研究者データベース

研究者情報

マスター

アカウント(マスター)

  • 氏名

    方波見 謙一(カタバミ ケンイチ), カタバミ ケンイチ

所属(マスター)

  • 北海道大学病院 外科

所属(マスター)

  • 北海道大学病院 外科

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プロフィール情報

プロフィール情報

  • 方波見
  • 謙一
  • ID各種

    201501025356702555

業績リスト

研究分野

  • ライフサイエンス / 救急医学

論文

  • Hirotsugu Yamada, Takahiro Ohara, Yukio Abe, Hiroyuki Iwano, Tetsuari Onishi, Kenichi Katabami, Kiyohiro Takigiku, Akira Tada, Hayato Tanigushi, Hirotsugu Mihara, Takeshi Yamamoto, Ken Maeda, Yasuaki Wada
    Journal of echocardiography 2024年05月09日 
    In recent years, bedside ultrasound examinations have been used in many clinical departments and are called point-of-care ultrasound (POCUS). Regarding POCUS in the cardiac field, a protocol called focus (focused) cardiac ultrasound (FoCUS) has been developed in Europe and the United States, is being used clinically, and an educational syllabus has been created. According to them, FoCUS is defined as a point-of-care cardiac ultrasound examination using standardized limited sections and protocols. FoCUS is primarily intended to be performed by non-cardiologists, and in order to avoid making mistakes in judgment, it is important to be familiar with its limitations and it is necessary to understand pathological conditions that can only be diagnosed using conventional comprehensive echocardiography. The Japanese Society of Echocardiography has edited this clinical guideline because we believe that FoCUS should be used effectively and appropriately in Japan, and that appropriate education is essential to popularize FoCUS in Japan. Furthermore, lung POCUS has recently come into clinical use. Lung POCUS is useful for the diagnosis and follow-up of heart failure when used in conjunction with FoCUS, and is especially useful in primary care where chest X-rays are not available. The working group that created this manual agreed that it is desirable to educate patients about lung POCUS in conjunction with FoCUS, so we decided to include the basic techniques of lung POCUS and how to use them in this manuscript.
  • Kenichi Katabami, Takashi Kimura, Takumi Hirata, Akiko Tamakoshi
    Journal of epidemiology 34 1 31 - 37 2024年01月05日 
    BACKGROUND: The neurological prognosis of asphyxia is poor and the effect of advanced airway management (AAM) in the prehospital setting remains unclear. This study aimed to evaluate the association between AAM with adrenaline injection and prognosis in adult patients with asystole asphyxia out-of-hospital cardiac arrest (OHCA). METHODS: This study assessed all-Japan Utstein cohort registry data between January 1, 2013 and December 31, 2019. We used propensity score matching analyses before logistic regression analysis to evaluate the effect of AAM on favorable neurological outcome. RESULTS: There were 879,057 OHCA cases, including 70,299 cases of asphyxia OHCAs. We extracted the data of 13,642 cases provided with adrenaline injection by emergency medical service. We divided 7,945 asphyxia OHCA cases in asystole into 5,592 and 2,353 with and without AAM, respectively. After 1:1 propensity score matching, 2,338 asphyxia OHCA cases with AAM were matched with 2,338 cases without AAM. Favorable neurological outcome was not significantly different between the AAM and no AAM groups (adjusted odds ratio [OR] 1.1; 95% confidence interval [CI], 0.5-2.5). However, the return of spontaneous circulation (ROSC) (adjusted OR 1.7; 95% CI, 1.5-1.9) and 1-month survival (adjusted OR 1.5; 95% CI, 1.1-1.9) were improved in the AAM group. CONCLUSION: AAM with adrenaline injection for patients with asphyxia OHCA in asystole was associated with improved ROSC and 1-month survival rate but showed no differences in neurologically favorable outcome. Further prospective studies may comprehensively evaluate the effect of AAM for patients with asphyxia.
  • Toru Kameda, Hiromoto Ishii, Seiro Oya, Kenichi Katabami, Takamitsu Kodama, Makoto Sera, Hirokazu Takei, Hayato Taniguchi, Shunichiro Nakao, Hiraku Funakoshi, Satoshi Yamaga, Satomi Senoo, Akio Kimura
    Acute medicine & surgery 11 1 e974  2024年 
    Owing to the miniaturization of diagnostic ultrasound scanners and their spread of their bedside use, ultrasonography has been actively utilized in emergency situations. Ultrasonography performed by medical personnel with focused approaches at the bedside for clinical decision-making and improving the quality of invasive procedures is now called point-of-care ultrasonography (POCUS). The concept of POCUS has spread worldwide; however, in Japan, formal clinical guidance concerning POCUS is lacking, except for the application of focused assessment with sonography for trauma (FAST) and ultrasound-guided central venous cannulation. The Committee for the Promotion of POCUS in the Japanese Association for Acute Medicine (JAAM) has often discussed improving the quality of acute care using POCUS, and the "Clinical Guidance for Emergency and Point-of-Care Ultrasonography" was finally established with the endorsement of JAAM. The background, targets for acute care physicians, rationale based on published articles, and integrated application were mentioned in this guidance. The core points include the fundamental principles of ultrasound, airway, chest, cardiac, abdominal, and deep venous ultrasound, ultrasound-guided procedures, and the usage of ultrasound based on symptoms. Additional points, which are currently being considered as potential core points in the future, have also been widely mentioned. This guidance describes the overview and future direction of ultrasonography for acute care physicians and can be utilized for emergency ultrasound education. We hope this guidance will contribute to the effective use of ultrasonography in acute care settings in Japan.
  • 院外心停止蘇生後における神経学的予後不良群の長期予後
    早水 真理子, 土田 拓見, 水柿 明日美, 高氏 修平, 本間 慶憲, 斉藤 智誉, 吉田 知由, 方波見 謙一, 和田 剛志, 前川 邦彦, 早川 峰司
    日本救急医学会雑誌 34 12 731 - 731 (一社)日本救急医学会 2023年12月
  • Tomoyo Saito, Mineji Hayakawa, Osamu Kumano, Yoshinori Honma, Mone Murashita, Jun Kato, Syouki Fukui, Masaki Takahashi, Yuki Takahashi, Takumi Tsuchida, Asumi Mizugaki, Shuhei Takauji, Mariko Hayamizu, Tomonao Yoshida, Kenichi Katabami, Takeshi Wada, Kunihiko Maekawa
    Journal of Intensive Care 11 1 54 - 54 2023年11月16日 
    Abstract Background Unfractionated heparin (UFH) is primarily monitored using activated partial thromboplastin time (APTT). However, the recent introduction of anti-activated factor X (anti-Xa) activity testing has provided a direct evaluation of Xa inhibition by anticoagulants. This study aimed to investigate discrepancies between APTT and anti-Xa activity during UFH monitoring in critically ill patients and explore their underlying causes. Methods This study analyzed 271 pairs of laboratory test results from blood samples of 99 critically ill patients receiving continuous intravenous UFH. Theoretical APTT values were calculated using fitted curve equations from spiked sample measurements with anti-Xa activity. Samples were categorized into three groups based on the measurement of the APTT/theoretical APTT ratio: the lower group (< 80%), the concordant group (80–120%), and the upper group (> 120%). Results The overall concordance rate between APTT and anti-Xa activity was 45%, with a 55% discrepancy rate. The lower group frequently showed apparent heparin overdoses, while coagulation factor activities in the lower and upper groups were higher and lower, respectively, than those in the concordant group. Particularly, the lower group exhibited higher factor VIII activity levels than the upper and concordant groups. Conclusions Discrepancies between APTT and anti-Xa activity were frequently observed, influenced by changes in coagulation factors activity levels. The lower and upper groups were classified as pseudo-heparin-resistant and coagulopathy types, respectively. Accurate monitoring of heparin in critically ill patients is crucial, especially in cases of pseudo-heparin resistance, where APTT values may wrongly indicate inadequate heparin dosing despite sufficient anti-Xa activity. Understanding these discrepancies is important for managing heparin therapy in critically ill patients. Trial registration: Not applicable.
  • 方波見 謙一, 松本 悠, 早川 峰司, 神 繁樹, 的場 光太郎, 富田 明子
    中毒研究 36 2 222 - 222 (株)へるす出版 2023年07月
  • 斉藤 智誉, 水柿 明日美, 早水 真理子, 本間 慶憲, 吉田 知由, 方波見 謙一, 和田 剛志, 前川 邦彦, 早川 峰司
    日本集中治療医学会雑誌 30 Suppl.1 S474 - S474 (一社)日本集中治療医学会 2023年06月
  • mRNA-1273ワクチン接種後心筋炎に伴う,心室細動でVeno-Arteria ECMO導入し社会復帰した劇症型心筋炎の一例
    松本 悠, 中嶋 拓磨, 水柿 明日美, 本間 慶憲, 斉藤 智誉, 吉田 知由, 方波見 謙一, 和田 剛志, 前川 邦彦, 早川 峰司
    日本集中治療医学会雑誌 30 Suppl.1 S677 - S677 (一社)日本集中治療医学会 2023年06月
  • 能戸 麻莉奈, 葛西 毅彦, 吉山 暉人, 鎌田 千奈美, 方波見 謙一, 早川 峰司, 神 繁樹, 的場 光太郎, 沢本 圭悟, 成松 英智
    日本集中治療医学会雑誌 30 Suppl.1 S724 - S724 (一社)日本集中治療医学会 2023年06月
  • 前川 邦彦, 高橋 正樹, 松本 悠, 水柿 明日美, 早水 真理子, 本間 慶憲, 斉藤 智誉, 吉田 知由, 方波見 謙一, 和田 剛志, 早川 峰司
    日本集中治療医学会雑誌 30 Suppl.1 S855 - S855 (一社)日本集中治療医学会 2023年06月
  • Toshiaki Asakura, Takashi Kimura, Isaku Kurotori, Katabami Kenichi, Miyuki Hori, Mariko Hosogawa, Masayuki Saijo, Kaori Nakanishi, Hiroyasu Iso, Akiko Tamakoshi
    Emerging infectious diseases 29 5 956 - 966 2023年05月 
    We conducted a cross-sectional survey among SARS-CoV-2-positive persons and negative controls in Sapporo, Japan, to clarify symptoms of long COVID. We collected responses from 8,018 participants, 3,694 case-patients and 3,672 controls. We calculated symptom prevalence for case-patients at 2-3, 4-6, 7-9, 10-12, and 13-18 months after illness onset. We used logistic regression, adjusted for age and sex, to estimate the odds ratio (OR) for each symptom and control reference. We calculated symptom prevalence by stratifying for disease severity, age, and sex. At 4-18 months from illness onset, ORs for anosmia, ageusia, dyspnea, alopecia, and brain fog were consistently >1, whereas ORs for common cold-like, gastrointestinal, and dermatologic symptoms were <1. Time trend ORs increased for diminished ability to concentrate, brain fog, sleep disturbance, eye symptoms, and tinnitus. Clinicians should focus on systemic, respiratory, and neuropsychiatric symptoms among long COVID patients.
  • Mariko Hayamizu, Akira Kodate, Hisako Sageshima, Takumi Tsuchida, Yoshinori Honma, Asumi Mizugaki, Tomonao Yoshida, Tomoyo Saito, Kenichi Katabami, Takeshi Wada, Kunihiko Maekawa, Mineji Hayakawa
    Resuscitation 188 109790 - 109790 2023年04月 
    AIM: To assess survival duration and frequency of delayed neurologic improvement in patients with poor neurologic status at discharge from emergency hospitals after out-of-hospital cardiac arrest (OHCA). METHODS: This retrospective cohort study included OHCA patients admitted to two tertiary emergency hospitals in Japan between January 2014 and December 2020. Pre-hospital, tertiary emergency hospital, and post-acute care hospital data, were retrospectively collected by reviewing medical records. Neurologic improvements were defined as an improvement of Cerebral Performance Category (CPC) scores from 3 or 4 at hospital discharge to 1 or 2. The primary outcome was neurologic improvement after discharge, while the secondary outcome was survival time after cardiac arrest. RESULTS: Of all patients (n = 1,012) admitted to tertiary emergency hospitals after OHCA during the observation period, 239 with CPC 3 or 4 at discharge were included, and all were Japanese. Median age was 75 years, 64% were male, and 31% had initially shockable rhythms. Neurologic improvements were observed in nine patients (3.6%), higher in CPC 3 (31%) than CPC 4 (1.3%) patients, but not after 6 months from cardiac arrest. The median survival time after cardiac arrest was 386 days (95% confidence interval: 303-469). CONCLUSION: Survival probability in patients with CPC 3 or 4 was 50% at 1-year and 20% at 3-year. Neurologic improvements were observed in 3.6% patients, higher in CPC 3 than in CPC 4 patients. During the first 6 months after OHCA, the neurologic status may improve in patients with CPC 3 or 4.
  • Kenichi Katabami, Takashi Kimura, Takumi Hirata, Akiko Tamakoshi
    Internal medicine (Tokyo, Japan) 61 9 1353 - 1359 2022年 
    Objective This study assessed the risk factors of mortality from foreign bodies in the respiratory tract using the Japan Collaborative Cohort Study for the Evaluation of Cancer Risk data. Methods Data of 110,585 participants 40-79 years old living in 45 areas in Japan were collected between 1988 and 2009. Mortality from foreign bodies in the respiratory tract was assessed in a multivariable-adjusted analysis using a Cox proportional hazard regression model. Results Among all participants, 202 deaths occurred from foreign bodies in the respiratory tract. In the multivariable-adjusted model, older age [50-59 (hazard ratio, 4.93; 95% confidence interval, 1.91-12.74), 60-69 (hazard ratio, 14.96, 6.01-37.25) and 70-79 (hazard ratio, 53.81; 95% confidence interval, 21.44-135.02) years old compared to 40-49 years old], male sex (hazard ratio, 2.34; 95% confidence interval, 1.54-3.54), a history of apoplexy (hazard ratio, 7.04; 95% confidence interval, 4.24-11.67) and the absence of a spouse (hazard ratio, 1.56; 95% confidence interval, 1.05-2.32) were associated with an increased risk of mortality from foreign bodies in the respiratory tract. Conclusions Older age, male sex, medical history of apoplexy and the absence of a spouse were potential risk factors of mortality from foreign bodies in the respiratory tract. Especially in elderly men, social connections, such as cohabitation or relationships, may be important for ensuring the early detection of asphyxia and preventing death due to foreign bodies in the respiratory tract.
  • Mineji Hayakawa, Takumi Tsuchida, Yoshinori Honma, Asumi Mizugaki, Takayoshi Ooyasu, Tomonao Yoshida, Tomoyo Saito, Kenichi Katabami, Takeshi Wada, Kunihiko Maekawa
    Scientific reports 11 1 20283 - 20283 2021年10月13日 
    In severe trauma, excessive fibrinolytic activation is associated with an increase in the transfusion volume and mortality rate. However, in the first several hours after a blunt trauma, changes in fibrinolytic activation, suppression, and activation-suppression balance have not yet been elucidated, which the present study aimed to clarify. Anesthetized 9-week-old male Wistar S/T rats experienced severe blunt trauma while being placed inside the Noble-Collip drum. Rats were randomly divided into four groups of seven. The no-trauma group was not exposed to any trauma; the remaining groups were analysed 0, 60, and 180 min after trauma. Immediately following trauma, total tissue-plasminogen activator (tPA) levels significantly increased in the plasma, and the balance of active tPA and active plasminogen activator inhibitor-1 (PAI-1) significantly tipped toward fibrinolytic activation. After trauma, both tPA and PAI-1 levels increased gradually in various organs and active and total PAI-1 levels increased exponentially in the plasma. Total plasma tPA levels 60 min after trauma returned quickly to levels comparable to those in the no-trauma group. In conclusion, fibrinolytic activation was observed only immediately following trauma. Therefore, immediately after trauma, the fibrinolytic system was activated; however, its activation was quickly and intensely suppressed.
  • 様々な心停止予後スコアの同時外部検証
    土田 拓見, 大野 浩太, 前川 邦彦, 和田 剛志, 方波見 謙一, 吉田 知由, 早川 峰司
    日本集中治療医学会雑誌 28 Suppl.2 423 - 423 (一社)日本集中治療医学会 2021年09月
  • Takumi Tsuchida, Kota Ono, Kunihiko Maekawa, Takeshi Wada, Kenichi Katabami, Tomonao Yoshida, Mineji Hayakawa
    Scandinavian journal of trauma, resuscitation and emergency medicine 29 1 117 - 117 2021年08月14日 
    BACKGROUND: This study aimed to compare and validate the out-of-hospital cardiac arrest (OHCA); cardiac arrest hospital prognosis (CAHP); non-shockable rhythm, unwitnessed arrest, long no-flow or long low-flow period, blood pH < 7.2, lactate > 7.0 mmol/L, end-stage chronic kidney disease, age ≥ 85 years, still resuscitation, and extracardiac cause (NULL-PLEASE) clinical; post-cardiac arrest syndrome for therapeutic hypothermia (CAST); and revised CAST (rCAST) scores in OHCA patients treated with recent cardiopulmonary resuscitation strategies. METHODS: We retrospectively collected data on adult OHCA patients admitted to our emergency department between February 2015 and July 2018. OHCA, CAHP, NULL-PLEASE clinical, CAST, and rCAST scores were calculated based on the data collected. The predictive abilities of each score were tested using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. RESULTS: We identified 236 OHCA patients from computer-based medical records and analyzed 189 without missing data. In OHCA patients without bystander witnesses, CAHP and OHCA scores were not calculated. Although the predictive abilities of the scores were not significantly different, the NULL-PLEASE score had a large AUC of ROC curve in various OHCA patients. Furthermore, in patients with bystander-witnessed OHCA, the NULL-PLEASE score had large partial AUCs of ROC from sensitivity 0.8-1.0 and specificity 0.8-1.0. CONCLUSIONS: The NULL-PLEASE score had a high, comprehensive predictive ability in various OHCA patients. Furthermore, the NULL-PLEASE score had a high predictive ability for good and poor neurological outcomes in patients with bystander-witnessed OHCA.
  • 高橋 正樹, 水柿 明日美, 吉田 知由, 方波見 謙一, 和田 剛志, 前川 邦彦, 早川 峰司
    日本救急医学会雑誌 32 6 295 - 302 (一社)日本救急医学会 2021年06月 
    【目的】重症熱傷は致死率の高い疾患であり,初療時に予後を的確に評価することが重要である。今回我々は,重症熱傷患者の在院死亡を予測する因子を後方視的に検討した。【対象】2010年4月から2020年3月の間に,北海道大学病院救急科に入院した成人重症熱傷患者を対象とした。重症熱傷の基準は,(1)2度以上熱傷面積25% total body surface area(TBSA)以上,(2)3度熱傷面積10%TBSA以上,(3)24時間以上の人工呼吸器管理を要した気道熱傷,のいずれかを満たすものとした。来院時心肺停止および外来死亡例,他院で24時間以上加療された症例は除外した。【結果】52名が参入基準を満たし,生存群が32名,死亡群が20名であった。既知の予後予測指標および搬入時血液検査を基に,在院死亡を予測するreceiver operating characteristic曲線下面積を算出すると,乳酸脱水素酵素(LDH)が0.960と最大で,次いで熱傷予後指数(PBI)が0.913,abbreviated burn severity index(ABSI)が0.898であった。【結語】重症熱傷において,LDHが予後予測に有用であり,カットオフ値を500IU/Lとすることで,在院死亡を予測できる可能性を示した。LDHは測定が簡便かつ客観的であり,他指標と併せて,熱傷の重症度評価の一助となりうる。(著者抄録)
  • Mineji Hayakwa, Takayoshi Ooyasu, Yoshihiro Sadamoto, Tomoyo Saito, Tomonao Yoshida, Kenichi Katabami, Takeshi Wada, Kunihiko Maekawa, Masahiro Ieko
    Clinical and Applied Thrombosis/Hemostasis 26 1076029620950825 - 1076029620950825 2020年 
    We investigated the relationships between circulating procoagulants and trauma severity, including cellular destruction, and the effects of thrombin generation on procoagulants in a rat blunt trauma model. The rats were subjected to tumbling blunt trauma, where they were tumbled for 0, 250, 500, or 1000 revolutions. Creatine kinase, nucleosome, and microparticle plasma levels increased gradually with trauma severity. Strong interrelationships were observed among creatine kinase, nucleosome, and microparticle levels. Time to initiation of thrombin generation shortened with increasing trauma severity. In accordance with trauma severity, prothrombin activity decreased, but the thrombin generation ratio increased. Time to initiation of thrombin generation and the thrombin generation ratio correlated with creatine kinase levels. In an in vitro study, a homogenized muscle solution, which included massive nucleosomes and microparticles, showed accelerated thrombin generation of plasma from healthy subjects. Procoagulants, such as microparticles and nucleosomes, are released from destroyed parenchymal cells immediately after external traumatic force, activating the coagulation cascade. The procoagulants shorten the time to initiation of thrombin generation. Furthermore, although coagulation factors are consumed, the thrombin generation ratio increases.
  • Tomoyo Saito, Mineji Hayakawa, Yoshinori Honma, Asumi Mizugaki, Tomonao Yoshida, Kenichi Katabami, Takeshi Wada, Kunihiko Maekawa
    Clinical and Applied Thrombosis/Hemostasis 26 107602962093300 - 107602962093300 2020年01月01日 
    The association between severity of fibrinolysis, ascertained by rotational thromboelastometry to diagnose hyperfibrinolysis in patients with out-of-hospital cardiac arrest (OHCA), and conventional fibrinolysis markers (ie, tissue-plasminogen activator [t-PA], plasminogen, α2-plasmin inhibitor [α2-PI], and plasminogen activator inhibitor [PAI]) with key roles in the fibrinolytic system was investigated. This prospective observational study included 5 healthy volunteers and 35 patients with OHCA from the Hokkaido University Hospital. Blood samples were drawn immediately upon admission to the emergency department. Assessments of the extrinsic pathway using tissue factor activation (EXTEM) and of fibrinolysis by comparison with EXTEM after aprotinin addition (APTEM) were undertaken. Conventional coagulation and fibrinolysis markers were measured in the stored plasma samples. Significant hyperfibrinolysis observed in EXTEM disappeared in APTEM. Patients exhibited significantly higher levels of fibrinogen/fibrin degradation products, plasmin–α2-PI complex, and t-PA but lower levels of fibrinogen, plasminogen, and α2-PI than healthy controls. The PAI level was unchanged. Fibrinolytic parameters of EXTEM correlated with levels of lactate and conventional fibrinolysis markers, especially t-PA. Increased t-PA activity and decreased plasminogen and α2-PI significantly correlated with increased severity of fibrinolysis (hyperfibrinolysis).
  • Yuki Itagaki, Mineji Hayakawa, Kunihiko Maekawa, Tomoyo Saito, Akira Kodate, Yoshinori Honma, Asumi Mizugaki, Tomonao Yoshida, Takayoshi Ohyasu, Kenichi Katabami, Takeshi Wada
    World journal of emergency surgery : WJES 15 1 7 - 7 2020年 [査読有り][通常論文]
     
