MISC - 森松　博史

呼吸器疾患合併症を有する患者の術前評価

松岡義和, 清水達彦, 森松博史

日本麻酔科学会学術集会(Web)   71st   2024年

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妊産婦の心肺蘇生—最善で最新の産科麻酔診療をめざして ; 妊産婦急変対応

木村 貴一, 金澤 伴幸, 森松 博史

臨床婦人科産科   77 ( 1 )   193 - 199   2023年

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記述言語：日本語   出版者・発行元：医学書院  

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顧客満足度分析を用いた岡山大学病院集中治療室における病棟薬剤師業務の評価

大川恭昌, 宮本朋佳, 村尾卓哉, 勝部理早, 森田幸子, 妹尾育美, 村川公央, 清水一好, 森松博史, 座間味義人

日本集中治療医学会中国・四国支部学術集会プログラム・抄録集(Web)   7th   2023年

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難治性の腸管蠕動痛に対してオピオイド鎮痛薬が有効であった3例

片山圭, 荒川恭佑, 森松博史

日本ペインクリニック学会誌(Web)   30 ( program )   2023年

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慢性疼痛発症に関与する炎症・侵害受容増幅因子HMGB1の血中動態解析に基づく客観的評価法の確立 慢性疼痛患者の診療・治療と臨床研究

森松博史, 松岡義和, 荒川恭佑, 妹尾悠祐

慢性疼痛発症に関与する炎症・侵害受容増幅因子HMGB1の血中動態解析に基づく客観的評価法の確立 令和4年度 総括・分担研究報告書(Web)   2023年

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硬膜外麻酔により持続的な下肢運動麻痺,感覚障害を生じた1症例—Prolonged Paralysis and Hypesthesia of the Leg after Epidural Anesthesia : A Case Study

大村 浩之, 金澤 伴幸, 小野 大輔, 賀来 隆治, 日高 秀邦, 小野 和身, 森松 博史

麻酔 = The Japanese journal of anesthesiology : 日本麻酔科学会準機関誌   71 ( 10 )   1112 - 1115   2022年10月

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記述言語：日本語   出版者・発行元：克誠堂出版  

CiNii Books

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Opioid free anesthesiaは必要か? Opioid-Free Anesthesiaのウィークポイント OFAは必要ない!

清水 達彦, 金澤 伴幸, 吉田 翼, 佐倉 考信, 木村 聡, 清水 一好, 岩崎 達雄, 森松 博史

日本小児麻酔学会誌   27 ( Suppl. )   77 - 77   2022年10月

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記述言語：日本語   出版者・発行元：(一社)日本小児麻酔学会  

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インヒビター保有血友病A患者に対する肝切除術後に出血を来した1症例—A Case of Postoperative Bleeding after Laparoscopic Hepatectomy in a Patient with Hemophilia A

佐藤 航貴, 松崎 孝, 佐倉 考信, 森松 博史

麻酔 = The Japanese journal of anesthesiology : 日本麻酔科学会準機関誌   71 ( 6 )   623 - 626   2022年6月

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記述言語：日本語   出版者・発行元：克誠堂出版  

CiNii Books

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レミフェンタニル投与時のシリンジポンプへの自動理想体重送信機能追加の評価

小坂順子, 松岡義和, 森松博史

日本臨床麻酔学会誌   42 ( 6 )   2022年

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全身麻酔下脊椎固定術後に奇異性声帯運動を認めた1症例

山崎友輔, 中村龍, 溝渕有助, 清水一好, 森松博史

麻酔   71 ( 5 )   2022年

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適応外薬を併用し鎮静薬を計画的に減量しえた小児長期人工呼吸管理の一症例

成谷俊輝, 黒田浩佐, 岡原修司, 鈴木聡, 清水一好, 森松博史

日本集中治療医学会中国・四国支部学術集会プログラム・抄録集(Web)   6th   2022年

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岡山大学病院における薬学実務実習生に対する術後疼痛管理教育の試み

森下 陽介, 槇田 崇志, 西原 茂樹, 牛尾 聡一郎, 江角 悟, 晴田 佑介, 川島 理沙, 猪田 宏美, 市川 裕規, 松村 真千子, 岩藤 晋, 松崎 孝, 森松 博史, 北村 佳久, 千堂 年昭

日本病院薬剤師会雑誌   57 ( 11 )   1237 - 1242   2021年11月

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記述言語：日本語   出版者・発行元：(一社)日本病院薬剤師会  

患者の周術期quality of life向上のため、適切な術後疼痛管理が必要である。そのため、岡山大学病院(以下、当院)では術後に自己調節鎮痛法(patient controlled analgesia:以下、PCA)を使用する患者に対し、術後疼痛ラウンドを行っている。しかしながら、当院で実務実習を行った全実習生がPCAを使用した術後疼痛管理を経験できていなかった。そこで、今回実務実習の一環として「術後疼痛管理実習プログラム」を立案し、実習内容の均一化を試みた。病棟実習での疼痛ラウンド経験にかかわらず、実習生の理解度の上昇が認められた。また、薬剤師の術後疼痛へのかかわりについて高い理解が得られた。「術後疼痛管理実習プログラム」の導入は、すべての実習生が周術期のチーム医療における薬剤師の役割および術後疼痛管理への理解を深めるために有用であると考えられる。(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J04451&link_issn=&doc_id=20211108270012&doc_link_id=%2Fdg4hppha%2F2021%2F005711%2F012%2F1237-1242%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg4hppha%2F2021%2F005711%2F012%2F1237-1242%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

難治性呼吸不全のためブリッジECMOを導入、ECMO下搬送し生体肺葉移植により救命しえた小児2症例

日笠 友起子, 小林 求, 岡原 修司, 谷 真規子, 谷口 新, 大藤 剛宏, 森松 博史

日本集中治療医学会雑誌   28 ( Suppl.2 )   421 - 421   2021年9月

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記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

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外来神経ブロック処置後の退室基準作成の試み

荒川 恭佑, 小野 大輔, 更科 紗和子, 武藤 典子, 松崎 孝, 賀来 隆治, 森松 博史

日本ペインクリニック学会誌   28 ( 7 )   164 - 164   2021年7月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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ケタミンはオピオイド反復投与によるμオピオイド受容体脱感作を回復させる

溝渕 有助, 上園 瑛子, 宮野 加奈子, 黒田 唯, 佐藤 哲文, 真鍋 星, 森松 博史, 上園 保仁

日本ペインクリニック学会誌   28 ( プログラム号 )   O32 - 5   2021年6月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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痛みの客観的評価としての尿中オキシトシンの研究

小野 大輔, 谷口 新, 松崎 孝, 賀来 隆治, 森松 博史

日本ペインクリニック学会誌   28 ( プログラム号 )   E2 - 4   2021年6月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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神経障害性痛類似の眼痛を呈した3症例

更科 紗和子, 松崎 孝, 小野 大輔, 中村 龍, 賀来 隆治, 森松 博史

日本ペインクリニック学会誌   28 ( 1 )   1 - 4   2021年1月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

ドライアイ類似の慢性難治性眼痛の3症例を経験した.当院の眼科治療後難治性眼痛の治療プロトコールに基づき,オキシブプロカイン点眼検査,リドカイン静脈内投与,薬物療法,神経ブロックを行い,痛みの機序を考慮し診断的治療を施行した.眼科領域では,客観的所見と疼痛の乖離を説明する概念として神経障害性眼痛(neuropathic ocular pain:NOP)が報告されているが,病態が国際疼痛学会の提唱する神経障害性痛の定義に適さないため,本稿では神経障害性痛を部分的に有する神経障害類似の眼痛(neuropathic like ocular pain:NLOP)と定義して症例を提示した.(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=2021&ichushi_jid=J03612&link_issn=&doc_id=20210226250001&doc_link_id=%2Fca0jjspc%2F2021%2F002801%2F001%2F0001-0004%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fca0jjspc%2F2021%2F002801%2F001%2F0001-0004%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

頭蓋咽頭腫摘出後の血清ナトリウム濃度変動により橋外性髄鞘崩壊症を生じた一小児例

松岡勇斗, 谷真規子, 清水一好, 金澤伴幸, 市川智継, 佐々木達也, 長谷川高誠, 森松博史

日本集中治療医学会雑誌(Web)   28 ( 3 )   2021年

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早期治療介入した産後発症のSystemic capillary leak syndrome

坂本里沙, 林真雄, 駿河磨矢, 佐倉孝信, 西本れい, 山之井智子, 黒田浩佐, 鈴木聡, 松岡義和, 森松博史

日本集中治療医学会学術集会(Web)   48th   2021年

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血漿交換療法により改善した産褥期HELLP症候群の一例

小島奈々, 黒田浩佐, 河野圭史, 西本れい, 西本れい, 谷真規子, 金澤伴幸, 清水一好, 森松博史

日本集中治療医学会中国・四国支部学術集会プログラム・抄録集(Web)   5th   2021年

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アンジオテンシン変換酵素阻害薬、アンジオテンシン2受容体拮抗薬の休薬が周術期の血圧に与える影響

井川 祐輔, 中村 水紀, 猪田 宏美, 錦織 淳美, 北村 佳久, 千堂 年昭, 小林 求, 森松 博史

日本臨床麻酔学会誌   40 ( 6 )   S351 - S351   2020年10月

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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眼科治療難治性の眼痛を呈した3症例

更科 紗和子, 松崎 孝, 栗田 真佐子, 小野 大輔, 武藤 典子, 中村 龍, 保田 裕子, 賀来 隆治, 森松 博史

日本ペインクリニック学会誌   27 ( 3 )   P3 - 49   2020年10月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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ICUでの術後せん妄と術中Double Lowとの関連

山之井 智子, 鈴木 聡, 西本 れい, 賀来 隆治, 森松 博史

日本集中治療医学会雑誌   27 ( Suppl. )   503 - 503   2020年9月

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記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

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【最期まで口から食べられるための医科歯科多職種連携の展開】医科歯科多職種チームによる効率的かつ効果的な術前・術中・術後管理

森松 博史, 花岡 愛弓, 山中 玲子

地域連携入退院と在宅支援   12 ( 6 )   70 - 81   2020年1月

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記述言語：日本語   出版者・発行元：日総研出版  

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リクルートメント手技が全身麻酔下の仰臥位と頭低位時の呼吸・循環動態に与える影響-大動物を用いた検討-

小坂順子, 清水一好, 森松博史

日本呼吸療法医学会学術集会プログラム・抄録集   42nd   2020年

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早期治療介入した産後発症のSystemic capillary leak syndrome

坂本里沙, 林真雄, 駿河磨矢, 佐倉孝信, 西本れい, 山之井智子, 黒田浩佐, 鈴木聡, 松岡義和, 森松博史

日本集中治療医学会学術集会(Web)   47th   2020年

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αアドレナリン受容体刺激によるGLT-1発現の低下が慢性痛モデルラットのmirror image pain発症に関係する

中塚洸輔, 松岡義和, 栗田真佐子, 賀来隆治, 森松博史

日本麻酔科学会学術集会(Web)   67th   2020年

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交通外傷後の肺コンプライアンス低下症例の術中管理において自発呼吸の回復により酸素化が改善した1症例

清水達彦, 清水一好, 大倉靖子, 森松博史

日本呼吸療法医学会学術集会プログラム・抄録集   42nd   2020年

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先天性心疾患合併妊婦に対する硬膜外無痛分娩の安全性の検討

駿河磨矢, 金澤伴幸, 清水一好, 岩崎達雄, 森松博史

日本麻酔科学会学術集会(Web)   67th   2020年

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開胸術後痛を有する患者の反対側肺切除に多職種で介入することにより遷延痛が回避できた2症例

松崎 孝, 小野 大輔, 栗田 真佐子, 更科 紗和子, 谷口 新, 賀来 隆治, 森松 博史

日本ペインクリニック学会誌   26 ( 4 )   334 - 334   2019年10月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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下部胸椎硬膜外穿刺時に発生した予期せぬ踵痛の1症例

池田 遼太郎, 松崎 孝, 小野 大輔, 賀来 隆治, 森松 博史

臨床麻酔   43 ( 10 )   1399 - 1400   2019年10月

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記述言語：日本語   出版者・発行元：真興交易(株)医書出版部  

硬膜外麻酔に関連した神経障害性疼痛の発生頻度は稀であり、一過性かつ自然経過で早期に改善することが報告されている。硬膜外穿刺を下位胸椎より穿刺した場合に生じる症状は、胸部や背中の違和感が通常考えやすいが、刺入部位の症状と乖離する踵の痛みが生じ下肢の神経障害性疼痛をきたした症例を経験した。(著者抄録)

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小児開心術における中枢神経障害 チアノーゼ疾患の周術期管理

金澤 伴幸, 岩崎 達雄, 森松 博史

Cardiovascular Anesthesia   23 ( Suppl. )   [SY4 - 2]   2019年9月

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記述言語：日本語   出版者・発行元：(一社)日本心臓血管麻酔学会  

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疼痛管理に難渋した治療後有痛性神経障害の1症例

角森 雅樹, 松崎 孝, 小野 大輔, 谷口 新, 賀来 隆治, 森松 博史

ペインクリニック   40 ( 9 )   1231 - 1233   2019年9月

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記述言語：日本語   出版者・発行元：真興交易(株)医書出版部  

治療後有痛性神経障害は、長期間放置された高血糖状態を急激に補正した後に発症し、通常時間経過とともに痛みの改善を認める。今回、われわれは、痛みの悪循環を呈した治療後有痛性神経障害の症例を経験した。種々の薬物療法・神経ブロックを行ったが鎮痛効果に乏しく、フェンタニルクエン酸塩貼付剤を導入したところ、痛みのコントロールが得られた。治療後有痛性神経障害での痛みの悪循環に対して、一時的なオピオイド鎮痛薬の導入は有効であると考えられた。(著者抄録)

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岡山大学病院ペインセンターにおける開胸術後遷延痛に対する取り組み

松崎 孝, 小野 大輔, 栗田 眞佐子, 角森 雅樹, 谷口 新, 更科 紗和子, 賀来 隆治, 森松 博史

日本ペインクリニック学会誌   26 ( 3 )   P2 - 44   2019年6月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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症例カンファレンス CRT-D挿入患者の胃癌手術

安田 篤史, 林 怜史, 尾頭 希代子, 松崎 孝, 森松 博史

LiSA   26 ( 4 )   309 - 325   2019年4月

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記述言語：日本語   出版者・発行元：(株)メディカル・サイエンス・インターナショナル  

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J02927&link_issn=&doc_id=20190410180005&doc_link_id=10.11477%2Fmf.3101201348&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.3101201348&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

疼痛管理に難渋した治療後有痛性神経障害の1症例

角森 雅樹, 松崎 孝, 小野 大輔, 賀来 隆治, 森松 博史

日本臨床麻酔学会誌   38 ( 6 )   S268 - S268   2018年10月

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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フォンタン術後患者の非開心術の麻酔管理 フォンタン患者に対する腹腔鏡下食道裂孔ヘルニアの麻酔管理

金澤 伴幸, 岩崎 達雄, 森松 博史

Cardiovascular Anesthesia   22 ( Suppl. )   125 - 125   2018年9月

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記述言語：日本語   出版者・発行元：(一社)日本心臓血管麻酔学会  

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医療用麻薬及びμ/δオピオイド受容体作動薬による各種オピオイド受容体の活性評価

藤井 百合子, 宮野 加奈子, 大島 佳織, 真鍋 星, 染谷 僚人, 吉澤 一巳, 森松 博史, 井関 雅子, 稲田 英一, 上園 保仁

日本ペインクリニック学会誌   25 ( 3 )   P4 - 67   2018年6月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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食道亜全摘手術患者における術前筋肉量が術後経過に与える影響

園井 みか, 伊藤 真理, 足羽 孝子, 前田 直見, 二宮 卓之, 田邊 俊介, 野間 和広, 白川 靖博, 藤原 俊義, 森松 博史

日本食道学会学術集会プログラム・抄録集   72回   315 - 315   2018年6月

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記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

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神経切離術で改善した前皮神経絞扼症候群(ACNES)の3症例

小野 大輔, 松崎 孝, 谷口 新, 賀来 隆治, 森松 博史, 近藤 喜太

日本ペインクリニック学会誌   25 ( 3 )   P2 - 2   2018年6月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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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

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記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

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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

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記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

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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

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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

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記述言語：日本語   出版者・発行元：(株)ジェフコーポレーション  

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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

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J-GLOBAL

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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

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J-GLOBAL

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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

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J-GLOBAL

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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

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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

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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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

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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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

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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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

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記述言語：日本語   出版者・発行元：日本プランニングセンター  

CiNii Article

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2017318909

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

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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

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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

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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

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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腹腔鏡下胃切除後の術後鎮痛方法の検討

木村 貴一, 松崎 孝, 菊地 覚次, 小野 大輔, 森松 博史

日本ペインクリニック学会誌   24 ( 3 )   219 - 219   2017年6月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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Milrinone Infusion Improves One-Year Survival After Norwood Sano Procedure

Tomoyuki Kanazawa, Hiroshi Morimatsu, Tatsuo Iwasaki, Kazuyoshi Shimizu, Kentaro Sugimoto

ANESTHESIA AND ANALGESIA   124   155 - 156   2017年5月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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【デスフルランを使いこなそう 1】総論 その特徴と注意点

山之井 智子, 賀来 隆治, 森松 博史

LiSA   24 ( 5 )   466 - 468   2017年5月

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記述言語：日本語   出版者・発行元：(株)メディカル・サイエンス・インターナショナル  

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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=J02927&link_issn=&doc_id=20170516220014&doc_link_id=10.11477%2Fmf.3101200855&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.3101200855&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

循環管理 : 成人期に達した先天性心疾患の周術期管理—Perioperative Management of Adult Congenital Heart Disease—特集 小児集中治療の新しい話題

黒江 泰利, 杉本 健太郎, 金澤 伴幸, 森松 博史, 岩崎 達雄

ICUとCCU = Japanese journal of intensive care medicine : 集中治療医学   41 ( 4 )   235 - 242   2017年4月

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記述言語：日本語   出版者・発行元：医学図書出版  

CiNii Article

CiNii Books

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その他リンク： https://search.jamas.or.jp/link/ui/2017189388

Perioperative Brain Natriuretic Peptide in Pediatric Cardiac Surgery Patients: Its Association With Postoperative Outcomes

Tomoyuki Kanazawa, Moritoki Egi, Yuichiro Toda, Kazuyoshi Shimizu, Kentaro Sugimoto, Tatsuo Iwasaki, Hiroshi Morimatsu

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA   31 ( 2 )   537 - 542   2017年4月

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記述言語：英語   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Objectives: The aim of this study was to investigate the relationship between perioperative brain natriuretic peptide levels and the incidence of postoperative serious adverse events (SAEs) in pediatric cardiac patients.
Design: A prospective observational study.
Setting: A single-institution university hospital.
Participants: Children under 15 years old who underwent cardiac surgery that required cardiopulmonary bypass from December 21, 2012 to February 26, 2014. The Risk Adjustment for Congenital Heart Surgery 1 category less than 1 was excluded.
Interventions: Brain natriuretic peptide (BNP) levels were measured preoperatively (BNPpre) and on postoperative day 1 (BNPpoDi) and postoperative day 3 (BNPpoD3).
Methods and Results: Primary outcome was the incidence of postoperative SAEs; (1) death in the intensive care unit, (2) requirement of extracorporeal membrane oxygenation, (3) cardiac arrest, and (4) requirement of reoperation for hemodynamic instability. The authors included 71 patients in this study. There were 8 patients (11%) who had at least 1 SAE. Median preoperative BNP level in patients with. SAEs was significantly higher than in those without SAEs (1,541 pg/mL [IQR: 121-5,962] v 122 pg/mL [QR: 34-342], p = 0.01). From the receiver operating characteristic curve of BNPpre for the incidence of SAEs, an area under the curve was 0.77 (95%CI 0.55-0.91). The best cutoff BNPpre number was 1,000 pg/mL. From the multivariate logistic regression model, BNPpre > 1,000 pg/mL was associated independently with risk of SAEs (adjusted odds ratio = 8.5, 95% CI [1.3, 59.3], p = 0.02).
Conclusions: In conclusion, the authors' study showed that increased preoperative brain natriuretic peptide concentration, especially a concentration of more than 1,000 pg/mL, was associated with risk of SAEs in pediatric. cardiac surgery patients. (C) 2017 Elsevier Inc. All rights reserved.

DOI： 10.1053/j.jvca.2016.09.008

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【突然死をきたす不整脈(致死的不整脈)と治療】カテコラミン誘発多形性心室頻拍

塩路 直弘, 金澤 伴幸, 森松 博史

臨床麻酔   41 ( 3 )   457 - 463   2017年3月

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記述言語：日本語   出版者・発行元：真興交易(株)医書出版部  

カテコラミン誘発多形性心室頻拍(Catecholaminergic polymorphic ventricular tachycardia:CPVT)は遺伝性不整脈疾患で突然死の原因となる。器質的心疾患がないこと、安静時心電図に異常がないこと、運動や情動による交感神経刺激で誘発される2方向性あるいは多形性の心室頻拍を特徴とする。β遮断薬が治療の中心になるが、治療中でも発作を起こす症例がある。本疾患は特異的な病態から急性期治療、周術期管理に特別の注意が必要で、病態生理を理解することが治療法の理解につながる。本稿ではCPVTの疾患の病態生理、分類、診断、慢性期治療について記述し、急性期治療、周術期管理について考察する。(著者抄録)

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Reverse Right Ventricular Remodeling After Lung Transplantation in Patients With Pulmonary Arterial Hypertension Under Combination Therapy of Targeted Medical Drugs

Toshihiro Sarashina, Kazufumi Nakamura, Satoshi Akagi, Takahiro Oto, Hiroki Oe, Kentaro Ejiri, Koji Nakagawa, Nobuhiro Nishii, Hiromi Matsubara, Motomu Kobayashi, Hiroshi Morimatsu, Shinichiro Miyoshi, Hiroshi Ito

CIRCULATION JOURNAL   81 ( 3 )   383 - 390   2017年3月

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記述言語：英語   出版者・発行元：JAPANESE CIRCULATION SOC  

Background: Patients with pulmonary arterial hypertension (PAH) are currently treated with combination therapy of PAH-targeted drugs. Reverse right ventricular (RV) remodeling after lung transplantation (LTx) in patients with end-stage PAH despite combination therapy of PAH-targeted drugs has not been fully elucidated.
Methods and Results: A total of 136 patients, including 32 with PAH, underwent LTx from 1998 to 2014. We enrolled 12 consecutive patients with PAH treated with combination therapy of PAH-targeted drugs who underwent LTx and retrospectively analyzed the temporal and serial changes in hemodynamics and echocardiography before LTx and at 3 and 12 months after LTx. Before LTx, the RV was markedly dilated with substantially reduced RV fractional area change (RVFAC). At 3 months after LTx, pulmonary artery pressure, pulmonary vascular resistance and RV stroke work index were significantly decreased, while left ventricular stroke work index was increased. RV size assessed by echocardiography also significantly decreased and RVFAC improved. At 12 months after LTx, RVFAC was further increased and RV wall thickness was decreased significantly.
Conclusions: Although severe RV dysfunction and dilation were observed in patients with end-stage PAH despite combination therapy of PAH-targeted drugs, RV function and morphology were improved after reduction of RV pressure load by LTx.

DOI： 10.1253/circj.CJ-16-0838

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NAVA : Neurally Adjusted Ventilatory Assist : 基礎と実践 (特集 急性期呼吸管理の基礎と実践)

塩路 直弘, 岡原 修司, 金澤 伴幸, 清水 一好, 森松 博史

ICUとCCU = Japanese journal of intensive care medicine : 集中治療医学   41 ( 1 )   21 - 27   2017年1月

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記述言語：日本語   出版者・発行元：医学図書出版  

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その他リンク： http://search.jamas.or.jp/link/ui/2017087182

High Ionized Calcium Concentration Is Associated With Prolonged Length of Stay in the Intensive Care Unit for Postoperative Pediatric Cardiac Patients 国際誌

Satoshi Kimura, Tatsuo Iwasaki, Katsunori Oe, Kazuyoshi Shimizu, Tomohiko Suemori, Tomoyuki Kanazawa, Naohiro Shioji, Yasutoshi Kuroe, Yuto Matsuoka, Hiroshi Morimatsu

Journal of Cardiothoracic and Vascular Anesthesia, Journal of Cardiothoracic Anesthesia   32 ( 4 )   371 - 377   2017年

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記述言語：英語  

DOI： 10.1053/j.jvca.2017.11.006

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急性期呼吸管理の基礎と実践 NAVA : Neurally Adjusted Ventilatory Assist:基礎と実践

塩路直弘, 岡原修司, 金澤伴幸, 清水一好, 森松博史

ICUとCCU   41 ( 1 )   2017年

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A Case of Refractory Systemic Capillary Leak Syndrome (Clarkson's Disease) during Pregnancy

Yukiko Hikasa, Masao Hayashi, Satoshi Suzuki, Hiroshi Morimatsu

ACTA MEDICA OKAYAMA   70 ( 6 )   497 - 501   2016年12月

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

A 32-year-old woman, pregnant with twins, presented with a chief complaint of general fatigue. Her general condition had rapidly deteriorated since her last visit to the primary obstetrician; the patient was then referred to our hospital because of suspected fetal death. She underwent emergency cesarean section because fetal death had indeed occurred, and she was then admitted to the intensive care unit (ICU). On ICI: admission, she was found to he in shock. Laboratory analysis revealed extreme hemoconcentration and a low albumin level, and initially, septic shock with obstetric complications was suspected. However, because she did not respond to conventional therapy but instead, rapidly developed severe generalized edema, systemic capillary leak syndrome (SCLS) was diagnosed. The patient remained in shock for several days until undergoing plasma exchange (PE), despite some earlier empirical treatments. She eventually recovered from profound shock status and was discharged from the ICU without sequelae. Among potentially effective treatments, PE seemed to be the most reasonable choice for the treatment of her SCLS.

