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Last Updated :2024/07/25

研究者情報

マスター

アカウント（マスター）

  • 氏名

    斉藤　仁志(サイトウ　ヒトシ), サイトウ　ヒトシ

所属（マスター）

  • 北海道大学病院　中央診療施設等　集中治療部

所属（マスター）

  • 北海道大学病院　中央診療施設等　集中治療部

独自項目

syllabus

  • 2021, 基本医学研究, Master's Thesis Research in Medical Sciences, 修士課程, 医学院, 麻酔　Anesthesiology 周術期管理　Perioperative care 痛み　Pain 救命救急　Critical Care 集中治療　Intensive Care
  • 2021, 基本医学総論, Basic Principles of Medicine, 修士課程, 医学院, 全身麻酔 局所麻酔 周術期管理 General anesthesia Local anesthesia Perioperative management
  • 2021, 基盤医学研究, Dissertation Research in Medical Sciences, 博士後期課程, 医学院, 麻酔　Anesthesiology 周術期管理　Perioperative care 痛み　Pain 救命救急　Critical Care 集中治療　Intensive Care
  • 2021, 臨床医学研究, Dissertation Research in Clinical Medicine, 博士後期課程, 医学院, 生体侵襲、生体反応、制御、感染、虚血、組織損傷 Insults responses, biological reaction, control, infection, ischemia, tissue damage
  • 2021, 医学総論, Principles of Medicine, 博士後期課程, 医学院, 全身麻酔 局所麻酔 周術期管理 General anesthesia Local anesthesia Perioperative management

