2024/05/24 更新

写真a

ホンゴウ タカシ
本郷 貴識
Hongo Takashi
所属
岡山大学病院 助教(特任)
職名
助教(特任)
外部リンク

学位

  • 学士 ( 2014年3月   香川大学 )

研究キーワード

  • 心肺停止

  • PICS

  • 嚥下障害

研究分野

  • ライフサイエンス / 救急医学

学歴

経歴

所属学協会

 

論文

  • Impact of sex of bystanders who perform cardiopulmonary resuscitation on return of spontaneous circulation in out-of-hospital cardiac arrest patients: A retrospective, observational study. 国際誌

    Shunsuke Nakamura, Tsuyoshi Nojima, Takafumi Obara, Takashi Hongo, Tetsuya Yumoto, Takashi Yorifuji, Atsunori Nakao, Hiromichi Naito

    Resuscitation plus   18   100659 - 100659   2024年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The impact of the sex of bystanders who initiate cardiopulmonary resuscitation (CPR) on out-of-hospital cardiac arrest (OHCA) patients has not been fully elucidated. This study aims to investigate the association between the sex of bystanders who perform CPR and the clinical outcomes of OHCA patients in real-world clinical settings. METHODS: We conducted a retrospective, observational study using data from the Okayama City Fire Department in Japan. Patients were categorized based on bystanders' sex. Our primary outcomes were return of spontaneous circulation (ROSC). Our secondary outcome was 30-day survival and 30-day favorable neurological outcome, defined as Cerebral Performance Category score of 1 or 2. Multivariable logistic regression analysis was used to examine the association between these groups and outcomes. RESULTS: The study included 3,209 patients with a comparable distribution of male (1,540 patients: 48.0%) and female bystanders (1,669 patients: 52.0%) between the groups. Overall, 221 (6.9%) ROSC at hospital arrival, 226 (7.0%) patients had 30-day survival, and 121 (3.8%) patients had 30-day favorable neurological outcomes. Bystander sex (female as reference) did not contribute to ROSC at hospital arrival (adjusted OR [aOR] 1.11, 95% CI: 0.76-1.61), 30-day survival (aOR 1.23, 95% CI: 0.83-1.82), or 30-day favorable neurological outcomes (aOR 0.66, 95% CI: 0.34-1.27). Basic life support education experience was a bystander factor positively associated with ROSC. Patient factors positively associated with ROSC were initial shockable rhythm and witness of cardiac arrest. CONCLUSION: There were no differences in ROSC, 30-day survival, or 30-day neurological outcomes in OHCA patients based on bystander sex.

    DOI: 10.1016/j.resplu.2024.100659

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  • Organ donation after extracorporeal cardiopulmonary resuscitation: a nationwide retrospective cohort study. 国際誌

    Tetsuya Yumoto, Kohei Tsukahara, Takafumi Obara, Takashi Hongo, Tsuyoshi Nojima, Hiromichi Naito, Atsunori Nakao

    Critical care (London, England)   28 ( 1 )   160 - 160   2024年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Limited data are available on organ donation practices and recipient outcomes, particularly when comparing donors who experienced cardiac arrest and received extracorporeal cardiopulmonary resuscitation (ECPR) followed by veno-arterial extracorporeal membrane oxygenation (ECMO) decannulation, versus those who experienced cardiac arrest without receiving ECPR. This study aims to explore organ donation practices and outcomes post-ECPR to enhance our understanding of the donation potential after cardiac arrest. METHODS: We conducted a nationwide retrospective cohort study using data from the Japan Organ Transplant Network database, covering all deceased organ donors between July 17, 2010, and August 31, 2022. We included donors who experienced at least one episode of cardiac arrest. During the study period, patients undergoing ECMO treatment were not eligible for a legal diagnosis of brain death. We compared the timeframes associated with each donor's management and the long-term graft outcomes of recipients between ECPR and non-ECPR groups. RESULTS: Among 370 brain death donors with an episode of cardiac arrest, 26 (7.0%) received ECPR and 344 (93.0%) did not; the majority were due to out-of-hospital cardiac arrests. The median duration of veno-arterial ECMO support after ECPR was 3 days. Patients in the ECPR group had significantly longer intervals from admission to organ procurement compared to those not receiving ECPR (13 vs. 9 days, P = 0.005). Lung graft survival rates were significantly lower in the ECPR group (log-rank test P = 0.009), with no significant differences in other organ graft survival rates. Of 160 circulatory death donors with an episode of cardiac arrest, 27 (16.9%) received ECPR and 133 (83.1%) did not. Time intervals from admission to organ procurement following circulatory death and graft survival showed no significant differences between ECPR and non-ECPR groups. The number of organs donated was similar between the ECPR and non-ECPR groups, regardless of brain or circulatory death. CONCLUSIONS: This nationwide study reveals that lung graft survival was lower in recipients from ECPR-treated donors, highlighting the need for targeted research and protocol adjustments in post-ECPR organ donation.

    DOI: 10.1186/s13054-024-04949-5

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  • Long-term, patient-centered, frailty-based outcomes of older critical illness survivors from the emergency department: a post hoc analysis of the LIFE Study. 国際誌

    Takashi Hongo, Tetsuya Yumoto, Mototaka Inaba, Shunsuke Taito, Takashi Yorifuji, Atsunori Nakao, Hiromichi Naito

    BMC geriatrics   24 ( 1 )   257 - 257   2024年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Evidence indicates frailty before intensive care unit (ICU) admission leads to poor outcomes. However, it is unclear whether quality of life (QOL) and activities of daily living (ADL) for survivors of critical illness admitted to the ICU via the emergency department remain consistent or deteriorate in the long-term compared to baseline. This study aimed to evaluate long-term QOL/ADL outcomes in these patients, categorized by the presence or absence of frailty according to Clinical Frailty Scale (CFS) score, as well as explore factors that influence these outcomes. METHODS: This was a post-hoc analysis of a prospective, multicenter, observational study conducted across Japan. It included survivors aged 65 years or older who were admitted to the ICU through the emergency department. Based on CFS scores, participants were categorized into either the not frail group or the frail group, using a threshold CFS score of < 4. Our primary outcome was patient-centered outcomes (QOL/ADL) measured by the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) and the Barthel Index six months post-ICU admission, comparing results from baseline. Secondary outcomes included exploration of factors associated with QOL/ADL six months post-ICU admission using multiple linear regression analyses. RESULTS: Of 514 candidates, 390 participants responded to the EQ-5D-5L questionnaire, while 237 responded to the Barthel Index. At six months post-admission, mean EQ-5D-5L values declined in both the not frail and frail groups (0.80 to 0.73, p = 0.003 and 0.58 to 0.50, p = 0.002, respectively); Barthel Index scores also declined in both groups (98 to 83, p < 0.001 and 79 to 61, p < 0.001, respectively). Multiple linear regression analysis revealed that baseline frailty (β coefficient, -0.15; 95% CI, - 0.23 to - 0.07; p < 0.001) and pre-admission EQ-5D-5L scores (β coefficient, 0.14; 95% CI, 0.02 to 0.26; p = 0.016) affected EQ-5D-5L scores at six months. Similarly, baseline frailty (β coefficient, -12.3; 95% CI, - 23.9 to - 0.80; p = 0.036) and Barthel Index scores (β coefficient, 0.54; 95% CI, 0.30 to 0.79; p < 0.001) influenced the Barthel Index score at six months. CONCLUSIONS: Regardless of frailty, older ICU survivors from the emergency department were more likely to experience reduced QOL and ADL six months after ICU admission compared to baseline.

    DOI: 10.1186/s12877-024-04881-x

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  • Changes in temporal muscle dimensions and their clinical impact in out-of-hospital cardiac arrest survivors

    Takashi Hongo, Hiromichi Naito, Keibun Liu, Yuya Murakami, Satoshi Nozaki, Hiroki Maeyama, Ayaka Matsuoka, Hisashi Dote, Kazumasa Inaba, Satoshi Miike, Shigeki Fujitani, Tomohiro Hiraoka, Takafumi Obara, Tsuyoshi Nojima, Atsunori Nakao, Tetsuya Yumoto

    Resuscitation Plus   17   100527 - 100527   2024年3月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier BV  

    DOI: 10.1016/j.resplu.2023.100527

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  • Successful Cardiac, Lung, and Kidney Transplantation from a Methanol-poisoned Donor.

    Takashi Hongo, Tetsuya Yumoto, Yoshinori Kosaki, Tomohiro Hiraoka, Kohei Tsukahara, Tsuyoshi Nojima, Takafumi Obara, Kohei Ageta, Yukie Yamasaki, Kaori Taniguchi, Masanobu Miura, Satoru Miyaishi, Hiromichi Naito, Atsunori Nakao

    JMA journal   7 ( 1 )   133 - 135   2024年1月

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    記述言語:英語  

    Massive methanol exposure can lead to severe and detrimental effects that can result in death or brain death. As organs from patients with brain death after methanol ingestion are less likely to be recovered, these patients have been considered marginal donors. We present a case of successful multiple organ transplantation (heart, lungs, and kidneys) from a methanol-poisoned patient. Our experience illustrates that donor death from methanol intoxication does not preclude organ transplantation.

    DOI: 10.31662/jmaj.2023-0081

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  • Hydrogen in Transplantation: Potential Applications and Therapeutic Implications. 国際誌

    Takafumi Obara, Hiromichi Naito, Tsuyoshi Nojima, Takahiro Hirayama, Takashi Hongo, Kohei Ageta, Toshiyuki Aokage, Masaki Hisamura, Tetsuya Yumoto, Atsunori Nakao

    Biomedicines   12 ( 1 )   2024年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Hydrogen gas, renowned for its antioxidant properties, has emerged as a novel therapeutic agent with applications across various medical domains, positioning it as a potential adjunct therapy in transplantation. Beyond its antioxidative properties, hydrogen also exerts anti-inflammatory effects by modulating pro-inflammatory cytokines and signaling pathways. Furthermore, hydrogen's capacity to activate cytoprotective pathways bolsters cellular resilience against stressors. In recent decades, significant advancements have been made in the critical medical procedure of transplantation. However, persistent challenges such as ischemia-reperfusion injury (IRI) and graft rejection continue to hinder transplant success rates. This comprehensive review explores the potential applications and therapeutic implications of hydrogen in transplantation, shedding light on its role in mitigating IRI, improving graft survival, and modulating immune responses. Through a meticulous analysis encompassing both preclinical and clinical studies, we aim to provide valuable insights into the promising utility of hydrogen as a complementary therapy in transplantation.

    DOI: 10.3390/biomedicines12010118

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  • Association of initial lactate levels and red blood cell transfusion strategy with outcomes after severe trauma: a post hoc analysis of the RESTRIC trial. 国際誌

    Yoshinori Kosaki, Takashi Hongo, Mineji Hayakawa, Daisuke Kudo, Shigeki Kushimoto, Takashi Tagami, Hiromichi Naito, Atsunori Nakao, Tetsuya Yumoto

    World journal of emergency surgery : WJES   19 ( 1 )   1 - 1   2024年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The appropriateness of a restrictive transfusion strategy for those with active bleeding after traumatic injury remains uncertain. Given the association between tissue hypoxia and lactate levels, we hypothesized that the optimal transfusion strategy may differ based on lactate levels. This post hoc analysis of the RESTRIC trial sought to investigate the association between transfusion strategies and patient outcomes based on initial lactate levels. METHODS: We performed a post hoc analysis of the RESTRIC trial, a cluster-randomized, crossover, non-inferiority multicenter trials, comparing a restrictive and liberal red blood cell transfusion strategy for adult trauma patients at risk of major bleeding. This was conducted during the initial phase of trauma resuscitation; from emergency department arrival up to 7 days after hospital admission or intensive care unit (ICU) discharge. Patients were grouped by lactate levels at emergency department arrival: low (< 2.5 mmol/L), middle (≥ 2.5 and < 4.0 mmol/L), and high (≥ 4.0 mmol/L). We compared 28 days mortality and ICU-free and ventilator-free days using multiple linear regression among groups. RESULTS: Of the 422 RESTRIC trial participants, 396 were analyzed, with low (n = 131), middle (n = 113), and high (n = 152) lactate. Across all lactate groups, 28 days mortality was similar between strategies. However, in the low lactate group, the restrictive approach correlated with more ICU-free (β coefficient 3.16; 95% CI 0.45 to 5.86) and ventilator-free days (β coefficient 2.72; 95% CI 0.18 to 5.26) compared to the liberal strategy. These findings persisted even after excluding patients with severe traumatic brain injury. CONCLUSIONS: Our results suggest that restrictive transfusion strategy might not have a significant impact on 28-day survival rates, regardless of lactate levels. However, the liberal transfusion strategy may lead to shorter ICU- and ventilator-free days for patients with low initial blood lactate levels.

