研究者詳細 - 森松　博史

MISC - 森松　博史

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周術期における歯科衛生士の専門的口腔衛生指導は食道癌患者の術後肺炎予防に有効である

花岡愛弓, 山中玲子, 足羽孝子, 森松博史

日本集中治療医学会雑誌 25 ( Suppl. ) [P67 - 1] 2018年2月

肝移植術後のアルブミン値と臓器障害の関係性

廣井一正, 松崎孝, Vika Lemoto, 賀来隆治, 森松博史

日本集中治療医学会雑誌 25 ( Suppl. ) [P1 - 5] 2018年2月

Associations between intraoperative ventilator settings during one-lung ventilation and postoperative pulmonary complications: A prospective observational study

Shuji Okahara, Kazuyoshi Shimizu, Satoshi Suzuki, Kenzo Ishii, Hiroshi Morimatsu

BMC Anesthesiology 18 ( 1 ) 13 2018年1月

記述言語：英語出版者・発行元：BioMed Central Ltd.

Background: The interest in perioperative lung protective ventilation has been increasing. However, optimal management during one-lung ventilation (OLV) remains undetermined, which not only includes tidal volume (VT) and positive end-expiratory pressure (PEEP) but also inspired oxygen fraction (FIO2). We aimed to investigate current practice of intraoperative ventilation during OLV, and analyze whether the intraoperative ventilator settings are associated with postoperative pulmonary complications (PPCs) after thoracic surgery. Methods: We performed a prospective observational two-center study in Japan. Patients scheduled for thoracic surgery with OLV from April to October 2014 were eligible. We recorded ventilator settings (FIO2, VT, driving pressure (ΔP), and PEEP) and calculated the time-weighted average (TWA) of ventilator settings for the first 2 h of OLV. PPCs occurring within 7 days of thoracotomy were investigated. Associations between ventilator settings and the incidence of PPCs were examined by multivariate logistic regression. Results: We analyzed perioperative information, including preoperative characteristics, ventilator settings, and details of surgery and anesthesia in 197 patients. Pressure control ventilation was utilized in most cases (92%). As an initial setting for OLV, an FIO2 of 1.0 was selected for more than 60% of all patients. Throughout OLV, the median TWA FIO2 of 0.8 (0.65-0.94), VT of 6.1 (5.3-7.0) ml/kg, ΔP of 17 (15-20) cm H2O, and PEEP of 4 (4-5) cm H2O was applied. Incidence rate of PPCs was 25.9%, and FIO2 was independently associated with the occurrence of PPCs in multivariate logistic regression. The adjusted odds ratio per FIO2 increase of 0.1 was 1.30 (95% confidence interval: 1.04-1.65, P =0.0195). Conclusions: High FIO2 was applied to the majority of patients during OLV, whereas low VT and slight degree of PEEP were commonly used in our survey. Our findings suggested that a higher FIO2 during OLV could be associated with increased incidence of PPCs.

DOI： 10.1186/s12871-018-0476-x

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膵頭十二指腸切除術におけるERAS(Enhanced recovery after surgery)の有効性に関するランダム化比較試験

高木弘誠, 吉田龍一, 八木孝仁, 楳田祐三, 信岡大輔, 杭瀬崇, 樋之津史郎, 松崎孝, 森松博史, 江口潤, 和田淳, 千田益生, 藤原俊義

日本静脈経腸栄養学会雑誌 33 ( Suppl. ) 227 - 227 2018年1月

非優位半球症状を伴う右側頭葉膠芽腫患者の周術期において歯科衛生士の関わりが有効であった症例

千神八重子, 花岡愛弓, 花岡愛弓, 吉冨愛子, 山中玲子, 曽我賢彦, 米田かおり, 藤田準平, 古西隆之, 森松博史, 市川智継

日本臨床脳神経外科学会プログラム・抄録集 21st 2018年

小児重症患者の鎮静管理

清水一好, 岩崎達雄, 森松博史

日本麻酔科学会学術集会(Web) 65th 2018年

胸部交感神経節ブロックが有効であった,治療抵抗性心室頻拍の1例

宮本真和, 渡邊敦之, 森田宏, 佃早央莉, 森本芳正, 三好章仁, 川田哲史, 中川晃志, 西井伸洋, 中村一文, 松崎孝, 松井裕輔, 渡邊伸英, 田邊一明, 森松博史, 金澤右, 伊藤浩

