012/09
  • 類天疱瘡治療に用いたアザチオプリン(AZA)による薬剤性汎血球減少から回復した高齢者の1例
    明石 直之, 菅原 斉, 眞山 英徳, 田中 彩, 渡辺 珠美, 石井 彰, 加計 正文  日本内科学会関東地方会  587回-  25  -25  2012/05
  • 頸部から上肢の疼痛で発症し、他病院の整形外科では診断に苦慮した神経痛性筋萎縮症の1例
    木村 真智子, 矢部 寛, 坂根 英夫, 石井 彰, 渡辺 珠美, 岩本 健一, 崎山 快夫, 大塚 美恵子, 菅原 斉  日本内科学会関東地方会  587回-  42  -42  2012/05
  • 後頸部激痛で発症、頸部前屈可・回旋不可の身体所見が診断の契機となったCrowned dens syndrome(CDS)の1例
    岩本 健一, 田巻 佐和子, 渡辺 珠美, 木村 真智子, 鈴木 潤, 矢部 寛樹, 石井 彰, 菅原 斉, 加計 正文, 川上 正舒  日本内科学会関東地方会  585回-  48  -48  2012/02
  • カフェインの過剰摂取による難治性嘔吐が原因と考えられた特発性縦隔気腫の1例
    田巻 佐和子, 岩本 健一, 渡辺 珠美, 木村 真智子, 矢部 寛樹, 鈴木 潤, 石井 彰, 菅原 斉, 加計 正文, 川上 正舒  日本内科学会関東地方会  585回-  54  -54  2012/02
  • 抗リン脂質抗体症候群(APS)を伴う腎機能障害に対してステロイド・血漿交換療法が奏功した一例
    伊藤 聖学, 石井 彰, 鶴岡 昭久, 平井 啓之, 植田 裕一郎, 森 穂波, 名畑 あおい, 吉田 泉, 山田 茂樹, 菅原 斉, 田部井 薫  日本腎臓学会誌  53-  (6)  941  -941  2011/08
  • 脳梗塞入院患者のコレステロール値に関する6年間の後方視的検討
    崎山 快夫, 大塚 美恵子, 菅原 斉, 植木 彰  日本老年医学会雑誌  48-  (Suppl.)  73  -73  2011/05
  • 漏出性胸水にも拘わらず胸水中PSA高値のparamalignant effusionを呈した前立腺癌の1例
    新川 尚子, 石井 彰, 松林 洋志, 渡辺 珠美, 矢部 寛樹, 菅原 斉, 加計 正文, 川上 正舒, 小林 裕, 土橋 洋  日本内科学会関東地方会  579回-  35  -35  2011/03
  • 全身性強皮症患者の栄養管理に対してチームでのアプローチが奏功した一例
    川畑 奈緒, 手塚 洋子, 茂木 さつき, 本多 晴美, 長谷部 忠史, 三ツ橋 美幸, 笹岡 康子, 石井 彰, 菅原 斉, 早田 邦康  静脈経腸栄養  26-  (1)  424  -424  2011/01
  • 脳梗塞入院患者のコレステロール値に関する5年間の後方視的検討
    崎山 快夫, 大塚 美恵子, 石川 真実, 菅原 斉, 植木 彰  臨床神経学  50-  (12)  1102  -1102  2010/12
  • 川畑 奈緒, 石井 彰, 手塚 洋子, 茂木 さつき, 本多 晴美, 長谷部 忠史, 三ツ橋 美幸, 笹岡 康子, 菅原 斉, 早田 邦康  日本病態栄養学会誌  13-  (5)  195  -195  2010/11
  • 青木 厚, 生駒 亜希, 佐々木 正美, 齊藤 智之, 豊島 秀男, 菅原 斉, 加計 正文, 石川 三衛, 川上 正舒  肥満研究  16-  (Suppl.)  161  -161  2010/09
  • 劇症1型糖尿病の発症を思わせた2型糖尿病の1例
    青木 厚, 松林 洋志, 木本 瑞穂, 斎藤 智之, 生駒 亜希, 豊島 秀男, 菅原 斉, 加計 正文, 石川 三衛, 川上 正舒  糖尿病  53-  (8)  651  -651  2010/08
  • 糖尿病性ケトーシスを契機に急性リチウム(Li)中毒に至った双極性うつ病の1例
    田代 研, 石井 彰, 渡辺 珠美, 吉川 修平, 大沼 哲, 石岡 春彦, 塩塚 潤二, 讃井 將満, 菅原 斉, 川上 正舒  日本内科学会関東地方会  573回-  19  -19  2010/07
  • 溶連菌感染後糸球体腎炎とEBV伝染性単核球症による急性心筋炎を併発した1例
    渡辺 珠美, 田村 洋行, 松林 洋志, 石井 彰, 青木 厚, 菅原 斉, 百村 伸一, 川上 正舒  日本内科学会関東地方会  571回-  29  -29  2010/05
  • 膵β細胞Kv2.1チャネルの代謝依存性調節機構
    加計 正文, 吉田 昌史, 出崎 克也, 青木 厚, 菅原 斉, 豊島 秀男, 石川 三衛, 川上 正舒, 中田 正範, 矢田 俊彦  糖尿病  53-  (Suppl.1)  S  -94  2010/04
  • 検診受診者におけるオステオカルシンと耐糖能異常の関連性について
    青木 厚, 吉田 昌史, 木本 瑞穂, 浅野 智子, 佐久間 由紀, 村田 美保, 斎藤 智之, 生駒 亜希, 宗雪 年孝, 宗像 博美, 菅原 斉, 豊島 秀男, 加計 正文, 石川 三衛, 川上 正舒  糖尿病  53-  (Suppl.1)  S  -105  2010/04