researchmap

プロフィール情報

学位

  • 医学博士（北海道大学）

プロフィール情報

  • 姓

    斉藤

  • 名

    仁志

  • ID各種

    201801014387447503

業績リスト

研究分野

  • ライフサイエンス / 麻酔科学

委員歴

  • 2019年04月 - 現在   日本集中治療医学会   代議員
  • 2018年04月 - 現在   日本麻酔科学会   評議員

論文

  • Yasunori Kubo, Yusuke Itosu, Tomonori Kubo, Hitoshi Saito, Kazufumi Okada, Yoichi M Ito, Yuji Morimoto
    Journal of clinical monitoring and computing 38 3 639 - 648 2024年06月 
    Few reports are available on the monitoring of regional cerebral oxygen saturation (rSO2) in pediatric patients undergoing non-cardiac surgical procedures. In addition, no study has examined the rSO2 levels in children of a broad age range. In this study, we aimed to assess and compare rSO2 levels in pediatric patients of different age groups undergoing non-cardiac surgery. We used two oximeters, tNIRS-1, which uses time-resolved spectroscopy, and conventional INVOS 5100C. Seventy-eight children-26 infants, 26 toddlers, and 26 schoolchildren-undergoing non-cardiac surgery were included. We investigated the differences in the rSO2 levels among the age groups and the correlation between the models and physiological factors influencing the rSO2 values. rSO2 measured by INVOS 5100C was significantly lower in infants than those in other patients. rSO2 measured by tNIRS-1 was higher in the toddler group than those in the other groups. The rSO2 values of tNIRS-1 and INVOS 5100C were moderately correlated (r = 0.41); however, those of INVOS 5100C were approximately 20% higher, and a ceiling effect was observed. The values in INVOS 5100C and tNIRS-1 were affected by blood pressure and the minimum alveolar concentration of sevoflurane, respectively. In pediatric patients undergoing non-cardiac surgery, rSO2 values differed across the three age groups, and the pattern of these differences varied between the two oximeters employing different algorithms. Further research must be conducted to clarify cerebral oxygenation in children.
  • Kazuyuki Mizunoya, Keisyu Onodera, Yuki Takahashi, Takayuki Toki, Hitoshi Saito, Yuji Morimoto
    JA clinical reports 9 1 44 - 44 2023年07月15日 
    BACKGROUND: Laryngomalacia is a dynamic airway condition characterized by flaccid laryngeal tissue and inward collapse of supraglottic structures during inspiration. Although it may cause airway obstruction and requires careful management, there have been few reports regarding laryngomalacia after surgery. We report a case of adult-onset laryngomalacia occurred after craniotomy requiring reintubation. CASE PRESENTATION: A 21-year-old man was admitted to the ICU after craniotomy for a cerebellopontine angle tumor. He developed severe stridor immediately after extubation on the postoperative day 2 and required reintubation. On the postoperative day 5, similar episode occurred following re-extubation and fiberoptic laryngoscopy revealed a collapsed epiglottis and left arytenoid into the glottis. A diagnosis of laryngomalacia was made, and he underwent tracheostomy. Laryngomalacia had completely improved; however, bilateral vocal cord paralysis was detected 2 weeks later. CONCLUSIONS: Acquired laryngomalacia should be considered as a possible mechanism of the airway symptoms in a patient with neurological dysfunction.
  • 大動脈縮窄・離断症に対する大動脈弓形成手術後気道出血発症のリスク因子
    泉 岳, 斉藤 仁志, 加藤 裕貴, 水野谷 和之, 糸洲 佑介, 西川 直樹, 武田 充人, 山澤 弘州, 加藤 伸康, 森本 裕二
    日本集中治療医学会雑誌 30 Suppl.1 S648 - S648 (一社)日本集中治療医学会 2023年06月
  • 気管支内視鏡で診断した開頭腫瘍摘出術後発症の成人混合型喉頭軟化症の一症例
    高橋 悠希, 水野谷 和之, 斉藤 仁志
    日本集中治療医学会雑誌 30 Suppl.1 S590 - S590 (一社)日本集中治療医学会 2023年06月
  • 大動脈縮窄・離断症に対する大動脈弓形成手術後気道出血発症のリスク因子
    泉 岳, 斉藤 仁志, 加藤 裕貴, 水野谷 和之, 糸洲 佑介, 西川 直樹, 武田 充人, 山澤 弘州, 加藤 伸康, 森本 裕二
    日本集中治療医学会雑誌 30 Suppl.1 S648 - S648 (一社)日本集中治療医学会 2023年06月
  • Kenji Yoshitani, Soshiro Ogata, Shinya Kato, Akito Tsukinaga, Tsunenori Takatani, Nobuhide Kin, Mariko Ezaka, Jun Shimizu, Yuko Furuichi, Shoichi Uezono, Kotaro Kida, Katsuhiro Seo, Shinichi Kakumoto, Hiroshi Miyawaki, Mikito Kawamata, Satoshi Tanaka, Manabu Kakinohana, Shunsuke Izumi, Hiroyuki Uchino, Takayasu Kakinuma, Kimitoshi Nishiwaki, Kazuko Hasegawa, Mishiya Matsumoto, Kazuyoshi Ishida, Atsuo Yamashita, Michiaki Yamakage, Yusuke Yoshikawa, Yuji Morimoto, Hitoshi Saito, Takahisa Goto, Tetsuhito Masubuchi, Masahiko Kawaguchi, Kosuke Tsubaki, Satoshi Mizobuchi, Norihiko Obata, Yoshimi Inagaki, Kazumi Funaki, Yoshiki Ishiguro, Masamitsu Sanui, Kazutaka Taniguchi, Kunihiro Nishimura, Yoshihiko Ohnishi
    Journal of anesthesia 37 3 408 - 415 2023年06月 
    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.
  • 中峯 奈央子, 水野谷 和之, 佐々木 慶子, 出村 理海, 斉藤 仁志, 森本 裕二
    日本集中治療医学会雑誌 30 3 171 - 177 (一社)日本集中治療医学会 2023年05月 
    【目的】外傷や敗血症患者で過大腎クリアランス(augmented renal clearance,ARC)が報告されている。本研究では,これまで報告が少ない腹部大手術におけるARC発生状況を調査し,発生リスク因子を検討した。【方法】2018年10月から2021年3月に当院ICUに入室した肝胆膵長時間手術後患者をARC発生の有無で比較検討した。6時間蓄尿によるクレアチニンクリアランス(creatinine clearance,CrCl)≧130mL/min/1.73m2をARCと定義した。【結果】対象144例(年齢中央値71歳)のうち,ARC発生は55例(38%)であった。多変量解析の結果,年齢(若年),術前腎機能,術中赤血球輸血がARC発生と関連していた。術翌日の推算糸球体濾過量(estimated glomerular filtration rate,eGFR)とCrClには比例誤差を認め,ARC症例では大きな乖離が生じていた。【結語】高齢患者群でも術前腎機能が正常であれば肝胆膵手術後のARCは高率に発生し,その認識にはCrClによる評価が必要である。(著者抄録)
  • 水野谷 和之, 斉藤 仁志, 森本 裕二
    麻酔 71 10 1068 - 1075 克誠堂出版(株) 2022年10月 
    術中の肺保護換気の概念は,低容量換気,プラトー圧制限,呼気終末陽圧(positive end-expiratory pressure:PEEP)の付加,リクルートメント手技から構成される。これまでの無作為化比較試験やメタ解析は,低容量換気に適度なPEEPを加えることを支持しているが,術後呼吸器合併症の減少効果について十分な結論は得られていない。近年,新しい概念である駆動圧,食道内圧に基づく経肺圧の理論が術中呼吸管理にも用いられ始めた。呼気経肺圧の考え方は患者や手術特性に応じて個別化されたPEEP設定を可能にし,呼吸器系メカニクスを改善させることが示されている。肺保護換気に個別化PEEP設定を組み合わせた呼吸管理が術後アウトカムへ与える影響が今後の検討課題である。(著者抄録)
  • Gaku Izumi, Atsuhito Takeda, Hirokuni Yamazawa, Nobuyasu Kato, Hiroki Kato, Tsuyoshi Tachibana, Osamu Sagae, Ryogo Yahagi, Motoki Maeno, Koji Hoshino, Hitoshi Saito
    Heart and vessels 37 10 1792 - 1800 2022年04月 
