Research activity information

• Comparison of survival outcomes and anatomically specific severe injuries following traffic accidents among occupants of standard and K-car vehicles: A retrospective cohort study at a teaching hospital in Japan

  Yuko Ono, Tasuku Uzawa, Jun Sugiyama, Nozomi Tomita, Takeyasu Kakamu, Tokiya Ishida, Joji Kotani, Kazuaki Shinohara

  Road traffic accidents are a global health concern. K-car vehicles, also known as "mini vehicles," are defined as those having an engine displacement <660 cc, vehicle length <3.4 m, width <1.48 m, and height <2.0 m. K-cars have become increasing popular not only in Japan but also in other countries. Compared with standard vehicles, the occupant space of a K-car vehicle is considerably smaller; thus, passengers may be more vulnerable to the external forces generated in a collision, which in turn can lead to deformation of the occupant space and less protection against injuries. However, data are scarce regarding whether K-car vehicles are related to poorer survival outcomes and severe trauma. We conducted a retrospective cohort study involving patients who were injured in four-wheeled vehicle accidents between 2002 and 2023 and admitted to a community teaching hospital in Japan. The vehicle configuration was divided into standard and K-car vehicles. The primary endpoint was in-hospital mortality. Other outcomes included severe trauma, defined as Injury Severity Score (ISS) >15, and anatomically specific severe injury of the head and neck, chest, abdomen, pelvis, and extremities, defined as Abbreviated Injury Scale score ≥3. Of 5331 eligible patients, 2384 (44.7%) were K-car vehicle occupants. In propensity score-matched analysis with 1947 pairs, we observed an increase for in-hospital mortality in the K-car vehicle group (2.6% vs. 4.0%, odds ratio 1.53, 95% confidence interval 1.07–2.19). Compared with standard vehicles, K-car vehicles were associated with a greater risk of severe trauma and serious injuries of the head and neck, chest, abdomen, pelvis, and extremities. These study data should be used to encourage vehicle occupants and automobile manufacturers to consider objective facts regarding the safety of vehicles in a traffic accident.

  Public Library of Science (PLoS), Feb. 2025, PLOS ONE, 20(2) (2), e0318748 - e0318748

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Effect of intravenous thiamine administration on critically ill patients: A systematic review and meta-analysis of randomized controlled trials

  Nobuto Nakanishi, Yoshinobu Abe, Mizue Matsuo, Akihito Tampo, Kohei Yamada, Junji Hatakeyama, Minoru Yoshida, Ryo Yamamoto, Naoki Higashibeppu, Kensuke Nakamura, Joji Kotani

  Elsevier BV, Nov. 2024, Clinical Nutrition, 43(11) (11), 1 - 9

  Scientific journal


• Sex Disparities in Applied Force on Maxillary Incisors Among Novices During Laryngoscopy Using a High-Fidelity Simulator: A Prospective Observational Study

  Yuko Ono, Kazuaki Shinohara, Jiro Shimada, Jun Sugiyama, Shigeaki Inoue, Joji Kotani

  Endotracheal intubation (ETI) is a common and crucial intervention. Whether the performance of ETI differs according to the sex of the laryngoscopist remains unclear. The aim of this study was to assess sex disparities in markers of ETI performance among novices using a high-fidelity simulator. This prospective observational study was conducted from April 2017 to March 2019 in a public medical university. In total, 209 medical students (4th and 5th grade) without clinical ETI experience were recruited. Of the 209 students, 64 (30.6%) were female. The participants used either a Macintosh direct laryngoscope or C-MAC video laryngoscope in combination with a stylet or gum-elastic bougie to perform ETI on a high-fidelity simulator. The primary endpoint was the maximum force applied on the maxillary incisors during laryngoscopy. The secondary endpoint was the time to ETI. The implanted sensors in the simulator automatically quantified the force and time to ETI. The maximum force applied on the maxillary incisors was approximately 30% lower in the male than female group for all laryngoscopes and intubation aids examined (all P < 0.001). Similarly, the time to ETI was approximately 10% faster in the male than female group regardless of the types of laryngoscopes and intubation aids used (all P < 0.05). In this study, male sex was associated with a lower maximum force applied on the maxillary incisors during both direct and indirect laryngoscopy performed by novices. A clinical study focusing on sex differences in ETI performance is needed to validate our findings. Keywords: Airway-related adverse events; Definitive airway management; Laryngoscopy; Medical student; Sex gap.

  Feb. 2024, Kobe J Med Sci, 69(4) (4), E151 - E158, English, International magazine

  [Refereed]

  Scientific journal


• Attempted Suicide Is Independently Associated with Increased In-Hospital Mortality and Hospital Length of Stay among Injured Patients at Community Tertiary Hospital in Japan: A Retrospective Study with Propensity Score Matching Analysis

  Yuko Ono, Tokiya Ishida, Nozomi Tomita, Kazushi Takayama, Takeyasu Kakamu, Joji Kotani, Kazuaki Shinohara

  Suicide is an increasingly important public healthcare concern worldwide. Studies examining the effect of attempted suicide on clinical outcomes among patients with trauma are scarce. We conducted a retrospective cohort study at a community emergency department in Japan. We included all severely injured patients with an Injury Severity Score > 15 from January 2002 to December 2021. The primary outcome measure was in-hospital mortality. The other outcome of interest was hospital length of stay. One-to-one propensity score matching was performed to compare these outcomes between suicide attempt and no suicide attempt groups. Of the 2714 eligible patients, 183 (6.7%) had trauma caused by a suicide attempt. In the propensity score-matched analysis with 139 pairs, the suicide attempt group showed a significant increase in-hospital mortality (20.9% vs. 37.4%; odds ratio 2.27; 95% confidence intervals 1.33–3.87) compared with the no suicide attempt group. Among survivors, the median hospital length of stay was significantly longer in the suicide attempt group than that in the no suicide attempt group (9 days vs. 12 days, p = 0.0076). Because of the unfavorable consequences and potential need for additional healthcare, increased attention should be paid to patients with trauma caused by a suicide attempt.

  MDPI AG, Jan. 2024, International Journal of Environmental Research and Public Health, 21(2) (2), 121 - 121

  Scientific journal


• Migration of a pericardial drainage catheter into the right main pulmonary artery

  Yuko Ono, Kauzaki Shinohara, Tokiya Ishida, Isamu Yamada, Joji Kotani

  Wiley, Jan. 2024, Acute Medicine & Surgery, 11(1) (1)

  Scientific journal


• Migration of a pericardial drainage catheter into the right main pulmonary artery.

  Yuko Ono, Kauzaki Shinohara, Tokiya Ishida, Isamu Yamada, Joji Kotani

  Migration of a pericardial drainage catheter into the right main pulmonary artery. If clinical symptoms of cardiac tamponade are unresolved and dense hemorrhagic fluid is evacuated after pericardial drain placement, this rare but lethal complication is a possibility.

  2024, Acute medicine & surgery, 11(1) (1), e968, English, International magazine

  Scientific journal


• Coagulopathy Parameters Predictive of Outcomes in Sepsis-induced Acute Respiratory Distress Syndrome: A Sub-Analysis of the Two Prospective Multicenter Cohort Studies.

  Tadashi Matsuoka, Seitaro Fujishima, Junchi Sasaki, Satoshi Gando, Daizoh Saitoh, Shigeki Kushimoto, Hiroshi Ogura, Toshikazu Abe, Atsushi Shiraishi, Toshihiko Mayumi, Joji Kotani, Naoshi Takeyama, Ryosuke Tsuruta, Kiyotsugu Takuma, Norio Yamashita, Shin-Ichiro Shiraishi, Hiroto Ikeda, Yasukazu Shiino, Takehiko Tarui, Taka-Aki Nakada, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Yuichiro Sakamoto, Akiyoshi Hagiwara, Tomohiko Masuno, Masashi Ueyama, Satoshi Fujimi, Kazuma Yamakawa, Yutaka Umemura

  BACKGROUND: Although coagulopathy is often observed in acute respiratory distress syndrome (ARDS), its clinical impact remains poorly understood. OBJECTIVES: This study aimed to clarify the coagulopathy parameters that are clinically applicable for prognostication and to determine anticoagulant indications in sepsis-induced ARDS. METHOD: This study enrolled patients with sepsis-derived ARDS from two nationwide multicenter, prospective observational studies. We explored coagulopathy parameters that could predict outcomes in the FORECAST cohort, and the defined coagulopathy criteria were validated in the SPICE-ICU cohort. The correlation between anticoagulant use and outcomes was also evaluated. RESULTS: A total of 181 patients with sepsis-derived ARDS in the FORECAST study and 61 patients in the SPICE-ICU study were included. In a preliminary study, we found the set of PT-INR ≥1.4 and platelets ≤12 × 104/μL, Thrombocytopenia and Elongated Prothrombin time, TEP, coagulopathy as the best coagulopathy parameters, and used for further analysis, of which odds ratio of TEP coagulopathy for in-hospital mortality adjusted for confounding was 3.84 (95% CI, 1.66-8.87; p = 0.005). In the validation cohort, the adjusted odds ratio for in-hospital mortality was 32.99 (95% CI, 2.60-418.72; p = 0.002). Although patients without TEP coagulopathy showed significant improvements in oxygenation over the first 4 days, patients with TEP coagulopathy showed no significant improvement (ΔPaO2/FiO2 ratio, 24 ± 20 vs. 90 ± 9; p = 0.026). Furthermore, anticoagulant use was significantly correlated with mortality and oxygenation recovery in patients with TEP coagulopathy but not in patients without TEP coagulopathy. CONCLUSION: TEP coagulopathy is closely associated with better outcomes and responses to anticoagulant therapy in sepsis-induced ARDS, and our coagulopathy criteria may be clinically useful.Trial registrationFORECAST study: UMIN-CTR ID: UMIN000019742. Registration date: November 11th, 2015.SPICE-ICU study: UMIN-CTR ID: UMIN000027258. Registration date: May 6th, 2017.

  Nov. 2023, Shock (Augusta, Ga.), English, International magazine

  Scientific journal


• Ultrasound-based upper limb muscle thickness is useful for screening low muscularity during intensive care unit admission: A retrospective study

  Nobuto Nakanishi, Shigeaki Inoue, Yuko Ono, Jun Sugiyama, Kazushi Takayama, Yuta Arai, Kensuke Nakamura, Jun Oto, Joji Kotani

  Elsevier BV, Oct. 2023, Clinical Nutrition ESPEN, 57, 569 - 574

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Gender Disparities in First Authorship at Three Medical Universities in an Area Affected by the Great East Japan Earthquake.

  Yuko Ono, Masafumi Saito, Kenju Shimomura, Kazuaki Shinohara, Naoto Yamada, Yudai Iwasaki, Shigeaki Inoue, Joji Kotani

  The Great East Japan Earthquake that occurred on March 11, 2011, was one of the largest natural disasters in modern times. Publication in medical journals is important aspects of the academic promotion process, and is thus important for all scientists. However, little is known about whether and how substantial natural disasters affect gender disparities in academic productivity in disaster-affected areas. We hypothesized that the Great East Japan Earthquake widened the existing disparities in scientific publishing between male and female researchers. To test this hypothesis, this retrospective observational study using existing databases was conducted. We extracted from the MEDLINE database all types of biomedical articles published from March 11, 2007, to March 11, 2015, by three medical universities in a disaster-affected area of Japan. Differences in the proportion of female first authorship during the 4 years before and after the Great East Japan Earthquake were compared. A total of 5,873 papers were analyzed. The proportion of female first authors significantly declined after the Great East Japan Earthquake (20.5% vs. 14.1%; odds ratio 0.64; 95% confidence interval 0.56-0.73). A similar trend was identified across all prespecified subgroups, including clinical department; original article; public medical university; and prestigious journal with impact factor >6. Reference data from two medical universities minimally affected by the Great East Japan Earthquake showed the opposite trend. These results collectively suggest that large natural disasters can reinforce existing gender disparities in first authorship in biomedicine.

  Aug. 2023, The Kobe journal of medical sciences, 69(2) (2), E64-E78, English, Domestic magazine

  Scientific journal


• Emergency airway management with the gum elastic bougie outside of the operating room: a narrative review

  Yuko Ono, Kazuaki Shinohara, Jiro Shimada, Shigeaki Inoue, Joji Kotani

  The ongoing coronavirus 2019 (COVID-19) pandemic has increased the need for healthcare professionals to perform emergency endotracheal intubation (ETI) in patients with COVID-19-related respiratory failure outside of the operating room. Difficult airways and severe airway-related adverse events occur much more frequently in such settings due to limited time and resources as well as the patient’s reduced physiological reserve. The gum elastic bougie (GEB) intubation tube is an inexpensive, simple, and readily transportable aid to intubation, but its effectiveness in emergency airway management has not been comprehensively evaluated in recent years. Here, we performed a literature review and have updated the available evidence on the utility of GEB in emergency airway management. After a systematic MEDLINE search, we identified 36 relevant reports that compared GEB with alternative airway management approaches in a variety of real-world and simulated settings. In most studies, GEB increased the first-pass ETI success rate and decreased the force applied on the tongue and incisors during laryngoscopy. GEB also increased the speed, safety, and reliability of emergency cricothyrotomy. Conflicting results were obtained in studies examining GEB use for ETI during cardiopulmonary resuscitation, and other special circumstances such as selective lung ventilation, the presence of vomitus, and the use of personal protective equipment. These results suggest that GEB use could be expanded beyond difficult airways and rescue after failed ETI attempts, but further studies will be necessary to determine the utility of GEB under special conditions. Because fatal airway-related adverse events can in part be attributed to limited accessibility of proper airway management equipment, devices such as GEB may increase successful outcomes, especially under the overwhelmingly challenging conditions imposed by the COVID-19 pandemic.

  MRE Press, Aug. 2023, Signa Vitae, doi:10.22514/sv.2023.074. - doi:10.22514/sv.2023.074., English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 侵襲とショックから明日のCritical care nutritionを科学する 経口からの栄養摂取量低下は、敗血症患者のPICS発症率と関連する 単一施設前向き敗血症観察研究

  井上 茂亮, 中西 信人, 藤浪 好寿, 杉山 隼, 大野 雄康, 小谷 穣治

  (一社)日本Shock学会, Jul. 2023, Shock: 日本Shock学会雑誌, 37(1) (1), 61 - 61, Japanese


• COVID-19感染拡大期における救急隊の業務効率低下と院外心肺停止患者の予後との関連性

  杉山 隼, 井上 茂亮, 中西 信人, 藤浪 好寿, 齋藤 雅史, 大野 雄康, 戸田 太, 城月 徹, 塩谷 壮史, 小谷 穣治

  (一社)日本Shock学会, Jul. 2023, Shock: 日本Shock学会雑誌, 37(1) (1), 99 - 99, Japanese


• Increased Interleukin-17-Producing γδT Cells in the Brain Exacerbate the Pathogenesis of Sepsis-Associated Encephalopathy and Sepsis-Induced Anxiety in Mice

  Naoki Moriyama, Masafumi Saito, Yuko Ono, Kimihiro Yamashita, Takashi Aoi, Joji Kotani

  Overactivated microglia play a key role in sepsis-associated encephalopathy (SAE), although the involvement of T cells is unclear. γδT cells in the brain and meninges regulate normal fear responses via interleukin (IL)-17 in healthy mice. In our sepsis model, the mice showed exacerbated anxious behavior at 10 days post-induction (dpi). At 8 dpi, IL-17 mRNA was significantly upregulated in the brains of septic mice compared with those of control mice. Simultaneously, the number of γδT cells increased in the brains of septic mice in a severity-dependent manner. Additionally, IL-17-producing γδT cells, expressing both the C-X-C motif receptor (CXCR) 6 and the C-C motif receptor (CCR) 6, increased in mice brains, dependent on the severity of sepsis. The frequency of γδT cells in the meninges fluctuated similarly to that in the brain, peaking at 8 dpi of sepsis. Behavioral tests were performed on septic mice after the continuous administration of anti-γδTCR (α-γδTCR) or anti-IL-17A (α-IL-17A) antibodies to deplete the γδT cells and IL-17A, respectively. Compared with IgG-treated septic mice, α-γδTCR- and α-IL-17A-treated septic mice showed suppressed microglial activation and improvements in anxious behavior. These results suggested that CCR6+CXCR6+ IL-17-producing γδT cells in the brain and meninges promote the exacerbation of SAE and sepsis-induced psychological disorders in mice.

  MDPI AG, Jun. 2023, Journal of Clinical Medicine, 12(13) (13), 4309 - 4309

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 徹底討論!ICU-AWの正体は一体何なのか? 高齢敗血症患者ではPICS発症率が上昇し,長期予後が不良である 単施設前向き観察研究

  井上 茂亮, 中西 信人, 大野 雄康, 小谷 穣治

  (一社)日本集中治療医学会, Jun. 2023, 日本集中治療医学会雑誌, 30(Suppl.1) (Suppl.1), S297 - S297, Japanese


• PICSのエビデンスをもとめて 高齢敗血症患者ではPICS発症率は上昇し長期予後は不良である 単施設前向き観察研究

  井上 茂亮, 中西 信人, 大野 雄康, 小谷 穣治

  (一社)日本集中治療医学会, Jun. 2023, 日本集中治療医学会雑誌, 30(Suppl.1) (Suppl.1), S328 - S328, Japanese


• 【集中治療:進歩と未来～50年を振りかえって～】マイクロバイオータとCritical Care Nutrition 栄養管理のパラダイムシフトと未来

  中西 信人, 小谷 穣治

  医学図書出版(株), Mar. 2023, ICUとCCU, 47(3) (3), 191 - 196, Japanese


• 重症病態における栄養療法～ベッドサイドで感じるものは何か、考えることは何か 亜急性期におけるカロリーおよびタンパク質の経口摂取不足は敗血症後のPICS発症率と関連する 単一施設の前向き観察研究

  井上 茂亮, 中西 信人, 藤浪 好寿, 大野 雄康, 小谷 穣治

  日本外科代謝栄養学会, 2023, 外科と代謝・栄養, 57(3) (3), 90 - 90, Japanese


• 敗血症による骨格筋萎縮と好中球の動態

  中西 信人, 大野 雄康, 井上 茂亮, 小谷 穣治

  日本外科代謝栄養学会, 2023, 外科と代謝・栄養, 57(3) (3), 158 - 158, Japanese


• Impact of the coronavirus disease 2019 (COVID‐19) pandemic on the operational efficiency of emergency medical services and its association with out‐of‐hospital cardiac arrest survival rates: A population‐based cohort study in Kobe, Japan

  Jun Sugiyama, Shigeaki Inoue, Masami Inada, Yusuke Miyazaki, Nobuto Nakanishi, Yoshihisa Fujinami, Masafumi Saito, Yuko Ono, Kazushige Toyama, Futoshi Toda, Tohru Shirotsuki, Soushi Shiotani, Joji Kotani

  Wiley, Jan. 2023, Acute Medicine & Surgery, 10(1) (1)

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Severe left kidney laceration after minor fall in a patient with lumbar spine scoliosis

  Takashi Sugimoto, Yuko Ono, Eisuke Ueshima, Keigo Matsushiro, Isamu Yamada, Joji Kotani

  Wiley, Jan. 2023, Acute Medicine & Surgery, 10(1) (1)

  Scientific journal


• ダビガトラン過量服薬に対するイダルシズマブの静脈内投与：血漿中ダビガトラン濃度と血液凝固能の関連性(Intravenous idarucizumab for dabigatran overdose: association between plasma dabigatran concentration and coagulation profile)

  兼田 圭介, 大野 雄康, 宮崎 勇輔, 遠山 一成, 山田 勇, 井上 茂亮, 小谷 穣治

  Wiley, Jan. 2023, Nihon Kyukyu Igakukai Zasshi: Journal of Japanese Association for Acute Medicine, 34(1) (1), 6 - 11

  Scientific journal


• C188-9, a specific inhibitor of STAT3 signaling, prevents thermal burn-induced skeletal muscle wasting in mice

  Yuko Ono, Masafumi Saito, Kazuho Sakamoto, Yuko Maejima, Shingen Misaka, Kenju Shimomura, Nobuto Nakanishi, Shigeaki Inoue, Joji Kotani

  Burn injury is the leading cause of death and disability worldwide and places a tremendous economic burden on society. Systemic inflammatory responses induced by thermal burn injury can cause muscle wasting, a severe involuntary loss of skeletal muscle that adversely affects the survival and functional outcomes of these patients. Currently, no pharmacological interventions are available for the treatment of thermal burn-induced skeletal muscle wasting. Elevated levels of inflammatory cytokines, such as interleukin-6 (IL-6), are important hallmarks of severe burn injury. The levels of signal transducer and activator of transcription 3 (STAT3)—a downstream component of IL-6 inflammatory signaling—are elevated with muscle wasting in various pro-catabolic conditions, and STAT3 has been implicated in the regulation of skeletal muscle atrophy. Here, we tested the effects of the STAT3-specific signaling inhibitor C188-9 on thermal burn injury-induced skeletal muscle wasting in vivo and on C2C12 myotube atrophy in vitro after the administration of plasma from burn model mice. In mice, thermal burn injury severity dependently increased IL-6 in the plasma and tibialis anterior muscles and activated the STAT3 (increased ratio of phospho-STAT3/STAT3) and ubiquitin-proteasome proteolytic pathways (increased Atrogin-1/MAFbx and MuRF1). These effects resulted in skeletal muscle atrophy and reduced grip strength. In murine C2C12 myotubes, plasma from burn mice activated the same inflammatory and proteolytic pathways, leading to myotube atrophy. In mice with burn injury, the intraperitoneal injection of C188-9 (50 mg/kg) reduced activation of the STAT3 and ubiquitin-proteasome proteolytic pathways, reversed skeletal muscle atrophy, and increased grip strength. Similarly, pretreatment of murine C2C12 myotubes with C188-9 (10 µM) reduced activation of the same inflammatory and proteolytic pathways, and ameliorated myotube atrophy induced by plasma taken from burn model mice. Collectively, these results indicate that pharmacological inhibition of STAT3 signaling may be a novel therapeutic strategy for thermal burn-induced skeletal muscle wasting.

  Frontiers Media SA, Dec. 2022, Frontiers in Pharmacology, 13

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 【サルコペニア併存消化器外科手術患者に対する術前・術後栄養管理】救急・集中治療領域重症患者における栄養管理

  中西 信人, 小谷 穣治

  日本外科代謝栄養学会, Dec. 2022, 外科と代謝・栄養, 56(6) (6), 229 - 234, Japanese


• Current practice and barriers in the implementation of ultrasound-based assessment of muscle mass in Japan: A nationwide, web-based cross-sectional study

  Keishi Nawata, Nobuto Nakanishi, Shigeaki Inoue, Keibun Liu, Masafumi Nozoe, Yuko Ono, Isamu Yamada, Hajime Katsukawa, Joji Kotani

  Muscle mass is an important factor for surviving an illness. Ultrasound has gained increased attention as a muscle mass assessment method because of its noninvasiveness and portability. However, data on the frequency of ultrasound-based muscle mass assessment are limited, and there are some barriers to its implementation. Hence, a web-based cross-sectional survey was conducted on healthcare providers in Japan, which comprised four parts: 1) participant characteristics; 2) general muscle mass assessment; 3) ultrasound-based muscle mass assessment; and 4) the necessity of, interest in, and barriers to its implementation. Necessity and interest were assessed using an 11-point Likert scale, whereas barriers were assessed using a 5-point Likert scale, in which “Strongly agree” and “Agree” were counted for the analysis. Of the 1,058 responders, 1,026 participants, comprising 282 physicians, 489 physical therapists, 84 occupational therapists, 120 nurses, and 51 dieticians, were included in the analysis. In total, 93% of the participants were familiar with general muscle mass assessment, and 64% had conducted it. Ultrasound-based muscle mass assessment was performed by 21% of the participants. Necessity and interest scored 7 (6–8) and 8 (7–10), respectively for ultrasound-based muscle mass assessment. The barriers to its implementation included lack of relevant education (84%), limited staff (61%), and absence of fixed protocol (61%). Regardless of the necessity of and interest in ultrasound-based muscle mass assessment, it was only conducted by one-fifth of the healthcare providers, and the most important barrier to its implementation was lack of education.

  Public Library of Science (PLoS), Nov. 2022, PLOS ONE, 17(11) (11), e0276855 - e0276855

  Scientific journal


• 敗血症/敗血症性ショックの基礎研究 敗血症モデルマウスにおける前脛骨筋、横隔膜および心筋の萎縮に関する検討

  中西 信人, 斎藤 雅史, 大野 雄康, 森山 直紀, 宮崎 勇輔, 藤浪 好寿, 井上 茂亮, 小谷 穣治

  (一社)日本集中治療医学会, Nov. 2022, 日本集中治療医学会雑誌, 29(Suppl.1) (Suppl.1), 333 - 333, Japanese


• 本邦での筋肉量評価における超音波検査の実施状況と障壁

  縄田 佳志, 中西 信人, 井上 茂亮, 劉 啓文, 野添 匡史, 大野 雄康, 曷川 元, 小谷 穣治

  (一社)日本集中治療医学会, Nov. 2022, 日本集中治療医学会雑誌, 29(Suppl.1) (Suppl.1), 562 - 562, Japanese


• 東日本大震災が被災地3つの医科大学におけるacademic outputの性差に与える影響

  大野 雄康, 斎藤 雅史, 篠原 一彰, 岩崎 夢大, 井上 茂亮, 小谷 穣治

  (一社)日本救急医学会, Oct. 2022, 日本救急医学会雑誌, 33(10) (10), 861 - 861, Japanese


• コロナ波は救急活動における不能時間とレスポンスタイムを延長させ,院外心肺停止患者の予後を増悪させる

  杉山 隼, 井上 茂亮, 斎藤 雅史, 中西 信人, 大野 雄康, 藤浪 好寿, 戸田 太, 城月 徹, 塩谷 壮史, 小谷 穣治

  (一社)日本救急医学会, Oct. 2022, 日本救急医学会雑誌, 33(10) (10), 837 - 837, Japanese


• Right thyrocervical trunk rupture after right internal jugular vein puncture: a case report and systematic review of the literature

  Yuko Ono, Eisuke Ueshima, Nobuto Nakanishi, Kazuaki Shinohara, Isamu Yamada, Joji Kotani

  Abstract Background Thyrocervical trunk rupture is an unusual, but critical, complication associated with central venous catheter (CVC) placement. The management of this complication has not been fully determined because it is rare. Case presentation A 53-year-old Japanese woman with anorexia nervosa developed refractory ventricular fibrillation. After returning spontaneous circulation, a CVC was successfully placed at the initial attempt in the right internal jugular vein using real-time ultrasound guidance. Immediately after CVC placement, she developed enlarging swelling around the neck. Contrast-enhanced computed tomography showed massive contrast media extravasation around the neck and mediastinum. Brachiocephalic artery angiography showed a “blush” appearance of the ruptured right thyrocervical trunk. After selective arterial embolization with 33% N-butyl-2-cyanoacrylate, the extravasation completely disappeared and hemostasis was achieved. Conclusion Our findings suggest that severe vascular complications arising from CVC placement can occur in patients with a fragile physiological state. Endovascular embolization is an effective treatment for such complications.

  Springer Science and Business Media LLC, Sep. 2022, JA Clinical Reports, 8(1) (1)

  Scientific journal


• Prevalence and Long-Term Prognosis of Post-Intensive Care Syndrome after Sepsis: A Single-Center Prospective Observational Study

  Shigeaki Inoue, Nobuto Nakanishi, Jun Sugiyama, Naoki Moriyama, Yusuke Miyazaki, Takashi Sugimoto, Yoshihisa Fujinami, Yuko Ono, Joji Kotani

  Post-intensive care syndrome (PICS) comprises physical, mental, and cognitive disorders following a severe illness. The impact of PICS on long-term prognosis has not been fully investigated. This study aimed to: (1) clarify the frequency and clinical characteristics of PICS in sepsis patients and (2) explore the relationship between PICS occurrence and 2-year survival. Patients with sepsis admitted to intensive care unit were enrolled. Data on patient background; clinical information since admission; physical, mental, and cognitive impairments at 3-, 6-, and 12-months post-sepsis onset; 2-year survival; and cause of death were obtained from electronic medical records and telephonic interviews with patients and their families. At 3 months, comparisons of variables were undertaken in the PICS group and the non-PICS group. Among the 77 participants, the in-hospital mortality rate was 11% and the 2-year mortality rate was 52%. The frequencies of PICS at 3, 6, and 12 months were 70%, 60%, and 35%, respectively. The 2-year survival was lower in the PICS group than in the non-PICS group (54% vs. 94%, p < 0.01). More than half of the survivors had PICS at 3 and 6 months after sepsis. Among survivors with sepsis, those who developed PICS after 3 months had a lower 2-year survival.

  MDPI AG, Sep. 2022, Journal of Clinical Medicine, 11(18) (18), 5257 - 5257

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Brain T cell ameliorates mental disorders in the mouse model of post-sepsis syndrome

  Masafumi Saito, Yoshihisa Fujinami, Yuko Ono, Kimihiro Yamashita, Shigeaki Inoue, Joji Kotani

  Japanese Society for Surgical Metabolism and Nutrition, Aug. 2022, The Japanese Journal of SURGICAL METABOLISM and NUTRITION, 56(4) (4), 155 - 159

  [Refereed][Invited]

  Scientific journal


• Effects of tranexamic acid on coagulofibrinolytic markers during the early stage of severe trauma: A propensity score-matched analysis.

  Satoshi Gando, Atsushi Shiraishi, Takeshi Wada, Kazuma Yamakawa, Seitaro Fujishima, Daizoh Saitoh, Shigeki Kushimoto, Hiroshi Ogura, Toshikazu Abe, Toshihiko Mayumi, Junichi Sasaki, Joji Kotani, Naoshi Takeyama, Ryosuke Tsuruta, Kiyotsugu Takuma, Shin-Ichiro Shiraishi, Yasukazu Shiino, Taka-Aki Nakada, Kohji Okamoto, Yuichiro Sakamoto, Akiyoshi Hagiwara, Satoshi Fujimi, Yutaka Umemura, Yasuhiro Otomo

  Tranexamic acid (TXA) reduces the risk of bleeding trauma death without altering the need for blood transfusion. We examined the effects of TXA on coagulation and fibrinolysis dynamics and the volume of transfusion during the early stage of trauma. This subanalysis of a prospective multicenter study of severe trauma included 276 patients divided into propensity score-matched groups with and without TXA administration. The effects of TXA on coagulation and fibrinolysis markers immediately at (time point 0) and 3 hours after (time point 3) arrival at the emergency department were investigated. The transfusion volume was determined at 24 hours after admission. TXA was administered to the patients within 3 hours (median, 64 minutes) after injury. Significant reductions in fibrin/fibrinogen degradation products and D-dimer levels from time points 0 to 3 in the TXA group compared with the non-TXA group were confirmed, with no marked differences noted in the 24-hour transfusion volumes between the 2 groups. Continuously increased levels of soluble fibrin, a marker of thrombin generation, from time points 0 to 3 and high levels of plasminogen activator inhibitor-1, a marker of inhibition of fibrinolysis, at time point 3 were observed in both groups. TXA inhibited fibrin(ogen)olysis during the early stage of severe trauma, although this was not associated with a reduction in the transfusion volume. Other confounders affecting the dynamics of fibrinolysis and transfusion requirement need to be clarified.

  Aug. 2022, Medicine, 101(32) (32), e29711, English, International magazine

  Scientific journal


• 敗血症後症候群および精神障害の病態形成と回復過程における脳内T細胞の役割

  齋藤 雅史, 藤浪 好寿, 大野 雄康, 山下 公大, 井上 茂亮, 小谷 穣治

  日本外科代謝栄養学会, Aug. 2022, 外科と代謝・栄養, 56(4) (4), 155 - 159, Japanese


• Oropharyngeal pleomorphic adenoma causing complete airway obstruction and cardiopulmonary arrest.

  Ono Y, Nakanishi N, Yamada I, Kotani J

  Aug. 2022, Oxf Med Case Reports., 2022(8) (8), omac083 - omac083, English, International magazine

  [Refereed]

  Link to Kobe Univ. Repository (Kernel)


• 敗血症後症候群および精神障害の病態形成と回復過程における脳内T細胞の役割

  齋藤 雅史, 藤浪 好寿, 大野 雄康, 山下 公大, 井上 茂亮, 小谷 穣治

  日本外科代謝栄養学会, Aug. 2022, 外科と代謝・栄養, 56(4) (4), 155 - 159, Japanese


• 口腔機能低下が重症患者に与える悪影響とそのメカニズムを探る

  藤浪 好寿, 斎藤 雅史, 大野 雄康, 中西 信人, 森山 直紀, 宮崎 勇輔, 切田 学, 井上 茂亮, 小谷 穣治

  日本外科代謝栄養学会, Jun. 2022, 外科と代謝・栄養, 56(3) (3), 91 - 91, Japanese


• Man with shortness of breath after meal

  Nobuto Nakanishi, Yuko Ono, Isamu Yamada, Joji Kotani

  Wiley, Jun. 2022, Journal of the American College of Emergency Physicians Open, 3(3) (3)

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• ショックに関する新しい側面からの臨床研究 重症患者における咬合不全のインパクトを探る

  藤浪 好寿, 斎藤 雅史, 大野 雄康, 中西 信人, 森山 直紀, 宮崎 勇輔, 井上 茂亮, 小谷 穣治

  (一社)日本Shock学会, May 2022, Shock: 日本Shock学会雑誌, 36(1) (1), 27 - 27, Japanese


• 敗血症後の骨格筋萎縮における好中球の動態解析と機序解明へのアプローチ

  中西 信人, 斎藤 雅史, 大野 雄康, 森山 直紀, 宮崎 勇輔, 井上 茂亮, 小谷 穣治

  (一社)日本Shock学会, May 2022, Shock: 日本Shock学会雑誌, 36(1) (1), 35 - 35, Japanese


• ショックに関する基礎的研究の最先端 敗血症後、制御性T細胞はどのように脳に増加するのか 制御性T細胞の供給源としての頸部リンパ節の役割

  齋藤 雅史, 大野 雄康, 藤浪 好寿, 宮崎 勇輔, 中西 信人, 森山 直紀, 山下 公大, 井上 茂亮, 小谷 穣治

  (一社)日本Shock学会, May 2022, Shock: 日本Shock学会雑誌, 36(1) (1), 24 - 24, Japanese


• Hour-1 bundle adherence was associated with reduction of in-hospital mortality among patients with sepsis in Japan.

  Yutaka Umemura, Toshikazu Abe, Hiroshi Ogura, Seitato Fujishima, Shigeki Kushimoto, Atsushi Shiraishi, Daizoh Saitoh, Toshihiko Mayumi, Yasuhiro Otomo, Toru Hifumi, Akiyoshi Hagiwara, Kiyotsugu Takuma, Kazuma Yamakawa, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Kohji Okamoto, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Ryosuke Tsuruta, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Gando

  BACKGROUND: The updated Surviving Sepsis Campaign guidelines recommend a 1-hour window for completion of a sepsis care bundle; however, the effectiveness of the hour-1 bundle has not been fully evaluated. The present study aimed to evaluate the impact of hour-1 bundle completion on clinical outcomes in sepsis patients. METHODS: This was a multicenter, prospective, observational study conducted in 17 intensive care units in tertiary hospitals in Japan. We included all adult patients who were diagnosed as having sepsis by Sepsis-3 and admitted to intensive care units from July 2019 to August 2020. Impacts of hour-1 bundle adherence and delay of adherence on risk-adjusted in-hospital mortality were estimated by multivariable logistic regression analyses. RESULTS: The final study cohort included 178 patients with sepsis. Among them, 89 received bundle-adherent care. Completion rates of each component (measure lactate level, obtain blood cultures, administer broad-spectrum antibiotics, administer crystalloid, apply vasopressors) within 1 hour were 98.9%, 86.2%, 51.1%, 94.9%, and 69.1%, respectively. Completion rate of all components within 1 hour was 50%. In-hospital mortality was 18.0% in the patients with and 30.3% in the patients without bundle-adherent care (p = 0.054). The adjusted odds ratio of non-bundle-adherent versus bundle-adherent care for in-hospital mortality was 2.32 (95% CI 1.09-4.95) using propensity scoring. Non-adherence to obtaining blood cultures and administering broad-spectrum antibiotics within 1 hour was related to in-hospital mortality (2.65 [95% CI 1.25-5.62] and 4.81 [95% CI 1.38-16.72], respectively). The adjusted odds ratio for 1-hour delay in achieving hour-1 bundle components for in-hospital mortality was 1.28 (95% CI 1.04-1.57) by logistic regression analysis. CONCLUSION: Completion of the hour-1 bundle was associated with lower in-hospital mortality. Obtaining blood cultures and administering antibiotics within 1 hour may have been the components most contributing to decreased in-hospital mortality.

  2022, PloS one, 17(2) (2), e0263936, English, International magazine

  Scientific journal


• Sepsis causes neutrophil infiltration in muscle leading to muscle atrophy and weakness in mice.

  Nobuto Nakanishi, Yuko Ono, Yusuke Miyazaki, Naoki Moriyama, Kazumichi Fujioka, Kimihiro Yamashita, Shigeaki Inoue, Joji Kotani

  Background: Sepsis-induced muscle atrophy leads to prolonged physical dysfunction. Although the interaction of muscle atrophy and macrophage has been reported in sepsis, the role of neutrophils in muscle atrophy has not been thoroughly investigated. This study sought to investigate the long-term changes in muscle-localized neutrophils after sepsis induction and their possible role in sepsis. Methods: Sepsis was induced in seven-week-old male C57BL/6J mice 8-12 (cecal slurry [CS] model) via intraperitoneal injection of 1 mg/g cecal slurry. The percentage change in body weight and grip strength was evaluated. The tibialis anterior muscles were dissected for microscopic examination of the cross-sectional area of myofibers or Fluorescence-activated cell sorting (FACS) analysis of immune cells. These changes were evaluated in the following conditions: (1) Longitudinal change until day 61, (2) CS concentration-dependent change on day 14 at the low (0.3 mg/g), middle (1.0 mg/g), and high (2.0 mg/g) concentrations, and (3) CS mice on day 14 treated with an anti-Ly6G antibody that depletes neutrophils. Results: Body weight and grip strength were significantly lower in the CS model until day 61 (body weight: 123.1% ± 1.8% vs. 130.3% ± 2.5%, p = 0.04; grip strength: 104.5% ± 3.8% vs. 119.3% ± 5.3%, p = 0.04). Likewise, cross-sectional muscle area gradually decreased until day 61 from the CS induction (895.6 [606.0-1304.9] μm2 vs. 718.8 [536.2-937.0] μm2, p < 0.01). The number of muscle-localized neutrophils increased from 2.3 ± 0.6 cell/mg on day 0 to 22.2 ± 13.0 cell/mg on day 14, and decreased thereafter. In terms of CS concentration-dependent change, cross-sectional area was smaller (484.4 ± 221.2 vs. 825.8 ± 436.2 μm2 [p < 0.001]) and grip strength was lower (71.4% ± 12.8% vs. 116.3% ± 7.4%, p = 0.01) in the CS High group compared with the control, with increased neutrophils (p = 0.03). Ly6G-depleted mice demonstrated significant increase of muscle cross-sectional area and grip strength compared with control mice (p < 0.01). Conclusions: Sepsis causes infiltration of neutrophils in muscles, leading to muscle atrophy and weakness. Depletion of neutrophils in muscle reverses sepsis-induced muscle atrophy and weakness. These results suggest that neutrophils may play a critical role in sepsis-induced muscle atrophy and weakness.

  2022, Frontiers in immunology, 13, 950646 - 950646, English, International magazine

  Scientific journal


• Impact of emergency physician-staffed ambulances on preoperative time course and survival among injured patients requiring emergency surgery or transarterial embolization: A retrospective cohort study at a community emergency department in Japan

  Yuko Ono, Yudai Iwasaki, Takaki Hirano, Katsuhiko Hashimoto, Takeyasu Kakamu, Shigeaki Inoue, Joji Kotani, Kazuaki Shinohara

  Injured patients requiring definitive intervention, such as surgery or transarterial embolization (TAE), are an extremely time-sensitive population. The effect of an emergency physician (EP) patient care delivery system in this important trauma subset remains unclear. We aimed to clarify whether the preoperative time course and mortality among injured patients differ between ambulances staffed by EPs and those staffed by emergency life-saving technicians (ELST). This was a retrospective cohort study at a community emergency department (ED) in Japan. We included all injured patients requiring emergency surgery or TAE who were transported directly from the ED to the operating room from January 2002 to December 2019. The primary exposure was dispatch of an EP-staffed ambulance to the prehospital scene. The primary outcome measures were preoperative time course including prehospital length of stay (LOS), ED LOS, and total time to definitive intervention. The other outcome of interest was in-hospital mortality. One-to-one propensity score matching was performed to compare these outcomes between the groups. Of the 1,020 eligible patients, 353 (34.6%) were transported to the ED by an EP-staffed ambulance. In the propensity score-matched analysis with 295 pairs, the EP group showed a significant increase in median prehospital LOS (71.0 min vs. 41.0 min, P < 0.001) and total time to definitive intervention (189.0 min vs. 177.0 min, P = 0.002) in comparison with the ELST group. Conversely, ED LOS was significantly shorter in the EP group than in the ELST group (120.0 min vs. 131.0 min, P = 0.043). There was no significant difference in mortality between the two groups (8.8% vs.9.8%, P = 0.671). At a community hospital in Japan, EP-staffed ambulances were found to be associated with prolonged prehospital time, delay in definitive treatment, and did not improve survival among injured patients needing definitive hemostatic procedures compared with ELST-staffed ambulances.

  Public Library of Science (PLoS), Nov. 2021, PLOS ONE, 16(11) (11), e0259733 - e0259733

  Scientific journal


• 前頭側頭型認知症患者の急性二酸化炭素中毒の一例

  関 恒慶, 関口 兼司, 宮崎 勇輔, 松野 祐久, 井上 茂亮, 松本 理器, 小谷 穣治

  (一社)日本救急医学会, Nov. 2021, 日本救急医学会雑誌, 32(12) (12), 1884 - 1884, Japanese


• Ultrasound assessment of muscle mass has potential to identify patients with low muscularity at intensive care unit admission: A retrospective study

  Yuta Arai, Nobuto Nakanishi, Yuko Ono, Shigeaki Inoue, Joji Kotani, Masafumi Harada, Jun Oto

  Elsevier BV, Oct. 2021, Clinical Nutrition ESPEN, 45, 177 - 183

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Incidence and Impact of Dysglycemia in Patients with Sepsis Under Moderate Glycemic Control.

  Seitaro Fujishima, Satoshi Gando, Daizoh Saitoh, Shigeki Kushimoto, Hiroshi Ogura, Toshikazu Abe, Atsushi Shiraishi, Toshihiko Mayumi, Junichi Sasaki, Joji Kotani, Naoshi Takeyama, Ryosuke Tsuruta, Kiyotsugu Takuma, Norio Yamashita, Shin-Ichiro Shiraishi, Hiroto Ikeda, Yasukazu Shiino, Takehiko Tarui, Taka-Aki Nakada, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Yuichiro Sakamoto, Akiyoshi Hagiwara, Tomohiko Masuno, Masashi Ueyama, Satoshi Fujimi, Kazuma Yamakawa, Yutaka Umemura

  ABSTRACT: Glycemic control strategies for sepsis have changed significantly over the last decade, but their impact on dysglycemia and its associated outcomes has been poorly understood. In addition, there is controversy regarding the detrimental effects of hyperglycemia in sepsis. To evaluate the incidence and risks of dysglycemia under current strategy, we conducted a preplanned subanalysis of the sepsis cohort in a prospective, multicenter FORECAST study. A total of 1,140 patients with severe sepsis, including 259 patients with pre-existing diabetes, were included. Median blood glucose levels were approximately 140 mg/dL at 0 and 72 h indicating that blood glucose was moderately controlled. The rate of initial and late hyperglycemia was 27.3% and 21.7%, respectively. The rate of early hypoglycemic episodes during the initial 24 h was 13.2%. Glycemic control was accompanied by a higher percentage of initial and late hyperglycemia but not with early hypoglycemic episodes, suggesting that glycemic control was targeted at excess hyperglycemia. In nondiabetic patients, late hyperglycemia (hazard ratio, 95% confidence interval; P value: 1.816, 1.116-2.955, 0.016) and early hypoglycemic episodes (1.936, 1.180-3.175, 0.009) were positively associated with in-hospital mortality. Further subgroup analysis suggested that late hyperglycemia and early hypoglycemic episodes independently, and probably synergistically, affect the outcomes. In diabetic patients, however, these correlations were not observed. In conclusion, a significantly high incidence of dysglycemia was observed in our sepsis cohort under moderate glycemic control. Late hyperglycemia in addition to early hypoglycemia was associated with poor outcomes at least in nondiabetic patients. More sophisticated approaches are necessary to reduce the incidence of these serious complications.

