Updated on 2026/04/03

写真a

 
AOKAGE Toshiyuki
 
Organization
Faculty of Medicine, Dentistry and Pharmaceutical Sciences Special-Appointment Lecturer
Position
Special-Appointment Lecturer
Profile

略歴
2004年3月 日本医科大学卒業
2004年4月 広島市立広島市民病院 初期研修医
2006年4月 広島市立広島市民病院 後期研修医(循環器内科、小児循環器科、心臓血管外科)
2009年4月 日本医科大学付属病院集中治療室 医員
2013年4月 Visiting researcher, Karolinska University Hospital, ECMO Centre Karolinska (Sweden).
2015年4月 会津中央病院 循環器科 医員
2015年10月 かわぐち心臓呼吸器病院 循環器科・集中治療科 科長
2017年4年 東京都立小児総合医療センター 集中治療科 医師
2017年11月 岡山大学大学院医歯薬学総合研究科 高齢者救急医療学講座 助教
2022年11月 岡山大学大学院医歯薬学総合研究科 周産期・小児救急医療学講座 助教

資格等

医学博士
日本内科学会認定内科医
日本内科学会総合内科専門医
日本循環器学会循環器専門医
日本救急医学会救急専門医
日本集中治療医学会集中治療専門医
日本呼吸療法医学会呼吸療法専門医
日本呼吸療法医学会評議員危機管理委員会委員
AP-ELSO Steering Committee Member

職歴等
東京都立小児総合医療センター 集中治療科 非常勤医師
東京都健康長寿医療センター研究所 生体調節機能研究 協力研究員

External link

Degree

  • Ph.D. ( 2022.3   Okayama University )

Research Interests

  • Hydrogen

  • Heart failure

  • Pneumonia

  • ECMO

  • Intensive Care

Research Areas

  • Life Science / Respiratory medicine  / Pneumonia

  • Life Science / Emergency medicine  / Intensive Care

  • Life Science / Medical biochemistry  / Oxidative stress

  • Life Science / Medical biochemistry  / Hydrogen

  • Life Science / Emergency medicine  / ECMO

  • Life Science / Cardiology  / Heart failure

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Education

  • 岡山大学大学院医歯薬学総合研究科   救命救急・災害医学講座  

    2018.4 - 2022.3

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    Country: Japan

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  • Nippon Medical School   医学部  

    1998.4 - 2004.3

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    Country: Japan

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Research History

  • 岡山大学学術研究院医歯薬学域 周産期・小児救急医療学講座   助教

    2022.11

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  • Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University   Department of Geriatric Emergency Medicine   Assistant Professor

    2017.11 - 2022.10

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  • Tokyo Metropolitan Children's Medical Centre   Department of Paediatric Critical Care & Emergency Medicine

    2017.4 - 2018.10

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  • かわぐち心臓呼吸器病院

    2015.10 - 2016.3

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  • Aidu Chuo Hospital   Department of Cardiology

    2015.4 - 2015.9

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  • Karolinska University Hospital   ECMO Center Karolinska   Visiting Researcher

    2013.4 - 2015.3

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  • Nippon Medical School, Graduate School of Medicine   Department of Functional Pathophysiology for Human Organs   Graduate student

    2009.4 - 2013.3

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  • Hiroshima City Hospital   Department of Cardiology, Pediatric cardiology, Cardiovascular surgery   Junior resident, Senior resident

    2004.4 - 2009.3

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  • Institute of Gerontology, Nippon Medical School   Department of Biochemistry and Cell Biology   University student

    2000.4 - 2004.3

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Professional Memberships

  • JAPANESE ASSOCIATION FOR ACUTE MEDICINE

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  • THE JAPANESE SOCIETY OF INTERNAL MEDICINE

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  • The Japanese Circulation Society

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  • THE JAPANESE SOCIETY OF INTENSIVE CARE MEDICINE

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  • JAPAN SOCIETY OF RESPIRATORY CARE MEDICINE

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Committee Memberships

  • Asia-Pacific ELSO   Steering Committee  

    2017.1   

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    Committee type:Academic society

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  • 日本呼吸療法医学会   危機管理委員会  

    2016.8   

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  • 日本呼吸療法医学会   ECMOプロジェクト委員会  

    2013.8 - 2017.4   

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Papers

  • Hydrogen-rich gas enhances mitochondrial membrane potential and respiratory function recovery in Caco-2 cells post-ischemia-reperfusion injury

    Mizuki Seya, Toshiyuki Aokage, Ying Meng, Takahiro Hirayama, Takafumi Obara, Tsuyoshi Nojima, Kosaki Yoshinori, Tetsuya Yumoto, Akihiro Watanabe, Taihei Yamada, Hiromichi Naito, Atsunori Nakao

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   786   2025.10

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    DOI: 10.1016/j.bbrc.2025.152753

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  • Hydrogen-rich gas enhances mitochondrial membrane potential and respiratory function recovery in Caco-2 cells post-ischemia-reperfusion injury. International journal

    Mizuki Seya, Toshiyuki Aokage, Ying Meng, Takahiro Hirayama, Takafumi Obara, Tsuyoshi Nojima, Kosaki Yoshinori, Tetsuya Yumoto, Akihiro Watanabe, Taihei Yamada, Hiromichi Naito, Atsunori Nakao

    Biochemical and biophysical research communications   786   152753 - 152753   2025.10

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    BACKGROUND: Ischemia-reperfusion (I/R) injury induces oxidative stress, leading to damage in highly susceptible intestinal tissues. Molecular hydrogen (H2) has shown therapeutic potential in I/R injuries, with our prior research showing its efficacy in improving outcomes in rat intestinal transplantation models. However, its impact on mitochondrial function remain insufficiently understood. This study aims to elucidate how H2 modulates mitochondrial function impaired by I/R injury. METHODS: To assess the effects of H2 on I/R injury, cells were divided into three groups: a control group, a hypoxic group (99 % N2, 1 % O2, without H2 for 3, 6, or 24 h), and a hypoxic-H2 group (99 % H2, 1 % O2, for the same durations). After treatment, cells were reoxygenated under normoxic conditions (21 % O2) for 1, 2, 4, or 6 h. Mitochondrial membrane potential, oxygen consumption, and ATP production were measured. Reactive oxygen species production and apoptotic and metabolic regulators were also assessed. RESULTS: H2 markedly promoting mitochondrial recovery following I/R injury, by enhancing ATP production, restoring mitochondrial membrane potential, and improving oxygen consumption. It also reduced ROS levels and suppressed pro-apoptotic signaling. Notably, H2 suppressed the expression of HIF1α and PDK1, suggesting that H2 may act upstream of hypoxia-driven signaling pathways. These changes promoted oxidative phosphorylation and overall cellular function during reperfusion. CONCLUSIONS: Our findings reveal that H2 therapy supports mitochondrial function, suppresses ROS, and modulates hypoxia-driven pathways in I/R injury. These insights advance the understanding of H2's potential in addressing I/R injury and provide a foundation for its application in other hypoxia-related conditions.

    DOI: 10.1016/j.bbrc.2025.152753

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  • Association Between Initial Symptoms and Clinical Outcomes in COVID-19. International journal

    Eiki Ichihara, Toshiharu Mitsuhashi, Mitsuru Tsuge, Kou Hasegawa, Kenichiro Kudo, Yasushi Tanimoto, Kazuhiro Nouso, Naohiro Oda, Sho Mitsumune, Goro Kimura, Haruto Yamada, Ichiro Takata, Hideharu Hagiya, Akihiko Taniguchi, Kohei Tsukahara, Toshiyuki Aokage, Shinichi Toyooka, Hirokazu Tsukahara, Yoshinobu Maeda

    Cureus   17 ( 5 )   e84919   2025.5

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    BACKGROUND: The clinical presentation of coronavirus disease 2019 (COVID-19) ranges from localized respiratory symptoms such as cough and sore throat to systemic symptoms such as fever and fatigue. To our knowledge, no study has assessed severe disease risk by dividing onset symptoms into localized respiratory and other symptoms. We aimed to determine whether the risk of severe COVID-19 differs depending on whether the symptoms at onset are limited to local respiratory symptoms. METHOD: This was a multicenter prospective cohort study. The patients were classified into localized respiratory or systemic symptom groups based on the symptoms at onset. Demographic data, blood biomarkers, and clinical outcomes, including mortality, intubation, admission to the intensive care unit, and time to discharge, were compared. This study included 100 adult patients diagnosed with COVID-19 between July 2020 and August 2021. RESULT: Twelve patients were classified into the localized respiratory symptom group and the remaining 88 into the systemic symptom group. No significant differences between the groups were observed in the baseline characteristics, blood biomarkers, or clinical outcomes. The mortality rates were 0.0% and 4.6%, respectively. The median durations to discharge were 11 and 10 days, respectively (p=0.512). The levels of inflammatory and oxidative stress biomarkers, including interleukin-6 and hydroperoxides, were similar between the groups. CONCLUSION: The symptom type at disease onset was not significantly associated with differences in clinical outcomes. Comprehensive assessments beyond initial symptoms are crucial for predicting disease progression and optimizing management strategies.

    DOI: 10.7759/cureus.84919

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  • Association of blood carboxyhemoglobin levels with mortality and neurological outcomes in out-of-hospital cardiac arrest. International journal

    Takashi Hongo, Tetsuya Yumoto, Hiromichi Naito, Tomohiro Hiraoka, Yuya Murakami, Takafumi Obara, Tsuyoshi Nojima, Toshiyuki Aokage, Atsunori Nakao

    Acute medicine & surgery   12 ( 1 )   e70053   2025

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    BACKGROUND: Carbon monoxide (CO), produced endogenously by heme oxygenase-1, plays a crucial role in the immune system by mitigating cellular damage under stress. However, the significance of carboxyhemoglobin (COHb) levels after out-of-hospital cardiac arrest (OHCA) is not well understood. This study aimed to explore the association between COHb levels at hospital arrival and within the first 24 h post-arrival with 30-day mortality and neurological outcomes in patients who experienced OHCA. METHODS: This single-center, retrospective study analyzed data from adult patients who experienced OHCA seen at Okayama University Hospital from 2019 to 2023. The patients were assigned to one of two study groups based on COHb levels (0.0% or ≥0.1%) upon hospital arrival. The primary outcome was 30-day mortality. RESULTS: Among the 560 eligible patients who experienced OHCA, 284 (50.7%) were in the COHb 0.0% group and 276 (49.3%) were in the COHb ≥ 0.1% group. The 30-day mortality was significantly higher in the COHb 0.0% group compared to the COHb ≥ 0.1% group (264 [92.9%] vs. 233 [84.4%]). Multivariable logistic regression showed that the COHb 0.0% group was associated with 30-day mortality (adjusted ORs: 2.24, 95% CIs: 1.10-4.56). Non-survivors at 30 days who were admitted to the intensive care unit had lower COHb levels at hospital arrival (0.0% vs. 0.2%) and lower mean COHb levels during the first 24 h post-arrival (0.7% vs. 0.9%) compared to survivors. CONCLUSIONS: COHb levels of 0.0% were linked to worse outcomes in patients experiencing OHCA, warranting further research on the prognostic implications of COHb in this context.