    The risk factors and the appropriate interventions for perioperative junctional ectopic tachycardia (JET) in congenital heart disease (CHD) surgery have not been sufficiently investigated despite the severity of this complication. This study aimed to examine the risk factors and interventions for perioperative JET. From 2013 to 2020, 1062 surgeries for CHD (median patient age: 4.3 years, range 0.0-53.0) with or without a cardiopulmonary bypass (CPB) were performed at Hokkaido University, Japan. We investigated the correlation between perioperative JET morbidity factors, such as age, genetic background, CPB/aortic cross-clamp (ACC) time, use of inotropes and dexmedetomidine, STAT score, and laboratory indices. The efficacy of JET therapies was also evaluated. Of the 1062 patients, 86 (8.1%) developed JET. The 30-day mortality was significantly high in JET groups (7% vs. 0.8%). The independent risk factors for JET included heterotaxy syndrome [odds ratio (OR) 4.83; 95% confidence interval (CI) 2.18-10.07], ACC time exceeding 90 min (OR 1.90; CI 1.27-2.39), and the use of 3 or more inotropes (OR 4.11; CI 3.02-5.60). The combination of anti-arrhythmic drugs and a temporary pacemaker was the most effective therapy for intractable JET. Perioperative JET after CHD surgery remains a common cause of mortality. Inotrope use was a risk factor for developing JET overall surgery risk. In short ACC surgeries, heterotaxy syndrome could increase the risk of JET, which could develop even without inotrope use in long ACC surgeries. It is crucial not to delay the treatment in cases with unstable hemodynamics caused by this arrhythmia. It is recommended to reduce numbers not dose of inotropes.
  • Yasunori Yagi, Kazuyuki Mizunoya, Toshihiro Mori, Hitoshi Saito, Yuji Morimoto
    JA clinical reports 8 1 19 - 19 2022年03月09日 
    BACKGROUND: Myocardial infarction (MI) complicated by cardiogenic shock during non-cardiac surgery is a rare but fatal complication. The management of intraoperative MI is challenging. CASE PRESENTATION: A 77-year-old hypertensive man with good functional capacity was scheduled for hepatectomy. After the start of liver resection, the electrocardiogram monitor showed ST depression, and the patient developed refractory cardiogenic shock. Transesophageal echocardiography revealed severe hypokinesis of the anteroseptal wall. The surgery was suspended, and an intra-aortic balloon pump was placed following immediate abdominal closure. Coronary angiography revealed severe stenosis of the left main coronary trunk, and percutaneous coronary intervention (PCI) was performed. Myocardial wall motion improved, and blood pressure stabilized. Two days after PCI, hepatectomy, which had been suspended, was successfully completed. CONCLUSIONS: Once intraoperative MI has occurred, early diagnosis and multidisciplinary approaches are important to manage the difficult clinical situation.
  • Yosuke UCHIDA, Toshikazu HASHIMOTO, Hitoshi SAITO, Koichi TAKITA, Yuji MORIMOTO
    Biomedical Research 43 1 1 - 9 2022年02月17日 
    It has been reported that neonatal isoflurane exposure causes behavioral abnormalities following neurodegeneration in animals and gamma-aminobutyric acid type A (GABAA) receptor activation during the synaptogenesis is considered to be one possible trigger. Additionally, the inhibitory effect of excitatory GABAA receptor signaling on the granule cell (GC) migration in the neonatal rat dentate gyrus (DG) was reported in a febrile seizure model. Then, we hypothesized that neonatal isoflurane exposure, which activates GABAA receptor, causes GC migration disturbances in the neonatal rat. Rat pups were injected with 5-bromo-2'-deoxyuridine (BrdU) and divided into five treatment groups, and double immunofluorescent staining targeting BrdU and homeobox prospero-like protein 1 (Prox1) was performed to examine the localization of BrdU/Prox1 colabeled cells, and then the GC migration was assessed. As a result, we found that the ectopic migration of GC after 2% isoflurane exposure on postnatal day 7 significantly increased after P21. The number of hilar ectopic GCs was influenced by the concentration of isoflurane and the exposure day but not by carbon dioxide exposure. Our main finding is that neonatal isoflurane anesthesia disturbs the migration of GCs in the rat DG, which may be one possible mechanism underlying the neurotoxicity following neonatal isoflurane anesthesia.
  • Naoya Iwahara, Takashige Abe, So Nagai, Masanao Yoshino, Hitoshi Saito, Hiromi Okada, Hiroshi Kikuchi, Ryuji Matsumoto, Takahiro Osawa, Nobuo Shinohara
    IJU case reports 4 5 330 - 332 2021年09月 
    Introduction: Thyroid storm is a rare life-threating condition. We report a case of thyroid storm after radical nephrectomy for renal cell carcinoma with inferior vena cava tumor thrombus. Case presentation: A 76-year-old man with a left renal tumor and tumor thrombus extending into the inferior vena cava underwent left radical nephrectomy and thrombectomy. After the surgery, his postoperative course rapidly deteriorated, including central nervous system disturbance, fever, tachycardia, congestive heart failure, and hepatic manifestation. Thyroid function test revealed perioperative hyperthyroidism. Corticosteroids and inorganic iodide improved his condition, suggesting that he developed thyroid storm after surgery. He was discharged 5 months after surgery and has been free from disease recurrence for more than 2 years. Conclusion: Thyroid storm after surgery is rare. However, this postoperative complication is important because it is fatal if not diagnosed and treated properly.
  • Yutaka Hoshino, Minako Sugiyama, Kenji Hirata, Shohei Honda, Hitoshi Saito, Atsushi Manabe, Kohsuke Kudo
    Acta radiologica open 10 7 20584601211026810 - 20584601211026810 2021年07月 
    Commonly, physiological 18F-fluorodeoxyglucose (FDG) uptake in the brain can be observed in 18F-FDG positron emission tomography. Abnormal uptake of 18F-FDG in the brain suggests disorders of central nervous system. Here, we present a case of extremely low 18F-FDG uptake in the brain of a 4-year-old girl with whole-body metastatic neuroblastoma. Almost missing of physiological 18F-FDG uptake in the brain was ascribed at least partly to the metastatic neuroblastoma. The brain could regain physiological 18F-FDG uptake after chemotherapy.
  • An appraisal of respiratory system compliance in mechanically ventilated covid-19 patients
    Gianluigi Li Bassi, Jacky Y. Suen, Heidi J. Dalton, Nicole White, Sally Shrapnel, Jonathon, P. Fanning, Benoit Liquet, Samuel Hinton, Aapeli Vuorinen, Gareth Booth, Jonathan E. Millar, Simon Forsyth, Mauro Panigada, John Laffey, Daniel Brodie, Eddy Fan, Antoni Torres, Davide Chiumello, Amanda Corley, Alyaa Elhazmi, Carol Hodgson, Shingo Ichiba, Carlos Luna, Srinivas Murthy, Alistair Nichol, Pauline Yeung Ng, Mark Ogino, Antonio Pesenti, Huynh Trung Trieu, John F, Fraser on behalf of, the COVID, Critical Care Consortium
