研究者総覧

佐藤 健夫 (サトウ タケオ)

  • 地域臨床教育センター 教授
Last Updated :2021/12/07

研究者情報

ホームページURL

J-Global ID

プロフィール

  • 大学院修了後は研究ではなく、臨床医として医療に貢献しようと思い東京都内で勤務してきましたが、北海道の地域で3年半の間診療する機会がありました。全く知らない土地でゼロからの診療開始となり、自分の専門のアレルギーリウマチ性疾患以外にも広く診療する必要に迫られ、大変な重圧の中勤務してきましたが、いい経験であったと考えています。それと同時になぜ地域医療が崩壊していくのか、自分自身の経験としても理解することができ、人間の身勝手さを痛感しています。今は縁あって自治医科大学に勤務していますが、現在も北海道の医師不足の地への支援を継続しています。今後は医師として患者様への診療により貢献するだけではなく、微力ながらアレルギーリウマチ領域での臨床研究に寄与していきたいと考えています。

経歴

  • 2000年  東京大学医学部附属病院助手

研究活動情報

論文

  • Shunichiro Hanai, Takeo Sato, Katsuya Nagatani, Seiji Minota
    INTERNAL MEDICINE 53 5 521 - 522 2014年 [査読有り][通常論文]
  • Hagiwara K, Abe Y, Sato T, Inokuma S, Akiyama O, Suzuki K, Sato H, Imakado S, Takemura T
    Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine 100 1956 - 1958 7 2011年07月 [査読有り][通常論文]
  • Takeo Sato, Shigeko Inokuma, Akira Sagawa, Takemasa Matsuda, Tamiko Takemura, Takeshi Otsuka, Yukihiko Saeki, Tsutomu Takeuchi, Tetsuji Sawada
    RHEUMATOLOGY 48 10 1265 - 1268 2009年10月 [査読有り][通常論文]
     
    Objective. To elucidate the factors associated with poor prognosis of LEF-induced lung injury in patients with RA. Methods. The background and clinical and laboratory features of LEF-induced lung injury were examined and compared between patients who died of and who recovered from it. Results. Among 22 patients who developed LEF-induced lung injury, 9 died of and 13 recovered from it. The patients who died tended to have pre-existing interstitial pneumonia (8/9 vs 6/13, P=0.07). The loading and maintenance doses, serum concentration of the LEF metabolite A771726 and administration period did not differ between the groups. Patients who died had more frequently hypoxaemia of < 60 Torr and mechanical ventilation, and had a high serum CRP level (19.3 +/- 9.4 vs 10.1 +/- 8.1 mg/dl, P=0.03) and a low albumin level (2.7 +/- 0.6 vs 3.3 +/- 0.5 g/dl, P=0.03) at the lung injury onset. The peripheral blood lymphocyte count decreased in both groups at the lung injury onset, and it remained low until fatal outcome, in contrast to a re-increase upon recovery (406 +/- 394 vs 1203 +/- 399/mu l, P=0.006). The main histopathological finding in two autopsied patients was diffuse alveolar damage, in contrast to the alveolitis observed in a biopsied patient who recovered. Conclusions. Pre-existing interstitial pneumonia, extremely high serum CRP and low albumin levels, severe hypoxaemia and mechanical ventilation indicated poor prognosis. Peripheral blood lymphocytopenia developed in association with lung injury, and a sustained low lymphocyte count indicated a fatal outcome.
  • Tetsuji Sawada, Shigeko Inokuma, Takeo Sato, Takeshi Otsuka, Yukihiko Saeki, Tsutomu Takeuchi, Takemasa Matsuda, Tamiko Takemura, Akira Sagawa
    RHEUMATOLOGY 48 9 1069 - 1072 2009年09月 [査読有り][通常論文]
     
    Objectives. The possible link between LEF and interstitial lung disease (ILD) has evoked increasing concern. The aim of the present study was to elucidate the prevalence and risk factors for newly developed and/or exacerbated ILD, based on post-marketing surveillance data, in which all RA patients receiving LEF were pre-registered and monitored for 24 weeks in Japan. Methods. We analysed data from a cohort of 5054 RA patients who were prescribed LEF since its launch in September 2003 in Japan. Multivariable logistic analysis was performed to identify the risk factors for newly developed and/or exacerbation of ILD. Results. Sixty-one (1.2%) of 5054 RA patients who received LEF were reported to have development and/or exacerbation of ILD as an adverse drug reaction to LEF, judged by the attending physicians. Multivariable logistic regression analysis identified pre-existing ILD [odds ratio (OR) 8.17; 95% CI 4.63, 14.4], cigarette smoking (3.12; 95% CI 1.73, 5.60), a low body weight (<40 kg vs >50 kg) (2.91; 95% CI 1.15, 7.37) and the use of a loading dose (3.97; 95% CI 1.22, 12.9) as independent risk factors for LEF-induced ILD. Conclusions. Pre-existing ILD was the most important risk factor for LEF-induced ILD. We suggest that LEF should not be prescribed for RA patients complicated with ILD.
  • Shigeko Inokuma, Takeo Sato, Akira Sagawa, Takemasa Matsuda, Tamiko Takemura, Takeshi Ohtsuka, Yukihiko Saeki, Tsutomu Takeuchi, Tetsuji Sawada
    MODERN RHEUMATOLOGY 18 5 442 - 446 2008年10月 [査読有り][通常論文]
     
