2023/12/11 更新

写真a

ニシワキ キミトシ
西脇 公俊
NISHIWAKI, Kimitoshi
所属
大学院医学系研究科 総合医学専攻 生体管理医学 教授
大学院担当
大学院医学系研究科
学部担当
医学部
職名
教授
外部リンク

学位 1

  1. 医学博士 ( 1995年4月   名古屋大学 ) 

研究キーワード 3

  1. 麻酔科学 集中治療医学 疼痛緩和学 ペインクリニック

  2. Pain clinic

  3. Critical care medicine

研究分野 2

  1. その他 / その他  / 麻酔・蘇生i医学

  2. ライフサイエンス / 麻酔科学

現在の研究課題とSDGs 1

  1. 肺血管透過性亢進の機序解明

経歴 14

  1. 名古屋大学   大学院医学系研究科 総合医学専攻 生体管理医学   教授

    2000年7月 - 現在

  2. 名古屋大学   医学部附属病院 外科系集中治療部   部長

    2019年4月 - 現在

  3. 名古屋大学   医学部 附属病院   副病院長

    2013年4月 - 現在

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    国名:日本国

  4. 名古屋大学   医学部附属病院   名古屋大学医学部附属病院 副院長

    2013年4月 - 現在

  5. 名古屋大学   集中治療部長

    2010年4月 - 2012年6月

  6. 名古屋大学   薬事審議会部長

    2010年4月 - 2011年3月

  7. 名古屋大学   大学院医学系研究科 機能構築医学専攻 生体管理医学(麻酔・蘇生医学)   教授

    2008年7月 - 現在

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    国名:日本国

  8. 名古屋大学   大学院医学系研究科 機能構築医学専攻 生体管理医学(麻酔・蘇生医学)   准教授

    2007年4月 - 2008年6月

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    国名:日本国

  9. 名古屋大学   大学院医学系研究科 機能構築医学専攻 生体管理医学(麻酔・蘇生医学)   助教授

    2004年12月 - 2007年3月

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    国名:日本国

  10. 名古屋大学   医学部 麻酔科    講師

    2000年7月 - 2004年11月

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    国名:日本国

  11. 名古屋第一赤十字病院    麻酔科   部長

    1998年4月 - 2000年6月

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    国名:日本国

  12. 名古屋第一赤十字病院   麻酔科   副部長

    1997年4月 - 1998年3月

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    国名:日本国

  13. 名古屋大学   医学部 麻酔科    講師

    1996年2月 - 1997年3月

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    国名:日本国

  14. 名古屋大学   医学部 麻酔学講座   助手

    1986年4月 - 1996年2月

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    国名:日本国

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学歴 1

  1. 名古屋大学   医学部   医学科

    1978年4月 - 1984年3月

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    国名: 日本国

所属学協会 6

  1. 日本麻酔科学会

  2. 日本ペインクリニック学会

  3. 日本集中治療医学会

  4. American Society of Anesthesiology

  5. 医療の質安全学会

  6. American Society of Anesthesiology

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論文 204

  1. Hypofibrinogenemia can be estimated by the predictive formula in aortic surgery. 査読有り 国際誌

    Nishi T, Mutsuga M, Akita T, Narita Y, Fujimoto K, Tokuda Y, Nishida K, Matsui S, Nishiwaki K, Usui A

    General thoracic and cardiovascular surgery   69 巻 ( 10 ) 頁: 1376 - 1382   2021年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:General Thoracic and Cardiovascular Surgery  

    Objective: Aortic surgery often causes massive bleeding due to hypofibrinogenemia. Predicting hypofibrinogenemia is useful for developing a hemostasis strategy, including preparing for blood transfusion. We made a formula for predicting the serum fibrinogen level (SFL) at the termination of cardiopulmonary bypass (CPB) in aortic surgery and examined its validity. Methods: We performed a retrospective observational study that consisted of 267 patients (group A) who underwent aortic surgery from July 2013 to December 2016 and made a formula for predicting the SFL at the termination of CPB in group A by a multiple linear regression analysis. The validity of this formula was then examined in another 60 patients (group B) who underwent aortic surgery from January 2017 to December 2017. Results: We developed the following predictive formula: SFL at the termination of CPB (mg/dL) = 14.7 + 0.44 × preoperative SFL (mg/dL) + (− 0.14) × CPB time (min) + 0.64 × preoperative body weight (kg) + (− 17.3) × lateral thoracotomy (Yes/No, Yes: 1, No: 0). In group B, the predictive formula proved to be statistically valid in group B (R2 = 0.531, p < 0.001). Conclusion: The SFL at the termination of CPB in aortic surgery can be predicted by the preoperative SFL, body weight, CPB time and surgical approach. The predictive formula is useful for developing a hemostasis strategy, including preparing for blood transfusion.

    DOI: 10.1007/s11748-021-01594-5

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  2. Accuracy of landmark scalp blocks performed during asleep-awake-asleep awake craniotomy: a retrospective study. 査読有り 国際誌

    Sato T, Nishiwaki K

    JA clinical reports   7 巻 ( 1 ) 頁: 8   2021年1月

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    担当区分:最終著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JA Clinical Reports  

    DOI: 10.1186/s40981-021-00412-4

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  3. Lidocaine inhibits vascular endothelial growth factor-A-induced angiogenesis. 査読有り 国際誌

    Suzuki S, Mori A, Fukui A, Ema Y, Nishiwaki K

    Journal of anesthesia   34 巻 ( 6 ) 頁: 857 - 864   2020年12月

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    担当区分:最終著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Purpose: Angiogenesis is closely related to the pathophysiology of diseases such as cancer or ischemia. Here, we investigated the effect of lidocaine at clinically effective blood concentrations on vascular endothelial growth factor A (VEGF-A)-induced angiogenesis. In addition, we aimed to clarify the mechanisms by which lidocaine could inhibit angiogenesis. Methods: Angiogenesis was analyzed using commercially available in vitro assay kits in human umbilical vein endothelial cells (HUVECs)/normal human dermal fibroblast co-culture systems. The effects of lidocaine on cytotoxicity, VEGF-induced cell migration, and VEGF-induced cell proliferation were examined in HUVECs using lactate dehydrogenase cytotoxic, Boyden chamber, and WST-8 assays, respectively. The VEGF signaling pathway via VEGF receptor 2 (VEGFR-2) was analyzed by western blotting. Results: Lidocaine elicited a significant dose-dependent, angiogenesis-inhibitory effect at a concentration range of 1–10 μg/ml. At this concentration range, cell death was not observed. Lidocaine, at a concentration of 10 μg/ml, significantly inhibited cell proliferation but not cell migration, induced by VEGF-A in HUVECs. Furthermore, lidocaine, in a dose-dependent manner, significantly inhibited the VEGF-A-induced phosphorylation of VEGFR-2 at 3 and 10 μg/ml. Conclusion: We demonstrated that lidocaine has an anti-angiogenesis effect on clinically effective blood concentrations without causing cell death. This finding could represent a new avenue for future research into anesthesia, cancer-related analgesia, and revascularization therapy.

    DOI: 10.1007/s00540-020-02830-7

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  4. Comparing oscillometric noninvasive and invasive intra-arterial blood pressure monitoring in term neonates under general anesthesia: A retrospective study. 査読有り 国際誌

    Fujii T, Nishiwaki K

    Paediatric anaesthesia   30 巻 ( 12 ) 頁: 1396 - 1401   2020年12月

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    担当区分:最終著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Paediatric Anaesthesia  

    Background: Oscillometric noninvasive blood pressure and/or invasive intra-arterial blood pressure are commonly used to measure the systolic, diastolic, and mean components of blood pressure. Agreement between the two methods has been reported in adults, children, and infants, but rarely in neonates, especially under general anesthesia. Aims: This retrospective study compared the agreement of each measured blood pressure value (oscillometric noninvasive or invasive intra-arterial blood pressure monitoring) in term neonates under general anesthesia. Methods: Data were collected from neonates born at ≥36 weeks of gestation whose body weight was ≥2500 g and who underwent abdominal or noncardiac thoracic surgery with both oscillometric noninvasive and invasive intra-arterial blood pressure measurements from January 2015 to March 2020. The primary outcome was the agreement of systolic, diastolic, and mean blood pressure values between the two methods using Bland-Altman analysis. Results: Paired blood pressure measurements (n = 1193) from 67 cases were compared. In Bland-Altman analysis, bias (standard deviation), 95% limits of agreement, and percentage error were −9.3 (8.4), −26.1-7.6, and 26.9% for systolic; 1.6 (6.5), −11.3-14.6, and 38.7% for diastolic; and −1.3 (5.8), −13.0-10.3, and 26.9% for mean blood pressure, respectively. During low blood pressure (intra-arterial mean blood pressure ≤30 mm Hg), the biases (standard deviation) of systolic, diastolic, and mean blood pressure were −11.4 (5.7), −0.7 (3.7), and −5.1 (4.2), whereas during high blood pressure (intra-arterial mean blood pressure ≥60 mm Hg), the values were 0.1 (9.7), 5.6 (9.4), and 6.4 (7.4), respectively. Conclusions: Based on the bias and percentage error, the mean blood pressure exhibited the most acceptable agreement between oscillometric noninvasive and invasive intra-arterial blood pressure monitoring in term neonates under general anesthesia. However, during hypertension or hypotension, there was a large discrepancy between the two methods.

    DOI: 10.1111/pan.14020

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  5. Novel anesthetic agent remimazolam as an alternative for the asleep-awake-asleep technique of awake craniotomy. 査読有り 国際誌

    Sato T, Kato Y, Yamamoto M, Nishiwaki K

    JA clinical reports   6 巻 ( 1 ) 頁: 92   2020年11月

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    担当区分:最終著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JA Clinical Reports  

    DOI: 10.1186/s40981-020-00398-5

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  6. Preanesthesia scalp blocks reduce intraoperative pain and hypertension in the asleep-awake-asleep method of awake craniotomy: A retrospective study. 査読有り 国際誌

    Sato T, Okumura T, Nishiwaki K

    Journal of clinical anesthesia   66 巻   頁: 109946   2020年11月

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    担当区分:最終著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Clinical Anesthesia  

    DOI: 10.1016/j.jclinane.2020.109946

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  7. Prompt prediction of fibrinogen concentration during cardiopulmonary bypass: a pilot study. 査読有り 国際誌

    Tamura T, Imaizumi T, Kubo Y, Waters JH, Nishiwaki K

    Nagoya journal of medical science   82 巻 ( 4 ) 頁: 623 - 630   2020年11月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya Journal of Medical Science  

    Platelet Mapping can measure both the degree of platelet inhibition and fibrinogen activation, was not originally designed to measure fibrinogen concentration. Traditional laboratory fibrinogen concentration testing requires around 60 minutes; however, fibrinogen activation only takes 10 minutes, and is indicated as maximum amplitude of activator f. If Platelet Mapping can predict fibrinogen concentration during cardiopulmonary bypass, this could facilitate rapid hemostasis management. The aim of this study was to verify whether fibrinogen concentration could be predicted using Platelet Mapping results. Thus, a pilot study was conducted to evaluate this concept during cardiopulmonary bypass. This prospective, observational pilot study investigated 15- to 90-year-old patients who underwent cardiac or aortic surgery from August 2019 to September 2019. Twenty-one patients enrolled in this study, and 43 blood samples were obtained for both fibrinogen activation measurements using Platelet Mapping and traditional laboratory-based tests, respectively. Correlations between results were analyzed using linear regression and the receiver operating characteristic curve. Correlation by Pearson's correlation analysis indicates a significant relationship (correlation coefficient of r = 0.91), and a receiver operating characteristic curve indicated that sensitivity, specificity, and receiver operating characteristic area were 100% (95% confidence interval, 75.3-100%), 93.8% (79.2-99.2%), and 0.995 (0.984-1.00), respectively. Our results indicate a strong correlation between fibrinogen activation and serum fibrinogen concentration. The maximum amplitude of activator f can estimate low fibrinogen concentration faster than traditional methods; this method quickly provides important information for anesthesia and hemostatic management in cardiac surgery.

    DOI: 10.18999/nagjms.82.4.623

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  8. Transverse vs. parasagittal in-plane approaches in ultrasound-guided paravertebral block using a microconvex probe: A randomised controlled trial. 査読有り 国際誌

    Fujii T, Shibata Y, Shinya S, Nishiwaki K

    European journal of anaesthesiology   37 巻 ( 9 ) 頁: 752 - 757   2020年9月

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    担当区分:最終著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:European journal of anaesthesiology  

    BACKGROUND Several approaches have been proposed for ultrasound-guided thoracic paravertebral block, but the best approach remains unclear. OBJECTIVE We compared two ultrasound-guided in-plane approaches using a microconvex probe, transverse and parasagittal. We assessed whether either approach would facilitate successful catheter placement in the paravertebral space. DESIGN Randomised controlled trial. SETTING University hospital, July 2015 to March 2016. PATIENTS Sixty patients scheduled to undergo thoracotomy were randomly allocated into two groups. INTERVENTIONS A microconvex probe was placed transversely between adjacent ribs (transverse) or sagittally between adjacent transverse processes (parasagittal). When the Tuohy needle reached the paravertebral space, a catheter was inserted to a depth of 4 cm. Then, 0.5-ml radiocontrast was injected through the catheter under fluoroscopy. MAIN OUTCOME MEASURES The primary outcome was successful catheter placement in the paravertebral space; secondary outcomes were 0 to 100 mm visual analogue scale pain score and morphine consumption in the first 24 h. RESULTS All patients received the allocated paravertebral block. Correct catheter placement occurred in 23 (77%) and 24 patients (80%) using the transverse (n=30) and parasagittal approaches (n=30), respectively (P = 1.00). Five patients were excluded due to changes in surgical procedure. Postoperative pain, represented by median [IQR] visual analogue scale score, was 19.5 [12 to 25] at rest and 55 [44 to 77] on movement with the transverse approach (n=28) vs. 22 [12 to 33.5] at rest and 59 [41.5 to 75] on movement with the parasagittal approach (n=27) (P = 0.57 at rest, P = 0.76 on movement). Median morphine consumption was 11.5 [5 to 21] and 11 [5 to 18] mg in the transverse and parasagittal approaches, respectively (P = 0.99). CONCLUSION There were no clinically significant differences between approaches for continuous ultrasound-guided thoracic paravertebral block using a microconvex probe, and both approaches achieved a high rate of correct catheter placement.

    DOI: 10.1097/EJA.0000000000001223

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  9. Heparin concentration in cell salvage during heparinization: a pilot study. 査読有り 国際誌

    Tamura T, Waters JH, Nishiwaki K

    Nagoya journal of medical science   82 巻 ( 3 ) 頁: 449 - 455   2020年8月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya Journal of Medical Science  

    Cell salvage is frequently used to avoid unnecessary allogeneic blood transfusions, which results in a reduction in blood transfusion volume and cost. The aspirated blood is washed with normal saline and centrifuged to recover only blood cells, salvaged blood is then made. In cardiovascular surgery, heparin is used to maintain activated clotting time over 400 seconds. Some practitioners believe that heparin remains in the salvaged blood. Therefore, we hypothesized that salvaged blood during cardiovascular surgery includes heparin. A pilot study was conducted to evaluate our hypothesis using three different salvage systems. This study was a prospective, observational, pilot study, with patients aged 20-85 years old who were scheduled for cardiovascular surgery from May 2018 to October 2018. The intent of this study was to evaluate whether salvaged blood with three different devices includes large enough quantities of heparin to influence activated clotting time in cardiovascular surgery. Between May and October 2018, 12 samples during heparinization were collected, and 12 samples of salvaged blood from 3 devices were collected after administrating protamine. The heparin concentration of the 24 samples was measured. All heparin concentrations in salvage blood sample from two devices was below the limit of measurement (0.10 IU/mL). Slightly measurable heparin was detected in salvaged blood sample from one device (mean 0.15 IU/mL). Salvaged blood during cardiovascular surgery intervention does not contain enough heparin to influence activated clotting time.

    DOI: 10.18999/nagjms.82.3.449

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  10. The incidence and risk factors of hypofibrinogenemia in cardiovascular surgery. 査読有り 国際誌

    Nishi T, Mutsuga M, Akita T, Narita Y, Fujimoto K, Tokuda Y, Terazawa S, Ito H, Nishiwaki K, Usui A

    General thoracic and cardiovascular surgery   68 巻 ( 4 ) 頁: 335 - 341   2020年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:General Thoracic and Cardiovascular Surgery  

    Objective: Cardiovascular surgery often causes massive bleeding due to coagulopathy, with hypofibrinogenemia being a major causative factor. We assessed the intraoperative incidence of hypofibrinogenemia and explored predictors of hypofibrinogenemia. Methods: The intraoperative serum fibrinogen level (SFL) was routinely measured in 872 consecutive patients [mean age: 66.9 ± 13.3 years; 598 men (68.6%)] undergoing cardiovascular surgery from July 2013 to November 2016 at Nagoya University Hospital. There were 275 aortic surgeries, 200 cases of coronary artery bypass grafting (CABG), 334 valvular surgeries and 63 other surgeries. We estimated hypofibrinogenemia incidence (intraoperative lowest SFL ≤ 150 mg/dL) and identified its predictors by a logistic regression analysis. Results: The average intraoperative lowest SFL of all cases, aortic surgery, CABG and valvular surgery was 185 ± 71, 156 ± 65, 198 ± 69 and 198 ± 68 mg/dL, respectively. Aortic surgery had a significantly lower intraoperative lowest SFL than CABG (p < 0.001) and valvular surgery (p < 0.001). The incidence of hypofibrinogenemia was 32.8%, 50.2%, 26.5% and 22.8% in all cases, aortic surgery, CABG and valvular surgery, respectively. The predictors of hypofibrinogenemia were the preoperative SFL, re-do surgery and perfusion time. A receiver operating characteristics curve analysis showed that the best preoperative SFL cutoff value for predicting hypofibrinogenemia was 308.5 mg/dL. Assuming preoperative SFL 300 mg/dL as the cutoff, the odds ratio for hypofibrinogenemia was 7.22 (95% confidence interval 5.26–9.92, p < 0.001). Conclusions: The incidence of hypofibrinogenemia in aortic surgery was high. The preoperative SFL, re-do surgery and perfusion time were identified as predictors for hypofibrinogenemia. Intraoperative measurement of SFL is important for detecting hypofibrinogenemia and applying appropriate and prompt transfusion treatment.

    DOI: 10.1007/s11748-019-01201-8

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  11. Chronic pain after breast surgery - still many unanswered questions: a reply. 査読有り 国際誌

    Fujii T, Nishiwaki K

    Anaesthesia   75 巻 ( 3 ) 頁: 416 - 417   2020年3月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Anaesthesia  

    DOI: 10.1111/anae.14982

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  12. <Editors' Choice> Efficacy of pectoral nerve block type-2 (Pecs II block) versus serratus plane block for postoperative analgesia in breast cancer surgery: a retrospective study. 査読有り 国際誌

    Kubodera K, Fujii T, Akane A, Aoki W, Sekiguchi A, Iwata K, Ban M, Ando R, Nakamura N, Shibata Y, Nishiwaki K

    Nagoya journal of medical science   82 巻 ( 1 ) 頁: 93 - 99   2020年2月

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    担当区分:最終著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya Journal of Medical Science  

    Thoracic wall nerve blocks reduce postoperative acute pain after breast cancer surgery (BCS); however, their short-term effects and the most effective technique remain unclear. To compare the effects of pectoral nerve block type-2 (Pecs II block) and serratus plane block for postoperative short-term analgesia, we retrospectively reviewed 43 BCS patients who underwent Pecs II block (n=22) or serratus plane block (n=21). The primary outcome was the proportion of patients with no complaints of pain 2 months post-BCS. The odds ratio (OR) was assessed, adjusting for axillary lymph node dissection. The secondary outcomes were pain severity 24 hours and 2 months post-operation using the numerical rating scale score, and morphine consumption within 24 hours. The proportion of patients without pain 2 months post-BCS was significantly less with Pecs II block than in patients with serratus plane block (55% vs. 19%, adjusted OR, 5.04; 95% confidence interval, 1.26-20.07; P=0.02); the median [interquartile range] score for pain 2 months post-operation was also significantly lower with Pecs II block (Pecs II block 0.5 [0-1] vs. serratus plane block 1 [1-2]); P=0.03). Regarding post-BCS acute analgesia, the median [interquartile range] postoperative 24-hour pain score was 2 [1-3] and 3 [1.5-3.5], and the median morphine consumption within 24 hours was 1.5 [0.75-5.5] and 3 [1.5-10] mg in Pecs II block and serratus plane block (P=0.47 and P=0.11), respectively. This study suggests that Pecs II block prevents short-term post-BCS pain better than serratus plane block. However, further studies are needed in order to support this finding.

    DOI: 10.18999/nagjms.82.1.93

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  13. 巨大心臓腫瘍に対する経静脈的ペースメーカー植え込み術において,経食道心エコーが術中麻酔管理とリード留置に有用であった一例 査読有り

    高倉 将司, 佐藤 威仁, 藤井 祐, 竹田 道宏, 西脇 公俊

    Cardiovascular Anesthesia   24 巻 ( 1 ) 頁: 173 - 177   2020年

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    担当区分:最終著者, 責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本心臓血管麻酔学会  

    <p> 今回,巨大な心臓原発性悪性リンパ腫の患者に対し経静脈的ペースメーカー植え込み術の麻酔管理を経食道心エコー(TEE)を用いて,ペーシングリードをエコー下に誘導することで安全に行いえた症例を経験したため報告する。症例は70歳代男性。右心系を占拠する巨大な心臓原発性悪性リンパ腫と診断された。経過中にⅢ度房室ブロックをきたしたため全身麻酔下でのペースメーカー留置術を施行された。循環虚脱に備え体外循環のスタンバイを行った上で慎重に麻酔導入を行った。術中ペーシングリードの位置決めに際して透視下のみでは適切な位置に誘導することが困難だったが,同時にTEEを併用する事で誘導が可能であり有用性が高かった。</p>

    DOI: 10.11478/jscva.2020-2-006

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  14. A randomised controlled trial of pectoral nerve-2 (PECS 2) block vs. serratus plane block for chronic pain after mastectomy 査読有り 国際誌

    Fujii T., Shibata Y., Akane A., Aoki W., Sekiguchi A., Takahashi K., Matsui S., Nishiwaki K.

    ANAESTHESIA   74 巻 ( 12 ) 頁: 1558 - 1562   2019年12月

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    担当区分:最終著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Anaesthesia  

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  15. Incidence of reexpansion pulmonary edema in minimally invasive cardiac surgery. 査読有り 国際誌

    Tamura T, Ito T, Yokota S, Ito S, Kubo Y, Ando M, Nishiwaki K

    Nagoya journal of medical science   81 巻 ( 4 ) 頁: 647 - 654   2019年11月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya Journal of Medical Science  

    Minimally invasive cardiac surgery requires fewer blood transfusions and mediastinitis is less frequently observed compared to conventional median sternotomy surgical intervention, and it leads to earlier recovery and discharge. However, once reexpansion pulmonary edema occurs, the patient requires long-term management in the intensive care unit. This retrospective study was performed to investigate the incidence of reexpansion pulmonary edema in minimally invasive cardiac surgery. Patients who underwent minimally invasive cardiac valve surgery using cardiopulmonary bypass and port-access by a minimal right lateral thoracic incision between January 2010 and January 2018 were enrolled in this single-center retrospective study, which was approved by the institutional review board of Japanese Red Cross Nagoya Daiichi Hospital (Nagoya, Japan), and the requirement for written informed consent was waived. All data were collected from electronic charts. The primary outcome was the incidence rate of reexpansion pulmonary edema in patients undergoing minimally invasive cardiac surgery. A total of 662 patients underwent minimally invasive cardiac surgery, and we analyzed 651 of these cases. No case of reexpansion pulmonary edema was observed in this study. The statistically-calculated incidence rate of reexpansion pulmonary edema was less than 0.6% (95% confidence interval: 0.0-0.6). The incidence of cerebral infarction was 0.92% (n = 6). Intensive care unit stay days, hospital stay days after surgery, and the death rate after 30 days were 1.5 ± 2.0 days, 9.6 ± 3.9 days, and 0.15%, respectively. Although there was no incidence of clinical reexpansion pulmonary edema in this study, the predicted incidence of reexpansion pulmonary edema by statistical analysis was less than 0.6%.