    DOI: 10.1186/s13017-023-00530-7

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  • Reply to: Stomach inflation during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: where did the air go? 国際誌

    Hiromichi Naito, Takashi Hongo, Tetsuya Yumoto, Hiroki Maeyama, Astunori Nakao

    Resuscitation   110099 - 110099   2023年12月

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  • Treatment patterns and clinician stress related to care of out-of-hospital cardiac arrest patients with a do not attempt resuscitation order. 国際誌

    Ryo Tanabe, Takashi Hongo, Takafumi Obara, Tsuyoshi Nojima, Atsunori Nakao, Jonathan Elmer, Hiromichi Naito, Tetsuya Yumoto

    Resuscitation plus   16   100507 - 100507   2023年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: This research investigated treatment patterns for out-of-hospital cardiac arrest patients with Do Not Attempt Resuscitation orders in Japanese emergency departments and the associated clinician stress. METHODS: A cross-sectional survey was conducted at 9 hospitals in Okayama, Japan, targeting emergency department nurses and physicians. The questionnaire inquired about the last treated out-of-hospital cardiac arrest patient with a Do Not Attempt Resuscitation. We assessed emotional stress on a 0-10 scale and moral distress on a 1-5 scale among clinicians. RESULTS: Of 208 participants, 107 (51%) had treated an out-of-hospital cardiac arrest patient with a Do Not Attempt Resuscitation order in the past 6 months. Of these, 65 (61%) clinicians used a "slow code" due to perceived futility in resuscitation (42/65 [65%]), unwillingness to terminate resuscitation upon arrival (38/65 [59%]), and absence of family at the time of patient's arrival (35/65 [54%]). Female clinicians had higher emotional stress (5 vs. 3; P = 0.007) and moral distress (3 vs. 2; P = 0.002) than males. Nurses faced more moral distress than physicians (3 vs. 2; P < 0.001). Adjusted logistic regression revealed that having performed a "slow code" (adjusted odds ratio, 5.09 [95% CI, 1.68-17.87]) and having greater ethical concerns about "slow code" (adjusted odds ratio, 0.35 [95% CI, 0.19-0.58]) were associated with high stress levels. CONCLUSIONS: The prevalent use of "slow code" for out-of-hospital cardiac arrest patients with Do Not Attempt Resuscitation orders underscores the challenges in managing these patients in clinical practice.

    DOI: 10.1016/j.resplu.2023.100507

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  • 蘇生を希望しない院外心停止の診療に関する救急外来での実態調査 多機関共同横断研究

    田邉 綾, 湯本 哲也, 本郷 貴識, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   34 ( 12 )   720 - 720   2023年12月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • Pharmacotherapy for Reducing RBC Transfusion for Patients in the ICU: A Systematic Review and Network Meta-Analysis. 国際誌

    Shodai Yoshihiro, Takashi Hongo, Mariko Yamamoto, Shunsuke Taito, Yuki Kataoka

    Critical care medicine   2023年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: To determine optional therapeutic strategies by comparing monotherapies and combination therapies to reduce RBC transfusion requirement for patients in the ICU. DATA SOURCES: MEDLINE, CENTRAL, and Embase were searched for studies published from database inception until July 2023. DATA EXTRACTION: We included randomized controlled trials comparing erythropoiesis-stimulating agents (Epo), iron, combination therapy with iron and Epo, hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), vitamin D3 (VD3), and placebo/no treatment. A frequentist network meta-analysis (NMA) was performed using a random effects model, and the confidence in NMA was rated. DATA SYNTHESIS: Of 117 eligible studies, 75 studies (15,091 patients) were included in the quantitative analysis. Compared with placebo/no treatment, the combination therapy reduces the requirement for RBC transfusion (risk ratio [RR]: 0.60; 95% CI, 0.49-0.74; confidence rating: moderate). The Epo or iron monotherapy may reduce the requirement for RBC transfusion (RR: 0.81; 95% CI, 0.63-1.04; confidence rating: low; RR: 0.83; 95% CI, 0.70-0.98; confidence rating: low, respectively). Combination therapy may not increase the prevalence of both venous thromboembolism (VTE) (RR: 0.73; 95% CI, 0.25-2.08; confidence rating: low) and infection. Epo monotherapy may not increase the prevalence of VTE but may increase that of infections (RR: 1.27; 95% CI, 0.94-1.73; confidence rating: low). Iron monotherapy may not increase the prevalence of both VTE and infection. Evidence for VD3 and HIF-PHI remains uncertain. CONCLUSIONS: Combination therapy with iron and Epo likely reduces the requirement for RBC transfusion and may be less harmful than other therapies.

    DOI: 10.1097/CCM.0000000000006114

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  • A protocol of an international validation study to assess the clinical accuracy of the eDIS-ICU delirium screening tool. 国際誌

    Oystein Tronstad, Sue Patterson, Anna-Liisa Sutt, India Pearse, Karen Hay, Keibun Liu, Kei Sato, Yuji Koga, Ayaka Matsuoka, Takashi Hongo, Indrek Rätsep, John F Fraser, Dylan Flaws

    Australian critical care : official journal of the Confederation of Australian Critical Care Nurses   36 ( 6 )   1043 - 1049   2023年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Delirium is a common, yet underdiagnosed neuropsychiatric complication of intensive care unit (ICU) admission, associated with significant mortality and morbidity. Delirium can be difficult to diagnose, with gold standard assessments by a trained specialist being impractical and rarely performed. To address this, various tools have been developed, enabling bedside clinicians to assess for delirium efficiently and accurately. However, the performance of these tools varies depending on factors including the assessor's training. To address the shortcomings of current tools, electronic tools have been developed. AIMS AND OBJECTIVES: The aims of this validation study are to assess the feasibility, acceptability, and generalisability of a recently developed and pilot-tested electronic delirium screening tool (eDIS-ICU) and compare diagnostic concordance, sensitivity, and specificity between eDIS-ICU, Confusion Assessment Method for the ICU (CAM-ICU), and the Diagnostic and Statistical Manual of Mental Disorders - 5th edition (DSM-V) gold standard in diverse ICU settings. METHODS: Seven hundred participants will be recruited across five sites in three countries. Participants will complete three assessments (eDIS-ICU, CAM-ICU, and DSM-V) twice within one 24-h period. At each time point, assessments will be completed within one hour. Assessments will be administered by three different people at any given time point, with the assessment order and assessor for eDIS-ICU and CAM-ICU randomly allocated. Assessors will be blinded to previous and concurrent assessment results. RESULTS: The primary outcome is comparing diagnostic sensitivity of eDIS-ICU and CAM-ICU against the DSM-V. RELEVANCE TO CLINICAL PRACTICE: This protocol describes a definitive validation study of an electronic diagnostic tool to assess for delirium in the ICU. Delirium remains a common and difficult challenge in the ICU and is linked with multiple neurocognitive sequelae. Various challenges to routine assessment mean many cases are still unrecognised or misdiagnosed. An improved ability for bedside clinicians to screen for delirium accurately and efficiently will support earlier diagnosis, identification of underlying cause(s) and timely treatments, and ultimately improved patient outcomes. CLINICAL TRIAL REGISTRATION NUMBER: This study was prospectively registered on the Australian New Zealand Clinical Trials Registry (ANZCTR) on 8th February 2022 (ACTRN12622000220763).

    DOI: 10.1016/j.aucc.2023.02.003

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  • Effect of Stomach Inflation during Cardiopulmonary Resuscitation on Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest Patients: A Retrospective Observational Study. 国際誌

    Hiromichi Naito, Hiroaki Hanafusa, Takashi Hongo, Tetsuya Yumoto, Takashi Yorifuji, Alexandra Weissman, Jon C Rittenberger, Francis X Guyette, Mamoru Fujishima, Hiroki Maeyama, Astunori Nakao

    Resuscitation   109994 - 109994   2023年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Gastric inflation caused by excessive ventilation is a common complication of cardiopulmonary resuscitation. Gastric inflation may further compromise ventilation via increases in intrathoracic pressure, leading to decreased venous return and cardiac output, which may impair out-of-hospital cardiac arrest (OHCA) outcomes. The purpose of this study was to measure the gastric volume of OHCA patients using computed tomography (CT) scan images and evaluate the effect of gastric inflation on return of spontaneous circulation (ROSC). METHODS: In this single-center, retrospective, observational study, CT scan was conducted after ROSC or immediately after death. Total gastric volume was measured. Primary outcome was ROSC. Achievement of ROSC was compared in the gastric distention group and the no gastric distention group; gastric distension was defined as total gastric volume in the ≥75th percentile. Additionally, factors associated with gastric distention were examined. RESULTS: A total of 446 cases were enrolled in the study; 120 cases (27%) achieved ROSC. The median gastric volume was 400 ml for all OHCA subjects; 1068 ml in gastric distention group vs. 287 ml in no gastric distention group. There was no difference in ROSC between the groups (27/112 [24.1%] vs. 93/334 [27.8%], p=0.440). Gastric distention did not have a significant impact, even after adjustments (adjusted odds ratio 0.73, 95% confidence interval [0.42 - 1.29]). Increased gastric volume was associated with longer emergency medical service activity time. CONCLUSIONS: We observed a median gastric volume of 400 ml in patients after OHCA resuscitation. In our setting, gastric distention did not prevent ROSC.

    DOI: 10.1016/j.resuscitation.2023.109994

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  • Radiation in an emergency situation: attempting to respect the patient's beliefs as reported by a minor. 国際誌

    Tetsuya Yumoto, Takashi Hongo, Yasuhiro Koide, Takafumi Obara, Kohei Tsukahara, Hiromichi Naito, Atsunori Nakao

    BMC medical ethics   24 ( 1 )   80 - 80   2023年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Each individual's unique health-related beliefs can greatly impact the patient-clinician relationship. When there is a conflict between the patient's preferences and recommended medical care, it can create a serious ethical dilemma, especially in an emergency setting, and dramatically alter this important relationship. CASE PRESENTATION: A 56-year-old man, who remained comatose after out-of-hospital cardiac arrest, was rushed to our hospital. The patient was scheduled for emergency coronary angiography when his adolescent daughter reported that she and her father held sincere beliefs against radiation exposure. We were concerned that she did not fully understand the potential consequences if her father did not receive the recommended treatment. A physician provided her with in depth information regarding the risks and benefits of the treatment. While we did not want to disregard her statement, we opted to save the patient's life due to concerns about the validity of her report. CONCLUSIONS: Variations in beliefs regarding medical care force clinicians to incorporate patient beliefs into medical practice. However, an emergency may require a completely different approach. When faced with a patient in a life-threatening condition and unconscious, we should take action to prioritize saving their life, unless we are highly certain about the validity of their advance directives.

    DOI: 10.1186/s12910-023-00962-5

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  • Collapse-related traumatic intracranial hemorrhage following out-of-hospital cardiac arrest: A multicenter retrospective cohort study. 国際誌

    Fumiya Inoue, Takashi Hongo, Toshihisa Ichiba, Takayuki Otani, Hiroshi Naito, Yoshinori Kosaki, Yuya Murakami, Atsuyoshi Iida, Tetsuya Yumoto, Hiromichi Naito, Atsunori Nakao

    Resuscitation plus   15   100418 - 100418   2023年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Sudden loss of consciousness as a result of cardiac arrest can cause severe traumatic head injury. Collapse-related traumatic intracranial hemorrhage (CRTIH) following out-of-hospital cardiac arrest (OHCA) may be linked to poor neurological outcomes; however, there is a paucity of data on this entity. This study aimed to investigate the frequency, characteristics, and outcomes of CRTIH following OHCA. METHODS: Adult patients treated post-OHCA at 5 intensive care units who had head computed tomography (CT) scans were included in the study. CRTIH following OHCA was defined as a traumatic intracranial injury from collapse due to sudden loss of consciousness associated with OHCA. Patients with and without CRTIH were compared. The primary outcome assessed was the frequency of CRTIH following OHCA. Additionally, the clinical features, management, and consequences of CRTIH were analyzed descriptively. RESULTS: CRTIH following OHCA was observed in 8 of 345 enrolled patients (2.3%). CRTIH was more frequent after collapse outside the home, from a standing position, or due to cardiac arrest with a cardiac etiology. Intracranial hematoma expansion on follow up CT was seen in 2 patients; both received anticoagulant therapy, and one required surgical evacuation. Three patients (37.5%) with CRTIH had favorable neurological outcomes 28 days after collapse. CONCLUSIONS: Despite its rare occurrence, physicians should pay special attention to CRTIH following OHCA during the post-resuscitation care period. Larger prospective studies are warranted to provide a more explicit picture of this clinical condition.