    Background: Fibrinogen plays an important role in haemostasis during the early phase of trauma, and low fibrinogen levels after severe trauma are associated with haemostatic impairment, massive bleeding, and poor outcomes. Aggressive fibrinogen supplementation may improve haemostatic function, as fibrinogen levels deteriorate before other routine coagulation parameters in this setting. Therefore, we evaluated whether early administration of fibrinogen concentrate (FC) was associated with improved survival in severe trauma patients. Methods: This single-centre retrospective study evaluated patients with severe trauma (injury severity score ≥ 16) who were admitted to our emergency department between January 2010 and July 2018. The exclusion criteria included age < 18 years, cardiac arrest before emergency department arrival, cervical spinal cord injury not caused by a high-energy accident, and severe burn injuries. The FC and control groups included trauma patients who received and did not receive FC within 1 h after emergency department arrival, respectively. Propensity scores were used to balance the two groups based on the trauma and injury severity score (TRISS), heart rate at emergency department admission, and age. The primary outcome was the in-hospital survival rate. Results: The propensity scoring model had a c-statistic of 0.734, the Hosmer-Lemeshow chi-squared value was 7.036 (degrees of freedom = 8), and the non-significant p value of 0.533 indicated a good model fit. The propensity score matching created 31 matched pairs of patients, who had appropriately balanced characteristics. The FC group had a significantly higher in-hospital survival rate than the control group (log-rank p = 0.013). The FC group also used significantly higher amounts of red blood cells and fresh frozen plasma within 6 h after emergency department admission. However, the two groups had similar transfusion amounts between 6 and 24 h after emergency department admission. Conclusions: The present study revealed that early FC administration was associated with a favourable survival rate among severe trauma patients. Therefore, FC may be useful for the early management of trauma-induced coagulopathy and may improve outcomes in this setting.
  • 不断前進、外傷診療 重症外傷に対するフィブリノゲン早期投与の効果
    斉藤 智誉, 板垣 有紀, 土田 拓見, 定本 圭弘, 本間 慶憲, 水柿 明日美, 吉田 知由, 方波見 謙一, 和田 剛志, 前川 邦彦, 早川 峰司
    日本救急医学会雑誌 30 9 550 - 550 (一社)日本救急医学会 2019年09月
  • 経腸栄養の早期確立不成功に関係する因子の同定
    高橋 正樹, 前川 邦彦, 土田 拓見, 定本 圭弘, 本間 慶憲, 水柿 明日美, 斉藤 智誉, 吉田 知由, 方波見 謙一, 和田 剛志, 早川 峰司
    日本救急医学会雑誌 30 9 677 - 677 (一社)日本救急医学会 2019年09月
  • 超音波診断が有用であった背部刺創の1例
    方波見 謙一, 森木 耕陽, 田原 就, 高橋 正樹, 高橋 悠希, 土田 拓見, 斉藤 智誉, 吉田 知由, 和田 剛志, 前川 邦彦, 早川 峰司
    日本救急医学会雑誌 30 9 822 - 822 (一社)日本救急医学会 2019年09月
  • PCPSが院外心停止蘇生後の凝固線溶動態へ及ぼす影響
    土田 拓見, 澤村 淳, 早川 峰司, 前川 邦彦, 川原 翔太, 富田 明子, 水柿 明日美, 吉田 知由, 和田 剛志, 方波見 謙一, 斉藤 智誉
    日本救急医学会雑誌 29 10 489 - 489 (一社)日本救急医学会 2018年10月
  • 単独頭部外傷時の線溶亢進型播種性血管内凝固症候群と組織低灌流に関する検討
    土田 拓見, 方波見 謙一, 和田 剛志, 前川 邦彦, 提嶋 久子, 早川 峰司, 澤村 淳, 丸藤 哲
    日本救急医学会雑誌 28 9 535 - 535 (一社)日本救急医学会 2017年09月
  • Takeshi Wada, Satoshi Gando, Kunihiko Maekaw, Kenichi Katabami, Hisako Sageshima, Mineji Hayakawa, Atsushi Sawamura
    CRITICAL CARE 21 1 2017年08月 [査読有り][通常論文]
     