DOI： 10.18926/AMO/54814

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INTRAOPERATIVE FLUID THERAPY IN VIDEO-ASSISTED THORACOSCOPIC ESOPHAGECTOMY: A RETROSPECTIVE STUDY

Yukiko Hikasa, Satoshi Suzuki, Tomoyuki Kanazawa, Masao Hayashi, Takashi Matsusaki, Kazuyoshi Shimizu, Hiroshi Morimatsu

CRITICAL CARE MEDICINE   44 ( 12 )   2016年12月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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Isoflurane Induces Transient Impairment of Retention of Spatial Working Memory in Rats

Masaaki Tanino, Motomu Kobayashi, Toshihiro Sasaki, Ken Takata, Yoshimasa Takeda, Satoshi Mizobuchi, Kiyoshi Morita, Taku Nagai, Hiroshi Morimatsu

ACTA MEDICA OKAYAMA   70 ( 6 )   455 - 460   2016年12月

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

Postoperative cognitive dysfunction (POCD) occurs in nearly one-third of patients after non-cardiac surgery. Many animal behavior studies have investigated the effect of general anesthesia on cognitive function. However, there have been no studies examining the effects on working memory specifically, with a focus on the retention of working memory. We demonstrate here that isoflurane anesthesia induces deficits in the retention of spatial working memory in rats, as revealed by an increase in isoflurane-induced across-phase errors in the delayed spatial win-shift (SWSh) task with a 30-min delay in an 8-arm radial arm maze on post-anesthesia days (PADs) 1,2,4, and 10. A post-hoc analysis revealed a significant increase in across-phase errors on PAD 1 and recovery on PAD 10 in the isoflurane group. In contrast, within-phase errors independent of the retention of working memory were unaffected by isoflurane. These results demonstrate that isoflurane anesthesia transiently impairs the retention of spatial working memory in rats.

DOI： 10.18926/AMO/54808

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THE STATE OF INTERVENTION BY BRAIN NATRIURETIC PEPTIDE VALUES IN PEDIATRIC CARDIAC SURGERY PATIENTS

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

CRITICAL CARE MEDICINE   44 ( 12 )   2016年12月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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Effect of Residual Cerebral Blood Flow During Ischemic Depolarization on Neuronal Cell Damage in Rats

Hirokazu Kawase, Yoshimasa Takeda, Ryoichi Mizoue, Sachiko Sato, Miki Fushimi, Hiroshi Morimatsu

CIRCULATION   134   2016年11月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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新生児の麻酔ぜよ!! 総肺静脈還流異常症、大血管転位症の麻酔管理

末盛 智彦, 塩路 直弘, 野々村 智子, 杉本 健太郎, 金澤 伴幸, 清水 一好, 岩崎 達雄, 森松 博史

日本臨床麻酔学会誌   36 ( 6 )   S196 - S196   2016年10月

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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術前肝硬変重症度と術後オピオイド使用量の関係

廣井 一正, 松崎 孝, 賀来 隆治, 森松 博史

日本ペインクリニック学会誌   23 ( 4 )   595 - 595   2016年10月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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症例 レボチロキシン内服中止により気管切開後気管狭窄が増悪した慢性甲状腺炎の1例

名原 功, 清水 一好, 片山 明, 川出 健嗣, 日笠 友起子, 林 真雄, 松岡 義和, 森松 博史

ICUとCCU = Japanese journal of intensive care medicine : 集中治療医学   40 ( 9 )   653 - 657   2016年9月

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記述言語：日本語   出版者・発行元：医学図書出版  

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その他リンク： http://search.jamas.or.jp/link/ui/2016359621

Analysis of Prognostic Factors of Hematopoietic Stem Cell Transplantation Patients Admitted to ICU

Malcoto Nakamura, Nobuharu Fujii, Kazuyoshi Shimizu, Hisakazu Nishimori, Ken-ichi Matsuoka, Eisei Kondo, Yoshinobu Maeda, Hiroshi Morimatsu, Mitsune Tanimoto

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION   22 ( 3 )   S293 - S293   2016年3月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：ELSEVIER SCIENCE INC  

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Urinary Albumin Levels Predict Development of Acute Kidney Injury After Pediatric Cardiac Surgery: A Prospective Observational Study

Kentaro Sugimoto, Yuichiro Toda, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tomoyuki Kanazawa, Noriko Muto, Hirokazu Kawase, Hiroshi Morimatsu, Kiyoshi Morita, Yohei Maeshima, Kiyoshi Mori, Shunji Sano

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA   30 ( 1 )   64 - 68   2016年2月

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記述言語：英語   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Objective: Mortality and morbidity of acute kidney injury (AKI) after cardiac surgery still remain high. The authors undertook the present study to evaluate the utility of early postoperative urinary albumin (uAlb) as a diagnostic marker for predicting occurrence of AKI and its severity in pediatric patients undergoing cardiac surgery.
Design: A prospective observational study.
Setting: A single-institution university hospital.
Participants: All patients <18 years of age who underwent repair of congenital heart disease with cardiopulmonary bypass between July 2010 and July 2012 were included in the study. Neonates age <1 month were excluded from the study population.
Interventions: The association between uAlb and occurrence of AKI within 3 days after admission to the intensive care unit was investigated. Criteria from pediatric modified Risk Injury Failure Loss and End-stage kidney disease (pRIFLE) were used to determine the occurrence of AKI. The value of uAlb was measured at intensive care unit admission immediately after cardiac surgery in all participants from whom a 5-mL urine sample was obtained.
Measurements and Main Results: Of 376 patients, AKI assessed by pRIFLE was identified in 243 (64.6%): 172 for risk (R; 45.7%), 44 for injury (I; 11.7%), and 27 for failure (F; 7.2%). One hundred thirty-three patients (35.4%) were classified as being without AKI (normal [N]) by pRIFLE. The concentration of uAlb was significantly higher in AKI patients than in non-AKI patients (median [interquartile range]): uAlb (mu g/mL): 13.5 (6.4-39.6) v 6.0 (3.4-16), p < 0.001; uAlb/Cr (mg/gCr): 325 (138-760) v 121 (53-269), p < 0.001.
Conclusions: The utility of uAlb for prompt diagnosis of AKI was shown. Obtaining uAlb measurements early after pediatric cardiac surgery may be useful for predicting the occurrence and severity of AKI. (C) 2016 Elsevier Inc. All rights reserved.

DOI： 10.1053/j.jvca.2015.05.194

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肝移植医療を地域と大学が一体としてまとめ上げた実績とさらなる発展

八木孝仁, 篠浦 先, 楳田祐三, 吉田龍一, 信岡大輔, 杭瀬 崇, 渡辺信之, 高木弘誠, 須井健太, 藤原俊義, 高木章乃夫, 吉田真理, 保田裕子, 森松博史

肝胆膵   72 ( 3 )   481 - 487   2016年

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Perioperative Management Center (PERIO) for Neurosurgical Patients

Takao Yasuhara, Tomohito Hishikawa, Takashi Agari, Kazuhiko Kurozumi, Tomotsugu Ichikawa, Masahiro Kameda, Aiko Shinko, Joji Ishida, Masafumi Hiramatsu, Motomu Kobayashi, Yoshikazu Matsuoka, Toshihiro Sasaki, Yoshihiko Soga, Reiko Yamanaka, Takako Ashiwa, Akemi Arioka, Yasuko Hashimoto, Ayasa Misaki, Yuriko Ishihara, Machiko Sato, Hiroshi Morimatsu, Isao Date

NEUROLOGIA MEDICO-CHIRURGICA   56 ( 9 )   574 - 579   2016年

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記述言語：英語   出版者・発行元：JAPAN NEUROSURGICAL SOC  

Perioperative management is critical for positive neurosurgical outcomes. In order to maintain safe and authentic perioperative management, a perioperative management center (PERIO) was introduced to patients of our Neurosurgery Department beginning in June 2014. PERIO involves a multidisciplinary team consisting of anesthesiologists, dentists/dental hygienists/technicians, nurses, physical therapists, pharmacists, and nutritionists. After neurosurgeons decide on the course of surgery, a preoperative evaluation consisting of blood sampling, electrocardiogram, chest X-ray, and lung function test was performed. The patients then visited the PERIO clinic 7-14 days before surgery. One or two days before surgery, the patients without particular issues enter the hospital and receive a mouth cleaning one day before surgery. After surgery, postoperative support involving eating/swallowing evaluation, rehabilitation, and pain control is provided. The differences in duration from admission to surgery, cancellation of surgery, and postoperative complications between PERIO and non-PERIO groups were examined. Eighty-five patients were enrolled in the PERIO group and 131 patients in the non-PERIO group. The duration from admission to surgery was significantly decreased in the PERIO group (3.6 +/- 0.3 days), compared to that in the non-PERIO group (4.7 +/- 0.2 days). There was one cancelled surgery in the PERIO group and six in the non-PERIO group. Postoperative complications and the overall hospital stay did not differ between the two groups. The PERIO system decreased the duration from admission to surgery, and it is useful in providing high-quality medical service, although the system should be improved so as not to increase the burden on medical staff.

DOI： 10.2176/nmc.oa.2016-0085

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iPS細胞から2型肺胞上皮細胞への分化誘導

林真雄, 神崎浩孝, 松岡義和, 森松博史

日本集中治療医学会学術集会(Web)   43rd   2016年

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術前ルーチン検査 : 海外のガイドライン,エビデンスから考える (特集 周術期マネジメント)

松﨑 孝, 森松 博史

Hospitalist = ホスピタリスト   4 ( 2 )   204 - 211   2016年

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記述言語：日本語   出版者・発行元：メディカル・サイエンス・インターナショナル  

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その他リンク： http://search.jamas.or.jp/link/ui/2016308707

小児心臓手術術後の血清Brain Natriuretic Peptide(BNP)に対する治療介入の現状

黒江泰利, 金澤伴幸, 塩路直弘, 野々村智子, 杉本健太郎, 末盛智彦, 清水一好, 岩崎達雄, 森松博史

Cardiovascular Anesthesia   20 ( Suppl )   2016年

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Intracranial hemorrhage and pneumozephalus after spinal cord tumor resection a case report

Keisuke Goda, Daniel Obata, Tomoyuki Kanazawa, Akiko Miyoshi, Toshihiro Sasaki, Tomohiko Suemori, Kazuyoshi Shimizu, Hiroshi Morimatsu

Japanese Journal of Anesthesiology   65 ( 12 )   1271 - 1275   2016年

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Kidney, fluid, and acid-base balance

Naohiro Shioji, Masao Hayashi, Hiroshi Morimatsu

Japanese Journal of Anesthesiology   65 ( 5 )   503 - 510   2016年

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記述言語：日本語   出版者・発行元：克誠堂出版  

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その他リンク： http://search.jamas.or.jp/link/ui/2016243341

Histidine-Rich Glycoprotein Prevents Septic Lethality through Regulation of Immunothrombosis and Inflammation.

Wake H, Mori S, Liu K, Morioka Y, Teshigawara K, Sakaguchi M, Kuroda K, Gao Y, Takahashi H, Ohtsuka A, Yoshino T, Morimatsu H, Nishibori M

EBioMedicine   9   180 - 194   2016年

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DOI： 10.1016/j.ebiom.2016.06.003

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コントロール不良の肺動脈性肺高血圧症に合併した急性肺動脈解離の一例

川出健嗣, 清水一好, 林真雄, 谷真規子, 鈴木聡, 金澤伴幸, 岩崎達雄, 森松博史

日本集中治療医学会雑誌(Web)   23 ( 3 )   2016年

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J-GLOBAL

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HISTIDINE-RICH GLYCOPROTEIN AS A NEW BIOMARKER FOR SEPSIS: COMPARISON TO PROCALCITONIN AND PRESEPSIN

Kosuke Kuroda, Hiroshi Morimatsu, Hidenori Wake, Shiji Mori, Masahiro Nishibori

CRITICAL CARE MEDICINE   43 ( 12 )   2015年12月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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岡山大学病院ICUにおける急性肝不全に対する肝移植までのBridging Therapyについて

賀来 隆治, 楳田 祐三, 松崎 孝, 柴田 麻里, 篠浦 先, 吉田 龍一, 信岡 大輔, 保田 裕子, 高木 章乃夫, 八木 孝仁, 森松 博史

移植   50 ( 4-5 )   477 - 478   2015年10月

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記述言語：日本語   出版者・発行元：(一社)日本移植学会  

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術後低換気高リスク患者における回復室でCapnostream 20を用いた呼吸状態の評価

黒江 泰利, 岡原 修司, 石井 賢造, 金澤 伴幸, 森松 博史

日本臨床麻酔学会誌   35 ( 6 )   S257 - S257   2015年10月

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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慢性疼痛患者に対するオピオイド使用経験 長期投与の検討

妹尾 悠祐, 松崎 孝, 谷口 新, 賀来 隆治, 森松 博史

日本臨床麻酔学会誌   35 ( 6 )   S310 - S310   2015年10月

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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Goal-Directed Therapy(目標指向型輸液療法)の実践 国内外の実例を交えて ERAS時代のGDT

松崎 孝, 賀来 隆治, 森松 博史

日本臨床麻酔学会誌   35 ( 6 )   S166 - S166   2015年10月

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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Cerebral Blood Flow Threshold Is Higher for Membrane Repolarization Than for Depolarization and Is Lowered by Intraischemic Hypothermia in Rats

Ryoichi Mizoue, Yoshimasa Takeda, Sachiko Sato, Ken Takata, Hiroshi Morimatsu

CRITICAL CARE MEDICINE   43 ( 9 )   E350 - E355   2015年9月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Objectives: To evaluate the cerebral blood flow thresholds for membrane depolarization and repolarization and the effect of brain hypothermia on the cerebral blood flow threshold for membrane repolarization.
Design: Prospective animal study.
Setting: Experimental laboratory in a university hospital.
Subjects: Male Sprague-Dawley rats (n = 40).
Interventions: Cerebral blood flow and membrane depolarization and repolarization in the cerebral cortex were simultaneously monitored by laser Doppler and extracellular potential, respectively. Following bilateral occlusion of the common carotid arteries, cerebral blood flow was decreased by draining blood at a rate of 2.5% of the control level/min until membrane depolarization was initiated. At 5 and 10 minutes (Normothermia 5 and Normothermia 10 groups, respectively) after depolarization onset, cerebral blood flow was restored at the same rate until membrane repolarization was observed. In some animals, intraischemic brain hypothermia targeting 31 degrees C was initiated immediately after the onset of depolarization (Hypothermia 5 and Hypothermia 10 groups).
Measurements and Main Results: The cerebral blood flow threshold for repolarization (46.5% +/- 12%) was significantly higher than that for depolarization (18.9% +/- 4.8%; p < 0.01) in the Normothermia 5 group and was further increased to 61.5% +/- 14% (p < 0.01) in the Normothermia 10 group. With initiation of hypothermia, the cerebral blood flow threshold for membrane repolarization was suppressed to 33.8% +/- 10% in the Hypothermia 5 group (p < 0.01 vs Normothermia 5 group) and was unaltered by prolongation of ischemia (Hypothermia 10 group; 36.6% +/- 6%).
Conclusions: Cerebral blood flow thresholds were significantly higher for repolarization than for depolarization and were further increased by prolonged ischemia. Intraischemic brain hypothermia decreased the repolarization threshold and abrogated the increase in the repolarization threshold caused by prolonged ischemia.

DOI： 10.1097/CCM.0000000000001095

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小児肝芽腫に対する生体肝移植術中の下大静脈-内頸静脈バイパス使用経験

熊田 雄太, 松崎 孝, 柴田 麻理, 賀来 隆治, 宮本 綾子, 吉田 龍一, 保田 裕子, 森松 博史

日本小児麻酔学会誌   21 ( 1 )   133 - 133   2015年8月

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記述言語：日本語   出版者・発行元：日本小児麻酔学会  

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当院における新たな脊髄硬膜外刺激電極療法の取り組み

松崎 孝, 賀来 隆治, 吉岡 清行, 西江 宏行, 佐藤 健治, 藤井 洋泉, 高須賀 功喜, 古川 達也, 森松 博史

日本ペインクリニック学会誌   22 ( 3 )   393 - 393   2015年6月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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Intraoperative change of lactate level is associated with postoperative outcomes in pediatric cardiac surgery patients: retrospective observational study

Tomoyuki Kanazawa, Moritoki Egi, Kazuyoshi Shimizu, Yuichiro Toda, Tatsuo Iwasaki, Hiroshi Morimatsu

BMC ANESTHESIOLOGY   15   29   2015年3月

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記述言語：英語   出版者・発行元：BIOMED CENTRAL LTD  

Background: A change of serum lactate concentrations appeared to be useful for predicting outcomes in various acute ill settings. However, there is little information on intraoperative change of lactate level in pediatric cardiac surgery patients.
Methods: We conducted a retrospective observational study of 459 children who received pediatric cardiac surgery to determine the association between change of lactate level after cardiopulmonary bypass (CPB) and patient prognosis (length of ICU stay and incidence of postoperative serious adverse events (SAEs)). We defined change of lactate level after CPB (LAC.) as (final lactate level measurement in the operating room) - (lactate level measured at the end of CPB). To study the independent association of LAC. with length of ICU stay, we used linear regression model.
Results: There were 1145 lactate measurements after CPB in this study cohort. After weaning from CPB, the serum lactate levels significantly increased from 2.1 mmol/L to 2.5 mmol/L (p < 0.001). Patients with higher LAC. had significantly longer stay in ICU (p = 0.017) and higher incidence of SAEs (p = 0.002). In multivariate linear regression analysis, higher LAC. showed a significant independent association with longer length of ICU stay.
Conclusions: Increased lactate level after CPB was associated with the longer duration of ICU stay and increased risk of postoperative SAEs in pediatric cardiac surgery patients. Future studies should be conducted to determine the clinical utility of intraoperative trend of lactate levels.

DOI： 10.1186/s12871-015-0007-y

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肝移植術中の酸素消費量の測定意義

柴田 麻理, 松崎 孝, 賀来 隆治, 藤井 洋泉, 森松 博史

日本集中治療医学会雑誌   22 ( Suppl. )   [DP62 - 3]   2015年1月

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記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

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ERASと周術期チーム医療

白川靖博, 加藤卓也, 竹原清人, 前田直見, 田辺俊介, 櫻間教文, 野間和広, 足羽孝子, 佐藤健治, 森松博史, 藤原俊義

臨床雑誌外科   77 ( 2 )   142 - 146   2015年

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AKIに対する急性血液浄化療法 (特集 Critical Care Nephrology)

黒江 泰利, 清水 一好, 森松 博史

The Japanese journal of nephrology = 日本腎臓学会誌   57 ( 2 )   308 - 312   2015年

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記述言語：日本語   出版者・発行元：日本腎臓学会  

CiNii Article

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2015189368

小児肺移植の麻酔および術後ICU管理

日笠友起子, 岡原修司, 清水一好, 小林求, 森松博史

移植(Web)   50 ( 6 )   2015年

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J-GLOBAL

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Management of Lacerated and Swollen Tongue after Convulsive Seizure with a Mouth Protector: Interprofessional Collaboration Including Dentists in Intensive Care

Reiko Yamanaka, Yoshihiko Soga, Yoshie Moriya, Akemi Okui, Tetsuo Takeuchi, Kenji Sato, Hiroshi Morimatsu, Manabu Morita

ACTA MEDICA OKAYAMA   68 ( 6 )   375 - 378   2014年12月

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

We encountered a 74-year-old male patient with tongue laceration after convulsive seizures under intensive care. The tongue showed severe swelling, and the right ventral surface had been lacerated by his isolated and pointed right lower canine. Our university hospital has established a perioperative management center, and is promoting interprofessional collaboration, including dentists, in perioperative management. Dentists collaborating in the perioperative management center took dental impressions, with the support of anesthesiologists who opened the patient's jaw under propofol sedation, to produce a mouth protector. By raising the patient's bite, the completed mouth protector prevented the isolated tooth from contacting the tongue and protected the lacerated wound. Use of the mouth protector prevented the lacerated tongue from coming into contact with the pointed tooth, and the tongue healed gradually. These findings underscore that interprofessional collaboration including dentists can improve the quality of medical care.

DOI： 10.18926/AMO/53027

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Living Will Interest and Preferred End-of-life Care and Death Locations among Japanese Adults 50 and over: A Population-based Survey

Hiroyuki Nishie, Satoshi Mizobuchi, Etsuji Suzuki, Kenji Sato, Yuichiro Toda, Junji Matsuoka, Hiroshi Morimatsu

ACTA MEDICA OKAYAMA   68 ( 6 )   339 - 348   2014年12月

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

The main purpose of this study was to determine the relationships between Japanese individuals' interest in living wills and their preferred end-of-life care and death locations. Questionnaires were mailed to 1,000 individuals aged >= 50 to measure these 2 factors. We examined the associations between the respondents' characteristics and their preferred care and death locations by using multinomial logistic regression models. The response rate was 74%. Home was the most frequently preferred place for end-of-life care (64%), and a palliative care unit (PCU) was the most commonly preferred place to die (51%). Living will interest was associated with a preference for care (odds ratio [OR] 4.74, 95% confidence interval [CI] 1.95-12.1) and death (OR 2.75, 95% CI 1.70-4.47) in a PCU rather than a hospital, but it was not associated with the choice between receiving care or dying at home instead of a hospital. We must consider why Japanese people think home death is impracticable. The Japanese palliative care system should be expanded to meet patients' end-of-life needs, and this includes not only facilitating home care but also increasing access to PCU care.

DOI： 10.18926/AMO/53023

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The association of plasma gamma-aminobutyric acid concentration with postoperative delirium in critically ill patients

Shiho Yoshitaka, Moritoki Egi, Tomoyuki Kanazawa, Yuichiro Toda, Kiyoshi Morita

CRITICAL CARE AND RESUSCITATION   16 ( 4 )   269 - 273   2014年12月

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記述言語：英語   出版者・発行元：AUSTRALASIAN MED PUBL CO LTD  

Objective: Delirium is a common complication in postoperative, critically ill patients. The mechanism of postoperative delirium is not well understood but many studies have shown significant associations between benzodiazepine use, alcohol withdrawal and cirrhosis, and an increased risk of delirium. We aimed to investigate a possible link with alterations of gamma-aminobutyric acid (GABA) activity.
Design, setting and participants: A prospective observational investigation of 40 patients >20 years old who had undergone elective surgery with general anaesthesia and were expected to need postoperative intensive care for more than 48 hours. We assessed postoperative delirium using the confusion assessment method in the intensive care unit at 1 hour after the operation and on postoperative Day (POD) 1 and POD 2. We collected blood samples for measurement of plasma GABA concentrations before the operation and on POD 1 and 2.
Main outcome measures: Postoperative delirium and perioperative plasma GABA concentrations in patients with and without delirium. Results: Postoperative delirium occurred in 13 of the patients. Patients with delirium had significantly higher Acute Physiology and Chronic Health Evaluation IF scores than patients without delirium. The mean plasma GABA concentration on POD 2 was significantly lower in patients with delirium than in those without delirium. After adjustment of relevant variables, plasma GABA concentration on POD 2 was independently associated with postoperative delirium.
Conclusions: Plasma GABA level on POD 2 has a significant independent association with postoperative delirium.

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周術期管理における気道および口腔ケアの重要性 (特集 口腔ケアは全身の健康に貢献する)

山中 玲子, 小林 求, 森松 博史

臨牀と研究   91 ( 10 )   1280 - 1284   2014年10月

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記述言語：日本語   出版者・発行元：大道学館出版部  

CiNii Article

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2015029994

筋萎縮性側索硬化症患者に対する肺切除術の麻酔経験

大岩 雅彦, 小林 求, 金澤 伴幸, 森松 博史

日本臨床麻酔学会誌   34 ( 6 )   S364 - S364   2014年10月

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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生体肝移植におけるBelmont Rapid Infuserの使用経験

松崎 孝, 柴田 麻里, 菊池 佳枝, 賀来 隆治, 岩崎 達雄, 藤井 洋泉, 森松 博史

日本臨床麻酔学会誌   34 ( 6 )   S309 - S309   2014年10月

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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ラジオ波経皮的椎間板髄核摘出術(Disk-Fx)に椎間板造影が有用であった3症例

石川 慎一, 荒川 恭佑, 木下 真佐子, 賀来 隆治, 西江 宏行, 佐藤 健治, 森松 博史

日本ペインクリニック学会誌   21 ( 3 )   456 - 456   2014年6月

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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肝移植術中酸素消費量測定の意義

柴田 麻理, 松崎 孝, 小幡 典彦, 賀来 隆治, 森松 博史, 楳田 祐三, 貞森 裕, 保田 裕子, 八木 孝人

移植   49 ( 1 )   120 - 120   2014年5月

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記述言語：日本語   出版者・発行元：(一社)日本移植学会  

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生体肝移植術中Bach 1 mRNA発現の意義

松崎 孝, 柴田 麻里, 小幡 典彦, 賀来 隆治, 森松 博史, 楳田 祐三, 貞森 裕, 保田 裕子, 八木 孝人

移植   49 ( 1 )   118 - 118   2014年5月

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記述言語：日本語   出版者・発行元：(一社)日本移植学会  

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筋弛緩薬投与を契機に呼吸循環不全が劇的に改善した肺高血圧症合併のFallot四徴症の一例.

