辻 喜久

写真a

所属

医学部 総合診療医学講座

職名

教授

学位 【 表示 / 非表示

  • 医学博士

研究分野 【 表示 / 非表示

  • ライフサイエンス   消化器内科学  

  • ライフサイエンス   放射線科学  

  • ライフサイエンス   免疫学  

researchmapの所属 【 表示 / 非表示

  • 滋賀医科大学   総合診療学講座   特任教授  

  • 札幌医科大学   総合診療医学講座   教授  

 

研究キーワード 【 表示 / 非表示

  • 医学教育

  • 重症急性膵炎

  • 急性膵炎

  • Perfusion CT

論文 【 表示 / 非表示

  • Gut microbiota and metabolites in patients with COVID-19 are altered by the type of SARS-CoV-2 variant.

    Yoshihiro Yokoyama, Tomoko Ichiki, Tsukasa Yamakawa, Yoshihisa Tsuji, Koji Kuronuma, Satoshi Takahashi, Eichi Narimatsu, Akio Katanuma, Hiroshi Nakase

    Frontiers in microbiology   15   1358530 - 1358530  2024年  [国際誌]

     概要を見る

    INTRODUCTION: Patients with COVID-19 have dysbiosis of the intestinal microbiota with altered metabolites in the stool. However, it remains unclear whether the differences among SARS-CoV-2 variants lead to differences in intestinal microbiota and metabolites. Thus, we compared the microbiome and metabolome changes for each SARS-CoV-2 variant in patients with COVID-19. MATERIALS AND METHODS: We conducted a multicenter observational study of patients with COVID-19 and performed fecal microbiome, metabolome, and calprotectin analyses and compared the results among the different SARS-CoV-2 variants. RESULTS: Twenty-one patients with COVID-19 were enrolled and stratified according to the SARS-CoV-2 strain: six with the Alpha, 10 with the Delta, and five with the Omicron variant. Fecal microbiome analysis showed that α-diversity was reduced in the order of the Omicron, Delta, and Alpha variants (p = 0.07). Linear discriminant analysis revealed differences in the abundance of short-chain fatty acid-producing gut microbiota for each SARS-CoV-2 variant. Fecal metabolome analysis showed that the Omicron and Delta variants had markedly reduced propionic and lactic acid levels compared to the Alpha strain (p < 0.05). CONCLUSION: The intestinal microbiota of patients with COVID-19 varies depending on the SARS-CoV-2 variant. Dysbiosis of the intestinal microbiota due to differences in SARS-CoV-2 variants causes a decrease in intestinal short-chain fatty acids.

    DOI PubMed

  • Sex-based differences in metabolic protection by the ANP genetic variant rs5068 in the general population.

    Tomoko Ichiki, Valentina Cannone, Christopher G Scott, Seethalakshmi R Iyer, S Jeson Sangaralingham, Kent R Bailey, Jens P Goetze, Yoshihisa Tsuji, Richard J Rodeheffer, John C Burnett Jr

    American journal of physiology. Heart and circulatory physiology   325 ( 3 ) H545-H552  2023年09月  [国際誌]

     概要を見る

    Atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) are produced in the heart and secreted into the circulation. As hormones, both peptides activate the guanylyl cyclase receptor A (GC-A), playing a role in blood pressure (BP) regulation. A significant role for ANP and BNP includes favorable actions in metabolic homeostasis. Sex-based high prevalence of risk factors for cardiovascular disease in males compared with females is well established, but sex-based differences on cardiometabolic protection have not been investigated in relation to ANP (NPPA) and BNP (NPPB) gene variants. We included 1,146 subjects in the general population from Olmsted County, Minnesota. Subjects were genotyped for the ANP gene variant rs5068 and BNP gene variant rs198389. Cardiometabolic parameters and medical records were reviewed. In the presence of the minor allele of rs5068, diastolic BP, creatinine, body mass index (BMI), waist measurement, insulin, and prevalence of obesity and metabolic syndrome were lower, whereas HDL was higher in males with only trends observed in females. We observed no associations of the minor allele with echocardiographic parameters in either males or females. Regarding rs198389 genotype, the minor allele was not associated with any BP, metabolic, renal, or echocardiographic parameters in either sex. In the general community, the minor allele of the ANP gene variant rs5068 is associated with a favorable metabolic phenotype in males. No associations were observed with the BNP gene variant rs198389. These studies support a protective role of the ANP pathway on metabolic function and underscore the importance of sex in relationship to natriuretic peptide responses.NEW & NOTEWORTHY Males are characterized by lower ANP and BNP with greater prevalence of cardiometabolic disease. The ANP genetic variant rs5068 was associated with less metabolic dysfunction in males, whereas no metabolic profile was related to the BNP genetic variant rs198389 in the general population. ANP may play a more biological role in metabolic homeostasis compared with BNP in the general population with greater physiological metabolic actions in males compared with females.