    Background: There is evidence to demonstrate that the coagulopathy which occurs in patients with traumatic brain injury coincides with disseminated intravascular coagulation (DIC). We hypothesized that DIC with increased fibrinolysis during the early stage of isolated traumatic brain injury (iTBI) affects the outcome of the patients and that hypoperfusion contributes to hyperfibrinolysis in the DIC. Methods: This retrospective study included 92 patients with iTBI who were divided into DIC and non-DIC groups according to the Japanese Association Acute Medicine DIC scoring system. The DIC patients were subdivided into those with and without hyperfibrinolysis. The platelet counts and global markers of coagulation and fibrinolysis were measured. Systemic inflammatory response syndrome (SIRS), organ dysfunction (assessed by the Sequential Organ Failure Assessment score), tissue hypoperfusion (assessed by the lactate levels) and the transfusion volume were also evaluated. The outcome measure was all-cause hospital mortality. Results: DIC patients showed consumption coagulopathy, lower antithrombin levels and higher fibrin/fibrinogen degradation products (FDP) and D-dimer levels than non-DIC patients. All of the DIC patients developed SIRS accompanied by organ dysfunction and required higher blood transfusion volumes, leading to a worse outcome than non-DIC patients. These changes were more prominent in DIC with hyperfibrinolysis. A higher FDP/D-dimer ratio suggests that DIC belongs to the fibrinolytic phenotype and involves fibrin(ogen)olysis. The mean blood pressures of the patients with and without DIC on arrival were identical. Hypoperfusion and the lactate levels were not identified as independent predictors of hyperfibrinolysis. Conclusions: DIC, especially DIC with hyperfibrinolysis, affects the outcome of patients with iTBI. Low blood pressure-induced tissue hypoperfusion does not contribute to hyperfibrinolysis in this type of DIC.
  • Wada T, Gando S, Maekaw K, Katabami K, Sageshima H, Hayakawa M, Sawamura A
    Critical care (London, England) 21 1 219 - 219 2017年08月 [査読有り][通常論文]
     
    BACKGROUND: There is evidence to demonstrate that the coagulopathy which occurs in patients with traumatic brain injury coincides with disseminated intravascular coagulation (DIC). We hypothesized that DIC with increased fibrinolysis during the early stage of isolated traumatic brain injury (iTBI) affects the outcome of the patients and that hypoperfusion contributes to hyperfibrinolysis in the DIC. METHODS: This retrospective study included 92 patients with iTBI who were divided into DIC and non-DIC groups according to the Japanese Association Acute Medicine DIC scoring system. The DIC patients were subdivided into those with and without hyperfibrinolysis. The platelet counts and global markers of coagulation and fibrinolysis were measured. Systemic inflammatory response syndrome (SIRS), organ dysfunction (assessed by the Sequential Organ Failure Assessment score), tissue hypoperfusion (assessed by the lactate levels) and the transfusion volume were also evaluated. The outcome measure was all-cause hospital mortality. RESULTS: DIC patients showed consumption coagulopathy, lower antithrombin levels and higher fibrin/fibrinogen degradation products (FDP) and D-dimer levels than non-DIC patients. All of the DIC patients developed SIRS accompanied by organ dysfunction and required higher blood transfusion volumes, leading to a worse outcome than non-DIC patients. These changes were more prominent in DIC with hyperfibrinolysis. A higher FDP/D-dimer ratio suggests that DIC belongs to the fibrinolytic phenotype and involves fibrin(ogen)olysis. The mean blood pressures of the patients with and without DIC on arrival were identical. Hypoperfusion and the lactate levels were not identified as independent predictors of hyperfibrinolysis. CONCLUSIONS: DIC, especially DIC with hyperfibrinolysis, affects the outcome of patients with iTBI. Low blood pressure-induced tissue hypoperfusion does not contribute to hyperfibrinolysis in this type of DIC.
  • Wada, T, Gando, S, Mizugaki, A, Kodate, A, Sadamoto, Y, Maekawa, K, Murakami, H, Katabami, K, Ono, Y, Hayakawa, M, Sawamura, A, Jesmin, S, Ieko, M
    Acute Medicine & Surgery 4 3 371 - 372 2017年03月 [査読有り][通常論文]
  • Yuichi Ono, Mineji Hayakawa, Kunihiko Maekawa, Akira Kodate, Yoshihiro Sadamoto, Naoki Tominaga, Hiromoto Murakami, Tomonao Yoshida, Kenichi Katabami, Takeshi Wada, Hisako Sageshima, Atsushi Sawamura, Satoshi Gando
    RESUSCITATION 111 62 - 67 2017年02月 [査読有り][通常論文]
     
    Objective: This study aimed to test the hypothesis that coagulation, fibrinolytic markers and disseminated intravascular coagulation (DIC) score (International Society on Thrombosis and Haemostasis) at hospital admission of out-of-hospital cardiac arrest (OHCA) patients can predict neurological outcomes 1 month after cardiac arrest. Methods: In this retrospective, observational analysis, data were collected from the Sapporo Utstein Registry and medical records at Hokkaido University Hospital. We included patients who experienced OHCA with successful return of spontaneous circulation (ROSC) between 2006 and 2012 and were transferred to Hokkaido University Hospital. From medical records, we collected information about the following coagulation and fibrinolytic factors at hospital admission: platelet count; prothrombin time; activated partial thromboplastin time; plasma levels of fibrinogen, D-dimer, fibrin/fibrinogen degradation products (FDP), and antithrombin; and calculated DIC score. Favorable neurological outcomes were defined as a cerebral performance category 1-2. Results: We analyzed data for 315 patients. Except for fibrinogen level, all coagulation variables, fibrinolytic variables, and DIC score were associated with favorable neurological outcomes. In the receiver operating characteristic curve analysis, FDP level had the largest area under the curve (AUC; 0.795). In addition, the AUC of FDP level was larger than that of lactate level. Conclusions: All of the coagulation and fibrinolytic markers, except for fibrinogen level, and DIC score at hospital admission, were associated with favorable neurological outcomes. Of all of the variables, FDP level was most closely associated with favorable neurological outcomes in OHCA patients who successfully achieved ROSC. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
  • Ono Y, Hayakawa M, Iijima H, Maekawa K, Kodate A, Sadamoto Y, Mizugaki A, Murakami H, Katabami K, Sawamura A, Gando S
    Resuscitation 107 65 - 70 2016年10月 [査読有り][通常論文]
     
    OBJECTIVE: It is well established that the period of time between a call being made to emergency medical services (EMS) and the time at which the EMS arrive at the scene (i.e. the response time) affects survival outcomes in patients who experience out-of-hospital cardiac arrest (OHCA). However, the relationship between the response time and favourable neurological outcomes remains unclear. We therefore aimed to determine a response time threshold in patients with bystander-witnessed OHCA that is associated with positive neurological outcomes and to assess the relationship between the response time and neurological outcomes in patients with OHCA. METHODS: This study was a retrospective, observational analysis of data from 204,277 episodes of bystander-witnessed OHCA between 2006 and 2012 in Japan. We used classification and regression trees (CARTs) and receiver operating characteristic (ROC) curve analyses to determine the threshold of response time associated with favourable neurological outcomes (Cerebral Performance Category 1 or 2) 1 month after cardiac arrest. RESULTS: Both CARTs and ROC analyses indicated that a threshold of 6.5min was associated with improved neurological outcomes in all bystander-witnessed OHCA events of cardiac origin. Furthermore, bystander cardiopulmonary resuscitation (CPR) prolonged the threshold of response time by 1min (up to 7.5min). The adjusted odds ratio for favourable neurological outcomes in patients with OHCA who received care within ≤6.5min was 1.935 (95% confidential interval: 1.834-2.041, P<0.001). CONCLUSIONS: A response time of ≤6.5min was closely associated with favourable neurological outcomes in all bystander-witnessed patients with OHCA. Bystander CPR prolonged the response time threshold by 1min.
  • Wada T, Gando S, Ono Y, Maekawa K, Katabami K, Hayakawa M, Sawamura A
    Thromb J 14 1 43 - 43 2016年09月 [査読有り][通常論文]
     
    BACKGROUND: We tested the hypothesis that disseminated intravascular coagulation (DIC) during the early phase of post-cardiopulmonary resuscitation (CPR) is associated with systemic inflammatory response syndrome (SIRS), multiple organ dysfunction syndrome (MODS) and affects the outcome of out-of-hospital cardiac arrest (OHCA) patients. METHODS: A review of the computer-based medical records of OHCA patients was retrospectively conducted and included 388 patients who were divided into DIC and non-DIC patients based on the Japanese Association for Acute Medicine DIC diagnostic criteria. DIC patients were subdivided into two groups: those with and without hyperfibrinolysis. Pre-hospital factors, platelet count, coagulation and fibrinolysis markers and lactate levels within 24 h after resuscitation were evaluated. The outcome measure was all-cause hospital mortality. RESULTS: DIC patients exhibited lower platelet counts, prolonged prothrombin time, decreased levels of fibrinogen and antithrombin associated with increased fibrinolysis than those without DIC. DIC patients more frequently developed SIRS and MODS, followed by worse outcomes than non-DIC patients. The same changes were observed in DIC patients with hyperfibrinolysis who showed a higher prevalence of MODS, leading to worse outcome than those without hyperfibrinolysis. Logistic regression analyses showed that lactate levels predicted hyperfibrinolysis and DIC is an independent predictor of patient death. Survival probabilities of DIC patients during hospital stay were significantly lower than non-DIC patients. The area under the receiver operating characteristic curve of DIC for the prediction of death was 0.704. CONCLUSIONS: The fibrinolytic phenotype of DIC during the early phase of post-CPR more frequently results in SIRS and MODS, especially in patients with hyperfibrinolysis, and affects the outcome of OHCA patients.
  • Sawamura A, Katabami K, Ishimori N, Singu Y, Nakayama N
    [Hokkaido igaku zasshi] The Hokkaido journal of medical science 91 1 27 - 30 2016年05月 [査読有り][通常論文]
     