  Oct. 2021, Shock (Augusta, Ga.), 56(4) (4), 507 - 513, English, International magazine

  Scientific journal


• A Novel Method for Measuring the Pupil Diameter and Pupillary Light Reflex of Healthy Volunteers and Patients With Intracranial Lesions Using a Newly Developed Pupilometer

  Joji Kotani, Hiroyuki Nakao, Isamu Yamada, Atsushi Miyawaki, Naomi Mambo, Yuko Ono

  Background: Physicians currently measure the pupil diameter and the pupillary light reflex with visual observations using a ruler and a traditional penlight, leading to possibly inaccurate and subjective assessments. Although a mobile pupillometer has been developed and is available in clinical settings, this device can only assess one pupil at a time. Hence, an indirect pupillary light reflex, including those under irradiation to the opposite side of pupil, cannot be evaluated. Consequently, we have developed a new automatic mobile pupilometer, the Hitomiru^®, with Hitomiru Co., Ltd. (Tokyo, Japan). This device is a two-glass type pupilometer with a video recording system. The pupil diameter and light reflex of both pupils can be measured simultaneously; therefore, both indirect and direct light reflexes can be assessed. Purpose: To evaluate the clinical ability of the Hitomiru^® pupilometer to assess the pupil diameter and the pupillary light reflex of healthy volunteers and patients with intracranial lesions in an intensive care unit (ICU). Methods: Twenty-five healthy volunteers and five ICU patients with intracranial lesions on only the left side were assessed using the Hitomiru^® pupilometer. The protocol was as follows: infrared light was applied to both pupils, followed by visible light to the right pupil, infrared light to both pupils, visible light to the left pupil, and then infrared light to both pupils. All the intervals were 2 s, and the dynamics of pupil diameters on both sides were continuously recorded. Results: The healthy adults had approximately 0.5 mm anisocoria, miosis was harder, and mydriasis was less with increased age. There were several differences in miosis rates, miosis times, and mydriasis rates between the healthy adults and the patients with intracranial lesions with both direct irradiation and indirect irradiation. Conclusions: The initial trial estimated and digitally recorded direct and indirect light reflexes, including rapidity of miosis after direct and indirect lights on, and mydriasis after direct and indirect lights off. The Hitomiru^® pupilometer was a useful device to digitally record and investigate the relationship between pupil reflexes and intracranial diseases.

  Frontiers Media SA, Sep. 2021, Frontiers in Medicine, 8, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 日本版敗血症ガイドライン2020;ダイジェスト・多職種チームの重要性 日本版敗血症診療ガイドライン2020における多職種連携

  河合 佑亮, 西田 修, 飯田 有輝, 宇都宮 明美, 古薗 弘隆, 山田 亨, 吉田 悠平, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会Patient-and Family-Centered Care班

  (一社)日本集中治療医学会, Sep. 2021, 日本集中治療医学会雑誌, 28(Suppl.2) (Suppl.2), 229 - 229, Japanese


• 日本版敗血症ガイドライン2020;ICU-AW・PICS・早期リハ・Patients Centered Therapy and Family Careを知る Patient-and Family-Centered Careに関するEvidence解説

  河合 佑亮, 西田 修, 飯田 有輝, 宇都宮 明美, 古薗 弘隆, 山田 亨, 吉田 悠平, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会Patient-and Family-Centered Care班

  (一社)日本集中治療医学会, Sep. 2021, 日本集中治療医学会雑誌, 28(Suppl.2) (Suppl.2), 234 - 234, Japanese


• 日本版敗血症ガイドライン2020;ICU-AW・PICS・早期リハ・Patients Centered Therapy and Family Careを知る Patient-and Family-Centered Careに関するEvidence解説

  河合 佑亮, 西田 修, 飯田 有輝, 宇都宮 明美, 古薗 弘隆, 山田 亨, 吉田 悠平, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会Patient-and Family-Centered Care班

  (一社)日本集中治療医学会, Sep. 2021, 日本集中治療医学会雑誌, 28(Suppl.2) (Suppl.2), 234 - 234, Japanese


• 日本版敗血症ガイドライン2020;ダイジェスト・多職種チームの重要性 日本版敗血症診療ガイドラインの歴史

  西田 修, 小倉 裕司, 江木 盛時, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会

  (一社)日本集中治療医学会, Sep. 2021, 日本集中治療医学会雑誌, 28(Suppl.2) (Suppl.2), 228 - 228, Japanese


• 日本版敗血症ガイドライン2020;ダイジェスト・多職種チームの重要性 日本版敗血症ガイドライン2020を要約してお伝えします

  江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会

  (一社)日本集中治療医学会, Sep. 2021, 日本集中治療医学会雑誌, 28(Suppl.2) (Suppl.2), 228 - 228, Japanese


• Association of frailty on treatment outcomes among patients with suspected infection treated at emergency departments.

  Shigeto Ishikawa, Ippei Miyagawa, Masashi Kusanaga, Toshikazu Abe, Atsushi Shiraishi, Seitaro Fujishima, Hiroshi Ogura, Daizoh Saitoh, Shigeki Kushimoto, Yasukazu Shiino, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Akiyoshi Hagiwara, Kazuma Yamakawa, Naoshi Takeyama, Satoshi Gando, Toshihiko Mayumi

  BACKGROUND: The clinical frailty scale (CFS) score has been validated as a predictor of adverse outcomes in community-dwelling older people. Older people are at a higher risk of sepsis and have a higher mortality rate. However, the association of frailty on outcomes in patients with sepsis has not been completely examined. OBJECTIVE: This study evaluated the association between CFS and outcomes in patients with sepsis. DESIGN: This was a multicenter prospective cohort substudy. SETTINGS AND PARTICIPANTS: The study included 37 emergency departments from across Japan. The patients (age ≥16 years) were included in this study if they had suspected infection at an emergency department during December 2017-February 2018. OUTCOME MEASURE AND ANALYSIS: The primary outcome was 28-day mortality, stratified by the CFS score categories. The secondary outcomes were the duration of hospital stay, number of ICU-free days (ICUFDs) and number of ventilator-free days (VFDs). MAIN RESULTS: A total of 917 patients were included. The median age was 79 years. The CFS score was associated with an increased risk of 28-day mortality and with a higher likelihood of long-term hospital stay and short-term VFDs and ICUFDs. Multivariate logistic regression analysis indicated that the CFS score was a predictor of 28-day mortality [odds ratio (OR), 1.26; 95% confidence interval (CI), 1.11-1.42]. CONCLUSIONS: This study reported that in patients with suspected sepsis in the emergency department, frailty may be associated with poor prognosis and length of hospital stay.

  Aug. 2021, European journal of emergency medicine : official journal of the European Society for Emergency Medicine, 28(4) (4), 285 - 291, English, International magazine

  Scientific journal


• The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020)

  Moritoki Egi, Hiroshi Ogura, Tomoaki Yatabe, Kazuaki Atagi, Shigeaki Inoue, Toshiaki Iba, Yasuyuki Kakihana, Tatsuya Kawasaki, Shigeki Kushimoto, Yasuhiro Kuroda, Joji Kotani, Nobuaki Shime, Takumi Taniguchi, Ryosuke Tsuruta, Kent Doi, Matsuyuki Doi, Taka-aki Nakada, Masaki Nakane, Seitaro Fujishima, Naoto Hosokawa, Yoshiki Masuda, Asako Matsushima, Naoyuki Matsuda, Kazuma Yamakawa, Yoshitaka Hara, Masaaki Sakuraya, Shinichiro Ohshimo, Yoshitaka Aoki, Mai Inada, Yutaka Umemura, Yusuke Kawai, Yutaka Kondo, Hiroki Saito, Shunsuke Taito, Chikashi Takeda, Takero Terayama, Hideo Tohira, Hideki Hashimoto, Kei Hayashida, Toru Hifumi, Tomoya Hirose, Tatsuma Fukuda, Tomoko Fujii, Shinya Miura, Hideto Yasuda, Toshikazu Abe, Kohkichi Andoh, Yuki Iida, Tadashi Ishihara, Kentaro Ide, Kenta Ito, Yusuke Ito, Yu Inata, Akemi Utsunomiya, Takeshi Unoki, Koji Endo, Akira Ouchi, Masayuki Ozaki, Satoshi Ono, Morihiro Katsura, Atsushi Kawaguchi, Yusuke Kawamura, Daisuke Kudo, Kenji Kubo, Kiyoyasu Kurahashi, Hideaki Sakuramoto, Akira Shimoyama, Takeshi Suzuki, Shusuke Sekine, Motohiro Sekino, Nozomi Takahashi, Sei Takahashi, Hiroshi Takahashi, Takashi Tagami, Goro Tajima, Hiroomi Tatsumi, Masanori Tani, Asuka Tsuchiya, Yusuke Tsutsumi, Takaki Naito, Masaharu Nagae, Ichiro Nagasawa, Kensuke Nakamura, Tetsuro Nishimura, Shin Nunomiya, Yasuhiro Norisue, Satoru Hashimoto, Daisuke Hasegawa, Junji Hatakeyama, Naoki Hara, Naoki Higashibeppu, Nana Furushima, Hirotaka Furusono, Yujiro Matsuishi, Tasuku Matsuyama, Yusuke Minematsu, Ryoichi Miyashita, Yuji Miyatake, Megumi Moriyasu, Toru Yamada, Hiroyuki Yamada, Ryo Yamamoto, Takeshi Yoshida, Yuhei Yoshida, Jumpei Yoshimura, Ryuichi Yotsumoto, Hiroshi Yonekura, Takeshi Wada, Eizo Watanabe, Makoto Aoki, Hideki Asai, Takakuni Abe, Yutaka Igarashi, Naoya Iguchi, Masami Ishikawa, Go Ishimaru, Shutaro Isokawa, Ryuta Itakura, Hisashi Imahase, Haruki Imura, Takashi Irinoda, Kenji Uehara, Noritaka Ushio, Takeshi Umegaki, Yuko Egawa, Yuki Enomoto, Kohei Ota, Yoshifumi Ohchi, Takanori Ohno, Hiroyuki Ohbe, Kazuyuki Oka, Nobunaga Okada, Yohei Okada, Hiromu Okano, Jun Okamoto, Hiroshi Okuda, Takayuki Ogura, Yu Onodera, Yuhta Oyama, Motoshi Kainuma, Eisuke Kako, Masahiro Kashiura, Hiromi Kato, Akihiro Kanaya, Tadashi Kaneko, Keita Kanehata, Ken-ichi Kano, Hiroyuki Kawano, Kazuya Kikutani, Hitoshi Kikuchi, Takahiro Kido, Sho Kimura, Hiroyuki Koami, Daisuke Kobashi, Iwao Saiki, Masahito Sakai, Ayaka Sakamoto, Tetsuya Sato, Yasuhiro Shiga, Manabu Shimoto, Shinya Shimoyama, Tomohisa Shoko, Yoh Sugawara, Atsunori Sugita, Satoshi Suzuki, Yuji Suzuki, Tomohiro Suhara, Kenji Sonota, Shuhei Takauji, Kohei Takashima, Sho Takahashi, Yoko Takahashi, Jun Takeshita, Yuuki Tanaka, Akihito Tampo, Taichiro Tsunoyama, Kenichi Tetsuhara, Kentaro Tokunaga, Yoshihiro Tomioka, Kentaro Tomita, Naoki Tominaga, Mitsunobu Toyosaki, Yukitoshi Toyoda, Hiromichi Naito, Isao Nagata, Tadashi Nagato, Yoshimi Nakamura, Yuki Nakamori, Isao Nahara, Hiromu Naraba, Chihiro Narita, Norihiro Nishioka, Tomoya Nishimura, Kei Nishiyama, Tomohisa Nomura, Taiki Haga, Yoshihiro Hagiwara, Katsuhiko Hashimoto, Takeshi Hatachi, Toshiaki Hamasaki, Takuya Hayashi, Minoru Hayashi, Atsuki Hayamizu, Go Haraguchi, Yohei Hirano, Ryo Fujii, Motoki Fujita, Naoyuki Fujimura, Hiraku Funakoshi, Masahito Horiguchi, Jun Maki, Naohisa Masunaga, Yosuke Matsumura, Takuya Mayumi, Keisuke Minami, Yuya Miyazaki, Kazuyuki Miyamoto, Teppei Murata, Machi Yanai, Takao Yano, Kohei Yamada, Naoki Yamada, Tomonori Yamamoto, Shodai Yoshihiro, Hiroshi Tanaka, Osamu Nishida

  Aug. 2021, JOURNAL OF INTENSIVE CARE, 9(1) (1), English

  Scientific journal


• Quick sequential organ failure assessment score combined with other sepsis-related risk factors to predict in-hospital mortality: Post-hoc analysis of prospective multicenter study data

  Ryo Ueno, Takateru Masubuchi, Atsushi Shiraishi, Satoshi Gando, Toshikazu Abe, Shigeki Kushimoto, Toshihiko Mayumi, Seitaro Fujishima, Akiyoshi Hagiwara, Toru Hifumi, Akira Endo, Takayuki Komatsu, Joji Kotani, Kohji Okamoto, Junichi Sasaki, Yasukazu Shiino, Yutaka Umemura

  Jul. 2021, PLOS ONE, 16(7) (7), English

  Scientific journal


• Rectus Femoris Mimicking Ultrasound Phantom for Muscle Mass Assessment: Design, Research, and Training Application.

  Nobuto Nakanishi, Shigeaki Inoue, Rie Tsutsumi, Yusuke Akimoto, Yuko Ono, Joji Kotani, Hiroshi Sakaue, Jun Oto

  Ultrasound has become widely used as a means to measure the rectus femoris muscle in the acute and chronic phases of critical illness. Despite its noninvasiveness and accessibility, its accuracy highly depends on the skills of the technician. However, few ultrasound phantoms for the confirmation of its accuracy or to improve technical skills exist. In this study, the authors created a novel phantom model and used it for investigating the accuracy of measurements and for training. Study 1 investigated how various conditions affect ultrasound measurements such as thickness, cross-sectional area, and echogenicity. Study 2 investigated if the phantom can be used for the training of various health care providers in vitro and in vivo. Study 1 showed that thickness, cross-sectional area, and echogenicity were affected by probe compression strength, probe angle, phantom compression, and varying equipment. Study 2 in vitro showed that using the phantom for training improved the accuracy of the measurements taken within the phantom, and Study 2 in vivo showed the phantom training had a short-term effect on improving the measurement accuracy in a human volunteer. The new ultrasound phantom model revealed that various conditions affected ultrasound measurements, and phantom training improved the measurement accuracy.

  Jun. 2021, Journal of clinical medicine, 10(12) (12), English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Impact of closure of the in-house psychiatric care unit on prehospital and emergency ward length of stay and disposition locations in patients who attempted suicide

  Yuko Ono, Nozomi Ono, Takeyasu Kakamu, Tokiya Ishida, Shigeaki Inoue, Joji Kotani, Kazuaki Shinohara

  Ovid Technologies (Wolters Kluwer Health), Jun. 2021, Medicine, 100(22) (22), e26252 - e26252

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 【凝固と炎症のクロストーク】抗凝固療法によるNETs抑制

  石川 倫子, 村上 博基, 小濱 圭祐, 桑原 正篤, 平田 淳一, 小谷 穣治

  医学図書出版(株), Jun. 2021, ICUとCCU, 45(6) (6), 351 - 355, Japanese


• 前頭側頭型認知症患者の急性二酸化炭素中毒の一例

  関 恒慶, 関口 兼司, 宮崎 勇輔, 松野 祐久, 井上 茂亮, 松本 理器, 小谷 穰治

  (株)へるす出版, Jun. 2021, Journal of Japan Society of Neurological Emergencies & Critical Care, 34(1) (1), 64 - 64, Japanese


• Disseminated intravascular coagulation immediately after trauma predicts a poor prognosis in severely injured patients.

  Takeshi Wada, Atsushi Shiraishi, Satoshi Gando, Kazuma Yamakawa, Seitaro Fujishima, Daizoh Saitoh, Shigeki Kushimoto, Hiroshi Ogura, Toshikazu Abe, Toshihiko Mayumi, Junichi Sasaki, Joji Kotani, Naoshi Takeyama, Ryosuke Tsuruta, Kiyotsugu Takuma, Norio Yamashita, Shin-Ichiro Shiraishi, Hiroto Ikeda, Yasukazu Shiino, Takehiko Tarui, Taka-Aki Nakada, Toru Hifumi, Kohji Okamoto, Yuichiro Sakamoto, Akiyoshi Hagiwara, Tomohiko Masuno, Masashi Ueyama, Satoshi Fujimi, Yutaka Umemura, Yasuhiro Otomo

  Trauma patients die from massive bleeding due to disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype in the early phase, which transforms to DIC with a thrombotic phenotype in the late phase of trauma, contributing to the development of multiple organ dysfunction syndrome (MODS) and a consequently poor outcome. This is a sub-analysis of a multicenter prospective descriptive cross-sectional study on DIC to evaluate the effect of a DIC diagnosis on the survival probability and predictive performance of DIC scores for massive transfusion, MODS, and hospital death in severely injured trauma patients. A DIC diagnosis on admission was associated with a lower survival probability (Log Rank P < 0.001), higher frequency of massive transfusion and MODS and a higher mortality rate than no such diagnosis. The DIC scores at 0 and 3 h significantly predicted massive transfusion, MODS, and hospital death. Markers of thrombin and plasmin generation and fibrinolysis inhibition also showed a good predictive ability for these three items. In conclusion, a DIC diagnosis on admission was associated with a low survival probability. DIC scores obtained immediately after trauma predicted a poor prognosis of severely injured trauma patients.

  May 2021, Scientific reports, 11(1) (1), 11031 - 11031, English, International magazine

  Scientific journal


• Malocclusion of Molar Teeth Is Associated with Activities of Daily Living Loss and Delirium in Elderly Critically Ill Older Patients.

  Yoshihisa Fujinami, Toru Hifumi, Yuko Ono, Masafumi Saito, Tomoya Okazaki, Natsuyo Shinohara, Kyoko Akiyama, Misa Kunikata, Shigeaki Inoue, Joji Kotani, Yasuhiro Kuroda

  A single-center retrospective cohort study examined the association between molar malocclusion status at ICU admission and loss of activities of daily living (ADL) at hospital discharge among acutely ill patients. Patients were assigned to the bilateral occlusion group or malocclusion group (N = 227 and 93, respectively). The following data were collected from electronic medical records: age, sex, Clinical Frailty Scale (CFS) on admission, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score, confirmed diagnosis (neurological disorders or others), CFS at hospital discharge, and occlusion condition. Patients who were frail at admission (CFS > 5) were excluded from analysis, and ADL loss was defined as CFS > 5 at hospital discharge. Multivariate analysis showed malocclusion was independently associated with ADL loss [OR, 2.03; 95% CI, 1.13-3.64; p = 0.02]. For those aged 65 and older, malocclusion was significantly associated with both ADL loss [OR, 3.25; 95% CI, 1.44-7.32; p < 0.01] and the incidence of delirium [OR, 2.61; 95% CI, 1.14-5.95; p = 0.02]. Malocclusion on ICU admission was associated with ADL loss in critically ill patients, and was associated with ADL loss and the incidence of delirium in the elderly. Poor oral health was a poor prognostic factor among critically ill patients.

  May 2021, Journal of clinical medicine, 10(10) (10), English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 敗血症マウスの脳内に浸潤したT細胞は、敗血症性脳症を抑制し、精神障害の回復を促進する

  齋藤 雅史, 藤浪 好寿, 大野 雄康, 大山 正平, 藤岡 一路, 山下 公大, 井上 茂亮, 小谷 穣治

  (一社)日本Shock学会, May 2021, Shock: 日本Shock学会雑誌, 35(1) (1), 37 - 37, Japanese


• Hyperoxemia during resuscitation of trauma patients and increased intensive care unit length of stay: inverse probability of treatment weighting analysis.

  Ryo Yamamoto, Seitaro Fujishima, Junichi Sasaki, Satoshi Gando, Daizoh Saitoh, Atsushi Shiraishi, Shigeki Kushimoto, Hiroshi Ogura, Toshikazu Abe, Toshihiko Mayumi, Joji Kotani, Taka-Aki Nakada, Yasukazu Shiino, Takehiko Tarui, Kohji Okamoto, Yuichiro Sakamoto, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Toru Hifumi, Kazuma Yamakawa, Akiyoshi Hagiwara, Yasuhiro Otomo

  BACKGROUND: Information on hyperoxemia among patients with trauma has been limited, other than traumatic brain injuries. This study aimed to elucidate whether hyperoxemia during resuscitation of patients with trauma was associated with unfavorable outcomes. METHODS: A post hoc analysis of a prospective observational study was carried out at 39 tertiary hospitals in 2016-2018 in adult patients with trauma and injury severity score (ISS) of > 15. Hyperoxemia during resuscitation was defined as PaO2 of ≥ 300 mmHg on hospital arrival and/or 3 h after arrival. Intensive care unit (ICU)-free days were compared between patients with and without hyperoxemia. An inverse probability of treatment weighting (IPW) analysis was conducted to adjust patient characteristics including age, injury mechanism, comorbidities, vital signs on presentation, chest injury severity, and ISS. Analyses were stratified with intubation status at the emergency department (ED). The association between biomarkers and ICU length of stay were then analyzed with multivariate models. RESULTS: Among 295 severely injured trauma patients registered, 240 were eligible for analysis. Patients in the hyperoxemia group (n = 58) had shorter ICU-free days than those in the non-hyperoxemia group [17 (10-21) vs 23 (16-26), p < 0.001]. IPW analysis revealed the association between hyperoxemia and prolonged ICU stay among patients not intubated at the ED [ICU-free days = 16 (12-22) vs 23 (19-26), p = 0.004], but not among those intubated at the ED [18 (9-20) vs 15 (8-23), p = 0.777]. In the hyperoxemia group, high inflammatory markers such as soluble RAGE and HMGB-1, as well as low lung-protective proteins such as surfactant protein D and Clara cell secretory protein, were associated with prolonged ICU stay. CONCLUSIONS: Hyperoxemia until 3 h after hospital arrival was associated with prolonged ICU stay among severely injured trauma patients not intubated at the ED. TRIAL REGISTRATION: UMIN-CTR, UMIN000019588 . Registered on November 15, 2015.

  Apr. 2021, World journal of emergency surgery : WJES, 16(1) (1), 19 - 19, English, International magazine

  Scientific journal


• Sepsis Induces Physical and Mental Impairments in a Mouse Model of Post-Intensive Care Syndrome.

  Yoshihisa Fujinami, Shigeaki Inoue, Yuko Ono, Yusuke Miyazaki, Kazumichi Fujioka, Kimihiro Yamashita, Joji Kotani

  Post-intensive care syndrome (PICS) is a physical, cognitive, and mental impairment observed in intensive care unit (ICU) survivors. Although this is an emerging problem in the ICU, how sepsis induces the characteristic symptoms of PICS remains unclear. To develop a model of PICS, we induced sepsis in male C57/B6 mice via sublethal cecum slurry injection and subsequently treated them using ICU-like interventions. At 1-2 weeks post-sepsis induction, we simultaneously evaluated the abilities of the surviving mice using the following behavioral tests: (1) a grip strength test (GST) and a treadmill test for physical assessment, (2) a novel object recognition test (NORT) for cognitive assessment, and (3) an open field test (OFT) and a marble burying test (MBT) for mental assessment. The surviving mice showed a range of deficits, including muscle weakness with significantly decreased grip strength in the GST; decreased total mileage during the treadmill test; anxiety and decreased activity, with significantly decreased time in the central area, and increased duration of immobility in the OFT; and an increased number of buried marbles in the MBT. Given these physical and mental impairments in the surviving mice, our model has the potential to elucidate mechanistic insights and to discover therapeutic targets and new interventions for PICS.

  Apr. 2021, Journal of clinical medicine, 10(8) (8), English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Factors associated with successful publication of research abstracts presented at the Japanese Society of Anesthesiologists annual meetings 2015-2017: a bibliometric analysis

  Yuko Ono, Masafumi Saito, Chiaki Shinohara, Kazuaki Shinohara, Shigeaki Inoue, Joji Kotani

  Background: Publication in a scientific journal is the desired outcome of the research cycle. However, previous anesthesiology research has not thoroughly examined factors predictive of subsequent publication after a meeting presentation. We aimed to assess the rate of peer-reviewed publication of abstracts presented at the Japanese Society of Anesthesiologists (JSA) annual meetings and identify factors associated with successful publication. Methods: This study included all abstracts presented at JSA meetings from 2015 to 2017. The outcome of interest was subsequent publication of abstracts in journals included in the MEDLINE database within 36 months after presentation. Differences between published and non-published abstracts were evaluated. Results: Among the 2,418 eligible abstracts, 487 were published within 3 years (publication rate, 20.1%). Multivariable logistic regression analysis showed that factors independently associated with subsequent publication were: presentation style (poster discussions: adjusted odds ratios (AOR) 1.70, 95% confidence interval [CI] 1.31-2.20; excellent abstracts: AOR 2.82, 95% CI 1.98-4.01); basic research (AOR 4.39, 95%CI 3.23-5.96), male first author (AOR 1.41, 95% CI 1.09-1.81); region (Kansai: AOR 2.16, 95% CI 1.57-2.99; abroad: AOR 4.57, 95% CI 2.58-8.09); facility characteristics (private university: AOR 3.97, 95% CI 2.60-6.08; public university: AOR 3.53, 95%CI 2.35-5.30; medical company: AOR 16.70, 95% CI 3.75-74.46); and number of collaborating facilities (two: AOR 1.50, 95% CI 1.15-1.97; three: AOR 1.83, 95% CI 1.23-2.73; four: AOR 2.40, 95% CI 1.27-4.54). Conclusions: Approximately one-fifth of abstracts presented at JSA meetings are published in peer-reviewed journals within 3 years. Factors independently associated with subsequent full publication are presentation style, basic research, male gender, specific region, affiliation characteristics, and number of collaborating facilities. Our data should stimulate further studies that elucidate ways to assist the full publication process of meeting abstracts.

  MRE Press, Mar. 2021, Signa Vitae, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Predictors of severe sepsis-related in-hospital mortality based on a multicenter cohort study: The Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma study.

  Akiyoshi Hagiwara, Noriko Tanaka, Yosuke Inaba, Satoshi Gando, Atsushi Shiraishi, Daizoh Saitoh, Yasuhiro Otomo, Hiroto Ikeda, Hiroshi Ogura, Shigeki Kushimoto, Joji Kotani, Yuichiro Sakamoto, Yasukazu Shiino, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Takehiko Tarui, Ryosuke Tsuruta, Taka-Aki Nakada, Toru Hifumi, Kazuma Yamakawa, Naoshi Takeyama, Norio Yamashita, Toshikazu Abe, Masashi Ueyama, Kohji Okamoto, Junichi Sasaki, Tomohiko Masuno, Toshihiko Mayumi, Seitaro Fujishima, Yutaka Umemura, Satoshi Fujimi

  ABSTRACT: This study aimed to identify prognostic factors for severe sepsis-related in-hospital mortality using the structural equation model (SEM) analysis with statistical causality. Sepsis data from the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma study (FORECAST), a multicenter cohort study, was used. Forty seven observed variables from the database were used to construct 4 latent variables. SEM analysis was performed on these latent variables to analyze the statistical causality among these data. This study evaluated whether the variables had an effect on in-hospital mortality. Overall, 1148 patients were enrolled. The SEM analysis showed that the 72-hour physical condition was the strongest latent variable affecting mortality, followed by physical condition before treatment. Furthermore, the 72-hour physical condition and the physical condition before treatment strongly influenced the Sequential Organ Failure Assessment (SOFA) score with path coefficients of 0.954 and 0.845, respectively. The SOFA score was the strongest variable that affected mortality after the onset of severe sepsis. The score remains the most robust prognostic factor and can facilitate appropriate policy development on care.

  Feb. 2021, Medicine, 100(8) (8), e24844, English, International magazine

  Scientific journal


• 中等度の血糖管理下にある敗血症患者における血糖異常の発生率と影響

  藤島 清太郎, 丸藤 哲, 齋藤 大蔵, 久志本 成樹, 小倉 裕司, 阿部 智一, 白石 淳, 真弓 俊彦, 佐々木 淳一, 小谷 穣治, 武山 直志, 鶴田 良介, 田熊 清継, 山下 典雄, 白石 振一郎, 池田 弘人, 椎野 泰和, 樽井 武彦, 中田 孝明, 一二三 亨

  (一社)日本病院総合診療医学会, Feb. 2021, 日本病院総合診療医学会雑誌, 17(臨増1) (臨増1), 162 - 162, Japanese


• Current spectrum of causative pathogens in sepsis: A prospective nationwide cohort study in Japan.

  Yutaka Umemura, Hiroshi Ogura, Kiyotsugu Takuma, Seitato Fujishima, Toshikazu Abe, Shigeki Kushimoto, Toru Hifumi, Akiyoshi Hagiwara, Atsushi Shiraishi, Yasuhiro Otomo, Daizoh Saitoh, Toshihiko Mayumi, Kazuma Yamakawa, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Kohji Okamoto, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Ryosuke Tsuruta, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Gando

  BACKGROUND: There is no one-size-fits-all empiric antimicrobial therapy for sepsis because the pathogens vary according to the site of infection and have changed over time. Therefore, updating knowledge on the spectrum of pathogens is necessary for the rapid administration of appropriate antimicrobials. OBJECTIVE: The aim of this study was to elucidate the current spectrum of pathogens and its variation by site of infection in sepsis. METHODS: This was a prospective nationwide cohort study of consecutive adult patients with sepsis in 59 intensive care units in Japan. The spectrum of pathogens was evaluated in all patients and in subgroups by site of infection. Regression analyses were conducted to evaluate the associations between the pathogens and mortality. RESULTS: The study cohort comprised 1184 patients. The most common pathogen was Escherichia coli (21.5%), followed by Klebsiella pneumoniae (9.0%). However, the pattern varied widely by site of infection; for example, gram-positive bacteria were the dominant pathogen in bone/soft tissue infection (55.7%) and cardiovascular infection (52.6%), but were rarely identified in urinary tract infection (6.4%). In contrast, gram-negative bacteria were the predominant pathogens in abdominal infection (38.4%) and urinary tract infection (72.0%). The highest mortality of 47.5% was observed in patients infected with methicillin-resistant Staphylococcus aureus, which was significantly associated with an increased risk of death (odds ratio 1.88, 95% confidence interval 1.22-2.91). CONCLUSIONS: This study revealed the current spectrum of pathogens and its variation based on the site of infection, which is essential for empiric antimicrobial therapy against sepsis.

  Feb. 2021, International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 103, 343 - 351, English, International magazine

  Scientific journal


• 日本版敗血症診療ガイドライン2020

  江木 盛時, 小倉 裕司, 矢田部 智昭, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 山川 一馬, 原 嘉孝, 大下 慎一郎, 青木 善孝, 稲田 麻衣, 梅村 穣, 河合 佑亮, 近藤 豊, 斎藤 浩輝, 櫻谷 正明, 對東 俊介, 武田 親宗, 寺山 毅郎, 東平 日出夫, 橋本 英樹, 林田 敬, 一二三 亨, 廣瀬 智也, 福田 龍将, 藤井 智子, 三浦 慎也, 安田 英人, 阿部 智一, 安藤 幸吉, 飯田 有輝, 石原 唯史, 井手 健太郎, 伊藤 健太, 伊藤 雄介, 稲田 雄, 宇都宮 明美, 卯野木 健, 遠藤 功二, 大内 玲, 尾崎 将之, 小野 聡, 桂 守弘, 川口 敦, 川村 雄介, 工藤 大介, 久保 健児, 倉橋 清泰, 櫻本 秀明, 下山 哲, 鈴木 武志, 関根 秀介, 関野 元裕, 高橋 希, 高橋 世, 高橋 弘, 田上 隆, 田島 吾郎, 巽 博臣, 谷 昌憲, 土谷 飛鳥, 堤 悠介, 内藤 貴基, 長江 正晴, 長澤 俊郎, 中村 謙介, 西村 哲郎, 布宮 伸, 則末 泰博, 橋本 悟, 長谷川 大祐, 畠山 淳司, 原 直己, 東別府 直紀, 古島 夏奈, 古薗 弘隆, 松石 雄二朗, 松山 匡, 峰松 佑輔, 宮下 亮一, 宮武 祐士, 森安 恵実, 山田 亨, 山田 博之, 山元 良, 吉田 健史, 吉田 悠平, 吉村 旬平, 四本 竜一, 米倉 寛, 和田 剛志, 渡邉 栄三, 青木 誠, 浅井 英樹, 安部 隆国, 五十嵐 豊, 井口 直也, 石川 雅巳, 石丸 剛, 磯川 修太郎, 板倉 隆太, 今長谷 尚史, 井村 春樹, 入野田 崇, 上原 健司, 生塩 典敬, 梅垣 岳志, 江川 裕子, 榎本 有希, 太田 浩平, 大地 嘉史, 大野 孝則, 大邉 寛幸, 岡 和幸, 岡田 信長, 岡田 遥平, 岡野 弘, 岡本 潤, 奥田 拓史, 小倉 崇以, 小野寺 悠, 小山 雄太, 貝沼 関志, 加古 英介, 柏浦 正広, 加藤 弘美, 金谷 明浩, 金子 唯, 金畑 圭太, 狩野 謙一, 河野 浩幸, 菊谷 知也, 菊地 斉, 城戸 崇裕, 木村 翔, 小網 博之, 小橋 大輔, 齊木 巌, 堺 正仁, 坂本 彩香, 佐藤 哲哉, 志賀 康浩, 下戸 学, 下山 伸哉, 庄古 知久, 菅原 陽, 杉田 篤紀, 鈴木 聡, 鈴木 祐二, 壽原 朋宏, 其田 健司, 高氏 修平, 高島 光平, 高橋 生, 高橋 洋子, 竹下 淳, 田中 裕記, 丹保 亜希仁, 角山 泰一朗, 鉄原 健一, 徳永 健太郎, 富岡 義裕, 冨田 健太朗, 富永 直樹, 豊崎 光信, 豊田 幸樹年, 内藤 宏道, 永田 功, 長門 直, 中村 嘉, 中森 裕毅, 名原 功, 奈良場 啓, 成田 知大, 西岡 典宏, 西村 朋也, 西山 慶, 野村 智久, 芳賀 大樹, 萩原 祥弘, 橋本 克彦, 旗智 武志, 浜崎 俊明, 林 拓也, 林 実, 速水 宏樹, 原口 剛, 平野 洋平, 藤井 遼, 藤田 基, 藤村 直幸, 舩越 拓, 堀口 真仁, 牧 盾, 増永 直久, 松村 洋輔, 真弓 卓也, 南 啓介, 宮崎 裕也, 宮本 和幸, 村田 哲平, 柳井 真知, 矢野 隆郎, 山田 浩平, 山田 直樹, 山本 朋納, 吉廣 尚大, 田中 裕, 西田 修, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本集中治療医学会, Feb. 2021, 日本集中治療医学会雑誌, 28(Suppl.) (Suppl.), S1 - S411, Japanese


• Association between low body mass index and increased 28-day mortality of severe sepsis in Japanese cohorts.

  Takehiko Oami, Satoshi Karasawa, Tadanaga Shimada, Taka-Aki Nakada, Toshikazu Abe, Hiroshi Ogura, Atsushi Shiraishi, Shigeki Kushimoto, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Yasukazu Shiino, Takehiko Tarui, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando

  Current research regarding the association between body mass index (BMI) and altered clinical outcomes of sepsis in Asian populations is insufficient. We investigated the association between BMI and clinical outcomes using two Japanese cohorts of severe sepsis (derivation cohort, Chiba University Hospital, n = 614; validation cohort, multicenter cohort, n = 1561). Participants were categorized into the underweight (BMI < 18.5) and non-underweight (BMI ≥ 18.5) groups. The primary outcome was 28-day mortality. Univariate analysis of the derivation cohort indicated increased 28-day mortality trend in the underweight group compared to the non-underweight group (underweight 24.4% [20/82 cases] vs. non-underweight 16.0% [85/532 cases]; p = 0.060). In the primary analysis, multivariate analysis adjusted for baseline imbalance revealed that patients in the underweight group had a significantly increased 28-day mortality compared to those in the non-underweight group (p = 0.031, adjusted odds ratio [OR] 1.91, 95% confidence interval [CI] 1.06-3.46). In a repeated analysis using a multicenter validation cohort (underweight n = 343, non-underweight n = 1218), patients in the underweight group had a significantly increased 28-day mortality compared to those in the non-underweight group (p = 0.045, OR 1.40, 95% CI 1.00-1.97). In conclusion, patients with a BMI < 18.5 had a significantly increased 28-day mortality compared to those with a BMI ≥ 18.5 in Japanese cohorts with severe sepsis.

  Jan. 2021, Scientific reports, 11(1) (1), 1615 - 1615, English, International magazine

  Scientific journal


• The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020)

  Moritoki Egi, Hiroshi Ogura, Tomoaki Yatabe, Kazuaki Atagi, Shigeaki Inoue, Toshiaki Iba, Yasuyuki Kakihana, Tatsuya Kawasaki, Shigeki Kushimoto, Yasuhiro Kuroda, Joji Kotani, Nobuaki Shime, Takumi Taniguchi, Ryosuke Tsuruta, Kent Doi, Matsuyuki Doi, Taka-aki Nakada, Masaki Nakane, Seitaro Fujishima, Naoto Hosokawa, Yoshiki Masuda, Asako Matsushima, Naoyuki Matsuda, Kazuma Yamakawa, Yoshitaka Hara, Masaaki Sakuraya, Shinichiro Ohshimo, Yoshitaka Aoki, Mai Inada, Yutaka Umemura, Yusuke Kawai, Yutaka Kondo, Hiroki Saito, Shunsuke Taito, Chikashi Takeda, Takero Terayama, Hideo Tohira, Hideki Hashimoto, Kei Hayashida, Toru Hifumi, Tomoya Hirose, Tatsuma Fukuda, Tomoko Fujii, Shinya Miura, Hideto Yasuda, Toshikazu Abe, Kohkichi Andoh, Yuki Iida, Tadashi Ishihara, Kentaro Ide, Kenta Ito, Yusuke Ito, Yu Inata, Akemi Utsunomiya, Takeshi Unoki, Koji Endo, Akira Ouchi, Masayuki Ozaki, Satoshi Ono, Morihiro Katsura, Atsushi Kawaguchi, Yusuke Kawamura, Daisuke Kudo, Kenji Kubo, Kiyoyasu Kurahashi, Hideaki Sakuramoto, Akira Shimoyama, Takeshi Suzuki, Shusuke Sekine, Motohiro Sekino, Nozomi Takahashi, Sei Takahashi, Hiroshi Takahashi, Takashi Tagami, Goro Tajima, Hiroomi Tatsumi, Masanori Tani, Asuka Tsuchiya, Yusuke Tsutsumi, Takaki Naito, Masaharu Nagae, Ichiro Nagasawa, Kensuke Nakamura, Tetsuro Nishimura, Shin Nunomiya, Yasuhiro Norisue, Satoru Hashimoto, Daisuke Hasegawa, Junji Hatakeyama, Naoki Hara, Naoki Higashibeppu, Nana Furushima, Hirotaka Furusono, Yujiro Matsuishi, Tasuku Matsuyama, Yusuke Minematsu, Ryoichi Miyashita, Yuji Miyatake, Megumi Moriyasu, Toru Yamada, Hiroyuki Yamada, Ryo Yamamoto, Takeshi Yoshida, Yuhei Yoshida, Jumpei Yoshimura, Ryuichi Yotsumoto, Hiroshi Yonekura, Takeshi Wada, Eizo Watanabe, Makoto Aoki, Hideki Asai, Takakuni Abe, Yutaka Igarashi, Naoya Iguchi, Masami Ishikawa, Go Ishimaru, Shutaro Isokawa, Ryuta Itakura, Hisashi Imahase, Haruki Imura, Takashi Irinoda, Kenji Uehara, Noritaka Ushio, Takeshi Umegaki, Yuko Egawa, Yuki Enomoto, Kohei Ota, Yoshifumi Ohchi, Takanori Ohno, Hiroyuki Ohbe, Kazuyuki Oka, Nobunaga Okada, Yohei Okada, Hiromu Okano, Jun Okamoto, Hiroshi Okuda, Takayuki Ogura, Yu Onodera, Yuhta Oyama, Motoshi Kainuma, Eisuke Kako, Masahiro Kashiura, Hiromi Kato, Akihiro Kanaya, Tadashi Kaneko, Keita Kanehata, Ken-ichi Kano, Hiroyuki Kawano, Kazuya Kikutani, Hitoshi Kikuchi, Takahiro Kido, Sho Kimura, Hiroyuki Koami, Daisuke Kobashi, Iwao Saiki, Masahito Sakai, Ayaka Sakamoto, Tetsuya Sato, Yasuhiro Shiga, Manabu Shimoto, Shinya Shimoyama, Tomohisa Shoko, Yoh Sugawara, Atsunori Sugita, Satoshi Suzuki, Yuji Suzuki, Tomohiro Suhara, Kenji Sonota, Shuhei Takauji, Kohei Takashima, Sho Takahashi, Yoko Takahashi, Jun Takeshita, Yuuki Tanaka, Akihito Tampo, Taichiro Tsunoyama, Kenichi Tetsuhara, Kentaro Tokunaga, Yoshihiro Tomioka, Kentaro Tomita, Naoki Tominaga, Mitsunobu Toyosaki, Yukitoshi Toyoda, Hiromichi Naito, Isao Nagata, Tadashi Nagato, Yoshimi Nakamura, Yuki Nakamori, Isao Nahara, Hiromu Naraba, Chihiro Narita, Norihiro Nishioka, Tomoya Nishimura, Kei Nishiyama, Tomohisa Nomura, Taiki Haga, Yoshihiro Hagiwara, Katsuhiko Hashimoto, Takeshi Hatachi, Toshiaki Hamasaki, Takuya Hayashi, Minoru Hayashi, Atsuki Hayamizu, Go Haraguchi, Yohei Hirano, Ryo Fujii, Motoki Fujita, Naoyuki Fujimura, Hiraku Funakoshi, Masahito Horiguchi, Jun Maki, Naohisa Masunaga, Yosuke Matsumura, Takuya Mayumi, Keisuke Minami, Yuya Miyazaki, Kazuyuki Miyamoto, Teppei Murata, Machi Yanai, Takao Yano, Kohei Yamada, Naoki Yamada, Tomonori Yamamoto, Shodai Yoshihiro, Hiroshi Tanaka, Osamu Nishida

  Jan. 2021, ACUTE MEDICINE & SURGERY, 8(1) (1), English

  Scientific journal


• Pathophysiology of Coagulopathy Induced by Traumatic Brain Injury Is Identical to That of Disseminated Intravascular Coagulation With Hyperfibrinolysis.

  Takeshi Wada, Atsushi Shiraishi, Satoshi Gando, Kazuma Yamakawa, Seitaro Fujishima, Daizoh Saitoh, Shigeki Kushimoto, Hiroshi Ogura, Toshikazu Abe, Toshihiko Mayumi, Junichi Sasaki, Joji Kotani, Naoshi Takeyama, Ryosuke Tsuruta, Kiyotsugu Takuma, Shin-Ichiro Shiraishi, Yasukazu Shiino, Taka-Aki Nakada, Kohji Okamoto, Yuichiro Sakamoto, Akiyoshi Hagiwara, Satoshi Fujimi, Yutaka Umemura, Yasuhiro Otomo

  Background: Traumatic brain injury (TBI)-associated coagulopathy is a widely recognized risk factor for secondary brain damage and contributes to poor clinical outcomes. Various theories, including disseminated intravascular coagulation (DIC), have been proposed regarding its pathomechanisms; no consensus has been reached thus far. This study aimed to elucidate the pathophysiology of TBI-induced coagulopathy by comparing coagulofibrinolytic changes in isolated TBI (iTBI) to those in non-TBI, to determine the associated factors, and identify the clinical significance of DIC diagnosis in patients with iTBI. Methods: This secondary multicenter, prospective study assessed patients with severe trauma. iTBI was defined as Abbreviated Injury Scale (AIS) scores ≥4 in the head and neck, and ≤2 in other body parts. Non-TBI was defined as AIS scores ≥4 in single body parts other than the head and neck, and the absence of AIS scores ≥3 in any other trauma-affected parts. Specific biomarkers for thrombin and plasmin generation, anticoagulation, and fibrinolysis inhibition were measured at the presentation to the emergency department (0 h) and 3 h after arrival. Results: We analyzed 34 iTBI and 40 non-TBI patients. Baseline characteristics, transfusion requirements and in-hospital mortality did not significantly differ between groups. The changes in coagulation/fibrinolysis-related biomarkers were similar. Lactate levels in the iTBI group positively correlated with DIC scores (rho = -0.441, p = 0.017), but not with blood pressure (rho = -0.098, p = 0.614). Multiple logistic regression analyses revealed that the injury severity score was an independent predictor of DIC development in patients with iTBI (odds ratio = 1.237, p = 0.018). Patients with iTBI were further subdivided into two groups: DIC (n = 15) and non-DIC (n = 19) groups. Marked thrombin and plasmin generation were observed in all patients with iTBI, especially those with DIC. Patients with iTBI and DIC had higher requirements for massive transfusion and emergency surgery, and higher in-hospital mortality than those without DIC. Furthermore, DIC development significantly correlated with poor hospital survival; DIC scores at 0 h were predictive of in-hospital mortality. Conclusions: Coagulofibrinolytic changes in iTBI and non-TBI patients were identical, and consistent with the pathophysiology of DIC. DIC diagnosis in the early phase of TBI is key in predicting the outcomes of severe TBI.

  2021, Frontiers in medicine, 8, 767637 - 767637, English, International magazine

  Scientific journal


• Characteristics and outcomes of frail patients with suspected infection in intensive care units: a descriptive analysis from a multicenter cohort study.