    Critical Care 25 119 2021年 [査読有り]
  • Koji Hoshino, Yuka Uchinami, Yosuke Uchida, Hitoshi Saito, Yuji Morimoto
    Frontiers in aging neuroscience 13 637703 - 637703 2021年 
    Background: Aging and pre-existing cognitive impairment are considered to be independent risk factors for sepsis-associated encephalopathy. This study aimed to investigate the manner in which aging and pre-existing cognitive dysfunction modified neuroinflammation, synaptic plasticity, and basal synaptic transmission during the acute phase of sepsis using Senescence-Accelerated Mice Prone 8 (SAMP8) and Senescence-Accelerated Resistant Mice 1 (SAMR1). Methods: We used 6-month-old SAMP8 and SAMR1. Sepsis was induced using cecal ligation and puncture (CLP). The animal's hippocampi and blood were collected for subsequent investigations 24 h after surgery. Results: Long-term potentiation (LTP) was impaired in the Shaffer-collateral (SC)-CA1 pathway of the hippocampus in SAMP8 without surgery compared to the age-matched SAMR1, which was reflective of cognitive dysfunction in SAMP8. CLP impaired the SC-CA1 LTP in SAMR1 compared to the sham-operated controls, but not in SAMP8. Moreover, CLP decreased the input-output curve and increased the paired-pulse ratio in SAMP8, suggesting the reduced probability of basal synaptic transmission due to sepsis. Immunohistochemical analysis revealed that CLP elevated IL-1β levels, especially in the hippocampi of SAMP8 with microglial activation. In vivo peripheral IL-1 receptor antagonist (IL-1ra) administration in the septic SAMP8 revealed that the neuroinflammation was not correlated with the peripheral elevation of IL-1β. Ex vivo IL-1ra administration to the hippocampus ameliorated LTP impairment in SAMR1 and the reduction in basal transmission in SAMP8 after sepsis. Conclusions: The mechanism of the modulation of synaptic transmission and synaptic plasticity by the acute stage of sepsis differed between SAMR1 and SAMP8. These changes were related to centrally derived IL-1 receptor-mediated signaling and were accompanied by microglial activation, especially in SAMP8.
  • 糸洲 佑介, 斉藤 仁志, 打浪 有可, 本間 慶憲, 吉田 知由, 干野 晃嗣, 西川 直樹, 森本 裕二
    日本集中治療医学会雑誌 27 6 491 - 492 (一社)日本集中治療医学会 2020年11月 
    30歳代女性。呼吸困難を主訴に近医を受診し、間質性肺炎の急性増悪と診断され加療されたが症状は改善せず、当院(札幌市)に転院となった。ただちに気管挿管し人工呼吸療法を開始したが、呼吸不全が進行し、転院3日目にVV-ECMOを導入した。その後、人工呼吸器を離脱したが、自己肺の改善はみられず、ECMOの離脱は困難な状態となり、東北大学病院へ転院し生体肺移植を受ける予定となった。転院26日目に北海道庁に災害派遣要請を行い、36日目に、高度な医療監視が行える機動衛生ユニットを有するC-130H型輸送機で航空自衛隊千歳基地から仙台空港へ搬送され、仙台空港から救急車で東北大学病院へ搬送された。一般にECMO患者の搬送は機器の脱落やライントラブルの危険性があるが、本例ではECMO装置とシリンジポンプが装着可能なバックボード装着型架台システム(BBT-2000)を使用したことでライントラブルを回避でき、移動時間の短縮にも繋がったと考えられた。
  • 土岐 崇幸, 斉藤 仁志, 久保 康則, 秋田 敬介, 佐々木 慶子, 森本 裕二
    日本臨床麻酔学会誌 40 5 485 - 489 日本臨床麻酔学会 2020年09月 
    志賀毒素産生性腸管出血性大腸菌(STEC)感染に伴う溶血性尿毒症症候群(ST-HUS)の診断には便からの病原菌や志賀毒素の検出が必要であるが,偽陰性も多く診断が困難となる症例がある.今回われわれは,便培養では診断不可能であったが,血清抗O157リポ多糖体(LPS)抗体検査を用いてST-HUSと診断した症例を経験した.臨床的にSTEC感染症が疑われる症例では血清抗LPS抗体検査は有用である可能性がある.(著者抄録)
  • 土岐 崇幸, 斉藤 仁志, 久保 康則, 秋田 敬介, 佐々木 慶子, 森本 裕二
    日本臨床麻酔学会誌 40 5 485 - 489 日本臨床麻酔学会 2020年09月
  • 八木 泰憲, 水野谷 和之, 森 敏洋, 斉藤 仁志, 森本 裕二
    Cardiovascular Anesthesia 24 Suppl. 140 - 140 (一社)日本心臓血管麻酔学会 2020年09月
  • 坂井 俊朗, 斉藤 仁志, 水野谷 和之, 田中 暢洋, 森本 裕二
    Cardiovascular Anesthesia 24 1 127 - 130 (一社)日本心臓血管麻酔学会 2020年08月 
    Cantrell症候群は上腹部腹壁欠損,胸骨下部欠損,横隔膜前部欠損,横隔膜部心膜欠損に先天性心疾患を伴う稀な疾患である。今回大動脈縮窄複合,心臓脱を合併したCantrell症候群児に対し,生後2日目にNorwood手術と右室-肺動脈conduit,脱出心の胸腔内還納を行った症例を経験した。閉創前後に呼吸循環状態の慎重な観察と人工呼吸器設定の調整を要したが,良好な転帰を得た。本疾患においては胸腔内容積の不足により,並列循環における呼吸循環動態の管理が一層困難となるため,厳重なモニタリングと適切な術中術後管理が必要となる。(著者抄録)
  • 老化促進マウスを用いた敗血症急性期の海馬神経炎症とミクログリア活性化の検討
    干野 晃嗣, 打浪 有可, 内田 洋介, 斉藤 仁志, 森本 裕二
    日本神経麻酔集中治療学会プログラム・抄録集 24回 24 - 24 日本神経麻酔集中治療学会 2020年08月
  • 坂井 俊朗, 斉藤 仁志, 水野谷 和之, 田中 暢洋, 森本 裕二
    Cardiovascular Anesthesia 24 1 127 - 130 (一社)日本心臓血管麻酔学会 2020年08月 
    Cantrell症候群は上腹部腹壁欠損,胸骨下部欠損,横隔膜前部欠損,横隔膜部心膜欠損に先天性心疾患を伴う稀な疾患である。今回大動脈縮窄複合,心臓脱を合併したCantrell症候群児に対し,生後2日目にNorwood手術と右室-肺動脈conduit,脱出心の胸腔内還納を行った症例を経験した。閉創前後に呼吸循環状態の慎重な観察と人工呼吸器設定の調整を要したが,良好な転帰を得た。本疾患においては胸腔内容積の不足により,並列循環における呼吸循環動態の管理が一層困難となるため,厳重なモニタリングと適切な術中術後管理が必要となる。(著者抄録)
  • 前田 洋典, 西田 紳悟, 水野谷 和之, 森 敏洋, 斉藤 仁志, 森本 裕二
    臨床麻酔 44 6 869 - 871 真興交易(株)医書出版部 2020年06月 
    症例は50歳代男性で、左室補助人工心臓植込み術後、両側膿胸に対して両側胸腔ドレナージ中であった。排液が減少したため両側の胸腔ドレーンが抜去されたが、1時間半後より呼吸状態が悪化し、左胸壁ドレーン抜去部からの出血が疑われた。呼吸状態安定化のために気管挿管され、左胸腔内出血に対する胸腔鏡下血腫除去止血術および右膿胸に対する胸腔鏡下膿胸掻爬術を予定した。術後は気管挿管下にICU帰室予定であったため、麻酔導入時同様にビデオ喉頭鏡(McGRATH MAC)のブレード4を使用しチューブ交換を行った。ICU帰室準備中に多量の口腔内出血を認め、何度か口腔内吸引を行ったがおさまらず、ICU帰室後に耳鼻科医に診察を依頼した。前口蓋弓-後口蓋弓を数針圧縮縫合して止血することができ、原病に対しての抗凝固療法は術翌日より再開し、その後、新規出血なく経過した。
  • 副島 崇旨, 内田 洋介, 斉藤 仁志, 森本 裕二
    麻酔 69 5 530 - 537 克誠堂出版(株) 2020年05月 
    プロポフォールからセボフルラン投与の麻酔導入過程での脳循環変化を、時間分解近赤外分光法を用いた脳血液量と脳組織酸素飽和度、経頭蓋ドプラを用いた脳血流量変化を指標として、気管挿管約20分後まで経時的に測定した。麻酔導入より、血圧は約25%低下し、脳血流量は20%程度、脳血液量は7%程度低下した。これは主にプロポフォールのボーラス投与による影響と考えられた。その後、脳血液量はさらに低下したが、脳血流量は増加し、両者とも対照の10%減となった。これはセボフルランによる脳血液量減少を反映したものと考えられた。一方、脳酸素飽和度は経過中ほぼ一定で、代謝・血流量連関が維持されていることが分かった。(著者抄録)
  • 【ICU治療指針 III】手術・麻酔と周術期管理 成人肝移植術の周術期管理(術後管理を中心に)
    斉藤 仁志, 加藤 裕貴, 森本 裕二
    救急・集中治療 31 4 1523 - 1528 (株)総合医学社 2020年03月 
    ＜POINT＞●我が国における肝移植は、生体肝移植の頻度が高い。脳死移植法案の施行後も十分な肝供給があるとは言えず、移植待機中に死亡する症例も多い。手術成績は年々向上しており、2017年度報告でのレシピエントの生存率は1年後、5年後でそれぞれ86.8%、80.4%と、欧米の成績と比しても高水準にある。●術前管理では、肝不全患者の病態生理を理解し、肝、肺、心、腎、血液凝固など、多岐にわたる全身評価・管理と、積極的な栄養療法を実施する。術後管理では、致死的な早期合併症である拒絶反応、感染症を常に警戒し、グラフト血流を継続的に評価しつつ、免疫抑制剤と抗生剤を適切に選択すること、さらには術後早期からの栄養療法、リハビリテーションを実施する。本稿では、術前管理および術中管理は誌面の都合で割愛し、術後管理について述べる。(著者抄録)
  • 【ICU治療指針 III】手術・麻酔と周術期管理 小児肝移植の周術期管理
    斉藤 仁志, 干野 晃嗣, 森本 裕二
    救急・集中治療 31 4 1529 - 1532 (株)総合医学社 2020年03月 
    ＜POINT＞●成人に比し、閉腹の遅れ、大量の腹水などによる循環呼吸管理に難渋し、比較的長期間の管理を要することがあるため注意を要する。●血管の狭窄、血栓閉塞リスクが高いと言われており、out flow blockの可能性を常に念頭においた、より慎重なグラフト血流の評価と管理が必要となる。(著者抄録)
  • 【ICU治療指針 III】手術・麻酔と周術期管理 周術期の血液製剤の用い方
    斉藤 仁志, 水野谷 和之, 森本 裕二
    救急・集中治療 31 4 1584 - 1589 (株)総合医学社 2020年03月 
    ＜POINT＞●急性出血は赤血球や凝固因子を喪失するだけでなく、全身臓器に対して様々な影響をもたらすことが知られている。その病態生理を概観した上で、早急かつ適切に対応することが重要である。●一部の疾患、病態に対してはトリガー輸血による予後の改善が報告されているため、各種ガイドラインを参考に適切な輸血療法を施行する。(著者抄録)
  • 斉藤 仁志, 水野谷 和之, 森本 裕二
    救急・集中治療 31 4 1584 - 1589 (株)総合医学社 2020年03月 [査読有り][通常論文]
     