日本循環器学会中国地方会(Web) 112th 2018年

Severe Acute Respiratory Distress Syndrome Using Electrical Activity of the Diaphragm on Weaning from Extracorporeal Membrane Oxygenation

Shuji Okahara, Kazuyoshi Shimizu, Hiroshi Morimatsu

ACTA MEDICA OKAYAMA 71 ( 6 ) 543 - 546 2017年12月

記述言語：英語出版者・発行元：OKAYAMA UNIV MED SCHOOL

The electrical activity of the diaphragm (EAdi) shows global diaphragmatic activation and power output from the central nervous system. We measured the EAdi as an indicator of breathing workload in a 40-year-old man suffering from severe acute respiratory distress syndrome (ARDS) secondary to influenza pneumonia in the process of weaning from extracorporeal membrane oxygenation (ECMO). Turning off the sweep gas flow immediately led to EAdi elevation, followed by hypoxia. The patient was successfully weaned from ECMO by reference to EAdi. This is the first case report to suggest that EAdi monitoring might be useful for ARDS patients during ECMO weaning.

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大動脈の蛇行によるPlatypnea-Orthodeoxia症候群を呈した高齢者の1症例

礒山智史, 森松博史, 岩崎達雄, 金澤伴幸, 木村聡

日本臨床麻酔学会誌 37 ( 6 ) S240 - S240 2017年10月

大腿腫瘍切除術後に発症した右下肢のComplex Regional Pain Syndrome(CRPS)

谷美里, 松崎孝, 中塚洸輔, 小野大輔, 谷口新, 賀来隆治, 森松博史

日本臨床麻酔学会誌 37 ( 6 ) S281 - S281 2017年10月

手術室から始める安全な輸液管理

賀来隆治, 森松博史

日本臨床麻酔学会誌 37 ( 6 ) S214 - S214 2017年10月

各種難病の最新治療情報神経障害性痛の薬物療法

松崎孝, 森松博史

難病と在宅ケア 23 ( 4 ) 55 - 59 2017年7月

Dynamic changes in Bach1 expression in the kidney of rhabdomyolysis-associated acute kidney injury

Masakazu Yamaoka, Hiroko Shimizu, Toru Takahashi, Emiko Omori, Hiroshi Morimatsu

PLOS ONE 12 ( 7 ) 430 - 436 2017年7月

記述言語：英語出版者・発行元：PUBLIC LIBRARY SCIENCE

Free heme, a pro-oxidant released from myoglobin, is thought to contribute to the pathogenesis of rhabdomyolysis-associated acute kidney injury (RM-AKI), because renal overexpression of heme oxygenase-1 (HO-1), the rate-limiting enzyme in heme catabolism, confers protection against RM-AKI. BTB and CNC homology 1 (Bach1) is a heme-responsive transcription factor that represses HO-1. Here, we examined the changes with time in the gene expression of Bach1, HO-1, and d-aminolevulinate synthase (ALAS1, a heme biosynthetic enzyme) in the rat kidney using an RM-AKI model induced by the injection of 50% glycerol (10 mL/kg body weight) into bilateral limbs. We also examined the protein expression of Bach1 in the nucleus and cytosol, and HO-1 in the rat kidney. Glycerol treatment induced significant elevation of serum creatinine kinase and aspartate aminotransferase levels followed by the marked elevation of serum blood urea nitrogen and creatinine levels, which caused serious damage to renal tubules. Following glycerol treatment, HO-1 mRNA and protein levels were significantly up-regulated, while ALAS1 mRNA expression was down-regulated, suggesting an increase in the free renal heme concentration. The Bach1 mRNA level was drastically increased 3 h after glycerol treatment, and the increased level was maintained for 12 h. Nuclear Bach1 protein levels were significantly decreased 3 h after treatment. Conversely, cytosolic Bach1 protein levels abruptly increased after 6 h. In conclusion, we demonstrate the dynamic changes in Bach1 expression in a rat model of RM-AKI. Our findings suggest that the increase in Bach1 mRNA and cytosolic Bach1 protein expression may reflect de novo Bach1 protein synthesis to compensate for the depletion of nuclear Bach1 protein caused by the induction of HO-1 by free heme.

