研究者詳細 - 森松　博史

論文 - 森松　博史

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Early detection of cerebral ischemia due to pericardium traction using cerebral oximetry in pediatric minimally invasive cardiac surgery: a case report. 国際誌

Fumiaki Hayashi, Rei Nishimoto, Kazuyoshi Shimizu, Tomoyuki Kanazawa, Tatsuo Iwasaki, Hiroshi Morimatsu

JA clinical reports 5 ( 1 ) 53 - 53 2019年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Minimally invasive cardiac surgery (MICS) for simple congenital heart defects has become popular, and monitoring of regional cerebral oxygen saturation (rSO2) is crucial for preventing cerebral ischemia during pediatric MICS. We describe a pediatric case with a sudden decrease in rSO2 during MICS. CASE PRESENTATION: An 8-month-old male underwent minimally invasive ventricular septal defect closure. He developed a sudden decrease in rSO2 and right radial artery blood pressure (RRBP) without changes in other parameters following pericardium traction. The rSO2 and RRBP immediately recovered after removal of pericardium fixation. Obstruction of the right innominate artery secondary to the pericardium traction would have been responsible for it. CONCLUSIONS: Pericardium traction, one of the common procedures during MICS, triggered rSO2 depression alerting us to the risk of cerebral ischemia. We should be aware that pericardium traction during MICS can lead to cerebral ischemia, which is preventable by cautious observation of the patient.

DOI： 10.1186/s40981-019-0273-7

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訂正：小児心臓手術後のNasal high flow therapyの現在と将来への展望

塩路直弘, 岩崎達雄, 清水一好, 金澤伴幸, 川瀬宏和, 木村聡, 黒江泰利, 佐藤明, 森松博史, 大月審一, 笠原真悟

Cardiovascular Anesthesia 23 ( 1 ) xli - xli 2019年8月

記述言語：日本語出版者・発行元：一般社団法人日本心臓血管麻酔学会

機関誌『Cardiovascular Anesthesia Vol. 22 No. 1 2018』におきまして，一部誤りがございましたので，下記の通り訂正いたします。

P45 著者名

正：塩路直弘，岩崎達雄，清水一好，金澤伴幸，川瀬宏和，木村聡

黒江泰利，佐藤明，森松博史，大月審一，笠原真悟

誤：塩路直弘，岩崎達雄，清水一好，金澤伴幸，川瀬宏和，木村聡

黒江泰利，佐藤明，森松博史，大月審一，笠原慎吾

DOI： 10.11478/jscva.2018-9-001

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Prognosis after lead extraction in patients with cardiac implantable electronic devices infection: Comparison of lead-related infective endocarditis with pocket infection in a Japanese single-center experience.

Nobuhiro Nishii, Yoshimasa Morimoto, Akihito Miyoshi, Saori Tsukuda, Masakazu Miyamoto, Satoshi Kawada, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Morimatsu, Nobuchika Kusano, Shingo Kasahara, Morio Shoda, Hiroshi Ito

Journal of arrhythmia 35 ( 4 ) 654 - 663 2019年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

Background: The increase in the use of cardiac implantable electronic devices (CIEDs) has been associated with an increase in CIED-related infections. Transvenous lead extraction is safe and effective for patients with CIED-related infections; however, the mortality rate in these patients is high. The prognosis after transvenous lead extraction in Japanese patients, especially those with lead-related infective endocarditis, has not been evaluated. Then, the purpose of this study is to clarify the prognosis after transvenous lead extraction in Japanese patients with CIED-related infections at a single Japanese center. Methods: A total of 107 patients who underwent transvenous lead extraction were retrospectively reviewed. The patients were divided into a lead-related infective endocarditis group (n = 32) and a pocket infection group (n = 75). Procedure success rate and prognosis after lead extraction were evaluated between the two groups. Results: Procedure success rate was not significantly different between the groups. There were no deaths associated with the procedure or with infection. The survival rate was not significantly different at 1 year or at a median of 816 days (lead-related infective endocarditis vs pocket infection; 93.7% vs 94.7%, P = 1.000; 78.1% vs 81.3%, P = 0.791) Time to reimplantation and duration of hospital stay and antibiotics therapy were significantly longer for patients with lead-related infective endocarditis. Conclusion: In this study, the prognosis for patients with lead-related infective endocarditis after transvenous lead extraction was favorable. Thus, extraction should be strongly recommended, even if the general condition of the patient is poor.