    ＜POINT＞●急性出血は赤血球や凝固因子を喪失するだけでなく、全身臓器に対して様々な影響をもたらすことが知られている。その病態生理を概観した上で、早急かつ適切に対応することが重要である。●一部の疾患、病態に対してはトリガー輸血による予後の改善が報告されているため、各種ガイドラインを参考に適切な輸血療法を施行する。(著者抄録)
  • 斉藤 仁志, 干野 晃嗣, 森本 裕二
    救急・集中治療 31 4 1529 - 1532 (株)総合医学社 2020年03月 [査読有り][通常論文]
     
    ＜POINT＞●成人に比し、閉腹の遅れ、大量の腹水などによる循環呼吸管理に難渋し、比較的長期間の管理を要することがあるため注意を要する。●血管の狭窄、血栓閉塞リスクが高いと言われており、out flow blockの可能性を常に念頭においた、より慎重なグラフト血流の評価と管理が必要となる。(著者抄録)
  • Nobuhiro Tanaka, Masataka Yamamoto, Takashige Abe, Takahiro Osawa, Ryuji Matsumoto, Nobuo Shinohara, Hitoshi Saito, Yosuke Uchida, Yuji Morimoto
    Journal of endourology 33 12 995 - 1001 2019年12月 [査読有り][通常論文]
     