    DOI: 10.1016/j.resplu.2023.100418

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  • Comparison of outcomes of out-of-hospital cardiac arrest patients: Emergency calls placed from mobile phones vs. landline phones. 国際誌

    Takeshi Nishimura, Masafumi Suga, Takashi Hongo, Tetsuya Yumoto, Atsunori Nakao, Satoshi Ishihara, Hiromichi Naito

    Resuscitation plus   15   100434 - 100434   2023年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Until recently, calls to the emergency medical service (EMS) from landline phones, which display the caller's exact location at the dispatch center, had been common. Since the use of mobile phones has become widespread, many emergency calls are now made from mobile phones. Differences in outcomes of out-of-hospital cardiac arrest (OHCA) patients for whom EMS was called from mobile versus landline phones has not yet been fully elucidated. METHODS: We performed a retrospective, population-based analysis in Kobe, Japan to examine whether EMS calls from mobiles improved the prognosis of OHCA patients over EMS calls placed from landlines. The primary outcome was favorable neurological outcome, defined as Cerebral Performance Category (CPC) scores of 1 or 2 at discharge. Secondary outcomes were survival at one-month, survival at discharge, and time durations between call and EMS activities. RESULTS: Of 4,231 OHCA cases, 2,194 cases (706 landline cases vs. 1,488 mobile cases) were included in this study. The percentages of favorable neurological outcomes were 0.7% (5/706) in the landline group and 3.8% (56/1,488) in the mobile group. Adjusted multivariable logistic regression revealed that favorable neurological outcomes (odds ratio [OR] 3.03, 95% confidence interval [CI] 1.12-8.17, p = 0.03) were better in the mobile group, while one-month survival (OR 1.30, 95% CI 0.80-2.14, p = 0.29) was not significantly different. Bystander CPR was more frequently administered in the mobile group (landlines 61.3% vs. mobiles 68.4%, p < 0.01). Time durations between call to EMS dispatch (184.5 [IQR 157-220 s] vs. 205 [IQR 174-248 s], p < 0.01) and EMS arrival (476.5 [IQR 377-599 s] vs. 491 [IQR 407.5-611.5 s], p < 0.01) were shorter in the landline group. CONCLUSIONS: Although the landline caller location display system seems effective for shorter times between EMS call and EMS arrival, mobile phone use was associated with better neurological outcomes.

    DOI: 10.1016/j.resplu.2023.100434

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  • 救急医療現場における個人的信念に基づく医療行為拒否への対応 放射線被曝拒否事例から考える

    小出 恭大, 湯本 哲也, 本郷 貴識, 小崎 吉訓, 野島 剛, 上田 浩平, 小原 隆史, 飯田 淳義, 山本 浩継, 青景 聡之, 塚原 紘平, 内藤 宏道, 中尾 篤典

    日本臨床救急医学会雑誌   26 ( 3 )   358 - 358   2023年7月

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    記述言語:日本語   出版者・発行元:(一社)日本臨床救急医学会  

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  • アセトアミノフェン中毒におけるプロカルシトニンの有用性

    野島 剛, 本郷 貴識, 小原 隆史, 小崎 吉訓, 飯田 淳義, 湯本 哲也, 青景 聡之, 塚原 紘平, 内藤 宏道, 中尾 篤典

    中毒研究   36 ( 2 )   207 - 207   2023年7月

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    記述言語:日本語   出版者・発行元:(株)へるす出版  

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  • つなぐ命と気持ち~脳死移植における集中治療の役割~潜在的なドナーの認知から移植外科医につなげるところまで 終末期の児童に対し「臓器移植の情報提供」を含めた選択肢提示を行うために 当院の体制作りと現状

    塚原 紘平, 小原 隆史, 野島 剛, 上田 浩平, 本郷 貴識, 小崎 吉訓, 山本 浩継, 飯田 淳義, 青景 聡之, 湯本 哲也, 内藤 宏道, 中尾 篤典

    日本集中治療医学会雑誌   30 ( Suppl.1 )   S331 - S331   2023年6月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 当科における小児急性脳症と体温管理療法の現状

    小原 隆史, 塚原 紘平, 平岡 知浩, 本郷 貴識, 湯本 哲也, 内藤 宏道, 中尾 篤典

    日本脳低温療法・体温管理学会誌   26 ( 1 )   47 - 47   2023年6月

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    記述言語:日本語   出版者・発行元:日本脳低温療法・体温管理学会  

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  • 小児の院外心停止における医師の病院前救急診療は神経学的転帰を改善する

    小原 隆史, 湯本 哲也, 塚原 紘平, 野島 剛, 本郷 貴識, 松本 尚美, 頼藤 貴志, 中尾 篤典, 内藤 宏道

    日本集中治療医学会雑誌   30 ( Suppl.1 )   S422 - S422   2023年6月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 体温管理療法中の温度管理が筋萎縮にあたえる影響の検討

    本郷 貴識, 小原 隆史, 湯本 哲也, 内藤 宏道, 中尾 篤典

    日本脳低温療法・体温管理学会誌   26 ( 1 )   48 - 48   2023年6月

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    記述言語:日本語   出版者・発行元:日本脳低温療法・体温管理学会  

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  • 集中治療領域での嚥下障害

    本郷 貴識, 小原 隆史, 野島 剛, 上田 浩平, 青景 聡之, 塚原 紘平, 湯本 哲也, 内藤 宏道, 中尾 篤典

    日本集中治療医学会雑誌   30 ( Suppl.1 )   S269 - S269   2023年6月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • つなぐいのち~小児脳死下臓器ドナー管理 小児脳死下臓器ドナー管理の特徴 当センターでの経験から

    小原 隆史, 内藤 宏道, 塚原 紘平, 野島 剛, 上田 浩平, 本郷 貴識, 小崎 吉訓, 山本 浩継, 青景 聡之, 湯本 哲也, 中尾 篤典

    日本集中治療医学会雑誌   30 ( Suppl.1 )   S283 - S283   2023年6月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • Association between prehospital advanced life support by emergency medical services personnel and neurological outcomes among adult out-of-hospital cardiac arrest patients treated with extracorporeal cardiopulmonary resuscitation: A secondary analysis of the SAVE-J II study. 国際誌

    Tetsuya Yumoto, Takashi Hongo, Toru Hifumi, Akihiko Inoue, Tetsuya Sakamoto, Yasuhiro Kuroda, Takashi Yorifuji, Atsunori Nakao, Hiromichi Naito

    Journal of the American College of Emergency Physicians open   4 ( 2 )   e12948   2023年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    STUDY OBJECTIVE: Early deployment of extracorporeal cardiopulmonary resuscitation (ECPR) is critical in treating refractory out-of-hospital cardiac arrest (OHCA) patients who are potential candidates for ECPR. The effect of prehospital advanced life support (ALS), including epinephrine administration or advanced airway, compared with no ALS in this setting remains unclear. This study's objective was to determine the association between any prehospital ALS care and outcomes of patients who received ECPR with emergency medical services-treated OHCA. METHODS: This was a secondary analysis of data from the Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J) II study. Patients were separated into 2 groups-those who received prehospital ALS (ALS group) and those did not receive prehospital ALS (no ALS group). Multiple logistic regression analysis was used to investigate the association between prehospital ALS and favorable neurological outcomes (defined as Cerebral Performance Category scores 1-2) at hospital discharge. RESULTS: A total of 1289 patients were included, with 644 patients in the ALS group and 645 patients in the no ALS group. There were fewer favorable neurological outcomes at hospital discharge in the ALS group compared with the no ALS group (10.4 vs 19.8%, p <0.001). A multiple logistic regression analysis revealed that any prehospital ALS care (adjusted odds ratios 0.47; 95% confidence interval 0.34-0.66; p <0.001) was associated with unfavorable neurological outcomes at hospital discharge. CONCLUSION: Prehospital ALS was associated with worse neurological outcomes at hospital discharge in patients treated with ECPR for OHCA. Further prospective studies are required to determine the clinical implications of these findings.

    DOI: 10.1002/emp2.12948

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  • Association of Prehospital Physician Presence During Pediatric Out-of-Hospital Cardiac Arrest With Neurologic Outcomes. 国際誌

    Takafumi Obara, Tetsuya Yumoto, Tsuyoshi Nojima, Takashi Hongo, Kohei Tsukahara, Naomi Matsumoto, Takashi Yorifuji, Atsunori Nakao, Jonathan Elmer, Hiromichi Naito

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies   2023年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: To examine the association of prehospital physician presence with neurologic outcomes of pediatric patients with out-of-hospital cardiac arrest (OHCA). DESIGN: Retrospective cohort study. SETTING: Data from the Japanese Association for Acute Medicine-OHCA Registry. INTERVENTIONS: None. PATIENTS: Pediatric patients (age 17 yr old or younger) registered in the database between June 2014 and December 2019. MEASUREMENT AND MAIN RESULTS: We used logistic regression models with stabilized inverse probability of treatment weighting (IPTW) to estimate the associated treatment effect of a prehospital physician with 1-month neurologically intact survival. Secondary outcomes included in-hospital return of spontaneous circulation (ROSC) and 1-month survival after OHCA. A total of 1,187 patients (276 in the physician presence group and 911 in the physician absence group) were included (median age 3 yr [interquartile range 0-14 yr]; 723 [61%] male). Comparison of the physician presence group, versus the physician absence, showed 1-month favorable neurologic outcomes of 8.3% (23/276) versus 3.6% (33/911). Physician presence was associated with greater odds of 1-month neurologically intact survival after stabilized IPTW adjustment (adjusted odds ratio [aOR] 1.98, 95% CI 1.08-3.66). We also found an association in the secondary outcome between physician presence, opposed to absence, and in-hospital ROSC (aOR 1.48, 95% CI 1.08-2.04). However, we failed to identify an association with 1-month survival (aOR 1.49, 95% CI 0.97-2.88). CONCLUSIONS: Among pediatric patients with OHCA, prehospital physician presence, compared with absence, was associated almost two-fold greater odds of 1-month favorable neurologic outcomes.

    DOI: 10.1097/PCC.0000000000003206

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  • Automatic emergency calls from smartphone/smartwatch applications in trauma. 国際誌

    Takashi Hongo, Shunki Yamamoto, Tsuyoshi Nojima, Hiromichi Naito, Atsunori Nakao, Tetsuya Yumoto

    Acute medicine & surgery   10 ( 1 )   e875   2023年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1002/ams2.875

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  • Heat stroke management during the COVID-19 pandemic: Recommendations from the experts in Japan (2nd edition). 国際誌

    Jun Kanda, Masahiro Wakasugi, Yutaka Kondo, Satoru Ueno, Hitoshi Kaneko, Yohei Okada, Yuichi Okano, Yuki Kishihara, Jun Hamaguchi, Tadashi Ishihara, Yutaka Igarashi, Ryuta Nakae, Sohma Miyamoto, Eri Yamada, Daisuke Ikechi, Maiko Yamazaki, Daiki Tanaka, Yusuke Sawada, Chiaki Suda, Satoshi Yoshimura, Ryuta Onodera, Kenichi Kano, Takashi Hongo, Kaori Endo, Yohei Iwasaki, Hiroshi Kodaira, Shunsuke Yasuo, Nozomu Seki, Hiroshi Okuda, Satoshi Nakajima, Tadashi Nagato, Keiko Terazumi, Satoshi Nakamura, Shoji Yokobori

    Acute medicine & surgery   10 ( 1 )   e827   2023年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Both coronavirus disease 2019 (COVID-19) and heat stroke have symptoms of fever or hyperthermia and the difficulty in distinguishing them could lead to a strain on emergency medical care. To mitigate the potential confusion that could arise from actions for preventing both COVID-19 spread and heat stroke, particularly in the context of record-breaking summer season temperatures, this work offers new knowledge and evidence that address concerns regarding indoor ventilation and indoor temperatures, mask wearing and heat stroke risk, and the isolation of older adults. Specifically, the current work is the second edition to the previously published guidance for handling heat stroke during the COVID-19 pandemic, prepared by the "Working group on heat stroke medical care during the COVID-19 epidemic," composed of members from four organizations in different medical and related fields. The group was established by the Japanese Association for Acute Medicine Heatstroke and Hypothermia Surveillance Committee. This second edition includes new knowledge, and conventional evidence gleaned from a primary selection of 60 articles from MEDLINE, one article from Cochrane, 13 articles from Ichushi, and a secondary/final selection of 56 articles. This work summarizes the contents that have been clarified in the prevention and treatment of infectious diseases and heat stroke to provide guidance for the prevention, diagnosis, and treatment of heat stroke during the COVID-19 pandemic.