DOI： 10.1002/joa3.12164

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某大学病院における周術期認定歯科衛生士育成への取り組みと課題について

花岡愛弓, 三浦留美, 山中玲子, 曽我賢彦, 森松博史

日本歯科衛生学会雑誌 14 ( 1 ) 179 - 179 2019年8月

食道癌術前化学療法中の口腔衛生管理が口腔粘膜炎の重症化を防ぎ歯科治療遂行に貢献した一症例

高坂由紀奈, 花岡愛弓, 三浦留美, 山中玲子, 吉冨愛子, 曽我賢彦, 白川靖博, 森松博史

日本歯科衛生学会雑誌 14 ( 1 ) 180 - 180 2019年8月

食道癌術前補助化学療法中のセルフケアの確立に難渋した一症例

小倉早妃, 花岡愛弓, 高坂由紀奈, 三浦留美, 吉富愛子, 山中玲子, 曽我賢彦, 白川靖博, 森松博史

日本歯科衛生学会雑誌 14 ( 1 ) 180 - 180 2019年8月

食道癌周術期患者の口腔衛生状態を改善させ術後肺炎予防に貢献した一症例

大森裕子, 花岡愛弓, 高坂由紀奈, 三浦留美, 佐藤あやめ, 吉冨愛子, 山中玲子, 曽我賢彦, 白川靖博, 森松博史

日本歯科衛生学会雑誌 14 ( 1 ) 181 - 181 2019年8月

Hyperchloremia Is Not an Independent Risk Factor for Postoperative Acute Kidney Injury in Pediatric Cardiac Patients. 国際誌

Satoshi Kimura, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tomoyuki Kanazawa, Hirokazu Kawase, Naohiro Shioji, Yasutoshi Kuroe, Yuto Matsuoka, Satoshi Isoyama, Hiroshi Morimatsu

Journal of cardiothoracic and vascular anesthesia 33 ( 7 ) 1939 - 1945 2019年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE: Hyperchloremia recently has been shown to have an association with the development of acute kidney injury (AKI) in critically ill patients. However, there is little information about the prevalence of an abnormal chloride concentration after pediatric cardiac surgery and its association with postoperative AKI. The aim of this study was to determine the prevalence of hyperchloremia and its association with AKI in pediatric patients after cardiac surgery. DESIGN: A retrospective single-center study. SETTING: Referral high-volume pediatric cardiac center in a tertiary teaching hospital. PARTICIPANTS: Patients under 72 months of age with congenital heart disease who underwent cardiac surgery with the use of cardiopulmonary bypass. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The primary outcome was development of AKI diagnosed by Kidney Disease Improving Global Outcomes consensus criteria. The associations of outcomes with the highest serum chloride concentration ([Cl-]max) and time-weighted average chloride concentration ([Cl-]ave) within the first 48 hours after surgery were investigated. Of 521 patients included in the study, 463 patients (88.9%) had hyperchloremia at least 1 time within the first 48 hours after surgery. Postoperative AKI occurred in 205 patients (39.3%). [Cl-]ave and [Cl-]max in the AKI group were significantly higher than those in the non-AKI group (112 [110-114] mEq/L v 111 [109-113] mEq/L, p = 0.001 and 116 [113, 119] mEq/L v 114 [112-118] mEq/L, p = 0.002, respectively). After adjustment for other predictors of AKI by multivariable analyses, neither [Cl-]ave nor [Cl-]max was associated independently with the development of AKI (odds ratio [OR] = 1.040, 95% confidence interval [CI]: 0.885-1.220, p = 0.63; OR = 0.992, 95% CI: 0.874-1.130. p = 0.90). CONCLUSION: Postoperative hyperchloremia was common and was associated with the development of AKI in pediatric patients after congenital cardiac surgery in univariate analysis. After adjustment for predictors of AKI by multivariate analyses, there was no significant relationship between postoperative chloride concentration and AKI.