  • ストレスマーカーとしての血糖 その有用性と活用法 アテローム血栓性脳梗塞診断への応用
    吉田 昌史, 青木 厚, 坪井 謙, 崎山 快夫, 菅原 斉, 藤原 俊文, 豊島 秀男, 石川 三衛, 川上 正舒, 加計 正文  糖尿病  53-  (Suppl.1)  S  -310  2010/04
  • 末梢性T細胞性リンパ腫による血球貪食性リンパ組織球症(HLH)の1剖検例
    石井 彰, 中井 秀一, 渡辺 珠美, 菅原 斉, 奥田 慎也, 大島 久美, 西田 淳二, 神田 善伸, 野首 光弘, 山田 茂樹  日本内科学会関東地方会  568回-  45  -45  2009/12
  • 交通事故直後には無症状であったが、遅発性に後腹膜血腫を発症したワーファリン治療中の大動脈弁置換術(AVR)後の1症例
    松林 洋志, 岩井 悠希, 石井 彰, 新藤 雄二, 柏浦 正広, 渡辺 珠美, 三輪 千尋, 菅原 斉, 松浦 克彦, 川上 正舒  日本内科学会関東地方会  567回-  27  -27  2009/11
  • メトロニダゾール(MTDZ)によるアレルギー反応のためチニダゾールで加療したAIDSに併発したアメーバ性大腸炎の1例
    渡辺 珠美, 松林 洋志, 石井 彰, 青木 厚, 牛丸 信也, 野首 光弘, 菅原 斉, 西田 淳二, 吉田 行雄, 川上 正舒  日本内科学会関東地方会  566回-  24  -24  2009/10
  • 青木 厚, 生駒 亜希, 斉藤 智之, 豊島 秀男, 菅原 斉, 加計 正文, 石川 三衛, 川上 正舒  日本臨床内科医会会誌  24-  (3)  383  -383  2009/09
  • 糖尿病と腎不全に伴ったbrainstem variant of reversible posterior leukoencephalopathy syndrome(RPLS)の1例
    多田 祐子, 大和 康彦, 菅原 斉, 崎山 快夫, 大塚 美恵子, 植木 彰  日本内科学会関東地方会  563回-  26  -26  2009/06
  • 心筋虚血、横紋筋融解症を呈した劇症1型糖尿病類似の症例
    吉田 昌史, 村田 美保, 斉藤 智之, 生駒 亜希, 菅原 斉, 豊島 秀男, 加計 正文, 石川 三衛, 川上 正舒  糖尿病  52-  (6)  471  -471  2009/06
  • 糖尿病ケトアシドーシスに急性心筋虚血を併発した2型糖尿病の1例
    大沼 哲, 石井 彰, 菅原 斉, 大和 康彦, 加計 正文, 石川 三衛, 川上 正舒  糖尿病  52-  (6)  488  -488  2009/06
  • アンジオテンシン受容体拮抗薬によると考えられた低血糖症の1例
    青木 厚, 生駒 亜紀, 斉藤 智之, 豊島 秀男, 菅原 斉, 加計 正文, 石川 三衛, 川上 正舒  糖尿病  52-  (6)  490  -490  2009/06
  • Amelanostic melanomaの1剖検例
    石井 彰, 松本 充也, 渡辺 珠美, 大和 康彦, 菅原 斉, 加計 正文, 出光 俊郎, 兵頭 隆史, 山田 茂樹, 川上 正舒  日本内科学会関東地方会  562回-  36  -36  2009/05
  • 膵β細胞Kv2.1チャンネルのブドウ糖代謝による新規調節機構
    吉田 昌史, 出崎 克也, 青木 厚, 菅原 斉, 豊島 秀男, 石川 三衛, 川上 正舒, 中田 正範, 矢田 俊彦, 加計 正文  糖尿病  52-  (Suppl.1)  S  -329  2009/04
  • バルサルタン(Val)中断が非閉塞性腸管虚血症(NOMI)発症に関与したと考えられる悪性高血圧症の1例
    大和 康彦, 菅原 斉, 小櫃 保, 渡辺 珠美, 石井 彰, 青木 厚, 渡辺 佳明, 松浦 克彦, 加計 正文, 川上 正舒  日本内科学会関東地方会  559回-  21  -21  2008/12
  • 青木 厚, 吉田 昌史, 村田 美保, 生駒 亜紀, 菅原 斉, 加計 正文, 川上 正舒, 石川 三衛  日本内分泌学会雑誌  84-  (3)  845  -845  2008/12
  • 抗サイトメガロウイルス(CMV)-IgM陰性、抗CMV-IgG陽性である健常成人に発症したCMVpp65抗原が陽性の伝染性単核球症の1例
    渡辺 珠美, 大和 康彦, 石井 彰, 青木 厚, 菅原 斉, 加計 正文, 川上 正舒  日本内科学会関東地方会  557回-  29  -29  2008/10
  • 佐々木 薫, 出光 俊郎, 中井 秀一, 飯田 絵理, 加倉井 真樹, 平塚 裕一郎, 岡田 栄子, 高田 大, 大沢 真澄, 梅本 尚可, 林 和, 和田 由香, 青木 厚, 大和 康彦, 菅原 斉, 東 隆一  Skin Surgery  17-  (2)  74  -79  2008/08  
