研究者詳細 - 森松　博史

論文 - 森松　博史

分割表示 296 件中 101 - 120 件目／全件表示 >>

くも膜下出血超急性期における皮質脱分極と細胞外グルタミン酸濃度が脳障害に与える影響

村井智, 菱川朋人, 平松匡文, 杉生憲志, 武田吉正, 森松博史, 伊達勲

脳血管攣縮 35 97 - 97 2020年2月

術後の肺血栓塞栓症発生率と重症化に対する加齢の影響

松岡義和, 中塚洸輔, 倉迫直子, 青江尚美, 森松博史

日本老年麻酔学会プログラム・抄録集 32回 68 - 68 2020年1月

Relationship between partial carbon dioxide pressure and strong ions in humans: A retrospective study

Satoshi Isoyama, Satoshi Kimura, Hiroshi Morimatsu

Acta Medica Okayama 74 ( 4 ) 319 - 325 2020年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Okayama University

Little is known about the role of a strong ions in humans with respiratory abnormalities. In this study, we investigated the associations between partial carbon dioxide pressure (pCO2) and each of sodium ion (Na+) concentrations, chloride ion (Cl-) concentrations and their difference (SIDNa-Cl). Blood gas data were obtained from patients in a teaching hospital intensive care unit between August 2013 and January 2017. The association between pCO2 and SIDNa-Cl was defined as the primary outcome. The associations between pCO2 and [Cl-], [Na+] and other strong ions were secondary outcomes. pCO2 was stratified into 10 mmHg-wide bands and treated as a categorical variable for comparison. As a result, we reviewed 115,936 blood gas data points from 3,840 different ICU stays. There were significant differences in SIDNa-Cl, [Cl-], and [Na+] among all categorized pCO2 bands. The respective pCO2 SIDNa-Cl, [Cl-], and [Na+] correlation coefficients were 0.48,-0.31, and 0.08. SIDNa-Cl increased and [Cl-] decreased with pCO2, with little relationship between pCO2 and [Na+] across subsets. In conclusion, we found relatively strong correlations between pCO2 and SIDNa-Cl in the multiple blood gas datasets examined. Correlations between pCO2 and chloride concentrations, but not sodium concentrations, were further found to be moderate in these ICU data.

Scopus

PubMed

researchmap

Histidine-rich glycoprotein: A novel biomarker for assessing the severity of sepsis

Masahiko Oiwa, Naoya Kawanoue, Kosuke Kuroda, Hiroshi Morimatsu

Japanese Journal of Clinical Chemistry 49 ( 4 ) 251 - 257 2020年

Relationship between a High-inspired Oxygen Concentration and Dorsal Atelectasis in High-energy Trauma Patients

Kenzo Ishii, Hiroshi Morimatsu, Kazumi Ono, Koji Miyasho

Acta Medica Okayama 74 ( 1 ) 17 - 26 2020年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Okayama University

We performed a retrospective cohort study of 911 high-energy trauma patients who underwent chest CT scans at least twice after admission. We hypothesized that in high-energy trauma patients, a high-inspired oxygen concentration delivered after admission results in dorsal atelectasis. The study’s primary outcome was dorsal atelectasis formation diagnosed based on CT images. We defined dorsal atelectasis as the presence of atelectasis at ≥ 10 mm thick on CT images. We defined high-inspired oxygen concentration as &gt
60% oxygen delivered between two CT scans. Four hundred sixty-five patients (51.0%) developed atelectasis according to the second CT scan, and 338 (37.1%) received a high-inspired oxygen concentration. A univariate analysis showed that the rate of the high-inspired oxygen concentration in the atelectasis group was significantly higher than that in the non-atelectasis group (43.4% vs. 30.1%, p&lt
0.001). However, a logistic regression analysis showed that there was no significant relationship between the oxygen concentration and the formation of dorsal atelectasis (OR: 1.197, 95%CI: 0.852-1.683, p=0.30). Age, the Injury Severity Score, BMI, and smoking were found to be risk factors of dorsal atelectasis formation in high-energy trauma patients. There was no relationship between the oxygen concentration and atelectasis formation in our series of high-energy trauma patients.

