2015年07月, 日本呼吸療法医学会, 日本呼吸療法医学会奨励論文賞　　　　　　　　　　　　　　　

2014年07月, 日本呼吸療法医学会, 日本呼吸療法医学会奨励論文賞　　　　　　　　　　　　　　　

Intensive care with endovascular catheter rewarming for accidental severe hypothermia (ICE-CRASH II): a protocol for a randomised controlled study.
Shuhei Takauji, Mineji Hayakawa, Shoji Yokobori, Hitoshi Kano, Keiki Shimizu, Yuichi Horikoshi, Junya Shimazaki, Jotaro Tachino, Akihiko Inoue, Taiki Moriyama, Hirotaka Sawano, Hidetada Fukushima, Kana Sugiyama, Daiki Sunada, Takashi Toyohara, Keigo Sawamoto, Shutaro Isokawa, Miki Morikawa, Ginga Suzuki, Noriyuki Omura, Kazunari Takeda, Tomohiro Inoue, Tian Tian, Fumiko Nakamura, Yoshihiro Nakamura, Yukitoshi Toyoda, Akihito Tampo, Yoshihiro Hagiwara, Daisuke Kudo, Norihiro Miyasaka, Tomohiro Morito, Makoto Kobayashi, Kazuto Ohtaka, Yusuke Watanabe, Tsuyoshi Maekawa, Takeshi Wada
BMJ open, 15, 9, e104625, 2025年09月16日, ［国際誌］
英語, 研究論文（学術雑誌）, INTRODUCTION: Accidental hypothermia (AH) can occur in mild-to-severe cases; however, its management is crucial in severe cases as it can cause ventricular fibrillation and lead to death. Among various rewarming therapies for AH, endovascular catheter rewarming has been the focus of recent studies as a minimally invasive alternative to invasive internal rewarming, such as extracorporeal membrane oxygenation (ECMO). However, no study has demonstrated the efficacy and safety of endovascular catheter rewarming therapy. This study aimed to validate the efficacy and safety of endovascular catheter rewarming for patients with AH. METHODS AND ANALYSES: The intensive care with endovascular catheter rewarming in accidental severe hypothermia (ICE-CRASH II) study is a multicentre, randomised study of patients with AH. This study will include patients with AH (age ≥65 years, core temperature <30°C) with preserved circulation and a target sample size of 88. Patients with cardiac arrest (CA), those who have undergone hospital transfers, and those in whom a central venous catheter could not be accessed through the femoral vein will be excluded from the study. Patients will be assigned to either the endovascular catheter plus conventional rewarming group or the conventional rewarming group based on stratified-substitution block randomisation. Patients will be followed up for 30 days after the initiation of the intervention or until discharge. The primary outcome will be to compare the percentage of patients achieving a rewarming rate ≥1.5°C/hour between the endovascular catheter plus conventional rewarming group and the conventional rewarming group. ETHICS AND DISSEMINATION: This study was approved by the Hokkaido University Certified Review Board (approval number: 024-00013). Written informed consent will be obtained from all the participants or their legally acceptable representatives. The results will be disseminated through publications and presentations. TRIAL REGISTRATION NUMBER: Japan Registry of Clinical Trials (jRCT1012240051).

Heat stroke-induced hepatic lipid dysregulation: histological and lipidomic insights.
Takahiro Deguchi, Hiroki Tanaka, Kie Horioka, Chihiro Matsuhisa, Akira Hayakawa, Shuhei Takauji, Shimpei Watanabe, Masanori Goto, Yumiko Fujii, Kumi Takasawa, Akira Takasawa
Medical molecular morphology, 2025年07月02日, ［国内誌］
英語, 研究論文（学術雑誌）, Global warming has increased summer temperatures, leading to a rise in heat stroke-related deaths in Japan. Heat stroke disrupts the body's adaptation to high temperatures, often resulting in severe complications, including liver damage and even death. However, despite the increasing incidence, pathological autopsies remain rare, and the histological changes associated with heat stroke are poorly understood. In this study, we investigated the pathogenesis of heat stroke using a mouse model. Mice were exposed to 45 °C for 30 min and dissected immediately or 24, 48, and 72 h post-exposure. Histological analysis revealed significant lipid accumulation in hepatocytes surrounding the central vein at 24, 48, and 72 h. At 24 h, hepatocytes also exhibited features of early degeneration, including cytoplasmic lysis and chromatin condensation. Lipidomics analysis of liver tissue collected 24 h post-exposure demonstrated a marked increase in 27-hydroxycholesterol levels. These results indicate that heat stress rapidly disrupts hepatic lipid homeostasis, causing cellular damage and metabolic remodeling. The observed lipid accumulation, including elevated 27-hydroxycholesterol, may play dual roles in mediating inflammation and serving as a protective response. Our findings provide new insight into the pathogenesis of heat stroke-induced liver injury and suggest potential molecular targets for early diagnosis and intervention.

Association Between Rewarming Rate and Survival and Neurologic Outcome of Accidental Hypothermia.
Chiaki Hara, Takuya Taira, Akihiko Inoue, Takeshi Nishimura, Shota Kikuta, Nobuhiro Yamamoto, Shinichi Ijuin, Shuhei Takauji, Mineji Hayakawa, Satoshi Ishihara
Critical care medicine, 53, 7, e1416-e1425, 2025年07月01日, ［国際誌］
英語, 研究論文（学術雑誌）, OBJECTIVES: Accidental hypothermia has high mortality. Rewarming is the initial primary management strategy. However, detailed evidence on rewarming management is limited, that is, rewarming rate is unclear, particularly with noncardiac arrest. Here, we evaluated the association between rewarming rate in the early phase of rewarming and survival and neurologic outcomes in patients with accidental hypothermia. DESIGN: A secondary analysis of a nationwide, multicenter, prospective, observational study-the Intensive Care with ExtraCorporeal membrane oxygenation Rewarming in Accidentally Severe Hypothermia (ICE-CRASH) study-including adult patients admitted with moderate-to-severe accidental hypothermia between 2019 and 2022. SETTING: Emergency medical facilities in Japan ( n = 36). PATIENTS: Patients whose body temperature less than 32°C on arrival at the emergency department. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The early phase of rewarming was defined as the time from arrival at the emergency department to achieving a body temperature of 33°C. Primary and secondary outcomes included 28-day survival after admission and favorable neurologic status at discharge (Cerebral Performance Category score of 1-2). The median rewarming rates in the early phase was 1.35°C/hr (interquartile range, 0.91-2.03°C/hr). Overall, the 28-day survival rate was 82.0% ( n = 324), and the proportion of favorable neurologic outcome was 66.6% ( n = 263). Multivariable logistic regression analysis showed that the rewarming rate was significantly associated with 28-day survival and favorable neurologic outcomes in the early phase (odds ratio [OR], 1.51; 95% CI, 1.10-2.09; p = 0.011 and OR, 1.32; 95% CI, 1.06-1.64; p = 0.015). CONCLUSIONS: In the early phase, the rewarming rate was associated with survival and favorable neurologic outcomes.

The Japanese Critical Care Nutrition Guideline 2024.
Kensuke Nakamura, Ryo Yamamoto, Naoki Higashibeppu, Minoru Yoshida, Hiroomi Tatsumi, Yoshiyuki Shimizu, Hiroo Izumino, Taku Oshima, Junji Hatakeyama, Akira Ouchi, Rie Tsutsumi, Norihiko Tsuboi, Natsuhiro Yamamoto, Ayumu Nozaki, Sadaharu Asami, Yudai Takatani, Kohei Yamada, Yujiro Matsuishi, Shuhei Takauji, Akihito Tampo, Yusuke Terasaka, Takeaki Sato, Saiko Okamoto, Hideaki Sakuramoto, Tomoka Miyagi, Keisei Aki, Hidehito Ota, Taro Watanabe, Nobuto Nakanishi, Hiroyuki Ohbe, Chihiro Narita, Jun Takeshita, Masano Sagawa, Takefumi Tsunemitsu, Shinya Matsushima, Daisuke Kobashi, Yorihide Yanagita, Shinichi Watanabe, Hiroyasu Murata, Akihisa Taguchi, Takuya Hiramoto, Satomi Ichimaru, Muneyuki Takeuchi, Joji Kotani
Journal of intensive care, 13, 1, 18, 18, 2025年03月21日, ［国際誌］
英語, 研究論文（学術雑誌）, Nutrition therapy is important in the management of critically ill patients and is continuously evolving as new evidence emerges. The Japanese Critical Care Nutrition Guideline 2024 (JCCNG 2024) is specific to Japan and is the latest set of clinical practice guidelines for nutrition therapy in critical care that was revised from JCCNG 2016 by the Japanese Society of Intensive Care Medicine. An English version of these guidelines was created based on the contents of the original Japanese version. These guidelines were developed to help health care providers understand and provide nutrition therapy that will improve the outcomes of children and adults admitted to intensive care units or requiring intensive care, regardless of the disease. The intended users of these guidelines are all healthcare professionals involved in intensive care, including those who are not familiar with nutrition therapy. JCCNG 2024 consists of 37 clinical questions and 24 recommendations, covering immunomodulation therapy, nutrition therapy for special conditions, and nutrition therapy for children. These guidelines were developed in accordance with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system by experts from various healthcare professionals related to nutrition therapy and/or critical care. All GRADE-based recommendations, good practice statements (GPS), future research questions, and answers to background questions were finalized by consensus using the modified Delphi method. Strong recommendations for adults include early enteral nutrition (EN) within 48 h and the provision of pre/synbiotics. Weak recommendations for adults include the use of a nutrition protocol, EN rather than parenteral nutrition, the provision of higher protein doses, post-pyloric EN, continuous EN, omega-3 fatty acid-enriched EN, the provision of probiotics, and indirect calorimetry use. Weak recommendations for children include early EN within 48 h, bolus EN, and energy/protein-dense EN formulas. A nutritional assessment is recommended by GPS for both adults and children. JCCNG 2024 will be disseminated through educational activities mainly by the JCCNG Committee at various scientific meetings and seminars. Since studies on nutritional treatment for critically ill patients are being reported worldwide, these guidelines will be revised in 4 to 6 years. We hope that these guidelines will be used in clinical practice for critically ill patients and in future research.