    Purpose: Robot-assisted laparoscopic radical prostatectomy (RARP) requires a steep head-down tilt and pneumoperitoneum, which may cause an increase in cerebral blood volume (CBV). With a new near-infrared time-resolved spectroscopy device, the tNIRS-1, we can measure the absolute value of the cerebral hemoglobin concentration and hence calculate CBV and cerebral oxygen saturation (rSO2). Using this device, we evaluated the time course of CBV during surgery and also evaluated the changes in rSO2 simultaneously. Materials and Methods: We performed a prospective observational study of 21 patients scheduled for RARP. We evaluated CBV and rSO2 by using the tNIRS-1 at 10 time points during surgery. Results: The CBV was 2.92 ± 0.38 mL ·100 g-1 after the end of anesthetic preparation. It significantly increased to 3.05 ± 0.44 mL ·100 g-1 after the head-down tilt and was around 3.1 mL ·100 g-1 until 120 minutes after the head-down tilt. However, just before the return to the horizontal position, it decreased to 2.93 ± 0.46 mL ·100 g-1 and then decreased more after the return to the horizontal position. Changes in rSO2 over time were within only 3%, and no significant differences from the control value were observed. Conclusions: The increase in CBV was <10% despite the steep head-down tilt and pneumoperitoneum, and it was compensated for at around the end of surgery. Clinically significant changes in rSO2 were not observed during the surgery.
  • Koji Hoshino, Toru Nakamura, Mineji Hayakawa, Yusuke Itosu, Hitoshi Saito, Satoshi Hirano, Yuji Morimoto
    JA clinical reports 5 1 65 - 65 2019年10月23日 
    BACKGROUND: The right external iliac vein (REIV) is often used for portal vein reconstruction in patients undergoing pancreatoduodenectomy with portal-superior mesenteric vein resection. We report a case of cardiac arrest caused by acute lower leg compartment syndrome as a result of REIV resection. CASE PRESENTATION: A 53-year-old man underwent pancreatoduodenectomy with portal vein resection. Hyperkalemia progressed during surgery due to intestinal reperfusion injury, which caused recurrent ventricular arrhythmia required for cardio-pulmonary resuscitation. The surgery was discontinued after resuscitation, and portal vein reconstruction using the REIV was performed 2 days post-operatively. Acute compartment syndrome was diagnosed immediately following the surgery. Hyperkalemia progressed, causing pulseless ventricular tachycardia. Emergent fasciotomy was performed, but right leg dysfunction persisted after discharge. CONCLUSION: REIV resection can cause lower-extremity acute compartment syndrome. The status, including intracompartmental pressure, of the lower extremity should be carefully observed after REIV resection during and after surgery.
  • 副島 崇旨, 水野谷 和之, 安藤 義崇, 斉藤 仁志, 森 敏洋, 森本 裕二
    麻酔 68 10 1099 - 1102 克誠堂出版(株) 2019年10月 [査読有り][通常論文]
     
    19歳男。湿性咳嗽を主訴に近医を受診し、感冒の診断で内服加療されたが改善せず、10日後に呼吸困難で救急搬送された。諸検査の結果から副腎外褐色細胞腫とカテコールアミン心筋症を強く疑い、全身麻酔下に腫瘍摘出術を施行した。一般に褐色細胞腫の術中管理ではカテコールアミンサージに備えるためにα遮断薬やβ遮断薬の投与が行われ、薬物による循環維持が困難な場合は体外循環も考慮される。本例では麻酔導入後の血圧低下に対してドブタミンとノルアドレナリンを投与し、結果的に有効な循環を確立できた。手術開始後は予想に反してカテコールアミンサージによる血圧上昇を認めず、これは本例が高度な心機能低下状態であったことに加え、内部壊死を伴う副腎外褐色細胞腫であったことと関係があると考えられた。
  • 斉藤 仁志, 内田 洋介, 干野 晃嗣, 打浪 有可, 森本 裕二
    Cardiovascular Anesthesia 23 Suppl. [SY4 - 3] (一社)日本心臓血管麻酔学会 2019年09月 [査読有り][通常論文]
  • 黒川 達哉, 田中 暢洋, 坂井 俊朗, 糸洲 佑介, 斉藤 仁志, 森本 裕二
    Cardiovascular Anesthesia 23 Suppl. [DP2 - 01] (一社)日本心臓血管麻酔学会 2019年09月 [査読有り][通常論文]
  • 斉藤 仁志, 内田 洋介, 森本 裕二
    臨床麻酔 43 6 790 - 798 真興交易(株)医書出版部 2019年06月 
    1990年代の動物実験、そして後ろ向きコホート研究は、麻酔薬が幼弱脳における神経細胞のアポトーシスを誘導する、そして長期的な異常行動や学習能力低下を惹起しうる、というセンセーショナルな報告をもたらした。一方で、最近の前向き介入研究の多くは、「単回かつ短時間の全身麻酔は安全である」という結論を出しており、これには多くの臨床家が安堵したに違いない。しかし、長時間手術や集中治療室における影響は未だ不明であり「安全性」が保障されたとは言いがたい。レミフェンタニル、デクスメデトミジンなど、神経毒性の報告がない薬物を使用した新たな鎮静・鎮痛方法の模索も始まっており、今後の研究報告が期待される。(著者抄録)
  • Nobuhiro Tanaka, Tomoaki Fujii, Niina Mikami, Yuka Uchinami, Hitoshi Saito, Yuji Morimoto
    JA clinical reports 5 1 31 - 31 2019年05月07日 [査読有り][通常論文]
     
    BACKGROUND: Although rare, long-lasting fetal tachyarrhythmia often leads to fetal heart failure and hydrops. Some mothers receive transplacental treatment of fetal tachyarrhythmia (TTFT), which can potentially worsen maternal hypotension and bradycardia. Moreover, the use of rescue cardiovascular agents intraoperatively can worsen fetal tachycardia. However, reports of the anesthetic management of patients receiving TTFT are rare. CASE PRESENTATION: A 31-year-old woman who was receiving digoxin and sotalol for TTFT underwent planned elective cesarean section. The fetus had hypoplastic left heart syndrome, hydrops, and tachycardia. We used combined spinal-epidural anesthesia with a reduced dose of local anesthetic. We also employed a non-invasive continuous hemodynamic monitoring system. The mother's systolic blood pressure remained at ≥ 90% of the baseline value; intraoperative administration of rescue cardiovascular agents was not required. CONCLUSIONS: We successfully anesthetized a woman for cesarean section, who was receiving TTFT for fetal tachyarrhythmia, using combined spinal-epidural anesthesia and non-invasive continuous hemodynamic monitoring.
  • 土岐 崇幸, 干野 晃嗣, 武田 圭史, 西川 直樹, 斉藤 仁志, 森本 裕二
    日本集中治療医学会雑誌 26 3 199 - 200 (一社)日本集中治療医学会 2019年05月 [査読有り][通常論文]
     
