A5050998096- Respiratory Support and Mechanisms
- Clinical Nutrition and Gastroenterology
- Sepsis Diagnosis and Treatment
- Intensive Care Unit Cognitive Disorders
- Diverticular Disease and Complications
- Appendicitis Diagnosis and Management
- Trauma and Emergency Care Studies
- Traumatic Brain Injury and Neurovascular Disturbances
- Hemodynamic Monitoring and Therapy
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Infant Nutrition and Health
- Cardiac Arrest and Resuscitation
- Thermal Regulation in Medicine
- Clostridium difficile and Clostridium perfringens research
- Neuroscience and Neural Engineering
- Muscle activation and electromyography studies
- Amoebic Infections and Treatments
- COVID-19 Clinical Research Studies
- Neutrophil, Myeloperoxidase and Oxidative Mechanisms
- Inflammasome and immune disorders
- Infant Health and Development
- Planarian Biology and Electrostimulation
- Healthcare cost, quality, practices
- Helicobacter pylori-related gastroenterology studies
- Immune Response and Inflammation
Aichi Medical University
2021-2024
Aichi Medical University Hospital
2021-2023
Nippon Medical School
2009-2019
Noguchi Hospital
2019
Kyoto University
2017-2018
Bridge University
2016
Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high.The 2013 update of the World Society Emergency Surgery (WSES) guidelines for management contains evidence-based recommendations patients infections.
The CIAOW study (Complicated intra-abdominal infections worldwide observational study) is a multicenter underwent in 68 medical institutions during six-month period (October 2012-March 2013). included patients older than 18 years undergoing surgery or interventional drainage to address complicated (IAIs). 1898 with mean age of 51.6 (range 18-99) were enrolled the study. 777 (41%) women and 1,121 (59%) men. Among these patients, 1,645 (86.7%) affected by community-acquired IAIs while...
Abstract Introduction Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is characterized by features other than increased pulmonary vascular permeability. Pulmonary permeability combined with extravascular water content has been considered a quantitative diagnostic criterion of ALI/ARDS. This prospective, multi-institutional, observational study aimed to clarify the clinical pathophysiological ALI/ARDS and establish its criteria. Methods The index (EVLWI) (PVPI) were...
Neutrophil elastase plays an important role in the development and progression of acute respiratory distress syndrome (ARDS). Although selective inhibitor, sivelestat, is widely used Japan for treating ARDS patients, its effectiveness remains controversial. The aim current study was to investigate effects sivelestat patients with evidence increased extravascular lung water by re-analyzing a large multicenter database. A post hoc analysis PiCCO Pulmonary Edema Study conducted. This...
Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The World Society of Emergency Surgery (WSES) has designed the CIAOW study order to describe clinical, microbiological, management-related profiles both community- healthcare-acquired a worldwide context. (Complicated Intra-Abdominal infection Observational Worldwide Study) is multicenter observational currently underway 57 medical...
Intra-aortic balloon occlusion (IABO) is useful for proximal vascular control, by clamping the descending aorta, in traumatic haemorrhagic shock. However, there are limited clinical studies regarding its effectiveness. This study aimed at investigating effectiveness of IABO shock.This retrospective, observational included trauma patients who underwent Emergency and Critical Care Center Nippon Medical School Tama-Nagayama Hospital between January 2009 March 2013. 14 were to this shock on...
The Berlin definition divides acute respiratory distress syndrome (ARDS) into three severity categories. relationship between these categories and pulmonary microvascular permeability as well extravascular lung water content, which is the hallmark of pathophysiology, remains to be elucidated. aim this study was evaluate water, vascular permeability, defined by definition, confirm associated predictive validity for severity. index (EVLWi) (PVPI) were measured using a transpulmonary...
The features of early-phase acute respiratory distress syndrome (ARDS) are leakage fluid into the extravascular space and impairment its reabsorption, resulting in lung water (EVLW) accumulation. current study aimed to identify how initial EVLW values their change were associated with mortality. This was a post hoc analysis PiCCO Pulmonary Edema Study, multicenter prospective cohort that included 23 institutions. Single-indicator transpulmonary thermodilution-derived index (EVLWi)...
Acute respiratory distress syndrome (ARDS) is characterized by the increased pulmonary permeability secondary to diffuse alveolar inflammation and injuries of several origins. Especially, distinction between a direct (pulmonary injury) an indirect (extrapulmonary lung injury etiology gaining more attention as means better comprehending pathophysiology ARDS. However, there are few reports regarding quantitative methods distinguishing degree ARDS patients due extrapulmonary injury. A...
Certain stimuli, such as microorganisms, cause neutrophils to release neutrophil extracellular traps (NETs), which are basically web-like structures composed of DNA with granule proteins, myeloperoxidase (MPO) and elastase (NE), cytoplasmic cytoskeletal proteins. Although interest in NETs has increased recently, no sensitive, reliable assay method is available for measuring clinical settings. This article describes a modified sandwich enzyme-linked immunosorbent quantitatively measure two...
In patients with severe sepsis, depression of cardiac performance is common and often associated left ventricular (LV) dilatation to maintain stroke volume. Although it essential optimize preload tissue perfusion in the optimal remains unknown. This study aimed evaluate reliability global end-diastolic volume index (GEDI) as a parameter early phase sepsis.Ninety-three mechanically ventilated acute lung injury/acute respiratory distress syndrome secondary sepsis were enrolled for subgroup...