Indications for extracorporeal membrane oxygenation in older adult patients with accidental hypothermia and hemodynamic instability
Shuhei Takauji, Mineji Hayakawa, Ryo Yamamoto
BMC Emergency Medicine, 25, 1, Springer Science and Business Media LLC, 2025年03月13日, ［査読有り］, ［筆頭著者］
研究論文（学術雑誌）

FATP1-mediated fatty acid uptake in renal tubular cells as a countermeasure for hypothermia
KIE HORIOKA, Hiroki Tanaka, Shimpei Watanabe, Shinnosuke Yamada, Shuhei Takauji, Akira Hayakawa, Shotaro Isozaki, Keisuke Okaba, Namiko Ishii, Ayumi Motomura, Hiroyuki Inoue, Lynda Addo, Daisuke Yajima, Yoichiro Takahashi, Henrik Druid, Lasse Pakanen, Katja Porvari
Journal of molecular medicine, 2025年03月05日
英語, 研究論文（学術雑誌）,
Abstract
Hypothermia is a condition in which body temperature falls below 35 °C, resulting from exposure to low environmental temperatures or underlying medical conditions. Postmortem examinations have revealed increased levels of fatty acids in blood and lipid droplet formation in renal tubules during hypothermia. However, the causes and implications of these findings are unclear. This study aimed to analyze the biological significance of these phenomena through lipidomics and transcriptomics analyses of specimens from emergency hypothermia patients and mouse hypothermia models. Both human hypothermia patients and murine models exhibited elevated plasma concentrations of fatty acids and their derivatives compared with controls. Hypothermic mouse kidneys displayed lipid droplet formation, with gene expression analysis revealing enhanced fatty acid uptake and β-oxidation in renal tubular cells. In primary cultured mouse renal proximal tubular cells, low temperatures increased the expression levels of Fatty acid transport protein 1 (FATP1), a fatty acid transporter, and boosted oxygen consumption via β-oxidation. Mice treated with FATP1 inhibitors showed a more rapid decrease in body temperature upon exposure to low temperatures compared with untreated mice. In conclusion, increased fatty acid uptake mediated by FATP1 in renal tubular cells plays a protective role during hypothermia.


Key messages



Low temperatures increase FATP1 expression and fatty acid uptake in renal proximal tubular cells, resulting in enhanced β-oxidation.


Renal proximal tubular cells play an important role in the resistance to hypothermia via lipid uptake.


Maintaining renal lipid metabolism is essential for cold stress adaptation.

The feasibility of point-of-care testing for initial urinary liver fatty acid-binding protein to estimate severity in severe heatstroke.
Shoji Yokobori, Junya Shimazaki, Hitoshi Kaneko, Hideki Asai, Jun Kanda, Shuhei Takauji, Eiichi Sato, Ryo Ichibayashi, Motoki Fujita, Shinichiro Shiraishi, Keiki Shimizu, Hiroyuki Yokota
Scientific reports, 15, 1, 5255, 5255, 2025年02月12日, ［国際誌］
英語, 研究論文（学術雑誌）, Rapid assessment of severity is crucial for timely intervention and improved patient outcomes in heatstroke (HS). However, existing biomarkers are limited in their accuracy and accessibility in ER settings. A prospective pilot study was conducted to assess urinary liver fatty acid-binding protein (L-FABP) levels using a point-of-care testing (POCT) upon HS. Severity was estimated using initial Sequential Organ Failure Assessment (SOFA) scores, and outcomes were measured using modified Rankin Scale (mRS) scores. In 78 severe HS patients, semi-quantitative L-FABP measurements were performed in ER and patients were divided as P-group (positive group, L-FABP ≧ 12.5 ng/mL on POCT) and N-group (negative group: L-FABP < 12.5ng/mL, on POCT). urinary L-FABP concentrations were also measured on admission, with a median concentration of 48.3 ng/mL. The positive correlation was observed between urinary L-FABP concentration and pulse rate (r = 0.300, P < 0.01) and lactate (r = 0.259, P < 0.01). The POCT of L-FABP showed promise in predicting severity, as indicated by higher concentrations in patients with higher initial SOFA scores. Furthermore, the comparison between semi-quantitative POCT measurements and urine concentrations of L-FABP measured by enzyme-linked immunosorbent assay (ELISA) revealed significant differences among three POCT groups (POC Range < 12.5 ng/ml, 12.6-100 ng/ml, and 55 > 100 ng/ml, P = 0.001). Additionally, patients in the POCT positive group had significantly worse outcomes at discharge compared to the negative group, although this difference diminished over time. The study demonstrates the feasibility and potential utility of POCT for initial L-FABP in estimating severity in HS patients. This rapid and accessible testing method may aid in early field triage and intervention, ultimately improving patient outcomes in the management of HS.

Effects of rewarming therapies on outcomes in accidental hypothermia: A secondary analysis of a multicenter prospective study
Kana Sugiyama, Osamu Nomura, Jin Irie, Yoshiya Ishizawa, Shuhei Takauji, Mineji Hayakawa, Yoshinori Tamada, Hiroyuki Hanada
The American Journal of Emergency Medicine, 2024年02月26日, ［査読有り］
英語, 研究論文（学術雑誌）

Variation in coagulation factor activity levels cause discrepancies between activated partial thromboplastin time and anti-Xa activity for heparin monitoring: a retrospective observational study
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, Springer Science and Business Media LLC, 2023年11月16日
研究論文（学術雑誌）, 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.

Hyperoxia for accidental hypothermia and increased mortality: a post-hoc analysis of a multicenter prospective observational study.
Ryo Yamamoto, Jo Yoshizawa, Shuhei Takauji, Mineji Hayakawa, Junichi Sasaki
Critical care (London, England), 27, 1, 131, 131, 2023年04月01日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Supraphysiologic oxygen administration causes unfavorable clinical outcomes in various diseases, including traumatic brain injury, post-cardiac arrest syndrome, and acute lung injury. Accidental hypothermia is a critical illness that reduces oxygen demands, and excessive oxygen is likely to emerge. This study aimed to determine whether hyperoxia would be associated with increased mortality in patients with accidental hypothermia. METHODS: A post-hoc analysis of a nationwide multicenter prospective observational study (ICE-CRASH study) on patients with accidental hypothermia admitted in 2019-2022 was conducted. Adult patients without cardiac arrest whose core body temperature was < 32 °C and whose arterial partial pressure of oxygen (PaO2) was measured at the emergency department were included. Hyperoxia was defined as a PaO2 level of 300 mmHg or higher, and 28-day mortality was compared between patients with and without hyperoxia before rewarming. Inverse probability weighting (IPW) analyses with propensity scores were performed to adjust patient demographics, comorbidities, etiology and severity of hypothermia, hemodynamic status and laboratories on arrival, and institution characteristics. Subgroup analyses were conducted according to age, chronic cardiopulmonary diseases, hemodynamic instability, and severity of hypothermia. RESULTS: Of the 338 patients who were eligible for the study, 65 had hyperoxia before rewarming. Patients with hyperoxia had a higher 28-day mortality rate than those without (25 (39.1%) vs. 51 (19.5%); odds ratio (OR) 2.65 (95% confidence interval 1.47-4.78); p < 0.001). IPW analyses with propensity scores revealed similar results (adjusted OR 1.65 (1.14-2.38); p = 0.008). Subgroup analyses showed that hyperoxia was harmful in the elderly and those with cardiopulmonary diseases and severe hypothermia below 28 °C, whereas hyperoxia exposure had no effect on mortality in patients with hemodynamic instability on hospital arrival. CONCLUSIONS: Hyperoxia with PaO2 levels of 300 mmHg or higher before initiating rewarming was associated with increased 28-day mortality in patients with accidental hypothermia. The amount of oxygen to administer to patients with accidental hypothermia should be carefully determined. TRIAL REGISTRATION: The ICE-CRASH study was registered at the University Hospital Medical Information Network Clinical Trial Registry on April 1, 2019 (UMIN-CTR ID, UMIN000036132).

