研究者総覧

山本 祐 (ヤマモト ユウ)

  • 総合診療部門 講師
Last Updated :2021/12/07

研究者情報

ホームページURL

J-Global ID

研究キーワード

  • 医学教育   地域医療   総合診療   

研究分野

  • ライフサイエンス / 医療管理学、医療系社会学 / 医学教育
  • ライフサイエンス / 内科学一般

研究活動情報

論文

  • Yu Yamamoto, Masami Matsumura
    Clinical Case Reports 9 5 2021年05月 [査読有り]
  • Yuji Nishizaki, Keigo Nozawa, Tomohiro Shinozaki, Taro Shimizu, Tomoya Okubo, Yu Yamamoto, Ryota Konishi, Yasuharu Tokuda
    BMC medical education 21 1 214 - 214 2021年04月 [査読有り]
     
    BACKGROUND: The general medicine in-training examination (GM-ITE) is designed to objectively evaluate the postgraduate clinical competencies (PGY) 1 and 2 residents in Japan. Although the total GM-ITE scores tended to be lower in PGY-1 and PGY-2 residents in university hospitals than those in community-based hospitals, the most divergent areas of essential clinical competencies have not yet been revealed. METHODS: We conducted a nationwide, multicenter, cross-sectional study in Japan, using the GM-ITE to compare university and community-based hospitals in the four areas of basic clinical knowledge". Specifically, "medical interview and professionalism," "symptomatology and clinical reasoning," "physical examination and clinical procedures," and "disease knowledge" were assessed. RESULTS: We found no significant difference in "medical interview and professionalism" scores between the community-based and university hospital residents. However, significant differences were found in the remaining three areas. A 1.28-point difference (95% confidence interval: 0.96-1.59) in "physical examination and clinical procedures" in PGY-1 residents was found; this area alone accounts for approximately half of the difference in total score. CONCLUSIONS: The standardization of junior residency programs and the general clinical education programs in Japan should be promoted and will improve the overall training that our residents receive. This is especially needed in categories where university hospitals have low scores, such as "physical examination and clinical procedures."
  • Shiori Sekiguchi, Yu Yamamoto, Shuji Hatakeyama, Masami Matsumura
    Internal medicine (Tokyo, Japan) 2021年01月 [査読有り]
     
    We herein report a 31-year-old man with recurrent aseptic meningitis associated with Kikuchi's disease. Although aseptic meningitis is the most common neurological complication of Kikuchi's disease, its characteristics remain unclear, especially in recurrent cases. A literature review revealed that aseptic meningitis associated with Kikuchi's disease was more likely to occur in men and was associated with a low cerebrospinal fluid (CSF)/serum glucose ratio. Lymphadenopathy tended to occur simultaneously or after the onset of meningitis. When encountering a patient with aseptic meningitis of unknown etiology, it may be worthwhile to focus on the CSF/serum glucose ratio and lymphadenopathy with a careful examination.
  • Yasushi Matsuyama, Motoyuki Nakaya, Jimmie Leppink, Cees van der Vleuten, Yoshikazu Asada, Adam Jon Lebowitz, Teppei Sasahara, Yu Yamamoto, Masami Matsumura, Akira Gomi, Shizukiyo Ishikawa, Hitoaki Okazaki
    BMC medical education 21 1 30 - 30 2021年01月 [査読有り]
     
    BACKGROUND: Developing self-regulated learning in preclinical settings is important for future lifelong learning. Previous studies indicate professional identity formation, i.e., formation of self-identity with internalized values and norms of professionalism, might promote self-regulated learning. We designed a professional identity formation-oriented reflection and learning plan format, then tested effectiveness on raising self-regulated learning in a preclinical year curriculum. METHODS: A randomized controlled crossover trial was conducted using 112 students at Jichi Medical University. In six one-day problem-based learning sessions in a 7-month pre-clinical year curriculum, Groups A (n = 56, female 18, mean age 21.5y ± 0.7) and B (n = 56, female 11, mean age 21.7y ± 1.0) experienced professional identity formation-oriented format: Group A had three sessions with the intervention format in the first half, B in the second half. Between-group identity stages and self-regulated learning levels were compared using professional identity essays and the Motivated Strategies for Learning Questionnaire. RESULTS: Two-level regression analyses showed no improvement in questionnaire categories but moderate improvement of professional identity stages over time (R2 = 0.069), regardless of timing of intervention. CONCLUSIONS: Professional identity moderately forms during the pre-clinical year curriculum. However, neither identity nor self-regulated learning is raised significantly by limited intervention.
  • Yu Yamamoto, Yukiko Ishikawa, Masahisa Shimpo, Masami Matsumura
    Journal of general and family medicine 22 1 55 - 56 2021年01月 [査読有り][通常論文]
     