    Among the 5,043 consecutive patients registered in the postmarketing surveillance for leflunomide, 61 were reported to have lung injury and 24 died from it. The adjusted multivariate logistic regression analysis of the risk factors showed that preexisting interstitial lung disease posed the greatest risk, as well as loading dose, smoking history, and low body weight of 40 kg or less with odds ratios of 8.17, 3.97, 3.12, and 2.91, respectively. In 12 patients, lung injury developed even 2 months after leflunomide withdrawal. When patients with (n = 9) and without (n = 13) fatal outcome were compared, eight out of the former, and six out of the latter had preexisting interstitial lung disease; the former showed severe hypoxemia, high serum C-reactive protein level, hypoalbuminemia, and continuous lymphocytopenia, and required mechanical ventilation. On the basis of these results and literature review, the committee proposes that leflunomide should only be recommended as a second-line drug, should not be administered to patients with preexisting interstitial lung disease, should also not be administered to patients with smoking history or those with low body weight, and should be administered without loading dose. Careful monitoring is necessary, and when lung injury develops, leflunomide elimination using colestyramine is mandatory.
  • Takeo Sato, Kiyofumi Hagiwara, Shoko Kobayashi, Shigeko Inokuma, Osamu Akiyama
    INTERNAL MEDICINE 47 19 1763 - 1764 2008年 [査読有り][通常論文]
  • Kiyofumi Hagiwara, Takeo Sato, Shoko Takagi-Kobayashi, Shunsuke Hasegawa, Nayumi Shigihara, Osamu Akiyama
    JOURNAL OF RHEUMATOLOGY 34 5 1151 - 1154 2007年05月 [査読有り][通常論文]
     
    A 70-year-old woman with a 6-year history of seropositive rheumatoid arthritis (RA) and asymptomatic interstitial lung disease (ILD) began taking etanercept for ongoing arthritis despite treatment with methotrexate (MTX) and bucillamine. MTX was discontinued before introduction of etanercept. She developed lung injury 8 weeks after starting etanercept. Etanercept was discontinued and oral prednisolone 40 mg/day was begun, and her clinical findings gradually improved. Lung injury, although rare, is a recently noticed, potentially fatal adverse effect of all 3 licensed biological anti-tumor necrosis factor (TNF) agents. We recommend caution in the use of anti-TNF agents in elderly RA patients with preexisting ILD.
  • Kiyofumi Hagiwara, Masakazu Sawanobori, Yasunori Nakagawa, Takeo Sato, Osamu Akiyama, Tamiko Takemura
    Modern Rheumatology 16 3 169 - 171 2006年03月 [査読有り][通常論文]
     
    A 38-year-old woman with pancytopenia and liver dysfunction was diagnosed with active systemic lupus erythematosus (SLE). On days 9 and 10 of admission, peripheral blood smears showed macrophages phagocytosing platelets, and reactive hemophagocytic syndrome (HPS) was diagnosed. Hemophagocytic syndrome was successfully treated with high-dose prednisolone therapy and one course of methylprednisolone pulse therapy. Detection of hemophagocytosing macrophages in peripheral blood smears would be a useful and noninvasive method of diagnosing SLE-associated HPS. © Japan College of Rheumatology 2006.
  • Taisuke Morimoto, Takeo Sato, Akihiro Matsuoka, Tetsu Sakamoto, Keisuke Ohta, Tsunehiro Ando, Soichiro Ikushima, Kiyofumi Hagiwara, Hiroaki Matsuno, Osamu Akiyama, Masaru Oritsu
    INTERNAL MEDICINE 45 2 101 - 105 2006年 [査読有り][通常論文]
     