  Akira Komori, Toshikazu Abe, Kazuma Yamakawa, Hiroshi Ogura, Shigeki Kushimoto, Daizoh Saitoh, Seitaro Fujishima, Yasuhiro Otomo, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Yasukazu Shiino, Naoshi Takeyama, Takehiko Tarui, Ryosuke Tsuruta, Taka-Aki Nakada, Toru Hifumi, Hiroki Iriyama, Toshio Naito, Satoshi Gando

  BACKGROUND: Frailty is associated with morbidity and mortality in patients admitted to intensive care units (ICUs). However, the characteristics of frail patients with suspected infection remain unclear. We aimed to investigate the characteristics and outcomes of frail patients with suspected infection in ICUs. METHODS: This is a secondary analysis of a multicenter cohort study, including 22 ICUs in Japan. Adult patients (aged ≥16 years) with newly suspected infection from December 2017 to May 2018 were included. We compared baseline patient characteristics and outcomes among three frailty groups based on the Clinical Frailty Scale (CFS) score: fit (score, 1-3), vulnerable (score, 4), and frail (score, 5-9). We conducted subgroup analysis of patients with sepsis defined as per Sepsis-3 criteria. We also produced Kaplan-Meier survival curves for 90-day survival. RESULTS: We enrolled 650 patients with suspected infection, including 599 (92.2%) patients with sepsis. Patients with a median CFS score of 3 (interquartile range [IQR] 3-5) were included: 337 (51.8%) were fit, 109 (16.8%) were vulnerable, and 204 (31.4%) were frail. The median patient age was 72 years (IQR 60-81). The Sequential Organ Failure Assessment scores for fit, vulnerable, and frail patients were 7 (IQR 4-10), 8 (IQR 5-11), and 7 (IQR 5-10), respectively (p = 0.59). The median body temperatures of fit, vulnerable, and frail patients were 37.5 °C (IQR 36.5 °C-38.5 °C), 37.5 °C (IQR 36.4 °C-38.6 °C), and 37.0 °C (IQR 36.3 °C-38.1 °C), respectively (p < 0.01). The median C-reactive protein levels of fit, vulnerable, and frail patients were 13.6 (IQR 4.6-24.5), 12.1 (IQR 3.9-24.9), 10.5 (IQR 3.0-21.0) mg/dL, respectively (p < 0.01). In-hospital mortality did not statistically differ among the patients according to frailty (p = 0.19). Kaplan-Meier survival curves showed little difference in the mortality rate during short-term follow-up. However, more vulnerable and frail patients died after 30-day than fit patients; this difference was not statistically significant (p = 0.25). Compared with the fit and vulnerable groups, the rate of home discharge was lower in the frail group. CONCLUSION: Frail and vulnerable patients with suspected infection tend to have poor disease outcomes. However, they did not show a statistically significant increase in the 90-day mortality risk.

  Nov. 2020, BMC geriatrics, 20(1) (1), 485 - 485, English, International magazine

  Scientific journal


• Infiltrated regulatory T cells and Th2 cells in the brain contribute to attenuation of sepsis-associated encephalopathy and alleviation of mental impairments in mice with polymicrobial sepsis.

  Masafumi Saito, Yoshihisa Fujinami, Yuko Ono, Shohei Ohyama, Kazumichi Fujioka, Kimihiro Yamashita, Shigeaki Inoue, Joji Kotani

  Sepsis-associated encephalopathy (SAE) increases not only morbidity and mortality but has been associated with long-lasting mental impairment after hospital discharge in septic patients. Recently, studies have shown that these mental impairments are caused by infection-induced neuroinflammation. However, the role of T cells in the pathogenesis of SAE and mental impairments remains unclear. Thus, in this study, we aimed to clarify how immune cells, especially T cells, influence the development and recovery of these disorders. In the cecal slurry (CS)-induced septic mouse model, we performed three different kinds of behavioral tests, open-field test, marble burying test, and forced swimming test, and observed anxiety-like behavior in septic mice. Additionally, increased interleukin (IL)-1β and IL-6 expression levels, and infiltration of neutrophils and T cells were examined in the brain of septic mice, 10 days after sepsis onset. Twenty days after sepsis onset, the septic mice could recover the number of astrocytes. At day 30, expression levels of IL-1β and tumor necrosis factor (TNF)-α returned to normal levels in the cerebral cortex of septic mice. Interestingly, resolution of neuroinflammation and alleviation of depression were delayed in septic mice treated with FTY720, which inhibits sphingosine-1-phosphate (S1P)-dependent lymphocyte egress from lymph nodes. On analyzing the brain T cells with or without FTY720 in septic mice, the FTY720 untreated mice presented increased regulatory T cells (Treg) and Th2 cells in the brain, whereas the FTY720 treated mice demonstrated increased Th17 in the brain at day 30. Furthermore, in FTY720 treated septic mice, the number of astrocytes in the cerebral cortex remained reduced at day 30. These results suggest that infiltrated Treg and Th2 cells contribute to the attenuation SAE and alleviate SAE-induce mental disorder by resolving neuroinflammation in the chronic phase of sepsis.

  Nov. 2020, Brain, behavior, and immunity, 92, 25 - 38, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 新しい敗血症診断基準(sepsis-3)による多施設前向き登録研究 MAESTRO研究

  小倉 裕司, 丸藤 哲, 阿部 智一, 齋藤 大蔵, 久志本 成樹, 藤島 清太郎, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Nov. 2020, 日本救急医学会雑誌, 31(11) (11), 941 - 941, Japanese


• 敗血症と免疫抑制 新生児敗血症は、亜急性期においてT細胞とB細胞の減少を引き起こす

  大山 正平, 斎藤 雅史, 藤浪 好寿, 大野 雄康, 藤岡 一路, 井上 茂亮, 小谷 穣治

  (一社)日本集中治療医学会, Sep. 2020, 日本集中治療医学会雑誌, 27(Suppl.) (Suppl.), 339 - 339, Japanese


• 敗血症と免疫抑制 新生児敗血症は、亜急性期においてT細胞とB細胞の減少を引き起こす

  大山 正平, 斎藤 雅史, 藤浪 好寿, 大野 雄康, 藤岡 一路, 井上 茂亮, 小谷 穣治

  (一社)日本集中治療医学会, Sep. 2020, 日本集中治療医学会雑誌, 27(Suppl.) (Suppl.), 339 - 339, Japanese


• 日本版敗血症診療ガイドライン2020;ICU-AW・PICS・早期リハ・Patients Centered Therapy and Family Careを知る Patient-and Family-Centered Careに関する推奨解説

  河合 佑亮, 西田 修, 飯田 有輝, 宇都宮 明美, 古薗 弘隆, 山田 亨, 吉田 悠平, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会Patient-and Family-Centered Care班

  (一社)日本集中治療医学会, Sep. 2020, 日本集中治療医学会雑誌, 27(Suppl.) (Suppl.), 288 - 288, Japanese


• Interleukin-18 levels and mouse Leydig cell apoptosis during lipopolysaccharide-induced acute inflammatory conditions

  Taketo Inoue, Michiko Aoyama-Ishikawa, Mikiko Uemura, Hayato Yamashita, Yuka Koga, Mariko Terashima, Makoto Usami, Joji Kotani, Junichi Hirata

  Sep. 2020, JOURNAL OF REPRODUCTIVE IMMUNOLOGY, 141, 103167 - 103167, English, International magazine

  [Refereed]

  Scientific journal


• Precision and Safety of an Intravascular Temperature Management System for Postcardiac Arrest Syndrome Patients: A Multicenter Clinical Trial (COOL-ARREST JP).

  Tsuyoshi Maekawa, Kotaro Kaneda, Ryosuke Tsuruta, Yasuhiro Kuroda, Ken Nagao, Hiroshi Rinka, Takeshi Takahashi, Hiroyuki Yokota, Shin-Ichi Shirai, Mamoru Hase, Joji Kotani, Shigeatsu Endo

  Rapid induction and maintaining a target temperature of 32.0-36.0°C within a narrow range for <24 hours are essential, but those are very hard to perform in postcardiac arrest syndrome (PCAS) patients. We investigated the usability of an intravascular temperature management (IVTM) system with neurolept-anesthesia (NLA; droperidol and fentanyl). Single-arm, prospective multicenter trial was carried out in the seven university and the three affiliated hospitals. In the 24 comatose PCAS patients, the target temperature (33.0°C) was rapidly induced and maintained for 24 hours using an IVTM system with NLA. The rewarming speed was 0.1°C/h until 36.5°C and was maintained for 24 hours. The primary end point was the ability to achieve ≤34.0°C for <3 hours after starting cooling, and the secondary end points were the cooling rate, deviation from the target temperature, and adverse events. Cerebral Performance Category (CPC) score at 14 days was also evaluated. Statistical analyses were performed by SPSS software, using the intention-to-treat data sets. The target temperature of ≤34.0°C was reached by 45 minutes (35-73 minutes) and was within 3 hours in all patients. The cooling rate from 36.4°C to 33.0°C was 2.7°C/h (2.4-3.6°C/h). The temperature of 33.1°C (33.1-33.1°C) and 36.7°C (36.6-36.9°C) for 24 hours each was held during the maintenance and the after rewarming phases, respectively. Temperature deviations >0.2°C from 33.0°C in the maintenance phase occurred once each in two patients. The favorable neurological outcomes (CPC1, 2) were relatively good (50%). Five patients experienced serious adverse events; none was device related. We rapidly achieved therapeutic hypothermia within a narrow temperature range without major complications using the IVTM system with NLA in PCAS patients.

  Sep. 2020, Therapeutic hypothermia and temperature management, 10(3) (3), 179 - 185, English, International magazine

  [Refereed]

  Scientific journal


• 日本版敗血症診療ガイドライン2020;栄養療法・血糖管理・ストレス潰瘍対策を知る 栄養療法とストレス潰瘍予防の推奨解説

  小谷 穣治, 原 嘉孝, 矢田部 智昭, 東別府 直紀, 中村 謙介, 巽 博臣, 土谷 飛鳥, 高橋 世, 磯川 修太郎, 大野 孝則, 大邉 寛幸, 増永 直久, 城戸 崇裕, 小橋 大輔, 高氏 修平, 野村 智久, 庄古 知久, 江木 盛時, 小倉 裕司, 西田 修, 田中 裕, J-SSCG2020特別委員会栄養班・ストレス潰瘍班

  (一社)日本集中治療医学会, Sep. 2020, 日本集中治療医学会雑誌, 27(Suppl.) (Suppl.), 264 - 264, Japanese


• 日本版敗血症診療ガイドライン2020;栄養療法・血糖管理・ストレス潰瘍対策を知る 日本版敗血症診療ガイドライン2020 栄養・ストレス潰瘍のEvidence解説

  原 嘉孝, 小谷 穣治, 矢田部 智昭, 東別府 直紀, 中村 謙介, 巽 博臣, 土谷 飛鳥, 高橋 世, 磯川 修太郎, 大野 孝則, 大邉 寛幸, 齊木 巌, 増永 直久, 城戸 崇裕, 小橋 大輔, 高氏 修平, 野村 智久, 庄古 知久, 江木 盛時, 小倉 裕司, 西田 修, 田中 裕, J-SSCG2020特別委員会栄養管理班

  (一社)日本集中治療医学会, Sep. 2020, 日本集中治療医学会雑誌, 27(Suppl.) (Suppl.), 264 - 264, Japanese


• The significance of disseminated intravascular coagulation on multiple organ dysfunction during the early stage of acute respiratory distress syndrome.

  Satoshi Gando, Seitaro Fujishima, Daizoh Saitoh, Atsushi Shiraishi, Kazuma Yamakawa, Shigeki Kushimoto, Hiroshi Ogura, Toshikazu Abe, Toshihiko Mayumi, Junichi Sasaki, Joji Kotani, Naoshi Takeyama, Ryosuke Tsuruta, Kiyotsugu Takuma, Norio Yamashita, Shin-Ichiro Shiraishi, Hiroto Ikeda, Yasukazu Shiino, Takehiko Tarui, Taka-Aki Nakada, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Yuichiro Sakamoto, Akiyoshi Hagiwara, Tomohiko Masuno, Masashi Ueyama, Satoshi Fujimi, Yutaka Umemura

  BACKGROUND: Multiple organ dysfunction syndrome (MODS) is a predominant cause of death in acute respiratory distress syndrome (ARDS). Disseminated intravascular coagulation (DIC) is recognized as a syndrome that frequently develops MODS. To test the hypothesis that DIC scores are useful for predicting MODS development and that DIC is associated with MODS, we retrospectively analyzed the data of a prospective, multicenter study on ARDS. METHODS: Patients who met the Berlin definition of ARDS were included. DIC scores as well as the disease severity and the development of MODS on the day of the diagnosis of ARDS (day 0) and day 3 were evaluated. The primary and secondary outcomes were the development of MODS and the hospital mortality. RESULTS: In the 129 eligible patients, the prevalence of DIC was 45.7% (59/129). DIC patients were more seriously ill and exhibited a higher prevalence of MODS on days 0 and 3 than non-DIC patients. The DIC scores on day 0 detected the development of MODS with good area under the receiver operating characteristic curve (0.714, p<.001). DIC on day 0 was significantly associated with MODS on days 0 and 3 (odds ratio 1.53 and 1.34, respectively). Patients with persistent DIC from days 0 to 3 had higher rates of both MODS on day 3 (p=.035) and hospital mortality (p=.031) than the other patients. CONCLUSIONS: DIC scores were able to predict MODS, and DIC was associated with MODS during the early stage of ARDS. Persistent DIC may also have role in this association.

  Jul. 2020, Thrombosis research, 191, 15 - 21, English, International magazine

  [Refereed]

  Scientific journal


• Significance of body temperature in elderly patients with sepsis.

  Takashi Shimazui, Taka-Aki Nakada, Keith R Walley, Taku Oshima, Toshikazu Abe, Hiroshi Ogura, Atsushi Shiraishi, Shigeki Kushimoto, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Yasukazu Shiino, Takehiko Tarui, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando

  BACKGROUND: Elderly patients have a blunted host response, which may influence vital signs and clinical outcomes of sepsis. This study was aimed to investigate whether the associations between the vital signs and mortality are different in elderly and non-elderly patients with sepsis. METHODS: This was a retrospective observational study. A Japanese multicenter sepsis cohort (FORECAST, n = 1148) was used for the discovery analyses. Significant discovery results were tested for replication using two validation cohorts of sepsis (JAAMSR, Japan, n = 624; SPH, Canada, n = 1004). Patients were categorized into elderly and non-elderly groups (age ≥ 75 or < 75 years). We tested for association between vital signs (body temperature [BT], heart rate, mean arterial pressure, systolic blood pressure, and respiratory rate) and 90-day in-hospital mortality (primary outcome). RESULTS: In the discovery cohort, non-elderly patients with BT < 36.0 °C had significantly increased 90-day mortality (P = 0.025, adjusted hazard ratio 1.70, 95% CI 1.07-2.71). In the validation cohorts, non-elderly patients with BT < 36.0 °C had significantly increased mortality (JAAMSR, P = 0.0024, adjusted hazard ratio 2.05, 95% CI 1.29-3.26; SPH, P = 0.029, adjusted hazard ratio 1.36, 95% CI 1.03-1.80). These differences were not observed in elderly patients in the three cohorts. Associations between the other four vital signs and mortality were not different in elderly and non-elderly patients. The interaction of age and hypothermia/fever was significant (P < 0.05). CONCLUSIONS: In septic patients, we found mortality in non-elderly sepsis patients was increased with hypothermia and decreased with fever. However, mortality in elderly patients was not associated with BT. These results illuminate the difference in the inflammatory response of the elderly compared to non-elderly sepsis patients.

  Jun. 2020, Critical care (London, England), 24(1) (1), 387 - 387, English, International magazine

  Scientific journal


• Lower maximum forces on oral structures when using gum-elastic bougie than when using endotracheal tube and stylet during both direct and indirect laryngoscopy by novices: a crossover study using a high-fidelity simulator.

  Ono Y, Shinohara K, Shimada J, Inoue S, Kotani J

  BMC Emerg Med, May 2020, BMC Emerg Med. 2020;20(1):34., 20(1) (1), 34, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Complementary Role of Hypothermia Identification to the Quick Sequential Organ Failure Assessment Score in Predicting Patients With Sepsis at High Risk of Mortality: A Retrospective Analysis From a Multicenter, Observational Study.

  Shigeki Kushimoto, Satoshi Gando, Hiroshi Ogura, Yutaka Umemura, Daizoh Saitoh, Toshihiko Mayumi, Seitaro Fujishima, Toshikazu Abe, Atsushi Shiraishi, Hiroto Ikeda, Joji Kotani, Yasuo Miki, Shin-Ichiro Shiraishi, Koichiro Suzuki, Yasushi Suzuki, Naoshi Takeyama, Kiyotsugu Takuma, Ryosuke Tsuruta, Yoshihiro Yamaguchi, Norio Yamashita, Naoki Aikawa

  BACKGROUND: Although the quick Sequential Organ Failure Assessment (qSOFA) has been recommended for identifying patients at higher risk of hospital death, it has only a 60% sensitivity for in-hospital mortality. On the other hand, hypothermia associates with increased mortality and organ failure in patients with sepsis. This study aimed to assess the predictive validity of qSOFA for identifying patients with sepsis at higher risk of multiple organ dysfunction or death and the complementary effect of hypothermia. METHODS: Patients with severe sepsis admitted to intensive care units (ICUs) were retrospectively analyzed. The predictive validities of qSOFA (≥2, positive) and the complementary effect of hypothermia (body temperature ≤36.5°C) for the identification of death or multiorgan dysfunction were evaluated. RESULTS: Of the 624 patients, 230 (36.9%) developed multiorgan dysfunction and 144 (23.1%) died within 28 days; 527 (84.5%) had a positive qSOFA. The 28-day mortality rates of patients with positive and negative qSOFA were 25.4% and 10.3%, respectively (P = .001). The rate of positive qSOFA was higher in patients with multiorgan dysfunction (sensitivity, 0.896; specificity, 0.185) and among patients who died within 28 days (sensitivity, 0.931; specificity, 0.181); 10 (6.9%) of 144 deaths were not identified. In cases of positive qSOFA without hypothermia, positive qSOFA + hypothermia, or negative qSOFA with hypothermia, the predictive value for 28-day mortality improved (sensitivity, 0.979). Among the 144 patients who died, only 3 were not identified. CONCLUSION: A qSOFA score ≥2 may identify >90% of 28-day deaths among patients with severe sepsis; hypothermia may complement the predictive ability of qSOFA.

  May 2020, Journal of intensive care medicine, 35(5) (5), 502 - 510, English, International magazine

  [Refereed]

  Scientific journal


• History of diabetes may delay antibiotic administration in patients with severe sepsis presenting to emergency departments.

  Toshikazu Abe, Tomoharu Suzuki, Shigeki Kushimoto, Seitaro Fujishima, Takehiro Sugiyama, Masao Iwagami, Hiroshi Ogura, Atsushi Shiraishi, Daizoh Saitoh, Toshihiko Mayumi, Hiroki Iriyama, Akira Komori, Taka-Aki Nakada, Yasukazu Shiino, Takehiko Tarui, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Kiyotsugu Takuma, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Gando

  Clinical manifestations of sepsis differ between patients with and without diabetes mellitus (DM), and these differences could influence the clinical behaviors of medical staff. Therefore, we aimed to investigate whether pre-existing DM was associated with the time to antibiotics or sepsis care protocols.This was a retrospective cohort study.It conducted at 53 intensive care units (ICUs) in Japan.Consecutive adult patients with severe sepsis admitted directly to ICUs form emergency departments from January 2016 to March 2017 were included.The primary outcome was time to antibiotics.Of the 619 eligible patients, 142 had DM and 477 did not have DM. The median times (interquartile ranges) to antibiotics in patients with and without DM were 103 minutes (60-180 minutes) and 86 minutes (45-155 minutes), respectively (P = .05). There were no significant differences in the rates of compliance with sepsis protocols or with patient-centred outcomes such as in-hospital mortality. The mortality rates of patients with and without DM were 23.9% and 21.6%, respectively (P = .55). Comparing patients with and without DM, the gamma generalized linear model-adjusted relative difference indicated that patients with DM had a delay to starting antibiotics of 26.5% (95% confidence intervals (95%CI): 4.6-52.8, P = .02). The gamma generalized linear model-adjusted relative difference with multiple imputation for missing data of sequential organ failure assessment was 19.9% (95%CI: 1.0-42.3, P = .04). The linear regression model-adjusted beta coefficient indicated that patients with DM had a delay to starting antibiotics of 29.2 minutes (95%CI: 6.8-51.7, P = .01). Logistic regression modelling showed that pre-existing DM was not associated with in-hospital mortality (odds ratio, 1.26; 95%CI: 0.72-2.19, P = .42).Pre-existing DM was associated with delayed antibiotic administration among patients with severe sepsis or septic shock; however, patient-centred outcomes and compliance with sepsis care protocols were comparable.

  Mar. 2020, Medicine, 99(11) (11), e19446, English, International magazine

  [Refereed]

  Scientific journal


• Characteristics and outcomes of bacteremia among ICU-admitted patients with severe sepsis.

  Akira Komori, Toshikazu Abe, Shigeki Kushimoto, Hiroshi Ogura, Atsushi Shiraishi, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Toshio Naito, Toru Hifumi, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando

  The clinical implications of bacteremia among septic patients remain unclear, although a vast amount of data have been accumulated on sepsis. We aimed to compare the clinical characteristics and outcomes of severe sepsis patients with and without bacteremia. This secondary analysis of a multicenter, prospective cohort study included 59 intensive care units (ICUs) in Japan between January 2016 and March 2017. The study cohort comprised 1,184 adults (aged ≥ 16 years) who were admitted to an ICU with severe sepsis and diagnosed according to the Sepsis-2 criteria. Of 1,167 patients included in the analysis, 636 (54.5%) had bacteremia. Those with bacteremia had significantly higher rates of septic shock (66.4% vs. 58.9%, p = 0.01) and higher sepsis severity scores, including the Acute Physiology and Chronic Health Evaluation (APACHE) II and the Sequential Organ Failure Assessment (SOFA). No significant difference in in-hospital mortality was seen between patients with and without bacteremia (25.6% vs. 21.0%, p = 0.08). In conclusion, half of severe sepsis patients in ICUs have bacteremia. Although patients with bacteremia had more severe state, between-group differences in patient-centered outcomes, such as in-hospital mortality, have not been fully elucidated.

  Feb. 2020, Scientific reports, 10(1) (1), 2983 - 2983, English, International magazine

  [Refereed]

  Scientific journal


• 高齢マウス反復感染モデルにおける長期的な疲弊の機序解明とIL-15の効果

  齋藤 雅史, 井上 茂亮, 藤岡 一路, 小谷 穣治

  (一社)日本Shock学会, Feb. 2020, Shock: 日本Shock学会雑誌, 34(2) (2), 72 - 72, Japanese


• IL-15 Improves Aging-Induced Persistent T Cell Exhaustion in Mouse Models of Repeated Sepsis.

  Masafumi Saito, Shigeaki Inoue, Kimihiro Yamashita, Yoshihiro Kakeji, Takumi Fukumoto, Joji Kotani

  Aging is a grave problem in sepsis, and T cell exhaustion is the main cause of sepsis-induced immunosuppression. Sepsis- and aging-induced T cell exhaustion is related to secondary infection with a poor long-term outcome in the elderly. However, the trend, impact, and mechanism of T cell exhaustion are still unclear. Interleukin (IL)-15 improves survival rate of septic mice via its antiapoptotic effect on T cells; however, it is still unclear how IL-15 reverses prolonged T cell exhaustion in aged septic mice. The purpose of this study was to clarify the trend of sepsis-induced T cell exhaustion and whether IL-15 prevents aging-induced persistent T cell exhaustion in septic mice. Preserved cecal slurry was injected intraperitoneally into young (6-week-old) and aged mice (18-24-month-old) 4 times, to induce clinically relevant repeated sepsis. IL-15 (1.5 μg) or phosphate-buffered saline was injected subcutaneously 3 times, body weight was serially measured, and peripheral blood cells from their cheek were serially collected for 50 days. Sepsis-induced T cell exhaustion was significantly severe in aged mice than in young mice and was accompanied with decreased naive CD4 and CD8 T cells (P < 0.01) and increased expression of program death 1 on T cell (P < 0.01) and regulatory T cell population (P < 0.01). IL-15 significantly improved sepsis-induced T exhaustion, with significantly increased numbers of natural killer cells and macrophages, and significantly enhanced phagocytosis activity in aged septic mice (P < 0.05). It decreased the long-term mortality associated with sepsis survivors by improving T cell exhaustion over an extended duration and also ameliorated aging-induced persistent T cell exhaustion in septic mice.

  Feb. 2020, Shock (Augusta, Ga.), 53(2) (2), 228 - 235, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• How Does Antimicrobial Stewardship Affect Inappropriate Antibiotic Therapy in Urological Patients?

  Atsushi Uda, Katsumi Shigemura, Koichi Kitagawa, Kayo Osawa, Kenichiro Onuma, Shigeaki Inoue, Joji Kotani, Yonmin Yan, Yuzo Nakano, Tatsuya Nishioka, Ikuko Yano, Takayuki Miyara, Masato Fujisawa

  Feb. 2020, ANTIBIOTICS-BASEL, 9(2) (2), English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• TAK-242, a specific inhibitor of Toll-like receptor 4 signalling, prevents endotoxemia-induced skeletal muscle wasting in mice.

  Yuko Ono, Yuko Maejima, Masafumi Saito, Kazuho Sakamoto, Shoichiro Horita, Kenju Shimomura, Shigeaki Inoue, Joji Kotani

  Circulating lipopolysaccharide (LPS) concentrations are often elevated in patients with sepsis or various endogenous diseases related to bacterial translocation from the gut. Systemic inflammatory responses induced by endotoxemia induce severe involuntary loss of skeletal muscle, termed muscle wasting, which adversely affects the survival and functional outcomes of these patients. Currently, no drugs are available for the treatment of endotoxemia-induced skeletal muscle wasting. Here, we tested the effects of TAK-242, a Toll-like receptor 4 (TLR4)-specific signalling inhibitor, on myotube atrophy in vitro and muscle wasting in vivo induced by endotoxin. LPS treatment of murine C2C12 myotubes induced an inflammatory response (increased nuclear factor-κB activity and interleukin-6 and tumour necrosis factor-α expression) and activated the ubiquitin-proteasome and autophagy proteolytic pathways (increased atrogin-1/MAFbx, MuRF1, and LC-II expression), resulting in myotube atrophy. In mice, LPS injection increased the same inflammatory and proteolytic pathways in skeletal muscle and induced atrophy, resulting in reduced grip strength. Notably, pretreatment of cells or mice with TAK-242 reduced or reversed all the detrimental effects of LPS in vitro and in vivo. Collectively, our results indicate that pharmacological inhibition of TLR4 signalling may be a novel therapeutic intervention for endotoxemia-induced muscle wasting.

  Jan. 2020, Scientific reports, 10(1) (1), 694 - 694, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Intravenous immunoglobulin g modulates the expression of sepsis-induced coagulopathy factors and increases serum igm levels: A prospective, single-center intervention study

  Yukihiro Ando, Shigeaki Inoue, Takahisa Kawashima, Masahiro Okashiro, Joji Kotani, Takashi Nishiyama

  Kobe University School of Medicine, 2020, Kobe Journal of Medical Sciences, 66(1) (1), E32 - E39, English

  Scientific journal


• Clinical characteristics of patients with severe sepsis and septic shock in relation to bacterial virulence of beta‐hemolytic Streptococcus and Streptococcus pneumoniae

  Toru Hifumi, Seitaro Fujishima, Kimiko Ubukata, Akiyoshi Hagiwara, Toshikazu Abe, Hiroshi Ogura, Atsushi Shiraishi, Shigeki Kushimoto, Daizoh Saitoh, Toshihiko Mayumi, Hiroto Ikeda, Masashi Ueyama, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Yasukazu Shiino, Shin‐ichiro Shiraishi, Kiyotsugu Takuma, Takehiko Tarui, Ryosuke Tsuruta, Taka‐aki Nakada, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Satoshi Fujimi, Satoshi Gando

  Wiley, Jan. 2020, Acute Medicine & Surgery, 7(1) (1)

  [Refereed]

  Scientific journal


• The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020（J-SSCG 2020）

  江木 盛時, 小倉 裕司, 矢田部 智昭, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 山川 一馬, 原 嘉孝, 大下 慎一郎, 青木 善孝, 稲田 麻衣, 梅村 穣, 河合 佑亮, 近藤 豊, 斎藤 浩輝, 櫻谷 正明, 對東 俊介, 武田 親宗, 寺山 毅郎, 東平 日出夫, 橋本 英樹, 林田 敬, 一二三 亨, 廣瀬 智也, 福田 龍将, 藤井 智子, 三浦 慎也, 安田 英人, 阿部 智一, 安藤 幸吉, 飯田 有輝, 石原 唯史, 井手 健太郎, 伊藤 健太, 伊藤 雄介, 稲田 雄, 宇都宮 明美, 卯野木 健, 遠藤 功二, 大内 玲, 尾崎 将之, 小野 聡, 桂 守弘, 川口 敦, 川村 雄介, 工藤 大介, 久保 健児, 倉橋 清泰, 櫻本 秀明, 下山 哲, 鈴木 武志, 関根 秀介, 関野 元裕, 高橋 希, 高橋 世, 高橋 弘, 田上 隆, 田島 吾郎, 巽 博臣, 谷 昌憲, 土谷 飛鳥, 堤 悠介, 内藤 貴基, 長江 正晴, 長澤 俊郎, 中村 謙介, 西村 哲郎, 布宮 伸, 則末 泰博, 橋本 悟, 長谷川 大祐, 畠山 淳司, 原 直己, 東別府 直紀, 古島 夏奈, 古薗 弘隆, 松石 雄二朗, 松山 匡, 峰松 佑輔, 宮下 亮一, 宮武 祐士, 森安 恵実, 山田 亨, 山田 博之, 山元 良, 吉田 健史, 吉田 悠平, 吉村 旬平, 四本 竜一, 米倉 寛, 和田 剛志, 渡邉 栄三, 青木 誠, 浅井 英樹, 安部 隆国, 五十嵐 豊, 井口 直也, 石川 雅巳, 石丸 剛, 磯川 修太郎, 板倉 隆太, 今長谷 尚史, 井村 春樹, 入野田 崇, 上原 健司, 生塩 典敬, 梅垣 岳志, 江川 裕子, 榎本 有希, 太田 浩平, 大地 嘉史, 大野 孝則, 大邉 寛幸, 岡 和幸, 岡田 信長, 岡田 遥平, 岡野 弘, 岡本 潤, 奥田 拓史, 小倉 崇以, 小野寺 悠, 小山 雄太, 貝沼 関志, 加古 英介, 柏浦 正広, 加藤 弘美, 金谷 明浩, 金子 唯, 金畑 圭太, 狩野 謙一, 河野 浩幸, 菊谷 知也, 菊地 斉, 城戸 崇裕, 木村 翔, 小網 博之, 小橋 大輔, 齊木 巌, 堺 正仁, 坂本 彩香, 佐藤 哲哉, 志賀 康浩, 下戸 学, 下山 伸哉, 庄古 知久, 菅原 陽, 杉田 篤紀, 鈴木 聡, 鈴木 祐二, 壽原 朋宏, 其田 健司, 高氏 修平, 高島 光平, 高橋 生, 高橋 洋子, 竹下 淳, 田中 裕記, 丹保 亜希仁, 角山 泰一朗, 鉄原 健一, 徳永 健太郎, 富岡 義裕, 冨田 健太朗, 富永 直樹, 豊﨑 光信, 豊田 幸樹年, 内藤 宏道, 永田 功, 長門 直, 中村 嘉, 中森 裕毅, 名原 功, 奈良場 啓, 成田 知大, 西岡 典宏, 西村 朋也, 西山 慶, 野村 智久, 芳賀 大樹, 萩原 祥弘, 橋本 克彦, 旗智 武志, 浜崎 俊明, 林 拓也, 林 実, 速水 宏樹, 原口 剛, 平野 洋平, 藤井 遼, 藤田 基, 藤村 直幸, 舩越 拓, 堀口 真仁, 牧 盾, 増永 直久, 松村 洋輔, 真弓 卓也, 南 啓介, 宮崎 裕也, 宮本 和幸, 村田 哲平, 柳井 真知, 矢野 隆郎, 山田 浩平, 山田 直樹, 山本 朋納, 吉廣 尚大, 田中 裕, 西田 修, 日本版敗血症診療ガイドライン2020特別委員会

  日本集中治療医学会と日本救急医学会は，合同の特別委員会を組織し，2016 年に発表した日本版敗血症診療ガイドライン（J-SSCG） 2016 の改訂を行った。本ガイドライン（J-SSCG 2020）の目的は，J-SSCG 2016 と同様に，敗血症・敗血症性ショックの診療において，医療従事者が患者の予後改善のために適切な判断を下す支援を行うことである。改訂に際し，一般臨床家だけでなく多職種医療者にも理解しやすく，かつ質の高いガイドラインとすることによって，広い普及を目指した。J-SSCG 2016 ではSSCG 2016 にない新しい領域［ICU-acquired weakness（ ICU-AW）と post-intensive care syndrome（PICS），体温管理など］を取り上げたが，J-SSCG 2020 では新たに注目すべき4 領域（Patient-and Family-Centered Care，sepsis treatment system，神経集中治療，ストレス潰瘍）を追加し，計22 領域とした。重要な118 の臨床課題（clinical question：CQ）をエビデンスの有無にかかわらず抽出した。これらのCQ には，本邦で特に注目されているCQ も含まれる。多領域にわたる大規模ガイドラインであることから，委員25 名を中心に，多職種（看護師，理学療法士，臨床工学技士，薬剤師）および患者経験者も含めたワーキンググループメンバー，両学会の公募によるシステマティックレビューメンバーによる総勢226 名の参加・協力を得た。また，中立的な立場で横断的に活躍するアカデミックガイドライン推進班をJ-SSCG 2016 に引き続き組織した。将来への橋渡しとなることを企図して，多くの若手医師をシステマティックレビューチーム・ワーキンググループに登用し，学会や施設の垣根を越えたネットワーク構築も進めた。作成工程においては，質の担保と作業過程の透明化を図るために様々な工夫を行い，パブリックコメント募集は計2 回行った。推奨作成にはGRADE方式を取り入れ，修正Delphi 法を用いて全委員の投票により推奨を決定した。結果，118CQ に対する回答として，79 個のGRADE による推奨，5 個のGPS（good practice statement），18 個のエキスパートコンセンサス，27 個のBQ（background question）の解説，および敗血症の定義と診断を示した。新たな試みとして，CQ ごとに診療フローなど時間軸に沿った視覚的情報を取り入れた。J-SSCG 2020 は，多職種が関わる国内外の敗血症診療の現場において，ベッドサイドで役立つガイドラインとして広く活用されることが期待される。なお，本ガイドラインは，日本集中治療医学会と日本救急医学会の両機関誌のガイドライン増刊号として同時掲載するものである。

  The Japanese Society of Intensive Care Medicine, 2020, Journal of the Japanese Society of Intensive Care Medicine, 28(Supplement) (Supplement), n/a, Japanese


• Impact of blood glucose abnormalities on outcomes and disease severity in patients with severe sepsis: An analysis from a multicenter, prospective survey of severe sepsis.

  Shigeki Kushimoto, Toshikazu Abe, Hiroshi Ogura, Atsushi Shiraishi, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Toru Hifumi, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando

  BACKGROUND: Dysglycemia is frequently observed in patients with sepsis. However, the relationship between dysglycemia and outcome is inconsistent. We evaluate the clinical characteristics, glycemic abnormalities, and the relationship between the initial glucose level and mortality in patients with sepsis. METHODS: This is a retrospective sub-analysis of a multicenter, prospective cohort study. Adult patients with severe sepsis (Sepsis-2) were divided into groups based on blood glucose categories (<70 (hypoglycemia), 70-139, 140-179, and ≥180 mg/dL), according to the admission values. In-hospital mortality and the relationship between pre-existing diabetes and septic shock were evaluated. RESULTS: Of 1158 patients, 69, 543, 233, and 313 patients were categorized as glucose levels <70, 70-139, 140-179, ≥180 mg/dL, respectively. Both the Acute Physiological and Chronic Health Evaluation II and Sequential Organ Failure Assessment (SOFA) scores on the day of enrollment were higher in the hypoglycemic patients than in those with 70-179 mg/dL. The hepatic SOFA scores were also higher in hypoglycemic patients. In-hospital mortality rates were higher in hypoglycemic patients than in those with 70-139 mg/dL (26/68, 38.2% vs 43/221, 19.5%). A significant relationship between mortality and hypoglycemia was demonstrated only in patients without known diabetes. Mortality in patients with both hypoglycemia and septic shock was 2.5-times higher than that in patients without hypoglycemia and septic shock. CONCLUSIONS: Hypoglycemia may be related to increased severity and high mortality in patients with severe sepsis. These relationships were evident only in patients without known diabetes. Patients with both hypoglycemia and septic shock had an associated increased mortality rate.

  2020, PloS one, 15(3) (3), e0229919, English, International magazine

  [Refereed]

  Scientific journal


• Epidemiology of sepsis and septic shock in intensive care units between sepsis-2 and sepsis-3 populations: sepsis prognostication in intensive care unit and emergency room (SPICE-ICU).

  Toshikazu Abe, Kazuma Yamakawa, Hiroshi Ogura, Shigeki Kushimoto, Daizoh Saitoh, Seitaro Fujishima, Yasuhiro Otomo, Joji Kotani, Yutaka Umemura, Yuichiro Sakamoto, Junichi Sasaki, Yasukazu Shiino, Naoshi Takeyama, Takehiko Tarui, Shin-Ichiro Shiraishi, Ryosuke Tsuruta, Taka-Aki Nakada, Toru Hifumi, Akiyoshi Hagiwara, Masashi Ueyama, Norio Yamashita, Tomohiko Masuno, Hiroto Ikeda, Akira Komori, Hiroki Iriyama, Satoshi Gando

  Background: Diagnosing sepsis remains difficult because it is not a single disease but a syndrome with various pathogen- and host factor-associated symptoms. Sepsis-3 was established to improve risk stratification among patients with infection based on organ failures, but it has been still controversial compared with previous definitions. Therefore, we aimed to describe characteristics of patients who met sepsis-2 (severe sepsis) and sepsis-3 definitions. Methods: This was a multicenter, prospective cohort study conducted by 22 intensive care units (ICUs) in Japan. Adult patients (≥ 16 years) with newly suspected infection from December 2017 to May 2018 were included. Those without infection at final diagnosis were excluded. Patient's characteristics and outcomes were described according to whether they met each definition or not. Results: In total, 618 patients with suspected infection were admitted to 22 ICUs during the study, of whom 530 (85.8%) met the sepsis-2 definition and 569 (92.1%) met the sepsis-3 definition. The two groups comprised different individuals, and 501 (81.1%) patients met both definitions. In-hospital mortality of study population was 19.1%. In-hospital mortality among patients with sepsis-2 and sepsis-3 patients was comparable (21.7% and 19.8%, respectively). Patients exclusively identified with sepsis-2 or sepsis-3 had a lower mortality (17.2% vs. 4.4%, respectively). No patients died if they did not meet any definitions. Patients who met sepsis-3 shock definition had higher in-hospital mortality than those who met sepsis-2 shock definition. Conclusions: Most patients with infection admitted to ICU meet sepsis-2 and sepsis-3 criteria. However, in-hospital mortality did not occur if patients did not meet any criteria. Better criteria might be developed by better selection and combination of elements in both definitions. Trial registration: UMIN000027452.

  2020, Journal of intensive care, 8, 44 - 44, English, International magazine

  Scientific journal


• Risk modifiers of acute respiratory distress syndrome in patients with non-pulmonary sepsis: a retrospective analysis of the FORECAST study.

  Hiroki Iriyama, Toshikazu Abe, Shigeki Kushimoto, Seitaro Fujishima, Hiroshi Ogura, Atsushi Shiraishi, Daizoh Saitoh, Toshihiko Mayumi, Toshio Naito, Akira Komori, Toru Hifumi, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando

  Background: Predisposing conditions and risk modifiers instead of causes and risk factors have recently been used as alternatives to identify patients at a risk of acute respiratory distress syndrome (ARDS). However, data regarding risk modifiers among patients with non-pulmonary sepsis is rare. Methods: We conducted a secondary analysis of the multicenter, prospective, Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis and Trauma (FORECAST) cohort study that was conducted in 59 intensive care units (ICUs) in Japan during January 2016-March 2017. Adult patients with severe sepsis caused by non-pulmonary infection were included, and the primary outcome was having ARDS, defined as meeting the Berlin definition on the first or fourth day of screening. Multivariate logistic regression modeling was used to identify risk modifiers associated with ARDS, and odds ratios (ORs) and their 95% confidence intervals were reported. The following explanatory variables were then assessed: age, sex, admission source, body mass index, smoking status, congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, steroid use, statin use, infection site, septic shock, and acute physiology and chronic health evaluation (APACHE) II score. Results: After applying inclusion and exclusion criteria, 594 patients with non-pulmonary sepsis were enrolled, among whom 85 (14.3%) had ARDS. Septic shock was diagnosed in 80% of patients with ARDS and 66% of those without ARDS (p = 0.01). APACHE II scores were higher in patients with ARDS [26 (22-33)] than in those without ARDS [21 (16-28), p < 0.01]. In the multivariate logistic regression model, the following were independently associated with ARDS: ICU admission source [OR, 1.89 (1.06-3.40) for emergency department compared with hospital wards], smoking status [OR, 0.18 (0.06-0.59) for current smoking compared with never smoked], infection site [OR, 2.39 (1.04-5.40) for soft tissue infection compared with abdominal infection], and APACHE II score [OR, 1.08 (1.05-1.12) for higher compared with lower score]. Conclusions: Soft tissue infection, ICU admission from an emergency department, and a higher APACHE II score appear to be the risk modifiers of ARDS in patients with non-pulmonary sepsis.

  2020, Journal of intensive care, 8, 7 - 7, English, International magazine

  [Refereed]

  Scientific journal


• Implementation of earlier antibiotic administration in patients with severe sepsis and septic shock in Japan: a descriptive analysis of a prospective observational study.

  Toshikazu Abe, Shigeki Kushimoto, Yasuharu Tokuda, Gary S Phillips, Andrew Rhodes, Takehiro Sugiyama, Akira Komori, Hiroki Iriyama, Hiroshi Ogura, Seitaro Fujishima, Atsushi Shiraishi, Daizoh Saitoh, Toshihiko Mayumi, Toshio Naito, Kiyotsugu Takuma, Taka-Aki Nakada, Yasukazu Shiino, Takehiko Tarui, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Gando

  BACKGROUND: Time to antibiotic administration is a key element in sepsis care; however, it is difficult to implement sepsis care bundles. Additionally, sepsis is different from other emergent conditions including acute coronary syndrome, stroke, or trauma. We aimed to describe the association between time to antibiotic administration and outcomes in patients with severe sepsis and septic shock in Japan. METHODS: This prospective observational study enrolled 1184 adult patients diagnosed with severe sepsis based on the Sepsis-2 criteria and admitted to 59 intensive care units (ICUs) in Japan between January 1, 2016, and March 31, 2017, as the sepsis cohort of the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis and Trauma (FORECAST) study. We compared the characteristics and in-hospital mortality of patients administered with antibiotics at varying durations after sepsis recognition, i.e., 0-60, 61-120, 121-180, 181-240, 241-360, and 361-1440 min, and estimated the impact of antibiotic timing on risk-adjusted in-hospital mortality using the generalized estimating equation model (GEE) with an exchangeable, within-group correlation matrix, with "hospital" as the grouping variable. RESULTS: Data from 1124 patients in 54 hospitals were used for analyses. Of these, 30.5% and 73.9% received antibiotics within 1 h and 3 h, respectively. Overall, the median time to antibiotic administration was 102 min [interquartile range (IQR), 55-189]. Compared with patients diagnosed in the emergency department [90 min (IQR, 48-164 min)], time to antibiotic administration was shortest in patients diagnosed in ICUs [60 min (39-180 min)] and longest in patients transferred from wards [120 min (62-226)]. Overall crude mortality was 23.4%, where patients in the 0-60 min group had the highest mortality (28.0%) and a risk-adjusted mortality rate [28.7% (95% CI 23.3-34.1%)], whereas those in the 61-120 min group had the lowest mortality (20.2%) and risk-adjusted mortality rates [21.6% (95% CI 16.5-26.6%)]. Differences in mortality were noted only between the 0-60 min and 61-120 min groups. CONCLUSIONS: We could not find any association between earlier antibiotic administration and reduction in in-hospital mortality in patients with severe sepsis.

  Nov. 2019, Critical care (London, England), 23(1) (1), 360 - 360, English, International magazine

  [Refereed]

  Scientific journal


• Identifying Sepsis Populations Benefitting from Anticoagulant Therapy: A Prospective Cohort Study Incorporating a Restricted Cubic Spline Regression Model.

  Kazuma Yamakawa, Satoshi Gando, Hiroshi Ogura, Yutaka Umemura, Daijiro Kabata, Ayumi Shintani, Atsushi Shiraishi, Daizoh Saitoh, Seitato Fujishima, Toshihiko Mayumi, Shigeki Kushimoto, Toshikazu Abe, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi

  BACKGROUND:  Anticoagulant therapy has seldom been achieved in randomized trials targeting nonspecific overall sepsis patients. Although the key components to identify the appropriate target in sepsis may be disseminated intravascular coagulation (DIC) and high disease severity, the interaction and relation of these two components for the effectiveness of therapy remain unknown. OBJECTIVE:  This article identifies the optimal target of anticoagulant therapy in sepsis. METHODS:  We used a prospective nationwide cohort targeting consecutive adult severe sepsis patients in 59 intensive care units in Japan to assess associations between anticoagulant therapy and in-hospital mortality according to DIC (International Society on Thrombosis and Haemostasis [ISTH] overt and Japanese Association for Acute Medicine DIC scores) and disease severity (Acute Physiology and Chronic Health Evaluation II [APACHE II] and Sequential Organ Failure Assessment scores). Multivariable Cox proportional hazard regression analysis with nonlinear restricted cubic spline including a two-way interaction term (treatment × each score) and three-way interaction term (treatment × ISTH overt DIC score × APACHE II score) was performed. RESULTS:  The final study cohort comprised 1,178 sepsis patients (371 received anticoagulants and 768 did not). The regression model including the two-way interaction term showed significant interaction between intervention and disease severity as indicated by the ISTH overt DIC score and APACHE II score (p = 0.046 and p = 0.101, respectively). Three-way interaction analysis revealed that risk hazard was suppressed in the anticoagulant group compared with the control group in the most severe subset of both scores. CONCLUSION:  Anticoagulant therapy was associated with better outcome according to the deterioration of both DIC and disease severity, suggesting that anticoagulant therapy should be restricted to patients having DIC and high disease severity simultaneously.

