Journal of Nippon Medical School最新文献_第2页

Cerebrospinal fluid leakage due to dural thinning after endoscopic pituitary tumor resection. 内窥镜垂体瘤切除术后硬脑膜变薄导致脑脊液漏。

IF 1 4区医学

Journal of Nippon Medical School Pub Date : 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-102

Shinichiro Teramoto

{"title":"Cerebrospinal fluid leakage due to dural thinning after endoscopic pituitary tumor resection.","authors":"Shinichiro Teramoto","doi":"10.1272/jnms.JNMS.2025_92-102","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2025_92-102","url":null,"abstract":"Sellar reconstruction is important for preventing cerebrospinal fluid (CSF) leakage after transsphenoidal pituitary surgery. This report describes how, despite standard sellar reconstruction, CSF exudation resulted from dural thinning at the anterior skull base, outside the intrasellar area manipulated during pituitary tumor resection. A 76-year-old man underwent endoscopic transsphenoidal surgery for a pituitary tumor extending toward the anterior skull base. After opening the sellar floor, intractable bleeding from the anterior intercavernous sinus occurred during bone removal at the anterior skull base. Pseudocapsule-based extracapsular resection was completed after stopping the bleeding. On the 10th postoperative day, the patient developed CSF rhinorrhea complicated by marked pneumocephalus, and emergency endoscopic repair of the CSF leak was performed. CSF leakage originated from the thinned dura at the anterior skull base located outside the intrasellar area manipulated during tumor resection. The thinned dural area at the anterior skull base coincided with the site of intractable bleeding of the anterior intercavernous sinus during bone removal in tumor resection. The thinned anterior skull base dura was covered with fascia, overlaid with fat, and closed with the nasoseptal flap. Endoscopic CSF leak repair was successful. Severe damage to the anterior intercavernous sinus can cause extensive exposure of the single-layered inner meningeal dura, where thinning might result in CSF exudation. Therefore, use of autologous tissues to cover and reinforce the severely damaged area of the anterior intercavernous sinus might help prevent postoperative CSF exudation.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Migraine-like headache with aura induced by a small infarct in the parieto-occipital cortex: A case report. 顶枕叶皮层小梗塞诱发的偏头痛样先兆头痛：病例报告。

IF 1 4区医学

Journal of Nippon Medical School Pub Date : 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-103

Hiroyuki Hokama, Yuki Sakamoto, Serika Yamamoto, Mizuho Takahashi, Hiroto Kodera, Akihito Kutsuna, Yosuke Fujisawa, Chikako Nito, Kazumi Kimura

引用次数: 0

Use of tocilizumab to treat arthritis associated with mixed connective tissue disease complicated by ovarian teratoma: a case report. 使用托西珠单抗治疗卵巢畸胎瘤并发混合结缔组织病相关关节炎：病例报告。

IF 1 4区医学

Journal of Nippon Medical School Pub Date : 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-303

Haruka Ota, Toru Igarashi, Ryosuke Matsui, Hikaru Takeshita, Koji Hashimoto, Masaki Miyao, Norio Motoda, Tsubasa Takahashi, Jun Hayakawa, Makoto Migita, Yasuhiko Itoh

{"title":"Use of tocilizumab to treat arthritis associated with mixed connective tissue disease complicated by ovarian teratoma: a case report.","authors":"Haruka Ota, Toru Igarashi, Ryosuke Matsui, Hikaru Takeshita, Koji Hashimoto, Masaki Miyao, Norio Motoda, Tsubasa Takahashi, Jun Hayakawa, Makoto Migita, Yasuhiko Itoh","doi":"10.1272/jnms.JNMS.2025_92-303","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2025_92-303","url":null,"abstract":"Mixed connective tissue disease (MCTD) is characterized by mixed features of systemic lupus erythematosus, systemic sclerosis, and polymyositis/dermatomyositis and is rare in children. Here, we report a case of MCTD in a 10-year-old girl who presented at our hospital with arthralgia, Raynaud's phenomenon, and fatigue. Blood tests were positive for anti-U1-ribonucleoprotein (RNP) antibodies and for rheumatoid factors (RFs) IgG-RF and anti-galactose-deficient IgG. Levels of myogenic enzymes and hypergammaglobulinemia were elevated. Macrophages were prominent in bone marrow, with scattered phagocytic macrophages. MCTD was diagnosed based on the patient's symptoms and laboratory findings. Methylprednisolone pulse therapy combined with oral tacrolimus was administered, which led to resolution of symptoms. Three months after pulse therapy, arthralgia worsened and methotrexate was administered. Arthralgia improved but did not resolve. Magnetic resonance imaging performed to investigate the hip pain revealed a mature ovarian teratoma, which was surgically removed. Because the pain persisted and interfered with her daily life, she was treated with tocilizumab for joint pain relief, which decreased the pain level. Tocilizumab is a candidate for additional treatment of juvenile idiopathic arthritis-like arthritis associated with childhood-onset MCTD.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Difficulties Nurses Report in Caring for Patients with Bone Metastases and Their Expectations after Participating in a Bone Metastasis Cancer Board: A Questionnaire Study. 护士在护理骨转移患者时遇到的困难及其参加骨转移癌症委员会后的期望：一项问卷调查研究。