    目的 壊死性筋膜炎を早期に診断し、進展を防ぐ可能性を模索するために、当科で経験した壊死性軟部組織感染症について臨床的に検討した。対象 2001年から当科で経験した壊死性皮膚軟部組織感染症18例(壊死性筋膜炎13例、壊死性蜂窩織炎5例)で男14例、女4例である。年齢は41〜91歳で、平均61.3歳であった。結果 部位 深頸部感染症および上腕、臀部の各1例を除き、15例が下肢病変であった。基礎疾患 糖尿病11例のほか、肝硬変2例、腎不全と咽頭癌放射線治療中の発症1例、下肢の慢性リンパ浮腫、骨折の既往、直腸癌穿孔も各1例にみられた。誘因 打撲に続発したもの2例、足背のBowen病術後にsurgical site infectionとして発症した例もみられた。検出菌 溶蓮菌11例(A群6例)、黄色ブドウ球菌5例(MRSA3例)、緑膿菌1例、大腸菌1例、クロストリジウム1例、陰性2例であった。混合感染は4例のみであった。手術 壊死性筋膜炎13例のうち、7例は全身麻酔でデブリードマンを施行したが、4例は局所麻酔でデブリードマンを行い、抗生物質の全身投与により感染症を治癒ないしコントロールさせることができた。合併症 DICを起こした例は4例、肝不全3例、腎不全1例であった。腸腰筋膿瘍、縦隔膿瘍を合併した例が各1例にみられた。予後 死亡例は2例(11%)で、急速な進行と全身状態からデブリードマンができなかった。大腿部切断は1例、足切断は1例、再発例は2例で1例は下腿の切断を行い救命し得た。考察 壊死性筋膜炎において、皮膚の水疱、血疱、壊死を呈し、急速に進行して多臓器不全に陥る劇症例の診断は皮膚外科医にとって困難ではない。しかし、急性ないし亜急性に経過する非劇症例では、実際上、蜂窩織炎との鑑別がしばしば困難である。したがって、壊死性軟部組織感染症を疑ったら、試験切開、生検をためらわないことが重要である。切開時の出血の有無、滲出液や脂肪織の状態を観察し、フィンガーテストを行う必要がある。壊死性筋膜炎の可能性があれば、広範囲のデブリードマンを行わなくてはならない。また、非劇症例で範囲の狭い場合は宿主の免疫状態にもよるが、早期に診断をすれば局所麻酔下での生検、試験切開と抗生物質で炎症を鎮静化できる例もあると思われた。(著者抄録)
  • CPAP・酸素・テオフィリン併用で著明に改善したCheyne-Stokes呼吸を伴ったうっ血性心不全の1症例
    大和 康彦, 菅原 斉  日本内科学会関東地方会  555回-  25  -25  2008/07
  • 壊死性筋膜炎、腸腰筋膿瘍、敗血症性ショックと重篤な感染症を繰り返した糖尿病の1例
    青木 厚, 菅原 斉, 柏浦 正広, 出光 俊郎, 税田 和夫, 豊島 秀男, 河野 幹彦, 加計 正文, 石川 三衛, 川上 正舒  糖尿病  51-  (7)  662  -662  2008/07
  • 上腹部痛と腹水増加、下腿浮腫を伴ったネフローゼ症候群患者
    石井 彰, 中島 嘉之, 田部井 薫, 菅原 斉  日本内科学会関東地方会  553回-  32  -32  2008/05
  • 直腸穿孔を認めた仙骨壊死性筋膜炎の1例
    中井 秀一, 佐々木 薫, 飯田 絵理, 加倉井 真樹, 出光 俊郎, 佐々木 純一, 讃井 將満, 藤原 俊文, 菅原 斉, 川上 正舒  日本皮膚科学会雑誌  118-  (4)  828  -828  2008/03
  • 心室期外収縮(VPC)の重症度と右室心内膜心筋生検(REMB)における脂肪組織との関連性について
    菅原 斉  Journal of Cardiology  22-  (Suppl.29)  345  -345  1992/08
  • 心筋細胞膜でのフリーラジカルによる過酸化脂質生成に対する漢方薬の効果
    菅原 斉  日本東洋医学雑誌  42-  (4)  439  -439  1992/04
  • 菅原 斉  Japanese Circulation Journal  56-  (増刊 ABSTRACTS)  392  -392  1992/03
  • Bizarre myocardial hypertrophy with disorganization (BMHD)を示した,非遺伝性肥大型心筋症(NHCM)におけるβ心筋ミオシン重鎖遺伝子の点突然変異の検討 ホルマリン固定パラフィン包埋組織からPCR法を用いて
    菅原 斉  循環器科  31-  (3)  331  -331  1992/03
  • 心室期外収縮(VPC)の重症度と右室心内膜心筋生検(REMB)の脂肪織の面積割合(F%)との関連性の検討 年齢,肥満度,比体重を考慮して
    菅原 斉  日本内科学会雑誌  81-  (臨増)  107  -107  1992/02
  • 左脚ブロック型持続型心室頻拍(SVT)症例の右室心内膜心筋生検(REMB)における脂肪組織の出現部位とその面積
    菅原 斉  循環器科  29-  (2)  206  -206  1991/02
  • 左室不全を契機に診断された多発性骨髄腫合併免疫グロブリンアミロイドーシスの1剖検例
    菅原 斉  循環器科  29-  (2)  203  -203  1991/02
  • 特異な気管支鏡所見を呈した縦隔海綿状血管腫の1例
    菅原 斉  日本胸部疾患学会雑誌  27-  (7)  868  -868  1989/07
  • 急性心筋梗塞患者のCCU入院時Killip分類の検討
    菅原 斉  ICUとCCU  11-  (臨増秋)  76  -76  1987/08