    Contrast-enhanced computed tomography angiography reveals "railroad track-like" calcifications bilaterally from the femoral to the popliteal arteries.
  • Yuji Nishizaki, Taro Shimizu, Tomohiro Shinozaki, Tomoya Okubo, Yu Yamamoto, Ryota Konishi, Yasuharu Tokuda
    BMC medical education 20 1 426 - 426 2020年11月 [査読有り]
     
    BACKGROUND: Although general medicine (GM) faculty in Japanese medical schools have an important role in educating medical students, the importance of residents' rotation training in GM in postgraduate education has not been sufficiently recognized in Japan. To evaluate the relationship between the rotation of resident physicians in the GM department and their In-Training Examination score. METHODS: This study is a nationwide multi-center cross-sectional study in Japan. Participants of this study are Japanese junior resident physicians [postgraduate year (PGY)-1 and PGY-2] who took the General Medicine In-Training Examination (GM-ITE) in fiscal years 2016 to 2018 at least once (n = 11,244). The numbers of participating hospitals in the GM-ITE were 381, 459, and 503 in 2016, 2017, and 2018.The GM-ITE score consisted of four categories (medical interview/professionalism, symptomatology/clinical reasoning, physical examination/procedure, and disease knowledge). We evaluated relationship between educational environment (including hospital information) and the GM-ITE score. RESULTS: A total of 4464 (39.7%) residents experienced GM department rotation training. Residents who rotated had higher total scores than residents who did not rotate (38.1 ± 12.1, 36.8 ± 11.7, and 36.5 ± 11.5 for residents who experienced GM rotation training, those who did not experience this training in hospitals with a GM department, and those who did not experience GM rotation training in hospitals without a GM department, p = 0.0038). The association between GM rotation and competency remained after multivariable adjustment in the multilevel model: the score difference between GM rotation training residents and non-GM rotation residents in hospitals without a GM department was estimated as 1.18 (standard error, 0.30, p = 0.0001), which was approximately half of the standard deviation of random effects due to hospital variation (estimated as 2.00). CONCLUSIONS: GM rotation training improved the GM-ITE score of residents and should be considered mandatory for junior residents in Japan.
  • Ayako Kumabe, Shuji Hatakeyama, Naoki Kanda, Yu Yamamoto, Masami Matsumura
    The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale 2020 5792937 - 5792937 2020年 [査読有り][通常論文]
     
    Background: Tuberculous peritonitis is difficult to diagnose due to its varying clinical features, in addition to the low yield on bacterial culture or polymerase chain reaction using ascitic fluid samples. This study aimed to investigate the sensitivity and specificity of elevated adenosine deaminase (ADA) levels as a diagnostic marker for tuberculous peritonitis. Methods: A retrospective cohort of 181 adult patients who underwent ascitic fluid ADA level examination at Jichi Medical University Hospital between January 2006 and December 2015 were included. We collected data regarding ascitic fluid analyses including ADA levels, bacteriology and cytology, final diagnosis (cause of ascites), basis of the diagnosis, duration to diagnosis, and disease outcome. Results: Among 181 patients, elevated ascitic ADA levels (≥40 IU/L) were observed in 15 patients (median, 87.2 IU/L; range, 44.0-176.1 IU/L); 8 patients had tuberculous peritonitis, 4 had lymphoma-related ascites, and 2,had peritoneal carcinomatosis with bacterial coinfection, and 1 had chlamydial pelvic inflammatory disease. Among 166 patients without ascitic ADA level elevation (median, 7.3 IU/L; range, <2.0-39.1 IU/L), none had tuberculosis, 4 had lymphoma-related ascites, 28 had cancer/mesothelioma-related ascites, and 134 had ascites due to other causes. In our cohort, elevated ascitic fluid ADA levels (≥40 IU/L) showed 100% sensitivity, 96.0% specificity, 53.3% positive predictive value (PPV), and 100% negative predictive value for the diagnosis of peritoneal tuberculosis. Conclusions: Ascitic fluid ADA levels ≥40 IU/L showed excellent sensitivity, despite a low PPV, for the diagnosis of tuberculous peritonitis. Lymphoma-related ascites is an important mimic of tuberculous peritonitis that can result in high ascitic fluid ADA levels with similar clinical manifestations.
  • Naoko Kamiya, Shuji Hatakeyama, Naoki Kanda, Sho Yonaha, Dai Akine, Yu Yamamoto, Masami Matsumura
    Journal of general and family medicine 20 2 68 - 71 2019年03月 [査読有り][通常論文]
     