DOI： 10.1053/j.jvca.2018.12.009

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Possible biased analgesic of hydromorphone through the G protein-over β-arrestin-mediated pathway: cAMP, CellKey™, and receptor internalization analyses.

Sei Manabe, Kanako Miyano, Yuriko Fujii, Kaori Ohshima, Yuki Yoshida, Miki Nonaka, Miaki Uzu, Yoshikazu Matsuoka, Tetsufumi Sato, Yasuhito Uezono, Hiroshi Morimatsu

Journal of pharmacological sciences 140 ( 2 ) 171 - 177 2019年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

Morphine, fentanyl, and oxycodone are widely used as analgesics, and recently hydromorphone has been approved in Japan. Although all of these are selective for μ-opioid receptors (MORs) and have similar structures, their analgesic potencies and adverse effects (AEs) are diverse. Recent molecular analyses of MOR signaling revealed that the G protein-mediated signaling pathway causes analgesic effects and the β-arrestin-mediated signaling pathway is responsible for AEs. We used several cell-based analyses that selectively measure cellular responses activated by either G protein- or β-arrestin-mediated pathways. GloSensor™ cAMP, CellKey™, and receptor internalization assays were performed with four different types of cells stably expressing differentially labelled MOR. EC50 values measured by cAMP and CellKey™ assays had potencies in the order fentanyl ≤ hydromorphone < morphine ≤ oxycodone, all also exhibiting full agonist responses. However, in the internalization assay, only fentanyl elicited a full agonist response. Hydromorphone had the strongest potency next to fentanyl; however, contribution of the β-arrestin-mediated pathway was small, suggesting that its effect could be biased toward the G protein-mediated pathway. Based on these properties, hydromorphone could be chosen as an effective analgesic.

DOI： 10.1016/j.jphs.2019.06.005

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Recent Changes and Improvements in Multidisciplinary Perioperative Management From a Nutritional Perspective: Dental Specialty Should Be Considered Important 査読

Yoshihiko Soga, Yasuhiro Shirakawa, Toshiyoshi Fujiwara, Takako Ashiwa, Hiroshi Morimatsu

Current Oral Health Reports 6 ( 2 ) 70 - 75 2019年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

Purpose of Review: Recently, multidisciplinary strategies on accelerated recovery postoperatively have been provided, and management of the perioperative period has changed and improved dramatically. We summarize the enhanced recovery after surgery (ERAS®) protocol and its outcomes from a nutritional perspective. We established the perioperative management center (PERiO), much of whose work contents conform to ERAS®, but intensive dental staff involvement is characteristic. We also summarize its outcomes. Recent Findings: ERAS® is a multimodal perioperative care pathway designed to achieve early recovery for patients undergoing major surgery. Nutrition is a key pillar for patient care. Throughout the perioperative period, oral nutrition is suggested as well as possible. Good outcomes have been reported by a meta-analysis of randomized controlled trials. However, the dental staff are not regarded as part of the professional team. PERiO reported good outcomes of care bundles and suggested the importance of dental staff contribution. The Japanese social insurance system began to cover involvements of the dental staff for perioperative oral management since 2012. Analysis of the nationwide administrative claims database in Japan concluded that preoperative oral care by a dentist significantly reduced postoperative complications in patients undergoing cancer surgery. Summary: Currently, the dental staff are not regarded as key professionals of ERAS®, although the dental staff can contribute to good outcomes in the perioperative period and PERiO, and consequently, the Japanese universal health insurance coverage system covering involvements of the dental staff for perioperative oral management showed good outcomes. Therefore, further clinical studies involving dental specialty should be considered important for perioperative management from nutritional perspectives.