    2歳女児。3週前より時折嘔吐し、意識障害を認め救急搬送された。高血圧と頻脈があり強直性間代性痙攣を認めたため、気管挿管されICUに搬送された。腹部造影CTでは左後腹膜腔に径63×59×73mmの腫瘤性病変を認め、腹部大動脈と左腎動静脈を巻き込み左腎萎縮と造影効果の低下を認め、生検で神経芽腫と診断された。カテコラミン産生腫瘍による高血圧と頻拍、可逆性後頭葉白質脳症による意識障害を疑った。心不全に対しnicardipine持続静注とamlodipineおよびcarvedilol経口投与を開始し、enalapril経口投与を追加してnicardipine持続静注を終了した。第3病日に全身強直性間代性痙攣を認め、MRAでは両側後大脳動脈や前大脳動脈で不整狭窄像とapparent diffusion coefficient低下や拡散強調像で高信号を認め、標記の診断とした。深鎮静管理として第8病日のMRAで脳血管攣縮は改善したが脳萎縮は進行し、意識障害が遷延した。
  • Hase T, Hashimoto T, Saito H, Uchida Y, Kato R, Tsuruga K, Takita K, Morimoto Y
    Journal of Anesthesia 33 4 562 - 566 2019年 [査読有り][通常論文]
     
    INTRODUCTION: Volatile anesthetics are speculated to cause postoperative nausea and vomiting via stimulation of the chemoreceptor trigger zone (CTZ). However, the precise mechanism underlying the emetic action of these drugs is not well understood. In this study, we assessed whether isoflurane induced the expression of c-Fos, a neuronal activation marker, in the area postrema (AP), the locus of the CTZ, in rats, which do not have vomiting action. MATERIALS AND METHODS: Male rats were exposed to 1.3% isoflurane for 0-240 min, or to various concentrations of isoflurane (0, 1.3%, or 2.6%) for 120 min. Finally, the rats were exposed to 1.3% isoflurane for 120 min after ondansetron administration. After the treatments, immunohistochemistry of the rat AP was performed using c-Fos antibody staining. RESULTS: One-way analysis of variance showed that isoflurane exposure significantly increased c-Fos expression in the AP; however, the rats pretreated with 4 mg/kg ondansetron showed significantly decreased c-Fos expression. Moreover, we evaluated the effect of the anesthetic on inducing pica in the rats, and found that kaolin intake was not influenced by isoflurane exposure. CONCLUSION: Overall, these results suggest that isoflurane activates AP neurons and may be involved in the emetic mechanism of isoflurane. This study further suggests the feasibility of using rats as a model for studying emetic mechanisms of drugs, despite their lack of vomit action.
  • Mizunoya K, Saito H, Morimoto Y
    Journal of anesthesia 32 4 558 - 564 2018年08月 [査読有り][通常論文]
     
    PURPOSE: A proper reference level is important for measuring intracardiac pressures, especially for parameters with small normal values such as central venous pressure (CVP). Although several external zero reference levels (eZRLs) have been proposed for non-obese patients, none has been reported for severely obese patients. The aim of this study was to investigate an appropriate eZRL for CVP measurements of severely obese patients. METHODS: Chest computed tomography images of 65 patients with body mass index (BMI) ≥ 35 kg/m2 were retrospectively reviewed. The anteroposterior thoracic diameter and height of the mid-right atrium (RA) were measured. Four reported eZRLs for CVP measurements (midthoracic level, two-thirds and four-fifths of the thoracic diameter above table level, and 5 cm below the anterior thorax) were examined for error when predicting the midpoint of the RA. RESULTS: The median BMI was 36.9 kg/m2 [interquartile range (IQR), 36.0-39.2]. There was a significant difference in the calculated errors for the midpoint of the RA among the four eZRLs (Kruskal-Wallis test, P < 0.001). Two-thirds of the thoracic diameter above table level was the most accurate reference level for CVP measurement (Steel-Dwass post hoc analysis, P < 0.001). The Bland-Altman plot showed acceptable agreement for clinical use (mean difference, - 7 mm; 95% limit of agreement, - 23 to 9 mm). CONCLUSION: The most accurate eZRL for CVP measurements of severely obese patients in the supine position was two-thirds of the thoracic diameter above table level. This result is consistent with that of a previous report of non-obese patients.
  • ゲンタマイシン吸入が奏功した気管支拡張症急性増悪の一例
    武田 圭史, 土岐 崇幸, 干野 晃嗣, 斉藤 仁志, 柳田 雄一郎, 森本 裕二
    日本集中治療医学会雑誌 25 3 185 - 189 (一社)日本集中治療医学会 2018年05月 [査読有り][通常論文]
     
    気管支拡張症は気管支の不可逆的な形態変化を呈する慢性の進行性疾患であり、反復性の気道感染症を引き起こす。急性増悪例では時に治療に難渋し、致死的になりうるが、定まった有効な治療法はない。症例は59歳、女性。30年前に気管支拡張症と診断され、外来管理されていた。呼吸困難感を主訴に救急搬送され、CT検査で著明な気管支拡張と気管支内に液面を形成するほど多量の喀痰貯留を認めた。ICUで人工呼吸管理、薬物的治療、体位ドレナージが開始されたが治療反応に乏しく、入院7日後よりゲンタマイシン120mg12時間ごとの吸入療法を開始したところ、喀痰の減少と呼吸状態の改善を認め、治療開始34日目で人工呼吸離脱が可能となった。通常の薬物・理学療法に抵抗性の気管支拡張症急性増悪に対し、ゲンタマイシン吸入は有効な可能性がある。(著者抄録)
  • Hitoshi Saito, Rui Kato, Toshikazu Hashimoto, Yosuke Uchida, Tetsutaro Hase, Kenkichi Tsuruga, Koichi Takita, Yuji Morimoto
    Biomedical Research (Japan) 39 1 39 - 45 2018年 [査読有り][通常論文]
     