Scopus

PubMed

researchmap

Unilateral Lung Recruitment Maneuver for Massive Atelectasis in a Child With Glenn Circulation: A Case Report. 国際誌

Yoshikazu Kimura, Tomoyuki Kanazawa, Yasutoshi Kuroe, Makiko Tani, Kazuyoshi Shimizu, Tatsuo Iwasaki, Hiroshi Morimatsu

A&A practice 13 ( 11 ) 430 - 432 2019年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

A 9-year-old girl with Glenn circulation suffered from massive atelectasis of the left lung caused by bleeding during cardiac catheterization. The atelectasis resulted in frequent hypoxia leading to oxygen saturation (SpO2) of 40%-50%. In the intensive care unit, we performed a unilateral lung recruitment maneuver (ULRM) for 2 days. The ULRM involved placement of a bronchial blocker in the right main bronchus and application of continuous positive airway pressure to the left lung without hemodynamic deterioration. Eventually, SpO2 improved to 80%-85%. ULRM can be a treatment option for unilateral atelectasis in a child with Glenn circulation.

DOI： 10.1213/XAA.0000000000001101

PubMed

researchmap

Local Anesthetic Systemic Toxicity Following General and Epidural Anesthesia in A patient with a History of Muscle Relaxant-induced Anaphylaxis.

Asuka Kubo, Kazuyoshi Shimizu, Kosuke Kuroda, Tomoyuki Kanazawa, Motomu Kobayashi, Hiroshi Morimatsu

Acta medica Okayama 73 ( 6 ) 543 - 546 2019年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

We here report that a 71-year-old Japanese woman with a history of anaphylaxis induced by muscle relaxants had local anesthetic systemic toxicity (LAST) following an abdominal surgery under general anesthesia with combined spinal-epidural anesthesia without muscle relaxants. The total dosages of local anesthetics reached 0.67 mg/kg of ropivacaine and 11.5 mg/kg of lidocaine over 12.5 h to obtain sufficient muscle relaxation for surgery. Regional anesthesia is useful in cases in which muscle relaxants are to be avoided during a surgery. However, especially for a patient with risk factors and prolonged surgery, precautions should be taken to prevent LAST.

DOI： 10.18926/AMO/57721

PubMed

researchmap

Anesthetic management of a patient with sodium-channel myotonia: a case report. 国際誌

Naohisa Matsumoto, Rei Nishimoto, Yoshikazu Matsuoka, Yoshimasa Takeda, Hiroshi Morimatsu

JA clinical reports 5 ( 1 ) 77 - 77 2019年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Sodium-channel myotonia (SCM) is a nondystrophic myotonia, characterized by pure myotonia without muscle weakness or paramyotonia. The prevalence of skeletal muscle channelopathies is approximately 1 in 100,000, and the prevalence of SCM is much lower. To our knowledge, this is the first report on anesthetic management of a patient with SCM. CASE PRESENTATION: A 23-year-old woman with congenital nasal dysplasia and SCM was scheduled to undergo rhinoplasty with autologous costal cartilage. Total intravenous anesthesia without muscle relaxants was administered followed by continuous intercostal nerve block. Although transient elevation of potassium level in the blood was observed during surgery, the patient did not show exacerbation of myotonic or paralytic symptoms in the postoperative period. CONCLUSION: Total intravenous anesthesia and peripheral nerve block can be administered safely to a patient with SCM. However, careful monitoring of the symptoms and electrolytes is recommended.