    The Hokkaido Medical Society is a group of doctors and medical researchers in Hokkaido. Its purpose is to contribute to medicine and to the improvement of medical treatment. This symposium was carried out in order to inform citizens about the condition known as sudden death. We hypothesize that the incidence of sudden death tends to increase in line with the incidence of metabolic syndrome. Approximately four hundred patients were transported to our hospital by ambulance in a state of cardiopulmonary arrest (CPA) last year. The number of CPA patients who are treated in our hospital has increased in comparison to the previous decade. The theme of this year is "The clinical condition and treatment of diseases associated with sudden death" in view of the above mentioned situation. In 2015, it was reported that sudden death occurred in an American pilot and that the co-pilot was forced to make an emergency landing. Interestingly, sudden death can ever sometimes occur in pilots who undergo regular physical examinations. Numerous diseases and conditions are associated with sudden death, including: acute myocardial infarction, irregular pulse, cardiac insufficiency, cerebrovascular disease, aortic dissection and choking. We are of the opinion that the frequency of sudden death is very high in the fields of emergency medicine, cardiovascular medicine, cardiovascular surgery and neurosurgery. In this symposium, we presented and explained the condition that is known as sudden death and the current state of treatment of sudden death in emergency medicine, cardiovascular medicine, cardiovascular surgery and neurosurgery departments of the Hokkaido University Graduate School of Medicine in October, 2015. We hope that the symposium will help the citizen audience to understand the condition and treatment of sudden death, and also to help prevent sudden death.
  • Katabami K, Hayakawa M, Gando S
    Case Reports in Emergency Medicine 2016 9013816 - 9013816 2016年 [査読有り][通常論文]
     
    ID 9013816 3pages
  • 丸藤哲, 和田剛志, 小野雄一, 前川邦彦, 方波見謙一, 早川峰司, 澤村淳
    ICUとCCU 40 171 - 178 2016年 [査読有り][通常論文]
  • Ono Y, Hayakawa M, Maekawa K, Mizugaki A, Katabami K, Wada T, Sawamura A, Gando S
    The American journal of emergency medicine 33 10 1360 - 1363 2015年10月 [査読有り][通常論文]
     
    OBJECTIVE: Few studies have compared airway management via laryngeal masks (LM) or laryngeal tubes (LT) in patients with out-of-hospital cardiac arrest (OHCA). This study evaluated whether LT insertion by emergency medical service (EMS) personnel affected ventilation and outcomes in OHCA patients (vs. the standard LM treatment). METHODS: This prospective, cluster-randomized, and open-label study evaluated data that were collected by the Sapporo Fire Department between June 2012 and January 2013. We selected the 14 EMS teams that treated the greatest number of OHCA patients in Sapporo, Japan during 2011, and randomized the teams into Groups A and B. In the first study period (June 2012 to September 2012), Group A treated OHCA patients via LT and Group B treated OHCA patients via LM. In the second period (October 2012 to January 2013), Group A treated OHCA patients via LM and Group B treated OHCA patients via LT. If necessary, both groups were allowed to use an esophageal obturator airway (EOA) kit. The primary endpoints were time from cardiopulmonary resuscitation to device insertion and the rate of successful pre-hospital ventilation. The secondary endpoints were return of spontaneous circulation and survival and favorable neurological outcomes at 1 month after cardiac arrest. RESULTS: LT was used in 148 OHCA patients and LM was used in 165 OHCA patients. Our intention-to-treat analyses revealed no significant differences in the primary and secondary outcomes of the LT- and LM-treated groups. CONCLUSION: Prehospital advanced airway management via LT provides similar outcomes to those of LM in OHCA patients.
  • Takeshi Wada, Masaki Kobayashi, Yuichi Ono, Asumi Mizugaki, Kenichi Katabami, Kunihiko Maekawa, Daisuke Miyamoto, Yuichiro Yanagida, Mineji Hayakawa, Atsushi Sawamura, Ken Iseki, Satoshi Gando
    Journal of Intensive Care 3 1 22  2015年05月08日 [査読有り][通常論文]
     
    The aim of this study was to establish the pharmacokinetics of levofloxacin (LVFX) and determine the optimal dose of this drug in critically ill patients receiving continuous hemodiafiltration (CHDF). The results of in vivo and in vitro studies showed the pharmacokinetics of LVFX total clearance (CLtotal) according to the creatinine clearance (CLCre), dialysate flow (QD), and ultrafiltrate flow (QF), to be as follows: CLtotal (l/h) = 0.0836 × CLCre (ml/min) + 0.013 × body weight (kg) + 0.94(QD + QF) (l/h). The optimal dose of LVFX was expressed by the following formula: 50 × CLtotal. These results demonstrate that the usual dose of LVFX (500 mg) was sufficient for the patients evaluated in this study.
  • Mineji Hayakawa, Satoshi Gando, Yuichi Ono, Asumi Mizugaki, Kenichi Katabami, Kunihiko Maekawa, Daisuke Miyamoto, Takeshi Wada, Yuichiro Yanagida, Atsushi Sawamura
    SEMINARS IN THROMBOSIS AND HEMOSTASIS 41 3 267 - 271 2015年04月 [査読有り][通常論文]
     
    Rapid evaluation of fibrinogen (Fbg) levels is essential for maintaining homeostasis in patients with massive bleeding during severe trauma and major surgery. This study evaluated the accuracy of fibrinogen levels measured by the CG02N whole blood coagulation analyzer (A&T Corporation, Kanagawa, Japan) using heparinized blood drawn for blood gas analysis (whole blood-Fbg). A total of 100 matched pairs of heparinized blood samples and citrated blood samples were simultaneously collected from patients in the intensive care unit. Whole blood-Fbg results were compared with those of citrated plasma (standard-Fbg). The whole blood coagulation analyzer measured fibrinogen levels within 2 minutes. Strong correlations between standard-Fbg and whole blood-Fbg were observed (=0.91, p<0.001). Error grid analysis showed that 88% of the values were clinically acceptable, and 12% were in a range with possible effects on clinical decision-making; none were in a clinically dangerous range without appropriate treatment. Using a fibrinogen cutoff value of 1.5 g/L for standard-Fbg, the area under the receiver operating characteristic curve of whole blood-Fbg was 0.980 (95% confidence interval 0.951-1.000, p<0.001). The whole blood coagulation analyzer can rapidly measure fibrinogen levels in heparinized blood and could be useful in critical care settings where excessive bleeding is a concern.
  • Kentaro Kobayashi, Khin Khin Tha, Satoshi Terae, Yuki Iijima, Kenichi Katabami, Yosuke Minami, Shinji Uegaki, Satoshi Gando, Hiroki Shirato
    JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY 35 4 498 - 500 2011年07月 [査読有り][通常論文]
     
    We report a case of heat stroke in which detection of brain injury was improved by high b-value diffusion-weighted imaging (DWI). High b-value DWI revealed moderate to marked hyperintensity at/around bilateral dentate nuclei and part of thalami. Apparent diffusion coefficient maps revealed apparent diffusion coefficient decrease of the dentate lesions. Routine DWI showed only mild hyperintensity of part of dentate lesions. High b-value DWI could be valuable for improved detection of heat stroke-induced brain injury.
  • Mineji Hayakawa, Kenichi Katabami, Takeshi Wada, Yousuke Minami, Masahiro Sugano, Hidekazu Shimojima, Nobuhiko Kubota, Shinji Uegaki, Atsushi Sawamura, Satoshi Gando
    INFLAMMATION 34 3 193 - 197 2011年06月 [査読有り][通常論文]
     
    Migration inhibitory factor (MIF) is associated with multiple organ dysfunction syndrome (MODS) in patients with systemic inflammatory response syndrome (SIRS). Our purposes were to determine the serum MIF, cortisol, and tumor narcosis factor-alpha (TNF-alpha) and to investigate the influences of the balance between the levels of MIF and cortisol in patients with blunt trauma. The cortisol levels were identical between the patients with and without MODS. However, the MIF and TNF-alpha levels in the patients with MODS were statistically higher than those of the patients without MODS. The cortisol/MIF ratios in the patients with MODS were statistically higher than those of the patients without MODS. The results show that MIF and TNF-alpha play an important role together in posttraumatic inflammatory response. An excessive serum MIF elevation overrides the anti-inflammatory effects of cortisol and leads to persistent SIRS followed by MODS in blunt trauma patients.
  • Yamada T, Yamamura MK, Katabami K, Hayakawa M, Tomar U, Ahimada S, Morikawa M, Seki T, Ariga S, Ishikawa K, Ikebe T, Gando S, Minakami H
    The Journal of infection 60 6 417 - 424 2010年06月 [査読有り][通常論文]
  • Takahiro Yamada, Takashi Yamada, Mie K. Yamamura, Kenichi Katabami, Mineji Hayakawa, Utano Tomaru, Shigeki Shimada, Mamoru Morikawa, Toshio Seki, Satoshi Ariga, Kaoru Ishikawa, Tadayoshi Ikebe, Satoshi Gando, Hisanori Minakami
    JOURNAL OF INFECTION 60 6 417 - 424 2010年06月 [査読有り][通常論文]
     
    We conducted a literature review of 55 pregnancies with symptomatic Group A streptococcus (Streptococcus pyogenes) infection reported in English (20 cases), French (2 cases) and Japanese (33 cases) to seek ways of improving prognosis. Multiparous women (83% [39/47]) in the third trimester (90% [47/52]) were prone to infection from winter to spring (75% [21/28]). Onset was heralded by flu-like symptoms, such as high fever (94% [46/49]), with upper respiratory (40% [22/55]) and/or gastrointestinal symptoms (49% [27/55]). Characteristic findings were early onset of shock (91% [50/55]) and infection-induced strong uterine contraction (73% [40/55]) suggestive of placental abruption. The clinical course was too acute and severe to rescue the mother (58% [32/55] died) and/or infant (66% [39/59] died). However, outcome has improved over the last decade, with rescue of 68% (15/22) of the mothers since 2000, and early use of antibiotics (71% [22/31] survived) and use of intravenous immunoglobulin (91% [10/11] survived) were associated with favourable outcome. Early use of antibiotics and intravenous immunoglobulin may improve outcome of pregnant women suffering from flu-like symptoms, shock and strong uterine contractions suggestive of placental abruption. (C) 2010 The British Infection Society. Published by Elsevier Ltd. All rights reserved.
  • Mineji Hayakawa, Kenichi Katabami, Takeshi Wada, Masahiro Sugano, Hirokatsu Hoshino, Atsushi Sawamura, Satoshi Gando
    SHOCK 33 1 14 - 18 2010年01月 [査読有り][通常論文]
     
    Neutrophil elastase plays an important role in the development of acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC) in sepsis. Sivelestat is a selective neutrophil elastase inhibitor. It is possible that sivelestat improves the outcome of septic patients associated with ARDS and DIC. A retrospective data analysis of septic patients associated with ARDS and DIC was conducted to investigate the effects of sivelestat. Observational period was 5 days after admission to intensive care unit (ICU). The study included 167 septic patients associated with ARDS and DIG. Control group included 133 patients without sivelestat, and sivelestat group included 34 patients started to deadministered sivelestat on the admission to ICU. The lung injury scores and Pao(2)/Fio(2) ratio of the sivelestat group were significantly more severe than those of the control group from days 1 to 4. On day 5, the lung injury score and Pao(2)/Fio(2) ratio of the sivelestat group improved to the same levels of those of the control group. The DIC score of sivelestat group improved on day 3 in comparison to day 1, and those of control group remained unchanged until day 4. The length of ICU stay of the sivelestat group was significantly shorter than that of the control group. A stepwise multiple logistic-regression analysis showed the sivelestat administration to be an independent predictor of survival of the septic patients associated with both ARDS and DIC. The length of ICU stay of the sivelestat group was significantly shorter than that of the control group. In addition, sivelestat administration was found to be an independent predictor of survival of those patients.
  • Atsushi Sawamura, Mineji Hayakawa, Satoshi Gando, Nobuhiko Kubota, Masahiro Sugano, Takeshi Wada, Ken-ichi Katabami
    THROMBOSIS RESEARCH 124 6 706 - 710 2009年12月 [査読有り][通常論文]
     