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  16. A Drainage System to Decrease Volatile Anesthetic Leakage for the Several Types of Oxygenators During Cardiopulmonary Bypass. 査読有り 国際誌

    Tamura T, Mori A, Nishiwaki K

    Journal of cardiothoracic and vascular anesthesia   33 巻 ( 9 ) 頁: 2610 - 2612   2019年9月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Cardiothoracic and Vascular Anesthesia  

    DOI: 10.1053/j.jvca.2019.05.022

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  17. Properties of echoic memory revealed by auditory-evoked magnetic fields. 査読有り 国際誌

    Kinukawa T, Takeuchi N, Sugiyama S, Nishihara M, Nishiwaki K, Inui K

    Scientific reports   9 巻 ( 1 ) 頁: 12260 - 12260   2019年8月

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

    We used auditory-evoked magnetic fields to investigate the properties of echoic memory. The sound stimulus was a repeated 1-ms click at 100 Hz for 500 ms, presented every 800 ms. The phase of the sound was shifted by inserting an interaural time delay of 0.49 ms to each side. Therefore, there were two sounds, lateralized to the left and right. According to the preceding sound, each sound was labeled as D (preceded by a different sound) or S (by the same sound). The D sounds were further grouped into 1D, 2D, and 3D, according to the number of preceding different sounds. The S sounds were similarly grouped to 1S and 2S. The results showed that the preceding event significantly affected the amplitude of the cortical response; although there was no difference between 1S and 2S, the amplitudes for D sounds were greater than those for S sounds. Most importantly, there was a significant amplitude difference between 1S and 1D. These results suggested that sensory memory was formed by a single sound, and was immediately replaced by new information. The constantly-updating nature of sensory memory is considered to enable it to act as a real-time monitor for new information.

    DOI: 10.1038/s41598-019-48796-9

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  18. Comparison between rectus sheath block with 0.25% ropivacaine and local anesthetic infiltration with 0.5% ropivacaine for laparoscopic inguinal hernia repair in children. 査読有り 国際誌

    Tamura T, Kaneko K, Yokota S, Kitao T, Ando M, Kubo Y, Nishiwaki K

    Nagoya journal of medical science   81 巻 ( 3 ) 頁: 341 - 349   2019年8月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya Journal of Medical Science  

    This randomized, observer-blinded prospective study aimed to compare the postoperative analgesic effects of ultrasound-guided rectus sheath block with those of local anesthetic infiltration of the surgical field in children undergoing inguinal hernia repair. Children aged 2 to 14 years, scheduled for elective single-incision laparoscopic percutaneous extraperitoneal closure, were randomly allocated to receive ultrasound-guided rectus sheath block (group R) or local anesthetic infiltration of the surgical field (group L). In group R, 0.5 ml/kg of 0.25% ropivacaine (per side) was administered after intubation. In group L, 0.4 ml/kg of 0.5% ropivacaine was administered after peritoneal closure. Postoperative pain was assessed using the Face Scale and Face, Legs, Activity, Cry, Consolability scale at various time points, including the primary endpoint of 2 h after leaving the operation room. Additional analgesic drugs were used according to the Face Scale scores. Patient characteristics, the amount of additional drugs, and complication rate were evaluated in both groups. The patient and surgical characteristics were comparable between groups. The Face Scale and Face, Legs, Activity, Cry, Consolability scale scores were not significantly different between group R (n = 38) and group L (n = 38) at 2 h after leaving the operation room. The amount of additional drugs administered at 2 h after leaving the operation room were also comparable between groups. Our findings suggest that the postoperative analgesic efficacy of ultrasound-guided rectus sheath block is not superior to that of local anesthetic infiltration of the surgical field for pediatric single-incision laparoscopic percutaneous extraperitoneal closure.

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  19. Association Between Motor-Evoked Potentials and Spinal Cord Damage Diagnosed With Magnetic Resonance Imaging After Thoracoabdominal and Descending Aortic Aneurysm Repair. 査読有り 国際誌

    Hattori K, Yoshitani K, Kato S, Kawaguchi M, Kawamata M, Kakinohana M, Yamada Y, Yamakage M, Nishiwaki K, Izumi S, Yoshikawa Y, Mori Y, Hasegawa K, Onishi Y

    Journal of cardiothoracic and vascular anesthesia   33 巻 ( 7 ) 頁: 1835 - 1842   2019年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Cardiothoracic and Vascular Anesthesia  

    Objectives: The authors investigated the association between intraoperative motor-evoked potential (MEP) changes and the severity of spinal cord infarction diagnosed with magnetic resonance imaging (MRI) to clarify the discrepancy between them, which was observed in patients with postoperative motor deficits after thoracic and thoracoabdominal aortic surgery. Design: A multicenter retrospective study. Setting: Motor-evoked potential <25% of control values was deemed positive for spinal cord ischemia. The severity of spinal cord infarction was categorized into grades A to D based on previous studies using the most severe axial MRI slices. The associations between MRI grade, MEP changes, and motor deficits were examined using logistic regression. Participants: Twenty-three of 1,245 patients (from 1999 to 2013, at 12 hospitals in Japan) were extracted from medical records of patients who underwent thoracic and thoracoabdominal aortic repair, with intraoperative MEP examinations and postoperative spinal MRI. Interventions: No intervention (observational study). Measurements and Main Results: Motor-evoked potential <25% of control value was associated significantly with motor deficits at discharge (adjusted odds ratio [OR], 130.0; p = 0.041), but not with severity of spinal cord infarction (adjusted OR, 0.917; p = 0.931). Motor deficit at discharge was associated with severe spinal cord infarction (adjusted OR, 4.83; p = 0.043), MEP <25% (adjusted OR, 13.95; p = 0.031), and combined deficits (motor and sensory, motor and bowel or bladder, or sensory and bowel or bladder deficits; adjusted OR, 31.03; p = 0.072) in stepwise logistic regression analysis. Conclusion: Motor-evoked potential <25% was associated significantly with motor deficits at discharge, but not with the severity of spinal cord infarction.

    DOI: 10.1053/j.jvca.2018.12.004

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  20. Fibrinogen levels measured by the dry hematology method are lower than those measured by the Clauss method under a high concentration of heparin. 査読有り 国際誌

    Suzuki S, Tamura T, Hasegawa K, Maeda S, Mori R, Kainuma M, Adachi Y, Nishiwaki K

    Nagoya journal of medical science   81 巻 ( 2 ) 頁: 259 - 267   2019年5月

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    担当区分:最終著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya journal of medical science  

    The activity of fibrinogen has been reported to decrease soon after the onset of major bleeding and to be an important determinant of the final extent of bleeding and postoperative outcome. A device that measures the perioperative fibrinogen level using the dry hematology (DH) method has recently become available. The aim of this study was to compare perioperative fibrinogen levels measured by the DH method with those measured by the conventional Clauss method and to assess the effects of heparin on these measurements. The study included 206 samples from 36 patients undergoing major surgery who received high-dose heparin (HH group, 23 samples), low-dose heparin (LH group, 57 samples), or no heparin (C group, 126 control samples). Each sample was measured using the DH and Clauss methods. After excluding samples outside the effective measurement range, the three study groups (HH group, n=23; LH group, n=49; C group, n=115) were compared. The mean fibrinogen level measured by the DH method in the HH group (87.9 ± 3.1%) was significantly lower than that measured by the Clauss method. There were no significant differences between the fibrinogen measurements obtained by the two methods between the LH and C groups. In patients on high-dose heparin, the mean fibrinogen level measured by the DH method was significantly lower than that measured by the Clauss method. When hemorrhage requires emergency treatment, a method that can measure the fibrinogen level rapidly is important. The DH method may be useful for decision-making with regard to perioperative coagulation factor replacement.

    DOI: 10.18999/nagjms.81.2.259

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  21. Safety of Fibrinogen Concentrate and Cryoprecipitate in Cardiovascular Surgery: Multicenter Database Study. 査読有り 国際誌

    Maeda T, Miyata S, Usui A, Nishiwaki K, Tanaka H, Okita Y, Katori N, Shimizu H, Sasaki H, Ohnishi Y, Ueda Y

    Journal of cardiothoracic and vascular anesthesia   33 巻 ( 2 ) 頁: 321 - 327   2019年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Cardiothoracic and Vascular Anesthesia  

    Objectives: To investigate whether administering fibrinogen concentrate or cryoprecipitate is associated with increased postoperative thromboembolic events and improved mortality in patients undergoing thoracic aortic surgery. Design: Multicenter retrospective cohort study using propensity-score analyses and multivariate logistic regression analysis to control for confounders. Setting: Four hospitals (1 national cardiovascular center and 3 university hospitals). Participants: Patients undergoing thoracic aortic surgery with cardiopulmonary bypass between January 2010 and October 2012 (n = 1,047). Interventions: Outcomes in patients treated with fibrinogen concentrate or cryoprecipitate (fibrinogen group) were compared with those who did not receive these products (no fibrinogen group) based on propensity-score matching. Multivariate logistic regression analysis then was performed to confirm the results. Measurements and Main Results: Among 1,047 patients enrolled in this study, 247 patients received fibrinogen concentrate or cryoprecipitate. The median amount of administered fibrinogen was 3 g (interquartile range 2-4 g). Eighty-seven patients were excluded from the propensity-score matching because of missing data. Propensity-score–matched analysis showed no significant difference in the incidence of thromboembolic events or 30-day mortality rate between the groups. Multivariate analysis revealed that the fibrinogen group showed no significant difference in thromboembolic events (odds ratio 1.22; 95% confidence interval 0.76-1.95; p = 0.408) or mortality rate (odds ratio 0.44; 95% confidence interval 0.18-1.12; p = 0.081) compared with those in the no fibrinogen group. Conclusions: Administering fibrinogen concentrate or cryoprecipitate was associated with neither thromboembolic events nor 30-day mortality in patients undergoing thoracic aortic surgery. Administering fibrinogen concentrate or cryoprecipitate is safe and does not appear to increase thromboembolic events and mortality in thoracic aortic surgery patients.

    DOI: 10.1053/j.jvca.2018.06.001

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  22. Local anesthetic spread into the paravertebral space with two types of quadratus lumborum blocks: a crossover volunteer study. 査読有り 国際誌

    Tamura T, Yokota S, Ito S, Shibata Y, Nishiwaki K

    Journal of anesthesia   33 巻 ( 1 ) 頁: 26 - 32   2019年2月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Purpose: Previous work showed that 20 mL of local anesthetic (LA) did not spread into the paravertebral space (PVS) via the intramuscular quadratus lumborum block (QLBi). If spread of LA into the PVS can be achieved by increasing the total LA volume, QLBi can be more effective. We hypothesized that a larger volume of LA for the QLBi would spread into the PVS. Methods: This crossover volunteer study included five healthy men. For comparison, both the ultrasound-guided QLB type 2 (QLB2) and QLBi were employed on opposite sides of each volunteer, and the spread of LA solution (0.7 mL/kg) mixed with contrast media in the PVS was assessed 1 h after the first injection using magnetic resonance imaging. Sensory loss was evaluated by pinprick 90 min post-injection. Each volunteer underwent both QLB types, and the same procedures were administered on opposite sides 7 days after the first experiment. Results: In total, 20 QLB blocks (10 QLB2 and 10 QLBi) were performed. LA did not spread into the PVS after the QLBi. The sensory block area included the lower abdomen after the QLB2, but not after the QLBi. The sensory block area did not extend to the upper abdominal region or the midline of the lower abdomen with either block method. Conclusion: LA administered by the QLB2 spreads into the PVS of T10–T12, resulting in lower and lateral abdominal sensory loss. In contrast, LA administered by the QLBi does not spread into the PVS and results in only lateral abdominal sensory loss.

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  23. FAM98A is localized to stress granules and associates with multiple stress granule-localized proteins. 査読有り 国際誌

    Ozeki K, Sugiyama M, Akter KA, Nishiwaki K, Asano-Inami E, Senga T

    Molecular and cellular biochemistry   451 巻 ( 1-2 ) 頁: 107 - 115   2019年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Molecular and Cellular Biochemistry  

    Stress granules are evolutionally conserved ribonucleoprotein structures that are formed in response to various stress stimuli. Recent studies have demonstrated that proteins with low complexity (LC) regions play a critical role for the formation of stress granules. In this study, we report that FAM98A, whose biological functions are unknown, is a novel component of stress granules. FAM98A is localized to stress granules, but not to P-bodies, after various stress stimuli. Analysis with deletion mutants revealed that C-terminal region that contains LC region was essential for FAM98A accumulation to stress granules. Depletion of FAM98A using two different siRNAs decreased the number of stress granules formed per cell. Finally, we show that FAM98A associates with stress granule-localized proteins, such as DDX1, ATXN2, ATXN2L, and NUFIP2. Our results show a partial role of FAM98A for the organization of stress granules.

    DOI: 10.1007/s11010-018-3397-6

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  24. 大量出血症例に対する血液製剤の適正な使用のガイドライン 査読有り

    宮田 茂樹, 志水 秀行, 西村 邦宏, 西脇 公俊, 松下 正, 小川 覚, 紀野 修一, 久保 隆彦, 齋藤 伸行, 田中 裕史, 田村 高廣, 板倉 敦夫, 中井 陸運, 藤井 聡, 前田 琢磨, 前田 平生, 牧野 真太郎, 松永 茂剛, 上田 裕一, 碓氷 章彦, 大北 裕, 大西 佳彦, 香取 信之, 久志本 成樹, 佐々木 啓明

    日本輸血細胞治療学会誌   65 巻 ( 1 ) 頁: 21 - 92   2019年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本輸血・細胞治療学会  

    DOI: 10.3925/jjtc.65.21

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  25. 食道閉鎖症/気管食道瘻術後に発生した気管憩室により挿管後換気困難となった症例 査読有り

    山田 章宏, 奥村 朋子, 森本 典行, 長谷川 和子, 荒川 陽子, 西脇 公俊

    日本臨床麻酔学会誌   39 巻 ( 3 ) 頁: 253 - 256   2019年

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    担当区分:最終著者, 責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本臨床麻酔学会  

    <p>食道閉鎖症/気管食道瘻根治術後に気管憩室が形成され,その後の全身麻酔時に気管チューブが憩室に陥入し換気困難となった症例を経験した.症例は7カ月の男児.食道閉鎖症/気管食道瘻根治術後に食道狭窄を認めたため,全身麻酔下で食道バルーン拡張術が予定された.全身麻酔導入後,気管挿管は容易であったが,換気困難で食道挿管と判断し抜管した.再挿管後,同様に換気困難に陥った.気管支鏡で原因検索したところ,気管後壁の憩室に気管チューブが陥入したため換気困難に陥ったと判断した.食道閉鎖症/気管食道瘻根治術後の場合,気管憩室など気道の解剖学的異常を考慮すべきであると考えられた.</p>

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  26. 胸部傍脊椎ブロックカテーテルの感染範囲の診断に造影CTが有用であった1症例 査読有り

    新屋 苑恵, 西脇 公俊

    日本ペインクリニック学会誌   26 巻 ( 1 ) 頁: 75 - 76   2019年

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    担当区分:最終著者, 責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本ペインクリニック学会  

    DOI: 10.11321/jjspc.18-0031

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  27. Spread of Quadratus Lumborum Block to the Paravertebral Space Via Intramuscular Injection: A Volunteer Study 査読有り 国際誌

    Tamura Takahiro, Kitamura Kana, Yokota Shuichi, Ito Shigeki, Shibata Yasuyuki, Nishiwaki Kimitoshi

    REGIONAL ANESTHESIA AND PAIN MEDICINE   43 巻 ( 4 ) 頁: 372 - 377   2018年5月

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    担当区分:最終著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Regional Anesthesia and Pain Medicine  

    Background and Objectives Several types of quadratus lumborum block (QLB) are used for postoperative analgesia and are believed to be effective against both somatic and visceral pain via a local anesthetic (LA) effect in the paravertebral space (PVS). However, it remains unclear whether all QLB techniques result in LA spread into the PVS. We hypothesized that LA administered via intramuscular QLB would spread into the paravertebral space and investigated the spread and sensory block area of LA in intramuscular QLB. Methods This volunteer study included 5 healthy men and 1 woman, with no previous medical history. Intramuscular QLB and lateral transversus abdominis plane block were performed under real-time ultrasound guidance for comparison of sensory deprivation range. Two days later, the same procedure was performed on the contralateral side of the body. The spread of LA via intramuscular QLB spread to the PVS was assessed 1 hour after the first injections using magnetic resonance imaging. Sensory perception was also evaluated by the pinprick test at 90 minutes after injection. Results In total, we performed 11 intramuscular QLBs and 11 lateral transversus abdominis plane blocks. Magnetic resonance imaging showed that LA did not spread into the PVS after ultrasound-guided intramuscular QLB. The analgesic area corresponded to the side of the body that was ipsilateral to the block. Conclusions Ultrasound-guided intramuscular QLBs are not clinically useful for procedures requiring LA spread into the PVS but do result in an ipsilateral analgesic effect in healthy volunteers.

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  28. Catheterization in an ultrasound-guided thoracic paravertebral block using thoracoscopy. 査読有り 国際誌

    Fujii T, Shibata Y, Ban Y, Shitaokoshi A, Nishiwaki K

    Asian journal of anesthesiology   55 巻 ( 1 ) 頁: 24 - 25   2017年3月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Asian Journal of Anesthesiology  

    Thoracic paravertebral block (TPVB) is an efficient alternative to epidural anesthesia. The location of a catheter within the thoracic paravertebral space (TPVS) has been examined in the human cadaver studies, but it is unclear how it goes into the TPVS during catheterization. In this report, thoracoscopy was used to observe the thoracic cavity in real-time during a parasagittal in-plane approach of ultrasound-guided TPVB. During thoracoscopy, we observed whether a paravertebral catheter could be advanced caudally beyond the ribs into the neighboring TPVS. Our result demonstrated that the catheter was difficult to be advanced beyond the ribs and confined within the same level of TPVS as where it was inserted. In the previous thoracoscopic observation of the paravertebral spread, we assumed that the local anesthetic acts most strongly at the intercostal level of the injection. Therefore, we recommend to insert the catheter for TPVB at the level corresponding to the incision site of thoracotomy.

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  29. 「手術室における医療安全」によせて 査読有り

    近江 明文, 西脇 公俊

    日本臨床麻酔学会誌   37 巻 ( 1 ) 頁: 58 - 58   2017年

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    担当区分:最終著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本臨床麻酔学会  

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  30. 世界における手術に関する患者安全の潮流─ヘルシンキ宣言の批准と麻酔科医のイニシアチブ─ 査読有り

    西脇 公俊

    日本臨床麻酔学会誌   37 巻 ( 1 ) 頁: 59 - 66   2017年

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    担当区分:筆頭著者, 最終著者, 責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本臨床麻酔学会  

    <p>近年手術技術の進歩と周術期全身管理の発展により,より多くの手術が世界中で行われるようになってきた.そこで世界保健機関(WHO)は手術関連の死亡・合併症を減らす目的でWHO Guidelines for Safe Surgery 2009を発表した.本稿では同ガイドラインを概説し,それに対する日本での取り組み,その遵守を含めた欧州麻酔科学会を中心とした麻酔科学分野における患者安全のためのヘルシンキ宣言とその批准の広がりについて述べ,世界における手術に関する患者安全の潮流について概説した.</p>

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  31. Observation of ultrasound-guided thoracic paravertebral block using thoracoscopy. 査読有り 国際誌

    Fujii T, Shibata Y, Nishiwaki K

    Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists   54 巻 ( 3 ) 頁: 101 - 102   2016年9月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Acta Anaesthesiologica Taiwanica  

    DOI: 10.1016/j.aat.2016.05.004

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  32. Comparison of kidney disease: improving global outcomes and acute kidney injury network criteria for assessing patients in intensive care units. 査読有り 国際誌

    Shinjo H, Sato W, Imai E, Kosugi T, Hayashi H, Nishimura K, Nishiwaki K, Yuzawa Y, Matsuo S, Maruyama S

    Clinical and experimental nephrology   18 巻 ( 5 ) 頁: 737 - 45   2014年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Clinical and Experimental Nephrology  

    Background: The Kidney Disease: Improving Global Outcomes (KDIGO) group proposed to adopt the 48-h time window for the 0.3  mg/dL rise in serum creatinine (sCr) proposed by the Acute Kidney Injury Network (AKIN) group as a modification to the original risk, injury, failure, loss, and end-stage renal disease criteria, keeping the 7-day window for the 50 % increase in sCr from baseline. The present study evaluates the prevalence of acute kidney injury (AKI) and the accuracy of predicting mortality based on the KDIGO and AKIN criteria.

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  33. [WHO Surgical Safety Checklist and guideline for safe surgery 2009]. 査読有り

    Nishiwaki K, Ichikawa T

    Masui. The Japanese journal of anesthesiology   63 巻 ( 3 ) 頁: 246 - 54   2014年3月

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    担当区分:筆頭著者, 責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  34. 「大量出血と輸液・輸血療法」によせて 査読有り

    西脇 公俊, 加藤 孝澄

    日本臨床麻酔学会誌   34 巻 ( 4 ) 頁: 538 - 538   2014年

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    担当区分:筆頭著者, 責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本臨床麻酔学会  

    DOI: 10.2199/jjsca.34.538

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  35. A prospective randomized multicenter comparative study of BLM-240 (desflurane) versus sevoflurane in Japanese patients 査読有り 国際誌

    Takeda Junzo, Namiki Akiyoshi, Ozaki Makoto, Fukuda Kazuhiko, Morita Kiyoshi, Kanmura Yuichi, Yamakage Michiaki, Komatsu Takami, Inada Eiichi, Kawate Ryoichi, Kanazawa Masahiro, Sakamoto Atsuhiro, Uezono Shoichi, Sato Shigehito, Nishiwaki Kimitoshi, Miyamoto Yoshikazu, Nakatsuka Hideki, Yasuda Nobuhiko

    JOURNAL OF ANESTHESIA   27 巻 ( 3 ) 頁: 468 - 471   2013年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    DOI: 10.1007/s00540-012-1536-x

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  36. 「手術室の安全管理」によせて 査読有り

    西脇 公俊

    日本臨床麻酔学会誌   33 巻 ( 7 ) 頁: 884 - 884   2013年

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    担当区分:筆頭著者, 最終著者, 責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本臨床麻酔学会  

    DOI: 10.2199/jjsca.33.884

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  37. Different effects of dibutyryl cAMP on monolayer permeability in human aortic and coronary arterial endothelial cells 査読有り 国際誌

    Nan Yong-Shan, Li Shao-Yan, Kang Ji-Long, Suzuki Shogo, Ema Yoshiaki, Nishiwaki Kimitoshi

    AFRICAN JOURNAL OF MICROBIOLOGY RESEARCH   6 巻 ( 5 ) 頁: 897 - 903   2012年2月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.5897/AJMR11.387

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  38. Effects of midazolam, diazepam, propofol and dexmedetomidine on endothelial cell proliferation and angiogenesis induced by VEGF 査読有り 国際誌

    Nan Yong-Shan, Li Shao-Yan, Kang Ji-Long, Suzuki Shogo, Ema Yoshiaki, Nishiwaki Kimitoshi

    AFRICAN JOURNAL OF MICROBIOLOGY RESEARCH   4 巻 ( 23 ) 頁: 2549 - 2555   2010年12月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  39. Significance of prevention and early treatment of a postoperative twisted neck : atlantoaxial rotatory subluxation after head and neck surgery 査読有り 国際誌

    KIM Byeoknyeon, IWATA Keiko, SUGIMOTO Kenji, SUZUKI Shogo, EMA Yoshiaki, TSUNOBUCHI Hironaka, NISHIWAKI Kimitoshi

    Journal of anesthesia   24 巻 ( 4 ) 頁: 598 - 602   2010年8月

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    担当区分:最終著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  40. 術中大量出血を防ぐための新たな輸血治療 : クリオプレシピテートおよびフィブリノゲン濃縮製剤投与効果の検討 査読有り

    山本 晃士, 西脇 公俊, 加藤 千秋, 花井 慶子, 菊地 良介, 柴山 修司, 梛野 正人, 木内 哲也, 上田 裕一, 高松 純樹

    日本輸血細胞治療学会誌 = Japanese journal of transfusion and cell therapy   56 巻 ( 1 ) 頁: 36 - 42   2010年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本輸血・細胞治療学会  

    <背景・目的>手術関連死亡の最大原因は術中の大量出血であるが,その背景には外科的手技による止血が不可能な希釈性凝固障害という病態が存在する.したがって術中の大量出血を未然に防ぐには止血のための輸血治療が必要であり,その治療指針の確立が急務である.<方法・結果>術中の大量出血・大量輸血症例を後方視的に調査した結果,その60%強を胸部大動脈瘤手術,肝臓移植術,肝臓癌・肝門部癌切除術が占めていた.術中大量出血の背景にある止血不全の主要因は,出血量の増加にともなう凝固因子(特にフィブリノゲン)の喪失,枯渇であると考えられた.そこで上記症例の手術中に起こった低フィブリノゲン血症に対し,クリオプレシピテートおよびフィブリノゲン濃縮製剤の投与を行ったところ,速やかなフィブリノゲン値の上昇と止血の改善,および術中出血量・輸血量の顕著な減少(平均で30~40%減)を認めた.<結論>術中の出血量増加時には,フィブリノゲン値を確認した上で速やかにフィブリノゲン濃縮製剤を投与することが,大量出血・大量輸血を未然に防ぎ,手術患者の予後改善に大きく貢献するとともに,血液製剤の使用削減・有効利用につながると考えられた.<br>

    DOI: 10.3925/jjtc.56.36

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  41. 公益社団法人日本麻酔科学会第70回学術集会講演特集号 学術委員会:学会賞記念講演 ヒト屈曲反射ワインドアップ観察の低侵襲手法 査読有り

    谷口 智哉, 西脇 公俊, 乾 幸二

    麻酔   72 巻 ( 13 ) 頁: 147 - 152   2023年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:克誠堂出版  

    DOI: 10.18916/masui.2023130022

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  42. Correction: A successful case of anesthetic management of awake craniotomy using remimazolam and flumazenil in an elderly patient. 査読有り

    Sato T, Nishiwaki K

    JA clinical reports   9 巻 ( 1 ) 頁: 75   2023年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JA Clinical Reports  

    Following publication of the original article [1], the author reported that there is an error in the maintext The sentence “After completion of, flumazenil 0.5 mg was administered following confirming recovery of spontaneous respiration, increase in BIS > 75, and response to naming.” should read “After completion of dura incision, flumazenil 0.5 mg was administered following confirming recovery of spontaneous respiration, increase in BIS > 75, and response to naming.” The original article has been corrected.