Bioprotective role of platelet-derived microvesicles in hypothermia: Insight into the differential characteristics of peripheral and splenic platelets
Kie Horioka, Hiroki Tanaka, Keisuke Okaba, Shinnosuke Yamada, Akira Hayakawa, Namiko Ishii, Ayumi Motomura, Hiroyuki Inoue, Shuhei Takauji, Shotaro Isozaki, Katsuhiro Ogawa, Daisuke Yajima, Henrik Druid, Lasse Pakanen, Katja Porvari
Thrombosis Research, 223, 155, 167, Elsevier BV, 2023年03月
研究論文（学術雑誌）

Current status of active cooling, deep body temperature measurement, and face mask wearing in heat stroke and heat exhaustion patients in Japan: a nationwide observational study based on the Heatstroke STUDY 2020 and 2021
Jun Kanda, Yasufumi Miyake, Daiki Tanaka, Tadashi Umehara, Maiko Yamazaki, Naoshige Harada, Motoki Fujita, Kei Hayashida, Hitoshi Kaneko, Tatsuho Kobayashi, Yukari Miyoshi, Yuki Kishihara, Yohei Okada, Yuichi Okano, Jotaro Tachino, Shuhei Takauji, Junko Yamaguchi, Atsuo Maeda, Hiroyuki Yokota, Shoji Yokobori
Acute Medicine & Surgery, 10, 1, Wiley, 2023年01月
研究論文（学術雑誌）

Outcome of extracorporeal membrane oxygenation use in severe accidental hypothermia with cardiac arrest and circulatory instability: A multicentre, prospective, observational study in Japan (ICE-CRASH study).
Shuhei Takauji, Mineji Hayakawa, Daisuke Yamada, Tian Tian, Keita Minowa, Akihiko Inoue, Yoshihiro Fujimoto, Shutaro Isokawa, Naoya Miura, Tomoyuki Endo, Jin Irie, Gen Otomo, Hiroki Sato, Keisuke Bando, Tsuyoshi Suzuki, Takashi Toyohara, Akiko Tomita, Motoko Iwahara, Satoru Murata, Junya Shimazaki, Takeo Matsuyoshi, Jo Yoshizawa, Kenichi Nitta, Yuta Sato
Resuscitation, 182, 109663, 109663, 2023年01月, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, AIM: To elucidate the effectiveness of extracorporeal membrane oxygenation (ECMO) in accidental hypothermia (AH) patients with and without cardiac arrest (CA), including details of complications. METHODS: This study was a multicentre, prospective, observational study of AH in Japan. All adult (aged ≥18 years) AH patients with body temperature ≤32 °C who presented to the emergency department between December 2019 and March 2022 were included. Among the patients, those with CA or circulatory instability, defined as severe AH, were selected and divided into the ECMO and non-ECMO groups. We compared 28-day survival and favourable neurological outcomes at discharge between the ECMO and non-ECMO groups by adjusting for the patients' background characteristics using multivariable logistic regression analysis. RESULTS: Among the 499 patients in this study, 242 patients with severe AH were included in the analysis: 41 in the ECMO group and 201 in the non-ECMO group. Multivariable analysis showed that the ECMO group was significantly associated with better 28-day survival and favourable neurological outcomes at discharge in patients with CA compared to the non-ECMO group (odds ratio [OR] 0.17, 95% confidence interval [CI]: 0.05-0.58, and OR 0.22, 95%CI: 0.06-0.81). However, in patients without CA, ECMO not only did not improve 28-day survival and neurological outcomes, but also decreased the number of event-free days (ICU-, ventilator-, and catecholamine administration-free days) and increased the frequency of bleeding complications. CONCLUSIONS: ECMO improved survival and neurological outcomes in AH patients with CA, but not in AH patients without CA.

Soluble thrombomodulin ameliorates aberrant hemostasis after rewarming in a rat accidental hypothermia model.
Shuhei Takauji, Hiroki Tanaka, Mineji Hayakawa, Kie Horioka, Shotaro Isozaki, Hiroaki Konishi
Biochemical and biophysical research communications, 587, 1, 8, 2021年11月26日, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Accidental hypothermia (AH) sometimes leads to coagulation disorder, especially in severe AH. We previously demonstrated that intrasplenic platelet activation caused aberrant hemostasis and thrombus formation after rewarming in a murine AH model. However, no study has focused on the appropriate management of platelets causing coagulation activation after rewarming of AH. We investigated whether or not recombinant soluble thrombomodulin (rTM) can suppress thrombosis formation after rewarming using a rat AH model. METHODS: Wistar rats were exposed to an ambient temperature of -20 °C under general anesthesia until their rectal temperature decreased to 26 °C. The Hypo group rats (n = 5) were immediately euthanized, while the Hypo/Re group (n = 5) and rTM group rats (n = 5), which were administered rTM (1 mg/kg) via the tail vein, were rewarmed until the rectal temperature returned to 34 °C and then euthanized 6 h later. Tissue and blood samples were collected from all rats for histopathological and coagulation analyses at euthanasia. RESULTS: There was no significant change in the D-dimer level in the Hypo group rats, while the D-dimer level was significantly elevated at 6 h after rewarming in the Hypo/Re group rats (P = 0.015), and histopathology detected both fibrin and platelets in the renal glomerulus. However, the rTM group rats did not show any elevation of the D-dimer levels at 6 h after rewarming, and no fibrin was noted on histopathology. CONCLUSIONS: rTM may be useful as an appropriate anticoagulant in cases of aberrant hemostasis after rewarming of AH.

Intensive care with extracorporeal membrane oxygenation rewarming in accident severe hypothermia (ICE-CRASH) study: a protocol for a multicentre prospective, observational study in Japan.
Shuhei Takauji, Mineji Hayakawa
BMJ open, 11, 10, e052200, 2021年10月28日, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, INTRODUCTION: Accidental hypothermia (AH) is a rare but critical disease, leading to death in severe cases. In recent decades, extracorporeal membrane oxygenation (ECMO) has been successfully used to rewarm hypothermic patients with cardiac arrest or circulation instability. However, data on the efficacy of rewarming using ECMO for patients with AH are limited. Therefore, a large-scale, multicentre, prospective study is warranted. The primary objective of this study will be to clarify the effectiveness of rewarming using ECMO for patients with AH. Our secondary objectives will be to compare the incidence of adverse effects between ECMO rewarming and non-ECMO rewarming and to identify the most appropriate management of ECMO for AH. METHODS AND ANALYSES: The Intensive Care with ExtraCorporeal membrane oxygenation Rewarming in Accidentally Severe Hypothermia study is taking place in 35 tertiary emergency medical facilities in Japan. The inclusion criteria are patients ≥18 years old with a body temperature ≤32°C. We will include patients with AH who present to the emergency department from December 2019 to March 2022. The research personnel at each hospital will collect several variables, including patient demographics, rewarming method, ECMO data and complications. Our primary outcome is to compare the 28-day survival rate between the ECMO and non-ECMO (other treatments) groups among patients with severe AH. Our secondary outcomes are to compare the following values between the ECMO and non-ECMO groups: length of stay in the intensive-care unit and complications. Furthermore, in patients with cardiac arrest, the Cerebral Performance Category score at discharge will be compared between both groups. ETHICS AND DISSEMINATION: This study received research ethics approval from Asahikawa Medical University (18194 and 19115). The study was approved by the institutional review board of each hospital, and the requirement for informed consent was waived due to the observational nature of the study. TRIAL REGISTRATION NUMBER: UMIN000036132.

Association between frailty and mortality among patients with accidental hypothermia: a nationwide observational study in Japan.
Shuhei Takauji, Toru Hifumi, Yasuaki Saijo, Shoji Yokobori, Jun Kanda, Yutaka Kondo, Kei Hayashida, Junya Shimazaki, Takashi Moriya, Masaharu Yagi, Junko Yamaguchi, Yohei Okada, Yuichi Okano, Hitoshi Kaneko, Tatsuho Kobayashi, Motoki Fujita, Keiki Shimizu, Hiroyuki Yokota, Arino Yaguchi
BMC geriatrics, 21, 1, 507, 507, 2021年09月25日, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Frailty has been associated with a risk of adverse outcomes, and mortality in patients with various conditions. However, there have been few studies on whether or not frailty is associated with mortality in patients with accidental hypothermia (AH). In this study, we aim to determine this association in patients with AH using Japan's nationwide registry data. METHODS: The data from the Hypothermia STUDY 2018&19, which included patients of ≥18 years of age with a body temperature of ≤35 °C, were obtained from a multicenter registry for AH conducted at 120 institutions throughout Japan, collected from December 2018 to February 2019 and December 2019 to February 2020. The clinical frailty scale (CFS) score was used to determine the presence and degree of frailty. The primary outcome was the comparison of mortality between the frail and non-frail patient groups. RESULTS: In total, 1363 patients were included in the study, of which 920 were eligible for the analysis. The 920 patients were divided into the frail patient group (N = 221) and non-frail patient group (N = 699). After 30-days of hospitalization, 32.6% of frail patients and 20.6% of non-frail patients had died (p < 0.001). Frail patients had a significantly higher risk of 90-day mortality (Hazard ratio [HR], 1.64; 95% confidence interval [CI], 1.25-2.17; p < 0.001). Based on the Cox proportional hazards analysis using multiple imputation, after adjustment for age, potassium level, lactate level, pH value, sex, CPK level, heart rate, platelet count, location of hypothermia incidence, and rate of tracheal intubation, the HR was 1.69 (95% CI, 1.25-2.29; p < 0.001). CONCLUSIONS: This study showed that frailty was associated with mortality in patients with AH. Preventive interventions for frailty may help to avoid death caused by AH.