IF 1 4区医学

Journal of Nippon Medical School Pub Date : 2024-05-21 Epub Date: 2024-03-02 DOI: 10.1272/jnms.JNMS.2024_91-210

Tsunemi Kitagawa, Yasuyuki Kitagawa, Yoichiro Aoyagi, Tokifumi Majima

{"title":"Difficulties Nurses Report in Caring for Patients with Bone Metastases and Their Expectations after Participating in a Bone Metastasis Cancer Board: A Questionnaire Study.","authors":"Tsunemi Kitagawa, Yasuyuki Kitagawa, Yoichiro Aoyagi, Tokifumi Majima","doi":"10.1272/jnms.JNMS.2024_91-210","DOIUrl":"10.1272/jnms.JNMS.2024_91-210","url":null,"abstract":"Background: Patients with bone metastases often face physical, mental, and social challenges that require multidisciplinary management. To improve treatment and practice, we conducted a questionnaire survey to assess nurses' opinions of problems related to caring for patients with bone metastases. In addition, we investigated nurses' perceptions of bone metastases after participating in a Bone Metastasis Cancer Board (BMCB).Methods: An anonymous questionnaire survey on problems in bone metastasis treatment and the BMCB was conducted. The respondents were nurses with more than 1 year of clinical experience working in wards where patients with bone metastases were admitted.Results: The number of valid responses was 224. Almost all the nurses felt anxiety about the risk of pathological fracture and paralysis while caring for patients with bone metastases. To reduce this anxiety, about 90% of the nurses supported the suggestion that \"patients should be referred to an orthopedic surgeon in advance to obtain opinions on load restrictions\". Nurses who had participated in the BMCB had higher expectations regarding treatment, multidisciplinary collaboration, and sharing and accumulating knowledge and experience.Conclusion: To improve treatment and nursing care for patients with bone metastases, it is important to make regular BMCB meetings more functional and to actively consult with specialists.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Oxidative Stress and Antioxidant Capacity in Patients with Endometrioma. 子宫内膜瘤患者的氧化应激和抗氧化能力。

IF 1 4区医学

Journal of Nippon Medical School Pub Date : 2024-05-21 Epub Date: 2024-03-02 DOI: 10.1272/jnms.JNMS.2024_91-204

Go Ichikawa, Yasuyuki Negishi, Ryo Tsuchiya, Lilika Higuchi, Tatsunori Shiraishi, Mariko Ikeda, Hanako Kaseki, Rimpei Morita, Shunji Suzuki

{"title":"Oxidative Stress and Antioxidant Capacity in Patients with Endometrioma.","authors":"Go Ichikawa, Yasuyuki Negishi, Ryo Tsuchiya, Lilika Higuchi, Tatsunori Shiraishi, Mariko Ikeda, Hanako Kaseki, Rimpei Morita, Shunji Suzuki","doi":"10.1272/jnms.JNMS.2024_91-204","DOIUrl":"10.1272/jnms.JNMS.2024_91-204","url":null,"abstract":"Background: Endometriosis has several clinical features, including dysmenorrhea, infertility, and endometrioma (EMO). Although oxidative stress status is closely related to endometriosis, it is unclear how the balance between oxidative stress capacity and antioxidant capacity correlates with treatment of or factors that worsen endometriosis. In this study, we used peritoneal fluid from patients with EMO to investigate the role of oxidative stress capacity and antioxidant capacity.Materials and methods: Participants with EMO (n = 30) and without EMO (uterine myoma, n = 13) were enrolled. All peritoneal fluid samples were collected at the beginning of surgery. We evaluated oxidative stress capacity and antioxidant capacity in peritoneal fluid samples by using the diacron-reactive oxygen metabolites (d-ROM) and biological antioxidant potential (BAP) tests, respectively. The d-ROM and BAP values and the d-ROM/BAP ratio were measured, and their correlations with the CA125 level, revised American Society for Reproductive Medicine (r-ASRM) score, and tumor size were analyzed.Results: The d-ROM/BAP ratio was significantly higher in patients with EMO than in those without EMO. In addition, the d-ROM/BAP ratio was positively correlated with CA125 level and r-ASRM scores in patients with EMO.Conclusions: Oxidative stress is correlated with factors that worsen EMO. The d-ROM/BAP test may be useful for assessing disease status in patients with EMO.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinicopathological Characteristics of Everolimus-Associated Interstitial Lung Disease: A Single-Center Consecutive Analysis. 依维莫司相关间质性肺病的临床病理特征：单中心连续分析