    DOI: 10.1002/ams2.70053

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  • いざ、多臓器不全に立ち向かえ!最新の基礎研究を眺めてみよう 治療的医療ガスのクリティカルケア領域への応用

    湯本 哲也, 青景 聡之, 小原 隆史, 上田 浩平, 野島 剛, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   35 ( 11 )   613 - 613   2024.11

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  • Increased Oxidative Stress and Decreased Citrulline in Blood Associated with Severe Novel Coronavirus Pneumonia in Adult Patients. International journal

    Mitsuru Tsuge, Eiki Ichihara, Kou Hasegawa, Kenichiro Kudo, Yasushi Tanimoto, Kazuhiro Nouso, Naohiro Oda, Sho Mitsumune, Goro Kimura, Haruto Yamada, Ichiro Takata, Toshiharu Mitsuhashi, Akihiko Taniguchi, Kohei Tsukahara, Toshiyuki Aokage, Hideharu Hagiya, Shinichi Toyooka, Hirokazu Tsukahara, Yoshinobu Maeda

    International journal of molecular sciences   25 ( 15 )   2024.7

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    This study investigated the correlation between oxidative stress and blood amino acids associated with nitric oxide metabolism in adult patients with coronavirus disease (COVID-19) pneumonia. Clinical data and serum samples were prospectively collected from 100 adult patients hospitalized for COVID-19 between July 2020 and August 2021. Patients with COVID-19 were categorized into three groups for analysis based on lung infiltrates, oxygen inhalation upon admission, and the initiation of oxygen therapy after admission. Blood data, oxidative stress-related biomarkers, and serum amino acid levels upon admission were compared in these groups. Patients with lung infiltrations requiring oxygen therapy upon admission or starting oxygen post-admission exhibited higher serum levels of hydroperoxides and lower levels of citrulline compared to the control group. No remarkable differences were observed in nitrite/nitrate, asymmetric dimethylarginine, and arginine levels. Serum citrulline levels correlated significantly with serum lactate dehydrogenase and C-reactive protein levels. A significant negative correlation was found between serum levels of citrulline and hydroperoxides. Levels of hydroperoxides decreased, and citrulline levels increased during the recovery period compared to admission. Patients with COVID-19 with extensive pneumonia or poor oxygenation showed increased oxidative stress and reduced citrulline levels in the blood compared to those with fewer pulmonary complications. These findings suggest that combined oxidative stress and abnormal citrulline metabolism may play a role in the pathogenesis of COVID-19 pneumonia.

    DOI: 10.3390/ijms25158370

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  • Evolution and Effects of Ad Hoc Multidisciplinary Team Meetings in the Emergency Intensive Care Unit: A Five-Year Analysis. International journal

    Tetsuya Yumoto, Takashi Hongo, Takafumi Obara, Kohei Ageta, Toshiyuki Aokage, Kohei Tsukahara, Atsunori Nakao, Hiromichi Naito

    Journal of clinical medicine   13 ( 15 )   2024.7

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    Background: Multidisciplinary team meetings (MDTMs) are crucial in the ICU. However, daily rounds may not address all sensitive issues due to time constraints and the complexity of cases. This study aimed to describe detailed information and characteristics of ad hoc MDTMs in the ICU. Methods: This single-center, retrospective study analyzed adult emergency ICU admissions at Okayama University Hospital from 1 January 2019 to 31 December 2023. During this period, weekly regular multidisciplinary team ICU rounds were introduced in June 2020, and regular weekday morning MDTMs began in April 2022. A multiple logistic regression analysis was applied to determine the impact of these changes on the frequency of ad hoc MDTMs, adjusting for variables including annual changes. Results: The study analyzed 2487 adult EICU patients, with a median age of 66, and 63.3% of them male. MDTMs were held for 168 patients (6.8%), typically those with severe conditions, including higher COVID-19 prevalence and APACHE II scores, and longer ICU stays. Despite a constant total number of MDTMs, the likelihood of conducting ad hoc MDTMs increased annually (adjusted OR 1.19; 95% CI, 1.04-1.35). Of the 329 MDTMs conducted for these patients, 59.0% addressed end-of-life care, involving an average of 11 participants, mainly nurses and emergency and critical-care physicians. Conclusions: Changes in ICU round and meeting structures might be associated with a higher frequency of conducting ad hoc MDTMs, highlighting their evolving role and importance in patient care management.

    DOI: 10.3390/jcm13154324

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  • Hydrogen in Transplantation: Potential Applications and Therapeutic Implications. International journal

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

    Biomedicines   12 ( 1 )   2024.1

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    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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  • アセトアミノフェン中毒に対する一酸化炭素放出物質(CORM-401)の新規治療法としての可能性

    青景 聡之, Meng Ying, 小原 隆史, 湯本 哲也, 平山 隆浩, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   34 ( 12 )   717 - 717   2023.12

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  • EICUでのドナー管理と救急応需率との関係

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

    日本救急医学会雑誌   34 ( 12 )   855 - 855   2023.12

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  • Attenuation of pulmonary damage in aged lipopolysaccharide-induced inflammation mice through continuous 2 % hydrogen gas inhalation: A potential therapeutic strategy for geriatric inflammation and survival. International journal

    Toshiyuki Aokage, Masumi Iketani, Mizuki Seya, Ying Meng, Kohei Ageta, Hiromichi Naito, Atsunori Nakao, Ikuroh Ohsawa

    Experimental gerontology   180   112270 - 112270   2023.9

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    INTRODUCTION: With the global population aging, there is an increased prevalence of sepsis among the elderly, a demographic particularly susceptible to inflammation. This study aimed to evaluate the therapeutic potential of hydrogen gas, known for its anti-inflammatory and antioxidant properties, in attenuating inflammation specifically in the lungs and liver, and age-associated molecular markers in aged mice. METHODS: Male mice aged 21 to 23 months, representative of the human elderly population, were subjected to inflammation via intraperitoneal injection of lipopolysaccharide (LPS). The mice were allocated into eight groups to examine the effects of varying durations and concentrations of hydrogen gas inhalation: control, saline without hydrogen, saline with 24-hour 2 % hydrogen, LPS without hydrogen, LPS with 24-hour 2 % hydrogen, LPS with 6-hour 2 % hydrogen, LPS with 1-hour 2 % hydrogen, and LPS with 24-hour 1 % hydrogen. Parameters assessed included survival rate, activity level, inflammatory biomarkers, and organ injury. RESULTS: Extended administration of hydrogen gas specifically at a 2 % concentration for 24 h led to a favorable prognosis in the aged mice by reducing mRNA expression of inflammatory biomarkers in lung and liver tissue, mitigating lung injury, and diminishing the expression of the senescence-associated protein p21. Moreover, hydrogen gas inhalation selectively ameliorated senescence-related markers in lung tissue, including C-X-C motif chemokine 2, metalloproteinase-3, and arginase-1. Notably, hydrogen gas did not alleviate LPS-induced liver injury under the conditions tested. CONCLUSION: The study highlights that continuous inhalation of hydrogen gas at a 2 % concentration for 24 h can be a potent intervention in the geriatric population for improving survival and physical activity by mitigating pulmonary inflammation and modulating senescence-related markers in aged mice with LPS-induced inflammation. This finding paves the way for future research into hydrogen gas as a therapeutic strategy to alleviate severe inflammation that can lead to organ damage in the elderly.

    DOI: 10.1016/j.exger.2023.112270

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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   2023.7

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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   2023.7

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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   2023.7

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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   2023.7

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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   2023.6

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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   2023.6

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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   2023.6

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  • Hydrogen inhalation attenuates lung contusion after blunt chest trauma in mice. International journal

    Kohei Ageta, Takahiro Hirayama, Toshiyuki Aokage, Mizuki Seya, Ying Meng, Tsuyoshi Nojima, Hirotsugu Yamamoto, Takafumi Obara, Atsunori Nakao, Tetsuya Yumoto, Kohei Tsukahara, Hiromichi Naito

    Surgery   2023.5

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    BACKGROUND: Lung contusion caused by blunt chest trauma evokes a severe inflammatory reaction in the pulmonary parenchyma that may be associated with acute respiratory distress syndrome. Although hydrogen gas has antioxidant and anti-inflammatory effects and is protective against multiple types of lung injury at safe concentrations, the effects of inhaled hydrogen gas on blunt lung injury have not been previously investigated. Therefore, using a mouse model, we tested the hypothesis that hydrogen inhalation after chest trauma would reduce pulmonary inflammation and acute lung injury associated with lung contusion. METHODS: Inbred male C57BL/6 mice were randomly divided into 3 groups: sham with air inhalation, lung contusion with air inhalation, and lung contusion with 1.3% hydrogen inhalation. Experimental lung contusion was induced using a highly reproducible and standardized apparatus. Immediately after induction of lung contusion, mice were placed in a chamber exposed to 1.3% hydrogen gas in the air. Histopathological analysis and real-time polymerase chain reaction in lung tissue and blood gas analysis were performed 6 hours after contusion. RESULTS: Histopathological examination of the lung tissue after contusion revealed perivascular/intra-alveolar hemorrhage, perivascular/interstitial leukocyte infiltration, and interstitial/intra-alveolar edema. These histological changes and the extent of lung contusion, as determined by computed tomography, were significantly mitigated by hydrogen inhalation. Hydrogen inhalation also significantly reduced inflammatory cytokine and chemokine mRNA levels and improved oxygenation. CONCLUSION: Hydrogen inhalation therapy significantly mitigated inflammatory responses associated with lung contusion in mice. Hydrogen inhalation therapy may be a supplemental therapeutic strategy for treating lung contusion.

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  • Hydrogen gas treatment improves survival in a rat model of crush syndrome by ameliorating rhabdomyolysis

    Tetsuya Yumoto, Toshiyuki Aokage, Takahiro Hirayama, Hirotsugu Yamamoto, Takafumi Obara, Tsuyoshi Nojima, Hiromichi Naito, Atsunori Nakao

    European Journal of Inflammation   21   1721727X2311685 - 1721727X2311685   2023.3

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    Objectives

    Crush syndrome (CS) is characterized by a systemic manifestation of traumatic rhabdomyolysis, leading to multiple organ dysfunction and death. Ischemia-reperfusion (IR) injury is commonly responsible for systemic response. Extending studies have shown that hydrogen gas treatment ameliorated IR injury in numerous experimental models; however, its effect on CS has not been well examined. This study aimed to investigate the effects of hydrogen gas inhalation following crush injury in an experimental model of CS.

    Methods

    Male Sprague-Dawley rats were subjected to experimental CS by applying a total of 3.0 kg weight to both hindlimb under general anesthesia for 6 h. Immediately after decompression, the animals were randomly placed in a gas chamber filled with either air or 1.3% hydrogen gas. Animals were sacrificed 18 h or 24 h following gas exposure for non-survival studies or for survival study, respectively.