    DOI: 10.1186/s40981-023-00671-3

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  43. A successful case of anesthetic management of awake craniotomy using remimazolam and flumazenil in an elderly patient. 査読有り

    Sato T, Nishiwaki K

    JA clinical reports   9 巻 ( 1 ) 頁: 71   2023年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JA Clinical Reports  

    DOI: 10.1186/s40981-023-00663-3

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  44. Correction: Comparison of remimazolam and propofol in anesthetic management for awake craniotomy: a retrospective study. 査読有り

    Sato T, Nishiwaki K

    Journal of anesthesia   37 巻 ( 5 ) 頁: 823   2023年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    In the original publication of the article, under the section “Methods”, on page 153, the following sentence “After the patient was confirmed to be awake, recovery of spontaneous breathing (defined as respiratory rate > 10 breaths/min, tidal volume > 0.5 ml/kg) …” was published incorrectly. The correct sentence should read as follows “After the patient was confirmed to be awake, recovery of spontaneous breathing (defined as respiratory rate > 10 breaths/min, tidal volume > 5 ml/kg) …”.

    DOI: 10.1007/s00540-023-03232-1

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  45. Hypopharyngeal Injury by Transesophageal Echocardiography During Cardiac Surgery. 査読有り

    Aoki Y, Tamura T, Uchida W, Morioka H, Yamamoto M, Yuhara S, Nishio N, Mutsuga M, Furune S, Suzuki S, Nishiwaki K

    Journal of cardiothoracic and vascular anesthesia   37 巻 ( 10 ) 頁: 2027 - 2031   2023年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Cardiothoracic and Vascular Anesthesia  

    DOI: 10.1053/j.jvca.2023.06.023

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  46. 【レミマゾラムを使いこなそう!】脳外科手術におけるレミマゾラム 査読有り

    佐藤 威仁, 西脇 公俊

    臨床麻酔   47 巻 ( 8 ) 頁: 968 - 973   2023年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(株)シービーアール  

    レミマゾラムは超短時間作用型ベンゾジアゼピン系麻酔薬である.脳神経外科麻酔領域においてはMEP,SEPをはじめとする神経筋モニタリング症例で波形描出を妨げることがなく使用可能である報告が多く,また覚醒下脳腫瘍摘出術においてもフルマゼニルを用いることで明確な覚醒を期待でき有用である.これまで脳神経外科麻酔領域で頻用されていたプロポフォールとほぼ同等に麻酔管理が行いうることが示されてきており,今後さらに使用頻度が増加していくことが期待される.(著者抄録)

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  47. Propofol elicits apoptosis and attenuates cell growth in esophageal cancer cell lines. 査読有り

    Zhou R, Konishi Y, Zhang A, Nishiwaki K

    Nagoya journal of medical science   85 巻 ( 3 ) 頁: 579 - 591   2023年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya Journal of Medical Science  

    Propofol is a pharmaceutical agent commonly used as an intravenous anesthetic in surgical treatments and a sedative in intensive care. However, it is largely unknown how exposure to propofol affects the proliferation, invasion, and apoptosis of neoplastic cells in esophageal cancer. In this study, we sought to elucidate the impact of propofol exposure on the growth properties of human esophageal cancer cell lines in vitro. We treated two human esophageal cancer cell lines, KYSE30 and KYSE960, with up to 10 μg/ mL of propofol for 12–36 h. The treated cells were then analyzed by cell proliferation assay, Matrigel invasion assay, quantification of caspase-3/7 and -9 activities, and cell staining with Annexin V and 7-aminoactinomycin D to detect early apoptosis and cell death, respectively, via flow cytometry. We found that 3–5 μg/mL propofol reduced the growth and Matrigel invasion of both cell lines in a dose-dependent manner. Executioner caspase-3/7, but not caspase-9 involved in intrinsic apoptosis pathway, was activated by cell exposure to 3–5 μg/mL propofol. In addition, 3–5 μg/mL propofol augmented early apoptosis in both cell lines and increased cell death in the KYSE30 cell line. In summary, exposure to propofol, at concentrations up to 5 μg/mL, led to the reduction of cell growth and Matrigel invasion, as well as the augmentation of apoptosis in esophageal cancer cell lines. These data will help define a methodology to safely utilize propofol, a common general anesthetic and sedative, with esophageal cancer patients.

    DOI: 10.18999/nagjms.85.3.579

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  48. Cortical activity during the wind-up of flexion reflex and pain: a magnetoencephalographic study using time-frequency analysis. 査読有り

    Taniguchi T, Kinukawa TA, Takeuchi N, Sugiyama S, Nishihara M, Kida T, Nishiwaki K, Inui K

    Cerebral cortex (New York, N.Y. : 1991)   33 巻 ( 12 ) 頁: 7678 - 7687   2023年6月

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

    Wind-up is a nociceptive-specific phenomenon in which pain sensations are facilitated, in a frequency-dependent manner, by the repeated application of noxious stimuli of constant intensity, with invariant tactile sensations. Thus, cortical activities during wind-up could be an alteration associated with pain potentiation. We aimed to investigate somatosensory-evoked cortical responses and induced brain oscillations during wind-up by recording magnetoencephalograms. Wind-up was produced by the application of 11 consecutive electrical stimuli to the sural nerve, repeated at a frequency of 1 Hz without varying the intensity. The augmentation of f lexion ref lexes and pain rating scores were measured simultaneously as an index of wind-up. In the time-frequency analyses, the γ -band late event-related synchronization and the β-band event-related desynchronization were observed in the primary somatosensory region and the bilateral operculo-insular region, respectively. Repetitive exposure to the stimuli enhanced these activities, along with an increase in the f lexion ref lex magnitude. The evoked cortical activity ref lected novelty, with no alteration to these repetitive stimuli. Observed oscillations enhanced by repetitive stimulation at a constant intensity could ref lect a pain mechanism associated with wind-up.

    DOI: 10.1093/cercor/bhad071

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  49. Effect of intensive insulin therapy on inflammatory response after cardiac surgery using bedside artificial pancreas: A propensity score-matched analysis. 査読有り

    Fujii T, Hirai T, Tamura T, Suzuki S, Nishiwaki K

    Artificial organs   47 巻 ( 6 ) 頁: 982 - 989   2023年6月

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

    Background: Perioperative hyperglycemia leads to poor postoperative clinical outcomes, including compromised immune function, cardiovascular events, and mortality. The optimal perioperative blood glucose levels during cardiac surgery remain unclear. A closed-loop glycemic control system (artificial pancreas, target blood glucose range:120–150 mg/dl) prevents postoperative inflammatory response more effectively than conventional insulin therapy (<200 mg/dl). However, the clinical effects of intensive insulin therapy with strict glycemic control (80–110 mg/dl) are controversial. This study aimed to determine whether intensive insulin therapy would further suppress postoperative inflammatory reactions. Methods: This study analyzed 262 patients who underwent cardiovascular surgery with cardiopulmonary bypass. The patients were divided into two groups according to their target blood glucose range: 80–110 mg/dl and 120–150 mg/dl. The primary outcome was the difference in the C-reactive protein levels between the two groups. Results: Propensity score matching resulted in 95 patients in each group based on their covariates. There was no difference in the postoperative maximum C-reactive protein levels between the two groups (14.81 ± 5.93 mg/dl vs. 14.34 ± 5.52 mg/dl; p = 0.571) following propensity score matching. Hypoglycemia did not occur during intensive insulin therapy. Conclusions: Intensive insulin therapy following cardiac surgery with cardiopulmonary bypass did not demonstrate significant advantages in the suppression of postoperative inflammatory reactions compared to that with mild glycemic control. However, intensive insulin therapy using an artificial pancreas was found to be safe, with no hypoglycemic events.

    DOI: 10.1111/aor.14418

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  50. Accuracy of a noninvasive estimated continuous cardiac output measurement under different respiratory conditions: a prospective observational study. 査読有り

    Takakura M, Fujii T, Taniguchi T, Suzuki S, Nishiwaki K

    Journal of anesthesia   37 巻 ( 3 ) 頁: 394 - 400   2023年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Purpose: The estimated continuous cardiac output (esCCO) system was recently developed as a noninvasive hemodynamic monitoring alternative to the thermodilution cardiac output (TDCO). However, the accuracy of continuous cardiac output measurements by the esCCO system compared to TDCO under different respiratory conditions remains unclear. This prospective study aimed to assess the clinical accuracy of the esCCO system by continuously measuring the esCCO and TDCO. Methods: Forty patients who had undergone cardiac surgery with a pulmonary artery catheter were enrolled. We compared the esCCO with TDCO from mechanical ventilation to spontaneous respiration through extubation. Patients undergoing cardiac pacing during esCCO measurement, those receiving treatment with an intra-aortic balloon pump, and those with measurement errors or missing data were excluded. In total, 23 patients were included. Agreement between the esCCO and TDCO measurements was evaluated using Bland–Altman analysis with a 20 min moving average of the esCCO. Results: The paired esCCO and TDCO measurements (939 points before extubation and 1112 points after extubation) were compared. The respective bias and standard deviation (SD) values were 0.13 L/min and 0.60 L/min before extubation, and − 0.48 L/min and 0.78 L/min after extubation. There was a significant difference in bias before and after extubation (P < 0.001); the SD before and after extubation was not significant (P = 0.315). The percentage errors were 25.1% before extubation and 29.6% after extubation, which is the criterion for acceptance of a new technique. Conclusion: The accuracy of the esCCO system is clinically acceptable to that of TDCO under mechanical ventilation and spontaneous respiration.

    DOI: 10.1007/s00540-023-03176-6

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  51. Effect of cerebrospinal fluid drainage pressure in descending and thoracoabdominal aortic repair: a prospective multicenter observational study. 査読有り

    Yoshitani K, Ogata S, Kato S, Tsukinaga A, Takatani T, Kin N, Ezaka M, Shimizu J, Furuichi Y, Uezono S, Kida K, Seo K, Kakumoto S, Miyawaki H, Kawamata M, Tanaka S, Kakinohana M, Izumi S, Uchino H, Kakinuma T, Nishiwaki K, Hasegawa K, Matsumoto M, Ishida K, Yamashita A, Yamakage M, Yoshikawa Y, Morimoto Y, Saito H, Goto T, Masubuchi T, Kawaguchi M, Tsubaki K, Mizobuchi S, Obata N, Inagaki Y, Funaki K, Ishiguro Y, Sanui M, Taniguchi K, Nishimura K, Ohnishi Y

    Journal of anesthesia   37 巻 ( 3 ) 頁: 408 - 415   2023年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Purpose: Cerebrospinal fluid drainage (CSFD) is recommended during open or endovascular thoracic aortic repair. However, the incidence of CSFD complications is still high. Recently, CSF pressure has been kept high to avoid complications, but the efficacy of CSFD at higher pressures has not been confirmed. We hypothesize that CSFD at higher pressures is effective for preventing motor deficits. Methods: This prospective observational study included 14 hospitals that are members of the Japanese Society of Cardiovascular Anesthesiologists. Patients who underwent thoracic and thoracoabdominal aortic repair were divided into four groups: Group 1, CSF pressure around 10 mmHg; Group 2, CSF pressure around 15 mmHg; Group 3, CSFD initiated when motor evoked potential amplitudes decreased; and Group 4, no CSFD. We assessed the association between the CSFD group and motor deficits using mixed-effects logistic regression with a random intercept for the institution. Results: Of 1072 patients in the study, 84 patients (open surgery, 51; thoracic endovascular aortic repair, 33) had motor deficits at discharge. Groups 1 and 2 were not associated with motor deficits (Group 1, odds ratio (OR): 1.53, 95% confidence interval (95% CI): 0.71–3.29, p = 0.276; Group 2, OR: 1.73, 95% CI: 0.62–4.82) when compared with Group 4. Group 3 was significantly more prone to motor deficits than Group 4 (OR: 2.56, 95% CI: 1.27–5.17, p = 0.009). Conclusion: CSFD is not associated with motor deficits in thoracic and thoracoabdominal aortic repair with CSF pressure around 10 or 15 mmHg.

    DOI: 10.1007/s00540-023-03179-3

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  52. Life-threatening chlorhexidine anaphylaxis caused by skin preparation before chlorhexidine-free central venous catheter insertion: a case report and literature review. 査読有り

    Amano Y, Matsuura A, Tamura T, Kato Y, Kameyama N, Takazawa T, Nishiwaki K

    Journal of anesthesia   37 巻 ( 3 ) 頁: 474 - 481   2023年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Chlorhexidine is a common cause of perioperative anaphylaxis, and global regulatory authorities have issued warnings about anaphylaxis due to chlorhexidine-containing central venous catheters (CVC) and its mucosal absorption. We present a case of life-threatening anaphylaxis after CVC insertion caused by chlorhexidine used for skin preparation. The onset of anaphylaxis was rapid and very severe, resulting in pulseless electrical activity. The patient was successfully resuscitated by emergency veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Our case suggests that even skin preparation before chlorhexidine-free CVC insertion can cause life-threatening anaphylaxis. We reviewed the literature on chlorhexidine anaphylaxis cases and categorized all potential routes of chlorhexidine exposure to assess the risk following skin preparation. Our results showed that skin preparation before CVC insertion was the third most common cause of chlorhexidine anaphylaxis after transurethral exposure and chlorhexidine-containing CVCs. However, skin preparation with chlorhexidine before CVC insertion was sometimes overlooked as a cause of chlorhexidine anaphylaxis, and its risk might be underestimated. Further, no previous reports have described life-threatening anaphylaxis solely due to chlorhexidine skin preparation before CVC insertion. CVC insertion might cause the chlorhexidine used for skin preparation to reach the vascular system and should be recognized as a potential cause of life-threatening chlorhexidine anaphylaxis.

    DOI: 10.1007/s00540-023-03189-1

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  53. Thromboelastographic evaluation after cardiac surgery optimizes transfusion requirements in the intensive care unit: a single-center retrospective cohort study using an inverse probability weighting method. 査読有り

    Tamura T, Suzuki S, Fujii T, Hirai T, Imaizumi T, Kubo Y, Shibata Y, Narita Y, Mutsuga M, Nishiwaki K

    General thoracic and cardiovascular surgery     頁: 1 - 9   2023年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:General Thoracic and Cardiovascular Surgery  

    Objective: There are no reports from Japan showing the effects of using the thromboelastography algorithm on transfusion requirements after Intensive Care Unit (ICU) admission, and post-implementation knowledge regarding the thromboelastography algorithm under the Japanese healthcare system is insufficient. Therefore, this study aimed to clarify the effect of the TEG6s thromboelastography algorithm on transfusion requirements for patients in the ICU after cardiac surgery. Methods: We retrospectively compared the requirements for blood transfusion up to 24 h after ICU admission using the thromboelastography algorithm (January 2021 to April 2022) (thromboelastography group; n = 201) and specialist consultation with surgeons and anesthesiologists (January 2018 to December 2020) (non-thromboelastography group; n = 494). Results: There were no significant between-group differences in terms of age, height, weight, body mass index, operative procedure, duration of surgery or cardiopulmonary bypass, body temperature, or urine volume during surgical intervention. Moreover, there was no significant between-group difference in the amount of drainage at 24 h after ICU admission. However, crystalloid and urine volumes were significantly higher in the thromboelastography group than in the non-thromboelastography group. Additionally, fresh-frozen plasma (FFP) transfusion volumes were significantly lower in the thromboelastography group. However, there were no significant between-group differences in red blood cell count or platelet transfusion volume. After variable adjustment, the amount of FFP used from the operating room to 24 h after ICU admission was significantly reduced in the thromboelastography group. Conclusions: The thromboelastography algorithm optimized transfusion requirements at 24 h after admission to the ICU following cardiac surgery.

    DOI: 10.1007/s11748-023-01941-8

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  54. Fibcare(®) shows correlation with fibrinogen levels by the Clauss method during cardiopulmonary bypass. 査読有り

    Yamada A, Tamura T, Imaizumi T, Kubo Y, Nishiwaki K

    Nagoya journal of medical science   85 巻 ( 2 ) 頁: 310 - 318   2023年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya Journal of Medical Science  

    Central laboratory measurements are time consuming, while rapid fibrinogen level measurements within the operating room improve transfusion strategies. We aimed to clarify the correlation between fibrinogen concentrations (measured using Fibcare® and the Clauss fibrinogen assay in a central laboratory) during cardiovascular surgery with cardiopulmonary bypass. Data of patients whose Fibcare, traditional laboratory-based testing, and thromboelastographic results were measured using the same blood sample during cardiopulmonary bypass from February 2021 to January 2022 were retrospectively examined. We analyzed correlation in categories of body temperature during cardiopulmonary bypass: total cases, mild hypothermia (28–34°C), and moderate or severe hypothermia (<28°C). The Clauss fibrinogen assay was performed in 123 cases, Fibcare in 107, and thromboelastography in 91. For mild hypothermia, moderate or severe hypothermia, and overall, the root mean squared error and R-square in Fibcare were 16.1 and 0.86, 13.1 and 0.87, and 14.9 and 0.87, respectively, and for thromboelastography, they were 3.26 and 0.74, 2.70 and 0.79, and 3.08 and 0.75, respectively. A significant relationship was noted between Fibcare and Claus fibrinogen analysis regardless of body temperature during cardiopulmonary bypass. The measurement of fibrinogen levels using Fibcare allows for faster transfusion preparation than that of the traditional Clauss fibrinogen assay.

    DOI: 10.18999/nagjms.85.2.310

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  55. Enteral liquid ventilation oxygenates a hypoxic pig model. 査読有り

    Fujii T, Yoneyama Y, Kinebuchi A, Ozeki N, Maeda S, Saiki N, Chen-Yoshikawa TF, Date H, Nishiwaki K, Takebe T

    iScience   26 巻 ( 3 ) 頁: 106142   2023年3月

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

    The potential of extrapulmonary ventilation pathways remains largely unexplored. Here, we assessed the enteral ventilation approach in hypoxic porcine models under controlled mechanical ventilation. 20 mL/kg of oxygenated perfluorodecalin (O2-PFD) was intra-anally delivered by a rectal tube. We simultaneously monitored arterial and pulmonary arterial blood gases every 2 min up to 30 min to determine the gut-mediated systemic and venous oxygenation kinetics. Intrarectal O2-PFD administration significantly increased the partial pressure of oxygen in arterial blood from 54.5 ± 6.4 to 61.1 ± 6.2 mmHg (mean ± SD) and reduced the partial pressure of carbon dioxide from 38.0 ± 5.6 to 34.4 ± 5.9 mmHg. Early oxygen transfer dynamics inversely correlate with baseline oxygenation status. SvO2 dynamic monitoring data indicated that oxygenation likely originated from the venous outflow of the broad segment of large intestine including the inferior mesenteric vein route. Enteral ventilation pathway offers an effective means for systemic oxygenation, thus warranting further clinical development.

    DOI: 10.1016/j.isci.2023.106142

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  56. Remimazolam should be antagonized by an adequate flumazenil. 査読有り

    Sato T, Nishiwaki K

    Journal of anesthesia   37 巻 ( 1 ) 頁: 164 - 165   2023年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    DOI: 10.1007/s00540-022-03117-9

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  57. mRNA COVID-19ワクチン接種の副反応として難治性心原性ショックを呈し,機械的補助循環を要した一例

    高倉 将司, 藤井 祐, 佐藤 威仁, 鈴木 章悟, 西脇 公俊

    日本集中治療医学会雑誌   30 巻 ( 1 ) 頁: 32 - 33   2023年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本集中治療医学会  

    DOI: 10.3918/jsicm.30_32

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  58. Awake craniotomyの麻酔を上手に行うために 覚醒中の合併症(副作用)に対し麻酔科医としてできること 査読有り

    佐藤 威仁, 西脇 公俊

    日本臨床麻酔学会誌   43 巻 ( 1 ) 頁: 60 - 67   2023年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本臨床麻酔学会  

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  59. 内陰部動脈が可視化困難な症例における坐骨棘レベルでの超音波ガイド下陰部神経ブロックの手技的工夫 査読有り

    浅野 市子, 柴田 康之, 西脇 公俊

    日本ペインクリニック学会誌   29 巻 ( 11 ) 頁: 229 - 231   2022年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本ペインクリニック学会  

    DOI: 10.11321/jjspc.22-0022

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  60. 投稿論文 症例報告 ミニトラック挿入後にボールバルブ血餅によって重篤な気道閉塞合併症を生じた1症例 査読有り

    高倉 将司, 藤井 祐, 喜多 桂, 谷口 智哉, 天野 靖大, 鈴木 章悟, 西脇 公俊

    麻酔   71 巻 ( 11 ) 頁: 1201 - 1204   2022年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:克誠堂出版(株)  

    DOI: 10.18916/j01397.2023016077

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  61. Secretory expression of mammalian NOTCH tandem epidermal growth factor-like repeats based on increased O-glycosylation. 査読有り

    Zhang A, Tsukamoto Y, Takeuchi H, Nishiwaki K, Tashima Y, Okajima T

    Analytical biochemistry   656 巻   頁: 114881   2022年11月

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

    The Notch pathway represents evolutionarily conserved intercellular signaling essential for cell–to–cell communication during development. Dysregulation of Notch signaling has been implicated in various diseases, and its control represents a potential cancer treatment strategy. Notch signaling is initiated by the interaction of NOTCH receptors with their ligands on neighboring cells. Therefore, the truncated NOTCH ectodomain, composed mainly of tandem repeats of epidermal growth factor-like (EGF) domains, serves as a decoy molecule that competes for ligand binding and thus inhibits ligand-dependent Notch signaling. Although full-length NOTCH EGF repeats exhibited potent Notch inhibitory activity, they were poorly produced in the transfected cells. This study evaluated the effect of EGF domain-modifying glycosyltransferases on the secretion of NOTCH EGF repeats. Our results in HEK293T cells revealed that, unlike the effect on endogenous NOTCH receptors, overexpressed EGF domain-specific O-GlcNAc transferase (EOGT) markedly enhanced the secretion of NOTCH1 EGF repeats in an enzyme activity-dependent manner. The co-expression of protein O-glucosyltransferase 1 further manifested the effect of EOGT. The resultant changes in O-glycosylation of NOTCH3 were evaluated by label-free glycopeptide quantification. This study provides an experimental strategy to efficiently generate NOTCH EGF repeats by manipulating the expression of glycosyltransferases that alter the O-glycosylation of EGF domains.

    DOI: 10.1016/j.ab.2022.114881

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  62. 周術期重症高血糖に対して36時間の人工膵臓STG<sup>®</sup>-55の使用によりその後良好な血糖管理を行い得た感染性腹部大動脈瘤の1例 査読有り

    谷口 智哉, 平井 昂宏, 藤井 祐, 高倉 将司, 喜多 桂, 鈴木 章悟, 西脇 公俊

    日本集中治療医学会雑誌   29 巻 ( 6 ) 頁: 601 - 602   2022年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本集中治療医学会  

    DOI: 10.3918/jsicm.29_601

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  63. Incidence rate of chronic pain after 1.5-2 years of thoracotomy between paravertebral block versus epidural block: a cohort study. 査読有り

    Mori R, Tamura T, Yokota S, Usami S, Ando M, Kubo Y, Nishiwaki K

    Nagoya journal of medical science   84 巻 ( 4 ) 頁: 752 - 761   2022年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya Journal of Medical Science  

    Paravertebral block and epidural block are frequently employed for post-thoracotomy pain relief. It is not clear which postoperative analgesia method is effective for the chronic pain after the postoperative long term progress. Our hypothesis was that paravertebral block would be more effective than epidural block for chronic pain 1.5–2 years after thoracotomy. A cohort study investigating postoperative pain was performed in lung cancer patients undergoing thoracotomy between the ages of 20–80 year-old, employed for another randomized controlled trial. In previously study, the patients were randomly allocated into either the epidural block or paravertebral block group (n = 36/group). Patients in each group received the respective block placement with continuous 0.2% ropivacaine infusion at 5 ml/h. The patients completed a telephone observational survey using the EQ-5D-5L at 1.5–2 years. Forty-eight patients, 23 in the epidural block group and 25 in the paravertebral block group, were included in the final analysis. Quality of life scores at 1.5–2 postoperative years was similar in both groups. Mean scores ± standard deviation and 95% confidence interval were 0.899 ± 0.081 (0.705–0.938) in the epidural block group and 0.905 ± 0.079 (0.713–0.938) in the paravertebral block group, respectively, p = 0.81. The incidence rate of chronic postsurgical pain was eight patients; four in the epidural block group (17.4%) and four in the paravertebral block group (16.0%). There was no difference in incidence rate of long-term chronic postsurgical pain at 1.5–2 years after thoracotomy between the both groups. Our result will be used for further study protocols.