DOI： 10.1007/s40496-019-0217-3

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Therapeutic effect of carbon monoxide-releasing molecule-3 on acute lung injury after hemorrhagic shock and resuscitation. 国際誌

Yuta Kumada, Toru Takahashi, Hiroko Shimizu, Ryu Nakamura, Emiko Omori, Kazuyoshi Inoue, Hiroshi Morimatsu

Experimental and therapeutic medicine 17 ( 5 ) 3429 - 3440 2019年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

Hemorrhagic shock and resuscitation (HSR) induces a pulmonary inflammatory response and frequently causes acute lung injury. Carbon monoxide-releasing molecule-3 (CORM-3) has been reported to liberate and deliver CO under physiological conditions, which exerts organ-protective effects during systemic insults. The present study aimed to determine whether the administration of CORM-3 following HSR exerts a therapeutic effect against HSR-induced lung injury without any detrimental effects on oxygenation and hemodynamics. To induce hemorrhagic shock, rats were bled to a mean arterial blood pressure of 30 mmHg for 45 min and then resuscitated with the shed blood. CORM-3 or a vehicle was intravenously administered immediately following the completion of resuscitation. The rats were divided into four groups, including sham, HSR, HSR/CORM-3 and HSR/inactive CORM-3 groups. Arterial blood gas parameters and vital signs were recorded during HSR. The histopathological changes to the lungs were evaluated using a lung injury score, while pulmonary edema was evaluated on the basis of the protein concentration in bronchoalveolar lavage fluid and the lung wet/dry ratio. We also investigated the pulmonary expression levels of inflammatory mediators and apoptotic markers such as cleaved caspase-3 and transferase-mediated dUTP-fluorescein isothiocyanate nick-end labeling (TUNEL) staining. Although HSR caused significant lung histopathological damage and pulmonary edema, CORM-3 significantly ameliorated this damage. CORM-3 also attenuated the HSR-induced upregulation of tumor necrosis factor-α, inducible nitric oxide synthase and interleukin-1β genes, and the expression of interleukin-1β and macrophage inflammatory protein-2. In addition, the expression of interleukin-10, an anti-inflammatory cytokine, was inversely enhanced by CORM-3, which also reduced the number of TUNEL-positive cells and the expression of cleaved caspase-3 following HSR. Although CORM-3 was administered during the acute phase of HSR, it did not exert any influence on arterial blood gas analysis data and vital signs during HSR. Therefore, treatment with CORM-3 ameliorated HSR-induced lung injury, at least partially, through anti-inflammatory and anti-apoptotic effects, without any detrimental effects on oxygenation and hemodynamics.

DOI： 10.3892/etm.2019.7390

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Prolonged Tachycardia with Higher Heart Rate Is Associated with Higher ICU and In-hospital Mortality. 査読

Hayashi M, Taniguchi A, Kaku R, Fujimoto S, Isoyama S, Manabe S, Yoshida T, Suzuki S, Shimizu K, Morimatsu H, Momota R

Acta medica Okayama 73 ( 2 ) 147 - 153 2019年4月

周術期におけるECMO 小児複雑心奇形の周術期におけるECMO治療

岩崎達雄, 金澤伴幸, 清水一好, 川瀬宏和, 森松博史, 笠原真悟

日本臨床麻酔学会誌 39 ( 2 ) 148 - 154 2019年3月

記述言語：日本語出版者・発行元：日本臨床麻酔学会

小児におけるECMO(Extracorporeal Membrane Oxygenation)治療は、先天性心疾患に対しても重要な適応がある。小児複雑心奇形周術期におけるECMO導入のコンセンサスの得られた明確な基準はないが、循環破綻による多臓器障害を合併した状態での導入より、計画的早期の導入の方が離脱率の向上につながると考えられる。出血性合併症が問題となりやすいが、病態を把握し補充療法に努める。心機能の回復には心室の十分な減圧が必要である。小児複雑心奇形の特徴的な疾患である単心室症例のECMO管理では循環生理および解剖学的特徴をよく理解し、各々の状態に応じた管理が肝要である。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01620&link_issn=&doc_id=20190319280006&doc_link_id=%2Fci4jjsca%2F2019%2F003902%2F007%2F0148-0154%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fci4jjsca%2F2019%2F003902%2F007%2F0148-0154%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

High-flow Nasal Cannula Versus Noninvasive ventilation for Postextubation Acute Respiratory Failure after Pediatric Cardiac Surgery.