    Results

    The rats with hydrogen treatment ( n = 6) had a higher 24-h survival than the rats with air treatment ( n = 9) (100% vs. 44%, p = 0.035). Lactate concentrations (2.9 ± 0.2 vs. 2.2 ± 0.2 mmol/L, p = 0.040) and creatine kinase (34,178 ± 13,580 vs. 5005 ± 842 IU/L, p = 0.016) were lower in the hydrogen group compared with the air group 18 h after decompression ( n = 4 in the air group, and n = 5 in the H2 group). Histological analysis revealed that the damage to the rectus femoris muscle and kidney appeared to be ameliorated by hydrogen treatment.

    Conclusion

    Hydrogen gas inhalation may be a promising therapeutic approach in the treatment of CS.

    DOI: 10.1177/1721727x231168547

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  • A randomized controlled trial of teprenone in terms of preventing worsening of COVID-19 infection. International journal

    Eiki Ichihara, Kou Hasegawa, Kenichiro Kudo, Yasushi Tanimoto, Kazuhiro Nouso, Naohiro Oda, Sho Mitsumune, Haruto Yamada, Ichiro Takata, Hideharu Hagiya, Toshiharu Mitsuhashi, Akihiko Taniguchi, Shinichi Toyooka, Kohei Tsukahara, Toshiyuki Aokage, Hirokazu Tsukahara, Katsuyuki Kiura, Yoshinobu Maeda

    PloS one   18 ( 10 )   e0287501   2023

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    BACKGROUND: Some COVID-19 patients develop life-threatening disease accompanied by severe pneumonitis. Teprenone induces expression of heat-shock proteins (HSPs) that protect against interstitial pneumonia in preclinical models. We explored whether teprenone prevented worsening of COVID-19 infections. METHODS: This open-label, randomized, pilot phase 2 clinical trial was conducted at five institutions in Japan. We randomized patients hospitalized for COVID-19 with fever to teprenone or no-teprenone groups in a 1:1 ratio. We stratified patients by sex, age < and ≥ 70 years and the existence (or not) of complications (hypertension, diabetes, ischemic heart disease, chronic pulmonary disease and active cancer). No limitation was imposed on other COVID-19 treatments. The primary endpoint was the intubation rate. RESULTS: One hundred patients were included, 51 in the teprenone and 49 in the no- teprenone groups. The intubation rate did not differ significantly between the two groups: 9.8% (5/51) vs. 2.0% (1/49) (sub-hazard ratio [SHR] 4.99, 95% confidence interval [CI]: 0.59-42.1; p = 0.140). The rates of intra-hospital mortality and intensive care unit (ICU) admission did not differ significantly between the two groups: intra-hospital mortality 3.9% (2/51) vs. 4.1% (2/49) (hazard ratio [HR] 0.78, 95%CI: 0.11-5.62; p = 0.809); ICU admission 11.8% (6/51) vs. 6.1% (3/49) (SHR 1.99, 95%CI: 0.51-7.80; p = 0.325). CONCLUSION: Teprenone afforded no clinical benefit. TRIAL REGISTRATION: Japan Registry of Clinical Trials jRCTs061200002 (registered on 20/May/2020).

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  • 臓器移植におけるドナー管理(臓器保護の観点から) 6歳未満おける臓器移植ドナー管理の特徴

    小原 隆史, 内藤 宏道, 塚原 紘平, 青景 聡之, 野島 剛, 上田 浩平, 小崎 吉訓, 山田 太平, 藤崎 宣友, 中尾 篤典

    日本集中治療医学会雑誌   29 ( Suppl.1 )   297 - 297   2022.11

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  • 脳死の状態判断に補助検査として脳血流シンチグラフィを施行した1例

    庵谷 紘美, 内藤 宏道, 小原 隆史, 青景 聡之, 塚原 紘平, 中尾 篤典

    日本集中治療医学会雑誌   29 ( Suppl.1 )   667 - 667   2022.11

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  • 臓器移植におけるドナー管理(臓器保護の観点から) 6歳未満おける臓器移植ドナー管理の特徴

    小原 隆史, 内藤 宏道, 塚原 紘平, 青景 聡之, 野島 剛, 上田 浩平, 小崎 吉訓, 山田 太平, 藤崎 宣友, 中尾 篤典

    日本集中治療医学会雑誌   29 ( Suppl.1 )   297 - 297   2022.11

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  • Bile pigments in emergency and critical care medicine. International journal

    Mizuki Seya, Toshiyuki Aokage, Tsuyoshi Nojima, Atsunori Nakao, Hiromichi Naito

    European journal of medical research   27 ( 1 )   224 - 224   2022.10

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    Bile pigments, such as bilirubin and biliverdin, are end products of the heme degradation pathway in mammals and are widely known for their cytotoxic effects. However, recent studies have revealed that they exert cytoprotective effects through antioxidative, anti-inflammatory, and immunosuppressive properties. All these mechanisms are indispensable in the treatment of diseases in the field of emergency and critical care medicine, such as coronary ischemia, stroke, encephalomyelitis, acute lung injury/acute respiratory distress syndrome, mesenteric ischemia, and sepsis. While further research is required before the safe application of bile pigments in the clinical setting, their underlying mechanisms shed light on their utilization as therapeutic agents in the field of emergency and critical care medicine. This article aims to summarize the current understanding of bile pigments and re-evaluate their therapeutic potential in the diseases listed above.

    DOI: 10.1186/s40001-022-00863-0

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  • 水素含有臓器保護液は,虚血再灌流後のミトコンドリアの機能回復を早め,細胞死を軽減する

    瀬谷 海月, 青景 聡之, 山田 太平, 渡邉 暁洋, 山本 浩継, 平山 隆浩, 野島 剛, 中尾 篤典, 内藤 宏道

    日本救急医学会雑誌   33 ( 10 )   891 - 891   2022.10

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  • 治療的医学ガス(Medical gas)を救急集中治療領域へ応用する 救急医による挑戦

    小原 隆史, 青景 聡之, 山本 浩継, 野島 剛, 上田 浩平, 湯本 哲也, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   33 ( 10 )   823 - 823   2022.10

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  • 組織の体制整備による持続可能な「臓器提供」

    塚原 紘平, 平岡 知浩, 薬師寺 泰匡, 小原 隆史, 小崎 吉訓, 野島 剛, 湯本 哲也, 山本 浩継, 青景 聡之, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   33 ( 10 )   847 - 847   2022.10

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  • Luminal administration of biliverdin ameliorates ischemia-reperfusion injury following intestinal transplant in rats. International journal

    Tsuyoshi Nojima, Takafumi Obara, Hirotsugu Yamamoto, Tetsuya Yumoto, Takuro Igawa, Toshiyuki Aokage, Mizuki Seya, Atsunori Nakao, Hiromichi Naito

    Surgery   172 ( 5 )   1522 - 1528   2022.9

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    BACKGROUND: Intestinal grafts are susceptible to ischemia-reperfusion injury, resulting in the loss of mucosal barrier function and graft failure. Biliverdin is known to exert a variety of cytoprotective functions against oxidative tissue injury. Because the mucosal layer is the primary site of ischemia-reperfusion injury, mucosa-targeting strategies by luminal delivery of reagents might be beneficial. We tested whether intraluminal administration of biliverdin as an adjuvant to standard preservation solutions protected against ischemia-reperfusion injury. METHODS: Orthotopic syngeneic intestinal transplants were performed on Lewis rats after 6 hours of cold preservation. Saline containing biliverdin (10 μM) or without biliverdin was introduced into the lumen of the intestinal grafts immediately before cold preservation. RESULTS: Damage to the intestinal mucosa caused by ischemia-reperfusion injury resulted in severe morphological changes, including blunting of the villi and erosion, and led to significant loss of gut barrier function 3 hours after reperfusion. These changes to the mucosa were notably ameliorated by intraluminal administration of biliverdin. Biliverdin also effectively inhibited upregulation of messenger RNAs for interleukin-6, inducible nitric oxide synthase, and C-C motif chemokine 2. Additionally, biliverdin treatment prevented the loss of expression of claudin-1, a transmembrane, tight-junction barrier protein. The 14-day survival of recipients of biliverdin-treated grafts was significantly improved as compared with the recipients of saline-treated control grafts (83.3% vs 38.9%, P = .030). CONCLUSION: This study demonstrated that luminally delivered biliverdin provides beneficial effects during the transplant of rat small intestinal grafts and could be an attractive therapeutic option in organ transplantation.

    DOI: 10.1016/j.surg.2022.07.021

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  • 人工呼吸管理中の喀痰評価の個人差に関する調査 喀痰評価デバイス開発に向けて

    平山 隆浩, 木口 隆, 野島 剛, 青景 聡之, 渡邉 暁洋, 内藤 宏道, 中尾 博之, 中尾 篤典

    日本臨床救急医学会雑誌   25 ( 2 )   388 - 388   2022.5

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  • A case of Fulminant Respiratory Failure Caused by Anti-asparaginyl tRNA Synthetase (Anti-KS) Antibody Syndrome-related Interstitial Lung Disease. Reviewed

    Naohiro Oda, Akihiko Taniguchi, Toshiyuki Aokage, Satoru Senoo, Kenta Nagashima, Reo Mitani, Ichiro Takata, Nobuaki Miyahara

    Internal medicine (Tokyo, Japan)   2022.4

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    Anti-asparaginyl tRNA synthetase (KS) antibodies, detected in <5% patients with anti-aminoacyl-tRNA synthetase antibody syndrome, are strongly associated with interstitial pneumonia but not myositis and skin symptoms. A recent report suggested that most patients with interstitial pneumonia and anti-KS antibody (KS-ILD) may present with chronic disease. We herein report a rare case of severe acute respiratory failure in a KS-ILD patient requiring extracorporeal membrane oxygenation (ECMO). ECMO is useful for facilitating not only lung rest until recovery but also the definitive diagnosis and treatment of ILD. KS-ILD can develop acutely with fulminant respiratory failure, as observed in this case.

    DOI: 10.2169/internalmedicine.9239-21

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  • Luminal Administration of a Water-soluble Carbon Monoxide-releasing Molecule (CORM-3) Mitigates Ischemia/Reperfusion Injury in Rats Following Intestinal Transplantation. Reviewed International journal

    Takafumi Obara, Hirotsugu Yamamoto, Toshiyuki Aokage, Takuro Igawa, Tsuyoshi Nojima, Takahiro Hirayama, Mizuki Seya, Michiko Ishikawa-Aoyama, Atsunori Nakao, Roberto Motterlini, Hiromichi Naito

    Transplantation   106 ( 7 )   1365 - 1375   2021.12

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    BACKGROUND: The protective effects of carbon monoxide (CO) against ischemia/reperfusion (IR) injury during organ transplantation have been extensively investigated. Likewise, CO-releasing molecules (CORMs) are known to exert a variety of pharmacological activities via liberation of controlled amounts of CO in organs. Therefore, we hypothesized that intraluminal administration of water-soluble CORM-3 during cold storage of intestinal grafts would provide protective effects against IR injury. METHODS: Orthotopic syngeneic intestinal transplantation was performed in Lewis rats following 6 h of cold preservation in Ringer solution or University of Wisconsin solution. Saline containing CORM-3 (100 µmol/L) or its inactive counterpart (iCORM-3) was intraluminally introduced in the intestinal graft before cold preservation. RESULTS: Histopathological analysis of untreated and iCORM-3-treated grafts revealed a similar erosion and blunting of the intestinal villi. These changes in the mucosa structure were significantly attenuated by intraluminal administration of CORM-3. Intestinal mucosa damage caused by IR injury led to considerable deterioration of gut barrier function 3 h postreperfusion. CORM-3 significantly inhibited upregulation of proinflammatory mRNA levels, ameliorated intestinal morphological changes, and improved graft blood flow and mucosal barrier function. Additionally, CORM-3-treated grafts increased recipient survival rates. Pharmacological blockade of soluble guanylyl cyclase activity significantly reversed the protective effects conferred by CORM-3, indicating that CO partially mediates its therapeutic actions via soluble guanylyl cyclase activation. CONCLUSION: Our study demonstrates that luminally delivered CORM-3 provides beneficial effects in cold-stored rat small intestinal grafts and could be an attractive therapeutic application of CO in the clinical setting of organ preservation and transplantation.