DOI： 10.1186/s40981-019-0300-8

PubMed

researchmap

Tチューブ挿入中の術中人工呼吸管理にFogartyカテーテルを使用した一症例

根ヶ山諒, 岡原修司, 熊代美香, 塩路直弘, 金澤伴幸, 松岡義和, 清水一好, 岩崎達雄, 森松博史

日本小児麻酔学会誌 25 ( 1 ) 29 - 32 2019年11月

記述言語：日本語出版者・発行元：日本小児麻酔学会

症例は1歳11ヵ月の男児、声門下狭窄に対して輪状軟骨前方切開術が予定された。術中管理の問題点として、Tチューブ挿入後の陽圧換気中のTチューブ口側断端からのエアリークが挙げられたため、Tチューブ内にTチューブ径より小径の挿管チューブを経鼻的に留置し、挿管チューブをクランプすることで口側断端を塞ぐ方法を計画した。しかしスペースが小さく留置困難だったため、経鼻的にFogartyカテーテルをTチューブ内に留置し、バルーン拡張にて口側断端からのエアリークを軽減し、確実に換気することができた。Tチューブ挿入下での呼吸管理において、位置調整など慎重な管理は必要となるが、小児症例ではFogartyカテーテルを用いた換気方法は有用性が高いと考える。(著者抄録)

researchmap

Cortical spreading depolarizationがくも膜下出血後のearly brain injuryに与える影響

村井智, 菱川朋人, 平松匡文, 杉生憲志, 武田吉正, 森松博史, 伊達勲

脳循環代謝 31 ( 1 ) 111 - 111 2019年11月

Comparison of the Effects of Epidural Analgesia and Patient-controlled Intravenous Analgesia on Postoperative Pain Relief and Recovery After Laparoscopic Gastrectomy for Gastric Cancer. 国際誌

Satoru Kikuchi, Shinji Kuroda, Masahiko Nishizaki, Takashi Matsusaki, Kazuya Kuwada, Yoshikazu Kimura, Shunsuke Kagawa, Hiroshi Morimatsu, Toshiyoshi Fujiwara

Surgical laparoscopy, endoscopy & percutaneous techniques 29 ( 5 ) 405 - 408 2019年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: Epidural analgesia (EDA) is an imperative modality for postoperative pain relief after major open abdominal surgery. However, whether EDA has benefits in laparoscopic surgery has not been clear. In this study, the effects of EDA and patient-controlled intravenous analgesia (PCIA) after laparoscopic distal gastrectomy (LDG) were compared. METHODS: This was a retrospective study that included 82 patients undergoing LDG for gastric cancer. Patients received either EDA (n=67) or PCIA (n=15) for postoperative pain relief. Postoperative outcomes and analgesia-related adverse events were compared between the two modalities. RESULTS: EDA and PCIA patients showed no differences in the incidence of complications [9 (13%) vs. 2 (13%); P=0.99] and the length of postoperative hospital stay (9.6±4.5 d vs. 9.7±4.0 d; P=0.90), although the PCIA included poorer preoperative physical status (PS) patients. The number of additional doses of analgesics was higher in the EDA than in the PCIA (1.8±2.4 vs. 0.9±1.0; P=0.01), although postoperative pain scores were similar in the 2 groups. Though the time to first passage of flatus was shorter in the EDA (P<0.05), more EDA patients developed postoperative hypotension as an adverse event (P<0.01). The full mobilization day and the day of oral intake tolerance were not significantly different between the 2 groups after surgery. CONCLUSIONS: After LDG, EDA may not be indispensable, while PCIA may be the optimal modality for providing safe and effective postoperative analgesia and recovery.