  Nov. 2019, Thrombosis and haemostasis, 119(11) (11), 1740 - 1751, English, International magazine

  [Refereed]

  Scientific journal


• 日本版敗血症診療ガイドライン2020(J-SSCG2020)のチャレンジ

  小倉 裕司, 江木 盛時, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会

  日本蘇生学会, Oct. 2019, 蘇生, 38(3) (3), 120 - 120, Japanese


• Trends in sepsis care in Japan: comparison of two sepsis cohort studies conducted by the Japanese Association for Acute Medicine.

  Fujishima S, Gando S, Saitoh D, Kushimoto S, Ogura H, Abe T, Shiraishi A, Mayumi T, Sasaki J, Kotani J, Takeyama N, Tsuruta R, Takuma K, Yamashita N, Shiraishi SI, Ikeda H, Shiino Y, Tarui T, Nakada TA, Hifumi T, Otomo Y, Okamoto K, Sakamoto Y, Hagiwara A, Masuno T, Ueyama M, Fujimi S, Yamakawa K, Umemura Y

  Wiley, Oct. 2019, Acute medicine & surgery, 6(4) (4), 425 - 427

  [Refereed]


• 日本版敗血症治療ガイドライン2020 Coming Soon! J-SSCG2016から2020へのバトンタッチ

  西田 修, 小倉 裕司, 江木 盛時, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 581 - 581, Japanese


• 日本版敗血症治療ガイドライン2020 Coming Soon! J-SSCG2020のチャレンジ 組織づくりと新たな取り組み

  小倉 裕司, 江木 盛時, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 581 - 581, Japanese


• 日本版敗血症治療ガイドライン2020 Coming Soon! 使ってもらえるガイドラインに挑む 小児領域の取り組み

  川崎 達也, 小倉 裕司, 江木 盛時, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 582 - 582, Japanese


• 日本版敗血症治療ガイドライン2020 Coming Soon! JSSCG2020の公開方法と見える化の革新

  中田 孝明, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 582 - 582, Japanese


• 日本版敗血症治療ガイドライン2020 Coming Soon! J-SSCGの作成を通した多職種・多学会の連携は敗血症診療に何をもたらすか?

  松嶋 麻子, 小倉 裕司, 江木 盛時, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 582 - 582, Japanese


• JAAM FORECAST DIC研究

  山川 一馬, 丸藤 哲, 梅村 穣, 小倉 裕司, 白石 淳, 阿部 智一, 齋藤 大蔵, 久志本 成樹, 藤島 清太郎, 真弓 俊彦, 池田 弘人, 射場 敏明, 上山 昌史, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 617 - 617, Japanese

  [Refereed]


• FORECAST研究・SPICE研究・MAESTRO研究の全体像と目指すもの

  小倉 裕司, 丸藤 哲, 阿部 智一, 齋藤 大蔵, 久志本 成樹, 藤島 清太郎, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 616 - 616, Japanese

  [Refereed]


• 急兵呼吸促迫症候群(ARDS)の疫学、治療状況と転帰 FORECAST-ARDS研究報告

  藤島 清太郎, 丸藤 哲, 阿部 智一, 小倉 裕司, 齋藤 大蔵, 久志本 成樹, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 616 - 616, Japanese

  [Refereed]


• 敗血症患者における体温異常と臨床的特徴、初期治療および臨床転帰 The FORECAST study副研究

  久志本 成樹, 丸藤 哲, 阿部 智一, 小倉 裕司, 齋藤 大蔵, 藤島 清太郎, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 616 - 616, Japanese

  [Refereed]


• 敗血症患者における入院時血糖値異常と臨床的特徴、重症化および臨床転帰 The FORECAST study副研究

  久志本 成樹, 丸藤 哲, 阿部 智一, 小倉 裕司, 齋藤 大蔵, 藤島 清太郎, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 616 - 616, Japanese

  [Refereed]


• β溶連菌と肺炎球菌による重症敗血症と敗血症性ショック患者の病原性と臨床的特徴

  一二三 亨, 藤島 清太郎, 丸藤 哲, 阿部 智一, 小倉 裕司, 齋藤 大蔵, 久志本 成樹, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 増野 智彦, 山川 一馬, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 616 - 616, Japanese

  [Refereed]


• Impact of the academic calendar cycle on survival outcome of injured patients: a retrospective cohort study at a community emergency department in Japan.

  Ono Y, Kakamu T, Ishida T, Sasaki T, Inoue S, Kotani J, Shinohara K

  BACKGROUND:
  Commencement of a new academic cycle is presumed to be associated with poor patient outcomes. However, supportive evidence is limited for trauma patients treated in under-resourced hospitals, especially those who require specialized interventions and with little physiological reserve. We examined whether a new academic cycle affects the survival outcomes of injured patients in a typical Japanese teaching hospital.
  
  METHODS:
  This historical cohort study was conducted at a Japanese community emergency department (ED). All injured patients brought to the ED from April 2002 to March 2018 were included in the analysis. The primary exposure was presentation to the ED during the first quartile of the academic cycle (April-June). The primary outcome measure was the hospital mortality rate.
  
  RESULTS:
  Of the 20,945 eligible patients, 5282 (25.2%) were admitted during the first quartile. In the univariable analysis, the hospital mortality rate was similar between patients admitted during the first quartile of the academic year and those admitted during the remaining quartiles (4.1% vs. 4.4%, respectively; odds ratio [OR], 0.931; 95% confidence interval [CI] 0.796-1.088). After adjusting for the potential confounding factors of the injury severity score, age, sex, Glasgow coma scale score, systolic blood pressure, trauma etiology (blunt or penetrating), and admission phase (2002-2005, 2006-2009, 2010-2013, and 2014-2018), no statistically significant association was present between first-quartile admission and trauma death (adjusted OR 0.980; 95% CI 0.748-1.284). Likewise, when patients were subgrouped according to age of > 55 years, injury severity score of > 15, Glasgow coma scale score of < 9, systolic blood pressure of < 90 mmHg, requirement for doctor car system dispatches, emergency operation, emergency endotracheal intubation, and weekend and night presentation, no significant associations were present between first-quartile admission and hospital mortality in both the univariable and multivariable analysis.
  
  CONCLUSIONS:
  At a community hospital in Japan, admission at the beginning of the academic year was not associated with an increased risk of hospital mortality among trauma patients, even those requiring specialized interventions and with little physiological reserve. Our results support the uniformity of trauma care provision throughout the academic cycle in a typical Japanese trauma system.

  Aug. 2019, J Intensive Care, 7(39) (39), English

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Resection for a Recurrent Mucus-Producing Cholangiocarcinoma After Surgery: a Case Report

  Isamu Yamada, Tetsuo Ajiki, Hirohiko Onoyama, Michiko Ishikawa, Joji Kotani, Yonson Ku

  Jul. 2019, INTERNATIONAL SURGERY, 104(7-8) (7-8), 358 - 363, English

  Scientific journal


• Demographics, Treatments, and Outcomes of Acute Respiratory Distress Syndrome: The Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma (Forecast) Study.

  Fujishima S, Gando S, Saitoh D, Kushimoto S, Ogura H, Abe T, Shiraishi A, Mayumi T, Sasaki J, Kotani J, Takeyama N, Tsuruta R, Takuma K, Yamashita N, Shiraishi SI, Ikeda H, Shiino Y, Tarui T, Nakada TA, Hifumi T, Otomo Y, Okamoto K, Sakamoto Y, Hagiwara A, Masuno T, Ueyama M, Fujimi S, Yamakawa K, Umemura Y, JAAM FORECAST ARDS, Study Group

  Jul. 2019, Shock (Augusta, Ga.)

  [Refereed]


• In-hospital mortality associated with the misdiagnosis or unidentified site of infection at admission.

  Abe T, Tokuda Y, Shiraishi A, Fujishima S, Mayumi T, Sugiyama T, Deshpande GA, Shiino Y, Hifumi T, Otomo Y, Okamoto K, Kotani J, Sakamoto Y, Sasaki J, Shiraishi SI, Takuma K, Hagiwara A, Yamakawa K, Takeyama N, Gando S, JAAM SPICE, Study Group

  Jun. 2019, Critical care (London, England), 23(1) (1), 202

  [Refereed]

  Link to Kobe Univ. Repository (Kernel)


• Impact of Body Temperature Abnormalities on the Implementation of Sepsis Bundles and Outcomes in Patients With Severe Sepsis: A Retrospective Sub-Analysis of the Focused Outcome Research on Emergency Care for Acute Respiratory Distress Syndrome, Sepsis and Trauma Study.

  Shigeki Kushimoto, Toshikazu Abe, Hiroshi Ogura, Atsushi Shiraishi, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Toru Hifumi, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando

  OBJECTIVES: To investigate the impact of body temperature on disease severity, implementation of sepsis bundles, and outcomes in severe sepsis patients. DESIGN: Retrospective sub-analysis. SETTING: Fifty-nine ICUs in Japan, from January 2016 to March 2017. PATIENTS: Adult patients with severe sepsis based on Sepsis-2 were enrolled and divided into three categories (body temperature < 36°C, 36-38°C, > 38°C), using the core body temperature at ICU admission. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Compliance with the bundles proposed in the Surviving Sepsis Campaign Guidelines 2012, in-hospital mortality, disposition after discharge, and the number of ICU and ventilator-free days were evaluated. Of 1,143 enrolled patients, 127, 565, and 451 were categorized as having body temperature less than 36°C, 36-38°C, and greater than 38°C, respectively. Hypothermia-body temperature less than 36°C-was observed in 11.1% of patients. Patients with hypothermia were significantly older than those with a body temperature of 36-38°C or greater than 38°C and had a lower body mass index and higher prevalence of septic shock than those with body temperature greater than 38°C. Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores on the day of enrollment were also significantly higher in hypothermia patients. Implementation rates of the entire 3-hour bundle and administration of broad-spectrum antibiotics significantly differed across categories; implementation rates were significantly lower in patients with body temperature less than 36°C than in those with body temperature greater than 38°C. Implementation rate of the entire 3-hour resuscitation bundle + vasopressor use + remeasured lactate significantly differed across categories, as did the in-hospital and 28-day mortality. The odds ratio for in-hospital mortality relative to the reference range of body temperature greater than 38°C was 1.760 (95% CI, 1.134-2.732) in the group with hypothermia. The proportions of ICU-free and ventilator-free days also significantly differed between categories and were significantly smaller in patients with hypothermia. CONCLUSIONS: Hypothermia was associated with a significantly higher disease severity, mortality risk, and lower implementation of sepsis bundles.

  May 2019, Critical care medicine, 47(5) (5), 691 - 699, English, International magazine

  [Refereed]

  Scientific journal


• Nighttime and non-business days are not associated with increased risk of in-hospital mortality in patients with severe sepsis in intensive care units in Japan: The JAAM FORECAST study.

  Matsumura Y, Nakada TA, Abe T, Ogura H, Shiraishi A, Kushimoto S, Saitoh D, Fujishima S, Mayumi T, Shiino Y, Tarui T, Hifumi T, Otomo Y, Okamoto K, Umemura Y, Kotani J, Sakamoto Y, Sasaki J, Shiraishi SI, Takuma K, Tsuruta R, Hagiwara A, Yamakawa K, Masuno T, Takeyama N, Yamashita N, Ikeda H, Ueyama M, Fujimi S, Gando S, JAAM FORECAST, Study Group

  Apr. 2019, Journal of critical care, 52, 97 - 102, English

  [Refereed]

  Scientific journal


• 日本版敗血症診療ガイドライン2020を展望する:New Challenge! J-SSCG2020におけるチャレンジと課題 新たな組織、作業工程

  江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本集中治療医学会, Feb. 2019, 日本集中治療医学会雑誌, 26(Suppl.) (Suppl.), [JPD1 - 1], Japanese


• 日本版敗血症診療ガイドライン2020を展望する:New Challenge! JSSCG2020 GLのバンドル化への期待Expectation for bundling JSSCG2020

  垣花 泰之, 小倉 裕司, 江木 盛時, 安宅 一晃, 井上 茂亮, 射場 敏明, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本集中治療医学会, Feb. 2019, 日本集中治療医学会雑誌, 26(Suppl.) (Suppl.), [JPD1 - 7], Japanese


• アンチトロンビンによるneutrophil extracellular traps(NETs)抑制効果についての検討

  小濱 圭祐, 石川 倫子, 藤崎 宣友, 山田 太平, 滿保 直美, 小谷 穣治, 藤原 智弘, 白井 邦博, 大家 宗彦, 平田 淳一

  (一社)日本集中治療医学会, Feb. 2019, 日本集中治療医学会雑誌, 26(Suppl.) (Suppl.), [O23 - 3], Japanese


• 日本版敗血症診療ガイドライン2020を展望する:New Challenge! JSSCG2020 注目領域Pick Up!抗菌薬治療

  志馬 伸朗, 小倉 裕司, 江木 盛時, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本集中治療医学会, Feb. 2019, 日本集中治療医学会雑誌, 26(Suppl.) (Suppl.), [JPD1 - 2], Japanese


• 日本版敗血症診療ガイドライン2020を展望する:New Challenge! JSSCG2020 注目領域Pick Up!小児

  川崎 達也, 小倉 裕司, 江木 盛時, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本集中治療医学会, Feb. 2019, 日本集中治療医学会雑誌, 26(Suppl.) (Suppl.), [JPD1 - 3], Japanese


• 日本版敗血症診療ガイドライン2020を展望する:New Challenge! JSSCG2020 注目領域Pick Up!神経集中治療

  黒田 泰弘, 小倉 裕司, 江木 盛時, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本集中治療医学会, Feb. 2019, 日本集中治療医学会雑誌, 26(Suppl.) (Suppl.), [JPD1 - 6], Japanese


• 日本版敗血症診療ガイドライン2020を展望する:New Challenge! JSSCGの将来展望 目指すべきもの

  小倉 裕司, 江木 盛時, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本集中治療医学会, Feb. 2019, 日本集中治療医学会雑誌, 26(Suppl.) (Suppl.), [JPD1 - 8], Japanese


• Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: the FORECAST study.

  Toshikazu Abe, Hiroshi Ogura, Atsushi Shiraishi, Shigeki Kushimoto, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando

  BACKGROUND: Sepsis is a leading cause of death and long-term disability in developed countries. A comprehensive report on the incidence, clinical characteristics, and evolving management of sepsis is important. Thus, this study aimed to evaluate the characteristics, management, and outcomes of patients with severe sepsis in Japan. METHODS: This is a cohort study of the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma (FORECAST) study, which was a multicenter, prospective cohort study conducted at 59 intensive care units (ICUs) from January 2016 to March 2017. We included adult patients with severe sepsis based on the sepsis-2 criteria. RESULTS: In total, 1184 patients (median age 73 years, interquartile range (IQR) 64-81) with severe sepsis were admitted to the ICU during the study period. The most common comorbidity was diabetes mellitus (23%). Moreover, approximately 63% of patients had septic shock. The median Sepsis-related Organ Failure Assessment (SOFA) score was 9 (IQR 6-11). The most common site of infection was the lung (31%). Approximately 54% of the participants had positive blood cultures. The compliance rates for the entire 3-h bundle, measurement of central venous pressure, and assessment of central venous oxygen saturation were 64%, 26%, and 7%, respectively. A multilevel logistic regression model showed that closed ICUs and non-university hospitals were more compliant with the entire 3-h bundle. The in-hospital mortality rate of patients with severe sepsis was 23% (21-26%). Older age, multiple comorbidities, suspected site of infection, and increasing SOFA scores correlated with in-hospital mortality, based on the generalized estimating equation model. The length of hospital stay was 24 (12-46) days. Approximately 37% of the patients were discharged home after recovery. CONCLUSION: Our prospective study showed that sepsis management in Japan was characterized by a high compliance rate for the 3-h bundle and low compliance rate for central venous catheter measurements. The in-hospital mortality rate in Japan was comparable to that of other developed countries. Only one third of the patients were discharged home, considering the aging population with multiple comorbidities in the ICUs in Japan. TRIAL REGISTRATION: UMIN-CTR, UMIN000019742 . Registered on 16 November 2015.

  Nov. 2018, Critical care (London, England), 22(1) (1), 322 - 322, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• β溶連菌と肺炎球菌による重症敗血症と敗血症性ショック患者の病原性と臨床的特徴

  一二三 亨, 藤島 清太郎, 萩原 章嘉, 小倉 裕司, 丸藤 哲, 齋藤 大蔵, 久志本 成樹, 真弓 俊彦, 阿部 智一, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 大友 康裕, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 増野 智彦, 山川 一馬, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 415 - 415, Japanese


• 記述疫学 感染部位と予後

  阿部 智一, 小倉 裕司, 白石 淳, 久志本 成樹, 齋藤 大蔵, 藤島 清太郎, 真弓 俊彦, 一二三 亨, 椎野 泰和, 中田 孝明, 樽井 武彦, 大友 康裕, 岡本 好司, 梅村 穣, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 白石 振一郎, 田熊 清継, 鶴田 良介, 萩原 章嘉, 山川 一馬, 増野 智彦, 武山 直志, 山下 典雄, 池田 弘人, 上山 昌史, 藤見 聡, 丸藤 哲, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 414 - 414, Japanese


• 日本版敗血症診療ガイドライン(J-SSCG)2020:新たなチャレンジと課題 J-SSCG2016作成の成果 SSCG2016との比較

  西田 修, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 322 - 322, Japanese


• 日本版敗血症診療ガイドライン(J-SSCG)2020:新たなチャレンジと課題 J-SSCG2020におけるチャレンジと課題 新たな組織、作業工程

  江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 322 - 322, Japanese


• 日本版敗血症診療ガイドライン(J-SSCG)2020:新たなチャレンジと課題 J-SSCG2020におけるチャレンジと課題 エビデンスの確実性と推奨の設定方法

  山川 一馬, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 322 - 322, Japanese


• 日本版敗血症診療ガイドライン(J-SSCG)2020:新たなチャレンジと課題 注目すべき項目 Management phaseにおけるJ-SSCGオリジナル課題

  久志本 成樹, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 323 - 323, Japanese


• 日本版敗血症診療ガイドライン(J-SSCG)2020:新たなチャレンジと課題 J-SSCG2020におけるチャレンジと課題 小児(定義と治療アルゴリズムを中心に)

  志馬 伸朗, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 323 - 323, Japanese


• 日本版敗血症診療ガイドライン(J-SSCG)2020:新たなチャレンジと課題 J-SSCG2020におけるチャレンジと課題 新たな項目とCQ選択

  小倉 裕司, 江木 盛時, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 322 - 322, Japanese


• 日本版敗血症診療ガイドライン(J-SSCG)2020:新たなチャレンジと課題 注目すべき項目 Resuscitation phase(ショック管理など)

  垣花 泰之, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 322 - 322, Japanese


• JAAM FORECAST Sepsis研究 敗血症治療における補助・支持療法の治療疫学

  小谷 穣治, 樽井 武彦, 久志本 成樹, 小倉 裕司, 丸藤 哲, 阿部 智一, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 大友 康裕, 岡本 好司, 齋藤 大蔵, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 淳, 白石 振一郎, 田熊 清継, 武山 直志, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 藤島 清太郎, 増野 智彦, 真弓 俊彦, 山川 一馬, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 414 - 414, Japanese

  [Refereed]


• 【高齢者の救急医療】 PostICU syndrome/ICU-AWの概念 特に高齢者の場合

  井上茂亮, 齋藤雅史

  Oct. 2018, Geriatric Medicine, 56(10号) (10号), 951 - 956, Japanese

  [Refereed]

  Scientific journal


• New Biomarkers for Prediction of Disseminated Intravascular Coagulation in Patients With Sepsis

  Wakabayashi I, Mambo N, Ueda T, Nonaka D, Lee LJ, Tanaka K, Kotani J

  Complication of disseminated intravascular coagulation (DIC) is a determinant of the prognosis for patients with sepsis. The purpose of this study was to find DIC-related peptides in blood for prediction and early diagnosis of DIC in patients with sepsis. The participants were 20 patients with sepsis (age: 68.9 ± 11.4 years) and they were divided into 2 groups with (n = 8) and without (n = 12) a complication of DIC. Peptides in the serum of the patients were inclusively analyzed by a new method for peptidome analysis using a target plate, BLOTCHIP. By differential analysis of peptides in the blood from patients in the groups with and without DIC, we selected 13 mass spectrometry (MS) peaks as candidate marker peptides for prediction of DIC. By subsequent MS/MS structural analysis, 8 peptides were successfully identified as marker peptides for DIC in patients with sepsis. The peptides were fragments of serum amyloid A-2 protein, α2-HS-glycoprotein, fibrinogen α chain, fibrinogen β chain, serum albumin, collagen α1 (I) chain, collagen α1 (III) chain, and coagulation factor XIII A chain. In receiver-operating characteristic analysis for the relationships between the marker peptides and DIC, the area under the curve for each of these peptides was 0.594 to 0.760. We identified 8 blood marker peptides for prediction of DIC complication in patients with sepsis. Further studies by direct measurements of the serum peptide levels in larger numbers of patients with sepsis-induced DIC are needed to confirm the findings of this study.

  Oct. 2018, Clin Appl Thromb Hemost, 24(9_suppl) (9_suppl), 223S-229S, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 本邦における敗血症診療ガイドライン作成の意義とその恩恵

  小倉 裕司, 西田 修, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞弘 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  (一社)日本集中治療医学会, Feb. 2018, 日本集中治療医学会雑誌, 25(Suppl.) (Suppl.), [CP1 - 2], Japanese


• The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016).

  Nishida O, Ogura H, Egi M, Fujishima S, Hayashi Y, Iba T, Imaizumi H, Inoue S, Kakihana Y, Kotani J, Kushimoto S, Masuda Y, Matsuda N, Matsushima A, Nakada TA, Nakagawa S, Nunomiya S, Sadahiro T, Shime N, Yatabe T, Hara Y, Hayashida K, Kondo Y, Sumi Y, Yasuda H, Aoyama K, Azuhata T, Doi K, Doi M, Fujimura N, Fuke R, Fukuda T, Goto K, Hasegawa R, Hashimoto S, Hatakeyama J, Hayakawa M, Hifumi T, Higashibeppu N, Hirai K, Hirose T, Ide K, Kaizuka Y, Kan'o T, Kawasaki T, Kuroda H, Matsuda A, Matsumoto S, Nagae M, Onodera M, Ohnuma T, Oshima K, Saito N, Sakamoto S, Sakuraya M, Sasano M, Sato N, Sawamura A, Shimizu K, Shirai K, Takei T, Takeuchi M, Takimoto K, Taniguchi T, Tatsumi H, Tsuruta R, Yama N, Yamakawa K, Yamashita C, Yamashita K, Yoshida T, Tanaka H, Oda S

  BACKGROUND AND PURPOSE: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 and published in the Journal of JSICM, [2017; Volume 24 (supplement 2)] 10.3918/jsicm.24S0001 and Journal of Japanese Association for Acute Medicine [2017; Volume 28, (supplement 1)] http://onlinelibrary.wiley.com/doi/10.1002/jja2.2017.28.issue-S1/issuetoc.This abridged English edition of the J-SSCG 2016 was produced with permission from the Japanese Association of Acute Medicine and the Japanese Society for Intensive Care Medicine. METHODS: Members of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ) and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two-thirds (> 66.6%) majority vote of each of the 19 committee members. RESULTS: A total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J-SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation, and its supporting evidence were also added to each recommendation statement. We conducted meta-analyses for 29 CQs. Thirty-seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for five CQs. CONCLUSIONS: Based on the evidence gathered, we were able to formulate Japanese-specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non-specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

  2018, Journal of intensive care, 6, 7 - 7, English, International magazine

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Assessment of mortality by qSOFA in patients with sepsis outside ICU: A post hoc subgroup analysis by the Japanese Association for Acute Medicine Sepsis Registry Study Group

  Yutaka Umemura, Hiroshi Ogura, Satoshi Gando, Shigeki Kushimoto, Daizoh Saitoh, Toshihiko Mayumi, Seitaro Fujishima, Toshikazu Abe, Hiroto Ikeda, Joji Kotani, Yasuo Miki, Shin-ichiro Shiraishi, Atsushi Shiraishi, Koichiro Suzuki, Yasushi Suzuki, Naoshi Takeyama, Kiyotsugu Takuma, Ryosuke Tsuruta, Yoshihiro Yamaguchi, Norio Yamashita, Naoki Aikawa

  Nov. 2017, JOURNAL OF INFECTION AND CHEMOTHERAPY, 23(11) (11), 757 - 762, English

  [Refereed]

  Scientific journal


• 外傷診療にとってハイブリッドERのメリットは限定的である

  白井 邦博, 藤崎 宣友, 寺嶋 真理子, 上田 敬博, 宮脇 淳志, 山田 勇, 中尾 博之, 小谷 穣治

  (一社)日本救急医学会, Sep. 2017, 日本救急医学会雑誌, 28(9) (9), 486 - 486, Japanese


• Efficacy and Bleeding Risk of Antithrombin Supplementation in Patients With Septic Disseminated Intravascular Coagulation: A Third Survey

  Toshiaki Iba, Satoshi Gando, Daizoh Saitoh, Toshiaki Ikeda, Hideaki Anan, Shigeto Oda, Nobuya Kitamura, Shigeru Mori, Joji Kotani, Yasuhiro Kuroda

  Jul. 2017, CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS, 23(5) (5), 422 - 428, English

  [Refereed]

  Scientific journal


• Early evaluation of severity in patients with severe sepsis: a comparison with "septic shock" - subgroup analysis of the Japanese Association for Acute Medicine Sepsis Registry (JAAM-SR)

  Tarui T, Yamaguchi Y, Suzuki K, Tsuruta R, Ikeda H, Ogura H, Kushimoto S, Kotani J, Shiraishi SI, Suzuki Y, Takuma K, Takeyama N, Fujishima S, Mayumi T, Miki Y, Yamashita N, Aikawa N, Gando S

  Jul. 2017, Acute Med Surg, 4(4) (4), 426 - 431, English

  [Refereed]

  Scientific journal


• Different Patterns in Abdominal Stab Wound in the Self-Inflicted and Assaulted Patients: An Observational Analysis of Single Center Experience

  Nishimura T, Sakata H, Yamada T, Terashima M, Shirai K, Yamada I, Kotani J

  Patterns of penetrating abdominal stab wounds (ASW) may be different according to the mechanism of injury. The purpose of this study was to review and characterize penetrating abdominal stab wounds in self-inflicted wound patients and assaulted patients.

  神戸大学医学部, Jul. 2017, Kobe J Med Sci, 63(1) (1), E17 - E21, English

  [Refereed]

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• INTERLEUKIN-18 REDUCES BLOOD GLUCOSE AND MODULATES PLASMA CORTICOSTERONE IN A SEPTIC MOUSE MODEL

  Hayato Yamashita, Michiko Ishikawa, Taketo Inoue, Makoto Usami, Yu Usami, Joji Kotani

  Apr. 2017, SHOCK, 47(4) (4), 455 - 462, English

  [Refereed]

  Scientific journal


• 日本版敗血症診療ガイドライン2016を読み解く 敗血症の診断

  中田 孝明, 松田 直之, 小倉 裕司, 藤島 清太郎, 西田 修, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 布宮 伸, 林 淑朗, 松嶋 麻子, 織田 成人, 田中 裕

  (一社)日本集中治療医学会, Feb. 2017, 日本集中治療医学会雑誌, 24(Suppl.) (Suppl.), SY12 - 3, Japanese


• 日本版敗血症診療ガイドライン2016を読み解く 輸血用血液製剤、静脈血栓塞栓症(VTE)の予防と診断

  松嶋 麻子, 角 由佳, 廣瀬 智也, 小倉 裕司, 西田 修, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  (一社)日本集中治療医学会, Feb. 2017, 日本集中治療医学会雑誌, 24(Suppl.) (Suppl.), SY12 - 6, Japanese


• 【外科侵襲・術後管理と新しい免疫の概念】外科侵襲とInterleukin-18遺伝子多型

  石川 倫子, 山田 太平, 満保 直美, 藤崎 宣友, 上田 敬博, 井上 岳人, 小谷 穣治

  日本外科代謝栄養学会, Feb. 2017, 外科と代謝・栄養, 51(1) (1), 17 - 24, Japanese


• 日本版敗血症診療ガイドライン2016を読み解く 日本版敗血症診療ガイドライン2016 初期蘚生と循環作動薬

  垣花 泰之, 松嶋 麻子, 久志本 成樹, 松田 明久, 神應 知道, 井手 健太郎, 安田 英人, 櫻谷 正明, 松田 直之, 西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 織田 成人, 田中 裕, 日本版重症敗血症診療ガイドライン2016作成特別委員会

  (一社)日本集中治療医学会, Feb. 2017, 日本集中治療医学会雑誌, 24(Suppl.) (Suppl.), SY12 - 4, Japanese


• 熊本地震発災後の避難所および療養施設における差し入れ内容と避難民の消化器症状 炭水化物過多への不満と食事の希望

  岩田 隆一, 小谷 穣治, 上田 敬博, 山田 太平

  (一社)日本災害医学会, Feb. 2017, Japanese Journal of Disaster Medicine, 21(3) (3), 517 - 517, Japanese


• 日本版敗血症診療ガイドライン2016

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 青山 和由, 小豆畑 丈夫, 井手 健太郎, 大嶋 清宏, 大沼 哲, 小野寺 睦雄, 海塚 安郎, 川崎 達也, 神應 知道, 黒田 浩光, 後藤 孝治, 近藤 豊, 齋藤 伸行, 坂本 壮, 櫻谷 正明, 笹野 幹雄, 佐藤 格夫, 澤村 淳, 清水 健太郎, 白井 邦博, 角 由佳, 滝本 浩平, 武居 哲洋, 竹内 宗之, 巽 博臣, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 長江 正晴, 橋本 悟, 長谷川 隆一, 畠山 淳司, 早川 峰司, 林田 敬, 原 嘉孝, 東別府 直紀, 一二三 亨, 平井 克樹, 廣瀬 智也, 福田 龍将, 藤村 直幸, 福家 良太, 松田 明久, 松本 正太朗, 安田 英人, 矢田部 智昭, 山川 一馬, 山下 和人, 山下 千鶴, 山 直也, 吉田 健史, 日本版敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Feb. 2017, 日本救急医学会雑誌, 28(S1) (S1), S1 - S232, Japanese

  [Refereed]


• Antithrombin III improved neutrophil extracellular traps in lung after the onset of endotoxemia

  Michiko Ishikawa, Hayato Yamashita, Nobuki Oka, Takahiro Ueda, Keisuke Kohama, Atsunori Nakao, Joji Kotani

  Feb. 2017, JOURNAL OF SURGICAL RESEARCH, 208, 140 - 150, English

  [Refereed]

  Scientific journal


• LIVER INJURY ASSOCIATED WITH CHEST COMPRESSION IN CARDIOPULMONARY ARREST PATIENTS

  NISHIMURA Takeshi, OKAMOTO Ayana, FUJISAKI Noritomo, SHIRAI Kunihiro, YAMADA Isamu, NAKAO Atsunori, KOTANI Joji

  Although chest compression is an effective emergency maneuver for cardiopulmonary arrest (CPA), it carries a risk of complications such as rib fracture, sternal fracture, and organ injury. Two cases of CPA due to pulmonary thromboembolism were admitted to our department. Spontaneous circulation was restored with cardiopulmonary resuscitation (CPR) including chest compression. After use of an anticoagulant drug and indication of veno-arterial extra corporeal membrane oxygenation, contrast-enhanced computed tomography demonstrated infra-diaphragmatic liver injury in both cases. One patient could survive with damage control surgery (DCS), while the other patient could not survive without surgical management. As a conclusion, patients with hemorrhagic diathesis are at critical risk for complications from chest compression. Aggressive treatments, including DCS, may be effective even for patients treated with anticoagulant drugs.

  The Japanese Association for the Surgery of Trauma, 2017, Journal of the Japanese Association for the Surgery of Trauma, 31(1) (1), 17 - 23, Japanese


• Donor pretreatment with carbon monoxide prevents ischemia/reperfusion injury following heart transplantation in rats

  FujisakiN, KohamaK, NishimuraT, YamashitaH, IshikawaM, KanematsuA, YamadaT, LeeS, YumotoT, TsukaharaK, NakaoA

  Medknow, Oct. 2016, Med Gas Res, 6(3) (3), 122 - 129, English

  [Refereed]

  Scientific journal


• Case of 24-week Fetus Delivered from Mother on Life Support with Brain-death from Suicide Attempt: Ethical Issues Associated with Severe Complications

  Takeshi Nishimura, Keisuke Kohama, Takaaki Osako, Taihei Yamada, Hiroyuki Tanaka, Atsunori Nakao, Joji Kotani

  Oct. 2016, ACTA MEDICA OKAYAMA, 70(5) (5), 389 - 392, English

  [Refereed]

  Scientific journal


• 日本版敗血症診療ガイドライン2016 日本版敗血症診療ガイドライン2016の概要

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 301 - 301, Japanese


• 日本版敗血症診療ガイドライン2016 初期蘇生・循環作動薬班からの報告

  垣花 泰之, 松嶋 麻子, 久志本 成樹, 松田 明久, 神應 知道, 井手 健太郎, 安田 英人, 櫻谷 正明, 松田 直之, 西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 302 - 302, Japanese


• 日本版敗血症診療ガイドライン2016 日本版敗血症診療ガイドライン作成における栄養管理の骨子

  小谷 穣治, 江木 盛時, 海塚 安郎, 神應 知道, 佐藤 格夫, 清水 健太郎, 白井 邦博, 巽 博臣, 東別府 直紀, 西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 垣花 泰之, 久志本 成樹, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 302 - 302, Japanese


• 日本版敗血症診療ガイドライン2016 AKIと急性血液浄化療法

  貞広 智仁, 山下 千鶴, 土井 研人, 中田 孝明, 西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 志馬 伸朗, 中川 聡, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 303 - 303, Japanese


• 日本版敗血症診療ガイドライン2016 小児班のまとめ 各論

  志馬 伸朗, 中川 聡, 西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 303 - 303, Japanese


• 日本版敗血症診療ガイドライン2016 輸血、静脈血栓塞栓症(VTE)の予防と診断

  松嶋 麻子, 角 由佳, 廣瀬 智也, 小倉 裕司, 西田 修, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 茂樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 303 - 303, Japanese


• 日本版敗血症診療ガイドライン2016 学会合同作成の意義と今後の展望

  小倉 裕司, 西田 修, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 304 - 304, Japanese


• 日本版敗血症診療ガイドライン2016 日本版敗血症診療ガイドライン 血糖管理およびPICS・ICU-AWについて

  井上 茂亮, 江木 盛時, 角 由佳, 林田 敬, 原 嘉孝, 福田 龍将, 松田 明久, 安田 英人, 矢田部 智昭, 山下 和人, 松嶋 麻子, 坂本 壮, 射場 敏明, 今泉 均, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松田 直之, 小倉 裕司, 西田 修, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 302 - 302, Japanese


• 日本版敗血症診療ガイドライン2016 敗血症患者に対する体温管理

  久志本 成樹, 垣花 泰之, 松嶋 麻子, 松田 明久, 福田 龍将, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 小倉 裕司, 小谷 穣治, 坂本 壮, 貞広 智仁, 志馬 伸朗, 角 由佳, 林田 敬, 原 嘉孝, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松田 直之, 安田 英人, 矢田部 智昭, 山下 和人, 西田 修, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 303 - 303, Japanese


• Intraperitoneally administered, hydrogen-rich physiologic solution protects against postoperative ileus and is associated with reduced nitric oxide production

  Ayana Okamoto, Keisuke Kohama, Michiko Aoyama-Ishikawa, Hayato Yamashita, Noritomo Fujisaki, Taihei Yamada, Tetsuya Yumoto, Nobuyuki Nosaka, Hiromichi Naito, Kohei Tsukahara, Atsuyoshi Iida, Keiji Sato, Joji Kotani, Atsunori Nakao

  Sep. 2016, SURGERY, 160(3) (3), 623 - 631, English

  [Refereed]

  Scientific journal


• Infection site is predictive of outcome in acute lung injury associated with severe sepsis and septic shock

  Seitaro Fujishima, Satoshi Gando, Saitoh Daizoh, Shigeki Kushimoto, Hiroshi Ogura, Toshihiko Mayumi, Kiyotsugu Takuma, Joji Kotani, Norio Yamashita, Ryosuke Tsuruta, Naoshi Takeyama, Shin-ichiro Shiraishi, Tsunetoshi Araki, Koichiro Suzuki, Hiroto Ikeda, Yasuo Miki, Yasushi Suzuki, Yoshihiro Yamaguchi, Naoki Aikawa

  Jul. 2016, RESPIROLOGY, 21(5) (5), 898 - 904, English

  [Refereed]

  Scientific journal


• Inhaled hydrogen ameliorates endotoxin-induced bowel dysfunction

  Sakata H, Okamoto A, Aoyama-Ishikawa M, Yamashita H, Kohama K, Fujisaki N, Yamada T, Kotani J, Tsukahara K, Iida A, Nakao A

  Aim: Gastrointestinal dysmotility frequently occurs during sepsis and multiple organ failure, remaining a major cause of morbidity and mortality in critically ill patients. Previous studies have shown that hydrogen, a new therapeutic gas, can improve various organ damage associated with sepsis. In this study, we investigated the protective efficacies of inhaled hydrogen against lipopolysaccharide (LPS)-induced ileus. Methods: Sepsis was induced in rats and mice by a single i.p. injection of LPS at 15 mg/kg for mice and 5 mg/kg for rats. Four groups of rats and mice including sham/air, sham/hydrogen, LPS/air, and LPS/hydrogen were analyzed. Hydrogen (1.3%) was inhaled for 25 h beginning at 1 h prior to LPS treatment. Gastrointestinal transit was quantified and cytokine levels, as well as neutrophil extravasation, in the intestinal muscularis propria were determined. Results: Lipopolysaccharide challenge remarkably delayed gastrointestinal transit of non-absorbable dextran, associated with increased leukocyte recruitment and upregulation of pro-inflammatory cytokine mRNA expressions in the muscularis propria. Hydrogen significantly prevented LPS-induced bowel dysmotility and reduced leukocyte extravasation, as well as inhibition of inflammatory cytokine expression. In vitro analysis of cytokine levels after LPS treatment of cultured macrophages showed an increase of interleukin-10 by hydrogen regardless of the presence of nitric oxide. Conclusions: This study showed the protective effects of hydrogen inhalation on LPS-induced septic ileus through inhibition of inflammation in the muscularis propria. These inhibitory effects on the pro-inflammatory response may be partially derived from anti-inflammatory cytokine interleukin-10 induction.

  Jun. 2016, Acute Med Surg, 4(1) (1), 38 - 45, English, International magazine

  [Refereed]

  Scientific journal


• Acute care surgery(ACS)における栄養管理

  小谷穣治, 東別府直紀, 白井邦博, 上田敬博, 山田太平, 平井康富, 満保直美, 中尾博之, 山田勇

  日本Acute Care Surgery学会, 2016, Japanese Journal of Acute Care Surgery, 6(1) (1), 37 - 48, Japanese


• 日本版敗血症診療ガイドライン2016 ガイドラインにおける推奨の強さの解釈の注意点

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  一般社団法人 日本集中治療医学会, 2016, 日本集中治療医学会雑誌, 24(2) (2), n/a, Japanese


• 日本版敗血症診療ガイドライン2016 CQ13 栄養管理

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  一般社団法人 日本集中治療医学会, 2016, 日本集中治療医学会雑誌, 24(2) (2), n/a, Japanese


• 日本版敗血症診療ガイドライン2016 CQ10 人工呼吸管理

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  一般社団法人 日本集中治療医学会, 2016, 日本集中治療医学会雑誌, 24(2) (2), n/a, Japanese


• 日本版敗血症診療ガイドライン2016 CQ1 定義と診断

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  一般社団法人 日本集中治療医学会, 2016, 日本集中治療医学会雑誌, 24(2) (2), n/a, Japanese


• 日本版敗血症診療ガイドライン2016 CQ3 画像診断

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  一般社団法人 日本集中治療医学会, 2016, 日本集中治療医学会雑誌, 24(2) (2), n/a, Japanese


• 日本版敗血症診療ガイドライン2016 CQ15 体温管理

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  一般社団法人 日本集中治療医学会, 2016, 日本集中治療医学会雑誌, 24(2) (2), n/a, Japanese


• 日本版敗血症診療ガイドライン2016 CQ11 鎮痛・鎮静・せん妄管理

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  一般社団法人 日本集中治療医学会, 2016, 日本集中治療医学会雑誌, 24(2) (2), n/a, Japanese


• 日本版敗血症診療ガイドライン2016 CQ17 静脈血栓塞栓症(venous thromboembolism, VTE)対策

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  一般社団法人 日本集中治療医学会, 2016, 日本集中治療医学会雑誌, 24(2) (2), n/a, Japanese


• 日本版敗血症診療ガイドライン2016 CQ14 血糖管理

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  一般社団法人 日本集中治療医学会, 2016, 日本集中治療医学会雑誌, 24(2) (2), n/a, Japanese


• 日本版敗血症診療ガイドライン2016 CQ6 免疫グロブリン（IVIG）療法

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライン2016作成特別委員会

  一般社団法人 日本集中治療医学会, 2016, 日本集中治療医学会雑誌, 24(2) (2), n/a, Japanese


• 日本版重症敗血症診療ガイドライン2016作成の概要

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版重症敗血症診療ガイドライン2016作成特別委員会

  (一社)日本集中治療医学会, Jan. 2016, 日本集中治療医学会雑誌, 23(Suppl.) (Suppl.), 324 - 324, Japanese


• 日本版重症敗血症診療ガイドライン2016作成の流れ

  松嶋 麻子, 西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松田 直之, 織田 成人, 田中 裕, 日本版重症敗血症診療ガイドライン2016作成特別委員会

  (一社)日本集中治療医学会, Jan. 2016, 日本集中治療医学会雑誌, 23(Suppl.) (Suppl.), 325 - 325, Japanese


• 日本集中治療医学会・日本救急医学会合同日本版重症敗血症診療ガイドライン 日本版重症敗血症診療ガイドライン2016 学会合同作成の意義と今後

  小倉 裕司, 西田 修, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版重症敗血症診療ガイドライン2016作成特別委員会

  (一社)日本集中治療医学会, Jan. 2016, 日本集中治療医学会雑誌, 23(Suppl.) (Suppl.), 354 - 354, Japanese


• 日本集中治療医学会・日本救急医学会合同日本版重症敗血症診療ガイドライン 日本版重症敗血症診療ガイドライン2016 初期蘇生領域のCQとガイドラインの方向性

  垣花 泰之, 松嶋 麻子, 久志本 成樹, 松田 明久, 神應 知道, 井手 健太郎, 安田 英人, 櫻谷 正明, 松田 直之, 西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 織田 成人, 田中 裕, 日本版重症敗血症診療ガイドライン2016作成特別委員会

  (一社)日本集中治療医学会, Jan. 2016, 日本集中治療医学会雑誌, 23(Suppl.) (Suppl.), 353 - 353, Japanese


• 重症患者栄養管理ガイドラインのオーバービュー

  小谷 穣治, 山田 勇, 平井 康富, 藤崎 宣友, 上田 敬博, 白井 邦博

  日本外科代謝栄養学会, 2016, 外科と代謝・栄養, 50(2) (2), 97 - 103, Japanese


• A case of traumatic abdominal wall hernia with delayed bowel obstruction.

  Takeshi Nishimura, Atsunori Nakao, Ayana Okamoto, Noritomo Fujisaki, Joji Kotani

  BACKGROUND: Traumatic abdominal hernia is rare and difficult to diagnose from physical symptoms. PATIENT: A 60-year-old woman was admitted to the emergency department with complaints of vomiting after falling off a bicycle and hitting her abdomen against one of the handlebars 2 days earlier. Computed tomography (CT) demonstrated abdominal wall hernia from blunt trauma to the left upper abdomen. The patient underwent exploratory laparotomy, and the herniated bowel loop was not found to be perforated or gangrenous. Primary hernia repair without resection of the bowel loop was performed. RESULTS: Postoperative course was uneventful. CONCLUSION: Surgical exploration with primary repair of the defect is the definitive treatment in the present case, as the hernia contained an incarcerated loop of small bowel. The use of abdominal CT to confirm the diagnosis before operative repair of the hernia appears to be a safe and efficacious adjunct to physical examination.