    DOI: 10.1097/TP.0000000000004007

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  • The effects of inhaling hydrogen gas on macrophage polarization, fibrosis, and lung function in mice with bleomycin-induced lung injury. Reviewed International journal

    Toshiyuki Aokage, Mizuki Seya, Takahiro Hirayama, Tsuyoshi Nojima, Masumi Iketani, Michiko Ishikawa, Yasuhiro Terasaki, Akihiko Taniguchi, Nobuaki Miyahara, Atsunori Nakao, Ikuroh Ohsawa, Hiromichi Naito

    BMC pulmonary medicine   21 ( 1 )   339 - 339   2021.10

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    BACKGROUND: Acute respiratory distress syndrome, which is caused by acute lung injury, is a destructive respiratory disorder caused by a systemic inflammatory response. Persistent inflammation results in irreversible alveolar fibrosis. Because hydrogen gas possesses anti-inflammatory properties, we hypothesized that daily repeated inhalation of hydrogen gas could suppress persistent lung inflammation by inducing functional changes in macrophages, and consequently inhibit lung fibrosis during late-phase lung injury. METHODS: To test this hypothesis, lung injury was induced in mice by intratracheal administration of bleomycin (1.0 mg/kg). Mice were exposed to control gas (air) or hydrogen (3.2% in air) for 6 h every day for 7 or 21 days. Respiratory physiology, tissue pathology, markers of inflammation, and macrophage phenotypes were examined. RESULTS: Mice with bleomycin-induced lung injury that received daily hydrogen therapy for 21 days (BH group) exhibited higher static compliance (0.056 mL/cmH2O, 95% CI 0.047-0.064) than mice with bleomycin-induced lung injury exposed only to air (BA group; 0.042 mL/cmH2O, 95% CI 0.031-0.053, p = 0.02) and lower static elastance (BH 18.8 cmH2O/mL, [95% CI 15.4-22.2] vs. BA 26.7 cmH2O/mL [95% CI 19.6-33.8], p = 0.02). When the mRNA levels of pro-inflammatory cytokines were examined 7 days after bleomycin administration, interleukin (IL)-6, IL-4 and IL-13 were significantly lower in the BH group than in the BA group. There were significantly fewer M2-biased macrophages in the alveolar interstitium of the BH group than in the BA group (3.1% [95% CI 1.6-4.5%] vs. 1.1% [95% CI 0.3-1.8%], p = 0.008). CONCLUSIONS: The results suggest that hydrogen inhalation inhibits the deterioration of respiratory physiological function and alveolar fibrosis in this model of lung injury.

    DOI: 10.1186/s12890-021-01712-2

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  • コロナ禍における面会制限は脳死下臓器提供に影響を与えたか? 岡山大学病院高度救命救急センターの経験から

    萩原 万瀧, 塚原 紘平, 中村 俊介, 小崎 吉訓, 小田 裕太, 小原 隆史, 上田 浩平, 野島 剛, 山本 浩継, 山田 太平, 青景 聡之, 藤崎 宣友, 内藤 宏道, 中尾 篤典

    移植   56 ( 総会臨時 )   O25 - 1   2021.9

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  • PCASに対する脳保護療法:TTMの普及とスタンダード 来院時アンモニア値に搬送時間を加味した院外心停止患者の予後予測

    野島 剛, 内藤 宏道, 小崎 吉訓, 小原 隆史, 山本 浩継, 藤崎 宣友, 青景 聡之, 塚原 紘平, 山田 太平, 中尾 篤典

    日本集中治療医学会雑誌   28 ( Suppl.2 )   223 - 223   2021.9

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  • Luminal preloading with hydrogen-rich saline ameliorates ischemia-reperfusion injury following intestinal transplantation in rats. Reviewed International journal

    Hirotsugu Yamamoto, Toshiyuki Aokage, Takuro Igawa, Takahiro Hirayama, Mizuki Seya, Michiko Ishikawa-Aoyama, Tsuyoshi Nojima, Atsunori Nakao, Hiromichi Naito

    Pediatric transplantation   24 ( 7 )   e13848   2020.11

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    Prolonged intestinal cold storage causes considerable mucosal breakdown, which could bolster bacterial translocation and cause life-threatening infection for the transplant recipient. The intestine has an intraluminal compartment, which could be a target for intervention, but has not yet been fully investigated. Hydrogen gas exerts organ protection and has used been recently in several clinical and basic research studies on topics including intestinal transplantation. In this study, we aimed to investigate the cytoprotective efficacy of intraluminally administered hydrogen-rich saline on cold IR injury in intestinal transplantation. Isogeneic intestinal transplantation with 6 hours of cold ischemia was performed on Lewis rats. Hydrogen-rich saline (H2 concentration at 5 ppm) or normal saline was intraluminally introduced immediately before preservation. Graft intestine was excised 3 hours after reperfusion and analyzed. Histopathological analysis of control grafts revealed blunting of the villi and erosion. These mucosal changes were notably attenuated by intraluminal hydrogen. Intestinal mucosa damage caused by IR injury led to considerable deterioration of gut barrier function 3 h post-reperfusion. However, this decline in permeability was critically prevented by hydrogen treatment. IR-induced upregulation of proinflammatory cytokine mRNAs such as IL-6 was mitigated by hydrogen treatment. Western blot revealed that hydrogen treatment regulated loss of the transmembrane protein ZO-1. Hydrogen-rich saline intraluminally administered in the graft intestine modulated IR injury to transplanted intestine in rats. Successful abrogation of intestinal IR injury with a novel strategy using intraluminal hydrogen may be easily clinically applicable and will compellingly improve patient care after transplantation.

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  • 岡山市消防局の救急活動時間におけるCOVID-19の影響

    上田 浩平, 小原 隆史, 野島 剛, 小崎 吉訓, 藤崎 宣友, 塚原 紘平, 山田 太平, 尾迫 貴章, 青景 聡之, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   31 ( 11 )   1368 - 1368   2020.11

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  • 水素吸入療法は間質性肺炎遠隔期の呼吸機能を温存する ブレオマイシン処理マウスを用いた研究

    青景 聡之, 平山 隆浩, 池谷 真澄, 大澤 郁朗, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   31 ( 11 )   1644 - 1644   2020.11

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  • 当院における産科救急の現状

    藤崎 宣友, 山本 浩継, 野島 剛, 小崎 吉訓, 青景 聡之, 塚原 紘平, 山田 太平, 尾迫 貴章, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   31 ( 11 )   1921 - 1921   2020.11

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  • amplitude-integrated EEGが意識障害患者の診断・早期治療に有効であった悪性症候群の1例

    中村 俊介, 内藤 宏道, 野島 剛, 小崎 吉訓, 山本 浩継, 藤崎 宣友, 青景 聡之, 塚原 紘平, 山田 太平, 尾迫 貴章, 中尾 篤典

    日本救急医学会雑誌   31 ( 11 )   1105 - 1105   2020.11

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  • COVID-19影響下における救急・集中治療関連医療従事者の心理的健康度

    久保 卓也, 小崎 吉訓, 藤崎 宣友, 青景 聡之, 塚原 紘平, 山田 太平, 尾迫 貴章, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   31 ( 11 )   1035 - 1035   2020.11

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  • 当院の救急集中治療室における、急性腎障害の持続的腎代替療法の導入時期と予後を検討する

    岡田 真澄, 平山 隆浩, 落葉 佑昌, 塚原 紘平, 青景 聡之, 藤崎 宣友, 山田 太平, 内藤 宏道, 中尾 篤典

    日本集中治療医学会雑誌   27 ( Suppl. )   506 - 506   2020.9

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  • 静脈-静脈体外式膜型人工肺療法(VV ECMO)ラットモデルの構築

    青景 聡之, 岡田 真澄, 平山 隆浩, 塚原 紘平, 内藤 宏道, 中尾 篤典

    日本集中治療医学会雑誌   27 ( Suppl. )   471 - 471   2020.9

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  • 急性肺傷害に対する治療開発 水素吸入療法の炎症・線維化の抑制効果 マウスを用いた検証

    青景 聡之, 池谷 真澄, 瀬谷 瑞樹, 平山 隆浩, 石川 倫子, 内藤 宏道, 大澤 郁朗, 中尾 篤典

    日本集中治療医学会雑誌   27 ( Suppl. )   476 - 476   2020.9

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  • mobile ECMOシステムの構築に向けての現状と問題点 臨床工学技士の立場から

    平山 隆浩, 落葉 佑昌, 堂口 琢磨, 岡田 真澄, 川田 将弘, 青景 聡之, 塚原 紘平, 小崎 吉訓, 内藤 宏道, 中尾 篤典

    日本集中治療医学会雑誌   27 ( Suppl. )   625 - 625   2020.9

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  • Therapeutic strategies for ischemia reperfusion injury in emergency medicine Reviewed International journal

    Hiromichi Naito, Tsuyoshi Nojima, Noritomo Fujisaki, Kohei Tsukahara, Hirotsugu Yamamoto, Taihei Yamada, Toshiyuki Aokage, Tetsuya Yumoto, Takaaki Osako, Atsunori Nakao

    Acute Medicine & Surgery   7 ( 1 )   e501   2020.1

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    Ischemia reperfusion (IR) injury occurs when blood supply, perfusion, and concomitant reoxygenation is restored to an organ or area following an initial poor blood supply after a critical time period. Ischemia reperfusion injury contributes to mortality and morbidity in many pathological conditions in emergency medicine clinical practice, including trauma, ischemic stroke, myocardial infarction, and post-cardiac arrest syndrome. The process of IR is multifactorial, and its pathogenesis involves several mechanisms. Reactive oxygen species are considered key molecules in reperfusion injury due to their potent oxidizing and reducing effects that directly damage cellular membranes by lipid peroxidation. In general, IR injury to an individual organ causes various pro-inflammatory mediators to be released, which could then induce inflammation in remote organs, thereby possibly advancing the dysfunction of multiple organs. In this review, we summarize IR injury in emergency medicine. Potential therapies include pharmacological treatment, ischemic preconditioning, and the use of medical gases or vitamin therapy, which could significantly help experts develop strategies to inhibit IR injury.