Naohiro Shioji, Tomoyuki Kanazawa, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tomohiko Suemori, Yasutoshi Kuroe, Hiroshi Morimatsu

Acta medica Okayama 73 ( 1 ) 15 - 20 2019年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

We compared the reintubation rate in children who received high-flow nasal cannula (HFNC) therapy to the rate in children who received noninvasive ventilation (NIV) therapy for acute respiratory failure (ARF) after cardiac surgery. This was a retrospective analysis of 35 children who received HFNC therapy for ARF after cardiac surgery in 2014-2015 (the HFNC group). We selected 35 children who had received NIV therapy for ARF after cardiac surgery in 2009-2012 as a control group. The matching parameters were body weight and risk adjustment for congenital heart surgery category 1. The reintubation rate within 48 h in the HFNC group tended to be lower than that in the NIV group (3% vs. 17%, p=0.06). The reintubation rate within 28 days was significantly lower in the HFNC group compared to the NIV group (3% vs. 26%, p=0.04). The HFNC group's ICU stays were significantly shorter than those of the NIV group: 10 (IQR: 7-17) days vs. 17 (11-32) days, p=0.009. HFNC therapy might be associated with a reduced reintubation rate in children with ARF after cardiac surgery.

DOI： 10.18926/AMO/56454

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Hemi-clamshell開胸法により片側の脳局所組織酸素飽和度が低下した1例

部村公香, 清水一好, 金澤伴幸, 廣井一正, 小林求, 森松博史

日本臨床麻酔学会誌 39 ( 1 ) 21 - 25 2019年1月

記述言語：日本語出版者・発行元：日本臨床麻酔学会

55歳、男性。左房浸潤を伴う肺癌に対し、右上葉切除、S6切除および人工心肺を用いた左房部分切除術が予定された。人工心肺使用症例であることから、両側の脳局所組織酸素飽和度(rSO2)をモニターした。胸壁への癒着剥離の際、hemi-clamshell開胸開始後から右rSO2値のみ低下を認めた。胸壁のつり上げに伴い腕頭動脈が狭窄し右脳血流が著明に低下したことが原因と考えた。つり上げ程度の調整により右rSO2値は速やかに改善した。術後は神経学的後遺症なく経過した。本症例ではrSO2測定により術操作に伴う脳血流異常を検知・対応でき、神経学的後遺症を回避できた。(著者抄録)

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Histidine-Rich Glycoprotein As a Prognostic Biomarker for Sepsis: A Multicenter Prospective Observational Cohort Study

Kosuke Kuroda, Kenzo Ishii, Yuko Mihara, Naoya Kawanoue, Hidenori Wake, Shuji Mori, Michihiro Yoshida, Masahiro Nishibori, Hiroshi Morimatsu, Okayama Research Investigation Orga Investigators

SSRN Electronic Journal 2019年

Incidence rates of postoperative pulmonary embolisms in symptomatic and asymptomatic patients, detected by diagnostic images: A single-center retrospective study

Yoshikazu Matsuoka, Hiroshi Morimatsu

Circulation Journal 83 ( 2 ) 432 - 440 2019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：Japanese Circulation Society