  Dec. 2015, Surgical case reports, 1(1) (1), 15 - 15, English, International magazine

  Scientific journal


• A case of traumatic abdominal wall hernia with delayed bowel obstruction

  Takeshi Nishimura, Atsunori Nakao, Ayana Okamoto, Noritomo Fujisaki, Joji Kotani

  Springer Science and Business Media LLC, Dec. 2015, Surgical Case Reports, 1(1) (1)

  Scientific journal


• Successfully treated life-threatening upper gastrointestinal bleeding from fistula between gastroduodenal artery pseudoaneurysm and duodenum

  KohamaK, ItoY, KaiT, NakaoA

  Sep. 2015, Acute Med Surg, 3(2) (2), 192 - 194, English

  [Refereed]

  Scientific journal


• 日本版重症敗血症診療ガイドライン2016に向けて 課題と展望 日本版重症敗血症診療ガイドライン2016 作成組織の概要と進捗状況、今後の展望

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版重症敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 312 - 312, Japanese


• 日本版重症敗血症診療ガイドライン2016に向けて 課題と展望 日本版重症敗血症診療ガイドライン2016作成におけるsystematic reviewの実際

  松嶋 麻子, 西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松田 直之, 織田 成人, 田中 裕, 日本版重症敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 312 - 312, Japanese


• 日本版重症敗血症診療ガイドライン2016に向けて 課題と展望 日本版重症敗血症診療ガイドライン2016 初期蘇生領域のCQとガイドラインの方向性

  垣花 泰之, 松嶋 麻子, 久志本 成樹, 松田 直之, 西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 織田 成人, 田中 裕, 日本版重症敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 312 - 312, Japanese


• 日本版重症敗血症診療ガイドライン2016に向けて 課題と展望 日本版重症敗血症診療ガイドライン2016 学会合同ガイドライン作成の意義

  小倉 裕司, 西田 修, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版重症敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 313 - 313, Japanese


• Endogenous interleukin 18 regulates testicular germ cell apoptosis during endotoxemia

  Taketo Inoue, Michiko Aoyama-Ishikawa, Shingo Kamoshida, Satoshi Nishino, Maki Sasano, Nobuki Oka, Hayato Yamashita, Motoki Kai, Atsunori Nakao, Joji Kotani, Makoto Usami

  Aug. 2015, REPRODUCTION, 150(2) (2), 105 - 114, English

  [Refereed]

  Scientific journal


• 日本版重症敗血症診療ガイドライン2016に向けて 課題と展望 日本版重症敗血症診療ガイドライン2016作成の方法論とアカデミックガイドライン推進班の役割

  江木 盛時, 井上 茂亮, 角 由佳, 林田 敬, 原 嘉孝, 福田 龍将, 松田 明久, 安田 英人, 矢田部 智昭, 山下 和人, 松嶋 麻子, 坂本 壮, 射場 敏明, 今泉 均, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松田 直之, 小倉 裕司, 西田 修, 織田 成人, 田中 裕, 日本版重症敗血症診療ガイドライン2016作成特別委員会

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 312 - 312, Japanese


• Hydrogen inhalation protects against acute lung injury induced by hemorrhagic shock and resuscitation.

  Kohama K, Yamashita H, Aoyama-Ishikawa M, Takahashi T, Billiar TR, Nishimura T, Kotani J, Nakao A

  INTRODUCTION: Hemorrhagic shock followed by fluid resuscitation (HS/R) triggers an inflammatory response and causes pulmonary inflammation that can lead to acute lung injury (ALI). Hydrogen, a therapeutic gas, has potent cytoprotective, antiinflammatory, and antioxidant effects. This study examined the effects of inhaled hydrogen on ALI caused by HS/R. METHODS: Rats were subjected to hemorrhagic shock by withdrawing blood to lower blood pressure followed by resuscitation with shed blood and saline to restore blood pressure. After HS/R, the rats were maintained in a control gas of similar composition to room air or exposed to 1.3% hydrogen. RESULTS: HS/R induced ALI, as demonstrated by significantly impaired gas exchange, congestion, edema, cellular infiltration, and hemorrhage in the lungs. Hydrogen inhalation mitigated lung injury after HS/R, as indicated by significantly improved gas exchange and reduced cellular infiltration and hemorrhage. Hydrogen inhalation did not affect hemodynamic status during HS/R. Exposure to 1.3% hydrogen significantly attenuated the upregulation of the messenger RNAs for several proinflammatory mediators induced by HS/R. Lipid peroxidation was reduced significantly in the presence of hydrogen, indicating antioxidant effects. CONCLUSION: Hydrogen, administered through inhalation, may exert potent therapeutic effects against ALI induced by HS/R and attenuate the activation of inflammatory cascades.

  Aug. 2015, Surgery, 158(2) (2), 399 - 407, English, International magazine

  [Refereed]

  Scientific journal


• Ileum perforation due to cytomegalovirus infection in a patient with adult T-cell leukemia

  NishimuraT, NakaoA, OkamotoA, KiharaT, HirotaS, FujisakiN

  Case: A 73-year-old woman was transferred to our department due to severe abdominal pain with peritonitis. Her laboratory data showed that her white blood cell count was elevated to more than 50,000/mm3. Antibodies to HTLV-I were positive and we made the diagnosis of adult T-cell leukemia (ATL). Outcome: Emergency laparotomy was performed and revealed two separate small perforations of the ileum, requiring bowel resection. Immunohistochemistry for cytomegalovirus (CMV) antigen revealed positive staining in the intestinal stromal cells. Despite surgery and antiviral therapy with ganciclovir, she died after 28 days. Conclusion: Adult T-cell leukemia patients may present acute abdominal pain due to intestinal perforation caused by CMV infection. We should be aware of CMV infection as one of the pathogens causing acute abdominal crises such as massive hemorrhage or visceral perforation.

  Aug. 2015, Acute Med Surg, 3(2) (2), 178 - 181, English, International magazine

  [Refereed]

  Scientific journal


• Hemorrhagic shock due to ruptured left and right gastric artery aneurysm

  NishimuraT, SakataH, YamadaT, OsakoT, KohamaK, KakoY, AchiwaS, FurukawaY, NakaoA

  May 2015, Acute Med Surg, 3(1) (1), 39 - 42, English

  [Refereed]

  Scientific journal


• Endogenous interleukin 18 suppresses hyperglycemia and hyperinsulinemia during the acute phase of endotoxemia in mice.

  Yamashita H, Aoyama-Ishikawa M, Takahara M, Yamauchi C, Inoue T, Miyoshi M, Maeshige N, Usami M, Nakao A, Kotani J

  Feb. 2015, Surgical infections, 16(1) (1), 90 - 96

  [Refereed]


• Impact of serum glucose levels on disease severity and outcome in patients with severe sepsis: an analysis from a multicenter, prospective survey of severe sepsis.

  Kushimoto S, Gando S, Saitoh D, Mayumi T, Ogura H, Fujishima S, Araki T, Ikeda H, Kotani J, Miki Y, Shiraishi SI, Suzuki K, Suzuki Y, Takeyama N, Takuma K, Tsuruta R, Yamaguchi Y, Yamashita N, Aikawa N, Japanese Association for, Acute Medicine, Sepsis Registry (JAAMSR, Study Group

  Jan. 2015, Acute medicine & surgery, 2(1) (1), 21 - 28

  [Refereed]


• エンドトキシン血症時における精巣生殖細胞アポトーシスと内因性IL-18の役割

  井上 岳人, 石川 倫子, 西野 哲, 笹野 真希, 岡 伸樹, 山下 勇人, 鴨志田 伸吾, 中尾 篤典, 宇佐美 眞, 小谷 穣治

  日本エンドトキシン・自然免疫研究会, Nov. 2014, エンドトキシン・自然免疫研究, 17, 98 - 102, Japanese


• To remove or not remove? Twenty or more sewing needles in the gastrointestinal tract

  Yoshimichi Yamaguchi, Mariko Terashima, Atsunori Nakao, Norichika Yoshie, Noritomo Fujisaki, Taihei Yamada, Ayana Okamoto, Atsunori Hashimoto, Joji Kotani

  Wiley, Oct. 2014, Acute Medicine & Surgery, 1(4) (4), 250 - 251

  Scientific journal


• Application of carbon monoxide for treatment of acute kidney injury

  Atsunori Nakao, Taihei Yamada, Keisuke Kohama, Norichika Yoshie, Noritomo Fujisaki, Joji Kotani

  Wiley, Jul. 2014, Acute Medicine & Surgery, 1(3) (3), 127 - 134

  Scientific journal


• IL18 Production and IL18 Promoter Polymorphisms Correlate with Mortality in ICU Patients

  Taihei Yamada, Michiko Aoyama-Ishikawa, Hayato Yamashita, Mayu Fujiwara, Makoto Usami, Takahiro Ueda, Mariko Terashima, Keisuke Kohama, Atsunori Nakao, Joji Kotani

  May 2014, IN VIVO, 28(3) (3), 391 - 396, English

  [Refereed]

  Scientific journal


• Recipient hyperbilirubinaemia protects cardiac graft in rat heterotopic heart transplantation

  Sungsoo Lee, Taihei Yamada, Takaaki Osako, Donna B. Stolz, Masanori Abe, Kenneth R. McCurry, Noriko Murase, Joji Kotani, Atsunori Nakao

  Mar. 2014, EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 45(3) (3), 481 - 488, English

  [Refereed]

  Scientific journal


• A simple scoring system based on neutrophil count in sepsis patients

  Takahiro Ueda, Michiko Aoyama-Ishikawa, Atsunori Nakao, Taihei Yamada, Makoto Usami, Joji Kotani

  Mar. 2014, MEDICAL HYPOTHESES, 82(3) (3), 382 - 386, English

  [Refereed]

  Scientific journal


• Supplementation of parenteral nutrition with fish oil attenuates acute lung injury in a rat model

  Keisuke Kohama, Atsunori Nakao, Mariko Terashima, Michiko Aoyama-Ishikawa, Takayuki Shimizu, Daisuke Harada, Mitsuo Nakayama, Hayato Yamashita, Mayu Fujiwara, Joji Kotani

  Mar. 2014, JOURNAL OF CLINICAL BIOCHEMISTRY AND NUTRITION, 54(2) (2), 116 - 121, English

  [Refereed]

  Scientific journal


• Epidemiology of severe sepsis in Japanese intensive care units: a prospective multicenter study.

  Ogura H, Gando S, Saitoh D, Takeyama N, Kushimoto S, Fujishima S, Mayumi T, Araki T, Ikeda H, Kotani J, Miki Y, Shiraishi S, Suzuki K, Suzuki Y, Takuma K, Tsuruta R, Yamaguchi Y, Yamashita N, Aikawa N, Japanese Association for, Acute Medicine, Sepsis Registry (JAAMSR, Study Group

  3, Mar. 2014, Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 20(3) (3), 157 - 162

  [Refereed]


• Intravenous immunoglobulin-induced neutrophil apoptosis in the lung during murine endotoxemia.

  Michiko Aoyama-Ishikawa, Ayumi Seishu, Saori Kawakami, Noriaki Maeshige, Makoto Miyoshi, Takahiro Ueda, Makoto Usami, Atsunori Nakao, Joji Kotani

  BACKGROUND: The pathophysiologic features of acute respiratory distress syndrome (ARDS) are attributed to neutrophil accumulation and over-activation. Low blood immunoglobulin G concentrations in septic shock patients are associated with higher risk of developing ARDS. This study showed the effects of intravenous immunoglobulin (IVIg) on neutrophil apoptosis and accumulation in the lung during murine endotoxemia. METHODS: Male C57BL/6J mice were injected with saline or 7 mg/kg of lipopolysaccharide (LPS), and 3 h later also were injected with saline, IVIg 300 mg/kg, or IVIg 1000 mg/kg intraperitoneally. At 12 h after LPS injection, mice were sacrificed and peripheral blood and lungs were collected. The lung messenger ribonucleic acid expression (tumor necrosis factor-α [TNF-α], inducible nitric oxide synthase [iNOS], and intercellular adhesion molecule-1 [ICAM-1]) was determined using quantitative realtime reverse transcriptase-polymerase chain reaction. Lungs were immersed in 4% paraformaldehyde and then embedded in paraffin. Tissue slices were prepared and stained with naphthol AS-D chloroacetate esterase to detect neutrophils. The numbers of neutrophils (characterized by the segment number of their nuclei) were counted. Peripheral neutrophil apoptosis was detected by annexin V using flow cytometry and lung neutrophil apoptosis was detected by cleaved caspase-3 using immunohistochemistry. RESULTS: The survival rates of the saline group, LPS group, and IVIg group were all 100%. Apoptosis of peripheral blood neutrophils was inhibited by LPS. Neutrophil accumulation in the lung was decreased by both IVIg 300 mg/kg and 1000 mg/kg. Segmented neutrophils were reduced by IVIg during endotoxemia. However, IVIg 300 mg/kg and 1000 mg/kg had no influence on the lung messenger ribonucleic acid expression of TNF-α, iNOS, or ICAM-1. Cleaved-caspase-3-positive neutrophils were increased in the IVIg 300 mg/kg group during endotoxemia. The 1000 mg/kg IVIG dose reduced the number of segmented neutrophils, but did not induce cleaved-caspase 3-positive neutrophils. CONCLUSION: A therapeutic IVIg dose can attenuate neutrophil accumulation and regulate neutrophil apoptosis in the lung during endotoxemia. It is possible that the pathways by which IVIG induces neutrophil apoptosis may differ depending on the IVIg concentration.

  Feb. 2014, Surgical infections, 15(1) (1), 36 - 42, English, International magazine

  [Refereed]

  Scientific journal


• A multicenter, prospective evaluation of quality of care and mortality in Japan based on the Surviving Sepsis Campaign guidelines.

  Fujishima S, Gando S, Saitoh D, Mayumi T, Kushimoto S, Shiraishi S, Ogura H, Takuma K, Kotani J, Ikeda H, Yamashita N, Suzuki K, Tsuruta R, Takeyama N, Araki T, Suzuki Y, Miki Y, Yamaguchi Y, Aikawa N, Japanese Association for, Acute Medicine, Sepsis Registry, JAAM SR, Study Group

  2, Feb. 2014, Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 20(2) (2), 115 - 120

  [Refereed]


• Gastrointestinal symptoms and food/nutrition concerns after the great east japan earthquake in march 2011: Survey of evacuees in a temporary shelter

  Tomoko Inoue, Atsunori Nakao, Kazutoshi Kuboyama, Atsunori Hashimoto, Motomaru Masutani, Takahiro Ueda, Joji Kotani

  Cambridge University Press, 2014, Prehospital and Disaster Medicine, 29(3) (3), 303 - 306, English

  [Refereed]

  Scientific journal


• Can carbon monoxide-poisoned victims be organ donors?

  Noritomo Fujisaki, Atsunori Nakao, Takaaki Osako, Takeshi Nishimura, Taihei Yamada, Keisuke Kohama, Hiroyuki Sakata, Michiko Ishikawa-Aoyama, Joji Kotani

  The increasing demand for organ allografts to treat end-stage organ failure has driven changes in traditional donor criteria. Patients who have succumbed to carbon monoxide (CO) poisoning, a common cause of toxicological mortality, are usually rejected as organ donors. To fulfill the increasing demand, selection criteria must be expanded to include CO-poisoned donors. However, the use of allografts exposed to high CO concentrations is still under debate. Basic research and literature review data suggest that patients with brain death caused by CO poisoning should be considered appropriate organ donors. Accepting organs from CO-poisoned victims could increase the number of potential donors and lower the death rate of patients on the waiting lists. This review and reported cases may increase awareness among emergency department physicians, as well as transplant teams, that patients dying of CO exposure may be acceptable organ donors.

  2014, Medical gas research, 4, 13 - 13, English, International magazine

  Scientific journal


• Can carbon monoxide-poisoned victims be organ donors?

  Noritomo Fujisaki, Atsunori Nakao, Takaaki Osako, Takeshi Nishimura, Taihei Yamada, Keisuke Kohama, Hiroyuki Sakata, Michiko Ishikawa-Aoyama, Joji Kotani

  Springer Science and Business Media LLC, 2014, Medical Gas Research, 4(1) (1), 13 - 13

  Scientific journal


• Role of endogenous IL-18 in the lung during endotoxin-induced systemic inflammation.

  Takahara M, Aoyama-Ishikawa M, Shuno K, Yamauhi C, Miyoshi M, Maeshige N, Usami M, Yamada T, Osako T, Nakao A, Kotani J

  BACKGROUND: Overactivated neutrophils are causes of acute lung injury, which is a major clinical problem with significant morbidity and mortality in sepsis. Serum interleukin (IL)-18 levels correspond to severity of systemic inflammation. AIM: To elucidate the roles of endogenous IL-18 in lung injury during endotoxin-induced systemic inflammation. METHODS: Wild-type (WT) and IL-18 gene knockout (KO) mice were injected with lipopolysaccharide (40 mg/kg) intraperitoneally and killed. Lungs were collected at 0 and 12 h to assess mRNA for intercellular adhesion molecule (ICAM)-1, inducible nitric oxide synthase, myeloperoxidase, immunohistochemistry (cleaved caspase-3, 8-hydroxy-2-deoxyguanosine), and wet/dry ratio. Blood was collected at 0, 1, 12, 18, and 24 h to assess plasma cytokine levels. RESULTS: The survival rates at 24 h were approximately 43% and 76% in the WT and KO mice, respectively. Plasma IL-18 levels were induced time-dependently only in the WT mice. Plasma interferon-γ levels were significantly higher in the WT than in the KO mice at 12 h, but IL-6 and tumor necrosis factor-α levels did not differ between the WT and KO mice. At 12 h, the WT mice showed higher myeloperoxidase activity (P < 0.05), ICAM-1, and wet/dry ratios than KO mice. Cleaved caspase-3 positive neutrophils, which migrated in the lung interstitium, were lower in WT mice than in KO mice. CONCLUSIONS: Endogenous IL-18 induced neutrophil accumulation, accompanied by induction of ICAM-1 expression, inhibition of neutrophil apoptosis, and increased inducible nitric oxide synthase-induced oxidative tissue injury in the lung, leading to lung edema and poor outcome during endotoxemia.

  Jan. 2014, Acute medicine & surgery, 1(1) (1), 23 - 30, English, International magazine

  [Refereed]

  Scientific journal


• The Japanese guidelines for the management of sepsis.

  Oda S, Aibiki M, Ikeda T, Imaizumi H, Endo S, Ochiai R, Kotani J, Shime N, Nishida O, Noguchi T, Matsuda N, Hirasawa H, Sepsis Registry Committee of The, Japanese Society of, Intensive, Care Medicine

  2014, Journal of intensive care, 2(1) (1), 55, English

  Scientific journal


• Incorrect first aid treatment information about stonefish envenomation on medical websites.

  Hashimoto A, Nakao A, Inoue T, Fuse C, Yamada T, Hirata J, Ueda T, Yoshinaga K, Kotani J

  へるす出版, Dec. 2013, Chudoku kenkyu : Chudoku Kenkyukai jun kikanshi = The Japanese journal of toxicology, 26(4) (4), 292 - 294, English

  [Refereed]


• The impact of body temperature abnormalities on the disease severity and outcome in patients with severe sepsis: an analysis from a multicenter, prospective survey of severe sepsis.

  Kushimoto S, Gando S, Saitoh D, Mayumi T, Ogura H, Fujishima S, Araki T, Ikeda H, Kotani J, Miki Y, Shiraishi SI, Suzuki K, Suzuki Y, Takeyama N, Takuma K, Tsuruta R, Yamaguchi Y, Yamashita N, Aikawa N

  6, Nov. 2013, Critical care (London, England), 17(6) (6), R271

  [Refereed]


• A multicenter, prospective validation study of the Japanese Association for Acute Medicine disseminated intravascular coagulation scoring system in patients with severe sepsis.

  Gando S, Saitoh D, Ogura H, Fujishima S, Mayumi T, Araki T, Ikeda H, Kotani J, Kushimoto S, Miki Y, Shiraishi SI, Suzuki K, Suzuki Y, Takeyama N, Takuma K, Tsuruta R, Yamaguchi Y, Yamashita N, Aikawa N, Japanese Association for, Acute Medicine, Sepsis Registry, Study Group

  3, Jun. 2013, Critical care (London, England), 17(3) (3), R111

  [Refereed]


• Successful treatment of a 14-year-old patient with intestinal malrotation with laparoscopic Ladd procedure: case report and literature review.

  Yuka Nakajima, Hiroyuki Sakata, Tomohiro Yamaguchi, Norichika Yoshie, Taihei Yamada, Takaaki Osako, Mariko Terashima, Naomi Mambo, Ryuta Saka, Satoko Nose, Takashi Sasaki, Hiroomi Okuyama, Atsunori Nakao, Joji Kotani

  Midgut malrotation is an anomaly of intestinal rotation that occurs during fetal development and usually presents in the neonatal period. We present a rare case of malrotation in a 14-year-old patient who presented with cramping, generalized right abdominal pain, and vomiting for a duration of one day. A computed tomography abdominal scan and upper gastrointestinal contrast studies showed malrotation of the small bowel without volvulus. Laparoscopy revealed typical Ladd's bands and a distended flabby third and fourth duodenal portion extrinsically obstructing the misplaced duodeno-jejunal junction. The Ladd procedure, including widening of the mesenteric base and appendectomy, was performed. Symptoms completely resolved in a half-year follow up period. Patients with midgut malrotation may present with vague abdominal pain, intestinal obstruction, or intestinal ischemia. The laparoscopic Ladd procedure is feasible and safe, and it appears to be as effective as the standard open Ladd procedure in the diagnosis and treatment of teenage or adult patients with intestinal malrotation.

  May 2013, World journal of emergency surgery : WJES, 8(1) (1), 19 - 19, English, International magazine

  [Refereed]

  Scientific journal


• Linezolid-induced lactic acidosis followed by severe hypophosphatemia after discontinuation of linezolid.

  Atsushi Miyawaki, Takahiro Ueda, Atsunori Nakao, Masaru Adachi, Munehiko Ohya, Isamu Yamada, Yoshio Takesue, Joji Kotani

  Apr. 2013, Surgical infections, 14(2) (2), 229 - 30, English, International magazine

  [Refereed]


• マウス急性エンドトキシン血症下の高血糖へ及ぼすIL-18の関与の検討

  山下 勇人, 青山 倫子, 岡 伸樹, 井上 岳人, 前重 伯壮, 三好 真琴, 置村 康彦, 宇佐美 眞, 小谷 穣治

  (一社)日本Shock学会, Apr. 2013, Shock: 日本Shock学会雑誌, 28(1) (1), 59 - 59, Japanese


• The effects of n-3 polyunsaturated fatty acid-rich total parenteral nutrition on neutrophil apoptosis in a rat endotoxemia.

  Terashima M, Aoyama-Ishikawa M, Ueda T, Hagi A, Usami M, Nakao A, Kotani J

  Mar. 2013, Journal of clinical biochemistry and nutrition, 52(2) (2), 154 - 159

  [Refereed]


• Accuracy of blood-glucose measurements using glucose meters and arterial blood gas analyzers in critically ill adult patients: systematic review.

  Inoue S, Egi M, Kotani J, Morita K

  INTRODUCTION: Glucose control to prevent both hyperglycemia and hypoglycemia is important in an intensive care unit. Arterial blood gas analyzers and glucose meters are commonly used to measure blood-glucose concentration in an intensive care unit; however, their accuracies are still unclear. METHODS: We performed a systematic literature search (January 1, 2001, to August 31, 2012) to find clinical studies comparing blood-glucose values measured with glucose meters and/or arterial blood gas analyzers with those simultaneously measured with a central laboratory machine in critically ill adult patients. RESULTS: We reviewed 879 articles and found 21 studies in which the accuracy of blood-glucose monitoring by arterial blood gas analyzers and/or glucometers by using central laboratory methods as references was assessed in critically ill adult patients. Of those 21 studies, 11 studies in which International Organization for Standardization criteria, error-grid method, or percentage of values within 20% of the error of a reference were used were selected for evaluation. The accuracy of blood-glucose measurements by arterial blood gas analyzers and glucose meters by using arterial blood was significantly higher than that of measurements with glucose meters by using capillary blood (odds ratios for error: 0.04, P<0.001; and 0.36, P<0.001). The accuracy of blood-glucose measurements with arterial blood gas analyzers tended to be higher than that of measurements with glucose meters by using arterial blood (P=0.20). In the hypoglycemic range (defined as <81 mg/dl), the incidence of errors using these devices was higher than that in the nonhypoglycemic range (odds ratios for error: arterial blood gas analyzers, 1.86, P=0.15; glucose meters with capillary blood, 1.84, P=0.03; glucose meters with arterial blood, 2.33, P=0.02). Unstable hemodynamics (edema and use of a vasopressor) and use of insulin were associated with increased error of blood glucose monitoring with glucose meters. CONCLUSIONS: Our literature review showed that the accuracy of blood-glucose measurements with arterial blood gas analyzers was significantly higher than that of measurements with glucose meters by using capillary blood and tended to be higher than that of measurements with glucose meters by using arterial blood. These results should be interpreted with caution because of the large variation of accuracy among devices. Because blood-glucose monitoring was less accurate within or near the hypoglycemic range, especially in patients with unstable hemodynamics or receiving insulin infusion, we should be aware that current blood glucose-monitoring technology has not reached a high enough degree of accuracy and reliability to lead to appropriate glucose control in critically ill patients.

  Mar. 2013, Critical care (London, England), 17(2) (2), R48, English, International magazine

  [Refereed]

  Scientific journal


• Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock, 2012

  R. Phillip Dellinger, Mitchell M. Levy, Andrew Rhodes, Djillali Annane, Herwig Gerlach, Steven M. Opal, Jonathan E. Sevransky, Charles L. Sprung, Ivor S. Douglas, Roman Jaeschke, Tiffany M. Osborn, Mark E. Nunnally, Sean R. Townsend, Konrad Reinhart, Ruth M. Kleinpell, Derek C. Angus, Clifford S. Deutschman, Flavia R. Machado, Gordon D. Rubenfeld, Steven A. Webb, Richard J. Beale, Jean-Louis Vincent, Rui Moreno, Leanne Aitken, Hussain Al Rahma, Gordon R. Bernard, Paolo Biban, Julian F. Bion, Thierry Calandra, Joseph A. Carcillo, Terry P. Clemmer, J. V. Divatia, Bin Du, Seitaro Fujishima, Satoshi Gando, Caryl Goodyear Bruch, Gordon Guyatt, Jan A. Hazelzet, Hiroyuki Hirasawa, Steven M. Hollenberg, Judith Jacobi, Ian Jenkins, Edgar Jimenez, Alan E. Jones, Robert M. Kacmarek, Winfried Kern, Shin Ok Koh, Joji Kotani, Mitchell Levy, Flavia Machado, John Marini, John C. Marshall, Henry Masur, Sangeeta Mehta, John Muscedere, Lena M. Napolitano, Margaret M. Parker, Joseph E. Parrrillo, Haibo Qiu, Adrienne G. Randolph, Jordi Rello, Ederlon Resende, Emanuel P. Rivers, Christa A. Schorr, Khalid Shukri, Eliezer Silva, Mark D. Soth, Ann E. Thompson, Jeffery S. Vender, Tobias Welte, Janice L. Zimmerman, The Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup

  Springer Verlag, Feb. 2013, Intensive Care Medicine, 39(2) (2), 165 - 228, English

  Scientific journal


• Application of a first impression triage in the Japan railway west disaster.

  Atsunori Hashimoto, Takahiro Ueda, Kazutoshi Kuboyama, Taihei Yamada, Mariko Terashima, Atsushi Miyawaki, Atsunori Nakao, Joji Kotani

  2013, Acta medica Okayama, 67(3) (3), 171 - 6, English, Domestic magazine

  [Refereed]

  Scientific journal


• A secure "double-check" technique of bedside post pyloric feeding tube placement using transnasal endoscopy.

  Atsunori Hashimoto, Munehiko Oya, Mika Iwano, Chisako Fuse, Tomoko Inoue, Taihei Yamada, Mariko Terashima, Takaaki Osako, Takahiro Ueda, Isamu Yamada, Atsunori Nakao, Joji Kotani

  Nov. 2012, Journal of clinical biochemistry and nutrition, 51(3) (3), 213 - 5, English, Domestic magazine

  [Refereed]

  Scientific journal


• Feasibility of (18)F-fluorodeoxyglucose positron-emission tomography for preoperative evaluation of biliary tract cancer.

  Yamada I, Ajiki T, Ueno K, Sawa H, Otsubo I, Yoshida Y, Shinzeki M, Toyama H, Matsumoto I, Fukumoto T, Nakao A, Kotani J, Ku Y

  (18)F-Labeled fluorodeoxyglucose positron-emission tomography (FDG-PET), a rapidly evolving functional imaging modality, has recently been shown to be useful in the diagnosis and staging of various malignant tumors due to focal uptake of FDG-labeled glucose in malignant cell populations. However, the role of FDG-PET in the diagnosis and staging of biliary tract cancer is still controversial and has not yet been fully evaluated. The aim of this study was to determine the clinical importance of FDG-PET in the preoperative evaluation of biliary tract cancer and retrospectively clarify the characteristics of false-negative and false-positive cases. We retrospectively analyzed data for 73 consecutive patients diagnosed with cancer of the biliary tract and were admitted to the Department of Hepato-Biliary-Pancreatic Surgery at Kobe University Hospital for treatment, from January 2007 to August 2009. Since the sensitivity, specificity and positive predictive value (PPV) of FDG-PET in the diagnosis of bile duct carcinoma are usually relatively high, FDG-PET is considered to be a useful tool in diagnosing biliary tract cancer. FDG-PET also seems to be useful in clinical decision-making, regarding treatment strategy, including surgery. Our results showed that FDG-PET is highly sensitive in delineating the primary focus of biliary cancer and is a useful tool in preoperative examination. A disadvantage of FDG-PET is its inability to indicate small metastases and false-positive findings of inflamed gallbladder and bile duct lesions.

  Nov. 2012, Anticancer research, 32(11) (11), 5105 - 5110, English, International magazine

  [Refereed]

  Scientific journal


• 敗血症患者におけるBody Mass Index(BMI)の影響 日本救急医学会Sepsis Registry 535例の解析

  山下 典雄, 相川 直樹, 丸藤 哲, 山口 芳裕, 齋藤 大蔵, 荒木 恒敏, 池田 弘人, 小倉 裕司, 久志本 成樹, 小谷 穣治, 白石 振一郎, 鈴木 幸一郎, 鈴木 泰, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 藤島 清太郎, 真弓 俊彦, 三木 靖雄, 日本救急医学会Sepsis Registry特別委員会

  (一社)日本救急医学会, Oct. 2012, 日本救急医学会雑誌, 23(10) (10), 524 - 524, Japanese


• 敗血症におけるアンチトロンビンIII(Antithrombin III:AT III)の効果

  岡 伸樹, 青山 倫子, 上田 敬博, 井上 岳人, 前重 伯壮, 宇佐美 眞, 小谷 穣治

  日本エンドトキシン・自然免疫研究会, Oct. 2012, エンドトキシン・自然免疫研究, 15, 35 - 39, Japanese


• 救急領域における侵襲と生体反応研究の最前線 敗血症における好中球の性差について

  石川 倫子[青山], 高原 美樹, 山内 千里, 岡 伸樹, 山下 勇人, 藤原 麻有, 上田 敬博, 宇佐美 眞, 小谷 穣治

  (一社)日本救急医学会, Oct. 2012, 日本救急医学会雑誌, 23(10) (10), 447 - 447, Japanese


• ショック、敗血症、臓器障害における最新治療 侵襲反応の性差について

  小谷 穣治, 青山 倫子, 上田 敬博, 高原 美樹, 山内 千里, 岡 伸樹, 宇佐美 眞

  (一社)日本Shock学会, Apr. 2012, Shock: 日本Shock学会雑誌, 27(1) (1), 41 - 41, Japanese


• エンドトキシン血症下の血糖変動とインスリンシグナルへのIL-18の役割

  青山 倫子, 高原 美樹, 山内 千里, 宇佐美 眞, 小谷 穣治

  (一社)日本Shock学会, Apr. 2012, Shock: 日本Shock学会雑誌, 27(1) (1), 53 - 53, Japanese


• エンドトキシン刺激下の好中球アポトーシスに対するアンチトロンビンIIIの効果

  岡 伸樹, 青山 倫子, 上田 敬博, 井上 岳人, 前重 伯壮, 藤原 麻有, 神前 雅彦, 三好 真琴, 寺嶋 真理子, 宇佐美 眞, 小谷 穣治

  (一社)日本Shock学会, Apr. 2012, Shock: 日本Shock学会雑誌, 27(1) (1), 78 - 78, Japanese


• エンドトキシン血症下の肺好中球アポトーシスへの静脈注射用免疫グロブリンの効果

  青山 倫子, 宇佐美 眞, 上田 敬博, 小谷 穣治

  (一社)日本外科感染症学会, Feb. 2012, 日本外科感染症学会雑誌, 9(1) (1), 63 - 69, Japanese


• 自然免疫系の解析と病態制御 エンドトキシン血症時の性差によるIL-18の役割と腸管iNOS発現の差異

  青山 倫子, 神前 雅彦, 井上 岳人, 前重 伯壮, 三好 真琴, 上田 敬博, 宇佐美 眞, 小谷 穣治

  日本エンドトキシン・自然免疫研究会, Nov. 2011, エンドトキシン・自然免疫研究, 14, 1 - 5, Japanese


• エンドトキシン血症下の骨髄細胞動向とアポトーシスにおけるTLR4 signalの役割とその雌雄差

  高原 美紀, 山内 千里, 青山 倫子, MAESHIGE NORIAKI, MIYOSHI MAKOTO, 井上 岳人, 神前 雅彦, 藤原 麻有, 宇佐美 眞, 上田 敬博, 小谷 穣治

  (株)自然科学社, Oct. 2011, エンドトキシン血症救命治療研究会誌, 15(1) (1), 110 - 113, Japanese


• エンドトキシン血症下における空腸粘膜iNOS mRNA発現の雌雄差とMyD88経路の関係

  青山 倫子, 神前 雅彦, 前重 伯壮, 三好 真琴, 濱田 康弘, 上田 敬博, 小谷 穣治, 宇佐美 眞

  日本外科代謝栄養学会, Jun. 2011, 外科と代謝・栄養, 45(3) (3), 122 - 122, Japanese


• n-3系多価不飽和脂肪酸(PUFAs)静脈投与による全身炎症下末梢血および骨髄好中球(PMN)アポトーシス(Ap)抑制解除

  小谷 穣治, 寺嶋 真理子, 青山 倫子, 上田 敬博, 萩 彰文, 中山 満雄, 小濱 圭祐, 宇佐美 眞

  (株)ジェフコーポレーション, Jan. 2011, 静脈経腸栄養, 26(1) (1), 210 - 210, Japanese


• 【血糖コントロールの基礎と臨床】自然免疫とインスリン抵抗性

  青山 倫子, 上田 敬博, 小谷 穣治

  (株)メジカルビュー社, Dec. 2010, 侵襲と免疫, 19(4) (4), 149 - 153, Japanese


• 急性エンドトキシン血症下の肺における好中球集積と組織障害に及ぼすInterleukin(IL)-18の役割と機序

  渡邉 まり, 青山 倫子, 秀野 克仁, 飯塚 宣仁, 前重 伯壮, 三好 真琴, 尾迫 貴章, 上田 敬博, 山田 太平, 宇佐美 眞, 小谷 穣治

  (株)自然科学社, Dec. 2010, エンドトキシン血症救命治療研究会誌, 14(1) (1), 212 - 216, Japanese


• エンドトキシン血症モデルマウスにおける肺の好中球集積へのIVIGの効果

  青山 倫子, 清酒 亜由美, 川上 沙央理, 前重 伯壮, 三好 真琴, 上田 敬博, 宇佐見 眞, 小谷 穣治

  (一社)日本外科感染症学会, Oct. 2010, 日本外科感染症学会雑誌, 7(5) (5), 576 - 576, Japanese


• エンドトキシン血症下免疫応答の性差におけるIL-18の役割

  青山 倫子, 渡邉 まり, 三好 真琴, 前重 伯壮, 宇佐美 眞, 小谷 穣治

  医学図書出版(株), Oct. 2010, エンドトキシン研究, 13, 29 - 34, Japanese


• Butyrate and propionate induced activated or non-activated neutrophil apoptosis via HDAC inhibitor activity but without activating GPR-41/GPR-43 pathways

  Michiko Aoyama, Joji Kotani, Makoto Usami

  Jun. 2010, NUTRITION, 26(6) (6), 653 - 661, English

  [Refereed]

  Scientific journal


• 敗血症性心筋症における核ゲノム傷害のミトコンドリア機能不全への関与について

  平田 淳一, 大家 宗彦, 寺嶋 真理子, 橋本 篤徳, 上田 敬博, 宮脇 淳志, 小谷 穣治

  (一社)日本集中治療医学会, Jan. 2010, 日本集中治療医学会雑誌, 17(Suppl.) (Suppl.), 287 - 287, Japanese


• The current status of the therapeutic approach for severe sepsis in Japan and its comparison to the international guidelines

  IBA Toshiaki, MAYUMI Toshihiko, OGURA Shinji, ISHIKURA Hiroyasu, KOTANI Jyoji, MATSUDA Naoyuki, YOKOTA Hiroyuki

  Both Intensive Insulin Therapy (IIT) and the low-dose hydrocortisone administration for septic shock are the hot stocks in the Surviving Sepsis Campaign guidelines 2004. However, the questions have occurred along with the accumulation of the recent evidences, and the recommendation levels for these treatments had been withdrawn. In contrast, although not included in the international guidelines, the treatments such as the direct-hemoperfusion with polymyxin B-immobilized column (PMX-DHP), anticoagulant therapy for disseminated intravascular coagulation (DIC) and sivelestat sodium for acute respiratory distress syndrome (ARDS), which are widely applied in Japan, attracts attention. Indeed, there are some significant differences in the therapeutic strategies for severe sepsis between Japan and other advanced countries. With regard to the PMX-DHP, although it has been ignored in the other countries, the recent randomized controlled study (RCT) performed in Italy proved its efficacy. Antithrombin was recommended not to administrate in DIC patients in the European guideline, while its administration is recommended in Japanese one. The efficacy of sivelestat sodium was proven again in the post-marketing surveillance performed in Japan, after the contrastive results from USA. Under these confusing situations, we clinicians must realize that the evidences for severe sepsis are quite unstable. There should not be any doubt for the importance of the evidence based medicine, however, we should recognize the differences of the genetics, health care systems and the historic backgrounds as well, and when we apply the certain treatment to the patients, we must consider not only the clinical evidences but also follow the individual experiences and the scientific knowledge. Actually, we think that the tailor-made medicine is just required for treatment of severe sepsis, and the uniform guideline treatment is not suitable.

  Japanese Association for Acute Medicine, Dec. 2009, Nihon Kyukyu Igakukai Zasshi, 20(12) (12), 915 - 922, Japanese


• 救急・集中治療領域での感染対策 救命救急センターでの内因性疾患における生存率の性差と機序の検討 マウス骨髄からの好中球動員の性差との関連について

  青山 倫子, 上田 敬博, 渡邉 まり, 三好 真琴, 山田 太平, 橋本 篤徳, 平田 淳一, 寺嶋 真理子, 宇佐美 眞, 小谷 穣治

  (一社)日本外科感染症学会, Nov. 2009, 日本外科感染症学会雑誌, 6(5) (5), 468 - 468, Japanese


• 感染症と分子生物学 救急患者における血漿遊離DNA量とSOFAスコアとの関連の検討

  渡邉 まり, 青山 倫子, 前川 彩香, 川上 沙央里, 清酒 亜由美, 上田 敬博, 山田 太平, 橋本 篤徳, 宇佐美 眞, 小谷 穣治

  (一社)日本外科感染症学会, Nov. 2009, 日本外科感染症学会雑誌, 6(5) (5), 491 - 491, Japanese


• GENDER DIFFERENCE IN GRANULOCYTE DYNAMICS AND APOPTOSIS AND THE ROLE OF IL-18 DURING ENDOTOXIN-INDUCED SYSTEMIC INFLAMMATION

  Michiko Aoyama, Joji Kotani, Makoto Usami

  Oct. 2009, SHOCK, 32(4) (4), 401 - 409, English

  [Refereed]

  Scientific journal


• エンドトキシン血症下腸管におけるIL-18とTLR4のmRNA発現の雌雄差

  青山 倫子, 小谷 穣治, 渡邉 まり, 飯塚 宣仁, 前重 伯壮, 三好 真琴, 寺嶋 真理子, 平田 淳一, 宮脇 淳志, 諸岡 孝俊, 宇佐美 眞

  (一社)日本救急医学会, Aug. 2009, 日本救急医学会雑誌, 20(8) (8), 685 - 685, Japanese


• エンドトキシン血症下のリンパ球Fas発現及びアポトーシスにおけるIL-18の役割

  渡邉 まり, 青山 倫子, 秀野 克仁, 飯塚 宣仁, 前重 伯壮, 三好 真琴, 山田 太平, 橋本 篤徳, 上田 敬博, 宇佐美 眞, 小谷 穣治

  (一社)日本救急医学会, Aug. 2009, 日本救急医学会雑誌, 20(8) (8), 686 - 686, Japanese


• Interleukin(IL)-18はエンドトキシン(Etx)血症に伴う急性肺損傷の発症に関与する

  秀野 克仁, 小谷 穣治, 青山 倫子, 渡邉 まり, 飯塚 宣仁, 三好 真琴, 前重 伯壮, 宇佐美 眞, 丸川 征四郎

  (一社)日本集中治療医学会, Jan. 2009, 日本集中治療医学会雑誌, 16(Suppl.) (Suppl.), 266 - 266, Japanese


• A ROLE FOR IL-18 IN HUMAN NEUTROPHIL APOPTOSIS

  Jun-ichi Hirata, Joji Kotani, Michiko Aoyama, Shin-ichiro Kashiwamura, Haruyasu Ueda, Yasuhiro Kuroda, Makoto Usami, Haruki Okamura, Seishiro Marukawa

  Dec. 2008, SHOCK, 30(6) (6), 628 - 633, English

  [Refereed]

  Scientific journal


• 2種類のナファモスタットメシル酸塩による好中球活性化抑制効果の比較検討

  渡邉 まり, 小谷 穣治, 青山 倫子, 秀野 克仁, 飯塚 宣仁, 三好 真琴, 宇佐美 眞, 丸川 征四郎

  (一社)日本外科感染症学会, Oct. 2008, 日本外科感染症学会雑誌, 5(5) (5), 541 - 541, Japanese


• 敗血症性心筋症におけるミトコンドリア機能不全の機序について

  平田 淳一, 大家 宗彦, 橋本 篤徳, 山田 太平, 寺嶋 真理子, 上田 敬博, 足立 克, 宮脇 淳, 小谷 穣治, 丸川 征四郎

  (一社)日本救急医学会, Aug. 2008, 日本救急医学会雑誌, 19(8) (8), 810 - 810, Japanese


• 【NST病態栄養シリーズ Immunonutrition】短鎖脂肪酸投与による腸管integrity改善と免疫調節効果

  宇佐美 眞, 三好 真琴, 坂木 宏衣, 飯塚 宣仁, 青山 倫子, 秀野 克仁, 渡邊 まり, 小谷 穣治, 森 砂織, 赤池 信英, 國場 幸史

  (株)東京医学社, Aug. 2008, 小児外科, 40(8) (8), 884 - 888, Japanese


• 日本人におけるtumor necrosis factor-α(TNF-α)gene-238 single nucleotide polymorphism(SNP)はTNF-α産生量と関係がある

  秀野 克仁, 青山 倫子, 不動 翔子, 飯塚 宣仁, 渡邉 まり, 三好 真琴, 前重 伯壮, 宇佐美 眞, 丸川 征四郎, 小谷 穣治

  (一社)日本救急医学会, Aug. 2008, 日本救急医学会雑誌, 19(8) (8), 777 - 777, Japanese


• 侵襲時サイトカイン制御の意義と問題点 侵襲時IL-18の果たす役割と一塩基多型(SNPs)に基づくIL-18産生能の個体差

  小谷 穣治, 寺嶋 真理子, 平田 淳一, 上野 直子, 青山 倫子, 秀野 克仁, 上田 敬博, 宇佐美 眞, 丸川 征四郎

  日本外科代謝栄養学会, Jun. 2008, 外科と代謝・栄養, 42(3) (3), 16 - 16, Japanese


• エンドトキシン誘発肝障害に対するtributyrin経口投与の効果

  坂木 宏衣, 三好 真琴, 宇佐美 眞, 青山 倫子, 秀野 克仁, 飯塚 宣仁, 渡邉 まり, 小谷 穣治

  日本外科代謝栄養学会, Jun. 2008, 外科と代謝・栄養, 42(3) (3), 20 - 20, Japanese


• Butyrate and trichostatin A attenuate nuclear factor kappaB activation and tumor necrosis factor alpha secretion and increase prostaglandin E2 secretion in human peripheral blood mononuclear cells.

  Makoto Usami, Kazunori Kishimoto, Atsushi Ohata, Makoto Miyoshi, Michiko Aoyama, Yuri Fueda, Joji Kotani

  The effects of short-chain fatty acids (butyrate, propionate, and acetate) and trichostatin A (TSA), a typical histone deacetylase inhibitor, on tumor necrosis factor (TNF)-alpha secretion and nuclear factor kappaB (NF-kappaB) activation in peripheral blood mononuclear cells induced with lipopolysaccharide were evaluated in relation to prostaglandin E(2) (PGE(2)) secretion. Treatment of cells with butyrate; tributyrin, a prodrug of butyrate; propionate; acetate; and TSA down-regulated TNF-alpha secretion but all up-regulated PGE(2) secretion. Butyrate, propionate, and TSA inhibited NF-kappaB activation. The effects of the cyclooxygenase-nonspecific inhibitor, indomethacin; the cyclooxygenase-2 selective inhibitor, N-[2-(cyclohexyloxy)-4-nitro-phenyl] methanesulfonamide; and the general lipoxygenase inhibitor, nordihydroguaiaretic acid, varied in cells treated with each short-chain fatty acids. N-[2-(cyclohexyloxy)-4-nitro-phenyl] methanesulfonamide inhibited the effect of propionate on TNF-alpha secretion, and nordihydroguaiaretic acid inhibited that of acetate. The results showed that butyrate, propionate, and TSA inhibited TNF-alpha production via PGE(2) secretion and down-regulated NF-kappaB activation by lipopolysaccharide. These data suggest that the mechanism of butyrate and propionate action is through histone deacetylation and acetate through lipoxygenase activation in the regulation of proinflammatory responses in cells.