    DOI: 10.1002/ams2.501

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  • Extracorporeal membrane oxygenation in Stenotrophomonas maltophilia pneumonia during acute myeloid leukemia: A case report. Reviewed International journal

    Kenki Saito, Toshiyuki Aokage, Takayuki Sato, Kohei Tsukahara, Fumiaki Tokioka, Takanao Otake, Hiromasa Irie, Yasunori Ueda

    Respiratory medicine case reports   31   101224 - 101224   2020

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    Stenotrophomonas maltophilia (S. maltophilia) is a Gram-negative, multidrug-resistant organism that both opportunistically infects the bloodstream and leads to pneumonia in immunosuppressed patients, including those with hematologic malignancies. In patients with severe respiratory failure, venovenous extracorporeal membrane oxygenation (VV ECMO) can stabilize the respiratory status. However, whether ECMO in patients with hematologic malignancies improves the clinical outcomes is still controversial because ECMO increases the risk of the exacerbation of sepsis and bleeding. We report a case of a 46-year-old man with Stenotrophomonas maltophilia hemorrhagic pneumonia acquired during consolidation chemotherapy for acute myeloid leukemia in whom VV ECMO lead to a good clinical outcome. The stabilization of his respiratory status achieved with VV ECMO allowed time for trimethoprim-sulfamethoxazole antibiotic therapy to improve the pneumonia. We suggest the background of patients, including comorbidities and general conditions, should be taken into account when considering the clinical indications of ECMO.

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  • 重症呼吸不全に対する ECMO 搬送の現状と方向性 Invited Reviewed

    青景 聡之

    日本救命医療学会雑誌   34   45 - 48   2020

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  • Huge abdominal cerebrospinal fluid pseudocyst following ventriculoperitoneal shunt: a case report. Reviewed International journal

    Yasuhiro Koide, Takaaki Osako, Masahiro Kameda, Hiromi Ihoriya, Hirotsugu Yamamoto, Noritomo Fujisaki, Toshiyuki Aokage, Tetsuya Yumoto, Isao Date, Hiromichi Naito, Atsunori Nakao

    Journal of medical case reports   13 ( 1 )   361 - 361   2019.12

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    INTRODUCTION: Abdominal pseudocysts comprising cerebrospinal fluid are an uncommon but significant complication in patients with ventriculoperitoneal shunt. We present a successfully treated 12-year-old boy with a history of ventriculoperitoneal shunting and a huge abdominal cerebrospinal fluid pseudocyst. CASE PRESENTATION: A12-year-old Japanese boy presented with a deteriorated consciousness and a palpable and elastic large lower abdominal mass. Computed tomography of his abdomen demonstrated a collection of homogenous low-density fluid near the catheter tip of the ventriculoperitoneal shunt. Cerebral computed tomography revealed an increased ventricular size. Based on the clinical diagnosis of abdominal pseudocyst, the peritoneal shunt catheter was secured and divided into two parts by cutting it on the chest; then, the proximal side of the peritoneal shunt catheter was externalized for extraventricular drainage. The cyst was percutaneously aspirated with ultrasound guidance, and the distal side of the peritoneal shunt catheter was removed. The distal side of the peritoneal shunt catheter was reinserted in another position into his abdomen after 3-week extraventricular drainage management. CONCLUSION: Emergency physicians should know about this potential complication as an important differential diagnosis resulting from acute abdominal complaints in patients with ventriculoperitoneal shunts.

    DOI: 10.1186/s13256-019-2308-0

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  • Association of Japan Coma Scale score on hospital arrival with in-hospital mortality among trauma patients. Reviewed International journal

    Yumoto T, Naito H, Yorifuji T, Aokage T, Fujisaki N, Nakao A

    BMC emergency medicine   19 ( 1 )   65 - 65   2019.11

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    BACKGROUND: The Japan Coma Scale (JCS) score has been widely used to assess patients' consciousness level in Japan. JCS scores are divided into four main categories: alert (0) and one-, two-, and three-digit codes based on an eye response test, each of which has three subcategories. The purpose of this study was to investigate the utility of the JCS score on hospital arrival in predicting outcomes among adult trauma patients. METHODS: Using the Japan Trauma Data Bank, we conducted a nationwide registry-based retrospective cohort study. Patients 16 years old or older directly transported from the trauma scene between January 2004 and December 2017 were included. Our primary outcome was in-hospital mortality. We examined outcome prediction accuracy based on area under the receiver operating characteristic curve (AUROC) and multiple logistic regression analysis with multiple imputation. RESULTS: A total of 222,540 subjects were included; their in-hospital mortality rate was 7.1% (n = 15,860). The 10-point scale JCS and the total sum of Glasgow Coma Scale (GCS) scores demonstrated similar performance, in which the AUROC (95% CIs) showed 0.874 (0.871-0.878) and 0.878 (0.874-0.881), respectively. Multiple logistic regression analysis revealed that the higher the JCS score, the higher the predictability of in-hospital death. When we focused on the simple four-point scale JCS score, the adjusted odds ratio (95% confidence intervals [CIs]) were 2.31 (2.12-2.45), 4.81 (4.42-5.24), and 27.88 (25.74-30.20) in the groups with one-digit, two-digit, and three-digit scores, respectively, with JCS of 0 as a reference category. CONCLUSIONS: JCS score on hospital arrival after trauma would be useful for predicting in-hospital mortality, similar to the GCS score.

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  • Heterogeneous impact of body mass index on in-hospital mortality in acute heart failure syndromes: An analysis from the ATTEND Registry

    Akiomi Yoshihisa, Takamasa Sato, Katsuya Kajimoto, Naoki Sato, Yasuchika Takeishi, Kuniya Asai, Ryo Munakata, Toshiyuki Aokage, Asuka Yoshida, Yuichiro Minami, Dai Yumino, Masayuki Mizuno, Erisa Kawada, Kentaro Yoshida, Yuri Ozaki, Tomohito Kogure, Shintaro Haruki, Koichi Nakao, Tadashi Sawamura, Toshiaki Nuki, Ryoji Ishiki, Shigeki Yokota, Hiroyuki Fujinaga, Takashi Yamamoto, Kenji Harada, Akihiro Saito, Norihito Kageyama, Takanobu Okumura, Noritake Hata, Koji Murai, Ayaka Nozaki, Hidekazu Kawanaka, Jun Tanabe, Yukihito Sato, Katsuhisa Ishii, Hitoshi Oiwa, Tomoaki Matsumoto, Daisuke Yoshida, Nobuo Kato, Hitoshi Oiwa, Daisuke Yoshida, Nobuo Kato, Hiroshi Suzuki, Nobuyuki Shimizu, Takehiko Keida, Masaki Fujita, Kentaro Nakamura, Toshiya Chinen, Kentaro Meguro, Tatsuro Kikuchi, Toshiyuki Nishikido, Marohito Nakata, Tatsuya Yamashita, Masaya Nakata, Akitoshi Hirono, Kazuaki Mitsudo, Kazushige Kadota, Noriko Makita, Nagisa Watanabe, Masaaki Kawabata, Kenichi Fuji, Shinichi Okuda, Shigeki Kobayashi, Ikuo Moriuchi, Kiyo-O Mizuno, Kazuo Osato, Tatsuaki Murakami, Yoshifumi Shimada, Katsushi Misawa, Hiromasa Kokado, Takashi Fujita, Yoshitomo Fukuoka, Syu Takabatake, Yoshifumi Takata, Manabu Miyagi, Nobuhiro Tanaka, Akira Yamashina, Shinji Sudo, Koichi Shimamura, Michitaka Nagashima, Tomoya Kaneda, Kosei Ueda, Hiromasa Kato, Toshinori Higashikata, Kanichi Fujimori, Hiroshi Kobayashi, Shinya Fujii, Masahiro Yagi, Jyunko Takaki, Eiji Yamashita, Takuji Toyama, Etsuo Hirata, Kazuho Kamisihima, Toshiaki Oka, Ryushi Komatsu, Akira Itoh, Takahiko Naruko, Yukio Abe, Eiichirou Nakagawa, Atsuko Furukawa, Naoto Kinou, Shoko Uematsu, Isao Tabuchi, Taku Imai, Takafumi Sakamoto, Koji Todaka, Yuji Koide, Koji Maemura, Koichiro Yoshioka, Akiomi Yoshihisa, Takamasa Sato, Yasuchika Takeish, Toshiaki Ebina, Kazuo Kimura, Masaaki Konishi, Masahiko Kato, Yoshiharu Kinugasa, Katsunori Ishida, Shinobu Sugihara, Kiyotaka Yanagihara, Toshiharu Takeuchi, Motoi Okada, Naoyuki Hasebe, Tetsuo Sakai, Taku Asano, Yoshino Minoura, Tsutomu Toshida, Takatoshi Sato, Yuya Yokota, Seita Kondo, Yasushi Sakata, Issei Komuro, Kinya Otsu, Shizuya Yamashita, Yoshihiro Asano, Atsuya Kajimoto, Kazunori Kashiwase, Yasunori Ueda, Aizo Kondo, Katsuhiro Kawaguchi, Akinori Sawamura, Taro Saito, Tom Higa, Hiroo Noguchi, Yoko Yanagita, Keita Nakamura, Tomo Komaki, Oshihiro Muramatsu, Tomomi Koizumi, Yoshie Nakajima, Toshihiko Kikutani, Yoshifimi Ikeda, Tom Tamaki, Shuhei Funada, Harumi Ogawa, Koichiro Sakuragawa, Shun Kohsaka, Shin-ichi Ando, Toshiaki Kadokami, Eiko Ishida, Katsumi Ide, Yohei Sotomi, Yoshiharu Higuchi, Motoko Uehara, Toshihiko Goto, Nobuyuki Ohte, Masanobu Miura, Nobuyuki Shiba, Kotaro Nochioka, Hiroaki Shimokawa, Shiro Ishihara, Tokushi Koga, Shinichiro Fujishima, Shigeru Kaseda, Yoshie Haga, Keisuke Kida, Kazuho Kamisihima, Makiko Nakamura, Osahiko Sunagawa, Takafumi Miyara, Youji Taba, Takashi Touma, Osamu Shinjo, Oshioki Nishimura, Kazuomi Kario, Hayato Shimizu, Takahiro Uchida, Ken-ichi Amitani, Katsunori Shimada

    EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE   8 ( 7 )   589 - 598   2019.10

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    DOI: 10.1177/2048872617703061

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  • ECMO Transport Network(ECMO net) 救命救急センター間のECMO連携 Reviewed

    小倉 崇以, 青景 聡之, 安部 隆三, 清水 敬樹, 清水 直樹, 鈴木 裕之, 増野 智彦, 竹内 一郎, 市場 晋吾, ECMO搬送ネットワーク

    日本救急医学会雑誌   30 ( 9 )   655 - 655   2019.9

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  • 集中治療中に胃壁内気腫症を発症し保存的に治療しえた1例