Machine learning-based mortality prediction model for heat-related illness.
Yohei Hirano, Yutaka Kondo, Toru Hifumi, Shoji Yokobori, Jun Kanda, Junya Shimazaki, Kei Hayashida, Takashi Moriya, Masaharu Yagi, Shuhei Takauji, Junko Yamaguchi, Yohei Okada, Yuichi Okano, Hitoshi Kaneko, Tatsuho Kobayashi, Motoki Fujita, Hiroyuki Yokota, Ken Okamoto, Hiroshi Tanaka, Arino Yaguchi
Scientific reports, 11, 1, 9501, 9501, 2021年05月04日, ［国際誌］
英語, 研究論文（学術雑誌）, In this study, we aimed to develop and validate a machine learning-based mortality prediction model for hospitalized heat-related illness patients. After 2393 hospitalized patients were extracted from a multicentered heat-related illness registry in Japan, subjects were divided into the training set for development (n = 1516, data from 2014, 2017-2019) and the test set (n = 877, data from 2020) for validation. Twenty-four variables including characteristics of patients, vital signs, and laboratory test data at hospital arrival were trained as predictor features for machine learning. The outcome was death during hospital stay. In validation, the developed machine learning models (logistic regression, support vector machine, random forest, XGBoost) demonstrated favorable performance for outcome prediction with significantly increased values of the area under the precision-recall curve (AUPR) of 0.415 [95% confidence interval (CI) 0.336-0.494], 0.395 [CI 0.318-0.472], 0.426 [CI 0.346-0.506], and 0.528 [CI 0.442-0.614], respectively, compared to that of the conventional acute physiology and chronic health evaluation (APACHE)-II score of 0.287 [CI 0.222-0.351] as a reference standard. The area under the receiver operating characteristic curve (AUROC) values were also high over 0.92 in all models, although there were no statistical differences compared to APACHE-II. This is the first demonstration of the potential of machine learning-based mortality prediction models for heat-related illnesses.

Accidental hypothermia: Factors related to a prolonged hospital stay - A nationwide observational study in Japan.
Shuhei Takauji, Toru Hifumi, Yasuaki Saijo, Shoji Yokobori, Jun Kanda, Yutaka Kondo, Kei Hayashida, Keiki Shimizu, Hiroyuki Yokota, Arino Yaguchi
The American journal of emergency medicine, 47, 169, 175, 2021年03月29日, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: The incidence of accidental hypothermia (AH) is low, and the length of hospital stay in patients with AH remains poorly understood. The present study explored which factors were related to prolonged hospitalization among patients with AH using Japan's nationwide registry data. METHODS: The data from the Hypothermia STUDY 2018, which included patients ≥18 years old with a body temperature ≤ 35 °C, were obtained from a multicenter registry for AH conducted at 89 institutions throughout Japan, collected from December 1, 2018, to February 28, 2019. The patients were divided into a "short-stay patients" group (within 7 days) and "long-stay patients" group (more than 7 days). A logistic regression analysis after multiple imputation was performed to obtain odds ratios (ORs) for prolonged hospitalization with age, frailty, location, causes underlying the hypothermia, temperature, pH, potassium level, and disseminated intravascular coagulation (DIC) score as independent variables. RESULTS: In total, 656 patients were included in the study, of which 362 were eligible for the analysis. The median length of hospital stay was 17 days. Of the 362 patients, 265 (73.2%) stayed in the hospital for more than 7 days. The factors associated with prolonged hospitalization were frailty (OR, 2.11; 95% confidence interval [CI], 1.09-4.10; p = 0.027), the occurrence of indoor (OR, 3.20; 95% CI, 1.58-6.46; p = 0.001), alcohol intoxication (OR, 0.17; 95% CI, 0.05-0.56; p = 0.004), pH (OR, 0.07; 95% CI, 0.01-0.76; p = 0.029), potassium level (OR, 1.36; 95% CI, 1.00-1.85; p = 0.048), and DIC score (OR, 1.54; 95% CI, 1.13-2.10; p = 0.006). CONCLUSIONS: Frailty, indoor situation, alcohol intoxication, pH value, potassium level, and DIC score were factors contributing to prolonged hospitalization in patients with AH. Preventing frailty may help reduce the length of hospital stay in patients with AH. In addition, measuring the pH value and potassium level by an arterial blood gas analysis at the ED is recommended for the early evaluation of AH.

Polyphosphate, Derived from Lactobacillus brevis, Modulates the Intestinal Microbiome and Attenuates Acute Pancreatitis.
Shuhei Takauji, Hiroaki Konishi, Mikihiro Fujiya, Nobuhiro Ueno, Hiroki Tanaka, Hiroki Sato, Shotaro Isozaki, Shin Kashima, Kentaro Moriichi, Yusuke Mizukami, Toshikatsu Okumura
Digestive diseases and sciences, 66, 11, 3872, 3884, 2021年01月25日, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: We previously showed that Lactobacillus brevis-derived polyphosphate (poly P) exerts a curative effect on intestinal inflammation. However, whether or not poly P improves the inflammation and injury of distant organs remains unclear. AIMS: We aimed to investigate the change in the intestinal microbiome and to evaluate the protective effect of poly P on injuries in a cerulein-induced acute pancreatitis (AP) mouse. METHODS: Poly P was orally administered to BALB/C mice every day for 24 days, and then mice were intraperitoneally injected with cerulein. Before cerulein injection, stool samples were collected and analyzed by 16S rRNA gene sequencing. Mice were sacrificed at 24 h after the last cerulein injection; subsequently, the serum, pancreas, and colon were collected. RESULTS: The microbial profile differed markedly between poly P and control group. Notably, the levels of beneficial bacteria, including Alistipes and Candidatus_Saccharimonas, were significantly increased, while those of the virulent bacteria Desulfovibrio were decreased in the poly P group. The elevations of the serum amylase and lipase levels by cerulein treatment were suppressed by the pre-administration of poly P for 24 days, but not for 7 days. The numbers of cells MPO-positive by immunohistology were decreased and the levels of MCP-1 significantly reduced in the AP + Poly P group. An immunofluorescence analysis showed that the ZO-1 and occludin in the colon was strongly augmented in the epithelial cell membrane layer in the AP + Poly P group. CONCLUSIONS: Poly P attenuates AP through both modification of the intestinal microbiome and enhancement of the intestinal barrier integrity.

Accidental hypothermia: characteristics, outcomes, and prognostic factors—A nationwide observational study in Japan (Hypothermia study 2018 and 2019)
Shuhei Takauji, Toru Hifumi, Yasuaki Saijo, Shoji Yokobori, Jun Kanda, Yutaka Kondo, Kei Hayashida, Junya Shimazaki, Takashi Moriya, Masaharu Yagi, Junko Yamaguchi, Yohei Okada, Yuichi Okano, Hitoshi Kaneko, Tatsuho Kobayashi, Motoki Fujita, Keiki Shimizu, Hiroyuki Yokota
Acute Medicine & Surgery, 8, 1, Wiley, 2021年01月, ［査読有り］, ［筆頭著者］
研究論文（学術雑誌）

Prognostic significance of skeletal muscle decrease in unresectable pancreatic cancer: Survival analysis using the Weibull exponential distribution model
Hiroki Sato, Takuma Goto, Akihiro Hayashi, Hidemasa Kawabata, Tetsuhiro Okada, Shuhei Takauji, Junpei Sasajima, Katsuro Enomoto, Mikihiro Fujiya, Kyohei Oyama, Yusuke Ono, Ayumu Sugitani, Yusuke Mizukami, Toshikatsu Okumura
Pancreatology, 2021年
研究論文（学術雑誌）

Probiotic‑derived ferrichrome inhibits the growth of refractory pancreatic cancer cells.
Akemi Kita, Mikihiro Fujiya, Hiroaki Konishi, Hiroki Tanaka, Shin Kashima, Takuya Iwama, Masami Ijiri, Yuki Murakami, Shuhei Takauji, Takuma Goto, Aki Sakatani, Katsuyoshi Ando, Nobuhiro Ueno, Naoki Ogawa, Toshikatsu Okumura
International journal of oncology, 57, 3, 721, 732, 2020年09月, ［国際誌］
英語, 研究論文（学術雑誌）, Pancreatic cancer is associated with a poor prognosis due to challenges in early detection, severe progression of the primary tumor, metastatic lesions, and resistance to antitumor agents. However, previous studies have indicated a relationship between the microbiome and pancreatic cancer outcomes. Our previous study demonstrated that ferrichrome derived from Lactobacillus casei, a probiotic bacteria, exhibited tumor‑suppressive effects in colorectal and gastric cancer, and that the suppressive effects were stronger than conventional antitumor agents, such as 5‑fluorouracil (5‑FU) and cisplatin, suggesting that certain probiotics exert antitumorigenic effects. However, whether or not probiotic‑derived molecules, including ferrichrome, exert a tumor‑suppressive effect in other gastrointestinal tumors, such as pancreatic cancer, remains unclear. In the present study, it was demonstrated that probiotic‑derived ferrichrome inhibited the growth of pancreatic cancer cells, and its tumor‑suppressive effects were further revealed in 5‑FU‑resistant pancreatic cancer cells in vitro and in vivo in a mouse xenograft model. Ferrichrome inhibited the progression of cancer cells via dysregulation of the cell cycle by activating p53. DNA fragmentation and cleavage of poly (ADP‑ribose) polymerase were induced by ferrichrome treatment, suggesting that ferrichrome induced apoptosis in pancreatic cancer cells. A transcriptome analysis revealed that the expression p53‑associated mRNAs was significantly altered by ferrichrome treatment. Thus, the tumor‑suppressive effects of probiotics may mediated by probiotic‑derived molecules, such as ferrichrome, which may have applications as an antitumor drug, even in refractory and 5‑FU‑resistant pancreatic cancer.