IF 1 4区医学

Journal of Nippon Medical School Pub Date : 2024-05-21 Epub Date: 2024-01-16 DOI: 10.1272/jnms.JNMS.2024_91-211

Yoshinobu Saito, Yasuhiro Terasaki, Takeru Kashiwada, Toru Tanaka, Hiroyuki Takei, Go Kimura, Yukihiro Kondo, Tetsuro Kawagoe, Akira Matsushita, Rintaro Noro, Yuji Minegishi, Koichiro Kamio, Masahiro Seike, Akihiko Gemma

{"title":"Clinicopathological Characteristics of Everolimus-Associated Interstitial Lung Disease: A Single-Center Consecutive Analysis.","authors":"Yoshinobu Saito, Yasuhiro Terasaki, Takeru Kashiwada, Toru Tanaka, Hiroyuki Takei, Go Kimura, Yukihiro Kondo, Tetsuro Kawagoe, Akira Matsushita, Rintaro Noro, Yuji Minegishi, Koichiro Kamio, Masahiro Seike, Akihiko Gemma","doi":"10.1272/jnms.JNMS.2024_91-211","DOIUrl":"10.1272/jnms.JNMS.2024_91-211","url":null,"abstract":"Background: Everolimus, a mammalian target of rapamycin inhibitor used as an antineoplastic drug, is associated with a remarkably high incidence of interstitial lung disease (ILD). The clinical and pathological characteristics of ILD caused by everolimus have not been thoroughly investigated; therefore, we aimed to elucidate the features of everolimus-associated ILD.Methods: We retrospectively reviewed the medical records of patients who received everolimus for cancer treatment at our hospital. Patient backgrounds were compared between the ILD and non-ILD groups. Chest computed tomography (CT), changes in biomarkers, and lung histopathological features were analyzed for ILD cases.Results: Sixty-six patients were reviewed, and ILD developed in 19. There were no differences in patient demographics between the ILD and non-ILD groups. The severity of ILD was grade 1 (G1) in 9 and grade 2 (G2) in 10 cases. Chest CT showed organizing pneumonia (OP) or a hypersensitive pneumonia pattern. The levels of lactate dehydrogenase, C-reactive protein, Krebs von den lungen-6, and surfactant protein-D (SP-D) at the onset of ILD were significantly higher than those at baseline. Analysis of G1 and G2 ILD subgroups showed a higher SP-D levels in the G2 subgroup. Five patients underwent lung biopsies; all specimens demonstrated alveolitis with lymphocytic infiltration and granulomatous lesions, and some had OP findings.Conclusions: Everolimus-associated ILD is mild and has a favorable prognosis. Patients with symptomatic ILD were more likely to have higher SP-D levels than those with asymptomatic ILD. Granulomatous lesions are an important pathological feature of everolimus-associated ILD.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Methylation of PLK-1 Potentially Drives Bendamustine Resistance in Leukemia Cells. PLK-1的甲基化可能导致白血病细胞对本达莫司汀产生抗药性

IF 1 4区医学

Journal of Nippon Medical School Pub Date : 2024-05-21 Epub Date: 2023-12-08 DOI: 10.1272/jnms.JNMS.2024_91-206