石井南穂子, 金澤伴幸, 清水一好, 戸田雄一郎, 川瀬宏和, 武藤典子, 杉本健太郎, 岩崎達雄, 森松博史, 森田 潔

日本小児麻酔学会   20 ( 1 )   260 - 263   2014年

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記述言語：日本語   出版者・発行元：日本小児麻酔学会  

1歳6ヵ月男児。生下時にFallot四徴症と診断され、Blalock-Taussigシャント術、狭窄に対する頻回のバルーン拡張術、狭窄解除術が施行されていた。今回、左肺動脈(PA)狭窄に対しカテーテルによるバルーン拡張術が施行された。術中にPA損傷による肺出血を来たし、術前からの低酸素血症もあるため、術後ICUで筋弛緩薬を用いた完全鎮静・抜管管理を行うこととした。ICU入室後に肺出血は消失したが、低酸素血症は遷延した。PAの著明狭窄に伴う肺高血圧症と肺出血による肺のコンプライアンス低下が問題であったため、人工呼吸器のモードは鎮静下に自発呼吸を温存することが有利と考え、ICU入室2日目に筋弛緩薬の投与を中止したところ、呼吸循環不全を生じた。ICU入室5日目に筋弛緩薬投与を再開したところ、呼吸循環動態は著明に改善し、11日目に抜管に至り、18日目には一般病棟に転棟することができた。

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【新しい酸塩基平衡の考え方 Stewart approachを活用した患者病態の理解】 酸塩基平衡に関する歴史的変遷 過去・現在・未来.

森松博史

薬局   65 ( 6 )   1909 - 1911   2014年

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【新しい酸塩基平衡の考え方 Stewart approachを活用した患者病態の理解】 酸塩基平衡の体内調節 緩衝系による酸塩基平衡の調節機構.

森松博史

薬局   65 ( 6 )   1913 - 1915   2014年

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【徹底ガイド 急性血液浄化法2014-15】 (II章)急性血液浄化法の種類と原理 血液浄化と酸塩基平衡.

森松博史, 岡原修司

救急・集中治療   26 ( 3-4 )   297 - 302   2014年

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Stewart approachによる電解質異常の捉え方.

森松博史

麻酔   63 ( 増 )   S50-S54 - 54   2014年

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記述言語：日本語   出版者・発行元：克誠堂出版  

CiNii Article

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2015122765

周術期管理における気道および口腔ケアの重要性.

山中玲子, 小林 求, 森松博史

月刊 臨床と研究 別冊   34 ( 2 )   169 - 176   2014年

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アコースティック呼吸数モニタリングの気管切開患者での使用経験.

戸田雄一郎, 森松博史, 林真雄, 清水一好, 森田 潔

麻酔   63   161 - 163   2014年

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頸部経皮的椎間板髄核摘出術に対して超音波ガイド下に椎間板穿刺を施行した1症例

荒川恭佑, 石川慎一, 木下真佐子, 賀来隆治, 西江宏行, 佐藤健治, 森松博史

日本ペインクリニック学会誌   21 ( 3 )   2014年

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J-GLOBAL

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Up-regulation of brain-derived neurotrophic factor in the dorsal root ganglion of the rat bone cancer pain model

Naoto Tomotsuka, Ryuji Kaku, Norihiko Obata, Yoshikazu Matsuoka, Hirotaka Kanzaki, Arata Taniguchi, Noriko Muto, Hiroki Omiya, Yoshitaro Itano, Tadasu Sato, Hiroyuki Ichikawa, Satoshi Mizobuchi, Hiroshi Morimatsu

JOURNAL OF PAIN RESEARCH   7   415 - 423   2014年

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記述言語：英語   出版者・発行元：DOVE MEDICAL PRESS LTD  

Metastatic bone cancer causes severe pain, but current treatments often provide insufficient pain relief. One of the reasons is that mechanisms underlying bone cancer pain are not solved completely. Our previous studies have shown that brain-derived neurotrophic factor (BDNF), known as a member of the neurotrophic family, is an important molecule in the pathological pain state in some pain models. We hypothesized that expression changes of BDNF may be one of the factors related to bone cancer pain; in this study, we investigated changes of BDNF expression in dorsal root ganglia in a rat bone cancer pain model. As we expected, BDNF mRNA (messenger ribonucleic acid) and protein were significantly increased in L3 dorsal root ganglia after intra-tibial inoculation of MRMT-1 rat breast cancer cells. Among the eleven splice-variants of BDNF mRNA, exon 1-9 variant increased predominantly. Interestingly, the up-regulation of BDNF is localized in small neurons (mostly nociceptive neurons) but not in medium or large neurons (non-nociceptive neurons). Further, expression of nerve growth factor (NGF), which is known as a specific promoter of BDNF exon 1-9 variant, was significantly increased in tibial bone marrow. Our findings suggest that BDNF is a key molecule in bone cancer pain, and NGF-BDNF cascade possibly develops bone cancer pain.

DOI： 10.2147/JPR.S63527

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神経障害痛に対するリドカイン点滴の鎮痛効果 ペインビジョンによる評価.

藤井真樹子, 西江宏行, 溝渕知司, 五藤恵次, 森松博史

日本ペインクリニック学会誌   21 ( 2 )   124 - 128   2014年

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DOI： 10.11321/jjspc.13-0033

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Induction of hepatic Bach1 mRNA expression by carbon tetrachloride-induced acute liver injury in rats. 国際誌

Tanioka N, Shimizu H, Takahashi T, Omori E, Kuroda K, Shibata M, Yamaoka M, Toda Y, Matsusaki T, Morimatsu H

Biomed Rep   2 ( 3 )   359 - 363   2014年

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記述言語：英語  

PubMed

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アコースティック呼吸数モニタリングの気管切開患者での使用経験.

戸田雄一郎, 森松博史, 林 真雄, 清水一好, 森田 潔

麻酔   63 ( 2 )   161 - 163   2014年

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【AKI診療の進歩】 血管作動性物質.

清水一好, 森松博史

腎と透析   76 ( 4 )   476 - 478   2014年

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複雑心奇形の周術期管理 並列循環症例の管理.

岩崎達雄, 戸田雄一郎, 清水一好, 金澤伴幸, 森松博史, 森田 潔

日本臨床麻酔学会誌   34 ( 2 )   169 - 176   2014年

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

先天性心疾患で最もその生理が成人と異なり管理が困難な症例は,並列循環を伴う単心室症である.これらの患児は,まず第一期姑息術を受けるが,術後にも並列循環が残存するため周術期管理ではこの並列循環の管理が大切になる.理想的な並列循環を達成するために動脈血酸素飽和度のみならず体静脈血酸素飽和度をモニタリングして循環動態を正確に把握する.また体静脈血酸素飽和度は患児の予後予測,目標指向型治療の指標としても有用である.体・肺血流のバランスをとるために心拍出量,体・肺血管抵抗を調節するが,第一期姑息術後では体血管抵抗を調節する方がより効果的で,積極的な後負荷軽減療法は並列循環を安定させ,術後合併症を低減する.(著者抄録)

DOI： 10.2199/jjsca.34.169

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J01620&link_issn=&doc_id=20140319200001&doc_link_id=%2Fci4jjsca%2F2014%2F003402%2F001%2F0169-0176%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fci4jjsca%2F2014%2F003402%2F001%2F0169-0176%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Eisenmenger症候群に対する肺移植術後の急性左心不全の病態.

清水一好, 小林 求, 森松博史

日本集中治療医学会雑誌   21 ( 5 )   481 - 484   2014年

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記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J02874&link_issn=&doc_id=20141020410004&doc_link_id=10.3918%2Fjsicm.21.481&url=https%3A%2F%2Fdoi.org%2F10.3918%2Fjsicm.21.481&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

筋弛緩モニター使用下でのスガマデクス投与にもかかわらずロクロニウムの再クラーレ化が疑われた1例

伊加真士, 清水一好, 川出健嗣, 金澤伴幸, 西谷恭子, 森松博史

日本臨床麻酔学会誌   34 ( 6 )   2014年

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J-GLOBAL

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Development of a Supraglottic Airway Device with the Function of Pharyngeal Cooling

Yoshimasa Takeda, Hiroshi Hashimoto, Ryoichi Mizoue, Sachiko Sato, Hiroshi Morimatsu

CIRCULATION   128 ( 22 )   2013年11月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

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GAIA検索システムを用いた臨床研究の可能性

戸田雄一郎, 荒川恭佑, 森松博史, 青江尚美, 森田潔, 中塚秀輝

日本臨床麻酔学会誌   33 ( 6 )   S300   2013年10月

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記述言語：日本語  

J-GLOBAL

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腹臥位胸腔鏡下食道切除術中に大量出血による心停止をきたしたが後遺症なく救命し得た1例

植村 真弓, 小林 求, 川西 裕之, 岡原 修司, 松岡 義和, 森松 博史

日本臨床麻酔学会誌   33 ( 6 )   S240 - S240   2013年10月

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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Perioperative plasma melatonin concentration in postoperative critically ill patients: Its association with delirium

Shiho Yoshitaka, Moritoki Egi, Hiroshi Morimatsu, Tomoyuki Kanazawa, Yuichiro Toda, Kiyoshi Morita

JOURNAL OF CRITICAL CARE   28 ( 3 )   236 - 242   2013年6月

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記述言語：英語   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Purpose: Delirium is a common complication in postoperative critically ill patients. Although abnormal melatonin metabolism is thought to be one of the mechanisms of delirium, there have been few studies in which the association between alteration of perioperative plasma melatonin concentration and postoperative delirium was assessed.
Materials: We conducted a prospective observational study to assess the association of perioperative alteration of plasma melatonin concentration with delirium in 40 postoperative patients who required intensive care for more than 48 hours. We diagnosed postoperative delirium using Confusion Assessment Method for the intensive care unit and measured melatonin concentration 4 times (before the operation as the preoperative value, 1 hour after the operation, postoperative day 1, and postoperative day 2).
Results: Postoperative delirium occurred in 13 (33%) of the patients. Although there was no significant difference in preoperative melatonin concentration, Delta melatonin concentration at 1 hour after the operation was significantly lower in patients with delirium than in those without delirium (-1.1 vs 0 pg/mL, P = .036). After adjustment of relevant confounders, Delta melatonin concentration was independently associated with risk of delirium (odds ratio, 0.50; P = .047).
Conclusions: Delta melatonin concentration at 1 hour after the operation has a significant independent association with risk of postoperative delirium. (c) 2013 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.jcrc.2012.11.004

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Effects of Biliverdin Administration on Acute Lung Injury Induced by Hemorrhagic Shock and Resuscitation in Rats

Junko Kosaka, Hiroshi Morimatsu, Toru Takahashi, Hiroko Shimizu, Susumu Kawanishi, Emiko Omori, Yasumasa Endo, Naofumi Tamaki, Manabu Morita, Kiyoshi Morita

PLOS ONE   8 ( 5 )   e63606-e63606   2013年5月

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記述言語：英語   出版者・発行元：PUBLIC LIBRARY SCIENCE  

Hemorrhagic shock and resuscitation induces pulmonary inflammation that leads to acute lung injury. Biliverdin, a metabolite of heme catabolism, has been shown to have potent cytoprotective, anti-inflammatory, and anti-oxidant effects. This study aimed to examine the effects of intravenous biliverdin administration on lung injury induced by hemorrhagic shock and resuscitation in rats. Biliverdin or vehicle was administered to the rats 1 h before sham or hemorrhagic shock-inducing surgery. The sham-operated rats underwent all surgical procedures except bleeding. To induce hemorrhagic shock, rats were bled to achieve a mean arterial pressure of 30 mmHg that was maintained for 60 min, followed by resuscitation with shed blood. Histopathological changes in the lungs were evaluated by histopathological scoring analysis. Inflammatory gene expression was determined by Northern blot analysis, and oxidative DNA damage was assessed by measuring 8-hydroxy-2' deoxyguanosine levels in the lungs. Hemorrhagic shock and resuscitation resulted in prominent histopathological damage, including congestion, edema, cellular infiltration, and hemorrhage. Biliverdin administration prior to hemorrhagic shock and resuscitation significantly ameliorated these lung injuries as judged by histopathological improvement. After hemorrhagic shock and resuscitation, inflammatory gene expression of tumor necrosis factor-alpha and inducible nitric oxide synthase were increased by 18- and 8-fold, respectively. Inflammatory gene expression significantly decreased when biliverdin was administered prior to hemorrhagic shock and resuscitation. Moreover, after hemorrhagic shock and resuscitation, lung 8-hydroxy-2' deoxyguanosine levels in mitochondrial DNA expressed in the pulmonary interstitium increased by 1.5-fold. Biliverdin administration prior to hemorrhagic shock and resuscitation decreased mitochondrial 8-hydroxy-2' deoxyguanosine levels to almost the same level as that in the control animals. We also confirmed that biliverdin administration after hemorrhagic shock and resuscitation had protective effects on lung injury. Our findings suggest that biliverdin has a protective role, at least in part, against hemorrhagic shock and resuscitation-induced lung injury through anti-inflammatory and anti-oxidant mechanisms.

DOI： 10.1371/journal.pone.0063606

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Inhalation of carbon monoxide following resuscitation ameliorates hemorrhagic shock-induced lung injury

Susumu Kawanishi, Toru Takahashi, Hiroshi Morimatsu, Hiroko Shimizu, Emiko Omori, Kenji Sato, Masaki Matsumi, Shigeru Maeda, Atsunori Nakao, Kiyoshi Morita

MOLECULAR MEDICINE REPORTS   7 ( 1 )   3 - 10   2013年1月

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記述言語：英語   出版者・発行元：SPANDIDOS PUBL LTD  

Even after successful resuscitation, hemorrhagic shock frequently causes pulmonary inflammation that induces acute lung injury (ALI). We previously demonstrated that when CO is inhaled at a low concentration both prior to and following hemorrhagic shock and resuscitation (HSR) it ameliorates HSR-induced ALI in rats due to its anti-inflammatory effects. In the present study, we administered CO to the same model of ALI only after resuscitation and examined whether it exerted a therapeutic effect without adverse events on HSR-induced ALI, since treatment of animals with CO prior to HSR did not prevent lung injury. HSR were induced by bleeding animals to achieve a mean arterial pressure of 30 mmHg for I h followed by resuscitation with the removed blood. HSR resulted in the upregulation of inflammatory gene expression and increased the rate of apoptotic cell death in the lungs. This was determined from an observed increase in the number of cells positive for transferase-mediated dUTP-fluorescein isothiocyanate (FITC), nick-end labeling staining and activated caspase-3. HSR also resulted in prominent histopathological damage, including congestion, edema, cellular infiltration and hemorrhage. By contrast, CO inhalation for 3 h following resuscitation significantly ameliorated these inflammatory events, demonstrated by reduced histological damage, inflammatory mediators and apoptotic cell death. The protective effects of CO against lung injury were notably associated with an increase in the protein expression level of peroxisome proliferator-activated receptor (PPAR)-gamma, an anti-inflammatory transcriptional regulator in the lung. Moreover, CO inhalation did not affect the hemodynamic status or tissue oxygenation during HSR. These findings suggest that inhalation of CO at a low concentration exerts a potent therapeutic effect against HSR-induced ALI and attenuates the inflammatory cascade by increasing PPAR-gamma protein expression.

DOI： 10.3892/mmr.2012.1173

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【麻酔・全身管理で使用される薬物の基礎知識と使用法】 晶質液と膠質液.

森松博史

月刊レジデント   6 ( 12 )   90 - 95   2013年

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記述言語：日本語   出版者・発行元：医学出版  

CiNii Article

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その他リンク： http://search.jamas.or.jp/link/ui/2014041699

腎代替療法における抗凝固薬としてのクエン酸.

森松博史

日本集中治療医学会雑誌(1340-7988)   20 ( 4 )   577 - 579   2013年

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生体ガスと臓器保護 呼気COガスは酸化ストレスの指標か?

髙橋 徹, 森松博史

Medical Gases   15 ( 1 )   17 - 19   2013年

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【エビデンスを超えたCRRT】 CRRT開始をどう考えるべきか.

塩崎恭子, 森松博史, 森田 潔

医学のあゆみ(0039-2359)   245 ( 4 )   292 - 294   2013年

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重症呼吸不全に対するAirway Pressure Release Ventilationの肺酸素化能および循環動態に与える影響の検討.

岡原修司, 内藤宏道, 萩岡信吾, 森 直樹, 森松博史, 森田 潔

ICUとCCU(0389-1194)   37 ( 3 )   219 - 223   2013年

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記述言語：日本語   出版者・発行元：医学図書出版  

CiNii Article

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2013173039

Heme breakdown and ischemia/reperfusion injury in grafted liver during living donor liver transplantation

Junya Matsumi, Hiroshi Morimatsu, Takashi Matsusaki, Ryuji Kaku, Hiroko Shimizu, Toru Takahashi, Takahito Yagi, Masaki Matsumi, Kiyoshi Morita

INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE   29 ( 2 )   135 - 140   2012年2月

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記述言語：英語   出版者・発行元：SPANDIDOS PUBL LTD  

Living donor liver transplantation (LDLT) requires ischemia/reperfusion (I/R), which can cause early graft injury. However, the detailed mechanism of I/R injury remains unknown. Heme oxygenase-1 (HO-1) is a rate-limiting enzyme in heme catabolism and results in the production of iron, carbon monoxide (CO), and biliverdin IX alpha. Furthermore, in animals, HO-1 has a protective effect against oxidative stress associated with I/R injury. However, in humans, the molecular mechanism and clinical significance of HO-1 remain unclear. We previously demonstrated that exhaled CO levels increase during LDLT, and postulated that this may indicate I/R injury. In this study, we elucidate the origin of increased exhaled CO levels and the role of HO-1 in I/R injury during LDLT. We studied 29 LDLT donors and recipients each. For investigation of HO-I gene expression by polymerase chain reaction and HO-I localization by immunohistological staining, liver biopsies from the grafted liver were conducted twice, once before and once after I/R. Exhaled CO levels and HO-I gene expression levels significantly increased after I/R. In addition, HO-I levels significantly increased after I/R in Kupffer cells. Furthermore, we found a significant positive correlation between exhaled CO levels and HO-I gene expression levels. These results indicated that increased heme breakdown in the grafted liver is the source of increased exhaled CO levels. We also found a significant relationship between HO-1 gene expression levels and alanine aminotransferase (ALT) levels; i.e., the higher the HO-I gene expression levels, the higher the ALT levels. These results suggest that HO-1-mediated heme breakdown is caused by I/R during LDLT, since it is associated with increased exhaled CO levels and liver damage.

DOI： 10.3892/ijmm.2011.821

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The Incidence and Prognostic Value of Hypochloremia in Critically Ill Patients

Makiko Tani, Hiroshi Morimatsu, Fumiaki Takatsu, Kiyoshi Morita

SCIENTIFIC WORLD JOURNAL   2012   Epub-Epub   2012年

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記述言語：英語   出版者・発行元：HINDAWI PUBLISHING CORPORATION  

Little is known on the clinical effects of chloride on critically ill patients. We conducted this retrospective, observational study in 488 critically ill patients to investigate the incidence of chloride abnormalities, effects of hypochloremia in acid-base disorders, and association between chloride and clinical outcome. The study involved retrieval of arterial blood gas analyses, biochemical and demographical data from electrical records as well as quantitative acid-base analyses. For statistical analysis, the patients were stratified into three groups according to their chloride level (normal range: 98-106 mEq/L). The distribution of chloride levels was hyperchloremia 16.6%, normochloremia 74.6%, and hypochloremia 8.8%. The hypochloremic group was significantly alkalemic (P < 0.0001) and has significantly higher apparent strong ion difference (SIDa) (P < 0.0001) compared to the two other groups. The hypochloremic group had significantly longer stays in the ICU and hospital (P < 0.0001) with higher mortality (P < 0.0001). However, multiple regression analysis showed that chloride was not an independent factor of poorer outcome. In conclusion, the acid-base characteristics of the hypochloremic patients were alkalemia coexisting with higher SIDa. And although it was not an independent prognostic factor, hypochloremia was related to poorer outcome in critically ill settings.

DOI： 10.1100/2012/474185

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Increase in exhaled CO concentration after reperfusion of the grafted liver during living donor liver transplantation

Toru Takahashi, Hiroshi Morimatsu, Takashi Matsusaki, Junya Matsumi, Hiroko Shimizu, Kiyoshi Morita

INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE   30   S29 - S29   2012年

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：SPANDIDOS PUBL LTD  

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[術後管理]心臓手術後の管理は誰がやる？周術期管理は最初から最後まで麻酔科医に任せるべし.

松崎 孝, 森松博史

INTENSIVIST   4 ( 2 )   379 - 381   2012年

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【酸塩基平衡の臨床上の諸問題-代謝性アシドーシスに焦点を当てて-】 ICUにおける酸塩基平衡の理解 Stewart approach.

森松博史, 谷 真規子, 守屋佳恵, 森田 潔

Nephrology Frontier   11 ( 1 )   28 - 33   2012年

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低濃度一酸化炭素吸入はPPARγを介した抗炎症作用によってラット出血性ショック後の急性肺傷害に治療効果をもたらす.

川西 進, 高橋 徹, 清水裕子, 小坂順子, 黒田浩佐, 森松博史, 森田 潔

エンドトキシン・自然免疫研究   15   65 - 68   2012年

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記述言語：日本語   出版者・発行元：日本エンドトキシン・自然免疫研究会  

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Effect of tranexamic acid on blood loss in pediatric cardiac surgery: a randomized trial

Kazuyoshi Shimizu, Yuichiro Toda, Tatsuo Iwasaki, Mamoru Takeuchi, Hiroshi Morimatsu, Moritoki Egi, Tomohiko Suemori, Satoshi Suzuki, Kiyoshi Morita, Shunji Sano

JOURNAL OF ANESTHESIA   25 ( 6 )   823 - 830   2011年12月

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記述言語：英語   出版者・発行元：SPRINGER TOKYO  

Purpose The benefit of tranexamic acid (TXA) in pediatric cardiac surgery on postoperative bleeding has varied among studies. It is also unclear whether the effects of TXA differ between cyanotic patients and acyanotic patients. The aim of this study was to test the benefit of TXA in pediatric cardiac surgery in a well-balanced study population of cyanotic and acyanotic patients.
Methods A total of 160 pediatric patients undergoing cardiac surgery with cardiopulmonary bypass (81 cyanotic, 79 acyanotic) were included in this single-blinded, randomized trial at a tertiary care university-affiliated teaching hospital. Eighty-one children (41 cyanotic, 40 acyanotic) were randomly assigned to a TXA group, in which they received 50 mg/kg of TXA as a bolus followed by 15 mg/kg/h infusion and another 50 mg/kg into the bypass circuit. The other 79 patients were randomly assigned to a placebo group. The primary end point was the amount of 24-h blood loss.
Results The amount of 24-h blood loss was significantly less in the TXA group than in the placebo group [mean (95% confidence interval): 18.6 (15.8-21.4) vs. 23.5 (19.4-27.5) ml/kg, respectively; mean difference -4.9 (-9.7 to -0.01) ml/kg; p = 0.049]. This effect of TXA was already significant at 6 h [9.5 (7.5-11.5) vs. 13.2 (10.6-15.9) ml/kg, respectively; mean difference -3.47 (-7.0 to -0.4) ml/kg; p = 0.027]. However, there was no significant difference in the amount of blood transfusion between the groups. There was also no statistical difference in the effect of TXA in each cyanotic and acyanotic subgroup.
Conclusion TXA can reduce blood loss in pediatric cardiac surgery but not the transfusion requirement (http://ClinicalTrials.gov number NCT00994994).

DOI： 10.1007/s00540-011-1235-z

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肺高血圧を呈し心房中隔欠損症を持つ非代償性肝硬変症例に対する生体肝移植周術期管理経験

松三 絢弥, 小坂 順子, 賀来 隆治, 森松 博史, 森田 潔

日本臨床麻酔学会誌   31 ( 6 )   S429 - S429   2011年10月

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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Two cases of variceal haemorrhage during living-donor liver transplantation

T. Matsusaki, H. Morimatsu, T. Sato, J. Matsumi, N. Okazaki, Y. Umeda, K. Morita

BRITISH JOURNAL OF ANAESTHESIA   106 ( 4 )   537 - 539   2011年4月

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記述言語：英語   出版者・発行元：OXFORD UNIV PRESS  

Some patients with cirrhosis experience rupture of venous varices before operation, and liver transplantation is a therapy of last resort for these patients. However, we have experienced two cases of intraoperative rupture in whom no abnormalities of the venous varices were seen on endoscopy before operation. One patient with ruptured gastrointestinal varices was treated by direct surgical ligation and the other with ruptured oesophageal gastric varices, spontaneously recovered with a Sengstaken-Blakemore tube. These cases suggest that acute variceal haemorrhage should always be considered as a possibility during living-donor liver transplantation in patients with a history of upper gastrointestinal bleeding. Careful observation of the nasogastic tube is important during clamping of the hepatic portal vein.