Rewarming from accidental hypothermia enhances whole blood clotting properties in a murine model.
Kie Horioka, Hiroki Tanaka, Shotaro Isozaki, Hiroaki Konishi, Lynda Addo, Shuhei Takauji, Henrik Druid
Thrombosis research, 195, 114, 119, 2020年07月10日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Hypothermia triggers coagulation, which can lead to the development of a life-threatening condition. We previously reported that hypothermia induces platelet activation in the spleen, resulting in microthrombosis after rewarming. However, the changes in whole blood clotting properties that occur remain unclear. Using thromboelastography, we investigated blood clotting activity and the effects of rewarming in a murine model of hypothermia. METHODS: C57Bl/6 mice were exposed to an ambient temperature of -20 °C under general anesthesia until their rectal temperature decreased to 15 °C. One group of mice was kept at 4 °C for 2 h and then euthanized. Another group was rewarmed, kept in normal conditions for 24 h, and then euthanized. Tissue and citrated whole blood samples were obtained from the mice for histopathological analysis, flow cytometry, and thromboelastography. RESULTS: Hypothermia induced the activation of platelets in the spleen; however, rewarming significantly reduced the number of activated platelets in the spleen while their numbers significantly increased in peripheral blood. In hypothermic mice not subjected to rewarming, no increase in activated platelets was observed in peripheral blood. Thromboelastography analysis showed that whole blood samples from the rewarmed mice displayed an enhanced clotting strength. CONCLUSIONS: Rewarming from hypothermia enhances whole blood coagulation activity accompanied by an increase in the number of active platelets in peripheral blood. This phenomenon may lead to formation of microthrombi and thrombotic disorders.

Low temperature induces von-willebrand factor expression via increased early growth response 1 transcriptional activity in splenic sinusoidal endothelial cells.
Kie Horioka, Hiroki Tanaka, Shotaro Isozaki, Hiroaki Konishi, Lynda Addo, Shuhei Takauji, Henrik Druid
Biochemical and biophysical research communications, 526, 1, 239, 245, 2020年05月21日, ［国際誌］
英語, 研究論文（学術雑誌）, von Willebrand factor (vWF) is a large plasma glycoprotein that plays an important role in hemostasis by forming molecular bridges with platelets following vascular injury. Previously, we reported that hypothermia enhanced vWF production in the spleen, which resulted in the activation of the platelet pool in a hypothermia-induced murine model. However, the mechanisms that regulate vWF expression under hypothermic conditions remain unclear. In this study, we focused on vWF expression under hypothermic conditions in splenic endothelial cell culture. Human splenic endothelial cells (HSEC) were incubated at 20 °C for 1 h. Total RNA was extracted from the cells, and cDNA microarray gene expression analysis was performed. Genes that may be associated with vWF expression in low temperature culture conditions were then selected for further analysis. Gene expression analysis showed that low temperature conditions increased the expression of FOS and EGR1. We then hypothesized that these factors upregulate vWF mRNA expression in HSEC. The transcriptional inhibitors of EGR1 significantly inhibited vWF mRNA expression in HSEC cultured at a low temperature. Our analysis revealed that low temperatures enhance the gene expression of EGR1, which transcriptionally increases vWF expression. This acute-phase reaction may play an important role in platelet activation in the spleen during hypothermia.

Heatstroke management during the COVID-19 epidemic: recommendations from the experts in Japan
Shoji Yokobori, Jun Kanda, Yohei Okada, Yuichi Okano, Hitoshi Kaneko, Tatsuho Kobayashi, Yutaka Kondo, Junya Shimazaki, Shuhei Takauji, Kei Hayashida, Toru Hifumi, Motoki Fujita, Takashi Moriya, Masaharu Yagi, Junko Yamaguchi, Yasutaka Oda, Shinichiro Shiraishi, Masahiro Wakasugi, Keiki Shimizu, Yasufumi Miyake, Hiroyuki Yokota, Arino Yaguchi, Takeshi Shimazu, Masahiro Asami, Jun Hamaguchi, Tadashi Ishihara, Toshiomi Kawagishi, Yutaka Igarashi, Yohei Hirano, Ryuta Nakae, Yuki Arakawa, Soma Miyamoto, Eri Yamada, Daisuke Ikechi, Junichi Sasaki, Shinji Nakahara, Masashi Ono, Takashi Kawahara, Michihiko Tonouchi, Toshiharu Ikaga, Yuzo Sakamoto, Satoru Ueno, Yasumitsu Mizobata, Naoto Morimura, Joji Tomioka, Satoshi Fujimi, Kiyoshi Matsuda, Shun Moriya, Seizan Tanabe, Kimiyuki Nagashima, Toshimitsu Morizumi, Noriaki Sato, Hiroko Unei, Shigeaki Nishiike, Hiroshi Okudera, Seiya Kato, Hideharu Tanaka, Tetsuya Sakamoto, Hiroki Ohge, Kazuhiro Tateda, Tomoshige Matsumoto, Hiroshi Mukae, Akihito Yokoyama
ACUTE MEDICINE & SURGERY, 7, 1, 2020年01月
英語, 研究論文（学術雑誌）

Genetic analysis of postoperative recurrence of pancreatic cancer potentially owing to needle tract seeding during EUS-FNB.
Hidemasa Kawabata, Yuki Miyazawa, Hiroki Sato, Tetsuhiro Okada, Akihiro Hayashi, Takuya Iwama, Shugo Fujibayashi, Takuma Goto, Junpei Sasajima, Shuhei Takauji, Mikihiro Fujiya, Yoshihiro Torimoto, Mishie Tanino, Yuko Omori, Yusuke Ono, Hidenori Karasaki, Yusuke Mizukami, Toshikatsu Okumura
Endoscopy international open, 7, 12, E1768-E1772, 2019年12月, ［国際誌］
英語, Background and study aims  Needle tract seeding during endoscopic ultrasound fine-needle biopsy (EUS-FNB) remains a concern. We investigated whether such seeding occurred in a patient with pancreatic ductal adenocarcinoma (PDA). Patient and methods  Surgically resected and EUS-FNB-derived specimens were genotyped to determine if a gastric wall tumor that emerged 3 years after curative resection of an early-stage PDA was clonally related to the original tumor. Results  The gastric tumor histologically resembled the primary PDA; the lesions also shared KRAS , SMAD4 , and RNF43 mutations. Genotyping of the preoperative EUS-FNB specimen, in which cancer was not detected, nevertheless revealed mutations that were identical to those in the resected primary and recurrent tumors. While the primary PDA had a low frequency of mutant SMAD4 , such mutations were highly prevalent in both the EUS-FNB and recurrent tumor specimens. Conclusions  The genetic lineages of sampled tissues from our patient revealed that needle tract seeding may have incidentally occurred when a subset of neoplastic cells within a heterogeneous tumor ( i. e. , an aggressive clone) was targeted during EUS-FNB.

A Nationwide Comparison Between Sepsis-2 and Sepsis-3 Definition in Japan.
Shuhei Takauji, Mineji Hayakawa, Satoshi Fujita
Journal of intensive care medicine, 885066618823151, 885066618823151, 2019年01月13日, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND:: Currently, it remains controversial whether the Sepsis-3 definition provides the most appropriate criteria for clinical use. The purpose of this study was to compare between the Sepsis-2 and Sepsis-3 definitions using Japan's nationwide registry. METHODS:: Data were obtained from a multicenter registry conducted at 42 intensive care units (ICUs) throughout Japan, in which patients received treatment for severe sepsis or septic shock between January 2011 and December 2013. RESULTS:: A total of 2797 patients diagnosed using the Sepsis-2 criteria were included in the present study. These patients were categorized into "Severe sepsis" (n = 1154) and "Sepsis-2 shock" (n = 1643) groups. Among the "Sepsis-2 shock" group, patients who did not meet the Sepsis-3 criteria for septic shock were categorized into the "Sepsis-2 shock-only" (n = 448, 27.3%) group, while patients who met the Sepsis-3 criteria for septic shock were categorized into "Sepsis-3 shock (n = 1195, 72.7%)" group. The ICU mortality in the "Sepsis-3 shock" group, "Sepsis-2 shock-only" group, and "Severe sepsis" group was 28.5%, 10.9%, and 14.1%, respectively. We observed no significant difference between the "Severe sepsis" and "Sepsis-2 shock-only" groups in terms of in-hospital survival ( P = .098), while the "Sepsis-3 shock" group had the highest in-hospital mortality rate ( P < .001). In a multivariate logistic regression analysis, liver insufficiency and immunocompromised status were independent prognostic factors in the "Sepsis-2 shock-only" group. In contrast, chronic heart disease and chronic hemodialysis were independent prognostic factors in the "Sepsis-3 shock" group. CONCLUSIONS:: The ICU mortality of the "Sepsis-2 shock-only" group was significantly low. Besides septic shock diagnosed by the Sepsis-3 definition selects patients with more severe cases of sepsis among the "Sepsis-2 shock" group.

Clinical course of conservative management for isolated superior mesenteric arterial dissection.
Sho Sosogi, Ryu Sato, Reona Wada, Hiroya Saito, Shuhei Takauji, Jun Sakamoto, Keisuke Kimura, Hidenori Karasaki, Yusuke Mizukami, Tomoyuki Ohta
European journal of radiology open, 6, 192, 197, 2019年, ［国際誌］
英語, 研究論文（学術雑誌）, Objectives: Isolated superior mesenteric arterial dissection (ISMAD) is an uncommon type of arterial dissection and treated with surgery, stenting, or conservative management. This study aimed to evaluate the criteria for conservative therapy for ISMAD patients based on imaging findings. Methods: Eighteen consecutive ISMAD patients without peritoneal irritation at onset were retrospectively studied. The decision to perform stenting was based on the emergence of peritoneal irritation, aneurysm, or mesenteric ischemia. Clinical manifestations, follow-up contrast-enhanced computed tomography (CECT) findings, and patient outcome were evaluated. Results: Most patients (16, 89%) were successfully treated conservatively; two patients (11%) required endovascular stenting because of an aneurysm or ulcer-like projection (ULP) sign. The median duration of fasting and hospital stays was 3 (range, 1-8) and 9 (range, 4-34) days, respectively. On CECT, the median distance from the superior mesenteric artery (SMA) origin to the entry site was 12 mm (range, 5-35 mm), and the median length of dissection was 87.5 mm (range, 20-150 mm). Among 16 patients treated conservatively, serial imaging was obtained in 11 patients (69%), and disappearance of the dissection within 4 months occurred in five patients. Two patients treated with endovascular stent underwent follow-up CECT 1 year after onset, and there were no complications. Conclusions: ISMAD patients without peritoneal irritation can be treated conservatively if there are no signs of an aneurysm, ULP, or mesenteric ischemia. When an aneurysm or ULP sign exists, endovascular stenting was able to preserve SMA blood flow with the improvement of the dissection.