    DOI: 10.1002/ams2.827

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  • Successfully treated case of severe hypothermia secondary to myxedema coma. 国際誌

    Hirotsugu Yamamoto, Takashi Hongo, Tsuyoshi Nojima, Takafumi Obara, Yoshinori Kosaki, Kohei Ageta, Kohei Tsukahara, Tetsuya Yumoto, Atsunori Nakao, Hiromichi Naito

    Acute medicine & surgery   10 ( 1 )   e828   2023年

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    記述言語:英語  

    BACKGROUND: Myxedema coma is an extremely rare but fatal endocrine emergency that requires urgent recognition and treatment. We describe a case of severe hypothermia that rapidly deteriorated to cardiac arrest that was attributed to myxedema coma. CASE PRESENTATION: A 52-year-old man without a history of hypothyroidism was transferred to our emergency department due to coma and profound hypothermia. The patient developed cardiac arrest immediately after hospital arrival but return of spontaneous circulation was achieved shortly after resuscitation. The patient was noted to have generalized, nonpitting edema, dry skin, severe respiratory acidosis, hyponatremia, and elevated creatinine kinase, which was indicative of hypothyroidism. Myxedema coma was confirmed by a thyroid profile. The patient was successfully treated with intravenous levothyroxine and glucocorticoid. CONCLUSION: Although myxedema coma is a rare cause of severe hypothermia, emergency physicians should be familiar with its clinical features and management.

    DOI: 10.1002/ams2.828

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  • Transcranial doppler ultrasound in a 3-month-old infant with brain death. 国際誌

    Tomohiro Hiraoka, Takafumi Obara, Takashi Hongo, Tsuyoshi Nojima, Kohei Tsukahara, Tetsuya Yumoto, Atsunori Nakao

    Pediatrics international : official journal of the Japan Pediatric Society   65 ( 1 )   e15587   2023年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/ped.15587

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  • A hyperechoic mass in femoral vein. 国際誌

    Naoko Kaku, Hiroki Sugiyama, Kazufumi Nakamura, Tomoki Furutani, Takashi Hongo, Hiroshi Ito

    Clinical case reports   10 ( 11 )   e6552   2022年11月

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    記述言語:英語  

    Here, we present a case of fat embolism syndrome (FES) in which ultrasound sonography and computed tomography successfully visualized fat embolus in the femoral vein. A multimodality approach was particularly useful for early and specific diagnosis.

    DOI: 10.1002/ccr3.6552

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  • Rare case of intracerebral hemorrhage in anaphylactic shock following administration of intramuscular adrenaline: A case report. 査読 国際誌

    Shunki Yamamoto, Takashi Hongo, Tomokazu Tamura, Tetsuya Yumoto, Hiromichi Naito, Atsunori Nakao

    Clinical case reports   10 ( 11 )   e6534   2022年11月

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    記述言語:英語  

    Intracerebral hemorrhage should be considered as a possible adverse event in patients with anaphylactic shock who are treated with adrenaline administration, especially in those at high risk of serious bleeding events.

    DOI: 10.1002/ccr3.6534

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  • デジタル田園健康特区における救急救命士の権限・役割の拡大による救急体制の充実への取り組み

    上田 浩平, 本郷 貴識, 小原 隆史, 野島 剛, 湯本 哲也, 塚原 紘平, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   33 ( 10 )   872 - 872   2022年10月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • Successful Recovery from Severe Fever with Thrombocytopenia Syndrome and Hemophagocytic Lymphohistiocytosis with Standard Treatment and a Calcium Channel Blocker of Nicardipine Hydrochloride: A Case Report.

    Nao Yamauchi, Takashi Hongo, Manri Kawakami, Kyosuke Inoguchi, Syunsuke Oguni, Noriya Momoki, Akiko Ueno, Fusao Ikeda, Shinichi Fujioka, Kazuhide Yamamoto

    Internal medicine (Tokyo, Japan)   2022年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 67-year-old man was admitted to our hospital with a high fever. Laboratory tests revealed leukopenia, thrombocytopenia, liver dysfunction, rhabdomyolysis, and hyperferritinemia. He was diagnosed with severe fever with thrombocytopenia syndrome (SFTS) complicated by hemophagocytic lymphohistiocytosis and treated with steroid therapy, intravenous calcium channel blocker (CCB), and supportive care, without favipiravir. Serum levels of ferritin and soluble interleukin 2 receptor (sIL2R) were markedly elevated on Day 3 after admission and decreased thereafter, while an SFTS viral load of 6.8×104 copies/μL was detected on Day 2, increasing to 2.9×105 copies/μL on Day 6. Serum ferritin and sIL2R levels may be better indicators of mortality than the SFTS viral load, and CCBs may have a therapeutic effect.

    DOI: 10.2169/internalmedicine.9052-21

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  • Frequency, associated factors, and associated outcomes of dysphagia following sepsis. 国際誌

    Takashi Hongo, Tetsuya Yumoto, Hiromichi Naito, Toshifumi Fujiwara, Jun Kondo, Satoshi Nozaki, Atsunori Nakao

    Australian critical care : official journal of the Confederation of Australian Critical Care Nurses   2022年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Identifying dysphagia as a potential complication of sepsis may improve swallowing function and survival while decreasing hospital length of stay. OBJECTIVES: Our goal was to determine the frequency of dysphagia in sepsis survivors on the 7th day after admission, as well as their associated factors and outcomes. METHODS: This single-centre, retrospective, observational study analysed data from sepsis survivors admitted to Okayama Saiseikai General Hospital from 2018 to 2019. Participants with sepsis were assigned to one of two study groups based on the presence or absence of dysphagia using the criterion of Functional Oral Intake Scale score <5 on the 7th day after admission. We used multivariate logistic regression to determine factors independently associated with dysphagia on the 7th day after admission. Multivariate logistic regression was also used to determine associations between groups and outcomes, including dysphagia on hospital discharge, direct discharge home (discharge of patients directly to their home), and total dependency (Barthel Index score ≤20) on hospital discharge. RESULTS: One hundred one patients met the study inclusion criteria, 55 with dysphagia and 46 without dysphagia. Fasting period (adjusted odds ratio [AOR]: 1.31, 95% confidence interval [CI]: 1.07-1.59) and enteral tube feeding (AOR: 8.56, 95% CI: 1.95-37.5) were independently associated with the presence of dysphagia on the 7th day after admission. Dysphagia on the 7th day after admission was associated with dysphagia on hospital discharge (AOR: 46.0, 95%, CI: 7.90-268.3), a lower chance of direct discharge home (AOR: 0.03, 95% CI: 0.01-0.15), and a higher incidence of total dependency (AOR: 9.30, 95% CI: 2.68-32.2). CONCLUSIONS: We found that dysphagia was commonly encountered post sepsis. Fasting period and enteral tube feeding were independently associated with dysphagia on the 7th day after admission. Dysphagia on the 7th day after admission was also associated with dysphagia on hospital discharge, nondirect discharge home, and dependency in activities of daily living at the time of hospital discharge.

    DOI: 10.1016/j.aucc.2022.06.003

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  • Successful Resuscitation of Cardiac Arrest After Refeeding Syndrome Associated with Hiatal Hernia: A Case Report. 国際誌

    Kazumasa Kotake, Takashi Hongo, Hiroki Sugiyama, Narusato Iizuka, Noriya Momoki, Yasuhiro Kawakami

    The American journal of case reports   23   e935605   2022年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND Refeeding syndrome (RFS) is a life-threatening syndrome, which can cause sudden death. RFS has been reported frequently in young patients with anorexia without organic disease; however, there are few reports in elderly patients with organic disease. Herein, we report a case of cardiac arrest after refeeding syndrome associated with hiatal hernia. CASE REPORT We report the case of a 59-year-old woman who had a diagnosis of RFS during treatment for anorexia secondary to hiatal hernia. She was hospitalized with hypothermia, anemia, and hypovolemic shock and treated with electrolytes, hydration, and transfusion at the Emergency Department. Upper gastrointestinal endoscopy revealed hiatal hernia with severe reflux esophagitis. We initiated parenteral nutrition (8.7 kcal/kg/day). However, QTc prolongation caused pulseless ventricular tachycardia. Temporary cardiac pacing was performed to prevent recurrence. Her nutritional status steadily improved, and she was transferred to another hospital without complications. CONCLUSIONS Patients with gastrointestinal comorbidities are more likely to have inadequate food intake and to be undernourished on admission and therefore should be carefully started on nutritional therapy, considering their risk of RFS.

    DOI: 10.12659/AJCR.935605

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  • Association between timing of speech and language therapy initiation and outcomes among post-extubation dysphagia patients: a multicenter retrospective cohort study. 国際誌

    Takashi Hongo, Ryohei Yamamoto, Keibun Liu, Takahiko Yaguchi, Hisashi Dote, Ryusuke Saito, Tomoyuki Masuyama, Kosuke Nakatsuka, Shinichi Watanabe, Takahiro Kanaya, Tomoya Yamaguchi, Tetsuya Yumoto, Hiromichi Naito, Atsunori Nakao

    Critical care (London, England)   26 ( 1 )   98 - 98   2022年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Post-extubation dysphagia (PED) is recognized as a common complication in the intensive care unit (ICU). Speech and language therapy (SLT) can potentially help improve PED; however, the impact of the timing of SLT initiation on persistent PED has not been well investigated. This study aimed to examine the timing of SLT initiation and its effect on patient outcomes after extubation in the ICU. METHODS: We conducted this multicenter, retrospective, cohort study, collecting data from eight ICUs in Japan. Patients aged ≥ 20 years with orotracheal intubation and mechanical ventilation for longer than 48 h, and those who received SLT due to PED, defined as patients with modified water swallowing test scores of 3 or lower, were included. The primary outcome was dysphagia at hospital discharge, defined as functional oral intake scale score < 5 or death after extubation. Secondary outcomes included dysphagia or death at the seventh, 14th, or 28th day after extubation, aspiration pneumonia, and in-hospital mortality. Associations between the timing of SLT initiation and outcomes were determined using multivariable logistic regression. RESULTS: A total of 272 patients were included. Of them, 82 (30.1%) patients exhibited dysphagia or death at hospital discharge, and their time spans from extubation to SLT initiation were 1.0 days. The primary outcome revealed that every day of delay in SLT initiation post-extubation was associated with dysphagia or death at hospital discharge (adjusted odds ratio (AOR), 1.09; 95% CI, 1.02-1.18). Similarly, secondary outcomes showed associations between this per day delay in SLT initiation and dysphagia or death at the seventh day (AOR, 1.28; 95% CI, 1.05-1.55), 14th day (AOR, 1.34; 95% CI, 1.13-1.58), or 28th day (AOR, 1.21; 95% CI, 1.07-1.36) after extubation and occurrence of aspiration pneumonia (AOR, 1.09; 95% CI, 1.02-1.17), while per day delay in post-extubation SLT initiation did not affect in-hospital mortality (AOR, 1.04; 95% CI, 0.97-1.12). CONCLUSIONS: Delayed initiation of SLT in PED patients was associated with persistent dysphagia or death. Early initiation of SLT may prevent this complication post-extubation. A randomized controlled study is needed to validate these results.

    DOI: 10.1186/s13054-022-03974-6

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  • Emotional work stress reactions of emergency medical technicians involved in transporting out-of-hospital cardiac arrest patients with "do not attempt resuscitation" orders. 国際誌

    Ryo Tanabe, Takashi Hongo, Yasuhiro Mandai, Mototaka Inaba, Takashi Yorifuji, Atsunori Nakao, Jonathan Elmer, Hiromichi Naito

    Resuscitation   173   61 - 68   2022年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Emergency medical technicians (EMTs) may be subjected to emotional stress during patient treatment/transport. In Japan, dispatched EMTs must attempt resuscitation in all cases of out-of-hospital cardiac arrest (OHCA), including patients with "do not attempt resuscitation" (DNAR) orders and patients whose families do not support resuscitation. We described the characteristics, prevalence, and outcomes of OHCA/DNAR patients, and aimed to identify factors associated with EMT stress when treating them. METHODS: We included OHCA patients transported by EMTs in the city of Okayama from 2015 to 2019. We identified patients with DNAR orders based on emergency medical service (EMS) records, then EMTs completed questionnaires regarding the management of those patients and EMTs' emotions. RESULTS: Among 3079 eligible OHCA patients, 122 patients (4%) had DNAR orders (DNAR group), and 2957 (96%) patients had no DNAR orders (no DNAR group). Based on responses from 243 EMT participants involved in OHCA/DNAR transports, we divided EMTs into high stress (73/243, 30%) and low stress (170/243, 70%) groups. EMTs experienced emotional stress from treating patients with family physician orders to transport (AOR: 4.74, 95% CI: 2.35-9.56) and those for whom prehospital defibrillation was performed (AOR: 20.7, 95% CI: 3.10-137.9). CONCLUSIONS: Approximately 30% of EMTs providing resuscitation to OHCA/DNAR patients experienced high levels of stress. Establishment of a prehospital emergency system incorporating physician medical direction and updated guidelines for treating patients with DNAR orders may reduce the psychosocial stress of EMTs.