    A 27-year-old man who had a history of bronchial asthma, eosinophilic enteritis, and eosinophilic pneumonia presented with fever, skin eruptions, cervical lymphadenopathy, hepatosplenomegaly, atypical lymphocytosis, and eosinophilia two weeks after receiving trimethoprim (TMP)-sulfamethoxazole (SMX) treatment. After the withdrawal of TMP-SMX and the administration of high-dose steroid, these systemic symptoms gradually resolved. During the disease course, the patient showed a transient increase in anti-human herpesvirus (HHV)-6 antibody titers and HHV-6 DNA in the peripheral blood, indicating the reactivation of a latent HHV-6 infection. This is the first case of TMP-SMX-induced hypersensitivity syndrome associated with the reactivation of a latent viral infection.
  • Takeo Sato, Satoko Unno, Kiyofumi Hagiwara, Hiroaki Matsuno, Katsuhiko Takeda, Osamu Akiyama
    INTERNAL MEDICINE 45 2 121 - 121 2006年 [査読有り][通常論文]
  • Takeo Sato, Tsunehisa Tsuru, Kiyofumi Hagiwara, Kazuhisa Miyashita, Hiroaki Matsuno, Atsuo Goto, Masaru Oritsu, Teruhiko Hamanaka, Osamu Akiyama
    INTERNAL MEDICINE 45 6 363 - 368 2006年 [査読有り][通常論文]
     
    A 45-year-old woman had bleary eyes and recurrent episodes of fever and arthritis in the knees and ankles. The patient had anterior uveitis, negative findings of the tuberculin test, and an increased serum lysozyme level, but bilateral hilar lymphadenopathy (BHL) was absent. During the course of her disease, the serum calcium and angiotensin- converting enzyme levels gradually increased to above the normal level, and the patient was clinically diagnosed as having sarcoidosis. The clinical features of arthritis were typical of those of Lofgren's syndrome although BHL and erythema nodosum were absent. The patient was successfully treated with 15 mg/day of prednisolone.
  • Takeo Sato, Shin-Ya Oominami, Takamitsu Souma, Kiyofumi Hagiwara, Shouko Kobayashi, Osamu Akiyama
    Japanese Journal of Allergology 55 7 827 - 831 2006年 [査読有り][通常論文]
     
    A 75-year-old woman was admitted to our hospital because of abnormal lung shadow and necrosis of the left feet She had a history of Raynaud's phenomenon from her twenties. On admission, she was diagnosed as having diffuse systemic sclerosis (SSc) and Sjögren's syndrome (SjS) because of scleroderma, interstitial pneumonia (IP), positive result of anti-Scl-70 and SS-A antibody, sicca, decreased tear excretion, and dysfunction of salivary glands. Seventy days after amputation of her left leg, she presented with edema, hypoxemia, chest discomfort, and fever. Blood test revealed inflammation and cardiac echography revealed pericardial effusion with a collapse sign of right atrium, thereby leading to the diagnosis of cardiac tamponade. After starting the daily dose of 20 mg of prednisolone, the pericardial effusion and cardiac tamponade sign disappeared. Pericarditis is seen in half of patients with SSc and rarely with SjS, and is usually asymptomatic. Pericarditis due to SSc has been reported unresponsive to steroid therapy, but several cases of steroid responsive pericarditis due to SSc or SjS have been reported. Clinically, they shared inflammatory responses and the presence of IP in the cases of SSc, which will be important when considering the pathogenesis and treatment of pericarditis due to SSc or SjS.
  • Sato T, Hagiwara K, Matsuno H, Akiyama O
    Arerugi = [Allergy] 54 1208 - 1212 10 2005年10月 [査読有り][通常論文]
  • Takeo Sato, Shigeko Inokuma, Reika Maezawa, Hisanori Nakayama, Ken Hamasaki, Yusuke Miwa, Yuko Okazaki, Masahiro Yamashita, Yoshiaki Tanaka, Hajime Kono
    Modern Rheumatology 15 3 191 - 197 2005年06月 [査読有り][通常論文]
     
    The characteristics of Pneumocystis carinii pneumonia (PCP) in patients with connective tissue diseases (CTDs) were examined retrospectively. Nine patients were enrolled in this study. Their mean age was 57.1 years. All the patients received a high-dose steroid or immunosuppressant. The onset (mean 6.6 days) of fever, cough, breathlessness, and geographical ground-glass opacities revealed by chest computed tomography was acute. The serum β-D-glucan level increased with a simultaneous increase in the Krebs von den Lungen (KL)-6 or surfactant protein D level. The serum immunoglobulin G (IgG) and albumin levels and the peripheral blood lymphocyte count at the onset of PCP were low, but only the serum IgG level decreased significantly. The patients were treated with trimethoprim-sulfamethoxazole or pentamidine isetionate. Six patients died eventually: two patients of progressive respiratory failure, two probably due to a recurrence of the PCP, and two with microbial respiratory infections other than PCP. Five of the six patients required mechanical ventilation. Three patients received secondary prophylaxis and survived. In conclusion, the acute onset was characteristic of PCP in patients with CTDs. High-dose steroids, immunosuppressants, and hypogammaglobulinemia are risk factors and respiratory failure requiring mechanical ventilation, severe secondary infections, and a lack of secondary prophylaxis are poor prognostic factors. Secondary prophylaxis is recommended for all of these patients. © Japan College of Rheumatology and Springer-Verlag Tokyo 2005.
  • T Sato, K Hagiwara, A Nishikido, S Miyamoto, K Komiyama, H Matsuno, H Hashida, N Kobayakawa, O Akiyama
    INTERNAL MEDICINE 44 3 251 - 255 2005年03月 [査読有り][通常論文]
     