    DOI: 10.18999/nagjms.84.4.752

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  64. ペインクリニック専門医不在の病院で発生した周術期発症の神経障害性疼痛に対し,ペインクリニック専門医への紹介で慢性疼痛への進行を防ぎえたと考えられた1例 査読有り

    佐藤 威仁, 浅野 市子, 西脇 公俊

    日本ペインクリニック学会誌   29 巻 ( 7 ) 頁: 173 - 175   2022年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本ペインクリニック学会  

    DOI: 10.11321/jjspc.22-0005

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  65. Successful perioperative management of extended right hemihepatectomy in a trisomy 18 infant with coarctation of the aorta after pulmonary artery banding 査読有り

    蘇生   41 巻 ( 1 ) 頁: 38 - 39   2022年6月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本蘇生学会  

    DOI: 10.11414/jjreanimatology.41.1_38

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  66. Interference of a ventricular assist device with magnetic navigation during insertion of Sherlock 3CG™, a bedside peripherally inserted central catheter. 査読有り

    Takakura M, Fujii T, Suzuki S, Nishiwaki K

    Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs   25 巻 ( 2 ) 頁: 105 - 109   2022年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Artificial Organs  

    Recently, the Sherlock 3CG™ Tip Confirmation System, including a magnetic tracking system and an intracavitary electrocardiography guidance system, has been introduced for bedside peripherally inserted central catheter (PICC) insertion. Magnetic field sources interfere with the magnetic tracking system. Electromagnetic interference of the ventricular assist device (VAD) has already been reported with various devices but not on Sherlock 3CG™. We assessed the availability of the magnetic tracking system in patients with and without a VAD during Sherlock 3CG™ insertion and evaluated the rate of optimal PICC tip position. We retrospectively reviewed 99 patients who had undergone PICC insertion using Sherlock 3CG™ on the bedside at our institutional intensive care unit from February 2018 to December 2020. Patients were divided into groups with and without a VAD. The availability of magnetic navigation and the success rate of optimal catheter tip position in each group were assessed. Among 87 cases analyzed, there were 12 and 75 cases with a VAD and without a VAD, respectively. The availability of magnetic navigation during Sherlock 3CG™ insertion was significantly lower in the group with a VAD [4/12 (33%) with VAD vs. 72/75 (96%) without VAD, P < 0.001]. In addition, the rate of optimal PICC tip position was also significantly lower in the group with a VAD [6/12 (50%) vs. 63/75 (84%), P = 0.015] The VAD significantly led to magnetic tracking system failure due to its electromagnetic interference during Sherlock 3CG™ insertion and significantly reduced the success rate of PICC insertions in the optimal position.

    DOI: 10.1007/s10047-021-01293-1

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  67. Incidence of intraoperative anaphylaxis caused by blood products: a 12-year single-center, retrospective study. 査読有り

    Amano Y, Tamura T, Fujii T, Nishiwaki K

    Journal of anesthesia   36 巻 ( 3 ) 頁: 390 - 398   2022年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Purpose: Intraoperative anaphylaxis caused by blood products is uncommon, but it is unclear whether the rarity of this reaction is attributable to the difficulty of diagnosis, underreporting, or both. We investigated the incidence of intraoperative transfusion anaphylaxis and its reporting to the hemovigilance system. Methods: We retrospectively reviewed cases wherein general anesthesia was used at a single hospital during a 12-year period. Cases of intraoperative anaphylaxis were extracted using an electronic search strategy and determined using the recently developed grading and clinical scoring system. The causative blood products were determined by the onset duration based on literature regarding intraoperative transfusion anaphylaxis cases. Results: Among the 62,146 general anesthesia cases, 22 cases of intraoperative anaphylaxis were identified, and 11 of the 22 cases received transfusions before the onset of anaphylaxis. Intraoperative transfusion anaphylaxis was defined as occurring within 30 min of transfusion. Finally, nine cases of intraoperative transfusion anaphylaxis were analyzed. The overall incidence of intraoperative transfusion anaphylaxis was 1/3,994, with the highest incidence noted for fresh frozen plasma (1/2146; 95% confidence interval [CI] 1/6610–1/920), platelet concentrate (1/2348; 95% CI 1/92,742–1/422), and red blood cells (1/22,867; 95% CI 1/903,199–1/4,105). No evidence indicated that these cases were reported to the Japanese hemovigilance system, although all intraoperative transfusion anaphylaxis cases were diagnosed by anesthesiologists. Conclusion: The incidence of intraoperative anaphylaxis caused by blood products was higher than that reported and may be underreported to the Japanese hemovigilance system. Further research, particularly multicenter studies, is needed to confirm our results.

    DOI: 10.1007/s00540-022-03059-2

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  68. 周術期に両側気胸を発症し高度酸素化障害を呈した食道癌術後において,診断および穿刺判断に肺超音波検査を施行した一例 査読有り

    前田 翔, 藤井 祐, 田村 高廣, 平井 昂宏, 鈴木 章悟, 西脇 公俊

    日本集中治療医学会雑誌   29 巻 ( 3 ) 頁: 216 - 218   2022年5月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本集中治療医学会  

    <p>食道癌術後に両側気胸を発症し,その周術期呼吸管理に肺超音波検査が有用であった症例を経験した。症例は50歳の男性。食道胃接合部癌に対して,胸腔鏡下食道亜全摘術・三領域リンパ節郭清・胃管再建(胸骨後経路)が施行されたが,術後に高度の酸素化障害を来した。術後,肺超音波検査を積極的に実施することで,両側気胸の診断および胸腔ドレナージの適切な施行判断が可能となった。</p>

    DOI: 10.3918/jsicm.29_216

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  69. Risk factors for postoperative sore throat associated with i-gel™, a supraglottic airway device. 査読有り

    Taniguchi T, Fujii T, Taniguchi N, Nishiwaki K

    Nagoya journal of medical science   84 巻 ( 2 ) 頁: 319 - 326   2022年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya Journal of Medical Science  

    i-gel™ is a supraglottic airway device widely used for airway management during general anesthesia as an alternative to tracheal intubation. It sometimes results in a sore throat postoperatively; however, the risk factors for a postoperative sore throat caused by i-gel remain unclear. Here, we clarify the risk factors for a postoperative sore throat associated with i-gel insertion. We retrospectively reviewed the data of 426 adult patients who received general anesthesia with i-gel at our institution from January 2018 to December 2019. The incidence of postoperative sore throat and intraoperative data (size of i-gel, number of insertion attempts, total insertion time, and dose of the neuromuscular blocker and opioid) were evaluated. Logistic regression analysis was performed to identify the risk factors. Postoperative sore throat following i-gel insertion occurred in 24/426 patients (5.6%). The insertion time was significantly associated with the incidence of postoperative sore throat in the univariate analysis, but not in the multivariate analysis (P=0.519). Increased doses of neuromuscular blockers before i-gel insertion (odds ratio [OR], 5.46; 95% confidence interval [CI], 1.50–19.80; P=0.001) and reduced doses of intraoperative fentanyl (OR, 0.51; 95% CI, 0.28–0.93; P=0.028) were risk factors in the univariate and multivariate analyses. In the subgroup that used neuromuscular blockers before i-gel insertion, only an increased dose of neuromuscular blocker (OR, 17.2; 95%, CI 1.06–280; P=0.046) was an associated risk factor in the univariate and multivariate analyses. Overall, increased doses of neuromuscular blockers before i-gel insertion could contribute to the development of postoperative sore throat.

    DOI: 10.18999/nagjms.84.2.319

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  70. Safe sedation management using volatile anesthetics during cardiopulmonary bypass. 査読有り

    Tamura T, Mori A, Nishiwaki K

    Journal of anesthesia   36 巻 ( 2 ) 頁: 287 - 293   2022年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Several pieces of evidence suggest that volatile anesthetics (VAs), which were originally used as sedatives, have myocardial protective effects against cardiac ischemia–reperfusion injury. In Europe and the United States, the use of VAs during cardiopulmonary bypass (CPB) is widespread, as 2019 European Association for Cardio-Thoracic Surgery (EACTS)/European Association of Cardiothoracic Anaesthesiology/European Board of Cardiovascular Perfusion, 2011 American College of Cardiology/American Heart Association, and 2017 EACTS guidelines recommend their use in cardiovascular surgery, based on their potential myocardial protective effects. In other countries, including Japan, the use of VAs is gradually increasing. Therefore, it is important to be aware of the risks and possible adverse events associated with VA use during CPB to ensure safe sedation management. Herein, we describe in detail issues such as intraoperative awareness, air pollution, and damage to oxygenators due to VA use and propose precautions.

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  71. Surgical Site Infections and Inflammatory Reaction After Cardiac Surgery; Bedside Artificial Pancreas Versus Conventional Insulin Therapy: A Propensity Score-Matched Analysis. 査読有り

    Fujii T, Hirai T, Suzuki S, Nishiwaki K

    Journal of cardiothoracic and vascular anesthesia   36 巻 ( 3 ) 頁: 840 - 846   2022年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Cardiothoracic and Vascular Anesthesia  

    Objectives: Perioperative hyperglycemia is associated with poor postoperative recovery, including compromised immune function and increased risk of infection. A closed-loop glycemic control system (artificial pancreas) has demonstrated strict safe perioperative glycemic control without hypoglycemia risk. The authors hypothesized that the artificial pancreas would reduce surgical site infections (SSIs) and postoperative inflammatory reactions. This study aimed to assess the effect of the artificial pancreas on SSIs and C-reactive protein (CRP) levels after cardiac surgery. Design: A single-center retrospective, propensity score–matched analysis. Setting: A university hospital. Participants: In total, 295 patients who underwent cardiovascular surgery with cardiopulmonary bypass were included. Interventions: Patients were divided into two groups: artificial pancreas (target blood glucose: 120-150 mg/dL) and intravenous insulin infusion (conventional insulin therapy, target blood glucose: <200 mg/dL). Measurements and Main Results: The differences in the incidence of SSIs and CRP levels between the two groups were assessed. After 1:1 propensity score matching based on their covariates, 101 matched patients were selected from each group. The incidence of SSIs was reduced by 3%, 5% (conventional insulin therapy), and 2% (artificial pancreas), but the reduction was not statistically significant (p = 0.45). The postoperative maximum CRP level was significantly lower in the artificial pancreas group than in the conventional insulin therapy group, mean (standard deviation)14.53 (5.64) mg/dL v 16.57 (5.58) mg/dL; p = 0.01. Conclusions: The artificial pancreas did not demonstrate a significant reduction in the incidence of SSIs. However, the artificial pancreas was safe and suppressed postoperative inflammation compared with conventional insulin therapy.

    DOI: 10.1053/j.jvca.2021.04.047

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  72. The equilibrated blood sevoflurane concentrations show a rapid decrease after switching from ventilation for the human lung to cardiopulmonary bypass. 査読有り

    Tamura T, Mori A, Ishii A, Nishiwaki K

    Nagoya journal of medical science   84 巻 ( 1 ) 頁: 163 - 168   2022年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya Journal of Medical Science  

    Volatile anesthetics (VAs) protect myocardial cells during cardiovascular surgeries, including cardiopulmonary bypass (CPB). In CPB, blood is gradually transferred from the body to a CPB unit until the target cardiac index is achieved, following which human lung (HL) ventilation is stopped. This pilot study aimed to evaluate changes in the blood sevoflurane concentrations 5 min after the start of CPB when its delivery to the oxygenator began after HL ventilation with sevoflurane was completed. Six patients were recruited and participated in this study. For each patient, the equilibrated blood sample, collected 20 min after starting the delivery of 1.7% sevoflurane (HL group), and another blood sample, collected 5 min after starting the CPB, were analyzed using gas chromatography equipped with a flame ionization detector. The mean (± standard deviation) sevoflurane concentrations in the HL and 5 min after starting CPB groups were 58.6 ± 4.7 and 14.5 ± 5.0 μg/ml, respectively (P < 0.01). In conclusion, the equilibrated blood sevoflurane concentrations showed a rapid decrease when switching from sevoflurane ventilation for the HL to CPB unless it was introduced to the oxygenator until completion of the switch

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  73. Ketamine reduces the dose of remifentanil required during prolonged head and neck surgery: a propensity-matched analysis. 査読有り

    Fujii T, Nishiwaki K

    Nagoya journal of medical science   84 巻 ( 1 ) 頁: 1 - 6   2022年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya Journal of Medical Science  

    High-dose opioids induce hyperalgesia and tolerance, which negatively affects postoperative recovery.Prolonged surgery inevitably requires higher opioid doses. Ketamine reduces perioperative opioid consumptionand prevents opioid-induced tolerance. However, its effects in cases of prolonged surgery remainunknown. This study aimed to evaluate the dose of intraoperative remifentanil, an ultrashort-acting μ-opioidagonist, administered after an intravenous ketamine bolus during prolonged head and neck surgery. Thissingle-center, retrospective, observational study included 251 patients who underwent head and necksurgery (operation time ≥8 h) between January 2015 and December 2019. The participants were stratifiedinto two groups: those who received an intravenous bolus of ketamine and those who did not (ketaminegroup and non-ketamine group, respectively). Propensity score-matching was used to match patients in a1:1 ratio between the two groups, based on their covariates. The difference in intraoperative remifentanildose administered between the two groups was assessed. After 1:1 propensity score-matching, 89 matchedpatients were selected from each group. The mean ± standard deviation dose of remifentanil administeredwas significantly lower in the ketamine group than in the non-ketamine group before (0.15±0.05 vs0.17±0.05 μg/kg/min; P=0.01) and after matching (0.15±0.06 vs 0.17±0.05 μg/kg/min; P=0.03). In conclusion,intravenous ketamine administration may reduce the intraoperative dose of remifentanil requiredduring prolonged head and neck surgery. However, further studies are required to evaluate the effect ofthis finding on enhanced recovery after surgery

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  74. Comparison of remimazolam and propofol in anesthetic management for awake craniotomy: a retrospective study. 査読有り

    Sato T, Nishiwaki K

    Journal of anesthesia   36 巻 ( 1 ) 頁: 152 - 155   2022年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    A new ultra-short-acting benzodiazepine intravenous anesthetic agent, remimazolam, was launched in Japan in 2020. Anesthesia during awake craniotomy is reportedly being performed safely using remimazolam; however, studies on its efficacy in awake craniotomy have not been conducted. We aimed to compare the efficacy of remimazolam and propofol in awake craniotomy. In this retrospective study, patients who underwent awake craniotomy (n = 36) at our hospital between December 2019 and January 2021 were divided into two groups: the propofol group (P group: n = 21) and the remimazolam group (R group: n = 15). There was no significant difference in the recovery time between the two groups (p = 0.18). The number of patients experiencing nausea was higher in the R group than in the P group (p = 0.02); however, regression analysis revealed that the use of remimazolam contributed to increased intraoperative nausea (odds ratio = 14.4, p = 0.04). No significant differences were observed in the frequency of vomiting and other intraoperative complications between the two groups. In conclusion, remimazolam has the potential for use as an alternative drug in anesthetic management during awake craniotomy.

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  75. A Minimally Invasive Method for Observing Wind-Up of Flexion Reflex in Humans: Comparison of Electrical and Magnetic Stimulation. 査読有り

    Taniguchi T, Kinukawa TA, Takeuchi N, Sugiyama S, Nishihara M, Nishiwaki K, Inui K

    Frontiers in neuroscience   16 巻   頁: 837340   2022年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Frontiers in Neuroscience  

    Wind-up like pain or temporal summation of pain is a phenomenon in which pain sensation is increased in a frequency-dependent manner by applying repeated noxious stimuli of uniform intensity. Temporal summation in humans has been studied by observing the increase in pain or flexion reflex by repetitive electrical or thermal stimulations. Nonetheless, because the measurement is accompanied by severe pain, a minimally invasive method is desirable. Gradual augmentation of flexion reflex and pain induced by repetitive stimulation of the sural nerve was observed using three stimulation methods—namely, bipolar electrical, magnetic, and monopolar electrical stimulation, with 11 healthy male subjects in each group. The effects of frequency, intensity, and number of repetitive stimuli on the increase in the magnitude of flexion reflex and pain rating were compared among the three methods. The reflex was measured using electromyography (EMG) from the short head of the biceps femoris. All three methods produced a frequency- and intensity-dependent progressive increase in reflex and pain; pain scores were significantly lower for magnetic and monopolar stimulations than for bipolar stimulation (P < 0.05). The slope of increase in the reflex was steep during the first 4–6 stimuli but became gentler thereafter. In the initial phase, an increase in the reflex during the time before signals of C-fibers arrived at the spinal cord was observed in experiments using high-frequency stimulation, suggesting that wind-up was caused by inputs of A-fibers without the involvement of C-fibers. Magnetic and monopolar stimulations are minimally invasive and useful methods for observing the wind-up of the flexion reflex in humans. Monopolar stimulation is convenient because it does not require special equipment. There is at least a partial mechanism underlying the wind-up of the flexion reflex that does not require C-fibers.

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  76. Serum Concentration of Ropivacaine After Repeated Administration to Several Parts of the Head During Awake Craniotomy: A Prospective Cohort Study. 査読有り

    Sato T, Ando T, Asano I, Mori A, Motomura K, Nishiwaki K

    Frontiers in medicine   9 巻   頁: 834334   2022年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Frontiers in Medicine  

    Introduction: During awake craniotomy, effective use of local anesthetics, such as ropivacaine, is critical. Blood concentrations of ropivacaine after repeated administration over a short period during awake craniotomy have not been studied. Materials and Methods: In this prospective cohort study, we evaluated serum concentrations of ropivacaine 15 min after each administration during awake craniotomy at Nagoya University Hospital between April 5, 2018 and August 31, 2019 to determine the safe dose. A total of 30 patients scheduled to undergo elective awake craniotomy were included. Patients were injected with 0.375% ropivacaine before the awake phase at the following points: scalp block (T1), headpin area (T2), skin incision area (T3), temporal muscle (T4), and dura mater (T5). Arterial blood samples were collected 15 min after ropivacaine administration. In addition to the blood concentrations of ropivacaine, complications during the awake phase were evaluated as secondary endpoints. Results: The mean total dose of ropivacaine was 5.01 ± 0.68 mg/kg (maximum total dose: 6.30 mg/kg). The mean interval from T1 to T5 was 128.0 ± 17.7 min. The maximum serum concentration did not exceed the toxicity threshold of 4.3 μg/mL in any patient (mean serum concentration: T1, 1.23 ± 0.36 μg/mL; T5, 0.82 ± 0.26 μg/mL). No addiction symptoms were observed during awakening in any case. Conclusion: Our results show that, in cases of awake craniotomy with repeated anesthetic administration, a total dose of up to 5.0 mg/kg is safe, without addiction symptoms. Relatively large amounts of ropivacaine can be safely injected during awake craniotomy.

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  77. Non-linear regression analysis for estimating the intraoperative motor evoked potential recovery time after bolus neuromuscular blockade. 査読有り 国際誌

    Tatsuoka T, Fujii T, Furuhashi T, Nishiwaki K

    Journal of clinical monitoring and computing   35 巻 ( 6 ) 頁: 1333 - 1339   2021年12月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Clinical Monitoring and Computing  

    The recovery time of the motor evoked potential (MEP) amplitude following a neuromuscular blockade (NMB) during surgery is useful for interpreting low-amplitude waveforms or selecting the baseline waveform. In this study, the MEP data of 195 orthopedic cases who received a bolus dose of rocuronium at the beginning of surgery, between June 2009 and January 2016 were used. A non-linear regression analysis was applied to MEP amplitude data of multiple patients. The time taken for 90% of the maximum-amplitude recovery was estimated from the identified time series model. The 90% amplitude recovery time was 88.6 min in the pharmacological model and 89.4 min in the logistic model. These results were included in the 95% confidence interval of the previous studies. Although MEP amplitude is relatively unstable because of anesthesia, the averaged time series model of MEP amplitude can be estimated by using a large number of data.

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  78. A mouse model of microglia-specific ablation in the embryonic central nervous system. 査読有り

    Li C, Konishi H, Nishiwaki K, Sato K, Miyata T, Kiyama H

    Neuroscience research   173 巻   頁: 54 - 61   2021年12月

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

    Microglia, which migrate into the central nervous system (CNS) during the early embryonic stages, are considered to play various roles in CNS development. However, their embryonic roles are largely unknown, partly due to the lack of an effective microglial ablation system in the embryo. Here, we show a microglial ablation model by injecting diphtheria toxin (DT) into the amniotic fluid of Siglechdtr mice, in which the gene encoding DT receptor is knocked into the microglia-specific gene locus Siglech. We revealed that embryonic microglia were depleted for several days throughout the CNS, including some regions where microglia transiently accumulated, at any embryonic time point from embryonic day 10.5, when microglia colonize the CNS. This ablation system was specific for microglia because CNS-associated macrophages, which are a distinct population from microglia that reside in the CNS interfaces such as meninges, were unaffected. Therefore, this microglial ablation system is highly effective for studying the embryonic functions of microglia.

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  79. 神経ブロックを併用した人工股関節置換術後に腓骨神経麻痺を呈し診断に苦慮した1例 査読有り

    絹川 友章, 田村 高廣, 竹上 靖彦, 関 泰輔, 西脇 公俊

    日本ペインクリニック学会誌   28 巻 ( 9 ) 頁: 194 - 198   2021年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本ペインクリニック学会  

    <p>【症例】46歳女性,身長157 cm,体重58 kg.20歳ごろより両股関節痛を生じ,変形性関節症と診断され保存的に加療していた.当院整形外科紹介受診し,左人工股関節置換術施行予定となった.腰神経叢ブロックと傍仙骨部の坐骨神経ブロックを施行後,全身麻酔導入し,手術を行った.術後のレントゲンで脚延長は20 mmであった.覚醒後,両下肢に運動障害と感覚障害があった.症状は数時間以内に改善し,腰神経叢ブロックが硬膜外ブロックになったと考えられ,画像検査で血種による神経圧迫などを除外した上で経過観察となった.その後,感覚障害と運動障害は改善傾向であったが左足関節の背屈運動のみ回復が遅れ,術28日後の筋電図検査にて腓骨頭レベルでの軽度腓骨神経障害と診断された.術32日後,杖歩行安定し退院した.【まとめ】本症例の神経症状は,腓骨頭レベルでの神経障害であることから,腓骨神経の過伸展等の物理的因子に起因することが推察されるが,腰神経叢ブロックが硬膜外ブロックになったことにより麻痺症状が初期段階ではマスクされた.また今回の神経ブロックが麻痺に影響した可能性も否定できない.</p>

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  80. Conditioned Pain Modulation: Comparison of the Effects on Nociceptive and Non-nociceptive Blink Reflex. 査読有り

    Kinukawa TA, Inui K, Taniguchi T, Takeuchi N, Sugiyama S, Nishihara M, Nishiwaki K, Kakigi R

    Neuroscience   468 巻   頁: 168 - 175   2021年8月

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

    Although conditioned pain modulation (CPM) is considered to represent descending pain inhibitory mechanisms triggered by noxious stimuli applied to a remote area, there have been no previous studies comparing CPM between pain and tactile systems. In this study, we compared CPM between the two systems objectively using blink reflexes. Intra-epidermal electrical stimulation (IES) and transcutaneous electrical stimulation (TS) were applied to the right skin area over the supraorbital foramen to evoke a nociceptive or a non-nociceptive blink reflex, respectively, in 15 healthy males. In the test session, IES or TS were applied six times and subjects reported the intensity of each stimulus on a numerical rating scale (NRS). Blink reflexes were measured using electromyography (R2). The first and second sessions were control sessions, while in the third session, the left hand was immersed in cold water at 10 °C as a conditioning stimulus. The magnitude of the R2 blink and NRS scores were compared among the sessions by 2-way ANOVA. Both the NRS score and nociceptive R2 were significantly decreased in the third session for IES, with a significant correlation between the two variables; whereas, TS-induced non-nociceptive R2 did not change among the sessions. Although the conditioning stimulus decreased the NRS score for TS, the CPM effect was significantly smaller than that for IES (p = 0.002). The present findings suggest the presence of a pain-specific CPM effect to a heterotopic noxious stimulus.