Utility of "liquid biopsy" using pancreatic juice for early detection of pancreatic cancer.
Tetsuhiro Okada, Hirotoshi Iwano, Yusuke Ono, Hidenori Karasaki, Takayuki Sato, Masataka Yamada, Yuko Omori, Hiroki Sato, Akihiro Hayashi, Hidemasa Kawabata, Takuma Goto, Junpei Sasajima, Shuhei Takauji, Kazuo Nagashima, Yusuke Mizukami, Toshikatsu Okumura
Endoscopy international open, 6, 12, E1454-E1461, 2018年12月, ［国際誌］
英語, Background  Despite advances in the diagnosis of pancreatic ductal adenocarcinoma (PDA), histological evaluation of small and poorly defined masses in the pancreas is uncomfortable and unsafe. Methods  We herein report a case of early stage PDA, in which multiple KRAS mutations were detected in the pancreatic juice preoperatively. A small hypoechoic area adjacent to the portal vein was detected through endoscopic ultrasound in the pancreatic body. KRAS mutations were evaluated using plasma, and the pancreatic juice by digital PCR. Results  Pancreatic duct biopsy and pancreatic juice cytology were performed with no evidence of malignancy; however, KRAS mutations, KRAS G12V and G12D, were detected in the pancreatic juice. Histological assessment of the resected specimen demonstrated a solid tumor with desmoplastic reaction accompanied by carcinoma in situ in the main pancreatic duct where KRAS G12V mutation was identified. More detailed analysis demonstrated KRAS G12D mutation in the cluster of low grade pancreatic intraepithelial neoplasia, implying that the lesion developed independently. Conclusions  Our study indicates the potential of "endoscopic liquid biopsy" to capture the driver gene for PDA diagnosis.

Evaluation of a Novel Classification of Heat-Related Illnesses: A Multicentre Observational Study (Heat Stroke STUDY 2012).
Takahiro Yamamoto, Motoki Fujita, Yasutaka Oda, Masaki Todani, Toru Hifumi, Yutaka Kondo, Junya Shimazaki, Shinichiro Shiraishi, Kei Hayashida, Shoji Yokobori, Shuhei Takauji, Masahiro Wakasugi, Shunsuke Nakamura, Jun Kanda, Masaharu Yagi, Takashi Moriya, Takashi Kawahara, Michihiko Tonouchi, Hiroyuki Yokota, Yasufumi Miyake, Keiki Shimizu, Ryosuke Tsuruta
International journal of environmental research and public health, 15, 9, 2018年09月08日, ［国際誌］
英語, 研究論文（学術雑誌）, The Japanese Association for Acute Medicine Committee recently proposed a novel classification system for the severity of heat-related illnesses. The illnesses are simply classified into three stages based on symptoms and management or treatment. Stages I, II, and III broadly correspond to heat cramp and syncope, heat exhaustion, and heat stroke, respectively. Our objective was to examine whether this novel severity classification is useful in the diagnosis by healthcare professionals of patients with severe heat-related illness and organ failure. A nationwide surveillance study of heat-related illnesses was conducted between 1 June and 30 September 2012, at emergency departments in Japan. Among the 2130 patients who attended 102 emergency departments, the severity of their heat-related illness was recorded for 1799 patients, who were included in this study. In the patients with heat cramp and syncope or heat exhaustion (but not heat stroke), the blood test data (alanine aminotransferase, creatinine, blood urea nitrogen, and platelet counts) for those classified as Stage III were significantly higher than those of patients classified as Stage I or II. There were no deaths among the patients classified as Stage I. This novel classification may avoid underestimating the severity of heat-related illness.

Respiratory extracorporeal membrane oxygenation for severe sepsis and septic shock in adults: a propensity score analysis in a multicenter retrospective observational study.
Shuhei Takauji, Mineji Hayakawa, Kota Ono, Hiroshi Makise
Acute medicine & surgery, 4, 4, 408, 417, 2017年10月, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, Aim: This multicenter retrospective observational study aimed to evaluate the efficacy of extracorporeal membrane oxygenation (ECMO) support for septic patients with severe respiratory failure using propensity score analyses. Methods: The data of severe sepsis patients from 42 intensive care units between January 2011 and December 2013 were retrospectively collected. Propensity score matching analyses were undertaken for severe respiratory failure patients with/without veno-venous ECMO support. The main outcome was in-hospital all-cause mortality. Results: Of 3195 patients with severe sepsis, 570 had severe respiratory failure. Forty patients in the ECMO group were matched with 150 patients in the control group. A survival time analysis revealed no difference in the in-hospital survival (hazard ratio, 0.854; 95% confidence interval, 0.531-1.373; P = 0.515). Two-hundred and eighty-five patients had severe respiratory failure induced by lung infection. Twenty-five ECMO group patients were matched with 89 patients in the control group. In the ECMO group, the survival time was longer than in the control group (hazard ratio, 0.498; 95% confidence interval, 0.279-0.889; P = 0.018). The number of renal replacement therapy- and vasopressor-free days improved. The ECMO group received more red blood cells transfused than the control group, but there was no significant difference in the rate of severe bleeding complications between the groups. Conclusions: There was no difference in the in-hospital survival between the ECMO group and control group among overall septic patients with severe respiratory failure. However, in sepsis patients with severe respiratory failure induced by lung infection, ECMO support may improve their survival time.

Low-dose immunoglobulin G is not associated with mortality in patients with sepsis and septic shock.
Yusuke Iizuka, Masamitsu Sanui, Yusuke Sasabuchi, Alan Kawarai Lefor, Mineji Hayakawa, Shinjiro Saito, Shigehiko Uchino, Kazuma Yamakawa, Daisuke Kudo, Kohei Takimoto, Toshihiko Mayumi, Takeo Azuhata, Fumihito Ito, Shodai Yoshihiro, Katsura Hayakawa, Tsuyoshi Nakashima, Takayuki Ogura, Eiichiro Noda, Yoshihiko Nakamura, Ryosuke Sekine, Yoshiaki Yoshikawa, Motohiro Sekino, Keiko Ueno, Yuko Okuda, Masayuki Watanabe, Akihito Tampo, Nobuyuki Saito, Yuya Kitai, Hiroki Takahashi, Iwao Kobayashi, Yutaka Kondo, Wataru Matsunaga, Sho Nachi, Toru Miike, Hiroshi Takahashi, Shuhei Takauji, Kensuke Umakoshi, Takafumi Todaka, Hiroshi Kodaira, Kohkichi Andoh, Takehiko Kasai, Yoshiaki Iwashita, Hideaki Arai, Masato Murata, Masahiro Yamane, Kazuhiro Shiga, Naoto Hori
Critical care (London, England), 21, 1, 181, 181, 2017年07月13日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: The administration of low-dose intravenous immunoglobulin G (IVIgG) (5 g/day for 3 days; approximate total 0.3 g/kg) is widely used as an adjunctive treatment for patients with sepsis in Japan, but its efficacy in the reduction of mortality has not been evaluated. We investigated whether the administration of low-dose IVIgG is associated with clinically important outcomes including intensive care unit (ICU) and in-hospital mortality. METHODS: This is a post-hoc subgroup analysis of data from a retrospective cohort study, the Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study. The JSEPTIC DIC study was conducted in 42 ICUs in 40 institutions throughout Japan, and it investigated associations between sepsis-related coagulopathy, anticoagulation therapies, and clinical outcomes of 3195 adult patients with sepsis and septic shock admitted to ICUs from January 2011 through December 2013. To investigate associations between low-dose IVIgG administration and mortalities, propensity score-based matching analysis was used. RESULTS: IVIgG was administered to 960 patients (30.8%). Patients who received IVIgG were more severely ill than those who did not (Acute Physiology and Chronic Health Evaluation (APACHE) II score 24.2 ± 8.8 vs 22.6 ± 8.7, p < 0.001). They had higher ICU mortality (22.8% vs 17.4%, p < 0.001), but similar in-hospital mortality (34.4% vs 31.0%, p = 0.066). In propensity score-matched analysis, 653 pairs were created. Both ICU mortality and in-hospital mortality were similar between the two groups (21.0% vs 18.1%, p = 0.185, and 32.9% vs 28.6%, p = 0.093, respectively) using generalized estimating equations fitted with logistic regression models adjusted for other therapeutic interventions. The administration of IVIgG was not associated with ICU or in-hospital mortality (odds ratio (OR) 0.883; 95% confidence interval (CI) 0.655-1.192, p = 0.417, and OR 0.957, 95% CI, 0.724-1.265, p = 0.758, respectively). CONCLUSIONS: In this analysis of a large cohort of patients with sepsis and septic shock, the administration of low-dose IVIgG as an adjunctive therapy was not associated with a decrease in ICU or in-hospital mortality. TRIAL REGISTRATION: University Hospital Medical Information Network Individual Clinical Trials Registry, UMIN-CTR000012543 . Registered on 10 December 2013.