    Introduction: To validate the diagnostic criteria for disseminated intravascular coagulation (DIC) established by the Japanese Association for Acute Medicine (JAAM) at an early stage of trauma and to evaluate the hypothesis that the JAAM criteria can diagnose DIC with a higher sensitivity than the International Society on Thrombosis and Haemostasis (ISTH) overt DIC criteria. Materials and Methods: Based on a review of medical records, the data of 314 trauma patients were retrospectively obtained at 4 time points within 24 hr after arrival to the Emergency Department. Results: One hundred and forty-one JAAM DIC patients (44.9%) showed differences in the prevalence of massive bleeding and multiple organ dysfunction syndrome (MODS), and the outcome in comparison to the non-DIC patients. A stepwise logistic regression analysis showed that the maximum JAAM DIC scores independently predicted the patient death. All of the patients who developed ISTH overt DIC could be identified by the JAAM DIC criteria at early time points. The mortality rate and the incidence of massive bleeding and MODS of the patients with the ISTH overt DIC were higher than those only met the JAAM DIC criteria. Stepwise increases in the ISTH overt DIC scores and the incidence of the overt DIC were observed in accordance with the increases in the JAAM DIC scores. While the mortality rates were identical, there were marked differences in the incidence of MODS and Sequential Organ Failure Assessment scores between the DIC patients associated with trauma and sepsis. Conclusions: The results show that the JAAM scoring system has acceptable validity for the DIC diagnosis at an early phase of trauma, and also that the scoring system can diagnose DIC with a higher sensitivity than the criteria of the ISTH overt DIC. Bleeding as well as MODS may affect the prognosis of the patients associated with DIC. (C) 2009 Elsevier Ltd. All rights reserved.
  • Atsushi Sawamura, Mineji Hayakawa, Satoshi Gando, Nobuhiko Kubota, Masahiro Sugano, Takeshi Wada, Ken-ichi Katabami
    THROMBOSIS RESEARCH 124 5 608 - 613 2009年11月 [査読有り][通常論文]
     
    Introduction: Disseminated intravascular coagulation (DIC) with an antifibrinolytic phenotype is characterized by microvascular thrombosis leading to poor outcome at the late-stage of trauma. To test the hypothesis that DIC with a fibrinolytic phenotype at an early stage of trauma also contributes to a poor outcome due to severe bleeding, we conducted a retrospective. cohort study. Materials and Methods: The subjects included 314 consecutive severe trauma patients. A systematic review of medical records of the patients was conducted to provide the base line characteristics and DIC-related variables. The data of these variables were obtained at 4 time points within 24 hr after arrival to the emergency department (ED): Time Point 1, immediately after arrival to the ED to 4 hr after arrival; Time Point 2, 4 to 8 hr after arrival; Time Point 3, 8 to 16 hr after arrival; Time Point 4, 16 to 24 hr after arrival. Results: Nonsurvivors (87.3%, 48/55) met the Japanese Association for Acute Medicine (JAAM) DIC criteria showing lower fibrinogen levels, a prolonged prothrombin time, and higher fibrin/fibrinogen degradation products (FDP) and D-dimer levels in comparison to those of the 289 survivors. The FDP/D-dimer ratio and lactate level were significantly higher in the nonsurvivors than those of the survivors. Lower fibrinogen levels and higher FDP/D-dimer ratio suggest fibrinogenolysis in DIC of the nonsurvivors. Furthermore a stepwise logistic regression analysis showed that the JAAM DIC score, levels of fibrinogen, FDP and lactate at Time Point 1 are independent predictors of death. Low levels of fibrinogen and high FDP but not D-dimer predict massive bleeding at an early stage of trauma. The optimal cutoff points for the prediction of death and massive bleeding were fibrinogen (1.90, 1.90 g/L) and FDP (35.2, 68.7 mg/L), respectively. Conclusions: DIC with a fibrinolytic phenotype modified through fibrinogenolysis at an early phase of trauma contributes to poor prognosis due to massive bleeding. Tissue hypoperfusion may be involved in the pathogenesis of this type of DIC. (C) 2009 Elsevier Ltd. All rights reserved.

MISC

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    加藤 諄, 本間 慶憲, 斉藤 智誉, 吉田 知由, 方波見 謙一, 和田 剛志, 前川 邦彦, 早川 峰司 日本救急医学会雑誌 34 (12) 782 -782 2023年12月
  • 松本 悠, 松田 知倫, 方波見 謙一, 神 繁樹, 的場 光太郎, 兵頭 秀樹, 丸藤 哲 日本集中治療医学会雑誌 30 (4) 252 -253 2023年07月 [査読無し]
     