    庵谷 紘美, 湯本 哲也, 小崎 吉訓, 山本 浩継, 青景 聡之, 藤崎 宣友, 山田 太平, 塚原 紘平, 尾迫 貴章, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   30 ( 9 )   777 - 777   2019.9

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  • 積極的な画像診断により救命した特発性腸間膜血腫の1例

    山田 太平, 小崎 吉訓, 湯本 哲也, 山本 浩継, 藤崎 宣友, 青景 聡之, 塚原 紘平, 尾迫 貴章, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   30 ( 9 )   838 - 838   2019.9

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  • 開腹止血術と同時に経腹部大動脈アプローチでTEVARを行った1例

    山川 泰明, 小崎 吉訓, 山本 浩継, 藤崎 宣友, 青景 聡之, 塚原 紘平, 山田 太平, 万代 康弘, 尾迫 貴章, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   30 ( 9 )   826 - 826   2019.9

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  • VV-ECMOを駆使して 他院に収容された超重症呼吸不全をECMOで救命する チーム派遣・ECMO導入・搬送まで担う高度ECMO搬送システムの構築

    青景 聡之, 小崎 吉訓, 塚原 紘平, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   30 ( 9 )   557 - 557   2019.9

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  • 診断の遅れから腹壁感染・腹壁欠損を併発し、皮弁再建を要した外傷性膀胱破裂の一例

    山本 徳高, 山川 泰明, 山本 浩継, 藤崎 宣友, 青景 聡之, 塚原 紘平, 山田 太平, 万代 康弘, 尾迫 貴章, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   30 ( 9 )   639 - 639   2019.9

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  • International Survey on Extracorporeal Membrane Oxygenation Transport Reviewed International journal

    Broman LM, Dirnberger DR, Malfertheiner MV, Aokage T, Morberg P, Næsheim T, Pappalardo F, Di Nardo M, Preston T, Burrell AJC, Daly I, Harvey C, Mason P, Philipp A, Bartlett RH, Lynch W, Belliato M, Taccone FS

    ASAIO J   doi: 10.1097 ( MAT.0000000000000997. )   214 - 225   2019.4

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    Extracorporeal membrane oxygenation (ECMO) is a lifesaving therapy for severe respiratory and circulatory failure. It is best performed in high-volume centers to optimize resource utilization and outcomes. Regionalization of ECMO might require the implementation of therapy before and during transfer to the high-volume center. The aim of this international survey was to describe the manner in which interhospital ECMO transport care is organized at experienced centers. Fifteen mobile ECMO centers from nine countries participated in this survey. Seven (47%) of them operated under the "Hub-and-Spoke" model. Transport team composition varies from three to nine members, with at least one ECMO specialist (i.e., nurse or perfusionist) participating in all centers, although intensivists and surgeons were present in 69% and 50% of the teams, respectively. All centers responded that the final decision to initiate ECMO is multidisciplinary and made bedside at the referring hospital. Most centers (75%) have a quality control system; all teams practice simulation and water drills. Considering the variability in ECMO transport teams among experienced centers, continuous education, training and quality control within each organization itself are necessary to avoid adverse events and maintain a low mortality rate. A specific international ECMO Transport platform to share data, benchmark outcomes, promote standardization, and provide quality control is required.

    DOI: 10.1097/MAT.0000000000000997

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  • Atypical case of posterior reversible encephalopathy syndrome related to late onset postpartum eclampsia: A case report. Reviewed International journal

    Kaori Masai, Yayoi Ueda, Hiromichi Naito, Kohei Tsukahara, Toshiyuki Aokage, Noritomo Fujisaki, Hirotsugu Yamamoto, Atsunori Nakao

    Medicine   98 ( 16 )   e15187   2019.4

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    RATIONALE: Eclampsia, an obstetric emergency frequently seen in pregnant or puerperal women, is a risk factor for posterior reversible encephalopathy syndrome (PRES). Most cases of eclampsia occur postpartum. We report a woman with PRES associated with eclampsia 10 weeks post-delivery, the latest onset ever reported. PATIENT CONCERNS: A 23-year-old healthy woman presented headache and nausea 10 weeks after delivery. Two days later, she generalized tonic-clonic seizure. Her brain MRI presented the foci which is typical of PRES. DIAGNOSIS: The patient was diagnosed as PRES associated with eclampsia. INTERVENTIONS: The patient received levetiracetam and edaravone. OUTCOMES: Her clinical course was uneventful and she fully recovered without neurological complications LESSONS:: The possible diagnosis of late onset postpartum eclampsia, even weeks post-delivery, should be considered, since initiation of early treatment averts severe complications and decreases mortality. Sharing our experience may increase awareness of PRES induced by late-onset postpartum eclampsia.

    DOI: 10.1097/MD.0000000000015187

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  • 千枚通しによる穿通性胸部外傷の一例

    川口 満理奈, 湯本 哲也, 青景 聡之, 山田 太平, 衛藤 弘城, 末澤 孝徳, 中尾 篤典

    日本臨床外科学会雑誌   80 ( 3 )   607 - 607   2019.3

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  • V-Pシャント機能不全を来たした腹腔内髄液仮性嚢胞の一例

    高瀬 了輔, 庵谷 紘美, 井本 良二, 亀田 雅博, 小崎 吉訓, 山川 泰明, 飯田 淳義, 湯本 哲也, 青景 聡之, 藤崎 宣友, 山田 太平, 山本 浩継, 塚原 紘平, 万代 康弘, 尾迫 貴章, 内藤 宏道, 中尾 篤典

    日本臨床外科学会雑誌   80 ( 3 )   608 - 608   2019.3

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  • 外傷性視神経症に対し早期ステロイドパルス療法が奏功したと考えられた1症例

    庵谷 紘美, 山田 太平, 小崎 吉訓, 山川 泰明, 飯田 淳義, 湯本 哲也, 山本 浩継, 青景 聡之, 藤崎 宣友, 塚原 紘平, 万代 康弘, 尾迫 貴章, 内藤 宏道, 中尾 博之, 中尾 篤典

    日本臨床外科学会雑誌   80 ( 3 )   608 - 608   2019.3

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  • 日本のキノコ中毒5年間の報告

    小崎 吉訓, 内藤 宏道, 庵谷 紘美, 山川 泰明, 飯田 淳義, 湯本 哲也, 青景 聡之, 藤崎 宣友, 山田 太平, 山本 継, 塚原 紘平, 万代 康弘, 尾迫 貴章, 中尾 博之, 中尾 篤典

    中毒研究   32 ( 1 )   99 - 99   2019.3

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  • ECMO中の輸血需要に関連した臨床的特徴と凝固管理

    青景 聡之, 平山 隆浩, 塚原 紘平, 高 寛, 清水 一好, 中川 晃志, 岩崎 達雄, 笠原 真悟, 内藤 宏道, 中尾 篤典

    日本集中治療医学会雑誌   26 ( Suppl. )   [O27 - 6]   2019.2

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  • Heat-not-burn cigarettes induce fulminant acute eosinophilic pneumonia requiring extracorporeal membrane oxygenation. Reviewed International journal

    Aokage T, Tsukahara K, Fukuda Y, Tokioka F, Taniguchi A, Naito H, Nakao A

    Respiratory medicine case reports   26   87 - 90   2019

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    Background: Although the cause of acute eosinophilic pneumonia (AEP) has not yet been fully clarified, cigarette smoking is reported to be a risk factor for developing AEP. The heat-not-burn cigarette (HNBC) was developed to reduce the adverse effects of smoke on the user's surroundings. However, the health risks associated with HNBCs have not yet been clarified. We report a successfully treated case of fatal AEP presumably induced by HNBC use. Presentation of case: A 16-year-old man commenced HNBC smoking two weeks before admission and subsequently suffered from shortness of breath that gradually worsened. The patient was transferred to emergency department and immediately intubated because of respiratory failure. Computed tomography showed mosaic ground-glass shadows on the distal side of both lungs with a PaO2/FIO2 ratio of 76. The patient required veno-venous extracorporeal membrane oxygenation (ECMO) for severe respiratory failure. He was diagnosed with AEP by clinical course and detection of eosinophils in sputum; thus, methylprednisolone was administrated. The patient was weaned off ECMO four days after initiation and extubated the day after. He fully recovered without sequelae. Conclusion: As far as we know, our patient is the first case of AEP induced by HNBC use successfully treated with ECMO. Emergency physicians must be aware that HNBCs can induce fatal AEP.

    DOI: 10.1016/j.rmcr.2018.12.002

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  • Orbital Emphysema as a Consequence of Forceful Nose-Blowing: Report of a Case. Reviewed International journal

    Yukino Ariyoshi, Hiromichi Naito, Tetsuya Yumoto, Atsuyoshi Iida, Hirotsugu Yamamoto, Noritomo Fujisaki, Toshiyuki Aokage, Kohei Tsukahara, Taihei Yamada, Yasuhiro Mandai, Takaaki Osako, Atsunori Nakao

    Case reports in emergency medicine   2019   4383086 - 4383086   2019

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    Orbital emphysema occurs when air enters the soft tissue surrounding the orbit. Although orbital blowout fractures are often caused by face trauma, nontraumatic orbital fractures can also occur but have been rarely described. Here, a case of orbital and palpebral emphysema caused by forceful nose-blowing is presented. Examination uncovered gross swelling of the right eye and discernable subcutaneous emphysema. The patient had normal eye movement and visual acuity. Orbital computed tomography (CT) revealed orbital emphysema secondary to an orbit floor fracture into the maxillary sinus, resulting from high intranasal pressure upon blowing her nose. The patient received conservative management with antibiotics and was given instructions not to sneeze or blow her nose. She fully recovered and all her symptoms completely resolved.