  May 2008, Nutrition research (New York, N.Y.), 28(5) (5), 321 - 8, English, International magazine

  [Refereed]

  Scientific journal


• 肝硬変併存が鈍的外傷の予後へ及ぼす影響

  小谷 穣治, 切田 学, 青山 倫子, 寺嶋 真理子, 上田 敬博, 平田 淳一, 宇佐美 眞, 丸川 征四郎

  (一社)日本外傷学会, Apr. 2008, 日本外傷学会雑誌, 22(2) (2), 196 - 196, Japanese


• n-3系多価不飽和脂肪酸(PUFAs)脂肪乳剤投与による侵襲下の好中球アポトーシス(Ap)抑制の解除の試み

  寺嶋 真理子, 小谷 穣治, 青山 倫子, 萩 彰文, 平田 淳一, 上田 敬博, 大家 宗彦, 宇佐美 眞, 丸川 征四郎

  (一社)日本集中治療医学会, Jan. 2008, 日本集中治療医学会雑誌, 15(Suppl.) (Suppl.), 185 - 185, Japanese


• トピックス エンドトキシン血症下の骨髄細胞アポトーシス誘導における内因性IL-18の役割

  青山 倫子, 小谷 穣治, 宇佐美 眞, 谷出 晶子, 秀野 克仁, 不動 翔子, 三好 真琴, 丸川 征四郎

  (一社)日本外科感染症学会, Nov. 2007, 日本外科感染症学会雑誌, 4(4) (4), 573 - 578, Japanese


• Proteinase-activated receptor(PAR)シグナルが好中球apoptosis(Ap)とphagocytosis(Ph)に及ぼす影響の検討

  渡邉 まり, 小谷 穣治, 青山 倫子, 坂木 宏衣, 秀野 克仁, 和田 哲, 飯塚 宣仁, 三好 真琴, 宇佐美 眞, 丸川 征四郎

  (一社)日本外科感染症学会, Oct. 2007, 日本外科感染症学会雑誌, 4(Suppl.) (Suppl.), 460 - 460, Japanese


• 【救急医療領域における感染症】トピックス 敗血症と遺伝子プロファイリング

  小谷 穣治, 青山 倫子, 宇佐美 眞, 丸川 征四郎

  (株)へるす出版, Sep. 2007, 救急医学, 31(10) (10), 1411 - 1415, Japanese


• 侵襲下における幼弱好中球の成熟に伴うアポトーシス感受性の変化と臓器障害発症の一考察 免疫修飾栄養素による制御の試み

  小谷 穣治, 青山 倫子, 平田 淳一, 寺嶋 真理子, 上田 敬博, 大家 宗彦, 切田 学, 宇佐美 眞, 丸川 征四郎

  (一社)日本救急医学会, Aug. 2007, 日本救急医学会雑誌, 18(8) (8), 388 - 388, Japanese


• 侵襲下における幼弱好中球のアポトーシス感受性の成熟に伴う変化の機序と臓器障害発症の一考察

  小谷 穣治, 青山 倫子, 平田 順一, 寺嶋 真理子, 上田 敬博, 大家 宗彦, 切田 学, 宇佐美 眞, 丸川 征四郎

  日本外科代謝栄養学会, Jun. 2007, 外科と代謝・栄養, 41(3) (3), 16 - 16, Japanese


• エンドトキシン血症動物における酪酸およびtributyrin投与による侵襲反応制御の可能性

  坂木 宏衣, 宇佐美 眞, 三好 真琴, 大畑 淳, 岸本 和徳, 青山 倫子, 布江田 友理, 谷出 晶子, 森 砂織, 赤池 信英, 國場 幸史, 小谷 穣治

  (公社)日本栄養・食糧学会, Apr. 2007, 日本栄養・食糧学会大会講演要旨集, 61回, 195 - 195, Japanese


• 重症敗血症治療の現状と将来展望 日本人TNF-αプロモーター領域遺伝子多型(SNP)と侵襲下免疫機能変化の関連の一考察

  小谷 穣治, 青山 倫子, 秀野 克仁, 不動 翔子, 山田 真理子, 切田 学, 吉永 和正, 宇佐美 眞, 丸川 征四郎

  (一社)日本腹部救急医学会, Feb. 2007, 日本腹部救急医学会雑誌, 27(2) (2), 301 - 301, Japanese


• エンドトキシン血症(Etx)下腸管のapoptosis(Ap)誘導とtoll-like receptor(TLR)4発現におけるIL-18の役割

  谷出 晶子, 小谷 穣治, 青山 倫子, 不動 翔子, 秀野 克仁, 坂木 宏衣, 赤松 加奈子, 八木 三保, 宇佐美 眞, 丸川 征四郎

  (一社)日本集中治療医学会, Jan. 2007, 日本集中治療医学会雑誌, 14(Suppl.) (Suppl.), 306 - 306, Japanese


• 外科的感染症対策としての栄養管理 全身性炎症下の好中球アポトーシス抑制に対するn-3系長鎖脂肪酸投与の効果

  小谷 穣治, 山田 真理子, 青山 倫子, 萩 彰文, 河野 裕一, 平田 淳一, 切田 学, 宇佐美 眞, 丸川 征四郎

  (一社)日本外科感染症学会, Oct. 2006, 日本外科感染症学会雑誌, 3(Suppl.) (Suppl.), 385 - 385, Japanese


• 急性エンドトキシン血症(Etx)下の骨髄細胞(BM)アポトーシス(Ap)誘導における内因性IL-18の役割

  青山 倫子, 小谷 穣治, 谷出 晶子, 秀野 克仁, 不動 翔子, 大野 葉月, 坂木 宏衣, 三好 真琴, 宇佐美 眞, 丸川 征四郎

  (一社)日本外科感染症学会, Oct. 2006, 日本外科感染症学会雑誌, 3(Suppl.) (Suppl.), 458 - 458, Japanese


• 分子生物学的研究と救急医療 侵襲下の好中球アポトーシス(Ap)抑制の免疫修飾栄養素材によるコントロールの試み

  小谷 穣治, 萩 彰文, 青山 倫子, 山田 真理子, 平田 淳一, 五島 正裕, 切田 学, 丸川 征四郎

  (一社)日本救急医学会, Aug. 2006, 日本救急医学会雑誌, 17(8) (8), 345 - 345, Japanese


• 急性膵炎の急性期においてIL-18はnitric oxide(NO)産生誘導を介して膵腺房細胞を保護する

  小谷 穣治, 上野 直子, 青山 倫子, 山田 真理子, 平田 淳一, 切田 学, 丸川 征四郎

  (一社)日本救急医学会, Aug. 2006, 日本救急医学会雑誌, 17(8) (8), 482 - 482, Japanese


• 侵襲下における腸管機能と代謝動態 周術期の腸内細菌叢・短鎖脂肪酸変動と酪酸投与による侵襲制御の可能性

  宇佐美 眞, 大畑 淳, 岸本 和徳, 三好 真琴, 青山 倫子, 布江田 友理, 谷出 晶子, 坂木 宏衣, 寒原 芳浩, 小谷 穣治, 森 砂織, 赤池 信英, 國場 幸史, 朝原 崇, 野本 康二

  日本外科代謝栄養学会, Jun. 2006, 外科と代謝・栄養, 40(3) (3), 56 - 57, Japanese


• 急性膵炎下のIL-18誘導nitric oxide(NO)産生が膵腺房細胞損傷に果たす役割

  小谷 穣治, 上野 直子, 柏村 信一郎, 上田 晴康, 平田 淳一, 青山 倫子, 山田 真理子, 切田 学, 宇佐美 真, 岡村 春樹, 丸川 征四郎

  (一社)日本外科学会, Mar. 2006, 日本外科学会雑誌, 107(臨増2) (臨増2), 447 - 447, Japanese


• 侵襲下におけるmicrobial translocationのup-to-date 腸内細菌コントロール(2)

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  日本外科代謝栄養学会, Dec. 2005, 外科と代謝・栄養, 39(5〜6) (5〜6), 211 - 223, Japanese


• IL-18のヒト好中球apoptosisの抑制効果とその機序についての検討

  平田 淳一, 小谷 穣治, 柏村 信一郎, 上田 晴康, 青山 倫子, 切田 学, 宇佐 美真, 岡村 春樹, 丸川 征四郎

  (一社)日本救急医学会, Aug. 2005, 日本救急医学会雑誌, 16(8) (8), 396 - 396, Japanese


• 酪酸投与によるエンドトキシン血症下侵襲反応の制御

  宇佐美 眞, 大畑 淳, 岸本 和徳, 三好 真琴, 青山 倫子, 布江田 友理, 谷出 晶子, 森 砂織, 赤池 信英, 國場 幸史, 小谷 穣治

  日本外科代謝栄養学会, Jun. 2005, 外科と代謝・栄養, 39(1) (1), 38 - 38, Japanese


• 血管内皮細胞tight junction permeabilityにおよぼす各種脂肪酸の効果

  三好 真琴, 宇佐美 眞, 大畑 淳, 布江田 友理, 青山 倫子, 谷出 晶子, 福田 祐子, 坂木 宏衣, 横田 佳代子, 小谷 穣治

  日本外科代謝栄養学会, Jun. 2005, 外科と代謝・栄養, 39(1) (1), 56 - 56, Japanese


• 生体侵襲時における経腸栄養の新しい試み 侵襲時の経腸栄養:Ecoimmunonutritionの可能性

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  (NPO)日本消化吸収学会, Feb. 2005, 消化と吸収, 27(1) (1), 95 - 101, Japanese


• 血管内皮細胞tight junction permeabilityへの短鎖脂肪酸の効果

  三好 真琴, 宇佐美 眞, 大畑 淳, 岸本 和徳, 青山 倫子, 布江田 友理, 武田 麻紀, 福田 祐子, 野口 依子, 松村 美穂, 小谷 穣治

  (株)ジェフコーポレーション, Jan. 2005, 静脈経腸栄養, 20(増刊) (増刊), 354 - 354, Japanese


• 短鎖脂肪酸の好中球apoptosis促進効果

  青山 倫子, 小谷 穣治, 宇佐美 眞, 大畑 淳, 岸本 和徳, 三好 真琴, 布江田 友理, 武田 麻紀, 福田 祐子, 野口 依子, 松村 美穂

  (株)ジェフコーポレーション, Jan. 2005, 静脈経腸栄養, 20(増刊) (増刊), 355 - 355, Japanese

• 重症患者における咬合不全のインパクトを探る

  藤浪好寿, 斎藤雅史, 大野雄康, 岡崎智哉, 篠原奈都代, 一二三亨, 黒田泰弘, 大山正平, 藤岡一路, 山田勇, 井上茂亮, 小谷穣治

  2023, 日本臨床栄養代謝学会学術集会(Web), 38th


• COVID-19感染拡大期における搬送先での医療廃棄物処理システムが救急隊業務効率と院外心肺停止患者予後へ与える影響

  杉山隼, 杉山隼, 井上茂亮, 高山和之, 中西信人, 藤浪好寿, 齋藤雅史, 大野雄康, 小谷穣治

  2023, 日本病院前救急診療医学会誌, 18(1) (1)


• 頸部リンパ節を除去した敗血症マウスでは,脳へのT細胞の浸潤が抑制され,敗血症に伴う精神障害の回復が遅れる

  齋藤雅史, 齋藤雅史, 大野雄康, 中西信人, 小谷穣治

  2023, 日本エンドトキシン・自然免疫研究会プログラム・抄録集, 28th


• 敗血症に伴う精神障害の回復にはCD4+T細胞が重要である

  齋藤雅史, 大野雄康, 山下公大, 関恒慶, 千原典夫, 小谷穣治

  2023, Neuroimmunology, 28(1) (1)


• IL-17産生γδT細胞は敗血症後の脳内に増加し,マウスの不安様行動の増悪に関与する

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  2023, Neuroimmunology, 28(1) (1)


• C188-9, a specific inhibitor of STAT3 signaling, ameliorates thermal burn-induced skeletal muscle wasting in mice

  大野雄康, 大野雄康, 斎藤雅史, 坂本多穂, 中西信人, 井上茂亮, 小谷穣治

  2023, 日本麻酔科学会学術集会(Web), 70th


• マウス敗血症モデルの骨格筋萎縮と重症度にOncostatin Mが関連する

  大野雄康, 斎藤雅史, 杉山隼, 高山和之, 中西信人, 井上茂亮, 小谷穣治

  2023, 日本エンドトキシン・自然免疫研究会プログラム・抄録集, 28th


• The Impact of Malocclusion in Critical Care

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  2022, 日本集中治療医学会学術集会(Web), 49th


• 「災害下におけるNST活動」熊本地震NST活動報告:避難所における食の問題~療養施設と対比して

  小谷穣治, 山田勇, 上田敬博

  2022, 外科と代謝・栄養, 56(1) (1)


• 日本版敗血症ガイドライン2020;ダイジェスト・多職種チームの重要性 日本版敗血症診療ガイドライン2020における多職種連携

  河合 佑亮, 西田 修, 飯田 有輝, 宇都宮 明美, 古薗 弘隆, 山田 亨, 吉田 悠平, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会Patient-and Family-Centered Care班

  (一社)日本集中治療医学会, Sep. 2021, 日本集中治療医学会雑誌, 28(Suppl.2) (Suppl.2), 229 - 229, Japanese


• 日本版敗血症診療ガイドライン2020

  江木 盛時, 小倉 裕司, 矢田部 智昭, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 山川 一馬, 原 嘉孝, 大下 慎一郎, 青木 善孝, 稲田 麻衣, 梅村 穣, 河合 佑亮, 近藤 豊, 斎藤 浩輝, 櫻谷 正明, 對東 俊介, 武田 親宗, 寺山 毅郎, 東平 日出夫, 橋本 英樹, 林田 敬, 一二三 亨, 廣瀬 智也, 福田 龍将, 藤井 智子, 三浦 慎也, 安田 英人, 阿部 智一, 安藤 幸吉, 飯田 有輝, 石原 唯史, 井手 健太郎, 伊藤 健太, 伊藤 雄介, 稲田 雄, 宇都宮 明美, 卯野木 健, 遠藤 功二, 大内 玲, 尾崎 将之, 小野 聡, 桂 守弘, 川口 敦, 川村 雄介, 工藤 大介, 久保 健児, 倉橋 清泰, 櫻本 秀明, 下山 哲, 鈴木 武志, 関根 秀介, 関野 元裕, 高橋 希, 高橋 世, 高橋 弘, 田上 隆, 田島 吾郎, 巽 博臣, 谷 昌憲, 土谷 飛鳥, 堤 悠介, 内藤 貴基, 長江 正晴, 長澤 俊郎, 中村 謙介, 西村 哲郎, 布宮 伸, 則末 泰博, 橋本 悟, 長谷川 大祐, 畠山 淳司, 原 直己, 東別府 直紀, 古島 夏奈, 古薗 弘隆, 松石 雄二朗, 松山 匡, 峰松 佑輔, 宮下 亮一, 宮武 祐士, 森安 恵実, 山田 亨, 山田 博之, 山元 良, 吉田 健史, 吉田 悠平, 吉村 旬平, 四本 竜一, 米倉 寛, 和田 剛志, 渡邉 栄三, 青木 誠, 浅井 英樹, 安部 隆国, 五十嵐 豊, 井口 直也, 石川 雅巳, 石丸 剛, 磯川 修太郎, 板倉 隆太, 今長谷 尚史, 井村 春樹, 入野田 崇, 上原 健司, 生塩 典敬, 梅垣 岳志, 江川 裕子, 榎本 有希, 太田 浩平, 大地 嘉史, 大野 孝則, 大邉 寛幸, 岡 和幸, 岡田 信長, 岡田 遥平, 岡野 弘, 岡本 潤, 奥田 拓史, 小倉 崇以, 小野寺 悠, 小山 雄太, 貝沼 関志, 加古 英介, 柏浦 正広, 加藤 弘美, 金谷 明浩, 金子 唯, 金畑 圭太, 狩野 謙一, 河野 浩幸, 菊谷 知也, 菊地 斉, 城戸 崇裕, 木村 翔, 小網 博之, 小橋 大輔, 齊木 巌, 堺 正仁, 坂本 彩香, 佐藤 哲哉, 志賀 康浩, 下戸 学, 下山 伸哉, 庄古 知久, 菅原 陽, 杉田 篤紀, 鈴木 聡, 鈴木 祐二, 壽原 朋宏, 其田 健司, 高氏 修平, 高島 光平, 高橋 生, 高橋 洋子, 竹下 淳, 田中 裕記, 丹保 亜希仁, 角山 泰一朗, 鉄原 健一, 徳永 健太郎, 富岡 義裕, 冨田 健太朗, 富永 直樹, 豊崎 光信, 豊田 幸樹年, 内藤 宏道, 永田 功, 長門 直, 中村 嘉, 中森 裕毅, 名原 功, 奈良場 啓, 成田 知大, 西岡 典宏, 西村 朋也, 西山 慶, 野村 智久, 芳賀 大樹, 萩原 祥弘, 橋本 克彦, 旗智 武志, 浜崎 俊明, 林 拓也, 林 実, 速水 宏樹, 原口 剛, 平野 洋平, 藤井 遼, 藤田 基, 藤村 直幸, 舩越 拓, 堀口 真仁, 牧 盾, 増永 直久, 松村 洋輔, 真弓 卓也, 南 啓介, 宮崎 裕也, 宮本 和幸, 村田 哲平, 柳井 真知, 矢野 隆郎, 山田 浩平, 山田 直樹, 山本 朋納, 吉廣 尚大, 田中 裕, 西田 修, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本救急医学会, Feb. 2021, 日本救急医学会雑誌, 32(S1) (S1), S1 - S411, Japanese


• 日本版敗血症診療ガイドライン2020

  江木 盛時, 小倉 裕司, 矢田部 智昭, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 山川 一馬, 原 嘉孝, 大下 慎一郎, 青木 善孝, 稲田 麻衣, 梅村 穣, 河合 佑亮, 近藤 豊, 斎藤 浩輝, 櫻谷 正明, 對東 俊介, 武田 親宗, 寺山 毅郎, 東平 日出夫, 橋本 英樹, 林田 敬, 一二三 亨, 廣瀬 智也, 福田 龍将, 藤井 智子, 三浦 慎也, 安田 英人, 阿部 智一, 安藤 幸吉, 飯田 有輝, 石原 唯史, 井手 健太郎, 伊藤 健太, 伊藤 雄介, 稲田 雄, 宇都宮 明美, 卯野木 健, 遠藤 功二, 大内 玲, 尾崎 将之, 小野 聡, 桂 守弘, 川口 敦, 川村 雄介, 工藤 大介, 久保 健児, 倉橋 清泰, 櫻本 秀明, 下山 哲, 鈴木 武志, 関根 秀介, 関野 元裕, 高橋 希, 高橋 世, 高橋 弘, 田上 隆, 田島 吾郎, 巽 博臣, 谷 昌憲, 土谷 飛鳥, 堤 悠介, 内藤 貴基, 長江 正晴, 長澤 俊郎, 中村 謙介, 西村 哲郎, 布宮 伸, 則末 泰博, 橋本 悟, 長谷川 大祐, 畠山 淳司, 原 直己, 東別府 直紀, 古島 夏奈, 古薗 弘隆, 松石 雄二朗, 松山 匡, 峰松 佑輔, 宮下 亮一, 宮武 祐士, 森安 恵実, 山田 亨, 山田 博之, 山元 良, 吉田 健史, 吉田 悠平, 吉村 旬平, 四本 竜一, 米倉 寛, 和田 剛志, 渡邉 栄三, 青木 誠, 浅井 英樹, 安部 隆国, 五十嵐 豊, 井口 直也, 石川 雅巳, 石丸 剛, 磯川 修太郎, 板倉 隆太, 今長谷 尚史, 井村 春樹, 入野田 崇, 上原 健司, 生塩 典敬, 梅垣 岳志, 江川 裕子, 榎本 有希, 太田 浩平, 大地 嘉史, 大野 孝則, 大邉 寛幸, 岡 和幸, 岡田 信長, 岡田 遥平, 岡野 弘, 岡本 潤, 奥田 拓史, 小倉 崇以, 小野寺 悠, 小山 雄太, 貝沼 関志, 加古 英介, 柏浦 正広, 加藤 弘美, 金谷 明浩, 金子 唯, 金畑 圭太, 狩野 謙一, 河野 浩幸, 菊谷 知也, 菊地 斉, 城戸 崇裕, 木村 翔, 小網 博之, 小橋 大輔, 齊木 巌, 堺 正仁, 坂本 彩香, 佐藤 哲哉, 志賀 康浩, 下戸 学, 下山 伸哉, 庄古 知久, 菅原 陽, 杉田 篤紀, 鈴木 聡, 鈴木 祐二, 壽原 朋宏, 其田 健司, 高氏 修平, 高島 光平, 高橋 生, 高橋 洋子, 竹下 淳, 田中 裕記, 丹保 亜希仁, 角山 泰一朗, 鉄原 健一, 徳永 健太郎, 富岡 義裕, 冨田 健太朗, 富永 直樹, 豊崎 光信, 豊田 幸樹年, 内藤 宏道, 永田 功, 長門 直, 中村 嘉, 中森 裕毅, 名原 功, 奈良場 啓, 成田 知大, 西岡 典宏, 西村 朋也, 西山 慶, 野村 智久, 芳賀 大樹, 萩原 祥弘, 橋本 克彦, 旗智 武志, 浜崎 俊明, 林 拓也, 林 実, 速水 宏樹, 原口 剛, 平野 洋平, 藤井 遼, 藤田 基, 藤村 直幸, 舩越 拓, 堀口 真仁, 牧 盾, 増永 直久, 松村 洋輔, 真弓 卓也, 南 啓介, 宮崎 裕也, 宮本 和幸, 村田 哲平, 柳井 真知, 矢野 隆郎, 山田 浩平, 山田 直樹, 山本 朋納, 吉廣 尚大, 田中 裕, 西田 修, 日本版敗血症診療ガイドライン2020特別委員会

  (一社)日本救急医学会, Feb. 2021, 日本救急医学会雑誌, 32(S1) (S1), S1 - S411, Japanese


• 高齢者におけるPost-intensive care syndrome/ICU-acquired weaknessとその対策

  井上茂亮, 斎藤雅史, 宮崎勇輔, 大野雄康, 中西信人, 森山直紀, 藤浪好寿, 小谷穣治

  2021, 外科と代謝・栄養, 55(4) (4)


• Nutrition Therapy

  小谷穣治, 小谷穣治, 山田勇, 山田勇, 土谷飛鳥, 中村謙介, 原嘉孝, 東別府直紀, 矢田部智昭

  2021, ICUとCCU, 45(10) (10)


• 栄養のEvidence解説,推奨解説

  小谷穣治, 土谷飛鳥, 中村謙介, 原嘉孝, 東別府直紀, 矢田部智昭

  2021, 日本集中治療医学会学術集会(Web), 48th


• 日本版敗血症診療ガイドライン2020:Now Open! 日本版敗血症診療ガイドライン2020栄養療法

  小谷 穣治, 土谷 飛鳥, 中村 謙介, 原 嘉孝, 東別府 直紀, 矢田部 智昭, 日本版敗血症診療ガイドライン2020特別委員会栄養班

  (一社)日本救急医学会, Nov. 2020, 日本救急医学会雑誌, 31(11) (11), 916 - 916, Japanese


• 日本版敗血症診療ガイドライン2020;ICU-AW・PICS・早期リハ・Patients Centered Therapy and Family Careを知る Patient-and Family-Centered Careに関する推奨解説

  河合 佑亮, 西田 修, 飯田 有輝, 宇都宮 明美, 古薗 弘隆, 山田 亨, 吉田 悠平, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, J-SSCG2020特別委員会Patient-and Family-Centered Care班

  (一社)日本集中治療医学会, Sep. 2020, 日本集中治療医学会雑誌, 27(Suppl.) (Suppl.), 288 - 288, Japanese


• 日本版敗血症診療ガイドライン2020;ダイジェスト・多職種チームの重要性(Sepsis Treatment System)

  升田 好樹, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 西田 修, 田中 裕, 日本敗血症ガイドライン2020特別委員会

  (一社)日本集中治療医学会, Sep. 2020, 日本集中治療医学会雑誌, 27(Suppl.) (Suppl.), 294 - 294, Japanese


• 咬合不全は,敗血症後の体重減少を引き起こし,敗血症の予後を悪化させる

  藤浪好寿, 井上茂亮, 斎藤雅史, 大山正平, 大野雄康, 小谷穣治

  2020, 日本集中治療医学会学術集会(Web), 47th


• The Pathophysiology of Sepsis-Induced ICU-Acquired Weakness

  大野雄康, 斎藤雅史, 藤浪好寿, 井上茂亮, 小谷穣治

  2020, ICUとCCU, 44(5) (5)


• Skeletal muscle protein catabolism, protein anabolism, and myogenesis after various types of insults

  大野雄康, 斎藤雅史, 藤浪好寿, 井上茂亮, 小谷穣治

  2020, 外科と代謝・栄養, 54(3) (3)


• The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020(J-SSCG 2020)

  江木盛時, 小倉裕司, 矢田部智昭, 安宅一晃, 井上茂亮, 射場敏明, 垣花泰之, 川崎達也, 久志本成樹, 黒田泰弘, 小谷穣治, 志馬伸朗, 谷口巧, 鶴田良介, 土井研人, 土井松幸, 中田孝明, 中根正樹, 藤島清太郎, 細川直登, 升田好樹, 松嶋麻子, 松田直之, 山川一馬, 原嘉孝, 大下慎一郎, 青木善孝, 稲田麻衣, 梅村穣, 河合佑亮, 近藤豊, 斎藤浩輝, 櫻谷正明, 對東俊介, 武田親宗, 寺山毅郎, 東平日出夫, 橋本英樹, 林田敬, 一二三亨, 廣瀬智也, 福田龍将, 藤井智子, 三浦慎也, 安田英人, 阿部智一, 安藤幸吉, 飯田有輝, 石原唯史, 井手健太郎, 伊藤健太, 伊藤雄介, 稲田雄, 宇都宮明美, 卯野木健, 遠藤功二, 大内玲, 尾崎将之, 小野聡, 桂守弘, 川口敦, 川村雄介, 工藤大介, 久保健児, 倉橋清泰, 櫻本秀明, 下山哲, 鈴木武志, 関根秀介, 関野元裕, 高橋希, 高橋世, 高橋弘, 田上隆, 田島吾郎, 巽博臣, 谷昌憲, 土谷飛鳥, 堤悠介, 内藤貴基, 長江正晴, 長澤俊郎, 中村謙介, 西村哲郎, 布宮伸, 則末泰博, 橋本悟, 長谷川大祐, 畠山淳司, 原直己, 東別府直紀, 古島夏奈, 古薗弘隆, 松石雄二朗, 松山匡, 峰松佑輔, 宮下亮一, 宮武祐士, 森安恵実, 山田亨, 山田博之, 山元良, 吉田健史, 吉田悠平, 吉村旬平, 四本竜一, 米倉寛, 和田剛志, 渡邉栄三, 青木誠, 浅井英樹, 安部隆国, 五十嵐豊, 井口直也, 石川雅巳, 石丸剛, 磯川修太郎, 板倉隆太, 今長谷尚史, 井村春樹

  2020, 日本集中治療医学会雑誌(Web), 28(Supplement) (Supplement)


• Prognostic Accuracy of Quick SOFA is different according to the severity of illness in infectious patients.

  Yutaka Umemura, Hiroshi Ogura, Satoshi Gando, Atsushi Shiraishi, Daizoh Saitoh, Seitato Fujishima, Toshihiko Mayumi, Shigeki Kushimoto, Toshikazu Abe, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Kazuma Yamakawa

  Dec. 2019, Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 25(12) (12), 943 - 949, English, International magazine


• 本邦の救急領域における敗血症起因菌の評価 FORECAST sepsisサブ解析

  梅村 穣, 田熊 清継, 丸藤 哲, 小倉 裕司, 阿部 智一, 藤島 清太郎, 佐々木 淳一, 齋藤 大蔵, 久志本 成樹, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 椎野 泰和, 白石 振一郎, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 616 - 616, Japanese


• ICUから生還後のQOLを向上するには? 「悪いかみ合わせ」はICU患者のADLを低下させる

  藤浪 好寿, 一二三 亨, 岡崎 智哉, 篠原 奈都代, 井上 茂亮, 小谷 穣治, 切田 学, 黒田 泰弘

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 555 - 555, Japanese


• 救急患者に対する痛み・不穏・せん妄のマネジメント(PAD管理) 「悪いかみ合わせ」は救急患者のせん妄を増加させる

  藤浪 好寿, 一二三 亨, 岡崎 智哉, 篠原 奈都代, 井上 茂亮, 小谷 穣治, 切田 学, 黒田 泰弘

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 588 - 588, Japanese


• 急兵呼吸促迫症候群(ARDS)の疫学、治療状況と転帰 FORECAST-ARDS研究報告

  藤島 清太郎, 丸藤 哲, 阿部 智一, 小倉 裕司, 齋藤 大蔵, 久志本 成樹, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 616 - 616, Japanese


• 敗血症患者における体温異常と臨床的特徴、初期治療および臨床転帰 The FORECAST study副研究

  久志本 成樹, 丸藤 哲, 阿部 智一, 小倉 裕司, 齋藤 大蔵, 藤島 清太郎, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 616 - 616, Japanese


• 敗血症患者における入院時血糖値異常と臨床的特徴、重症化および臨床転帰 The FORECAST study副研究

  久志本 成樹, 丸藤 哲, 阿部 智一, 小倉 裕司, 齋藤 大蔵, 藤島 清太郎, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 616 - 616, Japanese


• 本邦の救急領域における敗血症起因菌の評価 FORECAST sepsisサブ解析

  梅村 穣, 田熊 清継, 丸藤 哲, 小倉 裕司, 阿部 智一, 藤島 清太郎, 佐々木 淳一, 齋藤 大蔵, 久志本 成樹, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 椎野 泰和, 白石 振一郎, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 616 - 616, Japanese


• β溶連菌と肺炎球菌による重症敗血症と敗血症性ショック患者の病原性と臨床的特徴

  一二三 亨, 藤島 清太郎, 丸藤 哲, 阿部 智一, 小倉 裕司, 齋藤 大蔵, 久志本 成樹, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 増野 智彦, 山川 一馬, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 616 - 616, Japanese


• JAAM FORECAST DIC研究

  山川 一馬, 丸藤 哲, 梅村 穣, 小倉 裕司, 白石 淳, 阿部 智一, 齋藤 大蔵, 久志本 成樹, 藤島 清太郎, 真弓 俊彦, 池田 弘人, 射場 敏明, 上山 昌史, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山下 典雄, 大友 康裕, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2019, 日本救急医学会雑誌, 30(9) (9), 617 - 617, Japanese


• 【PICS update】敗血症とPICS

  井上 茂亮, 斉藤 雅史, 小谷 穣治

  医学図書出版(株), Jul. 2019, ICUとCCU, 43(7) (7), 411 - 416, Japanese


• 【高齢者の蘇生中止 在宅医療にかかわるみんなが、正しく学び、最期まで希望が叶う地域を!】積極的な蘇生を学ぶ 発見してから元に戻る(社会復帰)ようになるまでの道 蘇生後の集中治療 PICS(集中治療後症候群)と長期予後

  井上 茂亮, 小谷 穣治

  (株)へるす出版, Jun. 2019, 在宅新療0→100, 4(6) (6), 529 - 534, Japanese


• IL-15は、高齢マウス敗血症のT細胞疲弊とマクロファージ機能を改善し、長期予後を改善する

  齋藤 雅史, 井上 茂亮, 山田 勇, 安藤 維洋, 山下 公大, 掛地 吉弘, 福本 巧, 小谷 穣治

  日本外科代謝栄養学会, Jun. 2019, 外科と代謝・栄養, 53(3) (3), 110 - 110, Japanese


• Role of disseminated intravascular coagulation in severe sepsis.

  Satoshi Gando, Atsushi Shiraishi, Kazuma Yamakawa, Hiroshi Ogura, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Shigeki Kushimoto, Toshikazu Abe, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi

  Jun. 2019, Thrombosis research, 178, 182 - 188, English, International magazine


• 【救急医学研究 入門!】私の・私たちの研究 高齢敗血症患者の「長期予後改善」を目指して

  井上 茂亮, 齋藤 雅史, 小谷 穣治

  (株)へるす出版, Mar. 2019, 救急医学, 43(3) (3), 319 - 324, Japanese


• 敗血症の基礎研究Bench to bedside 高齢マウス反復性敗血症モデルにおいて、IL-15は遷延するT細胞疲弊を長期間改善する

  齋藤 雅史, 井上 茂亮, 安藤 維洋, 山田 勇, 前田 裕二, 小谷 穣治

  (一社)日本集中治療医学会, Feb. 2019, 日本集中治療医学会雑誌, 26(Suppl.) (Suppl.), [PD8 - 3], Japanese


• 日本版敗血症診療ガイドライン2020を展望する:New Challenge! J-SSCG2020 注目領域Pick Up!Patients Centered Therapy and Family Care

  西田 修, 江木 盛時, 小倉 裕司, 安宅 一晃, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 藤島 清太郎, 細川 直登, 升田 好樹, 松嶋 麻子, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライ, 特別委員会

  (一社)日本集中治療医学会, Feb. 2019, 日本集中治療医学会雑誌, 26(Suppl.) (Suppl.), [JPD1 - 4], Japanese


• 日本版敗血症診療ガイドライン2020を展望する:New Challenge! JSSCG2020 注目領域Pick Up!Sepsis Treatment System

  升田 好樹, 安宅 一晃, 松嶋 麻子, 小倉 裕司, 江木 盛時, 井上 茂亮, 射場 敏明, 垣花 泰之, 川崎 達也, 久志本 成樹, 黒田 泰弘, 小谷 穣治, 志馬 伸朗, 谷口 巧, 鶴田 良介, 土井 研人, 土井 松幸, 中田 孝明, 中根 正樹, 西田 修, 藤島 清太郎, 細川 直登, 松田 直之, 矢田部 智昭, 田中 裕, 日本版敗血症診療ガイドライ, 特別委員会

  (一社)日本集中治療医学会, Feb. 2019, 日本集中治療医学会雑誌, 26(Suppl.) (Suppl.), [JPD1 - 5], Japanese


• Variations in infection sites and mortality rates among patients in intensive care units with severe sepsis and septic shock in Japan.

  Toshikazu Abe, Hiroshi Ogura, Shigeki Kushimoto, Atsushi Shiraishi, Takehiro Sugiyama, Gautam A Deshpande, Masatoshi Uchida, Isao Nagata, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Toru Hifumi, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando

  2019, Journal of intensive care, 7, 28 - 28, English, International magazine


• マウス敗血症モデルにおける肺でのneutrophil extracellular taps(NETs)形成とその性差におけるIL-18の関与について

  石川倫子, 井上岳人, 小谷穣治, 藤原智弘, 小濱圭祐, 新田翔, 長谷川佳奈, 大家宗彦, 平田淳一

  (一社)日本救急医学会, 2019, 日本救急医学会雑誌, 30(9 (Web)) (9 (Web)), 705 - 705, Japanese


• An open-label, randomized, phase 3 study of the efficacy and safety of antithrombin gamma in patients with sepsis-induced disseminated intravascular coagulation syndrome

  Shigeatsu Endo, Ryutaro Shimazaki, Satoshi Gando, Shigeto Oda, Yasuhiro Ootomo, Masanao Miura, Shinji Ogura, Yutaka Eguchi, Joji Kotani, Norio Yamashita, Hiroyasu Ishikura, Yuichiro Sakamoto, Takeshi Takahashi, Yasushi Suzuki, Shigeki Kushimoto, Nobuya Kitamura, Naoyuki Matsuda, Takahiro Fujita, Mitsuhide Kitano, Junko Yamaguchi, Yoshikazu Yasuda, Hayato Takayama, Toshiharu Tanaka, Tetsuya Matsuoka, Tetsuhiro Takei, Tsuyoshi Hatada, Masahiro Tamashiro, Satoshi Fujimi, Osamu Nishida, Kazuhito Tamehiro, Junichi Maehara, Shinsuke Fujiwara, Hideo Wada

  16 Nov. 2018, Journal of Intensive Care, 6


• さあ、臨床研究を始めよう〜日々の疑問から論文まで 日本救急医学会の学会主導多施設研究の成果と課題 ANZICSと比較して

  小倉 裕司, 丸藤 哲, 齋藤 大蔵, 久志本 成樹, 藤島 清太郎, 真弓 俊彦, 阿部 智一, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 大友 康裕, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 355 - 355, Japanese


• SPICE-ICU研究報告 Sepsis-3を科学的に検証する

  小倉 裕司, 丸藤 哲, 齋藤 大蔵, 久志本 成樹, 藤島 清太郎, 真弓 俊彦, 阿部 智一, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 大友 康裕, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 412 - 412, Japanese


• Sepsis 定義と診断基準の変遷

  丸藤 哲, 齋藤 大蔵, 小倉 裕司, 久志本 成樹, 藤島 清太郎, 真弓 俊彦, 阿部 智一, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 大友 康裕, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 藤見 聡, 増野 智彦, 山川 一馬, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 413 - 413, Japanese


• Sepsis-3とqSOFAのpros & cons 敗血症診療における検証

  小倉 裕司, 梅村 穣, 丸藤 哲, 齋藤 大蔵, 久志本 成樹, 藤島 清太郎, 真弓 俊彦, 阿部 智一, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 大友 康裕, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 413 - 413, Japanese


• JAAM FORECAST Sepsis研究 全体疫学 敗血症患者の特徴と転帰

  小倉 裕司, 阿部 智一, 丸藤 哲, 齋藤 大蔵, 久志本 成樹, 藤島 清太郎, 真弓 俊彦, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 大友 康裕, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 414 - 414, Japanese


• 我が国における敗血症バンドル遵守率の推移

  藤島 清太郎, 丸藤 哲, 阿部 智一, 齋藤 大蔵, 小倉 裕司, 久志本 成樹, 白石 淳, 真弓 俊彦, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 大友 康裕, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 414 - 414, Japanese


• Quick SOFAの予後予測能は患者の重症度に左右される

  梅村 穣, 小倉 裕司, 丸藤 哲, 齋藤 大蔵, 久志本 成樹, 藤島 清太郎, 真弓 俊彦, 阿部 智一, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 大友 康裕, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 415 - 415, Japanese


• ARDSに対する前向き観察研究

  藤島 清太郎, 丸藤 哲, 齋藤 大蔵, 小倉 裕司, 久志本 成樹, 阿部 智一, 白石 淳, 真弓 俊彦, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 大友 康裕, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山川 一馬, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 415 - 415, Japanese


• JAAM FORECAST DIC研究 抗凝固療法の患者選択の最適化

  山川 一馬, 小倉 裕司, 丸藤 哲, 齋藤 大蔵, 久志本 成樹, 藤島 清太郎, 真弓 俊彦, 阿部 智一, 白石 淳, 池田 弘人, 射場 敏明, 上山 昌史, 梅村 穣, 大友 康裕, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 萩原 章嘉, 一二三 亨, 増野 智彦, 山下 典雄, 藤見 聡, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Oct. 2018, 日本救急医学会雑誌, 29(10) (10), 416 - 416, Japanese


• Immunosenescence in neurocritical care

  Inoue S, Saito M, Kotani J

  Background: Several advanced and developing countries are now entering a superaged society, in which the percentage of elderly people exceeds 20% of the total population. In such an aging society, the number of age-related diseases such as malignant tumors, diabetes, and severe infections including sepsis is increasing, and patients with such disorders often find themselves in the ICU. Main body: Age-related diseases are closely related to age-induced immune dysfunction, by which reductions in the efficiency and specificity of the immune system are collectively termed "immunosenescence." The most noticeable is a decline in the antigen-specific acquired immune response. The exhaustion of T cells in elderly sepsis is related to an increase in nosocomial infections after septicemia, and even death over subacute periods. Another characteristic is that senescent cells that accumulate in body tissues over time cause chronic inflammation through the secretion of proinflammatory cytokines, termed senescence-associated secretory phenotype. Chronic inflammation associated with aging has been called "inflammaging," and similar age-related diseases are becoming an urgent social problem. Conclusion: In neuro ICUs, several neuro-related diseases including stroke and sepsis-associated encephalopathy are related to immunosenescence and neuroinflammation in the elderly. Several advanced countries with superaged societies face the new challenge of improving the long-term prognosis of neurocritical patients.

  Oct. 2018, J Intensive Care, 6, 65 - 65, English, International magazine

  [Refereed]

  Introduction scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 血液浄化療法と免疫 マウス反復敗血症モデルにおける免疫老化の評価とIL-15の免疫賦活効果

  斉藤 雅史, 井上 茂亮, 小谷 穣治

  (NPO)日本急性血液浄化学会, Sep. 2018, 日本急性血液浄化学会雑誌, 9(Suppl.) (Suppl.), 79 - 79, Japanese


• 日本版敗血症診療ガイドライン2016の使用に関する実態調査報告

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 近藤 豊, 坂本 壮, 櫻谷 正明, 原 嘉孝, 福田 龍将, 安田 英人, 矢田部 智昭, 山川 一馬, 山下 和人, 日本版敗血症診療ガイドライ, 作成特別委員会

  (一社)日本救急医学会, Jul. 2018, 日本救急医学会雑誌, 29(7) (7), 175 - 182, Japanese


• 日本版敗血症診療ガイドライン2016の使用に関する実態調査報告

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 近藤 豊, 坂本 壮, 櫻谷 正明, 原 嘉孝, 福田 龍将, 安田 英人, 矢田部 智昭, 山川 一馬, 山下 和人

  (一社)日本集中治療医学会, Jul. 2018, 日本集中治療医学会雑誌, 25(4) (4), 271 - 277, Japanese


• 高齢マウス敗血症モデルにおける免疫疲弊とIL-15による免疫賦活効果

  井上 茂亮, 水嶋 七実, 山元 文晴, 小谷 穣治

  日本外科代謝栄養学会, Jun. 2018, 外科と代謝・栄養, 52(3) (3), 152 - 152, Japanese


• The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016).