    For several decades, the neurotoxicities of anesthetics to the developing brain have been reported by many researchers focusing on various phenomena such as apoptosis, neurodegeneration, electrophysiological aberrations, and behavioral abnormalities. According to these reports, signals via N-methyl-D-aspartate receptors (NMDA-r) and/or γ-aminobutyric acid type A receptors (GABAA-r) are implicated in the anesthetic neurotoxicity. On the other hand, during brain development, NMDA-r and GABAA-r are also recognized to play primary roles in neural cell migration. Therefore, anesthetics exposed in this period may influence the neural cell migration of neonates, and increase the number of hilar ectopic granule cells, which are reported to be a cause of continuous neurological deficits. To examine this hypothesis, we investigated immunohistochemically granule cell distribution in the hippocampal dentate gyrus of Wistar/ST rats after nitrous oxide (N2O) exposure. At postnatal day (P) 6, 5-bromo-2’-deoxyuridine (BrdU) was administered to label newly generated cells. Then, rats were divided into groups (n = 6 each group), exposed to 50% N2O at P7, and evaluated at P21. As a result, we found that ectopic ratios (ratio of hilar/total granule cells generated at P6) were decreased in rats at P21 compared with those at P7, and increased in N2O exposed rats for over 120 min compared with the other groups. These results suggest that 50% N2O exposure for over 120 min increases the ratios of ectopic granule cells in the rat dentate gyrus.
  • Yasunori Yagi, Masataka Yamamoto, Hitoshi Saito, Toshihiro Mori, Yuji Morimoto, Takayoshi Oyasu, Tsuyoshi Tachibana, Yoichi M. Ito
    PEDIATRIC CARDIOLOGY 38 6 1215 - 1219 2017年08月 [査読有り][通常論文]
     
    Recently, it is common to perform the Fontan procedure after the Glenn procedure as surgical repair for the univentricular heart. How the brain oxygen saturation (rSO(2)) values change with the cardiac restoration and the process of growth during these procedures in individual children remains unknown. In this study, we retrospectively studied rSO(2) data as well as the perioperative clinical records of 30 children who underwent both Glenn and Fontan procedures by the same surgeon in the same institute. The rSO(2) was measured at the beginning and end of each procedure with an INVOS 5100C. Cerebral perfusion pressure was calculated by subtracting central venous pressure from mean arterial pressure. Arterial oxygen saturation (SaO(2)) and the hemoglobin concentration were obtained as candidates affecting rSO(2) changes at the start and the end of both procedures. The rSO(2) increased during the Glenn procedure, but this increase was slight and insignificant. On the other hand, the rSO(2) significantly increased during the Fontan procedure. Significant increases in SaO(2) were observed only between the beginning and end of the Fontan procedure. Correlation coefficients determined by linear regression analysis were more than 0.5 between rSO(2) and SaO(2) in both procedures. Multiple linear regression analysis showed that SaO(2) was the key determinant of the rSO(2). The rSO(2) increases step by step from the Glenn to the Fontan procedure in the same patient. Within each procedure, SaO(2) is the key determinant of the rSO(2). The significance of rSO(2) monitoring in these procedures should be further evaluated.
  • Yuji Morimoto, Yosuke Uchida, Hitoshi Saito
    Anesthesia and Neurotoxicity 3 - 15 2017年05月30日 [査読無し][通常論文]
     
    After the "famous" paper by Jevtovic-Todorovic et al. published in the Journal of Neuroscience in 2003, the number of articles about the neurotoxicity of anesthetics in developing animals has increased year by year. Thus, it is no exaggeration to say that most anesthetics are neurotoxic to the developing animal brain. The mechanism was first suggested to be neuronal apoptosis, and then abnormality of neurotransmission, especially the manipulation of the GABAergic system during the most intense phase of synaptogenesis. Recently, based on various animal studies, many hypotheses have been reported. However, this finding has not been proven in humans yet. Moreover, the clinical impression that anesthesia has a negative effect on the neurological development of infants and children seems extremely rare for the clinician. Thus, there seem to be big discrepancies between the findings for animals and humans. The reasons for this are hypothesized to be respiratory depression caused by anesthetics, the absence of noxious stimulation during neonatal animal experiments, and the differences of the life span (that is, the length of anesthetic time) and the period of the brain growth spurt between humans and animals. Accordingly, we are now awaiting the results of several ongoing prospective clinical studies to determine whether anesthetics are really neurotoxic to the developing human brain.
  • Yasunori Yagi, Masataka Yamamoto, Hitoshi Saito, Toshihiro Mori, Yuji Morimoto, Takayoshi Oyasu, Tsuyoshi Tachibana, Yoichi M Ito
    Circulation Control 36 2 106 - 110 Japan Society of Circulation Control in Medicine 2015年 [査読有り][通常論文]
  • Akira Watabe, Hitoshi Saito, Katsumi Harasawa, Yuji Morimoto
    JOURNAL OF ANESTHESIA 23 2 270 - 274 2009年05月 [査読有り][通常論文]
     
    We report the anesthetic management of a 7-month-old male infant with severe aortic regurgitation (AR) scheduled for the Ross procedure. To the best of our knowledge, this is the first report from the viewpoint of anesthetic management for the Ross procedure performed in an infant. He had been suffering from severe AR that occurred suddenly when he was 5 months old. The cause of the AR was considered to be spontaneous rupture of a fenestrated aortic valve, owing to congenital tissue defect in part of the aortic valvular leaflet. The Ross procedure was scheduled to be performed under general anesthesia using deep hypothermic cardiopulmonary bypass (CPB). Continuous infusion of nitroglycerin was started during CPB and continued after CPB to dilate the newly implanted coronary arteries for the prevention of myocardial ischemia and to decrease afterload and pulmonary vascular resistance. Weaning from CPB was performed without difficulty, but after the prolonged CPB he had a bleeding tendency that needed transfusion and a hemostatic drug. Monitoring with transesophageal echocardiography was very useful for evaluating myocardial ischemia, and for assessing the procedure and the completion of surgical repair. His postoperative course was uneventful and he was discharged on the 25th postoperative day.

MISC

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  • 日本学術振興会：科学研究費助成事業
    研究期間 : 2018年04月 -2021年03月 
    代表者 : 森本 裕二, 斉藤 仁志
     
    加齢・認知機能障害合併マウスにおいて、麻酔・手術が認知機能に及ぼす影響を検討した。結果は、通常マウスにおいては、手術後にのみ神経炎症が増強していたのに比較して、加齢・認知機能障害合併マウスでは、麻酔暴露のみでも海馬における炎症性サイトカインの上昇を認め、神経炎症の増強を明らかにした。 しかし、行動学試験においては加齢・認知機能障害合併マウスの、術後認知機能障害について検出できなかった。理由としては、麻酔・手術を行わないコントロール群で既に認知機能が大幅に低下しており、麻酔・手術の影響を検出することができなかったためと考えている。

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