    DOI: 10.1016/j.resuscitation.2022.01.028

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  • Effects of evidence-based ICU care on long-term outcomes of patients with sepsis or septic shock (ILOSS): protocol for a multicentre prospective observational cohort study in Japan. 国際誌

    Keibun Liu, Toru Kotani, Kensuke Nakamura, Takai Chihiro, Yasunari Morita, Kenzo Ishii, Kenji Fujizuka, Daisetsu Yasumura, Daisuke Taniguchi, Tomohiro Hamagami, Nobutake Shimojo, Masakazu Nitta, Takashi Hongo, Kazuki Akieda, Maeda Atsuo, Tadashi Kaneko, Yutaka Sakuda, Kohkichi Andoh, Akiyoshi Nagatomi, Yukiko Tanaka, Yuhei Irie, Hiroshi Kamijo, Manabu Hanazawa, Daisuke Kasugai, Matsuoka Ayaka, Kenji Oike, Alan Kawarai Lefor, Kunihiko Takahashi, Hajime Katsukawa, Takayuki Ogura

    BMJ open   12 ( 3 )   e054478   2022年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: Sepsis is not only the leading cause of death in the intensive care unit (ICU) but also a major risk factor for physical and cognitive impairment and mental disorders, known as postintensive care syndrome (PICS), reduced health-related quality of life (HRQoL) and even mental health disorders in patient families (PICS-family; PICS-F). The ABCDEF bundle is strongly recommended to overcome them, while the association between implementing the bundle and the long-term outcomes is also unknown. METHODS AND ANALYSIS: This is a multicentre prospective observational study at 26 ICUs. All consecutive patients between 1 November 2020 and 30 April 2022, who are 18 years old or older and expected to stay in an ICU for more than 48 hours due to sepsis or septic shock, are enrolled. Follow-up to evaluate survival and PICS/ PICS-F will be performed at 3, 6 and 12 months and additionally every 6 months up to 5 years after hospital discharge. Primary outcomes include survival at 12 months, which is the primary outcome, and the incidence of PICS defined as the presence of any physical impairment, cognitive impairment or mental disorders. PICS assessment scores, HRQoL and employment status are evaluated. The association between the implementation rate for the ABCDEF bundle and for each of the individual elements and long-term outcomes will be evaluated. The PICS-F, defined as the presence of mental disorders, and HRQoL of the family is also assessed. Additional analyses with data up to 5 years follow-up are planned. ETHICS AND DISSEMINATION: This study received ethics approvals from Saiseikai Utsunomiya Hospital (2020-42) and all other participating institutions and was registered in the University Hospital Medical Information Network Clinical Trials Registry. Informed consent will be obtained from all patients. The findings will be published in peer-reviewed journals and presented at scientific conferences. TRIAL REGISTRATION NUMBER: UMIN000041433.

    DOI: 10.1136/bmjopen-2021-054478

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  • Impact of different medical direction policies on prehospital advanced airway management for out-of hospital cardiac arrest patients: A retrospective cohort study. 国際誌

    Takashi Hongo, Tetsuya Yumoto, Hiromichi Naito, Takeshi Mikane, Atsunori Nakao

    Resuscitation plus   9   100210 - 100210   2022年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Although optimal prehospital airway management after out-of-hospital cardiac arrest (OHCA) remains undetermined, no studies have compared different advanced airway management (AAM) policies adopted by two hospitals in charge of online medical direction by emergency physicians. We examined the impact of two different AAM policies on OHCA patient survival. METHODS: This observational cohort study included adult OHCA patients treated in Okayama City from 2013 to 2016. Patients were divided into two groups: the O group - those treated on odd days when a hospital with a policy favoring laryngeal tube ventilation (LT) supervised, and the E group - those treated on even days when the other hospital with a policy favoring endotracheal intubation (ETI) supervised. Multiple logistic regression analysis was performed to assess airway device effects. The primary outcome measure was seven-day survival. RESULTS: Of 2,406 eligible patients, 50.1% were in the O group and 49.9% were in the E group. O group patients received less ETI (1.0% vs. 12.0%) and more LT (53.3% vs. 43.0%) compared with E group patients. In univariate analysis, no differences were observed in seven-day survival (9.4% vs 10.1%). Multiple regression analysis revealed neither LT nor ETI had a significant independent effect on seven-day survival, considering bag-valve mask ventilation as a reference (OR, 0.78; 95% CI, 0.54 to 1.13, OR, 0.79; 95% CI, 0.36 to 1.72, respectively). CONCLUSION: Despite different advanced airway medical direction policies in a single city, there were no substantial impact on outcomes for OHCA patients.

    DOI: 10.1016/j.resplu.2022.100210

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  • Steroid treatment in patients with acute respiratory distress syndrome: a systematic review and network meta-analysis.

    Shodai Yoshihiro, Takashi Hongo, Shingo Ohki, Tadashi Kaneko, Junichi Ishikawa, Shoichi Ihara, Shunsuke Taito, Masahiko Sakaguchi, Tomoaki Yatabe

    Journal of anesthesia   36 ( 1 )   107 - 121   2022年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Although the most recent systematic review and meta-analyses on acute respiratory distress syndrome (ARDS) have shown that the use of steroids decreases mortality in adult patients, its benefits and risks may differ depending on the type and dosage of the steroid. Therefore, we conducted a network meta-analysis (NMA) to compare the differences in the efficacy among different doses and types of steroids. METHODS: We searched MEDLINE, CENTRAL, ICHUSHI, ClinicalTrials.gov, and WHO ICTRP databases from the earliest records to March 2021 for randomized control trials, which compared steroids with placebo or conventional therapy for ARDS. Using the random-effects model, we compared various categories of steroids (high-dose methylprednisolone, low-dose methylprednisolone, hydrocortisone, dexamethasone, and no steroid) concerning hospital mortality, incidence of infection, and ventilator-free days (VFD). RESULTS: We analyzed nine studies involving adult patients (n = 1212). Although there were no significant differences between the groups in terms of the mortality and incidence of infection, the number of VFD were greater when using low-dose methylprednisolone than when not using any steroids (Mean difference: 6.06; 95% confidence intervals: [2.5, 10.5]). Moreover, the rank probability showed that low-dose methylprednisolone might be the optimal treatment, whereas using no steroid or high-dose methylprednisolone may be inferior to other treatments in terms of mortality, infection, and VFD. CONCLUSION: This NMA suggested that the effect of steroids on the outcome in patients with ARDS might depend on the type of the steroid drug administered. Moreover, further studies are needed to identify the optimal type and dosage.

    DOI: 10.1007/s00540-021-03016-5

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  • Hamman's Syndrome Accompanied by Diabetic Ketoacidosis; a Case Report. 査読 国際誌

    Koya Yamashita, Takashi Hongo, Tsuyoshi Nojima, Tetsuya Yumoto, Atsunori Nakao, Hiromichi Naito

    Archives of academic emergency medicine   10 ( 1 )   e68   2022年

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    記述言語:英語  

    Hamman's syndrome is an uncommon clinical entity characterized by an idiopathic spontaneous pneumomediastinum as a result of a sudden increase in intra-alveolar pressure. It can be triggered by repeated vomiting or Kussmaul breathing associated with diabetic ketoacidosis (DKA). Careful attention to this particular condition is needed to avoid under-diagnosis and to provide optimal management. Herein, we report a case of an 18-year-old man complaining of chest discomfort and progressive weight loss, ultimately diagnosed with Hamman's syndrome secondary to DKA. The patient's symptoms disappeared after intravenous fluid and insulin administration, while his pneumomediastinum resolved following conservative treatment. Our report highlights the importance of recognition of the links between pneumomediastinum as a cause of chest pain in patients with DKA.

    DOI: 10.22037/aaem.v10i1.1709

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  • A Multidrug Therapy for Hydrocarbon Aspiration With Acute Respiratory Distress Syndrome After Exposure to Oral Benzine Intake: A Case Report. 国際誌

    Mari Uno, Takashi Hongo, Sho Kobayashi, Tomokazu Tamura

    Cureus   13 ( 11 )   e19693   2021年11月

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    記述言語:英語  

    Oral benzine intake with suicidal tendencies is an uncommon life-threatening respiratory emergency without a treatment regimen.  A 50-year-old man attempted suicide with 100 ml of oral benzine intake and developed severe acute respiratory distress syndrome (ARDS) with hydrocarbon aspiration. He received mechanical ventilation with placement in the prone position and low tidal volume, neuromuscular blocking agents, bronchoalveolar lavage, steroid pulse therapy, antibiotics, and sivelestat sodium hydrate. He was transferred to the psychiatric hospital five days after admission without any adverse events. ARDS associated with oral benzine intake could be treated with general treatments for ARDS.

    DOI: 10.7759/cureus.19693

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  • A Rare Case of Pelvic Abscess Due to Spontaneous Non-traumatic Bladder Rupture. 国際誌

    Kyosuke Inoguchi, Takashi Hongo, Hiromichi Naito, Atsunori Nakao

    Cureus   13 ( 10 )   e18913   2021年10月

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    記述言語:英語  

    Spontaneous bladder rupture is an uncommon and life-threatening urological emergency, and early diagnosis is often challenging. Herein, we report a case of intraperitoneal bladder rupture in an 81-year-old male with neurogenic bladder-the case of intraperitoneal bladder rupture required late laparotomy for pelvic abscess following initial conservative treatment. An eighty-one-year-old male presented to our emergency department with deterioration of consciousness, fever, and hematuria. He denied previous trauma history and had been treated for neurogenic bladder. Physical examination revealed signs of tenderness in the abdomen. A diagnosis of bladder rupture was made based on laboratory examination indicating renal failure and radiological imaging showing urinary ascites. Conservative management with a Foley catheter and antibiotics (meropenem administered 1 g/day) was initiated. On day seven after admission, the patient complained of abdominal pain and fever, and a diagnosis of pelvic abscess based on contrast-enhanced computed tomography and septic peritonitis was made. An emergency exploratory laparotomy for peritoneal drainage was performed. The postoperative course was uneventful, and the patient was discharged on day 29 after admission. Urinary bladder rupture should always be considered as a differential diagnosis in patients presenting with free fluid in the abdomen, peritonitis, reduced urine output, and hematuria. Clinicians should be aware that secondary bacterial peritonitis can occur as a major complication of a ruptured urinary bladder.

    DOI: 10.7759/cureus.18913

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  • Factors Determining the Efficacy of Recombinant Human Thrombomodulin in the Treatment of Sepsis-Induced Disseminated Intravascular Coagulation.

    Kazumasa Kotake, Takashi Hongo, Akihiro Tahira, Nana Niimi, Ikue Haisa, Yasuhiro Kawakami

    Biological & pharmaceutical bulletin   44 ( 5 )   605 - 610   2021年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Recombinant human thrombomodulin (rhTM) is an anti-coagulant used to treat disseminated intravascular coagulation (DIC). The efficacy of rhTM in patients with sepsis-induced DIC has been proved in some clinical trials, but the determining factors are not known. The aim of this study was to identify patients for whom rhTM will be effective and the factors that determine rhTM efficacy in alleviating DIC. A single-center, retrospective, observational study was conducted in patients with sepsis-induced DIC who were treated with rhTM in Okayama Saiseikai General Hospital (Okayama, Japan) between January 2010 and December 2019. Among 67 patients who were treated with rhTM, DIC was resolved in 24 patients. The multivariate logistic regression analysis revealed that age (odds ratio (OR) 1.05; 95% confidence interval (CI) 1.00-1.10; p < 0.05) and acute physiology and chronic health evaluation II scores (OR 0.88; 95% CI 0.78-0.98; p < 0.05) were factors that determined rhTM efficacy in alleviating DIC. Overall, our study provides valuable information on factors that should be considered before rhTM administration to patients with sepsis-induced DIC for a better management of healthcare costs.

    DOI: 10.1248/bpb.b20-00371

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  • Electron Microscopy Revealed Massive Lipid Droplets in Cardiomyocytes in a Patient with Cardiogenic Shock Following a Fulminant Type 1 Diabetes Mellitus.