Awards & Honors

  • 2019/04 日本内科学会 「日本内科学会ことはじめ2019名古屋」指導教官賞
     
    受賞者: 斉藤 開、菅原 斉
  • 2017/04 日本内科学会 「日本内科学会ことはじめ2017東京」指導教官賞
     
    受賞者: 湊さおり;菅原 斉
  • 2015/04 日本内科学会 「日本内科学会ことはじめ2015京都」指導教官賞
     
    受賞者: 飯嶋健太、菅原 斉
  • 1995 第3回僻地医療の体験に基づく学術論文最優秀賞
     JPN
  • 1993 第89回日本内科学会奨励賞
     JPN
  • 1993 第1回僻地医療の体験に基づく学術論文優秀賞
     JPN
  • 1991 第4回地域保健医療研究奨励賞
     JPN

Research Grants & Projects

  • へき地介護施設での看護師教育と、 尿検体アンチバイオブラムを利用した、施設から始める薬剤耐性対策の研究
    地域社会健康科学研究所:
    Date (from‐to) : 2019/04 -2022/03
  • 文部科学省:科学研究費補助金(基盤研究(C))
    Date (from‐to) : 2014/04 -2018/03 
    Author : 菅原 斉
  • Helicobacter pylori およびChlamydia pnemoniae感染の地域性と感染経路の検討
    公益法人地域社会振興財団:へき地住民の健康増進に関する研究
    Date (from‐to) : 1997/04 -1998/03 
    Author : 大澤博之
  • 公益財団法人長寿科学振興財団:海外派遣研究員研究費助成
    Date (from‐to) : 1994/04 -1995/03 
    Author : 黒崎知博
  • へき地における急性感染症の動態調査と主要な感染症に対するファーストチョイス薬剤のマニュアルの作製
    地域社会振興財団:へき地医療の開発に関する啓発研究
    Date (from‐to) : 1989/04 -1990/03 
    Author : 中野康伸
  • immunotherapy for end-stage carcinoma
  • Case study


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