Antithrombin Supplementation and Mortality in Sepsis-Induced Disseminated Intravascular Coagulation: A Multicenter Retrospective Observational Study.
Mineji Hayakawa, Daisuke Kudo, Shinjiro Saito, Shigehiko Uchino, Kazuma Yamakawa, Yusuke Iizuka, Masamitsu Sanui, Kohei Takimoto, Toshihiko Mayumi, Kota Ono, Takeo Azuhata, Fumihito Ito, Shodai Yoshihiro, Katsura Hayakawa, Tsuyoshi Nakashima, Takayuki Ogura, Eiichiro Noda, Yoshihiko Nakamura, Ryosuke Sekine, Yoshiaki Yoshikawa, Motohiro Sekino, Keiko Ueno, Yuko Okuda, Masayuki Watanabe, Akihito Tampo, Nobuyuki Saito, Yuya Kitai, Hiroki Takahashi, Iwao Kobayashi, Yutaka Kondo, Wataru Matsunaga, Sho Nachi, Toru Miike, Hiroshi Takahashi, Shuhei Takauji, Kensuke Umakoshi, Takafumi Todaka, Hiroshi Kodaira, Kohkichi Andoh, Takehiko Kasai, Yoshiaki Iwashita, Hideaki Arai, Masato Murata, Masahiro Yamane, Kazuhiro Shiga, Naoto Hori
Shock (Augusta, Ga.), 46, 6, 623, 631, 2016年12月, ［国際誌］
英語, 研究論文（学術雑誌）, Supplemental doses of antithrombin (AT) are widely used to treat sepsis-induced disseminated intravascular coagulation (DIC) in Japan. However, evidence on the benefits of AT supplementation for DIC is insufficient. This multicenter retrospective observational study aimed to clarify the effect of AT supplementation on sepsis-induced DIC using propensity score analyses. Data from 3,195 consecutive adult patients admitted to 42 intensive care units for severe sepsis treatment were retrospectively analyzed; 1,784 patients were diagnosed with DIC (n = 715, AT group; n = 1,069, control group). Inverse probability of treatment-weighted propensity score analysis indicated a statistically significant association between AT supplementation and lower in-hospital all-cause mortality (n = 1,784, odds ratio [95% confidence intervals]: 0.748 [0.572-0.978], P = 0.034). However, quintile-stratified propensity score analysis (n = 1,784, odds ratio: 0.823 [0.646-1.050], P = 0.117) and propensity score matching analysis (461 matching pairs, odds ratio: 0.855 [0.649-1.125], P = 0.263) did not show this association. In the early days after intensive care unit admission, the survival rate was statistically higher in the propensity score-matched AT group than in the propensity score-matched control group (P = 0.007). In DIC patients without concomitant heparin administration, similar results were observed. In conclusion, AT supplementation may be associated with reduced in-hospital all-cause mortality in patients with sepsis-induced DIC. However, the statistical robustness of this connection was not strong. In addition, although the number of transfusions needed in patients with AT supplementation increased, severe bleeding complications did not.

Characteristics, treatments, and outcomes of severe sepsis of 3195 ICU-treated adult patients throughout Japan during 2011-2013.
Mineji Hayakawa, Shinjiro Saito, Shigehiko Uchino, Kazuma Yamakawa, Daisuke Kudo, Yusuke Iizuka, Masamitsu Sanui, Kohei Takimoto, Toshihiko Mayumi, Takeo Azuhata, Fumihito Ito, Shodai Yoshihiro, Katsura Hayakawa, Tsuyoshi Nakashima, Takayuki Ogura, Eiichiro Noda, Yoshihiko Nakamura, Ryosuke Sekine, Yoshiaki Yoshikawa, Motohiro Sekino, Keiko Ueno, Yuko Okuda, Masayuki Watanabe, Akihito Tampo, Nobuyuki Saito, Yuya Kitai, Hiroki Takahashi, Iwao Kobayashi, Yutaka Kondo, Wataru Matsunaga, Sho Nachi, Toru Miike, Hiroshi Takahashi, Shuhei Takauji, Kensuke Umakoshi, Takafumi Todaka, Hiroshi Kodaira, Kohkichi Andoh, Takehiko Kasai, Yoshiaki Iwashita, Hideaki Arai, Masato Murata, Masahiro Yamane, Kazuhiro Shiga, Naoto Hori
Journal of intensive care, 4, 44, 44, 2016年, ［国際誌］
英語, 研究論文（学術雑誌）, Severe sepsis is a major concern in the intensive care unit (ICU), although there is very little epidemiological information regarding severe sepsis in Japan. This study evaluated 3195 patients with severe sepsis in 42 ICUs throughout Japan. The patients with severe sepsis had a mean age of 70 ± 15 years and a mean Acute Physiology and Chronic Health Evaluation II score of 23 ± 9. The estimated survival rates at 28 and 90 days after ICU admission were 73.6 and 56.3 %, respectively.

[Case with Todani's type Ib congenital cystic dilatation of the common bile duct].
Shuhei Takauji, Mitsuhiro Obara, Kazuya Koizumi, Shigeru Takeuchi, Masato Taniguchi, Ryu Sato, Takayuki Kazuma, Kimiharu Hasegawa, Ichirou Tomita, Hiroichi Asakawa
Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology, 105, 3, 391, 6, 2008年03月, ［国内誌］
日本語, 研究論文（学術雑誌）, A 56-year-old man, who had epigastralgia and abnormal liver function test, was admitted to our hospital. ERCP showed common bile duct dilation and stones. We therefore performed endoscopic lithotripsy after endoscopic sphincterotomy. Ten months later, MRCP showed recurrent CBD stones. After rehospitalization, resection of the dilated bile duct was carried out. This case was diagnosed Todani's type Ib congenital cystic dilatation of common bile duct. Todani's type Ib is rare type of congenital dilatation of bile duct, and is interesting embryologically.

[Case report: cystic metastasis in liver fifteen years after surgical operation of malignant melanoma].
Shuhei Takauji, Akinori Matsumoto, Naomi Shibata, Akimasa Yoshida, Fumika Orii, Tsuneshi Fujii, Masaki Taruishi, Naoyuki Miyokawa
Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology, 102, 10, 1321, 6, 2005年10月, ［国内誌］
日本語, 研究論文（学術雑誌）

低体温における凝固異常—特集 環境障害における凝固異常または炎症凝固
高氏 修平, 早川 峰司, Thrombosis medicine / 「Thrombosis medicine」編集委員会 編, 14, 4, 253, 259, 2024年12月
東京 : 先端医学社, 日本語

ECMOプロジェクトからECMOnetへの流れの中で:次の世代へ伝えたいこと
高氏修平, 日本呼吸療法医学会学術集会プログラム・抄録集, 44th (Web), 2022年

【集中治療医学レビュー 最新主要文献と解説 2020-'21】I章 集中治療管理 消化管管理　　　　　　　　　　　　　　　
高氏 修平, 集中治療医学レビュー, 2020-'21, 37, 43, 2020年03月
(株)総合医学社, 日本語

VV-ECMOを駆使して Sepsisを対象としたV-V ECMOの適応について　　　　　　　　　　　　　　　
高氏 修平, 早川 峰司, 日本救急医学会雑誌, 30, 9, 557, 557, 2019年09月
(一社)日本救急医学会, 日本語

学会主導研究費獲得への道　　　　　　　　　　　　　　　
高氏 修平, 早川 峰司, 藤田 智, 日本救急医学会雑誌, 30, 9, 590, 590, 2019年09月
(一社)日本救急医学会, 日本語

不断前進、敗血症診療 Sepsis-3時代を迎えての敗血症診療　　　　　　　　　　　　　　　
高氏 修平, 早川 峰司, 藤田 智, 日本救急医学会雑誌, 30, 9, 597, 597, 2019年09月
(一社)日本救急医学会, 日本語

低体温症にECMOすべきであることをエビデンスで示す　　　　　　　　　　　　　　　
高氏 修平, 日本救急医学会雑誌, 30, 9, 614, 614, 2019年09月
(一社)日本救急医学会, 日本語

体温異常の現状と対策 偶発性低体温症に対するV-A ECMO導入と予後について　　　　　　　　　　　　　　　
高氏 修平, 佐藤 朝之, 藤田 智, 小北 直宏, 岡田 基, 小林 厚志, 川田 大輔, 丹保 亜希仁, 日本救急医学会雑誌, 29, 10, 386, 386, 2018年10月
(一社)日本救急医学会, 日本語

敗血症診療は新しい定義(Sepsis-3)でどう変わったか? Sepsis-3はDIC治療が有効な患者を導き出す JSEPTIC DIC studyから見たSepsis-3の検証　　　　　　　　　　　　　　　
高氏 修平, 早川 峰司, 藤田 智, 日本集中治療医学会雑誌, 25, Suppl., [SY8, 2], 2018年02月
(一社)日本集中治療医学会, 日本語

集中治療管理 消化管管理　　　　　　　　　　　　　　　
高氏 修平, 集中治療医学レビュー, 2018-'19, 38, 43, 2018年02月
(株)総合医学社, 日本語