Toshikazu Itabashi, Takahiro Ueda, Ryohei Fukunaga, Takeshi Asano, Yasuhiko Itoh

{"title":"Methylation of PLK-1 Potentially Drives Bendamustine Resistance in Leukemia Cells.","authors":"Toshikazu Itabashi, Takahiro Ueda, Ryohei Fukunaga, Takeshi Asano, Yasuhiko Itoh","doi":"10.1272/jnms.JNMS.2024_91-206","DOIUrl":"10.1272/jnms.JNMS.2024_91-206","url":null,"abstract":"Background: Drug resistance remains a significant impediment in leukemia treatment. While Bendamustine hydrochloride (BH) stands out as a promising therapeutic agent for non-Hodgkin's lymphoma and mantle cell lymphoma, the mechanisms of resistance to BH are not yet fully understood. Our study focuses on elucidating the mechanisms behind bendamustine resistance in leukemia cells, with a specific emphasis on epigenetics.Methods: Bendamustine-resistant cells were cultivated from human B cell lymphoblastic leukemia cell lines through systematic and sustained exposure to bendamustine, using the limiting dilution method. Gene expression was assessed via real-time polymerase chain reaction, while the expression of the multidrug resistance protein 1 (MDR1) was evaluated using flow cytometry.Results: Bendamustine-resistant leukemia cells exhibited a decreased RNA expression level for Polo-like kinase-1 (PLK-1). Notably, after treatment with the demethylating agent 5-aza-2'-deoxycytidine, PLK-1 gene expression surged significantly, enhancing bendamustine's cytotoxicity in the resistant leukemia cells. However, MDR1 expression, as determined by flow cytometry, remained consistent between parental and bendamustine-resistant leukemia cells.Conclusions: Our findings indicate that the methylation of the PLK-1 gene plays a pivotal role in modulating PLK-1 expression and is central to the development of bendamustine resistance in leukemia cells.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Changes in Treatment Conditions for Patients Receiving Hemodialysis at Nippon Medical School Hospital during the COVID-19 Pandemic. COVID-19 大流行期间日本医科大学附属医院血液透析患者治疗条件的变化。

IF 1 4区医学

Journal of Nippon Medical School Pub Date : 2024-05-21 Epub Date: 2024-03-02 DOI: 10.1272/jnms.JNMS.2024_91-207

Naoko Shimoda, Yukinao Sakai, Takuya Nishino, Sayuri Kawasaki, Akio Hirama, Tetsuya Kashiwagi, Masato Iwabu

{"title":"Changes in Treatment Conditions for Patients Receiving Hemodialysis at Nippon Medical School Hospital during the COVID-19 Pandemic.","authors":"Naoko Shimoda, Yukinao Sakai, Takuya Nishino, Sayuri Kawasaki, Akio Hirama, Tetsuya Kashiwagi, Masato Iwabu","doi":"10.1272/jnms.JNMS.2024_91-207","DOIUrl":"10.1272/jnms.JNMS.2024_91-207","url":null,"abstract":"Background: The COVID-19 pandemic has had an enormous impact on hemodialysis patients. This study investigated changes in hemodialysis treatment at our hospital after the start of the pandemic.Methods: We analyzed data from the Diagnosis Procedure Combination (DPC) system. Data for inpatients receiving dialysis during collection periods A (before the COVID-19 pandemic) and B (after the start of the COVID-19 pandemic) were extracted and compared. The numbers of inpatients and new patients, the number of patients admitted (by department), duration of stay, mortality, place of residence, surgical procedures, and DPC classification were compared.Results: There were no significant differences between periods in patient age, duration of hospital stay, number of new patients, number of ambulance transports, number of deaths, body mass index, comorbidities, laboratory variables before the first dialysis after hospitalization, or patient area of residence. Although differences were observed among the departments, the numbers of emergency dialysis inpatients and maintenance dialysis inpatients increased. The number of surgeries also increased overall, particularly for maintenance dialysis patients (p = 0.0273). The percentage of DPC III patients was significantly higher in period B (p = 0.0368).Conclusions: The number of surgeries performed on maintenance dialysis patients and the overall DPC III rate significantly increased after the start of the COVID-19 pandemic at our hospital, suggesting that COVID-19 worsened the condition of maintenance dialysis patients and prolonged hospital stays.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Human Adipose Tissue-Derived Stem Cells Inhibit Coronary Artery Vasculitis in a Mouse Model of Kawasaki Disease. 人脂肪组织衍生干细胞可抑制川崎病小鼠模型中的冠状动脉血管炎。

IF 1 4区医学

Journal of Nippon Medical School Pub Date : 2024-05-21 Epub Date: 2024-01-16 DOI: 10.1272/jnms.JNMS.2024_91-212