    Ryosuke Sugawara, Hiroki Sugiyama, Kazufumi Nakamura, Kiyotaka Tohgi, Takashi Hongo, Midori Tsuchiya, Noriya Momoki, Soichiro Nose, Chikao Yutani, Yoshihiko Ikeda, Tetsuya Ikeda, Hiroshi Ito

    International heart journal   62 ( 1 )   197 - 200   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 52-year-old man with consciousness disorder following a 2-day history of general fatigue, diarrhea, vomiting and excessive thirst was admitted to our hospital. Severe hyperglycemia (1,739 mg/dL) with a slightly elevated HbA1c level (6.9%), ketonuria and low C-peptide level (0.07 ng/mL) confirmed the diagnosis of fulminant type 1 diabetes mellitus (FT1DM). Following sudden unexplained cardiogenic shock shortly after the initiation of insulin therapy with no evidence of myocardial ischemia assessed by coronary angiography, the patient was supported with percutaneous venoarterial extracorporeal membrane oxygenation. Electron microscopic analysis of the myocardium revealed massive lipid droplets without the infiltration of inflammatory cells. His left ventricular function began to recover during the following days and returned to a normal level on day 14. Currently, the impact of FT1DM on intramyocardial lipid deposition is poorly understood. However, this case suggests that even short-term exposure to high concentrations of glucose can be responsible for lipotoxicity followed by severe cardiac dysfunction.

    DOI: 10.1536/ihj.20-537

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  • Prevalence and predictors of direct discharge home following hospitalization of patients with serious adverse events managed by the rapid response system in Japan: a multicenter, retrospective, observational study. 国際誌

    Takashi Hongo, Hiromichi Naito, Toshifumi Fujiwara, Takaki Naito, Yosuke Homma, Yoshihisa Fujimoto, Morooka Takaya, Yuji Yamamori, Taka-Aki Nakada, Tsuyoshi Nojima, Atsunori Nakao, Shigeki Fujitani

    Acute medicine & surgery   8 ( 1 )   e690   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: The rapid response system (RRS) is an in-hospital medical safety system. To date, not much is known about patient disposition after RRS activation, especially discharge home. This study aimed to investigate the prevalence, characteristics, and outcomes of patients with adverse events who required RRS activation. METHODS: Retrospective data from the In-Hospital Emergency Registry in Japan collected from April 2016 to November 2020 were eligible for our analysis. We divided patients into Home Discharge, Transfer, and Death groups. The primary outcome was the prevalence of direct discharge home, and independently associated factors were determined using multivariable logistic regression. RESULTS: We enrolled 2,043 patients who met the inclusion criteria. The prevalence of discharge home was 45.7%; 934 patients were included in the Home Discharge group. Age (adjusted odds ratio [AOR] 0.96; 95% confidence interval [CI], 0.95-0.97), malignancy (AOR 0.69; 95% CI, 0.48-0.99), oxygen administration before RRS (AOR 0.49; 95% CI, 0.36-0.66), cerebral performance category score on admission (AOR 0.38; 95% CI, 0.26-0.56), do not attempt resuscitation order before RRS (AOR 0.17; 95% CI, 0.10-0.29), RRS call for respiratory failure (AOR 0.50; 95% CI, 0.34-0.72), RRS call for stroke (AOR 0.12; 95% CI, 0.03-0.37), and intubation (AOR 0.20; 95% CI, 0.12-0.34) were independently negative, and RRS call for anaphylaxis (AOR 15.3; 95% CI, 2.72-86.3) was positively associated with discharge home. CONCLUSION: Less than half of the in-hospital patients under RRS activation could discharge home. Patients' conditions before RRS activation, disorders requiring RRS activation, and intubation were factors that affected direct discharge home.

    DOI: 10.1002/ams2.690

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  • Intravenous Vitamin C as Ancillary Treatment for Cranial Polyneuritis and Meningitis due to Varicella Zoster Virus Reactivation.

    Takashi Hongo, Fusao Ikeda, Shinichi Fujioka, Riku Akatsuka, Tosifumi Fujiwara, Kazuhide Yamamoto

    Acta medica Okayama   74 ( 3 )   257 - 260   2020年6月

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    記述言語:英語  

    A 65-year-old Japanese woman developed vesicular eruptions on her right ear due to varicella zoster virus (VZV) reactivation, followed by cranial polyneuritis and meningitis affecting her right cranial nerves V, VII, VIII, IX, and X. After acyclovir administration, her facial paralysis worsened. Intravenous methylprednisolone and vitamin C were administered on Day 4 post-admission. Her symptoms steadily improved, and by Day 45 she had fully recovered. Cranial polyneuritis is a rare complication of VZV reactivation, and there is no established method of treatment. This is the first report of full recovery from cranial polyneuritis using intravenous vitamin C as ancillary treatment.

    DOI: 10.18926/AMO/59960

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  • A rare case of Reye's syndrome induced by influenza A virus with use of ibuprofen in an adult. 国際誌

    Takashi Hongo, Noriya Momoki, Souichiro Mae, Satoshi Nozaki, Kenji Takahashi, Toshifumi Fujiwara

    Acute medicine & surgery   7 ( 1 )   e457   2020年

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    記述言語:英語  

    BACKGROUND: Reye's syndrome (RS) is a rare but severe acute life-threating disease characterized by encephalopathy and fatty liver damage. Reye's syndrome is most common in children and rarely occurs in adults. CASE PRESENTATION: A 56-year-old woman was admitted to the emergency department with disturbance of consciousness and respiratory failure. She had taken ibuprofen for headache. Her Glasgow Coma Scale score was E3V3M5 on admission. The laboratory findings revealed acute liver failure with prothrombin time - international normalized ratio of 3.16, aspartate aminotransferase 12,548 IU/L, alanine aminotransferase 5,725 IU/L, and blood ammonia 102 μg/dL. Head magnetic resonance imaging showed hyperintense signals on diffusion-weighed images of globus pallidus.We diagnosed the patient with RS induced by influenza A and use of ibuprofen. The patient received supportive care in the intensive care unit and her clinical outcome was favorable. CONCLUSION: Ibuprofen might be a risk factor for RS.

    DOI: 10.1002/ams2.457

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  • Incidence and related factors of hypoxia associated with elderly femoral neck fractures in the emergency department setting. 国際誌

    Takashi Hongo, Hiromichi Naito, Toshifumi Fujiwara, Mototaka Inaba, Noritomo Fujisaki, Atsunori Nakao

    Acute medicine & surgery   7 ( 1 )   e618   2020年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: Femoral neck fractures in elderly patients needing oxygen therapy are often encountered in the emergency department. This single-center, retrospective, observational study aimed to examine the frequency, cause, and factors related to hypoxia in elderly patients with femoral neck fractures. METHODS: We analyzed data from 241 patients admitted to Okayama Saiseikai General Hospital (Okayama, Japan) from April 2016 to March 2019. Hypoxia was defined as PaO2 / FiO2 ratio under 300. The independent factors for hypoxia were determined by multiple logistic regression analysis. RESULTS: There were 194 patients who met the study inclusion criteria, 148 in the non-hypoxia group and 46 in the hypoxia group. The hypoxia group included patients with pneumonia (n = 3), chronic obstructive pulmonary disease (n = 2), pulmonary edema (n = 1), and pulmonary embolization (n = 1). The cause of hypoxia was undetermined in 39 cases. However, occult fat embolism syndrome was suspected in 29 of these 39 cases based on Gurd and Wilson criteria after considering clinical examination results. Barthel indexes were significantly lower in the hypoxia group on discharge. Age (adjusted odds ratio [OR] 1.07; 95% confidence interval [CI], 1.00-1.14; P = 0.038), D-dimer (adjusted OR 1.02; 95% CI, 1.00-1.03; P = 0.005), and transtricuspid pressure gradient (adjusted OR 1.03; 95% CI, 1.00-1.07; P = 0.015) were independently associated with the hypoxia. CONCLUSION: We found that hypoxia, including undetermined hypoxia, was commonly encountered in the emergency department. Hypoxia in elderly patients with femoral neck fractures was associated with age, D-dimer, and transtricuspid pressure gradient and needs further investigation.

    DOI: 10.1002/ams2.618

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  • Influenza A-induced croup in an adult.

    Takashi Hongo, Toshifumi Fujiwara

    Journal of general and family medicine   20 ( 5 )   213 - 214   2019年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Cervical radiography showed subglottic narrowing of the trachea suggestive of steeple sign.

    DOI: 10.1002/jgf2.266

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  • IVC Filter Perforation Through the Duodenum.

    Takashi Hongo, Ryoichi Harada, Akiko Fujiwara, Toshifumi Fujiwara

    Internal medicine (Tokyo, Japan)   58 ( 10 )   1529 - 1530   2019年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2169/internalmedicine.2228-18

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  • Loss of bone mineral density following sepsis using Hounsfield units by computed tomography. 国際誌

    Takashi Hongo, Kazumasa Kotake, Hirotada Muramatsu, Daisuke Omura, Yudai Yano, Daisuke Hasegawa, Noriya Momoki, Kenji Takahashi, Satoshi Nozaki, Toshifumi Fujiwara

    Acute medicine & surgery   6 ( 2 )   173 - 179   2019年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: To examine the change in vertebral bone mineral density (BMD) using abdominal computed tomography in patients treated for sepsis. METHODS: A single-center, retrospective, observational study was undertaken to evaluate BMD after critical care at Okayama Saiseikai General Hospital (Okayama, Japan) from January 2016 to April 2018. Sepsis was defined as an absolute increase of ≥2 in Sequential Organ Failure Assessment score in the intensive care unit or high care unit. Bone mineral density was evaluated in Hounsfield units (HU) by computed tomography. Patients were divided into groups based on the presence or absence of osteoporosis, which was defined as average vertebral body HU <110. Paired t-tests were used to compare the mean BMD of each vertebra between before and after critical care. We also analyzed accidental bone fracture events after discharge. The survival rate was analyzed as an outcome using the Kaplan-Meier method. RESULTS: Fifty-two of 188 patients met the inclusion criteria. We found significant differences between admission and follow-up vertebral BMD values in the spine at the thoracic 12, lumbar 1-5, and sacrum 1 levels (P < 0.05), especially in the non-osteoporosis groups. No difference in mortality was observed between patients with osteoporosis and those without. Two of 19 patients with osteoporosis developed a bone fracture. CONCLUSION: We found that sepsis was associated with loss in BMD following critical care.

    DOI: 10.1002/ams2.401

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  • Using kidney size for early detection of contrast-induced nephropathy in the emergency department setting. 国際誌

    Takashi Hongo, Midori Tsuchiya, Mototaka Inaba, Kenji Takahashi, Satoshi Nozaki, Toshifumi Fujiwara, Makoto Hiramatsu

    Acute medicine & surgery   5 ( 3 )   278 - 284   2018年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: We aimed to examine the relationship between kidney size and contrast-induced nephropathy (CIN) in patients who underwent contrast-enhanced computed tomography (CT) in the emergency department. METHODS: This single-center retrospective observational study was undertaken to evaluate risk factors for CIN at Okayama Saiseikai General Hospital (Okayama, Japan) from January 2014 through to December 2016. Contrast-induced nephropathy was defined as an absolute increase in serum creatinine level of ≥0.5 mg/dL or ≥25% over the baseline value within 72 h after contrast-enhanced CT. Independent risk factors for CIN were determined by multiple logistic regression analysis. The thickness of the kidney was evaluated as a predictor of CIN using the area under the receiver operating characteristic curve. We also analyzed CIN as an outcome using the Kaplan-Meier method. RESULTS: The incidence of CIN was 26/262 (9.9%). In the multivariate analysis, CIN was associated with renal thickness (odds ratio = 0.65; 95% confidence interval, 0.53-0.81). No patient underwent renal replacement therapy. CONCLUSION: Renal thickness could be used as a reliable, simple, and easily obtainable marker for identifying CIN in patients undergoing contrast-enhanced CT in the emergency department.

    DOI: 10.1002/ams2.346

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  • Two cases of spontaneous cervical epidural hematoma without back or neck pain in elderly Japanese men. 国際誌

    Takashi Hongo, Kenichi Iseda, Midori Tsuchiya, Mototaka Inaba, Satoshi Nozaki, Kenji Takahashi, Masaaki Nakajima, Toshifumi Fujiwara

    Acute medicine & surgery   5 ( 2 )   181 - 184   2018年4月

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    記述言語:英語  

    Cases: Spontaneous spinal epidural hematoma (SSEH) is an uncommon disease. Most SSEH cases involve back and/or neck pain. We report the cases of two men who experienced SSEH with dysstasia but without back or neck pain. Outcomes: This study presents two cases involving elderly Japanese men who visited an emergency department because of sudden dysstasia without back or neck pain. The results of the neurological examinations revealed ataxic gait. Cervical spinal epidural hematomas were observed by computed tomography and magnetic resonance imaging. One patient underwent hematoma removal and decompression by corpectomy, whereas the other patient received conservative treatment and observation. The patients were discharged without sequelae. Conclusion: Spinal epidural hematomas are difficult to diagnose, and a delayed diagnosis can adversely affect the patient's quality of life. These hematomas should be considered in the differential diagnosis of cerebrovascular diseases.