    DOI PubMed

  • 差異に着目した地域医療教育のデザインとその実践報告

    神野 敦, 佐藤 健太, 風間 友江, 野村 和史, 三原 弘, 杉原 伸明, 中川 貴史, 真部 建郎, 市来 智子, 辻 喜久

    日本病院総合診療医学会雑誌 ( (一社)日本病院総合診療医学会 )  19 ( 臨増2 ) 172 - 172  2023年08月

  • Impact of S‐1 adjuvant chemotherapy longer than 6 months on survival in patients with resected pancreatic cancer: a nationwide survey by the Japan Pancreas Society based on real‐world data

    Yoshito Tomimaru, Hidetoshi Eguchi, Yosuke Inoue, Yuichi Nagakawa, Akihiro Ohba, Hideki Takami, Michiaki Unno, Tomohisa Yamamoto, Shoji Kawakatsu, Tsuyoshi Hayashi, Ryota Higuchi, Hirohisa Kitagawa, Satoshi Hattori, Tsutomu Fujii, Yoshiki Hirooka, Hisato Igarashi, Masayuki Kitano, Tamotsu Kuroki, Atsushi Masamune, Yasuhiro Shimizu, Masaji Tani, Satoshi Tanno, Yoshihisa Tsuji, Hiroki Yamaue, Sohei Satoi, Yoshifumi Takeyama

    Cancer ( Wiley )  129 ( 5 ) 728 - 739  2022年12月  [査読有り]

    DOI

  • Self-assessment scale for the community-based and emergency practice.

    Takao Wakabayashi, Yoshihisa Tsuji, Takeshi Yamamoto, Hitoshi Sohma, Wari Yamamoto

    BMC medical education   22 ( 1 ) 799 - 799  2022年11月  [国際誌]

     概要を見る

    BACKGROUND: For current medical education, community-based primary care for the elderly is an essential topic. This study aimed to establish a scale of community-based assessment for clinical and emergency practice (C-CEP). METHODS: A self-assessment scale for C-CEP was developed according to four steps. Initially, we reviewed publications from the societies of the United States, British, and Japan regarding educational goals. In addition, we searched MEDLINE for educational goals regarding attitude, skills, and knowledge. Getting together, we established 23 items as the educational goals of the C-CEP. Second, we collected responses for these 23 items from 5th-grade medical students (n = 195). Third, we conducted an exploratory factor analysis (EFA) using their responses to determine the fundamental structure of the self-assessment scale. Finally, a confirmatory factor analysis (CFA) was performed to assess the fitness of the self-assessment scale developing the EFA, resulting in modification of the items. RESULTS: In EFA and CFA results, C-CEP Scale consisted of four factors with 15 items: "Attitude and communication in emergency care," Basic clinical skills," "Knowledge of community healthcare," and "Knowledge of evidence-based medicine perseverance." The model fit indices were acceptable (Goodness of Fix Index = 0.928, Adjusted Goodness of Fit Index = 0.900, Comparative Fit Index = 0.979, and Root Mean Square Error of Approximation = 0.045). The values of McDonald's omega as an estimate of scale reliability were more than 0.7 in all four factors. As for test-retest reliability, the intraclass correlation coefficients were ≥ 0.58 for all factors. All four factors of the C-CEP Scale correlated positively with the Medical Professionalism Evaluation Scale subscales. CONCLUSIONS: We developed a valid and reliable self-assessment scale to assess student competence.