成人重症敗血症・敗血症ショックに対するV-A ECMOについての後ろ向き研究　　　　　　　　　　　　　　　
高氏 修平, 早川 峰司, 大野 浩太, 藤田 智, 日本救急医学会雑誌, 28, 12, 904, 909, 2017年12月
(一社)日本救急医学会, 日本語

消化器内科医から救急医へのキャリアチェンジ。そして消化器へのフィードバック　　　　　　　　　　　　　　　
高氏 修平, 丹保 亜希仁, 川田 大輔, 小林 厚志, 岡田 基, 小北 直宏, 藤田 智, 日本救急医学会雑誌, 28, 9, 469, 469, 2017年09月
(一社)日本救急医学会, 日本語

VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION FOR SEVERE SEPSIS AND SEPTIC SHOCK IN 3,195 ADULTS
Shuhei Takauji, Mineji Hayakawa, Kota Ono, Satoshi Fujita, CRITICAL CARE MEDICINE, 44, 12, 2016年12月
英語, 研究発表ペーパー・要旨（国際会議）

JSEPTIC DIC study報告 敗血症におけるV-V ECMOの効果　　　　　　　　　　　　　　　
高氏 修平, 早川 峰司, 日本集中治療医学会雑誌, 23, Suppl., 439, 439, 2016年01月
(一社)日本集中治療医学会, 日本語

【ICUのモニターで呼吸・循環を診る!基本的な画面の見かたと病態把握、異常時の対応】肺動脈カテーテルのモニター
高氏 修平, 牧野 隆雄, レジデントノート, 17, 7, 1317, 1325, 2015年08月
(株)羊土社, 日本語

【ECMOを用いた呼吸不全の治療戦略】ECMOを用いた最新の呼吸管理 維持と離脱
高氏 修平, 斉藤 智誉, 牧瀬 博, 人工呼吸, 32, 1, 14, 19, 2015年05月
(一社)日本呼吸療法医学会, 日本語

RESPscoreを用いたRespiratory ECMO症例の予後予測と適応選択についての検討　　　　　　　　　　　　　　　
高氏 修平, 斉藤 智誉, 平安山 直美, 遠藤 晃生, 松井 俊尚, 提嶋 久子, 佐藤 朝之, 鹿野 恒, 牧瀬 博, 日本集中治療医学会雑誌, 22, Suppl., [DP5, 3], 2015年01月
(一社)日本集中治療医学会, 日本語

【症例とQ&Aで学ぶ最新のECMO】心停止後のECMOと低体温　　　　　　　　　　　　　　　
高氏 修平, 鹿野 恒, 救急・集中治療, 26, 11-12, 1573, 1578, 2014年12月
(株)総合医学社, 日本語

Long-term ECMO症例とShort-term ECMO症例の比較検討
高氏 修平, 斉藤 智誉, 佐藤 朝之, 岡田 昌生, 鹿野 恒, 牧瀬 博, 前中 則武, 高平 篤法, 人工呼吸, 31, 1, 45, 49, 2014年05月
(一社)日本呼吸療法医学会, 日本語

サルモネラ腸炎から敗血症、横紋筋融解症、急性腎不全、麻痺性イレウスを発症した1例　　　　　　　　　　　　　　　
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雑誌, 21, Suppl., [DP, 4], 2014年01月
(一社)日本集中治療医学会, 日本語

【希釈もバッチリ!救急・ICUの薬を使いこなす カテコラミン、抗凝固薬、t-PA、鎮静薬などの基本知識と超具体的な投与法】ICUでの頻脈性不整脈への薬剤
高氏 修平, 牧野 隆雄, レジデントノート, 15, 12, 2254, 2260, 2013年11月
(株)羊土社, 日本語

肝硬変患者に発症した重症皮膚軟部組織感染症の3例　　　　　　　　　　　　　　　
高氏 修平, 山崎 圭, 坂東 敬介, 松井 俊尚, 提嶋 久子, 佐藤 朝之, 岡田 昌生, 鹿野 恒, 斉藤 智誉, 牧瀬 博, 日本救急医学会雑誌, 24, 8, 646, 646, 2013年08月
(一社)日本救急医学会, 日本語

長期間ECMO管理を必要としたH1N1インフルエンザ急性呼吸促迫症候群(ARDS)の3例
高氏 修平, 佐藤 朝之, 山崎 圭, 斉藤 智誉, 岡田 昌生, 鹿野 恒, 牧瀬 博, 深澤 雄一郎, 人工呼吸, 30, 1, 42, 48, 2013年05月
(一社)日本呼吸療法医学会, 日本語

【救急薬剤プラクティカルガイド】疾患別救急薬剤ベストプラクティス 消化器疾患 胃食道逆流症(GERD)
高氏 修平, 斉藤 智誉, 救急医学, 35, 10, 1325, 1329, 2011年09月
(株)へるす出版, 日本語

H1N1インフルエンザによる重症呼吸不全に対して45日間の長期ECMO管理を行い救命し得た1例　　　　　　　　　　　　　　　
高氏 修平, 山崎 圭, 斉藤 智誉, 松井 俊尚, 岡田 昌生, 坂東 敬介, 遠藤 晃生, 秋田 真秀, 佐藤 朝之, 鹿野 恒, 牧瀬 博, 日本救急医学会雑誌, 22, 8, 634, 634, 2011年08月
(一社)日本救急医学会, 日本語

PMX-DHPが有効であった急性間質性肺炎の1例　　　　　　　　　　　　　　　
高氏 修平, 山崎 圭, 秋田 真秀, 遠藤 晃生, 松井 俊尚, 奥田 耕司, 佐藤 朝之, 岡田 昌生, 斉藤 智誉, 鹿野 恒, 牧瀬 博, 高平 篤法, 日本急性血液浄化学会雑誌, 1, 2, 289, 289, 2010年10月
(NPO)日本急性血液浄化学会, 日本語

III度熱中症による肝不全に対し人工肝補助療法を行い救命し得た1例
高氏 修平, 山崎 圭, 長間 将樹, 坂東 敬介, 秋田 真秀, 遠藤 晃生, 松井 俊尚, 奥田 耕司, 佐藤 朝之, 岡田 昌生, 斉藤 智誉, 鹿野 恒, 牧瀬 博, 奥田 正穂, 高平 篤法, 日本急性血液浄化学会雑誌, 1, 1, 176, 179, 2010年05月
35歳男性。患者は10kmマラソン大会のゴール直後に倒れこみ、意識障害および痙攣のため前医へ救急搬送となった。III度の熱中症と診断され、ジアゼパム静注、体表冷却、輸液にて意識レベルは改善したが、入院3日目に肝不全へ進行したため、著者らのセンターへ転院となった。入院時、血液検査所見より熱中症に伴う肝不全と診断され、血漿交換およびHigh flow CHDFによる人工肝補助療法を開始したところ、肝機能および凝固系機能は改善し、入院17日目に他院へ転院となった。, (NPO)日本急性血液浄化学会, 日本語

ECMO導入により危機的状況を回避したMRSA壊死性気管支炎の1例　　　　　　　　　　　　　　　
高氏 修平, 山崎 圭, 秋田 真秀, 遠藤 晃生, 松井 俊尚, 佐藤 朝之, 岡田 昌生, 斉藤 智誉, 鹿野 恒, 牧瀬 博, 日本救急医学会雑誌, 20, 8, 690, 690, 2009年08月
(一社)日本救急医学会, 日本語

戸谷Ib型先天性総胆管拡張症の1例
高氏 修平, 小原 充裕, 小泉 一也, 竹内 茂, 谷口 雅人, 佐藤 龍, 数馬 尚之, 長谷川 公治, 富田 一郎, 浅川 全一, 日本消化器病学会雑誌, 105, 3, 391, 396, 2008年03月
(一財)日本消化器病学会, 日本語

注目の画像 隆起型直腸粘膜脱症候群(mucosal prolapse syndrome,polypoid type)
高氏 修平, 谷口 雅人, 横田 欽一, Gastroenterological Endoscopy, 49, 2, 218, 219, 2007年02月
(一社)日本消化器内視鏡学会, 日本語

悪性黒色腫術後15年目に診断された嚢胞様肝転移の1例
高氏 修平, 松本 昭範, 柴田 直美, 吉田 暁正, 折居 史佳, 藤井 常志, 垂石 正樹, 三代川 斉之, 日本消化器病学会雑誌, 102, 10, 1321, 1326, 2005年10月
(一財)日本消化器病学会, 日本語

von Recklinghausen病に合併した十二指腸平滑筋肉腫の1例　　　　　　　　　　　　　　　
高氏 修平, 藤城 貴教, 幸田 久平, 久我 貴, 小池 和彦, 吉田 なつ, 菊地 智樹, 中澤 修, 中村 豊, 安藤 政克, 旭川赤十字病院医学雑誌, 16-17, 99, 103, 2004年04月
54歳女.von Recklinghausen病により自院の皮膚科に通院していたが,全身倦怠感,嘔気,タール便を契機に高度の貧血を認め,緊急入院となった.入院時の精査にて,十二指腸に腫瘍を認め,内視鏡による生検にて平滑筋肉腫と診断し,膵頭十二指腸切除術を施行した.切除標本にて病理組織学的に診断を確定した, 旭川赤十字病院編集委員会, 日本語

von Recklinghausen病に合併した十二指腸腫瘍の2例　　　　　　　　　　　　　　　
高氏 修平, 藤城 貴教, 菊地 智樹, 吉田 なつ, 久我 貴, 小池 和彦, 幸田 久平, 中澤 修, 安藤 政克, 日本内科学会雑誌, 92, Suppl., 108, 108, 2003年02月
(一社)日本内科学会, 日本語