  Osamu Nishida, Hiroshi Ogura, Moritoki Egi, Seitaro Fujishima, Yoshiro Hayashi, Toshiaki Iba, Hitoshi Imaizumi, Shigeaki Inoue, Yasuyuki Kakihana, Joji Kotani, Shigeki Kushimoto, Yoshiki Masuda, Naoyuki Matsuda, Asako Matsushima, Taka-Aki Nakada, Satoshi Nakagawa, Shin Nunomiya, Tomohito Sadahiro, Nobuaki Shime, Tomoaki Yatabe, Yoshitaka Hara, Kei Hayashida, Yutaka Kondo, Yuka Sumi, Hideto Yasuda, Kazuyoshi Aoyama, Takeo Azuhata, Kent Doi, Matsuyuki Doi, Naoyuki Fujimura, Ryota Fuke, Tatsuma Fukuda, Koji Goto, Ryuichi Hasegawa, Satoru Hashimoto, Junji Hatakeyama, Mineji Hayakawa, Toru Hifumi, Naoki Higashibeppu, Katsuki Hirai, Tomoya Hirose, Kentaro Ide, Yasuo Kaizuka, Tomomichi Kan'o, Tatsuya Kawasaki, Hiromitsu Kuroda, Akihisa Matsuda, Shotaro Matsumoto, Masaharu Nagae, Mutsuo Onodera, Tetsu Ohnuma, Kiyohiro Oshima, Nobuyuki Saito, So Sakamoto, Masaaki Sakuraya, Mikio Sasano, Norio Sato, Atsushi Sawamura, Kentaro Shimizu, Kunihiro Shirai, Tetsuhiro Takei, Muneyuki Takeuchi, Kohei Takimoto, Takumi Taniguchi, Hiroomi Tatsumi, Ryosuke Tsuruta, Naoya Yama, Kazuma Yamakawa, Chizuru Yamashita, Kazuto Yamashita, Takeshi Yoshida, Hiroshi Tanaka, Shigeto Oda

  Background and Purpose: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. Methods: Members of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two-thirds (>66.6%) majority vote of each of the 19 committee members. Results: A total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J-SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta-analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs. Conclusions: Based on the evidence gathered, we were able to formulate Japanese-specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non-specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

  Jan. 2018, Acute medicine & surgery, 5(1) (1), 3 - 89, English, International magazine

  [Refereed]

  Introduction scientific journal


• interleukin‐18の動態から見るマウス全身性炎症後の雄性不妊

  井上岳人, 井上岳人, 石川倫子, 石川倫子, 鴨志田伸吾, 山下勇人, 植村弥希子, 宇佐美眞, 小谷穣治

  (一社)日本救急医学会, 15 Sep. 2017, 日本救急医学会雑誌, 28(9) (9), 709 - 709, Japanese


• 一酸化炭素によるドナー前処置が及ぼすラット心臓移植後虚血再灌流障害の予防効果

  藤崎宣友, 石川倫子, 小谷穣治

  (一社)日本救急医学会, 15 Sep. 2017, 日本救急医学会雑誌, 28(9) (9), 607 - 607, Japanese


• 救急患者における栄養管理の最新トピックス 日本版ガイドラインの概説と実地臨床への応用

  小谷 穣治, 山田 勇, 白井 邦博, 上田 敬博, 平井 康富, 藤原 智弘, 大河原 悠介, 滿保 直美

  (一社)日本救急医学会, Sep. 2017, 日本救急医学会雑誌, 28(9) (9), 367 - 367, Japanese


• 多施設研究による日本からの情報発信 日本救急医学会 学会主導多施設研究の発展と今後の展望

  小倉 裕司, 丸藤 哲, 阿部 智一, 池田 弘人, 射場 敏明, 上山 昌史, 岡本 好司, 久志本 成樹, 小谷 穣治, 齋藤 大蔵, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 大友 康裕, 白石 振一郎, 田熊 清継, 樽井 武彦, 鶴田 良介, 中田 孝明, 一二三 亨, 藤島 清太郎, 藤見 聡, 増野 智彦, 真弓 俊彦, 武山 直志, 山下 典雄, 白石 淳, 萩原 章嘉, 水島 靖明, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Sep. 2017, 日本救急医学会雑誌, 28(9) (9), 436 - 436, Japanese


• A review of the history of the origin of triage from a disaster medicine perspective

  Nakao A, Ukai I, Kotani J

  Jul. 2017, Acute Med Surg, 4(4) (4), 379 - 384, English

  [Refereed]

  Introduction scientific journal


• Damage Control Orthopedics 当センターにおける多発外傷患者に対するDamage Control Orthopedics Surgery

  宮脇 淳志, 吉江 範親, 白井 邦博, 上田 敬博, 山田 太平, 小谷 穣治

  (一社)日本外傷学会, May 2017, 日本外傷学会雑誌, 31(2) (2), 259 - 259, Japanese


• Surgical Critical Careにおける栄養管理

  小谷 穣治, 白井 邦博, 上田 敬博, 寺嶋 真理子, 藤崎 宣友, 満保 直美, 中尾 博之, 山田 勇

  (一社)日本腹部救急医学会, Feb. 2017, 日本腹部救急医学会雑誌, 37(2) (2), 226 - 226, Japanese


• 日本版敗血症診療ガイドライン2016を読み解く 日本版敗血症診療ガイドライン2016(J-SSCG2016)の概要と作成の意義

  西田 修, 小倉 裕司, 井上 茂亮, 的場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライ, 作成特別委員会

  (一社)日本集中治療医学会, Feb. 2017, 日本集中治療医学会雑誌, 24(Suppl.) (Suppl.), SY12 - 1, Japanese


• 日本版敗血症診療GL2016(J-SSCG2016)とSurviving Sepsis Campaign Guidelines 2016(SSCG2016)の比較

  西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療, 作成特別委員会

  (一社)日本集中治療医学会, Feb. 2017, 日本集中治療医学会雑誌, 24(Suppl.) (Suppl.), SP - 1, Japanese


• マウスエンドトキシン血症下肝臓でのNeutrophil Extracellular Traps(NETs)形成へのInterleukin-18(IL-18)の関与

  石川 倫子, 神前 雅彦, 井上 岳人, 小濱 圭祐, 藤崎 宣友, 上田 敬博, 小谷 穣治

  (株)自然科学社, 2017, エンドトキシン血症救命治療研究会誌, 21(1) (1), 215 - 219, Japanese


• 熊本地震の避難所における栄養問題 差し入れは被災者のニーズを考えて送れ!

  小谷 穣治, 山田 太平, 上田 敬博, 大塚 裕之, 加藤 智崇, 福井 秀樹, 飯塚 利枝, 皆本 未由希, 全国保健師チー

  (株)ジェフコーポレーション, Jan. 2017, 日本静脈経腸栄養学会雑誌, 32(Suppl.) (Suppl.), 337 - 337, Japanese


• Taking action against malnutrition in Asian healthcare settings: an initiative of a Northeast Asia Study Group

  Takashi Higashiguchi, Hidenori Arai, Ling Hui Claytor, Masafumi Kuzuya, Joji Kotani, Shyh-Dye Lee, Jean-Pierre Michel, Tetsushi Nogami, Nanhai Peng

  2017, ASIA PACIFIC JOURNAL OF CLINICAL NUTRITION, 26(2) (2), 202 - 211, English

  [Refereed]

  Book review


• IS SKELETAL MUSCLE DEPLETION A PROGNOSTIC FACTOR FOR THE SEPTIC PATIENT?

  Noritomo Fujisaki, Michiko Ishikawa, Ayana Okamoto, Joji Kotani

  Dec. 2016, CRITICAL CARE MEDICINE, 44(12) (12), English

  Summary international conference


• Parenteral nutrition in critically ill patients

  白井 邦博, 小谷 穣治

  へるす出版, Dec. 2016, 救急医学 = The Japanese journal of acute medicine, 40(13) (13), 1625 - 1631, Japanese


• 早期社会復帰に向けた熱傷チームの工夫と取り組み

  上田 敬博, 白井 邦博, 寺嶋 真理子, 坂田 寛之, 小谷 穣治

  (一社)日本熱傷学会, Nov. 2016, 熱傷, 42(4) (4), 183 - 184, Japanese


• THE EFFECT OF ANTITHROMBIN III ON LIPOPOLYSACCHARIDE-INDUCED NEUTROPHIL EXTRACELLULAR TRAPS

  Michiko Ishikawa, Hayato Yamashita, Nobuki Oka, Noritomo Fujisaki, Taihei Yamada, Naomi Manbo, Takahiro Ueda, Joji Kotani

  Oct. 2016, SHOCK, 46(4) (4), 42 - 43, English

  Summary international conference


• HIGH-DOSE INTERLEUKIN-18 INDUCES MICE LEYDIG CELL APOPTOSIS VIA THE DEATH RECEPTOR PATHWAY

  Taketo Inoue, Michiko Ishikawa, Mikiko Uemura, Hayato Yamashita, Yuka Koga, Makoto Usami, Joji Kotani

  Oct. 2016, SHOCK, 46(4) (4), 63 - 63, English

  Summary international conference


• DOES INTERLEUKIN-18 PARTICIPATE IN HYPERGLYCEMIA IN SEPTIC MICE?

  Hayato Yamashita, Michiko Ishikawa, Taketo Inoue, Makoto Usami, Atsunori Nakao, Joji Kotani

  Oct. 2016, SHOCK, 46(4) (4), 29 - 29, English

  Summary international conference


• NUTRITION MANAGEMENT OF CRITICALLY ILL PATIENTS: EVIDENCES AND PRACTICE

  Joji Kotani, Atsunori Hashimoto, Kunihiro Shirai, Takahiro Ueda, Michiko Aoyama-Ishikawa, Taihei Yamada, Naomi Mambo, Yasutomi Hirai, Noritomo Fujisaki, Isamu Yamada, Hiroyuki Nakao

  Oct. 2016, SHOCK, 46(4) (4), 22 - 22, English

  Summary international conference


• Abdominal compartment syndrome(ACS)を呈した重症急性膵炎(severe acute pancreatitis:SAP)の特徴と予後

  白井 邦博, 山田 勇, 上田 敬博, 平井 康富, 山田 太平, 坂田 寛之, 中野 志保, 小谷 穣治

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 491 - 491, Japanese


• Surgical Critical Careにおける栄養管理

  小谷 穣治, 白井 邦博, 山田 勇, 山田 太平, 平井 康富, 上田 敬博, 岡本 彩那, 吉江 範親, 岩田 隆一

  日本Acute Care Surgery学会, Sep. 2016, Japanese Journal of Acute Care Surgery, 6(2) (2), 149 - 149, Japanese


• 日本版敗血症診療ガイドライン2016 成人敗血症患者に対する副腎皮質ステロイド投与について

  藤島 清太郎, 今泉 均, 升田 好樹, 巽 博臣, 藤村 直幸, 井上 茂亮, 射場 敏明, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞弘 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 松田 直之, 松嶋 麻子, 江木 盛時, 小倉 裕司, 西田 修, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライ, 作成特別委員会

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 302 - 302, Japanese


• 日本版敗血症診療ガイドライン2016 敗血症に対する免疫グロブリン投与

  今泉 均, 升田 好樹, 後藤 孝治, 早川 峰司, 安田 英人, 角 由佳, 井上 茂亮, 射場 敏明, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 松嶋 麻子, 松田 直之, 西田 修, 小倉 裕司, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライ, 作成特別委員会

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 303 - 303, Japanese


• 日本版敗血症診療ガイドライン2016 小児班のまとめ 定義

  中川 聡, 志馬 伸朗, 西田 修, 小倉 裕司, 井上 茂亮, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版敗血症診療ガイドライ, 作成特別委員会

  (一社)日本救急医学会, Sep. 2016, 日本救急医学会雑誌, 27(9) (9), 303 - 303, Japanese


• Donor pretreatment with carbon monoxide prevents ischemia/reperfusion injury following heart transplantation in rats

  Noritomo Fujisaki, Keisuke Kohama, Takeshi Nishimura, Hayato Yamashita, Michiko Ishikawa, Akihiro Kanematsu, Taihei Yamada, Sungsoo Lee, Joji Kotani, Atsunori Nakao

  Jul. 2016, TRANSPLANTATION, 100(7) (7), S469 - S469, English

  Summary international conference


• 【日本集中治療医学会重症患者の栄養療法ガイドラインをめぐって】 栄養ガイドライン作成方法

  小谷 穣治, 白井 邦博, 上田 敬博, 山田 勇, 日本集中治療医学会日本版重症患者の栄養管理ガイドライン作成委員会

  医学図書出版(株), Jun. 2016, ICUとCCU, 40(6) (6), 385 - 390, Japanese


• 心肺停止蘇生後にICUで緊急開胸術を施行するも救命し得なかった重症胸部外傷の一例

  白井 邦博, 上田 敬博, 山田 勇, 藤崎 宣友, 山田 太平, 平井 康富, 西村 健, 小谷 穣治

  (一社)日本外傷学会, May 2016, 日本外傷学会雑誌, 30(2) (2), 267 - 267, Japanese


• 日本版重症患者の栄養療法 ガイドラインの重要項目の紹介 国際ガイドラインと比較して

  小谷 穣治, 山田 勇, 平井 康富, 藤崎 宣友, 上田 敬博, 白井 邦博, 日本集中治療医学会, 日本版重症患者の栄養管理ガイドライン作成委員会

  真興交易(株)医書出版部, Mar. 2016, 臨床麻酔, 40(臨増) (臨増), 399 - 408, Japanese


• 敗血症病態における好中球アポトーシスへのアンチトロンビンIIIの効果について

  石川倫子, 石川倫子, 山下勇人, 宇佐美眞, 中尾篤典, 小谷穣治

  (一社)日本Shock学会, 18 Jan. 2016, Shock, 30(2) (2), 38‐43 - 43, Japanese


• n‐3不飽和多価脂肪酸はLPS刺激によるHMVEC‐L血管内皮モデル血管透過性を有意に減少させる

  尾迫貴章, 坂田寛之, 山田太平, 山下勇人, 石川倫子, 宇佐美眞, 中尾篤典, 小谷穣治

  (一社)日本集中治療医学会, 15 Jan. 2016, 日本集中治療医学会学術集会(Web), 43rd(Suppl.) (Suppl.), O3‐5 (WEB ONLY) - 399, Japanese


• 水素水の腹腔内注射によるマウス術後腸管麻痺の改善効果

  中尾篤典, 岡本彩那, 山下勇人, 石川倫子, 小濱圭祐, 西村健, 藤崎宣友, 小谷穣治

  (一社)日本集中治療医学会, 15 Jan. 2016, 日本集中治療医学会学術集会(Web), 43rd(Suppl.) (Suppl.), O43‐5 (WEB ONLY) - 479, Japanese


• 精巣男性ホルモン産生細胞におけるアポトーシスへのエンドトキシン及びIL‐18の関与

  井上岳人, 井上岳人, 石川倫子, 植村弥希子, 山下勇人, 古賀由華, 宇佐美眞, 小谷穣治

  日本エンドトキシン・自然免疫研究会, 2016, 日本エンドトキシン・自然免疫研究会プログラム・抄録集, 22nd, 22 - 34, Japanese


• 救急・集中治療領域における栄養学的リスクマネジメント:より安全で有効な栄養療法をめざして 重症患者に対する急性期栄養管理プロトコールの効果と課題

  白井 邦博, 小谷 穣治, 山田 勇, 上田 敬博, 山田 太平

  (株)ジェフコーポレーション, Jan. 2016, 日本静脈経腸栄養学会雑誌, 31(1) (1), 212 - 212, Japanese


• 日本集中治療医学会・日本救急医学会合同日本版重症敗血症診療ガイドライン ICU-acquired weaknessとPost-Intensive Care Syndrome CQの策定からメタ解析まで

  井上 茂亮, 畠山 淳司, 斉藤 伸行, 福家 良太, 近藤 豊, 一二三 亨, 武居 哲洋, 西田 修, 小倉 裕司, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版重症敗血症診療ガイドライ, 作成特別委員会

  (一社)日本集中治療医学会, Jan. 2016, 日本集中治療医学会雑誌, 23(Suppl.) (Suppl.), 352 - 352, Japanese


• 【臨床栄養-注目の話題】 救急集中治療の栄養管理を取り巻くガイドラインや潮流

  小谷 穣治, 山田 勇, 上田 敬博, 白井 邦博

  (株)へるす出版, Nov. 2015, 救急医学, 39(12) (12), 1641 - 1646, Japanese


• 自家培養表皮を早期に用いて治療戦略を立てた広範囲熱傷患者の1例

  井上 泰輔, 坂田 寛之, 上田 敬博, 小谷 穣治

  日本Acute Care Surgery学会, Oct. 2015, Japanese Journal of Acute Care Surgery, 5(2) (2), 242 - 242, Japanese


• ACSにおける栄養管理 ACSにおける早期経腸栄養 実施上の問題に対する我々の戦略と工夫

  小谷 穣治, 山田 太平, 橋本 篤徳, 小濱 圭祐, 寺嶋 真理子, 西村 健, 上田 敬博, 白井 邦博, 山田 勇, 中尾 篤典

  日本Acute Care Surgery学会, Oct. 2015, Japanese Journal of Acute Care Surgery, 5(2) (2), 154 - 154, Japanese


• 自家培養表皮植皮により救命・社会復帰しえた広範囲熱傷の1例

  空地 真依, 上田 敬博, 坂田 寛之, 小谷 穣治

  日本Acute Care Surgery学会, Oct. 2015, Japanese Journal of Acute Care Surgery, 5(2) (2), 242 - 242, Japanese


• 独歩受診で外来待合中、心肺停止に陥って判明した劇症型1型糖尿病の1例

  平井 康富, 上田 敬博, 山田 勇, 白井 邦博, 小谷 穣治

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 460 - 460, Japanese


• 広範囲熱傷における自家培養表皮植皮の手術・術後管理のストラテジー

  上田 敬博, 山田 勇, 白井 邦博, 坂田 寛之, 安田 之彦, 小谷 穣治

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 232 - 232, Japanese


• 出血性ショックを伴う骨盤骨折の特徴と治療についての検討

  白井 邦博, 宮脇 淳志, 神田 倫秀, 中野 志保, 加藤 久晶, 上田 敬博, 山田 勇, 小倉 真治, 小谷 穣治

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 391 - 391, Japanese


• 膵頭十二指腸切除術後11年目に胃空腸吻合部潰瘍穿孔をきたした1例

  川口 貴之, 白井 邦博, 坂田 寛之, 西村 健, 平井 康富, 山田 勇, 上田 敬博, 小谷 穣治

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 415 - 415, Japanese


• 学会主導多施設共同研究について考える 広範囲熱傷の初期輸液に関する多施設共同前向き無作為化比較対照試験の計画

  齋藤 大蔵, 丸藤 哲, 佐々木 淳一, 池田 弘人, 上山 昌史, 田熊 清継, 荒木 恒敏, 小倉 裕司, 藤島 清太郎, 阿部 智一, 白石 淳, 久志本 成樹, 真弓 俊彦, 射場 敏明, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 椎野 泰和, 白石 振一郎, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 水島 靖明, 一二三 亨, 藤見 聡, 増野 智彦, 三木 靖雄, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 315 - 315, Japanese


• 学会主導多施設共同研究について考える ALI/ARDSに対する多施設共同前向き観察研究

  藤島 清太郎, 丸藤 哲, 齋藤 大蔵, 小倉 裕司, 久志本 成樹, 真弓 俊彦, 阿部 智一, 白石 淳, 荒木 恒敏, 池田 弘人, 射場 敏明, 岡本 好司, 上山 昌史, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 一二三 亨, 藤見 聡, 増野 智彦, 三木 靖雄, 水島 靖明, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 315 - 315, Japanese


• 学会主導多施設共同研究について考える Sepsis registry 敗血症診療の国際標準化の現状と展望

  阿部 智一, 小倉 裕司, 齋藤 大蔵, 久志本 成樹, 白石 淳, 藤島 清太郎, 荒木 恒敏, 池田 弘人, 射場 敏明, 上山 昌史, 岡本 好司, 小谷 穣治, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 一二三 亨, 藤見 聡, 増野 智彦, 真弓 俊彦, 三木 靖雄, 水島 靖明, 山下 典雄, 丸藤 哲, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 315 - 315, Japanese


• 学会主導多施設共同研究について考える 日本救急医学会 学会主導多施設研究の発展とその経緯

  小倉 裕司, 丸藤 哲, 阿部 智一, 荒木 恒敏, 池田 弘人, 射場 敏明, 上山 昌史, 岡本 好司, 久志本 成樹, 小谷 穣治, 齋藤 大蔵, 阪本 雄一郎, 佐々木 淳一, 椎野 泰和, 白石 淳, 白石 振一郎, 田熊 清継, 武山 直志, 樽井 武彦, 鶴田 良介, 中田 孝明, 一二三 亨, 藤島 清太郎, 藤見 聡, 増野 智彦, 真弓 俊彦, 三木 靖雄, 水島 靖明, 山下 典雄, 日本救急医学会多施設共同試験特別委員会

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 316 - 316, Japanese


• 日本版重症敗血症診療ガイドライン2016に向けて 課題と展望 ICU-acquired weaknessとPost-Intensive Care Syndrome 最近の話題と動向

  井上 茂亮, 畠山 淳司, 齋藤 伸行, 福家 良太, 近藤 豊, 一二三 亨, 武居 哲洋, 西田 修, 小倉 裕司, 射場 敏明, 今泉 均, 江木 盛時, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 伸朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕, 日本版重症敗血症診療ガイドライ, 作成特別委員会

  (一社)日本救急医学会, Aug. 2015, 日本救急医学会雑誌, 26(8) (8), 312 - 312, Japanese


• 陰圧閉鎖療法後、自家培養表皮移植を用いた広範囲III度熱傷の1例

  坂田 寛之, 上田 敬博, 小谷 穣治

  (一社)日本熱傷学会, Jun. 2015, 熱傷, 41(2) (2), 65 - 69, Japanese


• 外科侵襲を代謝とサイトカインから考える 侵襲時のサイトカイン産生に関わる遺伝子多型の影響 本邦ICU多施設研究までの15年間の結果

  渡邉 栄三, 織田 成人, 坂本 照夫, 池田 寿昭, 小谷 穣治, 北村 伸哉, 高須 修, 安部 隆三, 服部 憲幸, 松村 洋輔, 高橋 和香

  日本外科代謝栄養学会, Jun. 2015, 外科と代謝・栄養, 49(3) (3), 140 - 140, Japanese


• 1.3%水素吸入はラット出血性ショック蘇生後急性肺障害を軽減する

  山下勇人, 小濱圭祐, 石川倫子, 西村健, 藤崎宣友, 宇佐美眞, 小谷穣治, 中尾篤典

  (一社)日本Shock学会, 11 May 2015, Shock, 30(1) (1), 62 - 62, Japanese


• ICU・CCU あんな症例、こんな症例(第38回) 歯科処置後に発症した縦隔気腫の1例

  西村 健, 中尾 篤典, 門井 謙典, 山田 太平, 吉江 範親, 澤井 龍生, 上田 敬博, 小谷 穣治

  医学図書出版(株), May 2015, ICUとCCU, 39(5) (5), 320 - 322, Japanese


• ショックと血液凝固異常 敗血症病態における好中球アポトーシスへのアンチトロンビンIIIの効果について

  石川 倫子, 山下 勇人, 宇佐美 眞, 中尾 篤典, 小谷 穣治

  (一社)日本Shock学会, May 2015, Shock: 日本Shock学会雑誌, 30(1) (1), 41 - 41, Japanese


• 致死的大量カフェイン錠服薬にてきたした急性カフェイン中毒の一例

  西村 健, 岡本 彩那, 藤崎 宣友, 坂田 寛之, 松田 健一, 橋本 篤徳, 上田 敬博, 山田 勇, 中尾 篤紀, 小谷 穣治

  (一社)日本集中治療医学会, Jan. 2015, 日本集中治療医学会雑誌, 22(Suppl.) (Suppl.), [DP93 - 6], Japanese


• 当院センターにおける重症敗血症に対するPMX-DHPの検討

  岡本 彩那, 山田 太平, 坂田 寛之, 松田 健一, 西村 健, 藤崎 宣友, 橋本 篤徳, 寺嶋 真理子, 上田 敬博, 小谷 穣治

  (一社)日本集中治療医学会, Jan. 2015, 日本集中治療医学会雑誌, 22(Suppl.) (Suppl.), [DP117 - 4], Japanese


• 重症敗血症における補助療法の現況―Antithrombinのエビデンスの整理と我々の基礎実験データ

  小谷穣治, 小谷穣治, 石川倫子, 石川倫子, 齋藤大蔵

  (一社)日本集中治療医学会, Jan. 2015, 日本集中治療医学会学術集会(Web), 42nd(Suppl.) (Suppl.), ES3-1 (WEB ONLY) - 1], Japanese


• Prior Arrangement by the Japan Association for Acute Medicine (JAAM) for a Future Japanese Board System Based on Accredited Residency Programs

  奥地 一夫, 浅利 靖, 兼坂 茂, 石松 伸一, 黒田 泰弘, 小谷 穣治, 鶴田 良介, 中川 隆, 中野 実, 山下 典雄

  [日本脳神経外科救急学会], 2015, Neurosurgical emergency, 20(1) (1), 14 - 19, Japanese


• 陰圧閉鎖療法・自家培養表皮を用いた全身III度熱傷の1例

  坂田 寛之, 上田 敬博, 小谷 穣治

  (一社)日本熱傷学会, Nov. 2014, 熱傷, 40(4) (4), 230 - 230, Japanese


• 出血性ショックを伴う腹部外傷症例に対する大動脈閉鎖バルーンの有効性についての検討

  西村 健, 岡本 彩那, 坂田 寛之, 松田 健一, 榎本 雄介, 満保 直美, 吉江 範親, 平井 康富, 藤崎 宣友, 山田 太平, 橋本 篤徳, 尾迫 貴章, 上田 敬博, 寺嶋 真理子, 宮脇 淳志, 山田 勇, 久保山 一敏, 中尾 篤典, 小谷 穣治

  日本Acute Care Surgery学会, Sep. 2014, Japanese Journal of Acute Care Surgery, 4(2) (2), 222 - 222, Japanese


• 【救急医療の現状と展望-セーフティネットを求めて-】 Surviving Sepsis Campaign Guidelines2012とセプシスレジストリー

  上田 敬博, 小谷 穣治

  (株)ライフメディコム, Aug. 2014, カレントテラピー, 32(8) (8), 774 - 780, Japanese


• 当施設における熱傷患者の治療実績と危険因子の考察

  坂田 寛之, 岡本 彩那, 吉江 範親, 山田 太平, 橋本 篤徳, 寺嶋 真理子, 山田 勇, 上田 敬博, 中尾 篤典, 小谷 穣治

  (一社)日本救急医学会, Aug. 2014, 日本救急医学会雑誌, 25(8) (8), 406 - 406, Japanese


• 血中IL18濃度とIL18プロモーター領域遺伝子多型はICU患者における死亡率と相関する

  山田 太平, 小濱 圭祐, 寺嶋 真理子, 上田 敬博, 中尾 篤典, 小谷 穣治

  (一社)日本救急医学会, Aug. 2014, 日本救急医学会雑誌, 25(8) (8), 418 - 418, Japanese


• 栴檀(センダン)果実摂食により死亡した1例

  松田 健一, 橋本 篤徳, 山田 勇, 上田 敬博, 平井 康富, 小谷 穣治

  (一社)日本救急医学会, Aug. 2014, 日本救急医学会雑誌, 25(8) (8), 567 - 567, Japanese


• 敗血症性ショックに至った、連鎖球菌による壊死性軟部感染症の2例

  吉江 範親, 宮脇 淳志, 松田 健一, 坂田 寛之, 岡本 彩那, 尾迫 貴章, 山田 太平, 橋本 篤徳, 上田 敬博, 中尾 篤典, 小谷 穣治

  (一社)日本救急医学会, Aug. 2014, 日本救急医学会雑誌, 25(8) (8), 568 - 568, Japanese


• 急性閉塞性化膿性胆管炎の治療経過中に左胃動脈瘤破裂をきたし救命した症例

  西村 健, 岡本 彩那, 坂田 寛之, 藤崎 宣友, 山田 太平, 橋本 篤徳, 尾迫 貴章, 上田 敬博, 山田 勇, 中尾 篤典, 小谷 穣治

  (一社)日本救急医学会, Aug. 2014, 日本救急医学会雑誌, 25(8) (8), 586 - 586, Japanese


• 魚油含有経静脈栄養の肺障害予防への可能性~ラットLPS誘発急性肺障害モデルを用いて~

  小濱圭祐, 中尾篤典, 寺嶋真理子, 石川倫子, 山下勇人, 藤原麻有, 清水隆雪, 原田大輔, 中山満雄, 宇佐美眞, 小谷穣治

  日本外科代謝栄養学会, 15 Jun. 2014, 外科と代謝・栄養, 48(3) (3), 73 - 73, Japanese


• 急性期病態におけるBile pigmentの生理的役割

  中尾 篤典, 小濱 圭祐, 山田 太平, 藤崎 宣友, 吉江 範親, 上田 敬博, 西村 健, 小谷 穣治

  (一社)日本救急医学会, Jun. 2014, 日本救急医学会雑誌, 25(6) (6), 239 - 246, Japanese


• 【日本版敗血症診療ガイドラインの評価】 日本版敗血症診療ガイドラインの概要とポイント

  上田 敬博, 小谷 穣治

  (一社)日本腹部救急医学会, May 2014, 日本腹部救急医学会雑誌, 34(4) (4), 779 - 785, Japanese


• ICU・CCU あんな症例、こんな症例(第25回) 人工呼吸管理に伴う気胸および縦隔気腫に合併した気腹症の1例

  岡本 彩那, 坂田 寛之, 松田 健一, 山田 太平, 尾迫 貴章, 上田 敬博, 中尾 篤典, 小谷 穣治

  医学図書出版(株), Apr. 2014, ICUとCCU, 38(4) (4), 282 - 284, Japanese


• 急性期診療環境更新にともなう当院の多数傷病者受入れ体制の再構築 防災訓練を通じての検証

  久保山 一敏, 小谷 穣治, 橋本 篤徳, 満保 直美, 松田 健一, 寺嶋 真理子, 上田 敬博, 山田 太平, 坂田 寛之

  (一社)日本臨床救急医学会, Apr. 2014, 日本臨床救急医学会雑誌, 17(2) (2), 231 - 231, Japanese


• 急性期DIC診断基準のsevere sepsisとseptic shockへの応用

  丸藤哲, 齋藤大蔵, 小倉裕司, 久志本成樹, 武山直志, 荒木恒敏, 池田弘人, 小谷穣治, 白石振一郎, 鈴木幸一郎, 鈴木泰, 田熊清継, 鶴田良介, 藤島清太郎, 真弓俊彦, 三木靖雄, 山下典雄, 山口芳裕, 相川直樹

  01 Apr. 2014, 日本血栓止血学会誌, 25(2) (2), 187, Japanese


• 魚油含有経静脈栄養がラットLPS誘導急性肺障害に及ぼす影響

  小濱圭祐, 寺嶋真理子, 石川倫子, 中尾篤典, 清水隆雪, 原田大輔, 中山満雄, 山田太平, 山田勇, 小谷穣治

  (一社)日本外科学会, 05 Mar. 2014, 日本外科学会雑誌, 115(臨増2) (臨増2), 293 - 293, Japanese


• 縊頸後の陽圧人工呼吸管理に伴い発生した気腹症の一例

  岡本 彩那, 坂田 寛之, 松田 健一, 吉江 範親, 山田 太平, 尾迫 貴章, 上田 敬博, 中尾 篤典, 久保山 一敏, 小谷 穣治

  (一社)日本腹部救急医学会, Feb. 2014, 日本腹部救急医学会雑誌, 34(2) (2), 560 - 560, Japanese


• 当施設における重症呼吸不全に対する体外式膜型人工肺(ECMO)導入症例の検討

  山田 太平, 尾迫 貴章, 吉江 範親, 松田 健一, 岡本 彩那, 坂田 寛之, 中尾 篤典, 上田 敬博, 久保山 一敏, 小谷 穣治

  (一社)日本集中治療医学会, Jan. 2014, 日本集中治療医学会雑誌, 21(Suppl.) (Suppl.), [O - 5], Japanese


• 当センターにおける早期再挿管例の検討

  坂田 寛之, 山田 太平, 尾迫 貴章, 岡本 彩那, 松田 健一, 吉江 範親, 上田 敬博, 久保山 一敏, 中尾 篤典, 小谷 穣治

  (一社)日本集中治療医学会, Jan. 2014, 日本集中治療医学会雑誌, 21(Suppl.) (Suppl.), [DP - 34, Japanese


• 敗血症性ショックを呈した、壊死性筋膜炎の1例

  寺嶋 真理子, 宮脇 敦志, 満保 直美, 中尾 篤典, 橋本 篤徳, 松田 健一, 坂田 寛之, 岡本 彩那, 上田 敬博, 小谷 穣治

  (一社)日本外科感染症学会, Oct. 2013, 日本外科感染症学会雑誌, 10(5) (5), 701 - 701, Japanese


• 急性炎症後の回復期における精巣生殖細胞のアポトーシスとIL‐18の関与

  井上岳人, 青山倫子, 西野哲, 笹野真希, 岡伸樹, 山下勇人, 上田敬博, 鴨志田伸吾, 宇佐美眞, 小谷穣治

  (一社)日本生殖医学会, 01 Oct. 2013, 日本生殖医学会雑誌, 58(4) (4), 297 - 297, Japanese


• 敗血症(セプシス)治療の標準化 敗血症患者の血糖管理

  江木 盛時, 小谷 穣治, 西田 修, 井上 茂亮

  (一社)日本外科感染症学会, Oct. 2013, 日本外科感染症学会雑誌, 10(5) (5), 581 - 581, Japanese


• FACT時代を迎える外傷初期診療 CTパンスキャンによる脊椎損傷の診断

  宮脇 淳志, 山田 太平, 橋本 篤徳, 松田 健一, 坂田 寛之, 岡本 絢菜, 寺嶋 真理子, 尾迫 貴章, 上田 敬博, 久保山 一敏, 小谷 穣治

  (一社)日本救急医学会, Aug. 2013, 日本救急医学会雑誌, 24(8) (8), 493 - 493, Japanese


• 重症病態の栄養治療戦略 当施設における早期経腸栄養開始の課題と解決策

  山田 太平, 小谷 穣治, 久保山 一敏, 上田 敬博, 尾迫 貴章, 吉江 範親, 松田 健一, 岡本 彩那, 坂田 寛之, 中尾 篤典, 橋本 篤徳

  (一社)日本救急医学会, Aug. 2013, 日本救急医学会雑誌, 24(8) (8), 498 - 498, Japanese


• 救急・集中治療分野における診療報酬査定の特徴について

  上田 敬博, 中尾 篤典, 坂田 寛之, 松田 健一, 橋本 篤徳, 山田 太平, 尾迫 貴章, 寺島 真理子, 山田 勇, 小谷 穣治

  (一社)日本臨床救急医学会, Jun. 2013, 日本臨床救急医学会雑誌, 16(3) (3), 427 - 427, Japanese


• 当施設における5年間の食物誤嚥による窒息症例の検討

  松田 健一, 上田 敬博, 中尾 篤典, 小谷 穣治

  (一社)日本臨床救急医学会, Jun. 2013, 日本臨床救急医学会雑誌, 16(3) (3), 432 - 432, Japanese


• ECMO導入により救命しえた墜落外傷によるびまん性肺挫傷の1例

  坂田 寛之, 上田 敬博, 松田 健一, 井上 朋子, 中島 有香, 山田 太平, 橋本 篤徳, 吉江 範親, 中尾 篤典, 小谷 穣治

  (一社)日本臨床救急医学会, Jun. 2013, 日本臨床救急医学会雑誌, 16(3) (3), 455 - 455, Japanese


• 重症敗血症への挑戦 n-3系多価不飽和脂肪酸静脈投与によるラットエンドトキシン血症下好中球アポトーシス抑制の解除

  寺嶋 真理子, 中尾 篤典, 石川 倫子, 萩 彰文, 小濱 圭介, 小谷 穣治

  (一社)日本臨床救急医学会, Jun. 2013, 日本臨床救急医学会雑誌, 16(3) (3), 307 - 307, Japanese


• NOMI(非閉塞性腸管虚血症)に伴う結腸壊死を合併した重症急性膵炎の1例

  山田 勇, 寺嶋 真理子, 橋本 篤典, 中尾 篤典, 上田 敬博, 小谷 穣治

  日本外科系連合学会, May 2013, 日本外科系連合学会誌, 38(3) (3), 693 - 693, Japanese


• 日本救急医学会Sepsis Registry特別委員会報告 Severe sepsisに対する診療の質と死亡率の検証

  藤島 清太郎, 丸藤 哲, 齋藤 大蔵, 真弓 俊彦, 久志本 成樹, 白石 振一郎, 小倉 裕司, 田熊 清継, 小谷 穣治, 池田 弘人, 山下 典雄, 鈴木 幸一郎, 鶴田 良介, 武山 直志, 荒木 恒敏, 鈴木 泰, 三木 靖雄, 山口 芳裕, 相川 直樹, 日本救急医学会Sepsis Registry特別委員会

  (一社)日本救急医学会, May 2013, 日本救急医学会雑誌, 24(5) (5), 263 - 269, Japanese


• 日本救急医学会Sepsis Registry特別委員会報告 Severe sepsis疫学データ解析結果

  小倉 裕司, 丸藤 哲, 齋藤 大蔵, 武山 直志, 久志本 成樹, 藤島 清太郎, 真弓 俊彦, 荒木 恒敏, 池田 弘人, 小谷 穣治, 白石 振一郎, 鈴木 幸一郎, 鈴木 泰, 田熊 清継, 鶴田 良介, 三木 靖雄, 山口 芳裕, 山下 典雄, 相川 直樹, 日本救急医学会Sepsis Registry特別委員会

  (一社)日本救急医学会, May 2013, 日本救急医学会雑誌, 24(5) (5), 270 - 277, Japanese


• 日本救急医学会Sepsis Registry特別委員会報告 Severe sepsisにおける急性期DIC診断基準の検証

  丸藤 哲, 齋藤 大蔵, 小倉 裕司, 久志本 成樹, 武山 直志, 荒木 恒敏, 池田 弘人, 小谷 穣治, 白石 振一郎, 鈴木 幸一郎, 鈴木 泰, 田熊 清継, 鶴田 良介, 藤島 清太郎, 真弓 俊彦, 三木 靖雄, 山下 典雄, 山口 芳裕, 相川 直樹, 日本救急医学会Sepsis Registry特別委員会

  (一社)日本救急医学会, May 2013, 日本救急医学会雑誌, 24(5) (5), 278 - 282, Japanese


• 日本救急医学会Sepsis Registry特別委員会報告 Severe sepsis症例からの分離菌の検討

  田熊 清継, 藤島 清太郎, 齋藤 大蔵, 白石 振一郎, 池田 弘人, 荒木 恒敏, 小倉 裕司, 久志本 成樹, 小谷 穣治, 鈴木 幸一郎, 鈴木 泰, 武山 直志, 鶴田 良介, 真弓 俊彦, 三木 靖雄, 山下 典雄, 丸藤 哲, 山口 芳裕, 相川 直樹, 日本救急医学会Sepsis Registry特別委員会

  (一社)日本救急医学会, May 2013, 日本救急医学会雑誌, 24(5) (5), 283 - 290, Japanese


• 日本救急医学会Sepsis Registry特別委員会報告 Severe Sepsis治療データ解析結果

  小谷 穣治, 齋藤 大蔵, 丸藤 哲, 鈴木 幸一郎, 鶴田 良介, 山下 典雄, 荒木 恒敏, 池田 弘人, 小倉 裕司, 久志本 成樹, 白石 振一郎, 鈴木 泰, 田熊 清継, 武山 直志, 藤島 清太郎, 真弓 俊彦, 三木 靖雄, 山口 芳裕, 相川 直樹, 日本救急医学会Sepsis Registry特別委員会

  (一社)日本救急医学会, May 2013, 日本救急医学会雑誌, 24(5) (5), 291 - 296, Japanese


• 日本救急医学会Sepsis Registry特別委員会報告 Severe sepsisにおける体温は重症度と転帰に関連する

  久志本 成樹, 丸藤 哲, 齋藤 大蔵, 真弓 俊彦, 荒木 恒敏, 池田 弘人, 小倉 裕司, 小谷 穣治, 白石 振一郎, 鈴木 幸一郎, 鈴木 泰, 田熊 清継, 武山 直志, 鶴田 良介, 藤島 清太郎, 三木 靖雄, 山下 典雄, 山口 芳裕, 相川 直樹, 日本救急医学会Sepsis Registry特別委員会

  (一社)日本救急医学会, May 2013, 日本救急医学会雑誌, 24(5) (5), 297 - 304, Japanese


• 日本救急医学会Sepsis Registry特別委員会報告 Severe sepsis患者におけるBody Mass Index(BMI)の影響 日本救急医学会Sepsis Registry 535例の解析

  山下 典雄, 丸藤 哲, 齋藤 大蔵, 荒木 恒敏, 池田 弘人, 小倉 裕司, 久志本 成樹, 小谷 穣治, 白石 振一郎, 鈴木 幸一郎, 鈴木 泰, 田熊 清継, 武山 直志, 鶴田 良介, 藤島 清太郎, 真弓 俊彦, 三木 靖雄, 山口 芳裕, 相川 直樹, 日本救急医学会Sepsis Registry特別委員会

  (一社)日本救急医学会, May 2013, 日本救急医学会雑誌, 24(5) (5), 305 - 309, Japanese


• 日本救急医学会Sepsis Registry特別委員会報告 肺炎・膿胸によるsevere sepsisの血液・巣培養結果と重症度の関係についての検討

  白石 振一郎, 丸藤 哲, 田熊 清継, 荒木 恒敏, 池田 弘人, 齋藤 大蔵, 藤島 清太郎, 小倉 裕司, 久志本 成樹, 小谷 穣治, 鈴木 幸一郎, 鈴木 泰, 武山 直志, 鶴田 良介, 真弓 俊彦, 三木 靖雄, 山下 典雄, 山口 芳裕, 相川 直樹, 日本救急医学会Sepsis Registry特別委員会

  (一社)日本救急医学会, May 2013, 日本救急医学会雑誌, 24(5) (5), 310 - 314, Japanese


• 日本救急医学会Sepsis Registry特別委員会報告 Severe sepsisの早期予後予測指標の検討 septic shockと比較して

  樽井 武彦, 山口 芳裕, 鈴木 幸一郎, 鶴田 良介, 丸藤 哲, 荒木 恒敏, 池田 弘人, 小倉 裕司, 久志本 成樹, 小谷 穣治, 斎藤 大蔵, 白石 振一郎, 鈴木 泰, 田熊 清継, 武山 直志, 藤島 清太郎, 真弓 俊彦, 三木 靖雄, 山下 典雄, 相川 直樹, 日本救急医学会Sepsis Registry特別委員会

  (一社)日本救急医学会, May 2013, 日本救急医学会雑誌, 24(5) (5), 315 - 319, Japanese


• 急性炎症後の回復期における精巣生殖細胞のアポトーシスとIL‐18の役割

  井上岳人, 青山倫子, 西野哲, 笹野真希, 岡伸樹, 山下勇人, 上田敬博, 鴨志田伸吾, 宇佐美眞, 小谷穣治

  (一社)日本Shock学会, 26 Apr. 2013, Shock, 28(1) (1), 60 - 60, Japanese


• 重症胸部外傷による呼吸不全に対し体外式肺補助(ECMO)管理した1症例

  山田 太平, 小谷 穣治, 久保山 一敏, 上田 敬博, 尾迫 貴章, 中島 有香, 吉江 範親, 松田 健一, 中尾 篤典, 寺嶋 真理子, 小濱 圭祐, 橋本 篤徳, 満保 直美

  (一社)日本外傷学会, Apr. 2013, 日本外傷学会雑誌, 27(2) (2), 225 - 225, Japanese


• 血糖管理による生体反応の制御はどこまで可能か?