    DOI PubMed

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Misc 【 表示 / 非表示

  • 【チーム医療で取り組む肝胆膵疾患の栄養マネジメント】急性膵炎の栄養管理とQOL維持 経腸栄養・食事開始のタイミングを含めて

    上野 真行, 辻 喜久, 宇座 徳光, 妹尾 浩

    肝胆膵 ( (株)アークメディア )  88 ( 1 ) 97 - 101  2024年01月

  • 都市と僻地の差異から学ぶ地域医療教育について

    辻 喜久

    医学教育 ( (一社)日本医学教育学会 )  54 ( 5 ) 467 - 473  2023年10月

     概要を見る

    我々は,北海道南部の南檜山地域(2次医療圏)をリソースとした地域医療教育に取り組んでいる.南檜山地域は(1万4千km2,人口2万3,000人,高齢化率41.6%)と僻地である.一方,近年,"地域"に求められる医師像が多様化し,高度にデザインされた医師養成プログラムが必要となった.そこで,我々は,"差異"の概念に基づき地域医療教育のデザインを試みている."差異"は都市-地方間だけではなく,異なった文化間に常に生じうる.ここでは南檜山と札幌を遠隔診療/教育のシステムでつなぐことで"差異"が生じ,差異を経験した学修者において,より地域医療への理解が深まることを期待した.(著者抄録)

  • 差異に着目した地域医療教育のデザインとその実践報告

    神野 敦, 佐藤 健太, 風間 友江, 野村 和史, 三原 弘, 杉原 伸明, 中川 貴史, 真部 建郎, 市来 智子, 辻 喜久

    日本病院総合診療医学会雑誌 ( (一社)日本病院総合診療医学会 )  19 ( 臨増2 ) 172 - 172  2023年08月

  • 関節症状の乏しいリウマチ性髄膜炎の診断にエコー所見が有用であった一例

    岩倉 伸昂, 眞部 建郎, 安場 遥香, 仲 郁子, 中澤 隆, 辻 喜久

    日本病院総合診療医学会雑誌 ( (一社)日本病院総合診療医学会 )  19 ( 臨増2 ) 143 - 143  2023年08月

  • 新モデルコアカリキュラム(令和4年)の目標達成のために各専門診療科臨床実習期間の1割から改革するエッセンス 各科実習中の症例および実習の振り返りを改革する重要性

    三原 弘, 元尾 伊織, 田尻 和人, 安田 一朗, 高村 昭輝, 神野 敦, 佐藤 健太, 市来 智子, 辻 喜久

    医学教育 ( (一社)日本医学教育学会 )  54 ( Suppl. ) 69 - 69  2023年07月

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共同研究・競争的資金等の研究課題 【 表示 / 非表示

  • ナトリウム利尿ペプチドを用いた非アルコール性脂肪性肝疾患の新規診断治療の開発

    基盤研究(C)

    研究期間:

    2022年04月
    -
    2025年03月
     

    市来 智子, 辻 喜久, 沼田 泰尚, 佐々木 茂

  • マウスPerfusion CTによる膵腫瘍線維化の定量的測定系の確立

    研究活動スタート支援

    研究期間:

    2013年08月
    -
    2015年03月
     

    辻 喜久

     研究概要を見る

    本年度の結果の意義として、小動物に関する腫瘍の線維化の非侵襲的な測定系は未だ未確立であるが、マウスでPerfusion CTによる線維化の測定ができるようになると分子学的検討や遺伝子学的検討が大変しやすくなることがあげられる。例えば、Perfusion CTを膵癌患者さんに応用し、膵癌の質的変化を正確に観察できれば、正確な分子標的薬剤の効果判定が可能となり、適切な抗がん剤投与の継続・中止の判断を可能とし予後改善に結びつくと考えられる。

 

委員歴 【 表示 / 非表示

  • 2017年04月
    -
    継続中

      急性膵炎分科会委員

  • 2014年04月
    -
    2016年04月

      研究協力者

  • 2013年11月
    -
    継続中

      Member of DDW abstract review comitee

  •  
    -
    継続中

      膵疾患臨床研究促進委員会委員