    Recently, a cardiac disorder characterized by ballooning and hypokinesis at the apex has been described as takotsubo (ampulla-shaped) cardiomyopathy. We encountered a patient with a rare case of takotsubo cardiomyopathy associated with microscopic polyangiitis. A 70-year-old woman suddenly presented with ventricular dysfunction during the active phase of microscopic polyangiitis. The findings on echocardiograms and electrocardiograms were consistent with those of takotsubo cardiomyopathy. The ventricular dysfunction completely resolved after treatment with 40 mg/day of prednisolone and methylprednisolone pulse therapy. This unique type of cardiomyopathy can be a complication of microscopic polyangiitis.
  • Sato T, Hagiwara K, Sasaki M, Matsuno H, Akiyama O
    Internal medicine (Tokyo, Japan) 44 160  2 2005年02月 [査読有り][通常論文]
  • Takeo Sato, Kiyofumi Hagiwara, Hiroaki Matsuno, Yoshihiro Chiyokura, Shuhei Morimoto, Jun-Ichi Kunogi, Osamu Akiyama
    Journal of Infection and Chemotherapy 11 3 160 - 163 2005年 [査読有り][通常論文]
     
    A 70-year-old woman presented with fever and pain in the right lower extremity. Fat-suppressed gadolinium-enhanced T1-weighted magnetic resonance imaging (MRI) showed contrast-enhanced fascia, fluid accumulation, and hypointense signals in the muscles. Surgical interventions including incisions and insertion of drainage tubes were performed on the basis of the MRI findings. The histopathological examinations of surgically obtained biopsy specimens demonstrated suppurative fasciitis, widespread myonecrosis, and thromboses of the vessels, all of which were compatible with a diagnosis of necrotizing fasciitis. The bacterial cultures were positive for a coagulase-negative staphylococcus. Following the surgical interventions, the patient was successfully treated by aggressive antimicrobial therapy. MRI can thus be useful for differentiating necrotizing fasciitis from nonnecrotizing soft tissue infection and for planning the treatment of necrotizing fasciitis. © Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases 2005.
  • Takeo Sato, Kiyofumi Hagiwara, Junnichi Chikazoe, Yasunori Nakagawa, Osamu Akiyama
    Modern Rheumatology 14 4 320 - 322 2004年09月 [査読有り][通常論文]
     
    We report the case of a patient who presented with acquired hemophilia associated with rheumatoid arthritis. The patient's factor VIII activity was less than 1% and factor VIII inhibitor was detected. Based on the blood analysis, the patient was diagnosed as having the factor VIII inhibitor. She was successfully treated with prednisolone, cyclophosphamide, and gammaglobulin to suppress the factor VIII inhibitor, and the administration of recombinant activated factor VII was effective in controlling severe bleeding episodes. © Japan College of Rheumatology and Springer-Verlag Tokyo 2004.
  • Miwa Y, Inokuma S, Yokoe Y, Okazaki Y, Sato T, Maezawa R
    Modern rheumatology / the Japan Rheumatism Association 13 2 160 - 167 2 2003年 [査読有り][通常論文]
     
    To determine the background features of peripheral nervous system (PNS) involvement in cases of primary Sjögren's syndrome (SS), we studied the nervous system involvement, mainly that of PNS, in patients with primary SS who were admitted to our hospital during a period of 19 years. Nine of 82 admitted patients with primary SS had PNS involvement and 12 had central nervous system (CNS) involvement. Among 182 secondary SS patients, 25 had CNS involvement, and none had PNS involvement. The nine patients with PNS involvement were older and their disease duration was shorter than those with CNS involvement and either primary or secondary SS. Four patients exhibiting active progression of PNS involvement had concomitant vasculopathy clinically that was confirmed by nerve or skin biopsy examination, with an increase in the serum C-reactive protein level. According to the literature, among 17 reported SS patients with PNS involvement, 13 had primary SS, and 13 had vasculitis as confirmed by biopsy examination. Nervous system involvement in cases of SS is not rare. PNS involvement was observed mostly in elderly patients with primary SS, and its active progression was concomitant with vasculopathy.

書籍

MISC



Copyright © MEDIA FUSION Co.,Ltd. All rights reserved.