    血液透析患者(80代男性)の急性テングタケ中毒に対し、間歇的血液透析を複数回行うことで意識障害の改善を得た症例について報告した。患者は公園に自生しているキノコを採取して摂取後、意識障害となり、当院へ搬送された。問診から「急性テングタケ中毒の疑い」と診断し、ICUへ移動し、第2病日に意識障害が遷延し徐脈となったため、中毒物質の除去目的に間歇的血液透析(血液流量200mL/hr、透析液流量500mL/hr、抗凝固薬はヘパリンナトリウム)を行った。意識障害の改善が認められないため、第3病日にも間歇的血液透析(同条件)を行った。その結果、意識状態が改善し、第7病日にICU退室となった。経過中、テングタケの主成分であるイボテン酸およびムシモールの血中濃度を測定し、血中濃度は間歇的血液透析を行うごとに低下し、2回目の血液透析後は測定限界値以下となった。意識障害を呈した慢性透析患者の急性テングタケ中毒では、複数回の血液透析が症状改善に寄与しており、同様の症例に遭遇した際には、症状改善まで複数回の血液透析を考慮してもよいと考えられた。
  • 【まず当ててみよう POCUS 各臓器のエコー描出・評価のポイントを押さえショック、呼吸困難、腹痛などさまざまな症状・症候にも対応できる】(第3章)胸部のPOCUS 心臓basic
    松本 悠, 方波見 謙一 レジデントノート 25 (2) 216 -222 2023年04月 
    ・基本的な心エコーの断面の描出ができる・循環動態に影響を及ぼすレベルの異常を指摘できる・異常を専門医へ適切に報告できる(著者抄録)
  • 松本 悠, 方波見 謙一 Heart View 27 (2) 166 -171 2023年02月 
    <文献概要>Point 1 ショックの分類を理解する。2 RUSH Examを理解する。3 HIMAPを理解する。
  • 方波見謙一 超音波医学 Supplement 50 2023年
  • 松本悠, 松本悠, 松田知倫, 方波見謙一, 神繁樹, 的場光太郎, 兵頭秀樹, 丸藤哲 日本集中治療医学会雑誌(Web) 30 (4) 2023年
  • 方波見謙一, 早川峰司, 神繁樹, 的場光太郎 日本集中治療医学会北海道支部学術集会プログラム・抄録集(Web) 7th 2023年
  • 超音波教育における遠隔ハンズオンの実際と課題
    方波見 謙一, 亀田 徹, 竹井 寛和, 谷口 隼人, 瀬良 誠 日本救急医学会雑誌 33 (10) 866 -866 2022年10月
  • 亀田 徹, 石井 浩統, 大屋 聖郎, 方波見 謙一, 児玉 貴光, 瀬良 誠, 竹井 寛和, 谷口 隼人, 中尾 俊一郎, 舩越 拓, 山賀 聡之, 妹尾 聡美, 木村 昭夫, 日本救急医学会Point-of-Care超音波推進委員会 日本救急医学会雑誌 33 (7) 338 -383 2022年07月 
    超音波装置の小型化とベッドサイドへの普及により,超音波検査は救急現場で積極的に利用されるようになった。医療従事者がベッドサイドで観察範囲を絞り,臨床決断と侵襲的手技の質向上のために実施する超音波検査はpoint-of-care ultrasonography(POCUS)と呼ばれる。その概念は世界中で広く共有されるようになったが,本邦ではfocused assessment with sonography for trauma(FAST)と超音波ガイド下中心静脈穿刺を除き,POCUSに関する正式な指針はこれまで存在しなかった。日本救急医学会Point-of-Care超音波推進委員会では,POCUSを用いた救急診療の質向上について議論を繰り返し,日本救急医学会からの認証を得て救急point-of-care超音波診療指針としてまとめた。この指針では,背景,救急科専門医の到達目標,その論文的根拠,領域横断的な活用について述べる。到達目標の主要項目には,超音波の基礎,上気道,胸部,心臓,腹部,深部静脈,ガイド下手技,症候別評価が含まれる。また将来主要項目になる可能性があるものは付加項目として広く言及した。この指針は救急科専門医にとっての超音波検査の概要と方向性を示すものであり,救急超音波教育のために利用できる。この指針をきっかけに,本邦の救急診療の現場で超音波検査が効果的に利用されることを願う。(著者抄録)
  • 方波見 謙一 INNERVISION 37 (5) 50 -53 2022年04月 
    超音波機器の発達により、臨床の現場においてその利用が広く普及してきた。特に、臨床医が超音波を利用して診断と治療を迅速に行うpoint-of-care ultrasound(以下、POCUS)が、救急医や集中治療医にとって習得すべきものとなり、その知識や技術に関する教育方法として、これまでは対面による講習会などが行われてきた。しかし、新型コロナウイルス感染症(以下、COVID-19)流行により、感染予防の観点からこれまでのようにある程度の人数の受講者が1ヶ所に集まり、ある程度の長い時間の講義と実技を行い知識と技術を学ぶという形式での講習会の開催が難しい状況となった。一方で、"Zoom"などのオンライン会議システムが普及し、学会や会議などがオンライン上で開催されることが多くなった。オンライン上で開催されることで、感染予防のためのいわゆるソーシャルディスタンスが確保でき、また、地域から地域への移動を行わずとも参加することができるようになった。さまざまな領域におけるハンズオントレーニングに関しても、感染流行により開催が控えられてきたが、こうしたオンラインツールを利用した開催が徐々になされるようになってきた。超音波教育におけるハンズオントレーニングに関しては、講義についてはオンラインでのリアルタイムの開催やe-learningを利用した事前学習により、ある程度これまでと同様に行うことができるが、実技に関してはその開催方法や評価方法について試行錯誤しながら行われている。このたび、Zoomを利用したPOCUSの遠隔ハンズオントレーニングを開催したので、その準備、開催方法、問題点、受講者からの評価を共有する。(著者抄録)
  • 方波見 謙一, 木村 尚史, 玉腰 暁子 日本在宅救急医学会誌 5 (2) 1 -7 2022年03月 
    【目的】平成30年北海道胆振東部地震に伴った停電における、札幌市在宅人工呼吸器患者への対応の実態と入院となったリスク要因を検討する。【方法】札幌市在宅医療協議会所属会員を対象として行われたアンケート調査を利用し、本研究を行った。【結果】札幌市内の在宅人工呼吸器患者数は230名であった。使用時間が常時(24時間)であれば入院に対するPR(prevalence ratio)は9.07(95%CI:5.10~16.10、p<.0001)、人工呼吸器設定についてはTPPV(tracheostomy positive pressure ventilation)の場合、TPPVではない場合に比べ入院に対するPRは3.57(95%CI:2.29~5.55、p<.0001)であった。年齢と使用時間による多変量解析では、使用時間のPRが9.21(95%CI:5.17~16.39、p<.0001)であった。入院とならなかった患者は147名であり、入院回避の理由として、電源が確保できたが87名(59.2%)で、自家用車からの電源確保が35名(40.2%)であった。【結語】災害に伴った停電時には在宅人工呼吸器24時間使用は入院のリスクとなる。リスクが高い患者において日ごろから自家用車などの非常電源を確保しておくことが、災害急性期の停電対策として重要である。(著者抄録)
  • 多発性脳内出血で発症し急激な経過で脳死に至ったT細胞性急性リンパ性白血病(T-ALL)
    長 祐子, 澤井 彩織, 原 和也, 寺下 友佳代, 杉山 未奈子, 平林 真介, 真部 淳, 杉山 拓, 方波見 謙一, 浜崎 和朗 日本小児科学会雑誌 126 (2) 423 -423 2022年02月
  • 胃気腫症を認め後腹膜膿瘍を伴う敗血症性ショックに対して緊急開腹手術による治療が奏功した一例
    本間 慶憲, 早川 峰司, 前川 邦彦, 和田 剛志, 方波見 謙一, 吉田 知由, 斎藤 智誉, 早水 真理子, 水柿 明日美, 定本 圭弘, 執行 亜希子 日本救急医学会雑誌 32 (12) 2579 -2579 2021年11月
  • 心停止蘇生後の低リン血症は予後不良因子である
    高橋 正樹, 和田 剛志, 中嶋 拓磨, 執行 亜希子, 田中 祥平, 田原 就, 吉田 知由, 方波見 謙一, 前川 邦彦, 早川 峰司 日本集中治療医学会雑誌 28 (Suppl.2) 451 -451 2021年09月
  • 執行亜希子, 早川峰司, 田中祥平, 中嶋拓磨, 高橋正樹, 田原就, 土田拓見, 定本圭弘, 川原翔太, 本間慶憲, 大安孝允, 早水真理子, 斉藤智誉, 吉田知由, 方波見謙一, 和田剛志, 前川邦彦 日本集中治療医学会北海道支部学術集会プログラム・抄録集(Web) 4th 2020年
  • 救急医療で求められるpoint-of-care ultrasound(POCUS) 日本救急医学会Point-of-Care超音波(POCUS)推進委員会の展開
    亀田 徹, 児玉 貴光, 方波見 謙一, 石井 浩統, 谷口 隼人, 妹尾 聡美, 瀬良 誠, 山賀 聡之, 大屋 聖郎, 木村 昭夫 日本救急医学会雑誌 30 (9) 569 -569 2019年09月
  • 髙橋 忠志, 尾身 諭, 泉 圭之介, 菊池 謙一, 遠藤 聡, 尾花 正義, 太田 岳洋, 長谷川 士朗, 柚木 泰広, 北澤 浩美, 方波見 裕子, 八木 真由美, 長井 ノブ子 総合リハビリテーション 47 (3) 271 -274 2019年03月10日
  • 富永 直樹, 方波見 謙一, 小舘 旭, 定本 圭弘, 村上 博基, 吉田 知由, 丸藤 哲 日集中医誌 25 (2) 145 -146 2018年 [査読無し][通常論文]
  • Yu-Ichi Ono, Tomonao Yoshida, Mineji Hayakawa, Kunihiko Maekawa, Hiromoto Murakami, Kenichi Katabami, Atsushi Sawamura, Satoshi Gando CRITICAL CARE MEDICINE 44 (12) 2016年12月 [査読無し][通常論文]
  • Kunihiko Maekawa, Mineji Hayakawa, Yuichi Ono, Tomonao Yoshida, Kenichi Katabami, Takeshi Wada, AtsUshi Sawamura, Satoshi Gando CRITICAL CARE MEDICINE 44 (12) 2016年12月 [査読無し][通常論文]
  • Kunihiko Maekawa, Mineji Hayakawa, Yuichi Ono, Tomonao Yoshida, Kenichi Katabami, Takeshi Wada, AtsUshi Sawamura, Satoshi Gando CRITICAL CARE MEDICINE 44 (12) 2016年12月 [査読無し][通常論文]
  • 当院におけるDMAT活動と今後の課題
    村上 壮一, 澤村 淳, 方波見 謙一, 早川 峰司, 前川 邦彦, 村上 博基, 丸藤 哲, 平野 聡 日本救急医学会雑誌 27 (9) 374 -374 2016年09月 [査読無し][通常論文]
  • 外傷性孤立性腹腔動脈解離と上腸間膜動脈解離を合併した1例
    板垣 有紀, 方波見 謙一, 小舘 旭, 定本 圭介, 富永 直樹, 村上 博基, 小野 雄一, 前川 邦彦, 早川 峰司, 澤村 淳, 丸藤 哲 日本救急医学会雑誌 27 (9) 389 -389 2016年09月 [査読無し][通常論文]
  • 心肺停止蘇生後早期の線溶亢進型DICは症例の予後を規定する
    方波見 謙一, 小舘 旭, 定本 圭弘, 富永 直樹, 村上 博基, 小野 雄一, 前川 邦彦, 早川 峰司, 澤村 淳, 丸藤 哲 日本救急医学会雑誌 27 (9) 427 -427 2016年09月 [査読無し][通常論文]
  • 院外心肺停止患者における神経学的予後を予測するresponse time閾値の検討
    小野 雄一, 早川 峰司, 前川 邦彦, 小館 旭, 定本 圭弘, 富永 直樹, 村上 博基, 方波見 謙一, 澤村 淳, 丸藤 哲 日本救急医学会雑誌 27 (9) 464 -464 2016年09月 [査読無し][通常論文]
  • 心肺停止蘇生後早期DICについての検討
    方波見 謙一, 小舘 旭, 定本 圭弘, 富永 直樹, 村上 博基, 小野 雄一, 前川 邦彦, 早川 峰司, 澤村 淳, 丸藤 哲 日本救急医学会雑誌 27 (9) 487 -487 2016年09月 [査読無し][通常論文]
  • 画像上明らかでない卵巣奇形腫を合併した抗NMDA受容体脳炎の一例
    定本 圭弘, 方波見 謙一, 小舘 旭, 村上 博基, 吉田 知由, 前川 邦彦, 宮本 大輔, 早川 峰司, 澤村 淳, 丸藤 哲 日本救急医学会雑誌 27 (9) 507 -507 2016年09月 [査読無し][通常論文]
  • PCPS脱血管が上行腰静脈へ迷入した一例
    富永 直樹, 方波見 謙一, 小舘 旭, 定本 佳弘, 村上 博基, 吉田 知由, 小野 雄一, 前川 邦彦, 早川 峰司, 澤村 淳, 丸藤 哲 日本救急医学会雑誌 27 (9) 540 -540 2016年09月 [査読無し][通常論文]
  • 突然死を来たす疾患の病態と治療
    澤村 淳, 方波見 謙一, 石森 直樹, 新宮 康栄, 中山 若樹 北海道医学雑誌 91 (1) 27 -30 2016年05月 [査読無し][通常論文]
  • 重症多発外傷患者における脳脂肪塞栓症の検討
    澤村 淳, 小館 明, 定本 圭弘, 村上 博基, 水柿 明日美, 方波見 謙一, 前川 邦彦, 宮本 大輔, 小野 雄一, 和田 剛志, 早川 峰司, 丸藤 哲 日本外傷学会雑誌 30 (2) 230 -230 2016年05月 [査読無し][通常論文]
  • 丸藤 哲, 和田 剛志, 小野 雄一, 前川 邦彦, 方波見 謙一, 早川 峰司, 澤村 淳 ICUとCCU = Japanese journal of intensive care medicine : 集中治療医学 40 (3) 171 -179 2016年03月 [査読無し][通常論文]
  • 方波見 謙一, 村上 博基, 吉田 知由, 小舘 旭, 定本 圭弘, 半田 つばさ, 岩永 航, 坂東 敬介 日本集中治療医学会雑誌 23 (5) 595 -596 2016年 [査読無し]
  • 心停止後症候群における凝固線溶異常 心停止の原因による凝血学的因子の変化の相違
    和田 剛志, 丸藤 哲, 家子 正裕, 水柿 明日美, 前川 邦彦, 方波見 謙一, 小野 雄一, 早川 峰司, 澤村 淳, Jesmin Subrina 日本集中治療医学会雑誌 23 (Suppl.) 451 -451 2016年01月 [査読無し][通常論文]
  • 外傷性脳内出血症例と鑑別が困難であったAOAVMの検討
    澤村 淳, 水柿 明日美, 村上 博基, 方波見 謙一, 前川 邦彦, 小野 雄一, 宮本 大輔, 和田 剛志, 早川 峰司, 丸藤 哲 日本集中治療医学会雑誌 23 (Suppl.) 495 -495 2016年01月 [査読無し][通常論文]
  • 外傷後急性硬膜下血腫により明らかとなった急性リンパ性白血病の1例
    高宮 宗一朗, 早川 峰司, 水柿 明日美, 方波見 謙一, 宮本 大輔, 寶金 清博, 丸藤 哲 日本救急医学会雑誌 26 (10) 625 -631 2015年10月 [査読無し][通常論文]
     
    頭部外傷による急性硬膜下血腫の治療中に明らかになった急性リンパ性白血病の1例を報告する。患者は6歳の男児。頭部打撲後に嘔吐、意識障害を伴って当科に救急搬送された。搬入時、深昏睡、瞳孔不同などから頭蓋内出血を疑い、緊急気管挿管後に頭部CTを施行した。急性硬膜下血腫の診断で緊急穿頭血腫除去術および開頭血腫除去術を行った。術後経過は良好であったが、汎血球減少を認めたため骨髄生検を施行した。急性リンパ性白血病の診断となり、頭蓋形成術後に化学療法を開始し、寛解を得た。重症頭部外傷では、出血や輸血、炎症などにより採血データに修飾が加わり、受傷直後の白血病の鑑別は困難であるが、経時的な観察により感知可能である。また、頭蓋内出血を伴う白血病においては、その治療にあたり、中枢神経浸潤を考慮する必要がある。(著者抄録)
  • 亜硝酸ナトリウム中毒による重症メトヘモグロビン血症を来した1例
    定本 圭弘, 方波見 謙一, 宮本 大輔, 早川 峰司, 澤村 淳, 丸藤 哲 日本救急医学会雑誌 26 (8) 371 -371 2015年08月 [査読無し][通常論文]
  • 3D-CTA診断が可能であったクモ膜下出血症例の検討
    澤村 淳, 小舘 旭, 村上 博基, 水柿 明日美, 前川 邦彦, 方波見 謙一, 小野 雄一, 宮本 大輔, 和田 剛志, 早川 峰司, 丸藤 哲 日本救急医学会雑誌 26 (8) 383 -383 2015年08月 [査読無し][通常論文]
  • 院外心肺停止患者における病院前気道確保器具(声門上デバイス)の検討 Laryngeal Mask vs Laryngeal Tube
    小野 雄一, 小舘 旭, 定本 圭弘, 水柿 明日美, 村上 博基, 方波見 謙一, 和田 剛志, 前川 邦彦, 早川 峰司, 澤村 淳, 丸藤 哲 日本救急医学会雑誌 26 (8) 398 -398 2015年08月 [査読無し][通常論文]
  • 北海道大学病院における広範囲熱傷の治療戦略 ICUにおけるシャワー浴の工夫について
    宮本 大輔, 水柿 明日美, 方波見 謙一, 小野 雄一, 前川 邦彦, 和田 剛志, 柳田 雄一郎, 早川 峰司, 澤村 淳, 丸藤 哲 熱傷 41 (2) 98 -98 2015年06月 [査読無し][通常論文]
  • 外傷性脳内出血症例のpitfall
    澤村 淳, 水柿 明日美, 方波見 謙一, 前川 邦彦, 小野 雄一, 宮本 大輔, 和田 剛志, 柳田 雄一郎, 早川 峰司, 丸藤 哲 日本外傷学会雑誌 29 (2) 197 -197 2015年05月 [査読無し][通常論文]
  • 急性期の血漿交換療法が有効であった後天性血友病Aの一例
    水柿 明日美, 方波見 謙一, 小野 雄一, 前川 邦彦, 和田 剛志, 柳田 雄一郎, 宮本 大輔, 早川 峰司, 澤村 淳, 丸藤 哲 日本集中治療医学会雑誌 22 (Suppl.) [DP50 -3] 2015年01月 [査読無し][通常論文]
  • 和田剛志, 小林正紀, 方波見謙一, 小野雄一, 前川邦彦, 柳田雄一郎, 早川峰司, 澤村淳, 井関健, 井関健, 丸藤哲 日本集中治療医学会学術集会(Web) 42nd DO18-5 (WEB ONLY) 2015年 [査読無し][通常論文]
  • T. Wada, S. Jesmin, A. Mizugaki, K. Katabami, Y. Ono, K. Maekawa, D. Miyamoto, Y. Yanagida, M. Hayakawa, A. Sawamura, S. Gando INTENSIVE CARE MEDICINE 40 S272 -S272 2014年09月 [査読無し][通常論文]
  • 柳田雄一郎, 水柿明日美, 方波見謙一, 小野雄一, 前川邦彦, 宮本大輔, 和田剛志, 早川峰司, 澤村淳, 丸藤哲 日本救急医学会雑誌 25 (8) 457 2014年08月15日 [査読無し][通常論文]
  • 小野雄一, 水柿明日美, 方波見謙一, 前川邦彦, 宮本大輔, 和田剛志, 柳田雄一郎, 早川峰司, 澤村淳, 丸藤哲 日本救急医学会雑誌 25 (8) 395 2014年08月15日 [査読無し][通常論文]
  • 前川邦彦, 水柿明日美, 方波見謙一, 小野雄一, 和田剛志, 柳田雄一郎, 早川峰司, 澤村淳, 丸藤哲 日本救急医学会雑誌 25 (8) 477 2014年08月15日 [査読無し][通常論文]
  • 小舘旭, 方波見謙一, 水柿明日美, 小野雄一, 前川邦彦, 宮本大輔, 和田剛志, 柳田雄一郎, 早川峰司, 澤村淳, 丸藤哲 日本救急医学会雑誌 25 (8) 547 2014年08月15日 [査読無し][通常論文]
  • 澤村淳, 水柿明日美, 方波見謙一, 前川邦彦, 小野雄一, 宮本大輔, 和田剛志, 柳田雄一郎, 早川峰司, 丸藤哲 日本救急医学会雑誌 25 (8) 454 2014年08月15日 [査読無し][通常論文]
  • 村上仁志, 水柿明日美, 方波見謙一, 小野雄一, 前川邦彦, 宮本大輔, 和田剛志, 柳田雄一郎, 早川峰司, 澤村淳, 丸藤哲 日本救急医学会雑誌 25 (8) 630 2014年08月15日 [査読無し][通常論文]
  • 鈴木理穂, 方波見謙一, 佐藤朝之, 高氏修平, 斎藤智誉, 宇塚武司, 中村雅則, 渡辺祝安, 牧瀬博 日本救急医学会雑誌 25 (8) 637 2014年08月15日 [査読無し][通常論文]
  • 早川峰司, 水柿明日美, 方波見謙一, 小野雄一, 前川邦彦, 和田剛志, 柳田雄一郎, 澤村淳, 丸藤哲 日本救急医学会雑誌 25 (8) 367 2014年08月15日 [査読無し][通常論文]
  • 方波見謙一, 立花義浩, 岩永航, 村上博基, 半田つばさ, 坂東敬介, 斉藤智誉, 牧瀬博 中毒研究 27 (2) 181 2014年07月25日 [査読無し][通常論文]
  • 方波見 謙一, 相川 忠夫, 三田 法子, 半田 つばさ, 平安山 直美, 松井 俊尚, 斉藤 智誉, 牧瀬 博 日本集中治療医学会雑誌 21 (3) 289 -290 2014年05月 [査読無し][通常論文]
     