The effect of exercise during the acute phase following sepsis onset is poorly understood. We investigated how low-intensity alters energy-substrate metabolism and survival in mice with lipopolysaccharide (LPS)-induced sepsis.Mice were divided into control (C, saline), low-dose LPS (L, 1 mg/kg), medium-dose (M, 5 high-dose (H, 10 mg/kg) groups. Each group was subdivided sedentary (SED) (EX) groups; EX exercised at low intensity on a treadmill after administration. Survival proportions vital...
Extravascular lung water (EVLW), as measured by the thermodilution method, reflects extent of pulmonary edema. Currently, there are no clinically effective treatments for preventing increases in vascular permeability, a hallmark pathophysiology, patients with acute injury/acute respiratory distress syndrome (ALI/ARDS). In this study, we examined contributions hemodynamic and osmolarity factors, which appropriate interventions expected critical care, to EVLW ALI/ARDS.We performed subgroup...
Abstract Background The purpose of this study is to investigate the time course syndecan-1 (Syn-1) plasma levels, correlation between Syn-1 and organ damage development, associations level with cumulative fluid balance ventilator-free days (VFD) in patients septic shock. Methods We collected blood samples from 38 shock upon their admission ICU for first 7 stay. level, acute respiratory distress syndrome (ARDS), other damage, VFD, were assessed daily. Results Over days, levels increased...
Clostridium difficile infections (CDI) have recently increased worldwide. Some CDI progress to fulminant and recurrent are associated with high mortality morbidity. CD produces toxins A B, which cause intestinal mucosal damage, although toxin B exhibits greater cytotoxicity. Pepsin-treated lactoferrin (PLF) is the decomposed product of (LF), a multifunctional glycoprotein anti-inflammatory properties. Here, we investigate effects LF PLF in B-stimulated rat epithelial (IEC-6) cells. Different...
腹部外傷による腹腔内出血に対し，開腹に先立つ下行大動脈遮断として大動脈閉塞バルーン（intra-aortic balloon occlusion;IABO）を使用し有効であった3例を報告する．症例1は18歳の男性．交通外傷による脾損傷・腎損傷に対し術前IABOを挿入し循環動態を安定させ，開腹止血・脾摘・腎摘を行った．症例2は46歳の男性．自傷による腹部刺創に対する開腹術前に予防的にIABOを挿入した．開腹すると肝左葉に刺創を認め，IABOにより出血を制御しつつ良好な視野で縫合止血を行い得た．症例3は40歳の男性．交通外傷による腸間膜損傷に対し術前IABOを挿入し循環動態を安定させ，開腹止血を行った．術後，一過性に腎機能悪化を認めたが回復した．IABOは術前の循環動態を安定させるとともに，術中の出血制御と良好な視野確保・止血に寄与し有効であるが，虚血による合併症に注意が必要である．
This study investigated the therapeutic benefits of neuromuscular electrical stimulation (NMES).C57BL/6 mice were administered lipopolysaccharide (LPS; 20 mg/kg body weight) by intraperitoneal injection and divided into control (C) NMES groups (n = 10-12 each). The latter received to bilateral gastrocnemius muscle for 1 h at low or high frequency (LF 2 Hz HF 50 Hz, respectively) voltage (LV 10 V HV V, respectively). In LF-LV LF-HV groups, was performed twice results compared with those that...
【目的】COVID‐19肺炎の炎症と栄養代謝動態の特徴を明らかにし, 治療的介入の可能性につき考察する. 【対象と方法】当院救急ICUにCOVID‐19肺炎の診断で入室した患者28名につき, 炎症や栄養代謝に関する血液検査や間接熱量測定にて得られたデータを分析した. 【結果】COVID‐19重症度の内訳は中等症18例, 重症10例であった. 重症は全例に挿管管理を要し4例にvv‐ECMO管理を要した. 炎症データは重症で有意に高くリンパ球数が重症で有意に低下していた（p=0.005）. 栄養代謝ではCONUT値およびPGC‐1α濃度が重症で有意に高値であった（p=0.03, 0.003）. 間接熱量測定を行い得た5例では通常肺炎と比して脂質酸化量が低く呼吸商は高い傾向があった.【結語】COVID‐19肺炎では重症度に応じて高度炎症および免疫麻痺状態に陥っており, 栄養学的リスクも高いことが示唆された. また特有の栄養代謝動態の変化があり栄養療法において考慮すべきと思われた.
In traumatic hemorrhagic shock, there are situations where rapid aortic occlusion is required. such cases, the best should be determined based on situation. Therefore, it essential to understand various types of occlusion, their characteristics, and indications. However, not hemostasis but temporary proximal control arterial bleeding; definitive delayed even if blood pressure elevated after occlusion. We describe indications, characteristics implementation each comparison between...
Sato, Norio1; Hatanaka, Naoki2; Irahara, Takayuki2; Murata, Satoru1; Ogura, Junpei1; Ohtake, Kosuke2; Okuno, Takuya1; Koike, Kaoru3 Author Information