    DOI: 10.1155/2019/4383086

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  • アンモニアガス曝露による気管狭窄・肺胞障害を認めた症例

    沢田 孝平, 小崎 吉訓, 山本 浩継, 藤崎 宣友, 青景 聡之, 山田 太平, 塚原 紘平, 万代 康弘, 尾迫 貴章, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   29 ( 10 )   437 - 437   2018.10

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  • 腹筋運動が誘因となったと思われる特発性腹直筋血腫の1症例

    山田 太平, 小崎 吉訓, 湯本 哲也, 飯田 淳義, 山本 浩継, 藤崎 宣友, 青景 聡之, 塚原 紘平, 尾迫 貴章, 内藤 宏道, 中尾 篤典

    日本救急医学会雑誌   29 ( 10 )   553 - 553   2018.10

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  • 高度救命救急センターにおける歯科医師の救命救急研修の意義

    柴田 茜, 内藤 宏道, 塚原 紘平, 湯本 哲也, 飯田 淳義, 山川 泰明, 尾迫 貴章, 万代 康弘, 山田 大平, 青景 聡之, 中尾 篤典

    日本救急医学会雑誌   29 ( 10 )   504 - 504   2018.10

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  • ANCA関連血管炎による重症呼吸不全に対しV-V ECMO管理中に血漿交換を並列で施行し人工肺の圧上昇を認めた1症例

    宮本 綾子, 高 寛, 堂口 琢磨, 西村 まどか, 高浪 大地, 塚原 紘平, 青景 聡之

    日本急性血液浄化学会雑誌   9 ( Suppl. )   127 - 127   2018.9

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  • Critical Care for Adult Congenital Heart Disease : The Role of Intensivist Invited

    Toshiyuki Aokage

    Japanese Journal of Intensive Care Medicine   42 ( 8 )   531 - 539   2018.8

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  • Penetrating thoracic ice pick injury extending into pulmonary artery: Report of a case. Reviewed International journal

    Kawaguchi M, Yamamoto H, Yamada T, Yumoto T, Aokage T, Ihoriya H, Eto K, Suezawa T, Naito H, Nakao A

    International journal of surgery case reports   52   63 - 66   2018

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    INTRODUCTION: Penetrating thoracic traumas have a wide spectrum, ranging from mild traumas to life-threatening injuries. PRESENTATION OF CASE: This paper illustrates a 40-year-old male with a penetrating pulmonary artery injury that was successfully treated with emergency surgery. The patient visited local hospital by foot complaining of moving object on his chest and was found that an ice pick was penetrating the man's left chest. An ambulance took the patient to our emergency department. Computed tomography of the chest showed linear metallic density in the pulmonary trunk and a small amount of pericardial fluid. Emergency surgery for removal of the object and repair of the pulmonary artery was performed. The ice pick had been stuck in the main pulmonary artery through the pericardium without any injury to the left lung or internal thoracic artery. Postoperative course was uneventful. DISCUSSION: A multidisciplinary team designed our treatment strategy, enabling us to select the optimal treatment, including diagnostic techniques and surgical approach. A successful trauma management depends on whether a life-threatening conditionexists. Major vascular injury should be rapidly assessed in these cases. Psychiatric aspects of the case are also discussed. CONCLUSION: Early removal of the foreign body is recommended to prevent further damage to the heart.

    DOI: 10.1016/j.ijscr.2018.09.052

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  • Ischemic or Nonischemic Functional Mitral Regurgitation and Outcomes in Patients With Acute Decompensated Heart Failure With Preserved or Reduced Ejection Fraction Reviewed

    Katsuya Kajimoto, Yuichiro Minami, Shigeru Otsubo, Naoki Sato, Naoki Sato, Kuniya Asai, Ryo Munakata, Toshiyuki Aokage, Asuka Yoshida, Yuichiro Minami, Dai Yumino, Masayuki Mizuno, Erisa Kawada, Kentaro Yoshida, Yuri Ozaki, Tomohito Kogure, Shintaro Haruki, Masayuki Mizuno, Katsuya Kajimoto, Koichi Nakao, Tadashi Sawamura, Toshiaki Nuki, Ryoji Ishiki, Shigeki Yokota, Hiroyuki Fujinaga, Takashi Yamamoto, Kenji Harada, Akihiro Saito, Norihito Kageyama, Takanobu Okumura, Noritake Hata, Koji Murai, Ayaka Nozaki, Hidekazu Kawanaka, Jun Tanabe, Yukihito Sato, Katsuhisa Ishii, Hitoshi Oiwa, Tomoaki Matsumoto, Daisuke Yoshida, Nobuo Kato, Hiroshi Suzuki, Nobuyuki Shimizu, Takehiko Keida, Masaki Fujita, Kentaro Nakamura, Toshiya Chinen, Kentaro Meguro, Tatsuro Kikuchi, Toshiyuki Nishikido, Marohito Nakata, Tatsuya Yamashita, Masaya Nakata, Akitoshi Hirono, Kazuaki Mitsudo, Kazushige Kadota, Noriko Makita, Nagisa Watanabe, Masaaki Kawabata, Kenichi Fujii, Shinichi Okuda, Shigeki Kobayashi, Ikuo Moriuchi, Kiyo o. Mizuno, Kazuo Osato, Tatsuaki Murakami, Yoshifumi Shimada, Katsushi Misawa, Hiromasa Kokado, Takashi Fujita, Yoshitomo Fukuoka, Syu Takabatake, Yoshifumi Takata, Manabu Miyagi, Nobuhiro Tanaka, Akira Yamashina, Shinji Sudo, Koichi Shimamura, Michitaka Nagashima, Tomoya Kaneda, Kosei Ueda, Hiromasa Kato, Toshinori Higashikata, Kanichi Fujimori, Hiroshi Kobayashi, Shinya Fujii, Masahiro Yagi, Yuri Ozaki, Jyunko Takaki, Eiji Yamashita, Takuji Toyama, Tetsuo Hirata, Kazuho Kamisihima, Toshiaki Oka, Ryushi Komatsu, Akira Itoh, Takahiko Naruko, Yukio Abe, Eiichirou Nakagawa, Atsuko Furukawa

    American Journal of Cardiology   120 ( 5 )   809 - 816   2017.9

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    DOI: 10.1016/j.amjcard.2017.05.051

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  • The clinical practice guideline for the management of ARDS in Japan Reviewed

    Satoru Hashimoto, ARDS clinical practice guideline committee from the Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine, Masamitsu Sanui, Moritoki Egi, Shinichiro Ohshimo, Junji Shiotsuka, Ryutaro Seo, Ryoma Tanaka, Yu Tanaka, Yasuhiro Norisue, Yoshiro Hayashi, Eishu Nango, Hideto Yasuda, Yoshitaka Aoki, Kohkichi Andoh, Yusuke Iizuka, Hitoshi Imaizumi, Satoshi Okamori, Motoshi Kainuma, Jun Kataoka, Tetsuro Kamo, Atsushi Kawaguchi, Junji Kumasawa, Kiyoyasu Kurahashi, Kunihiko Kooguchi, Yutaka Kondo, Masaaki Sakuraya, Akira Shimoyama, So Suzuki, Hiroyuki Suzuki, Motohiro Sekino, Mikio Nakajima, Tetsuro Nishimura, Tatsuma Fukuda, Jun Makino, Ryoichi Miyashita, Ryutaro Moriwaki, Shigenori Yoshitake, Yumi Yamashita, Yoshiko Nakagawa, Takaaki Suzuki, Toshiyuki Aokage, Kimitaka Tajimi, Hidemichi Yuasa, Hideaki Imanaka, Kazuya Ichikado, Ayumu Nozaki, Ryo Kozu, Takeshi Unoki, Yoshinori Takahashi, Akimichi Serita, Eriko Takezawa, Toshio Fukuoka, Taku Yabuki, Morio Aihara, Takeo Nakayama

    Journal of Intensive Care   5 ( 1 )   50   2017.7

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    DOI: 10.1186/s40560-017-0222-3

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  • Extracorporeal membrane oxygenation for acute respiratory distress syndrome Reviewed

    Toshiyuki Aokage, Kenneth Palmér, Shingo Ichiba, Shinhiro Takeda

    Journal of Intensive Care   3 ( 1 )   17   2015.6

  • Clinical Features and Outcome in Hospitalized Heart Failure in Japan (From the ATTEND Registry) Reviewed

    Naold Sato, Katsuya Kajimoto, Takehiko Keida, Masayuki Mizuno, Yuichiro Minami, Dai Yumino, Kuniya Asai, Koji Murai, Ryo Muanakata, Toshiyuki Aokage, Yasushi Sakata, Kyoichi Mizuno, Teruo Takano

    CIRCULATION JOURNAL   77 ( 4 )   944 - 951   2013.4

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    DOI: 10.1253/circj.CJ-13-0187

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  • Hyponatremia and In-Hospital Mortality in Patients Admitted for Heart Failure (from the ATTEND Registry) Reviewed

    Naoki Sato, Mihai Gheorghiade, Katsuya Kajimoto, Ryo Munakata, Yuichiro Minami, Masayuki Mizuno, Toshiyuki Aokage, Kuniya Asai, Yasushi Sakata, Dai Yumino, Kyoichi Mizuno, Teruo Takano

    AMERICAN JOURNAL OF CARDIOLOGY   111 ( 7 )   1019 - 1025   2013.4

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    DOI: 10.1016/j.amjcard.2012.12.019

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  • Giant left atrium due to mitral stenosis with massive atelectasis: A successful case with perioperative approach Reviewed

    Atsushi Tanita, Yusuke Hosokawa, Takeshi Tomiyama, Maiko Kato, Junya Matsuda, Keisuke Sawai, Yoshie Arita, Toshiyuki Aokage, Hiroomi Suzuki, Hiroshige Murata, Hideki Miyachi, Toshiyuki Shibui, Takahito Nei, Koichi Akutsu, Takeshi Yamamoto, Shinhiro Takeda, Takashi Nitta, Kunio Tanaka, Kyoichi Mizuno, Keiji Tanaka

    INTERNATIONAL JOURNAL OF CARDIOLOGY   163 ( 2 )   E23 - E25   2013.2

  • COPD and Heart Failure: A Report from the ATTEND Registry Reviewed

    Dai Yumino, Naoki Sato, Katsuya Kajimoto, Yuichiro Minami, Masayuki Mizuno, Kuniya Asai, Koji Murai, Ryo Munakata, Toshiyuki Aokage, Yasushi Sakata, Atsuhiko Keita, Keiji Tanaka, Kyoichi Mizuno, Nobuhisa Hagiwara, Hiroshi Kasanuki, Teruo Takano

    JOURNAL OF CARDIAC FAILURE   18 ( 10 )   S128 - S128   2012.10

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  • Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) severe respiratory failure in Japan Reviewed

    Shinhiro Takeda, Toru Kotani, Satoshi Nakagawa, Shingo Ichiba, Toshiyuki Aokage, Ryoichi Ochiai, Nobuyuki Taenaka, Kaneyuki Kawamae, Masaji Nishimura, Yoshihito Ujike, Kimitaka Tajimi

    JOURNAL OF ANESTHESIA   26 ( 5 )   650 - 657   2012.10

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    DOI: 10.1007/s00540-012-1402-x

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  • 急性B型大動脈解離における臓器虚血を緊急経カテーテル的開窓術によって解除した一例

    宮地 秀樹, 圷 宏一, 志摩 綾香, 澤井 啓介, 青景 聡之, 有田 淑恵, 川中 秀和, 北村 光信, 村田 広茂, 細川 雄亮, 山本 剛, 村井 綱児, 林 明聡, 小野澤 志郎, 村田 智, 水野 杏一, 田中 啓治

    脈管学   52 ( Suppl. )   S169 - S170   2012.9

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  • Inhaled nitric oxide therapy for secondary pulmonary hypertension with hypertrophic obstructive cardiomyopathy and severe kyphoscoliosis Reviewed

    Yusuke Hosokawa, Takeshi Yamamoto, Yuto Yabuno, Keisuke Hara, Toshiyuki Aokage, Keiko Nakazato, Hiroomi Suzuki, Manabu Suzuki, Akira Ueno, Ryo Munakata, Yukichi Tokita, Eisei Yamamoto, Koichi Akutsu, Hitoshi Takano, Naoki Sato, Morimasa Takayama, Keiji Tanaka, Kyoichi Mizuno