DOI： 10.1093/bja/aer008

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Tetrastarch for fluid resuscitation in septic shock: Good news for the kidneys?

Takashi Matsusaki, Hiroshi Morimatsu

CRITICAL CARE MEDICINE   39 ( 4 )   905 - 906   2011年4月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

DOI： 10.1097/CCM.0b013e31820a4f61

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Pituitary apoplexy precipitating diabetes insipidus after living donor liver transplantation

Takashi Matsusaki, Hiroshi Morimatsu, Junya Matsumi, Hiroaki Matsuda, Tetsufumi Sato, Kenji Sato, Satoshi Mizobuchi, Takahito Yagi, Kiyoshi Morita

JOURNAL OF ANESTHESIA   25 ( 1 )   108 - 111   2011年2月

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記述言語：英語   出版者・発行元：SPRINGER TOKYO  

Pituitary apoplexy occurring after surgery is a rare but life-threatening acute clinical condition that follows extensive hemorrhagenous necrosis within a pituitary adenoma. Pituitary apoplexy has been reported to occur spontaneously in the majority of cases or in association with various inducing factors. Reported is a case of pituitary apoplexy complicated by diabetes insipidus following living donor liver transplantation (LDLT). To the best of our knowledge, this has not been previously reported. A 56-year-old woman with nonalcoholic steatohepatitis underwent LDLT from her daughter. The patient also required dopamine support and transfusions because of massive intraoperative bleeding. Postoperatively, her coagulopathy continued, and she underwent a second laparotomy because of unknown bleeding on postoperative day 7, when she needed transfusions and dopamine support to maintain her vital signs. She complained of severe headache, excessive thirst, frequent urination, and diplopia from postoperative day 10. She also had polyuria greater than 300 ml/h and was diagnosed with pituitary apoplexy precipitating diabetes insipidus on postoperative day 13. She was treated conservatively without surgery because of the hormonally inactive status and slight mass effect of her tumor. It is important for anesthesiologists and critical care personnel in LDLT settings to take into consideration this complication as a differential diagnosis.

DOI： 10.1007/s00540-010-1070-7

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生体肝移植術後に急激な凝固異常を認めたアラジール症候群の1例

小坂 順子, 森松 博史, 松三 絢弥, 林 真雄, 賀来 隆治, 佐藤 哲文, 森田 潔

日本集中治療医学会雑誌   18 ( Suppl. )   360 - 360   2011年1月

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記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

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生体肝移植後肝腎不全にて持続濾過透析中の高カルシウム血症の検討 ケースコントロール研究

松三 絢弥, 森松 博史, 小坂 順子, 賀来 隆治, 佐藤 哲文, 森田 潔

日本集中治療医学会雑誌   18 ( Suppl. )   369 - 369   2011年1月

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記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

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Ⅱ.集中治療からみた薬剤とエビデンス-ステロイドを考える 2.ドパミンの在り方.

森松博史, 森田 潔

Modern Physician   31 ( 5 )   610 - 613   2011年

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Rapid Response System(RRS)RRS導入5年の実態からみえてきた課題 メールの限界と起動基準の重要性.

森松博史, 丸山雅道

LiSA   18 ( 7 )   692 - 694   2011年

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食道癌術後の難治性発作性心房細動に対して塩酸ランジオロールを使用した7例の検討.

鈴木 聡, 森松博史, 江木盛時, 清水一好, 松崎 孝, 佐藤哲文, 片山 浩, 森田 潔

日本集中治療医学会雑誌   18 ( 2 )   215 - 220   2011年

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記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

術後の発作性心房細動の発生は、ICUや病院滞在日数、医療費の増加につながることが報告されており、その管理は重要である。我々は、食道癌術後に難治性の発作性心房細動を合併し、短時間作用型β1選択的遮断薬である塩酸ランジオロールを使用した7例を経験した。症例は51〜87歳で、いずれも男性であった。複数の抗不整脈薬が無効であり、塩酸ランジオロール投与を開始した。初期の急速投与は行わず、4.3〜33.5μg/kg/minと低用量の範囲で開始し、投与前と投与1時間後の心拍数は平均153[140、167][95%信頼区間]/minから101[88、116]/min(P<0.0001)と有意な低下を認めた。平均血圧は88[78、94]mmHgから82[74、89]mmHg(P=0.37)と有意な変化を認めず、重症な低血圧に陥る症例もなかった。6例では投与開始24時間以内に洞調律に回復した。複数の抗不整脈薬に抵抗性の食道癌術後発作性心房細動に対する低用量の塩酸ランジオロール投与は、大きな血圧の低下なく心拍数の安定をもたらした。(著者抄録)

DOI： 10.3918/jsicm.18.215

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J02874&link_issn=&doc_id=20110422460012&doc_link_id=20110422460001%2C20111017450026&url=http%3A%2F%2Fsearch.jamas.or.jp%2Flink%2Fbc%2F20110422460001%2C20111017450026&type=jamaslink&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F99999_1.gif

特集 周術期輸液・輸血管理のup-to-date アルブミン.

森松博史, 守屋佳恵, 谷 真規子, 森田 潔

ICUとCCU   35 ( 4 )   285 - 289   2011年

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記述言語：日本語   出版者・発行元：医学図書出版  

CiNii Article

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2011191584

医療ガスと中枢神経系 毒ときどき薬 一酸化炭素.

高橋 徹, 森松博史, 川西 進, 清水裕子, 森田 潔

Medical Gases   13 ( 1 )   24 - 26   2011年

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低濃度一酸化炭素吸入は自然免疫系の活性を抑制してラット出血性ショック後の急性肺障害を軽減する.

川西 進, 高橋 徹, 清水裕子, 小坂順子, 森松博史, 松三昌樹, 森田 潔

エンドトキシン・自然免疫研究   14   70 - 74   2011年

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記述言語：日本語   出版者・発行元：日本エンドトキシン・自然免疫研究会  

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急性腎障害（AKI）の診療 ３．集中治療領域におけるAKI.

森松博史, 森田 潔

Modern Physician   31 ( 1 )   13 - 16   2011年

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An increase in exhaled CO concentration in systemic inflammation/sepsis

Hiroshi Morimatsu, Toru Takahashi, Takashi Matsusaki, Masao Hayashi, Jyunya Matsumi, Hiroko Shimizu, Masaki Matsumi, Kiyoshi Morita

JOURNAL OF BREATH RESEARCH   4 ( 4 )   47103 - 47103   2010年12月

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記述言語：英語   出版者・発行元：IOP PUBLISHING LTD  

Despite recent progress in Critical Care Medicine, sepsis is still a major medical problem with a high rate of mortality and morbidity especially in intensive care units. Oxidative stress induced by inflammation associated with sepsis causes degradation of heme protein, increases microsomal free heme content, promotes further oxidative stress and results in cellular and organ damage. Heme-oxygenase-1 (HO-1) is a rate-limiting enzyme for heme breakdown. HO-1 breaks down heme to yield CO, iron and biliverdin. Measurement of CO in exhaled air may potentially be useful in monitoring changes in HO enzyme activity in vivo, which might reflect the degree of inflammation or oxidative stress in patients with systemic inflammation. The increased exhaled CO concentrations were observed after anesthesia/surgery, in critically ill patients and also in systemic inflammation/sepsis. Some reports also showed that exhaled CO concentration is related to mortality. Further studies are needed to elucidate whether increased endogenous CO production may predict a patient&apos;s morbidity and mortality. Techniques for monitoring CO are continuously being refined and this technique may find its way into the office of clinicians.

DOI： 10.1088/1752-7155/4/4/047103

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LONG TERM OUTOCOME IN CHILDREN WITH CONGENITAL HEART DISEASE WHO SUFFERED FROM ACUTE KIDNEY INJURY DURING POSTOPERATIVE ICU STAY

Yuichiro Toda, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tomohiko Suemori, Noriko Ishii, Hirokazu Kawase, Kentaro Sugimoto, Moritoki Egi, Hiroshi Morimatsu, Kiyoshi Morita

CRITICAL CARE MEDICINE   38 ( 12 )   U188 - U188   2010年12月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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Responses to surgical stress after esophagectomy Gene expression of heat shock protein 70, toll-like receptor 4, tumor necrosis factor-α and inducible nitric oxide synthase

Suzuki S, Morimatsu H, Omori E, Shimizu H, Takahashi H, Yamatsuji T, Naomoto Y, Morita K

Mol Med Rep   3 ( 5 )   765 - 769   2010年9月

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記述言語：英語  

DOI： 10.3892/mmr.2010.335

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Thrombotic microangiopathy after living-donor liver re-transplantation

Takashi Matsusaki, Hiroshi Morimatsu, Tetsufumi Sato, Kenji Sato, Satoshi Mizobuchi, Kiyoshi Morita

JOURNAL OF ANESTHESIA   24 ( 4 )   614 - 617   2010年8月

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記述言語：英語   出版者・発行元：SPRINGER TOKYO  

Thrombotic microangiopathy (TMA) is a rare but potentially lethal complication encountered in solid organ and bone marrow transplant recipients that requires rapid recognition, diagnosis, and initiation of therapy. Several causes have been identified, including viral infections and various medications. We report a case of TMA after living-donor liver transplantation (LDLT). A 60-year-old man underwent LDLT for end-stage liver disease secondary to hepatitis C virus. After 6 months, he required re-transplantation because graft failure was caused by a small-for-size graft. The immunosuppressive regimen for the second transplantation consisted of tacrolimus and prednisolone; cyclosporine (CsA), mycophenolate mofetil, and prednisolone had been used for the first transplantation. Despite multiple transfusions of packed red blood cells and concentrated platelets, his hemoglobin and platelets decreased and lactate dehydrogenase increased following re-transplantation. Hematological evaluation revealed findings consistent with TMA. As soon as TMA was diagnosed, the calcineurin inhibitor (CNI) was changed from tacrolimus to CsA, and fresh frozen plasma (FFP) was given. The patient&apos;s platelets gradually increased after the CNI was changed, and no transfusions were needed. Therefore, tacrolimus was suspected as the cause of the patient&apos;s TMA. Early diagnosis, switching CNIs, and FFP supplementation allowed the TMA to resolve without the need for plasma exchange.

DOI： 10.1007/s00540-010-0953-y

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Protective Effect of Carbon Monoxide Inhalation on Lung Injury After Hemorrhagic Shock/Resuscitation in Rats

Fumitoshi Kanagawa, Toru Takahashi, Kazuyoshi Inoue, Hiroko Shimizu, Emiko Omori, Hiroshi Morimatsu, Shigeru Maeda, Hiroshi Katayama, Atsunori Nakao, Kiyoshi Morita

JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE   69 ( 1 )   185 - 194   2010年7月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Background: Hemorrhagic shock and resuscitation (HSR) induces pulmonary inflammation that leads to acute lung injury. Carbon monoxide (CO), a by-product of heme catalysis, was shown to have potent cytoprotective and anti-inflammatory effects. The aim of this study was to examine the effects of CO inhalation at low concentration on lung injury induced by HSR in rats.
Methods: Rats were subjected to HSR by bleeding to achieve mean arterial pressure of 30 mm Hg for 60 minutes followed by resuscitation with shed blood and saline as needed to restore blood pressure. HSR animals were either maintained in room air or were exposed to CO at 250 ppm for 1 hour before and 3 hours after HSR.
Results: HSR caused an increase in the DNA binding activity of nuclear factor-kappa B and activator protein-1 in the lung followed by the up-regulation of pulmonary gene expression of tumor necrosis factor-alpha, inducible nitric oxide synthase, and interleukin (IL)-10. HSR also resulted in an increase in myeloperoxidase activity and wet weight to dry weight ratio in the lung, and more prominent histopathologic changes including congestion, edema, cellular infiltration, and hemorrhage. In contrast, CO inhalation significantly ameliorated these inflammatory events as judged by fewer histologic changes, less up-regulation of inflammatory mediators, and less activation of nuclear factor-kappa B and activator protein-1. Interestingly, the protective effects against lung injury afforded by CO were associated with further increases in mRNA expression of IL-10 in the lung.
Conclusions: These findings suggest that inhaled CO at a low concentration ameliorated HSR-induced lung injury and attenuated inflammatory cascades by up-regulation of anti-inflammatory IL-10.

DOI： 10.1097/TA.0b013e3181bbd516

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Role of heme oxygenase-1 in protection of the kidney after hemorrhagic shock

Yutaka Arimori, Toru Takahashi, Hiroyuki Nishie, Kazuyoshi Inoue, Hiroko Shimizu, Emiko Omori, Susumu Kawanishi, Yuichiro Toda, Hiroshi Morimatsu, Kiyoshi Morita

INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE   26 ( 1 )   27 - 32   2010年7月

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記述言語：英語   出版者・発行元：SPANDIDOS PUBL LTD  

Hemorrhagic shock followed by resuscitation (HSR) causes oxidative stress, which results in multiple organ damage. The kidney is one of the target organs of HSR-mediated oxidative tissue injury. Heme oxygenase (HO)-1, the rate-limiting enzyme in heme catabolism, is induced by oxidative stress; it protects against oxidative tissue injuries. The aim of the present study was to examine the role of renal HO-1 induction after HSR. Rats were subjected to hemorrhagic shock to achieve a mean arterial pressure of 30 mmHg for 60 min, followed by resuscitation with the shed blood. HSR resulted in a significant increase in functional HO-1 protein in the tubular epithelial cells of the kidney, whereas HSR resulted in only a slight increase in gene expression of tumor necrosis factor (TNE)-alpha and inducible nitric oxide synthase (iNOS), and in protein expression of activated caspase-3 solely in renal cells where HO-1 expression was absent. HSR also resulted in a significant increase in Bcl-2 gene expression. Pretreatment of HSR animals with tin-mesoporphyrin (0.5 mu mol/kg), a specific competitive inhibitor of HO activity, resulted in a significant decrease in HO activity and exacerbated tissue inflammation and apoptotic cell death as judged by the marked increase in expression of TNF-alpha and iNOS, and in activated caspase-3-positive cells, and the significant reduction in Bcl-2 expression, respectively. These findings indicate that HO-1 induction is an adaptive response to HSR-induced oxidative stress and is essential for protecting tubular epithelial cells from oxidative damage through its anti-inflammatory and anti-apoptotic properties.

DOI： 10.3892/ijmm_00000430

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肝切除術後鎮痛の検討:生体肝移植ドナーと腫瘍による肝切除患者の比較

塩崎恭子, 松崎孝, 中村龍, 中塚秀輝, 森松博史, 佐藤哲文, 溝渕知司, 森田潔

日本ペインクリニック学会誌   17 ( 2 )   185   2010年5月

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記述言語：日本語  

J-GLOBAL

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Plasma and urine neutrophil gelatinase-associated lipocalin in septic versus non-septic acute kidney injury in critical illness

Sean M. Bagshaw, Michael Bennett, Michael Haase, Anja Haase-Fielitz, Moritoki Egi, Hiroshi Morimatsu, Giuseppe D&apos;amico, Donna Goldsmith, Prasad Devarajan, Rinaldo Bellomo

INTENSIVE CARE MEDICINE   36 ( 3 )   452 - 461   2010年3月

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記述言語：英語   出版者・発行元：SPRINGER  

Sepsis is the most common trigger for acute kidney injury (AKI) in critically ill patients. We sought to determine whether there are unique patterns to plasma and urine neutrophil gelatinase-associated lipocalin (NGAL) in septic compared with non-septic AKI.
Prospective observational study.
Two adult ICUs in Melbourne, Australia.
Critically ill patients with septic and non-septic AKI.
None.
Blood and urine specimens collected at enrollment, 12, 24 and 48 h to measure plasma and urine NGAL. Eighty-three patients were enrolled (septic n = 43). Septic AKI patients had more co-morbid disease (p = 0.005), emergency surgical admissions (p &lt; 0.001), higher illness severity (p = 0.008), more organ dysfunction (p = 0.008) and higher white blood cell counts (p = 0.01). There were no differences at enrollment between groups in AKI severity. Septic AKI was associated with significantly higher plasma (293 vs. 166 ng/ml) and urine (204 vs. 39 ng/mg creatinine) NGAL at enrollment compared with non-septic AKI (p &lt; 0.001). Urine NGAL remained higher in septic compared with non-septic AKI at 12 h (p &lt; 0.001) and 24 h (p &lt; 0.001). Plasma NGAL showed fair discrimination for AKI progression (area under receiver-operator characteristic curve 0.71) and renal replacement therapy (AuROC 0.78). Although urine NGAL performed less well (AuROC 0.70, 0.70), peak urine NGAL predicted AKI progression better in non-septic AKI (AuROC 0.82).
Septic AKI patients have higher detectable plasma and urine NGAL compared with non-septic AKI patients. These differences in NGAL values in septic AKI may have diagnostic and clinical relevance as well as pathogenetic implications.

DOI： 10.1007/s00134-009-1724-9

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Serious Adverse Events(SAEs)と術中輸液管理の関係

塩崎恭子, 森松博史, 中村龍, 横山正尚, 中塚秀輝, 佐藤健治, 片山浩, 森田潔

日本集中治療医学会雑誌   17 ( Supplement )   374   2010年1月

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記述言語：日本語  

J-GLOBAL

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大学病院における高度侵襲手術後のSerious Adverse Events(SAEs)

森松博史, 横山正尚, 中塚秀輝, 中村龍, 塩崎恭子, 佐藤健治, 森田潔

日本集中治療医学会雑誌   17 ( Supplement )   252   2010年1月

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記述言語：日本語  

J-GLOBAL

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大動脈弁置換術中の大動脈遮断解除直後に発生した難治性心室細動に対して塩酸アミオダロン静脈内投与が奏効した1症例

鈴木 聡, 岩崎達雄, 森松博史, 横井 渚, 松岡舞夕子, 末盛智彦, 金澤伴幸, 清水一好, 戸田雄一郎, 森田 潔

麻酔   59 ( 10 )   1266 - 1270   2010年

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記述言語：日本語   出版者・発行元：克誠堂出版(株)  

66歳男。労作時呼吸困難が持続し、高度大動脈弁狭窄症の診断で大動脈弁置換術が予定された。手術開始から大きな問題なく人工心肺開始、大動脈遮断となり、術操作も問題なく終了し、大動脈遮断時間は95分であった。遮断解除後に心室細動(VF)を認め、計3回の直流除細動器による電気ショックを行ったが改善せず、更に塩酸リドカインと硫酸マグネシウム液の静脈内投与後に計7回、次いで塩酸ニフェカラント投与後に計5回の電気ショックを行ったがVFは継続した。そこで、塩酸アミオダロンを静脈投与した後に電気ショックを行ったところ、1回で除細動に成功した。VFの持続時間は60分で、この間血液ガス分析では電解質や酸塩基平衡の異常はなかった。その後は心室ペーシング下で人工心肺を離脱し、手術終了となった。術後は塩酸アミオダロン、塩酸ランジオロールの静脈内持続投与を行い、VFの再発はなく、4日目に中止した。術後13日目にICUを退室し、63日目に退院した。

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【集中治療とMET(Medical Emergency Team)/RRT(Rapid Response Team)】 諸外国での現状

森松博史, 塩崎恭子, 中村龍, 森田 潔

ＩＣＵとＣＣＵ   34 ( 6 )   447 - 452   2010年

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記述言語：日本語   出版者・発行元：医学図書出版  

CiNii Article

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2010260735

【CRRT】 開始・中止のタイミング

森松博史

Intensivist   2 ( 2 )   257 - 262   2010年

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記述言語：日本語   出版者・発行元：メディカル・サイエンス・インターナショナル  

CiNii Article

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2010219045

【CRRT】 PMX-EUPHAS studyについて考える

森松博史

Intensivist   2 ( 2 )   395 - 397   2010年

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グルタミンはHo-1誘導を介して自然免疫系の活性化を抑制し出血性ショック後の腸管障害を軽減する

高橋 徹, 井上一由, 清水裕子, 楳田佳奈, 有森 豊, 川西 進, 松三昌樹, 片山 浩, 森松博史, 森田 潔

エンドトキシン研究   10   65 - 68   2010年

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集中治療室での先天性心疾患におけるベクロニウム持続投与 挿管時間との関係

清水一好, 森松博史, 戸田雄一郎, 鈴木 聡, 金澤伴幸, 末盛智彦, 岩崎達雄, 森田 潔

日本集中治療医学会雑誌   17 ( 3 )   353 - 354   2010年

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記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

2006年12月〜2007年6月に、ICU入室後に筋弛緩薬を持続投与された先天性心疾患40例(6.3〜15.8ヵ月・平均11ヵ月)を対象に、挿管時間への影響因子について検討した。40例のうち37例(92.5%)は心臓手術後患者で、施行術式はRACHS-1カテゴリーで2.8〜3.6(平均3.2)、人工心肺時間92〜140分(平均116分)、大動脈遮断時間49〜82分(平均65分)、人工心肺中の冷却温度は24.8〜28.4℃(平均26.6℃)であった。ICU入室中に投与したベクロニウムの総投与量は3.3〜11.7mg・kg-1(平均7.5mg・kg-1)、持続投与中止から抜管までの時間は48.4〜153.9時間(平均101.1時間)と4日間を要していた。そのうち約80%の症例は100時間以内に抜管可能であった。5例は抜管まで200時間以上と長時間を要した。挿管時間と各因子の比例ハザードモデルによる単変量解析の結果、ベクロニウム総投与量と人工心肺冷却温度が有意に独立した危険因子であった。

DOI： 10.3918/jsicm.17.353

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骨髄移植後呼吸不全に陥った重症Veno-Occlusive Diseaseの小児症例

横井 渚, 戸田雄一郎, 森松博史, 松﨑 孝, 鈴木 聡, 江木盛時, 片山 浩, 森田 潔

ＩＣＵとＣＣＵ   34 ( 11 )   1007 - 1011   2010年

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LOW ANTITHROMBIN III LEVEL AND MORTALITY IN CRITICALLY ILL PATIENTS

Shiho Takenouchi, Moritoki Egi, Hiroshi Morimatsu, Yuichiro Toda, Kazuyoshi Shimizu, Kiyoshi Morita

CRITICAL CARE MEDICINE   37 ( 12 )   A126 - A126   2009年12月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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ALTERATIONS OF PITUITARY HORMONES AFTER PEDIATRIC CARDIAC SURGERY

Kazuyoshi Shimizu, Hiroshi Morimatsu, Yuichiro Toda, Moritoki Egi, Tomohiko Suemori, Satoshi Suzuki, Tatsuo Iwasaki, Kiyoshi Morita

CRITICAL CARE MEDICINE   37 ( 12 )   A113 - A113   2009年12月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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PERIOPERATIVE GLUCOSE VARIABILITY AND OXIDATIVE STRESS IN CARDIAC SURGERY PATIENTS

Moritoki Egi, Kazuyoshi Shimizu, Yuichiro Toda, Tatsuo Iwasaki, Hiroshi Morimatsu, Kiyoshi Morita

CRITICAL CARE MEDICINE   37 ( 12 )   A112 - A112   2009年12月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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Discontinuation of continuous renal replacement therapy: A post hoc analysis of a prospective multicenter observational study

Shigehiko Uchino, Rinaldo Bellomo, Hiroshi Morimatsu, Stanislao Morgera, Miet Schetz, Ian Tan, Catherine Bouman, Ettiene Macedo, Noel Gibney, Ashita Tolwani, Heleen Oudemans-van Straaten, Claudio Ronco, John A. Kellum

CRITICAL CARE MEDICINE   37 ( 9 )   2576 - 2582   2009年9月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Objectives: To describe current practice for the discontinuation of continuous renal replacement therapy in a multinational setting and to identify variables associated with successful discontinuation. The approach to discontinue continuous renal replacement therapy may affect patient outcomes. However, there is lack of information on how and under what conditions continuous renal replacement therapy is discontinued.
Design: Post hoc analysis of a prospective observational study.
Setting. Fifty-four intensive care units in 23 countries.
Patients: Five hundred twenty-nine patients (52.6%) who survived initial therapy among 1006 patients treated with continuous renal replacement therapy.
Interventions: None.
Measurements and Main Results., Three hundred thirteen patients were removed successfully from continuous renal replacement therapy and did not require any renal replacement therapy for at least 7 days and were classified as the "success" group and the rest (216 patients) were classified as the "repeat-RRT" (renal replacement therapy) group. Patients in the "success" group had lower hospital mortality (28.5% vs. 42.7%, p &lt; .0001) compared with patients in the "repeat-RRT" group. They also had lower creatinine and urea concentrations and a higher urine output at the time of stopping continuous renal replacement therapy. Multivariate logistic regression analysis for successful discontinuation of continuous renal replacement therapy identified urine output (during the 24 hrs before stopping continuous renal replacement therapy: odds ratio, 1.078 per 100 mL/day increase) and creatinine (odds ratio, 0.996 per mu mol/L increase) as significant predictors of successful cessation. The area under the receiver operating characteristic curve to predict successful discontinuation of continuous renal replacement therapy was 0.808 for urine output and 0.635 for creatinine. The predictive ability of urine output was negatively affected by the use of diuretics (area under the receiver operating characteristic curve, 0.671 with diuretics and 0.845 without diuretics).
Conclusions. We report on the current practice of discontinuing continuous renal replacement therapy in a multinational setting. Urine output at the time of initial cessation (if continuous renal replacement therapy was the most important predictor of successful discontinuation, especially if occurring without the administration of diuretics. (Crit Care Med 2009; 37:2576-2582)

DOI： 10.1097/CCM.0b013e3181a38241

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肝切除術後鎮痛の検討:静脈内PCA法と硬膜外PCEA法の比較

塩崎恭子, 松崎孝, 梶原秀年, 溝渕知司, 佐藤哲文, 森松博史, 中塚秀輝, 西江宏行, 佐藤健治, 森田潔

日本ペインクリニック学会誌   16 ( 3 )   430   2009年6月

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記述言語：日本語  

J-GLOBAL

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Non-overt disseminated intravascular coagulation scoring for critically ill patients: The impact of antithrombin levels

Moritoki Egi, Hiroshi Morimatsu, Christian J. Wiedermann, Makiko Tani, Tomoyuki Kanazawa, Satoshi Suzuki, Takashi Matsusaki, Kazuyoshi Shimizu, Yuichiro Toda, Tatsuo Iwasaki, Kiyoshi Morita

THROMBOSIS AND HAEMOSTASIS   101 ( 4 )   696 - 705   2009年4月

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記述言語：英語   出版者・発行元：SCHATTAUER GMBH-VERLAG MEDIZIN NATURWISSENSCHAFTEN  

Validation of a scoring algorithm for non-overt disseminated intravascular coagulation (DIC) proposed by the International Society on Thrombosis and Haemostasis (ISTH) is still incomplete. It was the objective of this study to assess the impact of including AT to non-overt DIC scoring on the predictability for intensive care unit (ICU) death and the later development of overt-DIC defined by the Japanese Ministry of Health and Welfare (JMHW) or the ISTH. We performed a retrospective observational study conducted in 364 patients in critical care. Coagulation parameters obtained daily for DIC screening were utilised for scoring. There were 194 and 196 patients scored as positive non-overt DIC with and without AT, respectively; diagnostic agreement between the two was 78%. As compared with patients without non-overt DIC, these non-overt DIC patients had significantly higher mortality. In 37 ICU non-survivors, positive non-overt DIC scoring with AT preceded ICU death by a median of 6.8 days, which was significantly earlier as compared with a median of 5.4 days for non-overt DIC without AT (p=0.022). In patients who developed overt-DIC after admission, the time period from positive non-overt DIC to positive overt-DIC was significantly longer when AT was utilised (overt-DIC ISTH; 1.3 days vs. 0.1 days, p=0.004, overt-DIC JMHW; 2.5 days vs. 2.0 days, p=0.04, with AT vs. without AT, respectively). Non-overt DIC scoring predicted a high risk of death in critically ill patients. When information on AT levels was included, non-overt DIC scoring was found to predict development of overt-DIC significantly earlier than non-overt DIC scoring without AT.