Background: Pulmonary embolism (PE) is a serious complication during the perioperative period. However, because most previous studies on the incidence of postoperative PE are based on symptoms, asymptomatic occurrences of PE have been overlooked, and the absolute incidence of postoperative PE remains unknown. The aim of this study was to investigate the incidence of perioperative PE, regardless of its symptoms, by reviewing the clinical interpretations of the diagnostic images obtained during the postoperative period. Methods and Results: This study included all patients aged at least 18 years who underwent operations under general and/or neuraxial anesthesia in our institution from 2013 to 2016. We reviewed all interpretations of the diagnostic imaging performed in the postoperative period. We analyzed the 90-day cumulative incidence of postoperative PE and the characteristics, risk factors, and symptoms of patients with and without postoperative PE. Among 21,763 operations, postoperative diagnostic imaging was performed in 1,168 patients, which found PE in 217 patients. Symptoms appeared in 11.1% (24/217) of the PE patients, and 66.7% of these symptoms were decreased levels of SpO 2 alone. Mortality from PE was 0.5% (1/217). Conclusions: Diagnostic imaging found a number of postoperative PE cases, regardless of the presence of symptoms. Although symptomatic PE was not a frequent occurrence, these findings suggest that clinicians should be aware of postoperative PE even under current prophylaxis.

DOI： 10.1253/circj.CJ-18-0729

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Radio contrast imaging for continuous epidural infusion in humans: a report of three cases. 国際誌

Takashi Matsusaki, Ryuji Kaku, Daisuke Ono, Arata Taniguchi, Hiroshi Morimatsu

Journal of pain research 12 1077 - 1082 2019年

記述言語：英語掲載種別：研究論文（学術雑誌）

There are no reports of human research on continuous epidural contrast injection, and there are no definite methods to investigate the spread of drugs injected continuously into the epidural space. We investigated the feasibility of continuous epidural contrast injection in patients undergoing computed tomography (CT)-guided therapy. In this study, a combination of a contrast agent mixed with 0.75% ropivacaine was used as the test drug. The main outcome evaluated was the feasibility of continuous epidural contrast imaging by CT scan following epidural injection of a contrast agent with 0.75% ropivacaine. We studied three patients who underwent CT-guided procedures and found that continuous epidural contrast injection was possible without any deleterious effects, such as an allergic reaction. The spread of the contrast agent was not consistent with the level of the clinical analgesic effect. Continuous epidural contrast injection is a feasible procedure. The results of our study might contribute to future research on continuous epidural contrast administration, as well as provide patients with superior analgesia.

DOI： 10.2147/JPR.S193500

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Long-term outcomes in patients treated in the intensive care unit after hematopoietic stem cell transplantation. 査読

Nakamura M, Fujii N, Shimizu K, Ikegawa S, Seike K, Inomata T, Sando Y, Fujii K, Nishimori H, Matsuoka KI, Morimatsu H, Maeda Y

International journal of hematology 108 ( 6 ) 622 - 629 2018年12月

刺激神経の選択が可能な筋弛緩モニターの開発

岡久雄, 岸本俊夫, 木村聡, 川瀬宏和, 岩崎達雄, 青木梨奈, 有路未彩, 鴨川晴香, 森松博史

バイオメカニズム学術講演会予稿集 39回 48 - 51 2018年11月

記述言語：日本語出版者・発行元：バイオメカニズム学会

適切な神経刺激と誘発筋収縮の正確なモニタリングを行うことができる筋弛緩モニターを開発するために、機器の試作および刺激実験を行って性能を確認した。被験者は健常な50～60代男性2名とした。筋弛緩モニターシステムは、母指の筋振動を検出する軸加速度センサ、尺骨神経の選択的神経刺激が可能なアレイ電極、電極の自動探索を行う電極選択インタフェース、および電気刺激や四連刺激比を表示する筋弛緩モニターから構成された。まず、臨床でよく用いられ尺骨神経の支配を受ける母指内転筋を対象とし、筋弛緩モニタリングを行った。次に、試作したアレイ電極の神経刺激選択性を確認するために、正中神経を刺激して実験を行った。また、正中神経よりも細い尺骨神経を選択的に電気刺激して、正確に母指内転筋の筋振動を誘発できるかを確認した。本実験で得られた結果から、製作したアレイ電極は筋弛緩モニタリングに適した尺骨神経刺激部位を探索することが可能であり、また本実験で用いた加速度センサによって精度良く対象筋の動きを測定でき、当初の問題点を解決できたと考える。

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