    INTERNATIONAL JOURNAL OF CARDIOLOGY   158 ( 1 )   E20 - E21   2012.6

  • Admission time, variability in clinical characteristics, and in-hospital outcomes in acute heart failure syndromes: Findings from the ATTEND registry Reviewed

    Yuichiro Minami, Katsuya Kajimoto, Naoki Sato, Dai Yumino, Masayuki Mizuno, Toshiyuki Aokage, Koji Murai, Ryo Munakata, Kuniya Asai, Yasushi Sakata, Takehiko Keida, Nobuhisa Hagiwara, Kyoichi Mizuno, Hiroshi Kasanuki, Teruo Takano

    INTERNATIONAL JOURNAL OF CARDIOLOGY   153 ( 1 )   102 - 105   2011.11

  • Revealed Gap in Antithrombotic Therapy for Atrial Fibrillation in Acute Decompensated Heart Failure Patients: A Report from the Attend Registry Reviewed

    Takehiko Keida, Kuniya Asai, Katsuya Kajimoto, Yasushi Sakata, Masayuki Mizuno, Dai Yumino, Yuichiro Minami, Toshiyuki Aokage, Koji Murai, Ryo Munakata, Naoki Sato

    Journal of Arrhythmia   27   2011

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    DOI: 10.4020/jhrs.27.OP49_3

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  • Coronary angioscopic findings eight months after sirolimus-eluting stent implantation: a comparison between ST-elevation myocardial infarction and stable angina pectoris Reviewed

    Kazuoki Dai, Masaharu Ishihara, Ichiro Inoue, Takuji Kawagoe, Yuji Shimatani, Satoshi Kurisu, Yasuharu Nakama, Tatsuya Maruhashi, Eisuke Kagawa, Toshiyuki Aokage, Junichi Matsushita, Hiroki Ikenaga

    EUROINTERVENTION   6 ( 2 )   251 - 256   2010.6

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  • Coronary angioscopic findings eight months after sirolimus-eluting stent implantation: a comparison between ST-elevation myocardial infarction and stable angina pectoris Reviewed

    Kazuoki Dai, Masaharu Ishihara, Ichiro Inoue, Takuji Kawagoe, Yuji Shimatani, Satoshi Kurisu, Yasuharu Nakama, Tatsuya Maruhashi, Eisuke Kagawa, Toshiyuki Aokage, Junichi Matsushita, Hiroki Ikenaga

    EUROINTERVENTION   6 ( 2 )   251 - 256   2010.6

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    DOI: 10.4244/EIJV6I2A40

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  • Assessment of medications in patients with tako-tsubo cardiomyopathy Reviewed

    Satoshi Kurisu, Ichiro Inoue, Takuji Kawagoe, Masaharu Ishihara, Yuji Shimatani, Yasuharu Nakama, Tatsuya Maruhashi, Eisuke Kagawa, Kazuoki Dai, Junichi Matsushita, Toshiyuki Aokage, Hiroki Ikenaga

    INTERNATIONAL JOURNAL OF CARDIOLOGY   134 ( 3 )   E120 - E123   2009.5

  • Therapeutic hypothermia after out-of-hospital cardiac arrest due to Brugada syndrome Reviewed

    Satoshi Kurisu, Ichiro Inoue, Takuji Kawagoe, Masaharu Ishihara, Yuji Shimatani, Yasuharu Nakama, Tatsuya Maruhashi, Eisuke Kagawa, Kazuoki Dai, Toshiyuki Aokage, Junichi Matsushita, Hiroki Ikenaga

    RESUSCITATION   79 ( 2 )   332 - 335   2008.11

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    DOI: 10.1016/j.resuscitation.2008.05.007

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  • Torsade de pointes associated with bradycardia and takotsubo cardiomyopathy Reviewed

    Satoshi Kurisu, Ichiro Inoue, Takuji Kawagoe, Masaharu Ishihara, Yuji Shimatani, Yasuharu Nakama, Keisuke Ohkawa, Tatsuya Maruhashi, Eisuke Kagawa, Kazuoki Dai, Toshiyuki Aokage

    CANADIAN JOURNAL OF CARDIOLOGY   24 ( 8 )   640 - 642   2008.8

  • Clinical profile of patients with symptomatic glycyrrhizin-induced hypokalemia Reviewed

    Satoshi Kurisu, Ichiro Inoue, Takuji Kawagoe, Masaharu Ishihara, Yuji Shimatani, Yasuharu Nakama, Tatsuya Maruhashi, Eisuke Kagawa, Kazuoki Dai, Toshiyuki Aokage, Junichi Matsushita, Hiroki Ikenaga

    JOURNAL OF THE AMERICAN GERIATRICS SOCIETY   56 ( 8 )   1579 - 1581   2008.8

  • Role of telemetry monitoring to detect the onset of tako-tsubo cardiomyopathy in consciousness disturbance Reviewed

    Satoshi Kurisu, Ichiro Inoue, Takuji Kawagoe, Masaharu Ishihara, Yuji Shimatani, Yasuharu Nakama, Tatsuya Maruhashi, Eisuke Kagawa, Kazuoki Dai, Toshiyuki Aokage, Junichi Matsushita, Hiroki Ikenaga

    JOURNAL OF THE AMERICAN GERIATRICS SOCIETY   56 ( 6 )   1159 - 1160   2008.6

  • One year outcomes of cypher stent implantation for patients with acute myocardial infarction

    Kazuoki Dai, Masaharu Ishihara, Ichirou Inoue, Takuji Kawagoe, Yuji Shimatani, Satoshi Kurisu, Yasuharu Nakama, Tatsuya Maruhashi, Eisuke Kagawa, Toshiyuki Aokage, Junichi Matsushita, Hiroki Ikenaga

    Japanese Journal of Interventional Cardiology   23 ( 5 )   350 - 355   2008

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  • Variant form of tako-tsubo cardiomyopathy Reviewed

    Satoshi Kurisu, Ichiro Inoue, Takuji Kawagoe, Masaharu Ishihara, Yuji Shimatani, Yasuharu Nakatna, Keisuke Ohkawa, Tatsuya Marabashi, Eisuke Kagawa, Kazuoki Dai, Toshiyuki Aokage

    INTERNATIONAL JOURNAL OF CARDIOLOGY   119 ( 2 )   E56 - E58   2007.7

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    DOI: 10.1016/j.ijcard.2007.01.121

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  • Tako-tsubo cardiomyopathy after automobile accident Reviewed

    Satoshi Kurisu, Ichiro Inoue, Takuji Kawagoe, Masaharu Ishihara, Yuji Shimatani, Yasuharu Nakama, Keisuke Ohkawa, Tatsuya Maruhashi, Eisuke Kagawa, Kazuoki Dai, Toshiyuki Aokage

    International Journal of Cardiology   118 ( 1 )   e16 - e18   2007.5

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    DOI: 10.1016/j.ijcard.2006.11.214

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  • Documentation of early improvement of left ventricular function in tako-tsubo cardiomyopathy Reviewed

    Satoshi Kurisu, Ichiro Inoue, Takuji Kawagoe, Masaharu Ishihara, Yuji Shimatani, Yasuharu Nakama, Keisuke Ohkawa, Tatsuya Maruhashi, Eisuke Kagawa, Kazuoki Dai, Toshiyuki Aokage

    International Journal of Cardiology   114 ( 2 )   E70 - E72   2007.1

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    DOI: 10.1016/j.ijcard.2006.07.203

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  • Various morphologies of mitochondria Reviewed

    Ikuroh Ohsawa, Toshiyuki Aokage, Shigeo Ohta

    Journal of Nippon Medical School   72 ( 3 )   136   2005.6

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    DOI: 10.1272/jnms.72.136

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  • Prognostic significance of the immunohistochemical index of survivin in glioma: a comparative study with the MIB-1 index Reviewed

    M Uematsu, Ohsawa, I, T Aokage, K Nishimaki, K Matsumoto, H Takahashi, S Asoh, A Teramoto, S Ohta

    JOURNAL OF NEURO-ONCOLOGY   72 ( 3 )   231 - 238   2005.5

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    DOI: 10.1007/s11060-004-2353-3

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  • Aggregation of mitochondria Reviewed

    Toshiyuki Aokage, Ikuroh Ohsawa, Shigeo Ohta

    Journal of Nippon Medical School   72 ( 2 )   72 - 73   2005.4

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    DOI: 10.1272/jnms.72.72

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  • Green fluorescent protein causes mitochondria to aggregate in the presence of the Bcl-2 family proteins Reviewed

    T Aokage, Ohsawa, I, S Ohta

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   314 ( 3 )   711 - 716   2004.2

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    DOI: 10.1016/j.bbrc.2003.12.152

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Books

  • やさしくわかるECMOの基本〜患者に優しい心臓ECMO、呼吸ECMO、E-CPRの考え方教えます!

    小倉 崇以, 青景 聡之, 氏家良人( Role: Joint author)

    羊土社  2018.2  ( ISBN:475811823X

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Presentations

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Research Projects

  • Effects of hydrogen gas inhalation on differential TLR signaling pathways and suppression of cytokine storms.

    Grant number:22K09162  2022.04 - 2025.03

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    青景 聡之

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    Grant amount:\4160000 ( Direct expense: \3200000 、 Indirect expense:\960000 )

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  • Clinical research and development of hydrogen gas inhalation therapy for acute respiratory distress syndrome

    Grant number:22lk0201154h0001  2022.04 - 2023.03

    国立研究開発法人日本医療研究開発機構  患者のニーズに応える医薬品開発に資する臨床研究・治験の推進 

    Toshiyuki Aokage

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  • Lung fibrosis suppression effect by hydrogen inhalation at ARDS subacute-chronic phase: Verification by model mouse

    Grant number:19K09416  2019.04 - 2022.03

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C)  Grant-in-Aid for Scientific Research (C)

    Toshiyuki Aokage

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    Grant amount:\4420000 ( Direct expense: \3400000 、 Indirect expense:\1020000 )

    Acute respiratory distress syndrome causes alveolar fibrosis. We hypothesized that daily repeated inhalation of hydrogen gas could suppress persistent inflammatory and consequently inhibit lung fibrosis.
    To test this hypothesis, bleomycin lung injury model mouse, that is imitating ARDS, were exposed to hydrogen (3.2% in air) for 6 hours every day for 21 days. Respiratory physiology, tissue pathology, markers of inflammation, and macrophage phenotypes were examined.
    Mice with bleomycin-induced lung injury that received daily hydrogen therapy for 21 days (BH group) exhibited higher static compliance than mice with bleomycin-induced lung injury exposed only to air. When the mRNA levels of pro-inflammatory cytokines were examined 7 days after bleomycin administration, interleukin (IL)-6, IL-4 and IL-13 were significantly lower in the BH group than in the BA group. There were significantly fewer M2-biased macrophages in the alveolar interstitium of the BH group than in the BA group.

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  • Lecture : Elderly healthcare (2023academic year) special  - その他

  • Lecture : Elderly healthcare (2022academic year) special  - その他