DOI： 10.1160/TH08-07-0448

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Timing of renal replacement therapy and clinical outcomes in critically ill patients with severe acute kidney injury

Sean M. Bagshaw, Shigehiko Uchino, Rinaldo Bellomo, Hiroshi Morimatsu, Stanislao Morgera, Miet Schetz, Ian Tan, Catherine Bouman, Ettiene Macedo, Noel Gibney, Ashita Tolwani, Heleen M. Oudemans-van Straaten, Claudio Ronco, John A. Kellum

JOURNAL OF CRITICAL CARE   24 ( 1 )   129 - 140   2009年3月

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記述言語：英語   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Purpose: The aim of this study is to evaluate the relationship between timing of renal replacement therapy (RRT) in severe acute kidney injury and clinical outcomes.
Methods: This was a prospective multicenter observational study conducted at 54 intensive care units (ICUs) in 23 countries enrolling 1238 patients.
Results: Timing of RRT was stratified into "early" and "late" by median urea and creatinine at the time RRT was started. Timing was also categorized temporally from ICU admission into early (&lt;2 days), delayed (2-5 days), and late (&gt;5 days). Renal replacement therapy timing by serum urea showed no significant difference in crude (63.4% for urea &lt;= 24.2 mmol/L vs 61.4% for urea &gt;24.2 mmol/L; odds ratio [OR], 0.92; 95% confidence interval [CI], 0.73-1.15; P = .48) or covariate-adjusted mortality (OR, 1.25; 95% CI, 0.91-1.70; P = .16). When stratified by creatinine, late RRT was associated with lower crude (53.4% for creatinine &gt;309 mu mol/L vs 71.4% for creatinine &lt;= 309 mu mol/L; OR, 0.46; 95% CI, 0.36-0.58; P &lt; .0001) and covariate-adjusted mortality (OR, 0.51; 95% CI, 0.37-0.69; P &lt; .001).However, for timing relative to ICU admission, late RRT was associated with greater crude (72.8% vs 62.3% vs 59%, P &lt; .001) and covariate-adjusted mortality (OR, 1.95; 95% CI, 1.30-2.92; P = .001). Overall, late RRT was associated with a longer duration of RRT and stay in hospital and greater dialysis dependence.
Conclusion: Timing of RRT, a potentially modifiable factor, might exert an important influence on patient survival. However, this largely depended on its definition. Late RRT (days from admission) was associated with a longer duration of RRT, longer hospital stay, and higher dialysis dependence. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.jcrc.2007.12.017

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PREVENTION OF HEMORRHAGIC SHOCK-INDUCED INTESTINAL TISSUE INJURY BY GLUTAMINE VIA HEME OXYGENASE-1 INDUCTION

Kana Umeda, Toru Takahashi, Kazuyoshi Inoue, Hiroko Shimizu, Shigeru Maeda, Hiroshi Morimatsu, Emiko Omori, Reiko Akagi, Hiroshi Katayama, Kiyoshi Morita

SHOCK   31 ( 1 )   40 - 49   2009年1月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Hemorrhagic shock (HS) is an oxidative stress that causes intestinal tissue injury. Heme oxygenase 1 (HO-1) is induced by oxidative stress and is thought to play an important role in the protection of tissues from oxidative injury. We previously reported the ileum to be the most susceptible to HS-induced tissue injury site in the intestine because HO-1 induction is the lowest at this site. We also previously demonstrated that glutamine (GLN) significantly induced HO-1 in the lower intestinal tract. In the present study, we investigated whether GLN pretreatment improves HS-induced intestinal tissue injury in the ileum by HO-1 induction. Treatment of rats with GLN (0.75 g/kg, i.v.) markedly induced functional HO-1 protein in mucosal epithelial cells in the ileum. Glutamine treatment before HS (MAP of 30 mmHg for 60 min) significantly ameliorated HS-induced mucosal inflammation and apoptotic cell death in the ileum, as judged by significant decreases in gene expression of TNF-alpha, iNOS, intercellular adhesion molecule 1, and vascular cell adhesion molecule 1, myeloperoxidase activity, the number of infiltrated neutrophils, DNA fragmentation by in situ oligo ligation assay, and activated caspase-3 expression, and by increases in gene expression of IL-10 and Bcl-2. In contrast, treatment with tin mesoporphyrin, a specific inhibitor of HO activity, abolished the beneficial effect of GLN pretreatment. These findings indicate that GLN pretreatment significantly ameliorated tissue injury in the ileum after HS by inducing HO-1. Glutamine treatment may thus protect mucosal cells from HS-induced oxidative damage via the anti-inflammatory and antiapoptotic properties of HO-1.

DOI： 10.1097/SHK.0b013e318177823a

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Heme Oxygenase-1 is an Essential Cytoprotective Component in Oxidative Tissue Injury Induced by Hemorrhagic Shock

Toru Takahashi, Hiroko Shimizu, Hiroshi Morimatsu, Kyoichiro Maeshima, Kazuyoshi Inoue, Reiko Akagi, Masaki Matsumi, Hiroshi Katayama, Kiyoshi Morita

JOURNAL OF CLINICAL BIOCHEMISTRY AND NUTRITION   44 ( 1 )   28 - 40   2009年1月

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記述言語：英語   掲載種別：書評論文，書評，文献紹介等   出版者・発行元：JOURNAL CLINICAL BIOCHEMISTRY & NUTRITION  

Hemorrhagic shock causes oxidative stress that leads to tissue injuries in various organs including the lung, liver, kidney and intestine. Excess amounts of free heme released from destabilized hemoproteins under oxidative conditions might constitute a major threat because it can catalyze the formation of reactive oxygen species. Cells counteract this by rapidly inducing the rate-limiting enzyme in heme breakdown, heme oxygenase-1 (HO-1), which is a low-molecular-weight stress protein. The enzymatic HO-1 reaction removes heme. As such, endogenous HO-1 induction by hemorrhagic shock protects tissues from further degeneration by oxidant stimuli. In addition, prior pharmacological induction of HO-1 ameliorates oxidative tissue injuries induced by hemorrhagic shock. In contrast, the deletion of HO-1 expression, or the chemical inhibition of increased HO activity ablated the beneficial effect of HO-1 induction, and exacerbates tissue damage. Thus, HO-1 constitutes an essential cytoprotective component in hemorrhagic shock-induced oxidative tissue injures. This article reviews recent advances in understanding of the essential role of HO-1 in experimental models of hemorrhagic shock-induced oxidative tissue injuries with emphasis on the role of its induction in tissue defense.

DOI： 10.3164/jcbn.08-210-HO

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Heme oxygenase-1 is an essential cytoprotective component in oxidative tissue injury induced by hemorrhagic shock

Toru Takahashi, Hiroko Shimizu, Hiroshi Morimatsu, Kyoichiro Maeshima, Kazuyoshi Inoue, Reiko Akagi, Masaki Matsumi, Hiroshi Katayama, Kiyoshi Morita

Journal of Clinical Biochemistry and Nutrition   44 ( 1 )   28 - 40   2009年1月

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記述言語：英語   掲載種別：書評論文，書評，文献紹介等  

Hemorrhagic shock causes oxidative stress that leads to tissue injuries in various organs including the lung, liver, kidney and intestine. Excess amounts of free heme released from destabilized hemoproteins under oxidative conditions might constitute a major threat because it can catalyze the formation of reactive oxygen species. Cells counteract this by rapidly inducing the rate-limiting enzyme in heme breakdown, heme oxygenase-1 (HO-1), which is a low-molecular-weight stress protein. The enzymatic HO-1 reaction removes heme. As such, endogenous HO-1 induction by hemorrhagic shock protects tissues from further degeneration by oxidant stimuli. In addition, prior pharmacological induction of HO-1 ameliorates oxidative tissue injuries induced by hemorrhagic shock. In contrast, the deletion of HO-1 expression, or the chemical inhibition of increased HO activity ablated the beneficial effect of HO-1 induction, and exacerbates tissue damage. Thus, HO-1 constitutes an essential cytoprotective component in hemorrhagic shock-induced oxidative tissue injures. This article reviews recent advances in understanding of the essential role of HO-1 in experimental models of hemorrhagic shock-induced oxidative tissue injuries with emphasis on the role of its induction in tissue defense.

DOI： 10.3164/jcbn.08-210-HO

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Impairment of leukocyte deformability in patients undergoing esophagectomy

Tomohiko Suemori, Hiroshi Morimatsu, Satoshi Mizobuchi, Kiyoshi Morita, Yuki Katanosaka, Satoshi Mohri, Keiji Naruse

CLINICAL HEMORHEOLOGY AND MICROCIRCULATION   41 ( 2 )   127 - 136   2009年

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記述言語：英語   出版者・発行元：IOS PRESS  

Impaired deformability might contribute to the accumulation of activated leukocytes within pulmonary microcapillaries, leading to acute lung injury. The purpose of our study was to investigate changes in leukocyte deformability during periods of inflammation after esophagectomy. The study group comprised 20 patients who underwent esophagectomy. Changes in leukocyte deformability were investigated by examining filtration through a silicon microchannel, which simulated human pulmonary microcapillaries. Changes in the neutrophil cytoskeleton were investigated by measuring neutrophil F-actin assembly. The severity of patient clinical outcome was evaluated by the lung injury score. Leukocyte filtration through the microchannel was significantly weaker in esophagectomy patients than in healthy subjects (p &lt; 0.01). After esophagectomy, filtration was further impaired compared with preoperative values (p &lt; 0.05). The neutrophil F-actin content was higher in patients than in controls (p &lt; 0.01), and increased after esophagectomy compared with preoperative values (p &lt; 0.01). We concluded that circulating leukocytes showed reduced deformability and appeared to be sequestered within microcapillaries after esophagectomy. Changes in neutrophil cytoskeleton were considered to be responsible for the reduced deformability. Leukocyte accumulation within pulmonary microcapillaries might be related to the pathogenesis of lung injury after esophagectomy.

DOI： 10.3233/CH-2009-1164

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血糖持続測定を用いた小児インスリノーマの麻酔経験.

真鍋素子, 森松博史, 江木盛時, 鈴木聡, 賀来隆治, 松三昌樹, 森田潔

麻酔   58 ( 6 )   757 - 759   2009年

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記述言語：日本語   出版者・発行元：克誠堂出版(株)  

5歳女児。出生時に持続性高インスリン血症性低血糖症と診断された。内科的治療は効果なく、膵体部切除術の適応と判断された。麻酔はミダゾラム・ベクロニウム・セボフルラン・亜酸化窒素で導入し、酸素・亜酸化窒素・セボフルランで維持した。麻酔開始時に静脈路を確保し、血糖持続測定器STG-22で測定を開始した。手術室入室時は10%ブドウ糖液点滴を行っていたが、糖の過剰負荷を危惧してブドウ糖不添加リンゲル液に変更したところ、導入前200mg・dl-1であった血糖値が99mg・dl-1まで急速に低下した。このためブドウ糖液を再開して100ml・hr-1に設定し、以後徐々に血糖は上昇し、190mg・dl-1となった時点で20ml・hr-1とした。血管処置を始めた頃から血糖値は再上昇し220mg・dl-1となったため、5ml・hr-1に減速し、速効性インスリン静注を2単位・hr-1で30分間行った。麻酔時間6時間15分、出血量150mlで、循環動態は終始落ち着いており、術後経過も良好であった。

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ラット出血性ショック後腸管障害に対するHeme Oxygenase-1の保護効果.

高橋 徹, 清水裕子, 井上一由, 金川文俊, 森松博史, 片山 浩, 森田 潔

日本Shock学会雑誌   24 ( 2 )   28 - 32   2009年

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【敗血症診療の現在 SSCG2008とその後】 SSCG2008とその後の展開について 血糖コントロール.

森松博史

Progress in Medicine   29 ( 6 )   1499 - 1503   2009年

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重症敗血症の経過中に骨髄穿刺により鑑別診断が可能となった薬剤性好中球減少の1症例.

鈴木聡, 森松博史, 江木盛時, 清水一好, 松崎孝, 佐藤哲文, 片山浩, 森田潔

ICUとCCU   33 ( 9 )   703 - 707   2009年

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記述言語：日本語   出版者・発行元：医学図書出版  

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その他リンク： http://search.jamas.or.jp/link/ui/2009352463

酸塩基平衡の新しい考え方 Stewart Approach.

森松博史

臨床麻酔   33 ( 臨増 )   431 - 440   2009年

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【急性期栄養管理の基本と実際】 急性期栄養管理の施設独自の工夫 岡山大学における急性期栄養管理の実際.

松崎孝, 森松博史, 溝渕知司, 片山浩

救急医学   33 ( 13 )   1813 - 1815   2009年

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【AKI】 AKIの予防、治療 管理 血管作動薬 ドパミン、ノルアドレナリン、バソプレッシンの腎臓への影響を考える.

森松博史

Intensivist   1 ( 3 )   523 - 529   2009年

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記述言語：日本語   出版者・発行元：メディカル・サイエンス・インターナショナル  

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Hemin Treatment Abrogates Monocrotaline-Induced Pulmonary Hypertension

K. Shimzu, T. Takahashi, T. Iwasaki, H. Shimizu, K. Inoue, H. Morimatsu, E. Omori, M. Matsumi, R. Akagi, K. Morita

MEDICINAL CHEMISTRY   4 ( 6 )   572 - 576   2008年11月

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記述言語：英語   出版者・発行元：BENTHAM SCIENCE PUBL LTD  

Treatment of rats with monocrotaline (MCT), a pyrrolizidine alkaloid plant toxin, is known to cause pulmonary hypertension (PH), and it has been used as a useful experimental model of PH. Recent findings suggested that pulmonary inflammation may play a significant role in the pathogenesis of MCT-induced PH. We also demonstrated that, following MCT administration to rats, there was a significant and sustained increase in the pulmonary expression of heme oxygenase-1 (HO-1), which is known to be induced by various oxidative stresses, including inflammation and free heme, and is thought to be essential in the protection against oxidative tissue injuries. In this study, we administered hemin (ferriprotoporphyrin chloride, 30 mol/kg b.w., subcutaneously), a potent inducer of HO-1, every 3 days to rats following subcutaneous administration of MCT (60 mg/kg) and examined its effect on MCT-induced PH and pulmonary inflammation. MCT administration caused pulmonary arterial wall thickening with marked elevation of right ventricular pressure, in association with prominent pulmonary inflammation as revealed by the increase in gene expression of tumor necrosis factor-alpha and the number of infiltrated neutrophils in the lung. In contrast, hemin treatment of MCT-administered animals, which led to a further increase in pulmonary HO-1 mRNA expression, significantly ameliorated MCT-induced PH as well as tissue inflammation. These findings suggest that hemin treatment ameliorates MCT-induced PH possibly mediated through induction of pulmonary HO-1 which leads to the attenuation of pulmonary inflammation.

DOI： 10.2174/157340608786241972

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意識障害で発症したII型シトルリン血症の1症例

中西統子, 松崎孝, 林真雄, 森松博史, 佐藤健治, 佐藤哲文, 中塚秀輝, 松三昌樹, 森田潔

麻酔   57 ( 10 )   1298   2008年10月

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記述言語：日本語  

J-GLOBAL

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Hypertonic lactate solutions: a new horizon for fluid resuscitation?

Florian Wagner, Peter Radermacher, Hiroshi Morimatsu

INTENSIVE CARE MEDICINE   34 ( 10 )   1749 - 1751   2008年10月

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記述言語：英語   出版者・発行元：SPRINGER  

DOI： 10.1007/s00134-008-1166-9

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生体肝移植術中呼気一酸化炭素濃度の動態とその意義について

松崎 孝, 森松 博史, 高橋 徹, 林 真雄, 佐藤 哲文, 佐藤 健治, 松三 昌樹, 森田 潔

Shock : 日本Shock学会雑誌   23 ( 1 )   47 - 47   2008年4月

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記述言語：日本語  

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Acid-base balance in combined severe hepatic and renal failure: A quantitative analysis

T. Naka, R. Bellomo, H. Morimatsu, J. Rocktaschel, L. Wan, P. Gow, P. Angus

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS   31 ( 4 )   288 - 294   2008年4月

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記述言語：英語   出版者・発行元：WICHTIG EDITORE  

Background: Severe hepatic failure (SHF) commonly leads to major changes in acid-base balance status. However, the direct effects of liver failure per se on acid base balance are poorly understood because this condition is usually associated with acute renal failure (ARF). Aim: To assess the effect of SHF on acid-base balance.
Design: Retrospective laboratory investigation.
Subjects: Thirty-seven critically ill patients with SHF complicated by ARF, and 42 patients with severe ARF without liver failure prior to renal replacement therapy. Intervention: Retrieval of clinical and laboratory data from prospective unit and laboratory databases.
Methods: Quantitative acid-base assessment using Stewart-Figge methodology. Comparison of findings between the two groups. Comparison of demographic and clinical features.
Results: Patients with combined SHF and ARF were younger and had significantly higher mean bilirubin, ALT and INR levels (p&lt;0.0001). Their mean lactate concentration was higher (6.4 vs. 2.1 mmol/L; p&lt;0.0001) leading to a greater anion gap (25.8 vs. 16.1 mmol/L; p&lt;0.0001). The ionized calcium concentration (1.00 vs. 1.15 mmol/L; p&lt;0.0001) was lower but the strong ion difference apparent (SIDa) was greater (42.0 vs. 38.0 mEq/L; p&lt;0.005) due to hypochloremia. The albumin concentration was low but higher than in control patients (28 vs. 24 g/L; p&lt;0.01) and the calculated strong ion gap (SIG) was greater (12.6 vs. 9.3 mEq/L; p&lt;0.01). The base excess was similar to controls and the pH was preserved in the near normal range by marked hypocapnea.
Conclusions: Combined SHF and ARF is a syndrome with unique acid-base changes due mostly to lactic metabolic acidosis and, in smaller part, to the accumulation of unmeasured anions. This acidosis, like that of ARF, is attenuated by hypoalbuminemia, by a unique preservation of the SIDa due to hypochloremia, and by marked hypocapnea.

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Hyperglycemia and the outcome of pediatric cardiac surgery patients requiring peritoneal dialysis

M. Egi, H. Morimatsu, Y. Toda, T. Matsusaki, S. Suzuki, K. Shimizu, T. Iwasaki, M. Takeuchi, R. Bellomo, K. Morita

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS   31 ( 4 )   309 - 316   2008年4月

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記述言語：英語   出版者・発行元：WICHTIG EDITORE  

Objective: To study the nature of the association between glycemia and ICU mortality in pediatric cardiac surgery patients treated with peritoneal dialysis (PD).
Materials and methods: Retrospective observational study in the ICU of a tertiary hospital involving forty pediatric cardiac surgery patients treated with PD. We selected patients requiring PD, extracted glucose measurements and nutritional intake data during ICU stay and calculated mean and maximum blood glucose values i) during ICU stay; ii) during dependence on PD; and iii) during independence from PD. We statistically assessed the relationship between glycemia-related variables and ICU mortality.
Measurements and Results: Twenty-two patients treated with PD died (mortality 55%). In the PD cohort, 9725 blood glucose measurements were performed (every 3.3 hours on average). The mean glycemia during dependence on PD was significantly higher in non-survivors than survivors (p&lt;0.0001), but not during independence from PD (p=0.49). The area under the receiver operator characteristic curve for the mean glycemia during dependence on PD was significantly greater than that obtained during independence from PD. Even after adjustment for severity of illness using multivariate logistic analysis, the mean glycemia and calorie intake during PD were significant and independent predictors of ICU mortality.
Conclusions: A higher mean blood glucose concentration during PD, but not during PD-free periods was associated with greater ICU mortality. Mean glycemia and calorie intake during PD were significant and independent predictors of ICU mortality.

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Protective role of heme oxygenase 1 in the intestinal tissue injury in hemorrhagic shock in rats

Kazuyoshi Inoue, Toru Takahashi, Kenji Uehara, Hiroko Shimuzu, Kana Ido, Hiroshi Morimatsu, Emiko Omori, Hiroshi Katayama, Reiko Akagi, Kiyoshi Morita

SHOCK   29 ( 2 )   252 - 261   2008年2月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Heme oxygenase (HO) 1 is inducible by a variety of oxidative stress and is thought to play an important role in the protection of tissues from oxidative injuries. Because hemorrhagic shock (HS) is an oxidative stress that results in tissue injury, we examined in this study the role of HO-1 induction in intestinal tissue injuries in a rat model of HS. The levels of HO-1 were significantly increased after HS both at transcriptional and protein levels in mucosal epithelia[ cells in the duodenum, jejunum, and colon, whereas their expression in the ileum was hardly detectable and not increased at all by the treatment. In contrast, HS-induced mucosal inflammation and apoptotic cell death in the duodenum, jejunum, and colon were far less than those observed in ileum as judged by the levels of expression of TNF-alpha, NOS, activated caspase 3, and BcI-2. Of note, inhibition of HO activity by tin-mesoporphyrin resulted in an aggravation of HS-induced tissue inflammation and apoptotic cell death. These findings indicate that HO-1 expression in the intestine is regulated in a highly site-specific manner after HS, and that HO-1 induction plays a fundamental role in protecting mucosal cells of the intestine from oxidative damages induced by HS.