  石川倫子, 小谷穣治

  (株)メジカルビュー社, 10 Mar. 2013, 侵襲と免疫, 22(1) (1), 48 - 50, Japanese


• ショック、敗血症、臓器障害における最新治療 侵襲反応の性差について

  小谷 穣治, 石川 倫子, 上田 敬博, 高原 美樹, 山内 千里, 岡 伸樹, 宇佐美 眞

  (一社)日本Shock学会, Feb. 2013, Shock: 日本Shock学会雑誌, 27(2) (2), 52 - 58, Japanese


• 院内急変における救命センターの役割

  宮脇 淳志, 中尾 篤典, 橋本 篤徳, 尾迫 貴章, 山田 太平, 寺嶋 真理子, 上田 敬博, 小谷 穣治, 西 信一, 岡崎 理絵

  (一社)日本集中治療医学会, Jan. 2013, 日本集中治療医学会雑誌, 20(Suppl.) (Suppl.), 442 - 442, Japanese


• 日本版敗血症診療ガイドライン The Japanese Guidelines for the Management of Sepsis

  織田 成人, 相引 眞幸, 池田 寿昭, 今泉 均, 遠藤 重厚, 落合 亮一, 小谷 穣治, 志馬 伸朗, 西田 修, 野口 隆之, 松田 直之, 平澤 博之, 秋富 慎司, 安宅 一晃, 井上 茂亮, 氏家 良人, 江木 盛時, 垣花 泰之, 後藤 孝治, 坂本 照夫, 佐々木 淳一, 貞広 智仁, 佐藤 格夫, 柴田 純平, 鈴木 泰, 巽 博臣, 中永 士師明, 中村 智之, 仲村 将高, 布宮 伸, 長谷川 隆一, 林 淑朗, 藤島 清太郎, 升田 好樹, 松田 兼一, 真弓 俊彦, 山 直也, 日本集中治療医学会Sepsis Registry委員会

  (一社)日本集中治療医学会, Jan. 2013, 日本集中治療医学会雑誌, 20(1) (1), 124 - 173, Japanese


• 【ICU患者の栄養管理】 重症病態に対する栄養管理の実際 外傷・熱傷

  山田 太平, 上田 敬博, 小谷 穣治

  (株)メディカルレビュー社, Dec. 2012, 栄養-評価と治療, 29(4) (4), 320 - 324, Japanese


• 重症広範囲熱傷患者に対する自家培養皮膚(ジェイス)の生着評価の検討

  寺嶋 真理子, 上田 敬博, 松田 健一, 岩野 仁香, 山田 太平, 橋本 篤徳, 小濱 圭介, 尾迫 貴章, 中島 有香, 山田 勇, 小谷 穣治

  (一社)日本熱傷学会, Nov. 2012, 熱傷, 38(4) (4), 207 - 207, Japanese


• 後天性精子障害の病態解析 Interleukin-18は急性炎症下の精巣における生殖細胞のアポトーシスを制御する(The role of interleukin-18 on testicular germ cell apoptosis during acute inflammation)

  井上 岳人, 青山 倫子, 西野 哲, 笹野 真希, 岡 伸樹, 山下 勇人, 上田 敬博, 鴨志田 伸吾, 宇佐美 眞, 小谷 穣治

  日本生殖免疫学会, Nov. 2012, Reproductive Immunology and Biology, 27(1-2) (1-2), 53 - 53, English


• 【日本版敗血症診療ガイドラインを読み解く】血糖コントロールと栄養管理

  小谷 穣治, 江木 盛時, 佐藤 格夫, 井上 茂亮, 西田 修, 日本集中治療医学会Sepsis Registry委員会血糖, 栄養ワーキンググループ

  医学図書出版(株), Nov. 2012, ICUとCCU, 36(11) (11), 999 - 1006, Japanese


• 当救命救急センターにおけるCPAOA症例に対する異状死対応の実状

  久保山 一敏, 小谷 穣治, 宮脇 敦志, 上田 敬博, 寺嶋 真理子, 小濱 圭祐, 橋本 篤徳, 山田 太平

  (一社)日本救急医学会, Oct. 2012, 日本救急医学会雑誌, 23(10) (10), 542 - 542, Japanese


• 当センターにおける輸血拒否症例に対する対応

  宮脇 淳志, 久保山 一敏, 山田 勇, 上田 敬博, 寺嶋 真理子, 橋本 篤徳, 山田 太平, 尾迫 貴明, 小濱 圭祐, 井上 朋子, 小谷 穣治

  (一社)日本救急医学会, Oct. 2012, 日本救急医学会雑誌, 23(10) (10), 585 - 585, Japanese


• 当センターにおける急性薬物中毒患者の検討

  井上 朋子, 橋本 篤徳, 満保 直美, 寺嶋 真理子, 山田 勇, 小濱 圭祐, 山田 太平, 上田 敬博, 宮脇 淳志, 久保山 一敏, 小谷 穣治

  (一社)日本救急医学会, Oct. 2012, 日本救急医学会雑誌, 23(10) (10), 661 - 661, Japanese


• エンドトキシン血症下の精巣における生殖細胞アポトーシスとIL‐18の関与

  井上岳人, 青山倫子, 西野哲, 笹野真希, 神前雅彦, 岡伸樹, 藤原麻有, 上田敬博, 鴨志田伸吾, 宇佐美眞, 小谷穣治

  (一社)日本Shock学会, Apr. 2012, Shock, 27(1) (1), 79 - 79, Japanese


• 【重症患者の栄養管理〜各種病態下での管理〜】 免疫栄養について

  山田 太平, 上田 敬博, 佐藤 格夫, 小谷 穣治

  医学図書出版(株), Apr. 2012, ICUとCCU, 36(4) (4), 277 - 285, Japanese


• 当センターにおける心原性心停止に対するECPRの効果についての予後の検討

  中島 有香, 上田 敬博, 松田 健一, 満保 直美, 井上 朋子, 山田 太平, 橋本 篤徳, 小濱 圭祐, 尾迫 貴章, 小谷 穣治

  (一社)日本臨床救急医学会, Apr. 2012, 日本臨床救急医学会雑誌, 15(2) (2), 265 - 265, Japanese


• 当センターのおける脳梗塞に対するt-PA投与の時間因子と予後の検討

  尾迫 貴章, 上田 敬博, 松田 健一, 中島 有香, 山田 太平, 橋本 篤徳, 寺嶋 真理子, 宮脇 淳志, 久保山 一敏, 小谷 穣治

  (一社)日本臨床救急医学会, Apr. 2012, 日本臨床救急医学会雑誌, 15(2) (2), 266 - 266, Japanese


• 重症患者における血糖の正確性に関するsystematic review

  井上 茂亮, 江木 盛時, 小谷 穣治

  (一社)日本集中治療医学会, Jan. 2012, 日本集中治療医学会雑誌, 19(Suppl.) (Suppl.), 329 - 329, Japanese


• 広範囲重症熱傷における自家培養皮膚(ジェイス)の使用方法と課題

  岩野 仁香, 上田 敬博, 寺嶋 真理子, 井上 朋子, 山田 太平, 橋本 篤徳, 小濱 圭祐, 尾迫 貴章, 宮脇 敦志, 大家 宗彦, 小谷 穣治

  (一社)日本熱傷学会, Nov. 2011, 熱傷, 37(4) (4), 232 - 232, Japanese


• 【外傷(頭部・胸腹部・四肢・骨盤)と感染】 外傷と代謝栄養管理

  上田 敬博, 小谷 穣治, 橋本 篤徳, 寺嶋 真理子

  (一社)日本外科感染症学会, Aug. 2011, 日本外科感染症学会雑誌, 8(4) (4), 307 - 315, Japanese


• 栄養評価 (特集 急性期 代謝・栄養管理)

  上田 敬博, 井上 朋子, 小谷 穣治

  医学出版, Mar. 2011, レジデント, 4(3) (3), 15 - 22, Japanese


• 敗血症治療と凝固異常 Surviving Sepsis Campaign Guidelinesにおける抗凝固療法の位置づけ

  小谷 穣治, 橋本 篤徳, 山田 太平, 布施 知佐香, 井上 朋子, 本多 釈人, 満保 直美, 上田 敬博, 大家 宗彦, 久保山 一敏

  (一社)日本腹部救急医学会, Feb. 2011, 日本腹部救急医学会雑誌, 31(2) (2), 306 - 306, Japanese


• 集中治療におけるNST活動と栄養管理 重症患者の代謝と栄養管理のコツ

  小谷 穣治, 橋本 篤徳, 寺嶋 真理子, 山田 太平, 上田 敬博, 児島 正道, 高橋 留佳, 矢吹 浩子

  (一社)日本集中治療医学会, Jan. 2011, 日本集中治療医学会雑誌, 18(Suppl.) (Suppl.), 387 - 387, Japanese


• アクションカードを主軸とした多数傷病者受け入れ体制の構築 兵庫医科大学病院での取り組み

  久保山 一敏, 小谷 穣治, 上田 敬博, 橋本 篤徳, 山田 太平, 清水 真幸, 千島 佳也子, 源 貴裕

  (一社)日本集団災害医学会, Dec. 2010, 日本集団災害医学会誌, 15(3) (3), 387 - 387, Japanese


• 汎発性血管内血液凝固症の3病型に対するトロンボモジュリンの線溶系への影響

  布施 知佐香, 平田 淳一, 寺嶋 真理子, 尾迫 貴章, 小濱 圭祐, 橋本 篤徳, 山田 太平, 上田 敬博, 井上 朋子, 宮脇 淳志, 小谷 穣治

  (一社)日本救急医学会, Aug. 2010, 日本救急医学会雑誌, 21(8) (8), 649 - 649, Japanese


• 小児救急における小児外科の役割 救命救急センターとの連携について

  奥山 宏臣, 佐々木 隆士, 清水 義之, 小谷 穣治, 上田 敬博

  (一社)日本小児救急医学会, May 2010, 日本小児救急医学会雑誌, 9(2) (2), 183 - 183, Japanese


• 【Sepsisとその周辺】 Sepsisの補助療法 栄養管理

  小谷 穣治, 井上 朋子, 布施 知佐香, 宮脇 敦志, 諸岡 孝俊, 山田 太平, 橋本 篤徳, 伊東 真紀, 上田 敬博

  (株)へるす出版, Mar. 2010, 救急医学, 34(3) (3), 327 - 337, Japanese


• 【急性期呼吸不全の栄養管理 経腸栄養を中心に】 免疫能を考慮した経腸栄養法 免疫増強・免疫調節の観点から

  小谷 穣治, 小濱 圭祐, 布施 知佐香, 井上 朋子, 尾迫 貴章, 寺嶋 真理子, 上田 敬博, 宮脇 淳志

  医学図書出版(株), Mar. 2010, ICUとCCU, 34(3) (3), 205 - 212, Japanese


• 急性心不全におけるCarperitide投与量と血中BNP値の関連についての検討

  上田 敬博, 増山 理, 平田 淳一, 山田 太平, 橋本 篤徳, 寺嶋 真理子, 大家 宗彦, 小谷 穣治

  (一社)日本集中治療医学会, Jan. 2010, 日本集中治療医学会雑誌, 17(Suppl.) (Suppl.), 296 - 296, Japanese


• 【急性期栄養管理の基本と実際】 急性期患者の栄養管理を理解するために 栄養管理のプランニングと評価

  小谷 穣治, 橋本 篤徳, 尾迫 貴章, 蔭山 晶子, 木下 理恵, 上田 敬博

  (株)へるす出版, Dec. 2009, 救急医学, 33(13) (13), 1751 - 1756, Japanese


• 【消化器外科における経腸栄養の意義と役割】 重症救急患者における早期経腸栄養法

  小谷 穣治, 橋本 篤徳, 寺嶋 真理子, 山田 大平, 上田 敬博

  (株)医学書院, Oct. 2009, 臨床外科, 64(10) (10), 1383 - 1395, Japanese


• 救急・災害医療での人工臓器 1995年阪神淡路大震災(地震)と2005年JR福知山線脱線事故(脱線)における人工臓器医療の経験から本邦災害医療の進歩を考える

  小谷 穣治, 寺嶋 真理子, 平田 淳一, 橋本 篤徳, 山田 太平, 諸岡 孝俊, 上田 敬博, 宮脇 敦志, 大家 宗彦, 久保山 一敏, 切田 学

  (一社)日本人工臓器学会, Oct. 2009, 人工臓器, 38(2) (2), S - 30, Japanese


• Case Report: linezolid-induced lactic acidosis and hypophosphatemia after discontinuation of linezolid

  上田 敬博, 小谷 穣治, 竹松 芳生

  日本外科感染症学会, Aug. 2009, Journal of Japan Society for Surgical Infection, 6(4) (4), 343 - 346, Japanese


• 【ショック管理Q&A 迅速で、的確な対応のために】 ケース別ショックへの対応 食物依存性運動誘発アナフィラキシーの病態、診断と治療戦略とは?

  上田 敬博, 徳田 良, 小谷 穣治

  (株)総合医学社, Jul. 2009, 救急・集中治療, 21(7-8) (7-8), 968 - 972, Japanese


• 小児救急における小児外科の役割 救命救急センターとの連携について

  奥山 宏臣, 佐々木 隆士, 清水 義之, 小谷 穣治, 上田 敬博

  (NPO)日本小児外科学会, May 2009, 日本小児外科学会雑誌, 45(3) (3), 491 - 491, Japanese


• 感染症患者における栄養管理

  小谷 穣治, 橋本 篤徳, 上田 敬博

  アステラス製薬(株), Jan. 2009, 感染症, 39(1) (1), 32 - 36, Japanese


• 【生体侵襲と臓器管理 急性期病態の理解とその対応】 臓器管理 急性呼吸不全の管理

  上田 敬博, 小谷 穣治

  (株)総合医学社, Nov. 2008, 救急・集中治療, 20(9-10) (9-10), 1327 - 1332, Japanese


• 【急性肺傷害のup-to-date】 ALI/ARDSの薬物治療

  上田 敬博, 米田 雅洋, 小谷 穣治

  (株)メジカルビュー社, Jul. 2008, 侵襲と免疫, 17(2) (2), 57 - 61, Japanese


• Sexual dimorphism in the relationship of IL-18 to splenocyte apoptosis and mortality during systemic inflammation

  Mari Watanabe, Michiko Aoyama, Shoko Fudo, Katsuhito Shuno, Makoto Usami, Seishiro Marukawa, Joji Kotani

  2008, SHOCK, 29, 102 - 102, English

  Summary international conference


• Tumor necrosis factor-alpha gene-238 single nucleotide polymorphisms (SNPs) are associated with low TNF-alpha production from mononuclear cells in Japanese

  Katsuhito Shuno, Michiko Aoyama, Shoko Fudo, Hiroe Sakaki, Makoto Miyoshi, Makoto Usami, Seishiro Marukawa, Joji Kotani

  2008, SHOCK, 29, 77 - 78, English

  Summary international conference


• The role of IL-18 in apoptosis induction of bone marrow graneulocyte during systemic inflammation in mice

  Michiko Aoyama, Joji Kotani, Makoto Miyoshi, Hiroe Sakaki, Katsuhito Shuno, Mari Watanabe, Makoto Usami, Seisiro Marukawa

  2008, SHOCK, 29, 77 - 77, English

  Summary international conference


• 経腸栄養はラット急性膵炎

  小谷 穣治, 宇佐美 眞, 橋本 篤徳, 平田 淳, 上田 敬博, 寺嶋 真理子, 丸川 征四郎

  (一社)日本Shock学会, Dec. 2007, Shock: 日本Shock学会雑誌, 22(2) (2), 32 - 32, Japanese


• The effect of TPN with n-3 polyunsaturated fatty acids-enriched lipids on neutrophil apoptosis during systemic inflammation

  Joji Kotani, Mariko Terashima, Jun-ichi Hirata, Munehiko Ohya, Takahiro Ueda, Seishiro Marukawa, Akifumi Hagi, Michiko Aoyama, Makoto Usami

  Dec. 2007, CRITICAL CARE MEDICINE, 35(12) (12), A11 - A11, English

  Summary international conference


• The influence of TPN with n-3 polyunsaturated fatty acids-enriched lipids on neutrophil apoptosis during endotoxin-induced systemic inflammation in rats

  小谷 穣治, 寺嶋 真理子, 青山 倫子

  日本外科感染症学会, Nov. 2007, Journal of Japan Society for Surgical Infection, 4(4) (4), 543 - 549, Japanese


• Short-Chain Fatty Acids on Tight Junction Permeability and Remodelling in Intestinal Monolayer Cells and Their Mechanisms

  USAMI Makoto, OHATA Atsushi, MIYOSHI Makoto, AOYAMA Michiko, SAKAKI Hiroe, SHUNO Katsuhito, KOTANI Jyoji, KAMBARA Yoshihiro

  15 Oct. 2007, 外科と代謝・栄養, 41(5) (5), 129 - 142, Japanese


• 当救命救急センターにおける救急診療状況と問題点

  切田 学, 松平 宗典, 小谷 穣治, 山田 太平, 橋本 篤徳, 上田 敬博, 久保山 一敏, 吉永 和正, 丸川 征四郎

  (一社)日本救急医学会, Aug. 2007, 日本救急医学会雑誌, 18(8) (8), 394 - 394, Japanese


• フルニエ症候群の治療法の検 結腸瘻は必要か?

  寺嶋 真理子, 切田 学, 小谷 穣治, 橋本 篤徳, 山田 太平, 平田 淳一, 上田 敬博, 大家 宗彦, 松平 宗典, 吉永 和正, 丸川 征四郎

  (一社)日本救急医学会, Aug. 2007, 日本救急医学会雑誌, 18(8) (8), 405 - 405, Japanese


• 当センターの重症急性膵炎(SAP)における治療の現況 消化管機能評価と栄養管理を含めて

  小谷 穣治, 切田 学, 寺嶋 真理子, 松平 宗典, 上田 敬博, 平田 淳一, 大家 宗彦, 吉永 和正, 丸川 征四郎

  (一社)日本救急医学会, Aug. 2007, 日本救急医学会雑誌, 18(8) (8), 453 - 453, Japanese


• 重症病態における潜在性感染の再検討 バクテリアルトランスロケーションを中心に 経腸栄養はラット急性膵炎におけるBacterial translocatonを抑制する生存率を改善しない

  小谷 穣治, 宇佐美 眞, 橋本 篤徳, 平田 淳, 上田 敬博, 寺嶋 真理子, 丸川 征四郎

  (一社)日本Shock学会, Apr. 2007, Shock: 日本Shock学会雑誌, 22(1) (1), 40 - 40, Japanese


• 大阪国際空港訓練アンケート結果よりみた空港災害医療の課題

  上田 敬博, 吉永 和正, 山田 太平, 久保山 一敏, 小谷 穣治, 切田 学, 大植 麻衣, 安井 大雅, 高村 学, 丸川 征四郎

  (一社)日本臨床救急医学会, Apr. 2007, 日本臨床救急医学会雑誌, 10(2) (2), 252 - 252, Japanese


• 急性エンドトキシン血症(Etx)下における幼弱・成熟骨髄細胞 (BM) apoptosis (Ap) と生存率における内因性IL-18の役割

  青山 倫子, 小谷 穣治, 谷出 晶子, 不動 翔子, 秀野 克仁, 大野 葉月, 坂木 宏衣, 三好 真琴, 宇佐美 眞, 丸川 征四郎

  一般社団法人日本外科学会, 10 Mar. 2007, 日本外科学会雑誌, 108, 273 - 273, Japanese


• 身体的問題のある精神疾患患者の救命救急センターでの対応 精神疾患を有する外傷患者の在院日数長期化の検討 ISSと在院日数の関係から

  切田 学, 小谷 穣治, 松平 宗典, 上田 敬博, 大家 宗彦, 久保山 一敏, 平田 淳一, 橋本 篤徳, 吉永 和正, 丸川 征四郎

  (一社)日本救急医学会, Aug. 2006, 日本救急医学会雑誌, 17(8) (8), 356 - 356, Japanese


• 多発外傷 多発外傷Preventable Trauma Death例の検討 非多発外傷との比較から

  切田 学, 小谷 穣治, 山田 真理子, 橋本 篤徳, 久保山 一敏, 松平 宗典, 上田 敬博, 平田 淳一, 吉永 和正, 丸川 征四郎

  (一社)日本救急医学会, Aug. 2006, 日本救急医学会雑誌, 17(8) (8), 364 - 364, Japanese


• 多発外傷の死亡率は非多発外傷より悪いか? 各ISSレベルにおける死亡率の比較から

  山田 真理子, 切田 学, 小谷 穣治, 橋本 篤徳, 久保山 一敏, 松平 宗典, 上田 敬博, 平田 淳一, 吉永 和正, 丸川 征四郎

  (一社)日本救急医学会, Aug. 2006, 日本救急医学会雑誌, 17(8) (8), 522 - 522, Japanese


• 当センターにおける重症熱傷5例の検討

  澁谷 真彦, 上田 敬博, 吉見 宣子, 切田 学, 小谷 穣治, 吉永 和正, 丸川 征四郎

  (一社)日本臨床救急医学会, Apr. 2006, 日本臨床救急医学会雑誌, 9(2) (2), 202 - 202, Japanese


• 生体肝移植ドナー選定を巡って親族間に亀裂が残ったB型慢性肝炎急性増悪による亜急性劇症肝炎の一症例

  小谷 穣治, 上田 敬博, 平田 淳一, 切田 学, 丸川 征四郎

  (一社)日本臨床救急医学会, Apr. 2006, 日本臨床救急医学会雑誌, 9(2) (2), 179 - 179, Japanese


• 救命救急センターにおける臨床研修医教育の問題点 臨床研修医アンケートと上級医就労実態から

  切田 学, 小谷 穣治, 松平 宗典, 久保山 一敏, 大家 宗彦, 山田 真理子, 上田 敬博, 安井 大雅, 吉永 和正, 丸川 征四郎

  (一社)日本臨床救急医学会, Apr. 2006, 日本臨床救急医学会雑誌, 9(2) (2), 171 - 171, Japanese


• 気管挿管を拒否したため非侵襲的陽圧換気(NPPV)を用い治療しえた高齢者重症肺炎の1例

  山田 真規子, 上田 敬博, 久保 聡子, 澁谷 真彦, 松平 宗典, 小谷 穣治, 丸川 征四郎

  (一社)日本臨床救急医学会, Apr. 2006, 日本臨床救急医学会雑誌, 9(2) (2), 178 - 178, Japanese


• tributyrin及びHDAC inhibitorによる侵襲反応制御

  三好 真琴, 宇佐美 眞, 大畑 淳, 青山 倫子, 布江 田友理, 谷出 晶子, 森 砂織, 赤池 信英, 國場 幸史, 小谷 穣治

  一般社団法人日本外科学会, 05 Mar. 2006, 日本外科学会雑誌, 107(2) (2), 482 - 482, Japanese


• 短鎖脂肪酸(SCFA)による単球系細胞(MM 6)のapoptosis (Ap)誘導とその機序

  青山 倫子, 武田 麻紀, 大畑 淳, 小谷 穣治, 三好 真琴, 布江 田友理, 谷出 晶子, 宇佐美 眞

  一般社団法人日本外科学会, 05 Mar. 2006, 日本外科学会雑誌, 107(2) (2), 482 - 482, Japanese


• 急性膵炎に対する輸液と栄養管理 重症急性膵炎の輸液管理

  小谷 穣治, 切田 学, 大家 宗彦, 山田 真理子, 上田 敬博, 平田 淳一, 吉永 和正, 丸川 征四郎

  (一社)日本腹部救急医学会, Feb. 2006, 日本腹部救急医学会雑誌, 26(2) (2), 234 - 234, Japanese


• 多発外傷における腹部臓器損傷の診断と治療 AIS3以上の腹部損傷を伴う多発外傷例の治療戦略

  山田 真理子, 切田 学, 小谷 穣治, 平田 淳一, 上田 敬博, 大家 宗彦, 吉永 和正, 丸川 征四郎

  (一社)日本腹部救急医学会, Feb. 2006, 日本腹部救急医学会雑誌, 26(2) (2), 312 - 312, Japanese


• 当センターにおける重症急性膵炎治療の現況

  小谷 穣治, 切田 学, 山田 真理子, 上田 敬博, 平田 淳一, 安井 大雅, 松平 宗典, 大家 宗彦, 吉永 和正, 丸川 征四郎

  (一社)日本集中治療医学会, Jan. 2006, 日本集中治療医学会雑誌, 13(Suppl.) (Suppl.), 142 - 142, Japanese


• 敗血症症例における非侵襲的循環動態の検討

  上田 敬博, 大家 宗彦, 安井 大雅, 平田 淳一, 小谷 穣治, 切田 学, 丸川 征四郎

  (一社)日本救急医学会, Aug. 2005, 日本救急医学会雑誌, 16(8) (8), 380 - 380, Japanese


• 【侵襲下におけるmicrobial translocationのup-to-date】腸管上皮細胞におけるToll-like receptorsの役割

  小谷 穣治, 五島 正裕, 青山 倫子, 切田 学, 宇佐美 真, 丸川 征四郎

  日本外科代謝栄養学会, Aug. 2005, 外科と代謝・栄養, 39(4) (4), 165 - 178, Japanese


• 好中球 apoptosis への短鎖脂肪酸の効果(第105回日本外科学会定期学術集会)

  青山 倫子, 小谷 穣治, 宇佐美 眞, 大畑 淳, 岸本 和徳, 三好 真琴, 布江田 友理, 武田 麻紀, 福田 祐子, 野口 依子, 松村 美穂

  一般社団法人日本外科学会, 05 Apr. 2005, 日本外科学会雑誌, 106, 462 - 462, Japanese


• 内視鏡的クリッピング術を行い保存的に治療し得た突発性食道破裂の1例

  上田 敬博, 小谷 穣治, 平田 淳一, 切田 学, 丸川 征四郎

  (一社)日本腹部救急医学会, Feb. 2005, 日本腹部救急医学会雑誌, 25(2) (2), 393 - 393, Japanese


• 縫い針刺入による心損傷の一症例

  秋冨慎司, 小谷穣治, 上田敬博, 切田学, 吉永和正, 丸川征四郎

  2005, 日本外傷学会雑誌, 19(2) (2)


• 救急集中治療領域における続発性下肢深部静脈血栓症/肺血栓塞栓症の発症背景因子

  米田 雅洋, 切田 学, 安井 大雅, 平田 淳一, 上田 敬博, 小谷 穣治, 久保山 一敏, 吉永 和正, 丸川 征四郎

  (一社)日本集中治療医学会, Jan. 2005, 日本集中治療医学会雑誌, 12(Suppl.) (Suppl.), 209 - 209, Japanese


• 敗血症における免疫・抗免疫療法 エンドトキシン血症下骨髄幼弱及び成熟好中球のアポトーシス誘導におけるTNF receptorの役割

  小谷 穣治, スティーブ・カルバノ, スティーブ・ローリー, 平田 淳一, 上田 敬博, 大家 宗彦, 久保山 一敏, 切田 学, 吉永 和正, 丸川 征四郎

  (一社)日本集中治療医学会, Jan. 2004, 日本集中治療医学会雑誌, 11(Suppl.) (Suppl.), 130 - 130, Japanese


• 頸椎損傷例の死因の検討

  安井 大雅, 切田 学, 丸川 征四郎, 吉永 和正, 久保山 一敏, 大家 宗彦, 小谷 穣治, 細原 勝士, 上田 敬博, 上野 直子, 平田 淳一, 米田 雅洋

  (一社)日本救急医学会, Oct. 2003, 日本救急医学会雑誌, 14(10) (10), 533 - 533, Japanese


• 来院時心肺停止蘇生不成功例における死後CT scanの有用性

  久保山 一敏, 丸川 征四郎, 吉永 和正, 切田 学, 大家 宗彦, 小谷 穣治, 細原 勝士, 上野 直子, 上田 敬博, 平田 淳一, 米田 雅洋, 安井 大雅

  (一社)日本救急医学会, Oct. 2003, 日本救急医学会雑誌, 14(10) (10), 704 - 704, Japanese


• 重症肝機能障害,急性呼吸不全を合併した原発性肺高血圧症の1救命例

  上田 敬博, 細原 勝士, 平田 淳一, 小谷 穣治, 切田 学, 吉永 和正, 丸川 征四郎

  日本蘇生学会, Oct. 2003, 蘇生, 22(3) (3), 206 - 206, Japanese


• 年齢別に見たヒト外傷症例の死亡率における性差の検討

  上田 敬博, 小谷 穣治, 切田 学, 安井 大雅, 平田 淳一, 米田 雅洋, 上野 直子, 細原 勝士, 大家 宗彦, 久保山 一敏, 吉永 和正, 丸川 征四郎

  (一社)日本救急医学会, Oct. 2003, 日本救急医学会雑誌, 14(10) (10), 560 - 560, Japanese


• ヒト内因性疾患死亡率の性差における性ホルモンの関与の検討

  小谷 穣治, 切田 学, 上田 敬博, 安井 大雅, 平田 淳一, 米田 雅洋, 上野 直子, 細原 勝士, 大家 宗彦, 久保山 一敏, 吉永 和正, 丸川 征四郎

  (一社)日本救急医学会, Oct. 2003, 日本救急医学会雑誌, 14(10) (10), 561 - 561, Japanese


• 入院後に下肢深部静脈血栓症或いは肺血栓塞栓症を続発した症例の検討

  米田 雅洋, 切田 学, 安井 大雅, 平田 淳一, 上田 敬博, 小谷 穣治, 久保山 一敏, 吉永 和正, 丸川 征四郎

  (一社)日本救急医学会, Oct. 2003, 日本救急医学会雑誌, 14(10) (10), 603 - 603, Japanese


• 重症急性膵炎40例の治療現況

  切田 学, 小谷 穣治, 大家 宗彦, 安井 大雅, 上田 敬博, 吉永 和正, 丸川 征四郎

  (一社)日本救急医学会, Oct. 2003, 日本救急医学会雑誌, 14(10) (10), 647 - 647, Japanese

• 急性期脳梗塞治療における時間短縮に向けた多職種での取り組み

  野間 聰子, 大内 智恵, 中谷 真子, 吉次 育子, 立花 久嗣, 小林 和幸, 安藤 維洋, 今堀 太一郎, 佐藤 伊都子, 京谷 勉輔, 岡崎 裕太朗, KOTANI JOUJI

  第34回日本脳神経血管内治療学会学術総会, Nov. 2018, Japanese, 日本脳神経血管内治療学会, 仙台, Domestic conference

  Poster presentation


• 本邦における敗血症診療ガイドライン作成の意義とその恩恵

  小倉 裕司, 西田 修, 井上 茂亮, 射場 敏明, 今泉 均, Egi Moritoki, 垣花 泰之, 久志本 成樹, 小谷 穣治, 貞広 智仁, 志馬 仲朗, 中川 聡, 中田 孝明, 布宮 伸, 林 淑朗, 藤島 清太郎, 升田 好樹, 松嶋 麻子, 松田 直之, 織田 成人, 田中 裕

  第45回日本集中治療医学会学術集会, Feb. 2018, Japanese, 日本集中治療医学会, 千葉, Domestic conference

  [Invited]

  Nominated symposium


• 日本版重症患者の栄養療法ガイドラインダイジェスト版作成について

  東別府 直紀

  第45回日本集中治療医学会学術集会, Feb. 2018, Japanese, 日本集中治療医学会, 千葉, Domestic conference

  Public discourse


• 当院の救急専用集中治療室におけるNST活動報告

  前野 愛, 滿保 直美, 堀江 翔, 折野 芳香, 岡田 健男, 前林 秀治, 藁田 希世和, 白井 邦博, 冨田 尚裕

  第33回日本静脈経腸栄養学会学術集会, Feb. 2018, Japanese, 日本静脈経腸栄養学会, 横浜, Domestic conference

  Poster presentation


• 重症患者の栄養療法ガイドライン・ダイジェスト版を持ってベッドサイドに行こう!

  小谷 穣治

  第45回日本集中治療医学会学術集会, Feb. 2018, Japanese, 日本集中治療医学会, 千葉, Domestic conference

  Public discourse


• 災害医療教育・研修・訓練（座長）

  小谷 穣治

  第23回日本集団災害医学会総会・学術集会, Feb. 2018, Japanese, 日本集団災害医学会, 横浜, Domestic conference

  Others


• 共催ワークショップ（SW）徹底討論「高たんぱく質負荷」（司会）

  小谷 穣治

  第45回日本集中治療医学会学術集会, Feb. 2018, Japanese, 日本集中治療医学会, 千葉, Domestic conference

  Others


• TheGutintheintensivecareunit（ICU）―friendorfoeforadequatefeeding DepartmentofClinicalNutrition,GenevaUniversityHospital,Geneva,Switzerland. ClaudePICHARD （司会

  小谷 穣治

  第33回日本静脈経腸栄養学会学術集会, Feb. 2018, Japanese, 日本静脈経腸栄養学会, 横浜, Domestic conference

  Others


• 術後感染症抑止を目指した周術期感染対策と栄養管理（座長）

  小谷 穣治

  第30回日本外科感染症学会総会学術集会, Nov. 2017, Japanese, 日本外科感染症学会, 東京, Domestic conference

  Others


• Surgical Critical Care における栄養治療

  小谷 穣治

  第30回日本外科感染症学会総会学術集会, Nov. 2017, Japanese, 日本外科感染症学会, 東京, Domestic conference

  [Invited]

  Invited oral presentation


• 腸管不全の予防と治療：最先端のエビデンス（司会）

  小谷 穣治

  第45回日本救急医学会総会, Oct. 2017, Japanese, 日本救急医学会, 大阪, Domestic conference

  Others


• 重症病態の栄養療法-エビデンスと実践とNSTの役割-

  小谷 穣治

  第25回日本消化器関連学会週間(JDDW 2017 FUKUOKA), Oct. 2017, Japanese, 日本消化器関連学会, 福岡, Domestic conference

  Public discourse


• 重症救急患者に対する早期の経腸投与エネルギーは、標準量が必要か?（司会）

  小谷 穣治

  第45回日本救急医学会総会, Oct. 2017, Japanese, 日本救急医学会, 大阪, Domestic conference

  Others


• 高たんぱく・エネルギー制限をスタンダードに ～重症患者の栄養療法～（座長）

  小谷 穣治

  第45回日本救急医学会総会, Oct. 2017, Japanese, 日本救急医学会, 大阪, Domestic conference

  Others


• 救急患者における栄養管理の最新トピックス-日本版ガイドラインの概説と実地臨床への応用

  小谷 穣治

  第45回日本救急医学会総会, Oct. 2017, Japanese, 日本救急医学会, 大阪, Domestic conference

  Public discourse


• 一酸化炭素によるドナー前処置が及ぼすラット心臓移植後虚血再灌流障害の予防効果

  藤崎 宣友, 石川 倫子

  第45回日本救急医学会総会, Oct. 2017, Japanese, 日本救急医学会, 大阪, Domestic conference

  Oral presentation


• 意識障害を主訴に来院した特発性食道破裂の一例

  大河原 悠介, 藤原 智弘, 小林 智行, 山田 勇

  第45回日本救急医学会総会, Oct. 2017, Japanese, 日本救急医学会, 大阪, Domestic conference

  Oral presentation


• interleukin-18の動態から見るマウス全身性炎症後の雄性不妊

  井上 岳人, 石川 倫子, Kamoshida Shingo, 山下 勇人, 植村 弥希子, 宇佐 美眞

  第45回日本救急医学会総会, Oct. 2017, Japanese, 日本救急医学会, 大阪, Domestic conference

  Oral presentation


• ICU-AWを踏まえた機能予後改善のために 経腸栄養療法で今すぐ実行できること～重症患者の経腸栄養を血糖コントロールの観点から見直す～（座長）

  小谷 穣治

  第45回日本救急医学会総会, Oct. 2017, Japanese, 日本救急医学会, 大阪, Domestic conference

  Others


• 敗血症・DIC・血液凝固異常（座長）

  小谷 穣治

  第32回日本救命医療学会総会・学術集会, Sep. 2017, Japanese, 日本救命医療学会, 横浜, Domestic conference

  Others

• A therapeutic strategy of post-intensive care syndrome focused on its mechanism and inflammation regulation in brain.

  井上 茂亮, 松本 理器, 西田 修, 曽良 一郎, 黒田 泰弘, 小谷 穣治, 山下 公大, 酒井 良忠

  Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (B), Kobe University, 01 Apr. 2020 - 31 Mar. 2023

  敗血症患者や重症患者の長期予後は未だ不良である。その原因として、ICU退室後や退院後に運動機能，認知機能，精神障害が生じる集中治療後症候群(PICS）や、敗血症後のびまん性脳機能障害である敗血症性脳症（SAE）が知られているものの、未だ病態解明や治療ターゲットの同定に至っていない。本研究では、①重症患者の炎症・免疫機能とPICS発症の関係を明らかにし、②マウスPICSモデルでのSAE発症メカニズムを解明し、③感染・脳内炎症制御の観点からPICSの新規治療法を探索する。本研究は現代の集中治療医学で解決すべき喫緊の課題であるPICSおよびSAEの機序解明と、それに基づいた新規治療法まで応用しうる画期的かつ基盤的な研究である。 研究1:ICU敗血症患者の免疫機能解析とPICSの評価 インフォームドコンセントを得られた神戸大学救命救急センターICUに入院となった敗血症患者の末梢血より単離したT細胞のサブタイプならびに炎症系サイトカインをフローサイトメーターにて解析。さらに意識障害を有する患者では髄液より同様の検討を行う。またICU入院中・ICU退室時・退院後の身体機能・せん妄・認知機能・精神機能を評価しPICSの程度を評価する。中枢神経障害の程度は脳波・画像検査を適宜実施し、ICUでの免疫機能とPICSパラメーターの相関を比較検討する。 研究2:マウスPICSモデルの作成とその評価 C57B6マウス(6-8週雄)に便懸濁（Cecal Slurry:CS）を腹腔内に投与し作成した敗血症モデルマウスに対して輸液・人工呼吸管理・抗菌薬投与を実施しヒトの集中治療を模した治療を施行し、身体機能・認知機能・精神機能に関わる行動試験を行って各PICSの主要な症状を診断し、モデルを構築する。


• IL-18 as a therapeutic target for sepsis-associated encephalopathy and long-term prognosis of septic mouse

  Joji Kotani

  Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Kobe University, 01 Apr. 2019 - 31 Mar. 2022

  To investigate whether interleukin (IL)-18 involves in the pathogenesis of sepsis-associated encephalopathy (SAE), we analyzed the expression of inflammatory cytokines in the brain after sepsis. On day 8 after sepsis induction with the mouse, significant expression of inflammatory cytokines was observed in the brain, but IL-18 was not changed. Microglia, astrocytes, neutrophils, monocytes, and γδ T cells, which are predicted to induce brain inflammation, increased immediately after the induction of sepsis. Significant cognitive, mental, and physical impairments were observed in each behavioral test of septic mice performed one week after sepsis induction. 6, 12, and 18 months after sepsis induction, significant cognitive and physical impairments were observed in the septic mice compared with control mice.


• 敗血症における男性予後改善の治療標的としてのIL-18の可能性

  小谷 穣治

  学術研究助成基金助成金／基盤研究(C), Apr. 2016 - Mar. 2019, Principal investigator

  Competitive research funding


• Development of useful biomarkers for diagnosis of septic shock by using a new method for peptidome analysis

  Wakabayashi Ichiro

  Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Challenging Exploratory Research, Hyogo Medical University, 01 Apr. 2014 - 31 Mar. 2017

  Peptides in the blood of patients suffering from sepsis were inclusively analyzed using the BLOTCHIP―MS method. Twenty patients with sepsis were divided into two groups of patients with and those without a complication of disseminated intravascular coagulation (DIC). By differential analysis of peptides in blood for these groups, we selected thirteen MS peaks as candidate marker peptides for prediction of DIC. By further ROC analysis, eleven sets, each consisting of four peak peptides, were found to show AUC of 1. Among the thirteen peptides, four frequently detected peptides were subjected to precision mass measurement and subsequent MS/MS analysis. Consequently, two peptides of m/z = 2743 and m/z = 2886 were identified to be α2-HS-glycoprotein and fibrinogen β chain, respectively, both of which consist of 27 amino acids. These peptides are expected to be biomarkers for prediction of DIC in patients with sepsis.


• The relationship between IL-18 polymorphism and gender difference in emergency intensive care unit

  Kotani Joji, KUBOYAMA Kazutoshi, UEDA Takahiro, USAMI Makoto, ISHIKAWA Michiko, YAMADA Isamu, MIYAWAKI Atsushi, NAKAO Atsunori, TERASHIMA Mariko, HASHIMOTO Atsunori

  Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Hyogo Medical University, 01 Apr. 2013 - 31 Mar. 2016

  This study examined the relationship between the plasma IL-18 levels, IL-18 promoter polymorphism, and outcomes or pathological conditions of the patients in the emergency intensive care unit (ICU). Only sex, APACHE II score, and plasma IL-18 level were identified as independent predictors of mortality by multivariate analysis. The plasma IL-18 levels were correlated with APACHE II score, and the patients who did not survive showed significantly higher levels of plasma IL-18 as compared with survivors. Patients who did not survive and had the -607 CA genotype (CA/GC or CA/GG) showed significantly higher plasma IL-18 levels than survivors with the same genotype. However, there were no relationship between IL-18 promoter genotypes and pathological conditions (non-sepsis, sepsis, septic shock). And there were also no relationship between IL-18 promoter genotypes and the neutrophil ability or gender difference. Plasma IL-18 levels may be predictive of outcome in patients with sepsis.


• Hydrogen Inhalation Protects Against Acute Lung Injury Induced by Hemorrhagic Shock and Resuscitation

  Nakao Atsunori, ISHIKAWA Michiko, KOTANI joji

  Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Hyogo Medical University, 01 Apr. 2013 - 31 Mar. 2016

  Hemorrhagic shock followed by fluid resuscitation (HS/R) leads acute lung injury (ALI). Hydrogen, atherapeutic gas, has potent cytoprotective, antiinflammatory, and antioxidant effects. Rats were subjected to hemorrhagic shock by withdrawing blood to lower blood pressure followed by resuscitation with shed blood and saline to restore blood pressure. After HS/R, the rats were maintained in a control gas of similar composition to room air or exposed to 1.3% hydrogen. HS/R induced ALI, as demonstrated by significantly impaired gas exchange, congestion, edema, cellular infiltration, and hemorrhage in the lungs. Exposure to 1.3% hydrogen significantly attenuated the upregulation of neutrophil accumulation, alveolar cell wall thickness, oxidative stress, the mRNAs for several proinflammatory mediators induced by HS/R. Hydrogen, administered through inhalation, may exert potent therapeutic effects against ALI induced by HS/R and attenuate the activation of inflammatory cascades.


• The effect of IL-18 and gender difference on inflammation-related insulin resistance.

  KOTANI Joji, USAMI Makoto, AOYAMA Michiko, OKIMURA Yasuhiko

  Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Challenging Exploratory Research, Hyogo Medical University, 2011 - 2012

  The purpose of this study was to evaluate the effects of endogenous IL-18 and its gender difference on inflammation-related insulin resistance. The endogenous IL-18 might inhibit hyperglycemia and hyperinsulinemia during acute inflammation. The plasma insulin concentration was higher in male than in female mice, however, the relation of IL-18 to this gender differencve has not been elucidated clearly yet. Further studies are needed to investigate the role ofendogenous IL-18 on the gender difference in inflammation-related insulin resistance.


• 魚油の静脈投与による侵襲下好中球アポトーシス抑制の解除と組織障害軽減の研究

  小谷 穣治

  日本学術振興会, 科学研究費助成事業, 挑戦的萌芽研究, 兵庫医科大学, 2009 - 2010

  経腸栄養が不可能な症例ではTPNは全身の栄養状態の改善に非常に有効な手段である。n-3系多価不飽和脂肪酸は抗炎症作用を有し、免疫栄養として注目されている。我々はn-3脂肪製剤の静脈投与が自然免疫の中心的役割を担う好中球に及ぼす影響を検討した。ラットエンドトキシン血症モデルを用いて無脂肪群、n-6群、n-3群の3群での3日間のTPN施行後、腹腔滲出細胞を採取、脂肪酸構成比率の変化とLTB4、B5産生能を検討した。また、TPN施行後に生食またはLPSを腹腔内投与し、末梢血と骨髄細胞の脂肪酸構成比率とアポトーシスを検討した。 腹腔内滲出細胞では、n-3群でn-3/n-6比が増加し、細胞内にn-3系多価不飽和脂肪酸が多く取り込まれていることが明らかとなった。また、この時の腹腔内滲出細胞をin vitroで培養すると、LTB4の産生が抑制され、LTB5の産生が優位になったことから、n-3系多価不飽和脂肪酸は腹腔内滲出細胞の構成成分を3日間で変え、LT産生を炎症性から抗炎症性へとシフトする可能性が示唆された。末梢血では、血漿中の脂肪酸のn-3/n-6比は生食群、LPS群ともn-3系多価不飽和脂肪酸により増加することが示され、LPS群では生食群よりも増加が顕著であった。骨髄細胞においてもn-3/n-6比は同様の傾向を示した。しかし、末梢血好中球においてはアポトーシスには変化がなく、骨髄細胞でのみn-6群に比較してn-3群でアポトーシスが増加した。 以上より、好中球のLT産生能は脂肪酸構成比率に依存し、n-3系多価不飽和脂肪酸により侵襲下での骨髄細胞のアポトーシスは促進した。これは早期の末梢好中球過剰による組織障害を回避する可能性があるが、骨髄での好中球アポトーシス抑制をより解除することにより、免疫抑制をきたす可能性が考えられた。


• The role of TIR family receptors in the apoptosis of the intestinal epithelium under endotoxinemia.

  TERASHIMA Mariko, KOTANI Joji, UEDA Takahiro, MARUKAWA Seishirou

  Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Exploratory Research, Hyogo College of Medicine, 2007 - 2008

  本研究ではIL-18 knock outマウス(KO)を用いてlipopolysacc haride(LPS)投与によりエンドトキシン血症モデルを作成し、空腸、回腸のapoptosisとTIRファミリーであるIL-18およびTLR4の関連を調べた。空腸ではエンドトキシンによりIL-18濃度が減少してTLR4の発現とapoptosisが増加し、IL-18濃度はTLR4の発現に関与している可能性が示唆された。しかし、回腸ではIL-18とTLR4の関係は明らかではなかった。本研究によりIL-18はエンドトキシン血症下のTIRレセプターファミリーの発現に関与すること、腸管の部位により働きが異なる可能性が示唆され、現在さらに解析を進めている。


• The role of TIR family receptors in the induction of apoptosis of bone marrow cells and the immunosuppression after the endotoxinemia.

  KOTANI Joji, TERASHIMA Mariko, OYA Munehiko, KIRITA Manabu, MARUKAWA Seichirou, USAMI Makoto

  Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Hyogo College of Medicine, 2007 - 2008

  本研究ではIL-18 knock outマウス(KO)を用いてlipopolysacc haride (LPS)投与によりエンドトキシン血症モデルを作成し、エンドトキシン血症下での過剰なIL-18の存在が生存率に関与する可能性が示唆された。また、顆粒球の細胞動態とアポトーシスには性差が存在し、IL-18は性別により血中濃度や顆粒球系細胞に対する作用が異なることが明らかとなった。このことは性差における致命率の差にIL-18が関与していることを示しており、今後のIL-18投与、又は中和療法において性別が重要であることを示すものである。


• The role of Il-18 In Inducing or preventing apoptosis in neutrophils during acute endotoxemia

  KOTANI Joji, OHYA Munehiko, OKAMURA Haruki, MARUKAWA Seishiro

  Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Hyogo College of Medicine, 2004 - 2005

  1.The role of TNR receptors in bone marrow cell apoptosis during endotoxin-induced systemic inflammatory state. Apoptosis of myeloid cells in the bone marrow during endotoxemia is minimized as these cells undergo differentiation, which in turn, may be due to the attenuation of the pro-apoptotic effect of TNFR-p55 shown herein to occur with myeloid differentiation. In contrast, TNFR-p75 appears to play a minimal role in apoptosis induction in Grl(-) myeloid cells during endotoxemia. One explanation for a decrease in bone marrow cell numbers during endotoxemia may be via induction of apoptosis in immature myeloid cells. 2.The role of IL-18 in bone marrow cell apoptosis during endotoxin-induced systemic inflammatory state. It has been demonstrated that IL-18 plays a anti-apoptotic role in mature and immature myeloid cells in the bone marrow during endotoxin-induced systemic inflammatory state. 3.The role of IL-18 in both nitric oxide production and pancreatic damage during acute pancreatitis. IL-18 appears to protect the pancreas during early caerulein-induced AP in mice, probably through induction of NO release from an iNOS source. IL-18 may be a target for new AP therapeutics. 4.Establishment of the technique of total parenteral nutrition (TPN) in rats. We have developed the techniques to insert and fix the silicon tube into the jugular vein, transfuse TPN solution for three days safely without restriction in Wister rats. 5.Apoptosis induction in the bone marrow cells during endotoxin-induced systemic inflammatory state in rats. We have confirmed that apoptosis is induced in both immature and mature bone marrow cells after intra-peritoneal injection of endotoxin like apoptosis induction in the bone marrow cells in mouse acute endotoxemia model. 6.The influence of pretreatment with TPN with n-6 and n-3 poly unsaturated fatty acids (PUFAs) on apoptosis in bone marrow cells and peripheral neutrophils during endotoxin-induced systemic inflammatory state. The HPLC analysis revealed that three days TPN could change the cell wall components of spleen cells and red blood cells. Furthermore, we have found that pretreatment with TPN with n-3 PUFAs appears to increase apoptotic cell rate in the immature and mature bone marrow cells and peripheral neutrophils compared to TPN with n-6 PUFAs although the mechanisms have not been elucidated. 7.The role of IL-18 in human neutrophils apotosis. IL-18, like LPS, inhibits PMN apoptosis by activating PI3-kinase and ERK pathways. However, PI3-kinase plays more important role(s) in IL-18-induced inhibition of apoptosis than in LPS-induced apoptosis inhibition. 8.The influence of short chain fatty acids (SCFAs). Butyrate activates caspase cascade and induces apoptosis via signal transduction(s) other than GPR and MAPKs. It is most likely that butyrate modulate apoptosis via HDAC inhibition.