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  81. Comparison between the effects of normal saline with and without heparin for the prevention and management of arterial catheter occlusion: a triple-blinded randomized trial. 査読有り

    Tamura T, Kobayashi E, Kawaguchi M, Matsuoka Y, Fujii A, Ando M, Kubo Y, Imaizumi T, Miyagawa Y, Inagaki T, Nishiwaki K

    Journal of anesthesia   35 巻 ( 4 ) 頁: 536 - 542   2021年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Purpose: We aimed to compare the effects of saline with and without heparin on the catheter-occlusion rate and coagulation-related blood test results for the management of arterial catheters among patients admitted to a short-term intensive care unit postoperatively. Methods: This prospective, triple-blinded, randomized controlled study recruited patients aged 20–90 years scheduled to undergo radial arterial catheter insertion and postoperative intensive care unit admission between February and August 2019. Patients were randomly allocated to two groups (1:1 ratio) depending on the use of heparin: study (normal saline with heparin, 3000 units to 500 ml of normal saline) and control (normal saline without heparin) groups with arterial catheters. The allocated management method was employed immediately after intensive care unit admission. Occlusion assessment (every 12 h), arterial blood gas tests (every 6 h), and blood sample collection (every 24 h) were performed. The occlusion of arterial catheter was assessed using occlusion rate, and blood test results were assessed using a linear mixed model. Results: There were 147 patients in the arterial catheter groups. There were no significant differences in occlusion rates and changes in platelet counts and activated partial thromboplastin time between the groups with arterial (p = 0.98, 0.16, and 0.32, respectively) catheters during the first 6 days after intensive care unit admission. Conclusion: Normal saline with and without heparin showed similar efficiency for both the prevention of occlusion and the results of coagulation.

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  82. Difficult Airway Management in a Patient With Nicolaides-Baraitser Syndrome Who Had a Small Jaw and Limited Mouth Opening 査読有り 国際誌

    Saori Taharabaru, DDS ; Takehito Sato, MD ; Kimitoshi Nishiwaki, MD, PHD

    Anesthsia Progress   68 巻 ( 1 ) 頁: 47 - 49   2021年4月

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  83. Difficult Airway Management in a Patient With Nicolaides-Baraitser Syndrome Who Had a Small Jaw and Limited Mouth Opening 査読有り 国際誌

    Saori Taharabaru, DDS, Takehito Sato, MD, Kimitoshi Nishiwaki, MD, PHD

    Anesthsia Progress   68 巻 ( 1 ) 頁: 47 - 49   2021年4月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  84. Morphology, localization, and postnatal development of dural macrophages. 査読有り 国際誌

    Sato T, Konishi H, Tamada H, Nishiwaki K, Kiyama H

    Cell and tissue research   384 巻 ( 1 ) 頁: 49 - 58   2021年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Cell and Tissue Research  

    The dura mater contains abundant macrophages whose functions remain largely elusive. Recent studies have demonstrated the origin, as well as the gene expression pattern, of dural macrophages (dMΦs). However, their histological features have not been explored yet. In this study, we performed immunohistochemistry and electron microscopy to elucidate their precise morphology, localization, and postnatal development in mice. We found that the morphology, as well as the localization, of dMΦs changed during postnatal development. In neonatal mice, dMΦ exhibited an amoeboid morphology. During postnatal development, their cell bodies elongated longitudinally and became aligned along dural blood vessels. In adulthood, nearly half of the dMΦs aligned along blood vessel networks. However, most of these cells were not directly attached to vessels; pericytes and fibroblasts interposed between dMΦs and vessels. This morphological information may provide further indications for the functional significance of dMΦs.

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  85. Cerebrospinal fluid drainage to prevent postoperative spinal cord injury in thoracic aortic repair. 査読有り 国際誌

    Yoshitani K, Kawaguchi M, Kawamata M, Kakinohana M, Kato S, Hasuwa K, Yamakage M, Yoshikawa Y, Nishiwaki K, Hasegawa K, Inagaki Y, Funaki K, Matsumoto M, Ishida K, Yamashita A, Seo K, Kakumoto S, Tsubaki K, Tanaka S, Ishida T, Uchino H, Kakinuma T, Yamada Y, Mori Y, Izumi S, Shimizu J, Furuichi Y, Kin N, Uezono S, Kida K, Nishimura K, Nakai M, Ohnishi Y

    Journal of anesthesia   35 巻 ( 1 ) 頁: 43 - 50   2021年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Background: Cerebrospinal fluid drainage (CSFD) is recommended as a spinal cord protective strategy in open and endovascular thoracic aortic repair. Although small studies support the use of CSFD, systematic reviews have not suggested definite conclusion and a large-scale study is needed. Therefore, we reviewed medical records of patients who had undergone descending and thoracoabdominal aortic repair (both open and endovascular repair) at multiple institutions to assess the association between CSFD and postoperative motor deficits. Methods: Patients included in this study underwent descending or thoracoabdominal aortic repair between 2000 and 2013 at 12 hospitals belonging to the Japanese Association of Spinal Cord Protection in Aortic Surgery. We conducted a retrospective study to investigate whether motor-evoked potential monitoring is effective in reducing motor deficits in thoracic aortic aneurysm repair. We use the same dataset to examine whether CSFD reduces motor deficits after propensity score matching. Results: We reviewed data from 1214 patients [open surgery, 601 (49.5%); endovascular repair, 613 (50.5%)]. CSFD was performed in 417 patients and not performed in the remaining 797 patients. Postoperative motor deficits were observed in 75 (6.2%) patients at discharge. After propensity score matching (n = 700), mixed-effects logistic regression performed revealed that CSFD is associated with postoperative motor deficits at discharge [adjusted odds ratio (OR), 3.87; 95% confidence interval (CI), 2.30–6.51]. Conclusion: CSFD may not be effective for postoperative motor deficits at discharge.

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  86. Reply to the letter. 査読有り 国際誌

    Tamura T, Mori A, Nishiwaki K

    Journal of anesthesia   35 巻 ( 1 ) 頁: 164 - 164   2021年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

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  87. Impact of Perioperative Steroid Administration in Patients Undergoing Major Hepatectomy with Extrahepatic Bile Duct Resection: A Randomized Controlled Trial. 査読有り 国際誌

    Onoe S, Yokoyama Y, Ebata T, Igami T, Mizuno T, Yamaguchi J, Watanabe N, Suzuki S, Nishiwaki K, Ando M, Nagino M

    Annals of surgical oncology   28 巻 ( 1 ) 頁: 121 - 130   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Annals of Surgical Oncology  

    Background: To date, five randomized controlled trials have assessed the clinical benefit of perioperative steroid administration in hepatectomy; however, all of these studies involved a substantial number of ‘minor’ hepatectomies. The benefit of steroid administration for patients undergoing ‘complex’ hepatectomy, such as major hepatectomy with extrahepatic bile duct resection, is still unclear. This study aimed to evaluate the clinical benefit of perioperative steroid administration for complex major hepatectomy. Methods: Patients with suspected hilar malignancy scheduled to undergo major hepatectomy with extrahepatic bile duct resection were randomized into either the control or steroid groups. The steroid group received hydrocortisone 500 mg immediately before hepatic pedicle clamping, followed by hydrocortisone 300 mg on postoperative day (POD) 1, 200 mg on POD 2, and 100 mg on POD 3. The control group received only physiologic saline. The primary endpoint was the incidence of postoperative liver failure. Results: A total of 94 patients were randomized to either the control (n = 46) or steroid (n = 48) groups. The two groups had similar baseline characteristics; however, there were no significant differences between the groups in the incidence of grade B/C postoperative liver failure (control group, n = 8, 17%; steroid group, n = 4, 8%; p = 0.188) and other complications. Serum bilirubin levels on PODs 2 and 3 were significantly lower in the steroid group than those in the control group; however, these median values were within normal limits in both groups. Conclusion: Perioperative steroid administration did not reduce the risk of postoperative complications, including liver failure following major hepatectomy with extrahepatic bile duct resection.

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  88. Coagulation ability when separating from cardiopulmonary bypass with and without fresh frozen plasma: a pilot study. 査読有り 国際誌

    Tamura T, Yokota S, Ito T, Ando M, Kubo Y, Waters JH, Nishiwaki K

    General thoracic and cardiovascular surgery   68 巻 ( 12 ) 頁: 1361 - 1368   2020年12月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:General Thoracic and Cardiovascular Surgery  

    Objective: Several strategies are employed for administering fresh frozen plasma (FFP) during weaning from cardiopulmonary bypass (CPB). This study evaluated by coagulation function aimed to compare two strategies of administering FFP in cardiovascular surgery: administering 4 units of FFP before separating from CPB or administering it after weaning from CPB. Methods: Thirty patients who underwent CPB and were expected to receive 8 units of FFP and 20 units of platelet concentrate were randomly allocated into group A (8 units of FFP and 20 units of platelet concentrate administered after separating from CPB) and group B (4 units of FFP administered before separation, and 4 units of FFP and 20 units of platelet concentrate administered after separating from CPB). Thromboelastography (TEG6s®, HAEMONETICS Japan GK, Tokyo, Japan) was conducted at four time points before and after separation. Blood test results, blood loss, and required amounts of blood transfusion were compared. The primary outcome was the difference in coagulation function evaluated by TEG6s 90 min after protamine administration. Results: Twenty-eight patients were enrolled in the study. Coagulation function after separating from CPB was not significantly different between the groups. Additionally, no significant differences were found in intensive care unit outcomes, such as 24-h transfusion requirements. Conclusions: Coagulation function 90 min after separating from CPB was not significantly different between the groups. Prior FFP administration before separation did not provide significant improvement in coagulation function.

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  89. Desflurane and sevoflurane concentrations in blood passing through the oxygenator during cardiopulmonary bypass: a randomized prospective pilot study. 査読有り 国際誌

    Tamura T, Mori A, Ishii A, Ando M, Kubo Y, Nishiwaki K

    Journal of anesthesia   34 巻 ( 6 ) 頁: 904 - 911   2020年12月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Purpose: Volatile anesthetics (VAs) protect myocardial cells in cardiovascular surgery. A recent clinical trial of cardiopulmonary bypass (CPB) surgery reported no significant difference in mortality rates between the use of VAs and total intravenous anesthetics at 1 year postoperatively. However, oxygenator function may affect the VA pharmacokinetics. Thus, we measured the VA blood concentrations during CPB in patients managed with four different microporous polypropylene hollow fiber membrane oxygenators. Methods: Twenty-four patients scheduled for elective CPB were randomly allocated to one of the two VA groups (desflurane and sevoflurane groups) and, then, randomly divided into one of four oxygenator groups: Terumo, LivaNova, Medtronic, and Senko (n = 3). Additionally, in each VA group, three patients were randomly selected and redundantly allocated to the human lung group (for control blood VA concentration without oxygenator). Blood samples collected 20 min after starting 6.0 vol% desflurane or 1.7 vol% sevoflurane were analyzed using gas chromatography. Oxygenator-related complications and structural changes in the membrane surface of each oxygenator after surgery were evaluated. Results: The mean (standard deviation) concentrations of desflurane and sevoflurane in the human lung were 182.4 (23.2) and 54.0 (9.6) μg/ml, respectively; not significantly different from those in the four oxygenator groups. No oxygenator-related complications occurred. Structural changes in membrane fibers did not occur after clinical use, except for difficulty in image acquisition with Senko products. Conclusion: Our results demonstrated that the blood concentrations of desflurane and sevoflurane passing through oxygenators used during CPB were similar to those in the human lung control.

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  90. Sizing of mitral annuloplasty rings using real-time three-dimensional transesophageal echocardiography and the difference between patients with and without recurrent mitral regurgitation: retrospective cohort study. 査読有り 国際誌

    Fujii T, Yoshitani K, Kanemaru E, Nakai M, Nishimura K, Ohnishi Y, Nishiwaki K

    Journal of echocardiography   18 巻 ( 3 ) 頁: 169 - 174   2020年9月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Echocardiography  

    Background: Previous studies showed that the mitral inter-commissural (IC) distance differed by a few millimeters between the systolic and diastolic cardiac cycles. However, sizing of the mitral annuloplasty ring with a ring sizer, which should be performed in the systole, is performed in diastole during hyperkalemic cardioplegic arrest. The aim of this study was to investigate whether three-dimensional transesophageal echocardiography (3D-TEE) measurements of the mitral valve in end-systole are effective to determine the size of the annuloplasty ring. Methods: This study retrospectively reviewed 92 patients who underwent mitral annuloplasty for degenerative. The IC distance and anterior leaflet height of the A2 segment of the mitral valve were measured by 3D-TEE at the end-systole. The annuloplasty ring size was measured by the surgeons using specific ring sizers. We compared the IC distance measured by 3D-TEE with the implanted annuloplasty size. We also investigated differences in IC distance, A2 height, and ratio of A2 height to IC distance in patients with and without recurrent mild to moderate MR for 36 months. Results: There was a significant correlation between the IC distance by 3D-TEE and the implanted ring size (R2 = 0.7023, p < 0.001). Eight cases had mild or greater recurrent MR. There was a significant difference in the ratio of A2 height to IC distance between patients with and without recurrent MR (p = 0.006). A2 height was greater in patients with recurrent MR, but this difference was not significant (p = 0.059). Conclusions: Our results demonstrated a larger ratio of A2 height to IC distance in patients with recurrent MR. 3D-TEE could be useful for the ring sizing.

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  91. Difficult Airway Management in a Patient With Nicolaides-Baraitser Syndrome Who Had a Small Jaw and Limited Mouth Opening. 査読有り

    Taharabaru S, Sato T, Nishiwaki K

    Anesthesia progress   68 巻 ( 1 ) 頁: 47 - 49   2020年3月

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.2344/anpr-67-04-05

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  92. Clarification on chronic pain - a painfully persistent problem? A reply. 査読有り 国際誌

    Fujii T, Nishiwaki K

    Anaesthesia   75 巻 ( 3 ) 頁: 408 - 409   2020年3月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Anaesthesia  

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  93. Differential effects of sevoflurane on the growth and apoptosis of human cancer cell lines. 査読有り

    Hirai T, Konishi Y, Mizuno S, Rui Z, Sun Y, Nishiwaki K

    Journal of anesthesia   34 巻 ( 1 ) 頁: 47 - 57   2020年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Purpose: There have been contradictory findings regarding the effects of sevoflurane on the oncogenic properties of cancer cells. This study was conducted to gain insights into the fundamental rules governing the differential effects of sevoflurane exposure on various cancer cells derived from multiple origins. Methods: A series of cancer cell lines were exposed to 1% (v/v) sevoflurane for 2–8 h and then assessed for their proliferation, Matrigel invasion, and apoptotic cell death, in comparison with their untreated counterparts. Cell proliferation and Matrigel invasion assays were performed using Coulter counter and Boyden chamber techniques, respectively. Apoptosis was evaluated by staining cells with Annexin V and 7-AAD followed by fluorescence flow cytometry. In addition, the expression of cleaved caspase-3 protein, another marker of apoptosis, was assessed using immunoblotting. Results: Proliferation was significantly enhanced after sevoflurane exposure in six of eight cancer cell lines (NCI-H1299, MDA-MB-231, HCT116, DLD-1, HT29, and RKO). In contrast, sevoflurane attenuated proliferation in the last two cancer cell lines, A549 and MCF-7, as well as in the non-cancerous MCF10A cell line. Cell biological assays using four cancer cell lines demonstrated that accelerated but not attenuated cancer cell proliferation after sevoflurane exposure is associated with enhanced Matrigel invasion and suppressed apoptosis. Conclusion: Sevoflurane augmented or hampered cell proliferation and Matrigel invasion depending on the cancer cell line examined. Loss of sevoflurane-induced apoptosis occurring in cancer cell lines is likely to be correlated with their enhanced proliferation after sevoflurane exposure.

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  94. Correction to: Differential effects of sevoflurane on the growth and apoptosis of human cancer cell lines.

    Hirai T, Konishi Y, Mizuno S, Rui Z, Sun Y, Nishiwaki K

    Journal of anesthesia   34 巻 ( 1 ) 頁: 58   2020年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s00540-019-02719-0

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  95. A single paravertebral injection via a needle vs. a catheter for the spreading to multiple intercostal levels: a randomized controlled trial. 査読有り

    Fujii T, Shibata Y, Ban Y, Shitaokoshi A, Takahashi K, Matsui S, Nishiwaki K

    Journal of anesthesia   34 巻 ( 1 ) 頁: 72 - 78   2020年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Purpose: Thoracic paravertebral block (TPVB) provides a unilateral nerve block at multiple intercostal levels allowing injection of a local anesthetic into paravertebral space (PVS) via a needle or catheter. However, the most effective injection method remains unclear. This study compared the real-time spread of ropivacaine between two paravertebral injection methods using thoracoscopy. Methods: Thirty-four patients scheduled for thoracoscopic surgery were randomly allocated into the Needle or Catheter groups, and performed transverse in-plane ultrasound-guided TPVB. The Needle group received 20 ml of 0.5% ropivacaine via a needle placed into the lateral edge of PVS; the Catheter group received the same dose of ropivacaine via a catheter inserted 5 cm into PVS. The primary outcome was the spreading pattern of ropivacaine in each group. The secondary outcome was intraoperative vasopressor requirement after paravertebral injection. Results: In the Needle group, all cases showed ropivacaine spread to multiple intercostal levels, mainly across the ribs. Contrastingly, the Catheter group showed variable spreading patterns; multiple intercostal levels (n = 10) [across the ribs (n = 4), anterolateral aspect of the vertebral bodies (n = 6)] or unobservable spreading (no change; n = 7) (P = 0.007). Vasopressors were required in two and ten cases in the Needle and Catheter groups, respectively (P = 0.010). Conclusion: Paravertebral injection via a needle typically resulted in spreading to multiple intercostal levels, especially across the ribs on the peripheral side of injection site, whereas injection via a catheter resulted in variable spreading patterns. Therefore, injections via needles are more stable.

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  96. A triple-blinded randomized trial comparing spinal morphine with posterior quadratus lumborum block after cesarean section (vol 40, pg 32, 2019) 査読有り

    Tamura T., Yokota S., Ando M., Kubo Y., Nishiwaki K.

    INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA   41 巻   頁: 129 - 130   2020年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:International Journal of Obstetric Anesthesia  

    The authors regret that there was an error in Fig. 1 of their article. The correct Fig. 1 is as follows: [Figure presented] The incorrect Fig. 1 was as follows: [Figure presented] The authors would like to apologise for any inconvenience caused.

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  97. 亜全胃温存膵頭十二指腸切除術の周術期に広範囲の肝虚血を生じた1例 査読有り

    山田 章宏, 前田 翔, 竹市 広, 足立 裕史, 西脇 公俊

    日本集中治療医学会雑誌   27 巻 ( 2 ) 頁: 113 - 114   2020年

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    担当区分:最終著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本集中治療医学会  

    DOI: 10.3918/jsicm.27_113

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  98. A triple-blinded randomized trial comparing spinal morphine with posterior quadratus lumborum block after cesarean section. 査読有り 国際誌

    Tamura T, Yokota S, Ando M, Kubo Y, Nishiwaki K

    International journal of obstetric anesthesia   40 巻   頁: 32 - 38   2019年11月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:International Journal of Obstetric Anesthesia  

    Background: This study aimed to compare the postoperative analgesic effects of ultrasound-guided posterior quadratus lumborum block with spinal morphine, after cesarean section, using the visual analogue scale pain score. Methods: One-hundred-and-seventy-six pregnant women scheduled for elective cesarean section with spinal anesthesia were randomly allocated into four groups to receive spinal morphine 0.1 mg (group M+); spinal saline (M−); posterior quadratus lumborum block using either 0.3% ropivacaine (0.45 mL/kg each side, maximum 150 mg) group pQ+); or saline (pQ−). All patients received 11–13 mg hyperbaric bupivacaine 0.5% and 10 μg fentanyl. Intravenous droperidol, fentanyl and acetaminophen were administered during surgery. Bilateral posterior quadratus lumborum block was performed immediately after surgery. Postoperative pain was assessed at 0.5, 1, 2, 4, 6, 18 and 24 h after surgery, and the pain score 6 h after surgery was the primary endpoint. Results: One-hundred-and-forty-six patients were included in the final analysis. Pain scores 6 h after surgery, both at rest and when moving, were significantly different when comparing the M+pQ+ group with the M−pQ+ or M−pQ− groups, and when comparing the M+pQ− group with the M− pQ+ or M− pQ− groups (all P <0.05). There was no significant difference between the M+pQ+ and M+pQ– groups, or between the M−pQ+ and M−pQ− groups. Conclusion: Spinal morphine improved postoperative analgesia but the combination of posterior quadratus lumborum block with spinal morphine did not lead to further improvement.

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  99. Retrospective investigation about anesthetic management of biliary atresia in children: laparoscopic versus conventional Kasai portoenterostomy. 査読有り

    Sato T, Nishiwaki K

    JA clinical reports   5 巻 ( 1 ) 頁: 7   2019年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  100. Clinical Benefit of Preoperative Exercise and Nutritional Therapy for Patients Undergoing Hepato-Pancreato-Biliary Surgeries for Malignancy. 査読有り 国際誌

    Nakajima H, Yokoyama Y, Inoue T, Nagaya M, Mizuno Y, Kadono I, Nishiwaki K, Nishida Y, Nagino M

    Annals of surgical oncology   26 巻 ( 1 ) 頁: 264 - 272   2019年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Annals of Surgical Oncology  

    Background: The impact of prehabilitation on physical fitness and postoperative course after hepato-pancreato-biliary (HPB) surgeries for malignancy is unknown. The current study aimed to investigate the effect of preoperative exercise and nutritional therapies on nutritional status, physical fitness, and postoperative outcomes of patients undergoing an invasive HPB surgery for malignancy. Methods: Patients who underwent open abdominal surgeries for HPB malignancies (major hepatectomy, pancreatoduodenectomy, or hepato-pancreatoduodenectomy) between 2016 and 2017 were subjected to prehabilitation. Patients before the introduction of prehabilitation were included as historical control subjects for 1:1 propensity score-matching (no-prehabilitation group). The preoperative nutritional status and postoperative course were compared between the two groups. Results: The prehabilitation group consisted of 76 patients scheduled to undergo HPB surgeries for malignancy. An identical number of patients were selected as the no-prehabilitation group after propensity score-matching. During the waiting period, serum albumin levels were significantly deteriorated in the no-prehabilitation group, whereas this index did not deteriorate or even improved in the prehabilitation group. By performing prehabilitation, a 6-min walk distance and total muscle/fat ratio were significantly increased during the waiting period. Although the overall incidence of postoperative complications did not differ between the two groups, the postoperative hospital stay was shorter in the prehabilitation group than in the no-prehabilitation group (median, 23 vs 30 days; p = 0.045). Conclusion: The introduction of prehabilitation prevented nutritional deterioration, improved physical fitness before surgery, and shortened the postoperative hospital stay for the patients undergoing HPB surgeries for malignancy.

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  101. 睡眠時無呼吸, 小顎, 開口制限を伴うニコライデスバライスター症候群患児の全身麻酔経験 査読有り

    田原春 早織, 佐藤 威仁, 西脇 公俊

    日本歯科麻酔学会雑誌   47 巻 ( 3 ) 頁: 107 - 109   2019年

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    担当区分:最終著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本歯科麻酔学会  

    <p>  Nicolaides-Baraitser syndrome (NCBRS) is a rare congenital genetic disorder characterized by specific facial features, distal limb malformations, and mental retardation. At present, there are no reports of anesthetic management in patients with NCBRS. We report the first case of a successful nasal fiberscopic intubation in a patient with NCBRS in whom intubation was difficult because of a prominent small jaw, restricted mouth opening, and sleep apnea. A 9-year-old girl who had been diagnosed as having NCBRS was scheduled to undergo the extraction of decayed teeth under general anesthesia. She had a medical history of a cleft palate revision at the age of 3 years. Because she had a small jaw and restricted mouth opening, intubation was performed using an Airwayscope<sup>®</sup> (AWS) during the previous anesthesia. First, we attempted oral intubation using an AWS after induction. After the administration of muscle relaxants, however, mouth opening was not possible. Therefore, we could not intubate using AWS or an oral fiberscope. Next, we tried nasal intubation using a bronchofiberscope. Despite an unclear visualization because of the presence of the adenoids and oral secretions, we were able to intubate the patient. There were no complications during the intubation, such as nose bleeding, and there were no problems in providing positive ventilation. The operation was completed without any adverse events. The postoperative course was not problematic, and she was discharged on the third day after surgery. Intubation might be difficult in patients with NCBRS ; therefore, the risk of a difficult airway should be evaluated during the anesthetic management of these patients.</p>

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  102. Reply to Drs El-Boghdadly and Elsharkawy. 査読有り 国際誌

    Tamura T, Kitamura K, Yokota S, Ito S, Shibata Y, Adachi YU, Nishiwaki K

    Regional anesthesia and pain medicine   43 巻 ( 5 ) 頁: 558 - 559   2018年7月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Regional Anesthesia and Pain Medicine  

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  103. A rise in the platelet count by HLA-antigen negative compatible platelet transfusion in a platelet anti-HLA antibody-positive patient 査読有り

    Mori R.