DOI： 10.1097/shk.0b013e3180cab913

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Increased exhaled carbon monoxide concentration during living donor liver transplantation

Takashi Matsusaki, Hiroshi Morimatsu, Toru Takahashi, Masaki Matsumi, Kenji Sato, Ryuji Kaku, Tetsufumi Sato, Takahito Yagi, Noriaki Tanaka, Kiyoshi Morita

INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE   21 ( 1 )   75 - 81   2008年1月

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記述言語：英語   出版者・発行元：PROFESSOR D A SPANDIDOS  

Exhaled carbon monoxide concentration (ExCO-C) has been reported to increase in oxidative tissue injuries such as systemic inflammation, and is thought to reflect increased heme breakdown in the affected organ. As a transplanted liver undergoes ischemia-reperfusion, we hypothesized that ExCO-C might also increase following liver transplantation and might serve as a measure of the severity of the graft tissue injury. We prospectively studied 67 living donor liver transplantation (LDLT) patients in a consecutive fashion. During anesthesia, ExCO-C was determined at 6 time points, ranging from anesthesia induction, to admission to the intensive care unit. We also measured two markers of endothelial cellular injury, i.e., serum soluble thrombomodulin (sTM) and intercellular adhesion molecule (ICAM)-1. At 5 min after reperfusion of the grafted liver, ExCO-C markedly increased from 5.69 +/- 2.34 ppm at baseline, to 9.79 +/- 4.72 ppm (p &lt; 0.0001). There was an excellent correlation among an increase in CO concentration, arterial carboxyhemoglobin levels at the time of reperfusion (r(2)=0.19, p=0.0003), and postoperative total bilirubin levels (day 1, 2, and 3; r(2)=0. 102, 0.109 and 0.100; p=0.008, 0.007 and 0.010, respectively). Serum sTM and ICAM-1 levels were also significantly increased after reperfusion (sTM: 3.3 +/- 0.8 to 5.1 +/- 1.7 FU/ml, p=0.0001; ICAM-1: 271.9 +/- 86.3 to 515.0 +/- 157.8 FU/ml, p=0.0001). ExCO-C had a positive relationship with sTM (r(2)=0.16, p=0.035) and ICAM-1 (r(2)=0.12, p=0.08). There was, however, no correlation of ExCO-C with serum AST/ALT levels or clinical outcomes. This study demonstrated that ExCO-C significantly increased after reperfusion during LDLT. The increased ExCO-C may likely reflect increased heme breakdown and endothelial cell injury in the grafted liver.

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生体肝移植の麻酔（当院における術中麻酔管理）

松崎 孝, 森松博史, 林 真雄, 松三昌樹, 佐藤哲文, 佐藤健治, 中塚秀輝, 森田 潔

Anesthesia Network   12 ( 2 )   3 - 8   2008年

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高用量フェンタニルパッチによりがん性疼痛が軽減した1症例.

松崎 孝, 西江宏行, 森松博史, 石川慎一, 佐藤健治, 溝渕知司, 中塚秀輝, 松三昌樹, 横山正尚, 森田 潔

日本ペインクリニック学会誌   15 ( 2 )   150 - 152   2008年

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記述言語：日本語   出版者・発行元：一般社団法人 日本ペインクリニック学会  

がん性疼痛の軽減にフェンタニルパッチの高用量が必要であった症例を報告する．56歳の男性で，直腸癌による肛門部から仙骨部に持続的な疼痛があった．モルヒネ徐放薬150 mg/日とフェンタニルパッチ2.5 mgを使用していたが，疼痛管理が困難であったので，ペインセンターへ紹介となった．副作用の便秘が強く，フェンタニルパッチ単独に変更し，リドカインの全身投与，アミトリプチリンの内服を併用した．しかし，疼痛は軽減しなかったので，くも膜下フェノールブロックや持続硬膜外ブロックを行い，疼痛は一時的には軽減した．その後，腫瘍が増大し，痛みが増強したので，フェンタニルパッチを65 mgまで増量し，疼痛は軽減した．疼痛管理開始から7カ月後に永眠したが，意識障害や呼吸抑制はなかった．治療中にフェンタニルパッチの20 mg，50 mg，65 mgを使用していた時のフェンタニルの血中濃度は，それぞれ，9.8，21.6，22.0 ng/mlと高値であった．いずれの時期も呼吸抑制，意識障害はなかった．

DOI： 10.11321/jjspc.07-0019

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生体肝移植術後に中心性橋髄鞘融解症を生じた1症例.

松﨑 孝, 森松博史, 佐藤哲文, 佐藤健治, 松三昌樹, 森田 潔

麻酔   57 ( 9 )   1136 - 1138   2008年

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記述言語：日本語   出版者・発行元：克誠堂出版  

CiNii Article

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その他リンク： http://search.jamas.or.jp/link/ui/2008366585

生体肝移植術中呼気一酸化炭素濃度の動態とその意義について

松﨑 孝, 森松博史, 高橋 徹, 林 真雄, 佐藤哲文, 佐藤健治, 清水裕子, 松三昌樹, 森田 潔

日本Shock学会雑誌   23 ( 2 )   85 - 89   2008年

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MRSA敗血症に合併した腸腰筋膿瘍の2症例.

谷 真規子, 森松博史, 戸田雄一郎, 片山 浩, 森田 潔

ICUとCCU   32 ( 12 )   1149 - 1154   2008年

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酸塩基平衡の新しい考え方 Stewart Approach

森松博史

臨床麻酔   33 ( 臨増 )   431 - 440   2008年

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Validation of PIM, PRISM, and PELOD for children with congenital heart disease in pediatric cardiac care unit

Yuichiro Toda, Hiroshi Morimatsu, Moritoki Egi, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tionloyuki Kanazawa, Satoshi Suzuki, Kiyoshi Morita

CRITICAL CARE MEDICINE   35 ( 12 )   A7 - A7   2007年12月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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Application of simplified Stewart methodology to pediatric patients with acute kidney injury in a cardiac care unit

Hiroshi Morimatsu, Moritoki Egi, Yuichiro Toda, Kiyoshi Morita

CRITICAL CARE MEDICINE   35 ( 12 )   A269 - A269   2007年12月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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Stewart has come to the bedside: Is it time to use the Stewart methodology routinely?

Hiroshi Morimatsu

CRITICAL CARE MEDICINE   35 ( 10 )   2456 - 2457   2007年10月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

DOI： 10.1097/01.CCM.0000284489.62413.90

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Comparison of contamination between conventional three-way stopcock and needleless injection device: A randomized controlled trial

Jun Oto, Masaji Nishimura, Hiroshi Morimatsu, Hiroshi Katayama, Mutsuo Onodera, Hideo Takahashi, Jun Takezawa

MEDICAL SCIENCE MONITOR   13 ( 10 )   CR417 - CR421   2007年10月

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記述言語：英語   出版者・発行元：INT SCIENTIFIC LITERATURE, INC  

Background: Intraluminal contamination of catheter hubs has been recognized as the most frequent cause of catheter-related blood stream infections. We have investigated the efficacy of a new hub device. Placenta SC (R) (PNSC), in preventing endoluminal catheter contamination, compared to a conventional three-way stopcock.
Materials/Methods: Adults patients requiring an intravascular catheter placement for at least 48 hours in intensive care units were randomly assigned to receive either the infusion device with the newly designed hub, PNSC(P group, n=89), or with a conventional three-way stopcock (C group,n=73). To evaluate intraluminal contamination, we examined the bacteria isolated in the inline bacterial filters which were attached to downstream of the injection ports. In assition to the clinical study,we conducted a bench study to investigate if use of protection caps or strict disinfection technique prevented intraluminal contamination with this new needleless connector.
Results: The incidence of bacterial contamination was not significantly different between the groups (P roup9/89(10.1%) vs. C group 6/73(8.2%). P=0.79). There was no correlation between the numbers of injections,durations of the use of the device or the microbial contamination rate. In the bench study, protection caps and disinfection technique significantly decreased microbial transfer from the hub to the fluid space.
Conclusion: We concluded that the use of the new hub device did not reduce endoluminal bacteriol contamination rate in comparison with that of a three way stopcock. Intraluminal bacterial contamination may be reduced by either strict disinfection technique or when a protection cap is use.

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Continuous renal replacement therapy: A worldwide practice survey

Shigehiko Uchino, Rinaldo Bellomo, Hiroshi Morimatsu, Stanislao Morgera, Miet Schetz, Ian Tan, Catherine Bouman, Ettiene Macedo, Noel Gibney, Ashita Tolwani, Heleen Oudemans-van Straaten, Claudio Ronco, John A. Kellum

INTENSIVE CARE MEDICINE   33 ( 9 )   1563 - 1570   2007年9月

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記述言語：英語   出版者・発行元：SPRINGER  

Objective: Little information is available regarding current practice in continuous renal replacement therapy ( CRRT) for the treatment of acute renal failure ( ARF) and the possible clinical effect of practice variation. Design: Prospective observational study. Setting: A total of 54 intensive care units ( ICUs) in 23 countries. Patients and participants: A cohort of 1006 ICU patients treated with CRRT for ARF. Interventions: Collection of demographic, clinical and outcome data. Measurements and results: All patients except one were treated with venovenous circuits, most commonly as venovenous hemofiltration ( 52.8%). Approximately one- third received CRRT without anticoagulation ( 33.1%). Among patients who received anticoagulation, unfractionated heparin ( UFH) was the most common choice ( 42.9%), followed by sodium citrate ( 9.9%), nafamostat mesilate ( 6.1%), and low- molecular- weight heparin ( LMWH; 4.4%). Hypotension related to CRRT occurred in 19% of patients and arrhythmias in 4.3%. Bleeding complications occurred in 3.3% of patients. Treatment with LMWH was associated with a higher incidence of bleeding complications ( 11.4%) compared to UFH ( 2.3%, p = 0.0083) and citrate ( 2.0%, p = 0.029). The median dose of CRRT was 20.4ml/ kg/ h. Only 11.7% of patients received a dose of &gt; 35 ml/ kg/ h. Most ( 85.5%) survivors recovered to dialysis independence at hospital discharge. Hospital mortality was 63.8%. Multivariable analysis showed that no CRRT- related variables ( mode, filter material, drug for anticoagulation, and prescribed dose) predicted hospital mortality. Conclusions: This study supports the notion that, worldwide, CRRT practice is quite variable and not aligned with best evidence.

DOI： 10.1007/s00134-007-0754-4

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Heme oxygenase-1: A fundamental guardian against oxidative tissue injuries in acute inflammation

T. Takahashi, H. Shimizu, H. Morimatsu, K. Inoue, R. Akagi, K. Morita, S. Sassa

MINI-REVIEWS IN MEDICINAL CHEMISTRY   7 ( 7 )   745 - 753   2007年7月

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記述言語：英語   掲載種別：書評論文，書評，文献紹介等   出版者・発行元：BENTHAM SCIENCE PUBL LTD  

Free heme contributes as a major threat to the oxidative tissue injuries because it catalyzes the formation of reactive oxygen species. When free heme concentration is increased, it results in the induction of heme oxygenase-1 (1401), which then breaks free heme down. As such, HO-1 plays a pivotal role in the protection of tissues from oxidative injuries.

DOI： 10.2174/138955707781024517

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Peak exhaled carbon monoxide concentration after reperfusion influenced hyperbilirubinemia early after liver transplantation.

Takashi Matsusaki, Hiroshi Morimatsu, Tom Takahashi, Masaki Matsumi, Kiyoshi Morita

AMERICAN JOURNAL OF TRANSPLANTATION   7   557 - 558   2007年5月

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：BLACKWELL PUBLISHING  

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Septic acute kidney injury in critically ill patients: Clinical characteristics and outcomes

Sean M. Bagshaw, Shigehiko Uchino, Rinaldo Bellomo, Hiroshi Morimatsu, Stanislao Morgera, Miet Schetz, Ian Tan, Catherine Bouman, Ettiene Macedo, Noel Gibney, Ashita Tolwani, Heleen M. Oudemans-van Straaten, Claudio Ronco, John A. Kellum

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY   2 ( 3 )   431 - 439   2007年5月

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記述言語：英語   出版者・発行元：AMERICAN SOCIETY NEPHROLOGY  

Sepsis is the most common cause of acute kidney injury (AKI) in critical illness, but there is limited information on septic AKI. A prospective, observational study of critically ill patients with septic and nonseptic AKI was performed from September 2000 to December 2001 at 54 hospitals in 23 countries. A total of 1753 patients were enrolled. Sepsis was considered the cause in 833 (47.5%); the predominant sources of sepsis were chest and abdominal (54.3%). Septic AKI was associated with greater aberrations in hemodynamics and laboratory parameters, greater severity of illness, and higher need for mechanical ventilation and vasoactive therapy. There was no difference in enrollment kidney function or in the proportion who received renal replacement therapy (RRT; 72 versus 71%; P=0.83). Oliguria was more common in septic AKI (67 versus 57%; P&lt;0.001). Septic AKI had a higher in-hospital case-fatality rate compared with nonseptic AKI (70.2 versus 51.8%; P&lt;0.001). After adjustment for covariates, septic AKI remained associated with higher odds for death (1.48; 95% confidence interval 1.17 to 1.89; P=0.001). Median (IQR) duration of hospital stay for survivors (37 [19 to 59] versus 21 [12 to 42] d; P&lt;0.0001) was longer for septic AKI. There was a trend to lower serum creatinine (106 [73 to 158] versus 121 [88 to 184] mu mol/L; P=0.01) and RRT dependence (9 versus 14%; P=0.052) at hospital discharge for septic AKI. Patients with septic AKI were sicker and had a higher burden of illness and greater abnormalities in acute physiology. Patients with septic AKI had an increased risk for death and longer duration of hospitalization yet showed trends toward greater renal recovery and independence from RRT.

DOI： 10.2215/CJN.03681106

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IL-11はヘム蛋白安定化作用により四塩化炭素肝障害に対して保護作用を示す

高橋 徹, 川上 朋子, 清水 裕子, 井上 一由, 森松 博史, 片山 浩, 松三 昌樹, 森田 潔

Shock : 日本Shock学会雑誌   22 ( 1 )   62 - 62   2007年4月

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記述言語：日本語  

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ラット出血性ショック後急性肺障害に対するウリナスタチンの治療効果

井上 一由, 高橋 徹, 井戸 佳奈, 清水 裕子, 森松 博史, 森田 潔

Shock : 日本Shock学会雑誌   22 ( 1 )   36 - 36   2007年4月

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記述言語：日本語  

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ラット出血性ショック後急性肺障害に対するウリナスタチンの保護効果のメカニズム

井上 一由, 高橋 徹, 井戸 佳奈, 清水 裕子, 森松 博史, 森田 潔

Shock : 日本Shock学会雑誌   22 ( 1 )   54 - 54   2007年4月

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記述言語：日本語  

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ラット出血性ショックモデルにおける急性肺障害に対するCO吸入の保護効果

井上 一由, 高橋 徹, 井戸 佳奈, 清水 裕子, 森松 博史, 森田 潔

Shock : 日本Shock学会雑誌   22 ( 1 )   63 - 63   2007年4月

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記述言語：日本語  

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The effect of albumin concentration on plasma sodium and chloride measurements in critically ill patients

David A. Story, Hiroshi Morimatsu, Moritoki Egi, Rinaldo Bellomo

ANESTHESIA AND ANALGESIA   104 ( 4 )   893 - 897   2007年4月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

BACKGROUND: We tested the hypothesis that the difference between indirect and direct sodium assays would be related to the plasma albumin concentration. Further, we proposed that differences between indirect and direct chloride assays might be explained by interference from other plasma constituents, particularly bicarbonate, and possibly albumin.
METHODS: We studied 300 critically ill patients at the time of admission to the intensive care unit (ICU) and compared each patient's plasma sodium and chloride measurements from a central laboratory assay (indirect electrode) and an ICU blood gas machine assay (direct electrode).
RESULTS: The central laboratory sodium measurement was, on average, 2.1 mmol/L more than the ICU assay, limits of agreement 1.8-2.4 mmol/L greater, P &lt; 0.001. The central laboratory chloride measurement was, on average, I mmol/L less than the ICU assay (limits of agreement 1.3-0.7 mmol/L less, P &lt; 0.001). All correlations between the assay differences and plasma constituents were weak except for a moderately strong correlation between differences in sodium measurements and albumin. The difference in plasma sodium concentration between the assays (central laboratory ICU) increased as the plasma concentration albumin decreased (difference 6.2-0.16 albumin (g/L); P &lt; 0.001, r = -0.46, r(2) = 0.22).
CONCLUSIONS: The central laboratory and ICUs assays are analytic-ally, statistically, and clinically different for both sodium and chloride. Unless taken into account, the differences could be large enough in hypoalbuminemic populations (such as critically ill patients) to affect clinical diagnosis and decision making.

DOI： 10.1213/01.ane.0000258015.87381.61

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Patient and kidney survival by dialysis modality in critically ill patients with acute kidney injury

S. Uchino, R. Bellomo, J. A. Kellum, H. Morimatsu, S. Morgera, M. Schetz, I. Tan, C. Bouman, E. Macedo, N. Gibney, A. Tolwani, H. Oudemans-Van Straaten, C. Ronco

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS   30 ( 4 )   281 - 292   2007年4月

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記述言語：英語   出版者・発行元：WICHTIG EDITORE  

Using a large, international cohort, we sought to determine the effect of initial technique of renal replacement therapy (RRT) on the outcome of acute renal failure (ARF) in the intensive care unit (ICU). We enrolled 1218 patients treated with continuous RRT (CRRT) or intermittent RRT (IRRT) for ARF in 54 ICUs in 23 countries. We obtained demographic, biochemical and clinical data and followed patients to either death or hospital discharge. Information was analyzed to assess the independent impact of treatment choice on survival and renal recovery. Patients treated first with CRRT (N=1006, 82.6%) required vasopressor drugs and mechanical ventilation more frequently compared to those receiving IRRT (N=212, 17.40%), (p &lt; 0.0001). Unadjusted hospital survival was lower (35.8% vs. 51.9%, p &lt; 0.0001). However, unadjusted dialysis-independence at hospital discharge was higher after CRRT (85.5% vs. 66.2%, p &lt; 0.0001). Multivariable logistic regression showed that choice of CPPT was not an independent predictor of hospital survival or dialysis-free hospital survival. However, the choice of CRRT was a predictor of dialysis independence at hospital discharge among survivors (OR: 3.333, 95% Cl: 1.845 - 6.024, p &lt; 0.0001). Further adjustment using a propensity score did not significantly change these results. We conclude that worldwide, the choice of CRRT as initial therapy is not a predictor of hospital survival or dialysis-free hospital survival but is an independent predictor of renal recovery among survivors.

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Effects of a novel palatinose based enteral formula (MHN-01) carbohydrate-adjusted fluid diet in improving the metabolism of carbohydrates and lipids in patients with esophageal cancer complicated by diabetes mellitus

Toshiya Fujiwara, Yoshio Naomoto, Takayuki Motoki, Kaori Shigemitsu, Yasuhiro Shirakawa, Tomoki Yamatsuji, Masafumi Kataoka, Minoru Haisa, Toshiyoshi Fujiwara, Maritoki Egi, Hiroshi Morimatsu, Motohiko Hanazaki, Hiroshi Katayama, Kiyoshi Morita, Kenji Mizumoto, Takanobu Asou, Hirofumi Arima, Hajime Sasaki, Motoi Matsuura, Mehmet Gunduz, Noriaki Tanaka

JOURNAL OF SURGICAL RESEARCH   138 ( 2 )   231 - 240   2007年4月

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記述言語：英語   出版者・発行元：ACADEMIC PRESS INC ELSEVIER SCIENCE  

Background. During perioperative management of patients with gastrointestinal cancer complicated by diabetes mellitus, adequate alimentation is required, but we often face difficulties associated with hyperglycemia and other accompanying complications. Recently, we investigated the effects of a novel palatinose based enteral formula (MHN-01) in suppressing post-prandial hyperglycemia and improving lipid metabolism in experimental animals and perioperative management of patients with esophageal cancer complicated by diabetes mellitus.
Materials and methods. We gave normal rats and rats with type 2 diabetes mellitus a single oral dose of fluid diet, and analyzed comparatively the time course of blood glucose level in each group until 3 h after the dose. In both the normal rat group and the type 2 diabetes group, peak blood glucose level after the MHN-01 dose was significantly lower than after a dose of ordinary fluid diet and was comparable to the peak level after a dose of a fluid diet rich in MUFA (monounsaturated fatty acid). We allowed normal mice free access to fluid diet for 43 days, and measured their body fat levels. Fat accumulation was significantly lower in mice given MHN-01 than in mice given ordinary fluid diet. We also analyzed the respiratory quotient and resting energy expenditure of normal Sprague-Dawley rats fed by MHN-01 or an ordinary fluid diet. The respiratory quotient of the MHN-01 group was significantly lower than the ordinary fluid group, although the resting energy expenditure of both groups was almost the same level. The effect of MHN-01 was estimated to be based on improvement of lipid metabolism.
Results. Between 2003 and 2005, among 164 patients who underwent radical thoracic esophagectomy and/or reconstruction for esophageal carcinoma at Okayama University Hospital, nine patients (5.5%) were diagnosed with diabetes mellitus in preoperative screening and were treated with MHN-01. Clinical courses of two cases with severe status of diabetes mellitus were presented as successful case reports of MHN-01.
Conclusion. MHN-01 was very useful in perioperative management of patients complicated by diabetes mellitus, unable to ingest food p.o. such as esophageal cancer or other diseases. (c) 2007 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.jss.2006.06.025

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A neutrophil elastase inhibitor, sivelestat, ameliorates lung injury after hemorrhagic shock in rats

Yuichiro Toda, Toru Takahashi, Kyoichiro Maeshima, Hiroko Shimizu, Kazuyoshi Inoue, Hiroshi Morimatsu, Emiko Omori, Mamoru Takeuchi, Reiko Akagi, Kiyoshi Morita

INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE   19 ( 2 )   237 - 243   2007年2月

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記述言語：英語   出版者・発行元：PROFESSOR D A SPANDIDOS  

Hemorrhagic shock followed by resuscitation (HSR) causes neutrophil sequestration in the lung which leads to acute lung injury (ALI). Neutrophil elastase (NE) is thought to play a pivotal role in the pathogenesis of ALI. This study investigated whether sivelestat, a specific NE inhibitor, can attenuate ALI induced by HSR in rats. Male Sprague-Dawley rats were subjected to hemorrhagic shock by withdrawing blood so as to maintain a mean arterial blood pressure of 30 +/- 5 mm Hg for 60 min followed by resuscitation with the shed blood. HSR-treated animals received a bolus injection of sivelestat (10 mg/kg) intravenously at the start of resuscitation followed by continuous infusion for 60 min (10 mg/kg/h) during the resuscitation phase, or the vehicle. Lung injury was assessed by pulmonary histology, lung wet-weight to dry-weight (W/D) ratio, myeloperoxidase (MPO) activity, gene expression of tumor necrosis factor (TNF)-alpha and inducible nitric oxide synthase (iNOS), DNA binding activity of nuclear factor (NF)-kappa B, and immunohistochemical analysis of intercellular adhesion molecule (ICAM)-1. HSR treatment induced lung injury, as demonstrated by pulmonary edema with infiltration of neutrophils, the increase in lung W/D ratio, MPO activity, gene expression of TNF-alpha and iNOS, and DNA-binding activity of NF-kappa B, and enhanced expression of ICAM-1. In contrast, sivelestat treatment significantly ameliorated the HSR-induced lung injury, as judged by the marked improvement in all these indices. These results indicate that sivelestat attenuated HSR-induced lung injury at least in part through an inhibition of the inflammatory signaling pathway, in addition to the direct inhibitory effect on NE.

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小児心臓外科術後急性腎不全患者における腹膜透析の効果

森松博史, 戸田雄一郎, 江木盛時, 清水一好, 岩崎達雄, 竹内護, 中塚秀輝, 森田潔

日本集中治療医学会雑誌   14 ( Supplement )   251   2007年1月

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記述言語：日本語  

J-GLOBAL

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急性疾患成人の持続血糖測定の信頼性(原標題は英語)

江木盛時, 森松博史, 戸田雄一郎, 鈴木聡, 溝渕知司, 竹内護, 中塚秀輝, 片山浩, 横山正尚, 森田潔

日本集中治療医学会雑誌   14 ( Supplement )   303   2007年1月

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記述言語：日本語  

J-GLOBAL

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敗血症性ショックの治療中に好中球減少を併発した1症例

鈴木聡, 森松博史, 江木盛時, 清水一好, 佐藤哲文, 武田吉正, 中塚秀輝, 片山浩, 横山正尚, 森田潔

日本集中治療医学会雑誌   14 ( Supplement )   257   2007年1月

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記述言語：日本語  

J-GLOBAL

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外科手術後・重症患者の免疫応答能低下のメカニズム 末梢血単核球のLPS反応性とCD14,TLR-4.

斎藤信也, 岩垣博巳, 高橋英夫, 勝野剛太郎, 森松博史, 片山浩, 森田潔, 田中紀章

日本外科感染症学会雑誌(1349-5755)   4 ( 2 )   149 - 156   2007年

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記述言語：日本語   出版者・発行元：日本外科感染症学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2007289387

【急性血液浄化法のnon-renal indicationの拡大】 High volume hemofiltrationの可能性と限界.

森松博史

ICUとCCU(0389-1194)   31   S60-S62   2007年

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RIFLE criteriaにおける尿量の基準の妥当性と有効性に関する検討.

内野滋彦, 森松博史, 上原淳, 間藤卓

日本集中治療医学会雑誌(1340-7988)   14 ( 4 )   611 - 612   2007年

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記述言語：日本語   出版者・発行元：The Japanese Society of Intensive Care Medicine  

DOI： 10.3918/jsicm.14.611

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【集中治療・周術期管理と長期予後】 ICUにおける代謝管理と長期予後.