DOI： 10.1371/journal.pone.0180934

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生体部分肝移植術後の疼痛管理に腹横筋膜面ブロックを施行した1例

吉田翼, 松崎孝, Lemoto Vika, 鈴木聡, 賀来隆治, 森松博史

日本臨床麻酔学会誌 37 ( 4 ) 439 - 441 2017年7月

記述言語：日本語出版者・発行元：日本臨床麻酔学会

生体肝移植術後の疼痛管理に腹横筋膜面ブロック(transversus abdominis plane block:TAPB)を併用した報告は少ない.今回,われわれは生体肝移植術後にTAPBで術後鎮痛を行い,手術室で抜管した症例を経験したので報告する.症例は16歳女性で先天性胆道閉鎖症に対して生体部分肝移植術が施行された.術直後に超音波ガイド下肋骨弓下アプローチで0.2%ロピバカインを左右15mLずつ使用しTAPBを行った.手術室で抜管し,術後12時間までのNRSは3/10以下で推移した.局所麻酔薬中毒や穿刺に伴う合併症は認められなかった.(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=2017&ichushi_jid=J01620&link_issn=&doc_id=20170727200006&doc_link_id=%2Fci4jjsca%2F2017%2F003704%2F006%2F0439-0441%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fci4jjsca%2F2017%2F003704%2F006%2F0439-0441%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Physiological impact of high-flow nasal cannula therapy on postextubation acute respiratory failure after pediatric cardiac surgery: A prospective observational study

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

Journal of Intensive Care 5 ( 1 ) 140 - 149 2017年6月

記述言語：英語出版者・発行元：BioMed Central Ltd.

Background: Reintubation after pediatric cardiac surgery is associated with a high rate of mortality. Therefore, adequate respiratory support for postextubation acute respiratory failure (ARF) is important. However, little is known about the physiological impact of high-flow nasal cannula (HFNC) therapy on ARF after pediatric cardiac surgery. Our working hypothesis was that HFNC therapy for postextubation ARF after pediatric cardiac surgery improves hemodynamic and respiratory parameters. Methods: This was a prospective observational study conducted at a single university hospital. Children less than 48 months of age who had postextubation ARF after cardiac surgery were included in this study. HFNC therapy was started immediately after diagnosis of postextubation ARF. Data obtained just before starting HFNC therapy were used for pre-HFNC analysis, and data obtained 1 h after starting HFNC therapy were used for post-HFNC analysis. We compared hemodynamic and respiratory parameters between pre-HFNC and post-HFNC periods. The Wilcoxon signed-rank test was used to analyze these indices. Results: Twenty children were included in this study. The median age and body weight were 4.5 (2.3-14.0) months and 4.3 (3.1-7.1) kg, respectively. Respiratory rate (RR) significantly decreased from 43.5 (32.0-54.8) to 28.5 (21.0-40.5) breaths per minute (p = 0.0008) 1 h after the start of HFNC therapy. Systolic blood pressure also decreased from 87.5 (77.8-103.5) to 76.0 (70.3-85.0) mmHg (p = 0.003). Oxygen saturation, partial pressure of arterial carbon dioxide, heart rate, and lactate showed no remarkable changes. There was no adverse event caused by HFNC therapy. Conclusions: HFNC therapy improves the RR of patients who have postextubation ARF after pediatric cardiac surgery without any adverse events.

DOI： 10.1186/s40560-017-0226-z

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ラット神経障害性疼痛モデルに対するパルス高周波療法の効果について通電時間と神経障害マーカーATF3

荒川恭佑, 賀来隆治, 小野大輔, 谷口新, 松崎孝, 佐藤健治, 森松博史

日本ペインクリニック学会誌 24 ( 3 ) 103 - 103 2017年6月