    Japanese Journal of Anesthesiology   67 巻 ( 6 ) 頁: 642 - 646   2018年6月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Journal of Anesthesiology  

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  104. A rise in the platelet count by HLA-antigen negative compatible platelet transfusion in a platelet anti-HLA antibody-positive patient 査読有り

    Mori R

    Japanese Journal of Anesthesiology   67 巻 ( 6 ) 頁: 642 - 646   2018年6月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Journal of Anesthesiology  

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  105. Clinical Utility of Intraoperative Motor-Evoked Potential Monitoring to Prevent Postoperative Spinal Cord Injury in Thoracic and Thoracoabdominal Aneurysm Repair: An Audit of the Japanese Association of Spinal Cord Protection in Aortic Surgery Database 査読有り

    Yoshitani Kenji, Masui Kenichi, Kawaguchi Masahiko, Kawamata Mikito, Kakinohana Manabu, Kato Shinya, Hasuwa Kyoko, Yamakage Michiaki, Yoshikawa Yusuke, Nishiwaki Kimitoshi, Aoyama Tadashi, Inagaki Yoshimi, Yamasaki Kazumasa, Matsumoto Mishiya, Ishida Kazuyoshi, Yamashita Atsuo, Seo Katsuhiro, Kakumoto Shinichi, Hayashi Hironobu, Tanaka Yuu, Tanaka Satoshi, Ishida Takashi, Uchino Hiroyuki, Kakinuma Takayasu, Yamada Yoshitsugu, Mori Yoshiteru, Izumi Shunsuke, Nishimura Kunihiro, Nakai Michikazu, Ohnishi Yoshihiko

    ANESTHESIA AND ANALGESIA   126 巻 ( 3 ) 頁: 763 - 768   2018年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Anesthesia and Analgesia  

    BACKGROUND: Spinal cord ischemic injury is the most devastating sequela of descending and thoracoabdominal aortic surgery. Motor-evoked potentials (MEPs) have been used to intraoperatively assess motor tract function, but it remains unclear whether MEP monitoring can decrease the incidence of postoperative motor deficits. Therefore, we reviewed multicenter medical records of patients who had undergone descending and thoracoabdominal aortic repair (both open surgery and endovascular repair) to assess the association of MEP monitoring with postoperative motor deficits. METHODS: Patients included in the study underwent descending or thoracoabdominal aortic repair at 12 hospitals belonging to the Japanese Association of Spinal Cord Protection in Aortic Surgery between 2000 and 2013. Using multivariable mixed-effects logistic regression analysis, we investigated whether intraoperative MEP monitoring was associated with postoperative motor deficits at discharge after open and endovascular aortic repair. RESULTS: We reviewed data from 1214 patients (open surgery, 601 [49.5%]; endovascular repair, 613 [50.5%]). MEP monitoring was performed in 631 patients and not performed in the remaining 583 patients. Postoperative motor deficits were observed in 75 (6.2%) patients at discharge. Multivariable logistic regression analysis revealed that postoperative motor deficits at discharge did not have a significant association with MEP monitoring (adjusted odds ratio [OR], 1.13; 95% confidence interval [CI], 0.69-1.88; P =.624), but with other factors: History of neural deficits (adjusted OR, 6.08; 95% CI, 3.10-11.91; P <.001), spinal drainage (adjusted OR, 2.14; 95% CI, 1.32-3.47; P =.002), and endovascular procedure (adjusted OR, 0.45; 95% CI, 0.27- 0.76; P =.003). The sensitivity and specificity of MEP <25% of control value for motor deficits at discharge were 37.8% (95% CI, 26.5%-49.5%) and 95.5% (95% CI, 94.7%-96.4%), respectively. CONCLUSIONS: MEP monitoring was not significantly associated with motor deficits at discharge.

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  106. Important role of calcium chloride in preventing carbon monoxide generation during desflurane degradation with alkali hydroxide-free carbon dioxide absorbents 査読有り

    Ando Takahiro, Mori Atsushi, Ito Rie, Nishiwaki Kimitoshi

    JOURNAL OF ANESTHESIA   31 巻 ( 6 ) 頁: 911 - 914   2017年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    We investigated whether calcium chloride (CaCl2), a supplementary additive in carbon dioxide (CO2) absorbents, could affect carbon monoxide (CO) production caused by desflurane degradation, using a Japanese alkali-free CO2 absorbent Yabashi Lime®-f (YL-f), its CaCl2-free and 1% CaCl2-added derivatives, and other commercially available alkali-free absorbents with or without CaCl2. The reaction between 1 L of desflurane gas (3–10%) and 20 g of desiccated specimen was performed in an artificial closed-circuit anesthesia system for 3 min at 20 or 40 °C. The CO concentration was measured using a gas chromatograph equipped with a semiconductor sensor detector. The systems were validated by detecting dose-dependent CO production with an alkali hydroxide-containing CO2 absorbent, Sodasorb®. Compared with YL-f, the CaCl2-free derivative caused the production of significantly more CO, while the 1% CaCl2-added derivative caused the production of a comparable amount of CO. These phenomena were confirmed using commercially available absorbents AMSORB® PLUS, an alkali-free absorbent with CaCl2, and LoFloSorb™, an alkali-free absorbent without CaCl2. These results suggest that CaCl2 plays an important role in preventing CO generation caused by desflurane degradation with alkali hydroxide-free CO2 absorbents like YL-f.

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  107. 症例検討 予期せぬICU入室 2 術中の大量出血-術後のプロブレムリストも解決しよう 査読有り

    平井 昂宏, 西脇 公俊

    LiSA   24 巻 ( 11 ) 頁: 1100 - 1106   2017年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:株式会社医学書院  

    DOI: 10.11477/mf.3101200998

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  108. Efficacy of urinary midkine as a biomarker in patients with acute kidney injury 査読有り

    Hayashi Hiroki, Sato Waichi, Kosugi Tomoki, Nishimura Kunihiro, Sugiyama Daisuke, Asano Naoko, Ikematsu Shinya, Komori Kimihiro, Nishiwaki Kimitoshi, Kadomatsu Kenji, Matsuo Seiichi, Maruyama Shoichi, Yuzawa Yukio

    CLINICAL AND EXPERIMENTAL NEPHROLOGY   21 巻 ( 4 ) 頁: 597 - 607   2017年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Clinical and Experimental Nephrology  

    Background: The mortality and morbidity associated with acute kidney injury (AKI) remains high, despite advances in interventions. A multifunctional heparin-binding growth factor, midkine (MK), is involved in the pathogenesis of ischemic kidney injury. However, the clinical relevance of MK has not yet been elucidated. The present study investigated whether urinary MK can serve as a novel biomarker of AKI. Methods: We initially compared the predictive value of MK with other urinary biomarkers, including N-acetyl-β-d-glucosaminidase (NAG), interleukin (IL)-18, and neutrophil gelatinase-associated lipocalin (NGAL), for the detection and differential diagnosis of established AKI (549 patients). Subsequently, the reliability of MK for the early detection of AKI was prospectively evaluated in 40 patients undergoing elective abdominal aortic aneurysm surgery. Urine samples were obtained at baseline, the period of aortic cross-clamping and declamping, the end of the surgery, and on post-operative day 1. Results: The areas under the receiver operating characteristic curves for the diagnosis of AKI in various kidney diseases were 0.88, 0.70, 0.72, and 0.84 for MK, NAG, IL-18, and NGAL, respectively. When the optimal cutoff value of urinary MK was set at 11.5 pg/mL, the sensitivity and specificity were 0.87 and 0.85, respectively. In the second study, urinary MK peaked at the period of aortic declamping, about 1 h after cross-clamping in patients with AKI. Interestingly, the rise of MK in AKI patients was very precipitous compared with other biomarker candidates. Conclusion: Urinary MK was prominent in its ability to detect AKI and may allow the start of preemptive medication.

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  109. Two cases of autoimmune pulmonary alveolar proteinosis with rheumatoid arthritis

    Ito Satoru, Wakahara Keiko, Kojima Toshihisa, Takahashi Nobunori, Nishiwaki Kimitoshi, Yamaguchi Etsuro, Hasegawa Yoshinori

    ALLERGOLOGY INTERNATIONAL   66 巻 ( 3 ) 頁: 507 - 509   2017年7月

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

    DOI: 10.1016/j.alit.2017.02.002

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  110. Rapid Fluid Infusion and Depth of Anesthesia.

    Adachi YU, Satomoto M, Nishiwaki K

    Anesthesiology   126 巻 ( 5 ) 頁: 985-986   2017年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/ALN.0000000000001577

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  111. A randomized controlled trial comparing paravertebral block via the surgical field with thoracic epidural block using ropivacaine for post-thoracotomy pain relief.

    Tamura T, Mori S, Mori A, Ando M, Yokota S, Shibata Y, Nishiwaki K

    Journal of anesthesia   31 巻 ( 2 ) 頁: 263-270   2017年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s00540-017-2307-5

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  112. [Ultrasound-guided Truncal Block for Abdominal Surgery: Present and Future Perspectives].

    Shinya S, Shibata Y, Nishiwaki K

    Masui. The Japanese journal of anesthesiology   66 巻 ( 3 ) 頁: 255-262   2017年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  113. A randomized controlled trial comparing paravertebral block via the surgical field with thoracic epidural block using ropivacaine for post-thoracotomy pain relief 査読有り

    Takahiro TamuraShoichi MoriAtsushi MoriMasahiko AndoShuichi YokotaYasuyuki ShibataKimitoshi Nishiwaki

    Journal of Anesthesia     2017年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s00540-017-2307-5

  114. [Acute Subdural Hematoma due to the Breakage of an Epidural Catheter Left for a Long Time].

    Fujii T, Suzuki K, Shibata Y, Nishiwaki K

    Masui. The Japanese journal of anesthesiology   66 巻 ( 1 ) 頁: 65-69   2017年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  115. Breakage and retention of thoracic paravertebral catheter: a case report. 査読有り

    Fujii T, Shibata Y, Nishiwaki K

    JA clinical reports   3 巻 ( 1 ) 頁: 4   2017年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1186/s40981-016-0074-1

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  116. HIT(heparin-induced thrombocytopenia)-associated consumptive coagulopathyが疑われた症例 査読有り

    水野 祥子, 貝沼 関志, 西脇 公俊

    日本集中治療医学会雑誌   24 巻 ( 1 ) 頁: 22 - 25   2017年

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    担当区分:最終著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本集中治療医学会  

    症例は69歳の男性。突然の左腰背部痛のため当院に救急搬送され,腹部大動脈瘤破裂の診断で緊急腹部大動脈人工血管置換術が行われた。術後9日目に施行したCTにて右内頸静脈血栓を認めたためヘパリン持続静注を開始したが,術後10日目に血小板数が前日の40%に減少しており,HIT(heparin-induced thrombocytopenia)の可能性を考えてすべてのヘパリンを中止した。術後11日目にHIT抗体強陽性との結果を受けアルガトロバンの持続静注を開始したが,APTT延長が続いたため,アルガトロバンを漸減,術後15日目には中止せざるを得なかった。その後も抗凝固療法が行えないまま術後59日目に死亡した。本邦でHIT治療薬として承認されているのはアルガトロバンのみであるが,APTTによってその投与量を決定するため,本症例のように凝固障害に陥ると減量が必要となりHITの病態悪化を招く可能性がある。HIT-associated consumptive coagulopathyに陥った場合の治療法は確立されておらず,今後の課題である。

    DOI: 10.3918/jsicm.24_22

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  117. 僧帽弁形成術後の僧帽弁前尖収縮期前方運動に対してシベンゾリン静脈内投与が有効であった一例 査読有り

    藤井 祐, 青山 正, 石田 祐基, 新屋 苑恵, 貝沼 関志, 西脇 公俊

    Cardiovascular Anesthesia   21 巻 ( 1 ) 頁: 69 - 74   2017年

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    担当区分:最終著者, 責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本心臓血管麻酔学会  

    <p> 僧帽弁形成術(MVP)後の僧帽弁前尖収縮期前方運動(SAM)に対してシベンゾリン静脈内投与が有効であった症例を報告する。</p><p> SAMは狭い左室流出路(LVOT)を通過する加速血流のVenturi効果により増幅弁前尖がLVOTに引き込まれて生じる。周術期管理は前負荷・後負荷の維持,心収縮力の抑制,心拍数の調節が重要である。SAMの発生機序から閉塞性肥大型心筋症の治療(β遮断薬,Ca<sup>2+</sup>拮抗薬,Na<sup>+</sup>チャネル遮断薬)も有効となる。β遮断薬が一般的に使用されているが,MVP後のLVOT狭窄は頻脈より心収縮力増強が主因とされているため,陰性変時作用より陰性変力作用が優位なNa<sup>+</sup>チャネル遮断薬のシベンゾリンも有用となりえる。</p>

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  118. Combination of Continuous Epidural Block and Rehabilitation in a Case of Complex Regional Pain Syndrome 査読有り

    Hayashi Kazuhiro, Nishiwaki Kimitoshi, Kako Masato, Suzuki Kentaro, Hattori Keiko, Sato Koji, Kadono Izumi, Nishida Yoshihiro

    JOURNAL OF NIPPON MEDICAL SCHOOL   83 巻 ( 6 ) 頁: 262 - 267   2016年12月

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    掲載種別:研究論文(学術雑誌)  

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  119. 症例検討 薬をめぐるトラブル < 後編 > 麻酔導入後の治療抵抗性の低血圧-慌てず騒がず理論的に 査読有り

    平井 昂宏, 西脇 公俊

    LiSA   23 巻 ( 3 ) 頁: 254 - 258   2016年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:株式会社医学書院  

    DOI: 10.11477/mf.3101200524

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  120. Pain-reducing anesthesia prevents oxidative stress in human term placenta. 査読有り 国際誌

    Tsuzuki Y, Yamashita Y, Hattori Y, Hua Li G, Akatsuka S, Kotani T, Kikkawa F, Naiki-Ito A, Takahashi S, Nishiwaki K, Toyokuni S

    Journal of clinical biochemistry and nutrition   58 巻 ( 2 ) 頁: 156 - 60   2016年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Clinical Biochemistry and Nutrition  

    Anesthesia is sometimes used for the reduction of maternal pain in normal human term labor, but whether the drugs affect oxidative stress remains unclear. The placenta serves as an interface between the maternal and fetal vasculature. In this study, we immunohistochemically analyzed two markers for oxidative stress, namely 8-hydroxy-2'-deoxyguanosine (8-OHdG) and 4-hydroxy-2-nonenal–modified proteins (HNE), using placentas from 21 cases of normal tansvaginal delivery (V group), 20 Caesarean sections (C group), and 17 normal transvaginal deliveries with epidural anesthesia (E group). 8-OHdG staining in the nuclei of trophoblasts lining the chorionic villi was significantly stronger in the V group either compared with the C or E group (<i>p</i><0.001), without significant differences in the C and E groups (<i>p</i> = 0.792). Moderate to intense staining by HNE of the intravascular serum of chorionic villi vasculature was frequently observed in the placentas from the V group, but less frequently of those in either C or E groups (<i>p</i><0.001), nor the <i>p</i> value comparing the C and E groups was significant (<i>p</i> = 0.128) for HNE staining. Our results suggest that although the role of oxidative stress and its influences on fetal state in the placenta in labor remains unclear, it seems to be lessened by epidural anesthesia.

    DOI: 10.3164/jcbn.15-138

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  121. Delayed Onset of Subdural Hematoma following Epidural Catheter Breakage 査読有り 国際誌

    Ishikawa Yoshimoto, Imagama Shiro, Ito Zenya, Ando Kei, Gotoh Momokazu, Nishiwaki Kimitoshi, Nagao Yoshimasa, Ishiguro Naoki

    GLOBAL SPINE JOURNAL   6 巻 ( 1 ) 頁: E1 - E6   2016年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Global Spine Journal  

    DOI: 10.1055/s-0035-1549030

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  122. Combination of Continuous Epidural Block and Rehabilitation in a Case of Complex Regional Pain Syndrome. 査読有り

    Hayashi K, Nishiwaki K, Kako M, Suzuki K, Hattori K, Sato K, Kadono I, Nishida Y

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   83 巻 ( 6 ) 頁: 262 - 267   2016年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本医科大学医学会  

    <p>Epidural analgesia is used to promote rehabilitation in patients with refractory complex regional pain syndrome (CRPS) who cannot bear physical programs due to intense pain. However, the actual rehabilitation process has not been focused in previous reports. Here, we outline our experience of treating a young woman with CRPS type 1 who underwent rehabilitation facilitated by a continuous lumbar epidural block. A 15-year-old girl developed throbbing pain from her left toe to her ankle, with no obvious cause. She was admitted to the hospital 2 months after symptom onset for an assessment of pain intensity, range of motion, weight-bearing, neglect-like symptoms, pain catastrophizing, and a CRPS severe score with impaired activities of daily living. The rehabilitation program was initiated under facilitation of continuous epidural block. Her rehabilitation program included physical therapy, motor imagery, mirror therapy, and cognitive behavioral therapy. The intensity of the exercise was gradually increased without exacerbating her symptoms. Ultimately, she recovered completely after a continuous epidural block for 21 days and rehabilitation for 80 days. A combination of continuous epidural block and intensive rehabilitation improved the symptoms of this patient. The treatment course would be helpful for planning rehabilitation programs in other patients with CRPS.</p>

    DOI: 10.1272/jnms.83.262

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  123. 大血管手術後にプロポフォール注入症候群による横紋筋融解を発症したと考えられる一症例 査読有り

    平井 昂宏, 貝沼 関志, 林 智子, 長谷川 和子, 青山 正, 水野 祥子, 鈴木 章悟, 西脇 公俊

    日本集中治療医学会雑誌   23 巻 ( 6 ) 頁: 647 - 650   2016年

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    担当区分:最終著者, 責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本集中治療医学会  

    プロポフォール注入症候群(propofol infusion syndrome, PRIS)は,プロポフォール使用中に横紋筋融解,急性腎傷害(acute kidney injury, AKI),乳酸アシドーシス,脂質異常症などを来す症候群である。早期にPRISを疑いプロポフォール中止によって救命できた一例を経験した。症例は44歳の男性,スタンフォードA型大動脈解離に対して弓部置換術を行った。術後にプロポフォールを用いて鎮静を行っていたところ,血液生化学検査でCKが15,247 IU/<I>l</I>まで上昇し,AKI,乳酸アシドーシスを認めたためにPRISを強く疑った。プロポフォールの投与中止によりCKは速やかに減少し,AKI,乳酸アシドーシスも改善した。後に撮影されたCTで大腿から臀部の筋内に高吸収域を認め,横紋筋融解後の変化があった。プロポフォールの長期投与中はCK,pH,乳酸値などを定期的にモニタリングし,PRISを疑った場合は早期に他の鎮静薬への変更が必要であると考えられた。

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  124. 特集 外科医に求められる積極的緩和医療-延命と症状緩和の狭間で 知っておきたい緩和医療の積極的介入法 がん性疼痛に対する神経ブロック療法 査読有り

    春原 啓一, 西脇 公俊

    臨床外科   70 巻 ( 13 ) 頁: 1500 - 1508   2015年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:株式会社医学書院  

    DOI: 10.11477/mf.1407211022

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  125. Radial artery cannulation decreases the distal arterial blood flow measured by power Doppler ultrasound 査読有り 国際誌

    Numaguchi Atsushi, Adachi Yushi U., Aoki Yoshitaka, Ishii Yasuhiro, Suzuki Katsumi, Obata Yukako, Sato Shigehito, Nishiwaki Kimitoshi, Matsuda Naoyuki

    JOURNAL OF CLINICAL MONITORING AND COMPUTING   29 巻 ( 5 ) 頁: 653 - 657   2015年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Clinical Monitoring and Computing  

    DOI: 10.1007/s10877-014-9648-5

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  126. 学童期のMenkes病患者に対し全身麻酔を施行した一例 査読有り

    佐藤 威仁, 西脇 公俊

    蘇生: 日本蘇生学会雑誌   34 巻 ( 3 ) 頁: 282a - 282a   2015年

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    担当区分:最終著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本蘇生学会  

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    DOI: 10.11414/jjreanimatology.34.3_282a

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  127. [WHO Surgical Safety Checklist and guideline for safe surgery 2009]. 査読有り

    Nishiwaki K, Ichikawa T

    Masui. The Japanese journal of anesthesiology   63 巻 ( 3 ) 頁: 246 - 54   2014年3月

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    担当区分:筆頭著者, 責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  128. WHO surgical safety checklist and guideline for safe surgery 2009 査読有り

    Nishiwaki K., Ichikawa T.

    Japanese Journal of Anesthesiology   63 巻 ( 3 ) 頁: 246 - 254   2014年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Journal of Anesthesiology  

    The World Health Organization WHO launched the Safe Surgery Saves Lives campaign in 2007 to improve safety of surgical care in the world. As a part of the campaign, the first edition of the Surgical Safety Checklist was created through an international consultative process in 2008 and the second edition was published in the WHO Guidelines for Safe Surgery 2009. The guidelines consist of ten essential objectives for safe surgery, and nine of the ten objectives are facilitated by introducing the surgical checklist in the operating room, which is designed to improve teamwork of the operating room member and to give them chances to use the safety processes consistently. It consists of nineteen check points scheduled to be used in three phases : before anesthesia induction, before any skin incisioa and at the end of surgery. In this article we gave an outline of WHO Surgical Safety Checklist and WHO Guidelines for Safe Surgery 2009, and reviewed the evidence of the guidelines and checklist Finally we presented the evidence indicating the efficacy of the WHO Surgical Safety Checklist, which included the pilot study attached in the guidelines showing that its use markedly decreased complications in patients undergoing noncardiac surgery in eight diverse international hospitals.

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  129. Dexmedetomidine-induced atrioventricular block followed by cardiac arrest during atrial pacing: a case report and review of the literature 査読有り 国際誌

    Takata Kotaro, Adachi Yushi U., Suzuki Katsumi, Obata Yukako, Sato Shigehito, Nishiwaki Kimitoshi

    JOURNAL OF ANESTHESIA   28 巻 ( 1 ) 頁: 116 - 120   2014年2月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    DOI: 10.1007/s00540-013-1676-7

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  130. 症例検討 術中の低酸素血症2 気管挿管中の脳出血患者に対する気管切開術-急変は突然やってくる? 査読有り

    石田 祐基, 西脇 公俊

    LiSA   21 巻 ( 1 ) 頁: 38 - 42   2014年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:株式会社医学書院  

    DOI: 10.11477/mf.3101102022

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  131. 重症心不全に対し集中治療を施行し補助人工心臓を装着した10症例の検討 査読有り

    貝沼 関志, 西脇 公俊, 石田 祐基, 長谷川 和子, 林 智子, 平井 昴宏, 水野 祥子, 市川 崇, 青山 正, 鈴木 章悟

    蘇生: 日本蘇生学会雑誌   33 巻 ( 3 ) 頁: 177b - 177b   2014年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本蘇生学会  

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    DOI: 10.11414/jjreanimatology.33.177b

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  132. Intravenous droperidol decreases the bispectral index during general anesthesia with sevoflurane and remifentanil. 査読有り

    Adachi YU, Tanaka K, Suzuki S, Nishiwaki K, Matsuda N

    Masui. The Japanese journal of anesthesiology   62 巻 ( 1 ) 頁: 71 - 4   2013年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  133. 名大外科系集中治療部での体外式補助人工心臓長期管理6症例の検討 査読有り

    貝沼 関志, 西脇 公俊, 長柄 祐輝, 水野 祥子, 尾関 奏子, 萩原 伸昭, 青山 正, 市川 崇, 鈴木 章悟, 高橋 英夫

    蘇生: 日本蘇生学会雑誌   32 巻 ( 3 ) 頁: 186b - 186b   2013年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本蘇生学会  

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    DOI: 10.11414/jjreanimatology.32.186b

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  134. WHO手術安全のガイドライン 査読有り

    西脇 公俊

    臨床麻酔   37 巻   頁: 19 - 26   2013年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  135. [ECG changes after the induction of general anesthesia with remifentanil: a report of three case]. 査読有り

    Tanaka K, Adachi Y, Suzuki S, Nishiwaki K, Matsuda N

    Masui. The Japanese journal of anesthesiology   61 巻 ( 10 ) 頁: 1128 - 32   2012年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  136. ICUにて診断治療に難渋した術後症例の紹介 査読有り

    貝沼 関志, 市川 崇, 金 碧年, 西脇 公俊

    日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia   32 巻 ( 4 ) 頁: 507 - 512   2012年7月

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    担当区分:最終著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本臨床麻酔学会  

    &nbsp;&nbsp;麻酔科医の周術期管理という面における代表例として,最近当院ICUにて診断治療に難渋した術後症例の2例を紹介する.症例1は肺手術後に繰り返す胸腔内出血があり,後天性血友病と診断された症例である.術前からPT(prothrombin time)は正常かつAPTT(activated partial thromboplastin time)の延長がみられ,術後に診断した.遺伝子組換え活性型第VII因子製剤,活性化プロトロンビン複合体製剤,ステロイド投与にてインヒビターは消失し軽快退院となった.症例2はLVOT狭窄解除,AVR術後症例である.肺動脈性肺高血圧症,急性腎不全となりPCPS,CHDFを施行し,シルデナフィル,ボセンタン,NOを投与した.また,APRVを施行したが,患者は腸管虚血から死亡した.麻酔科医は術後集中治療での診断・治療に深く関与することによって患者のアウトカムに大きく関与することが可能である.