江木盛時, 森松博史, 片山浩, 森田潔

ICUとCCU(0389-1194)   31   527 - 534   2007年

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【急性腎不全の基礎と新たな治療法への期待】 HF-CHDF・HV-CHDF使用の治療戦略.

片山浩, 森松博史, 江木盛時, 佐藤哲文, 森田潔

ICUとCCU(0389-1194)   31   S12-S13   2007年

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Stewart Approach 新しい酸塩基平衡の考え方.

森松博史

臨床麻酔(0387-3668)   31   1281 - 1287   2007年

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集中治療領域における急性血液浄化法の今後の展望 集中治療に役立つ血液浄化の最先端 HF,HV-CHDFに対する期待と展望.

片山浩, 森松博史, 佐藤哲文, 武田吉正, 中塚秀輝, 森田潔

日本臨床麻酔学会誌(0285-4945)   27 ( 1 )   28 - 33   2007年

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DOI： 10.2199/jjsca.27.28

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Protective role of HO-1 in oxidative tissue injuries

Takahashi, T. Shimizu, H. Inoue, K. *Morimatsu, H. Umeda, K. Omori, E. Akagi, R. Morita, K

Nippon Yakurigaku Zasshi   130, 252-6 ( 4 )   252 - 256   2007年

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記述言語：日本語   出版者・発行元：公益社団法人 日本薬理学会  

昨今の生命科学の進歩は薬理学の研究をより病態に応じた新薬の開発へと向かわせている．しかし，肝不全，腎不全，多臓器不全など，急性臓器不全は高い死亡率を示すにもかかわらず，その治療において決め手となる薬物は未だ開発されていない．これら急性臓器不全の組織障害の病態生理は完全に明らかでないが，好中球の活性化や虚血・再潅流にともなう酸化ストレスによる細胞傷害が大きな役割を果たしている．酸化ストレスはヘムタンパク質からヘムを遊離させる．遊離ヘムは脂溶性の鉄であることから，活性酸素生成を促進して細胞傷害を悪化させる．この侵襲に対抗するために，ヘム分解の律速酵素：Heme Oxygenase-1（HO-1）が細胞内に誘導される．HO-1によるヘム分解反応産物である一酸化炭素，胆汁色素には，抗炎症・抗酸化作用がある．したがって，遊離ヘム介在性酸化ストレスよって誘導されたHO-1は酸化促進剤である遊離ヘムを除去するのみならず，これらの代謝産物の作用を介して細胞保護的に機能する．一方，HO-1の発現抑制やHO活性の阻害は酸化ストレスによる組織障害を悪化させる．この，HO-1の細胞保護作用に着目して，HO-1誘導を酸化ストレスによる組織障害の治療に応用する試みがなされている．本稿では，急性臓器不全モデルにおいて障害臓器に誘導されたHO-1が，遊離ヘム介在性酸化ストレスから組織を保護するのに必須の役割を果たしていることを述べる．また，抗炎症性サイトカイン：インターロイキン11，塩化スズ，グルタミンがそれぞれ，肝臓，腎臓，下部腸管特異的にHO-1を誘導し，これら組織特異的に誘導されたHO-1が標的臓器の保護・回復に重要な役割を果たしていることを示す．HO-1誘導剤の開発は急性臓器不全の新しい治療薬となる可能性を秘めている．<br>

DOI： 10.1254/fpj.130.252

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Stewart Approach : 新しい酸塩基平衡の考え方

森松 博史

臨床麻酔   31, 1281-1287   2007年

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ﾗｯﾄ出血性ｼｮｯｸ後急性肺傷害に対するｳﾘﾅｽﾀﾁﾝの治療効果.

井上一由, 高橋徹, 井戸佳奈, 清水裕子, 森松博史, 前島亨一朗, 松三昌樹, 片山浩, 森田潔

shock学会雑誌   22 ( 2 )   96 - 99   2007年

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誌上抄読会 ﾚﾐﾌｪﾝﾀﾆﾙ ー本邦での臨床使用に際して最近の話題ー.

溝渕知司, 佐藤健治, 花崎元彦, 中塚秀輝, 大西藍, 大西淳司, 那須敬, 脇有紀, 谷真規子, 金澤伴幸, 鈴木聡, 林真雄

臨床麻酔   31   93 - 100   2007年

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腹膜透析を要した小児心臓周術期患者の過血糖(原標題は英語)

江木盛時, 森松博史, 戸田雄一郎, 岩崎達雄, 清水一好, 竹内護, 松崎孝, 鈴木聡, 横山正尚, 森田潔

日本集中治療医学会雑誌   14 ( Supplement )   2007年

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The effects of saline or albumin resuscitation on acid-base status and serum electrolytes

Rinaldo Bellomo, Hiroshi Morimatsu, Craig French, Louise Cole, David Story, Shigehiko Uchino, Toshio Naka

CRITICAL CARE MEDICINE   34 ( 12 )   2891 - 2897   2006年12月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Objective: To test whether fluid resuscitation with normal saline or 4% albumin is associated with differential changes in acid-base status and serum electrolytes.
Design: Nested cohort study.
Setting. Three general intensive care units.
Patients: Six hundred and ninety-one critically ill patients.
Interventions: Randomization of patients to receive blinded solutions of either 4% human albumin or normal saline for fluid resuscitation.
Measurements and Main Results. Albumin was given to 339 patients and saline to 352. At baseline, both groups had a similar serum bicarbonate, albumin, and base excess levels. After randomization, bicarbonate and base excess increased significantly and similarly over time (p &lt;.0001). On multivariate analysis, fluid resuscitation with albumin predicted a smaller increase in pH (p =.0051), bicarbonate (p =.034), and base excess (p =.015). The amount of fluid was an independent predictor of pH (p &lt;.0001), serum chloride (p &lt;.0001), calcium (p =.0001), bicarbonate (p =.0002), and base excess (p &lt;.0001) on the first day of treatment. In patients who received &gt;3 L of fluids in the first 24 hrs, albumin administration was associated with a significantly greater increase in serum chloride (p =.0026). Acute Physiology and Chronic Health Evaluation II score and the presence of sepsis also independently predicted changes in several electrolytes and acid-base variables.
Conclusions. When comparing albumin and saline, the choice and amount of resuscitation fluid are independent predictors of acid-base status and serum electrolytes. When large volumes are given, albumin administration leads to a higher chloride concentration. However, overall differences between the types of fluid are minor, whereas the volume of fluid administered is a much stronger predictor of such changes, which are also influenced by illness severity and the passage of time.

DOI： 10.1097/01.CCM.0000242159.32764.86

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Effect of low-dose vasopressin infusion on vital organ blood flow in the conscious normal and septic sheep

D. Di Giantomasso, H. Morimatsu, R. Bellomo, C. N. May

ANAESTHESIA AND INTENSIVE CARE   34 ( 4 )   427 - 433   2006年8月

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記述言語：英語   出版者・発行元：AUSTRALIAN SOC ANAESTHETISTS  

The effect of low-dose vasopressin (AVP) on vital regional circulations may be clinically relevant but has not been fully described. We sought to determine the effect of low-dose AVP on systemic haemodynamics, coronary, mesenteric and renal circulations in the conscious normal and septic mammal.
We studied seven Merino sheep using a prospective randomized cross-over double-blind placebo-controlled animal design. We inserted flow probes around aorta, coronary, mesenteric and renal arteries and, three weeks later, we infused low-dose AVP (0.02 IU/min) or placebo in the normal and septic state induced by intravenous E. coli. In normal sheep, AVP (0. 02 IU/min) induced a 17% decrease in mesenteric blood flow (393.0 +/- 134.9 vs 472.1 +/- 163.8 ml/min, P&lt;0.05) and a 14% decrease in mesenteric conductance (P&lt;0.05). In septic sheep, APT decreased heart rate and cardiac output by 28% and 22%, respectively (P&lt;0.05). It also decreased mesenteric blood flow and mesenteric conductance by 23% (flow: 468.5 +/- 159.7 vs 611.3 +/- 1363 ml/min, P&lt;0.05; conductance: 63 +/- 2.7 vs 8.2 +/- 2.7 ml/min/mmHg; P&lt;0.05). Renal blood flow was unchanged but urine output and creatinine clearance increased (P &lt; 0.05). We conclude that low-dose AVP infusion has similar effects in the normal and septic mammalian circulation: bradycardia, decreased cardiac output, decreased mesenteric blood flow and conductance and increased urine output and creatinine clearance. This information is important to clinicians considering its administration in humans.

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Hyperchloremic acidosis in the critically ill: One of the strong-ion acidoses?

DA Story, H Morimatsu, R Bellomo

ANESTHESIA AND ANALGESIA   103 ( 1 )   144 - 148   2006年7月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Decreases in plasma bicarbonate are associated with hyperchloremic acidosis and lactic acidosis. According to the Stewart approach to acid-base physiology, the strong-ion difference regulates plasma bicarbonate, with chloride and lactate being the only strong anions routinely measured in clinical chemistry. We hypothesized that the plasma strong-ion difference, both with and without lactate, would have a stronger association with plasma bicarbonate than plasma chloride alone would have with bicarbonate. We used plasma acid-base data from 300 critically ill patients. The correlation with bicarbonate became progressively weaker (P &lt; 0.001): all measured strong ions, r = 0.60; measured strong ions without lactate, r = 0.42; chloride alone, r = -0.27. In a subgroup of 26 patients with traditional hyperchloremic acidosis (base excess &lt; -2mmol/L and anion gap &lt; 17 mmol/L), the measured strong-ion difference (without lactate) had a stronger correlation (P &lt; 0.001) with bicarbonate than chloride had: r = 0.85 versus r = -0.60. We conclude that hyperchloremic acidosis and lactic acidosis are strong-ion acidoses. Hyperchloremia should be viewed relative to the plasma strong cations. A practical conclusion is that both managing and preventing acid-base disorders with IV fluid therapy involves manipulating each of the plasma strong ions, particularly sodium and chloride.

DOI： 10.1213/01.ane.0000221449.67354.52

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Acid-base balance during continuous veno-venous hemofiltration: The impact of severe hepatic failure

T. Naka, R. Bellomo, H. Morimatsu, J. Rocktaschel, L. Wan, P. Gow, P. Angus

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS   29 ( 7 )   668 - 674   2006年7月

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記述言語：英語   出版者・発行元：WICHTIG EDITORE  

Background: Continuous renal replacement therapy (CRRT) affects acid-base balance but the influence of severe hepatic failure (SHF) on this effect is unknown.
Aim: To assess the effect of SHF on acid-base balance in patients receiving CVVH.
Design: Retrospective laboratory investigation.
Subjects: Forty patients with SHF and acute renal failure (ARF) treated with CVVH and 42 critically ill patients with severe ARF but no liver disease also treated with CVVH (controls).
Intervention: Retrieval of clinical and laboratory data from prospective unit and laboratory databases.
Methods: Quantitative acid-base status assessment using the Stewart-Figge methodology. Comparison of findings between the two groups.
Results: Although CVVH had a major effect on acid base balance in both groups, patients with SHF had a higher mean lactate concentrations (4.8 vs. 3.1 mmol/L; p &lt; 0.0005), a greater base deficit compared to controls (-1 vs. 4.1 mEq/L; p &lt; 0.0001) and a lower PaCO2 tension (36.8 vs. 42.5 mmHg; p &lt; 0.0001), despite the use of bicarbonate replacement fluid. The acidifying effect of hyperlactatemia was slightly worsened by an increased strong ion gap (9.3 vs. 4.9 mEq/L; p &lt; 0.0001). It was, however, attenuated by an increased strong ion difference apparent (SIDa) (43.6 vs. 41.9 mEq/L; p &lt; 0.05) secondary to hypochloremia (96 vs. 100 mmol/L; p &lt; 0.0001) and by hypoalbuminemia, although hypoalbuminemia in SHF patients (26 vs. 23; p &lt; 0.005) was less pronounced than in controls.
Conclusion: The use of CVVH does not fully correct the independent acidifying effect of liver failure on acid-base status. Increased lactate and strong ion gap values maintain a persistent base deficit despite the alkalinizing effects of hypoalbuminemia and hypochloremia. The correction of acidosis in SHF patients may require more intensive CVVH.

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General anesthesia in a patient with dystrophic epidermolysis bullosa

Yuichiro Toda, Masataka Yokoyama, Hiroshi Morimatsu, Hideki Nakatsuka, Mamoru Takeuchi, Hiroshi Katayama, Kiyoshi Morita

Journal of Anesthesia   20 ( 2 )   138 - 140   2006年5月

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記述言語：英語  

A 13-year-old boy with epidermolysis bullosa underwent a repair of pseudosyndactyly. He had a long history of bullae formation in the oral cavity and on the pharynx and body surface, and some were active at the time of surgery. We chose inhalational general anesthesia with tracheal intubation using sevoflurane and nitrous oxide. The trachea was successfully extubated after the surgery, and no major bulla formation was observed. General anesthesia with tracheal intubation may be chosen as anesthesia for patients with epidermolysis bullosa. © JSA 2006.

DOI： 10.1007/s00540-006-0388-7

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Heme arginate pretreatment attenuates pulmonary NF-κB and AP-1 activation induced by hemorrhagic shock via heme oxygenase-1 induction

T. Sasaki, Takatoru Takahashi, H. Shimizu, Y. Toda, H. Morimatsu, M. Takeuchi, M. Yokoyama, R. Akagi, K. Morita

Medicinal Chemistry   2 ( 3 )   271 - 274   2006年5月

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記述言語：英語  

Hemorrhagic shock followed by resuscitation (HSR) induces oxidative stress that leads to acute lung injury. Heme oxygenase-1 (HO-1), the rate-limiting enzyme in heme catabolism, is induced by oxidative stress and is thought to play an important role in the protection from oxidative tissue injuries. We previously demonstrated that HO-1 induction by heme arginate (HA), a strong inducer of HO-1, ameliorated HSR-induced lung injury and inflammation. Cellular redox state is known to modulate the DNA biding activity of the transcription factors
nuclear factor-κB (NF-κB) and activator protein-1 (AP-1). In the present study, we treated rats with HA (30 mg/kg of hemin) 18 h prior to HSR and examined its effect on the DNA binding activity of NF-κB and AP-1 at 1.5 h after HSR. HSR significantly increased the DNA binding activity of NF-κB as well as AP-1, while HA pretreatment markedly attenuated the activities of these transcription factors. In contrast, administration of tin mesoporphyrin, a specific competitive inhibitor of HO activity, to HA-pretreated animals abolished the suppressive effect of HA on the activities of NF-κB and AP-1, and increased these activities to almost the same level as those in HSR animals. Our findings indicate that HA pretreatment can significantly suppress the increased activity of NF-κB and AP-1 induced by HSR by virtue of its ability to induce HO-1. Our findings also suggest that HO-1 induced by HA pretreatment ameliorates HSR-induced lung injury at least in part mediated through the suppression of the activities of these transcription factors. © 2006 Bentham Science Publishers Ltd.

DOI： 10.1263/jbb.101.271

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成人心臓血管手術後症例における呼気一酸化炭素(CO)濃度の上昇

森松 博史, 高橋 徹, 竹内 護, 戸田 雄一郎, 松崎 孝, 森田 潔

Shock : 日本Shock学会雑誌   21 ( 1 )   56 - 56   2006年4月

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記述言語：日本語  

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ウリナスタチンはラット出血性ショック後急性肺傷害を改善する

井上 一由, 高橋 徹, 井戸 加奈, 川上 朋子, 森松 博史, 森田 潔

Shock : 日本Shock学会雑誌   21 ( 1 )   46 - 46   2006年4月

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記述言語：日本語  

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Increased heme catabolism in critically ill patients: correlation among exhaled carbon monoxide, arterial carboxyhemoglobin, and serum bilirubin IX alpha concentrations

H Morimatsu, T Takahashi, K Maeshima, K Inoue, T Kawakami, H Shimizu, M Takeuchi, M Yokoyama, H Katayama, K Morita

AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY   290 ( 1 )   L114 - L119   2006年1月

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記述言語：英語   出版者・発行元：AMER PHYSIOLOGICAL SOC  

It has been reported that exhaled carbon monoxide (CO) concentrations and arterial carboxyhemoglobin (CO-Hb) concentration in blood may be increased in critically ill patients. However, there was no study that examined correlation among amount of CO in exhaled air, CO-Hb concentrations in erythrocytes, and bilirubin IX alpha (BR) in serum, i.e., the three major indexes of heme catabolism, within the same subject. Here, we examined CO concentrations in exhaled air, CO-Hb concentrations in arterial blood, and BR levels in serum in 29 critically ill patients. Measurements of exhaled CO, arterial CO-Hb, and serum total BR have been done in the intensive care unit. As control, exhaled CO concentration was also measured in eight healthy volunteers. A median exhaled CO concentration was significantly higher in critically ill patients compared with control. There was significant correlation between CO and CO-Hb and CO and total BR level. We also found CO concentrations correlated with indirect BR but not direct BR. Multivariate linear regression analysis for amount of exhaled CO concentrations also showed significant correlation with CO-Hb and total BR, despite the fact that respiratory variables of study subjects were markedly heterogeneous. We found no correlation among exhaled CO, patients' severity, and degree of inflammation, but we found a strong trend of a higher exhaled CO concentration in survivors than in nonsurvivors. These findings suggest there is an increased heme breakdown in critically ill patients and that exhaled CO concentration, arterial CO-Hb, and serum total BR concentrations may be useful markers in critically ill conditions.

DOI： 10.1152/ajplung.00031.2005

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Pulmonary artery catheter versus pulse contour analysis: a prospective epidemiological study

Shigehiko Uchino, Rinaldo Bellomo, Hiroshi Morimatsu, Makoto Sugihara, Craig French, Dianne Stephens, Julia Wendon, Patrick Honore, John Mulder, Andrew Turner

CRITICAL CARE   10 ( 6 )   2006年

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記述言語：英語   出版者・発行元：BIOMED CENTRAL LTD  

Introduction The choice of invasive systemic haemodynamic monitoring in critically ill patients remains controversial as no multicentre comparative clinical data exist. Accordingly, we sought to study and compare the features and outcomes of patients who receive haemodynamic monitoring with either the pulmonary artery catheter (PAC) or pulse contour cardiac output (PiCCO) technology.
Methods We conducted a prospective multicentre, multinational epidemiological study in a cohort of 331 critically ill patients who received haemodynamic monitoring by PAC or PiCCO according to physician preference in intensive care units (ICUs) of eight hospitals in four countries. We collected data on haemodynamics, demographic features, daily fluid balance, mechanical ventilation days, ICU days, hospital days, and hospital mortality. We statistically compared the two techniques.
Results Three hundred and forty-two catheters ( PiCCO 192 and PAC 150) were inserted in 331 patients. On direct comparison, patients with PAC were older ( 68 versus 64 years of age; p = 0.0037), were given inotropic drugs more frequently 37.3% versus 13%; p &lt; 0.0001), and had a lower cardiac index (2.6 versus 3.2 litres/ minute per square meter; p &lt; 0.0001). Mean daily fluid balance was significantly greater during PiCCO monitoring (+ 659 versus + 350 ml/day; p = 0.017) and mechanical ventilation-free days were fewer ( 12 for PiCCO versus 21 for PAC; p = 0.045). However, after multiple regression analysis, we found no significant effect of monitoring technique on mean daily fluid balance, mechanical ventilation-free days, ICU-free days, or hospital mortality. A secondary multiple logistic regression analysis for hospital mortality which included mean daily fluid balance showed that positive fluid balance was a significant predictor of hospital mortality ( odds ratio = 1.0002 for each ml/day; p = 0.0073).
Conclusion On direct comparison, the use of PiCCO was associated with a greater positive fluid balance and fewer ventilator-free days. After correction for confounding factors, the choice of monitoring did not influence major outcomes, whereas a positive fluid balance was a significant independent predictor of outcome. Future studies may best be targeted at understanding the effect of pursuing different fluid balance regimens rather than monitoring techniques per se.

DOI： 10.1186/cc5126

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【これまでのそしてこれからの循環動態モニタリング】 胸郭インピーダンス法

森松博史, 竹内護, 下野綾子, 戸田雄一郎, 森田潔

ICUとCCU   30 ( 3 )   203 - 206   2006年

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記述言語：日本語   出版者・発行元：医学図書出版  

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先天性表皮水疱症の食道狭窄に対するバルーン拡張術の麻酔経験

松三絢弥, 森松博史, 松崎孝, 戸田雄一郎, 中塚秀輝, 森田潔

麻酔   55 ( 3 )   362 - 364   2006年

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記述言語：日本語   出版者・発行元：克誠堂出版  

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[急性血液浄化法 徹底ガイド] 最近注目されている血液浄化法 High folw CHDF,High volume CHF

片山 浩, 森松博史, 江木盛時, 岡部悠吾, 佐藤哲文, 森田 潔

救急・集中治療   2006年

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Non Renal Indicationによる血液浄化法の考察

森松博史

ICUとCCU   30 ( 8 )   541 - 545   2006年

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記述言語：日本語   出版者・発行元：医学図書出版  

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ストレス蛋白Heme Oxygenase-1(HO-1)の腎および腸管保護作用

高橋 徹, 森松博史, 森田 潔

ICUとCCU   30 ( 5 )   359 - 365   2006年

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記述言語：日本語   出版者・発行元：医学図書出版  

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ドパミン神話の崩壊？ドパミンのない世界へようこそ

森松博史

Cardiovascular Anesthesia   2006年

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血液浄化と酸塩基平衡

森松 博史, 江木 盛時, 片山 浩

救急・集中治療   2006年

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生体肝移植術後の敗血症症例にPMX‐DHPを施行した1例

佐藤哲文, 片山浩, 松三絢弥, 松崎孝, 新井美奈子, 竹中央, 森松博史, 賀来隆治, 佐藤健治, 中塚秀輝, 松三昌樹, 森田潔

エンドトキシン血症救命治療研究会誌   9 ( 1 )   212 - 217   2005年12月

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記述言語：日本語  

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The effects of continuous epidural anesthesia and analgesia on stress response and immune function in patients undergoing radical esophagectomy

M Yokoyama, Y Itano, H Katayama, H Morimatsu, Y Takeda, T Takahashi, O Nagano, K Morita

ANESTHESIA AND ANALGESIA   101 ( 5 )   1521 - 1527   2005年11月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

We investigated whether perioperative extensive epidural block (C3-L) affects postoperative immune response in patients undergoing radical esophagectomy. Patients undergoing radical esophagectomy were randomly assigned to either general anesthesia with continuous epidural infusion via 2 epidural catheters that was continued for postoperative analgesia (group E, n = 15) or intraoperative general anesthesia and postoperative IV morphine analgesia (group G, n = 15). Plasma levels of stress hormones, cytokines, C-reactive protein (CRP), leukocyte counts, and distribution of lymphocyte subsets were assessed before and after surgery and on postoperative days (PODs) 1 and 3. In comparison with group E, significant increases in plasma epinephrine level at the end of surgery (P &lt; 0.05) and norepinephrine level at the end of surgery (P &lt; 0.01) and on POD1 (P &lt; 0.01) and POD3 (P &lt; 0.01) and significant decrease in cluster of differentiation (CD4/CD8 ratio) at the end of surgery (P &lt; 0.05) were observed in group G. However, there were no significant differences in other variables between groups. In both groups, plasma cortisol, adrenocorticotropic hormone, interleukin (IL)-1 beta, IL-6, IL-10, and CRP levels were increased after surgery (each group P &lt; 0.01) and IL-1 beta, IL-6, IL-10, and CRP were still increased on POD1 and POD3 (each change, each group P &lt; 0.01). Leukocyte counts were increased on PODI (each group P &lt; 0.05) and POD3 (each group P &lt; 0.01). The proportion of lymphocytes decreased from the end of surgery to POD3 (each group P &lt; 0.01). The proportion of B cells was increased on POD1 (each group P &lt; 0.01); that of natural killer cells was decreased at PODI and POD3 (each group P &lt; 0.01). We conclude that tissue damage and inflammation apparently overcome the effects of extensive epidural block on stress response and immune function in radical esophagectomy.