    33歳女。20日前から発熱を認め、背部痛、咳嗽を訴え、急性上気道炎の診断で経過観察となっていた。症状が改善しないため受診し、肺炎の診断でレボフロキサシンを投与した。翌日に39℃の発熱、咳嗽と背部痛の悪化を認め、CTにて肺塞栓がみつかり、緊急入院となった。血液培養からグラム陽性球菌を検出し、第2病日よりバンコマイシンを追加した。MSSAであることが判明しベンジルペニシリンに変更となった。発熱が持続し血圧低下を認めた。造影CTで、右肺動脈の塞栓と両肺に空洞を伴う膿瘍を認めた。経胸壁心エコーでは、三尖弁中隔尖に10mmを超える疣腫を認めた。経食道心エコーでは、三尖弁逆流も認めた。詳細な病歴を聴取したところ、覚醒剤の使用歴が判明した。第8病臼に三尖弁形成術を施行した。第33病日には退院し外来通院となった。
  • 方波見謙一, 平安山直美, 佐藤朝之, 立花義浩 日本プライマリ・ケア連合学会学術大会抄録集 5th 233 2014年 [査読無し][通常論文]
  • 方波見謙一, 相川忠夫, 三田法子, 半田つばさ, 平安山直美, 松井俊尚, 斉藤智誉, 牧瀬博 日本集中治療医学会雑誌(Web) 21 (3) 289-290 (J-STAGE) -290 2014年 [査読無し][通常論文]
  • 村上博基, 高氏修平, 方波見謙一, 立花義浩, 斎藤智誉, 牧瀬博 日本集中治療医学会学術集会(Web) 41st WEB ONLY DP-44-1 2014年 [査読無し][通常論文]
  • 加藤喜哉, 高氏修平, 方波見謙一, 遠藤晃生, 松井俊尚, 佐藤朝之, 岡田昌生, 鹿野恒, 斎藤智誉, 牧瀬博 日本集中治療医学会学術集会(Web) 41st WEB ONLY O-11-6 2014年 [査読無し][通常論文]
  • 高氏修平, 方波見謙一, 坂東敬介, 遠藤晃生, 松井俊尚, 佐藤朝之, 岡田昌生, 鹿野恒, 斎藤智誉, 牧瀬博 日本集中治療医学会学術集会(Web) 41st (Suppl.) DP-147-4 (WEB ONLY) -4] 2014年 [査読無し][通常論文]
  • 方波見謙一, 牧瀬博, 斉藤智誉, 鹿野恒, 岡田昌生, 佐藤朝之, 提嶋久子, 松井俊尚, 遠藤晃生, 高氏修平, 平安山直美 日本救急医学会雑誌 24 (8) 584 2013年08月15日 [査読無し][通常論文]
  • 平安山直美, 方波見謙一, 松井俊尚, 山崎圭, 佐藤朝之, 斉藤智誉, 鹿野恒, 牧瀬博 日本集中治療医学会雑誌 20 (Supplement) 429 2013年01月25日 [査読無し][通常論文]
  • 三田法子, 斉藤智誉, 方波見謙一, 松田知倫, 坂東敬介, 平安山直美, 提嶋久子, 佐藤朝之, 山崎圭, 牧瀬博 日本集中治療医学会雑誌 20 (Supplement) 302 2013年01月25日 [査読無し][通常論文]
  • 奥田謙一, 村上博基, 方波見謙一, 下嶋秀和 日本救急医学会雑誌 23 (10) 509 2012年10月15日 [査読無し][通常論文]
  • 向井信貴, 早川峰司, 方波見謙一, 澤村淳, 北川真吾, 丸藤哲 日本外傷学会雑誌 26 (2) 248 2012年04月20日 [査読無し][通常論文]
  • 中橋 奨, 早川 峰司, 方波見 謙一, 和田 剛志, 澤村 淳, 石川 岳彦, 丸藤 哲 日本集中治療医学会雑誌 = Journal of the Japanese Society of Intensive Care Medicine 19 (2) 191 -196 2012年04月01日
  • 中橋奨, 早川峰司, 方波見謙一, 和田剛志, 澤村淳, 石川岳彦, 丸藤哲 日本集中治療医学会雑誌 19 (2) 191 -196 2012年04月01日 [査読無し][通常論文]
     
    【目的】Intrapulmonary percussive ventilation(IPV)は,急性呼吸不全の血液ガス改善に優れるとされているが,その主要因は明らかでない。そこで本研究では,IPVの効果をpercussionを伴わないPEEPと比較した。【方法】対象は人工呼吸管理を受けている急性呼吸不全患者8例で,「synchronized intermittent mandatory ventilation(SIMV)+PEEP」モードに,IPVによるpercussion圧を重畳した換気法(IPV法)と,PEEPを追加上昇させた換気法(PEEP法)でクロスオーバー法対照試験を行った。【結果】P/F比の改善は両換気法で差がなかったが,PaCO2と1回換気量の改善はIPV法がPEEP法より優れていた。【結論】IPVのガス交換改善効果は単純な気道内圧上昇によるものではなく,percussion作用が影響していると考えられた。
  • 泉健太郎, 阿部理一郎, 方波見謙一, 守内玲寧, 浜坂明日香, 阿部由紀子, 清水宏, 川村邦子 日本皮膚科学会雑誌 121 (14) 3363 2011年12月20日 [査読無し][通常論文]
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  • 水野谷和之, 丸山崇, 藤田憲明, 方波見謙一, 伊藤綾希子, 伊部博行, 中村高士, 下嶋秀和, 雨森英彦 日本集中治療医学会雑誌 18 (Supplement) 322 2011年01月24日 [査読無し][通常論文]
  • 向井信貴, 早川峰司, 方波見謙一, 澤村淳, 丸藤哲 日本救急医学会雑誌 21 (8) 476 2010年08月15日 [査読無し][通常論文]
  • 方波見謙一, 澤村淳, 三浪陽介, 和田剛志, 菅野正寛, 下嶋秀和, 久保田信彦, 上垣慎二, 早川峰司, 丸藤哲 北海道外科雑誌 55 (1) 91 2010年06月20日 [査読無し][通常論文]
  • 三浪陽介, 方波見謙一, 和田剛, 菅野正寛, 上垣慎二, 下嶋秀和, 早川峰司, 澤村淳, 丸藤哲 熱傷 36 (2) 109 2010年06月15日 [査読無し][通常論文]
  • 和田剛志, 澤村淳, 方波見謙一, 菅野正寛, 久保田信彦, 早川峰司, 丸藤哲 ICUとCCU 34 (3) 243 -247 2010年03月10日 [査読無し][通常論文]
  • 方波見謙一, 三浪陽介, 和田剛志, 菅野正寛, 下嶋秀和, 上垣慎二, 久保田信彦, 早川峰司, 澤村淳, 丸藤哲 日本集中治療医学会雑誌 17 (Supplement) 320 2010年01月31日 [査読無し][通常論文]
  • 和田剛志, 方波見謙一, 三浪陽介, 菅野正寛, 下嶋秀和, 久保田信彦, 上垣慎二, 早川峰司, 澤村淳, 丸藤哲 日本集中治療医学会雑誌 17 (Supplement) 311 2010年01月31日 [査読無し][通常論文]
  • 澤村淳, 三浪陽介, 方波見謙一, 和田剛志, 菅野正寛, 下嶋秀和, 上垣慎二, 久保田信彦, 早川峰司, 丸藤哲 日本集中治療医学会雑誌 17 (Supplement) 270 2010年01月31日 [査読無し][通常論文]
  • 下嶋秀和, 丸藤哲, 澤村淳, 早川峰司, 上垣慎二, 久保田信彦, 菅野正寛, 和田剛志, 三浪陽介, 方波見謙一 日本集中治療医学会雑誌 17 (Supplement) 302 2010年01月31日 [査読無し][通常論文]
  • 中橋奨, 早川峰司, 方波見謙一, 和田剛志, 菅野正寛, 澤村淳, 石川岳彦, 丸藤哲 日本呼吸療法医学会学術総会プログラム・抄録集 32nd 156 2010年 [査読無し][通常論文]
  • 和田剛志, 澤村淳, 方波見謙一, 菅野正寛, 早川峰司, 丸藤哲 日本救急医学会雑誌 21 (9) 799-803 (J-STAGE) -803 2010年 [査読無し][通常論文]
     