    DOI: 10.2199/jjsca.32.507

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  137. SF-046-5 敗血症性DICに対するアンチトロンビン製剤とトロンボモジュリン製剤の使用戦略(SF-046 サージカルフォーラム(46)救急 治療,第112回日本外科学会定期学術集会) 査読有り

    真弓 俊彦, 鈴木 秀一, 小野寺 睦雄, 市川 崇, 都築 通孝, 金 碧年, 高橋 英夫, 貝沼 関志, 西脇 公俊, 松田 直之

    日本外科学会雑誌   113 巻 ( 2 )   2012年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人日本外科学会  

  138. 術後脳梗塞が2度の再気管挿管の要因になったと考えられた1症例 査読有り

    足立 裕史, 市川 崇, 貝沼 関志, 西脇 公俊, 山本 尚範, 松田 直之

    日本集中治療医学会雑誌   19 巻 ( 4 ) 頁: 699 - 700   2012年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本集中治療医学会  

    DOI: 10.3918/jsicm.19.699

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  139. 術前・術後管理必携 無機肺 査読有り

    西脇 公俊

    消化器外科   4 巻   頁: 856 - 858   2012年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    CiNii Research

  140. 気管挿管後に直達喉頭鏡刺激で高度徐脈を呈した1例 査読有り

    西脇 公俊

    臨床麻酔   36 巻   頁: 963 - 964   2012年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    CiNii Research

  141. Spinal cord stimulation markedly ameliorated refractory neuropathic pain in transthyretin Val30Met familial amyloid polyneuropathy. 査読有り 国際誌

    Miyazaki Y, Koike H, Akane A, Shibata Y, Nishiwaki K, Sobue G

    Amyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis   18 巻 ( 2 ) 頁: 87 - 90   2011年6月

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

    Although spinal cord stimulation has been reported to be effective for controlling neuropathic pain in diabetic neuropathy, it has rarely been investigated in other peripheral neuropathies. We describe, for the first time, the efficacy of spinal cord stimulation for refractory neuropathic pain in a patient with transthyretin Val30Met associated familial amyloid polyneuropathy (FAP ATTR Val30Met). A 72-year-old man was diagnosed as having FAP ATTR Val30Met when he was 70 years old. He had been complained of burning pain in the distal portion of his bilateral lower limbs since he was 69 years old. Because conventional symptomatic therapies, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, and tricyclic antidepressants did not ameliorate pain, he underwent bilateral lumbar spinal cord electrical stimulation at high frequency and low voltage at the level of Th12 vertebral body and this was markedly effective. Our case expands the application of spinal cord stimulation, which should be considered as an alternative therapeutic approach for relief of neuropathic pain, which can be extremely distressful for patients and may lead to an impaired quality of life. © 2011 Informa UK, Ltd.

    DOI: 10.3109/13506129.2011.569782

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  142. LEVELS OF ANTITHROMBIN ACTIVITY AFTER ANTITHROMBIN ADMINISTRATION INDICATE PROGNOSIS OF SEPTIC DIC PATIENTS 査読有り 国際誌

    Mayumi T., Suzuki S., Yamamoto T., Ichikawa T., Onodera M., Tsuzuki M., Kin B., Inoue T., Kainuma M., Takahashi H., Matsuda N., Nishiwaki K.

    SHOCK   35 巻   頁: 13 - 13   2011年6月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  143. 肺血管透過性亢進のメカニズムと麻酔薬の影響ー神経原生肺水腫から 査読有り

    西脇 公俊

    Anesthesia Network   15(2) 巻   頁: 34 - 36   2011年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    CiNii Research

  144. Effects of midazolam, diazepam, propofol and dexmedetomidine on endothelial cell proliferation and angiogenesis induced by VEGF 査読有り 国際誌

    Nan Yong-Shan, Li Shao-Yan, Kang Ji-Long, Suzuki Shogo, Ema Yoshiaki, Nishiwaki Kimitoshi

    AFRICAN JOURNAL OF MICROBIOLOGY RESEARCH   4 巻 ( 23 ) 頁: 2549 - 2555   2010年12月

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    担当区分:最終著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Web of Science

  145. A randomized comparison of ultrasound guided thoracic para vertebral block and epidural analgesia for post-thoracotomy pain relief and respiratory function 査読有り 国際共著 国際誌

    Aly H.M., Mousa E.A., Mohammad S.A., Nishiwaki K.

    Egyptian Journal of Anaesthesia   26 巻 ( 3 ) 頁: 189 - 198   2010年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Egyptian Journal of Anaesthesia  

    Objectives: Thoracic epidural block is considered by many as the method of choice for control of post-thoracotomy pain. Ultrasound guided thoracic paravertebral block is a recent technique which may offer several advantages. We therefore evaluated the analgesic effects of both bocks. Methods: We randomized 30 patients undergoing elective thoracotomy to two groups: thoracic epidural group (TED) and ultrasound guided thoracic paravertebral group (TPV). During early postoperative 72 h, we measured pain intensity, intravenous fentanyl consumption by patient controlled analgesia pump, spirometric tests, arterial blood gas analysis and complications. Results: Analgesic quality was comparable in both groups with a higher consumption of fentanyl in ultrasound guided TPV group. Spirometric tests were comparable between both groups except forced vital capacity and forced expiratory volume in one second at 24h which was more favorable in TED group. Values of vital parameters (SpO2%, respiratory rate, heart rate and mean arterial blood pressure) were comparable in both groups. Perforation of the pleura was reported in one patient who belongs to the TPV group. Conclusion: TPVB is a suitable alternative to epidural analgesia for pain management following thoracotomy and it can provide proper anesthesia and analgesia in patients with severe comorbidities and contraindications to neuroaxial blocks... Despite the use of ultrasound guided, puncture of the pleura is still a possible complication.

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  146. Adding fentanyl to the continuous infusion in lumbar plexus block: Is there a difference? 査読有り 国際誌

    Abd El-Ghany F.I., Mousa E.H.A., Ali A.E.A., Shiha A.E.M., Nishiwaki K.

    Egyptian Journal of Anaesthesia   26 巻 ( 3 ) 頁: 167 - 174   2010年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Egyptian Journal of Anaesthesia  

    Background and Objectives: Continuous lumbar plexus block (CLPB) 1, 2 has recently been shown to give effective postoperative analgesia following total hip arthroplasty. The aim of this retrospective study was to evaluate the effectiveness of continuous infusion of lumbar plexus block (LPB) with only a local anesthetic compared with continuous infusion of the LPB with fentanyl added to the local anesthetic for postoperative analgesia after total hip arthroplasty. We also compared the patient satisfaction, PCA fentanyl consumption, complications and side effects. Methods: Thirty patients who underwent total hip arthroplasty surgery were included in the study. The subjects were randomly assigned to Group R (n=15; posterior lumbar plexus block with only a local anesthetic where 25 ml of 0.375% ropivacaine then continuous infusion of 0.2% of ropivacaine at a rate of 6-8 ml/h or Group F (n=15; posterior lumbar plexus block with 25 ml of 0.375% ropivacaine plus100 μg fentanyl then continuous infusion of 0.2% ropivacaine plus fentanyl 0.5 μg/kg/h at the same rate. Patient controlled analgesia (PCA) pump containing fentanyl was given to all patients that was calibrated to deliver a dose of 20ug, the lock out time is 5 minutes and maximum dose was 200 ug /h. Scores on a visual analog pain scale (VAS) at rest and on movement were used as the primary outcome measured. Secondary outcomes included PCA fentanyl consumption, opioid-related side effects, complications and patient satisfaction. Results: CLPB with fentanyl added to the continuous infusion significantly reduced pain scores at 2, 4, 16, 24 and 66 h at rest and at 16, 24 h on movement compared with CLPB with only ropivacaine. The use of a continuous lumbar plexus block also favorably affected secondary outcomes such as PCA fentanyl consumption which was statistically significant at 2, 4, 16, 24, 48 and 66h and the overall patient satisfaction that was statistically higher in the group F compared with group R. Nausea was significantly higher in group R, while other opioid-related side effects or complications were similar in the two groups. Conclusion: Adding fentanyl to the continuous infusion of Lumbar plexus block provides more effective analgesia with less side effects and better patient satisfaction than continuous infusion with only local anesthetic after hip arthroplasty surgery.

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  147. A randomized comparison of ultrasound guided thoracic para vertebral block and epidural analgesia for post-thoracotomy pain relief and respiratory function 査読有り 国際共著 国際誌

    Aly H.M

    Egyptian Journal of Anaesthesia   26 巻 ( 3 ) 頁: 189 - 198   2010年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Egyptian Journal of Anaesthesia  

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  148. Significance of prevention and early treatment of a postoperative twisted neck : atlantoaxial rotatory subluxation after head and neck surgery 査読有り 国際誌

    KIM Byeoknyeon, IWATA Keiko, SUGIMOTO Kenji, SUZUKI Shogo, EMA Yoshiaki, TSUNOBUCHI Hironaka, NISHIWAKI Kimitoshi

    Journal of anesthesia   24 巻 ( 4 ) 頁: 598 - 602   2010年8月

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    担当区分:最終著者, 責任著者   掲載種別:研究論文(学術雑誌)  

  149. Significance of prevention and early treatment of a postoperative twisted neck: Atlantoaxial rotatory subluxation after head and neck surgery 査読有り

    Kim B., Iwata K., Sugimoto K., Suzuki S., Ema Y., Tsunobuchi H., Nishiwaki K.

    Journal of Anesthesia   24 巻 ( 4 ) 頁: 598 - 602   2010年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Anesthesia  

    Atlantoaxial rotatory subluxation (AARS) is an infrequent condition that occurs most commonly in children for unknown reasons. Pediatric surgery, otopharyngeal inflammation, general anesthesia, and extreme rotation of the head are risk factors for development of postsurgical AARS, but AARS can often occur unnoticed, and the syndrome is not well known. We encountered three cases of postoperative AARS that occurred within 7 months; therefore, we have developed guidelines for prevention and early treatment of postoperative AARS. Postoperative AARS cannot be eliminated completely, but informed consent, a preoperative check, an appropriate surgical position, and a postoperative check may reduce the risk and damage related to this condition. © Japanese Society of Anesthesiologists 2010.

    DOI: 10.1007/s00540-010-0932-3

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  150. [Prevention of catheter-related bloodstream infections in the operation room]. 査読有り

    Ema Y, Nishiwaki K

    Masui. The Japanese journal of anesthesiology   59 巻 ( 5 ) 頁: 577 - 84   2010年5月

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    担当区分:最終著者, 責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  151. Prevention of catheter-related bloodstream infections in the operation room 査読有り

    Ema Y., Nishiwaki K.

    Japanese Journal of Anesthesiology   59 巻 ( 5 ) 頁: 577 - 584   2010年5月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Journal of Anesthesiology  

    Catheter-related bloodstream infections (CRBSIs) are recognized as an important and serious problem, especially in an intensive care unit (ICU), since they have far higher infection rates compared to those for other type of intravascular devices. However, in the operation room, there seems to be little concern among anesthesiologists regarding this problem. It is important for anesthesiologists to understand that CRBSIs can be prevented or reduced by evidence-based interventions such as hand hygiene, education in hand washing and alcohol-based hand rubbing, sterile catheter care techniques, proper skin disinfection, maximal barrier precautions during catheter insertion, choice of subclavian vein placement, avoidance of femoral vein placement, and removal of an unnecessary catheter. This evidence is based mainly on findings in ICU patients, but introduction of these interventions into operation rooms may be very useful for reducing perioperative CRBSIs.

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  152. 術中大量出血を防ぐための新たな輸血治療 : クリオプレシピテートおよびフィブリノゲン濃縮製剤投与効果の検討 査読有り

    山本 晃士, 西脇 公俊, 加藤 千秋, 花井 慶子, 菊地 良介, 柴山 修司, 梛野 正人, 木内 哲也, 上田 裕一, 高松 純樹

    日本輸血細胞治療学会誌 = Japanese journal of transfusion and cell therapy   56 巻 ( 1 ) 頁: 36 - 42   2010年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  153. 神経原生肺水腫と神経性肺血管透過性調節 査読有り

    西脇 公俊

    別冊・医学のあゆみ最新ARDSのすべて     頁: 200 - 205   2010年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  154. Ultrasound-guided intercostal approach to thoracic paravertebral block.

    Shibata Y, Nishiwaki K

    Anesthesia and analgesia   109 巻 ( 3 ) 頁: 996-7   2009年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1213/ane.0b013e3181af7e7b

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  155. Preliminary measurement of intraoperative sympathetic nerve activity using microneurography and laser Doppler flowmetry during surgical resection of suprasellar tumors.

    Kurimoto F, Saito K, Watanabe T, Nagatani T, Nishiwaki K, Wakabayashi T, Iwase S

    Neurologia medico-chirurgica   49 巻 ( 1 ) 頁: 13-21   2009年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  156. A greater decrease in blood pressure after spinal anaesthesia in patients with low entropy of the RR interval. 査読有り

    Fujiwara Y, Sato Y, Shibata Y, Asakura Y, Nishiwaki K, Komatsu T.

    Acta Anaesthesiol Scand.   51 巻 ( 9 ) 頁: 1161-5   2007年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  157. Possible roles of neuropeptide Y Y3-receptor subtype in rat aortic endothelial cell proliferation under hypoxia, and its specific signal transduction.

    Chen ZY, Feng GG, Nishiwaki K, Shimada Y, Fujiwara Y, Komatsu T, Ishikawa N

    American journal of physiology. Heart and circulatory physiology   293 巻 ( 2 ) 頁: H959-67   2007年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1152/ajpheart.00886.2006

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  158. Preoperative ultra short-term entropy predicts arterial blood pressure fluctuation during the induction of anesthesia.

    Fujiwara Y, Ito H, Asakura Y, Sato Y, Nishiwaki K, Komatsu T

    Anesthesia and analgesia   104 巻 ( 4 ) 頁: 853-6   2007年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1213/01.ane.0000258756.41649.2d

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  159. Correlation between heart rate variability and haemodynamic fluctuation during induction of general anaesthesia: comparison between linear and non-linear analysis.Anaesthesia. 査読有り

    Fujiwara Y, Kurokawa S, Asakura Y, Wakao Y, Nishiwaki K, Komatsu T.

    Anaesthesia.   62 巻 ( 2 ) 頁: 117-21   2007年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  160. Pediatric anesthesia practice and training in Japan: a survey.

    Shimada Y, Nishiwaki K, Sato K, Sato E, Miyasaka K

    Paediatric anaesthesia   16 巻 ( 5 ) 頁: 543-7   2006年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/j.1460-9592.2005.01817.x

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  161. A marked decrease in heart rate variability associated with junctional rhythmduring anesthesia with sevoflurane and fentanyl. 査読有り

    Fujiwara Y, Asakura Y, Shibata Y, Nishiwaki K, Komatsu T.

    Acta Anaesthesiol Scand.   50 巻 ( 4 ) 頁: 509-511   2006年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  162. Different effects of optical isomers of the 5-HT1A receptor antagonistpyrapyridolol against postischemic guinea-pig myocardial dysfunction andapoptosis through the mitochondrial permeability transition pore. 査読有り

    Huang L, Hotta Y, Miyazeki K, Ishikawa N, Miki Y, Sugimoto Y, Yamada J,Nakano A, Nishiwaki K, Shimada Y.

    Eur J Pharmacol.   18 巻 ( 534 ) 頁: 165-177   2006年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  163. *Opposing effects of isoflurane and sevoflurane on neurogenic pulmonary edema development in an animal model. 査読有り

    Kandatsu N, Nan YS, Feng GG, Nishiwaki K, Hirokawa M, Ishikawa K, Komatsu T,Yokochi T, Shimada Y, Ishikawa N.

    Anesthesiology.   102 巻 ( 6 ) 頁: 1182-9   2005年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  164. Severe hypertension after stellate ganglion block. 査読有り

    Kimura T, Nishiwaki K, Yokota S, Komatsu T, Shimada Y.

    Br J Anaesth.   94 巻 ( 6 ) 頁: 840-842   2005年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  165. Opposing effects of isoflurane and sevoflurane on neurogenic pulmonary edema development in an animal model.

    Kandatsu N, Nan YS, Feng GG, Nishiwaki K, Hirokawa M, Ishikawa K, Komatsu T, Yokochi T, Shimada Y, Ishikawa N

    Anesthesiology   102 巻 ( 6 ) 頁: 1182-9   2005年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  166. [A case of spontaneous intracranial hypotension effectively treated with cervical epidural blood patch].

    Asano N, Taki K, Kondo T, Nishiwaki K, Kimura T, Shimada Y

    Masui. The Japanese journal of anesthesiology   53 巻 ( 10 ) 頁: 1185-8   2004年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  167. A role for L-glutamate ionotropic receptors in the development of rat neurogenic pulmonary edema. 査読有り

    Kondo H, Feng GG, Nishiwaki K, Shimada Y, Hirokawa M, Komatsu T, Yokochi T,Ishikawa N.

    Eur J Pharmacol.   24 巻 ( 499 ) 頁: 257-263   2004年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  168. Neuropeptide Y enhances permeability across a rat aortic endothelial cell monolayer.

    Nan YS, Feng GG, Hotta Y, Nishiwaki K, Shimada Y, Ishikawa A, Kurimoto N, Shigei T, Ishikawa N

    American journal of physiology. Heart and circulatory physiology   286 巻 ( 3 ) 頁: H1027-33   2004年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1152/ajpheart.00630.2003

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  169. Is massive transfusion of fresh frozen plasma necessary in extensive hepatectomy? 査読有り

    KOBAYASHOI M, NISHIWAKI K, TAKAHASHI T, KOBAYASHOI M, NISHIWAKI K, TAKAHASHI T,FUJIWARA Y, KIMURA T, SHIMADA Y

    Anesth & Resuscitation   40 巻 ( 1 ) 頁: 39-42   2004年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  170. *Neuropeptide Y enhances permeability across a rat aortic endothelial cell monolayer. 査読有り

    NAN YS, FENG GG, HOTTA Y, NISHIWAKI K, SHIMADA Y, ISHIKAWA A, KURIMOTO N, SHIGEI T, ISHIKAWA N

    Am J PhysiolAm J Physiol Heart Circ Physiol   286 巻 ( 3 ) 頁: H1027-33   2004年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  171. Severe bradycardia in a patient undergoing endovascular stent-graft repair for abdominal aortic aneurysm with vena cava balloon occlusion. 査読有り

    SATO Y, KIMURA T, SATO E, NISHIWAKI K, SHIMADA Y

    Can J Anaesth   50 巻 ( 9 ) 頁: 970-1   2003年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  172. Inhibition of fibrin-induced neurogenic pulmonary edema by previous unilateral left-vagotomy correlates with increased levels of brain nitric oxide synthase in the nucleus tractus solitarii of rats.

    Feng GG, Nishiwaki K, Kondo H, Shimada Y, Ishikawa N

    Autonomic neuroscience : basic & clinical   102 巻 ( 1-2 ) 頁: 1-7   2002年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PubMed

  173. Heart rate variability and arterial blood pressure variability show different characteristic changes during hemorrhage in isoflurane-anesthetized, mechanically ventilated dogs.

    Kawase M, Komatsu T, Nishiwaki K, Kobayashi M, Kimura T, Shimada Y

    Anesthesia and analgesia   94 巻 ( 1 ) 頁: 16-21, table of contents   2002年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PubMed

  174. Heart rate variability and arterial blood pressure variability show different characteristic changes during hemorrhage in isoflurane-anesthetized, mechanically ventilated dogs. 査読有り

    KAWASE M, KOMATSU T, NISHIWAKI K, KOBAYASHI M,KAWASE M, KOMATSU T, NISHIWAKI K, KOBAYASHI M,KAWASE M, KOMATSU T, NISHIWAKI K, KOBAYASHI M, KIMURA T, SHIMADA Y

    Anesth Analg   94 巻 ( 1 ) 頁: 16-21   2002年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  175. Perioperative management of a patient with purpura fulminans syndrome due to protein C deficiency. 査読有り

    KUMAGAI K, NISHIWAKI K, SATO K, KITAMURA H, YANO K, KOMATSU T, SHIMADA Y

    Can J Anaesth   48 巻 ( 11 ) 頁: 1070-4   2001年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  176. Angiotensin-converting enzyme gene polymorphism in patients with neuropathic pain. 査読有り

    KIMURA T, KOMATSU T, HOSODA R. NISHIWAKI K, SHIMADA Y

    Prog Pain Res Manage   16 巻   頁: 471-6   2000年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  177. Unilateral pulmonary cystic enlargement in a newborn: remember the one sided blind intubation. 査読有り

    KUMAGAI K, NISHIWAKI K, SATO K, KITAMURA H,YANO K, ONISHI S, SHIMADA Y

    Paediatr Anaesth   10 巻 ( 1 ) 頁: 111-3   2000年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  178. *Presence and quantification of neuropeptide Y in pulmonary edema fluid in rats. 査読有り

    HAMDY O, NISHIWAKI K, YAJIMA M, MURAKAMI HO, MAEKAWA H, MOY RT, SHIMADA Y, ISHIKAWA N

    Exp Lung Res   26 巻 ( 3 ) 頁: 137-47   2000年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  179. Heart rate variability during massive hemorrhage and progressive hemorrhagic shock in dogs. 査読有り

    KAWASE M, KOMATSU T, NISHIWAKI K, KIMURA T, FUJIWARA Y, TAKAHASHI T, SHIMADA Y

    Can J Anaesth   47 巻 ( 8 ) 頁: 807-814   2000年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  180. *Unexpected hyperkalemia following succinylcholin administration in prolonged immobilized parturients treated with magnesium and ritodrine. 査読有り

    SATO K, NISHIWAKI K, KUNO N, KUMAGAI K, KITAMURA H, YANO K, KOMATSU T, SHIMADA Y

    Anesthesiology   93 巻 ( 6 ) 頁: 1539-41   2000年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  181. Transfer function analysis of the circulation in patients undergoing sevoflurane anesthesia. 査読有り

    FUJIWARA Y, KOMATSU T, KIMURA T, KAWASE M, NISHIWAKI K, SHIMADA Y

    Can J Anaeth   46 巻   頁: 820-26   1999年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  182. Heart rate and blood pressure power spectral analysis during calcium channel blocker induced hypotension. 査読有り

    KIMURA T, ITO M, KOMATSU T, NISHIWAKI K, SHIMADA Y

    Can J Anaesth   46 巻 ( 12 ) 頁: 1110-6   1999年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  183. Pretretment with topical 60% lidocaine tape reduces pain on injection of propofol. 査読有り

    YOKOTA S, KOMATSU T, KOMURA Y, NISHIWAKI K, KIMURA T, HOSODA R, SHIMADA Y

    Anesth Analg   85 巻   頁: 672-74   1997年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  184. Recovery of heart rate variability profile in patients after coronary artery surgery. 査読有り

    KOMATSU T, KIMURA T, NISHIWAKI K, FUJIWARA Y, SAWADA K, SHIMADA Y

    Anesth Analg   85 巻   頁: 713-18   1997年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  185. No changes in cerebrospinal fluid levels of nitrite, nitrate and cyclic GMP with aging. 査読有り

    YAMADA K, NISHIWAKI K, HATTORI K,SENZAKI K, NAGATA M, KOMATSU T,SHIMADA Y, NABESHIMA T.

    J Neural Transm   104 巻   頁: 825-31   1997年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  186. Role of neuropeptide Y and its receptor subtype in the neurogenic pulmonary edema. 査読有り

    HIRABAYASHI A, NISHIWAKI K, SHIMADA Y, ISHIKAWA N

    Eur J Pharmacol   296 巻   頁: 297-305   1996年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  187. Decreased interleukin-6 level in the cerebrospinal fluid of patients with Alzheimer-type dementia. 査読有り

    YAMADA K, KUNO K, UMEGAKI H, YAMADA K, IGUCHI A, FUKATSU T, NAKASHIMA N, NISHIWAKI K, SHIMADA Y,SUGITA Y, YAMAMOTO T, HASEGAWA T, NABESHIMA T

    NeuroscienceLetters   186 巻   頁: 219-21   1995年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  188. Differential effects of ketamine and midazolam on heart-rate-variability. 査読有り

    KOMATU T, SINGH PK, KIMURA T, NISHIWKI K, BANDO K, SIMADA Y

    Can J Anaesth   42 巻   頁: 1003-09   1995年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  189. Effects of vasodilators on fibrin-induced pulmonary edema, so-called neurogenic pulmonary edema, in the rat.