Ryohei Fukunaga, Takahiro Ueda, Ryosuke Matsui, Toshikazu Itabashi, Ryuji Fukazawa, Noriko Nagi-Miura, Yasuhiko Itoh

{"title":"Human Adipose Tissue-Derived Stem Cells Inhibit Coronary Artery Vasculitis in a Mouse Model of Kawasaki Disease.","authors":"Ryohei Fukunaga, Takahiro Ueda, Ryosuke Matsui, Toshikazu Itabashi, Ryuji Fukazawa, Noriko Nagi-Miura, Yasuhiko Itoh","doi":"10.1272/jnms.JNMS.2024_91-212","DOIUrl":"10.1272/jnms.JNMS.2024_91-212","url":null,"abstract":"Background: Adipose tissue-derived mesenchymal stem cells (ADSCs) are used for the treatment of various diseases because of their rapid proliferation and high anti-inflammatory and tissue repair properties. Kawasaki disease is a systemic vasculitis with coronary arteritis and aneurysms occurring in pediatric patients. In this study, we examined serologically and pathologically whether the administration of human ADSCs (hADSCs) to a mouse model of Kawasaki disease could suppress vasculitis.Methods: Candida albicans water-soluble fractions were intraperitoneally injected into DBA/2 mice for 5 consecutive days to generate a mouse model of Kawasaki disease. The model mice were intravenously administered hADSCs or phosphate-buffered saline (PBS). Serum samples collected on days 15 and 29 were used to compare cytokine levels. Mouse hearts dissected on day 29 were subjected to hematoxylin and eosin and immunohistological staining using Galectin-1 (Gal-1), a protein involved in cardiovascular homeostasis, and CD44, a cell-surface marker of hADSCs.Results: Comparison of inflammation-related cytokines showed a significant decrease in IL-1α expression at day 15 (P<0.05) and IL-6 expression at day 29 (P<0.01) in the hADSCs-treated group compared to the PBS group. Evaluation by hematoxylin and eosin staining showed decreased inflammatory cell infiltration and a tendency towards increased Gal-1 expression in the hADSCs group. CD44 expression was not observed in both the groups. The survival curve showed that the hADSCs group had a significantly longer survival time (P<0.05).Conclusions: The present experimental results indicate that hADSCs have an early anti-inflammatory effect, and that Gal-1 may be involved in preventing inflammation and reducing tissue damage.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Performance of a Large Language Model on Japanese Emergency Medicine Board Certification Examinations. 大型语言模型在日本急诊医学委员会认证考试中的表现。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2024-05-21 Epub Date: 2024-03-02 DOI: 10.1272/jnms.JNMS.2024_91-205

Yutaka Igarashi, Kyoichi Nakahara, Tatsuya Norii, Nodoka Miyake, Takashi Tagami, Shoji Yokobori

{"title":"Performance of a Large Language Model on Japanese Emergency Medicine Board Certification Examinations.","authors":"Yutaka Igarashi, Kyoichi Nakahara, Tatsuya Norii, Nodoka Miyake, Takashi Tagami, Shoji Yokobori","doi":"10.1272/jnms.JNMS.2024_91-205","DOIUrl":"10.1272/jnms.JNMS.2024_91-205","url":null,"abstract":"Background: Emergency physicians need a broad range of knowledge and skills to address critical medical, traumatic, and environmental conditions. Artificial intelligence (AI), including large language models (LLMs), has potential applications in healthcare settings; however, the performance of LLMs in emergency medicine remains unclear.Methods: To evaluate the reliability of information provided by ChatGPT, an LLM was given the questions set by the Japanese Association of Acute Medicine in its board certification examinations over a period of 5 years (2018-2022) and programmed to answer them twice. Statistical analysis was used to assess agreement of the two responses.Results: The LLM successfully answered 465 of the 475 text-based questions, achieving an overall correct response rate of 62.3%. For questions without images, the rate of correct answers was 65.9%. For questions with images that were not explained to the LLM, the rate of correct answers was only 52.0%. The annual rates of correct answers to questions without images ranged from 56.3% to 78.8%. Accuracy was better for scenario-based questions (69.1%) than for stand-alone questions (62.1%). Agreement between the two responses was substantial (kappa = 0.70). Factual error accounted for 82% of the incorrectly answered questions.Conclusion: An LLM performed satisfactorily on an emergency medicine board certification examination in Japanese and without images. However, factual errors in the responses highlight the need for physician oversight when using LLMs.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0