    症例は21歳の男性。バイクで走行中,右折してきた乗用車と衝突し受傷した。搬入後のバイタルサインは安定していたが,腹部造影CTで後腹膜出血と第4腰椎椎体レベルで腰動脈損傷と思われる造影剤の血管外漏出像を認めた。翌日のフォローアップの造影CTでは,第4腰動脈の偽性動脈瘤と思われる増強効果を認めた。同日血管造影が行われ,左右第4腰動脈共通幹部に造影剤の貯留を認めたが,腹部大動脈からの距離が不十分であり,interventional radiology(IVR)による治療が困難であった。年齢など患者背景を考え治療方針を検討し,開腹手術での治療を行うこととした。術中所見としては,血管造影所見同様,第4腰動脈起始部は大動脈から引き抜かれた状態であった。腰動脈根部の大動脈を直接修復して手術を終了した。腰動脈損傷は腎生検や腰椎手術時など医原性に起こることが知られている。外傷においては腰椎骨折や骨盤骨折に合併した偽性腰動脈瘤の報告は多いが,腰動脈の引き抜き損傷に続発した偽性腰動脈瘤の報告は我々が検索し得た範囲では存在しない。腰動脈が大動脈から引き抜かれることにより腰動脈根部に生じた偽性腰動脈瘤はIVRが困難であり,年齢などを考慮した慎重な治療法の検討が必要であると思われた。
  • Kenichi Katabami, Takahiro Yamada, Mineji Hayakawa, Hisanori Minakami, Satoshi Gando CRITICAL CARE MEDICINE 37 (12) A519 -A519 2009年12月 [査読無し][通常論文]
  • M. Hayakawa, T. Wada, K. Katabami, M. Sugano, N. Henzan, H. Hoshino, A. Sawamura, S. Gando INTENSIVE CARE MEDICINE 35 10 -10 2009年09月 [査読無し][通常論文]
  • 早川峰司, 方波見謙一, 三浪陽介, 和田剛志, 菅野正寛, 下嶋秀和, 久保田信彦, 上垣慎二, 澤村淳, 丸藤哲 日本救急医学会雑誌 20 (8) 506 2009年08月15日 [査読無し][通常論文]
  • 和田剛志, 澤村淳, 方波見謙一, 三浪陽介, 菅野正寛, 下嶋秀和, 久保田信彦, 上垣慎二, 早川峰司, 丸藤哲 日本救急医学会雑誌 20 (8) 479 2009年08月15日 [査読無し][通常論文]
  • 澤村淳, 方波見謙一, 三浪陽介, 和田剛志, 菅野正寛, 下嶋秀和, 上垣慎二, 久保田信彦, 早川峰司, 丸藤哲 日本救急医学会雑誌 20 (8) 527 2009年08月15日 [査読無し][通常論文]
  • 方波見謙一, 三浪陽介, 和田剛志, 菅野正寛, 下嶋秀和, 久保田信彦, 上垣慎二, 早川峰司, 澤村淳, 丸藤哲 日本救急医学会雑誌 20 (8) 689 2009年08月15日 [査読無し][通常論文]
  • 菅野正寛, 澤村淳, 方波見謙一, 和田剛志, 平安山直美, 久保田信彦, 星野弘勝, 早川峰司, 石川岳彦, 丸藤哲 北海道外科雑誌 54 (1) 78 -79 2009年06月20日 [査読無し][通常論文]
  • 方波見謙一, 早川峰司, 和田剛志, 菅野正寛, 平安山直美, 久保田信彦, 星野弘勝, 澤村淳, 石川岳彦, 丸藤哲 北海道外科雑誌 54 (1) 81 2009年06月20日 [査読無し][通常論文]
  • 方波見謙一, 早川峰司, 和田剛志, 菅野正寛, 平安山直美, 久保田信彦, 星野弘勝, 澤村淳, 丸藤哲 日本外傷学会雑誌 23 (2) 201 2009年04月20日 [査読無し][通常論文]
  • 和田剛志, 澤村淳, 方波見謙一, 菅野正寛, 平安山直美, 久保田信彦, 星野弘勝, 早川峰司, 丸藤哲 日本外傷学会雑誌 23 (2) 201 2009年04月20日 [査読無し][通常論文]
  • 早川峰司, 方波見謙一, 和田剛志, 澤村淳, 丸藤哲 日本外傷学会雑誌 23 (2) 162 2009年04月20日 [査読無し][通常論文]
  • 平安山直美, 早川峰司, 方波見謙一, 和田剛司, 菅野正寛, 久保田信彦, 星野弘勝, 澤村淳, 丸藤哲 日本外傷学会雑誌 23 (2) 205 2009年04月20日 [査読無し][通常論文]
  • 丸藤哲, 澤村淳, 早川峰司, 久保田信彦, 平安山直美, 菅野正寛, 和田剛志, 方波見謙一 救急医学 33 (3) 311 -315 2009年03月10日 [査読無し][通常論文]
  • 中橋奨, 早川峰司, 方波見謙一, 和田剛志, 菅野正寛, 平安山直美, 星野弘勝, 澤村淳, 石川岳彦, 丸藤哲 日本集中治療医学会雑誌 16 (Supplement) 251 2009年01月20日 [査読無し][通常論文]
  • 飯谷麻里, 青柳哲, 方波見謙一, 本間英里奈, 猪熊大輔, 清水宏 日本皮膚科学会雑誌 119 (1) 82 2009年01月20日 [査読無し][通常論文]
  • 剱持靖子, 阿部理一郎, 方波見謙一, 浜坂明日香, 阿部由紀子, 清水宏, 中村準之助 日本皮膚科学会雑誌 119 (1) 76 2009年01月20日 [査読無し][通常論文]
  • 早川峰司, 方波見謙一, 和田剛志, 菅野正寛, 平安山直美, 久保田信彦, 星野弘勝, 澤村淳, 丸藤哲 日本集中治療医学会雑誌 16 (Supplement) 162 2009年01月20日 [査読無し][通常論文]
  • 和田剛志, 澤村淳, 方波見謙一, 菅野正寛, 平安山直美, 久保田信彦, 星野弘勝, 早川峰司, 石川岳彦, 丸藤哲 日本集中治療医学会雑誌 16 (Supplement) 301 2009年01月20日 [査読無し][通常論文]
  • 澤村淳, 方波見謙一, 和田剛志, 菅野正寛, 平安山直美, 久保田信彦, 星野弘勝, 早川峰司, 石川岳彦, 丸藤哲 日本集中治療医学会雑誌 16 (Supplement) 224 2009年01月20日 [査読無し][通常論文]
  • 丸藤哲, 澤村淳, 早川峰司, 星野弘勝, 久保田信彦, 平安山直美, 菅野正寛, 和田剛志, 方波見謙一 日本救急医学会雑誌 20 (1) 1 -15 2009年01月15日 [査読無し][通常論文]
     
    出血傾向・血栓傾向を呈する病態,各種凝固線溶療法,血液浄化装置・補助体外循環装置等,血小板・凝固線溶系モニタリングが要求される疾患・病態,治療法,そして医療機器が救急集中治療域では数多い。このように救急集中治療に携わる医師にとり,血栓止血学の知識とその理解に基づく血小板・凝固線溶系モニタリングは,救急疾患や重症病態の診断とそれらの集中治療の実践に必須である。本稿では血小板・凝固線溶系モニタリングが必要な病態,治療法,医療機器を述べ,それらに使用される血小板,凝固線溶系モニタリングと機器を使用したモニタリングの実際を解説した。
  • Mineji Hayakawa, Kenichi Katabami, Takeshi Wada, Masahiro Sugano, Naomi Henzan, Nobuhiko Kubota, Hirokatsu Hoshino, Atsushi Sawamura, Satoshi Gando CRITICAL CARE MEDICINE 36 (12) A142 -A142 2008年12月 [査読無し][通常論文]
  • Mineji Hayakawa, Naomi Henzan, Kenichi Katabami, Takeshi Wada, Masahiro Sugano, Nobuhiko Kubota, Horokatsu Hoshino, Atsushi Sawamura, Satoshi Gando CRITICAL CARE MEDICINE 36 (12) A111 -A111 2008年12月 [査読無し][通常論文]
  • 飯谷麻里, 青柳哲, 方波見謙一, 本間英里奈, 猪熊大輔, 清水宏 日本皮膚科学会雑誌 118 (11) 2256 2008年10月20日 [査読無し][通常論文]
  • 澤村淳, 方波見謙一, 和田剛志, 菅野正寛, 平安山直美, 久保田信彦, 星野弘勝, 早川峰司, 石川岳彦, 丸藤哲 日本外科感染症学会雑誌 5 (5) 594 2008年10月05日 [査読無し][通常論文]
  • 剱持靖子, 阿部理一郎, 方波見謙一, 浜坂明日香, 阿部由紀子, 中村準之助, 清水宏 皮膚科の臨床 50 (10) 1207 -1211 2008年10月01日 [査読無し][通常論文]
  • 和田剛志, 早川峰司, 方波見謙一, 菅野正寛, 平安山直美, 久保田信彦, 星野弘勝, 澤村淳, 丸藤哲 日本救急医学会雑誌 19 (8) 566 2008年08月15日 [査読無し][通常論文]
  • 方波見謙一, 早川峰司, 和田剛志, 菅野正寛, 平安山直美, 久保田信彦, 星野弘勝, 澤村淳, 石川岳彦, 丸藤哲 日本救急医学会雑誌 19 (8) 629 2008年08月15日 [査読無し][通常論文]
  • 中田 麻子, 方波見 謙一, 和田 剛志, 菅野 正寛, 平安山 直美, 久保田 信彦, 星野 弘勝, 早川 峰司, 澤村 淳, 丸藤 哲 日本救急医学会雑誌 19 (8) 668 -668 2008年08月 [査読無し][通常論文]
  • 方波見謙一, 青柳哲, 本間英里奈, 秦洋郎, 猪熊大輔, 阿部由紀子, 清水宏, 渡辺宏数, 田村あゆみ, 柴田雅彦 西日本皮膚科 70 (3) 349 -350 2008年06月01日 [査読無し][通常論文]
  • 剱持靖子, 阿部理一郎, 方波見謙一, 浜坂明日香, 阿部由紀子, 中村準之助, 清水宏 J Environ Dermatol Cutan Allergol 1 (Suppl.1) 147 2007年12月 [査読無し][通常論文]

講演・口頭発表等

  • 札幌市ドクターカーにおける気道異物による窒息心肺停止症例の検討  [通常講演]
    方波見 謙一
    第42回日本救急医学会・学術集会 2014年02月 口頭発表(一般)
  • A Case of Group A Streptococcal Infection In Late Pregnancy  [通常講演]
    方波見 謙一
    Society of Critical Care Medicine 2010年 口頭発表(一般)
  • 冷却持続血液透析治療により良好な転帰を得た重症熱中症の1例  [通常講演]
    方波見 謙一
    第25回急性循環不全研究会 2010年 口頭発表(一般)
  • 妊婦劇症型A群溶血性連鎖球菌感染症の1例  [通常講演]
    方波見 謙一
    第38回日本救急医学会・学術集会 2010年 口頭発表(一般)
  • The response of antithrombin Ⅲ activity after supplementation decreases in proportion to the severity of sepsis and liver dysfunction  [通常講演]
    Kenichi Katabami
    Society of Critical Care Medicine 2009年 口頭発表(一般)
  • 指摘されていなかった過去の右横隔膜ヘルニアに嵌頓した肝挫傷の1例  [通常講演]
    方波見 謙一
    第23回日本外傷学会総会・学術集会 2009年 口頭発表(一般)
  • 速乾性摩擦式手指消毒剤ウェルパス(R)誤飲により食道炎を併発した1例  [通常講演]
    方波見 謙一
    第37回日本救急医学会・学術集会 2009年 口頭発表(一般)
  • Imbalance between macrophage migration inhibitory factor and cortisol induces multiple organ dysfunction in patients with blunt trauma  [通常講演]
    方波見 謙一
    The American Association for the Surgery of Trauma 2008年 口頭発表(一般)
  • 左臀部ガス壊疽の1症  [通常講演]
    方波見 謙一
    第36回日本救急医学会総会・学術集会 2008年 口頭発表(一般)

共同研究・競争的資金等の研究課題

  • 日本学術振興会:科学研究費助成事業
    研究期間 : 2022年04月 -2027年03月 
    代表者 : 村上 壮一, 土佐 紀子, 方波見 謙一, 倉島 庸, 平野 聡, 本間 宙, 七戸 俊明, 伊澤 祥光
     
    2022年度は、『一般外科医のための外傷診療DCRトレーニングコース』試行、および、ボランティア外科医の募集と外傷診療データ集積の開始を目標としており、特に後者については、北海道内の救命救急センター12病院とこれに準ずる5病院、救命救急センターの設置地域で外傷を受け入れている23病院、救命救急センター設置のない地域で外傷を受け入れている20病院の3群に分け、それぞれ10病院より最低1名ずつを目標にボランティア外科医を募集する予定であった。しかしCOVID-19流行継続により各病院の業務量が増加したこと、またボランティア外科医のタスクである外傷診療トレーニングコース受講が病院の規定で禁止となった事から進められない状況であった。このため研究を前者に集中、大規模な集合研修が出来ない状況でも個別にトレーニングを行える教育プログラムの開発に絞り実施した。具体的には腹部のダメージコントロール手術に絞った教育プログラムを開発、これに適した持ち運び可能なシミュレーターを新規作成し、これをボランティア外科医の元に持参し教育を行う事で、プログラムの有用性を科学的に検証した。その有用性は際立っており、この研究結果は2023年4月13-16日に米国サンディアゴで開催されるAssociation for Surgical Education (ASE) 2023 Annual Meeting、および4月27-29日に東京で開催される日本外科学会定期学術集会のシンポジウムにおいて公表する予定である。またASEの演題がacceptされた時点でGlobal Surgical Education誌に掲載される事が決まっており、近日同誌で公表予定である。なお使用したシミュレーターについては現在特許申請中であり、その開発経緯は第14回日本Acute Care Surgery学会において公表した。


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