DOI： 10.1213/01.ANE.0000184287.15086.1E

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集中治療に役立つ血液浄化の最先端:HF,HV‐CHDFに対する期待と展望

片山浩, 森松博史, 佐藤哲文, 岩崎達雄, 武田吉正, 竹内護, 中塚秀輝, 森田潔

日本臨床麻酔学会誌   25 ( 6 )   S148   2005年10月

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記述言語：日本語  

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External validation of severity scoring systems for acute renal failure using a multinational database

S Uchino, R Bellomo, H Morimatsu, S Morgera, M Schetz, Tan, I, C Bouman, E Macedo, N Gibney, A Tolwani, GS Doig, HO van Straaten, C Ronco, JA Kellum

CRITICAL CARE MEDICINE   33 ( 9 )   1961 - 1967   2005年9月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Objective. Several different severity scoring systems specific to acute renal failure have been proposed. However, most validation studies of these scoring systems were conducted in a single center or in a small number of centers, often the same ones used for their development. Therefore, it is not known whether such severity scoring systems may be widely applied.
Design: Prospective clinical investigation.
Setting: Intensive care units.
Patients: One thousand seven hundred and forty-two intensive care unit patients with acute renal failure who were either treated with renal replacement therapy or fulfilled predefined criteria.
Interventions: Demographic and clinical information and outcomes were measured.
Measurements and Main Results. Scores for four acute renal failure-specific scoring systems and two general scoring systems (Simplified Acute Physiology Score II and Sequential Organ Failure Assessment) were calculated, and their discrimination and calibration were tested with receiver operating characteristic curves and Hosmer-Lemeshow goodness-of fit-tests. For the receiver operating characteristic curves, blood lactate levels were also used as a reference. All scores had an area under the receiver operating characteristic curve &lt; 0.7 (Mehta 0.670, Liano 0.698, Chertow 0.610, Paganini 0.643, Simplified Acute Physiology Score II 0.645, Sequential Organ Failure Assessment 0.675, lactate 0.639). For scores that can calculate predicted mortality, the Hosmer-Lemeshow goodness-of-fit test showed poor calibration.
Conclusions: None of the scoring systems tested had a high level of discrimination or calibration to predict mortality for patients with acute renal failure when tested in a broad cohort of patients from multiple countries. A large, multiple-center database might be needed to improve the discrimination and calibration of acute renal failure scoring system.

DOI： 10.1097/01.CCM.0000172279.66229.07

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Acute renal failure in critically ill patients - A multinational, multicenter study

S Uchino, JA Kellum, R Bellomo, GS Doig, H Morimatsu, S Morgera, M Schetz, Tan, I, C Bouman, E Macedo, N Gibney, A Tolwani, C Ronco

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION   294 ( 7 )   813 - 818   2005年8月

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記述言語：英語   出版者・発行元：AMER MEDICAL ASSOC  

Context Although acute renal failure (ARF) is believed to be common in the setting of critical illness and is associated with a high risk of death, little is known about its epidemiology and outcome or how these vary in different regions of the world.
Objectives To determine the period prevalence of ARF in intensive care unit (ICU) patients in multiple countries; to characterize differences in etiology illness severity, and clinical practice; and to determine the impact of these differences on patient outcomes.
Design, Setting, and Patients Prospective observational study of ICU patients who either were treated with renal replacement therapy (RRT) or fulfilled at least 1 of the predefined criteria for ARF from September 2000 to December 2001 at 54 hospitals in 23 countries.
Main Outcome Measures Occurrence of ARF, factors contributing to etiology, illness severity, treatment, need for renal support after hospital discharge, and hospital mortality.
Results Of 29 269 critically ill patients admitted during the study period, 1738 (5.7%; 95% confidence interval [CI], 5.5%-6.0%) had ARF during their ICU stay, including 1260 who were treated with RRT. The most common contributing factor to ARF was septic shock (47.5%; 95% Cl, 45.2%-49.5%). Approximately 30% of patients had preadmission renal dysfunction. Overall hospital mortality was 60.3% (95% Cl, 58.0%-62.6%). Dialysis dependence at hospital discharge was 13.8% (95% Cl, 11.2%-16.3%) for survivors. Independent risk factors for hospital mortality included use of vasopressors (odds ratio [OR], 1.95; 95% Cl, 1.50-2.55; P&lt;.001), mechanical ventilation (OR, 2.11; 95% Cl, 1.58-2.82; P&lt;.001), septic shock (OR, 1.36; 95% Cl, 1.03-1.79; P=.03), cardiogenic shock (OR, 1.41; 95% Cl, 1.05-1.90; P=.02), and hepatorenal syndrome (OR, 1.87; 95% Cl, 1.07-3.28; P=.03).
Conclusion In this multinational study; the period prevalence of ARF requiring RRT in the ICU was between 5% and 6% and was associated with a high hospital mortality rate.

DOI： 10.1001/jama.294.7.813

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A quantitative analysis of the acidosis of cardiac arrest: a prospective observational study

J Makino, S Uchino, H Morimatsu, R Bellomo

CRITICAL CARE   9 ( 4 )   R357 - R362   2005年8月

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記述言語：英語   出版者・発行元：BIOMED CENTRAL LTD  

Introduction Metabolic acidosis is common in patients with cardiac arrest and is conventionally considered to be essentially due to hyperlactatemia. However, hyperlactatemia alone fails to explain the cause of metabolic acidosis. Recently, the Stewart Figge methodology has been found to be useful in explaining and quantifying acid - base changes in various clinical situations. This novel quantitative methodology might also provide useful insight into the factors responsible for the acidosis of cardiac arrest. We proposed that hyperlactatemia is not the sole cause of cardiac arrest acidosis and that other factors participate significantly in its development.
Methods One hundred and five patients with out-of-hospital cardiac arrest and 28 patients with minor injuries ( comparison group) who were admitted to the Emergency Department of a tertiary hospital in Tokyo were prospectively included in this study. Serum sodium, potassium, ionized calcium, magnesium, chloride, lactate, albumin, phosphate and blood gases were measured as soon as feasible upon arrival to the emergency department and were later analyzed using the Stewart - Figge methodology.
Results Patients with cardiac arrest had a severe metabolic acidosis ( standard base excess - 19.1 versus - 1.5; P &lt; 0.0001) compared with the control patients. They were also hyperkalemic, hypochloremic, hyperlactatemic and hyperphosphatemic. Anion gap and strong ion gap were also higher in cardiac arrest patients. With the comparison group as a reference, lactate was found to be the strongest determinant of acidosis (- 11.8 meq/ l), followed by strong ion gap (- 7.3 meq/ l) and phosphate (- 2.9 meq/ l). This metabolic acidosis was attenuated by the alkalinizing effect of hypochloremia (+ 4.6 meq/ l), hyperkalemia (+ 3.6 meq/ l) and hypoalbuminemia (+ 3.5 meq/ l).
Conclusion The cause of metabolic acidosis in patients with out-of-hospital cardiac arrest is complex and is not due to hyperlactatemia alone. Furthermore, compensating changes occur spontaneously, attenuating its severity.

DOI： 10.1186/cc3714

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重症患者における呼気一酸化炭素濃度(CO)と臓器不全との関係

森松 博史, 高橋 徹, 井戸 佳奈, 川上 朋子, 前島 亨一郎, 戸田 雄一郎, 清水 裕子, 森田 潔

Shock : 日本Shock学会雑誌   20 ( 1 )   44 - 44   2005年4月

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記述言語：日本語  

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Exhaled CO after surgery: A consequence of postoperative narcotics? - Response

H Morimatsu, T Takahashi

ANESTHESIA AND ANALGESIA   100 ( 3 )   896 - 896   2005年3月

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記述言語：英語   掲載種別：速報，短報，研究ノート等（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

DOI： 10.1213/01.ANE.0000146646.02457.55

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ICU入室患者における尿中分離菌の検討

佐藤哲文, 森松博史, 佐藤健治, 中塚秀輝, 横山正尚, 片山浩, 森田潔

日本集中治療医学会雑誌   12 ( Supplement )   230   2005年1月

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J-GLOBAL

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集中治療における急性血液浄化法の標準化と問題点 急性血液浄化法の標準とは BEST KIDNEY STUDY

中敏夫, 内野滋彦, Bellomo Rinaldo, 森松博史

ICUとCCU   2005年

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ピエール・ロバン症候群患者の手術室外での麻酔経験

紙谷順子, 戸田雄一郎, 中塚秀輝, 佐藤健治, 森松博史, 多賀直行, 竹内護, 森田潔

麻酔   2005年

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Septic MODSに対しての急性血液浄化法のプランニング septic MODSに対する血液浄化法の新しいアプローチ

中敏夫, Bellomo Rinaldo, 篠崎正博, 内野滋彦, 森松博史, Baldwin Ian

ICUとCCU   29   S101 - 103   2005年

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記述言語：日本語   出版者・発行元：医学図書出版  

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その他リンク： http://search.jamas.or.jp/link/ui/2005182701

ラット出血性ショックモデルにおける消化管障害に対するヘムオキシゲナーゼ－1の保護効果（日本Shock学会会長賞）.

井上一由, 高橋 徹, 井戸佳奈, 川上朋子, 上原健司, 森松博史, 前島亨一郎, 横山正尚, 森田 潔

日本Shock学会雑誌   2005年

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Rapid development of severe interstitial pneumonia caused by epoprostenol in a patient with primary pulmonary hypertension

H Morimatsu, K Goto, T Matsusaki, H Katayama, H Matsubara, T Ohe, K Morita

ANESTHESIA AND ANALGESIA   99 ( 4 )   1205 - 1207   2004年10月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

A young woman with primary pulmonary hypertension developed severe interstitial pneumonia (IP) 5 days after induction of epoprostenol infusion. Although the pathogen involved was not identified, her IP was initially responsive to steroids, and discontinuation of steroid therapy caused the redevelopment of IP. After intensive treatment, including steroid therapy and inhaled nitric oxide, epoprostenol was successfully switched to prostaglandin E-1 infusion and she recovered. Epoprostenol infusion can cause a rapid severe IP, even soon after the induction of therapy. Clinicians should keep this syndrome in mind, especially when treating a severe case of IP.

DOI： 10.1213/01.ANE.0000130615.28893.52

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Pierre Robin症候群患者の手術室外での麻酔経験

紙谷順子, 戸田雄一郎, 中塚秀輝, 森松博史, 多賀直行, 竹内護, 森田潔

日本臨床麻酔学会誌   24 ( 8 )   1 - 191   2004年9月

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記述言語：日本語  

J-GLOBAL

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先天性表皮水ほう症患者の麻酔経験

戸田雄一郎, 中塚秀輝, 森松博史, 多賀直行, 竹内護, 片山浩, 森田潔

日本小児麻酔学会誌   10 ( 1 )   107   2004年9月

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気管支喘息 (特集 急性呼吸不全に対する呼吸管理ベストプラクティス) -- (救急患者にみられる急性呼吸不全の病態と治療)

森松 博史, 片山 浩

救急医学   28 ( 10 )   1348 - 1354   2004年9月

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記述言語：日本語   出版者・発行元：へるす出版  

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その他リンク： http://search.jamas.or.jp/link/ui/2004305649

Diuretics and mortality in acute renal failure

S Uchino, GS Doig, R Bellomo, H Morimatsu, S Morgera, M Schetz, Tan, I, C Bouman, E Macedo, N Gibney, A Tolwani, C Ronco, JA Kellum

CRITICAL CARE MEDICINE   32 ( 8 )   1669 - 1677   2004年8月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Objective: According to recent research, diuretics may increase mortality in acute renal failure patients. The administration of diuretics in such patients has been discouraged. Our objective was to determine the impact of diuretics on the mortality rate of critically ill patients with acute renal failure.
Design: Prospective, multiple-center, multinational epidemiologic study.
Setting, Intensive care units from 54 centers and 23 countries.
Patients, Patients were 1,743 consecutive patients who either were treated with renal replacement therapy or fulfilled predefined criteria for acute renal failure.
Interventions: Three distinct multivariate models were developed to assess the relationship between diuretic use and subsequent mortality: a) a propensity score adjusted multivariate model containing terms previously identified to be important predictors of outcome; b) a new propensity score adjusted multivariate model; and c) a multivariate model developed using standard methods, compensating for collinearity.
Measurements and Main Results: Approximately 70% of patients were treated with diuretics at study inclusion. Mean age was 68 and mean Simplified Acute Physiology Score II was 47. Severe sepsis/septic shock (43.8%), major surgery (39.1), low cardiac output (29.7), and hypovolemia (28.2%) were the most common conditions associated with the development of acute renal failure. Furosemide was the most common diuretic used (98.3%). Combination therapy was used in 98 patients only. In all three models, diuretic use was not associated with a significantly increased risk of mortality.
Conclusions: Diuretics are commonly prescribed in critically ill patients with acute renal failure, and their use is not associated with higher mortality. There is full equipoise for a randomized controlled trial of diuretics in critically ill patients with renal dysfunction.

DOI： 10.1097/01.CCM.0000132892.51063.2F

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Increased carbon monoxide concentration in exhaled air after surgery and anesthesia

M Hayashi, T Takahashi, H Morimatsu, H Fujii, N Taga, S Mizobuchi, M Matsumi, H Katayama, M Yokoyama, M Taniguchi, K Morita

ANESTHESIA AND ANALGESIA   99 ( 2 )   444 - 448   2004年8月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Heme oxygenase-1 (HO-1) is induced by oxidative stress and is thought to confer protection against oxidative tissue injuries. HO-1 catalyzes the conversion of the heme moiety of hemeproteins, such as hemoglobin, myoglobin, and cytochrome P450, to biliverdin, liberating carbon monoxide (CO) in the process. CO reacts with hemoglobin to form carboxyhemoglobin. In this study, to examine the effect of anesthesia and/or surgery on endogenous CO production, we measured the amount of exhaled CO and the arterial carboxyhemoglobin concentration of patients who underwent surgery under general or spinal anesthesia. Both CO and carboxyhemoglobin concentrations were significantly larger on the day after surgery than during the preoperative period (P &lt; 0.05) and in the recovery room (P &lt; 0.05), regardless of anesthesia. However, neither index differed between general and spinal anesthesia. These results suggest that oxidative stress caused by anesthesia and/or surgery may induce HO-1, which catalyzes heme to produce CO, leading to increased exhaled CO concentration.

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Early and exclusive use of norepinephrine in septic shock

H Morimatsu, K Singh, S Uchino, R Bellomo, G Hart

RESUSCITATION   62 ( 2 )   249 - 254   2004年8月

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記述言語：英語   出版者・発行元：ELSEVIER SCI IRELAND LTD  

Background: The timing and use of norepinephrine (noradrenaline) (NE) in septic shock remain a matter of controversy. Aim: To study the outcome of septic patients treated with early and exclusive NE. Setting: Tertiary Intensive Care Unit. Patients: 142 patients with septic shock. Intervention: Exclusive NE infusion within 24 hours of admission to ICU. Methods and main results: Retrospective analysis of data from a unit database identified 142 patients. Their median admission simplified acute physiology score (SAPS II) score was 46 [38, 56] with 98 (69%) receiving mechanical ventilation. Mean arterial pressure (MAP) at the start of NE infusion was 60 [58, 68] mmHg. NE infusion was started at a median of 1.3 [0.3, 5.0] h after ICU admission. Restoration and maintenance of target MAP was achieved initially in all patients and, in 61.3%, within 30 min. The median peak dose of NE was 0.28 [0.14, 0.61] mug/(kg min) and the duration of infusion was 88 [42, 175] h. SAPS II predicted mortality was 40.8%, however, only 34.5% (P = 0.27) died. Among the most severely ill patients (SAPS II score &gt; 56) actual mortality was 50.0% versus 74.7% predicted (P = 0.07). Conclusions: Early and exclusive use of NE in hyperdynamic septic shock achieved a stable MAP &gt; 75 mmHg in all patients. Survival compared favorably with that predicted by illness severity scores. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.resuscitation.2004.03.016

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Increasing renal blood flow - Low-dose dopamine or medium-dose norepinephrine

D Di Giantomasso, H Morimatsu, CN May, R Bellomo

CHEST   125 ( 6 )   2260 - 2267   2004年6月

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記述言語：英語   出版者・発行元：AMER COLL CHEST PHYSICIANS  

Background and objectives: Many clinicians believe that low-dose dopamine (LDD) [2 mug/kg/min] increases renal blood flow (RBF) and medium-dose norepinephrine (MD-NE) [0.4 mug/kg/min] decreases RBF. They also believe that MD-NE might induce mesenteric and/or coronary ischemia. In fact, the effects of these drugs on renal and vital organ blood flow are poorly understood. The aim of this study was to compare the effects of 6 h of IV LDD and MD-NE infusion on mammalian renal, coronary, mesenteric, and sagittal blood flow.
Design: Randomized, controlled, experimental animal study.
Setting: Animal laboratory of tertiary physiology institute.
Subjects: Seven Merino cross sheep were studied.
Measurements and results: We performed a staged insertion of transit-time flow probes around ascending aorta, sagittal sinus and circumflex coronary, superior mesenteric, and left renal arteries. We then randomized these animal with long-term embedded flow probes to either 6 h of placebo (saline solution) or drugs (MD-NE at 0.4 mug/kg/min or LDD at 2 mug/kg/min), and performed continuous measurement of systemic pressures, cardiac output (CO), and flow to vital organs. We also sampled blood and urine for the measurement of lactate, creatinine, and creatinine clearances at preset intervals.
Results: Compared to placebo, LDD did not affect systemic hemodynamics. However, it increased mean RBF by 20% (267.3 +/- 87.6 mL/min vs 222.0 +/- 74.4 mL/min, p = 0.028) without a detectable effect on other vital regional circulations. MD-NE, however, increased mean arterial pressure (101.0 +/- 8.3 mL/min vs 84.2 +/- 5.2 mL/min, p = 0.018) [mean +/- SD] and CO (4.93 +/- 1.45 L/min vs 3.81 +/- 0.57 L/min, p = 0.028). It also increased coronary blood flow (36.0 +/- 15.7 mL/min vs 23.0 +/- 10.7 mL/min, p = 0.018) and RBF (286.5 +/- 79.0 mL/min vs 222.0 +/- 74.4 mL/min, p = 0.018). MD-NE had no detectable effect on mesenteric or sagittal sinus flow. LDD infusion increased urine output, but did not change creatinine clearance. MD-NE infusion increased urine output significantly more than LDD but not creatinine clearance.
Conclusions: Both LDD (2 mug/kg/min) and MD-NE (0.4 mug/kg/min) increased RBF and urine output. However, the effect of MD-NE was more pronounced. LDD did not affect other vital organ flows, but MD-NE increased coronary blood flow without any changes in mesenteric and sagittal sinus blood flow.

DOI： 10.1378/chest.125.6.2260

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重症心不全を合併した心室性不整脈に対する塩酸ニフェカラントの使用経験

杉本健太郎, 森松博史, 小林求, 藤井洋泉, 佐藤哲文, 中塚秀輝, 五藤恵次, 片山浩, 森田潔

日本集中治療医学会雑誌   11 ( Supplement )   204   2004年1月

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原発性肺高血圧症の治療中にプロスタサイクリンが原因と思われる間質性肺炎を合併した1症例

松崎孝, 森松博史, 清水一好, 小林求, 中塚秀輝, 五藤恵次, 片山浩, 森田潔

日本集中治療医学会雑誌   11 ( Supplement )   176   2004年1月

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Strong ions, weak acids and base excess: a simplified Fencl-Stewart approach to clinical acid-base disorders

DA Story, H Morimatsu, R Bellomo

BRITISH JOURNAL OF ANAESTHESIA   92 ( 1 )   54 - 60   2004年1月

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記述言語：英語   出版者・発行元：OXFORD UNIV PRESS  

Background. The Fencl-Stewart approach to acid-base disorders uses five equations of varying complexity to estimate the base excess effects of the important components: the strong ion difference (sodium and chloride), the total weak acid concentration (albumin) and unmeasured ions. Although this approach is straightforward, most people would need a calculator to use the equations. We proposed four simpler equations that require only mental arithmetic and tested the hypothesis that these simpler equations would have good agreement with more complex Fencl-Stewart equations.
Methods. We reduced two complex equations for the sodium-chloride effect on base excess to one simple equation: sodium-chloride effect (meq litre(-1))=[Na+]-[Cl-]-38. We simplified the equation of the albumin effect on base excess to an equation with two constants: albumin effect (meq litre(-1))=0.25x(42-[albumin]g litre(-1)). Using 300 blood samples from critically ill patients, we examined the agreement between the more complex Fencl-Stewart equations and our simplified versions with Bland-Altman analyses.
Results. The estimates of the sodium-chloride effect on base excess agreed well, with no bias and limits of agreement of -0.5 to 0.5 meq litre(-1). The albumin effect estimates required log transformation. The simplified estimate was, on average, 90% of the Fencl-Stewart estimate. The limits of agreement for this percentage were 82-98%.
Conclusions. The simplified equations agree well with the previous, more complex equations. Our findings suggest a useful, simple way to use the Fencl-Stewart approach to analyse acid-base disorders in clinical practice.

DOI： 10.1093/bja/aeh018

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Continuous Venovenous hemofiltration without anticoagulation

S Uchino, N Fealy, Baldwin, I, H Morimatsu, R Bellomo

ASAIO JOURNAL   50 ( 1 )   76 - 80   2004年1月

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

We conducted a prospective observational study to assess the efficacy of continuous venovenous hemofiltration (CVVH) with no anticoagulation. A standard anticoagulation protocol for CVVH, which prescribed no anticoagulation for patients at risk of bleeding, was applied to 48 critically ill patients treated with CVVH. Circuit life was prospectively observed, and the following data were obtained for each circuit: heparin use and dose, protamine use, daily prothrombin time-international normalized ratio, activated partial thromboplastin time, and platelet count. Out of 300 consecutive circuits 143 (47.6%) received no anticoagulation, 31 (10.3%) received regional anti coagulation, and 126 received low dose heparin. No patients experienced bleeding complications secondary to CVVH. Platelet count was significantly lower in the no anticoagulation group (73 X 10(3)/mul) compared with the low dose heparin group (19 X 10(3)/mul) and the protamine group (104 X 10(3)/mul) (p &lt; 0.01 for both comparisons). There was no significant difference in mean circuit life among the three groups (heparin, 20.9 hours; no anti coagulation, 19.3 hours; protamine, 21.2 hours; not significant). In conclusion, for a group of patients deemed to be at risk of bleeding, CVVH without anticoagulation achieved an acceptable circuit life, which was similar to that obtained in other patients with low dose heparin atiticoagulation or regional anticoagulation with heparin/protamine.

DOI： 10.1097/01.MAT.0000104822.30759.A7

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急性血液浄化 劇症肝炎における予後と意識改善に影響を与える因子.

森松博史, 片山 浩, 清水一好, 賀来隆治, 藤井洋泉, 松三昌樹, 森田 潔

ICUとCCU   2004年

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喘息

森松 博史, 片山 浩

救急医学   28 (10)、1348-1354   2004年

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直腸癌術後急性肺塞栓症の一例

篠浦先, 森松博史, 片山浩, 国富彩, 貞森裕, 八木孝仁, 河田政明, 金沢右, 岩垣博巳, 田中紀章

岡山医学会雑誌   2004年

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15.肝移植に対するブリッジ療法としての血液浄化(一般演題)(日本アフェレシス学会第22回関西地方会抄録)

井戸 和己, 片山 浩, 森松 博史, 佐藤 哲文, 松三 昌樹, 森田 潔

日本アフェレシス学会雑誌   23 ( 2 )   210 - 210   2004年

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記述言語：日本語   出版者・発行元：日本アフェレシス学会  

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その他リンク： http://id.nii.ac.jp/1141/00150452/

16.劇症肝炎における血液浄化の検討(一般演題)(日本アフェレシス学会第22回関西地方会抄録)

森松 博史, 片山 浩, 清水 一好, 賀来 隆治, 藤井 洋泉, 松三 昌樹, 森田 潔

日本アフェレシス学会雑誌   23 ( 2 )   210 - 210   2004年

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記述言語：日本語   出版者・発行元：日本アフェレシス学会  

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その他リンク： http://id.nii.ac.jp/1141/00150453/

とう痛治療開始後に進行癌が判明した3症例

谷野雅昭, 中塚秀輝, 賀来隆治, 井上一由, 森松博史, 大江克憲, 大橋一郎, 倉迫敏明, 平川方久

日本ペインクリニック学会誌   8 ( 4 )   417   2001年10月

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記述言語：日本語  

J-GLOBAL

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腫瘍随伴性天疱瘡に免疫吸着を施行した一症例

賀来 隆治, 森松 博史, 奥 格, 長野 修, 片山 浩, 平川 方久

ICUとCCU   25 ( 別冊 )   S195 - S196   2001年2月

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

症例は19歳男で,抗体価を測定しながらトリプトファンカラムによる免疫吸着療法を行ったところ,治療後臨床症状が改善したのに対し抗体価の明らかな低下はみられなかった

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CHDにおける透析液流量(Qd)とβ2-Microglobulin clearanceの検討

森松 博史, 賀来 隆治, 長野 修, 福島 臣啓, 片山 浩, 平川 方久

ICUとCCU   25 ( 別冊 )   S151 - S152   2001年2月

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

Polyacrylonitrile膜を用いた持続血液透析患者8例を対象に,β2-Microglobulin(β2-M)クリアランスとQd,血流量(Qb)との関係を検討した.β2-Mの血漿クリアランスはQd,Qbに関わらず一定であった.β2-Mの透析クリアランスは血漿クリアランスよりも著しく低い値を示し,本透析における血液からのβ2-M除去には吸着の関与が大きいことを示唆した

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グラム陽性球菌感染症によるショックに対して血行動態の改善にPMX-DHPが有効であった２症例

賀来隆治, 森松博史, 溝渕知司, 奥 格, 長野 修, 片山 浩, 平川方久

エンドトキシン血症救命治療研究会誌   2001年

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臨床経過よりToxic shock syndrome(TSS)が疑われ,エンドトキシン吸着及びCHDFが有効であった1例

松岡 義和, 森松 博史, 藤井 洋泉, 奥 格, 長野 修, 松三 昌樹, 片山 浩, 平川 方久

日本臨床麻酔学会誌   20 ( 8 )   S321 - S321   2000年9月

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

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