    Vertebral osteomyelitis can result in serious complications if diagnosis is delayed. Magnetic resonance imaging (MRI) is considered the most useful modality for the early diagnosis of vertebral osteomyelitis. We examined three patients with vertebral osteomyelitis whose initial MRI (obtained <2 weeks after the onset of symptoms) did not reveal obvious findings of pyogenic vertebral osteomyelitis. However, follow-up MRI clearly demonstrated typical findings of the disease. This case series illustrates that a repeat MRI must be performed 2-4 weeks after the onset of symptoms in patients presenting with clinical manifestations and microbiological findings suggestive of vertebral osteomyelitis.
  • Kaoru Morita, Shin-Ichiro Fujiwara, Takashi Ikeda, Shin-Ichiro Kawaguchi, Yumiko Toda, Shoko Ito, Shin-Ichi Ochi, Takashi Nagayama, Kiyomi Mashima, Kento Umino, Daisuke Minakata, Hirofumi Nakano, Ryoko Yamasaki, Yasufumi Kawasaki, Miyuki Sugimoto, Masahiro Ashizawa, Chihiro Yamamoto, Kaoru Hatano, Kazuya Sato, Iekuni Oh, Ken Ohmine, Kazuo Muroi, Kentaro Ashizawa, Yu Yamamoto, Hisashi Oshiro, Yoshinobu Kanda
    Acta haematologica 141 3 158 - 163 2019年 [査読有り][通常論文]
     