    DOI: 10.1002/ams2.317

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  • Contrast medium-induced transient severe leukopenia. 国際誌

    Takashi Hongo, Satoshi Nozaki, Midori Tsuchiya, Mototaka Inaba, Kenji Takahashi, Toshifumi Fujiwara

    Acute medicine & surgery   5 ( 2 )   185 - 188   2018年4月

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    記述言語:英語  

    Case: Contrast medium-induced transient leukopenia is very rare. Here, we report a case of a 73-year-old man diagnosed with contrast media-induced transient leukopenia. The patient underwent abdominal contrast-enhanced computed tomography, where he was given non-ionic iodinated contrast medium i.v. His medical history included an allergic reaction to a different contrast medium. One hour later, the patient was admitted to the emergency department complaining of chest discomfort. He had leukopenia and a fever (temperature of 38.9°C). Complete blood count showed a white blood cell count of 930/μL and an absolute neutrophilic count of 232/μL. Outcome: The patient was given i.v. antibiotics and 5 mg chlorpheniramine maleic acid, 20 mg famotidine, and 125 mg methylprednisolone. The patient's white blood cell count recovered the next day, and he was discharged after 2 days of hospitalization. Conclusion: We diagnosed the patient with contrast media-induced transient leukopenia, which is a rare phenomenon.

    DOI: 10.1002/ams2.319

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MISC

  • 救急医療現場における個人的信念に基づく医療行為拒否への対応 放射線被曝拒否事例から考える

    小出 恭大, 湯本 哲也, 本郷 貴識, 小崎 吉訓, 野島 剛, 上田 浩平, 小原 隆史, 飯田 淳義, 山本 浩継, 青景 聡之, 塚原 紘平, 内藤 宏道, 中尾 篤典

    日本臨床救急医学会雑誌   26 ( 3 )   358 - 358   2023年7月

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    記述言語:日本語   出版者・発行元:(一社)日本臨床救急医学会  

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  • アセトアミノフェン中毒におけるプロカルシトニンの有用性

    野島 剛, 本郷 貴識, 小原 隆史, 小崎 吉訓, 飯田 淳義, 湯本 哲也, 青景 聡之, 塚原 紘平, 内藤 宏道, 中尾 篤典

    中毒研究   36 ( 2 )   207 - 207   2023年7月

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    記述言語:日本語   出版者・発行元:(株)へるす出版  

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  • 寝たきりを防ぎたければ今すぐ嚥下にアプローチしよう! ICUから始める"超"早期嚥下障害対策

    本郷 貴識

    早期離床   9 ( 2 )   7 - 7   2023年6月

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    記述言語:日本語   出版者・発行元:日本離床学会  

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  • PICSのエビデンスをもとめて 敗血症のPICS発症率 多施設前向き観察研究 ILOSS Study

    劉 啓文, 高井 千尋, 花澤 学, 森田 恭成, 本郷 貴識, 下條 信威, 入江 悠平, 小倉 崇以, 小谷 透

    日本集中治療医学会雑誌   30 ( Suppl.1 )   S330 - S330   2023年6月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 【FIX PICS 集中治療後症候群の予防と治療】PICSを理解する ICUでの嚥下障害

    本郷 貴識, 湯本 哲也

    救急医学   47 ( 6 )   661 - 667   2023年6月

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    記述言語:日本語   出版者・発行元:(株)へるす出版  

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  • 遺伝性血管浮腫(HAE)の診断後に、腹痛発作で救急搬送を繰り返していた一例

    佐々並 三紗, 薬師寺 泰匡, 本郷 貴識, 野島 剛, 上田 浩平, 内藤 宏道, 中尾 篤典

    日本腹部救急医学会雑誌   43 ( 2 )   520 - 520   2023年2月

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    記述言語:日本語   出版者・発行元:(一社)日本腹部救急医学会  

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  • 横紋筋融解症と喉頭浮腫と縦隔気腫を合併したカフェイン中毒の1例

    赤木 洋介, 本郷 貴識, 井口 京介, 野崎 哲, 難波 研二, 小林 洋二, 水川 俊一

    日本集中治療医学会雑誌   29 ( Suppl.1 )   718 - 718   2022年11月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • Pros & Cons:集中治療におけるステロイド療法の是非 肺を守るためにステロイドを積極的に使用しましょう システマティックレビューの結果から

    吉廣 尚大, 本郷 貴識, 大木 伸吾, 金子 唯, 石川 順一, 井原 祥一, 對東 俊介, 阪口 昌彦

    日本集中治療医学会雑誌   29 ( Suppl.1 )   389 - 389   2022年11月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 認知機能および(または)摂食嚥下機能の障害予防を目指すICU早期リハビリテーション 人工呼吸管理後の嚥下障害におけるST介入時期の検討 多施設後ろ向き観察研究(中間報告)

    本郷 貴識, 山本 良平, 劉 啓文, 内藤 宏道, 中尾 篤典, 水川 俊一

    日本集中治療医学会雑誌   29 ( Suppl.1 )   373 - 373   2022年11月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 縦隔気腫を合併した糖尿病性ケトアシドーシスの1例

    山下 航矢, 本郷 貴識, 野島 剛, 湯本 哲也, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   33 ( 10 )   881 - 881   2022年10月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 縦隔気腫が頸部に波及し上気道閉塞を来したカフェイン中毒の一例

    水川 俊一, 本郷 貴識, 井口 京介, 野崎 哲, 難波 研二

    日本集中治療医学会雑誌   29 ( 5 )   545 - 546   2022年9月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

    症例は26歳女性で、激しい嘔吐と嗄声を主訴とした。受診時には高度頻脈、腎障害、横紋筋融解症、低K血症を呈し、著明な頸部腫脹がみられ、CT撮影では頸部軟部組織、咽頭粘膜下、胸腹壁、後腹壁に広がる著明な気腫、縦隔気腫と下部食道の全周性壁肥厚、上気道狭窄を認めた。来院2時間後に市販の眠気除去薬(カフェイン含有100mg/錠)120錠を約10時間前に摂取したことが判明した。診察中に嗄声が悪化して呼吸困難を訴えたため、来院3時間後に気管挿管を行ったところ、後鼻孔から咽頭粘膜は浮腫様に著しく腫れていた。気腫による著明な頸部腫脹から頸部の還流障害を来たし、咽頭粘膜下気腫や咽喉頭浮腫を生じて上気道閉塞に陥ったと推測され、血液透析開始から約3時間で循環動態は安定した。

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    その他リンク: https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J02874&link_issn=&doc_id=20220929450016&doc_link_id=1390293268649266304&url=https%3A%2F%2Fcir.nii.ac.jp%2Fcrid%2F1390293268649266304&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_2.gif

  • 2次救急病院におけるIII度熱傷の治療戦略

    久保 元志郎, 本郷 貴識, 安積 昌吾

    熱傷   48 ( 1 )   39 - 39   2022年3月

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    記述言語:日本語   出版者・発行元:(一社)日本熱傷学会  

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  • クレブシエラによるARDSに伴う敗血症性心筋症発症後、VA、VAV、VV ECMOを導入し、心機能改善を認めた剖検例

    井口 京介, 本郷 貴識, 野崎 哲

    日本救急医学会雑誌   32 ( 12 )   2758 - 2758   2021年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 横紋筋融解症と喉頭浮腫と縦隔気腫を合併したカフェイン中毒の1例

    村上 俊太郎, 本郷 貴識, 野崎 哲

    日本救急医学会雑誌   32 ( 12 )   2747 - 2747   2021年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 犬咬創後、涙小管断裂と診断し涙小管吻合を行った一例

    久保 元志郎, 本郷 貴識

    日本救急医学会雑誌   32 ( 12 )   2732 - 2732   2021年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • Youtubeを利用した救急診療教育の検討

    山城 有斗, 本郷 貴識, 野崎 哲

    日本救急医学会雑誌   32 ( 12 )   2055 - 2055   2021年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 二峰性の呼吸不全の悪化を辿った溺水後高齢者の1例

    小林 尚, 本郷 貴識, 野崎 哲

    日本救急医学会雑誌   32 ( 12 )   2766 - 2766   2021年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 原因不全の心不全を合併したMPO-ANCA関連血管炎の1例

    難波 俊介, 野崎 哲, 本郷 貴識

    日本救急医学会雑誌   32 ( 12 )   2765 - 2765   2021年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • ここまできたPICS研究 敗血症治療後の嚥下障害の頻度、特徴、転帰(Frequency, Characteristics, and Outcomes of Dysphagia Following Sepsis Treatment)

    本郷 貴識, 内藤 宏道, 藤原 俊文, 赤木 洋介, 伏見 美紀, 難波 研二, 小林 洋二, 水川 俊一, 中尾 篤典

    日本集中治療医学会雑誌   28 ( Suppl.2 )   291 - 291   2021年9月

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    記述言語:英語   出版者・発行元:(一社)日本集中治療医学会  

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  • 高浸透圧性高血糖症候群を合併したジスチグミンによるコリン作動性クリーゼの1例

    小武 和正, 田平 明啓, 本郷 貴識

    日本臨床救急医学会雑誌   24 ( 2 )   224 - 224   2021年5月

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    記述言語:日本語   出版者・発行元:(一社)日本臨床救急医学会  

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  • 敗血症治療後嚥下障害の発症頻度とリスク因子(Frequency and Risk Factors of Dysphagia Following Sepsis Treatment)

    本郷 貴識, 内藤 宏道, 藤原 俊文, 野崎 哲, 中尾 篤典

    日本救急医学会雑誌   31 ( 11 )   2261 - 2261   2020年11月

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    記述言語:英語   出版者・発行元:(一社)日本救急医学会  

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  • 複数関連福祉施設を有する市中病院の新型コロナウイルス感染症クラスターマニュアル策定

    野崎 哲, 本郷 貴識, 稲葉 基高, 高橋 健治

    日本救急医学会雑誌   31 ( 11 )   2231 - 2231   2020年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 救急外来でみた後天性血友病の2例

    濃野 優, 本郷 貴識, 野崎 哲, 藤原 俊文

    日本救急医学会雑誌   31 ( 11 )   1104 - 1104   2020年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 論文執筆も点数化を 2019年度救急科専門医試験受験して

    本郷 貴識, 藤原 俊文, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   31 ( 11 )   880 - 880   2020年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • Ludwig's anginaの一例

    藤岡 紘平, 本郷 貴識, 藤原 俊文, 野崎 哲

    日本救急医学会雑誌   31 ( 11 )   1012 - 1012   2020年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 亜急性心タンポナーデにて救急搬送されたPrimary Effusion Lymphomalike Lymphomaの一例

    本田 章, 本郷 貴識, 野崎 哲, 藤原 俊文

    日本救急医学会雑誌   31 ( 11 )   1083 - 1083   2020年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 黄色ブドウ球菌による壊死性筋膜炎と腎膿瘍合併の一例

    福元 裕貴, 本郷 貴識, 野崎 哲

    日本救急医学会雑誌   31 ( 11 )   1028 - 1028   2020年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 水痘・帯状疱疹ウイルスによる多発脳神経炎および髄膜炎に対してビタミンCが補助的治療として奏功した1例

    赤塚 陸, 本郷 貴識, 野崎 哲, 藤原 俊文

    日本救急医学会雑誌   31 ( 11 )   1019 - 1019   2020年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 急性の大量の腹水と偽性腎不全を伴い、尿路性敗血症に至った膀胱破裂の1例

    井口 京介, 本郷 貴識, 野崎 哲

    日本救急医学会雑誌   31 ( 11 )   1017 - 1017   2020年11月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 吐下血を伴うショック 胃潰瘍に鼻出血が併発した一例

    矢野 友大, 本郷 貴識, 栗山 明, 藤原 俊文

    日本救急医学会雑誌   30 ( 9 )   833 - 833   2019年9月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • ICUから生還後のQOLを向上するには? 敗血症後の骨密度低下度についてのCTにおけるHounsfield unitを用いた評価(Loss of bone mineral density following sepsis using Hounsfield units by computed tomography)

    本郷 貴識, 稲葉 基高, 野崎 哲, 藤原 俊文

    日本救急医学会雑誌   30 ( 9 )   556 - 556   2019年9月

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    記述言語:英語   出版者・発行元:(一社)日本救急医学会  

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  • 日本救急医学会誌:その役割と執筆から採用までの問題点-日本救急医学会誌にどんどん投稿しましょう 若手救急医によるAMSへの投稿の取り組み!!!(Challenge to submit manuscripts in AMS by young emergency physician!!!)