    Nishiwaki K, Hirabayashi A, Shimada Y, Ishikawa N

    Journal of anesthesia   8 巻 ( 2 ) 頁: 208-212   1994年6月

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/BF02514715

    PubMed

  190. Effects of vasodilators on fibrin induced pulmonary edema, so-called neurogenic pulmonary edema, in the rat. 査読有り

    NISHIWAKI K, HIRABAYASHI A, SHIMADA Y, ISHIKAWA N

    J Anesth   8 巻   頁: 208-12   1994年

     詳細を見る

    担当区分:筆頭著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

  191. Prolonged pulmonary vascular hyperreactivity in conscious dogs after cardiopulmonary bypass. 査読有り

    NYHAN DP, REDMOND JM, GILLINOV AM, NISHIWAKI K, MURRAY PA

    J Appl Physiol   77 巻 ( 4 ) 頁: 1584-90   1994年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  192. Humoral pulmonary vasoregulation in conscious dogs after left lung autotransplantaion. 査読有り

    DESAI PM, NISHIWAKI K, STUART RS, NYHAN DP, MURRAY PA

    J Appl Physiol   76 巻 ( 2 ) 頁: 902-8   1994年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  193. Effects of neuropeptide Y on lung vascular permeability in the pulmonary circulation of rats. 査読有り

    HIRABAYASHI A, NISHIWAKI K, TAKI K,SHIMADA Y, ISHIKAWA N

    Eur J Pharmacol   256 巻   頁: 227-30   1994年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  194. Pulmonary vascular α1-adrenoreceptor activity in conscious dogs after left lung autotransplantation. 査読有り

    NISHIWAKI K, NYHAN DP, STUART SR, DESAI PM, PETERSON WP, ROCK P, PRIBBLE CG, MURRAY PA

    J Appl Physiol   74 巻 ( 2 ) 頁: 733-41   1993年

     詳細を見る

    担当区分:筆頭著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

  195. Amrinone and the pulmonary vascular pressure-flow relationship in conscious control dogs and following left lung autotransplantation. 査読有り

    NYHAN DP, PRIBBLE CG, PETERSON WP,NISHIWAKI K, TREMPY GA, DESAI PM, ROCK P, MURRY PA

    Anesthesiology   78 巻 ( 6 ) 頁: 1166-74   1993年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  196. Neurohumoral regulation of the pulmonary circulation during circulatory hypotension in conscious dogs. 査読有り

    PETERSON WP, TREMPY GA, NISHIWAKI K, NYHAN DP, MURRY PA

    J Appl Physiol   75 巻 ( 4 ) 頁: 1675-82   1993年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  197. Abnormal responses to pulmonary vasodilators in conscious dogs after left lung autotransplantation. 査読有り

    NISHIWAKI K, NYHAN DP, STUART SR, ROCK P, DESAI PM, PETERSON WP, MURRAY PA

    Am J Physiol   264 巻   頁: H917-25   1993年

     詳細を見る

    担当区分:筆頭著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

  198. Pulmonary vascular β-adrenoreceptor activity in conscious dogs after left lung autotransplantation. 査読有り

    NISHIWAKI K, ROCK P, STUART SR, NYHAN DP, PETERSON WP, MURRAY PA

    J Appl Physiol   75 巻 ( 1 ) 頁: 256-63   1993年

     詳細を見る

    担当区分:筆頭著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

  199. Nω-nitro-L-arginine and pulmonary vascular pressure-flow relationship in conscious dogs. 査読有り

    NISHIWAKI K, NYHAN DP, ROCK P, DESAI PM, PATERSON WP, PRIBBLE CG, MURRAY PA

    Am J Physiol   262 巻   頁: H1331-7   1992年

     詳細を見る

    担当区分:筆頭著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

  200. Determination of the optimal pressure support level evaluated by measuring transdiaphragmatic pressure. 査読有り

    KIMURA T, TAKEZAWA J, NISHIWAKI K, SHIMADA Y

    Respiratory Diseases Digest   4 巻   頁: 27-28   1992年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  201. Determination of the optimal pressre support level evaluated by measuring transdiaphragmatic pressure. 査読有り

    KIMURA T, TAKEZAWA J, NISHIWAKI K, SHIMADA YKIMURA T, TAKEZAWA J, NISHIWAKI K, SHIMADA Y

    Chest   100 巻   頁: 112-7   1991年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  202. Comparison of inspiratory work of breathing in T-piece breathig, PSV, and pleural pressure support ventilation (PPSV). 査読有り

    TAKAHASHI T, TAKEZAWA J, KIMURA T, NISHIWAKI K, SHIMADA Y

    Chest   100 巻   頁: 1030-4   1991年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  203. Severe tracheal compression caused by false aneurysm arising from the ascending aorta: successful airway management using induced hypotension and bronchoscopy. 査読有り

    NISHIWAKI K, KOMATSU T, SHIMADA Y,NISHIWAKI K, KOMATSU T, SHIMADA Y, TAKEUCHI E, ABE T

    Anesthesiology   73 巻   頁: 1047-49   1990年

     詳細を見る

    担当区分:筆頭著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

  204. Rise in pulmonary arterial pressure following release of aortic crossclamp in abdominal aortic aneurysmectomy. 査読有り

    KAINUMA M, NISHIWAKI K, SHIMADA Y

    Anesthesiology   69 巻   頁: 257-60   1988年

     詳細を見る

    記述言語:英語   掲載種別:研究論文(学術雑誌)  

▼全件表示

書籍等出版物 6

  1. 標準麻酔科学

    稲田 英一 , 森崎 浩, 西脇 公俊 , 古家 仁( 担当: 単著)

    医学書院  2018年  ( ISBN:9784260030304

     詳細を見る

    記述言語:日本語 著書種別:学術書

    CiNii Books

  2. 必ず上手くなる!中心静脈穿刺中心静脈カテーテル挿入法(総論)3準備・器材・挿入

    佐藤栄一、西脇公俊、島田康弘( 担当: 共著)

    羊土社  2007年 

     詳細を見る

    記述言語:日本語

  3. 必ず上手くなる! 中心静脈穿刺 リスク・マネージメント上の問題点

    ( 担当: 共著)

    羊土社  2007年 

     詳細を見る

    記述言語:日本語

  4. LISA・中心静脈穿刺(総論)穿刺・挿入操作、挿入後の処置

    西脇公俊、佐藤栄一( 担当: 共著)

    2006年 

     詳細を見る

    記述言語:日本語

  5. ARDSのすべて

    ( 担当: 共著)

    医歯薬出版社  2004年 

     詳細を見る

    記述言語:日本語

  6. SIRSの病態と治療Ⅰ ALI/ARDS

    ( 担当: 共著)

    医薬ジャーナル社  2004年 

     詳細を見る

    記述言語:日本語

    特殊なALI/ARDSの1病態である神経原性肺水腫について、臨床像、肺水腫発生のメカニズム、肺水腫治療・予防について、現在の最先端の情報を概説した。特に神経原性肺水腫発生のメカニズムについて、肺毛細管内圧の上昇によるという従来の説と、我々の報告しているニュウロペプタイドYによる神経性透過性亢進の関与について、日本語でわかり易く説明した。

▼全件表示

MISC 7

  1. ミニトラック挿入後にボールバルブ血餅によって重篤な気道閉塞合併症を生じた1症例—Severe Ball-valve Airway Obstruction by a Blood Clot after Cricothyroid Mini-tracheostomy : A Case Report

    高倉 将司, 藤井 祐, 喜多 桂, 谷口 智哉, 天野 靖大, 鈴木 章悟, 西脇 公俊  

    麻酔 = The Japanese journal of anesthesiology : 日本麻酔科学会準機関誌71 巻 ( 11 ) 頁: 1201 - 1204   2022年11月

     詳細を見る

    記述言語:日本語   出版者・発行元:克誠堂出版  

    CiNii Books

    researchmap

  2. BNT162b2 mRNA COVID-19ワクチン接種後に劇症型心筋炎を発症した一例

    高倉将司, 藤井祐, 佐藤威仁, 鈴木章悟, 西脇公俊  

    日本集中治療医学会学術集会(Web)49th 巻   2022年

     詳細を見る

  3. BMI43 高度肥満患者の脊椎手術に際し,覚醒下挿管の後に自己による体位変換を行った一例

    絹川友章, 佐藤威仁, 西脇公俊  

    日本臨床麻酔学会誌41 巻 ( 6 )   2021年

     詳細を見る

  4. 上大静脈・右冠動脈に浸潤した原発性心臓腫瘍に対して麻酔管理を行った一例

    三澤 知子, 佐藤 威仁, 藤井 祐, 西脇 公俊  

    日本臨床麻酔学会誌39 巻 ( 6 ) 頁: S232 - S232   2019年10月

     詳細を見る

    記述言語:日本語   出版者・発行元:日本臨床麻酔学会  

    researchmap

  5. 巨大心臓腫瘍に対する経静脈的ペースメーカー植え込み術に経食道心エコー(TEE)が有用であった一例

    高倉 将司, 佐藤 威仁, 藤井 祐, 西脇 公俊  

    Cardiovascular Anesthesia23 巻 ( Suppl. ) 頁: [DP1 - 03]   2019年9月

     詳細を見る

    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  

    researchmap

  6. ヘパリン起因性血小板減少症の患者に対する左室補助人工心臓植え込み術の1例

    柴田 紘葉, 佐藤 威仁, 竹市 広, 長谷川 和子, 石田 祐基, 西脇 公俊  

    Cardiovascular Anesthesia20 巻 ( Suppl. ) 頁: 221 - 221   2016年9月

     詳細を見る

    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  

    researchmap

  7. Delayed Onset of Subdural Hematoma following Epidural Catheter Breakage. 国際誌

    Ishikawa Y, Imagama S, Ito Z, Ando K, Gotoh M, Nishiwaki K, Nagao Y, Ishiguro N  

    Global spine journal6 巻 ( 1 ) 頁: e1 - 6   2016年2月

     詳細を見る

    記述言語:英語   出版者・発行元:Global Spine Journal  

    Study Design Case report. Objectives To describe a case of delayed-onset spinal hematoma following the breakage of a spinal epidural catheter. Methods The authors describe the clinical case review. Results A 64-year-old woman had undergone epidural anesthesia 18 years before she was referred to our hospital because of lower-back pain and lower neurologic deficit with leg pain. The clinical examination showed the presence of a fragment of an epidural catheter in the thoracolumbar canal, as assessed by computed tomography, and a spinal hematoma that compressed the spinal cord at the same spinal level, as assessed by magnetic resonance imaging. Surgical removal of the epidural catheter and decompression surgery were performed. The patient exhibited substantial clinical improvement 1 month after surgery; she achieved a steady gait without the need for a cane and had no leg pain. Conclusion This is the first report of delayed onset of spinal hematoma following the breakage of an epidural catheter. Generally, when the breakage of an epidural catheter occurs without symptoms, follow-up alone is recommended. However, because spinal hematoma might exhibit a late onset, the possibility of this complication should be considered when deciding whether to remove the catheter fragment. We believe that in our patient, there could be a relationship between the catheter fragment and subdural hematoma, and catheter breakage could have been a risk factor for the spinal hematoma.

    DOI: 10.1055/s-0035-1549030

    Scopus

    PubMed

    researchmap

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講演・口頭発表等 7

  1. 「手術室の安全管理」によせて

    西脇 公俊

    THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 

     詳細を見る

    開催年月日: 2013年

    記述言語:日本語   会議種別:口頭発表(一般)  

    国名:日本国  

  2. 術中MRIを使用した麻酔経験

    中澤 朋子 橋本篤 富田彰 角渕浩央 西脇公俊 島田康弘

    日本麻酔科学会第54回学術集会 

     詳細を見る

    開催年月日: 2007年6月

    記述言語:日本語   会議種別:ポスター発表  

    国名:日本国  

  3. 内皮細胞の増殖とVEGFによる血管新生での静脈麻酔剤の影響

    南 勇善 鈴木章悟 西脇公俊 島田康弘

    日本麻酔科学会第54回学術集会 

     詳細を見る

    開催年月日: 2007年6月

    記述言語:日本語   会議種別:ポスター発表  

    国名:日本国  

  4. 胸部大血管手術における血小板アフェレーシスの有用性について

    日本麻酔科学会第54回学術集会 

     詳細を見る

    開催年月日: 2007年6月

    記述言語:日本語   会議種別:ポスター発表  

    国名:日本国  

  5. ヒューマン動脈内皮細胞の単層透過性に対するイソフルランの影響

    鈴木 章悟 南勇善 西脇公俊 島田康弘

    日本麻酔科学会第54回学術集会 

     詳細を見る

    開催年月日: 2007年5月

    記述言語:日本語   会議種別:ポスター発表  

    国名:日本国  

  6. 腹部大動脈瘤手術患者におけるカルペリチド低用量持続投与の腎保護効果

    浅野 市子 西脇公俊 梅田亜希子 辻里花 金碧年 島田康弘

     詳細を見る

    開催年月日: 2007年5月

    記述言語:日本語   会議種別:ポスター発表  

    国名:日本国  

  7. 大動脈瘤に対するバルーン閉塞併用によるステントグラフト内挿術の麻酔管理

    木村 智政, 佐藤 祐子, 菅原 昭憲, 佐藤 栄一, 西脇 公俊, 島田 康弘

    THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 

     詳細を見る

    開催年月日: 2002年3月

    記述言語:日本語   会議種別:口頭発表(一般)  

    国名:日本国  

▼全件表示

科研費 6

  1. 脳死関連肺障害の病態解明と予防・治療法の開発ー特にNPYとVEGFと関連して

    研究課題/研究課題番号:19K09325  2019年4月 - 2022年3月

    科学研究費補助金  基盤研究(C)

    西脇 公俊

      詳細を見る

    担当区分:研究代表者  資金種別:競争的資金

    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

    我々はこれまでに、神経原生肺水腫の発生において、肺交感神経終末でカテコールアミンと共存する神経ペプチドY (NPY)を介した神経性調節による細胞透過性亢進が関与していること、および肺周辺領域における血管内皮細胞増殖因子(VEGF)の発現が肺血管透過性亢進に深く関与していることを明らかにしてきた。本研究では、ヒト正常肺微小血管内皮細胞とヒト気管支上皮細胞株を用いたin vitro細胞透過性アッセイ系やラット脳死モデルを利用したin vivo実験から、脳死関連肺障害病態におけるNPYおよびVEGFの役割を明らかとし、脳死患者の肺障害の予防・治療法を探ることを目的とする。
    研究代表者は、ラット神経付き肺潅流標本およびラットフィブリン誘発神経原性肺水腫モデルを用いた検討において、肺交感神経終末でカテコールアミンと共存する神経ペプチドY(NPY)による神経性調節が細胞透過性に関与することを明らかにした。しかしながら、NPYの作用機序については未だ不明なままである。本研究の目的は、in vitro肺細胞透過性評価系を確立し、NPYの作用機序を細胞レベルで明らかにすることである。
    研究代表者はこれまでに、ヒト正常肺微小血管内皮細胞(HMVEC-L)とヒト気管支上皮細胞株(Calu-3)を用いた、2つのin vitro細胞透過性亢進作用アッセイ系を確立し、NPYの作用を検討してきた。両方のアッセイ系において、1 × 10-7 MのNPYは細胞透過性に影響を及ぼさなかった。しかしながら、ヒト単球細胞株THP-1細胞を分化処理したマクロファージモデル細胞に1 × 10-8 MのNPYを添加し、6時間培養した後の培養上清は、Calu-3アッセイ系で有意な細胞透過性亢進作用を示した。本年度は、Calu-3とTHP-1由来マクロファージモデル細胞を共培養するアッセイ系の構築を試みた。さらに、細胞透過性亢進作用に寄与するタイトジャンクション蛋白の検出に用いる抗体選定を行った。
    Calu-3細胞単層上に、細胞数がCalu-3の約1/3になるようにマクロファージ様細胞を播種する系を作製した。しかしながら、選定したタイトジャンクション蛋白のOccludinやZo-1の抗体を用いた細胞溶解物のウェスタンブロッティングにおいて、Calu-3とマクロファージ様細胞の両方に蛋白発現が見られること(発現量はCalu-3>マクロファージ様細胞)、共培養サンプルで検出される蛋白発現量にバラツキが見られることが判明した。このことから、本共培養系を用いて各種解析を行うことを断念した。
    研究代表者が新たに構築したCalu-3とTHP-1由来マクロファージモデル細胞を共培養するアッセイ系が、NPYの生化学的なメカニズム解析に不適であると判断したことから、細胞透過性亢進作用の評価にも用いることができなくなった。そのため、より実際の肺環境に近いin vitroアッセイ系の構築がスタートに戻る状況となり、進捗はやや遅れている。
    上記に加え、当初の優先検討課題であった「脳死モデルでの神経原生肺水腫に関わるneuropeptidesの同定とVEGFの関与」についても検討を進めているが、マウス脳死モデル作製方法、肺水腫評価法、および肺水腫液と血清中の蛋白質比測定法など、全てが検討途中段階にある。
    肺上皮細胞、マクロファージ細胞、肺微小血管内皮細胞の3つの細胞を共培養系するin vivo肺モデル作製のための検討を引き続き行う。共培養系とは別に、NPY添加したマクロファージモデル細胞の培養上清をCalu-3アッセイ系に添加することで細胞透過性亢進作用が観察されることはすでに確認できている。しかしながら、マクロファージ様細胞に関しては、使用する培地、細胞播種密度、細胞培養期間など、検討必要事項が複数残っている。これらの検討項目を解決した上で、NPYの細胞透過性亢進作用の再評価ならびにNPYのメカニズム解析を行う。
    また、in vivoの検討課題「脳死モデルでの神経原生肺水腫に関わるneuropeptidesの同定とVEGFの関与」では、マウス脳死モデルの早期の確立を目指す。具体的には、マウス頭蓋内に血栓除去用カテーテルを挿入し、バルーンを用いて頭蓋内圧を上昇させ、脳幹部にヘルニアを起こすことにより脳死モデルを作製する。血液ガス分析による肺障害の重症度解析、摘出肺のWet/Dry Ratioの測定、血中、気管支肺胞洗浄液中および肺組織中の神経ペプチド同定を可能にし、神経原生肺水腫を抑制できる薬物の評価系を作製する。

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  2. 脳死関連肺障害の病態解明と予防・治療法の開発-特にNPYとVEGFと関連して

    研究課題/研究課題番号:15K10510  2015年4月 - 2019年3月

    科学研究費補助金  基盤研究(C)

    西脇 公俊

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    担当区分:研究代表者  資金種別:競争的資金

    配分額:4810000円 ( 直接経費:3700000円 、 間接経費:1110000円 )

    本研究は、神経原生肺水腫(NPE)における細胞透過性に関与する神経ペプチドY (NPY)の作用機序を、ヒト正常肺微小血管内皮細胞とヒト気管支上皮細胞株Calu-3のin vitro細胞透過性評価系を用いて明らかにすることを目的とした。
    1.0E-7 MのNPYは両評価系で細胞透過性に影響を及ぼさなかった。しかしながら、1.0E-8 MのNPYで処理したマクロファージ培地の添加により、Calu-3細胞透過性は有意に亢進した。これらの結果は、NPEにおいて、NPYが血管内皮細胞や肺上皮細胞に直接作用するのではなく、マクロファージ刺激を介して肺上皮細胞透過性亢進を引き起こすことを示唆する。
    臓器移植医療において、たとえ脳死患者側が肺を提供臓器として了解していたとしても、肺障害のため移植手術に至らない場合が多い。その原因として、肺炎以外に脳浮腫・脳圧亢進による神経原生肺水腫の関与が報告されている。すでに研究代表者は、ラット肺水腫モデルを利用して、神経ペプチドY (NPY)の肺血管透過性亢進作用を見出している。この作用が、マクロファージを介して引き起こされるという本研究成果から、脳死後に誘発される肺障害の発生機序を明らかにできる可能性がある。さらに研究を発展させ、脳死患者の肺障害予防法・治療法を開発することで、より多くの脳死肺移植を可能とする。

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  3. 脳死関連肺障害の病態解明と予防・治療法の開発

    研究課題/研究課題番号:23592251  2011年 - 2013年

    科学研究費補助金  基盤研究(C)

    西脇 公俊, 石川 直久

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    担当区分:研究代表者  資金種別:競争的資金

    配分額:5070000円 ( 直接経費:3900000円 、 間接経費:1170000円 )

    臓器移植医療において、脳死患者から提供される肺が移植に至らない理由の一つに、脳浮腫・脳圧亢進による神経原性肺水腫(NPE)の発生が肺機能障害を引き起こすことが示唆されている。本研究では、in vitro肺動脈内皮細胞モデルを確立し、NPE発生関連物質として見出した神経ペプチド Y(NPY)の細胞透過性亢進作用の有無を評価した。その結果、NPYは10-11~10-7 Mの濃度範囲において有意な細胞透過性亢進作用を示さなかった。また、低酸素条件下およびノルエピネフリン共存下においてもNPYに有意な作用が認められなかったことから、NPEにおけるNPYの作用点は肺血管内皮細胞以外にあると考えられた。

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  4. 交感神経興奮に伴う肺血管透過性亢進機序の解明とARDS治療法の開発

    研究課題/研究課題番号:20591801  2008年 - 2010年

    科学研究費補助金  基盤研究(C)

    西脇 公俊

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    担当区分:研究代表者  資金種別:競争的資金

    配分額:4550000円 ( 直接経費:3500000円 、 間接経費:1050000円 )

    NPYの血管内皮細胞透過性亢進作用を、正常ヒト肺動脈内皮細胞の単層培養における、Transendothelial FITC-labeled albumin permeabilityの測定から検討した。NPY濃度10段階(0,10^<-7>,10^<-6>,10^<-5>,10^<-4>,10^<-3>,10^<-2>,10^<-1>,1,10μg/ml)に対する透過性はコントロールを100%としてそれぞれ(100,101,102,169,173,163,172,220,229,226%)であり、NPYはヒト肺血管内皮細胞の透過性を濃度依存性に亢進させた。

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  5. 神経原性肺水腫におけるneuropeptideYの透過性亢進作用機序の解明

    研究課題/研究課題番号:16591532  2004年4月 - 2007年3月

    科学研究費補助金  基盤研究(C)

    西脇 公俊

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    担当区分:研究代表者  資金種別:競争的資金

  6. 脳死関連肺障害の病態解明と予防・治療法の開発ーNPY,VEGFと腸換気法の検討

    研究課題/研究課題番号:22K09045  2022年4月 - 2025年3月

    科学研究費助成事業  基盤研究(C)

    西脇 公俊, 藤井 祐, 田村 高廣, 森 厚詞

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    担当区分:研究代表者 

    配分額:4160000円 ( 直接経費:3200000円 、 間接経費:960000円 )

    臓器移植医療において、たとえ脳死患者側が肺を提供臓器として了解していたとしても、肺障害のため移植手術に至らない場合が多い。その原因として肺炎以外に脳浮腫・脳圧亢進による神経原性肺水腫の関与が報告されている。本研究では、ラットを用いた動物実験を通して、脳死関連肺障害の病態におけるneuropeptideおよびVEGFの役割を明らかとし、合わせて脳死患者の肺障害の予防・治療法を探る。

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担当経験のある科目 (本学) 9

  1. 痛み治療の進歩

    2020

  2. 麻酔学

    2012

  3. 痛み治療の進歩 痛みの臨床ー神経障害性疼痛を理解する

    2012

  4. 痛み治療の進歩 痛みの特殊治療

    2012

  5. 周術期全身管理の最前線 麻酔と長期予後

    2012

  6. 麻酔学

    2011

  7. 痛み治療の進歩 痛みの臨床ー神経障害性疼痛を理解する

    2011

  8. 痛み治療の進歩 痛みの特殊治療

    2011

  9. 周術期全身管理の最前線 麻酔と長期予後

    2011

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担当経験のある科目 (本学以外) 3

  1. 麻酔科学 呼吸管理

    2020年6月 愛知医科大学)

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    科目区分:学部専門科目  国名:日本国

  2. 麻酔科学 呼吸管理

    2020年6月 愛知医科大学)

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    科目区分:学部専門科目  国名:日本国

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  3. 痛み治療の進歩

    2020年 名古屋大学)

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    科目区分:学部教養科目  国名:日本国

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社会貢献活動 1

  1. 医療安全全国共同行動の支援チーム活動

    2012年1月 - 現在

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    医療安全を推進するためのボランティア活動