DOI： 10.1097/SLE.0000000000000605

PubMed

researchmap

食道胃接合部癌に対する観音開き法鏡視下再建中、心臓圧排を誘因として心室頻拍とST上昇が生じた1症例

藤井彩加, 清水達彦, 角森雅樹, 谷真規子, 松岡義和, 森松博史

日本臨床麻酔学会誌 39 ( 6 ) S313 - S313 2019年10月

Propofolにketamineを併用した麻酔による電気けいれん療法で有効かつ安全に治療し得た難治性統合失調症の2例査読

山田裕士, 藤原雅樹, 酒本真次, 冨永悟, 稲垣正俊, 松崎孝, 森松博史, 山田了士

総合病院精神医学 31 ( 4 ) 448 - 454 2019年10月

記述言語：日本語出版者・発行元：(一社)日本総合病院精神医学会

電気けいれん療法(ECT)は、統合失調症患者においても緊張病状態や薬物治療抵抗例に対して考慮される重要な治療法である。ECTにおいて本邦で頻用される麻酔薬のpropofolは、強い抗けいれん作用を有するため、高い発作閾値が問題になるケースでは麻酔に工夫を要する。発作閾値上昇効果がないとされるketamineへの切り替え、または併用によるpropofolの減量は有効な方法の1つで、うつ病患者では抗うつ効果の増強も期待したketamineによるECTの報告が多い。一方でketamineは、その作用機序から統合失調症の精神症状を悪化させる懸念もある。今回、高い発作閾値が問題化したが、ketamineの併用によりpropofolを減量したECTで有効な発作が得られ、精神病症状の悪化を認めることなく有効かつ安全に治療し得た統合失調症の2例を経験したため報告する。(著者抄録)

researchmap

Postoperative Course of Serum Albumin Levels and Organ Dysfunction After Liver Transplantation. 国際誌

Kazumasa Hiroi, Takashi Matsusaki, Ryuji Kaku, Yuzo Umeda, Takahito Yagi, Hiroshi Morimatsu

Transplantation proceedings 51 ( 8 ) 2750 - 2754 2019年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND AIMS: Postoperative hypoalbuminemia, especially following liver transplantation, can lead to adverse multisystem effects and even death. We investigated the relationship between postoperative albumin levels and organ failure (assessed using Sequential Organ Failure Assessment [SOFA] scores). METHODS: Sixty liver transplant recipients admitted to the intensive care unit (ICU) from 2012 to 2015 were retrospectively divided into 2 groups: lower albumin (LA) (n=28) and higher albumin (HA) (n=32), using whether serum albumin level fell below 3.0 g/dL during the first postoperative week as the stratifying factor. The SOFA scores (primary endpoint) and associated complications (ascites amount, rejection, re-intubation, abdominal re-operation, thrombosis), additional treatment (dialysis, pleural effusion drainage), and duration of ICU stay (secondary endpoints) of the 2 groups were compared. RESULTS: Average serum albumin levels were significantly different between HA and LA groups (3.6 [3.4-3.8] vs 3.1 [2.9-3.3], respectively, P<.05), although the amounts of albumin infused in the 2 groups during the first postoperative week were not different (HA vs LA: 42 [30-71] vs 40 [30-58], respectively, P=.37). Mean daily SOFA scores were not significantly different between the HA and LA groups (8.3 [6.6-9.0] vs 7.2 [6.3-8.6], P=.73), although the HA group had lower mean cardiovascular SOFA sub-scores than the LA group (0.1 [0-0.4] vs 0.4 [0-1.3], P=.032). There were no significant differences between the groups with regard to complication rates and duration of ICU and hospital stays. CONCLUSIONS: Serum albumin level might not influence cumulative organ function, but it decreases the amount of hemodynamic support required in liver transplant recipients.

DOI： 10.1016/j.transproceed.2019.01.199

PubMed

researchmap

Propofolにketamineを併用した麻酔による電気けいれん療法で有効かつ安全に治療し得た難治性統合失調症の2例査読

山田裕士, 藤原雅樹, 酒本真次, 冨永悟, 稲垣正俊, 松崎孝, 森松博史, 山田了士

総合病院精神医学 31 ( 4 ) 448 - 454 2019年10月

記述言語：日本語出版者・発行元：(一社)日本総合病院精神医学会

researchmap

大学病院における専攻医臨床能力評価システム導入後の現状

谷真規子, 金澤伴幸, 清水一好, 森松博史

日本臨床麻酔学会誌 39 ( 6 ) S272 - S272 2019年10月