    本郷 貴識, 藤原 俊文

    日本救急医学会雑誌   30 ( 9 )   571 - 571   2019年9月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • イブプロフェン内服を契機とした成人ライ症候群の1例

    日笠 晋太郎, 本郷 貴識, 桃木 律也, 野崎 哲, 藤原 俊文

    日本救急医学会雑誌   30 ( 9 )   634 - 634   2019年9月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 気道緊急に至った高齢者外傷性縦隔血腫の1例

    近藤 崇弘, 野崎 哲, 本郷 貴識, 高橋 健治, 稲葉 基高, 藤原 俊文

    日本救急医学会雑誌   30 ( 9 )   622 - 622   2019年9月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • コーヒーの過剰摂取による急性カフェイン中毒の1例

    小武 和正, 本郷 貴識, 野崎 哲, 田平 明啓, 川上 恭弘, 藤原 俊文

    中毒研究   32 ( 2 )   220 - 220   2019年7月

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    記述言語:日本語   出版者・発行元:(株)へるす出版  

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  • 気道緊急の3症例

    野崎 哲, 本郷 貴識, 稲葉 基高, 藤原 俊文

    日本病院総合診療医学会雑誌   15 ( 3 )   263 - 263   2019年5月

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    記述言語:日本語   出版者・発行元:(一社)日本病院総合診療医学会  

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  • 大網出血の1例

    安井 光太郎, 本郷 貴識, 藤原 俊文, 金澤 右

    日本インターベンショナルラジオロジー学会雑誌   33 ( 4 )   417 - 417   2019年4月

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    記述言語:日本語   出版者・発行元:(一社)日本インターベンショナルラジオロジー学会  

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  • EWSによる気管支充填とAPRVの併用で救命しえたANCA関連血管炎によるびまん性肺胞出血の一例

    桃木 律也, 渡辺 一彦, 廣瀬 啓, 本郷 貴識, 岡 聖子, 赤木 洋介, 水川 俊一, 小林 洋二

    日本集中治療医学会雑誌   26 ( Suppl. )   [P71 - 1]   2019年2月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 外傷後脳出血による入院中に破傷風を発症した一症例

    赤木 洋介, 稲井 舞夕子, 岡 聖子, 本橋 靖子, 本郷 貴識, 桃木 律也, 小林 洋二, 水川 俊一

    日本集中治療医学会雑誌   26 ( Suppl. )   [P8 - 6]   2019年2月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • E.coliによる感染性心内膜炎に脳幹、両側視床梗塞を合併した僧帽弁形成術後の1例

    清水 洋, 本郷 貴識, 田邉 真樹, 中村 一葉, 宮崎 紀樹, 小林 未央子, 石田 琢人, 田邉 孝大, 杉山 和宏, 濱邊 祐一

    日本集中治療医学会雑誌   26 ( Suppl. )   [P25 - 3]   2019年2月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 敗血症患者におけるCT値を用いた骨密度の検討

    本郷 貴識, 稲葉 基高, 岡 聖子, 本橋 靖子, 赤木 洋介, 稲井 舞夕子, 小林 洋二, 水川 俊一, 桃木 律也, 藤原 俊文

    日本集中治療医学会雑誌   26 ( Suppl. )   [O61 - 1]   2019年2月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 小腸出血に対するNBCA塞栓後に穿孔をきたしたSLE患者の1例

    川端 隆寛, 安井 光太郎, 佐伯 基次, 石原 節子, 守都 常晴, 戸上 泉, 本郷 貴識, 稲葉 基高, 金澤 右

    Japanese Journal of Radiology   37 ( Suppl. )   51 - 51   2019年2月

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    記述言語:日本語   出版者・発行元:(公社)日本医学放射線学会  

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  • 救急外来における腎臓の大きさからみた造影剤誘発性腎障害の早期検出(Kidney size for early detection of contrast-induced nephropathy in the emergency department setting)

    本郷 貴識, 稲葉 基高, 高橋 健次, 野崎 哲, 藤原 俊文

    日本救急医学会雑誌   29 ( 10 )   479 - 479   2018年10月

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    記述言語:英語   出版者・発行元:(一社)日本救急医学会  

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  • 中国地区DMAT連絡協議会実働訓練を開催して

    野崎 哲, 本郷 貴識, 高橋 健治, 藤原 俊文

    日本救急医学会雑誌   29 ( 10 )   603 - 603   2018年10月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • シキミ中毒の1例

    本郷 貴識, 野崎 哲, 稲葉 基高, 藤原 俊文

    中毒研究   31 ( 2 )   248 - 248   2018年7月

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    記述言語:英語   出版者・発行元:(株)へるす出版  

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  • 副腎皮質腺腫破裂による腹腔内出血に対し緊急Interventional Radiology(IVR)止血後、腹腔鏡下切除を施行した1例

    本郷 貴識, 稲葉 基高, 安井 光太郎

    日本腹部救急医学会雑誌   38 ( 5 )   853 - 856   2018年7月

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    記述言語:日本語   出版者・発行元:(一社)日本腹部救急医学会  

    症例は79歳女性。左側腹部痛を主訴に近医を受診、単純CT検査の結果、腹腔内出血を疑われて当院に転院した。来院時のバイタルサインは安定しており、造影CT検査では左副腎腫瘍の破裂所見と血管外漏出像を認めた。副腎腫瘍出血の診断で緊急Interventional Radiology(以下、IVR)を施行、左中副腎動脈と上副腎動脈の責任血管にゼラチンスポンジを用い止血した。術後経過は良好で術後第8病日自宅退院、発症約4ヵ月後に待機的に腹腔鏡下副腎腫瘍摘出術を施行した。摘出標本は直径3.0×5.2×3.0cm、重量57gの表面平滑な腫瘍で、病理組織学検査で副腎皮質腺腫と診断した。副腎皮質腺腫破裂はまれである。本症例は緊急性の高い腹腔内出血に対しIVRで止血、待機的に低侵襲な腹腔鏡下副腎腫瘍摘出術を施行し得たため報告する。(著者抄録)

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    その他リンク: https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J02824&link_issn=&doc_id=20180907460012&doc_link_id=10.11231%2Fjaem.38.853&url=https%3A%2F%2Fdoi.org%2F10.11231%2Fjaem.38.853&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • IVRにて止血し得た特発性大網出血の1例

    本郷 貴識, 野崎 哲, 安井 光太郎, 藤原 俊文

    日本病院総合診療医学会雑誌   14 ( 3 )   225 - 226   2018年5月

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    記述言語:日本語   出版者・発行元:(一社)日本病院総合診療医学会  

    症例は33歳男性で、4時間前、咳嗽時に突然左下腹部痛が出現した。症状が持続するため救急外来を独歩で受診した。腹部単純CTで左上腹部に淡い高濃度軟部影、骨盤内に高濃度腹水がみられ、造影CTでは軟部影内に軽度拡張した左胃大網動脈分枝からの造影剤の血管外漏出を認めた。画像所見から左胃大網動脈分枝からの大網出血と診断し、Interventional Radiology(IVR)での止血術を選択した。3mm、2mmコイルとゼラチンスポンジを用い塞栓術を施行し、止血が得られた。治療後、再出血や感染の合併なく術後6日目に退院した。退院1ヵ月後、再出血は認めていない。

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  • 地域住民に対する動画によるACP啓蒙活動から見えてきたもの

    稲葉 基高, 野崎 哲, 土屋 翠子, 本郷 貴識, 藤原 俊文

    日本救急医学会雑誌   28 ( 9 )   457 - 457   2017年9月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 救急外来における造影剤腎症のリスクの検討 迅速なマーカーの提案

    本郷 貴識, 土屋 翠子, 稲葉 基高, 高橋 健次, 野崎 哲, 藤原 俊文

    日本救急医学会雑誌   28 ( 9 )   450 - 450   2017年9月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 緊急止血術における術前のCT-Angiographyの必要性

    安井 光太郎, 川端 隆寛, 稲葉 基高, 本郷 貴識, 金澤 右

    IVR: Interventional Radiology   32 ( Suppl. )   228 - 228   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本インターベンショナルラジオロジー学会  

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  • 当院における救急車で来院した急性アルコール中毒に対する検討

    本郷 貴識, 野崎 哲, 土屋 翠子, 稲葉 基高, 高橋 健治, 藤原 俊文

    日本臨床救急医学会雑誌   20 ( 2 )   316 - 316   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本臨床救急医学会  

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  • 心嚢液貯留に対しCTガイド下ドレナージを施行した3例

    本郷 貴識, 杉山 洋樹, 土屋 翠子, 稲葉 基高, 高橋 健治, 野崎 哲, 吉川 昌樹, 川端 隆寛, 安井 光太郎, 藤原 俊文

    IVR: Interventional Radiology   32 ( Suppl. )   319 - 319   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本インターベンショナルラジオロジー学会  

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  • 一般市民へいかに事前意思表明の重要性を伝えるか 地域医師会との取り組み

    稲葉 基高, 本郷 貴識, 魚住 翠子, 本橋 靖子, 赤木 洋介, 仲原 隆弘, 水川 俊一, 小林 洋二

    日本集中治療医学会雑誌   24 ( Suppl. )   O40 - 5   2017年2月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 急性上腸間膜動脈血栓症に対する血栓溶解療法に続発した脊髄くも膜下血腫の一例

    仲原 隆弘, 赤木 洋介, 本橋 靖子, 本郷 貴識, 魚住 翠子, 稲葉 基高, 水川 俊一, 小林 洋二

    日本集中治療医学会雑誌   24 ( Suppl. )   DP14 - 5   2017年2月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • From Bedside to Lab,from Lab to Bedside 救急医学研究を発展させるために Rapid Response System導入以前の院内急変患者の検討

    本郷 貴識, 稲葉 基高, 魚住 翠子, 野崎 哲, 藤原 俊文

    日本救急医学会雑誌   27 ( 9 )   349 - 349   2016年9月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 被災地外DMAT県調整本部(隣接ブロック)の活動と課題

    野崎 哲, 稲葉 基高, 魚住 翠子, 本郷 貴識, 高橋 健治, 藤原 俊文

    日本救急医学会雑誌   27 ( 9 )   362 - 362   2016年9月

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    記述言語:日本語   出版者・発行元:(一社)日本救急医学会  

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  • 腎生検に伴う副左腎動脈の出血に対し、IVRが奏功した1例

    本郷 貴識, 稲葉 基高, 桃木 律也, 野崎 哲, 高橋 健治, 安井 光太郎, 藤原 俊文

    IVR: Interventional Radiology   31 ( Suppl. )   190 - 190   2016年4月

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    記述言語:日本語   出版者・発行元:(一社)日本インターベンショナルラジオロジー学会  

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  • 血液浄化療法により救命し得た最重症型MPO-ANCA関連血管炎の一例

    本郷 貴識, 野崎 哲, 稲葉 基高, 高橋 健治, 桃木 律也, 山村 昌弘, 藤原 俊文

    日本臨床救急医学会雑誌   19 ( 2 )   344 - 344   2016年4月

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    記述言語:日本語   出版者・発行元:(一社)日本臨床救急医学会  

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  • 上行結腸癌イレウスに対して大腸ステント留置後、虫垂炎を発症した1例

    本郷 貴識, 庄司 良平, 新田 泰樹, 河本 洋伸, 児島 亨, 丸山 昌伸, 宇野 太, 木村 臣一, 片岡 正文, 高畑 隆臣, 仁熊 健文, 赤在 義浩, 西山 宜孝, 三村 哲重, 大原 利憲

    日本臨床外科学会雑誌   76 ( 増刊 )   1137 - 1137   2015年10月

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    記述言語:日本語   出版者・発行元:日本臨床外科学会  

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  • 糖尿病透析予防指導管理料算定患者における糖尿病性腎症進行抑制効果の検討

    丸山 啓輔, 松浦 郁子, 野村 祥久, 庄島 蘇音, 西村 晋輔, 桃木 律也, 中尾 一志, 本郷 貴識, 中塔 辰明, 平松 信

    日本腎臓学会誌   57 ( 3 )   551 - 551   2015年4月

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    記述言語:日本語   出版者・発行元:(一社)日本腎臓学会  

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