    TAFRO syndrome, a rare systemic inflammatory disease, can lead to multiorgan failure without appropriate treatment. Although thrombocytopenia is frequently seen in patients with TAFRO syndrome, little is known about its pathogenesis. Moreover, while recent studies have reported the presence of an anterior mediastinal mass in some patients, the pathological status of this remains unclear. Here, we report a case of fatal bleeding in a patient with TAFRO syndrome accompanied by an anterior mediastinal mass. A 55-year-old female was transferred to our hospital with a 2-week history of fever, epistaxis, and dyspnea. Laboratory tests revealed severe thrombocytopenia, computed tomography (CT) showed pleural effusions, and bone marrow biopsy revealed reticulin myelofibrosis. We suspected TAFRO syndrome, but the CT scan showed an anterior mediastinal mass that required a biopsy to exclude malignancy. She soon developed severe hemorrhagic diathesis and died of intracranial hemorrhage despite intensive treatment. She had multiple autoantibodies against platelets, which caused platelet destruction. An autopsy of the mediastinal mass revealed fibrous thymus tissues with infiltration by plasma cells. Our case suggests that thrombocytopenia could be attributed to antibody-mediated destruction and could be lethal. Hence, immediate treatment is imperative in cases of severe thrombocytopenia, even when accompanied by an anterior mediastinal mass.
  • Ryosuke Akiyama, Jun Suzuki, Koichi Ito, Yu Yamamoto
    Internal medicine (Tokyo, Japan) 57 2 293 - 294 2018年01月 [査読有り][通常論文]
  • Yuji Nishizaki, Atsushi Mizuno, Tomohiro Shinozaki, Tomoya Okubo, Yusuke Tsugawa, Taro Shimizu, Ryota Konishi, Yu Yamamoto, Naotake Yanagisawa, Toshiaki Shiojiri, Yasuharu Tokuda
    JOURNAL OF GENERAL AND FAMILY MEDICINE 18 5 312 - 314 2017年10月 [査読有り][通常論文]
  • Yu Yamamoto, Sayaka Yamamoto
    The New England journal of medicine 376 26 e53  2017年06月 [査読有り][通常論文]
  • Naoki Kanda, Ayako Kumabe, Yu Yamamoto, Shuji Hatakeyama, Masami Matsumura
    JOURNAL OF GENERAL INTERNAL MEDICINE 32 S462 - S462 2017年04月 [査読有り][通常論文]
  • Ryo Sasaki, Naoki Kanda, Dai Akine, Ayako Kumabe, Yu Yamamoto, Shuji Hatakeyama, Masami Matsumura
    JOURNAL OF GENERAL INTERNAL MEDICINE 32 S390 - S391 2017年04月 [査読有り][通常論文]
  • Ayako Kumabe, Shuji Hatakeyama, Koki Kosami, Tadahiro Suzuki, Yu Yamamoto, Masami Matsumura
    JOURNAL OF GENERAL INTERNAL MEDICINE 31 S598 - S599 2016年05月 [査読有り][通常論文]
  • Hiromi Sekiguchi, Koki Kosami, Jun Suzuki, Kozue Murayama, Yu Yamamoto, Shuji Hatakeyama, Masami Matsumura
    JOURNAL OF GENERAL INTERNAL MEDICINE 31 S723 - S723 2016年05月 [査読有り][通常論文]
  • Tomoya Shiba, Tadahiro Suzuki, Taro Okabe, Tomohiro Ogawa, Takuya Murakami, Yu Yamamoto, Shuji Hatakeyama, Masami Matsumura
    JOURNAL OF GENERAL INTERNAL MEDICINE 31 S590 - S591 2016年05月 [査読有り][通常論文]
  • Yu Yamamoto, Tsuneaki Kenzaka, Shigehiro Kuroki, Eiji Kajii
    European heart journal cardiovascular Imaging 16 7 817 - 817 2015年07月 [査読有り][通常論文]
  • Yuki Ueda, Tsuneaki Kenzaka, Ayako Noda, Yu Yamamoto, Masami Matsumura
    International medical case reports journal 8 225 - 30 2015年 [査読有り][通常論文]
     
    INTRODUCTION: Kawasaki disease (KD) most commonly develops in infants, although its specific cause is still unclear. We report here a rare case of adult-onset KD which revealed to be concurrently infected by Coxsackievirus A4. CASE PRESENTATION: The patient was a 37-year-old Japanese man who presented with fever, exanthema, changes in the peripheral extremities, bilateral non-exudative conjunctival injection, and changes in the oropharynx, signs that meet the diagnostic criteria for KD defined by the Centers for Disease Control and Prevention. In this case, the patient had a significantly high antibody titer for Coxsackievirus A4, which led us to presume that the occurrence of KD was concurrent Coxsackievirus A4 infection. CONCLUSION: We reported a very rare case of KD which suggests that the disease can be concurrent Coxsackievirus A4 infection. Although KD is an acute childhood disease, with fever as one of the principal features, KD should also be considered in the differential diagnosis when adult patients present with a fever of unknown cause associated with a rash.
  • Ayako Kumabe, Tsuneaki Kenzaka, Yu Yamamoto, Eiji Kajii
    BMJ case reports 2013 2013年04月 [査読有り][通常論文]
     
    Corpus cavernosum abscesses are rarely seen in the clinical setting. We report the case of an early diagnosis of corpus cavernosum abscess due to a blind-ending urethra in a 60-year-old man without known risk factors and who was successfully treated by antibiotic therapy alone. In this case, the blind-ending urethra after urinary diversion surgery was considered a risk factor of the abscess formation. If the physician notes that the patient has fever of uncertain cause after urinary diversion surgery, he/she should examine the penis and perineum in consideration of the possibility of corpus cavernosum abscess.
  • Yu Yamamoto, Sayaka Yamamoto, Shigehiro Kuroki
    Internal medicine (Tokyo, Japan) 51 14 1949 - 1949 2012年 [査読有り][通常論文]


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